Trends of Non-Fatal HEMS Accident-Related Injuries

We conducted an investigation into non-fatal helicopter emergency medical service accidents from January 26, 1991 to April 26, 2018 via the National Transportation Safety Board aviation accident database. Over this 28-year timeframe 247 accidents results in 251 fatalities and 179 non-fatal injuries. Exploratory analysis of the data indicate that more non-fatal injuries occurred in September compared to any other month during the study timeframe. Exploratory correlational analysis via elastic net logistic regression concluded that no linear relationship of NTSB accident database data provide insights into what factors are correlated with an increased likelihood of non-fatal injuries. Further, no linear relationships of available variables provide insights into the increased number of non-fatal injuries in September during this investigation’s timeframe. Future research should identify if these null results are due to a true lack or no relationship between available data and non-fatal injuries or if these results are due to inaccessibility to relevant data

The Need for Recategorized Video Game Labels: A Quantitative Approach

Prior research has suggested that video game genre labels are an ineffective method of communicating a game\u27s experience. Our investigation serves to provide a quantitative means of assessing experience communication effectiveness. We assessed game similarities by their associated game genre labels. The ratio between the small number of available developer-generated labels and the number of games led to too few labels to effectively delineate between similar and dissimilar games. The ratio between the large number of user-generated labels and the number of games led to too many labels to effectively cluster similar games with one another. However, games that had matching genres (e.g., direct sequels to each other) led to direct clustering. The result from this analysis provides evidence that this novel method of assessing games\u27 communication experience works as intended and may be used by future research to assess the effectiveness of alternative categorization systems

The Reliability of the Seated Medicine Ball Throw as Assessed with Accelerometer Instrumentation

The Seated Medicine Ball Throw (SMBT) is low-risk, easy to perform, requires minimal equipment, and is a valid measure of upper body explosiveness. The Ballistic Ball™ (BB) medicine ball contains inertial sensors which estimate peak velocity, and transmits these values to an iPad™ app via Bluetooth™. This method of gathering data may be superior to using horizontal distance as there is less chance of confounding factors and it is easier to administer. The objective of this study was to evaluate the reliability of the BB peak velocity measurement in the SMBT. Twenty healthy, rested, recreationally-active, undergraduate students volunteered to participate in this study. After a standard dynamic warm-up, subjects were taught proper throwing technique. For familiarization, subjects performed repeated SMBTs with a 10 lb BB until horizontal distance thrown for 3 consecutive trials was within 0.25m. After 20 minutes of rest, subjects repeated the warm-up protocol, then performed 6 trials with the same 10 lb BB for which peak velocity was recorded. The test-retest reliability of these 6 trials was analyzed using intraclass correlations (ICC). The ICCs between consecutive trials ranged from 0.94 to 0.98. Peak velocity for trials 1-6 were: 3.85±1.14 m/s, 3.86±1.06 m/s, 3.94±1.22 m/s, 3.85±1.13 m/s, 3.95±1.21 m/s, 3.92±1.20 m/s, respectively. The high ICC values suggest excellent reliability of the peak velocity measurement from the BB device. The BB peak velocity as assessed during a SMBT is a reliable method for assessment of upper body explosiveness

The Reliability of the Seated Medicine Ball Throw for Distance

Measuring distance thrown during the Seated Medicine Ball Throw (SMBT) has been used frequently within the literature to quantify upper body explosiveness, due to the test being easy to learn, low-risk, and requiring minimal equipment. The reliability of distance thrown in the SMBT has not been broadly reported, nor have familiarization protocols been thoroughly documented. The purpose of this study is to assess the reliability of distance thrown during the SMBT as a representative measurement for upper body explosiveness in active, recreationally trained adults. Before testing, 20 subjects completed a dynamic warm-up. After learning proper technique, subjects were familiarized with the exercise by completing continuous trials using a 10 lb medicine ball, with 1 minute of rest between trials, until three consecutive throws within 0.25 m were achieved. Subjects rested 20 minutes, repeated the warm-up, and then completed 6 trials of the SMBT where distance of each throw was measured. Any trial in which technique deviated significantly from the instructions was repeated. Intraclass correlation coefficients (ICCs) were used to assess reliability between trials. Distances thrown for trials 1-6 were as follows: 3.43±0.99 m, 3.41±0.95 m, 3.48±1.00 m, 3.48±1.00 m, 3.46±1.03 m, and 3.54±1.05 m respectively. ICCs for consecutive trial pairs ranged from 0.97-0.99. These findings suggest that distance thrown is a reliable representative measure of upper body explosiveness in recreationally trained adults. The familiarization protocol used was sufficient for producing consistent performance

