Freezing of gait (FOG) in advanced Parkinson's disease (PD) remains a therapeutic challenge, with conventional subthalamic nucleus deep brain stimulation (STN-DBS) demonstrating limited efficacy. This multicenter, prospective, single-blind study investigated the effects of combined high-frequency (HF) STN stimulation and ultra-low-frequency (ULF) substantia nigra pars reticulata (SNr) stimulation in six PD patients with refractory FOG. Assessments included Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III, New Freezing of Gait Questionnaire (NFOGQ), Gait and Falls Questionnaire (GFQ) and Schwab & England Activities of Daily Living (ADL) scale. Dual-target stimulation significantly outperformed STN-only stimulation in improving appendicular motor symptoms (MDS-UPDRS Part III: p = 0.04 medication-ON, p = 0.009 medication-OFF) and reducing FOG severity (NFOGQ: p = 0.02, GFQ: p=0.01 vs. STN-DBS). Postural stability remained unchanged, while ADL scores improved clinically (p = 0.04). Volume of tissue activated (VTA) analysis revealed more STN VTA connectivity in cerebrum, in contrast with more SNr VTA connectivity in cerebellum. These findings highlight the potential of dual-target free-frequency DBS for multimodal symptom control in PD and hopefully bring new sights in understanding mechanisms of DBS treatments in FOG.

BackgroundScheduled cardioversion is a common and resource-intensive procedure in rhythm treatment of atrial fibrillation and atrial flutter. Cancellations of cardioversion procedures are common due to spontaneous conversion to sinus rhythm.PurposeThe aim of this study was to study the efficacy and feasibility of pre-cardioversion rhythm monitoring using smartphone photoplethysmography as compared to standard of care in scheduled cardioversion of atrial fibrillation.MethodsRandomized, controlled, single-blinded study at a single center in a tertiary hospital.Adult patients with persistent atrial fibrillation or atrial flutter scheduled for cardioversion were included. Pre-cardioversion ambulatory heart rhythm monitoring using smartphone photoplethysmography and reminders to support adherence to anticoagulation was applied in the intervention group as compared to standard of care (no active monitoring). Heart rhythm recordings were encrypted and transferred following recording and overread daily. A one-lead ECG recording was made simultaneous to each photoplethysmography recording for validation purposes. In case of spontaneous conversion to sinus rhythm in the intervention group, participants were contacted and cardioversion was canceled. In the control group, no further action was taken in case of rhythm conversion.The primary efficacy outcome was proportion of same-day cancellations of scheduled atrial fibrillation or flutter cardioversions.ResultsAmong 369 contacted patients, 286 responded and 207 accepted participation and attended an inclusion visit, of which 206 were randomized. There were 105 participants assigned to intervention, and 101 assigned to standard of care. Three participants were excluded after randomization due to having a cardiac implantable device, leaving 104 and 99 participants for final analysis in the intervention and control group, respectively. Median age was 69.7 years and 27.7% were female. The participants performed 5226 heart rhythm recordings pre-cardioversion and the median number of daily recordings per participant pre-cardioversion was 2.1.There were 4.8% (5/104) same-day cancellations of scheduled cardioversions in the intervention group compared to 23.2% (23/99) in the control group (P < .001). For same-day cancellations due to spontaneous sinus rhythm conversion, the corresponding results were 1.0% (1/104) versus 18.2% (18/99) (P < .001), relative risk reduction (RRR) 94,7%, absolute risk reduction (ARR) 17,2 % and number needed to treat (NNT) was 6.ConclusionPre-cardioversion monitoring using smartphone PPG represents an easy-to-use and highly disseminated digital intervention significantly reducing same-day cancellations.Difference cardioversion cancellations.

