Why bystanders decline telephone cardiac resuscitation advice.

OBJECTIVES: The aim of this study was to evaluate the rate and reason for refusal of telephone-based cardiopulmonary resuscitation (CPR) instruction by bystanders after the implementation of the dispatch center's systematic telephone CPR protocol. METHODS: Over a 15-month period the authors prospectively collected all case records from the emergency medical services (EMS) dispatch center when CPR had been proposed to the bystander calling in and recorded the reason for declining or not performing that the bystander spontaneously mentioned. All pediatric and adult traumatic and nontraumatic cases were included. Situations when resuscitation had been spontaneously initiated by bystanders were excluded. RESULTS: During the study period, dispatchers proposed CPR on 264 occasions: 232 adult nontraumatic cases, 17 adult traumatic cases, and 15 pediatric (traumatic and nontraumatic) cases. The proposal was accepted in 163 cases (61.7%, 95% confidence interval [CI] = 54.6% to 66.5%), and CPR was eventually performed in 134 cases (51%, 95% CI = 43.2% to 55.3%). In 35 of the cases where resuscitation was not carried out, the condition of the patient or conditions at the scene made this decision medically appropriate. Of the remaining 95 cases, 55 were due to physical limitations of the caller, and 33 were due to emotional distress. CONCLUSIONS: The telephone CPR acceptance rate of 62% in this study is comparable to those of other similar studies. Because bystanders' physical condition is one of the keys to success, the rate may not improve as the population ages.

Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

OBJECTIVE: In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. METHODS: This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. RESULTS: During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. CONCLUSIONS: This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery rate and false positive are similar to those found in previous studies. We found our results satisfying the given short time frame of this study. Our results demonstrate that it is possible to improve the quality of emergency services at moderate or even no additional costs and this should be of interest to all EMS that do not presently benefit from using T-CPR procedures. EMS that currently do not offer T-CPR should consider implementing this technique as soon as possible, and we expect our experience may provide answers to those planning to incorporate T-CPR in their daily practice.

Infrastructure and Transportation Task Force Report, August 2008

The Rebuild Iowa Infrastructure and Transportation Task Force is acutely aware of the critical role infrastructure plays in Iowa’s communities, the lives of the residents, and the economic well-being of the state. With encouragement to the Rebuild Iowa Advisory Commission (RIAC) for its consideration of great need for infrastructure and transportation repairs, the Task Force provides its assessment and recommendations. As the RIAC fulfills its obligations to guide the recovery and reconstruction in Iowa, infrastructure and transportation must be recognized for its impact on all Iowans. The tornadoes, storms, and floods were devastating to infrastructure and transportation systems across the state. The damage did not distinguish between privately-owned and public assets. The significance of the damage emerges further with the magnitude of the damage estimates. Infrastructure includes components that some might initially overlook, such as communication systems, landfills, and water treatment. The miles of damaged roads and bridges are more evident to many Iowans. Given the reliance on infrastructure systems, many repairs are already underway, though gaps have emerged in the funding for repairs to certain infrastructure systems.

Historical contingency affects signaling strategies and competitive abilities in evolving populations of simulated robots.

One of the key innovations during the evolution of life on earth has been the emergence of efficient communication systems, yet little is known about the causes and consequences of the great diversity within and between species. By conducting experimental evolution in 20 independently evolving populations of cooperatively foraging simulated robots, we found that historical contingency in the occurrence order of novel phenotypic traits resulted in the emergence of two distinct communication strategies. The more complex foraging strategy was less efficient than the simpler strategy. However, when the 20 populations were placed in competition with each other, the populations with the more complex strategy outperformed the populations with the less complex strategy. These results demonstrate a tradeoff between communication efficiency and robustness and suggest that stochastic events have important effects on signal evolution and the outcome of competition between distinct populations.

The Handheld Library: Developments at the Rector Gabriel Ferraté Library, UPC

The purpose of this paper is to highlight the mobile services developed by the Rector Gabriel Ferraté Library (BRGF) of the Universitat Politècnica de Catalunya (UPC Barcelona Tech) in Barcelona, Spain.We hope this paper will be of use to other libraries exploring new technologies for communicating and delivering their services to users at a time when mobile services are an emerging topic in librarianship and information science literature. By setting out the successive steps involved in the as yet unfinished process of building our mobile services portfolio, we aim to offer a detailed picture of the mobile services and features offered by a university library from a case study perspective.The main topics to be discussed include:- The BRGF’s mobile website, including the information available, its interactivecapabilities and the services it provides to its users.- The mobile-friendly version of UPCommons (the UPC Library Service’s institutionalrepositories).- The UPC Library Service’s mobile OPAC.- The mobile version of u-win (BRGF’s videogame service).- The use of QR codes to deliver information to mobile devices.- Text message notifications.Additional topics for discussion include:- The library’s organisation and the organisational concepts that underpin andmake possible its technological developments (including mobile).- BRGF’s concern regarding the reduction of investment in the development of mobile services.- The criteria and tools used to guide the library’s decisions regarding thedesign and orientation of current and future mobile services.- How mobile services can help to improve the image of the library as a leadingtechnology site.- Selected mobile features that BRGF plans to offer in the near future.Ultimately, this paper aims to delineate the effectiveness and potential of deliveringlibrary services by the preferred means of communication of a new generation of studentsand teachers.

Software de prototipado para la arquitectura de la información: funcionalidad y evaluación

El diseño y planificación de la arquitectura de la información de los distintos componentes de un sitio web pasa necesariamente por una propuesta de prototipado de la estructura arquitectónica de ese entorno informacional. El objetivo de este artículo es analizar y evaluar una serie de herramientas informáticas diseñadas para facilitar la creación de prototipos en el diseño y creación de sitios web.

