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Background/Objectives: Conducting advanced resuscitation requires medical personnel to carry out appropriately coordinated actions. Certain difficulties arise when it becomes necessary to conduct cardiopulmonary resuscitation (CPR) on two patients at the same time. The aim of this paper was to assess the actions of teams participating in emergency medicine championships in tasks related to simultaneous cardiac arrests in two patients. Methods: The study was conducted on the basis of an analysis of assessment cards for tasks carried out during the 'International Winter Championships in Emergency Medicine'. Three-person medical response teams (MRTs), with the support of two people, had the task of conducting advanced resuscitation on an adult and child simultaneously. The tasks were prepared and developed by European Resuscitation Council (ERC) instructors. Results: The study showed that teams used four methods of checking heart rhythm and performing defibrillation during CPR—using paddles only, using paddles and self-adhesive electrodes, using paddles and a three-lead ECG and using two pairs of self-adhesive electrodes. Teams performing cardiopulmonary resuscitation using paddles and a three-lead ECG performed significantly more actions incorrectly than other teams—in part due to the fact that they incorrectly interpreted which patient's heart rhythm was displayed on the defibrillator screen. The effectiveness of the remaining methods was similar for most of the actions. The CPR method using two pairs of electrodes enabled personal safety to be maintained to the significantly highest percentage during defibrillation. Conclusions: The study demonstrated that the need to conduct CPR on two patients at the same time, irrespective of the method used, caused MRT members considerable difficulties in correctly conducting some of the actions. The method of assessing heart rhythm using paddles and a three-lead ECG should not be used. The study showed that the optimal method of CPR in use appears to be the method using two pairs of adhesive electrodes—it provided, among other things, the significantly highest percentage of safely conducted defibrillation. [ABSTRACT FROM AUTHOR]

Background: Medical personnel carrying out electrical cardioversion (EC) procedures must remember to have the R-wave sync mode switched on, use the correct energy and maintain personal safety. The defibrillators used by medical response teams most often switch out of cardioversion mode once a shock is delivered. Therefore, this mode must be switched on again before subsequent shocks are delivered. The main aim of the study was to assess the ability of emergency medical teams participating in emergency medicine championships to perform EC. Methods: The research was a retrospective observational study and was based on an analysis of the evaluation sheets from two tasks simulating the management of a patient with unstable tachycardia conducted during the International Winter Emergency Medicine Championships. Three-person teams consisting of paramedics and representing the Polish emergency services were included in the study. The team representing the championship organiser and the few foreign teams participating in the competition were excluded from the study. Results: The decision to conduct EC was taken by 36 teams (83.72%) in 2015 and 27 teams (87.10%) in 2019. In both editions of the championships, during consecutive shocks, the percentage of actions performed correctly decreased significantly—switching on synchronisation mode in 2015 (94.4%, 83.33%, 72.22%) and in 2019 (100%, 88.89%, 81.48%); correct energies in 2015 (91.67%, 80.56%, 77.78%) and in 2019 (92.59%, 85.19%, 81.48%); shocks in a safe manner in 2015 (94.44%, 94.44%, 91.67%) and in 2019 (100%, 96.30%, 96.30%). Conclusions: Teams participating in the assessed tasks in a significant majority of cases correctly qualified the patient for EC, and correctly carried out the actions required for this procedure. It is of particular note that with every subsequent shock, the percentage of shocks carried out without the sync mode increased significantly. [ABSTRACT FROM AUTHOR]

Mechanical action can damage physical objects, such as building structures. The transfer of energy to the ground through the falling mass, forming a crater, can cause kinematic forces in the soil medium. An effect of these forces, connected with the technology of geotechnical machines, is vibrations of the ground and building structures. When finding the energy impact on the object is difficult or even impossible, vibration monitoring and indirect estimation of the negative energy impact effects is possible. Commercial off-the-shelf solutions exist for vibration monitoring and recording, but they are dedicated to one application type and are relatively expensive. This paper presents a proprietary system for monitoring and recording vibrations of building objects transmitted through the ground. This allows for local registration and remote administration and presentation of data via a computer network. Vibrations can be analysed according to the requirements of developers and clients. The developed system shows that creating an effective approach for collecting data on building vibrations using components from different suppliers is possible. The waveforms collected using the system confirm the effectiveness and flexibility of the presented solution, providing a possibility of using the results to decide whether the vibrations are within the standard limits.