Patient education significantly improves outcomes, especially in high-risk procedures. However, traditional educational resources often fail to address patient literacy and emotional needs adequately. Large language models like ChatGPT (OpenAI) and Gemini (Google) offer promising alternatives, potentially enhancing both accessibility and comprehensibility of procedural information. This study evaluates and compares the effectiveness of ChatGPT and Gemini in generating accurate, readable, and clinically relevant patient education materials (PEMs) for pulmonary artery catheter insertion. A comparative, single-blinded study was conducted using structured validation methods using a common prompt for both gen artificial intelligence (AI) chatbots. AI-generated PEMs were assessed by board-certified anesthesiologists and intensivists. Face validity was determined using a 5-point Likert scale evaluating appropriateness, clarity, relevance, and trustworthiness. Content validity was measured by calculating content validity index. Accuracy and completeness were evaluated by a separate expert panel using a 10-point Likert scale. Readability and sentiment analysis were assessed via automated online tools. Both chatbots achieved robust face and content validity (S-CVI = 0.91). ChatGPT scored significantly higher on accuracy [9.00 vs. 8.00; P = 0.021] and perceived trustworthiness, while Gemini outperformed in readability (Flesch Reading Ease score: 65 vs. 54; Flesch-Kincaid Grade Level: 7.58 vs. 8.64) and clarity. Both outputs maintained a neutral emotional tone. AI chatbots show promise as innovative tools for patient education. By leveraging the strengths of both AI-driven technologies and human expertise, healthcare providers can enhance patient education and empower individuals to make informed decisions about their health and medical care involving complex clinical procedures.

Effects of dual-task prioritization training on dual-task walking in older people: A single-blinded randomized controlled trial.

Studies have shown that using warmed irrigation solution is an effective method for maintaining perioperative patient normothermia. This randomized single-blind comparative study aimed to evaluate the accuracy of a hand-checking method to assess irrigation fluid temperature and suitability for use. Twenty-eight scrub nurses were enrolled and assigned to one of three groups using either hot, cold, or euthermic irrigation fluid. Measurements were taken at 30-minute intervals in either a cold (18°C [64.4°F]) or room-temperature (22°C to 24°C [71.6°F to 75.2°F]) environment. Incorrect assessments regarding irrigation fluid temperature were made by 89.3% of participants, with 78.6% doing so in the cold environment. Participants with experience in gynecological and plastic surgery were more accurate in their assessments. This study revealed disparities between subjective assessments and objectively measured temperatures. The high rate of inaccurate evaluations underscores the need to use objective methods for temperature measurements.

Introduction: Nasotracheal Intubation (NTI) is frequently required for oral and maxillofacial surgeries, but optimal techniques for guiding the Endotracheal Tube (ETT) towards the glottis remain debated. While Magill’s forceps have traditionally been used to guide the ETT towards the glottis during NTI, the cuff inflation technique has emerged as a potentially safer alternative. Aim: To compare the intubating conditions between cuff inflation and Magill’s’s forceps techniques for NTI in adults under direct laryngoscopy. Materials and Methods: The present randomised clinical single blinded study was conducted at Dhiraj Hospital Piparia, Vadodara, Gujarat, India, from 13th July 2024 to 1st may 2025 on 80 American Society of Anaesthesiologists (ASA) I-II patients aged 18-60 years undergoing elective surgeries requiring NTI. Patients were randomly allocated into two groups using computer generated sequence: Group C (n=40) underwent NTI using the cuff inflation technique, while group M (n=40) underwent NTI using Magill’s forceps. The primary outcomes included the time required for successful intubation, number of attempts, and secondary outcomes included haemodynamic response, external laryngeal manoeuvre requirement, and complications. Data were analysed using unpaired Student’s t-test for numerical variables and Chi-square test for categorical variables. Statistical significance was set at p&lt;0.05. Results: A total of 80 patients were included in the study with 40 patients per group groups were demographically comparable. Total intubation time was significantly shorter in group C (40.38±3.95) compared to group M (51.84±4.78 seconds) (p&lt;0.001). Group C showed higher first-attempt success rate (80.0% vs 75.0%, p=0.008). External laryngeal manoeuvre was required less frequently in group C 6 (15.0%) patients compared to group M 14 (35.0%) patients (p=0.037). The cuff inflation technique demonstrated attenuated haemodynamic response with significantly lower increases in Heart Rate (HR) and blood pressure at 1 and 3 minutes post intubation. Complications including nasal bleeding and ETT cuff damage were significantly lower in group C. Conclusion: The cuff inflation technique provides superior intubating conditions compared to the Magill’s’s forceps technique, with shorter intubation time and fewer complications. It may be considered a safer and more efficient alternative for NTI under direct laryngoscopy in adults.

