Search

Background: Chest compressions are life-saving in cardiac arrest but concern by layperson of causing unintentional injury to patients who are not in cardiac arrest may limit provision and therefore delay initiation when required. Aim: To perform a systematic review of the evidence to identify if; among patients not in cardiac arrest outside of a hospital, does provision of chest compressions from a layperson, compared to no use of chest compressions, worsen outcomes. Method: We searched Medline (Ovid), Web of Science Core Collection (clarivate) and Cinahl (Ebsco). Outcomes included survival with favourable neurological/functional outcome at discharge or 30 days; unintentional injury (e.g. rib fracture, bleeding); risk of injury (e.g. aspiration). ROBINS-I was used to assess for risk of bias. Grading of Recommendations, Assessment, Development and Evaluation methodology was used to determine the certainty of evidence. (PROSPERO registration number: CRD42023476764). Results: From 7832 screened references, five observational studies were included, totaling 1031 patients. No deaths directly attributable to chest compressions were reported, but 61 (6 %) died before discharge due to underlying conditions. In total, 9 (

In recent years, communication robots are commonly used in various places and situations such as guidance work at hotels and stations and elderly supports for the purpose of reducing human loads and releasing from simple works. However, it is also shown that people still have a sense of anxiety toward robots. For this reason, there are few people who have motivations to communicate with robots. On the other hand, it has been suggested that the emotion expression of robots contributes to create a sense of familiarity and smooth communication. Therefore, we propose a method of emotion expression and enhancement by changing the color of the clothes the robot is wearing. Also, we have clarified the matching between the clothes colors and 10 emotions (joy, anger, sorrow, fear, shame, like, dislike, excite, relief and surprise). In this research, we investigate the influences of changing the clothes color in scenes where the robot's speech emotions change in time series. As a result of the experiment, it becomes clear that feeling of transmission can be improved by changing the clothes color according to the speech emotion in case that the mechanism of clothes color change is correctly understood. On the other hand, feeling of transmission is decreased in case that the mechanism is not understood.

Electrochemical capacitors are known for their high power density and cyclability, and various redox reactions can be utilized to improve their energy density. A great variety of redox materials have been investigated recently for use in electrochemical capacitors, not only transition metal oxides, which have been studied for many years. In this review, we provide a comprehensive explanation of redox materials for electrochemical capacitors. Manganese oxides and ruthenium oxides, which are typical metal oxides exhibiting pseudocapacitance, are first discussed. Nickel oxides used in hybrid capacitors are also covered. Various 0D and 2D nanomaterials are highlighted. Pseudo-capacitance using nanosized complex materials and metal-organic frameworks is also presented. Furthermore, electrolyte systems that exhibit redox characteristics for electrochemical capacitors are also reviewed.

Redox-flow batteries (RFBs) are promising electrochemical energy storage devices to load-level intermittent power from renewable energy. In particular, aqueous RFBs using aqueous electrolytes possess several advantages over nonaqueous ones, such as low fabrication cost, nontoxicity, safety, and environmental benignity. Therefore, developing high-performance, abundant, less-expensive iron-based catholytes for aqueous RFBs is essential toward their wide deployment in a power grid. In this Perspective, we summarize the recent progress of iron-based catholytes for aqueous RFBs. We emphasize that iron-based catholytes possess widely ranged redox potentials (−1.0 to 1.5 V vs standard hydrogen electrodes) and solubility in water (0.2–4.0 mol L−1), thereby providing a wide range of cell performance. The molecular design, such as ligand functionalization, counter ion mixing, and asymmetrization, allows for rationally improving solubility, redox potential, and energy density. Furthermore, we demonstrate a simple evaluation method of the redox potential of iron-based catholytes using the calculated energy levels of the lowest unoccupied molecular orbital of ligand molecules. Finally, we rationalize the design strategy of iron-based catholytes for advanced aqueous RFBs.

