Search

Objectives: To compare the effects of powered and manual stretchers on participants' perceived comfort and measured acceleration during lifting and loading operations., Methods: This non-randomized, laboratory-based crossover study involved forty-one participants (thirty-one firefighters and ten third-year paramedic students) who served as simulated patients experiencing lifting, lowering, loading, and unloading maneuvers using manual and powered stretchers. Four stretcher types were evaluated: one powered stretcher (Power-PRO ™ XT) and three manual stretchers (Matsunaga GT, Exchange 4070, Scad Mate), with each group using the manual stretcher they routinely operated. Linear acceleration data were collected using a nine-axis inertial measurement unit placed at the participants' anterior waist. Root mean square (RMS) and peak accelerations along the X-, Y-, and Z-axes were calculated. Participants completed a twenty-three-item comfort questionnaire based on the Semantic Differential method. Due to non-normal data distribution, nonparametric statistical tests were employed for analysis., Results: The lifting/lowering and loading/unloading movements showed that the powered stretcher significantly reduced the RMS values, maximum accelerations, and minimum accelerations in the vertical axis (Z-axis) compared to manual stretchers. Specifically, the powered stretcher demonstrated lower RMS acceleration (0.29 m/s 2 vs. 0.73 m/s 2 , p  < 0.001), maximum acceleration (1.60 m/s 2 vs. 2.90 m/s 2 , p  < 0.001), and minimum acceleration (-1.48 m/s 2 vs. -3.30 m/s 2 , p  < 0.001) in the vertical direction compared to other manual stretchers. Similar results were observed in the comparison of participant loading/unloading movements. However, no significant differences were observed between the powered and Exchange stretchers in X-axis minimum acceleration, Y-axis maximum and minimum accelerations, or Z-axis maximum acceleration. Similarly, Y-axis minimum accelerations did not significantly differ between the powered stretcher and Matsunaga GT or Scad Mate stretchers. After loading and unloading movements, the questionnaire results showed that the powered stretcher was rated significantly higher on comfort-related items including "comfortable," "secure," "like," "smooth," and "relaxing.", Conclusions: In a controlled, laboratory-based setting, simulated use of manual and powered stretchers showed that powered stretchers significantly minimize patient discomfort and vibrations. This study underscores the potential for enhancing patient safety and quality of care. In conclusion, the powered stretcher is a promising tool for improving the quality and safety of patient transportation in prehospital settings.

The present paper investigates the possibility of replacing the traditional L-type corner joint used in chair construction with a 3D printed connector, manufactured using the Fused Filament Fabrication (FFF) method and black PLA as filament. The connector was designed to assemble the legs with seat rails and stretchers, and it was tested under diagonal tensile and compression loads. Its performance was compared to that of the traditional mortise-and-tenon joint. Stresses and displacements of the jointed members with connector were analyzed using non-linear Finite Element Method (FEM) analysis. Both connector and mortise-and-tenon joint were employed to build chair prototypes made from beech wood (Fagus sylvatica L.). Digital Image Correlation (DIC) method was used to analyze the displacements in the vicinity of the jointed members of the chairs. Seat and backrest static load tests were carried out in order to verify if the chairs withstand standard loading requirements. Results indicated that the 3D printed connector exhibited equivalent mechanical performance as the traditional joint. The recorded displacement values of the chair with 3D-printed connectors were higher than those of the traditional chair reaching 0.6 mm on the X-axis and 1.1 mm on the Y-axis, without any failures under a maximum vertical load of approximately 15 kN applied to the seat. However, it successfully withstood the loads for seating and backrest standard tests, in accordance with EN 1728:2012, without any structural failure. This paper presents a new approach for the chair manufacturing sector, with potential applicability to other types of furniture. [ABSTRACT FROM AUTHOR]

• A new method of spectrum retrieval and loss compensation for point-by-point inscribed fiber Bragg gratings is proposed. • Chirped fiber Bragg gratings (CFBG) with a dispersion of −15 ps/nm were inscribed in a heavily Yb-doped silica fiber. • The effects of spectral retrieval and amplification in the developed CFBGs are studied for various pumping conditions. • The effective use of the developed CFBGs for stretching femtosecond pulses in a CPA setup has been demonstrated. Point-by-point femtosecond laser inscribed chirped Bragg gratings are good candidates for use in fiber chirped pulse amplification systems due to the high flexibility of their dispersion properties, low cost, and no length limitation. However, such gratings have two significant drawbacks: high losses and distortions of the short-wavelength part of the spectrum when operating in the normal group velocity dispersion mode. We propose a novel approach based on writing such gratings in a highly doped active fiber, which allows us to correct both shortcomings. We have also demonstrated, for the first time to our knowledge, a successful use of such gratings as stretchers in a fiber chirped pulse amplification system. [ABSTRACT FROM AUTHOR]