Impact of Critical Narrative on Students’ Abilities to Recognize Ethical Dilemmas in Engineering Work

This study aims to investigate the impact of exposure to critical narratives on students\u27 abilities to recognize ethical dilemmas and broader impacts in engineering work. Critical narratives are place-based stories that engage students and help them enhance their critical thinking skills by making connections between the narratives, broader impacts of engineering work, and their responsibility to address these issues. The effectiveness of the critical narrative intervention was assessed by implementing discussion-based assignments around three critical narratives, which required students to listen to the narrative, respond to focus questions, engage with their peers, and reflect on the process. The intervention was completed by 58 students as part of their ethics module in a senior capstone design engineering course, while a comparison group of 60 students did not receive the intervention. Both groups completed a project-group discussion assignment where they were asked to identify and discuss ethical dilemmas and broader impacts encountered while working on their capstone design projects. Researchers developed a 5-point rubric to evaluate the responses to focus questions and reflections on the process. Results indicated that the study group that received the intervention achieved higher average scores on each of the three criteria that were evaluated, but lower scores on the reflection component. The accompanying paper will discuss the theoretical motivation relying on critical narratives, deployment of the intervention, and statistical analysis of the results

Validation of the GUESS-18: A Short Version of the Game User Experience Satisfaction Scale (GUESS)

The Game User Experience Satisfaction Scale (GUESS) is a 55-item tool assessing nine constructs describing video game satisfaction. While the development of the GUESS followed best practices and resulted in a versatile, comprehensive tool for assessing video game user experience, responding to 55 items can be cumbersome in situations where repeated assessments are necessary. The aim of this research was to develop a shorter version of the scale for use in iterative game design, testing, and research. Two studies were conducted: the first one to create a configural model of the GUESS that was then truncated to an 18-item short scale to establish an initial level of validity and a second study with a new sample to demonstrate cross-sample validity of the 18- item GUESS scale. Results from a confirmatory factor analysis of the 18-item scale demonstrated excellent fit and construct validity to the original nine construct instrument. Use of the GUESS-18 is encouraged as a brief, practical, yet comprehensive measure of video game satisfaction for practitioners and researchers

A murine specific expansion of the Rhox cluster involved in embryonic stem cell biology is under natural selection

BACKGROUND: The rodent specific reproductive homeobox (Rhox) gene cluster on the X chromosome has been reported to contain twelve homeobox-containing genes, Rhox1-12. RESULTS: We have identified a 40 kb genomic region within the Rhox cluster that is duplicated eight times in tandem resulting in the presence of eight paralogues of Rhox2 and Rhox3 and seven paralogues of Rhox4. Transcripts have been identified for the majority of these paralogues and all but three are predicted to produce full-length proteins with functional potential. We predict that there are a total of thirty-two Rhox genes at this genomic location, making it the most gene-rich homoeobox cluster identified in any species. From the 95% sequence similarity between the eight duplicated genomic regions and the synonymous substitution rate of the Rhox2, 3 and 4 paralogues we predict that the duplications occurred after divergence of mouse and rat and represent the youngest homoeobox cluster identified to date. Molecular evolutionary analysis reveals that this cluster is an actively evolving region with Rhox2 and 4 paralogues under diversifying selection and Rhox3 evolving neutrally. The biological importance of this duplication is emphasised by the identification of an important role for Rhox2 and Rhox4 in regulating the initial stages of embryonic stem (ES) cell differentiation. CONCLUSION: The gene rich Rhox cluster provides the mouse with significant biological novelty that we predict could provide a substrate for speciation. Moreover, this unique cluster may explain species differences in ES cell derivation and maintenance between mouse, rat and human

