Patient and carer perceptions of video, telephone and in-person clinics for Phenylketonuria (PKU).

BACKGROUND: In phenylketonuria (PKU), attending multidisciplinary clinic reviews is an important aspect of life-long care. Since the COVID-19 pandemic, video and telephone clinics are used as alternative methods for people with PKU to have contact with their care team. There is limited research concerning patient preference, experience and perceptions of alternative types of clinic review. Individuals from the UK with PKU and their caregivers were invited to complete an online questionnaire, hosted on the National Society for PKU (NSPKU) website and social media platform. RESULTS: Data was available from 203 respondents. Forty one per cent of respondents (n = 49/119) preferred in-person clinics; 41% (n = 49) a hybrid of in-person, video and telephone clinics; 9% (n = 11) video clinics only, 6% (n = 7) telephone only and 3% (n = 3) were unsure. The main respondent obstacles to in-person clinics were costs, travel and time, but this was balanced by the benefits of a physical examination and better patient engagement/motivation. Twenty one per cent (n = 36/169) of respondents were uncomfortable with the number of healthcare professionals (HCPs) in a clinic room. Patients were less likely to consult with a doctor on video (64%, n = 91/143) or phone (50%, n = 59/119) reviews compared to in-person (80%, n = 146/183). Issues with video and telephone reviews included the shorter time length of review, distractions, technical issues and poor patient engagement. CONCLUSIONS: Online video and telephone clinic platforms were effective in overcoming the challenging circumstances in management, monitoring and treatment of patients with PKU during the COVID-19 pandemic. However, in-person clinics remain the preferred respondent option. It is important that HCPs are flexible, enabling people with PKU a choice of clinic options according to their individual clinical need and circumstances.

Enhancing left ventricular segmentation in echocardiography with a modified mixed attention mechanism in SegFormer architecture.

Echocardiography is a key tool for the diagnosis of cardiac diseases, and accurate left ventricular (LV) segmentation in echocardiographic videos is crucial for the assessment of cardiac function. However, since semantic segmentation of video needs to take into account the temporal correlation between frames, this makes the task very challenging. This article introduces an innovative method that incorporates a modified mixed attention mechanism into the SegFormer architecture, enabling it to effectively grasp the temporal correlation present in video data. The proposed method processes each time series by encoding the image input into the encoder to obtain the current time feature map. This map, along with the historical time feature map, is then fed into a time-sensitive mixed attention mechanism type of convolution block attention module (TCBAM). Its output can serve as the historical time feature map for the subsequent sequence, and a combination of the current time feature map and historical time feature map for the current sequence. The processed feature map is then input into the Multilayer Perceptron (MLP) and subsequent networks to generate the final segmented image. Through extensive experiments conducted on two different datasets: Hamad Medical Corporation, Tampere University, and Qatar University (HMC-QU), Cardiac Acquisitions for Multi-structure Ultrasound Segmentation (CAMUS) and Sunnybrook Cardiac Data (SCD), achieving a Dice coefficient of 97.92 % on the SCD dataset and an F1 score of 0.9263 on the CAMUS dataset, outperforming all other models. This research provides a promising solution to the temporal modeling challenge in video semantic segmentation tasks using transformer-based models and points out a promising direction for future research in this field.

A comprehensive study on factors influencing online impulse buying behavior: Evidence from Shopee video platform.