The article presents detailed guidelines for the nonlinear modelling of wood–CFRP beams with full cross-section using the Finite Element Method (FEM). Reviewing the literature has shown that behaviour of such composites is a current research topic, undertaken by many scientists. Complex numerical models made in the Simulia ABAQUS software are the basis for modelling recommendations. Properties of the materials consider the orthotropy and plasticity of wood and CFRP tapes, and the stiffness of adhesive layers with delamination. Results of laboratory experiments, got for a statistically significant number of specimens, confirm the model assumptions. This research paper provides a rich source of knowledge and experiences for scientists and engineers, who deal with mechanics of wood–CFRP composites. The uniqueness of the presentation lies in the detailed description of the complex numerical model. Specification comprises the steps necessary to do complete and successful calculations. The model is suitable for analysing the behaviour of wood–CFRP composites in different reinforcement configurations.

The aim of the study was to analyse changes in the physicochemical, rheological, and textural properties occurring during the storage of industrially produced smoked salami and mould salami. Tests on these cold cuts were conducted on the 2nd, 15th, 30th, and 45th days of storage. There was a significant increase in the pH value of the mould salami from 5.16 on the 2nd day to 5.42 on the 45th day (p < 0.05). There was a downward trend in the Aw of the smoked salami sample from 0.892 on the 2nd day to 0.873 on the 45th day. The Aw in the mould salami sample decreased from 0.889 on the 2nd day to 0.847 on the 15th day and then increased to 0.871 on the 45th day (p < 0.05). In the first two test periods, the smoked salami was characterised by a higher modulus of elasticity value than the non-smoked salami but lower loss tangent and dynamic viscosity values. The hardness of the whole bars, as well as the hardness of the salami pieces, was affected by their storage time and the related water content. The texture test results showed that the smoked salami was more resistant to compressive force than the mould salami, which affected the sensory evaluation and ease of slicing of this type of salami.

Affective polarization refers to people having favorable attitudes toward their preferred political parties, or inparties, along with their supporters, and negative attitudes toward other parties, or outparties, and their supporters. Originally an American concept, there is now growing interest in studying (AP) in European countries characterized by multiparty systems. So far, researchers have primarily focused on like-dislike ratings when measuring affect, which has relegated another important aspect to the background, namely attitudes toward ordinary supporters of parties. Open questions also remain relating to how political ingroups and outgroups should be conceptualized in situations with large numbers of relevant political parties. We examine these puzzles using data from an online panel in Finland. First, we measure partisan social distance, or feelings toward interacting with supporters of different parties, in addition to commonly used like-dislike ratings of parties. We find that social distance differs from party like-dislike ratings in that respondents are less likely to report animosity toward outparty supporters. Second, we measure multiple party identification based on party support and closeness, and find that people commonly have not one, but many potential inparties. Finally, we build two individual-level AP measures and apply them using both like-dislike ratings and social distance scales. One of the measures is based on identifying a single inparty, while the other takes the possibility of multiple inparties into account. We find that choosing which type of attitude to measure is more consequential for the outcome than how partisanship is operationalized. Our results and discussion clarify relationships between AP and related constructs, and highlight the necessity to consider the political and social context when measuring AP and interpreting results.

Objectives The COVID-19 pandemic has forced emergency services to implement new standards of practice around the world. The dynamic and unpredictable nature of many clinical situations has placed emergency service personnel in direct danger of contracting the disease. This work uses a validated survey developed for the study to assess the predictors of stress that paramedics, nurses and doctors experience in the face of the COVID-19 pandemic. Material and Methods The study group included 955 medical staff, and the level of significance adopted for statistical analysis was p = 0.05. Non-parametric Mann-Whitney and Kruskal-Wallis tests were used to analyze the qualitative variables divided into groups. The selection of tests was carried out based on the distribution of variables, verified using the Shapiro-Wilk test. In order to determine the predictors that caused the feelings of stress, it was necessary to use the linear regression model. Results During the COVID-19 pandemic, stress among emergency medical personnel has increased considerably due to new factors that did not previously exist. The predictors of stress in the professional environment include the fear of contracting COVID-19, a decrease in the level of safety while conducting emergency medical procedures, and the marginalization of treatment for patients not suffering from COVID-19. Additional socio-demographic factors that increase stress among emergency medical personnel are being female and working in the nursing profession. Appropriate training, the supply of personal protective equipment and opinions on the preparedness of the system to deal with the outbreak of the pandemic did not affect the level of stress among health service personnel. Conclusions The factors that can be considered to act as predictors of occupational stress include the fear of contracting COVID-19, a decrease in the level of safety and security while conducting emergency medical procedures, and the marginalization of patients not suffering from COVID-19. Int J Occup Med Environ Health. 2021;34(2):139–49

