Sample records for european arrest warrant

  1. The Principle of Proportionality and the European Arrest Warrant

    Directory of Open Access Journals (Sweden)

    Sarah Haggenmüller


    Full Text Available The European Arrest Warrant (EAW is a grossly coercive instrument that was designed for the persecution of serious cross-border crimes. In recent years, however, Member States have increasingly reported cases in which EAWs have not been issued for serious, but rather for harmless and minor offences. This article analyses the reasons behind the disproportionate use of the EAW and outlines measures to alleviate the problem. Thereby, it claims that in current debates different categories of disproportionate use of EAWs are often lumped together, and only concentrate on the introduction of a (binding proportionality test, failing to consider other alternative legislative solutions regarding minor crimes, such as the introduction of new comparable and effective alternative measures. These, however, are considered to be crucial for an alleviation of disproportionate warrants. La orden de detención europea (ODE es un instrumento extremadamente coercitivo que fue diseñado para la persecución de delitos transfronterizos graves. En años recientes, sin embargo, los Estados miembro han notificado cada vez más casos en los que la ODE no se debía a delitos serios, sino a casos menores e inofensivos.. En este artículo se analizan las razones que hay detrás del uso desproporcionado de la orden de detención europea y propone medidas para paliar el problema. De esta manera, se defiende que el debate actual, frecuentemente agrupan diferentes categorías de uso desproporcionado de la ODE, y sólo se concentran en la introducción de un test de proporcionalidad (vinculante, sin tener en cuenta otras soluciones legislativas alternativas, en lo que respecta a delitos menores, como la introducción de nuevas medidas alternativas, comparables y eficaces. Sin embargo, se considera que estas medidas son cruciales para reducir las órdenes de arresto desproporcionadas. DOWNLOAD THIS PAPER FROM SSRN:

  2. Execution of the European Arrest Warrant by the Romanian Judicial Authorities

    Directory of Open Access Journals (Sweden)

    Ion Rusu


    Full Text Available The unprecedented development of criminality at the social and economical levels, the tendency toglobalize some categories of crimes, of maximum gravity, as terrorism, armament traffic, drug traffic orhuman traffic, have determined the world states to undertake specific measures to prevent, combat and finallyreduce it. The first and most important measure taken by the Europe’s Council, regarding the intensificationof judicial cooperation in criminal matters was the adoption of the European Convention on extradition, inParis on 13 December 1957, completed by the two Additional Protocols in Strasbourg, on 15 October 1975and 17 March 1978. In this context, the release of the Council’s Framework Decision on 13 June 2002 on theEuropean arrest warrant and the procedures of delivery among the member states (2002/584/JAI representeda natural decision, with the purpose of contributing at ensuring a free, secure and just European space. TheEuropean arrest warrant is a judicial decision through which a competent judicial authority of a EuropeanUnion member state solicits the arrest and delivery by another member state, in order to proceed to theprosecution, trial or execution of a penalty or safety measure that is privative of freedom.

  3. Effective and Legitimate? Learning from the Lessons of 10 Years of Practice with the European Arrest Warrant

    NARCIS (Netherlands)

    Marin, Luisa


    The article examines the European Arrest Warrant (EAW) and the issues which have emerged in its first 10 years of practice. After a first section explaining the choice for the principle of mutual recognition as expression of effectiveness and subsidiarity in judicial cooperation in criminal matters,

  4. Peculiarities of the Enforcement of the European Arrest Warrant in the Case of an Illegal Liberty Deprivation

    Directory of Open Access Journals (Sweden)

    Minodora Ioana Rusu


    Full Text Available The illegal deprivation of liberty is, under the current context, one of the most serious offenses, being treated differently in the European Union. The need to prevent and combat this violation, it has led the European legislator to include it under different names in the European legislative act that governs the institution of the European arrest warrant. In this context, the European arrest warrant is the most important form of judicial cooperation in penal matters between the Member States of the EU, which is based on mutualrecognition of criminal judgments. The research conducted on how it is regulated the enforcement of the European arrest warrant in the case of illegal liberty deprivation in the European legislative act (the Framework Decision 2002/584/JHA leads to the conclusion that the legislature failed to mention the violation in question in the group of the violation for which it was not necessary the inspection of the double incrimination, but, still, including the offenses as kidnapping, illegal restraint and hostage-taking. Even if theRomanian legislator included this violation in the above mentioned group, this situation is not solved, because it will cause some problems in the request by the Romanian judicial authorities of the enforcement of such warrant. Another criticized issue, observed not only in the European legislative act, but also in the internal law, is related to the lack of stipulations, which can lead to the possibility of issuing and executing a European arrest warrant and for the execution of educational measures for illegal deprivation of liberty and also others. Also, in order to increase the effectiveness of the execution of a European arrest warrant, we consider that it should be granted executive powers of all courts of Romania. The originality of the work consists of the critical observations and the lege ferenda proposal which covers both the European legislativeact and the Romanian Law. At the same time

  5. A Spectre Is Haunting Europe: European Citizenship in the Area of Freedom, Security, and Justice: Some Reflections on the Principles of Non-Discrimination (on the Basis of Nationality), Mutual Recognition, and Mutual Trust Originating from the European Arrest Warrant

    NARCIS (Netherlands)

    Marin, Luisa


    After a reconstruction of the traditional legal setting of extradition, the paper explores the European Arrest Warrant Framework Decision’s nationality and residence clauses in their normative context: mutual recognition and mutual trust. It then discusses how these clauses have been implemented at

  6. Judicial Cooperation Based On a European Evidence Warrant

    Directory of Open Access Journals (Sweden)

    Mihaela Laura Pamfil


    Full Text Available The assurance of a better judicial cooperation between European Union Member States is aconstant preoccupation of the Council of Europe, taking into consideration that the European Union has setitself the objective of maintaining and developing an area of freedom, security and justice. The achievementof this objective is only possible if among EU Member States there is a high level of confidence and a mutualrecognition of the decisions issued by the competent judicial authorities. The European arrest warrant was thefirst concrete measure in the field of criminal law implementing the principle of mutual recognition which theEuropean Council referred to as cornerstone of judicial cooperation. It was followed by other measuresdesigned to create the legal framework of the judicial cooperation; some of these measures concerns the fightagainst corruption, terrorism, cross-border criminality, racism and xenophobia while others are applicable inany case, such as the order of freezing the property and the evidence. On 18 December 2008, a newinstrument was created in order to improve the judicial cooperation between the Member States: the Europeanevidence warrant. Its purpose is to assure the obtaining of the objects, documents and data which may be usedas evidence in proceedings in criminal matters in issuing State, from another Member State. So, the aim ofthis Framework Decision is to complete the provision of the Decision on the execution of orders freezingproperty and evidence which is not talking about the transfer of the evidence after the freezing.Romania, like the other European Union Member States must transpose the provision of this Decision in thenational law by 19 January 2011. That is why we would like to analyse the procedures and the safeguardsprovided by this Decision and to show the way we see the European evidence warrant settled in ourlegislation.

  7. 8 CFR 287.3 - Disposition of cases of aliens arrested without warrant. (United States)


    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Disposition of cases of aliens arrested without warrant. 287.3 Section 287.3 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS FIELD OFFICERS; POWERS AND DUTIES § 287.3 Disposition of cases of aliens arrested without warrant...

  8. La cooperación judicial y policial europea. La orden europea de detención y entrega/Police and judicial cooperation in criminal matters. The European arrest warrant

    National Research Council Canada - National Science Library

    María Gavilán Rubio


    ..., showing the relevance of court decision's mutual recognition between member states. The tools that are utilized to articulate this cooperation are Eurojust, European Judicial Network, Europol, Sirene Bureau and Interpol...

  9. Standard of Proof Required to Issue an Arrest Warrant for Genocide

    Directory of Open Access Journals (Sweden)

    Enrique Carnero Rojo


    Full Text Available At the time of writing this case note, the case against Omar Al Bashir is the only genocide case before the InternationalCriminal Court. So far, the main legal question concerns whether the existence of reasonable grounds to believe that a personhas committed a crime of genocide within the jurisdiction of the Court must be the only reasonable conclusion to be drawnfrom the evidence presented by the Prosecutor for an arrest warrant to be issued against the suspect of such crime.

  10. Africa in Dilemma: The Implication of the Warrant of Arrest Against ...

    African Journals Online (AJOL)

    This diplomatic impasse invokes many queries: Has the warrant split Africa's solidarity? Would it diminish the support of the ICC in Africa? Was the decision to issue the warrant lawfully exercised or even necessary? This article seeks answers, and suggests a credible approach in view of the persistence of gross atrocities.

  11. Plantinga-Warrant and Reliabilist Warrant

    Directory of Open Access Journals (Sweden)

    Jerome Gellman


    Full Text Available I argue that reliabilist warrant should not require that a true belief have been produced in accordance with a design plan. At least sometimes, it seems sufficient that there be an intent for the faculty to have the reliable outcomes it in fact has. This pertains to the notion of warrant of Alvin Plantinga.

  12. Determinants of occurrence and survival after sudden cardiac arrest-A European perspective: The ESCAPE-NET project. (United States)

    Empana, Jean-Philippe; Blom, Marieke T; Bӧttiger, Bernd W; Dagres, Nikolaos; Dekker, Jacqueline M; Gislason, Gunnar; Jouven, Xavier; Meitinger, Thomas; Ristagno, Giuseppe; Schwartz, Peter J; Jonsson, Martin; Tfelt-Hansen, Jacob; Truhlar, Anatolij; Tan, Hanno L


    The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies for survival after SCA on a European scale. This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. The 11 clinical studies with SCA cases comprise 85,790 SCA cases; the 5 observational prospective population cohorts include 53,060 subjects. A total of 15,000 SCA samples will be genotyped for common and rare variants at the Helmholtz Zentrum München (Germany) using the Illumina Global Screening Array which contains > 770,000 SNPs, and after imputation, a database of an estimated > 9 million variants will be available for genome wide association studies. Standardization of risk factors definition and outcomes is ongoing. An Executive Committee has been created along with a Collaboration Policy document. ESCAPE-NET will complement ongoing efforts on SCA outside Europe and within Europe including the EuReCa project. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  13. The Post-9/11 European Union Counterterrorism Response: Legal-Institutional Framework (United States)


    Madrid bombings , London bombings , effectiveness, legality, measures, Europol, Eurojust. 15. NUMBER OF PAGES 189 16. PRICE CODE 17. SECURITY...European Arrest Warrant EBDS European Bomb Data System ECHR European Court on Human Rights xiv ECJ European Court of Justice ECRIS...groups included: the Club of Berne established in 1971 by national security services of Belgium, Denmark, France, Germany, Switzerland, Great Britain

  14. 28 CFR 2.99 - Execution of warrant and service of summons. (United States)


    ... Parolees § 2.99 Execution of warrant and service of summons. (a) Any officer of any Federal or District of Columbia correctional institution, any Federal Officer authorized to serve criminal process, or any officer... custody of the Attorney General. (b) Upon the arrest of the parolee, the officer executing the warrant...

  15. 28 CFR 2.46 - Execution of warrant and service of summons. (United States)


    ... § 2.46 Execution of warrant and service of summons. (a) Any officer of any Federal correctional institution or any Federal officer authorized to serve criminal process within the United States, to whom a... the Attorney General. (b) On arrest of the parolee the officer executing the warrant shall deliver to...

  16. Black-Scholes finite difference modeling in forecasting of call warrant prices in Bursa Malaysia (United States)

    Mansor, Nur Jariah; Jaffar, Maheran Mohd


    Call warrant is a type of structured warrant in Bursa Malaysia. It gives the holder the right to buy the underlying share at a specified price within a limited period of time. The issuer of the structured warrants usually uses European style to exercise the call warrant on the maturity date. Warrant is very similar to an option. Usually, practitioners of the financial field use Black-Scholes model to value the option. The Black-Scholes equation is hard to solve analytically. Therefore the finite difference approach is applied to approximate the value of the call warrant prices. The central in time and central in space scheme is produced to approximate the value of the call warrant prices. It allows the warrant holder to forecast the value of the call warrant prices before the expiry date.

  17. A Spectre is Haunting Europe : European Citizenship in the Area of Freedom, Security, and Justice

    NARCIS (Netherlands)

    Marin, Luisa


    After a reconstruction of the traditional legal setting of extradition, the paper explores the European Arrest Warrant Framework Decision's nationality and residence clauses in their normative context: mutual recognition and mutual trust. It then discusses how these clauses have been implemented at

  18. Trading Platform for the Global Warrant Markets

    Directory of Open Access Journals (Sweden)

    Iosif ZIMAN


    Full Text Available Global warrant markets are among the most active financial markets in the retail derivatives investment landscape currently. In this context some of the most relevant markets in the last years have been the ones across Asia and in particular Hong Kong, Korea and Japan. This paper introduces the financial instruments used in connection with the warrant markets, pre-sents and offers suggestions for setting up a generic warrant market making system and in-troduces the main concepts and components that need to be taken into account when develop-ing these systems targeting an exchange driven or E-Businesscontext.

  19. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. (United States)

    Solberg, E E; Borjesson, M; Sharma, S; Papadakis, M; Wilhelm, M; Drezner, J A; Harmon, K G; Alonso, J M; Heidbuchel, H; Dugmore, D; Panhuyzen-Goedkoop, N M; Mellwig, K-P; Carre, F; Rasmusen, H; Niebauer, J; Behr, E R; Thiene, G; Sheppard, M N; Basso, C; Corrado, D


    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal. © The European Society of Cardiology 2015.

  20. 32 CFR 935.122 - Arrests. (United States)


    ..., without a warrant, for any crime (including a petty offense) that is committed in his presence. (b) Any... this part or commits a crime that is not a violation of this part, in his presence, or that he... to enter any building, vehicle, or aircraft to execute a warrant of arrest, force an entry after...

  1. 32 CFR 935.125 - Citation in place of arrest. (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Citation in place of arrest. 935.125 Section 935... INSULAR REGULATIONS WAKE ISLAND CODE Peace Officers § 935.125 Citation in place of arrest. In any case in which a peace officer may make an arrest without a warrant, he may issue and serve a citation if he...

  2. Daily Arrests (United States)

    Montgomery County of Maryland — This dataset provides the public with arrest information from the Montgomery County Central Processing Unit (CPU) systems. The data presented is derived from every...

  3. Cardiac arrest (United States)

    ... also run other tests, depending on your health history and the results of these tests. Treatment Cardiac arrest needs emergency treatment right away to get the heart started again. Cardiopulmonary resuscitation (CPR) . This is often the first type of ...

  4. Fideicomiso de warrants : (el "warrant" como instrumento de financiación)


    Veiga Tartara, Juan carlos


    La tesis se estructura en cinco capitulos: I. El deposito en almacenes generales II. El Warrants III. Titulación IV. Fideicomiso V. Fideicomiso de Warrants Con ello, se diseña un instrumento juridico que permite mejorar la comercializacion y la financiacion del azucar, industria esencial en la provincia de Tucuman.

  5. Warrant Officer Senior Course WOSC Evaluation. (United States)


    ADOAII2 935 AMY AVIATION CENTER PORT RUCKER AL DIRECTORATE OF E-ETC F/M 5/9 WARRANT OFICER SENIOR COURSE WOS EVALUATION.(U) AL $I S N GOWIN ...achievement. v (12) Meau scores for those examinations reviewed ranged from 97.96 to 89.26. The significance of these high scores cannot be adequately assessed...choice v , given credit as being correct. (15) Students c.iio missed a substantial portion of testable training were not rcquir ’ ., make up the

  6. Sudden Cardiac Arrest (SCA) (United States)

    ... Arrest (SCA) Back to Heart Diseases & Disorders Sudden Cardiac Arrest (SCA) Sudden Cardiac Arrest ( SCA ) occurs when the heart stops beating, abruptly ... to saving someone who is having a sudden cardiac arrest , it is important to understand the difference. The ...

  7. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation

    NARCIS (Netherlands)

    Solberg, E.E.; Borjesson, M.; Sharma, S.; Papadakis, M.; Wilhelm, M.; Drezner, J.A.; Harmon, K.G.; Alonso, J.M.; Heidbuchel, H.; Dugmore, D.; Panhuyzen-Goedkoop, N.M.; Mellwig, K.P.; Carre, F.; Rasmusen, H.; Niebauer, J.; Behr, E.R.; Thiene, G.; Sheppard, M.N.; Basso, C.; Corrado, D.


    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities.

  8. Standard of Proof Required to Issue an Arrest Warrant for Genocide

    NARCIS (Netherlands)

    Carnero Rojo, E.


    At the time of writing this case note, the case against Omar Al Bashir is the only genocide case before the InternationalCriminal Court. So far, the main legal question concerns whether the existence of reasonable grounds to believe that a personhas committed a crime of genocide within the

  9. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation.


    Solberg, EE; Borjesson, M; Sharma, S; Papadakis, M; Wilhelm, M; Drezner, JA; Harmon, KG; Alonso, JM; Heidbuchel, H; Dugmore, D; Panhuyzen-Goedkoop, NM; Mellwig, KP; Carre, F; Rasmusen, H; Niebauer, J


    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters ...

  10. Resuscitation, prolonged cardiac arrest, and an automated chest compression device

    DEFF Research Database (Denmark)

    Risom, Martin; Jørgensen, Henrik; Rasmussen, Lars S


    The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest.......The European Resuscitation Council's 2005 guidelines for cardiopulmonary resuscitation (CPR) emphasize the delivery of uninterrupted chest compressions of adequate depth during cardiac arrest....

  11. [Heart arrest]. (United States)

    Chiarella, F; Giovannini, E; Bozzano, A; Caristo, G; Delise, P; Fedele, F; Fera, M S; Lavalle, C; Roghi, A; Valagussa, F


    Cardiac arrest is one of the leading causes of mortality in industrialized countries and is mainly due to ischemic heart disease. According to ISTAT estimates, approximately 45,000 sudden deaths occur annually in Italy whereas according to the World Health Organization, its incidence is 1 per 1000 persons. The most common cause of cardiac arrest is ventricular fibrillation due to an acute ischemic episode. During acute ischemia the onset of a ventricular tachyarrhythmia is sudden, unpredictable and often irreversible and lethal. Each minute that passes, the probability that the patient survives decreases by 10%. For this reason, the first 10 min are considered to be priceless for an efficacious first aid. The possibility of survival depends on the presence of witnesses, on the heart rhythm and on the resolution of the arrhythmia. In the majority of cases, the latter is possible by means of electrical defibrillation followed by the reestablishment of systolic function. An increase in equipment alone does not suffice for efficacious handling of cardiac arrest occurring outside the hospital premises. Above all, an adequate intervention strategy is required. Ambulance personnel must be well trained and capable of intervening rapidly, possibly within the first 5 min. The key to success lies in the diffusion and proper use of defibrillators. The availability of new generation instruments, the external automatic defibrillators, encourages their widespread use. On the territory, these emergencies are the responsibility of the 118 organization based, according to the characteristics specific to each country, on the regulated coordination between the operative command, the crews and the first-aid means. Strategies for the handling of these emergencies within hospitals have been proposed by the Conference of Bethesda and tend to guarantee an efficacious resuscitation with a maximum latency of 2 min between cardiac arrest and the first electric shock. The diffusion of external

  12. About Cardiac Arrest (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More About Cardiac Arrest Updated:Mar 10,2017 What is cardiac arrest? ... and procedures related to heart disease and stroke. Cardiac Arrest • Home • About Cardiac Arrest • Understand Your Risk for ...

  13. victoria cross awards warrants concerning the victoria cross (1920)

    African Journals Online (AJOL)

    Gazette" of that date. The Royal Warrant of 21 October, 1911. The Royal Warrant of 22 May, 1920. Scientia Militaria, South African Journal of Military Studies, Vol 3 ... shall prove the act to the satisfaction of the captain or officer commanding .... which, through the courage and devotion displayed, life or public property might.

  14. What Causes Sudden Cardiac Arrest? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  15. What Is Sudden Cardiac Arrest? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  16. Some Remarks on Bonjour on Warrant, Proper Function, and Defeasibility

    Directory of Open Access Journals (Sweden)

    Colin P. Ruloff


    Full Text Available A number of counterexamples have recently been leveled against Alvin Plantinga's Proper Functionalism, counterexamples aimed at showing that Plantinga's theory fads to provide sufficient conditions for warrant — that elusive epistemic property which together with true belief yields knowledge Among these counterexamples, Laurence Bonjour s is perhaps the most formidable and, if successful, shows that Proper Functionalism is simply too weak to serve as an acceptable theory of warrant In this paper, I argue that, contrary to initial appearances, BonJour's counterexample is not successful More exactly, I argue that, once it is recognized that a defeasibility constraint is deeply embedded within Plantinga's proper function condition for warrant — a constraint which says, in effect, that a belief B is warranted for an agent S only of S does not possess any defeaters against B — BonJour's counterexample to Proper Functionalism can be handled quite straightforwardly

  17. Epidemiology and management of cardiac arrest: what registries are revealing. (United States)

    Gräsner, Jan-Thorsten; Bossaert, Leo


    Major European institutions report cardiovascular disease (CVD) as the first cause of death in adults, with cardiac arrest and sudden death due to coronary ischaemia as the primary single cause. Global incidence of CVD is decreasing in most European countries, due to prevention, lifestyle and treatment. Mortality of acute coronary events inside the hospital decreases more rapidly than outside the hospital. To improve the mortality of cardiac arrest outside the hospital, reliable epidemiological and process figures are essential: "we can only manage what we can measure". Europe is a patchwork of 47 countries (total population of 830 million), with a 10-fold difference in incidence of coronary heart disease between North and South, East and West, and a 5-fold difference in number of EMS-treated cardiac arrest (range 17-53/1000,000/year). Epidemiology of cardiac arrest should not be calculated as a European average, but it is appropriate to describe the incidence of cardiac arrest, the resuscitation process, and the outcome in each of the European regions, for benchmarking and quality management. Epidemiological reports of cardiac arrest should specify definitions, nominator (number of cases) and denominator (study population). Recently some regional registries in North America, Japan and Europe fulfilled these conditions. The European Registry of Cardiac Arrest (EuReCa) has the potential to achieve these objectives on a pan-European scale. For operational applications, the Utstein definition of "Cardiac arrest" is used which includes the potential of survival. For application in community health, the WHO definition of "sudden death" is frequently used, describing the mode of death. There is considerable overlap between both definitions. But this explains that no single method can provide all information. Integrating data from multiple sources (local, national, multinational registries and surveys, death certificates, post-mortem reports, community statistics, medical

  18. victoria cross awards warrants concerning the victoria cross (1920)

    African Journals Online (AJOL)

    INTRODUCTION. In the military history of both the British Empire and of the Western World, the highest British military decoration, namely the Victoria Cross, has attained con- siderable renown. The Victoria Cross was introduced in terms of the Royal Warrant of 29 January,. 1856 and by 1957 a total of 1346 had been ...

  19. Reliability in Plantinga´s Account of Epistemic Warrant

    Directory of Open Access Journals (Sweden)

    John C. Wingard, Jr.


    Full Text Available In das paper 1 consider the reliability condition in Alvin Platinga’s proper functionalist account of epistemic warrant I begin by reviewing m some detail the features of the reliability condition as Platinga has articulated a From there, 1 consider what is needed to ground or secure the sort of reliability which Plantinga has m mind, and argue that what is needed is a significant causal condition which has generally been overlooked Then, after identifying eight versions of the relevant sort of reliability, I exam me each alternative as to whether as requirement, along with Platinga’s other proposed conditions, would give us a satisfactory account of epistemic warrant I conclude that there is bale to no hope of formulating a reliability condition that would yield a satisfactory analysts of the sort Plantinga desires

  20. Aviary: Distributed, Tamper-Proof, Per-User Warrant Canaries


    Bose-Kolanu, Abhishek


    Governments routinely claim the power to subject individuals to secret investigation, forcing technology Service Providers to divulge User data without notification. Warrant canaries invert the notification problem by telling a User each time a Service Provider has not received a secret request for their data. Current canaries suffer from non-standardization, poor granularity, and brittleness in the face of attacks, leading the Electronic Frontier Foundation and Berkman Center to discontinue ...

  1. Study on the Future of Mutual Recognition in Criminal Matters in the European Union

    DEFF Research Database (Denmark)

    Vestergaard, Jørn; Adamo, Silvia


    Practitioners in the criminal justice system are fairly content with the European Arrest Warrant and other schemes based on the principle of mutual recognition of judicial decisions. This is the result of a survey published by Professor of Criminal Law Jørn Vestergaard and research asststant Silvia...... in an extradition case is the judicial decision issued in the requesting country. The conditions for surrender are less burdensome than previously, and the process is speedy. Similar schemes have been introduced regarding fines, confiscation and evidence but have so far only been of minor practical relevance...

  2. Clinical pathways for inborn errors of metabolism: warranted and feasible

    Directory of Open Access Journals (Sweden)

    Demirdas Serwet


    Full Text Available Abstract Inborn errors of metabolism (IEMs are known for their low prevalence and multidisciplinary care mostly founded on expert opinion. Clinical pathways are multidisciplinary tools to organise care which provide a clear route to the best care and improve communication. In 2010 the Dutch Society for Children and Adults with an Inborn Error of Metabolism (VKS initiated development of clinical pathways for inborn errors of metabolism. In this letter to the editor we describe why it is warranted to develop clinical pathways for IEMs and shortly discuss the process of development for these pathways in the Netherlands.

  3. Pittsburgh Police Arrest Data (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Arrest data contains information on people taken into custody by City of Pittsburgh police officers. More serious crimes such as felony offenses are more likely to...

  4. Epidemiology and Outcomes After In-Hospital Cardiac Arrest After Pediatric Cardiac Surgery (United States)

    Gupta, Punkaj; Jacobs, Jeffrey P.; Pasquali, Sara K.; Hill, Kevin D.; Gaynor, J. William; O’Brien, Sean M.; He, Max; Sheng, Shubin; Schexnayder, Stephen M.; Berg, Robert A.; Nadkarni, Vinay M.; Imamura, Michiaki; Jacobs, Marshall L.


    Background Multicenter data regarding cardiac arrest in children undergoing heart operations are limited. We describe epidemiology and outcomes associated with postoperative cardiac arrest in a large multiinstitutional cohort. Methods Patients younger than 18 years in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2007 through 2012) were included. Patient factors, operative characteristics, and outcomes were described for patients with and without postoperative cardiac arrest. Multivariable models were used to evaluate the association of center volume with cardiac arrest rate and mortality after cardiac arrest, adjusting for patient and procedural factors. Results Of 70,270 patients (97 centers), 1,843 (2.6%) had postoperative cardiac arrest. Younger age, lower weight, and presence of preoperative morbidities (all p cardiac arrest. Arrest rate increased with procedural complexity across common benchmark operations, ranging from 0.7% (ventricular septal defect repair) to 12.7% (Norwood operation). Cardiac arrest was associated with significant mortality risk across procedures, ranging from 15.4% to 62.3% (all p arrest rate was not associated with center volume (odds ratio, 1.06; 95% confidence interval, 0.71 to 1.57 in low- versus high-volume centers). However, mortality after cardiac arrest was higher in low-volume centers (odds ratio, 2.00; 95% confidence interval, 1.52 to 2.63). This association was present for both high- and low-complexity operations. Conclusions Cardiac arrest carries a significant mortality risk across the stratum of procedural complexity. Although arrest rates are not associated with center volume, lower-volume centers have increased mortality after cardiac arrest. Further study of mechanisms to prevent cardiac arrest and to reduce mortality in those with an arrest is warranted. PMID:25443018

  5. Runway Arrested Landing Site (RALS) (United States)

    Federal Laboratory Consortium — The Runway Arrested Landing Site includes an underground complex located on a Mod 2, Mod 3, and Mod 3+ arresting gear and are located under the runway and accurately...

  6. Electrophysiological prognostication and brain injury from cardiac arrest. (United States)

    Kaplan, Peter W


    Anoxic coma after cardiorespiratory arrest warrants precocious investigation to establish probable outcome. Electroencephalogram (EEG) may uncover subclinical seizures; EEG grades have provided accurate prognosis of poor and favorable outcomes, but are weakest in those patients in between. Somatosensory evoked potentials now have proven benefit in accurately establishing a poor outcome (death or persistent vegetative state) when cortical responses (N20) are absent. These studies are particularly helpful when clinical examination of coma, early on, might yield uncertain prognosis (i.e., when brain stem reflexes are present). Combining clinical examination with electrophysiology has increasingly yielded multimodality approaches to early prognostication of coma after cardiorespiratory arrest, with more recent studies using event-related and middle-latency potentials showing promise for distinguishing good outcome (to consciousness), from awake but vegetative states. Further studies are warranted for this multimodality approach which, hopefully, may yield more widespread practical use of these testing modalities.

  7. How Is Sudden Cardiac Arrest Treated? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  8. How Is Sudden Cardiac Arrest Diagnosed? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  9. Who Becomes a Limited Duty Officer and Chief Warrant Officer? An Examination of Differences of Limited Duty Officers and Chief Warrant Officers

    National Research Council Canada - National Science Library

    Manuel, Walter F


    .... The results of the study revealed the background characteristics age, education, race and ethnicity groups were significantly different between the Limited Duty Officer and Chief Warrant Officer Communities...

  10. Registry of Unexplained Cardiac Arrest (United States)


    Cardiac Arrest; Long QT Syndrome; Brugada Syndrome; Catecholaminergi Polymorphic Ventricular Tachycardia; Idiopathic VentricularFibrillation; Early Repolarization Syndrome; Arrhythmogenic Right Ventricular Cardiomyopathy

  11. Understand Your Risk for Cardiac Arrest (United States)

    ... Thromboembolism Aortic Aneurysm More Understand Your Risk for Cardiac Arrest Updated:Mar 10,2017 Cardiac arrest may be ... arrest. This content was last reviewed March 2017. Cardiac Arrest • Home • About Cardiac Arrest • Understand Your Risk for ...

  12. ECPR for Refractory Out-Of-Hospital Cardiac Arrest (United States)


    Cardiac Arrest; Heart Arrest; Sudden Cardiac Arrest; Cardiopulmonary Arrest; Death, Sudden, Cardiac; Cardiopulmonary Resuscitation; CPR; Extracorporeal Cardiopulmonary Resuscitation; Extracorporeal Membrane Oxygenation

  13. Adaptation of warrant price with Black Scholes model and historical volatility (United States)

    Aziz, Khairu Azlan Abd; Idris, Mohd Fazril Izhar Mohd; Saian, Rizauddin; Daud, Wan Suhana Wan


    This project discusses about pricing warrant in Malaysia. The Black Scholes model with non-dividend approach and linear interpolation technique was applied in pricing the call warrant. Three call warrants that are listed in Bursa Malaysia were selected randomly from UiTM's datastream. The finding claims that the volatility for each call warrants are different to each other. We have used the historical volatility which will describes the price movement by which an underlying share is expected to fluctuate within a period. The Black Scholes model price that was obtained by the model will be compared with the actual market price. Mispricing the call warrants will contribute to under or over valuation price. Other variables like interest rate, time to maturity date, exercise price and underlying stock price are involves in pricing call warrants as well as measuring the moneyness of call warrants.

  14. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani


    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  15. Cardiac Arrest: MedlinePlus Health Topic (United States)

    ... and Blood Institute Start Here About Cardiac Arrest (American Heart Association) Sudden Cardiac Arrest (Texas Heart Institute) Also in ... Blood Institute) Understand Your Risk for Cardiac Arrest (American Heart Association) Warning Signs of Heart Attack, Stroke and Cardiac ...

  16. Phenolic Fractions from Muscadine Grape "Noble" Pomace can Inhibit Breast Cancer Cell MDA-MB-231 Better than those from European Grape "Cabernet Sauvignon" and Induce S-Phase Arrest and Apoptosis. (United States)

    Luo, Jianming; Wei, Zheng; Zhang, Shengyu; Peng, Xichun; Huang, Yu; Zhang, Yali; Lu, Jiang


    Tons of grape pomace which still contained a rich amount of plant polyphenols, is discarded after winemaking. Plant polyphenols have multi-functional activities for human body. In this study, polyphenols of pomaces from Muscadinia rotundifolia "Noble" and Vitis vinifera "Cabernet Sauvignon" were extracted and fractionated, and then they were analyzed with LC-MS and the inhibitory effects on breast cancer cells were compared. The inhibition on MDA-MB-231 cells of fractions from "Noble" was further evaluated. The results showed that polyphenols from 2 grape pomaces could be separated into 3 fractions, and ellagic acid and/or ellagitannins were only detected in fractions from "Noble" pomace. All 3 fractions from "Noble" pomace inhibited MDA-MB-231 better than MCF-7. But fraction 2 from "Cabernet Sauvignon" inhibited MCF-7 better while fraction 1 and fraction 3 inhibited both 2 cells similarly. Moreover, the fractions from "Noble" pomace rather than "Cabernet Sauvignon" can inhibit MDA-MB-231 better. Finally, fractions from "Noble" pomace can induce S-phase arrest and apoptosis on MDA-MB-231. These findings suggested the extracts from grape pomace especially those from "Noble," are potential to be utilized as health beneficial products or even anti-breast cancer agents. © 2017 Institute of Food Technologists®.

  17. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. (United States)

    Perkins, Gavin D; Jacobs, Ian G; Nadkarni, Vinay M; Berg, Robert A; Bhanji, Farhan; Biarent, Dominique; Bossaert, Leo L; Brett, Stephen J; Chamberlain, Douglas; de Caen, Allan R; Deakin, Charles D; Finn, Judith C; Gräsner, Jan-Thorsten; Hazinski, Mary Fran; Iwami, Taku; Koster, Rudolph W; Lim, Swee Han; Huei-Ming Ma, Matthew; McNally, Bryan F; Morley, Peter T; Morrison, Laurie J; Monsieurs, Koenraad G; Montgomery, William; Nichol, Graham; Okada, Kazuo; Eng Hock Ong, Marcus; Travers, Andrew H; Nolan, Jerry P


    Utstein-style guidelines contribute to improved public health internationally by providing a structured framework with which to compare emergency medical services systems. Advances in resuscitation science, new insights into important predictors of outcome from out-of-hospital cardiac arrest, and lessons learned from methodological research prompted this review and update of the 2004 Utstein guidelines. Representatives of the International Liaison Committee on Resuscitation developed an updated Utstein reporting framework iteratively by meeting face to face, by teleconference, and by Web survey during 2012 through 2014. Herein are recommendations for reporting out-of-hospital cardiac arrest. Data elements were grouped by system factors, dispatch/recognition, patient variables, resuscitation/postresuscitation processes, and outcomes. Elements were classified as core or supplemental using a modified Delphi process primarily based on respondents' assessment of the evidence-based importance of capturing those elements, tempered by the challenges to collect them. New or modified elements reflected consensus on the need to account for emergency medical services system factors, increasing availability of automated external defibrillators, data collection processes, epidemiology trends, increasing use of dispatcher-assisted cardiopulmonary resuscitation, emerging field treatments, postresuscitation care, prognostication tools, and trends in organ recovery. A standard reporting template is recommended to promote standardized reporting. This template facilitates reporting of the bystander-witnessed, shockable rhythm as a measure of emergency medical services system efficacy and all emergency medical services system-treated arrests as a measure of system effectiveness. Several additional important subgroups are identified that enable an estimate of the specific contribution of rhythm and bystander actions that are key determinants of outcome. © 2014 by the American Heart

  18. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore


    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  19. An airline cardiac arrest program

    National Research Council Canada - National Science Library

    O'Rourke, M F; Donaldson, E; Geddes, J S


    ...) available for use on airline passengers with cardiac arrest. AEDs were installed on international Qantas aircraft and at major terminals, selected crew were trained in their use, and all crew members were trained in cardiopulmonary resuscitation...

  20. Homotopy Analysis Method for Boundary-Value Problem of Turbo Warrant Pricing under Stochastic Volatility

    Directory of Open Access Journals (Sweden)

    Hoi Ying Wong


    Full Text Available Turbo warrants are liquidly traded financial derivative securities in over-the-counter and exchange markets in Asia and Europe. The structure of turbo warrants is similar to barrier options, but a lookback rebate will be paid if the barrier is crossed by the underlying asset price. Therefore, the turbo warrant price satisfies a partial differential equation (PDE with a boundary condition that depends on another boundary-value problem (BVP of PDE. Due to the highly complicated structure of turbo warrants, their valuation presents a challenging problem in the field of financial mathematics. This paper applies the homotopy analysis method to construct an analytic pricing formula for turbo warrants under stochastic volatility in a PDE framework.

  1. Intra-arrest hypothermia during cardiac arrest: a systematic review (United States)


    Introduction Therapeutic hypothermia is largely used to protect the brain following return of spontaneous circulation (ROSC) after cardiac arrest (CA), but it is unclear whether we should start therapeutic hypothermia earlier, that is, before ROSC. Methods We performed a systematic search of PubMed, EMBASE, CINAHL, the Cochrane Library and Ovid/Medline databases using "arrest" OR "cardiac arrest" OR "heart arrest" AND "hypothermia" OR "therapeutic hypothermia" OR "cooling" as keywords. Only studies using intra-arrest therapeutic hypothermia (IATH) were selected for this review. Three authors independently assessed the validity of included studies and extracted data regarding characteristics of the studied cohort (animal or human) and the main outcomes related to the use of IATH: Mortality, neurological status and cardiac function (particularly, rate of ROSC). Results A total of 23 animal studies (level of evidence (LOE) 5) and five human studies, including one randomized controlled trial (LOE 1), one retrospective and one prospective controlled study (LOE 3), and two prospective studies without a control group (LOE 4), were identified. IATH improved survival and neurological outcomes when compared to normothermia and/or hypothermia after ROSC. IATH was also associated with improved ROSC rates and with improved cardiac function, including better left ventricular function, and reduced myocardial infarct size, when compared to normothermia. Conclusions IATH improves survival and neurological outcome when compared to normothermia and/or conventional hypothermia in experimental models of CA. Clinical data on the efficacy of IATH remain limited. PMID:22397519

  2. Warrants, design, and safety of road ranger service patrols : draft final report. (United States)


    This research project created a decision support system for managers who must decide if a roadway warrants the addition of the Safety Service Patrol (SSP). Meetings with Florida Department of Transportation (FDOT) service patrol program manager...

  3. Assessing the Hemodynamic Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Traumatic Cardiac Arrest When Closed Chest Compressions are Augmented by Directing the Area of Maximal Compression Over the Left Ventricle in a Swine Model (sus scrofa) (United States)


    Assessing the hemodynamic effects of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in traumatic cardiac arrest when closed...groups with REBOA. 7. How may your findings benefit the Air Force? Survival of military traumatic cardiopulmonary arrest (TCPA) victims is low...Although a statistically significant difference was not determined in this study, the trend of increased survival definitely warrants further study

  4. Problems of house arrest application

    Directory of Open Access Journals (Sweden)

    Mikhail Vladimirovich Kolesnikov


    Full Text Available Objective to determine the position of house arrest in the system of preventive measures and to identify the main problems of criminal procedural regulation that prevent its broader use during the preliminary investigation and trial. Methods dialectical approach to the analysis of social phenomena allowing to view them in static and dynamic aspect evolutionarysynergetic paradigm providing the opportunity to explore the phenomenon under investigation with respect to the system subordinate and coordinating relationships within the system. Dialectical approach and the evolutionarysynergetic paradigm determined the choice of specific methods of research historical comparative law comparative formallegal statistical. Results the problems arising with application of house arrest are grouped by author depending on the structure of the provisions of Article 107 of the CriminalProcedural Code of the Russian Federation. The first group of problems includes the determination of the location of the accused suspect under house arrest and the scope of the legal restrictions imposed. The second group includes the establishment of terms of house arrest and their subsequent renewal or change of the preventive measure. The third group is the identification of persons to which the house arrest will be the best preventive measure. The results of the study allow to make proposals to change the current wording of Art. 107 of the CriminalProcedural Code of Russia. Scientific novelty a comprehensive study of current state of the normativelegal regulation of house arrest in the context of its practical application. Practical value the main provisions and conclusions of the article can be used in scientific and pedagogical activity when considering questions about the nature of preventive measures related to the restraint of personal liberty of the accused. nbsp

  5. Sudden Cardiac Arrest (SCA) Risk Assessment (United States)

    ... Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without warning, and two- ... and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool is supported in part ...

  6. DUI Arrests and Academic Attrition (United States)

    Thompson, Kevin M.; Richardson, Katie


    A sobering 2002 study reported that over 2 million college students drove under the influence of alcohol (DUI) in 1999. Among those driving while intoxicated, approximately 1.7% or roughly 34,000 students reported being arrested on DUI charges. Regrettably, a significant proportion of the 1,400 college student deaths and 500,000 injuries are…

  7. An airline cardiac arrest program. (United States)

    O'Rourke, M F; Donaldson, E; Geddes, J S


    As many as 1000 lives are lost annually from cardiac arrest in commercial aircraft. Ventricular fibrillation (VF), the most common mechanism, can be treated effectively only with prompt defibrillation, whereas the current policy of most airlines is to continue cardiopulmonary resuscitation pending aircraft diversion. The objective of this study was to assess the impact of making semiautomatic external defibrillators (AEDs) available for use on airline passengers with cardiac arrest. AEDs were installed on international Qantas aircraft and at major terminals, selected crew were trained in their use, and all crew members were trained in cardiopulmonary resuscitation. Supervision was provided by medical volunteers or (remotely) by airline physicians. During a 64-month period, AEDs were used on 109 occasions: 63 times for monitoring an acutely ill passenger and 46 times for cardiac arrest. Twenty-seven episodes of cardiac arrest occurred in aircraft, often (11 of 27 [41%]) unwitnessed, and they were usually (21 of 27 [78%]) associated with asystole or pulseless idioventricular rhythm. All 19 arrests in terminals were witnessed; VF was present in 17 (89%). Overall, defibrillation was initially successful in 21 of 23 cases (91%). Long-term survival from VF was achieved in 26% (2 of 6 in aircraft and 4 of 17 in terminals). The ability to monitor cardiac rhythm aided decisions on diversion, which was avoided in most passengers with asystole or idioventricular rhythm. AEDs in aircraft and terminals, with appropriate crew training, are helpful in the management of cardiac emergencies. Survival from VF is practicable and is comparable with the most effective prehospital ambulance emergency services. Costly aircraft diversions can be avoided in clearly futile situations, enhancing the cost-effectiveness of the program.

  8. Cardiac arrest: resuscitation and reperfusion. (United States)

    Patil, Kaustubha D; Halperin, Henry R; Becker, Lance B


    The modern treatment of cardiac arrest is an increasingly complex medical procedure with a rapidly changing array of therapeutic approaches designed to restore life to victims of sudden death. The 2 primary goals of providing artificial circulation and defibrillation to halt ventricular fibrillation remain of paramount importance for saving lives. They have undergone significant improvements in technology and dissemination into the community subsequent to their establishment 60 years ago. The evolution of artificial circulation includes efforts to optimize manual cardiopulmonary resuscitation, external mechanical cardiopulmonary resuscitation devices designed to augment circulation, and may soon advance further into the rapid deployment of specially designed internal emergency cardiopulmonary bypass devices. The development of defibrillation technologies has progressed from bulky internal defibrillators paddles applied directly to the heart, to manually controlled external defibrillators, to automatic external defibrillators that can now be obtained over-the-counter for widespread use in the community or home. But the modern treatment of cardiac arrest now involves more than merely providing circulation and defibrillation. As suggested by a 3-phase model of treatment, newer approaches targeting patients who have had a more prolonged cardiac arrest include treatment of the metabolic phase of cardiac arrest with therapeutic hypothermia, agents to treat or prevent reperfusion injury, new strategies specifically focused on pulseless electric activity, which is the presenting rhythm in at least one third of cardiac arrests, and aggressive post resuscitation care. There are discoveries at the cellular and molecular level about ischemia and reperfusion pathobiology that may be translated into future new therapies. On the near horizon is the combination of advanced cardiopulmonary bypass plus a cocktail of multiple agents targeted at restoration of normal metabolism and

  9. Who Is at Risk for Sudden Cardiac Arrest? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  10. How Can Death Due to Sudden Cardiac Arrest Be Prevented? (United States)

    ... Back To Health Topics / Sudden Cardiac Arrest Sudden Cardiac Arrest Also known as Cardiac Arrest , Sudden Cardiac Death ... the condition For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're ...

  11. Police Response to Mandatory Arrest Laws. (United States)

    Mignon, Sylvia I.; Holmes, William M.


    Examines how police officers in 24 departments have responded to mandatory arrest statutes in 861 cases of domestic violence. Arrests of offenders, especially those violating restraining orders, increased. Arrest was affected by victim injury, use of a weapon, use of alcohol, and presence of a witness. Police training was crucial to implementation…

  12. Intraday Trading Patterns in the Equity Warrants and Equity Options Markets: Australian Evidence

    Directory of Open Access Journals (Sweden)

    Lydia Segara


    Full Text Available This paper extends the microstructure literature, by examining the previouslyundocumented intraday trading patterns in trading volume, price volatility, order depthand relative spreads for both the warrant and option market in Australia. Comparisons ofintraday variations across these derivative securities allows for insight to be drawn intocompeting market microstructure theories and provides the opportunity to examinewhether market design differences explain variations in observed intraday patterns. Wefind that intraday trading patterns documented in the warrant and option markets can beexplained by their market designs, along with theories relating to time-varying informationasymmetry and time-varying hedging trades around nontrading periods.

  13. National Board Certified Physical Educators: Background Characteristics, Subjective Warrants, and Motivations (United States)

    Woods, Amelia Mays; Rhoades, Jesse Lee


    This study examined National Board Certified Physical Education Teacher's (NBCPETs) demographic characteristics, recalled subjective warrants for entrance into the profession, and reasons for seeking this advanced certification. An extensive search for approximately 1,200 NBCPETs resulted in contact information for 819 NBCPETs. All were sent a…

  14. 28 CFR 2.212 - Execution of warrant and service of summons. (United States)


    ... Supervised Releasees § 2.212 Execution of warrant and service of summons. (a) Any officer of any Federal or District of Columbia correctional institution, any Federal Officer authorized to serve criminal process, or any officer or designated civilian employee of the Metropolitan Police Department of the District of...

  15. Show me the goods: The warranting effect of user-generated photographs in online auctions

    NARCIS (Netherlands)

    Johnson, B.K.; Vang, M.H.; van der Heide, B.


    Consumers using online auction websites face the challenge of appraising products at a distance. Sellers and buyers in online auctions navigate this challenge by displaying and evaluating various cues, a critical one being use of photographs. Warranting theory predicts that cues less subject to

  16. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

    DEFF Research Database (Denmark)

    Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.


    2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...

  17. Improved survival after an out-of-hospital cardiac arrest using new guidelines

    DEFF Research Database (Denmark)

    Steinmetz, Jacob; Barnung, S.; Nielsen, S.L.


    BACKGROUND: An out-of-hospital cardiac arrest (OHCA) is associated with a poor prognosis. We hypothesized that the implementations of 2005 European Resuscitation Council resuscitation guidelines were associated with improved 30-day survival after OHCA. METHODS: We prospectively recorded data on all...

  18. Clinical Trials in Cardiac Arrest and Subarachnoid Hemorrhage: Lessons from the Past and Ideas for the Future

    Directory of Open Access Journals (Sweden)

    Jennifer A. Frontera


    Full Text Available Introduction. Elevated intracranial pressure that occurs at the time of cerebral aneurysm rupture can lead to inadequate cerebral blood flow, which may mimic the brain injury cascade that occurs after cardiac arrest. Insights from clinical trials in cardiac arrest may provide direction for future early brain injury research after subarachnoid hemorrhage (SAH. Methods. A search of PubMed from 1980 to 2012 and was conducted to identify published and ongoing randomized clinical trials in aneurysmal SAH and cardiac arrest patients. Only English, adult, human studies with primary or secondary mortality or neurological outcomes were included. Results. A total of 142 trials (82 SAH, 60 cardiac arrest met the review criteria (103 published, 39 ongoing. The majority of both published and ongoing SAH trials focus on delayed secondary insults after SAH (70%, while 100% of cardiac arrest trials tested interventions within the first few hours of ictus. No SAH trials addressing treatment of early brain injury were identified. Twenty-nine percent of SAH and 13% of cardiac arrest trials showed outcome benefit, though there is no overlap mechanistically. Conclusions. Clinical trials in SAH assessing acute brain injury are warranted and successful interventions identified by the cardiac arrest literature may be reasonable targets of the study.

  19. A review on Black-Scholes model in pricing warrants in Bursa Malaysia (United States)

    Gunawan, Nur Izzaty Ilmiah Indra; Ibrahim, Siti Nur Iqmal; Rahim, Norhuda Abdul


    This paper studies the accuracy of the Black-Scholes (BS) model and the dilution-adjusted Black-Scholes (DABS) model to pricing some warrants traded in the Malaysian market. Mean Absolute Error (MAE) and Mean Absolute Percentage Error (MAPE) are used to compare the two models. Results show that the DABS model is more accurate than the BS model for the selected data.

  20. The Recruitment and Retention of the 180A: The Special Forces Warrant Officer (United States)


    assessment process that utilizes grounded theory (Glaser & Strauss 1967; Strauss 1995) to gather in-depth insights in conditions affecting the decline...Warrant Officer. Research Report 1851. U.S. Army Research Institute. Glaser, B., & Strauss , A. (1967). The discovery of grounded theory : Strategies...POTENTIAL REMEDIES Assessment of the collected data were initially analyzed using grounded theory to identify the range of concepts and themes within the

  1. Analyzing problem solving using math in physics: Epistemological framing via warrants (United States)

    Bing, Thomas J.; Redish, Edward F.


    Developing expertise in physics entails learning to use mathematics effectively and efficiently as applied to the context of physical situations. Doing so involves coordinating a variety of concepts and skills including mathematical processing, computation, blending ancillary information with the math, and reading out physical implications from the math and vice versa. From videotaped observations of intermediate level students solving problems in groups, we note that students often “get stuck” using a limited group of skills or reasoning and fail to notice that a different set of tools (which they possess and know how to use effectively) could quickly and easily solve their problem. We refer to a student’s perception or judgment of the kind of knowledge that is appropriate to bring to bear in a particular situation as epistemological framing. Although epistemological framing is often unstated (and even unconscious), in group problem-solving situations students sometimes get into disagreements about how to progress. During these disagreements, they bring forth reasons or warrants in support of their point of view. For the context of mathematics use in physics problem solving, we present a system for classifying physics students’ warrants and analyze a case study. This warrant analysis provides a general widely applicable technique for identifying students’ epistemological framings.

  2. Analyzing problem solving using math in physics: Epistemological framing via warrants

    Directory of Open Access Journals (Sweden)

    Thomas J. Bing


    Full Text Available Developing expertise in physics entails learning to use mathematics effectively and efficiently as applied to the context of physical situations. Doing so involves coordinating a variety of concepts and skills including mathematical processing, computation, blending ancillary information with the math, and reading out physical implications from the math and vice versa. From videotaped observations of intermediate level students solving problems in groups, we note that students often “get stuck” using a limited group of skills or reasoning and fail to notice that a different set of tools (which they possess and know how to use effectively could quickly and easily solve their problem. We refer to a student’s perception or judgment of the kind of knowledge that is appropriate to bring to bear in a particular situation as epistemological framing. Although epistemological framing is often unstated (and even unconscious, in group problem-solving situations students sometimes get into disagreements about how to progress. During these disagreements, they bring forth reasons or warrants in support of their point of view. For the context of mathematics use in physics problem solving, we present a system for classifying physics students’ warrants and analyze a case study. This warrant analysis provides a general widely applicable technique for identifying students’ epistemological framings.

  3. Out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Sondergaard, Kathrine B; Hansen, Steen Moller; Pallisgaard, Jannik L


    : We used data from the nationwide Danish Cardiac Arrest Registry and the Danish AED Network to identify out-of-hospital cardiac arrests and route distances to nearest accessible registered AED during 2008-2013. The association between route distance and bystander defibrillation was described using...... restricted cubic spline logistic regression. RESULTS: We included 6,971 out-of-hospital cardiac arrest cases. The proportion of arrests according to distance in meters (≤100, 101-200, >200) to the nearest accessible AED was: 4.6% (n=320), 5.3% (n=370), and 90.1% (n=6,281), respectively. For cardiac arrests......meters route distance from cardiac arrest to nearest accessible AED whereas the probability of bystander defibrillation was low for all distances in residential areas....

  4. Politics and Policies of Promoting Multilingualism in the European Union (United States)

    Romaine, Suzanne


    This article examines the politics of policies promoting multilingualism in the European Union (EU), specifically in light of the recently released European Union Civil Society Platform on Multilingualism. As the most far-reaching and ambitious policy document issued by the European Commission, the Platform warrants close scrutiny at a significant…

  5. Prediction of cardiac arrest recurrence using ensemble classifiers

    Indian Academy of Sciences (India)

    Inability of a heart to contract effectually or its failure to contract prevents blood from circulating efficiently, causing circulatory arrest or cardiac arrest or cardiopulmonary arrest. The unexpected cardiac arrest is medically referred to as sudden cardiac arrest (SCA). Poor survival rate of patients with SCA is one of themost ...

  6. 10 CFR 1047.4 - Arrest authority. (United States)


    ... OF ENERGY (GENERAL PROVISIONS) LIMITED ARREST AUTHORITY AND USE OF FORCE BY PROTECTIVE FORCE OFFICERS General Provisions § 1047.4 Arrest authority. (a) Under the Act, the authority of a DOE protective force... badges, identification cards, other insignia—18 U.S.C. 701—(pertains to the manufacture, sale, and...

  7. Psychopathology in Women Arrested for Domestic Violence (United States)

    Stuart, Gregory L.; Moore, Todd M.; Gordon, Kristina Coop; Ramsey, Susan E.; Kahler, Christopher W.


    This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N=103) completed measures of IPV…

  8. Diagnosing true virtue? Remote scenarios, warranted virtue attributions, and virtuous medical practice. (United States)

    Oakley, Justin


    Immanuel Kant argues in the Foundations that remote scenarios are diagnostic of genuine virtue. When agents commonly thought to have a particular virtue fail to exhibit that virtue in an extreme situation, he argues, they do not truly have the virtue at all, and our propensities to fail in such ways indicate that true virtue might never have existed. Kant's suggestion that failure to show, say, courage in extraordinary circumstances necessarily silences one's claim to have genuine courage seems to rely on an implausibly demanding standard for warranted virtue attributions. In contrast to this approach, some philosophers-such as Robert Adams and John Doris-have argued for probabilistic accounts of warranted virtue attributions. But despite the initial plausibility of such accounts, I argue that a sole reliance on probabilistic approaches is inadequate, as they are insufficiently sensitive to considerations of credit and fault, which emerge when agents have developed various insurance strategies and protective capacities against their responding poorly to particular eventualities. I also argue that medical graduates should develop the sorts of virtuous dispositions necessary to protect patient welfare against various countervailing influences (even where such influences might be encountered only rarely), and that repeated failures to uphold the proper goals of medicine in emergency scenarios might indeed be diagnostic of whether an individual practitioner does have the relevant medical virtue. In closing, I consider the dispositions involved in friendship. I seek to develop a principled way of determining when remote scenarios can be illuminating of genuine friendship and genuine virtue.

  9. Digital Watermarking Method Warranting the Lower Limit of Image Quality of Watermarked Images

    Directory of Open Access Journals (Sweden)

    Iwata Motoi


    Full Text Available We propose a digital watermarking method warranting the lower limit of the image quality of watermarked images. The proposed method controls the degradation of a watermarked image by using a lower limit image. The lower limit image means the image of the worst quality that users can permit. The proposed method accepts any lower limit image and does not require it at extraction. Therefore lower limit images can be decided flexibly. In this paper, we introduce 2-dimensional human visual MTF model as an example of obtaining lower limit images. Also we use JPEG-compressed images of quality 75% and 50% as lower limit images. We investigate the performance of the proposed method by experiments. Moreover we compare the proposed method using three types of lower limit images with the existing method in view of the tradeoff between PSNR and the robustness against JPEG compression.

  10. Is screening for renal anomalies warranted in neonates with isolated single umbilical artery? (United States)

    de Boom, M L; Kist-van Holthe, J E; Sramek, A; Lardenoye, S W J; Walther, F J; Lopriore, E


    To determine the prevalence of renal anomalies in patients with an isolated single umbilical artery (SUA). We performed a retrospective study of all renal ultrasound examinations assessed at our centre between January 1998 and December 2008 in neonates with SUA with or without associated anomalies. Renal ultrasound examination was performed in 65 neonates with SUA (57 neonates with isolated SUA and 8 neonates with nonisolated SUA). The prevalence of renal anomalies in the group with and without isolated SUA was 2% (1/57) and 38% (3/8), respectively. Only one patient with isolated SUA had a mild renal abnormality without clinical consequences. The prevalence of renal anomalies in neonates with isolated SUA is low. We suggest that routine ultrasound screening for renal anomalies is not warranted in neonates with isolated SUA. Copyright 2009 S. Karger AG, Basel.

  11. Myocardial Dysfunction and Shock after Cardiac Arrest (United States)

    Jentzer, Jacob C.; Chonde, Meshe D.; Dezfulian, Cameron


    Postarrest myocardial dysfunction includes the development of low cardiac output or ventricular systolic or diastolic dysfunction after cardiac arrest. Impaired left ventricular systolic function is reported in nearly two-thirds of patients resuscitated after cardiac arrest. Hypotension and shock requiring vasopressor support are similarly common after cardiac arrest. Whereas shock requiring vasopressor support is consistently associated with an adverse outcome after cardiac arrest, the association between myocardial dysfunction and outcomes is less clear. Myocardial dysfunction and shock after cardiac arrest develop as the result of preexisting cardiac pathology with multiple superimposed insults from resuscitation. The pathophysiology involves cardiovascular ischemia/reperfusion injury and cardiovascular toxicity from excessive levels of inflammatory cytokine activation and catecholamines, among other contributing factors. Similar mechanisms occur in myocardial dysfunction after cardiopulmonary bypass, in sepsis, and in stress-induced cardiomyopathy. Hemodynamic stabilization after resuscitation from cardiac arrest involves restoration of preload, vasopressors to support arterial pressure, and inotropic support if needed to reverse the effects of myocardial dysfunction and improve systemic perfusion. Further research is needed to define the role of postarrest myocardial dysfunction on cardiac arrest outcomes and identify therapeutic strategies. PMID:26421284

  12. Extracorporeal membrane oxygenation for refractory cardiac arrest

    Directory of Open Access Journals (Sweden)

    Steven A Conrad


    Full Text Available Extracorporeal cardiopulmonary resuscitation (ECPR is the use of rapid deployment venoarterial (VA extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR. Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates. Percutaneous cannulation where feasible is rapid and can be performed by nonsurgeons (emergency physicians, intensivists, cardiologists, and interventional radiologists. Modern extracorporeal systems are easy to prime and manage and are technically easy to manage with proper training and experience. ECPR can be deployed in the emergency department for out-of-hospital arrest or in various inpatient units for in-hospital arrest. ECPR should be considered for patients with refractory cardiac arrest in hospitals with an existing extracorporeal life support program, able to provide rapid deployment of support, and with resources to provide postresuscitation evaluation and management.

  13. Chromosomal Aneuploidies and Early Embryonic Developmental Arrest

    Directory of Open Access Journals (Sweden)

    Maria Maurer


    Full Text Available Background: Selecting the best embryo for transfer, with the highest chance of achieving a vital pregnancy, is a major goal in current in vitro fertilization (IVF technology. The high rate of embryonic developmental arrest during IVF treatment is one of the limitations in achieving this goal. Chromosomal abnormalities are possibly linked with chromosomal arrest and selection against abnormal fertilization products. The objective of this study was to evaluate the frequency and type of chromosomal abnormalities in preimplantation embryos with developmental arrest. Materials and Methods: This cohort study included blastomeres of embryos with early developmental arrest that were biopsied and analyzed by fluorescence in-situ hybridization (FISH with probes for chromosomes 13, 16, 18, 21 and 22. Forty-five couples undergoing IVF treatment were included, and 119 arrested embryos were biopsied. All probes were obtained from the Kinderwunsch Zentrum, Linz, Austria, between August 2009 and August 2011. Results: Of these embryos, 31.6% were normal for all chromosomes tested, and 68.4% were abnormal. Eleven embryos were uniformly aneuploid, 20 were polyploid, 3 were haploid, 11 displayed mosaicism and 22 embryos exhibited chaotic chromosomal complement. Conclusion: Nearly 70% of arrested embryos exhibit chromosomal errors, making chromosomal abnormalities a major cause of embryonic arrest and may be a further explanation for the high developmental failure rates during culture of the embryos in the IVF setting.

  14. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa). (United States)

    Jacobs, Ian; Nadkarni, Vinay; Bahr, Jan; Berg, Robert A; Billi, John E; Bossaert, Leo; Cassan, Pascal; Coovadia, Ashraf; D'Este, Kate; Finn, Judith; Halperin, Henry; Handley, Anthony; Herlitz, Johan; Hickey, Robert; Idris, Ahamed; Kloeck, Walter; Larkin, Gregory Luke; Mancini, Mary Elizabeth; Mason, Pip; Mears, Gregory; Monsieurs, Koenraad; Montgomery, William; Morley, Peter; Nichol, Graham; Nolan, Jerry; Okada, Kazuo; Perlman, Jeffrey; Shuster, Michael; Steen, Petter Andreas; Sterz, Fritz; Tibballs, James; Timerman, Sergio; Truitt, Tanya; Zideman, David


    Outcome following cardiac arrest and cardiopulmonary resuscitation is dependent on critical interventions, particularly early defibrillation, effective chest compressions, and advanced life support. Utstein-style definitions and reporting templates have been used extensively in published studies of cardiac arrest, which has led to greater understanding of the elements of resuscitation practice and progress toward international consensus on science and resuscitation guidelines. Despite the development of Utstein templates to standardize research reports of cardiac arrest, international registries have yet to be developed. In April 2002 a task force of ILCOR met in Melbourne, Australia, to review worldwide experience with the Utstein definitions and reporting templates. The task force revised the core reporting template and definitions by consensus. Care was taken to build on previous definitions, changing data elements and operational definitions only on the basis of published data and experience derived from those registries that have used Utstein-style reporting. Attention was focused on decreasing the complexity of the existing templates and addressing logistical difficulties in collecting specific core and supplementary (i.e., essential and desirable) data elements recommended by previous Utstein consensus conference. Inconsistencies in terminology between in-hospital and out-of-hospital Utstein templates were also addressed. The task force produced a reporting tool for essential data that can be used for both quality improvement (registries) and research reports and that should be applicable to both adults and children. The revised and simplified template includes practical and succinct operational definitions. It is anticipated that the revised template will enable better and more accurate completion of all reports of cardiac arrest and resuscitation attempts. Problems with data definition, collection, linkage, confidentiality, management, and registry

  15. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Councils of Southern Africa). (United States)

    Jacobs, Ian; Nadkarni, Vinay; Bahr, Jan; Berg, Robert A; Billi, John E; Bossaert, Leo; Cassan, Pascal; Coovadia, Ashraf; D'Este, Kate; Finn, Judith; Halperin, Henry; Handley, Anthony; Herlitz, Johan; Hickey, Robert; Idris, Ahamed; Kloeck, Walter; Larkin, Gregory Luke; Mancini, Mary Elizabeth; Mason, Pip; Mears, Gregory; Monsieurs, Koenraad; Montgomery, William; Morley, Peter; Nichol, Graham; Nolan, Jerry; Okada, Kazuo; Perlman, Jeffrey; Shuster, Michael; Steen, Petter Andreas; Sterz, Fritz; Tibballs, James; Timerman, Sergio; Truitt, Tanya; Zideman, David


    Outcome after cardiac arrest and cardiopulmonary resuscitation is dependent on critical interventions, particularly early defibrillation, effective chest compressions, and advanced life support. Utstein-style definitions and reporting templates have been used extensively in published studies of cardiac arrest, which has led to greater understanding of the elements of resuscitation practice and progress toward international consensus on science and resuscitation guidelines. Despite the development of Utstein templates to standardize research reports of cardiac arrest, international registries have yet to be developed. In April 2002, a task force of the International Liaison Committee on Resuscitation (ILCOR) met in Melbourne, Australia, to review worldwide experience with the Utstein definitions and reporting templates. The task force revised the core reporting template and definitions by consensus. Care was taken to build on previous definitions, changing data elements and operational definitions only on the basis of published data and experience derived from those registries that have used Utstein-style reporting. Attention was focused on decreasing the complexity of the existing templates and addressing logistical difficulties in collecting specific core and supplementary (ie, essential and desirable) data elements recommended by previous Utstein consensus conferences. Inconsistencies in terminology between in-hospital and out-of-hospital Utstein templates were also addressed. The task force produced a reporting tool for essential data that can be used for both quality improvement (registries) and research reports and that should be applicable to both adults and children. The revised and simplified template includes practical and succinct operational definitions. It is anticipated that the revised template will enable better and more accurate completion of all reports of cardiac arrest and resuscitation attempts. Problems with data definition, collection, linkage

  16. Preventing and arresting coronary atherosclerosis. (United States)

    Roberts, W C


    The good news about coronary atherosclerosis is that it takes an awful lot of plaque before symptoms of myocardial ischemia occur. The bad news is that despite the need for large quantities of plaque for symptoms to occur, nevertheless nearly half of us in the United States eventually have the necessary quantity. Atherosclerosis is infrequently hereditary in origin. Most of us get atherosclerosis because we consume too much fat, cholesterol, and calories. The consequence is an elevated ( > 150 mg/dl) serum total cholesterol level, and the higher the number is above 150, the greater is the quantity of plaque deposited in our arteries. If the serum total cholesterol level can be prevented from rising to more than 150 mg/dl, plaques are not laid down; if elevated levels are lowered to 150 mg/dl, further plaque does not form, and parts of those present may vanish. A fruit-vegetarian-starch diet is necessary as a rule to achieve the 150 mg/dl level in most adults. Lipid-lowering drugs are required in the patients with familial hypercholesterolemia and in most patients with atherosclerotic events. The best news about atherosclerosis is that it can be prevented in those without the hereditary form, and it can be arrested by lowering elevated serum total (and LDL) cholesterol to the 150 mg/dl level.

  17. Survey on current practices for neurological prognostication after cardiac arrest. (United States)

    Friberg, Hans; Cronberg, Tobias; Dünser, Martin W; Duranteau, Jacques; Horn, Janneke; Oddo, Mauro


    To investigate current practices and timing of neurological prognostication in comatose cardiac arrest patients. An anonymous questionnaire was distributed to the 8000 members of the European Society of Intensive Care Medicine during September and October 2012. The survey had 27 questions divided into three categories: background data, clinical data, decision-making and consequences. A total of 1025 respondents (13%) answered the survey with complete forms in more than 90%. Twenty per cent of respondents practiced outside of Europe. Overall, 22% answered that they had national recommendations, with the highest percentage in the Netherlands (>80%). Eighty-nine per cent used induced hypothermia (32-34 °C) for comatose cardiac arrest patients, while 11% did not. Twenty per cent had separate prognostication protocols for hypothermia patients. Seventy-nine per cent recognized that neurological examination alone is not enough to predict outcome and a similar number (76%) used additional methods. Intermittent electroencephalography (EEG), brain computed tomography (CT) scan and evoked potentials (EP) were considered most useful. Poor prognosis was defined as cerebral performance category (CPC) 3-5 (58%) or CPC 4-5 (39%) or other (3%). When prognosis was considered poor, 73% would actively withdraw intensive care while 20% would not and 7% were uncertain. National recommendations for neurological prognostication after cardiac arrest are uncommon and only one physician out of five uses a separate protocol for hypothermia treated patients. A neurological examination alone was considered insufficient to predict outcome in comatose patients and most respondents advocated a multimodal approach: EEG, brain CT and EP were considered most useful. Uncertainty regarding neurological prognostication and decisions on level of care was substantial. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Fidaxomicin for Clostridium difficile-associated diarrhoea: epidemiological method for estimation of warranted price. (United States)

    Sclar, David Alexander; Robison, Linda M; Oganov, Ambartsum M; Schmidt, Jennifer M; Bowen, Kurt A; Castillo, Leigh V


    Fidaxomicin is a macrocyclic antibiotic approved in 2011 by the US Food and Drug Administration for treatment of Clostridium difficile-associated diarrhoea (CDAD). Herein, we present an epidemiological method to estimate, on a case mix basis, and from the perspective of the US health system, the warranted (justifiable) price per day for fidaxomicin, as a percent of the wholesale acquisition cost (WAC) per day for fidaxomicin ($US280). Data from two randomized controlled studies (Optimer-003 [n = 596] and Optimer-004 [n = 509]) were used to discern the number-needed-to-treat (NNT = 7.1) for sustained clinical response. Sustained clinical response was defined as clinical response at the end of treatment, and survival without proven or suspected CDAD recurrence through 25 days beyond the end of treatment. National data for primary and secondary cases (the case mix) of CDAD (mean hospital length of stay [LOS], and mean cost) were derived from the 2009 US Healthcare Cost and Utilization Project. The method for attribution of hospital LOS for secondary cases of CDAD was derived from a study published by O'Brien et al. in 2007. Comparative regimens of vancomycin were: (i) injectable used orally, 125 mg four times daily (qid; WAC of $US6/day), with use of vancomycin hydrochloride (HCl) capsules, 125 mg qid (WAC of $US106/day) post-hospital discharge; (ii) vancomycin HCl capsules, 125 mg qid; and (iii) vancomycin HCl capsules, 250 mg qid (WAC of $US196/day). Findings are expressed in 2011 US dollars. The study perspective is that of the US health system. The warranted price per day for fidaxomicin represented 95% of the WAC per day for fidaxomicin compared with use of injectable vancomycin (orally) 125 mg qid (with subsequent use of vancomycin HCl capsules, 125 mg qid post-hospital discharge); 109% of the WAC per day for fidaxomicin compared with use of vancomycin HCl capsules, 125 mg qid; and 141% of the WAC per day for fidaxomicin when compared with use of vancomycin HCl

  19. Sex Disparities in Arrest Outcomes for Domestic Violence (United States)

    Hamilton, Melissa; Worthen, Meredith G. F.


    Domestic violence arrests have been historically focused on protecting women and children from abusive men. Arrest patterns continue to reflect this bias with more men arrested for domestic violence compared to women. Such potential gender variations in arrest patterns pave the way to the investigation of disparities by sex of the offender in…

  20. Lobaplatin arrests cell cycle progression in human hepatocellular carcinoma cells

    Directory of Open Access Journals (Sweden)

    Chen Chang-Jie


    Full Text Available Abstract Background Hepatocellular carcinoma (HCC still is a big burden for China. In recent years, the third-generation platinum compounds have been proposed as potential active agents for HCC. However, more experimental and clinical data are warranted to support the proposal. In the present study, the effect of lobaplatin was assessed in five HCC cell lines and the underlying molecular mechanisms in terms of cell cycle kinetics were explored. Methods Cytotoxicity of lobaplatin to human HCC cell lines was examined using MTT cell proliferation assay. Cell cycle distribution was determined by flow cytometry. Expression of cell cycle-regulated genes was examined at both the mRNA (RT-PCR and protein (Western blot levels. The phosphorylation status of cyclin-dependent kinases (CDKs and retinoblastoma (Rb protein was also examined using Western blot analysis. Results Lobaplatin inhibited proliferation of human HCC cells in a dose-dependent manner. For the most sensitive SMMC-7721 cells, lobaplatin arrested cell cycle progression in G1 and G2/M phases time-dependently which might be associated with the down-regulation of cyclin B, CDK1, CDC25C, phosphorylated CDK1 (pCDK1, pCDK4, Rb, E2F, and pRb, and the up-regulation of p53, p21, and p27. Conclusion Cytotoxicity of lobaplatin in human HCC cells might be due to its ability to arrest cell cycle progression which would contribute to the potential use of lobaplatin for the management of HCC.

  1. The valuation of equity warrants under the fractional Vasicek process of the short-term interest rate (United States)

    Xiao, Weilin; Zhang, Weiguo; Zhang, Xili; Chen, Xiaoyan


    Motivated by the empirical evidence of long range dependence in short-term interest rates and considering the long maturities of equity warrants, we propose the fractional Vasicek model to describe the dynamics of the short rate in the pricing environment of equity warrants. Using the partial differential equation approach, we present a valuation model for equity warrants under the assumption that the short rate follows the fractional Vasicek process. After identifying the pricing model for equity warrants, we provide the parameter estimation procedure for the proposed pricing model. Since obtaining the values of equity warrants from the proposed model needs to solve a nonlinear equation, we employ a hybrid intelligent algorithm to get around this optimization problem. Furthermore, to illustrate the practicality of our proposed model, we conduct an empirical study to ascertain the performance of our proposed model using the data from China’s warrant market and the China Foreign Exchange Trade System. The comparison of traditional models (such as the Black-Scholes model, the Noreen-Wolfson model, the Lauterbach-Schultz model, and the Ukhov model) with our proposed model is also presented. The empirical results show that the mean absolute percentage error of our pricing model is 10.30%. By contrast, the Black-Scholes model, the Noreen-Wolfson model, the Lauterbach-Schultz model, and the Ukhov model applied to the same warrant produce mean absolute errors of 35.26%, 37.67%, 33.40%, 32.81%, respectively. Thus the long memory property in stochastic interest rates cannot be ignored in determining the valuation of equity warrants.

  2. Chinese medicine treatment for menopausal symptoms in the UK health service: is a clinical trial warranted? (United States)

    Scheid, Volker; Tuffrey, Veronica; Weijburg, Thomas; Bovey, Mark; Ward, Trina


    The aims of this pilot study were to evaluate treatment effects, ascertain safety and formulate best practice Chinese medicine protocols relevant for London women suffering from menopausal symptoms. This clinical pilot study employed a case series design within a wider action-based research project. 117 perimenopausal women between 45 and 55 years of age recruited from the general population were treated for menopausal symptoms by six experienced practitioners of Chinese medicine at the Polyclinic of the University of Westminster. Practitioners were instructed to treat as near to their usual practice style as possible. This involved using Chinese herbal medicine and/or acupuncture along with dietary and lifestyle advice. A maximum of 12 treatments over 6 months was allowed per patient. The menopause specific quality of life questionnaire (MenQoL), the Greene climacteric scale, and flushing diaries were used to evaluate treatment outcomes. Liver and kidney function tests were carried out at intake and after 1, 6 and 12 treatments to evaluate the safety particularly in relation to the use of herbal medicines. Patients showed significant improvement across all domains measured by the MenQoL and Greene climacteric scales. Reduction on the MenQoL scale between first and last visit was from 4.31 to 3.27 (p<0.001) and on the Green climacteric scale from 21.01 to 13.00 (p<0.001). Study participants did not reliably complete their flushing diaries. No adverse events or abnormal liver or kidney function values were observed during the course of the study. Further research that seeks to investigate the effects observed in more detail and to evaluate them against other forms of treatment and/or no-treatment controls is warranted. This could be achieved by way of a pragmatic randomized controlled trial that evaluated Chinese medicine against orthodox medical care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Is elective vulvar plastic surgery ever warranted, and what screening should be conducted preoperatively? (United States)

    Goodman, Michael P; Bachmann, Gloria; Johnson, Crista; Fourcroy, Jean L; Goldstein, Andrew; Goldstein, Gail; Sklar, Susan


    Elective vulvar plastic surgery was the topic of a heated discussion on the list-serve of the International Society for the Study of Women's Sexual Medicine. At the suggestion of a board member, it was determined that this discussion might of interest to journal readers in the form of a published controversy. Six people with expertise and/or strong opinions in the area of vulvar health, several of whom had been involved in the earlier online discussion, were invited to submit evidence-based opinions on the topic. To provide food for thought, discussion, and possible further research in a poorly discussed area of sexual medicine. Goodman believes that patients should make their own decisions. Bachmann further states that, while that is a woman's right, she should be counseled first, because variations in looks of the vulvar region are normal. Johnson furthers this thought, discussing the requirement for counseling before performing reinfibulation surgery on victims of female genital cutting. Fourcroy emphasizes the need to base surgical procedures on safety and efficacy in the long term, and not merely opportunity at the moment. Goldstein and Goldstein state that, based on the four principles of ethical practice of medicine, vulvar plastic surgery is not always ethical, but not always unethical. Sklar pursues this thought further, pointing out specific examples in regard to the principles of ethics. Vulvar plastic surgery may be warranted only after counseling if it is still the patient's preference, provided that it is conducted in a safe manner and not solely for the purpose of performing surgery.

  4. Comparison of strategies for grading retinal images of premature infants for referral warranted retinopathy of prematurity. (United States)

    Rogers, David L; Bremer, Don L; Fellows, Rae R; Baumritter, Agnieshka; Daniel, Ebenezer; Pastilli, Max; Ying, Gui-Shang; Quinn, Graham E


    To determine the accuracy of identifying referral-warranted retinopathy of prematurity (RW-ROP, defined as any zone I ROP, stage 3 or worse, or plus disease) from retinal image sets using three grading protocols: a single optic disk-centered image, a set of 3 horizontal images, and a 5-image set. In this secondary analysis of images from the e-ROP study, a weighted sample of 250 image sets from 250 infants (125 with RW-ROP and 125 without RW-ROP) was randomly selected. The sensitivities and specificities for detecting RW-ROP and its components from a single disk center image, along with nasal and temporal retinal images, were calculated and compared with the e-ROP grading of RW-ROP of all 5 retinal images (disk center and nasal, temporal, superior, and inferior retinal images). RW-ROP was identified with a sensitivity of 11.2% (95% CI, 6.79%-17.9%) using a single disk center image, with a sensitivity of 70.4% (95% CI, 61.9%-77.9%) using 3 horizontal images, and a statistically higher sensitivity of 82.4% (95% CI, 75.0%-89.0%) using all 5 images (P = 0.002). The specificities were 100%, 86.4%, and 90.4%, respectively. For grading using 3 horizontal images, sensitivity was 14.3% for plus disease, 25% for zone I ROP, and 71.2% for stage 3 or worse compared to 40.8%, 50%, and 79.8% for grading using 5-image sets, respectively. Both a single, disk-centered, posterior pole image and 3 horizontal images were less effective than a 5-image set in determining the presence of RW-ROP on qualitative grading by trained readers. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  5. Cardiac arrest leadership: in need of resuscitation? (United States)

    Robinson, Philip S; Shall, Emma; Rakhit, Roby


    Leadership skills directly correlate with the quality of technical performance of cardiopulmonary resuscitation (CPR) and clinical outcomes. Despite an improved focus on non-technical skills in CPR training, the leadership of cardiac arrests is often variable. To assess the perceptions of leadership and team working among members of a cardiac arrest team and to evaluate future training needs. Cross-sectional survey of 102 members of a cardiac arrest team at an Acute Hospital Trust in the UK with 892 inpatient beds. Responses sought from doctors, nurses and healthcare assistants to 12 rated statements and 4 dichotomous questions. Of 102 responses, 81 (79%) were from doctors and 21 (21%) from nurses. Among specialist registrars 90% agreed or strongly agreed that there was clear leadership at all arrests compared with between 28% and 49% of nurses and junior doctors respectively. Routine omission of key leadership tasks was reported by as many as 80% of junior doctors and 50% of nurses. Almost half of respondents reported non-adherence with Advanced Life Support (ALS) guidelines. Among junior members of the team, 36% felt confident to lead an arrest and 75% would welcome further dedicated cardiac arrest leadership training. Leadership training is integrated into the ALS (Resus Council, UK) qualification. However, this paper found that in spite of this training; standards of leadership are variable. The findings suggest a pressing need for further dedicated cardiac arrest leadership training with a focus on improving key leadership tasks such as role assignment, team briefing and debriefing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  6. European communion

    DEFF Research Database (Denmark)

    Manners, Ian James


    Political theory of European union, through an engagement between political concepts and theoretical understandings, provides a means of identifying the EU as a political object. It is argued that understanding the projects, processes and products of European union, based on ‘sharing’ or ‘communion......’, provides a better means of perceiving the EU as a political object rather than terms such as ‘integration’ or ‘co-operation’. The concept of ‘European communion’ is defined as the ‘subjective sharing of relationships’, understood as the extent to which individuals or groups believe themselves to be sharing...... relations (or not), and the consequences of these beliefs for European political projects, processes and products. By exploring European communion through an engagement with contemporary political theory, using very brief illustrations from the Treaty of Lisbon, the article also suggests that European...

  7. Arrested coalescence of viscoelastic droplets: polydisperse doublets. (United States)

    Dahiya, Prerna; Caggioni, Marco; Spicer, Patrick T


    Arrested droplet coalescence produces stable anisotropic shapes and is a key mechanism for microstructure development in foods, petroleum and pharmaceutical formulations. Past work has examined the dynamic elastic arrest of coalescing monodisperse droplet doublets and developed a simple model of doublet strain as a function of physical variables. Although the work describes experimental data well, it is limited to describing same-size droplets. A new model incorporating a generalized description of doublet shape is developed to describe polydisperse doublet formation in more realistic emulsion systems. Polydisperse doublets are shown to arrest at lower strains than monodisperse doublets as a result of the smaller contribution of surface area in a given pair. Larger droplet size ratios have lower relative degrees of strain because coalescence is arrested at an earlier stage than in more monodisperse cases. Experimental observations of polydisperse doublet formation indicate that the model under-predicts arrest strains at low solid levels and small droplet sizes. The discrepancy is hypothesized to be the result of nonlinear elastic deformation at high strains.This article is part of the themed issue 'Soft interfacial materials: from fundamentals to formulation'. © 2016 The Author(s).

  8. Arrested larval development in cattle nematodes. (United States)

    Armour, J; Duncan, M


    Most economically important cattle nematodes are able to arrest their larval development within the host - entering a period of dormancy or hypobiosis. Arrested larvae have a low death rate, and large numbers can accumulate in infected cattle during the grazing season. Because of this, outbreaks of disease caused by such nematodes can occur at times when recent infection with the parasites could not have occurred, for example during winter in temperature northern climates when cattle are normally housed. The capacity to arrest is a heritable trait. It is seen as an adaptation by the parasite to avoid further development to its free-living stages during times when the climate is unsuitable for free-living survival. But levels of arrestment can vary markedly in different regions, in different cattle, and under different management regimes. Climatic factors, previous conditioning, host immune status, and farm management all seem to affect arrestment levels. In this article, James Armour and Mary Duncan review the biological basis of the phenomenon, and discuss the apparently conflicting views on how it is controlled.

  9. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest A Statement for Healthcare Professionals From a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation

    NARCIS (Netherlands)

    Perkins, Gavin D.; Jacobs, Ian G.; Nadkarni, Vinay M.; Berg, Robert A.; Bhanji, Farhan; Biarent, Dominique; Bossaert, Leo L.; Brett, Stephen J.; Chamberlain, Douglas; de Caen, Allan R.; Deakin, Charles D.; Finn, Judith C.; Gräsner, Jan-Thorsten; Hazinski, Mary Fran; Iwami, Taku; Koster, Rudolph W.; Lim, Swee Han; Ma, Matthew Huei-Ming; McNally, Bryan F.; Morley, Peter T.; Morrison, Laurie J.; Monsieurs, Koenraad G.; Montgomery, William; Nichol, Graham; Okada, Kazuo; Ong, Marcus Eng Hock; Travers, Andrew H.; Nolan, Jerry P.; Aikin, Richard P.; Böttiger, Bernd W.; Callaway, Clifton W.; Castren, Maaret K.; Eisenberg, Mickey S.; Kleinman, Monica E.; Kloeck, David A.; Kloeck, Walter G.; Mancini, Mary E.; Neumar, Robert W.; Ornato, Joseph P.; Paiva, Edison F.; Peberdy, Mary Ann; Soar, Jasmeet; Sierra, Alfredo F.; Stanton, David; Zideman, David A.; Rea, Thomas


    Utstein-style guidelines contribute to improved public health internationally by providing a structured framework with which to compare emergency medical services systems. Advances in resuscitation science, new insights into important predictors of outcome from out-of-hospital cardiac arrest, and

  10. Electronic Data Exchange within European Justice: A Good Opportunity?

    Directory of Open Access Journals (Sweden)

    Nadia Carboni


    Claim procedure, European Arrest Warrant (EAW, and the Secure cross-border exchange of sensitive data. The paper provides a description of the on-going project, showing the additional layers of complexity which affect the design and innovation of ICT when the scope of the system being created crosses not only organizational and institutional boundaries, but also national borders. When implementing their National Systems, many European countries have experienced difficulties ranging from delays to never ending design or piloting stages to more or less openly declared failures. According to the authors’ main hypothesis, and in line with a growing number of empirical studies, this complexity is caused by several factors such as technological, organisational, normative, and their intertwining. Furthermore, it provides the opportunity to begin investigating the changes deriving from such a project in terms of governance and public value of the services delivered.

  11. Miller Fisher syndrome with sinus arrest

    Directory of Open Access Journals (Sweden)

    Nobuko Shiraiwa


    Full Text Available Dysautonomia in Guillain-Barre syndrome (GBS rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

  12. Are lower TSH cutoffs in neonatal screening for congenital hypothyroidism warranted? (United States)

    Lain, Samantha; Trumpff, Caroline; Grosse, Scott D; Olivieri, Antonella; Van Vliet, Guy


    When newborn screening (NBS) for congenital hypothyroidism (CH) using thyroid-stimulating hormone (TSH) as a primary screening test was introduced, typical TSH screening cutoffs were 20-50 U/L of whole blood. Over the years, lowering of TSH cutoffs has contributed to an increased prevalence of detected CH. However, a consensus on the benefit deriving from lowering TSH cutoffs at screening is lacking. The present paper outlines arguments both for and against the lowering of TSH cutoffs at NBS. It includes a review of recently published evidence from Australia, Belgium and Italy. A section focused on economic implications of lowering TSH cutoffs is also provided. One issue that bears further examination is the extent to which mild iodine deficiency at the population level might affect the association of neonatal TSH values with cognitive and developmental outcomes. A debate on TSH cutoffs provides the opportunity to reflect on how to make NBS for CH more effective and to guarantee optimum neurocognitive development and a good quality of life to babies with mild as well as with severe CH. All authors of this debate article agree on the need to establish optimal TSH cutoffs for screening programs in various settings and to ensure the benefits of screening and access to care for newborns worldwide. © 2017 European Society of Endocrinology.

  13. Predictive factors warrant screening for obstructive sleep apnea in COPD: a Taiwan National Survey

    Directory of Open Access Journals (Sweden)

    Hang LW


    questionnaire to assess COPD symptoms and OSA risk, comorbidities, and performance of daily activities. Data from COPD cohorts with and without risk of OSA were analyzed and compared. Results: Of 6,600 interviews completed, 404 subjects fit the epidemiological case definition of COPD – an overall prevalence of 6.1% in this national sample. Data on OSA risk were available for 292 of this COPD cohort, of whom 29.5% were at risk of OSA. Compared to those without risk of OSA, those with risk of OSA were significantly more likely to have hypertension or cardiovascular disease and diabetes, had significantly higher body mass index and COPD Assessment Test scores, and reported impaired work performance and leisure activities. Conclusion: Among adults in Taiwan who fulfill epidemiologic criteria for COPD, 29.5% have coexisting risk of OSA. Comorbid hypertension or cardiovascular disease and diabetes are common and significantly more prevalent among the COPD population at risk of OSA than those who are not. OSA screening is warranted in patients with COPD with those risk factors that are more prevalent in COPD with risk of OSA than without, to target early interventions to reduce adverse cardiovascular sequelae from overlap syndrome. Keywords: cardiovascular risk, COPD, coexistent, obstructive sleep apnea, OSA, overlap syndrome

  14. European Institutions?

    NARCIS (Netherlands)

    Meacham, Darian


    The aim of this article is to sketch a phenomenological theory of political institutions and to apply it to some objections and questions raised by Pierre Manent about the project of the European Union and more specifically the question of “European Construction”, i.e. what is the aim of the

  15. Selective Europeanization

    DEFF Research Database (Denmark)

    Hoch Jovanovic, Tamara; Lynggaard, Kennet


    political contexts at the European level. We further show how the “translation” of international norms to a domestic context has worked to reinforce the original institutional setup, dating back to the mid-1950s. The translation of European-level minority policy developed in the 1990s and 2000s works most...

  16. Association between a Hospital’s Rate of Cardiac Arrest Incidence and Cardiac Arrest Survival (United States)

    Chen, Lena M.; Nallamothu, Brahmajee K.; Spertus, John A.; Li, Yan; Chan, Paul S.


    Context National efforts to measure hospital performance for cardiac arrest have focused on case survival, with the hope of improving survival after cardiac arrest. However, it is plausible that hospitals with high case-survival rates do a poor job of preventing cardiac arrests in the first place. Objective To describe the association between inpatient cardiac arrest incidence and survival rates. Design, Setting, and Patients Within a large, national registry, we identified hospitals with at least 50 adult in-hospital cardiac arrest cases between January 1, 2000 and November 30, 2009. We used multivariable hierarchical regression to evaluate the correlation between a hospital’s cardiac arrest incidence rate and its case-survival rate after adjusting for patient and hospital characteristics. Main Outcome Measure The correlation between a hospital’s incidence rate and case-survival rate for cardiac arrest. Results Of 102,153 cases at 358 hospitals, the median hospital cardiac arrest incidence rate was 4.02 per 1000 admissions (IQR: 2.95 to 5.65 per 1000 admissions), and the median hospital case-survival rate was 18.8% (IQR: 14.5% to 22.6%). In crude analyses, hospitals with higher case-survival rates also had lower cardiac arrest incidence (correlation of -0.16; P=0.003). This relationship persisted after adjusting for patient characteristics (correlation of -0.15; P=0.004). After adjusting for potential mediators of this relationship (i.e., hospital characteristics), the relationship between incidence and case-survival was attenuated (correlation of -0.07; P=0.18). The one modifiable hospital factor that most attenuated this relationship was a hospital’s nurse-to-bed ratio (correlation of -0.12; P=0.03). Conclusions Hospitals with exceptional rates of survival for in-hospital cardiac arrest are also better at preventing cardiac arrests, even after adjusting for patient case-mix. This relationship is partially mediated by measured hospital attributes

  17. Warning Signs of Heart Attack, Stroke and Cardiac Arrest (United States)


  18. Heart Attack or Sudden Cardiac Arrest: How Are They Different? (United States)

    ... Thromboembolism Aortic Aneurysm More Heart Attack or Sudden Cardiac Arrest: How Are They Different? Updated:Sep 19,2016 ... flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops ...

  19. Respiratory arrest after retrobulbar anaesthesia | Ashaye | West ...

    African Journals Online (AJOL)

    This is a report of a patient who developed respiratory arrest some minutes after retrobulbar block was given for ocular anesthesia before cataract extraction. She was managed by artificial ventilation and haemodynamic support without any cardiac or neurological sequelae. This report highlights this rare but fatal ...

  20. Cerebral dysplastic vascular malformation: a developmental arrest

    Energy Technology Data Exchange (ETDEWEB)

    Wortzman, G.; Sima, A.A.F.; Morley, T.P.


    A cryptic malformation of the brain was found to represent an arrest in vascular development. Microscopy showed plump endothelium of blood vessels, which did not have a normal lumen and consisted of solid cords of cells. The microscopic, angiographic, and computed tomographic appearance of this anomaly are discussed and compared with cavernous angiomas, arteriovenous malformations, and venous angiomas.

  1. Sudden cardiac arrest risk in young athletes

    African Journals Online (AJOL)

    Underlying cardiac abnormalities are the main cause of unexpected death in athletes on field. These abnormalities have been associated with a previous history of syncope, a family history of sudden cardiac arrest (SCA), cardiac murmur, a history of over-exhaustion post exercise and ventricular tachyarrhythmia during ...

  2. European Whiteness?

    DEFF Research Database (Denmark)

    Blaagaard, Bolette


    Born out of the United States’ (U.S.) history of slavery and segregation and intertwined with gender studies and feminism, the field of critical whiteness studies does not fit easily into a European setting and the particular historical context that entails. In order for a field of European...... critical whiteness studies to emerge, its relation to the U.S. theoretical framework, as well as the particularities of the European context need to be taken into account.. The article makes a call for a multi-layered approach to take over from the identity politics so often employed in the fields of U...

  3. Fall arrest characteristics of a scissor lift. (United States)

    Harris, James R; Powers, John R; Pan, Christopher S; Boehler, Brad


    Census of Fatal Occupational Injuries (CFOI) data indicate 306 aerial lift fatalities between 1992-2003. Seventy-eight of these fatalities specifically involved scissor lifts. Members of standards committees have requested that NIOSH conduct research to determine the effects of safety-control practices related to using fall-protection systems for scissor lifts. This research examined the structural and dynamic stability of a scissor lift subjected to fall arrest forces. This was accomplished by conducting drop tests from a scissor lift. Anchorage locations evaluated included manufacturer-supplied anchorage points on the scissor lift platform as well as mid-rail and top-rail locations. Preliminary drop tests determined that a 2400 lb maximum arrest force (MAF) could be generated by dropping 169 lb through a fall height of 36" using Nystron rope as a lanyard. The scissor lift maintained structural and dynamic stability for all drop tests when fully extended and on an incline. Anchoring a fall arrest system to either the mid-rail or top-rail is not a recommended practice by the scissor lift manufacturer. Anchor points are provided on the platform floor of the scissor lift for this purpose. However, our results demonstrate that the mid-rail and top-rail absorb substantial energy from an arrested fall and may have potential as appropriate anchorage points. Employers and workers should consider implementing fall arrest systems when using scissor lifts as part of their overall risk mitigation plan for fall injury prevention. (c) 2010 National Safety Council. Published by Elsevier Ltd. All rights reserved.

  4. Announcement effects of convertible bond loans versus warrant-bond loans : An empirical analysis for the Dutch market

    NARCIS (Netherlands)

    de Roon, F.A.; Veld, C.H.


    This study investigates the announcement effects of offerings of convertible bond loans and warrant-bond loans using data for the Dutch market. Using standard event study methodology it is found that on average stock prices show a positive but insignificant abnormal return for the announcement of a

  5. An Audit Of Perioperative Cardiac Arrest At Lagos University ...

    African Journals Online (AJOL)

    Objective: Intraoperative cardiac arrests are not uncommon and are related to both surgical and anaesthetic factors. This study aimed to examine the factors which predispose to a periopeartive cardiac arrest, to assess the appropriateness of therapy and the outcome. Materials and Methods: All perioperative cardiac arrests ...

  6. Transient Central Diabetes Insipidus and Marked Hypernatremia following Cardiorespiratory Arrest

    Directory of Open Access Journals (Sweden)

    Sahar H. Koubar


    Full Text Available Central Diabetes Insipidus is often an overlooked complication of cardiopulmonary arrest and anoxic brain injury. We report a case of transient Central Diabetes Insipidus (CDI following cardiopulmonary arrest. It developed 4 days after the arrest resulting in polyuria and marked hypernatremia of 199 mM. The latter was exacerbated by replacing the hypotonic urine by isotonic saline.

  7. Surge arresters - Part 5: Selection and application recommendations

    CERN Document Server

    International Electrotechnical Commission. Geneva


    Provides recommendations for the selection and application of surge arresters to be used in three-phase systems with nominal voltages above 1kV. It applies to non-linear resistor type gapped surge arresters as defined in IEC 60099-1 and to gapless metal-oxide surge arresters as defined in IEC 60099-4.

  8. A novel survival model of cardioplegic arrest and cardiopulmonary bypass in rats: a methodology paper

    Directory of Open Access Journals (Sweden)

    Podgoreanu Mihai V


    Full Text Available Abstract Background Given the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted. Prior research is mostly limited to either large animal models or ex vivo preparations. We developed a new in vivo survival model that combines administration of antegrade cardioplegia with endoaortic crossclamping during cardiopulmonary bypass (CPB in the rat. Methods Sprague-Dawley rats were cannulated for CPB (n = 10. With ultrasound guidance, a 3.5 mm balloon angioplasty catheter was positioned via the right common carotid artery with its tip proximal to the aortic valve. To initiate cardioplegic arrest, the balloon was inflated and cardioplegia solution injected. After 30 min of cardioplegic arrest, the balloon was deflated, ventilation resumed, and rats were weaned from CPB and recovered. To rule out any evidence of cerebral ischemia due to right carotid artery ligation, animals were neurologically tested on postoperative day 14, and their brains histologically assessed. Results Thirty minutes of cardioplegic arrest was successfully established in all animals. Functional assessment revealed no neurologic deficits, and histology demonstrated no gross neuronal damage. Conclusion This novel small animal CPB model with cardioplegic arrest allows for both the study of myocardial ischemia-reperfusion injury as well as new cardioprotective strategies. Major advantages of this model include its overall feasibility and cost effectiveness. In future experiments long-term echocardiographic outcomes as well as enzymatic, genetic, and histologic characterization of myocardial injury can be assessed. In the field of myocardial protection, rodent models will be an important avenue of research.

  9. Location of cardiac arrest and impact of pre-arrest chronic disease and medication use on survival

    DEFF Research Database (Denmark)

    Granfeldt, Asger; Wissenberg, Mads; Hansen, Steen Møller


    INTRODUCTION: Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have not accounted for pre-arrest factors such as chronic disease and medication. AIM: To investigate whether the association between cardiac arrest in a private...... location and a higher mortality can be explained by differences in chronic diseases and medication. METHODS: We identified 27,771 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001-2012). Using National Registries, we identified pre-arrest chronic disease...... and medication. To investigate the importance of cardiac arrest related factors and chronic disease and medication use we performed adjusted Cox regression analyses during day 0-7 and day 8-365 following cardiac arrest to calculate hazard ratios (HR) for death. RESULTS: Day 0-7: Un-adjusted HR for death day 0...

  10. European Security

    DEFF Research Database (Denmark)

    Møller, Bjørn

    Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"......Theoretical chapters on "Security", "Organisations" and "Regions," Historical Chapters on "Europe and Its Distinguishing Features" and on "The United Nations," "NATO," "The CSCE/OSCE and the Council of Europe" and "The European Union"...

  11. Resistin causes G1 arrest in colon cancer cells through upregulation of SOCS3. (United States)

    Singh, Snahlata; Chouhan, Surbhi; Mohammad, Naoshad; Bhat, Manoj Kumar


    Resistin, a proinflammatory cytokine, is elevated in a number of pathological disorders, including cancer. The serum resistin level in colon cancer patients is elevated and correlates with tumor grade. However, the implications of increased resistin on colon cancer cells remain unclear. In the present study, we find that resistin binds to TLR4 on colon cancer cell membrane and initiates TLR4-MyD88-dependent activation of ERK. In addition, the upregulation of SOCS3 by ERK downregulates the JAK2/TAT3 pathway and causes the arrest of cells in G1 phase. Interestingly, we observe that resistin-exposed cells survive 5-fluorouracil treatment because of a decrease in drug uptake due to the arrest of cells in G1 phase. © 2017 Federation of European Biochemical Societies.

  12. Arrest History and Intimate Partner Violence Perpetration in a Sample of Men and Women Arrested for Domestic Violence


    Shorey, Ryan C.; Ninnemann, Andrew; Elmquist, Joanna; Labrecque, Lindsay; Zucosky, Heather; Febres, Jeniimarie; Brasfield, Hope; Temple, Jeff R.; Stuart, Gregory L.


    Intimate partner violence (IPV) is a serious and prevalent problem throughout the United States. Currently, individuals arrested for domestic violence are often court mandated to batterer intervention programs (BIPs). However, little is known about the arrest histories of these individuals, especially women. The current study examined the arrest histories of men (n = 303) and women (n = 82) arrested for domestic violence and court-referred to BIPs. Results demonstrated that over 30% of the en...

  13. Using a laryngeal tube during cardiac arrest reduces "no flow time" in a manikin study: a comparison between laryngeal tube and endotracheal tube. (United States)

    Wiese, Christoph H R; Bartels, Utz; Bergmann, Anna; Bergmann, Ingo; Bahr, Jan; Graf, Bernhard M


    In 2005 the European Resuscitation Council published new guidelines for advanced life support. One of the issues was to reduce the "no flow time", which is defined as the time without chest compression in the first period of cardiac arrest. In a manikin study, we evaluated whether using the laryngeal tube instead of endotracheal intubation for airway management during cardiac arrest could reduce the "no flow time". The study was prospective and included 50 volunteers who performed standardized management of simulated cardiac arrest in a manikin. All participants had completed an obligatory course in emergency medicine but had not been specifically trained in endotracheal intubation; they were therefore designated as unfamiliar in using the endotracheal tube to secure the airway, in accordance with the definition of the European Resuscitation Council. We defined two groups for the study: the LT group, who used the laryngeal tube to secure the airway; and the ET group, who used the endotracheal tube and bag-mask ventilation to ventilate the manikin. The participants were initially randomly assigned to one of the groups and thereafter completed the other scenario. Study endpoints were the total "no flow time" and adherence to guidelines of the European Resuscitation Council. Use of the laryngeal tube during cardiac arrest in the manikin significantly reduced the "no flow time" when compared with endotracheal intubation (109.3 s vs. 190.4 s; P cardiac arrest supraglottic airway devices should be used by emergency personnel unfamiliar with endotracheal intubation.

  14. An association between snowfall and ED presentation of cardiac arrest. (United States)

    Spitalnic, S J; Jagminas, L; Cox, J


    Studies from several cities have reported increased cardiovascular mortality associated with snowfall; whether this weather also results in increased emergency department (ED) presentation of cardiac arrests is not known. A retrospective review was conducted of cardiac arrest patients presenting to a New England ED during the months of October through May, from 1991 to 1994. Comparing daily frequency of cardiac arrest patients with climactic data, a 27% increase was observed in the frequency of cardiac arrest presentation to the ED on days with snowfall (P = .0004). ED physicians and staff should anticipate an increased frequency of cardiac arrest patients on days with snowfall.

  15. European visit

    CERN Multimedia


    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  16. Out-of-Hospital Cardiac Arrest in Denmark

    DEFF Research Database (Denmark)

    Wissenberg Jørgensen, Mads

    BACK COVER TEXT Cardiac arrest is an emergency medical condition characterized by the cessation of cardiac mechanical activity; without immediate and decisive treatment, a victim’s chances of survival are minimal. Out-of-hospital cardiac arrest is a particular arrest subgroup that poses additional...... challenges, due to the victim’s physical location, which brings an inherent risk of delay (or altogether absence) of recognition and treatment of cardiac arrest. A low frequency of bystander cardiopulmonary resuscitation and low 30-day survival after out-of-hospital cardiac arrest were identified nearly ten...... in patient survival following out-of hospital cardiac arrest; utilizing the Danish nationwide registries, we sought to answer these questions. Moreover, in order to further improve understanding and target future national strategies for cardiac arrest management, we examined whether there were sex- and age...

  17. A case report: arresting dental caries. (United States)

    Milgrom, P; Rothen, M; Spadafora, A; Skaret, E


    To arrest dental caries in the dentin in a patient that had been refractory to other attempts at caries control. Repeated applications of fluoride varnish (5%, Duraflor, Pharmascience Laboratories, Montreal) in the clinic every three months along with two daily two-minute rinses with sodium fluoride at home. Results over five years are presented. None of the lesions identified five years earlier had been restored. The teeth were monitored with frequent bitewing radiographs and clinical exams; the interproximal decay appears inactive clinically. This present case report shows that fluoride varnish may be a good addition to preventive therapy for arresting caries in adult patients in general practice. Surgical intervention may be avoided in patients whose risk has shifted to a lower level.

  18. [Cardiorespiratory arrest at the age of 30]. (United States)

    Porlier, Magali; Porlier, Ludovic; Lefort, Hugues

    The cardiovascular risk of women is specific and polymorphous. Delays in treatment in women are evident and caused by multiple social and anthropological factors as well as changes to lifestyle habits which are becoming similar to those of men. Young women thereby have a higher risk of sudden death than the rest of the female and general population. A nurse who experienced cardiorespiratory arrest at the age of 30 shares her story. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Dental Calculus Arrest of Dental Caries. (United States)

    Keyes, Paul H; Rams, Thomas E

    An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.

  20. Arrest History and Intimate Partner Violence Perpetration in a Sample of Men and Women Arrested for Domestic Violence. (United States)

    Shorey, Ryan C; Ninnemann, Andrew; Elmquist, Joanna; Labrecque, Lindsay; Zucosky, Heather; Febres, Jeniimarie; Brasfield, Hope; Temple, Jeff R; Stuart, Gregory L


    Intimate partner violence (IPV) is a serious and prevalent problem throughout the United States. Currently, individuals arrested for domestic violence are often court mandated to batterer intervention programs (BIPs). However, little is known about the arrest histories of these individuals, especially women. The current study examined the arrest histories of men ( n = 303) and women ( n = 82) arrested for domestic violence and court-referred to BIPs. Results demonstrated that over 30% of the entire sample had been previously arrested for a non-violent offense, and over 25% of the participants had been previously arrested for a violent offense other than domestic violence. Moreover, men were arrested significantly more frequently for violence-related and non-violent offenses than their female counterparts. In addition, men were more likely than women to have consumed binge-levels of alcohol prior to the offense that led to their most recent arrest and court-referral to a BIP. Lastly, arrest history was positively associated with physical and psychological aggression perpetration against an intimate partner for men only, such that more previous arrests were associated with more frequent aggression. These results provide evidence that many men and women arrested for domestic violence have engaged in a number of diverse criminal acts during their lifetimes, suggesting that BIPs may need to address general criminal behavior.

  1. European Cinema

    NARCIS (Netherlands)

    Elsaesser, Thomas


    In the face of renewed competition from Hollywood since the early 1980s and the challenges posed to Europe's national cinemas by the fall of the Wall in 1989, independent filmmaking in Europe has begun to re-invent itself. European Cinema: Face to Face with Hollywood re-assesses the different

  2. Improvements in Out-of-Hospital Cardiac Arrest Survival from 1998 to 2013. (United States)

    Yamaguchi, Yutaka; Woodin, Jeff A; Gibo, Koichiro; Zive, Dana M; Daya, Mohamud R


    Out-of-hospital cardiac arrest (OHCA) remains a major public health burden. Aggregate OHCA survival to hospital discharge has reportedly remained unchanged at 7.6% for almost 30 years from 1970 to 2008. We examined the trends in adult OHCA survival over a 16-year period from 1998 to 2013 within a single EMS agency. Observational cohort study of adult OHCA patients treated by Tualatin Valley Fire & Rescue (TVF&R) from 1998 to 2013. This is an ALS first response fire agency that maintains an active Utstein style cardiac arrest registry and serves a population of approximately 450,000 in 9 incorporated cities in Oregon. Primary outcomes were survival to hospital discharge in all patients and in the subgroup with witnessed ventricular fibrillation/pulseless ventricular tachycardia (VF/VT). The impact of key covariates on survival was assessed using univariate logistic regression. These included patient factors (age and sex), event factors (location of arrest, witnessed status, and first recorded cardiac arrest rhythm), and EMS system factors (response time interval, bystander CPR, and non-EMS AED shock). We used multivariate logistic regression to examine the impact of year increment on survival after multiple imputation for missing data. Sensitivity analysis was performed with complete cases. During the study period, 2,528 adult OHCA had attempted field resuscitation. The survival rate for treated cases increased from 6.7% to 18.2%, with witnessed VF/VT cases increasing from 14.3% to 31.4% from 1998 to 2013. Univariate analysis showed that younger age, male sex, public location of arrest, bystander or EMS witnessed event, initial rhythm of pulseless electrical activity (PEA) or VF/VT, bystander CPR, non-EMS AED shock, and a shorter EMS response time were independently associated with survival. After adjustment for covariates, the odds of survival increased by 9% (OR 1.09, 95%CI: 1.05-1.12) per year in all treated cases, and by 6% (OR 1.06, 95% 1.01-1.10) per year in

  3. A case of thyroid storm with cardiac arrest

    Directory of Open Access Journals (Sweden)

    Nakashima Y


    Full Text Available Yutaka Nakashima,1 Tsuneaki Kenzaka,2 Masanobu Okayama,3 Eiji Kajii31Department for Support of Rural Medicine, Yamaguchi Grand Medical Center, 2Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan; 3Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, JapanAbstract: A 23-year-old man became unconscious while jogging. He immediately received basic life support from a bystander and was transported to our hospital. On arrival, his spontaneous circulation had returned from a state of ventricular fibrillation and pulseless electrical activity. Following admission, hyperthyroidism led to a suspicion of thyroid storm, which was then diagnosed as a possible cause of the cardiac arrest. Although hyperthyroidism-induced cardiac arrest including ventricular fibrillation is rare, it should be considered when diagnosing the cause of treatable cardiac arrest.Keywords: hyperthyroidism, ventricular fibrillation, treatable cardiac arrest, cardiac arrest, cardiopulmonary arrest

  4. Interrater variability of EEG interpretation in comatose cardiac arrest patients

    DEFF Research Database (Denmark)

    Westhall, Erik; Rosén, Ingmar; Rossetti, Andrea O


    of cardiac arrest patients included in the Target Temperature Management trial. The main objective was to evaluate if malignant EEG-patterns could reliably be identified. METHODS: Full-length EEGs from 103 comatose cardiac arrest patients were interpreted by four EEG-specialists with different nationalities...... in an international context with high reliability. SIGNIFICANCE: The establishment of strict criteria with high transferability between interpreters will increase the usefulness of routine EEG to assess neurological prognosis after cardiac arrest....

  5. Predictors for outcome among cardiac arrest patients

    DEFF Research Database (Denmark)

    Wibrandt-Johansen, Ida Maria; Norsted, Kristine; Schmidt, Henrik


    BackgroundIn the past decade, early treatment of cardiac arrest (CA) victims has been improved in several ways, leading to more optimistic over all prognoses. However, the global survival rate after out-of-hospital CA (OHCA) is still not more than 5-10%. With a better knowledge of the predictors...... circulation (ROSC).ResultsThe overall mortality was 44% and a favorable neurological outcome was seen among 52%. Strong predictors for survival and favorable neurological outcome were ventricular tachycardia/ventricular fibrillation (VT/VF) as initial rhythm, cardiac etiology and time to ROSC¿... rhythm of VT/VF and a cardiac etiology were the strongest....

  6. Growth arrest specific protein (GAS) 6

    DEFF Research Database (Denmark)

    Haase, T N; Rasmussen, Morten; Jaksch, C A M


    Aims/hypothesis Maternal low-protein (LP) diet during gestation results in a reduced beta cell mass in the offspring at birth and this may hamper the ability to adapt to high-energy food and sedentary lifestyle later in life. To investigate the biology behind the LP-offspring phenotype, this study...... using RNA microarray and quantitative PCR. The role of a differentially expressed gene, growth arrest specific protein 6 (GAS6), was evaluated in vitro using neonatal rat islets. Results The mRNA level of Gas6, known to be mitogenic in other tissues, was reduced in LP offspring. The mRNA content of Mafa...

  7. Automated auditory mismatch negativity paradigm improves coma prognostic accuracy after cardiac arrest and therapeutic hypothermia. (United States)

    Rossetti, Andrea O; Tzovara, Athina; Murray, Micah M; De Lucia, Marzia; Oddo, Mauro


    EEG and somatosensory evoked potential are highly predictive of poor outcome after cardiac arrest; their accuracy for good recovery is however low. We evaluated whether addition of an automated mismatch negativity-based auditory discrimination paradigm (ADP) to EEG and somatosensory evoked potential improves prediction of awakening. EEG and ADP were prospectively recorded in 30 adults during therapeutic hypothermia and in normothermia. We studied the progression of auditory discrimination on single-trial multivariate analyses from therapeutic hypothermia to normothermia, and its correlation to outcome at 3 months, assessed with cerebral performance categories. At 3 months, 18 of 30 patients (60%) survived; 5 had severe neurologic impairment (cerebral performance categories = 3) and 13 had good recovery (cerebral performance categories = 1-2). All 10 subjects showing improvements of auditory discrimination from therapeutic hypothermia to normothermia regained consciousness: ADP was 100% predictive for awakening. The addition of ADP significantly improved mortality prediction (area under the curve, 0.77 for standard model including clinical examination, EEG, somatosensory evoked potential, versus 0.86 after adding ADP, P = 0.02). This automated ADP significantly improves early coma prognostic accuracy after cardiac arrest and therapeutic hypothermia. The progression of auditory discrimination is strongly predictive of favorable recovery and appears complementary to existing prognosticators of poor outcome. Before routine implementation, validation on larger cohorts is warranted.

  8. Sublingual Microcirculation is Impaired in Post-cardiac Arrest Patients

    DEFF Research Database (Denmark)

    G. Omar, Yasser; Massey, Michael; Wiuff Andersen, Lars


    the microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients. RESULTS: We evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual...... markers in the post-cardiac arrest state. METHODS: We prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using...

  9. Impact of time to cooling initiation and time to target temperature in patients treated with hypothermia after cardiac arrest. (United States)

    Uribarri, Aitor; Bueno, Héctor; Pérez-Castellanos, Alberto; Loughlin, Gerard; Sousa, Iago; Viana-Tejedor, Ana; Fernández-Avilés, Francisco


    Little is known about the role of time to initiation of therapeutic hypothermia and time to target temperature (TTT) in the prognosis of patients resuscitated from cardiac arrest. A retrospective analysis was performed in 145 survivors of cardiac arrest who underwent therapeutic hypothermia between January 2003 and January 2013. The objective was to identify predictors of survival free from significant neurological sequelae (Cerebral Performance Categories Scale (CPC): >2) six months after cardiac arrest. We evaluated the effect of faster and earlier cooling. Overall survival at six months was 42.1% (61 patients); 59 of these were considered to have a good neurological status (CPC ≤ 2), and in whom therapeutic hypothermia was initiated earlier (87 ± 17 min vs. 111 ± 14 min; p=0.042), and the target temperature was reached at an earlier time (TTT: 316 ± 30 min vs. 365 ± 27 min; p=0.017). Multivariate analysis selected longer duration of cardiac arrest (odds ratio (OR) = 1.06 per min), a non-shockable initial rhythm (OR=13.8), severe acidosis (OR=0.009 per 0.01 unit), older age (OR=1.04 per year) and longer TTT (OR=1.005 per min) as associated with poor prognosis. The most important prognostic factors for death or lack of neurological recovery in patients with cardiac arrest treated with therapeutic hypothermia are initial-rhythm, time from cardiac arrest to return of spontaneous circulation and arterial-pH at admission. Although the speed of cooling initiation and the time to reach target temperature may play a role, its influence on prognosis seems to be less important. © The European Society of Cardiology 2014.

  10. How much additional model complexity do the use of catchment hydrological signatures, additional data and expert knowledge warrant? (United States)

    Hrachowitz, M.; Fovet, O.; RUIZ, L.; Gascuel-odoux, C.; Savenije, H.


    In the frequent absence of sufficient suitable data to constrain hydrological models, it is not uncommon to represent catchments at a range of scales by lumped model set-ups. Although process heterogeneity can average out on the catchment scale to generate simple catchment integrated responses whose general flow features can frequently be reproduced by lumped models, these models often fail to get details of the flow pattern as well as catchment internal dynamics, such as groundwater level changes, right to a sufficient degree, resulting in considerable predictive uncertainty. Traditionally, models are constrained by only one or two objectives functions, which does not warrant more than a handful of parameters to avoid elevated predictive uncertainty, thereby preventing more complex model set-ups accounting for increased process heterogeneity. In this study it was tested how much additional process heterogeneity is warranted in models when optimizing the model calibration strategy, using additional data and expert knowledge. Long-term timeseries of flow and groundwater levels for small nested experimental catchments in French Brittany with considerable differences in geology, topography and flow regime were used in this study to test which degree of model process heterogeneity is warranted with increased availability of information. In a first step, as a benchmark, the system was treated as one lumped entity and the model was trained based only on its ability to reproduce the hydrograph. Although it was found that the overall modelled flow generally reflects the observed flow response quite well, the internal system dynamics could not be reproduced. In further steps the complexity of this model was gradually increased, first by adding a separate riparian reservoir to the lumped set-up and then by a semi-distributed set-up, allowing for independent, parallel model structures, representing the contrasting nested catchments. Although calibration performance increased

  11. Effectiveness of Naltrexone in the Prevention of Delayed Respiratory Arrest in Opioid-Naive Methadone-Intoxicated Patients

    Directory of Open Access Journals (Sweden)

    Abbas Aghabiklooei


    Full Text Available Acute methadone toxicity is a major public health concern in Iran. Methadone-intoxicated patients are in a great risk of recurrent or delayed respiratory arrest despite the prescription of initial doses of naloxone. This study aimed to evaluate the effectiveness of oral naltrexone in the management of acute methadone overdose in opioid-naive patients and check if it could be a substitute of continuous infusion of naloxone in maintaining adequate ventilation. In a randomized, double-blind, placebo-controlled study, a total of 54 opioid-naive patients with acute methadone toxicity were enrolled. The patients received either oral naltrexone or placebo capsules after awakening by naloxone. All patients underwent close monitoring of respiration. Frequency of respiratory depression or arrest, need for another dose of naloxone, duration of hospital stay, and adverse outcomes compared between the two groups. The incidence of respiratory depression was significantly less in those who had received naltrexone. Our results show that single oral dose of naltrexone is quite efficient in the prevention of recurrent or delayed respiratory arrest in opioid-naive methadone-intoxicated patients. It can shorten the duration of hospitalization and, as a consequence, decreased the risk of complications. Further studies are warranted before the generalization of this approach to other patient populations.

  12. 29 CFR 1915.159 - Personal fall arrest systems (PFAS). (United States)


    ... 29 Labor 7 2010-07-01 2010-07-01 false Personal fall arrest systems (PFAS). 1915.159 Section 1915... Protective Equipment (PPE) § 1915.159 Personal fall arrest systems (PFAS). The criteria of this section apply to PFAS and their use. Effective January 1, 1998, body belts and non-locking snaphooks are not...

  13. Cardiac arrest during anesthesia at a University Hospital in Nigeria ...

    African Journals Online (AJOL)

    Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased remarkably.

  14. Thiamine as a neuroprotective agent after cardiac arrest. (United States)

    Ikeda, Kohei; Liu, Xiaowen; Kida, Kotaro; Marutani, Eizo; Hirai, Shuichi; Sakaguchi, Masahiro; Andersen, Lars W; Bagchi, Aranya; Cocchi, Michael N; Berg, Katherine M; Ichinose, Fumito; Donnino, Michael W


    Reduction of pyruvate dehydrogenase (PDH) activity in the brain is associated with neurological deficits in animals resuscitated from cardiac arrest. Thiamine is an essential co-factor of PDH. The objective of this study was to examine whether administration of thiamine improves outcomes after cardiac arrest in mice. Secondarily, we aimed to characterize the impact of cardiac arrest on PDH activity in mice and humans. Animal study: Adult mice were subjected to cardiac arrest whereupon cardiopulmonary resuscitation was performed. Thiamine or vehicle was administered 2min before resuscitation and daily thereafter. Mortality, neurological outcome, and metabolic markers were evaluated. Human study: In a convenience sample of post-cardiac arrest patients, we measured serial PDH activity from peripheral blood mononuclear cells and compared them to healthy controls. Animal study: Mice treated with thiamine had increased 10-day survival (48% versus 17%, Pcardiac arrest patients had lower PDH activity in mononuclear cells than did healthy volunteers (estimated difference: -5.8O.D./min/mg protein, Pcardiac arrest improved neurological outcome and 10-day survival in mice. PDH activity was markedly depressed in post-cardiac arrest patients suggesting that this pathway may represent a therapeutic target. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Cooling the crisis: Therapeutic hypothermia after sickle cardiac arrest

    NARCIS (Netherlands)

    Metske, Hennie A.; Postema, Pieter G.; Biemond, Bart J.; Bouman, Catherine S. C.


    Objective: The management of patients with sickle-cell disease and cardiac arrest presents special challenges. Mild therapeutic hypothermia may improve survival and neurologic outcome after cardiac arrest, however, it may also precipitate sickling in patients with sickle-cell disease. Rigorous

  16. Performance of Surge Arrester Installation to Enhance Protection

    Directory of Open Access Journals (Sweden)

    Mbunwe Muncho Josephine


    Full Text Available The effects of abnormal voltages on power system equipment and appliances in the home have raise concern as most of the equipments are very expensive. Each piece of electrical equipment in an electrical system needs to be protected from surges. To prevent damage to electrical equipment, surge protection considerations are paramount to a well designed electrical system. Lightning discharges are able to damage electric and electronic devices that usually have a low protection level and these are influenced by current or voltage pulses with a relatively low energy, which are induced by lightning currents. This calls for proper designed and configuration of surge arresters for protection on the particular appliances. A more efficient non-linear surge arrester, metal oxide varistor (MOV, should be introduced to handle these surges. This paper shows the selection of arresters laying more emphasis on the arresters for residential areas. In addition, application and installation of the arrester will be determined by the selected arrester. This paper selects the lowest rated surge arrester as it provides insulation when the system is under stress. It also selected station class and distribution class of arresters as they act as an open circuit under normal system operation and to bring the system back to its normal operation mode as the transient voltage is suppressed. Thus, reduces the risk of damage, which the protection measures can be characterized, by the reduction value of the economic loss to an acceptable level.

  17. Alterations in Cerebral Blood Flow after Resuscitation from Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Bistra Iordanova


    Full Text Available Greater than 50% of patients successfully resuscitated from cardiac arrest have evidence of neurological disability. Numerous studies in children and adults, as well as in animal models have demonstrated that cerebral blood flow (CBF is impaired after cardiac arrest. Stages of cerebral perfusion post-resuscitation include early hyperemia, followed by hypoperfusion, and finally either resolution of normal blood flow or protracted hyperemia. At the level of the microcirculation the blood flow is heterogeneous, with areas of no flow, low flow, and increased flow. CBF directed therapies in animal models of cardiac arrest improved neurological outcome, and therefore, the alterations in CBF after cardiac arrest likely contribute to the development of hypoxic ischemic encephalopathy. Current intensive care after cardiac arrest is centered upon maintaining systemic oxygenation, normal blood pressure values for age, maintaining general homeostasis, and avoiding hyperthermia. Assessment of CBF and oxygenation is not routinely performed after cardiac arrest. Currently available and underutilized techniques to assess cerebral perfusion include transcranial doppler, near-infrared spectroscopy, and arterial spin labeling magnetic resonance imaging. Limited clinical studies established the role of CBF and oxygenation monitoring in prognostication after cardiac arrest and few studies suggest that guiding critical care post-resuscitation to mean arterial pressures above the minimal autoregulatory range might improve outcome. Important knowledge gaps thus remain in cerebral monitoring and CBF and oxygen goal-directed therapies post-resuscitation from cardiac arrest.

  18. Exercise-related cardiac cardiac rehabilitation arrest In

    African Journals Online (AJOL)

    most important being myocardial infarction and cardiac arrest. (CA).1,2. 'Normal' ... myocardial infarction and CA in cardiac rehabilitation pro- ..... The acute risk of. Strenuous exercise.JAMA 1980; 244: 1799-1801. 5. Siscovick DS, Weiss NS, Fletcber RH et al. The incidence of primary cardiac arrest during vigorous exercise.

  19. Cardiac arrest during anesthesia at a University Hospital in Nigeria

    African Journals Online (AJOL)


    Mar 7, 2013 ... Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased ...

  20. Efficacy of silver diamine fluoride for Arresting Caries Treatment.

    NARCIS (Netherlands)

    Yee, R.; Holmgren, C.J.; Mulder, J.; Lama, D.; Walker, D.; Palenstein Helderman, W.H. van


    Arresting Caries Treatment (ACT) has been proposed to manage untreated dental caries in children. This prospective randomized clinical trial investigated the caries-arresting effectiveness of a single spot application of: (1) 38% silver diamine fluoride (SDF) with tannic acid as a reducing agent;

  1. Location of cardiac arrest and impact of pre-arrest chronic disease and medication use on survival. (United States)

    Granfeldt, Asger; Wissenberg, Mads; Hansen, Steen Møller; Lippert, Freddy K; Torp-Pedersen, Christian; Christensen, Erika Frischknecht; Christiansen, Christian Fynbo


    Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have not accounted for pre-arrest factors such as chronic disease and medication. To investigate whether the association between cardiac arrest in a private location and a higher mortality can be explained by differences in chronic diseases and medication. We identified 27,771 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001-2012). Using National Registries, we identified pre-arrest chronic disease and medication. To investigate the importance of cardiac arrest related factors and chronic disease and medication use we performed adjusted Cox regression analyses during day 0-7 and day 8-365 following cardiac arrest to calculate hazard ratios (HR) for death. Day 0-7: Un-adjusted HR for death day 0-7 was 1.21 (95%CI:1.18-1.25) in private compared to public location. When including cardiac arrest related factors HR for death was 1.09 (95%CI:1.06-1.12). Adding chronic disease and medication to the analysis changed HR for death to 1.08 (95%CI:1.05-1.12). 8-365 day: The un-adjusted HR for death day 8-365 was 1.70 (95% CI: 1.43-2.02) in private compared to public location. When including cardiac arrest related factors the HR decreased to 1.39 (95% CI: 1.14-1.68). Adding chronic disease and medication to the analysis changed HR for death to 1.27 (95% CI:1.04-1.54). The higher mortality following cardiac arrest in a private location is partly explained by a higher prevalence of chronic disease and medication use in patients surviving until day 8. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Serum tau and neurological outcome in cardiac arrest

    DEFF Research Database (Denmark)

    Mattsson, Niklas; Zetterberg, Henrik; Nielsen, Niklas


    OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 h after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome was poor...... neurological outcome, defined as Cerebral Performance Category 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median 38.5 [IQR 5.7-245] ng/L in poor versus 1.5 [0.7-2.4] ng/L in good outcome, for tau at 72 h, p... and 36°C targeted temperature after cardiac arrest. INTERPRETATION: Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest. It may be significantly better than serum NSE, which is recommended in guidelines and currently used in clinical practice...

  3. The role of bystanders, first responders, and emergency medical service providers in timely defibrillation and related outcomes after out-of-hospital cardiac arrest: Results from a statewide registry. (United States)

    Hansen, Carolina Malta; Kragholm, Kristian; Granger, Christopher B; Pearson, David A; Tyson, Clark; Monk, Lisa; Corbett, Claire; Nelson, R Darrell; Dupre, Matthew E; Fosbøl, Emil L; Strauss, Benjamin; Fordyce, Christopher B; McNally, Bryan; Jollis, James G


    Defibrillation by bystanders and first responders has been associated with increased survival, but limited data are available from non-metropolitan areas. We examined time from 911-call to defibrillation (according to who defibrillated patients) and survival in North Carolina. Through the Cardiac Arrest Registry to Enhance Survival, we identified 1732 defibrillated out-of-hospital cardiac arrests from counties with complete case capture (population 2.7 million) from 2010 to 2013. Most patients (60.9%) were defibrillated in > 10 min. A minority (8.0%) was defibrillated defibrillated by first responders (51.8%) and bystanders (33.1%), independent of location of arrest (residential or public). Bystanders initiated cardiopulmonary resuscitation (CPR) in 49.0% of cases and defibrillated 13.4% of those. Survival decreased with increasing time to defibrillation ( 10 min: 13.2%). Odds of survival with favorable neurologic outcome adjusted for age, sex, and bystander CPR improved with faster defibrillation ( 10 min: reference). Bystanders and first responders were mainly responsible for defibrillation within 5 min, independent of location of arrest. Bystanders initiated CPR in half of the cardiac arrest cases but only defibrillated a minority of those. Timely defibrillation and defibrillation by bystanders and/or first responders were strongly associated with increased survival. Strategic efforts to increase bystander and first-responder defibrillation are warranted to increase survival after out-of-hospital cardiac arrest. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Characterization of mitochondrial injury after cardiac arrest (COMICA). (United States)

    Donnino, Michael W; Liu, Xiaowen; Andersen, Lars W; Rittenberger, Jon C; Abella, Benjamin S; Gaieski, David F; Ornato, Joseph P; Gazmuri, Raúl J; Grossestreuer, Anne V; Cocchi, Michael N; Abbate, Antonio; Uber, Amy; Clore, John; Peberdy, Mary Anne; Callaway, Clifton W


    Mitochondrial injury post-cardiac arrest has been described in pre-clinical settings but the extent to which this injury occurs in humans remains largely unknown. We hypothesized that increased levels of mitochondrial biomarkers would be associated with mortality and neurological morbidity in post-cardiac arrest subjects. We performed a prospective multicenter study of post-cardiac arrest subjects. Inclusion criteria were comatose adults who suffered an out-of-hospital cardiac arrest. Mitochondrial biomarkers were measured at 0, 12, 24, 36 and 48h after return of spontaneous circulation as well as in healthy controls. Out of 111 subjects enrolled, 102 had evaluable samples at 0h. Cardiac arrest subjects had higher baseline cytochrome c levels compared to controls (2.18ng/mL [0.74, 7.74] vs. 0.16ng/mL [0.03, 0.91], pcardiac arrest subjects at baseline compared to the control subjects. There were no differences between survivors and non-survivors for mitochondrial DNA, nuclear DNA, or cell free DNA. Cytochrome c was increased in post- cardiac arrest subjects compared to controls, and in post-cardiac arrest non-survivors compared to survivors. Nuclear DNA and cell free DNA was increased in plasma of post-cardiac arrest subjects. There were no differences in mitochondrial DNA, nuclear DNA, or cell free DNA between survivors and non-survivors. Mitochondrial injury markers showed mixed results in the post-cardiac arrest period. Future research needs to investigate these differences. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Effect of donor cardiac arrest and arrest duration on outcomes of lung transplantation. (United States)

    Mohite, Prashant N; Zych, Bartlomiej; Sabashnikov, Anton; Popov, Aron-Frederik; Garcia-Saez, Diana; Patil, Nikhil P; Koch, Achim; Zeriouh, Mohamed; Rahmanian, Parwis B; Dhar, Dhruva; Amrani, Mohamed; Bahrami, Toufan; DeRobertis, Fabio; Carby, Martin; Reed, Anna; Simon, Andre R


    Limited data are available about lung transplantation (LTx) from donors suffering cardiac arrest (CA) prior to actual donation. A retrospective analysis of LTx performed between January 2007 and September 2012 was done with the focus on CA in donors. The recipients were grouped depending on the history of donor CA and CA duration (downtime) as: No cardiac arrest ("NoCA"), CA downtime less than 20 min ("CA 20"). Early and mid-term outcomes after LTx were compared among the three groups. A total of 237 LTx were performed during the study period. One hundred eighty-eight patients received organs from "NoCA" donors, 25 from "CA 20" donors. There was a trend toward better overall cumulative survival in both CA groups (log rank p = 0.076) whereas the survival in the "CA > 20" group was significantly better than in the "NoCA" group in the subgroup analysis (log rank p = 0.045). Freedom from bronchiolitis obliterans syndrome (BOS) also increased with increase in CA duration, although it did not reach statistical significance. Transplantation of lungs from donors with a history of CA is safe and feasible. Longer duration of cardiac arrest may improve the outcomes after the LTx in terms of survival and freedom from BOS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Experimental investigation of interfacial crack arrest in sandwich beams subjected to fatigue loading using a novel crack arresting device

    DEFF Research Database (Denmark)

    Martakos, G.; Andreasen, J.H.; Berggreen, Christian


    A recently proposed face-sheet–core interface crack arresting device is implemented in sandwich beams and tested using the Sandwich Tear Test configuration. Fatigue loading conditions are applied to propagate the crack and determine the effect of the crack stopper on the fatigue growth rate...... and arrest of the crack. Digital image correlation is used through the duration of the fatigue experiment to track the strain evolution as the crack tip advances. The measured strains are related to crack tip propagation, arrest, and re-initiation of the crack. A finite element model is used to calculate...... the energy release rate, mode mixity and to simulate crack propagation and arrest of the crack. Finally, the effectiveness of the crack arresting device is demonstrated on composite sandwich beams subjected to fatigue loading conditions....

  7. Sudden Cardiac Arrest during Participation in Competitive Sports. (United States)

    Landry, Cameron H; Allan, Katherine S; Connelly, Kim A; Cunningham, Kris; Morrison, Laurie J; Dorian, Paul


    The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac

  8. Inhibition of monoamine oxidase A increases recovery after experimental cardiac arrest. (United States)

    Vuohelainen, Vilma; Hämäläinen, Mari; Paavonen, Timo; Karlsson, Sari; Moilanen, Eeva; Mennander, Ari


    Perioperative myocardial infarction (MI) with ischaemia-reperfusion injury (IRI) is a devastating entity occurring in 1-2% of patients after cardiac surgery. The molecular pathway leading to myocardial cellular destruction after MI may include monoamine oxidases. We experimentally investigated whether moclobemide, a monoamine oxidase inhibitor, enhances myocardial recovery after cardiac arrest and MI. Fifty-six syngeneic Fischer rats underwent heterotopic cardiac transplantation to induce reversible IRI after cardiac arrest. Twenty-eight rats also underwent permanent ligation of the left anterior descending coronary artery to induce MI after cardiac arrest. Twenty-eight rats with or without MI were treated with subcutaneous moclobemide 10 mg/kg/day. Methods used to study myocardial recovery were microdialysis for intramyocardial metabolism, histology and quantitative reverse-transcription polymerase chain reaction for high-mobility group box-1 (HMGB1), haeme oxygenase-1 (HO-1), interleukin-6, hypoxia-inducible factor 1α and macrophages (CD68). Pyruvate increased in MI treated with moclobemide versus IRI with moclobemide (29.19 ± 7.64 vs 13.86 ± 8.49 µM, P = 0.028), reflecting metabolic activity after cardiac arrest and reperfusion. Myocardial inflammation increased in MI compared with IRI after 1 h (0.80 ± 0.56 vs 0, point score units [PSUs], P = 0.003), but decreased after 5 days in MI treated with moclobemide versus MI alone (0.80 ± 0.83 vs 2.00 ± 0.70, PSU, P = 0.033). Expressions of HMGB1, CD68 and HO-1 decreased in MI treated with moclobemide versus MI alone (1.33 ± 0.20 vs 1.75 ± 0.24, fold changes [FCs], P = 0.028; 5.15 ± 1.10 vs 9.59 ± 2.75, FC, P = 0.050; 10.41 ± 4.17 vs 21.28 ± 10.01, FC, P = 0.047), indicating myocardial recovery and increased cellularity of remote intramyocardial arteries. Moclobemide enhances myocardial recovery after cardiac arrest and MI; inhibition of remote myocardial changes may be achieved by targeting treatment

  9. 'Thinking ill of others without sufficient warrant?' Transcending the accuracy-inaccuracy dualism in prejudice and stereotyping research. (United States)

    Dixon, John


    Research on prejudice seeks to understand and transform inaccurate beliefs about others. Indeed, historically such research has offered a cautionary tale of the biased nature of human cognition. Recently, however, this view has been challenged by work defending the essential rationality of intergroup perception, a theme captured controversially in Jussim and colleagues' (2009) research on the 'unbearable accuracy of stereotyping'. The present paper argues that in its own terms the 'rationalist turn' in socio-cognitive research on stereotyping presents an important challenge to the prejudice tradition, raising troubling questions about its conceptual and empirical foundations. However, it also argues for the necessity of transcending those terms. By focusing on the correspondence between individual beliefs and the supposedly 'objective' characteristics of others, we neglect the historical and discursive practices through which the social realities that we 'perceive' are actively constructed and institutionalized. We mask their social origins, contested and perspectival nature, relativity, and relationship to wider structures of power. By implication, moving beyond the Allportian perspective that has dominated both the prejudice tradition and the emerging stereotype accuracy paradigm, we may now need to prioritize other kinds of questions. Reversing Allport's famous definition of prejudice, it may now be time to ask: How, and with what consequences, does 'thinking ill of others' become sufficiently warranted? How does such thinking become part of institutionalized relations of power and an accepted way of perceiving, evaluating and treating others? What should social psychologists be doing to challenge this state of affairs? © 2017 The British Psychological Society.

  10. Measuring the Effect of Housing Quality Interventions: The Case of the New Zealand "Rental Warrant of Fitness". (United States)

    Telfar-Barnard, Lucy; Bennett, Julie; Howden-Chapman, Philippa; Jacobs, David E; Ormandy, David; Cutler-Welsh, Matthew; Preval, Nicholas; Baker, Michael G; Keall, Michael


    In New Zealand, as in many other countries, housing in the private-rental sector is in worse condition than in the owner-occupier housing sector. New Zealand residential buildings have no inspection regime after original construction signoff. Laws and regulations mandating standards for existing residential housing are outdated and spread over a range of instruments. Policies to improve standards in existing housing have been notoriously difficult to implement. In this methods paper, we describe the development and implementation of a rental Warrant of Fitness (WoF) intended to address these problems. Dwellings must pass each of 29 criteria for habitability, insulation, heating, ventilation, safety, amenities, and basic structural soundness to reach the WoF minimum standard. The WoF's development was based on two decades of research on the impact of housing quality on health and wellbeing, and strongly influenced by the UK Housing Health and Safety Rating System and US federal government housing standards. Criteria were field-tested across a range of dwelling types and sizes, cities, and climate zones. The implementation stage of our WoF research consists of a non-random controlled quasi-experimental study in which we work with two city-level local government councils to implement the rental WoF, recruiting adjoining council areas as controls, and measuring changes in health, economic, and social outcomes.

  11. Post-resuscitation care for survivors of cardiac arrest (United States)

    Mangla, Ashvarya; Daya, Mohamud R.; Gupta, Saurabh


    Cardiac arrest can occur following a myriad of clinical conditions. With advancement of medical science and improvements in Emergency Medical Services systems, the rate of return of spontaneous circulation for patients who suffer an out-of-hospital cardiac arrest (OHCA) continues to increase. Managing these patients is challenging and requires a structured approach including stabilization of cardiopulmonary status, early consideration of neuroprotective strategies, identifying and managing the etiology of arrest and initiating treatment to prevent recurrence. This requires a closely coordinated multidisciplinary team effort. In this article, we will review the initial management of survivors of OHCA, highlighting advances and ongoing controversies. PMID:24568821

  12. Crack propagation and arrest of structural steels and pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Takehiro


    Crack arrest of fast running cracks is an important issue for the safety of steel structures. Crack arrest design can prevent fatal damage of large structures by restricting the influence of the incidents. Therefore crack arrest design is important especially for very large structure, where accidents may cause huge economical and social losses. Propagating shear fracture, long running ductile crack propagation in pipelines and brittle crack propagation in heavy thick shipbuilding steels have been investigated. For the propagating shear fracture issue, a new HLP simulation model, applicable to various backfill conditions, including underwater backfill, was developed. The proposed backfill model can be applied to the prediction of the crack arrest of propagating shear fracture under various backfill conditions. The new HLP simulation was successful in estimating full-scale burst tests with various backfill depths. The new HLP simulation for underwater pipelines indicated that propagating shear cracks are easily arrested in offshore pipelines compared to onshore pipeline. The toughness requirement of the line pipe for preventing propagating shear fracture can be significantly smaller in underwater pipelines compared to onshore pipelines. The margin of the underwater pipeline for propagating shear fracture was clarified by the new model developed in this thesis. For brittle crack arrest, an empirical approach for long crack propagation has been conducted. Several large-scale crack arrest tests were carried out in order to investigate the long crack arrestability of heavy-thick shipbuilding steel plates. All plates and their welded joints used in this study satisfied the Charpy toughness requirement for EH-grade shipbuilding steels and welded joints. A brittle crack ran along a welded joint and penetrated through the test plate under a stress exceeding 200MPa, despite the presence of longitudinal stiffeners across the test weld. A brittle crack in a base plate model

  13. Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence. (United States)

    MacLeod, Kara E; Karriker-Jaffe, Katherine J; Satariano, William A; Kelley-Baker, Tara; Lacey, John H; Ragland, David R


    Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home). This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009-2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year. As the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions. The results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.

  14. Cardiac Arrest in Pediatric Patients Receiving Azithromycin. (United States)

    Valdés, Santiago O; Kim, Jeffrey J; Niu, Mary C; de la Uz, Caridad M; Miyake, Christina Y; Moffett, Brady S


    To compare outcomes of pediatric patients treated with azithromycin compared with penicillin or cephalosporin. We hypothesized that azithromycin use would not be associated with increased cardiac mortality in the pediatric population. Retrospective cohort study from the Pediatric Health Information System database between 2008 and 2012. Patients Azithromycin was used in 5039 (6.1%); penicillin or cephalosporin was used in 77 943 (93.9%). Overall prevalence of antibiotic-associated CPR was 0.14%. Patients receiving a macrolide antibiotic had a lower prevalence of CPR compared with patients receiving a penicillin or cephalosporin (0.04% vs 0.14%, P = .04), and there was no difference in mortality. Multivariable analysis did not find an association between macrolide use and CPR. In contrast to recent adult studies, among children hospitalized for community-acquired pneumonia, azithromycin use was not associated with a greater prevalence of cardiac arrest compared with penicillin or cephalosporin use. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Arresting dissolution by interfacial rheology design (United States)

    Beltramo, Peter J.; Gupta, Manish; Alicke, Alexandra; Liascukiene, Irma; Gunes, Deniz Z.; Baroud, Charles N.; Vermant, Jan


    A strategy to halt dissolution of particle-coated air bubbles in water based on interfacial rheology design is presented. Whereas previously a dense monolayer was believed to be required for such an “armored bubble” to resist dissolution, in fact engineering a 2D yield stress interface suffices to achieve such performance at submonolayer particle coverages. We use a suite of interfacial rheology techniques to characterize spherical and ellipsoidal particles at an air-water interface as a function of surface coverage. Bubbles with varying particle coverages are made and their resistance to dissolution evaluated using a microfluidic technique. Whereas a bare bubble only has a single pressure at which a given radius is stable, we find a range of pressures over which bubble dissolution is arrested for armored bubbles. The link between interfacial rheology and macroscopic dissolution of ˜ 100 μm bubbles coated with ˜ 1 μm particles is presented and discussed. The generic design rationale is confirmed by using nonspherical particles, which develop significant yield stress at even lower surface coverages. Hence, it can be applied to successfully inhibit Ostwald ripening in a multitude of foam and emulsion applications.

  16. Risk of breast cancer after a diagnosis of ovarian cancer in BRCA mutation carriers: Is preventive mastectomy warranted? (United States)

    McGee, Jacob; Giannakeas, Vasily; Karlan, Beth; Lubinski, Jan; Gronwald, Jacek; Rosen, Barry; McLaughlin, John; Risch, Harvey; Sun, Ping; Foulkes, William D; Neuhausen, Susan L; Kotsopoulos, Joanne; Narod, Steven A


    Preventive breast surgery and MRI screening are offered to unaffected BRCA mutation carriers. The clinical benefit of these two modalities has not been evaluated among mutation carriers with a history of ovarian cancer. Thus, we sought to determine whether or not BRCA mutation carriers with ovarian cancer would benefit from preventive mastectomy or from MRI screening. First, the annual mortality rate for ovarian cancer patients was estimated for a cohort of 178 BRCA mutation carriers from Ontario, Canada. Next, the actuarial risk of developing breast cancer was estimated using an international registry of 509 BRCA mutation carriers with ovarian cancer. A series of simulations was conducted to evaluate the reduction in the probability of death (from all causes) associated with mastectomy and with MRI-based breast surveillance. Cox proportional hazards models were used to evaluate the impacts of mastectomy and MRI screening on breast cancer incidence as well as on all-cause mortality. Twenty (3.9%) of the 509 patients developed breast cancer within ten years following ovarian cancer diagnosis. The actuarial risk of developing breast cancer at ten years post-diagnosis, conditional on survival from ovarian cancer and other causes of mortality was 7.8%. Based on our simulation results, among all BRCA mutation-carrying patients diagnosed with stage III/IV ovarian cancer at age 50, the chance of dying before age 80 was reduced by less than 1% with MRI and by less than 2% with mastectomy. Greater improvements in survival with MRI or mastectomy were observed for women who had already survived 10years after ovarian cancer, and for women with stage I or II ovarian cancer. Among BRCA mutation-carrying ovarian cancer patients without a personal history of breast cancer, neither preventive mastectomy nor MRI screening is warranted, except for those who have survived ovarian cancer without recurrence for ten years and for those with early stage ovarian cancer. Copyright © 2017

  17. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams. (United States)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne; Østergaard, Doris


    The application of non-technical skills (NTSs) in health care has previously been described in other health-care educational programmes. NTSs are behavioural principles such as leadership, task distribution and communication. The aim of this study was to identify NTSs suitable for improving team performance in multi-professional cardiac arrest teams, and to describe barriers to the use and implementation of such NTSs by using a qualitative method. Individual semi-structured interviews were conducted with 11 Danish Advanced Life Support instructors during the period April 2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews and data analysis were supported by a template describing 25 NTSs derived from other educational programmes in health care. A framework with five categories relating to NTSs was identified: leadership, communication, mutual performance monitoring, maintenance of standards and guidelines and task management. Important barriers that were identified were inexperienced team leaders, task overload and hierarchic structure in the teams' inability to maintain focus on chest compressions. Interview participants pointed out that NTSs of teams could improve the treatment of cardiac arrest, but several barriers to this exist. Improving resuscitation training should include considerations regarding team leader experience, structured communication, mandatory use of cognitive aids, avoidance of task overload and mutual performance monitoring to avoid unnecessary interruptions in chest compressions. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  18. Cardiac Arrest? Someday, Drones May Come to Your Rescue (United States)

    ... gov/news/fullstory_166543.html Cardiac Arrest? Someday, Drones May Come to Your Rescue Like something from ... 13, 2017 TUESDAY, June 13, 2017 (HealthDay News) -- Drones have been proposed for some pretty mundane uses, ...

  19. Arrest of cytoplasmic streaming induces algal proliferation in green paramecia.

    Directory of Open Access Journals (Sweden)

    Toshiyuki Takahashi

    Full Text Available A green ciliate Paramecium bursaria, bearing several hundreds of endosymbiotic algae, demonstrates rotational microtubule-based cytoplasmic streaming, in which cytoplasmic granules and endosymbiotic algae flow in a constant direction. However, its physiological significance is still unknown. We investigated physiological roles of cytoplasmic streaming in P. bursaria through host cell cycle using video-microscopy. Here, we found that cytoplasmic streaming was arrested in dividing green paramecia and the endosymbiotic algae proliferated only during the arrest of cytoplasmic streaming. Interestingly, arrest of cytoplasmic streaming with pressure or a microtubule drug also induced proliferation of endosymbiotic algae independently of host cell cycle. Thus, cytoplasmic streaming may control the algal proliferation in P. bursaria. Furthermore, confocal microscopic observation revealed that a division septum was formed in the constricted area of a dividing paramecium, producing arrest of cytoplasmic streaming. This is a first report to suggest that cytoplasmic streaming controls proliferation of eukaryotic cells.

  20. Fewer Heart Failure Patients Dying of Cardiac Arrest (United States)

    ... Fewer Heart Failure Patients Dying of Cardiac Arrest Researchers chock it ... 6, 2017 THURSDAY, July 6, 2017 (HealthDay News) -- Heart failure patients are much less likely now to die ...

  1. The outcome of anaesthesia related cardiac arrest in a

    Directory of Open Access Journals (Sweden)

    O.O. Adekola


    Conclusion: Anaesthesia related cardiac arrest and mortality were linked to cardiovascular depression from halothane overdose in our institution. The burden can be reduced by improving on establishing standard monitoring in the perioperative period, and a team approach to patients care.

  2. Al-Qaeda arrest casts shadow over the LHC

    CERN Document Server

    Dacey, James


    "Cern remains on course for the imminent switch-on of the Large Hadron Collider (LHC) despite the media frenzy following the recent arrest of a physicist who had been working at the facility. The researcher in question is a 32-year-old man of Algerian descent who is expected to face trail in France - the country in which he was arrested" (0.5 page)

  3. Impact of donor cardiac arrest on heart transplantation. (United States)

    Southerland, Kevin W; Castleberry, Anthony W; Williams, Judson B; Daneshmand, Mani A; Ali, Ayyaz A; Milano, Carmelo A


    Cardiac transplantation is an effective therapy for patients with end-stage heart failure, but it is still hindered by the lack of donor organs. A history of donor cardiac arrest raises trepidation regarding the possibility of poor post-transplant outcomes. The impact of donor cardiac arrest following successful cardiopulmonary resuscitation on heart transplant outcomes is unknown. Therefore, we sought to evaluate the impact of donor cardiac arrest on orthotropic heart transplantation using the United Network for Organ Sharing database. We performed a secondary longitudinal analysis of all cardiac transplants performed between April 1994 and December 2011 through the United Network for Organ Sharing registry. Multiorgan transplants, repeat transplants, and pediatric recipients were excluded. Survival analyses were performed using Kaplan-Meier methods as well as multivariate adjusted logistic regression and Cox proportional hazard models. A total of 19,980 patients were analyzed. In 856 cases, the donors had histories of cardiac arrest, and in the remaining 19,124 cases, there was no history of donor cardiac arrest. The unadjusted 1-, 5-, and 10-year actuarial survival rates between the arrest and the nonarrest groups were not significantly different. Multivariate logistic regression demonstrated no difference in survival in the donor arrest group at 30 days, 1 year, or 3 years. Furthermore, the adjusted Cox proportional hazard model for cumulative survival also showed no survival difference between the 2 groups. If standard recipient and donor transplantation criteria are met, a history of donor cardiac arrest should not prohibit the potential consideration of an organ for transplantation. Copyright © 2013 Mosby, Inc. All rights reserved.

  4. Heritability of Risk for Sudden Cardiac Arrest in ESRD. (United States)

    Chan, Kevin E; Newton-Cheh, Christopher; Gusella, James F; Maddux, Franklin W


    Patients on dialysis are 20 times more likely to have a cardiac arrest compared with the general population. We considered whether inherited factors associate with cardiac arrest among patients on dialysis. From a sample of 647,457 patients on chronic dialysis, we identified 5117 pairs of patients who came from the same family. These patients were each matched to a control subject from the same population. McNemar's tests were used to compare the risk of cardiac arrest between the familial related and unrelated pairs. Genetically related family members who did not cohabitate had an odds ratio of 1.88 (95% confidence interval [95% CI], 1.25 to 2.84) for cardiac arrest compared with their phenotypically matched unrelated controls. Genetically related family members who lived together in the same environment had an odds ratio of 1.66 (95% CI, 1.20 to 2.28). Spouses, who are genetically unrelated but live together in the same environment, had an odds ratio of 0.95 (95% CI, 0.60 to 1.59) for cardiac arrest. The risk of cardiac arrest in patients on dialysis may be attributable to inherited factors. Additional studies are needed to identify such candidate genes that modify cardiovascular risk in ESRD. Copyright © 2015 by the American Society of Nephrology.

  5. Arrested coalescence of viscoelastic droplets with internal microstructure. (United States)

    Pawar, Amar B; Caggioni, Marco; Hartel, Richard W; Spicer, Patrick T


    There are many new approaches to designing complex anisotropic colloids, often using droplets as templates. However, droplets themselves can be designed to form anisotropic shapes without any external templates. One approach is to arrest binary droplet coalescence at an intermediate stage before a spherical shape is formed. Further shape relaxation of such anisotropic, arrested structures is retarded by droplet elasticity, either interfacial or internal. In this article we study coalescence of structured droplets, containing a network of anisotropic colloids, whose internal elasticity provides a resistance to full shape relaxation and interfacial energy minimization during coalescence. Precise tuning of droplet elasticity arrests coalescence at different stages and leads to various anisotropic shapes, ranging from doublets to ellipsoids. A simple model balancing interfacial and elastic energy is used to explain experimentally observed coalescence arrest in viscoelastic droplets. During coalescence of structured droplets the interfacial energy is continuously reduced while the elastic energy is increased by compression of the internal structure and, when the two processes balance one another, coalescence is arrested. Experimentally we observe that if either interfacial energy or elasticity dominates, total coalescence or total stability of droplets results. The stabilization mechanism is directly analogous to that in a Pickering emulsion, though here the resistance to coalescence is provided via an internal volume-based, rather than surface, structure. This study provides guidelines for designing anisotropic droplets by arrested coalescence but also explains some observations of "partial" coalescence observed in commercial foods like ice cream and whipped cream.

  6. Cardiac arrest due to lymphocytic colitis: a case report

    Directory of Open Access Journals (Sweden)

    Groth Kristian A


    Full Text Available Abstract Introduction We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis. Case presentation A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L and pH 6.86 (reference range: pH 7.37 to 7.45. As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest. Conclusion Diarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.

  7. The neighborhood context of racial and ethnic disparities in arrest. (United States)

    Kirk, David S


    This study assesses the role of social context in explaining racial and ethnic disparities in arrest, with afocus on how distinct neighborhood contexts in which different racial and ethnic groups reside explain variations in criminal outcomes. To do so, I utilize a multilevel, longitudinal research design, combining individual-level data with contextual data from the Project on Human Development in Chicago Neighborhoods (PHDCN). Findings reveal that black youths face multiple layers of disadvantage relative to other racial and ethnic groups, and these layers work to create differences in arrest. At the family level, results show that disadvantages in the form of unstable family structures explain much of the disparities in arrest across race and ethnicity. At the neighborhood level, black youths tend to reside in areas with both significantly higher levels of concentrated poverty than other youths as well as lower levels of collective efficacy than white youths. Variations in neighborhood tolerance of deviance across groups explain little of the arrest disparities, yet tolerance of deviance does influence the frequency with which a crime ultimately ends in an arrest. Even after accounting for relevant demographic, family, and neighborhood-level predictors, substantial residual arrest differences remain between black youths and youths of other racial and ethnic groups.

  8. Respiratory Arrest in an Obese Pregnant Woman with Hyperemesis Gravidarum

    Directory of Open Access Journals (Sweden)

    Ayumi Iwashita


    Full Text Available A pregnant, non-Japanese-speaking Peruvian, and, thus, with communication difficulty, suffered hyperemesis gravidarum and had respiratory arrest, requiring cardiopulmonary resuscitation. The obese pregnant woman (prepregnancy weight: 107 kg had vomited and lost 15 kg in bodyweight over appropriately 2 weeks prior to the arrest but had not complained due to communication difficulty, which, together with her obesity, prevented a Japanese obstetrician from noticing her severe condition. 1,000 mL of low potassium fluid plus thiamine was administered. She became unable to stand, suggesting lower-extremity-proximal-muscle weakness, and then respiratory arrest occurred. Hypopotassemia (2.3 mEq/L, pulseless electrical activity, and muscle weakness suggested the presence of severe potassium deficiency, which may have caused respiratory muscle paralysis, leading to the respiratory arrest. Hypercapnea was severer than expected for compensatory hypoventilation, indicating the presence of concomitant severe hypoventilation, which may also have contributed to respiratory arrest. She recovered with electrolyte and volume replacement. Respiratory arrest can occur with hyperemesis gravidarum, and obesity and communication difficulties can prevent the early detection of severe conditions.

  9. Associates of Cardiopulmonary Arrest in the Perihemodialytic Period

    Directory of Open Access Journals (Sweden)

    Jennifer E. Flythe


    Full Text Available Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes. This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath and to use the lowest effective erythropoietin stimulating agent dose.

  10. Imaging-Concordant Benign MRI-Guided Vacuum-Assisted Breast Biopsy May Not Warrant MRI Follow-Up. (United States)

    Huang, Monica L; Speer, Megan; Dogan, Basak E; Rauch, Gaiane M; Candelaria, Rosalind P; Adrada, Beatriz E; Hess, Kenneth R; Yang, Wei T


    results may not be warranted.

  11. Acute kidney injury after cardiac arrest. (United States)

    Tujjar, Omar; Mineo, Giulia; Dell'Anna, Antonio; Poyatos-Robles, Belen; Donadello, Katia; Scolletta, Sabino; Vincent, Jean-Louis; Taccone, Fabio Silvio


    The aim of this study was to evaluate the incidence and determinants of AKI in a large cohort of cardiac arrest patients. We reviewed all patients admitted, for at least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October 2012. AKI was defined as oligo-anuria (daily urine output <0.5 ml/kg/h) and/or an increase in serum creatinine (≥0.3 mg/dl from admission value within 48 hours or a 1.5 time from baseline level). Demographics, comorbidities, CA details, and ICU interventions were recorded. Neurological outcome was assessed at 3 months using the Cerebral Performance Category scale (CPC 1-2 = favorable outcome; 3-5 = poor outcome). A total of 199 patients were included, 85 (43%) of whom developed AKI during the ICU stay. Independent predictors of AKI development were older age, chronic renal disease, higher dose of epinephrine, in-hospital CA, presence of shock during the ICU stay, a low creatinine clearance (CrCl) on admission and a high cumulative fluid balance at 48 hours. Patients with AKI had higher hospital mortality (55/85 vs. 57/114, p = 0.04), but AKI was not an independent predictor of poor 3-month neurological outcome. AKI occurred in more than 40% of patients after CA. These patients had more severe hemodynamic impairment and needed more aggressive ICU therapy; however the development of AKI did not influence neurological recovery.

  12. Characterizing cardiopulmonary arrest during interventional radiology procedures. (United States)

    Rueb, George Richard; Brady, William J; Gilliland, Charles A; Patrie, James T; Saad, Wael E; Sabri, Saher S; Park, Auh W; Stone, James R; Angle, John F


    Careful case selection and preparation can prevent most cardiopulmonary arrest (CPA) in the interventional radiology (IR) suite. A series of CPAs was analyzed to provide insight into risk factors for these events. A single-institution CPA database was used to identify all code team activations from January 1, 2005, to May 30, 2011, in the IR department. Medical records were searched for medical history, American Society of Anesthesiologists (ASA) classification, moderate sedation, and outcomes. Procedural data and procedure classification was acquired from the HI-IQ database. There were 36,489 procedures and 23 CPAs during the study period. Of the 23 patients with CPAs, 12 (52%) were male and 11 (48%) female, and average age was 57 years ± 19 (standard deviation). Risk factors included a 56% incidence of diabetes mellitus, 48% incidence of hypertension, and 78% incidence of renal failure. Of the patients with kidney disease, 56% were chronically dialysis-dependent, and an additional 9% were undergoing central venous catheter placement for new hemodialysis. Seventy-eight percent had ASA status of III or greater, and 57% underwent moderate sedation during the procedure. Relative risk of a CPA during dialysis shunt interventions versus arterial interventions was 3.6 (95% confidence interval, 1.0-11.3; P = .045). Eight of 23 (35%) died: one (12%) during resuscitation and seven (88%) after resuscitation (P = .070). The most common comorbidity of patients with CPA in IR was kidney disease, and the most patients who had CPA underwent dialysis access-related procedures. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  13. Perioperative cardiac arrest: an evolutionary analysis of the intra-operative cardiac arrest incidence in tertiary centers in Brazil. (United States)

    Vane, Matheus Fachini; do Prado Nuzzi, Rafael Ximenes; Aranha, Gustavo Fabio; da Luz, Vinicius Fernando; Sá Malbouisson, Luiz Marcelo; Gonzalez, Maria Margarita Castro; Auler, José Otávio Costa; Carmona, Maria José Carvalho


    Great changes in medicine have taken place over the last 25 years worldwide. These changes in technologies, patient risks, patient profile, and laws regulating the medicine have impacted the incidence of cardiac arrest. It has been postulated that the incidence of intraoperative cardiac arrest has decreased over the years, especially in developed countries. The authors hypothesized that, as in the rest of the world, the incidence of intraoperative cardiac arrest is decreasing in Brazil, a developing country. The aim of this study was to search the literature to evaluate the publications that relate the incidence of intraoperative cardiac arrest in Brazil and analyze the trend in the incidence of intraoperative cardiac arrest. There were 4 articles that met our inclusion criteria, resulting in 204,072 patients undergoing regional or general anesthesia in two tertiary and academic hospitals, totalizing 627 cases of intraoperative cardiac arrest. The mean intraoperative cardiac arrest incidence for the 25 years period was 30.72:10,000 anesthesias. There was a decrease from 39:10,000 anesthesias to 13:10,000 anesthesias in the analyzed period, with the related lethality from 48.3% to 30.8%. Also, the main causes of anesthesia-related cause of mortality changed from machine malfunction and drug overdose to hypovolemia and respiratory causes. There was a clear reduction in the incidence of intraoperative cardiac arrest in the last 25 years in Brazil. This reduction is seen worldwide and might be a result of multiple factors, including new laws regulating the medicine in Brazil, incorporation of technologies, better human development level of the country, and better patient care. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  14. [Perioperative cardiac arrest: an evolutionary analysis of the intra-operative cardiac arrest incidence in tertiary centers in Brazil]. (United States)

    Vane, Matheus Fachini; do Prado Nuzzi, Rafael Ximenes; Aranha, Gustavo Fabio; da Luz, Vinicius Fernando; Sá Malbouisson, Luiz Marcelo; Gonzalez, Maria Margarita Castro; Auler, José Otávio Costa; Carmona, Maria José Carvalho


    Great changes in medicine have taken place over the last 25 years worldwide. These changes in technologies, patient risks, patient profile, and laws regulating the medicine have impacted the incidence of cardiac arrest. It has been postulated that the incidence of intraoperative cardiac arrest has decreased over the years, especially in developed countries. The authors hypothesized that, as in the rest of the world, the incidence of intraoperative cardiac arrest is decreasing in Brazil, a developing country. The aim of this study was to search the literature to evaluate the publications that relate the incidence of intraoperative cardiac arrest in Brazil and analyze the trend in the incidence of intraoperative cardiac arrest. There were 4 articles that met our inclusion criteria, resulting in 204,072 patients undergoing regional or general anesthesia in two tertiary and academic hospitals, totalizing 627 cases of intraoperative cardiac arrest. The mean intraoperative cardiac arrest incidence for the 25 years period was 30.72:10,000 anesthesias. There was a decrease from 39:10,000 anesthesias to 13:10,000 anesthesias in the analyzed period, with the related lethality from 48.3% to 30.8%. Also, the main causes of anesthesia-related cause of mortality changed from machine malfunction and drug overdose to hypovolemia and respiratory causes. There was a clear reduction in the incidence of intraoperative cardiac arrest in the last 25 years in Brazil. This reduction is seen worldwide and might be a result of multiple factors, including new laws regulating the medicine in Brazil, incorporation of technologies, better human development level of the country, and better patient care. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Montani Guido


    Full Text Available The European project is facing a crisis. Citizens no longer understand what the EU is about. Young people and the new ruling class have forgotten the clear message of the European project launched just after the Second World War "No wars ever again among Europeans." The founding fathers of the European Union are mentioned in history textbooks, but today Europe is felt as an irritating bureaucracy. In Europe, peace and economic stability are considered as a natural state, a gift from above. Why keep a useless EU alive? The state of the European Union is swiftly degenerating. In almost all the member states, the anti-European forces are gaining ground. Populism is not a new ideology and is not necessarily European: let's recall Peronism. In today's Europe populism is the new manifestation of nationalism. In Italy the Lega Nord is in Berlusconi's eurosceptic government. In France, the National Front is endangering UMP's hegemony. In Belgium the rows between the Flemish and the Walloons threatens the state's unity. In the Netherlands, Hungary, the Czech Republic, Austria and Finland, populist forces are either in the government or strongly influencing the government. National-populism is different from the nationalism of the past. De Gaulle's nationalism was an ideology founded on the "grandeur" of France's history and on a certain idea of Europe, which was "l'Europe de patrie", a kind of European unity accepting French leadership in world politics. Today national-populism is a form of micro-nationalism: it opposes the European project but without having a serious alternative. This is why populism is dangerous. Its real goal is not only the breaking down of the European Union but also the disintegration of the old nation states into micro-ethnic states, as what happened in former Yugoslavia.

  16. Editor's Choice-Extracorporeal life support for out-of-hospital cardiac arrest: Part of a treatment bundle. (United States)

    Lazzeri, Chiara; Valente, Serafina; Peris, Adriano; Gensini, Gian Franco


    In recent years, an increasing number of papers have been published on the use of extracorporeal cardiopulmonary resuscitation (ECPR) in adult patients, but, although promising results have been reported in patients with in-hospital refractory cardiac arrest supported by extracorporeal life support (ECLS), data on patients with out-of-hospital (OHCA) cardiac arrest are scarce and conflicting. The present study aims at summarizing the available evidence on the use of ECPR in adult patients with OHCA, clinically focusing on the factors most often associated with outcome in these patients. Even in the absence of randomized trials, there is growing evidence from ECLS centers documenting sound clinical benefits of ECPR in selected OHCA. According to the available evidence, three factors seem to contribute strongly to the favorable outcome of ECLS supported OHCA patients: (a) selection of patients (mainly definition of age range and a witnessed cardiac arrest); (b) the availability of an ECLS team, well skilled and experienced (to reduce time of implantation and incidence of complications); (c) a multifaceted approach to the OHCA patient (the so-called ECLS-bundle) to treat the reversible cause of CA (i.e. percutaneous coronary intervention), ensure neuroprotection (hypothermia), and maintain organ perfusion (till recovery). Taking into account the promising results of ECPR in selected OHCA patients, there is a clinical need for shared protocols to reduce differences related to the center experience and mostly to increase availability of ECLS as part of a multifaceted approach for these patients. © The European Society of Cardiology 2015.

  17. Contemporary animal models of cardiac arrest: A systematic review. (United States)

    Vognsen, Mikael; Fabian-Jessing, Bjørn K; Secher, Niels; Løfgren, Bo; Dezfulian, Cameron; Andersen, Lars W; Granfeldt, Asger


    Animal models are widely used in cardiac arrest research. This systematic review aimed to provide an overview of contemporary animal models of cardiac arrest. Using a comprehensive research strategy, we searched PubMed and EMBASE from March 8, 2011 to March 8, 2016 for cardiac arrest animal models. Two investigators reviewed titles and abstracts for full text inclusion from which data were extracted according to pre-defined definitions. Search criteria yielded 1741 unique titles and abstracts of which 490 full articles were included. The most common animals used were pigs (52%) followed by rats (35%) and mice (6%). Studies favored males (52%) over females (16%); 17% of studies included both sexes, while 14% omitted to report on sex. The most common methods for induction of cardiac arrest were either electrically-induced ventricular fibrillation (54%), asphyxia (25%), or potassium (8%). The median no-flow time was 8min (quartiles: 5, 8, range: 0-37min). The majority of studies used adrenaline during resuscitation (64%), while bicarbonate (17%), vasopressin (8%) and other drugs were used less prevalently. In 53% of the studies, the post-cardiac arrest observation time was ≥24h. Neurological function was an outcome in 48% of studies while 43% included assessment of a cardiac outcome. Multiple animal models of cardiac arrest exist. The great heterogeneity of these models along with great variability in definitions and reporting make comparisons between studies difficult. There is a need for standardization of animal cardiac arrest research and reporting. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Visualizing Vpr-induced G2 arrest and apoptosis.

    Directory of Open Access Journals (Sweden)

    Tomoyuki Murakami

    Full Text Available Vpr is an accessory protein of human immunodeficiency virus type 1 (HIV-1 with multiple functions. The induction of G2 arrest by Vpr plays a particularly important role in efficient viral replication because the transcriptional activity of the HIV-1 long terminal repeat is most active in G2 phase. The regulation of apoptosis by Vpr is also important for immune suppression and pathogenesis during HIV infection. However, it is not known whether Vpr-induced apoptosis depends on the ability of Vpr to induce G2 arrest, and the dynamics of Vpr-induced G2 arrest and apoptosis have not been visualized. We performed time-lapse imaging to examine the temporal relationship between Vpr-induced G2 arrest and apoptosis using HeLa cells containing the fluorescent ubiquitination-based cell cycle indicator2 (Fucci2. The dynamics of G2 arrest and subsequent long-term mitotic cell rounding in cells transfected with the Vpr-expression vector were visualized. These cells underwent nuclear mis-segregation after prolonged mitotic processes and then entered G1 phase. Some cells subsequently displayed evidence of apoptosis after prolonged mitotic processes and nuclear mis-segregation. Interestingly, Vpr-induced apoptosis was seldom observed in S or G2 phase. Likewise, visualization of synchronized HeLa/Fucci2 cells infected with an adenoviral vector expressing Vpr clearly showed that Vpr arrests the cell cycle at G2 phase, but does not induce apoptosis at S or G2 phase. Furthermore, time-lapse imaging of HeLa/Fucci2 cells expressing SCAT3.1, a caspase-3-sensitive fusion protein, clearly demonstrated that Vpr induces caspase-3-dependent apoptosis. Finally, to examine whether the effects of Vpr on G2 arrest and apoptosis were reversible, we performed live-cell imaging of a destabilizing domain fusion Vpr, which enabled rapid stabilization and destabilization by Shield1. The effects of Vpr on G2 arrest and subsequent apoptosis were reversible. This study is the first to

  19. Current Pharmacological Advances in the Treatment of Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Andry Papastylianou


    Full Text Available Cardiac arrest is defined as the sudden cessation of spontaneous ventilation and circulation. Within 15 seconds of cardiac arrest, the patient loses consciousness, electroencephalogram becomes flat after 30 seconds, pupils dilate fully after 60 seconds, and cerebral damage takes place within 90–300 seconds. It is essential to act immediately as irreversible damage can occur in a short time. Cardiopulmonary resuscitation (CPR is an attempt to restore spontaneous circulation through a broad range of interventions which are early defibrillation, high-quality and uninterrupted chest compressions, advanced airway interventions, and pharmacological interventions. Drugs should be considered only after initial shocks have been delivered (when indicated and chest compressions and ventilation have been started. During cardiopulmonary resuscitation, no specific drug therapy has been shown to improve survival to hospital discharge after cardiac arrest, and only few drugs have a proven benefit for short-term survival. This paper reviews current pharmacological treatment of cardiac arrest. There are three groups of drugs relevant to the management of cardiac arrest: vasopressors, antiarrhythmics, and other drugs such as sodium bicarbonate, calcium, magnesium, atropine, fibrinolytic drugs, and corticosteroids.

  20. Serum tau and neurological outcome in cardiac arrest

    DEFF Research Database (Denmark)

    Mattsson, Niklas; Zetterberg, Henrik; Nielsen, Niklas


    OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 hours after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome...... was poor neurological outcome, defined as Cerebral Performance Categories 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median = 38.5, interquartile range [IQR] = 5.7-245ng/l in poor vs median = 1.5, IQR = 0.7-2.4ng/l in good outcome, for tau....... The accuracy in predicting outcome by serum tau was equally high for patients randomized to 33 °C and 36 °C targeted temperature after cardiac arrest. INTERPRETATION: Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest. It may be significantly better...

  1. The effectiveness of silver diamine fluoride in arresting caries. (United States)

    Richards, Derek


    Data sourcesPubMed, Embase, Scopus, China National Knowledge Infrastructure (CNKI), Ichushi-web, Biblioteca Virtual en Salud Espana (BVSE) and Biblioteca Virtual em Saude (BVS) databases. There were no limits on language or publication dates.Study selectionTwo reviewers selected prospective clinical studies investigating SDF treatment for caries prevention in children.Data extraction and synthesisData was abstracted independently by two reviewers and risk of bias assessed. Meta-analysis was performed on studies in which the caries-arresting rate using 38% SDF solution on primary teeth could be obtained or calculated.ResultsNineteen studies were included; 16 were conducted in the primary dentition and three in permanent dentition. Fourteen studies used 38% SDF, three 30% SDF, and two 10% SDF. Eight studies using 38% SDF contributed to a meta-analysis and the overall proportion of arrested caries was 81% (95% CI; 68-89%). Percentage reductions were also calculated for 6,12,18,24 and >30 months. Arrested carious lesions stained black but no other adverse effects were reported.ConclusionsSDF commonly used at a high concentration (38%, 44,800ppm fluoride) is effective in arresting caries among children. There is no consensus on its number and frequency of application to arrest caries. Further studies are necessary to develop evidence-based guidelines on its use in children.

  2. Remineralisation and arresting caries in children with topical fluorides. (United States)

    Gugnani, Neeraj; Gugnani, Shalini


    Data sourcesThe Cochrane Library, PubMed, Embase and the ISI Web of Science.Study selectionEnglish language clinical trials in children with outcome measures including the remineralisation or arresting effect of caries by professional fluoride treatment were considered.Data extraction and synthesisTwo reviewers screened the studies and assessed risk of bias. Random effects meta-analysis was conducted.ResultsSeventeen studies were included, ten focused on remineralisation, seven on arresting carious lesions. Meta-analysis of four studies using 5% fluoride varnish found a 63.6% (95% CI; 36.0% - 91.2%) remineralisation of early enamel caries. For five studies using 38% silver diamine fluoride solution meta-analysis found 65.9% (95% CI; 41.2% - 90.7%) of caries arrested.ConclusionsProfessionally applied 5% sodium fluoride varnish shows the capability to remineralise early enamel caries in children. Silver diamine fluoride solution at 38% is effective in arresting active dentine caries. Because the number of clinical trials that studied the arresting effect of dental caries is limited, more clinical trials should be performed.

  3. Survival After Ventricular Fibrillation Cardiac Arrest in the Sao Paulo Metropolitan Subway System: First Successful Targeted Automated External Defibrillator (AED) Program in Latin America. (United States)

    Gianotto-Oliveira, Renan; Gonzalez, Maria Margarita; Vianna, Caio Brito; Monteiro Alves, Maurício; Timerman, Sergio; Kalil Filho, Roberto; Kern, Karl B


    Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. Pattern of perioperative cardiac arrests at University of Maiduguri Teaching Hospital. (United States)

    Kwari, Y D; Bello, M R; Eni, U E


    Perioperative cardiac arrests and death on the table represent the most serious complications of surgery and anaesthesia. This paper was designed to study their pattern, causes and outcomes following cardiopulmonary resuscitation (CPR) and intensive care unit (ICU) management in our institution. Three year retrospective review of perioperative cardiac arrests and death on operating table following surgical procedure under anaesthesia. For each cardiac arrest or death on the table the sequence of events leading to the arrest was evaluated using case notes, anaesthetic chart and ICU records. Study variables which include demographic data, ASA score, anaesthetic technique, causes and outcome were analysed and discussed. Fourteen perioperative cardiac arrests were encountered following 4051 anaesthetics administered over the three year study period. Twelve out of the fourteen cardiac arrests occurred following general anaesthesia, while the remaining two occurred following spinal anaesthesia. There was no cardiac arrest following local anaesthesia. Children suffered more cardiac arrest than adults. ASA class III and IV risk status suffered more arrests than ASA I and II. Hypoxia from airway problems was the commonest cause of cardiac arrest followed by septic shock. Monitoring with pulse oximeter was done in only 4 out of the 14 cardiac arrests. Only 2 (14%) out of 14 cardiac arrests recovered to home discharge, one of them with significant neurological deficit. Majority of arrests were due to hypoxia from airway problems that were not detected early There is need to improve on patient monitoring, knowledge of CPR and intensive care so as to improve the outcome of perioperative cardiac arrest.

  5. Numerical study of fracture arrest on snow cover

    Directory of Open Access Journals (Sweden)

    B. Frigo


    Full Text Available Under the hypothesis of a perfectly brittle phenomenon, avalanche triggering can be investigated numerically by means of Linear Elastic Fracture Mechanics (LEFM. Since, however, the real phenomenon is intrinsically dynamical, another aspect to investigate is represented by dynamic fracture propagation. In this paper, we model dynamic crack propagation into a dry snow slab and we investigate the possibility to arrest the crack propagation through the presence of weak zones distributed along the extension of the snow slope. Assuming that the weak layer is almost collapsed, we simulate the efficiency of artificial voids in the slab to arrest fracture propagation, into the framework of Dynamical Fracture Mechanics. We put forward here a new philosophy for the use of artificial discontinuities (void into the snowpack able to perform as crack arresters distributed along the snow slope area: the target is to split a large avalanche slab into smaller slabs, causing small avalanches to propagate with less catastrophic effects.

  6. Transcranial optical vascular imaging (TOVI) during cardiac arrest (Conference Presentation) (United States)

    Kalchenko, Vyacheslav; Kuznetsov, Yuri; Meglinski, Igor; Harmelin, Alon


    Based on the recent studies the prognosis of patients after cardiac arrest (CA) remains poor. Thus it is extremely important to understand fine mechanisms related to the influence of CA on the brain and Cerebral Blood Flow (CBF) during and after cardiac arrest. Recently our group introduced Transcranial Optical Vascular Imaging (TOVI) approach that combines laser speckle and dynamic fluorescent imaging. TOVI proved to be useful during various preclinical brain research applications. For example it allows imaging of brain blood vessels of a mouse in vivo through the intact cranium. Herein for the first time we present the use of TOVI during cardiac arrest. TOVI possibly could be a useful tool for preclinical studies of CBF during and after CA.

  7. Electronic registration of out-of-hospital cardiac arrests

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Dahl, Michael; Gade, John


    Introduction: The reported incidences of out-of-hospital cardiac arrests (OHCA) in western countries vary considerably. According to the latest report from Danish Cardiac Arrest Database (DCAD) the incidence rate in Denmark in 2004 was 51/100,000/year. The report states however that this number...... patients according to whether they received first aid, the identity of the first aid provider and the initial cardiac rhythm as diagnosed by the patient monitor.   Results: 18,666 patients where in contact with an emergency ambulance in the study period. Of those 296 (89/100,000/year) met the definition...... of cardiac arrest. 83 of those (28 %) received first aid. The first aid was provided by layman (68 %), physicians (11 %), nurses (11 %) and first-aiders (4 %). In 6 % the identity of the first aid provider was unknown. The majority of the patients (n = 177 (58 %)) had asystole upon ambulance arrival. 37 (12...

