Mediating effect of sleep in the association between social media use and mental health among French adolescents during the COVID-19 sanitary crisis.

OBJECTIVE/BACKGROUND: Social media use could have deleterious effects on mental health through short sleep duration and poor sleep quality among adolescents. This study aimed to investigate the mediating role of both sleep duration and sleep quality in the association between social media use and mental health among adolescents. PATIENTS/METHODS: We used cross-sectional data collected from adolescents in the EXIST pilot project conducted during COVID-19 pandemic. Adolescents self-reported wellbeing (WEMWBS), anxiety and depression (HADS) as mental health outcomes. We used ad-hoc questionnaires to assess social media use during weekdays and weekend days, and sleep duration and quality. Mediation analyses were carried out following Baron and Kenny's method, using adjusted linear regression models. RESULTS: A total of 340 adolescents (13.5 ± 0.6 years, 45.3 % girls) were included. Greater social media use, poorer sleep quality, and shorter sleep duration were associated with poorer mental health. Greater social media use was associated with poorer sleep quality only during the weekend days. The total effect of social media use during weekend days on anxiety (ß = 2.54; 95%CI [-1.59; 6.68]) was significantly conveyed through sleep quality (ß = 1.22; 95%CI [0.17; 2.62]; mediated proportion = 48.0 %) and duration (mediated proportion = 46.8 %). Mediated proportions ranged from 12.5 % to 20.6 % for wellbeing and depression. Mediating effects were not evident during weekdays. CONCLUSIONS: Sleep duration and quality mediated the association between social media use and mental health among adolescents during weekend days but not weekdays. Our findings highlight the importance of promoting healthy social media habits, especially during periods of increased reliance on digital platforms, such as COVID-19 pandemic.

Applying fuzzy logic to estimate the parameters of the length-weight relationship / O uso da lógica fuzzy para estimar os parâmetros da relação entre peso e comprimento

Abstract We evaluated three mathematical procedures to estimate the parameters of the relationship between weight and length for Cichla monoculus: least squares ordinary regression on log-transformed data, non-linear estimation using raw data and a mix of multivariate analysis and fuzzy logic. Our goal was to find an alternative approach that considers the uncertainties inherent to this biological model. We found that non-linear estimation generated more consistent estimates than least squares regression. Our results also indicate that it is possible to find consistent estimates of the parameters directly from the centers of mass of each cluster. However, the most important result is the intervals obtained with the fuzzy inference system.

Resumo Empregamos três procedimentos matemáticos, regressão com mínimos quadrados ordinários com dados log-transformados, estimação não-linear e uma combinação de análise multivariada e lógica fuzzy para estimar os parâmetros da relação peso × comprimento para Cichla monoculus. Nosso objetivo foi apresentar uma abordagem alternativa que considere as incertezas inerentes ao modelo. Observamos que as estimativas da estimação não-linear foram mais consistentes que as obtidas por regressão linear sobre dados log-transformados. Nossos resultados também mostraram que é possível obter estimativas dos parâmetros diretamente dos centros de máximos formados dos grupos por uma análise de agrupamento k-means. No entanto, os resultados mais importantes foram os intervalos obtidos com o sistema de inferência fuzzy.

Applying fuzzy logic to estimate the parameters of the length-weight relationship.

We evaluated three mathematical procedures to estimate the parameters of the relationship between weight and length for Cichla monoculus: least squares ordinary regression on log-transformed data, non-linear estimation using raw data and a mix of multivariate analysis and fuzzy logic. Our goal was to find an alternative approach that considers the uncertainties inherent to this biological model. We found that non-linear estimation generated more consistent estimates than least squares regression. Our results also indicate that it is possible to find consistent estimates of the parameters directly from the centers of mass of each cluster. However, the most important result is the intervals obtained with the fuzzy inference system.

Caesarean delivery rates, determinants and indications in Makassed Hospital, Jerusalem 1993 and 2002.

