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      Data-driven resuscitation training using pose estimation

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          Abstract

          Background

          Cardiopulmonary resuscitation (CPR) training improves CPR skills while heavily relying on feedback. The quality of feedback can vary between experts, indicating a need for data-driven feedback to support experts. The goal of this study was to investigate pose estimation, a motion detection technology, to assess individual and team CPR quality with the arm angle and chest-to-chest distance metrics.

          Methods

          After mandatory basic life support training, 91 healthcare providers performed a simulated CPR scenario in teams. Their behaviour was simultaneously rated based on pose estimation and by experts. It was assessed if the arm was straight at the elbow, by calculating the mean arm angle, and how close the distance between the team members was during chest compressions, by calculating the chest-to-chest distance. Both pose estimation metrics were compared with the expert ratings.

          Results

          The data-driven and expert-based ratings for the arm angle differed by 77.3%, and based on pose estimation, 13.2% of participants kept the arm straight. The chest-to-chest distance ratings by expert and by pose estimation differed by 20.7% and based on pose estimation 63.2% of participants were closer than 1 m to the team member performing compressions.

          Conclusions

          Pose estimation-based metrics assessed learners’ arm angles in more detail and their chest-to-chest distance comparably to expert ratings. Pose estimation metrics can complement educators with additional objective detail and allow them to focus on other aspects of the simulated CPR training, increasing the training’s success and the participants’ CPR quality.

          Trial registration

          Not applicable.

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          Most cited references28

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          The Measurement of Observer Agreement for Categorical Data

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            Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK

            Background To mitigate and slow the spread of COVID-19, many countries have adopted unprecedented physical distancing policies, including the UK. We evaluate whether these measures might be sufficient to control the epidemic by estimating their impact on the reproduction number (R 0, the average number of secondary cases generated per case). Methods We asked a representative sample of UK adults about their contact patterns on the previous day. The questionnaire was conducted online via email recruitment and documents the age and location of contacts and a measure of their intimacy (whether physical contact was made or not). In addition, we asked about adherence to different physical distancing measures. The first surveys were sent on Tuesday, 24 March, 1 day after a “lockdown” was implemented across the UK. We compared measured contact patterns during the “lockdown” to patterns of social contact made during a non-epidemic period. By comparing these, we estimated the change in reproduction number as a consequence of the physical distancing measures imposed. We used a meta-analysis of published estimates to inform our estimates of the reproduction number before interventions were put in place. Results We found a 74% reduction in the average daily number of contacts observed per participant (from 10.8 to 2.8). This would be sufficient to reduce R 0 from 2.6 prior to lockdown to 0.62 (95% confidence interval [CI] 0.37–0.89) after the lockdown, based on all types of contact and 0.37 (95% CI = 0.22–0.53) for physical (skin to skin) contacts only. Conclusions The physical distancing measures adopted by the UK public have substantially reduced contact levels and will likely lead to a substantial impact and a decline in cases in the coming weeks. However, this projected decline in incidence will not occur immediately as there are significant delays between infection, the onset of symptomatic disease, and hospitalisation, as well as further delays to these events being reported. Tracking behavioural change can give a more rapid assessment of the impact of physical distancing measures than routine epidemiological surveillance.
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              OpenPose: Realtime Multi-Person 2D Pose Estimation using Part Affinity Fields

              Realtime multi-person 2D pose estimation is a key component in enabling machines to have an understanding of people in images and videos. In this work, we present a realtime approach to detect the 2D pose of multiple people in an image. The proposed method uses a nonparametric representation, which we refer to as Part Affinity Fields (PAFs), to learn to associate body parts with individuals in the image. This bottom-up system achieves high accuracy and realtime performance, regardless of the number of people in the image. In previous work, PAFs and body part location estimation were refined simultaneously across training stages. We demonstrate that a PAF-only refinement rather than both PAF and body part location refinement results in a substantial increase in both runtime performance and accuracy. We also present the first combined body and foot keypoint detector, based on an internal annotated foot dataset that we have publicly released. We show that the combined detector not only reduces the inference time compared to running them sequentially, but also maintains the accuracy of each component individually. This work has culminated in the release of OpenPose, the first open-source realtime system for multi-person 2D pose detection, including body, foot, hand, and facial keypoints.
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                Author and article information

                Contributors
                weisske@ethz.ch
                michaela.kolbe@usz.ch
                andrea.nef@usz.ch
                bastian.grande@usz.ch
                k-bravin@hotmail.com
                meboldtm@ethz.ch
                qlohmeyer@ethz.ch
                Journal
                Adv Simul (Lond)
                Adv Simul (Lond)
                Advances in Simulation
                BioMed Central (London )
                2059-0628
                16 April 2023
                16 April 2023
                2023
                : 8
                : 12
                Affiliations
                [1 ]GRID grid.5801.c, ISNI 0000 0001 2156 2780, Product Development Group Zurich, Department of Mechanical and Process Engineering, , ETH Zurich, ; Leonhardstrasse 21, Zurich, 8092 Switzerland
                [2 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Simulation Center, , University Hospital Zurich, ; Rämistrasse 100, 8091 Zurich, Switzerland
                [3 ]GRID grid.412004.3, ISNI 0000 0004 0478 9977, Institute of Anaesthesiology, , University Hospital Zurich, ; Rämistrasse 100, 8091 Zurich, Switzerland
                Author information
                http://orcid.org/0000-0002-1337-2191
                Article
                251
                10.1186/s41077-023-00251-6
                10105636
                3c3be8de-a485-48d2-b7fd-572b2f363094
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 12 July 2022
                : 29 March 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001711, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung;
                Award ID: 106014_17706
                Award Recipient :
                Funded by: Swiss Federal Institute of Technology Zurich
                Categories
                Methodological Intersections
                Custom metadata
                © The Author(s) 2023

                education,simulation,feedback,training,pose estimation,basic life support,technology,cardiopulmonary resuscitation,assessment

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