Effects of cholesterol levels on outcomes of out-of-hospital cardiac arrest: a cross-sectional study

Objective High cholesterol level is a risk factor for coronary artery disease, and coronary artery disease is a major risk factor for out-of-hospital cardiac arrest (OHCA). However, the effect of cholesterol level on outcomes of OHCA has been poorly studied. This study aimed to determine the effect of cholesterol level on outcomes of OHCA. Methods This cross-sectional study used the CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance) project database in Korea. Multivariable conditional logistic regression analysis was performed to estimate the effect of cholesterol level on outcomes in OHCA. Results In all, 584 cases of OHCA were analyzed; those with cholesterol levels <120 mg/dL were classified as having low total cholesterol (TC) (n=197), those with levels ranging from 120–199 mg/dL as middle TC (n=322), and those with ≥200 mg/dL as high TC (n=65). Compared to low TC, more patients with middle TC and high TC survived to discharge (9.1% vs. 22.0% and 26.2%, respectively, P=0.001). The good cerebral performance category also increased in that order (4.1 % vs. 14.6% and 23.1%, respectively, P≤0.001). Comparing middle TC and high TC with low TC, adjusted odds ratios (95% confidence intervals) were 1.97 (1.06 to 3.64) and 2.53 (1.08 to 5.92) for survival to discharge, respectively, and 2.53 (1.07 to 5.98) and 4.73 (1.63 to 13.71) for good neurological recovery, respectively. Conclusion Higher cholesterol is associated with better outcomes in OHCA; cholesterol level is a good predictor of outcomes of OHCA

Comparison of trauma systems in Asian countries: a cross-sectional study.

OBJECTIVE: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS). METHODS: Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics. RESULTS: Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%). CONCLUSION: Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies

Comparison of trauma systems in Asian countries: a cross-sectional study

Objective This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS). Methods Medical directors and emergency physicians at PATOS-participating hospitals in countries across the Asia Pacific were surveyed through a standardized questionnaire. General information, trauma care system data, and trauma emergency department (ED) outcomes at each hospital were collected by email and analyzed using descriptive statistics. Results Survey data from 35 hospitals across 15 countries were collected from archived data between June 2014 and July 2015. Designated trauma centers were identified as the highest hospital level for trauma patients in 70% of surveyed countries. Half of the hospitals surveyed had special teams for trauma care, and almost all prepared activation protocol documents for these teams. Most hospitals offered specialized trauma education programs, and 72.7% of hospitals had a hospital-based trauma registry. The total number of trauma patients visiting the ED across 25 of the hospitals was 300,376. The overall survival-to-discharge rate was 97.2%; however, it varied greatly between 85.1% and 99.7%. The difference between survival-to-discharge rates of moderate and severe injury groups was highest in Taiwan (41.8%) and lowest in Thailand (18.6%). Conclusion Trauma care systems and ED outcomes vary widely among surveyed hospitals and countries. This information is useful to build further detailed, systematic platforms for trauma surveillance and evidence-based trauma care policies

Metal–Semiconductor Heteronanocrystals with Desired Configurations for Plasmonic Photocatalysis

Precise control over the topology of plasmonic metal–semiconductor heteronanostructures is essential for fully harnessing their plasmonic function and hence for designing innovative solar energy conversion platforms. Here, we present a rational synthesis strategy for the realization of plasmonic metal–semiconductor heteronanocrystals with intended configurations through the site-selective overgrowth of semiconductor Cu₂O on desired sites of anisotropic Au nanocrystals. Both the exploitation of structural characteristics of Au nanocrystals and the selective stabilization of their surfaces are keys to the construction of heteronanocrystals with a specific configuration. Our approach can provide an opportunity to precisely explore the link between the solar energy conversion efficiency and the structure of heteronanocrystals as well as to obtain important insights into the underpinning mechanism. Heteronanocrystals produced by Cu₂O overgrowth preferentially on the multiple high-curvature sites of Au nanocrystals exhibited prominent photocatalytic hydrogen production activity due to efficient charge separation by strong plasmon excitation at the Au–Cu₂O interface and subsequent sustainable hot electron transfer from Au to Cu₂O

Opportunistic and Location-Based Collaboration Architecture among Mobile Assets and Fixed Manufacturing Processes

