Educational quality of Robotic Whipple videos on YouTube.

BACKGROUND: Videos on Robotic pancreaticoduodenectomy (RPD) may be watched by surgeons learning RPD. This study sought to appraise the educational quality of RPD videos on YouTube. METHODS: One-hundred videos showing RPD or 'Robotic Whipple' were assessed using validated scales (LAP-VEGaS & Consensus Statement Score (CSS)). The association between the scores and the video characteristics (e.g. order of appearance, provider type etc) was assessed. The minimum number of videos required to cumulatively cover the entire LAP-VEGaS and CSS was also noted. RESULTS: The videos were of variable quality; median LAP-VEGaS = 0.67 (0.17-0.94), median CSS = 0.45 (0.29-0.53). There was no association between the educational quality of the videos and their order of appearance, view counts, provider type, length or country of origin. Videos lacked information such as patient consent (100%), potential pitfalls (97%) or surgeon credentials (84%). The first 29 videos cumulatively met all the criteria of CSS and LAP-VEGaS scores except for reporting consent. CONCLUSION: YouTube videos on RPD are of variable quality, without any recognised predictors of quality, and miss important safety information. An impractical number of videos need to be watched to cumulatively fulfil educational criteria. There is a need for high-quality, peer-reviewed videos that adhere to educational principles.

Raman spectroscopy system for real-time diagnosis of clinically significant prostate cancer tissue.

Prostate cancer (PCa) is a significant healthcare problem worldwide. Current diagnosis and treatment methods are limited by a lack of precise in vivo tissue analysis methods. Real-time cancer identification and grading could dramatically improve current protocols. Here, we report the testing of a thin optical probe using Raman spectroscopy (RS) and classification methods to detect and grade PCa accurately in real-time. We present the first clinical trial on fresh ex vivo biopsy cores from an 84 patient cohort. Findings from 2395 spectra measured on 599 biopsy cores show high accuracy for diagnosing and grading PCa. We can detect clinically significant PCa from benign and clinically insignificant PCa with 90% sensitivity and 80.2% specificity. We also demonstrate the ability to differentiate cancer grades with 90% sensitivity and specificity ≥82.8%. This work demonstrates the utility of RS for real-time PCa detection and grading during routine transrectal biopsy appointments.

The Role of Online Videos in Teaching Procedural Skills in Postgraduate Medical Education: A Scoping Review.

OBJECTIVE: The purpose of this scoping review was to outline the extent of available literature including the prevalence of video quality appraisal tools, characterize how online videos were used, and identify the gaps in the literature with implications for future research. DESIGN: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR). Six databases were searched: (1) MEDLINE (Ovid), (2) EMBASE, (3) Cochrane, (4) ERIC, (5) CINAHL PLUS, and (6) Google Scholar for Medical Subject Headings terms online videos, postgraduate health education, and health professional/s. RESULTS: A total of 6948 articles were identified, of which 78 were included in the review. The articles included were primarily either experimental or observational studies, with most being from North America. Twelve concepts were identified: (1) procedural skills teaching; (2) video assessment; (3) validation of an assessment tool; (4) video feedback; (5) coaching; (6) broadcasting; (7) learner characteristics; (8) video characteristics; (9) video quality; (10) a quality assessment tool; (11) platforms and video library; and (12) health information governance. CONCLUSIONS: While there is a diverse and growing body of literature on this area, information is lacking about the quality appraisal of online videos.

Diffusion histology imaging differentiates distinct pediatric brain tumor histology.

High-grade pediatric brain tumors exhibit the highest cancer mortality rates in children. While conventional MRI has been widely adopted for examining pediatric high-grade brain tumors clinically, accurate neuroimaging detection and differentiation of tumor histopathology for improved diagnosis, surgical planning, and treatment evaluation, remains an unmet need in their clinical management. We employed a novel Diffusion Histology Imaging (DHI) approach employing diffusion basis spectrum imaging (DBSI) derived metrics as the input classifiers for deep neural network analysis. DHI aims to detect, differentiate, and quantify heterogeneous areas in pediatric high-grade brain tumors, which include normal white matter (WM), densely cellular tumor, less densely cellular tumor, infiltrating edge, necrosis, and hemorrhage. Distinct diffusion metric combination would thus indicate the unique distributions of each distinct tumor histology features. DHI, by incorporating DBSI metrics and the deep neural network algorithm, classified pediatric tumor histology with an overall accuracy of 85.8%. Receiver operating analysis (ROC) analysis suggested DHI's great capability in distinguishing individual tumor histology with AUC values (95% CI) of 0.984 (0.982-0.986), 0.960 (0.956-0.963), 0.991 (0.990-0.993), 0.950 (0.944-0.956), 0.977 (0.973-0.981) and 0.976 (0.972-0.979) for normal WM, densely cellular tumor, less densely cellular tumor, infiltrating edge, necrosis and hemorrhage, respectively. Our results suggest that DBSI-DNN, or DHI, accurately characterized and classified multiple tumor histologic features in pediatric high-grade brain tumors. If these results could be further validated in patients, the novel DHI might emerge as a favorable alternative to the current neuroimaging techniques to better guide biopsy and resection as well as monitor therapeutic response in patients with high-grade brain tumors.

BRAF Alteration in Central and Peripheral Nervous System Tumors.

BRAF (alternately referred to as v-raf murine sarcoma viral oncogene homolog B1) is a proto-oncogene involved in the mitogen-activated protein kinase (MAPK) pathway. BRAF alterations are most commonly missense mutations or aberrant fusions. These mutations are observed in numerous primary central nervous system tumors as well as metastases. This review discusses the prevalence of BRAF alteration within select notable CNS tumors, and their prognostic associations. Included are some novel entities such as diffuse leptomeningeal glioneuronal tumor (DLGNT), polymorphous low grade neuroepithelial tumor of the young (PLNTY), and multinodular and vacuolating neuronal tumor (MVNT). Knowledge of this gene's integrity in CNS and PNS tumors can have profound diagnostic and therapeutic implications. Also reviewed are the current state of targeted therapy against aberrant BRAF as it pertains mostly to the CNS and to a lesser extent in PNS, and certain diagnostic aspects.

The role of online videos in teaching procedural skills to post-graduate medical learners: A systematic narrative review.

Objective: Online videos are commonly used in medical education. The aim of this review was to investigate the role of online instructional videos in teaching procedural skills to postgraduate medical learners.Methods: This systematic narrative review was conducted according to the PRISMA guidelines. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, ERIC and Google Scholar were searched. Full texts that applied to online videos, postgraduate medical learners and procedural skills were included without language restrictions. The methodological quality of the studies was evaluated using a validated tool. A thematic analysis of the studies was carried out using a general inductive approach.Results: A total of 785 articles were retrieved and the full text was reviewed for 66 articles that met the inclusion and exclusion criteria of the study. Twenty papers that were relevant to the role of online videos in postgraduate medical education of procedural skills were used for this review. They were heterogenous in the outcomes collected and the evidence was of variable quality. There was strong evidence for the use of online videos for procedural skill knowledge acquisition and retention. Online videos were used for various purposes, such as supervision, assessment, postoperative debriefing, providing feedback, and promoting reflection.Conclusion: Online videos are a valuable educational tool especially for procedural skill knowledge acquisition and retention. Future research needs to be carried out on the appropriate use of platforms in disseminating and using online videos, identifying the factors surrounding the learners, video characteristics, and data protection.