Comparison of different chest compression positions for use while wearing CBRN-PPE: a randomized crossover simulation trial

Background: The prevailing COVID-19 pandemic forces paramedics to take medical rescue operations using personal protective equipment (PPE) for aerosol-generating procedures (AGP). The use of PPE-AGP may reduce the effectiveness of the procedures performed, including airway management, intravascular access, or chest compression. The goal of the current study was to compare the quality by which a chest compression during simulated COVID-19 resuscitation while wearing PPE-AGP. A secondary goal was to assess provider preferences with standard versus OHD chest compression methods while wearing PPE-AGP.   Methods: This is a randomized cross-over single-blinded study involving 37 paramedics performing 2-min continuous chest compression using two methods: the standard chest compression (CC) method during which the rescuer takes a position to the side of the victim (STD) and over-the-head position (OHD). During cardiopulmonary resuscitation, study participants wore Class C PPE-AGP. Both the order of study participants and compression methods were random. The results were blinded before statistical analysis. The compression rate per minute (CPM), CC depth as well as full chest recoil were measured. The analysis was undertaken using STATISTICA (V13.3EN).   Results : Mean chest compression depth using distinct CC methods varied and amounted to 42 ± 2mm for STD vs. 46 ± 4mm for OHD (p < 0.001). Chest compressions based on the OHD method were associated with a lower frequency of chest compressions (107 ± 7CPM) compared with STD (114.5 ± 8; p< 0.001). A higher percentage of full chest recoil was observed in the case of STD (42 ± 6%) than in the case of OHD (34 ± 10%).   Conclusions: Based on the current simulation trial, it is impossible to clearly determine which method (STD vs. OHD) is more effective in resuscitation with PPE-AGP. Paramedics wearing PPE-AGP achieved better chest compression depth for OHD compared to the STD, however, OHD resuscitation causes a lower degree of full chest relaxation. A further well-designed clinical study looking at efficacy, safety, and outcomes is needed to confirm current results

Statins Impair Antitumor Effects of Rituximab by Inducing Conformational Changes of CD20

Jakub Golab and colleagues found that statins significantly decrease rituximab-mediated complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity against B cell lymphoma cells

Internet evolved : from secondary to primary competitive intelligence data

Primary data is an important source ofinformation for Competitive Intelligence. Traditionally, it has been collected from interviews with stakeholders, talks at conferences and other means of direct interpersonal communication. The role of the Internet in the data collection – if it was used at all – was that of a provider of supplementary secondary data. Here, this approach is challenged and, using three examples of Social Media, it is shown that the Internet can and does provide valuable primary information to the Competitive Intelligence professional. Accordingly, a case is made for a shift of focus in the data collection process

Estudio experimental y teórico de la matriz de scattering de análogos de polvo de Marte

Tesis Univ. Granada. Programa Oficial de Doctorado en: Física y Matemática

Enhancing Guest Participation and Experiences in Events: Case Viaporin Kekri

This thesis is a product-based academic document focusing on enhancing guest participation and experiences in events, with the use of Viaporin Kekri event as a test field. The authors of the thesis were commissioned by the main event coordinator of Viaporin Kekri to bring novelty and innovation into the event by exploring theories on topics as experience design, sensory perception and guest experience and participation. The authors created own theoretical framework by extracting the most important elements from the theory. Thesis’s main aim was to create ready-to-use event guidelines and the objectives to reach the goal were to enhance visitor participation and thus visitor/guest experience of Viaporin Kekri event by designing and testing new concepts for experiences and evaluate prototyped and tested elements by further applying knowledge into the event guidelines. The process of ideating and developing new concepts was concluded as a Service Design process, which involved 6 unique stages of development and research. Each stage has introduced tools and put emphasis on certain elements that are characteristic to the phase, to help the authors explore and reach the knowledge needed in designing enhancing experiences and elements for the event. The document’s main objective was to design event guidelines with practical application of the experience enhancing elements that later were passed on to the Viaporin Kekri 2022 organizing team. The authors focused on exploring the many ways event’s participation and experience can be influenced and manipulated and based on their findings designed elements to be tested during the actual event that happened in November 2021. They were given an incredibly unique opportunity to test ideas and elements on mass audience and draw conclusions that led them to improve initial concepts as well as implement gained knowledge into the design of event guidelines for the product of the thesis. The product of this thesis is concluded as event guidelines that offer recommendations and practical application ready to be used in the upcoming edition of VIaporin Kekri 2022. The product is based on the tested elements and its outcomes gathered after the event in 2021

Causes, Types and Consequences of Municipal Waste Landfill Fires—Literature Review

The amount of municipal waste produced worldwide has seen a significant increase in recent years. The need to store waste is a significant problem in the context of environmental threats and spatial development. Due to the fact that the easiest way to reduce the amount of waste is to incinerate it, and despite the fact that waste incineration plants have existed since the late 1800s, the amount of illegal waste burning and landfills has also increased. Subsurface landfill fires are particularly dangerous, as they can affect the structure of the landfill. Methane also plays an important role in fires as it is flammable and contributes to the spread of fire. In addition, the leachate from incinerated waste is much more dangerous than the leachate from waste in its natural state. The effluents from incinerated waste include heavy metals and persistent organic pollutants, as well as sulphates, chlorides, and polycyclic aromatic hydrocarbons. Other pollutants also end up in the atmosphere. The aim of this article is to present the problem of landfill fires and their impact on air, soil, and water, based on a review of the selected documented fires as well as indicators of fires in the areas in which the authors of this article conducted their research. The article presents an overview of methods and tests, such as dynamic leaching tests, monitoring tests, and lysimetric tests, all of which can be implemented to prevent fires as well as for research purposes after a fire has occurred, so that this article can be utilitarian not only for researchers, but also for decision makers

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications