Food Noise is a topic of growing interest in media, social media, and reports from patients and clinicians. A theoretical definition of "Food Noise" has recently been established as "heightened and/or persistent manifestations of food cue reactivity, often leading to food-related intrusive thoughts and maladaptive eating behaviors," but research focusing on the lived experiences of people who report experiencing it is limited. TikTok has become a major outlet for content creators to disseminate information on Food Noise, with over 3600 videos under the hashtag #FoodNoise as of June 2024. This study aimed to examine the top videos on TikTok under the hashtag "FoodNoise" and explore what content creators discuss around food noise. We analyzed 100 videos on TikTok under the hashtag #FoodNoise. Video links and metadata (such as engagement metrics) were retrieved on June 24th, 2024. After one duplicated video was excluded, the final analysis included 99 videos. Following pilot testing of the codebook, we conducted a quantitative content analysis of the videos. This study required no ethical approval. The sampled videos had a mean of 1,173,323.63 views, 8,154.57 likes, 246.99 comments, and 582.65 shares. Content creators were primarily female (91.92%), aged 30 or older (82.83%), and White (85.86%). 22.22% of content creators were healthcare professionals, and 70.71% of videos were patient testimonies. 49.49% of videos mentioned medications, mainly GLP-1 receptor agonists. 42.42% mentioned food, mostly candies, desserts, and fast foods. Of the videos that defined Food Noise (82.82%), 93.9% defined it consistently with the current theoretical definition. Most videos (85.86%) depicted food noise negatively. The top content available on TikTok on food noise is mainly comprised of patient testimonies that describe food noise as negative and distressful, and depict the use of medications, mostly GLP-1RAs, as a positive strategy to help manage food noise.

On-call simulation in diagnostic radiology; an underused medical education tool.

Background: Both peer teaching and self-directed learning have become substantial areas of interest and research in medical education. However, there is limited educational intervention to improve nursing students’ knowledge of infusion phlebitis. Aim: To evaluate the effects of an educational intervention on improving nursing students’ knowledge of infusion phlebitis. Methods: A quasi-experimental (pre-post) study with 222 first- to fourth-year undergraduate nursing students was purposively and conveniently conducted at a referral hospital in northeastern Namibia. The experimental group (n = 111) engaged in peer-assisted learning (PAL), which incorporated brainstorming, targeted lectures, group discussions and the use of intravenous training arm visualisations. Conversely, the control group (n = 111) used articles and video links for self-directed learning (SDL) between March and April 2024. The intervention consisted of weekly two-hour sessions (eight sessions in total), amounting to 960 minutes (16 hours) over the eight-week period. Results: Both groups demonstrated significant knowledge gains (SDL + 4 marks, PAL + 5 marks), suggesting both teaching methods are viable. However, despite a positive trend, the observed effect size of 0.685 marks (≈ 3.4% improvement) indicated that the differences between PAL and SDL interventions were statistically insignificant (p = 0.464). Conclusion: Positive knowledge trends demonstrate the viability of both PAL and SDL, suggesting these methods can play a transformative role in nursing curricula and evidence-based practice. The study suggests that future investigations prioritise larger samples and repeated interventions within true experimental designs, using more challenging tests to increase data accuracy.

Autonomous monitoring is essential for precision agriculture in greenhouses, yet deploying unmanned aerial vehicles (UAVs) in confined, GPS-denied environments remains limited by payload, power, and cost constraints. This study developed and validated an autonomous UAV system for reliable, low-cost operation in such conditions. The proposed system employs a dual-link edge-computing architecture: a lightweight onboard controller handles flight control and sensor acquisition, while visual simultaneous localization and mapping (V-SLAM) is offloaded to an edge computer via the FPV video link. Phenotyping (flower detection and tracking/counting) is performed offline from the side-view RGB stream and does not participate in the flight control loop. Using muskmelon (Cucumis melo L.) flower development as a case study, the UAV autonomously executed daily missions for 27 days in a commercial greenhouse, performing flower detection and tracking to monitor phenological dynamics. Localization and control accuracy were evaluated against a validated UWB reference system, achieving 5.4~8.0 cm 2D RMSE for trajectory tracking and 12.7 cm translation RMSE for greenhouse mapping. This work demonstrates a practical architecture for autonomous monitoring in GPS-denied agricultural environments, with operational boundaries characterized through the sustained field deployment. The system’s design principles may extend to other indoor or communication-limited scenarios requiring lightweight, intelligent robotic operation.

AI-driven pulse thermography (PT) has become a crucial tool in non-destructive testing (NDT), enabling automatic detection of hidden anomalies in various industrial components. Current state-of-the-art PT segmentation and depth estimation networks rely on thermal features extracted from Principal Component Thermography (PCT) or Thermographic Signal Reconstruction (TSR) representations. However, relying on PCT and TSR independently constrains the performance of PT inspection models, as these representations possess complementary semantic features. To address this limitation, this work proposes PT-Fusion, a novel feature fusion network for enhanced analysis of subsurface defects in PT setups. PT-Fusion introduces novel fusion modules, Adaptive Weighing Fusion Gate (AWFG) and Gating Enhanced Decoding Block (GEDB), to adaptively fuse thermal features extracted from PCT and TSR representations. A novel data augmentation technique is also proposed based on random data sampling from thermographic sequences to address the scarcity of PT datasets. PT-Fusion is benchmarked against state-of-the-art PT inspection models, including U-Net, attention U-Net, 3D-CNN, TransUNet, and Swin-UNet on the Université Laval IRT-PVC dataset. The results demonstrate that PT-Fusion outperforms U-Net, attention U-Net, and 3D-CNN architectures in defect segmentation and depth estimation accuracies with a margin of 10%. Compared to TransUNet and Swin-UNet, the results show that PT-Fusion's performance is on par with the aforementioned models, with fewer parameters. Video Link .

Introduction: Multiple healthcare providers (HCPs) are represented in an ICU/healthcare system with each requiring specialized education and continuing education (CE) requirements to maintain licensure. Educational opportunities abound in these institutions but achieving accreditation to provide CE for each profession can be prohibitive. Interprofessional continuing education (IPCE) is a multidisciplinary joint accreditation avenue to provide CE to physicians, nurses, pharmacists, physician associates, and others. We report our experience developing an IPCE program. Methods: It was identified that the organization was providing IPCE for Advance Practice Providers (APPs) and physician CE. Joint accreditation costs $22,000 for initial accreditation and $25,500 for 210 hours of CE or less. APCE costs $6,750 for initial accreditation and $3600 for 0.1-99 hours of CE. An opportunity to provide IPCE with little to no cost while providing pharmacology related CE to HCPs across the 13-hospital system was identified. A committee was developed to implement and vet the IPCE. A system wide IPCE event was held. Attendees were required to pass a post-test and complete a survey to receive credit. Survey responses were deidentified. Descriptive statistics are reported. Results: The first IPCE event was held in June of 2025 with approximately 80 attendees. A video link was sent to HCPs that were unable to attend. 63 participants completed the post-test with 100% successful completion. 47 participants claimed IPCE and provided feedback. Most respondents were pharmacists and pharmacy technicians. Respondents were overwhelmingly positive with the experience with all recommending (32%) or strongly recommending (68%) the experience to others. The self-reported ability to apply the content improved from 38% prior to the IPCE to 74% after. The implementation of the CE program did not result in any additional cost to provide IPCE whereas applying for and providing APCE for the same education would have cost $10,350. Efforts are underway to broaden topics, attendees, and healthcare professions attending. Conclusions: Organizations may utilize Joint Accreditation to provide learning opportunities across a broad spectrum of HCPs while curtailing costs. Use was well received amongst a group of HCPs.

