Radar Scattering and Block Size Properties of Lunar Crater Ejecta From Mini-RF and LROC NAC Data

NASA Technical Reports Server (NTRS)

Spudis, P. D.; Baloga, S. M.; Glaze, L. S.; Dixit, V.; Pantone, S. M.; Juvanescu, I.

2012-01-01

A major objective of the Mini-RF experiment is to distinguish lunar surfaces that may contain water/ice deposits [1,2]. Better understanding of the backscattering properties of craters of varying age and size is crucial for interpreting data received from the Mini-RF. The Mini-RF transmits a circularly polarized RF electromagnetic energy and coherently receives orthogonal linear polarization echoes [1]. The Mini- RF maps in two separate bands ( =12.6 and 4.5 cm) at a high resolution mode of 30 m/pixel [1]. Given the variables mentioned, the four stokes parameters are reconstructed. The Circular Polarization Ratio (CPR) is calculated for the purposes of understanding subsurface and surface roughness. The CPR is determined from reflections acquired from the ratio of power of the transmitted radio wave in same sense to the reflected radio wave in the opposite sense [1]. Ice in the permanently shadowed regions (PSRs) would be transparent to radar, but the inclusions of materials and imperfections would cause the radio wave to reflect multiple times [3], enhancing the number of same sense reflections and increasing the CPR. In addition, ice also displays the coherent backscatter opposition effect (CBOE), an interferrometric addition of same sense backscatter that further increases the CPR of ice targets [7]. High CPR values also correlate to multiple reflections and are typically associated with very rough surfaces [3]. The average dry lunar surface has a CPR in the range of 0.2-0.4 at 48deg incidence [3]. The purpose of this study is to begin to quantify degrees of surface wavelength-scale roughness with CPR and to understand how such surface roughness is created and gradually destroyed by erosion on the lunar surface. Another goal is to identify and isolate the possible causes of high CPR within the shadowed areas of anomalous polar craters [3]. All the studied craters are non-polar, so that we can see into their interiors in NAC images. The idea is to understand what controls blockiness in these craters so that we can rule out rocks (and rule in ice) for the anomalous polar dark ones [3].

A-Train Observations of Deep Convective Storm Tops

NASA Technical Reports Server (NTRS)

Setvak, Martin; Bedka, Kristopher; Lindsey, Daniel T.; Sokol, Alois; Charvat, Zdenek; Stastka, Jindrich; Wang, Pao K.

2013-01-01

The paper highlights simultaneous observations of tops of deep convective clouds from several space-borne instruments including the Moderate Resolution Imaging Spectroradiometer (MODIS) of the Aqua satellite, Cloud Profiling Radar (CPR) of the CloudSat satellite, and Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) flown on the CALIPSO satellite. These satellites share very close orbits, thus together with several other satellites they are referred to as the "A-Train" constellation. Though the primary responsibility of these satellites and their instrumentation is much broader than observations of fine-scale processes atop convective storms, in this study we document how data from the A-Train can contribute to a better understanding and interpretation of various storm-top features, such as overshooting tops, cold-U/V and cold ring features with their coupled embedded warm areas, above anvil ice plumes and jumping cirrus. The relationships between MODIS multi-spectral brightness temperature difference (BTD) fields and cloud top signatures observed by the CPR and CALIOP are also examined in detail to highlight the variability in BTD signals across convective storm events.

Integration of Lunar Polar Remote-Sensing Data Sets: Evidence for Ice at the Lunar South Pole

NASA Technical Reports Server (NTRS)

Nozette, Stewart; Spudis, Paul D.; Robinson, Mark S.; Bussey, D. B. J.; Lichtenberg, Chris; Bonner, Robert

2001-01-01

In order to investigate the feasibility of ice deposits at the lunar south pole, we have integrated all relevant lunar polar data sets. These include illumination data, Arecibo ground-based monostatic radar data, newly processed Clementine bistatic radar data, and Lunar Prospector neutron spectrometer measurements. The possibility that the lunar poles harbor ice deposits has important implications not only as a natural resource for future human lunar activity but also as a record of inner solar system volatiles (e.g., comets and asteroids) over the past billion years or more. We find that the epithermal neutron flux anomalies, measured by Lunar Prospector, are coincident with permanently shadowed regions at the lunar south pole, particularly those associated with Shackleton crater. Furthermore, these areas also correlate with the beta=0 circular polarization ratio (CPR) enhancements revealed by new processing of Clementine bistatic radar echoes, which in turn are colocated with areas of anomalous high CPR observed by Arecibo Observatory on the lower, Sun-shadowed wall of Shackleton crater. Estimates of the extent of high CPR from Arecibo Observatory and Clementine bistatic radar data independently suggest that approximately 10 square kilometers of ice may be present on the inner Earth-facing wall of Shackleton crater. None of the experiments that obtained the data presented here were ideally suited for definitively identifying ice in lunar polar regions. By assessing the relative merits of all available data, we find that it is plausible that ice does occur in cold traps at the lunar south pole and that future missions with instruments specifically designed to investigate these anomalies are worthy.

Development of Spaceborne Radar Simulator by NICT and JAXA using JMA Cloud-resolving Model

NASA Astrophysics Data System (ADS)

Kubota, T.; Eito, H.; Aonashi, K.; Hashimoto, A.; Iguchi, T.; Hanado, H.; Shimizu, S.; Yoshida, N.; Oki, R.

2009-12-01

We are developing synthetic spaceborne radar data toward a simulation of the Dual-frequency Precipitation Radar (DPR) aboard the Global Precipitation Measurement (GPM) core-satellite. Our purposes are a production of test-bed data for higher level DPR algorithm developers, in addition to a diagnosis of a cloud resolving model (CRM). To make the synthetic data, we utilize the CRM by the Japan Meteorological Agency (JMA-NHM) (Ikawa and Saito 1991, Saito et al. 2006, 2007), and the spaceborne radar simulation algorithm by the National Institute of Information and Communications Technology (NICT) and the Japan Aerospace Exploration Agency (JAXA) named as the Integrated Satellite Observation Simulator for Radar (ISOSIM-Radar). The ISOSIM-Radar simulates received power data in a field of view of the spaceborne radar with consideration to a scan angle of the radar (Oouchi et al. 2002, Kubota et al. 2009). The received power data are computed with gaseous and hydrometeor attenuations taken into account. The backscattering and extinction coefficients are calculated assuming the Mie approximation for all species. The dielectric constants for solid particles are computed by the Maxwell-Garnett model (Bohren and Battan 1982). Drop size distributions are treated in accordance with those of the JMA-NHM. We assume a spherical sea surface, a Gaussian antenna pattern, and 49 antenna beam directions for scan angles from -17 to 17 deg. in the PR. In this study, we report the diagnosis of the JMA-NHM with reference to the TRMM Precipitation Radar (PR) and CloudSat Cloud Profiling Radar (CPR) using the ISOSIM-Radar from the view of comparisons in cloud microphysics schemes of the JMA-NHM. We tested three kinds of explicit bulk microphysics schemes based on Lin et al. (1983), that is, three-ice 1-moment scheme, three-ice 2-moment scheme (Eito and Aonashi 2009), and newly developed four-ice full 2-moment scheme (Hashimoto 2008). The hydrometeor species considered here are rain, graupel, snow, cloud water, cloud ice and hail (4-ice scheme only). We examined a case of an intersection with the TRMM PR and the CloudSat CPR on 6th April 2008 over sea surface in the south of Kyushu Island of Japan. In this work, observed rainfall systems are simulated with one-way double nested domains having horizontal grid sizes of 5 km (outer) and 2 km (inner). Data used here are from the inner domain only. Results of the PR indicated better performances of 2-moment bulk schemes. It suggests that prognostic number concentrations of frozen hydrometeors are more effective in high altitudes and constant number concentrations can lead to the overestimation of the snow there. For three-ice schemes, simulated received power data overestimated above freezing levels with reference to the observed data. In contrast, the overestimation of frozen particles was heavily reduced for the four-ice scheme.

Mini-RF Bistatic Observations of Lunar Crater Ejecta

NASA Astrophysics Data System (ADS)

Stickle, A. M.; Patterson, G. W.; Cahill, J. T.

2017-12-01

The Mini-RF radar onboard the Lunar Reconnaissance Orbiter (LRO) is currently operating in a bistatic configuration using the Goldstone DSS-13 and Arecibo Observatory as transmitters in X-band (4.2-cm) and S-band (12.6 cm), respectively. The Circular Polarization Ratio (CPR) is a typical product derived from backscattered microwave radiation that examines the scattering properties of the lunar surface, particularly the roughness of the surface on the order of the radar wavelength. Throughout the LRO extended mission, Mini-RF has targeted young craters on the lunar surface to examine the scattering properties of their ejecta blankets in both S- and X-band. Several observed craters and their ejecta blankets exhibit a clear coherent backscatter opposition effect at low bistatic (phase) angles. This opposition effect is consistent with optical studies of lunar soils done in the laboratory, but these observations are the first time this effect has been measured on the Moon at radar wavelengths. The style of the observed opposition effect differs between craters, which may indicate differences in ejecta fragment formation or emplacement. Differences in the CPR behavior as a function of bistatic angle may also provide opportunities for relative age dating between Copernican craters. Here, we examine the ejecta of nine Copernican and Eratosthenian aged craters in both S-band and X-band and document CPR characteristics as a function bistatic angle in order to test that hypothesis. The youngest craters observed by Mini-RF (e.g., Byrgius A (48 My), Kepler (635-1250 My)) exhibit a clear opposition effect, while older craters such as Hercules have a fairly flat response in CPR as a function of phase angle. Craters with ages between these two ends, e.g., Aristarchus, exhibit a weaker opposition response. Observing the scattering behavior of continuous ejecta blankets in multiple wavelengths may provide further information about the rate of breakdown of rocks of varying size to provide increased understanding of how impacts produce regolith on the Moon.

A study of the 3D radiative transfer effect in cloudy atmospheres

NASA Astrophysics Data System (ADS)

Okata, M.; Teruyuki, N.; Suzuki, K.

2015-12-01

Evaluation of the effect of clouds in the atmosphere is a significant problem in the Earth's radiation budget study with their large uncertainties of microphysics and the optical properties. In this situation, we still need more investigations of 3D cloud radiative transer problems using not only models but also satellite observational data.For this purpose, we have developed a 3D-Monte-Carlo radiative transfer code that is implemented with various functions compatible with the OpenCLASTR R-Star radiation code for radiance and flux computation, i.e. forward and backward tracing routines, non-linear k-distribution parameterization (Sekiguchi and Nakajima, 2008) for broad band solar flux calculation, and DM-method for flux and TMS-method for upward radiance (Nakajima and Tnaka 1998). We also developed a Minimum cloud Information Deviation Profiling Method (MIDPM) as a method for a construction of 3D cloud field with MODIS/AQUA and CPR/CloudSat data. We then selected a best-matched radar reflectivity factor profile from the library for each of off-nadir pixels of MODIS where CPR profile is not available, by minimizing the deviation between library MODIS parameters and those at the pixel. In this study, we have used three cloud microphysical parameters as key parameters for the MIDPM, i.e. effective particle radius, cloud optical thickness and top of cloud temperature, and estimated 3D cloud radiation budget. We examined the discrepancies between satellite observed and mode-simulated radiances and three cloud microphysical parameter's pattern for studying the effects of cloud optical and microphysical properties on the radiation budget of the cloud-laden atmospheres.

Computational Age Dating of Special Nuclear Materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

2012-06-30

This slide-show presented an overview of the Constrained Progressive Reversal (CPR) method for computing decays, age dating, and spoof detecting. The CPR method is: Capable of temporal profiling a SNM sample; Precise (compared with known decay code, such a ORIGEN); Easy (for computer implementation and analysis). We have illustrated with real SNM data using CPR for age dating and spoof detection. If SNM is pure, may use CPR to derive its age. If SNM is mixed, CPR will indicate that it is mixed or spoofed.

Relation of Cloud Occurrence Frequency, Overlap, and Effective Thickness Derived from CALIPSO and CloudSat Merged Cloud Vertical Profiles

NASA Technical Reports Server (NTRS)

Kato, Seiji; Sun-Mack, Sunny; Miller, Walter F.; Rose, Fred G.; Chen, Yan; Minnis, Patrick; Wielicki, Bruce A.

2009-01-01

A cloud frequency of occurrence matrix is generated using merged cloud vertical profile derived from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) and Cloud Profiling Radar (CPR). The matrix contains vertical profiles of cloud occurrence frequency as a function of the uppermost cloud top. It is shown that the cloud fraction and uppermost cloud top vertical pro les can be related by a set of equations when the correlation distance of cloud occurrence, which is interpreted as an effective cloud thickness, is introduced. The underlying assumption in establishing the above relation is that cloud overlap approaches the random overlap with increasing distance separating cloud layers and that the probability of deviating from the random overlap decreases exponentially with distance. One month of CALIPSO and CloudSat data support these assumptions. However, the correlation distance sometimes becomes large, which might be an indication of precipitation. The cloud correlation distance is equivalent to the de-correlation distance introduced by Hogan and Illingworth [2000] when cloud fractions of both layers in a two-cloud layer system are the same.

Optimal control of CPR procedure using hemodynamic circulation model

DOEpatents

Lenhart, Suzanne M.; Protopopescu, Vladimir A.; Jung, Eunok

2007-12-25

A method for determining a chest pressure profile for cardiopulmonary resuscitation (CPR) includes the steps of representing a hemodynamic circulation model based on a plurality of difference equations for a patient, applying an optimal control (OC) algorithm to the circulation model, and determining a chest pressure profile. The chest pressure profile defines a timing pattern of externally applied pressure to a chest of the patient to maximize blood flow through the patient. A CPR device includes a chest compressor, a controller communicably connected to the chest compressor, and a computer communicably connected to the controller. The computer determines the chest pressure profile by applying an OC algorithm to a hemodynamic circulation model based on the plurality of difference equations.

Improvements of top-of-atmosphere and surface irradiance computations with CALIPSO-, CloudSat-, and MODIS-derived cloud and aerosol properties

NASA Astrophysics Data System (ADS)

Kato, Seiji; Rose, Fred G.; Sun-Mack, Sunny; Miller, Walter F.; Chen, Yan; Rutan, David A.; Stephens, Graeme L.; Loeb, Norman G.; Minnis, Patrick; Wielicki, Bruce A.; Winker, David M.; Charlock, Thomas P.; Stackhouse, Paul W., Jr.; Xu, Kuan-Man; Collins, William D.

2011-10-01

One year of instantaneous top-of-atmosphere (TOA) and surface shortwave and longwave irradiances are computed using cloud and aerosol properties derived from instruments on the A-Train Constellation: the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) on the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellite, the CloudSat Cloud Profiling Radar (CPR), and the Aqua Moderate Resolution Imaging Spectrometer (MODIS). When modeled irradiances are compared with those computed with cloud properties derived from MODIS radiances by a Clouds and the Earth's Radiant Energy System (CERES) cloud algorithm, the global and annual mean of modeled instantaneous TOA irradiances decreases by 12.5 W m-2 (5.0%) for reflected shortwave and 2.5 W m-2 (1.1%) for longwave irradiances. As a result, the global annual mean of instantaneous TOA irradiances agrees better with CERES-derived irradiances to within 0.5W m-2 (out of 237.8 W m-2) for reflected shortwave and 2.6W m-2 (out of 240.1 W m-2) for longwave irradiances. In addition, the global annual mean of instantaneous surface downward longwave irradiances increases by 3.6 W m-2 (1.0%) when CALIOP- and CPR-derived cloud properties are used. The global annual mean of instantaneous surface downward shortwave irradiances also increases by 8.6 W m-2 (1.6%), indicating that the net surface irradiance increases when CALIOP- and CPR-derived cloud properties are used. Increasing the surface downward longwave irradiance is caused by larger cloud fractions (the global annual mean by 0.11, 0.04 excluding clouds with optical thickness less than 0.3) and lower cloud base heights (the global annual mean by 1.6 km). The increase of the surface downward longwave irradiance in the Arctic exceeds 10 W m-2 (˜4%) in winter because CALIOP and CPR detect more clouds in comparison with the cloud detection by the CERES cloud algorithm during polar night. The global annual mean surface downward longwave irradiance of 345.4 W m-2 is estimated by combining the modeled instantaneous surface longwave irradiance computed with CALIOP and CPR cloud profiles with the global annual mean longwave irradiance from the CERES product (AVG), which includes the diurnal variation of the irradiance. The estimated bias error is -1.5 W m-2 and the uncertainty is 6.9 W m-2. The uncertainty is predominately caused by the near-surface temperature and column water vapor amount uncertainties.

Remote Sensing of Cloud Top Height from SEVIRI: Analysis of Eleven Current Retrieval Algorithms

NASA Technical Reports Server (NTRS)

Hamann, U.; Walther, A.; Baum, B.; Bennartz, R.; Bugliaro, L.; Derrien, M.; Francis, P. N.; Heidinger, A.; Joro, S.; Kniffka, A.;

Global snowfall: A combined CloudSat, GPM, and reanalysis perspective.

NASA Astrophysics Data System (ADS)

Milani, Lisa; Kulie, Mark S.; Skofronick-Jackson, Gail; Munchak, S. Joseph; Wood, Norman B.; Levizzani, Vincenzo

2017-04-01

Quantitative global snowfall estimates derived from multi-year data records will be presented to highlight recent advances in high latitude precipitation retrievals using spaceborne observations. More specifically, the analysis features the 2006-2016 CloudSat Cloud Profiling Radar (CPR) and the 2014-2016 Global Precipitation (GPM) Microwave Imager (GMI) and Dual-frequency Precipitation Radar (DPR) observational datasets and derived products. The ERA-Interim reanalysis dataset is also used to define the meteorological context and an independent combined modeling/observational evaluation dataset. An overview is first provided of CloudSat CPR-derived results that have stimulated significant recent research regarding global snowfall, including seasonal analyses of unique snowfall modes. GMI and DPR global annual snowfall retrievals are then evaluated against the CloudSat estimates to highlight regions where the datasets provide both consistent and diverging snowfall estimates. A hemispheric seasonal analysis for both datasets will also be provided. These comparisons aim at providing a unified global snowfall characterization that leverages the respective instrument's strengths. Attention will also be devoted to regions around the globe that experience unique snowfall modes. For instance, CloudSat has demonstrated an ability to effectively discern snowfall produced by shallow cumuliform cloud structures (e.g., lake/ocean-induced convective snow produced by air/water interactions associated with seasonal cold air outbreaks). The CloudSat snowfall database also reveals prevalent seasonal shallow cumuliform snowfall trends over climate-sensitive regions like the Greenland Ice Sheet. Other regions with unique snowfall modes, such as the US East Coast winter storm track zone that experiences intense snowfall rates directly associated with strong low pressure systems, will also be highlighted to demonstrate GPM's observational effectiveness. Linkages between CloudSat and GPM global snowfall analyses and independent ERA-Interim datasets will also be presented as a final evaluation exercise.

Use of ARM observations and numerical models to determine radiative and latent heating profiles of mesoscale convective systems for general circulation models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robert A. Houze, Jr.

2013-11-13

We examined cloud radar data in monsoon climates, using cloud radars at Darwin in the Australian monsoon, on a ship in the Bay of Bengal in the South Asian monsoon, and at Niamey in the West African monsoon. We followed on with a more in-depth study of the continental MCSs over West Africa. We investigated whether the West African anvil clouds connected with squall line MCSs passing over the Niamey ARM site could be simulated in a numerical model by comparing the observed anvil clouds to anvil structures generated by the Weather Research and Forecasting (WRF) mesoscale model at highmore » resolution using six different ice-phase microphysical schemes. We carried out further simulations with a cloud-resolving model forced by sounding network budgets over the Niamey region and over the northern Australian region. We have devoted some of the effort of this project to examining how well satellite data can determine the global breadth of the anvil cloud measurements obtained at the ARM ground sites. We next considered whether satellite data could be objectively analyzed to so that their large global measurement sets can be systematically related to the ARM measurements. Further differences were detailed between the land and ocean MCS anvil clouds by examining the interior structure of the anvils with the satellite-detected the CloudSat Cloud Profiling Radar (CPR). The satellite survey of anvil clouds in the Indo-Pacific region was continued to determine the role of MCSs in producing the cloud pattern associated with the MJO.« less

Initial Observations of Lunar Impact Melts and Ejecta Flows with the Mini-RF Radar

NASA Technical Reports Server (NTRS)

Carter, Lynn M.; Neish, Catherine D.; Bussey, D. B. J.; Spudis, Paul D.; Patterson, G. Wesley; Cahill, Joshua T.; Raney, R. Keith

2011-01-01

The Mini-RF radar on the Lunar Reconnaissance Orbiter's spacecraft has revealed a great variety of crater ejecta flow and impact melt deposits, some of which were not observed in prior radar imaging. The craters Tycho and Glushko have long melt flows that exhibit variations in radar backscatter and circular polarization ratio along the flow. Comparison with optical imaging reveals that these changes are caused by features commonly seen in terrestrial lava flows, such as rafted plates, pressure ridges, and ponding. Small (less than 20 km) sized craters also show a large variety of features, including melt flows and ponds. Two craters have flow features that may be ejecta flows caused by entrained debris flowing across the surface rather than by melted rock. The circular polarization ratios (CPRs) of the impact melt flows are typically very high; even ponded areas have CPR values between 0.7-1.0. This high CPR suggests that deposits that appear smooth in optical imagery may be rough at centimeter- and decimeter- scales. In some places, ponds and flows are visible with no easily discernable source crater. These melt deposits may have come from oblique impacts that are capable of ejecting melted material farther downrange. They may also be associated with older, nearby craters that no longer have a radar-bright proximal ejecta blanket. The observed morphology of the lunar crater flows has implications for similar features observed on Venus. In particular, changes in backscatter along many of the ejecta flows are probably caused by features typical of lava flows.

The EarthCARE satellite payload

NASA Astrophysics Data System (ADS)

Wallace, Kotska; Perez-Albinana, Abelardo; Lemanczyk, Jerzy; Heliere, Arnaud; Wehr, Tobias; Eisinger, Michael; Lefebvre, Alain; Nakatsuka, Hirotaka; Tomita, Eiichi

2014-10-01

EarthCARE is ESA's third Earth Explorer Core Mission, with JAXA providing one instrument. The mission facilitates unique data product synergies, to improve understanding of atmospheric cloud-aerosol interactions and Earth radiative balance, towards enhancing climate and numerical weather prediction models. This paper will describe the payload, consisting of two active instruments: an ATmospheric LIDar (ATLID) and a Cloud Profiling Radar (CPR), and two passive instruments: a Multi Spectral Imager (MSI) and a Broad Band Radiometer (BBR). ATLID is a UV lidar providing atmospheric echoes, with a vertical resolution of 100 m, up to 40 km altitude. Using very high spectral resolution filtering the relative contributions of particle (aerosols) and Rayleigh (molecular) back scattering will be resolved, allowing cloud and aerosol optical depth to be deduced. Particle scatter co- and cross-polarisation measurements will provide information about the cloud and aerosol particles' physical characteristics. JAXA's 94.05 GHz Cloud Profiling Radar operates with a pulse width of 3.3 μm and repetition frequency 6100 to 7500 Hz. The 2.5 m aperture radar will retrieve data on clouds and precipitation. Doppler shift measurements in the backscatter signal will furthermore allow inference of the vertical motion of particles to an accuracy of about 1 m/s. MSI's 500 m pixel data will provide cloud and aerosol information and give context to the active instrument measurements for 3-D scene construction. Four solar channels and three thermal infrared channels cover 35 km on one side to 115 km on the other side of the other instrument's observations. BBR measures reflected solar and emitted thermal radiation from the scene. To reduce uncertainty in the radiance to flux conversion, three independent view angles are observed for each scene. The combined data allows more accurate flux calculations, which can be further improved using MSI data.

ATLID: atmospheric lidar for clouds and aerosol observation combined with radar sounding

NASA Astrophysics Data System (ADS)

Pain, Th.; Martimort, Ph.; Tanguy, Ph.; Leibrandt, W.; Heliere, A.

2017-11-01

The atmospheric lidar ATLID is part of the payload of the joint collaborative satellite mission Earth Cloud and Aerosol Explorer (EarthCARE) conducted by the European Space Agency (ESA) and the National Space Development Agency of Japan (JAXA). In December 2002, ESA granted Alcatel Space with a phase A study of the EarthCARE mission in which Alcatel Space is also in charge to define ATLID. The primary objective of ATLID at the horizon 2011 is to provide global observation of clouds in synergy with a cloud profiling radar (CPR) mounted on the same platform. The planned spaceborne mission also embarks an imager and a radiometer and shall fly for 3 years. The lidar design is based on a novel concept that maximises the scientific return and fosters a cost-effective approach. This improved capability results from a better understanding of the way optical characteristics of aerosol and clouds affect the performance budget. For that purpose, an end to end performance model has been developed utilising a versatile data retrieval method suitable for new and more conventional approaches. A synthesis of the achievable performance will be presented to illustrate the potential of the system together with a description of the design.

Combining In-situ Measurements, Passive Satellite Imagery, and Active Radar Retrievals for the Detection of High Ice Water Content

NASA Astrophysics Data System (ADS)

Yost, C. R.; Minnis, P.; Bedka, K. M.; Nguyen, L.; Palikonda, R.; Spangenberg, D.; Strapp, J. W.; Delanoë, J.; Protat, A.

2016-12-01

At least one hundred jet engine power loss events since the 1990s have been attributed to the phenomenon known as ice crystal icing (ICI). Ingestion of high concentrations of ice particles into aircraft engines is thought to cause these events, but it is clear that the use of current on-board weather radar systems alone is insufficient for detecting conditions that might cause ICI. Passive radiometers in geostationary orbit are valuable for monitoring systems that produce high ice water content (HIWC) and will play an important role in nowcasting, but are incapable of making vertically resolved measurements of ice particle concentration, i.e., ice water content (IWC). Combined radar, lidar, and in-situ measurements are essential for developing a skilled satellite-based HIWC nowcasting technique. The High Altitude Ice Crystals - High Ice Water Content (HAIC-HIWC) field campaigns in Darwin, Australia, and Cayenne, French Guiana, have produced a valuable dataset of in-situ total water content (TWC) measurements with which to study conditions that produce HIWC. The NASA Langley Satellite ClOud and Radiative Property retrieval System (SatCORPS) was used to derive cloud physical and optical properties such cloud top height, temperature, optical depth, and ice water path from multi-spectral satellite imagery acquired throughout the HAIC-HIWC campaigns. These cloud properties were collocated with the in-situ TWC measurements in order to characterize cloud properties in the vicinity of HIWC. Additionally, a database of satellite-derived overshooting cloud top (OT) detections was used to identify TWC measurements in close proximity to convective cores likely producing large concentrations of ice crystals. Certain cloud properties show some sensitivity to increasing TWC and a multivariate probabilistic indicator of HIWC was developed from these datasets. This paper describes the algorithm development and demonstrates the HIWC indicator with imagery from the HAIC-HIWC campaigns. Vertically resolved IWC retrievals from active sensors such as the Cloud Profiling Radar (CPR) on CloudSat and the Doppler Radar System Airborne (RASTA) provide IWC profiles with which to validate and potentially enhance the satellite-based HIWC indicator.

Lunar pyroclastic deposits as seen by the Mini-SAR on Chandrayaan-1

NASA Astrophysics Data System (ADS)

Thomson, B. J.; Spudis, P.; Bussey, B.; Neisch, C.

2009-12-01

The principal objective of the Mini-SAR (synthetic aperture radar) instrument on the Chandrayaan-1 spacecraft is the investigation of permanently shadowed regions in the lunar polar regions. But additional radar observations have been made of selected non-polar targets for comparison with observations of polar targets, as well as for their own intrinsic scientific merit. These non-polar targets include former Apollo and other landing sites, lunar pyroclastic deposits, and select fresh and degraded impact craters. Here we focus on observations of a maar-type volcanic feature on the floor of Schrödinger Basin, which has been previously interpreted as a pyroclastic deposit [1]. Lunar pyroclastic deposits have a unique physical texture - glass spheres - resulting from their origin in fire fountains associated with basaltic eruptions. Schrödinger Basin is a 320 km diameter peak ring basin centered at 75°S, 138°E. Based on crater counts and superposition relationships, it appears to be only slightly older than the Orientale Basin, making it among the youngest and freshest lunar basins of its size [2]. Mini-SAR observations cover half of the basin closest to the south pole, including a portion of the central smooth plains material. Circular polarization ratio (CPR) values for the dark mantle deposits on the floor of Schrödinger are 0.2 to 0.3, which are lower than the median value of about 0.5 for the surrounding terrain. High CPR values can result from rough, rocky surfaces or from the presence of ice. Since the floor of Schrödinger is not in shadow, low CPR values here are likely indicative of a low abundance of scattering elements (e.g., rocks), consistent with the known properties of pyroclastic deposits. Comparisons of the radar return of the Schrödinger floor deposits with other dark mantle deposits are ongoing. [1] Shoemaker, E.M. et al. (1994) Science, 266, 1851-1854. [2] Wilhelms, D.E. (1987) USGS Prof Paper 1348, 302 pp.

Dietary flavonoids added to pharmacological antihypertensive therapy are effective in improving blood pressure.

PubMed

de Jesús Romero-Prado, Marina María; Curiel-Beltrán, Jesús Aarón; Miramontes-Espino, María Viviana; Cardona-Muñoz, Ernesto Germán; Rios-Arellano, Angeles; Balam-Salazar, Lol-Be

2015-07-01

Epidemiological studies have suggested that the daily intake of flavonoids is associated with a decreased risk of developing cardiovascular disease. Our purpose was to evaluate the effect of the addition of dietary flavonoids (DF) to antihypertensive treatment (AHT), based on telmisartan (Tms) or captopril (Cpr), on blood pressure (BP), body mass index (BMI), waist/hip ratio, leptin, lipid profile and inflammation in hypertensive young patients. An open-label, randomized, controlled trial was performed among 79 patients aged 20-55 years with grade I or grade II systemic arterial hypertension. The subjects were assigned to one of four groups for AHT plus DF during 6 months: Cpr (n = 14), Cpr + DF (n = 19), Tms (n = 25) and Tms + DF (n = 21). DF consisted of dark chocolate, dehydrated red apple and green tea in an infusion to obtain a daily dose of 425.8 ± 13.9 mg epicatechin equivalents. The BP and anthropometric parameters were measured every 2 weeks. Lipid profile, leptin and hsCRP were determined by standard methods. The combination AHT-DF produced an additional and significant reduction in (i) SBP/DBP of -5/-4 mmHg, being -7/-5 for Cpr + DF and -4/-3 for Tms + DF; (ii) triglyceride levels (-30.6%) versus AHT alone (-9.6%); and (iii) leptin: Cpr + DF versus Tms + DF (p < 0.005). Finally, C-reactive protein plasma levels were reduced significantly in all groups independently of the applied treatment. We conclude that the addition of flavonoids to pharmacological antihypertensive therapy shows additional benefits on BP, lipid profile, leptin, obesity and inflammation. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Adrenodoxin supports reactions catalyzed by microsomal steroidogenic cytochrome P450s

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pechurskaya, Tatiana A.; Harnastai, Ivan N.; Grabovec, Irina P.

2007-02-16

The interaction of adrenodoxin (Adx) and NADPH cytochrome P450 reductase (CPR) with human microsomal steroidogenic cytochrome P450s was studied. It is found that Adx, mitochondrial electron transfer protein, is able to support reactions catalyzed by human microsomal P450s: full length CYP17, truncated CYP17, and truncated CYP21. CPR, but not Adx, supports activity of truncated CYP19. Truncated and the full length CYP17s show distinct preference for electron donor proteins. Truncated CYP17 has higher activity with Adx compared to CPR. The alteration in preference to electron donor does not change product profile for truncated enzymes. The electrostatic contacts play a major rolemore » in the interaction of truncated CYP17 with either CPR or Adx. Similarly electrostatic contacts are predominant in the interaction of full length CYP17 with Adx. We speculate that Adx might serve as an alternative electron donor for CYP17 at the conditions of CPR deficiency in human.« less

EarthCARE mission, overview, implementation approach and development status

NASA Astrophysics Data System (ADS)

Lefebvre, Alain; Hélière, Arnaud; Pérez Albiñana, Abelardo; Wallace, Kotska; Maeusli, Damien; Lemanczyk, Jerzy; Lusteau, Cyrille; Nakatsuka, Hirotaka; Tomita, Eiichi

2016-05-01

The European Space Agency (ESA) and the Japan Aerospace Exploration Agency (JAXA) are co-operating to develop the EarthCARE satellite mission with the fundamental objective of improving the understanding of the processes involving clouds, aerosols and radiation in the Earth's atmosphere in order to include them correctly and reliably in climate and numerical weather prediction models. The satellite will be placed in a Sun-Synchronous Orbit at about 400 Km altitude and14h00 mean local solar time. The payload consisting of a High Spectral Resolution UV Atmospheric LIDar (ATLID), a 94GHz Cloud Profiling Radar (CPR) with Doppler capability, a Multi-Spectral Imager (MSI) and a Broad-Band Radiometer will provide information on cloud and aerosol vertical structure of the atmosphere along the satellite track as well as information about the horizontal structures of clouds and radiant flux from sub-satellite cells. The presentation will cover the configuration of the satellite with its four instruments, the mission implementation approach, an overview of the ground segment and the overall mission development status.

Modeling Radar Scattering by Planetary Regoliths for Varying Angles of Incidence

NASA Astrophysics Data System (ADS)

Prem, P.; Patterson, G. W.; Zimmerman, M. I.

2017-12-01

Bistatic radar observations can play an important role in characterizing the texture and composition of planetary regoliths. Multiple scattering within a closely-packed particulate medium, such as a regolith, can lead to a response referred to as the Coherent Backscatter Opposition Effect (CBOE), associated with an increase in the intensity of backscattered radiation and an increase in Circular Polarization Ratio (CPR) at small bistatic angles. The nature of the CBOE is thought to depend not only on regolith properties, but also on the angle of incidence (Mishchenko, 1992). The latter factor is of particular interest in light of recent radar observations of the Moon over a range of bistatic and incidence angles by the Mini-RF instrument (on board the Lunar Reconnaissance Orbiter), operating in bistatic mode with a ground-based transmitter at the Arecibo Observatory. These observations have led to some intriguing results that are not yet well-understood ­- for instance, the lunar South Polar crater Cabeus shows an elevated CPR at only some combinations of incidence angle/bistatic angle, a potential clue to the depth distribution of water ice at the lunar poles (Patterson et al., 2017). Our objective in this work is to develop a model for radar scattering by planetary regoliths that can assist in the interpretation of Mini-RF observations. We approach the problem by coupling the Multiple Sphere T-Matrix (MSTM) code of Mackowski and Mishchenko (2011) to a Monte Carlo radiative transfer model. The MSTM code is based on the solution of Maxwell's equations for the propagation of electromagnetic waves in the presence of a cluster of scattering/absorbing spheres, and can be used to model the scattering of radar waves by an aggregation of nominal regolith particles. The scattering properties thus obtained serve as input to the Monte Carlo model, which is used to simulate radar scattering at larger spatial scales. The Monte Carlo approach has the advantage of being able to readily accommodate varying incidence angles, as well as heterogeneities in regolith composition and properties - factors that may be of interest in both lunar and other contexts. We will report on the development and validation of the coupled MSTM-Monte Carlo model, and discuss its application to problems of interest.

Members of the Candidate Phyla Radiation are functionally differentiated by carbon and nitrogen cycling capabilities.

NASA Astrophysics Data System (ADS)

Danczak, R.; Johnston, M.; Kenah, C.; Slattery, M.; Wrighton, K. C.; Wilkins, M.

2017-12-01

The Candidate Phyla Radiation (CPR) is a recently described expansion of the tree of life that represents more than 15% of all bacterial diversity and putatively contains over 70 different phyla. Despite this broad phylogenetic variation, these microorganisms often feature limited functional diversity, with members generally characterized as obligate fermenters. Additionally, much of the data describing CPR phyla has been generated from a limited number of environments, constraining our knowledge of their functional roles and biogeographical distribution. To better understand subsurface CPR microorganisms, we sampled four groundwater wells over two years across three Ohio counties. Samples were analyzed using 16S rRNA gene amplicon and shotgun metagenomic sequencing. Amplicon results indicated that CPR members comprised 2-20% of the microbial communities, with relative abundances stable through time in Athens and Greene county samples but dynamic in Licking county groundwater. Shotgun metagenomic analyses generated 71 putative CPR genomes, representing roughly 32 known phyla and potentially two new phyla, Candidatus Brownbacteria and Candidatus Hugbacteria. While these genomes largely mirrored typical CPR metabolism, some features were previously uncharacterized. For instance, a nirK-encoded nitrite reductase was found in four of our Parcubacteria genomes and multiple CPR genomes from other studies, indicating a possibly undescribed role for these microorganisms in denitrification. Additionally, glycoside hydrolase (GH) family profiles for our genomes and over 2000 other CPR genomes were analyzed to characterize their carbon processing potential. Although common trends were present throughout the radiation, differences highlighted mechanisms that may allow microorganisms across the CPR to occupy various subsurface niches. For example, members of the Microgenomates superphylum appear to potentially degrade a wider range of carbon substrates than other CPR phyla. The CPR appear to be distributed across a range of groundwater systems and often constitute a large fraction of the microbial population. Further sampling of such environments will resolve this phylogenetically broad radiation at finer taxonomic levels and will likely solidify functional differences between phyla.

Using Observations from GPM and CloudSat to Produce a Climatology of Precipitation over the Ocean

NASA Astrophysics Data System (ADS)

Hayden, L.; Liu, C.

2017-12-01

Satellite based instruments are essential to the observation of precipitation at a global scale, especially over remote oceanic regions. Each instrument has its own strengths and limitations when it comes to accurately determining the rate of precipitation occurring at the surface. By using the complementary strengths of two satellite based instruments, we attempt to produce a more complete climatology of global oceanic precipitation. The Global Precipitation Measurement (GPM) Core Osbervatory's Dual-frequency Precipitation Radar (DPR) is capable of measuring precipitation producing radar reflectivity above 12 dBZ [Hamada and Takayabu 2016]. The CloudSat satellite's Cloud Profiling Radar (CPR) uses higher frequency C band (94 GHz) radiation, and is therefore capable of measuring precipitation occurring at low precipitation rates which are not detected by the GPM DPR. The precipitation estimates derived by the two satellites are combined and the results are examined. CloudSat data from July 2006 to December 2010 are used. GPM data from March 2014 through May 2016 are used. Since the two datasets do not temporally overlap, this study is conducted from a climatological standpoint. The average occurrence for different precipitation rates is calculated for both satellites. To produce the combined dataset, the precipitation from CloudSat are used for the low precipitation rates while CloudSat precipitation amount is greater than that from GPM DPR, until GPM DPR precipitation amount is higher than that from CloudSat, at which precipitation rate data from the GPM are used. By combining the two datasets, we discuss the seasonal and geo-graphical distribution of weak precipitation detected by CloudSat that is beyond the sensitivity of GPM DPR. We also hope to gain a more complete picture of the precipitation that occurs over oceanic regions.

The Maturely, Immature Orientale Impact Basin

NASA Astrophysics Data System (ADS)

Cahill, J. T.; Lawrence, D. J.; Stickle, A. M.; Delen, O.; Patterson, G.; Greenhagen, B. T.

2015-12-01

Lunar surface maturity is consistently examined using the NIR optical maturity parameter (OMAT) [1]. However, the NIR only provides a perspective of the upper microns of the lunar surface. Recent studies of Lunar Prospector (LP) and Lunar Reconnaissance Orbiter data sets are now demonstrating additional measures of maturity with sensitivities to greater depths (~2 m) in the regolith. These include thermal infrared, S-band radar, and epithermal neutron data sets [2-4]. Interestingly, each of these parameters is directly comparable to OMAT despite each measuring slightly different aspects of the regolith. This is demonstrated by Lawrence et al. [3] where LP-measured non-polar highlands epithermal neutrons trend well with albedo, OMAT, and the Christensen Feature (CF). Lawrence et al. [3] used these data to derive and map highlands hydrogen (H) which is dominantly a function of H-implantation. With this in mind, areas of enriched-H are mature, while areas of depleted H are immature. Surface roughness as measured by S-band radar [4], also provides a measure of maturity. In this case, the circular polarization ratio (CPR) is high when rough and immature, and low when smooth and mature. Knowing this, one can recognize areas in the non-polar lunar highlands that show contradictory measures of maturity. For example, while many lunar localities show consistently immature albedo, OMAT, CF, CPR, and H concentrations (e.g., Tycho), others do not. Orientale basin is the most prominent example, shown to have immature CPR, CF, and H concentrations despite a relatively mature albedo and OMAT values as well as an old age determination (~3.8 Ga). To better understand how the lunar regolith is weathering in the upper 1-2 m of regolith with time we examine the Orientale basin relative to other highlands regions. [1] Lucey et al. (2000) JGR, 105, 20377; [2] Lucey et al. (2013) LPSC, 44, 2890; [3] Lawrence et al. (2015) Icarus, j.icarus.2015.01.005; [4] Neish et al. (2013) JGR, 118, 2247.

Corpuls cpr resuscitation device generates superior emulated flows and pressures than LUCAS II in a mechanical thorax model.

PubMed

Eichhorn, S; Mendoza Garcia, A; Polski, M; Spindler, J; Stroh, A; Heller, M; Lange, R; Krane, M

2017-06-01

The provision of sufficient chest compression is among the most important factors influencing patient survival during cardiopulmonary resuscitation (CPR). One approach to optimize the quality of chest compressions is to use mechanical-resuscitation devices. The aim of this study was to compare a new device for chest compression (corpuls cpr) with an established device (LUCAS II). We used a mechanical thorax model consisting of a chest with variable stiffness and an integrated heart chamber which generated blood flow dependent on the compression depth and waveform. The method of blood-flow generation could be changed between direct cardiac-compression mode and thoracic-pump mode. Different chest-stiffness settings and compression modes were tested to generate various blood-flow profiles. Additionally, an endurance test at high stiffness was performed to measure overall performance and compression consistency. Both resuscitation machines were able to compress the model thorax with a frequency of 100/min and a depth of 5 cm, independent of the chosen chest stiffness. Both devices passed the endurance test without difficulty. The corpuls cpr device was able to generate about 10-40% more blood flow than the LUCAS II device, depending on the model settings. In most scenarios, the corpuls cpr device also generated a higher blood pressure than the LUCAS II. The peak compression forces during CPR were about 30% higher using the corpuls cpr device than with the LUCAS II. In this study, the corpuls cpr device had improved blood flow and pressure outcomes than the LUCAS II device. Further examination in an animal model is required to prove the findings of this preliminary study.

Survival and neurological outcome following in-hospital paediatric cardiopulmonary resuscitation in North India.

PubMed

Rathore, Vinay; Bansal, Arun; Singhi, Sunit C; Singhi, Pratibha; Muralidharan, Jayashree

2016-05-01

Data on outcome of children undergoing in-hospital cardiopulmonary resuscitation (CPR) in low- and middle-income countries are scarce. To describe the clinical profile and outcome of children undergoing in-hospital CPR. This prospective observational study was undertaken in the Advanced Pediatric Center, PGIMER, Chandigarh. All patients aged 1 month to 12 years who underwent in-hospital CPR between July 2010 and March 2011 were included. Data were recorded using the 'Utstein style'. Outcome variables included 'sustained return of spontaneous circulation' (ROSC), survival at discharge and neurological outcome at 1 year. The incidence of in-hospital CPR in all hospital admissions (n = 4654) was 6.7% (n = 314). 64.6% (n = 203) achieved ROSC, 14% (n = 44) survived to hospital discharge and 11.1% (n = 35) survived at 1 year. Three-quarters of survivors had a good neurological outcome at 1-year follow-up. Sixty per cent of patients were malnourished. The Median Pediatric Risk of Mortality-III (PRISM-III) score was 16 (IQR 9-25). Sepsis (71%), respiratory (39.5%) and neurological (31.5%) illness were the most common diagnoses. The most common initial arrhythmia was bradycardia (52.2%). On multivariate logistic regression, duration of CPR, diagnosis of sepsis and requirement for vasoactive support prior to arrest were independent predictors of decreased hospital survival. The requirement for in-hospital CPR is common in PGIMER. ROSC was achieved in two-thirds of children, but mortality was higher than in high-income countries because of delayed presentation, malnutrition and severity of illness. CPR >15 min was associated with death. Survivors had good long-term neurological outcome, demonstrating the value of timely CPR.

NADPH-Cytochrome P450 Reductase: Molecular Cloning and Functional Characterization of Two Paralogs from Withania somnifera (L.) Dunal

PubMed Central

Rana, Satiander; Lattoo, Surrinder K.; Dhar, Niha; Razdan, Sumeer; Bhat, Wajid Waheed; Dhar, Rekha S.; Vishwakarma, Ram

2013-01-01

Withania somnifera (L.) Dunal, a highly reputed medicinal plant, synthesizes a large array of steroidal lactone triterpenoids called withanolides. Although its chemical profile and pharmacological activities have been studied extensively during the last two decades, limited attempts have been made to decipher the biosynthetic route and identification of key regulatory genes involved in withanolide biosynthesis. Cytochrome P450 reductase is the most imperative redox partner of multiple P450s involved in primary and secondary metabolite biosynthesis. We describe here the cloning and characterization of two paralogs of cytochrome P450 reductase from W. somnifera. The full length paralogs of WsCPR1 and WsCPR2 have open reading frames of 2058 and 2142 bp encoding 685 and 713 amino acid residues, respectively. Phylogenetic analysis demonstrated that grouping of dual CPRs was in accordance with class I and class II of eudicotyledon CPRs. The corresponding coding sequences were expressed in Escherichia coli as glutathione-S-transferase fusion proteins, purified and characterized. Recombinant proteins of both the paralogs were purified with their intact membrane anchor regions and it is hitherto unreported for other CPRs which have been purified from microsomal fraction. Southern blot analysis suggested that two divergent isoforms of CPR exist independently in Withania genome. Quantitative real-time PCR analysis indicated that both genes were widely expressed in leaves, stalks, roots, flowers and berries with higher expression level of WsCPR2 in comparison to WsCPR1. Similar to CPRs of other plant species, WsCPR1 was un-inducible while WsCPR2 transcript level increased in a time-dependent manner after elicitor treatments. High performance liquid chromatography of withanolides extracted from elicitor-treated samples showed a significant increase in two of the key withanolides, withanolide A and withaferin A, possibly indicating the role of WsCPR2 in withanolide biosynthesis. Present investigation so far is the only report of characterization of CPR paralogs from W. somnifera. PMID:23437311

Combined VHF Dopplar radar and airborne (CV-990) measurements of atmospheric winds on the mesoscale

NASA Technical Reports Server (NTRS)

Fairall, Christopher W.; Thomson, Dennis W.

1989-01-01

Hourly measurements of wind speed and direction obtained using two wind profiling Doppler radars during two prolonged jet stream occurrences over western Pennsylvania were analyzed. In particular, the time-variant characteristics of derived shear profiles were examined. To prevent a potential loss of structural detail and retain statistical significance, data from both radars were stratified into categories based on the location data from the Penn State radar were also compared to data from Pittsburgh radiosondes. Profiler data dropouts were studied in an attempt to determine possible reasons for the apparently reduced performance of profiling radars operating beneath a jet stream. Temperature profiles for the radar site were obtained using an interpolated temperature and dewpoint temperature sounding procedure developed at Penn State. The combination of measured wind and interpolated temperature profiles allowed Richardson number profiles to be generated for the profiler sounding volume. Both Richardson number and wind shear statistics were then examined along with pilot reports of turbulence in the vicinity of the profiler.

Cloning, functional characterization, and expression profiles of NADPH-cytochrome P450 reductase gene from the Asiatic rice striped stem borer, Chilo suppressalis (Lepidoptera: Pyralidae).

PubMed

Liu, Su; Liang, Qing-Mei; Huang, Yuan-Jie; Yuan, Xin; Zhou, Wen-Wu; Qiao, Fei; Cheng, Jiaan; Gurr, Geoff M; Zhu, Zeng-Rong

2013-01-01

NADPH-cytochrome P450 reductase (CPR) is one of the most important components of the cytochrome P450 enzyme system. It catalyzes electron transfer from NADPH to all known P450s, thus plays central roles not only in the metabolism of exogenous xenobiotics but also in the regulation of endogenous hormones in insects. In this study, a full-length cDNA encoding of a CPR (named CsCPR) was isolated from the Asiatic rice striped stem borer, Chilo suppressalis, by using reverse transcription-polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) methods. The cDNA contains a 2061 bp open reading frame, which encodes an enzyme of 686 amino acid residues, with a calculated molecular mass of 77.6 kDa. The deduced peptide has hallmarks of typical CPR, including an N-terminal membrane anchor and the FMN, FAD and NADPH binding domains. The N-terminal-truncated protein fused with a 6 × His·tag was heterologously expressed in Escherichia coli Rosetta (DE3) cells and purified, specific activity and the Km values of the recombinant enzyme were determined. Tissue- and developmental stage-dependent expression of CsCPR mRNA was investigated by real-time quantitative PCR. The CsCPR mRNA was noticeably expressed in the digestive, metabolic, and olfactory organs of the larvae and adults of C. suppressalis. Our initial results would provide valuable information for further study on the interactions between CPR and cytochrome P450 enzyme systems. © 2013.

Polar cloud observatory at Ny-Ålesund in GRENE Arctic Climate Change Research Project

NASA Astrophysics Data System (ADS)

Yamanouchi, Takashi; Takano, Toshiaki; Shiobara, Masataka; Okamoto, Hajime; Koike, Makoto; Ukita, Jinro

2016-04-01

Cloud is one of the main processes in the climate system and especially a large feed back agent for Arctic warming amplification (Yoshimori et al., 2014). From this reason, observation of polar cloud has been emphasized and 95 GHz cloud profiling radar in high precision was established at Ny-Ålesund, Svalbard in 2013 as one of the basic infrastructure in the GRENE (Green Network of Excellence Program) Arctic Climate Change Research Project. The radar, "FALCON-A", is a FM-CW (frequency modulated continuous wave) Doppler radar, developed for Arctic use by Chiba University (PI: T. Takano) in 2012, following its prototype, "FALCON-1" which was developed in 2006 (Takano et al., 2010). The specifications of the radar are, central frequency: 94.84 GHz; antenna power: 1 W; observation height: up to 15 km; range resolution: 48 m; beam width: 0.2 degree (15 m at 5 km); Doppler width: 3.2 m/s; time interval: 10 sec, and capable of archiving high sensitivity and high spatial and time resolution. An FM-CW type radar realizes similar sensitivity with much smaller parabolic antennas separated 1.4 m from each other used for transmitting and receiving the wave. Polarized Micro-Pulse Lidar (PMPL, Sigma Space MPL-4B-IDS), which is capable to measure the backscatter and depolarization ratio, has also been deployed to Ny-Ålesund in March 2012, and now operated to perform collocated measurements with FALCON-A. Simultaneous measurement data from collocated PMPL and FALCON-A are available for synergetic analyses of cloud microphysics. Cloud mycrophysics, such as effective radius of ice particles and ice water content, are obtained from the analysis based on algorithm, which is modified for ground-based measurements from Okamoto's retrieval algorithm for satellite based cloud profiling radar and lidar (CloudSat and CALIPSO; Okamoto et al., 2010). Results of two years will be shown in the presentation. Calibration is a point to derive radar reflectivity (dBZ) from original intensity data. Degradation of transmission power was monitored and sensitivity of receiving system was derived with estimating antenna gain by using radio wave absorber and considering antenna geometry of two antenna system. In order to estimate final results, altitude dependent detection limit curve was also calculated. Original intensity data in real time and calibrated radar reflectivity data are archived on "Arctic Data archive System (ADS)". Other collocated observations were made with fog monitor (particle size distribution), MPS (particle image) for continuous measurements at Zeppelin Mountain, 450 m height a. s. l., and tethered balloon for intense observing period. From these measurements together with aerosol and meteorological monitoring made by collaborating institutes (Stockholm University, University of Florence, AWI, NILU, NCAR and NPI) microphysics of low level cloud and aerosol-cloud interactions are discussed. Ground based remote sensors provide a powerful validation for satellite cloud observations. Radar reflectivity (dBZ) by FALCON-A was compared with that by CPR on CloudSAT during several overpasses around Ny-Ålesund, and though some difference due to the different vertical resolution was seen, overall agreement was confirmed. We are planning to establish Ny-Ålesund observatory as the super site for validation for EarthCARE (JAXA-ESA) mission.

Objective Classification of Radar Profile Types, and Their Relationship to Lightning Occurrence

NASA Technical Reports Server (NTRS)

Boccippio, Dennis

2003-01-01

A cluster analysis technique is used to identify 16 "archetypal" vertical radar profile types from a large, globally representative sample of profiles from the TRMM Precipitation Radar. These include nine convective types (7 of these deep convective) and seven stratiform types (5 of these clearly glaciated). Radar profile classification provides an alternative to conventional deep convective storm metrics, such as 30 dBZ echo height, maximum reflectivity or VIL. As expected, the global frequency of occurrence of deep convective profile types matches satellite-observed total lightning production, including to very small scall local features. Each location's "mix" of profile types provides an objective description of the local convective spectrum, and in turn, is a first step in objectively classifying convective regimes. These classifiers are tested as inputs to a neural network which attempts to predict lightning occurrence based on radar-only storm observations, and performance is compared with networks using traditional radar metrics as inputs.

Evaluation of cardiopulmonary resuscitation techniques in microgravity

NASA Technical Reports Server (NTRS)

Billica, Roger; Gosbee, John; Krupa, Debra T.

1991-01-01

Cardiopulmonary resuscitation (CPR) techniques were investigated in microgravity with specific application to planned medical capabilities for Space Station Freedom (SSF). A KC-135 parabolic flight test was performed with the goal of evaluating and quantifying the efficacy of different types of microgravity CPR techniques. The flight followed the standard 40 parabola profile with 20 to 25 seconds of near-zero gravity in each parabola. Three experiments were involved chosen for their clinical background, certification, and practical experience in prior KC-135 parabolic flight. The CPR evaluation was performed using a standard training mannequin (recording resusci-Annie) which was used in practice prior to the actual flight. Aboard the KC-135, the prototype medical restraint system (MRS) for the SSF Health Maintenance Facility (HMF) was used for part of the study. Standard patient and crew restraints were used for interface with the MRS. During the portion of study where CPR was performed without MRS, a set of straps for crew restraint similar to those currently employed for the Space Shuttle program were used. The entire study was recorded via still camera and video.

Performance of the Colorado wind-profiling network, part 1.5A

NASA Technical Reports Server (NTRS)

Strauch, R. G.; Earnshaw, K. B.; Merritt, D. A.; Moran, K. P.; Vandekamp, D. W.

1984-01-01

The Wave Propagation Laboratory (WPL) has operated a network of radar wind Profilers in Colorado for about 1 year. The network consists of four VHF (50-MHz) radars and a UHF (915-MHz) radar. The Platteville VHF radar was developed by the Aeronomy Laboratory (AL) and has been operated jointly by WPL and AL for several years. The other radars were installed between February and May 1983. Experiences with these radars and some general aspects of tropospheric wind measurements with Doppler radar are discussed.

Parameterization of Cirrus Cloud Vertical Profiles and Geometrical Thickness Using CALIPSO and CloudSat Data

NASA Astrophysics Data System (ADS)

Khatri, P.; Iwabuchi, H.; Saito, M.

2017-12-01

High-level cirrus clouds, which normally occur over more than 20% of the globe, are known to have profound impacts on energy budget and climate change. The scientific knowledge regarding the vertical structure of such high-level cirrus clouds and their geometrical thickness are relatively poorer compared to low-level water clouds. Knowledge regarding cloud vertical structure is especially important in passive remote sensing of cloud properties using infrared channels or channels strongly influenced by gaseous absorption when clouds are geometrically thick and optically thin. Such information is also very useful for validating cloud resolving numerical models. This study analyzes global scale data of ice clouds identified by Cloud profiling Radar (CPR) onboard CloudSat and Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) onboard CALIPSO to parameterize (i) vertical profiles of ice water content (IWC), cloud-particle effective radius (CER), and ice-particle number concentration for varying ice water path (IWP) values and (ii) the relation of cloud geometrical thickness (CGT) with IWP and CER for varying cloud top temperature (CTT) values. It is found that the maxima in IWC and CER profile shifts towards cloud base with the increase of IWP. Similarly, if the cloud properties remain same, CGT shows an increasing trend with the decrease of CTT. The implementation of such cloud vertical inhomogeneity parameterization in the forward model used in the Integrated Cloud Analysis System ICAS (Iwabuchi et al., 2016) generally shows increase of brightness temperatures in infrared channels compared to vertically homogeneous cloud assumption. The cloud vertical inhomogeneity is found to bring noticeable changes in retrieved cloud properties. Retrieved CER and cloud top height become larger for optically thick cloud. We will show results of comparison of cloud properties retrieved from infrared measurements and active remote sensing.

Neural network cloud top pressure and height for MODIS

NASA Astrophysics Data System (ADS)

Håkansson, Nina; Adok, Claudia; Thoss, Anke; Scheirer, Ronald; Hörnquist, Sara

2018-06-01

Cloud top height retrieval from imager instruments is important for nowcasting and for satellite climate data records. A neural network approach for cloud top height retrieval from the imager instrument MODIS (Moderate Resolution Imaging Spectroradiometer) is presented. The neural networks are trained using cloud top layer pressure data from the CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) dataset. Results are compared with two operational reference algorithms for cloud top height: the MODIS Collection 6 Level 2 height product and the cloud top temperature and height algorithm in the 2014 version of the NWC SAF (EUMETSAT (European Organization for the Exploitation of Meteorological Satellites) Satellite Application Facility on Support to Nowcasting and Very Short Range Forecasting) PPS (Polar Platform System). All three techniques are evaluated using both CALIOP and CPR (Cloud Profiling Radar for CloudSat (CLOUD SATellite)) height. Instruments like AVHRR (Advanced Very High Resolution Radiometer) and VIIRS (Visible Infrared Imaging Radiometer Suite) contain fewer channels useful for cloud top height retrievals than MODIS, therefore several different neural networks are investigated to test how infrared channel selection influences retrieval performance. Also a network with only channels available for the AVHRR1 instrument is trained and evaluated. To examine the contribution of different variables, networks with fewer variables are trained. It is shown that variables containing imager information for neighboring pixels are very important. The error distributions of the involved cloud top height algorithms are found to be non-Gaussian. Different descriptive statistic measures are presented and it is exemplified that bias and SD (standard deviation) can be misleading for non-Gaussian distributions. The median and mode are found to better describe the tendency of the error distributions and IQR (interquartile range) and MAE (mean absolute error) are found to give the most useful information of the spread of the errors. For all descriptive statistics presented MAE, IQR, RMSE (root mean square error), SD, mode, median, bias and percentage of absolute errors above 0.25, 0.5, 1 and 2 km the neural network perform better than the reference algorithms both validated with CALIOP and CPR (CloudSat). The neural networks using the brightness temperatures at 11 and 12 µm show at least 32 % (or 623 m) lower MAE compared to the two operational reference algorithms when validating with CALIOP height. Validation with CPR (CloudSat) height gives at least 25 % (or 430 m) reduction of MAE.

Development status of the EarthCARE Mission and its atmospheric Lidar

NASA Astrophysics Data System (ADS)

Hélière, A.; Wallace, K.; Pereira Do Carmo, J.; Lefebvre, A.; Eisinger, M.; Wehr, T.

2016-09-01

The European Space Agency (ESA) and the Japan Aerospace Exploration Agency (JAXA) are co-operating to develop as part of ESA's Living Planet Programme, the third Earth Explorer Core Mission, EarthCARE, with the fundamental objective of improving the understanding of the processes involving clouds, aerosols and radiation in the Earth's atmosphere. EarthCARE payload consists of two active and two passive instruments: an ATmospheric LIDar (ATLID), a Cloud Profiling Radar (CPR), a Multi-Spectral Imager (MSI) and a Broad-Band Radiometer (BBR). The four instruments data are processed individually and in a synergetic manner to produce a large range of products, which include vertical profiles of aerosols, liquid water and ice, observations of cloud distribution and vertical motion within clouds, and will allow the retrieval of profiles of atmospheric radiative heating and cooling. Operating in the UV range at 355 nm, ATLID provides atmospheric echoes with a vertical resolution up to 100 m from ground to an altitude of 40 km. Thanks to a high spectral resolution filtering, the lidar is able to separate the relative contribution of aerosol (Mie) and molecular (Rayleigh) scattering, which gives access to aerosol optical depth. Co-polarised and cross-polarised components of the Mie scattering contribution are also separated and measured on dedicated channels. This paper gives an overview of the mission science objective, the satellite configuration with its four instruments and details more specifically the implementation and development status of the Atmospheric Lidar. Manufacturing status and first equipment qualification test results, in particular for what concerns the laser transmitter development are presented.

Earth cloud, aerosol, and radiation explorer optical payload development status

NASA Astrophysics Data System (ADS)

Hélière, A.; Wallace, K.; Pereira do Carmo, J.; Lefebvre, A.

2017-09-01

The European Space Agency (ESA) and the Japan Aerospace Exploration Agency (JAXA) are co-operating to develop as part of ESA's Living Planet Programme, the third Earth Explorer Core Mission, EarthCARE, with the ojective of improving the understanding of the processes involving clouds, aerosols and radiation in the Earth's atmosphere. EarthCARE payload consists of two active and two passive instruments: an ATmospheric LIDar (ATLID), a Cloud Profiling Radar (CPR), a Multi-Spectral Imager (MSI) and a Broad-Band Radiometer (BBR). The four instruments data are processed individually and in a synergetic manner to produce a large range of products, which include vertical profiles of aerosols, liquid water and ice, observations of cloud distribution and vertical motion within clouds, and will allow the retrieval of profiles of atmospheric radiative heating and cooling. MSI is a compact instrument with a 150 km swath providing 500 m pixel data in seven channels, whose retrieved data will give context to the active instrument measurements, as well as providing cloud and aerosol information. BBR measures reflected solar and emitted thermal radiation from the scene. Operating in the UV range at 355 nm, ATLID provides atmospheric echoes from ground to an altitude of 40 km. Thanks to a high spectral resolution filtering, the lidar is able to separate the relative contribution of aerosol and molecular scattering, which gives access to aerosol optical depth. Co-polarised and cross-polarised components of the Mie scattering contribution are measured on dedicated channels. This paper will provide a description of the optical payload implementation, the design and characterisation of the instruments.

On the potential use of radar-derived information in operational numerical weather prediction

NASA Technical Reports Server (NTRS)

Mcpherson, R. D.

1986-01-01

Estimates of requirements likely to be levied on a new observing system for mesoscale meteonology are given. Potential observing systems for mesoscale numerical weather prediction are discussed. Thermodynamic profiler radiometers, infrared radiometer atmospheric sounders, Doppler radar wind profilers and surveillance radar, and moisture profilers are among the instruments described.

Estimating the contribution of a service delivery organisation to the national modern contraceptive prevalence rate: Marie Stopes International's Impact 2 model

PubMed Central

2013-01-01

Background Individual family planning service delivery organisations currently rely on service provision data and couple-years of protection as health impact measures. Due to the substitution effect and the continuation of users of long-term methods, these metrics cannot estimate an organisation's contribution to the national modern contraceptive prevalence rate (CPR), the standard metric for measuring family planning programme impacts. Increasing CPR is essential for addressing the unmet need for family planning, a recognized global health priority. Current health impact estimation models cannot isolate the impact of an organisation in these efforts. Marie Stopes International designed the Impact 2 model to measure an organisation's contribution to increases in national CPR, as well as resulting health and demographic impacts. This paper aims to describe the methodology for modelling increasing national-level CPR as well as to discuss its benefits and limitations. Methods Impact 2 converts service provision data into estimates of the number of family planning users, accounting for continuation among users of long-term methods and addressing the challenges of converting commodity distribution data of short-term methods into user numbers. These estimates, combined with the client profile and data on the organisation's previous year's CPR contribution, enable Impact 2 to estimate which clients maintain an organisation's baseline contribution, which ones fulfil population growth offsets, and ultimately, which ones increase CPR. Results Illustrative results from Marie Stopes Madagascar show how Impact 2 can be used to estimate an organisation's contribution to national changes in the CPR. Conclusions Impact 2 is a useful tool for service delivery organisations to move beyond cruder output measures to a better understanding of their role in meeting the global unmet need for family planning. By considering health impact from the perspective of an individual organisation, Impact 2 addresses gaps not met by other models for family planning service outcomes. Further, the model helps organisations improve service delivery by demonstrating that increases in the national CPR are not simply about expanding user numbers; rather, the type of user (e.g. adopters, provider changers) must be considered. Impact 2 can be downloaded at http://www.mariestopes.org/impact-2. PMID:23902699

Laser one-dimensional range profile and the laser two-dimensional range profile of cylinders

NASA Astrophysics Data System (ADS)

Gong, Yanjun; Wang, Mingjun; Gong, Lei

2015-10-01

Laser one-dimensional range profile, that is scattering power from pulse laser scattering of target, is a radar imaging technology. The laser two-dimensional range profile is two-dimensional scattering imaging of pulse laser of target. Laser one-dimensional range profile and laser two-dimensional range profile are called laser range profile(LRP). The laser range profile can reflect the characteristics of the target shape and surface material. These techniques were motivated by applications of laser radar to target discrimination in ballistic missile defense. The radar equation of pulse laser is given in this paper. This paper demonstrates the analytical model of laser range profile of cylinder based on the radar equation of the pulse laser. Simulations results of laser one-dimensional range profiles of some cylinders are given. Laser range profiles of cylinder, whose surface material with diffuse lambertian reflectance, is given in this paper. Laser range profiles of different pulse width of cylinder are given in this paper. The influences of geometric parameters, pulse width, attitude on the range profiles are analyzed.

Applicability of radar subsurface profiling in estimating sidewalk undermining.

DOT National Transportation Integrated Search

1979-01-01

An evaluation was made of the applicability of the geophysical technique of radar subsurface profiling to estimating the extent of sidewalk undermining. It was found that there is a distinct difference between the observed radar echo patterns of a no...

Bird migration flight altitudes studied by a network of operational weather radars.

PubMed

Dokter, Adriaan M; Liechti, Felix; Stark, Herbert; Delobbe, Laurent; Tabary, Pierre; Holleman, Iwan

2011-01-06

A fully automated method for the detection and quantification of bird migration was developed for operational C-band weather radar, measuring bird density, speed and direction as a function of altitude. These weather radar bird observations have been validated with data from a high-accuracy dedicated bird radar, which was stationed in the measurement volume of weather radar sites in The Netherlands, Belgium and France for a full migration season during autumn 2007 and spring 2008. We show that weather radar can extract near real-time bird density altitude profiles that closely correspond to the density profiles measured by dedicated bird radar. Doppler weather radar can thus be used as a reliable sensor for quantifying bird densities aloft in an operational setting, which--when extended to multiple radars--enables the mapping and continuous monitoring of bird migration flyways. By applying the automated method to a network of weather radars, we observed how mesoscale variability in weather conditions structured the timing and altitude profile of bird migration within single nights. Bird density altitude profiles were observed that consisted of multiple layers, which could be explained from the distinct wind conditions at different take-off sites. Consistently lower bird densities are recorded in The Netherlands compared with sites in France and eastern Belgium, which reveals some of the spatial extent of the dominant Scandinavian flyway over continental Europe.

Wind measurements by electromagnetic probes

NASA Technical Reports Server (NTRS)

Susko, Michael

1989-01-01

The operation and performance characteristics of the Marshall Space Flight Center's Radar Wind Profiler, designed to provide measurement of the wind in the troposphere, are discussed. The Radar Wind Profiler uses a technology similar to that used in conventional Doppler radar systems, except the frequency is generally lower, antenna is larger, and dwell time is much longer. Its primary function is to monitor the vertical wind profile prior to launch of the Space Shuttle at more frequency intervals and nearer to launch time than is presently possible with the conventional balloon systems. A new wind profile will be obtained on the order of every 15 min based on an average of five wind profiles measured every 3 min at a height interval of 150 m to 20 km. The most significant features of the Radar Wind Profiler are the continuity in time and reliability.

Reflectivity retrieval in a networked radar environment

NASA Astrophysics Data System (ADS)

Lim, Sanghun

Monitoring of precipitation using a high-frequency radar system such as X-band is becoming increasingly popular due to its lower cost compared to its counterpart at S-band. Networks of meteorological radar systems at higher frequencies are being pursued for targeted applications such as coverage over a city or a small basin. However, at higher frequencies, the impact of attenuation due to precipitation needs to be resolved for successful implementation. In this research, new attenuation correction algorithms are introduced to compensate the attenuation impact due to rain medium. In order to design X-band radar systems as well as evaluate algorithm development, it is useful to have simultaneous X-band observation with and without the impact of path attenuation. One way to obtain that data set is through theoretical models. Methodologies for generating realistic range profiles of radar variables at attenuating frequencies such as X-band for rain medium are presented here. Fundamental microphysical properties of precipitation, namely size and shape distribution information, are used to generate realistic profiles of X-band starting with S-band observations. Conditioning the simulation from S-band radar measurements maintains the natural distribution of microphysical parameters associated with rainfall. In this research, data taken by the CSU-CHILL radar and the National Center for Atmospheric Research S-POL radar are used to simulate X-band radar variables. Three procedures to simulate the radar variables at X-band and sample applications are presented. A new attenuation correction algorithm based on profiles of reflectivity, differential reflectivity, and differential propagation phase shift is presented. A solution for specific attenuation retrieval in rain medium is proposed that solves the integral equations for reflectivity and differential reflectivity with cumulative differential propagation phase shift constraint. The conventional rain profiling algorithms that connect reflectivity and specific attenuation can retrieve specific attenuation values along the radar path assuming a constant intercept parameter of the normalized drop size distribution. However, in convective storms, the drop size distribution parameters can have significant variation along the path. In this research, a dual-polarization rain profiling algorithm for horizontal-looking radars incorporating reflectivity as well as differential reflectivity profiles is developed. The dual-polarization rain profiling algorithm has been evaluated with X-band radar observations simulated from drop size distribution derived from high-resolution S-band measurements collected by the CSU-CHILL radar. The analysis shows that the dual-polarization rain profiling algorithm provides significant improvement over the current algorithms. A methodology for reflectivity and attenuation retrieval for rain medium in a networked radar environment is described. Electromagnetic waves backscattered from a common volume in networked radar systems are attenuated differently along the different paths. A solution for the specific attenuation distribution is proposed by solving the integral equation for reflectivity. The set of governing integral equations describing the backscatter and propagation of common resolution volume are solved simultaneously with constraints on total path attenuation. The proposed algorithm is evaluated based on simulated X-band radar observations synthesized from S-band measurements collected by the CSU-CHILL radar. Retrieved reflectivity and specific attenuation using the proposed method show good agreement with simulated reflectivity and specific attenuation.

Combined Lidar-Radar Remote Sensing: Initial Results from CRYSTAL-FACE and Implications for Future Spaceflight Missions

NASA Technical Reports Server (NTRS)

McGill, Matthew J.; Li, Li-Hua; Hart, William D.; Heymsfield, Gerald M.; Hlavka, Dennis L.; Vaughan, Mark A.; Winker, David M.

2003-01-01

In the near future NASA plans to fly satellites carrying a multi-wavelength backscatter lidar and a 94-GHz cloud profiling radar in formation to provide complete global profiling of cloud and aerosol properties. The CRYSTAL-FACE field campaign, conducted during July 2002, provided the first high-altitude colocated measurements from lidar and cloud profiling radar to simulate these spaceborne sensors. The lidar and radar provide complementary measurements with varying degrees of measurement overlap. This paper presents initial results of the combined airborne lidar-radar measurements during CRYSTAL-FACE. The overlap of instrument sensitivity is presented, within the context of particular CRYSTAL-FACE conditions. Results are presented to quantify the portion of atmospheric profiles sensed independently by each instrument and the portion sensed simultaneously by the two instruments.

Comparing helicopter-borne profiling radar with airborne laser scanner data for forest structure estimation.

NASA Astrophysics Data System (ADS)

Piermattei, Livia; Hollaus, Markus; Pfeifer, Norbert; Chen, Yuwei; Karjalainen, Mika; Hakala, Teemu; Hyyppä, Juha; Wagner, Wolfgang

2017-04-01

Forests are complex ecosystems that show substantial variation with respect to climate, management regime, stand history, disturbance, and needs of local communities. The dynamic processes of growth and disturbance are reflected in the structural components of forests that include the canopy vertical structure and geometry (e.g. size, height, and form), tree position and species diversity. Current remote-sensing systems to measure forest structural attributes include passive optical sensors and active sensors. The technological capabilities of active remote sensing like the ability to penetrate the vegetation and provide information about its vertical structure has promoted an extensive use of LiDAR (Light Detection And Ranging) and radar (RAdio Detection And Ranging) system over the last 20 years. LiDAR measurements from aircraft (airborne laser scanning, ALS) currently represents the primary data source for three-dimensional information on forest vertical structure. Contrary, despite the potential of radar remote sensing, their use is not yet established in forest monitoring. In order to better understand the interaction of pulsed radar with the forest canopy, and to increase the feasibility of this system, the Finnish Geospatial Research Institute has developed a helicopter-borne profiling radar system, called TomoRadar. TomoRadar is capable of recording a canopy-penetrating profile of forests. To georeference the radar measurements the system was equipped with a global navigation satellite system and an inertial measurement unit with a centimeter level accuracy of the flight trajectory. The TomoRadar operates at Ku-band, (wave lengths λ 1.5cm) with two separated parabolic antennas providing co- and cross-polarization modes. The purpose of this work is to investigate the capability of the TomoRadar system, for estimating the forest vertical profile, terrain topography and tree height. We analysed 600 m TomoRadar crosspolarized (i.e. horizontal - vertical) profile, acquired in October 2016 over a boreal test site in Evo, Finland. The intensity of the reflected backscatter energy was used to measure the height canopy distribution within an individual footprint. As the intensity of the backscatter energy from the ground is exceeding the intensity from vegetation, the estimation of canopy height and the forest structure were based on i) a threshold between canopy and ground and ii) a peak analysis of the backscattering profile. ALS data collected simultaneously was used to validate the TomoRadar results (i.e. canopy height) and to obtain elevation ground truth. The first results show a high agreement between ALS and TomoRadar derived canopy heights. The derived knowledge about the energy distribution within the canopy height profile leads to an increased understanding of the interactions between the radar signal and the forest canopy and will support optimization of future radar systems with respect to forest structure observation.

Bird migration flight altitudes studied by a network of operational weather radars

PubMed Central

Dokter, Adriaan M.; Liechti, Felix; Stark, Herbert; Delobbe, Laurent; Tabary, Pierre; Holleman, Iwan

2011-01-01

A fully automated method for the detection and quantification of bird migration was developed for operational C-band weather radar, measuring bird density, speed and direction as a function of altitude. These weather radar bird observations have been validated with data from a high-accuracy dedicated bird radar, which was stationed in the measurement volume of weather radar sites in The Netherlands, Belgium and France for a full migration season during autumn 2007 and spring 2008. We show that weather radar can extract near real-time bird density altitude profiles that closely correspond to the density profiles measured by dedicated bird radar. Doppler weather radar can thus be used as a reliable sensor for quantifying bird densities aloft in an operational setting, which—when extended to multiple radars—enables the mapping and continuous monitoring of bird migration flyways. By applying the automated method to a network of weather radars, we observed how mesoscale variability in weather conditions structured the timing and altitude profile of bird migration within single nights. Bird density altitude profiles were observed that consisted of multiple layers, which could be explained from the distinct wind conditions at different take-off sites. Consistently lower bird densities are recorded in The Netherlands compared with sites in France and eastern Belgium, which reveals some of the spatial extent of the dominant Scandinavian flyway over continental Europe. PMID:20519212

Measurements and Simulations of Nadir-Viewing Radar Returns from the Melting Layer at X- and W-Bands

NASA Technical Reports Server (NTRS)

Liao, Liang; Meneghini, Robert; Tian, Lin; Heymsfield, Gerald M.

2010-01-01

Simulated radar signatures within the melting layer in stratiform rain, namely the radar bright band, are checked by means of comparisons with simultaneous measurements of the bright band made by the EDOP (X-band) and CRS (W-band) airborne Doppler radars during the CRYSTAL-FACE campaign in 2002. A stratified-sphere model, allowing the fractional water content to vary along the radius of the particle, is used to compute the scattering properties of individual melting snowflakes. Using the effective dielectric constants computed by the conjugate gradient-fast Fourier transform (CGFFT) numerical method for X and W bands, and expressing the fractional water content of melting particle as an exponential function in particle radius, it is found that at X band the simulated radar bright-band profiles are in an excellent agreement with the measured profiles. It is also found that the simulated W-band profiles usually resemble the shapes of the measured bright-band profiles even though persistent offsets between them are present. These offsets, however, can be explained by the attenuation caused by cloud water and water vapor at W band. This is confirmed by the comparisons of the radar profiles made in the rain regions where the un-attenuated W-band reflectivity profiles can be estimated through the X- and W band Doppler velocity measurements. The bright-band model described in this paper has the potential to be used effectively for both radar and radiometer algorithms relevant to the TRMM and GPM satellite missions.

Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta‐analysis

PubMed Central

De Boer, M. A.; Heymans, M. W.; Schoonmade, L. J.; Bossuyt, P. M. M.; Mol, B. W. J.; De Groot, C. J. M.; Bax, C. J.

2018-01-01

ABSTRACT Objective Doppler ultrasonographic assessment of the cerebroplacental ratio (CPR) and middle cerebral artery (MCA) is widely used as an adjunct to umbilical artery (UA) Doppler to identify fetuses at risk of adverse perinatal outcome. However, reported estimates of its accuracy vary considerably. The aim of this study was to review systematically the prognostic accuracies of CPR and MCA Doppler in predicting adverse perinatal outcome, and to compare these with UA Doppler, in order to identify whether CPR and MCA Doppler evaluation are of added value to UA Doppler. Methods PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched, from inception to June 2016, for studies on the prognostic accuracy of UA Doppler compared with CPR and/or MCA Doppler in the prediction of adverse perinatal outcome in women with a singleton pregnancy of any risk profile. Risk of bias and concerns about applicability were assessed using the QUADAS‐2 (Quality Assessment of Diagnostic Accuracy Studies‐2) tool. Meta‐analysis was performed for multiple adverse perinatal outcomes. Using hierarchal summary receiver–operating characteristics meta‐regression models, the prognostic accuracy of CPR vs MCA Doppler was compared indirectly, and CPR and MCA Doppler vs UA Doppler compared directly. Results The search identified 4693 articles, of which 128 studies (involving 47 748 women) were included. Risk of bias or suboptimal reporting was detected in 120/128 studies (94%) and substantial heterogeneity was found, which limited subgroup analyses for fetal growth and gestational age. A large variation was observed in reported sensitivities and specificities, and in thresholds used. CPR outperformed UA Doppler in the prediction of composite adverse outcome (as defined in the included studies) (P < 0.001) and emergency delivery for fetal distress (P = 0.003), but was comparable to UA Doppler for the other outcomes. MCA Doppler performed significantly worse than did UA Doppler in the prediction of low Apgar score (P = 0.017) and emergency delivery for fetal distress (P = 0.034). CPR outperformed MCA Doppler in the prediction of composite adverse outcome (P < 0.001) and emergency delivery for fetal distress (P = 0.013). Conclusion Calculating the CPR with MCA Doppler can add value to UA Doppler assessment in the prediction of adverse perinatal outcome in women with a singleton pregnancy. However, it is unclear to which subgroup of pregnant women this applies. The effectiveness of the CPR in guiding clinical management needs to be evaluated in clinical trials. © 2017 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. PMID:28708272

Public awareness and self-efficacy of cardiopulmonary resuscitation in communities and outcomes of out-of-hospital cardiac arrest: A multi-level analysis.

