Simultaneous Signs Research Articles

Simultaneous multi-person vital signs monitoring using multiple-input multiple-output FMCW millimeter wave radar

Non-contact radar-based vital signs measurement holds immense significance in the context of a rapidly ageing society, underscoring its pivotal role in modern healthcare. While substantial progress has been made in developing radar-based systems for single-person vital sign detection, there remains a conspicuous gap in the domain of simultaneous multi-person measurement. This challenge is compounded by the inherently weak heart signals captured by radar, further exacerbated when dealing with multiple individuals. This paper presents a cutting-edge non-contact measurement system with multiple-input multiple-output (MIMO) frequency modulated continuous wave (FMCW) millimeter wave (mmW) radar for simultaneous multi-person vital signs monitoring. Firstly, a fusion-based approach is presented for multi-person localization within sequential MIMO range-angle maps. Subsequently, an optimization-based method is outlined for the extraction of vital signs, adeptly retrieving respiratory and cardiac signals from the radar’s phase data for each individual. Through extensive experimental validations, the system demonstrates a remarkably low error rate of 1.03% for respiratory measurement and 2.70% for cardiac measurement, reaffirming its efficacy and reliability.

High‐Speed Flexible Near‐Infrared Organic Photodetectors for Self‐Powered Optical Integrated Sensing and Communications

AbstractIntegrated sensing and communications (ISAC) based on radio frequency (RF), merging the sensing and communication functionalities into a single platform, can effectively address the increasing demand for spectrums due to the proliferation of wireless devices. However, the ISAC commonly suffers from spectrum scarcity, high power consumption, and limited sensing capabilities. Here flexible self‐powered optical ISAC (O‐ISAC) is proposed and fabricated by preparing a high‐speed near‐infrared organic photodetector (NIR OPD) that exhibits a broad photodetection ranging from 300 to 1100 nm, specific detectivity over 1013 Jones, and −3 dB cutoff frequency over 1 MHz (λ = 1050 nm) in self‐powered mode, ranking as the fastest among self‐powered NIR OPDs in the region above 1000 nm. The device is fabricated by incorporating a narrow‐bandgap non‐fullerene acceptor BTPSV‐4Cl into the PCE‐10:BTPSV‐4F system to finely tune the film morphology and reduce trap states and energetic disorder. The semitransparent and regular NIR OPDs are integrated on one substrate to fabricate flexible O‐ISAC, realizing simultaneous accurate vital signs monitoring and high‐speed data transmission under ambient, sunlight, and NIR lighting conditions. It is envisioned that the proposed O‐ISAC will inspire a new generation of wireless technology to address RF limitations for emerging applications, such as intelligent healthcare, autonomous vehicles, and security.

Mental Health Disorders of Bulgarian Healthcare Professionals during a Recurring Wave of the COVID-19 Pandemic

Introduction: During the COVID-19 pandemic, health hazards for medical professionals are associated not only with the high risk of infection, but also with poor working conditions, a stressful psychosocial environment and several socio-demographic factors. Objectives: The study aims to gain insight into possible mental health disorders among healthcare professionals working in the Bulgarian healthcare system and to determine which professional and socio-demographic categories are most significantly affected. Methods: This cross-sectional study was conducted in October 2022 in healthcare facilities from seven regions in Southern Bulgaria. A total of 665 workers from hospitals, emergency centers, general and specialized medical practices, and medical laboratories filled out the self-assessment mental health questionnaire DASS-21 (Depression, Anxiety and Stress Scale), as well as a survey about their occupational and socio-demographic characteristics. Suitable statistical methods were used to assess the scientific hypothesis. Results: 40% of all surveyed healthcare workers had some type of self-reported mental health disorder, with 27% having more than one. 13% had simultaneous signs of depression, anxiety and stress. The rates of depression, anxiety and stress were highest among those working in COVID wards and emergency care centers, among young workers under 26 years of age, and among workers with disabilities and frequently ill workers. Conclusions: Protecting healthcare workers’ physical and mental health and work ability is a matter of primary importance, particularly under challenging working conditions such as the COVID-19 epidemic.

Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria.

