Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation

Background: Retention of mouth-to-mouth, mouth-to-mask and mouth-to-face shield ventilation techniques is poorly understood.Methods: A prospective randomised clinical trial was undertaken in January 2004 in 70 candidates randomly assigned to training in mouth-to-mouth, mouth-to-mask or mouth-to-face shield ventilation. Each candidate was trained for 10 min, after which tidal volume, respiratory rate, minute volume, peak airway pressure and the presence or absence of stomach inflation were measured. 58 subjects were reassessed 1 year later and study parameters were recorded again. Data were analysed with ANOVA, \textgreekq2 and McNemar tests.Results: Tidal volume, minute volume, peak airway pressure, ventilation rate and stomach inflation rate increased significantly at reassessment with all ventilation techniques compared with the initial assessment. However, at reassessment, mean (SD) tidal volume (960 (446) vs 1008 (366) vs 1402 (302) ml; p<0.05), minute volume (12 (5) vs 13 (7) vs 18 (3) l/min; p<0.05), peak airway pressure (14 (8) vs 17 (13) vs 25 (8) cm H2O; p<0.05) and stomach inflation rate (63% vs 58% vs 100%; p<0.05) were significantly lower with mouth-to-mask and mouth-to-face shield ventilation than with mouth-to-mouth ventilation. The ventilation rate at reassessment did not differ significantly between the ventilation techniques.Conclusions: One year after a single episode of ventilation training, lay persons tended to hyperventilate; however, the degree of hyperventilation and resulting stomach inflation were lower when a mouth-to-mask or a face shield device was employed. Regular training is therefore required to retain ventilation skills; retention of skills may be better with ventilation devices

Effects of Hydrogen Peroxide on Wound Healing in Mice in Relation to Oxidative Damage

10.1371/journal.pone.0049215PLoS ONE711

International Olympic Committee consensus statement on pain management in elite athletes

Pain is a common problem among elite athletes and is frequently associated with sport injury. Both pain and injury interfere with the performance of elite athletes. There are currently no evidence-based or consensus-based guidelines for the management of pain in elite athletes. Typically, pain management consists of the provision of analgesics, rest and physical therapy. More appropriately, a treatment strategy should address all contributors to pain including underlying pathophysiology, biomechanical abnormalities and psychosocial issues, and should employ therapies providing optimal benefit and minimal harm. To advance the development of a more standardised, evidence-informed approach to pain management in elite athletes, an IOC Consensus Group critically evaluated the current state of the science and practice of pain management in sport and prepared recommendations for a more unified approach to this important topic

Short and long-term acceptability and efficacy of extended-release cornstarch in the hepatic glycogen storage diseases:results from the Glyde study

Background: Hypoglycaemia is the primary manifestation of all the hepatic types of glycogen storage disease (GSD). In 2008, Glycosade®, an extended-release waxy maize cornstarch, was reported as an alternative to uncooked cornstarch (UCCS) which could prolong the duration of fasting in the GSD population. To date, there has been minimal published experience in (a) young children, (b) the ketotic forms of GSD, and (c) with daytime dosing. The Glyde study was created as a prospective, global initiative to test the efficacy and tolerance of Glycosade use across a broader and more diverse population. Methods: A randomised double-blind cross-over fasting study assessing the tolerance and efficacy of Glycosade compared with cornstarch was performed across disease types and ages. Participants and clinicians chose the product deemed superior, whilst still blinded. Participants were followed for 2 years to assess long-term metabolic control, growth, and quality of life. Results: Sixty-one participants (age 2–62 years; 59% female) were enrolled, and 58 participants completed the fasting studies (28 GSD I; 30 GSD III, VI, IX). Glycosade improved duration of fasting in GSD I and duration of fasting without ketosis in the ketotic forms. Chronic Glycosade use was chosen by 69% of participants. Those treated with Glycosade for the 2-year chronic phase used fewer doses of therapy while markers of metabolic control remained stable. Conclusion: The Glyde study is the first multi-centre international trial demonstrating the efficacy and tolerance of Glycosade in a large cohort of hepatic GSD patients across a diverse international population. The ability to use fewer doses of therapy per day and avoidance of overnight therapy may improve compliance, safety, and quality of life without sacrificing metabolic control.</p

Correction to Short and long-term acceptability and efficacy of extended-release cornstarch in the hepatic glycogen storage diseases: results from the Glyde study

Following publication of the original article [1], we have been notified that there was a mistake in the published articles and authors’ first and last names were published incorrectly. They are now as follows: Weinstein DA1,2*, Jackson RJ3, Brennan EA4, Williams M1, Davison JE5, de Boer F6, Derks TGJ6, Ellerton C7,Faragher B8, Gribben J9, Labrune P10, McKittrick KM4, Murphy E7, Ross KM1, Steuerwald U11, Voillot C10,Woodward AJM9 and Mundy HR9 They should be as follows: DA Weinstein 1,2*, RJ Jackson 3, EA Brennan 4, M Williams1, JE Davison5, F de Boer 6, TGJ Derks 6, C Ellerton7,B Faragher 8, J Gribben 9, P Labrune 10, KM McKittrick 4, E Murphy 7, KM Ross 1, U Steuerwald 11, C Voillot 10,AJM Woodward 9 and HR Mundy 9 The original article was updated.</p

