Extreme sacrifice: sudden cardiac death in the US Fire Service

Firefighting is a hazardous profession which has claimed on average the lives of 105 US firefighters per year for the past decade. The leading cause of line-of-duty mortality is sudden cardiac death, which accounts for approximately 45% of all firefighter duty-related fatalities. Strenuous physical activity, emotional stress, and environmental pollutants all strain the cardiovascular system, and each can increase the risk of sudden cardiac events in susceptible individuals. Sudden cardiac death is more likely to occur during or shortly after emergency duties such as fire suppression, despite the fact that these duties comprise a relatively small proportion of firefighters' annual duties. Additionally, cardiac events are more likely to occur in firefighters who possess an excess of traditional risk factors for cardiovascular disease along with underlying atherosclerosis and/or structural heart disease. In this review, we propose a theoretical model for the interaction between underlying cardiovascular disease in firefighters and the multifactorial physiological strain of firefighting

Manufacturing of Human Umbilical Cord Mesenchymal Stromal Cells on Microcarriers in a Dynamic System for Clinical Use

Citation: Florian Petry, J. Robert Smith, Jasmin Leber, Denise Salzig, Peter Czermak, and Mark L. Weiss, “Manufacturing of Human Umbilical Cord Mesenchymal Stromal Cells on Microcarriers in a Dynamic System for Clinical Use,” Stem Cells International, vol. 2016, Article ID 4834616, 12 pages, 2016. doi:10.1155/2016/4834616The great properties of human mesenchymal stromal cells (hMSCs) make these cells an important tool in regenerative medicine. Because of the limitations of hMSCs derived from the bone marrow during isolation and expansion, hMSCs derived from the umbilical cord stroma are a great alternative to overcome these issues. For a large expansion of these cells, we performed a process transfer from static culture to a dynamic system. For this reason, a microcarrier selection out of five microcarrier types was made to achieve a suitable growth surface for the cells. The growth characteristics and metabolite consumption and production were used to compare the cells growth in 12-well plate and spinner flask. The goal to determine relevant process parameters to transfer the expansion process into a stirred tank bioreactor was achieved

The Effects of Fire Fighting and On-Scene Rehabilitation on Hemostatis

Fire fighting is a dangerous occupation – in part because firefighters are called upon to perform strenuous physical activity in hot, hostile environments. Each year, approximately 100 firefighters lose their lives in the line of duty and tens of thousands are injured. Over the past 15 years, approximately 45% of line of duty deaths have been attributed to heart attacks and another 650-1,000 firefighters suffer non-fatal heart attacks in the line of duty each year. From 1990 to 2004, the total number of fireground injuries has declined, yet during this same period, the number of cases related to the leading cause of injury - overexertion/strain – remained relatively constant. It is well recognized that fire fighting leads to increased cardiovascular and thermal strain. However, the time course of recovery from fire fighting is not well documented, despite the fact that a large percentage of fire fighting fatalities occur after fire fighting activity. Furthermore, on scene rehabilitation (OSR) has been broadly recommended to mitigate the cardiovascular and thermal strain associated with performing strenuous fire fighting activity, yet the efficacy of different rehabilitation interventions has not been documented. Twenty-five firefighters were recruited to participate in a “within-subjects, repeated measures” study designed to describe the acute effects of fire fighting on a broad array of physiological and psychological measures and several key cardiovascular variables. This study provided the first detailed documentation of the time course of recovery during 2½ hours post-fire fighting. Additionally, we compared two OSR strategies (standard and enhanced) to determine their effectiveness.published or submitted for publicationnot peer reviewe

Association between physical fitness and cardiovascular health in firefighters

Firefighters perform strenuous work in dangerous and unpredictable environments requiring optimal physical conditioning. The aim of this study was to investigate the association between physical fitness and cardiovascular health (CVH) in firefighters. This cross-sectional study systematically recruited 309 full-time male and female firefighters between the ages of 20 to 65 years in Cape Town, South Africa. Physical fitness was assessed using absolute (ab˙VO2max) and relative oxygen consumption (relVO2max), grip and leg strength, push-ups and sit-ups, sit-and-reach for flexibility and lean body mass (LBM). CVH encompassed age, smoking, blood pressure (BP), blood glucose, lipid profile, body mass index, body fat percentage (BF%), and waist circumference. Linear regressions and logistic regressions were applied. Multivariable analysis indicated that relVO2max was associated with systolic BP (p < 0.001), diastolic BP (p < 0.001), non-fasting blood glucose (p < 0.001), and total cholesterol (p = 0.037). Poor CVH index was negatively associated with rel˙VO2max (p < 0.001), leg strength (p = 0.019), and push-ups (p = 0.012)