The rapid expansion of online commerce has significantly altered consumer behavior, particularly among digitally-savvy Generation Z individuals. This research analyzes the influence of product presentation videos on online impulsive buying behaviors in this demographic, using the Shopee video platform as a case study. The study aims to investigate how various external factors, including time pressure (TP), quantity pressure (QP), economic benefits (EB), social influence (SI), visual (VS), and sound (SO), affect online impulse buying by mediating emotions of arousal (AR) and pleasure (PL). This study employed a quantitative approach, and data was collected through a Likert scale questionnaire using a non-probability sampling technique. PLS-SEM statistical analysis was utilized to assess the research model, exploring the interplay of these stimuli in shaping impulsive buying behavior on the Shopee platform, among 438 Vietnamese Generation Z. The study's results indicate significant impacts of all factors on arousal, while time pressure, quantity pressure, and economic benefits did not significantly influence pleasure. Notably, arousal and pleasure emerged as mediators shaping impulsive buying decisions among Generation Z. These findings indicate that strategic use of external factors can effectively trigger emotions, leading to impulsive buying among digital natives. This also offers valuable insights for marketers looking to enhance e-commerce strategies on platforms such as Shopee video. Marketers can trigger customers' impulsive buying by creating a sense of urgency (e.g. flash sales, limited quantities), useful online reviewing, and personalizing discounts. Additionally, using visual and sound strategies in a positive online experience can further enhance this behavior and shape preferences. This study's findings contribute to a deeper understanding of consumer behavior theories in the digital era, highlighting the intricate roles of arousal and pleasure in online impulse buying.

Qualitative research on undergraduate nursing students' recognition and response to short videos' health disinformation.

Background: With the popularity of the internet, short videos have become an indispensable tool to obtain health information. However, avoiding health disinformation owing to the openness of the Internet is difficult for users. Disinformation may endanger the health and lives of users. Objective: With a focus on the process of identifying short videos' health disinformation and the factors affecting the accuracy of identification, this study aimed to investigate the identification methods, coping strategies, and the impact of short videos' health disinformation on undergraduate nursing students. The findings will provide guidance to users on obtaining high-quality and healthy information, in addition to reducing health risks. Methods: Semi-structured in-depth interviews were conducted with 22 undergraduate nursing students in October 2022, and data were collected for collation and content analyses. Results: The techniques used to identify short videos that include health disinformation as well as how undergraduate nursing students perceived these videos' features are among the study's findings. The failure factors in identification, coping paths, and adverse impacts of short videos on health disinformation were analyzed. The platform, the material itself, and the students' individual characteristics all have an impact on their identifying behavior. Conclusions: Medical students continue to face many obstacles in identifying and responding to health disinformation through short videos. Preventing and stopping health disinformation not only requires individual efforts to improve health literacy and maintain rational thinking, it also requires the joint efforts of short video producers, relevant departments, and platforms.

Severity of inattention symptoms, experiences of being bullied, and school anxiety as mediators in the association between excessive short-form video viewing and school refusal behaviors in adolescents.

Background: Recent years have seen an increase in school refusal behavior among adolescents, potentially due to factors like excessive short-form video viewing, bullying, and school anxiety. Limited research has investigated how these factors contribute to school refusal behavior. This study used random forest regression, path analysis, and network analysis to identify key variables and pathways leading to school refusal behavior. Methods: In this cross-sectional questionnaire-based study, 2,056 (996 male, 1,060 female, mean age: 14.79 ± 1.24 years) middle and senior high school students were asked to complete the School Refusal Behavior Assessment questionnaire to assess school refusal behavior features, the Excessive Short-Form Video Viewing Scale as well as self-reported viewing times during leisure days to assess excessive short-form video viewing, the SNAP-IV Rating Scale to assess the severity of inattention symptoms, and the self-administered questionnaires to assess experiences of being bullied and school anxiety. Results: The prevalence of school refusal behavior in the surveyed adolescents was found to be 31.9% [95% confidence interval (CI): 29.8-33.9%]. In terms of significance, the severity of inattention symptoms exhibited the greatest predictive power, while excessive short-form video viewing accounted for the most variance. Path analysis revealed that excessive short-form video viewing not only directly affects school refusal behavior features but also does so indirectly through severity of inattention symptoms and school anxiety. Key bridge factors in this pathway include intense fear and anxiety associated with school attendance, manifesting as somatic symptoms and avoidance behaviors. Conclusion: The findings indicate that not only does excessive short-form video viewing directly influence school refusal behavior features in adolescents, but it also indirectly impacts these features through mechanisms involving severity of inattention symptoms and school anxiety. The bridge factors highlight potential targets for interventions among the SRB features and predictors.

Live Streaming of the Professor's Ward Rounds in Undergraduate Neurology Education: Usability Study.

