medical students. Problems with device operation were recorded and data collected in this phased was used to calculate the number of sample size in the next phase. Phase 3 -A randomized, non-inferiority trial was conducted to compare the efficacy of the novel device with the current device in BLS training for 60 lay rescuers. Phase 4 -A 6-point Likert type scale was evaluated by 44 BLS instructors for a satisfaction survey after using the novel device. Stage 3: The novel device's cost effectiveness was evaluated.Results: Novel device (Figure ) can give CPR quality feedback, can be used in AED training, and can operate on both functions consecutively and simultaneously. Expert opinions were in consistent with the device being up to standard and practical (Kappa ¼ 0.94). The factorial design, randomized controlled trial-design pilot study demonstrated that the best BLS practice test result was yielded in the group using the novel device, with a median(IQR) of 26(26-26) (p-value < 0.01), while the randomized, non-inferiority trial showed that the novel device was not inferior to the current device (p-value 0.28). The satisfaction survey using a 6-point Likert type scale demonstrated a median(IQR) satisfaction score for the novel device in terms of convenience and realism at 5(4-6) and 5(4-5.75), respectively. Cost-effectiveness analysis from the study showed that 1 set of novel BLS training device cost 3-5 times less than commercial models, and mass production of the device could reduce the cost by 5-10 times.Conclusions: Novel BLS training device can increase the instructor's convenience and the trainer's realism during the training. Its effectiveness in BLS training is equivalent to other commercial models and its cost is appropriate for a developing country. We expect to make quality BLS education accessible for all kinds of people.

Background: Computed tomography (CT) scans’ predictive value is not well established for screening prior to renal transplantation. The purpose of this study is to measure the extent to which CT findings during transplant evaluation alter candidacy.Methods: Data for 639 renal transplant candidates who underwent CT screening were obtained. Of these, 454 patients had sufficient data and met criterium of having undergone screening CT within six months of official renal transplant evaluation. Transplant status before and after CT imaging was assessed.Results: Those who had screening CTs prior to renal transplantation who were older (p=0.01), had coronary artery disease (p=0.006), or had diabetes mellitus (p=0.042) had significant waitlist status changes. Candidates whose CT findings included vascular calcification or pulmonary nodules were more likely to be permanently excluded from the waitlist (p<0.05). Thirty-two, or 7.0%, had a permanent waitlist status change due to pathologic CT findings that precluded transplantation.Conclusions: Focusing on older patients with coronay artery disease, atherosclerosis, or diabetes would reduce the number of CTs obtained during workup. Candidates with systemic vascular calcification or pulmonary nodules found on subsequent imaging are at the greatest risk for permanent exclusion from renal transplantation.

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses. Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance were performed. Results: Data from 573 residents found several stressful factors: working with a nurse perceived to be inefficient, working with no inpatient beds available, and working with a colleague perceived to be inefficient. The majority of respondents reported some general anxiety on the GAD-7 assessment. There was no difference on anxiety level as a function of year of residency (p > .05). There was a significant gender difference on anxiety level, t(571) = -4.8689, p < .05, where male residents reported lower anxiety levels (mean=5.15) as compared to female residents (mean=7.02). Lastly, post-hoc analyses revealed that male and female respondents reported differing levels of stress in response to several intrinsic stress factors. Conclusion: We identified several intrinsic factors during a shift that contribute to resident anxiety and analyzed differing gender responses to these factors; this may provide a framework for residency programs to minimize stressors in the future.