Purpose: This study investigated correlations between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients.Methods: With parental consent, 84 children who were placed under moderate or deep sedation with chloral hydrate for examinations from November 19, 2020 to July 9, 2022 were recruited.Results: Patients' average age was 19.9 months. Pediatric neurology patients and those who underwent electroencephalography took significantly longer to achieve sedation with chloral hydrate. There was a negative correlation between the time to achieve sedation and actual sleep time within 24 hours prior to the examination. Positive correlations were found between the actual sleep time 24 hours prior to the examination and the second dose per weight, as well as between the sedation recovery time and awake hours before the examination.Conclusion: Sleep restriction is not an effective adjuvant therapy for chloral hydrate sedation in children, and sedation effects vary according to pediatric patients' characteristics. Therefore, it would be possible to reduce the unnecessary efforts of caregivers who restrict children's sleep for examinations. It is more important to educate parents about safe sedation than about sleep restriction.

Medical imagery require to protect the privacy with preserving the quality of the original contents. Therefore, reversible watermarking is a solution for this purpose. Previous researches have focused on general imagery and achieved high capacity and high quality. However, they raise a distortion over entire image and hence are not applicable to medical imagery which require to preserve the quality of the objects. In this paper, we propose a novel reversible watermarking for medical imagery, which preserve the quality of the objects and achieves high capacity. First, object and background region is segmented and then predicted error histogram-based reversible watermarking is applied for each region. For the efficient watermark embedding with small distortion in the object region, the embedding level at object region is set as low while the embedding level at background region is set as high. In experiments, the proposed algorithm is compared with the previous predicted error histogram-based algorithm in aspects of embedding capacity and perceptual quality. Results support that the proposed algorithm performs well over the previous algorithm.

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