Are YouTube videos on cutaneous squamous cell carcinoma a useful and reliable source for patients?

A variety of new treatment options for skin cancer patients drives the need for information and education, which is increasingly met by videos and websites [1, 2]. However, distinguishing between high- and low-quality content becomes more difficult as the number of videos increases. Recently, videos addressing patients with melanoma or basal cell carcinoma (BCC) were found to be of predominantly mediocre quality and poor reliability [3, 4]. Until now, no evaluation of videos on cutaneous squamous cell carcinoma (cSCC) has been performed. Furthermore, no patient guideline currently exists for this entity [5–7]. Therefore, we aimed to systematically identify and evaluate videos on cSCC, the worldwide second most common type of skin cancer after BCC [8]. Our results will contribute to shared decision-making and help physicians and patients to select high-quality videos

Assessment of the Quality, Understandability, and Reliability of YouTube Videos as a Source of Information on Basal Cell Carcinoma: Web-Based Analysis

Background: Patients with skin cancer increasingly watch online videos to acquire disease-related information. Until now, no scientific evaluation of the quality of videos available for German-speaking patients with basal cell carcinoma (BCC) has been performed. Objective: In this study, we aimed to identify and evaluate videos about BCC provided on YouTube. Methods: A video search on YouTube was conducted in July 2020, using German BCC-related keywords (eg, “Basalzellkarzinom,” “Basaliom,” “weißer hautkrebs,” and “heller hautkrebs”). The first three pages (ie, 60 videos) were searched by two independent researchers for each keyword. Two authors evaluated videos that met the predefined eligibility criteria. The quality of the information of the videos was evaluated using the DISCERN tool and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The reliability was assessed with the JAMA (Journal of the American Medical Association) criteria score. Subgroup differences were identified using the Kruskal-Wallis test. Results: A total of 41 videos were included in the evaluation. The mean assessment scores were as follows: DISCERN, 3.3 (SD 0.80); GQS, 3.8 (SD 1.1); JAMA, 27.74% (SD 22.1%); understandability, 70.8% (SD 13.3%); and actionability, 45.9% (SD 43.7%). These values indicated that the videos were of medium to good quality and had good understandability, low actionability, and poor reliability. The quality of videos provided by health professionals was significantly higher than that of videos provided by laypersons. Conclusions: Optimization of health-related videos about BCC is desirable. In particular, adaptation to reliability criteria is necessary to support patient education and increase transparency

Airborne observations of peroxy radicals during the EMeRGe campaign in Europe

In this study, airborne measurements of the sum of hydroperoxyl (HO$_2$) and organic peroxy (RO$_2$) radicals that react with nitrogen monoxide (NO) to produce nitrogen dioxide (NO$_2$), coupled with actinometry and other key trace gases measurements, have been used to test the current understanding of the fast photochemistry in the outflow of major population centres. The measurements were made during the airborne campaign of the EMeRGe (Effect of Megacities on the transport and transformation of pollutants on the Regional to Global scales) project in Europe on board the High Altitude and Long Range Research Aircraft (HALO). The measurements of RO$^∗_2$ on HALO were made using the in situ instrument Peroxy Radical Chemical Enhancement and Absorption Spectrometer (PeRCEAS). RO$^∗_2$ is to a good approximation the sum of peroxy radicals reacting with NO to produce NO$_2$. RO$^∗_2$ mixing ratios up to 120 pptv were observed in air masses of different origins and composition under different local actinometric conditions during seven HALO research flights in July 2017 over Europe. Radical production rates were estimated using knowledge of the photolysis frequencies and the RO$^∗_2$ precursor concentrations measured on board, as well as the relevant rate coefficients. Generally, high RO$^∗_2$ concentrations were measured in air masses with high production rates. In the air masses investigated, RO$^∗_2$ is primarily produced by the reaction of O$^1$D with water vapour and the photolysis of nitrous acid (HONO) and of the oxygenated volatile organic compounds (OVOCs, e.g. formaldehyde (HCHO) and glyoxal (CHOCHO)). Due to their short lifetime in most environments, the RO$^∗_2$ concentrations are expected to be in a photostationary steady state (PSS), i.e. a balance between production and loss rates is assumed. The RO$^∗_2$ production and loss rates and the suitability of PSS assumptions to estimate the RO$^∗_2$ mixing ratios and variability during the airborne observations are discussed. The PSS assumption for RO$^∗_2$ is considered robust enough to calculate RO$^∗_2$ mixing ratios for most conditions encountered in the air masses measured. The similarities and discrepancies between measured and PSS calculated RO$^∗_2$ mixing ratios are discussed. The dominant terminating processes for RO$^∗_2$ in the pollution plumes measured up to 2000 m are the formation of nitrous acid, nitric acid, and organic nitrates. Above2000 m, HO$_2$–HO$_2$ and HO$_2$–RO$_2$ reactions dominate the RO$^∗_2$ removal. RO$^∗_2$ calculations by the PSS analytical expression inside the pollution plumes probed often underestimated the measurements. The underestimation is attributed to the limitations of the PSS equation used for the analysis. In particular, this expression does not account for the yields of RO$^∗_2$ from the oxidation and photolysis of volatile organic compounds, VOCs, and OVOCs other than those measured during the EMeRGe research flights in Europe. In air masses with NO mixing ratios ≤ 50 pptv and low VOC/NO ratios, the RO$^∗_2$ measured is overestimated by the analytical expression. This may be caused by the formation of H$_2$O and O$_2$ from OH and HO$_2$, being about 4 times faster than the rate of the OH oxidation reaction of the dominant OVOCs considered

A Systematic Review and Meta-Analysis of Interventions for Actinic Keratosis from Post-Marketing Surveillance Trials

Multiple interventions are available for the treatment of actinic keratosis (AK) showing high efficacy in pivotal trials. However, data from post-marketing surveillance studies have received little attention until now. Here, we systematically investigate interventions for AK from post-marketing surveillance trials as a proxy for real-world efficacy and tolerability. A systematic literature search was conducted in Medline, Embase, and CENTRAL. Pertinent trial registers were hand-searched until 25 March 2020. Results were pooled using a random-effects model to calculate pooled proportions and relative risks (RR) or were described qualitatively. Eleven records with a total sample size of n = 4109 were included. Three of the studies had an active-controlled design, while seven were single-armed. Participant complete clearance ranged from 23.1% for diclofenac sodium 3% gel to 88.9% for ingenol mebutate 0.05% gel. The lesion-specific clearance rate for photodynamic therapy (PDT) was 74% (95% confidence interval (CI) 56–87%). The recurrence rate was significantly higher for diclofenac sodium 3% in comparison to imiquimod 5% cream (RR 1.10, 95% CI 1.02–1.1.8) and ranged from 10.6% for ingenol mebutate 0.015% gel to 23.5% for PDT. Few patients discontinued the trials due to adverse events. The results from the majority of the post-marketing surveillance studies deviated from those of pivotal trials