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Introduction: Prompt defibrillation is critical during paediatric cardiac arrest. The main objective of this systematic review was to determine the initial defibrillation energy dose for ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) that is associated with sustained return of spontaneous circulation (ROSC) during paediatric cardiac arrest. Associations between initial defibrillation energy dose with any ROSC, survival and defibrillation-induced complications were also assessed. Methods: A systematic review was performed using four databases (Medline, Embase, Web of Science, Cochrane Library) (PROSPERO: CRD42016036734). Human studies (cohort studies or controlled trials) and animal model studies (controlled trials) of pediatric cardiac arrest involving assessment of external defibrillation energy dosing were considered. The primary outcome was sustained ROSC. Two researchers independently reviewed all the titles and abstracts of the retrieved citations, selected the studies and extracted the data using a standardized template. Risk of bias of human non-randomised studies were assessed using the ROBIN-I tool (formerly ACROBAT-NRSI) tool proposed by the Cochrane Collaboration group. Results: The search strategy identified 14,471 citations of which 232 manuscripts were reviewed. Ten human and 10 animal model studies met the inclusion criteria. Human studies were prospective (n = 6) or retrospective (n = 4) cohort studies and included between 11 and 266 patients (median = 46 patients). Sustained ROSC rates ranged from 0 to 61% (n = 7). No studies reported a statistically significant association between the initial defibrillation energy dose and the rate of sustained ROSC (n = 7) or survival (n = 6). No human studies reported defibrillation-induced complications. Meta-analysis was not considered appropriate due to clinical heterogeneity. The overall risk of bias was moderate. All animal studies were randomized controlled trials with 8 and 52 (median = 27) piglets. ROSC was frequently achieved (more than 85%) with energy dose ranging from 2 to 7 joules/kg (n = 7). The defibrillation threshold varied according to the body weight and appears to be higher in infant models. Conclusion: Defibrillation energy doses and thresholds varied according to the body weight and trended higher for infants. No definitive association between initial defibrillation doses and the outcomes of sustained ROSC or survival could be demonstrated.
Introduction: Head injury is a common presentation to all emergency departments. Previous research has shown that such injuries may be complicated by delayed intracranial hemorrhage (D-ICH) after the initial scan is negative. Exposure to anticoagulant or anti-platelet medications (ACAP) may be a risk factor for D-ICH. We have conducted a systematic review and meta-analysis to determine the incidence of delayed traumatic intracranial hemorrhage in patients taking anticoagulants, anti-platelets or both. Methods: The literature search was conducted in March 2017 with an update in April 2017. Keyword and MeSH terms were used to search OVID Medline, Embase and the Cochrane database as well as grey literature sources. All cohort and experimental studies were eligible for selection. Inclusion criteria included pre-injury exposure to oral anticoagulant and / or anti-platelet medication and a negative initial CT scan of the brain (CT1). The primary outcome was delayed intracranial hemorrhage present on repeat CT scan (CT2) within 48 hours of the presentation. Only patients who were rescanned or observed minimally were included. Clinically significant D-ICH were those that required neurosurgery, caused death or necessitated a change in management strategy, such as admission. Results: Fifteen primary studies were ultimately identified, comprising a total of 3801 patients. Of this number, 2111 had a control CT scan. 39 cases of D-ICH were identified, with the incidence of D-ICH calculated to be 1.31% (95% CI [0.56, 2.27]). No more than 12 of these patients had a clinically significant D-ICH representing 0.09% (95% CI [0.00, 0.31]). 10 of them were on warfarin and two on aspirin. There were three deaths recorded and three patients needed neurosurgery. Conclusion: The relatively low incidence suggests that repeat CT should not be mandatory for patients without ICH on first CT. This is further supported by the negligibly low rate of clinically significant D-ICH. Evidence-based assessments should be utilised to indicate the appropriate discharge plan, with further research required to guide the balance between clinical observation and repeat CT.
New simultaneous X-ray and radio observations of the archetypal mode-switching pulsar PSR B0943+10 have been carried out with XMM-Newton and the LOFAR, LWA and Arecibo radio telescopes in November 2014. They allowed us to better constrain the X-ray spectral and variability properties of this pulsar and to detect, for the first time, the X-ray pulsations also during the X-ray-fainter mode. The combined timing and spectral analysis indicates that unpulsed non-thermal emission, likely of magnetospheric origin, and pulsed thermal emission from a small polar cap are present during both radio modes and vary in a correlated way.
