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Airway management is a controversial topic in modern Emergency Medical Services (EMS) systems. Among many concerns regarding endotracheal intubation (ETI), unrecognized esophageal intubation and observations of unfavorable neurologic outcomes in some studies raise the question of whether alternative airway techniques should be first-line in EMS airway management protocols. Supraglottic airway devices (SADs) are simpler to use, provide reliable oxygenation and ventilation, and may thus be an alternative first-line airway device for paramedics. In 2019, Alachua County Fire Rescue (ACFR; Alachua, Florida USA) introduced a novel protocol for advanced airway management emphasizing first-line use of a second-generation SAD (i-gel) for patients requiring medication-facilitated airway management (referred to as “rapid sequence airway” [RSA] protocol).
Study Objective:
This was a one-year quality assurance review of care provided under the RSA protocol looking at compliance and first-pass success rate of first-line SAD use.
Methods:
Records were obtained from the agency’s electronic medical record (EMR), searching for the use of the RSA protocol, advanced airway devices, or either ketamine or rocuronium. If available, hospital follow-up data regarding patient condition and emergency department (ED) airway exchange were obtained.
Results:
During the first year, 33 advanced airway attempts were made under the protocol by 23 paramedics. Overall, compliance with the airway device sequence as specified in the protocol was 72.7%. When ETI was non-compliantly used as first-line airway device, the first-pass success rate was 44.4% compared to 87.5% with adherence to first-line SAD use. All prehospital SADs were exchanged in the ED in a delayed fashion and almost exclusively per physician preference alone. In no case was the SAD exchanged for suspected dislodgement evidenced by lack of capnography.
Conclusion:
First-line use of a SAD was associated with a high first-pass attempt success rate in a real-life cohort of prehospital advanced airway encounters. No SAD required emergent exchange upon hospital arrival.
Fewer than half of patients with major depressive disorder (MDD) respond to psychotherapy. Pre-emptively informing patients of their likelihood of responding could be useful as part of a patient-centered treatment decision-support plan.
Methods
This prospective observational study examined a national sample of 807 patients beginning psychotherapy for MDD at the Veterans Health Administration. Patients completed a self-report survey at baseline and 3-months follow-up (data collected 2018–2020). We developed a machine learning (ML) model to predict psychotherapy response at 3 months using baseline survey, administrative, and geospatial variables in a 70% training sample. Model performance was then evaluated in the 30% test sample.
Results
32.0% of patients responded to treatment after 3 months. The best ML model had an AUC (SE) of 0.652 (0.038) in the test sample. Among the one-third of patients ranked by the model as most likely to respond, 50.0% in the test sample responded to psychotherapy. In comparison, among the remaining two-thirds of patients, <25% responded to psychotherapy. The model selected 43 predictors, of which nearly all were self-report variables.
Conclusions
Patients with MDD could pre-emptively be informed of their likelihood of responding to psychotherapy using a prediction tool based on self-report data. This tool could meaningfully help patients and providers in shared decision-making, although parallel information about the likelihood of responding to alternative treatments would be needed to inform decision-making across multiple treatments.
To determine whether: the N95 respirator affects nasal valve patency; placement on the bony vault improves patency; and external nasal anatomy affects the outcome.
Methods
A prospective study with 50 participants was conducted. Nasal patency was measured by the minimal cross-sectional area via acoustic rhinometry, and using the Nasal Obstruction Symptom Evaluation survey, before and after wearing the N95 respirator and after adjustment.
Results
The minimal cross-sectional area was narrowed by 27 per cent when wearing the N95 respirator (p < 0.001), and improved by 9.2 per cent after adjustment (p = 0.003). The total Nasal Obstruction Symptom Evaluation score increased from 10.2 to 25.4 after donning the N95 respirator (p < 0.001), and decreased from 25.4 to 15.6 after adjustment (p < 0.001). There was no correlation with external nasal anatomy parameters.
Conclusion
Wearing the N95 respirator causes narrowing of the nasal valve, and adjustment onto the bony vault improves symptoms. The findings were not affected by external nasal anatomy.
Serosurveillance is an important epidemiologic tool for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), used to estimate infection rates and the degree of population immunity. There is no general agreement on which antibody biomarker(s) should be used, especially with the rollout of vaccines globally. Here, we used random forest models to demonstrate that a single spike or receptor-binding domain (RBD) antibody was adequate for classifying prior infection, while a combination of two antibody biomarkers performed better than any single marker for estimating time-since-infection. Nucleocapsid antibodies performed worse than spike or RBD antibodies for classification, but can be useful for estimating time-since-infection, and in distinguishing infection-induced from vaccine-induced responses. Our analysis has the potential to inform the design of serosurveys for SARS-CoV-2, including decisions regarding a number of antibody biomarkers measured.
