Immersive Virtual Reality Serious Games With DL-Assisted Learning in High-Rise Fire Evacuation on Fire Safety Training and Research.

In case of fires in high-rise buildings, appropriate safe behaviors for leaving the high floors are the key to reducing injuries and increasing the chance of survival. Traditional training methods are often used to provide knowledge about a fire escape but may become ineffective in terms of knowledge acquisition and internalization. Serious games are an innovative teaching method, aiming at training and educating people in game environments. In recent years, immersive virtual reality has become popular in many educational environments. Various educational training programs are combined with serious games and attract more and more attention because they can make users feel highly involved and promote learning cognition. Therefore, this study proposed the fire safety training of high-rise building fire escape based on virtual reality and invited 140 college students to make explorations through this virtual situation. In addition, deep learning was integrated into the recommended safety training system, so that students could be trained in areas where concepts were ill-defined. According to the results, through the high-rise building fire escape training based on virtual reality, students' fire safety skills were significantly improved and most students could use their behavioral skills in real situations, which has positive effects on promoting the development of fire escape knowledge. Finally, according to the analysis on the results of the DL-assisted learning system, some suggestions were made in this study on behavioral skills training for professional firefighters and researchers.

Children's Digital Art Ability Training System Based on AI-Assisted Learning: A Case Study of Drawing Color Perception.

This study proposed a children's digital art ability training system with artificial intelligence-assisted learning (AI-assisted learning), which was designed to achieve the goal of improving children's drawing ability. AI technology was introduced for outline recognition, hue color matching, and color ratio calculation to machine train students' cognition of chromatics, and smart glasses were used to view actual augmented reality paintings to enhance the effectiveness of improving elementary school students' imagination and painting performance through the diversified stimulation of colors. This study adopted the quasi-experimental research method and designs the pre-test and post-test for different groups. The research subjects are the Grade 4 students of an elementary school in Taitung City, Taiwan. The test tools included an imagination test and an evaluation of painting performance ability. The test results of a total of 30 students before and after the experiment included the experimental group that received the children's digital art ability training system with AI-assisted learning and 30 students in the control group that had not received the teaching were analyzed by covariance. These results were supplemented by the description and interpretation of student feedback, teachers' reflection notes, and other qualitative data to understand the performance of the students in the experimental group in terms of imagination and painting performance.

Traditional versus blended CPR training program: A randomized controlled non-inferiority study.

Cardiopulmonary resuscitation (CPR) training and its quality are critical in improving the survival rate of cardiac arrest. This randomized controlled study investigated the efficacy of a newly developed CPR training program for the public in a Taiwanese setting. A total of 832 adults were randomized to either a traditional or blended (18-minute e-learning plus 30-minute hands-on) compression-only CPR training program. The primary outcome was compression depth. Secondary outcomes included CPR knowledge test, practical test, quality of CPR performance, and skill retention. The mean compression depth was 5.21 cm and 5.24 cm in the blended and traditional groups, respectively. The mean difference in compression depth between groups was -0.04 (95% confidence interval -0.13 to infinity), demonstrating that the blended CPR training program was non-inferior to the traditional CPR training program in compression depth after initial training. Secondary outcome results were comparable between groups. Although the mean compression depth and rate were guideline-compliant, only half of the compressions were delivered with adequate depth and rate in both groups. CPR knowledge and skill retained similarly in both groups at 6 and 12 months after training. The blended CPR training program was non-inferior to the traditional CPR training program. However, there is still room for improvement in optimizing initial skill performance as well as skill retention. Clinical Trial Registration: NCT03586752; www.clinicaltrial.gov.

Impact of Transport Time and Cardiac Arrest Centers on the Neurological Outcome After Out-of-Hospital Cardiac Arrest: A Retrospective Cohort Study.

Background Should all out-of-hospital cardiac arrest (OHCA) patients be directly transported to cardiac arrest centers (CACs) remains under debate. Our study evaluated the impacts of different transport time and destination hospital on the outcomes of OHCA patients. Methods and Results Data were collected from 6655 OHCA patients recorded in the regional prospective OHCA registry database of Taoyuan City, Taiwan, between January 2012 and December 2016. Patients were matched on propensity score, which left 5156 patients, 2578 each in the CAC and non-CAC groups. Transport time was dichotomized into <8 and ≥8 minutes. The relations between the transport time to CACs and good neurological outcome at discharge and survival to discharge were investigated. Of the 5156 patients, 4215 (81.7%) presented with nonshockable rhythms and 941 (18.3%) presented with shockable rhythms. Regardless of transport time, transportation to a CAC increased the likelihoods of survival to discharge (<8 minutes: adjusted odds ratio [aOR], 1.95; 95% CI, 1.11-3.41; ≥8 minutes: aOR, 1.92; 95% CI, 1.25-2.94) and good neurological outcome at discharge (<8 minutes: aOR, 2.70; 95% CI, 1.40-5.22; ≥8 minutes: aOR, 2.20; 95% CI, 1.29-3.75) in OHCA patients with shockable rhythms but not in patients with nonshockable rhythms. Conclusions OHCA patients with shockable rhythms transported to CACs demonstrated higher probabilities of survival to discharge and a good neurological outcome at discharge. Direct ambulance delivery to CACs should thus be considered, particularly when OHCA patients present with shockable rhythms.

