1,327 research outputs found
Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms
Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Design: Retrospective analysis of audio-video recorded neonatal simulation training. Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Subjects: Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Interventions: Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. Measurements and Main Results: The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Conclusions: Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings
Quintessence and the Separation of CMB Peaks
We propose that it should be possible to use the CMB to discriminate between
dark energy models with different equations of state, including distinguishing
a cosmological constant from many models of quintessence. The separation of
peaks in the CMB anisotropies can be parametrised by three quantities: the
amount of quintessence today, the amount at last scattering, and the averaged
equation of state of quintessence. In particular, we show that the CMB peaks
can be used to measure the amount of dark energy present before last
scattering.Comment: Replaced with version to appear in Astrophysical Journa
Measuring a photonic qubit without destroying it
Measuring the polarisation of a single photon typically results in its
destruction. We propose, demonstrate, and completely characterise a
\emph{quantum non-demolition} (QND) scheme for realising such a measurement
non-destructively. This scheme uses only linear optics and photo-detection of
ancillary modes to induce a strong non-linearity at the single photon level,
non-deterministically. We vary this QND measurement continuously into the weak
regime, and use it to perform a non-destructive test of complementarity in
quantum mechanics. Our scheme realises the most advanced general measurement of
a qubit: it is non-destructive, can be made in any basis, and with arbitrary
strength.Comment: 4 pages, 3 figure
Versorgung und Reanimation des reifen Neugeborenen nach der Geburt : Basierend auf der aktuellen Leitlinie des European Resuscitation Council 2021
Zusammenfassung
Die volle Reanimation eines Neugeborenen mit Beatmungen, Thoraxkompressionen und der Gabe von Medikamenten ist ein äußerst seltenes Ereignis, das selbst neonatologische Teams immer wieder vor Herausforderungen stellt. Gerade in diesen seltenen und häufig dramatischen Situationen ist schnelles und umsichtiges Handeln im Team gefragt. Dabei ist die effektivste und meist einzig notwendige Maßnahme für die erfolgreiche Versorgung eines nicht spontan atmenden Neugeborenen eine suffiziente Maskenbeatmung. Wird diese effektiv durchgeführt, sind beim Neugeborenen in den seltensten Fällen tatsächlich Thoraxkompressionen notwendig. Im März 2021 wurde vom European Resuscitation Council (ERC) die neue Leitlinie zur Reanimation von Neugeborenen publiziert. Auf Basis dieser Leitlinie beschreibt der vorliegende Beitrag detailliert den im Algorithmus der Versorgung und Reanimation von reifen Neugeborenen dargestellten Handlungsablauf. Er richtet sich damit einerseits insbesondere an NichtneonatologInnen, die für die Versorgung v. a. von reifen Neugeborenen nach der Geburt verantwortlich sind. Andererseits soll er auch jenen zur Unterstützung dienen, die medizinisches Personal in der Versorgung von lebensbedrohten Neugeborenen trainieren und den Algorithmus der Neugeborenenreanimation als didaktisches Konzept vermitteln.
Abstract
The resuscitation of a neonate with the need for ventilation, chest compressions and the administration of drugs is an extremely rare event that repeatedly challenges even neonatal teams. It is precisely in these rare and often dramatic situations that rapid and prudent team action is required. The most effective and usually the only necessary measure for the successful resuscitation of a neonate who is not breathing spontaneously is sufficient mask ventilation. If ventilation is performed effectively, chest compressions are rarely necessary in the neonate. In March 2021, the European Resuscitation Council (ERC) published the new guidelines for neonatal resuscitation. Based on these guidelines, this article describes in detail the course of action outlined in the algorithm for the stabilisation and resuscitation of term neonates. On the one hand, it is aimed at non-neonatologists who are responsible for the care of term neonates after birth. On the other hand, it is also intended to support those who train medical personnel in the care of life-threatened neonates and teach the algorithm of neonatal resuscitation as a didactic concept
Global environmental changes: setting priorities for Latin American coastal habitats.
