Laboratory Activities Research Articles

Integrating a PABX Telephone System Learning Tool into Telecommunications Technology Curricula

This study aims to develop an operational Private Automatic Branch Exchange (PABX) telephone system to be used as a laboratory tool for students in the Bachelor of Science in Electronics and Communications Technology (BSECT) program at the University of Science and Technology of Southern Philippines (USTP). The PABX trainer is expected to enhance students' occupational preparation for potential employment in the telecommunications and networking industries. Through the operational platform, students' cognitive, manipulative, and programming skills related to PABX can be assessed. A telecommunications course is a core component of the BSECT curriculum, familiarizing students with corporate communications platforms like PABX. The presence of physical PABX equipment is crucial for quality instruction aligned with the Commission on Higher Education's (CHED) standards and the university's accreditation requirements. While PABX has been widely used in industry, incorporating its technology into the BSECT curriculum remains necessary. This study aims to innovate pedagogical tools that establish students' PABX-related skill sets and potentially lead to further investigations and system integrations with other ICT technologies. The study yielded positive affirmation of the content, technical, and instructional qualities, and its overall acceptability relative to the learning tool. There are also significant improvements in the student’s cognitive skills, manipulative skills, and programming skills set out of using the PABX learning tool in laboratory activities.

Efficacy and safety of levilimab in the treatment of patients with rheumatoid arthritis

Evaluation in real clinical practice of the effectiveness and safety of levilimab therapy in patients with highly and moderately active rheumatoid arthritis (RA). A prospective observational study (6 months) involving 35 patients with RA (29 women and 6 men, mean age 53.17±13.2 years) who were treated at the Ochapovsky Regional Clinic Hospital of Krasnodar Region. All patients included in the study were prescribed the drug levilimab (Ilsira). After 1 month of observation, there was a decrease in the clinical and laboratory activity of the process in the form of a decrease in the number of painful joints - 17.0 (14.0; 20.0) vs 8.0 (6.0; 10.0); p=0.000001, number of swollen joints - 3.0 (2.0; 4.0) vs 0.0 (0.0; 0.0); p=0.000002, reduction in pain intensity according to visual analog scale - 60.0 (60.0; 70.0) mm vs 30.0 (20.0; 40.0) mm (p=0.000001). Also, by the end of the first month of therapy, there was a decrease in clinical activity indices DAS28-ESR by 43%, SDAI by 60%, CDAI by 55%. Positive dynamics of laboratory parameters were noted - a decrease in erythrocyte sedimentation rate by 76%, a decrease in C-reactive protein level by 98%. By the 6th month of therapy, a decrease in RF by 36% and ACCP by 11% was recorded, but the dynamics of these indicators did not reach statistical significance. By the end of 4 weeks of treatment, 24 (68.6%) patients showed an increase in the level of total blood cholesterol - 5.1 (3.91; 6.0) mmol/L vs 6.1 (4.99; 7.07) mmol/L (p=0.000006), while 11 (45.8%) patients from this group had initially elevated cholesterol levels (6.4±0.6 mmol/L). In 5 (14.3%) patients, an increase in alanine aminotransferase (ALT) was recorded in the 4th week - 17.0 (11.0; 25.0) U/L vs 32.0 (22.0; 43.0) U/L (p=0.000062) and aspartate aminotransferase (AST) - 19.0 (14.0; 24.0) U/L vs 25.0 (18.0; 36.0) U/L (p=0.000171), in 1 (2.85%) of the patient, an increase in ALT and AST above normal was noted (ALT 144 U/L, AST 52 U/L), which required discontinuation of levilimab. In 2 (5.7%) patients, by the end of the 4th week a decrease in the absolute number of neutrophils was registered - 3.2 (2.6; 4.0)×10E9/L vs 2.3 (2.0; 2.5)×10E9/L (p=0.002), which did not require discontinuation of treatment, since the number of cells remained more than 1×10E9/L. During treatment with levilimab 162 mg subcutaneously once a week, the proportion of patients taking prednisolone decreased from 46% at the start of therapy to 11% at the end of 6 months of therapy. Levilimab is a highly effective drug for the treatment of patients with highly and moderately active RA and has a favorable tolerability and safety profile.

