The standard method of chest compression for adults is a two-handed procedure. One-handed external chest compression (ECC) is used in some situations such as during transport of patients who had an ...out-of-hospital cardiac arrest, but the quality of one-handed ECC is still not well known. The distribution of force is related to the quality of chest compression and may affect the risk of injury. This study aimed to determine the differences in the quality and potential safety concern between one-handed ECC and two- handed ECC.
In this randomised crossover study, participants recruited from National Cheng Kung University Hospital and the ambulance team from the fire bureau were asked to perform one-handed and two-handed ECC on the Resusci Anne manikin according to standard 2015 ECC guidelines. The MatScan Pressure Measurement system was used to investigate the compression pressure and force distribution.
Two-handed ECC had better results than one-handed ECC in terms of the median (IQR) depth (51.00 (41.50-54.75) mm vs 42.00 (27.00-49.00) mm, p=0.018), the proportion of depth accuracy (82.05% (13.95%-99.86%) vs 11.17% (0.00%-42.13%), p=0.028) and the proportion of incomplete recoil (0.23% (0.01%-0.44%) vs 2.42% (0.60%-4.21%), p=0.002). The maximum force (45.72 (36.10-80.84) kgf vs 35.64 (24.13-74.34) kgf, p<0.001) and ulnar-radial force difference (7.13 (-16.58 to 21.07) kgf vs 23.93 (11.19-38.74) kgf, p<0.001) showed statistically significant differences. The perceived fatigue of two-handed ECC versus one-handed ECC was 5.00 (3.00-6.00) vs 6.00 (5.00-8.00), p<0.001.
The quality of one-handed ECC, based on depth and recoil, is worse than that of standard two-handed ECC. The pressure and force distribution of one-handed ECC result in greater ulnar pronation of the hand than that of two-handed ECC. One-handed ECC more easily causes operator fatigue. Acknowledging these findings and adjusting training for one-handed ECC would potentially improve the quality of cardiopulmonary resuscitation during transport.
Remote teaching and online learning have significantly changed the responsiveness and accessibility after the COVID-19 pandemic. Disaster medicine (DM) has recently gained prominence as a critical ...issue due to the high frequency of worldwide disasters, especially in 2021. The new artificial intelligence (AI)-enhanced technologies and concepts have recently progressed in DM education.
The aim of this article is to familiarize the reader with the remote technologies that have been developed and used in DM education over the past 20 years.
Mobile edge computing (MEC), unmanned aerial vehicles (UAVs)/drones, deep learning (DL), and visual reality stimulation, e.g., head-mounted display (HMD), are selected as promising and inspiring designs in DM education.
We performed a comprehensive review of the literature on the remote technologies applied in DM pedagogy for medical, nursing, and social work, as well as other health discipline students, e.g., paramedics. Databases including PubMed (MEDLINE), ISI Web of Science (WOS), EBSCO (EBSCO Essentials), Embase (EMB), and Scopus were used. The sourced results were recorded in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart and followed in accordance with the PRISMA extension Scoping Review checklist. We included peer-reviewed articles, Epubs (electronic publications such as databases), and proceedings written in English. VOSviewer for related keywords extracted from review articles presented as a tabular summary to demonstrate their occurrence and connections among these DM education articles from 2000 to 2022.
A total of 1,080 research articles on remote technologies in DM were initially reviewed. After exclusion, 64 articles were included in our review.
are the most frequently used keywords. As new remote technologies used in emergencies become more advanced, DM pedagogy is facing more complex problems.
Artificial intelligence-enhanced remote technologies promote learning incentives for medical undergraduate students or graduate professionals, but the efficacy of learning quality remains uncertain. More blended AI-modulating pedagogies in DM education could be increasingly important in the future. More sophisticated evaluation and assessment are needed to implement carefully considered designs for effective DM education.
This study aimed to investigate the effects of a psychological growth camp in the treatment of adolescents at risk of Internet addiction in Taiwan.
We designed a psychological growth camp to treat ...adolescents at risk of Internet addiction. The CIAS (Chen Internet Addiction Scale) was used to assess the severity of Internet addiction at baseline, immediately after the camp, and at 1-month and 2-month follow-up visits.
A total of 16 participants were recruited, including 10 at risk of Internet addiction and 6 without the risk of Internet addiction. The results indicated that the participants not in a 2-parent family had significantly higher CIAS scores than those in a 2-parent family (p = .034). The participants at risk of Internet addiction exhibited significant improvements in total CIAS score at the time immediately after the camp (p = .033) and at 1-month (p = .001) and 2-month (p = .003) follow-up visits. Moreover, the incidence of possible Internet addiction was not significantly decreased immediately after the camp (p = .056) but was significantly decreased at 1- and 2-month follow-up visits (p < .05) compared with the baseline level. Otherwise, no significant improvements in total CIAS score or subscales were observed at the follow-up visits (p > .05) for the participants not at risk of Internet addiction.
The results indicate that the psychological growth camp without Internet might be effective in treating adolescents with Internet addiction.
The objective of this study was to investigate the effect of job satisfaction on psychological well-being through emotional labor for Taiwanese home-care workers. A total of 316 home-care workers who ...worked in Chiayi, Taiwan, were recruited in this study. Most of the participants were Taiwanese (96.5%). The mean age of the participants was 42.05 ± 12.15 years, and the participants were predominantly female (80%). The mean work experience was 5.64 ± 5.13 years. Job satisfaction, emotional labor, and psychological well-being were measured. Partial least squares structural equation modeling was used to examine the direct and indirect effects on job satisfaction, emotional labor, and psychological well-being. The results demonstrated that the internal factors of job satisfaction had indirect effects on psychological well-being through the mediating effects of surface acting and deep acting. However, it was also observed that the external factors of job satisfaction had indirect effects on psychological well-being through the mediating effect of surface acting but not deep acting. The model explained 57.6% of the variance in psychological well-being. The internal factors of job satisfaction are more important than the external factors affecting psychological well-being through the mediating effect of deep acting. Based on our results, we recommend enhancing the deep acting of emotional labor to improve the psychological well-being of Taiwanese home-care workers.
New programming models have been developed to embrace contemporary heterogeneous machines, each of which may contain several types of processors, e.g., CPUs, GPUs, FPGAs and ASICs. Unlike the ...conventional ones, which use separate programming schemes for different processors of the machine, e.g., OpenMP for the CPU and CUDA for the GPU, the new ones tend to offer a unified programming model to abstract details of heterogeneous computing engines. One such programming model is Halide that is designed for high performance image processing. Halide programmers are allowed to map data and computation to either the CPUs or GPUs through high-level C++ functions, which are converted to various code targets, including x86, ARM, CUDA, and OpenCL, by the Halide compiler. Nevertheless, it becomes complex when the programmers attempt to write a Halide program for cooperative computation on both the CPU and GPU. In this work, we propose the synergistic computing framework that extends Halide to improve program execution performance. Several key issues are tackled, including data coherence, workload partitioning, job dispatching and communication/synchronization, so that the Halide programmers are allowed to take advantage of the heterogeneous computing engines with the two developed C++ classes, one is for static workload partitioning/dispatching and the other is the dynamic counterpart. Furthermore, optimizations are developed to improve performance by generating adequate the CPU code, and eliminating extra memory copies. We characterize and discuss the performance of two image processing programs and our framework on the heterogeneous platforms, i.e., Android Nexus 7 smartphone and x86-based computers. Our results show that significant performance gain can be achieved while the CPU and GPU execute a program synergistically with the proposed framework.
Aerosols and droplets are the transmission routes of many respiratory infectious diseases. The COVID-19 management guidance recommends against the use of nebulized inhalation therapy directly in the ...emergency room or in an ambulance to prevent possible viral transmission. The three-dimensional printing method was used to develop an aerosol inhalation treatment mask that can potentially prevent aerosol dispersion. We conducted this utility validation study to understand the practicability of this new nebulizer mask system. The fit test confirmed that the filter can efficiently remove small particles. The different locations of the mask had an excellent fit with a high pressure making a proper face seal usability. The full-face mask appeared to optimize filtration with pressure and is an example of materials that perform well for improvised respiratory protection using this design. The filtering effect test confirmed that the contamination of designated locations could be protected when using the mask with filters. As in the clinical safety test, a total of 18 participants (10 55.6% females; aged 33.1 + or - 0.6 years) were included in the final analysis. There were no significant changes in SPO.sub.2, EtCO.sub.2, HR, SBP, DBP, and RR at the beginning, 20th, 40th, or 60th minutes of the test (all p >.05). The discomfort of wearing a mask increased slightly after time but remained within the tolerable range. The vision clarity score did not significantly change during the test. The mask also passed the breathability test. The results of our study showed that this mask performed adequately in the fit test, the filtering test, and the clinical safety test. The application of a full-face mask with antiviral properties, together with the newly designed shape of a respirator that respects the natural curves of a human face, will facilitate the production of personal protective equipment with a highly efficient filtration system. We conducted three independent tests in this validation study: (1) a fit test to calculate the particle number concentration and its association with potential leakage; (2) a filtering effect test to verify the mask's ability to contain aerosol spread; and (3) a clinical safety test to examine the clinical safety, comfortableness, and visual clarity of the mask.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•For HIV genotyping, the undetected minority populations by standard Sanger sequencing (SS) were not always minor.•9–15% of cases with treatment failure/interruption had underestimated drug resistant ...variants accounting for ≥15–25% total viral population.•The study suggested that 10-15% threshold deep sequencing may be considered a suitable substitute for SS on HIV drug resistant mutation detection.
The clinical utilisation of deep sequencing in HIV treatment has been hindered due to its unknown correlation with standard Sanger genotyping and the undetermined value of minority drug resistance mutation (DRM) detection.
To compare deep sequencing performance to standard Sanger genotyping with clinical samples, in an effort to delineate the correlation between the results from the two methods and to find the optimal deep sequencing threshold for clinical utilisation.