PubMed

Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Sung Ok; Kim, Young Taek; Lee, Dong-Woo; Cho, Sung-Il

2016-05-01

This study aims to test the association between capacity of cardiopulmonary resuscitation (CPR) at community level and survival after out-of-hospital cardiac arrest (OHCA). Emergency medical service (EMS)-treated OHCAs with cardiac etiology in Korea between 2012 and 2013 were analyzed, excluding cases witnessed by EMS providers. Exposure variables were five indexes of community CPR capacity: awareness of CPR (CPR-Awareness), any training experience of CPR (CPR-Any-Training), recent CPR training within the last 2 years (CPR-Recent-Training), CPR training with a manikin (CPR-Manikin-Training), and CPR self-efficacy (CPR-Self-Efficacy). All measures of capacity were calculated as aggregated values for each county level using the national Korean Community Health Survey database of 228,921 responders sampled representatively from 253 counties in 2012. Endpoints were bystander CPR (BCPR) and survival to discharge. We calculated adjusted odds ratios (AORs) per 10% increment in community CPR capacity using multi-level logistic regression models, adjusting for potential confounders at individual levels. Of 29,052 eligible OHCAs, 11,079 (38.1%) received BCPR. Patients were more likely to receive BCPR in communities with higher proportions of residents with CPR-Awareness, CPR-Any-Training, CPR-Recent-Training, CPR-Manikin-Training, and CPR-Self-Efficacy (all p<0.01). AORs for BCPR were 1.06 (1.03-1.10) per 10% increment in CPR-Awareness, 1.10 (1.04-1.15) for CPR-Any-Training, and 1.08 (1.03-1.13) for CPR-Self-Efficacy. For survival to discharge, AORs (95% CIs) were 1.34 (1.23-1.47) per 10% increment in CPR-Awareness, 1.36 (1.20-1.54) for CPR-Any-Training, and 1.29 (1.15-1.45) for CPR-Self-Efficacy. Higher CPR capacity at community level was associated with higher bystander CPR and survival to discharge rates after OHCA. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessment of 3D cloud radiative transfer effects applied to collocated A-Train data

NASA Astrophysics Data System (ADS)

Okata, M.; Nakajima, T.; Suzuki, K.; Toshiro, I.; Nakajima, T. Y.; Okamoto, H.

2017-12-01

This study investigates broadband radiative fluxes in the 3D cloud-laden atmospheres using a 3D radiative transfer (RT) model, MCstar, and the collocated A-Train cloud data. The 3D extinction coefficients are constructed by a newly devised Minimum cloud Information Deviation Profiling Method (MIDPM) that extrapolates CPR radar profiles at nadir into off-nadir regions within MODIS swath based on collocated information of MODIS-derived cloud properties and radar reflectivity profiles. The method is applied to low level maritime water clouds, for which the 3D-RT simulations are performed. The radiative fluxes thus simulated are compared to those obtained from CERES as a way to validate the MIDPM-constructed clouds and our 3D-RT simulations. The results show that the simulated SW flux agrees with CERES values within 8 - 50 Wm-2. One of the large biases occurred by cyclic boundary condition that was required to pose into our computational domain limited to 20km by 20km with 1km resolution. Another source of the bias also arises from the 1D assumption for cloud property retrievals particularly for thin clouds, which tend to be affected by spatial heterogeneity leading to overestimate of the cloud optical thickness. These 3D-RT simulations also serve to address another objective of this study, i.e. to characterize the "observed" specific 3D-RT effects by the cloud morphology. We extend the computational domain to 100km by 100km for this purpose. The 3D-RT effects are characterized by errors of existing 1D approximations to 3D radiation field. The errors are investigated in terms of their dependence on solar zenith angle (SZA) for the satellite-constructed real cloud cases, and we define two indices from the error tendencies. According to the indices, the 3D-RT effects are classified into three types which correspond to different simple three morphologies types, i.e. isolated cloud type, upper cloud-roughened type and lower cloud-roughened type. These 3D-RT effects linked to cloud morphologies are also visualized in the form of the RGB composite maps constructed from MODIS/Aqua three channels, which show cloud optical thickness and cloud height information. Such a classification offers a novel insight into 3D-RT effect in a manner that directly relates to cloud morphology.

Rain rate range profiling from a spaceborne radar

NASA Technical Reports Server (NTRS)

Meneghini, R.

1980-01-01

At certain frequencies and incidence angles the relative invariance of the surface scattering properites over land can be used to estimate the total attenuation and the integrated rain from a spaceborne attenuation-wavelength radar. The technique is generalized so that rain rate profiles along the radar beam can be estimated, i.e., rain rate determination at each range bin. This is done by modifying the standard algorithm for an attenuating-wavelength radar to include in it the measurement of the total attenuation. Simple error analyses of the estimates show that this type of profiling is possible if the total attenuation can be measured with a modest degree of accuracy.

End-tidal CO2-guided automated robot CPR system in the pig. Preliminary communication.

PubMed

Suh, Gil Joon; Park, Jaeheung; Lee, Jung Chan; Na, Sang Hoon; Kwon, Woon Yong; Kim, Kyung Su; Kim, Taegyun; Jung, Yoon Sun; Ko, Jung-In; Shin, So Mi; You, Kyoung Min

2018-06-01

Our aim was to compare the efficacy of the end-tidal CO 2 -guided automated robot CPR (robot CPR) system with manual CPR and mechanical device CPR. We developed the algorithm of the robot CPR system which automatically finds the optimal compression position under the guidance of end-tidal CO 2 feedback in swine models of cardiac arrest. Then, 18 pigs after 11 min of cardiac arrest were randomly assigned to one of three groups, robot CPR, LUCAS CPR, and manual CPR groups (n = 6 each group). Return of spontaneous circulation (ROSC) and Neurological Deficit Score 48 h after ROSC were compared. A ROSC was achieved in 5 pigs, 4 pigs, and 3 pigs in the robot CPR, LUCAS CPR, and manual CPR groups, respectively (p = 0.47). Robot CPR showed a significant difference in Neurological Deficit Score 48 h after ROSC compared to manual CPR, whereas LUCAS CPR showed no significant difference over manual CPR. (p = 0.01; Robot versus Manual adjusted p = 0.04, Robot versus LUCAS adjusted p = 0.07, Manual versus LUCAS adjusted p = 1.00). The end-tidal CO 2 -guided automated robot CPR system did not significantly improve ROSC rate in a swine model of cardiac arrest. However, robot CPR showed significant improvement of Neurological Deficit Score 48 h after ROSC compared to Manual CPR while LUCAS CPR showed no significant improvement compared to Manual CPR. Copyright © 2018 Elsevier B.V. All rights reserved.

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia.

PubMed

Bray, Janet E; Straney, Lahn; Smith, Karen; Cartledge, Susie; Case, Rosalind; Bernard, Stephen; Finn, Judith

2017-06-05

Bystander cardiopulmonary resuscitation (CPR) more than doubles the chance of surviving an out-of-hospital cardiac arrest. Recent data have shown considerable regional variation in bystander CPR rates across the Australian state of Victoria. This study aims to determine whether there is associated regional variation in rates of CPR training and willingness to perform CPR in these communities. We categorized each Victorian postcode as either a low or high bystander CPR region using data on adult, bystander-witnessed, out-of-hospital cardiac arrests of presumed cardiac etiology (n=7175) from the Victorian Ambulance Cardiac Arrest Registry. We then surveyed adult Victorians (n=404) and compared CPR training data of the respondents from low and high bystander CPR regions. Of the 404 adults surveyed, 223 (55%) resided in regions with low bystander CPR. Compared with respondents from high bystander CPR regions, respondents residing in regions with low bystander CPR had lower rates of CPR training (62% versus 75%, P =0.009) and lower self-ratings for their overall knowledge of CPR (76% versus 84%, P =0.04). There were no differences between the regions in their reasons for not having undergone CPR training or in their willingness to perform CPR. Rates of survival for bystander-witnessed, out-of-hospital cardiac arrests were significantly lower in low bystander CPR regions (15.7% versus 17.0%, P <0.001). This study found lower rates of CPR training and lower survival in regions with lower rates of bystander CPR in Victoria, Australia. Targeting these regions with CPR training programs may improve bystander CPR rates and out-of-hospital cardiac arrest outcomes. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial.

PubMed

Spelten, Oliver; Warnecke, Tobias; Wetsch, Wolfgang A; Schier, Robert; Böttiger, Bernd W; Hinkelbein, Jochen

2016-08-01

High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR. The aim of this study was to evaluate both principles of T-CPR with respect to CPR quality. Randomised controlled single-blinded manikin trial. University Hospital of Cologne, Germany, 1 July 2012 to 30 September 2012. Sixty laypersons between 18 and 65 years. Medically educated individuals, medical professionals and pregnant women were excluded. Participants were asked to resuscitate a manikin and were randomised into three groups: not dispatcher-assisted (uninstructed) CPR (group 1; U-CPR; n = 20), dispatcher-assisted compression-only CPR (group 2; DACO-CPR; n = 19) and full dispatcher-assisted CPR with rescue ventilation (group 3; DAF-CPR; n = 19). Specific parameters of CPR quality [i.e. no-flow-time (NFT) as well as compression and ventilation parameters] were analysed. To compare different groups we used Student's t test and P less than 0.05 was considered significant. Initial NFT was lowest in the DACO-CPR group (mean 21.3 ± 14.4%), followed by dispatcher-assisted full CPR (mean 49.1 ± 8.5%) and by unassisted CPR (mean 55.0 ± 12.9%). Initial NFT covering the time of instruction was lower in DACO-CPR (12.1 ± 5.4%) as compared to dispatcher-assisted full CPR (20.7 ± 8.1%). Compression depth was similar in all three groups: 40.6 ± 13.0 mm (unassisted CPR), 41.0 ± 12.2 mm (DACO-CPR) and 38.8 ± 15.8 mm (dispatcher-assisted full CPR). Average compression frequency was highest in the DACO-CPR group (65.2 ± 22.4 min) compared with the unassisted CPR group (35.6 ± 24.2 min) and the dispatcher-assisted full CPR group (44.5 ± 10.8 min). Correct rescue ventilation was given in 3.1 ± 11.1% (unassisted CPR) and 1.6 ± 16.1% (dispatcher-assisted full CPR) of all ventilation attempts. Best quality of CPR was achieved by DACO-CPR because of superior compression frequencies and reduced NFT. In contrast, the full dispatcher-assisted CPR with a longer initial instructing phase (initial NFT) did not result in enhanced CPR quality or an optimised compression depth.

Utilizing the Vertical Variability of Precipitation to Improve Radar QPE

NASA Technical Reports Server (NTRS)

Gatlin, Patrick N.; Petersen, Walter A.

2016-01-01

Characteristics of the melting layer and raindrop size distribution can be exploited to further improve radar quantitative precipitation estimation (QPE). Using dual-polarimetric radar and disdrometers, we found that the characteristic size of raindrops reaching the ground in stratiform precipitation often varies linearly with the depth of the melting layer. As a result, a radar rainfall estimator was formulated using D(sub m) that can be employed by polarimetric as well as dual-frequency radars (e.g., space-based radars such as the GPM DPR), to lower the bias and uncertainty of conventional single radar parameter rainfall estimates by as much as 20%. Polarimetric radar also suffers from issues associated with sampling the vertical distribution of precipitation. Hence, we characterized the vertical profile of polarimetric parameters (VP3)-a radar manifestation of the evolving size and shape of hydrometeors as they fall to the ground-on dual-polarimetric rainfall estimation. The VP3 revealed that the profile of ZDR in stratiform rainfall can bias dual-polarimetric rainfall estimators by as much as 50%, even after correction for the vertical profile of reflectivity (VPR). The VP3 correction technique that we developed can improve operational dual-polarimetric rainfall estimates by 13% beyond that offered by a VPR correction alone.

Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial.

PubMed

Wik, Lars; Olsen, Jan-Aage; Persse, David; Sterz, Fritz; Lozano, Michael; Brouwer, Marc A; Westfall, Mark; Souders, Chris M; Malzer, Reinhard; van Grunsven, Pierre M; Travis, David T; Whitehead, Anne; Herken, Ulrich R; Lerner, E Brooke

2014-06-01

To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge. Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group sequential trial of adult out-of-hospital cardiac arrests of presumed cardiac origin was conducted at three US and two European sites. After EMS providers initiated manual compressions patients were randomized to receive either iA-CPR or M-CPR. Patient follow-up was until all patients were discharged alive or died. The primary outcome, survival to hospital discharge, was analyzed adjusting for covariates, (age, witnessed arrest, initial cardiac rhythm, enrollment site) and interim analyses. CPR quality and protocol adherence were monitored (CPR fraction) electronically throughout the trial. Of 4753 randomized patients, 522 (11.0%) met post enrollment exclusion criteria. Therefore, 2099 (49.6%) received iA-CPR and 2132 (50.4%) M-CPR. Sustained ROSC (emergency department admittance), 24h survival and hospital discharge (unknown for 12 cases) for iA-CPR compared to M-CPR were 600 (28.6%) vs. 689 (32.3%), 456 (21.8%) vs. 532 (25.0%), 196 (9.4%) vs. 233 (11.0%) patients, respectively. The adjusted odds ratio of survival to hospital discharge for iA-CPR compared to M-CPR, was 1.06 (95% CI 0.83-1.37), meeting the criteria for equivalence. The 20 min CPR fraction was 80.4% for iA-CPR and 80.2% for M-CPR. Compared to high-quality M-CPR, iA-CPR resulted in statistically equivalent survival to hospital discharge. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Fingerprints of a riming event on cloud radar Doppler spectra: observations and modeling

DOE PAGES

Kalesse, Heike; Szyrmer, Wanda; Kneifel, Stefan; ...

2016-03-09

In this paper, Radar Doppler spectra measurements are exploited to study a riming event when precipitating ice from a seeder cloud sediment through a supercooled liquid water (SLW) layer. The focus is on the "golden sample" case study for this type of analysis based on observations collected during the deployment of the Atmospheric Radiation Measurement Program's (ARM) mobile facility AMF2 at Hyytiälä, Finland, during the Biogenic Aerosols – Effects on Clouds and Climate (BAECC) field campaign. The presented analysis of the height evolution of the radar Doppler spectra is a state-of-the-art retrieval with profiling cloud radars in SLW layers beyondmore » the traditional use of spectral moments. Dynamical effects are considered by following the particle population evolution along slanted tracks that are caused by horizontal advection of the cloud under wind shear conditions. In the SLW layer, the identified liquid peak is used as an air motion tracer to correct the Doppler spectra for vertical air motion and the ice peak is used to study the radar profiles of rimed particles. A 1-D steady-state bin microphysical model is constrained using the SLW and air motion profiles and cloud top radar observations. The observed radar moment profiles of the rimed snow can be simulated reasonably well by the model, but not without making several assumptions about the ice particle concentration and the relative role of deposition and aggregation. In conclusion, this suggests that in situ observations of key ice properties are needed to complement the profiling radar observations before process-oriented studies can effectively evaluate ice microphysical parameterizations.« less

Recommendations for a wind profiling network to support Space Shuttle launches

NASA Technical Reports Server (NTRS)

Zamora, R. J.

1992-01-01

The feasibility is examined of a network of clear air radar wind profilers to forecast wind conditions before Space Shuttle launches during winter. Currently, winds are measured only in the vicinity of the shuttle launch site and wind loads on the launch vehicle are estimated using these measurements. Wind conditions upstream of the Cape are not monitored. Since large changes in the wind shear profile can be associated with weather systems moving over the Cape, it may be possible to improve wind forecasts over the launch site if wind measurements are made upstream. A radar wind profiling system is in use at the Space Shuttle launch site. This system can monitor the wind profile continuously. The existing profiler could be combined with a number of radars located upstream of the launch site. Thus, continuous wind measurements would be available upstream and at the Cape. NASA-Marshall representatives have set the requirements for radar wind profiling network. The minimum vertical resolution of the network must be set so that the wind shears over the depths greater than or = 1 km will be detected. The network should allow scientists and engineers to predict the wind profile over the Cape 6 hours before a Space Shuttle launch.

First evidence of epithelial transport in tardigrades: a comparative investigation of organic anion transport.

PubMed

Halberg, Kenneth Agerlin; Møbjerg, Nadja

2012-02-01

We investigated transport of the organic anion Chlorophenol Red (CPR) in the tardigrade Halobiotus crispae using a new method for quantifying non-fluorescent dyes. We compared the results acquired from the tardigrade with CPR transport data obtained from Malpighian tubules of the desert locust Schistocerca gregaria. CPR accumulated in the midgut lumen of H. crispae, indicating that organic anion transport takes place here. Our results show that CPR transport is inhibited by the mitochondrial un-coupler DNP (1 mmol l(-1); 81% reduction), the Na(+)/K(+)-ATPase inhibitor ouabain (10 mmol l(-1); 21% reduction) and the vacuolar H(+)-ATPase inhibitor bafilomycin (5 μmol l(-1); 21% reduction), and by the organic anions PAH (10 mmol l(-1); 44% reduction) and probenecid (10 mmol l(-1); 61% reduction, concentration-dependent inhibition). Transport by locust Malpighian tubules exhibits a similar pharmacological profile, albeit with markedly higher concentrations of CPR being reached in S. gregaria. Immunolocalization of the Na(+)/K(+)-ATPase α-subunit in S. gregaria revealed that this transporter is abundantly expressed and localized to the basal cell membranes. Immunolocalization data could not be obtained from H. crispae. Our results indicate that organic anion secretion by the tardigrade midgut is transporter mediated with likely candidates for the basolateral entry step being members of the Oat and/or Oatp transporter families. From our results, we cautiously suggest that apical H(+) and possibly basal Na(+)/K(+) pumps provide the driving force for the transport; the exact coupling between electrochemical gradients generated by the pumps and transport of ions, as well as the nature of the apical exit step, are unknown. This study is, to our knowledge, the first to show active epithelial transport in tardigrades.

High-quality cardiopulmonary resuscitation: current and future directions.

PubMed

Abella, Benjamin S

2016-06-01

Cardiopulmonary resuscitation (CPR) represents the cornerstone of cardiac arrest resuscitation care. Prompt delivery of high-quality CPR can dramatically improve survival outcomes; however, the definitions of optimal CPR have evolved over several decades. The present review will discuss the metrics of CPR delivery, and the evidence supporting the importance of CPR quality to improve clinical outcomes. The introduction of new technologies to quantify metrics of CPR delivery has yielded important insights into CPR quality. Investigations using CPR recording devices have allowed the assessment of specific CPR performance parameters and their relative importance regarding return of spontaneous circulation and survival to hospital discharge. Additional work has suggested new opportunities to measure physiologic markers during CPR and potentially tailor CPR delivery to patient requirements. Through recent laboratory and clinical investigations, a more evidence-based definition of high-quality CPR continues to emerge. Exciting opportunities now exist to study quantitative metrics of CPR and potentially guide resuscitation care in a goal-directed fashion. Concepts of high-quality CPR have also informed new approaches to training and quality improvement efforts for cardiac arrest care.

On Study of Air/Space-borne Dual-Wavelength Radar for Estimates of Rain Profiles

NASA Technical Reports Server (NTRS)

Liao, Liang; Meneghini, Robert

2004-01-01

In this study, a framework is discussed to apply air/space-borne dual-wavelength radar for the estimation of characteristic parameters of hydrometeors. The focus of our study is on the Global Precipitation Measurements (GPM) precipitation radar, a dual-wavelength radar that operates at Ku (13.8 GHz) and Ka (35 GHz) bands. As the droplet size distributions (DSD) of rain are expressed as the Gamma function, a procedure is described to derive the median volume diameter (D(sub 0)) and particle number concentration (N(sub T)) of rain. The correspondences of an important quantity of dual-wavelength radar, defined as deferential frequency ratio (DFR), to the D(sub 0) in the melting region are given as a function of the distance from the 0 C isotherm. A self-consistent iterative algorithm that shows a promising to account for rain attenuation of radar and infer the DSD without use of surface reference technique (SRT) is examined by applying it to the apparent radar reflectivity profiles simulated from the DSD model and then comparing the estimates with the model (true) results. For light to moderate rain the self-consistent rain profiling approach converges to unique and correct solutions only if the same shape factors of Gamma functions are used both to generate and retrieve the rain profiles, but does not converges to the true solutions if the DSD form is not chosen correctly. To further examine the dual-wavelength techniques, the self-consistent algorithm, along with forward and backward rain profiling algorithms, is then applied to the measurements taken from the 2nd generation Precipitation Radar (PR-2) built by Jet Propulsion Laboratory. It is found that rain profiles estimated from the forward and backward approaches are not sensitive to shape factor of DSD Gamma distribution, but the self-consistent method is.

Validation of COSMIC radio occultation electron density profiles by incoherent scatter radar data

NASA Astrophysics Data System (ADS)

Cherniak, Iurii; Zakharenkova, Irina

The COSMIC/FORMOSAT-3 is a joint US/Taiwan radio occultation mission consisting of six identical micro-satellites. Each microsatellite has a GPS Occultation Experiment payload to operate the ionospheric RO measurements. FS3/COSMIC data can make a positive impact on global ionosphere study providing essential information about height electron density distribu-tion. For correct using of the RO electron density profiles for geophysical analysis, modeling and other applications it is necessary to make validation of these data with electron density distributions obtained by another measurement techniques such as proven ground based facili-ties -ionosondes and IS radars. In fact as the ionosondes provide no direct information on the profile above the maximum electron density and the topside ionosonde profile is obtained by fitting a model to the peak electron density value, the COSMIC RO measurements can make an important contribution to the investigation of the topside part of the ionosphere. IS radars provide information about the whole electron density profile, so we can estimate the agreement of topside parts between two independent measurements. To validate the reliability of COS-MIC data we have used the ionospheric electron density profiles derived from IS radar located near Kharkiv, Ukraine (geographic coordinates: 49.6N, 36.3E, geomagnetic coordinates: 45.7N, 117.8E). The Kharkiv radar is a sole incoherent scatter facility on the middle latitudes of Eu-ropean region. The radar operates with 100-m zenith parabolic antenna at 158 MHz with peak transmitted power 2.0 MW. The Kharkiv IS radar is able to determine the heights-temporal distribution of ionosphere parameters in height range of 70-1500 km. At the ionosphere in-vestigation by incoherent scatter method there are directly measured the power spectrum (or autocorrelation function) of scattered signal. With using of rather complex procedure of the received signal processing it is possible to estimate the majority of the ionospheric parameters -density and kinetic temperature of electron and main ions, the plasma drift velocity and others. The comparison of RO reveals that usually COSMIC RO profiles are in a rather good agreement with ISR profiles both in the F2 layer peak electron density (NmF2) and the form of profiles. The coincidence of profiles is better in the cases when projection of the ray path of tangent points is closer to the ISR location. It is necessary to note that retrieved electron density profiles should not be interpreted as actual vertical profiles. The geographical location of the ray path tangent points at the top and at the bottom of a profile may differ by several hundred kilometers. So the spatial smearing of data takes place and RO technique represents an image of vertical and horizontal ionospheric structure. That is why the comparison with ground-based data has rather relative character. We derived quantitative parameters to char-acterize the differences of the compared profiles: the peak height difference, the relative peak density difference. Most of the compared profiles agree within error limits, depending on the accuracy of the occultation-and the radar-derived profiles. In general COSMIC RO profiles are in a good agreement with incoherent radar profiles both in the F2 layer peak electron density (NmF2) and the form of the profiles. The coincidence of COSMIC and incoherent radar pro-files is better in the cases when projection of the ray path tangent points is closer to the radar location. COSMIC measurements can be efficiently used to study the topside part of the iono-spheric electron density. To validate the reliability of the COSMIC ionospheric observations it must be done the big work on the analysis and statistical generalization of the huge data array (today the total number of ionospheric occultation is more than 2.300.000), but this technique is a very promising one to retrieve accurate profiles of the ionospheric electron density with ground-based measurements on a global scale. We acknowledge the Taiwan's National Space Organization (NSPO) and the University Corporation for Atmospheric Research (UCAR) for providing the COSMIC Data.

Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial.

PubMed

Kim, Young Joon; Cho, Youngsuk; Cho, Gyu Chong; Ji, Hyun Kyung; Han, Song Yi; Lee, Jin Hyuck

2017-06-01

Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant's CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kalesse, Heike; Szyrmer, Wanda; Kneifel, Stefan

In this paper, Radar Doppler spectra measurements are exploited to study a riming event when precipitating ice from a seeder cloud sediment through a supercooled liquid water (SLW) layer. The focus is on the "golden sample" case study for this type of analysis based on observations collected during the deployment of the Atmospheric Radiation Measurement Program's (ARM) mobile facility AMF2 at Hyytiälä, Finland, during the Biogenic Aerosols – Effects on Clouds and Climate (BAECC) field campaign. The presented analysis of the height evolution of the radar Doppler spectra is a state-of-the-art retrieval with profiling cloud radars in SLW layers beyondmore » the traditional use of spectral moments. Dynamical effects are considered by following the particle population evolution along slanted tracks that are caused by horizontal advection of the cloud under wind shear conditions. In the SLW layer, the identified liquid peak is used as an air motion tracer to correct the Doppler spectra for vertical air motion and the ice peak is used to study the radar profiles of rimed particles. A 1-D steady-state bin microphysical model is constrained using the SLW and air motion profiles and cloud top radar observations. The observed radar moment profiles of the rimed snow can be simulated reasonably well by the model, but not without making several assumptions about the ice particle concentration and the relative role of deposition and aggregation. In conclusion, this suggests that in situ observations of key ice properties are needed to complement the profiling radar observations before process-oriented studies can effectively evaluate ice microphysical parameterizations.« less

High-resolution humidity profiles retrieved from wind profiler radar measurements

NASA Astrophysics Data System (ADS)

Saïd, Frédérique; Campistron, Bernard; Di Girolamo, Paolo

2018-03-01

The retrieval of humidity profiles from wind profiler radars has already been documented in the past 30 years and is known to be neither as straightforward and nor as robust as the retrieval of the wind velocity. The main constraint to retrieve the humidity profile is the necessity to combine measurements from the wind profiler and additional measurements (such as observations from radiosoundings at a coarser time resolution). Furthermore, the method relies on some assumptions and simplifications that restrict the scope of its application. The first objective of this paper is to identify the obstacles and limitations and solve them, or at least define the field of applicability. To improve the method, we propose using the radar capacity to detect transition levels, such as the top level of the boundary layer, marked by a maximum in the radar reflectivity. This forces the humidity profile from the free troposphere and from the boundary layer to coincide at this level, after an optimization of the calibration coefficients, and reduces the error. The resulting mean bias affecting the specific humidity profile never exceeds 0.25 g kg-1. The second objective is to explore the capability of the algorithm to retrieve the humidity vertical profiles for an operational purpose by comparing the results with observations from a Raman lidar.

What are the associated parameters and temporal coverage?

Atmospheric Science Data Center

2014-12-08

... Extinction Coefficient, Cloud Vertical Profile, Radar-only Liquid Water Content, Radar-only Liquid Ice Content, Vertical Flux Profile, ... ISCCP-D2like Cloud fraction, Effective Pressure, Temperature, optical depth, IWP/LWP, particle size, IR Emissivity in ...

Perception of CPR quality: Influence of CPR feedback, Just-in-Time CPR training and provider role.

PubMed

Cheng, Adam; Overly, Frank; Kessler, David; Nadkarni, Vinay M; Lin, Yiqun; Doan, Quynh; Duff, Jonathan P; Tofil, Nancy M; Bhanji, Farhan; Adler, Mark; Charnovich, Alex; Hunt, Elizabeth A; Brown, Linda L

2015-02-01

Many healthcare providers rely on visual perception to guide cardiopulmonary resuscitation (CPR), but little is known about the accuracy of provider perceptions of CPR quality. We aimed to describe the difference between perceived versus measured CPR quality, and to determine the impact of provider role, real-time visual CPR feedback and Just-in-Time (JIT) CPR training on provider perceptions. We conducted secondary analyses of data collected from a prospective, multicenter, randomized trial of 324 healthcare providers who participated in a simulated cardiac arrest scenario between July 2012 and April 2014. Participants were randomized to one of four permutations of: JIT CPR training and real-time visual CPR feedback. We calculated the difference between perceived and measured quality of CPR and reported the proportion of subjects accurately estimating the quality of CPR within each study arm. Participants overestimated achieving adequate chest compression depth (mean difference range: 16.1-60.6%) and rate (range: 0.2-51%), and underestimated chest compression fraction (0.2-2.9%) across all arms. Compared to no intervention, the use of real-time feedback and JIT CPR training (alone or in combination) improved perception of depth (p<0.001). Accurate estimation of CPR quality was poor for chest compression depth (0-13%), rate (5-46%) and chest compression fraction (60-63%). Perception of depth is more accurate in CPR providers versus team leaders (27.8% vs. 7.4%; p=0.043) when using real-time feedback. Healthcare providers' visual perception of CPR quality is poor. Perceptions of CPR depth are improved by using real-time visual feedback and with prior JIT CPR training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Easy-to-learn cardiopulmonary resuscitation training programme: a randomised controlled trial on laypeople’s resuscitation performance

PubMed Central

Ko, Rachel Jia Min; Lim, Swee Han; Wu, Vivien Xi; Leong, Tak Yam; Liaw, Sok Ying

2018-01-01

INTRODUCTION Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CPR training in improving lay rescuers’ CPR performance as compared to standard CPR. METHODS A total of 85 laypeople (aged 21–60 years) were recruited and randomly assigned to undertake either a two-hour simplified or standard CPR training session. They were tested two months after the training on a simulated cardiac arrest scenario. Participants’ performance on the sequence of CPR steps was observed and evaluated using a validated CPR algorithm checklist. The quality of chest compression and ventilation was assessed from the recording manikins. RESULTS The simplified CPR group performed significantly better on the CPR algorithm when compared to the standard CPR group (p < 0.01). No significant difference was found between the groups in time taken to initiate CPR. However, a significantly higher number of compressions and proportion of adequate compressions was demonstrated by the simplified group than the standard group (p < 0.01). Hands-off time was significantly shorter in the simplified CPR group than in the standard CPR group (p < 0.001). CONCLUSION Simplifying the learning of CPR by focusing on continuous chest compressions, with simple hand placement for chest compression, could lead to better acquisition and retention of CPR algorithms, and better quality of chest compressions than standard CPR. PMID:29167910

Easy-to-learn cardiopulmonary resuscitation training programme: a randomised controlled trial on laypeople's resuscitation performance.

PubMed

Ko, Rachel Jia Min; Lim, Swee Han; Wu, Vivien Xi; Leong, Tak Yam; Liaw, Sok Ying

2018-04-01

Simplifying the learning of cardiopulmonary resuscitation (CPR) is advocated to improve skill acquisition and retention. A simplified CPR training programme focusing on continuous chest compression, with a simple landmark tracing technique, was introduced to laypeople. The study aimed to examine the effectiveness of the simplified CPR training in improving lay rescuers' CPR performance as compared to standard CPR. A total of 85 laypeople (aged 21-60 years) were recruited and randomly assigned to undertake either a two-hour simplified or standard CPR training session. They were tested two months after the training on a simulated cardiac arrest scenario. Participants' performance on the sequence of CPR steps was observed and evaluated using a validated CPR algorithm checklist. The quality of chest compression and ventilation was assessed from the recording manikins. The simplified CPR group performed significantly better on the CPR algorithm when compared to the standard CPR group (p < 0.01). No significant difference was found between the groups in time taken to initiate CPR. However, a significantly higher number of compressions and proportion of adequate compressions was demonstrated by the simplified group than the standard group (p < 0.01). Hands-off time was significantly shorter in the simplified CPR group than in the standard CPR group (p < 0.001). Simplifying the learning of CPR by focusing on continuous chest compressions, with simple hand placement for chest compression, could lead to better acquisition and retention of CPR algorithms, and better quality of chest compressions than standard CPR. Copyright: © Singapore Medical Association.

Community involvement in out of hospital cardiac arrest

PubMed Central

Shams, Ali; Raad, Mohamad; Chams, Nour; Chams, Sana; Bachir, Rana; El Sayed, Mazen J.

2016-01-01

Abstract Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Developing countries including Lebanon report low survival rates and poor neurologic outcomes in affected victims. Community involvement through early recognition and bystander cardiopulmonary resuscitation (CPR) can improve OHCA survival. This study assesses knowledge and attitude of university students in Lebanon and identifies potential barriers and facilitators to learning and performing CPR. A cross-sectional survey was administered to university students. The questionnaire included questions regarding the following data elements: demographics, knowledge, and awareness about sudden cardiac arrest, CPR, automated external defibrillator (AED) use, prior CPR and AED training, ability to perform CPR or use AED, barriers to performing/learning CPR/AED, and preferred location for attending CPR/AED courses. Descriptive analysis followed by multivariate analysis was carried out to identify predictors and barriers to learning and performing CPR. A total of 948 students completed the survey. Participants’ mean age was 20.1 (±2.1) years with 53.1% women. Less than half of participants (42.9%) were able to identify all the presenting signs of cardiac arrest. Only 33.7% of participants felt able to perform CPR when witnessing a cardiac arrest. Fewer participants (20.3%) reported receiving previous CPR training. Several perceived barriers to learning and performing CPR were also reported. Significant predictors of willingness to perform CPR when faced with a cardiac arrest were: earning higher income, previous CPR training and feeling confident in one's ability to apply an AED, or perform CPR. Lacking enough expertise in performing CPR was a significant barrier to willingness to perform CPR. University students in Lebanon are familiar with the symptoms of cardiac arrest, however, they are not well trained in CPR and lack confidence to perform it. The attitude towards the importance of bystander CPR and the need to learn CPR is very positive. Interventions should focus on public awareness campaigns regarding the importance of initiating bystander CPR while activating emergency medical services (EMS) and on making CPR training more available. PMID:27787361

Retention of cardiopulmonary resuscitation skills after hands-only training versus conventional training in novices: a randomized controlled trial

PubMed Central

Kim, Young Joon; Cho, Youngsuk; Cho, Gyu Chong; Ji, Hyun Kyung; Han, Song Yi; Lee, Jin Hyuck

2017-01-01

Objective Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. Methods Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training. Each participant’s CPR skills were evaluated at the end of training and 3 months thereafter using the Resusci Anne manikin with a skill-reporting software. Results In total, 252 participants completed training; there were 125 in the hands-only CPR group and 127 in the conventional CPR group. After 3 months, 118 participants were randomly selected to complete a post-training test. The hands-only CPR group showed a significant decrease in average compression rate (P=0.015), average compression depth (P=0.031), and proportion of adequate compression depth (P=0.011). In contrast, there was no difference in the skills of the conventional CPR group after 3 months. Conclusion Conventional CPR training appears to be more effective for the retention of chest compression skills than hands-only CPR training; however, the retention of artificial ventilation skills after conventional CPR training is poor. PMID:28717778

Barriers and Facilitators to Community CPR Education in San José, Costa Rica.

PubMed

Schmid, Kristin M; Mould-Millman, Nee-Kofi; Hammes, Andrew; Kroehl, Miranda; García, Raquel Quiros; McDermott, Manrique Umaña; Lowenstein, Steven R

2016-10-01

Bystander cardiopulmonary resuscitation (CPR) improves survival after prehospital cardiac arrest. While community CPR training programs have been implemented across the US, little is known about their acceptability in non-US Latino populations. The purpose of this study was to identify barriers to enrolling in CPR training classes and performing CPR in San José, Costa Rica. After consulting 10 San José residents, a survey was created, pilot-tested, and distributed to a convenience sample of community members in public gathering places in San José. Questions included demographics, CPR knowledge and beliefs, prior CPR training, having a family member with heart disease, and prior witnessing of a cardiac arrest. Questions also addressed barriers to enrolling in CPR classes (cost/competing priorities). The analysis focused on two main outcomes: likelihood of registering for a CPR class and willingness to perform CPR on an adult stranger. Odds ratios and 95% CIs were calculated to test for associations between patient characteristics and these outcomes. Among 371 participants, most were male (60%) and <40 years old (77%); 31% had a college degree. Many had family members with heart disease (36%), had witnessed a cardiac arrest (18%), were trained in CPR (36%), and knew the correct CPR steps (70%). Overall, 55% (95% CI, 50-60%) indicated they would "likely" enroll in a CPR class; 74% (95% CI, 70-78%) would perform CPR on an adult stranger. Cardiopulmonary resuscitation class enrollment was associated with prior CPR training (OR: 2.6; 95% CI, 1.6-4.3) and a prior witnessed cardiac arrest (OR: 2.0; 95% CI, 1.1-3.5). Willingness to perform CPR on a stranger was associated with a prior witnessed cardiac arrest (OR: 2.5; 95% CI, 1.2-5.4) and higher education (OR: 1.9; 95% CI, 1.1-3.2). Believing that CPR does not work was associated with a higher likelihood of not attending a CPR class (OR: 2.4; 95% CI, 1.7-7.9). Fear of performing mouth-mouth, believing CPR is against God's will, and fear of legal risk were associated with a likelihood of not attending a CPR class and not performing CPR on a stranger (range of ORs: 2.4-3.9). Most San José residents are willing to take CPR classes and perform CPR on a stranger. To implement a community CPR program, barriers must be considered, including misgivings about CPR efficacy and legal risk. Hands-only CPR programs may alleviate hesitancy to perform mouth-to-mouth. Schmid KM , Mould-Millman NK , Hammes A , Kroehl M , Quiros García R , Umaña McDermott M , Lowenstein SR . Barriers and facilitators to community CPR education in San José, Costa Rica. Prehosp Disaster Med. 2016;31(5):509-515.

Greenland annual accumulation along the EGIG line, 1959-2004, from ASIRAS airborne radar and neutron-probe density measurements

NASA Astrophysics Data System (ADS)

Overly, Thomas B.; Hawley, Robert L.; Helm, Veit; Morris, Elizabeth M.; Chaudhary, Rohan N.

2016-08-01

We report annual snow accumulation rates from 1959 to 2004 along a 250 km segment of the Expéditions Glaciologiques Internationales au Groenland (EGIG) line across central Greenland using Airborne SAR/Interferometric Radar Altimeter System (ASIRAS) radar layers and high resolution neutron-probe (NP) density profiles. ASIRAS-NP-derived accumulation rates are not statistically different (95 % confidence interval) from in situ EGIG accumulation measurements from 1985 to 2004. ASIRAS-NP-derived accumulation increases by 20 % below 3000 m elevation, and increases by 13 % above 3000 m elevation for the period 1995 to 2004 compared to 1985 to 1994. Three Regional Climate Models (PolarMM5, RACMO2.3, MAR) underestimate snow accumulation below 3000 m by 16-20 % compared to ASIRAS-NP from 1985 to 2004. We test radar-derived accumulation rates sensitivity to density using modeled density profiles in place of NP densities. ASIRAS radar layers combined with Herron and Langway (1980) model density profiles (ASIRAS-HL) produce accumulation rates within 3.5 % of ASIRAS-NP estimates in the dry snow region. We suggest using Herron and Langway (1980) density profiles to calibrate radar layers detected in dry snow regions of ice sheets lacking detailed in situ density measurements, such as those observed by the Operation IceBridge campaign.

Radar - ESRL Wind Profiler with RASS, Wasco Airport - Derived Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

McCaffrey, Katherine

Profiles of turbulence dissipation rate for 15-minute intervals, time-stamped at the beginning of the 15-minute period, during the final 30 minutes of each hour. During that time, the 915-MHz wind profiling radar was in an optimized configuration with a vertically pointing beam only for measuring accurate spectral widths of vertical velocity. A bias-corrected dissipation rate also was profiled (described in McCaffrey et al. 2017). Hourly files contain two 15-minute profiles.

Evaluation of the Boussignac Cardiac arrest device (B-card) during cardiopulmonary resuscitation in an animal model.

PubMed

Moore, Johanna C; Lamhaut, Lionel; Hutin, Alice; Dodd, Kenneth W; Robinson, Aaron E; Lick, Michael C; Salverda, Bayert J; Hinke, Mason B; Labarere, José; Debaty, Guillaume; Segal, Nicolas

2017-10-01

The purpose of this study was to examine continuous oxygen insufflation (COI) in a swine model of cardiac arrest. The primary hypothesis was COI during standard CPR (S-CPR) should result in higher intrathoracic pressure (ITP) during chest compression and lower ITP during decompression versus S-CPR alone. These changes with COI were hypothesized to improve hemodynamics. The second hypothesis was that changes in ITP with S-CPR+COI would result in superior hemodynamics compared with active compression decompression (ACD) + impedance threshold device (ITD) CPR, as this method primarily lowers ITP during chest decompression. After 6min of untreated ventricular fibrillation, S-CPR was initiated in 8 female swine for 4min, then 3min of S-CPR+COI, then 3min of ACD+ITD CPR, then 3min of S-CPR+COI. ITP and hemodynamics were continuously monitored. During S-CPR+COI, ITP was always positive during the CPR compression and decompression phases. ITP compression values with S-CPR+COI versus S-CPR alone were 5.5±3 versus 0.2±2 (p<0.001) and decompression values were 2.8±2 versus -1.3±2 (p<0.001), respectively. With S-CPR+COI versus ACD+ITD the ITP compression values were 5.5±3 versus 1.5±2 (p<0.01) and decompression values were 2.8±2 versus -4.7±3 (p<0.001), respectively. COI during S-CPR created a continuous positive pressure in the airway during both the compression and decompression phase of CPR. At no point in time did COI generate a negative intrathoracic pressures during CPR in this swine model of cardiac arrest. Copyright © 2017 Elsevier B.V. All rights reserved.

Bystander cardiopulmonary resuscitation training experience and self-efficacy of age and gender group: a nationwide community survey.

PubMed

Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Sung Ok; Kim, Young Taek; Cho, Sung-Il

2016-08-01

We hypothesized that recent hands-on practice for cardiopulmonary resuscitation (CPR) would be strongly associated with a higher likelihood of self-efficacy in bystander CPR among laypersons according to age and gender group. We used the National Korean Community Health Survey database of 228921 representatively sampled responders from 253 counties in 2012. Laypersons who had previous CPR training were eligible. Exposure variables were having had CPR training with hands-on practice session with a manikin (Practical-CPR-Training) and CPR training within the last 2 years (Recent-CPR-Training). Primary outcome was self-efficacy in bystander CPR. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects of CPR training across different age and gender groups. Of 62425 eligible respondents who have had CPR training, 20213 (32.4%) had Practical-CPR-Training. Adjusted odds ratios (AORs) for self-efficacy were 4.08 (3.78-4.41) in Practical-CPR-Training, 2.61 (2.50-2.73) in male, 1.26 (1.16-1.36) in good self-rated health, 1.19 (1.10-1.29) in high school graduate, 1.19 (1.01-1.39) in persons living with stroke patients in household, and 1.17 (1.10-1.24) in Recent-CPR-Training. In interaction models, Practical-CPR-Training showed higher self-efficacy in all age and gender groups, whereas Recent-CPR-Training was not associated with better self-efficacy in elderly group, male (AOR, 0.90 [0.69-1.18]) and female (AOR, 0.94 [0.72-1.23]). Self-efficacy in bystander CPR was higher in person with recent CPR training with hands-on practice with a manikin. Copyright © 2015 Elsevier Inc. All rights reserved.

Automated cardiopulmonary resuscitation using a load-distributing band external cardiac support device for in-hospital cardiac arrest: a single centre experience of AutoPulse-CPR.

PubMed

Spiro, J R; White, S; Quinn, N; Gubran, C J; Ludman, P F; Townend, J N; Doshi, S N

2015-02-01

Poor quality cardiopulmonary resuscitation (CPR) predicts adverse outcome. During invasive cardiac procedures automated-CPR (A-CPR) may help maintain effective resuscitation. The use of A-CPR following in-hospital cardiac arrest (IHCA) remains poorly described. Firstly, we aimed to assess the efficiency of healthcare staff using A-CPR in a cardiac arrest scenario at baseline, following re-training and over time (Scenario-based training). Secondly, we studied our clinical experience of A-CPR at our institution over a 2-year period, with particular emphasis on the details of invasive cardiac procedures performed, problems encountered, resuscitation rates and in-hospital outcome (AutoPulse-CPR Registry). Scenario-based training: Forty healthcare professionals were assessed. At baseline, time-to-position device was slow (mean 59 (±24) s (range 15-96s)), with the majority (57%) unable to mode-switch. Following re-training time-to-position reduced (28 (±9) s, p<0.01 vs baseline) with 95% able to mode-switch. This improvement was maintained over time. AutoPulse-CPR Registry: 285 patients suffered IHCA, 25 received A-CPR. Survival to hospital discharge following conventional CPR was 28/260 (11%) and 7/25 (28%) following A-CPR. A-CPR supported invasive procedures in 9 patients, 2 of whom had A-CPR dependant circulation during transfer to the catheter lab. A-CPR may provide excellent haemodynamic support and facilitate simultaneous invasive cardiac procedures. A significant learning curve exists when integrating A-CPR into clinical practice. Further studies are required to better define the role and effectiveness of A-CPR following IHCA. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Shock outcome prediction before and after CPR: a comparative study of manual and automated active compression-decompression CPR.

PubMed

Box, M S; Watson, J N; Addison, P S; Clegg, G R; Robertson, C E

2008-09-01

We report on a study designed to compare the relative efficacy of manual CPR (M-CPR) and automated mechanical CPR (ACD-CPR) provided by an active compression-decompression (ACD) device. The ECG signals of out-of-hospital cardiac arrest patients of cardiac aetiology were analysed just prior to, and immediately after, cardiopulmonary resuscitation (CPR) to assess the likelihood of successful defibrillation at these time points. The cardioversion outcome prediction (COP) measure previously developed by our group was used to quantify the probability of return of spontaneous circulation (ROSC) after counter-shock and was used as a measure of the efficacy of CPR. An initial validation study using COP to predict shock outcome from the patient data set resulted in a performance of 60% specificity achieved at 100% sensitivity on a blind test of the data. This is comparable with previous studies and provided confidence in the robustness of the technique across hardware platforms. Significantly, the COP marker also displayed an ability to stratify according to outcomes: asystole, ventricular fibrillation (VF), pulseless electrical activity (PEA), normal sinus rhythm (NSR). We then used the validated COP marker to analyse the ECG data record just prior to and immediately after the chest compression segments. This was initially performed for 87 CPR segments where VF was both the pre- and post-CPR waveform. An increase in the mean COP values was found for both CPR types. A signed rank sum test found the increase due to manual CPR not to be significant (p>0.05) whereas the automated CPR was found to be significant (p<0.05). This increase was larger for the automated CPR (1.26, p=0.024) than for the manual CPR (0.99, p=0.124). These results indicate that the application of CPR does indeed provide beneficial preparation of the heart prior to defibrillation therapy whether manual or automated CPR is applied. The COP marker shows promise as a definitive, quantitative determinant of the immediate positive effect of both types of CPR regardless of the details of use. In work of a more exploratory nature we then used the validated COP marker to analyse the ECG pre- and post-CPR for all rhythm types (212 traces). We show a significant increase in the COP measure (p<0.001 in both cases) as indicated by a shift in the median COP marker distribution values. This increase was more pronounced for automated ACD-CPR than for manual CPR. However, a detailed statistical analysis carried out between the groups adjusted for pre-CPR value showed no significant difference between the two methods of CPR (p=0.20). Similarly, adjusting for length of CPR showed no significant difference between the groups. Secondary, subgroup analysis of the ECG according to the length of time for which CPR was performed showed that both types of CPR led to an increase in the likelihood of successful defibrillation after increasing durations of CPR, however results were less reliable after longer periods of continuous CPR.

Borehole radar interferometry revisited

USGS Publications Warehouse

Liu, Lanbo; Ma, Chunguang; Lane, John W.; Joesten, Peter K.

2014-01-01

Single-hole, multi-offset borehole-radar reflection (SHMOR) is an effective technique for fracture detection. However, commercial radar system limitations hinder the acquisition of multi-offset reflection data in a single borehole. Transforming cross-hole transmission mode radar data to virtual single-hole, multi-offset reflection data using a wave interferometric virtual source (WIVS) approach has been proposed but not fully demonstrated. In this study, we compare WIVS-derived virtual single-hole, multi-offset reflection data to real SHMOR radar reflection profiles using cross-hole and single-hole radar data acquired in two boreholes located at the University of Connecticut (Storrs, CT USA). The field data results are similar to full-waveform numerical simulations developed for a two-borehole model. The reflection from the adjacent borehole is clearly imaged by both the real and WIVS-derived virtual reflection profiles. Reflector travel-time changes induced by deviation of the two boreholes from the vertical can also be observed on the real and virtual reflection profiles. The results of this study demonstrate the potential of the WIVS approach to improve bedrock fracture imaging for hydrogeological and petroleum reservoir development applications.

Molecular cloning and functional characterization of multiple NADPH-cytochrome P450 reductases from Andrographis paniculata.

PubMed

Lin, Huixin; Wang, Jian; Qi, Mengdie; Guo, Juan; Rong, Qixian; Tang, Jinfu; Wu, Yisheng; Ma, Xiaojing; Huang, Luqi

2017-09-01

Andrographis paniculata (Burm.f.) Wall. ex Nees is widely used as medicinal herb in Southern and Southeastern Asia and andrographolide is its main medicinal constituent. Based on the structure of andrographolide, it has been proposed that cytochrome P450 enzymes play vital roles on its biosynthesis. NADPH:cytochrome P450 reductase (CPR) is the most important redox partner of multiple P450s. In this study, three CPRs were identified in the genomic data of A. paniculata (namely ApCPR1, ApCPR2, and ApCPR3), and their coding regions were cloned. They varied from 62% to 70% identities to each other at the amino acid sequence level. ApCPR1 belongs to Class I of dicotyledonous CPR while both ApCPR2 and ApCPR3 are grouped to Class II. The recombinant enzymes ApCPR1 and ApCPR2 reduced cytochrome c and ferricyanide in an NADPH-dependent manner. In yeast, they supported the activity of CYP76AH1, a ferruginol-forming enzyme. However, ApCPR3 did not show any enzymatic activities either in vitro or in vivo. Quantitative real-time PCR analysis showed that both ApCPR1 and ApCPR2 expressed in all tissues examined, but ApCPR2 showed higher expression in leaves. Expression of ApCPR2 was inducible by MeJA and its pattern matched with andrographolide accumulation. Present investigation suggested ApCPR2 involves in the biosynthesis of secondary metabolites including andrographolide. Copyright © 2017. Published by Elsevier B.V.

The effectiveness of cardiopulmonary resuscitation instruction: animation versus dispatcher through a cellular phone.

PubMed

Choa, Minhong; Park, Incheol; Chung, Hyun Soo; Yoo, Sun K; Shim, Hoshik; Kim, Seungho

2008-04-01

We developed a cardiopulmonary resuscitation (CPR) instruction programme using motion capture animation integrated into cellular phones. We compared the effectiveness of animation-assisted CPR instruction with dispatcher-assisted instruction in participants with no previous CPR training. This study was a single blind cluster randomized trial. Participants were allocated to either animation-assisted CPR (AA-CPR; 8 clusters, 44 participants) group or dispatcher-assisted CPR (DA-CPR; 8 clusters, 41 participants). The overall performance and time of each step of CPR cycle were recorded on a checklist by 3 assessors. The objective performances were evaluated using the Resusci Anne SkillReporter Manikin. Differences between the groups were compared using an independent t-test adjusted for the effect of clustering. The AA-CPR group had a significantly better checklist score (p<0.001) and time to completion of 1 CPR cycle (p<0.001) than the DA-CPR group. In an objective assessment of psychomotor skill, the AA-CPR group demonstrated more accurate hand positioning (68.8+/-3.6%, p=0.033) and compression rate (72.4+/-3.7%, p=0.015) than DA-CPR group. However, the accuracy of compression depth (p=0.400), ventilation volume (p=0.977) and flow rate (p=0.627) were below 30% in both groups. Audiovisual animated CPR instruction through a cellular phone resulted in better scores in checklist assessment and time interval compliance in participants without CPR skill compared to those who received CPR instructions from a dispatcher; however, the accuracy of important psychomotor skill measures was unsatisfactory in both groups.

Assessing CPR training: The willingness of teaching credential candidates to provide CPR in a school setting.

PubMed

Winkelman, Jack L; Fischbach, Ronald; Spinello, Elio F

2009-12-01

The study explores the anticipated willingness of teacher credential candidates at one California public university in the U.S. to perform cardiopulmonary resuscitation (CPR) or foreign body airway obstruction (FBAO) skills in a school setting. Objectives included (1) identifying reasons that credential candidates would elect or decline to perform CPR, (2) assisting schools to remediate cardiac/respiratory emergency preparedness, and (3) assessing CPR training courses to determine how they may influence teachers' willingness to perform CPR. Participants included 582 teacher credential candidates, who were 95.2% of those surveyed after completion of a health science course and CPR certification. Participants described their attitudes regarding the importance of CPR, the CPR training course, and their willingness to perform CPR in a school environment. Based upon chi-square analysis, an association was found between the willingness to perform CPR and the presence of any one concern regarding training, with 68.6% of those expressing concerns willing to perform CPR compared to 81.9% of those expressing no concerns (p<.0005). Participants certified multiple times stated that they were more likely to perform FBAO skills on both conscious (89% vs. 78.9%, p=.025) and unconscious victims (80% vs. 72%, p<.001), as were participants who believed CPR to be an important skill for teachers (76.9% vs. 43.5%, p<.001). Males were more likely to express willingness to perform CPR than females (84.6% vs. 72.1%, p<.001). Attitudes regarding CPR training may influence teachers' willingness to perform CPR. Recommendations based on these findings include pedagogical changes to CPR curricula, focusing on the importance of CPR as a teacher skill and additional time for hands-on practice. Future research should include U.S. and international participants from a broader geographic area and assessment of both learning and affective outcomes.

Use of impedance threshold device in conjunction with our novel adhesive glove device for ACD-CPR does not result in additional chest decompression.

PubMed

Shih, Andre; Udassi, Sharda; Porvasnik, Stacy L; Lamb, Melissa A; Badugu, Srinivasarao; Venkata, Giridhar Kaliki; Lopez-Colon, Dalia; Haque, Ikram U; Zaritsky, Arno L; Udassi, Jai P

2013-10-01

To evaluate the hemodynamic effects of using an adhesive glove device (AGD) to perform active compression-decompression CPR (AGD-CPR) in conjunction with an impedance threshold device (ITD) in a pediatric cardiac arrest model. Controlled, randomized animal study. In this study, 18 piglets were anesthetized, ventilated, and continuously monitored. After 3min of untreated ventricular fibrillation, animals were randomized (6/group) to receive either standard CPR (S-CPR), active compression-decompression CPR via adhesive glove device (AGD-CPR) or AGD-CPR along with an ITD (AGD-CPR+ITD) for 2min at 100-120compressions/min. AGD is delivered using a fingerless leather glove with a Velcro patch on the palmer aspect and the counter Velcro patch adhered to the pig's chest. Data (mean±SD) were analyzed using one-way ANOVA with pair wise multiple comparisons to assess differences between groups. p-Value≤0.05 was considered significant. Both AGD-CPR and AGD-CPR+ITD groups produced lower intrathoracic pressure (IttP, mmHg) during decompression phase (-13.4±6.7, p=0.01 and -11.9±6.5, p=0.01, respectively) in comparison to S-CPR (-0.3±4.2). Carotid blood flow (CBF, % of baseline mL/min) was higher in AGD-CPR and AGD-CPR+ITD (respectively 64.3±47.3%, p=0.03 and 67.5±33.1%, p=0.04) as compared with S-CPR (29.1±12.5%). Coronary perfusion pressure (CPP, mmHg) was higher in AGD-CPR and AGD-CPR+ITD (respectively 19.7±4.6, p=0.04 and 25.6±12.1, p=0.02) when compared to S-CPR (9.6±9.1). There was no statistically significant difference between AGD-CPR and AGD-CPR+ITD groups with reference to intra-thoracic pressure, carotid blood flow and coronary perfusion pressure. Active compression decompression delivered by this simple and inexpensive adhesive glove device resulted in improved cerebral blood flow and coronary perfusion pressure. There was no statistically significant added effect of ITD use along with AGD-CPR on the decompression of the chest. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

3D CPR Game Can Improve CPR Skill Retention.

PubMed

Li, Jia; Xu, Yimin; Xu, Yahong; Yue, Peng; Sun, Liu; Guo, Ming; Xiao, Shuqin; Ding, Shu; Cui, Yanyan; Li, Shulan; Yang, Qiuying; Chang, Polun; Wu, Ying

2015-01-01

Adequate cardiopulmonary resuscitation (CPR) skill is essential in improving survival rate of sudden cardiac arrest (SCA). However, the skill deteriorates rapidly following CPR training. We developed a computer game by using 3-Dimensional virtual technology (3-D CPR game) for laypersons in the purpose to improve skill retention. As the testing phase, a randomized control trial, in which we recruited 97 freshman medical students who had no prior CPR training experience, was used to test its effect on 3-month CPR Skill retention. The usability of the game was also tested using a 33 item questionnaire rated with 5-point Likert scale. Three months after the initial CPR training, the retention rate of CPR skill in the game group was significantly higher compared with the control (p<0.05) and the average score on 4 dimensions of usability were 3.99-4.05. Overall, using 3-D CPR game in improving CPR skill retention is feasible and effective.

Use of ground-penetrating radar techniques in archaeological investigations

NASA Technical Reports Server (NTRS)

Doolittle, James A.; Miller, W. Frank

1991-01-01

Ground-penetrating radar (GPR) techniques are increasingly being used to aid reconnaissance and pre-excavation surveys at many archaeological sites. As a 'remote sensing' tool, GPR provides a high resolution graphic profile of the subsurface. Radar profiles are used to detect, identify, and locate buried artifacts. Ground-penetrating radar provides a rapid, cost effective, and nondestructive method for identification and location analyses. The GPR can be used to facilitate excavation strategies, provide greater areal coverage per unit time and cost, minimize the number of unsuccessful exploratory excavations, and reduce unnecessary or unproductive expenditures of time and effort.

Simple CPR: A randomized, controlled trial of video self-instructional cardiopulmonary resuscitation training in an African American church congregation.

PubMed

Todd, K H; Heron, S L; Thompson, M; Dennis, R; O'Connor, J; Kellermann, A L

1999-12-01

Despite the proven efficacy of cardiopulmonary resuscitation (CPR), only a small fraction of the population knows how to perform it. As a result, rates of bystander CPR and rates of survival from cardiac arrest are low. Bystander CPR is particularly uncommon in the African American community. Successful development of a simplified approach to CPR training could boost rates of bystander CPR and save lives. We conducted the following randomized, controlled study to determine whether video self-instruction (VSI) in CPR results in comparable or better performance than traditional CPR training. This randomized, controlled trial was conducted among congregational volunteers in an African American church in Atlanta, GA. Subjects were randomly assigned to receive either 34 minutes of VSI or the 4-hour American Heart Association "Heartsaver" CPR course. Two months after training, blinded observers used explicit criteria to assess CPR performance in a simulated cardiac arrest setting. A recording manikin was used to measure ventilation and chest compression characteristics. Participants also completed a written test of CPR-related knowledge and attitudes. VSI trainees displayed a comparable level of performance to that achieved by traditional trainees. Observers scored 40% of VSI trainees competent or better in performing CPR, compared with only 16% of traditional trainees (absolute difference 24%, 95% confidence interval 8% to 40%). Data from the recording manikin confirmed these observations. VSI trainees and traditional trainees achieved comparable scores on tests of CPR-related knowledge and attitudes. Thirty-four minutes of VSI can produce CPR of comparable quality to that achieved by traditional training methods. VSI provides a simple, quick, consistent, and inexpensive alternative to traditional CPR instruction, and may be used to extend CPR training to historically underserved populations.

Barriers to dispatcher-assisted cardiopulmonary resuscitation in Singapore.

PubMed

Ho, Andrew Fu Wah; Sim, Zariel Jiaying; Shahidah, Nur; Hao, Ying; Ng, Yih Yng; Leong, Benjamin S H; Zarinah, Siti; Teo, Winston K L; Goh, Geraldine Shu Yi; Jaafar, Hamizah; Ong, Marcus E H

2016-08-01

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Differentially regulated NADPH:cytochrome P450 oxidoreductases in parsley

PubMed Central

Koopmann, Edda; Hahlbrock, Klaus

1997-01-01

Two NADPH:cytochrome P450 oxidoreductases (CPRs) from parsley (Petroselinum crispum) were cloned, and the complete proteins were expressed and functionally identified in yeast. The two enzymes, designated CPR1 and CPR2, are 80% identical in amino acid sequence with one another and about 75% identical with CPRs from several other plant species. The mRNA accumulation patterns for CPR1 and CPR2 in fungal elicitor-treated or UV-irradiated cultured parsley cells and in developing or infected parsley plants were compared with those for cinnamate 4-hydroxylase (C4H), one of the most abundant CPR-dependent P450 enzymes in plants. All treatments strongly induced the mRNAs for C4H and CPR1 but not for CPR2, suggesting distinct metabolic roles of CPR1 and CPR2 and a functional relationship between CPR1 and C4H. PMID:9405720

Estimation of Cloud Fraction Profile in Shallow Convection Using a Scanning Cloud Radar

DOE PAGES

Oue, Mariko; Kollias, Pavlos; North, Kirk W.; ...

2016-10-18

Large spatial heterogeneities in shallow convection result in uncertainties in estimations of domain-averaged cloud fraction profiles (CFP). This issue is addressed using large eddy simulations of shallow convection over land coupled with a radar simulator. Results indicate that zenith profiling observations are inadequate to provide reliable CFP estimates. Use of Scanning Cloud Radar (SCR), performing a sequence of cross-wind horizon-to-horizon scans, is not straightforward due to the strong dependence of radar sensitivity to target distance. An objective method for estimating domain-averaged CFP is proposed that uses observed statistics of SCR hydrometeor detection with height to estimate optimum sampling regions. Thismore » method shows good agreement with the model CFP. Results indicate that CFP estimates require more than 35 min of SCR scans to converge on the model domain average. Lastly, the proposed technique is expected to improve our ability to compare model output with cloud radar observations in shallow cumulus cloud conditions.« less

Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

PubMed Central

Hilberman, M; Kutner, J; Parsons, D; Murphy, D J

1997-01-01

Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated. PMID:9451605

Does Non-Targeted Community CPR Training Increase Bystander CPR Frequency?

PubMed

Uber, Amy; Sadler, Richard C; Chassee, Todd; Reynolds, Joshua C

2018-05-01

Only 37% of out-of-hospital cardiac arrests (OHCA) receive bystander Cardiopulmonary resuscitation (CPR) in Kent County, MI. In May 2014, prehospital providers offered one-time, point-of-contact compression-only CPR training to 2,253 passersby at 7 public locations in Grand Rapids, Michigan. To assess the impact of this intervention, we compared bystander CPR frequency and clinical outcomes in regions surrounding training sites before and after the intervention, adjusting for prehospital covariates. We aimed to assess the effect of this broad, non-targeted intervention on bystander CPR frequency, type of CPR utilized, and clinical outcomes. We also tested for differences in geospatial variation of bystander CPR and clinical outcomes clustered around training sites. Retrospective, observational, before-after study of adult, EMS-treated OHCA in Kent County from January 1, 2010 to December 31, 2015. We generated a 5-kilometer radius surrounding each training site to estimate any geospatial influence that training sites might have on bystander CPR frequency in nearby OHCA cases. Chi-squared, Fisher's exact, and t-tests assessed differences in subject features. Difference-in-differences analysis with generalized estimating equation (GEE) modeling assessed bystander CPR frequency, adjusting for training site, covariates (age, sex, witnessed, shockable rhythm, public location), and clustering around training sites. Similar modeling tested for changes in bystander CPR type, return of spontaneous circulation (ROSC), survival to hospital discharge, and cerebral performance category (CPC) of 1-2 at hospital discharge. We included 899 cases before and 587 cases post-intervention. Overall, we observed no increase in the frequency of bystander CPR or favorable clinical outcomes. We did observe an increase in compression-only CPR, but this was paradoxically restricted to OHCA cases falling outside radii around training sites. In adjusted modeling, the bystander CPR training intervention was not associated with bystander CPR frequency (β -0.002; 95% CI -0.16, 0.15), compression-only CPR (β -0.06; 95% CI -0.15, 0.02), ROSC (β -0.06; 95% CI -0.21, 0.25), survival (β -0.02; 95% CI -0.11, 0.06), or favorable neurologic outcome (β -0.01; 95% CI -0.07, 0.09). We observed no impact in bystander CPR performance or outcomes from a blanket, non-targeted approach to community CPR education. The effect of targeted CPR education in locales with known low bystander CPR rates should be tested in this region.

Are Chinese Students Willing to Learn and Perform Bystander Cardiopulmonary Resuscitation?

PubMed

Huang, Qiao; Hu, Cuihuan; Mao, Jing

2016-12-01

Immediate cardiopulmonary resuscitation (CPR) can improve survival rate from cardiac arrest and students are potentially important bystander CPR providers. Our aim was to investigate the willingness among Chinese students to learn and perform bystander CPR. Questionnaires were distributed to 1407 students. The survey investigated the willingness to learn and perform bystander CPR and the barriers to performing CPR on family members and strangers, assuming that students had mastered CPR. Only 14.6% of respondents reported having ever attended CPR training classes, however, 88.3% expressed their willingness to learn. The main characteristics of the students who were willing to learn were the following: they considered the development of the local emergency system excellent (odds ratio [OR] = 3.15); cardiovascular diseases were present within their family (OR = 2.74); and they had previously heard about CPR (OR = 2.43). Almost all respondents (94.6%) reported that they would conduct bystander CPR on family members, while only 59.7% of respondents would do it for strangers. A lack of confidence was the principal barrier to doing CPR for family members (78.4%) and the leading barrier to stranger CPR was the fear of legal liability if their lifesaving attempts failed (90.8%). The complicated process of performing CPR was also a major barrier in both scenarios. When there is a great desire to learn CPR, the rate and effect of training can be significantly improved by providing students with regular CPR training, especially compression-only CPR training. Training classes should focus on enhancing the participants' confidence. In addition, legislation by the government is needed to protect the rescuers. Copyright © 2016 Elsevier Inc. All rights reserved.

CloudSat Profiles Tropical Storm Andrea

NASA Image and Video Library

2007-05-10

CloudSat's Cloud Profiling Radar captured a profile across Tropical Storm Andrea on Wednesday, May 9, 2007, near the South Carolina/Georgia/Florida Atlantic coast. The upper image shows an infrared view of Tropical Storm Andrea from the Moderate Resolution Imaging Spectroradiometer instrument on NASA's Aqua satellite, with CloudSat's ground track shown as a red line. The lower image is the vertical cross section of radar reflectivity along this path, where the colors indicate the intensity of the reflected radar energy. CloudSat orbits approximately one minute behind Aqua in a satellite formation known as the A-Train. http://photojournal.jpl.nasa.gov/catalog/PIA09379

The effect of basic life support education on laypersons' willingness in performing bystander hands only cardiopulmonary resuscitation.

PubMed

Cho, Gyu Chong; Sohn, You Dong; Kang, Ku Hyun; Lee, Won Woong; Lim, Kyung Soo; Kim, Won; Oh, Bum Jin; Choi, Dai Hai; Yeom, Seok Ran; Lim, Hoon

2010-06-01

Recently, hands only CPR (cardiopulmonary resuscitation) has been proposed as an alternative to standard CPR for bystanders. The present study was performed to identify the effect of basic life support (BLS) training on laypersons' willingness in performing standard CPR and hands only CPR. The participants for this study were non-medical personnel who applied for BLS training program that took place in 7 university hospitals in and around Korea for 6 months. Before and after BLS training, all the participants were given questionnaires for bystander CPR, and 890 respondents were included in the final analyses. Self-assessed confidence score for bystander CPR, using a visual analogue scale from 0 to 100, increased from 51.5+/-30.0 before BLS training to 87.0+/-13.7 after the training with statistical significance (p 0.001). Before the training, 19% of respondents reported willingness to perform standard CPR on a stranger, and 30.1% to perform hands only CPR. After the training, this increased to 56.7% of respondents reporting willingness to perform standard CPR, and 71.9%, hands only CPR, on strangers. Before and after BLS training, the odds ratio of willingness to perform hands only CPR versus standard CPR were 1.8 (95% CI 1.5-2.3) and 2.0 (95% CI 1.7-2.6) for a stranger, respectively. Most of the respondents, who reported they would decline to perform standard CPR, stated that fear of liability and fear of disease transmission were deciding factors after the BLS training. The BLS training increases laypersons' confidence and willingness to perform bystander CPR on a stranger. However, laypersons are more willing to perform hands only CPR rather than to perform standard CPR on a stranger regardless of the BLS training. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Cardiopulmonary Resuscitation Training Disparities in the United States.

PubMed

Blewer, Audrey L; Ibrahim, Said A; Leary, Marion; Dutwin, David; McNally, Bryan; Anderson, Monique L; Morrison, Laurie J; Aufderheide, Tom P; Daya, Mohamud; Idris, Ahamed H; Callaway, Clifton W; Kudenchuk, Peter J; Vilke, Gary M; Abella, Benjamin S

2017-05-17

Bystander cardiopulmonary resuscitation (CPR) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of CPR training in the United States and associated individual-level disparities are unknown. We sought to measure the national prevalence of CPR training and hypothesized that older age and lower socioeconomic status would be independently associated with a lower likelihood of CPR training. We administered a cross-sectional telephone survey to a nationally representative adult sample. We assessed the demographics of individuals trained in CPR within 2 years (currently trained) and those who had been trained in CPR at some point in time (ever trained). The association of CPR training and demographic variables were tested using survey weighted logistic regression. Between September 2015 and November 2015, 9022 individuals completed the survey; 18% reported being currently trained in CPR, and 65% reported training at some point previously. For each year of increased age, the likelihood of being currently CPR trained or ever trained decreased (currently trained: odds ratio, 0.98; 95% CI, 0.97-0.99; P <0.01; ever trained: OR, 0.99; 95% CI, 0.98-0.99; P =0.04). Furthermore, there was a greater then 4-fold difference in odds of being currently CPR trained from the 30-39 to 70-79 year old age groups (95% CI, 0.10-0.23). Factors associated with a lower likelihood of CPR training were lesser educational attainment and lower household income ( P <0.01 for each of these variables). A minority of respondents reported current training in CPR. Older age, lesser education, and lower income were associated with reduced likelihood of CPR training. These findings illustrate important gaps in US CPR education and suggest the need to develop tailored CPR training efforts to address this variability. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Impact of Eclipse of 21 August 2017 ON the Atmospheric Boundary Layer

NASA Astrophysics Data System (ADS)

Knupp, K.

2017-12-01

The (total) solar eclipse of 21 August 2017 presents a prodigious opportunity to improve our understanding of the physical response of decreases in turbulence within the ABL produced by a rapid reduction in solar radiation, since the transition in this eclipse case, close to local solar noon, is more rapid than at natural sunset. A mesoscale network of three UAH atmospheric profiling systems will be set up around Clarksville, TN, and Hopkinsville, KY, to document the details of the physical response of the ABL to the rapid decrease in solar radiation. The region offers a heterogeneous surface, including expansive agricultural and forested regions. Data from the following mobile systems will be examined: Mobile Integrated Profiling System (MIPS) with a 915 MHz Doppler wind profiler, X-band Profiling Radar (XPR), Microwave Profiling Radiometer (MPR), lidar ceilometer, and Doppler mini-sodar, Rapidly Deployable Atmospheric Profiling System (RaDAPS) with a 915 MHz Doppler wind profiler, MPR, lidar ceilometer, Doppler mini-sodar, Mobile Doppler Lidar and Sounding system (MoDLS) with a Doppler Wind Lidar and MPR. A tethered balloon will provide high temporal and vertical resolution in situ sampling of the surface layer temperature and humidity vertical profiles over the lowest 120 m AGL. Two of the profiling systems (MIPS and MoDLS) will include 20 Hz sonic anemometer measurements for documentation of velocity component (u, v, w) variance, buoyancy flux, and momentum flux. The Mobile Alabama X-band (MAX) dual polarization radar will be paired with the Ft. Campbell WSR-88D radar, located 29 km east of the MAX, to provide dual Doppler radar coverage of flow within the ABL over the profiler domain. The measurements during this eclipse will also provide information on the response of insects to rapidly changing lighting conditions. During the natural afternoon-to-evening transition, daytime insect concentrations decrease rapidly, and stronger-flying nighttime flyers emerge rapidly following sunset. We hypothesize that a similar transition will occur on a limited basis: nighttime flyers will emerge, but the daytime flyers will not rapidly disappear due to the short time scale of the darkness. This insect transition will be measured with the radar wind profilers and the MAX and WSR-88D dual polarization radars.

Factors influencing Chinese university students' willingness to performing bystander cardiopulmonary resuscitation.

PubMed

Lu, Cui; Jin, Ying-Hui; Shi, Xiao-Tong; Ma, Wen-Jing; Wang, Yun-Yun; Wang, Wei; Zhang, Yao

2017-05-01

Low rates of bystander-initiated CPR are a major obstacle to improved survival rates, and the aim of this study is to elucidate the factors associated with university students' attitudes toward performing bystander CPR. Questionnaires were distributed to 18 universities across three metropolises in China. One question asking for respondents' attitudes toward performing bystander CPR was set as the dependent variable, and the logistic regression models were used to extract independent factors for respondents' attitudes toward performing bystander CPR. 2934 questionnaires were completed, with a response rate of 81.5%. Results suggested that predictors of willingness to perform bystander CPR were: previous experience of performing bystander CPR, higher self-perceived ability to perform bystander CPR properly after instruction, medicine and law discipline, male gender, not being the single child of their parents, higher participation in university societies, being used to taking decisive action immediately, less self-perceived life stress and higher self-perceived knowledge level of CPR. Persons having previous experience of performing bystander CPR and those who thought they would have the ability to perform bystander CPR properly are predominantly associated with willingness to perform bystander CPR. Psychological and cultural factors need further study. Copyright © 2016 Elsevier Ltd. All rights reserved.

Left-right asymmetry in firing rate of extra-retinal photosensitive neurons in the crayfish.

PubMed

Pacheco-Ortiz, José A; Sánchez-Hernández, Juan C; Rodríguez-Sosa, Leonardo; Calderón-Rosete, Gabina; Villagran-Vargas, Edgar

2018-01-01

The purpose of this paper is to explore the firing rate of the caudal photoreceptors (CPRs) from the sixth abdominal ganglion of the crayfish Cherax quadricarinatus. We use simultaneous extracellular recordings on left and right CPR in the isolated ganglion (n = 10). The CPRs showed an asymmetry in the spontaneous activity and light-induced response. In darkness, we observed one subgroup (70%) in which the left CPR (CPR-L) and right CPR (CPR-R) had spontaneous firing rates with a median of 18 impulses/s and 6 impulses/s, respectively. In another subgroup (20%), the CPR-R had a median of 15 impulses/s and the CPR-L had 8 impulses/s. In both groups, the differences were significant. Furthermore, the CPRs showed an asymmetrical photoresponse induced by a pulse of white light (700 Lux, 4 s). In one subgroup (30%), the CPR-L showed light-induced activity with a median of 73%, (interquartile range, IQR = 51), while the CPR-R had a median of 41%, (IQR = 47). In another subgroup (70%), the CPR-R showed a median of 56%, (IQR = 51) and the CPR-L had a median of 42%, (IQR = 46). In both groups, the differences were significant. Moreover, we observed a differential effect of temperature on CPR activity. These results suggest a functional asymmetry in both activities from left and right CPRs. These CPR activity fluctuations may modulate the processing of information by the nervous system.

Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.

PubMed

Nord-Ljungquist, Helena; Brännström, Margareta; Bohm, Katarina

2015-07-01

In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions. We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design. If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR. Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Functional characterization of NADPH-cytochrome P450 reductase from Bactrocera dorsalis: Possible involvement in susceptibility to malathion

PubMed Central

Huang, Yong; Lu, Xue-Ping; Wang, Luo-Luo; Wei, Dong; Feng, Zi-Jiao; Zhang, Qi; Xiao, Lin-Fan; Dou, Wei; Wang, Jin-Jun

2015-01-01

NADPH cytochrome P450 reductase (CPR) is essential for cytochrome P450 catalysis, which is important in the detoxification and activation of xenobiotics. In this study, two transcripts of Bactrocera dorsalis CPR (BdCPR) were cloned, and the deduced amino-acid sequence had an N-terminus membrane anchor for BdCPR-X1 and three conserved binding domains (FMN, FAD, and NADP), as well as an FAD binding motif and catalytic residues for both BdCPR-X1 and BdCPR-X2. BdCPR-X1 was detected to have the high expression levels in adults and in Malpighian tubules, fat bodies, and midguts of adults, but BdCPR-X2 expressed lowly in B. dorsalis. The levels of BdCPRs were similar in malathion-resistant strain compared to susceptible strain. However, injecting adults with double-stranded RNA against BdCPR significantly reduced the transcript levels of the mRNA, and knockdown of BdCPR increased adult susceptibility to malathion. Expressing complete BdCPR-X1 cDNA in Sf9 cells resulted in high activity determined by cytochrome c reduction and these cells had higher viability after exposure to malathion than control. The results suggest that BdCPR could affect the susceptibility of B. dorsalis to malathion and eukaryotic expression of BdCPR would lay a solid foundation for further investigation of P450 in B. dorsalis. PMID:26681597

End-tidal carbon dioxide output in manual cardiopulmonary resuscitation versus active compression-decompression device during prehospital quality controlled resuscitation: a case series study.