BACKGROUND: Although neurology department ward rounds are among the most important medical education exercises in Japan, they have several issues. Patients may find it unpleasant to undergo repeated neurological tests, especially when in the presence of several students. Only the front row of students can closely observe the examination findings; moreover, students were prohibited from contacting patients altogether during the COVID-19 pandemic. One possible solution is to use commercial videoconferencing systems. However, Japanese patients are reluctant to have their medical information or video footage of them sent outside of the hospital via the internet. OBJECTIVE: The study aimed to confirm the feasibility of conducting remote teaching rounds using an in-house web conferencing system in which the patients' personal data are securely protected. This study also explored whether using remote rounds alongside face-to-face participation would enhance learning. METHODS: We created an on-premises videoconferencing system using an open-source app. To perform video ward rounds, the professor wore a wireless microphone while leading routine in-person rounds and the attending physician carried a tablet device linked to a web conference, allowing students in another room to watch the rounds on a live stream. In total, 112 of 5th-year students who entered their 1-week neurology rotation between 2021 and 2022 were instructed to participate in 1-hour in-person and remote rounds. Students were given questionnaires to evaluate their satisfaction and the educational effects of the remote rounds. RESULTS: The remote ward rounds were conducted easily with no interference with the in-person rounds, nor any complaints from the patients. Each examination technique was explained by another teacher to the students who participated in remote rounds in the conference room. Characteristic neurological findings, such as plantar reflexes (Babinski sign), which are usually seen only by close observers during in-person rounds, could be visualized under magnification by all students. The postexperience survey (82/112, 73% response rate) showed that the mean score of participants' satisfaction was 3.94 (SD 0.83; excellent 5 and poor 1). No participant scoring 1 was noted. The proportion of students who observed 6 representative abnormal neurological findings (Babinski sign, hyperreflexia, cerebellar ataxia, involuntary movement, muscular weakness, and abnormality in sensory examination) increased by 22% (18/82, range 13-24) compared to in-person rounds alone. When self-rating the learning value, 43% (35/82) of the students answered that remote rounds are equally as valuable as in-person rounds, while 32% (26/82) preferred remote rounds. CONCLUSIONS: Live-streaming of neurology ward rounds using a secure in-house web conferencing system provides additional learning experience without concerns regarding leakage of patient information. This initiative could enhance neurology learning before entering a clinical clerkship.

Comparison of AirAngel® vs. Storz® videolaryngoscope and Macintosh® laryngoscope for endotracheal intubation training: prospective randomized crossover study.

BACKGROUND: For both normal and difficult airway management, VL is thought to be more effective. However, VL seems far from being offered as a standard option in both healthcare delivery and educational activities in low-income countries, considering its high costs. Therefore, three-dimensional(3D)printed VLs may be considered an alternative to conventional VLs in low-income countries and other places with limited resources. Our objective was to compare the efficacy of AirAngel 3D-printed VL (3D-PVL) with those of commercially available Storz® VL (SVL) and conventional Macintosh® laryngoscope (MCL) in normal and difficult airway scenarios in the hands of inexperienced users. METHODS: This is a prospective randomized crossover manikin study that included 126 senior medical students with no experience in intubation. The effectiveness of all three laryngoscopy devices in the hands of inexperienced users was evaluated in terms of intubation time, glottic visualization, ease of use, endotracheal tube placement, and intubation success rate. Between 2020 and 2022, 126 last year medical students participated in the study. RESULTS: MCL resulted in significantly longer intubation times than 3D-PVL and SVL in the difficult airway scenario, with no significant difference between 3DPVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction MCL: 28.54 s; SVL: 26.68 s; 3DPVL: 26.64 s). Both SVL and 3D-PVL resulted in significantly better Cormack - Lehane grades in both normal and difficult airway scenarios, and thus provided better glottic viewing than MCL, with no significant difference between 3D-PVL and SVL (Wilcoxon test, p < 0.016; Bonferroni correction, MCL: 1.73; SVL: 1.29; 3DPVL: 1.25). The SVL was the easiest device to use for normal airway scenarios (1: very easy, 5: very difficult), while the MCL was the most difficult (MCL: 2.64; 3DPVL: 1.98; SVL: 1.49). Conversely, no significant difference was found between 3DPVL and other devices in terms of ease of use in difficult airway scenarios and in terms of accurate placement of the endotracheal tube and successful intubation attempts. CONCLUSION: 3D-PVL is a good educational and possible clinical alternative to conventional VL, particularly in places with limited resources, due to its low cost.

