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BackgroundSleep plays an essential role in the psychological and physiological functioning of humans. A report from the Centers for Disease Control and Prevention (CDC) found that sleep duration was significantly reduced among US adults in 2012 compared to 1985. Studies have described a significant association between listening to soothing music and an improvement in sleep quality and sleep duration. YouTube is a platform where users can access sleep-aiding music videos. No literature exists pertaining to the use of sleep-aiding music on YouTube. ObjectiveThis study aimed to examine the patterns of viewing sleep-aiding music videos on YouTube. We also performed a content analysis of the comments left on sleep-aiding music video posts, to describe the perception of users regarding the effects of these music videos on their sleep quality. MethodsWe searched for sleep-aiding music videos published on YouTube between January 1, 2012, and December 31, 2017. We sorted videos by view number (highest to lowest) and used a targeted sampling approach to select eligible videos for qualitative content analysis. To perform the content analysis, we imported comments into a mixed-method analytical software. We summarized variables including total views, likes, dislikes, play duration, and age of published music videos. All descriptive statistics were completed with SAS statistical software. ResultsWe found a total of 238 sleep-aiding music videos on YouTube that met the inclusion criteria. The total view count was 1,467,747,018 and the total playtime was 84,252 minutes. The median play length was 186 minutes (IQR 122 to 480 minutes) and the like to dislike ratio was approximately 9 to 1. In total, 135 (56.7%) videos had over 1 million views, and 124 (52.1%) of the published sleep-aiding music videos had stayed active for 1 to 2 years. Overall, 4023 comments were extracted from 20 selected sleep-aiding music videos. Five overarching themes emerged in the reviewed comments, including viewers experiencing a sleep problem, perspective on the positive impact of the sleep-aiding music videos, no effect of the sleep-aiding music videos, time to initiation of sleep or sleep duration, and location of viewers. The overall κ statistic for the codes was 0.87 (range 0.85-0.96). ConclusionsThis is the first study to examine the patterns of viewing sleep-aiding music videos on YouTube. We observed a substantial increase in the number of people using sleep-aiding music videos, with a wide variation in viewer location. This study supports the hypothesis that listening to soothing music has a positive impact on sleep habits.

Background: This study examined the association between participation in school-based and/or community-based activity and major depressive episodes (MDE) in adolescents using nationally representative data. Methods: This study utilized cross-sectional data from the National Survey of Drug Use and Health from 2015 to 2019. Nine screening questions determined the presence of past-year MDE in adolescents ages 12-17 (n = 67,033). Participants indicated past-year participation in school-based (eg, team sports, cheerleading, choir, band, student government, or clubs) and/or community-based activities (eg, volunteer activities, sports, clubs, or groups). Sociodemographic variables included sex, race/ethnicity, family income, and age. Descriptive statistics, univariable and multivariable regression analyses were conducted. The multivariable model included interaction terms between age and sex, and age and race/ethnicity. Results: Overall, 14% of the sample met the criteria for having MDE. The odds of MDE increased with age. Joint effects of age and sex, and age and race/ethnicity significantly influenced the association between MDE and school- or community-based activities. Participation in 1+ community-based activities was protective for MDE across all races/ethnicities. Conclusions: Findings help illuminate the direct association of school- and community-based activity participation on MDE risk in adolescents, improving our understanding of MDE across various sociodemographic subgroups in an adolescent population. Schools should aim to facilitate equitable programming and endorse adolescent participation in multiple activities throughout the year. Schools should examine the resources available and consider partnerships that would bolster resources, access, and social capital throughout the community.