The Rapid ASKAP Continuum Survey (RACS) is the first large sky survey using the Australian Square Kilometre Array Pathfinder (ASKAP), covering the sky south of
$+41^\circ$
declination. With ASKAP’s large, instantaneous field of view,
${\sim}31\,\mathrm{deg}^2$
, RACS observed the entire sky at a central frequency of 887.5 MHz using 903 individual pointings with 15 minute observations. This has resulted in the deepest radio survey of the full Southern sky to date at these frequencies. In this paper, we present the first Stokes I catalogue derived from the RACS survey. This catalogue was assembled from 799 tiles that could be convolved to a common resolution of
$25^{\prime\prime}$
, covering a large contiguous region in the declination range
$\delta=-80^{\circ}$
to
$+30^\circ$
. The catalogue provides an important tool for both the preparation of future ASKAP surveys and for scientific research. It consists of
$\sim$
2.1 million sources and excludes the
$|b|<5^{\circ}$
region around the Galactic plane. This provides a first extragalactic catalogue with ASKAP covering the majority of the sky (
$\delta<+30^{\circ}$
). We describe the methods to obtain this catalogue from the initial RACS observations and discuss the verification of the data, to highlight its quality. Using simulations, we find this catalogue detects 95% of point sources at an integrated flux density of
$\sim$
5 mJy. Assuming a typical sky source distribution model, this suggests an overall 95% point source completeness at an integrated flux density
$\sim$
3 mJy. The catalogue will be available through the CSIRO ASKAP Science Data Archive (CASDA).
The Variables and Slow Transients Survey (VAST) on the Australian Square Kilometre Array Pathfinder (ASKAP) is designed to detect highly variable and transient radio sources on timescales from 5 s to
$\sim\!5$
yr. In this paper, we present the survey description, observation strategy and initial results from the VAST Phase I Pilot Survey. This pilot survey consists of
$\sim\!162$
h of observations conducted at a central frequency of 888 MHz between 2019 August and 2020 August, with a typical rms sensitivity of
$0.24\ \mathrm{mJy\ beam}^{-1}$
and angular resolution of
$12-20$
arcseconds. There are 113 fields, each of which was observed for 12 min integration time, with between 5 and 13 repeats, with cadences between 1 day and 8 months. The total area of the pilot survey footprint is 5 131 square degrees, covering six distinct regions of the sky. An initial search of two of these regions, totalling 1 646 square degrees, revealed 28 highly variable and/or transient sources. Seven of these are known pulsars, including the millisecond pulsar J2039–5617. Another seven are stars, four of which have no previously reported radio detection (SCR J0533–4257, LEHPM 2-783, UCAC3 89–412162 and 2MASS J22414436–6119311). Of the remaining 14 sources, two are active galactic nuclei, six are associated with galaxies and the other six have no multi-wavelength counterparts and are yet to be identified.
Cross-cultural research is burgeoning. Behavioral and social sciences such as psychology, sociology, management, marketing, and political science witness a steady increase in cross-cultural studies. For example, during the last decades, there has been a consistently increasing number of psychological studies on cross-cultural similarities and differences (Boer, Hanke, & He, 2018; Smith, Harb, Lonner, & Van de Vijver, 2001; Van de Vijver & Lonner, 1995). The increased interest is undoubtedly inspired by various factors, such as the opening of previously sealed international borders, large migration streams, globalization of the economic market, international tourism, increased cross-cultural communications, and technological innovations such as new means of telecommunication.
In the previous chapters, typical problems and pitfalls of cross-cultural research were discussed and solutions proposed. The current chapter briefly integrates the major methodological issues into eight statements. Each statement is followed by an explanation. The last section is devoted to our view on the future of cross-cultural research.
This chapter contains a description of the sampling of cultures, design, data analysis, and major strengths and weaknesses of the eight types of cross-cultural studies described in Chapter 2: structure- and level-oriented psychological differences studies; structure- and level-oriented generalizability studies; structure- and level-oriented contextual linkage exploration studies; and structure- and level-oriented contextual linkage validation studies. The structure- and level-oriented studies differ primarily in the analyses employed, so their presentation is integrated. A schematic overview is given in Table 5.1.
This book addresses the methodological features of cross-cultural research. The common characteristic of such studies is their comparative nature, which involves the comparison of at least two cultural populations. Many studies involve different nation states, in sociology (e.g., Inglehart & Welzel, 2010; Van Deth, Montero, & Westholm, 2007), education (e.g., Arnove, Torres, & Franz, 2012; Van de Werfhorst & Mijs, 2010), political sciences (e.g., Coffé & Bolzendahl, 2010; Poguntke & Webb, 2007), management (e.g., House et al., 2004), and psychology (e.g., Schmitt, Allik, McCrae, & Benet-Martínez, 2007). However, comparative studies can also involve different ethnic groups from a single country such as the comparison of ethnic groups in the United States (e.g., Trinidad, Pérez-Stable, White, Emery, & Messer, 2011) and in Europe (Phalet & Kosic, 2006).
Two closely related concepts play an essential role in cross-cultural comparisons, namely equivalence and bias (Poortinga, 1989; Van de Vijver, 2015). There is no consensual definition of either concept in the cross-cultural literature. Johnson (1998) identified more than fifty types of definitions of equivalence, addressing dissimilar features, such as constructs, methodology, language, and context. All definitions refer to some aspect that is shared across cultures or to a qualitative or quantitative procedure to establish the shared features. A review of bias approaches would probably show a comparable variety.