Effect evaluation of outpatient long-term video EEGs for people with seizure disorders - study protocol of the ALVEEG project: a randomized controlled trial in Germany.

BACKGROUND: Epilepsy and other seizure disorders account for a high disease burden in Germany. As a timely diagnosis and accurate treatment are crucial, improving the management of these disorders is important. Outside of Germany, outpatient long-term video EEGs (ALVEEGs) have demonstrated the potential to support the diagnosis and management of epilepsy and other seizure disorders. This study aims to evaluate the implementation of ALVEEGs as a new diagnostic pathway in eastern parts of Germany to diagnose epilepsy and other seizure disorders and to assess if ALVEEGs are equally effective as the current inpatient-monitoring gold standard, which is currently only available at a limited number of specialized centers in Germany. METHODS: ALVEEG is a prospective, multicenter, randomized controlled equivalence trial, involving five epilepsy centers in the eastern states of Germany. Patients will be randomized into either intervention (IG) or control group (CG), using a permuted block randomization. The sample size targeted is 688 patients, continuously recruited over the trial. The IG will complete an ALVEEG in a home setting, including getting access to a smartphone app to document seizure activity. The CG will receive care as usual, i.e., inpatient long-term video-EEG monitoring. The primary outcome is the proportion of clinical questions being solved in the IG compared to the CG. Secondary outcomes include hospital stays, time until video EEG, time until diagnosis and result discussion, patients' health status, quality of life and health competence, and number and form of epilepsy-related events and epileptiform activity. Alongside the trial, a process implementation and health economic evaluation will be conducted. DISCUSSION: The extensive evaluation of this study, including an implementation and health economic evaluation, will provide valuable information for health policy decision-makers to optimize future delivery of neurological care to patients affected by epilepsy and other seizure disorders and on the uptake of ALVEEG into standard care in Germany. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00032220), date registered: December 11, 2023.

ESFPNet: Efficient Stage-Wise Feature Pyramid on Mix Transformer for Deep Learning-Based Cancer Analysis in Endoscopic Video.

For patients at risk of developing either lung cancer or colorectal cancer, the identification of suspect lesions in endoscopic video is an important procedure. The physician performs an endoscopic exam by navigating an endoscope through the organ of interest, be it the lungs or intestinal tract, and performs a visual inspection of the endoscopic video stream to identify lesions. Unfortunately, this entails a tedious, error-prone search over a lengthy video sequence. We propose a deep learning architecture that enables the real-time detection and segmentation of lesion regions from endoscopic video, with our experiments focused on autofluorescence bronchoscopy (AFB) for the lungs and colonoscopy for the intestinal tract. Our architecture, dubbed ESFPNet, draws on a pretrained Mix Transformer (MiT) encoder and a decoder structure that incorporates a new Efficient Stage-Wise Feature Pyramid (ESFP) to promote accurate lesion segmentation. In comparison to existing deep learning models, the ESFPNet model gave superior lesion segmentation performance for an AFB dataset. It also produced superior segmentation results for three widely used public colonoscopy databases and nearly the best results for two other public colonoscopy databases. In addition, the lightweight ESFPNet architecture requires fewer model parameters and less computation than other competing models, enabling the real-time analysis of input video frames. Overall, these studies point to the combined superior analysis performance and architectural efficiency of the ESFPNet for endoscopic video analysis. Lastly, additional experiments with the public colonoscopy databases demonstrate the learning ability and generalizability of ESFPNet, implying that the model could be effective for region segmentation in other domains.

Flipping Veterinary Biochemistry, Anatomy, and Physiology: Students' Engagement and Perception.