Telerounding: A Scoping Review and Implications for Future Healthcare Practice

Telerounding is slated to become an important avenue for future healthcare practice. As utilization of telerounding is increasing, a review of the literature is necessary to distill themes and identify critical considerations for the implementation of telerounding. We provide evidence of the utility of telerounding and considerations to support its implementation in future healthcare practice based on a scoping review. Method: We collected articles from nine scientific databases from the earliest dated available articles to August 2020. We identified whether each article centered on telerounding policies, regulations, or practice. We also organized information from each article and sorted themes into four categories: sample characteristics, technology utilized, study constructs, and research outcomes. Results: We identified 21 articles related to telerounding that fit our criteria. All articles emphasized telerounding practice. Most articles reported data collected from surgical wards, had adult samples, and utilized robotic telerounding systems. Most articles reported null effects or positive effects on their measured variables. Discussion: Providers and patients can benefit from the effective implementation of telerounding. Telerounding can support patient care by reducing travel expenses and opportunities for infection. Evidence suggests that telerounding can reduce patient length of stay. Patients and providers are willing to utilize telerounding, but patient willingness is influenced by age and education. Telerounding does not appear to negatively impact satisfaction or patient care. Organizations seeking to implement telerounding systems must consider education for their providers, logistics associated with hardware and software, scheduling, and characteristics of the organizational context that can support telerounding. Considerations provided in this article can mitigate difficulties associated with the implementation of telerounding

Reflecting the real value of health care resources in modelling and cost-effectiveness studies-The example of viral load informed differentiated care

BACKGROUND: The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. KEY ISSUES FOR ECONOMIC EVALUATION: The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter's value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. IMPLICATIONS: The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented

Early intervention for lactate dehydrogenase elevation improves clinical outcomes in patients with the HeartMate II left ventricular assist device: Insights from the PREVENT study

BACKGROUND: Hemolysis, assessed by elevated serum lactate dehydrogenase (LDH), is strongly associated with HeartMate II pump thrombosis (PT). However, it is unknown whether early intervention for elevated LDH circumvents the risk of serious PT requiring pump exchange. We sought to evaluate the relationship between elevated LDH and clinical outcomes, the effectiveness of early medical intervention, and risk factors for elevated LDH. METHODS: We studied 268 patients in the prospective, multicenter PREVENT study who had 2 or more LDH measurements at ≥30 days post-implant. Elevated LDH was defined as LDH ≥2.5× upper limit of normal (ULN) for 2 consecutive measurements. RESULTS: Fourteen percent of patients had elevated LDH. Stroke-free survival at 6 months was lower in patients with elevated LDH vs patients with normal LDH (83 ± 6% vs 93 ± 2%, p = 0.035). Elevated LDH resolved without intervention in 19% of patients, with intensified medical therapy in 43% and required surgical intervention in 38%. For patients receiving only medical therapy, survival was 94 ± 6% at 6 months post-treatment. In this subgroup, resolution of symptoms with intensified medical therapy was sustained in 15 of 16 patients, with PT occurring in 1 patient at 171 days after initial treatment for elevated LDH (202 days post-implant). Early medical intervention at moderately elevated LDH (2.5× to 3.2× ULN), as compared with higher levels (>3.2× ULN), led to more sustained resolution of symptoms without subsequent PT or need for surgical intervention (91% vs 26% at 6 months post-treatment, p = 0.002). CONCLUSIONS: Early medical intervention can successfully resolve moderate LDH elevations (2.5× to 3.2× ULN) with a low incidence of death or PT at 6 months post-treatment