Supplement Information to the August 2008 Infrastructure and Transportation Task Force Report, August 2008

The Rebuild Iowa Infrastructure and Transportation Task Force is acutely aware of the critical role infrastructure plays in Iowa’s communities, the lives of the residents, and the economic well-being of the state. With encouragement to the Rebuild Iowa Advisory Commission (RIAC) for its consideration of great need for infrastructure and transportation repairs, the Task Force provides its assessment and recommendations. As the RIAC fulfills its obligations to guide the recovery and reconstruction in Iowa, infrastructure and transportation must be recognized for its impact on all Iowans. The tornadoes, storms, and floods were devastating to infrastructure and transportation systems across the state. The damage did not distinguish between privately-owned and public assets. The significance of the damage emerges further with the magnitude of the damage estimates. Infrastructure includes components that some might initially overlook, such as communication systems, landfills, and water treatment. The miles of damaged roads and bridges are more evident to many Iowans. Given the reliance on infrastructure systems, many repairs are already underway, though gaps have emerged in the funding for repairs to certain infrastructure systems. Supplement Information to the August 2008

Integration of Bridge Damage Detection Concepts and Components (3 volumes), TR-636, 2013

This work is divided into three volumes: Volume I: Strain-Based Damage Detection; Volume II: Acceleration-Based Damage Detection; Volume III: Wireless Bridge Monitoring Hardware. Volume I: In this work, a previously-developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. The statistical damage-detection tool, control-chart-based damage-detection methodologies, were further investigated and advanced. For the validation of the damage-detection approaches, strain data were obtained from a sacrificial specimen attached to the previously-utilized US 30 Bridge over the South Skunk River (in Ames, Iowa), which had simulated damage,. To provide for an enhanced ability to detect changes in the behavior of the structural system, various control chart rules were evaluated. False indications and true indications were studied to compare the damage detection ability in regard to each methodology and each control chart rule. An autonomous software program called Bridge Engineering Center Assessment Software (BECAS) was developed to control all aspects of the damage detection processes. BECAS requires no user intervention after initial configuration and training. Volume II: In this work, a previously developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. The objective of this part of the project was to validate/integrate a vibration-based damage-detection algorithm with the strain-based methodology formulated by the Iowa State University Bridge Engineering Center. This report volume (Volume II) presents the use of vibration-based damage-detection approaches as local methods to quantify damage at critical areas in structures. Acceleration data were collected and analyzed to evaluate the relationships between sensors and with changes in environmental conditions. A sacrificial specimen was investigated to verify the damage-detection capabilities and this volume presents a transmissibility concept and damage-detection algorithm that show potential to sense local changes in the dynamic stiffness between points across a joint of a real structure. The validation and integration of the vibration-based and strain-based damage-detection methodologies will add significant value to Iowa’s current and future bridge maintenance, planning, and management Volume III: In this work, a previously developed structural health monitoring (SHM) system was advanced toward a ready-for-implementation system. Improvements were made with respect to automated data reduction/analysis, data acquisition hardware, sensor types, and communication network architecture. This report volume (Volume III) summarizes the energy harvesting techniques and prototype development for a bridge monitoring system that uses wireless sensors. The wireless sensor nodes are used to collect strain measurements at critical locations on a bridge. The bridge monitoring hardware system consists of a base station and multiple self-powered wireless sensor nodes. The base station is responsible for the synchronization of data sampling on all nodes and data aggregation. Each wireless sensor node include a sensing element, a processing and wireless communication module, and an energy harvesting module. The hardware prototype for a wireless bridge monitoring system was developed and tested on the US 30 Bridge over the South Skunk River in Ames, Iowa. The functions and performance of the developed system, including strain data, energy harvesting capacity, and wireless transmission quality, were studied and are covered in this volume.

SDF 1-alpha (CXCL12) triggers glutamate exocytosis from astrocytes on a millisecond time scale: Imaging analysis at the single-vesicle level with TIRF microscopy

Chemokines are small chemotactic molecules widely expressed throughout the central nervous system. A number of papers, during the past few years, have suggested that they have physiological functions in addition to their roles in neuroinflammatory diseases. In this context, the best evidence concerns the CXC-chemokine stromal cell-derived factor (SDF-1alpha or CXCL12) and its receptor CXCR4, whose signalling cascade is also implicated in the glutamate release process from astrocytes. Recently, astrocytic synaptic like microvesicles (SLMVs) that express vesicular glutamate transporters (VGLUTs) and are able to release glutamate by Ca(2+)-dependent regulated exocytosis, have been described both in tissue and in cultured astrocytes. Here, in order to elucidate whether SDF-1alpha/CXCR4 system can participate to the brain fast communication systems, we investigated whether the activation of CXCR4 receptor triggers glutamate exocytosis in astrocytes. By using total internal reflection (TIRF) microscopy and the membrane-fluorescent styryl dye FM4-64, we adapted an imaging methodology recently developed to measure exocytosis and recycling in synaptic terminals, and monitored the CXCR4-mediated exocytosis of SLMVs in astrocytes. We analyzed the co-localization of VGLUT with the FM dye at single-vesicle level, and observed the kinetics of the FM dye release during single fusion events. We found that the activation of CXCR4 receptors triggered a burst of exocytosis on a millisecond time scale that involved the release of Ca(2+) from internal stores. These results support the idea that astrocytes can respond to external stimuli and communicate with the neighboring cells via fast release of glutamate.