The definitive version is available at www.blackwell-synergy.comThe Intergovernmental Panel for Climate Change (IPCC) reports that Global Environmental Changes (GEC) are occurring quicker than at any other time over the last 25 million years and impacting upon marine environments (Bellard et al., 2012). There is overwhelming evidence showing that GEC are affecting both the quality and quantity of the goods and services provided by a wide range of marine ecosystems. In order to discuss regional preparedness for global environmental changes, a workshop was held in Ilhabela, Brazil (22- 26 April 2012) entitled "Evaluating the Sensitivity of Central and South American Benthic Communities to Global Environmental Changes" that drew together scientists from ten Latin American and three European countries. © 2013 Blackwell Publishing Ltd
Guiding neutral atoms around curves with lithographically patterned current-carrying wires
Laser-cooled neutral atoms from a low-velocity atomic source are guided via a
magnetic field generated between two parallel wires on a glass substrate. The
atoms bend around three curves, each with a 15-cm radius of curvature, while
traveling along a 10-cm-long track. A maximum flux of 2*10^6 atoms/sec is
achieved with a current density of 3*10^4 A/cm^2 in the
100x100-micrometer-cross-section wires. The kinetic energy of the guided atoms
in one transverse dimension is measured to be 42 microKelvin.Comment: 9 page
Cold atoms in videotape micro-traps
We describe an array of microscopic atom traps formed by a pattern of
magnetisation on a piece of videotape. We describe the way in which cold atoms
are loaded into one of these micro-traps and how the trapped atom cloud is used
to explore the properties of the trap. Evaporative cooling in the micro-trap
down to a temperature of 1 microkelvin allows us to probe the smoothness of the
trapping potential and reveals some inhomogeneity produced by the magnetic
film. We discuss future prospects for atom chips based on microscopic
permanent-magnet structures.Comment: Submitted for EPJD topical issue "Atom chips: manipulating atoms and
molecules with microfabricated structures
Cosmological Evolution of a Purely Conical Codimension-2 Brane World
We study the cosmological evolution of isotropic matter on an infinitely thin
conical codimension-two brane-world. Our analysis is based on the boundary
dynamics of a six-dimensional model in the presence of an induced gravity term
on the brane and a Gauss-Bonnet term in the bulk. With the assumption that the
bulk contains only a cosmological constant Lambda_B, we find that the isotropic
evolution of the brane-universe imposes a tuned relation between the energy
density and the brane equation of state. The evolution of the system has fixed
points (attractors), which correspond to a final state of radiation for
Lambda_B=0 and to de Sitter state for Lambda_B>0. Furthermore, considering
anisotropic matter on the brane, the tuning of the parameters is lifted, and
new regions of the parametric space are available for the cosmological
evolution of the brane-universe. The analysis of the dynamics of the system
shows that, the isotropic fixed points remain attractors of the system, and for
values of Lambda_B which give acceptable cosmological evolution of the equation
of state, the line of isotropic tuning is a very weak attractor. The initial
conditions, in this case, need to be fine tuned to have an evolution with
acceptably small anisotropy.Comment: 20 pages, 4 figures, typo correcte
4D MR imaging of cerebrospinal fluid flow in Chiari I malformation with and without syringomyelia and flow changes after decompressive surgery
Brane-bulk matter relation for a purely conical codimension-2 brane world
We study gravity on an infinitely thin codimension-2 brane world, with purely
conical singularities and in the presence of an induced gravity term on the
brane. We show that in this approximation, the energy momentum tensor of the
bulk is strongly related to the energy momentum tensor of the brane and thus
the gravity dynamics on the brane are induced by the bulk content. This is in
contrast with the gravity dynamics on a codimension-1 brane. We show how this
strong result is relaxed after including a Gauss-Bonnet term in the bulk.Comment: 12 pages, mistake corrected, references adde
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