Valium. Paxil. Prozac. Prescribed by the millions each year, these medications have been hailed as wonder drugs and vilified as numbing and addictive crutches. Where did this “blockbuster drug” ...phenomenon come from? What factors led to the mass acceptance of tranquilizers and antidepressants? And how has their widespread use affected American culture?
David Herzberg addresses these questions by tracing the rise of psychiatric medicines, from Miltown in the 1950s to Valium in the 1970s to Prozac in the 1990s. The result is more than a story of doctors and patients. From bare-knuckled marketing campaigns to political activism by feminists and antidrug warriors, the fate of psychopharmacology has been intimately wrapped up in the broader currents of modern American history. Beginning with the emergence of a medical marketplace for psychoactive drugs in the postwar consumer culture, Herzberg traces how “happy pills” became embroiled in Cold War gender battles and the explosive politics of the “war against drugs”—and how feminists brought the two issues together in a dramatic campaign against Valium addiction in the 1970s. A final look at antidepressants shows that even the Prozac phenomenon owed as much to commerce and culture as to scientific wizardry.
With a barrage of “ask your doctor about” advertisements competing for attention with shocking news of drug company malfeasance, Happy Pills is an invaluable look at how the commercialization of medicine has transformed American culture since the end of World War II.
NSAIDs for analgesia in the era of COVID-19 Herzberg, Daniel L; Sukumaran, Harry P; Viscusi, Eugene
Regional anesthesia and pain medicine,
2020-September, Letnik:
45, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns ...are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one's likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.
In the current state of innovation in wearable technology, there is a vast array of biomonitoring devices available to record electrocardiogram (ECG) in users, a key indicator of cardiovascular ...health. Of these devices, armband form factors serve as a convenient all-in-one platform for integration of electronic systems; yet, much of the current literature does not address the appropriate electrode location nor contact pressures necessary to achieve reliable system level ECG sensing. Therefore, this paper will elucidate the role of electrode location and contact pressure on the ECG sensing performance of an electronic textile (E-textile) armband worn on the upper left arm. We first carry out an ECG signal characterization to validate the ideal armband electrode placement necessary to measure high quality signals without sacrificing practical assembly of the armband. We then model and experimentally quantify the contact pressure between the armband onto the upper arm as a function of armband size, a critical parameter dictating skin-electrode impedance and ECG signal quality. Finally, we evaluate how the size of the armband form factor affects its ECG sensing performance. Our experimental results confirm that armbands exhibiting modeled contact pressures between 500 Pa to 1500 Pa can acquire ECG signals. However, armband sizes exhibiting experimental contact pressures of 1297 ± 102 Pa demonstrate the best performance with similar signal-to-noise ratios (SNR) compared to wet electrode benchmarks. The fundamental design parameters discussed in this work serve as a benchmark for the design of future E-textile and wearable form factors with efficient sensing performance.
Abstract Background Rescuer fatigue during cardiopulmonary resuscitation (CPR) is a likely contributor to variable CPR quality during clinical resuscitation efforts, yet investigations into fatigue ...and CPR quality degradation have only been performed in simulated environments, with widely conflicting results. Objective We sought to characterize CPR quality decay during actual in-hospital cardiac arrest, with regard to both chest compression (CC) rate and depth during the delivery of CCs by individual rescuers over time. Methods Using CPR recording technology to objectively quantify CCs and provide audiovisual feedback, we prospectively collected CPR performance data from arrest events in two hospitals. We identified continuous CPR “blocks” from individual rescuers, assessing CC rate and depth over time. Results 135 blocks of continuous CPR were identified from 42 cardiac arrests at the two institutions. Median duration of continuous CPR blocks was 112 s (IQR 101–122). CC rate did not change significantly over single rescuer performance, with an initial mean rate of 105 ± 11/min, and a mean rate after 3 min of 106 ± 9/min ( p = NS). However, CC depth decayed significantly between 90 s and 2 min, falling from a mean of 48.3 ± 9.6 mm to 46.0 ± 9.0 mm ( p = 0.0006) and to 43.7 ± 7.4 mm by 3 min ( p = 0.002). Conclusions During actual in-hospital CPR with audiovisual feedback, CC depth decay became evident after 90 s of CPR, but CC rate did not change. These data provide clinical evidence for rescuer fatigue during actual resuscitations and support current guideline recommendations to rotate rescuers during CC delivery.
