English, German, and French were ranked first to third, respectiv

English, German, and French were ranked first to third, respectively. A comparison between TLCS and TGCS revealed that most

of the citations were related to other fields. A few citations were devoted to medical ethics which was not unexpected because of the limited number of documents (3035 documents). The general impact factor illustrated that the articles of this field had a high average citation, which indicated that there was a close relationship between the articles related to this field and the other fields. The most productive authors had a high local Inhibitors,research,lifescience,medical impact factor and according to their records, their local impact factor was higher than total local impact factor. All of the documents were published in 901 journals among which “Journal of Medical Ethics” had published 290 articles (9.55%) Inhibitors,research,lifescience,medical and it was ranked first.

The existence of different journals with different scopes indicates that medical ethics is an interdisciplinary subject and the researchers of other fields are interested in this specialized field. Articles Inhibitors,research,lifescience,medical of this field have an increasing CI-1033 supplier growth rate and the present study indicates greater participation of the science community in medical ethics publishing. However, the number of citations does not have a uniform growth rate. This could be due to the small size of this field and its association with other small fields. The global distribution of the papers and their language variations signify the global concerns for medical ethics. Moreover, linguistic, geographic, and publication type diversity of the published articles indicate a sustainable development in this field. Conflict of interest: None declared
Carcinoma of the gallbladder is more common in women and usually Inhibitors,research,lifescience,medical seen in patients older than 50 years of age. It is more common in the white population than the black and in western countries than the Mediterranean.1 The relation between gallstone and gallbladder

carcinoma remain controversial. Adenocarcinoma is Inhibitors,research,lifescience,medical the most common malignant neoplasm of the gallbladder.1 Although areas of squamous differentiation is seen in adenocarcinoma, pure primary squamous cell carcinoma is rarely reported and accounts for less than 1% of all gallbladder malignancies.1 The histogenesis of squamous cell carcinoma of the gallbladder PAK6 has not been well understood. Some researchers have stated that squamous cell carcinoma originates from pre-existing squamous metaplasia of the gallbladder epithelium, while others concluded that it originates from squamous differentiation of neoplastic cells of adenocarcinoma.1,2 We present a pure case of squamous cell carcinoma with some areas of squamous metaplasia in the vicinity of the invasive tumor. Therefore, the former theory is more compatible with this case. Another purpose of this case presentation was to emphasize on the vague clinical presentation of gallbladder carcinoma.

In Figure 1, we see that, previously, clinical areas, especially

In Figure 1, we see that, previously, clinical areas, especially the central area (for assessing and treating minor and major injuries/illnesses) and the resuscitation room, constituted the main hub where all the activity was taking place. The reception desk and the waiting areas were peripheral to this hub, with the Children’s section at the back of

the department. For patients, the reception desk was not directly visible and there was a long Inhibitors,research,lifescience,medical public corridor which led them to the two main waiting areas. Another public corridor separated reception from the main area of clinical activity. With these long corridors, natural way-finding was quite difficult for walking patients and visitors. In addition, staff had to walk through public spaces to access other administrative and clinical areas. The U-shape design inside the central area created many problems for movement as well as for maintaining an adequate level of privacy and security for more remote

rooms.In Inhibitors,research,lifescience,medical contrast, the new INK 128 mw layout (Figure 2) necessitated that all clinical areas were placed around the waiting area for patients. Public spaces were integrated and distances minimised so patients walked a straight line to get to treatment areas. Common corridors between the main and ambulance entrances to the resuscitation room were replaced by a more direct and private one. There was also a smaller, private corridor adjacent to Areas 1 (“minors”) and 3 (“majors”) Inhibitors,research,lifescience,medical for cases where the ambulance

Inhibitors,research,lifescience,medical crew needs to transfer a patient directly. EDAs could overlook the entrance and waiting area from the reception desk, as well as control access for patients who enter the two main treatment areas. This arrangement brought the clerical and nursing staff closer together with an internal, private door. Now, all the paperwork could easily be retrieved without distant journeys through public Inhibitors,research,lifescience,medical spaces that led to impromptu encounters with patients and, thus, delays in treatment. Similarly, the resuscitation room was brought closer to the ambulance entrance. In this way, nurses could interact with the ambulance crew unobstructed. Figure 1 Old layout of ED. Figure 2 New layout of ED. This segregation of patients and visitors in one waiting area created more space for Areas 1 and Etomidate 3. These areas were integrated and connected with the Children’s section via a private corridor, while the old Children’s area was allocated to the new ENPs. The new design layout created more space for accommodating a large number of patients and clinicians. Importantly, it allowed their cooperation in numerous ways with minimum turns of direction and within minimum walking distances. Lastly, the incorporation of a central staff station, where all activities were organised, allowed increased surveillance of patients. From this observatory, everyone was directly visible and reachable, whether it is a patient or a member of staff, facilitating security, safety and monitoring.