Flipped classroom (FC) is a teaching method where traditional learning roles are inverted. Students are provided with material in advance and are expected to study the content prior to in-class sessions. These sessions are subsequently utilized to clarify doubts and examine in greater depth the previously acquired knowledge. Despite the widespread nature of its approach in health education, its application in basic veterinary subjects remains poorly described. This study explores the implementation of the FC approach in veterinary physiology, biochemistry, anatomy, and embryology. Pre-class material was mainly provided in video format, and class sessions facilitated quizzes and interactive activities aimed to reinforce understanding. The findings indicate a high level of student involvement and effective class preparation, as evidenced by over 84% of students participating in FC in-class sessions and generally achieving satisfactory scores on quizzes. A survey conducted at the end of the first semester shows that a high proportion of students positively valued pre-class material (>90%), quizzes (82%), and the FC approach (66%). However, by the end of the second semester, traditional lectures were preferred by more students than FC (45% and 25%, respectively), while 30% of the students mentioned having no preference between the two methods. Analysis of open-ended responses underscored positive facets of the FC approach, including self-organization, enhanced understanding, and availability of pre-class material. However, it also emphasized challenges associated with FC, such as the significant time and effort required. In conclusion, this study suggests that the FC approach can be well received in integrated basic veterinary subjects if it does not imply an excessive student workload, underscoring the potential benefits of a blended teaching approach that combines elements of both traditional and FC methods.

Age dependent vestibulo-ocular reflex gain in video head impulse test among normal Indians.

Determination of the normative data of Vestibulo-Ocular Reflex gain using VHIT of all three semicircular canals (anterior, posterior, horizontal) on both sides in different age groups is of interest. This is an observational study comprised of 10 healthy individuals in each decade from less than 10 years to 80 years of both sexes making a total of 80. The study was done using the equipment SYNAPSYS VHIT ULMER with Software EVOLUTION 3.0. Mean VOR gain of each decade for all the semicircular canals is calculated and they are compared using ANOVA (Analysis of variance). In our study, percentage of patients with overt saccades is nil. Hence, in our study, the occurrence of covert saccades was insignificant as compared to the above studies. Age dependent VOR gain in normal individuals did not have any significance in our study of 80 patients performed by video head impulse test. VOR gain in our study is not affected by age. Normative data for different age groups obtained compared among different age groups showing no significant difference in Mean VOR gain. The normative values of VOR gain can be compared to patients with dizziness thus helping in determining any vestibular loss.

When the Crown has Thorns - Epileptic Spike-Wave Discharges over the Vertex.

Epileptiform abnormalities that arise over the midline can sometimes be confused with normal sleep transients, such as vertex sharp waves, because of their location and their activation during sleep. However, epileptiform transients can be distinguished from sleep architecture by their waveform and their occurrence during wakefulness. Here, we report a 24-year-old man with drug-resistant epilepsy whose seizures began with tonic posturing of the left leg before progressing to bilateral tonic-clonic activity. During presurgical scalp video-EEG monitoring, his interictal background showed focal spike-wave discharges maximal over the vertex (phase reversal at Cz), with a more-well-defined field over the right parasagittal region (C4/F4), that were present during both sleep and awake states. The discharges met the IFCN criteria for focal interictal epileptiform discharges (spiky morphology, duration shorter than background activity, asymmetric waveform, after-going slow wave, and physiologic distribution) and appeared to be distinct from the patient's vertex sharp waves. Prior to electroclinical seizures, these discharges would increase in prevalence and appear as repetitive spike-wave discharges. When distinguishing epileptiform from nonepileptiform transients, it is critical to consider both their morphology, especially the degree of background disruption and presence of an after-going slow wave, and their variability with state changes.

Using Video-Reflexive Methods to Develop a Provider Down Protocol for the New South Wales Biocontainment Center.

