Resident Education on the Surgical Treatment of Distal Radius Fractures Using a Point-of-View Camera.

Background: In the coronavirus disease 2019 (COVID-19) era, surgical resident education depends largely on virtual materials. With the help of point-of-view (POV) cameras, educational videos have become widely used for surgical training. A video recorded from the surgeon's POV helps demonstrate the procedure. We made training movies of the surgical approach to distal radius fractures for residents using a head-mounted video recording system with a laser point targeting device (LPTD). Methods: A 15-minnute movie of the trans-flexor carpi radialis approach for distal radius fractures was made. A POV camera was assembled with an LPTD and strapped on the surgeon's head. This enabled maintenance of the surgical field while recording the procedure. A shorter version of the clip was also made to investigate trainee preference. We asked 24 trainees to watch the two versions of the video and complete a short questionnaire. Results: All trainees felt that the movie made with a POV camera was more efficient than existing materials. Only 1 (4.2%) felt that the laser pointer hindered the view. Four of the 23 trainees (16.7%) felt dizzy while watching the video. Of the two versions, 16 trainees (66.7%) preferred the shorter, edited version. The average score for the video was 8.42 out of 10. Conclusions: A video recording system in the operating room that uses an LPTD-POV camera is an efficient way to produce educational material, particularly for surgical residents during the COVID-19 era.

An experimental study of animating-based facial image manipulation in online class environments.

Recent advances in artificial intelligence technology have significantly improved facial image manipulation, which is known as Deepfake. Facial image manipulation synthesizes or replaces a region of the face in an image with that of another face. The techniques for facial image manipulation are classified into four categories: (1) entire face synthesis, (2) identity swap, (3) attribute manipulation, and (4) expression swap. Out of them, we focus on expression swap because it effectively manipulates only the expression of the face in the images or videos without creating or replacing the entire face, having advantages for the real-time application. In this study, we propose an evaluation framework of the expression swap models targeting the real-time online class environments. For this, we define three kinds of scenarios according to the portion of the face in the entire image considering actual online class situations: (1) attendance check (Scenario 1), (2) presentation (Scenario 2), and (3) examination (Scenario 3). Considering the manipulation on the online class environments, the framework receives a single source image and a target video and generates the video that manipulates a face of the target video to that in the source image. To this end, we select two models that satisfy the conditions required by the framework: (1) first order model and (2) GANimation. We implement these models in the framework and evaluate their performance for the defined scenarios. Through the quantitative and qualitative evaluation, we observe distinguishing properties of the used two models. Specifically, both models show acceptable results in Scenario 1, where the face occupies a large portion of the image. However, their performances are significantly degraded in Scenarios 2 and 3, where the face occupies less portion of the image; the first order model causes relatively less loss of image quality than GANimation in the result of the quantitative evaluation. In contrast, GANimation has the advantages of representing facial expression changes compared to the first order model. Finally, we devise an architecture for applying the expression swap model to the online video conferencing application in real-time. In particular, by applying the expression swap model to widely used online meeting platforms such as Zoom, Google Meet, and Microsoft Teams, we demonstrate its feasibility for real-time online classes.

Video recording of hand surgeries using a field of view (FOV) matching USB camera module and smartphone in the era of COVID-19.

BACKGROUND: As the online medium has gained in popularity due to the recent coronavirus disease (COVID-19) pandemic, video recording of surgical procedures has become crucial in medical education. Various methods for recording are available but many require professional equipment and experienced personnel. Here, we propose a feasible and acceptable method for video recording of surgeries. METHODS: An M12 mount USB camera, which is based on an Android micro-USB, was utilized. The device was purchased from a website for $32-$40. The camera was mounted between the eyes of the binocular loupes. Surgical procedures were recorded with the camera. The optimal settings were determined according to the types of surgeries. RESULTS: We recorded the following surgical procedures: radial artery superficial palmar branch (RASP) free flap harvest, carpal tunnel release, and free flap operation. The default values were retained for all settings, but the highest image quality (1080 p) was selected with an 8 mm lens. The camera battery was sufficient to record each surgery in its entirety. CONCLUSIONS: The USB camera produced high-quality videos that perfectly matched the surgeon's field of view without the need for additional staff for recording. This low-cost equipment could be widely employed for the recording of educational videos for surgeons, especially in the era of COVID 19.

