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The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.
Hypothesis/Problem:
The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.
Methods:
The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable survival, as defined by cerebral performance category (CPC).
Results:
Neurologically favorable survival was statistically significantly associated with CV-CPR in pediatric patients aged five to 15 years (aOR = 2.68; 95% CI, 1.10–6.77; P = .03), as well as all age group survival to hospital discharge (aOR = 1.54; 95% CI, 1.01–2.36; P = .046). There was a trend with CV-CPR toward neurologically favorable survival in all age groups (aOR = 1.35; 95% CI, 0.86–2.10; P = .19) and all age group survival to hospital admission (aOR = 1.29; 95% CI, 0.91–1.84; P = .157).
Conclusion:
In cases of cardiac arrest following drowning, bystander CV-CPR was statistically significantly associated with neurologically favorable survival in children aged five to 15 years and survival to hospital discharge.
Cover crops are known to promote many aspects of soil and water quality, yet estimates find that in 2012 only 2.3% of the total agricultural lands in the Midwestern USA were using cover crops. Focus groups were conducted across the Corn Belt state of Iowa to better understand how farmers confront barriers to cover crop adoption in highly intensive agricultural production systems. Although much prior research has focused on analyzing factors that help predict cover crop use on farms, there is limited research on how farmers navigate and overcome field-level (e.g. proper planting of a cover crop) and structural barriers (e.g. market forces) associated with the use of cover crops. The results from the analysis of these conversations suggest that there is a complex dialectical relationship between farmers' individual management decisions and the broader agricultural context in the region that constrains their decisions. Farmers in these focus groups shared how they navigate complex management decisions within a generally homogenized agricultural and economic landscape that makes cover crop integration challenging. Many who joined the focus groups have found ways to overcome barriers and successfully integrate cover crops into their cropping systems. This is illustrated through farmers' descriptions of their ‘whole system’ approach to cover crops management, where they described how they prioritize the success of their cover crops by focusing on multiple aspects of management, including changes they have made to nutrient application and modifications to equipment. These producers also engage with farmer networks to gain strategies for overcoming management challenges associated with cover crops. Although many participants had successfully planted cover crops, they tended to believe that greater economic incentives and/or more diverse crop and livestock markets would be needed to spur more widespread adoption of the practice. Our results further illustrate how structural and field-level barriers constrain individual actions, as it is not simply the basic agronomic considerations (such as seeding and terminating cover crops) that pose a challenge to their use, but also the broader economic and market drivers that exist in agriculturally intensive systems. Our study provides evidence that reducing structural barriers to adoption may be necessary to increase the use of this conservation practice to reduce environmental impacts associated with intensive agricultural production.
We describe the cases of two children who both presented in infancy with recurrent severe pulmonary hypertensive crises. Exhaustive clinical work-up failed to identify an underlying aetiology. The patients had no clinical response to steroids, immunoglobulins, or pulmonary vasodilators. Post-mortem examination revealed extensive invasive pulmonary capillary haemangiomatosis. There was no evidence of pulmonary venous occlusive disease. Given the lethal nature of this condition, early consideration of referral to a lung transplant centre should be considered in selected patients.
In Navajo Nation v. U.S. Forest Service, 535 F.3d 1058 (9th Cir. 2008), cert. denied, 129 S. Ct. 2763 (2009), the Ninth Circuit seated en banc found that federal approval of a plan by a ski resort to make artificial snow with treated sewage effluent on Arizona's San Francisco Peaks, a mountain massif held sacred by the Navajo, Hopi, and four other claimant tribes, did not violate their religious liberty under the Religious Freedom Restoration Act (RFRA). The court accepted numerous factual findings about sincere religious exercise, but found federal approval of the scheme did not constitute a “substantial burden” on religion; rather, it only “decreased spiritual fulfillment” of tribal members. Despite a spirited dissent, the Ninth Circuit narrowly interpreted RFRA's language of “substantial burden” by making reference to the Supreme Court's 1988 holding in Lyng v. Northwest Cemetery Protective Association, 485 U.S. 439 (1988). This article shows how conventional wisdom about individualistic, subjective, and protean “spirituality” and in particular about “Native American spirituality” equips the court to denature highly specific and collective religious claims about the mountain by plaintiff tribes, and in turn to naturalize those claims as merely spiritual. Misrecognition of Native religions as Native spirituality then troubles the substantial burden analysis. While Navajo Nation suggests courts may never fully understand Native claims to sacred sites, the Supreme Court's 2014 holding in Burwell v. Hobby Lobby, Inc., 134 S. Ct. 2751, 2759 (2014), opens the door to revisiting the interpretive posture spelled out in Navajo Nation, and the Ninth Circuit's interpretive approach to “substantial burden” bears revisiting.