The New South Wales Biocontainment Centre is a statewide referral facility for patients with high-consequence infectious disease (HCID). The facility collaborates with researchers to adapt existing HCID procedures such as donning and doffing of personal protective equipment (PPE). However, information on how to respond safely to collapse of a healthcare provider in full PPE within a contaminated zone is scarce. To address this gap, we adapted Nebraska Medicine's "provider down" protocol on paper and then simulated and video recorded the process, iteratively, in the facility. Clinicians analyzed the recordings collaboratively in researcher-facilitated reflexive discussions. Our primary aim was to ascertain how to maintain optimal infection prevention and control while providing urgent care for the healthcare provider. We tested participants' suggested modifications, in repeated video recorded simulations, until consensus on optimal practice was achieved. Our secondary aim was to assess the utility of video-reflexive methods to enhance clinicians' awareness and understanding of infection prevention and control in a rare and complex scenario. Six adaptations and simulations were discussed in video-reflexive sessions before consensus was reached; the final version of the protocol differed considerably from the first. Viewing footage of simulations in situ enabled participants to (1) identify infection and occupational risks not identified on paper or during verbal postsimulation debriefs and (2) test alternative perspectives on safe procedure. Video-reflexivity enables context-sensitive and consensus-building codesign of policies and procedures, critical to protocol development in a new unit. It contributes to a culture of teamwork, preparedness, and confidence before, rather than in the heat of, a crisis.

Systematic assessment of square-wave jerks in progressive supranuclear palsy: a video-oculographic study.

BACKGROUND: The presence of frequent macro-square-wave jerks (SWJs) has been recently included in the diagnostic criteria for progressive supranuclear palsy (PSP). The aim of the current video-oculographic study was to systematically assess the presence and features of SWJs during a brief fixation task in PSP, in comparison with Parkinson's disease (PD) patients and healthy controls (HC). METHODS: Thirty-eight PSP patients, 55 PD patients and 40 HC were enrolled in the study. All patients underwent a video-oculographic (VOG) examination including a 5-s fixation task, and the number, duration and amplitude of SWJs were recorded. The diagnostic performance of several SWJs parameters were then compared in distinguishing PSP from PD patients and controls. RESULTS: PSP patients showed a higher number and amplitude of SWJs compared to PD patients and controls. At least two SWJs within the 5-s fixation task were observed in 81.6% of PSP patients, 52.7% of PD patients and 25% of HC. The SWJs amplitude was the parameter showing the highest performances in distinguishing PSP from PD (AUC: 0.78) and HC (AUC: 0.88), outperforming the SWJ number and duration. The SWJ amplitude was larger in PSP-Richardson's syndrome than in PSP-Parkinsonism patients, while no difference was found between PSP patients with different degrees of vertical ocular motor dysfunction. CONCLUSIONS: This video-oculographic study provides robust evidence of larger SWJs number and amplitude in PSP than in PD patients, with some potential for differential diagnosis, supporting the inclusion of this ocular sign in PSP criteria.

Small Intestinal Complications of Intestinal Transplant-Associated Microangiopathy Post-stem Cell Transplantation.

We present the case of a patient who underwent human leukocyte antigen-haploidentical transplantation for T-cell acute lymphoblastic leukemia. Seven weeks after transplantation, the patient developed intestinal transplant-associated microangiopathy (iTAM). Although the iTAM was resolved temporarily, it recurred. Video capsule enteroscopy revealed multiple erosions and shallow ulcers in the jejunum and ileum. To the best of our knowledge, this is the first report to present images of possible small intestinal lesions in iTAM. The small intestinal mucosal images presented herein may potentially aid in the management of similar patients.

TikTok as a platform for hysteroscopy information: An analytical video-based cross-sectional study to assess quality, reliability, and accuracy.