PubMed

Setälä, Piritta Anniina; Virkkunen, Ilkka Tapani; Kämäräinen, Antti Jaakko; Huhtala, Heini Sisko Annamari; Virta, Janne Severi; Yli-Hankala, Arvi Mikael; Hoppu, Sanna Elisa

2018-05-16

Active compression-decompression (ACD) devices have enhanced end-tidal carbon dioxide (ETCO 2 ) output in experimental cardiopulmonary resuscitation (CPR) studies. However, the results in out-of-hospital cardiac arrest (OHCA) patients have shown inconsistent outcomes, and earlier studies lacked quality control of CPR attempts. We compared manual CPR with ACD-CPR by measuring ETCO 2 output using an audiovisual feedback defibrillator to ensure continuous high quality resuscitation attempts. 10 witnessed OHCAs were resuscitated, rotating a 2 min cycle with manual CPR and a 2 min cycle of ACD-CPR. Patients were intubated and the ventilation rate was held constant during CPR. CPR quality parameters and ETCO 2 values were collected continuously with the defibrillator. Differences in ETCO 2 output between manual CPR and ACD-CPR were analysed using a linear mixed model where ETCO 2 output produced by a summary of the 2 min cycles was included as the dependent variable, the patient as a random factor and method as a fixed effect. These comparisons were made within each OHCA case to minimise confounding factors between the cases. Mean length of the CPR episodes was 37 (SD 8) min. Mean compression depth was 76 (SD 1.3) mm versus 71 (SD1.0) mm, and mean compression rate was 100 per min (SD 6.7) versus 105 per min (SD 4.9) between ACD-CPR and manual CPR, respectively. For ETCO 2 output, the interaction between the method and the patient was significant (P<0.001). ETCO 2 output was higher with manual CPR in 6 of the 10 cases. This study suggests that quality controlled ACD-CPR is not superior to quality controlled manual CPR when ETCO 2 is used as a quantitative measure of CPR effectiveness. NCT00951704; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness of different compression-to-ventilation methods for cardiopulmonary resuscitation: A systematic review.

PubMed

Ashoor, Huda M; Lillie, Erin; Zarin, Wasifa; Pham, Ba'; Khan, Paul A; Nincic, Vera; Yazdi, Fatemeh; Ghassemi, Marco; Ivory, John; Cardoso, Roberta; Perkins, Gavin D; de Caen, Allan R; Tricco, Andrea C

2017-09-01

To compare the effectiveness of different compression-to-ventilation methods during cardiopulmonary resuscitation (CPR) in patients with cardiac arrest. We searched MEDLINE and Cochrane Central Register of Controlled Trials from inception until January 2016. We included experimental, quasi-experimental, and observational studies that compared different chest compression-to-ventilation ratios during CPR for all patients and assessed at least one of the following outcomes: favourable neurological outcomes, survival, return of spontaneous circulation (ROSC), and quality of life. Two reviewers independently screened literature search results, abstracted data, and appraised the risk of bias. Random-effects meta-analyses were conducted separately for randomised and non-randomised studies, as well as study characteristics, such as CPR provider. After screening 5703 titles and abstracts and 229 full-text articles, we included 41 studies, of which 13 were companion reports. For adults receiving bystander or dispatcher-instructed CPR, no significant differences were observed across all comparisons and outcomes. Significantly less adults receiving bystander-initiated or plus dispatcher-instructed compression-only CPR experienced favourable neurological outcomes, survival, and ROSC compared to CPR 30:2 (compression-to-ventilation) in un-adjusted analyses in a large cohort study. Evidence from emergency medical service (EMS) CPR providers showed significantly more adults receiving CPR 30:2 experiencing improved favourable neurological outcomes and survival versus those receiving CPR 15:2. Significantly more children receiving CPR 15:2 or 30:2 experienced favourable neurological outcomes, survival, and greater ROSC compared to compression-only CPR. However, for children <1 years of age, no significant differences were observed between CPR 15:2 or 30:2 and compression-only CPR. Our results demonstrated that for adults, CPR 30:2 is associated with better survival and favourable neurological outcomes when compared to CPR 15:2. For children, more patients receiving CPR with either 15:2 or 30:2 compression-to ventilation ratio experienced favourable neurological function, survival, and ROSC when compared to CO-CPR for children of all ages, but for children <1years of age, no statistically significant differences were observed. Copyright © 2017 Elsevier B.V. All rights reserved.

Radar Cuts Subsoil Survey Costs

NASA Technical Reports Server (NTRS)

Johnson, R.; Glaccum, R.

1984-01-01

Soil features located with minimum time and labor. Ground-penetrating radar (GPR) system supplements manual and mechanical methods in performing subsurface soil survey. Mobile system obtains graphic profile of soil discontinuities and interfaces as function of depth. One or two test borings necessary to substantiate soil profile. GPR proves useful as reconnaissance tool.

Modeling englacial radar attenuation at Siple Dome, West Antarctica, using ice chemistry and temperature data

USGS Publications Warehouse

MacGregor, J.A.; Winebrenner, D.P.; Conway, H.; Matsuoka, K.; Mayewski, P.A.; Clow, G.D.

2007-01-01

The radar reflectivity of an ice-sheet bed is a primary measurement for discriminating between thawed and frozen beds. Uncertainty in englacial radar attenuation and its spatial variation introduces corresponding uncertainty in estimates of basal reflectivity. Radar attenuation is proportional to ice conductivity, which depends on the concentrations of acid and sea-salt chloride and the temperature of the ice. We synthesize published conductivity measurements to specify an ice-conductivity model and find that some of the dielectric properties of ice at radar frequencies are not yet well constrained. Using depth profiles of ice-core chemistry and borehole temperature and an average of the experimental values for the dielectric properties, we calculate an attenuation rate profile for Siple Dome, West Antarctica. The depth-averaged modeled attenuation rate at Siple Dome (20.0 ?? 5.7 dB km-1) is somewhat lower than the value derived from radar profiles (25.3 ?? 1.1 dB km-1). Pending more experimental data on the dielectric properties of ice, we can match the modeled and radar-derived attenuation rates by an adjustment to the value for the pure ice conductivity that is within the range of reported values. Alternatively, using the pure ice dielectric properties derived from the most extensive single data set, the modeled depth-averaged attenuation rate is 24.0 ?? 2.2 dB km-1. This work shows how to calculate englacial radar attenuation using ice chemistry and temperature data and establishes a basis for mapping spatial variations in radar attenuation across an ice sheet. Copyright 2007 by the American Geophysical Union.

Compression-only CPR training in elementary schools and student attitude toward CPR.

PubMed

Kitamura, Tetsuhisa; Nishiyama, Chika; Murakami, Yukiko; Yonezawa, Takahiro; Nakai, Shohei; Hamanishi, Masayoshi; Marukawa, Seishiro; Sakamoto, Tetsuya; Iwami, Taku

2016-08-01

Little is known about the effectiveness of systematic cardiopulmonary resuscitation (CPR) training for elementary school children. We introduced systematic training of chest compression-only CPR and automated external defibrillator (AED) use to elementary school students aged 10-12 years at 17 schools. The questionnaire compared student attitudes towards CPR and their knowledge about it before and after CPR training. We also evaluated parent and teacher views about CPR training in school education. The primary outcome was positive attitude, defined as "yes" and "maybe yes" on a 5 point Likert-type scale of student attitudes towards CPR.1 RESULTS: A total of 2047 elementary school students received CPR training. Of them, 1899 (92.8%) responded to the questionnaire regarding their attitude towards CPR before and after the training. Before training, 50.2% answered "yes" and 30.3% answered "maybe yes", to the question: "If someone suddenly collapses in front of you, can you do something such as check response or call emergency?" After training, their answers changed to 75.6% and 18.3% for "yes" and "maybe yes", respectively. Many of the students (72.3%, 271/370) who did not have a positive attitude before CPR training had a positive attitude after the training (P < 0.001). Most students understood how to perform CPR (97.7%) and use an AED (98.5%). Parents (96.2%, 1173/1220) and teachers (98.3%, 56/57) answered that it was "good" and "maybe good" for children to receive the training at elementary schools. Systematic chest compression-only CPR training helped elementary school students to improve their attitude towards CPR. © 2015 Japan Pediatric Society.

The Epidemiology of In-Hospital Cardiopulmonary Resuscitation in Older Adults: 1992-2005

PubMed Central

Ehlenbach, William J.; Barnato, Amber E.; Curtis, J. Randall; Kreuter, William; Koepsell, Thomas D.; Deyo, Richard A.; Stapleton, Renee D.

2010-01-01

BACKGROUND It is unknown whether survival after in-hospital cardiopulmonary resuscitation (CPR) is improving and which patient and hospital characteristics predict survival. METHODS We examined fee-for-service Medicare data from 1992 to 2005 to identify beneficiaries ≥ 65 years old who received CPR in US hospitals. We examined temporal trends in the incidence of and survival after CPR, as well as patient and hospital-level predictors of survival to discharge. RESULTS We identified 433,985 cases of in-hospital CPR and 18.3% survived to discharge (95% CI 18.2-18.5%). Survival was static during this period. The incidence of CPR was 2.73 events per 1000 admissions and was higher among non-white patients. The proportion of dying patients receiving in-hospital CPR prior to death increased over time and was higher for non-white patients. Patients who were male, older, had more co-morbid illness, or were admitted from a skilled nursing facility had lower survival. Adjusted odds of survival for black patients were 23.6% lower than similar white patients (95% CI 21.2%-25.9%). The association between race and survival was partially explained by hospital effects: black patients were more likely to receive CPR in hospitals with lower post-CPR survival. Among patients surviving in-hospital CPR, the proportion of patients discharged home decreased over time. CONCLUSIONS Survival following in-hospital CPR did not improve from 1992-2005 and the proportion of patients receiving in-hospital CPR prior to death increased while the proportion of survivors discharged home after CPR decreased. Black race was associated with higher rates of CPR, but lower survival after CPR. PMID:19571280

An error analysis of the recovery capability of the relative sea-surface profile over the Puerto Rican trench from multi-station and ship tracking of GEOS-2

NASA Technical Reports Server (NTRS)

Stanley, H. R.; Martin, C. F.; Roy, N. A.; Vetter, J. R.

1971-01-01

Error analyses were performed to examine the height error in a relative sea-surface profile as determined by a combination of land-based multistation C-band radars and optical lasers and one ship-based radar tracking the GEOS 2 satellite. It was shown that two relative profiles can be obtained: one using available south-to-north passes of the satellite and one using available north-to-south type passes. An analysis of multi-station tracking capability determined that only Antigua and Grand Turk radars are required to provide satisfactory orbits for south-to-north type satellite passes, while a combination of Merritt Island, Bermuda, and Wallops radars provide secondary orbits for north-to-south passes. Analysis of ship tracking capabilities shows that high elevation single pass range-only solutions are necessary to give only moderate sensitivity to systematic error effects.

The crystal structure of the Hsp90 co-chaperone Cpr7 from Saccharomyces cerevisiae.

PubMed

Qiu, Yu; Ge, Qiangqiang; Wang, Mingxing; Lv, Hui; Ebrahimi, Mohammad; Niu, Liwen; Teng, Maikun; Li, Xu

2017-03-01

The versatility of Hsp90 can be attributed to the variety of co-chaperone proteins that modulate the role of Hsp90 in many cellular processes. As a co-chaperone of Hsp90, Cpr7 is essential for accelerating the cell growth in an Hsp90-containing trimeric complex. Here, we report the crystal structure of Cpr7 at a resolution of 1.8Å. It consists of an N-terminal PPI domain and a C-terminal TPR domain, and exhibits a U-shape conformation. Our studies revealed the aggregation state of Cpr7 in solution and the interaction properties between Cpr7 and the MEEVD sequence from the C-terminus of Hsp90. In addition, the structure and sequence analysis between Cpr7 and homologues revealed the structure basis both for the function differences between Cpr6 and Cpr7 and the functional complements between Cns1 and Cpr7. Our studies facilitate the understanding of Cpr7 and provide decent insights into the molecular mechanisms of the Hsp90 co-chaperone pathway. Copyright © 2017 Elsevier Inc. All rights reserved.

Gene cloning and overexpression of two conjugated polyketone reductases, novel aldo-keto reductase family enzymes, of Candida parapsilosis.

PubMed

Kataoka, M; Delacruz-Hidalgo, A-R G; Akond, M A; Sakuradani, E; Kita, K; Shimizu, S

2004-04-01

The genes encoding two conjugated polyketone reductases (CPR-C1, CPR-C2) of Candida parapsilosis IFO 0708 were cloned and sequenced. The genes encoded a total of 304 and 307 amino acid residues for CPR-C1 and CPR-C2, respectively. The deduced amino acid sequences of the two enzymes showed high similarity to each other and to several proteins of the aldo-keto reductase (AKR) superfamily. However, several amino acid residues in putative active sites of AKRs were not conserved in CPR-C1 and CPR-C2. The two CPR genes were overexpressed in Escherichia coli. The E. coli transformant bearing the CPR-C2 gene almost stoichiometrically reduced 30 mg ketopantoyl lactone/ml to D-pantoyl lactone.

“Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest

PubMed Central

Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

2013-01-01

Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and <120 min−1); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Conclusions Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336

"Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.

PubMed

Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay

2011-05-01

To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and <120 min(-1)); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.

What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools? A qualitative study

PubMed Central

Malta Hansen, Carolina; Rod, Morten Hulvej; Folke, Fredrik; Torp-Pedersen, Christian; Tjørnhøj-Thomsen, Tine

2016-01-01

Objective Cardiopulmonary resuscitation (CPR) training in schools is recommended to increase bystander CPR and thereby survival of out-of-hospital cardiac arrest, but despite mandating legislation, low rates of implementation have been observed in several countries, including Denmark. The purpose of the study was to explore barriers to implementation of CPR training in Danish secondary schools. Design A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and across the interviews. Setting 8 secondary schools in Denmark. Schools were selected using strategic sampling to reach maximum variation, including schools with/without recent experience in CPR training of students, public/private schools and schools near to and far from hospitals. Participants The study population comprised 25 participants, 9 school leadership members and 16 teachers. Results School leadership and teachers considered it important for implementation and sustainability of CPR training that teachers conduct CPR training of students. However, they preferred external instructors to train students, unless teachers acquired the CPR skills which they considered were needed. They considered CPR training to differ substantially from other teaching subjects because it is a matter of life and death, and they therefore believed extraordinary skills were required for conducting the training. This was mainly rooted in their insecurity about their own CPR skills. CPR training kits seemed to lower expectations of skill requirements to conduct CPR training, but only among those who were familiar with such kits. Conclusions To facilitate implementation of CPR training in schools, it is necessary to have clear guidelines regarding the required proficiency level to train students in CPR, to provide teachers with these skills, and to underscore that extensive skills are not required to provide CPR. Further, it is important to familiarise teachers with CPR training kits. PMID:27113236

Long-term retention of cardiopulmonary resuscitation skills after shortened chest compression-only training and conventional training: a randomized controlled trial.

PubMed

Nishiyama, Chika; Iwami, Taku; Kitamura, Tetsuhisa; Ando, Masahiko; Sakamoto, Tetsuya; Marukawa, Seishiro; Kawamura, Takashi

2014-01-01

It is unclear how much the length of a cardiopulmonary resuscitation (CPR) training program can be reduced without ruining its effectiveness. The authors aimed to compare CPR skills 6 months and 1 year after training between shortened chest compression-only CPR training and conventional CPR training. Participants were randomly assigned to either the compression-only CPR group, which underwent a 45-minute training program consisting of chest compressions and automated external defibrillator (AED) use with personal training manikins, or the conventional CPR group, which underwent a 180-minute training program with chest compressions, rescue breathing, and AED use. Participants' resuscitation skills were evaluated 6 months and 1 year after the training. The primary outcome measure was the proportion of appropriate chest compressions 1 year after the training. A total of 146 persons were enrolled, and 63 (87.5%) in the compression-only CPR group and 56 (75.7%) in the conventional CPR group completed the 1-year evaluation. The compression-only CPR group was superior to the conventional CPR group regarding the proportion of appropriate chest compression (mean ± SD = 59.8% ± 40.0% vs. 46.3% ± 28.6%; p = 0.036) and the number of appropriate chest compressions (mean ± SD = 119.5 ± 80.0 vs. 77.2 ± 47.8; p = 0.001). Time without chest compression in the compression-only CPR group was significantly shorter than that in the conventional CPR group (mean ± SD = 11.8 ± 21.1 seconds vs. 52.9 ± 14.9 seconds; p < 0.001). The shortened compression-only CPR training program appears to help the general public retain CPR skills better than the conventional CPR training program. UMIN-CTR UMIN000001675. © 2013 by the Society for Academic Emergency Medicine.

Comparison of raindrop size distributions measured by radar wind profiler and by airplane

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rogers, R.R.; Ethier, S.A.; Baumgardner, D.

1993-04-01

Wind profilers are radars that operate in the VHF and UHF bands and are designed for detecting the weak echoes reflected by the optically clear atmosphere. An unexpected application of wind profilers has been the revival of an old method of estimating drop size distributions in rain from the Doppler spectrum of the received signal. Originally attempted with radars operating at microwave frequencies, the method showed early promise but was seriously limited in application because of the crucial sensitivity of the estimated drop sizes to the vertical air velocity, a quantity generally unknown and, at that time, unmeasurable. Profilers havemore » solved this problem through their ability to measure, under appropriate conditions, both air motions and drop motions. This paper compares the drop sizes measured by a UHF profiler at two altitudes in a shower with those measured simultaneously by an instrumented airplane. The agreement is satisfactory, lending support to this new application of wind profilers. 20 refs., 5 figs.« less

Improvement in Trainees' Attitude and Resuscitation Quality With Repeated Cardiopulmonary Resuscitation Training: Cross-Sectional Simulation Study.

PubMed

Kim, Jong Won; Lee, Jeong Hun; Lee, Kyeong Ryong; Hong, Dae Young; Baek, Kwang Je; Park, Sang O

2016-08-01

This study investigated the effect of increasing numbers of training sessions in cardiopulmonary resuscitation (CPR) on trainees' attitude and CPR quality. Cardiopulmonary resuscitation training for hospital employees was held every year from 2006 to 2010. Participants were recruited among the trainees in 2010. The trainees' attitudes toward CPR were surveyed by questionnaire, and the quality of their CPR was measured using 5-cycle 30:2 CPR on a manikin. Participants were categorized according to the number of consecutive CPR training sessions as T1 (only 2010), T2 (2009 and 2010), T3 (from 2008 to 2010) and T4-5 (from 2006 or 2007 to 2010). The trainee attitude and CPR quality were compared among the 4 groups. Of 923 CPR trainees, 267 were enrolled in the study. There was significant increase in willingness to start CPR and confidence in chest compression and mouth-to-mouth ventilation (MTMV) with increasing number of CPR training sessions attended (especially for ≥ 3 sessions). There was a significant increase in mean compression depth and decrease in percentage of chest compressions with depth of less than 38 mm in the T3 and T4-5 compared with the T1 and T2. No-flow time decreased significantly, and the percentage of MTMV with visible chest rise increased, as the number of training sessions increased. Repeated CPR training improved trainees' attitude and CPR quality. Because the number of training sessions increased (≥3), the willingness to start CPR and the confidence in skills increased significantly, and chest compression depth, no-flow time, and MTMV improved.

Association between public cardiopulmonary resuscitation education and the willingness to perform bystander cardiopulmonary resuscitation: a metropolitan citywide survey.

PubMed

Son, Jeong Woo; Ryoo, Hyun Wook; Moon, Sungbae; Kim, Jong-Yeon; Ahn, Jae Yun; Park, Jeong Bae; Seo, Kang Suk; Kim, Jong Kun; Kim, Yun Jeong

2017-06-01

Bystander cardiopulmonary resuscitation (CPR) is an important factor associated with improved survival rates and neurologic prognoses in cases of out-of-hospital cardiac arrest. We assessed how factors related to CPR education including timing of education, period from the most recent education session, and content, affected CPR willingness. In February 2012, trained interviewers conducted an interview survey of 1,000 Daegu citizens through an organized questionnaire. The subjects were aged ≥19 years and were selected by quota sampling. Their social and demographic characteristics, as well as CPR and factors related to CPR education, were investigated. Chi-square tests and multivariate logistic regression analyses were used to evaluate how education-related factors affected the willingness to perform CPR. Of total 1,000 cases, 48.0% were male. The multivariate analyses revealed several factors significantly associated with CPR willingness: didactic plus practice group (adjusted odds ratio [AOR], 3.38; 95% confidence interval [CI], 2.3 to 5.0), group with more than four CPR education session (AOR, 7.68; 95% CI, 3.21 to 18.35), interval of less than 6 months from the last CPR education (AOR, 4.47; 95% CI 1.29 to 15.52), and education with automated external defibrillator (AOR, 5.98; 95% CI 2.30 to 15.53). The following were associated with increased willingness to perform CPR: practice sessions and automated electrical defibrillator training in public CPR education, more frequent CPR training, and shorter time period from the most recent CPR education sessions.

Public cardiopulmonary resuscitation training rates and awareness of hands-only cardiopulmonary resuscitation: a cross-sectional survey of Victorians.

PubMed

Bray, Janet E; Smith, Karen; Case, Rosalind; Cartledge, Susie; Straney, Lahn; Finn, Judith

2017-04-01

To provide contemporary Australian data on the public's training in cardiopulmonary resuscitation (CPR) and awareness of hands-only CPR. A cross-sectional telephone survey in April 2016 of adult residents of the Australian state of Victoria was conducted. Primary outcomes were rates of CPR training and awareness of hands-only CPR. Of the 404 adults surveyed (mean age 55 ± 17 years, 59% female, 73% metropolitan residents), 274 (68%) had undergone CPR training. Only 50% (n = 201) had heard of hands-only CPR, with most citing first-aid courses (41%) and media (36%) as sources of information. Of those who had undergone training, the majority had received training more than 5 years previously (52%) and only 28% had received training or refreshed training in the past 12 months. Most received training in a formal first-aid class (43%), and received training as a requirement for work (67%). The most common reasons for not having training were: they had never thought about it (59%), did not have time (25%) and did not know where to learn (15%). Compared to standard CPR, a greater proportion of respondents were willing to provide hands-only CPR for strangers (67% vs 86%, P < 0.001). From an Australian perspective, there is still room for improvement in CPR training rates and awareness of hands-only CPR. Further promotion of hands-only CPR and self-instruction (e.g. DVD kits or online) may see further improvements in CPR training and bystander CPR rates. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Association between public cardiopulmonary resuscitation education and the willingness to perform bystander cardiopulmonary resuscitation: a metropolitan citywide survey

PubMed Central

Son, Jeong Woo; Ryoo, Hyun Wook; Moon, Sungbae; Kim, Jong-yeon; Ahn, Jae Yun; Park, Jeong Bae; Seo, Kang Suk; Kim, Jong Kun; Kim, Yun Jeong

2017-01-01

Objective Bystander cardiopulmonary resuscitation (CPR) is an important factor associated with improved survival rates and neurologic prognoses in cases of out-of-hospital cardiac arrest. We assessed how factors related to CPR education including timing of education, period from the most recent education session, and content, affected CPR willingness. Methods In February 2012, trained interviewers conducted an interview survey of 1,000 Daegu citizens through an organized questionnaire. The subjects were aged ≥19 years and were selected by quota sampling. Their social and demographic characteristics, as well as CPR and factors related to CPR education, were investigated. Chi-square tests and multivariate logistic regression analyses were used to evaluate how education-related factors affected the willingness to perform CPR. Results Of total 1,000 cases, 48.0% were male. The multivariate analyses revealed several factors significantly associated with CPR willingness: didactic plus practice group (adjusted odds ratio [AOR], 3.38; 95% confidence interval [CI], 2.3 to 5.0), group with more than four CPR education session (AOR, 7.68; 95% CI, 3.21 to 18.35), interval of less than 6 months from the last CPR education (AOR, 4.47; 95% CI 1.29 to 15.52), and education with automated external defibrillator (AOR, 5.98; 95% CI 2.30 to 15.53). Conclusion The following were associated with increased willingness to perform CPR: practice sessions and automated electrical defibrillator training in public CPR education, more frequent CPR training, and shorter time period from the most recent CPR education sessions. PMID:28717777

Cardiopulmonary resuscitation using the cardio vent device in a resuscitation model.

PubMed

Suner, Selim; Jay, Gregory D; Kleinman, Gary J; Woolard, Robert H; Jagminas, Liudvikas; Becker, Bruce M

2002-05-01

To compare the "Bellows on Sternum Resuscitation" (BSR) device that permits simultaneous compression and ventilation by one rescuer with two person cardiopulmonary resuscitation (CPR) with bag-valve-mask (BVM) ventilation in a single blind crossover study performed in the laboratory setting. Tidal volume and compression depth were recorded continuously during 12-min CPR sessions with the BSR device and two person CPR. Six CPR instructors performed a total of 1,894 ventilations and 10,532 compressions in 3 separate 12-min sessions. Mean tidal volume (MTV) and compression rate (CR) with the BSR device differed significantly from CPR with the BVM group (1242 mL vs. 1065 mL, respectively, p = 0.0018 and 63.2 compressions per minute (cpm) vs. 81.3 cpm, respectively, p = 0.0076). Error in compression depth (ECD) rate of 9.78% was observed with the BSR device compared to 8.49% with BMV CPR (p = 0.1815). Error rate was significantly greater during the second half of CPR sessions for both BSR and BVM groups. It is concluded that one-person CPR with the BSR device is equivalent to two-person CPR with BVM in all measured parameters except for CR. Both groups exhibited greater error rate in CPR performance in the latter half of 12-min CPR sessions.

Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation.

PubMed

Siao, Fu-Yuan; Chiu, Chun-Chieh; Chiu, Chun-Wen; Chen, Ying-Chen; Chen, Yao-Li; Hsieh, Yung-Kun; Lee, Chien-Hui; Wu, Chang-Te; Chou, Chu-Chung; Yen, Hsu-Heng

2015-07-01

Refractory ventricular fibrillation, resistant to conventional cardiopulmonary resuscitation (CPR), is a life threatening rhythm encountered in the emergency department. Although previous reports suggest the use of extracorporeal CPR can improve the clinical outcomes in patients with prolonged cardiac arrest, the effectiveness of this novel strategy for refractory ventricular fibrillation is not known. We aimed to compare the clinical outcomes of patients with refractory ventricular fibrillation managed with conventional CPR or extracorporeal CPR in our institution. This is a retrospective chart review study from an emergency department in a tertiary referral medical center. We identified 209 patients presenting with cardiac arrest due to ventricular fibrillation between September 2011 and September 2013. Of these, 60 patients were enrolled with ventricular fibrillation refractory to resuscitation for more than 10 min. The clinical outcome of patients with ventricular fibrillation received either conventional CPR, including defibrillation, chest compression, and resuscitative medication (C-CPR, n = 40) or CPR plus extracorporeal CPR (E-CPR, n = 20) were compared. The overall survival rate was 35%, and 18.3% of patients were discharged with good neurological function. The mean duration of CPR was longer in the E-CPR group than in the C-CPR group (69.90 ± 49.6 min vs 34.3 ± 17.7 min, p = 0.0001). Patients receiving E-CPR had significantly higher rates of sustained return of spontaneous circulation (95.0% vs 47.5%, p = 0.0009), and good neurological function at discharge (40.0% vs 7.5%, p = 0.0067). The survival rate in the E-CPR group was higher (50% vs 27.5%, p = 0.1512) at discharge and (50% vs 20%, p = 0. 0998) at 1 year after discharge. The management of refractory ventricular fibrillation in the emergency department remains challenging, as evidenced by an overall survival rate of 35% in this study. Patients with refractory ventricular fibrillation receiving E-CPR had a trend toward higher survival rates and significantly improved neurological outcomes than those receiving C-CPR. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A tourniquet assisted cardiopulmonary resuscitation augments myocardial perfusion in a porcine model of cardiac arrest.

PubMed

Yang, Zhengfei; Tang, David; Wu, Xiaobo; Hu, Xianwen; Xu, Jiefeng; Qian, Jie; Yang, Min; Tang, Wanchun

2015-01-01

During cardiopulmonary resuscitation (CPR), myocardial blood flow generated by chest compression rarely exceeds 35% of its normal level. Cardiac output generated by chest compression decreases gradually with the prolongation of cardiac arrest and resuscitation. Early studies have demonstrated that myocardial blood flow during CPR is largely dependent on peripheral vascular resistance. In this study, we investigated the effects of chest compression in combination with physical control of peripheral vascular resistance assisted by tourniquets on myocardial blood flow during CPR. Ventricular fibrillation was induced and untreated for 7 min in ten male domestic pigs weighing between 33 and 37 kg. The animals were then randomized to receive CPR alone or a tourniquet assisted CPR (T-CPR). In the CPR alone group, chest compression was performed by a miniaturized mechanical chest compressor. In the T-CPR group, coincident with the start of resuscitation, the thin elastic tourniquets were wrapped around the four limbs from the distal end to the proximal part. After 2 min of CPR, epinephrine (20 μg/kg) was administered via the femoral vein. After 5 min of CPR, defibrillation was attempted by a single 150 J shock. If resuscitation was not successful, CPR was resumed for 2 min before the next defibrillation. The protocol was continued until successful resuscitation or for a total of 15 min. Five minutes after resuscitation, the elastic tourniquets were removed. The resuscitated animals were observed for 2h. T-CPR generated significantly greater coronary perfusion pressure, end-tidal carbon dioxide and carotid blood flow. There was no difference in both intrathoracic positive and negative pressures between the two groups. All animals were successfully resuscitated with a single shock in both groups. There were no significant changes in hemodynamics observed in the animals treated in the T-CPR group before-and-after the release of tourniquets at post-resuscitation 5 min. T-CPR improves myocardial and cerebral perfusion during CPR. It may provide a new and convenient method for augmenting myocardial and cerebral blood flow during CPR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

New distributed radar technology based on UAV or UGV application

NASA Astrophysics Data System (ADS)

Molchanov, Pavlo A.; Contarino, Vincent M.

2013-05-01

Regular micro and nano radars cannot provide reliable tracking of low altitude low profile aerial targets in urban and mountain areas because of reflection and re-reflections from buildings and terrain. They become visible and vulnerable to guided missiles if positioned on a tower or blimp. Doppler radar cannot distinguish moving cars and small low altitude aerial targets in an urban area. A new concept of pocket size distributed radar technology based on the application of UAV (Unmanned Air Vehicles), UGV (Unmanned Ground Vehicles) is proposed for tracking of low altitude low profile aerial targets at short and medium distances for protection of stadium, camp, military facility in urban or mountain areas.

Vertical structure of the lower troposphere derived from MU radar, unmanned aerial vehicle, and balloon measurements during ShUREX 2015

NASA Astrophysics Data System (ADS)

Luce, Hubert; Kantha, Lakshmi; Hashiguchi, Hiroyuki; Lawrence, Dale; Mixa, Tyler; Yabuki, Masanori; Tsuda, Toshitaka

2018-12-01

The ShUREX (Shigaraki UAV Radar Experiment) 2015 campaign carried out at the Shigaraki Middle and Upper atmosphere (MU) observatory (Japan) in June 2015 provided a unique opportunity to compare vertical profiles of atmospheric parameters estimated from unmanned aerial vehicle (UAV), balloon, and radar data in the lower troposphere. The present work is intended primarily as a demonstration of the potential offered by combination of these three instruments for studying the small-scale structure and dynamics in the lower troposphere. Here, we focus on data collected almost simultaneously by two instrumented UAVs and two meteorological balloons, near the MU radar operated continuously during the campaign. The UAVs flew along helical ascending and descending paths at a nearly constant horizontal distance from the radar ( 1.0 km), while the balloons launched from the MU radar site drifted up to 3-5 km in the altitude range of comparisons ( 0.5 to 4.0 km) due to wind advection. Vertical profiles of squared Brünt-Väisälä frequency N 2 and squared vertical gradient of generalized potential refractive index M 2 were estimated at a vertical resolution of 20 m from pressure, temperature, and humidity data collected by UAVs and radiosondes. Profiles of M 2 were also estimated from MU radar echo power at vertical incidence at a vertical sampling of 20 m and various time resolutions (1-4 min). The balloons and the MU radar provided vertical profiles of wind and wind shear S so that two independent estimates of the gradient Richardson number ( Ri = N 2/ S 2) could be obtained at a range resolution of 150 m. The two estimates of Ri profiles also showed remarkable agreement at all altitudes. We show that all three instruments detected the same prominent temperature and humidity gradients, down to decameter scales in stratified conditions. These gradients extended horizontally over a few kilometers at least and persisted for hours without significant changes, indicating that the turbulent diffusion was weak . Large discrepancies between N 2and M 2 profiles derived from the balloon, UAV, and radar data were found in a turbulent layer generated by a Kelvin-Helmholtz (KH) shear flow instability in the height range from 1.80 to 2.15 km. The cause of these discrepancies appears to depend on the stage of the KH billows.

Prevalence and hemodynamic effects of leaning during CPR

PubMed Central

Niles, Dana E.; Sutton, Robert M.; Nadkarni, Vinay M.; Glatz, Andrew; Zuercher, Mathias; Maltese, Matthew R.; Eilevstjønn, Joar; Abella, Benjamin S.; Becker, Lance B.; Berg, Robert A.

2013-01-01

Background Cardiopulmonary resuscitation (CPR) guidelines recommend complete release between chest compressions (CC). Objective Evaluate the hemodynamic effects of leaning (incomplete chest wall release) during CPR and the prevalence of leaning during CPR. Results In piglet ventricular fibrillation cardiac arrests, 10% and 20% (1.8 kg and 3.6 kg, respectively), leaning during CPR increased right atrial pressures, decreased coronary perfusion pressures, and decreased cardiac index and left ventricular myocardial blood flow by nearly 50%. In contrast, residual leaning of a 260 g accelerometer/ force feedback device did not adversely affect cardiac index or myocardial blood flow. Among 108 adult in-hospital CPR events, leaning ≥2.5 kg was demonstrable in 91% of the events and 12% of the evaluated CC. For 12 children with in-hospital CPR, 28% of CC had residual leaning ≥2.5 kg and 89% had residual leaning ≥0.5 kg. Conclusions Leaning during CPR increases intrathoracic pressure, decreases coronary perfusion pressure, and decreases cardiac output and myocardial blood flow. Leaning is common during CPR. PMID:22208173

Novel electronic refreshers for cardiopulmonary resuscitation: a randomized controlled trial

PubMed Central

2012-01-01

Background Currently the American Red Cross requires that individuals renew their cardiopulmonary resuscitation (CPR) certification annually; this often requires a 4- to 8-hour refresher course. Those trained in CPR often show a decrease in essential knowledge and skills within just a few months after training. New electronic means of communication have expanded the possibilities for delivering CPR refreshers to members of the general public who receive CPR training. The study’s purpose was to determine the efficacy of three novel CPR refreshers - online website, e-mail and text messaging – for improving three outcomes of CPR training - skill retention, confidence for using CPR and intention to use CPR. These three refreshers may be considered “novel” in that they are not typically used to refresh CPR knowledge and skills. Methods The study conducted two randomized clinical trials of the novel CPR refreshers. A mailed brochure was a traditional, passive refresher format and served as the control condition. In Trial 1, the refreshers were delivered in a single episode at 6 months after initial CPR training. In Trial 2, the refreshers were delivered twice, at 6 and 9 months after initial CPR training, to test the effect of a repeated delivery. Outcomes for the three novel refreshers vs. the mailed brochure were determined at 12 months after initial CPR training. Results Assignment to any of three novel refreshers did not improve outcomes of CPR training one year later in comparison with receiving a mailed brochure. Comparing outcomes for subjects who actually reviewed some of the novel refreshers vs. those who did not indicated a significant positive effect for one outcome, confidence for performing CPR. The website refresher was associated with increased behavioral intent to perform CPR. Stated satisfaction with the refreshers was relatively high. The number of episodes of refreshers (one vs. two) did not have a significant effect on any outcomes. Conclusions There was no consistent evidence for the superiority of novel refreshers as compared with a traditional mailed brochure, but the low degree of actual exposure to the materials does not allow a definitive conclusion. An online web-based approach seems to have the most promise for future research on electronic CPR refreshers. PMID:23170816

No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device.

PubMed

Newberry, Ryan; Redman, Ted; Ross, Elliot; Ely, Rachel; Saidler, Clayton; Arana, Allyson; Wampler, David; Miramontes, David

2018-01-01

Out-of-hospital cardiac arrest (OHCA) is a major cause of death and morbidity in the United States. Quality cardiopulmonary resuscitation (CPR) has proven to be a key factor in improving survival. The aim of our study was to investigate the outcomes of OHCA when mechanical CPR (LUCAS 2 Chest Compression System™) was utilized compared to conventional CPR. Although controlled trials have not demonstrated a survival benefit to the routine use of mechanical CPR devices, there continues to be an interest for their use in OHCA. We conducted a retrospective observational study of OHCA comparing the outcomes of mechanical and manual chest compressions in a fire department based EMS system serving a population of 1.4 million residents. Mechanical CPR devices were geographically distributed on 11 of 33 paramedic ambulances. Data were collected over a 36-month period and outcomes were dichotomized based on utilization of mechanical CPR. The primary outcome measure was survival to hospital discharge with a cerebral performance category (CPC) score of 1 or 2. This series had 3,469 OHCA reports, of which 2,999 had outcome data and met the inclusion criteria. Of these 2,236 received only manual CPR and 763 utilized a mechanical CPR device during the resuscitation. Return of spontaneous circulation (ROSC) was attained in 44% (334/763) of the mechanical CPR resuscitations and in 46% (1,020/2,236) of the standard manual CPR resuscitations (p = 0.32). Survival to hospital discharge was observed in 7% (52/763) of the mechanical CPR resuscitations and 9% (191/2,236) of the manual CPR group (p = 0.13). Discharge with a CPC score of 1 or 2 was observed in 4% (29/763) of the mechanical CPR resuscitation group and 6% (129/2,236) of the manual CPR group (p = 0.036). In our study, use of the mechanical CPR device was associated with a poor neurologic outcome at hospital discharge. However, this difference was no longer evident after logistic regression adjusting for confounding variables. Resuscitation management following institution of mechanical CPR, specifically medication and airway management, may account for the poor outcome reported. Further investigation of resuscitation management when a mechanical CPR device is utilized is necessary to optimize survival benefit.

What do I have to lose? Effects of a psycho-educational intervention on cancer patient preference for resuscitation.

PubMed

Sears, Sharon R; Woodward, Julia T; Twillman, Robert K

2007-12-01

This original empirical study examined effects of a psycho-educational intervention on cancer patients' knowledge, concern, and preferences for cardiopulmonary resuscitation (CPR). We examined message framing as one factor that might impact subsequent decision making. In addition, we examined personality and coping style as predictors and moderators of patients' reactions to an informational intervention. As hypothesized, participants initially underestimated CPR complications and overestimated survival rates. The intervention significantly increased concern, improved knowledge, and decreased preference for CPR, particularly for participants receiving both numerical and descriptive information. Message framing of survival data did not uniquely affect CPR preference. Higher optimism predicted less increase in concern about CPR, and higher hope predicted greater decrease in preference for CPR. More approach coping related to increased concern about CPR and decreased preference for CPR.

A paediatric cardiopulmonary resuscitation training project in Honduras.

PubMed

Urbano, Javier; Matamoros, Martha M; López-Herce, Jesús; Carrillo, Angel P; Ordóñez, Flora; Moral, Ramón; Mencía, Santiago

2010-04-01

It is possible that the exportation of North American and European models has hindered the creation of a structured cardiopulmonary resuscitation (CPR) training programme in developing countries. The objective of this paper is to describe the design and present the results of a European paediatric and neonatal CPR training programme adapted to Honduras. A paediatric CPR training project was set up in Honduras with the instructional and scientific support of the Spanish Group for Paediatric and Neonatal CPR. The programme was divided into four phases: CPR training and preparation of instructors; training for instructors; supervised teaching; and independent teaching. During the first phase, 24 Honduran doctors from paediatric intensive care, paediatric emergency and anaesthesiology departments attended the paediatric CPR course and 16 of them the course for preparation as instructors. The Honduran Paediatric and Neonatal CPR Group was formed. In the second phase, workshops were given by Honduran instructors and four of them attended a CPR course in Spain as trainee instructors. In the third phase, a CPR course was given in Honduras by the Honduran instructors, supervised by the Spanish team. In the final phase of independent teaching, eight courses were given, providing 177 students with training in CPR. The training of independent paediatric CPR groups with the collaboration and scientific assessment of an expert group could be a suitable model on which to base paediatric CPR training in Latin American developing countries. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Overview of Japanese Earth observation programs

NASA Astrophysics Data System (ADS)

Shimoda, Haruhisa; Honda, Yoshiaki

2017-09-01

Five programs, i.e. ASTER, GOSAT, GCOM-W1, GPM and ALOS-2 are going on in Japanese Earth Observation programs. ASTER has lost its short wave infrared channels. AMSR-E stopped its operation, but it started its operation from Sep. 2012 with slow rotation speed. It finally stopped on December 2015. GCOM-W1 was launched on 18, May, 2012 and is operating well as well as GOSAT. ALOS (Advanced Land Observing Satellite) was successfully launched on 24th Jan. 2006. ALOS carries three instruments, i.e., PRISM (Panchromatic Remote Sensing Instrument for Stereo Mapping), AVNIR-2 (Advanced Visible and Near Infrared Radiometer), and PALSAR (Phased Array L band Synthetic Aperture Radar). Unfortunately, ALOS has stopped its operation on 22nd, April, 2011 by power loss. GOSAT (Greenhouse Gas Observation Satellite) was successfully launched on 29, January, 2009. GOSAT carries 2 instruments, i.e. a green house gas sensor (TANSO-FTS) and a cloud/aerosol imager (TANSO-CAI). The main sensor is a Fourier transform spectrometer (FTS) and covers 0.76 to 15 μm region with 0.2 to 0.5 cm-1 resolution. SMILES (Superconducting Millimeter wave Emission Spectrometer) was launched on September 2009 to ISS and started the observation, but stopped its operation on April 2010. GPM (Global Precipitation Mission) core satellite was launched on Feb. 2014. GPM is a joint project with NASA and carries two instruments. JAXA has developed DPR (Dual frequency Precipitation Radar) which is a follow on of PR on TRMM. ALOS F/O satellites are divided into two satellites, i.e. SAR and optical satellites. The first one of ALOS F/O is called ALOS 2 and carries L-band SAR. It was launched on May 2014. JAXA is planning to launch follow on of optical sensors. It is now called Advanced Optical Satellite and the planned launch date is fiscal 2019. Other future satellites are GCOM-C1 (ADEOS-2 follow on), GOSAT-2 and EarthCare. GCOM-C1 will be launched on 2017 and GOSAT-2 will be launched on fiscal 2018. Another project is EarthCare. It is a joint project with ESA and JAXA is going to provide CPR (Cloud Profiling Radar). EarthCare will be launched on 2019.

Systematic review and meta-analysis of hemodynamic-directed feedback during cardiopulmonary resuscitation in cardiac arrest.

PubMed

Chopra, A S; Wong, N; Ziegler, C P; Morrison, L J

2016-04-01

Physiologic monitoring of resuscitative efforts during cardiac arrest is gaining in importance, as it provides a real-time window into the cellular physiology of patients. The aim of this review is to assess the quality of evidence surrounding the use of physiologic monitoring to guide cardiopulmonary resuscitation (CPR), and to examine whether the evidence demonstrates an improvement in patient outcome when comparing hemodynamic-directed CPR versus standard CPR. Studies were obtained through a search of the PubMed, Embase and Cochrane databases. Peer-reviewed randomized trials, case-control studies, systematic reviews, and cohort studies that titrated CPR to physiologic measures, compared results to standard CPR, and examined patient outcome were included. Six studies met inclusion criteria, with all studies conducted in animal populations. Four studies examined the effects of hemodynamic-directed CPR on survival, with 35/37 (94.6%) animals surviving in the hemodynamic-directed CPR groups and 12/35 (34.3%) surviving in the control groups (p<0.001). Two studies examined the effects of hemodynamic-directed CPR on ROSC, with 22/30 (73.3%) achieving ROSC in the hemodynamic-directed CPR group and 19/30 (63.3%) achieving ROSC in the control group (p=0.344). These results suggest a trend in survival from hemodynamic-directed CPR over standard CPR, however the small sample size and lack of human data make these results of limited value. Future human studies examining hemodynamic-directed CPR versus current CPR standards are needed to enhance our understanding of how to effectively use physiologic measures to improve resuscitation efforts and ultimately incorporate concrete targets into international resuscitation guidelines. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

PubMed

Atkins, Dianne L; de Caen, Allan R; Berger, Stuart; Samson, Ricardo A; Schexnayder, Stephen M; Joyner, Benny L; Bigham, Blair L; Niles, Dana E; Duff, Jonathan P; Hunt, Elizabeth A; Meaney, Peter A

2018-01-02

This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age. Four large database studies were available for review, including 2 published after the "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Two demonstrated worse 30-day outcomes with chest compression-only CPR for children 1 through 18 years of age, whereas 2 studies documented no difference between chest compression-only CPR and CPR using chest compressions with rescue breaths. When the results were analyzed for infants <1 year of age, CPR using chest compressions with rescue breaths was better than no CPR but was no different from chest compression-only CPR in 1 study, whereas another study observed no differences among chest compression-only CPR, CPR using chest compressions with rescue breaths, and no CPR. CPR using chest compressions with rescue breaths should be provided for infants and children in cardiac arrest. If bystanders are unwilling or unable to deliver rescue breaths, we recommend that rescuers provide chest compressions for infants and children. © 2017 American Heart Association, Inc.

Inspiratory impedance during active compression-decompression cardiopulmonary resuscitation: a randomized evaluation in patients in cardiac arrest.

PubMed

Plaisance, P; Lurie, K G; Payen, D

2000-03-07

Blood pressure is severely reduced in patients in cardiac arrest receiving standard cardiopulmonary resuscitation (CPR). Although active compression-decompression (ACD) CPR improves acute hemodynamic parameters, arterial pressures remain suboptimal with this technique. We performed ACD CPR in patients with a new inspiratory threshold valve (ITV) to determine whether lowering intrathoracic pressures during the "relaxation" phase of ACD CPR would enhance venous blood return and overall CPR efficiency. This prospective, randomized, blinded trial was performed in prehospital mobile intensive care units in Paris, France. Patients in nontraumatic cardiac arrest received ACD CPR plus the ITV or ACD CPR alone for 30 minutes during advanced cardiac life support. End tidal CO(2) (ETCO(2)), diastolic blood pressure (DAP) and coronary perfusion pressure, and time to return of spontaneous circulation (ROSC) were measured. Groups were similar with respect to age, gender, and initial rhythm. Mean maximal ETCO(2), coronary perfusion pressure, and DAP values, respectively (in mm Hg), were 13.1+/-0.9, 25.0+/-1.4, and 36.5+/-1.5 with ACD CPR alone versus 19.1+/-1.0, 43.3+/-1.6, and 56.4+/-1.7 with ACD plus valve (P<0.001 between groups). ROSC was observed in 2 of 10 patients with ACD CPR alone after 26.5+/-0.7 minutes versus 4 of 11 patients with ACD CPR plus ITV after 19.8+/-2.8 minutes (P<0.05 for time from intubation to ROSC). Conclusions-Use of an inspiratory resistance valve in patients in cardiac arrest receiving ACD CPR increases the efficiency of CPR, leading to diastolic arterial pressures of >50 mm Hg. The long-term benefits of this new CPR technology are under investigation.

Dynamic Gesture Recognition with a Terahertz Radar Based on Range Profile Sequences and Doppler Signatures

PubMed Central

Pi, Yiming

2017-01-01

The frequency of terahertz radar ranges from 0.1 THz to 10 THz, which is higher than that of microwaves. Multi-modal signals, including high-resolution range profile (HRRP) and Doppler signatures, can be acquired by the terahertz radar system. These two kinds of information are commonly used in automatic target recognition; however, dynamic gesture recognition is rarely discussed in the terahertz regime. In this paper, a dynamic gesture recognition system using a terahertz radar is proposed, based on multi-modal signals. The HRRP sequences and Doppler signatures were first achieved from the radar echoes. Considering the electromagnetic scattering characteristics, a feature extraction model is designed using location parameter estimation of scattering centers. Dynamic Time Warping (DTW) extended to multi-modal signals is used to accomplish the classifications. Ten types of gesture signals, collected from a terahertz radar, are applied to validate the analysis and the recognition system. The results of the experiment indicate that the recognition rate reaches more than 91%. This research verifies the potential applications of dynamic gesture recognition using a terahertz radar. PMID:29267249

Dynamic Gesture Recognition with a Terahertz Radar Based on Range Profile Sequences and Doppler Signatures.

PubMed

Zhou, Zhi; Cao, Zongjie; Pi, Yiming

2017-12-21

The frequency of terahertz radar ranges from 0.1 THz to 10 THz, which is higher than that of microwaves. Multi-modal signals, including high-resolution range profile (HRRP) and Doppler signatures, can be acquired by the terahertz radar system. These two kinds of information are commonly used in automatic target recognition; however, dynamic gesture recognition is rarely discussed in the terahertz regime. In this paper, a dynamic gesture recognition system using a terahertz radar is proposed, based on multi-modal signals. The HRRP sequences and Doppler signatures were first achieved from the radar echoes. Considering the electromagnetic scattering characteristics, a feature extraction model is designed using location parameter estimation of scattering centers. Dynamic Time Warping (DTW) extended to multi-modal signals is used to accomplish the classifications. Ten types of gesture signals, collected from a terahertz radar, are applied to validate the analysis and the recognition system. The results of the experiment indicate that the recognition rate reaches more than 91%. This research verifies the potential applications of dynamic gesture recognition using a terahertz radar.

A hemodynamic-directed approach to pediatric cardiopulmonary resuscitation (HD-CPR) improves survival.

PubMed

Morgan, Ryan W; Kilbaugh, Todd J; Shoap, Wesley; Bratinov, George; Lin, Yuxi; Hsieh, Ting-Chang; Nadkarni, Vinay M; Berg, Robert A; Sutton, Robert M

2017-02-01

Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR. After 7min of asphyxia followed by VF, 4-week-old piglets received either hemodynamic-directed CPR (HD-CPR; compression depth titrated to SBP of 90mmHg and vasopressor administration to maintain CoPP ≥20mmHg); or Standard Care (compression depth 1/3 of the anterior-posterior chest diameter and epinephrine every 4min). All animals received CPR for 10min prior to the first defibrillation attempt. CPR was continued for a maximum of 20min. Protocolized intensive care was provided to all surviving animals for 4h. The primary outcome was 4-h survival. Survival rate was greater with HD-CPR (12/12) than Standard Care (6/10; p=0.03). CoPP during HD-CPR was higher compared to Standard Care (point estimate +8.1mmHg, CI 95 : 0.5-15.8mmHg; p=0.04). Chest compression depth was lower with HD-CPR than Standard Care (point estimate -14.0mm, CI95: -9.6 to -18.4mm; p<0.01). Prior to the first defibrillation attempt, more vasopressor doses were administered with HD-CPR vs. Standard Care (median 5 vs. 2; p<0.01). Hemodynamic-directed CPR improves short-term survival compared to standard depth-targeted CPR in a porcine model of pediatric asphyxia-associated VF IHCA. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Hemodynamic-Directed Approach to Pediatric Cardiopulmonary Resuscitation (HD-CPR) Improves Survival

PubMed Central

Morgan, Ryan W.; Kilbaugh, Todd J.; Shoap, Wesley; Bratinov, George; Lin, Yuxi; Hsieh, Ting-Chang; Nadkarni, Vinay M.; Berg, Robert A.; Sutton, Robert M.

2016-01-01

Aim Most pediatric in-hositalcardiac arrests(IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR. Methods After 7 minutes of asphyxia followed by VF, 4-week-old piglets received either Hemodynamic-Directed CPR (HD-CPR; compression depth titrated to SBP of 90mmHg and vasopressor administration to maintain CoPP ≥20mmHg); or Standard Care (compression depth 1/3 of the anterior-posterior chest diameter and epinephrine every 4 minutes). All animals received CPR for 10 minutes prior to the first defibrillation attempt. CPR was continued for a maximum of 20 minutes. Protocolized intensive care was provided to all surviving animals for 4 hours. The primary outcome was 4-hour survival. Results Survival rate was greater with HD-CPR (12/12) than Standard Care (6/10; p=0.03). CoPP during HD-CPR was higher compared to Standard Care (point estimate +8.1mmHg, CI95: 0.5–15.8mmHg; p=0.04). Chest compression depth was lower with HD-CPR than Standard Care (point estimate 14.0mm, CI95: 9.6–18.4mm; p<0.01). Prior to the first defibrillation attempt, more vasopressor doses were administered with HD-CPR versus Standard Care (median 5 versus 2; p<0.01). Conclusions Hemodynamic-directed CPR improves short-term survival compared to standard depth-targeted CPR in a porcine model of pediatric asphyxia-associated VF IHCA. PMID:27923692

Using multimedia tools and high-fidelity simulations to improve medical students' resuscitation performance: an observational study

PubMed Central

Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen

2016-01-01

Objectives The goal of our study was to shed light on educational methods to strengthen medical students' cardiopulmonary resuscitation (CPR) leadership and team skills in order to optimise CPR understanding and success using didactic videos and high-fidelity simulations. Design An observational study. Setting A tertiary medical centre in Northern Taiwan. Participants A total of 104 5–7th year medical students, including 72 men and 32 women. Interventions We provided the medical students with a 2-hour training session on advanced CPR. During each class, we divided the students into 1–2 groups; each group consisted of 4–6 team members. Medical student teams were trained by using either method A or B. Method A started with an instructional CPR video followed by a first CPR simulation. Method B started with a first CPR simulation followed by an instructional CPR video. All students then participated in a second CPR simulation. Outcome measures Student teams were assessed with checklist rating scores in leadership, teamwork and team member skills, global rating scores by an attending physician and video-recording evaluation by 2 independent individuals. Results The 104 medical students were divided into 22 teams. We trained 11 teams using method A and 11 using method B. Total second CPR simulation scores were significantly higher than first CPR simulation scores in leadership (p<0.001), teamwork (p<0.001) and team member skills (p<0.001). For methods A and B students' first CPR simulation scores were similar, but method A students' second CPR simulation scores were significantly higher than those of method B in leadership skills (p=0.034), specifically in the support subcategory (p=0.049). Conclusions Although both teaching strategies improved leadership, teamwork and team member performance, video exposure followed by CPR simulation further increased students' leadership skills compared with CPR simulation followed by video exposure. PMID:27678539

Medical students and physical education students as CPR instructors: an appropriate solution to the CPR-instructor shortage in secondary schools?

PubMed

Cuijpers, P J P M; Bookelman, G; Kicken, W; de Vries, W; Gorgels, A P M

2016-07-01

Integrating cardiopulmonary resuscitation (CPR) training in secondary schools will increase the number of potential CPR providers. However, currently too few certified instructors are available for this purpose. Training medical students and physical education student teachers to become CPR instructors could decrease this shortage. Examine whether medical students and physical education student teachers can provide CPR training for secondary school pupils as well as (i. e., non-inferior to) registered nurses. A total of 144 secondary school pupils were randomly assigned to CPR training by a registered nurse (n = 12), a  medical student (n = 17) or a physical education student teacher (n = 15). CPR performance was assessed after training and after eight weeks in a simulated cardiac arrest scenario on a resuscitation manikin, using manikin software and video recordings. No significant differences were found between the groups on the overall Cardiff Test scores and the correctness of the CPR techniques during the post-training and retention test. All pupils showed sufficient CPR competence, even after eight weeks. Training by medical students or physical education student teachers is non-inferior to training by a registered nurse, suggesting that school teachers, student teachers and medical students can be recruited for CPR training in secondary schools.

Retrieve Optically Thick Ice Cloud Microphysical Properties by Using Airborne Dual-Wavelength Radar Measurements

NASA Technical Reports Server (NTRS)

Wang, Zhien; Heymsfield, Gerald M.; Li, Lihua; Heymsfield, Andrew J.

2005-01-01

An algorithm to retrieve optically thick ice cloud microphysical property profiles is developed by using the GSFC 9.6 GHz ER-2 Doppler Radar (EDOP) and the 94 GHz Cloud Radar System (CRS) measurements aboard the high-altitude ER-2 aircraft. In situ size distribution and total water content data from the CRYSTAL-FACE field campaign are used for the algorithm development. To reduce uncertainty in calculated radar reflectivity factors (Ze) at these wavelengths, coincident radar measurements and size distribution data are used to guide the selection of mass-length relationships and to deal with the density and non-spherical effects of ice crystals on the Ze calculations. The algorithm is able to retrieve microphysical property profiles of optically thick ice clouds, such as, deep convective and anvil clouds, which are very challenging for single frequency radar and lidar. Examples of retrieved microphysical properties for a deep convective clouds are presented, which show that EDOP and CRS measurements provide rich information to study cloud structure and evolution. Good agreement between IWPs derived from an independent submillimeter-wave radiometer, CoSSIR, and dual-wavelength radar measurements indicates accuracy of the IWC retrieved from the two-frequency radar algorithm.

A new retrieval method for the ice water content of cirrus using data from the CloudSat and CALIPSO

NASA Astrophysics Data System (ADS)

Pan, Honglin; Bu, Lingbing; Kumar, K. Raghavendra; Gao, Haiyang; Huang, Xingyou; Zhang, Wentao

2017-08-01

The CloudSat and CALIPSO (Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations) are the members of satellite observation system of A-train to achieve the quasi-synchronization observation on the same orbit. With the help of active (CALIOP and CPR) and passive payloads from these two satellites, respectively, unprecedented detailed information of microphysical properties of ice cloud can be retrieved. The ice water content (IWC) is regarded as one of the most important microphysical characteristics of cirrus for its prominent role in cloud radiative forcing. In this paper, we proposed a new joint (Combination) retrieval method using the full advantages of different well established retrieval methods, namely the LIDAR method (for the region Lidar-only), the MWCR method (for the region Radar-only), and Wang method (for the region Lidar-Radar) proposed by Wang et al. (2002). In retrieval of cirrus IWC, empirical formulas of the exponential type were used for both thinner cirrus (detected by Lidar-only), thicker cirrus (detected by radar-only), and the part of cirrus detected by both, respectively. In the present study, the comparison of various methods verified that our proposed new joint method is more comprehensive, rational and reliable. Further, the retrieval information of cirrus is complete and accurate for the region that Lidar cannot penetrate and Radar is insensitive. On the whole, the retrieval results of IWC showed certain differences retrieved from the joint method, Ca&Cl, and ICARE which can be interpreted from the different hypothesis of microphysical characteristics and parameters used in the retrieval method. In addition, our joint method only uses the extinction coefficient and the radar reflectivity factor to calculate the IWC, which is simpler and reduces to some extent the accumulative error. In future studies, we will not only compare the value of IWC but also explore the detailed macrophysical and microphysical characteristics of cirrus.

Improving workplace safety training using a self-directed CPR-AED learning program.

PubMed

Mancini, Mary E; Cazzell, Mary; Kardong-Edgren, Suzan; Cason, Carolyn L

2009-04-01

Adequate training in cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) is an important component of a workplace safety training program. Barriers to traditional in-classroom CPR-AED training programs include time away from work to complete training, logistics, learner discomfort over being in a classroom setting, and instructors who include information irrelevant to CPR. This study evaluated differences in CPR skills performance between employees who learned CPR using a self-directed learning (SDL) kit and employees who attended a traditional instructor-led course. The results suggest that the SDL kit yields learning outcomes comparable to those obtained with traditional instructor-led courses and is a more time-efficient tool for CPR-AED training. Furthermore, the SDL kit overcomes many of the barriers that keep individuals from learning CPR and appears to contribute to bystanders' confidently attempting resuscitation.

Insights into riming and aggregation processes as revealed by aircraft, radar, and disdrometer observations for a 27 April 2011 widespread precipitation event: Insights into Riming and Aggregation

DOE PAGES

Giangrande, Scott E.; Toto, Tami; Bansemer, Aaron; ...

2016-05-19

Our study presents aircraft spiral ascent and descent observations intercepting a transition to riming processes during widespread stratiform precipitation. The sequence is documented using collocated scanning and profiling radar, including longer-wavelength dual polarization measurements and shorter-wavelength Doppler spectra. Riming regions are supported using aircraft measurements recording elevated liquid water concentrations, spherical particle shapes, and saturation with respect to water. Profiling cloud radar observations indicate riming regions during the event as having increasing particle fall speeds, rapid time-height changes, and bimodalities in Doppler spectra. These particular riming signatures are coupled to scanning dual polarization radar observations of higher differential reflectivity (ZDR)more » aloft. Moreover, reduced melting layer enhancements and delayed radar bright-band signatures in the column are also observed during riming periods, most notably with the profiling radar observations. The bimodal cloud radar Doppler spectra captured near riming zones indicate two time-height spectral ice peaks, one rimed particle peak, and one peak associated with pristine ice needle generation and/or growth between -4°C and -7°C also sampled by aircraft probes. We observe this pristine needle population near the rimed particle region which gives a partial explanation for the enhanced ZDR. The riming signatures aloft and radar measurements within the melting level are weakly lag correlated (r~0.6) with smaller median drop sizes at the surface, as compared with later times when aggregation of larger particle sizes was believed dominant.« less

Insights into riming and aggregation processes as revealed by aircraft, radar, and disdrometer observations for a 27 April 2011 widespread precipitation event: Insights into Riming and Aggregation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Giangrande, Scott E.; Toto, Tami; Bansemer, Aaron

Our study presents aircraft spiral ascent and descent observations intercepting a transition to riming processes during widespread stratiform precipitation. The sequence is documented using collocated scanning and profiling radar, including longer-wavelength dual polarization measurements and shorter-wavelength Doppler spectra. Riming regions are supported using aircraft measurements recording elevated liquid water concentrations, spherical particle shapes, and saturation with respect to water. Profiling cloud radar observations indicate riming regions during the event as having increasing particle fall speeds, rapid time-height changes, and bimodalities in Doppler spectra. These particular riming signatures are coupled to scanning dual polarization radar observations of higher differential reflectivity (ZDR)more » aloft. Moreover, reduced melting layer enhancements and delayed radar bright-band signatures in the column are also observed during riming periods, most notably with the profiling radar observations. The bimodal cloud radar Doppler spectra captured near riming zones indicate two time-height spectral ice peaks, one rimed particle peak, and one peak associated with pristine ice needle generation and/or growth between -4°C and -7°C also sampled by aircraft probes. We observe this pristine needle population near the rimed particle region which gives a partial explanation for the enhanced ZDR. The riming signatures aloft and radar measurements within the melting level are weakly lag correlated (r~0.6) with smaller median drop sizes at the surface, as compared with later times when aggregation of larger particle sizes was believed dominant.« less

What are the barriers to implementation of cardiopulmonary resuscitation training in secondary schools? A qualitative study.

PubMed

Zinckernagel, Line; Malta Hansen, Carolina; Rod, Morten Hulvej; Folke, Fredrik; Torp-Pedersen, Christian; Tjørnhøj-Thomsen, Tine

2016-04-25

Cardiopulmonary resuscitation (CPR) training in schools is recommended to increase bystander CPR and thereby survival of out-of-hospital cardiac arrest, but despite mandating legislation, low rates of implementation have been observed in several countries, including Denmark. The purpose of the study was to explore barriers to implementation of CPR training in Danish secondary schools. A qualitative study based on individual interviews and focus groups with school leadership and teachers. Thematic analysis was used to identify regular patterns of meaning both within and across the interviews. 8 secondary schools in Denmark. Schools were selected using strategic sampling to reach maximum variation, including schools with/without recent experience in CPR training of students, public/private schools and schools near to and far from hospitals. The study population comprised 25 participants, 9 school leadership members and 16 teachers. School leadership and teachers considered it important for implementation and sustainability of CPR training that teachers conduct CPR training of students. However, they preferred external instructors to train students, unless teachers acquired the CPR skills which they considered were needed. They considered CPR training to differ substantially from other teaching subjects because it is a matter of life and death, and they therefore believed extraordinary skills were required for conducting the training. This was mainly rooted in their insecurity about their own CPR skills. CPR training kits seemed to lower expectations of skill requirements to conduct CPR training, but only among those who were familiar with such kits. To facilitate implementation of CPR training in schools, it is necessary to have clear guidelines regarding the required proficiency level to train students in CPR, to provide teachers with these skills, and to underscore that extensive skills are not required to provide CPR. Further, it is important to familiarise teachers with CPR training kits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Bioinformatics analysis for structure and function of CPR of Plasmodium falciparum.

PubMed

Fan, Zhigang; Zhang, Lingmin; Yan, Guogang; Wu, Qiang; Gan, Xiufeng; Zhong, Saifeng; Lin, Guifen

2011-02-01

To analyse the structure and function of NADPH-cytochrome p450 reductase (CYPOR or CPR) from Plasmodium falciparum (Pf), and to predict its' drug target and vaccine target. The structure, function, drug target and vaccine target of CPR from Plasmodium falciparum were analyzed and predicted by bioinformatics methods. PfCPR, which was older CPR, had close relationship with the CPR from other Plasmodium species, but it was distant from its hosts, such as Homo sapiens and Anopheles. PfCPR was located in the cellular nucleus of Plasmodium falciparum. 335aa-352aa and 591aa - 608aa were inserted the interior side of the nuclear membrane, while 151aa-265aa was located in the nucleolus organizer regions. PfCPR had 40 function sites and 44 protein-protein binding sites in amino acid sequence. The teriary structure of 1aa-700aa was forcep-shaped with wings. 15 segments of PfCPR had no homology with Homo sapien CPR and most were exposed on the surface of the protein. These segments had 25 protein-protein binding sites. While 13 other segments all possessed function sites. The evolution or genesis of Plasmodium falciparum is earlier than those of Homo sapiens. PfCPR is a possible resistance site of antimalarial drug and may involve immune evasion, which is associated with parasite of sporozoite in hepatocytes. PfCPR is unsuitable as vaccine target, but it has at least 13 ideal drug targets. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

Visual assessment of CPR quality during pediatric cardiac arrest: does point of view matter?

PubMed

Jones, Angela; Lin, Yiqun; Nettel-Aguirre, Alberto; Gilfoyle, Elaine; Cheng, Adam

2015-05-01

In many clinical settings, providers rely on visual assessment when delivering feedback on CPR quality. Little is known about the accuracy of visual assessment of CPR quality. We aimed to determine how accurate pediatric providers are in their visual assessment of CPR quality and to identify the optimal position relative to the patient for accurate CPR assessment. We videotaped high-quality CPR (based on 2010 American Heart Association guidelines) and 3 variations of poor quality CPR in a simulated resuscitation, filmed from the foot, head and the side of the manikin. Participants watched 12 videos and completed a questionnaire to assess CPR quality. One hundred and twenty-five participants were recruited. The overall accuracy of visual assessment of CPR quality was 65.6%. Accuracy was better from the side (70.8%) and foot (68.8%) of the bed when compared to the head of the bed (57.2%; p<0.001). The side was the best position for assessing depth (p<0.001). Rate assessment was equivalent between positions (p=0.58). The side and foot of the bed were superior to the head when assessing chest recoil (p<0.001). Factors associated with increased accuracy in visual assessment of CPR quality included recent CPR course completion (p=0.034) and involvement in more cardiac arrests as a team member (p=0.003). Healthcare providers struggle to accurately assess the quality of CPR using visual assessment. If visual assessment is being used, providers should stand at the side of the bed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses.

PubMed

Saramma, P P; Raj, L Suja; Dash, P K; Sarma, P S

2016-04-01

Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Tertiary care hospital, Prospective, repeated-measures design. A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3-4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. SPSS for Windows version 21.0. The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification.

Pay It Forward: High School Video-based Instruction Can Disseminate CPR Knowledge in Priority Neighborhoods.

PubMed

Del Rios, Marina; Han, Josiah; Cano, Alejandra; Ramirez, Victor; Morales, Gabriel; Campbell, Teri L; Hoek, Terry Vanden

2018-03-01

The implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations. As more communities implement laws requiring CPR training in high schools, there is potential for a multiplier effect and reach into priority communities with low bystander-CPR rates. We investigated the feasibility, knowledge acquisition, and dissemination of a high school-centered, CPR video self-instruction program with a "pay-it-forward" component in a low-income, urban, predominantly Black neighborhood in Chicago, Illinois with historically low bystander-CPR rates. Ninth and tenth graders followed a video self-instruction kit in a classroom setting to learn CPR. As homework, students were required to use the training kit to "pay it forward" and teach CPR to their friends and family. We administered pre- and post-intervention knowledge surveys to measure knowledge acquisition among classroom and "pay-it-forward" participants. Seventy-one classroom participants trained 347 of their friends and family, for an average of 4.9 additional persons trained per kit. Classroom CPR knowledge survey scores increased from 58% to 93% (p < 0.0001). The pay-it-forward cohort saw an increase from 58% to 82% (p < 0.0001). A high school-centered, CPR educational intervention with a "pay-it-forward" component can disseminate CPR knowledge beyond the classroom. Because schools are centrally-organized settings to which all children and their families have access, school-based interventions allow for a broad reach that encompasses all segments of the population and have potential to decrease disparities in bystander CPR provision.

CPR Facts and Stats

MedlinePlus

... Formats Course FAQs Course Card Information Lost Your AHA Completion Card Need To Claim Your AHA CE Credits? Training CPR Anytime Family & Friends CPR ... Workforce Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational ...

Estimating cost-effectiveness of mass cardiopulmonary resuscitation training strategies to improve survival from cardiac arrest in private locations.

PubMed

Swor, Robert; Compton, Scott

2004-01-01

Most cardiopulmonary resuscitation (CPR) trainees are young, and most cardiac arrests occur in private residences witnessed by older individuals. To estimate the cost-effectiveness of a CPR training program targeted at citizens over the age of 50 years compared with that of current nontargeted public CPR training. A model was developed using cardiac arrest and known demographic data from a single suburban zip code (population 36,325) including: local data (1997-1999) regarding cardiac arrest locations (public vs. private); incremental survival with CPR (historical survival rate 7.8%, adjusted odds ratio for CPR 2.0); arrest bystander demographics obtained from bystander telephone interviews; zip code demographics regarding population age and distribution; and 12.50 dollars per student for the cost of CPR training. Published rates of CPR training programs by age were used to estimate the numbers typically trained. Several assumptions were made: 1) there would be one bystander per. arrest; 2) the bystander would always perform CPR if trained; 3) cardiac arrest would be evenly distributed in the population; and 4) CPR training for a proportion of the population would proportionally increase CPR provision. Rates of arrest, bystanders by age, number of CPR trainees needed to result in increased arrest survival, and training cost per life saved for a one-year study period were calculated. There were 24.3 cardiac arrests per year, with 21.9 (90%) occurring in homes. In 66.5% of the home arrests, the bystander was more than 50 years old. To yield one additional survivor using the current CPR training strategy, 12,306 people needed to be trained (3,510 bystanders aged < or = 50 years and 8,796 bystanders aged > 50 years), which resulted in CPR provision to 7.14 additional patients. The training cost per life saved for a bystander aged < or = 50 years was 313,214 dollars, and that for a bystander aged > 50 years was 785,040 dollars. Using a strategy of training only those < or = 50 years, 583 elders per cardiac arrest would need to be trained, with a cost of 53,383 dollars per life saved. Using these assumptions, current CPR training strategy is not a cost-effective intervention for home cardiac arrests. The high rate of elders witnessing CPR mandates focused CPR interventions for this population.

COMBINING A MONOSTATIC SODAR WITH A RADAR WIND PROFILER AND RASS IN A POWER PLANT POLLUTION STUDY

EPA Science Inventory

A single-beam monostatic sodar, radar wind profiler, radio acoustic sounding system (RASS), and in situ sensors mounted on a 100-m tower were used to acquire meteorological data in the vicinity of a coal burning power plant in a northern Thailand valley. hese data were used to ex...

Advanced studies of electromagnetic scattering

NASA Technical Reports Server (NTRS)

Ling, Hao

1994-01-01

In radar signature applications it is often desirable to generate the range profiles and inverse synthetic aperture radar (ISAR) images of a target. They can be used either as identification tools to distinguish and classify the target from a collection of possible targets, or as diagnostic/design tools to pinpoint the key scattering centers on the target. The simulation of synthetic range profiles and ISAR images is usually a time intensive task and computation time is of prime importance. Our research has been focused on the development of fast simulation algorithms for range profiles and ISAR images using the shooting and bouncing ray (SBR) method, a high frequency electromagnetic simulation technique for predicting the radar returns from realistic aerospace vehicles and the scattering by complex media.

Quantitative precipitation estimation in complex orography using quasi-vertical profiles of dual polarization radar variables

NASA Astrophysics Data System (ADS)

Montopoli, Mario; Roberto, Nicoletta; Adirosi, Elisa; Gorgucci, Eugenio; Baldini, Luca

2017-04-01

Weather radars are nowadays a unique tool to estimate quantitatively the rain precipitation near the surface. This is an important task for a plenty of applications. For example, to feed hydrological models, mitigate the impact of severe storms at the ground using radar information in modern warning tools as well as aid the validation studies of satellite-based rain products. With respect to the latter application, several ground validation studies of the Global Precipitation Mission (GPM) products have recently highlighted the importance of accurate QPE from ground-based weather radars. To date, a plenty of works analyzed the performance of various QPE algorithms making use of actual and synthetic experiments, possibly trained by measurement of particle size distributions and electromagnetic models. Most of these studies support the use of dual polarization variables not only to ensure a good level of radar data quality but also as a direct input in the rain estimation equations. Among others, one of the most important limiting factors in radar QPE accuracy is the vertical variability of particle size distribution that affects at different levels, all the radar variables acquired as well as rain rates. This is particularly impactful in mountainous areas where the altitudes of the radar sampling is likely several hundred of meters above the surface. In this work, we analyze the impact of the vertical profile variations of rain precipitation on several dual polarization radar QPE algorithms when they are tested a in complex orography scenario. So far, in weather radar studies, more emphasis has been given to the extrapolation strategies that make use of the signature of the vertical profiles in terms of radar co-polar reflectivity. This may limit the use of the radar vertical profiles when dual polarization QPE algorithms are considered because in that case all the radar variables used in the rain estimation process should be consistently extrapolated at the surface. To avoid facing such a complexity, especially with a view to operational implementation, we propose to look at the features of the vertical profile of rain (VPR), i.e. after performing the rain estimation. This procedure allows characterizing a single variable (i.e. rain) when dealing with vertical extrapolations. Some case studies of severe thunderstorms that hit the mountainous area surrounding Rome in Italy causing floodings and damages and observed by the research C-band polarization agility Doppler radar named Polar 55C, managed by the Institute of Atmospheric Sciences and Climate (ISAC) at the National Research Council of Italy (CNR), are used to support the concept of VPR. Our results indicate that the combined algorithm, which merges together the differential phase shift (Kdp), the reflectivity factor at horizontal polarization (Zhh), and differential reflectivity (Zdr), once accurately processed, performs best among those tested that make use of Zhh alone, Kdp alone, and Zhh and Zdr pair. Improvements from 25% to 80% are found for the total rain accumulations in terms of normalized bias when the VPR extrapolation is applied.

A-Train Observations of Young Volcanic Eruption Clouds

NASA Astrophysics Data System (ADS)

Carn, S. A.; Prata, F.; Yang, K.; Rose, W. I.

2011-12-01

NASA's A-Train satellite constellation (including Aqua, CloudSat, CALIPSO, and Aura) has been flying in formation since 2006, providing unprecedented synergistic observations of numerous volcanic eruption clouds in various stages of development. Measurements made by A-Train sensors include total column SO2 by the Ozone Monitoring Instrument (OMI) on Aura, upper tropospheric and stratospheric (UTLS) SO2 column by the Atmospheric Infrared Sounder (AIRS) on Aqua and Microwave Limb Sounder (MLS) on Aura, ash mass loading from AIRS and the Moderate resolution Imaging Spectroradiometer (MODIS) on Aqua, UTLS HCl columns and ice water content (IWC) from MLS, aerosol vertical profiles from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) instrument aboard CALIPSO, and hydrometeor profiles from the Cloud Profiling Radar (CPR) on CloudSat. The active vertical profiling capability of CALIPSO, CloudSat and MLS sychronized with synoptic passive sensing of trace gases and aerosols by OMI, AIRS and MODIS provides a unique perspective on the structure and composition of volcanic clouds. A-Train observations during the first hours of atmospheric residence are particularly valuable, as the fallout, segregation and stratification of material in this period determines the concentration and altitude of constituents that remain to be advected downwind. This represents the eruption 'source term' essential for dispersion modeling, and hence for aviation hazard mitigation. In this presentation we show examples of A-Train data collected during recent eruptions including Chaitén (May 2008), Kasatochi (August 2008), Redoubt (March 2009), Eyjafjallajökull (April 2010) and Cordón Caulle (June 2011). We interpret the observations using the canonical three-stage view of volcanic cloud development [e.g., Rose et al., 2000] from initial rapid ash fallout to far-field dispersion of fine ash, gas and aerosol, and results from numerical modeling of volcanic plumes [e.g., Textor et al., 2003] and discuss the degree to which the observations validate existing theory and models. We also describe plans for advanced SO2 and ash retrieval algorithms that will exploit the synergy between UV and IR sensors in the A-Train for improved quantification of ash and SO2 loading by volcanic eruptions.

Statistics of Storm Updraft Velocities from TWP-ICE Including Verification with Profiling Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Collis, Scott; Protat, Alain; May, Peter T.

2013-08-01

Comparisons between direct measurements and modeled values of vertical air motions in precipitating systems are complicated by differences in temporal and spatial scales. On one hand, vertically profiling radars more directly measure the vertical air motion but do not adequately capture full storm dynamics. On the other hand, vertical air motions retrieved from two or more scanning Doppler radars capture the full storm dynamics but require model constraints that may not capture all updraft features because of inadequate sampling, resolution, numerical constraints, and the fact that the storm is evolving as it is scanned by the radars. To investigate themore » veracity of radar-based retrievals, which can be used to verify numerically modeled vertical air motions, this article presents several case studies from storm events around Darwin, Northern Territory, Australia, in which measurements from a dual-frequency radar profiler system and volumetric radar-based wind retrievals are compared. While a direct comparison was not possible because of instrumentation location, an indirect comparison shows promising results, with volume retrievals comparing well to those obtained from the profiling system. This prompted a statistical analysis of an extended period of an active monsoon period during the Tropical Warm Pool International Cloud Experiment (TWP-ICE). Results show less vigorous deep convective cores with maximum updraft velocities occurring at lower heights than some cloudresolving modeling studies suggest. 1. Introduction The regionalization of global climate models has been a driver of demand for more complex convective parameterization schemes. A key readjustment of the modeled atmosphere« less

Characterization of Lunar Crater Ejecta Deposits Using Radar Data from the Mini-RF Instrument on LRO

NASA Astrophysics Data System (ADS)

Patterson, G. W.; Raney, R. K.; Cahill, J. T.; Bussey, B.