We conducted a retrospective study using stored plasma collected from August 2014 to March 2018 for HIV genotyping with the commercial Sanger genotyping kit. Samples with available Sanger genotyping reports were further deep sequenced. Drug resistance was interpreted according to the Stanford HIV drug resistance database algorithm.
At 15–25% minority detection thresholds, 9–15% cases had underestimated DRMs by Sanger sequencing. The concordance between the Sanger and deep sequencing reports was 68–82% in protease-reverse transcriptase region and 88–97% in integrase region at 5–25% thresholds. The undetected drug resistant minority variants by Sanger sequencing contributed to the lower negative predictive value of Sanger genotyping in cases harbouring DRMs.
Use of deep sequencing improved detection of antiretroviral resistance mutations especially in cases with virological failure or previous treatment interruption. Deep sequencing with 10–15% detection thresholds may be considered a suitable substitute for Sanger sequencing on antiretroviral DRM detection.
Abstract
Background
Effective ART is crucial for combating the HIV pandemic. Clinically, plasma viral load monitoring to achieve virological suppression is the guide for an optimal ART. The presence ...of low-level viraemia (LLV) below the definition level of virological failure is a risk factor for ART failure. However, there is no treatment consensus over LLV yet, mainly due to the limitation of standard HIV-RNA genotyping and the resultant insufficient understanding of LLV characteristics.
Objectives
To better profile drug resistance mutations (DRMs) and the associated factors in cases experiencing LLV.
Methods
A prospective observational study was conducted from 2017 to 2019. HIV-DNA was used as an alternative to HIV-RNA for HIV genotyping coupled with deep sequencing for ART-naive and ART-failure cases, as well as those with LLV.
Results
Eighty-one ART-naive, 18 ART-failure and 16 LLV cases received HIV genotyping in the study. Three-quarters (12/16) of cases experiencing LLV harboured DRMs. Cases with LLV had higher prevalence of DRMs to NNRTIs than the ART-naive group (69% versus 20%, P < 0.001), but lower DRM prevalence to NRTIs than the ART-failure group (25% versus 61%, P < 0.001). Approximately half of the LLV cases had issues of suboptimal ART compliance/ART interruption, and 68.8% (11/16) did not display drug resistance to their ART at the time of LLV.
Conclusions
HIV DRM profiles in LLV cases were significantly different to those in ART-naive and ART-failure cases. Approaches to consolidate ART compliance and early exploration of potential ART resistance may be needed for cases experiencing LLV episodes.
Magnesium oxide (MgO) sensing membranes in pH-sensitive electrolyte-insulator-semiconductor structures were fabricated on silicon substrate. To optimize the sensing capability of the membrane, CF4 ...plasma was incorporated to improve the material quality of MgO films. Multiple material analyses including FESEM, XRD, AFM, and SIMS indicate that plasma treatment might enhance the crystallization and increase the grain size. Therefore, the sensing behaviors in terms of sensitivity, linearity, hysteresis effects, and drift rates might be improved. MgO-based EIS membranes with CF4 plasma treatment show promise for future industrial biosensing applications.
Even force distribution would generate efficient external chest compression (ECC). Little research has been done to compare force distribution between one-hand (OH) and two-handed (TH) during child ...ECC. Therefore, this study was to investigate force distribution, rescuer perceived fatigue and discomfort/pain when applying OH and TH ECC in children.
Crossover manikin study. Thirty-five emergency department registered nurses performed lone rescuer ECC using TH and OH techniques, each for 2 min at a rate of at least 100 compressions/min. A Resusci Junior Basic manikin equipped with a MatScan pressure measurement system was used to collect data. The perceived exertion scale (modified Borg scale) and numerical rating scale (NRS) was applied to evaluate the fatigue and physical pain of delivering chest compressions.
The maximum compression force (kg) delivered was 56.58 ± 13.67 for TH and 45.12 ± 7.90 for OH ECC (p < 0.001). The maximum-minimum force difference force delivered by TH and OH ECC was 52.24 ± 13.43 and 41.36 ± 7.57, respectively (p < 0.001). The mean caudal force delivered by TH and OH ECC was 29.45 ± 16.70 and 34.03 ± 12.01, respectively (p = 0.198). The mean cranial force delivered by TH and OH ECC was 27.13 ± 11.30 and 11.09 ± 9.72, respectively (p < 0.001). The caudal-cranial pressure difference delivered by TH and OH ECC was 19.14 ± 15.96 and 26.94 ± 14.48, respectively (p = 0.016). The perceived exertion and NRS for OH ECC was higher than that of the TH method (p < 0.001, p = 0.004, respectively).
The TH method produced greater compression force, had more efficient compression, and delivered a more even force distribution, and produced less fatigue and physical pain in the rescuer than the OH method.
The Cheng Kung University Institutional Review Board A-ER-103-387. http://nckuhirb.med.ncku.edu.tw/sitemap.php.
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