Focused Sonography in Cardiac Arrest

Cardiac arrest (CA) is a high mortality event where the ability for clinicians to diagnose etiology and assess for intervention has a direct impact on patient outcomes. Bedside ultrasound (US) has emerged in current literature as a clinical tool to aid clinicians in CA resuscitation, though it remains underutilized. Reversible etiologies that can be efficiently diagnosed with US include tension pneumothorax, hypovolemia, pulmonary embolus with acute cor pulmonale, and cardiac tamponade. Other US findings may provide evidence in regard to prognosis. In this review, we present major applications of US in CA, compare existing protocols, and propose future research needs

Determination of lead dust fall rates during deconstruction of wood frame buildings in an urban region in the Northeastern United States

Title: Lead dust fall deposition rates during deconstruction of wood frame buildings in an urban region in the Northeastern United States. Objectives: Determine the lead dust fall deposition rate due to hybrid deconstruction (separation and removal of building components) of wood-frame structures, and compare that to the lead dust fall deposition rate from demolition (compression and collapse of building components). Scope: A city block with a total of 11 wood-frame structures was selected as the location for the deconstruction leadfall testing. Testing was done during the deconstruction of 7 of the 11 pre-1950 homes (mean construction year 1928, mean floor area 283 square meter). Method: During deconstruction, the lead deposition rate was measured by using the modified APHA 502 method (Mucha et al. 2009). Findings: The geometric mean deposition rate for the lead dust fall at the property perimeter from the houses using deconstruction was 61.3 ug/sg m/hr. Published values for deposition rates from demolition in Chicago (Jacobs, et al. 2013) are 59.0 and 152 ug/sq m/hr for homes with and without the use of dust suppression. The deposition rate during hybrid deconstruction is similar to the deposition rate during demolition when dust suppression is employed. Implications: Many older urban areas have abandoned buildings containing lead-based paint. Governments in these regions invest in removing these buildings, using a variety of methods. To avoid further lead contamination in the soil surrounding these buildings, methods which minimize the total lead dust fall must be employed. The proper quantification and evaluation of these methods will help policy makers with their decisions

Temperature responsive 4D liquid crystal microactuators fabricated by direct laser writing by two-photon polymerization

Over the past decade, progress in direct laser writing by two-photon polymerization (DLW-TPP) of stimuli-responsive materials has made considerable inroads into the realization of microactuators. With the focus on performing complex tasks such as walking, grasping, or delivering drugs, these actuators require a controlled preprogrammed actuation. Liquid crystalline microactuators enable such programmed movement when the mesogenic alignment can be successfully controlled. To date, this has necessitated low crosslink density networks, which are not readily conducive to the fabrication of 3D geometries. Herein, a liquid crystalline photoresist is reported, which results in a highly crosslinked network, that permits fabrication of 4D microactuators having a highly crosslinked network in which the molecular alignment is determined by the alignment layers in the cell construct. In addition to controllable deformation of the microactuators, they also display a characteristic and unique polarization color that can be used for both identification and reporting in real time, enabling their integration into sensing and anti-anticounterfeiting microdevices

Morphological evolution of the fivefold surface of i-AlPdMn quasicrystals

Morphology of the fivefold symmetric quasicrystal surface of AlPdMn was investigated by x-ray reflectivity and by x-ray diffraction. X-ray experiments revealed two different morphologies depending on the surface preparation. Sputtering and annealing up to 900 K, under UHV conditions, produced a rough and facetted quasicrystal surface. These features were confirmed by atomic force microscopy and scanning tunnel microscopy measurements. We also observed that an annealing above 900 K induces a rapid and irreversible transition toward a flat surface

Remarks about spin measurements in pˉp→Λ‾Λ\bar{\rm p}{\rm p} \to \overline{\Lambda}{\Lambda}

We comment on the proposed measurement of the spin-depolarisation parameter $D_{nn}$ in the strangeness-exchange reaction $\bar{\rm p}{\rm p} \rightarrow \overline{\Lambda}{\Lambda}$. It is shown that the existing data on the correlation coefficients $C_{ij}$ limit the range allowed for $D_{nn}$.Comment: 6 pages, ordinary latex, 1 figure in latex included, to appear in Physics Letters

Constraints on spin observables in antiproton-proton to antiLambda-Lambda

It is recalled that spin-observables in the strangeness-exchange reaction $\bar{p}{p} \to \bar{\Lambda}{\Lambda}$ are not independent but are related to each other by simple algebraic relations. This provides constraints on the existing data on polarization and spin-correlation coefficients, and also on the forthcoming data obtained using a polarized proton target.Comment: RevTex, 9 page

Randomised trial of proton vs. carbon ion radiation therapy in patients with low and intermediate grade chondrosarcoma of the skull base, clinical phase III study