The article presents an original method for determining the modulus of elasticity of natural materials. A studied solution was based on vibrations of non-uniform circular cross-section cantilevers solved using Bessel functions. The derived equations, together with experimental tests, allowed for calculating the material’s properties. Assessments were based on the measurement of the free-end oscillations in time using the Digital Image Correlation (DIC) method. They were induced manually and positioned at the end of a cantilever and monitored in time using a fast Vision Research Phantom v12.1 Camera with 1000 fps. GOM Correlate software tools were then used to find increments of deflection on a free end in every frame. It provided us with the ability to make diagrams containing a displacement–time relation. To find natural vibration frequencies, fast Fourier transform (FFT) analyses were conducted. The correctness of the proposed method was compared with a three-point bending test performed on a Zwick/Roell Z2.5 testing machine. The presented solution generates trustworthy results and can provide a method to confirm the elastic properties of natural materials obtained in various experimental tests.

Determining the amount of electromagnetic wave energy absorbed by the human body is an important issue in the analysis of wireless systems. Typically, numerical methods based on Maxwell’s equations and numerical models of the body are used for this purpose. This approach is time-consuming, especially in the case of high frequencies, for which a fine discretization of the model should be used. In this paper, the surrogate model of electromagnetic wave absorption in human body, utilizing Deep-Learning, is proposed. In particular, a family of data from finite-difference time-domain analyses makes it possible to train a Convolutional Neural Network (CNN), in view of recovering the average and maximum power density in the cross-section region of the human head at the frequency of 3.5 GHz. The developed method allows for quick determination of the average and maximum power density for the area of the entire head and eyeball areas. The results obtained in this way are similar to those obtained by the method based on Maxwell’s equations.

From the moment the SARS-CoV-2 virus was identified in December 2019, the COVID-19 disease spread around the world, causing an increase in hospitalisations and deaths. From the beginning of the pandemic, scientists tried to determine the major cause that led to patient deaths. In this paper, the background to creating a research model was diagnostic problems related to early assessment of the degree of damage to the lungs in patients with COVID-19. The study group comprised patients hospitalised in one of the temporary COVID hospitals. Patients admitted to the hospital had confirmed infection with SARS-CoV-2. At the moment of admittance, arterial blood was taken and the relevant parameters noted. The results of physical examinations, the use of oxygen therapy and later test results were compared with the condition of the patients in later computed tomography images and descriptions. The point of reference for determining the severity of the patient's condition in the computer imagery was set for a mild condition as consisting of a percentage of total lung parenchyma surface area affected no greater than 30%, an average condition of between 30% and 70%, and a severe condition as greater than 70% of the lung parenchyma surface area affected. Patients in a mild clinical condition most frequently had mild lung damage on the CT image, similarly to patients in an average clinical condition. Patients in a serious clinical condition most often had average levels of damage on the CT image. On the basis of the collected data, it can be said that at the moment of admittance, BNP, PE and HCO3− levels, selected due to the form of lung damage, on computed tomography differed from one another in a statistically significant manner (p < 0.05). Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of a physical examination and applied oxygen therapy. Patients can qualify for an appropriate group according to the severity of COVID-19 on the basis of BNP, HCO3 and BE parameters obtained from arterial blood. [ABSTRACT FROM AUTHOR]

Tetralogy of Fallot is a congenital heart disease affecting newborns and involves stenosis of the right ventricular outflow tract (RVOT). Surgical correction often widens the RVOT with a transannular enlargement patch, but this causes issues including pulmonary valve insufficiency and progressive right ventricle failure. A monocusp valve can prevent pulmonary regurgitation; however, valve failure resulting from factors including leaflet design, morphology, and immune response can occur, ultimately resulting in pulmonary insufficiency. A multimodal platform to quantitatively evaluate the effect of shape, size, and material on clinical outcomes could optimize monocusp design. This study introduces a benchtop soft biorobotic heart model, a computational fluid model of the RVOT, and a monocusp valve made from an entirely biological cell-assembled extracellular matrix (CAM) to tackle the multifaceted issue of monocusp failure. The hydrodynamic and mechanical performance of RVOT repair strategies was assessed in biorobotic and computational platforms. The monocusp valve design was validated in vivo in ovine models through echocardiography, cardiac magnetic resonance, and catheterization. These models supported assessment of surgical feasibility, handling, suturability, and hemodynamic and mechanical monocusp capabilities. The CAM-based monocusp offered a competent pulmonary valve with regurgitation of 4.6 ± 0.9% and a transvalvular pressure gradient of 4.3 ± 1.4 millimeters of mercury after 7 days of implantation in sheep. The biorobotic heart model, in silico analysis, and in vivo RVOT modeling allowed iteration in monocusp design not now feasible in a clinical environment and will support future surgical testing of biomaterials for complex congenital heart malformations. Editor's summary: Congenital heart defects such as Tetralogy of Fallot require surgical correction to address complex and multifactorial deficits in cardiac function. Here, Singh et al. develop a model of impaired right ventricular outflow tract function in a biorobotic heart paired with an in silico hemodynamic model. The hybrid soft robotic and ovine myocardium exhibited anatomical and biomechanical characteristics of the heart for ex vivo iteration of surgical repair strategies with a cell-assembled matrix biomaterial. The optimized surgical approach was further supported by an acute in vivo ovine model. This multimodal platform will support the hemodynamic evaluation of complex cardiac defects, aiding in the translation of new therapeutic approaches. —Molly Ogle [ABSTRACT FROM AUTHOR]