The apparatus for X-ray diffraction imaging (XRDI) of 450-mm wafers, is now placed at the ANKA synchrotron radiation source in Karlsruhe, is described in the context of the drive to inspect wafers for plastic deformation or mechanical damage. It is shown that full wafer maps at high resolution can be expected to take a few hours to record. However, we show from experiments on 200-, 300-, and 450-mm wafers that a perimeter-scan on a 450-mm wafer, to pick up edge damage and edge-originated slip sources, can be achieved in just over 10 min. Experiments at the Diamond Light Source, on wafers still in their cassettes, suggest that clean-room conditions may not be necessary for such characterization. We conclude that scaling up of the 300-mm format Jordan Valley tools, together with the existing facility at ANKA, provides satisfactory capability for future XRDI analysis of 450-mm wafers.
The purpose of this article is to set the context for this special issue of Disaster Medicine and Public Health Preparedness on the allocation of scarce resources in an improvised nuclear device incident. A nuclear detonation occurs when a sufficient amount of fissile material is brought suddenly together to reach critical mass and cause an explosion. Although the chance of a nuclear detonation is thought to be small, the consequences are potentially catastrophic, so planning for an effective medical response is necessary, albeit complex. A substantial nuclear detonation will result in physical effects and a great number of casualties that will require an organized medical response to save lives. With this type of incident, the demand for resources to treat casualties will far exceed what is available. To meet the goal of providing medical care (including symptomatic/palliative care) with fairness as the underlying ethical principle, planning for allocation of scarce resources among all involved sectors needs to be integrated and practiced. With thoughtful and realistic planning, the medical response in the chaotic environment may be made more effective and efficient for both victims and medical responders.
(Disaster Med Public Health Preparedness. 2011;5:S20-S31)
The nucleation of dislocations at indents in silicon following rapid thermal annealing (RTA) has been examined by X-ray diffraction imaging (topography). For indentation loads below 200 mN, no slip bands were generated from the indent sites following RTA at 1000 °C under spike conditions. Upon plateau annealing at 1000 °C, slip dislocations were propagated from some indents but not all. Slip was also observed from edge defects not associated with indentation. For 500-mN indentation load, large scale dislocation sources were generated from the indent sites propagating on two of the four {111} slip planes. These dislocations multiplied into macroscopic-scale slip bands. A significant change in morphology was observed in the 60° dislocation segments after the screw segment reached the rear surface of the wafer. Dislocations changed line direction and in some cases appeared to leave the Peierls trough during glide.
How do students learn astronomy? How can the World-Wide Web be used to teach? And how do planetariums help with educating the public? These are just some of the timely questions addressed in this stimulating review of new trends in the teaching of astronomy. Based on an international meeting hosted by the University of London and the Open University (IAU Colloquium 162), this volume presents articles by experts from around the world. The proceedings of the first IAU Colloquium (105), The Teaching of Astronomy, edited by Percy and Pasachoff, were first published in 1990 and soon became established as the definitive resource for astronomy teachers. Astronomy education has advanced enormously in the intervening 7 years, and this sequel will inspire and encourage teachers of astronomy at all levels and provide them with wealth of ideas and experience on which to build.
Four equally spaced feeding levels, estimated to cover the range of commercial practice, were examined using a total of 208 pigs over the live-weight range 28–100 kg. The pigs were penned in groups of six or eight and were balanced for sex within pens. Three centres participated in the experiment contributing five, two and one replicates respectively.
Efficiency of feed conversion was not significantly affected over the range of feed intakes studied, thus daily gain was linearly related to feed intake. A 10 decrease in feed intake increased killing-out percentage by 0·3 unit and decreased backfat thickness by 1 mm at both the shoulder and mid rump. The corresponding changes in the percentages of subcutaneous fat plus skin and meat were similar in magnitude at approximately 0·85 unit.
Muscle quality was reduced with higher feed intakes but weight of liver, as increased. Details of other offal weights and carcass measurements are given.
An abattoir survey was undertaken to determine the prevalence of foodborne zoonotic organisms colonizing cattle, sheep and pigs at slaughter in Great Britain. The study ran for 12 months from January 2003, involved 93 abattoirs and collected 7703 intestinal samples. The design was similar to two previous abattoir surveys undertaken in 1999–2000 allowing comparisons. Samples were examined for VTEC O157, Salmonella, thermophilic Campylobacter and Yersinia enterocolitica. The prevalence of VTEC O157 faecal carriage was 4·7% in cattle, 0·7% in sheep and 0·3% in pigs. A significant decrease in sheep was detected from the previous survey (1·7%). Salmonella carriage was 1·4% in cattle, a significant increase from the previous survey of 0·2%. In sheep, faecal carriage was 1·1% a significant increase from the previous survey (0·1%). In pigs, carriage was 23·4%, consistent with the previous study. Thermophilic Campylobacter spp. were isolated from 54·6% of cattle, 43·8% of sheep and 69·3% of pigs. Y. enterocolitica was isolated from 4·5% of cattle, 8·0% of sheep and 10·2% of pigs.
