Evaluating lay first responder (LFR) first aid kit supplies usage and appropriateness in Western Kenya.

Introduction: low- and middle-income countries (LMICs) disproportionately bear 90% of global mortality from trauma, yet robust emergency medical services (EMS) are often lacking to address the prehospital injury burden. Training lay-first responders (LFRs) is the first step toward formal (EMS) development in (LMICs). However, a gap remains as LFR first aid kit supply usage, appropriateness, and decay rates have yet to be studied but remain critical information for building sustainable LFR programs.

Emergency medical services infrastructure development and operations in low- and middle-income countries: Community first responder-driven (Tier-1) emergency medical services systems.

Low- and middle-income countries face unique challenges in delivering prehospital emergency care, often requiring context-appropriate emergency medical services development focused on community-driven solutions (tier 1 systems). Replicating high-income country tier 2 systems in low- and middle-income countries is not financially feasible in resource-limited settings. Instead, tier 1 systems composed of trained layperson first responders use locally available vehicles and involve local communities and stakeholders in their design and implementation to address specific local needs and emergencies.

Financing and cost-effectiveness of emergency medical services in low- and middle-income countries.

In 2023, the 76th World Health Assembly declared coordinated emergency, critical, and operative care services fundamental for comprehensive universal health coverage in low- and middle-income countries. With increasing mortality from noncommunicable diseases, an organized emergency care system has the capacity to treat a variety of conditions with a common set of resources, optimizing per-unit cost efficiency by applying economies of scope and increasing cost-effectiveness. However, the financing and cost-effectiveness of emergency medical services remain poorly understood despite affordability and financial barriers comprising some of the most significant obstacles to development.

Bystander intervention is associated with reduced early mortality among injury victims in Cameroon.

Despite high injury mortality rates, Cameroon currently lacks a formal prehospital care system. In other sub-Saharan African low and middle-income countries, Lay First Responder (LFR) programs have trained non-medical professionals with high work-related exposure to injury in principles of basic trauma care. To develop a context-appropriate LFR program in Cameroon, we used trauma registry data to understand current layperson bystander involvement in prehospital care and explore associations between current non-formally trained bystander-provided prehospital care and clinical outcomes.

The emergency burden in low and middle-income countries.

Injuries are the greatest single cause of surgical disease globally, disproportionately affecting low and middle-income countries and representing 10% of global mortality and 32% greater annual mortality than HIV/AIDS, tuberculosis, and malaria combined. Road traffic injuries are the single greatest contributor to the global injury burden and the leading cause of death for young people aged 5 to 29 years. In May 2023, the 76th World Health Assembly resolved that emergency, critical, and operative care services are an integral part of a comprehensive national primary health care approach and foundational for health systems to effectively address emergencies.

Emergency medical dispatch technologies: Addressing communication challenges and coordinating emergency response in low and middle-income countries.

A majority of emergency response in low and middle-income countries (LMICs) without formal emergency medical services (EMS) rely on uncoordinated layperson first responders (LFRs) to respond to emergencies using readily available mobile phones and private transport. Although formally trained LFRs are an important foundation for nascent emergency medical services (EMS) development, without coordination by standardized emergency medical dispatch (EMD) systems, LFR response is limited to witnessed emergencies, which provides significant but incomplete coverage. After training and equipping LFRs, EMD implementation using telecommunications technologies is the next step in formal EMS development and is essential to coordinate response, given the impact of timely prehospital response, intervention, and transportation on reducing morbidity/mortality.

Future directions for emergency medical services development in low- and middle-income countries.

The lack of prehospital care access in low- and middle-income countries is one of the greatest unmet needs and, therefore, one of the most urgent priorities in global health. Establishing emergency medical services in low- and middle-income countries poses significant challenges and complexities, requiring solutions tailored to prevailing conditions, informed by needs assessments, and adapted to meet local demands in a culturally appropriate and sustainable manner. In areas without existing emergency medical services, patients must rely on informal networks of untrained bystanders and community members to provide first aid and transport to definitive care.

Leveraging transportation providers to deploy lay first responder (LFR) programs in three sub-Saharan African countries without formal emergency medical services: Evaluating longitudinal impact and cost-effectiveness.

Introduction: In 2019, the World Health Assembly declared emergency care essential to achieve the 2030 Sustainable Development Goals. Few sub-Saharan African (SSA) countries have developed robust approaches to sustainably deliver emergency medical services (EMS) at scale, as high-income country models are financially impractical. Innovative reassessment of EMS delivery in resource-limited settings is necessary as timely emergency care access can substantially reduce mortality.

