Early Outcomes of Out-of-Hospital Cardiac Arrest after Early Defibrillation: a 24 Months Retrospective Analysis

Introduction: Cardiovascular disease remains the most common cause of death in the United States and most other Western nations. Among these deaths, sudden, out-of-hospital cardiac arrest claims approximately 1000 lives each day in the United States alone. Most of these cardiac arrests are due to ventricular fibrillation. Though highly reversible with the rapid application of a defibrillator, ventricular fibrillation is otherwise fatal within minutes, even when cardiopulmonary resuscitation is provided immediately. The overall survival rate in the United States is estimated to be less than 5 percent. Recent developments in automated-external-defibrillator technology have provided a means of increasing the rate of prompt defibrillation after out-of-hospital cardiac arrest. After minimal training, nonmedical personnel (e.g., flight attendants and casino workers) are also able to use defibrillators in the workplace, with lifesaving effects. Nonetheless, such programs have involved designated personnel whose job description includes assisting persons who have had sudden cardiac arrest. Data are still lacking on the success of programs in which automated external defibrillators have been installed in public places to be used by persons who have no specific training or duty to act. Materials and Methods: All patients who had an out-of-hospital cardiac arrest between January 2003 and December 2004 and who received early defibrillation for ventricular fibrillation were included. We conducted a 24 months retrospective population-based analysis of the outcome in our population. Results: Over a 24 month period, 446 people had non–traumatic cardiac arrest, and in all of them it was observed to be ventricular fibrillation. In a very few cases, the defibrillator operators were good Samaritans, acting voluntarily. Eighty-nine patients (about 19%) with ventricular fibrillation were successfully resuscitated, including eighteen who regained consciousness before hospital admission. Conclusion: Automated external defibrillators deployed in readily accessible, well-marked areas, are really very effective in assisting patients with cardiac arrest. However, it's quite true that, in the cases of survivors, most of our users had good prior training in the use of these devices

R&S e competitività internazionale in Europa: un'analisi settoriale

Scopo di questo lavoro è quello di indagare la relazione fra dinamica della R&S e dinamica delle esportazioni nei quattro principali paesi dell'Unione Europea: Francia, Germania, Italia e Regno Unito. La stima di un modello panel a effetti fissi (Least Squares Dummy Variables) per l'industria manifatturiera nel suo complesso e per quattordici settori all'interno di questa in riferimento al periodo 1981-92 evidenzia una relazione positiva e significativa tra variazione della quota di R&S di ciascun paese considerato sulla R&S totale dei paesi OCSE e variazione della quota di esportazioni di ognuno di essi sulle esportazioni totali dei paesi OCSE. In particolare, questa relazione è più forte nelle industrie dei Mezzi di trasporto, dei Prodotti chimici e farmaceutici, dei Prodotti alimentari, bevande e tabacchi, della Carta, stampa e editoria. La relazione è invece non significativa nel caso dell'industria dei Prodotti, tessili, dell'abbigliamento e delle calzature. Alla luce di questa evidenza, trova conferma l'ipotesi secondo la quale il vantaggio/svantaggio competitivo delle nazioni è associato in gran parte delle industrie alla loro capacità innovativa. The purpose is to explain the relation between the dynamics of R&D expenditures and that of exports in the four largest EU countries: France, Germany, Italy, and United Kingdom. Estimation of a fixed effects (Least Squares Dummy Variable) panel model for manufacturing as a whole and for fourteen (two digit) industries in manufacturing over the 1981-1992 period points out a positive and significant relation between variation in the share of R&D by each of the relevant countries on total R&D by all OECD countries and variation in the share of export by each of the relevant countries on total exports by OECD countries. In particular, this relation is stronger in Motor vehicles & equipment, Chemicals & pharmaceuticals, Mechanical engineering, Food, beverages & tobacco, paper & printing, whereas it turns out to be of scant significance for Textiles, clothing & footwear. In the light of these findings, further support is forthcoming to the hypothesis that the competitive advantage/disadvantage of nations is strongly connected to their innovative capability

R&S e Competitivita' internazionale nell'industria manifatturiera europea: un'analisi settoriale

The purpose is to explain the relation between the dynamics of R&D expenditures and that of exports in the four largest EU countries: France, Germany, Italy, and United Kingdom. Estimation of a fixed effects (Least Squares Dummy Variable) panel model for manufacturing as a whole and for fourteen (two digit) industries in manufacturing over the 1981-1992 period points out a positive and significant relation between variation in the share of R&D by each of the relevant countries on total R&D by all OECD countries and variation in the share of export by each of the relevant countries on total exports by OECD countries. In particular, this relation is stronger in Motor vehicles & equipment, Chemicals & pharmaceuticals, Mechanical engineering, Food, beverages & tobacco, paper & printing, whereas it turns out to be of scant significance for Textiles, clothing & footwear. In the light of these findings, further support is forthcoming to the hypothesis that the competitive advantage/disadvantage of nations is strongly connected to their innovative capability

Investigating mass segregation process in globular clusters with Blue Straggler Stars: the impact of dark remnants