This paper describes the diagnostic criteria for Acute Unilateral Vestibulopathy (AUVP), a synonym for vestibular neuritis, as defined by the Committee for the Classification of Vestibular Disorders of the Bárány Society. AUVP manifests as an acute vestibular syndrome due to an acute unilateral loss of peripheral vestibular function without evidence for acute central or acute audiological symptoms or signs. This implies that the diagnosis of AUVP is based on the patient history, bedside examination, and, if necessary, laboratory evaluation. The leading symptom is an acute or rarely subacute onset of spinning or non-spinning vertigo with unsteadiness, nausea/vomiting and/or oscillopsia. A leading clinical sign is a spontaneous peripheral vestibular nystagmus, which is direction-fixed and enhanced by removal of visual fixation with a trajectory appropriate to the semicircular canal afferents involved (generally horizontal-torsional). The diagnostic criteria were classified by the committee for four categories: 1. "Acute Unilateral Vestibulopathy", 2. "Acute Unilateral Vestibulopathy in Evolution", 3. "Probable Acute Unilateral Vestibulopathy" and 4. "History of Acute Unilateral Vestibulopathy". The specific diagnostic criteria for these are as follows:"Acute Unilateral Vestibulopathy": A) Acute or subacute onset of sustained spinning or non-spinning vertigo (i.e., an acute vestibular syndrome) of moderate to severe intensity with symptoms lasting for at least 24 hours. B) Spontaneous peripheral vestibular nystagmus with a trajectory appropriate to the semicircular canal afferents involved, generally horizontal-torsional, direction-fixed, and enhanced by removal of visual fixation. C) Unambiguous evidence of reduced VOR function on the side opposite the direction of the fast phase of the spontaneous nystagmus. D) No evidence for acute central neurological, otological or audiological symptoms. E) No acute central neurological signs, namely no central ocular motor or central vestibular signs, in particular no pronounced skew deviation, no gaze-evoked nystagmus, and no acute audiologic or otological signs. F) Not better accounted for by another disease or disorder."Acute Unilateral Vestibulopathy in Evolution": A) Acute or subacute onset of sustained spinning or non-spinning vertigo with continuous symptoms for more than 3 hours, but not yet lasting for at least 24 h hours, when patient is seen; B) - F) as above. This category is useful for diagnostic reasons to differentiate from acute central vestibular syndromes, to initiate specific treatments, and for research to include patients in clinical studies."Probable Acute Unilateral Vestibulopathy": Identical to AUVP except that the unilateral VOR deficit is not clearly observed or documented."History of acute unilateral vestibulopathy": A) History of acute or subacute onset of vertigo lasting at least 24 hours and slowly decreasing in intensity. B) No history of simultaneous acute audiological or central neurological symptoms. C) Unambiguous evidence of unilaterally reduced VOR function. D) No history of simultaneous acute central neurological signs, namely no central ocular motor or central vestibular signs and no acute audiological or otological signs. E) Not better accounted for by another disease or disorder. This category allows a diagnosis in patients presenting with a unilateral peripheral vestibular deficit and a history of an acute vestibular syndrome who are examined well after the acute phase.It is important to note that there is no definite test for AUVP. Therefore, its diagnosis requires the exclusion of central lesions as well as a variety of other peripheral vestibular disorders. Finally, this consensus paper will discuss other aspects of AUVP such as etiology, pathophysiology and laboratory examinations if they are directly relevant to the classification criteria.

\u201cLocus minoris resistentiae\u201d and connective tissue weakness in older women: a case report and literature review on pelvic organ prolapse with inguinal bladder hernia