Association between cardiovascular disease risk factors and cardiorespiratory fitness in firefighters: A systematic review and meta-analysis

Approximately 45% of on-duty related mortalities were due to sudden cardiac death, with many of these fatalities related to cardiovascular disease and overexertion, while performing emergency duties. Therefore, the aim of this systematic review was to determine the association between cardiovascular disease risk factors and cardiorespiratory fitness in firefighters. A literature search of PubMed, SCOPUS, Web of Science, Embase, EBSCOHost, and ScienceDirect was conducted; the Rayyan® intelligent systematic review tool was used to screen and select studies for inclusion. The appraisal tool for cross-sectional studies and the Critical Appraisal Skills Programme toolkit were used for methodological assessment of included studies. Data were analyzed using the Review Manager 5.3 and MedCalc® statistical softwares to determine the effects of obesity (Z = 10.29, p < 0.001) and aging (Z = 4.72, p < 0.001) on cardiorespiratory fitness

An Ultraviolet and Near-Infrared View of NGC 4214: A Starbursting Core Embedded in a Low Surface Brightness Disk

During the Astro-2 Spacelab mission in 1995 March, the Ultraviolet Imaging Telescope (UIT) obtained far-UV (λ = 1500 A) imagery of the nearby Sm/Im galaxy NGC 4214. The UIT images have a spatial resolution of ~3'' and a limiting surface brightness, μ1500 > 25 mag arcsec-2, permitting detailed investigation of the intensity and spatial distribution of the young, high-mass stellar component. These data provide the first far-UV imagery covering the full spatial extent of NGC 4214. Comparison with a corresponding I-band image reveals the presence of a starbursting core embedded in an extensive low surface brightness disk. In the far-UV (FUV), NGC 4214 is resolved into several components: a luminous, central knot; an inner region (r 2.5 kpc) with ~15 resolved sources embedded in bright, diffuse emission; and a population of fainter knots extending to the edge of the optically defined disk (r ≈ 5 kpc). The FUV light, which traces recent massive star formation, is observed to be more centrally concentrated than the I-band light, which traces the global stellar population. The FUV radial light profile is remarkably well represented by an R1/4 law, providing evidence that the centrally concentrated massive star formation in NGC 4214 is the result of an interaction, possibly a tidal encounter, with a dwarf companion(s). The brightest FUV source produces ~8% of the global FUV luminosity. This unresolved source, corresponding to the Wolf-Rayet knot described by Sargent & Filippenko, is located at the center of the FUV light distribution, giving NGC 4214 an active galactic nucleus-like morphology. Another strong source is present in the I band, located 19'' west, 10'' north of the central starburst knot, with no FUV counterpart. The I-band source may be the previously unrecognized nucleus of NGC 4214 or an evolved star cluster with an age greater than ~200 Myr. The global star formation rate derived from the total FUV flux is consistent with rates derived using data at other wavelengths and lends support to the scenario of roughly constant star formation during the last few hundred million years at a level significantly enhanced relative to the lifetime averaged star formation rate. The hybrid disk/starburst-irregular morphology evident in NGC 4214 emphasizes the danger of classifying galaxies based on their high surface brightness components at any particular wavelength

School Counseling Site Supervision: Training Recommendations to Benefit School Counselor Interns and Site Supervisors

The importance of supervision is supported in the research literature. Site supervision in school counseling does not require formal training. The absence of formal training has potential implications for the novice school counselor, the P-12 students they serve, and future school counseling supervisees. The authors compare current training models and explore best practices to improve site supervision for school counseling interns. accreditation, ethics, and current needs in school counseling for the school counselor intern and the site supervisor. Finally, the authors review supervision training and models, accreditation, ethics, and current needs for the school counselor intern and the site supervisor, including a recommendation for a school supervisory endorsement