Eosinophilic esophagitis (EoE) is a chronic immune and antigen-mediated disease of the esophagus. EoE is the second most common cause of esophagitis and the dominant cause of food impaction in children and adolescent patients. As per guidelines, the diagnosis of EoE is mainly based on clinical and histologic data that requires the presence of symptoms of esophageal dysfunction and eosinophils in esophageal biopsies in the absence of secondary causes to make a definitive diagnosis. The clinical presentation of EoE in the pediatric population depends mainly on the patient's age and ability to report symptoms promptly. While there is no cure for EoE, the recommended treatments, including dietary elimination, pharmacological therapy, or a combination of both, have effectively managed this chronic condition. Dupilumab, approved by the US Department of Food and Drug Administration in 2022, is the first approved EoE therapy for children ages 12 and older. [ABSTRACT FROM AUTHOR]

Pediatric inflammatory bowel disease (IBD) is a chronic, life-threatening gastrointestinal tract disease that usually involves the terminal ileum, cecum, colon, and perianal area. There has been a growing incidence of IBD reported worldwide, and it is becoming an increasing concern for pediatric health care. This discussion covers the global significance, the subtypes, diagnostic criteria, and advances in pediatric IBD management. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the association between race and concussion diagnosis as well as the association between race and mechanism of injury (MOI) for concussion diagnoses in adult patients (>19 years old) visiting the emergency department (ED). A retrospective analysis of patient visits to the ED for concussion between 2010 and 2018, using the National Hospital Ambulatory Medical Care Survey, was conducted. Outcome measures included concussion diagnosis and MOI. Multivariable and multinomial logistic regression analyses were conducted to assess associations between race and outcome variables. The results were weighted to reflect population estimates with a significance set at p < 0.05. Overall, 714 patient visits for concussions were identified, representing an estimated 4.3 million visits nationwide. Black adults had lower odds of receiving a concussion diagnosis [p < 0.05, Odds Ratio (OR), 0.54; 95% Confidence Interval (CI), 0.38–0.76] compared to White adults in the ED. There were no significant differences in MOI for a concussion diagnosis by race. Racial differences were found in the ED for concussion diagnosis. Disparities in concussion diagnosis for Black or other minoritized racial groups could have significant repercussions that may prolong recovery or lead to long-term morbidity. [ABSTRACT FROM AUTHOR]

There are limited data on health service use and cost in low-income children with type 1 diabetes. This study examined the pattern of use and cost of health care services among low-income children diagnosed with type 1 diabetes in the state of Alabama Medicaid program. The authors performed descriptive analysis and examined factors that influence cost and health service utilization. Results showed that 5638 children with type 1 diabetes were enrolled in the Medicaid program over 7 years. Direct medical costs for patients with type 1 diabetes increased at a rate substantially higher than total Medicaid spending. White children with type 1 diabetes were found to have significantly higher Medicaid spending and service utilization than Black children with type 1 diabetes, while Hispanic children had the lowest costs. Further, older children with type 1 diabetes were found to have significantly higher Medicaid spending and service utilization than younger children with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background Inpatient care for patients with eosinophilic esophagitis (EoE) is thought to be uncommon, there are few data on inpatient care costs for individuals with EoE. The purpose of this study was to assess trends in inpatient admissions for EoE and examine factors that drive hospitalization costs. Methods We examined EoE hospitalizations using ICD-9/10 codes, from 2010-2016 in the National Inpatient Sample. We also identified the diagnosis-related group codes, current procedural terminology codes, and common symptom codes documented during admission. We conducted 2 main analyses, primary (all EoE-related hospitalizations) and secondary (hospitalization with a primary diagnosis for EoE), and a sensitivity analysis using only hospitalizations with the secondary diagnosis for EoE, to determine the trend and cost of EoE-related hospitalizations. We used univariate and multivariate models to evaluate the effect of factors that drive hospitalization on total costs. Results Our primary analysis showed that an estimated total of 33,467 EoE-related hospitalizations occurred in the US between 2010 and 2016, representing approximately 13 per 100,000 hospitalizations in the US. The admission rate increased by approximately 70% from 2010-2016 (9.26 to 15.75 per 100,000 hospitalizations), while the total annual and mean inflation-adjusted per-patient costs for EoE-related admissions were $24 million per year and $5135 (standard deviation $153), respectively. Patients and hospital characteristics were independently associated with cost of hospitalization. Conclusion The rate of hospital admission for EoE has markedly increased in the US, as has the mean cost for EoE-related hospitalization, at a rate tenfold that of inflation from 2010-2016. [ABSTRACT FROM AUTHOR]