2012-12-01

Impact cratering is the dominant weathering process on the surface of the Moon and a primary means of distrib-uting material on the lunar surface [1]. Radar data provide unique information on both the horizontal and vertical distribution of impact deposits [2]. The Miniature Radio Frequency (Mini-RF) instrument flown on the Lunar Re-connaissance Orbiter (LRO) is a Synthetic Aperture Radar (SAR) with an innovative hybrid dual-polarimetric archi-tecture, transmitting (quasi-) circular polarization, and receiving orthogonal linear polarizations and their relative phase [3]. The four Stokes parameters that characterize the observed backscattered EM field are calculated from the received data. These parameters can be used to derive a variety of child products that include the circular polariza-tion ratio (CPR) and the m-chi decomposition. The former provides an indication of surface roughness and the latter provides an indication of the scattering properties of the surface [4]. Using these products, we examine the crater Byrgius A and demonstrate the ability to differentiate materials within ejecta deposits and their relative thicknesses. Byrgius A is a 19 km diameter Copernican located in the lunar highlands east of the Orientale Basin and west of Mare Humorum. Visible image data of the region obtained by the Lunar Reconnaissance Orbiter Camera Wide An-gle Camera (LROC WAC) [5] at a resolution of 100 m/pixel show optically bright ejecta deposits associated with the crater that extend to radial distances of 100s of km, with near continuous deposits observed to an average radial distance of 70 km. Mini-RF CPR information derived from S-band (12.6 cm) data of the region show an increased roughness for Byrgius A and its ejecta deposits relative to the surrounding terrain. This is a commonly observed characteristic of young, fresh craters and indicates that the crater and its ejecta have a higher fraction of cm- to m-scale scatterers at the surface and/or buried to depths of up to ~1 m. As observed with visible image data, the increased roughness as-sociated with the ejecta of Byrgius A appears nearly continuous to a radial distance of ~70 km. An m-chi decomposition of Mini-RF S-band data for Byrgius A suggests that the portion of ejecta that extends radially from ~10 to 70 km appears far less continuous than is suggested in both optical data and CPR information (Fig. 1). The implication is that we are observing properties of the ejecta and lunar background terrain in the top meter of the surface. In other words the thickness of the ejecta in this distance range is on the order of meters or less. This result suggests that the thickness of ejecta at radial distances > a crater radius differ significantly from estimates of ejecta thickness derived from models of ejecta emplacement [6,7]. References: [1] Melosh, H. J. (1989), Oxford Univ. Press; [2] Ghent, R. R. et al. (2008), Geology, 36, 343-346; [3] Raney, R. K. et al. (2011), Proc. of the IEEE, 99, 808-823; [4] Raney, R.K. et al. (2012), JGR, 117, E00H21; [5] Robinson, M. S. et al. (2010), Space Sci. Rev., 150, 81-124; [6] McGetchin et al. (1973), EPSL, 20, 226-236; [7] Pike (1974), EPSL, 23, 265-274.

Quantitative analysis of CPR quality during in-hospital resuscitation of older children and adolescents.

PubMed

Sutton, Robert M; Niles, Dana; Nysaether, Jon; Abella, Benjamin S; Arbogast, Kristy B; Nishisaki, Akira; Maltese, Matthew R; Donoghue, Aaron; Bishnoi, Ram; Helfaer, Mark A; Myklebust, Helge; Nadkarni, Vinay

2009-08-01

Few data exist on pediatric cardiopulmonary resuscitation (CPR) quality. This study is the first to evaluate actual in-hospital pediatric CPR. We hypothesized that with bedside CPR training and corrective feedback, CPR quality can approach American Heart Association (AHA) targets. Using CPR recording/feedback defibrillators, quality of CPR was assessed for patients >or=8 years of age who suffered a cardiac arrest in the PICU or emergency department (ED). Before and during the study, a bedside CPR training program was initiated. Between October 2006 and February 2008, twenty events in 18 patients met inclusion criteria and resulted in 36749 evaluable chest compressions (CCs) during 392.3 minutes of arrest. CCs were shallow (<38 mm or <1.5 in) in 27.2% (9998 of 36749), with excessive residual leaning force (>or=2500 g) in 23.4% (8611 of 36749). Segmental analysis of the first 5 minutes of the events demonstrated that shallow CCs and excessive residual leaning force were less prevalent during the first 5 minutes. AHA targets were not achieved for CC rate in 62 (43.1%) of 144 segments, CC depth in 52 (36.1%) of 144 segments, and residual leaning force in 53 (36.8%) of 144 segments. This prospective, observational study demonstrates feasibility of monitoring in-hospital pediatric CPR. Even with bedside CPR retraining and corrective audiovisual feedback, CPR quality frequently did not meet AHA targets. Importantly, no flow fraction target of 10% was achieved. Future studies should investigate novel educational methods and targeted feedback technologies.

RNA interference of NADPH-cytochrome P450 reductase of the rice brown planthopper, Nilaparvata lugens, increases susceptibility to insecticides.

PubMed

Liu, Su; Liang, Qing-Mei; Zhou, Wen-Wu; Jiang, Yan-Dong; Zhu, Qing-Zi; Yu, Hang; Zhang, Chuan-Xi; Gurr, Geoff M; Zhu, Zeng-Rong

2015-01-01

NADPH-cytochrome P450 reductase (CPR) is essential for numerous biological reactions catalysed by microsomal cytochrome P450 monooxygenases (P450s). Knockdown of CPR in several insects leads to developmental defects and increased susceptibility to insecticides. However, information about the role of CPR in the brown planthopper, Nilaparvata lugens, is still unavailable. A full-length cDNA encoding CPR was cloned from N. lugens (NlCPR). The deduced amino acid sequence showed marked features of classical CPRs, such as an N-terminus membrane anchor, conserved domains for flavin mononucleotide, flavin adenine dinucleotide (FAD) and nicotinamide adenine dinucleotide phosphate binding, as well as an FAD-binding motif and catalytic residues. Phylogenetic analysis revealed that NlCPR was located in a branch along with bed bug and pea aphid hemipteran insects. NlCPR mRNA was detectable in all tissues and developmental stages of N. lugens, as determined by real-time quantitative PCR. NlCPR transcripts were most abundant in the abdomen in adults, and in first-instar nymphs. Injection of N. lugens with double-strand RNA (dsRNA) against NlCPR significantly reduced the transcription level of the mRNA, and silencing of NlCPR resulted in increased susceptibility in N. lugens to beta-cypermethrin and imidacloprid. The results provide first evidence that NlCPR contributes to the susceptibility to beta-cypermethrin and imidacloprid in N. lugens. © 2014 Society of Chemical Industry.

Even Four Minutes of Poor Quality of CPR Compromises Outcome in a Porcine Model of Prolonged Cardiac Arrest

PubMed Central

Li, Heng; Zhang, Lei; Yang, Zhengfei; Huang, Zitong; Chen, Bihua; Li, Yongqin; Yu, Tao

2013-01-01

Objective. Untrained bystanders usually delivered suboptimal chest compression to victims who suffered from cardiac arrest in out-of-hospital settings. We therefore investigated the hemodynamics and resuscitation outcome of initial suboptimal quality of chest compressions compared to the optimal ones in a porcine model of cardiac arrest. Methods. Fourteen Yorkshire pigs weighted 30 ± 2 kg were randomized into good and poor cardiopulmonary resuscitation (CPR) groups. Ventricular fibrillation was electrically induced and untreated for 6 mins. In good CPR group, animals received high quality manual chest compressions according to the Guidelines (25% of animal's anterior-posterior thoracic diameter) during first two minutes of CPR compared with poor (70% of the optimal depth) compressions. After that, a 120-J biphasic shock was delivered. If the animal did not acquire return of spontaneous circulation, another 2 mins of CPR and shock followed. Four minutes later, both groups received optimal CPR until total 10 mins of CPR has been finished. Results. All seven animals in good CPR group were resuscitated compared with only two in poor CPR group (P < 0.05). The delayed optimal compressions which followed 4 mins of suboptimal compressions failed to increase the lower coronary perfusion pressure of five non-survival animals in poor CPR group. Conclusions. In a porcine model of prolonged cardiac arrest, even four minutes of initial poor quality of CPR compromises the hemodynamics and survival outcome. PMID:24364028

Data collection as the first step in program development: the experience of a chronic care palliative unit.

PubMed

Munn, B; Worobec, F

1997-01-01

This retrospective descriptive study of 73 patients who died in St. Peter's Hospital examines and contrasts the patients profile and referral sources of a palliative care unit in a chronic care hospital over two six-month periods during 1994 and 1995. Shortened length of stay (83.8 and 43.2 days respectively), documentation issues, CPR practices (CPR was desired by seven patients up to the time of death), and lack of referrals from long-term care facilities have led St. Peter's Hospital to ask further questions of its palliative care program, e.g. given the lack of referrals from long-term care facilities, how is palliative care being managed in this sector? In Ontario, palliative care has been placed under the domain of chronic care and program development depends in part on the knowledge of the population it serves. This study is a first step.

Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study.

PubMed

Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Høyland, Sindre; Braut, Geir Sverre; Søreide, Eldar

2017-02-01

Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome. Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts. The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety. Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision. Mathiesen WT , Bjørshol CA , Høyland S , Braut GS , Søreide E . Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med. 2017;32(1):27-32.

CPR feedback/prompt device improves the quality of hands-only CPR performed in manikin by laypersons following the 2015 AHA guidelines.

PubMed

Liu, Yuanshan; Huang, Zitong; Li, Heng; Zheng, Guanghui; Ling, Qin; Tang, Wanchun; Yang, Zhengfei

2018-03-06

We investigated the effects of a cardiopulmonary resuscitation (CPR) feedback/prompt device on the quality of chest compression (CC) during hands-only CPR following the 2015 AHA guidelines. A total of 124 laypersons were randomly assigned into three groups. The first (n=42) followed the 2010 guidelines, the second (n=42) followed the 2015 guidelines with no feedback/prompt device, the third (n=40) followed the 2015 guidelines with a feedback/prompt device (2015F). Participants underwent manual CPR training and took a written basic life support examination, then required to perform 2min of hands-only CPR monitored by a CPR feedback/prompt device. The quality of CPR was quantified as the percentage of correct CCs (mean CC depth and rate, complete recoil and chest compression fraction (CCF)) per 20s, as recorded by the CPR feedback/prompt device. Significantly higher correct ratios of CC, CC depth, and rate were achieved in the 2010 group in each minute vs the 2015 group. The greater mean CC depth and rate were observed in the 2015F group vs the 2015 group. The correct ratio of CC was significantly higher in the 2015F group vs the 2015 group. CCF was also significantly higher in the 2015F group vs the 2015 group in the last 20s of CPR. It is difficult for a large percentage of laypersons to achieve the targets of CC depth and rate following the 2015 AHA guidelines. CPR feedback/prompt devices significantly improve the quality of hands-only CPR performance by laypersons following the standards of the 2015 AHA guidelines. Copyright © 2017. Published by Elsevier Inc.

What is the true definition of a "Do-Not-Resuscitate" order? A Japanese perspective.

PubMed

Hiraoka, Eiji; Homma, Yosuke; Norisue, Yasuhiro; Naito, Takaki; Kataoka, Yuko; Hamada, Osamu; Den, Yo; Takahashi, Osamu; Fujitani, Shigeki

2016-01-01

Japan has no official guidelines for do-not-resuscitate (DNR) orders. Therefore, we investigated the effect of DNR orders on physician decision making in relation to performing noncardiopulmonary resuscitation (CPR) and CPR procedures. A case-scenario-based questionnaire that included a case of advanced cancer, a case of advanced dementia, and a case of nonadvanced heart failure was administered to physicians. The questions determined whether physicians would perform different non-CPR procedures and CPR procedures in the presence or absence of DNR orders. The number of non-CPR procedures each physician would perform and the number of physicians who would perform each non-CPR and CPR procedure in the absence and presence of DNR ocrders were compared. Physicians from three Japanese municipal acute care hospitals participated. We analyzed 111 of 161 (69%) questionnaires. Physicians would perform significantly fewer non-CPR procedures in the presence of DNR orders than in the absence of DNR orders for all three case scenarios (median [interquartile range] percentages: Case 1: 72% [45%-90%] vs 100% [90%-100%]; Case 2: 55% [36%-72%] vs 91% [63%-100%]; Case 3: 78% [55%-88%] vs 100% [88%-100%]). Fewer physicians would perform non-CPR and CPR procedures in the presence of DNR orders than in the absence of DNR orders. However, considerable numbers of physicians would perform electric shock treatment for ventricular fibrillation in the presence of DNR orders (Case 1: 26%; Case 2: 16%; Case 3: 20%). DNR orders affect physician decision making about performing non-CPR procedures. Although some physicians would perform CPR for ventricular fibrillation in the presence of DNR orders, others would not. Therefore, a consensus definition for DNR orders should be developed in Japan, otherwise DNR orders may cause harm.

Pay It Forward: High School Video-based Instruction Can Disseminate CPR Knowledge in Priority Neighborhoods

PubMed Central

Han, Josiah; Cano, Alejandra; Ramirez, Victor; Morales, Gabriel; Campbell, Teri L.; Hoek, Terry Vanden

2018-01-01

Introduction The implementation of creative new strategies to increase layperson cardiopulmonary resuscitation (CPR) and defibrillation may improve resuscitation in priority populations. As more communities implement laws requiring CPR training in high schools, there is potential for a multiplier effect and reach into priority communities with low bystander-CPR rates. Methods We investigated the feasibility, knowledge acquisition, and dissemination of a high school-centered, CPR video self-instruction program with a “pay-it-forward” component in a low-income, urban, predominantly Black neighborhood in Chicago, Illinois with historically low bystander-CPR rates. Ninth and tenth graders followed a video self-instruction kit in a classroom setting to learn CPR. As homework, students were required to use the training kit to “pay it forward” and teach CPR to their friends and family. We administered pre- and post-intervention knowledge surveys to measure knowledge acquisition among classroom and “pay-it-forward” participants. Results Seventy-one classroom participants trained 347 of their friends and family, for an average of 4.9 additional persons trained per kit. Classroom CPR knowledge survey scores increased from 58% to 93% (p < 0.0001). The pay-it-forward cohort saw an increase from 58% to 82% (p < 0.0001). Conclusion A high school-centered, CPR educational intervention with a “pay-it-forward” component can disseminate CPR knowledge beyond the classroom. Because schools are centrally-organized settings to which all children and their families have access, school-based interventions allow for a broad reach that encompasses all segments of the population and have potential to decrease disparities in bystander CPR provision. PMID:29560076

Assessment of long-term impact of formal certified cardiopulmonary resuscitation training program among nurses

PubMed Central

Saramma, P. P.; Raj, L. Suja; Dash, P. K.; Sarma, P. S.

2016-01-01

Context: Cardiopulmonary resuscitation (CPR) and emergency cardiovascular care guidelines are periodically renewed and published by the American Heart Association. Formal training programs are conducted based on these guidelines. Despite widespread training CPR is often poorly performed. Hospital educators spend a significant amount of time and money in training health professionals and maintaining basic life support (BLS) and advanced cardiac life support (ACLS) skills among them. However, very little data are available in the literature highlighting the long-term impact of these training. Aims: To evaluate the impact of formal certified CPR training program on the knowledge and skill of CPR among nurses, to identify self-reported outcomes of attempted CPR and training needs of nurses. Setting and Design: Tertiary care hospital, Prospective, repeated-measures design. Subjects and Methods: A series of certified BLS and ACLS training programs were conducted during 2010 and 2011. Written and practical performance tests were done. Final testing was undertaken 3–4 years after training. The sample included all available, willing CPR certified nurses and experience matched CPR noncertified nurses. Statistical Analysis Used: SPSS for Windows version 21.0. Results: The majority of the 206 nurses (93 CPR certified and 113 noncertified) were females. There was a statistically significant increase in mean knowledge level and overall performance before and after the formal certified CPR training program (P = 0.000). However, the mean knowledge scores were equivalent among the CPR certified and noncertified nurses, although the certified nurses scored a higher mean score (P = 0.140). Conclusions: Formal certified CPR training program increases CPR knowledge and skill. However, significant long-term effects could not be found. There is a need for regular and periodic recertification. PMID:27303137

Lay Bystanders' Perspectives on What Facilitates Cardiopulmonary Resuscitation and Use of Automated External Defibrillators in Real Cardiac Arrests.

PubMed

Malta Hansen, Carolina; Rosenkranz, Simone Mørk; Folke, Fredrik; Zinckernagel, Line; Tjørnhøj-Thomsen, Tine; Torp-Pedersen, Christian; Sondergaard, Kathrine B; Nichol, Graham; Hulvej Rod, Morten

2017-03-13

Many patients who suffer an out-of-hospital cardiac arrest will fail to receive bystander intervention (cardiopulmonary resuscitation [CPR] or defibrillation) despite widespread CPR training and the dissemination of automated external defibrillators (AEDs). We sought to investigate what factors encourage lay bystanders to initiate CPR and AED use in a cohort of bystanders previously trained in CPR techniques who were present at an out-of-hospital cardiac arrest. One-hundred and twenty-eight semistructured qualitative interviews with CPR-trained lay bystanders to consecutive out-of-hospital cardiac arrest, where an AED was present were conducted (from January 2012 to April 2015, in Denmark). Purposive maximum variation sampling was used to establish the breadth of the bystander perspective. Twenty-six of the 128 interviews were chosen for further in-depth analyses, until data saturation. We used cross-sectional indexing (using software), and inductive in-depth thematic analyses, to identify those factors that facilitated CPR and AED use. In addition to prior hands-on CPR training, the following were described as facilitators: prior knowledge that intervention is crucial in improving survival, cannot cause substantial harm, and that the AED will provide guidance through CPR; prior hands-on training in AED use; during CPR performance, teamwork (ie, support), using the AED voice prompt and a ventilation mask, as well as demonstrating leadership and feeling a moral obligation to act. Several factors other than previous hands-on CPR training facilitate lay bystander instigation of CPR and AED use. The recognition and modification of these factors may increase lay bystander CPR rates and patient survival following an out-of-hospital cardiac arrest. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer.

PubMed

Volandes, Angelo E; Paasche-Orlow, Michael K; Mitchell, Susan L; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J; Hartshorn, Kevan L; Jackson, Vicki Ann; Gillick, Muriel R; Walker-Corkery, Elizabeth S; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D; Eichler, April F; Epstein, Andrew S; Noy, Ariela; Levin, Tomer T; Temel, Jennifer S

2013-01-20

Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P < .001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v 2.6 ± 1.3, respectively; P < .001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative.

Sodium Nitroprusside Enhanced Cardiopulmonary Resuscitation Improves Short Term Survival in a Porcine Model of Ischemic Refractory Ventricular Fibrillation

PubMed Central

Yannopoulos, Demetris; Bartos, Jason A.; George, Stephen A.; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P.

2017-01-01

Introduction Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. Hypothesis SNPeCPR will increase short term (4-hour) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Methods Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5 minutes. Basic life support was performed for 10 minutes. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3 minutes. CPR continued for a total of 45 minutes, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60 minutes, if unsuccessful. SNPeCPR animals received 2 mg of SNP at minute 10 followed by 1 mg every 5 minutes until ROSC. Standard ACLS animals received 0.5 mg epinephrine every 5 minutes until ROSC. Primary endpoints were ROSC and 4-hour survival. Results All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-hour survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. Conclusion SNPeCPR significantly improved ROSC and 4-hour survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. PMID:27771299

The combined use of mechanical CPR and a carry sheet to maintain quality resuscitation in out-of-hospital cardiac arrest patients during extrication and transport.

PubMed

Lyon, Richard M; Crawford, Anna; Crookston, Colin; Short, Steven; Clegg, Gareth R

2015-08-01

Quality of manual cardiopulmonary resuscitation (CPR) during extrication and transport of out-of-hospital cardiac arrest victims is known to be poor. Performing manual CPR during ambulance transport poses significant risk to the attending emergency medical services crew. We sought to use pre-hospital video recording to objectively analyse the impact of introducing mechanical CPR with an extrication sheet (Autopulse, Zoll) to an advanced, second-tier cardiac arrest response team. The study was conducted prospectively using defibrillator downloads and analysis of pre-hospital video recording to measure the quality of CPR during extrication from scene and ambulance transport of the OHCA patient. Adult patients with non-traumatic OHCA were included. The interruption to manual CPR to during extrication and to deploy the mechanical CPR device was analysed. In the manual CPR group, 53 OHCA cases were analysed for quality of CPR during extrication. The median time that chest compression was interrupted to allow the patient to be carried from scene to the ambulance was 270 s (IQR 201-387 s). 119 mechanical CPR cases were analysed. The median time interruption from last manual compression to first Autopulse compression was 39 s (IQR 29-47 s). The range from last manual compression to first Autopulse compression was 14-118 s. Mechanical CPR used in combination with an extrication sheet can be effectively used to improve the quality of resuscitation during extrication and ambulance transport of the refractory OHCA patient. The time interval to deploy the mechanical CPR device can be shortened with regular simulation training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sodium nitroprusside enhanced cardiopulmonary resuscitation improves short term survival in a porcine model of ischemic refractory ventricular fibrillation.

PubMed

Yannopoulos, Demetris; Bartos, Jason A; George, Stephen A; Sideris, George; Voicu, Sebastian; Oestreich, Brett; Matsuura, Timothy; Shekar, Kadambari; Rees, Jennifer; Aufderheide, Tom P

2017-01-01

Sodium nitroprusside (SNP) enhanced CPR (SNPeCPR) demonstrates increased vital organ blood flow and survival in multiple porcine models. We developed a new, coronary occlusion/ischemia model of prolonged resuscitation, mimicking the majority of out-of-hospital cardiac arrests presenting with shockable rhythms. SNPeCPR will increase short term (4-h) survival compared to standard 2015 Advanced Cardiac Life Support (ACLS) guidelines in an ischemic refractory ventricular fibrillation (VF), prolonged CPR model. Sixteen anesthetized pigs had the ostial left anterior descending artery occluded leading to ischemic VF arrest. VF was untreated for 5min. Basic life support was performed for 10min. At minute 10 (EMS arrival), animals received either SNPeCPR (n=8) or standard ACLS (n=8). Defibrillation (200J) occurred every 3min. CPR continued for a total of 45min, then the balloon was deflated simulating revascularization. CPR continued until return of spontaneous circulation (ROSC) or a total of 60min, if unsuccessful. SNPeCPR animals received 2mg of SNP at minute 10 followed by 1mg every 5min until ROSC. Standard ACLS animals received 0.5mg epinephrine every 5min until ROSC. Primary endpoints were ROSC and 4-h survival. All SNPeCPR animals (8/8) achieved sustained ROSC versus 2/8 standard ACLS animals within one hour of resuscitation (p=0.04). The 4-h survival was significantly improved with SNPeCPR compared to standard ACLS, 7/8 versus 1/8 respectively, p=0.0019. SNPeCPR significantly improved ROSC and 4-h survival compared with standard ACLS CPR in a porcine model of prolonged ischemic, refractory VF cardiac arrest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Barriers and facilitators to CPR knowledge transfer in an older population most likely to witness cardiac arrest: a theory-informed interview approach.

PubMed

Vaillancourt, Christian; Charette, Manya; Kasaboski, Ann; Brehaut, Jamie C; Osmond, Martin; Wells, George A; Stiell, Ian G; Grimshaw, Jeremy

2014-09-01

We sought to identify perceived barriers and facilitators to cardiopulmonary resuscitation (CPR) training and performing CPR among people above the age of 55 years. We conducted semistructured qualitative interviews with a purposive sample of independent-living individuals aged 55 years and older from urban and rural settings. We developed an interview guide based on the constructs of the Theory of Planned Behaviour, which elicits salient attitudes, social influences and control beliefs potentially influencing CPR training and performance. Interviews were recorded, transcribed verbatim and analysed until achieving data saturation. Two independent reviewers performed inductive analyses to identify emerging themes, and ranked them by way of consensus. Demographics for the 24 interviewees: mean age 71.4 years, women 58.3%, urban location 75.0%, single dwelling 58.3%, CPR training 79.2% and prior CPR on real victim 8.3%. Facilitators of CPR training included: (1) classes in a convenient location; (2) more advertisements; and (3) having a spouse. Barriers to taking CPR training included: (1) perception of physical limitations; (2) time commitment; and (3) cost. Facilitators of providing CPR included: (1) 9-1-1 CPR instructions; (2) reminders/pocket cards; and (3) frequent but brief updates. Barriers to providing CPR included: (1) physical limitations; (2) lack of confidence; and (3) ambivalence of duty to act in a large group. We identified key facilitators and barriers for CPR training and performance in a purposive sample of individuals aged 55 years and older. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The use of ground-penetrating radar in the surveying of overlaid bridge decks : summary report.

DOT National Transportation Integrated Search

1993-01-01

It was shown in a previous study that the presence of delamination in concrete can be detected by the appearance of a distinctive signature in the analog radar reflection profiles recorded when a concrete deck is scanned with ground-penetrating radar...

Characterization of a Highly Enriched Microbial Consortium Reductively Dechlorinating 2,3-Dichlorophenol and 2,4,6-Trichlorophenol and the Corresponding cprA Genes from River Sediment.

PubMed

El-Sayed, Wael S

2016-08-26

Anaerobic reductive dechlorination of 2,3-dichlorophenol (2,3DCP) and 2,4,6-trichlorophenol (2,4,6TCP) was investigated in microcosms from River Nile sediment. A stable sediment-free anaerobic microbial consortium reductively dechlorinating 2,3DCP and 2,4,6TCP was established. Defined sediment-free cultures showing stable dechlorination were restricted to ortho chlorine when enriched with hydrogen as the electron donor, acetate as the carbon source, and either 2,3-DCP or 2,4,6-TCP as electron acceptors. When acetate, formate, or pyruvate were used as electron donors, dechlorination activity was lost. Only lactate can replace dihydrogen as an electron donor. However, the dechlorination potential was decreased after successive transfers. To reveal chlororespiring species, the microbial community structure of chlorophenol-reductive dechlorinating enrichment cultures was analyzed by PCR-denaturing gradient gel electrophoresis (DGGE) of 16S rRNA gene fragments. Eight dominant bacteria were detected in the dechlorinating microcosms including members of the genera Citrobacter, Geobacter, Pseudomonas, Desulfitobacterium, Desulfovibrio and Clostridium. Highly enriched dechlorinating cultures were dominated by four bacterial species belonging to the genera Pseudomonas, Desulfitobacterium, and Clostridium. Desulfitobacterium represented the major fraction in DGGE profiles indicating its importance in dechlorination activity, which was further confirmed by its absence resulting in complete loss of dechlorination. Reductive dechlorination was confirmed by the stoichiometric dechlorination of 2,3DCP and 2,4,6TCP to metabolites with less chloride groups and by the detection of chlorophenol RD cprA gene fragments in dechlorinating cultures. PCR amplified cprA gene fragments were cloned and sequenced and found to cluster with the cprA/pceA type genes of Dehalobacter restrictus.

Improved chest recoil using an adhesive glove device for active compression–decompression CPR in a pediatric manikin model☆

PubMed Central

Udassi, Jai P.; Udassi, Sharda; Lamb, Melissa A.; Lamb, Kenneth E.; Theriaque, Douglas W.; Shuster, Jonathan J.; Zaritsky, Arno L.; Haque, Ikram U.

2013-01-01

Objective We developed an adhesive glove device (AGD) to perform ACD-CPR in pediatric manikins, hypothesizing that AGD-ACD-CPR provides better chest decompression compared to standard (S)-CPR. Design Split-plot design randomizing 16 subjects to test four manikin-technique models in a crossover fashion to AGD-ACD-CPR vs. S-CPR. Healthcare providers performed 5 min of CPR with 30:2 compression:ventilation ratio in the four manikin models: (1) adolescent; (2) child two-hand; (3) child one-hand; and (4) infant two-thumb. Methods Modified manikins recorded compression pressure (CP), compression depth (CD) and decompression depth (DD). The AGD consisted of a modified oven mitt with an adjustable strap; a Velcro patch was sewn to the palmer aspect. The counter Velcro patch was bonded to the anterior chest wall. For infant CPR, the thumbs of two oven mitts were stitched together with Velcro. Subjects were asked to actively pull up during decompression. Subjects’ heart rate (HR), respiratory rate (RR) and recovery time (RT) for HR/RR to return to baseline were recorded. Subjects were blinded to data recordings. Data (mean ± SEM) were analyzed using a two-tailed paired t-test. Significance was defined qualitatively as P ≤ 0.05. Results Mean decompression depth difference was significantly greater with AGD-ACD-CPR compared to S-CPR; 38–75% of subjects achieved chest decompression to or beyond baseline. AGD-ACD-CPR provided 6–12% fewer chest compressions/minute than S-CPR group. There was no significant difference in CD, CP, HR, RR and RT within each group comparing both techniques. Conclusion A simple, inexpensive glove device for ACD-CPR improved chest decompression with emphasis on active pull in manikins without excessive rescuer fatigue. The clinical implication of fewer compressions/minute in the AGD group needs to be evaluated. PMID:19683849

Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.

PubMed

Wolfe, Heather; Maltese, Matthew R; Niles, Dana E; Fischman, Elizabeth; Legkobitova, Veronika; Leffelman, Jessica; Berg, Robert A; Nadkarni, Vinay M; Sutton, Robert M

2015-11-01

Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. A CPR manikin creating a realistic relationship between chest compression depth and ABP was used for training/testing. Thirty-six ICU providers were randomized to brief, bedside ABP-directed CPR manikin skill retrainings: (1) Booster Plus (ABP visible during training and testing) versus (2) Booster Alone (ABP visible only during training, not testing) versus (3) control (testing, no intervention). Subjects completed skill tests pretraining (baseline), immediately after training (acquisition), and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of 100 mm Hg or higher and compression rate 100 to 120 per minute. Overall, 14 of 24 (58%) participants acquired excellent CPR skills after their initial training (Booster Plus 75% vs 50% Booster Alone, P = 0.21). Adjusted for age, ABP-trained providers were 5.2× more likely to perform excellent CPR after the initial training (95% confidence interval [95% CI], 1.3-21.2; P = 0.02), and to retain these skills at 12 hours (adjusted odds ratio, 4.4; 95% CI, 1.3-14.9; P = 0.018) and 3 months (adjusted odds ratio, 4.1; 95% CI, 1.2-13.9; P = 0.023) when compared to baseline performance. The ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.

Effects of Dispatcher-assisted Cardiopulmonary Resuscitation on Survival Outcomes in Infants, Children, and Adolescents with Out-of-hospital Cardiac Arrests.

PubMed

Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Ki Jeong; Ahn, Ki Ok; Kim, Do Kyun; Kwak, Young Ho

2016-11-01

We studied the effect of a dispatcher-assisted cardiopulmonary resuscitation (CPR) program on paediatric out-of-hospital cardiac arrest (OHCA) outcomes by age groups. All emergency medical services (EMS)-treated paediatric OHCAs in Korea were enrolled between 2012 and 2014, excluding cases witnessed by EMS providers and those with unknown outcomes. The cases were divided into three groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no-bystander CPR. The endpoint was survival until discharge from hospital. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across age groups. A total of 1529 patients (32.8% bystander CPR with dispatcher assistance, 17.3% without dispatcher assistance, and 54.6% no-bystander CPR) were included. Both bystander CPR groups were more likely to have higher rate of survival to discharge (8.8% and 12.1%) compared to no-bystander CPR (3.9%). The adjusted OR (95% CI) for survival to discharge were 1.77 (1.04-3.00) in bystander CPR with dispatcher assistance and 2.86 (1.61-5.08) in without dispatcher assistance compared with no-bystander CPR. By age groups, the adjusted OR (95% CI) in bystander CPR with and without dispatcher assistance were 2.18 (1.07-4.42) and 2.27 (1.01-5.14) for the group aged 9-18 years; 2.32 (0.64-8.44) and 6.21 (1.83-21.01) for the group aged 1-8 years; 1.06 (0.41-2.77) and 2.00 (0.64-6.18) for the group aged 0-12 months, respectively. Bystander CPR, regardless of dispatcher assistance, was associated with improved survival outcomes after OHCA in the paediatric population. However, the associations between dispatcher-assisted bystander CPR and survival outcomes varied by age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Doppler Radar Profiler for Launch Winds at the Kennedy Space Center (Phase 1a)

NASA Technical Reports Server (NTRS)

Murri, Daniel G.

2011-01-01

The NASA Engineering and Safety Center (NESC) received a request from the, NASA Technical Fellow for Flight Mechanics at Langley Research Center (LaRC), to develop a database from multiple Doppler radar wind profiler (DRWP) sources and develop data processing algorithms to construct high temporal resolution DRWP wind profiles for day-of-launch (DOL) vehicle assessment. This document contains the outcome of Phase 1a of the assessment including Findings, Observations, NESC Recommendations, and Lessons Learned.

Development of a Software-Defined Radar

DTIC Science & Technology

2017-10-01

waveform to the widest available (unoccupied) instantaneous bandwidth in real time. Consequently, the radar range resolution and target detection are...LabVIEW The matched filter range profile is calculated in real time using fast Fourier transform (FFT) operations to perform a cross-correlation...between the transmitted waveform and the received complex data. Figure 4 demonstrates the block logic used to achieve real -time range profile

CPR Instruction in U.S. High Schools: What Is the State in the Nation?

PubMed

Brown, Lorrel E; Lynes, Carlos; Carroll, Travis; Halperin, Henry

2017-11-28

Cardiopulmonary resuscitation (CPR) training in high schools is required by law in the majority of U.S. states. However, laws differ from state to state, and it is unknown how this legislation is being enacted. The authors sent a cross-sectional, closed survey to educational superintendents in 32 states with CPR laws in June 2016. The authors subsequently performed direct examination and categorization of CPR legislation in 39 states (several states passed legislation as of September 2017). Survey results indicated differing practices with regard to CPR instruction in areas such as course content (63% perform automated external defibrillator training), instructor (47% used CPR-certified teachers/coaches, 30% used other CPR-certified instructors, 11% used noncertified teachers/coaches), and method (7% followed American Red Cross methods, 55% followed American Heart Association methods). CPR laws differ, although almost all (97%) require hands-on training. Although hands-on practice during CPR instruction in high school is required by law in the majority of U.S. states, there is currently no standardized method of implementation. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Advances in clinical studies of cardiopulmonary resuscitation

PubMed Central

Chen, Shou-quan

2015-01-01

BACKGROUND: The survival rate of patients after cardiac arrest (CA) remains lower since 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) was published. In clinical trials, the methods and techniques for CPR have been overly described. This article gives an overview of the progress in methods and techniques for CPR in the past years. DATA SOURCES: Original articles about cardiac arrest and CPR from MEDLINE (PubMed) and relevant journals were searched, and most of them were clinical randomized controlled trials (RCTs). RESULTS: Forty-two articles on methods and techniques of CPR were reviewed, including chest compression and conventional CPR, chest compression depth and speed, defibrillation strategies and priority, mechanical and manual chest compression, advanced airway management, impedance threshold device (ITD) and active compression-decompression (ACD) CPR, epinephrine use, and therapeutic hypothermia. The results of studies and related issues described in the international guidelines had been testified. CONCLUSIONS: Although large multicenter studies on CPR are still difficult to carry out, progress has been made in the past 4 years in the methods and techniques of CPR. The results of this review provide evidences for updating the 2015 international guidelines. PMID:26056537

Doppler Feature Based Classification of Wind Profiler Data

NASA Astrophysics Data System (ADS)

Sinha, Swati; Chandrasekhar Sarma, T. V.; Lourde. R, Mary

2017-01-01

Wind Profilers (WP) are coherent pulsed Doppler radars in UHF and VHF bands. They are used for vertical profiling of wind velocity and direction. This information is very useful for weather modeling, study of climatic patterns and weather prediction. Observations at different height and different wind velocities are possible by changing the operating parameters of WP. A set of Doppler power spectra is the standard form of WP data. Wind velocity, direction and wind velocity turbulence at different heights can be derived from it. Modern wind profilers operate for long duration and generate approximately 4 megabytes of data per hour. The radar data stream contains Doppler power spectra from different radar configurations with echoes from different atmospheric targets. In order to facilitate systematic study, this data needs to be segregated according the type of target. A reliable automated target classification technique is required to do this job. Classical techniques of radar target identification use pattern matching and minimization of mean squared error, Euclidean distance etc. These techniques are not effective for the classification of WP echoes, as these targets do not have well-defined signature in Doppler power spectra. This paper presents an effective target classification technique based on range-Doppler features.

Impacts of distinct observations during the 2009 Prince William Sound field experiment: A data assimilation study

NASA Astrophysics Data System (ADS)

Li, Zhijin; Chao, Yi; Farrara, John D.; McWilliams, James C.

2013-07-01

A set of data assimilation experiments, known as Observing System Experiments (OSEs) are performed to assess the relative impacts of different types of observations acquired during the 2009 Prince William Sound Field Experiment. The observations assimilated consist primarily of two types: High Frequency (HF) radar surface velocities and vertical profiles of temperature/salinity (T/S) measured by ships, moorings, an Autonomous Underwater Vehicle and a glider. The impact of all the observations, HF radar surface velocities, and T/S profiles is assessed. Without data assimilation, a frequently occurring cyclonic eddy in the central Sound is overly persistent and intense. The assimilation of the HF radar velocities effectively reduces these biases and improves the representation of the velocities as well as the T/S fields in the Sound. The assimilation of the T/S profiles improves the large scale representation of the temperature/salinity and also the velocity field in the central Sound. The combination of the HF radar surface velocities and sparse T/S profiles results in an observing system capable of representing the circulation in the Sound reliably and thus producing analyses and forecasts with useful skill.

Availability and quality of cardiopulmonary resuscitation information for Spanish-speaking population on the Internet.

PubMed

Liu, Kirsten Y; Haukoos, Jason S; Sasson, Comilla

2014-01-01

Bystander cardiopulmonary resuscitation (CPR) is a vital link in the chain of survival for out-of-hospital cardiac arrest (OHCA); however, there are racial/ethnic disparities in the provision of bystander CPR. Approximately 32% of Hispanics perform CPR when confronted with cardiac arrest, whereas approximately 41% of non-Hispanics perform CPR. Public education, via the Internet, may be critical in improving the performance of bystander CPR among Hispanics. The objective of this study was to evaluate the availability and quality of CPR-related literature for primary Spanish-speaking individuals on the Internet. Two search engines (Google and Yahoo!) and a video-site (YouTube) were searched using the following terms: "resucitacion cardiopulmonar" and "reanimacion cardiopulmonar." Inclusion criteria were: education of CPR technique. Exclusion criteria were: instruction on pediatric CPR technique, failure to provide any instruction on CPR technique, or duplicated website. Data elements were collected on the content and quality of the websites and videos, such as assessing scene safety, verifying responsiveness, activating EMS, properly positioning hands on chest, performing accurate rate and depth of compressions. Of the 515 websites or videos screened, 116 met criteria for inclusion. The majority of websites (86%; 95% Confidence Interval [CI] 79-92%) educated viewers on traditional bystander CPR (primarily, 30:2 CPR), while only 14% (95% CI 9-21%) taught hands-only CPR. Of websites that used video (N=62), 84% were conducted in Spanish and 16% in English. The quality of CPR education was generally poor (median score of 3/6, IQR of 3.0). Only half of websites properly educated on how to check responsiveness, activate EMS and position hands on chest. Eighty-eight percent of websites failed to educate viewers on assessing scene safety. The majority of websites had improper or no education on both rate and depth of compressions (59% and 63%, respectively). Only 16% of websites included 5 or more quality markers for proper bystander CPR. A small proportion of internet resources have high quality CPR education for a Spanish-speaking population. More emphasis should be placed on improving the quality of educational resources available on the Internet for Spanish-speaking populations, and with particular emphasis on current basic life support recommendations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cardiopulmonary resuscitation quality and beyond: the need to improve real-time feedback and physiologic monitoring.

PubMed

Lin, Steve; Scales, Damon C

2016-06-28

High-quality cardiopulmonary resuscitation (CPR) has been shown to improve survival outcomes after cardiac arrest. The current standard in studies evaluating CPR quality is to measure CPR process measures-for example, chest compression rate, depth, and fraction. Published studies evaluating CPR feedback devices have yielded mixed results. Newer approaches that seek to optimize CPR by measuring physiological endpoints during the resuscitation may lead to individualized patient care and improved patient outcomes.

A Novel Use of a Metronome in Dispatcher-assisted Cardiopulmonary Resuscitation.

PubMed

Ateyyah, Khalid A; Cady, Charles E; Poltrock, James T; Pirrallo, Ronald G

2015-01-01

Abstract Early, high-quality cardiopulmonary resuscitation (CPR) is the key to increasing the likelihood of successful resuscitation in cardiac arrest. The use of dispatch-assisted (DA) CPR can increase the likelihood of bystander CPR. We describe a case in which a metronome was introduced to guide DA-CPR. The wife of a 52-year-old male activated 9-1-1 after her husband suffered a cardiac arrest. During her 9-1-1 call she received CPR instructions and heard a metronome over the phone while following the instructions. Return of spontaneous circulation of the patient occurred during paramedic on scene care. The patient was transported to hospital and discharged 6 days later with no neurological deficit. This case supports the use of a metronome by emergency medical dispatchers during the provision of DA-CPR to improve bystander CPR.

Cell phone cardiopulmonary resuscitation: audio instructions when needed by lay rescuers: a randomized, controlled trial.

PubMed

Merchant, Raina M; Abella, Benjamin S; Abotsi, Edem J; Smith, Thomas M; Long, Judith A; Trudeau, Martha E; Leary, Marion; Groeneveld, Peter W; Becker, Lance B; Asch, David A

2010-06-01

Given the ubiquitous presence of cellular telephones, we seek to evaluate the extent to which prerecorded audio cardiopulmonary resuscitation (CPR) instructions delivered by a cell telephone will improve the quality of CPR provided by untrained and trained lay rescuers. We randomly assigned both previously CPR trained and untrained volunteers to perform CPR on a manikin for 3 minutes with or without audio assistance from a cell telephone programmed to provide CPR instructions. We measured CPR quality metrics-pauses (ie, no flow time), compression rate (minute), depth (millimeters), and hand placement (percentage correct)-across the 4 groups defined by being either CPR trained or untrained and receiving or not receiving cell telephone CPR instructions. There was no difference in CPR measures for participants who had or had not received previous CPR training. Participants using the cell telephone aid performed better compression rate (100/minute [95% confidence interval (CI) 97 to 103/minute] versus 44/minute [95% CI 38 to 50/minute]), compression depth (41 mm [95% CI 38 to 44 mm] versus 31 mm [95% CI 28 to 34 mm]), hand placement (97% [95% CI 94% to 100%] versus 75% [95% CI 68% to 83%] correct), and fewer pauses (74 seconds [95% CI 72 to 76 seconds] versus 89 seconds [95% CI 80 to 98 seconds]) compared with participants without the cell telephone aid. A simple audio program that can be made available for cell telephones increases the quality of bystander CPR in a manikin simulation. Copyright (c) 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

PyCPR - a python-based implementation of the Conjugate Peak Refinement (CPR) algorithm for finding transition state structures.

PubMed

Gisdon, Florian J; Culka, Martin; Ullmann, G Matthias

2016-10-01

Conjugate peak refinement (CPR) is a powerful and robust method to search transition states on a molecular potential energy surface. Nevertheless, the method was to the best of our knowledge so far only implemented in CHARMM. In this paper, we present PyCPR, a new Python-based implementation of the CPR algorithm within the pDynamo framework. We provide a detailed description of the theory underlying our implementation and discuss the different parts of the implementation. The method is applied to two different problems. First, we illustrate the method by analyzing the gauche to anti-periplanar transition of butane using a semiempirical QM method. Second, we reanalyze the mechanism of a glycyl-radical enzyme, namely of 4-hydroxyphenylacetate decarboxylase (HPD) using QM/MM calculations. In the end, we suggest a strategy how to use our implementation of the CPR algorithm. The integration of PyCPR into the framework pDynamo allows the combination of CPR with the large variety of methods implemented in pDynamo. PyCPR can be used in combination with quantum mechanical and molecular mechanical methods (and hybrid methods) implemented directly in pDynamo, but also in combination with external programs such as ORCA using pDynamo as interface. PyCPR is distributed as free, open source software and can be downloaded from http://www.bisb.uni-bayreuth.de/index.php?page=downloads . Graphical Abstract PyCPR is a search tool for finding saddle points on the potential energy landscape of a molecular system.

The effectiveness of ultrabrief and brief educational videos for training lay responders in hands-only cardiopulmonary resuscitation: implications for the future of citizen cardiopulmonary resuscitation training.

PubMed

Bobrow, Bentley J; Vadeboncoeur, Tyler F; Spaite, Daniel W; Potts, Jerald; Denninghoff, Kurt; Chikani, Vatsal; Brazil, Paula R; Ramsey, Bob; Abella, Benjamin S

2011-03-01

Bystander cardiopulmonary resuscitation (CPR) improves survival from out-of-hospital cardiac arrest (OHCA) but often is not performed. We hypothesized that subjects viewing very short Hands-Only CPR videos will (1) be more likely to attempt CPR in a simulated OHCA scenario and (2) demonstrate better CPR skills than untrained individuals. This study is a prospective trial of 336 adults without recent CPR training randomized into 4 groups: (1) control (no training) (n=51); (2) 60-second video training (n=95); (3) 5-minute video training (n=99); and (4) 8-minute video training, including manikin practice (n=91). All subjects were tested for their ability to perform CPR during an adult OHCA scenario using a CPR-sensing manikin and Laerdal PC SkillReporting software. One half of the trained subjects were randomly assigned to testing immediately and the other half after a 2-month delay. Twelve (23.5%) controls did not even attempt CPR, which was true of only 2 subjects (0.7%; P=0.01) from any of the experimental groups. All experimental groups had significantly higher average compression rates (closer to the recommended 100/min) than the control group (P<0.001), and all experimental groups had significantly greater average compression depth (>38 mm) than the control group (P<0.0001). Laypersons exposed to very short Hands-Only CPR videos are more likely to attempt CPR and show superior CPR skills than untrained laypersons. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT01191736.

Animation-assisted CPRII program as a reminder tool in achieving effective one-person-CPR performance.

PubMed

Choa, Minhong; Cho, Junho; Choi, Young Hwan; Kim, Seungho; Sung, Ji Min; Chung, Hyun Soo

2009-06-01

The objective of this study is to compare the skill retention of two groups of lay persons, six months after their last CPR training. The intervention group was provided with animation-assisted CPRII (AA-CPRII) instruction on their cellular phones, and the control group had nothing but what they learned from their previous training. This study was a single blind randomized controlled trial. The participants' last CPR trainings were held at least six months ago. We revised our CPR animation for on-site CPR instruction content emphasizing importance of chest compression. Participants were randomized into two groups, the AA-CPRII group (n=42) and the control group (n=38). Both groups performed three cycles of CPR and their performances were video recorded. These video clips were assessed by three evaluators using a checklist. The psychomotor skills were evaluated using the ResusciAnne SkillReporter. Using the 30-point scoring checklist, the AA-CPRII group had a significantly better score compared to the control group (p<0.001). Psychomotor skills evaluated with the AA-CPRII group demonstrated better performance in hand positioning (p=0.025), compression depth (p=0.035) and compression rate (p<0.001) than the control group. The AA-CPRII group resulted in better checklist scores, including chest compression rate, depth and hand positioning. Animation-assisted CPR could be used as a reminder tool in achieving effective one-person-CPR performance. By installing the CPR instruction on cellular phones and having taught them CPR with it during the training enabled participants to perform better CPR.

International CPR guidelines - perspectives in CPR.

PubMed

Nolan, Jerry P

2013-09-01

The International Liaison Committee on Resuscitation (ILCOR) co-ordinates regular reviews of cardiopulmonary resuscitation (CPR) science and publishes consensus on science statements and treatment recommendations. These outputs are used by international resuscitation organisations to generate clinical guidelines. This review will outline the history behind the development of international CPR guidelines and will provide a detailed description of the current guideline generating process. A perspective is provided on the future of this process and the prospects for completely unified international CPR guidelines. Copyright © 2013 Elsevier Ltd. All rights reserved.

Distributed micro-radar system for detection and tracking of low-profile, low-altitude targets

NASA Astrophysics Data System (ADS)

Gorwara, Ashok; Molchanov, Pavlo

2016-05-01

Proposed airborne surveillance radar system can detect, locate, track, and classify low-profile, low-altitude targets: from traditional fixed and rotary wing aircraft to non-traditional targets like unmanned aircraft systems (drones) and even small projectiles. Distributed micro-radar system is the next step in the development of passive monopulse direction finder proposed by Stephen E. Lipsky in the 80s. To extend high frequency limit and provide high sensitivity over the broadband of frequencies, multiple angularly spaced directional antennas are coupled with front end circuits and separately connected to a direction finder processor by a digital interface. Integration of antennas with front end circuits allows to exclude waveguide lines which limits system bandwidth and creates frequency dependent phase errors. Digitizing of received signals proximate to antennas allows loose distribution of antennas and dramatically decrease phase errors connected with waveguides. Accuracy of direction finding in proposed micro-radar in this case will be determined by time accuracy of digital processor and sampling frequency. Multi-band, multi-functional antennas can be distributed around the perimeter of a Unmanned Aircraft System (UAS) and connected to the processor by digital interface or can be distributed between swarm/formation of mini/micro UAS and connected wirelessly. Expendable micro-radars can be distributed by perimeter of defense object and create multi-static radar network. Low-profile, lowaltitude, high speed targets, like small projectiles, create a Doppler shift in a narrow frequency band. This signal can be effectively filtrated and detected with high probability. Proposed micro-radar can work in passive, monostatic or bistatic regime.

Retention of Cardiopulmonary Resuscitation Skills in Nigerian Secondary School Students

ERIC Educational Resources Information Center

Onyeaso, Adedamola Olutoyin

2016-01-01

Background/Objective: For effective bystander cardiopulmonary resuscitation (CPR), retention of CPR skills after the training is central. The objective of this study was to find out how much of the CPR skills a group of Nigerian secondary school students would retain six weeks after their first exposure to the conventional CPR training. Materials…

High-quality cardiopulmonary resuscitation.

PubMed

Nolan, Jerry P

2014-06-01

The quality of cardiopulmonary resuscitation (CPR) impacts on outcome after cardiac arrest. This review will explore the factors that contribute to high-quality CPR and the metrics that can be used to monitor performance. A recent consensus statement from North America defined five key components of high-quality CPR: minimizing interruptions in chest compressions, providing compressions of adequate rate and depth, avoiding leaning on the chest between compressions, and avoiding excessive ventilation. Studies have shown that real-time feedback devices improve the quality of CPR and, in one before-and-after study, outcome from out-of-hospital cardiac arrest. There is evidence for increasing survival rates following out-of-hospital cardiac arrest and this is associated with increasing rates of bystander CPR. The quality of CPR provided by healthcare professionals can be improved with real-time feedback devices. The components of high-quality CPR and the metrics that can be measured and fed back to healthcare professionals have been defined by expert consensus. In the future, real-time feedback based on the physiological responses to CPR may prove more effective.

High resolution vertical profiles of wind, temperature and humidity obtained by computer processing and digital filtering of radiosonde and radar tracking data from the ITCZ experiment of 1977

NASA Technical Reports Server (NTRS)

Danielson, E. F.; Hipskind, R. S.; Gaines, S. E.

1980-01-01

Results are presented from computer processing and digital filtering of radiosonde and radar tracking data obtained during the ITCZ experiment when coordinated measurements were taken daily over a 16 day period across the Panama Canal Zone. The temperature relative humidity and wind velocity profiles are discussed.

'Do not attempt resuscitation'--do standardised order forms make a clinical difference above hand-written note entries?

PubMed

Lewis, Keir Edward; Edwards, Victoria Middleton; Hall, Sian; Temblett, Paul; Hutchings, Hayley

2009-01-01

To quantify any effect of Standardised Order Forms (SOFs), versus hand-written note entries for 'Do Not Attempt Resuscitation'--on the selection and survival of remaining cardiopulmonary resuscitation (CPR) attempts. A prospective, observational study in two UK Hospitals, comparing numbers, demographics and survival rates from CPR attempts for 2 years prior to and 2 years after the introduction of SOFs (the only change in DNAR policy). There were 133 CPR attempts, representing 0.30% of the 44,792 admissions, pre SOFs and 147 CPR attempts representing 0.32% of the 45,340 admissions following the SOFs (p=0.46). The median duration of a CPR attempt was 11min prior to and 15min following the SOFs (p=0.02). Of the CPR attempts, there was no change in mean age (p=0.34), proportions occurring outside working hours (p=0.70) or proportions presenting with an initial shockable rhythm (p=0.30). Survival to discharge following CPR was unchanged (p=0.23). The introduction of SOFs for DNAR orders was associated with a significantly longer duration of CPR (on average by 3-4min) but no difference in overall number, demographics or type of arrest or survival in the remaining CPR attempts.

Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association.

PubMed

Meaney, Peter A; Bobrow, Bentley J; Mancini, Mary E; Christenson, Jim; de Caen, Allan R; Bhanji, Farhan; Abella, Benjamin S; Kleinman, Monica E; Edelson, Dana P; Berg, Robert A; Aufderheide, Tom P; Menon, Venu; Leary, Marion

2013-07-23

The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient's response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

Analysis of cost and assessment of computerized patient record systems in Japan based on questionnaire survey.

PubMed

Zhang, W P; Yamauchi, K; Mizuno, S; Zhang, R; Huang, D M

2004-01-01

The purpose of this study was to clarify the implementation and maintenance costs of a computerized patient record (CPR) system by means of a questionnaire survey. Moreover, the benefits of CPR systems were evaluated to determine their contribution to enhancing the quality of medical care and hospital management. Data were collected by a questionnaire survey mailed out to participants. The per-bed mean cost for implementation was 14,308 dollars (range: 3538-38,077 dollars). The mean annual maintenance cost for the CPR system was 457,615 dollars (range: 39,769-2,307,692 dollars). The multivariate analysis (Hayashi's Quantification Type I) revealed high partial correlation coefficients between implementation cost and the CPR system maker. In addition, the multiple correlation coefficient for four factors (CPR system maker, number of servers, institution type and implementation date) in predicting implementation cost was 0.798. Over 60% of respondents replied that their satisfaction with the CPR system was 'very high' or 'high.' Eighty-two percent of the hospitals responded positively that CPR systems improve the quality of medical care, and 70% felt that the systems help prevent medical errors. Our findings indicate that the maker of CPR system, number of servers, institution type and implementation date had a strong influence on per-bed implementation costs in that order. Finally, it was found that CPR systems were considered effective for hospital administration and medical examinations, based on the high assessments of the results of installing a CPR system.

Health practitioners’ perceptions of adopting clinical prediction rules in the management of musculoskeletal pain: a qualitative study in Australia

PubMed Central

Kelly, Joan; Sterling, Michele; Rebbeck, Trudy; Bandong, Aila Nica; Leaver, Andrew; Mackey, Martin; Ritchie, Carrie

2017-01-01

Objectives To investigate health practitioners’ understanding and practice behaviours with regards to clinical prediction rules (CPRs) and explore their perceptions of adopting a new whiplash CPR. Design Qualitative study using six semistructured focus groups. Setting Primary and secondary care in New South Wales and Queensland, Australia. Participants Physiotherapists (n=19), chiropractors (n=6) and osteopaths (n=3) were purposively sampled to include health practitioners who provide routine treatment to people with whiplash-associated disorders. Methods Focus group discussions (n=6) were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. Results Health practitioners’ understanding and use of CPRs were mixed. Clinicians considered components relating to acceptability (‘whether I agree with it’) and implementation (‘how I'll use it’) when deciding on whether to adopt a new CPR. Acceptability was informed by four themes: knowledge and understanding, CPR type, congruence and weighted value. Consideration of matters that promote implementation occurred once a CPR was deemed to be acceptable. Three themes were identified as potentially enhancing whiplash CPR implementation: the presence of an external driver of adoption, flexibility in how the CPR could be administered and guidance regarding communication of CPR output to patients. Conclusions Education on CPR purpose and fit with practice is needed to enhance the perceived acceptability of CPRs. Strategies that facilitate practitioner motivation, enable administrative flexibility and assist clinicians in communicating the results of the whiplash CPR could promote adoption of the whiplash CPR. PMID:28801412

Vertical Profiles of Latent Heat Release over the Global Tropics using TRMM Rainfall Products from December 1997 to November 2002

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Lang, S.; Simpson, J.; Meneghini, R.; Halverson, J.; Johnson, R.; Adler, R.

2003-01-01

NASA Tropical Rainfall Measuring Mission (TRMM) precipitation radar (PR) derived rainfall information will be used to estimate the four-dimensional structure of global monthly latent heating and rainfall profiles over the global tropics from December 1997 to November 2000. Rainfall, latent heating and radar reflectivity structures between El Nino (DJF 1997-98) and La Nina (DJF 1998-99) will be examined and compared. The seasonal variation of heating over various geographic locations (i.e., oceanic vs continental, Indian ocean vs west Pacific, Africa vs. S. America ) will also be analyzed. In addition, the relationship between rainfall, latent heating (maximum heating level), radar reflectivity and SST is examined and will be presented in the meeting. The impact of random error and bias in stratiform percentage estimates from PR on latent heating profiles is studied and will also be presented in the meeting. The Goddard Cumulus Ensemble Model is being used to simulate various mesoscale convective systems that developed in different geographic locations. Specifically, the model estimated rainfall, radar reflectivity and latent heating profiles will be compared to observational data collected from TRMM field campaigns over the South China Sea in 1998 (SCSMEX), Brazil in 1999 (TRMM-LBA), and the central Pacific in 1999 (KWAJEX). Sounding diagnosed heating budgets and radar reflectivity from these experiments can provide the means to validate (heating product) as well as improve the GCE model. Review of other latent heating algorithms will be discussed in the workshop.

Vertical Profiles of Latent Heat Release over the Global Tropics using TRMM rainfall products from December 1997 to November 2001

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Lang, S.; Simpson, J.; Meneghini, R.; Halverson, J.; Johnson, R.; Adler, R.

2002-01-01

NASA Tropical Rainfall Measuring Mission (TRMM) precipitation radar (PR) derived rainfall information will be used to estimate the four-dimensional structure of global monthly latent heating and rainfall profiles over the global tropics from December 1997 to November 2001. Rainfall, latent heating and radar reflectivity structures between El Nino (DE 1997-98) and La Nina (DJF 1998-99) will be examined and compared. The seasonal variation of heating over various geographic locations (i.e., oceanic vs continental, Indian ocean vs. west Pacific, Africa vs. S. America) will also be analyzed. In addition, the relationship between rainfall, latent heating (maximum heating level), radar reflectivity and SST is examined and will be presented in the meeting. The impact of random error and bias in strtaiform percentage estimates from PR on latent heating profiles is studied and will also be presented in the meeting. The Goddard Cumulus Ensemble Model is being used to simulate various mesoscale convective systems that developed in different geographic locations. Specifically, the model estimated rainfall, radar reflectivity and latent heating profiles will be compared to observational data collected from TRMM field campaigns over the South China Sea in 1998 (SCSMEX), Brazil in 1999 (TRMM-LBA), and the central Pacific in 1999 (KWAJEX). Sounding diagnosed heating budgets and radar reflectivity from these experiments can provide the means to validate (heating product) as well as improve the GCE model.

Vertical Profiles of Latent Heat Release Over the Global Tropics using TRMM Rainfall Products from December 1997 to November 2001

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Lang, S.; Simpson, J.; Meneghini, R.; Halverson, J.; Johnson, R.; Adler, R.; Starr, David (Technical Monitor)

2002-01-01

NASA Tropical Rainfall Measuring Mission (TRMM) precipitation radar (PR) derived rainfall information will be used to estimate the four-dimensional structure of global monthly latent heating and rainfall profiles over the global tropics from December 1997 to November 2000. Rainfall, latent heating and radar reflectivity structures between El Nino (DJF 1997-98) and La Nina (DJF 1998-99) will be examined and compared. The seasonal variation of heating over various geographic locations (i.e., oceanic vs continental, Indian ocean vs west Pacific, Africa vs S. America) will also be analyzed. In addition, the relationship between rainfall, latent heating (maximum heating level), radar reflectivity and SST is examined and will be presented in the meeting. The impact of random error and bias in stratiform percentage estimates from PR on latent heating profiles is studied and will also be presented in the meeting. The Goddard Cumulus Ensemble Model is being used to simulate various mesoscale convective systems that developed in different geographic locations. Specifically, the model estimated rainfall, radar reflectivity and latent heating profiles will be compared to observational data collected from TRMM field campaigns over the South China Sea in 1998 (SCSMEX), Brazil in 1999 (TRMM-LBA), and the central Pacific in 1999 (KWAJEX). Sounding diagnosed heating budgets and radar reflectivity from these experiments can provide the means to validate (heating product) as well as improve the GCE model.

Vertical Profiles of Latent Heat Release over the Global Tropics Using TRMM Rainfall Products from December 1997 to November 2002

NASA Technical Reports Server (NTRS)

Tao, W.-K.

2003-01-01

NASA Tropical Rainfall Measuring Mission (TRMM) precipitation radar (PR) derived rainfall information will be used to estimate the four-dimensional structure of global monthly latent heating and rainfall profiles over the global tropics from December 1997 to November 2000. Rainfall, latent heating and radar reflectivity structures between El Nino (DJF 1997-98) and La Nina (DJF 1998-99) will be examined and compared. The seasonal variation of heating over various geographic locations (i.e., oceanic vs continental, Indian ocean vs west Pacific, Africa vs S. America) will also be analyzed. In addition, the relationship between rainfall, latent heating (maximum heating level), radar reflectivity and SST is examined and will be presented in the meeting. The impact of random error and bias in straitform percentage estimates from PR on latent heating profiles is studied and will also be presented in the meeting. The Goddard Cumulus Ensemble Model is being used to simulate various mesoscale convective systems that developed in different geographic locations. Specifically, the model estimated rainfall, radar reflectivity and latent heating profiles will be compared to observational data collected from TRMM field campaigns over the South China Sea in 1998 (SCSMXX), Brazil in 1999 (TRMM- LBA), and the central Pacific in 1999 (KWAJEX). Sounding diagnosed heating budgets and radar reflectivity from these experiments can provide the means to validate (heating product) as well as improve the GCE model.

Incidence, characteristics, and survival following cardiopulmonary resuscitation in the quaternary neonatal intensive care unit.

PubMed

Foglia, Elizabeth E; Langeveld, Robert; Heimall, Lauren; Deveney, Alyson; Ades, Anne; Jensen, Erik A; Nadkarni, Vinay M

2017-01-01

The contemporary characteristics and outcomes of cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU) are poorly described. The objectives of this study were to determine the incidence, interventions, and outcomes of CPR in a quaternary referral NICU. Retrospective observational study of infants who received chest compressions for resuscitation in the Children's Hospital of Philadelphia NICU between April 1, 2011 and June 30, 2015. Patient, event, and survival characteristics were abstracted from the medical record and the hospital-wide resuscitation database. The primary outcome was survival to hospital discharge. Univariable and multivariable analyses were performed to identify patient and event factors associated with survival to discharge. There were 1.2 CPR events per 1000 patient days. CPR was performed in 113 of 5046 (2.2%) infants admitted to the NICU during the study period. The median duration of chest compressions was 2min (interquartile range 1, 6min). Adrenaline was administered in 34 (30%) CPR events. Of 113 infants with at least one CPR event, 69 (61%) survived to hospital discharge. Factors independently associated with decreased survival to hospital discharge were inotrope treatment prior to CPR (adjusted Odds Ratio [aOR] 0.14, 95% Confidence Interval [CI] 0.04, 0.54), and adrenaline administration during CPR (aOR 0.14, 95% CI 0.04, 0.50). Although it was not uncommon, the incidence of CPR was low (<3%) among infants hospitalized in a quaternary referral NICU. Infants receiving inotropic therapy prior to CPR and adrenaline administration during CPR were less likely to survive to hospital discharge. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Rescuer fatigue during actual in-hospital cardiopulmonary resuscitation with audiovisual feedback: a prospective multicenter study

PubMed Central

Sugerman, Noah T.; Herzberg, Daniel; Leary, Marion; Weidman, Elizabeth K.; Edelson, Dana P.; Vanden Hoek, Terry L.; Becker, Lance B.; Abella, Benjamin S.

2009-01-01

Background Rescuer fatigue during cardiopulmonary resuscitation (CPR) is a likely contributor to variable CPR quality during clinical resuscitation efforts, yet investigations into fatigue and CPR quality degradation have only been performed in simulated environments, with widely conflicting results. Objective We sought to characterize CPR quality decay during actual in-hospital cardiac arrest, with regard to both chest compression (CC) rate and depth during the delivery of CCs by individual rescuers over time. Methods Using CPR-recording technology to objectively quantify CCs and provide audiovisual feedback, we prospectively collected CPR performance data from arrest events in two hospitals. We identified continuous CPR “blocks” from individual rescuers, assessing CC rate and depth over time. Results 135 blocks of continuous CPR were identified from 42 cardiac arrests at the two institutions. Median duration of continuous CPR blocks was 112 sec (IQR 101–122). CC rate did not change significantly over single rescuer performance, with an initial mean rate of 105 ± 11 / min, and a mean rate after 3 min of 106 ± 9 / min (p=NS). However, CC depth decayed significantly starting between 90 sec and 2 min, falling from a mean of 48.3 ± 9.6 mm to 46.0 ± 9.0 mm (p=0.0006) and to 43.7 ± 7.4 mm by 3 minutes (p=0.002). Conclusions During actual in-hospital CPR with audiovisual feedback, CC depth decay became evident after 90 sec of CPR, but CC rate did not change. These data provide clinical evidence for rescuer fatigue during actual resuscitations and support current guideline recommendations to rotate rescuers during CC delivery. PMID:19581036

Comparison of two training programmes on paramedic-delivered CPR performance.

PubMed

Govender, Kevin; Sliwa, Karen; Wallis, Lee; Pillay, Yugan

2016-05-01

To compare CPR performance in two groups of paramedics who received CPR training from two different CPR training programmes. Conducted in June 2014 at the Hamad Medical Corporation Ambulance Service, the national ambulance service of the State of Qatar, the CPR performances of 149 new paramedic recruits were evaluated after they had received training from either a traditional CPR programme or a tailored CPR programme. Both programmes taught the same content but differed in the way in which this content was delivered to learners. Exclusive to the tailored programme was mandatory precourse work, continuous assessments, a locally developed CPR instructional video and pedagogical activities tailored to the background education and learner style preferences of paramedics. At the end of each respective training programme, a single examiner who was blinded to the type of training paramedics had received, rated them as competent or non-competent on basic life support skills, condition specific skills, specific overall skills and non-technical skills during a simulated out-of-hospital cardiac arrest (OHCA) assessment. Paramedics who received CPR training with the tailored programme were rated competent 70.9% of the time, compared with paramedics who attended the traditional programme and who achieved this rating 7.9% of the time (p<0.001). Specific improvements were seen in the time required to detect cardiac arrest, chest compression quality, and time to first monitored rhythm and delivered shock. In an OHCA scenario, CPR performance rated as competent was significantly higher when training was received using a tailored CPR programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Barriers and Facilitators to Learning and Performing Cardiopulmonary Resuscitation (CPR) in Neighborhoods with Low Bystander CPR Prevalence and High Rates of Cardiac Arrest in Columbus, Ohio

PubMed Central

Sasson, Comilla; Haukoos, Jason S.; Bond, Cindy; Rabe, Marilyn; Colbert, Susan H.; King, Renee; Sayre, Michael; Heisler, Michele

2013-01-01

Background Residents who live in neighborhoods that are primarily African-American, Latino, or poor are more likely to have an out-of-hospital cardiac arrest (OHCA), less likely to receive cardiopulmonary resuscitation (CPR), and less likely to survive. No prior studies have been conducted to understand the contributing factors that may decrease the likelihood of residents learning and performing CPR in these neighborhoods. The goal of this study was to identify barriers and facilitators to learning and performing CPR in three low-income, “high-risk” predominantly African American, neighborhoods in Columbus, Ohio. Methods and Results Community-Based Participatory Research (CBPR) approaches were used to develop and conduct six focus groups in conjunction with community partners in three target high-risk neighborhoods in Columbus, Ohio in January-February 2011. Snowball and purposeful sampling, done by community liaisons, was used to recruit participants. Three reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. Three major barriers to learning CPR were identified and included financial, informational, and motivational factors. Four major barriers were identified for performing CPR and included fear of legal consequences, emotional issues, knowledge, and situational concerns. Participants suggested that family/self-preservation, emotional, and economic factors may serve as potential facilitators in increasing the provision of bystander CPR. Conclusion The financial cost of CPR training, lack of information, and the fear of risking one's own life must be addressed when designing a community-based CPR educational program. Using data from the community can facilitate improved design and implementation of CPR programs. PMID:24021699

Prevalence of neuromuscular disorders in Qena governorate/Egypt: population-based survey.

PubMed

Khedr, Eman M; Fawi, Gharib; Abbas, Mohammed Abd-Allah; Abo El-Fetoh, Noha; Zaki, Ahmed F; Gamea, Ayman; Al Attar, Ghada

2016-12-01

Few epidemiological studies of the prevalence of neuromuscular disorders have been undertaken. The aim of the study was to estimate the prevalence of the most common types of neuromuscular disorders in Qena governorate/Egypt. A random sample was taken from 11 districts, involving 9303 inhabitants with 57.3% urban residents and 42.7% rural residence. Patients were diagnosed using a screening questionnaire for the diagnosis of neuromuscular disorders. All positive cases were referred to Qena University hospital where they underwent full clinical, electrophysiological, and laboratory investigations. Out of 9303 participants 448 cases were identified positive during survey. Four hundred and twenty-six cases proved to have neuromuscular disorders giving a crude prevalence rate (CPR) of 4.57%; 408 cases had definite neuropathy and 18 cases had muscular disorders equivalent to CPR of 4.39% and 193/10 5 respectively. There was a higher prevalence in the rural than urban population. The CPR of focal compression neuropathies was 1.8%, with the majority of cases having carpal tunnel syndrome (CPR = 1.67%). CPR of diabetic neuropathy was 1.67%. The CPR of compressive radiculopathy was 0.34%. Traumatic nerve injury had a CPR 0.06%. The lifetime prevalence of Bell's palsy was 0.16%. Hereditary motor and sensory neuropathy had a CPR 0.08%. The CPR of idiopathic neuropathy was 0.09% and Infective Leprotic neuropathy was 0.04%. Five patients were diagnosed as having muscular dystrophy and another 5 patients had myotonia with CPR of 54/10 5 for each. Two cases of myasthenia gravis and another two cases with systemic myopathy were recorded giving a CPR of 21/10 5 . The overall CPR of neuromuscular disorders in the general population in Qena governorate/Egypt was higher than reported in other countries.

Analysis of bystander CPR quality during out-of-hospital cardiac arrest using data derived from automated external defibrillators.

PubMed

Fernando, Shannon M; Vaillancourt, Christian; Morrow, Stanley; Stiell, Ian G

2018-07-01

Little is known regarding the quality of cardiopulmonary resuscitation (CPR) performed by bystanders in out-of-hospital cardiac arrest (OHCA). We sought to determine quality of bystander CPR provided during OHCA using CPR quality data stored by Automated External Defibrillators (AEDs). We used the Resuscitation Outcomes Consortium database to identify OHCA cases of presumed cardiac etiology where an AED was utilized. We then matched AED data to each case identified. AED data was analyzed using manufacturer software in order to determine overall measures of bystander CPR quality, changes in bystander CPR quality over time, and adherence to existing 2010 Resuscitation Quality Guidelines. 100 cases of OHCA of presumed cardiac etiology involving bystander CPR and with corresponding AED data. Mean age was 62.3 years, and 75% were male. Bystanders demonstrated high-quality CPR over all minutes of resuscitation, with a chest compression fraction of 76%, a compression depth of 5.3 cm, and a compression rate of 111.2 compressions/min. Mean perishock pause was 26.8 s. Adherence rates to 2010 Resuscitation Guidelines for compression rate and depth were found to be 66% and 55%, respectively. CPR quality was lowest in the first minute, resulting from increased delay to rhythm analysis (mean 40.7 s). In cases involving shock delivery, latency from initiation of AED to shock delivery was 59.2 s. We found that bystanders perform high-quality CPR, with strong adherence rates to existing Resuscitation Guidelines. High-quality CPR is maintained over the first five minutes of resuscitation, but was lowest in the first minute. Copyright © 2018 Elsevier B.V. All rights reserved.

The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study.

PubMed

Cheng, Adam; Lin, Yiqun; Nadkarni, Vinay; Wan, Brandi; Duff, Jonathan; Brown, Linda; Bhanji, Farhan; Kessler, David; Tofil, Nancy; Hecker, Kent; Hunt, Elizabeth A

2018-01-01

We aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality. We analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training. Step stool use was voluntary. We explored the association between 1) step stool use and CPR quality, and 2) provider adjusted height and CPR quality. Adjusted height was defined as provider height + 23 cm (if step stool was used). Below-average height participants were ≤ gender-specific average height; the remainder were above average height. We assessed for interaction between study arm and both adjusted height and step stool use. One hundred twenty-four subjects participated; 1,230 30-second epochs of CPR were analysed. Step stool use was associated with improved compression depth in below-average (female, p=0.007; male, p<0.001) and above-average (female, p=0.001; male, p<0.001) height providers. There is an association between adjusted height and compression depth (p<0.001). Visual feedback attenuated the effect of height (p=0.025) on compression depth; JIT training did not (p=0.918). Visual feedback and JIT training attenuated the effect of step stool use (p<0.001) on compression depth. Step stool use is associated with improved compression depth regardless of height. Increased provider height is associated with improved compression depth, with visual feedback attenuating the effects of height and step stool use.

A comparison between over-the-head and lateral cardiopulmonary resuscitation with a single rescuer by bag-valve mask

PubMed Central

Nasiri, Ebrahim; Nasiri, Reza

2014-01-01

Context: mask fixation in the lateral position is difficult during CPR. Aim: the aim of this study is to compare the lateral CPR for the use of bag-valve mask by single paramedic rescuer as well as over-the-head CPR on the chest compression and ventilation on the manikin. Settings and Design: Mazandaran University of Medical Sciences. The design of this study was a randomized cross-over trial. Methods: participants learned a standardized theoretical introduction CPR according to the 2010 guidelines. The total number of chest compressions per two minutes was measured. Total number of correct and wrong ventilation per two minutes was evaluated. Statistical Analysis: we used Wilcoxon signed-rank test to analyze the non-normally distributed data in dependence groups A. P-value of more than 0.05 was considered to show statistical significance. Results: there were 100 participants (45 women and 55 men) who participated in the study from September to March, 2011. The compression and ventilation rate in lateral CPR was lower than OTH CPR. Around 51% of participants had correct chest compression rate more than 90 beats per minute in lateral CPR and 65% of them had equal or more than ten correct ventilations per minute. Conclusions: in conclusion, this study confirmed that in a simulated CPR model over-the-head position CPR led to a better BLS than the lateral position CPR by a single paramedic student with a BVM device. We also concluded that by this new BVM fixation method on the face of the patients in the lateral position CPR can be a good alternative over-the-head mask fixation by a single trained rescuer. PMID:24665237

A randomized controlled trial comparing traditional training in cardiopulmonary resuscitation (CPR) to self-directed CPR learning in first year medical students: The two-person CPR study.

PubMed

Roppolo, Lynn P; Heymann, Rahm; Pepe, Paul; Wagner, James; Commons, Bradford; Miller, Ronna; Allen, Emilie; Horne, Leyla; Wainscott, Michael P; Idris, Ahamed H

2011-03-01

The primary purpose of this study was to compare two, shorter, self-directed methods of cardiopulmonary resuscitation (CPR) education for healthcare professionals (HCP) to traditional training with a focus on the trainee's ability to perform two-person CPR. First-year medical students with either no prior CPR for HCP experience or prior training greater than 5 years were randomized to complete one of three courses: 1) HeartCode BLS System, 2) BLS Anytime, or 3) Traditional training. Only data from the adult CPR skills testing station was reviewed via video recording by certified CPR instructors and the Laerdal PC Skill Reporter software program (Laerdal Medical, Stavanger, Norway). There were 180 first-year medical students who met inclusion criteria: 68 were HeartCode BLS System, 53 BLS Anytime group, and 59 traditional group Regarding two-person CPR, 57 (84%) of Heartcode BLS students and 43 (81%) of BLS Anytime students were able to initiate the switch compared to 39 (66%) of traditional course students (p = 0.04). There were no significant differences in the quality of chest compressions or ventilations between the three groups. There was a trend for a much higher CPR skills testing pass rate for the traditional course students. However, failure to "clear to analyze or shock" while using the AED was the most common reason for failure in all groups. The self-directed learning groups not only had a high level of success in initiating the "switch" to two-person CPR, but were not significantly different from students who completed traditional training. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Cardiopulmonary resuscitation (CPR)-related posterior rib fractures in neonates and infants following recommended changes in CPR techniques.

PubMed

Franke, I; Pingen, A; Schiffmann, H; Vogel, M; Vlajnic, D; Ganschow, R; Born, M

2014-07-01

Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the "two-thumbs" technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period. We included all infants with anterior-posterior chest radiographs taken after CPR. Exclusion criteria were sternotomy, osteopenia, various other bone diseases and NAT. The radiographs were independently reviewed by the Chief of Pediatric Radiology (MB) and a Senior Pediatrician, Head of the local Child Protection Team (IF). Eighty infants with 546 chest radiographs were identified, and 50 of those infants underwent CPR immediately after birth. Data concerning the length of CPR was available for 41 infants. The mean length of CPR was 11min (range: 1-180min, median: 3min). On average, there were seven radiographs per infant. A total of 39 infants had a follow-up radiograph after at least 10 days. No rib fracture was visible on any chest X-ray. The results of this study suggest rib fracture after the use of the "two-thumbs" CPR technique is uncommon. Thus, there should be careful consideration of abuse when these fractures are identified, regardless of whether CPR was performed and what technique used. The discovery of rib fractures in an infant who has undergone CPR without underlying bone disease or major trauma warrants a full child protection investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Incidence, characteristics, and survival following cardiopulmonary resuscitation in the quaternary neonatal intensive care unit

PubMed Central

Foglia, Elizabeth E.; Langeveld, Robert; Heimall, Lauren; Deveney, Alyson; Ades, Anne; Jensen, Erik A.; Nadkarni, Vinay M.

2016-01-01

Background The contemporary characteristics and outcomes of cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU) are poorly described. The objectives of this study were to determine the incidence, interventions, and outcomes of CPR in a quaternary referral NICU. Methods Retrospective observational study of infants who received chest compressions for resuscitation in the Children’s Hospital of Philadelphia NICU between April 1, 2011 and June 30, 2015. Patient, event, and survival characteristics were abstracted from the medical record and the hospital-wide resuscitation database. The primary outcome was survival to hospital discharge. Univariable and multivariable analyses were performed to identify patient and event factors associated with survival to discharge. Results There were 1.2 CPR events per 1,000 patient days. CPR was performed in 113 of 5,046 (2.2%) infants admitted to the NICU during the study period. The median duration of chest compressions was 2 minutes (interquartile range 1, 6 minutes). Adrenaline was administered in 34 (30%) CPR events. Of 113 infants with at least one CPR event, 69 (61%) survived to hospital discharge. Factors independently associated with decreased survival to hospital discharge were inotrope treatment prior to CPR (adjusted Odds Ratio [aOR] 0.14, 95% Confidence Interval [CI] 0.04, 0.54), and adrenaline administration during CPR (aOR 0.14, 95% CI 0.04, 0.50). Conclusions Although it was not uncommon, the incidence of CPR was low (<3%) among infants hospitalized in a quaternary referral NICU. Infants receiving inotropic therapy prior to CPR and adrenaline administration during CPR were less likely to survive to hospital discharge. PMID:27984153

Haemodynamic effects of adrenaline (epinephrine) depend on chest compression quality during cardiopulmonary resuscitation in pigs.

PubMed

Pytte, Morten; Kramer-Johansen, Jo; Eilevstjønn, Joar; Eriksen, Morten; Strømme, Taevje A; Godang, Kristin; Wik, Lars; Steen, Petter Andreas; Sunde, Kjetil

2006-12-01

Adrenaline (epinephrine) is used during cardiopulmonary resuscitation (CPR) based on animal experiments without supportive clinical data. Clinically CPR was reported recently to have much poorer quality than expected from international guidelines and what is generally done in laboratory experiments. We have studied the haemodynamic effects of adrenaline during CPR with good laboratory quality and with quality simulating clinical findings and the feasibility of monitoring these effects through VF waveform analysis. After 4 min of cardiac arrest, followed by 4 min of basic life support, 14 pigs were randomised to ClinicalCPR (intermittent manual chest compressions, compression-to-ventilation ratio 15:2, compression depth 30-38 mm) or LabCPR (continuous mechanical chest compressions, 12 ventilations/min, compression depth 45 mm). Adrenaline 0.02 mg/kg was administered 30 s thereafter. Plasma adrenaline concentration peaked earlier with LabCPR than with ClinicalCPR, median (range), 90 (30, 150) versus 150 (90, 270) s (p = 0.007), respectively. Coronary perfusion pressure (CPP) and cortical cerebral blood flow (CCBF) increased and femoral blood flow (FBF) decreased after adrenaline during LabCPR (mean differences (95% CI) CPP 17 (6, 29) mmHg (p = 0.01), FBF -5.0 (-8.8, -1.2) ml min(-1) (p = 0.02) and median difference CCBF 12% of baseline (p = 0.04)). There were no significant effects during ClinicalCPR (mean differences (95% CI) CPP 4.7 (-3.2, 13) mmHg (p = 0.2), FBF -0.2 (-4.6, 4.2) ml min(-1)(p = 0.9) and CCBF 3.6 (-1.8, 9.0)% of baseline (p = 0.15)). Slope VF waveform analysis reflected changes in CPP. Adrenaline improved haemodynamics during laboratory quality CPR in pigs, but not with quality simulating clinically reported CPR performance.

A Randomized Controlled Trial of Compression Rates during Cardiopulmonary Resuscitation

PubMed Central

2016-01-01

The objective of this study was to compare the efficacy of cardiopulmonary resuscitation (CPR) with 120 compressions per minute (CPM) to CPR with 100 CPM in patients with non-traumatic out-of-hospital cardiac arrest. We randomly assigned patients with non-traumatic out-of-hospital cardiac arrest into two groups upon arrival to the emergency department (ED). The patients received manual CPR either with 100 CPM (CPR-100 group) or 120 CPM (CPR-120 group). The primary outcome measure was sustained restoration of spontaneous circulation (ROSC). The secondary outcome measures were survival discharge from the hospital, one-month survival, and one-month survival with good functional status. Of 470 patients with cardiac arrest, 136 patients in the CPR-100 group and 156 patients in the CPR-120 group were included in the final analysis. A total of 69 patients (50.7%) in the CPR-100 group and 67 patients (42.9%) in the CPR-120 group had ROSC (absolute difference, 7.8% points; 95% confidence interval [CI], -3.7 to 19.2%; P = 0.183). The rates of survival discharge from the hospital, one-month survival, and one-month survival with good functional status were not different between the two groups (16.9% vs. 12.8%, P = 0.325; 12.5% vs. 6.4%, P = 0.073; 5.9% vs. 2.6%, P = 0.154, respectively). We did not find differences in the resuscitation outcomes between those who received CPR with 100 CPM and those with 120 CPM. However, a large trial is warranted, with adequate power to confirm a statistically non-significant trend toward superiority of CPR with 100 CPM. (Clinical Trial Registration Information: www.cris.nih.go.kr, cris.nih.go.kr number, KCT0000231) PMID:27510396

Generation of a mouse model with a reversible hypomorphic cytochrome P450 reductase gene: utility for tissue-specific rescue of the reductase expression, and insights from a resultant mouse model with global suppression of P450 reductase expression in extrahepatic tissues.

PubMed

Wei, Yuan; Zhou, Xin; Fang, Cheng; Li, Lei; Kluetzman, Kerri; Yang, Weizhu; Zhang, Qing-Yu; Ding, Xinxin

2010-07-01

A mouse model termed Cpr-low (CL) was recently generated, in which the expression of the cytochrome P450 reductase (Cpr) gene was globally down-regulated. The decreased CPR expression was accompanied by phenotypical changes, including reduced embryonic survival, decreases in circulating cholesterol, increases in hepatic P450 expression, and female infertility (accompanied by elevated serum testosterone and progesterone levels). In the present study, a complementary mouse model [named reversible-CL (r-CL)] was generated, in which the reduced CPR expression can be reversed in an organ-specific fashion. The neo cassette, which was inserted into the last Cpr intron in r-CL mice, can be deleted by Cre recombinase, thus returning the structure of the Cpr gene (and hence CPR expression) to normal in Cre-expressing cells. All previously identified phenotypes of the CL mice were preserved in the r-CL mice. As a first application of the r-CL model, we have generated an extrahepatic-CL (xh-CL) mouse for testing of the functions of CPR-dependent enzymes in all extrahepatic tissues. The xh-CL mice, generated by mating of r-CL mice with albumin-Cre mice, had normal CPR expression in hepatocytes but down-regulated CPR expression elsewhere. They were indistinguishable from wild-type mice in body and liver weights, circulating cholesterol levels, and hepatic microsomal P450 expression and activities; however, they still showed elevated serum testosterone and progesterone levels and sterility in females. Embryonic lethality was prevented in males, but apparently not in females, indicating a critical role for fetal hepatic CPR-dependent enzymes in embryonic development, at least in males.

The Effect of Head Up Cardiopulmonary Resuscitation on Cerebral and Systemic Hemodynamics.

PubMed

Ryu, Hyun Ho; Moore, Johanna C; Yannopoulos, Demetris; Lick, Michael; McKnite, Scott; Shin, Sang Do; Kim, Tae Yun; Metzger, Anja; Rees, Jennifer; Tsangaris, Adamantios; Debaty, Guillaume; Lurie, Keith G

2016-05-01

Chest compressions during cardiopulmonary resuscitation (CPR) increase arterial and venous pressures, delivering simultaneous bidirectional high-pressure compression waves to the brain. We hypothesized that this may be detrimental and could be partially overcome by elevation of the head during CPR. Female Yorkshire farm pigs (n=30) were sedated, intubated, anesthetized, and placed on a table able to elevate the head 30° (15cm) (HUP) and the heart 10° (4cm) or remain in the supine (SUP) flat position during CPR. After 8minutes of untreated ventricular fibrillation and 2minutes of SUP CPR, pigs were randomized to HUP or SUP CPR for 20 more minutes. In Group A, pigs were randomized after 2minutes of flat automated conventional (C) CPR to HUP (n=7) or SUP (n=7) C-CPR. In Group B, pigs were randomized after 2minutes of automated active compression decompression (ACD) CPR plus an impedance threshold device (ITD) SUP CPR to either HUP (n=8) or SUP (n=8). The primary outcome of the study was difference in CerPP (mmHg) between the HUP and SUP positions within groups. After 22minutes of CPR, CerPP was 6±3mmHg in the HUP versus -5±3 in the SUP (p=0.016) in Group A, and 51±8 versus 20±5 (p=0.006) in Group B. Coronary perfusion pressures after 22minutes were HUP 6±2 vs SUP 3±2 (p=0.283) in Group A and HUP 32±5 vs SUP 19±5, (p=0.074) in Group B. In Group B, 6/8 pigs were resuscitated in both positions. No pigs were resuscitated in Group A. The HUP position in both C-CPR and ACD+ITD CPR significantly improved CerPP. This simple maneuver has the potential to improve neurological outcomes after cardiac arrest. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study

PubMed Central

Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Braut, Geir Sverre; Søreide, Eldar

2016-01-01

Objective Cardiopulmonary resuscitation (CPR) provided by community citizens is of paramount importance for out-of-hospital cardiac arrest (OHCA) victims' survival. Fortunately, CPR rates by community citizens seem to be rising. However, the experience of providing CPR is rarely investigated. The aim of this study was to explore reactions and coping strategies in lay rescuers who have provided CPR to OHCA victims. Methods, participants This is a qualitative study of 20 lay rescuers who have provided CPR to 18 OHCA victims. We used a semistructured interview guide focusing on their experiences after providing CPR. Setting The study was conducted in the Stavanger region of Norway, an area with very high bystander CPR rates. Results Three themes emerged from the interview analysis: concern, uncertainty and coping strategies. Providing CPR had been emotionally challenging for all lay rescuers and, for some, had consequences in terms of family and work life. Several lay rescuers experienced persistent mental recurrences of the OHCA incident and had concerns about the outcome for the cardiac arrest victim. Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle. Several reported the need to be acknowledged for their CPR attempts. Health-educated lay rescuers seemed to be less affected than others. A common coping strategy was confiding in close relations, preferably the health educated. However, some required professional help to cope with the OHCA incident. Conclusions Lay rescuers experience emotional and social challenges, and some struggle to cope in life after providing CPR in OHCA incidents. Experiencing a positive patient outcome and being a health-educated lay rescuer seem to mitigate concerns. Common coping strategies are attempts to reduce uncertainty towards patient outcome and own CPR quality. Further studies are needed to determine whether an organised professional follow-up can mitigate the concerns and uncertainty of lay rescuers. PMID:27225648

Metronome Use for Coordination of Breaths and Cardiac Compressions Delivered by Minimally-Trained Caregivers During Two-Person CPR

NASA Technical Reports Server (NTRS)

Hurst, Victor, IV; West, Sarah; Austin, Paul; Branson, Richard; Beck, George

2005-01-01

Astronaut crew medical officers (CMO) aboard the International Space Station (ISS) receive 40 hours of medical training over 18 months before each mission, including two-person cardiopulmonary resuscitation (2CPR) as recommended by the American Heart Association (AHA). Recent studies have concluded that the use of metronomic tones improves the coordination of 2CPR by trained clinicians. 2CPR performance data for minimally-trained caregivers has been limited. The goal of this study was to determine whether use of a metronome by minimally-trained caregivers (CMO analogues) would improve 2CPR performance. 20 pairs of minimally-trained caregivers certified in 2CPR via AHA guidelines performed 2CPR for 4 minutes on an instrumented manikin using 3 interventions: 1) Standard 2CPR without a metronome [NONE], 2) Standard 2CPR plus a metronome for coordinating compression rate only [MET], 3) Standard 2CPR plus a metronome for coordinating both the compression rate and ventilation rate [BOTH]. Caregivers were evaluated for their ability to meet the AHA guideline of 32 breaths-240 compressions in 4 minutes. All (100%) caregivers using the BOTH intervention provided the required number of ventilation breaths as compared with the NONE caregivers (10%) and MET caregivers (0%). For compressions, 97.5% of the BOTH caregivers were not successful in meeting the AHA compression guideline; however, an average of 238 compressions of the desired 240 were completed. None of the caregivers were successful in meeting the compression guideline using the NONE and MET interventions. This study demonstrates that use of metronomic tones by minimally-trained caregivers for coordinating both compressions and breaths improves 2CPR performance. Meeting the breath guideline is important to minimize air entering the stomach, thus decreasing the likelihood of gastric aspiration. These results suggest that manifesting a metronome for the ISS may augment the performance of 2CPR on orbit and thus may increase the level of care.

Bystander Cardiopulmonary Resuscitation Is Clustered and Associated With Neighborhood Socioeconomic Characteristics: A Geospatial Analysis of Kent County, Michigan.

PubMed

Uber, Amy; Sadler, Richard C; Chassee, Todd; Reynolds, Joshua C

2017-08-01

Geographic clustering of bystander cardiopulmonary resuscitation (CPR) is associated with demographic and socioeconomic features of the community where out-of-hospital cardiac arrest (OHCA) occurred, although this association remains largely untested in rural areas. With a significant rural component and relative racial homogeneity, Kent County, Michigan, provides a unique setting to externally validate or identify new community features associated with bystander CPR. Using a large, countywide data set, we tested for geographic clustering of bystander CPR and its associations with community socioeconomic features. Secondary analysis of adult OHCA subjects (2010-2015) in the Cardiac Arrest Registry to Enhance Survival (CARES) data set for Kent County, Michigan. After linking geocoded OHCA cases to U.S. census data, we used Moran's I-test to assess for spatial autocorrelation of population-weighted cardiac arrest rate by census block group. Getis-Ord Gi statistic assessed for spatial clustering of bystander CPR and mixed-effects hierarchical logistic regression estimated adjusted associations between community features and bystander CPR. Of 1,592 subjects, 1,465 met inclusion criteria. Geospatial analysis revealed significant clustering of OHCA in more populated/urban areas. Conversely, bystander CPR was less likely in these areas (99% confidence) and more likely in suburban and rural areas (99% confidence). Adjusting for clinical, demographic, and socioeconomic covariates, bystander CPR was associated with public location (odds ratio [OR] = 1.19; 95% confidence interval [CI] = 1.03-1.39), initially shockable rhythms (OR = 1.48; 95% CI = 1.12-1.96), and those in urban neighborhoods (OR = 0.54; 95% CI = 0.38-0.77). Out-of-hospital cardiac arrest and bystander CPR are geographically clustered in Kent County, Michigan, but bystander CPR is inversely associated with urban designation. These results offer new insight into bystander CPR patterns in mixed urban and rural regions and afford the opportunity for targeted community CPR education in areas of low bystander CPR prevalence. © 2017 by the Society for Academic Emergency Medicine.

Knowledge and willingness to teach cardiopulmonary resuscitation: a survey amongst 4273 teachers.

PubMed

Mpotos, Nicolas; Vekeman, Eva; Monsieurs, Koenraad; Derese, Anselm; Valcke, Martin

2013-04-01

Schoolteachers are expected to play a role in teaching cardiopulmonary resuscitation (CPR) to schoolchildren, but little is known about their attitudes, actual knowledge and willingness to do so. We conducted a survey about CPR knowledge, preparedness to perform and teach CPR as well as attitude towards an alternative self-learning strategy amongst Flemish teachers. A questionnaire was developed consisting of four distinct parts: (1) Demographics; (2) CPR knowledge and skills level; (3) Attitude towards training and (4) Resuscitation experience. Content experts screened the questionnaire in view of content validity. One hundred and seventy-one students in Educational Sciences were each asked to interview 25 different teachers. A total of 4273 teachers participated in the study (primary school n=856; secondary school n=2562; higher education n=855). Of all respondents, 59% (2539/4273) had received previous CPR training with the highest proportion observed in primary schoolteachers (69%) and in the age group 21-30 years (68%). Mandatory CPR training at school was supported by 41% (1751/4273) of the teachers and only 36% was aware that CPR is now formally included in the secondary education curriculum. Sixty-one percent (2621/4273) did not feel capable and was not willing to teach CPR, mainly because of a perceived lack of knowledge in 50% (2151/2621). In addition 69% (2927/4273) felt incompetent to perform correct CPR and 73% (3137/4273) wished more training. Feeling incompetent and not willing to teach was related to the absence of previous training. Primary schoolteachers and the age group 21-30 years were most willing to teach CPR. Although many teachers mentioned previous CPR training, only a minority of mostly young and primary schoolteachers felt competent in CPR and was willing to teach it to their students. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Randomized Controlled Trial of a Video Decision Support Tool for Cardiopulmonary Resuscitation Decision Making in Advanced Cancer

PubMed Central

Volandes, Angelo E.; Paasche-Orlow, Michael K.; Mitchell, Susan L.; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J.; Hartshorn, Kevan L.; Jackson, Vicki Ann; Gillick, Muriel R.; Walker-Corkery, Elizabeth S.; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D.; Eichler, April F.; Epstein, Andrew S.; Noy, Ariela; Levin, Tomer T.; Temel, Jennifer S.

2013-01-01

Purpose Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. Patients and Methods We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. Results The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P < .001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v 2.6 ± 1.3, respectively; P < .001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Conclusion Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative. PMID:23233708

Early Effects of Prolonged Cardiac Arrest and Ischemic Postconditioning during Cardiopulmonary Resuscitation on Cardiac and Brain Mitochondrial Function in Pigs.

PubMed

Matsuura, Timothy R; Bartos, Jason A; Tsangaris, Adamantios; Shekar, Kadambari Chandra; Olson, Matthew D; Riess, Matthias L; Bienengraeber, Martin; Aufderheide, Tom P; Neumar, Robert W; Rees, Jennifer N; McKnite, Scott H; Dikalova, Anna E; Dikalov, Sergey I; Douglas, Hunter F; Yannopoulos, Demetris

2017-07-01

Out-of-hospital cardiac arrest (CA) is a prevalent medical crisis resulting in severe injury to the heart and brain and an overall survival of less than 10%. Mitochondrial dysfunction is predicted to be a key determinant of poor outcomes following prolonged CA. However, the onset and severity of mitochondrial dysfunction during CA and cardiopulmonary resuscitation (CPR) is not fully understood. Ischemic postconditioning (IPC), controlled pauses during the initiation of CPR, has been shown to improve cardiac function and neurologically favorable outcomes after 15min of CA. We tested the hypothesis that mitochondrial dysfunction develops during prolonged CA and can be rescued with IPC during CPR (IPC-CPR). A total of 63 swine were randomized to no ischemia (Naïve), 19min of ventricular fibrillation (VF) CA without CPR (Untreated VF), or 15min of CA with 4min of reperfusion with either standard CPR (S-CPR) or IPC-CPR. Mitochondria were isolated from the heart and brain to quantify respiration, rate of ATP synthesis, and calcium retention capacity (CRC). Reactive oxygen species (ROS) production was quantified from fresh frozen heart and brain tissue. Compared to Naïve, Untreated VF induced cardiac and brain ROS overproduction concurrent with decreased mitochondrial respiratory coupling and CRC, as well as decreased cardiac ATP synthesis. Compared to Untreated VF, S-CPR attenuated brain ROS overproduction but had no other effect on mitochondrial function in the heart or brain. Compared to Untreated VF, IPC-CPR improved cardiac mitochondrial respiratory coupling and rate of ATP synthesis, and decreased ROS overproduction in the heart and brain. Fifteen minutes of VF CA results in diminished mitochondrial respiration, ATP synthesis, CRC, and increased ROS production in the heart and brain. IPC-CPR attenuates cardiac mitochondrial dysfunction caused by prolonged VF CA after only 4min of reperfusion, suggesting that IPC-CPR is an effective intervention to reduce cardiac injury. However, reperfusion with both CPR methods had limited effect on mitochondrial function in the brain, emphasizing an important physiological divergence in post-arrest recovery between those two vital organs. Copyright © 2017 Elsevier B.V. All rights reserved.

Brief compression-only cardiopulmonary resuscitation training video and simulation with homemade mannequin improves CPR skills.

PubMed

Wanner, Gregory K; Osborne, Arayel; Greene, Charlotte H

2016-11-29

Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt). Participants viewed the training video and practiced with the homemade mannequin. This was a parallel-design study with pre and post training evaluations of CPR skills (compression rate, depth, hand position, release), and hands-off time (time without compressions). CPR skills were evaluated using a sensor-equipped mannequin and two blinded CPR experts observed testing of participants. Twenty-four participants were included: 12 never-trained and 12 currently certified in CPR. Comparing pre and post training, the never-trained group had improvements in average compression rate per minute (64.3 to 103.9, p = 0.006), compressions with correct hand position in 1 min (8.3 to 54.3, p = 0.002), and correct compression release in 1 min (21.2 to 76.3, p < 0.001). The CPR-certified group had adequate pre and post-test compression rates (>100/min), but an improved number of compressions with correct release (53.5 to 94.7, p < 0.001). Both groups had significantly reduced hands-off time after training. Achieving adequate compression depths (>50 mm) remained problematic in both groups. Comparisons made between groups indicated significant improvements in compression depth, hand position, and hands-off time in never-trained compared to CPR-certified participants. Inter-rater agreement values were also calculated between the CPR experts and sensor-equipped mannequin. A brief internet-based video coupled with skill practice on a homemade mannequin improved compression-only CPR skills, especially in the previously untrained participants. This training method allows for widespread compression-only CPR training with a tactile learning component, without fees or advance preparation.

Decarbonylated cyclophilin A Cpr1 protein protects Saccharomyces cerevisiae KNU5377Y when exposed to stress induced by menadione.

PubMed

Kim, Il-Sup; Jin, Ingnyol; Yoon, Ho-Sung

2011-01-01

Cyclophilins are conserved cis-trans peptidyl-prolyl isomerase that are implicated in protein folding and function as molecular chaperones. The accumulation of Cpr1 protein to menadione in Saccharomyces cerevisiae KNU5377Y suggests a possibility that this protein may participate in the mechanism of stress tolerance. Stress response of S. cerevisiae KNU5377Y cpr1Δ mutant strain was investigated in the presence of menadione (MD). The growth ability of the strain was confirmed in an oxidant-supplemented medium, and a relationship was established between diminishing levels of cell rescue enzymes and MD sensitivity. The results demonstrate the significant effect of CPR1 disruption in the cellular growth rate, cell viability and morphology, and redox state in the presence of MD and suggest the possible role of Cpr1p in acquiring sensitivity to MD and its physiological role in cellular stress tolerance. The in vivo importance of Cpr1p for antioxidant-mediated reactive oxygen species (ROS) neutralization and chaperone-mediated protein folding was confirmed by analyzing the expression changes of a variety of cell rescue proteins in a CPR1-disrupted strain. The cpr1Δ to the exogenous MD showed reduced expression level of antioxidant enzymes, molecular chaperones, and metabolic enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH)- or adenosine triphosphate (ATP)-generating systems. More importantly, it was shown that cpr1Δ mutant caused imbalance in the cellular redox homeostasis and increased ROS levels in the cytosol as well as mitochondria and elevated iron concentrations. As a result of excess ROS production, the cpr1Δ mutant provoked an increase in oxidative damage and a reduction in antioxidant activity and free radical scavenger ability. However, there was no difference in the stress responses between the wild-type and the cpr1Δ mutant strains derived from S. cerevisiae BY4741 as a control strain under the same stress. Unlike BY4741, KNU5377Y Cpr1 protein was decarbonylated during MD stress. Decarbonylation of Cpr1 protein in KNU5377Y strain seems to be caused by a rapid and efficient gene expression program via stress response factors Hsf1, Yap1, and Msn2. Hence, the decarbonylated Cpr1 protein may be critical in cellular redox homeostasis and may be a potential chaperone to menadione.

Radar research at University of Oklahoma (Conference Presentation)

NASA Astrophysics Data System (ADS)

Zhang, Yan R.; Weber, Mark E.

2017-05-01

This abstract is for the academic institution profiles session This presentation will focus on radar research programs at the University of Oklahoma, the radar research in OU has more than 50 years history of collaboration with NOAA, and has been through tremendous growth since early 2000. Before 2010, the focus was weather radar and weather surveillance, and since the Defense, Security and Intelligence (DSI) initiative in 2011, there have many new efforts on the defense and military radar applications. This presentation will focus on the following information: (1) The history, facilities and instrumentations of Advanced Radar Research Center, (2) Focus area of polarimetric phased array systems, (3) Focus area of airborne and spaceborne radars, (4) Intelligent radar information processing, (5) Innovative antenna and components.

N(h) profile data at World Data Centers

NASA Technical Reports Server (NTRS)

Allen, J. H.; Conkright, R.; Bilitza, D.; Feldstein, A. IA.; Willis, D. M.

1990-01-01

The data base for ionospheric electron density profiles at the World Data Centers is assessed. Past and future N(h) profiling from ionograms and profiles from incoherent scatter radar measurements are considered.

Middle Atmosphere Program. Handbook for MAP, volume 28

NASA Technical Reports Server (NTRS)

Liu, C. H. (Editor); Edwards, Belva (Editor)

1989-01-01

Extended abstracts from the fourth workshop on the technical and scientific aspects of MST (mesosphere stratosphere troposphere) radar are presented. Individual sessions addressed the following topics: meteorological applications of MST and ST radars, networks, and campaigns; dynamics of the equatorial middle atmosphere; interpretation of radar returns from clear air; techniques for studying gravity waves and turbulence; intercomparison and calibration of wind and wave measurements at various frequencies; progress in existing and planned MST and ST radars; hardware design for MST and ST radars and boundary layer/lower troposphere profilers; signal processing; and data management.

CPR: Key to Cardiac Consciousness?

ERIC Educational Resources Information Center

Hyner, Gerald C.; Box, Colin E.

1980-01-01

Recommendations are made for improving certification standards for programs providing training in cardiopulmonary resuscitation (CPR). Training techniques, cost effectiveness, and teachers for CPR programs are discussed. (JD)

Non-Cooperative Target Recognition by Means of Singular Value Decomposition Applied to Radar High Resolution Range Profiles †

PubMed Central

López-Rodríguez, Patricia; Escot-Bocanegra, David; Fernández-Recio, Raúl; Bravo, Ignacio

2015-01-01

Radar high resolution range profiles are widely used among the target recognition community for the detection and identification of flying targets. In this paper, singular value decomposition is applied to extract the relevant information and to model each aircraft as a subspace. The identification algorithm is based on angle between subspaces and takes place in a transformed domain. In order to have a wide database of radar signatures and evaluate the performance, simulated range profiles are used as the recognition database while the test samples comprise data of actual range profiles collected in a measurement campaign. Thanks to the modeling of aircraft as subspaces only the valuable information of each target is used in the recognition process. Thus, one of the main advantages of using singular value decomposition, is that it helps to overcome the notable dissimilarities found in the shape and signal-to-noise ratio between actual and simulated profiles due to their difference in nature. Despite these differences, the recognition rates obtained with the algorithm are quite promising. PMID:25551484

Altitude profiles of temperature from 4 to 80 km over the tropics from MST radar and lidar

NASA Astrophysics Data System (ADS)

Parameswaran, K.; Sasi, M. N.; Ramkumar, G.; Nair, P. R.; Deepa, V.; Murthy, B. V. K.; Nayar, S. R. P.; Revathy, K.; Mrudula, G.; Satheesan, K.; Bhavanikumar, Y.; Sivakumar, V.; Raghunath, K.; Rajendraprasad, T.; Krishnaiah, M.

2000-10-01

Using ground-based techniques of MST radar and Lidar, temperature profiles in the entire height range of 4 to 75km are obtained for the first time at a tropical location. The temporal resolution of the profiles is ~1h in the lower altitudes and 12.5min in the higher altitudes and altitude resolution is ~300m. The errors involved in the derived values are presented. Preliminary analysis of temperature variations in a night revealed fluctuations with characteristics resembling those of large-scale gravity waves.

Translation compensation and micro-Doppler extraction for precession ballistic targets with a wideband terahertz radar

NASA Astrophysics Data System (ADS)

Yang, Qi; Deng, Bin; Wang, Hongqiang; Zhang, Ye; Qin, Yuliang

2018-01-01

Imaging, classification, and recognition techniques of ballistic targets in midcourse have always been the focus of research in the radar field for military applications. However, the high velocity translation of ballistic targets will subject range profile and Doppler to translation, slope, and fold, which are especially severe in the terahertz region. Therefore, a two-step translation compensation method based on envelope alignment is presented. The rough compensation is based on the traditional envelope alignment algorithm in inverse synthetic aperture radar imaging, and the fine compensation is supported by distance fitting. Then, a wideband imaging radar system with a carrier frequency of 0.32 THz is introduced, and an experiment on a precession missile model is carried out. After translation compensation with the method proposed in this paper, the range profile and the micro-Doppler distributions unaffected by translation are obtained, providing an important foundation for the high-resolution imaging and micro-Doppler extraction of the terahertz radar.

Measuring flood discharge in unstable stream channels using ground-penetrating radar

USGS Publications Warehouse

Spicer, K.R.; Costa, J.E.; Placzek, G.

1997-01-01

Field experiments were conducted to test the ability of ground-penetrating radar (GPR) to measure stream-channel cross sections at high flows without the necessity of placing instruments in the water. Experiments were conducted at four U.S. Geological Survey gaging stations in southwest Washington State. With the GPR antenna suspended above the water surface from a bridge or cableway, traverses were made across stream channels to collect radar profile plots of the streambed. Subsequent measurements of water depth were made using conventional depth-measuring equipment (weight and tape) and were used to calculate radar signal velocities. Other streamflow-parameter data were collected to examine their relation to radar signal velocity and to claritv of streambed definition. These initial tests indicate that GPR is capable of producing a reasonably accurate (??20%) stream-channel profile and discharge far more quickly than conventional stream-gaging procedures, while avoiding the problems and hazards associated with placing instruments in the water.

Eliminating the Lost Time Interval of Law Enforcement to Active Shooter Events in Schools

DTIC Science & Technology

2015-09-01

Bureau of Justice Assistance BJS Bureau of Justice Statistics BPD Blacksburg Police Department CPR cardiopulmonary resuscitation CSP...Big Brother and Big Sisters,11 and the Strengthening Families program.12 The Bureau of Justice Statistics (BJS) released the Indicators of School...result in school transfers or discipline were found to increase delinquency , dropout rate, and increased violence.44 Profiling students in an attempt

The investigation of improved SHARAD profiles over Martian lobate debris aprons

NASA Astrophysics Data System (ADS)

Kim, J.; Baik, H. S.

2016-12-01

The Shallow Subsurface Radar (SHARAD), a radar sounding radar on the Mars Reconnaissance Orbiter has produced high valuable information concerning subsurface of Mars. It has been successfully used to observe complicate substructures of Mars such as polar deposit, pedestal crater and the other geomorphic features involving possible subsurface ice body. In this study, we summarized all SHARAD profiles over Martian Lobate debris aprons (LDAs) where significant arguments about their origins are undergoing. To make clear result, we used radon transformation for noise filtering. Also, we tried the clutter simulation on our target's Digital elevation model(DEM) produced by High Resolution Stereo Camera(HRSC) of Mars Express; As the comparison results between noise-removed SHARAD profile and clutter simulation, layers were able to be more clearly identified at many LDAs. We integrated our SHARAD profiles over all mid latitude LDAs into GIS. These will be demonstrated together with several radargram structures. However, it appeared the discontinuities over SHARAD profile result is not sufficient to be a clue of its origin. Thus the intensive interpretations employing thermal inertia, high resolution topographic profile with CTX and HiRISE stereo DTM altogether will be further conducted.

Optimal design of reflectometer density profile measurements using a radar systems approach (invited) (abstract)

NASA Astrophysics Data System (ADS)

Doyle, E. J.; Kim, K. W.; Peebles, W. A.; Rhodes, T. L.

1997-01-01

Reflectometry is an attractive and versatile diagnostic technique that can address a wide range of measurement needs on fusion devices. However, progress in the area of profile measurement has been hampered by the lack of a well-understood basis for the optimum design and implementation of such systems. Such a design basis is provided by the realization that reflectometer systems utilized for density profile measurements are in fact specialized forms of radar systems. In this article five criteria are introduced by which reflectometer systems can be systematically designed for optimal performance: range resolution, spatial sampling, turbulence immunity, bandwidth optimization, and the need for adaptive data processing. Many of these criteria are familiar from radar systems analysis, and are applicable to reflectometry after allowance is made for differences stemming from the nature of the plasma target. These criteria are utilized to critically evaluate current reflectometer density profile techniques and indicate improvements that can impact current and next step devices, such as ITER.

A statistical model to estimate refractivity turbulence structure constant C sub n sup 2 in the free atmosphere

NASA Technical Reports Server (NTRS)

Warnock, J. M.; Vanzandt, T. E.

1986-01-01

A computer program has been tested and documented (Warnock and VanZandt, 1985) that estimates mean values of the refractivity turbulence structure constant in the stable free atmosphere from standard National Weather Service balloon data or an equivalent data set. The program is based on the statistical model for the occurrence of turbulence developed by VanZandt et al. (1981). Height profiles of the estimated refractivity turbulence structure constant agree well with profiles measured by the Sunset radar with a height resolution of about 1 km. The program also estimates the energy dissipation rate (epsilon), but because of the lack of suitable observations of epsilon, the model for epsilon has not yet been evaluated sufficiently to be used in routine applications. Vertical profiles of the refractivity turbulence structure constant were compared with profiles measured by both radar and optical remote sensors and good agreement was found. However, at times the scintillometer measurements were less than both the radar and model values.

Remote Sensing of Precipitation from Airborne and Spaceborne Radar. Chapter 13

NASA Technical Reports Server (NTRS)

Munchak, S. Joseph

2017-01-01

Weather radar measurements from airborne or satellite platforms can be an effective remote sensing tool for examining the three-dimensional structures of clouds and precipitation. This chapter describes some fundamental properties of radar measurements and their dependence on the particle size distribution (PSD) and radar frequency. The inverse problem of solving for the vertical profile of PSD from a profile of measured reflectivity is stated as an optimal estimation problem for single- and multi-frequency measurements. Phenomena that can change the measured reflectivity Z(sub m) from its intrinsic value Z(sub e), namely attenuation, non-uniform beam filling, and multiple scattering, are described and mitigation of these effects in the context of the optimal estimation framework is discussed. Finally, some techniques involving the use of passive microwave measurements to further constrain the retrieval of the PSD are presented.

Delayed return of spontaneous circulation (the Lazarus phenomenon) after cessation of out-of-hospital cardiopulmonary resuscitation.

PubMed

Kuisma, Markku; Salo, Ari; Puolakka, Jyrki; Nurmi, Jouni; Kirves, Hetti; Väyrynen, Taneli; Boyd, James

2017-09-01

The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016. All out-of-hospital CPR attempts were carefully monitored for 10min after the cessation of CPR in order to detect delayed ROSC. Altogether, 2102 out-of-hospital cardiac arrests occurred during the six-year study period. CPR was attempted in 1376 (65.5%) cases. In 840 cases (61.0% of all attempts) CPR attempts were terminated on site. The Lazarus phenomenon occurred five times, with an incidence of 5.95/1000 (95% CI 2.10-14.30) in field-terminated CPR attempts. Time to delayed ROSC from the cessation of CPR varied from 3 to 8min. Three of the five patients with delayed ROSC died at the scene within 2-15min while two died later in hospital within 1.5 and 26h, respectively. We observed that the Lazarus phenomenon is a real albeit rare event and can occur a few minutes after the cessation of out-of-hospital CPR. We suggest a 10-min monitoring period before diagnosing death. CPR guidelines should be updated to include information of the Lazarus phenomenon and appropriate monitoring for it. Copyright © 2017 Elsevier B.V. All rights reserved.

"Stayin' alive": a novel mental metronome to maintain compression rates in simulated cardiac arrests.

PubMed

Hafner, John W; Sturgell, Jeremy L; Matlock, David L; Bockewitz, Elizabeth G; Barker, Lisa T

2012-11-01

A novel and yet untested memory aid has anecdotally been proposed for aiding practitioners in complying with American Heart Association (AHA) cardiopulmonary resuscitation (CPR) compression rate guidelines (at least 100 compressions per minute). This study investigates how subjects using this memory aid adhered to current CPR guidelines in the short and long term. A prospective observational study was conducted with medical providers certified in 2005 AHA guideline CPR. Subjects were randomly paired and alternated administering CPR compressions on a mannequin during a standardized cardiac arrest scenario. While performing compressions, subjects listened to a digital recording of the Bee Gees song "Stayin' Alive," and were asked to time compressions to the musical beat. After at least 5 weeks, the participants were retested without directly listening to the recorded music. Attitudinal views were gathered using a post-session questionnaire. Fifteen subjects (mean age 29.3 years, 66.7% resident physicians and 80% male) were enrolled. The mean compression rate during the primary assessment (with music) was 109.1, and during the secondary assessment (without music) the rate was 113.2. Mean CPR compression rates did not vary by training level, CPR experience, or time to secondary assessment. Subjects felt that utilizing the music improved their ability to provide CPR and they felt more confident in performing CPR. Medical providers trained to use a novel musical memory aid effectively maintained AHA guideline CPR compression rates initially and in long-term follow-up. Subjects felt that the aid improved their technical abilities and confidence in providing CPR. Copyright © 2012. Published by Elsevier Inc.

Cardiopulmonary Resuscitation Training in Schools: A Comparison of Trainee Satisfaction among Different Age Groups.

PubMed

Hori, Shingo; Suzuki, Masaru; Yamazaki, Motoyasu; Aikawa, Naoki; Yamazaki, Hajime

2016-09-25

Cardiopulmonary resuscitation (CPR) has recently been added to the school curriculum worldwide and is currently taught to students between the ages of 10 and 16 years. The effect of the age of trainees on their satisfaction with CPR training has yet been elucidated. The aim of this study was to compare the satisfaction of trainees of different ages who participated in CPR training in schools in Japan. In total, 392 primary school students (10-11 years old), 1798 junior high school students (12-13 years old), and 4162 high schools students (15-16 years old) underwent the same 3-h course of CPR training, according to the guidelines of 2000 for Emergency Cardiovascular Care and CPR. The course was evaluated by a questionnaire completed by the participants. Primary school students responded most positively to all questions, including those reflecting enjoyment and the confidence of participants to apply CPR (Jonckheere-Terpstra test: P < 0.01). Exploratory factor analysis defined three latent variables (reaction, concentration, and naïveté) based on the seven variables addressed in the questionnaire. In the causal relationships analyzed by structural equation modeling (SEM), naïveté (which is related to age) directly affected the other latent variables. The current model suggested that the students' satisfaction with CPR training was strongly related to their age. Primary school students enjoyed CPR training more and were more confident in their ability to perform CPR than junior high and high school students were. Therefore, children aged 10-11 years may be the most appropriate candidates for the introduction of CPR training in schools.

Effect of a reminder video using a mobile phone on the retention of CPR and AED skills in lay responders.

PubMed

Ahn, Ji Yun; Cho, Gyu Chong; Shon, You Dong; Park, Seung Min; Kang, Ku Hyun

2011-12-01

Skills related to cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use by lay responders decay rapidly after training, and efforts are required to maintain competence among trainees. We examined whether repeated viewing of a reminder video on a mobile phone would be an effective means of maintaining CPR and AED skills in lay responders. In a single-blind case-control study, 75 male students received training in CPR and AED use. They were allocated either to the control or to the video-reminded group, who received a memory card containing a video clip about CPR and AED use for their mobile phone, which they were repeatedly encouraged to watch by SMS text message. CPR and AED skills were assessed in scenario format by examiners immediately and 3 months after initial training. Three months after initial training, the video-reminded group showed more accurate airway opening (P<0.001), breathing check (P<0.001), first rescue breathing (P=0.004), hand positioning (P=0.004), AED electrode positioning (P<0.001), pre-shock safety check (P<0.001), defibrillation within 90s (P=0.010), and resuming CPR after defibrillation (P<0.001) than controls. They also showed significantly higher self-assessed CPR confidence scores and increased willingness to perform bystander CPR in cardiac arrest than the controls at 3 months (P<0.001, P=0.024, respectively). Repeated viewing of a reminder video clip on a mobile phone increases retention of CPR and AED skills in lay responders. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Outcome of Extremely Low Birth Weight Infants Who Received Delivery Room Cardiopulmonary Resuscitation

PubMed Central

Wyckoff, Myra H.; Salhab, Walid A.; Heyne, Roy J.; Kendrick, Douglas E.; Stoll, Barbara J.; Laptook, Abbot R.

2011-01-01

Objective To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NI) in extremely low birth weight (ELBW) infants. Study design Cohort study of infants born with birth weight (BW) 401-1000g and gestational age (GA) 23-30wks. DR-CPR was defined as chest compressions and/or drugs. Logistic regression was used to determine associations between DR-CPR and morbidities, mortality and NI at 18-24 months (Bayley II mental or psychomotor index < 70, cerebral palsy, blindness or deafness). Data are adjusted Odds Ratio (OR) with 95% confidence interval. Results Of 8685 infants, 1333(15%) received DR-CPR. DR-CPR infants had lower BW (708±141vs 764±146g, p<0.0001) and GA (25±2 vs 26±2 wks, p<0.0001). DR-CPR infants had more pneumothoraces (OR 1.28, 1.48-2.99), Grade 3-4 intraventricular hemorrhage (OR 1.47, 1.23-1.74), bronchopulmonary dysplasia (OR 1.34, 1.13-1.59), death by 12 hours (OR 3.69, 2.98-4.57) and by 120 days after birth (OR 2.22, 1.93-2.57). NI among survivors (OR 1.23, 1.02-1.49), and death or NI (OR 1.70, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score<2 survived without NI. Conclusions DR-CPR is a prognostic marker for higher mortality and NI for ELBW survivors. New DR-CPR strategies are needed for this population. PMID:21930284

Training hospital providers in basic CPR skills in Botswana: Acquisition, retention and impact of novel training techniques☆

PubMed Central

Meaney, Peter A.; Sutton, Robert M.; Tsima, Billy; Steenhoff, Andrew P.; Shilkofski, Nicole; Boulet, John R.; Davis, Amanda; Kestler, Andrew M.; Church, Kasey K.; Niles, Dana E.; Irving, Sharon Y.; Mazhani, Loeto; Nadkarni, Vinay M.

2013-01-01

Objective Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. Methods HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Results Of 214 HCP trained, 40% resuscitate ≥1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p < 0.01; adult 28% vs. 48%, p < 0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p < 0.01) and 6 months (38% vs. 67%, p < 0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p = 0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. Conclusions HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. PMID:22561463

Push hard, push fast, if you’re downtown: a citation review of urban-centrism in American and European basic life support guidelines

PubMed Central

2013-01-01

Bystander cardiopulmonary resuscitation (CPR) improves out-of-hospital cardiac arrest (OHCA) survival. In settings with prolonged ambulance response times, skilled bystanders may be even more crucial. In 2010, American Heart Association (AHA) and European Resuscitation Council (ERC) introduced compression-only CPR as an alternative to conventional bystander CPR under some circumstances. The purpose of this citation review and document analysis is to determine whether the evidentiary basis for 2010 AHA and ERC guidelines attends to settings with prolonged ambulance response times or no formal ambulance dispatch services. Primary and secondary citations referring to epidemiological research comparing adult OHCA survival based on the type of bystander CPR were included in the analysis. Details extracted from the citations included a study description and primary outcome measure, the geographic location in which the study occurred, EMS response times, the role of dispatchers, and main findings and summary statistics regarding rates of survival among patients receiving no CPR, conventional CPR or compression-only CPR. The inclusion criteria were met by 10 studies. 9 studies took place exclusively in urban settings. Ambulance dispatchers played an integral role in 7 studies. The cited studies suggest either no survival benefit or harm arising from compression-only CPR in settings with extended ambulance response times. The evidentiary basis for 2010 AHA and ERC bystander CPR guidelines does not attend to settings without rapid ambulance response times or dispatch services. Standardized bystander CPR guidelines may require adaptation or reconsideration in these settings. PMID:23601200

Identifying barriers to the provision of bystander cardiopulmonary resuscitation (CPR) in high-risk regions: a qualitative review of emergency calls.

PubMed

Case, Rosalind; Cartledge, Susie; Siedenburg, Josine; Smith, Karen; Straney, Lahn; Barger, Bill; Finn, Judith; Bray, Janet E

2018-06-01

Understanding regional variation in bystander cardiopulmonary resuscitation (CPR) is important to improving out-of-hospital cardiac arrest (OHCA) survival. In this study we aimed to identify barriers to providing bystander CPR in regions with low rates of bystander CPR and where OHCA was recognised in the emergency call. We retrospectively reviewed emergency calls for adults in regions of low bystander CPR in the Australian state of Victoria. Included calls were those where OHCA was identified during the call but no bystander CPR was given. A thematic content analysis was independently conducted by two investigators. Saturation of themes was reached after listening to 139 calls. Calls progressed to the point of compression instructions before EMS arrival in only 26 (18.7%) of cases. Three types of barriers were identified: procedural barriers (time lost due to language barriers and communication issues; telephone problems), CPR knowledge (skill deficits; perceived benefit) and personal factors (physical frailty or disability; patient position; emotional factors). A range of factors are associated with barriers to delivering bystander CPR even in the presence of dispatcher instructions -some of which are modifiable. To overcome these barriers in high-risk regions, targeted public education needs to provide information about what occurs in an emergency call, how to recognise an OHCA and to improve CPR knowledge and skills. Copyright © 2018. Published by Elsevier B.V.

Analysis of Near Simultaneous Jimsphere and AMPS High Resolution Wind Profiles

NASA Technical Reports Server (NTRS)

Adelfang, S. I.

2003-01-01

The high-resolution wind profile of the Automated Meteorological Profiling System (HRAMPS) is the proposed replacement for the Jimsphere measurement system used to support NASA Shuttle launches from the Eastern Test Range (ETR). Samples of twenty-six ETR near simultaneous Jimsphere and HRAMPS wind profiles were obtained for Shuttle program HRAMPS certification studies. Shuttle systems engineering certification is to ensure that spacecraft and launch vehicle systems performance and safety evaluations for each launch (derived from flight simulations with Jimsphere wind profile data bases) retain their validity when HRAMPS profiles are used on day-of-launch (DOL) in trajectory and loads simulations to support the commit-to-launch decision. This paper describes a statistical analysis of the near simultaneous profiles. In principle the differences between a Jimsphere profile and an HRAMPS profile should be attributed to tracking technology (radar versus GPS tracking of a Jimsphere flight element) and the method for derivation of wind vectors from the raw tracking data. In reality, it is not technically feasible to track the same Jimsphere balloon with the two systems. The aluminized Mylar surface of the standard Jimsphere flight element facilitates radar tracking, but it interferes with HRAMPS during simultaneous tracking. Suspending a radar reflector from an HRAMPS flight element (Jimsphere without aluminized coating) does not produce satisfactory Jimsphere profiles because of intermittent radar returns. Thus, differences between the Jimsphere and HRAMPS profiles are also attributed to differences in the trajectories of separate flight elements. Because of small sample size and a test period limited to one winter season, test measurements during extreme high winds aloft could not have been expected and did not occur. It is during the highest winds that the largest differences between Jimsphere and HRAMPS would occur because the distance between flight elements would be larger. Jimsphere radar tracking noise increases as a function of balloon displacement downrange. The Jimsphere data processing compensates for tracking signal/noise degradation by increasing the smoothing interval. The Jimsphere wind profile effective resolution is a function of downrange distance and altitude, whereas the effective resolution of the HRAMPS should be independent of those variables. The procedure used for editing Jimsphere spikes in Shuttle DOL profiles was not implemented for the Jimsphere profile measurements during the AMPS field tests. For this analysis a code was developed that essentially mimics DOL Jimsphere spike editing. Jimsphere profiles have somewhat more noise in the wavelength range less than 200m defined as the noise floor. No differences between Jimsphere and HRAMPS wind profile pairs have been found that would support denial of HRAMPS certification for application in Shuttle DOL applications. The reliability of the HRAMPS system, which is an important certification issue, is not addressed in this study.

The new American Heart Association cardiopulmonary resuscitation guidelines: should children and adults have to share?

PubMed

Sherman, Mindy

2007-06-01

The latest American Heart Association guidelines for pediatric cardiopulmonary resuscitation (CPR) were published in December 2005. Changes from the 2000 guidelines were directed toward simplifying CPR. Infants, children, and adults now share the same recommendation for the initial compression:ventilation ratio. This is a significant change for pediatricians trained in the importance of a respiratory etiology of pediatric cardiopulmonary arrest. The present review will focus on the rationale behind these guideline changes. The new guidelines for single rescuer CPR include a compression:ventilation ratio of 30: 2 for both adult and pediatric victims. The impetus for this recommendation is based on recent appreciation for the deleterious effects of hyperventilation as well as an attempt to increase bystander delivery of CPR. The physiologic results of hyperventilation are discussed. The new pediatric basic life support guideline changes are underscored. Research representing the spectrum of opinions on the optimal compression:ventilation ratio, including compression-only CPR, is presented. Although based primarily on adult, animal, and computational models, the new compression:ventilation ratio, recommended for both initial pediatric and adult CPR, is a reasonable recommendation. The simplified CPR guidelines released in 2005 will hopefully contribute to improved bystander delivery of CPR and improved outcome.

Controlled by Love: The Harmful Relational Consequences of Perceived Conditional Positive Regard.

PubMed

Kanat-Maymon, Yaniv; Roth, Guy; Assor, Avi; Raizer, Abira

2016-08-01

Research on conditional positive regard (CPR) has shown that this seemingly benign practice has maladaptive correlates when used by parents. However, there is no research on the correlates of this practice in romantic relationships or on the processes mediating its effects. Building on self-determination theory (Deci & Ryan, ), three studies tested the hypothesis that perceived CPR impairs relationship quality, partly because it undermines the fulfillment of the basic psychological needs for autonomy and relatedness. Study 1 (N = 125) examined perceived CPR and relationship quality across four relationship targets: mother, father, romantic partner, and best friend. Study 2, involving romantic partners (N = 142), examined whether needs fulfillment mediated the association between perceived CPR and relationship quality. Study 3, involving romantic dyads (N = 85), also included partner reports on CPR. Across the three studies, CPR was linked with poor relationship quality between relationships, between people, and between dyadic partners. Moreover, results of Study 2 and Study 3 revealed that the inverse association between perceived CPR and relationship quality was mediated by dissatisfaction of autonomy but not relatedness. Despite its seemingly benign nature, CPR is detrimental to relationship quality, partly because it thwarts the basic need for autonomy. © 2015 Wiley Periodicals, Inc.

Use of borehole radar tomography to monitor steam injection in fractured limestone

USGS Publications Warehouse

Gregoire, C.; Joesten, P.K.

2006-01-01

Borehole radar tomography was used as part of a pilot study to monitor steam-enhanced remediation of a fractured limestone contaminated with volatile organic compounds at the former Loring Air Force Base, Maine, USA. Radar tomography data were collected using 100-MHz electric-dipole antennae before and during steam injection to evaluate whether cross-hole radar methods could detect changes in medium properties resulting from the steam injection. Cross-hole levelrun profiles, in which transmitting and receiving antennae are positioned at a common depth, were made before and after the collection of each full tomography data set to check the stability of the radar instruments. Before tomographic inversion, the levelrun profiles were used to calibrate the radar tomography data to compensate for changes in traveltime and antenna power caused by instrument drift. Observed changes in cross-hole radar traveltime and attenuation before and during steam injection were small. Slowness- and attenuation-difference tomograms indicate small increases in radar slowness and attenuation at depths greater than about 22 m below the surface, consistent with increases in water temperature observed in the boreholes used for the tomography. Based on theoretical modelling results, increases in slowness and attenuation are interpreted as delineating zones where steam injection heating increased the electrical conductivity of the limestone matrix and fluid. The results of this study show the potential of cross-hole radar tomography methods to monitor the effects of steam-induced heating in fractured rock environments. ?? 2006 European Association of Geoscientists & Engineers.

Radar Thickness Measurements over the Southern Part of the Greenland Ice Sheet

NASA Technical Reports Server (NTRS)

Chuah, Teong Sek; Gogineni, Siva Prasad; Allen, Christopher; Wohletz, Brad; Wong, Y. C.; Ng, P. Y.; Ajayi, E.

1996-01-01

We performed ice thickness measurements over the southern part of the Greenland ice sheet during June and July 1993. We used an airborne coherent radar depth sounder for these measurements. The radar was operated from a NASA P-3 aircraft equipped with GPS receivers. Radar data were collected in conjunction with laser altimeter and microwave altimeter measurements of ice surface elevation. This report provides radio echograms and thickness profiles from data collected during 1993.

Basic life support and cardiopulmonary resuscitation training for pharmacy students and the community by a pharmacy student committee.

PubMed

Goddard, Kara B; Eppert, Heather D; Underwood, Elizabeth L; McLean, Katie Maxwell; Finks, Shannon W; Rogers, Kelly C

2010-08-10

To create a self-sufficient, innovative method for providing cardiopulmonary resuscitation (CPR) education within a college of pharmacy using a student-driven committee, and disseminating CPR education into the community through a service learning experience. A CPR committee comprised of doctor of pharmacy (PharmD) students at the University of Tennessee College of Pharmacy provided CPR certification to all pharmacy students. The committee developed a service learning project by providing CPR training courses in the community. Participants in the course were required to complete an evaluation form at the conclusion of each training course. The CPR committee successfully certified more than 1,950 PharmD students and 240 community members from 1996 to 2009. Evaluations completed by participants were favorable, with 99% of all respondents (n = 351) rating the training course as either "excellent" or "good" in each of the categories evaluated. A PharmD student-directed committee successfully provided CPR training to other students and community members as a service learning experience.

High School CPR/AED Training in Washington State.

PubMed

Salvatierra, Gail G; Palazzo, Steven J; Emery, Allison

2017-05-01

Describe the rates of CPR/AED training in high schools in the state of Washington after passage of legislation mandating CPR/AED training. A web-based survey was sent to administrators at 660 public and private high schools in the state of Washington. The survey was completed by 148 schools (22%); 64% reported providing CPR training and 54% provided AED training. Reported barriers to implementation included instructor availability, cost, and a lack of equipment. Descriptive statistics were used to describe the sample characteristics and implementation rates. Mandates without resources and support do not ensure implementation of CPR/AED training in high schools. Full public health benefits of a CPR mandate will not be realized until barriers to implementation are identified and eliminated through use of available, accessible public health resources. © 2016 Wiley Periodicals, Inc.

Advantages to Geoscience and Disaster Response from QuakeSim Implementation of Interferometric Radar Maps in a GIS Database System

NASA Astrophysics Data System (ADS)

Parker, Jay; Donnellan, Andrea; Glasscoe, Margaret; Fox, Geoffrey; Wang, Jun; Pierce, Marlon; Ma, Yu

2015-08-01

High-resolution maps of earth surface deformation are available in public archives for scientific interpretation, but are primarily available as bulky downloads on the internet. The NASA uninhabited aerial vehicle synthetic aperture radar (UAVSAR) archive of airborne radar interferograms delivers very high resolution images (approximately seven meter pixels) making remote handling of the files that much more pressing. Data exploration requiring data selection and exploratory analysis has been tedious. QuakeSim has implemented an archive of UAVSAR data in a web service and browser system based on GeoServer (http://geoserver.org). This supports a variety of services that supply consistent maps, raster image data and geographic information systems (GIS) objects including standard earthquake faults. Browsing the database is supported by initially displaying GIS-referenced thumbnail images of the radar displacement maps. Access is also provided to image metadata and links for full file downloads. One of the most widely used features is the QuakeSim line-of-sight profile tool, which calculates the radar-observed displacement (from an unwrapped interferogram product) along a line specified through a web browser. Displacement values along a profile are updated to a plot on the screen as the user interactively redefines the endpoints of the line and the sampling density. The profile and also a plot of the ground height are available as CSV (text) files for further examination, without any need to download the full radar file. Additional tools allow the user to select a polygon overlapping the radar displacement image, specify a downsampling rate and extract a modest sized grid of observations for display or for inversion, for example, the QuakeSim simplex inversion tool which estimates a consistent fault geometry and slip model.

High Ice Water Content at Low Radar Reflectivity near Deep Convection. Part I ; Consistency of In Situ and Remote-Sensing Observations with Stratiform Rain Column Simulations

NASA Technical Reports Server (NTRS)

Fridlind, A. M.; Ackerman, A. S.; Grandin, A.; Dezitter, F.; Weber, M.; Strapp, J. W.; Korolev, A. V.; Williams, C. R.

2015-01-01

Occurrences of jet engine power loss and damage have been associated with flight through fully glaciated deep convection at -10 to -50 degrees Centigrade. Power loss events commonly occur during flight through radar reflectivity (Zeta (sub e)) less than 20-30 decibels relative to Zeta (dBZ - radar returns) and no more than moderate turbulence, often overlying moderate to heavy rain near the surface. During 2010-2012, Airbus carried out flight tests seeking to characterize the highest ice water content (IWC) in such low-radar-reflectivity regions of large, cold-topped storm systems in the vicinity of Cayenne, Darwin, and Santiago. Within the highest IWC regions encountered, at typical sampling elevations (circa 11 kilometers), the measured ice size distributions exhibit a notably narrow concentration of mass over area-equivalent diameters of 100-500 micrometers. Given substantial and poorly quantified measurement uncertainties, here we evaluate the consistency of the Airbus in situ measurements with ground-based profiling radar observations obtained under quasi-steady, heavy stratiform rain conditions in one of the Airbus-sampled locations. We find that profiler-observed radar reflectivities and mean Doppler velocities at Airbus sampling temperatures are generally consistent with those calculated from in situ size-distribution measurements. We also find that column simulations using the in situ size distributions as an upper boundary condition are generally consistent with observed profiles of radar reflectivity (Ze), mean Doppler velocity (MDV), and retrieved rain rate. The results of these consistency checks motivate an examination of the microphysical pathways that could be responsible for the observed size-distribution features in Ackerman et al. (2015).

An effective CPR home learning system. A program evaluation.

PubMed

Starr, L M

1998-06-01

1. Program evaluation using a self instruction CPR home learning system indicated that people could learn CPR without attending a formal class. Reported training time for adult CPR averaged 1 hour, and ease of understanding was rated 4.9 on a 5 point scale. 2. Use of a home learning system can benefit a workplace by reducing reliance on a CPR instructor, reducing total training time, and exposing families and others in the community to the learning experience. 3. This program evaluation suggests that this training methodology supports the mission of AHA, and also can meet corporate objectives.

Production of a highly active, soluble form of the cytochrome P450 reductase (CPR A) from Candida tropicalis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donnelly, Mark

2006-08-01

The present invention provides soluble cytochrome p450 reductase (CPR) proteins from Candida sp. having an altered N-terminal region which results in reduced hydrophobicity of the N-terminal region. Also provided are host cells comprising the subject soluble CPR proteins. In addition, the present invention provides nucleotide and corresponding amino acid sequences for soluble CPR proteins and vectors comprising the nucleotide sequences. Methods for producing a soluble CPR, for increasing production of a dicarboxylic acid, and for detecting a cytochrome P450 are also provided.

Rates of cardiopulmonary resuscitation training in the United States.

PubMed

Anderson, Monique L; Cox, Margueritte; Al-Khatib, Sana M; Nichol, Graham; Thomas, Kevin L; Chan, Paul S; Saha-Chaudhuri, Paramita; Fosbol, Emil L; Eigel, Brian; Clendenen, Bill; Peterson, Eric D

2014-02-01

Prompt bystander cardiopulmonary resuscitation (CPR) improves the likelihood of surviving an out-of-hospital cardiac arrest. Large regional variations in survival after an out-of-hospital cardiac arrest have been noted. To determine whether regional variations in county-level rates of CPR training exist across the United States and the factors associated with low rates in US counties. We used a cross-sectional ecologic study design to analyze county-level rates of CPR training in all US counties from July 1, 2010, through June 30, 2011. We used CPR training data from the American Heart Association, the American Red Cross, and the Health & Safety Institute. Using multivariable logistic regression models, we examined the association of annual rates of adult CPR training of citizens by these 3 organizations (categorized as tertiles) with a county's geographic, population, and health care characteristics. Completion of CPR training. Rate of CPR training measured as CPR course completion cards distributed and CPR training products sold by the American Heart Association, persons trained in CPR by the American Red Cross, and product sales data from the Health & Safety Institute. RESULTS During the study period, 13.1 million persons in 3143 US counties received CPR training. Rates of county training ranged from 0.00% to less than 1.29% (median, 0.51%) in the lower tertile, 1.29% to 4.07% (median, 2.39%) in the middle tertile, and greater than 4.07% or greater (median, 6.81%) in the upper tertile. Counties with rates of CPR training in the lower tertile were more likely to have a higher proportion of rural areas (adjusted odds ratio, 1.12 [95% CI, 1.10-1.15] per 5-percentage point [PP] change), higher proportions of black (1.09 [1.06-1.13] per 5-PP change) and Hispanic (1.06 [1.02-1.11] per 5-PP change) residents, a lower median household income (1.18 [1.04-1.34] per $10 000 decrease), and a higher median age (1.28 [1.04-1.58] per 10-year change). Counties in the South, Midwest, and West were more likely to have rates of CPR training in the lower tertile compared with the Northeast (adjusted odds ratios, 7.78 [95% CI, 3.66-16.53], 5.56 [2.63-11.75], and 5.39 [2.48-11.72], respectively). Annual rates of US CPR training are low and vary widely across communities. Counties located in the South, those with higher proportions of rural areas and of black and Hispanic residents, and those with lower median household incomes have lower rates of CPR training than their counterparts. These data contribute to known geographic disparities in survival of cardiac arrest and offer opportunities for future community interventions.

CPR - infant - slideshow

MedlinePlus

... this page: //medlineplus.gov/ency/presentations/100216.htm CPR - infant - series—Check for responsiveness To use the ... yourself to call 911 until you have performed CPR for about 2 minutes. 3. Carefully place the ...

Decarbonylated cyclophilin A Cpr1 protein protects Saccharomyces cerevisiae KNU5377Y when exposed to stress induced by menadione

PubMed Central

Jin, Ingnyol; Yoon, Ho-Sung

2010-01-01

Cyclophilins are conserved cis–trans peptidyl-prolyl isomerase that are implicated in protein folding and function as molecular chaperones. The accumulation of Cpr1 protein to menadione in Saccharomyces cerevisiae KNU5377Y suggests a possibility that this protein may participate in the mechanism of stress tolerance. Stress response of S. cerevisiae KNU5377Y cpr1Δ mutant strain was investigated in the presence of menadione (MD). The growth ability of the strain was confirmed in an oxidant-supplemented medium, and a relationship was established between diminishing levels of cell rescue enzymes and MD sensitivity. The results demonstrate the significant effect of CPR1 disruption in the cellular growth rate, cell viability and morphology, and redox state in the presence of MD and suggest the possible role of Cpr1p in acquiring sensitivity to MD and its physiological role in cellular stress tolerance. The in vivo importance of Cpr1p for antioxidant-mediated reactive oxygen species (ROS) neutralization and chaperone-mediated protein folding was confirmed by analyzing the expression changes of a variety of cell rescue proteins in a CPR1-disrupted strain. The cpr1Δ to the exogenous MD showed reduced expression level of antioxidant enzymes, molecular chaperones, and metabolic enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH)- or adenosine triphosphate (ATP)-generating systems. More importantly, it was shown that cpr1Δ mutant caused imbalance in the cellular redox homeostasis and increased ROS levels in the cytosol as well as mitochondria and elevated iron concentrations. As a result of excess ROS production, the cpr1Δ mutant provoked an increase in oxidative damage and a reduction in antioxidant activity and free radical scavenger ability. However, there was no difference in the stress responses between the wild-type and the cpr1Δ mutant strains derived from S. cerevisiae BY4741 as a control strain under the same stress. Unlike BY4741, KNU5377Y Cpr1 protein was decarbonylated during MD stress. Decarbonylation of Cpr1 protein in KNU5377Y strain seems to be caused by a rapid and efficient gene expression program via stress response factors Hsf1, Yap1, and Msn2. Hence, the decarbonylated Cpr1 protein may be critical in cellular redox homeostasis and may be a potential chaperone to menadione. Electronic supplementary material The online version of this article (doi:10.1007/s12192-010-0215-9) contains supplementary material, which is available to authorized users. PMID:20680535

Quality Control of Wind Data from 50-MHz Doppler Radar Wind Profiler

NASA Technical Reports Server (NTRS)

Vacek, Austin

2016-01-01

Upper-level wind profiles obtained from a 50-MHz Doppler Radar Wind Profiler (DRWP) instrument at Kennedy Space Center are incorporated in space launch vehicle design and day-of-launch operations to assess wind effects on the vehicle during ascent. Automated and manual quality control (QC) techniques are implemented to remove spurious data in the upper-level wind profiles caused from atmospheric and non-atmospheric artifacts over the 2010-2012 period of record (POR). By adding the new quality controlled profiles with older profiles from 1997-2009, a robust database will be constructed of upper-level wind characteristics. Statistical analysis will determine the maximum, minimum, and 95th percentile of the wind components from the DRWP profiles over recent POR and compare against the older database. Additionally, this study identifies specific QC flags triggered during the QC process to understand how much data is retained and removed from the profiles.

Quality Control of Wind Data from 50-MHz Doppler Radar Wind Profiler

NASA Technical Reports Server (NTRS)

Vacek, Austin

2015-01-01

Upper-level wind profiles obtained from a 50-MHz Doppler Radar Wind Profiler (DRWP) instrument at Kennedy Space Center are incorporated in space launch vehicle design and day-of-launch operations to assess wind effects on the vehicle during ascent. Automated and manual quality control (QC) techniques are implemented to remove spurious data in the upper-level wind profiles caused from atmospheric and non-atmospheric artifacts over the 2010-2012 period of record (POR). By adding the new quality controlled profiles with older profiles from 1997-2009, a robust database will be constructed of upper-level wind characteristics. Statistical analysis will determine the maximum, minimum, and 95th percentile of the wind components from the DRWP profiles over recent POR and compare against the older database. Additionally, this study identifies specific QC flags triggered during the QC process to understand how much data is retained and removed from the profiles.

Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study.

PubMed

Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Braut, Geir Sverre; Søreide, Eldar

2016-05-25

Cardiopulmonary resuscitation (CPR) provided by community citizens is of paramount importance for out-of-hospital cardiac arrest (OHCA) victims' survival. Fortunately, CPR rates by community citizens seem to be rising. However, the experience of providing CPR is rarely investigated. The aim of this study was to explore reactions and coping strategies in lay rescuers who have provided CPR to OHCA victims. This is a qualitative study of 20 lay rescuers who have provided CPR to 18 OHCA victims. We used a semistructured interview guide focusing on their experiences after providing CPR. The study was conducted in the Stavanger region of Norway, an area with very high bystander CPR rates. Three themes emerged from the interview analysis: concern, uncertainty and coping strategies. Providing CPR had been emotionally challenging for all lay rescuers and, for some, had consequences in terms of family and work life. Several lay rescuers experienced persistent mental recurrences of the OHCA incident and had concerns about the outcome for the cardiac arrest victim. Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle. Several reported the need to be acknowledged for their CPR attempts. Health-educated lay rescuers seemed to be less affected than others. A common coping strategy was confiding in close relations, preferably the health educated. However, some required professional help to cope with the OHCA incident. Lay rescuers experience emotional and social challenges, and some struggle to cope in life after providing CPR in OHCA incidents. Experiencing a positive patient outcome and being a health-educated lay rescuer seem to mitigate concerns. Common coping strategies are attempts to reduce uncertainty towards patient outcome and own CPR quality. Further studies are needed to determine whether an organised professional follow-up can mitigate the concerns and uncertainty of lay rescuers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Quality of CPR: An important effect modifier in cardiac arrest clinical outcomes and intervention effectiveness trials.

PubMed

Yannopoulos, Demetris; Aufderheide, Tom P; Abella, Benjamin S; Duval, Sue; Frascone, Ralph J; Goodloe, Jeffrey M; Mahoney, Brian D; Nadkarni, Vinay M; Halperin, Henry R; O'Connor, Robert; Idris, Ahamed H; Becker, Lance B; Pepe, Paul E

2015-09-01

To determine if the quality of CPR had a significant interaction with the primary study intervention in the NIH PRIMED trial. The public access database from the NIH PRIMED trial was accessed to determine if there was an interaction between quality of CPR performance, intervention, and outcome (survival to hospital discharge with modified Rankin Score (mRS) ≤ 3). Multi-centered prehospital care systems across North America. Of 8719 adult patients enrolled, CPR quality was electronically recorded for compression rate, depth, and fraction in 6199 (71.1%), 3750 (43.0%) and 6204 (71.2%) subjects, respectively. "Acceptable" quality CPR was defined prospectively as simultaneous provision of a compression rate of 100/min (± 20%), depth of 5 cm (± 20%) and fraction of > 50%. Significant interaction was considered as p < 0.05. Standard CPR with an activated versus sham (inactivated) ITD. Overall, 848 and 827 patients, respectively, in the active and sham-ITD groups had "acceptable" CPR quality performed (n = 1675). There was a significant interaction between the active and sham-ITD and compression rate, depth and fraction as well as their combinations. The strongest interaction was seen with all three parameters combined (unadjusted and adjusted interaction p-value, < 0.001). For all presenting rhythms, when "acceptable" quality of CPR was performed, use of an active-ITD increased survival to hospital discharge with mRS ≤ 3 compared to sham (61/848 [7.2%] versus 34/827 [4.1%], respectively; p = 0.006). The opposite was true for patients that did not receive "acceptable" quality of CPR. In those patients, use of an active - ITD led to significantly worse survival to hospital discharge with mRS ≤ 3 compared to sham (34/1012 [3.4%] versus 62/1061 [5.8%], p = 0.007). There was a statistically significant interaction between the quality of CPR provided, intervention, and survival to hospital discharge with mRS ≤ 3 in the NIH PRIMED trial. Quality of CPR delivered can be an underestimated effect modifier in CPR clinical trials. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cardiopulmonary Resuscitation Training in Schools Following 8 Years of Mandating Legislation in Denmark: A Nationwide Survey.

PubMed

Malta Hansen, Carolina; Zinckernagel, Line; Ersbøll, Annette Kjær; Tjørnhøj-Thomsen, Tine; Wissenberg, Mads; Lippert, Freddy Knudsen; Weeke, Peter; Gislason, Gunnar Hilmar; Køber, Lars; Torp-Pedersen, Christian; Folke, Fredrik

2017-03-14

School cardiopulmonary resuscitation (CPR) training has become mandatory in many countries, but whether legislation has translated into implementation of CPR training is largely unknown. We assessed CPR training of students following 8 years of legislative mandates in Denmark. A nationwide cross-sectional survey of Danish school leadership (n=1240) and ninth-grade homeroom teachers (n=1381) was carried out for school year 2013-2014. Qualitative interviews and the Theory of Planned Behavior were used to construct the survey. Logistic regression models were employed to identify factors associated with completed CPR training. Information from 63.1% of eligible schools was collected: 49.3% (n=611) of leadership and 48.2% (n=665) of teachers responded. According to teachers, 28.4% (95% CI 25.0% to 32.0%) and 10.3% (95% CI 8.1% to 12.8%) of eligible classes had completed CPR and automated external defibrillator training, respectively. Among leadership, 60.2% (95% CI 56.2% to 64.1%) reported CPR training had occurred during the 3 years prior to the survey. Factors associated with completed CPR training included believing other schools were conducting training (odds ratio [OR] 9.68 [95% CI 4.65-20.1]), awareness of mandating legislation (OR 4.19 [95% CI 2.65-6.62]), presence of a school CPR training coordinator (OR 3.01 [95% CI 1.84-4.92]), teacher feeling competent to conduct training (OR 2.78 [95% CI 1.74-4.45]), and having easy access to training material (OR 2.08 [95% CI 1.57-2.76]). Despite mandating legislation, school CPR training has not been successfully implemented. Completed CPR training was associated with believing other schools were conducting training, awareness of mandating legislation, presence of a school CPR training coordinator, teachers teacher feeling competent to conduct training, and having easy access to training material. Facilitating these factors may increase rates of school CPR training. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

RNA Interference of NADPH-Cytochrome P450 Reductase Results in Reduced Insecticide Resistance in the Bed Bug, Cimex lectularius

PubMed Central

Zhu, Fang; Sams, Sarah; Moural, Tim; Haynes, Kenneth F.; Potter, Michael F.; Palli, Subba R.

2012-01-01

Background NADPH-cytochrome P450 reductase (CPR) plays a central role in cytochrome P450 action. The genes coding for P450s are not yet fully identified in the bed bug, Cimex lectularius. Hence, we decided to clone cDNA and knockdown the expression of the gene coding for CPR which is suggested to be required for the function of all P450s to determine whether or not P450s are involved in resistance of bed bugs to insecticides. Methodology/Principal Findings The full length Cimex lectularius CPR (ClCPR) cDNA was isolated from a deltamethrin resistant bed bug population (CIN-1) using a combined PCR strategy. Bioinformatics and in silico modeling were employed to identify three conserved binding domains (FMN, FAD, NADP), a FAD binding motif, and the catalytic residues. The critical amino acids involved in FMN, FAD, NADP binding and their putative functions were also analyzed. No signal peptide but a membrane anchor domain with 21 amino acids which facilitates the localization of ClCPR on the endoplasmic reticulum was identified in ClCPR protein. Phylogenetic analysis showed that ClCPR is closer to the CPR from the body louse, Pediculus humanus corporis than to the CPRs from the other insect species studied. The ClCPR gene was ubiquitously expressed in all tissues tested but showed an increase in expression as immature stages develop into adults. We exploited the traumatic insemination mechanism of bed bugs to inject dsRNA and successfully knockdown the expression of the gene coding for ClCPR. Suppression of the ClCPR expression increased susceptibility to deltamethrin in resistant populations but not in the susceptible population of bed bugs. Conclusions/Significance These data suggest that P450-mediated metabolic detoxification may serve as one of the resistance mechanisms in bed bugs. PMID:22347424

RNA interference of NADPH-cytochrome P450 reductase results in reduced insecticide resistance in the bed bug, Cimex lectularius.

PubMed

Zhu, Fang; Sams, Sarah; Moural, Tim; Haynes, Kenneth F; Potter, Michael F; Palli, Subba R

2012-01-01

NADPH-cytochrome P450 reductase (CPR) plays a central role in cytochrome P450 action. The genes coding for P450s are not yet fully identified in the bed bug, Cimex lectularius. Hence, we decided to clone cDNA and knockdown the expression of the gene coding for CPR which is suggested to be required for the function of all P450s to determine whether or not P450s are involved in resistance of bed bugs to insecticides. The full length Cimex lectularius CPR (ClCPR) cDNA was isolated from a deltamethrin resistant bed bug population (CIN-1) using a combined PCR strategy. Bioinformatics and in silico modeling were employed to identify three conserved binding domains (FMN, FAD, NADP), a FAD binding motif, and the catalytic residues. The critical amino acids involved in FMN, FAD, NADP binding and their putative functions were also analyzed. No signal peptide but a membrane anchor domain with 21 amino acids which facilitates the localization of ClCPR on the endoplasmic reticulum was identified in ClCPR protein. Phylogenetic analysis showed that ClCPR is closer to the CPR from the body louse, Pediculus humanus corporis than to the CPRs from the other insect species studied. The ClCPR gene was ubiquitously expressed in all tissues tested but showed an increase in expression as immature stages develop into adults. We exploited the traumatic insemination mechanism of bed bugs to inject dsRNA and successfully knockdown the expression of the gene coding for ClCPR. Suppression of the ClCPR expression increased susceptibility to deltamethrin in resistant populations but not in the susceptible population of bed bugs. These data suggest that P450-mediated metabolic detoxification may serve as one of the resistance mechanisms in bed bugs.

Training mothers in infant cardiopulmonary resuscitation with an instructional DVD and manikin.

PubMed

Barr, Gavin C; Rupp, Valerie A; Hamilton, Kimberly M; Worrilow, Charles C; Reed, James F; Friel, Kristin S; Dusza, Stephen W; Greenberg, Marna Rayl

2013-07-01

Classes in infant cardiopulmonary resuscitation (CPR) can be time consuming and costly. To determine whether mothers in an obstetric unit could learn infant CPR by using a 22-minute instructional kit and to assess the value and confidence they gained by learning CPR. Quasi-experimental study with enrollment between January and December 2008. Obstetric unit in Lehigh Valley Hospital, a suburban teaching hospital in Allentown, Pennsylvania. Mothers at least 18 years old who had given birth within the previous 24 hours. The experimental group included mothers without prior CPR training who watched a 22-minute instructional DVD and practiced on a manikin. The control group included mothers with prior conventional CPR training. In both groups, knowledge and proficiency were assessed with written and practical examinations developed by certified CPR instructors. Participant surveys were conducted at 3 times: immediately before dissemination of course materials, within 24 hours after the mother agreed to participate in the study, and 6 months after initial evaluation. A total of 126 mothers were enrolled in the study: 79 in the experimental group, 25 in the control group, and 22 who withdrew from the study. Written and practical examinations were used to determine proficiency, and composite scores were generated, with a maximum composite score of 12. The composite scores were statistically significantly higher in the experimental group than in the control group, with median scores of 10 and 7, respectively (P<.001). Twenty-two mothers (21%) had been previously offered CPR training. In the experimental group, 76 mothers (96%) felt more confident as caregivers after learning CPR. Before training in both groups, 84 mothers (81%) stated that learning CPR was extremely important, compared with 100 mothers (96%) after training (P=.001). Use of an instructional kit is an effective method of teaching CPR to new mothers. Mothers reported that learning CPR is extremely important and that it increases their confidence as caregivers.

Passive continuous positive airway pressure ventilation during cardiopulmonary resuscitation: a randomized cross-over manikin simulation study.

PubMed

Winkler, Bernd E; Muellenbach, Ralf M; Wurmb, Thomas; Struck, Manuel F; Roewer, Norbert; Kranke, Peter

2017-02-01

While controlled ventilation is most frequently used during cardiopulmonary resuscitation (CPR), the application of continuous positive airway pressure (CPAP) and passive ventilation of the lung synchronously with chest compressions and decompressions might represent a promising alternative approach. One benefit of CPAP during CPR is the reduction of peak airway pressures and therefore a potential enhancement in haemodynamics. We therefore evaluated the tidal volumes and airway pressures achieved during CPAP-CPR. During CPR with the LUCAS™ 2 compression device, a manikin model was passively ventilated at CPAP levels of 5, 10, 20 and 30 hPa with the Boussignac tracheal tube and the ventilators Evita ® V500, Medumat ® Transport, Oxylator ® EMX, Oxylog ® 2000, Oxylog ® 3000, Primus ® and Servo ® -i as well as the Wenoll ® diver rescue system. Tidal volumes and airway pressures during CPAP-CPR were recorded and analyzed. Tidal volumes during CPAP-CPR were higher than during compression-only CPR without positive airway pressure. The passively generated tidal volumes increased with increasing CPAP levels and were significantly influenced by the ventilators used. During ventilation at 20 hPa CPAP via a tracheal tube, the mean tidal volumes ranged from 125 ml (Medumat ® ) to 309 ml (Wenoll ® ) and the peak airway pressures from 23 hPa (Primus ® ) to 49 hPa (Oxylog ® 3000). Transport ventilators generated lower tidal volumes than intensive care ventilators or closed-circuit systems. Peak airway pressures during CPAP-CPR were lower than those during controlled ventilation CPR reported in literature. High peak airway pressures are known to limit the applicability of ventilation via facemask or via supraglottic airway devices and may adversely affect haemodynamics. Hence, the application of ventilators generating high tidal volumes with low peak airway pressures appears desirable during CPAP-CPR. The limited CPAP-CPR capabilities of transport ventilators in our study might be prerequisite for future developments of transport ventilators.

