An experiment with two bottle tops

Two bottle tops are connected by a short length of string. What happens when one is given a short duration push in a direction at right angles to the string? Several answers are provided, plus a supplementary video.

Video Consultation for Parents with a Child Newly Diagnosed with Type 1 Diabetes: A Qualitative Study

Aims With the exception of the coronavirus pandemic, video consultations have not been a part of the standard care for children with diabetes in Germany. The "Virtual Diabetes Outpatient Clinic for Children and Adolescents 2.0" (VIDIKI 2.0) study investigated the effect of monthly and supplementary video consultations on standard care over one year. The qualitative substudy investigated the experiences of families with a child newly diagnosed with type 1 diabetes mellitus (T1DM) who received at least four weekly supplementary video consultations. Methods Guideline-based qualitative interviews were conducted with seven families with children under the age of eight and T1DM onset shortly before study entry. The answers were analyzed using a qualitative content analysis approach, particularly inductive category formation. Results Families of patients with T1DM onset have questions, almost daily, concerning various aspects of insulin therapy. The offer of high-frequency video consultations can reduce the number of trips to the diabetes team, facilitate the organization of daily life and increase the sense of security. Conclusion Video consultations as a supplementary offer of health care, especially after diabetes onset, were considered very helpful by the affected families. High-frequency video consultations may provide a tool to overcome existing deficiencies in specialized diabetes care.

Intraoperative fundus inspection during surgery

Introduction: We describe a technique of intraoperative fundus visualization during anterior segment surgery using an anterior chamber air bubble. Methods: An air bubble that occupies one-half to two-thirds of the anterior chamber is injected via existing corneal incisions at any time during surgery. By focusing downwards and looking through the air bubble, an upright image of the posterior pole of the fundus is seen. The technique is demonstrated in a series of cases in the form of photos and supplementary video files. Results: Visualization of the fundus can be safely and effectively performed regardless of the lens status (phakic/pseudophakic/aphakic) of the eye. This technique allows the posterior pole and up to mid-peripheral fundus to be quickly inspected at any stage of surgery. Conclusion: This technique may help surgeons to briefly inspect the fundus in cases of unusual light reflex or following complicated surgery without any additional instrumentation.

A man with intolerant vomiting

Case presentationA 57-year-old man was in a healthy state until 6 hours before presenting to the emergency department, when he suffered from more than 10 episodes of vomiting after a large meal at lunchtime. On physical examination, vital signs were unremarkable. Tenderness was noted over the epigastrium on palpation. Point-of-care ultrasound (POCUS) of the abdomen is shown in figure 1 and online supplementary video 1.Supplementary videoFigure 1Transverse (A) and longitudinal (B) ultrasonography of the epigastrium.QuestionWhat is the most likely diagnosis?Hypertrophic pylorus stenosisAortic dissectionSuperior mesentery artery (SMA) syndromeVolvulusFor answer see page 2

A keystone solution for major head and neck reconstructions

This ‘How to do it’ lists a range of cases, demonstrated by supplementary video discussion, that explain the refinements of the keystone perforator island flap (KPIF) technique applied to specific sites of the head and neck, with a focus on the elderly. When the P A C E acronym is applied (pain-free, aesthetic outcome, minimal complications, economical) the KPIF technique is a respectable alternative to microvascular surgery, particularly in the elderly, with minimal returns to theatre for vascular impedance problems which are not infrequent in microvascular reconstructions.

Supplementary video to The Wrath of Zemi: Arawak Hurricane Prediction in the Caribbean

Supplementary video to The Wrath of Zemi: Arawak Hurricane Prediction in the Caribbean