Emotion theory – old beliefs and new realities Primary-process em

Emotion theory – old beliefs and new realities mTOR inhibitor primary-process emotion approaches to the BrainMind are not well represented in modern psychology, psychiatry, or even neuroscience. The most widely acknowledged theory of emotional feelings remains the JamesLange conjecture (see above) that advanced the counterintuitive idea of life-challenging situations (ie, when inadvertently confronted by

a grizzly bear in the woods) resulting first in various bodily symptoms of autonomic arousal, and emotional experiences following only after bodily arousals are “read out” by higher cognitive processes. This has promoted the misleading belief that emotions are just a subset of cognitive Inhibitors,research,lifescience,medical process. If one defines cognitive processes as neural handling of incoming sensory stimuli, a disciplined distinction

can be made between cognitive and primaryprocess emotional processes, with the former consisting of externally sourced information processing and the Inhibitors,research,lifescience,medical latter being internal state-control processes, as done here. When one moves to higher levels of processing, secondary (learning), and tertiary processes (thought) levels Inhibitors,research,lifescience,medical of analysis, cognitive and emotional issues do get more conflated. Another bias impeding progress is the fact that many psychologists believe that emotions arise not from brain evolution but from social-developmental learning based on primal gradients (dimensions) of arousal and valence.13 This “experimental convenience” – namely a convenient conceptual way Inhibitors,research,lifescience,medical to study human emotions verbally – goes back to the 19th-century work of Wilhelm Wundt, but it has never been firmly connected to neuroscientific facts. Such dimensional approaches effectively focus on the diverse languages of emotion (ie, tertiary processes) Inhibitors,research,lifescience,medical with no compelling strategy for unraveling primary-process emotional networks. To this day, abundant “battles” are waged between psychologists who espouse “basic emotion” views in human research and those who prefer dimensional views. The “basic

emotion” approaches posit a variety of distinct, inherited brain emotional systems; the “dimensional” views envision distinct emotions simply to reflect verbal labeling of locations in some type of continuous affective below space that is defined by two continuous axes: generalized forms of: (i) low and high arousal; and (ii) positive and negative valence. The study of primary-process brain mechanisms of emotions, best pursued in animal models, provides a bridge that can help settle such debates. A primaryprocess/basic emotion view may prevail in many subcortical regions, and constructivist/dimensional approaches may effectively parse higher emotional concepts as processed by the neocortex (Table I). In other words, such debates may simply reflect investigators working at different levels of control.

Clearly, depending on culture conditions, metabolic flux distribu

Clearly, depending on culture conditions, metabolic flux distributions can differ considerably, reflecting the variable efficiency of carbon utilization either for biomass formation or starvation responses. Besides the aforementioned activities, a general increase in the central metabolism seems to occur at a dilution rate of 0.1 h−1, at which most metabolites reached its maximum levels. It is generally Inhibitors,research,lifescience,medical accepted that under steady state conditions

an increase in metabolite levels would correspond to an increase in metabolic activities, since metabolism is fully balanced and no accumulation of intracellular metabolites is expected to occur due to a tight coupling of the anabolism and catabolism [29,30]. In this work, metabolic profiles of chemostat cultures of two E. coli TGF-beta inhibitor strains (W3110 and the isogenic ΔrelA mutant) were determined by GC-MS analysis to explore