OBJECTIVE: To assess the quality, reliability, and level of misinformation in TikTok videos about hysteroscopy. METHODS: A cross-sectional analysis of TikTok videos retrieved using "hysteroscopy" as search term was performed. Patient education materials assessment tool for audio-visual content (PEMAT A/V), the modified DISCERN (mDISCERN), global quality scale (GQS), video information and quality index (VIQI) and misinformation assessment were used. RESULTS: Of three hundred videos captured, 156 were excluded and 144 were included. Most videos were partially accurate or uninformative (43.8% and 34.7%, respectively). Non-healthcare providers produced more inaccurate or uninformative videos than healthcare workers (51.1% vs 4.0%; P < 0.001). Compared to content by professionals, content by patients showed increased distrust towards gynecologists (11.7% vs 0%; P = 0.012) and increased incidence of anxiety and concern towards hysteroscopy (25.5% vs 2%; P < 0.001). PEMAT A/V scores for understandability and actionability were low at 42.9% (interquartile range [IQR]: 11.1-70) and 0% (IQR: 0-0), respectively. Understandability (P < 0.001) and actionability (P = 0.001) were higher for professionals' created content relative to patients' videos. Similarly, median mDISCERN score was low (1 [IQR 0-2]), with significantly higher score for healthcare professionals compared to patients (P < 0.001). Overall video quality was also low, with median VIQI and GQS score of 7 (IQR 4-11) and 1 (IQR 1-3), respectively, and significantly higher scores for healthcare workers' captions compared to patients' for both (P < 0.001 and P = 0.001, respectively). CONCLUSION: TikTok videos' quality on hysteroscopy seems unsatisfactory and misinformative, with low understandability and actionability scores. Videos recorded by healthcare workers show higher quality and less misinformation than those by patients. Raising the awareness regarding the low quality of medical information on social media is crucial to increase future reliability and trustworthiness.

US cat caregivers' attitudes on veterinary video telemedicine.

OBJECTIVES: Many cats do not see a veterinarian on an annual basis, and their caregivers face many barriers to accessing veterinary care. A potential solution to overcome some of these barriers is video telemedicine. Thus, the aim of this study was to understand companion cat caregivers' perceptions of using veterinary video telemedicine with their cats. METHODS: An online quantitative questionnaire was used to survey US cat caregivers on their experiences of and attitudes to using video telemedicine with their cats. Participants were required to reside in the USA, be the primary caregiver of at least one cat and be aged 18 years or older. RESULTS: The majority (97.3%) of the 1254 respondents indicated they had never used a video telemedicine appointment with their cat(s) before; however, most (85.7%) indicated they were very or somewhat interested in using video telemedicine with their cat. Overall, caregivers perceived video telemedicine visits as less stressful for themselves (P <0.0002) and their cats (P <0.0001), and as increasing their access to veterinary care (P <0.0001) compared with in-clinic visits. Participants also indicated they would prefer a video telemedicine appointment over an in-clinic appointment for most cat behavioral concerns but preferred in-clinic appointments for most health concerns. Most respondents (51.3%) indicated they would be willing to pay a little less for a telemedicine appointment than an in-clinic visit. CONCLUSIONS AND RELEVANCE: Cat caregivers represent an important population that could benefit from the implementation of video telemedicine into veterinary care. Our results suggest many US cat caregivers indicate an interest and willingness to pay for video telemedicine visits to increase their access to veterinary care and reduce stress associated with veterinary visits for both themselves and their cats. Caregivers showed more interest in using video telemedicine for behavioral concerns than health concerns.

Channel attention convolutional aggregation network based on video-level features for EEG emotion recognition.

Electroencephalogram (EEG) emotion recognition plays a vital role in affective computing. A limitation of the EEG emotion recognition task is that the features of multiple domains are rarely included in the analysis simultaneously because of the lack of an effective feature organization form. This paper proposes a video-level feature organization method to effectively organize the temporal, frequency and spatial domain features. In addition, a deep neural network, Channel Attention Convolutional Aggregation Network, is designed to explore deeper emotional information from video-level features. The network uses a channel attention mechanism to adaptively captures critical EEG frequency bands. Then the frame-level representation of each time point is obtained by multi-layer convolution. Finally, the frame-level features are aggregated through NeXtVLAD to learn the time-sequence-related features. The method proposed in this paper achieves the best classification performance in SEED and DEAP datasets. The mean accuracy and standard deviation of the SEED dataset are 95.80% and 2.04%. In the DEAP dataset, the average accuracy with the standard deviation of arousal and valence are 98.97% ± 1.13% and 98.98% ± 0.98%, respectively. The experimental results show that our approach based on video-level features is effective for EEG emotion recognition tasks.

Robotic-assisted versus video-assisted lobectomy for resectable non-small-cell lung cancer: the RVlob randomized controlled trial.