Majority of oxygen-redox electrodes exhibit a large voltage hysteresis but its origin is not fully understood. Here, the authors use combined RIXS and magnetic measurements to provide insights into the origin of the typically large voltage hysteresis observed upon oxygen redox.

Abstract Background The national incidence and characteristics of out‐of‐hospital cardiac arrest in the United States is unclear. We sought to describe the national characteristics of adult out‐of‐hospital cardiac arrest reported in the National Emergency Medical Services Information System (NEMSIS). Methods We used 2016 NEMSIS data, consisting of most emergency medical services (EMS) responses from 46 states and territories. We limited the analysis to adult (age ≥18 years) emergency “9‐1‐1” events. We defined out‐of‐hospital cardiac arrest as: (1) patient condition reported as cardiac arrest, (2) EMS reported attempted resuscitation of cardiac arrest, (3) EMS performance of cardiopulmonary resuscitation (CPR), or (4) EMS performance of defibrillation. We determined the incidence of adult out‐of‐hospital cardiac arrest among EMS responses. We also determined patient demographics (age, sex, race, ethnicity, location, US census region, and urbanicity), response characteristics (dispatch complaint and elapsed time) and clinical interventions (medications and procedures) of adult out‐of‐hospital cardiac arrest. We analyzed the data using descriptive techniques, calculating binomial proportions with exact 95% confidence intervals (CI). Results Among 18,679,873 adult 9‐1‐1 responses, there were 224,992 with patient condition cardiac arrest, 344,274 with EMS‐reported attempted cardiac arrest resuscitation, 149,775 with EMS performance of CPR, and 185,388 cases with EMS performance of defibrillation, resulting in a total of 574,824 out‐of‐hospital cardiac arrest (incidence 30.8 per 1000 EMS 9‐1‐1 responses, 95% CI = 30.69–30.85). Among identified out‐of‐hospital cardiac arrest responses, most involved patients who were older (mean = 62.4 ± 20.1 years). Most out‐of‐hospital cardiac arrest occurred at home (58.8%), in the South census region (65.4%), and in urban settings (79.8%). The most commonly reported medications used in out‐of‐hospital cardiac arrest were: epinephrine (22.5%), amiodarone (2.9%), sodium bicarbonate (6.2%), glucose (3.0%), and naloxone (5.1%). Commonly reported procedures included CPR (26.1%), orotracheal intubation (14.2%), bag‐valve‐mask ventilation (10.1%), manual defibrillation (29.3%) and automated external defibrillation (5.6%). Out‐of‐hospital cardiac arrest EMS treatment times were: elapsed response time (median = 7 minutes [interquartile range (IQR) = 5–10]), scene time (median = 17 minutes [IQR = 12–25]), and elapsed transport time (median = 11 minutes [IQR = 6–17]). Conclusions Using information available in the 2016 NEMSIS data, we estimate that there were over 570,000 reported adult out‐of‐hospital cardiac arrests in the United States. These results highlight the challenges of characterizing the epidemiology of adult out‐of‐hospital cardiac arrest in the United States.

Abstract Aqueous lithium‐ion batteries are promising electrochemical energy storage devices owing to their sustainable nature, low cost, high level of safety, and environmental benignity. The recent development of a high‐salt‐concentration strategy for aqueous electrolytes, which significantly expands their electrochemical potential window, has created attractive opportunities to explore high‐performance electrode materials for aqueous lithium‐ion batteries. This study evaluates the compatibility of large‐capacity oxygen‐redox cathodes with hydrate‐melt electrolytes. Using conventional oxygen‐redox cathode materials (Li2RuO3, Li1.2Ni0.13Co0.13Mn0.54O2, and Li1.2Ni0.2Mn0.6O2), it is determined that avoiding the use of transition metals with high catalytic activity for the oxygen evolution reaction is the key to ensuring the stable progress of the oxygen redox reaction in concentrated aqueous electrolytes.