This study investigated the rising rate of caesarean section (CS) deliveries between 1993 and 2002 (9.4% to 14.4%) and associated factors, including indications for CS and sociodemographic and clinical characteristics based on the register of a major Palestinian teaching hospital. Instrumental deliveries declined from 12.6% to 4.4%. Fetal distress decreased as an indication for CS, while previous CS and breech presentations contributed to the increase. Decision-making for CS needs to frame the benefits and risks of the intervention within the context of women's entire reproductive life-cycle and existing standards of care, avoiding unnecessary and costly CS deliveries to reduce iatrogenic complications and conserve resources.

Caesarean delivery rates, determinants and indications in Makassed Hospital, Jerusalem 1993 and 2002

This study investigated the rising rate of caesarean section [CS] deliveries between 1993 and 2002 [9.4% to 14.4%] and associated factors, including indications for CS and sociodemographic and clinical characteristics based on the register of a major Palestinian teaching hospital. Instrumental deliveries declined from 12.6% to 4.4%. Fetal distress decreased as an indication for CS, while previous CS and breech presentations contributed to the increase. Decision-making for CS needs to frame the benefits and risks of the intervention within the context of women's entire reproductive life-cycle and existing standards of care, avoiding unnecessary and costly CS deliveries to reduce iatrogenic complications and conserve resources

Platypnea-orthodeoxia: management by transcatheter buttoned device implantation.

Dyspnea and arterial desaturation on upright position in elderly subjects is described as platypnea-orthodeoxia syndrome (POS) and in some patients it is due to right-to-left shunt across the atrial septal defect (ASD)/patent foramen ovale (PFO). Surgical closure of ASD/PFO has been the only available treatment option. Buttoned device has been used for occlusion of ostium secundum ASD, PFO associated with presumed paradoxical embolism and cerebrovascular accidents and ASD/PFO in association with other congenital heart defects causing right-to-left shunt. The objective of this article is to describe the use of buttoned device in effectively occluding ASD/PFO to relieve hypoxemia of POS. During a 4-year period ending January 2000, 10 patients, ages 71 +/- 9 (range 60-83) years with POS underwent buttoned device closure of their ASD/PFO. Echocardiographic and balloon-stretched atrial defect sizes were 8 +/- 3 mm and 12 +/- 3 mm, respectively. The ASD/PFO were occluded with devices ranging in size from 25 to 40 mm delivered via 9 French, long, blue Cook sheaths; eight had an additional 25- or 35-mm occluder placed on the right atrial side. The oxygen saturation increased (P < 0.001) from 76 +/- 7% (range 69-86%) to 95 +/- 2% (range 92-98%). No complications were encountered. Relief of symptoms was seen in all patients. Follow-up of 1-36 months (median 12 months) revealed persistent improvement of symptoms. Buttoned device occlusion of ASD/PFO to relieve hypoxemia of POS is feasible, safe, and effective and is an excellent alternative to surgery. Cathet Cardiovasc Intervent 2001;54:77-82.

Comparison of relative coronary Doppler flow velocity reserve to stress myocardial perfusion imaging in patients with coronary artery disease.

To compare relative coronary artery vasodilator reserve (rCVR = CVRtarget/CVRreference) to myocardial perfusion stress imaging, 48 patients with coronary artery stenoses (61% +/- 16%; mean, +/- SD; range, 30%-91%) had measurements of target and reference vessel CVR (Doppler-tipped guidewire). rCVR was computed and compared to stress 201thallium or (99m)technetium-sestamibi myocardial tomography. Compared to 24 patients with negative stress imaging studies, 24 patients with positive stress studies had angiographically more severe stenoses (74% +/- 13% vs. 44% +/- 24%; P = 0.0005) with lower CVR(target) (1.68 +/- 0.55 vs. 2.46 +/- 0.74; P = 0.002) and lower rCVR (0.72 +/- 0.22 vs. 1.0 +/- 0.26; P < 0.003). Based on receiver-operator characteristic (ROC) cut points (CVR > 1.9; rCVR > 0.75), compared to CVR, rCVR had similar agreement (Kappa 0.54 vs. 0.50), sensitivity (63% vs. 71%), specificity (88% vs. 83%), and positive predictive value (83% vs. 81%) with myocardial perfusion tomography. A concordant CVRtarget/rCVR only slightly increased sensitivity, specificity, and positive predictive values (77%, 90%, and 87%, respectively). Although rCVR, like CVR, correlates with stress myocardial perfusion imaging results, rCVR did not have significant incremental prognostic value over CVR alone for myocardial perfusion imaging. However, rCVR does provide additional information regarding the status of the microcirculation in patients with coronary artery disease and complements the CVR for lesion assessment.