CPR

MedlinePlus

... 9, 2017. American Red Cross. First Aid/CPR/AED Participant's Manual . 2nd ed. Dallas, TX: American Red ... redcross.org/images/MEDIA_CustomProductCatalog/m55540601_FA-CPR-AED-Part-Manual.pdf . Accessed September 14, 2017. Berg ...

Metronome improves compression and ventilation rates during CPR on a manikin in a randomized trial.

PubMed

Kern, Karl B; Stickney, Ronald E; Gallison, Leanne; Smith, Robert E

2010-02-01

We hypothesized that a unique tock and voice metronome could prevent both suboptimal chest compression rates and hyperventilation. A prospective, randomized, parallel design study involving 34 pairs of paid firefighter/emergency medical technicians (EMTs) performing two-rescuer CPR using a Laerdal SkillReporter Resusci Anne manikin with and without metronome guidance was performed. Each CPR session consisted of 2 min of 30:2 CPR with an unsecured airway, then 4 min of CPR with a secured airway (continuous compressions at 100 min(-1) with 8-10 ventilations/min), repeated after the rescuers switched roles. The metronome provided "tock" prompts for compressions, transition prompts between compressions and ventilations, and a spoken "ventilate" prompt. During CPR with a bag/valve/mask the target compression rate of 90-110 min(-1) was achieved in 5/34 CPR sessions (15%) for the control group and 34/34 sessions (100%) for the metronome group (p<0.001). An excessive ventilation rate was not observed in either the metronome or control group during CPR with a bag/valve/mask. During CPR with a bag/endotracheal tube, the target of both a compression rate of 90-110 min(-1) and a ventilation rate of 8-11 min(-1) was achieved in 3/34 CPR sessions (9%) for the control group and 33/34 sessions (97%) for the metronome group (p<0.001). Metronome use with the secured airway scenario significantly decreased the incidence of over-ventilation (11/34 EMT pairs vs. 0/34 EMT pairs; p<0.001). A unique combination tock and voice prompting metronome was effective at directing correct chest compression and ventilation rates both before and after intubation. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Health practitioners' perceptions of adopting clinical prediction rules in the management of musculoskeletal pain: a qualitative study in Australia.

PubMed

Kelly, Joan; Sterling, Michele; Rebbeck, Trudy; Bandong, Aila Nica; Leaver, Andrew; Mackey, Martin; Ritchie, Carrie

2017-08-11

To investigate health practitioners' understanding and practice behaviours with regards to clinical prediction rules (CPRs) and explore their perceptions of adopting a new whiplash CPR. Qualitative study using six semistructured focus groups. Primary and secondary care in New South Wales and Queensland, Australia. Physiotherapists (n=19), chiropractors (n=6) and osteopaths (n=3) were purposively sampled to include health practitioners who provide routine treatment to people with whiplash-associated disorders. Focus group discussions (n=6) were audio-recorded, transcribed verbatim and analysed using an inductive thematic approach. Health practitioners' understanding and use of CPRs were mixed. Clinicians considered components relating to acceptability ('whether I agree with it') and implementation ('how I'll use it') when deciding on whether to adopt a new CPR. Acceptability was informed by four themes: knowledge and understanding, CPR type, congruence and weighted value. Consideration of matters that promote implementation occurred once a CPR was deemed to be acceptable. Three themes were identified as potentially enhancing whiplash CPR implementation: the presence of an external driver of adoption, flexibility in how the CPR could be administered and guidance regarding communication of CPR output to patients. Education on CPR purpose and fit with practice is needed to enhance the perceived acceptability of CPRs. Strategies that facilitate practitioner motivation, enable administrative flexibility and assist clinicians in communicating the results of the whiplash CPR could promote adoption of the whiplash CPR. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Low-Dose, High-Frequency CPR Training Improves Skill Retention of In-Hospital Pediatric Providers

PubMed Central

Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

2011-01-01

OBJECTIVE: To investigate the effectiveness of brief bedside cardiopulmonary resuscitation (CPR) training to improve the skill retention of hospital-based pediatric providers. We hypothesized that a low-dose, high-frequency training program (booster training) would improve CPR skill retention. PATIENTS AND METHODS: CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated arrest. Basic life support–certified, hospital-based providers were randomly assigned to 1 of 4 study arms: (1) instructor-only training; (2) automated defibrillator feedback only; (3) instructor training combined with automated feedback; and (4) control (no structured training). Each session (time: 0, 1, 3, and 6 months after training) consisted of a pretraining evaluation (60 seconds), booster training (120 seconds), and a posttraining evaluation (60 seconds). Excellent CPR was defined as chest compression (CC) depth ≥ one-third anterior-posterior chest depth, rate ≥ 90 and ≤120 CC per minute, ≤20% of CCs with incomplete release (>2500 g), and no flow fraction ≤ 0.30. MEASUREMENTS AND MAIN RESULTS: Eighty-nine providers were randomly assigned; 74 (83%) completed all sessions. Retention of CPR skills was 2.3 times (95% confidence interval [CI]: 1.1–4.5; P = .02) more likely after 2 trainings and 2.9 times (95% CI: 1.4–6.2; P = .005) more likely after 3 trainings. The automated defibrillator feedback only group had lower retention rates compared with the instructor-only training group (odds ratio: 0.41 [95% CI: 0.17–0.97]; P = .043). CONCLUSIONS: Brief bedside booster CPR training improves CPR skill retention. Our data reveal that instructor-led training improves retention compared with automated feedback training alone. Future studies should investigate whether bedside training improves CPR quality during actual pediatric arrests. PMID:21646262

The effect of time on CPR and automated external defibrillator skills in the Public Access Defibrillation Trial

PubMed Central

Christenson, Jim; Nafziger, Sarah; Compton, Scott; Vijayaraghavan, Kris; Slater, Brian; Ledingham, Robert; Powell, Judy; McBurnie, Mary Ann

2009-01-01

Background The time to skill deterioration between primary training/retraining and further retraining in Cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) for lay-persons is unclear. The Public Access Defibrillation (PAD) Trial was a multi-center randomized controlled trial evaluating survival after CPR-only vs. CPR+AED delivered by onsite non-medical volunteer responders in out-of-hospital cardiac arrest. Aims This sub-study evaluated the relationship of time between primary training/retraining and further retraining on volunteer performance during pretest AED and CPR skill evaluation. Methods Volunteers at 1260 facilities in 24 North American regions underwent training/retraining according to facility randomization, which included an initial session and a refresher session at approximately 6 months. Before the next retraining, a CPR and AED skill test was completed for 2729 volunteers. Primary outcome for the study was assessment of global competence of CPR or AED performance (adequate vs not adequate) using Chi-square tests for trends by time interval (3, 6, 9, and 12 months). Confirmatory (GEE) logistic regression analysis, adjusted for site and potential confounders. Results The proportion of volunteers judged to be competent did not diminish by interval (3,6,9,12 months) for either CPR or AED skills. After adjusting for site and potential confounders, longer intervals before to further retraining was associated with a slightly lower likelihood of performing adequate CPR but not with AED scores. Conclusions After primary training/retraining, the CPR skills of targeted lay responders deteriorate nominally but 80% remain competent up to one year. AED skills do not significantly deteriorate and 90% of volunteers remain competent up to one year. PMID:17303309

Modeling instructor preferences for CPR and AED competence estimation.

PubMed

Birnbaum, Alice; McBurnie, Mary Ann; Powell, Judy; Ottingham, Lois Van; Riegel, Barbara; Potts, Jerry; Hedges, Jerris R

2005-03-01

Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skills competency can be tested using a checklist of component skills, individually graded "pass" or "fail." Scores are typically calculated as the percentage of skills passed, but may differ from an instructor's overall subjective assessment of simulated CPR or AED adequacy. To identify and evaluate composite measures (methods for scoring checklists) that reflect instructors' subjective assessments of CPR or AED skills performance best. Associations between instructor assessment and lay-volunteer skill performance were made using 6380 CPR and 3313 AED skill retention tests collected in the Public Access Defibrillation Trial. Checklists included CPR skills (e.g., calling 911, administering compressions) and AED skills (e.g., positioning electrodes, shocking within 90 s of AED arrival). The instructor's subjective overall assessment (adequate/inadequate) of CPR performance (perfusion) or AED competence (effective shock) was compared to composite measures. We evaluated the traditional composite measure (assigning equal weights to individual skills) and several nontraditional composite measures (assigning variable weights). Skills performed out of sequence were further weighted from 0% (no credit) to 100% (full credit). Composite measures providing full credit for skills performed out of sequence and down-weighting process skills (e.g., calling 911, clearing oneself from the AED) had the strongest association with the instructor's subjective assessment; the traditional CPR composite measure had the weakest association. Our findings suggest that instructors in public CPR and AED classes may tend to down-weight process skills and to excuse step sequencing errors when evaluating CPR and AED skills subjectively for overall proficiency. Testing methods that relate classroom performance to actual performance in the field and to clinical outcomes require further research.

Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation.

PubMed

Wyckoff, Myra H; Salhab, Walid A; Heyne, Roy J; Kendrick, Douglas E; Stoll, Barbara J; Laptook, Abbot R

2012-02-01

To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs. Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, P<.0001) and gestational age (25±2 weeks versus 26±2 weeks, P<.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population. Copyright © 2012 Mosby, Inc. All rights reserved.

Two minutes CPR versus five cycles CPR prior to reanalysis of the cardiac rhythm: A prospective, randomized simulator-based trial.

PubMed

Weichert, Veronika; Sellmann, Timur; Wetzchewald, Dietmar; Gasch, Bernd; Hunziker, Sabina; Marsch, Stephan

2015-11-01

While the 2005 cardiopulmonary resuscitation (CPR) guidelines recommended to provide CPR for five cycles before the next cardiac rhythm check, the current 2010 guideline now recommend to provide CPR for 2 min. Our aim was to compare adherence to both targets in a simulator-based randomized trial. 119 teams, consisting of three to four physicians each, were randomized to receive a graphical display of the simplified circular adult BLS algorithm with the instruction to perform CPR for either 2 min or five cycles 30:2. Subsequently teams had to treat a simulated unwitnessed cardiac arrest. Data analysis was performed using video-recordings obtained during simulations. The primary endpoint was adherence, defined as being within ±20% of the instructed target (i.e. 96-144s in the 2 min teams and 4-6 cycles in the fivex30:2 teams). 22/62 (35%) of the "two minutes" teams and 48/57 (84%) of the "five×30:2″ teams provided CPR within a range of ± 20% of their instructed target (P<0.0001). The median time of CPR prior to rhythm check was 91s and 87s, respectively, (P=0.59) with a significant larger variance (P=0.023) in the "two minutes" group. This randomized simulator-based trial found better adherence and less variance to an instruction to continue CPR for five cycles before the next cardiac rhythm check compared to continuing CPR for 2 min. Avoiding temporal targets whenever possible in guidelines relating to stressful events appears advisable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Training hospital providers in basic CPR skills in Botswana: acquisition, retention and impact of novel training techniques.

PubMed

Meaney, Peter A; Sutton, Robert M; Tsima, Billy; Steenhoff, Andrew P; Shilkofski, Nicole; Boulet, John R; Davis, Amanda; Kestler, Andrew M; Church, Kasey K; Niles, Dana E; Irving, Sharon Y; Mazhani, Loeto; Nadkarni, Vinay M

2012-12-01

Globally, one third of deaths each year are from cardiovascular diseases, yet no strong evidence supports any specific method of CPR instruction in a resource-limited setting. We hypothesized that both existing and novel CPR training programs significantly impact skills of hospital-based healthcare providers (HCP) in Botswana. HCP were prospectively randomized to 3 training groups: instructor led, limited instructor with manikin feedback, or self-directed learning. Data was collected prior to training, immediately after and at 3 and 6 months. Excellent CPR was prospectively defined as having at least 4 of 5 characteristics: depth, rate, release, no flow fraction, and no excessive ventilation. GEE was performed to account for within subject correlation. Of 214 HCP trained, 40% resuscitate ≥ 1/month, 28% had previous formal CPR training, and 65% required additional skills remediation to pass using AHA criteria. Excellent CPR skill acquisition was significant (infant: 32% vs. 71%, p<0.01; adult 28% vs. 48%, p<0.01). Infant CPR skill retention was significant at 3 (39% vs. 70%, p<0.01) and 6 months (38% vs. 67%, p<0.01), and adult CPR skills were retained to 3 months (34% vs. 51%, p=0.02). On multivariable analysis, low cognitive score and need for skill remediation, but not instruction method, impacted CPR skill performance. HCP in resource-limited settings resuscitate frequently, with little CPR training. Using existing training, HCP acquire and retain skills, yet often require remediation. Novel techniques with increased student: instructor ratio and feedback manikins were not different compared to traditional instruction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Innovative cardiopulmonary resuscitation and automated external defibrillator programs in schools: Results from the Student Program for Olympic Resuscitation Training in Schools (SPORTS) study.

PubMed

Vetter, Victoria L; Haley, Danielle M; Dugan, Noreen P; Iyer, V Ramesh; Shults, Justine

2016-07-01

Bystander cardiopulmonary resuscitation (CPR) rates are low. Our study objective was to encourage Philadelphia high school students to develop CPR/AED (automated external defibrillator) training programs and to assess their efficacy. The focus was on developing innovative ways to learn the skills of CPR/AED use, increasing willingness to respond in an emergency, and retention of effective psychomotor resuscitation skills. Health education classes in 15 Philadelphia School District high schools were selected, with one Control and one Study Class per school. Both completed CPR/AED pre- and post-tests to assess cognitive knowledge and psychomotor skills. After pre-tests, both were taught CPR skills and AED use by their health teacher. Study Classes developed innovative programs to learn, teach, and retain CPR/AED skills. The study culminated with Study Classes competing in multiple CPR/AED skills events at the CPR/AED Olympic event. Outcomes included post-tests, Mock Code, and presentation scores. All students' cognitive and psychomotor skills improved with standard classroom education (p<0.001). Competition with other schools at the CPR/AED Olympics and the development of their own student-directed education programs resulted in remarkable retention of psychomotor skill scores in the Study Class (88%) vs the Control Class (79%) (p<0.001). Olympic participants averaged 93.1% on the Mock Code with 10 of 12 schools ≥94%. Students who developed creative and novel methods of teaching and learning resuscitation skills showed outstanding application of these skills in a Mock Code with remarkable psychomotor skill retention, potentially empowering a new generation of effectively trained CPR bystanders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Relationship Between the Duration of Cardiopulmonary Resuscitation and Favorable Neurological Outcomes After Out-of-Hospital Cardiac Arrest: A Prospective, Nationwide, Population-Based Cohort Study.

PubMed

Goto, Yoshikazu; Funada, Akira; Goto, Yumiko

2016-03-18

The determination of appropriate duration of in-the-field cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients is one of the biggest challenges for emergency medical service providers and clinicians. The appropriate CPR duration before termination of resuscitation remains unclear and may differ based on initial rhythm. We aimed to determine the relationship between CPR duration and post-OHCA outcomes. We analyzed the records of 17 238 OHCA patients (age ≥18 years) who achieved prehospital return of spontaneous circulation. Data were prospectively recorded in a nationwide, Japanese database between 2011 and 2012. The time from CPR initiation to prehospital return of spontaneous circulation (CPR duration) was calculated. The primary end point was 1-month survival with favorable neurological outcomes (Cerebral Performance Category [CPC] scale; CPC 1-2). The 1-month CPC 1-2 rate was 21.8% (n=3771). CPR duration was inversely associated with 1-month CPC 1-2 (adjusted unit odds ratio: 0.95, 95% CI: 0.94-0.95). Among all patients, a cumulative proportion of >99% of 1-month CPC 1-2 was achieved with a CPR duration of 35 minutes. When sorted by the initial rhythm, the CPR duration producing more than 99% of survivors with CPC 1-2 was 35 minutes for shockable rhythms and pulseless electrical activity, and 42 minutes for asystole. CPR duration was independently and inversely associated with favorable 1-month neurological outcomes. The critical prehospital CPR duration for OHCA was 35 minutes in patients with initial shockable rhythms and pulseless electrical activity, and 42 minutes in those with initial asystole. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Discrimination of haptens from prohaptens using the metabolically deficient Cpr{sup low/low} mouse

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chipinda, Itai, E-mail: IChipinda@cdc.gov; Blachere, Francoise M.; Anderson, Stacey E.

2011-05-01

The murine local lymph node assay (LLNA) is a validated, well accepted method for identification of chemical contact allergens. Both direct acting haptens and prohaptens (requiring metabolic activation) can be identified, but not differentiated by this assay. This study was used to assess the utility of a pan microsomal metabolic deficient mouse to distinguish between direct acting haptens and prohaptens in the LLNA. Hapten and prohapten induced cell proliferation was compared in C57BL/6J (B6) wild type (WT) versus homozygous (HO) knockout mice with a hypomorphic NADPH-Cytochrome P450 Reductase (CPR) gene (termed Cpr{sup low/low}) resulting in low CPR enzyme activity. Micemore » were dosed with known prohaptens; benzo(a)pyrene (BaP), carvone oxime (COx) and paracetamol (PCM) and haptens; oxazolone (OX), 4-ethoxymethylene-2-phenyl-2-oxazolin-5-one (EtOX), and N-acetylbenzoquinoneimine (NABQI) in this study. Skin microsomes from the WT, HO and heterozygous (HT) Cpr{sup low/low} mice were compared and evaluated for CPR activity. Lymphocyte proliferative responses to BaP, COx and PCM were significantly abrogated by 36.4%, 45.2% and 50.8%, respectively; in Cpr{sup low/low} knock out (KO) mice versus WT mice; while the lymphocyte proliferative responses to the direct acting haptens OX, EtOX and NABQI were comparable. CPR activity, determined as Units/mg protein, was determined to be significantly lower in the Cpr{sup low/low} mice compared to the WT. Results of the present study suggest potential utility of the Cpr{sup low/low} mice in the LLNA to differentiate prohaptens from direct acting haptens.« less

A novel protocol for dispatcher assisted CPR improves CPR quality and motivation among rescuers-A randomized controlled simulation study.

PubMed

Rasmussen, Stinne Eika; Nebsbjerg, Mette Amalie; Krogh, Lise Qvirin; Bjørnshave, Katrine; Krogh, Kristian; Povlsen, Jonas Agerlund; Riddervold, Ingunn Skogstad; Grøfte, Thorbjørn; Kirkegaard, Hans; Løfgren, Bo

2017-01-01

Emergency dispatchers use protocols to instruct bystanders in cardiopulmonary resuscitation (CPR). Studies changing one element in the dispatcher's protocol report improved CPR quality. Whether several changes interact is unknown and the effect of combining multiple changes previously reported to improve CPR quality into one protocol remains to be investigated. We hypothesize that a novel dispatch protocol, combining multiple beneficial elements improves CPR quality compared with a standard protocol. A novel dispatch protocol was designed including wording on chest compressions, using a metronome, regular encouragements and a 10-s rest each minute. In a simulated cardiac arrest scenario, laypersons were randomized to perform single-rescuer CPR guided with the novel or the standard protocol. a composite endpoint of time to first compression, hand position, compression depth and rate and hands-off time (maximum score: 22 points). Afterwards participants answered a questionnaire evaluating the dispatcher assistance. The novel protocol (n=61) improved CPR quality score compared with the standard protocol (n=64) (mean (SD): 18.6 (1.4)) points vs. 17.5 (1.7) points, p<0.001. The novel protocol resulted in deeper chest compressions (mean (SD): 58 (12)mm vs. 52 (13)mm, p=0.02) and improved rate of correct hand position (61% vs. 36%, p=0.01) compared with the standard protocol. In both protocols hands-off time was short. The novel protocol improved motivation among rescuers compared with the standard protocol (p=0.002). Participants guided with a standard dispatch protocol performed high quality CPR. A novel bundle of care protocol improved CPR quality score and motivation among rescuers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Bystander fatigue and CPR quality by older bystanders: a randomized crossover trial comparing continuous chest compressions and 30:2 compressions to ventilations.

PubMed

Liu, Shawn; Vaillancourt, Christian; Kasaboski, Ann; Taljaard, Monica

2016-11-01

This study sought to measure bystander fatigue and cardiopulmonary resuscitation (CPR) quality after five minutes of CPR using the continuous chest compression (CCC) versus the 30:2 chest compression to ventilation method in older lay persons, a population most likely to perform CPR on cardiac arrest victims. This randomized crossover trial took place at three tertiary care hospitals and a seniors' center. Participants were aged ≥55 years without significant physical limitations (frailty score ≤3/7). They completed two 5-minute CPR sessions (using 30:2 and CCC) on manikins; sessions were separated by a rest period. We used concealed block randomization to determine CPR method order. Metronome feedback maintained a compression rate of 100/minute. We measured heart rate (HR), mean arterial pressure (MAP), and Borg Exertion Scale. CPR quality measures included total number of compressions and number of adequate compressions (depth ≥5 cm). Sixty-three participants were enrolled: mean age 70.8 years, female 66.7%, past CPR training 60.3%. Bystander fatigue was similar between CPR methods: mean difference in HR -0.59 (95% CI -3.51-2.33), MAP 1.64 (95% CI -0.23-3.50), and Borg 0.46 (95% CI 0.07-0.84). Compared to 30:2, participants using CCC performed more chest compressions (480.0 v. 376.3, mean difference 107.7; p<0.0001) and more adequate chest compressions (381.5 v. 324.9, mean difference. 62.0; p=0.0001), although good compressions/minute declined significantly faster with the CCC method (p=0.0002). CPR quality decreased significantly faster when performing CCC compared to 30:2. However, performing CCC produced more adequate compressions overall with a similar level of fatigue compared to the 30:2 method.

Installation and Initial Operation of DOE's 449-MHz Wind Profiling Radars on the U.S. West Coast

DOE Office of Scientific and Technical Information (OSTI.GOV)

Flaherty, Julia E.; Shaw, William J.; Morris, Victor R.

The U.S. Department of Energy (DOE), in collaboration with the National Oceanic and Atmospheric Administration (NOAA), has recently completed the installation of three new wind profiling radars on the Washington and Oregon coasts. These systems operate at a frequency of 449 MHz and provide mean wind profiles to a height of roughly 8 km, with the maximum measurement height depending on time-varying atmospheric conditions. This is roughly half the depth of the troposphere at these latitudes. Each system is also equipped with a radio acoustic sounding system (RASS), which provides a measure of the temperature profile to heights of approximatelymore » 2 km. Other equipment deployed alongside the radar includes a surface meteorological station and GPS for column water vapor. This project began in fiscal year 2014, starting with equipment procurements and site selection. In addition, environmental reviews, equipment assembly and testing, site access agreements, and infrastructure preparations have been performed. Finally, with equipment deployment with data collection and dissemination, the primary tasks of this project have been completed. The three new wind profiling radars have been deployed at airports near Coos Bay, OR, and Astoria, OR, and at an industrial park near Forks, WA. Data are available through the NOAA Earth Systems Research Laboratory Data Display website, and will soon be made available through the DOE Atmosphere to Electrons data archive and portal as well.« less

Impacts of distinct observations during the 2009 Prince William Sound field experiment: A data assimilation study

NASA Astrophysics Data System (ADS)

Li, Z.; Chao, Y.; Farrara, J.; McWilliams, J. C.

2012-12-01

A set of data assimilation experiments, known as Observing System Experiments (OSEs), are performed to assess the relative impacts of different types of observations acquired during the 2009 Prince William Sound Field Experiment. The observations assimilated consist primarily of three types: High Frequency (HF) radar surface velocities, vertical profiles of temperature/salinity (T/S) measured by ships, moorings, Autonomous Underwater Vehicles and gliders, and satellite sea surface temperatures (SSTs). The impact of all the observations, HF radar surface velocities, and T/S profiles is assessed. Without data assimilation, a frequently occurring cyclonic eddy in the central Sound is overly persistent and intense. The assimilation of the HF radar velocities effectively reduces these biases and improves the representation of the velocities as well as the T/S fields in the Sound. The assimilation of the T/S profiles improves the large scale representation of the temperature/salinity and also the velocity field in the central Sound. The combination of the HF radar surface velocities and sparse T/S profiles results in an observing system capable of representing the circulation in the Sound reliably and thus producing analyses and forecasts with useful skill. It is suggested that a potentially promising observing network could be based on satellite SSHs and SSTs along with sparse T/S profiles, and future satellite SSHs with wide swath coverage and higher resolution may offer excellent data that will be of great use for predicting the circulation in the Sound.

A multi-sensor study of the impact of ground-based glaciogenic seeding on clouds and precipitation over mountains in Wyoming. Part I: Project description

NASA Astrophysics Data System (ADS)

Pokharel, Binod; Geerts, Bart

2016-12-01

The AgI Seeding Cloud Impact Investigation (ASCII) campaign was conducted in early 2012 and 2013 over two mountain ranges in southern Wyoming to examine the impact of ground-based glaciogenic seeding on snow growth in winter orographic clouds. The campaign was supported by a network of ground-based instruments, including microwave radiometers, two profiling Ka-band Micro-Rain Radars (MRRs), a Doppler on Wheels (DOW) X-band radar, and a Parsivel disdrometer. The University of Wyoming King Air operated the profiling Wyoming Cloud Radar, the Wyoming Cloud Lidar, and in situ cloud and precipitation particle probes. The characteristics of the orographic clouds, flow field, and upstream stability profiles in 27 intensive observation periods (IOPs) are described here. A composite analysis of the impact of seeding on snow growth is presented in Part II of this study (Pokharel et al., 2017).

Radar - ANL Wind Profiler with RASS, Yakima - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ESRL Wind Profiler with RASS, Condon - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ANL Wind Profiler with RASS, Walla Walla - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ESRL Wind Profiler with RASS, Prineville - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ESRL Wind Profiler with RASS, Troutdale - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ANL Wind Profiler with RASS, Goldendale - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Radar - ESRL Wind Profiler with RASS, Wasco Airport - Raw Data

DOE Data Explorer

Gottas, Daniel

2017-10-23

**Winds** A radar wind profiler measures the Doppler shift of electromagnetic energy scattered back from atmospheric turbulence and hydrometeors along 3-5 vertical and off-vertical point beam directions. Back-scattered signal strength and radial-component velocities are remotely sensed along all beam directions and combined to derive the horizontal wind field over the radar. These data typically are sampled and averaged hourly and usually have 6-m and/or 100-m vertical resolutions up to 4 km for the 915 MHz and 8 km for the 449 MHz systems. **Temperature** To measure atmospheric temperature, a radio acoustic sound system (RASS) is used in conjunction with the wind profile. These data typically are sampled and averaged for five minutes each hour and have a 60-m vertical resolution up to 1.5 km for the 915 MHz and 60-m up to 3.5k m for the 449 MHz.

Mobile Three Frequency Radar as Research Platform for Precipitation Profiling

NASA Astrophysics Data System (ADS)

Schmidt, Walter; Rautiainen, Kimmo; Harri, Ari-Matti

2014-05-01

Precipitation profiling at the frequency bands of Ku, Ka and W bands are becoming increasingly popular in the studies of atmospheric microphysics. Ever since the introduction of Ku / Ka pair of frequencies for the Global Precipitation Measurement mission (GPM) and the success of W band in Cloudsat, the interest in precipitation profiling using these frequencies has increased. The profiling observations will also serve as ground validation instruments for several space missions such as GPM and EarthCARE [1]. In order to get better information to retrieve ice microphysics as well as to enhance sensitivity, we need to move from the standard S- and C-band weather radars to higher frequencies [2]. As was recently shown, the use of multi- frequency profiling yields important additional information compared to single-frequency radar mapping [3]. During the past four years a consortium of research, academic and private industries in Finland has been developing a flexible low-cost mobile three-band radar system for precipitation profiling. The feasibility of the concept is being demonstrated by implementing the Ku- and Ka-band part of the system. The antenna structure with antennas for Ku-, Ka- and W-band is completed allowing the pointing of all three antenna systems into the same direction during an azimuth and elevation scan. Using a freely programmable digital waveform generator and decoding electronics for the received data, the implementation of different wave form generation, compression and decoding schemes and their influence on the radar performance in the different bands can be evaluated and optimized. The modular design allows the connection of different transmitter control and receiver decoding units to any of the three band front-end electronics to evaluate the performance of different approaches in the various bands simultaneously. A real-time analysis software supports the data interpretation and system optimization during field tests. Via mobile internet connection and standard data formats the collected data can be made available for operative use. The mechanical integration on a standard car trailer allows the fast deployment to different locations. References [1] V. Chandrasekar, D. Moisseev, W. Schmidt, K. Rautiainen and A.-M Harri, "Scientific and engineering overview of the three frequency precipitation profiling radar at Helsinki" The 9th International Symposium on Advanced Environmental Monitoring and Modeling Helsinki, 2012. [2] V. Chandrasekar, H. Fukatsu and K. Mubarak, "Global mapping of attenuation at Ku- and Ka-band", IEEE Transactions on Geoscience and Remote Sensing, vol. 41, pp. 2166-2176, 2003 [3] J.Leinonen, D. Moisseev, V. Chandrasekar, J. Koskinen, "Mapping Radar Reflectivity Values of Snowfall Between Frequency Bands", IEEE Transactions on Geoscience and Remote Sensing, vol. 49, no.8, pp. 3047-3058, 2011 doi: 10.1109/TGRS.2011.2117432

Hands-Only CPR

MedlinePlus

... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ...

Quality of cardio-pulmonary resuscitation (CPR) during paediatric resuscitation training: time to stop the blind leading the blind.

PubMed

Arshid, Muhammad; Lo, Tsz-Yan Milly; Reynolds, Fiona

2009-05-01

Recent evidence suggested that the quality of cardio-pulmonary resuscitation (CPR) during adult advanced life support training was suboptimal. This study aimed to assess the CPR quality of a paediatric resuscitation training programme, and to determine whether it was sufficiently addressed by the trainee team leaders during training. CPR quality of 20 consecutive resuscitation scenario training sessions was audited prospectively using a pre-designed proforma. A consultant intensivist and a senior nurse who were also Advanced Paediatric Life Support (APLS) instructors assessed the CPR quality which included ventilation frequency, chest compression rate and depth, and any unnecessary interruption in chest compressions. Team leaders' response to CPR quality and elective change of compression rescuer during training were also recorded. Airway patency was not assessed in 13 sessions while ventilation rate was too fast in 18 sessions. Target compression rate was not achieved in only 1 session. The median chest compression rate was 115 beats/min. Chest compressions were too shallow in 10 sessions and were interrupted unnecessarily in 13 sessions. More than 50% of training sessions did not have elective change of the compression rescuer. 19 team leaders failed to address CPR quality during training despite all team leaders being certified APLS providers. The quality of CPR performance was suboptimal during paediatric resuscitation training and team leaders-in-training had little awareness of this inadequacy. Detailed CPR quality assessment and feedback should be integrated into paediatric resuscitation training to ensure optimal performance in real life resuscitations.

Motivating people to learn cardiopulmonary resuscitation and use of automated external defibrillators.

PubMed

McDonald, Deborah Dillon; Martin, Deborah; Foley, Diane; Baker, Lee; Hintz, Deborah; Faure, Lauren; Erman, Nancy; Palozie, Jessica; Lundquist, Kathleen; O'Brien, Kara; Prior, Laura; Songco, Narra; Muscillo, Gwyn; Graziani, Denise; Tomczyk, Michael; Price, Sheryl

2010-01-01

The purpose of this study was to test the effect of a motivational message on the intention of laypersons to learn cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. A pretest-posttest, double-blind, randomized design was used with 220 community-dwelling adults. Participants were randomly assigned to the treatment group reading the CPR and AED pamphlet emphasizing learning CPR and AED use to save someone they love and the 3-minute window for response time; or to the comparison group reading the identical pamphlet without the 2 motivational statements. Intention to learn CPR and AED use and to look for AEDs in public areas was measured before and after reading the respective pamphlet. No significant difference emerged between the groups for the number of participants planning to learn CPR and AED use. A significant number of participants in both groups increased intention to learn CPR and AED use. Significantly more treatment participants than comparison participants planned to routinely look for AEDs in public areas after reading the pamphlet, however. Teaching critical facts such as the low survival rate for out-of-hospital cardiac arrest might encourage laypersons to learn CPR and AED use. Routinely teaching family members of people at risk for a cardiac arrest about the short window of time in which CPR and AED use must begin and encouraging them to learn about CPR and AEDs to save someone they love may encourage family members to identify the location of AEDs in public places.

Cardiopulmonary resuscitation training of family members before hospital discharge using video self-instruction: a feasibility trial.

PubMed

Blewer, Audrey L; Leary, Marion; Decker, Christopher S; Andersen, James C; Fredericks, Amanda C; Bobrow, Bentley J; Abella, Benjamin S

2011-09-01

Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest (SCA), yet rates of bystander CPR are low. This is especially the case for SCA occurring in the home setting, as family members of at-risk patients are often not CPR trained. To evaluate the feasibility of a novel hospital-based CPR education program targeted to family members of patients at increased risk for SCA. Prospective, multicenter, cohort study. Inpatient wards at 3 hospitals. Family members of inpatients admitted with cardiac-related diagnoses. Family members were offered CPR training via a proctored video-self instruction (VSI) program. After training, CPR skills and participant perspectives regarding their training experience were assessed. Surveys were conducted one month postdischarge to measure the rate of "secondary training" of other individuals by enrolled family members. At the 3 study sites, 756 subjects were offered CPR instruction; 280 agreed to training and 136 underwent instruction using the VSI program. Of these, 78 of 136 (57%) had no previous CPR training. After training, chest compression performance was generally adequate (mean compression rate 90 ± 26/minute, mean depth 37 ± 12 mm). At 1 month, 57 of 122 (47%) of subjects performed secondary training for friends or family members, with a calculated mean of 2.1 persons trained per kit distributed. The hospital setting offers a unique "point of capture" to provide CPR instruction to an important, undertrained population in contact with at-risk individuals. Copyright © 2010 Society of Hospital Medicine.

Do Cardiac Rehabilitation Programs Offer Cardiopulmonary Resuscitation Training in Australia and New Zealand?

PubMed

Cartledge, Susie H; Bray, Janet E; Stub, Dion; Krum, Henry; Finn, Judith

2016-06-01

Cardiac rehabilitation may provide an ideal environment to train high-risk cardiac patients and their families in cardiopulmonary resuscitation (CPR). However, whether this training is currently offered is unknown. The aims of this study were to: 1) describe the prevalence of CPR training in cardiac rehabilitation programs in Australia and New Zealand (NZ); and 2) examine perceived barriers and attitudes of cardiac rehabilitation coordinators towards providing CPR training. We conducted a cross-sectional online survey of Australian and NZ cardiac rehabilitation coordinators. We received 253 completed surveys (46.7% response rate) (Australia n=208, NZ n=45). Cardiopulmonary resuscitation training was included in 23.9% of Australian programs and 56.6% in NZ. Common barriers to CPR training included lack of resources (49.7%) and a lack of awareness to provide CPR training for this high-risk group (33.7%). The majority of coordinators believed that lay people should be trained in CPR (96.3%) and were comfortable with recommending CPR training to this high-risk group (89.4%). While cardiac rehabilitation coordinators have positive attitudes towards CPR training, it is not currently part of most programs - particularly in Australia. Organisations formulating cardiac rehabilitation recommendations and guidelines should give consideration to include the provision of CPR training. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Ice Flow in the Humboldt, Petermann, and Ryder Glaciers, North Greenland

NASA Technical Reports Server (NTRS)

Joughin, I.; Fahnestock, M.; Kwok, R.; Gogineni, P.; Allen, C.

1998-01-01

Radar Interferometry, ice-penetrating radar profiles, and an elevation model are used to determine the catchment area, rates of ice discharge, and approximate states of balance for three large outlet glaciers in northeast Greenland.

Developments in Coherent Perfect Polarization Rotation

NASA Astrophysics Data System (ADS)

Crescimanno, Michael; Andrews, James; Zhou, Chaunhong; Baker, Michael

2015-05-01

Coherent Perfect Polarization Rotation (CPR) is a useful technique akin to Coherent Perfect Absorption (CPA, also known as the anti-laser) but that results in very high efficiency optical mode conversion. We describe the analysis of recent experimental data from our CPR testbed, the use of CPR in miniaturizing optical isolators and CPR phenomena in non-linear optics. Work supported by the N.S.F. under Grant No. ECCS-1360725.

Use of empirically supported interventions for psychopathology: can the participatory approach move us beyond the research-to-practice gap?

PubMed

Becker, Carolyn Black; Stice, Eric; Shaw, Heather; Woda, Susan

2009-04-01

Dissemination, or distribution, of empirically supported interventions (ESIs) for psychopathology remains a significant challenge. This paper reviews the principles of community-partnership research (CPR) and explores why CPR might improve distribution of psychological ESIs. Benefits of CPR include building trust, pooling resources and knowledge, and better serving a community by directly involving its members in the design and implementation of research. In addition, after establishing a community's trust using CPR, researchers are likely to be better positioned to partner with communities in the further distribution of ESIs via community networks. This paper reviews the case of dissonance-based eating disorder prevention interventions to provide an example of how CPR can facilitate the adoption and distribution of an ESI by a community, in this case, sororities. CPR also presents a number of challenges, however, because it is time consuming and does not always align with funding mechanisms and research designs used in randomized controlled trials. Further, CPR does not necessarily solve the challenge of training providers, though it may help with problem solving. Ultimately, we suggest that the benefits of CPR far outweigh the challenges, and hope that more researchers will adopt these practices so that more individuals can benefit from empirically supported psychological interventions.

Coastal Fishermen as Lifesavers While Sailing at High Speed: A Crossover Study

PubMed Central

Fungueiriño-Suárez, Ramón; Martínez-Isasi, Santiago; Fernández-Méndez, Felipe; González-Salvado, Violeta; Navarro-Patón, Rubén; Rodríguez-Núñez, Antonio

2018-01-01

Purpose Starting basic cardiopulmonary resuscitation (CPR) early improves survival. Fishermen are the first bystanders while at work. Our objective was to test in a simulated scenario the CPR quality performed by fishermen while at port and while navigating at different speeds. Methods Twenty coastal fishermen were asked to perform 2 minutes of CPR (chest compressions and mouth-to-mouth ventilations) on a manikin, in three different scenarios: (A) at port on land, (B) on the boat floor sailing at 10 knots, and (C) sailing at 20 knots. Data was recorded using quality CPR software, adjusted to current CPR international guidelines. Results The quality of CPR (QCPR) was significantly higher at port (43% ± 10) than sailing at 10 knots (30% ± 15; p = 0.01) or at 20 knots (26% ± 12; p = 0.001). The percentage of ventilation that achieved some lung insufflation was also significantly higher when CPR was done at port (77% ± 14) than while sailing at 10 knots (59% ± 18) or 20 knots (57% ± 21) (p = 0.01). Conclusion In the event of drowning or cardiac arrest on a small boat, fishermen should immediately start basic CPR and navigate at a relatively high speed to the nearest port if the sea conditions are safe. PMID:29854735

An assessment of resuscitation quality in the television drama Emergency Room: guideline non-compliance and low-quality cardiopulmonary resuscitation lead to a favorable outcome?

PubMed

Hinkelbein, Jochen; Spelten, Oliver; Marks, Jörg; Hellmich, Martin; Böttiger, Bernd W; Wetsch, Wolfgang A

2014-08-01

Two earlier studies found that outcome after cardiopulmonary resuscitation (CPR) in the television medical drama Emergency Room (ER) is not realistic. No study has yet evaluated CPR quality in ER. Retrospective analysis of CPR quality in episodes of ER. Three independent board-certified emergency physicians trained in CPR and the American Heart Association (AHA) guidelines reviewed ER episodes in two 5-year time-frames (2001-2005 and 2005-2009). Congruency with the corresponding 2000 and 2005 AHA guidelines was determined for each CPR scene. None. None. To evaluate whether CPR is in agreement with the specific algorithms of the AHA guidelines. Fisher's exact test and Mann-Whitney-U-test were used to evaluate statistical significance (P<0.05). A total of 136 on-screen cardiac arrests occurred in 174 episodes. Trauma was the leading cause of cardiac arrest (56.6%), which was witnessed in 80.1%. Return of spontaneous circulation occurred in 38.2%. Altogether, 19.1% of patients survived until ICU admission, and 5.1% were discharged alive. Only one CPR scene was in agreement with the published AHA guidelines. However, low-quality CPR and non-compliance with the guidelines resulted in favorable outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Arabidopsis CPR5 regulates ethylene signaling via molecular association with the ETR1 receptor.

PubMed

Wang, Feifei; Wang, Lijuan; Qiao, Longfei; Chen, Jiacai; Pappa, Maria Belen; Pei, Haixia; Zhang, Tao; Chang, Caren; Dong, Chun-Hai

2017-11-01

The plant hormone ethylene plays various functions in plant growth, development and response to environmental stress. Ethylene is perceived by membrane-bound ethylene receptors, and among the homologous receptors in Arabidopsis, the ETR1 ethylene receptor plays a major role. The present study provides evidence demonstrating that Arabidopsis CPR5 functions as a novel ETR1 receptor-interacting protein in regulating ethylene response and signaling. Yeast split ubiquitin assays and bi-fluorescence complementation studies in plant cells indicated that CPR5 directly interacts with the ETR1 receptor. Genetic analyses indicated that mutant alleles of cpr5 can suppress ethylene insensitivity in both etr1-1 and etr1-2, but not in other dominant ethylene receptor mutants. Overexpression of Arabidopsis CPR5 either in transgenic Arabidopsis plants, or ectopically in tobacco, significantly enhanced ethylene sensitivity. These findings indicate that CPR5 plays a critical role in regulating ethylene signaling. CPR5 is localized to endomembrane structures and the nucleus, and is involved in various regulatory pathways, including pathogenesis, leaf senescence, and spontaneous cell death. This study provides evidence for a novel regulatory function played by CPR5 in the ethylene receptor signaling pathway in Arabidopsis. © 2017 Institute of Botany, Chinese Academy of Sciences.

CPR Facts and Stats

MedlinePlus

... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ... Training CPR In Schools Training Kits RQI AHA Blended Learning & eLearning Guide AHA Instructors ECC Educational Conferences Programs ...

A Review of Compression, Ventilation, Defibrillation, Drug Treatment, and Targeted Temperature Management in Cardiopulmonary Resuscitation

PubMed Central

Pan, Jian; Zhu, Jian-Yong; Kee, Ho Sen; Zhang, Qing; Lu, Yuan-Qiang

2015-01-01

Objective: Important studies of cardiopulmonary resuscitation (CPR) techniques influence the development of new guidelines. We systematically reviewed the efficacy of some important studies of CPR. Data Sources: The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1964 to 2014. Study Selection: Original articles and critical reviews about CPR techniques were selected for review. Results: The survival rate after out-of-hospital cardiac arrest (OHCA) is improving. This improvement is associated with the performance of uninterrupted chest compressions and simple airway management procedures during bystander CPR. Real-time feedback devices can be used to improve the quality of CPR. The recommended dose, timing, and indications for adrenaline (epinephrine) use may change. The appropriate target temperature for targeted temperature management is still unclear. Conclusions: New studies over the past 5 years have evaluated various aspects of CPR in OHCA. Some of these studies were high-quality randomized controlled trials, which may help to improve the scientific understanding of resuscitation techniques and result in changes to CPR guidelines. PMID:25673462

Differential absorption radar techniques: water vapor retrievals

NASA Astrophysics Data System (ADS)

Millán, Luis; Lebsock, Matthew; Livesey, Nathaniel; Tanelli, Simone

2016-06-01

Two radar pulses sent at different frequencies near the 183 GHz water vapor line can be used to determine total column water vapor and water vapor profiles (within clouds or precipitation) exploiting the differential absorption on and off the line. We assess these water vapor measurements by applying a radar instrument simulator to CloudSat pixels and then running end-to-end retrieval simulations. These end-to-end retrievals enable us to fully characterize not only the expected precision but also their potential biases, allowing us to select radar tones that maximize the water vapor signal minimizing potential errors due to spectral variations in the target extinction properties. A hypothetical CloudSat-like instrument with 500 m by ˜ 1 km vertical and horizontal resolution and a minimum detectable signal and radar precision of -30 and 0.16 dBZ, respectively, can estimate total column water vapor with an expected precision of around 0.03 cm, with potential biases smaller than 0.26 cm most of the time, even under rainy conditions. The expected precision for water vapor profiles was found to be around 89 % on average, with potential biases smaller than 77 % most of the time when the profile is being retrieved close to surface but smaller than 38 % above 3 km. By using either horizontal or vertical averaging, the precision will improve vastly, with the measurements still retaining a considerably high vertical and/or horizontal resolution.

Longitudinal adoption rates of complex decision support tools in primary care.

PubMed

McCullagh, Lauren; Mann, Devin; Rosen, Lisa; Kannry, Joseph; McGinn, Thomas

2014-12-01

Translating research findings into practice promises to standardise care. Translation includes the integration of evidence-based guidelines at the point of care, discerning the best methods to disseminate research findings and models to sustain the implementation of best practices.By applying usability testing to clinical decision support(CDS) design, overall adoption rates of 60% can be realised.What has not been examined is how long adoption rates are sustained and the characteristics associated with long-term use. We conducted secondary analysis to decipher the factors impacting sustained use of CD Stools. This study was a secondary data analysis from a clinical trial conducted at an academic institution in New York City. Study data was identified patients electronic health records (EHR). The trial was to test the implementation of an integrated clinical prediction rule(iCPR) into the EHR. The primary outcome variable was iCPR tool acceptance of the tool. iCPR tool completion and iCPR smartest completion were additional outcome variables of interest. The secondary aim was to examine user characteristics associated with iCPR tool use in later time periods. Characteristics of interest included age, resident year, use of electronic health records (yes/no) and use of best practice alerts (BPA) (yes/no). Generalised linear mixed models (GLiMM) were used to compare iCPR use over time for each outcome of interest: namely, iCPR acceptance, iCPR completion and iCPR smartset completion.GLiMM was also used to examine resident characteristics associated with iCPR tool use in later time periods; specifically, intermediate and long-term (ie, 90+days). The tool was accepted, on average, 82.18% in the first 90 days (short-term period). The use decreases to 56.07% and 45.61% in intermediate and long-term time periods, respectively. There was a significant association between iCPR tool completion and time periods(p<0.0001). There was no significant difference in iCPR tool completion between resident encounters in the intermediate and long-term periods (p<0.6627). There was a significant association between iCPR smartset completion and time periods (p<0.0021). There were no significant associations between iCPR smartest completion and any of the four predictors of interest. We examined the frequencies of components of the iCPR tool being accepted over time by individual clinicians. Rates of adoption of the different components of the tool decreased substantially over time. The data suggest that over time and prolonged exposure to CDS tools, providers are less likely to utilise the tool. It is not clear if it is fatigue with the CDS tool, acquired knowledge of the clinical prediction rule, or gained clinical experience and gestalt that are influencing adoption rates. Further analysis of individual adoption rates over time and the impact it has on clinical outcomes should be conducted.

Truview EVO2 and standard Macintosh laryngoscope for tracheal intubation during cardiopulmonary resuscitation: a comparative randomized crossover study.

PubMed

Gaszynska, Ewelina; Gaszynski, Tomasz

2014-09-01

The aim of this study was to compare the performance of the Truview EVO2 laryngoscope in manikin-simulated cardiopulmonary resuscitation (CPR) and no-CPR scenarios with standard intubation technique. Participants performed 4 scenarios in random order: endotracheal intubation (ETI) using Macintosh laryngoscope (MCL), Truview EVO2 laryngoscope in no-CPR patient scenario, and intubation during uninterrupted chest compressions using both laryngoscopes. The participants were directed to make 3 attempts in each scenario. Primary outcomes were time to tracheal intubation (TTI) and intubation success, whereas secondary outcomes were cumulative success ratio and the number of esophageal intubation (EI). TTI and success ratios were reported per attempt. Thirty paramedics completed the study. Median TTI with Truview EVO2 with CPR was 36 (interquartile range [IQR] 29.00-52.00), 22.5 (IQR 18.33-35.00), and 18 (IQR 11.00-23.00) seconds; MCL with CPR was 23 (IQR 18.92-36.90), 16.8 (IQR 14.00-22.31), and 14.5 (IQR 11.12-16.36) seconds; Truview EVO2 without CPR was 28.6 (IQR 24.02-38.34), 21.7 (IQR 17.00-25.00), and 13 (IQR 11.90-17.79) seconds; MCL without CPR was 17 (IQR 13.23-22.29), 13 (IQR 12.09-15.26), and 12.4 (IQR 10.08-19.84) seconds for first, second, and third attempts, respectively. The P values for differences in TTI between Truview EVO2 and MCL were P < 0.0001, P = 0.0540, and P = 0.7550 in CPR scenario and P = 0.0080, P = 0.1570, and P = 0.7652 in no-CPR scenario for first, second, and third attempts, respectively. The success ratios for each of the scenarios were as follows: in CPR scenario it was 0.73 versus 0.53 (P = 0.0558), 0.83 versus 0.76 (P = 0.2633), and 1 versus 0.8 (P = 0.0058); in no-CPR scenario it was 0.63 versus 0.73 (P = 0.2068), 0.86 versus 0.86, and 0.97 versus 1 (P = 0.1637) for Truview EVO2 vs MCL in first, second, and third attempts, respectively. The cumulative success ratio related to the time of ETI was better for MCL compared with Truview EVO2 laryngoscope in both scenarios (P = 0.0029 and P = 0.0004 in no-CPR and CPR scenarios). The number of EI with MCL was 30% versus 13.3% (P = 0.0113), and for Truview EVO2 it was 20.45% versus 15.56% in CPR and no-CPR scenarios, respectively. The application of Truview EVO2 during uninterrupted chest compressions increased TTI but increased the success ratio of ETI and decreased number of EIs.

Interpretation of combined wind profiler and aircraft-measured tropospheric winds and clear air turbulence

NASA Technical Reports Server (NTRS)

Thomson, D. W.; Syrett, William J.; Fairall, C. W.

1991-01-01

In the first experiment, it was found that wind profilers are far better suited for the detailed examination of jet stream structure than are weather balloons. The combination of good vertical resolution with not previously obtained temporal resolution reveals structural details not seen before. Development of probability-derived shear values appears possible. A good correlation between pilot reports of turbulence and wind shear was found. In the second experiment, hourly measurements of wind speed and direction obtained using two wind profiling Doppler radars during two prolonged jet stream occurrences over western Pennsylvania were analyzed. In particular, the time-variant characteristics of derived shear profiles were examined. Profiler data dropouts were studied in an attempt to determine possible reasons for the apparently reduced performance of profiling radar operating beneath a jet stream. Richardson number and wind shear statistics were examined along with pilot reports of turbulence in the vicinity of the profiler.

Radar Detection of Layering in Ice: Experiments on a Constructed Layered Ice Sheet

NASA Astrophysics Data System (ADS)

Carter, L. M.; Koenig, L.; Courville, Z.; Ghent, R. R.; Koutnik, M. R.

2016-12-01

The polar caps and glaciers of both Earth and Mars display internal layering that preserves a record of past climate. These layers are apparent both in optical datasets (high resolution images, core samples) and in ground penetrating radar (GPR) data. On Mars, the SHARAD (Shallow Radar) radar on the Mars Reconnaissance Orbiter shows fine layering that changes spatially and with depth across the polar caps. This internal layering has been attributed to changes in fractional dust contamination due to obliquity-induced climate variations, but there are other processes that can lead to internal layers visible in radar data. In particular, terrestrial sounding of ice sheets compared with core samples have revealed that ice density and composition differences account for the majority of the radar reflectors. The large cold rooms and ice laboratory facility at the U.S. Army Cold Regions Research and Engineering Laboratory (CRREL) provide us a unique opportunity to construct experimental ice sheets in a controlled setting and measure them with radar. In a CRREL laboratory, we constructed a layered ice sheet that is 3-m deep with a various snow and ice layers with known dust concentrations (using JSC Mars-1 basaltic simulant) and density differences. These ice sheets were profiled using a commercial GPR, at frequencies of 200, 400 and 900 MHz, to determine how the radar profile changes due to systematic and known changes in snow and ice layers, including layers with sub-wavelength spacing. We will report results from these experiments and implications for interpreting radar-detected layering in ice on Earth and Mars.

Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC). Part VIII: Medicolegal considerations and recommendations.

PubMed

1986-06-06

These resuscitation guidelines were developed to "enhance the quality of care while protecting the patient's right to accept or reject therapy and to clarify the physician's role in making decisions to provide, withhold, or withdraw life support." Among the issues covered are the obligation to provide cardiopulmonary resuscitation (CPR), reasons to withhold or withdraw CPR, and the liability risks of CPR providers--laypersons, CPR teachers and organizations, and hospitals. Also discussed are the role of hospital ethics committees and medicolegal considerations in treating minors. The guidelines conclude with recommendations that states enact legislation allowing allied health personnel to render emergency care more effectively outside the hospital, providing "good samaritan" immunity to laypersons administering CPR, requiring basic life support training for police and firefighters, and acknowledging the patient's right to self determination in life-or-death decisions.

Calibrated peer review assignments for the earth sciences

USGS Publications Warehouse

Rudd, J.A.; Wang, V.Z.; Cervato, C.; Ridky, R.W.

2009-01-01

Calibrated Peer Review ??? (CPR), a web-based instructional tool developed as part of the National Science Foundation reform initiatives in undergraduate science education, allows instructors to incorporate multiple writing assignments in large courses without overwhelming the instructor. This study reports successful implementation of CPR in a large, introductory geology course and student learning of geoscience content. For each CPR assignment in this study, students studied web-based and paper resources, wrote an essay, and reviewed seven essays (three from the instructor, three from peers, and their own) on the topic. Although many students expressed negative attitudes and concerns, particularly about the peer review process of this innovative instructional approach, they also recognized the learning potential of completing CPR assignments. Comparing instruction on earthquakes and plate boundaries using a CPR assignment vs. an instructional video lecture and homework essay with extensive instructor feedback, students mastered more content via CPR instruction.

Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

PubMed

Dami, Fabrice; Fuchs, Vincent; Praz, Laurent; Vader, John-Paul

2010-07-01

In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12 months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery rate and false positive are similar to those found in previous studies. We found our results satisfying the given short time frame of this study. Our results demonstrate that it is possible to improve the quality of emergency services at moderate or even no additional costs and this should be of interest to all EMS that do not presently benefit from using T-CPR procedures. EMS that currently do not offer T-CPR should consider implementing this technique as soon as possible, and we expect our experience may provide answers to those planning to incorporate T-CPR in their daily practice.

Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest.

PubMed

Rajan, Shahzleen; Wissenberg, Mads; Folke, Fredrik; Hansen, Steen Møller; Gerds, Thomas A; Kragholm, Kristian; Hansen, Carolina Malta; Karlsson, Lena; Lippert, Freddy K; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

2016-12-20

Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out-of-hospital cardiac arrest, but it is unknown to what degree bystander CPR remains positively associated with survival with increasing time to potential defibrillation. The main objective was to examine the association of bystander CPR with survival as time to advanced treatment increases. We studied 7623 out-of-hospital cardiac arrest patients between 2005 and 2011, identified through the nationwide Danish Cardiac Arrest Registry. Multiple logistic regression analysis was used to examine the association between time from 911 call to emergency medical service arrival (response time) and survival according to whether bystander CPR was provided (yes or no). Reported are 30-day survival chances with 95% bootstrap confidence intervals. With increasing response times, adjusted 30-day survival chances decreased for both patients with bystander CPR and those without. However, the contrast between the survival chances of patients with versus without bystander CPR increased over time: within 5 minutes, 30-day survival was 14.5% (95% confidence interval [CI]: 12.8-16.4) versus 6.3% (95% CI: 5.1-7.6), corresponding to 2.3 times higher chances of survival associated with bystander CPR; within 10 minutes, 30-day survival chances were 6.7% (95% CI: 5.4-8.1) versus 2.2% (95% CI: 1.5-3.1), corresponding to 3.0 times higher chances of 30-day survival associated with bystander CPR. The contrast in 30-day survival became statistically insignificant when response time was >13 minutes (bystander CPR vs no bystander CPR: 3.7% [95% CI: 2.2-5.4] vs 1.5% [95% CI: 0.6-2.7]), but 30-day survival was still 2.5 times higher associated with bystander CPR. Based on the model and Danish out-of-hospital cardiac arrest statistics, an additional 233 patients could potentially be saved annually if response time was reduced from 10 to 5 minutes and 119 patients if response time was reduced from 7 (the median response time in this study) to 5 minutes. The absolute survival associated with bystander CPR declined rapidly with time. Yet bystander CPR while waiting for an ambulance was associated with a more than doubling of 30-day survival even in case of long ambulance response time. Decreasing ambulance response time by even a few minutes could potentially lead to many additional lives saved every year. © 2016 American Heart Association, Inc.

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animal CPR guidelines.

PubMed

Boller, Manuel; Fletcher, Daniel J

2012-06-01

To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animal CPR and to compose consensus-based clinical CPR guidelines for dogs and cats. This report is part of a series of 7 articles on the RECOVER evidence and knowledge gap analysis and consensus-based small animal CPR guidelines. It describes the organizational structure of RECOVER, the evaluation process employed, consisting of standardized literature searches, the analysis of relevant articles according to study design, species and predefined quality markers, and the drafting of clinical CPR guidelines based on these data. Therefore, this article serves as the methodology section for the subsequent 6 RECOVER articles. Academia, referral practice. RECOVER is a collaborative initiative that systematically evaluated the evidence on 74 topics relevant to small animal CPR and generated 101 clinical CPR guidelines from this analysis. All primary contributors were veterinary specialists, approximately evenly split between academic institutions and private referral practices. The evidence evaluation and guideline drafting processes were conducted according to a predefined sequence of steps designed to reduce bias and increase the repeatability of the findings, including multiple levels of review, culminating in a consensus process. Many knowledge gaps were identified that will allow prioritization of research efforts in veterinary CPR. Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process. © Veterinary Emergency and Critical Care Society 2012.

CPR methodology with new steady-state criterion and more accurate statistical treatment of channel bow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baumgartner, S.; Bieli, R.; Bergmann, U. C.

2012-07-01

An overview is given of existing CPR design criteria and the methods used in BWR reload analysis to evaluate the impact of channel bow on CPR margins. Potential weaknesses in today's methodologies are discussed. Westinghouse in collaboration with KKL and Axpo - operator and owner of the Leibstadt NPP - has developed an optimized CPR methodology based on a new criterion to protect against dryout during normal operation and with a more rigorous treatment of channel bow. The new steady-state criterion is expressed in terms of an upper limit of 0.01 for the dryout failure probability per year. This ismore » considered a meaningful and appropriate criterion that can be directly related to the probabilistic criteria set-up for the analyses of Anticipated Operation Occurrences (AOOs) and accidents. In the Monte Carlo approach a statistical modeling of channel bow and an accurate evaluation of CPR response functions allow the associated CPR penalties to be included directly in the plant SLMCPR and OLMCPR in a best-estimate manner. In this way, the treatment of channel bow is equivalent to all other uncertainties affecting CPR. Emphasis is put on quantifying the statistical distribution of channel bow throughout the core using measurement data. The optimized CPR methodology has been implemented in the Westinghouse Monte Carlo code, McSLAP. The methodology improves the quality of dryout safety assessments by supplying more valuable information and better control of conservatisms in establishing operational limits for CPR. The methodology is demonstrated with application examples from the introduction at KKL. (authors)« less

Cardiopulmonary Resuscitation Training of Family Members Before Hospital Discharge Using Video Self-Instruction: A Feasibility Trial

PubMed Central

Blewer, Audrey L.; Leary, Marion; Decker, Christopher S.; Andersen, James C.; Fredericks, Amanda C.; Bobrow, Bentley J.; Abella, Benjamin S.

2014-01-01

BACKGROUND Bystander cardiopulmonary resuscitation (CPR) is a crucial therapy for sudden cardiac arrest (SCA), yet rates of bystander CPR are low. This is especially the case for SCA occurring in the home setting, as family members of at-risk patients are often not CPR trained. OBJECTIVE To evaluate the feasibility of a novel hospital-based CPR education program targeted to family members of patients at increased risk for SCA. DESIGN Prospective, multicenter, cohort study. SETTING Inpatient wards at 3 hospitals. SUBJECTS Family members of inpatients admitted with cardiac-related diagnoses. MEASUREMENTS AND RESULTS Family members were offered CPR training via a proctored video-self instruction (VSI) program. After training, CPR skills and participant perspectives regarding their training experience were assessed. Surveys were conducted one month postdischarge to measure the rate of “secondary training” of other individuals by enrolled family members. At the 3 study sites, 756 subjects were offered CPR instruction; 280 agreed to training and 136 underwent instruction using the VSI program. Of these, 78 of 136 (57%) had no previous CPR training. After training, chest compression performance was generally adequate (mean compression rate 90 ± 26/minute, mean depth 37 ± 12 mm). At 1 month, 57 of 122 (47%) of subjects performed secondary training for friends or family members, with a calculated mean of 2.1 persons trained per kit distributed. CONCLUSIONS The hospital setting offers a unique “point of capture” to provide CPR instruction to an important, undertrained population in contact with at-risk individuals. PMID:21916007

Delivery of cardiopulmonary resuscitation in the microgravity environment

NASA Technical Reports Server (NTRS)

Barratt, M. R.; Billica, R. D.

1992-01-01

The microgravity environment presents several challenges for delivering effective cardiopulmonary resuscitation (CPR). Chest compressions must be driven by muscular force rather than by the weight of the rescuer's upper torso. Airway stabilization is influenced by the neutral body posture. Rescuers will consist of crew members of varying sizes and degrees of physical deconditioning from space flight. Several methods of CPR designed to accommodate these factors were tested in the one G environment, in parabolic flight, and on a recent shuttle flight. Methods: Utilizing study participants of varying sizes, different techniques of CPR delivery were evaluated using a recording CPR manikin to assess adequacy of compressive force and frequency. Under conditions of parabolic flight, methods tested included conventional positioning of rescuer and victim, free floating 'Heimlich type' compressions, straddling the patient with active and passive restraints, and utilizing a mechanical cardiac compression assist device (CCAD). Multiple restrain systems and ventilation methods were also assessed. Results: Delivery of effective CPR was possible in all configurations tested. Reliance on muscular force alone was quickly fatiguing to the rescuer. Effectiveness of CPR was dependent on technique, adequate restraint of the rescuer and patient, and rescuer size and preference. Free floating CPR was adequate but rapidly fatiguing. The CCAD was able to provide adequate compressive force but positioning was problematic. Conclusions: Delivery of effective CPR in microgravity will be dependent on adequate resuer and patient restraint, technique, and rescuer size and preference. Free floating CPR may be employed as a stop gap method until patient restraint is available. Development of an adequate CCAD would be desirable to compensate for the effects of deconditioning.

Barriers and facilitators to learning and performing cardiopulmonary resuscitation in neighborhoods with low bystander cardiopulmonary resuscitation prevalence and high rates of cardiac arrest in Columbus, OH.

PubMed

Sasson, Comilla; Haukoos, Jason S; Bond, Cindy; Rabe, Marilyn; Colbert, Susan H; King, Renee; Sayre, Michael; Heisler, Michele

2013-09-01

Residents who live in neighborhoods that are primarily black, Latino, or poor are more likely to have an out-of-hospital cardiac arrest, less likely to receive cardiopulmonary resuscitation (CPR), and less likely to survive. No prior studies have been conducted to understand the contributing factors that may decrease the likelihood of residents learning and performing CPR in these neighborhoods. The goal of this study was to identify barriers and facilitators to learning and performing CPR in 3 low-income, high-risk, and predominantly black neighborhoods in Columbus, OH. Community-Based Participatory Research approaches were used to develop and conduct 6 focus groups in conjunction with community partners in 3 target high-risk neighborhoods in Columbus, OH, in January to February 2011. Snowball and purposeful sampling, done by community liaisons, was used to recruit participants. Three reviewers analyzed the data in an iterative process to identify recurrent and unifying themes. Three major barriers to learning CPR were identified and included financial, informational, and motivational factors. Four major barriers were identified for performing CPR and included fear of legal consequences, emotional issues, knowledge, and situational concerns. Participants suggested that family/self-preservation, emotional, and economic factors may serve as potential facilitators in increasing the provision of bystander CPR. The financial cost of CPR training, lack of information, and the fear of risking one's own life must be addressed when designing a community-based CPR educational program. Using data from the community can facilitate improved design and implementation of CPR programs.

Videographic assessment of cardiopulmonary resuscitation quality in the pediatric emergency department.

PubMed

Donoghue, Aaron; Hsieh, Ting-Chang; Myers, Sage; Mak, Allison; Sutton, Robert; Nadkarni, Vinay

2015-06-01

To describe the adherence to guidelines for CPR in a tertiary pediatric emergency department (ED) where resuscitations are reviewed by videorecording. Resuscitations in a tertiary pediatric ED are videorecorded as part of a quality improvement project. Patients receiving CPR under videorecorded conditions were eligible for inclusion. CPR parameters were quantified by retrospective review. Data were described by 30-s epoch (compression rate, ventilation rate, compression:ventilation ratio), by segment (duration of single providers' compressions) and by overall event (compression fraction). Duration of interruptions in compressions was measured; tasks completed during pauses were tabulated. 33 children received CPR under videorecorded conditions. A total of 650 min of CPR were analyzed. Chest compressions were performed at <100/min in 90/714 (13%) of epochs; 100-120/min in 309/714 (43%); >120/min in 315/714 (44%). Ventilations were 6-12 breaths/min in 201/708 (23%) of epochs and >12/min in 489/708 (70%). During CPR without an artificial airway, compression:ventilation coordination (15:2) was done in 93/234 (40%) of epochs. 178 pauses in CPR occurred; 120 (67%) were <10s in duration. Of 370 segments of compressions by individual providers, 282/370 (76%) were <2 min in duration. Median compression fraction was 91% (range 88-100%). CPR in a tertiary pediatric ED frequently met recommended parameters for compression rate, pause duration, and compression fraction. Hyperventilation and failure of C:V coordination were very common. Future studies should focus on the impact of training methods on CPR performance as documented by videorecording. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

CPR: A Real Lifesaver (For Kids)

MedlinePlus

... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... English Español CPR: A Real Lifesaver KidsHealth / For Kids / CPR: A Real Lifesaver What's in this article? ...

TRMM Precipitation Radar and Microwave Imager Observations of Convective and Stratiform Rain Over Land and Their Theoretical Implications

NASA Technical Reports Server (NTRS)

Prabhakara, C.; Iacovazzi, R., Jr.; Yoo, J.-M.; Weinman, J. A.; Lau, William K. M. (Technical Monitor)

2001-01-01

Observations of brightness temperature, Tb made over land regions by the Tropical Rainfall Measuring Mission (TRMM) Microwave Imager (TMI) radiometer have been analyzed along with the nearly simultaneous measurements of the vertical profiles of reflectivity factor, Z, made by the Precipitation Radar (PR) onboard the TRMM satellite. This analysis is performed to explore the interrelationship between the TMI and PR data in areas that are covered predominantly by convective or stratiform rain. In particular, we have compared on a scale of 20 km, average vertical profiles of Z with the averages of Tbs in the 19, 37 and 85 GHz channels. Generally, we find from these data that as Z increases, Tbs in the three channels decrease due to extinction. In order to explain physically the relationship between the Tb and Z observations, we have performed radiative transfer simulations utilizing vertical profiles of hydrometeors applicable to convective and stratiform rain regions. These profiles are constructed taking guidance from the Z observations of PR and recent LDR and ZDR measurements made by land-based polarimetric radars.

Millimeter-Wave Radar Field Measurements and Inversion of Cloud Parameters for the 1999 Mt. Washington Icing Sensors Project

NASA Technical Reports Server (NTRS)

Pazmany, Andrew L.; Reehorst, Andrew (Technical Monitor)

2001-01-01

The Mount Washington Icing Sensors Project (MWISP) was a multi-investigator experiment with participants from Quadrant Engineering, NOAA Environmental Technology Laboratory (NOAA/ETL), the Microwave Remote Sensing Laboratory (MIRSL) of the University of Massachusetts (UMass), and others. Radar systems from UMass and NOAA/ETL were used to measure X-, Ka-, and W-band backscatter data from the base of Mt. Washington, while simultaneous in-situ particle measurements were made from aircraft and from the observatory at the summit. This report presents range and time profiles of liquid water content and particle size parameters derived from range profiles of radar reflectivity as measured at X-, Ka-, and W-band (9.3, 33.1, and 94.9 GHz) using an artificial neural network inversion algorithm. In this report, we provide a brief description of the experiment configuration, radar systems, and a review of the artificial neural network used to extract cloud parameters from the radar data. Time histories of liquid water content (LWC), mean volume diameter (MVD) and mean Z diameter (MZD) are plotted at 300 m range intervals for slant ranges between 1.1 and 4 km. Appendix A provides details on the extraction of radar reflectivity from measured radar power, and Appendix B provides summary logs of the weather conditions for each day in which we processed data.

Knockdown of NADPH-cytochrome P450 reductase results in reduced resistance to buprofezin in the small brown planthopper, Laodelphax striatellus (fallén).

PubMed

Zhang, Yueliang; Wang, Yaming; Wang, Lihua; Yao, Jing; Guo, Huifang; Fang, Jichao

2016-02-01

NADPH-cytochrome P450 reductase (CPR) plays an important role in cytochrome P450 function, and CPR knockdown in several insects leads to increased susceptibility to insecticides. However, a putative CPR gene has not yet been fully characterized in the small brown planthopper Laodelphax striatellus, a notorious agricultural pest in rice that causes serious damage by transmitting rice stripe and rice black-streaked dwarf viruses. The objective of this study was to clone the cDNA and to knock down the expression of the gene that encodes L. striatellus CPR (LsCPR) to further determine whether P450s are involved in the resistance of L. striatellus to buprofezin. First, the full-length cDNA of LsCPR was cloned and found to contain an open reading frame (ORF) encoding a polypeptide of 679 amino acids with a calculated molecular mass and isoelectric point of 76.92kDa and 5.37, respectively. The deduced amino acid sequence shares high identity with the CPRs of other insects (98%, 97%, 75% and 68% for Sogatella furcifera, Nilaparvata lugens, Cimex lectularius and Anopheles gambiae, respectively) and possesses the characteristic features of classical CPRs, such as an N-terminal membrane anchor and conserved domains for flavin mononucleotide (FMN), flavin adenine dinucleotide (FAD) and nicotinamide adenine dinucleotide phosphate (NADPH) binding. Phylogenetic analysis revealed that LsCPR is located in a branch along with the CPRs of other hemipteran insects. LsCPR mRNA was detectable in all examined body parts and developmental stages of L. striatellus, as determined by real-time quantitative PCR (qPCR), and transcripts were most abundant in the adult abdomen and in first-instar nymphs and adults. Ingestion of 200μg/mL of LsCPR double-stranded RNA (dsLsCPR) by the planthopper for 5days significantly reduced the transcription level of LsCPR. Moreover, silencing of LsCPR caused increased susceptibility to buprofezin in a buprofezin-resistant (YN-BPF) strain but not in a susceptible (YN) strain. These data further suggested that the P450-mediated metabolic detoxification of xenobiotics might be an important mechanism for buprofezin resistance in L. striatellus. Copyright © 2015 Elsevier B.V. All rights reserved.

A comparison between CloudSat and aircraft data for mixed-phase and cirrus clouds

NASA Astrophysics Data System (ADS)

Mioche, G.; Gayet, J.-F.; Minikin, A.; Herber, A.; Pelon, J.

2009-04-01

Nowadays, space remote sensing measurements are a very useful way to study the atmosphere on a global scale. Among the numerous scientific satellites in space, the A-Train is a constellation of 6 satellites flying together with on board complementary instruments of new generation (radiometers, radar, lidar, spectrometers…) to study all parts of the atmosphere: gas composition, clouds and aerosols distribution and properties, and radiation budget. Among these satellites, two of them where launched in 2006: CALIPSO and CloudSat, respectively with a Lidar (532 and 1064 nm channels with depolarization) and a 94 GHz radar on board. They are especially dedicated to the study of clouds and aerosols, and will allow to obtain for the first time the vertical profiles of clouds and aerosols on a global scale during 3 years. However, to determine clouds and aerosols properties from space raw data, retrieval methods need to be developed. In order to validate these retrieved techniques, and thus the clouds and aerosols properties, numerous validation plans take place around the world, included different ways as ground based measurements, in situ measurements, or airborne remote sensing instruments in collocation with the satellite tracks. In this context, the ASTAR-2007 and POLARCAT-2008 campaigns took place respectively in the Arctic region of Spitzbergen-Norway in April 2007 and in North part of Sweden in April 2008 to study mixed-phase clouds and the CIRCLE-2 campaign was carried out in Western Europe in May 2007 to sample mid-latitude cirrus clouds. The main objectives are the study of microphysical and optical properties of mixed-phase and ice clouds with particular interest on the validation of clouds products derived from CloudSat and CALIPSO data during co-located remote and in situ observations. The airborne microphysical instruments include the Polar Nephelometer probe to measure the scattering phase function and asymmetry parameter of cloud particles, the high resolution Cloud Particle Imager probe (CPI) for imaging the ice particle morphology (2.3 microns pixels size) and standard PMS probes: 2D-C, FSSP-100 and FSSP-300. This presentation focuses on the validation of the standard parameter of the Cloud Profiling Radar (CPR) of CloudSat (equivalent radar reflectivity factor Z). The different IWC(ice water content)-Z relationships determined from combined CloudSat and in situ data are then discussed. The method to derive equivalent reflectivity factor from the CPI data is first presented. According to the particle shape, a mass-diameter relationship and thus a reflectivity factor is determined for each type of ice crystal. This technique noticeably decreases the discrepancies of radar reflectivity-derived values due to the natural variability of ice crystal shapes. Comparisons of the reflectivity factor deduced from CPI and those from CloudSat for various types of clouds are then discussed. The next step to the interpretation of the CloudSat product is to derive IWC-Z relationships for assessing IWC distributions on a global scale, which is an important improvement to constrain global scale modelling. Several IWC-Z relationships are determined from in situ measurements according to the various case studies including Arctic mixed-phase clouds, Arctic and mid-latitude cirrus. The improvements on the results by using the CPI data-processing method are discussed. Acknowledgements: This work was funded by the Centre National d'Etudes Spatiales (CNES), the Agence Nationale de la Recherche (ANR BLAN06-1_137670), the Institut National des Sciences de l'Univers (INSU/CNRS), the Institut Polaire Français Paul Emile Victor (IPEV), the Alfred Wegener Institute (AWI) and the Deutsches Zentrum für Luft-und Raumfahrt (DLR). The CloudSat data are courtesy of the CloudSat Data Processing Center.

A community-based epidemiological study of peripheral neuropathies in Assiut, Egypt.

PubMed

Kandil, Mahmoud R; Darwish, Esam S; Khedr, Eman M; Sabry, Mahmoud M; Abdulah, Mohamed A

2012-12-01

There is very little published information about the prevalence, patterns, and predictors of peripheral neuropathies. The current study is a community-based survey was conducted in the Assiut Governorate to estimate their prevalence and clinical profile. A door-to-door study was carried out on 42,223 persons from rural and urban communities in the Assiut Governorate, Egypt. There were 13,288 (31.5%) subjects from the urban and 28,935 (68·5%) from the rural area. All subjects filled in a questionnaire designed specifically for diagnosis of peripheral neuropathy. Positive cases were then given a complete medical and neurological examination, routine laboratory tests, neurophysiology, and neuroimaging (magnetic resonance). The crude prevalence rate (CPR) of peripheral neuropathy was 3181/100,000 inhabitants. There was a significantly higher prevalence in the rural compared with the urban population (3795 versus 1844/100,000) and in females than males (4473 versus 1943/100,000; P<0.001 for both). The most common type reported was entrapment neuropathy (736 cases with CPR of 1743/100,000), particularly carpal tunnel syndrome (1686/100,000). Diabetic neuropathy was the most common non-compressive neuropathy with a CPR of 649/100,000. Type II diabetes was recorded in 241 patients with a CPR of 571/100,000. Compressive radiculopathy had a crude prevalence of 358/100,000; traumatic and iatrogenic radiculopathy had a prevalence rate of 149/100,000. Less common conditions were: uremic neuropathy (21/100,000) hepatic neuropathy (14/100,000), Bell's palsy (28/100,000), Guillian-Barre' syndrome (12/100,000), chronic inflammatory demyelinating polyneuropathy (12/100,000), hereditary sensory motor neuropathy (12/100,000), and idiopathic neuropathy (92/100,000). The overall prevalence of peripheral neuropathies was high in comparison to other studies. Entrapment neuropathy, diabetic neuropathy, and spondylotic radiculopathy were the most common. Overall, the prevalence of peripheral neuropathy was higher in the rural than in the urban population.

A browser-based 3D Visualization Tool designed for comparing CERES/CALIOP/CloudSAT level-2 data sets.

NASA Astrophysics Data System (ADS)

Chu, C.; Sun-Mack, S.; Chen, Y.; Heckert, E.; Doelling, D. R.

2017-12-01

In Langley NASA, Clouds and the Earth's Radiant Energy System (CERES) and Moderate Resolution Imaging Spectroradiometer (MODIS) are merged with Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) on the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) and CloudSat Cloud Profiling Radar (CPR). The CERES merged product (C3M) matches up to three CALIPSO footprints with each MODIS pixel along its ground track. It then assigns the nearest CloudSat footprint to each of those MODIS pixels. The cloud properties from MODIS, retrieved using the CERES algorithms, are included in C3M with the matched CALIPSO and CloudSat products along with radiances from 18 MODIS channels. The dataset is used to validate the CERES retrieved MODIS cloud properties and the computed TOA and surface flux difference using MODIS or CALIOP/CloudSAT retrieved clouds. This information is then used to tune the computed fluxes to match the CERES observed TOA flux. A visualization tool will be invaluable to determine the cause of these large cloud and flux differences in order to improve the methodology. This effort is part of larger effort to allow users to order the CERES C3M product sub-setted by time and parameter as well as the previously mentioned visualization capabilities. This presentation will show a new graphical 3D-interface, 3D-CERESVis, that allows users to view both passive remote sensing satellites (MODIS and CERES) and active satellites (CALIPSO and CloudSat), such that the detailed vertical structures of cloud properties from CALIPSO and CloudSat are displayed side by side with horizontally retrieved cloud properties from MODIS and CERES. Similarly, the CERES computed profile fluxes whether using MODIS or CALIPSO and CloudSat clouds can also be compared. 3D-CERESVis is a browser-based visualization tool that makes uses of techniques such as multiple synchronized cursors, COLLADA format data and Cesium.