the effects of different growth rate conditions on the E. coli metabolism, as well as to verify the involvement of RelA under such conditions. It has been proposed that under low growth, Inhibitors,research,lifescience,medical the RelA-dependent stringent control of many cellular activities is promoted, including some key metabolic activities [8,31,32,33,34,35]. Yet, little is known about the RelA-dependent ppGpp control over the E. coli metabolism and its influence on central metabolic activities. Our results show that metabolite pools were strongly affected by the relA gene mutation as well as by the dilution Inhibitors,research,lifescience,medical rate. Though it was expected that metabolite levels would be altered with the dilution rate, due to the capacity of cells to alter their metabolism to cope with new growth conditions, the effect of the introduction of the single gene mutation (ΔrelA) was more difficult to predict. Inhibitors,research,lifescience,medical Differences observed in biomass yields have originally pointed to distinct metabolic behaviors between the two strains, i.e., biomass yields were higher in the ΔrelA mutant cultures and were not linearly-dependent Inhibitors,research,lifescience,medical on the growth rate at lower dilution rates (0.05 and 0.1 h−1). Additionally, metabolomics analysis revealed that approximately 50% of the whole

set of metabolites detected in this study presented significant changes between the E. coli W3110 and the ΔrelA mutant cultures (Figure 1). Most of these differences consisted in altered levels of amino acids and fatty acids indicating Ketanserin that the RelA-dependent ppGpp control of metabolic activities involving these metabolites might be affected. This seems to be the case of fatty acids like octadecanoate (ocdca), tetradecanoate (ttdca), pentadecanoate (pdca) and 10,13-dimethyltetradecanoate (1013mlt), that presented maximum levels at a dilution rate of 0.05 h−1 in the E. coli W3110 culture. Other examples include metabolites that were uniquely detected in the E. coli W3110 culture at a dilution rate of 0.1 h−1: N-acetyl-L-glutamate (acglu), lysine (lys), malate (mal), alpha-ketoglutarate (akg), itaconate (itcon) and malonate (ma) (see Figure S1).

Information on mental disorders and their relationships to legal

Information on mental disorders and their relationships to legal selleck issues is introduced through use of expert witnesses, who if qualified under the Federal Rules of Evidence, Rule 702 as experts “by knowledge, skill, experience, training or education”18 may testify in the form of an opinion or otherwise if: a) The expert’s scientific, technical, or specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue b) The

testimony is based on significant facts or data c) The testimony is the product of reliable principles and methods and d) The expert has reliably applied the principles and methods to the facts of the case. The landmark Supreme Court Inhibitors,research,lifescience,medical case Daubert v. Merrell Dow Pharmaceuticals, Inc. ,19 a product liability/malpractice case, established the judge as the gatekeeper to allow or exclude expert testimony. Subsequently in Kumho Tire Co. v. Carmichael,20 the Court found that this function

applied to all expert testimony. Daubert established Inhibitors,research,lifescience,medical a list of factors for courts to consider in determining the reliability of proposed expert testimony including: (i) is the proprosed theory testable? (ii) has it been tested with valid, reliable procedures? (iii) has it has been subjected to peer review or been published; (iv) what is the error rate if known or available? (v) are standards or controls in existence? and (vi) is there general acceptance Inhibitors,research,lifescience,medical by the scientific community?21 This is not an exclusive or exhaustive list, and there is no requirement that all factors be applicable in any particular case. Nonetheless, it is a guideline for experts seeking to testify about mental health issues. Inhibitors,research,lifescience,medical Hearings on admissibility are often referred to as “Daubert Hearings.” A judge is under no obligation to conduct a Daubert hearing in any particular case. Federal Rules of Evidence, Rule 70322 also requires the court to determine if information forming the basis of the expert’s opinion is of a type relied on by other experts in the field. The existence and importance of an adversary system of justice was not precluded in Daubert19: “Vigorous cross-examination, presentation of Inhibitors,research,lifescience,medical contrary

evidence, and careful instruction on the burden of proof are the traditional and appropriate means of attacking shaky but admissible evidence.” (p 595) It is, however, ultimately the judge who determines Phosphoprotein phosphatase whether or not an individual may serve as an expert for the court. In the area of personality disorders, this begs the questions of what is the current state of assessment for personality disorders and what is the general acceptance of the use of personality assessment within the legal arena. Furthermore, the issues of whether assessment and acceptance should differ in criminal and civil situations remain pertinent. Measurement of personality for the courts The identification and labeling of personality disorders is highly dependent on use and analysis of psychological testing.

