The effects of prefrontal tDCS and hf-tRNS on the processing of positive and negative emotions evoked by video clips in first- and third-person.

The causal role of the cerebral hemispheres in positive and negative emotion processing remains uncertain. The Right Hemisphere Hypothesis proposes right hemispheric superiority for all emotions, while the Valence Hypothesis suggests the left/right hemisphere's primary involvement in positive/negative emotions, respectively. To address this, emotional video clips were presented during dorsolateral prefrontal cortex (DLPFC) electrical stimulation, incorporating a comparison of tDCS and high frequency tRNS stimulation techniques and manipulating perspective-taking (first-person vs third-person Point of View, POV). Four stimulation conditions were applied while participants were asked to rate emotional video valence: anodal/cathodal tDCS to the left/right DLPFC, reverse configuration (anodal/cathodal on the right/left DLPFC), bilateral hf-tRNS, and sham (control condition). Results revealed significant interactions between stimulation setup, emotional valence, and POV, implicating the DLPFC in emotions and perspective-taking. The right hemisphere played a crucial role in both positive and negative valence, supporting the Right Hemisphere Hypothesis. However, the complex interactions between the brain hemispheres and valence also supported the Valence Hypothesis. Both stimulation techniques (tDCS and tRNS) significantly modulated results. These findings support both hypotheses regarding hemispheric involvement in emotions, underscore the utility of video stimuli, and emphasize the importance of perspective-taking in this field, which is often overlooked.

Occurrence, Concentration and Toxicity of 54 Polycyclic Aromatic Hydrocarbons in Butter during Storage.

Polycyclic aromatic hydrocarbons (PAHs) are a class of highly carcinogenic compounds with a lipophilic nature. This study investigated the characterization of PAH24 contamination in twenty-one types of butter and five types of margarines using the QuEChERS pretreatment coupled with GC-QqQ-MS. Additionally, low-temperature storage experiments were conducted to explore the variations in oxidation index as well as the PAH levels. The results revealed that PAH24 concentrations in butter and margarine were 50.75-310.64 µg/kg and 47.66-118.62 µg/kg, respectively. The PAH4 level in one type of butter reached 11.24 µg/kg beyond the EU standards. Over 160 days of storage at 4 °C, acid value (AV), peroxide value (POV), and acidity significantly increased, while malondialdehyde (MDA) content and carbonyl value (CGV) fluctuated. Concentrations of PAH24 and oxidized PAHs (OPAHs) experienced a notable reduction of 29.09% and 63.85%, respectively. The slow reduction in naphthalene (NaP) indicated the dynamic nature of PAHs during storage. However, the toxic equivalency quotients (TEQs) decreased slightly from a range of 0.65-1.90 to 0.39-1.77, with no significant difference. This study contributes to the understanding of variations in PAHs during storage, which is of great significance for food safety.

A study of the influence of genetic variance and sex on the density and thickness of the calvarial bone in collaborative cross mice.

BACKGROUND: Bone microarchitecture is affected by multiple genes, each having a small effect on the external appearance. It is thus challenging to characterize the genes and their specific effect on bone thickness and porosity. The purpose of this study was to assess the heritability and the genetic variation effect, as well as the sex effect on the calvarial bone thickness (Ca.Th) and calvarial porosity (%PoV) using the Collaborative Cross (CC) mouse population. METHODS: In the study we examined the parietal bones of 56 mice from 9 lines of CC mice. Morphometric parameters were evaluated using microcomputed tomography (µCT) and included Ca.Th and %PoV. We then evaluated heritability, genetic versus environmental variance and the sex effect for these parameters. RESULTS: Our morphometric analysis showed that Ca.Th and %PoV are both significantly different among the CC lines with a broad sense heritability of 0.78 and 0.90, respectively. The sex effect within the lines was significant in line IL111 and showed higher values of Ca.Th and %PoV in females compared to males. In line IL19 there was a borderline sex effect in Ca.Th in which males showed higher values than females. CONCLUSIONS: These results stress the complexity of sex and genotype interactions controlling Ca.Th and %PoV, as the skeletal sexual dimorphism was dependent on the genetic background. This study also shows that the CC population is a powerful tool for establishing the genetic effect on these traits.

