During times of increased crowding, rapid pathway use continued to be associated with reduction in ED LOS (p<0.01). The reduction in ED LOS was sustained when comparing initial results (2013-2014) to recent data (2015-2018).
 
  This study found that a streamlined process to admit critically-ill trauma patients is sustainable and associated with reduction in ED LOS. As ED crowding remains pervasive, these findings support restructured care processes to limit prolonged ED boarding times for critically-ill patients.
 This study found that a streamlined process to admit critically-ill trauma patients is sustainable and associated with reduction in ED LOS. As ED crowding remains pervasive, these findings support restructured care processes to limit prolonged ED boarding times for critically-ill patients.
  Lifeguard teams carry out their work in extremely hot conditions in many parts of the world. The aim of this study was to analyze the impact of high temperatures on physiological parameters during cardiopulmonary resuscitation (CPR).
 
  A randomized quasi-experimental cross-over design was used to test physiological lifesaving demands (50min acclimatization +10min CPR) in two different thermal environments Thermo-neutral environment (25°C) vs Hyperthermic environment (37°C).
 
  The data obtained from 21 lifeguards were included, this covers a total of 420min of resuscitation. The CPR performance was constantly maintained during the 10min. The Oxygen uptake (VO 2) ranged from 17 to 18ml/min/kg for chest compressions (CC) and between 13 and 14ml/min/kg for ventilations (V) at both 25°C and 37°C, with no significant difference between environments (p>0.05). The percentage of maximum heart rate (%HR max) increased between 7% and 8% at 37°C (p<0.001), ranging between 75% and 82% of HR max. The loss of body fluids (LBF) was higher in the hyperthermic environment; LBF (37°C 400±187g vs 25°C 148±81g, p<0.001). Body temperature was 1°C higher at the end of the test (p<0.001). The perceived fatigue (RPE) increased by 37° an average of 2 points on a scale of 10 (p=0.001).
 
  Extreme heat is not a limiting factor in CPR performance with two lifeguards. Metabolic consumption is sustained, with an increase in CC, so V can serve as active rest. Nevertheless, resuscitation at 37°C results in a higher HR, is more exhausting and causes significant loss of fluids due to sweating.
 Extreme heat is not a limiting factor in CPR performance with two lifeguards. Metabolic consumption is sustained, with an increase in CC, so V can serve as active rest. Nevertheless, resuscitation at 37 °C results in a higher HR, is more exhausting and causes significant loss of fluids due to sweating.The COVID19 crisis has provided a portal to revisit and understand qualities of screening tests and the importance of Bayes' theorem in understanding how to interpret results and implications of next actions.
  Socioeconomic disparities are engrained in the US healthcare system and may extend to the prehospital cardiac arrest setting where mortality is high.
 
  Using the National Emergency Medical Services Information System (NEMSIS) database, 150,003 cases were analyzed comparing socioeconomic status and cardiac arrest outcomes. Cardiac arrest outcomes were measured by the percent of cases that achieved return of spontaneous circulation (ROSC) and the percent of cases in which ROSC occurred in the Emergency Department (ED) as opposed to a prehospital setting which was a proxy for the length of time spent in cardiac arrest. Chi-square tests checked for statistical significance and effect size was measured using Pearson's r values and linear regression coefficients.
 
  Comparing neighborhood poverty level and the percent of cardiac arrest cases that achieved ROSC resulted in a Pearson's r value of 0.9424 (R
  =0.8881, p<0.005) and a linear regression coefficient of 2.088 (p<0.05, R
  =0.8881, 95% CI [1.059, 3.117]) meaning for every interval increase in poverty, the chance of an individual in cardiac arrest achieving ROSC decreases 2.09%. Comparing neighborhood poverty level and the percent of ROSC cases that occurred in the ED yielded a Pearson's r value of 0.9005 (R
  =0.8109, p<0.05) and a linear regression coefficient of 0.7701 (p<0.05, R
  =0.8109, 95% CI [0.254, 1.286]) meaning for every interval increase in poverty, the chance that ROSC is delayed increases 0.77%.
 
  Low income individuals in cardiac arrest have a statistically significant lower probability of achieving ROSC and a higher chance of delayed ROSC.
 Low income individuals in cardiac arrest have a statistically significant lower probability of achieving ROSC and a higher chance of delayed ROSC.Learning a script with mirrored graphs (e.g., d ≠ b) requires overcoming the evolutionary-old perceptual tendency to process mirror images as equivalent. Thus, breaking mirror invariance offers an important tool for understanding cultural re-shaping of evolutionarily ancient cognitive mechanisms. Here we investigated the role of script (i.e., presence vs. absence of mirrored graphs Latin alphabet vs. Tamil) by revisiting mirror-image processing by illiterate, Tamil monoliterate, and Tamil-Latin-alphabet bi-literate adults. Participants performed two same-different tasks (one orientation-based, another shape-based) on Latin-alphabet letters. Tamil monoliterate were significantly better than illiterate and showed good explicit mirror-image discrimination.  https://www.selleckchem.com/products/Masitinib-(AB1010).html  However, only bi-literate adults fully broke mirror invariance slower shape-based judgments for mirrored than identical pairs and reduced disadvantage in orientation-based over shape-based judgments of mirrored pairs. These findings suggest learning a script with mirrored graphs is the strongest force for breaking mirror invariance.How the functional connectivity of brain networks affects the relationship between psychological stress and sleep quality remains unclear. To better understand the associations between psychological stress, resting-state functional connectivity (RSFC), and sleep quality, we used the RSFC, Pittsburgh Sleep Quality Index (PSQI), and Psychosomatic Tension Relaxation Inventory (PSTRI) to investigate the relationship between psychological stress, sleep quality, and RSFC in four brain networks, the sensory/somatomotor (SM) network, cigulo-opercular control (CO) network, default mode (DM) network, and dorsal attention (DA) network, in a large healthy sample of 315 college students from Southwest University. Results showed that the brain functional connectivity in the SM, CO, DM, and DA networks was significantly correlated to sleep quality. Meanwhile, we also found that the brain functional connectivity between the SM and CO networks partially mediated the relationship between psychological stress and sleep quality, suggesting that psychological stress has an important effect on individuals' sleep quality, and increased functional connectivity between the SM and CO networks provides a neural basis for the association between psychological stress and poor sleep quality.