Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.

BACKGROUND: Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopulmonary resuscitation (CPR) quality. METHODS: Mock out-of-hospital cardiac arrest simulations that included a 9-1-1 call, CPR, and drone-delivered AED were conducted. Each simulation was timed and video-recorded. CPR performance metrics were recorded by a Laerdal Resusci Anne Quality Feedback System. Multivariable regression modeling examined factors associated with time from 9-1-1 call to AED shock and CPR quality metrics (compression rate, depth, recoil, and chest compression fraction). Comparisons were made among those with recent CPR training (≤2 years) versus no recent (>2 years) or prior CPR training. RESULTS: We recruited 51 research participants between September 2019 and March 2020. The median age was 34 (Q1-Q3, 23-54) years, 56.9% were female, and 41.2% had recent CPR training. The median time from 9-1-1 call to initiation of CPR was 1:19 (Q1-Q3, 1:06-1:26) minutes. A median time of 1:59 (Q1-Q3, 01:50-02:20) minutes was needed to retrieve a drone-delivered AED and deliver a shock. The median CPR compression rate was 115 (Q1-Q3, 109-124) beats per minute, the correct compression depth percentage was 92% (Q1-Q3, 25-98), and the chest compression fraction was 46.7% (Q1-Q3, 39.9%-50.6%). Recent CPR training was not associated with CPR quality or time from 9-1-1 call to AED shock. Younger age (per 10-year increase; ß, 9.97 [95% CI, 4.63-15.31] s; P<0.001) and prior experience with AED (ß, -30.0 [95% CI, -50.1 to -10.0] s; P=0.004) were associated with more rapid time from 9-1-1 call to AED shock. Prior AED use (ß, 6.71 [95% CI, 1.62-11.79]; P=0.011) was associated with improved chest compression fraction percentage. CONCLUSION: Research participants were able to rapidly retrieve an AED from a drone while largely maintaining CPR quality according to American Heart Association guidelines. Chest compression fraction was lower than expected.

Greenhouse gas emissions from petroleum production in Guyana: An examination of the implications for the country's net carbon sink status.

The emerging petroleum production sector has been positively impacting Guyana's economic prospects while contributing to an anticipated increase in the country's greenhouse gas emissions. This article presents a case study that adopts a convergent mixed methods approach. The methods selected for data collection consisted of in-depth interviews, document review and quantitative analysis to examine the implications of the GHG emissions from Guyana's emerging petroleum production sector for the country's net carbon sink status. The article explores measures to enable Guyana to remain a net carbon sink. The study reveals that fugitive emissions were the highest component of greenhouse gas emissions, mostly accounted for by flaring and venting from well testing and flaring from conventional petroleum production. The annual GHG emissions from petroleum production for 2025, 2027 and 2030 were 9034, 13,397 and 20,516 kilotons of CO2e, respectively. Moreover, the combination of the emissions from the oil and gas production and those from three scenarios of growth in Guyana's energy sector, the total annual GHG emissions could vary from 4445 kilotons of CO2e by 2025 to the largest amount of 24,888 kilotons of CO2e by 2030 across various scenarios and conditions. Further, the highest total GHG emissions for 2025 would be 11,015 kilotons CO2e compared to a sequestration rate of 154,060 kilotons CO2 (7%) for 2025. In 2027, the highest total GHG emissions would be 16,234 kilotons CO2e as compared to a sequestration rate of 153,860 kilotons CO2 (11%). No negative implication for Guyana's net carbon sink is projected. However, Guyana should review, update and implement policies to mitigate GHG emissions and offset unavoidable ones. This research highlights the efforts of Guyana to adopt a development path that seeks to fulfil obligations to the UNFCCC and the Paris Accord while improving the social and economic well-being of its citizens.

Promoting the Quarry Workers' Hazard Identification Through Formal and Informal Safety Training.

BACKGROUND: The surface mining industry has one of the highest fatality rates among private industries in the United States. Despite recent decreases in the fatality rates of comparable industries, the fatality rate in the surface mining industry has increased. Meanwhile, a lack of safety research in surface mining has hindered efforts to improve safety strategies in the surface mining workplace. METHOD: This study examined quarry workers' hazard identification skills by conducting a case study of a surface mining facility in the Mid-Atlantic region of the United States. Semistructured interviews were conducted with eight quarry workers who were employed at the mine facility. In addition to the interviews, data were collected through field notes, notes from an expert meeting with safety managers, and site photographs to explore quarry workers' safety behaviors in the workplace. RESULTS: The results showed that quarry workers identified hazards and improved their safety performance by translating safety knowledge learned from training into practice, acquiring hands-on work experience, learning from coworkers, and sharing responsibilities among team members. CONCLUSION: This study contributes to understanding quarry workers' safe performance beyond what they have learned in safety training to include their interaction with other workers and hand-on experience in the workplace. This study informs practitioners in the surface mining industry to build a safe work environment as they design effective safety programs for employees.

Single-Step Photochemical Formation of Near-Infrared-Absorbing Gold Nanomosaic within PNIPAm Microgels: Candidates for Photothermal Drug Delivery.

