The Need for Advanced Cardiac Life Support Certification for Open-Water Lifeguards at Huntington Beach, CA

The number of people visiting U.S. beaches increased in 2007 to more than 240 million people. This increase in activities does not come without danger. Lifeguards maintain beach safety, but little research is available to assist us in determining appropriate certification levels for lifeguards. The authors analyzed various injuries that occurred in the open-water environment of Huntington Beach, CA. Based on the nature of the injuries, they attempted to determine the level of training lifeguards needed. The vast majority of injuries (99%) were soft-tissue injuries, musculoskeletal injuries, or environmental injuries. It was felt that lifeguards with first-aid and basic-life-support (BLS) -level training were able to handle these injuries adequately and that advanced cardiac life support (ACLS) was not necessary. Injuries that happened at Huntington Beach primarily required lifeguards with first-aid and BLS training. It does not seem necessary that all open-water lifeguards be trained in ACLS

Validation and Performance Comparison of Two Scoring Systems Created Specifically to Predict the Risk of Deep Sternal Wound Infection after Bilateral Internal Thoracic Artery Grafting

Background: The Gatti and the bilateral internal mammary artery (BIMA) scores were created to predict the risk of deep sternal wound infection (DSWI) after bilateral internal thoracic artery (BITA) grafting. Methods: Both scores were evaluated retrospectively in two consecutive series of patients undergoing isolated multi-vessel coronary surgical procedures - i.e., the Trieste (n = 1,122; BITA use, 52.1%; rate of DSWI, 5.7%) and the Besan\ue7on cohort (n = 721; BITA use, 100%; rate of DSWI, 2.5%). Baseline patient characteristics were compared between the two validation samples. For each score, the accuracy of prediction and predictive power were assessed by the area under the receiver-operating characteristic curve (AUC) and the Goodman-Kruskal gamma coefficient, respectively. Results: There were significant differences between the two series in terms of age, gender, New York Heart Association functional class, chronic lung disease, left ventricular function, surgical priority, and the surgical techniques used. In the Trieste series, accuracy of prediction of the Gatti score for DSWI was higher than that of the BIMA score (AUC, 0.729 vs. 0.620, p = 0.0033). The difference was not significant, however, in the Besan\ue7on series (AUC, 0.845 vs. 0.853, p = 0.880) and when only BITA patients of the Trieste series were considered for analysis (AUC, 0.738 vs. 0.665, p = 0.157). In both series, predictive power was at least moderate for the Gatti score and low for the BIMA score. Conclusions: The Gatti and the BIMA scores seem to be useful for pre-operative evaluation of the risk of DSWI after BITA grafting. Further validation studies should be performed

C. elegans expressing human β2-microglobulin: a novel model for studying the relationship between the molecular assembly and the toxic phenotype.

Availability of living organisms to mimic key step of amyloidogenesis of human protein has become an indispensable tool for our translation approach aiming at filling the deep gap existing between the biophysical and biochemical data obtained in vitro and the pathological features observed in patients. Human β(2)-microglobulin (β(2)-m) causes systemic amyloidosis in haemodialysed patients. The structure, misfolding propensity, kinetics of fibrillogenesis and cytotoxicity of this protein, in vitro, have been studied more extensively than for any other globular protein. However, no suitable animal model for β(2)-m amyloidosis has been so far reported. We have now established and characterized three new transgenic C. elegans strains expressing wild type human β(2)-m and two highly amyloidogenic isoforms: P32G variant and the truncated form ΔN6 lacking of the 6 N-terminal residues. The expression of human β(2)-m affects the larval growth of C. elegans and the severity of the damage correlates with the intrinsic propensity to self-aggregate that has been reported in previous in vitro studies. We have no evidence of the formation of amyloid deposits in the body-wall muscles of worms. However, we discovered a strict correlation between the pathological phenotype and the presence of oligomeric species recognized by the A11 antibody. The strains expressing human β(2)-m exhibit a locomotory defect quantified with the body bends assay. Here we show that tetracyclines can correct this abnormality confirming that these compounds are able to protect a living organism from the proteotoxicity of human β(2)-m

From direct to inverse Giant Magnetocaloric Effect in Co-doped NiMnGa multifunctional alloys

We report the magnetic and magnetocaloric properties in Co-doped Ni–Mn–Ga Heusler alloys around the Mn-rich composition Ni50Mn30Ga20. The presence of Co affects profoundly the critical temperatures and alters the exchange interactions of martensite and austenite to different extents; by varying the composition it is possible to tune the critical temperatures and to induce a paramagnetic gap between the magnetically ordered martensite and magnetic austenite, thus giving rise to a reverse magnetostructural transformation. Contrary to the Co-free alloys, the saturation magnetization moment of austenite is strongly enhanced by Co with respect to the martensitic one: thus the magnetocaloric effect turns from direct into inverse. Remarkable values of the magnetic properties related to the magnetocaloric effect, e.g. the saturation magnetization jump at the transformation (DM) and the field dependence of the transformation temperature (dT/dH) are reported, together with high positive values of the isothermal magnetic entropy change (DS). The conditions for enhancing the magnetocaloric properties and triggering the sign reversal of the magnetocaloric effect are discussed

Prediction of exercise capacity and training prescription from the 6-minute walk test and rating of perceived exertion

Walking tests, such as the 6-min walk test (6MWT), are popular methods of estimating peak oxygen uptake (VO(2)peak) in clinical populations. However, the strength of the distance vs. VO(2)peak relationship is not strong, and there are no equations for estimating ventilatory threshold (VT), which is important for training prescription and prognosis. Since the 6MWT is often limited by walking mechanics, prediction equations that include simple additional predictors, such as the terminal rating of perceived exertion (RPE), hold the potential for improving the prediction of VO(2)max and VT. Therefore, this study was designed to develop equations for predicting VO(2)peak and VT from performance during the 6MWT, on the basis of walking performance and terminal RPE. Clinically stable patients in a cardiac rehabilitation program (N = 63) performed the 6MWT according to the American Thoracic Society guidelines. At the end of each walk, the subject provided their terminal RPE on a 6–20 Borg scale. Each patient also performed a maximal incremental treadmill test with respiratory gas exchange to measure VO(2)peak and VT. There was a good correlation between VO(2)peak and 6MWT distance (r = 0.80) which was improved by adding the terminal RPE in a multiple regression formula (6MWT + RPE, R(2) = 0.71, standard error of estimate, SEE = 1.3 Metabolic Equivalents (METs). The VT was also well correlated with walking performance, 6MWT distance (r = 0.80), and was improved by the addition of terminal RPE (6MWT + RPE, R(2) = 0.69, SEE = 0.95 METs). The addition of terminal RPE to 6MWT distance improved the prediction of maximal METs and METs at VT, which may have practical applications for exercise prescription