RESUMO
Introduction: End stage liver disease (ESLD) is associated with loss of muscle mass and function, known as sarcopenia, which can increase the risk of complications of ESLD, hospitalization and mortality. Therefore, the accurate assessment of muscle mass is essential to evaluate sarcopenia in ESLD. However, manual segmentation of muscle volume (MV) can be laborious on cross-sectional imaging, due to the number of slices that require analysis. This study aimed to investigate the impact of reducing the number of slices required for MV estimation. Further, we aimed to compare two equations utilized in estimating MV (cylindrical and truncated cone). Methods: Thirty eight ESLD patients (23 males; 54.8 ± 10.7 years) were recruited from the Queen Elizabeth University Hospital Birmingham. A 3T MRI scan was completed of the lower limbs. Quadriceps MV was estimated utilizing 1-, 2-, 3-, and 4 cm slice intervals with both cylindrical and truncated cone equations. Absolute and relative error (compared to 1 cm slice interval) was generated for 2-, 3-, and 4 cm slice intervals. L3 skeletal muscle index (SMI) was also calculated in 30 patients. Results: Relative error increased with slice interval using the cylindrical (0.45 vs. 1.06 vs. 1.72%) and truncated cone equation (0.27 vs. 0.58 vs. 0.74%) for 2, 3, and 4 cm, respectively. Significantly, the cylindrical equation produced approximately twice the error compared to truncated cone, with 3 cm (0.58 vs. 1.06%, P < 0.01) and 4 cm intervals (0.74 vs. 1.72%, P < 0.001). Finally, quadriceps MV was significantly correlated to L3 SMI (r 2 = 0.44, P < 0.0001). Conclusion: The use of the truncated equation with a 4 cm slice interval on MRI offers an efficient but accurate estimation of quadricep muscle volume in ESLD patients.
RESUMO
Aim: To assess the learning impact of a virtual interactive CPR webinar for seniors through mix-methods quantitative and qualitative survey analysis. Methods: We surveyed 350 webinar attendees. The webinar trained participants in hands-only CPR technique and AED use. Survey questions included multiple-choice selection and open-ended responses. Qualitative inductive thematic analysis was conducted on open-ended question responses. Knowledge of CPR was measured on a 3-point scale (very little knowledge, some knowledge, a lot of knowledge). Proportions were compared pre and post seminar using a z-test. Results: 231 respondents ≥ 65 years participated in the survey (response rate 66.0 %). There was a significant increase in self-reported knowledge of CPR pre and post webinar (very little knowledge 33.9 % to 1.8 % P < 0.00001, some knowledge 54.2 % to 12.1 % P < 0.0001, a lot of knowledge 11.9 % to 86.1 % P < 0.0001). We found 5 main themes on participant feedback: Positive affective comments, learning, constructive criticism, the desire to share information and comments on CPR ability. We identified 4 main themes related to further questions: Performing CPR in different circumstances, risks of CPR, information sharing, and prevention of death from myocardial infarction. Following the webinar, 89.9 % of respondents chose that they would be very likely to perform CPR on a friend, family member or colleague. Conclusion: This study highlights the success of virtual CPR webinars for senior citizens in improving self-reported CPR knowledge. This has potential to address barriers to online education for seniors and increase bystander CPR rates.
