The impact of response time reliability on CPR incidence and resuscitation success : a benchmark study from the German Resuscitation Registry

Sudden cardiac arrest is one of the most frequent causes of death in the world. In highly qualified EMS systems, including well trained emergency physicians, spontaneous circulation may be restored in up to 53% of patients at least until admission to hospital. Compared with these highly qualified EMS systems, in other systems markedly lower success rates are observed. These data clearly show that there are considerable differences between EMS systems concerning treatment success following cardiac arrest and resuscitation, although in all systems international guidelines for resuscitation are used. This study compares 7 German EMS systems participating in the German Resuscitation Registry. The influence of response time reliability on CPR incidence and resuscitation success is analysed. Anonymized patient data after out of hospital cardiac arrest from 2006 to 2009 of 7 EMS systems in Germany were analysed to socioeconomic factors (population, area, EMS unit hours), process quality (response time reliability, CPR incidence, special CPR measures, prehospital cooling), patient factors (age, gender, cause of cardiac arrest, bystander CPR). Endpoints were defined as ROSC, admission to hospital, 24h survival and hospital discharge rate. For statistical analyses, chi-square, t-test and Bonferroni correction were used. 2,330 prehospital CPR from 7 centres were included in this analysis. Incidence of sudden cardiac arrest differs from 36.0 to 65.1 / 100,000 inhabitants / year. We identified two EMS systems reaching the patients within 8 min in 62.0 and 65.6% while the other five EMS systems achieved 70.4 up to 95.5%. EMS systems arriving relatively later at the patients side (RTR This study demonstrates that on the level of EMS systems, faster ones will more often initiate CPR and will increase number of patients admitted alive to hospital. Furthermore it is shown that with very different approaches, all adhering to and intensely training in the ERC guidelines 2005, superior and, according to international comparison, excellent success rates following resuscitation may be achieved

Achieving traceability of industrial computed tomography, Key Engineering Materials 437

Abstract Achieving traceability is crucial for complex measurement techniques, especially for coordinate measuring machines (CMMs). For CMMs using tactile probes, traceability can for certain measurements be achieved using model-based uncertainty budgets. Up to now, uncertainty simulations could be used applicable only for tactile CMM measurements of regular geometries, but are available as an add-on for CMMs of different brands. This procedure is accepted by guidelines and international standards (VDI/VDE 2617-7 and supplement 1 [1] to the GUM). Furthermore, empirical approaches to assess the measurement uncertainty by means of calibrated workpieces or prior knowledge exist or are under development. These approaches can as a matter of principle also be used for CMMs featuring computed tomography (CT). In this paper, the empirical assessment of the measurement uncertainty of the upcoming measurement technology CT [2, 3] will be discussed uniting the present approaches and the current knowledge, with the focus being on the applicability of concepts for users in industry. For this purpose, the influences on dimensional CT measurements are analyzed and evaluated, taking the measurement data of a current industrial micro CT system as a basis

Cabbage Cryoprotectin Is a Member of the Nonspecific Plant Lipid Transfer Protein Gene Family

We have recently purified a protein (cryoprotectin) from the leaves of cold-acclimated cabbage (Brassica oleracea) to electrophoretic homogeneity, which protects thylakoids isolated from the leaves of nonacclimated spinach (Spinacia oleracea) from freeze-thaw damage. Sequencing of cryoprotectin showed the presence of at least three isoforms of WAX9 proteins, which belong to the class of nonspecific lipid transfer proteins. Antibodies raised against two synthetic peptides derived from the WAX9 proteins recognized a band of approximately 10 kD in western blots of crude cryoprotectin preparations. This protein and the cryoprotective activity could be precipitated from solution by the antiserum. We show further that cryoprotectin is structurally and functionally different from WAX9 isolated from the surface wax of cabbage leaves. WAX9 has lipid transfer activity for phosphatidylcholine, but no cryoprotective activity. Cryoprotectin, on the other hand, has cryoprotective, but no lipid transfer activity. The cryoprotective activity of cryoprotectin was strictly dependent on Ca(2+) and Mn(2+) and could be inhibited by chelating agents, whereas the lipid transfer activity of WAX9 was higher in the presence of ethylenediaminetetraacetate than in the presence of Ca(2+) and Mn(2+)