The viability of transplanting organs from donors who underwent cardiopulmonary resuscitation: A systematic review.

PubMed

West, Stephen; Soar, Jasmeet; Callaway, Clifton W

2016-11-01

To identify reports of patients who underwent cardiopulmonary resuscitation (CPR) prior to solid organ donation and compare recipient and organ function outcomes to those that did not undergo CPR. Donation after restoration of circulation then progressing to death and those donating with on-going CPR who would have otherwise have termination of efforts were both included. Systematic review. Clinical studies comparing the outcome of patients and organs retrieved from donors who underwent CPR with those that did not require CPR. Full-text articles were searched on EmBASE, MEDLINE, Cochrane Database of Systematic Reviews and the Cochrane Register of Controlled Trials. Twenty-two observational studies were included. There were 12,206 adult and 2552 paediatric organ transplantation identified. Comparing donation after restoration of circulation there was no difference in immediate, one year, and five-year graft function. Donation with on-going CPR was associated with reduced immediate graft function for both renal and hepatic transplantation, however long term function was not different. CPR does not appear to adversely affect graft function. Patients who have restored circulation after resuscitation and subsequently progress to death should be evaluated for organ donation. Those with on-going CPR should be considered for hepatic and renal transplantation but there may be worse initial graft function. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The effect of real-time CPR feedback and post event debriefing on patient and processes focused outcomes: a cohort study: trial protocol.

PubMed

Perkins, Gavin D; Davies, Robin P; Quinton, Sarah; Woolley, Sarah; Gao, Fang; Abella, Ben; Stallard, Nigel; Cooke, Matthew W

2011-10-18

Cardiac arrest affects 30-35, 000 hospitalised patients in the UK every year. For these patients to be given the best chance of survival, high quality cardiopulmonary resuscitation (CPR) must be delivered, however the quality of CPR in real-life is often suboptimal. CPR feedback devices have been shown to improve CPR quality in the pre-hospital setting and post-event debriefing can improve adherence to guidelines and CPR quality. However, the evidence for use of these improvement methods in hospital remains unclear. The CPR quality improvement initiative is a prospective cohort study of the Q-CPR real-time feedback device combined with post-event debriefing in hospitalised adult patients who sustain a cardiac arrest. The primary objective of this trial is to assess whether a CPR quality improvement initiative will improve rate of return of sustained spontaneous circulation in in-hospital-cardiac-arrest patients. The study is set in one NHS trust operating three hospital sites. Secondary objectives will evaluate: any return of spontaneous circulation; survival to hospital discharge and patient cerebral performance category at discharge; quality of CPR variables and cardiac arrest team factors. All three sites will have an initial control phase before any improvements are implemented; site 1 will implement audiovisual feedback combined with post event debriefing, site 2 will implement audiovisual feedback only and site 3 will remain as a control site to measure any changes in outcome due to any other trust-wide changes in resuscitation practice. All adult patients sustaining a cardiac arrest and receiving resuscitation from the hospital cardiac arrest team will be included. Patients will be excluded if; they have a Do-not-attempt resuscitation order written and documented in their medical records, the cardiac arrest is not attended by a resuscitation team, the arrest occurs out-of-hospital or the patient has previously participated in this study. The trial will recruit a total of 912 patients from the three hospital sites. This trial will evaluate patient and process focussed outcomes following the implementation of a CPR quality improvement initiative using real-time audiovisual feedback and post event debriefing. ISRCTN56583860.

Cardiopulmonary Resuscitation Training Rates in the United States

PubMed Central

Anderson, Monique L.; Cox, Margueritte; Al-Khatib, Sana M.; Nichol, Graham; Thomas, Kevin L.; Chan, Paul S.; Saha-Chaudhuri, Paramita; Fosbol, Emil L.; Eigel, Brian; Clendenen, Bill; Peterson, Eric D.

2014-01-01

Context Bystander cardiopulmonary resuscitation (CPR) improves the likelihood of surviving out-of-hospital cardiac arrest (OHCA), yet treatment rates differ by a community’s racial and income composition. Objective To determine if CPR training differs by the race and income of communities across the United States (U.S.). Design, Setting, and Participants We analyzed county-level CPR training rates from 2010–2011 using CPR training data from the American Heart Association, the American Red Cross, and the Health and Safety Institute. We utilized multivariable logistic regression models to examine the association of annual adult CPR training rates with a county’s proportion of black residents and median household income (categorized as tertiles), as well as other demographic, geographic, and healthcare characteristics. Main Outcome Measure CPR training rate. Results From 07/01/2010–06/30/2011, 13.1 million persons in 3143 U.S. counties received CPR training. The median county training rate ranged from 0.00%–1.29% (median=0.51%) in the lower tertile, 1.29%–4.07% (median=2.39%) in the middle tertile, and >4.07% (median=6.81%) in the upper tertile. Counties that were most likely to have CPR training rates in the lower tertile included those with a higher proportion of rural (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.10, 1.15 per 5 percentage point [PP] change), black (OR 1.09, 95% CI 1.06, 1.13 per 5 PP change), and Hispanic residents (OR 1.06, 95% CI 1.02, 1.11 per 5 PP change); those with a lower median household income (OR 1.18, 95% CI 1.04, 1.34 per $10,000 decrease); those with a higher median age (OR 1.28, 95% CI 1.04, 1.53 per 10 year change); and those located in the South. Conclusions Counties with a higher proportion of rural, black, Hispanic, and lower income residents had lower CPR training rates. Differences in CPR training by race and income may contribute to recognized disparities in bystander CPR treatment and OHCA survival, and offer opportunities for future community interventions. PMID:24247329

A Randomized Controlled Trial of a CPR and Intubation Video Decision Support Tool for Hospitalized Patients.

PubMed

El-Jawahri, Areej; Mitchell, Susan L; Paasche-Orlow, Michael K; Temel, Jennifer S; Jackson, Vicki A; Rutledge, Renee R; Parikh, Mihir; Davis, Aretha D; Gillick, Muriel R; Barry, Michael J; Lopez, Lenny; Walker-Corkery, Elizabeth S; Chang, Yuchiao; Finn, Kathleen; Coley, Christopher; Volandes, Angelo E

2015-08-01

Decisions about cardiopulmonary resuscitation (CPR) and intubation are a core part of advance care planning, particularly for seriously ill hospitalized patients. However, these discussions are often avoided. We aimed to examine the impact of a video decision tool for CPR and intubation on patients' choices, knowledge, medical orders, and discussions with providers. This was a prospective randomized trial conducted between 9 March 2011 and 1 June 2013 on the internal medicine services at two hospitals in Boston. One hundred and fifty seriously ill hospitalized patients over the age of 60 with an advanced illness and a prognosis of 1 year or less were included. Mean age was 76 and 51% were women. Three-minute video describing CPR and intubation plus verbal communication of participants' preferences to their physicians (intervention) (N = 75) or control arm (usual care) (N = 75). The primary outcome was participants' preferences for CPR and intubation (immediately after viewing the video in the intervention arm). Secondary outcomes included: orders to withhold CPR/intubation, documented discussions with providers during hospitalization, and participants' knowledge of CPR/ intubation (five-item test, range 0-5, higher scores indicate greater knowledge). Intervention participants (vs. controls) were more likely not to want CPR (64% vs. 32%, p <0.0001) and intubation (72% vs. 43%, p < 0.0001). Intervention participants (vs. controls) were also more likely to have orders to withhold CPR (57% vs. 19%, p < 0.0001) and intubation (64% vs.19%, p < 0.0001) by hospital discharge, documented discussions about their preferences (81% vs. 43%, p < 0.0001), and higher mean knowledge scores (4.11 vs. 2.45; p < 0.0001). Seriously ill patients who viewed a video about CPR and intubation were more likely not to want these treatments, be better informed about their options, have orders to forgo CPR/ intubation, and discuss preferences with providers. Clinicaltrials.gov NCT01325519 Registry Name: A prospective randomized trial using video images in advance care planning in seriously ill hospitalized patients.

The Microwave Radiative Properties of Falling Snow Derived from Nonspherical Ice Particle Models. Part II: Initial Testing Using Radar, Radiometer and In Situ Observations

NASA Technical Reports Server (NTRS)

Olson, William S.; Tian, Lin; Grecu, Mircea; Kuo, Kwo-Sen; Johnson, Benjamin; Heymsfield, Andrew J.; Bansemer, Aaron; Heymsfield, Gerald M.; Wang, James R.; Meneghini, Robert

2016-01-01

In this study, two different particle models describing the structure and electromagnetic properties of snow are developed and evaluated for potential use in satellite combined radar-radiometer precipitation estimation algorithms. In the first model, snow particles are assumed to be homogeneous ice-air spheres with single-scattering properties derived from Mie theory. In the second model, snow particles are created by simulating the self-collection of pristine ice crystals into aggregate particles of different sizes, using different numbers and habits of the collected component crystals. Single-scattering properties of the resulting nonspherical snow particles are determined using the discrete dipole approximation. The size-distribution-integrated scattering properties of the spherical and nonspherical snow particles are incorporated into a dual-wavelength radar profiling algorithm that is applied to 14- and 34-GHz observations of stratiform precipitation from the ER-2 aircraft-borne High-Altitude Imaging Wind and Rain Airborne Profiler (HIWRAP) radar. The retrieved ice precipitation profiles are then input to a forward radiative transfer calculation in an attempt to simulate coincident radiance observations from the Conical Scanning Millimeter-Wave Imaging Radiometer (CoSMIR). Much greater consistency between the simulated and observed CoSMIR radiances is obtained using estimated profiles that are based upon the nonspherical crystal/aggregate snow particle model. Despite this greater consistency, there remain some discrepancies between the higher moments of the HIWRAP-retrieved precipitation size distributions and in situ distributions derived from microphysics probe observations obtained from Citation aircraft underflights of the ER-2. These discrepancies can only be eliminated if a subset of lower-density crystal/aggregate snow particles is assumed in the radar algorithm and in the interpretation of the in situ data.

Functioning of Microsomal Cytochrome P450s: Murburn Concept Explains the Metabolism of Xenobiotics in Hepatocytes.

PubMed

Manoj, Kelath Murali; Parashar, Abhinav; Gade, Sudeep K; Venkatachalam, Avanthika

2016-01-01

Using oxygen and NADPH, the redox enzymes cytochrome P450 (CYP) and its reductase (CPR) work in tandem to carry out the phase I metabolism of a vast majority of drugs and xenobiotics. As per the erstwhile understanding of the catalytic cycle, binding of the substrate to CYP's heme distal pocket allows CPR to pump electrons through a CPR-CYP complex. In turn, this trigger (a thermodynamic push of electrons) leads to the activation of oxygen at CYP's heme-center, to give Compound I, a two-electron deficient enzyme reactive intermediate. The formation of diffusible radicals and reactive oxygen species (DROS, hitherto considered an undesired facet of the system) was attributed to the heme-center. Recently, we had challenged these perceptions and proposed the murburn ("mured burning" or "mild unrestricted burning") concept to explain heme enzymes' catalytic mechanism, electron-transfer phenomena and the regulation of redox equivalents' consumption. Murburn concept incorporates a one-electron paradigm, advocating obligatory roles for DROS. The new understanding does not call for high-affinity substrate-binding at the heme distal pocket of the CYP (the first and the most crucial step of the erstwhile paradigm) or CYP-CPR protein-protein complexations (the operational backbone of the erstwhile cycle). Herein, the dynamics of reduced nicotinamide nucleotides' consumption, peroxide formation and depletion, product(s) formation, etc. was investigated with various controls, by altering reaction variables, environments and through the incorporation of diverse molecular probes. In several CYP systems, control reactions lacking the specific substrate showed comparable or higher peroxide in milieu, thereby discrediting the foundations of the erstwhile hypothesis. The profiles obtained by altering CYP:CPR ratios and the profound inhibitions observed upon the incorporation of catalytic amounts of horseradish peroxidase confirm the obligatory roles of DROS in milieu, ratifying murburn as the operative concept. The mechanism of uncoupling (peroxide/water formation) was found to be dependent on multiple one and two electron equilibriums amongst the reaction components. The investigation explains the evolutionary implications of xenobiotic metabolism, confirms the obligatory role of diffusible reactive species in routine redox metabolism within liver microsomes and establishes that a redox enzyme like CYP enhances reaction rates (achieves catalysis) via a novel (hitherto unknown) modality.

Application of wind-profiling radar data to the analysis of dust weather in the Taklimakan Desert.

PubMed

Wang, Minzhong; Wei, Wenshou; Ruan, Zheng; He, Qing; Ge, Runsheng

2013-06-01

The Urumqi Institute of Desert Meteorology of the China Meteorological Administration carried out an atmospheric scientific experiment to detect dust weather using a wind-profiling radar in the hinterland of the Taklimakan Desert in April 2010. Based on the wind-profiling data obtained from this experiment, this paper seeks to (a) analyze the characteristics of the horizontal wind field and vertical velocity of a breaking dust weather in a desert hinterland; (b) calculate and give the radar echo intensity and vertical distribution of a dust storm, blowing sand, and floating dust weather; and (c) discuss the atmosphere dust counts/concentration derived from the wind-profiling radar data. Studies show that: (a) A wind-profiling radar is an upper-air atmospheric remote sensing system that effectively detects and monitors dust. It captures the beginning and ending of a dust weather process as well as monitors the sand and dust being transported in the air in terms of height, thickness, and vertical intensity. (b) The echo intensity of a blowing sand and dust storm weather episode in Taklimakan is about -1~10 dBZ while that of floating dust -1~-15 dBZ, indicating that the dust echo intensity is significantly weaker than that of precipitation but stronger than that of clear air. (c) The vertical shear of horizontal wind and the maintenance of low-level east wind are usually dynamic factors causing a dust weather process in Taklimakan. The moment that the low-level horizontal wind field finds a shear over time, it often coincides with the onset of a sand blowing and dust storm weather process. (d) When a blowing sand or dust storm weather event occurs, the atmospheric vertical velocity tends to be of upward motion. This vertical upward movement of the atmosphere supported with a fast horizontal wind and a dry underlying surface carries dust particles from the ground up to the air to form blown sand or a dust storm.

VHF radar measurements during MAP/WINE

NASA Technical Reports Server (NTRS)

Czechowsky, P.; Klostermeyer, J.; Ruster, R.; Schmidt, G.; Rottger, J.

1983-01-01

Sensitive Doppler radars which operate in the very high frequency (VHF) band, usually near 50 MHz can measure profiles of background winds, tides, atmospheric gravity waves and turbulence at tropospheric, stratospheric and mesospheric heights. Their ability to observe simultaneously large and small-scale processes makes them unique instruments for studying not only each process separately but also their nonlinear interactions. The mobile VHF radar to be used during the MAP/WINE campaign on Andoya is a modified version of the SOUSY VHF radar being in operation for six years in the Harz Mountains.

A microprogrammable radar controller

NASA Technical Reports Server (NTRS)

Law, D. C.

1986-01-01

The Wave Propagation Lab. has completed the design and construction of a microprogrammable radar controller for atmospheric wind profiling. Unlike some radar controllers using state machines or hardwired logic for radar timing, this design is a high speed programmable sequencer with signal processing resources. A block diagram of the device is shown. The device is a single 8 1/2 inch by 10 1/2 inch printed circuit board and consists of three main subsections: (1) the host computer interface; (2) the microprogram sequencer; and (3) the signal processing circuitry. Each of these subsections are described in detail.

Airborne radar and radiometer experiment for quantitative remote measurements of rain

NASA Technical Reports Server (NTRS)

Kozu, Toshiaki; Meneghini, Robert; Boncyk, Wayne; Wilheit, Thomas T.; Nakamura, Kenji

1989-01-01

An aircraft experiment has been conducted with a dual-frequency (10 GHz and 35 GHz) radar/radiometer system and an 18-GHz radiometer to test various rain-rate retrieval algorithms from space. In the experiment, which took place in the fall of 1988 at the NASA Wallops Flight Facility, VA, both stratiform and convective storms were observed. A ground-based radar and rain gauges were also used to obtain truth data. An external radar calibration is made with rain gauge data, thereby enabling quantitative reflectivity measurements. Comparisons between path attenuations derived from the surface return and from the radar reflectivity profile are made to test the feasibility of a technique to estimate the raindrop size distribution from simultaneous radar and path-attenuation measurements.

The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study.

PubMed

Gyory, Robert A; Buchle, Scott E; Rodgers, David; Lubin, Jeffrey S

2017-04-01

High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines. We performed a crossover-controlled study in which a recording mannequin was placed on the second floor of a building. An emergency medical services (EMS) crew responded, defibrillated, and provided either manual or LUCAS CPR. The team transported the mannequin through hallways and down stairs to an ambulance and drove to the hospital with CPR in progress. Critical events were manually timed while the mannequin recorded data on compressions. Twenty-three EMS providers participated. Median time to defibrillation was not different for LUCAS compared to manual CPR (p=0.97). LUCAS had a lower median number of compressions per minute (112/min vs. 125/min; IQR = 102-128 and 102-126 respectively; p<0.002), which was more consistent with current American Heart Association CPR guidelines, and percent adequate compression rate (71% vs. 40%; IQR = 21-93 and 12-88 respectively; p<0.002). In addition, LUCAS had a higher percent adequate depth (52% vs. 36%; IQR = 25-64 and 29-39 respectively; p<0.007) and lower percent total hands-off time (15% vs. 20%; IQR = 10-22 and 15-27 respectively; p<0.005). LUCAS performed no differently than manual CPR in median compression release depth, percent fully released compressions, median time hands off, or percent correct hand position. In our simulation, LUCAS had a higher rate of adequate compressions and decreased total hands-off time as compared to manual CPR. Chest compression quality may be better when using a mechanical device during patient movement in prehospital cardiac arrest patient.

Impact of cardiopulmonary resuscitation duration on survival from paramedic witnessed out-of-hospital cardiac arrests: An observational study.

PubMed

Nehme, Z; Andrew, E; Bernard, S; Smith, K

2016-03-01

Resuscitation guidelines often recommend ongoing cardiopulmonary resuscitation (CPR) efforts to hospital for out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical service (EMS) personnel. In this study, we examine the relationship between EMS CPR duration and survival to hospital discharge in EMS witnessed OHCA patients. Between January 2003 and December 2011, 1035 adult EMS witnessed arrests of presumed cardiac aetiology were included from the Victorian Ambulance Cardiac Arrest Registry. CPR duration was defined as the total sum of prehospital CPR time in minutes. Adjusted logistic regression analyses were used to assess the impact of EMS CPR duration on survival to hospital discharge. 382 (37.3%) patients were discharged alive. The median CPR duration was 12 min (95% CI: 11-13) overall, but was higher in non-survivors compared to survivors (24 min vs. 2 min, p<0.001). The 99th percentile CPR duration in patients surviving to hospital discharge differed by the initial rhythm of arrest: 32 min (95% CI: 27-44) overall, 32 min (95% CI: 23-44) for ventricular fibrillation and pulseless ventricular tachycardia (VF/VT), 34 min (95% CI: 30-34) for pulseless electrical activity (PEA), and 28 min (95% CI: 21-28) for asystole. There were no survivors after 44 min for all rhythms. After adjusting for prehospital confounders, every minute increase in CPR duration was associated with a 13% reduction in the odds of survival to hospital discharge (OR 0.87, 95% CI: 0.84-0.89, p<0.001). The multivariable model predicted no chance of survival at or after a CPR duration of 48 min for VF/VT patients, 47 min for PEA patients and 45 min for asystole patients. Resuscitation efforts exceeding 32 min yielded less than 1% of survivors from EMS witnessed OHCA. On the basis of this data, EMS witnessed OHCA patients may benefit from ongoing CPR efforts up to 48 min in duration. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Dispatchers' impressions and actual quality of cardiopulmonary resuscitation during telephone-assisted bystander cardiopulmonary resuscitation: a pooled analysis of 94 simulated, manikin-based scenarios].

PubMed

van Tulder, Raphael; Roth, Dominik; Laggner, Roberta; Krammel, Mario; Schriefl, Christoph; Kienbacher, Calvin; Novosad, Heinz; Chwojka, Constantin Christof; Sterz, Fritz; Havel, Christof; Schreiber, Wolfgang; Herkner, Harald

2017-02-01

The quality of telephone-assisted cardiopulmonary resuscitation (CPR) needs improvement. This study investigates whether a dispatchers' perception is an adequate measure of the actual quality of CPR provided by laypersons. Individual participant data from 3 randomized simulation trials, with identical methodology but different interventions, were combined for this analysis. Professional dispatchers gave telephone assistance to laypersons, who each provided 10 minutes of CPR on a manikin. Dispatchers were requested to classify the quality of providers' CPR as adequate or inadequate. Based on actual readings from manikins we classified providers' performance as adequate at 5-6 cm for depth and 100-120 compressions per minute (cpm) for rate. We calculated metrics of dispatcher accuracy. Six dispatchers rated the performance of 94 laypersons (38 women [42%]) with a mean (SD) age of 37 (14) years. In 905 analyzed minutes of telephone-assisted CPR, the mean compression depth and rate was 41 (13) mm and 98 (24) cpm, respectively. Analysis of dispatchers' diagnostic test accuracy for adequate compression depth yielded a sensitivity of 65% (95 CI 36%-95%) and specificity of 42% (95% CI, 32%-53%). Analysis of their assessment of adequate compression rate yielded a sensitivity of 75% (95% CI, 64%-86%) and specificity of 42% (95% CI, 32%-52%). Although dispatchers always underestimated the actual values of CPR parameters, the female dispatchers evaluations were less inaccurate than the evaluations of make dispatchers; the dispatchers overall (males and females together) underestimated the adequacy of female laypersons' CPR performance to a greater degree than female dispatchers did. The ability of dispatchers to estimate the quality of telephone-assisted CPR is limited. Dispatchers estimates of CPR adequacy needs to be studied further in order to find ways that telephone-assisted CPR might be improved.

Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the MECCA study report

PubMed Central

Anantharaman, Venkataraman; Ng, Boon Lui Benjamin; Ang, Shiang Hu; Lee, Chun Yue Francis; Leong, Siew Hon Benjamin; Ong, Marcus Eng Hock; Chua, Siang Jin Terrance; Rabind, Antony Charles; Anjali, Nagaraj Baglody; Hao, Ying

2017-01-01

INTRODUCTION Early use of mechanical cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) may improve survival outcomes. Current evidence for such devices uses outcomes from an intention-to-treat (ITT) perspective. We aimed to determine whether early use of mechanical CPR using a LUCAS 2 device results in better outcomes. METHODS A prospective, randomised, multicentre study was conducted over one year with LUCAS 2 devices in 14 ambulances and manual CPR in 32 ambulances to manage OHCA. The primary outcome was return of spontaneous circulation (ROSC). Secondary outcomes were survival at 24 hours, discharge from hospital and 30 days. RESULTS Of the 1,274 patients recruited, 1,191 were eligible for analysis. 889 had manual CPR and 302 had LUCAS CPR. From an ITT perspective, outcomes for manual and LUCAS CPR were: ROSC 29.2% and 31.1% (odds ratio [OR] 1.09, 95% confidence interval [CI] 0.82–1.45; p = 0.537); 24-hour survival 11.2% and 13.2% (OR 1.20, 95% CI 0.81–1.78; p = 0.352); survival to discharge 3.6% and 4.3% (OR 1.20, 95% CI 0.62–2.33; p = 0.579); and 30-day survival 3.0% and 4.0% (OR 1.32, 95% CI 0.66–2.64; p = 0.430), respectively. By as-treated analysis, outcomes for manual, early LUCAS and late LUCAS CPR were: ROSC 28.0%, 36.9% and 24.5%; 24-hour survival 10.6%, 15.5% and 8.2%; survival to discharge 2.9%, 5.8% and 2.0%; and 30-day survival 2.4%, 5.8% and 0.0%, respectively. Adjusted OR for survival with early LUCAS vs. manual CPR was 1.47 after adjustment for other variables (p = 0.026). CONCLUSION This study showed a survival benefit with LUCAS CPR as compared to manual CPR only, when the device was applied early on-site. PMID:28741013

Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis

PubMed Central

Sehatzadeh, S

2014-01-01

Background Cardiopulmonary resuscitation (CPR) was first introduced in 1960 for people who unexpectedly experience sudden cardiac arrest. Over the years, it became routine practice in all institutions to perform CPR for all patients even though, for some patients with fatal conditions, application of CPR only prolongs the dying process through temporarily restoring cardiac function. Objectives This analysis aims to systematically review the literature to provide an accurate estimate of survival following CPR in patients with terminal health conditions. Data Sources A literature search was performed for studies published from January 1, 2004, until January 10, 2014. The search was updated monthly to March 1, 2014. Review Methods Abstracts and full text of studies that met eligibility criteria were reviewed. Reference lists were also examined for any additional relevant studies not identified through the search. Results Cancer patients have lower survival rates following CPR than patients with conditions other than cancer, and cancer patients who receive CPR in intensive care units have one-fifth the rate of survival to discharge of cancer patients who receive CPR in general wards. While the meta-analysis of studies published between 1967 and 2005 reported a lower survival to discharge for cancer patients (6.2%), more recent studies reported higher survival to discharge or to 30-day survival for these patients. Higher survival rates in more recent studies could originate with more “do not attempt resuscitation” orders for patients with end-stage cancer in recent years. Older age does not significantly decrease the rate of survival following CPR while the degree, the type, and the number of chronic health conditions; functional dependence; and multiple CPRs (particularly in advanced age) do reduce survival rates. Emergency Medical Services response time have a significant impact on survival following out-of-hospital CPR. Conclusions Survival after CPR depends on the severity of illness, type and number of health conditions, functional dependence, and multiple CPRs. PMID:26339301

Recruitments of trained citizen volunteering for conventional cardiopulmonary resuscitation are necessary to improve the outcome after out-of-hospital cardiac arrests in remote time-distance area: A nationwide population-based study.

PubMed

Takei, Yutaka; Kamikura, Takahisa; Nishi, Taiki; Maeda, Tetsuo; Sakagami, Satoru; Kubo, Minoru; Inaba, Hideo

2016-08-01

To compare the factors associated with survival after out-of-hospital cardiac arrests (OHCAs) among three time-distance areas (defined as interquartile range of time for emergency medical services response to patient's side). From a nationwide, prospectively collected data on 716,608 OHCAs between 2007 and 2012, this study analyzed 193,914 bystander-witnessed OHCAs without pre-hospital physician involvement. Overall neurologically favourable 1-month survival rates were 7.4%, 4.1% and 1.7% for close, intermediate and remote areas, respectively. We classified BCPR by type (compression-only vs. conventional) and by dispatcher-assisted CPR (DA-CPR) (with vs. without); the effects on time-distance area survival were analyzed by BCPR classification. Association of each BCPR classification with survival was affected by time-distance area and arrest aetiology (p<0.05). The survival rates in the remote area were much higher with conventional BCPR than with compression-only BCPR (odds ratio; 95% confidence interval, 1.26; 1.05-1.51) and with BCPR without DA-CPR than with BCPR with DA-CPR (1.54; 1.29-1.82). Accordingly, we classified BCPR into five groups (no BCPR, compression-only with DA-CPR, conventional with DA-CPR, compression-only without DA-CPR, and conventional without DA-CPR) and analyzed for associations with survival, both cardiac and non-cardiac related, in each time-distance area by multivariate logistic regression analysis. In the remote area, conventional BCPR without DA-CPR significantly improved survival after OHCAs of cardiac aetiology, compared with all the other BCPR groups. Other correctable factors associated with survival were short collapse-to-call and call-to-first CPR intervals. Every effort to recruit trained citizens initiating conventional BCPR should be made in remote time-distance areas. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Isolation and Expression Analysis of CYP9A11 and Cytochrome P450 Reductase Gene in the Beet Armyworm (Lepidoptera: Noctuidae)

PubMed Central

Zhao, Chunqing; Feng, Xiaoyun; Tang, Tao; Qiu, Lihong

2015-01-01

Cytochrome P450 monooxygenases (CYPs), as an enzyme superfamily, is widely distributed in organisms and plays a vital function in the metabolism of exogenous and endogenous compounds by interacting with its obligatory redox partner, CYP reductase (CPR). A novel CYP gene (CYP9A11) and CPR gene from the agricultural pest insect Spodoptera exigua were cloned and characterized. The complete cDNA sequences of SeCYP9A11 and SeCPR are 1,931 and 3,919 bp in length, respectively, and contain open reading frames of 1,593 and 2,070 nucleotides, respectively. Analysis of the putative protein sequences indicated that SeCYP9A11 contains a heme-binding domain and the unique characteristic sequence (SRFALCE) of the CYP9 family, in addition to a signal peptide and transmembrane segment at the N-terminal. Alignment analysis revealed that SeCYP9A11 shares the highest sequence similarity with CYP9A13 from Mamestra brassicae, which is 66.54%. The putative protein sequence of SeCPR has all of the classical CPR features, such as an N-terminal membrane anchor; three conserved domain flavin adenine dinucleotide (FAD), flavin mononucleotide (FMN), and nicotinamide adenine dinucleotide phosphate (NADPH) domain; and characteristic binding motifs. Phylogenetic analysis revealed that SeCPR shares the highest identity with HaCPR, which is 95.21%. The SeCYP9A11 and SeCPR genes were detected in the midgut, fat body, and cuticle tissues, and throughout all of the developmental stages of S. exigua. The mRNA levels of SeCYP9A11 and SeCPR decreased remarkably after exposure to plant secondary metabolites quercetin and tannin. The results regarding SeCYP9A11 and SeCPR genes in the current study provide foundation for the further study of S. exigua P450 system. PMID:26320261

Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis.

PubMed

Sehatzadeh, S

2014-01-01

Cardiopulmonary resuscitation (CPR) was first introduced in 1960 for people who unexpectedly experience sudden cardiac arrest. Over the years, it became routine practice in all institutions to perform CPR for all patients even though, for some patients with fatal conditions, application of CPR only prolongs the dying process through temporarily restoring cardiac function. This analysis aims to systematically review the literature to provide an accurate estimate of survival following CPR in patients with terminal health conditions. A literature search was performed for studies published from January 1, 2004, until January 10, 2014. The search was updated monthly to March 1, 2014. Abstracts and full text of studies that met eligibility criteria were reviewed. Reference lists were also examined for any additional relevant studies not identified through the search. Cancer patients have lower survival rates following CPR than patients with conditions other than cancer, and cancer patients who receive CPR in intensive care units have one-fifth the rate of survival to discharge of cancer patients who receive CPR in general wards. While the meta-analysis of studies published between 1967 and 2005 reported a lower survival to discharge for cancer patients (6.2%), more recent studies reported higher survival to discharge or to 30-day survival for these patients. Higher survival rates in more recent studies could originate with more "do not attempt resuscitation" orders for patients with end-stage cancer in recent years. Older age does not significantly decrease the rate of survival following CPR while the degree, the type, and the number of chronic health conditions; functional dependence; and multiple CPRs (particularly in advanced age) do reduce survival rates. Emergency Medical Services response time have a significant impact on survival following out-of-hospital CPR. Survival after CPR depends on the severity of illness, type and number of health conditions, functional dependence, and multiple CPRs.

On interrelations of recurrences and connectivity trends between stock indices

NASA Astrophysics Data System (ADS)

Goswami, B.; Ambika, G.; Marwan, N.; Kurths, J.

2012-09-01

Financial data has been extensively studied for correlations using Pearson's cross-correlation coefficient ρ as the point of departure. We employ an estimator based on recurrence plots - the correlation of probability of recurrence (CPR) - to analyze connections between nine stock indices spread worldwide. We suggest a slight modification of the CPR approach in order to get more robust results. We examine trends in CPR for an approximately 19-month window moved along the time series and compare them to trends in ρ. Binning CPR into three levels of connectedness (strong, moderate, and weak), we extract the trends in number of connections in each bin over time. We also look at the behavior of CPR during the dot-com bubble by shifting the time series to align their peaks. CPR mainly uncovers that the markets move in and out of periods of strong connectivity erratically, instead of moving monotonically towards increasing global connectivity. This is in contrast to ρ, which gives a picture of ever-increasing correlation. CPR also exhibits that time-shifted markets have high connectivity around the dot-com bubble of 2000. We use significance tests using twin surrogates to interpret all the measures estimated in the study.

Implementation of a mechanical CPR device in a physician staffed HEMS - a prospective observational study.

PubMed

Rauch, Simon; Strapazzon, Giacomo; Brodmann, Monika; Fop, Ernst; Masoner, Christian; Rauch, Lydia; Forti, Alessandro; Pietsch, Urs; Mair, Peter; Brugger, Hermann

2018-04-28

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.

Review and Outcome of Prolonged Cardiopulmonary Resuscitation

PubMed Central

Youness, Houssein; Al Halabi, Tarek; Hussein, Hussein; Awab, Ahmed; Jones, Kellie; Keddissi, Jean

2016-01-01

The maximal duration of cardiopulmonary resuscitation (CPR) is unknown. We report a case of prolonged CPR. We have then reviewed all published cases with CPR duration equal to or more than 20 minutes. The objective was to determine the survival rate, the neurological outcome, and the characteristics of the survivors. Measurements and Main Results. The CPR data for 82 patients was reviewed. The median duration of CPR was 75 minutes. Patients mean age was 43 ± 21 years with no significant comorbidities. The main causes of the cardiac arrests were myocardial infarction (29%), hypothermia (21%), and pulmonary emboli (12%). 74% of the arrests were witnessed, with a mean latency to CPR of 2 ± 6 minutes and good quality chest compression provided in 96% of the cases. Adjunct therapy included extracorporeal membrane oxygenation (18%), thrombolysis (15.8%), and rewarming for hypothermia (19.5%). 83% were alive at 1 year, with full neurological recovery reported in 63 patients. Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts. PMID:26885387

Learn CPR You Can Do It!

MedlinePlus

... free mobile training apps for the iPhone and Android Phones. Get the iPhone App Here - Get the Android App Here STANDARD CPR FOR ADULTS - CPR in ... Take the videos wherever you go free. FREE ANDROID APP - Free training app for Android equipped phones. ...

Continuous wind measurement in the tropical Pacific using VHF radars

NASA Technical Reports Server (NTRS)

Balsley, B. B.; Ecklund, W. L.; Carter, D. A.

1986-01-01

Very High Frequency (VHF) Radar Wind Profilers are being installed on Ponape, East Caroline Islands and Christmas Island, Republic of Kiribati to continuously monitor winds aloft. The purpose of this experiment is to study wind fluctuations on time scales between minutes and days, to determine the longitudinal character of these fluctuations, and to examine their relationship to climate variability. Six-hourly wind profiles will be provided via satellite to the scientific community for Project TOGA (Tropical Ocean Global Atmosphere).

Nineteenth International Laser Radar Conference. Part 2

NASA Technical Reports Server (NTRS)

Singh, Upendra N. (Editor); Ismail, Syed (Editor); Schwemmer, Geary K. (Editor)

1998-01-01

This publication contains extended abstracts of papers presented at the Nineteenth International Laser Radar Conference, held at Annapolis, Maryland, July 6-10, 1998; 260 papers were presented in both oral and poster sessions. The topics of the conference sessions were Aerosol Clouds, Multiple Scattering; Tropospheric Profiling, Stratospheric/Mesospheric Profiling; Wind Profiling; New Lidar Technology and Techniques; Lidar Applications, Including Altimetry and Marine; Space and Future Lidar; and Lidar Commercialization/Eye Safety. This conference reflects the breadth of research activities being conducted in the lidar field. These abstracts address subjects from lidar-based atmospheric investigations, development of new lasers and lidar system technology, and current and future space-based lidar systems.

Nineteenth International Laser Radar Conference. Part 1

NASA Technical Reports Server (NTRS)

Singh, Upendra N. (Editor); Ismail, Syed (Editor); Schwemmer, Geary K. (Editor)

1998-01-01

This publication contains extended abstracts of papers presented at the Nineteenth International Laser Radar Conference, held at Annapolis, Maryland, July 6-10, 1998; 260 papers were presented in both oral and poster sessions. The topics of the conference sessions were Aerosol Clouds, Multiple Scattering; Tropospheric Profiling; Stratospheric/Mesospheric Profiling; Wind Profiling; New Lidar Technology and Techniques; Lidar Applications, including Altimetry and Marine; Space and Future Lidar; and Lidar Commercialization/Eye Safety. This conference reflects the breadth of research activities being conducted in the lidar field. These abstracts address subjects from lidar-based atmospheric investigations, development of new lasers and lidar system technology, and current and future space-based lidar systems.

Estimating Mixing Heights Using Microwave Temperature Profiler

NASA Technical Reports Server (NTRS)

Nielson-Gammon, John; Powell, Christina; Mahoney, Michael; Angevine, Wayne

2008-01-01

A paper describes the Microwave Temperature Profiler (MTP) for making measurements of the planetary boundary layer thermal structure data necessary for air quality forecasting as the Mixing Layer (ML) height determines the volume in which daytime pollution is primarily concentrated. This is the first time that an airborne temperature profiler has been used to measure the mixing layer height. Normally, this is done using a radar wind profiler, which is both noisy and large. The MTP was deployed during the Texas 2000 Air Quality Study (TexAQS-2000). An objective technique was developed and tested for estimating the ML height from the MTP vertical temperature profiles. In order to calibrate the technique and evaluate the usefulness of this approach, estimates from a variety of measurements during the TexAQS-2000 were compared. Estimates of ML height were used from radiosondes, radar wind profilers, an aerosol backscatter lidar, and in-situ aircraft measurements in addition to those from the MTP.

Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders.

PubMed

Fujie, Keiko; Nakata, Yoshio; Yasuda, Susumu; Mizutani, Taro; Hashimoto, Koichi

2014-03-01

Bystander-initiated cardiopulmonary resuscitation (CPR) has been reported to increase the possibility of survival in patients with out-of-hospital cardiopulmonary arrest (OHCA). We evaluated the effects of CPR instructions by emergency medical dispatchers on the frequency of bystander CPR and outcomes, and whether these effects differed between family and non-family bystanders. We conducted a retrospective cohort study, using Utstein-style records of OHCA taken in a rural area of Japan between January 2004 and December 2009. Of the 559 patients with non-traumatic OHCA witnessed by laypeople, 231 (41.3%) were given bystander CPR. More OHCA patients received resuscitation when the OHCA was witnessed by non-family bystanders than when it was witnessed by family members (61.4% vs. 34.2%). The patients with non-family-witnessed OHCA were more likely to be given conventional CPR (chest compression plus rescue breathing) or defibrillation with an AED than were those with family-witnessed OHCA. Dispatcher instructions significantly increased the provision of bystander CPR regardless of who the witnesses were. Neurologically favorable survival was increased by CPR in non-family-witnessed, but not in family-witnessed, OHCA patients. No difference in survival rate was observed between the cases provided with dispatcher instructions and those not provided with the instructions. Dispatcher instructions increased the frequency of bystander CPR, but did not improve the rate of neurologically favorable survival in patients with witnessed OHCA. Efforts to enhance the frequency and quality of resuscitation, especially by family members, are required for dispatcher-assisted CPR. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

CPR Induced Consciousness During Out-of-Hospital Cardiac Arrest: A Case Report on an Emerging Phenomenon.

PubMed

Pound, Joshua; Verbeek, P Richard; Cheskes, Sheldon

2017-01-01

High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers. A 52-year-old male presented as a witnessed out-of-hospital cardiac arrest (OHCA). During CPR the patient began to exhibit signs of life including severe agitation and thrashing of his limbs while CPR was ongoing for ventricular fibrillation prior to defibrillation. Resuscitation became considerably more complicated due to the violent and counterintuitive motions done by the patient during their own resuscitation. Despite the atypical presentation of cardiac arrest the patient was successfully resuscitated employing high quality CPR, standard advanced life support (ALS) care as well as two double sequential external defibrillation shocks. The patient underwent emergency percutaneous coronary intervention (PCI) for a 100% occlusion of his left anterior descending artery (LAD). The patient returned home 3 days later fully recovered with a Cerebral Performance Score of 1. CPR induced consciousness is emerging as a new phenomenon challenging providers of high quality CPR during cardiac arrest resuscitation. Our case report describes the manifestations of CPR induced consciousness as well as the resuscitative challenges which occur during resuscitation. Further research is required to determine the true frequency of this condition as well as treatment algorithms that would allow for appropriate and safe management for both the patient and EMS providers.

Cardiopulmonary resuscitation in real life: the most frequent fears of lay rescuers.

PubMed

Savastano, Simone; Vanni, Vincenzo

2011-05-01

Surviving cardiac arrest depends on early cardiopulmonary resuscitation (CPR). Only one third of cardiac arrest victims receive prompt CPR in spite of well-attended Basic Life Support (BLS) courses. Our study aimed to investigate that how many lay rescuers, capable of performing CPR, would do so, and to analyse their impeding fears. After each BLS course for lay rescuers (American Heart Association (AHA) CPR for family and friends), an anonymous questionnaire was distributed asking participants whether they would perform CPR on an adult or on a child in a real case of cardiac arrest. In the case of a negative response, we questioned them why. A total of 1000 questionnaires were analysed. The sample group was predominantly made up of males (77.7%), Italians (82.2%), individuals aged between 26 and 35 years (41.2%) and individuals possessing a high-school diploma (61.8%). The percentages that would perform CPR on an unknown adult or child were different (86.2% vs. 73.9% p = 0.005). The prevalent fears were regarding infection, being incapable, legal implications and causing damage and fear in general. The first three differ significantly in adult and paediatric cases. Subdividing the population according to sex, age and education did not demonstrate significant differences regarding willingness to perform adult or paediatric CPR. This descriptive study demonstrates that the percentage that would really perform CPR is too low, particularly in the case of a child. Part of the course should be dedicated to discussing these arguments to ensure that all those capable of performing good CPR would immediately do so. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.

PubMed

Ringh, Mattias; Rosenqvist, Mårten; Hollenberg, Jacob; Jonsson, Martin; Fredman, David; Nordberg, Per; Järnbert-Pettersson, Hans; Hasselqvist-Ax, Ingela; Riva, Gabriel; Svensson, Leif

2015-06-11

Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiac arrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital cardiac arrest. We conducted a blinded, randomized, controlled trial in Stockholm from April 2012 through December 2013. A mobile-phone positioning system that was activated when ambulance, fire, and police services were dispatched was used to locate trained volunteers who were within 500 m of patients with out-of-hospital cardiac arrest; volunteers were then dispatched to the patients (the intervention group) or not dispatched to them (the control group). The primary outcome was bystander-initiated CPR before the arrival of ambulance, fire, and police services. A total of 5989 lay volunteers who were trained in CPR were recruited initially, and overall 9828 were recruited during the study. The mobile-phone positioning system was activated in 667 out-of-hospital cardiac arrests: 46% (306 patients) in the intervention group and 54% (361 patients) in the control group. The rate of bystander-initiated CPR was 62% (188 of 305 patients) in the intervention group and 48% (172 of 360 patients) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001). A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiac arrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.).

Protein/Protein Interactions in the Mammalian Heme Degradation Pathway

PubMed Central

Spencer, Andrea L. M.; Bagai, Ireena; Becker, Donald F.; Zuiderweg, Erik R. P.; Ragsdale, Stephen W.

2014-01-01

Heme oxygenase (HO) catalyzes the rate-limiting step in the O2-dependent degradation of heme to biliverdin, CO, and iron with electrons delivered from NADPH via cytochrome P450 reductase (CPR). Biliverdin reductase (BVR) then catalyzes conversion of biliverdin to bilirubin. We describe mutagenesis combined with kinetic, spectroscopic (fluorescence and NMR), surface plasmon resonance, cross-linking, gel filtration, and analytical ultracentrifugation studies aimed at evaluating interactions of HO-2 with CPR and BVR. Based on these results, we propose a model in which HO-2 and CPR form a dynamic ensemble of complex(es) that precede formation of the productive electron transfer complex. The 1H-15N TROSY NMR spectrum of HO-2 reveals specific residues, including Leu-201, near the heme face of HO-2 that are affected by the addition of CPR, implicating these residues at the HO/CPR interface. Alanine substitutions at HO-2 residues Leu-201 and Lys-169 cause a respective 3- and 22-fold increase in Km values for CPR, consistent with a role for these residues in CPR binding. Sedimentation velocity experiments confirm the transient nature of the HO-2·CPR complex (Kd = 15.1 μm). Our results also indicate that HO-2 and BVR form a very weak complex that is only captured by cross-linking. For example, under conditions where CPR affects the 1H-15N TROSY NMR spectrum of HO-2, BVR has no effect. Fluorescence quenching experiments also suggest that BVR binds HO-2 weakly, if at all, and that the previously reported high affinity of BVR for HO is artifactual, resulting from the effects of free heme (dissociated from HO) on BVR fluorescence. PMID:25196843

The impact of ultra-brief chest compression-only CPR video training on responsiveness, compression rate, and hands-off time interval among bystanders in a shopping mall.

PubMed

Panchal, Ashish R; Meziab, Omar; Stolz, Uwe; Anderson, Wes; Bartlett, Mitchell; Spaite, Daniel W; Bobrow, Bentley J; Kern, Karl B

2014-09-01

Recent studies have demonstrated higher-quality chest compressions (CCs) following a 60 s ultra-brief video (UBV) on compression-only CPR (CO-CPR). However, the effectiveness of UBVs as a CPR-teaching tool for lay bystanders in public venues remains unknown. Determine whether an UBV is effective in teaching laypersons CO-CPR in a public setting and if viewing leads to superior responsiveness and CPR skills. Adult lay bystanders were enrolled in a public shopping mall and randomized to: (1) Control (CTR): sat idle for 60 s; (2) UBV: watched a 60 s UBV on CO-CPR. Subjects were read a scenario detailing a sudden collapse in the mall and asked to do what they "thought was best" on a mannequin. Performance measures were recorded for 2 min: responsiveness (time to call 911 and first CCs) and CPR quality [CC depth, rate, hands-off interval (time without CC after first CC)]. One hundred subjects were enrolled. Demographics were similar between groups. UBV subjects called 911 more frequently (percent difference: 31%) and initiated CCs sooner in the arrest scenario (median difference (MD): 5 s). UBV cohort had increased CC rate (MD: 19 cpm) and decreased hands-off interval (MD: 27 s). There was no difference in CC depth. Bystanders with UBV training in a shopping mall had significantly improved responsiveness, CC rate, and decreased hands-off interval. Given the short length of training, UBV may have potential as a ubiquitous intervention for public venues to help improve bystander reaction to arrest and CO-CPR performance. Published by Elsevier Ireland Ltd.

The potential role for automatic external defibrillators in palliative care units.

PubMed

Thorns, Andrew; Gannon, Craig

2003-07-01

Cardiopulmonary resuscitation (CPR) has received frequent attention by professionals and the public in recent times. Concerns regarding the potential harms for little chance of success have caused palliative care units (PCUs) doubts about initiating CPR. However, there appears to be a moral responsibility to offer CPR to some, carefully selected, patients. Automatic external defibrillators (AEDs) have been shown to significantly increase chances of survival following CPR and are simple to use, even for non-professionals. It is argued that AEDs may increase the moral imperative on PCUs to offer CPR to certain patients and provide the basis for a necessary debate on where the border between appropriate active treatment and a disturbance to the aim of a peaceful death rests.

The New Weather Radar for America's Space Program in Florida: A Temperature Profile Adaptive Scan Strategy

NASA Technical Reports Server (NTRS)

Carey, L. D.; Petersen, W. A.; Deierling, W.; Roeder, W. P.

2009-01-01

A new weather radar is being acquired for use in support of America s space program at Cape Canaveral Air Force Station, NASA Kennedy Space Center, and Patrick AFB on the east coast of central Florida. This new radar replaces the modified WSR-74C at Patrick AFB that has been in use since 1984. The new radar is a Radtec TDR 43-250, which has Doppler and dual polarization capability. A new fixed scan strategy was designed to best support the space program. The fixed scan strategy represents a complex compromise between many competing factors and relies on climatological heights of various temperatures that are important for improved lightning forecasting and evaluation of Lightning Launch Commit Criteria (LCC), which are the weather rules to avoid lightning strikes to in-flight rockets. The 0 C to -20 C layer is vital since most generation of electric charge occurs within it and so it is critical in evaluating Lightning LCC and in forecasting lightning. These are two of the most important duties of 45 WS. While the fixed scan strategy that covers most of the climatological variation of the 0 C to -20 C levels with high resolution ensures that these critical temperatures are well covered most of the time, it also means that on any particular day the radar is spending precious time scanning at angles covering less important heights. The goal of this project is to develop a user-friendly, Interactive Data Language (IDL) computer program that will automatically generate optimized radar scan strategies that adapt to user input of the temperature profile and other important parameters. By using only the required scan angles output by the temperature profile adaptive scan strategy program, faster update times for volume scans and/or collection of more samples per gate for better data quality is possible, while maintaining high resolution at the critical temperature levels. The temperature profile adaptive technique will also take into account earth curvature and refraction when geo-locating the radar beam (i.e., beam height and arc distance), including non-standard refraction based on the user-input temperature profile. In addition to temperature profile adaptivity, this paper will also summarize the other requirements for this scan strategy program such as detection of low-level boundaries, detection of anvil clouds, reducing the Cone Of Silence, and allowing for times when deep convective clouds will not occur. The adaptive technique will be carefully compared to and benchmarked against the new fixed scan strategy. Specific environmental scenarios in which the adaptive scan strategy is able to optimize and improve coverage and resolution at critical heights, scan time, and/or sample numbers relative to the fixed scan strategy will be presented.

Quantifying the microphysical impacts of fire aerosols on clouds in Indonesia using remote sensing observations

NASA Astrophysics Data System (ADS)

Tosca, M. G.; Diner, D. J.; Garay, M. J.; Kalashnikova, O. V.

2012-12-01

Fire-emitted aerosols modify cloud and precipitation dynamics by acting as cloud condensation nuclei in what is known as the first and second aerosol indirect effect. The cloud response to the indirect effect varies regionally and is not well understood in the highly convective tropics. We analyzed nine years (2003-2011) of aerosol data from the Multi-angle Imaging SpectroRadiometer (MISR), and fire emissions data from the Global Fire Emissions Database, version 3 (GFED3) over southeastern tropical Asia (Indonesia), and identified scenes that contained both a high atmospheric aerosol burden and large surface fire emissions. We then collected scenes from the Cloud Profiling Radar (CPR) on board the CLOUDSAT satellite that corresponded both spatially and temporally to the high-burning scenes from MISR, and identified differences in convective cloud dynamics over areas with varying aerosol optical depths. Differences in overpass times (MISR in the morning, CLOUDSAT in the afternoon) improved our ability to infer that changes in cloud dynamics were a response to increased or decreased aerosol emissions. Our results extended conclusions from initial studies over the Amazon that used remote sensing techniques to identify cloud fraction reductions in high burning areas (Koren et al., 2004; Rosenfeld, 1999) References Koren, I., Y.J. Kaufman, L.A. Remer and J.V. Martins (2004), Measurement of the effect of Amazon smoke on inhibition of cloud formation, Science, 303, 1342-1345 Rosenfeld, D. (1999), TRMM observed first direct evidence of smoke from forest fires inhibiting rainfall, Gephys. Res. Lett., 26, 3105.

Seasonal Differences in Tropical Western Pacific Cloud Ice, Water Vapor and Aerosols Observed From Space During ATTREX-III and POSIDON

NASA Astrophysics Data System (ADS)

Avery, M. A.; Rosenlof, K. H.; Vaughan, M.; Getzewich, B. J.; Thornberry, T. D.; Gao, R. S.; Rollins, A. W.; Woods, S.; Yorks, J. E.; Jensen, E. J.

2017-12-01

Recent aircraft missions sampling the tropical tropopause layer (TTL) in the tropical Western Pacific have provided a wealth of detailed cloud microphysical and associated aerosol, water vapor and temperature data for understanding processes that regulate stratospheric composition and hydration. This presentation seeks to provide a regional context for these measurements by comparing and contrasting active space-based observations from these time periods (Feb-Mar 2014 for ATTREX-III and Oct 2016 for POSIDON), primarily from the Clouds and Aerosol Lidar with Orthogonal Polarization (CALIOP), with the addition of Cloud Profiling Radar (CPR) and the Cloud-Aerosol Transport System (CATS) where these data sets are available. While the ATTREX III and POSIDON aircraft field missions both took place from Guam in the Western Pacific, there were striking differences between the amount, geographical distribution and properties of cirrus clouds and aerosols in the Tropical TTL. In addition to cloud and aerosol amount and location, we present geometric properties, including cloud top heights, transparent cloud and aerosol layer thicknesses and location of the 532 nm backscatter centroid, which is roughly equivalent to the layer vertical center of mass. We also present differences in the distribution of cirrus cloud extinction coefficients and ice water content, and aerosol optical depths, as detected from space, and compare these with in situ measurements and with temperature and water vapor distributions from the Microwave Limb Sounder (MLS). We find that there is more intense convection reaching the tropical tropopause during the POSIDON mission, and consequently more associated cloud ice observed during POSIDON than during ATTREX-III.

Estimating surface longwave radiative fluxes from satellites utilizing artificial neural networks

NASA Astrophysics Data System (ADS)

Nussbaumer, Eric A.; Pinker, Rachel T.

2012-04-01

A novel approach for calculating downwelling surface longwave (DSLW) radiation under all sky conditions is presented. The DSLW model (hereafter, DSLW/UMD v2) similarly to its predecessor, DSLW/UMD v1, is driven with a combination of Moderate Resolution Imaging Spectroradiometer (MODIS) level-3 cloud parameters and information from the European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-Interim model. To compute the clear sky component of DSLW a two layer feed-forward artificial neural network with sigmoid hidden neurons and linear output neurons is implemented; it is trained with simulations derived from runs of the Rapid Radiative Transfer Model (RRTM). When computing the cloud contribution to DSLW, the cloud base temperature is estimated by using an independent artificial neural network approach of similar architecture as previously mentioned, and parameterizations. The cloud base temperature neural network is trained using spatially and temporally co-located MODIS and CloudSat Cloud Profiling Radar (CPR) and the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) observations. Daily average estimates of DSLW from 2003 to 2009 are compared against ground measurements from the Baseline Surface Radiation Network (BSRN) giving an overall correlation coefficient of 0.98, root mean square error (rmse) of 15.84 W m-2, and a bias of -0.39 W m-2. This is an improvement over an earlier version of the model (DSLW/UMD v1) which for the same time period has an overall correlation coefficient 0.97 rmse of 17.27 W m-2, and bias of 0.73 W m-2.

The visible, near-infrared and short wave infrared channels of the EarthCARE multi-spectral imager

NASA Astrophysics Data System (ADS)

Doornink, J.; de Goeij, B.; Marinescu, O.; Meijer, E.; Vink, R.; van Werkhoven, W.; van't Hof, A.

2017-11-01

The EarthCARE satellite mission objective is the observation of clouds and aerosols from low Earth orbit. The payload will include active remote sensing instruments being the W-band Cloud Profiling Radar (CPR) and the ATLID LIDAR. These are supported by the passive instruments Broadband Radiometer (BBR) and the Multispectral Imager (MSI) providing the radiometric and spatial context of the ground scene being probed. The MSI will form Earth images over a swath width of 150 km; it will image the Earth atmosphere in 7 spectral bands. The MSI instrument consists of two parts: the Visible, Near infrared and Short wave infrared (VNS) unit, and the Thermal InfraRed (TIR) unit. Subject of this paper is the VNS unit. In the VNS optical unit, the ground scene is imaged in four spectral bands onto four linear detectors via separate optical channels. Driving requirements for the VNS instrument performance are the spectral sensitivity including out-of-band rejection, the MTF, co-registration and the inter-channel radiometric accuracy. The radiometric accuracy performance of the VNS is supported by in-orbit calibration, in which direct solar radiation is fed into the instrument via a set of quasi volume diffusers. The compact optical concept with challenging stability requirements together with the strict thermal constraints have led to a sophisticated opto-mechanical design. This paper, being the second of a sequence of two on the Multispectral Imager describes the VNS instrument concept chosen to fulfil the performance requirements within the resource and accommodation constraints.

Domain-averaged, Shallow Precipitation Measurements During the Aerosol and Cloud Experiments in the Eastern North Atlantic (ACE-ENA)

NASA Astrophysics Data System (ADS)

Lamer, K.; Luke, E. P.; Kollias, P.; Oue, M.; Wang, J.

2017-12-01

The Atmospheric Radiation Measurement (ARM) Climate Research Facility operates a fixed observatory in the Eastern North Atlantic (ENA) on Graciosa Island in the Azores. Straddling the tropics and extratropics, the Azores receive air transported from North America, the Arctic and sometimes Europe. At the ARM ENA site, marine boundary layer clouds are frequently observed all year round. Estimates of drizzle mass flux from the surface to cloud base height are documented using a combination of high sensitivity profiling 35-GHz radar and ceilometer observations. Three years of drizzle mass flux retrievals reveal that statistically, directly over the ENA site, marine boundary layer cloud drizzle rates tend to be weak with few heavy drizzle events. In the summer of 2017, this site hosted the first phase of the Aerosol and Cloud Experiments in the Eastern North Atlantic (ACE-ENA) field campaign, which is motivated by the need for comprehensive in situ characterization of boundary layer structure, low clouds and aerosols. During this phase, the 35-GHz scanning ARM cloud radar was operated as a surveillance radar, providing regional context for the profiling observations. While less sensitive, the scanning radar measurements document a larger number of heavier drizzle events and provide domain-representative estimates of shallow precipitation. A best estimate, domain averaged, shallow precipitation rate for the region around the ARM ENA site is presented. The methodology optimally combines the ability of the profiling observations to detect the weak but frequently occurring drizzle events with the scanning cloud radar's ability to capture the less frequent heavier drizzle events. The technique is also evaluated using high resolution model output and a sophisticated forward radar operator.

Comparison of MESSENGER Optical Images with Thermal and Radar Data for the Surface of MERCURY

NASA Astrophysics Data System (ADS)

Blewett, D. T.; Coman, E. I.; Chabot, N. L.; Izenberg, N. R.; Harmon, J. K.; Neish, C.

2010-12-01

Images collected by the MESSENGER spacecraft during its three Mercury flybys cover nearly the entire surface of the planet that was not imaged by Mariner 10. The MESSENGER data now allow us to observe features at optical wavelengths that were previously known only through remote sensing in other portions of the electromagnetic spectrum. For example, the Mariner 10 infrared (IR) radiometer made measurements along a track on the night side of Mercury during the spacecraft's first encounter in 1974. Analysis of the IR radiometer data identified several thermal anomalies that we have correlated to craters with extensive rays or ejecta deposits, including Xiao Zhao and Eminescu. The thermal properties are consistent with a greater exposure of bare rock (exposed in steep walls or as boulders and cobbles) in and around these craters compared with the lower-thermal-inertia, finer-grained regolith of the surrounding older surface. The portion of Mercury not viewed by Mariner 10 has also been imaged by Earth-based radar. The radar backscatter gives information on the wavelength-scale surface roughness. Arecibo S-band (12.6-cm wavelength) radar observations have produced images of Eminescu and also revealed two spectacular rayed craters (Debussy and Hokusai) that have since been imaged by MESSENGER. We are examining radial profiles for these craters, extracted from both the radar images and MESSENGER narrow-angle camera mosaics, that extend from the crater center outwards to a distance of several crater diameters. Comparison of optical and radar profiles for the craters, as well as similar profiles for lunar craters, can provide insight into ejecta deposition, the effect of surface gravity on the cratering process, and space weathering.

Cardiopulmonary Resuscitation and Older Adults' Expectations.

ERIC Educational Resources Information Center

Godkin, M. Dianne; Toth, Ellen L.

1994-01-01

Examined knowledge, attitudes, and opinions of 60 older adults about cardiopulmonary resuscitation (CPR). Most had little or no accurate knowledge of CPR. Knowledge deficits and misconceptions of older adults should be addressed so that they may become informed and active participants in CPR decision-making process. (BF)

The survival benefit of bystander cardiopulmonary resuscitation in a paramedic served metropolitan area.

PubMed Central

Guzy, P M; Pearce, M L; Greenfield, S

1983-01-01

We investigated the survival benefit bystander cardiopulmonary resuscitation (CPR) for out-of-hospital emergencies in a paramedic served area of metropolitan Los Angeles. Clinical information for all events occurring between January 1 and December 31, 1978 was obtained from paramedic report forms and hospital medical records. Bystander CPR was performed for 93 cases and, of these, 20 (22 per cent) survived to hospital discharge, as compared to 7 (5 per cent) of the 150 patients not receiving bystander CPR (p less than 0.001). Twelve (27 per cent) of the 45 patients in ventricular fibrillation (VF) who had bystander CPR survived, as compared to 4 (6 per cent) of 70 VF patients without bystander CPR (p less than 0.01). We conclude that bystander CPR, initiated prior to arrival of paramedics, produced a fourfold improvement in survival. Overall there was a 10 per cent survival rate at hospital discharge. Survival rates reported from Seattle may not necessarily be generalized to larger cities. PMID:6859360

Development of a Culturally-Adapted Graphic Novella about Emergency Communication: Collaborations with a Limited English Speaking Chinese Immigrant Community.

PubMed

Eisenberg, Devora; Seino, Lena; Meischke, Hendrika; Tu, Shin-Ping; Turner, Anne M; Ike, Brooke; Painter, Ian; Yip, Mei-Po

2016-01-01

Bystander CPR doubles survival from cardiac arrest but limited English proficient (LEP) individuals face barriers calling 911 and performing CPR. Previous training increases the chance that an individual will perform CPR, yet access to classes in non-English speaking populations is limited. We used a cultural adaptation approach to develop a graphic novella for Chinese LEP immigrants about how to call 911 and perform bystander CPR. Collaboration with members of this community occurred through all stages of novella development. One hundred and thirty-two LEP Chinese adults read the novella and answered a survey measuring behavioral intentions. All respondents stated they would call 911 after witnessing a person's collapse, but those previously trained in CPR were more likely to say that they would perform CPR. All participants indicated that they would recommend this novella to others. Developing culturally-responsive evidence-based interventions is necessary to reduce disproportionate death and disability from cardiac arrest in LEP communities.

Laser range profile of cones

NASA Astrophysics Data System (ADS)

Zhou, Wenzhen; Gong, Yanjun; Wang, Mingjun; Gong, Lei

2016-10-01

technology. Laser one-dimensional range profile can reflect the characteristics of the target shape and surface material. These techniques were motivated by applications of laser radar to target discrimination in ballistic missile defense. The radar equation of pulse laser about cone is given in this paper. This paper demonstrates the analytical model of laser one-dimensional range profile of cone based on the radar equation of the pulse laser. Simulations results of laser one-dimensional range profiles of some cones are given. Laser one-dimensional range profiles of cone, whose surface material with diffuse lambertian reflectance, is given in this paper. Laser one-dimensional range profiles of cone, whose surface mater with diffuse materials whose retroreflectance can be modeled closely with an exponential term that decays with increasing incidence angles, is given in this paper. Laser one-dimensional range profiles of different pulse width of cone is given in this paper. The influences of surface material, pulse width, attitude on the one-dimensional range are analyzed. The laser two-dimensional range profile is two-dimensional scattering imaging of pulse laser of target. The two-dimensional range profile of roughness target can provide range resolved information. An analytical model of two-dimensional laser range profile of cone is proposed. The simulations of two-dimensional laser range profiles of some cones are given. Laser two-dimensional range profiles of cone, whose surface mater with diffuse lambertian reflectance, is given in this paper. Laser two-dimensional range profiles of cone, whose surface mater with diffuse materials whose retroreflectance can be modeled closely with an exponential term that decays with increasing incidence angles, is given in this paper. The influence of pulse width, surface material on laser two-dimensional range profile is analyzed. Laser one-dimensional range profile and laser two-dimensional range profile are called as laser range profile (LRP).

Determination of precipitation profiles from airborne passive microwave radiometric measurements

NASA Technical Reports Server (NTRS)

Kummerow, Christian; Hakkarinen, Ida M.; Pierce, Harold F.; Weinman, James A.

1991-01-01

This study presents the first quantitative retrievals of vertical profiles of precipitation derived from multispectral passive microwave radiometry. Measurements of microwave brightness temperature (Tb) obtained by a NASA high-altitude research aircraft are related to profiles of rainfall rate through a multichannel piecewise-linear statistical regression procedure. Statistics for Tb are obtained from a set of cloud radiative models representing a wide variety of convective, stratiform, and anvil structures. The retrieval scheme itself determines which cloud model best fits the observed meteorological conditions. Retrieved rainfall rate profiles are converted to equivalent radar reflectivity for comparison with observed reflectivities from a ground-based research radar. Results for two case studies, a stratiform rain situation and an intense convective thunderstorm, show that the radiometrically derived profiles capture the major features of the observed vertical structure of hydrometer density.

Mechanical CPR: Who? When? How?

PubMed

Poole, Kurtis; Couper, Keith; Smyth, Michael A; Yeung, Joyce; Perkins, Gavin D

2018-05-29

In cardiac arrest, high quality cardiopulmonary resuscitation (CPR) is a key determinant of patient survival. However, delivery of effective chest compressions is often inconsistent, subject to fatigue and practically challenging.Mechanical CPR devices provide an automated way to deliver high-quality CPR. However, large randomised controlled trials of the routine use of mechanical devices in the out-of-hospital setting have found no evidence of improved patient outcome in patients treated with mechanical CPR, compared with manual CPR. The limited data on use during in-hospital cardiac arrest provides preliminary data supporting use of mechanical devices, but this needs to be robustly tested in randomised controlled trials.In situations where high-quality manual chest compressions cannot be safely delivered, the use of a mechanical device may be a reasonable clinical approach. Examples of such situations include ambulance transportation, primary percutaneous coronary intervention, as a bridge to extracorporeal CPR and to facilitate uncontrolled organ donation after circulatory death.The precise time point during a cardiac arrest at which to deploy a mechanical device is uncertain, particularly in patients presenting in a shockable rhythm. The deployment process requires interruptions in chest compression, which may be harmful if the pause is prolonged. It is recommended that use of mechanical devices should occur only in systems where quality assurance mechanisms are in place to monitor and manage pauses associated with deployment.In summary, mechanical CPR devices may provide a useful adjunct to standard treatment in specific situations, but current evidence does not support their routine use.

Use of whole body CT to detect patterns of CPR-related injuries after sudden cardiac arrest.

PubMed

Dunham, Gregor M; Perez-Girbes, Alexandre; Bolster, Ferdia; Sheehan, Kellie; Linnau, Ken F

2017-11-09

We have recently implemented a dedicated sudden cardiac arrest (SCA) - whole-body computed tomography (WBCT) protocol to evaluate SCA patients with return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR). The aim of this study is to evaluate the number and pattern of CPR-related injuries in ROSC patients with SCA-WBCT. Single-centre retrospective review of 39 patients (13 female; 20 male, mean age 51.8 years) with non-traumatic, out-of-hospital SCA and ROSC and evaluation with dedicated SCA-WBCT over a 10-month period. In-hospital mortality was 54%. CPR-related injuries were detected in 85% (33/39). Chest injuries were most common on WBCT: 85% (33) subjects had rib fractures (mean of 8.5 fractures/subject); 31% (12) sternal fractures; 13% (5) mediastinal haematoma; 10% (4) pneumothorax; 8% (3) pneumomediastinum and 3% (1) haemothorax. Three subjects (8%) had abdominal injuries on WBCT, including one hepatic haematoma with active haemorrhage. CPR-related injuries on WBCT after ROSC are common, with serial rib fractures detected most commonly. An unexpectedly high rate of abdominal injuries was detected on SCA-WBCT. Radiologists need to be attuned to the spectrum of CPR-related injuries in WBCT, including abdominal injuries and subtle rib fractures. • CPR frequently causes injuries. • Radiologists should be aware of the spectrum of CPR related injuries. • Rib fractures are frequent and radiologic findings often subtle. • Clinically unexpected abdominal injuries may be present.

Effects of diaspirin cross-linked hemoglobin (DCLHb) during and post-CPR in swine.

PubMed

Chow, M S; Fan, C; Tran, H; Zhao, H; Zhou, L

2001-04-01

The purpose of the study was to test the hypothesis that diaspirin cross-linked hemoglobin (DCLHb) can produce improved resuscitation during cardiac arrest. DCLHb, a derivative of human hemoglobin, has previously been demonstrated to produce a vasopressor response that is associated with increased blood flow to vital organs. In addition, it is an oxygen carrier. These effects may be beneficial to extreme low flow states, such as that during cardiac arrest and cardiopulmonary resuscitation (CPR). Experimental cardiac arrest and CPR were carried out in 32 anesthetized immature pigs. In each animal, ventricular fibrillation was induced for 5 min, followed by 10 min of standard CPR with a pneumatic device and room air ventilation. High (15 ml/kg) and low (5 ml/kg) doses of DCLHb or equivalent volume of normal saline were infused at the beginning of CPR in a random and blind manner. Cardiac output, organ blood flow, aortic pressure, coronary perfusion pressure, blood gases, and lactate concentrations were obtained before and during CPR. Following the 10-min CPR, the animals were defibrillated and the return of spontaneous circulation (ROSC) determined. DCLHb treatment achieved 75% ROSC compared with 25% in the saline group (p < 0.05). In addition, a better (p < 0.05) myocardial O(2) delivery, venous blood O(2) content, and myocardial and cerebral perfusion pressure were observed in the DCLHb group. DCLHb treatment during cardiac arrest and CPR significantly improves ROSC. This is most likely related to its improvement in coronary perfusion and myocardial oxygen delivery.

Using adrenaline during neonatal resuscitation may have an impact on serum cardiac troponin-T levels.

PubMed

Helmer, Caroline; Skranes, Janne H; Liestøl, Knut; Fugelseth, Drude

2015-09-01

It has been suggested that serum cardiac troponin-T (cTnT) can predict the severity of neonatal hypoxic-ischaemic encephalopathy. We evaluated whether cTnT was better correlated with adrenaline during cardiopulmonary resuscitation (CPR) than with the severity of the insult itself, based on the Apgar scores. Serum cTnT was analysed in 47 asphyxiated newborn infants treated with hypothermia. Blood samples and resuscitation data were collected from medical records, and multiple linear regressions were used to evaluate the effect of the treatment and the Apgar scores on cTnT levels. The infants were divided into three groups: the no CPR group (n = 29) just received stimulation and ventilation, the CPR minus adrenaline group (n = 9) received cardiac compression and ventilation and the CPR plus adrenaline group (n = 9) received complete CPR, including adrenaline. In the univariate analysis, the five and ten-minute Apgar scores were significantly lower in the CPR plus adrenaline group and the cTnT was significantly higher. Multiple regression analysis showed significantly higher cTnT values in the CPR plus adrenaline group, but no significant relationship between cTnT and the Apgar scores. Although cTnT correlated with the severity of the insult in neonatal hypoxic-ischaemic encephalopathy, the levels may have been affected by adrenaline administered during CPR. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Why does radar reflectivity tend to increase downward toward the ocean surface, but decrease downward toward the land surface?

NASA Astrophysics Data System (ADS)

Liu, Chuntao; Zipser, Edward J.

2013-01-01

Both ground and space borne radars have shown that radar reflectivity profiles below the freezing level have different slopes over land and ocean in general. This is critical in correctly estimating the surface precipitation rate in the usual situation in which the radar reflectivity cannot be measured as close to the surface as one would like. Using 14 years of Tropical Rainfall Measuring Mission precipitation radar observations, the variations of slopes of the radar reflectivity in the low troposphere are examined over the stratiform and convective precipitation regions. Radar reflectivity below the freezing level usually decreases toward the surface over land, but increases toward the surface over the ocean. Increasing reflectivity toward the surface is hypothesized to occur mainly when raindrops grow while falling through low clouds, which is favored by high humidity at low levels, and by updraft speeds lower than the fall speed of raindrops, both more likely over oceans. Other things being equal, proxy evidence is presented that the more intense the convection, the more likely reflectivity is to decrease toward the surface, and that this is at least as important as low-level relative humidity. Over monsoon regions with more moderate convection but higher humidity, such as southeast China and the Amazon, there are more profiles with reflectivity increasing toward the surface than over other continental regions such as Africa. Radar reflectivity tends to increase toward the surface in shallow warm rain systems in trade cumulus regions, but tends to decrease toward the surface when high reflectivity values are present at or above the freezing level.

TRMM Precipitation Radar Reflectivity Profiles Compared to High-Resolution Airborne and Ground-Based Radar Measurements

NASA Technical Reports Server (NTRS)

Heymsfield, G. M.; Geerts, B.; Tian, L.

1999-01-01

In this paper, TRMM (Tropical Rainfall Measuring Mission Satellite) Precipitation Radar (PR) products are evaluated by means of simultaneous comparisons with data from the high-altitude ER-2 Doppler Radar (EDOP), as well as ground-based radars. The comparison is aimed primarily at the vertical reflectivity structure, which is of key importance in TRMM rain type classification and latent heating estimation. The radars used in this study have considerably different viewing geometries and resolutions, demanding non-trivial mapping procedures in common earth-relative coordinates. Mapped vertical cross sections and mean profiles of reflectivity from the PR, EDOP, and ground-based radars are compared for six cases. These cases cover a stratiform frontal rainband, convective cells of various sizes and stages, and a hurricane. For precipitating systems that are large relative to the PR footprint size, PR reflectivity profiles compare very well to high-resolution measurements thresholded to the PR minimum reflectivity, and derived variables such as bright band height and rain types are accurate, even at high PR incidence angles. It was found that for, the PR reflectivity of convective cells small relative to the PR footprint is weaker than in reality. Some of these differences can be explained by non-uniform beam filling. For other cases where strong reflectivity gradients occur within a PR footprint, the reflectivity distribution is spread out due to filtering by the PR antenna illumination pattern. In these cases, rain type classification may err and be biased towards the stratiform type, and the average reflectivity tends to be underestimated. The limited sensitivity of the PR implies that the upper regions of precipitation systems remain undetected and that the PR storm top height estimate is unreliable, usually underestimating the actual storm top height. This applies to all cases but the discrepancy is larger for smaller cells where limited sensitivity is compounded by incomplete beam filling. Users of level three TRMM PR products should be aware of this scale dependency.

Vertical Profiles of Latent Heat Release Over the Global Tropics using TRMM Rainfall Products from December 1997 to November 2001

NASA Technical Reports Server (NTRS)

Tao, W.-K.; Lang, S.; Simpson, J.; Meneghini, R.; Halverson, J.; Johnson, R.; Adler, R.; Starr, David (Technical Monitor)

2002-01-01

NASA Tropical Rainfall Measuring Mission (TRMM) precipitation radar (PR) derived rainfall information will be used to estimate the four-dimensional structure of global monthly latent heating and rainfall profiles over the global tropics from December 1997 to November 2000. Rainfall, latent heating and radar reflectivity structures between El Nino (DJF 1997-98) and La Nina (DJF 1998-99) will be examined and compared. The seasonal variation of heating over various geographic locations (i.e., oceanic vs continental, Indian ocean vs west Pacific, Africa vs S. America) will also be analyzed. In addition, the relationship between rainfall, latent heating (maximum heating level), radar reflectivity and SST is examined and will be presented in the meeting. The impact of random error and bias in stratiform percentage estimates from PR on latent heating profiles is studied and will also be presented in the meeting. Additional information is included in the original extended abstract.

77 FR 74278 - Proposed Information Collection (Internet Student CPR Web Registration Application); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... (Internet Student CPR Web Registration Application); Comment Request AGENCY: Veterans Health Administration... web registration application. DATES: Written comments and recommendations on the proposed collection.... Title: Internet Student CPR Web Registration Application, VA Form 10-0468. OMB Control Number: 2900-0746...

Instituting the Updated CPR Protocol: The Team Physician's Role.

ERIC Educational Resources Information Center

Araujo, David

1994-01-01

Summarizes recommendations from the 1992 National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care. Because team physicians may have to provide basic life support for athletes or spectators, knowing current (CPR) protocol is essential in developing emergency response plans and training personnel. Practice removing…

The use of CPR data in fisheries research [review article

NASA Astrophysics Data System (ADS)

Corten, A.; Lindley, J. A.

2003-08-01

The Continuous Plankton Recorder (CPR) survey was initiated partly to contribute to our understanding of the variability of fish stocks and as a potential method for predicting fish distributions from the abundance and composition of the plankton. The latter objective has been superseded by technological developments in fish detection, but the former has been the subject of continuing, and in recent years expanding use of the CPR data. Examples are presented of application of the data to studies on North Sea herring, cod, mackerel, blue whiting and redfish as well as more general plankton studies relevant to fisheries research. Variations in the migration patterns of herring as well as recruitment have been related to abundances and species composition of the plankton in the CPR survey. Extensive use has been made of the CPR data in relation to cod, particularly in the development and testing of the ‘match-mismatch’ hypothesis. Advection of sufficient numbers of Calanus from the core oceanic areas of its distribution into the areas where the cod stocks occur may partly determine the success of those stocks. The analysis of the distribution and abundances of mackerel larvae in the CPR survey have shown contrasting variations between the North Sea and Celtic Sea. The expansion of the horse mackerel fishery in the north-eastern North Sea since 1987 has been related to physical events and a ‘regime shift’ in the plankton, described from CPR data. The oceanic spawning areas of the blue whiting and redfish were highlighted by the expansion of the CPR survey into the north-eastern and north-western Atlantic respectively. These results helped to focus the attention of fisheries scientists on stocks that have subsequently become the targets for commercial exploitation. The results of the CPR survey, particularly those on Calanusfinmarchicus, the phytoplankton standing stock as measured by the CPR colour index, the overall patterns of trends in plankton abundance and distributions of indicator species have been used by fisheries scientists to interpret variations in fish stocks. Generally the CPR data can be used to determine whether changes in the distributions and growth rates of fish have resulted from changes in planktonic food, changes in strength of ocean currents and distribution of water masses and to identify trends in larval abundances. With the tightening regulation of fisheries to reduce overfishing, global climate change and changing anthropogenic inputs into the sea, the unique source of information on unexploited populations in the long-term time series of the CPR survey will be of increasing value to fisheries scientists in the study of natural variability.