Introduction. The BRAF mutation occurs in 8-12% of patients with colorectal cancer. This is associated with unfavorable prognosis -- in metastatic disease, median survival does not exceed one year. Molecularly targeted treatment -- encorafenib with cetuximab -- is the standard of care in cases of chemotherapy failure. Material and methods. Medical data of 18 patients treated with encorafenib and cetuximab in 2021-2023 in 10 oncology centers in Poland were assessed. We analyzed clinical, pathomorphological, and molecular factors, as well as the effectiveness and safety of treatment. Results. The median age in the group was 63 years. Patients with metastases limited to one location predominated (78%). Treatment with encorafenib and cetuximab was used not only in the third (in 50% of patients) or fourth (in 28%) lines of treatment but also in the second (in 22%). The objective response rate was 29.4%, and the disease control rate was 76.4%. The median progression-free survival was 7.1 months. Four patients (22%) had a response lasting over 12 months. Conclusions. The results of the analysis confirmed the efficacy and safety of targeted treatment with encorafenib and cetuximab in patients with metastatic colorectal cancer with the BRAFV600E mutation, known from other studies. [ABSTRACT FROM AUTHOR]

Structural connections are one of the most important parts influencing the overall performance of a wooden structure. The way of design of these can lead both to increasing and decreasing internal stresses occurring in the load-carrying elements and total deformations of the structure. Typical mechanical joints in wooden structures are defined as plastic hinges or, at best, semi-rigid. The innovative hybrid proposed in the paper with adhesive added between elements can be much stiffer than a typical connection, which can lead to assuming rigid joint and significant reduction in stresses and deformations of a structure. The research comprised 30 specimens in three groups (10 per each group: reference - without adhesive, hybrid with one-component PUR - polyurethane adhesive and hybrid with one-component PVAc - polyvinyl acetate adhesive) tested on the MTS 809 testing machine up to failure. An innovative idea was to connect elements initially by applying an accurately predicted tightening torque value to bolts. This resulted in obtaining enough clamping pressure between elements for adhesive curing, with none other equipment. The load was applied in parallel-to-grain wood direction. The results showed that utilising hybrid connection caused, both for PUR and PVAc adhesive, a huge increase in stiffness. When comparing to the reference no-adhesive, bolted connection, this was 2365% stiffer (nearly 24 times). Load-carrying capacity was higher too, however, the increase was not that significant and was at the level of 14.4% and 27.1%, for PUR and PVAc adhesives, consecutively. Worth noting is that the hybrid connection could continue to work after adhesive failure with 60% higher stiffness than the reference one and its load-carrying capacity was only 10% lower than the reference. Hybrid connections of this type can potentially serve as structural joints because of the innovative concept of combining components. Steel plates can be covered with adhesive and then inserted between wooden parts. Next, the tightened bolts can work as clamps producing enough pressure for adhesive curing, enabling the joint to be assembled directly on the construction site. Despite the mentioned advantages, before providing the connections' design methods, the idea needs to be tested towards various effects influencing wooden structures. Incorporating numerical modelling can be extremely important too. [ABSTRACT FROM AUTHOR]

AbstractThis study explores the link between ethnic divides and affective polarization by proposing that individual differences in outparty affect towards ethnic parties are associated with either prejudice against the ethnic group or dissatisfaction with minority accommodation at the sociotropic or egotropic level. We test this proposal through a case study of the Swedish People’s Party in Finland. Using survey data, we find that sociotropic concerns have the strongest link to affective evaluations of the ethnic party. However, among right-wing populist voters, egotropic concerns also stand out. The association between ethnic prejudice and evaluations of the SFP was weak and ambiguous. [ABSTRACT FROM AUTHOR]