• Quantified the loss of pretightening force due to bolt interference. • Defined cycle count and target force value to optimize the pretightening procedure. • Revealed the pretightening pattern of multi-head synchronous hydraulic tensioners. • Validated the effectiveness of cleats with larger wrapping angles. To address recurring issues identified during comprehensive maintenance of a specific generator model—particularly the loosening of ring lead fixing structures at the generator ends, along with the detachment of felt and insulation wear—a detailed investigation was conducted. This study focused on analyzing the root causes of these problems and developing targeted improvement strategies. Taking the ring lead fixing structure as the research object, the investigation explored enhancements to the fixing structure and optimization of the bolt pretightening process. By comparing the fixing structure of faulty units with that of fault-free units and considering practical field conditions, a solution involving an increased cleat wrapping angle was proposed. The effectiveness of this improved design was verified through testing. Furthermore, the interaction of adjacent bolts during the stretching of single-head bolt stretchers was investigated for the bolt pre-tightening process. In view of the bolt pretightening process, the study explored the interaction between adjacent bolts when utilizing single-head bolt tensioners was studied, and experiments using multi-head synchronous hydraulic tensioners were conducted to evaluate their pretightening performance. The results revealed the pretightening behavior of multi-head systems, demonstrating their superior efficiency compared to single-head methods. These findings provide a robust foundation for applying such systems in industrial settings. This study aims to resolve technical challenges related to the ring lead fixing structure and the bolt pretightening process, ultimately ensuring the safe and stable operation of the generator. [ABSTRACT FROM AUTHOR]

With sufficiently high signal-to-noise, several systematic errors become prominent in dual-comb interferometry measurements. This paper reviews several error sources including electrical, photo-detection, amplification and acquisition chain non-linearity. Sources of optical non-linearity such as self-phase modulation, cross-phase modulation and Raman soliton shifting are also covered, as are spectral fringing due to parasitic reflections and back-scattering. The non-linear response of the target sample itself can also be a source of errors. Methods to identify and minimize errors in experimental data are discussed. Good practices, instrument design strategies and tools, such as the dynamic range diagram, are suggested. [ABSTRACT FROM AUTHOR]

Emergency departments in many nations worldwide have been struggling for many years with crowding and the subsequent provision of care in hallways and other unconventional spaces. While this issue has been investigated and analyzed from multiple perspectives, the ethical dimensions of the place of emergency department care have been underexamined. Specifically, the impacts of the place of care on patients and their caregivers have not been robustly explored in the literature. In this article, a feminist ethics and human geography framing is utilized to argue that care provision in open and unconventional spaces in the emergency department can be unethical, as vulnerability can be amplified by the place of care for patients and their caregivers. The situational and pathogenic vulnerability of patients can be heightened by the place of the emergency department and by the constraints to healthcare providers' capacity to promote patient comfort, privacy, communication, and autonomy in this setting. The arrangements of care in the emergency department are of particular concern for older adults given the potential increased risks for vulnerability in this population. As such, hallway healthcare can reflect the normalized inequities of structural ageism. Recommendations are provided to address this complicated ethical issue, including making visible the moral experiences of patients and their caregivers, as well as those of healthcare providers in the emergency department, advocating for a systems-level accounting for the needs of older adults in the emergency department and more broadly in healthcare, as well as highlighting the need for further research to examine how to foster autonomy and care in the emergency department to reduce the risk for vulnerabilities. [ABSTRACT FROM AUTHOR]

Background: The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses experience their work as more fulfilling, they are more inclined to remain within a role for an extended period. One of the ways to determine the lived experience of nurses is to measure their Professional Quality of Life. This is the first study to look at the Professional Quality of Life of Flight Nurses who work in public sector Aeromedical Retrieval Services in New Zealand. Aims: The aim of this study was to determine the Professional Quality of Life of Flight Nurses working in the public sector in New Zealand. Design: A survey based cross-sectional design was employed, using the Professional Quality of Life (ProQOL) V Health survey tool. Methods: Online survey data was collected from a convenience sample of 169 Flight Nurses working in public sector Aeromedical Retrieval services in New Zealand. Results: Of the 88 respondents, all reported either high or average levels of Compassion Satisfaction (High 48.86%, Average 51.13%) and Perceived support (High 44.31%, Average 55.68%). The majority reported Low to Average scores for Secondary Traumatic Stress (Low 30.68%, Average 67.04% and High 2.27%), Burnout (Low 4.54%, Average 89.77% and High 5.68%) and Moral Distress (Low 23.86% and Average 76.13%). Conclusion: This study highlights that Flight Nurses in New Zealand's public sector generally experience a positive Professional Quality of Life, but that there are also instances of Burnout and Secondary Traumatic stress. [ABSTRACT FROM AUTHOR]