The practical application of Li-rich cathode materials exhibiting higher energy density with oxygen redox activity requires improved cycle performance and energy efficiency. Since several conditions such as the amount of excess lithium, transition metal species, and cutoff voltage influence the electrochemical properties of Li-rich cathode materials, comprehensive determination of the optimal conditions often rely on repeating empirical try error processes. Here, the dominant factors in the energy density of Li-rich cathode materials were analyzed by constructing machine learning prediction models based on well-controlled experimental data for simplicity. Choosing a moderate amount of excess lithium and increasing the cobalt contents are the keys to achieve high energy density in long-term cycles.

Background The timing of advanced airway management (AAM) on patient outcomes after out‐of‐hospital cardiac arrest has not been fully investigated. We evaluated the association between the timing of prehospital AAM and 1‐month survival. Methods and Results We conducted a secondary analysis of a prospective, nationwide, population‐based out‐of‐hospital cardiac arrest registry in Japan. We included emergency medical services–treated adult (≥18 years) out‐of‐hospital cardiac arrests from 2014 through 2017, stratified into initial shockable or nonshockable rhythms. Patients who received AAM at any minute after emergency medical services–initiated cardiopulmonary resuscitation underwent risk‐set matching with patients who were at risk of receiving AAM within the same minute using time‐dependent propensity scores. Eleven thousand three hundred six patients with AAM in shockable and 163 796 with AAM in nonshockable cohorts, respectively, underwent risk‐set matching. For shockable rhythms, the risk ratios (95% CIs) of AAM on 1‐month survival were 1.01 (0.89–1.15) between 0 and 5 minutes, 1.06 (0.98–1.15) between 5 and 10 minutes, 0.99 (0.87–1.12) between 10 and 15 minutes, 0.74 (0.59–0.92) between 15 and 20 minutes, 0.61 (0.37–1.00) between 20 and 25 minutes, and 0.73 (0.26–2.07) between 25 and 30 minutes after emergency medical services–initiated cardiopulmonary resuscitation. For nonshockable rhythms, the risk ratios of AAM were 1.12 (1.00–1.27) between 0 and 5 minutes, 1.34 (1.25–1.44) between 5 and 10 minutes, 1.39 (1.26–1.54) between 10 and 15 minutes, 1.20 (0.99–1.45) between 15 and 20 minutes, 1.18 (0.80–1.73) between 20 and 25 minutes, 0.63 (0.29–1.38) between 25 and 30 minutes, and 0.44 (0.11–1.69) after 30 minutes. Conclusions In this observational study, the timing of AAM was not statistically associated with improved 1‐month survival for shockable rhythms, but AAM within 15 minutes after emergency medical services–initiated cardiopulmonary resuscitation was associated with improved 1‐month survival for nonshockable rhythms.

Here the authors report the evolution of stacking faults in Na2RuO3 showing that there is progressive cation ordering upon charging and notably the stacking faults can disappear. This behavior is driven by cooperative Coulombic interactions and can contribute to stabilizing the phase transformations.

Confinement within nanospace could significantly alter the properties of chemical species. Here the authors report the negative dielectric constant of water confined in nanosheets that can enhance the capacitance of electric-double layer capacitor electrodes.

Recently, typing skills especially touch typing is given much importance. However, the typing skill of entrant students tends to be poor, because of the use of smart phone. Although some students try to improve their typing skill using typing software, pre-existing one similarly ignores which fingers are used, and instead emphasizes hitting the correct keys as fast as possible. The goal of this study is to develop a learning support system for touch typing based on fingering detected when typing, and to evaluate the possibility of teaching touch typing to non-touch typists through practicing with this system. In this study, we propose a method to determine which fingers are used to press which keys by using video of fingering made when typing and data of the pressed keys. Furthermore, we conduct evaluation experiments with the system using this method and evaluate the effectiveness of the system. According to the experiment results, estimation accuracy tended to decrease as CPM values increase. We learned that there were cases in which incorrect estimations were made, and we classified the causes into two categories: errors caused by occlusion and errors due to the image sampling being unable to keep up with the fingering. It is evident from the experimental results and discussion that when this system is used for non-touch typists to learn touch typing, it gives correct estimation results and is effective. For further research, we suggest using this system to facilitate the learning of touch typing for non-touch typists. More specifically, learners should enter a sequence of letters shown on-screen. Messages should be displayed on-screen when an incorrect key is pressed or when the recommended finger is not used. We believe that touch typing skills can be easily acquired by making users aware of what fingers they use to press the keys.