Advances in health professions education increasingly emphasize the use of digital technologies to enhance student engagement and support diverse learning needs. In physiotherapy training, particularly in technically complex subjects like electrotherapy, conventional instruction may fall short in fostering active learning and knowledge retention. Game-based platforms such as Ren'Py offer an opportunity to integrate interactive, scenario-based learning into the curriculum. This study aimed to assess the impact of Ren'Py-based digital materials on learning outcomes by comparing conventional, digital, and hybrid teaching models in an undergraduate electrotherapy course. This single-blind, three-arm randomized controlled trial was conducted between October-December 2024 at the Department of Physiotherapy and Rehabilitation. Eighty second-year physiotherapy students who had not previously taken the course were randomly assigned via computerized sequence to one of three groups: Conventional Education Group (CEG, n = 23), Digital Education Group (DEG, n = 29), or Conventional and Digital Education Group (CaDEG, n = 28). Instructional delivery included theoretical and practical sessions, followed by theoretical and practical exams. Outcomes included exam scores, the Cognitive Load Scale, the Attitude Scale Towards the Physiotherapy Profession, and the Educational Materials Motivation Survey. The data were analyzed using SPSS 27.0 package program. The parametric ANOVA test was used for normally distributed data, and the nonparametric Kruskal-Wallis test was used for nonnormally distributed data. Post-hoc analyses were performed using the Bonferroni test for normally distributed data and the Dunn-Bonferroni test for non-normally distributed data. A p < 0.05 level of significance was accepted for all findings. Theoretical exam scores were similar between groups (CI(95%) = 0.00 to 0.07; p = 0.616), but practical exam scores were significantly different (CI(95%) = 0.03 to 0.30; p < 0.001); both CEG and CaDEG performed better than DEG (CI(95%) = 2.22 to 18.01, p = 0.007 and CI(95%)=-18.51 to -3.52, p = 0.002, respectively). In ASTPP scores, no significant difference was observed between the groups in pre-training, post-training, post-pre-training differences, and in within-group comparisons in any of the CEG, DEG and CaDEG groups (CI(95%) = 130.13 to 136.16, p = 0.858; CI(95%) = 131.91 to 137.08, p = 0.511; CI(95%)=-1.27 to 3.97, p = 0.852; CI(95%)=-4.59 to 3.63, p = 0.987; CI(95%)=-7.31 to 5.10, p = 0.335; CI(95%)=-5.22 to 0.57, p = 0.075, respectively). Cognitive load was significantly higher in the CEG group compared to DEG and CaDEG (CI(95%)=-2.04 to 0.09, p = 0.020; CI(95%)=-0.01 to 2.11, p = 0.016, respectively). IMMS scores were significantly higher in the CaDEG group than in CEG (CI(95%) = 1.77 to 30.32, p = 0.022). Face-to-face and hybrid models were more effective than digital-only instruction for developing practical skills in physiotherapy education. The hybrid model also reduced cognitive load and increased motivation. These findings suggest that integrating tools like Ren'Py into conventional instruction may enhance learning when used as a complement. Further studies with larger samples and extended durations are recommended. This study was retrospectively registered on ClinicalTrials.gov (NCT07274839).

