Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act

Background The Life-Sustaining Treatment (LST) Decisions Act allows withholding and withdrawal of LST, including cardiopulmonary resuscitation (CPR). In the present study, the incidence of CPR before and after implementation of the Act was compared. Methods This was a retrospective review involving hospitalized patients who underwent CPR at a single center between February 2016 and January 2020 (pre-implementation period, February 2016 to January 2018; post-implementation period, February 2018 to January 2020). The primary outcome was monthly incidence of CPR per 1,000 admissions. The secondary outcomes were duration of CPR, return of spontaneous circulation (ROSC) rate, 24-hour survival rate, and survival-to-discharge rate. The study outcomes were compared before and after implementation of the Act. Results A total of 867 patients who underwent CPR was included in the analysis. The incidence of CPR per 1,000 admissions showed no significant difference before and after implementation of the Act (3.02±0.68 vs. 2.81±0.75, P=0.255). The ROSC rate (67.20±0.11 vs. 70.99±0.12, P=0.008) and survival to discharge rate (20.24±0.09 vs. 22.40±0.12, P=0.029) were higher after implementation of the Act than before implementation. Conclusions The incidence of CPR did not significantly change for 2 years after implementation of the Act. Further studies are needed to assess the changes in trends in the decisions of CPR and other LSTs in real-world practice

TriTap: Identifying Finger Touches on Smartwatches

The small screens of smartwatches provide limited space for input tasks. Finger identification is a promising technique to address this problem by associating different functions with different fingers. However, current technologies for finger identification are unavailable or unsuitable for smartwatches. To address this problem, this paper observes that normal smartwatch use takes places with a relatively static pose between the two hands. In this situation, we argue that the touch and angle profiles generated by different fingers on a standard smartwatch touch screen will differ sufficiently to support reliable identification. The viability of this idea is explored in two studies that capture touches in natural and exaggerated poses during tapping and swiping tasks. Machine learning models report accuracies of up to 93% and 98% respectively, figures that are sufficient for many common interaction tasks. Furthermore, the exaggerated poses show modest costs (in terms of time/errors) compared to the natural touches. We conclude by presenting examples and discussing how interaction designs using finger identification can be adapted to the smartwatch form factor

Efficacy of nutritional support protocol for patients with pressure ulcer: comparison of before and after the protocol

Objectives: Because most patients who develop pressure ulcer (PU) are malnourished, additional nutritional support is important for PU improvement. The aim of this study was to investigate the potential benefit of a simple nutritional support protocol in PU improvement. Methods: This study was a comparative before-and-after study, prospectively performed from May to December 2020. Participants were inpatients of Seoul National University Hospital (SNUH), South Korea. Among the patients who developed PU from May to December 2020, those on enteral nutrition were included in the protocol group. Application of the nutritional support protocol was established in May 2020 in SNUH. Serum levels of prealbumin, transferrin, cholesterol, and zinc were measured initially and 2 and 4 wk after protocol application to evaluate clinical course. A tailored regimen that adjusted the amount of protein and trace elements was provided according to consultation with the nutritional support team. Size and Pressure Ulcer Scale for Healing was evaluated every 2 wk by the same nurse in charge of PU. To validate the efficacy of the protocol, patients who developed PU from May to December 2018, were hospitalized for 2 wk, and who received enteral nutrition were selected as a control group. Results: Sixty-one patients were included in the protocol group and 100 were in the control group. The protocol group had a higher proportion of PU improvement (85.2 versus 50%; P < 0.001), daily protein intake (1.6 ?? 3.2 versus 0.9 ?? 0.4; P = 0.048), Braden scale (12.9 ?? 1.8 versus 12.3 ?? 1.8; P = 0.025), and baseline albumin level (3.1 ?? 0.5 versus 2.8 ?? 0.4; P = 0.001) when compared with the control group. Multivariate analysis showed that implementation of the nutritional support protocol was the most effective factor in improving PU (odds ratio, 0.18; 95% confidence interval, 0.089-0.366; P < 0.001). Conclusions: A simple nutritional support protocol was easy to develop and its application contributed significantly to the recovery of PU.N

Schottky Barrier Lowering Induced by Ultrathin Aluminum Oxynitride Interlayer in Metal/SiC Junctions

It is known that the electrical characteristics of SiC Schottky diode depend strongly on the interface energy barrier (Schottky barrier) and lower Schottky barriers bring essential advantages of improving the power efficiency and obtaining the fast switching. In this work, the Schottky barrier of metal/SiC junction is reported experimentally to be reduced significantly with an ultra-thin (down to ~1.0 nm) aluminum oxynitride (AlON) interlayer inserted at the junction interface. It was also found that the contact resistance of junction decreased with the AlON interlayer. The barrier height was lowered by up to 0.8 eV and the reduction was similar for three types of metal with different work function (Pt: 5.65 eV, Ni: 5.01 eV, Cu: 4.33 eV). The adjustment of Schottky barrier with an interlayer is generally considered due to the potential change driven by fixed changes in the interlayer or Fermi-level depinning associated with the suppression of metal-induced gap states. In our case, the Fermi-level pinning factor remained almost unchanged (Fig. 1), implying that the surface states of SiC is NOT the main factor of the observed Schottky barrier reduction. It seems most likely that the Schottky barrier reduction arises from the fixed positive charges in the AlON thin film