Quality of Internet Videos Related to Pediatric Urology in Mainland China: A Cross-Sectional Study.

Background: Pediatric urological diseases pose serious threats to children's physical and mental health. The COVID-19 pandemic has resulted in poor pediatric outcomes for cryptorchidism, hypospadias, and testicular torsion. Presently, many people tend to seek health information via social media platforms. This study aims to quantitatively assess the quality of videos as an information source for pediatric urology in mainland China. Methods: In this cross-sectional study, a search was performed on social media platforms (Tiktok, Bilibili, and Weibo) with the search terms "cryptorchidism", "hypospadias", and "testicular torsion". The first 30 results with any search term listed by relevance were selected in each platform. Video features (duration, number of likes, comments, and shares) and video sources were collected. Each video included in the study was assessed using DISCERN, Journal of the American Medical Association (JAMA) Benchmark Criteria, and Hexagonal Radar Schema. A correlation analysis was performed considering video features, video source, DISCERN scores and JAMA scores. Results: A total of 152 videos were included and analyzed. The majority of videos were from physicians (65.8%). According to the DISCERN classification, most videos were rated as "very poor" (48.0%) and "poor" (36.8%). The mean DISCERN and JAMA scores were 36.56 and 2.68, respectively. The duration of videos uploaded by physicians was the shortest (P < 0.001). The video source had no relevance to numbers of "likes", "comments", "shares", DISCERN scores, and JAMA scores (all P-values > 0.05). Other than video duration (P < 0.001), there was no statistically significant difference between groups for any of the recorded or calculated video data (all P values > 0.05). Hexagonal Radar Charts showed the severe imbalance and deficiency of video information. In general, Tiktok videos with the shortest duration received the most numbers of "likes", "comments", and "shares", whereas the overall quality of videos on Weibo was relatively high. Conclusions: Despite most of the videos on social media platforms being uploaded by medical authors, the overall quality was poor. The misleading, inaccurate and incomplete information may pose a health risk to the viewers, especially during the COVID-19 pandemic. Much effort needs to be undertaken to improve the quality of health-related videos regarding pediatric urology.

Assessment of Esophagectomy Videos on YouTube: Is Peer Review Necessary for Quality?

INTRODUCTION: Various online platforms, such as YouTube, are used for surgical education. Esophageal surgery is sophisticated and surgical videos may help reduce the time it takes for surgeons to learn these complicated operations. There is no clear consensus regarding the quality and reliability of esophagectomy videos on YouTube. We aimed to evaluate esophageal surgery videos published on YouTube in terms of quality and reliability. METHODS: The keywords "esophagectomy" and "surgery" were both searched on YouTube and the first 150 results were evaluated. Eighty two videos were included in the analysis. The quality and reliability of the videos were determined using the esophagectomy scoring system (ESS) developed by the authors, the Journal of the American Medical Association benchmark criteria, and the video power index. RESULTS: A total of 82 videos were reviewed. About two-thirds of the videos demonstrated the Ivor Lewis technique and included surgeries performed using the thoracoscopic/laparoscopic method. The videos were analyzed as per the source of the upload: academic (25.7%), industry-sponsored (9.7%), or individual (64.6%). When the scores were compared by the origin of the videos, industry-sponsored videos scored significantly higher than the videos produced by individuals and academic centers (P = 0.01). While the ESS and Journal of the American Medical Association benchmark criteria scores were significantly correlated (P = 0.00), no correlation was found between video length, video power index score, and ESS score. CONCLUSIONS: Conducting a professional evaluation of videos before they are published on YouTube may enhance video quality. Moreover, valuable videos of better quality can be produced by improving the ESS and by assessing more videos.

Social Media for the Dissemination of Educational Videos About Inflammatory Bowel Diseases.