Background: Attenuation of stress response to direct laryngoscopy and endotracheal intubation is crucial to prevent perianesthetic complications. To lessen this stress response on the body, we compared the effect of oral Pregabalin and Gabapentin, administered preoperatively, on patients undergoing laparoscopic cholecystectomy. Materials and Methods: This is a prospective, randomized, single-blinded controlled study. Ninenty patients with American Society of Anesthesiologists (ASA) physical status I or II who were scheduled for elective laparoscopic cholecystectomy were enrolled. Random allocation was done in to the three groups, receiving either oral Gabapentin 600 mg, oral Pregabalin 150 mg, or oral placebo, 90 minutes prior to the induction of anesthesia. Monitoring the hemodynamic parameters which included heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) was done at different time frames. Results: The groups which received oral Pregabalin and Gabapentin had significantly blunted hemodynamic stress response to direct laryngoscopy and endotracheal intubation compared to the placebo group. There was no statistically significant reduction in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure at baseline or during the preoperative period at 30, 60, or 90 minutes (P &gt; 0.05). Both Pregabalin and Gabapentin groups had statistically significant reduction in heart rate, SBP, DBP, and MAP at 2, 4, 6, 8, and 10 minutes following intubation (p &lt; 0.05). Conclusion: Both Pregabalin and Gabapentin can effective in attenuating haemodynamic stress response to laryngoscopy and endotracheal intubation in patients undergoing laparoscopic cholecystectomy. Keywords Pregabalin, Gabapentin, Stress response, Attenuation

There are limited treatment options to improve vision in patients with infantile nystagmus. We aimed to examine the use of repeated visual stimulation with Gabor patches to improve vision. A prospective randomised (3:1) controlled single-blind study. Included were patients aged 9-55 years with infantile nystagmus, treated in one tertiary referral centre in central Israel. The treatment group underwent visual stimulation for 4 months, which consisted of treatment sessions of approximately 30 min, 3-4 times a week, using web-based dedicated software. Controls were followed without treatment. 26 patients were treated, and 10 served as controls. Mean age was 22.47±12 years. 12/26 (46%) of treated subjects achieved driving licence best corrected visual acuity (BCVA) (20/40) versus 1/10 (10%) of controls. Distance BCVA improved by 0.11±0.07 logMAR (one line) in treated patients compared with 0.013±0.06 logMAR in controls (p<0.001). Near BCVA improved by 0.20±0.18 logMAR (2 lines) in treated patients compared with 0.06±0.06 logMAR in controls (p=0.040). 88% (8/9) of study patients who had no stereopsis prior to treatment achieved stereopsis (mean 630') as opposed to 25% (1/4) of controls (p=0.10). Mean stereoacuity and contrast sensitivity improved by 802±730' and 292±391% in the study group as opposed to 246±376' and 152±67% in controls, respectively (p=0.031; p=0.157). Visual perceptual learning using Gabor patches resulted in a significant improvement in near and distance visual acuity, as well as stereopsis. This modality may represent a promising non-invasive treatment option for improving visual function in patients with infantile nystagmus.

Emotional freedom techniques-based counseling with breathing exercises in in vitro fertilization: effects on psychological distress and well-being.

Pain can also cause problems in preterm infants. Pain management in preterm infants supports neurodevelopment. This study aimed to examine the effects of facilitated tucking (FT), swaddling, and prone positioning during endotracheal suctioning (ES) on pain, comfort, and physiological parameters in preterm infants. This randomized controlled study included 4 cohort groups. This was a single-blind study. This study was conducted between August 2022 and February 2023 in the neonatal intensive care unit of a gynecology and pediatric hospital. The study sample comprised 100 preterm infants. Pain was measured using the Premature Infant Pain Profile-Revised, and comfort was measured using the Newborn Comfort Behavior Scale. Facilitated tucking and swaddling were found to be more effective in terms of pain and comfort assessments during and after ES. There was no difference between the groups in terms of average heart rate. Average oxygen saturation was higher in the swaddling group during ES and in the prone position group after ES. The most beneficial practices for reducing pain, increasing comfort, and providing physiological stability in preterm infants during ES have been scientifically revealed to be FT and swaddling.

