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BACKGROUND: Internet addiction is an emerging mental health issue in this digital age. Nowadays, children start using the internet in early childhood, thus making them vulnerable to addictive use. Previous studies have reported that the risk of internet addiction tends to be higher in lower-income regions with lower quality of life, such as Indonesia. Indonesia has high risks and prevalence of internet addiction, including in children. Digital interventions have been developed as an option to combat internet addiction in children. However, little is known about what parents and therapists in Indonesia perceive about these types of interventions.
OBJECTIVE: This study aims to investigate the experiences, perceptions, and considerations of parents and therapists regarding digital interventions for combating internet addiction in young Indonesian children.
METHODS: This study used a qualitative exploratory approach through semistructured interviews. We involved 22 parents of children aged 7 to 11 years and 6 experienced internet addiction therapists for children. The interview data were transcribed and analyzed using thematic analysis.
RESULTS: Participants in this study recognized 3 existing digital interventions to combat internet addiction: Google Family Link, YouTube Kids, and Apple parental control. They perceived that digital interventions could be beneficial in continuously promoting healthy digital behavior in children and supporting parents in supervision. However, the existing interventions were not highly used due to limitations such as the apps\' functionality and usability, parental capability, parent-child relationships, cultural incompatibility, and data privacy.
CONCLUSIONS: The findings suggest that digital interventions should focus not only on restricting and monitoring screen time but also on suggesting substitutive activities for children, developing children\'s competencies to combat addictive behavior, improving digital literacy in children and parents, and supporting parental decision-making to promote healthy digital behavior in their children. Suggestions for future digital interventions are provided, such as making the existing features more usable and relatable, investigating gamification features to enhance parental motivation and capability in managing their children\'s internet use, providing tailored or personalized content to suit users\' characteristics, and considering the provision of training and information about the use of interventions and privacy agreements.

As the COVID-19 pandemic lockdowns forced populations across the world to become completely dependent on digital devices for working, studying, and socializing, there has been no shortage of published studies about the possible negative effects of the increased use of digital devices during this exceptional period. In seeking to empirically address how the concern with digital dependency has been experienced during the pandemic, we present findings from a study of daily self-reported logbooks by 59 university students in Copenhagen, Denmark, over 4 weeks in April and May 2020, investigating their everyday use of digital devices. We highlight two main findings. First, students report high levels of online fatigue, expressed as frustration with their constant reliance on digital devices. On the other hand, students found creative ways of using digital devices for maintaining social relations, helping them to cope with isolation. Such online interactions were nevertheless seen as a poor substitute for physical interactions in the long run. Our findings show how the dependence on digital devices was marked by ambivalence, where digital communication was seen as both the cure against, and cause of, feeling isolated and estranged from a sense of normality.

BACKGROUND: eHealth applications can support early mobilization and physical activity (PA) after surgery. This systematic review provides an overview of eHealth services to enhance or record PA after visceral surgery interventions.
METHODS: Two electronic databases (MEDLINE PubMed and Web of Science) were systematically searched (November 2023). Articles were considered eligible if they were controlled trials and described digital devices used to promote PA after visceral surgery. The Cochrane risk of bias (RoB-2) tool was used to determine the methodological quality of studies.
RESULTS: A total of nine randomized controlled studies (RCT) were included in this systematic review. The studies differed with respect to the interventions, surgical indications and evaluation variables. The risk of bias of the individual studies was moderate. The six studies using activity trackers (AT) predominantly showed insignificant improvements in the postoperative step count. The more complex fitness applications could partially reveal significant advantages compared to the control groups and the home-based online training also showed a significant increase in functional capacity.
CONCLUSIONS: Activity tracking alone has so far failed to show clinically relevant effects. In contrast, the more complex eHealth applications revealed advantages compared to usual postoperative care. More high-quality studies are needed for evidence-based recommendations for eHealth services in conjunction with visceral surgery.
UNASSIGNED: HINTERGRUND: eHealth-Anwendungen können die Frühmobilisation und körperliche Aktivität (kA) nach Operationen unterstützen. Dieses systematische Review soll einen Überblick über eHealth-Dienste zur Verbesserung oder Erfassung von kA nach viszeralchirurgischen Eingriffen geben.
METHODS: Zwei elektronische Datenbanken (MEDLINE PubMed und Web of Science) wurden systematisch durchsucht (November 2023). Artikel wurden als geeignet betrachtet, wenn es sich um kontrollierte Studien handelte, die digitale Geräte zur Förderung der kA nach viszeralchirurgischen Eingriffen beschrieben. Zur Bestimmung der methodischen Qualität der Studien wurde das Cochrane Risk of Bias (RoB-2) Tool verwendet.
UNASSIGNED: Neun randomisierte kontrollierte Studien wurden eingeschlossen. Die Studien unterschieden sich hinsichtlich der Interventionen, der chirurgischen Indikationen und der Bewertungsvariablen. Das Biasrisiko der einzelnen Studien war moderat. Die sechs Studien, in denen Aktivitäts-Tracker (AT) verwendet wurden, erzielten überwiegend keine Verbesserungen der Schrittzahl nach der Operation. Die komplexeren Fitnessapplikationen konnten teilweise signifikante Vorteile gegenüber den Kontrollgruppen nachweisen. Ebenso zeigte ein heimbasiertes Onlinetraining eine signifikante Steigerung der funktionellen Kapazität.
UNASSIGNED: Alleiniges AT zeigt bisher keine klinisch relevanten Effekte. Im Gegensatz dazu zeigten die komplexeren eHealth-Anwendungen Vorteile im Vergleich zur üblichen postoperativen Versorgung. Für evidenzbasierte Empfehlungen für eHealth-Dienste in Verbindung mit Viszeralchirurgie sind weitere hochwertige Studien erforderlich.