BackgroundConditions such as genital prolapse and hernia are known to be related to connective tissue dysfunction. In this report on cases of the rare simultaneous finding of large genital prolapse and post-prolapse repair female inguinal bladder hernia, we aim to contribute to the discussion of a possible clinical definition of connective tissue weakness, for its clinical assessment and preoperative patient counselling.Case presentationThree cases of medial third-grade (MIII, Aachen classification) inguinal bladder hernia developing or enlarging after successful stage-IV pelvic organ prolapse (POP) repair at a university pelvic floor centre are presented. All patients were aged ≥ 80 years with long-standing postmenopausal status. One patient was followed for 5 years and two patients were followed for 6 months. In all patients, ultrasound revealed that the hernia sac contained the urinary bladder, which had herniated through the inguinal hernia orifice. A literature search revealed only one case report of direct female inguinal bladder hernia and few investigations of the simultaneous occurrence of POP and hernia in general.ConclusionThe simultaneous occurrence of inguinal hernia and female POP can lead to bladder herniation following prolapse surgery in the sense of a “locus minoris resistentiae”. Clinical examination for simultaneous signs of connective tissue weakness and counselling prior to pelvic reconstructive surgery could help to increase patients’ compliance with further surgical treatment for hernia.

Multitarget Vital Signs Measurement With Chest Motion Imaging Based on MIMO Radar

Simultaneous multitarget vital signs measurement has become a hot issue for noncontact vital signs perception. However, there is still challenge in the multitarget heartbeat measurement due to the weakness of heartbeat signal and interference from complex environment. In this article, a new multiple-input–multiple-output (MIMO) continuous-wave (CW) radar system equipped with 2-D digital beamforming (DBF) is presented to measure the respiration and heartbeat of multiple human subjects at unknown positions simultaneously. Through 2-D beam scanning of the whole scene, a 2-D radar image is generated. From the image, the chest motion of multiple targets is accurately located. Then, the vital signs of targets are obtained through forming individual beams focusing on the chests of targets. Moreover, the low intermediate frequency (low-IF) architecture is adopted to minimize the impact of flicker noise in low-frequency amplifier stages. The experimental results demonstrate that the proposed MIMO 2-D imaging radar system can locate chest areas of multiple targets, suppress the clutters, and make vital signs measurement, heartbeat measurement in particular, more robust compared with single-input–multiple-output (SIMO) radar system in complex environment.

Контроль стану кровообігу нижніх кінцівок у хворих на цукровий діабет

Дослідження проблеми ураження нижніх кінцівок у хворих на цукровий діабет (ЦД) набуває все більшого значення у зв’язку зі значним поширенням кількості хворих. Важливим є питання ранньої діагностики діабетичної ангіопатії нижніх кінцівок. У проявах хвороби Рейно й ураження нижніх кінцівок у хворих на ЦД є багато спільного. При хворобі Рейно, як правило, спостерігається спазм дрібних артерій дистальних відділів кінцівок. У хворих на ЦД відбувається порушення магістрального кровотоку в артеріях нижніх кінцівок різного ступеня тяжкості, що також призводить до спазму дрібних артерій дистальних відділів. Впровадження термографічної діагностики дозволяє диференціювати хворобу Рейно від проявів ускладнень ЦД.

The Role of Aberrations in the Immune-Inflammatory Response System (IRS) and the Compensatory Immune-Regulatory Reflex System (CIRS) in Different Phenotypes of Schizophrenia: the IRS-CIRS Theory of Schizophrenia.

Several lines of evidence indicate that aberrations in immune-inflammatory pathways may contribute to the pathophysiology of schizophrenia spectrum disorders. Here, we propose a novel theoretical framework that was previously developed for major depression and bipolar disorder, namely, the compensatory immune-regulatory reflex system (CIRS), as applied to the neuro-immune pathophysiology of schizophrenia and its phenotypes, including first-episode psychosis (FEP), acute relapses, chronic and treatment-resistant schizophrenia (TRS), comorbid depression, and deficit schizophrenia. These schizophrenia phenotypes and manifestations are accompanied by increased production of positive acute-phase proteins, including haptoglobin and α2-macroglobulin, complement factors, and macrophagic M1 (IL-1β, IL-6, and TNF-α), T helper (Th)-1 (interferon-γ and IL-2R), Th-2 (IL-4, IL-5), Th-17 (IL-17), and T regulatory (Treg; IL-10 and transforming growth factor (TGF)-β1) cytokines, cytokine-induced activation of the tryptophan catabolite (TRYCAT) pathway, and chemokines, including CCL-11 (eotaxin), CCL-2, CCL-3, and CXCL-8. While the immune profiles in the different schizophrenia phenotypes indicate the activation of the immune-inflammatory response system (IRS), there are simultaneous signs of CIRS activation, including increased levels of the IL-1 receptor antagonist (sIL-1RA), sIL-2R and tumor necrosis factor-α receptors, Th-2 and Treg phenotypes with increased IL-4 and IL-10 production, and increased levels of TRYCATs and haptoglobin, α2-macroglobulin, and other acute-phase reactants, which have immune-regulatory and anti-inflammatory effects. Signs of activated IRS and CIRS pathways are also detected in TRS, chronic, and deficit schizophrenia, indicating that these conditions are accompanied by a new homeostatic setpoint between upregulated IRS and CIRS components. In FEP, increased baseline CIRS activity is a protective factor that may predict favorable clinical outcomes. Moreover, impairments in the CIRS are associated with deficit schizophrenia and greater impairments in semantic and episodic memory. It is concluded that CIRS plays a key role in the pathophysiology of schizophrenia by negatively regulating the primary IRS and contributing to recovery from the acute phase of illness. Therefore, components of the CIRS may offer promising therapeutic targets for schizophrenia.

