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Objectives: Cognitive load refers to the working memory resources required during a task. When the load is too high or too low this has implications for an individual's task performance. In the context of paramedicine and emergency medical services (EMS) broadly, high cognitive load could potentially put patient and personnel safety at risk. This systematic review aimed to determine the current understanding of the role of cognitive load in paramedical contexts.Methods: To do this, five databases were searched (Elsevier Embase, ProQuest Psychology, CINAHL, Ovid Medline, and Ovid PsychINFO) using synonyms of cognitive load and paramedical contexts. Included articles were full text, peer reviewed empirical research, with a focus on cognitive load and EMS work. Two reviewers screened titles, abstracts, and full text using a traffic light system against the inclusion and exclusion criteria. The quality of evidence was assessed using the GRADE framework. This study was registered on PROSPERO (CRD42022384246). No funding was received for this research.Results: The searches identified 73 unique articles and after title/abstract and full text screening, 25 articles were included in the final review. Synthesis of the research revealed 10 categories of findings in the area. These are clinical performance, cognitive processes, emotional responses, physical expenditure, physiological responses, equipment and ergonomics, expertise and experience, multiple loads, cognitive load measures, and task complexity.Conclusions: From these findings it was determined that there is agreement in terms of what factors influence cognitive load in paramedical contexts, such as cognitive processes, task complexity, physical expenditure, level of experience, multiple types of loads, and the use of equipment. Cognitive load influences clinical task performance and has a bi-directional relationship with emotion. However, the literature is mixed regarding physiological responses to cognitive load, and how they are best measured. These findings highlight potential intervention points where cognitive load can be managed or reduced to improve working conditions for EMS clinicians and safety for their patients.
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[reaction: see text] Crossover-Linstead macrocyclization reactions of two norbornenyl-tagged diaminomaleonitriles with dipropylmaleonitrile gave access to crude mixtures of porphyrazines containing diamino-hexapropyl-porphyrazine magnesium complexes. The mixtures were subjected to ring-opening metathesis polymerization to yield the insoluble diaminoporphyrazine-functionalized polymers. Acid-mediated cleavage from the polymer backbone followed by acylation of the resultant sensitive macrocyclic diamines gave monoacetyl-, monotrifluoroacetyl-, and ditrifluoroacetyl-substituted porphyrazinediamines. Conversion of these amido-porphyrazines to the corresponding zinc macrocycles and studies of their electronic absorption and emission spectra, electrochemistry, and photophysics are described.
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Four ruthenium nitrosyls, namely [(bpb)Ru(NO)(Cl)] (1), [(Me(2)bpb)Ru(NO)(Cl)] (2), [(Me(2)bpb)Ru(NO)(py)](BF(4)) (3), and [(Me(2)bqb)Ru(NO)(Cl)] (4) (H(2)bpb = 1,2-bis(pyridine-2-carboxamido)benzene, H(2)Me(2)bpb = 1,2-bis(pyridine-2-carboxamido)-4,5-dimethylbenzene, H(2)Me(2)bqb = 1,2-bis(quinaldine-2-carboxamido)-4,5-dimethylbenzene; H is the dissociable amide proton), have been synthesized and characterized by spectroscopy and X-ray diffraction analysis. All four complexes exhibit nu(NO) in the range 1830-1870 cm(-)(1) indicating the [Ru-NO](6) configuration. Clean (1)H NMR spectra in CD(3)CN (or (CD(3))(2)SO) confirm the S = 0 ground state for all four complexes. Although the complexes are thermally stable, they release NO upon illumination. Rapid NO dissociation occurs when solutions of 1-3 in acetonitrile (MeCN) or DMF are exposed to low-intensity (7 mW) UV light (lambda(max) = 302 nm). Electron paramagnetic resonance (EPR) spectra of the photolyzed solutions display anisotropic signals at g approximately 2.00 that confirm the formation of solvated low-spin Ru(III) species upon NO release. The ligand trans to bound NO namely, anionic Cl(-) and neutral pyridine, has significant effect on the electronic and NO releasing properties of these complexes. Change in the in-plane ligand strength also has effects on the rate of NO release. The absorption maximum (lambda(max)) of 4 is significantly red shifted (455 nm in DMF) compared to the lambda(max) values of 1-3 (380-395 nm in DMF) due to the extension of conjugation on the in-plane ligand frame. As a consequence, 4 is also sensitive to visible light and release NO (albeit at a slower rate) upon illumination to low-intensity visible light (lambda > 465 nm). Collectively, the photosensitivity of the present series of ruthenium nitrosyls demonstrates that the extent of NO release and their wavelength dependence can be modulated by changes of either the in-plane or the axial ligand (trans to bound NO) field strength.