  8. Automated external defibrillators and simulated in-hospital cardiac arrests. (United States)

    Rossano, Joseph W; Jefferson, Larry S; Smith, E O'Brian; Ward, Mark A; Mott, Antonio R


    To test the hypothesis that pediatric residents would have shorter time to attempted defibrillation using automated external defibrillators (AEDs) compared with manual defibrillators (MDs). A prospective, randomized, controlled trial of AEDs versus MDs was performed. Pediatric residents responded to a simulated in-hospital ventricular fibrillation cardiac arrest and were randomized to using either an AED or MD. The primary end point was time to attempted defibrillation. Sixty residents, 21 (35%) interns, were randomized to 2 groups (AED = 30, MD = 30). Residents randomized to the AED group had a significantly shorter time to attempted defibrillation [median, 60 seconds (interquartile range, 53 to 71 seconds)] compared with those randomized to the MD group [median, 103 seconds (interquartile range, 68 to 288 seconds)] (P attempted defibrillation at attempted defibrillation by pediatric residents in simulated cardiac arrests. Further studies are needed to help determine the role of AEDs in pediatric in-hospital cardiac arrests.

  9. [Cardiac arrest in France: Why a national register?]. (United States)

    Gueugniaud, Pierre-Yves; Bertrand, C; Savary, Dominique; Hubert, H


    Cardiac arrest is a public health issue for which international guidelines are updated every five years (last bringing up to date on 2010 october). The lake of epidemiologic data on cardiac arrest justifies the building of a national register. French SAMU experienced registers especially in the field of acute coronary syndrom. Our national register "RéAC"is planned to deploy the present year for out-of-hospital cardiac arrest with the help of our scientific societies and the Department of Health. It is integrated in a program of evaluation and improvement of professional practices for physicians and prehospital teams who will be involved in its exhaustive use. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. Fatigue crack arrest in a self-healing polymer composite

    Energy Technology Data Exchange (ETDEWEB)

    Brown, E. N. (Eric N.); White, S. R. (Scott R.); Sottos, Nancy R.


    A comprehensive experimental program is performed to assess the in situ fatigue behavior of a self-healing polymer. A fatigue-life-extension protocol is established for characterizing healing efficiency of the self-healing epoxy under cyclic loading. At moderate {Delta}K{sub I} and at high {Delta}K{sub I}, when a rest period is employed, in situ healing extends fatigue life though temporary crack arrest and retardation. In situ self-healing permanently arrests crack growth at low {delta}K{sub I} and at moderate {Delta}K{sub I}, when a rest period is employed. Fatigue crack retardation and arrest result from two primary crack-tip shielding mechanisms: hydrodynamic pressure in the viscous healing agent and artificial crack closure. Application of self-healing functionality to fatigue slows the crack growth rate and increases the fatigue threshold.

  11. Increased risk of sudden cardiac arrest in obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Blom, Marieke Tabo; Bardai, Abdennasser


    BACKGROUND: We aimed to determine whether (1) patients with obstructive pulmonary disease (OPD) have an increased risk of sudden cardiac arrest (SCA) due to ventricular tachycardia or fibrillation (VT/VF), and (2) the SCA risk is mediated by cardiovascular risk-profile and/or respiratory drug use....... METHODS: A community-based case-control study was performed, with 1310 cases of SCA of the ARREST study and 5793 age, sex and SCA-date matched non-SCA controls from the PHARMO database. Only incident SCA cases, age older than 40 years, that resulted from unequivocal cardiac causes...

  12. Delamination Arrestment in Bonded-Bolted Composite Structures by Fasteners (United States)

    Cheung, Chi Ho Eric

    Laminated composites have exceptional in-plane strengths and fatigue properties. However, they are susceptible to the interlaminar mode of failure, namely disbond and delamination. This failure mode challenges the edges of structural interface, such as the skin-stringer flange and run-out, where interlaminar tension, shear, and opening moment are concentrated. The fasteners provide a substantiation path for the FAA damage tolerance requirement for composite bonded joints (FAR 23.573). A comprehensive understanding of delamination arrestment by fasteners was developed. The fastener provides crack arrest capability by three main mechanisms: 1) mode I suppression, 2) crack-face friction, and 3) fastener joint shear stiffness. The fastener mechanically closes the crack tip, suppressing mode I fracture and forcing the crack to propagate in pure mode II with higher fracture toughness. Fastener preload generates significant friction force on the cracked surfaces which reduces crack-tip forces and moments. The fastener shear joint provides an alternate load path around the crack tip that becomes more effective as crack length increases. The three mechanisms work in concert to provide various degrees of crack arrestment and retardation capability. A novel test technique was developed to quantify the delamination arrestment capability by fasteners under in-plane dominated loading, i.e. mode II propagation. The test results show that the fastener is highly capable of delamination arrestment and retardation. The test also demonstrates that fastener installation preload, which is directly related to crack-face friction, is an important factor in delamination arrestment. A computationally efficient analytical method was developed to capture the behavior and efficacy of delamination arrestment by fasteners. The solution method is based on the principle of minimum potential energy and beam-column modeling of the delaminating structure. The fastener flexibility approach is used to

  13. Educating in European Identity?

    National Research Council Canada - National Science Library

    Enrique Banús


    In the last decades, the claim for a "European identity" has been manifested sometimes as a solution for the citizens' distance to the European project, sometimes also as a precondition for a further...

  14. Temporal patterns of change in vital signs and Cardiac Arrest Risk Triage scores over the 48 hours preceding fatal in-hospital cardiac arrest. (United States)

    Oh, HyunSoo; Lee, KangIm; Seo, WhaSook


    To determine temporal patterns of vital sign and Cardiac Arrest Risk Triage score changes over the 48-hour period preceding cardiac arrest in an ICU setting. Vital sign instability usually occurs prior to cardiac arrest. However, few studies have been conducted on the temporal patterns of individual vital signs preceding cardiac arrest. A retrospective case-control study. The study subjects were 140 ICU patients (1 June 2011-31 December 2012): 46 died of cardiac arrest (case group), 45 died of other illnesses (control I group) and 49 were discharged after recovering (control II group). Initial detectable changes in blood pressure appeared 18-20 hours and became dramatic at 5-10 hours before cardiac arrest. Noticeable changes in heart rates began at 4 hours and became more prominent at 2 hours pre-arrest. No apparent patterns in respiratory rate changes were observed. Body temperatures usually indicated a hypothermic state pre-arrest. Cardiac Arrest Risk Triage scores were 16-18 at 48 hours pre-arrest and then continuously increased to 20. Only mean values of systolic blood pressures were significantly different between the three study groups. Mean diastolic blood pressures, heart rates, respiratory rates and Cardiac Arrest Risk Triage scores differed between the case and control II groups and between the control I and II groups. The study demonstrates vital sign instability preceded cardiac arrest and that the temporal patterns of changes in individual vital signs and Cardiac Arrest Risk Triage scores differed between groups. The findings of this study may aid the development of management strategies for cardiac arrest. © 2016 John Wiley & Sons Ltd.

  15. Interfacial crack arrest in sandwich beams subjected to fatigue loading using a novel crack arresting device – Numerical modelling

    DEFF Research Database (Denmark)

    Martakos, G.; Andreasen, J.H.; Berggreen, Christian


    fatigue test study. Based on a linear elastic fracture mechanics approach, the developed FE model is utilised to simulate crack propagation and arrest in foam-cored sandwich beam specimens subjected to fatigue loading conditions. The effect of the crack arresters on the fatigue life is analysed......A novel crack arresting device is implemented in foam-cored composite sandwich beams and tested using the Sandwich Tear Test (STT) configuration. A finite element model of the setup is developed, and the predictions are correlated with observations and results from a recently conducted experimental......, and the predictive results are subsequently compared with the observations from the previously conducted fatigue tests. The FE model predicts the energy release rate and the mode mixity based on the derived crack surface displacements, utilising algorithms for the prediction of accelerated fatigue crack growth...

  16. Clinical characteristics and reproductive outcomes in infertile men with testicular early and late maturation arrest. (United States)

    Tsai, Ming-Chun; Cheng, Yu-Sheng; Lin, Tsung-Yen; Yang, Wen-Horng; Lin, Yung-Ming


    To compare the clinical characteristics and reproductive outcomes of nonobstructive azoospermic men with uniform early and late maturation arrest. Patients with biopsy-documented uniform maturation arrest undergoing testicular sperm retrieval and complete medical records were enrolled in the present study. Their medical history, physical examination findings, testicular volume, serum hormone parameters, genetic anomalies, sperm retrieval, and reproductive outcomes were retrospectively analyzed. In a cohort of 223 nonobstructive azoospermic men, 34 men with uniform maturation arrest (21 early maturation arrest and 13 late maturation arrest) were identified. No significant differences were seen in the age distribution, testicular volume, or hormone parameters between patients with early and late maturation arrest. Only 13 patients (38.2%) had a normal serum follicle-stimulating hormone level and normal testicular volume. Patients with early maturation arrest had a greater frequency of overall genetic anomalies, and patients with late maturation arrest had a greater frequency of previous testicular insults. The sperm retrieval and impregnation rate were nonsignificantly greater in patients with late maturation arrest. Maturation arrest has a variety of causes and presents with diverse phenotypes. Not all patients with uniform maturation arrest have a normal follicle-stimulating hormone level or testicular volume. Patients with early maturation arrest have a greater incidence of genetic anomalies and are more likely to have worse reproductive outcomes than are patients with late maturation arrest. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Genetic Testing in the Evaluation of Unexplained Cardiac Arrest: From the CASPER (Cardiac Arrest Survivors With Preserved Ejection Fraction Registry). (United States)

    Mellor, Greg; Laksman, Zachary W M; Tadros, Rafik; Roberts, Jason D; Gerull, Brenda; Simpson, Christopher S; Klein, George J; Champagne, Jean; Talajic, Mario; Gardner, Martin; Steinberg, Christian; Arbour, Laura; Birnie, David H; Angaran, Paul; Leather, Richard; Sanatani, Shubhayan; Chauhan, Vijay S; Seifer, Colette; Healey, Jeffrey S; Krahn, Andrew D


    Unexplained cardiac arrest may be because of an inherited arrhythmia syndrome. The role of genetic testing in cardiac arrest survivors without a definite clinical phenotype is unclear. The CASPER (Cardiac Arrest Survivors with Preserved Ejection Fraction Registry) is a large registry of cardiac arrest survivors where initial assessment reveals normal coronary arteries, left ventricular function, and resting ECG. Of 375 cardiac arrest survivors in CASPER from 2006 to 2015, 174 underwent genetic testing. Patients were classified as phenotype-positive (n=72) or phenotype-negative (n=102). Genetic testing was performed at treating physicians' discretion in line with contemporary guidelines and availability. All genetic variants identified from original laboratory reports were reassessed by the investigators in line with modern criteria. Pathogenic variants were identified in 29 (17%) patients (60% channelopathy-associated and 40% cardiomyopathy-associated genes) and 70 variants of unknown significance were identified in 32 (18%) patients. Prior syncope (odds ratio, 4.0; 95% confidence interval, 1.6-9.7) and a family history of sudden death (odds ratio, 3.2; 95% confidence interval, 1.1-9.4) were independently associated with the presence of a pathogenic variant. In phenotype-negative patients, broad multiphenotype genetic testing led to higher yields (21% versus 8%; P=0.04) but was associated with more variants of unknown significance (55% versus 5%; Pcardiac arrest survivors. Prior syncope and family history of sudden death are predictors of a positive genetic test. Both arrhythmia and cardiomyopathy genes are implicated. Broad, multiphenotype testing revealed the highest frequency of pathogenic variants in phenotype-negative patients. Unique Identifier: NCT00292032. © 2017 American Heart Association, Inc.

  18. 10 CFR 1047.5 - Exercise of arrest authority-general guidelines. (United States)


    .... (c) After the arrest is effected, the arrested person shall be advised of his or her constitutional right against self-incrimination (Miranda warnings). If the circumstances are such that making such...

  19. Is Ward Experience in Resuscitation Effort Related to the Prognosis of Unexpected Cardiac Arrest?

    Directory of Open Access Journals (Sweden)

    Sen-Kuang Hou


    Conclusion: Hospital wards with more than 5 cardiac arrests per year have a better patient survival rate than those with fewer arrests. This is despite all ward staff receiving the same level of training.

  20. Prognostic Value of A Qualitative Brain MRI Scoring System After Cardiac Arrest

    NARCIS (Netherlands)

    Hirsch, Karen G.; Mlynash, Michael; Jansen, Sofie; Persoon, Suzanne; Eyngorn, Irina; Krasnokutsky, Michael V.; Wijman, Christine A. C.; Fischbein, Nancy J.


    BACKGROUND AND PURPOSETo develop a qualitative brain magnetic resonance imaging (MRI) scoring system for comatose cardiac arrest patients that can be used in clinical practice. METHODSConsecutive comatose postcardiac arrest patients were prospectively enrolled. Routine MR brain sequences were scored

  1. Anaphylactic shock and cardiac arrest caused by thiamine infusion

    DEFF Research Database (Denmark)

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald


    intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations. He was discharged in good health after 14 days. This case report emphasises both the importance...

  2. Exercise-related cardiac arrest in cardiac rehabilitation - The ...

    African Journals Online (AJOL)

    ... to establish the safety of cardiac rehabilitation as a medical intervention at the Johannesburg Cardiac Rehabilitation Centre from its inception in September 1982 to July 1988, and analyses the medical status of patients who suffered a cardiac arrest (CA) in order to determine possible factors predictive of sudden death.

  3. Haemodynamic consequences of mild therapeutic hypothermia after cardiac arrest.

    NARCIS (Netherlands)

    Bergman, R.; Braber, A.; Adriaanse, M.A.; Vugt, R. van; Tjan, D.H.; Zanten, A.R. van


    BACKGROUND AND OBJECTIVE: Mild therapeutic hypothermia (MTH) is used after out-of-hospital cardiac arrest (OHCA) to minimize cerebral damage. Induced hypothermia may further interfere with cardiac function and influence haemodynamics after OHCA. METHODS: This was a prospective study of haemodynamic

  4. An evaluation of the narrowing gender gap in DUI arrests. (United States)

    Robertson, Angela A; Liew, Hui; Gardner, Sheena


    Although males account for the vast majority of those convicted of driving under the influence of alcohol and/or other drugs (DUI), female DUI convictions have increased over the past two decades. In this study, we examined the ratio of males-to-females who were court-mandated between the years 1992 and 2008 to attend the Mississippi Alcohol Safety Education Program (MASEP), a DUI intervention program in Mississippi. The data for this study came from MASEP records; the Behavioral Risk Factor Surveillance System (BRFSS); the Uniform Crime Reports (UCR); the Treatment Episode Data Set (TEDS); the National Household Travel Survey (NHTS); and National Highway Traffic Safety Administration (NHTSA), an agency within the US Department of Transportation. Augmented Dickey-Fuller (ADF) tests were used to assess the nature (i.e., convergence, divergence, or stability) of this trend and to identify predictors. The results showed that, over the 17-year period, the gender gap in DUI convictions, self-reported history of prior arrest, official drug arrests, and substance abuse treatment admissions has narrowed considerably. Results from the autoregressive integrated moving average (ARIMA) models show that three factors account for increases in the proportion of women mandated to attend MASEP: self-reported arrest prior to the DUI conviction, female admissions to substance abuse treatment, and annual miles driven. Changes in both women's behavior and law enforcement practices have increased female exposure to DUI arrests and narrowed the gender gap in DUI convictions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Hemodynamics and vasopressor support in therapeutic hypothermia after cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Søholm, Helle


    AIM: Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level...

  6. Cardiac Arrest after Local Anaesthetic Toxicity in a Paediatric Patient

    Directory of Open Access Journals (Sweden)

    Liana Maria Torres de Araújo Azi


    Full Text Available We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome.

  7. [Cardio respiratory arrest out of the hospital at the eldest]. (United States)

    Karma, Sonia; Zouari, Abdelaziz; Frikha, Mokhtar; Dridi, Sana; Ghanem, Chedli; Jedidi, Slim; Belakhdar, Hajer; Abdelmoumen, Samir; Daghfous, Mounir


    The management of the older constituted a problematic that will be more attractive in the future because of the population's advanced age. To evaluate the management of the older more than 75 years that presented an arrest chest. Retrospective study during 12 months (from the first January 2004 to 31 December 2004) and interested 15 regulation's documents; we studied demographic parameters, the cause and the time of called the evolution after cardio-respiratory resuscitation. We had 9276 called cases: 320 concerned patients more than 75 years (3, 45%) among 15 (4, 68%) had a chest arrest, the ratio sex was 0, 5 and the middle age: 78, 4 years. In the most cases; the called arrived by night (40%). The principal symptomatology was respiratory troubles (33, 33%); the outcome was fatal in all cases. The older over than 75 years had many pathologies that is why the prognostic of the chest arrest was very bad (mortality 100%), the gravity of the chest arrest was seen on this study so we must take seriously all the pathology presented by the older, multiplied the medical consultations to detect the complications earlier and to improve the life's quality.

  8. [Refractory cardiac arrest patients in prehospital care, potential organ donors]. (United States)

    Le Jan, Arnaud; Dupin, Aurélie; Garrigue, Bruno; Sapir, David


    Under the authority of the French Biomedicine Agency, a new care pathway integrates refractory cardiac arrest patients into a process of organ donation. It is a medical, logistical and ethical challenge for the staff of the mobile emergency services. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  9. A novel parameter estimation method for metal oxide surge arrester ...

    Indian Academy of Sciences (India)

    In this paper, a new technique, which is the combination of Adaptive Particle Swarm Optimization (APSO) and Ant Colony Optimization (ACO) algorithms and linking the MATLAB and EMTP, is proposed to estimate the parameters of MO surge arrester models. The proposed algorithm is named Modified Adaptive Particle ...

  10. Sudden cardiac arrest in sports - need for uniform registration

    DEFF Research Database (Denmark)

    Solberg, E E; Borjesson, M; Sharma, S


    There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities....

  11. Sudden cardiac arrest risk in young athletes | Gradidge | South ...

    African Journals Online (AJOL)

    Underlying cardiac abnormalities are the main cause of unexpected death in athletes on field. These abnormalities have been associated with a previous history of syncope, a family history of sudden cardiac arrest (SCA), cardiac murmur, a history of over-exhaustion post exercise and ventricular tachyarrhythmia during ...

  12. Cdc20 control of cell fate during prolonged mitotic arrest

    DEFF Research Database (Denmark)

    Nilsson, Jakob


    The fate of cells arrested in mitosis by antimitotic compounds is complex but is influenced by competition between pathways promoting cell death and pathways promoting mitotic exit. As components of both of these pathways are regulated by Cdc20-dependent degradation, I hypothesize that variations...

  13. Public Cardiac Arrest Characteristics in Enclosed Pedestrian Networks

    NARCIS (Netherlands)

    Lee, Minha; Demirtas, Derya; Buick, Jason E.; Ng, Amy; Feldman, Michael J.; Cheskes, Sheldon; Morrison, Laurie J.; Chan, Timothy C.Y.


    Background: Cities around the world have underground or above-ground enclosed networks for pedestrian travel, representing unique environments for studying out-of-hospital cardiac arrest (OHCA) and resuscitation. The characteristics of OHCAs that occur in such networks are unknown. Objective: To

  14. Carbamazepine induces mitotic arrest in mammalian Vero cells

    Energy Technology Data Exchange (ETDEWEB)

    Perez Martin, J.M.; Fernandez Freire, P.; Labrador, V. [Departamento de Biologia, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, 28049 Madrid (Spain); Hazen, M.J. [Departamento de Biologia, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, 28049 Madrid (Spain)], E-mail:


    We reported recently that the anticonvulsant drug carbamazepine, at supratherapeutic concentrations, exerts antiproliferative effects in mammalian Vero cells, but the underlying mechanism has not been elucidated. This motivates us to examine rigorously whether growth arrest was associated with structural changes in cellular organization during mitosis. In the present work, we found that exposure of the cells to carbamazepine led to an increase in mitotic index, mainly due to the sustained block at the metaphase/anaphase boundary, with the consequent inhibition of cell proliferation. Indirect immunofluorescence, using antibodies directed against spindle apparatus proteins, revealed that mitotic arrest was associated with formation of monopolar spindles, caused by impairment of centrosome separation. The final consequence of the spindle defects induced by carbamazepine, depended on the duration of cell cycle arrest. Following the time course of accumulation of metaphase and apoptotic cells during carbamazepine treatments, we observed a causative relationship between mitotic arrest and induction of cell death. Conversely, cells released from the block of metaphase by removal of the drug, continued to progress through mitosis and resume normal proliferation. Our results show that carbamazepine shares a common antiproliferative mechanism with spindle-targeted drugs and contribute to a better understanding of the cytostatic activity previously described in Vero cells. Additional studies are in progress to extend these initial findings that define a novel mode of action of carbamazepine in cultured mammalian cells.

  15. Standardized EEG interpretation accurately predicts prognosis after cardiac arrest

    NARCIS (Netherlands)

    Westhall, Erik; Rossetti, Andrea O.; van Rootselaar, Anne-Fleur; Wesenberg Kjaer, Troels; Horn, Janneke; Ullén, Susann; Friberg, Hans; Nielsen, Niklas; Rosén, Ingmar; Åneman, Anders; Erlinge, David; Gasche, Yvan; Hassager, Christian; Hovdenes, Jan; Kjaergaard, Jesper; Kuiper, Michael; Pellis, Tommaso; Stammet, Pascal; Wanscher, Michael; Wetterslev, Jørn; Wise, Matt P.; Cronberg, Tobias; Saxena, Manoj; Miller, Jennene; Inskip, Deborah; Macken, Lewis; Finfer, Simon; Eatough, Noel; Hammond, Naomi; Bass, Frances; Yarad, Elizabeth; O'Connor, Anne; Bird, Simon; Jewell, Timothy; Davies, Gareth; Ng, Karl; Coward, Sharon; Stewart, Antony; Micallef, Sharon; Parker, Sharyn; Cortado, Dennis; Gould, Ann; Harward, Meg; Thompson, Kelly; Glass, Parisa; Myburgh, John; Smid, Ondrej; Belholavek, Jan; Kreckova, Marketa; Kral, Ales; Horak, Jan; Otahal, Michal; Rulisek, Jan; Malik, Jan; Prettl, Martin; Wascher, Michael; Boesgaard, Soeren; Moller, Jacob E.; Bro-Jeppesen, John; Johansen, Ane Loof; Campanile, Vincenzo; Peratoner, Alberto; Verginella, Francesca; Leone, Daniele; Pellis, Thomas; Roncarati, Andrea; Franceschino, Eliana; Sanzani, Anna; Martini, Alice; Perlin, Micol; Pelosi, Paolo; Brunetti, Iole; Insorsi, Angelo; Pezzato, Stefano; de Luca, Giorgio; Gazzano, Emanuela; Ottonello, Gian Andrea; Furgani, Andrea; Telani, Rosanna; Maiani, Simona; Werer, Christophe; Kieffer, Jaqueline; van der Veen, Annelou L.; Winters, Tineke; Juffermans, Nicole P.; Egbers, Ph; Boerma, EC; Gerritsen, R. T.; Buter, H.; de Jager, C.; de Lange, F.; Loos, M.; Koetsier, P. M.; Kingma, W. P.; Bruins, N.; de Kock, L.; Koopmans, M.; Bosch, Frank; Raaijmakers, Monique A. M.; Metz-Hermans, S. W. L.; Endeman, Henrik; Rijkenberg, Saskia; Bianchi, Addy; Bugge, Jan Frederik; Norum, Hilde; Espinoza, Andreas; Kerans, Viesturs; Brevik, Helene; Svalebjørg, Morten; Grindheim, Guro; Petersen, Arne Jan; Baratt-Due, Andreas; Laake, Jon Henrik; Spreng, Ulrik; Wallander Karlsen, Marte Marie; Langøren, Jørund; Fanebust, Rune; Holm, Marianne Sætrang; Flinterud, Stine Iren; Wickman, Carsten; Johnsson, Jesper; Ebner, Florian; Gustavsson, Nerida; Petersson, Heléne; Petersson, Jörgen; Nasiri, Faezheh; Stafilidou, Frida; Edqvist, Kristine; Uhlig, Sven; Sköld, Gunilla; Sanner, Johan; Wallskog, Jesper; Wyon, Nicholas; Golster, Martin; Samuelsson, Anders; Hildebrand, Carl; Kadowaki, Taichi; Larsson-Viksten, Jessica; de Geer, Lina; Hansson, Patrik; Appelberg, Henrik; Hellsten, Anders; Lind, Susanne; Rundgren, Malin; Kander, Thomas; Persson, Johan; Annborn, Martin; Adolfsson, Anne; Corrigan, Ingrid; Dragancea, Irina; Undén, Johan; Larsson, Marina; Chew, Michelle; Unnerbäck, Mårten; Petersen, Per; Svedung-Rudebou, Anna; Svensson, Robert; Elvenes, Hilde; Bäckman, Carl; Rylander, Christian; Martner, Patrik; Martinell, Louise; Biber, Björn; Ahlqvist, Marita; Jacobson, Caisa; Forsberg, Marie-Louise; Lindgren, Roman Desta; Bergquist, Fatma; Thorén, Anders; Fredholm, Martin; Sellgren, Johan; Hård Af Segerstad, Lisa; Löfgren, Mikael; Gustavsson, Ingvor; Henström, Christina; Andersson, Bertil; Thiringer, Karin; Rydholm, Nadja; Persson, Stefan; Jawad, Jawad; Östman, Ingela; Berglind, Ida; Bergström, Eric; Andersson, Annika; Törnqvist, Cathrine; Marques de Mello, Nubia Lafayete; Gardaz, Valérie; Kleger, Gian-Reto; Schrag, Claudia; Fässler, Edith; Zender, Hervé; Wise, Matthew; Palmer, Nicki; Fouweather, Jen; Cole, Jade M.; Cocks, Eve; Frost, Paul J.; Saayman, Anton G.; Holmes, Tom; Hingston, Christopher D.; Scholey, Gareth M.; Watkins, Helen; Fernandez, Stephen; Walden, Andrew; Atkinson, Jane; Jacques, Nicola; Brown, Abby; Cranshaw, Julius; Berridge, Peter; McCormick, Robert; Schuster-Bruce, Martin; Scott, Michelle; White, Nigel; Vickers, Emma; Glover, Guy; Ostermann, Marlies; Holmes, Paul; Koutroumanidis, Michael; Lei, Katie; Sanderson, Barnaby; Smith, John; al-Subaie, Nawaf; Moore, Matthew; Randall, Paul; Mellinghoff, Johannes; Buratti, Azul Forti; Ryan, Chris; Ball, Jonathan; Francis, Gaynor


    To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. In this cohort study, 4 EEG specialists, blinded to outcome,

  16. 19 CFR 162.63 - Arrests and seizures. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Arrests and seizures. 162.63 Section 162.63 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162...

  17. Europeanization and transnational states

    DEFF Research Database (Denmark)

    Jacobsson, Bengt; Lægreid, Per; Pedersen, Ove K.

    This work investigates what happens to an organized political unit when it becomes part of a larger entity and, in particular, how increased European integration and the tentative moves towards a transnational state will affect the European Union's nation state. Europeanization and the transforma......This work investigates what happens to an organized political unit when it becomes part of a larger entity and, in particular, how increased European integration and the tentative moves towards a transnational state will affect the European Union's nation state. Europeanization...... in central government agencies. It concludes that the consequences of Europeanization can be described as the growth of a transnational administration where identities as well as loyalties are created in processes that transcend the borders of states....

  18. The arresting phase determines the total healing time of

    Directory of Open Access Journals (Sweden)

    LI Ping


    Full Text Available 【Abstract】Objective: Radiation is an important cause of delayed wound healing, and there still exist many questions regarding the patterns and mechanisms of wound healing. This study investigated the characteristics of wound healing after varying doses of local radiation and explored possible causes of the delay in healing caused by radiation. Methods: A full-thickness dorsal longitudinal skin tissue, 2 cm in diameter, was excised after local irradiation on one side of the back of swine, and the other side was wounded as a control. The size of the wound area was re-corded every two days after injury. Pathological changes, proliferating cell nuclear antigen (PCNA, immunohisto-chemistry and apoptosis levels (TUNEL assay were mea-sured at different time points after wounding. Results: The course of wound healing can be divided into four phases, namely: the arresting phase, the healing priming phase, the fast healing phase, and the healed phase. Although the total wound healing time was closely corre-lated to the dose of irradiation (R 2 = 0.9758, it was more dependent on the length of the arresting phase (R 2 =0.9903 because once the arresting phase ended, the wound healed at a similar speed regardless of radiation doses. Pathologi-cal analysis showed that compared with the control side there were more necrotic tissues, slower epithelial crawling, as well as fewer blood vessels and cellular components in the irradiated side at the arresting phase, while other phases revealed no significant difference concerning these measurements. Immunohistochemistry showed that the ir-radiated wounds had significantly less PCNA-positive and more TUNEL-positive labeling of cells in the arresting phase than in other phases. Moreover, the changes were posi-tively related to the radiation doses, but there was no obvi-ous difference in cell proliferation or apoptosis among the healing priming phase, fast healing phase or healed phase, whether on the control side

  19. Exercise-related sudden cardiac arrest in London: incidence, survival and bystander response


    Edwards, Melanie J; Fothergill, Rachael T


    Objective The study aimed to (1) establish the incidence of exercise-related sudden cardiac arrest (SCA) in London, (2) investigate survival from exercise-related SCA and (3) examine factors related to survival. Method This retrospective observational study examined 2 years’ data from the London Ambulance Service (LAS) cardiac arrest registry for patients in whom resuscitation was attempted following an out-of-hospital cardiac arrest (OHCA), a cardiac cause was presumed and the arrest occurre...

  20. Cardiopulmonary arrest in pregnancy with schizophrenia: a case report. (United States)

    Kudo, Takako; Kaga, Akimune; Akagi, Kozo; Iwahashi, Hideki; Makino, Hiromitsu; Watanabe, Yoko; Kawamura, Takae; Sato, Taiju; Shinozaki, Tsuyoshi; Miwa, Shinya; Okazaki, Nobuo; Kure, Shigeo; Nakae, Shingi


    Cardiopulmonary arrest in pregnancy has a very high maternal and fetal mortality rate. We report a case of successful maternal and neonatal survival in association with emergency cesarean section of a schizophrenic pregnant patient. To our knowledge, this is the first reported case of cardiopulmonary arrest in a pregnant woman with schizophrenia. The parents were Japanese. The mother was 39 years old and had no history of prior pregnancy. Her admission to our hospital at 36 weeks and 4 days of pregnancy was due to deterioration of schizophrenia. On the first day of hospitalization, she collapsed after a seizure and vomiting, and an emergency resuscitation team was called immediately. The team identified apparent aspiration and successfully resuscitated the patient after 11 minutes of cardiopulmonary arrest. An emergency cesarean section was performed in the operating room. The newborn male infant received bag and mask ventilation at birth, and his Apgar scores were 5 at 1 minute and 8 at 5 minutes. He had a myoclonic seizure on the 2nd day of life: however, he experienced no further seizures on anticonvulsant medication after that episode. On the 18th day of life, magnetic resonance imaging of his brain revealed bilateral small hyperintensities on T1-weighted images in the basal ganglia. The mother and her newborn were discharged from our hospital without neurological disorders. We speculate that the cause of cardiopulmonary arrest was aspiration due to seizure, and it is possible that a neurological response was evoked by administration of antipsychotic drugs and/or by eclampsia. Medical staff must be aware of the possibility of cardiopulmonary arrest in pregnant women with schizophrenia.

  1. Gender and Relational-Distance Effects in Arrests for Domestic Violence (United States)

    Lally, William; DeMaris, Alfred


    This study tests two hypotheses regarding factors affecting arrest of the perpetrator in domestic violence incidents. Black's relational-distance thesis is that the probability of arrest increases with increasing relational distance between perpetrator and victim. Klinger's leniency principle suggests that the probability of arrest is lower for…

  2. Mechanical cardiopulmonary resuscitation in in-hospital cardiac arrest : a systematic review

    NARCIS (Netherlands)

    Lameijer, Heleen; Immink, Rosa S.; Broekema, Josien J.; Ter Maaten, Jan C.


    With increasing rates of in-hospital cardiac arrest, improving resuscitation outcomes is essential. Mechanical chest compressors seem to be related to improved outcome in out-of hospital cardiac arrest; however, the literature on its use in in-hospital cardiac arrest is scarce. We used the Medline

  3. Shockable rhythms and defibrillation during in-hospital pediatric cardiac arrest. (United States)

    Rodríguez-Núñez, Antonio; López-Herce, Jesús; del Castillo, Jimena; Bellón, José María


    To analyze the results of cardiopulmonary resuscitation (CPR) that included defibrillation during in-hospital cardiac arrest (IH-CA) in children. A prospective multicenter, international, observational study on pediatric IH-CA in 12 European and Latin American countries, during 24 months. Data from 502 children between 1 month and 18 years were collected using the Utstein template. Patients with a shockable rhythm that was treated by electric shock(s) were included. The primary endpoint was survival at hospital discharge. Univariate logistic regression analysis was performed to find outcome factors. Forty events in 37 children (mean age 48 months, IQR: 7-15 months) were analyzed. An underlying disease was present in 81.1% of cases and 24.3% had a previous CA. The main cause of arrest was a cardiac disease (56.8%). In 17 episodes (42.5%) ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) was the first documented rhythm, and in 23 (57.5%) it developed during CPR efforts. In 11 patients (27.5%) three or more shocks were needed to achieve defibrillation. Return of spontaneous circulation (ROSC) was obtained in 25 cases (62.5%), that was sustained in 20 (50.0%); however only 12 children (32.4%) survived to hospital discharge. Children with VF/pVT as first documented rhythm had better sustained ROSC (64.7% vs. 39.1%, p=0.046) and survival to hospital discharge rates (58.8% vs. 21.7%, p=0.02) than those with subsequent VF/pVT. Survival rate was inversely related to duration of CPR. Clinical outcome was not related to the cause or location of arrest, type of defibrillator and waveform, energy dose per shock, number of shocks, or cumulative energy dose, although there was a trend to better survival with higher doses per shock (25.0% with 4Jkg(-1)) and worse with higher number of shocks and cumulative energy dose. The termination of pediatric VF/pVT in the IH-CA setting is achieved in a low percentage of instances with one electrical shock at 4Jkg(-1

  4. Girls with Emotional Disturbance and a History of Arrest: Characteristics and School-Based Predictors of Arrest (United States)

    Gage, Nicholas A.; Josephs, Nikki L.; Lunde, Kimberly


    Research suggests that girls receiving special education services for Emotional Disturbance (ED) may have unique characteristics and needs. Similarly, juvenile justice research has identified unique characteristics of court-involved girls. This study examined characteristics of girls with ED and a history of arrest. Additionally, classroom-based…

  5. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Wissenberg, Mads; Lippert, Freddy K.; Folke, Fredrik


    IMPORTANCE Out-of-hospital cardiac arrest is a major health problem associated with poor outcomes. Early recognition and intervention are critical for patient survival. Bystander cardiopulmonary resuscitation (CPR) is one factor among many associated with improved survival. OBJECTIVE To examine...... temporal changes in bystander resuscitation attempts and survival during a 10-year period in which several national initiatives were taken to increase rates of bystander resuscitation and improve advanced care. DESIGN, SETTING, AND PARTICIPANTS Patients with out-of-hospital cardiac arrest for which...... resuscitation was attempted were identified between 2001 and 2010 in the nationwide Danish Cardiac Arrest Registry. Of 29 111 patients with cardiac arrest, we excluded those with presumed noncardiac cause of arrest (n = 7390) and those with cardiac arrests witnessed by emergency medical services personnel (n...

  6. European Symposium on Precision Medicine in Allergy and Airways Diseases: Report of the European Union Parliament Symposium (October 14, 2015). (United States)

    Muraro, A; Fokkens, W J; Pietikainen, S; Borrelli, D; Agache, I; Bousquet, J; Costigliola, V; Joos, G; Lund, V J; Poulsen, L K; Price, D; Rolland, C; Zuberbier, T; Hellings, P W


    The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS), and the European Medical Association (EMA) organized, on October 14, 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP David Borrelli, and with active participation of the EU Commissioner for Health and Food Safety Vytenis Andriukaitis, MEP Sirpa Pietikainen, Chair of the European Parliament Interest Group on Allergy and Asthma, the European Respiratory Society (ERS), the European Federations of Allergy and Airways Diseases Patients Associations (EFA), the Global Allergy and Asthma European Network (Ga2len), Allergic Rhinitis and Its Impact on Asthma (ARIA), and the Respiratory Effectiveness Group (REG). The socioeconomic impact of allergies and chronic airways diseases cannot be underestimated, as they represent the most frequently diagnosed chronic noncommunicable diseases in the EU; 30% of the total European population is suffering from allergies and asthma, and more than half are deprived from adequate diagnosis and treatment. Precision medicine represents a novel approach, embracing four key features: personalized care based on molecular, immunologic, and functional endotyping of the disease, with participation of the patient in the decision-making process of therapeutic actions, and considering predictive and preventive aspects of the treatment. Implementation of precision medicine into clinical practice may help to achieve the arrest of the epidemic of allergies and chronic airways diseases. Participants underscored the need for optimal patient care in Europe, supporting joint action plans for disease prevention, patient empowerment, and cost-effective treatment strategies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Local Immigration Enforcement and Arrests of the Hispanic Population

    Directory of Open Access Journals (Sweden)

    Michael Coon


    Full Text Available Section 287(g of the Immigration and Nationality Act (INA, which was added to the INA by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA, allows the federal government to enter into voluntary partnerships with state and local law enforcement agencies to enforce immigration law. Upon entering these agreements, law enforcement officers are trained by Immigration and Customs Enforcement (ICE and receive delegated authority to enquire about an individual’s immigration status and, if found to be removable, to detain the individual while ICE makes a determination of whether to initiate deportation proceedings. In some instances, this inquiry about immigration status takes place as part of the intake process when a criminal defendant is arrested and placed into a criminal jail. In other instances, task force officers are trained to inquire in the field about immigration status and enforce immigration law against people who have not committed any criminal offense.  The key difference between the two models is that task force agents can arrest for immigration violations undocumented individuals who have not committed any criminal offense, whereas in the jail model individuals must be arrested on some other criminal charge before immigration status can be determined. The 287(g program has raised several concerns regarding its implementation and results. First, the program could lead to racial and ethnic profiling. In particular, given that the majority of undocumented immigrants hail from Latin American countries, it is highly plausible that Hispanics, regardless of immigrant status, might be disproportionally affected by this program. That is, in a jurisdiction that participates in the jail model, an officer might arrest a Hispanic individual for a very minor offence in order to process them through the jail and determine their immigration status, when perhaps without the program they may have only issued a citation

  8. Cognitive function after cardiac arrest and temperature management; rationale and description of a sub-study in the Target Temperature Management trial. (United States)

    Lilja, Gisela; Nielsen, Niklas; Friberg, Hans; Horn, Janneke; Kjaergaard, Jesper; Pellis, Tommaso; Rundgren, Malin; Wetterslev, Jørn; Wise, Matt P; Nilsson, Fredrik; Cronberg, Tobias


    Mild to moderate cognitive impairment is common amongst long-term survivors of cardiac arrest. In the Target Temperature Management trial (TTM-trial) comatose survivors were randomized to 33°C or 36°C temperature control for 24 hours after cardiac arrest and the effects on survival and neurological outcome assessed. This protocol describes a sub-study of the TTM-trial investigating cognitive dysfunction and its consequences for patients' and relatives' daily life. Sub-study sites in five European countries included surviving TTM patients 180 days after cardiac arrest. In addition to the instruments for neurological function used in the main trial, sub-study patients were specifically tested for difficulties with memory (Rivermead Behavioural Memory Test), attention (Symbol Digit Modalities Test) and executive function (Frontal Assessment Battery). Cognitive impairments will be related to the patients' degree of participation in society (Mayo-Portland Adaptability Inventory-4), health related quality of life (Short Form Questionnaire-36v2©), and the caregivers' situation (Zarit Burden Interview©). The two intervention groups (33°C and 36°C) will be compared with a group of myocardial infarction controls. This large international sub-study of a randomized controlled trial will focus on mild to moderate cognitive impairment and its consequences for cardiac arrest survivors and their caregivers. By using an additional battery of tests we may be able to detect more subtle differences in cognitive function between the two intervention groups than identified in the main study. The results of the study could be used to develop a relevant screening model for cognitive dysfunction after cardiac arrest. NCT01946932.

  9. Community involvement in out of hospital cardiac arrest (United States)

    Shams, Ali; Raad, Mohamad; Chams, Nour; Chams, Sana; Bachir, Rana; El Sayed, Mazen J.


    Abstract Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Developing countries including Lebanon report low survival rates and poor neurologic outcomes in affected victims. Community involvement through early recognition and bystander cardiopulmonary resuscitation (CPR) can improve OHCA survival. This study assesses knowledge and attitude of university students in Lebanon and identifies potential barriers and facilitators to learning and performing CPR. A cross-sectional survey was administered to university students. The questionnaire included questions regarding the following data elements: demographics, knowledge, and awareness about sudden cardiac arrest, CPR, automated external defibrillator (AED) use, prior CPR and AED training, ability to perform CPR or use AED, barriers to performing/learning CPR/AED, and preferred location for attending CPR/AED courses. Descriptive analysis followed by multivariate analysis was carried out to identify predictors and barriers to learning and performing CPR. A total of 948 students completed the survey. Participants’ mean age was 20.1 (±2.1) years with 53.1% women. Less than half of participants (42.9%) were able to identify all the presenting signs of cardiac arrest. Only 33.7% of participants felt able to perform CPR when witnessing a cardiac arrest. Fewer participants (20.3%) reported receiving previous CPR training. Several perceived barriers to learning and performing CPR were also reported. Significant predictors of willingness to perform CPR when faced with a cardiac arrest were: earning higher income, previous CPR training and feeling confident in one's ability to apply an AED, or perform CPR. Lacking enough expertise in performing CPR was a significant barrier to willingness to perform CPR. University students in Lebanon are familiar with the symptoms of cardiac arrest, however, they are not well trained in CPR and lack confidence to perform it. The attitude towards the importance of

  10. Use of Automated External Defibrillators in Cardiac Arrest (United States)


    Executive Summary Objective The objectives were to identify the components of a program to deliver early defibrillation that optimizes the effectiveness of automated external defibrillators (AEDs) in out-of-hospital and hospital settings, to determine whether AEDs are cost-effective, and if cost-effectiveness was determined, to advise on how they should be distributed in Ontario. Clinical Need Survival in people who have had a cardiac arrest is low, especially in out-of-hospital settings. With each minute delay in defibrillation from the onset of cardiac arrest, the probability of survival decreases by 10%. (1) Early defibrillation (within 8 minutes of a cardiac arrest) has been shown to improve survival outcomes in these patients. However, in out-of-hospital settings and in certain areas within a hospital, trained personnel and their equipment may not be available within 8 minutes. This implies that “first responders” should take up the responsibility of delivering shock. The first responders in out-of-hospital settings are usually bystanders, firefighters, police, and community volunteers. In hospital settings, they are usually nurses. These first responders are not trained in reading electrocardiograms and identifying abnormal heart rhythms restorable by defibrillation. The Technology An AED is a device that can analyze a heart rhythm and deliver a shock if needed. Thus, AEDs can be used by first responders to deliver early defibrillation in out-of-hospital and hospital settings. However, simply providing an AED would not likely improve survival outcomes. Rather, AEDs have a role in strengthening the “chain of survival,” which includes prompt activation of the 911 telephone system, early cardiopulmonary resuscitation (CPR), rapid defibrillation, and timely advanced life support. In the chain of survival, the first step for a witness of a cardiac arrest in an out-of-hospital setting is to call 911. Second, the witness initiates CPR (if she or he is

  11. Nascent SecM chain outside the ribosome reinforces translation arrest.

    Directory of Open Access Journals (Sweden)

    Zhuohao Yang

    Full Text Available SecM, a bacterial secretion monitor protein, contains a specific amino acid sequence at its C-terminus, called arrest sequence, which interacts with the ribosomal tunnel and arrests its own translation. The arrest sequence is sufficient and necessary for stable translation arrest. However, some previous studies have suggested that the nascent chain outside the ribosome affects the stability of translation arrest. To clarify this issue, we performed in vitro translation assays with HaloTag proteins fused to the C-terminal fragment of E. coli SecM containing the arrest sequence or the full-length SecM. We showed that the translation of HaloTag proteins, which are fused to the fragment, is not effectively arrested, whereas the translation of HaloTag protein fused to full-length SecM is arrested efficiently. In addition, we observed that the nascent SecM chain outside the ribosome markedly stabilizes the translation arrest. These results indicate that changes in the nascent polypeptide chain outside the ribosome can affect the stability of translation arrest; the nascent SecM chain outside the ribosome stabilizes the translation arrest.

  12. Nascent SecM chain outside the ribosome reinforces translation arrest. (United States)

    Yang, Zhuohao; Iizuka, Ryo; Funatsu, Takashi


    SecM, a bacterial secretion monitor protein, contains a specific amino acid sequence at its C-terminus, called arrest sequence, which interacts with the ribosomal tunnel and arrests its own translation. The arrest sequence is sufficient and necessary for stable translation arrest. However, some previous studies have suggested that the nascent chain outside the ribosome affects the stability of translation arrest. To clarify this issue, we performed in vitro translation assays with HaloTag proteins fused to the C-terminal fragment of E. coli SecM containing the arrest sequence or the full-length SecM. We showed that the translation of HaloTag proteins, which are fused to the fragment, is not effectively arrested, whereas the translation of HaloTag protein fused to full-length SecM is arrested efficiently. In addition, we observed that the nascent SecM chain outside the ribosome markedly stabilizes the translation arrest. These results indicate that changes in the nascent polypeptide chain outside the ribosome can affect the stability of translation arrest; the nascent SecM chain outside the ribosome stabilizes the translation arrest.

  13. A large specific deterrent effect of arrest for patronizing a prostitute.

    Directory of Open Access Journals (Sweden)

    Devon D Brewer


    Full Text Available Prior research suggests that arrest, compared with no police detection, of some types of offenders does not decrease the chances they will reoffend.We assessed the specific deterrent effect of arrest for patronizing a street prostitute in Colorado Springs by comparing the incidence of arrest for clients of prostitutes first detected through public health surveillance with the incidence of rearrest for clients first detected by police arrest. Although these sets of clients were demographically and behaviorally similar, arrest reduced the likelihood of a subsequent arrest by approximately 70%. In other areas of the United States, arrest did not appear to displace a client's patronizing.Our results suggest that apprehending clients decreases their patronizing behavior substantially.

  14. A Large Specific Deterrent Effect of Arrest for Patronizing a Prostitute (United States)

    Brewer, Devon D.; Potterat, John J.; Muth, Stephen Q.; Roberts, John M.


    Background Prior research suggests that arrest, compared with no police detection, of some types of offenders does not decrease the chances they will reoffend. Methodology/Principal Findings We assessed the specific deterrent effect of arrest for patronizing a street prostitute in Colorado Springs by comparing the incidence of arrest for clients of prostitutes first detected through public health surveillance with the incidence of rearrest for clients first detected by police arrest. Although these sets of clients were demographically and behaviorally similar, arrest reduced the likelihood of a subsequent arrest by approximately 70%. In other areas of the United States, arrest did not appear to displace a client's patronizing. Conclusions/Significance Our results suggest that apprehending clients decreases their patronizing behavior substantially. PMID:17183691

  15. Amnesia, anesthesia, and warranted fear. (United States)

    Carbonell, Vanessa


    Is a painful experience less bad for you if you will not remember it? Do you have less reason to fear it? These questions bear on how we think about medical procedures and surgeries that use an anesthesia regimen that leaves patients conscious - and potentially in pain - but results in complete 'drug-induced amnesia' after the fact. I argue that drug-induced amnesia does not render a painful medical procedure a less fitting object of fear, and thus the prospect of amnesia does not give patients a reason not to fear it. I expose three mistakes in reasoning that might explain our tendency to view pain or discomfort as less fearful in virtue of expected amnesia: a mistaken view of personal identity; a mistaken view of the target of anticipation; and a mistaken method of incorporating past evidence into calculations about future experiences. Ultimately my argument has implications for whether particular procedures are justified and how medical professionals should speak with anxious patients about the prospect of drug-induced amnesia. © 2012 John Wiley & Sons Ltd.

  16. Warrant Officer Examinations. PR-4018 (United States)


    ccouunting, Administrative - Clcorica1, Judge, Advo Ge~nc. De~ptsAdxiiniistrati~ve 1 icl Adi isrtv - Supp:ly, generaile8 ~ Administrativo ’ - Supply, Air...n; htay assist in the 3stcblishmunt -at extending of horizontal and vertical cntrol f:orwird rnd the supply of necessary ground mapping control the Air Forces: Air-air andaikr-81.grund communicatiuns,9 control tower operations (comnunications phases), A.A*C.Szsystims, radio aids to

  17. Cardiac Arrest in a Pregnant Patient Diagnosed with Bochdalek Hernia

    Directory of Open Access Journals (Sweden)

    Pinar Karabacak


    Full Text Available Bochdalek hernia is thought to be the result of a defect of the pleuroperitoneal fold and the septum transversum fusion in the 8th week of gestation. The majority of these patients present with respiratory distress after delivery; asymptomatic progress until adulthood is an extremely rare clinical occurrence. The adult form of a Bochdalek hernia accompanying pregnancy is a rare entity. A 39-year-old, 24-week pregnant patient applied to Emergency service with epigastric pain and vomiting. Abdominal ultrasonography was planned due to the abdominal pain; sudden cardiopulmonary arrest occurred during the procedure. In this case report, congenital diaphragmatic hernia in a young pregnant woman who underwent cardiac arrest is presented.

  18. Drugs in cardiac arrest: the rise and fall of antiarrhythmics. (United States)

    Karlis, George; Afantenou, Sevasti


    Since the publication of 2000 guidelines for resuscitation, amiodarone is considered the antiarrhythmic drug of choice for refractory ventricular fibrillation/pulseless ventricular tachycardia. However, to date there is no proven benefit in terms of neurologically intact survival to hospital discharge. A comprehensive search of the recent literature on amiodarone, nifekalant and lidocaine in cardiac arrest was performed. Amiodarone and nifekalant are superior to lidocaine with regards to the return of spontaneous circulation and survival to hospital admission. Nifekalant shows a trend towards quicker termination of ventricular fibrillation compared to amiodarone. There is great uncertainty about the efficacy of antiarrhythmics in cardiac arrest. Failure to show improvements regarding meaningful survival questions their current use and suggests the need for re-evaluating their place in cardiopulmonary resuscitation.

  19. Metazoan operons accelerate recovery from growth arrested states (United States)

    Zaslaver, Alon; Baugh, L. Ryan; Sternberg, Paul W.


    Summary Existing theories explain why operons are advantageous in prokaryotes, but their occurrence in metazoans is an enigma. Nematode operon genes, typically consisting of growth genes, are significantly up-regulated during recovery from growth-arrested states. This expression pattern is anti-correlated to non-operon genes consistent with a competition for transcriptional resources. We find that transcriptional resources are initially limiting during recovery, and that recovering animals are highly sensitive to any additional decrease in transcriptional resources. Operons become advantageous because by clustering growth genes into operons, fewer promoters compete for the limited transcriptional machinery, effectively increasing the concentration of transcriptional resources, and accelerating recovery. Mathematical modeling reveals how a moderate increase in transcriptional resources can substantially enhance transcription rate and recovery. This design principle occurs in different nematodes and the chordate C. intestinalis. As transition from arrest to rapid growth is shared by many metazoans, operons could have evolved to facilitate these processes. PMID:21663799

  20. Metazoan operons accelerate recovery from growth-arrested states. (United States)

    Zaslaver, Alon; Baugh, L Ryan; Sternberg, Paul W


    Existing theories explain why operons are advantageous in prokaryotes, but their occurrence in metazoans is an enigma. Nematode operon genes, typically consisting of growth genes, are significantly upregulated during recovery from growth-arrested states. This expression pattern is anticorrelated to nonoperon genes, consistent with a competition for transcriptional resources. We find that transcriptional resources are initially limiting during recovery and that recovering animals are highly sensitive to any additional decrease in transcriptional resources. We provide evidence that operons become advantageous because, by clustering growth genes into operons, fewer promoters compete for the limited transcriptional machinery, effectively increasing the concentration of transcriptional resources and accelerating recovery. Mathematical modeling reveals how a moderate increase in transcriptional resources can substantially enhance transcription rate and recovery. This design principle occurs in different nematodes and the chordate C. intestinalis. As transition from arrest to rapid growth is shared by many metazoans, operons could have evolved to facilitate these processes. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Cardiac arrest during a twin birth caesarean delivery. (United States)

    Pampín-Huerta, F R; Moreira-Gómez, D; Lozano-Requelme, M L; Molina-Nieto, F; Fontán-García-Boente, L; Moreira-Pacheco, M


    The case of a 35 year-old pregnant woman with a right ovarian vein thrombosis complicated with a floating thrombus in the inferior vena cava reaching the right atrium, is presented. The patient had a cardiac arrest due to a pulmonary embolism during a twin-birth caesarean delivery. Discussion includes the pathophysiology of this condition and management options in a cardiac arrest secondary to this aetiology, recovered with stable blood pressure, highlighting the role of thrombolytic therapy in the Postoperative Care Unit in this situation. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. A Case of Morgagni Hernia Resulting with Respiratory Arrest

    Directory of Open Access Journals (Sweden)

    Cavit Çöl


    Full Text Available Morgagni’s hernia is seen at a rate of 3-4% among all diaphragmatic hernias. It develops from a defect in the pleuroperitoneal membrane. Herniation of the omentum is seen most commonly, that of the colon frequently, and herniation of small bowel and stomach is seen rarely. When being examined due to anemia and dyspnea, a 53-year-old male patient suffered from a respiratory arrest and was hence intubated and placed under treatment at the intensive care unit. On radiological examination, a giant diaphragmatic hernia was observed bilaterally, more marked on the right side. On laparotomy, especially on the right side, the caecum, the ascending colon, the transverse colon, the appendix, the omentum and part of the small bowel was seen to be herniated. Primary diaphragmatic repair + right hemicolectomy + end-to-end ileo-transversostomy was performed. We have reported this case because it was a giant hernia which caused respiratory arrest.

  3. Cardiac arrest related to anaesthesia in Williams-Beuren syndrome. (United States)

    Lucena Delgado, J; Sanabria Carretero, P; Durán la Fuente, P; Gónzalez Rocafort, A; Castro Parga, L; Reinoso Barbero, F


    Williams-Beuren syndrome is the clinical manifestation of a congenital genetic disorder in the elastin gene, among others. There is a history of cardiac arrest refractory to resuscitation manoeuvres in anaesthesia. The incidence of myocardial ischaemia is high during anaesthetic induction, but there are patients who do not have this condition yet also have had very serious cardiac events, and issues that are still to be resolved. Case descriptions will enable the common pathophysiological factors to be defined, and decrease morbidity and mortality. We report the case of a 3-year-old boy with cardiac arrest at induction, rescued with circulatory assistance with extracorporeal membrane oxygenation and hypothermia induced for cerebral protection. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Thermal Arrest Memory Effect in Ni-Mn-Ga Alloys

    Directory of Open Access Journals (Sweden)

    A. Rudajevova


    Full Text Available Dilatation characteristics were measured to investigate the thermal arrest memory effect in Ni53.6Mn27.1Ga19.3 and Ni54.2Mn29.4Ga16.4 alloys. Interruption of the martensite-austenite phase transformation is connected with the reduction of the sample length after thermal cycle. If a total phase transformation took place in the complete thermal cycle following the interruption, then the sample length would return to its original length. Analysis of these results has shown that the thermal arrest memory effect is a consequence of a stress-focusing effect and shape memory effect. The stress-focusing effect occurs when the phase transformation propagates radially in a cylindrical sample from the surface, inward to the center. Evolution and release of the thermoelastic deformations in both alloys during heating and cooling are analyzed.

  5. Luminescence from Tube-Arrest Bubbles in Pure Glycerin (United States)

    Chen, Qi-Dai; Wang, Long


    Single transient cavitation bubble with luminescence has been generated in pure glycerin by using the `tube arrest' method. The analyses of high-speed photograph and light emission data suggest that the light emission would be a single bubble sonoluminescence. The luminescence pulse width is observed to vary from sub-nanosecond to about 30 ns. The width and intensity of luminescence pulses increases with the height of the liquid column height and decreases with the liquid temperature.

  6. Circulatory Arrest: A Surgical Option for Adult Window Ductus Closure

    Directory of Open Access Journals (Sweden)

    Vithalkumar Malleshi Betigeri


    Full Text Available The window ductus , an atypical type of patent ductus arteriosus(PDA is a characteristically large in size(>2cm with no recognizable length, characteristic continuation of main pulmonary artery with aortic arch and absence of internal ductal tissue. Surgical safety and effectiveness of its closure can be increased by using cardiopulmonary bypass (CPB and hypothermic total circulatory arrest (HTCA via median sternotomy.

  7. Cardiac arrest in schools: Nationwide incidence, risk, and outcome. (United States)

    Hwang, Soyun; Shin, Sang Do; Lee, Kyungwon; Song, Kyoung Jun; Ahn, Ki Ok; Kim, Yu Jin; Hong, Ki Jeong; Ro, Young Sun; Lee, Eui Jung


    Schools are an important location for improving OHCA outcome. But there are few data on out of hospital cardiac arrest (OHCA) in schools. This study aimed to show incidence and outcome of OHCA in schools, specifying location and activities. We used the Korean nationwide OHCA registry from 2008 to 2014. OHCA victims were categorized regarding level of school. The average annual incidence of OHCA was calculated based on per 1000 schools. The epidemiological characteristics are analysed and location and activity at the time of arrest is further described. The outcome of OHCA victims were analysed. 511 OHCA occurred in school while 374 cases were cardiac origin, 125 cases were non-cardiac, and 12 cases were missing in information. Annual incidence was 5.72 per 1000 school while highest incidence was shown in university (11.02 per 1000 school). The majority of victims were male (84.1%), aged 19-64 (62.2%, median 44.75), either students (35.0%) or visitors (35.2%). Most victims had none shockable rhythms, did not received EMS defibrillation and were not witnessed arrests, while most received bystander CPR. A large proportion of arrests occurred at an outdoor campus (29.7%) or sports facility (28.8%), and the most frequent activity was exercise (30.7%). 100 patients (19.6%) survived to discharge, and 66 patients (12.9%) were discharged with good neurological outcome. Incidence of OHCA in school is low. Most of victims were adult visitors. About one third of OHCA occurred during sports activity or at the sports facility. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Arresting Strategy Based on Dynamic Criminal Networks Changing over Time

    Directory of Open Access Journals (Sweden)

    Junqing Yuan


    Full Text Available We investigate a sequence of dynamic criminal networks on a time series based on the dynamic network analysis (DNA. According to the change of networks’ structure, networks’ variation trend is analyzed to forecast its future structure. Finally, an optimal arresting time and priority list are designed based on our analysis. Better results can be expected than that based on social network analysis (SNA.