This paper examines the systemic and multidimensional impacts of inadequate road infrastructure on social inequality in the rural Eastern Cape province of South Africa, focusing on the Hlankomo community from Mdeni to Upper Tsitsana. By integrating a sociological framework, the study explores how deteriorating road conditions perpetuate structural and symbolic violence, exacerbating economic marginalization, social exclusion, and cultural disempowerment. Drawing on site observations, qualitative interviews, and photographic evidence, the research highlights how poor road infrastructure restricts access to essential services, including healthcare, education, and economic opportunities, deepening historical and spatial inequalities. The findings underscore the urgent need for transformative, equity-driven infrastructure policies that address governance inefficiencies, historical neglect, and systemic marginalization. By prioritizing inclusivity, social justice, and sustainable development, this paper contributes to the broader discourse on rural development and infrastructural justice in South Africa's marginalized landscapes. [ABSTRACT FROM AUTHOR]

Pre-established anaesthetic protocols in animal models might unexpectedly interfere with the main outcome of scientific projects and therefore they need to account for the specific research goals. We aimed to optimize the anaesthetic protocol and animal handling strategies in a diabetes-related-study exemplifying how the anaesthetic approach must be adjusted for individual research targets. Aachen minipigs were used as a model to test long-lasting skin glucose sensors for diabetic human patients. A total of 6 animals participated in two or three rounds of experiments. Each round lasted 2 months, with a maximum of 2 rounds per year. In each round, animals were anaesthetised 4 times: for glucose sensors insertion, twice for glucagon stress tests (GST), and a last time for removal of sensors. Acepromazine (ACE) was compared to medetomidine (MED) in association with butorphanol (BUT) and Ketamine (KET) and 4 parameters were analysed to define the optimum anaesthetic protocol including: sedation level, anaesthesia duration, effects on blood glucose and safety. ACE-BUT demonstrated a weaker sedative effect but reduced overall experimental time, minimized anaesthetic risk and minimally interfered with the glucose metabolism. The improvement obtained by animal conditioning and handling strategies applied in this study were not objectively estimated, although the aversion behavior was completely abolished. Based on the analysed parameters, the use of acepromazine is proposed to be superior when Aachen Minipigs are used specifically as a model for diabetes-related studies, albeit the recommendations for the anaesthesia of minipigs suggest otherwise. [ABSTRACT FROM AUTHOR]

Background: One way to measure emergency department (ED) performance is using key performance indicators (KPIs). Thus, identifying reliable KPIs can be critical in appraising ED performance. This study aims to introduce and classify the KPIs related to ED in simulations through the Balanced Scorecard (BSC) framework. Method: This scoping review was performed in 2024 without any time limitation based on the Arksey and O'Malley framework. The electronic databases of PubMed, Scopus, Web of Science, EMBASE, MathSciNet, Google Scholar, and Persian databases such as IranDoc, MagIran, and SID were searched. The winter simulation conference was also investigated through manual searching. Furthermore, the screening process of included studies was based on the PRISMA reporting checklist. The data were analyzed by content analysis deductively and inductively. The extracted KPIs were coded as analysis units and transferred to the MAXQDA2020 software. Then, the KPIs were integrated and organized based on similarity. Moreover, the two authors discussed disagreements to reach a consensus on the final codes. The final KPIs classification was carried out based on the BSC framework to achieve a holistic view. The BSC is a managerial tool for evaluating organizations' performance via different dimensions. It contains four main dimensions: Customer, Financial, Growth and infrastructure, and Internal Processes. In addition, the management (vision, objectives, and strategies) has been positioned at the heart of the framework. Result: Initially, 4257 articles were retrieved, and 125 articles were included after screening. Finally, 109 KPIs were extracted and classified into five categories. They include input, processing time, cost and revenue, utilization and productivity, and output indicators. Then, each category of KPIs was positioned in the BSC framework dimensions. Additionally, the findings showed that most indicators were related to the time of process indicators. Conclusions: The study findings have collected a comprehensive set of KPIs to measure ED performance in simulations. These results can assist policymakers, managers, and researchers in measuring ED performance and help improve ED performance through a holistic view. [ABSTRACT FROM AUTHOR]