Exploring the influence of external electric fields on the catalytic pyrolysis of oil shale kerogen molecules

Oil shale is a widely distributed and abundant sedimentary rock that can be converted into shale oil through pyrolysis, providing a supplementary solution to the increasing scarcity of conventional fossil energy. However, the traditional pyrolysis process of oil shale faces problems such as low oil yield, high energy consumption, and poor oil quality. Recent experiments have demonstrated that using an external electric field to catalyze the pyrolysis of oil shale can address these problems. However, due to the complex physical and chemical properties of oil shale and its pyrolysis process, the catalytic mechanisms and effects have not been reasonably explained. To address these issues, this study uses density functional theory to calculate the properties of oil shale molecules under external electric fields of different directions and strengths. The results indicate that at electric field strengths far exceeding experimental conditions, the external electric field does have a certain catalytic effect on oil shale, which varies depending on the molecule. However, at electric field strengths achievable in actual laboratory conditions, the catalytic effect of the electric field on oil shale is not significant. Therefore, the mechanisms revealed by past experiments on the catalytic effects of electric fields on oil shale pyrolysis may be partially flawed. This study not only fills the gap in understanding the mechanisms of external electric field catalysis of oil shale but also provides a theoretical foundation for future applications of electric fields in catalyzing oil shale.

An effective Caenorhabditis elegans CRISPR training module for high school and undergraduate summer research experiences in molecular biology.

Engaging in research experiences as a high school or undergraduate student interested in science, technology, engineering, and mathematics (STEM) is pivotal for their academic and professional development. A structured teaching framework can help cultivate a student's curiosity and passion for learning and research. In this study, an eight-week training program was created to encompass fundamental molecular biology principles and hands-on laboratory activities. This curriculum focuses on using clustered regularly interspaced short palindromic repeats (CRISPR) gene editing in the Caenorhabditis elegans model organism. Through pre- and post-program assessments, enhancements in students' molecular biology proficiency and enthusiasm for scientific exploration were observed. Overall, this training module demonstrated its accessibility and ability to engage inexperienced students in molecular biology and gene editing methodologies.

Freshmen: Incentive to Participate in Research Activities in Laboratories at The Faculty of Mechanical Engineering of UFPA

Objective: This work aims to analyze the impacts of the participation of freshmen of the Mechanical Engineering course of the Federal University of Pará in research projects and in the preparation of scientific articles. This approach seeks to encourage the insertion of these students in laboratory activities, promoting their academic and scientific development since the beginning of the course. Theoretical Framework: Entry to university brings many challenges. Therefore, the practice of activities that inhibit academic evasion are beneficial for the scientific environment and labor market, by acting in the development of new professionals. Method: Freshmen of the Mechanical Engineering course were invited to experimental activities in order to encourage them to research and inclusion in academia, acting in the production of scientific articles for the Brazilian Symposium for the Progress of Science (SBPC)for its 75th Annual Meeting of 2023. Results and Discussion: Initially 22 students participated in the project, however only 5 remained until the end, resulting in 5 work submissions. In addition, it was verified the insertion of a portion of the students who gave up the project in other laboratories of the Faculty of Mechanical Engineering. Research Implications: Affirmative actions that promote student integration are beneficial, providing opportunities for teamwork, knowledge sharing and appreciation of inclusion in the academic environment. Originality/Value: This type of incentive has a significant impact on the academic and professional life of the students involved, favoring curricular complementation for those who wish to follow postgraduate courses, or in the engineering job market.

Triaxiality and Plastic-Strain-Dependent Proposed PEAK Parameter for Predicting Crack Formation in Polypropylene Polymer Reservoir Subjected to Pressure Load.

