bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Review of the Literature: The Transition of Entry-Level Paramedic Education in Australia from Vocational to Higher Education (1961–2017)
Authors: Brooks Ingrid Ann , Grantham Hugh , Spencer Caroline , Archer Frank 
Published: December 2018

Introduction Today in Australia, university degree programs provide the education pathway into the paramedic profession reflecting a more than 50-year process of transition from on-the-job first aid training. The formal organisation of paramedic education began in the early 1960s with the establishment of ambulance service training centres. The factors that contributed to this transition are poorly described when compared with that of paramedics in other parts of the world such as the United States and England. The history of Australian paramedic education is important to capture for the benefit of the profession in Australia and to situate it within a global context of modern emergency medical services. This paper examines the peer reviewed and grey literature to chart the transition of Australian paramedic education from vocational to higher education and uncovers signposts of change leading to this transition. Methods Following a systematic search of MEDLINE and CINAHL Plus databases, the university library collection, Google and the websites of Australian ambulance services, Paramedics Australasia (PA) and the Council of Ambulance Authorities (CAA), 31 reports, 12 journal articles and three texts are included in this review. Results Advances in emergency medicine, vocational education training sector reform in the 1970s and 1980s, reviews into ambulance services, health workforce reform and the efforts of PA and CAA contributed to the transition to university-based education, development of university paramedic program accreditation standards and, ultimately, progression towards registration and professionalisation. These signposts of change that chart developments in Australian paramedic education however, proved difficult to uncover in the literature. Conclusion Unexpectedly, this review finds peak Australian ambulance and paramedic professional bodies perceive difficulty in influencing policy direction that impacts the profession. Absence of thorough and detailed accounts of Australian paramedic education keeps hidden a unique and important history. We invite further research to preserve the history of paramedic education in Australia within the public domain, to assist the profession to understand what went before and to inform its future directions.
Paramedic Identification of Ecg J Point and St Segments: A Pilot Study
Authors: Williams Brett , Boyle Malcolm , Lord Bill 
Published: December 2018

Objective To identify if undergraduate paramedic students are accurate at identifying J Point and ST segments on electrocardiograms. Methods A prospective single-blinded observational pilot study asking students to identify ST segment and J point location on four different ECG complexes Results Of 32 students that participated in the study the findings demonstrated variations in students’ accuracy with both J Point and ST segment identification. Undergraduate paramedic students in most cases were able to recognise ST segment elevation; however, definition of the amount of ST segment elevation varied greatly. A quarter of students did not complete all 4 J Point estimations. Overall the student's estimations varied considerably. Conclusion Results from this pilot study have identified significant variation in students’ interpretation of J Point and ST Segment in ECG analysis.
Rescuer Fatigue in Cardiopulmonary Resuscitation: A Review of the Literature
Authors: Gutwirth Hendrik , Williams Brett , Boyle Malcolm 
Published: December 2018

Introduction Provision of adequate chest compressions remains a standard of care for optimal outcome in cardiopulmonary arrest. Given the recent changes to CPR rates and a greater emphasis on pushing faster and deeper, this has raised questions surrounding rescuer fatigue and efficacy of compressions. While a body of work has been undertaken on previous CPR rates and associated fatigue levels, there is a shortage of literature on the latest CPR rates and associated rescuer fatigue in the hospital and prehospital settings. The objective of this paper was to determine the extent of fatigue associated with CPR in both the hospital and prehospital settings. Design A review of the literature using a variety of medical databases, including Cochrane Database of Systemic Reviews, Ovid MEDLINE, EMBASE, and CINAHL electronic databases. The following MeSH terms were used in the search: CPR fatigue, chest compression, compression depth, out of hospital, in-hospital, prehospital, emergency medical services. Results 21 articles met the inclusion criteria, with three of these papers being from the prehospital setting. Currently, there is low level evidence determining the most appropriate length of time in providing quality chest compression before rescuer fatigue occurs. Overall chest compressions were shallower at least half of the time due to fatigue, and the mean compression rate was found to be higher than recommended. Conclusion The findings of this study suggest that the quality of chest compressions deteriorates soon after commencing CPR, and that high quality prehospital studies are lacking.
Effect of Road Traffic Accident Contaminants on Pulse Oximetry among Normoxaemic Volunteers
Authors: Kamaras Gyorgyi , Geller Tamas , Dioszeghy Csaba 
Published: December 2018

Objectives Pulse oximetry is a simple and reliable non-invasive method used widely in emergency care. Signal strength is usually easy to interpret in most monitors and is used as a simple validation tool for the reliability of the readings. However it is known from the literature that in certain circumstances the oxygen saturation readings could be false in spite of a deceptively normal signal. The aim of this study was to compare the pulse oximetry readings on fingers contaminated with natural contaminants which might appear in a road traffic accident (RTA) scenario. Methods 50 healthy volunteers were included. Beside the control fingers, the others were contaminated by (1) dried blood (B), (2) soil (S), (3) oil grease (O) and (4) green extract from natural leaves (G). Results The average control reading was 99.1% (SD 1.11). The average readings on the contaminated fingers were as follows: B: 98.6% (SD 1.27); S: 98.7% (SD 1.17); O: 98.5% (SD 1.09); G: 98.7% (SD 1.06). There was a statistically different decrease in the readings between the B and O groups compared to control. Conclusion Pulse oximetry could give unreliable readings despite a normal signal when a patient's fingers are contaminated - especially with dried blood or black oil grease which are both common in road traffic accidents. Cleaning the fingers before pulse oximetry therefore should be considered.
Use of the Ottawa Ankle Rule by Paramedics in the Out-of-Hospital Setting
Authors: Simpson Paul 
Published: December 2018

Objective The Ottawa Ankle Rule (OAR) is extensively documented in the emergency department setting and has been subjected to repeated validation. However, the prehospital experience in implementing this clinical decision rule appears poorly described. The objective of this study is to identify evidence (of any level) describing the use of the OAR by paramedics. Methods A literature search was conducted of the following key electronic databases; Medline (1950 to March Week 1 2010); EMBASE (1980-Week 10 2010) and CINAHL (1981-March 2010). The keywords ‘ankle injury’, ‘clinical decision rule’, ‘paramedic’, ‘ambulance’, ‘prehospital’, and ‘emergency care’ were used to frame the search, while a prehospital and emergency care search filter was used to maximise the sensitivity of the search. A review was conducted of the reference lists accompanying each relevant article to identify other potentially relevant citations. The search criteria included published articles which were both primary research and secondary review papers, and conference abstracts of any research design. We excluded non-English articles and letters. The abstracts of all citations in the search results were reviewed and full text articles for studies of interest were retrieved for examination. Results The search yielded 98 citations, with 80 relating directly to the OAR. After reviewing the abstracts of all citations, no articles of any study design, discussing the use of the OAR by paramedics in the out-of-hospital setting were identified. Conclusion Whilst there is no published evidence describing the use of the OAR by paramedics in the prehospital setting, it is feasible that paramedics could implement the rule safely and with equivalent sensitivity and specificity to other settings. This clinical decision rule may have good utility as a triage tool that could be used to stream suitable patients into non-emergency department alternatives. Research is needed to validate the use of the OAR when used within EMS jurisdictions.
The Exploration of Physical Fatigue, Sleep and Depression in Paramedics: A Pilot Study
Authors: Sofianopoulos Sarah , Williams Brett , Archer Frank , Thompson Bruce 
Published: December 2018