  9. A descriptive study of feelings of arrested escape (entrapment and arrested anger in people presenting to an Emergency Department following an episode of self-harm

    Directory of Open Access Journals (Sweden)

    Martin Clarke


    Full Text Available Background and objectives: To explore the role of elevated feelings of anger and desires to escape (fight or flight which are experienced as inhibited, blocked and arrested (i.e. arrested anger and arrested flight escape leading to feelings of entrapment. This descriptive study developed measures of arrested anger and arrested flight and explored these in the context of a recent self-harm event in people presenting to a Hospital’s Emergency Department (ED.Methods: Fifty-eight individuals presenting to an ED following an act of self-harm were recruited. Participants completed newly developed measures of arrested flight, arrested anger and anger with self in regard to self-harm and suicide intent and depression. Results: 93% participants presented after self-poisoning. The majority (95% reported having experienced high escape motivation that felt blocked (arrested flight with 69% reporting feeling angry with someone but unable to express it (arrested anger. For many participants (53.7%, strong desires to escape from current situations and/or to express anger did not diminish immediately after the act. Limitations: As with many studies, a select group of participants agreed to take part and we did not keep records of how many refused.There are no other validated measures of arrested escape and arrested anger and so for this study, our short item-focused measures rely on face validity. Conclusions: Arrested defences of fight and flight, and self-criticism are common in those who have self-harmed and may continue after acts of self-harm. Many participants revealed that talking about their experiences of escape motivation and blocked anger (using our measures was helpful to them.   Practice points: •Feelings of entrapment and arrested anger are common in people who self-harm •Clinicians could benefit from increased awareness and measures of arrested flight and arrested anger•Discussing these concepts and experiences appears to be useful to

  10. Family Burden After Out-of-Hospital Cardiac Arrest in Children. (United States)

    Meert, Kathleen L; Slomine, Beth S; Christensen, James R; Telford, Russell; Holubkov, Richard; Dean, J Michael; Moler, Frank W


    To describe family burden among caregivers of children who survived out-of-hospital cardiac arrest and who were at high risk for neurologic disability and examine relationships between family burden, child functioning, and other factors during the first year post arrest. Secondary analysis of data from the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. Thirty-six PICUs in the United States and Canada. Seventy-seven children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial who had normal prearrest neurologic functioning and were alive 1 year post arrest. Family burden was assessed using the Infant Toddler Quality of Life Questionnaire for children less than 5 years old and the Child Health Questionnaire for children 5 years old or older at baseline (reflecting prearrest status), 3 months, and 12 months post arrest. Child functioning was assessed using the Vineland Adaptive Behavior Scale II, the Pediatric Overall Performance Category, and Pediatric Cerebral Performance Category scales and caregiver perception of global functioning. Fifty-six children (72.7%) were boys, 48 (62.3%) were whites, and 50 (64.9%) were less than 5 years old prior to out-of-hospital cardiac arrest. Family burden at baseline was not significantly different from reference values. Family burden was increased at 3 and 12 months post arrest compared with reference values (p family burden all measured 3 months post arrest were associated with higher family burden 12 months post arrest (p family burden 12 months post arrest. Families of children who survive out-of-hospital cardiac arrest and have high risk for neurologic disability often experience substantial burden during the first year post arrest. The extent of child dysfunction 3 months post arrest is associated with family burden at 12 months.

  11. Mitotic arrest in teratoma susceptible fetal male germ cells.

    Directory of Open Access Journals (Sweden)

    Patrick S Western

    Full Text Available Formation of germ cell derived teratomas occurs in mice of the 129/SvJ strain, but not in C57Bl/6 inbred or CD1 outbred mice. Despite this, there have been few comparative studies aimed at determining the similarities and differences between teratoma susceptible and non-susceptible mouse strains. This study examines the entry of fetal germ cells into the male pathway and mitotic arrest in 129T2/SvJ mice. We find that although the entry of fetal germ cells into mitotic arrest is similar between 129T2/SvJ, C57Bl/6 and CD1 mice, there were significant differences in the size and germ cell content of the testis cords in these strains. In 129T2/SvJ mice germ cell mitotic arrest involves upregulation of p27(KIP1, p15(INK4B, activation of RB, the expression of male germ cell differentiation markers NANOS2, DNMT3L and MILI and repression of the pluripotency network. The germ-line markers DPPA2 and DPPA4 show reciprocal repression and upregulation, respectively, while FGFR3 is substantially enriched in the nucleus of differentiating male germ cells. Further understanding of fetal male germ cell differentiation promises to provide insight into disorders of the testis and germ cell lineage, such as testis tumour formation and infertility.

  12. Sildenafil after cardiac arrest and infarction; an experimental rat model. (United States)

    Mennander, Ari A; Vuohelainen, Vilma; Aanismaa, Riikka S; Narkilahti, Susanna; Paavonen, Timo; Tarkka, Matti


    Resuscitation after cardiac arrest may lead to ischemia-reperfusion injury and infarction. We evaluated whether sildenafil, a phosphodiesterase-5 inhibitor, has an impact on recovery after cardiac arrest in a rat cardiac transplantation model. Sixty-one Fischer344 rats underwent syngeneic heterotopic cardiac transplantation after ischemia and ligation of the left anterior coronary artery of the heart to yield myocardial infarction (IRI + MI). Of these, 22 rats received subcutaneously injected sildenafil (1 mg/kg/day) (IRI +MI + S). Twenty-three additional grafted animals with transplantation only served as controls with ischemia reperfusion injury (IRI). After 2 days, immunohistochemistry for eNOS, and RT-PCR for iNOS and Aquaporin-7 were performed after graft harvesting and histology. Two days after transplantation, remote intramyocardial arteries were more preserved in IRI + MI + S as compared with IRI +MI and IRI (0.74 ± 0.14, 0.56 ± 0.23 and 0.55 ± 0.22, PSU, p cardiac arrest and ischemia.

  13. Brain injury following cardiac arrest: pathophysiology for neurocritical care. (United States)

    Uchino, Hiroyuki; Ogihara, Yukihiko; Fukui, Hidekimi; Chijiiwa, Miyuki; Sekine, Shusuke; Hara, Naomi; Elmér, Eskil


    Cardiac arrest induces the cessation of cerebral blood flow, which can result in brain damage. The primary intervention to salvage the brain under such a pathological condition is to restore the cerebral blood flow to the ischemic region. Ischemia is defined as a reduction in blood flow to a level that is sufficient to alter normal cellular function. Brain tissue is highly sensitive to ischemia, such that even brief ischemic periods in neurons can initiate a complex sequence of events that may ultimately culminate in cell death. However, paradoxically, restoration of blood flow can cause additional damage and exacerbate the neurocognitive deficits in patients who suffered a brain ischemic event, which is a phenomenon referred to as "reperfusion injury." Transient brain ischemia following cardiac arrest results from the complex interplay of multiple pathways including excitotoxicity, acidotoxicity, ionic imbalance, peri-infarct depolarization, oxidative and nitrative stress, inflammation, and apoptosis. The pathophysiology of post-cardiac arrest brain injury involves a complex cascade of molecular events, most of which remain unknown. Many lines of evidence have shown that mitochondria suffer severe damage in response to ischemic injury. Mitochondrial dysfunction based on the mitochondrial permeability transition after reperfusion, particularly involving the calcineurin/immunophilin signal transduction pathway, appears to play a pivotal role in the induction of neuronal cell death. The aim of this article is to discuss the underlying pathophysiology of brain damage, which is a devastating pathological condition, and highlight the central signal transduction pathway involved in brain damage, which reveals potential targets for therapeutic intervention.

  14. Collapse arresters for deep water pipelines: identification of crossover mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Toscano, Rita G.; Mantovano, Luciano; Assanelli, Andrea; Amenta, Pablo; Johnson, Daniel; Charreau, Roberto; Dvorkin, Eduardo [Tenaris Center for industrial Research (CINI), Siderca, Campana (Argentina)


    Deep water pipelines, normally subjected to external pressure and bending, fail due to structural collapse when the external loading exceeds the pipes collapse limit surface. For steel pipes, the influence on this limit surface of manufacturing imperfections has been thoroughly studied by CINI using finite element models that have been validated via laboratory full-scale tests. After a steel pipeline collapses, the collapse is restrained to the collapse initiation section or it propagates along the pipeline, being this second alternative the most detrimental one for the pipeline integrity. Therefore, it is necessary to build in the pipeline periodic reinforcements, to act as arresters for the collapse propagation. Using finite element models, we study the crossover of collapse arresters by the propagating collapse. The occurrence of different crossover mechanisms is determined by the geometry of the pipes and of the arresters. Laboratory tests were carried out at CINI in order to obtain experimental results that could be used to validate the numerical models. In this paper, we compare the numerical and experimental results for external pressure lo (author)

  15. Long-term neuropsychological outcomes in children and adolescents after cardiac arrest. (United States)

    van Zellem, Lennart; Buysse, Corinne; Madderom, Marlous; Legerstee, Jeroen S; Aarsen, Femke; Tibboel, Dick; Utens, Elisabeth M


    Research into neuropsychological functioning of survivors of cardiac arrest (CA) in childhood is scarce. We sought to assess long-term neuropsychological functioning in children and adolescents surviving CA. Neuropsychological follow-up study involving all consecutive children surviving CA between January 2002 and December 2011. Intelligence (IQ), language, attention, memory, visual-spatial, and executive functioning were assessed with internationally validated, neuropsychological tests and questionnaires. Scores were compared with Dutch normative data. Of 107 eligible children, 47 who visited the outpatient clinic (median follow-up interval: 5.6 years) were analyzed. Fifty-five percent had an in-hospital CA, 86% a non-shockable rhythm, and 49% a respiratory-related etiology. CA survivors scored significantly worse on full-scale IQ (mean = 87.3), verbal IQ (mean = 92.7), performance IQ (mean = 85.6), verbal comprehension index (mean = 93.4), perceptual organization index (mean = 83.8), and processing speed index (mean = 91.1), than the norm population (mean IQ = 100). On neuropsychological tests, compared with norms, respectively adjusted for IQ, significantly worse scores were found on visual memory, significantly better on verbal memory (recognition), and comparable outcomes on visual-motor integration, attention, other measures of verbal memory, and executive functioning. On questionnaires, parents reported better executive functioning than the norm, but teachers reported more problems in planning/organizing skills. Long-term neuropsychological assessment of CA survivors showed significant weaknesses, but also relatively intact functioning. As deficits in IQ, memory and executive functioning have significant impact on the child, long-term follow-up and neuropsychological support of CA survivors is warranted.


    Directory of Open Access Journals (Sweden)

    Ignat Ion


    Full Text Available The construction of European Monetary Union has raised several questions about the existence of a common business cycle, a European one. The lack of cyclical synchronization would complicate the monetary and fiscal policies in the Union, being a negative

  17. European Home Energy

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.


    An important aim of the european energy performance of buildings directive is to improve the overall energy efficiency of new homes......An important aim of the european energy performance of buildings directive is to improve the overall energy efficiency of new homes...

  18. European Industry, 1700 - 1870

    NARCIS (Netherlands)

    Broadberry, Stephen; Fremdling, Rainer; Solar, Peter M.


    This paper offers an overview of the development of European industry between 1700 and 1870, drawing in particular on the recent literature that has emerged following the formation of the European Historical Economics Society in 1991. The approach thus makes use of economic analysis and quantitative

  19. The European Programme Manager

    DEFF Research Database (Denmark)

    Larson, Anne; Bergman, E.; Ehlers, S.

    The publication is a result of a cooperation between organisations in six European countries with the aim to develop a common European education for programme managers. It contains of a description of the different elements of the education together with a number of case-studies from the counties...

  20. European works councils

    DEFF Research Database (Denmark)

    Knudsen, Herman Lyhne


    The theme adressed by this paper is the opportunities for European Works Councils (EWCs) of gaining influence on corporate decisions in multinational companies.......The theme adressed by this paper is the opportunities for European Works Councils (EWCs) of gaining influence on corporate decisions in multinational companies....

  1. European works councils

    DEFF Research Database (Denmark)

    Knudsen, Herman Lyhne


    The theme addressed by this artcle is the opportunities for European Works Councils of gaining influence on corporate decisions in multinational companies.......The theme addressed by this artcle is the opportunities for European Works Councils of gaining influence on corporate decisions in multinational companies....

  2. Introduction: European climate leadership

    NARCIS (Netherlands)

    Wurzel, R.K.W.; Liefferink, J.D.; Connelly, J.


    There is no shortage of would-be leaders in EU climate change politics. The EU institutions (e.g. European Council, Council of the EU, Commission and the European Parliament (EP)), member states and societal actors have all, though to varying degrees and at different time periods, tried to offer

  3. Europeanization : A Poststructuralist Approach

    NARCIS (Netherlands)

    Neuman-Stanivukovic, Senka


    This dissertation begins from the hypothesis that the direction and extent of Europeanization depends on domestic perception of the European Union and its norms. Accordingly, it was my empirical ambition to study how competing articulations of the EU and its norms constructed debates in EU member

  4. European media law

    NARCIS (Netherlands)

    Castendyk, O.; Dommering, E.; Scheuer, A.


    European Union legislation concerning electronic communications media is firmly established as an essential part of the law in the field in Europe. From relevant provisions of the European Convention of Human Rights and the EC Treaty to numerous directives, the most recent being the Audiovisual

  5. Development of a data dictionary for the Strategies for Post Arrest Resuscitation Care (SPARC) network for post cardiac arrest research. (United States)

    Lin, Steve; Morrison, Laurie J; Brooks, Steven C


    The widely accepted Utstein style has standardized data collection and analysis in resuscitation and post resuscitation research. However, collection of many of these variables poses significant practical challenges. In addition, several important variables in post resuscitation research are missing. Our aim was to develop a comprehensive data dictionary and web-based data collection tool as part of the Strategies for Post Arrest Resuscitation Care (SPARC) Network project, which implemented a knowledge translation program for post cardiac arrest therapeutic hypothermia in 37 Ontario hospitals. A list of data variables was generated based on the current Utstein style, previous studies and expert opinion within our group of investigators. We developed a data dictionary by creating clear definitions and establishing abstraction instructions for each variable. The data dictionary was integrated into a web-based collection form allowing for interactive data entry. Two blinded investigators piloted the data collection tool, by performing a retrospective chart review. A total of 454 variables were included of which 400 were Utstein, 2 were adapted from existing studies and 52 were added to address missing elements. Kappa statistics for two outcome variables, survival to discharge and induction of therapeutic hypothermia were 0.86 and 0.64, respectively. This is the first attempt in the literature to develop a data dictionary as part of a standardized, pragmatic data collection tool for post cardiac arrest research patients. In addition, our dataset defined important variables that were previously missing. This data collection tool can serve as a reference for future trials in post cardiac arrest care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Escape from Mitotic Arrest: An Unexpected Connection Between Microtubule Dynamics and Epigenetic Regulation of Centromeric Chromatin in Schizosaccharomyces pombe. (United States)

    George, Anuja A; Walworth, Nancy C


    Accurate chromosome segregation is necessary to ensure genomic integrity. Segregation depends on the proper functioning of the centromere, kinetochore, and mitotic spindle microtubules and is monitored by the spindle assembly checkpoint (SAC). In the fission yeast Schizosaccharomyces pombe, defects in Dis1, a microtubule-associated protein that influences microtubule dynamics, lead to mitotic arrest as a result of an active SAC and consequent failure to grow at low temperature. In a mutant dis1 background (dis1-288), loss of function of Msc1, a fission yeast homolog of the KDM5 family of proteins, suppresses the growth defect and promotes normal mitosis. Genetic analysis implicates a histone deacetylase (HDAC)-linked pathway in suppression because HDAC mutants clr6-1, clr3∆, and sir2∆, though not hos2∆, also promote normal mitosis in the dis1-288 mutant. Suppression of the dis phenotype through loss of msc1 function requires the spindle checkpoint protein Mad2 and is limited by the presence of the heterochromatin-associated HP1 protein homolog Swi6. We speculate that alterations in histone acetylation promote a centromeric chromatin environment that compensates for compromised dis1 function by allowing for successful kinetochore-microtubule interactions that can satisfy the SAC. In cells arrested in mitosis by mutation of dis1, loss of function of epigenetic determinants such as Msc1 or specific HDACs can promote cell survival. Because the KDM5 family of proteins has been implicated in human cancers, an appreciation of the potential role of this family of proteins in chromosome segregation is warranted. Copyright © 2015 by the Genetics Society of America.

  7. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study). (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline


    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p resuscitation durations compared to that of the other groups (p resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. PREFACE: Dynamically slow processes and near-arrest phenomena in soft matter Dynamically slow processes and near-arrest phenomena in soft matter (United States)

    Chen, Sow-Hsin


    The aim of this special issue is to summarize what has been learnt by both the network (the Marie Curie Research and Training Network on Arrested Matter) and the broader international community on dynamically slow processes and near-arrest phenomena. Another aspect of this special issue is to highlight new directions in which dynamical slowing down is, or may be, important. In particular, this issue is dedicated to a member of this network, Professor Francesco Mallamace, who reached the venerable age of 60 in 2008. Professor Francesco Mallamace is one of the group leaders of the complex materials and systems worldwide network. In particular he is a pioneer who has successfully investigated aggregation phenomena and the dynamics of colloids, and the properties of water in the deeply supercooled phase region. The scientific activities of Professor Mallamace are mainly experimental, making use of different scattering and spectroscopic techniques. He is a very active and well-known scientist not only for his research but also for training young scientists by organizing many international networks, congresses and schools. Under his influence, mainly by taking advantage of large international collaborative activities, the University of Messina has become one of the major European centers for complex systems. Among the invited speakers to the final conference of the network, we have collected the following 11 interesting articles. In this special issue, we roughly classify the papers according to three major groups: the first four papers deal with the theory and experiments on the dynamic crossover phenomena in general glass-forming liquids, the next four papers deal explicitly with slow dynamics in supercooled confined water and the last three papers deal with the interpretation of the near-arrest phenomena in colloids. Chong et al used an extended mode coupling theory, which includes the hopping effect, to predict a dynamic crossover at Tc in the α-relaxation time and

  9. The fully automatic external cardioverter defibrillator: reality of a new meaningful scenario for in-hospital cardiac arrests. (United States)

    Martínez-Rubio, Antoni; Gusi, Gabriel; Guillaumet, Eva; Cazorla, Montse; Galán, Sonia; Bagà, Rosa; Guilera, Elena; Bonastre, Manel; Raimón Gumà, Joan; Anguera, Ignaci; Ibars, Sonia; Ochagavia, Ana; Mestre, Jaume; Font, Juli; Saura, Pilar; Dalmases, Martí; Blanch, Lluís; Artigas, Antoni


    Sudden cardiac death is an unresolved problem which causes significant mortality and morbidity in both the community and in-hospital setting. Cardiac arrest is often caused by ventricular tachyarrhythmias which may be mostly interrupted by cardioversion or defibrillation. The single most critical factor for survival is the response time. Over the last 30 years, there have been virtually no procedural changes in the way hospitals address in-hospital resuscitation. A unique device has been developed that eliminates human intervention and assures defibrillation therapy is administered in seconds. This is accomplished with a fully automatic, external bedside monitor defibrillator designed to be prophylactically attached to hospitalized patients at risk of ventricular tachyarrhythmia. The safety and efficacy of the device has been demonstrated in multicenter US and European trials. Thus, this device allows a new scenario which may increase survival and enables meaningful redistribution of health resources.

  10. Matter of 381 Search Warrants Directed to Facebook, 2017 N.Y. Lexis 767, 2; 2017 NY Slip op. 02586, 2 (N.Y. April 4, 2017

    Directory of Open Access Journals (Sweden)

    Trad. Leopoldo Villar


    Full Text Available The growing importance of electronic communications gives a special interest to its protection, which involves several fundamental rights and guarantees such as freedom, privacy and property. Due to the importance of the discussion and the different positions it reflects on an issue of such sensitivity and pertinence in the world today, we publish below the translation of the decision by the Supreme Court of the State of New York of April 4, 2017, on the 381 search warrants directed to Facebook user accounts, ordered by the same Court in 2013 in response to a request by the New York County District Attorney, supported in turn by an affidavit given by a prosecutor in a criminal investigation. Facebook filed a motion seeking annulment of the search warrants and disclosure of the Prosecutor’s affidavit but both motions were rejected by the Appeals Division, whereupon Facebook appealed to the New York Supreme Court, which dismissed the appeal. Although most agreed that the appeal was not appropriate, the views of the judges contain interpretations that make their reading very useful and particularly the opinión given by the dissenting judge offers enriching arguments for defending the rights of users of electronic services.

  11. Hospital Variation in Mortality From Cardiac Arrest After Cardiac Surgery: An Opportunity for Improvement? (United States)

    LaPar, Damien J.; Ghanta, Ravi K.; Kern, John A.; Crosby, Ivan K.; Rich, Jeffrey B.; Speir, Alan M.; Kron, Irving L.; Ailawadi, Gorav


    Background Among all postoperative complications, cardiac arrest after cardiac surgical operations has the greatest association with mortality. However, hospital variation in the ability to rescue after cardiac arrest is unknown. The purpose of this study was to characterize the impact of cardiac arrest on mortality and determine the relative impact of patient, operative, and hospital factors on failure to rescue (FTR) rates and surgical mortality after cardiac arrest. Methods A total of 79,582 patients underwent operations at 17 different hospitals (2001 through 2011), including 5.2% (n = 4,138) with postoperative cardiac arrest. Failure to rescue was defined as mortality after cardiac arrest. Patient risk, operative features, and outcomes were compared among hospitals. Results Overall FTR rate was 60% with significant variation among hospitals (range, 50% to 83%; p cardiac arrest, and FTR rates varied across hospitals and did not correlate. High-performing hospitals with lowest FTR rates accrued longer postoperative and intensive care unit stays after the index operation (2 to 3 days; p cardiac surgical mortality and FTR rates after cardiac arrest. Institutional factors appear to confer the strongest influence on the likelihood for mortality after cardiac arrest compared with patient and operative factors. Identifying best practice patterns at the highest performing centers may serve to improve surgical outcomes after cardiac arrest and improve patient quality. PMID:24820394

  12. Good quality of life before cardiac arrest predicts good quality of life after resuscitation. (United States)

    Hellevuo, H; Sainio, M; Huhtala, H; Olkkola, K T; Tenhunen, J; Hoppu, S


    The survival rate of cardiac arrest patients is increasing. Our aim was to compare the quality of life before and after cardiac arrest and analyse the factors associated with outcome. All adult cardiac arrest patients admitted to the Tampere University Hospital intensive care unit between 2009 and 2011 were included in a retrospective follow-up study if surviving to discharge and were asked to return a questionnaire after 6 months. Data on patient demographics and pre-arrest quality of life were retrieved from medical records. Data are given as means (SD) or medians [Q 1 , Q 3 ]. We used logistic regression to identify factors associated with better quality of life after cardiac arrest. Six months after cardiac arrest, 36% (79/222) were alive and 70% (55/79) of those patients completed the follow-up EuroQoL (EQ-5D) quality of life questionnaire. Median values for the EQ-5D before and after cardiac arrest were 0.89 [0.63, 1] and 0.89 [0.62, 1], respectively (P = 0.75). Only the EQ-5D prior to cardiac arrest was associated with better quality of life afterwards (OR 1.2; 95% CI 1.0-1.3; P = 0.02). Quality of life remained good after cardiac arrest especially in those patients who had good quality of life before cardiac arrest. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. Biological Evidence in Adult and Adolescent Sexual Assault Cases: Timing and Relationship to Arrest. (United States)

    Cross, Theodore P; Alderden, Megan; Wagner, Alex; Sampson, Lisa; Peters, Brittany; Lounsbury, Kaitlin


    This study examined the timing of the crime laboratory report relative to arrests in sexual assault cases and explored the relationship between biological evidence and arrest in those cases in which the crime laboratory report came first and thus could have influenced the arrest decision. A random sample ( N = 528) of cases that occurred between 2008 and 2010 and included a report to police was drawn from a Massachusetts statewide database of medical reports on sexual assault cases. Data from medical providers were merged with data abstracted from crime laboratory reports and with data requested from police departments. The vast majority (91.5%) of arrests took place before crime laboratory analysis could be conducted. The crime laboratory report was available before or near in time to the arrest in 11 cases. These cases were significantly more likely than other cases to have DNA profiles of the assailant, DNA matches to the suspect, and a match to another investigation in the FBI's CODIS DNA database. Given that the probable cause needed to make an arrest in these cases was presumably established only after crime laboratory analysis was available, DNA may have helped lead to the arrest in these cases. However, these results should be interpreted very cautiously, because statistically significant results in early, small studies can have inflated effect sizes and often do not replicate in future studies. Because most arrests occur well before biological evidence is available, improvements in recovering biological evidence may have modest effects on arrest rates, though they may impact arrest rates by identifying more serial offenders. Future research on the relationship of biological evidence to arrest should use methods to increase sample size of relevant cases, such as oversampling cases with later arrests and using case control study designs. Future studies should also use case abstraction and interview methods to explore how police use biological evidence to

  14. Update of European bioethics

    DEFF Research Database (Denmark)

    Rendtorff, Jacob Dahl


    , the principles of autonomy, dignity, integrity and vulnerability are proposed as the most important ethical principles for respect for the human person in biomedical and biotechnological development. This approach to bioethics and biolaw is presented here in a short updated version that integrates the earlier......This paper presents an update of the research on European bioethics undertaken by the author together with Professor Peter Kemp since the 1990s, on Basic ethical principles in European bioethics and biolaw. In this European approach to basic ethical principles in bioethics and biolaw...... research in a presentation of the present understanding of the basic ethical principles in bioethics and biolaw....

  15. Democratic Citizenship: European referents

    Directory of Open Access Journals (Sweden)



    Full Text Available Let’s sense beforehand in this article a tour concerning the educational European policies that favors the development of a democratic citizenship. The aim that we chase is to understand the way in which nowadays it is being interpreted and stimulated the Citizenship education from European Union. for it we offer a conceptual delimiting of «Citizenship education» and later, we show an analysis of the principal documents and materials elaborated principally by the Council of Europe that mark the way followed by European Union as for education for Democratic Citizenship (EDC.

  16. SKLB70326, a novel small-molecule inhibitor of cell-cycle progression, induces G{sub 0}/G{sub 1} phase arrest and apoptosis in human hepatic carcinoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yuanyuan; He, Haiyun [State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041 (China); Peng, Feng [Department of Thoracic Oncology of the Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041 (China); Liu, Jiyan; Dai, Xiaoyun; Lin, Hongjun; Xu, Youzhi; Zhou, Tian; Mao, Yongqiu; Xie, Gang; Yang, Shengyong; Yu, Luoting; Yang, Li [State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041 (China); Zhao, Yinglan, E-mail: [State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041 (China)


    Highlights: Black-Right-Pointing-Pointer SKLB70326 is a novel compound and has activity of anti-HCC. Black-Right-Pointing-Pointer SKLB70326 induces cell cycle arrest and apoptosis in HepG2 cells. Black-Right-Pointing-Pointer SKLB70326 induces G{sub 0}/G{sub 1} phase arrest via inhibiting the activity of CDK2, CDK4 and CDK6. Black-Right-Pointing-Pointer SKLB70326 induces apoptosis through the intrinsic pathway. -- Abstract: We previously reported the potential of a novel small molecule 3-amino-6-(3-methoxyphenyl)thieno[2.3-b]pyridine-2-carboxamide (SKLB70326) as an anticancer agent. In the present study, we investigated the anticancer effects and possible mechanisms of SKLB70326 in vitro. We found that SKLB70326 treatment significantly inhibited human hepatic carcinoma cell proliferation in vitro, and the HepG2 cell line was the most sensitive to its treatment. The inhibition of cell proliferation correlated with G{sub 0}/G{sub 1} phase arrest, which was followed by apoptotic cell death. The SKLB70326-mediated cell-cycle arrest was associated with the downregulation of cyclin-dependent kinase (CDK) 2, CDK4 and CDK6 but not cyclin D1 or cyclin E. The phosphorylation of the retinoblastoma protein (Rb) was also observed. SKLB70326 treatment induced apoptotic cell death via the activation of PARP, caspase-3, caspase-9 and Bax as well as the downregulation of Bcl-2. The expression levels of p53 and p21 were also induced by SKLB70326 treatment. Moreover, SKLB70326 treatment was well tolerated. In conclusion, SKLB70326, a novel cell-cycle inhibitor, notably inhibits HepG2 cell proliferation through the induction of G{sub 0}/G{sub 1} phase arrest and subsequent apoptosis. Its potential as a candidate anticancer agent warrants further investigation.

  17. Cardiac arrest without physical cardiac injury during Nuss repair of pectus excavatum. (United States)

    Zou, Jianyong; Luo, Canqiao; Liu, Zhenguo; Cheng, Chao


    Cardiac arrest is a lethal complication of Nuss repair of pectus excavatum which is strongly related to heart or big vessels injury. A rare case developed cardiac arrest without direct cardiac injury during Nuss procedure is presented in this article. In July 2015, a previously healthy 18-year-old man undergoing Nuss repair for pectus excavatum developed cardiac arrest while the Nuss bar was being inserted into the chest. After successful resuscitation and exclusion of direct cardiac injury, the Nuss procedure was continued. The patient suffered a second cardiac arrest during rotation of the Nuss bar. This time, the patient had poor initial response to resuscitation and defibrillation until the retrosternal bar was removed. He ultimately recovered well from the episodes of cardiac arrest, but was unable to receive surgical correction of his pectus excavatum deformity. The possible mechanisms of cardiac arrest and lessons we can learn from this complication are discussed.

  18. Arrest types and co-occurring disorders in persons with schizophrenia or related psychoses. (United States)

    McCabe, Patrick J; Christopher, Paul P; Druhn, Nicholas; Roy-Bujnowski, Kristen M; Grudzinskas, Albert J; Fisher, William H


    This study examined the patterns of criminal arrest and co-occurring psychiatric disorders among individuals with schizophrenia or related psychosis that were receiving public mental health services and had an arrest history. Within a 10-year period, 65% of subjects were arrested for crimes against public order, 50% for serious violent crimes, and 45% for property crimes. The presence of any co-occurring disorder increased the risk of arrest for all offense categories. For nearly all offense types, antisocial personality disorder and substance use disorders conferred the greatest increase in risk for arrest. Among anxiety disorders, post-traumatic stress disorder was associated with a greater risk of arrest for serious violent crimes but not other offense types. Criminal risk assessments and clinical management in this population should focus on co-occurring antisocial personality disorder and substance use disorders in addition to other clinical and non-clinical factors.

  19. CERN welcomes European science

    CERN Multimedia


    On 3 and 4 October CERN will host a special workshop for Marie Curie fellows. This programme is a key plank in the EU's strategy for creating a European research area.     With thousands of scientists from all over the continent working together, CERN is already an exemplary European science showcase. On 3 and 4 October, the Laboratory will contribute further to unifying all European science by hosting a special workshop for EU-funded Marie Curie fellows. This scheme gives young researchers from around the continent the mobility to go to wherever Europe's best facilities in their chosen field happen to be. The event that will take place at CERN, entitled 'Special workshop of Marie Curie Fellows on research and training in physics and technology', organised together with the European Commission, is a continuation of a series of workshops with the aim, among others, of promoting young researchers, supporting their training and mobility, and facilitating the interdisciplinary dissemination of knowledge. Dur...

  20. European Economic Integration (United States)

    Huston, James A.


    Recounts the history and problems of European Economic Integration from the first post World War II organization, the OEEC, to the EEC (Common Market) and the EFTA. Suggestions for further reading are included. (JB)

  1. European Molecular Biology Laboratory

    CERN Multimedia


    On 10 May an Agreement was signed at CERN setting up a new European Laboratory. It will be concerned with research in molecularbiology and will be located at Heidelberg in the Federal Republic of Germany.

  2. The European University Landscape

    DEFF Research Database (Denmark)

    Daraio, Cinzia; Bonaccorsi, Andrea; Geuna, Aldo


    This paper provides a new and systematic characterization of 488 universities, from 11 European countries: Finland, France, Germany, Hungary, Italy, Netherlands, Norway, Portugal, Spain, Switzerland and UK. Using micro indicators built on the integrated Aquameth database, we characterize the Euro...

  3. European mobility cultures

    DEFF Research Database (Denmark)

    Haustein, Sonja; Nielsen, Thomas A. Sick


    More targeted European policies promoting green travel patterns require better knowledge on differing mobility cultures across European regions. As a basis for this, we clustered the EU population into eight mobility styles based on Eurobarometer data. The mobility styles - including, for example......-economic resources. In a second step, the 28 EU member countries were clustered into six country clusters based on their representation of mobility styles. The country clusters indicate the existence of considerably different mobility cultures across the EU. Sub-regions can be identified that have highly different...... positions on the path towards sustainable mobility and therefore different requirements towards European platforms and support measures, e.g. for 'Sustainable Urban Mobility Plans'. The country clusters can provide a starting point for future communication and targeting of European efforts in sustainable...

  4. European Cyber Security Policy


    Bendiek, Annegret


    The gradually developing European cyber security policy tries to establish minimum standards in all EU member states with regard to prevention, resilience and international cooperation. It aims to foster national security without compromising democratic principles or unduly limiting individual liberties. However, it is hard to find a balance between these goals, and the EU’s measures thus inevitably raise questions about the democratic implications of European cyber security policy. Are the i...

  5. Timetabling on European Corridors


    Lischke, Andreas; Führer, B. (Bernhard); Garavagno, G.


    The Path Allocation Re-engineering of Timetable Networks for European Railways (PARTNER) project aims to demonstrate a new way of train path allocation and assembly along international corridors towards a faster and more coordinated railway infrastructure capacity management. PARTNER will assist two neighbour infrastructure managers to develop a common understanding of the effects of international train paths. The results of a survey of European infrastructure managers and railway underta...

  6. European Physical Society awards

    CERN Multimedia


    The winners of the 2004 Accelerator Prizes, awarded by the European Physical Society's Interdivisional Group on Accelerators (EPS-IGA), have been announced. Vladmir Shiltsev (Fermilab) and Igor Meshkov (JINR, Joint Institute of Nuclear Research, Dubna) will be presented with their awards during the 9th European Particle Accelerator Conference, EPAC'04, on 8 July 2004 in Lucerne. Both physicists will also give a talk about their work. More details on:

  7. European Banking Union


    Breuss, Fritz


    The ongoing Euro crisis and the worse economic development in Europe than in the USA are grounded, not the least in the delayed implementation of reforms of the banking sector. Whereas the leaks in economic governance of EMU have been fixed the banking sector is still not stabilised, even five years after Lehman Brothers. From the grand solution of a "European Banking Union" (EBU) only the first pillar, the European Bank Supervision with the single supervisory mechanism (SSM) will come into e...

  8. European DHC Research Issues

    Energy Technology Data Exchange (ETDEWEB)

    Wiltshire, Robin; Williams, Jonathan (Building Research Establishment, BRE, Bucknalls Lane, Watford (United Kingdom)); Werner, Sven (Halmstad University, School of Business and Engineering, Halmstad (Sweden))


    Euroheat and Power is now working towards a European Technology Platform for District Heating and Cooling. In response to this important European DHC research initiative, a preliminary detailed list of research issues within 18 dimensions was elaborated and communicated to more than 100 people in February 2008. After additions and comments received, an updated list of research issues was again distributed in July 2008. This paper contains the current list of suggested research issues

  9. Characteristics and possibilities of software tool for metal-oxide surge arresters selection

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan


    Full Text Available This paper presents a procedure for the selection of metal-oxide surge arresters based on the instructions given in the Siemens and ABB catalogues, respecting their differences and the characteristics and possibilities of the software tool. The software tool was developed during the preparation of a Master's thesis titled, 'Automation of Metal-Oxide Surge Arresters Selection'. An example is presented of the selection of metal-oxide surge arresters using the developed software tool.

  10. Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) (United States)


    Award Number: W81XWH-07-1-0682 TITLE: Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) PRINCIPAL INVESTIGATOR...COVERED (From - To) 26 SEP 2014 – 25 SEP 2015 4. TITLE AND SUBTITLE Emergency Preservation and Resuscitation for Cardiac Arrest 5a. CONTRACT NUMBER It was felt that patients who arrive at the hospital with a pulse, but then develop cardiac arrest in the operating room, rather than in the

  11. Cardiac Arrest in Acute Ischemic Stroke: Incidence, Predisposing Factors, and Clinical Outcomes. (United States)

    Joundi, Raed A; Rabinstein, Alejandro A; Nikneshan, Davar; Tu, Jack V; Fang, Jiming; Holloway, Robert; Saposnik, Gustavo


    Cardiac arrest is a devastating complication of acute ischemic stroke, but little is known about its incidence and characteristics. We studied a large ischemic stroke inpatient population and compared patients with and without cardiac arrest. We studied consecutive patients from the Ontario Stroke Registry who had an ischemic stroke between July 2003 and June 2008 at 11 tertiary care stroke centers in Ontario. Multivariable analyses were used to determine independent predictors of cardiac arrest and associated outcomes. Adjusted survival curves were computed, and hazard ratios for mortality at 30 days and 1 year were determined for cardiac arrest and other major outcomes. Among the 9019 patients with acute ischemic stroke, 352 had cardiac arrest, for an overall incidence of 3.9%. In a sensitivity analysis with palliative patients removed, the incidence of cardiac arrest was 2.5%. Independent predictors of cardiac arrest were as follows: older age, greater stroke severity, preadmission dependence, and a history of diabetes, myocardial infarction, congestive heart failure, and atrial fibrillation. Systemic complications associated with cardiac arrest were as follows: myocardial infarction, pulmonary embolism, sepsis, gastrointestinal hemorrhage, and pneumonia. Patients with cardiac arrest had higher disability at discharge, and a markedly increased 30-day mortality of 82.1% compared with 9.3% without cardiac arrest. Cardiac arrest had a high incidence and was associated with poor outcomes after ischemic stroke, including multiple medical complications and very high mortality. Predictors of cardiac arrest identified in this study could help risk stratify ischemic stroke patients for cardiac investigations and prolonged cardiac monitoring. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Applications of elastic-viscoplastic constitutive models in dynamic analyses of crack run-arrest events (United States)

    Bass, B. R.; Pugh, C. E.; Swindeman, R. W.


    Applications of nonlinear techniques to the first series of six HSST wide-plate crack-arrest tests that were performed are described. The experiments include crack initiations at low temperatures and relatively long (20 cm) cleavage propagation phases which are terminated by arrest in high temperature regions. Crack arrest are then followed by ductile tearing events. Consequently, the crack front regions are exposed to wide ranges of strain rates and temperatures.

  13. Testing and checking of zinc oxide overvoltage arresters. Beproeven en keuren van zinkoxide overspanningsafleiders

    Energy Technology Data Exchange (ETDEWEB)

    Baron van Boetzelaer, A.W. (NV KEMA, Arnhem (Netherlands))


    Surge arresters are relatively inexpensive, but because they protect components with multiple costs against overvoltages they take an important place in the high voltage grid. Therefore it is of great importance to check whether these arresters perform properly. KEMA's laboratories are able to carry out all the necessary tests according to the relevant IEC standards on surge arresters. 6 figs., 2 tabs.

  14. Causes of sudden cardiac arrest in young athletes. (United States)

    Westrol, Michael S; Kapitanyan, Raffi; Marques-Baptista, Andreia; Merlin, Mark A


    Knowledge of sudden cardiac death in young athletes is imperative for all physicians and allied health professionals. The complete differential diagnosis of a young patient with sudden cardiac arrest will result in proper work-up and treatment. In this article, we review several etiologies of sudden cardiac death, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, Wolff-Parkinson-White syndrome, long QT syndrome, Brugada syndrome, and commotio cordis. Clinical findings, work-up, treatment, long-term management, and athlete preparticipation screening guidelines are discussed.

  15. Adulthood animal abuse among men arrested for domestic violence. (United States)

    Febres, Jeniimarie; Brasfield, Hope; Shorey, Ryan C; Elmquist, Joanna; Ninnemann, Andrew; Schonbrun, Yael C; Temple, Jeff R; Recupero, Patricia R; Stuart, Gregory L


    Learning more about intimate partner violence (IPV), perpetrators could aid the development of more effective treatments. The prevalence of adulthood animal abuse (AAA) perpetration and its association with IPV perpetration, antisociality, and alcohol use in 307 men arrested for domestic violence were examined. Forty-one percent (n = 125) of the men committed at least one act of animal abuse since the age of 18, in contrast to the 1.5% prevalence rate reported by men in the general population. Controlling for antisociality and alcohol use, AAA showed a trend toward a significant association with physical and severe psychological IPV perpetration. © The Author(s) 2014.

  16. The inflammatory marker suPAR after cardiac arrest

    DEFF Research Database (Denmark)

    Rundgren, Malin; Lyngbaek, Stig; Fisker, Helle


    BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) is released in response to inflammatory stimuli, and plasma levels are associated with long-term outcomes. The ischemia/reperfusion injury caused by cardiac arrest (CA) and resuscitation triggers an inflammatory response...... analysis shoved an AUC of 0.76 at 6 hours. In the subgroup of CA of cardiac cause, the AUC was 0.84. CONCLUSION: suPAR levels at 6 and 36 hours after CA were significantly higher in nonsurviving patients compared with survivors; however, the overlap in suPAR levels between the outcome groups...

  17. Coordination of the insulation and the choice of lightning arresters

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, A.


    The relationship between the operating conditions and the necessary insulation levels is investigated for networks operating at 525 and 750 kV. The use of high-voltage shunt reactors limits the power-frequency overvoltages and allows lightning arresters having a lower voltage rating to be used. Their use to limit switching surges is discussed and related to the withstand strength of the insulation in air and when immersed in oil. A table lists the attainable insulation levels that were calculated. Also stated are the levels employed in completed installations or visualized for projected networks.

  18. Cardiac Arrest Caused by Multiple Recurrent Pulmonary Embolism

    Directory of Open Access Journals (Sweden)

    Kjartan Eskjaer Hannig


    Full Text Available Pulmonary embolism is a common condition with a high mortality. We describe a previously healthy 68-year-old male who suffered three pulmonary embolisms during a short period of time, including two embolisms while on anticoagulant treatment. This paper illustrates three important points. (1 The importance of optimal anticoagulant treatment in the prevention of pulmonary embolism reoccurrence. (2 The benefit of immediate accessibility to echocardiography in the handling of haemodynamically unstable patients with an unknown underlying cause. (3 Thrombolytic treatment should always be considered and may be life-saving in patients with cardiac arrest suspected to be caused by pulmonary embolism.

  19. [Cerebral oximetry in pulmonary thromboendarterectomy with circulatory arrest]. (United States)

    Catalán Escudero, P; González Román, A; Serra Ruiz, C N; Barbero Mielgo, M; García Fernández, J


    Pulmonary thromboendarterectomy is an uncommon procedure and should be performed with circulatory arrest. One of the major concerns is the postoperative central neurological injuries. Perioperative brain oxygen monitoring is advisable in this surgical procedure for the early detection of brain hypoperfusion episodes and their intensity as well as any other postoperative episodes that can deteriorate the neurological outcome. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  20. [Cardiac arrest in newborn of mother treated with labetalol]. (United States)

    Sala, X; Monsalve, C; Comas, C; Botet, F; Nalda, M A


    The use of beta-adrenergic antagonists for the control of high blood pressure associated to pregnancy is frequent. Their use is related with the appearance of undesirable effects of the fetus. The case of neonatal cardiac arrest attributed, to the administration of labetalol to the mother is presented. The high transplacentary passage, the different pharmacokinetics of the drug in the newborn and the clinical evolution of the patient suggests its involvement. It is concluded that labetalol may cause severe undesirable effects in newborns and fetal heart rate of the mother and neonate should be monitored upon use of this drug.

  1. Advanced life support for cardiac arrest beyond the algorithm

    DEFF Research Database (Denmark)

    Rudolph, Søren Steemann; Isbye, Dan Lou; Pfeiffer, Peter


    circulation fails in most cases, but in some circumstances the patient may benefit from additional interventional approaches, in which case transport to hospital with ongoing cardiopulmonary resuscitation is indicated. This paper has summarized treatments outside the ALS algorithm, which may be beneficial......In an advanced emergency medical service all parts of the advanced life support (ALS) algorithm can be provided. This evidence-based algorithm outlines resuscitative efforts for the first 10-15 minutes after cardiac arrest, whereafter the algorithm repeats itself. Restoration of spontaneous......, but are not supported by firm scientific evidence....

  2. Biphasic versus monophasic waveforms for transthoracic defibrillation in out-of-hospital cardiac arrest. (United States)

    Faddy, Steven C; Jennings, Paul A


    Transthoracic defibrillation is a potentially life-saving treatment for people with ventricular fibrillation (VF) and haemodynamically unstable ventricular tachycardia (VT). In recent years, biphasic waveforms have become more commonly used for defibrillation than monophasic waveforms. Clinical trials of internal defibrillation and transthoracic defibrillation of short-duration arrhythmias of up to 30 seconds have demonstrated the superiority of biphasic waveforms over monophasic waveforms. However, out-of-hospital cardiac arrest (OHCA) involves a duration of VF/VT of several minutes before defibrillation is attempted. To determine the efficacy and safety of biphasic defibrillation waveforms, compared to monophasic, for resuscitation of people experiencing out-of-hospital cardiac arrest. We searched the following electronic databases for potentially relevant studies up to 10 September 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Also we checked the bibliographies of relevant studies and review articles, contacted authors of published reviews and reviewed webpages (including those of device manufacturers) relevant to the review topic. We handsearched the abstracts of conference proceedings for the American Heart Association, American College of Cardiology, European Society of Cardiology, European Resuscitation Council, Society of Critical Care Medicine and European Society of Intensive Care Medicine. Regarding language restrictions, we did not apply any. We included randomised controlled trials (RCTs) that compared biphasic and monophasic waveform defibrillation in adults with OHCA. Two review authors independently screened the literature search results. Two review authors independently extracted data from the included trials and performed 'Risk of bias' assessments. We resolved any disagreements by discussion and consensus. The primary outcome was the risk of failure to achieve return of spontaneous circulation (ROSC

  3. A review of epidermal maturation arrest: a unique entity or another description of persistent granulation tissue? (United States)

    Kessides, Maria C; Khachemoune, Amor


    To conduct a review of reported cases of epidermal maturation arrest and to compare their clinical and histological descriptions with that of persistent granulation tissue with a focus on diagnostic methods and response to treatment. The authors performed a literature search within Pubmed, Embase, Google Scholar, and Web of Science for all reported cases of epidermal maturation arrest under the terms "epidermal maturation arrest," "epidermal arrest," "epidermal maturation," and "re-epithelialization maturation arrest." They reviewed the clinical and histological presentation of hypergranulation tissue as well as the evidence for the most widely used treatments. There is only one case series and one case report of epidermal maturation arrest, and the former gives the most detailed clinical and histological description including response to treatment. The clinical description, histological findings, and response to treatment of all cases are comparable to that of persistent granulation tissue and there is no histological or cytological data provided to support that epidermal maturation arrest exists as a distinct entity. Among the cases of epidermal maturation arrest reported in the literature, there is insufficient evidence that keratinocytes acquired a state of arrest in their migration. Rather, the described cases appear to have been complicated by persistent granulation tissue, a well-known aberration in wound healing.

  4. Clinical and ultramicroscopic myocardial randomized study of beating versus arrested heart for mitral surgery

    National Research Council Canada - National Science Library

    Clotario Neptali Carrasco Cueva; Maiara dosSantos Rocha; Carlos Mauricio Cardeal Mendes; Luiz Antonio Rodrigues deFreitas; Jose Augusto Baucia; Roberto Badaro


    ...: This study compared clinical and transmission electron microscopic aspects of myocardial protection during mitral valve replacement using warm retrograde perfusion in empty beating versus arrested...

  5. Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011 (United States)

    Mhyre, Jill M.; Tsen, Lawrence C.; Einav, Sharon; Kuklina, Elena V.; Leffert, Lisa R.; Bateman, Brian T.


    Background The objective of this analysis was to evaluate the frequency, distribution of potential etiologies, and survival rates of maternal cardiopulmonary arrest during the hospitalization for delivery in the United States. Methods By using data from the Nationwide Inpatient Sample during the years 1998 through 2011, the authors obtained weighted estimates of the number of U.S. hospitalizations for delivery complicated by maternal cardiac arrest. Clinical and demographic risk factors, potential etiologies, and outcomes were identified and compared in women with and without cardiac arrest. The authors tested for temporal trends in the occurrence and survival associated with maternal arrest. Results Cardiac arrest complicated 1 in 12,000 or 8.5 per 100,000 hospitalizations for delivery (99% CI, 7.7 to 9.3 per 100,000). The most common potential etiologies of arrest included hemorrhage, heart failure, amniotic fluid embolism, and sepsis. Among patients with cardiac arrest, 58.9% of patients (99% CI, 54.8 to 63.0%) survived to hospital discharge. Conclusions Approximately 1 in 12,000 hospitalizations for delivery is complicated by cardiac arrest, most frequently due to hemorrhage, heart failure, amniotic fluid embolism, or sepsis. Survival depends on the underlying etiology of arrest. PMID:24694844

  6. Sudden cardiac arrest and coexisting mitral valve prolapse: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed


    Full Text Available The aetiology of sudden cardiac arrest can often be identified to underlying cardiac pathology. Mitral valve prolapse is a relatively common valvular pathology with symptoms manifesting with increasing severity of mitral regurgitation (MR. It is unusual for severe MR to be present without symptoms, and there is growing evidence that this subset of patients may be at increased risk of sudden cardiac arrest or death. The difficulty lies in identifying those patients at risk and applying measures that are appropriate to halting progression to cardiac arrest. This article examines the association of mitral valve prolapse with cardiac arrests, the underlying pathophysiological process and the strategies for identifying those at risk.

  7. Enforcement following 0.08% BAC law change: sex-specific consequences of changing arrest practices? (United States)

    Schwartz, Jennifer; Davaran, Ardavan


    This research evaluated effects of stricter 0.08% BAC drunken driving law on changes in sex-specific DUI arrest rates, controlling for increased law enforcement resources and shifts in DUI-related behaviors. Another main purpose, the study assessed female/male differences in arrest increases due to broader enforcement standards and efforts. Panel data was assembled for 24 states over 1990-2007 on DUI arrests, alcohol policy, law enforcement resources, drinking and drunken driving prevalence. Two-way fixed-effects seemingly unrelated regression models predicted female versus male changes in DUI arrests following implementation of lower legal limits of intoxication, net controls. Findings suggest, first, that a broader legal definition of drunken driving intending to officially sanction less serious offenders (0.08% vs. 0.10% BAC) was associated with increased DUI arrests for both sexes. Second, growth in specialized DUI-enforcement units also was related to increased arrests. Whereas male and female arrest trends were equally affected by the direct net-widening effects of 0.08% BAC alcohol-policy, specialized DUI-enforcement efforts to dig deeper into the offender-pool had stronger arrest-producing effects on females, particularly prior to law change. Specifying how changes in law and enforcement resources affect arrest outcomes is an important pre-cursor to alcohol-policy analyses of effectiveness. A potential unintended consequence, effects of law and enforcement may differ across population segments. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Rates of organ donation in a UK tertiary cardiac arrest centre following out-of-hospital cardiac arrest. (United States)

    Cheetham, Olivia V; Thomas, Matthew J C; Hadfield, John; O'Higgins, Fran; Mitchell, Claire; Rooney, Kieron D


    To ascertain the rate of successful organ donation (OD) within patients who sustained an out of hospital cardiac arrest (OHCA) with initial return of spontaneous circulation (ROSC) and survival to hospital admission, but whom subsequently do not survive to hospital discharge. A retrospective audit of ambulance service and hospital databases from January 2010 to January 2015 was undertaken in a United Kingdom tertiary-referral regional cardiac arrest centre. Crude denominator data for cardiac arrests was obtained from the regional ambulance service; the ICU database was interrogated for OHCA patient admissions and outcomes. Patients who died were cross-referenced against the local Organ Donation service database. Five hundred and fourteen {514} patients were admitted to ICU following OHCA over this five year period. Two hundred and forty-one {241} patients (47%) survived to hospital discharge and 273 (53%) died of whom 106 (39%) were referred to a Specialist Nurse for Organ Donation (SNOD). The conversion rate after the family was approached was 64%. Twenty-eight {28} patients proceeded to donation and 25 patients (24%) successfully donated at least one organ. On average, a patient proceeding to donation provided 1.9 organs. A proactive, systematic approach to OD in OHCA patients can provide a good conversion rate and substantial number of donors. Most donations occur after death from circulatory criteria. There is a positive socio-economic benefit with nearly £4m in savings to the health service within the next 5 years potentially being realised during this period by liberating patients from dialysis. Copyright © 2016. Published by Elsevier Ireland Ltd.

  9. Habermas on European Constitution and European Identity

    Directory of Open Access Journals (Sweden)

    Éva Biró-Kaszás


    Full Text Available For the last two decades or so philosophers have been reflecting on a set of practical and political concerns in connection with the new political structural arrangements beyond the nation-state. In this article two essays by Jürgen Habermas shall be examined. An attempt shall be made to tackle Habermas’ philosophical concepts of personal and collective identity as well as the role that a constitution may play in building the post-national constellation. It has been shown that Habermas has normative answers. Firstly, according to him, the fragile balance between the legal order and the particular cultures and traditions of a community has to be protected by the constitutional state. For that reason the political culture has to be “decoupled” from the majority culture. Secondly, the democratically structured attempt to achieve shared meaning has to find the delicate balance between the context-transcending universal normative claims and the claims of particular individual and collective life. Thirdly, it is possible to expand legally mediated civil solidarity trans-nationally, across Europe – we may recognize this development as the emergence of European identity –, since the process of democratic will-formation of citizens may get loose from the structures provided by the state if both shared democratic political cultures as well as a European-wide public sphere exist. The European Constitution may have a catalytic function in materialization of these conditions. It has been shown that in his deliberations Habermas tried to find a reflective equilibrium between the normative and the empirical.

  10. Reasons for intimate partner violence perpetration among arrested women. (United States)

    Stuart, Gregory L; Moore, Todd M; Gordon, Kristina Coop; Hellmuth, Julianne C; Ramsey, Susan E; Kahler, Christopher W


    There are limited empirical data regarding the reasons or motives for the perpetration of intimate partner violence among women arrested for domestic violence and court referred to violence intervention programs. The present study examined arrested women's self-report reasons for partner violence perpetration and investigated whether women who were victims of severe intimate partner violence were more likely than were women who were victims of minor partner violence to report self-defense as a reason for their behavior. In all, 87 women in violence intervention programs completed a measure of violence perpetration and victimization and a questionnaire assessing 29 reasons for violence perpetration. Self-defense, poor emotion regulation, provocation by the partner, and retaliation for past abuse were the most common reasons for violence perpetration. Victims of severe partner violence were significantly more likely than were victims of minor partner violence to report self-defense as a reason for their violence perpetration. The clinical implications of these findings are discussed.

  11. Electrophysiological Monitoring of Brain Injury and Recovery after Cardiac Arrest

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    Ruoxian Deng


    Full Text Available Reliable prognostic methods for cerebral functional outcome of post cardiac-arrest (CA patients are necessary, especially since therapeutic hypothermia (TH as a standard treatment. Traditional neurophysiological prognostic indicators, such as clinical examination and chemical biomarkers, may result in indecisive outcome predictions and do not directly reflect neuronal activity, though they have remained the mainstay of clinical prognosis. The most recent advances in electrophysiological methods—electroencephalography (EEG pattern, evoked potential (EP and cellular electrophysiological measurement—were developed to complement these deficiencies, and will be examined in this review article. EEG pattern (reactivity and continuity provides real-time and accurate information for early-stage (particularly in the first 24 h hypoxic-ischemic (HI brain injury patients with high sensitivity. However, the signal is easily affected by external stimuli, thus the measurements of EP should be combined with EEG background to validate the predicted neurologic functional result. Cellular electrophysiology, such as multi-unit activity (MUA and local field potentials (LFP, has strong potential for improving prognostication and therapy by offering additional neurophysiologic information to understand the underlying mechanisms of therapeutic methods. Electrophysiology provides reliable and precise prognostication on both global and cellular levels secondary to cerebral injury in cardiac arrest patients treated with TH.

  12. Non-equilibrium theory of arrested spinodal decomposition

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    Olais-Govea, José Manuel; López-Flores, Leticia; Medina-Noyola, Magdaleno [Instituto de Física “Manuel Sandoval Vallarta,” Universidad Autónoma de San Luis Potosí, Álvaro Obregón 64, 78000 San Luis Potosí, SLP (Mexico)


    The non-equilibrium self-consistent generalized Langevin equation theory of irreversible relaxation [P. E. Ramŕez-González and M. Medina-Noyola, Phys. Rev. E 82, 061503 (2010); 82, 061504 (2010)] is applied to the description of the non-equilibrium processes involved in the spinodal decomposition of suddenly and deeply quenched simple liquids. For model liquids with hard-sphere plus attractive (Yukawa or square well) pair potential, the theory predicts that the spinodal curve, besides being the threshold of the thermodynamic stability of homogeneous states, is also the borderline between the regions of ergodic and non-ergodic homogeneous states. It also predicts that the high-density liquid-glass transition line, whose high-temperature limit corresponds to the well-known hard-sphere glass transition, at lower temperature intersects the spinodal curve and continues inside the spinodal region as a glass-glass transition line. Within the region bounded from below by this low-temperature glass-glass transition and from above by the spinodal dynamic arrest line, we can recognize two distinct domains with qualitatively different temperature dependence of various physical properties. We interpret these two domains as corresponding to full gas-liquid phase separation conditions and to the formation of physical gels by arrested spinodal decomposition. The resulting theoretical scenario is consistent with the corresponding experimental observations in a specific colloidal model system.

  13. [Adult cardio-respiratory arrest: guidelines 2005-2010]. (United States)

    Mols, P; Claessens, B


    At the end of 2005 the new guidelines for the treatment of cardiac arrest were published. The diagnostic criteria of cardiac arrest were simplified and priority is given to thoracic compressions. The ratio of thoracic compressions to insufflations is 30/2. The frequency of thoracic compression is 100/min. In ventricular tachycardia (VT) without pulse or in ventricle fibrillation (VF), defibrillation is attempted with a single external electric shock per cycle. The reanimation cycles are divided in periods of 2 minutes. The two drugs, used to treat VF and VT without pulse, are amiodarone and adrenaline. Adrenaline is not given before the fourth minute into the reanimation and it is administered before the third electrical external shock. In case of asystole or pulse less electrical activity adrenaline is administered as early as possible. Atropine is used in case of pulse less electrical activity with a ventricular response lower than 60/min. In advanced life support a priority is given to whether or not there are treatable secondary causes (4H, 4T), furthermore controlled hypothermia is installed when systemic circulation is restored and optimal support to all vital functions is given.

