Efficacy of a Simplified Feedback Trainer for High-Quality Chest Compression Training: A Randomized Controlled Simulation Study.

Background: The most recent international guidelines recommended support training of chest compression (CC) using feedback devices. This study aimed to compare the training efficacy of a simplified feedback trainer with the traditional cardiopulmonary resuscitation (CPR) simulator in CPR training. Methods: A total of 60 soldiers were randomly allocated into three groups equally, trained with a simplified external cardiac massage (ECM) trainer named Soul SheathTM (SS) (SS group), a Resusci Anne manikin (RA group), or traditional simulation training with instructor feedback, respectively. After 7 days of training, the CPR skills were tested blindly in a 2-min assessment session. The primary outcome was the proportion of effective CC, and the secondary outcome included CC rate, depth, compression position, and extent of the release. Results: The percentage of effective CC achieved in the SS group was comparable with the RA group (77.0 ± 15.52 vs. 77.5 ± 10.73%, p = 0.922), and significantly higher than that in the control group (77.0 ± 15.52 vs. 66.8 ± 16.87%, p = 0.037). Both the SS and RA groups showed better CC performance than the control group in terms of CC rate (SS group vs. control group, P = 0.032 and RA group vs. control group, P = 0.026), the proportion of shallow CC (SS group vs. control group, P = 0.011 and RA group vs. control group, P = 0.017). No difference between the SS group and RA group was found in all the CC parameters. Conclusions: The simplified ECM trainer (SS) provides a similar efficacy to the traditional manikin simulator with feedback in CC training to improve the quality of CPR skills.

Vancomycin-induced acute kidney injury in elderly Chinese patients: a single-centre cross-sectional study.

AIMS: The objective of the present study was to investigate the current situation concerning, and risk factors for, vancomycin (VAN)-induced acute kidney injury (VI-AKI) in elderly Chinese patients, to assess outcomes and risk factors in patients who have developed VI-AKI, in order to provide suggestions for improving the prevention and treatment of this condition in these patients. METHOD: We retrospectively identified elderly older inpatients who had received four or more doses of VAN treatment. We compared patients with VI-AKI with those who received VAN treatment and had not developed AKI (NO-AKI). We defined VI-AKI as developing AKI during VAN therapy or within 3 days after withdrawal of VAN. RESULTS: A total of 647 out of 862 elderly inpatients were included in the study. Among those excluded, in 89.3% of cases (192/215) this was because of lack of data on serum creatinine (SCr). Among included patients, 32.5% (210/647) of patients received therapeutic drug monitoring (TDM) during VAN therapy. In 66.9% of cases (424/634), there was insufficient TDM, and in 3.9% (25/634) this was appropriate. A total of 102 patients had confirmed VI-AKI, with an incidence of 15.8% (102/647). Multiple logistic regression analysis revealed that hyperuricaemia [odds ratio (OR) = 3.045; P = 0.000)], mechanical ventilation (OR = 1.906; P = 0.022) and concomitant vasopressor therapy (OR = 1.919; P = 0.027) were independent risk factors for VI-AKI; higher serum albumin (OR = 0.885; P = 0.000) was determined to be an independent protective factor for VI-AKI. CONCLUSIONS: For the elderly Chinese patients treated with VAN, there was insufficient monitoring of SCr, too little use of VAN TDM, and lower rate of patients whose VAN though serum concentrations were not obtained at the correct time. We recommend that hospital managers increase investment in clinical pharmacists, to strengthen professional management. Patients with concomitant hyperuricaemia and on mechanical ventilation and vasopressor therapy should be paid more attention, and a higher serum albumin was determined to be an independent protective factor for VI-AKI.

Note: a novel method to measure the deformation of diamond anvils under high pressure.

A novel and simple method based on optical-fiber frequency domain interferometer to measure the deformation of diamond anvils under high pressure is presented. The working principle and application examples are given in this paper. The deformation of diamond anvils is obtained up to 37.7 GPa, our results verify that the deformation has an obvious difference between uploading and downloading at a given pressure, the maximum difference is up to 4.5 µm at 18.8 GPa, and the cupping effect is observed directly.

Pressure-induced structural phase transition and equation of state of LiTaO3.

Using in situ high-pressure x-ray diffraction and ab initio techniques, a high-pressure structure of LiTaO3 has been determined to be an orthorhombic phase with the space group Pnma. At ambient temperature, the transition pressure from the R3c phase (the ordinary phase at ambient pressure and temperature) to the Pnma phase is about 33.0 GPa and the phase transition is reversible. This phase transition can be reproduced qualitatively by ab initio calculations, but with a lower transition pressure of 19.9 GPa. The equation of state of LiTaO3 is also reported.

[Raman scattering study of water up to 600 MPa at 290 K].

Raman scattering studies of the stretching band from liquid water have been conducted up to 600 MPa at 290 K. It is shown that (r1)(max) decreases with increasing pressure initially and reaches the minimum at about 200 MPa, and increases at higher pressure up to about 400 MPa, then decreases with increasing pressure up to 600 MPa. And this is also in accordance with the behavior of r(oo) under pressure. The authors conclude that, just like ice phase transition ice ( I h) --> ice(II) --> ice (V), there also probably exists water phase transition water ( I h) --> water (III) --> water (V).