Ambulance paramedics are members of a discipline that forms a unique part of the emergency services. As pre-hospital providers they are constantly and increasing faced with heavy workloads that are physically, mentally and emotionally tiring. Fatigue and sleep disturbance are factors which can compromise the effectiveness of these workers, and as a result not only hamper patient safety but can have detrimental consequences on the paramedics‟ health and overall well-being. The objective of this study was to investigate the impact shift work on physical fatigue, sleep and psychological factors among paramedics in Australia. Methods A convenience sample of paramedics was asked to complete a number of self-reporting standardised questionnaires: The Epworth Sleepiness Scale (ESS) (8-items), Berlin Questionnaire (BQ) (10-items), Pittsburgh Sleep Quality Index (PSQI) (19-items) and the Beck Depression Inventory (BDI) (21-items). Ethics approval was granted. Results The study recruited 60 participants, the majority of which were male 77% (n=46), > 45 years of age 31% (n=19), and having worked shift work between 5-10 years 35% (n=21). Nine out of ten (92%, n=55) of paramedics reported having experienced fatigue in the last 6 months, with 88% (n=53) believing it had affected their performance at work. The ESS reported 30% (n=18) of people had excessive daytime sleepiness, and 10% (n=6) being dangerously sleepy. Statistical significance was observed in the ESS items „chance of dozing while sitting and talking to someone‟ (p<0.05), and „whilst stopped in traffic for a few minutes‟ (p<0.05) between males and females. Almost half (48%, n=29) of paramedics answered yes to having nodded off or fallen asleep whilst driving. The PSQI found 68% (n=41) of participants suffered poor quality sleep, while 21 % (n=13) of respondents were at high risk for sleep apnoea (BQ). Depression was found to be mild among 27% (n=16) and moderate among 10% (n=6) of respondents Conclusion Shift work affects health and well-being both physiologically and psychologically, which translates from work into home. Further research using a larger sample size is warranted to prevent the issues of patient safety, work-related fatigue and the cumulative effects of shift work in paramedic employees.
G337.342–0.119 (The “Pebble”): A Cold, Dense, High-mass Molecular Cloud with Unusually Large Line Widths and a Candidate High-mass Star Cluster Progenitor
Authors: Jackson James M. , Contreras Yanett , Rathborne Jill M. , Whitaker J. Scott , Guzmán Andrés , Stephens Ian W. , Sanhueza Patricio , Longmore Steven , Zhang Qizhou , Allingham David 
Published: December 2018

Abstract
How high-mass star clusters form, especially young massive clusters (YMCs: age <100 Myr; mass >104

), remains an open problem, largely because they are so rare that examples of their cold, dense, molecular progenitors continue to be elusive. The molecular cloud G337.342−0.119, the “Pebble,” is a candidate cold progenitor. Although G337.342−0.119 was originally identified as four separate ATLASGAL clumps, the similarities in their molecular line velocities and line widths in the MALT90 data set demonstrate that these four clumps are in fact one single, coherent cloud. This cloud is unique in the MALT90 survey for its combination of both cold temperatures (T
dust ∼ 14 K) and large line widths (ΔV ∼ 10 km s−1). The near/far kinematic distance ambiguity is difficult to resolve for G337.342−0.119. At the near kinematic distance (4.7 kpc), the mass is 5000

and the size is 7 × 2 pc. At the far kinematic distance (11 kpc), the mass is 27,000

and the size is 15 × 4 pc. The unusually large line widths of G337.342−0.119 are difficult to reconcile with a gravitationally bound system in equilibrium. If our current understanding of the Galaxy’s Long Bar is approximately correct, G337.342−0.119 cannot be located at its end. Rather, it is associated with a large star-forming complex that contains multiple clumps with large line widths. If G337.342−0.119 is a prototypical cold progenitor for a high-mass cluster, its properties may indicate that the onset of high-mass star cluster formation is dominated by extreme turbulence.
Multi-epoch Proper Motion Magnetic Field Comparison of SiO Masers around R Cas
Authors: Assaf K. A. 
Published: December 2018