  14. Cariporide for pharmacologic defibrillation after prolonged cardiac arrest. (United States)

    Wann, Shue-ren; Weil, Max Harry; Sun, Shijie; Tang, Wanchun; Yu, Ting


    We hypothesized that cariporide, a sodium-hydrogen exchange inhibitor, would be as cardioprotective during the global myocardial ischemia of prolonged cardiac arrest as it is in settings of coronary occlusion. Fifteen Sprague-Dawley rats were randomized to receive bolus injections of cariporide or placebo in a dose of 3 mgxkg(-1) into the right atrium either 5 minutes before, or at 8 minutes after, onset of ventricular fibrillation. Ventricular fibrillation was electrically induced and untreated for 8 minutes. Precordial compression, together with mechanical ventilation, was then started and continued for an interval of 8 minutes prior to attempted resuscitation. All but one placebo-treated animal were successfully resuscitated. Spontaneous defibrillation with restoration of circulation was observed in both cariporide-pretreatment and post-treatment groups but in none of the placebo-treated animals. Postresuscitation cardiac index, end-tidal CO(2), mean aortic pressure, left ventricular systolic pressure, left ventricular end-diastolic pressure, and left ventricular contractile and lusitropic functions (dP/dt(40), and -dP/dt) were significantly less impaired after cariporide, especially in the pretreated group, compared to electrically defibrillated controls. Postresuscitation ventricular premature beats were significantly reduced after cariporide. The duration of post-resuscitation survival was significantly increased in animals pretreated with cariporide. Cariporide, when administered prior to and during cardiac arrest, improved both the success of resuscitation and postresuscitation myocardial function.

  15. Arrested coalescence of viscoelastic droplets: triplet shape and restructuring (United States)

    Dahiya, Prerna; DeBenedictis, Andrew; Atherton, Timothy J.; Caggioni, Marco; Prescott, Stuart W.; Hartel, Richard W.; Spicer, Patrick T.

    The stability of shapes formed by three viscoelastic droplets during their arrested coalescence has been investigated using micromanipulation experiments. Addition of a third droplet to arrested droplet doublets is shown to be controlled by the balance between interfacial pressures driving coalescence and internal elasticity that resists total consolidation. The free fluid available within the droplets controls the transmission of stress during droplet combination and allows connections to occur via formation of a neck between the droplets. The anisotropy of three-droplet systems adds complexity to the symmetric case of two-droplet aggregates because of the multiplicity of orientations possible for the third droplet. When elasticity dominates, the initial orientation of the third droplet is preserved in the triplet's final shape. When elasticity is dominated by the interfacial driving force, the final shape can deviate strongly from the initial positioning of droplets. Movement of the third droplet to a more compact packing occurs, driven by liquid meniscus expansion that minimizes the surface energy of the triplet. A range of compositions and orientations are examined and the resulting domains of restructuring and stability are mapped based on the final triplet structure. A geometric and a physical model are used to explain the mechanism driving meniscus-induced restructuring and are related to the impact of these phenomena on multiple droplet emulsions.

  16. Computation Molecular Kinetics Model of HZE Induced Cell Cycle Arrest (United States)

    Cucinotta, Francis A.; Ren, Lei


    Cell culture models play an important role in understanding the biological effectiveness of space radiation. High energy and charge (HZE) ions produce prolonged cell cycle arrests at the G1/S and G2/M transition points in the cell cycle. A detailed description of these phenomena is needed to integrate knowledge of the expression of DNA damage in surviving cells, including the determination of relative effectiveness factors between different types of radiation that produce differential types of DNA damage and arrest durations. We have developed a hierarchical kinetics model that tracks the distribution of cells in various cell phase compartments (early G1, late G1, S, G2, and M), however with transition rates that are controlled by rate-limiting steps in the kinetics of cyclin-cdk's interactions with their families of transcription factors and inhibitor molecules. The coupling of damaged DNA molecules to the downstream cyclin-cdk inhibitors is achieved through a description of the DNA-PK and ATM signaling pathways. For HZE irradiations we describe preliminary results, which introduce simulation of the stochastic nature of the number of direct particle traversals per cell in the modulation of cyclin-cdk and cell cycle population kinetics. Comparison of the model to data for fibroblast cells irradiated photons or HZE ions are described.

  17. Salivary mutans streptococci and lactobacilli after self arresting caries treatment. (United States)

    Thaweboon, Sroisiri; Thaweboon, Boonyanit; Soo-Ampon, Surin; Soo-Ampon, Malinee


    Previous studies have shown that Self Arresting Caries Treatment (SACT) may be a useful technique to arrest active caries in Thai preschool children in remote areas. The objective of this study was to examine the effect of SACT on the levels of salivary mutans streptococci and lactobacilli in Thai children. Eighty-two subjects aged 4-6 years from primary school in a remote area of Thailand were recruited for this study. Each subject has at least two pairs of interproximal carious cavities between the first and second deciduous molars, and no history of severe pain. The subjects were divided into the control and SACT groups. The SACT technique was performed by removing food remnants and the surrounding overhang enamel of the carious cavity walls to enlarge the space between the carious cavities. The levels of mutans streptococci and lactobacilli in paraffin-stimulated whole saliva were determined at baseline, 2 and 4 months after treatment compared to those of the control group by the spatula method. The bacterial growth score was divided into three categories: 1 = 0-20 CFU, 2 = 21-100 CFU, and 3 > or = 100 CFU. At baseline, no differences in the mutans streptococci and lactobacilli scores were found between the SACT and control groups (p>0.05). Lower salivary lactobacilli levels were found in the SACT group on follow-up at 2 and 4 months (pinterproximal lesions and can reduce the retentive sites in the oral cavity due to a reduction in salivary lactobacilli.

  18. Theophylline improves lipopolysaccharide-induced alveolarization arrest through inflammatory regulation. (United States)

    He, Hua; Chen, Fei; Ni, Wensi; Li, Jianhui; Zhang, Yongjun


    Bronchopulmonary dysplasia (BPD) is characterized by alveolar simplification with decreased numbers of alveoli and increased airspace. BPD, frequently suffered by very low birth weight infants, has been closely associated with intrauterine infection. However, the underlying mechanisms of BPD remain unclear. In the present study, it was identified that administration of intra-amniotic lipopolysaccharide (LPS) to pregnant rats on embryonal day 16.5 (E16.5) induced significant alveolarization arrest similar to that of BPD in neonatal pups, and theophylline injected subcutaneously into the newborns improved the pathological changes. To further investigate the underlying mechanism of the morphogenesis amelioration of theophylline, cytokine antibody arrays were performed with the lung lysates of neonatal rats. The results indicated that LPS upregulated a series of pro-inflammatory cytokines and theophylline significantly attenuated the expression levels of pro-inflammatory cytokines tumor necrosis factor‑α, macrophage inflammatory protein (MIP)-1α and MIP-2, and markedly elevated the production of tumor growth factor (TGF)-β family members TGF-β1, TGF-β2 and TGF-β3, which are anti‑inflammatory cytokines. Accordingly, it was hypothesized that theophylline may protect against BPD and improve chorioamnionitis‑induced alveolar arrest by regulating the balance between pro‑and anti-inflammatory cytokine expression.

  19. Variation in Out-of-Hospital Cardiac Arrest Management

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    Jason M. Jones


    Full Text Available Objective. To evaluate variation in airway management strategies in one suburban emergency medical services system treating patients experiencing out-of-hospital cardiac arrest (OHCA. Method. Retrospective chart review of all adult OHCA resuscitation during a 13-month period, specifically comparing airway management decisions. Results. Paramedics demonstrated considerable variation in their approaches to airway management. Approximately half of all OHCA patients received more than one airway management attempt (38/77 [49%], and one-quarter underwent three or more attempts (25/77 [25%]. One-third of patients arrived at the emergency department with a different airway device than initially selected (25/77 [32%]. Conclusion. This study confirmed our hypothesis that paramedics’ selection of ventilation strategies in cardiac arrest varies considerably. This observation raises concern because airway management diverts time and energy from interventions known to improve outcomes in OHCA management, such as cardiopulmonary resuscitation and defibrillation. More research is needed to identify more focused airway management strategies for prehospital care providers.

  20. Ponatinib promotes a G1 cell-cycle arrest of merlin/NF2-deficient human schwann cells. (United States)

    Petrilli, Alejandra M; Garcia, Jeanine; Bott, Marga; Klingeman Plati, Stephani; Dinh, Christine T; Bracho, Olena R; Yan, Denise; Zou, Bing; Mittal, Rahul; Telischi, Fred F; Liu, Xue-Zhong; Chang, Long-Sheng; Welling, D Bradley; Copik, Alicja J; Fernández-Valle, Cristina


    Neurofibromatosis type 2 (NF2) is a genetic syndrome that predisposes individuals to multiple benign tumors of the central and peripheral nervous systems, including vestibular schwannomas. Currently, there are no FDA approved drug therapies for NF2. Loss of function of merlin encoded by the NF2 tumor suppressor gene leads to activation of multiple mitogenic signaling cascades, including platelet-derived growth factor receptor (PDGFR) and SRC in Schwann cells. The goal of this study was to determine whether ponatinib, an FDA-approved ABL/SRC inhibitor, reduced proliferation and/or survival of merlin-deficient human Schwann cells (HSC). Merlin-deficient HSC had higher levels of phosphorylated PDGFRα/β, and SRC than merlin-expressing HSC. A similar phosphorylation pattern was observed in phospho-protein arrays of human vestibular schwannoma samples compared to normal HSC. Ponatinib reduced merlin-deficient HSC viability in a dose-dependent manner by decreasing phosphorylation of PDGFRα/β, AKT, p70S6K, MEK1/2, ERK1/2 and STAT3. These changes were associated with decreased cyclin D1 and increased p27Kip1levels, leading to a G1 cell-cycle arrest as assessed by Western blotting and flow cytometry. Ponatinib did not modulate ABL, SRC, focal adhesion kinase (FAK), or paxillin phosphorylation levels. These results suggest that ponatinib is a potential therapeutic agent for NF2-associated schwannomas and warrants further in vivo investigation.

  1. Measuring survival rates from sudden cardiac arrest: the elusive definition. (United States)

    Sayre, Michael R; Travers, Andrew H; Daya, Mohamud; Greene, H Leon; Salive, Marcel E; Vijayaraghavan, Krishnaswami; Craven, Richard A; Groh, William J; Hallstrom, Alfred P


    Measuring survival from sudden out-of-hospital cardiac arrest (OOH-CA) is often used as a benchmark of the quality of a community's emergency medical service (EMS) system. The definition of OOH-CA survival rates depends both upon the numerator (surviving cases) and the denominator (all cases). The purpose of the public access defibrillation (PAD) trial was to measure the impact on survival of adding an automated external defibrillator (AED) to a volunteer response system trained in CPR. This paper reports the definition of OOH-CA developed by the PAD trial investigators, and it evaluates alternative statistical methods used to assess differences in reported "survival." Case surveillance was limited to the prospectively determined geographic boundaries of the participating trial units. The numerator in calculating a survival rate should include only those patients who survived an event but who otherwise would have died except for the application of some facet of emergency medical care-in this trial a defibrillatory shock. Among denominators considered were: total population of the study unit, all deaths within the study unit, and documented ventricular fibrillation cardiac arrests. The PAD classification focused upon cases that might have benefited from the early use of an AED, in addition to the likely benefit from early recognition of OOH-CA, early access of EMS, and early cardiopulmonary resuscitation (CPR). Results of this classification system were used to evaluate the impact of the PAD definition on the distribution of cardiac arrest case types between CPR only and CPR + AED units. Potential OOH-CA episodes were classified into one of four groups: definite, probable, uncertain, or not an OOH-CA. About half of cardiac arrests in the PAD units were judged to be definite OOH-CA events and therefore potentially treatable with an AED. However, events that occurred in CPR-only units were less likely to be classified as definite or probable OOH-CA events than those

  2. Prescription Monitoring Program Trends Among Individuals Arrested in Maine for Trafficking Prescription Drugs in 2014. (United States)

    McCall, Kenneth; Nichols, Stephanie D; Holt, Christina; Ochs, Leslie; Cattabriga, Gary; Tu, Chunhao


    To evaluate controlled substance prescribing trends available in the Maine Prescription Monitoring Program (PMP) among individuals arrested for prescription drug "trafficking." The demographic characteristics of the individuals who had matching prescription records in the PMP within 90 days of the arrest were identified. A population-based, retrospective cohort study using data from the Maine Diversion Alert Program (DAP) and the Maine PMP. The study population consisted of persons arrested for trafficking prescription drugs in Maine during the 2014 calendar year from January 1 to December 31. There were 594 trafficking arrests reported by the Maine DAP in 2014. The study population consisted of the 235 persons (40%) with arrests involving controlled prescription medications. The mean age of these persons was 33 years (range 18-77 yrs), and 156 (66%) were male. Arrests involved 154 prescription opioids (65%), seven stimulants (3%), seven benzodiazepines (3%), and 77 unspecified controlled prescription drugs (33%). A minority of individuals (n=57, 24%) had a prescription record in the PMP that matched the substance involved in the arrest. Only one person with matching PMP and arrest records utilized ≥ 5 prescribers, while none used ≥ 5 pharmacies within 90 days before the arrest. Payment methods for matching prescriptions were commercial insurance (n=28, 49%), Medicaid (n=19, 33%), Medicare (n=5, 9%), and cash (n=5, 9%). The majority (76%) of persons arrested for prescription drug trafficking did not have PMP records and did not directly obtain the diverted medication from a licensed pharmacy. Traditional red flags, like cash payment and using multiple prescribers or pharmacies, were uncommon. Therefore, arrest records for diversion and PMPs are distinct and complementary tools for identifying individuals at risk for substance misuse. © 2016 Pharmacotherapy Publications, Inc.

  3. Epidemiology of Cardiac Arrest During Hospitalization for Delivery in Canada: A Nationwide Study. (United States)

    Balki, Mrinalini; Liu, Shiliang; León, Juan Andrés; Baghirzada, Leyla


    Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015. The data were accessed through the Public Health Agency of Canada's (PHAC) Canadian Perinatal Surveillance System. Cases of cardiac arrest were identified using the diagnostic and intervention codes from the International Statistical Classification of Diseases and the Canadian Classification of Health Interventions, respectively. Data on patient demographics, medical and obstetrical conditions, and potential etiologies of cardiac arrest were collected. Multivariable logistic regression analysis was used to identify conditions associated with cardiac arrest. There were 286 cases of maternal cardiac arrest among 3,568,597 hospitalizations for delivery during the 13-year period. A total of 204 (71.3%) women survived to hospital discharge (95% confidence interval, 65.7%-76.5%). There was no significant variation in the incidence of cardiac arrest or survival from arrest over time or across provinces. Among the pre-existing conditions, hypertensive disorders of pregnancy, gestational diabetes, malignancy, and diseases of the respiratory and nervous system were found to be significantly associated with cardiac arrest. Among the obstetrical conditions, placental abnormalities and polyhydramnios were associated with cardiac arrest. The common potential etiologies included postpartum hemorrhage, heart failure, amniotic fluid embolism, and complications of anesthesia. In this first Canadian study, the incidence of cardiac arrest during

  4. Hospital Variation in Survival After Pediatric In-Hospital Cardiac Arrest (United States)

    Jayaram, Natalie; Spertus, John A.; Nadkarni, Vinay; Berg, Robert A.; Tang, Fengming; Raymond, Tia; Guerguerian, Anne-Marie; Chan, Paul S.


    Background Although survival after in-hospital cardiac arrest is likely to vary among hospitals caring for children, validated methods to risk-standardize pediatric survival rates across sites do not currently exist. Methods and Results Within the American Heart Association’s Get With the Guidelines-Resuscitation registry for in-hospital cardiac arrest, we identified 1,551 cardiac arrests in children (cardiac arrest survival for hospitals with a minimum of 10 pediatric cardiac arrest cases. A total of 13 patient-level predictors were identified: age, sex, cardiac arrest rhythm, location of arrest, mechanical ventilation, acute non-stroke neurologic event, major trauma, hypotension, metabolic or electrolyte abnormalities, renal insufficiency, sepsis, illness category, and need for intravenous vasoactive agents prior to the arrest. The model had good discrimination (C-statistic of 0.71), confirmed by bootstrap validation (validation C-statistic of 0.69). Among 30 hospitals with at least 10 cardiac arrests, unadjusted hospital survival rates varied considerably (median, 37%; inter-quartile range [IQR]: 24%–42%; range: 0%–61%). After risk-standardization, the range of hospital survival rates narrowed (median, 37%; IQR: 33%–38%; range: 29%– 48%), but variation in survival persisted. Conclusion Using a national registry, we developed and validated a model to predict survival after in-hospital cardiac arrest in children. After risk-standardization, significant variation in survival rates across hospitals remained. Leveraging these models, future studies can identify best practices at high-performing hospitals to improve survival outcomes for pediatric cardiac arrest. PMID:24939940

  5. Organisation of in-hospital cardiac arrest teams - a nationwide study. (United States)

    Lauridsen, Kasper Glerup; Schmidt, Anders Sjørslev; Adelborg, Kasper; Løfgren, Bo


    In-hospital cardiac arrests are treated by a team of health care providers. Improving team performance may increase survival. Currently, no international standards for cardiac arrest teams exist in terms of member composition and allocation of tasks. To describe the composition of in-hospital cardiac arrest teams and review pre-arrest allocation of tasks. A nationwide cross-sectional study was performed. Data on cardiac arrest teams and pre-arrest allocation of tasks were collected from protocols on resuscitation required for hospital accreditation in Denmark. Additional data were collected through telephone interviews and email correspondence. Psychiatric hospitals and hospitals serving outpatients only were excluded. Data on the cardiac arrest team were available from 44 of 47 hospitals. The median team size was 5 (25th percentile; 75th percentile: 4; 6) members. Teams included a nurse anaesthetist (100%), a medical house officer (82%), an orderly (73%), an anaesthesiology house officer (64%) and a medical assistant (20%). Less likely to participate was a cardiology house officer (23%) or a cardiology specialist registrar (5%). Overall, a specialist registrar was represented on 20% of teams and 20% of cardiac arrest teams had a different team composition during nights and weekends. In total, 41% of teams did not define a team leader pre-arrest, and the majority of the teams did not define the tasks of the remaining team members. In Denmark, there are major differences among cardiac arrest teams. This includes team size, profession of team members, medical specialty and seniority of the physicians. Nearly half of the hospitals do not define a cardiac arrest team leader and the majority do not define the tasks of the remaining team members. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Induced hypothermia after cardiac arrest in trauma patients: a case series. (United States)

    Tuma, Mazin A; Stansbury, Lynn G; Stein, Deborah M; McQuillan, Karen A; Scalea, Thomas M


    Induced hypothermia after cardiac arrest is an accepted neuroprotective strategy. However, its role in cardiac arrest during acute trauma care is not yet defined. To characterize recent experience with this technique at our center, we undertook a detailed chart review of acute trauma patients managed with induced hypothermia after cardiac arrest. From Trauma Registry records, we identified all adult patients (older than 17 years) admitted to our Level I trauma center from July 1, 2008, through June 30, 2010, who experienced cardiac arrest during acute trauma care and were managed via our induced hypothermia protocol. This requires maintenance of core body temperature between 32°C and 34°C for 24 hours after arrest. Patient clinical records were then reviewed for selected factors. Six acute trauma patients (3 male and 3 female; median age, 53 years) with cardiac arrest managed per protocol were identified. All injuries were due to blunt impact, and five of six injuries were motor-vehicle-associated. Median Injury Severity Score was 27; median prearrest Glasgow Coma Scale (GCS) score was 15. One patient arrested prehospital and the other 5 in-hospital. Median duration of arrest was 8 minutes. All were comatose after arrest. One death occurred, in the patient with a prehospital cardiac arrest. Two patients were discharged to chronic care facilities with GCS11-tracheostomy; three were discharged to active rehabilitation care facilities with GCS score of 14 to 15. There were no obvious complications related to cooling. Mild induced hypothermia can be beneficial in a selected group of trauma patients after cardiac arrest. Prospective trials are needed to explore the effects of targeted temperature management on coagulation in this patient group.

  7. Epidemiology and outcomes of cardiac arrest among children with Down Syndrome: a multicenter analysis. (United States)

    Padiyath, Asif; Rettiganti, Mallikarjuna; Gossett, Jeffrey M; Tadphale, Sachin D; Garcia, Xiomara; Seib, Paul M; Gupta, Punkaj


    With the increasing prevalence of Down Syndrome, it is unknown if children with Down Syndrome are associated with increased incidence of cardiac arrest and poor outcomes after cardiac arrest. The objective of this study was to evaluate the epidemiology of cardiac arrest and mortality after cardiac arrest among critically ill children with and without Down Syndrome. Patients ≤18 years admitted at a Pediatric Health Information Systems (PHIS) participating Intensive Care Unit were included (2004-2014). Multivariable logistic regression models were fitted to evaluate association of Down Syndrome with study outcomes after adjusting for patient and center characteristics. A total of 849,250 patients from 44 centers were included. Of the 25,143 patients with Down Syndrome, cardiac arrest was noted among 568 (2.3%) patients with an associated mortality at hospital discharge of 248 (43.6%) patients. In contrast, of the 824,107 patients without Down Syndrome, cardiac arrest was noted among 15,822 (1.9%) patients with an associated mortality at hospital discharge of 7775 (49.1%) patients. In adjusted models, patients with Down Syndrome had a higher likelihood of having cardiac arrest as compared to patients without Down Syndrome (with vs. without Down, OR: 1.14, 95% CI: 1.03-1.25, P=0.01). Despite having a higher likelihood of cardiac arrest, patients with Down Syndrome were associated with a lower mortality after cardiac arrest (OR: 0.78, 95% CI: 0.63-0.96, P=0.02). Both incidence of cardiac arrest, and mortality at hospital discharge in those with cardiac arrest vary substantially in children with and without Down Syndrome.

  8. Comparable Outcome of Out-of-Hospital Cardiac Arrest and In-Hospital Cardiac Arrest Treated With Extracorporeal Life Support. (United States)

    Ellouze, Omar; Vuillet, Melitine; Perrot, Justine; Grosjean, Sandrine; Missaoui, Anis; Aho, Serge; Malapert, Ghislain; Bouhemad, Belaid; Bouchot, Oliver; Girard, Claude


    Extracorporeal life support (ECLS) has shown benefits in the management of refractory in-hospital cardiac arrest (IHCA) by improving survival. Nonetheless, the results concerning out-of-hospital refractory cardiac arrests (OHCA) remain uncertain. The aim of our investigation was to compare survival between the two groups. We realized a single-center retrospective, observational study of all patients who presented IHCA or OHCA treated with ECLS between 2011 and 2015. Multivariate analysis was realized to determine independent factors associated with mortality. Over the 4-year period, 65 patients were included, 43 in the IHCA group (66.2%), and 22 (33.8%) in the OHCA group. The duration of low flow was significantly longer in the OHCA group (60 vs. 90 min, P = 0.004). Survival to discharge from the hospital was identical in the two groups (27% in the OHCA group vs. 23% in the IHCA group, P = 0.77). All surviving patients in the OHCA group had a cerebral performance categories score of 1-2. In multivariate analysis, we found that the initial lactate level and baseline blood creatinine were independently associated with mortality. We found comparable survival and neurological score in patients who presented IHCA and OHCA treated with ECLS. We believe that appropriate selection of patients and optimization of organ perfusion during resuscitation can lead to good results in patients with OHCA treated with ECLS. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  9. Transnational European Television Drama

    DEFF Research Database (Denmark)

    Bondebjerg, Ib; Redvall, Eva Novrup; Helles, Rasmus

    This book deals with the role of television drama in Europe as enabler of transnational, cultural encounters for audiences and the creative community. It demonstrates that the diversity of national cultures is a challenge for European TV drama but also a potential richness and source of creative...... variation. Based on data on the production, distribution and reception of recent TV drama from several European countries, the book presents a new picture of the transnational European television culture. The authors analyse main tendencies in television policy and challenges for national broadcasters...... coming from new global streaming services. Comparing cases of historical, contemporary and crime drama from several countries, this study shows the importance of creative co-production and transnational mediated cultural encounters between national cultures of Europe....

  10. The Europeanization of Eurosceptics?

    DEFF Research Database (Denmark)

    Dutceac Segesten, Anamaria; Bossetta Jr, Michael Joseph

    with the case of Sweden. Sweden is a good example because it has a high density of internet use, a politically active population as reflected in voter turnout and many politicians and political parties with a web presence. The main research questions of the paper are: Which actors are involved in the Swedish...... of a Europeanized network of anti-European voices for European integration and democracy. We plan to operationalize our research question through the use of webcrawling (i.e. Issue Crawler) and social media analytic softwares (Twitonomy and Bluenod). Using these softwares we will be able to discern whether...... or not non-Swedish Twitter users are participating in and/or affecting the Swedish Eurosceptic dialogue on social media....

  11. European Analytical Column

    DEFF Research Database (Denmark)

    Karlberg, B.; Grasserbauer, M.; Andersen, Jens Enevold Thaulov


    The European Analytical Column has once more invited a guest columnist to give his views on various matters related to analytical chemistry in Europe. This year, we have invited Professor Manfred Grasserbauer of the Vienna University of Technology to present some of the current challenges...... for European analytical chemistry. During the period 2002–07, Professor Grasserbauer was Director of the Institute for Environment and Sustainability, Joint Research Centre of the European Commission (EC), Ispra, Italy. There is no doubt that many challenges exist at the present time for all of us representing...... a major branch of chemistry, namely analytical chemistry. The global financial crisis is affecting all branches of chemistry, but analytical chemistry, in particular, since our discipline by tradition has many close links to industry. We have already noticed decreased industrial commitment with respect...

  12. European Universe Awareness (United States)

    Russo, P.; Miley, G.; Westra van Holthe, F.; Schrier, W.; Reed, S.


    The European Universe Awareness (EU-UNAWE) programme uses the beauty and grandeur of the cosmos to encourage young children, particularly those from underprivileged backgrounds, to develop an interest in science and technology and to foster a sense of global citizenship. EU-UNAWE is already active in 40 countries and comprises a global network of almost 500 astronomers, teachers and other educators. The programme was recently awarded a grant of 1.9 million euros by the European Union so that it can be further developed in five European countries and South Africa. The grant will be used to organise teacher training workshops and to develop educational materials, such as an astronomy news service for children and games. During this presentation we will outline some of the biggest achievements of EU-UNAWE to date and discuss future plans for the programme.

  13. The European Identity

    Directory of Open Access Journals (Sweden)

    Alberto Martinelli


    Full Text Available European identity is not only a scientifically interesting question, but also a politically important issue: in fact, sixty years after the signing of the Treaty of Rome, the European Union finds itself for the first time facing risks that threaten its own existence. The European Union is a limited and incomplete project because Europe’s economic integration has not been accompanied by a genuine supranational political union and greater cultural integration. The deficit of democratic representation and cultural integration is due to the fact that the community process is based only on economic rationality and not on a feeling of common belonging. In the current situation in which the Union faces difficult challenges which threaten to undermine the future, it necessary to affirm the policy of interests with a policy of identity. In this essay, we will first concentrate on the concept of identity – that is on the nucleus of values and common institutions –; then we will discuss how the European identity has changed over time (also in relation to national identities and what are the mechanisms that may favour its taking root in the current situation. The European project of political unification needs to be re-emphasized, finding the way to a European collective identity, not contrasted with but alongside the different national identities, referring to loyalty and shared commitment to a whole collection of cultural values: fundamental human rights, civil liberties, democratic political institutions, rule of law, freedom of movement of people, goods and capital, social justice and non-violent resolution of conflicts.

  14. European Gas Dependency


    Antonsen, Iben; Bieber, Martin; Gandrup, Tobias; Lehmann, Tina; Weinberger, Ashley


    The focal point of the project is, as it is implied in the title, European gas dependency, to be more specific; the dependency of Russian gas. We chose Russia, because the EU's import of gas is mainly supplied by Russia. We present background information and knowledge to describe why the case is of relevance and that a situation of dependency exists. We solely look at the dependency from the European Union's point of view, taking point of departure in the Green Paper. The Green Paper is a pap...

  15. European Values and Globalization

    Directory of Open Access Journals (Sweden)

    Heinz Theisen


    Full Text Available Good Governance, Social Market Economy, Culture and Education are the decisive elements for Human Development. We need a third way between the extremes of the Utopian Global Free Market and a new nationalism. A Social Market Economy and the European Model of a Union could be such third way. For a new Social Market Economy we need a renaissance of the European dialectics between culture and society, idealism and materialism, religion and enlightenment, solidarity and profitability. The balancing of those poles is deeply rooted in our best traditions. 

  16. [Cardiocirculatory arrest caused by electric shock: importance of semi-automatic defibrillator]. (United States)

    Siah, S; Fouadi, F E; Ababou, K; Ihrai, I; Drissi, N K


    Accidental electrical burn injuries are serious because they can cause death by cardiocirculatory arrest. Cardiocirculatory arrest induced by low-voltage current is generally due to ventricular fibrillation, and the prognosis is fairly good if the survival chain is efficient. It is necessary to give priority to early defibrillation using an automated external defibrillator. Early defibrillation can immediately restore spontaneous circulation.

  17. A Summary and Analysis of Warrantless Arrest Statutes for Domestic Violence in the United States (United States)

    Zeoli, April M.; Norris, Alexis; Brenner, Hannah


    In the United States, all 50 states and the District of Columbia have enacted statutes that allow police officers to make warrantless arrests for domestic violence given probable cause; however, state laws differ from one another in multiple, important ways. Research on domestic violence warrantless arrest laws rarely describe them as anything…

  18. Cardiac Arrest During Anaesthesia In Enugu Nigeria,1994-96 | Nze ...

    African Journals Online (AJOL)

    Aim: To determine the incidence and outcome of cardiac arrest during general anaesthesia at the University of Nigerian Teaching Hospital Enugu, Nigeria. Patient and Methods: A retrospective study of 6,450 anaesthetic charts from January 1994 to December1996 was undertaken. The cases where cardiac arrest box had ...

  19. Temporal differences in out-of-hospital cardiac arrest incidence and survival

    DEFF Research Database (Denmark)

    Bagai, Akshay; McNally, Bryan F.; Al-Khatib, Sana M.


    Understanding temporal differences in the incidence and outcomes of out-of-hospital cardiac arrest (OHCA) has important implications for developing preventative strategies and optimizing systems for OHCA care.......Understanding temporal differences in the incidence and outcomes of out-of-hospital cardiac arrest (OHCA) has important implications for developing preventative strategies and optimizing systems for OHCA care....

  20. 38 CFR 3.375 - Determination of inactivity (complete arrest) in tuberculosis. (United States)


    ... inactivity (complete arrest) in tuberculosis. 3.375 Section 3.375 Pensions, Bonuses, and Veterans' Relief...) in tuberculosis. (a) Pulmonary tuberculosis. A veteran shown to have had pulmonary tuberculosis will...) Nonpulmonary disease. Determination of complete arrest of nonpulmonary tuberculosis requires absence of...

  1. Outcome of out-of-hospital cardiac arrest--why do physicians withhold resuscitation attempts?

    DEFF Research Database (Denmark)

    Horsted, Tina I; Rasmussen, Lars S; Lippert, Freddy K


    To describe the outcome of out-of-hospital cardiac arrest (OHCA) with a focus on why physicians withhold resuscitation attempts.......To describe the outcome of out-of-hospital cardiac arrest (OHCA) with a focus on why physicians withhold resuscitation attempts....

  2. Programmed cell cycle arrest is required for infection of corn plants by the fungus Ustilago maydis. (United States)

    Castanheira, Sónia; Mielnichuk, Natalia; Pérez-Martín, José


    Ustilago maydis is a plant pathogen that requires a specific structure called infective filament to penetrate the plant tissue. Although able to grow, this filament is cell cycle arrested on the plant surface. This cell cycle arrest is released once the filament penetrates the plant tissue. The reasons and mechanisms for this cell cycle arrest are unknown. Here, we have tried to address these questions. We reached three conclusions from our studies. First, the observed cell cycle arrest is the result of the cooperation of at least two distinct mechanisms: one involving the activation of the DNA damage response (DDR) cascade; and the other relying on the transcriptional downregulation of Hsl1, a kinase that modulates the G2/M transition. Second, a sustained cell cycle arrest during the infective filament step is necessary for the virulence in U. maydis, as a strain unable to arrest the cell cycle was severely impaired in its ability to infect corn plants. Third, production of the appressorium, a structure required for plant penetration, is incompatible with an active cell cycle. The inability to infect plants by strains defective in cell cycle arrest seems to be caused by their failure to induce the appressorium formation process. In summary, our findings uncover genetic circuits to arrest the cell cycle during the growth of this fungus on the plant surface, thus allowing the penetration into plant tissue. © 2014. Published by The Company of Biologists Ltd.

  3. Out of hospital thoracotomy for cardiac arrest after penetrating thoracic trauma

    NARCIS (Netherlands)

    M.G. van Vledder (Mark); O.J.F. van Waes (Oscar); Kooij, F.O. (Fabian O.); Peters, J.H. (Joost H.); E.M.M. van Lieshout (Esther); M.H.J. Verhofstad (Michiel)


    textabstractIntroduction: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and

  4. Out of hospital thoracotomy for cardiac arrest after penetrating thoracic trauma

    NARCIS (Netherlands)

    van Vledder, Mark G.; van Waes, Oscar J. F.; Kooij, Fabian O.; Peters, Joost H.; van Lieshout, Esther M. M.; Verhofstad, Michael H. J.


    Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated

  5. The science of reperfusion injury post cardiac arrest--Implications for emergency nurses. (United States)

    Baker, Edward; Lee, Geraldine


    Survival following cardiac arrest in the developed world remains below 10%. In those who survive the initial cardiac arrest, prognosis remains poor due to the onset of multi-organ failure with both significant cardiac and neurological dysfunction. Nurses have demonstrated good understanding of cardiac arrest/post arrest guidelines and have good technical skills but deficits remain in their understanding of pathophysiological processes involved in post cardiac arrest syndromes. This article aims to provide an overview of these pathophysiological processes involved in the post cardiac arrest phase, potential treatment options and the nursing interventions that may be required within the emergency department setting. This article will focus emergency nurses to become more involved in patient management at this critical phase of treatment and highlight potential early signs of deterioration. Although return of spontaneous circulation (ROSC) is crucial in the process of recovery from cardiac arrest, it is only the first of many complex stages. Given the complexity of post cardiac arrest syndrome and its impact on the patient, healthcare professionals need to understand the cellular changes associated with reperfusion injuries in order to improve outcomes. It is only through effective nursing care and medical management that improved outcomes will become more common in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography

    DEFF Research Database (Denmark)

    Dankiewicz, J; Nielsen, N; Annborn, M


    PURPOSE: To investigate whether early coronary angiography (CAG) after out-of-hospital cardiac arrest of a presumed cardiac cause is associated with improved outcomes in patients without acute ST elevation. METHODS: The target temperature management after out-of-hospital cardiac arrest (TTM) tria...

  7. Same-Sex and Race-Based Disparities in Statutory Rape Arrests. (United States)

    Chaffin, Mark; Chenoweth, Stephanie; Letourneau, Elizabeth J


    This study tests a liberation hypothesis for statutory rape incidents, specifically that there may be same-sex and race/ethnicity arrest disparities among statutory rape incidents and that these will be greater among statutory rape than among forcible sex crime incidents. 26,726 reported incidents of statutory rape as defined under state statutes and 96,474 forcible sex crime incidents were extracted from National Incident-Based Reporting System data sets. Arrest outcomes were tested using multilevel modeling. Same-sex statutory rape pairings were rare but had much higher arrest odds. A victim-offender romantic relationship amplified arrest odds for same-sex pairings, but damped arrest odds for male-on-female pairings. Same-sex disparities were larger among statutory than among forcible incidents. Female-on-male incidents had uniformly lower arrest odds. Race/ethnicity effects were smaller than gender effects and more complexly patterned. The findings support the liberation hypothesis for same-sex statutory rape arrest disparities, particularly among same-sex romantic pairings. Support for race/ethnicity-based arrest disparities was limited and mixed. © The Author(s) 2014.

  8. Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

    NARCIS (Netherlands)



    textabstractMeasurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the

  9. Evaluation of surge protection in underground distribution systems using zinc oxide (metal oxide) surge arresters

    Energy Technology Data Exchange (ETDEWEB)

    Banda, J.


    Application of zinc oxide arresters represents a significant development in surge protection. One area of distribution system protection where the new arrester technology can be immediately valuable is underground distribution system protection. Increasing system voltage levels and the economic advantages of lower basic insulation level have led to increased interest in improving protection of underground distribution system equipment. Because conventional silicon-carbide surge arresters have not met the challenges imposed by system requirements, costly alternatives such as paralleling arresters have been used in an attempt to limit surges imposed on systems. In this thesis differences between the two types of arresters are reviewed, and an evaluation of surge protection employing zinc oxide arresters in underground distribution systems is carried out. In order to evaluate zinc oxide surge arrester's performance under various conditions, transient phenomena of single- and multi-line underground distribution systems, with and without surge arresters, are studied. The conditions considered include; (i) low and high surge impedance systems, (ii) slow and fast front surges and (iii) different line terminations. Actual data obtained from a typical and operative underground distribution system is used in the study.

  10. 10 CFR 1047.6 - Use of physical force when making an arrest. (United States)


    ... physical force by the offender. It should be noted that verbal abuse alone by the offender cannot be the... 10 Energy 4 2010-01-01 2010-01-01 false Use of physical force when making an arrest. 1047.6... BY PROTECTIVE FORCE OFFICERS General Provisions § 1047.6 Use of physical force when making an arrest...

  11. Proteomic analysis of Bacillus thuringiensis ΔphaC mutant BMB171/PHB(-1) reveals that the PHB synthetic pathway warrants normal carbon metabolism. (United States)

    Chen, Deju; Xu, Dong; Li, Mingshun; He, Jin; Gong, Yuhua; Wu, Dandan; Sun, Ming; Yu, Ziniu


    A phaC knockout mutant from Bacillus thuringiensis (Bt) strain BMB171, named BMB171/PHB(-1), was constructed. A physiological and metabolic investigation and a proteomic analysis were conducted for both ΔphaC mutant and its parent strain. Grown in peptone medium with 5 gram glucose per liter as sole carbon source, BMB171/PHB(-1) produced various organic acids. Here the excreted pyruvate, citrate, lactate, acetate and glutamate were quantitatively analyzed. Deletion of phaC gene from the BMB171 strain resulted in 1) growth delay; 2) higher consumption of dioxigen but lower cell yield; 3) stagnation of pH movement; 4) overproduction of organic acids; 5) rapid descent of cell density in the stationary phase; and 6) a sporulation-deficient phenotype. Our proteomic study with qPCR reconfirmation reveals that the absence of PhaC led to a metabolic turmoil which showed repressed glycolysis, and over-expressed TCA cycle, various futile pathways and amino acid synthesis during vegetative growth. It is thus thought that B. thuringiensis BMB171 effectively regulated its carbon metabolism upon the presence of the functional PHB synthetic pathway. The presence of this pathway warrants a PHB-producing bacterium better surviving under different environmental conditions. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Autoimmune hemolysis and immune thrombocytopenic purpura after cord blood transplantation may be life-threatening and warrants early therapy with rituximab. (United States)

    Bhatt, V; Shune, L; Lauer, E; Lubin, M; Devlin, S M; Scaradavou, A; Parameswaran, R; Perales, M A; Ponce, D M; Mantha, S; Kernan, N A; Barker, J N


    Autoimmune hemolysis (AH) and immune thrombocytopenic purpura (ITP) are recognized complications after cord blood transplantation (CBT). We evaluated the incidence and characteristics of AH/ITP after double-unit CBT in a day 100 landmark analysis of 152 patients (median age 36 years, range 0.9-70 years) transplanted for hematologic malignancies with myeloablative or nonmyeloablative conditioning and calcineurin inhibitor (CNI)/mycophenolate mofetil. With a median 5.2-year (range 1.6-9.7 years) survivor follow-up, 10 patients developed autoimmune cytopenias (8 AH, 1 ITP, 1 both) at a median of 10.4 months (range 5.8-24.5) post CBT for a 7% cumulative incidence 3 years after the day 100 landmark. Six patients presented with severe disease (hemoglobin ⩽6 g/dL and/or platelets <20 × 10(9)/L). All AH patients were direct antiglobulin test positive. All 10 cases developed during immunosuppression taper with 8 having prior acute GVHD. All 10 patients received rituximab 2-18 days after diagnosis, and corticosteroids combined with rituximab within <7 days was the most effective. No patient died of AH/ITP. AH/ITP occurs infrequently after CBT but may be life-threatening requiring emergency therapy. Rituximab combined with corticosteroids at diagnosis is warranted in patients with severe disease.

  13. RNA Pol II accumulates at promoters of growth genes during developmental arrest. (United States)

    Baugh, L Ryan; Demodena, John; Sternberg, Paul W


    When Caenorhabditis elegans larvae hatch from the egg case in the absence of food, their development is arrested (L1 arrest), and they show increased stress resistance until food becomes available. To study nutritional control of larval development, we analyzed growth and gene expression profiles during L1 arrest and recovery. Larvae that were fed responded relatively slowly to starvation compared with the rapid response of arrested larvae to feeding. Chromatin immunoprecipitation of RNA polymerase II (Pol II) followed by deep sequencing showed that during L1 arrest, Pol II continued transcribing starvation-response genes, but the enzyme accumulated on the promoters of growth and development genes. In response to feeding, promoter accumulation decreased, and elongation and messenger RNA levels increased. Therefore, accumulation of Pol II at promoters anticipates nutritionally controlled gene expression during C. elegans development.

  14. Reversible cryo-arrest for imaging molecules in living cells at high spatial resolution (United States)

    Sabet, Ola; Wehner, Frank; Konitsiotis, Antonios; Fuhr, Günther R.; Bastiaens, Philippe I. H.


    The dynamics of molecules in living cells hamper precise imaging of molecular patterns by functional and super resolution microscopy. Circumventing lethal chemical fixation, an on-stage cryo-arrest was developed for consecutive imaging of molecular patterns within the same living, but arrested cells. The reversibility of consecutive cryo-arrests was demonstrated by the high survival rate of different cell lines and intact growth factor signaling that was not perturbed by stress response. Reversible cryo-arrest was applied to study the evolution of ligand-induced receptor tyrosine kinase activation at different scales. The nanoscale clustering of epidermal growth factor receptor (EGFR) in the plasma membrane was assessed by single molecule localization microscopy and endosomal microscale activity patterns of ephrin receptor type-A (EphA2) by fluorescence lifetime imaging microscopy. We thereby demonstrate that reversible cryo-arrest allows the precise determination of molecular patterns while conserving the dynamic capabilities of living cells. PMID:27400419

  15. Outdoor air pollution and out-of-hospital cardiac arrest in Okayama, Japan. (United States)

    Yorifuji, Takashi; Suzuki, Etsuji; Kashima, Saori


    We evaluated the association between short-term exposure to outdoor air pollution and out-of-hospital cardiac arrest in Japan. We studied 558 residents of Okayama, Japan, who visited hospital emergency departments between January 2006 and December 2010 for out-of-hospital cardiac arrest using a time-stratified case-crossover design. We calculated city-representative average concentrations of different air pollutants and examined the association between air pollution and cardiac arrest. Exposure to air pollution was associated with an elevated risk of cardiac arrest; for example, odds ratios was 1.17 (95% confidence interval, 1.02 to 1.33) per interquartile-range increase in suspended particulate matter concentrations in the previous 48 to 72 hours. We also observed different susceptibilities to suspended particulate matter and ozone exposures by age category. Short-term exposure to outdoor air pollution was associated with increased risk of cardiac arrest.

  16. Application of Powell's optimization method to surge arrester circuit models' parameters

    Energy Technology Data Exchange (ETDEWEB)

    Christodoulou, C.A.; Stathopulos, I.A. [National Technical University of Athens, School of Electrical and Computer Engineering, 9 Iroon Politechniou St., Zografou Campus, 157 80 Athens (Greece); Vita, V.; Ekonomou, L.; Chatzarakis, G.E. [A.S.PE.T.E. - School of Pedagogical and Technological Education, Department of Electrical Engineering Educators, N. Heraklion, 141 21 Athens (Greece)


    Powell's optimization method has been used for the evaluation of the surge arrester models parameters. The proper modelling of metal-oxide surge arresters and the right selection of equivalent circuit parameters are very significant issues, since quality and reliability of lightning performance studies can be improved with the more efficient representation of the arresters' dynamic behavior. The proposed approach selects optimum arrester model equivalent circuit parameter values, minimizing the error between the simulated peak residual voltage value and this given by the manufacturer. Application of the method in performed on a 120 kV metal oxide arrester. The use of the obtained optimum parameter values reduces significantly the relative error between the simulated and manufacturer's peak residual voltage value, presenting the effectiveness of the method. (author)

  17. The physiology of growth arrest: uniting molecular and environmental microbiology. (United States)

    Bergkessel, Megan; Basta, David W; Newman, Dianne K


    Most bacteria spend the majority of their time in prolonged states of very low metabolic activity and little or no growth, in which electron donors, electron acceptors and/or nutrients are limited, but cells are poised to undergo rapid division cycles when resources become available. These non-growing states are far less studied than other growth states, which leaves many questions regarding basic bacterial physiology unanswered. In this Review, we discuss findings from a small but diverse set of systems that have been used to investigate how growth-arrested bacteria adjust metabolism, regulate transcription and translation, and maintain their chromosomes. We highlight major questions that remain to be addressed, and suggest that progress in answering them will be aided by recent methodological advances and by dialectic between environmental and molecular microbiology perspectives.

  18. Partners in Crime in the Setting of Recurring Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Lida P. Papavasileiou


    Full Text Available No previous reports are available about the potential dramatic effects resulting from the combination of acquired long QT interval not associated to bradycardia and myocardial ischemia. We report the case of a man that during acute necrotic pancreatitis presented QT interval prolongation without bradycardia, TdP, and two episodes of cardiac arrest. A coronary angiogram revealed a subocclusive stenosis of left anterior descending coronary artery, treated with a percutaneous coronary intervention. After myocardial revascularization, even in presence of long QT interval, no arrhythmic events occurred suggesting the key role of myocardial ischemia in triggering TdP in acquired long QT even without bradycardia. ECG performed six months later, after complete recovery from pancreatitis, showed a normal QT interval.

  19. Partners in crime in the setting of recurring cardiac arrest. (United States)

    Papavasileiou, Lida P; Forleo, Giovanni B; Santini, Luca; Martuscelli, Eugenio; Romeo, Francesco


    No previous reports are available about the potential dramatic effects resulting from the combination of acquired long QT interval not associated to bradycardia and myocardial ischemia. We report the case of a man that during acute necrotic pancreatitis presented QT interval prolongation without bradycardia, TdP, and two episodes of cardiac arrest. A coronary angiogram revealed a subocclusive stenosis of left anterior descending coronary artery, treated with a percutaneous coronary intervention. After myocardial revascularization, even in presence of long QT interval, no arrhythmic events occurred suggesting the key role of myocardial ischemia in triggering TdP in acquired long QT even without bradycardia. ECG performed six months later, after complete recovery from pancreatitis, showed a normal QT interval.

  20. Out-of-hospital cardiac arrests in children and adolescents

    DEFF Research Database (Denmark)

    Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik


    BACKGROUND: There is insufficient knowledge of out-of-hospital cardiac arrest (OHCA) in the very young. OBJECTIVES: This nationwide study sought to examine age-stratified OHCA characteristics and the role of parental socioeconomic differences and its contribution to mortality in the young...... population. METHODS: All OHCA patients in Denmark, ≤21 years of age, were identified from 2001 to 2010. The population was divided into infants (children (1-5 years); school children (6-15 years); and high school adolescents/young adults (16-21 years). Multivariate logistic regression...... analyses were used to investigate associations between pre-hospital factors and study endpoints: return of spontaneous circulation and survival. RESULTS: A total of 459 individuals were included. Overall incidence of OHCA was 3.3 per 100,000 inhabitants per year. The incidence rates for infants, pre...

  1. Central diabetes insipidus following cardiopulmonary arrest in a dog. (United States)

    Bellis, Tara; Daly, Meredith; Davidson, Benjamin


    To describe a clinical case of transient central diabetes insipidus (CDI) occurring post cardiopulmonary arrest (CPA) in a dog. An 8-week-old dog presented for intensive care after successful resuscitation following CPA. The patient exhibited neurologic deficits at initial presentation and over the following days developed marked polyuria, isosthenuria, and low urine osmolality. Treatment with synthetic vasopressin resulted in a reduction in urine output, increase in urine specific gravity (>50%), and increase in urine osmolality, suggesting a diagnosis of partial CDI. Clinical signs resolved over the following weeks and treatment was discontinued. CPA has been described as a cause of ischemic injury to the pituitary gland resulting in CDI in people. To the authors' knowledge, this is the first report of a dog developing transient partial CDI following CPA and successful resuscitation. © Veterinary Emergency and Critical Care Society 2015.

  2. Opiate Withdrawal Complicated by Tetany and Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Irfanali R. Kugasia


    Full Text Available Patients with symptoms of opiate withdrawal, after the administration of opiate antagonist by paramedics, are a common presentation in the emergency department of hospitals. Though most of opiate withdrawal symptoms are benign, rarely they can become life threatening. This case highlights how a benign opiate withdrawal symptom of hyperventilation led to severe respiratory alkalosis that degenerated into tetany and cardiac arrest. Though this patient was successfully resuscitated, it is imperative that severe withdrawal symptoms are timely identified and immediate steps are taken to prevent catastrophes. An easier way to reverse the severe opiate withdrawal symptom would be with either low dose methadone or partial opiate agonists like buprenorphine. However, if severe acid-base disorder is identified, it would be safer to electively intubate these patients for better control of their respiratory and acid-base status.

  3. A Unique Case of Cardiac Arrest following K2 Abuse

    Directory of Open Access Journals (Sweden)

    Saif Ibrahim


    Full Text Available Sudden cardiac death (SCD accounts for up to 450,000 deaths every year in the United States (Zipes et al. (2006. Most cases of sudden cardiac death occur in subjects with no prior history of heart disease (Myerburg et al. (1998. The incidence of sudden death in a general population has been shown to increase contemporaneously with substance abuse (Phillips et al. (1999. The causative association of sudden death with cocaine, methadone, and volatile agents is well established (Adgey et al. (1995 and Isner et al. (1986. We describe a case of out-of-hospital cardiac arrest temporally related to abuse of the synthetic cannabinoid street drug known as K2. To our knowledge, there are no previously documented cases of sudden cardiac death associated with synthetic cannabinoids although they have been linked to myocardial infarction in teenagers despite normal coronary angiography (Mir et al. (2011.

  4. The Involvement of Danger-Associated Molecular Patterns in the Development of Immunoparalysis in Cardiac Arrest Patients

    NARCIS (Netherlands)

    Timmermans, K.; Kox, M.; Gerretsen, J.; Peters, E.; Scheffer, G.J.; Hoeven, J.G. van der; Pickkers, P.; Hoedemaekers, C.W.E.


    OBJECTIVES: After cardiac arrest, patients are highly vulnerable toward infections, possibly due to a suppressed state of the immune system called "immunoparalysis." We investigated if immunoparalysis develops following cardiac arrest and whether the release of danger-associated molecular patterns

  5. Automated External Defibrillators Inaccessible to More Than Half of Nearby Cardiac Arrests in Public Locations During Evening, Nighttime, and Weekends

    DEFF Research Database (Denmark)

    Hansen, Carolina Malta; Wissenberg, Mads; Weeke, Peter


    BACKGROUND: Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations. METHODS AND RESULTS: We identified cardiac arrests in public locations (1994...

  6. Lithium Causes G2 Arrest of Renal Principal Cells (United States)

    de Groot, Theun; Alsady, Mohammad; Jaklofsky, Marcel; Otte-Höller, Irene; Baumgarten, Ruben; Giles, Rachel H.


    Vasopressin-regulated expression and insertion of aquaporin-2 channels in the luminal membrane of renal principal cells is essential for urine concentration. Lithium affects urine concentrating ability, and approximately 20% of patients treated with lithium develop nephrogenic diabetes insipidus (NDI), a disorder characterized by polyuria and polydipsia. Lithium-induced NDI is caused by aquaporin-2 downregulation and a reduced ratio of principal/intercalated cells, yet lithium induces principal cell proliferation. Here, we studied how lithium-induced principal cell proliferation can lead to a reduced ratio of principal/intercalated cells using two-dimensional and three-dimensional polarized cultures of mouse renal collecting duct cells and mice treated with clinically relevant lithium concentrations. DNA image cytometry and immunoblotting revealed that lithium initiated proliferation of mouse renal collecting duct cells but also increased the G2/S ratio, indicating G2/M phase arrest. In mice, treatment with lithium for 4, 7, 10, or 13 days led to features of NDI and an increase in the number of principal cells expressing PCNA in the papilla. Remarkably, 30%–40% of the PCNA-positive principal cells also expressed pHistone-H3, a late G2/M phase marker detected in approximately 20% of cells during undisturbed proliferation. Our data reveal that lithium treatment initiates proliferation of renal principal cells but that a significant percentage of these cells are arrested in the late G2 phase, which explains the reduced principal/intercalated cell ratio and may identify the molecular pathway underlying the development of lithium-induced renal fibrosis. PMID:24408872

  7. Generation of a Spindle Checkpoint Arrest from Synthetic Signaling Assemblies. (United States)

    Yuan, Ivan; Leontiou, Ioanna; Amin, Priya; May, Karen M; Soper Ní Chafraidh, Sadhbh; Zlámalová, Eliška; Hardwick, Kevin G


    The spindle checkpoint acts as a mitotic surveillance system, monitoring interactions between kinetochores and spindle microtubules and ensuring high-fidelity chromosome segregation [1-3]. The checkpoint is activated by unattached kinetochores, and Mps1 kinase phosphorylates KNL1 on conserved MELT motifs to generate a binding site for the Bub3-Bub1 complex [4-7]. This leads to dynamic kinetochore recruitment of Mad proteins [8, 9], a conformational change in Mad2 [10-12], and formation of the mitotic checkpoint complex (MCC: Cdc20-Mad3-Mad2 [13-15]). MCC formation inhibits the anaphase-promoting complex/cyclosome (Cdc20-APC/C), thereby preventing the proteolytic destruction of securin and cyclin and delaying anaphase onset. What happens at kinetochores after Mps1-dependent Bub3-Bub1 recruitment remains mechanistically unclear, and it is not known whether kinetochore proteins other than KNL1 have significant roles to play in checkpoint signaling and MCC generation. Here, we take a reductionist approach, avoiding the complexities of kinetochores, and demonstrate that co-recruitment of KNL1(Spc7) and Mps1(Mph1) is sufficient to generate a robust checkpoint signal and prolonged mitotic arrest. We demonstrate that a Mad1-Bub1 complex is formed during synthetic checkpoint signaling. Analysis of bub3Δ mutants demonstrates that Bub3 acts to suppress premature checkpoint signaling. This synthetic system will enable detailed, mechanistic dissection of MCC generation and checkpoint silencing. After analyzing several mutants that affect localization of checkpoint complexes, we conclude that spindle checkpoint arrest can be independent of their kinetochore, spindle pole, and nuclear envelope localization. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  8. Ethical dilemmas during cardiac arrest incidents in the patient's home. (United States)

    Karlsson, Mattias; Karlsson, Niclas; Hilli, Yvonne


    The majority (70%) of cardiac arrests in Sweden are experienced in the patient's home. In these situations, the ambulance nurses may encounter several ethical dilemmas. The aim was to investigate Swedish specialist ambulance nurses' experiences of ethical dilemmas associated with cardiac arrest situations in adult patients' homes. Nine interviews were conducted with specialist ambulance nurses at four different ambulance stations in the southeast region of Sweden. Data were analysed using content analysis. Ethical considerations: Ethical principles mandated by the Swedish Research Council were carefully followed during the whole process. Two main themes with six sub-themes were identified: The scene - creating a sheltered space for caring and Ethical decision-making. The results showed that ethical dilemmas might occur when trying to create a sheltered space to preserve the patients' integrity and dignity. A dilemma could be whether or not to invite significant others to be present during the medical treatment. Ethical decision-making was dependent on good communication and ethical reasoning among all parties. In certain situations, decisions were made not to commence or to terminate care despite guidelines. The decision was guided by combining the medical/nursing perspectives and ethical competence with respect to the human being's dignity and a will to do good for the patient. The nurses followed the voice of their heart and had the courage to be truly human. The ambulance nurses were guided by their ethos, including the basic motive to care for the patient, to alleviate suffering, to confirm the patient's dignity and to serve life and health.

  9. Causality in Europeanization Research

    DEFF Research Database (Denmark)

    Lynggaard, Kennet


    to develop discursive institutional analytical frameworks and something that comes close to the formulation of hypothesis on the effects of European Union (EU) policies and institutions on domestic change. Even if these efforts so far do not necessarily amount to substantive theories or claims of causality...

  10. Measuring European selves

    DEFF Research Database (Denmark)

    Antalikova, Radka

    Taking the perspective of cross-cultural psychology, the current thesis sets out to investigate self in a European context. For this purpose, the thesis first thoroughly reviews the most prominent conceptualizations of self in cross-cultural psychology, specifically focusing on disentangling...... to the field of cross-cultural psychology, specifically highlighting the utility of autobiographical memories as measures of self....

  11. European Psychology Map

    Directory of Open Access Journals (Sweden)



    Full Text Available The Institute for Psychology Information (ZPID compiled an extensive list of European psycho-logical organizations, comprised of university departments, research institutions, professional associa-tions and publishing houses. The list is available on the ZPID website, together with a web mapping applet that indicates the exact geographical location of the organizations.

  12. European Pine Shoot Moth (United States)

    William E. Miller; Arthur R. Hastings; John F. Wootten


    In the United States, the European pine shoot moth has caused much damage in young, plantations of red pine. It has been responsible for reduced planting of red pine in many areas. Although attacked trees rarely if ever die, their growth is inhibited and many are, deformed. Scotch pine and Austrian pine (Pinus nigra Arnold) are usually not so badly damaged. Swiss...

  13. Inequalities in European cities

    NARCIS (Netherlands)

    Musterd, S.; Ostendorf, W.; Smith, S.J.; Elsinga, M.; Eng, O.S.; Fox O’Mahony, L.; Wachter, S.


    The consequences of inequalities in European cities are a big fear for many governments at the state and urban levels. Journalists, as well as many scholars who are dealing with urban issues, express their fears about the development of social, ethnic, and spatial divisions. Population categories

  14. European 'Stabilisation through Association'

    DEFF Research Database (Denmark)

    Rodt, Annemarie Peen

    ’s success in repeatedly reconciling a divided continent and complemented its efforts to build peace beyond its borders. But does the EU (continue to) deserve such praise? This contribution examines European peacebuilding from the early inte-gration of post-World War Two economies, through the uniting...