Multi-omics revealed the formation mechanism of flavor in salted egg yolk induced by the stages of lipid oxidation during salting.

To explore the contribution of different lipid oxidation stages to flavor formation in salted egg yolk, potential pathways of flavor formation were characterized by multi-omics strategy and partial least squares structural equation model (PLS-SEM). 72 lipids, 135 metabolites and 5 volatiles related to lipid oxidation were screened out. The degradation of aldehydes and ketones, and the generation of tryptamine and elaidic acid, etc. were promoted by triglycerides (TG) (10:0 16:0 18:1), triglycerides (TG) (18:0 20:1 22:0), etc. at primary and secondary oxidation stage, respectively. The generation of acetophenone, thianaphthene, etc. through the pathway of 2-phenylacetamide, hexanoylcarnitine, etc. was facilitated by these triglycerides (TG) at primary oxidation stage. Furthermore, amino acid metabolisms, pentose phosphate pathway and linoleic acid metabolism occurred at secondary oxidation stage were key pathways to form distinctive flavor. In conclusion, secondary oxidation stage may be more important for the formation of unique flavor (taste) in salted egg yolk.

Successful endoscopic resection by using gel immersion and the technique of endoscopic papillectomy for a tumor adjacent to the papilla of Vater.

Video 1Successful endoscopic resection using gel immersion for a tumor adjacent to the papilla of Vater.

Polymorphisms of 5-hydroxytryptamine receptor type 3B gene and clinical characteristics for vomiting after breast surgery in chinese han female population.

WHAT IS KNOWN AND OBJECTIVE: The 5-hydroxytryptamine type 3B receptor (HTR3B) is involved in postoperative vomiting. We aimed to investigate whether genomic variations of rs1176744 and rs1672717 in HTR3B are associated with postoperative vomiting (POV) in the Chinese Han female population after surgery. METHODS: Five hundred and sixty-eight female patients classified as ASA I-II undergoing breast surgery under standard general anaesthesia were enrolled in the study. Episodes of POV in the first 24 h after surgery were recorded. Targeted single nucleotide polymorphisms (SNPs) in the HTR3B gene were identified by genotyping using the SNPscanTM technique. Univariate and multivariate analyses were conducted to investigate the association between SNPs and POV. RESULTS: We eventually analysed 407 subjects undergoing breast surgery under general anaesthesia. Of these, 104(25.6%) patients suffered POV within 24 h after surgery. In the multivariate logistic regression analysis, we found that age≥50 years (p = 0.012) and longer duration of surgery (p = 0.019) were independent risk factors for POV. Simultaneously, in the dominant model of rs1672717, compared with the AA genotype, GG+GA carriers suffered more POV (OR=1.669, p = 0.038). However, the use of atropine reduced the incidence of POV in our study (p = 0.019). WHAT IS NEW AND CONCLUSION: Our investigation demonstrated that polymorphism of rs1672717 (HTR3B) may be a genetic risk factor for developing POV. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT03705026.

Determination of environmental properties and toxicity of octyl-dimethyl-para-aminobenzoic acid and its degradation products.

Octyl-dimethyl-para-aminobenzoic acid (ODPABA) is one of compounds of emerging concern. It undergoes transformations under the influence of oxidizing or chlorinating agents and UV radiation forming products with different properties. There is very little experimental data concerning the environmental fate of ODPABA and its transformation products. Therefore, the purpose of the studies was to determine environmental parameters: water solubility, soil - water partition coefficient, octanol - air partition coefficient, bioconcentration factor as well as half-life in air, water and soil. Based on the results obtained, the persistence and migration possibilities of ODPABA and its transformation products in the aquatic environment were estimated. Moreover, the ecological toxicity of oxidation and chlorination products was investigated. Microtox®, Daphtoxkit F® and Artoxkit M® tests were used to determine toxicity. LC50 for Fish and Daphnia magna was calculated by Ecosar module. Studies have shown that as a result of ODPABA transformations, chloroorganic products are formed, which are lipophilic, are bioconcentrated in organic matter, are characterized by significant environmental persistence, can spread over considerable distances and are toxic. Oxidation products have significantly smaller impact on the environment. They are characterized by higher water solubility, lower bioconcentration factor and are less toxic.