Background: Firsthand accounts by autistic people describe a need for regular time alone. However, there is little in the literature that explores (1) why time alone is desired, (2) how that time is spent, or (3) where that time is spent. This article describes a neurodiversity-informed, qualitative study that demonstrates the importance and purpose of “alone-time” for autistic adults. Methods: We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their “alone-time” and the benefits experienced from this time. We conducted the interviews online, some using a video link, and some using a synchronously accessed text-based document, according to the participants’ preferences. Results: We used Reflexive Thematic Analysis with the interview data to generate four qualitative themes as follows: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others. Conclusions: These themes highlight a need for balancing social activities and spaces with time and space alone and the benefits of creating or protecting spaces, which encourage recovery from overwhelm.

Background: Zonular instability complicates cataract surgery and creates uncertainty about choosing sutureless or sutured capsular tension rings (CTRs). Sutureless CTRs are preferred for mild zonulopathy, while sutured CTRs or segments are favored in advanced cases. Borderline situations, however, lack clear guidelines. This video presents a reversible CTR implantation technique using a temporary 10-0 nylon suture threaded through the trailing eyelet. After CTR and intraocular lens implantation, capsular stability is evaluated. If stable, the suture is removed, leaving the CTR in place; if unstable, the CTR can be safely retrieved. This reversible approach enhances flexibility, safety, and real-time surgical decision-making. Purpose: Management of zonular instability during cataract surgery remains challenging. Current literature suggests employing a sutureless capsular tension ring (CTR) in cases of mild diffuse zonular weakness or focal zonular weakness extending fewer than 3 clock hours. [1] However, in scenarios with eyes with advanced zonular weakness, more than 4 clock hours of zonular loss, or progressive zonulopathy, or sutured CTR or segments are recommended to enhance stability. [2] Nevertheless, precise criteria defining indications for sutured versus sutureless CTR are often ambiguous, complicating intraoperative decision-making. Synopsis: This video introduces a reversible implantation technique of CTRs, particularly beneficial in borderline cases. Initially, an appropriately sized, sutureless CTR is selected based on the white-to-white and axial length. A 10-0 nylon suture is threaded through the CTR’s trailing terminal eyelet before implantation. The CTR is gently implanted into the capsular bag utilizing a push–pull maneuver to minimize mechanical stress on compromised zonules, thereby aiming to reduce the risk of further zonular damage. Following insertion, capsular stability is carefully evaluated. If the capsular bag demonstrates sufficient stability, an intraocular lens (IOL) is subsequently implanted. Stability is then reassessed post IOL implantation. Provided adequate stability is maintained, the temporary 10-0 nylon suture is easily removed by severing one end and gently extracting the suture from the CTR. The reversible nature of this method significantly enhances surgical safety. If capsular instability is encountered after CTR and IOL placement, the nylon suture allows effortless removal of both implants without additional trauma. Consequently, this approach provides valuable intraoperative flexibility, enabling dynamic decision-making based on real-time capsular stability assessments. In addition, in some cases, it may be necessary to implant a CTR in the early stages of surgery. [1] It may also be necessary to remove these CTRs due to a complication that may occur after implantation (posterior capsule rupture, disruption of the CCC). Highlights: Suture-guided CTR insertion has been described with variations in suture placement and purpose. Sethi and Naik proposed forceps-assisted, 10-0 nylon suture-guided insertion for controlled distal eyelet placement and safe retrieval in subluxated cataracts. [3] Similarly, Oudjani et al . [4] introduced CTRs with a knotted thread to permit removal at the end of surgery. In conclusion, this reversible CTR implantation technique offers ophthalmologists a practical and safe way to manage variable cases of zonular instability. It facilitates intraoperative decision-making and reduces potential complications associated with zonular compromise. Video Link: https://youtu.be/u5aS-RpkjJ8

