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Preprocedural detailed discussion of the cases between the proctor and the operator occurred via teleconferencing. Successful procedural virtual support was determined by the presence of a session coordinator, high quality of the central camera, high-speed and stable wireless internet connection. Limitations were the relative discomfort of the earpieces, discordance between the central and zoom camera and the absence of visual fixation during head motions.

In a highly complex and demanding context such as TAVR, remote proctoring by means of virtual support is feasible and efficacious.

In a highly complex and demanding context such as TAVR, remote proctoring by means of virtual support is feasible and efficacious.It has become a general practice worldwide to wear a face mask serving as a barrier against the transmission of pathogens. This has prompted us to investigate whether masks could also protect our skin from UV radiation. We have studied eight masks, four surgical and four "homemade" using an in vitro method. The study demonstrated that they all offered protection against both UVB and UVA radiation. As with clothing, fabric masks offer the highest level of protection against UV radiation.

The topical antispasmodic agent l-menthol is commonly used for gastric peristalsis suppression during diagnostic upper gastrointestinal (GI) endoscopy. We evaluated the efficacy and safety of a single dose l-menthol solution in suppressing gastric peristalsis during upper GI endoscopy in Chinese patients.

In this phase III, multicenter, randomized, double-blind, placebo-controlled study (ClinicalTrials.gov NCT03263910), 220 patients scheduled to undergo upper GI endoscopy at five Chinese referral centers received a single dose of either 160mg of l-menthol (n=109) or placebo (n=111). Both treatments were sprayed endoscopically on the gastric mucosa. An independent committee evaluated the degree of gastric peristalsis (peristaltic score grade 1-5).

At baseline, the proportion of patients with grade 1 peristalsis (no peristalsis) did not differ between the groups. The proportion of patients with grade 1 peristalsis post-treatment was significantly higher in the l-menthol group (40.37%, 44/109) versus the placebo group (16.22%, 18/111; P<0.001); the difference between the groups was 24.15% (95% confidence interval 12.67%-35.63%; P<0.001). In the l-menthol group, 61.47% of patients had grade 1 peristalsis after endoscopy versus 24.55% in the placebo group (P<0.001). The ease of intragastric examination correlated significantly with the grade of peristalsis. The incidence of adverse events was comparable between the groups (P=0.340).

During upper GI endoscopy, a single dose of l-menthol solution (160mg) sprayed on the gastric mucosa significantly attenuated gastric peristalsis versus placebo, thereby improving the visual stability without any safety concerns.

During upper GI endoscopy, a single dose of l-menthol solution (160 mg) sprayed on the gastric mucosa significantly attenuated gastric peristalsis versus placebo, thereby improving the visual stability without any safety concerns.Why do people punish selfish behavior? Are they motivated to punish perpetrators of selfishness (retribution) or to compensate the victims of selfishness (restoration)? Developmental data can provide important insight into these questions by revealing whether punishment of selfishness is more retributive or restorative when it first emerges. Across two studies, we examined costly third-party intervention in 6- to 9-year-olds. In Study 1, children learned about a selfish actor who refused to share with a recipient. Children then chose to (1) punish the selfish actor by rejecting their payoff (retribution); (2) compensate the victim of selfishness by equalizing payoffs between the perpetrator and victim (restoration); or (3) do nothing. We found that children were more likely to punish than compensate in response to selfishness, suggesting that intervention in this context is more retributive than restorative. In Study 2, we tested third-party intervention in the face of generosity which, like selfishness, can lead to unequal outcomes. As in Study 1, children in this context could reject unequal payoffs, thereby depriving the recipient of the advantageous payoff but having no effect on the actor. Children could also use compensation in this context, equalizing the payoffs between actor and recipient. We found that children did not punish inequality that stemmed from generosity, suggesting that the retributive punishment in Study 1 was specifically targeting selfishness rather than inequality more generally. These results contribute to the debate on the function of third-party punishment in humans, suggesting that retributive motives toward selfish transgressors are privileged during ontogeny.

The repercussions of the pandemic on patients without COVID-19 have been well documented. Although there is evidence that adult patients present later with complicated appendicitis, the impact on the paediatric population is unknown. Therefore, the aim of this study was to assess the impact of the COVID-19 pandemic on the presentation and management of paediatric appendicitis.

Data from consecutive paediatric patients admitted with right iliac fossa pain to a teaching hospital from 1 March 2020 until 30 June 2020 (COVID-19) were compared with patients admitted from 1 March 2019 until 30 June 2019 (control).

One hundred and seventy-two patients were admitted with right iliac fossa pain (control = 97, COVID-19 = 75). Seven patients had a normal diagnostic laparoscopy in the control group compared with none in the COVID-19 group. The proportion of patients diagnosed with appendicitis was significantly higher during the COVID-19 pandemic (24% vs. 10%, P = 0.03). They presented later (3 days vs. 1 day, P < 0.01) with higher inflammatory markers (white cell count 15.8 vs. AUNP-12 clinical trial 13.2 × 10

cells per litre, P = 0.02; C-reactive protein 53 vs. 27 mg/L P = 0.04). The majority of patients underwent surgery within 1 day of admission (94% COVID-19 vs. 70% control, P = 0.13). Although there was a trend towards a greater proportion of complicated appendicitis (22% vs. 10%, P = 0.6) during COVID-19, this did not affect outcomes (no morbidity in both groups, length of hospital stay 4 vs. 2.5 days, P = 0.29).

Despite presenting later during COVID-19, paediatric patients with appendicitis were treated expediently with good outcomes.

Despite presenting later during COVID-19, paediatric patients with appendicitis were treated expediently with good outcomes.