The effect of an artificial intelligence algorithm on chest X-ray interpretation of radiology residents.

OBJECTIVE: Chest X-rays are the most commonly performed diagnostic examinations. An artificial intelligence (AI) system that evaluates the images fast and accurately help reducing workflow and management of the patients. An automated assistant may reduce the time of interpretation in daily practice. We aim to investigate whether radiology residents consider the recommendations of an AI system for their final decisions, and to assess the diagnostic performances of the residents and the AI system. METHODS: Posteroanterior (PA) chest X-rays with confirmed diagnosis were evaluated by 10 radiology residents. After interpretation, the residents checked the evaluations of the AI Algorithm and made their final decisions. Diagnostic performances of the residents without AI and after checking the AI results were compared. RESULTS: Residents' diagnostic performance for all radiological findings had a mean sensitivity of 37.9% (vs 39.8% with AI support), a mean specificity of 93.9% (vs 93.9% with AI support). The residents obtained a mean AUC of 0.660 vs 0.669 with AI support. The AI algorithm diagnostic accuracy, measured by the overall mean AUC, was 0.789. No significant difference was detected between decisions taken with and without the support of AI. CONCLUSION: Although, the AI algorithm diagnostic accuracy were higher than the residents, the radiology residents did not change their final decisions after reviewing AI recommendations. In order to benefit from these tools, the recommendations of the AI system must be more precise to the user. ADVANCES IN KNOWLEDGE: This research provides information about the willingness or resistance of radiologists to work with AI technologies via diagnostic performance tests. It also shows the diagnostic performance of an existing AI algorithm, determined by real-life data.

Impact of the coronavirus disease 2019 pandemic on obesity, internet addiction, and sleep quality in adolescents.

PURPOSE: This descriptive cross-sectional study aimed to examine the effects of the coronavirus disease-19 (COVID-19) pandemic on obesity, Internet addiction, and sleep quality in adolescents. METHODS: In this study, data were collected from 395 healthy adolescents using a sociodemographic form, an Internet addiction scale, and a sleep quality scale. Descriptive statistics were analyzed as numbers, percentages, and mean values. The Wilcoxon test was performed to compare the mean body mass index (BMI), Internet addiction, and sleep quality scores of the participants before and after the COVID-19 pandemic. The differences were significant at a p value of <0.05. RESULTS: The mean age of the participants was 15.04 ± 1.81 years, and 53% of them were female. The difference between the mean BMI scores of adolescents before and after the COVID-19 pandemic was significant (p < 0.01). The difference between the mean Internet addiction scale scores of the participants before and after the COVID-19 pandemic was significant (p < 0.01). The difference between the mean sleep quality scale scores before and after the COVID-19 pandemic was also significant (p < 0.01). Approximately 27.1% and 34.9% of the participants were obese before and after COVID-19, respectively. CONCLUSION: The obesity rate, BMI, and Internet addiction levels of children increased, whereas their sleep quality decreased after the COVID-19 pandemic. PRACTICAL IMPLICATIONS: During the pandemic period, online trainings for parents should be organized on planning physical activities during closure periods, regulating the adolescents' sleep and eating habits.

Educational Features of YouTube Videos Depicting Breastfeeding: Quality, Utility, and Reliability Analysis.

Objective: In this study, we aimed to evaluate the quality, reliability, and utility of breastfeeding videos on YouTube. Materials and Methods: We conducted a YouTube search with the keyword "breastfeeding education" and limited our search results to the first 200 videos. After exclusion criteria, 165 videos were investigated. The viewer parameters including likes, dislikes, the total number of views, comments, and source of the videos were evaluated. The educational content of the videos was evaluated with the Global Quality Score. In addition, the popularity of the videos was assessed with the video power index (VPI). Upload sources were categorized as the academic institutions and individual users. Results: There were 134 (81.2%) videos in group 1 (poor and suboptimal quality videos) and 31 (18.8%) videos in group 2 (good and excellent quality videos). The mean number of views, likes, and comments were 96.212 ± 198.445, 241.2 ± 310.2, and 45.3 ± 67.9, respectively, in group 1, and 203.057 ± 388.722, 474.1 ± 560.6, and 63.6 ± 98, respectively, in group 2. Comparing both groups, the length of good-excellent videos was longer than poor-suboptimal videos. There were no differences between groups based on number of comments and number of dislikes. In addition, VPI values in group 2 were statistically higher than those in group 1 (p < 0.001). Conclusions: Only ∼18.8% of YouTube videos presenting breastfeeding education were good or excellent. YouTube videos depicting breastfeeding were a limited source for the patients.

Evaluation and management of urachal remnants in children.

BACKGROUND: This study aimed to evaluate the diagnosis and treatment of pediatric patients with urachal remnants. METHODS: Medical records of patients diagnosed with urachal remnants between 2015-2019 were evaluated retrospectively. Age, gender, admission complaints, diagnosis, size of cysts, the complications that developed, and treatment modalities were recorded. RESULTS: The study population consisted of 15 cases including seven girls. Most of the cases were asymptomatic. The urachal remnants were detected by ultrasonography. The most common symptom in symptomatic patients was abdominal pain and umbilical discharge. Three patients required surgery and most of them were conservatively followed up. Complication, infection, and bladder rupture were observed in one case. CONCLUSIONS: Follow-up of patients with urachal remnants can be performed conservatively. The type of complaint and the presence of clinical and radiological regression (if any) are important for deciding the treatment during the follow-up. However, conservative follow-up is more prominent today, as shown in this study.

