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Pain is a frequent problem faced by emergency medical services (EMS) in pre-hospital settings. This large observational study aims to assess the prevalence of sufficiently provided analgesia and to analyze the efficacy of different analgesics. Moreover, we evaluated if quality of analgesia changed with an emergency physician on scene or depended on paramedics' gender.This is a retrospective analysis of all pre-hospital medical charts from adults and adolescents treated by the municipal EMS SchutzRettung Zürich over a period of 4 years from 2013 to 2016. Inclusion criteria were age ≥16 years, initial GCS 13, NACA score ≥I and ≤V, an initial numeric rating scale (NRS) ≥ I and a documented NRS at hospital admission. 20,978 out of 142,484 missions fulfilled the inclusion criteria and therefore underwent further investigation. Descriptive, univariate and multivariate analyses were applied.Initial NRS on scene was on average 5.2 ± 3.0. Mean NRS reduction after treatment was 2.2 ± 2.5 leading to a NRS at hospital admission of 3.0 ± 1.9. This resulted in sufficient analgesia for 77% of included patients. Among analgesics, the highest odds ratio for sufficient analgesia was observed for ketamine (OR 4.7, 95%CI 2.2-10.4, p 0.001) followed by fentanyl (OR 1.4, 95%CI 1.1-1.7, p = 0.004). Female paramedics provided better analgesia (OR 1.2, 95%CI 1.1-1.2; p 0.001). Patient's sex had no influence on analgesia. In patients with a NACA score 2, the presence of an emergency physician on scene improved the quality of analgesia significantly.Pre-hospital analgesia is mostly adequate, especially when done with ketamine or fentanyl. Female paramedics provided better analgesia and in selected patients, an emergency physician on scene improved quality of analgesia in critical patients.

As artificial intelligence advances towards unprecedented levels of competence, people's acceptance of autonomous technology has become a hot topic among psychology and HCI scholars. Previous studies suggest that threat perceptions—regarding observers' immediate physical safety (proximal) as well as their more abstract concepts of human uniqueness (distal)—impede the positive reception of self-controlled digital systems. Developing a Model of Autonomous Technology Threat, we propose both of these threat forms as common antecedents of users' general threat experience, which ultimately predicts reduced technology acceptance. In a laboratory study, 125 participants were invited to interact with a virtual reality agent, assuming it to be the embodiment of a fully autonomous personality assessment system. In a path analysis, we found correlational support for the proposed model, as both situational control and human uniqueness attitudes predicted threat experience, which in turn connected to stronger aversion against the presented system. Other potential state and trait influences are discussed.

Smartphone use while walking (i.e., being a smartphone zombie) has become a prevalent phenomenon in many cities worldwide. Previous research shows that many pedestrians choose to interact with their phones as they walk around in cities, despite being aware that their behavior might be dangerous. To investigate potential reasons for the prevalence of distracted walking, the current study explores the construct Fear of Missing Out (FoMO) as a potential antecedent of pedestrians' smartphone use while walking. Hierarchical OLS and logistic regression analyses show that FoMO predicts distracted walking, the tendency to engage in virtual social interactions while walking, and dangerous traffic incidents—irrespective of participants’ age and gender. Virtual communication might serve as a compensation for real-world company, thus sidelining the need to traverse safely.

Fueled by tragic incidents worldwide, many studies have investigated dispositional factors that lead to virtual abuse and cyberbullying. In contrast to this, less extreme forms of uncivil online behavior have received only little attention. The current paper strives to overcome this research gap by focusing on uncivil commenting intentions in public Facebook discussions. We presented controversial online comments to a convenient student sample of 256 Facebook users asking them to consider their likely response on several scales ranging from a functional to an uncivil style of reasoning. Users' intended commenting was then linked to several personality traits (Big Five, Dark Triad, sensation seeking, and impulsivity) and their Facebook intensity. Analyses revealed openness, agreeableness, and experience seeking as negative predictors of participants' intention to comment uncivilly, whereas attentional impulsivity, boredom susceptibility as well as intense Facebook use emerged as positive predictors. No connections were found for the Dark Triad. Possible explanations for these effects are discussed.