This work demonstrates the dynamic potential for tailoring the surface plasmon resonance (SPR), size, and shapes of gold nanoparticles (AuNPs) starting from an Au(I) precursor, chloro(dimethyl sulfide)gold (I) (Au(Me2S)Cl), in lieu of the conventional Au(III) precursor hydrogen tetrachloroaurate (III) hydrate (HAuCl4). Our approach presents a one-step method that permits regulation of an Au(I) precursor to form either visible-absorbing gold nanospheres or near-infrared-window (NIRW)-absorbing anisotropic AuNPs. A collection of shapes is obtained for the NIR-absorbing AuNPs herein, giving rise to spontaneously formed nanomosaic (NIR-absorbing anisotropic gold nanomosaic, NIRAuNM) without a dominant geometry for the tesserae elements that comprise the mosaic. Nonetheless, NIRAuNM exhibited high stability; one test sample remains stable with the same SPR absorption profile 7 years post-synthesis thus far. These NIRAuNM are generated within thermoresponsive poly(N-isopropylacrylamide) (PNIPAm) microgels, without the addition of any growth-assisting surfactants or reducing agents. Our directed-selection methodology is based on the photochemical reduction of a light-, heat-, and water-sensitive Au(I) precursor via a disproportionation mechanism. The NIRAuNM stabilized within the thermoresponsive microgels demonstrates a light-activated size decrease of the microgels. On irradiation with a NIR lamp source, the percent decrease in the size of the microgels loaded with NIRAuNM is at least five times greater compared to the control microgels. The concept of photothermal shrinkage of hybrid microgels is further demonstrated by the release of a model luminescent dye, as a drug release model. The absorbance and emission of the model dye released from the hybrid microgels are over an order of magnitude higher compared to the absorbance and emission of the dye released from the unloaded-control microgels.

Formula-Driven, Size-Tunable Synthesis of PMMA Nanoparticles by Varying Surfactant Concentration.

In this communication, we present a streamlined, reproducible synthetic method for the production of size-tunable poly(methyl methacrylate) (PMMA) nanoparticles (PMMANPs) and amine-functionalized block-copolymer PMMANPs (H2N-PMMANPs) by varying subcritical concentrations (i.e., below the concentration required to form micelles at 1 atm and 20 °C) of sodium dodecyl sulfate (SDS). We plotted the Z-average size data against SDS concentration, which revealed a second-order exponential decay function, expressed as [...] .

Log2Lose: Development and Lessons Learned From a Mobile Technology Weight Loss Intervention.

BACKGROUND: Providing financial incentives has gained popularity as a strategy to promote weight loss, but questions remain about how best to utilize them. A promising mobile health strategy provides users with near-real-time financial incentives based on both the process of weight loss (behavioral modification) and actual weight loss. To maximize the impact of this strategy, a methodology is needed to close the gap between the desired behavior and the financial incentive. Leveraging mobile health tools-such as mobile phone apps, cellular body weight scales that transmit data to physicians and researchers, and text messaging for instructions and encouragement-has the potential to close this gap. OBJECTIVE: This study aimed to describe the development of an innovative technology-based solution and lessons learned from a feasibility trial-Log2Lose-that encouraged individuals to lose weight by providing near-real-time financial incentives for weight loss and/or dietary self-monitoring. METHODS: We recruited participants (N=96) with a body mass index greater than or equal to 30 kg/m2 for a 24-week weight loss trial. Participants received a behavioral intervention of biweekly, in-person group sessions and were instructed to log a minimum number of daily calories in MyFitnessPal and to step on the BodyTrace cellular scale at least twice per week. In a 2×2 design, participants were randomized into 4 groups to receive financial incentives for the following: (group 1) weekly weight loss and dietary self-monitoring, (group 2) dietary self-monitoring only, (group 3) weekly weight loss only, or (group 4) no financial incentives. Diet and weight data from the devices were obtained through application programming interfaces. Each week, we applied algorithms to participants' data to determine whether they qualified for a monetary incentive (groups 1-3). A text message notified these participants of whether they met weight loss and/or self-monitoring requirements to earn an incentive and the amount they earned or would have earned. The money was uploaded to a debit card. RESULTS: Our custom-engineered software platform analyzed data from multiple sources, collated and processed the data to send appropriate text messages automatically, and informed study staff of the appropriate incentives. We present lessons learned from the development of the software system and challenges encountered with technology, data transmission, and participants (eg, lost connections or delayed communication). CONCLUSIONS: With consistent and constant validation checks and a robust beta test run, the process of analyzing data and determining eligibility for weekly incentives can be mostly automated. We were able to accomplish this project within an academic health system, which required significant security and privacy safeguards. Our success demonstrates how this methodology of automated feedback loops can provide health interventions via mobile technology. TRIAL REGISTRATION: ClinicalTrials.gov NCT02691260; https://clinicaltrials.gov/ct2/show/NCT02691260.

Publication Productivity of Nursing Faculty in Selected Schools of Nursing Across the United States.

