Yu Da University

Introduction: First aid is multifaceted, with one scenario involving mass casualty incidents where multiple patients are injured simultaneously. In such situations, triage must first be conducted, followed by the allocation of appropriate medical resources according to the severity of injuries and the available resources. However, emergency care education in Taiwan rarely addresses this topic, often focusing solely on one-on-one scenarios, leading to a disconnect between education and real-world practice. This study surveys perceptions of mass casualty incidents to explore the importance of community people learning to triage, and then provides scientific suggestions on the design of resilience education for Taiwanese people to jointly build a resilient urban and rural area. Methods: According to the medical treatment process of injured and injured patients, it can be divided into three stages: first aid/first response, ambulance transfer, and medical treatment in the hospital. Therefore, this study focuses on “Community people”, “Civilian rescuer”, “Emergency medical practitioners (including fire department)”, and “Hospital medical staff” are the research objects for which questionnaires are distributed. Then use Standard deviation, One-way ANOVA, Scheffe’s method/Tukey’s range test to analyze and obtain key information. Results: The study found that all four groups agreed that courses on “first aid education under 39 hours” and “disaster preparedness education” should include triage training. Additionally, the study found that hospital-based medical personnel and emergency medical practitioners believe that community members with basic first aid training, volunteers of disaster response teams, and community leaders should learn triage, rather than requiring everyone to learn it. Conclusion: This study suggests that triage training should be included as an extension/supplementary course in disaster resilience education or as part of continuing/in-service education. Give priority to those who already have first aid knowledge and disaster prevention teaming skills to improve their survival rate and resilience in emergencies.

Distinguishing dangerous from benign vertigo remains a diagnostic challenge. Our study aimed to develop and evaluate a machine learning model to differentiate between dangerous and benign vertigo in the outpatient setting across two medical institutions that used different equipment, testing methods, and protocols. Patients in the dizziness clinics of Shuang Ho Hospital (SHH) and Taichung Tzu Chi Hospital (TTCH) were classified into "benign vertigo" and "dangerous vertigo" groups. The data of video-oculography (VOG) and video head impulse test were combined and preprocessed by applying the min-max scaler and the synthetic minority oversampling technique. The optimized Random Forest (RF)-Adaptive Boosting (AdaBoost) model was employed for classification. The SHapley Additive exPlanations method provided feature importance. Model performance was evaluated using a random 70/30 stratified split across sites, and 95% confidence intervals (CIs) were computed using stratified bootstrapping. A total of 294 patients were enrolled, including 184 (171 with benign vertigo and 13 with dangerous vertigo) in SHH and 110 (63 with benign vertigo and 47 with dangerous vertigo) in TTCH. The optimized RF-AdaBoost model was used to identify dangerous vertigo. The accuracy was 97% (95% CI: 92 - 100%), the sensitivity was 92% (95% CI: 75 - 100%), the specificity was 97% (95% CI: 93 - 100%), and the AUC was 0.95 (95% CI: 0.86 - 1.00). Our VOG-based machine learning model for differentiating dangerous from benign vertigo demonstrated good accuracy and showed potential for use across different equipment, testing methods, and institutional protocols.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of taxane chemotherapy in breast cancer individuals, often leading to functional impairment and reduced quality of life (QOL). This study evaluated the effectiveness of a hand-foot exercise intervention in reducing CIPN severity and improving QOL. This randomized controlled trial included 74 breast cancer individuals undergoing taxane chemotherapy, who were randomly assigned to an exercise (n = 36) or a control group (n = 38). The exercise group performed a structured hand-foot exercise program, while the control group received standard care. CIPN severity was assessed using the Total Neuropathy Score-Clinical version (TNSc) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (NTX) scores, while QOL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G). Assessments were conducted at four time points: post-diagnosis, after the first taxane session, midway through treatment, and within 1month of completion. Data analysis included t-tests, chi-squared tests, and generalized estimating equations. Significant time effects were observed for both subjective and objective CIPN symptoms, with the highest increases at the completion of taxane chemotherapy. However, no significant group effects were found for CIPN severity. QOL remained stable, with no significant time or group effects. CONCLUSIONAND CLINICAL IMPLICATIONS: CIPN symptoms worsened over time, peaking at the end of chemotherapy, while the hand-foot exercise intervention had no significant impact on CIPN severity or QOL. Although the intervention did not yield significant benefits, its feasibility suggests potential for future modifications. Early, personalized, and multimodal interventions may be necessary to mitigate CIPN progression and improve patient outcomes. NCT05641571 (Date of registration: December 7, 2022).

PurposeThe aim of this study is to evaluate the myopic control effect between defocus-incorporated multiple segments (DIMS) spectacle lenses plus 0.01% atropine (ATR), and 0.125% ATR, for patients with fast myopia progression.MethodsA retrospective cohort study was conducted, and patients who had experienced myopic progression of more than -1.00 diopter (D) within a one-year period were enrolled. Then, the patients were divided according to the management they received. A total of 53 and 46 eyes were assigned to the ATR and DIMS groups, respectively. The primary outcomes were the progression of spherical equivalent refraction (SER) and axial length (AXL). The independent t-test and generalized linear model were used for statistical analysis.ResultsAfter the one-year follow-up period, the progression of SER was significantly greater in the ATR group (0.31 ± 0.11 D) than in the DIMS group (0.10 ± 0.07 D) (p < 0.001). On the other hand, the elongation of AXL was significantly larger in the ATR group (0.12 ± 0.06 mm) than in the DIMS group (0.03 ± 0.02 mm) (p < 0.001) at the final visit. In addition, the ATR group with low- or moderate-baseline myopia revealed more significant SER and AXL progression than the DIMS group (all p < 0.001). A young age at onset was correlated with greater SER and AXL progression in the ATR group (both p < 0.05). Still, no pre-treatment parameter was associated with increased SER or AXL progression in the DIMS group (all p > 0.05).ConclusionsDIMS spectacle lenses plus 0.01% ATR management showed greater efficacy for SER and AXL control than 0.125% ATR management in the fast myopia progression population.

To evaluate alterations in total antioxidant capacity (TAC) and ascorbic acid (AA) levels in femtosecond laser-assisted cataract surgery (FLACS) compared with conventional cataract surgery. A prospective non-randomized study was conducted wherein 18 and 36 patients undergoing FLACS and conventional cataract surgery, respectively, with the same phacoemulsification and femtosecond laser devices were enrolled. Samples of aqueous humor were obtained via paracentesis before and 1 day after the cataract surgery, and TAC and AA concentrations were determined. The generalized linear mixed model was adopted to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) of changes in TAC and AA between groups. The TAC and AA levels significantly decreased postoperatively in both groups (p=0.05). In the multivariate analysis, the trend in decline in TAC (aOR=0.352, 95% CI=0.218-0.527, p=0.0177) and AA (aOR=0.308, 95% CI=0.156-0.488, p=0.0204) was significantly lower in the FLACS group. In the subgroup analyses, the correlation between FLACS and smaller TAC reduction was more significant in patients with high myopia, dense cataract, short anterior chamber depth, and greater axial length (p<0.05). In addition, the correlation between FLACS and smaller reduction in AA was more significant in patients with high myopia, dense cataract, greater axial length, and greater central corneal thickness (p<0.05). Patients with high myopia and dense cataract may consider FLACS to reduce the possibility of oxidative stress-related postoperative complications.