Objectives Although frequent emergency department (ED) use is a global issue, little research has been conducted in a country like Japan where universal health insurance is available. The study aims to (1) document the proportion of ED visits that are by frequent users and (2) describe the differences in characteristics of frequent ED users and other ED users including expenditures between a secondary and a tertiary hospital.Design A prevalence study for a period of 1 year.Setting A secondary hospital and a tertiary hospital in central Japan.Participants All patients who presented to the EDs.Primary outcome measures We defined frequent ED user as a patient who visited the ED≥5 times/year. The main outcome measures were the proportion of frequent ED users among all ED users and the proportion of healthcare expenditures by the frequent ED users among all ED expenditures.Results Of 25 231 ED visits over 1 year, 134 frequent ED users accounted for 1043 visits—0.66% of all ED users, comprised 4.1% of all ED visits, and accounted for 1.9% of total healthcare expenditures. Median ED visits per one frequent ED user was 7.9. At the patient level, after adjusting for age, gender and receiving public assistance, older age (OR 1.01, 95% CI: 1.00 to 1.02) and receiving public assistance (OR 7.19, 95% CI 2.87 to 18.07) had an association with frequent ED visits. At the visit-level analysis, evaluation by internal medicine (OR 1.27, 95% CI 1.02 to 1.57), psychiatry (OR 124.69, 95% CI 85.89 to 181.01) and obstetrics/gynaecology (OR 2.77, 95% CI 2.09 to 3.67) were associated with frequent ED visits.Conclusion The proportion of frequent ED users, of total visits, and of expenditures attributable to them—while still in the low end of the distribution of published ranges—are lower in this study from Japan than in reports from many other countries.

Objectives Patient outcomes after out-of-hospital cardiac arrest (OHCA) varies at multilevel (geographical regions, emergency medical service agencies and receiving hospitals) in the USA. However, it remains unclear whether there is a variation in patient outcomes after OHCA between relevant units of the healthcare system such as receiving hospitals in Japan. Therefore, we aimed to quantify the variation in patient outcomes after OHCA between receiving hospitals in Japan.Design Secondary analysis of the prospective multicentre OHCA registry.Setting The Japan Association for Acute Medicine OHCA Registry, a prospective multicentre OHCA registry, including 73 medical institutions in Japan.Participants 9303 adults (≥18 years old) with OHCA of medical origin, treated at 67 hospitals from June 2014 to December 2015.Primary and secondary outcome measures The primary outcome was 1-month survival after OHCA. The secondary outcome was favourable functional status at 1 month, defined as cerebral performance category scale 1 or 2. We constructed a series of multivariable hierarchical logistic regression models predicting outcomes, accounting for patient-level variables and clustering of patients within hospitals. We evaluated the adjusted 1-month survival and functional outcome for each hospital, ranked hospitals for each outcome and calculated median ORs (MORs) to quantify the between-hospital variation in outcomes.Results The prevalence of 1-month survival after OHCA was 7.1% (663/9303) and that of favourable functional outcome was 3.6% (331/9303). After adjustment for patient-level factors, we observed variations in 1-month survival (range, 1.6%–13.8%; adjusted MOR 1.34; 95% CI 1.16 to 1.67) and favourable functional outcome (range, 0.7%–7.3%; adjusted MOR 1.53; 95% CI 1.10 to 2.24) between hospitals.Conclusions We found substantial variations in patient outcomes after OHCA within a large group of hospitals in Japan, despite adjustment for patient factors that are known to be associated with different outcomes.