Background: Among ocular injuries, corneal foreign bodies (FBs) are the most reported in clinical practice. Superficial FBs are easily visualized using slit-lamp biomicroscopy and can often be removed immediately as an outpatient procedure. [1] In children and uncooperative patients where the exact location and depth cannot be commented on slit-lamp examination, anterior segment optical coherence tomography (AS-OCT) plays a critical role in evaluating FB depth, location, and possibility of Descemet’s membrane (DM) breach. [2] Purpose: A depth-based surgical technique facilitates precise management, maintaining corneal structural integrity and reducing the likelihood of postoperative complications. Synopsis: This video explores the clinical challenges associated with the removal of various intraocular foreign bodies via the anterior approach. Through case-based clinical scenarios, it illustrates depth-based surgical planning and various FB removal techniques and highlights the role of AS-OCT in guiding surgical decisions. Postoperative outcomes are also discussed, emphasizing the importance of precise preoperative assessment and technique selection. Highlights: This video highlights a detailed overview of various intraocular FB (IOFB) management techniques, emphasizing individualized approaches based on FB characteristics and tissue response. Organic FBs pose a high risk of infection and necessitate prompt removal. In contrast, inert materials are usually well tolerated, while metallic FBs can trigger inflammation and require vigilant follow-up. [3] AS-OCT plays a vital role in surgical planning by delineating entry tracts and evaluating the integrity of DM. [2,4] Superficial FBs limited to the anterior stroma are typically removed externally. However, when an FB breaches the DM, removal via the anterior chamber using long vitreoretinal forceps is preferred. [5] This internal approach provides better surgical access, preserves corneal architecture, and minimizes the risk of enlarging the entry tract or inducing astigmatism. Video Link: https://youtu.be/SBH0Aa9kj7c

Background: Minimally invasive glaucoma surgeries are a breakthrough and have added significantly to the glaucoma surgical armamentarium in the recent past. Angle surgeries, in particular, using the trabecular bypass micro-stents, are one of the safest ones for mild to moderate primary open-angle glaucoma. These can be safely done along with the cataract surgeries. Purpose: The purpose of this video is to demonstrate the exact technique of performing iStent inject W in the angle using intraoperative gonioscopy and to help the audience with tackling suboptimal implantation of the iStent intra-operatively. Synopsis: This video demonstrates how to perform the intraoperative gonioscopy, explains about the lenses used for the procedure, and describes the exact technique for performing the iStent procedure. This video describes in detail the iStent inject device and its injector system. It also explains in detail about the different types of intraoperative gonioscopy lenses that can be used to perform the angle procedures. The video describes a step-by-step procedure to implant an iStent in the angle and also to check its efficacy using trypan blue injection. Further, it also explains to the audience about the corrective measures in case there is under-implantation, over-implantation, or wrong implantation of the stent. Highlights: The appropriate technique of performing intraoperative gonioscopy for obtaining a clear view of angles and exact demonstration of the steps of iStent inject implantation, along with tips to avoid problems at each step are the major highlight of this video. Further, it also demonstrates examples of suboptimal implantation and their corrections. Video Link: https://youtu.be/cVW2k_TVSXc

Background: It is not uncommon to encounter a case of posterior dislocation of the intraocular lens (IOL). A bimodal trend is seen where posterior dislocation can occur soon after the cataract surgery due to an intraoperative rent in the posterior capsule. [1] Late dislocations can be seen following either trauma or due to zonular loss in old age or uveitis. [2,3] We present a series of videos depicting management of posteriorly dislocated IOLs in various situations. Purpose: We present surgical videos showing IOL refixation in cases of posterior dislocation of the IOL. The surgeries shown include repositioning the IOL over residual capsular rim, lasso technique for complete internal IOL refixation, a cow-hitch technique for securing IOL, refixation of an IOL along with capsular bag complex, IOL exchange with 4-point scleral fixation (SFIOL) with Goretex suture, and refixation of a previously sutured SFIOL, which is dislocated. Synopsis: Apart from reduced vision, the dislocated IOL can potentially cause retinal injury, glaucoma, or bleeding. [4] This video shows various case scenarios of posterior IOL dislocation and their management using various techniques. The common thread is scleral fixation using sutures and without exteriorizing any part of the dislocated IOL. Highlights: The video highlights different surgical approaches and techniques to manage a traumatic or spontaneous posterior dislocation of an IOL. It particularly highlights the technique of lasso using Prolene or the sturdier Goretex suture for fixing the IOL to the sclera without exteriorizing it. This mitigates the risk of infection. The exact marking of the four fixation points 180 degrees apart under scleral flaps ensures good centration and prevents suture exposure or infection. [5] With minimal risk of retinal detachment or bleeding, any IOL can be repositioned using one of these techniques. However, it is a demanding surgery requiring dexterity and bimanual maneuverability. Conclusion: Traumatic or spontaneously dislocated IOL can be rescued by refixing it to sclera using various techniques with either Prolene or Goretex suture with successful results. Video Link: https://youtu.be/8VvQAHX2-tk