This article raises the topic of the critical examination of polypropylene, a key polymeric material, and its extensive application within the automotive industry, particularly focusing on the manufacturing of brake fluid reservoirs. This study aims to enhance the understanding of polypropylene's behavior under mechanical stresses through a series of laboratory destruction tests and numerical simulations, emphasizing the finite element method (FEM). A novel aspect of this research is the introduction of the PEAK parameter, a groundbreaking approach designed to assess the material's resilience against varying states of strain, known as triaxiality. This parameter facilitates the identification of critical areas prone to crack initiation, thereby enabling the optimization of component design with a minimized safety margin, which is crucial for cost-effective production. The methodology involves conducting burst tests to locate crack initiation sites, followed by FEM simulations to determine the PEAK threshold value for the Sabic 83MF10 polypropylene material. The study successfully validates the predictive capability of the PEAK parameter, demonstrating a high correlation between simulated results and actual laboratory tests. This validation underscores the potential of the PEAK parameter as a predictive tool for enhancing the reliability and safety of polypropylene automotive components. The research presented in this article contributes significantly to the field of material science and engineering by providing a deeper insight into the mechanical behavior of polypropylene and introducing an effective tool for predicting crack initiation in automotive components. The findings hold promise for advancing the design and manufacturing processes in the automotive industry, with potential applications extending to other sectors.

The Impact of a Mobile Phone and Mobile Application-Supported Science Laboratory on the Digital Literacy of Preservice Teachers and Their Disposition Toward Using Technology in Class

Science education at different levels can be supported by various mobile applications that can be downloaded for free onto mobile phones, tablets, and other devices. Such applications can also be used in laboratory work, but it must be said that their use in science laboratories is a relatively new approach. This study is aimed at determining the impact of mobile phone and mobile application-supported laboratory work on the digital literacy of preservice science teachers and on their disposition toward using technology in class. The study was carried out with 17 participants at the second-year level of a Science Teacher Education Program in Turkey. It was a single-group pretest-posttest study, representing a type of weak experimental research design. Data for the study were collected with the Digital Literacy Scale developed by Hamutoğlu et al. (Ege Journal of Education 18(1):408–429, 2017) and the Disposition toward Using Technology in the Classroom Scale developed by Gunuc and Kuzu (Journal of Theory and Practice in Education 10(4):863–884, 2014). The data collection tools were implemented prior to and following a 6-week teaching period, and the quantitative data compiled from the participants were analyzed with the SPSS 21.0 program. The parametric t-test of related samples was used in the pretest/posttest comparison of the data sets. The results of the study demonstrated that science laboratory activities supported by mobile phones and mobile applications provided preservice teachers with increased digital literacy and enhanced their disposition toward using technology in the classroom. It is recommended that preservice teachers make extensive use of experiments supported by the mobile applications in this study.

Applying the FAO surveillance evaluation tool (SET) to assess the fish farming disease surveillance system in Spain.

EU Member States should ensure that they implement adequate health surveillance schemes in all aquaculture farming areas, as appropriate for the type of production. This study presents the results of applying the FAO's Surveillance Evaluation Tool (SET) to assess the Spanish disease surveillance system for farmed fish species, which although applied previously in livestock production, is applied here to aquaculture for the first time. Overall, there were important score differences between trout and marine fish (seabass and seabream) surveillance, which were higher for trout in the following areas: Institutional (70.8% versus 50.0%), Laboratory (91.7% versus 47.2%), and Surveillance activities (75.3% versus 61.3%). For other categories, the values were lower and no significant differences were found. However, most surveillance efforts focused only on trout, for which there are EU and WOAH listed (notifiable) diseases. In contrast, for seabream and seabass, for which there are no listed diseases, it was considered that surveillance efforts should, nevertheless, be in place and should focus on the identification of abnormal mortalities and emerging diseases, for which there are as yet no standardized harmonised methodologies.

CDC's Laboratory Activities to Support Newborn Screening for Spinal Muscular Atrophy.