Randomized comparison of coronary angiography using 4F catheters: 4F manual versus "Acisted" power injection technique.

Compared with 6F catheters, diagnostic coronary angiographic and ventriculographic images with 4F catheters can be obtained with equivalent results using less radiographic contrast volume. Whether 4F coronary angiography would be superior using a power-assisted, operator-controlled technique compared with manual technique is unknown. To determine whether 4F coronary angiography using operator-controlled power injection (Acist, Minneapolis, MN) was equivalent or superior to the 4F manual technique, 96 unselected patients undergoing transfemoral coronary angiography were randomized to 4F catheter using a power injection or manual technique. Procedural characteristics and angiographic quality scores were analyzed. Comparing the 4F manual with the 4F power-injection technique, coronary angiographic quality scores were equivalent (left coronary artery 4.7 +/- 0.5 vs. 4.7 +/- 0.6, P = 0.99; right coronary artery 4.94 +/- 0.2 vs. 4.88 +/- 0.1, P = 0.21). Left ventriculography scores were lower in 4F Acist with similar contrast volumes. The total study contrast volume was significantly less in the 4F Acist group (119 +/- 35 vs. 149 +/- 49 ml, P = 0.001). Compared with the 4F manual contrast injection technique, diagnostic angiography through 4F catheters with power contrast injection resulted in equivalent coronary angiographic image quality with significantly less radiographic contrast volume.

Coronary angiography using 4 Fr catheters with acisted power injection: A randomized comparison to 6 Fr manual technique and early ambulation.

Coronary angiography using 4 Fr catheters may reduce access site complications, promote better utilization of outpatient facilities, but at a cost of suboptimal image quality. To determine whether 4 Fr diagnostic angiography with power injection (Acist, Minneapolis, MN) was equivalent to 6 Fr manual technique, 101 unselected patients were randomized to transfemoral coronary angiography with 4 or 6 Fr catheters. Procedural characteristics, angiographic quality scores, and results of 90 min ambulation were analyzed. Coronary angiographic quality scores using 4 Fr and 6 Fr catheters were equivalent (left coronary artery 4.73 +/- 0.6 vs. 4.80 +/- 0.65, P = 0.28; right coronary artery 4.98 +/- 90.13 vs. 4.97 +/- 0.16, P = 0.48). However, 4 Fr left ventriculographic image score was lower (4.53 +/- 0.68 vs. 4.83 +/- 0.42, P = 0.0002), attributed, in part, to a smaller injected contrast volume (32 +/- 11 vs. 37 +/- 4 mL, P = 0.001). The total study contrast volume was significantly less in the 4 Fr group (119 +/- 35 vs. 159 +/- 52 mL, P = 0.001). Complications related to early ambulation at 90 min were similar and minimal in both groups. Compared to 6 Fr manual contrast injection technique, diagnostic angiography through 4 Fr catheters with power contrast injection resulted in equivalent coronary angiographic image quality, slightly reduced but diagnostic left ventricular image quality, and significantly less contrast volume. Four Fr angiography facilitates early ambulation without compromising safety and image quality.

Characterization of intra-arterial flow velocity within left coronary to pulmonary artery fistula.