Introduction: Mild traumatic brain injury (mTBI) is a major cause of morbidity but there are no validated tools to help clinicians predict post-concussion symptoms. This systematic review and meta-analysis aimed to determine the prognostic value of S-100B protein to predict post-concussion symptoms following a mTBI in adults. Methods: The protocol of this systematic review was registered with the PROSPERO database (CRD42016032578). A search strategy was performed on seven databases (CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, Web of Knowledge, PyscBITE, PsycINFO) from their inception to October 2016. Studies evaluating the association between S-100B protein level and post-concussion symptoms assessed at least seven days after the mTBI were eligible. Individual patient data were requested. Studies eligibility assessment, data extraction and risk of bias assessment were performed independently by two researchers. Analyses were done following the meta-analysis using individual participant data or summary aggregate data guidelines from the Cochrane Methodology Review Group. Results: Outcomes were dichotomised as persistent (≥3 months) or early (≥7 days <3 months). Our search strategy yielded 23,298 citations of which 29 studies presenting between seven and 223 patients (n=2505) were included. Post-concussion syndrome (PCS) (16 studies), neuropsychological symptoms (9 studies) and health-related quality of life (4 studies) were the most frequently presented outcomes. The S-100B protein serum level of patients with no PCS was similar to that of patients experiencing persistent PCS (mean difference 0.00 [-0.05, 0.04]) or early PCS (mean difference 0.03 [-0.02, 0.08]). The odds of having persistent PCS (OR 0.56 (95% CI: 0.29-1.10) or early PCS (OR 1.67 (95% CI: 0.98-2.85) in patients with an elevated S-100B protein serum level was not significantly different from that of patients with normal values. No meta-analysis was performed for other outcomes than PCS due to heterogeneity and small samples. Studies’ overall risk of bias was considered moderate. Conclusion: Results suggest that the prognostic value of S-100B protein serum level to predict persistent and early post-concussion symptoms is limited. Variability in injury to S-100B protein sample time and outcomes assessed could potentially explain the lack of association and needs further evaluation.
Introduction: Mild traumatic brain injury (mTBI) is an understudied worldwide health problem and a socio-economic burden that remains a major cause of morbidity. However, there is no prognostication tool to help clinicians predict the occurrence of post-concussion symptoms. This systematic review aimed to determine the prognostic value of neuron-specific enolase (NSE) to predict post-concussion symptoms following a mTBI in adults. Methods: The protocol of this systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number CRD42016033683). Seven databases (CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, PsycBITE, PsycINFO, Web of Knowledge/Biosis) were searched for cohort studies evaluating the association between NSE levels and post-concussion symptoms assessed at least seven days after the mild TBI. Grey literature was also screened using databases on dissertations and theses as well as abstracts from relevant congresses. Two researchers independently screened studies for inclusion, extracted data, and appraised their quality using the Quality in Prognostic Studies (QUIPS) tool from the Cochrane Collaboration Group. Results: Our search strategy yielded a total of 23,298 citations from which eight cohorts presented in 10 studies were included. Studies included between 45 and 141 patients (total=608 patients). The most frequently assessed outcomes were post-concussion syndrome (PCS) (13 assessments), neuropsychological disorders (10 assessments), return to work or sick leave (2 assessments) and Glasgow Outcome Scale (GOS) (2 assessments). No association was found between an elevated NSE serum level and the occurrence of PCS. Of the 33 outcomes assessments performed, only three showed an association between a higher level of serum NSE and a post-concussion symptom (alteration of at least three cognitive domains at 2 weeks, standardised physician assessment at 6 weeks and headache at 6 months following a mild TBI). Included studies’ overall risk of bias was considered moderate. Conclusion: Results of this systematic review conclude that based on current levels of evidence, serum NSE levels alone do not provide prognostic information on persistent or early post-concussion symptoms after a mTBI.