Sodium-excess metal oxides Na2MO3 are appealing cathode materials for sodium-ion batteries. Here, the authors demonstrate that honeycomb-type cation ordering in Na2RuO3 triggers the oxygen redox reaction via frontier orbital reorganization, increasing the capacity by 1/3 compared with disordered Na2RuO3.

Introduction: The objective of this study was to investigate the factors associated with first-pass success in pediatric intubation in the emergency department (ED). Methods: We analyzed the data from two multicenter prospective studies of ED intubation in 17 EDs between April 2010 and September 2014. The studies prospectively measured patient’s age, sex, principal indication for intubation, methods (e.g., rapid sequence intubation [RSI]), devices, and intubator’s level of training and specialty. To evaluate independent predictors of first-pass success, we fit logistic regression model with generalized estimating equations. In the sensitivity analysis, we repeated the analysis in children

Background Layperson cardiopulmonary resuscitation (CPR) is a crucial intervention for patients with out‐of‐hospital cardiac arrest (OHCA). Although a sex disparity in receiving layperson CPR (ie, female patients were less likely to receive layperson CPR) has been reported in adults, there are few data in the pediatric population, and we therefore investigated sex differences in receiving layperson CPR in pediatric patients with OHCA. Methods and Results From the All‐Japan Utstein Registry, a prospective, nationwide, population‐based OHCA database, we included pediatric patients (≤17 years) with layperson‐witnessed OHCA from 2005 through 2015. The primary outcome was receiving layperson CPR. Patient sex was the main exposure. We fitted multivariable logistic regression models to examine associations between patient sex and receiving layperson CPR. We included a total of 4525 pediatric patients with layperson‐witnessed OHCA in this study, 1669 (36.9%) of whom were female. Female patients received layperson CPR more often than male patients (831/1669 [49.8%] versus 1336/2856 [46.8%], P=0.05). After adjustment for age, time of day of arrest, year, witnesses persons, and dispatcher CPR instruction, the sex difference in receiving layperson CPR was not significant (adjusted odds ratio for female subjects 1.14, 95% CI, 0.996‐1.31). Conclusions In a pediatric population, female patients with layperson‐witnessed OHCA received layperson CPR more often than male patients. After adjustment for covariates, there was no significant association between patient sex and receiving layperson CPR.

The 3D pen is a tool that can output a melted resin from a pen tip to form a 3D object. In order to shape an object using a 3D pen, it is necessary to practice it and understand how to use it, and many beginners find it difficult to handle. Most of the difficulty is caused by users not understanding the appropriate moving speed. On the other hand, it is necessary to have interactivity in the learning system. In 3D object drawing learning, a learning system using VR/AR capable of displaying three dimensions is desired. In this research, we aim to support learning in 3D object drawing, and proposed and developed a 3D object drawing learning support system with interactivity. Furthermore, the influence of the proposed system and a video learning system on 3D object drawing skill by 3D pen is examined. As the results of the experiments, it was necessary to practice 3D drawing with 3D pen, and it was deduced that interactive learning may be more effective than non-interactive learning after practicing 3D pen. In addition, it was suggested that interactive learning is more likely to make feel that learners improved with respect to speed and drawing related to pen. In 3D pen drawing learning, it was suggested that those who are not good at 3D drawing are more likely to feel that interactive learning has improved their drawing techniques.

The goal of this paper is to clarify the optimal combination of team members to maximize the learning effectiveness in information systems education courses. We surveyed the correlation of students’ five factor model personalities and the learning effectiveness, which is the amount of increase in team management or technical knowledge, and skill, which is the IPA common carrier skill framework based on SFIA. Specifically, we targeted were three actual courses (a System Development Project course, an IT Management Project course, and an Application Development Project course) to elucidate the relationships between personality characteristics and learning effectiveness. Although individual students’ personality characteristics are not strongly related to learning effectiveness, team personality characteristics are related to learning effectiveness. In particular, Neuroticism and Conscientiousness characteristics are negatively correlated to learning effectiveness.