Objective To evaluate the stain resistance and color stability of four Clear aligners (CA) brands against various beverages at different intervals, along with assessing the elaboration of cleaning agents. Methods In a strictly controlled lab environment, 48 CAs from four different companies (Invisalign, EON, Clear Cap, and K clear) were immersed for seven days in six different beverages based on their pH (Pepsi, orange juice, milk, coffee, and black tea), as well as a control solution (distilled water). The VITA Easy-Shade compact colorimeter used the Commission International lightening L*a*b* color scheme to evaluate the color change of the aligners at four intervals. T0: before immersing in the solution; T1: twelve hours after immersion; T2: seven days after immersion; and T3/T4: fifteen minutes after exposure to two cleaning agents. The color values were then converted into National Bureau of Standards System (NBS) units. The statistical analysis was carried out using SPSS. A one-way ANOVA test was used to compare the mean color change values of all aligners and staining agents. Results A significant color change in aligners was observed after immersion in the stated solutions (p = 0.01). Additionally, there is a difference when washing with Invisalign foam and M3 cleaners (p < 0.001). Similarly, there were significant color variations between twelve hours and seven days after soaking (p = 0.01). Nonetheless, there were no significant differences in discoloration among the CAs’ manufacturing materials. Conclusions CAs’ staining ability at different time intervals after immersion in various solutions was clearly visible. Aligner cleanser use has a substantial influence on reducing acquired pigmentation. However, there were minimal differences in discoloration across CA brands. [ABSTRACT FROM AUTHOR]

This study employs the finite element method to propose a model-based design strategy for upholstered furniture frames. Three-dimensional discrete models of these frames were created, considering the orthotropic characteristics of pine (Pinus sylvestris L.) and spruce (Picea abies L.) wood, reinforced structurally with glue joints and upholstery staples. The modelling process utilised the CAE system Autodesk Inventor Nastran, applying the finite element method (FEM). Static analyses were performed by simulating standard loading conditions. The calculations incorporated the stiffness coefficients of the frame's comb joint connections. The findings illustrate the stress distribution, displacements, and equivalent strains within the furniture frame models. The deformation and strength parameters of the frames introduce a novel perspective on designing upholstered furniture structures using the component-based FEM approach. These outcomes are applicable to the development of upholstered furniture designs. [ABSTRACT FROM AUTHOR]

Background: Saudi ambulance clinicians face unique challenges in providing prehospital care to older trauma patients. Limited geriatric-specific training and complex needs of this population hinder effective management, leading to adverse outcomes. This study explores the perceptions of Saudi ambulance clinicians regarding geriatric trauma care and identify facilitators and barriers to improved care. Methods: A qualitative study was conducted using a purposive sample of Saudi paramedics and ambulance technicians from Riyadh and Makkah using online semi-structured interviews and analysed using the framework method. Results: The qualitative study recruited twenty participants and identified that they reported age-related challenges including physiological changes, polypharmacy, and communication difficulties. They all wanted training and guidelines to improve their knowledge. They reported struggling with communication difficulties, inaccurate adverse outcomes predictions, difficult intravenous cannulations, and cultural restrictions affecting care provision for female patients. We identified organisational barriers (e.g. lack of shared patient records and lack of guidelines) and cultural barriers (e.g. barriers to assessing women, attitudes towards older people, and attitudes towards paramedics) that influenced implementation of knowledge. Conclusion: Ambulance clinicians in Saudi Arabia want guidelines and training in managing older trauma patients but these need to take into account the organisational and cultural barriers that we identified to facilitate implementing knowledge and changing practice to providing improved care. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Delivering chest compressions (CCs) at the targeted depth and rate is a crucial aspect of maintaining the quality of cardiopulmonary resuscitation (CPR). Although administering CCs on a firm surface is recommended, it may not always be feasible. This study aimed to determine whether the underlying surface affects CC depth and rate using a real-time feedback device. METHODS: An observational study was conducted on a manikin (ResusciAnne; Laerdal). 25 volunteer emergency medicine physicians performed 2 min of continuous CCs without feedback on the floor, emergency department stretcher (EDS), and ambulance stretcher (AS). The following day, all participants performed an additional 2 min of CCs while receiving audiovisual real-time feedback (ZOLL M2 series). Compression depths and rates were measured and recorded in a real-time feedback device. RESULTS: A total of 150 CC intervals were analyzed. The mean values of compression depths and rates on all surfaces are within the targeted range for high-quality CPR, except for the mean depth without feedback on the EDS (mean: 6.37 cm). There were a statistically significant difference, with both AS and EDS were achieved deeper compressions than those on the floor (P < 0.05). When examining the mean compression depths on three different surfaces with feedback, no statistically significant difference was observed. However, CCs performed without feedback on both AS and EDS were statistically significantly deeper than those on the floor. The mean compression rates both on the floor and the AS were statistically significantly faster compared to EDS. When examining the mean compression rates during CCs performed on three different surfaces with feedback, no statistically significant difference was observed but in the without feedback compressions, both on AS and floor were found to be statistically significantly faster than EDS. CONCLUSIONS: CC's depth are influenced by the underlying surface. It appears more feasible to minimize surface-related differences while maintaining appropriate targets for depth using real-time feedback devices. The mean compression rate could be kept within the targeted range regardless of the surface. [ABSTRACT FROM AUTHOR]