Magnetic resonance neuroimaging promotes the preservation of pelvic autonomic nerves in laparoscopic total mesorectal excision: a comparative study.

BACKGROUND: How to preserve pelvic autonomic nerves system (PANS) in total mesorectal excision (TME) is still a technical challenge for gastrointestinal surgeons, and nerve preservation according to preoperative magnetic resonance imaging (MRI) is a hot topic in pelvic surgery. The purpose of this study was to assess the postoperative urogenital function of patients with rectal cancer (RC) who underwent preoperative and postoperative neuroimaging of PANS vs. patients who did not. METHODS: Patients meeting the inclusion criteria were prospectively enrolled in a magnetic resonance neuroimaging (MRN) group from June 2018, while primary RC patients from January 2016 to May 2018 who met the inclusion criteria were enrolled in a non-MRN group. Patients in the MRN group underwent MRN examination before operation and 6 months after operation, while those in the non-MRN group were collected and analyzed retrospectively. RESULTS: Based on International Prostate Symptom Score (IPSS) and International Index of Erectile Function 5 (IIEF5) scores at 6 months, the postoperative urinary and sexual function of male patients in the MRN group were significantly better than that in the non-MRN group (P<0.05). In addition, based on International Consultation on Incontinence modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Female Sexual Function Index (FSFI) scores at 6 months, the postoperative sexual function of female patients in the MRN group was significantly better than that in the non-MRN group (P<0.05). CONCLUSIONS: In the present study, we constructed a three-dimensional (3D) presentation of PANS based on preoperative MRN which showed in vivo pelvic autonomous innervation. This may promote the preservation of PANS during TME and reduce the postoperative urogenital dysfunction rate.

What is the ideal combination antiemetic regimen?

Postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) are frequent unpleasant complaints that patients and clinicians report after surgery. PONV and PDNV have been associated with postoperative complications and hospital discharge delays. Despite the extensive evidence describing the use of several regimens in different surgical populations, the ideal regimen has not been established. Several antiemetic drugs have been evaluated in more than 1000 clinical controlled trials for management of this complex emetogenic pathway, including the 5-hydroxytryptamine (5-HT3) receptor antagonists, dopamine receptor antagonists, neurokinin-type receptor antagonists, antihistaminics, anticholinergics, and corticosteroids, with the 5-HT3 receptor antagonists being the most commonly used for PONV prophylaxis. Because of the complex emetogenic pathway and multifactorial etiology of PONV, a multimodal approach using two or more drugs that act at different neuro-receptor sites is suggested in patients with one or more risk factors to successfully address PONV and reduce its incidence. Nevertheless, the most studied regimens in randomized clinical trials (RCTs) are the combination of serotonin 5-HT3 receptor antagonists with dexamethasone or dopamine receptor antagonists (droperidol). Therefore, the safest and more effective combination regimen appears to be the use of serotonin 5-HT3 receptor antagonist antiemetic drugs with dexamethasone.

Changes of hydroxyl-linoleic acids during Chinese-style sausage processing and their relationships with lipids oxidation.