About Competition Between Tetrahedral and Octahedral Symmetries in Atomic Nuclei

Following a recent discovery of the simultaneous signs of the octahedral and tetrahedral symmetries in 152 Sm, we discuss the issue of a competition between the two symmetries in atomic nuclei together with the identification criteria. Illustrations using selected rare-earth and zirconium nuclei as examples are presented.

Lasalocid immediately and completely prevents the myocardial damage caused by coronary ischemia reperfusion in rat heart

Lasalocid, a specific mobile membrane ionophore for calcium, dopamine and norepinephrine was assayed in its capacity to reduce or maintain unaltered the cardiovascular function in conditions of imminent myocardial injury. In experiments of coronary blockade and reperfusion carried out in rat heart, it was found that when administered from 5 to 30 minutes prior to the induction of coronary blockade, at a concentration of 2 mg/kg of body weight, the ionophore immediately, simultaneously, and completely interrupts the blood pressure decay, cardiac frequency increase, electrical ventricular tachycardia and fibrillation, as well as the fall of mitochondrial oxidative phosphorylation and decay of mitochondrial oxygen uptake provoked by the induced myocardial injury. It appears that the molecular mode of action of the lasalocid is associated with its unique ability to transport both calcium and the catecholamines, dopamine and norepinephrine, across mitochondrial and bimolecular lipid membranes, as well as through synaptic cell membrane terminals from rat heart, myocardial fibers of the heart and heart chromaffin membrane vesicles. It is suggested that for the potential medical use of lasalocid to detain incoming ischemic myocardial damage, there exists a need to develop a personal electronic device able to simultaneously monitor, detect, and inform on the very early and simultaneous signs of cardiac alterations of electrical, mechano-chemical, metabolic and hydraulic nature, all which precede heart failure and to administer the lasalocid.

Retrospective analysis of 185 inpatients with acute urticaria

Objective To analyze the precipitating factors for, clinical manifestations of, laboratory findings in and therapeutic effect on acute urticaria. Methods Clinical data were collected from 185 inpatients with acute urticaria in Shanxi Dayi Hospital from January 2013 to December 2016. Clinical features, laboratory examination results, treatment, prognosis and adverse reactions were analyzed retrospectively. Statistical analysis was carried out by chi-square test. Results There were 63 male patients and 122 female patients in this study, with an average age at onset of 32.87 ± 14.18 years. Of the 185 patients, 78 (42.2%) were able to report the aetiological agents accurately, 33 (17.8%) were induced by infection or drug therapy following infection, and 82 (44.3%) had fever. Blood cell analysis showed increased white blood cell count in 132 (71.4%) cases and increased proportion of neutrophils in 128 (69.2%) cases. The level of C reactive protein increased in 118 (69%) of 171 cases. A total of 185 patients received routine anti-anaphylactic treatment. Of 183 cured patients, 153 (83.6%) were treated with antibiotics, 26 (14.2%) with antibiotics alone, and 24 (13.1%) with azithromycin. There were 127 (69.4%) patients receiving combined treatment with glucocorticoids, antibiotics, and so on, and the antibiotic used in 111 (60.7%) cases was azithromycin. Of 88 cured patients with simultaneous signs of infection, 85 (96.6%) showed increased levels of part or all of infection markers (including the white blood cell count, proportion of neutrophils and level of C reactive protein) , and 69 (78.4%) were treated with azithromycin. Of 95 cured patients without signs of infection, 83 (87.4%) showed increased levels of infection markers, and 61 (64.2%) were treated with azithromycin. Moreover, there were significant differences in the proportion of patients with increased levels of infection markers and that of patients treated with azithromycin between the cured patients with and without signs of infection (χ2 = 5.164, 4.476, both P < 0.05) . Conclusions Infection is a common cause of acute urticaria, and laboratory examinations including white blood cell count, proportion of neutrophils and level of C reactive protein are of important reference value to the diagnosis of infection in patients with acute urticaria. Patients with signs of infection or increased levels of infection markers need to be treated with combined anti-infective therapy, and in the cured patients, the proportion of patients administrating azithromycin was higher than that of those administrating other antibiotics for the treatment of acute infectious urticaria. Key words: Urticaria; Infection; Glucocorticoids; Azithromycin