We present the results of a set of N-body simulations aimed at exploring how the process of mass segregation (as traced by the spatial distribution of blue straggler stars, BSSs) is affected by the presence of a population of heavy dark remnants (as neutron stars and black holes). To this end, clusters characterized by different initial concentrations and different fractions of dark remnants have been modeled. We find that an increasing fraction of stellar-mass black holes significantly delays the mass segregation of BSSs and the visible stellar component. In order to trace the evolution of BSS segregation, we introduce a new parameter ($A^+$) that can be easily measured when the cumulative radial distribution of these stars and a reference population are available. Our simulations show that $A^+$ might also be used as an approximate indicator of the time remaining to the core collapse of the visible component.Comment: ApJ accepte

Flexible human-robot cooperation models for assisted shop-floor tasks

The Industry 4.0 paradigm emphasizes the crucial benefits that collaborative robots, i.e., robots able to work alongside and together with humans, could bring to the whole production process. In this context, an enabling technology yet unreached is the design of flexible robots able to deal at all levels with humans' intrinsic variability, which is not only a necessary element for a comfortable working experience for the person but also a precious capability for efficiently dealing with unexpected events. In this paper, a sensing, representation, planning and control architecture for flexible human-robot cooperation, referred to as FlexHRC, is proposed. FlexHRC relies on wearable sensors for human action recognition, AND/OR graphs for the representation of and reasoning upon cooperation models, and a Task Priority framework to decouple action planning from robot motion planning and control.Comment: Submitted to Mechatronics (Elsevier

Modelling the Observed Stellar Mass Function and its Radial Variation in Galactic Globular Clusters

We measure how the slope $\alpha$ of the stellar mass function (MF) changes as a function of clustercentric distance $r$ in five Galactic globular clusters and compare $\alpha(r)$ to predictions from direct $N$-body star cluster simulations. Theoretical studies predict that $\alpha(r)$ (which traces the degree of mass segregation in a cluster) should steepen with time as a cluster undergoes two-body relaxation and that the amount by which the global MF can evolve from its initial state due to stellar escape is directly linked to $\alpha(r)$. We find that the amount of mass segregation in M10, NGC 6218, and NGC 6981 is consistent with their dynamical ages, but only the global MF of M10 is consistent with its degree of mass segregation as well. NGC 5466 and NGC 6101 on the other hand appear to be less segregated than their dynamical ages would indicate. Furthermore, despite the fact that the escape rate of stars in non-segregated clusters is independent of stellar mass, both NGC 5466 and NGC 6101 have near-flat MFs. We discuss various mechanisms which could produce non-segregated clusters with near-flat MFs, including higher mass-loss rates and black hole retention, but argue that for some clusters (NGC 5466 and NGC 6101) explaining the present-day properties might require either a non-universal IMF or a much more complex dynamical history.Comment: 12 pages, 9 figures, Accepted for publication in MNRA

G-protein dependent signal transduction and ubiquitination in dictyostelium

Signal transduction through G-protein-coupled receptors (GPCRs) is central for the regulation of virtually all cellular functions, and it has been widely implicated in human diseases. These receptors activate a common molecular switch that is represented by the heterotrimeric G-protein generating a number of second messengers (cAMP, cGMP, DAG, IP3, Ca2+ etc.), leading to a plethora of diverse cellular responses. Spatiotemporal regulation of signals generated by a given GPCR is crucial for proper signalling and is accomplished by a series of biochemical modifications. Over the past few years, it has become evident that many signalling proteins also undergo ubiquitination, a posttranslational modification that typically leads to protein degradation, but also mediates processes such as protein-protein interaction and protein subcellular localization. The social amoeba Dictyostelium discoideum has proven to be an excellent model to investigate signal transduction triggered by GPCR activation, as cAMP signalling via GPCR is a major regulator of chemotaxis, cell differentiation, and multicellular morphogenesis. Ubiquitin ligases have been recently involved in these processes. In the present review, we will summarize the most significant pathways activated upon GPCRs stimulation and discuss the role played by ubiquitination in Dictyostelium cells

A new HECT ubiquitin ligase regulating chemotaxis and development in Dictyostelium discoideum

Cyclic AMP binding to G protein-coupled receptors orchestrates chemotaxis and development in Dictyostelium. By activating the RasC-TORC2-AKT/PKB module, cAMP regulates cell polarization during chemotaxis. TORC2 also mediates GPCR-dependent stimulation of adenylyl cyclase A (ACA), enhancing cAMP relay and developmental gene expression. Thus, mutants defective in the TORC2 Pia/Rictor subunit are impaired in chemotaxis and development. Near-saturation mutagenesis of a Pia/Rictor mutant by random gene disruption led to selection of two suppressor mutants, in which spontaneous chemotaxis and development were restored. PKB phosphorylation and chemotactic cell polarization were rescued, whereas Pia/Rictor-dependent ACA stimulation was not restored but bypassed, leading to cAMP-dependent developmental gene expression. Knocking out the gene encoding the adenylylcyclase B (ACB) in the parental strain showed ACB to be essential for this process. The gene tagged in the suppressor mutants encodes a novel HECT ubiquitin ligase, homologous to mammalian HERC1, but harbouring a pleckstrin homology domain. Expression of the isolated HECTwt, but not HECTC5185S, domain was sufficient to reconstitute the parental phenotype. The novel ubiquitin ligase appears to regulate cell sensitivity to cAMP signalling and TORC2-dependent PKB phosphorylation.</jats:p