Research into integrating the concept of the internet of things (IoT) into smart factories has accelerated, leading to the emergence of various smart factory solutions. Most ideas, however, focus on the automation and integration of processes in factory, rather than organic cooperation among mobile assets (e.g., the workers and manufactured products) and fixed manufacturing equipment (e.g., press molds, computer numerical controls, painting). Additionally, it is difficult to apply smart factory and IoT designs to analog factories, because such a factory would require the integration of mobile assets and smart manufacturing processes. Thus, existing analog factories remain intact and smart factories are newly constructed. To overcome this disparity and to make analog factories compatible with smart technologies and IoT, we propose the opportunistic and location-based collaboration architecture (OLCA) platform, which allows for smart devices to be attached to workers, products, and facilities to enable the collaboration of location and event information in devices. Using this system, we can monitor workers&rsquo; positions and production processes in real-time to help prevent dangerous situations and better understand product movement. We evaluate the proposed OLCA platform&rsquo;s performance while using a simple smart factory scenario, thus confirming its suitability

The surface plasmon-induced hot carrier effect on the catalytic activity of CO oxidation on a Cu2O/hexoctahedral Au inverse catalyst

The intrinsic correlation between an enhancement of catalytic activity and the flow of hot electrons generated at metal-oxide interfaces suggests an intriguing way to control catalytic reactions and is a significant subject in heterogeneous catalysis. Here, we show surface plasmon-induced catalytic enhancement by the peculiar nanocatalyst design of hexoctahedral (HOH) Au nanocrystals (NCs) with Cu2O clusters. We found that this inverse catalyst comprising a reactive oxide for the catalytic portion and a metal as the source of electrons by localized surface plasmon resonance (localized SPR) exhibits a change in catalytic activity by direct hot electron transfer or plasmon-induced resonance energy transfer (PIRET) when exposed to light. We prepared two types of inverse catalysts, Cu2O at the vertex sites of HOH Au NCs (Cu2O/Au vertex site) and a HOH Au NC-Cu2O core-shell structure (HOH Au@Cu2O), to test the structural effect on surface plasmons. Under broadband light illumination, the Cu2O/Au vertex site catalyst showed 30-90% higher catalytic activity and the HOH Au@Cu2O catalyst showed 10-30% higher catalytic activity than when in the dark. Embedding thin SiO2 layers between the HOH Au NCs and the Cu2O verified that the dominant mechanism for the catalytic enhancement is direct hot electron transfer from the HOH Au to the Cu2O. Finite-difference time domain calculations show that a much stronger electric field was formed on the vertex sites after growing the Cu2O on the HOH Au NCs. These results imply that the catalytic activity is enhanced when hot electrons, created from photon absorption on the HOH Au metal and amplified by the presence of surface plasmons, are transferred to the reactive Cu2O. © 2018 The Royal Society of Chemistr

Clinical Characteristics of Elderly Acute Ischemic Stroke Patients Calling Emergency Medical Services

Background : Time is the most important determining factor in acute ischemic stroke (AIS) treatment. Calling emergency medical services (EMS) during an AIS can reduce the time until treatment. Although differences in clinical characteristics, including sex, have been studied in patients with acute coronary syndrome, limited data are available on the differences among patients with AIS who call EMS, especially elderly patients. Methods : Patients aged 65 years or older who had received a diagnosis of AIS within 1 week of hospitalization were recruited and analyzed within 24 hours after symptom onset between January 1, 2012 and December 31, 2015. Calls to EMS was assessed by self-report during an in-hospital interview and verified using structured chart reviews to determine clinical differences among patients calls to EMS. Results : Of the 1,002 patients studied, 414 patients (41.3%) called EMS. A similar percentage of women and men with AIS called EMS (43.1% and 39.3%, respectively). The group calls to EMS had a faster median arrival time at the hospital (159 minutes vs. 793 minutes) and higher National Institutes of Health Stroke Scale (NIHSS) score (8.2±6.25 vs. 4.28±3.73). After adjusting for sociodemographic factors, EMS users were found to have shorter median onset-to-door time and higher NIHSS scores (odds ratio [OR], 3.538; 95% confidence interval [CI], 2.333-5.366; p〈0.01, and OR, 3.336; 95% CI, 1.032-10.786; p〈0.05, respectively). Conclusion : Our study suggests that calls to EMS reduces prehospital delay and expedites treatment for stroke. We expect that a wide-ranging and specialized educational program for increasing EMS use and enhancing stroke knowledge will lead to early hospital arrival for all age groups