INTRODUCTION: To broadly disseminate 5 user-centered educational videos for patients with inflammatory bowel disease and their family and friends on social media. METHODS: Relevant social media users were iteratively identified based on their online behavior. For each video, 2 different accompanying texts were tested. RESULTS: We reached 4.2 million social media users of whom 320,302 watched at least 50% of the video. A short description resulted in higher view rates than posing an open-ended question. DISCUSSION: We showed the feasibility of large-scale dissemination of health-related educational videos through social media. Our findings can inform future online dissemination approaches of educational content.

Review of the Quality of YouTube Videos Recommending Exercises for the COVID-19 Lockdown.

BACKGROUND: The world is experiencing a pandemic caused by COVID-19. Insufficient physical activity can increase the risk of illness. Trying to replicate a normal search that any user/patient could do in YouTube, the objective of this study was to evaluate the quality of YouTube videos related to home exercises during lockdown and their adherence to World Health Organization (WHO) recommendations. METHODS: A simple search was carried out on YouTube. The first 150 videos were selected. After applying exclusion criteria, 68 videos were analyzed and evaluated. Two statistical analyses based on machine learning techniques were carried out. Videos were classified according to principal component analysis (PCA) models as 'Relevant' and 'Non-Relevant'. Popularity was assessed using the video power index (VPI). Information's quality and accuracy were gauged using the DISCERN scale and global quality score (GQS). Reliability and credibility of information that can be found on health-related websites was assessed using the Health On the Net Code (HONCode). Exercises were evaluated according to WHO recommendations. RESULTS: DISCERN, HONCode, and GQS scored a mean of 2.29, 58.95, and 2.32, respectively. The PCA calculation allowed videos to auto-classify into high- and low-quality videos. CONCLUSIONS: The quality of YouTube videos recommending exercises during lockdown is low and doesn't reflect WHO recommendations. Effective strategies and tools capable of indicating the quality of this information are needed to filter out erroneous or non-rigorous information that may affect people's health. These tools should help any user/viewer to distinguish videos of high and low quality.

How common are high-risk coronavirus contacts? A video-observational analysis of outdoor public place behavior during the COVID-19 pandemic.

Epidemiological evidence and recommendations from the World Health Organization suggest that close face-to-face interactions pose a particular coronavirus transmission risk. The real-life prevalence and nature of such high-risk contacts are understudied, however. Here, we video-observed high-risk contacts in outdoor public places in Amsterdam, the Netherlands, during the COVID-19 pandemic. We found that high-risk contacts were relatively uncommon: Of the 7,813 individuals observed, only 20 (0.26%) displayed high-risk contacts. Further, we qualitatively examined the 20 high-risk contacts identified and found that they occurred disproportionally between affiliated persons engaged in affiliative behaviors. We discuss the potential public health implications of the relatively low incident rate of high-risk contacts.

Evaluation of YouTube laparoscopic hysterectomy videos as educational materials during the COVID-19 era using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) and LAP-VEGaS video assessment tool.

With increasing numbers of laparoscopic hysterectomies, surgical trainees are compelled to learn more about endoscopy. Owing to coronavirus disease-related social distancing requirements, online education has gained prominence. Here, we aimed to investigate the laparoscopic hysterectomy video quality on YouTube using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). YouTube was searched on June 7, 2020 using 'laparoscopic hysterectomy'. Three examiners evaluated videos using Global Operative Assessment of Laparoscopic Skills (GOALS). Subsequently, videos were assessed for their conformity to the LAP-VEGaS and LAP-VEGaS Video Assessment Tool. Interobserver reliability was estimated using intraclass coefficients and Cronbach's alpha. Cochran's Q test was used to determine correlations among quantitative data. The median GOALS score was 21.50. The observers' GOALS scores were significantly correlated. The results showed low conformity to the LAP-VEGaS. YouTube is the most used platform among trainees. The low YouTube video educational quality highlights the necessity for peer review, as trainees increasingly seek such resources during the pandemic.IMPACT STATEMENTWhat is already known on this subject? YouTube is the most commonly used online resource for educational material among surgical trainees. Online videos usually do not undergo a peer-review process. The LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) may be used to assess the educational quality of surgical videos.What do the results of this study add? To our knowledge, this is the first study on the quality of laparoscopic hysterectomy videos available on YouTube and the first study to evaluate YouTube laparoscopic surgery videos using the LAP-VEGaS Video Assessment Tool (VAT). Our study revealed the low educational quality of YouTube laparoscopic hysterectomy videos. The LAP-VEGaS VAT seems to be a valid and practical tool for assessing online laparoscopic hysterectomy videos.What are the implications of these findings for clinical practice and/or further research? Medical communities, especially tertiary care or academic centres, may upload educational peer-reviewed videos for trainees seeking this type of resource, especially during the coronavirus disease pandemic, as surgical education alternatives are limited.