Pest and disease management system for supporting winter oilseed rape decisions (PASSWORD) - vaildation phase (HGCA Project Report No. 390)

Pests and particularly diseases cause serious loss of yield and quality in winter oilseed rape estimated to exceed £80 million/annum in some years. These losses have occurred despite an annual expenditure of about £3.5 million for insecticides and £12 million on fungicides. Decision-making is difficult because there is complex spatial and temporal variation in pest and disease problems and improved guidance is required. The main objective of this project was to test new disease models developed in the first phase of this project and deliver a decision support system for both pest and disease control in oilseed rape. The regional light leaf spot forecast is well-established and reliable and indicates an increased risk of this disease in spring 2006. A new regional forecast for stem canker incidence preharvest has been developed and made available on the Internet. It was successful in 2004/05 and offers strategic guidance on risk provided weather factors are within the range used to develop the model. A four-stage crop-specific stem canker risk assessment method was developed that predicts the onset of phoma leaf spotting using post-harvest weather data and thermal time relationships for canker development and canker severity. Yield loss can then be calculated from canker severity and the economic impact of stem canker predicted. There is some flexibility in the timing of fungicide sprays to control stem canker. Delays of 2 to 3 weeks beyond a 10-20% plants affected threshold did not adversely affect yield. Stem canker severity and yield of different cultivars showed large variation between years and sites and smaller, but significant, variation in responses to fungicide. When phoma leaf spot appears in late autumn, it is only when plants are small that stem canker is likely to cause yield loss. In commercial crops, there were consistent trends for higher yields to be associated with higher fungicide inputs. Light leaf spot was very difficult to control with fungicides in the Aberdeen area where use of resistant cultivars is essential. The most effective disease control was obtained using a combination of resistant cultivars and fungicides. In some years, responses to fungicides were not cost-effective and targeting their use to high-risk situations is necessary to give the best margins over input costs. Close contact was maintained with potential users during the project and they influenced priorities and design features. The components of PASSWORD decision support system were tested and provide guidance for the management of invertebrate pests, phoma stem canker and light leaf spot. The system will be available to ArableDS for use in autumn 2006

Pulmonary Rehabilitation with balance training for fall reduction in Chronic Obstructive Pulmonary Disease: a randomized controlled trial

Introduction: Patients with Chronic obstructive pulmonary disease (COPD) have an increased fallrisk in part due to impaired balance and other comorbidities. Traditional pulmonary rehabilitation(PR) primarily focuses on exercise, education and psychosocial support. Long-term effects ofadding balance training to traditional PR on falls is not well understood. Methods: To determine theeffect of a tailored balance exercise program on the 12-month rate of falls in adults with COPD, weconducted a prospective, parallel-group, multi-center randomized controlled trial (RCT) in Canada,the United Kingdom, Portugal, and Australia (NCT02995681). Eligible participants were adults withCOPD at a high risk of falls who were randomly assigned (1:1) to the intervention or control group.Both groups received traditional PR (2-3 times per week for 8-12 weeks). The intervention includedthe addition of tailored balance training. Primary outcome was the incidence of falls at 12-monthfollow-up using monthly fall diary calendars. We employed zero-inflated generalized linear mixedmodels (Poisson regression) to examine the effect of the intervention on the rate of falls and usedmultiple imputation to deal with missing values as the sensitivity analysis. Results: This studyincluded 245 participants (125 in the intervention group and 120 in the control group), with the meanage at study entry being 72±9 years (from 37 to 95 years); 104 (42%) were female; 146 (60%) hada fall history in the last two years. Of the 245 participants, 67 (27%) did not return any fall informationduring the follow-up and therefore were excluded. We included 178 participants (91 assigned tointervention group and 87 assigned to control group) in the main analysis with well-balancedbaseline characteristics between the two groups. Falls occurred in 41 (45%) participants in theintervention group and 33 (38%) in the control group (Chi-Square= 0.93, P=0.34). The meannumber of falls was similar between the two groups (intervention: 1.10 ± 2.43 versus control 1.01 ±1.87). We did not find statistically significant effects of adding balance training to PR on the rate offalls in the mixed models (Relative risk 1.30; 95% CI: 0.59-2.87, p=0.52). The results are robustafter multiple imputations for missing data. Conclusion: Adding tailored balance training totraditional PR was not different from PR only in terms of the rate of falls over 12-months of follow-upin adults with COPD with high fall risk. COVID-19 pandemic impacted study recruitment, participantretention and data collection.publishe

Exploration of key stakeholders' preferences for pre-hospital physiologic monitoring by emergency rescue services

Peer reviewedPostprintPostprin