UNASSIGNED: Acute acquired concomitant esotropia induced by excessive digital device usage, especially smartphones (SAACE), has been increasing over the past few years. Convergence spasm induced by excessive near work has been suggested as a mechanism. Anatomical differences could also potentially contribute to SAACE onset. The present study investigated the conformation of horizontal recti between SAACE patients and normal subjects.
UNASSIGNED: In 15 SAACE patients (SAACE group), the distances between the limbus and insertion of the horizontal recti (LI distance) and the widths of horizontal recti on the insertion (insertion width) were measured. The control group consisted of 30 patients who underwent retinal detachment surgery. Differences in LI distances and insertion widths were compared between SAACE and control groups.
UNASSIGNED: While there were no differences between the two groups for LI distances and insertion widths of lateral recti, there were significantly shorter LI distances for the medial recti in the SAACE group (P<0.05). Moreover, the SAACE group tended to exhibit larger insertion widths of the medial recti. Medial/lateral ratio of LI distances were significantly lower and insertion widths were significantly higher in the SAACE compared to the control group (P<0.05).
UNASSIGNED: Based on the observations of more anterior insertion and larger muscle widths, this suggests there are stronger forces of medial recti in SAACE. In addition to excessive accommodation followed by increases in medial recti tonus, the results also suggest that an anatomical imbalance between lateral and medial recti contributes to esotropia onset following excessive near work.

UNASSIGNED: The range of digital technologies that children use from an early age has expanded significantly. Most studies demonstrate that preschoolers now spend substantially longer on digital devices and start using them at a younger age. Finding a solution for this challenge has research merits and relevance, as the data on benefits and harm of early preschoolers\' exposure to digital devices is contradictory. This poses a need to determine theoretically sound and practically validated criteria that could guide the duration and quality of children\'s exposure to the digital environment.
UNASSIGNED: To review studies that contain recommendations on preschoolers\' exposure to the digital environment, namely, exposure limits and evidence to justify the limitation of preschoolers\' time on digital media.
UNASSIGNED: The analysis starts by identifying theoretical foundations that researchers use in their studies of children\'s behavior in the digital environment. This is followed by an overview of 40 studies that include research papers, official reports, and methodological recommendations made by healthcare and governmental organizations.
UNASSIGNED: The review identified the following ground rules for children\'s exposure to the digital environment: to provide for child\'s interaction with a digital device, to use educational applications that will develop skills appropriate to the child\'s age, to ensure mandatory supervision of children\'s engagement by an adult who limits the exposure according to child\'s age-related capabilities and creates conditions for active exploration of the real rather than a virtual world. Children\'s cognitive development suffers the most from passive intake of digital content.
UNASSIGNED: The data herein can help to develop strategies to promote healthy and educational engagement of children with digital devices and media; however, the review highlights the insufficiency of psychophysiological research that would make it possible to practically validate the recommendations on the duration of preschoolers\' exposure to the digital environment.