Impact of the caller's emotional state and cooperation on out-of-hospital cardiac arrest recognition and dispatcher-assisted cardiopulmonary resuscitation.

OBJECTIVE: This study determined the impact of the caller's emotional state and cooperation on out-of-hospital cardiac arrest (OHCA) recognition and dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) performance metrics. METHODS: This was a retrospective study using data from November 2015 to October 2016 from the emergency medical service dispatching centre in northern Taiwan. Audio recordings of callers contacting the centre regarding adult patients with non-traumatic OHCA were reviewed. The reviewers assigned an emotional content and cooperation score (ECCS) to the callers. ECCS 1-3 callers were graded as cooperative and ECCS 4-5 callers as uncooperative and highly emotional. The relation between ECCS and OHCA recognition, time to key events and DA-CPR delivery were investigated. RESULTS: Of the 367 cases, 336 (91.6%) callers were assigned ECCS 1-3 with a good inter-rater reliability (k=0.63). Dispatchers recognised OHCA in 251 (68.4%) cases. Compared with callers with ECCS 1, callers with ECCS 2 and 3 were more likely to give unambiguous responses about the patient's breathing status (adjusted OR (AOR)=2.6, 95% CI 1.1 to 6.4), leading to a significantly higher rate of OHCA recognition (AOR=2.3, 95% CI 1.1 to 5.0). Thirty-one callers were rated uncooperative (ECCS 4-5) but had shorter median times to OHCA recognition and chest compression (29 and 122 s, respectively) compared with the cooperative caller group (38 and 170 s, respectively). Nevertheless, those with ECCS 4-5 had a significantly lower DA-CPR delivery rate (54.2% vs 85.9%) due to 'caller refused' or 'overly distraught' factors. CONCLUSIONS: The caller's high emotional state is not a barrier to OHCA recognition by dispatchers but may prevent delivery of DA-CPR instruction. However, DA-CPR instruction followed by first chest compression is possible despite the caller's emotional state if dispatchers are able to skilfully reassure the emotional callers.

Influence of pretilt angle on disclination lines of liquid crystal lens.

This article investigates the effect of pretilt angle on disclination lines of liquid crystal (LC) lenses. When the pretilt angle of LCs is higher than 7°, the disclination lines are reduced and are moved to the boundary of the LC lens. The disclination lines at the boundary do not influence the focused beam profile of the LC lens. As the pretilt angle of LCs further increases, the disclination lines at the boundary become almost invisible. However, the interference rings become asymmetrical. The response time of an LC lens with a pretilt angle higher than 7° is ∼60% of the conventionally homogeneous LC lens. This value is a result of the decrease in the rotation angle of the LCs and the reduced disclination lines.

EDC/NHS-mediated heparinization of small intestinal submucosa for recombinant adeno-associated virus serotype 2 binding and transduction.

A major challenge in the use of gene transfer vectors as therapeutic tools is controlling vector administration at a desired tissue site. One potential solution is implanting tissue-engineering constructs loaded with gene transfer vectors such as viruses for localized transgene delivery. In this work, we conjugated recombinant adeno-associated virus serotype 2 (rAAV2) to a heparinized small intestinal submucosa (H-SIS) matrix, which resulted in vector transduction upon cellular adhesion. H-SIS was prepared by incorporating heparin, the rAAV2 receptor, into SIS through N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide (EDC) and N-hydroxysuccinimide (NHS) mediated crosslinking. Incorporated heparin adsorbed rAAV2 onto the H-SIS matrix for conjugation. Using green fluorescent protein and beta-galactosidase as reporters, we showed that conjugated rAAV2 was active and capable of mediating transgene delivery in cell culture. Additionally, we applied H-SIS to adsorb unpurified rAAV2 from the crude lysate of packaging cells for conjugation, avoiding the use of ultracentrifugation or chromatography in preparation of infectious rAAV2 for transduction. Our work provides a unique, modified tissue substrate H-SIS for rAAV2 binding and transduction, which can be a useful tool in developing localized gene transfer.