Inkjet printing is a well-accepted deposition technology for functional materials in the area of printed electronics. It allows the precise deposition of patterned functional layers on both, rigid and flexible substrates. Furthermore, inkjet printing is considered as up-scalable technology towards industrial applications. Many electronic devices manufactured with inkjet printing have been reported in the recent years. Some of the evident examples are capacitors, resistors, organic thin film transistors and rectifying Schottky diodes. [1, 2, 3] In this paper we report on the manufacturing of an inkjet-printed metal-insulator-semiconductor (MIS) diode on flexible plastic substrate. The structure is comprised of an insulating and a polymeric semiconducting layer sandwiched between two silver electrodes. The current vs. voltage characteristics are rectifying with rectification ratio up to 100 at |4 V|. Furthermore, they can carry high current densities (up to mA/cm2) and have a low capacitance which makes them attractive for high frequency rectifying circuits. They are also an ideal candidate to replace conventional Schottky diodes for which the fabrication remains a challenge. This is because inkjet printing of Schottky diodes require additional processing steps such as intense pulsed light sintering (IPL sintering)  or post-treatments at high temperatures. The deposition of two different metal layers using inkjet printing e.g. Cu or Al with Ag is possible. However, the mentioned post treatment technologies might be incompatible with the already existing layer stack– e.g. it could degrade the organic semiconductor or can damage insulator which in this case is present in the MIS diode architecture.
The material characterization toolbox has recently experienced a number of parallel revolutionary advances, foreshadowing a time in the near future when material scientists can quantify material structure evolution across spatial and temporal space simultaneously. This will provide insight to reaction dynamics in four-dimensions, spanning multiple orders of magnitude in both temporal and spatial space. This study presents the authors’ viewpoint on the material characterization field, reviewing its recent past, evaluating its present capabilities, and proposing directions for its future development. Electron microscopy; atom probe tomography; x-ray, neutron and electron tomography; serial sectioning tomography; and diffraction-based analysis methods are reviewed, and opportunities for their future development are highlighted. Advances in surface probe microscopy have been reviewed recently and, therefore, are not included [D.A. Bonnell et al.: Rev. Modern Phys. in Review]. In this study particular attention is paid to studies that have pioneered the synergetic use of multiple techniques to provide complementary views of a single structure or process; several of these studies represent the state-of-the-art in characterization and suggest a trajectory for the continued development of the field. Based on this review, a set of grand challenges for characterization science is identified, including suggestions for instrumentation advances, scientific problems in microstructure analysis, and complex structure evolution problems involving material damage. The future of microstructural characterization is proposed to be one not only where individual techniques are pushed to their limits, but where the community devises strategies of technique synergy to address complex multiscale problems in materials science and engineering.
We report on UV Raman spectroscopy of InxGa1−xN thin films grown on (0001) sapphire substrates using a specially designed metal-organic chemical vapor deposition (MOCVD) reactor. Eight films were examined in the compositional range 0<×<0.50. Mid and deep-UV Raman spectroscopy was done with the 325.2 nm line of the HeCd laser and the 244 nm line of a double frequency Ar ion laser. The mode behavior of the A1(LO) and E2 phonons was also investigated. We have found compelling evidence for one-mode behavior for the A1(LO) phonon mode, while our data for the E2 mode deviates from the predictions for one-mode behavior. The results for the A1(LO) mode are consistent with the previously reported phonon mode behavior in AlGaN alloys. Also, evidence regarding the presence of compositional inhomogeneities and spinodal decomposition in InGaN thin films is presented.
We have investigated molecular confinement in materials with nanometer sized pores, fabricated from amorphous superlattices of a-Si:H/a-SiOx:H, using 1,10-bis(1-pyrenyl)decane as a fluorescent probe. In large (46 Å) pores, the emission and excitation spectra and their time dependence are similar to microcrystalline material, showing the presence of molecules aggregated in the ground state. This dimer emission decreases sharply as the pore size is decreased, showing that the minimum size for aggregate formation is about 20 Å.