Background: Canalicular lacerations following dog bites are more common in children due to their short height, the nature of playing around with pets, and the preference for the dog to attack the central area of the face. Purpose: This video discusses the nuances involved in managing pediatric canalicular lacerations following dog bites. Synopsis: Periocular dog bite injuries commonly lead to canalicular lacerations, which are more common in children. This is due to shearing forces applied to the eyelids when the dog attacks the central face and direct perforating injury with the canine teeth. Dog bites near the medial canthus can lead to canalicular lacerations as the canaliculi are superficial structures and prone to injury due to the stretching or avulsion of the eyelid. Getting the antirabies vaccine and immunoglobulin injections around the wound is important. There is controversy in the literature regarding the primary suturing of dog bite lacerations. [1,2] However, restoring normal anatomy is essential to providing an acceptable cosmetic result and preventing epiphora. Lacerations should be thoroughly cleaned and explored. The proximal and distal ends of the lacerated canaliculus are identified with magnification and good lighting and approximated with a stent. In certain situations, injecting viscoelastic or trypan blue dye through the opposite canaliculus can be helpful. Highlights: Managing dog bites in the periocular location requires some distinct considerations, which will be discussed in this video. Video Link: https://youtu.be/2nzddny_NFo

Reinforcement learning (RL) holds great promise for generating dynamic whole-body motions on humanoid robots, but its real-world application is hindered by the significant sim-to-real gap caused by actuator model mismatch. Most simulators assume torque-controlled or idealized PD actuators, whereas real-world platforms like the NAO robot employ position-controlled joints with hidden, proprietary control loops and nonlinear dynamics. To bridge this gap, we present a simulation-to-reality framework for whole-body motion control that integrates two key components: an equivalent torque-space PID actuator model and a neural network-based inverse kinematics method. First, we perform system identification on the physical robot by analyzing step response data and computing ground-truth joint torques via Lagrangian dynamics, from which we estimate equivalent PID parameters that replicate the real joint dynamics in simulation. Second, we design a learnable inverse kinematics module that maps human motion, represented by end-effector trajectories, into robot-executable joint commands. Using this high-fidelity simulation environment and motion retargeting pipeline, we train a whole-body control policy via RL in IsaacLab and deploy it directly on the physical NAO robot without any fine-tuning. Experimental results demonstrate successful reproduction of diverse human-like motions, including waving, squatting, and bimanual coordination, validating that accurate actuator modeling and structured motion representation are essential for reliable sim-to-real transfer in learning-based humanoid control. (Supplementary video link: https://youtu.be/zLWXgGZQAFk).

Musculoskeletal (MSK) conditions are a leading cause of disability, particularly in rural regions of developing nations where access to physiotherapy is limited. Telehealth offers a potential solution by delivering physical therapy remotely. However, its feasibility for conservative musculoskeletal management beyond post-surgical care remains underexplored in such settings. The study aimed to assess the feasibility and patient acceptance of telehealth physical therapy for musculoskeletal complaints in a rural region of a developing country. A cross-sectional, questionnaire-based study was conducted in a tertiary care institute serving a predominantly rural population. Patients with non-surgical musculoskeletal conditions who had access to smartphones and English literacy were included. Participants were guided to access prescribed physical therapy exercises via online video links and completed a structured questionnaire four weeks later to evaluate understanding, adherence and symptom relief. Among 257 participants (72.8% rural), 75.1% reported symptom relief and 68.9% preferred telehealth for future care. Over 90.0% successfully accessed and understood the exercises; however, barriers included lack of time (48.6%), difficulty understanding techniques (12.1%) and unavailability of local-language content (10.9%). No demographic factors significantly correlated with symptom relief. Telehealth physical therapy is a feasible and well-accepted modality for managing MSK complaints in rural populations of developing nations. Despite adherence and content-language challenges, it holds promise for improving rehabilitation access. Strategic implementation focusing on culturally appropriate content, digital literacy and hybrid care models could expand its effectiveness and scalability.