2004) Therefore, a methodical analysis of differences between B6

2004). Therefore, a methodical analysis of differences between B6 inbred lines and their B6 × 129 hybrid counterparts would be useful for planning new ethanol studies and for interpreting prior studies that used different strains. Here, we examined

five strains of mice: B6NT and B6J inbreds, and B6129S6, B6129X1, and B6129S4 hybrids in five ethanol studies: continuous access two-bottle choice drinking, intermittent limited-access binge drinking, ethanol-induced loss of the righting reflex (LORR), ethanol clearance, and conditioned place preference (CPP) for ethanol. Our findings may inform decisions on whether or not to backcross newly generated hybrid lines of gene-targeted Inhibitors,research,lifescience,medical mice to study ethanol-related behaviors. Inhibitors,research,lifescience,medical Materials and Methods Rodent care and breeding Mice were housed under a 12:12 h light–dark cycle (lights off from 7 PM to 7 AM), except for mice used in the limited-access drinking procedure (see below). A naïve group of mice was used for each experiment, with the exception of the ethanol clearance tests, which were performed on mice that underwent the loss of righting procedure at least one week prior. All mice had ad libitum access to food and water. All experiments were conducted using eight- to

13-week-old male mice. For experiments involving B6129S6 mice, C57BL/6NTac mice obtained from Taconic were compared with C57BL/6NTac × 129S6/mTOR inhibitor SvEvTac (B6129S6) F1 hybrids obtained from Taconic or bred in house Inhibitors,research,lifescience,medical by mating C57BL/6NTac females with 129S6/SvEvTac males. No differences in ethanol-related behaviors were observed between Inhibitors,research,lifescience,medical mice generated at Taconic versus mice bred in house. For experiments involving B6129X1 and B6129S4 mice, C57BL/6J mice were obtained from The Jackson Laboratory and compared with C57BL/6J × 129X1/SvJ (B6129X1) and C57BL/6J × 129S4/SvJae (B6129S4) F1 hybrids. Both of these hybrid lines were bred in house Inhibitors,research,lifescience,medical by mating C57BL/6J females with

129X1/SvJ or 129S4/SvJae males. All procedures were approved and conducted in accordance with Gallo Center Institutional Animal Care and Use Committee policies and NIH guidelines for the care and use of animals in research. Continuous access two-bottle Bumetanide choice ethanol drinking Naïve mice were singly housed for one week and then were given 24-h access to two bottles, one containing ethanol and the other water. The ethanol concentration was increased every four to five days as follows: 3%, 6%, 10%, 14%, and 20% (v/v) ethanol in water. Bottles were weighed on Monday, Wednesday, and Friday, and the positions of the bottles were alternated every day to control for any side preferences. Baseline water consumption was measured prior to the start of the ethanol series, and mice were weighed weekly throughout the study. Ethanol consumption was measured as the difference between bottle weights between weighing sessions and calculated as g ethanol/kg mouse/24 h. Ethanol preference was calculated as g ethanol/g total fluid consumed/24 h.

Mk-AT exhibited a significant preference for the right hand in th

Mk-AT exhibited a significant preference for the right hand in the bimanual board task (P < 0.05), whereas a significant left-hand preference

was present for the tube and the drawer tasks (P < 0.05). In Mk-MA, there was a significant left hand preference for the first two tasks (P < 0.05), whereas for the drawer task the right hand was preferred (P < 0.05). Human Regorafenib subjects Two tasks, namely the tube and the bimanual Brinkman board tasks, as well as the handedness questionnaire were used to assess the hand preference Inhibitors,research,lifescience,medical in human subjects. The observed HI values obtained for the bimanual board and for the tube tasks were plotted on the same graph for all subjects (Fig. ​(Fig.7A,7A, left and middle parts of the graph, separated from the rightmost part concerning monkeys by the solid vertical black line). Most human subjects exhibited a HI near to −1 or 1. The P-value for each test and Inhibitors,research,lifescience,medical for each subject was statistically significant (P < 0.05; binomial test), except for the tube task in the subject FL (P > 0.05). The results for both tasks (Fig. ​(Fig.7A)7A) showed that most self-declared left-handers indeed Inhibitors,research,lifescience,medical used their left hand as the preferred hand (HI negative), and similarly most