Expressing time through space

Abstract This study describes how temporal discourse content is expressed in signing space in Swedish Sign Language (SSL) and identifies and describes the differences between L1- and L2-interpreters’ signed target language output. The study found that L1-interpreters systematically use complex simultaneous combinations of lexical signs and various hand, arm and body movements on and along time lines. The L2-interpreters stand more still, and their use of body movements differs from that of the L1-interpreters. Though the L2-interpreters in the study often succeed in showing that two or more entities/events are separate, they are less successful in showing the more specific, temporal and/or other, relationship(s) between them. This crucial aspect of idiomatic signed language production, therefore, should be included in interpreter training to improve the quality of interpreted target language output.

Magnetization and specific heat studies of the low temperature anomalies in terbium iron garnet Tb3Fe5O12

The macroscopic magnetic properties of the terbium iron garnet (Tb3Fe5O12) single crystals were studied at low temperature by magnetizations MT (H) in magnetic fields up to 80 kOe and applied along the easy axis <111>. Maxima are observed near ∼ 65 and ∼ 47 K, respectively in the curves of the initial magnetic susceptibility χ0(T), and the parameter |b|(T) of the bH2 term are associated with the non linear variation of the MT (H) magnetizations. From the specific heat Cp(T) measurements, a great peak is observed near 57 K in the excess contribution of the Tb3+ ions Cpex(T) to Cp(T) which vanishes in the 170–208 K temperature range. The results are discussed with respect to the simultaneous signs of the “low-temperature point” TB predicted by Belov at 58 K and the ‘Schottky anomaly’ detected experimentally by the presence in the Cpex(T) curve of a 1/T2 term for T > TB.

Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection

The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015. Patients triaged to fast-track, dentistry, psychiatry, and labor and delivery were excluded. qSOFA scores were calculated with simultaneous vital signs and Modified Early Warning System scores. Patients receiving intravenous antibiotics were presumed to have suspected infection. Univariate and multivariate analyses were performed to explore the association between qSOFA scores and inpatient mortality, admission, and length of stay. Receiver operating characteristics curve analysis and c statistics were also calculated for ICU admission and mortality. We included 22,530 patients. Mean age was 54 years (SD 21 years), 53% were women, 45% were admitted, and mortality rate was 1.6%. qSOFA scores were associated with mortality (0 [0.6%], 1 [2.8%], 2 [12.8%], and 3 [25.0%]), ICU admission (0 [5.1%], 1 [10.5%], 2 [20.8%], and 3 [27.4%]), and hospital length of stay (0 [123 hours], 1 [163 hours], 2 [225 hours], and 3 [237 hours]). Adjusted rates were also associated with qSOFA. The c statistics for mortality in patients with and without suspected infection were similarly high (0.75 [95% confidence interval 0.71 to 0.78) and 0.70 (95% confidence interval 0.65 to 0.74), respectively. qSOFA scores were associated with inpatient mortality, admission, ICU admission, and hospital length of stay in adult ED patients likely to be admitted both with and without suspected infection and may be useful in predicting outcomes.

