Comparison of the effects of using feedback devices for training or simulated cardiopulmonary arrest.

BACKGROUND: High-quality chest compression is essential for successful cardiac arrest resuscitation. High-quality cardiopulmonary resuscitation (CPR) can effectively improve the survival rate of patients with cardiopulmonary arrest. However, bystanders untrained in cardiopulmonary resuscitation may provide inadequate chest compressions. Previous studies have shown that the use of feedback devices in training alone or in simulated cardiopulmonary arrest alone can improve cardiopulmonary resuscitation. This study aims to determine whether using an audiovisual feedback (AVF) device during CPR training or a simulated cardiopulmonary arrest (CA) scenario would be more effective in improving the quality of chest compressions (CC). METHODS: We use a prospective, randomized, 2 × 2 factorial design trial. A total of 160 participants from Wuhan University and senior clinical medicine undergraduates who had not participated in any CPR training before and had no actual CPR experience are recruited. Each participant is randomized to 1 of 4 permutations, including AVF device vs. no AVF device during CPR training and AVF device vs. no AVF device during simulated CA. Main outcomes and measures are the depth, the percentage of CCs with correct depth (5-6 cm), the rate of CCs, and the percentage of CCs with the correct rate (100-120 cpm). RESULTS: The use of the AVF device during simulated CA resulted in improved CC quality. In CA without AVF device, the average compression depth and the percentage of adequate depth with AVF device are 5.1 cm, 5.0 cm and 55.5%, 56.3%, respectively, which are higher than those without AVF device (4.5 cm, 4.7 cm and 32.8%, 33.6%). (p = 0.011, p = 0.000, both < 0.05).Compared with CA without AVF device, the average compression rate and the percentage of adequate rate with AVF device are 112.3 cpm, 111.2 cpm and 79.4%, 83.1%, respectively. The average compression rate and the percentage of adequate rate without using the AVF device are 112.4 cpm, 110.3 cpm and 71.5%, 68.5%, respectively. (p = 0.567 > 0.05, p = 0.017 < 0.05)Although the average compression rate in group D is slightly lower than that in group C, the percentage of suitable frequency with the feedback device is still higher than that without AVF device. CONCLUSION: Using a feedback device during simulated cardiopulmonary arrest is more effective in improving cardiopulmonary resuscitation than during training.

Using the pedicle screw-U rod system for the treatment of double-level lumbar spondylolysis and isthmic spondylolisthesis.

Objective: The aim of this study was to evaluate the efficacy of the pedicle screw-U rod system in treating double-level lumbar spondylolysis with or without spondylolisthesis. Methods: A retrospective study was conducted. Twenty-six patients were included in this study and followed up at 3, 6, and 12 months. Patients without spondylolisthesis were treated with double U-shaped rods (group I), and patients with spondylolisthesis were treated with a lengthened U-shaped rod (group II). Japanese Orthopedic Association (JOA) scores, Oswestry disability index (ODI) scores, disc range of motion (ROM), intervertebral space height of fixed levels and adjacent levels, and grading the degeneration of adjacent segmental intervertebral discs were evaluated preoperatively and postoperatively. Results: JOA and ODI scores improved significantly at 3 months both in groups I and II. The average bone grafting healing time was 6.1 ± 3.1 months for group I and 6 ± 2.8 months for group II. The intervertebral space heights of L4/L5 and L5/S1 were improved significantly at the final follow-up (p < 0.05 for both groups). Surgical segmental and adjacent segmental ROM had no significant change at the final follow-up, in comparison with data preoperatively (p > 0.05). No significant changes of intervertebral space height (L3/L4) and grading of intervertebral disc degeneration were noted before and after surgery (p = 0.141 and 0.484, respectively). Conclusions: The pedicle screw-U rod system provided advantages of being easy in repairing symptomatic double-level lumbar spondylolysis. This technique improved disabilities of patients, preserved the lumbar spine ROM, and delayed the degeneration of adjacent segments.

Public knowledge and attitudes toward automated external defibrillators use among first aid eLearning course participants: a survey.

OBJECTIVE: Survival from out-of-hospital cardiac arrest (OHCA) often depends on the effective and immediate use of automated external defibrillators (AEDs). Given that there have been few studies about AED use in China, the purpose of this study is to investigate the knowledge and attitudes regarding AED use among the Chinese public, then provide an effective suggestion for AED education strategies and legislation. METHOD: The online survey was conducted among Chinese participants of the First Aid eLearning courses in June 2020. RESULT: A total of 2565 (95.00%) surveys were completed, only 23.46% of respondents with non-medical related respondents reported having attended previous AED training courses. Regarding the basic knowledge of AEDs, few respondents (12.28%, n = 315) could answer all four questions correctly. 95.67% (n = 2454) were willing to learn AED use. Even if without the precondition of being skilled in AEDs, the female was more likely to rescue OHCA patients than the male (p = 0.003). Almost all respondents (96.65%) showed a strong willingness to rescue OHCA patients with training in using AEDs. The top four barriers to rescuing OHCA patients were lack of practical performing ability (60.47%), fear of hurting patients (59.30%), inadequate knowledge of resuscitation techniques (44.19%), and worry about taking legal responsibility (26.74%). CONCLUSION: Our study reflects a deficiency of AED knowledge among the general public in China. However, positive attitudes towards rescuing OHCA patients and learning AED use were observed, which indicates that measures need to be taken to disseminate knowledge and use of AEDs.

The comparison of rDNA spacer regions of Nosema ceranae isolates from different hosts and locations.

Nosema ceranae is a common microsporidian pathogen, one of two Nosema species that cause "nosema disease" in honeybees, Apis cerana and Apis mellifera. Samples of N. ceranae rDNA from isolates collected in different locations were sequenced and one 5S rRNA was found to be upstream of SSUrRNA. The rDNA arrangement, 5'-5S rRNA-IGS-SSUrRNA-ITS-LSUrRNA-3', was found in all isolates. In order to better understand the distribution relationship between N. ceranae isolates from A. cerana and A. mellifera, their rRNA spacer regions were also sequenced for analysis. Results showed that there are no significant differences between the IGS sequences of the isolates and no difference in the ITS sequence with the exception of one transition found in an isolate from Martinique. These isolates showed consistency in the IGS phylogenic analysis suggesting that no transmission barrier exists between A. mellifera and A. cerana and there is no difference between isolates from geography separated areas.