Making Effective Educational Videos for Clinical Teaching.

Prerecorded video content in medical education has become more common. Increasingly accessible technology coupled with the COVID-19 pandemic and subsequent need for distanced learning has greatly increased the interest in and need for high-quality video content. The use of short educational videos to augment other teaching methods has been shown to improve learners' experiences, knowledge retention, and understanding of content. Multiple studies have demonstrated that video education can be a highly effective tool for learning, particularly for hard-to-visualize processes and for procedural education. Videos allow learners to view content at their own pace and revisit materials on demand. In addition, well-designed videos can be repurposed by educators, ultimately reducing time needed to create high-quality educational content. Currently available technology allows educators to create high-quality videos at minimal cost and with a modest investment of time. This article details practical tips for creating high-yield educational videos.

Video-based cognitive-behavioral intervention for COVID-19 anxiety: a randomized controlled trial.

OBJECTIVE: Cognitive-behavioral interventions can be effective for relieving anxiety associated with coronavirus disease 2019 (COVID-19), but complications such as social distancing, quarantine, a shortage of experts, and delayed care provisions have made it difficult to access face-to-face therapeutic interventions. The purpose of this study was to investigate the efficacy of a video-based cognitive-behavioral intervention for reducing COVID-19 anxiety. METHOD: In the present randomized controlled trial, 150 college students with severe COVID-19 anxiety were randomly assigned to either an intervention (n = 75) or a waiting list control (n = 75) group. The intervention group participated in a video-based cognitive-behavioral program consisting of nine 15-20-minute sessions (three days a week for three weeks). Dependent measures included the COVID-19 Anxiety Questionnaire, Short Health Anxiety Inventory, Anxiety Sensitivity Index-3, Somatosensory Amplification Scale, Experience of Parasocial Interaction Scale, and Source Credibility Scale. RESULTS: Participants who were randomly assigned to the cognitive-behavioral program reported high parasocial interaction, source credibility, and satisfaction with the intervention. Eighty percent reported that the video-based intervention was a beneficial alternative to traditional face-to-face therapeutic intervention. At post-treatment evaluation, the video-based cognitive-behavioral intervention group showed a significant reduction in COVID-19 anxiety, health anxiety, anxiety sensitivity, and somatosensory amplification when compared to the wait-listed control group. CONCLUSIONS: This study suggests that video-based cognitive-behavioral interventions can be an affordable, feasible, and effective method to reduce anxiety during a large-scale pandemic.

Guidance for using text, email, and video communication in practices devoted to reproductive medicine.

The prevalence and ease of electronic communication, specifically email through patient portals associated with electronic medical records or via traditional enterprise email clients (e.g., Outlook) and video, have resulted in increased use for rapid communication between practitioners and their patients. Concerns regarding patient privacy and compliance with the regulations of the Health Insurance Portability and Accountability Act (HIPAA) remain a barrier to routine incorporation of electronic communication into practice. Furthermore, capital investment, implementation, and maintenance costs may provide additional barriers. These long-standing concerns have been heightened and tested by the COVID-19 pandemic. Best-practice guidelines for the secure and safe use of electronic communication with reproductive care patients are provided.

BET 2: Video laryngoscopy for patients requiring endotracheal intubation in the emergency department.

A short-cut review of the literature was carried out to examine whether video laryngoscopy (VL) could improve first-pass success and reduce complication rates in ED patients requiring endotracheal intubation, when compared with direct laryngoscopy. Four papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that current evidence suggests VL is likely to improve first-pass success and reduce oesophageal intubation rates, but there is no evidence at present that it improves clinically relevant outcomes. In addition, no difference was found between first-pass success rates in senior/experienced operators, who should use techniques with which they are familiar.