  15. European Integration and Globalization

    Directory of Open Access Journals (Sweden)

    Diana Bobica


    Full Text Available According to many, the term globalization is able to explain any phenomenon whatsoever, be it positive or negative, that takes place within the global social system. It seems like a sort of magical formula, which is to be found in the speeches of all sorts of people, be they economists, politicians, businessmen or sociologists. However this magical formula of globalization has its limitations, since it encompasses a certain amount of quibbling, beyond which not many can pass. In the context of globalization there appears the question on its role in the process of European integration. Is European integration a part of this global process or, quite on the contrary, does it present certain distinctive features, as it moulds itself differently from the globalization phenomenon? A clear-cut answer seems difficult because of the various aspects involved. Not only the general phenomenon of globalization, but also the economic integration on European level is based on the liberalization of markets and on the opening of national economies towards the exterior,having as direct consequence the intensification of trade exchanges. If from a global point of view one may talk of a market fundamentalism in that the market principles know no boundary, European integration on the other hand implies not only market economy, but also a guided and monitored action of Member Statesaccording to the needs of the whole entity, also taking into consideration - as far as possible – all aspects and consequences on social level.

  16. Becoming Pan-European?

    DEFF Research Database (Denmark)

    Schulz-Forberg, Hagen; Brüggemann, Michael


    be platforms of a transnational European discourse. Four ideal-types of transnational media can be distinguished: (1) national media with a transnational mission, (2) international media, (3) pan-regional media and (4) global media. Within this framework the article analyses transnational media in Europe...

  17. European Metals Conference

    CERN Document Server

    Vereecken, Jean


    This volume contains the papers that will be presented at 'EMC '91 '-the European Metals Conference-to be held in Brussels, Belgium, from 15 to 20 September 1991, and organized by Benelux Metallurgie, GDMB (Gesellschaft Deutscher Metallhutten­ und Bergleute) and IMM (the Institution of Mining and Metallurgy). 'EMC '91' is the first of an intended major series organized at the European level with the aim of bringing together all those who are involved with the extraction and processing of non-ferrous metals-European metallurgists and their international colleagues-to provide them with the opportunity to exchange views on the state and evolution of their industry. The programme covers all the different aspects of the metallurgy of non-ferrous metals from mining to fabricated products. Particular attention is being paid to the European non -ferrous industry with respect to changes in demand, the technology used, pressures on the environment and the competitive position of manufacturers. The contributions of the...


    African Journals Online (AJOL)

    Regulations governing the production and use of genetically modified organisms have been developed in the United Kingdom since 1976. Regulations covering the release of transgenic organisms into the environment were initially voluntary. Since 1990, the European Economic Commission (EEC) Directive. 90/219 and ...

  19. European Music Year 1985. (United States)

    Alexanderson, Thomas; And Others


    Articles concerning music are included in this newsletter dedicated to cultural venture to be jointly carried out by the Council of Europe and the European communities. Many events will mark Music Year 1985, including concerts, dance performances, operas, publications, recordings, festivals, exhibitions, competitions, and conferences on musical…

  20. Post-resuscitation care following out-of-hospital and in-hospital cardiac arrest. (United States)

    Girotra, Saket; Chan, Paul S; Bradley, Steven M


    Cardiac arrest is a leading cause of death in developed countries. Although a majority of cardiac arrest patients die during the acute event, a substantial proportion of cardiac arrest deaths occur in patients following successful resuscitation and can be attributed to the development of post-cardiac arrest syndrome. There is growing recognition that integrated post-resuscitation care, which encompasses targeted temperature management (TTM), early coronary angiography and comprehensive critical care, can improve patient outcomes. TTM has been shown to improve survival and neurological outcome in patients who remain comatose especially following out-of-hospital cardiac arrest due to ventricular arrhythmias. Early coronary angiography and revascularisation if needed may also be beneficial during the post-resuscitation phase, based on data from observational studies. In addition, resuscitated patients usually require intensive care, which includes mechanical ventilator, haemodynamic support and close monitoring of blood gases, glucose, electrolytes, seizures and other disease-specific intervention. Efforts should be taken to avoid premature withdrawal of life-supporting treatment, especially in patients treated with TTM. Given that resources and personnel needed to provide high-quality post-resuscitation care may not exist at all hospitals, professional societies have recommended regionalisation of post-resuscitation care in specialised 'cardiac arrest centres' as a strategy to improve cardiac arrest outcomes. Finally, evidence for post-resuscitation care following in-hospital cardiac arrest is largely extrapolated from studies in patients with out-of-hospital cardiac arrest. Future studies need to examine the effectiveness of different post-resuscitation strategies, such as TTM, in patients with in-hospital cardiac arrest. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  1. Rationale, development and implementation of the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. (United States)

    Morrison, Laurie J; Nichol, Graham; Rea, Thomas D; Christenson, Jim; Callaway, Clifton W; Stephens, Shannon; Pirrallo, Ronald G; Atkins, Dianne L; Davis, Daniel P; Idris, Ahamed H; Newgard, Craig


    To describe the development, design and consequent scientific implications of the Resuscitation Outcomes Consortium (ROC) population-based registry; ROC Epistry-Cardiac Arrest. The ROC Epistry--Cardiac Arrest is designed as a prospective population-based registry of all Emergency Medical Services (EMSs)-attended 9-1-1 calls for patients with out-of-hospital cardiac arrest occurring in the geographical area described by the eight US and three Canadian regions. The dataset was derived by an North American interdisciplinary steering committee. Enrolled cases include individuals of all ages who experience cardiac arrest outside the hospital, with evaluation by organized EMS personnel and: (a) attempts at external defibrillation (by lay responders or emergency personnel), or chest compressions by organized EMS personnel; (b) were pulseless but did not receive attempts to defibrillate or CPR by EMS personnel. Selected data items are categorized as mandatory or optional and undergo revisions approximately every 12 months. Where possible all definitions are referenced to existing literature. Where a common definition did not exist one was developed. Optional items include standardized CPR process data elements. It is anticipated the ROC Epistry--Cardiac Arrest will enroll between approximately 9000 and 13,500 treated all rhythm arrests and 4000 and 5000 ventricular fibrillation arrests annually and approximately 8000 EMS-attended but untreated arrests. We describe the rationale, development, design and future implications of the ROC Epistry--Cardiac Arrest. This paper will serve as the reference for subsequent ROC manuscripts and for the common data elements captured in both ROC Epistry--Cardiac Arrest and the ROC trials.

  2. Differential arrest and adhesion of tumor cells and microbeads in the microvasculature. (United States)

    Guo, Peng; Cai, Bin; Lei, Ming; Liu, Yang; Fu, Bingmei M


    To investigate the mechanical mechanisms behind tumor cell arrest in the microvasculature, we injected fluorescently labeled human breast carcinoma cells or similarly sized rigid beads into the systemic circulation of a rat. Their arrest patterns in the microvasculature of mesentery were recorded and quantified. We found that 93% of rigid beads were arrested either at arteriole-capillary intersections or in capillaries. Only 3% were at the capillary-postcapillary venule intersections and in postcapillary venules. In contrast, most of the flexible tumor cells were either entrapped in capillaries or arrested at capillary or postcapillary venule-postcapillary venule intersections and in postcapillary venules. Only 12% of tumor cells were arrested at the arteriole-capillary intersections. The differential arrest and adhesion of tumor cells and microbeads in the microvasculature was confirmed by a χ(2) test (p < 0.001). These results demonstrate that mechanical trapping was responsible for almost all the arrest of beads and half the arrest of tumor cells. Based on the measured geometry and blood flow velocities at the intersections, we also performed a numerical simulation using commercial software (ANSYS CFX 12.01) to depict the detailed distribution profiles of the velocity, shear rate, and vorticity at the intersections where tumor cells preferred to arrest and adhere. Simulation results reveal the presence of localized vorticity and shear rate regions at the turning points of the microvessel intersections, implying that hemodynamic factors play an important role in tumor cell arrest in the microcirculation. Our study helps elucidate long-debated issues related to the dominant factors in early-stage tumor hematogenous metastasis.

  3. Arrest functions of the MIF ligand/receptor axes in atherogenesis

    Directory of Open Access Journals (Sweden)

    Sabine eTillmann


    Full Text Available Macrophage migration inhibitory factor (MIF has been defined as an important chemokine-like function (CLF chemokine with an essential role in monocyte recruitment and arrest. Adhesion of monocytes to the vessel wall and their transendothelial migration are critical in atherogenesis and many other inflammatory diseases. Chemokines carefully control all steps of the monocyte recruitment process. Those chemokines specialized in controlling arrest are typically immobilized on the endothelial surface, mediating the arrest of rolling monocytes by chemokine receptor-triggered pathways. The chemokine receptor CXCR2 functions as an important arrest receptor on monocytes. An arrest function has been revealed for the bona fide CXCR2 ligands CXCL1 and CXCL8, but genetic studies also suggested that additional arrest chemokines are likely to be involved in atherogenic leukocyte recruitment. While CXCR2 is known to interact with numerous CXC chemokine ligands, the CLF-chemokine MIF, which structurally does not belong to the CXC chemokine sub-family, was surprisingly identified as a non-cognate ligand of CXCR2, responsible for critical arrest functions during the atherogenic process. MIF was originally identified as macrophage migration inhibitory factor, but is now known as a potent inflammatory cytokine with chemokine-like functions including chemotaxis and leukocyte arrest. This review will cover the mechanisms underlying these functions, including MIF’s effects on LFA1 integrin activity and signal transduction, and will discuss the structural similarities between MIF and the bona fide CXCR2 ligand CXCL8 while emphasizing the structural differences. As MIF also interacts with CXCR4, a chemokine receptor implicated in CXCL12-elicited lymphocyte arrest, the arrest potential of the MIF/CXCR4 axis will also be scrutinized as well as the recently identified role of pericyte MIF in attracting leukocytes exiting through venules as part of the pericyte 'motility

  4. Cardiac arrest during gamete release in chum salmon regulated by the parasympathetic nerve system.

    Directory of Open Access Journals (Sweden)

    Yuya Makiguchi

    Full Text Available Cardiac arrest caused by startling stimuli, such as visual and vibration stimuli, has been reported in some animals and could be considered as an extraordinary case of bradycardia and defined as reversible missed heart beats. Variability of the heart rate is established as a balance between an autonomic system, namely cholinergic vagus inhibition, and excitatory adrenergic stimulation of neural and hormonal action in teleost. However, the cardiac arrest and its regulating nervous mechanism remain poorly understood. We show, by using electrocardiogram (ECG data loggers, that cardiac arrest occurs in chum salmon (Oncorhynchus keta at the moment of gamete release for 7.39+/-1.61 s in females and for 5.20+/-0.97 s in males. The increase in heart rate during spawning behavior relative to the background rate during the resting period suggests that cardiac arrest is a characteristic physiological phenomenon of the extraordinarily high heart rate during spawning behavior. The ECG morphological analysis showed a peaked and tall T-wave adjacent to the cardiac arrest, indicating an increase in potassium permeability in cardiac muscle cells, which would function to retard the cardiac action potential. Pharmacological studies showed that the cardiac arrest was abolished by injection of atropine, a muscarinic receptor antagonist, revealing that the cardiac arrest is a reflex response of the parasympathetic nerve system, although injection of sotalol, a beta-adrenergic antagonist, did not affect the cardiac arrest. We conclude that cardiac arrest during gamete release in spawning release in spawning chum salmon is a physiological reflex response controlled by the parasympathetic nervous system. This cardiac arrest represents a response to the gaping behavior that occurs at the moment of gamete release.

  5. Quality of bystander cardiopulmonary resuscitation during real-life out-of-hospital cardiac arrest. (United States)

    Gyllenborg, Tore; Granfeldt, Asger; Lippert, Freddy; Riddervold, Ingunn Skogstad; Folke, Fredrik


    Cardiopulmonary resuscitation (CPR) can increase survival in out-of-hospital cardiac arrest (OHCA). However, little is known about bystander CPR quality in real-life OHCA. To describe bystander CPR quality based on automated external defibrillator (AED) CPR process data during OHCA and compare it with the European Resuscitation Council 2010 and 2015 Guidelines. We included OHCA cases from the Capital Region, Denmark, (2012-2016) where a Zoll AED was used before ambulance arrival. For cases with at least one minute of continuous data, the initial 10min of CPR data were analysed for compression rate, depth, fraction and compressions delivered for each minute of CPR. Data are presented as median [25th;75th percentile]. We included 136 cases. Bystander median compression rate was 101min(-1) [94;113], compression depth was 4.8cm [3.9;5.8] and compressions per minute were 62 [48;73]. Of all cases, the median compression rate was 100-120min(-1) in 42%, compression depth was 5-6cm in 26%, compression fraction≥60% in 51% and compressions delivered per minute exceeded 60 in 54%. In a minute-to-minute analysis, we found no evidence of deterioration in CPR quality over time. The median peri-shock pause was 27s [23;31] and the pre-shock pause was 19s [17;22]. The median CPR performed by bystanders using AEDs with audio-feedback in OHCA was within guideline recommendations without deterioration over time. Compression depth had poorer quality compared with other parameters. To improve bystander CPR quality, focus should be on proper compression depth and minimizing pauses. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. The Europeanness of European cinema: Identity, meaning, globalization


    Willems, Gertjan


    According to its editors, the aim of The Europeanness of European cinema is ‘to revisit the issue of the significance of European cinema as a category in the wake of the recent acceleration in transnational filmmaking and globalization as a whole’ (p. 7). Taking the transnational prominence of European cinema as a starting point, the anthology’s introduction presents some brief reflections about what ‘Europeanness’ – the central, overarching concept for the various chapters – has meant histor...

  7. Cutaneous lymphomas in European pet rabbits (Oryctolagus cuniculus). (United States)

    Ritter, J M; von Bomhard, W; Wise, A G; Maes, R K; Kiupel, M


    Cutaneous lymphoma is a common skin neoplasm of pet rabbits in Europe but is rarely reported in pet rabbits in North America. These neoplasms have not been previously characterized, nor has the cause for the apparent predilection for cutaneous lymphoma in European pet rabbits compared with North American pet rabbits been investigated. In this retrospective study, the authors morphologically and immunohistochemically characterized 25 cutaneous lymphomas in European pet rabbits according to the World Health Organization classification. Tumors were classified as diffuse large B cell lymphomas, with 14 lymphomas exhibiting a centroblastic/centrocytic subtype and 11 tumors exhibiting a T cell-rich B cell subtype. To investigate a potential viral etiology of these lymphomas, 3 diffuse large B cell and 3 T cell-rich B cell lymphomas were evaluated by polymerase chain reaction for retroviral and herpesviral genes. Neither virus was detected. In contrast to other domestic animals, cutaneous lymphomas in European pet rabbits were highly pleomorphic and frequently contained multinucleated giant cells. Unexpectedly, the second most common subtype was T cell-rich B cell lymphoma, a subtype that is rare in species other than horses. Based on a limited number of samples, there was no support for a viral etiology that would explain the higher incidence of lymphoma in European pet rabbits compared with American pet rabbits. Further investigation into genetic and extrinsic factors associated with the development of these tumors is warranted.

  8. Survey of Abdominal Access and Associated Morbidity for Robot-Assisted Radical Prostatectomy: Does Palmer's Point Warrant Further Awareness and Study? (United States)

    Johnston, William K; Linsell, Susan; Miller, David; Ghani, Khurshid R


    . Palmer's point, located away from major vasculature, may reduce the morbidity of access for RARP and warrants further awareness and study.

  9. Incidence and consequence of close margins in patients with ductal carcinoma-in situ treated with mastectomy: is further therapy warranted? (United States)

    Fitzsullivan, Elizabeth; Lari, Sara A; Smith, Benjamin; Caudle, Abigail S; Krishnamurthy, Savitri; Lucci, Anthony; Mittendorf, Elizabeth A; Babiera, Gildy V; Black, Dalliah M; Wagner, Jamie L; Bedrosian, Isabelle; Woodward, Wendy; Gainer, Sarah M; Hwang, Rosa; Meric-Bernstam, Funda; Hunt, Kelly K; Kuerer, Henry M


    The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy. The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years. Overall, 94 patients (11.7 %) had close margins (positive, n = 5; negative but ≤1 mm, n = 54; 1.1-2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size ≥1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p > 0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 % (5.0 % for margins ≤1 mm, 3.6 % for margins 1.1-2.9 mm, and 0.7 % for margins ≥3 mm [p < 0.001]). The 10-year rate of contralateral breast cancer was 6.4 %. On multivariate analysis, close margins was the only independent predictor of LRR (p = 0.005). Close margins occur in a minority of patients undergoing mastectomy for DCIS and is the only independent risk factor for LRR. As the LRR rate in patients with close margins is low and less than the rate of contralateral breast cancer, PMRT is not warranted except for patients with multiple close/positive margins that cannot be surgically excised.

  10. In vitro maturation is associated with increased early embryo arrest without impairing morphokinetic development of useable embryos progressing to blastocysts. (United States)

    Walls, M L; Ryan, J P; Keelan, J A; Hart, R


    Does polycystic ovarian syndrome (PCOS) or in vitro maturation (IVM) treatment affect embryo development events and morphokinetic parameters after time-lapse incubation? There was an increase in some abnormal phenotypic events in PCOS-IVM embryos as well as an increase in early arrest of PCOS-IVM and PCOS-ICSI embryos; however, IVM treatment or PCOS status did not alter morphokinetic development of embryos suitable for transfer of vitrification. IVM has been less successful than standard IVF in terms of clinical pregnancy, implantation and live birth rates. There is currently no information available about the development of IVM embryos according to time-lapse analysis. This article represents a prospective case-control study. The study involved 93 participants who underwent 93 treatment cycles. Cycles were completed between January 2013 and July 2014. Participants were recruited for the study at Fertility Specialists of WA and Fertility Specialists South, Perth, Western Australia. Of the PCOS diagnosed patients, 32 underwent IVM treatment (PCOS-IVM) and 23 had standard ICSI treatment (PCOS-ICSI). There were 38 patients without PCOS who underwent standard ICSI treatment comprising the control group (control-ICSI). The PCOS-IVM group showed significantly more embryos with multinucleated two cells (P = 0.041), multinucleated four cells (P = 0.001) and uneven two cells (P = 0.033) compared with the control-ICSI group, but not the PCOS-ICSI group. There were no significant differences in the rates of any abnormal events between the PCOS-ICSI and control-ICSI groups. Embryo arrest between Days 2 and 3 was higher in the PCOS-IVM and PCOS-ICSI groups compared with the control-ICSI group (P events from embryos generated using this approach for patients diagnosed with PCOS and shows that embryos generated from IVM have an increased rate of early embryo arrest, however; morphokinetic development is not impaired in embryos that progress to the useable blastocyst stage. The

  11. Intra-arrest selective brain cooling improves success of resuscitation in a porcine model of prolonged cardiac arrest. (United States)

    Wang, Hao; Barbut, Denise; Tsai, Min-Shan; Sun, Shijie; Weil, Max Harry; Tang, Wanchun


    We have previously demonstrated that early intra-nasal cooling improved post-resuscitation neurological outcomes. The present study utilizing a porcine model of prolonged cardiac arrest investigated the effects of intra-nasal cooling initiated at the start of cardiopulmonary resuscitation (CPR) on resuscitation success. Our hypothesis was that rapid nasal cooling initiated during "low-flow" improves return of spontaneous resuscitation (ROSC). In 16 domestic male pigs weighing 40+/-3 kg, VF was electrically induced and untreated for 15 min. Animals were randomized to either head cooling or control. CPR was initiated and continued for 5 min before defibrillation was attempted. Coincident with starting CPR, the hypothermic group was cooled with a RhinoChill device which produces evaporative cooling in the nasal cavity of pigs. No cooling was administrated to control animals. If ROSC was not achieved after defibrillation, CPR was resumed for 1 min prior to the next defibrillation attempt until either successful resuscitation or for a total of 15 min. Seven of eight animals in the hypothermic group (87.5%) and two of eight animals in control group (25%) (p=0.04) were successfully resuscitated. At ROSC, brain temperature was increased from baseline by 0.3 degrees C in the control group, and decreased by 0.1 degrees C in the hypothermic animals. Pulmonary artery temperature was above baseline in both groups. Intra-nasal cooling initiated at the start of CPR significantly improves the success of resuscitation in a porcine model of prolonged cardiac arrest. This may have occurred by preventing brain hyperthermia. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Crack arrestability of ship hull steel plate in accidental conditions: Application of high arrestability endowed ultra fine-grain surface layer steel

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Tadashi; Hagiwara, Yukito [Oita R and D Lab. (Japan); Oshita, Shigeru [Nippon Steel Corp., Oita (Japan). Oita Works; Inoue, Takehiro [Nippon Steel Corp., Futsu, Chiba (Japan). Steel Research Labs.; Hashimoto, Kunifumi; Kuroiwa, Takashi; Tada, Masuo [Mitsubishi Heavy Industries, Ltd., Nagasaki (Japan); Yajima, Hiroshi [Univ. of Hiroshima (Japan)


    A new type steel plate with ultra fine-grained surface layers (SUF steel) has been developed to improve crack arrestability. The application of this new type steel makes it possible to prevent catastrophic brittle fracture accidents of ship hull structures in emergency conditions, such as in serious collisions or groundings. It will reduce further the risk of casualties and environmental pollutions, caused by accidents of large crude oil carriers (VLCCs). The authors have investigated the validity for the application of the new type steel with ultra-high crack arrestability. Both computer simulations for collision of two VLCCs and large-scale fracture testings for crack arrestability have been carried out to study the accidental cases. The simulation results suggest that a collision generates a significant amount of plastic strain damage for the hull plate around a struck part. For example, the sheer strake plate near the struck part suffers 5 to 10% of plastic strain, before an inner-hull ruptures. Therefore, the effect of plastic strain (10% level) on crack arrestability of steel plates (the SUF plate and a conventional TMCP plate) was examined by standard ESSO tests, ultra wide-plate duplex ESSO tests, and sheer strake model tests. The test results are as follows: (1) Plastic strain deteriorates crack arrestability of steel plates. (2) Sufficient crack arrestability at 0 deg. C cannot be expected in the conventional TMCP steel plate plastically strained by about 10%. (3) The SUF plate maintains high crack arrestability even after introducing 10% plastic strain, at design temperature of 0 deg. C.

  13. European core curriculum in neurorehabilitation

    NARCIS (Netherlands)

    Sandrini, G.; Binder, H.; Homberg, V.; Saltuari, L.; Tarkka, I.; Smania, N.; Corradini, C.; Giustini, A.; Katterer, C.; Picari, L.; Diserens, K.; Koenig, E.; Geurts, A.C.; Anghelescu, A.; Opara, J.; Tonin, P.; Kwakkel, G.; Golyk, V.; Onose, G.; Perennou, D.; Picelli, A.


    To date, medical education lacks Europe-wide standards on neurorehabilitation. To address this, the European Federation of NeuroRehabilitation Societies (EFNR) here proposes a postgraduate neurorehabilitation training scheme. In particular, the European medical core curriculum in neurorehabilitation

  14. European and Integration Studies

    Directory of Open Access Journals (Sweden)

    N. Yu. Kaveshnikov


    Full Text Available Soviet scientific school of pan-European integration studies began to emerge in the 1960s at the Institute of World Economy and International Relations (Russian Academy of Science. Among the leading scientists who have developed methodological approaches of Soviet integration studies were M.M. Maximova, Y.A. Borko, Y. Shishkov, L.I. Capercaillie. Later, a new center for integration studies became the Institute of Europe, created in 1987. It was led by such renowned scientists as Academicians V.V. Zhurkin and N.P. Shmelev. In the 1980s the subject of the integration process in Europe attracted attention of experts from MGIMO. An important role in the development of school of integration research in the USSR was played by a MGIMO professor, head of the chair of history of international relations and foreign policy of the USSR V.B. Knyazhinskiy. His work contributed to the deliverance of the national scientific community from skepticism about the prospects for European integration. Ideas of V.B. Knyazhinsky are developed today in MGIMO by his followers A.V. Mal'gin and T.V. Ur'eva. In the mid-1990s, having retired from diplomatic service, professor Yu. Matveevskiy started to work at MGIMO. With a considerable practical experience in the field, he produced a series of monographs on the history of European integration. In his works, he analyses the development of integration processes in Western Europe from their inception to the present day, showing the gradual maturation of the necessary spiritual and material prerequisites for the start of integration and traces the various stages of the "integration". In the late 1990s, the growing demand from the domestic business and government for professionals who are capable of interacting with the European Union, has produced the necessary supply in the form of educational programs based on accumulated scientific knowledge. Setting up a discipline "European Integration" was a major step in the development

  15. A standardized Code Blue Team eliminates variable survival from in-hospital cardiac arrest. (United States)

    Qureshi, Sultana A; Ahern, Terence; O'Shea, Ryan; Hatch, Lorien; Henderson, Sean O


    Recent studies suggest that time of day affects survival from in-hospital cardiac arrest. Lower survival rates are observed during nights and on weekends, except in areas with consistent physician care, such as the Emergency Department. Since 1997, our hospital has utilized a standard, hospital-wide "Code Blue Team" (CBT) to respond to cardiac arrests at any time. This team is always led by an emergency physician, and includes specially trained nurses. To assess if time of day or week affects survival from in-hospital cardiac arrest when a trained, consistent, emergency physician-led CBT is implemented. This is an analysis of prospectively collected data on initial survival rates (return of spontaneous circulation >20 min) of all cardiac arrests that were managed by the CBT from 2000 to 2008. Cardiac arrests were also subcategorized based on initial cardiac rhythm. Survival rates were compared according to time of day or week. A total of 1692 cardiac arrests were included. There was no significant difference in the overall rate of initial survival between day/evening vs. night hours (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.83-1.29), or between weekday vs. weekend hours (OR 1.10, 95% CI 0.85-1.38). This held true for all cardiac rhythms. At our institution, there is no significant difference in survival from cardiac arrest when a standardized "Code Blue Team" is utilized, regardless of the time of day or week. Copyright © 2012. Published by Elsevier Inc.

  16. Communication between members of the cardiac arrest team--a postal survey. (United States)

    Pittman, J; Turner, B; Gabbott, D A


    Effective communication enhances team building and is perceived to improve the quality of team performance. A recent publication from the Resuscitation Council (UK) has highlighted this fact and recommended that cardiac arrest team members make contact daily. We wished to identify how often members of this team communicate prior to a cardiopulmonary arrest. A questionnaire on cardiac arrest team composition, leadership, communication and debriefing was distributed nationally to Resuscitation Training Officers (RTOs) and their responses analysed. One hundred and thirty (55%) RTOs replied. Physicians and anaesthetists were the most prominent members of the team. The Medical Senior House Officer is usually nominated as the team leader. Eighty-seven centres (67%) have no communication between team members prior to attending a cardiopulmonary arrest. In 33%, communication occurs but is either informal or fortuitous. The RTOs felt that communication is important to enhance team dynamics and optimise task allocation. Only 7% achieve a formal debrief following a cardiac arrest. Communication between members of the cardiac arrest team before and after a cardiac arrest is poor. Training and development of these skills may improve performance and should be prioritised. Team leadership does not necessarily reflect experience or training.

  17. Acute-phase reactants after paediatric cardiac arrest. Procalcitonin as marker of immediate outcome

    Directory of Open Access Journals (Sweden)

    Medina Alberto


    Full Text Available Abstract Objective Procalcitonin (PCT and C reactive protein (CRP have been used as infection parameters. PCT increase correlates with the infection's severity, course, and mortality. Post-cardiocirculatory arrest syndrome may be related to an early systemic inflammatory response, and may possibly be associated with an endotoxin tolerance. Our objective was to report the time profile of PCT and CRP levels after paediatric cardiac arrest and to assess if they could be use as markers of immediate survival. Materials and methods A retrospective observational study set in an eight-bed PICU of a university hospital was performed during a period of two years. Eleven children younger than 14 years were admitted in the PICU after a cardiac arrest. PCT and CRP plasma concentrations were measured within the first 12 and 24 hours of admission. Results In survivors, PCT values increased 12 hours after cardiac arrest without further increase between 12 and 24 hours. In non survivors, PCT values increased 12 hours after cardiac arrest with further increase between 12 and 24 hours. Median PCT values (range at 24 hours after cardiac arrest were 22.7 ng/mL (0.2 – 41.0 in survivors vs. 205.5 ng/mL (116.6 – 600.0 in non survivors (p Conclusion Measurement of PCT during the first 24 hours after paediatric cardiac arrest could serve as marker of mortality.

  18. Discrimination, arrest history, and major depressive disorder in the U.S. Black population. (United States)

    Anglin, Deidre M; Lighty, Quenesha; Yang, Lawrence H; Greenspoon, Michelle; Miles, Rashun J; Slonim, Tzachi; Isaac, Kathleen; Brown, Monique J


    Everyday discrimination contributes negatively to depressive symptomatology among Blacks in the US and being arrested could add to this depression. Using data from the National Survey on American Life, the present study determined the association between an arrest history and major depressive disorder (MDD), while accounting for discrimination among African Americans, US-born Afro-Caribbeans and first-generation Black immigrants. Findings from logistic regression analyses adjusted for discrimination suggested an arrest history is associated with 12-month MDD (Adjusted OR=1.47; 95% CI=1.02-2.10) and lifetime MDD (Adjusted OR=1.56 CI=1.17-2.09). Accounting for drug and alcohol dependence attenuated the association between arrest history and 12-month MDD, but not lifetime MDD. The associations between arrest history and both 12-month and lifetime MDD, and discrimination and lifetime MDD varied by ethnic/immigrant group. Specifically, while the association between arrest history and MDD (both 12-month and lifetime) was strongest among US-born Afro-Caribbeans, evidence consistent with the immigrant paradox, the association between discrimination and lifetime MDD was particularly relevant for first-generation Black immigrants, suggesting discrimination may hinder the protection of first-generation status. Mental health prevention and treatment programs should target the stress associated with being arrested and experiencing discrimination among US Blacks. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Reduced right ventricular diameter during cardiac arrest caused by tension pneumothorax - a porcine ultrasound study. (United States)

    Caap, P; Aagaard, R; Sloth, E; Løfgren, B; Granfeldt, A


    Advanced life support (ALS) guidelines recommend ultrasound to identify reversible causes of cardiac arrest. Right ventricular (RV) dilatation during cardiac arrest is commonly interpreted as a sign of pulmonary embolism. The RV is thus a focus of clinical ultrasound examination. Importantly, in animal studies ventricular fibrillation and hypoxia results in RV dilatation. Tension pneumothorax (tPTX) is another reversible cause of cardiac arrest, however, the impact on RV diameter remains unknown. To investigate RV diameter evaluated by ultrasound in cardiac arrest caused by tPTX or hypoxia. Pigs were randomized to cardiac arrest by either tPTX (n = 9) or hypoxia (n = 9) and subsequently resuscitated. Tension pneumothorax was induced by injection of air into the pleural cavity. Hypoxia was induced by reducing tidal volume. Ultrasound images of the RV were obtained throughout the study. Tension pneumothorax was decompressed after the seventh rhythm analysis. The primary endpoint was RV diameter after the third rhythm analysis. At cardiac arrest the RV diameter was 17 mm (95% CI: 13; 21) in the tPTX group and 36 mm (95% CI: 33; 40) in the hypoxia group (P cardiac arrest caused by tPTX when compared with hypoxia. The difference disappears after tPTX decompression. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. The Association Between Arterial Oxygen Tension and Neurological Outcome After Cardiac Arrest. (United States)

    Johnson, Nicholas J; Dodampahala, Kalani; Rosselot, Babette; Perman, Sarah M; Mikkelsen, Mark E; Goyal, Munish; Gaieski, David F; Grossestreuer, Anne V


    A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included. Our primary exposure of interest was PaO2. Hyperoxemia was defined as PaO2 > 300 mmHg, hypoxemia as PaO2 arrests were witnessed, and pulseless electrical activity was the most common initial rhythm (40%). More than 72% of the patients had cardiac etiology for their arrests, and 55% underwent targeted temperature management. A total of 38% of patients survived to hospital discharge. There was no significant association between PaO2 at any time interval and neurological outcome at hospital discharge. Hyperoxemia at 12 hours after cardiac arrest was associated with decreased odds of survival (OR 0.17 [0.03-0.89], p = 0.032). There was no significant association between arterial oxygen tension measured within the first 48 hours after cardiac arrest and neurological outcome.

  1. Detection of Pulmonary Embolism During Cardiac Arrest-Ultrasonographic Findings Should Be Interpreted With Caution. (United States)

    Aagaard, Rasmus; Caap, Philip; Hansson, Nicolaj C; Bøtker, Morten T; Granfeldt, Asger; Løfgren, Bo


    The aim of this study was to test the hypothesis that the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary embolism, compared with hypoxia and primary arrhythmia. Twenty-four pigs were anesthetized and cardiac arrest was induced using three different methods. Pigs were resuscitated after 7 minutes of untreated cardiac arrest. Ultrasonographic images were obtained and the right ventricular diameter was measured. University hospital animal laboratory. Female crossbred Landrace/Yorkshire/Duroc pigs (27-32 kg). Pigs were randomly assigned to cardiac arrest induced by pulmonary embolism, hypoxia, or primary arrhythmia. There was no difference at baseline. During induction of cardiac arrest, the right ventricle dilated in all groups (p cardiac ultrasonography were able to detect a difference in right ventricle diameter of approximately 10 mm with a sensitivity of 79% (95% CI, 64-94) and a specificity of 68% (95% CI, 56-80). The right ventricle was more dilated during resuscitation when cardiac arrest was caused by pulmonary embolism compared with hypoxia and primary arrhythmia. However, the right ventricle was dilated, irrespective of the cause of arrest, and diagnostic accuracy by physicians with basic training in focused cardiac ultrasonography was modest. These findings challenge the paradigm that right ventricular dilatation on ultrasound during cardiopulmonary resuscitation is particularly associated with pulmonary embolism.

  2. Early Recognition of Foreign Body Aspiration as the Cause of Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Muhammad Kashif


    Full Text Available Foreign body aspiration (FBA is uncommon in the adult population but can be a life-threatening condition. Clinical manifestations vary according to the degree of airway obstruction, and, in some cases, making the correct diagnosis requires a high level of clinical suspicion combined with a detailed history and exam. Sudden cardiac arrest after FBA may occur secondary to asphyxiation. We present a 48-year-old male with no history of cardiac disease brought to the emergency department after an out-of-hospital cardiac arrest (OHCA. The patient was resuscitated after 15 minutes of cardiac arrest. He was initially managed with therapeutic hypothermia (TH. Subsequent history suggested FBA as a possible etiology of the cardiac arrest, and fiberoptic bronchoscopy demonstrated a piece of meat and bone lodged in the left main stem bronchus. The foreign body was removed with the bronchoscope and the patient clinically improved with full neurological recovery. Therapeutic hypothermia following cardiac arrest due to asphyxia has been reported to have high mortality and poor neurological outcomes. This case highlights the importance of early identification of FBA causing cardiac arrest, and we report a positive neurological outcome for postresuscitation therapeutic hypothermia following cardiac arrest due to asphyxia.

  3. The Shoah within European identity

    NARCIS (Netherlands)

    van der Poel, Stefan


    In the Epilogue of Postwar, titled: From the House ofthe Dead: An essay on Modern European memory, Tony Judt concludes that: ‘those who would become full Europeans in the dawn of the twenty-first century must first assume a new and far more oppressive heritage. Today the pertinent European reference

  4. Future European biogas

    DEFF Research Database (Denmark)

    Meyer, A. K.P.; Ehimen, E. A.; Holm-Nielsen, J. B.


    Biogas is expected to play an important role in reaching the future energy policy targets of the European Union (EU). The sustainability of biogas substrates has however been recently critically discussed due to the increasing shares of agricultural land used for energy crop production.The aim...... were animal manure, straw by-products from cereal production, and excess grass from rotational and permanent grasslands and meadows. The biogas energy potential from the investigated biomass was projected to range from 1.2·103 to 2.3·103 PJ y-1 in year 2030 in the EU28, depending on the biomass...... availability. Alone the biogas energy potential projected in the scenario representing low substrate availability corresponds to a doubling of the European biogas production in 2015. The results shows that sustainable alternatives to the use of maize are present in all the member states of the EU28...

  5. European Patterns of Participation

    DEFF Research Database (Denmark)

    Harrebye, Silas Fehmerling; Ejrnæs, Anders


    Social Survey (ESS) Round 4 (2008), the article finds that satisfaction/dissatisfaction with the government is an important predictor alongside the institutional macro-level variable. The article combines a critical tradition, which suggests that political participation is motivated by a feeling...... of dissatisfaction with the government and feelings of being member of a discriminated group affect the level of extra-parliamentary participation, and second, how different welfare regimes condition the extend to which these groups chose to act. In a comparative multilevel design, using data from the European...... of dissatisfaction with an institutional perspective in which certain institutional conditions are seen as enablers for citizens to actively participate in political life. Our results show that the overall level of extra-parliamentary activity in the Scandinavian countries is higher than in the other European...

  6. Chestnut, European (Castanea sativa). (United States)

    Corredoira, Elena; Valladares, Silvia; Vieitez, Ana M; Ballester, Antonio


    Development of a system for direct transfer of antifungal candidate genes into European chestnut (Castanea sativa) would provide an alternative approach to conventional breeding for production of chestnut trees that are tolerant to ink disease caused by Phytophthora spp. Overexpression of genes encoding PR proteins (such as thaumatin-like proteins), which display antifungal activity, may represent an important advance in control of the disease. We have used a chestnut thaumatin-like protein gene (CsTL1) isolated from European chestnut cotyledons and have achieved overexpression of the gene in chestnut somatic embryogenic lines used as target material. We have also acclimatized the transgenic plants and grown them on in the greenhouse. Here, we describe the various steps of the process, from the induction of somatic embryogenesis to the production of transgenic plants.

  7. Do Europeans Like Nudges?

    DEFF Research Database (Denmark)

    Reisch, Lucia A.; Sunstein, Cass R.


    In recent years, many governments have shown a keen interest in “nudges” — approaches to law and policy that maintain freedom of choice, but that steer people in certain directions. Yet to date, there has been little evidence on whether citizens of various societies support nudges and nudging. We...... report the results of nationally representative surveys in six European nations: Denmark, France, Germany, Hungary, Italy, and the United Kingdom. We find strong majority support for nudges of the sort that have been adopted, or under serious consideration, in democratic nations. Despite the general...... European consensus, we find markedly lower levels of support for nudges in two nations: Hungary and Denmark. We are not, in general, able to connect support for nudges with distinct party affiliations....

  8. Pirating European Studies

    Directory of Open Access Journals (Sweden)

    Natalia Timus


    Full Text Available Open Science has gained a lot of attention not only within the academic community but also among policy-makers. Some international publishers have been active in moving towards open access publications and research data, but, overall, modest results have been achieved so far. In this context, the digital piracy engines emerge as vital actors in disseminating and determining the impact of research. This study examines the Sci-Hub downloads data in order to uncover patterns of piracy in European Studies research. We identify journals and the subjects of articles that have been pirated the most. We also study the geographical distribution of download requests. The analysis reveals that the readers are mostly interested in subjects reflecting the current major European challenges, specifically populism and the economic crisis. Both developing countries as well as the ‘old’ EU members are active in illegal downloads.

  9. Stature of early Europeans. (United States)

    Hermanussen, Michael


    The ancestors of modern Europeans arrived in Europe at least 40,000 years before present. Pre-glacial maximum Upper Palaeolithic males (before 16,000 BC) were tall and slim (mean height 179 cm, estimated average body weight 67 kg), while the females were comparably small and robust (mean height 158 cm, estimated average body weight 54 kg). Late Upper Palaeolithic males (8000-6600 BC) were of medium stature and robusticity (mean height 166 cm, estimated average body weight 62 kg). Stature further decreased to below 165 cm with estimated average body weight of 64 kg in Neolithic males of the Linear Band Pottery Culture, and to 150 cm with estimated average body weight of 49 kg in Neolithic females. The body stature of European males remained within the range of 165 to 170 cm up to the end of the 19th century.

  10. European Corporate Law

    DEFF Research Database (Denmark)

    Werlauff, Erik; Dorresteijn, Adriaan; Teichmann, Christoph

    This fully updated new edition provides the best-known practical overview of the law regarding companies, business activities, and capital markets in Europe, at both the European Union (EU) and Member State levels. It incorporates analysis of recent developments including the impact of global......; - a company’s freedom to incorporate in a jurisdiction not its own; - competition among the legal forms of different Member States; and - safeguarding of employee involvement in cross-border transactions. With respect to national law, the laws of Belgium, France, Germany, the Netherlands, Poland, Spain...... initiatives in such aspects of the corporate environment as regulation of financial institutions and non-financial reporting obligations with a view to sustainability and other social responsibility concerns. The authors, all leading experts in European corporate law, describe current and emerging trends...

  11. Inhibition of the Mitochondrial Fission Protein Drp1 Improves Survival in a Murine Cardiac Arrest Model (United States)

    Sharp, Willard W.; Beiser, David G.; Fang, Yong Hu; Han, Mei; Piao, Lin; Varughese, Justin; Archer, Stephen L.


    Objectives Survival following sudden cardiac arrest is poor despite advances in cardiopulmonary resuscitation (CPR) and the use of therapeutic hypothermia. Dynamin related protein 1 (Drp1), a regulator of mitochondrial fission, is an important determinant of reactive oxygen species generation, myocardial necrosis, and left ventricular function following ischemia/reperfusion injury, but its role in cardiac arrest is unknown. We hypothesized that Drp1 inhibition would improve survival, cardiac hemodynamics, and mitochondrial function in an in vivo model of cardiac arrest. Design Laboratory investigation. Setting University laboratory Interventions Anesthetized and ventilated adult female C57BL/6 wild-type mice underwent an 8-min KCl induced cardiac arrest followed by 90 seconds of CPR. Mice were then blindly randomized to a single intravenous injection of Mdivi-1 (0.24 mg/kg), a small molecule Drp1 inhibitor or vehicle (DMSO). Measurements and Main Results Following resuscitation from cardiac arrest, mitochondrial fission was evidenced by Drp1 translocation to the mitochondrial membrane and a decrease in mitochondrial size. Mitochondrial fission was associated with increased lactate and evidence of oxidative damage. Mdivi-1 administration during CPR inhibited Drp1 activation, preserved mitochondrial morphology, and decreased oxidative damage. Mdivi-1 also reduced the time to return of spontaneous circulation (ROSC) 116±4 vs. 143±7 sec (pcardiac arrest. Conclusions Post cardiac arrest inhibition of Drp1 improves time to ROSC and myocardial hemodynamics resulting in improved survival and neurological outcomes in a murine model of cardiac arrest. Pharmacological targeting of mitochondrial fission may be a promising therapy for cardiac arrest. PMID:25599491

  12. Performance analysis of surge arrester on high voltage systems using ATP

    Energy Technology Data Exchange (ETDEWEB)

    Nallagownden, P.; Magumane, A.H. [Univ. Teknologi Petronas, Perak (Malaysia); Kanth, K.S.R. [Tenaga National Berhad (Malaysia)


    Lightning strikes are among the major factors that cause failures in electrical power systems. Phase to ground arresters are commonly installed at power transformer terminals to offer some lightning protection. However, it is important to understand the performance of metal oxide arresters under very fast transient overvoltages in order to determine the protection zone of the arrester and to achieve economical benefits. This study investigated lightning overvoltage protection in a complete three-phase scheme of a 500 KV substation. Overvoltages originated from direct lightning stroke on a phase of a real overhead line (OHL) model. The effect of the separation distance of the arrester from the transformer connected at the open end of the substations was investigated as well as the performance of the arrester for different substation configurations. In the first scenario, the connection of the arrester and transformer was done with a direct connection of an overhead line. In the second scenario, the connection of these devices was done through a cable. Both the overhead line and cable lengths were varied and the maximum overvoltages coming to the transformer were recorded. The results showed that there is a direct proportionality between overvoltages and length of the overhead line or cable. As long the length of the line or cable between the arrester and the transformer was increased, the vulnerability of the transformer to receive high overvoltages also increased. Surge overvoltages were found to be very sensitive to impedance of the line or cable. The direct connections of overhead lines between the arrester and transformer make it necessary to add some protective device. It was suggested that surge arresters should be installed every 200 meters along the overhead lines in order to ensure the safety of equipment. 12 refs., 4 tabs., 8 figs.

  13. Assessment of fall-arrest systems for scissor lift operators: computer modeling and manikin drop testing. (United States)

    Pan, Christopher S; Powers, John R; Hartsell, Jared J; Harris, James R; Wimer, Bryan M; Dong, Renguang G; Wu, John Z


    The current study is intended to evaluate the stability of a scissor lift and the performance of various fall-arrest harnesses/lanyards during drop/fall-arrest conditions and to quantify the dynamic loading to the head/ neck caused by fall-arrest forces. No data exist that establish the efficacy of fall-arrest systems for use on scissor lifts or the injury potential from the fall incidents using a fall-arrest system. The authors developed a multibody dynamic model of the scissor lift and a human lift operator model using ADAMS and LifeMOD Biomechanics Human Modeler. They evaluated lift stability for four fall-arrest system products and quantified biomechanical impacts on operators during drop/fall arrest, using manikin drop tests. Test conditions were constrained to flat surfaces to isolate the effect of manikin-lanyard interaction. The fully extended scissor lift maintained structural and dynamic stability for all manikin drop test conditions. The maximum arrest forces from the harnesses/lanyards were all within the limits of ANSI Z359.1. The dynamic loading in the lower neck during the fall impact reached a level that is typically observed in automobile crash tests, indicating a potential injury risk for vulnerable participants. Fall-arrest systems may function as an effective mechanism for fall injury protection for operators of scissor lifts. However, operators may be subjected to significant biomechanical loadings on the lower neck during fall impact. Results suggest that scissor lifts retain stability under test conditions approximating human falls from predefined distances but injury could occur to vulnerable body structures.

  14. Telemedicine and European law. (United States)

    Callens, Stefaan


    A Directive of the European Union was first published in 2000, which dealt with telemedicine as part of its provisions. This E-Commerce Directive, as it became known, was subjected to further study which revealed some problems relative to the practice of telemedicine. Among the subjects discussed in this paper are those of privacy, data protection, free movement of services, the impact of electronic communication and ethical issues.

  15. European Automotive Congress

    CERN Document Server

    Clenci, Adrian


    The volume includes selected and reviewed papers from the European Automotive Congress held in Bucharest, Romania, in November 2015. Authors are experts from research, industry and universities coming from 14 countries worldwide. The papers are covering the latest developments in fuel economy and environment, automotive safety and comfort, automotive reliability and maintenance, new materials and technologies, traffic and road transport systems, advanced engineering methods and tools, as well as advanced powertrains and hybrid and electric drives.

  16. Localization of out-of-hospital cardiac arrest in Goteborg 1994-2002 and implications for public access defibrillation. (United States)

    Engdahl, Johan; Herlitz, Johan


    The purpose of this study was to report the locality of out-of-hospital cardiac arrest (OHCA) in the city of Goteborg and to identify implications for public access defibrillation (PAD). Ambulance run reports for the years 1994-2002 were studied retrospectively and manually to establish the location of the cardiac arrest. The location could be identified in 2194 of 2197 patients (99.9%). One thousand four hundred and twenty-nine (65%) of the arrests took place in the victims' homes. Two hundred eighty-five (13%) were outdoors and 57 (3%) in cars. Fifty-one (2%) took place en route in ambulances. These arrests were regarded not to be generally suitable for PAD. One hundred thirty-five (6%) of the arrests happened in a public building. Eighteen of these 135 were in 15 different general practitioners' offices. A ferry terminal had 11 cardiac arrests. One hundred fifty (7%) of the arrests took place in different care facilities. Twenty-one (1%) patients had their cardiac arrest in public transport locations. Twenty-two (1%) patients arrested at work in 20 different sites. In total, 17% of the cardiac arrests were regarded as generally suitable for PAD. Several sites with more than one cardiac arrest in five years could be identified and 54 patients (2.5%) had their cardiac arrest in these high-incidence sites. Among patients suffering from out-of-hospital cardiac arrest in Goteborg in whom resuscitation efforts were attempted 17% of all cardiac arrests were regarded as generally suitable for PAD. According to previous suggestions, the indication for public access defibrillation is in a place with a reasonable probability of use of one AED in 5 years. Several high-incidence sites that probably would benefit from defibrillator availability could be identified, and 54 patients (2.5%) arrested in these sites.

  17. Geography of European Migration

    Directory of Open Access Journals (Sweden)

    Zhitin Dmitry V.


    Full Text Available In recent decades, the role of international migration has increased dramatically in most European countries. The growth in migration has made some authors proclaim the beginning of a second Migration Period that could transform the social and cultural identity of Europe. The article presents an analysis of international migration geography in Europe in the last twenty-five years. The authors identify the main trends in migration, provide migration profiles of European countries, and propose a classification based on the recent changes in the migrant stock. Changes in the migrant stock (total emigration and immigration reflect the level of involvement in international and global processes. They can serve as an indicator of a country’s attractiveness for both foreigners and the country’s citizens. The study shows that European countries are increasingly split into ‘immigrant’ and ‘emigrant’ states. The authors describe spatial patterns of migration. The volume and localisation of migration flows in Europe are affected not only by cultural and historical circumstance, such as a colonial past or a common language. The scale of immigrant influx often does not depend on a donor country’s demographic potential or the level of its socio-economic development. The links between the place of origin and destination are often more complex than it might initially seem. The authors stress the importance of a differentiated immigration policy taking into account ethnic and cultural features of host societies.

  18. When is a Cardiac Arrest Non-Cardiac? (United States)

    Carter, Ryan M; Cone, David C


    Introduction While the overall survival rate for out-of-hospital cardiac arrest (OHCA) is low, ranging from 5%-10%, several characteristics have been shown to decrease mortality, such as presence of bystander cardiopulmonary resuscitation (CPR), witnessed vs unwitnessed events, and favorable initial rhythm (VF/VT). More recently, studies have shown that modified CPR algorithms, such as chest-compression only or cardio-cerebral resuscitation, can further increase survival rates in OHCA. Most of these studies have included only OHCA patients with "presumed cardiac etiology," on the assumption that airway management is of lesser impact than chest compressions in these patients. However, prehospital personnel often lack objective and consistent criteria to assess whether an OHCA is of cardiac or non-cardiac etiology. Hypothesis/Problem The relative proportions of cardiac vs non-cardiac etiology in published data sets of OHCA in the peer-reviewed literature were examined in order to assess the variability of prehospital clinical etiology assessment. A Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA) search was performed using the subject headings "OHCA" and "Emergency Medical Services" (EMS). Studies were included if they reported prevalence of cardiac etiology among OHCA in the entire patient sample, or in all arms of a comparison study. Studies that either did not report etiology of OHCA, or that excluded all cardiac or non-cardiac etiologies prior to reporting clinical data, were excluded. Twenty-four studies were identified, containing 27 datasets of OHCA which reported the prevalence of presumed cardiac vs non-cardiac etiology. These 27 datasets were drawn from 15 different countries. The prevalence of cardiac etiology among OHCA ranged from 50% to 91%. No obvious patterns were found regarding database size, year of publication, or global region (continent) of origin. There exists significant variation in published

  19. Sex differences in cardiac arrest survivors who receive therapeutic hypothermia. (United States)

    Greenberg, Marna Rayl; Ahnert, Amy M; Patel, Nainesh C; Bennett, Courtney E; Elliott, Nicole; Lundquist, Mark; Miller, Andrew; Feiner, Ellina C; Kurt, Anita; Glenn-Porter, Bernadette; Scott, Mercedes; Burmeister, David B


    Sex differences have not been well defined for patients undergoing therapeutic hypothermia (TH). We aimed to determine sex differences in mortality and Cerebral Performance Category (CPC) scores at discharge among those receiving TH. This retrospective cohort study used data abstracted from an "ICE alert" database, an institutional protocol expediting mild TH for postarrest patients. Quality assurance variables (such as age, time to TH, CPC scores, and mortality) were reviewed and compared by sex. χ2 Test and Wilcoxon rank sum test were used. Stepwise logistic regression was used to assess the association between mortality and sex, while controlling for patient characteristics and clinical presentation of cardiac arrest. Three hundred thirty subjects were analyzed, 198 males and 132 females. Subjects' mean age (SD) was 61.7 years (15.0); there was no significant sex difference in age. There were no statistically significant sex differences in history of coronary artery disease, congestive heart failure, arrhythmia, hypertension, chronic obstructive pulmonary disease, renal disease, type 1 and/or type 2 diabetes mellitus, or those previously healthy. Obesity (body mass index>35 kg/m2) was more likely in females (37, 28.0%) than males (35, 17.7%); P=.03. Females (64, 49.6%) were more likely than males (71, 36.8%) to have shock; P=.02. There was no difference in arrest to initiating hypothermia, but there was a significant difference in time to target temperature (in median minutes, interquartile range): male (440, 270) vs female (310, 270), P=.003. There was no statistical difference in CPC at discharge. Crude mortality was not different between sexes: male, 67.7%; female, 70.5%; P=.594. However, after controlling for differences in age, obesity, shock, and other variables, females were less likely to die (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P=.03) than males. There is no statistically significant difference in CPC or crude mortality outcomes

  20. European Law in the Making:

    DEFF Research Database (Denmark)

    Rasmussen, Morten

    the legal service of the High Authority from early on promoted a ‘constitutional’ interpretation of European law, but where the member state, as well as most legal experts, still considered European law a subset of international law. How did the Court of Justice of the ECSC manoeuvre between...... on European law in the making.......Traditionally, the Court of Justice of the European Coal and Steel Community (ECSC) has mainly been considered the somewhat dull predecessor to the more famous Court of Justice of the European Communities, which in 1963-64 ‘constitutionalised’ the Treaties of Rome with the seminal judgments of Van...

  1. Eastern Dimension of the European Neighbourhood Policy: Europeanization Mutual Trap

    Directory of Open Access Journals (Sweden)

    V. A. Latkina


    Full Text Available The article analyses the Europeanization policy of the European Union towards the Eastern Partnership participant countries. Suffering from the lack of clear strategy and ultimate goal in the European Neighbourhood Policy the European Union enhances external democratization and its governance in post soviet states without immediate Union's membership perspective. Underestimation of common neighbourhood geopolitical duality in the context of growing rivalry between European (EU and Eurasian (Custom Union/Eurasian Economic Union integration gravitation centers presents the Eastern partners of the EU with a fierce dilemma of externally forced immediate geopolitical and civilizational choice while not all of them are well prepared to such a choice. The mutual Europeanization trap here to be studied both for the EU and its Eastern partners (involving Russia is a deficiency of regulating cooperation mechanism in the situation of European and Eurasian free trades zones overlapping. Vilnius Summit 2013 results test the "European aspirations" of the New Independent States and upset the ongoing process of the European Neighbourhood Policy in the context of growing economic interdependence in Wider Europe. Besides, the Ukrainian crisis escalation during 2014 as a new seat of tension provokes unbalance of the whole European security system and creates new dividing lines in Europe from Vancouver to Vladivostok.

  2. Arrested Development of Audiovisual Speech Perception in Autism Spectrum Disorders (United States)

    Stevenson, Ryan A.; Siemann, Justin K.; Woynaroski, Tiffany G.; Schneider, Brittany C.; Eberly, Haley E.; Camarata, Stephen M.; Wallace, Mark T.


    Atypical communicative abilities are a core marker of Autism Spectrum Disorders (ASD). A number of studies have shown that, in addition to auditory comprehension differences, individuals with autism frequently show atypical responses to audiovisual speech, suggesting a multisensory contribution to these communicative differences from their typically developing peers. To shed light on possible differences in the maturation of audiovisual speech integration, we tested younger (ages 6-12) and older (ages 13-18) children with and without ASD on a task indexing such multisensory integration. To do this, we used the McGurk effect, in which the pairing of incongruent auditory and visual speech tokens typically results in the perception of a fused percept distinct from the auditory and visual signals, indicative of active integration of the two channels conveying speech information. Whereas little difference was seen in audiovisual speech processing (i.e., reports of McGurk fusion) between the younger ASD and TD groups, there was a significant difference at the older ages. While TD controls exhibited an increased rate of fusion (i.e., integration) with age, children with ASD failed to show this increase. These data suggest arrested development of audiovisual speech integration in ASD. The results are discussed in light of the extant literature and necessary next steps in research. PMID:24218241

  3. Code Blue on Orbit: Treating Cardiac Arrest on the ISS (United States)

    Bacal, Kira; Redmond, Melissa


    As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program.

  4. [Heart arrest during dextran infusion despite hapten blockade]. (United States)

    Schöning, B; Sommer, K; Koch, H


    In a running clinical prospective study on the incidence of adverse reactions to colloidal polysaccharides (randomised, single blind, n = 300) a bronchospasm followed by cardiac arrest occurred during dextran infusion although the necessary hapten blockage with monovalent dextran-1 had been effected. Resuscitation was successful. Directly after this, surgery was carried out as planned under general anaesthesia. The 69-year-old patient was discharged without noticeable sequelae. For the first time in the literature on dextran the studied sample allows a generalisation: The event occurred with an incidence of about 0.9% (of 116 patients who had received dextran infusion). This incidence corresponds to a confidence interval ranging from 0.02 to 4.96%. If the study would be continued as planned, the upper limit of this interval signals the probability of another case of severe intolerance. The diagnosis "dextran adverse reaction" can be made in this case by clinical symptoms. Since no previous or concomitant medication had been administered as provided in the protocol to confirm the diagnosis as an adverse reaction to dextran by determination of the titer of dextran antibodies prior to infusion is not required and it may be concluded that dextran was the causative agent.

  5. Bispectral index monitoring is useless during cardiac arrest patients' resuscitation. (United States)

    Chollet-Xémard, Charlotte; Combes, Xavier; Soupizet, François; Jabre, Patricia; Penet, Candice; Bertrand, Catherine; Margenet, Alain; Marty, Jean


    It has been suggested that out-of-hospital bispectral (BIS) index monitoring during advanced cardiac life support (ACLS) might provide an indication of cerebral resuscitation. The aims of our study were to establish whether BIS values during ACLS might predict return to spontaneous circulation, and whether BIS values on hospital admission might predict survival. This was a prospective observational study in 92 patients with cardiac arrest who received basic life support from a fire-fighter squad and ACLS on arrival of an emergency medical team on the scene. BIS values, electromyographic activity, and signal quality index were recorded throughout resuscitation and out-of-hospital management. Seven patients had recovered spontaneous cardiac activity by the time the medical team arrived on scene. Of the 92 patients, 62 patients died on scene and 30 patients returned to spontaneous cardiac activity and were admitted to hospital. The correlation between BIS values and end-tidal CO(2) during the first minutes of ACLS was poor (r(2)=0.02, P=0.19). Of the 30 admitted patients, 27 died. Three were discharged with no disabilities. There was no significant difference in BIS values on admission between the group of patients who died and the group who survived (P=0.78). Although BIS monitoring during resuscitation was not difficult, it did not predict return to spontaneous cardiac activity, nor survival after admission to intensive care. Its use to monitor cerebral function during ACLS is therefore pointless.