<p/> <p>Background</p> <p>Low and intermediate grade chondrosarcomas are relative rare bone tumours. About 5-12% of all chondrosarcomas are localized in base of skull region. Low grade chondrosarcoma has a low incidence of distant metastasis but is potentially lethal disease. Therefore, local therapy is of crucial importance in the treatment of skull base chondrosarcomas. Surgical resection is the primary treatment standard. Unfortunately the late diagnosis and diagnosis at the extensive stage are common due to the slow and asymptomatic growth of the lesions. Consequently, complete resection is hindered due to close proximity to critical and hence dose limiting organs such as optic nerves, chiasm and brainstem. Adjuvant or additional radiation therapy is very important for the improvement of local control rates in the primary treatment. Proton therapy is the gold standard in the treatment of skull base chondrosarcomas. However, high-LET (linear energy transfer) beams such as carbon ions theoretically offer advantages by enhanced biologic effectiveness in slow-growing tumours.</p> <p>Methods/Design</p> <p>The study is a prospective randomised active-controlled clinical phase III trial. The trial will be carried out at Heidelberger Ionenstrahl-Therapie (HIT) centre as monocentric trial.</p> <p>Patients with skull base chondrosarcomas will be randomised to either proton or carbon ion radiation therapy. As a standard, patients will undergo non-invasive, rigid immobilization and target volume definition will be carried out based on CT and MRI data. The biologically isoeffective target dose to the PTV (planning target volume) in carbon ion treatment will be 60 Gy E ± 5% and 70 Gy E ± 5% (standard dose) in proton therapy respectively. The 5 year local-progression free survival (LPFS) rate will be analysed as primary end point. Overall survival, progression free and metastasis free survival, patterns of recurrence, local control rate and morbidity are the secondary end points.</p> <p>Discussion</p> <p>Up to now it was impossible to compare two different particle therapies, i.e. protons and carbon ions, directly at the same facility in connection with the treatment of low grade skull base chondrosarcomas.</p> <p>This trial is a phase III study to demonstrate that carbon ion radiotherapy (experimental treatment) is not relevantly inferior and at least as good as proton radiotherapy (standard treatment) with respect to 5 year LPFS in the treatment of chondrosarcomas. Additionally, we expect less toxicity in the carbon ion treatment arm.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov identifier: NCT01182753</p

Randomised trial of proton vs. carbon ion radiation therapy in patients with chordoma of the skull base, clinical phase III study HIT-1-Study

<p>Abstract</p> <p>Background</p> <p>Chordomas of the skull base are relative rare lesions of the bones. Surgical resection is the primary treatment standard, though complete resection is nearly impossible due to close proximity to critical and hence also dose limiting organs for radiation therapy. Level of recurrence after surgery alone is comparatively high, so adjuvant radiation therapy is very important for the improvement of local control rates. Proton therapy is the gold standard in the treatment of skull base chordomas. However, high-LET beams such as carbon ions theoretically offer biologic advantages by enhanced biologic effectiveness in slow-growing tumors.</p> <p>Methods/design</p> <p>This clinical study is a prospective randomised phase III trial. The trial will be carried out at Heidelberger Ionenstrahl-Therapie centre (HIT) and is a monocentric study.</p> <p>Patients with skull base chordoma will be randomised to either proton or carbon ion radiation therapy. As a standard, patients will undergo non-invasive, rigid immobilization and target volume delineation will be carried out based on CT and MRI data. The biologically isoeffective target dose to the PTV in carbon ion treatment (accelerated dose) will be 63 Gy E ± 5% and 72 Gy E ± 5% (standard dose) in proton therapy respectively. Local-progression free survival (LPFS) will be analysed as primary end point. Toxicity and overall survival are the secondary end points. Additional examined parameters are patterns of recurrence, prognostic factors and plan quality analysis.</p> <p>Discussion</p> <p>Up until now it was impossible to compare two different particle therapies, i.e. protons and carbon ions directly at the same facility.</p> <p>The aim of this study is to find out, whether the biological advantages of carbon ion therapy can also be clinically confirmed and translated into the better local control rates in the treatment of skull base chordomas.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: NCT01182779</p

Characterization And Properties Of The AIPdMn 5 Surface

The surface of the AlPdMn quasicrystal perpendicular to a fivefold axis has been probed by LEED, XPS, Auger spectroscopy and surface EXAFS.This article is from MRS Proceedings 553 (1998): 243–250, doi:10.1557/PROC-553-243.</p

Intricate macrophage-colorectal cancer cell communication in response to radiation

Both cancer and tumour-associated host cells are exposed to ionizing radiation when a tumour is subjected to radiotherapy. Macrophages frequently constitute the most abundant tumour-associated immune population, playing a role in tumour progression and response to therapy. The present work aimed to evaluate the importance of macrophage-cancer cell communication in the cellular response to radiation. To address this question, we established monocultures and indirect co-cultures of human monocyte-derived macrophages with RKO or SW1463 colorectal cancer cells, which exhibit higher and lower radiation sensitivity, respectively. Mono- and co-cultures were then irradiated with 5 cumulative doses, in a similar fractionated scheme to that used during cancer patients' treatment (2 Gy/fraction/day). Our results demonstrated that macrophages sensitize RKO to radiation-induced apoptosis, while protecting SW1463 cells. Additionally, the co-culture with macrophages increased the mRNA expression of metabolism- and survival-related genes more in SW1463 than in RKO. The presence of macrophages also upregulated glucose transporter 1 expression in irradiated SW1463, but not in RKO cells. In addition, the influence of cancer cells on the expression of pro- and anti-inflammatory macrophage markers, upon radiation exposure, was also evaluated. In the presence of RKO or SW1463, irradiated macrophages exhibit higher levels of pro-inflammatory TNF, IL6, CCL2 and CCR7, and of anti-inflammatory CCL18. However, RKO cells induce an increase of macrophage pro-inflammatory IL1B, while SW1463 cells promote higher pro-inflammatory CXCL8 and CD80, and also anti-inflammatory VCAN and IL10 levels. Thus, our data demonstrated that macrophages and cancer cells mutually influence their response to radiation. Notably, conditioned medium from irradiated co-cultures increased non-irradiated RKO cell migration and invasion and did not impact on angiogenesis in a chicken embryo chorioallantoic membrane assay. Overall, the establishment of primary human macrophage-cancer cell co-cultures revealed an intricate cell communication in response to ionizing radiation, which should be considered when developing therapies adjuvant to radiotherapy