BackgroundThe effects of peri-operative training interventions in connection with oesophageal surgery have not been thoroughly investigated. The aim of this randomised, controlled, single-blind study was to evaluate a peri-operative physical training programme in patients undergoing oesophageal cancer resection surgery due to cancer of the oesophagus or the gastro-oesophageal junction.MethodsOne hundred patients scheduled to undergo Ivor Lewis oesophagectomy in one of five university hospitals in Sweden were randomised to a control group or intervention including respiratory muscle training, strength training, and increased physical activity before surgery and up to 3 months postoperatively. Outcome measures were physical capacity, respiratory muscle strength, spirometry, grip strength, and chest mobility. Questionnaires regarding physical activity and function, recovery, and health-related quality of life were completed at inclusion and 3 and 12 months postoperatively.ResultsWe did not find significant differences between the groups in physical capacity during follow-up. However, the intervention group performed significantly better than the control group in maximal inspiratory pressure (Δ18%), maximal expiratory pressure (Δ18%), and peak expiratory flow (Δ12%) 3 months postoperatively (p < 0.05). Patients in the intervention group also developed fewer pulmonary complications (p = 0.019). We did not find differences between the groups in recovery or health-related quality of life.ConclusionA peri-operative training intervention including respiratory muscle training had a positive impact on respiratory function and pulmonary complications. However, neither strength training nor increased physical activity had any effects. Thus, respiratory muscle training may be offered as a peri-operative regimen in oesophageal cancer surgery.Trial registrationFoU i VGR 238,651 (Released Dec 15, 2017), Clinical Trials NCT03452319 (Released Feb 18, 2018).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12893-025-03416-4.

BackgroundFunctional constipation is one of the most prevalent functional gastrointestinal disorders in the pediatric population, frequently resulting in quality of life impairment and elevated healthcare costs. Despite the availability of evidence-based treatment guidelines, adherence remains an essential challenge to achieving sustained therapeutic success.MethodsThis randomized, single-blind per-protocol study assessed the efficacy of a mobile application compared to conventional printed educational materials in supporting the management of functional constipation in children aged 4–12 years. 100 patient–caregiver dyads were randomized into two arms: an intervention group using a mobile application and a control group receiving printed recommendations. Clinical outcomes were evaluated over a six-month follow-up using the Pediatric Quality of Life Inventory™ (PedsQL™) Gastrointestinal Symptoms Module.ResultsThere were 113 complete questionnaires, 65 from adults and 48 from children. Participants in the intervention cohort demonstrated significantly greater improvements in symptom control (mean difference 21.4 vs. 12.3 points; p = 0.014), particularly in the domains of constipation, abdominal pain, and bloating.ConclusionsThe mobile application’s interactive features, behavioral tracking tools, and integrated reward system appeared to enhance adherence and self-efficacy among users. Overall, the results support the potential utility of mobile health interventions as adjuncts to standard care in managing pediatric functional constipation. Trial Registration: ClinicalTrials.gov NCT07025135. Registered 17/06/2025 (trial start 05/02/2023).Trial registrationClinicalTrials.gov NCT07025135. Registered 17/06/2025 (trial start 05/02/2023).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12887-025-06385-y.

Background The ability to predict a difficult airway is paramount for Anesthesiologist for devising a secure intubation strategy. The inability to secure a patent airway may precipitate life-threatening complications such as hypoxic brain injury or fatal cardiopulmonary arrest. Preoperative tests like the ULBT (Upper Lip Bite Test) and RHTMD (Ratio of Height to Thyromental Distance) are employed to predict airway management challenges. This study sought to compare the diagnostic performance of ULBT and RHTMD against the standard Intubation Difficulty Scale (IDS).Data &amp; Methods An observational, single-blind comparative study was carried out during the period of May 2022 to April 2023, among 130 individuals between the ages of 18 and 65, with an ASA classification of I or II, all scheduled for elective procedures under general anesthesia with endotracheal intubation. After obtaining ethical clearance (Ref:NMC/540/078/079), study was commenced. After informed written consent, each participant’s airway was pre-operatively evaluated using the RHTMD and ULBT. The complexity of each intubation was then objectively quantified using the IDS.Results The findings demonstrated a marked superiority of the Upper Lip Bite Test. ULBT exhibited a sensitivity of 86.36% and a specificity of 87.96%. In contrast, the Ratio of Height to Thyromental Distance showed lower efficacy, with a sensitivity of 68.18% and a specificity of 66.66%. Crucially, while both tests were comparable in their ability to correctly rule out a difficult airway (negative predictive value), the ULBT proved significantly more accurate in confirming one (positive predictive value), establishing it as the more robust predictive instrument.Conclusion The study concludes that the Upper Lip Bite Test (ULBT) is a more dependable and accurate predictor of difficult tracheal intubation, as defined by the Intubation Difficulty Scale (IDS), than the Ratio of Height to Thyromental Distance (RHTMD).