Evaluation of the patients admitted to the pediatric emergency service: Cross-sectional analysis of the pediatric emergency and trauma clinic of a tertiary training hospital in Turkey.

BACKGROUND: This study aims to carry out a cross-sectional analysis of the applications during three months to the Pediatric Emergency Service of Izmir University of Health Sciences, Tepecik Training and Research Hospital and determination of demographical features and distribution of cases in line with provided data and planning the positive changes and innovations in the current service and functioning of the Pediatric Emergency Service. METHODS: The file records of 46038 patients between the ages of 0-18 who applied to the University of Health Science, Tepecik Training and Research Hospital Pediatric Emergency Training Clinic were examined retrospectively in this study. RESULTS: A total of 46038 patients (53.6% male) applied to the emergency service. The average age was 7.07 for both genders. In the application, the average age of the patients with a history of trauma was 9.3, whereas the average age of the patients without a history of trauma is 6.7. While 82.7% of the patients was male with no trauma history, 86.9% was female without a history of trauma. When the application diagnoses were examined, the most common diagnosis was Upper Respiratory Infection (58.5%). More than half of the applications were monitored in the emergency observation unit (62.5%). When the patients were evaluated according to age groups, 49.2% of them were the children aged between 1-6. While 10.5% of the applicants were infants, and 38.7% were game children, it was noteworthy that the number of male patients was higher in the 1-6 age group, with 54.7%. There was no trauma in 49.5% of the cases. 78,3% of the cases were applied directly to the Paediatric Emergency. Secondly, 16.6% were to the Green Area-1 and Green Area-2. 98.2% of the cases were applied to the Emergency Service for ambulatory care. The 48.8% of the applications were made out of working hours. 97.6% of the cases were not hospitalized for the treatment and were addressed to home. The average staying period of the hospitalized cases in the Service was 4.53 days. Among applications, seven cases died. CONCLUSION: Most of the patients admitted to pediatric emergency service for non-urgent reasons which can be managed in primary care services.

Adolescents with unexplained chest pain reported depression and impaired emotional and social functioning.

AIM: Chest pain is common in adolescence, but there are no established criteria for managing this problem, which is rarely associated with cardiac disease. This study addressed the gaps in the literature by evaluating psychosocial factors that could be associated with medically unexplained chest pain. METHODS: We consecutively selected 100 patients (68% girls) aged 13-18 who were diagnosed with unexplained chest pain when they presented to the cardiology outpatient clinics of Tepecik Research Hospital, Izmir, Turkey, between 30 September 2015 and 30 June 2018. The controls were 76 age- and sex-matched adolescents (69% girls) aged 13-18 who were undergoing routine cardiology assessments before joining sports clubs. We assessed their health-related quality of life and any depression and physical symptoms. RESULTS: Regression analysis showed some adolescents were a number of times more likely to report chest pain. These included those who reported boredom (4.1 times), felt stressed or anxious (2.2) and those who experienced sleep disturbance (2.6), co-morbid headaches (2.0), back pain (3.1) and impaired social functioning (1.2). CONCLUSION: The results indicated a significant association between unexplained chest pain and physical symptoms, depression and impaired emotional and social functioning. These factors warrant further evaluation.

Echocardiographic evaluation of cardiac functions in newborns of mildly preeclamptic pregnant women within postnatal 24-48 hours.

The aim of this study is to detect preeclampsia-related cardiac dysfunction within 24-48 hours of delivery in newborns born from preeclamptic mothers. Forty newborns from mildly preeclamptic mothers formed the study group and the control group was formed by 40 healthy newborns. Cardiac function for the groups were evaluated using conventional echocardiography and myocardial performance index (MPI) within the first 24-48 hours of their lifetime and the results of both groups were compared. A significant difference between the groups was observed especially in the PW Doppler MPI measurements (the left ventricle MPI 0.37 ± 0.09 and 0.26 ± 0.11, p < .001; the right ventricle MPI 0.29 ± 0.08 and 0.26 ± 0.07, p < .035) for the control group and the study group. Elongation in the left and right ventricle MPI was detected to be more significant in terms of comparing systolic and diastolic functions to determine preeclampsia-related cardiac injury in newborns from preeclamptic mothers within the first 24-48 hours of their lifetime. Impact statement Today, the methods which may detect cardiac injury earlier than conventional echocardiographic methods are used for evaluating cardiac functions. Among them, myocardial performance index (MPI) measurement with PW Doppler is the most common ones. While studies are available in the literature evaluating foetal cardiac functions with MPI in foetuses of preeclamptic women, studies evaluating cardiac functions with MPI index within the first 24-48 hours in postnatal period are not available. This is the first study to detect cardiac injury by measuring cardiac functions of the newborns of preeclamptic babies using conventional echocardiography (EF, SF, mitral and tricuspid E/A) and myocardial performance index within the first 24-48 hours of life and compare these values with those of a control group composed of healthy newborns with similar demographic characteristics. According to the results of the study, elongation in right and left ventricle MPI was detected to be more significant compared to systolic and diastolic functions for determining preeclampsia-related cardiac injury in newborns of preeclamptic mothers within 24-48 hours of delivery. Ventricle functions of the newborns of preeclamptic mothers should also be evaluated with MPI measurement besides conventional echocardiographic measurements.