The physiology of a coronary to pulmonary artery fistula has not been well characterized. This case report demonstrates the flow velocity pattern of a coronary fistula to the pulmonary artery which supports the hypothesized physiology that flow is predominantly continuous without a phasic pattern. The flow velocity within a coronary fistula has not been previously demonstrated.

Stroke following injection of a melted suppository.

BACKGROUND AND PURPOSE: Stroke following the intravenous injection of drugs may be secondary to the direct effect of the substance itself or from embolization by the inert vehicle used in the manufacturing process of the drug. CASE DESCRIPTION: We describe a 39-year-old man who developed a left homonymous hemianopia after intravenous injection of a melted suppository. CONCLUSIONS: Paradoxical fat embolism should be added to the possible list of stroke mechanisms in intravenous drug abusers.

Epidermoid-induced pulsating eye.

An otherwise asymptomatic 62-year-old woman had a pulsating but not proptotic eye. Computed tomography showed a low-density mass lesion in the temporal lobe that extended through a defective greater wing of the sphenoid, indented the lateral rectus muscle, and displaced the optic nerve. Magnetic resonance imaging confirmed these findings and showed no enhancement of the lesion by gadolinium. An epidermoid cyst was diagnosed on the basis of its location in the cleavage lines of the temporal lobe, irregular margins, low density by imaging scans, lack of enhancement, and invasion of the orbit. Epidermoid tumors are, therefore, another cause for a pulsating eye.

[Regional circulatory changes in heart failure as affected by intravenous nitroglycerin administration]. / Izmenenie regionarnogo krovoobrashcheniia u bol'nykh s serdechnoi nedostatochnost'iu pod vliianiem vnutrivennogo vvedeniia nitroglitserina.

The effect of nitroglycerin intravenously injected in 23 patients with heart failure (stage A and stage B), on the regional blood circulation (the chest, abdominal cavity, crus and finger) was studied by the method of impedansplethysmography. Various reactivity of capacious and resistive vessels of different vascular regions was found in reply to an intravenous injection of the drug. The redistribution of the venoarterial circulation in the regions studied occurred depending on the changes in the central hemodynamics. While administering nitrates to patients with circulatory failure it is necessary to take into account the state of the central and regional hemodynamics in the initially high total peripheral resistance. The control over changes of the pulse blood filling in different vascular vessels under the influence of nitroglycerin may be sufficiently informative for the choice of individual doses of the vasodilator and the assessment of the effectiveness of the therapy.

[The Ender nailing : state of the art and new improvements. The sliding nailing (author's transl)]. / L'enclouage selon Ender : bilan at améliorations techniques. Le verrouillage coulissant.

The authors, as well as many other people, have encountered some misuses and complications of Ender nailing. Some surgical improvements are pointed out : reduction with a slight valgus, meticulous digging of the hole, sagital precurving of the nails, careful selection of loading criteria. A new device is also described from the Ender nail, that they modified : an Ender nail with a distal screwing slide which allows distal screwing and therefore prevents going down and rotation of the nails. A case study of three comparative series showed the substantial progress which was made possible by these technical improvements, and most of all by the distal sliding screwing.

[Various methods of determining left ventricular stroke volume by using echocardiography]. / Razlichnye sposoby opredeleniia udarnogo ob"ema levogo zheludochka s pomoshch'iu ékhokardiografii.

The determinations of stroke volume (SV) were used with the aid of different formulae in patients with the ischaemic heart disease with areas of akinesia of the left ventricle, and those with the acquired mitral and aortal valve disease, congestive cardiopathy and in healthy individuals. Tetrapolar rheography was used as control. The calculation of SV with echocardiogram of the left ventricle in patients with areas of akinesia of the left ventricle and valvular regurgitation gives unduly high figures. The same data have been obtained in determining the SV with echocardiogram of the mitral valve with relative insufficiency. The figures of SV calculated with the echocardiogram of the aortal valve in patients with the disease of the aortal valve are lower as compared to the rheographic data.