BACKGROUND AND OBJECTIVES: Child mobile device use is increasingly prevalent, but research is limited by parent-report survey methods that may not capture the complex ways devices are used. We aimed to implement mobile device sampling, a set of novel methods for objectively measuring child mobile device use. METHODS:We recruited 346 English-speaking parents and guardians of children aged 3 to 5 years to take part in a prospective cohort study of child media use. All interactions with participants were through e-mail, online surveys, and mobile device sampling; we used a passive-sensing application (Chronicle) in Android devices and screenshots of the battery feature in iOS devices. Baseline data were analyzed to describe usage behaviors and compare sampling output with parent-reported duration of use. RESULTS:The sample comprised 126 Android users (35 tablets, 91 smartphones) and 220 iOS users (143 tablets, 77 smartphones); 35.0% of children had their own device. The most commonly used applications were YouTube, YouTube Kids, Internet browser, quick search or Siri, and streaming video services. Average daily usage among the 121 children with their own device was 115.3 minutes/day (SD 115.1; range 0.20-632.5) and was similar between Android and iOS devices. Compared with mobile device sampling output, most parents underestimated (35.7%) or overestimated (34.8%) their child's use. CONCLUSIONS:Mobile device sampling is an unobtrusive and accurate method for assessing mobile device use. Parent-reported duration of mobile device use in young children has low accuracy, and use of objective measures is needed in future research.

We compared the use of the GlideScope® and the conventional Macintosh laryngoscope in a simulated difficult airway. The primary hypothesis was that time to intubation would be shorter using the GlideScope® than using the Macintosh laryngoscope.After obtaining approval from the ethics committee and written informed consent, we recruited 60 ASA 1 and 2 patients to our randomized controlled trial. Group G (n=30) had tracheal intubation performed using the GlideScope® and Group M (n=30) were intubated using a Macintosh laryngoscope. We simulated a difficult airway in each patient by having an experienced assistant provide in-line manual stabilization of the head and neck. We recorded the best laryngeal view; difficulty of the tracheal intubation; time taken for successful tracheal intubation; manoeuvre needed to aid tracheal intubation and complications associated with the tracheal intubation.The median Cormack and Lehane grade was significantly better in Group G than Group M. Group G had a significantly shorter intubation time than group M (mean 41.8 s±SD 20.2 vs mean 56.2 s±26.6, P<0.05).The GlideScope® improved the laryngeal view and decreased time for tracheal intubation time when compared with the Macintosh laryngoscope in patients with simulated difficult airway. The GlideScope® may be a good alternative for managing the difficult airway but clinical trials evaluating its use on patients with an actual difficult airway are needed.

Objective Primary outcome was to compare neurodevelopmental outcome at two years in intracytoplasmic sperm injection (ICSI) conceived children versus matched controls. Secondary outcome was to determine incidence of major congenital malformations and study perinatal outcome. Design Prospective cohort study.Setting Tertiary care perinatal centre over a period of 13 months.

SummaryCaesarean section carries a high risk of awareness, especially in the period prior to neonatal delivery. We investigated the concentration of sevoflurane required to maintain bispectral index (BIS) < 60 until delivery occurred. We enrolled 23 parturients into an up-down sequential allocation study. The median effective end-tidal concentration (EC 50 ) of sevoflurane was defined as that which maintained BIS < 60 between skin incision and delivery in 50% of patients. This was calculated using Dixon and Massey's method. Receiver operating characteristic curve analysis was used to establish BIS response probability thresholds. The EC 50 for sevoflurane was 1.22% (1.08-1.33, 95% CI). The probability of maintaining BIS < 60 was < 55% at a concentration of < 1.1%; this increased to 80% at concentrations of 1.2-1.3%. We conclude that sevoflurane concentrations of at least 1.2-1.3% should be administered in uncomplicated Caesarean section, so as to minimise the risk of awareness and recall.

Bispectral index (BIS) values <60 are consistent with a high probability of unconsciousness. An end-tidal concentration of 1.5% sevoflurane maintained BIS values <60 during cesarean delivery, whereas 1% did not. Adverse effects were not seen with the use of larger concentrations of sevoflurane.

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Two methods of measuring the amniotic fluid index (AFI) were subjected to tests of intra- and interobserver reproducibility. In the first method, amniotic fluid in each quadrant was measured by using the deepest pool perpendicular to the floor; in the second method, amniotic fluid in each quadrant was measured by using the deepest pool perpendicular to the uterine contour. Intraobserver and interobserver variability were assessed by using one-way analysis of variance and limits of agreement, respectively. Intraobserver standard deviations were all < 9 mm. When the AFI was measured using the first method, there was an inverse relationship between the interobserver difference and mean values of AFI. Plots of the differences between observers against their means showed that the lower the AFI, the greater the interobserver variability. No such correlation was noted when the AFI was measured by the second method. The limits of agreement (within which 95% of interobserver differences lie) were comparable for the two methods [(-42 mm to 29.4 mm) and (-46.4 mm to 41.6 mm), respectively]. The results suggest that the amniotic fluid index measured by the second method is more reproducible, especially in the presence of reduced amniotic fluid.

EUR). 99.97% of costs was spent on the treatment of female patients. The highest patient numbers were in outpatient care: 30,112 patients. Acute inpatient care (53.2% of total health insurance costs), pharmaceuticals (42.2%) and outpatient care (3% in women) were the main cost drivers, while all other forms of medical care amounted to 1.6% in women. Annual health care treatment cost per patient was 229.387 HUF (849 USD/719 EUR) for women. Conclusions: Acute inpatient care was the major cost driver in the treatment of female infertility. The treatment of patients aged 25-44 accounted for 96.2% of costs.