Sheet resistance (Rs) reductions are presented for antimony and arsenic doped layers produced in strained Si. Results re-emphasise the Rs reduction for As comes purely as a result of mobility improvement whereas for Sb, a superior lowering is observed from improvements in both mobility and activation. For the first time, strain is shown to enhance the activation of dopant atoms whilst Sb is seen to create stable ultra-shallow junctions. Our results propose Sb as a viable alternative to As for the creation of highly activated, low resistance ultra-shallow junctions for use with strain-engineered CMOS devices.
Bio-inspired assembly, through the use of bio-molecules such as DNA and proteins, will play a critical role in the advancement of novel sensing techniques and for the realization of heterogeneous integration of materials. For many of these applications, such as antibody-based biosensor and the study of controlled cell growth, DNA and protein patterning techniques are crucial. We will present an update of our work on protein patterning techniques using microelectronic fabrication, DNA hybridization and biotin-streptavidin pairing. To show its application in biological inspired self-assembly, this technique was used successfully in the self-assembly of 20 nm streptavidin conjugated gold particles. In addition, the integration of nano-and micro-scale heterogeneous materials is very important for novel material synthesis and electro-optic applications. We will present an update on our work to assemble silicon electronic devices using DNA/charged molecules and electric fields. Devices are fabricated, released, charged with molecules, and subsequently manipulated in electric fields. The techniques described can be used to integrate the hybrid devices such as nano- or micro-scale resistors, PN diodes, and MOSFETs on silicon or other substrates such as glass, plastic, etc.
Protein patterning techniques are crucial for the development of antibody-based biosensor and the study of controlled cell growth. This paper discusses a protein patterning technique based on microelectronic fabrication, DNA hybridization and biotin-streptavidin pair. A gold-on-silicon-dioxide substrate with micron size pattern was fabricated with photolithography and lift-off process. The average surface roughness of the gold pattern is 4.3 nm, measured by contact mode AFM. Thiol derivatized single stranded DNA was attached to the gold pattern surface by the chemical bonding between gold atom and sulfur atom. Surface attached DNA was then hybridized with a biotin conjugated complementary DNA sequence. Thus, the gold pattern was translated into a biotin pattern with similar resolution. Fluorescein conjugated streptavidin was patterned as demonstration. Fluorescence microscopy shows relative uniform streptavidin coverage of micron resolution and low background non-specific binding. The proposed protein patterning technique takes advantage of the high resolution of modern microelectronic fabrication. It has the potential of reaching sub-micron resolution. The biotin-streptavidin pair provides extremely specific and stable linking for protein immobilization. To show its application in biological inspired self-assembly, this technique was used successfully in the self-assembly of 20 nm streptavidin conjugated gold particles.
Protein patterning techniques are crucial for the development of antibody-based biosensor and the study of controlled cell growth. This paper discusses a protein patterning technique based on microelectronic fabrication, DNA hybridization and biotin-streptavidin pair. A gold-on-silicon-dioxide substrate with micron size pattern was fabricated with photolithography and lift-off process. The average surface roughness of the gold pattern is 4.3 nm, measured by contact mode AFM. Thiol derivatized single stranded DNA was attached to the gold pattern surface by the chemical bonding between gold atom and sulfur atom. Surface attached DNA was then hybridized with a biotin conjugated complementary DNA sequence. Thus, the gold pattern was translated into a biotin pattern with similar resolution. Fluorescein conjugated streptavidin was patterned as demonstration. Fluorescence microscopy shows relative uniform streptavidin coverage of micron resolution and low background non-specific binding. The proposed protein patterning technique takes advantage of the high resolution of modern microelectronic fabrication. It has the potential of reaching sub-micron resolution. The biotin-streptavidin pair provides extremely specific and stable linking for protein immobilization. To show its application in biological inspired self-assembly, this technique was used successfully in the self-assembly of 20 nm streptavidin conjugated gold particles.
In recent years, there has been a merger of microelectronics and biological sciences to develop integrated nano and micro-scale biosensors or biochips. The implementation of portable, rapid and economic methods for detecting different biological species on a chip will benefit from the development of electronic means for the analysis of cells. Neurons are very attractive as chemical sensors due to their sensitivity to specific toxins and their unique electrical properties. The use of closed well micro-fluidic devices for the growth of neurons has not been explored extensively. In this work, we will describe surface preparation techniques to enhance the neuronal cell viability and growth on microfabricated surfaces. We have fabricated micro-fluidic bio-chips for the trapping of neurons and to examine their growth. Neural cells are maintained in a chamber on the chip with fresh nutrient media continuously flowing through the chamber. The temporal viability of the neural cells within the chip will be reported. The long-term goals of the project include electrically measuring the viability of the cells inside the micro-fluidic chambers.