Spinal muscular atrophy (SMA) was added to the HHS Secretary's Recommended Uniform Screening Panel for newborn screening (NBS) in 2018, enabling early diagnosis and treatment of impacted infants to prevent irreversible motor neuron damage. In anticipation of supporting SMA newborn screening, scientists at the U.S. Centers for Disease Control and Prevention (CDC) have worked towards building resources for public health laboratories in four phases since 2013. In Phase 1, CDC established a real-time PCR assay, which uses a locked nucleic acid probe to attain the needed specificity, to detect SMN1 exon 7. In Phase 2, we developed quality assurance dried blood spot materials made with transduced lymphoblast cell lines established from de-identified SMA patients, carriers, and unaffected donors. In 2021, CDC implemented Phase 3, a proficiency testing program, that now supports 115 NBS labs around the world. We are currently completing Phase 4, which includes the implementation of an external SMA quality control material program. Also, during this time, CDC has provided individual technical assistance to NBS programs and bench training to NBS scientists during our annual molecular workshop. These CDC-led activities have contributed to the rapid and full implementation of SMA screening in all 50 U.S. states as of February 2024.

A Flexible Practicum Model on Education: Hybrid Learning Integrated Remote Laboratory Activity Design

This study’s objective was to create a hybrid learning-integrated remote laboratory model with validity and practicality. This model has four learning spaces, namely live synchronous, virtual synchronous, self-paced asynchronous, and collaborative asynchronous, so it can support flexible learning. Besides that, this learning model is also based on cognitivism, connectivism, constructivism, behaviourism learning theories and Bloom’s digital taxonomy. The hybrid learning integrated remote laboratory model consists of six syntaxes: 1) issue; 2) investigation; 3) team discussion to solve problems; 4) experiment using a remote laboratory; 5) analysis and evaluation; and 6) explore new solutions. Focus group discussions (FGD) were used to collect high-quality data by seven experts in learning models, vocational education, language and technology. The hybrid learning-integrated remote laboratory model quality analysis used Aiken’s V. The result showed that the hybrid learning integratedremote laboratory model content is valid, with a validity value of 0.87. The practicality analysis result showed that the average percentage of the assessments from lecturers and students was 88.16%, so it can be concluded that it has a high validity value and is very practical.

Exploring the Effects of Mathematics Laboratory Usage on students’ Skills Development: A Case of Selected Public Secondary Schools in Musanze District, Rwanda

The aim of this study was to explore how the use of mathematics laboratories affects the development of mathematics skills in learners from selected public secondary schools in Musanze District, Rwanda. Adopting constructivism theory, the study utilized a descriptive research design and a mixed-methods approach to collect both quantitative and qualitative data from surveys, interviews, and classroom observations, respectively. The study randomly sampled 348 learners and 16 mathematics teachers from the targeted population of 2679 participants. In relation to students' standardized test scores and teacher assessments, the analysis examined the frequency of lab use, lab activities, resource quality, and teacher training. Findings from quantitative data revealed positive correlations between lab usage and skill development across all measures. The frequency of lab use and teacher training were particularly strong predictors of improved performance. The results show that how often teachers use the lab (B =.122, p <.001) and their training and support (B =.150, p =.010) have a big effect on their evaluations, which means that these things have a positive effect on evaluations. In contrast, the types of lab activities and the quality of lab resources have no significant impact. These findings suggest that enhancing lab use frequency and providing robust training and support for teachers are crucial for improving teacher assessments. Interview results show that hands-on activities significantly boost critical thinking and the real-world application of mathematical concepts. From classroom observations, the study revealed remarkable discrepancies in student participation and resource availability between day and boarding schools. The findings suggest that the school administration should incorporate lab activities into the curriculum, enhance the frequency of lab use, and facilitate continuous teacher training by providing sufficient resources. Teachers should integrate engaging lab activities to strengthen theoretical concepts and encourage active learning. Students are urged to actively participate in lab sessions and look for help when necessary. These results help us understand how mathematics laboratories can improve learning outcomes in Rwandan secondary schools.

PH Measurement and Modelling as a Link between High School Chemistry and Mathematics

Investigating the acidity and alkalinity of solutions is linked to understanding the pH of solutions. At the secondary school level, this also means understanding the concept of the logarithmic function, which is a suitable topic for developing mathematical literacy. The objective was to design a laboratory activity in which students would not only measure solutions with the expected pH, but also construct a graph from the measured values without being aware of the dependence of pH on H3O+ concentration. This would enable them to identify the function that best fits the obtained curve. The problem presented discusses the limitations of the design and provides teachers with a basis for preparing the laboratory exercise, including a worksheet for students. The validation of the laboratory activity demonstrates that during the implementation of the exercise, students are able to construct a graph from the measured values and solve application problems related to understanding the concept of a logarithmic function.