Adenotonsillectomy has been shown to promote “catch-up growth” in children with obstructive sleep apnea. However, its impact on children with mild sleep-disordered breathing (SDB) (i.e., habitual snoring but not frequent obstructive breathing events) remains unclear. This secondary analysis utilized data from the Pediatric Adenotonsillectomy Trial for Snoring (PATS), a multicenter, randomized, single-blinded interventional study. PATS enrolled 459 children aged 3–12 years with mild SDB, all of whom had an obstructive apnea-hypopnea index (OAHI) no greater than 3. These children were randomized to either adenotonsillectomy or watchful waiting and were followed for 12 months. Growth outcomes included height, weight, and body mass index (BMI) expressed in sex- and age-specific percentiles. Sleep parameters were measured using polysomnography. We used multivariable linear regression to assess the statistical significance of differences in these outcomes at 12 months after adenotonsillectomy or randomization between the surgery and watchful waiting groups. Among the 330 children who consented to share data (median age 6.4 years), 231 had an OAHI below 1. After multivariable adjustment, the adenotonsillectomy group had significantly higher increase in height (mean difference: 2.74, 95% confidence interval [CI] 0.33 to 5.15) and weight (mean difference: 2.79, 95% CI 0.29 to 5.28) percentiles at 12-month follow-up, compared with the watchful waiting group. Significant differences were also observed for sleep parameters, including OAHI (mean difference: -1.36, 95% CI -2.07 to -0.65), respiratory disturbance index (mean difference: -0.47, 95% CI -0.74 to -0.20), and oxygen desaturation index (mean difference: -0.99, 95% CI -1.85 to -0.13). The adenotonsillectomy group further demonstrated better sleep architecture, including decreased Stage 1 sleep (mean difference: -1.00, 95% CI -1.90 to -0.11) and increased Stage 2 sleep (mean difference: 2.06, 95% CI 0.54 to 3.59). Subgroup analysis indicated greater benefit of adenotonsillectomy for children at 3–5 years, boys, children with grade III or IV tonsillar hypertrophy, and non-asthmatic children. In conclusion, adenotonsillectomy improved not only sleep-related outcomes but also growth in children with mild SDB, suggesting that surgical intervention may provide additional health benefits beyond symptom relief, particularly in younger children with tonsillar hypertrophy. Trial registration: ClinicalTrials.gov NCT02562040, registered on September 25, 2015.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-30271-3.

BackgroundInterdental spaces are particularly susceptible to biofilm accumulation and gingival inflammation, which contribute to periodontal diseases and their systemic associations. While interdental brushes (IDBs) are recognized as the most effective method of interdental cleaning, their efficacy depends on proper adaptation to the interdental space. Calibration with a colorimetric probe may enhance their effectiveness and comfort. However, evidence directly comparing calibrated and noncalibrated IDBs, especially in young adults, a key target group for preventive strategies, remains limited. The Hygiene of Interdental Junctions in Adults (HIJA) trial was designed to address this gap.ObjectiveThis protocol aims to compare the clinical, microbiological, and acceptability outcomes associated with calibrated versus noncalibrated IDBs in young adults, focusing on interdental inflammation, periodontal indices, and microbiota composition.MethodsThe HIJA trial is a monocentric, randomized, controlled, single-blind, and parallel-arm study. Overall, 50 healthy, nonsmoking adults aged 18‐30 years will be randomized (1:1) to receive either calibrated or noncalibrated IDBs. Participants will perform daily interdental cleaning in addition to conventional toothbrushing for 3 months. The primary outcome will be the reduction in interdental inflammation, expressed as the change in bleeding on probing at 3 months. Secondary outcomes will assess differences in interdental microbiota composition (16S ribosomal RNA sequencing), periodontal indices (plaque index, gingival index, probing depth, and clinical attachment loss), and user acceptability measured through the Theoretical Framework of Acceptability questionnaire at 1, 2, and 3 months.ResultsThe HIJA trial will generate evidence on whether calibrated IDBs provide additional benefits over noncalibrated brushes in reducing interdental inflammation and improving oral health in young adults.ConclusionsHIJA findings could contribute to the implementation of clinical guidelines and preventive strategies for interdental hygiene in daily practice.

