Implementation of a Smart Teaching and Assessment System for High-Quality Cardiopulmonary Resuscitation.

The purpose of this study is to develop a smart training and assessment system called SmartCPR, for teaching and training cardiopulmonary resuscitation (CPR), based on human posture estimation techniques. In this system, trainees can automatically recognize and evaluate whether chest compressions during CPR meet the standard of high-quality CPR by simply using a device such as a smart phone. Through the system, trainees are able to obtain real-time feedback on the quality of compressions so that they can adjust the cycle, depth, frequency, and posture of compressions to meet the standard of high-quality CPR. In addition, the SmartCPR system is convenient for CPR trainers. Trainers can instantly and accurately assess whether the trainee's compressions meet the standard of high-quality CPR, which reduces the risk of manual assessment errors and also reduces the trainer's teaching pressures. Therefore, the SmartCPR system developed in this study can be an important tool for CPR teaching and training for physicians, which can provide training and guidance for high-quality CPR maneuvers and enable trainees to become more proficient in CPR and self-training.

Testosterone Level Reduction Increases the 10-Year Risk of Cardiovascular Diseases: A Retrospective Cohort Study in a Taiwanese Young Male Population.

Low testosterone levels are associated with increased risk of cardiovascular disease; however, most previous studies assessed the relationship of testosterone levels with a history of cardiovascular (CV) events rather than with CV risk prediction scores consequently neglecting the effect of testosterone on CV risk in healthy young individuals. The aim of this study was to investigate the relationship between testosterone levels and predict the 10-year risk of cardiovascular disease. This retrospective cohort study was conducted through a large medical health examination system in four metropolises in Taiwan. Two risk scores were used to predict the 10-year cardiovascular risk of participants: the Framingham Risk Score (FRS) (2008) and the Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator (2013). Multivariate-adjusted logistic regression was used to calculate odds ratios (ORs) for the correlation of testosterone level reduction with the increase in predicted CV risk. We used the MJ Health Research Foundation database to collect reports of 125,414 individuals who underwent medical checkups between 2007 and 2016. The final sample size included 1,253 male participants. A reduction in testosterone level between two subsequent medical checkups was associated with higher CV risk estimated by the FRS and ASCVD Risk Estimator in young participants aged 30-49 years (OR = 0.804, 95% CI: 0.711-0.909, p < 0.01 and OR = 0.841, 95% CI: 0.742-0.953, p < 0.01, respectively). Reduction in total testosterone levels increases CV risk in men aged 30 to 49 years, while the CV risk is not influenced by low testosterone levels at baseline.

Association Between Low Serum Testosterone and the Development of Metabolic Syndrome in Elderly Taiwanese Men.

PURPOSE: To assess the association between serum testosterone (T) and metabolic syndrome (MS) in different age groups in Taiwanese men. MATERIALS AND METHODS: Male participants, regardless of age or any underlying disease, were identified from MJ Health Screening Center in Taiwan from 2007 to 2016 for this cross-sectional study. They were divided into three groups according to age, and further classified according to MS diagnosis. Basic patient characteristics with relevant parameters were obtained. One-way ANOVA of mean T values between different numbers of measures that exceeds the cut-off values of MS components was performed to assess the relationship of T and MS. Logistic regression analysis was also used to estimate the risk for MS with each increment in T, age, and BMI. RESULTS: A total of 4,931 men were included. The MS group had significantly lower serum T levels compared to the non-MS group in each age group. The one-way ANOVA found the mean value of T was significantly higher in patients without MS component (6.19±2.12 ng/mL) than those with 1-5 MS components (with one MS component: 5.48±2.13 ng/mL, two MS components: 4.93±2.03 ng/mL, three MS components: 4.37±1.60 ng/mL, four MS components: 4.13±2.89 ng/mL, five MS components: 3.74±1.27 ng/mL, and P<0.001). There was no significant difference between the patients with three components and the patients with four or five components. Logistic regression models with age stratification showed T with lower odds ratio (OR) for MS after adjusting for BMI in those ≥65 years old (OR=0.693; 95% CI=0.559-0.858; P<0.001); 50-64 years old (OR=0.868; 95% CI=0.802-0.940; P<0.001) and <50 years old (OR=0.810; 95% CI=0.758-0.865; P<0.001). CONCLUSION: Lower serum T was strongly associated with MS, with the predictive value increasing with age in Taiwanese men.

Conscious and Non-conscious Representations of Emotional Faces in Asperger's Syndrome.

Several neuroimaging studies have suggested that the low spatial frequency content in an emotional face mainly activates the amygdala, pulvinar, and superior colliculus especially with fearful faces(1-3). These regions constitute the limbic structure in non-conscious perception of emotions and modulate cortical activity either directly or indirectly(2). In contrast, the conscious representation of emotions is more pronounced in the anterior cingulate, prefrontal cortex, and somatosensory cortex for directing voluntary attention to details in faces(3,4). Asperger's syndrome (AS)(5,6) represents an atypical mental disturbance that affects sensory, affective and communicative abilities, without interfering with normal linguistic skills and intellectual ability. Several studies have found that functional deficits in the neural circuitry important for facial emotion recognition can partly explain social communication failure in patients with AS(7-9). In order to clarify the interplay between conscious and non-conscious representations of emotional faces in AS, an EEG experimental protocol is designed with two tasks involving emotionality evaluation of either photograph or line-drawing faces. A pilot study is introduced for selecting face stimuli that minimize the differences in reaction times and scores assigned to facial emotions between the pretested patients with AS and IQ/gender-matched healthy controls. Information from the pretested patients was used to develop the scoring system used for the emotionality evaluation. Research into facial emotions and visual stimuli with different spatial frequency contents has reached discrepant findings depending on the demographic characteristics of participants and task demands(2). The experimental protocol is intended to clarify deficits in patients with AS in processing emotional faces when compared with healthy controls by controlling for factors unrelated to recognition of facial emotions, such as task difficulty, IQ and gender.

Face recognition in Asperger syndrome: a study on EEG spectral power changes.

EEG reactions in emotional face recognition were studied in five participants with Asperger syndrome (AS) and seven control subjects. Control subjects showed a spectral power increase following the stimulus onset in two time-frequency intervals-(1) 150-300ms in the 1-16Hz frequency range and (2) 300-650ms in the 1-8Hz range. Also, alpha/beta desynchronization occurred 400-1000ms after the stimulus onset with maximal amplitude in the posterior region. Theta synchronization (4-8Hz) was weaker in the AS group than in the control group, but beta2 desynchronization was stronger in the AS group. The results were interpreted in terms of automatic and voluntary control of perception.