Implementation of Crisis Checklists in the Operating Room

Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events. Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education. Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education session followed by crisis event simulation in two operating rooms with high-fidelity models and monitoring equipment. A post-simulation survey was completed by participants regarding their perceptions of crisis checklists and their future value. Results: All respondents (N=16) reported increased preparedness to manage or assist a patient having a perioperative cardiac arrest and malignant hyperthermia crisis event after implementation of the crisis checklists. All respondents suggest implementing the crisis checklists into their daily practice. Conclusions: The respondents’ positive responses display the implementation of operating room crisis checklists’ value and how they assist anesthesia providers in high-stress situations

PERENCANAAN KEBUTUHAN MATERIAL (PKM) PADA PRODUKSI KINCIR ANGIN KAPASITAS 100 WATT

Banda Ace

Cor/log BAN BT a wearable battery powered mHealth data logger and telemetry unit for multiple vital sign monitoring

The wireless data logger system "Cor/log® BAN BT" (CL) allows seamless 24/7 monitoring of relevant vital sign parameters. CL covers the entire period of acute point of care inside the hospital and the recovery period, when first mobility is achieved and when the patient is released into an ambulatory or homecare environment. The CL records the relevant vital signs such as ECG, respiration, pulse oximetry with plethysmogram and movement. The vital data collected with the CL data logger is saved on a memory card for further analysis and is simultaneously transmitted in real-time to a telemedicine server via a smartphone or tablet. The smartphone also provides GPS location information. In addition Cor/log View, an Android™ Application for viewing recorded vital sign data originating from the CL, was developed. CL has also a connector to the generic MedM health cloud. MedM is a generic patient data management system (PDMS) consisting of a cloud portal and a mobile health app. The app runs on Android™, iOS™ and Windows™. The app can connects wirelessly to the CL physiologic monitor and stores the vital signs in the cloud

Filter and processing method to improve R-peak detection for ECG data with motion artefacts from wearable systems

The electrocardiogram (ECG) is one of the most reliable information sources for assessing cardiovascular health and training success. Since the early 1990s, the heart rate variability (HRV), namely the variation from beat to beat, has become the focus of investigations as it provides insight into the complex interplay of body circulation and the influence of the autonomic nervous system on heartbeats. However, HRV parameters during physical activity are poorly understood, mostly due to the challenging signal processing in the presence of motion artefacts. To derive HRV parameters in time (heart rate (HR)) and frequency domains (high frequency (HF), low frequency (LF)), it is crucial to reliably detect the exact position of the R-peaks. We introduce a full algorithm chain where a sophisticated filtering technique is combined with an enhanced R-peak detection that can cope with motion artefacts in ECG data originating from physical activity

Plant Mol.Biol.

Protein array technology has emerged as a new tool to enable ordered screening of proteins for expression and molecular interactions in high throughput. Besides classical solid-phase substrates, such as micro-titre plates and membrane filters, protein arrays have recently been devised with chip-sized supports. Several applications on protein chips have been described, but to our knowledge no studies using plant protein chips were published so far. The aim of this study was to generate Arabidopsis protein chips and to demonstrate the feasibility of the protein chip technology for the investigation of antigen-antibody interactions. Therefore, Arabidopsis cDNAs encoding 95 different proteins were cloned into a GATEWAY-compatible Escherichia coli expression vector. RGS-His6-tagged recombinant proteins were purified in high throughput and robotically arrayed onto glass slides coated either with a nitrocellulose based polymer (FAST slides) or polyacrylamide (PAA slides). Using an anti-RGS-His6 antibody all proteins were detected on the chips. The detection limit was ca. 2–3.6 fmol per spot on FAST slides or 0.1–1.8 fmol per spot on PAA slides. The Arabidopsis protein chips were used for the characterisation of monoclonal antibodies or polyclonal sera. We were able to show that a monoclonal anti-TCP1 antibody and anti-MYB6 and anti-DOF11 sera bound specifically to their respective antigens and did not cross-react with the other 94 proteins including other DOF and MYB transcription factors on the chips. To enable screening of antibodies or other interacting molecules against thousands of Arabidopsis proteins in future, we generated an ordered cDNA expression library and started with high-throughput cloning of full-length cDNAs with GATEWAY technology

Generation of Arabidopsis protein chips for antibody and serum screening

Kersten B, Feilner T, Kramer A, et al. Generation of Arabidopsis protein chips for antibody and serum screening. Plant Molecular Biology. 2003;52(5):999-1010