Background: Functional electrical stimulation-assisted rowing (FES rowing) is a rehabilitation exercise used to prevent disuse osteoporosis, which is common in people with spinal cord injury (SCI). However, its effect on bone loss prevention varied in SCI patients, potentially due to inconsistent loading. This study investigates the effect of ergometer setup and rowing speed on lower extremity loading during rowing. Methods: Twenty able-bodied participants and one participant with SCI rowed on an adapted ergometer with different speeds and setups. We calculated foot reaction force and knee moment for all participants, and tibiofemoral force for the rower with SCI. Results: Able-bodied rowers generated 0.22–0.45 body weight (BW) foot reaction forces, and a higher force was associated with a fast speed, forward seat position, and large knee range of motion (RoM). The rower with SCI had the greatest foot reaction force (0.39 BW) when rowing with a small knee RoM at a rear seat position, and the highest tibiofemoral force (2.23 BW) with a large knee RoM or at a rear seat position. Conclusions: Ergometer setup and speed both affect lower limb loading and should be further studied in more rowers with SCI. This can inform rehabilitation protocols to standardize ergometer configuration to improve bone health. [ABSTRACT FROM AUTHOR]

Purpose: Investigating the role of leadership during the COVID-19 pandemic in maintaining the well-being and performance of the medical personnel, as frontline workers, is of major importance. The aim of this study was to investigate the relationships between engaging leadership in health care during COVID-19 pandemic and followers' work engagement and performance and to test the mediating role of followers' basic psychological need satisfaction in these relationships. Design/methodology/approach: A cross-sectional study was conducted on a sample consisting of 200 health-care employees. Data were collected starting with May 2020 and ending with November 2020, during the COVID-19 pandemic. Participants reported on the engaging leadership of their direct supervisor and on their own psychological need satisfaction, work meaningfulness, work engagement and quality of care. Findings: The positive association between engaging leadership and followers' work engagement was fully mediated by followers' basic needs satisfaction. The relationship between engaging leadership and followers' quality of patient care was not supported. Work meaningfulness did not mediate the link between engaging leadership and followers' engagement. Practical implications: By meeting followers' needs for autonomy, competence and relatedness, engaging leaders can stimulate followers' work engagement during outbreaks and other similar crises. Managers in health care may maintain a high level of followers' work engagement during crises if they adopt an engaging leadership style. Originality/value: The study investigated for the first time the role of meeting the psychological needs of health-care workers by leaders during a health-care crisis. [ABSTRACT FROM AUTHOR]

The LINC (linker of nucleoskeleton and cytoskeleton) complex is a critical component of the cellular architecture that bridges the nucleoskeleton and cytoskeleton and mediates mechanotransduction to and from the nucleus. Though it plays important roles in all blood vessels, it is in arterioles that this complex plays a pivotal role in maintaining endothelial cell integrity, regulating vascular tone, forming new microvessels and modulating responses to mechanical and biochemical stimuli. It is also important in vascular smooth muscle cells and fibroblasts, where it possibly plays a role in the contractile to secretory phenotypic transformation during atherosclerosis and vascular ageing, and in fibroblasts' migration and inflammatory responses in the adventitia. Physiologically, the LINC complex contributes to the stability of arteriolar structure, adaptations to changes in blood flow and injury repair mechanisms. Pathologically, dysregulation or mutations in LINC complex components can lead to compromised endothelial function, vascular remodelling and exacerbation of cardiovascular diseases such as atherosclerosis (arteriolosclerosis). This review summarizes our current understanding of the roles of the LINC complex in cells from arterioles, highlighting its most important physiological functions, exploring its implications for vascular pathology and emphasizing some of its functional characteristics in endothelial cells. By elucidating the LINC complex's role in health and disease, we aim to provide insights that could improve future therapeutic strategies targeting LINC complex-related vascular disorders., (© 2025 The Authors. The Journal of Physiology © 2025 The Physiological Society.)