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Background: The use of personal protective equipment for respiratory infection control during cardiopulmonary resuscitation (CPR) is a physical burden to healthcare providers. The duration for which CPR quality according to recommended guidelines can be maintained under these circumstances is important. We investigated whether a 2-min shift was appropriate for chest compression and determined the duration for which chest compression was maintained in accordance with the recommended guidelines while wearing personal protective equipment.Methods: This prospective crossover simulation study was performed at a single center from September 2020 to October 2020. Five indicators of CPR quality were measured during the first and second sessions of the study period. All participants wore a Level D powered air-purifying respirator (PAPR), and the experiment was conducted using a Resusci Anne manikin, which can measure the quality of chest compressions. Each participant conducted two sessions. In Session 1, the sequence of 2 min of chest compressions, followed by a 2-min rest, was repeated twice; in Session 2, the sequence of 1-min chest compressions followed by a 1-min rest was repeated four times.Results: All 34 participants completed the study. The sufficiently deep compression rate was 65.9 ± 31.1% in the 1-min shift group and 61.5 ± 30.5% in the 2-min shift group. The mean compression depth was 52.8 ± 4.3 mm in the 1-min shift group and 51.0 ± 6.1 mm in the 2-min shift group. These two parameters were significantly different between the two groups. There was no significant difference in the other values related to CPR quality.Conclusions: Our findings indicated that 1 min of chest compressions with a 1-min rest maintained a better quality of CPR while wearing a PAPR. [ABSTRACT FROM AUTHOR]

Background: Serum interleukin-6 (IL-6) is a cytokine released in response to an inflammatory stimulus or tissue injury. IL-6 levels are known to increase in patients with brain injury.Objective: We investigated the neurologic outcomes associated with serum IL-6 levels in out-of-hospital cardiac arrest (OHCA) survivors who underwent target temperature management (TTM).Methods: This was a prospective single-center observational study from October 2018 to November 2019 in a cohort of 45 patients. Serum inflammatory markers (IL-6, C-reactive protein, white blood cells) were determined in samples obtained immediately and at 24, 48, and 72 h after the return of spontaneous circulation (ROSC). Poor neurologic outcome, defined as Cerebral Performance Category 3-5 at 3 months after cardiac arrest, was the primary outcome.Results: Among 45 patients enrolled in this study, 25 (55.6%) patients showed a poor neurologic outcome. IL-6 levels were significantly higher in the poor neurologic outcome group immediately (IL-60) after ROSC. The area under the curve (AUC) value of IL-60 was the highest among those of serum IL-6, CRP, and WBC at each time point. The IL-6 levels for predicting poor neurologic outcome had a sensitivity of 75.0%, with 80% specificity at IL-60. The AUC of IL-60 was 0.810 (95% confidence interval 0.664-0.913), with a cutoff value of 346.7 pg mL-1.Conclusions: Serum IL-6 level immediately after ROSC was a highly specific and sensitive marker for the 3-month poor neurologic outcome, and may be a useful early predictive marker of neurologic outcome in OHCA survivors treated with TTM. [ABSTRACT FROM AUTHOR]