A Chinese-style sausage was processed using pork as the raw material. During the whole process, 13-hydroxyoctadecadienoic acid (13-HODE), 9-hydroxyoctadecadienoic acid (9-HODE), 9,10-dihydroxyoctadecenoic acid (9,10-DHODE) and 9,10,13-trihydroxyoctadecenoic acid (9,10,13-THODE) kept increasing. All of them were found to be correlated negatively and significantly with lipoxygenases (LOX) activity, and positively and significantly with peroxide value (POV) and thiobarbituric acid reactive substances (TBARS). The ratio of 13-HODE to 9-HODE decreased slowly during drying stage and stayed higher than 2 during the whole process, and it was found to be positively and significantly with LOX activity. The ratio of variation of 13-HODE to variation of 9-HODE in every sampling period (the ratio of Δ13-HODE to Δ9-HODE) decreased sharply from 2.75 in the stage of curing for 12 h to 1.37 in the stage drying from 24 d to 30 d. The changes of ratio of 13HODE to 9-HODE and ratio of Δ13-HODE to Δ9-HODE indicated LOX-catalyzed oxidation predominated in curing and early drying stages, and such predominance was taken over by non-enzymatic oxidation during late drying stage; LOX-catalyzed oxidation was the major contributor to lipids oxidation during the whole process of the Chinese-style sausage preparing.

Intraoperative Point of View Video Capture and Surgical Segmentation in Carpal Tunnel Release: A Feasibility Analysis.

OBJECTIVE: The purpose of this study was to (1) examine the feasibility of intraoperative point of view video while performing open and endoscopic carpal tunnel release (CTR), (2) define surgical segments of CTR, and (3) describe the duration of various surgical steps of open versus endoscopic CTR in a teaching setting. DESIGN: Fellowship trained hand surgeons reached consensus on surgical segments for CTR. Adult patients 18 and older previously indicated for CTR in clinic were eligible. Head-mounted point-of-view cameras were worn during endoscopic and open CTR by resident surgeons. Video was reviewed to determine segment duration. Independent sample t tests were used for comparison of duration by technique with statistical significance set as p < 0.05. SETTING: University of Iowa Hospitals and Clinics; 200 Hawkins Dr, Iowa City, IA 52242; Tertiary Academic Medical Center. PARTICIPANTS: Orthopedic Surgery Residents and Orthopedic Surgery Faculty. RESULTS: Surgical segments were defined as incision, dissection of superficial soft tissue structures, transection of the carpal ligament, and surgical incision closure. Twelve of 14 video capture events yielded data. In the teaching setting, the average duration of endoscopic CTR was 609.5 seconds (±111.07) versus 547.75 seconds (±82.06) for open with p value = 0.406. No surgical segments were significantly different. Transition time from dissection to ligament transection differed significantly (p = 0.004) between endoscopic (46.88 seconds ± 19.19) and open (9.0 seconds ± 7.90) CTR. Transition time between ligament transection and closure was significantly different (p = 0.029) among endoscopic (50.5 seconds ± 15.0) and open (26.25 seconds ± 2.99) CTR. CONCLUSIONS: Point-of-view video capture is feasible for the capture of video during a common hand surgery procedure. A method for managing device battery power is necessary for future applications. CTR can be defined as, and described in, individual procedure segments potentially useful for surgical education as well as efficiency improvements. Identification of surgical segments may aid the development of better objective tools for the assessment of surgeon skill and competency for common orthopedic procedures.

Molecular and genetic characterization of the pOV plasmid from Pasteurella multocida and construction of an integration vector for Gallibacterium anatis.

BACKGROUND: The pOV plasmid isolated from the Pasteurella multocida strain PMOV is a new plasmid, and its molecular characterization is important for determining its gene content and its replicative properties in Pasteurellaceae family bacteria. METHODS: Antimicrobial resistance mediated by the pOV plasmid was tested in bacteria. Purified pOV plasmid DNA was used to transform E. coli DH5α and Gallibacterium anatis 12656-12, including the pBluescript II KS(-) plasmid DNA as a control for genetic transformation. The pOV plasmid was digested with EcoRI for cloning fragments into the pBluescript II KS(-) vector to obtain constructs and to determine the full DNA sequence of pOV. RESULTS: The pOV plasmid is 13.5 kb in size; confers sulfonamide, streptomycin and ampicillin resistance to P. multocida PMOV; and can transform E. coli DH5α and G. anatis 12656-12. The pOV plasmid was digested for the preparation of chimeric constructs and used to transform E. coli DH5α, conferring resistance to streptomycin (plasmid pSEP3), ampicillin (pSEP4) and sulfonamide (pSEP5) on the bacteria; however, similar to pBluescript II KS(-), the chimeric plasmids did not transform G. anatis 12656-12. A 1.4 kb fragment of the streptomycin cassette from pSEP3 was amplified by PCR and used to construct pSEP7, which in turn was used to interrupt a chromosomal DNA locus of G. anatis by double homologous recombination, introducing strA-strB into the G. anatis chromosome. CONCLUSION: The pOV plasmid is a wide-range, low-copy-number plasmid that is able to replicate in some gamma-proteobacteria. Part of this plasmid was integrated into the G. anatis 12656-12 chromosome. This construct may prove to be a useful tool for genetic studies of G. anatis.