Learning innovation: Reconstruction laboratory activities design on respiratory air and designing a simple spirometer

Laboratory practicum in science learning is considered important, especially in the context of the Independent Curriculum. Science-based learning is needed to encourage the development of students' skills and character, supported by practical activities. Good practical activities not only allow students to understand scientific concepts but also train students to apply scientific methods effectively. The aim of this research is to analyze, reconstruct, and design simple tools to improve Laboratory Activities Designed (LAD) on the respiratory air sub-material. The research method used is descriptive to show existing phenomena. Analysis was carried out using Vee Diagrams; then trials were carried out, reconstruction and design of simple tools, second trials, and revisions. The results of the analysis show that the five LAD samples are still in the very poor category, so improvements need to be made to avoid mistakes in the future. Researchers carried out LAD reconstruction, which included appearance, title, purpose, tools and materials, procedures, and questions. Reconstruction is supported by designing a tool in the form of a simple spirometer. The design of this simple tool can be assigned to students to train creativity and solve problems. It is hoped that the results of this analysis and reconstruction can help teachers in designing LAD for other materials in the future to suit learning objectives and the applicable curriculum.Abstract. Praktikum laboratorium dalam pembelajaran sains dinilai penting terutama dalam konteks Kurikulum Merdeka. Pembelajaran berbasis sains diperlukan untuk mendorong pengembangan keterampilan dan karakter siswa dengan didukung kegiatan praktikum. Kegiatan praktikum yang baik tidak hanya memungkinkan siswa untuk memahami konsep sains, tetapi juga melatih siswa dalam menerapkan metode ilmiah dengan efektif. Tujuan penelitian ini yaitu untuk menganalisis, melakukan rekonstruksi dan merancang alat sederhana untuk menyempurnakan Laboratory Activities Designed (LAD) pada sub materi udara hasil pernafasan. Metode penelitian yang digunakan yaitu deskriptif untuk menunjukkan fenomena yang ada. Analisis dilakukan menggunakan Diagram Vee, selanjutnya dilakukan uji coba, rekonstruksi dan perancangan alat sederhana, uji coba kedua, dan revisi. Hasil analisis menunjukkan bahwa kelima sampel LAD masih dalam kategori sangat buruk sehingga perlu dilakukan perbaikan untuk menghindari kekeliruan di masa yang akan datang. Peneliti melakukan rekonstruksi LAD yang mencakup tampilan, judul, tujuan, alat dan bahan, prosedur, dan pertanyaan. Rekonstruksi didukung dengan perancangan alat berupa spirometer sederhana. Perancangan alat sederhana ini dapat ditugaskan kepada siswa untuk melatih kreativitas dan memecahkan masalah. Hasil analisis dan rekonstruksi ini diharapkan dapat membantu guru-guru dalam merancang LAD materi lain di masa depan agar sesuai dengan tujuan pembelajaran dan kurikulum yang berlaku.

To study the features of vegetative homeostasis in patients with ankylosing spondylitis with anxiety-depressive spectrum disorders

Objective: study of indicators of vegetative homeostasis and psychosocial functioning in patients with ankylosing spondylitis (AS) with anxiety-depressive spectrum disorders (RTDS).Materials and methods: the study involved 112 patients with AS in whom the presence of RTDS was assessed according to the Taylor, Hamilton, Spielberger scales, autonomic disorders by testing according to the methods “Wayne-patient” (VP) and “Wayne-doctor” (BB), heart rate variability (HRV), quality of life (QOL) and clinical and laboratory activity of the disease.Results: the majority of patients with AS showed signs of RTDS, while this category of patients showed signs of autonomic dysfunction, lower indicators of vital activity, the ability to adapt social functioning and the level of mental health. The HRV indicators obtained in this category of patients indicate an imbalance of sympathetic and parasympathetic influences with the dominance of the sympathetic link of regulation, which confirms the correlation analysis.Conclusions: patients with AS with RTDS are characterized by low vital activity, reduced adaptation to social functioning, depletion of antioxidant potential. They are characterized by a deterioration in HRV indicators with a predominance of the sympathetic link of the ANS, low resistance to psychoemotional stress with a predominance of the defensive component in the structure of vegetative security.