Objectives: Feedback on community pharmacists' practice is limited after graduation and often comes in the form of annual performance evaluations by pharmacy managers based on company-provided templates. The objective of this study was to examine the relevance of these review processes to all aspects of community pharmacy practice.Methods: Competencies evaluated in performance evaluation templates used by pharmacy organizations were mapped to the General Level Framework (GLF)-a tool developed to assess the competency of general-level pharmacy practitioners-and studied in hospital and community practice settings. The competencies were further assessed with consideration of their applicability to the current scope of practice of Canadian community pharmacy practice.Results: Performance evaluation templates from 7 community pharmacy organizations in Canada were obtained and evaluated. Performance evaluations mapped most closely to the GLF tool related to personal competencies (e.g., organization, communication, and teamwork), with the lowest level of congruence observed among competencies specific to patient care activities. Few evaluations considered recent expansions of scope in place across various Canadian provinces, such as ordering and interpreting laboratory tests or pharmacist prescribing.Conclusion: Performance evaluation can be a valuable tool to improve quality of care and the professional development of pharmacists; however, these tools should be reexamined to ensure that feedback on the most valuable aspects of a pharmacist's professional practice is the focus. As pharmacy practice continues to evolve toward greater direct patient care activities, so too should our evaluation tools align with this increasingly recognized role. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents decentralized formation controls for a team of anonymous mobile robots performing a task through cooperation. Robot teams are required to generate and maintain various geometric patterns adapting to environmental changes in many cooperative robotics applications. In particular, all robots must continue to strive toward achieving the team’s mission even if some members fail to perform their role. Toward this end, formation control approaches are proposed under the conditions that robot teams are initially not allowed to have individual identification numbers (IDs), a predetermined leader, and agreement on coordinate systems. Therefore, all members are required first to reach agreement on their coordinate system and obtain unique IDs for role allocations in a self-organizing way. Then, employing IDs within a common coordinate system, two formation control approaches can be realized: leader-referenced and neighbor-referenced formations. Both approaches are verified using an in-house simulator and physical mobile robots. We detail and evaluate each formation control approach, whose common features include self-organization, robustness, and flexibility. [Copyright &y& Elsevier]

Abstract: Retrieving accurate location information about an object in real-time, as well as any general information pertinent to the object, is a key to enabling a robot to perform a task in cluttered, dynamically changing environment. In this paper, we address a novel technique for the guidance of mobile robots to help them identify, locate, and approach a target in our daily environments. To this end, we propose a standard for the use of radio-frequency identification (RFID) systems and develop a prototype that can be easily installed in the existing mobile robots. Specifically, when an RF signal is transmitted from an RF transponder, the proposed RFID system reads the transponder-encoded data and simultaneously picks up the direction of the transponder using the received signal strength pattern. Based on the angle of signal arrival, we develop the guidance strategies that enable a robot to find its way to the transponder position. Moreover, to cope with multi-path reflection and unexpected distortions of the signals that resulted from environmental effects, we present several algorithms for reconstructing the signals. We demonstrate that an off-the-self mobile robot equipped with the proposed system locates and approaches a stationary target object. Experimental results show that the accuracy of the proposed system operating at a frequency of 315MHz falls within a reasonable range in our normal office environment. [Copyright &y& Elsevier]

We have developed an advanced infrastructure and technologies for collaborative remote operations, enabling multiple operators with large physical separation to control multiple slave robots in a common environment over the network. Human operators’ delayed visual perception arising from communication time delays seriously affects the performance of collaborative multi-site operations and accordingly requires supplementary information locally available to operators irrespective of time delays. Few facilities exist to investigate remote multi-site operations, thus we have built an experimental test bed connecting Tsukuba and Kawasaki in Japan via an integrated services digital network. In particular, an on-line predictive graphics simulator is incorporated to cope with image feedback delays from the remote site. Specifically, exploiting audio-visual features of the simulator, operators can detect a priori the possibility of collision between robots and guide them towards task goal through time delays. To verify the validity of the simulator assisted approach, we have performed a demonstration of prototype plant maintenance in April 2000 between Tsukuba and Kawasaki. [Copyright &y& Elsevier]

Abstract Mobile robots are being increasingly deployed in fields where human intervention is deemed risky. However, in doing so, one of the prime concern is to prevent complete battery depletion which may in turn lead to immobilization of the robot during the mission. Thus, we need to carefully manage the energy available to explore as much of the unknown environment as feasible whilst guaranteeing a safe return journey to home base. For this, we need to identify the key components that draw energy and quantify their individual energy requirements. However, this problem is difficult due to the fact that most of the robots have different motion models, and the energy consumption usually also varies from mission to mission. It is desirable to have a generic framework that takes into account different locomotion models and possible mission profiles. This paper presents a methodology to unify the energy consumption models for various robotic platforms thereby allowing us to estimate operational range in both offline and online fashions. The existing models consider a given mission profile and try to estimate its energy requirements whilst our model considers the energy as a given resource constraint and tries to optimize the mission to be accomplished within these constraints. The proposed unified energy consumption framework is verified by field experiments for micro UGV and multi-rotor UAV test-beds operating under myriad of environmental conditions. The online model estimates operational range with an average accuracy (measured with respect to true range across multiple field trials) of 93.87% while the offline model attains 82.97%. [ABSTRACT FROM AUTHOR]