OBJECTIVE: To evaluate the association between visual symptoms and use of digital devices considering the presence of visual dysfunctions.
METHODS: An optometric examination was conducted in a clinical sample of 346 patients to diagnose any type of visual anomaly. Visual symptoms were collected using the validated SQVD questionnaire. A threshold of 6 hours per day was used to quantify the effects of digital device usage and patients were divided into two groups: under and above of 35 years old. A multivariate logistic regression was employed to investigate the association between digital device use and symptoms, with visual dysfunctions considered as a confounding variable. Crude and the adjusted odds ratio (OR) were calculated for each variable.
RESULTS: 57.02 % of the subjects reported visual symptoms, and 65.02% exhibited some form of visual dysfunction. For patients under 35 years old, an association was found between having visual symptoms and digital device use (OR = 2.10, p = 0.01). However, after adjusting for visual dysfunctions, this association disappeared (OR = 1.44, p = 0.27) and the association was instead between symptoms and refractive dysfunction (OR = 6.52, p < 0.001), accommodative (OR = 10.47, p < 0.001), binocular (OR = 6.68, p < 0.001) and accommodative plus binocular dysfunctions (OR = 46.84, p < 0.001). Among patients over 35 years old, no association was found between symptoms and the use of digital devices (OR = 1.27, p = 0.49) but there was an association between symptoms and refractive dysfunction (OR = 3.54, p = 0.001).
CONCLUSIONS: Visual symptoms are not dependent on the duration of digital device use but rather on the presence of any type of visual dysfunction: refractive, accommodative and/or binocular one, which should be diagnosed.

Background Digital eye strain has become a serious concern due to the exponential increase in the usage of digital devices in recent years. This study aimed to assess the prevalence of digital eye strain among medical students. Methods A cross-sectional study was conducted over a period of one month, from 15th June to 15th July 2023, among undergraduate medical students at King Khalid University, Aseer Region, Saudi Arabia. An online survey was carried out using a structured questionnaire that was circulated through social media platforms (Facebook, Messenger, Instagram, Telegram, and WhatsApp). Results A total of 300 students were enrolled in this study. The prevalence of ocular problems, in descending order, was as follows: asthenopia had the highest prevalence at 30.5% (94), followed by conjunctivitis at 9.4% (29); squint, glaucoma, and cataract had lower prevalence rates of 3.9% (12), 1.6% (5), and 1.6% (5), respectively. The majority of participants used digital devices for fun (92.9% (286)) and study (95.5% (294)). Significant positive correlations were found between asthenopia and the hours spent on digital devices for studying (r = 0.161, p = 0.005), communication (r = 0.146, p = 0.011), and entertainment (r = 0.206, p < 0.001). Conclusions A substantial number of medical students are experiencing asthenopia. Prolonged usage of these devices is linked to a higher prevalence of asthenopia.

UNASSIGNED: Digital devices such as smartphones, tablets, computers, and laptops are used for various purposes. The digital display quality has been improved, making it less tiring and more favoured among users. This study aimed to review the visual comfort of digital devices and the preferences of digital display settings that enhance the visual comfort experienced by digital device users.
UNASSIGNED: A search of PubMed, EBSCO host MEDLINE Complete, Scopus database, Google Scholar, and manual citation review was conducted, covering the period between 2010 and 2022. The criteria were selected based on the PRISMA statements. The search mainly focused on finding the existing literature on digital devices that contribute to visual discomfort and digital device settings that provide better visual comfort.
UNASSIGNED: The database search resulted in 533 references via the application of Microsoft Excel. There were 28 studies included in the final assessment. Twelve studies accounted for digital devices that contributed to visual discomfort, while another sixteen studies for digital device settings provided better visual comfort.
UNASSIGNED: Digital displays with high luminance contrast, positive polarity and adequate colour were preferred for better visual comfort. Meanwhile, smaller fonts were preferred for desktops and laptops, while larger fonts were favoured for smartphones. This study provides insights for digital display developers to learn and improve their display technology to fit the preferences expressed.

The detection of atrial fibrillation (AF) in patients with cryptogenic stroke (CS) is an essential part of management to limit the risk of recurrence. However, in practice, not all patients who need AF screening are screened, or are screened with significant delays. The disparities of access to examinations, their costs as well as the increasing workload require an evolution of practices both in terms of organization and the type of equipment used. The ubiquity and ease of use of digital devices, together with their evaluation in large population and their expected lower cost, make them attractive as potential alternatives to current equipment at all stages of patient management. However, reliability and accuracy of each digital device for the detection of paroxysmal AF in CS patients should be established before consideration for inclusion in clinical practice. The aim of this short analysis is therefore to review the current practical issues for AF detection in post stroke patients, the potential benefits and issues using digital devices in stroke patients and to position the different digital devices as alternative to standard equipment at each stage of stroke patient pathway. This may help to design future studies for the evaluation of these devices in this context. Under this condition, the time for digital devices to detect AF after stroke seems very close.