self-declared right-handers indeed used their right hand as the preferred hand (HI positive). Only three left-handers exhibited a preference for the right hand in the tube task (subjects AP, CC, and MB). One of these three left-handed subjects (CC) furthermore showed a preference for the right hand in the bimanual board task. In the population of self-declared right-handers (Fig. ​(Fig.7A),7A), four of them (subjects AC, GS, JG, and NF) showed a preference for their Inhibitors,research,lifescience,medical left hand in the tube task, whereas another right-handed subject (MS) exhibited a preference for the left hand in the bimanual board task. Statistical comparisons (t-test or Mann–Whitney) between the

groups of right-handers versus left-handers for the tube Inhibitors,research,lifescience,medical task (blue bars in Fig. ​Fig.7A)7A) did not reveal any significant difference (P > 0.05) for both the real HI values and the absolute HI values. On the other hand, for the bimanual board task (gray bars in Fig. ​Fig.7A),7A), there was a significant difference for the real HI values between the right-handers and the left-handers (P = 0.002), but not for the absolute HI values (P = 0.33), indicating that the degree of lateralization is comparable in both groups. The scores derived from the handedness questionnaire was calculated and transformed into percentages most (Fig. ​(Fig.7B).7B). The overall questionnaire scores for the self-announced right-handers (ID initials in red in Fig. ​Fig.7B)7B) were clearly positive, ranging between 53.85% and 100%. The questionnaire scores derived from the self-announced left-handers (ID initials in blue in Fig. ​Fig.7B)7B) were mostly negative, ranging between −30.77% and −73.08%. The exception was the subject AB, who surprisingly showed a positive questionnaire score (26.92%).

A summary about the most important features of the discussed soft

A summary about the most important features of the discussed Stem Cells inhibitor software packages is given in Table 1. Table 1 Overview about various lipidomic data processing software packages. Developed by AB Sciex, Lipid View is the only commercially available lipidomic processing software so far. The concept of this software is based on the earlier developments of Lipid Profiler [24] and Lipid Inspector [23]. Basically all three software packages rely on shotgun data acquired by MPIS either on low resolution or high resolution instrumentation. Inhibitors,research,lifescience,medical The software processes information about precursor

and fragment masses obtained from full scan and MS/MS data and matches it against an internal database containing possible fragments for molecular lipid species. On the downside, Lipid View is only able to process data acquired on AB Sciex triple quadrupole or quadrupole-TOF instruments, which severely limits the software’s availability to the lipid mass spectrometry community. Recently, the group of Shevchenko has launched LipidXplorer,

Inhibitors,research,lifescience,medical an informatics concept based on molecular fragmentation query language (MFQL) [75]. LipidXplorer is designed for shotgun lipidomics and takes MS full scan data and product ion scans into account. Although Inhibitors,research,lifescience,medical it is also possible to process low resolution data, this program is primarily developed Inhibitors,research,lifescience,medical for high resolution spectra and was shown to work best with LTQ-Orbitrap or quadrupole-TOF instrumentation. In contrast to other shotgun lipidomics software packages, LipidXplorer does not rely on a database for MS/MS spectra but rather depends on the concept of fragmentation queries, which reflects the variability of MS/MS spectra due to different

experimental settings much better. The software allows a lot of freedom for the user, like, for example, customized adjustment to various experimental parameters, but this requires some dedication. Processing of LC-MS generated data is usually more challenging because retention time adds Inhibitors,research,lifescience,medical another dimension of information. Cell press Originally developed for metabolomic data acquired by mass spectrometry [76,77], m/zMine and its sequel m/zMine2 were also successfully applied on lipidomic data [78]. Following peak detection, identification of lipids is performed by searches in public libraries or customized internal databases containing exact mass and approximate retention times. Furthermore also isotopic distributions and adducts can be taken into account for lipid identification. Although originally applied on quadrupole-TOF LC-MS data, m/zMine2 has become a versatile and highly flexible software, which can be used for data generated with various experimental platforms. In contrast to other software solutions, Lipid Data Analyzer (LDA) is based on a 3D algorithm (m/z, retention time, intensity) for peak detection [79].