We compared the outcomes of patients with higher-risk diffuse large B-cell lymphoma (DLBCL) who were treated with either up-front autologous stem cell transplantation (ASCT) or salvage chemotherapy followed by delayed ASCT after relapse. Data for 122 DLBCL patients who underwent ASCT as up-front or salvage treatment were analyzed. The 3-year overall survival (OS) rate in DLBCL patients who underwent up-front ASCT was 76.6%, and the rate for those who underwent delayed ASCT was 60.9% ( p = 0.017). In a subgroup analysis of patients with a high-intermediate/high-risk age-adjusted International Prognostic Index, achievement of complete remission translated into improved OS in the up-front ASCT group, whereas patients who achieved partial remission had similar OS rates in both groups. The up-front ASCT group had improved OS in patients aged <50 years or with good performance status, whereas the OS rates of both groups were similar in patients aged ≥60 years or with poor performance status. When the OS outcome is analyzed by the number of factors (no complete remission during R-CHOP induction chemotherapy, age ≥50 years, and performance status ≥2), the 3-year OS rates of patients with zero or one, two, and three clinical factors were 80.2%, 51.6%, and 0%, respectively ( p < 0.001). In conclusion, in higher-risk DLBCL patients, induction chemotherapy followed by up-front ASCT may have a survival benefit compared with induction chemotherapy alone in highly selected patients who have achieved a complete remission, who are aged <50 years, and who have a good performance status at diagnosis. [ABSTRACT FROM AUTHOR]

Abstract: Background: 5-Fluorouracil (5-FU) is a cornerstone of chemotherapy for colorectal cancer (CRC), and the major targets of 5-FU are thymidylate synthase (TS), methylenetetrahydrofolate reductase (MTHFR), and reduced folate carrier 1 (RFC1). We hypothesized that polymorphisms in the genes encoding these proteins would be associated with CRC patient survival. Patients and methods: We genotyped the following polymorphisms in 372 CRC patients: TS enhancer region (TSER), TS 1494del6, MTHFR 677C>T and 1298A>C, and RFC1 −43T>C, 80G>A, and 696C>T. Using Kaplan–Meier curves, log-rank tests, and Cox proportional hazard models, we evaluated associations between these polymorphisms and overall survival (OS). Results: The combined TS 1494 0bp6bp+6bp6bp genotype was associated with reduced OS compared to the TS 1494 0bp0bp genotype. Among rectal cancer patients, the RFC1 −43CC and 80AA genotypes were associated with favorable OS. Conclusions: Our data suggest that TS and RFC1 polymorphisms are associated with CRC prognosis in Korean patients. Further studies are needed to verify these findings. [Copyright &y& Elsevier]

Abstract: Background: Polymorphisms of endothelial nitric oxide synthases (eNOS) have been shown to be associated with cancer susceptibility. However, the results of such studies are conflicting to date. We investigated whether polymorphisms of the eNOS gene correlated with patients with colorectal cancer (CRC), relative to healthy individuals. Patients and methods: In the present study, we analyzed three polymorphisms of eNOS (-786T>C, 4a4b, and 894G>T) in 509 healthy controls and 528 patients with CRC. The genotyping of eNOS polymorphisms was performed using polymerase chain reaction or polymerase chain reaction–restriction fragment length polymorphism assays. Results: We found that the TC+CC genotype of the -786T>C polymorphism was significantly associated with an increased risk of CRC compared with the TT genotype. Similarly, the GT+TT genotype of the 894G>T polymorphism was associated with an increased susceptibility to CRC. However, no evidence was found for any association between the 4a4b polymorphism and CRC risk. In addition, the C/4b/G (-786T>C/4a4b/894G>T) haplotype was significantly associated with increased risk of CRC and C/4b/T (-786T>C/4a4b/894G>T) haplotype was only detected in CRC patients. Conclusions: Our study suggests that the eNOS -786T>C and 894G>T polymorphisms may be associated with the development of CRC in the Korean population. [Copyright &y& Elsevier]