Abstract Objective Successful resuscitation from cardiac arrest requires the delivery of high-quality chest compressions, encompassing parameters such as adequate rate, depth, and full recoil between ...compressions. The lack of compression recoil (“leaning” or “incomplete recoil”) has been shown to adversely affect hemodynamics in experimental arrest models, but the prevalence of leaning during actual resuscitation is poorly understood. We hypothesized that leaning varies across resuscitation events, possibly due to rescuer and/or patient characteristics and may worsen over time from rescuer fatigue during continuous chest compressions. Methods This was an observational clinical cohort study at one academic medical center. Data were collected from adult in-hospital and Emergency Department arrest events using monitor/defibrillators that record chest compression characteristics and provide real-time feedback. Results We analyzed 112,569 chest compressions from 108 arrest episodes from 5/2007 to 2/2009. Leaning was present in 98/108 (91%) cases; 12% of all compressions exhibited leaning. Leaning varied widely across cases: 41/108 (38%) of arrest episodes exhibited <5% leaning yet 20/108 (19%) demonstrated >20% compression leaning. When evaluating blocks of continuous compressions (>120 s), only 4/33 (12%) had an increase in leaning over time and 29/33 (88%) showed a decrease ( p < 0.001). Conclusions Chest compression leaning was common during resuscitation care and exhibited a wide distribution, with most leaning within a subset of resuscitations. Leaning decreased over time during continuous chest compression blocks, suggesting that either leaning may not be a function of rescuer fatiguing, or that it may have been mitigated by automated feedback provided during resuscitation episodes.
A neural network for beam background decomposition in Belle II at SuperKEKB Schwenker, B.; Herzberg, L.; Buch, Y. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
April 2023, 2023-04-00, 2023-04-01, Letnik:
1049, Številka:
C
Journal Article
Recenzirano
Odprti dostop
We describe a neural network for predicting the background hit rate in the Belle II detector produced by the SuperKEKB electron–positron collider. The neural network, BGNet, learns to predict the ...individual contributions of different physical background sources, such as beam-gas scattering or continuous top-up injections into the collider, to Belle II sub-detector rates. The samples for learning are archived 1Hz time series of diagnostic variables from the SuperKEKB collider subsystems and measured hit rates of Belle II used as regression targets. We test the learned model by predicting detector hit rates on archived data from different run periods not used during training. We show that a feature attribution method can help interpret the source of changes in the background level over time.
Standardized reporting of data is crucial for out-of-hospital cardiac arrest (OHCA) research. While the implementation of first responder systems dispatching volunteers to OHCA is encouraged, there ...is currently no uniform reporting standard for describing these systems.
A steering committee established a literature search to identify experts in smartphone alerting systems. These international experts were invited to a conference held in Hinterzarten, Germany, with 40 researchers from 13 countries in attendance. Prior to the conference, participants submitted proposals for parameters to be included in the reporting standard. The conference comprised five workshops covering different aspects of smartphone alerting systems. Proposed parameters were discussed, clarified, and consensus was achieved using the Nominal Group Technique. Participants voted in a modified Delphi approach on including each category as a core or supplementary element in the reporting standard. Results were presented, and a writing group developed definitions for all categories and items, which were sent to participants for revision and final voting using LimeSurvey web-based software.
The resulting reporting standard consists of 68 core items and 21 supplementary items grouped into five topics (first responder system, first responder network, technology/algorithm/strategies, reporting data, and automated external defibrillators (AED)).
This proposed reporting standard generated by an expert opinion group fills the gap in describing first responder systems. Its adoption in future research will facilitate comparison of systems and research outcomes, enhancing the transfer of scientific findings to clinical practice.
Qualitative research methodology was used to explore supervisor perceptions of learning style characteristics required for student success in fieldwork. A focus discussion group was used to elicit ...success themes identified by clinicians. These themes were compared to learning style themes previously identified in quantitative studies. Techniques of conversation analysis were used to assess congruence of verbalized themes with participant interactions during the discussion group. Themes that emerged were the importance of teamwork, active experimentation, flexibility, adaptability, and doing. Discussion participants actively modeled teamwork.
PDF