For this route, all the lipids and surfactants used in traditiona

For this route, all the lipids and surfactants used in traditional dosage forms can be exploited. In addition, all compounds of GRAS status or accepted GRAS status can be employed as well as from the food industry [40]. Since the stomach acidic environment and high ionic strength favour the

particle aggregation, aqueous dispersions of lipid nanoparticles might not be suitable to be MGCD0103 mw administered as dosage form. In addition, the presence of food will also have a high impact on their performance [41]. The packing of SLN in a sachet for redispersion Inhibitors,research,lifescience,medical in water or juice prior to administration will allow an individual dosing by volume of the reconstituted SLN. For the production Inhibitors,research,lifescience,medical of tablets, the aqueous SLN dispersions can be used instead of a granulation fluid in the granulation process. Alternatively, SLN can be transferred to a powder (by spray-drying or lyophilization) and added to the tabletting powder mixture. In both cases, it is beneficial to have a higher

solid content to avoid the need of having to remove too much water. For cost reasons, spray drying might be the preferred method for transforming SLN dispersions into powders, with the previous addition of a protectant [42]. For the production of pellets, the SLN dispersion can be used as a wetting agent in the extrusion Inhibitors,research,lifescience,medical process. SLN powders can also be used for the filling of hard gelatine Inhibitors,research,lifescience,medical capsules. Alternatively, SLN can be produced directly in liquid PEG 600 and put into soft gelatine capsules. Advantages of the

use of SLN for oral and peroral administration are the possibility of drug protection from hydrolysis, as well as the possible increase of drug bioavailability. Prolonged plasma levels has also been postulated due to a controlled, optimized released [22] in combination with general adhesive properties of small particles [43]. The advantage of colloidal drug carriers described above is that they are generally linked to their size in the submicron range. Inhibitors,research,lifescience,medical Therefore, the preservation of particle size of colloidal carrier systems after peroral administration is a crucial point. The gastric environment (ionic strength, low pH) may destabilize the SLN and potentially lead to aggregation. However, it is possible to produce stable Oxalosuccinic acid SLN dispersions by optimizing the surfactant/mixture for each lipid in vitro [44]. The drug release from SLN in the GIT is also dependent on the lipase/colipase activity for the GIT digestion of the lipid matrix. The lipase/colipase complex leads to a degradation of food lipids as a prestep of the absorption. In vitro degradation assay based on pancreas lipase/colipase complex have been developed to obtain basic information about the degradation velocity of SLN as a function of lipid and surfactant used in the production process [45, 46].

It is likely true that training programmes might even be of a sh

It is likely true that training programmes might even be of a shorter duration. By this time we conceptionalized this course embedded into a new Medical Reform Curriculum Aachen [13]. In a problem-oriented approach to medical education, the first year medical students received defined teaching objectives concerning Basic Life Support including AED use and, as seen in this context, airway management. The extremely positive evaluation of the new approach encouraged us to further promote this concept. To our knowledge, there is no evident data or clear existing guideline that shows a specific

time frame for an Inhibitors,research,lifescience,medical airway management training programme. A definite duration of Selleck Wee1 inhibitor theoretical introduction with or without practical skill training for inexperienced people is not described until now. Garcia-Guasch and co-workers compared the use of LMA with a cuffed oropharyngeal airway and a face mask in a resuscitation model in inexperienced Inhibitors,research,lifescience,medical personnel [14]. However, they did

not show improvement in performance or point out a time frame for training. Yet, it seems quite clear that the use of laryngeal masks improves the quality of ventilation when compared to face mask [15]. With these Inhibitors,research,lifescience,medical results, we affirm the opinion of implementing airway management into an early stage of first aid measures. It might have been helpful to split up another “control group” of students which did not attend the training programme. Thereby, we could have examined whether or whether not they might have improved only due to redundant performance within their second evaluation even without training Inhibitors,research,lifescience,medical sessions. However, we cannot exclude the possibility that the initial use of the laryngeal airway devices has had a training effect on the performance of the students by itself. Clearly it would be beneficial to address this issue using a more refined study design, i.e. cross-over study design and furthermore our results would be Inhibitors,research,lifescience,medical strengthened by introducing a control group of students performing with bag valve mask ventilation (BVM).

But within this study, the Tolmetin particular attention was turned to improvement in performance after a training programme, questioning whether or whether not this specific training concept might be sufficient. Besides, it is questionable which results BVM-ventilation would have shown in this setting. Recent studies of Noordergraaf et al. showed poor BVM ventilation of laypersons. In a clinical design, patients were ventilated by fireman first responders using a hand-held mask or an Oxylator. The working group could conclude that Oxylators perform significantly better (p < 0.0001) than the bag-valve device [16]. It seems therefore debatable whether inexperienced persons would be able to handle BVM sufficiently.