Simultaneous perception of a spoken and a signed language: The brain basis of ASL-English code-blends

Code-blends (simultaneous words and signs) are a unique characteristic of bimodal bilingual communication. Using fMRI, we investigated code-blend comprehension in hearing native ASL-English bilinguals who made a semantic decision (edible?) about signs, audiovisual words, and semantically equivalent code-blends. English and ASL recruited a similar fronto-temporal network with expected modality differences: stronger activation for English in auditory regions of bilateral superior temporal cortex, and stronger activation for ASL in bilateral occipitotemporal visual regions and left parietal cortex. Code-blend comprehension elicited activity in a combination of these regions, and no cognitive control regions were additionally recruited. Furthermore, code-blends elicited reduced activation relative to ASL presented alone in bilateral prefrontal and visual extrastriate cortices, and relative to English alone in auditory association cortex. Consistent with behavioral facilitation observed during semantic decisions, the findings suggest that redundant semantic content induces more efficient neural processing in language and sensory regions during bimodal language integration.

PP.LB01.24

Objective: To assess heart rate variability (HRV) parameters in hypertensive and normotensive postmenopausal women.Design and method: 203 women with surgical and natural menopause were included in the investigation: 115 normotensive women (average age 47,3 ± 5,4 years, menopause duration 4,8 ± 5,4 years) and 88 hypertensive patients (average age 43,2 ± 2,7 years, menopause duration 4,3 ± 2,1 years). 35 healthy women were included in the control group. Electrocardiogram was recorded in the supine position for 10 min. Spectral analysis included total power (TP), low and high frequencies (LF and HF) in absolute units. The LF/HF ratio was also calculated. All patients underwent ambulatory blood pressure and electrocardiogram monitoring (Cardiotens-01, Meditech, Hungary). Time-domain HRV parameters evaluated were the standard deviation of all normal RR intervals (SDNN), the root mean square of differences between adjacent R-R intervals (rMSSD) and the percentage of adjacent R-R intervals that varied by more than 50 ms (pNN50). Statistical methods such as Cruskell-Walles and Dan criteria were used. Results: TP, LF, and HF were significantly reduced in all postmenopausal women compared with healthy controls. SDNN, rMSSD and pNN50 were also significantly reduced in all postmenopausal women compared with healthy controls. All above indicators were significantly reduced in hypertensive postmenopausal women in compared with normotensive ones. LF/HF ratio was 2,2 times higher in hypertensive postmenopausal than in healthy women and it was 54% more than in normotensive postmenopausal women. This fact testifies about increased cardiac sympathetic modulation in postmenopausal women, especially in hypertensive ones. Conclusions: Decreased HRV at simultaneous signs of a sympathetic overactivity can reflect increased cardiovascular risk at postmenopausal (in particular hypertensive) women.

Simultaneous Erb’s and Klumpke’s palsy: Case report

Mapping nerve deficits during a physical exam after trauma to the upper extremity can help determine not only if the brachial plexus was injured but also which nerve roots were involved. A 28-year-old male presented with simultaneous signs and symptoms of Erb's (C5) and Klumpke's (C8, T1) palsy, with sparing of the C6 and C7 roots. The patient presented several months ago to his local emergency room with shortness of breath, which was determined to be caused by left diaphragmatic paralysis through clinical and radiographical evidence. However, the etiology of the current nerve dysfunction in the upper extremity remained unknown. With persistent questioning and establishing the patient's trust in the caregivers, it was revealed that the patient had attempted suicidal hanging. We describe the clinical features and the likely mechanism of injury leading to this previously unreported combination of brachial plexus injuries. The unique injuries to this patient's brachial plexus can be explained by the sequence of events during the attempted suicidal hanging. The upper brachial plexus was injured during the initial moments where the neck was excessively stretched and the lower brachial plexus was injured due to the patient reaching up and holding himself by his arm for an extended period of time.