  6. Adrenaline in cardiac arrest: Prefilled syringes are faster. (United States)

    Helm, Claire; Gillett, Mark


    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  7. Amiodarone and cardiac arrest: Systematic review and meta-analysis. (United States)

    Laina, Ageliki; Karlis, George; Liakos, Aris; Georgiopoulos, Georgios; Oikonomou, Dimitrios; Kouskouni, Evangelia; Chalkias, Athanasios; Xanthos, Theodoros


    The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest. We systematically searched MEDLINE and Cochrane Library from 1940 to March 2016 without language restrictions. Randomized control trials (RCTs) and observational studies were selected. Our search initially identified 1663 studies, 1458 from MEDLINE and 205 from Cochrane Library. Of them, 4 randomized controlled studies and 6 observational studies met the inclusion criteria and were selected for further review. Three randomized studies were included in the meta-analysis. Amiodarone significantly improves survival to hospital admission (OR=1.402, 95% CI: 1.068-1.840, Z=2.43, P=0.015), but neither survival to hospital discharge (RR=0.850, 95% CI: 0.631-1.144, Z=1.07, P=0.284) nor neurological outcome compared to placebo or nifekalant (OR=1.114, 95% CI: 0.923-1.345, Z=1.12, P=0.475). Amiodarone significantly improves survival to hospital admission. However there is no benefit of amiodarone in survival to discharge or neurological outcomes compared to placebo or other antiarrhythmics. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Dexmedetomidine Related Bradycardia Leading to Cardiac Arrest in a Dog

    Directory of Open Access Journals (Sweden)

    C. Y. Chen2, K-S. Chen1,2, K. M. Chang2, W. M. Lee1,2, S. C. Chang1,2 and H. C. Wang1,2


    Full Text Available A 2-year-old, mixed breed female dog (16 kg underwent an exploratory laparotomy following ultrasonographic diagnosis of foreign body and a segment of small intestine intussusceptions. The patient was classified as an ASA II. Ketamine (1mg/kg, IV, and dexmedetomidine (2.5 µg/kg, IV, and morphine (0.6 mg/kg, SC were given as anesthetic premedication. Propofol (0.1 mg/kg, IV titrated to a total amount of 4 ml (2.5 mg/ kg was given for intubation. Asystole was occurred. Cardiac resuscitation was then conducted immediately. Atipamezole (0.1 ml was injected, but showed no response on ECG. Atropine (0.02 mg/kg was then injected, and a second dosage was given. Two-three mins later, the heart rate at 84 beats/min. The NIBP showed 203/132 with MAP 153 mmHg, and the SpO2 showed 95% after the cardiac function was regained. Dexmedetomidine related bradycardia leading to cardiac arrest has been suggested in this case.

  9. Horizontal fall arrest systems: rigid systems vs. flexible line systems. (United States)

    Lough, David


    There are many types of flexible and rigid systems on the market, both permanent and temporary. This article does not mean to encompass all possible systems or hazards and only intends to give an outline of what at a minimum should be examined to make an educated purchasing decision. In many instances, the buyer will use the same type of horizontal system for all situations. This is a good idea in some cases because it will reduce the need for training on a number of different systems, reduce system compatibility issues, and may reduce costs for installation, supply, and maintenance. This may not be the best idea if the hazard areas differ a great deal; as we have illustrated, one system may not function for all areas and tasks. The rigid system is typically the best solution simply based on the fact the worker won't fall as far as when he is connected to a flexible system, because of the elimination of any dynamic sag and horizontal energy absorber deployment. In any case, where you stop the worker from falling farther, you decrease the chance there may be an incident where the worker is injured. From a cost standpoint, flexible fall arrest systems typically are cheapest. In the end, safety professionals must balance the cost and effectiveness of the system to prevent an injury.

  10. The best timing for defibrillation in shockable cardiac arrest. (United States)

    Scapigliati, A; Ristagno, G; Cavaliere, F


    High quality cardiopulmonary resuscitation (CPR, i.e. chest compressions and ventilations) and prompt defibrillation when appropriate (i.e. in ventricular fibrillation and pulseless ventricular tachycardia, VF/VT) are currently the best early treatment for cardiac arrest (CA). In cases of prolonged CA due to shockable rhythms, it is reasonable to presume that a period of CPR before defibrillation could partially revert the metabolic and hemodynamic deteriorations imposed to the heart by the no flow state, thus increasing the chances of successful defibrillation. Despite supporting early evidences in CA cases in which Emergency Medical System response time was longer than 5 minutes, recent studies have failed to confirm a survival benefit of routine CPR before defibrillation. These data have imposed a change in guidelines from 2005 to 2010. To take in account all the variables encountered when treating CA (heart condition before CA, time elapsed, metabolic and hemodynamic changes, efficacy of CPR, responsiveness to defibrillation attempt), it would be very helpful to have a real-time and non invasive tool able to predict the chances of defibrillation success. Recent evidences have suggested that ECG waveform analysis of VF, such as the derived Amplitude Spectrum Area, can fit the purpose of monitoring the CPR effectiveness and predicting the responsiveness to defibrillation. While awaiting clinical studies confirming this promising approach, CPR performed according to high quality standard and with minimal interruptions together with early defibrillation are the best immediate way to achieve resuscitation in CA due to shochable rhythms..

  11. Variability of Post-Cardiac Arrest Care Practices Among Cardiac Arrest Centers: United States and South Korean Dual Network Survey of Emergency Physician Research Principal Investigators. (United States)

    Coppler, Patrick J; Sawyer, Kelly N; Youn, Chun Song; Choi, Seung Pill; Park, Kyu Nam; Kim, Young-Min; Reynolds, Joshua C; Gaieski, David F; Lee, Byung Kook; Oh, Joo Suk; Kim, Won Young; Moon, Hyung Jun; Abella, Benjamin S; Elmer, Jonathan; Callaway, Clifton W; Rittenberger, Jon C


    There is little consensus regarding many post-cardiac arrest care parameters. Variability in such practices could confound the results and generalizability of post-arrest care research. We sought to characterize the variability in post-cardiac arrest care practice in Korea and the United States. A 54-question survey was sent to investigators participating in one of two research groups in South Korea (Korean Hypothermia Network [KORHN]) and the United States (National Post-Arrest Research Consortium [NPARC]). Single investigators from each site were surveyed (N = 40). Participants answered questions based on local institutional protocols and practice. We calculated descriptive statistics for all variables. Forty surveys were completed during the study period with 30 having greater than 50% of questions completed (75% response rate; 24 KORHN and 6 NPARC). Most centers target either 33°C (N = 16) or vary the target based on patient characteristics (N = 13). Both bolus and continuous infusion dosing of sedation are employed. No single indication was unanimous for cardiac catheterization. Only six investigators reported having an institutional protocol for withdrawal of life-sustaining therapy (WLST). US patients with poor neurological prognosis tended to have WLST with subsequent expiration (N = 5), whereas Korean patients are transferred to a secondary care facility (N = 19). Both electroencephalography modality and duration vary between institutions. Serum biomarkers are commonly employed by Korean, but not US centers. We found significant variability in post-cardiac arrest care practices among US and Korean medical centers. These practice variations must be taken into account in future studies of post-arrest care.

  12. Survival and Neurologic Outcome After Out-of-hospital Cardiac Arrest. Results of the Andalusian Out-of-hospital Cardiopulmonary Arrest Registry. (United States)

    Rosell Ortiz, Fernando; Mellado Vergel, Francisco; López Messa, Juan Bautista; Fernández Valle, Patricia; Ruiz Montero, María M; Martínez Lara, Manuela; Vergara Pérez, Santiago; Vivar Díaz, Itziar; Caballero García, Auxiliadora; García Alcántara, Ángel; García Del Águila, Javier


    There is a paucity of data on prehospital cardiac arrest in Spain. Our aim was to describe the incidence, patient characteristics, and outcomes of out-of-hospital emergency care for this event. We conducted a retrospective analysis of a prospective registry of cardiopulmonary arrest handled by an out-of-hospital emergency service between January 2008 and December 2012. The registry included all patients considered to have a cardiac etiology as the cause of arrest, with a descriptive analysis performed of general patient characteristics and factors associated with good neurologic outcome at hospital discharge. A total of 4072 patients were included, with an estimated incidence of 14.6 events per 100000 inhabitants and year; 72.6% were men. The mean age was 62.0 ± 15.8 years, 58.6% of cases occurred in the home, 25% of patients had initial defibrillable rhythm, 28.8% of patients arrived with a pulse at the hospital (58.3% of the group with defibrillable rhythm), and 10.2% were discharged with good neurologic outcome. The variables associated with this recovery were: witnessed arrest (P=.04), arrest witnessed by emergency team (P=.005), previous life support (P=.04), initial defibrillable rhythm (P=.0001), and performance of a coronary interventional procedure (P=.0001). More than half the cases of sudden cardiac arrest occur at home, and the population was found to be relatively young. Although recovery was satisfactory in 1 out of every 10 patients, there is a need for improvement in the phase prior to emergency team arrival. Coronary interventional procedures had an impact on patient prognosis. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Editor's Choice-Is the pre-hospital ECG after out-of-hospital cardiac arrest accurate for the diagnosis of ST-elevation myocardial infarction? (United States)

    Salam, Idrees; Hassager, Christian; Thomsen, Jakob Hartvig; Langkjær, Sandra; Søholm, Helle; Bro-Jeppesen, John; Bang, Lia; Holmvang, Lene; Erlinge, David; Wanscher, Michael; Lippert, Freddy K; Køber, Lars; Kjaergaard, Jesper


    Current guidelines recommend that comatose out-of-hospital cardiac arrest patients with ST-segment elevations (STEs) following return of spontaneous circulation (ROSC) should be referred for an acute coronary angiography. We sought to investigate the diagnostic value of the pre-hospital ROSC-ECG in predicting ST-elevation myocardial infarction (STEMI). ROSC-ECGs of 145 comatose survivors of out-of-hospital cardiac arrest, randomly assigned in the Target Temperature Management trial, were classified according to the current STEMI ECG criteria (third universal definition of myocardial infarction). STEs were present in the pre-hospital ROSC-ECG of 78 (54%) patients. A final diagnosis revealed that 69 (48%) patients had STEMI, 31 (21%) patients had non-STEMI and 45 (31%) patients had no myocardial infarction. STE in ROSC-ECGs had a sensitivity of 74% (95% confidence interval (CI) 62-84), specificity of 65% (95% CI 53-75) and a positive and negative predictive value of 65% (95% CI 54-76) and 73% (95% CI 61-83) in predicting STEMI. Time to ROSC was significantly longer (24 minutes vs. 19 minutes, P=0.02) in STE compared with no STE patients. Percutaneous coronary intervention was successful in 68% versus 36% (Pcardiac centres. This supports the incentive of referring all comatose survivors of out-of-hospital cardiac arrest of suspected cardiac origin to a tertiary heart centre with the availability of acute coronary angiography, even in the absence of STEs. © The European Society of Cardiology 2015.

  14. Excessive chest compression rate is associated with insufficient compression depth in prehospital cardiac arrest

    NARCIS (Netherlands)

    Monsieurs, Koenraad G.; De Regge, Melissa; Vansteelandt, Kristof; De Smet, Jeroen; Annaert, Emmanuel; Lemoyne, Sabine; Kalmar, Alain F.; Calle, Paul A.


    Background and goal of study: The relationship between chest compression rate and compression depth is unknown. In order to characterise this relationship, we performed an observational study in prehospital cardiac arrest patients. We hypothesised that faster compressions are associated with

  15. Effect of a pharmacologically induced decrease in core temperature in rats resuscitated from cardiac arrest (United States)

    Targeted temperature management is recommended to reduce brain damage after resuscitation from cardiac arrest in humans although the optimal target temperature remains controversial. 1 4 The American Heart Association (AHA) and the International Liaison Committee on Resuscitation...

  16. GLP-1 analogues for neuroprotection after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Wiberg, Sebastian; Hassager, Christian; Thomsen, Jakob Hartvig


    BACKGROUND: Attenuating the neurological damage occurring after out-of-hospital cardiac arrest is an ongoing research effort. This dual-centre study investigates the neuroprotective effects of the glucagon-like-peptide-1 analogue Exenatide administered within 4 hours from the return of spontaneous...... circulation to comatose patients resuscitated from out-of-hospital cardiac arrest. METHODS/DESIGN: This pilot study will randomize a total of 120 unconscious patients with sustained return of spontaneous circulation after out-of-hospital cardiac arrest undergoing targeted temperature management in a blinded...... one-to-one fashion to a 6-hour and 15-minute infusion of either Exenatide or placebo. Patients are eligible for inclusion if resuscitated from cardiac arrest with randomization from 20 minutes to 240 minutes after return of spontaneous circulation. The co-primary endpoint is feasibility, defined...

  17. Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Sørensen, Kristian Dahl Kragholm; Wissenberg, Mads; Mortensen, Rikke N


    BACKGROUND: The effect of bystander interventions on long-term functional outcomes among survivors of out-of-hospital cardiac arrest has not been extensively studied. METHODS: We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data and reported the 1-year...... risks of anoxic brain damage or nursing home admission and of death from any cause among patients who survived to day 30 after an out-of-hospital cardiac arrest. We analyzed risks according to whether bystander cardiopulmonary resuscitation (CPR) or defibrillation was performed and evaluated temporal...... changes in bystander interventions and outcomes. RESULTS: Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period...

  18. Multiple cardiac arrests induced by pulmonary embolism in a traumatically injured patient (United States)

    Sun, Shu-Qing; Li, Ke-Peng; Zhi, Jianming


    Abstract Rationale: Pulmonary embolism-induced cardiac arrest should not be given up arbitrarily, knowing that the etiology of pulmonary embolism is reversible in most cases. Patient concerns: We present a case of continuous resuscitation lasting approximately 4 hours, during which 21 episodes of cardiac arrest occurred in a 46-year-old man who sustained high-level paraplegia after a road traffic accident. Diagnoses: Multiple cardiac arrests induced by pulmonary embolism. Interventions: The patient received cardiopulmonary resuscitation and thrombolytic therapy. Outcomes: The patient was discharged in 2 weeks when his condition turned for the better. Lessons: Cardiopulmonary resuscitation of patients with pulmonary embolism-induced cardiac arrest should not be given up arbitrarily, knowing that the etiology of pulmonary embolism is reversible in most cases. Effective external cardiac compression can not only save the patient's life but also attenuate neurological sequelae. Thrombolytic therapy is the key to the final success of resuscitation. PMID:29245284

  19. Optimizing Neurologically Intact Survival from Sudden Cardiac Arrest: A Call to Action

    Directory of Open Access Journals (Sweden)

    Jeffrey M. Goodloe


    Full Text Available The U.S. national out-of-hospital and in-hospital cardiac arrest survival rates, although improving recently, have remained suboptimal despite the collective efforts of individuals, communities, and professional societies. Only until very recently, and still with inconsistency, has focus been placed specifically on survival with pre-arrest neurologic function. The reality of current approaches to sudden cardiac arrest is that they are often lacking an integrative, multi-disciplinary approach, and without deserved funding and outcome analysis. In this manuscript, a multidisciplinary group of authors propose practice, process, technology, and policy initiatives to improve cardiac arrest survival with a focus on neurologic function. [West J Emerg Med. 2014;15(7:-0.

  20. Recurrent respiratory distress and cardiopulmonary arrest caused by megaoesophagus secondary to achalasia

    Directory of Open Access Journals (Sweden)

    Nigel Tapiwa Mabvuure


    CONCLUSION: Oesophagectomy should be considered for patients with end-stage achalasia and mega-oesophagus causing respiratory compromise to avoid potential fatal complications such as tracheal compression and subsequent respiratory arrest.

  1. Management of cardiac arrest caused by coronary artery spasm: epinephrine/adrenaline versus nitrates. (United States)

    Kiss, Gabor; Corre, Olivier; Gueret, Gildas; Nguyen Ba, Vinh; Gilard, Martine; Boschat, Jaques; Arvieux, Charles Chistian


    Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious. A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries. Radiologic imaging revealed a positive methylergonovine maleate (Methergine, Novartis Pharmaceuticals, East Hanover, NJ) test, with subocclusive CAS in several coronary vessels leading to electromechanical dissociation. Cardiopulmonary resuscitation was performed, and intracoronary boluses of isosorbide dinitrate were given to treat CAS. Epinephrine/adrenaline was not administered during resuscitation. Spontaneous circulation was obtained after cardioversion for ventricular fibrillation, and the patient progressively regained consciousness. Resuscitation guidelines do not specify the use of trinitrate derivatives in cardiac arrest situations caused by CAS. The pros and cons of the use of nitrates and epinephrine/adrenaline during cardiac arrest caused by CAS are analyzed in this case report.

  2. Parameter identification of ZnO surge arrester models based on genetic algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Bayadi, Abdelhafid [Laboratoire d' Automatique de Setif, Departement d' Electrotechnique, Faculte des Sciences de l' Ingenieur, Universite Ferhat ABBAS de Setif, Route de Bejaia Setif 19000 (Algeria)


    The correct and adequate modelling of ZnO surge arresters characteristics is very important for insulation coordination studies and systems reliability. In this context many researchers addressed considerable efforts to the development of surge arresters models to reproduce the dynamic characteristics observed in their behaviour when subjected to fast front impulse currents. The difficulties with these models reside essentially in the calculation and the adjustment of their parameters. This paper proposes a new technique based on genetic algorithm to obtain the best possible series of parameter values of ZnO surge arresters models. The validity of the predicted parameters is then checked by comparing the predicted results with the experimental results available in the literature. Using the ATP-EMTP package, an application of the arrester model on network system studies is presented and discussed. (author)

  3. Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Do Wan Kim


    Full Text Available Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.

  4. The European populist challenge

    Directory of Open Access Journals (Sweden)

    Yannis Stavrakakis


    Full Text Available In today’s Europe, the word ‘populism’ usually refers to right-wing populism or the populist extreme right. Is, however, the concept of ‘populism’ the proper theoreticopolitical instrument through which such identifications should be perceived, categorized and debated? What are the implications (direct and indirect of such a naming? And what are the risks for critical analysis and for democratic politics in the European context? The hypothesis explored in this essay is that sticking to a restrictive association between ‘populism’ and the extreme right poses certain dangers that have to be seriously taken into account, especially in times of crisis. For a start, it is often premised on a rather simplistic euro-centrism that reduces the broad conceptual spectrum covered by the category ‘populism’ in its global use to a very particular European experience and then essentializes the resulting association, over-extending its scope. In addition, the category ‘populism’ is aften used to describe political forces, identities and discourses in which the role of ‘the people’ is only secondary or peripheral, to the extent that it has to coincide with strongly hierarchical and elitist visions of society. What complicates things even further is that, within the context of the European (economic and political crisis, whoever questions/ resists the austerity agenda – especially on the left – is increasingly discredited and denounced as an irresponsible populist. Indeed, it is not by coincidence that doubts are increasingly voiced both in the theoretical and in the political literature regarding the rationale behind such a strong association between populism and the extreme right. A series of points will thus be raised that may help us develop a plausible theoretico-political strategy in the new emerging conditions from a discursive perspective.*

  5. European Network Against Racism

    DEFF Research Database (Denmark)

    Nielsen, Helene Pristed

    of discussions about intersectionality, the article investigates ENAR´s attention and ability to integrate questions of e.g. gender, sexuality or age in their policy input, given the potentially rigid compartmentalisation of discrimination strands within the European Commission´s system of civil society...... consultations. The article therefore overall aims to assess ENAR´s position as potentially hemmed in between 1) the Commission vs. member organisations’ expectations for its focus and modus operandi and 2) attention to intersectional discrimination vs. potential compartmentalisation within the Commission...

  6. Cooperative strategies European perspectives

    CERN Document Server

    Killing, J Peter


    Cooperative Strategies: European Perspectives is one of three geographically targeted volumes in which the contributors present the most current research on topics such as advances in theories of cooperative strategies, the formation of cooperative alliances, the dynamics of partner relationships, and the role of information and knowledge in cooperative alliances. Blending conceptual insights with empirical analyses, the contributors highlight commonalities and differences across national, cultural, and trade zones. The chapters in this volume are anchored in a wide set of theoretical approaches, conceptual frameworks, and models, illustrating how rich the area of cooperative strategies is for scholarly inquiry.

  7. European Regional Modernism

    Directory of Open Access Journals (Sweden)

    Vincent Brian Canizaro


    Full Text Available In recent years, beginning with the publication in 2003 of Liane Lefaivre and Alexander Tzonis’ 'Critical Regionalism', followed by my 'Architectural Regionalism: Collected Writings on Place, Identity, Modernity and Tradition 'in 2007, there has been a quiet resurgence in the discourse of architectural regionalism.' 'Leuven University Press’s 'Regionalism and Modernity: Architecture in Western Europe 1914–1940 'continues in this direction, with eleven chapters devoted to variations of the regionalist tendency in European architecture focused primarily on Belgium and France, but also Great Britain, Italy, and Germany.

  8. European Union of Memories?

    DEFF Research Database (Denmark)

    Wæhrens, Anne

    After a very brief introduction to history and memory in Europe after 1989, as seen by Aleida Assmann, I will give a short introduction to the EP and to their adoption of resolutions and declarations. Then I will define some concepts central to my study before I proceed to the analysis. Finally I...... these changes have come about. Moreover, I show that there seems to be a political memory split between Left and Right and I suggest that the time might not be ripe for a shared European memory....

  9. European Union Budget Politics

    DEFF Research Database (Denmark)

    Citi, Manuele


    The marginal involvement of the European Union (EU) in redistributive policies and its limited fiscal resources have led to a notable lack of attention by EU scholars towards the EU budget and its dynamics. Yet the nature of the budgetary data and their high usability for statistical analysis make...... them an excellent tool for studying and measuring policy change in the EU. In this article, I analyse an original dataset containing yearly data for the main categories of expenditure and how they have changed over the last three decades (1979–2013). Using time-series analysis, I find that the ability...

  10. Arctigenin, a natural lignan compound, induces G0/G1 cell cycle arrest and apoptosis in human glioma cells. (United States)

    Maimaitili, Aisha; Shu, Zunhua; Cheng, Xiaojiang; Kaheerman, Kadeer; Sikandeer, Alifu; Li, Weimin


    The aim of the current study was to investigate the anticancer potential of arctigenin, a natural lignan compound, in malignant gliomas. The U87MG and T98G human glioma cell lines were treated with various concentrations of arctigenin for 48 h and the effects of arctigenin on the aggressive phenotypes of glioma cells were assessed. The results demonstrated that arctigenin dose-dependently inhibited the growth of U87MG and T98G cells, as determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and bromodeoxyuridine incorporation assays. Arctigenin exposure also induced a 60-75% reduction in colony formation compared with vehicle-treated control cells. However, arctigenin was not observed to affect the invasiveness of glioma cells. Arctigenin significantly increased the proportion of cells in the G0/G1 phase and reduced the number of cells in the S phase, as compared with the control group (Parctigenin increased the expression levels of p21, retinoblastoma and p53 proteins, and significantly decreased the expression levels of cyclin D1 and cyclin-dependent kinase 4 proteins. Additionally, arctigenin was able to induce apoptosis in glioma cells, coupled with increased expression levels of cleaved caspase-3 and the pro-apoptotic BCL2-associated X protein. Furthermore, arctigenin-induced apoptosis was significantly suppressed by the pretreatment of cells with Z-DEVD-FMK, a caspase-3 inhibitor. In conclusion, the results suggest that arctigenin is able to inhibit cell proliferation and may induce apoptosis and cell cycle arrest at the G0/G1 phase in glioma cells. These results warrant further investigation of the anticancer effects of arctigenin in animal models of gliomas.

  11. How campaigns enhance European issues voting during European Parliament elections

    DEFF Research Database (Denmark)

    Beach, Derek; Møller Hansen, Kasper; Larsen, Martin Vinæs


    allegiances less important and attitudes about the European project more important by informing voters of and getting them interested in European politics. In effect, we argue that the political campaign leading up to the election makes European Parliament elections less second-order. While previous studies...... have demonstrated that EU attitudes can matter for voting behavior in European Parliament elections, existing research has drawn on post-election surveys that do not enable us to capture campaign effects. Our contribution is to assess the impact of a campaign by utilizing a rolling cross sectional......Based on findings from the literature on campaign effects on the one hand, and the literature on European Parliament elections on the other, we propose a model of European Parliamentary elections in which the campaign shift the calculus of electoral support, making differences in national political...

  12. Postoperative cardiac arrest after heart surgery: does extracorporeal perfusion support a paradigm change in management? (United States)

    Gologorsky, Edward; Macedo, Francisco Igor B; Carvalho, Enisa M; Gologorsky, Angela; Ricci, Marco; Salerno, Tomas A


    Early institution of extracorporeal perfusion support (ECPS) may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU) following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes) advanced cardiac life support (ACLS) protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.

  13. Cardiopulmonary resuscitation of adults with in-hospital cardiac arrest using the Utstein style. (United States)

    Silva, Rose Mary Ferreira Lisboa da; Silva, Bruna Adriene Gomes de Lima E; Silva, Fábio Junior Modesto E; Amaral, Carlos Faria Santos


    The objective of this study was to analyze the clinical profile of patients with in-hospital cardiac arrest using the Utstein style. This study is an observational, prospective, longitudinal study of patients with cardiac arrest treated in intensive care units over a period of 1 year. The study included 89 patients who underwent cardiopulmonary resuscitation maneuvers. The cohort was 51.6% male with a mean age 59.0 years. The episodes occurred during the daytime in 64.6% of cases. Asystole/bradyarrhythmia was the most frequent initial rhythm (42.7%). Most patients who exhibited a spontaneous return of circulation experienced recurrent cardiac arrest, especially within the first 24 hours (61.4%). The mean time elapsed between hospital admission and the occurrence of cardiac arrest was 10.3 days, the mean time between cardiac arrest and cardiopulmonary resuscitation was 0.68 min, the mean time between cardiac arrest and defibrillation was 7.1 min, and the mean duration of cardiopulmonary resuscitation was 16.3 min. Associations between gender and the duration of cardiopulmonary resuscitation (19.2 min in women versus 13.5 min in men, p = 0.02), the duration of cardiopulmonary resuscitation and the return of spontaneous circulation (10.8 min versus 30.7 min, p cardiac arrest, until hospital discharge and 6 months after discharge were 71%, 9% and 6%, respectively. The main initial rhythm detected was asystole/bradyarrhythmia; the interval between cardiac arrest and cardiopulmonary resuscitation was short, but defibrillation was delayed. Women received cardiopulmonary resuscitation for longer periods than men. The in-hospital survival rate was low.

  14. Antidepressant Use and Risk of Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Weeke, P; Jensen, Aksel Karl Georg; Folke, F


    Treatment with some types of antidepressants has been associated with sudden cardiac death. It is unknown whether the increased risk is due to a class effect or related to specific antidepressants within drug classes. All patients in Denmark with an out-of-hospital cardiac arrest (OHCA) were.......17-12.2). An association between cardiac arrest and antidepressant use could be documented in both the SSRI and TCA classes of drugs....

  15. Out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge. (United States)

    Donoghue, Aaron J; Nadkarni, Vinay; Berg, Robert A; Osmond, Martin H; Wells, George; Nesbitt, Lisa; Stiell, Ian G


    We systematically summarize pediatric out-of-hospital cardiac arrest epidemiology and assess knowledge of effects of specific out-of-hospital interventions. We conducted a comprehensive review of published articles from 1966 to 2004, available through MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EmBase, and the Cochrane Registry, describing outcomes of children younger than 18 years with an out-of-hospital cardiac arrest. Patient characteristics, process of care, and outcomes were compared using pediatric Utstein outcome report guidelines. Effects of out-of-hospital care processes on survival outcomes were summarized. Forty-one studies met inclusion criteria; 8 complied with Utstein reporting guidelines. Included in the review were 5,363 patients: 12.1% survived to hospital discharge, and 4% survived neurologically intact. Trauma patients (n=2,299) had greater overall survival (21.9%, 6.8% intact); a separate examination of studies with more rigorous cardiac arrest definition showed poorer survival (1.1% overall, 0.3% neurologically intact). Submersion injury-associated arrests (n=442) had greater overall survival (22.7%, 6% intact). Pooled data analysis of bystander cardiopulmonary resuscitation and witnessed arrest status showed increased likelihood of survival (relative risk 1.99, 95% confidence interval 1.54 to 2.57) for witnessed arrests. The effect of bystander cardiopulmonary resuscitation is difficult to determine because of study heterogeneity. Outcomes from out-of-hospital pediatric cardiac arrest are generally poor. Variability may exist in survival by patient subgroups, but differences are hard to accurately characterize. Conformity with Utstein guidelines for reporting and research design is incomplete. Witnessed arrest status remains associated with improved survival. The need for prospective controlled trials remains a high priority.

  16. Cardiac arrest after sugammadex administration in a patient with variant angina: a case report


    KO, Myoung Jin; Kim, Yong Han; Kang, Eunsu; Lee, Byeong-Cheol; Lee, Sujung; Jung, Jae-Wook


    A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day...

  17. Clinical review: Continuous and simplified electroencephalography to monitor brain recovery after cardiac arrest.


    Friberg, Hans; Westhall, Erik; Rosén, Ingmar; Rundgren, Malin; Nielsen, Niklas; Cronberg, Tobias


    There has been a dramatic change in hospital care of cardiac arrest survivors in recent years, including the use of target temperature management (hypothermia). Clinical signs of recovery or deterioration, which previously could be observed, are now concealed by sedation, analgesia, and muscle paralysis. Seizures are common after cardiac arrest, but few centers can offer high-quality electroencephalography (EEG) monitoring around the clock. This is due primarily to its complexity and lack of ...

  18. [Evolution of the nurse's role in the management of a cardiac arrest]. (United States)

    Loosli, Florian; Hutin, Alice; Lefort, Hugues; Carli, Pierre; Lamhaut, Lionel


    In France, there are 40 000 sudden deaths each year and the cardiac arrest survival rate is less than 10%. The arrival of extracorporeal cardio pulmonary resuscitation (ECPR) offers hope in the event of refractory cardiac arrest in prehospital care. Extending ECPR programmes requires more scientific evidence, training and an evolution of the role of paramedics. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients. (United States)

    Adnet, Frederic; Triba, Mohamed N; Borron, Stephen W; Lapostolle, Frederic; Hubert, Hervé; Gueugniaud, Pierre-Yves; Escutnaire, Josephine; Guenin, Aurelien; Hoogvorst, Astrid; Marbeuf-Gueye, Carol; Reuter, Paul-Georges; Javaud, Nicolas; Vicaut, Eric; Chevret, Sylvie


    Relationship between cardiopulmonary arrest and resuscitation (CPR) durations and survival after out-of-hospital cardiac arrest (OHCA) remain unclear. Our primary aim was to determine the association between survival without neurologic sequelae and cardiac arrest intervals in the setting of witnessed OHCA. We analyzed 27,301 non-traumatic, witnessed OHCA patients in France included in the national registry from June 1, 2011 through December 1, 2015. We analyzed cardiac arrest intervals, designated as no-flow (NF; from collapse to start of CPR) and low-flow (LF; from start of CPR to cessation of resuscitation) in relation to 30-day survival without sequelae. We determined the influence of recognized prognostic factors (age, gender, initial rhythm, location of cardiac arrest) on this relation. For the entire cohort, the area delimited by a value of NF greater than 12min (95% confidence interval: 11-13min) and LF greater than 33min (95% confidence interval: 29-45min), yielded a probability of 30-day survival of less than 1%. These sets of values were greatly influenced by initial cardiac arrest rhythm, age, sex and location of cardiac arrest. Extended CPR duration (greater than 40min) in the setting of initial shockable cardiac rhythm is associated with greater than 1% survival with NF less than 18min. The NF interval was highly influential on the LF interval regardless of outcome, whether return of spontaneous circulation (pCPR duration in OHCA patients. The knowledge of (NF, LF) curves as function of age, initial rhythm, location of cardiac arrest or gender may aid in decision-making vis-à-vis the termination of CPR or employment of advanced techniques. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest


    Ya-hua LIU; Xiu-man LI; Li-xiang WANG


    Objective To observe the effects of four cardiopulmonary resuscitation (CPR) methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR), compression under the diaphragm CPR (D-CPR), abdominal compression CPR (A-CPR), and abdominal wall lifting and compression CPR (L-CPR). Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of s...

  1. Pediatric In-Hospital Cardiac Arrest Secondary to Acute Pulmonary Embolism. (United States)

    Morgan, Ryan W; Stinson, Hannah R; Wolfe, Heather; Lindell, Robert B; Topjian, Alexis A; Nadkarni, Vinay M; Sutton, Robert M; Berg, Robert A; Kilbaugh, Todd J


    Pulmonary embolism is a rarely reported and potentially treatable cause of cardiac arrest in children and adolescents. The objective of this case series is to describe the course of five adolescent patients with in-hospital cardiac arrest secondary to pulmonary embolism. Case series. Single, large academic children's hospital. All patients under the age of 18 years (n = 5) who experienced an in-hospital cardiac arrest due to apparent pulmonary embolism from August 1, 2013, to July 31, 2017. All five patients received systemic thrombolytic therapy (IV tissue plasminogen activator) during cardiac arrest or periarrest during ongoing resuscitation efforts. Five adolescent patients, 15-17 years old, were treated for pulmonary embolism-related cardiac arrests during the study period. These accounted for 6.3% of all children and 25% of adolescents (12-17 yr old) receiving at least 5 minutes of in-hospital cardiopulmonary resuscitation during the study period. All five had venous thromboembolism risk factors. Two patients had known, extensive venous thrombi at the time of cardiac arrest, and one was undergoing angiography at the time of arrest. The diagnoses of pulmonary embolism were based on clinical suspicion, bedside echocardiography (n = 4), and low end-tidal CO2 levels relative to arterial CO2 values (n = 5). IV tissue plasminogen activator was administered during cardiopulmonary resuscitation in three patients and after the return of spontaneous circulation, in the setting of severe hemodynamic instability, in the other two patients. Four of five patients were successfully resuscitated and survived to hospital discharge. Pulmonary embolism was recognized as the etiology of multiple adolescent cardiac arrests in this single-center series and may be more common than previously reported. Recognition, high-quality cardiopulmonary resuscitation, and treatment with thrombolytic therapy resulted in survival in four of five patients.

  2. Cardiac Arrest in Children: Long-Term Health Status and Health-Related Quality of Life. (United States)

    van Zellem, Lennart; Utens, Elisabeth M; Legerstee, Jeroen S; Cransberg, Karlien; Hulst, Jessie M; Tibboel, Dick; Buysse, Corinne


    To assess long-term health status and health-related quality of life in survivors of cardiac arrest in childhood and their parents. In addition, to identify predictors of health status and health-related quality of life. This medical follow-up study involved consecutive children surviving cardiac arrest between January 2002 and December 2011, who had been admitted to the ICU. Health status was assessed with a medical interview, physical examination, and the Health Utilities Index. Health-related quality of life was assessed with the Child Health Questionnaires and Short-Form 36. A tertiary care university children's hospital. Of the eligible 107 children, 57 (53%) filled out online questionnaires and 47 visited the outpatient clinic (median age, 8.7 yr; median follow-up interval, 5.6 yr). None. Of the participants, 60% had an in-hospital cardiac arrest, 90% a nonshockable rhythm, and 50% a respiratory etiology of arrest. Mortality rate after hospital discharge was 10%. On health status, we found that 13% had long-term neurologic deficits, 34% chronic symptoms (e.g., fatigue, headache), 19% at least one sign suggestive of chronic kidney injury, and 15% needed special education. Health Utilities Index scores were significantly decreased on most utility scores and the overall Health Utilities Index mark 3 score. Compared with Dutch normative data, parent-reported health-related quality of life of cardiac arrest survivors was significantly worse on general health perception, physical role functioning, parental impact, and overall physical summary. On patient reports, no significant differences with normative data were found. Parents reported better family cohesion and better health-related quality of life for themselves on most scales. Patients' health status, general health perceptions, and physical summary scores were significantly associated with cardiac arrest-related preexisting condition. Considering the impact of cardiac arrest, the overall outcome after cardiac

  3. Hospital discharge diagnoses of ventricular arrhythmias and cardiac arrest were useful for epidemiologic research

    DEFF Research Database (Denmark)

    De Bruin, M L; van Hemel, N M; Leufkens, H G M


    OBJECTIVE: We investigated the validity of hospital discharge diagnosis regarding ventricular arrhythmias and cardiac arrest. METHODS: We identified patients whose record in the PHARMO record linkage system database showed a code for ventricular or unspecified cardiac arrhythmias according to cod...... according to ICD-9-CM as paroxysmal ventricular tachycardia, ventricular fibrillation, ventricular flutter, ventricular premature beats, or cardiac arrest) have a high PPV and are useful for selecting events in epidemiological studies on drug-induced arrhythmias....

  4. The right to information within the criminal proceedings in the European Union. Comparative examination. Critical opinions

    Directory of Open Access Journals (Sweden)

    Ioana-Minodora Rusu


    Full Text Available In the present study we have examined the provisions of Directive 2012/13 / EU of the European Parliament and the Council on the right to information in criminal proceedings and a compared examination relating to the provisions of Romanian law regarding ensuring the right to information within the Romanian criminal proceedings. The innovations and the value of the work consist of the examination of the European legal instrument, the comparative examination and the critical opinions and the proposals of de lege ferenda. As recognized in the jurisprudence of the ECHR, the right to information of the person suspected or accused of committing a crime or arrested for committing a crime on the territory of another Member State is part of the right to a fair trial, being necessary its compliance throughout the criminal trial, on the territory of each Member State. At the same time the European legislative act establishes a general procedure that needs to be respected by each Member State, which entails the obligation for Member States to ensure at least the same rights as for the citizen or the conditions under which a national of another Member State is suspected, accused or arrested for the commission of a crime. This paper continues the research conducted in the field of International and European judicial cooperation in criminal matters, which have resulted in the publication of papers in wellknown publishing houses in the country and abroad, in national and international specialized journals or conference proceedings. The work can be useful to both theorists and practitioners in the field of judicial cooperation in criminal matters regarding the rights of certain categories of people and to the Romanian or European legislator for amending and supplementing the legislation.

  5. Europeanness: A Path To Unity Within The European Union

    Directory of Open Access Journals (Sweden)

    Piasecki Ryszard


    Full Text Available The postwar experience has shown that the implanting of European consciousness, or Europeanness, calls for coordinated efforts among the European institutions, national states, and NGOs. Such consciousness, a key pillar of the European integration, is necessary for the EU to effectively function and motivate member states’ − also the EU’s − citizens. And yet European institutions and EU governments show little interest in promoting the formation of this European consciousness. Pro-European social movements are weak, while anti- European ones gain strength. This désintéressement of the EU countries probably results from the conviction that the goal has been reached and that there is no more need for a widespread pro-European education of their societies. However analysis of the problem, and in particular of the interaction between European and national identities, shows that this is not the case. We fear that this lack of proactive measures mobilizing EU citizens to keep on struggling for a common Europe will lead to the erosion of existing achievements of integration within the EU, and undermine European values. It may threaten the future of the EU, which is not an ordinary integration grouping but a great peaceful, civilizational, social and economic project. Our hypothesis − positively verified in this article − is that the promotion of Europeanness in the EU societies is urgently needed to maintain the unity (and even membership of the Union, and to avert trends unfavorable for all of Europe and therefore for the West as a whole.

  6. SMC1-mediated intra-S-phase arrest facilitates bocavirus DNA replication. (United States)

    Luo, Yong; Deng, Xuefeng; Cheng, Fang; Li, Yi; Qiu, Jianming


    Activation of a host DNA damage response (DDR) is essential for DNA replication of minute virus of canines (MVC), a member of the genus Bocavirus of the Parvoviridae family; however, the mechanism by which DDR contributes to viral DNA replication is unknown. In the current study, we demonstrate that MVC infection triggers the intra-S-phase arrest to slow down host cellular DNA replication and to recruit cellular DNA replication factors for viral DNA replication. The intra-S-phase arrest is regulated by ATM (ataxia telangiectasia-mutated kinase) signaling in a p53-independent manner. Moreover, we demonstrate that SMC1 (structural maintenance of chromosomes 1) is the key regulator of the intra-S-phase arrest induced during infection. Either knockdown of SMC1 or complementation with a dominant negative SMC1 mutant blocks both the intra-S-phase arrest and viral DNA replication. Finally, we show that the intra-S-phase arrest induced during MVC infection was caused neither by damaged host cellular DNA nor by viral proteins but by replicating viral genomes physically associated with the DNA damage sensor, the Mre11-Rad50-Nbs1 (MRN) complex. In conclusion, the feedback loop between MVC DNA replication and the intra-S-phase arrest is mediated by ATM-SMC1 signaling and plays a critical role in MVC DNA replication. Thus, our findings unravel the mechanism underlying DDR signaling-facilitated MVC DNA replication and demonstrate a novel strategy of DNA virus-host interaction.

  7. Lateral growth arrest of the proximal femoral physis: a new technique for serial radiological observation. (United States)

    McGillion, S; Clarke, N M P


    Lateral growth arrest is recognised as the most common form of avascular necrosis (AVN) seen in the management of developmental dysplasia of the hip (DDH). The purpose of this report is to present a new technique that is of benefit in the early identification and subsequent radiological monitoring of lateral growth arrest and which may permit appropriate timely surgical intervention. We performed a retrospective review of the medical records and serial radiographs of 11 patients (three males and eight females) with lateral growth disturbance in the proximal femoral physis. We devised a new technique (named the 'Tilt angle') for serial radiographic observation of lateral growth arrest. This study included 11 hips in 11 patients. Ten patients had screw epiphyseodesis performed after progression of lateral growth arrest was noted. One patient did not have screw epiphyseodesis but the results for this patient are included, as they provide an interesting 'control' case for comparison. The average age of screw epiphyseodesis was 12 years. Seven patients demonstrated improvement in their tilt angle following screw epiphyseodesis (i.e. less valgus), one showed no change and two continued to decline. Using a new technique to monitor the progression of lateral growth arrest, we noted that screw epiphyseodesis can be used for guided growth of the proximal femoral physis. This technique can be employed for serial radiographic observation of lateral growth arrest and can guide the clinician on the optimal timing of screw epiphyseodesis. Further studies are needed in order to clarify the optimal timing of screw epiphyseodesis.

  8. Shock duration after resuscitation is associated with occurrence of post-cardiac arrest acute kidney injury. (United States)

    Kim, Yong Won; Cha, Kyoung Chul; Cha, Yong Sung; Kim, Oh Hyun; Jung, Woo Jin; Kim, Tae Hoon; Han, Byoung Keun; Kim, Hyun; Lee, Kang Hyun; Choi, Eunhee; Hwang, Sung Oh


    This retrospective observational study investigated the clinical course and predisposing factors of acute kidney injury (AKI) developed after cardiac arrest and resuscitation. Eighty-two patients aged over 18 yr who survived more than 24 hr after cardiac arrest were divided into AKI and non-AKI groups according to the diagnostic criteria of the Kidney Disease/Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for AKI. Among 82 patients resuscitated from cardiac arrest, AKI was developed in 66 (80.5%) patients (AKI group) leaving 16 (19.5%) patients in the non-AKI group. Nineteen (28.8%) patients of the AKI group had stage 3 AKI and 7 (10.6%) patients received renal replacement therapy during admission. The duration of shock developed within 24 hr after resuscitation was shorter in the non-AKI group than in the AKI group (OR 1.02, 95% CI 1.01-1.04, P cardiac arrest AKI was the duration of shock. In conclusion, occurrence and severity of post-cardiac arrest AKI is associated with the duration of shock after resuscitation. Renal replacement therapy is required for patients with severe degree (stage 3) post-cardiac arrest AKI.

  9. Recent developments in the management of patients resuscitated from cardiac arrest. (United States)

    Jentzer, Jacob C; Clements, Casey M; Murphy, Joseph G; Scott Wright, R


    Cardiac arrest is the leading cause of death in Europe and the United States. Many patients who are initially resuscitated die in the hospital, and hospital survivors often have substantial neurologic dysfunction. Most cardiac arrests are caused by coronary artery disease; patients with coronary artery disease likely benefit from early coronary angiography and intervention. After resuscitation, cardiac arrest patients remain critically ill and frequently suffer cardiogenic shock and multiorgan failure. Early cardiopulmonary stabilization is important to prevent worsening organ injury. To achieve best patient outcomes, comprehensive critical care management is needed, with primary goals of stabilizing hemodynamics and preventing progressive brain injury. Targeted temperature management is frequently recommended for comatose survivors of cardiac arrest to mitigate the neurologic injury that drives outcomes. Accurate neurologic assessment is central to managing care of cardiac arrest survivors and should combine physical examination with objective neurologic testing, with the caveat that delaying neurologic prognosis is essential to avoid premature withdrawal of supportive care. A combination of clinical findings and diagnostic results should be used to estimate the likelihood of functional recovery. This review focuses on recent advances in care and specific cardiac intensive care strategies that may improve morbidity and mortality for patients after cardiac arrest. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. [Serum neuron-specific enolase as a prognostic marker after a cardiac arrest]. (United States)

    Rech, Tatiana H; Vieira, Silvia Regina Rios; Brauner, Janete Salles


    Cardiac arrest is a state of severe cerebral perfusion deficit. Patients recovering from a cardiopulmonary resuscitation are at great risk of subsequent death or incapacitating neurologic injury, including persistent vegetative state. The early definition of prognosis for these patients has ethical and economic implications. The main purpose of this manuscript was to review the prognostic value of serum Neuron-Specific Enolase (NSE) in predicting outcomes in patients early after a cardiac arrest. Severe neurologic disability is the most feared complication after a cardiac arrest. Many studies are trying to find prognostic markers that can be associated with outcomes in patients surviving a cardiac arrest. Biochemical markers of neuronal injury seem to be promising in this scenario. Therefore, NSE levels have been studied in patients after a cardiac arrest and high enzyme levels suggest more extensive brain damage and are associated with unfavorable clinical outcomes. Outcome after a cardiac arrest is mostly determined by the degree of hypoxic brain damage and early determinations of serum NSE level can be a valuable ancillary method for assessing outcome in these patients.

  11. Association between blood pressure and outcomes in patients after cardiac arrest: A systematic review. (United States)

    Bhate, Tahara D; McDonald, Braedon; Sekhon, Mypinder S; Griesdale, Donald E G


    Hypoxic ischaemic brain injury (HIBI) is a major cause of disability after cardiac arrest. HIBI leads to impaired cerebral autoregulation such that adequate cerebral perfusion becomes critically dependent on blood pressure. However, the optimal blood pressure after cardiac arrest remains unclear. Therefore, we conducted a systematic review to investigate the association between blood pressure and neurologic outcome patients after cardiac arrest. We systematically searched MEDLINE, EMBASE, conference abstracts and article references to identify randomized and observational studies investigating the relationship between blood pressure and neurologic outcome. We included studies that reported adjusted point estimates for the relationship between blood pressure and neurologic status in adult patients after cardiac arrest. We included 9 studies with a total of 13,150 patients. Three studies included only patients with an out-of-hospital cardiac arrest. There was marked between-study heterogeneity with respect to blood pressure definition (MAP vs. systolic), exposure duration and modelling (dichotomous vs. continuous). All studies examined either mortality or neurological status as an outcome. Seven of nine studies demonstrated that higher blood pressure was associated with improved outcomes either by an association between higher MAP and good neurologic outcome or the presence of hypotension and increased odds of mortality. The included studies suggest improved neurologic outcomes are associated with higher blood pressures in patients after cardiac arrest. This study highlights a need for further research to define the optimal management of blood pressure in this population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Advanced cardiac life support and defibrillation in severe hypothermic cardiac arrest. (United States)

    Lee, Christopher H; Van Gelder, Carin; Burns, Kevin; Cone, David C


    The application of Advanced Cardiac Life Support (ACLS) in severe hypothermic cardiac arrest remains controversial. While the induction of mild hypothermia has been shown to improve outcomes in patients already resuscitated from cardiac arrest, it is unknown whether ACLS protocols are effective during the resuscitation of the severely hypothermic cardiac arrest patient. We describe a case of a 47-year-old man who was successfully resuscitated from a ventricular fibrillation (VF) arrest with a core body temperature of 26.4 degrees C. The patient had been found unresponsive in a bathtub of cold water following an apparent suicide attempt. An incorrect pronouncement of death by the fire department delayed his transport to the hospital by more than four hours. Once in the emergency department (ED), the patient sustained a VF cardiac arrest and was successfully defibrillated using ACLS protocols. He ultimately survived his hospitalization with near-complete neurologic recovery. In this case report, we discuss the application of ACLS to the resuscitation of the hypothermic cardiac arrest patient as well as the issues involved in the prehospital determination of death.

  13. Occurrence of spontaneous and audiogenic seizures following global brain ischaemia due to cardiac arrest. (United States)

    Ułamek-Kozioł, Marzena; Kocki, Janusz; Bogucka-Kocka, Anna; Januszewski, Sławomir; Czuczwar, Stanisław J; Pluta, Ryszard


    Transient cardiac arrest due to cardiac vessel bundle occlusion was used to produce a rat model of spontaneous and audiogenic seizures. Among the rats, spontaneous seizures were present in 64%, and audiogenic seizures could be evoked in 86%, during two weeks of survival after cardiac arrest, by exposure to a loud sound produced by rattling keys, beginning one day after the post-ischaemic injury. Data from literature suggested a key role for GABA-ergic system widespread dysfunction especially in the hippocampus in post-cardiac arrest onset of audiogenic seizures. Reduced GABA inhibition in the hippocampus seems responsible for audiogenic seizures following cardiac arrest. In summary it may be considered that the occurrence of audiogenic seizures following cardiac arrest is determined not only by a neuronal loss, especially in the hippocampus, but also by a condition of synapse modification by a regenerative phenomenon. Data from our study clearly indicate that global brain ischaemia due to cardiac arrest may induce the susceptibility to spontaneous and audiogenic seizures, but this effect is transient.

  14. A profile of out-of-hospital cardiac arrests in Northern Emirates, United Arab Emirates (United States)

    Batt, Alan M.; Al-Hajeri, Ahmed S.; Cummins, Fergal H.


    Objectives: To report the characteristics of out-of-hospital cardiac arrest patients and their outcomes in the emirates of Sharjah, Ras-al-Khaimah, Umm Al-Quwain, Fujairah, and Ajman in the United Arab Emirates (collectively known as the Northern Emirates). Methods: This is a prospective descriptive cohort study of out-of-hospital cardiac arrest incidents transported by the national ambulance crews between February 2014 and March 2015 in the Northern Emirates. Results: A total of 384 patients were enrolled in this study. Male victims of out-of-hospital cardiac arrest represented 76% of the participants. The mean age of the study population was 50.9 years. An over-all prehospital return of spontaneous circulation rate of 3.1% was documented, as well as a 30% rate of bystander cardiopulmonary resuscitation being performed. Public access defibrillators were applied in 0.5% of cases. Data is presented according to Utstein reporting criteria. Conclusion: Baseline data for out-of-hospital cardiac arrest was established for the first time in the Northern Emirates of the United Arab Emirates. A low survival rate for out-of-hospital cardiac arrest, low rates of bystander cardiopulmonary resuscitation, and low public access defibrillator use were discovered. Although low by comparison to established western systems results are similar to other systems in the region. Determining the baseline data presented in this study is essential in recommending and implementing strategies to reduce mortality from out-of-hospital cardiac arrest. PMID:27761558

  15. Explaining lifetime criminal arrests among clients of a psychiatric probation and parole service. (United States)

    Solomon, P; Draine, J


    This study examines the extent to which sociodemographic characteristics, clinical characteristics, substance abuse problems, and the array of lifetime criminal behavior may explain lifetime arrests among offenders supervised by the psychiatric probation and parole service. Three hundred twenty-five clients with new cases at a psychiatric probation and parole service in a large urban center were screened for major psychiatric disorders. They were also interviewed for socio-demographic characteristics, mental health treatment history, criminal behavior, and arrest history. Hierarchical block multiple regression analysis tested a model explaining lifetime arrests. After controlling for age and other demographic variables, the number of lifetime psychiatric hospitalizations and lifetime occurrences of mania diagnosis significantly explained lifetime arrests. The total model explained about 10 percent of the variance in lifetime arrests after controlling for opportunity variables, which explained 45 percent. The explanatory power of lifetime hospitalizations and mania support the contention that symptoms, rather than diagnosis, may be the most important clinical factor in explaining criminal arrest among persons with mental illness. Implications for psychiatric services include the development of effective jail diversion programs.

  16. Assessment of surge arrester failure rate and application studies in Hellenic high voltage transmission lines

    Energy Technology Data Exchange (ETDEWEB)

    Christodoulou, C.A.; Fotis, G.P.; Gonos, I.F.; Stathopulos, I.A. [National Technical University of Athens, School of Electrical and Computer Engineering, High Voltage Laboratory, 9 Iroon Politechniou St., Zografou Campus, 157 80 Athens (Greece); Ekonomou, L. [A.S.PE.T.E. - School of Pedagogical and Technological Education, Department of Electrical Engineering Educators, N. Heraklion, 141 21 Athens (Greece)


    The use of transmission line surge arresters to improve the lightning performance of transmission lines is becoming more common. Especially in areas with high soil resistivity and ground flash density, surge arresters constitute the most effective protection mean. In this paper a methodology for assessing the surge arrester failure rate based on the electrogeometrical model is presented. Critical currents that exceed arresters rated energy stress were estimated by the use of a simulation tool. The methodology is applied on operating Hellenic transmission lines of 150 kV. Several case studies are analyzed by installing surge arresters on different intervals, in relation to the region's tower footing resistance and the ground flash density. The obtained results are compared with real records of outage rate showing the effectiveness of the surge arresters in the reduction of the recorded failure rate. The presented methodology can be proved valuable to the studies of electric power systems designers intending in a more effective lightning protection, reducing the operational costs and providing continuity of service. (author)

  17. SMC1-Mediated Intra-S-Phase Arrest Facilitates Bocavirus DNA Replication (United States)

    Luo, Yong; Deng, Xuefeng; Cheng, Fang; Li, Yi


    Activation of a host DNA damage response (DDR) is essential for DNA replication of minute virus of canines (MVC), a member of the genus Bocavirus of the Parvoviridae family; however, the mechanism by which DDR contributes to viral DNA replication is unknown. In the current study, we demonstrate that MVC infection triggers the intra-S-phase arrest to slow down host cellular DNA replication and to recruit cellular DNA replication factors for viral DNA replication. The intra-S-phase arrest is regulated by ATM (ataxia telangiectasia-mutated kinase) signaling in a p53-independent manner. Moreover, we demonstrate that SMC1 (structural maintenance of chromosomes 1) is the key regulator of the intra-S-phase arrest induced during infection. Either knockdown of SMC1 or complementation with a dominant negative SMC1 mutant blocks both the intra-S-phase arrest and viral DNA replication. Finally, we show that the intra-S-phase arrest induced during MVC infection was caused neither by damaged host cellular DNA nor by viral proteins but by replicating viral genomes physically associated with the DNA damage sensor, the Mre11-Rad50-Nbs1 (MRN) complex. In conclusion, the feedback loop between MVC DNA replication and the intra-S-phase arrest is mediated by ATM-SMC1 signaling and plays a critical role in MVC DNA replication. Thus, our findings unravel the mechanism underlying DDR signaling-facilitated MVC DNA replication and demonstrate a novel strategy of DNA virus-host interaction. PMID:23365434

  18. Arrested embryonic development: a review of strategies to delay hatching in egg-laying reptiles (United States)

    Rafferty, Anthony R.; Reina, Richard D.


    Arrested embryonic development involves the downregulation or cessation of active cell division and metabolic activity, and the capability of an animal to arrest embryonic development results in temporal plasticity of the duration of embryonic period. Arrested embryonic development is an important reproductive strategy for egg-laying animals that provide no parental care after oviposition. In this review, we discuss each type of embryonic developmental arrest used by oviparous reptiles. Environmental pressures that might have directed the evolution of arrest are addressed and we present previously undiscussed environmentally dependent physiological processes that may occur in the egg to bring about arrest. Areas for future research are proposed to clarify how ecology affects the phenotype of developing embryos. We hypothesize that oviparous reptilian mothers are capable of providing their embryos with a level of phenotypic adaptation to local environmental conditions by incorporating maternal factors into the internal environment of the egg that result in different levels of developmental sensitivity to environmental conditions after they are laid. PMID:22438503

  19. Predicting the Presence of an Acute Coronary Lesion Among Patients Resuscitated From Cardiac Arrest. (United States)

    Waldo, Stephen W; Chang, Lee; Strom, Jordan B; O'Brien, Cashel; Pomerantsev, Eugene; Yeh, Robert W


    A mechanism to stratify patients resuscitated from a cardiac arrest according to the likelihood of an acute coronary lesion would have significant utility. We thus sought to develop and validate a risk prediction model for the presence of an acute coronary lesion among patients resuscitated from an arrest. All subjects undergoing coronary angiography after resuscitation from a cardiac arrest were identified in an ongoing institutional registry from 2009 to 2014. Backwards stepwise selection of candidate covariates was used to create a logistic regression model for the presence of an angiographic culprit lesion and internally validated with bootstrapping. A clinical point score was generated and its prognostic abilities compared with contemporary measures. Among 247 subjects undergoing coronary angiography after resuscitation from a cardiac arrest, 130 (52%) had an acute lesion in a coronary artery. A multivariable model-including angina, congestive heart failure symptoms, shockable arrest rhythm (ventricular fibrillation/ventricular tachycardia), and ST-elevations-had excellent discrimination (optimism corrected C-Statistic, 0.88) and calibration (Hosmer-Lemeshow P=0.540) for an acute coronary lesion. Compared with electrocardiographic findings alone, a point score based on this model more accurately predicted the presence of an acute lesion among patients resuscitated from a cardiac arrest (integrated discrimination improvement, 0.10; 95% confidence interval, 0.04-0.19; Plesion using 4 easily measured variables. This simple risk score may be used to improve patient selection for emergent coronary angiography among resuscitated patients. © 2015 American Heart Association, Inc.

  20. Pathological Internet Use Is on the Rise Among European Adolescents. (United States)

    Kaess, Michael; Parzer, Peter; Brunner, Romuald; Koenig, Julian; Durkee, Tony; Carli, Vladimir; Wasserman, Camilla; Hoven, Christina W; Sarchiapone, Marco; Bobes, Julio; Cosman, Doina; Värnik, Airi; Resch, Franz; Wasserman, Danuta


    Increased Internet accessibility has been accompanied by an increased awareness of pathological Internet use (PIU). The aim of the study was to investigate a potential increase of PIU among European adolescents. Comparable data from two large cross-sectional multicentre, school-based studies conducted in 2009/2010 and 2011/2012 in five European countries (Estonia, Germany, Italy, Romania, and Spain) were used. The Young's Diagnostic Questionnaire was used to assess the prevalence of PIU. The comparison of the two samples provides evidence that the prevalence of PIU is on the rise (4.01%-6.87%, odds ratio = 1.69, p Internet accessibility suggests that the rise in prevalence of adolescent PIU may be a consequence of increased Internet accessibility. Our findings are the first data to confirm the rise of PIU among European adolescents. They definitively warrant further efforts in the implementation and evaluation of preventive interventions. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.