Abstract
We imaged silicon monoxide masers toward the asymptotic giant branch star R Cas at 23 intervals covering almost 2 pulsation cycles. The masers are concentrated in a shell within 4 stellar radii. Between 19 and 62 features were identified per epoch and 184 of these were matched at 3 or more epochs, forming 38 series. The features probably survive more epochs than their detectable masers. We compared the proper motions and polarization of these clumps, providing the first complete assessment of the net expansion velocity over more than one cycle and the significance of the magnetic field. Proper motions are irregular, dominated by outflow (infall) in the first (second) cycles. Sixty-five matched pairs had maser polarization angles consistent within π/8. A small excess (22) of this subsample has proper motion vectors within ±22.°5 of being parallel to the inferred magnetic field, 10 of which have approximately radial proper motions. The average field strength needed to provide a magnetic energy density equivalent to the bulk kinetic and thermal energy densities of a clump is ∼2 G, similar to direct magnetic field measurements. While some clumps possess a consistent magnetic field, capable of influencing the direction of motion, only a minority flow along magnetic field lines. The resultant SiO expansion proper motion over the entire periods is ∼0.4 km s−1 (taking ∼67 yr to cross the shell), which, compared with the mass in the shell, implies a wind similar to mass-loss rates from the literature measured on larger scales.
A Possible Explanation of Vanishing Halo Velocity Bias
Authors: Zhang Pengjie 
Published: December 2018

Abstract
Recently, Chen et al. accurately determined the volume weighted halo velocity bias in simulations and found that the deviation of velocity bias from unity is much weaker than the peak model prediction. Here we present a possible explanation of this vanishing velocity bias. The starting point is that halos are peaks in the low redshift non-Gaussian density field with smoothing scale R
Δ (virial radius), instead of peaks in the high-redshift initial Gaussian density field with a factor of

larger smoothing scale. Based on the approximation that the density field can be Gaussianized by a local and monotonic transformation, we extend the peak model to the non-Gaussian density field and derive the analytical expression of velocity dispersion and velocity power spectrum of these halos. The predicted deviation of velocity bias from unity is indeed much weaker than the previous prediction, and the agreement with the simulation results is significantly improved.
IN-SYNC. VIII. Primordial Disk Frequencies in NGC 1333, IC 348, and the Orion A Molecular Cloud
Authors: Yao Yuhan , Meyer Michael R. , Covey Kevin R. , Tan Jonathan C. , Rio Nicola Da 
Published: December 2018

Abstract
In this paper, we address two issues related to primordial disk evolution in three clusters (NGC 1333, IC 348, and Orion A) observed by the INfrared Spectra of Young Nebulous Clusters (IN-SYNC) project. First, in each cluster, averaged over the spread of age, we investigate how disk lifetime is dependent on stellar mass. The general relation in IC 348 and Orion A is that primordial disks around intermediate-mass stars (2–5 M
⊙) evolve faster than those around loss-mass stars (0.1–1 M
⊙), which is consistent with previous results. However, considering only low-mass stars, we do not find a significant dependence of disk frequency on stellar mass. These results can help to better constrain theories on gas giant planet formation timescales. Second, in the Orion A molecular cloud, in the mass range of 0.35–0.7M
⊙, we provide the most robust evidence to date for disk evolution within a single cluster exhibiting modest age spread. By using surface gravity as an age indicator and employing 4.5 μm excess as a primordial disk diagnostic, we observe a trend of decreasing disk frequency for older stars. The detection of intra-cluster disk evolution in NGC 1333 and IC 348 is tentative, since the slight decrease of disk frequency for older stars is a less than 1σ effect.
Constraining the Volume Density of Dusty Star-forming Galaxies through the First 3 mm Number Counts from ALMA
Authors: Zavala J. A. , Casey C. M. , Cunha E. da , Spilker J. , Staguhn J. , Hodge J. , Drew P. M. 
Published: December 2018