Toxicity studies for the use of prodrug of voriconazole in rats.

It has been reported that voriconazole is used to treat infections caused by invasive aspergillosis, fluconazole-resistant Candida, Actinoplanes and Fusarium. This study was performed to investigate the safety of prodrug of voriconazole (POV) and explore the distribution and metabolism of POV in vivo. The POV for injection was formulated into POV injection. In this study, POV injection was given intravenously at the doses of 0, 30, 60, and 120 mg/kg/d to SD rats for 4 weeks consecutively. Toxicokinetic study was also performed to explore its distribution and metabolism. POV injection was found to be safe and well tolerated. Some statistically significant differences in relative liver weight were observed and several cases of hepatocyte hypertrophy occurred after the 4-week POV injection treatment. Liver-related toxic response could be reversed after recovery period. The results of toxicokinetics showed that POV can rapidly converts to voriconazole in SD rats after administration. The exposure of voriconazole in each group was significantly different between male and female rats. The results showed that the target organ for the toxic effect of POV is liver and the no-toxic-reaction-dose for long-term administration of POV injection was 60 mg/kg/d.

A polyoxometalate-based metal-organic polyhedron constructed from a {V5O9Cl} building unit with rhombicuboctahedral geometry.

The design and construction of metal-organic polyhedra has received much attention by chemists due to the intriguing diversity of architectures and topologies that can be achieved. There are several crucial factors which should be considered for the construction of metal-organic polyhedra, such as the starting materials, reaction time and temperature, solvent and suitable organic ligands. Recently, polyoxometalates (POMs), serving as secondary building units to construct POM-based metal-organic polyhedra, have been the subject of much interest. The title compound, dodecakis(dimethylammonium) octakis(µ-benzene-1,3,5-tricarboxylato)hexa-µ-chlorido-tetracosa-µ-oxido-triacontaoxidotriacontavanadium, (NH2Me2)12[(V5O9Cl)6(C9H3O6)8], was synthesized successfully by self-assembly of VOCl3 and benzene-1,3,5-tricarboxylic acid under solvothermal conditions. The title polyhedron has an rdo topology when the {V5O9Cl} building unit and the benzene-1,3,5-tricarboxylate (BTC3-) ligand were simplified into 4-connected and 3-connected vertices. Interestingly, when the {V5O9Cl} building unit and the BTC3- ligand are considered as quadrangular and triangular faces, the structure displays rhombicuboctahedral geometry with an outer diameter of 21.88 Å. The packing of the polyhedra produces a circular channel with a diameter of 8.2 Å. The title compound was characterized by single-crystal X-ray diffraction, elemental analysis, IR spectroscopy, thermogravimetric analysis and powder X-ray diffraction.

Identifying the Palisades of Vogt in Human Ex Vivo Tissue.