Epistemic fluency in virtual laboratories as flipped classroom’s innovative learning delivery

PurposeDesign an innovative Flipped classroom’s Delivery through virtual laboratory.Design/methodology/approachThe fundamental framework of the present investigation is a Participatory Action Research (PAR) design. By merging the impetus of “action.” with the inclusiveness of “participation,” PAR establishes a “network” for collaborative teaching or research. PAR is pertinent to our research because it facilitates the participation of infrastructures and individuals in formulating a critical community. This community encourages critical self-reflection, promotes accountability, redistributes authority, and cultivates confidence in research. PAR fosters constructive transformation in educational environments by utilizing participants' combined insights and experiences to establish a structure for substantive dialogue and proactive measures.FindingsAs virtual laboratories are becoming essential in 21st-century science education, we found groundbreaking evidence that can support our novel approach to enhance the quality and equity in education. Our results show that virtual labs engage scientific goals and practices, develop scientific literacy, foster scientific inquiry and problem-solving, and promote metacognition. The effects of the virtual laboratory can develop high self-efficacy and positive attitudes among students. It improves students' laboratory performance, which we noted from laboratory activities, simulations, and long exam results.Originality/valueThe study offers groundbreaking account to depict epistemic fluency aided by virtual laboratory.

Development of STEM-Based Biology Laboratory Activities in Creating Filter Paper Utilizing Indigenous Materials

This study aims to develop STEM-based laboratory activities in creating filter paper using indigenous materials. The researcher initially devised a formulation for creating filter papers from indigenous materials (Corchorus olitorius leaves and waste papers) and subjected them to various tests. It was determined that Filter Paper B is the most effective among all other formulations. Subsequently, it was compared to Grade 2 Whatman filter paper using the same methodology. These precise procedures were also incorporated into the laboratory activities developed by the researcher and utilized by students during implementation. Following the tests stated in the laboratory manual, the students also determined that filter paper B containing 20 g (40%) of jute mallow leaves and 30 g (60%) of waste paper was the most effective in terms of the criteria and qualities. A pre-and post-test were also administered during the implementation. This is aimed at assessing the degree of STEM literacy among students regarding the topic of Filtration. It is interesting to note that using STEM - Based Biology Laboratory Activities increased the students’ STEM literacy. Hence, it is recommended that the STEM – Based Biology Laboratory Activities be used in class to foster scientific learning among students.

271 Effects of Bariatric Surgery on Metabolic and Hormonal Balance: A 10-Year Retrospective Study

Abstract Background The increasing demand on Gastric bypass and other weight-loss surgeries known collectively as bariatric surgery is well documented but the long-term effects on some parameters have not been satisfactorily analysed over the years. Surgeons are dealing with a level of uncertainty regarding the most likely reason behind this metabolic derangement following such procedures in the follow up clinics. Aim To study the long-term effects of bariatric surgery and weight reduction procedures on Parathyroid function, calcium levels, Vitamin D and determinants of bone health. Method 10-year retrospective study looking at patients underwent bariatric surgery between the years 2006 – 2008 within the Yorkshire area and their follow up data. Results We found that the median calcium levels have decreased significantly compared to its level prior to the operation, even though the absolute value of calcium remained within the normal reference range, it was lower than that of the baseline for each individual, resulting in an increased PTH and ALP levels to a low statistical significance and important clinical significance. Conclusions Calcium levels being lower than the baseline but still within the normal reference range is affecting both PTH and ALP leaving the patient at increased risk of bone weakness complications and other hormonal disturbances. Recommendation During the post-operative follow up plan, calcium levels should be adjusted to mimic the levels of the individuals’ pre-operative values, and the baseline should be the reference range rather than the actual lab reference assuming Calcium levels preoperatively were within the normal range.

Wild yeast isolation by middle school students reveals features of North American oak populations of Saccharomyces cerevisiae and Kluyveromyces lactis.