Elemental diets, dietary elimination, and steroid therapies are the most common therapies in the clinical trials for eosinophilic esophagitis (EoE). Histological findings (usually reported as eosinophils per microscopic high‐powered field [hpf]) remain the most common end‐point used to define response. Yet, the threshold for defining “response” and “remission” are ill‐defined among consensus guidelines and may vary from study to study. We conducted a systematic literature review of articles on eosinophilic esophagitis, published between January 2007 and November 2017, considering histological remission as the primary outcome. We abstracted treatment information and definitions of histological remission or response. A comparison of definitions of histological remission across and within institutions was performed. A total of 61 articles were included in this review, with approximately 60% of the studies published from centers in the United States. Histological definitions of remission of EoE ranged from 0 to ≤20 eosinophils/hpf. The most stringent criteria, ranging from 0 to ≤5 eosinophils/hpf, were commonly used in interventional trial studies that examined the effects of new treatments. We found remarkable variability in definitions between studies, treatment types, and regions. Age or epidemiological distribution of study subjects did not influence the criteria for histological remission. Clinical and histological improvements are important measures of the effects of treatment. Histological findings, the most objective measure of treatment, should provide an optimal method for comparing the effectiveness of various treatments. Yet, our findings suggest a lack of consistent remission criteria in published studies. Considering these inconsistencies, it is difficult to compare the effectiveness of various treatments. [ABSTRACT FROM AUTHOR]

Objectives: To assess the time from linkage to care and viro-immunologic parameters before and after implementation of the Centers for Disease Control and Prevention's 2006 revised human immunodeficiency virus (HIV) testing strategy. Methods: Case reports from South Carolina's enhanced HIV/AIDS (acquired immunodeficiency syndrome) Reporting System were used to compare time to linkage to care and viro-immunologic indicators at diagnosis and 1 year after diagnosis of HIV in individuals diagnosed between 2004 and 2006 (n = 2456) with those diagnosed between 2008 and 2010 (n = 2118). CD4 T-cell count/percent and viral load tests were used as a proxy for a clinical visit and to determine disease stage. Results: Individuals diagnosed between 2008 and 2010 were less likely than those diagnosed between 2004 and 2006 to be in care after 12 months than within 3 months of HIV diagnosis (adjusted odds ratio [AOR] 0.42, 95% confidence interval [I] 0.34-0.51). Individuals diagnosed between 2008 and 2010 were more likely than those diagnosed between 2004 and 2006 to have high CD4 T-cell counts (>500 cells per cubic millimeter than S200 cells per cubic millimeter; AOR 1.24, 95% CI 1.01-1.51) and have undetectable viral loads 1 year post-HIV diagnosis (AOR 8.42, 95% CI 6.96-10.18). Although period of diagnosis did not predict disease stage 1 year post-HIV diagnosis (AOR 0.99, 95% CI 0.87-1.13), there was a decrease from 13% between 2004 and 2006 to 10% between 2008 and 2010 in the percentage of HIV-only patients at diagnosis who progressed to AIDS 1 year postHW diagnosis. Conclusions: Implementation of routine, opt-out HIV testing resulted in more timely linkage to care and improved viro-immunologic parameters 1 year postdiagnosis when compared with the previous testing recommendations. [ABSTRACT FROM AUTHOR]