Novel prehospital monitor with injury acuity alarm to identify trauma patients who require lifesaving intervention

A miniature wireless vital signs monitor (MWVSM, www.athena.gtx.com) has been designed according to US Special Operations Command specifications for field monitoring of combat casualties. It incorporates an injury acuity algorithm termed the Murphy Factor (MF), which is calculated from whatever vital signs are available at the moment and changes in the last 30 seconds. We tested the hypothesis that MF can identify civilian trauma patients during prehospital transport who will require a lifesaving intervention (LSI) upon hospital admission. From December 2011 to June 2013, a prospective trial was conducted in collaboration with prehospital providers. The MWVSM detects skin temperature, pulse oximetry (SpO2), heart rate (HR), pulse wave transit time, and MF. LSIs included: intubation, tube thoracostomy, central line insertion, blood product transfusion, and operative intervention. Prehospital MWVSM data were compared with simultaneous vital signs (SaO2, systolic blood pressure (SBP), and HR) from a conventional vital signs monitor. Sensitivity, specificity, negative predictive value, positive predictive value, and area under the receiving operating characteristic curves were calculated. Ninety-six trauma patients experienced predominantly blunt trauma (n = 80, 84%), were mostly male (n = 79, 82%), and had a mean ± SD age of 48 ± 19 years and an Injury Severity Score (ISS) of 10 (17). Those who received an LSI (n = 48) had similar demographics but higher ISS (18 vs. 5) and mortality (23% vs. 0%) (all p < 0.05). The most common LSIs were intubation (n = 24, 25%), blood product transfusion (n = 19, 20%), and emergency surgery (n = 19, 20%). Compared with HR > 100 beats/min, SBP < 90 mm Hg, SaO2 < 95% alone or in combination, MF > 3 during the entire transport time had the largest area under the receiving operating characteristic curves (0.620, p = 0.081). MF greater than 3 had a specificity of 81%, sensitivity of 39%, positive predictive value of 68%, and negative predictive value of 57% for the need for LSI. A single numeric value has the potential to summarize overall patient status and identify prehospital trauma patients who need an LSI. Prehospital monitoring combined with algorithms that include trends over time could improve prehospital care for both civilian and military trauma. Prospective observational, level II.

The developmental quality of participation experiences: Beyond the rhetoric that “participation is always good!”

A powerful rhetoric regarding the importance of adolescents’ civic engagement and political participation is common in contemporary societies, whilst citizens, both adolescent and adults, seem to express a growing scepticism and alienation regarding politics. Even if this disengagement is debatable, as there are simultaneous signs of an increasing involvement in a variety of emerging and broadly-defined civic and political activities, we argue that the benefits of these experiences should be scrutinized using psychological evidence-based criteria. We rest on classical contributions from developmental psychology, educational theory and political science to define criteria that could inform the quality of participation experiences, and then present two studies that explore its adequacy. Study 1 is a cross-sectional study that observes that higher quality civic and political experiences are connected with more complex modes of thinking about politics. In Study 2, a two-wave longitudinal design, the quality of participation experiences is a significant predictor of change patterns of political attitudes; moreover, results support the argument that participation is not good in itself and that some experiences, with lesser developmental quality, might have a detrimental effect on adolescents’ political development.

Prevalence of Otitis Media With Effusion Among Children in Xi'an, China: A Randomized Survey in China's Mainland

We sought to identify the prevalence of otitis media with effusion (OME) in urban Chinese children in Xi'an, China. Five kindergartens and 3 primary schools were randomly selected in the urban area of Xi'an. Screening otoscopic and tympanometric examinations were performed on 2,902 children (1,491 boys and 1,411 girls) 2 to 8 years of age. Children with an abnormal tympanogram and simultaneous otomicroscopic signs of effusion were given a diagnosis of OME. The overall prevalence of OME was 4.3%. By age group, the prevalence was 14.0% in 2-year-olds, 8.3% in 3-year-olds, 5.0% in 4-year-olds, 4.9% in 5-year-olds, 2.8% in 6-year-olds, 1.7% in 7-year-olds, and 3.2% in 8-year-olds. The prevalence rate for OME was 4.7% for boys versus 3.9% for girls, and 3.0% in the right ear versus 2.7% in the left, showing no statistically significant difference between genders or between ear sides (p > 0.05). The prevalence of OME in urban areas of Xi'an is not high in comparison with that of the same age group in surrounding areas.