The aerospace industry has been at the forefront of robotic automation over the past decades. Existing robotic manufacturing systems are either constrained by limited workspaces, performing specialized single tasks, or rely on hard-coded operations, reducing their flexibility and autonomy. Collaborative robots (Cobots) offer a promising alternative for executing multiple aerospace machining operations within shared workspaces alongside human operators. Nevertheless, their relatively low stiffness and payload capacity pose challenges in achieving the high precision and accuracy demanded in aerospace machining. To address these limitations, this paper presents a fully autonomous, Cobot system for large-scale aerospace machining tasks. The proposed autonomous system introduces novel end-effector designs, including deburring and painting, each customized to the Cobot’s structural characteristics to ensure high precision during machining. In addition, the framework incorporates intelligent vision-based perception and control algorithms that enable autonomous execution of multiple machining tasks at scale, without external supervision. In addition, the proposed framework presents intelligent vision-based control algorithms for autonomously carrying out multiple machining tasks at scale, without requiring external supervision. The system is validated in rigorous experiments reflecting on industrial settings and testing the proposed system’s autonomy and machining precision. The results demonstrate that the introduced Cobot system meets the aerospace industry standards with a machining standard deviation on the order of 0.01 mm under fully autonomous operation. Video Link

AimTo explore and describe the experiences of Swedish diabetes specialist nurses in supporting emerging adults with type 1 diabetes mellitus after the transfer from paediatric to adult care.BackgroundThe transfer from paediatric to adult care for emerging adults living with type 1 diabetes mellitus is a critical period that can impact their well‐being and long‐term health outcomes. Diabetes specialist nurses play a crucial role in supporting these individuals during the transitions in emerging adulthood. However, their experiences and challenges in providing optimal support have not been extensively studied.MethodWe used a qualitative descriptive design. Ten diabetes nurse specialists from six different Swedish hospitals participated in recorded individual interviews by video link or face‐to‐face using a semistructured interview guide. Data collection spanned from May to December 2023, and the data were analysed with qualitative content analysis. Informed consent was obtained.ResultsThe main theme of the results was ambition to optimise individual support but with hands tied by structural barriers with three additional themes concentrating on the individual and the relationship, emphasising long‐term objectives in self‐management support, and struggling with obstacles to providing accessible care. The results indicate that while diabetes specialist nurses focus on building strong relationships and emphasise long‐term goals in self‐management support, they encounter significant obstacles when providing accessible care after the transfer to adult care.ConclusionDiabetes specialist nurses highlighted a need for education and training that extends beyond simply managing the medical condition, considering various life transitions and psychosocial challenges. The findings indicate that future standards for supportive interventions should prioritise existential and psychosocial factors. There is a lack of systematic national consensus on collaboration, as the diabetes specialist nurses reported differing experiences regarding transfers and continuity of care.

Multimanipulator robotic cells are increasingly employed to satisfy stringent cycle‐time and dexterity requirements through parallel operations and coordinated multiarm actions. The increased co‐occupancy of shared workspaces elevates self‐ and inter‐robot collision risks and complicates motion coordination. This study presents a hierarchical closed‐loop control architecture that integrates high‐level multiagent reinforcement learning (MARL) for global strategy with a low‐level motion layer based on enhanced optimized normalized dynamic movement primitives (ON‐DMP*). The ON‐DMP* model automates parameter selection, eliminates manual tuning, generating smooth and collision‐aware joint trajectories in real time. At the supervisory level, the MARL coordinator dynamically resolves contention in overlapping regions, assigns subgoals, and adapts to disturbances based on shared feedback. Experimental validation on assembly and disassembly tasks with temporal and spatial overlap demonstrates consistent avoidance of self‐ and mutual‐collision, improved coordination smoothness, and reduced task completion time compared to reinforcement learning‐based and noncooperative movement primitive baselines. The results indicate a versatile approach to scalable cooperative manipulation in shared work environments. Video Link: https://youtu.be/G‐ON6DK62YQ