Background: Many patients with chronic medical conditions search the internet to obtain medical advice and health information to improve their health condition and quality of life. Diabetes is a common chronic disease that disproportionately affects different race and ethnicity groups in the United States. In the existing literature on the popularity of internet health information seeking among persons with a chronic medical condition, there are limited data on US adults living with diabetes.Objective: This study aims to examine the factors associated with internet health information seeking among US adults living with diabetes and whether there is a disparity in internet health information seeking stratified by race and ethnicity.Methods: We conducted a cross-sectional study using the Health Information National Trends Survey data from 2017 to 2020. We selected our study sample based on respondents' reports on whether they were told they had diabetes, and our primary outcome was internet health information-seeking behavior. We used 2 multivariable logistic regression models to examine the effects of sociodemographic factors and other covariates on the internet health information-seeking behavior of adults with diabetes. Jackknife replicate weights were used to provide bias-corrected variance estimates.Results: Our study sample included 2903 adults who self-reported that they had diabetes. In total, 60.08% (1744/2903) were non-Hispanic White individuals, 46.88% (1336/2850) were men, and 64% (1812/2831) had some college or graduate education. The prevalence of internet health information seeking in this population was 64.49% (1872/2903), and the main factors associated with internet health information seeking included education level (some college vs less than high school: odds ratio [OR] 1.42, 95% CI 1.44-1.88; and college graduate or higher vs less than high school: OR 2.50, 95% CI 1.79-3.50), age (age group ≥65 years vs age group 18-44 years: OR 0.46, 95% CI 0.34-0.63), and household income level (P<.001). In addition, we found significant differences in the effects of predictors stratified by race.Conclusions: The findings from this study suggest that internet health information seeking is common among US adults living with diabetes. Internet health information could influence the relationship between health care providers and adults living with diabetes and improve their self-management and quality of life. [ABSTRACT FROM AUTHOR]

Background: The application of enhanced recovery after surgery principles decreases postoperative complications (POCs), length of stay (LOS), and readmissions. Pharmacoprophylaxis decreases morbidity, but the effect of specific regimens on clinical outcomes is unclear., Methods and Materials: Records of 476 randomly selected adult patients who underwent elective colorectal surgeries (ECRS) at 10 US hospitals were abstracted. Primary outcomes were surgical site infection (SSI), venous thromboembolism (VTE), postoperative nausea and vomiting (PONV), pain, and ileus rates. Secondary outcomes included LOS and 7- and 30-day readmission rates., Results: POC rates were SSI (3.4%), VTE (1.5%), PONV (47.9%), pain (58.1%), and ileus (16.1%). Cefazolin 2 g/metronidazole 500 mg and ertapenem 1 g were associated with the shortest LOS; cefotetan 2 g and cefoxitin 2 g with the longest LOS. No SSI occurred with ertapenem and cefotetan. More Caucasians than Blacks received oral antibiotics before intravenous antibiotics without impact. Enoxaparin 40 mg subcutaneously daily was the most common inpatient and discharge VTE prophylaxis. All in-hospital VTEs occurred with unfractionated heparin. Most received rescue rather than around-the-clock antiemetics. Scopolamine patches, spinal opioids, and IV lidocaine continuous infusion were associated with lower PONV. Transversus abdominis plane block with long-acting local anesthetics, celecoxib, non-anesthetic ketamine bolus, ketorolac IV, lidocaine IV, and pregabalin were associated with lower in-hospital pain severity rates. Gabapentinoids and alvimopan were associated with lower ileus rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches were associated with shorter LOS., Conclusions: Significant differences in pharmacotherapy regimens that may improve primary and secondary outcomes in ECRS were identified. In adult ECRS, cefotetan or ertapenem may be better regimens for preventing in-hospital SSI, while ertapenem or C/M may lead to shorter LOS. The value of OA to prevent SSI was not demonstrated. Inpatient enoxaparin, compared to UFH, may reduce VTE rates with a similar LOS. A minority of patients had a documented PONV risk assessment, and a majority used as-needed rather than around-the-clock strategies. Preoperative scopolamine patches continued postoperatively may lower PONV and PDNV severity and shorter LOS. Alvimopan may reduce ileus and shorten LOS. Anesthesia that includes TAP block, ketorolac IV, and pregabalin use may lead to reduced pain rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches may shorten LOS. Given the challenges of pain management and the incidence of PONV/PDNV found in this study, additional studies should be conducted to determine optimal opioid-free anesthesia and the benefit of newer antiemetics on patient outcomes. Moreover, future research should identify latent pharmacotherapy variables that impact patient outcomes, correlate pertinent laboratory results, and examine the impact of order or care sets used for ECRS at study hospitals.