Introduction Chest decompression can be performed by different techniques, like needle thoracocentesis (NT), lateral thoracostomy (LT), or tube thoracostomy (TT). The aim of this study was to report the incidence of prehospital chest decompression and to analyse the effectiveness of these techniques. Material and methods In this retrospective case series study, all medical records of adult trauma patients undergoing prehospital chest decompression and admitted to the resuscitation area of a level-1 trauma center between 2009 and 2015 were reviewed and analysed. Only descriptive statistics were applied. Results In a 6-year period 24 of 2261 (1.1%) trauma patients had prehospital chest decompression. Seventeen patients had NT, six patients TT, one patient NT as well as TT, and no patients had LT. Prehospital successful release of a tension pneumothorax was reported by the paramedics in 83% (5/6) with TT, whereas NT was effective in 18% only (3/17). In five CT scans all thoracocentesis needles were either removed or extrapleural, one patient had a tension pneumothorax, and two patients had no pneumothorax. No NT or TT related complications were reported during hospitalization. Conclusion Prehospital NT or TT is infrequently attempted in trauma patients. Especially NT is associated with a high failure rate of more than 80%, potentially due to an inadequate ratio between chest wall thickness and catheter length as previously published as well as a possible different pathophysiological cause of respiratory distress. Therefore, TT may be considered already in the prehospital setting to retain sufficient pleural decompression upon admission.

Digital technologies are advancing rapidly, growing to be more human-like and intelligent by the day. However, research shows that a machine's resemblance to humans can reach a critical level, which makes it seem uncanny to observers. While scholars have discussed this effect in terms of both human-like appearances and mental abilities, a potential interaction between the two aspects has hardly been addressed in literature. We designed a two-factorial experiment to overcome the identified research gap, introducing participants to digital agents with varying embodiment (text interface/human rendering) and mental capacity (simple algorithms/complex artificial intelligence). Our results show that the interaction of both factors indeed affects participants’ experience in a crucial way: Whereas an agent based on simple algorithms only evokes discomfort when embedded in a human-like body, the artificial intelligence is always perceived as eerie, regardless of its embodiment. Yet, additional findings raise doubts on the unidimensionality of participants’ affective response.

Sevoflurane is a potent non-toxic inducer of the hepatoprotective enzyme heme oxygenase-1 (HO-1). So far, little is known about the underlying molecular mechanism. Therefore the aim of this study was to characterize the respective signal transduction pathway and in particular to elucidate the role of Kupffer cells in this context. Rats were treated with or without sevoflurane. The effects on hepatic HO-1 gene expression, mitogen-activated protein kinases and transcription factors were studied by Northern and Western blot analyses, immunostaining, electrophoretic mobility shift assays, and enzymatic activity assays. Kupffer cells were depleted by administration of clodronate liposomes in vivo to characterize their role in HO-1 signal transduction. In additional in vitro experiments, HO-1 mRNA expression in primary rat hepatocytes and HepG2 cells was assessed. Sevoflurane up-regulated HO-1 gene expression in pericentral hepatocytes and increased HO enzyme activity in vivo. This was associated with activation of ERK1/2 and activator protein-1. We identified c-jun/AP-1, JunD, c-fos, and Fra-1 as active subunits of the activator protein-1 complex. Administration of clodronate liposomes to rats led to depletion of Kupffer cells without affecting sevoflurane induced HO-1 expression. Moreover, sevoflurane up-regulated HO-1 mRNA in primary rat hepatocytes but not in HepG2 cells. Our results suggest that sevoflurane induced HO-1 gene expression in pericentral hepatocytes does not depend on Kupffer cells and is associated with activation of ERK1/2 and activator protein-1. Since we could recently demonstrate significant hepatoprotective effects of HO-1 induced by isoflurane, the present results may help to establish new concepts in hepatic organ protection.