This study aims to develop a Canva-based Interactive E-Module for Hadith Science to improve the quality of learning media for grade XI students of MA Al-Mukmin Ngruki. The study used a research and development (R&D) approach with the ADDIE model, including the stages of analysis, design, development, implementation, and evaluation. The needs analysis showed that most students had difficulty understanding abstract concepts such as sanad, matan, and hadith classification and preferred interactive digital learning media. The design and development stage resulted in a module that integrates text, visualisations, diagrams, interactive quizzes, and video links according to multimedia learning principles. Validation by material and media experts obtained an average score of 4.45 (89%) and 4.35 (87%), and was declared very feasible. Implementation on 30 students as trial participants obtained a score of 4.32 (86%), indicating the module is effective in facilitating understanding, increasing motivation, and active involvement of students. Formative evaluation included revisions to the glossary, typography, and examples of hadith. The results of the study prove that the Canva-based interactive E-Module is able to be an innovative, interesting, and effective learning medium in supporting the understanding of Hadith Science for the younger generation.

Robotic surgery alone will not close the surgical gap in low- and middle-income countries. Telesurgery, in which a remote expert directly controls instruments on a local robotic platform, is technically possible but expensive, bandwidth heavy, and does little to strengthen local capacity. In contrast, telementoring uses relatively simple video and audio links to allow experienced surgeons to supervise and guide on site teams, supporting skill acquisition and autonomy using low cost, low bandwidth infrastructure that is already widely available. Its use is expanding across urology, gynaecology, thoracic, cardiac, head and neck, and general surgery. By enhancing accuracy, field of vision and ergonomics for locally based surgeons, and by raising minimally invasive rates beyond those achievable with laparoscopy alone, robotics combined with telementoring offers a more sustainable route to improving access to safe surgery than remote robotic operating.

Introduction: Swarm debrief is one of the Patient Safety Incident Response Framework (PSIRF) learning response methods [1]. It is a group debrief aimed at fostering collective, system-based learning, used immediately after any event where there is something new to learn. During the implementation of PSIRF in our trust, a gap in Swarm debriefing skills was identified, and the simulation and human factors team was asked to provide educational support. In collaboration with the patient safety team and input from the NHS England PSIRF team, we developed a systems-based Swarm guide and an accessible, engaging audio-visual (AV) Swarm simulation to illustrate a more realistic ‘work-as-done’ example [2]. Methods: A fictional patient incident was scripted, drawing inspiration from recent incident reviews and our own collective clinical experiences as healthcare professionals. The script mirrored the debriefing prompts and system-based questions within the Swarm guide so that viewers could review the guide and video concurrently. The video, featuring a nurse manager, doctor, nurse, and healthcare assistant, depicts a simulated Swarm debrief held in the manager’s office (Figure 1). Filmed on a smartphone and edited using Mac and CapCut software, the 15-minute video was enhanced with subtitles to improve accessibility and engagement. The video has been shown to over 100 learning response leads as part of their formal Swarm debriefing training. The Swarm guide and video link are also hosted on our website and are freely available on YouTube, making these resources accessible to a wider audience. Results: Participants in the Swarm debrief training filled out a post-course survey, where 96.67% rated the video as “very helpful” in enhancing their understanding of a Swarm debrief. Participants described the video as “relatable,” “clear,” and “confidence-building,” noting that it helped clarify the process and provided a relevant and safe example for discussion. Faculty observed that the use of the video within the course enhanced participant engagement and reflective practice. Discussion: This AV simulated example of a Swarm debrief demonstrates how low-cost, low-tech media can be produced to enhance staff education and support PSIRF implementation. Video-based learning offers a powerful modality for teaching these complex skills, allowing learners to observe key interactions directed by the Swarm guide and reflect on the process [3]. This video provides a clear example of how a Swarm debrief should unfold in the real world, making this abstract concept more tangible. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.