Is "memory-for-when" universal? Group and individual variability in temporal position memory for words, faces, and classrooms.

Many contemporary theories of memory assume that everyone automatically stores temporal contextual information about all types of encountered information, yet most studies on this topic have used words and ignored individual differences. Five experiments accumulated evidence that explicit storage of temporal context information does not appear to occur automatically for all people and types of memoranda. We collected judgments of temporal position (memory-for-when) for words (Experiments 1 & 3), faces (Experiments 2A, 3, 4, and 5), and classrooms (Experiments 2B & 3).

Prehospital hemorrhage management in low- and middle-income countries: A scoping review.

Introduction: Low- and middle-income countries (LMICs) account for 90% of deaths due to injury, largely due to hemorrhage. The increased hemorrhage mortality burden in LMICs is exacerbated by absent or ineffective prehospital care. Hemorrhage management (HM) is an essential component of prehospital care in LMICs, yet current practices for prehospital HM and outcomes from first responder HM training have yet to be summarized.

Evaluating a digital hybrid training-of-trainers (TOT) approach for lay first responder trauma education in urban Nigeria during the COVID-19 pandemic.

Introduction: Road traffic injuries (RTIs) are the largest contributor to the global burden of injury, and in 2016 were among the five leading causes of global disability-adjusted life years (DALYs). In regions with limited emergency medical services (EMS), training lay first responders (LFRs) has been shown to increase availability of prehospital care for RTIs, but sustainable mechanisms to scale these programs remain unstudied.

Methods: Using a training of trainers (TOT) model, a 5.

Oxidation of Sulphur pollutants in model and real fuels using hydrodynamic cavitation.

Hydrodynamic Cavitation (HC) offers an attractive platform for intensifying oxidative desulphurization of fuels. In the first part of this work, we present new results on oxidising single ring thiophene in a model fuel over the extended range of volume fraction of organic phase from 2.5 to 80 v/v %.

Updating and pre-existing semantic associations: testing can enhance or impair new learning.

We often need to update what we have learned, building on older information by adding newer information. When updating, is it better to review the older information by retrieving it (testing) or restudying it? In other words, do tests result in enhanced updating or impaired updating compared to restudying? Past research has obtained divergent conclusions to this question. The present study used a paired associates updating paradigm in which participants studied a cue and the older response (A-B).

Evaluating feasibility of a novel mobile emergency medical dispatch tool for lay first responder prehospital response coordination in Sierra Leone: A simulation-based study.

Introduction: The global injury burden, driven by road traffic injuries, disproportionately affects low- and middle-income countries, which lack robust emergency medical services (EMS) to address injury. The WHO recommends training lay first responders (LFRs) as the first step toward formal EMS development. Emergency medical dispatch (EMD) systems are the recognized next step but whether small groups of LFRs equipped with mobile dispatch infrastructure can efficiently respond to geographically-dispersed emergencies in a timely fashion and the quality of prehospital care provided is unknown.

People sometimes remember to forget: Strategic retrieval from the list before last enables directed forgetting of the most recent information.

List-method directed forgetting usually involves asking people to study a list, followed by a cue to forget it, and then studying a second list. Prior work suggests that List 2 encoding is necessary for directed forgetting to occur, but recent studies have found that moving the forget cue from List 1 to List 2 allows people to selectively forget List 2. These results were attributed to an inhibitory mechanism.

Removal of single and dual ring thiophene's from dodecane using cavitation based processes.

Utilising cavitation for enhancing oxidative desulphurization has been investigated for nearly-two decades with recent investigations shifting focus from low-capacity acoustic cavitation (AC) to scalable hydrodynamic cavitation (HC). This work focuses on developing a viable means for removing thiophene's from fuels. In the first phase of this work, use of vortex based HC devices for removal of single and dual ring thiophenes from dodecane was investigated.

Comparing Ugandan motorcycle taxi driver estimations of injury incidence to District-level injury surveillance data as a proxy to determine factors influencing risk perception.

Introduction: road traffic incidents (RTIs) are a leading cause of death among young people, disproportionately affecting low- and middle-income countries (LMICs), where motorcycle taxis disproportionately contribute to injury. Though driver behavior has been identified as the most important factor in RTIs, the factors that influence risk perception, which affect driver behavior, have not been well-studied in LMICs and may inform future strategies to limit risky behavior.