Interactive pedagogical tools could be helpful for medical education continuity during COVID-19 outbreak.

Training and education are essential for medical students. During the COVID-19 outbreak, numerous schools and universities have had to close. Ensuring pedagogical continuity requires alternatives to the traditional classroom, especially in medical education. Usual distance learning tools such as videos and downloadable handouts are not sufficient to promote efficient teaching. Distance learning requires self-motivation and does not give you direct access to your instructor. Some students fear the loss of human contact with an instructor - like asking questions during and after class - which promotes learning, understanding and communication. Moreover, classical distance learning methods do not offer immediate feedback that can help students in their understanding of the lecture. In this context, interactive pedagogic tools (IPT) could be useful for medical education continuity and for maintaining human contact necessary in pedagogy. We briefly evaluated interactive pedagogic tool compared to traditionnal distancial tools on medical students. This study showed the importance to have direct contact with a teacher and feedback during a lecture and to not exclusively perform distance learning without direct interaction and feedback. Hence, in the present context, we encourage teacher to use this type of tools to maintain direct interaction with students - which is essential in pedagogy - and ensure a qualitative pedagogical continuity.

Using video presentation to recruit healthcare workers during COVID-19 pandemic.

During COVID-19 pandemic, the recruitment of new personnel was necessary to guarantee an adequate healthcare level to all patients affected by SARS-CoV-2 virus. In order to deal with the sanitary emergency, unusual selection procedures have been adopted inside the public health system by searching for new healthcare personnel. The recruitment of new candidates with a short self-introduction was very effective and permitted to select 65 nurses.

Pilot Study Using Telemedicine Video Consultation for Vascular Patients' Care During the COVID-19 Period.

BACKGROUND: The aim of this pilot study was to evaluate the effectiveness and patients satisfaction of using telemedicine virtual communications to provide remote health care to vascular patients during the coronavirus disease 2019 (COVID-19) period in China. METHODS: Video calls using WeChat software (Tencent, Shenzhen, China) between patients and vascular surgeons were conducted in a period when there were restrictions and limitations for people' travels in China. At the end of each video call, a short questionnaire was used to evaluate the patient satisfaction level. RESULTS: During the COVID-19 period from 19 February to March 16, 2020, a sample of 114 from 165 (69%) patients was reached after one phone call attempt. One hundred forty-two telemedicine remote communications were made between the two vascular surgeons and 114 patients. The mean age of this cohort of patients were 60 ± 15.2 (range 25 to 90) years old, and 74 (65%) were men. Twenty-five patients (22%) were outside of our province when they received the video call. The mean duration of the video call was 11.0 ± 8.9 minutes. All of the patients thought telemedicine was a good substitute for coming to hospital, and 95% (108/114) of them preferred to have remote telemedicine rather than postpone the appointment. All the patients agreed with the advantages of telemedicine including no infection risks, no need to travel, and no need to wait for long time. All the patients were "satisfied" or "highly satisfied" with the video call and they would like to use telemedicine for follow-up in the future. CONCLUSIONS: Telemedicine virtual communications was effective to provide remote health care with a high patient satisfaction during the COVID-19 period. Telemedicine offers support to vulnerable vascular patients without the need for travel and face-to-face hospital consultation, and so avoided transmission and infection.

Creation of Educational Videos for Patients Undergoing Nonelective Surgery: Tools for the COVID-19 Era.

Currently, there is a lack of reliable patient-centric educational videos in otolaryngology. In light of COVID-19, otolaryngologists have had to see patients through virtual visits and have been encouraged to send patients home after nonelective surgery. Additionally, most hospitals are not permitting patients' family members and caretakers to enter patient rooms, thus often preventing them from receiving adequate education on postoperative care. Embracing educational videos as a valuable tool will improve communication with patients, especially during the times of COVID-19 and beyond. The goal of this commentary is to describe our early lessons learned in developing educational videos in a streamlined, efficient, and accessible format that can be shared among all members of the multidisciplinary and design production team. Background on the use of multimedia to reduce patient anxiety and frustration with surgical interventions is provided.