Abstract
We carry out a blind search of 3 mm continuum sources using the ALMA Science Archive to derive the first galaxy number counts at this wavelength. The analyzed data are drawn from observations toward three extragalactic legacy fields: COSMOS, CDF-S, and the UDS comprising more than 130 individual ALMA Band 3 pointings and an effective survey area of ≈200 arcmin2 with a continuum sensitivity that allows for the direct detection of unlensed Dusty Star-forming Galaxies (DSFGs) dust emission beyond the epoch of reionization. We present a catalog of 16 sources detected at >5σ with flux densities

from which number counts are derived. These number counts are then used to place constraints on the volume density of DSFGs with an empirical backward evolution model. Our measured 3 mm number counts indicate that the contribution of DSFGs to the cosmic star formation rate density at z ≳ 4 is non-negligible. This is contrary to the generally adopted assumption of a sharply decreasing contribution of obscured galaxies at z > 4 as inferred by optical and near-infrared surveys. This work demonstrates the power of ALMA-3 mm observations, which can reach outstanding continuum sensitivities during typical spectral line science programs. Further constraints on 3 mm selected galaxies will be essential to refine models of galaxy formation and evolution as well as models of early universe dust production mechanisms.
Roles of Photospheric Motions and Flux Emergence in the Major Solar Eruption on 2017 September 6
Authors: Wang Rui , Liu Ying D. , Hoeksema J. Todd , Zimovets I. V. , Liu Yang 
Published: December 2018

Abstract
We study the magnetic field evolution in the active region (AR) 12673 that produced the largest solar flare in the past decade on 2017 September 6. Fast flux emergence is one of the most prominent features of this AR. We calculate the magnetic helicity from photospheric tangential flows that shear and braid field lines (shear helicity) and from normal flows that advect twisted magnetic flux into the corona (emergence helicity), respectively. Our results show that the emergence helicity accumulated in the corona is −1.6 × 1043 Mx2 before the major eruption, while the shear helicity accumulated in the corona is −6 × 1043 Mx2, which contributes about 79% of the total helicity. The shear-helicity flux is dominant throughout the overall investigated emergence phase. Our results imply that the emerged fields initially contain relatively low helicity. Much more helicity is built up by shearing and converging flows acting on preexisting and emerging flux. Shearing motions are getting stronger with the flux emergence, and especially on both sides of the polarity inversion line of the core field region. The evolution of the vertical currents shows that most of the intense currents do not appear initially with the emergence of the flux, which implies that most of the emerging flux is probably not strongly current carrying. The helical magnetic fields (flux rope) in the core field region are probably formed by long-term photospheric motions. The shearing and converging motions are continuously generated, driven by the flux emergence. AR 12673 is representative, as photospheric motions contribute most of the nonpotentiality in the AR with vigorous flux emergence.
Is Barotrauma an Important Factor in the Discard Mortality of Yellow Perch?
Authors: Knight Carey T. , Kraus Richard T. , Panos Demetra A. , Gorman Ann Marie , Leonhardt Benjamin S. , Robinson Jason , Thomas Michael 
Published: December 2018

Abstract
In physoclistous fishes, barotrauma caused by rapid decompression during capture may be an important source of fishing mortality that is unquantified for some fisheries. We developed a predictive logistic model for barotrauma incidence in Yellow Perch Perca flavescens and applied this model to Ohio's recreational and commercial fisheries in Lake Erie where fisheries managers implicitly consider discard mortality to be negligible in current stock assessment. As expected, capture depth explained most of the variation in incidence, with comparatively small effects of season, sex, and size categories. Measurements of whole body and gonad density provided limited explanation for the categorical effects. Both fisheries spanned a range of depths (7.6 to 16.8 m) that corresponded to a broad range of barotrauma incidence (13 to 74%). Using a recent example, we estimated that additional fishing mortality due to barotrauma in discards was approximately six-fold higher in the commercial than recreational fishery. Overall, this additional mortality was &lt;1% of lake-wide population size estimates. Thus, the assumption that all discarded Yellow Perch survive is unlikely to result in a detectable bias in population estimates. One caveat is that we still do not understand how strong year-classes might influence discard mortality via increased discard rate and barotrauma incidence for small fish.