To compare sevoflurane with laryngeal mask airway (LMA) and propofol infusion with an oxygen facemask in children undergoing ophthalmic examinations under anesthesia (EUA) regarding time to operating room discharge. In this prospective, randomized, single-blind study, children aged 1 to 6 years undergoing EUA were assigned to sevoflurane with LMA (the sevoflurane group) or propofol with oxygen facemask (the propofol group). The primary outcome was operating room discharge time. Secondary outcomes included induction time, nonoperative time, total anesthesia time, surgery duration, post-anesthesia care unit stay, ophthalmologist satisfaction, respiratory adverse events/interventions, EUA interruptions, wake-up time, emergence agitation, postoperative nausea and vomiting, and pain medication use. Sixty patients were enrolled. Operating room discharge time was significantly shorter in the propofol group than the sevoflurane group (7.17 ± 3.11 vs 9.81 ± 4.38 minutes, 95% CI: 0.67 to 4.60, P = .009). Induction time (8.63 ± 4.37 vs 11.93 ± 6.26 minutes, 95% CI: 0.48 to 5.99, P = .022) and nonoperative time (15.80 ± 5.57 vs 21.67 ± 8.90 minutes, 95% CI: 2.03 to 9.71, P = .003) were shorter in the propofol group. Total anesthesia time remained shorter in the propofol group (35.53 ± 15.57 vs 43.74 ± 16.10 minutes, 95% CI: 0.02 to 16.39, P = .050). No significant differences were found in other outcomes, except more emergence agitation in the sevoflurane group (P = .029). Ophthalmologist satisfaction was high and comparable. Respiratory adverse events were low and similar in both groups. Propofol with oxygen facemask resulted in shorter operating room discharge time and less emergence agitation compared to sevoflurane with LMA in pediatric ophthalmic EUAs. Both techniques yielded high ophthalmologist satisfaction and low respiratory event rates.

ObjectiveTo investigate the effects of narrative care combined with life review among patients with advanced cancer.MethodsNinety patients who met the inclusion criteria were recruited from the palliative medicine ward of a tertiary-level oncology specialty hospital in Xinjiang and the community hospitals hosted by our hospital from January 2024 to January 2025. This study is a randomized controlled single-blind study. They were randomly divided into control and experimental groups (n = 45 patients per group). The control group received usual care, whereas the experimental group received narrative nursing combined with life review as a psychological intervention in addition to the usual care received by the control group. The number of interventions per patient was not less than 4 times, and the intervention period was 2 weeks. Before and after the intervention, the experimental and control groups were evaluated using the Psychological Distress Management Screening Tool, the Sense of Meaning of Life Scale for Advanced Cancer Patients, and the EORTC Quality of Life Measurement Scale QLQ-C30.ResultsEighty-three participants completed the study. No statistically significant differences were observed in psychological distress, scores for the total meaning of life scale and its individual dimensions, and scores for the total quality of life scale and its individual dimensions between the two groups before the intervention (p > 0.05). After the intervention, the distress thermometer scores were significantly lower in the experimental group than in the control group (p < 0.05). The scores for the total meaning of life scale and its individual dimensions were significantly higher in the experimental group than in the control group (p < 0.05). The scores for the total quality of life scale and its individual dimensions were significantly higher in the experimental group than in the control group (p < 0.05).ConclusionNarrative nursing combined with life review can effectively alleviate the psychological suffering, increase the sense of meaning of life to a certain extent, and improve the quality of survival among patients with advanced cancer. It is recommended to incorporate it into routine hospice care practice, through structured life review guidance, to help patients affirm their self-worth and enhance their dignity and calm at the end of life.