Methods: Ugandan motorcycle taxi drivers (n=117) were surveyed on personal characteristics and experiences, ranking apparent risk of select injury conditions.

Item method directed forgetting occurs independently of borderline personality traits, even for borderline-salient items.

Clinical populations sometimes demonstrate difficulties forgetting stimuli related to their trauma-related disorder, perhaps because their intense personal connection to these stimuli produce deficits in the inhibitory control abilities necessary for forgetting. The present work examined this possibility for people who have high levels of traits implicated in borderline personality disorder (BPD). In two well-powered studies, we found no evidence for deficits in forgetting specific to BPD traits, even for people with clinically significant levels of the traits, contrary to previous studies.

Prehospital Airway Management for Trauma Patients by First Responders in Six Sub-Saharan African Countries and Five Other Low- and Middle-Income Countries: A Scoping Review.

The global injury burden disproportionately affecting low- and middle-income countries (LMICs) is exacerbated by a lack of robust emergency medical services. Though airway management (AM) is an essential component of prehospital emergency care, the current standard of prehospital AM training and resources for first responders in LMICs is unknown. This scoping review includes articles published between January 2000 and June 2021, identified using PMC, MEDLINE, and SCOPUS databases, following PRISMA-ScR guidelines.

Evaluating a novel, low-cost technique for cervical-spine immobilization for application in resource-limited LMICs: a non-inferiority trial.

Study Design: Non-inferiority trial.

Objective: Limited cervical spinal (c-spine) immobilization in resource-limited settings of LMICs suggests alternatives are necessary for patients with traumatic injuries. We propose a novel method of c-spine immobilization using folded towels.

Cost-Effectiveness of Lay First Responders Addressing Road Traffic Injury in Sub-Saharan Africa.

Background: To investigate the cost-effectiveness of training lay first responders (LFRs) to address road traffic injury (RTI) in sub-Saharan Africa (SSA) as the first step toward formal emergency medical services (EMS) development.

Materials/methods: Cost data from five LFR programs launched between 2008 and 2019 in SSA was collected for LFR cost estimation, including three prospective collections from our group. We systematically reviewed literature and projected aggregate disability-adjusted life years (DALYs) from RTI in SSA that are addressable by LFRs to inform cost-effectiveness ratios ($USD cost per DALY averted).

Identifying a 'super-responder' phenomenon in three African countries: Implications for prehospital emergency care training.

Background: Few countries in Sub-Saharan Africa have robust emergency medical services (EMS). The WHO recommends training lay first responders (LFRs) as the first step toward EMS development while Disease Control Priorities (DCP) suggests training 0.5%-1% of a population for adequate emergency catchment.

Prehospital care for traumatic spinal cord injury by first responders in 8 sub-Saharan African countries and 6 other low- and middle-income countries: A scoping review.

Introduction: Traumatic spinal cord injury (TSCI) constitutes a considerable portion of the global injury burden, disproportionately affecting low- and middle-income countries (LMICs). Prehospital care can address TSCI morbidity and mortality, but emergency medical services are lacking in LMICs. The current standard of prehospital care for TSCI in sub-Saharan Africa and other LMICs is unknown.

Evaluating a Novel Prehospital Emergency Trauma Care Assessment Tool (PETCAT) for Low- and Middle-Income Countries in Sierra Leone.

Background: WHO recommends training lay first responders (LFRs) as the first step toward formal emergency medical services development, yet no tool exists to evaluate LFR programs.

Methods: We developed Prehospital Emergency Trauma Care Assessment Tool (PETCAT), a seven-question survey administered to first-line hospital-based healthcare providers, to independently assess LFR prehospital intervention frequency and quality. PETCAT surveys were administered one month pre-LFR program launch (June 2019) in Makeni, Sierra Leone and again 14 months post-launch (August 2020).

NOD2 drives early IL-33-dependent expansion of group 2 innate lymphoid cells during Crohn's disease-like ileitis.

Innate lymphoid cells (ILCs) are enriched at barrier surfaces, including the gastrointestinal tract. While most studies have focused on the balance between pathogenic group 1 ILCs (ILC1s) and protective ILC3s in maintaining gut homeostasis and during chronic intestinal inflammation, such as Crohn's disease (CD), less is known regarding ILC2s. Using an established murine model of CD-like ileitis, i.