PURPOSE: Faculty productivity related to research and scholarship is assessed in schools of nursing throughout the world. The purpose of this study was to examine the publication productivity of nursing faculty at each academic rank and in both tenure and nontenure tracks in selected schools of nursing across the United States. DESIGN: This was a descriptive study of publications and the h-index of nursing faculty. METHODS: Publication and citation data and the h-index for faculty (N = 1,354) in 18 schools of nursing were obtained from the Scopus database. FINDINGS: Overall, the number of publications and citations and the h-index of faculty increased at higher academic ranks. The median number of publications for tenure track faculty was 13 for assistant professors, 33 for associate professors, and 81 for full professors. Citation medians ranged from 80.5 for assistant professors, to 378 for associate professors, to 1,401 for full professors. The median h-index was 4 for assistant professors, 10 for associate professors, and 20 for full professors. Significant differences were found across academic ranks and between tenure and nontenure track faculty. CONCLUSIONS: The findings provide the first documentation of scholarly productivity of nursing faculty, as measured by number of publications and citations and by h-index, across schools of nursing in the United States. CLINICAL RELEVANCE: These findings can be used as benchmarks by appointment, promotion, and tenure committees and by faculty for self-assessment.

Evidence that sequence homologous region in LRAT-like proteins possesses anti-proliferative activity and DNA binding properties: translational implications and mechanism of action.

LRAT (lecithin:retinol acyltransferase), an enzyme whose levels are modulated during malignant conversion, has been reported as the founder member of a new LRAT-like family that includes tumor suppressors TIG-3(1-164) and Ha-Rev107(1-162). The mechanisms that link these three proteins to carcinogenesis as well as the significance of a reported shared sequence homologous region remain unclear. This begs the question if the tumor suppressors possess enzyme properties and/or if the LRAT enzyme possesses tumor suppressor properties. We use the reported homologous region as a first approach to address the question from the perspective that all three proteins can possess tumor suppressor properties. We postulated that the homologous sequence harbors an anti-proliferation domain within the full-length proteins and that dodecapeptides of this sequence possess anti-proliferative activity. We report that H-TIG-3(111-123), H-Ha-Rev107-1(111-123) and H-LRAT160-171:C168L exhibited in vitro growth inhibitory activity in a human cutaneous melanoma (HCM) model and affected tumor growth in a nude mouse model. Further, in peptide-sensitive HCM cells, these peptides crossed the plasma membrane and localized to the nucleus, where they could bind and activate promoters of transcription factors involved in G1-->S transition. Moreover, peptide-induced abrogation of cyclin dependent kinase-2 expression was concomitant with sub-cellular re-distribution of cyclins E and A. Indeed, the sequence homologous region within each full-length wild-type protein as well as the growth inhibitory peptides can form alpha helices, a likely configuration for binding to DNA. This is the first report that this sequence homologous region (AA111-123) within these LRAT-like proteins harbors an anti-proliferative domain with DNA binding properties. Sequences from this sequence homologous region can be used as templates for anti-tumor drug design and as probes to investigate disease-related mechanisms and structure-activity relationships of the full-length proteins, TIG-3(1-164), Ha-Rev107(1-162) and LRAT160-171.

Human melanomas of fibroblast and epithelial morphology differ widely in their ability to synthesize retinyl esters.

Reduced retinyl ester synthesis has been associated with several forms of cancer; we therefore proposed studying melanoma development from the perspective of this biochemical pathway. Cultures of human melanoma cells with fibroblastoid morphology showed negligible retinyl ester synthesis; in sharp contrast, those with epithelioid morphology were capable of retinol esterification. Further, isolated proliferating epidermal melanocytes (HFSC/2) esterified retinol, whereas proliferating normal skin fibroblasts (F:CCD-1121.Sk) did not. A primary site cutaneous melanoma and its metastatic match (both of epithelioid morphology) were capable of retinol esterification, while a matched fibroblastoid tumor pair did not synthesize retinyl esters; nevertheless, LRAT (lecithin:retinol acyltransferase) protein was found in microsomal fractions from all four tumors. A mutation screen in the LRAT coding region and adjacent intronic sequences revealed several novel mutations in these melanomas as well as in HFSC/2 and F:CCD-1121.Sk cells: a single nucleotide polymorphism in exon 1(37A-->G), a silent mutation in exon 2a (188 A-->G/186 G-->A), and an insertion in the 5'UTR (9-10insC). CRBP-1 basal expression was present in the HFSC/2, and in both sets of matched tumor pairs; however, steady-state levels in the fibroblastoid melanoma pair were one-third that found in the epithelioid matched tumor pair. Co-culture of human primary site epithelioid melanoma with proliferating normal human skin fibroblasts abrogated retinol esterification within 96 h and increased the expression of the active form of TGFbeta-1 by 2.4-fold. A concomitant 3.2-fold downregulation of CRBP-1 expression took place. This is the first study to (1) demonstrate an association between retinyl ester synthesis and cutaneous melanoma morphological phenotypes; (2) suggest the existence of a soluble, diffusible inhibitor of the retinol esterification pathway; (3) report the ability of the isolated, proliferating human epidermal melanocyte to esterify retinol; and (4) provide evidence of DNA variants in the coding region of LRAT.