Introduction: Prediction of a difficult airway is of utmost importance, as an unanticipated difficult airway can lead to severe adverse events. Clinically, prediction is done using independent bedside tests; however, these often lack accuracy. Moreover, most airway assessment scores are cumbersome and subject to interobserver variability because of subjective parameters. Wilson’s Score and the Intubation Prediction Score (IPS) are commonly used scoring systems for preoperative airway evaluation. Aim: To determine the diagnostic accuracy of the Wilson Score and IPS in predicting difficult airways. Materials and Methods: This prospective, observational, analytical, single-blind study was conducted among 120 patients aged 18 to 70 years who underwent surgeries requiring endotracheal intubation. All patients underwent airway assessment using both the Wilson Score and IPS. General anaesthesia with endotracheal intubation was performed by an anaesthesiologist who was unaware of the patients’ scores. The ease of laryngoscopy and intubation was assessed using the Intubation Difficulty Scale (IDS), where an IDS score greater than 5 indicated a difficult airway. Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and overall accuracy of both scoring systems were calculated. McNemar’s test was used to compare diagnostic performance, with p-value &lt;0.05 considered statistically significant. Results: A total of 120 patients were assessed, of whom 58 (48.33%) were male and 62 (51.67%) were female. The mean age and weight of the patients were 40.47±12.14 years and 70.53±13.76 kg, respectively. Sixty-six (55%) patients belonged to American Society of Anaesthesiologists (ASA) Grade I, and 54 (45%) to ASA Grade II. The actual incidence of difficult airway was 11.67%. Wilson’s Score showed a sensitivity of 21.43%, specificity of 93.40%, PPV of 30.00%, NPV of 90.00%, and accuracy of 85.00%. IPS demonstrated significantly better sensitivity (71.43%; p-value=0.014), PPV (83.33%; p-value=0.023), and overall accuracy (95.00%; p-value=0.012). Both systems showed high specificity (IPS: 98.11%; Wilson’s: 93.40%; p-value=0.172), while NPV was higher for IPS (96.30% vs. 90.00%; p-value=0.057). Conclusion: The IPS outperforms Wilson’s Score in predicting difficult endotracheal intubation, particularly in terms of sensitivity, PPV, and overall accuracy. Incorporating IPS into routine preoperative assessment may enhance patient safety. Therefore, it can be preferred as a simple and accurate bedside tool for predicting difficult airways in patients undergoing endotracheal intubation under general anaesthesia.

Background:Dental caries, being an infectious, microbiologic disease, can cause dissolution and destruction of calcified tissues. Early detection of dental caries is therefore crucial for maintaining overall tooth health.Materials and Methods:A randomized, single-blinded retrospective study was conducted. Three groups participated: dentists with <10 years of experience, dentists with more than 10 years of experience, and the AI model. An external dataset of 20 anonymized bitewing radiographs served as the test set, reviewed and annotated by experienced dentists as the gold standard. Performance metrics included Intersection over Union, Confusion Matrix, Sensitivity, Precision, and F1 score.Results:Among all, the AI model showed a high precision of 0.87, a recall of 0.77, and an F1 score of 0.82. This shows the AI model’s superior precision in identifying caries and avoiding misinterpretations, like cervical burnout and Mach band effect.Conclusion:The study achieved high diagnostic accuracy in identifying early carious lesions and offered advantages in efficiency and avoiding misinterpretations. Integrating AI with dental expertise could enhance diagnostic accuracy, optimize workflow, and support preventive interventions, ultimately improving patient care. Future research should focus on expanding the model’s capabilities and exploring its seamless integration into clinical practice.