Features of the natural life cycle of the budding yeast Saccharomyces cerevisiae were crucial to its domestication as a laboratory experimental model, especially the ability to maintain stable haploid clones and cross them at will to combine alleles via meiosis. Stable haploidy results from mutations in HO, which encodes an endonuclease required for haploid-specific mating-type switching. Previous studies found an unexpected diversity of HO alleles among natural isolates within a small geographic area. We developed a hands-on field and laboratory activity for middle school students in Denver, Colorado, USA to isolate wild yeast from oak bark, identify species via DNA sequencing, and sequence HO from S. cerevisiae isolates. We find limited HO diversity in North American oak isolates, pointing to efficient, continuous dispersal across the continent. By contrast, we isolated the "dairy yeast", Kluyveromyces lactis, from a tree <10 m away and found that it represents a new population distinct from an oak population in an adjacent state, pointing to high genetic diversity. The outreach activity partnered middle school, high school, and university students in making scientific discoveries and can be adapted to other locations and natural yeast habitats. Indeed, a pilot sampling activity in southeast Texas yielded S. cerevisiae oak isolates with a new allele of HO and, from a nearby prickly pear cactus, a heat-tolerant isolate of Saccharomyces paradoxus.

Development of Clinically Validated Artificial Intelligence Model for Detecting ST-segment Elevation Myocardial Infarction

ObjectiveAlthough the importance of primary percutaneous coronary intervention (PCI) has been emphasized for ST-segment elevation myocardial infarction (STEMI), the appropriateness of the cardiac catheterization laboratory (CCL) activation remains suboptimal. This study aimed to develop a precise artificial intelligence (AI) model for diagnosis of STEMI and accurate CCL activation. MethodsWe used electrocardiography (ECG) waveform data from a prospective PCI registry in Korea in this study. Two independent board-certified cardiologists established a criterion standard (STEMI or Not-STEMI) for each ECG based on corresponding coronary angiography data. We developed a deep ensemble model by combining five convolutional neural networks. In addition, we performed clinical validation based on a symptom-based ECG dataset, comparisons with clinical physicians, and external validation. ResultsWe used 18,697 ECGs for the model development dataset and 1,745 (9.3%) were STEMI. The AI model achieved an accuracy of 92.1%, sensitivity of 95.4% and specificity of 91.8 %. The performances of the AI model were well-balanced and outstanding in the clinical validation, comparison with clinical physicians, and the external validation. ConclusionsThe deep ensemble AI model showed a well-balanced and outstanding performance. As visualized with the Grad-CAM, the AI model has a reasonable explainability. Further studies with prospective validation regarding clinical benefit in a real-world setting should be warranted.

Reducing Door-to-Balloon Time Using EMS-Initiated App-Based Communication

BackgroundReducing door-to-balloon (D2B) time for ST-segment elevation myocardial infarction (STEMI) has been shown to improve outcomes. Delays still occur due to various factors such as time to laboratory activation and diagnostic clarification in equivocal cases. We propose that early communication through a mobile application (app) between emergency medical services (EMS) and in-hospital providers can reduce EMS-to-balloon time and provide coordinated care to impact D2B time. MethodsThe General Devices e-Bridge mobile app, which allows real-time communication and data transmission between EMS providers and the cardiac catheterization laboratory and emergency department staff, was implemented on May 14, 2019. A single-center, retrospective observational study was conducted on 795 STEMI activations undergoing emergent coronary angiography between January 2017 and July 2020. After exclusions, EMS transmissions of 428 cases were analyzed, of which 132 used the app. ResultsImplementation of e-Bridge significantly reduced D2B time by 7.2 minutes (P = .005) and emergency department board time by 4.41 minutes (P = .01). First medical contact to balloon (FMC2B) time trended toward reduction but was not statistically significant. The app did not significantly reduce D2B or FMC2B time during the day shift but significantly improved these metrics during the night shift. ConclusionsImplementation of app-based communication between EMS and in-hospital providers resulted in statistically significant reductions in D2B time at our institution. This approach holds promise in improving the timely management of STEMI patients, particularly during the night shift.