PURPOSE: The Palisades of Vogt (POV) constitute the corneal epithelial stem cell niche, but identification of this region in ex vivo tissue is difficult. Here we introduce a simple, direct method of identifying the POV in unsectioned, ex vivo human tissue. METHODS: Twenty-two eyes were studied, four whole and eighteen rims. Orientation of whole eyes was determined and the eyes were marked to maintain their cardinal orientation prior to dissection. Samples were imaged with brightfield, linearly polarized light and transmitted circularly polarized light (CPL), and optical coherence tomography (OCT) volumes were acquired in all twelve clock hrs around the limbus. Five samples were also fluorescently labeled to identify the epithelial basement membrane, and whole mounts were imaged with laser scanning confocal microscopy. Images were compared to confirm that the structures visible with polarized light were POV. RESULTS: Under CPL the POV presented as amber radial ridges visible in the superior and inferior regions of the tissue. Identification of POV was confirmed by correlating the structures seen under CPL, OCT and laser-scanning confocal microscopy. CONCLUSIONS: CPL can be used to quickly identify POV regions in donor tissue. This technique can assist in targeted harvesting of stem cell regions for research and tissue for limbal transplant.

Parallel image computation in clusters with task-distributor.

Distributed systems, especially clusters, can be used to execute ray tracing tasks in parallel for speeding up the image computation. Because ray tracing is a computational expensive and memory consuming task, ray tracing can also be used to benchmark clusters. This paper introduces task-distributor, a free software solution for the parallel execution of ray tracing tasks in distributed systems. The ray tracing solution used for this work is the Persistence Of Vision Raytracer (POV-Ray). Task-distributor does not require any modification of the POV-Ray source code or the installation of an additional message passing library like the Message Passing Interface or Parallel Virtual Machine to allow parallel image computation, in contrast to various other projects. By analyzing the runtime of the sequential and parallel program parts of task-distributor, it becomes clear how the problem size and available hardware resources influence the scaling of the parallel application.

Effects of oxidised dietary fish oil and high-dose vitamin E supplementation on growth performance, feed utilisation and antioxidant defence enzyme activities of juvenile large yellow croaker (Larmichthys crocea).

This study was conducted to elucidate the effects of oxidised dietary lipids and high-dose vitamin E (VE) on growth performance and immune responses of large yellow croaker. Juvenile fish (initial average body weight of 7·82 (sem 0·68) g) were fed diets containing either fresh fish oil (fresh diet, peroxide value (POV)=1·72 mEq/kg) or fish oil oxidised to varying degrees (oxidised diets, POV=28·29-104·21 mEq/kg), with or without supplementary 600 mg VE/kg diet, for 10 weeks in floating cages. Growth was significantly lower and feed intake (g/100 g body weight per d) was higher in fish fed the oxidised diet. Supplementation with VE increased the growth of fish fed the oxidised diets, but significantly decreased the growth of fish fed the fresh diet. Hepatosomatic index increased with increasing dietary POV and decreased with VE supplementation. Hepatic catalase activity, superoxide dismutase (SOD) activity and malondialdehyde content were significantly higher in fish fed the oxidised diets, and these values decreased significantly following VE supplementation. However, hepatic SOD activity was enhanced by VE supplementation in fish fed the fresh diet. Air-exposure mortality was significantly increased by dietary POV, and this effect was inhibited by VE supplementation. These results suggest that dietary oxidised fish oil could stimulate the activities of antioxidant defence enzymes in stressed large yellow croaker. High-dose VE supplementation can alleviate oxidative stress of large yellow croaker fed oxidised fish oil, but can exert deleterious effects on fish in the absence of oxidative stress.

Novel flame retardants: Estimating the physical-chemical properties and environmental fate of 94 halogenated and organophosphate PBDE replacements.

In the wake of the listing by the Stockholm Convention of PBDEs, an increasing number of "novel" flame retardants (NFRs) are being used in products. The properties that make for desirable flame retardants can also lead to negative health effects, long environmental residence times and an affinity for organic matrices. While NFRs are currently in use, little information is available regarding their physical-chemical properties and environmental fate. In this study, 94 halogenated and organophosphate NFRs were evaluated for their persistence and long-range transport potential. Physical-chemical properties (namely liquid sub-cooled vapor pressure P(l) and solubility S(l), air-water (K(AW)), octanol-water (K(OW)), and octanol-air (K(OA)) partition coefficients) of the NFRs were predicted using three chemical property estimation tools: EPI Suite, SPARC and Absolv. Physical-chemical properties predicted using these tools were generally within 10(2)-10(3) for compounds with molecular weight < 800 g/mol. Estimated physical-chemical properties of compounds with >800 g/mol, and/or the presence of a heteroatom and/or a polar functional group could deviate by up to 10(12). According to the OECD P(OV) and LRTP Screening Tool, up to 40% of the NFRs have a persistence and/or long range transport potential of medium to high level of concern and up to 60% have persistence and or long range transport potential similar to the PBDEs they are replacing. Long range transport potential could be underestimated by the OECD model since the model under-predicts long range transport potential of some organophosphate compounds.