Background: The long-term survival and perioperative outcomes of robotic-assisted lobectomy (RAL) and video-assisted lobectomy (VAL) in resectable non-small-cell lung cancer (NSCLC) were found to be comparable in retrospective studies, but they have not been investigated in a randomized trial setting. We conducted the RVlob trial to investigate if RAL was non-inferior to VAL in patients with resectable NSCLC. Methods: In this single-center, open-label, and parallel-arm randomized controlled trial conducted in Ruijin Hospital (Shanghai, China) between May 2017 and May 2020, we randomly assigned patients with resectable NSCLC in a 1:1 ratio to receive either RAL or VAL. One of the primary endpoints was 3-year overall survival. Secondary endpoints included 3-year disease-free survival. The Kaplan-Meier approach was used to calculate overall survival and disease-free survival at 3 years. This study was registered with ClinicalTrials.gov, NCT03134534. Findings: A total of 320 patients were randomized to receive RAL (n = 157) or VAL (n = 163). The baseline characteristics of patients were well balanced between the two groups. After a median follow-up of 58.0 months, the 3-year overall survival was 94.6% (95% confidence interval [CI], 91.0-98.3) in the RAL group and 91.5% (95% CI, 87.2-96.0) in the VAL group (hazard ratio [HR] for death, 0.65; 95% CI, 0.33-1.28; P = 0.21); noninferiority of RAL was confirmed according to the predefined margin of -5% (absolute difference, 2.96%; a one-sided 90% CI, -1.39% to ∞; P = 0.0029 for noninferiority). The 3-year disease-free survival was 88.7% (95% CI, 83.6-94.1) in the RAL group and 85.4% (95% CI, 80.0-91.2) in the VAL group (HR for disease recurrence or death, 0.87; 95% CI, 0.50-1.52; P = 0.62). Interpretation: This study is the first randomized trial to show that RAL resulted in non-inferior overall survival compared with VAL in patients with resectable NSCLC. Based on our results, RAL is an equally oncologically effective treatment and can be considered as an alternative to VAL for resectable NSCLC. Funding: National Natural Science Foundation of China (82072557), National Key Research and Development Program of China (2021YFC2500900), Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant (20172005, the 2nd round of disbursement), program of Shanghai Academic Research Leader from Science and Technology Commission of Shanghai Municipality (20XD1402300), Novel Interdisciplinary Research Project from Shanghai Municipal Health Commission (2022JC023), and Interdisciplinary Program of Shanghai Jiao Tong University (YG2023ZD04).

Predictive nomograms and an algorithm for managing patients with probable Meniere's disease.

PURPOSE: To explore the efficacy of diagnostic tests in accurately reclassifying patients initially diagnosed with probable Meniere's disease (MD) into either definite or non-MD categories. MATERIALS AND METHODS: A retrospective cohort study was conducted at a neurotology clinic between 1/2016 and 5/2022. Patients underwent a battery of tests, from which sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios, were calculated. Additionally, prediction nomograms were developed. RESULTS: Of the 69 patients, 25 (36.2 %) were initially classified as definite MD, 21 (30.4 %), probable MD, and 23 (33.4 %) non-MD. The mean follow-up was 3.5 years. The sensitivity of electrocochleography (ECochG) was the highest (92 %), with a negative likelihood ratio of 15 %. Magnetic resonance imaging (MRI) with MD-protocol had the highest specificity (100 %), with a positive likelihood ratio of 100 %. Videonystagmography, video head impulse test, and cervical vestibular-evoked myogenic potentials, had lower sensitivity and specificity. We were able to reclassify 18 (86 %) patients with probable MD: 12 (57 %) were diagnosed with definite MD, and 6 (29 %) were diagnosed with non-MD, consistent with their clinical course. CONCLUSIONS: The combination of ECochG and MRI with MD-protocol provides the most reliable approach to reclassify patients with Probable MD, ensuring a precise and accurate diagnosis. Vestibular tests express the functional status of the labyrinth and may not be reliable. Our findings provide valuable insights into clinical decision-making for patients with Probable MD and raise the consideration of additional diagnostic tests as supplementary to the existing clinical-only diagnosis criteria.