The effect of substrate bias on the properties of rf sputtered boron nitride films on Si and GaAs substrate were investigated. IR transmission and reflectivity of films with different substrate bias were measured with Perkin Elmer 983 IR spectroscopy. From the IR reflectivity data, transverse optical mode(TO) and longitudinal optical mode(LO) frequencies were derived by fitting Kramer-Kronig model. Absorption coefficient was determined from IR transmission data. The resultant TO and LO modes showed that substrate bias caused broadening of reststrahlen band of rf sputtered boron nitride. We also tried to dope boron nitride films with silicon by alternate sputtering of BN and Si targets controlling sputtering time of each target followed by annealing. Electrical resistivity was measured over the temperature range between 175 K to 370 K for both intrinsic and Si-doped boron nitride films. Intrinsic rf sputtered boron nitride showed Little change in resistivity (109 Ω cm - 1011 Ω cm ) over the temperature range studied. While Si doped BN showed linear change in resistivity with increasing temperature and its activation energy was about 0.22 eV. The effect of substrate bias was also investigated by monitoring the XPS core level spectra of both Bis and N Is peaks, respectively. Substrate bias caused the shift of both B ls and N ls peak to higher binding energy. The effect of substrate bias on refractive index was also studied.
Fullerene (C60 and C70) synthesis by combustion of ethylene and benzene in a flat flame burner was investigated. This method of fullerene synthesis is particularly attractive because of its potential of scale up. Also the ability to change the flame conditions andcontrol the yield of C60 and C70 makes this method versatile. No fullerenes were found in soot samples collected from the ethylene flame. However, fullerenes were formed in a benzene flame with C/O = 0.88 and operated at 40 torr, with cold gas velocity of 25.3 cm/s (273 K) and containing 10% argon. The concentration of fullerenes in this flame was found to depend strongly on the height above the burner surface. It exhibited a strong maxima at about 1.0 cm above the burner height suggesting the presence of both growth and destruction mechanisms.
Boron nitride films were deposited by rf reactive sputtering. The
composition of the film was determined by X-ray photo-electron
spectroscopy(XPS). Optical properties of boron nitride were studied by IR
spectroscopy. Resultant films showed optical characteristics similar to
those of hexagonal boron nitride. The ratio of boron to nitrogen was varied
from 3.11 to 1.45 by varying the amount of nitrogen. Resulting films have
refractive index in the range of 2.05 – 3.21.
Polysilicon TFT characteristics are shown to be dependent on the nature of the polysilicon film used as well as the TFT fabrication process. Best results were obtained when silicon self-implant and regrowth techniques were used together with plasma hydrogenation. TFTs exhibiting a mobility of 115 cm2/V-sec, subthreshold slope of 0.27 V/decade, leakage current below 0.01 pA/μ;m, and an on-off ratio of 10 orders of magnitude have been fabricated.
Recent results on MOVPE growth of multilayer two-color HgCdTe detectors, for simultaneous and independent detection of medium wavelength (MW, 3–5 μm) and long wavelength (LW, 8–12 μm) bands, are reported. The structures are grown in situ on lattice matched (100) CdZnTe in the double-heterojunction p-n-N-P configuration. A barrier layer is placed between the LW and MW absorber layers to prevent diffusion of MW photocarriers into the LW junction and thereby eliminate spectral crosstalk. X-ray double crystal rocking curve widths are ∼ 45 arc-secs, indicating good epitaxial quality. SIMS depth profile measurements of these 28 μm thick structures show well-defined alloy compositions, and arsenic and iodine doping. SIMS data on a series of thirteen films show that good run-to-run repeatability is obtained on thicknesses, compositions, and dopant levels with values close to the device design targets. Depth profile of etch pits through the thickness of the films show etch pit densities in the range of 8×105-5×106 cm−2.
We have investigated the effect of biaxial strain on local electrical/electronic properties in thin films of La0.7Ca0.3MnO3 with varying degrees of biaxial strain in them. The local electrical properties were investigated as a function of temperature by scanning tunneling spectroscopy (STS) and scanning tunneling potentiometry (STP), along with the bulk probe like conductance fluctuations.
The results indicate a positive correlation between the lattice mismatch biaxial strain and the local electrical/electronic inhomogenities observed in the strained sample. This is plausible since the crystal structure of the manganites interfere rather strongly with the magnetic/electronic degrees of freedom. Thus even a small imbalance (biaxial strain) can induce significant changes in the electrical properties of the system.