The use and limits of eye-tracking in high-fidelity clinical scenarios: A pilot study.

AIM: To explore the potential of mobile eye-tracking to identify healthcare students' area of visual interest and its relationship to performance ratings. BACKGROUND: Eye-tracking identifies an individual's visual attention focus, and has been used as a training technique in medicine and in nursing. In this study participants wore a point of view (PoV) camera within a spectacle frame during simulation education experiences. METHODS: Thirty-nine final year nursing and paramedicine students individually participated in three 8 minute clinical simulations with debriefing using videoed eye-tracking recordings. Coloured dots on the video depicted the participant's pupil fixation on five targeted areas. Data extracted from the video camera were collated to report time spent on each target (their 'gaze'). RESULTS: The mean total gaze of expert designated targets in the environment for three 8 minute scenarios was 40-77%. Of 35 participants' focus on three main areas of interest, their priority was the patient's head (34%), the patient's trunk (24%) and their clinical assistant (5%), with significant differences between nursing and paramedic disciplines (P < 0.05). Objectively rated clinical performance improved significantly by the third scenario (P ≤ 0.001). Participants were positive regarding use of eye tracking during debriefing. CONCLUSIONS: Eye tracking has the potential to enhance debriefing and educational outcomes, although there are limitations to gaze capture in high fidelity environments and resource cost is high. Further study is warranted to enable better understanding of how expert clinicians achieve high levels of performance.

Mobile Versus Fixed Deployment of Automated External Defibrillators in Rural EMS.

INTRODUCTION: There is no consensus on where automated external defibrillators (AEDs) should be placed in rural communities to maximize impact on survival from cardiac arrest. In the community of Stokes County, North Carolina (USA) the Emergency Medical Services (EMS) system promotes cardiopulmonary resuscitation (CPR) public education and AED use with public access defibrillators (PADs) placed mainly in public schools, churches, and government buildings. HYPOTHESIS/PROBLEM: This study tested the utilization of AEDs assigned to first responders (FRs) in their private-owned-vehicle (POV) compared to AEDs in fixed locations. METHODS: The authors performed a prospective, observational study measuring utilization of AEDs carried by FRs in their POV compared to utilization of AEDs in fixed locations. Automated external defibrillator utilization is activation with pads placed on the patient and analysis of heart rhythm to determine if shock/no-shock is indicated. The Institutional Review Board of Wake Forest University Baptist Health System approved the study and written informed consent was waived. The study began on December 01, 2012 at midnight and ended on December 01, 2013 at midnight. RESULTS: During the 12-month study period, 81 community AEDs were in place, 66 in fixed locations and 15 assigned to FRs in their POVs. No utilizations of the 66 fixed location AEDs were reported (0.0 utilizations/AED/year) while 19 utilizations occurred in the FR POV AED study group (1.27 utilizations/AED/year; P<.0001). Odds ratio of using a FR POV located AED was 172 times more likely than using a community fixed-location AED in this rural community. Discussion Placing AEDs in a rural community poses many challenges for optimal utilization in terms of cardiac arrest occurrences. Few studies exist to direct rural community efforts in placing AEDs where they can be most effective, and it has been postulated that placing them directly with FRs may be advantageous. CONCLUSIONS: In this rural community, the authors found that placing AED devices with FRs in their POVs resulted in a statistically significant increase in utilizations over AED fixed locations.