Kinematic and Hydrometer Data Products from Scanning Radars during MC3E

DOE Data Explorer

matthews, Alyssa; Dolan, Brenda; Rutledge, Steven

2016-02-29

Recently the Radar Meteorology Group at Colorado State University has completed major case studies of some top cases from MC3E including 25 April, 20 May and 23 May 2011. A discussion on the analysis methods as well as radar quality control methods is included. For each case, a brief overview is first provided. Then, multiple Doppler (using available X-SAPR and C-SAPR data) analyses are presented including statistics on vertical air motions, sub-divided by convective and stratiform precipitation. Mean profiles and CFAD's of vertical motion are included to facilitate comparison with ASR model simulations. Retrieved vertical motion has also been verified with vertically pointing profiler data. Finally for each case, hydrometeor types are included derived from polarimetric radar observations. The latter can be used to provide comparisons to model-generated hydrometeor fields. Instructions for accessing all the data fields are also included. The web page can be found at: http://radarmet.atmos.colostate.edu/mc3e/research/

Rain retrieval from dual-frequency radar Doppler spectra: validation and potential for a midlatitude precipitating case-study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tridon, F.; Battaglia, A.; Luke, E.

A recently developed technique retrieving the binned raindrop size distributions (DSDs) and air state parameters from ground-based K a and W-band radars Doppler spectra profiles is improved and applied to a typical midlatitude rain event. The retrievals are thoroughly validated against DSD observations of a 2D video disdrometer and independent X-band observations. Here for this case-study, profiles of rain rate, R, mean volume diameter and concentration parameter are retrieved, with low bias and standard deviations. In light rain (0.1 < R < 1 mm h -1), the radar reflectivities must be calibrated with a collocated disdrometer which introduces random errorsmore » due to sampling mismatch between the two instruments. The best performances are obtained in moderate rain (1 < R < 20 mm h -1) where the retrieval is providing self-consistent estimates of the absolute calibration and of the attenuation caused by antenna or radome wetness for both radars.« less

The effect of recombination and attachment on meteor radar diffusion coefficient profiles

NASA Astrophysics Data System (ADS)

Lee, C. S.; Younger, J. P.; Reid, I. M.; Kim, Y. H.; Kim, J.-H.

2013-04-01

Estimates of the ambipolar diffusion coefficient producedusing meteor radar echo decay times display an increasing trend below 80-85 km, which is inconsistent with a diffusion-only theory of the evolution of meteor trails. Data from the 33 MHz meteor radar at King Sejong Station, Antarctica, have been compared with observations from the Aura Earth Observing System Microwave Limb Sounder satellite instrument. It has been found that the height at which the diffusion coefficient gradient reverses follows the height of a constant neutral atmospheric density surface. Numerical simulations of meteor trail diffusion including dissociative recombination with atmospheric ions and three-body attachment of free electrons to neutral molecules indicate that three-body attachment is responsible for the distortion of meteor radar diffusion coefficient profiles at heights below 90 km, including the gradient reversal below 80-85 km. Further investigation has revealed that meteor trails with low initial electron line density produce decay times more consistent with a diffusion-only model of meteor trail evolution.

Rain retrieval from dual-frequency radar Doppler spectra: validation and potential for a midlatitude precipitating case-study

DOE PAGES

Tridon, F.; Battaglia, A.; Luke, E.; ...

2017-01-27

A recently developed technique retrieving the binned raindrop size distributions (DSDs) and air state parameters from ground-based K a and W-band radars Doppler spectra profiles is improved and applied to a typical midlatitude rain event. The retrievals are thoroughly validated against DSD observations of a 2D video disdrometer and independent X-band observations. Here for this case-study, profiles of rain rate, R, mean volume diameter and concentration parameter are retrieved, with low bias and standard deviations. In light rain (0.1 < R < 1 mm h -1), the radar reflectivities must be calibrated with a collocated disdrometer which introduces random errorsmore » due to sampling mismatch between the two instruments. The best performances are obtained in moderate rain (1 < R < 20 mm h -1) where the retrieval is providing self-consistent estimates of the absolute calibration and of the attenuation caused by antenna or radome wetness for both radars.« less

Examples of mesoscale structures and short-term wind variations detected by VHF Doppler radar

NASA Technical Reports Server (NTRS)

Forbes, G. S.

1986-01-01

The first of three wind profilers planned for operation in central and western Pennsylvania began full-time, high-quality operation during July 1985. It is located about 20 km south-southeast of University Park and operates at 50 MHz. Another 50-MHz radar and a 400-MHz radar are to be installed over the next few months, to complete a mesoscale triangle with sides of 120 to 160 km. During the period since early July, a number of weather systems have passed over the wind profiler. Those accompanied by thunderstorms caused data losses either because the Department computer system lost power or because power went out at the profiler site. A backup power supply and an automatic re-start program will be added to the profiler system to minimize such future losses. Data have normally been averaged over a one-hour period, although there have been some investigations of shorter-period averaging. In each case, preliminary examinations reveal that the profiler winds are indicative of meteorological phenomena. The only occasions of bad or missing data are obtained when airplane noise is occasionally experienced and when the returned power is nearly at the noise level, at the upper few gates, where a consensus wind cannot be determined. Jets streams, clouds, and diurnal variations of winds are discussed.

Development of wide band digital receiver for atmospheric radars using COTS board based SDR

NASA Astrophysics Data System (ADS)

Yasodha, Polisetti; Jayaraman, Achuthan; Thriveni, A.

2016-07-01

Digital receiver extracts the received echo signal information, and is a potential subsystem for atmospheric radar, also referred to as wind profiling radar (WPR), which provides the vertical profiles of 3-dimensional wind vector in the atmosphere. This paper presents the development of digital receiver using COTS board based Software Defined Radio technique, which can be used for atmospheric radars. The developmental work is being carried out at National Atmospheric Research Laboratory (NARL), Gadanki. The digital receiver consists of a commercially available software defined radio (SDR) board called as universal software radio peripheral B210 (USRP B210) and a personal computer. USRP B210 operates over a wider frequency range from 70 MHz to 6 GHz and hence can be used for variety of radars like Doppler weather radars operating in S/C bands, in addition to wind profiling radars operating in VHF, UHF and L bands. Due to the flexibility and re-configurability of SDR, where the component functionalities are implemented in software, it is easy to modify the software to receive the echoes and process them as per the requirement suitable for the type of the radar intended. Hence, USRP B210 board along with the computer forms a versatile digital receiver from 70 MHz to 6 GHz. It has an inbuilt direct conversion transceiver with two transmit and two receive channels, which can be operated in fully coherent 2x2 MIMO fashion and thus it can be used as a two channel receiver. Multiple USRP B210 boards can be synchronized using the pulse per second (PPS) input provided on the board, to configure multi-channel digital receiver system. RF gain of the transceiver can be varied from 0 to 70 dB. The board can be controlled from the computer via USB 3.0 interface through USRP hardware driver (UHD), which is an open source cross platform driver. The USRP B210 board is connected to the personal computer through USB 3.0. Reference (10 MHz) clock signal from the radar master oscillator is used to lock the board, which is essential for deriving Doppler information. Input from the radar analog receiver is given to one channel of USRP B210, which is down converted to baseband. 12-bit ADC present on the board digitizes the signal and produces I (in-phase) and Q (quadrature-phase) data. The maximum sampling rate possible is about 61 MSPS. The I and Q (time series) data is sent to PC via USB 3.0, where the signal processing is carried out. The online processing steps include decimation, range gating, decoding, coherent integration and FFT computation (optional). The processed data is then stored in the hard disk. C++ programming language is used for developing the real time signal processing. Shared memory along with multi threading is used to collect and process data simultaneously. Before implementing the real time operation, stand alone test of the board was carried out through GNU radio software and the base band output data obtained is found satisfactory. Later the board is integrated with the existing Lower Atmospheric Wind Profiling radar at NARL. The radar receive IF output at 70 MHz is given to the board and the real-time radar data is collected. The data is processed off-line and the range-doppler spectrum is obtained. Online processing software is under progress.

Handbook for MAP, volume 32. Part 1: MAP summary. Part 2: MAPSC minutes, reading, August 1989. MAP summaries from nations. Part 3: MAP data catalogue

NASA Technical Reports Server (NTRS)

Vincent, R. A. (Editor); Edwards, B. (Editor); Hirota, I. (Editor)

1991-01-01

Extended abstracts from the fourth workshop on the technical and scientific aspects of mesosphere stratosphere troposphere (MST) radar are presented. Individual sessions addressed the following topics: meteorological applications of MST and ST radars, networks, and campaigns; the dynamics of the equatorial middle atmosphere; interpretation of radar returns from clear air; techniques for studying gravity waves and turbulence, intercomparison and calibration of wind and wave measurements at various frequencies; progress in existing and planned MST and ST radars; hardware design for MST and ST radars and boundary layer/lower troposphere profilers; signal processing; and data management.

Detection of ventricular fibrillation in the presence of cardiopulmonary resuscitation artefacts.

PubMed

Aramendi, Elisabete; de Gauna, Sofia Ruiz; Irusta, Unai; Ruiz, Jesus; Arcocha, M Fe; Ormaetxe, Jose Miguel

2007-01-01

Providing cardiopulmonary resuscitation (CPR) to a patient in cardiac arrest introduces artefacts into the electrocardiogram (ECG), corrupting the diagnosis of the underlying heart rhythm. CPR must therefore be discontinued for reliable shock advice analysis by an automated external defibrillator (AED). Detection of ventricular fibrillation (VF) during CPR would enable CPR to continue during AED rhythm analysis, thereby increasing the likelihood of resuscitation success. This study presents a new adaptive filtering method to clean the ECG. The approach consists of a filter that adapts its characteristics to the spectral content of the signal exclusively using the surface ECG that commercial AEDs capture through standard patches. A set of 200 VF and 25 CPR artefact samples collected from real out-of-hospital interventions were used to test the method. The performance of a shock advice algorithm was evaluated before and after artefact removal. CPR artefacts were added to the ECG signals and four degrees of corruption were tested. Mean sensitivities of 97.83%, 98.27%, 98.32% and 98.02% were achieved, producing sensitivity increases of 28.44%, 49.75%, 59.10% and 64.25%, respectively, sufficient for ECG analysis during CPR. Although satisfactory and encouraging sensitivity values have been obtained, further clinical and experimental investigation is required in order to integrate this type of artefact suppressing algorithm in current AEDs.

Unusual respiratory capacity and nitrogen metabolism in a Parcubacterium (OD1) of the Candidate Phyla Radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castelle, Cindy J.; Brown, Christopher T.; Thomas, Brian C.

The Candidate Phyla Radiation (CPR) is a large group of bacteria, the scale of which approaches that of all other bacteria. CPR organisms are inferred to depend on other community members for many basic cellular building blocks and all appear to be obligate anaerobes. To date, there has been no evidence for any significant respiratory capacity in an organism from this radiation. Here we report a curated draft genome for Candidatus Parcunitrobacter nitroensis' a member of the Parcubacteria (OD1) superphylum of the CPR. The genome encodes versatile energy pathways, including fermentative and respiratory capacities, nitrogen and fatty acid metabolism, asmore » well as the first complete electron transport chain described for a member of the CPR. The sequences of all of these enzymes are highly divergent from sequences found in other organisms, suggesting that these capacities were not recently acquired from non-CPR organisms. Although the wide respiration-based repertoire points to a different lifestyle compared to other CPR bacteria, we predict similar obligate dependence on other organisms or the microbial community. The results substantially expand the known metabolic potential of CPR bacteria, although sequence comparisons indicate that these capacities are very rare in members of this radiation.« less

Unusual respiratory capacity and nitrogen metabolism in a Parcubacterium (OD1) of the Candidate Phyla Radiation

DOE PAGES

Castelle, Cindy J.; Brown, Christopher T.; Thomas, Brian C.; ...

2017-01-09

The Candidate Phyla Radiation (CPR) is a large group of bacteria, the scale of which approaches that of all other bacteria. CPR organisms are inferred to depend on other community members for many basic cellular building blocks and all appear to be obligate anaerobes. To date, there has been no evidence for any significant respiratory capacity in an organism from this radiation. Here we report a curated draft genome for Candidatus Parcunitrobacter nitroensis' a member of the Parcubacteria (OD1) superphylum of the CPR. The genome encodes versatile energy pathways, including fermentative and respiratory capacities, nitrogen and fatty acid metabolism, asmore » well as the first complete electron transport chain described for a member of the CPR. The sequences of all of these enzymes are highly divergent from sequences found in other organisms, suggesting that these capacities were not recently acquired from non-CPR organisms. Although the wide respiration-based repertoire points to a different lifestyle compared to other CPR bacteria, we predict similar obligate dependence on other organisms or the microbial community. The results substantially expand the known metabolic potential of CPR bacteria, although sequence comparisons indicate that these capacities are very rare in members of this radiation.« less

RNase alleviates neurological dysfunction in mice undergoing cardiac arrest and cardiopulmonary resuscitation

PubMed Central

Ma, Ye; Chen, Chan; Zhang, Shu; Wang, Qiao; Chen, Hai; Dong, Yuanlin; Zhang, Zheng; Li, Yan; Niu, Zhendong; Zhu, Tao; Yu, Hai; Liu, Bin

2017-01-01

Cardiac arrest (CA) is one of the leading lethal factors. Despite cardiopulmonary resuscitation (CPR) procedure has been consecutively improved and lots of new strategies have been developed, neurological outcome of the patients experienced CPR is still disappointing. Ribonuclease (RNase) has been demonstrated to have neuroprotective effects in acute stroke and postoperative cognitive impairment, possibly through acting against endogenous RNA that released from damaged tissue. However, the role of RNase in post-cardiac arrest cerebral injury is unknown. In the present study, we investigated the role of RNase in neurological outcome of mice undergoing 5 minutes of CA and followed by CPR. RNase or the same dosage of normal saline was administrated. We found that RNase administration could: 1) improve neurologic score on day 1 and day 3 after CA/CPR performance; 2) improve memory and learning ability on day 3 after training in contextual fear-conditioning test; 3) reduce extracellular RNA (exRNA) level in plasma and hippocampus tissue, and hippocampal cytokines mRNA production on day 3 after CA/CPR procedure; 4) attenuate autophagy levels in hippocampus tissue on day 3 after CA/CPR procedure. In conclusion, RNase could improve neurological function by reducing inflammation response and autophagy in mice undergoing CA/CPR. PMID:28881795

Development of a smart backboard system for real-time feedback during CPR chest compression on a soft back support surface.

PubMed

Gohier, Francis; Dellimore, Kiran; Scheffer, Cornie

2013-01-01

The quality of cardiopulmonary resuscitation (CPR) is often inconsistent and frequently fails to meet recommended guidelines. One promising approach to address this problem is for clinicians to use an active feedback device during CPR. However, one major deficiency of existing feedback systems is that they fail to account for the displacement of the back support surface during chest compression (CC), which can be important when CPR is performed on a soft surface. In this study we present the development of a real-time CPR feedback system based on an algorithm which uses force and dual-accelerometer measurements to provide accurate estimation of the CC depth on a soft surface, without assuming full chest decompression. Based on adult CPR manikin tests it was found that the accuracy of the estimated CC depth for a dual accelerometer feedback system is significantly better (7.3% vs. 24.4%) than for a single accelerometer system on soft back support surfaces, in the absence or presence of a backboard. In conclusion, the algorithm used was found to be suitable for a real-time, dual accelerometer CPR feedback application since it yielded reasonable accuracy in terms of CC depth estimation, even when used on a soft back support surface.

The effect of real-time CPR feedback and post event debriefing on patient and processes focused outcomes: A cohort study: trial protocol

PubMed Central

2011-01-01

Background Cardiac arrest affects 30-35, 000 hospitalised patients in the UK every year. For these patients to be given the best chance of survival, high quality cardiopulmonary resuscitation (CPR) must be delivered, however the quality of CPR in real-life is often suboptimal. CPR feedback devices have been shown to improve CPR quality in the pre-hospital setting and post-event debriefing can improve adherence to guidelines and CPR quality. However, the evidence for use of these improvement methods in hospital remains unclear. The CPR quality improvement initiative is a prospective cohort study of the Q-CPR real-time feedback device combined with post-event debriefing in hospitalised adult patients who sustain a cardiac arrest. Methods/design The primary objective of this trial is to assess whether a CPR quality improvement initiative will improve rate of return of sustained spontaneous circulation in in-hospital-cardiac-arrest patients. The study is set in one NHS trust operating three hospital sites. Secondary objectives will evaluate: any return of spontaneous circulation; survival to hospital discharge and patient cerebral performance category at discharge; quality of CPR variables and cardiac arrest team factors. Methods: All three sites will have an initial control phase before any improvements are implemented; site 1 will implement audiovisual feedback combined with post event debriefing, site 2 will implement audiovisual feedback only and site 3 will remain as a control site to measure any changes in outcome due to any other trust-wide changes in resuscitation practice. All adult patients sustaining a cardiac arrest and receiving resuscitation from the hospital cardiac arrest team will be included. Patients will be excluded if; they have a Do-not-attempt resuscitation order written and documented in their medical records, the cardiac arrest is not attended by a resuscitation team, the arrest occurs out-of-hospital or the patient has previously participated in this study. The trial will recruit a total of 912 patients from the three hospital sites. Conclusion This trial will evaluate patient and process focussed outcomes following the implementation of a CPR quality improvement initiative using real-time audiovisual feedback and post event debriefing. Trial registration ISRCTN56583860 PMID:22008636

Active compression-decompression cardiopulmonary resuscitation (CPR) versus standard CPR for cardiac arrest patients: a meta-analysis

PubMed Central

Luo, Xu-rui; Zhang, Hui-li; Chen, Geng-jin; Ding, Wen-shu; Huang, Liang

2013-01-01

BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACDCPR) has been popular in the treatment of patients with cardiac arrest (CA). However, the effect of ACD-CPR versus conventional standard CPR (S-CRP) is contriversial. This study was to analyze the efficacy and safety of ACD-CPR versus S-CRP in treating CA patients. METHODS: Randomized or quasi-randomized controlled trials published from January 1990 to March 2011 were searched with the phrase “active compression-decompression cardiopulmonary resuscitation and cardiac arrest” in PubMed, EmBASE, and China Biomedical Document Databases. The Cochrane Library was searched for papers of meta-analysis. Restoration of spontaneous circulation (ROSC) rate, survival rate to hospital admission, survival rate at 24 hours, and survival rate to hospital discharge were considered primary outcomes, and complications after CPR were viewed as secondary outcomes. Included studies were critically appraised and estimates of effects were calculated according to the model of fixed or random effects. Inconsistency across the studies was evaluated using the I2 statistic method. Sensitivity analysis was made to determine statistical heterogeneity. RESULTS: Thirteen studies met the criteria for this meta-analysis. The studies included 396 adult CA patients treated by ACD-CPR and 391 patients by S-CRP. Totally 234 CA patients were found out hospitals, while the other 333 CA patients were in hospitals. Two studies were evaluated with high-quality methodology and the rest 11 studies were of poor quality. ROSC rate, survival rate at 24 hours and survival rate to hospital discharge with favorable neurological function indicated that ACD-CPR is superior to S-CRP, with relative risk (RR) values of 1.39 (95% CI 0.99–1.97), 1.94 (95% CI 1.45–2.59) and 2.80 (95% CI 1.60–5.24). No significant differences were found in survival rate to hospital admission and survival rate to hospital discharge for ACD-CPR versus S-CRP with RR values of 1.06 (95% CI 0.76–1.60) and 1.00 (95% CI 0.73–1.38). CONCLUSION: Quality controlled studies confirmed the superiority of ACD-CPR to S-CRP in terms of ROSC rate and survival rate at 24 hours. Compared with S-CRP, ACD-CPR could not improve survival rate to hospital admission or survival rate to hospital discharge. PMID:25215130

Improving cardiopulmonary resuscitation with a CPR feedback device and refresher simulations (CPR CARES Study): a randomized clinical trial.

PubMed

Cheng, Adam; Brown, Linda L; Duff, Jonathan P; Davidson, Jennifer; Overly, Frank; Tofil, Nancy M; Peterson, Dawn T; White, Marjorie L; Bhanji, Farhan; Bank, Ilana; Gottesman, Ronald; Adler, Mark; Zhong, John; Grant, Vincent; Grant, David J; Sudikoff, Stephanie N; Marohn, Kimberly; Charnovich, Alex; Hunt, Elizabeth A; Kessler, David O; Wong, Hubert; Robertson, Nicola; Lin, Yiqun; Doan, Quynh; Duval-Arnould, Jordan M; Nadkarni, Vinay M

2015-02-01

The quality of cardiopulmonary resuscitation (CPR) affects hemodynamics, survival, and neurological outcomes following pediatric cardiopulmonary arrest (CPA). Most health care professionals fail to perform CPR within established American Heart Association guidelines. To determine whether "just-in-time" (JIT) CPR training with visual feedback (VisF) before CPA or real-time VisF during CPA improves the quality of chest compressions (CCs) during simulated CPA. Prospective, randomized, 2 × 2 factorial-design trial with explicit methods (July 1, 2012, to April 15, 2014) at 10 International Network for Simulation-Based Pediatric Innovation, Research, & Education (INSPIRE) institutions running a standardized simulated CPA scenario, including 324 CPR-certified health care professionals assigned to 3-person resuscitation teams (108 teams). Each team was randomized to 1 of 4 permutations, including JIT training vs no JIT training before CPA and real-time VisF vs no real-time VisF during simulated CPA. The proportion of CCs with depth exceeding 50 mm, the proportion of CPR time with a CC rate of 100 to 120 per minute, and CC fraction (percentage CPR time) during simulated CPA. The quality of CPR was poor in the control group, with 12.7% (95% CI, 5.2%-20.1%) mean depth compliance and 27.1% (95% CI, 14.2%-40.1%) mean rate compliance. JIT training compared with no JIT training improved depth compliance by 19.9% (95% CI, 11.1%-28.7%; P < .001) and rate compliance by 12.0% (95% CI, 0.8%-23.2%; P = .037). Visual feedback compared with no VisF improved depth compliance by 15.4% (95% CI, 6.6%-24.2%; P = .001) and rate compliance by 40.1% (95% CI, 28.8%-51.3%; P < .001). Neither intervention had a statistically significant effect on CC fraction, which was excellent (>89.0%) in all groups. Combining both interventions showed the highest compliance with American Heart Association guidelines but was not significantly better than either intervention in isolation. The quality of CPR provided by health care professionals is poor. Using novel and practical technology, JIT training before CPA or real-time VisF during CPA, alone or in combination, improves compliance with American Heart Association guidelines for CPR that are associated with better outcomes. clinicaltrials.gov Identifier: NCT02075450.

An Interventional Quality Improvement Study to Assess the Compliance to Cardiopulmonary Resuscitation Documentation in an Indian Teaching Hospital

PubMed Central

Nevrekar, Viraj; Panda, Prasan Kumar; Wig, Naveet; Pandey, R. M.; Agarwal, Praveen; Biswas, Ashutosh

2017-01-01

Background: Cardiopulmonary resuscitation (CPR) should be performed as per the international guidelines; however, compliance to these guidelines is difficult to assess. This study was conducted to determine the compliance to American Heart Association (2010) guideline on CPR documentation by among resident physicians before and after resident training (two arms). Methods: This pre–postinterventional quality improvement study was conducted in a referral center, North India. Data of hospitalized in-hospital CPR patients were collected in the form of quality indicators (checklists) as defined by the guideline and compared between two arms of before–after resident training. Residents were given appropriate training in CPR technique as per the guideline. The compliance of CPR documentation was assessed pre- and post-intervention. Results: The baseline arm compliance of various components of CPR documentation was low. The postintervention arm compliances of all components significantly increased (baseline, 2.5% to postintervention, 15.11%, P = 0.03). Individual components assessed were documentation of assessment of responsiveness (65% to 77.9%, P = 0.19), assessment of breathing (37.5% to 58.1%, P = 0.03), assessment of carotid pulse (62.5% to 79%, P = 0.05), rate of chest compressions (20% to 39.5%, P = 0.04), airway management (62.5% to 82.5%, P = 0.02), and compressions to breaths ratio (12.5% to 31.4%, P = 0.02). Documentation of chest compression rate compared to nondocumentation (12 of 42 vs. 11 of 84, P = 0.04) was independently associated with a higher rate of return of spontaneous circulation. The study however did not show any survival benefits. Conclusions: This study establishes that the compliance to CPR documentation is poor as assessed by CPR documentation content and quality, which improves after physician training, but not up to the mark level (100%) that may be due to busy Indian hospital settings and human behavioral factors. Due to ethical constraints of live CPR assessment, this document checklist approach may be considered as an internal quality assessment method for CPR compliance. Furthermore, correct instruction in CPR technique along with proper documentation of the procedure is required, followed up with periodic re-education during the residency period and beyond. PMID:29279637

Does real-time objective feedback and competition improve performance and quality in manikin CPR training--a prospective observational study from several European EMS.

PubMed

Smart, J R; Kranz, K; Carmona, F; Lindner, T W; Newton, A

2015-10-15

Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is important for patient survival. Real time objective feedback during manikin training has been shown to improve CPR performance. Objective measurement could facilitate competition and help motivate participants to improve their CPR performance. The aims of this study were to investigate whether real time objective feedback on manikins helps improve CPR performance and whether competition between separate European Emergency Medical Services (EMS) and between participants at each EMS helps motivation to train. Ten European EMS took part in the study and was carried out in two stages. At Stage 1, each EMS provided 20 pre-hospital professionals. A questionnaire was completed and standardised assessment scenarios were performed for adult and infant out of hospital cardiac arrest (OHCA). CPR performance was objectively measured and recorded but no feedback given. Between Stage 1 and 2, each EMS was given access to manikins for 6 months and instructed on how to use with objective real-time CPR feedback available. Stage 2 was undertaken and was a repeat of Stage 1 with a questionnaire with additional questions relating to usefulness of feedback and the competition nature of the study (using a 10 point Likert score). The EMS that improved the most from Stage 1 to Stage 2 was declared the winner. An independent samples Student t-test was used to analyse the objective CPR metrics with the significance level taken as p < 0.05. Overall mean Improvement of CPR performance from Stage 1 to Stage 2 was significant. The improvement was greater for the infant assessment. The participants thought the real-time feedback very useful (mean score of 8.5) and very easy to use (mean score of 8.2). Competition between EMS organisations recorded a mean score of 5.8 and competition between participants recorded a mean score of 6.0. The results suggest that the use of real time objective feedback can significantly help improve CPR performance. Competition, especially between participants, appeared to encourage staff to practice and this study suggests that competition might have a useful role to help motivate staff to perform CPR training.

Thermal Stability of Frozen Volatiles in the North Polar Region of Mercury

NASA Technical Reports Server (NTRS)

Paige, David A.; Siegler, Matthew A.; Harmon, John K.; Smith, David E.; Zuber, Maria T.; Neumann, Gregory A.; Solomon, Sean C.

2012-01-01

Earth-based radar observations have revealed the presence on Mercury of anomalously bright, depolarizing features that appear to be localized in the permanently shadowed regions of high-latitude impact craters [1]. Observations of similar radar signatures over a range of radar wavelengths implies that they correspond to deposits that are highly transparent at radar wavelengths and extend to depths of several meters below the surface [1]. Thermal models using idealized crater topographic profiles have predicted the thermal stability of surface and subsurface water ice at these same latitudes [2]. One of the major goals of the MESSENGER mission is to characterize the nature of radar-bright craters and presumed associated frozen volatile deposits at the poles of Mercury through complementary orbital observations by a suite of instruments [3]. Here we report on an examination of the thermal stability of water ice and other frozen volatiles in the north polar region of Mercury using topographic profiles obtained by the Mercury Laser Altimeter (MLA) instrument [4] in conjunction with a three-dimensional ray-tracing thermal model previously used to study the thermal environment of polar craters on the Moon [5].

Analysis of 35 GHz Cloud Radar polarimetric variables to identify stratiform and convective precipitation.

NASA Astrophysics Data System (ADS)

Fontaine, Emmanuel; Illingworth, Anthony, J.; Stein, Thorwald

2017-04-01

This study is performed using vertical profiles of radar measurements at 35GHz, for the period going from 29th of February to 1rst October 2016, at the Chilbolton observatory in United Kingdom. During this period, more than 40 days with precipitation events are investigated. The investigation uses the synergy of radar reflectivity factors, vertical velocity, Doppler spectrum width, and linear depolarization ratio (LDR) to differentiate between stratiform and convective rain events. The depth of the layer with Doppler spectrum width values greater than 0.5 m s-1 is shown to be a suitable proxy to distinguish between convective and stratiform events. Using LDR to detect the radar bright band, bright band characteristics such as depth of the layer and maximum LDR are shown to vary with the amount of turbulence aloft. Profiles of radar measurements are also compared to rain gauge measurements to study the contribution of convective and stratiform rainfall to total rain duration and amount. To conclude, this study points out differences between convective and stratiform rains and quantifies their contributions over a precipitation event, highlighting that convective and stratiform rainfall should be considered as a continuum rather than a dichotomy.

Synthetic range profiling in ground penetrating radar

NASA Astrophysics Data System (ADS)

Kaczmarek, Pawel; Lapiński, Marian; Silko, Dariusz

2009-06-01

The paper describes stepped frequency continuous wave (SFCW) ground penetrating radar (GPR), where signal's frequency is discretely increased in N linear steps, each separated by a fixed ▵f increment from the previous one. SFCW radar determines distance from phase shift in a reflected signal, by constructing synthetic range profile in spatial time domain using the IFFT. Each quadrature sample is termed a range bin, as it represents the signal from a range window of length cτ/2, where τ is duration of single frequency segment. IFFT of those data samples resolves the range bin in into fine range bins of c/2N▵f width, thus creating the synthetic range profile in a GPR - a time domain approximation of the frequency response of a combination of the medium through which electromagnetic waves propagates (soil) and any targets or dielectric interfaces (water, air, other types of soil) present in the beam width of the radar. In the paper, certain practical measurements done by a monostatic SFCW GPR were presented. Due to complex nature of signal source, E5062A VNA made by Agilent was used as a signal generator, allowing number of frequency steps N to go as high as 1601, with generated frequency ranging from 300kHz to 3 GHz.

Scientific reasons for a network of ST radars and cooperative campaigns

NASA Technical Reports Server (NTRS)

Petitdidier, M.; Crochet, M.

1986-01-01

Due to their capabilities of measuring wind profiles in the troposphere and stratosphere with good time and height resolution, whatever the weather conditions, stratosphere-troposphere (ST) radars are well adapted to carry out atmospheric research in many fields as well as to fulfill the meteorological forecasting needs. Examples are presented from previous and future national or international campaigns planned in France. The ST radars were used first by themselves with the adjunction of radiosonde data. Then networks were built and used to get horizontal parameters. It appears that ST radar networks should naturally be included in cooperative campaigns.

Ground-penetrating radar--A tool for mapping reservoirs and lakes

USGS Publications Warehouse

Truman, C.C.; Asmussen, L.E.; Allison, H.D.

1991-01-01

Ground-penetrating radar was evaluated as a tool for mapping reservoir and lake bottoms and providing stage-storage information. An impulse radar was used on a 1.4-ha (3.5-acre) reservoir with 31 transects located 6.1 m (20 feet) apart. Depth of water and lateral extent of the lake bottom were accurately measured by ground-penetrating radar. A linear (positive) relationship existed between measured water depth and ground-penetrating radar-determined water depth (R2=0.989). Ground-penetrating radar data were used to create a contour map of the lake bottom. Relationships between water (contour) elevation and water surface area and volume were established. Ground-penetrating radar proved to be a useful tool for mapping lakes, detecting lake bottom variations, locating old stream channels, and determining water depths. The technology provides accurate, continuous profile data in a relatively short time compared to traditional surveying and depth-sounding techniques.

RaInCube: a proposed constellation of precipitation profiling Radars In Cubesat

NASA Astrophysics Data System (ADS)

Peral, E.; Tanelli, S.; Haddad, Z. S.; Stephens, G. L.; Im, E.

2014-12-01

Precipitation radars in Low-Earth-Orbit provide vertically resolved profiles of rain and snow on a global scale. With the recent advances in miniaturized radar and CubeSat/SmallSat technologies, it would now be feasible to launch multiple copies of the same radar instrument in desirable formations to allow measurements of short time scale evolution of atmospheric processes. One such concept is the novel radar architecture compatible with the 6U CubeSat class that is being developed at JPL by exploiting simplification and miniaturization of the radar subsystems. The RaInCube architecture would significantly reduce the number of components, power consumption and mass with respect to existing spaceborne radars. The baseline RaInCube instrument configuration would be a fixed nadir-pointing profiler at Ka-band with a minimum detectable reflectivity better than +10 dBZ at 250m range resolution and 5 km horizontal resolution. The low cost nature of the RaInCube platform would enable deployment of a constellation of identical copies of the same instrument in various relative positions in LEO to address specific observational gaps left open by the current missions that require high-resolution vertical profiling capability. A constellation of only four RaInCubes would populate the precipitation statistics in a distributed fashion across the globe and across the times of day, and therefore, would enable substantially better sampling of the diurnal cycle statistics. One could extend this scheme by adding more RaInCubes in each of the orbital planes, and phase them once in orbit so that they would be separated by an arbitrary amount of time among them. Wide separations (say 20-30 min) would further extend the sampling of the diurnal cycle to sub-hourly scales. Narrower time separations between RaInCubes would allow studying the evolution of convective systems at the convective time scale in each region of interest and would reveal the dominant modes of evolution of each corresponding climatological regime. A constellation of RaInCubes would also be a natural complement to other resources aiming at monitoring the evolution of weather systems, for example the Geostationary IR/VIS imagers, the NEXRAD network, and the GPM constellation.

Evaluation of Improvements to the TRMM Microwave Rain Algorithm

NASA Technical Reports Server (NTRS)

Yang, Song; Olson, Williams S.; Smith, Eric A.; Kummerow, Christian

2002-01-01

Improvements made to the Version 5 TRMM passive microwave rain retrieval algorithm (2A-12) are evaluated using independent data. Surface rain rate estimates from the Version 5 TRMM TMI (2A-12), PR (2A-25) and TMI/PR Combined (2B-31) algorithms and ground-based radar estimates for selected coincident subset datasets in 1998 over Melbourne and Kwajalein show varying degrees of agreement. The surface rain rates are then classified into convective and stratiform rain types over ocean, land, and coastal areas for more detailed comparisons to the ground radar measurements. These comparisons lead to a better understanding of the relative performances of the current TRMM rain algorithms. For example, at Melbourne more than 80% of the radar-derived rainfall is classified as convective rain. Convective rain from the TRMM rain algorithms is less than that from ground radar measurements, while TRMM stratiform rain is much greater. Rain area coverage from 2A-12 is also in reasonable agreement with ground radar measurements, with about 25% more over ocean and 25% less over land and coastal areas. Retrieved rain rates from the improved (Version 6) 2A-12 algorithm will be compared to 2A-25, 2B-31, and ground-based radar measurements to evaluate the impact of improvements to 2A-12 in Version 6. An important improvement to the Version 6 2A-12 algorithm is the retrieval of Q1/Q2 (latent heating/drying) profiles in addition to the surface rain rate and hydrometeor profiles. In order to ascertain the credibility of the new products, retrieved Q1/Q2 profiles are compared to independent ground-based estimates. Analyses of dual-Doppler radar data in conjunction with coincident rawinsonde data yield estimates of the vertical distributions of diabatic heating/drying at high horizontal resolution for selected cases over the Kwajalein and LBA field sites. The estimated vertical heating/drying structures appear to be reasonable. Comparisons of Q1/Q2 profiles from Version 6 2A-12 and the ground-based estimates are in progress. Retrieved Q1/Q2 structures will also be compared to MM5 hurricane simulations for selected cases. The results of these intercomparisons will be presented at the conference.

Vertical structure of radar reflectivity in deep intense convective clouds over the tropics

NASA Astrophysics Data System (ADS)

Kumar, Shailendra; Bhat, G. S.

2015-04-01

This study is based on 10 years of radar reflectivity factor (Z) data derived from the TRMM Precipitation Radar (PR) measurements. We define two types of convective cells, namely, cumulonimbus towers (CbTs) and intense convective clouds (ICCs), essentially following the methodology used in deriving the vertical profiles of radar reflectivity (VPRR). CbT contains Z≥ 20 dBZ at 12 km height with its base height below 3 km. ICCs belong to the top 5% reflectivity population at 3 km and 8 km altitude. Regional differences in the vertical structure of convective cells have been explored for two periods, namely, JJAS (June, July, August and September) and JFM (January, February and March) months. Frequency of occurrences of CbTs and ICCs depend on the region. Africa and Latin America are the most productive regions for the CbTs while the foothills of Western Himalaya contain the most intense profiles. Among the oceanic areas, the Bay of Bengal has the strongest vertical profile, whereas Atlantic Ocean has the weakest profile during JJAS. During JFM months, maritime continent has the strongest vertical profile whereas western equatorial Indian Ocean has the weakest. Monsoon clouds lie between the continental and oceanic cases. The maximum heights of 30 and 40 dBZ reflectivities (denoted by MH30 and MH40, respectively) are also studied. MH40 shows a single mode and peaks around 5.5 km during both JJAS and JFM months. MH30 shows two modes, around 5 km and between 8 km and 10 km, respectively. It is also shown that certain conclusions such as the area/region with the most intense convective cells, depend of the reference height used in defining a convective cell.

Normalized vertical ice mass flux profiles from vertically pointing 8-mm-wavelength Doppler radar

NASA Technical Reports Server (NTRS)

Orr, Brad W.; Kropfli, Robert A.

1993-01-01

During the FIRE 2 (First International Satellite Cloud Climatology Project Regional Experiment) project, NOAA's Wave Propagation Laboratory (WPL) operated its 8-mm wavelength Doppler radar extensively in the vertically pointing mode. This allowed for the calculation of a number of important cirrus cloud parameters, including cloud boundary statistics, cloud particle characteristic sizes and concentrations, and ice mass content (imc). The flux of imc, or, alternatively, ice mass flux (imf), is also an important parameter of a cirrus cloud system. Ice mass flux is important in the vertical redistribution of water substance and thus, in part, determines the cloud evolution. It is important for the development of cloud parameterizations to be able to define the essential physical characteristics of large populations of clouds in the simplest possible way. One method would be to normalize profiles of observed cloud properties, such as those mentioned above, in ways similar to those used in the convective boundary layer. The height then scales from 0.0 at cloud base to 1.0 at cloud top, and the measured cloud parameter scales by its maximum value so that all normalized profiles have 1.0 as their maximum value. The goal is that there will be a 'universal' shape to profiles of the normalized data. This idea was applied to estimates of imf calculated from data obtained by the WPL cloud radar during FIRE II. Other quantities such as median particle diameter, concentration, and ice mass content can also be estimated with this radar, and we expect to also examine normalized profiles of these quantities in time for the 1993 FIRE II meeting.

Effect of mobile application-based versus DVD-based CPR training on students’ practical CPR skills and willingness to act: a cluster randomised study

PubMed Central

Nord, Anette; Svensson, Leif; Hult, Håkan; Kreitz-Sandberg, Susanne; Nilsson, Lennart

2016-01-01

Objectives The aim was to compare students’ practical cardiopulmonary resuscitation (CPR) skills and willingness to perform bystander CPR, after a 30 min mobile application (app)-based versus a 50 min DVD-based training. Settings Seventh grade students in two Swedish municipalities. Design A cluster randomised trial. The classes were randomised to receive app-based or DVD-based training. Willingness to act and practical CPR skills were assessed, directly after training and at 6 months, by using a questionnaire and a PC Skill Reporting System. Data on CPR skills were registered in a modified version of the Cardiff test, where scores were given in 12 different categories, adding up to a total score of 12–48 points. Training and measurements were performed from December 2013 to October 2014. Participants 63 classes or 1232 seventh grade students (13-year-old) were included in the study. Primary and secondary outcome measures Primary end point was the total score of the modified Cardiff test. The individual variables of the test and self-reported willingness to make a life-saving intervention were secondary end points. Results The DVD-based group was superior to the app-based group in CPR skills; a total score of 36 (33–38) vs 33 (30–36) directly after training (p<0.001) and 33 (30–36) and 31 (28–34) at 6 months (p<0.001), respectively. At 6 months, the DVD group performed significantly better in 8 out of 12 CPR skill components. Both groups improved compression depth from baseline to follow-up. If a friend suffered cardiac arrest, 78% (DVD) versus 75% (app) would do compressions and ventilations, whereas only 31% (DVD) versus 32% (app) would perform standard CPR if the victim was a stranger. Conclusions At 6 months follow-up, the 50 min DVD-based group showed superior CPR skills compared with the 30 min app-based group. The groups did not differ in regard to willingness to make a life-saving effort. PMID:27130166

Resuscitation on television: realistic or ridiculous? A quantitative observational analysis of the portrayal of cardiopulmonary resuscitation in television medical drama.

PubMed

Harris, Dylan; Willoughby, Hannah

2009-11-01

Patients' preferences for cardiopulmonary resuscitation (CPR) relate to their perception about the likelihood of success of the procedure. There is evidence that the lay public largely base their perceptions about CPR on their experience of the portrayal of CPR in the media. The medical profession has generally been critical of the portrayal of CPR on medical drama programmes although there is no recent evidence to support such views. To compare the patient characteristics, cause and success rates of cardiopulmonary resuscitation (CPR) on medical television drama with published resuscitation statistics. Observational study. 88 episodes of television medical drama were reviewed (26 episodes of Casualty, Casualty, 25 episodes of Holby City, 23 episodes of Grey's Anatomy and 14 episodes of ER) screened between July 2008 and April 2009. The patient's age and sex, medical history, presumed cause of arrest, use of CPR and immediate and long term survival rate were recorded. Immediate survival and survival to discharge following CPR. There were a total of 76 cardio-respiratory arrests and 70 resuscitation attempts in the episodes reviewed. The immediate success rate (46%) did not differ significantly from published real life figures (p=0.48). The resuscitation process appeared to follow current guidelines. Survival (or not) to discharge was rarely shown. The average age of patients was 36 years and contrary to reality there was not an age related difference in likely success of CPR in patients less than 65 compared with those 65 and over (p=0.72). The most common cause of cardiac arrest was trauma with only a minor proportion of arrests due to cardio-respiratory causes such as myocardial infarction. Whilst the immediate success rate of CPR in medical television drama does not significantly differ from reality the lack of depiction of poorer medium to long term outcomes may give a falsely high expectation to the lay public. Equally the lay public may perceive that the incidence and likely success of CPR is equal across all age groups.

Proteomic and transcriptomic analyses of rigid and membranous cuticles and epidermis from the elytra and hindwings of the red flour beetle, Tribolium castaneum.

PubMed

Dittmer, Neal T; Hiromasa, Yasuaki; Tomich, John M; Lu, Nanyan; Beeman, Richard W; Kramer, Karl J; Kanost, Michael R

2012-01-01

The insect cuticle is a composite biomaterial made up primarily of chitin and proteins. The physical properties of the cuticle can vary greatly from hard and rigid to soft and flexible. Understanding how different cuticle types are assembled can aid in the development of novel biomimetic materials for use in medicine and technology. Toward this goal, we have taken a combined proteomics and transcriptomics approach with the red flour beetle, Tribolium castaneum, to examine the protein and gene expression profiles of the elytra and hindwings, appendages that contain rigid and soft cuticles, respectively. Two-dimensional gel electrophoresis analysis revealed distinct differences in the protein profiles between elytra and hindwings, with four highly abundant proteins dominating the elytral cuticle extract. MALDI/TOF mass spectrometry identified 19 proteins homologous to known or hypothesized cuticular proteins (CPs), including a novel low complexity protein enriched in charged residues. Microarray analysis identified 372 genes with a 10-fold or greater difference in transcript levels between elytra and hindwings. CP genes with higher expression in the elytra belonged to the Rebers and Riddiford family (CPR) type 2, or cuticular proteins of low complexity (CPLC) enriched in glycine or proline. In contrast, a majority of the CP genes with higher expression in hindwings were classified as CPR type 1, cuticular proteins analogous to peritrophins (CPAP), or members of the Tweedle family. This research shows that the elyra and hindwings, representatives of rigid and soft cuticles, have different protein and gene expression profiles for structural proteins that may influence the mechanical properties of these cuticles.

How the gender of a victim character in a virtual scenario created to learn CPR protocol affects student nurses' performance.

PubMed

Boada, Imma; Rodriguez-Benitez, Antonio; Thió-Henestrosa, Santiago; Olivet, Josep; Soler, Josep

2018-08-01

Virtual simulations recreate scenarios where student nurses can practice procedures in a safe and supervised manner and with no risk to the patient. Virtual scenarios include digital characters that reproduce human actions. Generally, these characters are modeled as males and restricted roles are assigned to females. Our objective is to evaluate how the character gender of a victim in a scenario created to practice the cardiopulmonary resuscitation protocol (CPR) affects performance of student nurses. Three virtual scenarios with cardiac arrest victims modeled as males or females were assigned to 41 students of the Nursing Faculty to practice the CPR protocol. We evaluated student performance with respect to the time to remove clothes, the time to perform the CPR maneuver, and the hands position for CPR. Chi-square, Fisher exact, and Mann-Whitney U were used to test primary outcome measures in the experimental design of victim character sex (male vs. female) and student sex (men vs. women). The analysis performed did not find statistically differences in time to remove clothes or in time to start CPR. With respect to hands placement we also did not find significant difference in any of the cases. Nurse student actions are not influenced by the character gender of the victim. Excellent results with respect to hands placement to start CPR are obtained. Virtual scenarios can be a suitable strategy to reduce gender differences in gender sensitive situations such as CPR performance. Copyright © 2018 Elsevier B.V. All rights reserved.

Survival after in-hospital cardiac arrest among cerebrovascular disease patients.

PubMed

Fehnel, Corey R; Trepman, Alissa; Steele, Dale; Khan, Muhib A; Silver, Brian; Mitchell, Susan L

2018-05-19

Stroke is a leading cause of death and disability, and while preferences for cardiopulmonary resuscitation (CPR) are frequently discussed, there is limited evidence detailing outcomes after CPR among acute cerebrovascular neurology (inclusive of stroke, subarachnoid hemorrhage (SAH)) patients. Systematic review and meta-analysis of PubMed and Cochrane libraries from January 1990 to December 2016 was conducted among stroke patients undergoing in-hospital CPR. Primary data from studies meeting inclusion criteria at two levels were extracted: 1) studies reporting survival to hospital discharge after CPR with cerebrovascular primary admitting diagnosis, and 2) studies reporting survival to hospital discharge after CPR with cerebrovascular comorbidity. Meta-analysis generated weighted, pooled survival estimates for each population. Of 818 articles screened, there were 176 articles (22%) that underwent full review. Three articles met primary inclusion criteria, with an estimated 8% (95% Confidence Interval (CI) 0.01, 0.14) rate of survival to hospital discharge from a pooled sample of 561 cerebrovascular patients after in-hospital CPR. Twenty articles met secondary inclusion criteria, listing a cerebrovascular comorbidity, with an estimated rate of survival to hospital discharge of 16% (95% CI 0.14, 0.19). All studies demonstrated wide variability in adherence to Utstein guidelines, and neurological outcomes were detailed in only 6 (26%) studies. Among the few studies reporting survival to hospital discharge after CPR among acute cerebrovascular patients, survival is lower than general inpatient populations. These findings synthesize the limited empirical basis for discussions about resuscitation among stroke patients, and highlight the need for more disease stratified reporting of outcomes after inpatient CPR. Copyright © 2018 Elsevier Ltd. All rights reserved.

Viewing an ultra-brief chest compression only video improves some measures of bystander CPR performance and responsiveness at a mass gathering event.

PubMed

Beskind, Daniel L; Stolz, Uwe; Thiede, Rebecca; Hoyer, Riley; Robertson, Whitney; Brown, Jeffrey; Ludgate, Melissa; Tiutan, Timothy; Shane, Romy; McMorrow, Deven; Pleasants, Michael; Kern, Karl B; Panchal, Ashish R

2017-09-01

CPR training at mass gathering events is an important part of health initiatives to improve cardiac arrest survival. However, it is unclear whether training lay bystanders using an ultra-brief video at a mass gathering event improves CPR quality and responsiveness. To determine if showing a chest-compression only (CCO) Ultra-Brief Video (UBV) at a mass gathering event is effective in teaching lay bystanders CCO-CPR. Prospective control trial in adults (age >18) who attended either a women's University of Arizona or a men's Phoenix Suns basketball game. Participants were evaluated using a standardized cardiac arrest scenario with Laerdal Skillreporter™ mannequins. CPR responsiveness (calling 911, time to calling 911, starting compressions within two minutes) and quality (compression rate, depth, hands-off time) were assessed for participants and data collected at Baseline and Post-intervention. Different participants were tested before and after the exposure of the UBV. Data were analyzed via the intention to treat principle using logistic regression for binary outcomes and median regression for continuous outcomes, controlling for clustering by venue. A total of 96 people were consented (Baseline=45; Post intervention=51). CPR responsiveness post intervention improved with faster time to calling 911 (s) and time to starting compressions (sec). Likewise, CPR quality improved with deeper compressions and improved hands-off time. Showing a UBV at a mass gathering sporting event is associated with improved CPR responsiveness and performance for lay bystanders. This data provides further support for the use of mass media interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

Incorporating cardiopulmonary resuscitation training into a cardiac rehabilitation programme: A feasibility study.

PubMed

Cartledge, Susie; Finn, Judith; Bray, Janet E; Case, Rosalind; Barker, Lauren; Missen, Diane; Shaw, James; Stub, Dion

2018-02-01

Patients with a cardiac history are at future risk of cardiac events, including out-of-hospital cardiac arrest. Targeting cardiopulmonary resuscitation (CPR) training to family members of cardiac patients has long been advocated, but is an area in need of contemporary research evidence. An environment yet to be investigated for targeted training is cardiac rehabilitation. To evaluate the feasibility of providing CPR training in a cardiac rehabilitation programme among patients, their family members and staff. A prospective before and after study design was used. CPR training was delivered using video self-instruction CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Cardiac patient participation rates in CPR classes were high ( n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use skills significantly increased post-training (both p<0.001). Post training participants demonstrated a mean compression rate of 112 beats/min and a mean depth of 48 mm. Training reach was doubled as participants shared the video self-instruction kit with a further 87 people. Patients, family members and cardiac rehabilitation staff had positive feedback about the training. We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using video self-instruction CPR training kits enabled further training reach to the target population.

EEG power as a biomarker to predict the outcome after cardiac arrest and cardiopulmonary resuscitation induced global ischemia.

PubMed

Weitzel, Lindsay-Rae; Sampath, Dayalan; Shimizu, Kaori; White, Andrew M; Herson, Paco S; Raol, Yogendra H

2016-11-15

Cardiac arrest (CA) is a major cause of mortality and survivors often develop neurologic deficits. The objective of this study was to determine the effect of CA and cardiopulmonary resuscitation (CPR) in mice on the EEG and neurologic outcomes, and identify biomarkers that can prognosticate poor outcomes. Video-EEG records were obtained at various periods following CA-CPR and examined manually to determine the presence of spikes and sharp-waves, and seizures. EEG power was calculated using a fast Fourier transform (FFT) algorithm. Fifty percent mice died within 72h following CA and successful CPR. Universal suppression of the background EEG was observed in all mice following CA-CPR, however, a more severe and sustained reduction in EEG power occurred in the mice that did not survive beyond 72h than those that survived until sacrificed. Spikes and sharp wave activity appeared in the cortex and hippocampus of all mice, but only one out of eight mice developed a purely electrographic seizure in the acute period after CA-CPR. Interestingly, none of the mice that died experienced any acute seizures. At 10days after the CA-CPR, 25% of the mice developed spontaneous convulsive and nonconvulsive seizures that remained restricted to the hippocampus. The frequency of nonconvulsive seizures was higher than that of convulsive seizures. A strong association between changes in EEG power and mortality following CA-CPR were observed in our study. Therefore, we suggest that the EEG power can be used to prognosticate mortality following CA-CPR induced global ischemia. Copyright © 2016 Elsevier Inc. All rights reserved.

Computational simulation of passive leg-raising effects on hemodynamics during cardiopulmonary resuscitation.

PubMed

Shin, Dong Ah; Park, Jiheum; Lee, Jung Chan; Shin, Sang Do; Kim, Hee Chan

2017-03-01

The passive leg-raising (PLR) maneuver has been used for patients with circulatory failure to improve hemodynamic responsiveness by increasing cardiac output, which should also be beneficial and may exert synergetic effects during cardiopulmonary resuscitation (CPR). However, the impact of the PLR maneuver on CPR remains unclear due to difficulties in monitoring cardiac output in real-time during CPR and a lack of clinical evidence. We developed a computational model that couples hemodynamic behavior during standard CPR and the PLR maneuver, and simulated the model by applying different angles of leg raising from 0° to 90° and compression rates from 80/min to 160/min. The simulation results showed that the PLR maneuver during CPR significantly improves cardiac output (CO), systemic perfusion pressure (SPP) and coronary perfusion pressure (CPP) by ∼40-65% particularly under the recommended range of compression rates between 100/min and 120/min with 45° of leg raise, compared to standard CPR. However, such effects start to wane with further leg lifts, indicating the existence of an optimal angle of leg raise for each person to achieve the best hemodynamic responses. We developed a CPR-PLR model and demonstrated the effects of PLR on hemodynamics by investigating changes in CO, SPP, and CPP under different compression rates and angles of leg raising. Our computational model will facilitate study of PLR effects during CPR and the development of an advanced model combined with circulatory disorders, which will be a valuable asset for further studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Pharmacokinetical and clinical study of cefpirome in children].

PubMed

Kida, K; Morimoto, T; Matsuda, H; Murase, M

1991-02-01

This study describes the pharmacokinetic characteristics and clinical usefulness of cefpirome (CPR) in children. Mean half-lives of 20 mg/kg and 40 mg/kg of CPR injected intravenously in one shot were 1.18 and 1.34 hours, respectively, and their mean recovery rates into urine were 69.8 and 72.2%, respectively. Minimum inhibitory concentrations of CPR against Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli and Haemophilus influenzae were the same as or lower than those of ceftazidime. CPR was clinically effective in 14/15 of patients with bacterial infections; 8/9 of pneumonia, 2/2 of bronchitis, 1/1 of pharyngitis, 1/1 of tonsillitis, 1/1 of osteomyelitis, 1/1 of urinary tract infection. No clinically overt side effects of CPR were found, while an increase of eosinophils in blood was observed in 2 cases, and an increase of platelet in blood in 1 case and an elevation of serum GPT activity in 1 case were also observed. These findings indicate that CPR is useful for the treatment of bacterial infections in children.

Eighth grade students become proficient at CPR and use of an AED following a condensed training programme.

PubMed

Kelley, James; Richman, Peter B; Ewy, Gordon A; Clark, Lani; Bulloch, Blake; Bobrow, Bentley J

2006-11-01

To evaluate a new, 1-h, condensed training programme to teach continuous chest compression cardiopulmonary resuscitation (CCC-CPR) and automated external defibrillator (AED) skills to a cohort of eight grade public school students. Thirty-three eligible subjects completed the programme; mean age 13.7 years; 48.5% female. Eight participants reported some prior training in CPR and AED use. Following initial training, 29/33 (87.8%) subjects demonstrated proficiency at CCC-CPR and AED application/operation in a mock adult cardiac arrest scenario. At four-weeks, 28/33 (84.8%) subjects demonstrated skill retention in similar scenario testing. Subjects also showed improvement in written knowledge regarding AED use as shown by scores on an AHA based written exam (60.9% versus 77.3%; p<0.001). With our focused, condensed training program, eighth grade public school students became proficient in CCC-CPR and AED use. This is the first study to document the ability of middle school students to learn and retain CCC-CPR and AED skills for adult sudden cardiac arrest victims with such a curriculum.

Reduction of radar cross-section of a wind turbine

DOEpatents

McDonald, Jacob Jeremiah; Brock, Billy C.; Clem, Paul G.; Loui, Hung; Allen, Steven E.

2016-08-02

The various technologies presented herein relate to formation of a wind turbine blade having a reduced radar signature in comparison with a turbine blade fabricated using conventional techniques. Various techniques and materials are presented to facilitate reduction in radar signature of a wind turbine blade, where such techniques and materials are amenable for incorporation into existing manufacturing techniques without degradation in mechanical or physical performance of the blade or major alteration of the blade profile.

Bi-Spectral Method for Radar Target Recognition

DTIC Science & Technology

2006-12-01

θazimuth=60° and ϕelevation=30° with HV Polarization....................................53 Figure 50 Comparison of Radar Range Profile with Actual...radar systems. A comparison of the NCTR techniques and their relative advantages and disadvantages in target recognition performance is presented. 8...32 f fR i R R c c f fi R R i R R c c A e A e A e ψ ψ π ψ ψ π ψ ψ π ψ ψ

Soil Moisture Project Evaluation Workshop

NASA Technical Reports Server (NTRS)

Gilbert, R. H. (Editor)

1980-01-01

Approaches planned or being developed for measuring and modeling soil moisture parameters are discussed. Topics cover analysis of spatial variability of soil moisture as a function of terrain; the value of soil moisture information in developing stream flow data; energy/scene interactions; applications of satellite data; verifying soil water budget models; soil water profile/soil temperature profile models; soil moisture sensitivity analysis; combinations of the thermal model and microwave; determing planetary roughness and field roughness; how crust or a soil layer effects microwave return; truck radar; and truck/aircraft radar comparison.

[An experimental study on the effects of rhythmic abdominal lifting and compression during cardiopulmonary resuscitation in a swine model of asphyxia].

PubMed

Li, Xiu-man; Wang, Li-xiang; Liu, Ya-hua; Sun, Kun; Ma, Li-zhi; Guo, Xiao-dong; Li, Hui-qing

2012-04-01

To compare the hemodynamic and respiratory influences of chest compression- cardiopulmonary resuscitation (CC-CPR) and rhythmic abdominal lifting and compression-cardiopulmonary resuscitation (ALC-CPR) in a swine model of asphyxia cardiac arrest (CA), and evaluate the effectiveness of rhythmic abdominal lifting and compression. Thirty swines were randomly divided into two groups, with 15 swines in each group. CA model was reproduced by asphyxia as a result of clamping the trachea, and CC-CPR and ALC-CPR was conducted in two groups, respectively. Electrocardiogram (ECG), pulse oxygen saturation [SpO(2)], end-tidal partial pressure of carbon dioxide [P(ET)CO(2)], aorta systolic blood pressure (SBP), diastolic blood pressure (DBP), central venous pressure (CVP), and tidal volume (VT) were monitored continuously from 10 minutes before asphyxia to the end of experiment. The aorta mean arterial pressure (MAP), coronary perfusion pressure (CPP) and minute ventilation (MV) were calculated. Artery blood samples were collected to determine the blood gas analysis at 10 minutes before asphyxia, 10 minutes after asphyxia, and 5, 10, 20 minutes after resuscitation. The restoration of spontaneous circulation (ROSC) rate, 24-hour survival rate and 24-hour neurological function score were observed. There were no significant differences in all mentioned indexes between two groups at 10 minutes before and 10 minutes after asphyxia. At 2 minutes after the resuscitation, the MAP (mm Hg, 1 mm Hg = 0.133 kPa) and CPP (mm Hg) in CC-CPR group were significantly higher than those in ALC-CPR group (MAP: 43.60 ± 12.91 vs. 33.40 ± 6.59, P < 0.05; CPP: 21.67 ± 11.28 vs. 11.80 ± 4.16, P < 0.01), the VT (ml) and MV (L/min)in ALC-CPR group were significantly higher than those in CC-CPR group (VT: 111.67 ± 18.12 vs. 56.60 ± 7.76; MV: 11.17 ± 1.81 vs. 5.54 ± 0.79, both P < 0.01). At 5, 10, 20 minutes after resuscitation, in ALC-CPR group, pH value, arterial partial pressure of oxygen [PaO(2), mm Hg] and arterial oxygen saturation [SaO(2)] were increased, and HCO(3)(-) (mmol/L) and base excess (BE, mmol/L) were decreased, which significantly higher than those in CC-CPR group [pH at 20 minutes after resuscitation: 7.16 ± 0.16 vs. 7.01 ± 0.14; PaO(2): 82.73 ± 13.20 vs. 58.33 ± 17.77; HCO(3)(-): 27.71 ± 3.11 vs. 21.04 ± 3.62; BE: -4.78 ± 4.30 vs. -10.23 ± 2.12; SaO(2): 0.893 ± 0.088 vs. 0.764 ± 0.122], and arterial partial pressure of carbon dioxide [PaCO(2), mm Hg], K(+) (mmol/L) and lactic acid (Lac,mmol/L) were significantly lower than those in CC-CPR group [PaCO(2) at 20 minutes after resuscitation: 49.40 ± 15.60 vs. 79.80 ± 15.35; K(+): 7.18 ± 1.76 vs. 8.55 ± 1.02; Lac: 8.17 ± 1.46 vs. 10.39 ± 1.92], with statistical significant (P < 0.05 or P < 0.01). But the ROSC rate and 24-hour survival rate in ALC-CPR group were significantly higher than those in CC-CPR group (ROSC rate: 80.0% vs. 26.7%, P < 0.01; 24-hour survival rate: 60.0% vs. 13.3%, P < 0.05), and the 24-hour neurological function score was significantly lower than that in CC-CPR group (1.11 ± 0.33 vs. 3.50 ± 0.70, P < 0.01). In the incipient stage of cardiopulmonary resuscitation of the swine CA model of asphyxia, compared with CC-CPR, ALC-CPR can be more effective.

A simple biota removal algorithm for 35 GHz cloud radar measurements

NASA Astrophysics Data System (ADS)

Kalapureddy, Madhu Chandra R.; Sukanya, Patra; Das, Subrata K.; Deshpande, Sachin M.; Pandithurai, Govindan; Pazamany, Andrew L.; Ambuj K., Jha; Chakravarty, Kaustav; Kalekar, Prasad; Krishna Devisetty, Hari; Annam, Sreenivas

2018-03-01

Cloud radar reflectivity profiles can be an important measurement for the investigation of cloud vertical structure (CVS). However, extracting intended meteorological cloud content from the measurement often demands an effective technique or algorithm that can reduce error and observational uncertainties in the recorded data. In this work, a technique is proposed to identify and separate cloud and non-hydrometeor echoes using the radar Doppler spectral moments profile measurements. The point and volume target-based theoretical radar sensitivity curves are used for removing the receiver noise floor and identified radar echoes are scrutinized according to the signal decorrelation period. Here, it is hypothesized that cloud echoes are observed to be temporally more coherent and homogenous and have a longer correlation period than biota. That can be checked statistically using ˜ 4 s sliding mean and standard deviation value of reflectivity profiles. The above step helps in screen out clouds critically by filtering out the biota. The final important step strives for the retrieval of cloud height. The proposed algorithm potentially identifies cloud height solely through the systematic characterization of Z variability using the local atmospheric vertical structure knowledge besides to the theoretical, statistical and echo tracing tools. Thus, characterization of high-resolution cloud radar reflectivity profile measurements has been done with the theoretical echo sensitivity curves and observed echo statistics for the true cloud height tracking (TEST). TEST showed superior performance in screening out clouds and filtering out isolated insects. TEST constrained with polarimetric measurements was found to be more promising under high-density biota whereas TEST combined with linear depolarization ratio and spectral width perform potentially to filter out biota within the highly turbulent shallow cumulus clouds in the convective boundary layer (CBL). This TEST technique is promisingly simple in realization but powerful in performance due to the flexibility in constraining, identifying and filtering out the biota and screening out the true cloud content, especially the CBL clouds. Therefore, the TEST algorithm is superior for screening out the low-level clouds that are strongly linked to the rainmaking mechanism associated with the Indian Summer Monsoon region's CVS.

Impact of cardiopulmonary resuscitation duration on neurologically favourable outcome after out-of-hospital cardiac arrest: A population-based study in Japan.

PubMed

Matsuyama, Tasuku; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Nishiyama, Chika; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Kawamura, Takashi; Ohta, Bon; Iwami, Taku

2017-04-01

The optimal cardiopulmonary resuscitation (CPR) duration for patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to assess the association between CPR duration and outcome after OHCA. This prospective, population-based observational study conducted in Osaka, Japan enrolled 6981 adult patients with non-traumatic witnessed OHCA who achieved return of spontaneous circulation (ROSC) from January 2005 through December 2012. CPR duration was defined as the time of CPR initiation by emergency medical service personnel to the ROSC in pre-hospital settings or after hospital admission. The primary outcome was one-month survival with neurologically favourable outcome (cerebral performance category scale 1 or 2). Overall, median CPR duration was 25min (interquartile range: 15-34) and the proportion of neurologically favourable outcome was 12.5% (875/6,981). The proportion of neurologically favourable outcome among the CPR duration ≥31min group was significantly lower compared with that among the 0-5min group (55.1% [320/581] versus 2.2% [54/2424], adjusted odds ratio [AOR] 0.04; 95% confidence interval [CI] 0.03-0.05 in all patients, 78.4% [240/306] versus 11.4% [30/264], AOR 0.04; 95% CI 0.02-0.06 in the shockable group, 29.1% [80/275] versus 1.1% [24/2160], and AOR 0.03; 95% CI 0.02-0.05 in the non-shockable group). The cumulative proportion for neurologically favourable outcome reached 99% after 44, 41, and 43min of CPR in all patients, the shockable group, and the non-shockable group, respectively. The proportion of patients with neurologically favourable outcome declined with increasing CPR duration, but some OHCA patients could benefit from prolonged CPR duration >30min. Copyright © 2017 Elsevier B.V. All rights reserved.

Senior citizens as rescuers: Is reduced knowledge the reason for omitted lay-resuscitation-attempts? Results from a representative survey with 2004 interviews.

PubMed

Brinkrolf, Peter; Bohn, Andreas; Lukas, Roman-Patrik; Heyse, Marko; Dierschke, Thomas; Van Aken, Hugo Karel; Hahnenkamp, Klaus

2017-01-01

Resuscitation (CPR) provided by a bystander prior to the arrival of the emergency services is a beneficial factor for surviving a cardiac arrest (CA). Our registry-based data show, that older patients receive bystander-CPR less frequently. Little is known on possible reasons for this finding. We sought to investigate the hypothesis that awareness of CPR measures is lower in older laypersons being a possible reason for less CPR-attempts in senior citizens. 1206 datasets on bystander resuscitations actually carried out were analyzed for age-dependent differences. Subsequently, we investigated whether the knowledge required carrying out bystander-CPR and the self-confidence to do so differ between younger and older citizens using computer-assisted telephone interviewing. 2004 interviews were performed and statistically analyzed. A lower level of knowledge to carry out bystander-CPR was seen in older individuals. For example, 82.4% of interviewees under 65 years of age, knew the correct emergency number. In this group, 66.6% named CPR as the relevant procedure in CA. Among older individuals these responses were only given by 75.1% and 49.5% (V = 0.082; P < 0.001 and V = 0.0157; P < 0.001). Additionally, a difference concerning participants' confidence in their own abilities was detectable. 58.0% of the persons younger than 65 years were confident that they would detect a CA in comparison to 44.6% of the participants older than 65 years (V = 0.120; P < 0.001). Similarly, 62.7% of the interviewees younger than 65 were certain to know what to do during CPR compared to 51.3% of the other group (V = 0.103; P < 0.001). Lower levels of older bystanders' knowledge and self-confidence might provide an explanation for why older patients receive bystander-CPR less frequently. Further investigation is necessary to identify causal connections and optimum ways to empower bystander resuscitation.

Family presence during cardiopulmonary resuscitation.

PubMed

Jabre, Patricia; Belpomme, Vanessa; Azoulay, Elie; Jacob, Line; Bertrand, Lionel; Lapostolle, Frederic; Tazarourte, Karim; Bouilleau, Guillem; Pinaud, Virginie; Broche, Claire; Normand, Domitille; Baubet, Thierry; Ricard-Hibon, Agnes; Istria, Jacques; Beltramini, Alexandra; Alheritiere, Armelle; Assez, Nathalie; Nace, Lionel; Vivien, Benoit; Turi, Laurent; Launay, Stephane; Desmaizieres, Michel; Borron, Stephen W; Vicaut, Eric; Adnet, Frederic

2013-03-14

The effect of family presence during cardiopulmonary resuscitation (CPR) on the family members themselves and the medical team remains controversial. We enrolled 570 relatives of patients who were in cardiac arrest and were given CPR by 15 prehospital emergency medical service units. The units were randomly assigned either to systematically offer the family member the opportunity to observe CPR (intervention group) or to follow standard practice regarding family presence (control group). The primary end point was the proportion of relatives with post-traumatic stress disorder (PTSD)-related symptoms on day 90. Secondary end points included the presence of anxiety and depression symptoms and the effect of family presence on medical efforts at resuscitation, the well-being of the health care team, and the occurrence of medicolegal claims. In the intervention group, 211 of 266 relatives (79%) witnessed CPR, as compared with 131 of 304 relatives (43%) in the control group. In the intention-to-treat analysis, the frequency of PTSD-related symptoms was significantly higher in the control group than in the intervention group (adjusted odds ratio, 1.7; 95% confidence interval [CI], 1.2 to 2.5; P=0.004) and among family members who did not witness CPR than among those who did (adjusted odds ratio, 1.6; 95% CI, 1.1 to 2.5; P=0.02). Relatives who did not witness CPR had symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medicolegal claims. Family presence during CPR was associated with positive results on psychological variables and did not interfere with medical efforts, increase stress in the health care team, or result in medicolegal conflicts. (Funded by Programme Hospitalier de Recherche Clinique 2008 of the French Ministry of Health; ClinicalTrials.gov number, NCT01009606.).

Senior citizens as rescuers: Is reduced knowledge the reason for omitted lay-resuscitation-attempts? Results from a representative survey with 2004 interviews

PubMed Central

Lukas, Roman-Patrik; Heyse, Marko; Dierschke, Thomas; Van Aken, Hugo Karel; Hahnenkamp, Klaus

2017-01-01

Objective Resuscitation (CPR) provided by a bystander prior to the arrival of the emergency services is a beneficial factor for surviving a cardiac arrest (CA). Our registry-based data show, that older patients receive bystander-CPR less frequently. Little is known on possible reasons for this finding. We sought to investigate the hypothesis that awareness of CPR measures is lower in older laypersons being a possible reason for less CPR-attempts in senior citizens. Methods 1206 datasets on bystander resuscitations actually carried out were analyzed for age-dependent differences. Subsequently, we investigated whether the knowledge required carrying out bystander-CPR and the self-confidence to do so differ between younger and older citizens using computer-assisted telephone interviewing. 2004 interviews were performed and statistically analyzed. Results A lower level of knowledge to carry out bystander-CPR was seen in older individuals. For example, 82.4% of interviewees under 65 years of age, knew the correct emergency number. In this group, 66.6% named CPR as the relevant procedure in CA. Among older individuals these responses were only given by 75.1% and 49.5% (V = 0.082; P < 0.001 and V = 0.0157; P < 0.001). Additionally, a difference concerning participants’ confidence in their own abilities was detectable. 58.0% of the persons younger than 65 years were confident that they would detect a CA in comparison to 44.6% of the participants older than 65 years (V = 0.120; P < 0.001). Similarly, 62.7% of the interviewees younger than 65 were certain to know what to do during CPR compared to 51.3% of the other group (V = 0.103; P < 0.001). Conclusions Lower levels of older bystanders' knowledge and self-confidence might provide an explanation for why older patients receive bystander-CPR less frequently. Further investigation is necessary to identify causal connections and optimum ways to empower bystander resuscitation. PMID:28604793

Feasibility of absolute cerebral tissue oxygen saturation during cardiopulmonary resuscitation.

PubMed

Meex, Ingrid; De Deyne, Cathy; Dens, Jo; Scheyltjens, Simon; Lathouwers, Kevin; Boer, Willem; Vundelinckx, Guy; Heylen, René; Jans, Frank

2013-03-01

Current monitoring during cardiopulmonary resuscitation (CPR) is limited to clinical observation of consciousness, breathing pattern and presence of a pulse. At the same time, the adequacy of cerebral oxygenation during CPR is critical for neurological outcome and thus survival. Cerebral oximetry, based on near-infrared spectroscopy (NIRS), provides a measure of brain oxygen saturation. Therefore, we examined the feasibility of using NIRS during CPR. Recent technologies (FORE-SIGHT™ and EQUANOX™) enable the monitoring of absolute cerebral tissue oxygen saturation (SctO2) values without the need for pre-calibration. We tested both FORE-SIGHT™ (five patients) and EQUANOX Advance™ (nine patients) technologies in the in-hospital as well as the out-of-hospital CPR setting. In this observational study, values were not utilized in any treatment protocol or therapeutic decision. An independent t-test was used for statistical analysis. Our data demonstrate the feasibility of both technologies to measure cerebral oxygen saturation during CPR. With the continuous, pulseless near-infrared wave analysis of both FORE-SIGHT™ and EQUANOX™ technology, we obtained SctO2 values in the absence of spontaneous circulation. Both technologies were able to assess the efficacy of CPR efforts: improved resuscitation efforts (improved quality of chest compressions with switch of caregivers) resulted in higher SctO2 values. Until now, the ability of CPR to provide adequate tissue oxygenation was difficult to quantify or to assess clinically due to a lack of specific technology. With both technologies, any change in hemodynamics (for example, ventricular fibrillation) results in a reciprocal change in SctO2. In some patients, a sudden drop in SctO2 was the first warning sign of reoccurring ventricular fibrillation. Both the FORE-SIGHT™ and EQUANOX™ technology allow non-invasive monitoring of the cerebral oxygen saturation during CPR. Moreover, changes in SctO2 values might be used to monitor the efficacy of CPR efforts.

Evaluation of a cardiopulmonary resuscitation course for secondary schools retention study.

PubMed

Vanderschmidt, H; Burnap, T K; Thwaites, J K

1976-02-01

A retention study was implemented in Marshfield, Massachusetts in May 1974 in order to ascertain if cardiopulmonary resuscitation (CPR) skills could be retained by secondary school students who had 15 months previously received training in mouth to mouth resuscitation and cardiac compression. The retention study also addressed itself to the question whether a 28-minute "refresher" film on CPR skills prior to the test would serve to improve performance of CPR skills. (In the initial study, the students had been divided into two groups: those that received both didactic and practice sessions and those who received didactic training only.) All the initial practice group students (178 students who had received both didactic and practical CPR training) were divided equally into "film" and "no film" groups. A small sample of students (38) who had initially learned CPR skills from didactic materials only were also tested. These students were also divided into "film" and "no film" groups. Retention of continuous CPR skills, breaths anc compressions, showed very little loss. Retention of discrete CPR skills which included checking for breathing, opening the airway by tilting the head and lifting the neck, giving three quick breaths, feeling the pulse, and examining the pupil showed considerable loss of learning overtime. The film intervention did little to improve performance of CPR skills. No significant differences in performance were observed between "film" and "no film" groups. The findings of this study with respect to retention of continuous and discrete psychomotor sills closely parallel findings of the three-month retention study. In summary, this study would indicate that training of secondary students in CPR leads to good retention of essential skills. As indicated in the previous study, retention of the ancillary decision-making skills was not satisfactory. Methods for teaching these skills so that they will be retained over time need further development.

Probabilistic discrimination between liquid rainfall events, hailstorms, biomass burning and industrial fires from C-Band Radar Polarimetric Variables

NASA Astrophysics Data System (ADS)

Valencia, J. M.; Sepúlveda, J.; Hoyos, C.; Herrera, L.

2017-12-01

Characterization and identification of fire and hailstorm events using weather radar data in a tropical complex topography region is an important task in risk management and agriculture. Polarimetric variables from a C-Band Dual polarization weather radar have potential uses in particle classification, due to the relationship their sensitivity to shape, spatial orientation, size and fall behavior of particles. In this sense, three forest fires and two chemical fires were identified for the Áburra Valley regions. Measurements were compared between each fire event type and with typical data radar retrievals for liquid precipitation events. Results of this analysis show different probability density functions for each type of event according to the particles present in them. This is very important and useful result for early warning systems to avoid precipitation false alarms during fire events within the study region, as well as for the early detection of fires using radar retrievals in remote cases. The comparative methodology is extended to hailstorm cases. Complementary sensors like laser precipitation sensors (LPM) disdrometers and meteorological stations were used to select dates of solid precipitation occurrence. Then, in this dates weather radar data variables were taken in pixels surrounding the stations and solid precipitation polar values were statistically compared with liquid precipitation values. Spectrum precipitation measured by LPM disdrometer helps to define typical features like particles number, fall velocities and diameters for both precipitation types. In addition, to achieve a complete hailstorm characterization, other meteorological variables were analyzed: wind field from meteorological stations and radar wind profiler, profiling data from Micro Rain Radar (MRR), and thermodynamic data from a microwave radiometer.

Awareness and knowledge of pediatric cardio- pulmonary resuscitation in the community of Al-Khobar city.

PubMed

Al-Turkistani, Hatim K

2014-05-01

The history of resuscitation going back thousands of years has been reported in literature throughout history. This concept has undergone several decisive revolutionary changes particularly in pediatrics. Although the cardio-pulmonary resuscitation (CPR) is relatively new in pediatrics, progress has been remarkable in the last a few decades. As it becomes more popular, especially under the influence of globalizing media, CPR also becomes a life requirement that is not restricted to health professionals. This was a cross-sectional community-based survey of 753 individuals of both sexes, visiting the first Pediatric Health Awareness Week held at Dammam University Hospital in April 2013. Data were collected by a personal face-to-face interview during which a short history was taken and a check list of sociodemographic data and questions related to infants' CPR was completed. Statistical analysis was performed by using SPSS. The study was carried out on 753 subjects (602 Saudis, 151 non-Saudis, 483 females, and 270 males). The mean age of participants was 33.3 ± 10.9 years. The postsecondary school level of education was 37.5% among females versus 21.9% among males. Of the participants, 80.8% of the females and 86.5% of males were totally unaware of CPR. The mean number of children among participants was 3.5 ± 2.5 children. There were 150 participants (19.9%) with disabled children; 32% of them (6.4% of all participants) were completely unaware of CPR despite having disabled children. Overall, 15.5% of all female participants had attended some CPR course (s) compared with 6.1% of the males; 18.7% of the females had watched CPR program (s)/video (s) on TV or online compared to 11.1% of the males, and 59.4% of the females were willing and eager to participate in any CPR course compared with 29.3% of the males. The reasons for not wanting to attend CPR courses were as follows: 48.6% indicated that it was because of the unavailability of such courses, 41.4% said because of time constraints, and 10% gave financial reasons. Finally, the study showed that 365 females (84.3%) and 247 males (91.2%) did not know when to perform mouth-to-mouth resuscitation and/or chest compression, and would do it for the wrong reasons. Public awareness and knowledge on CPR was inadequate even among the younger population, and among parents with disabled children. The general public were willing to improve their knowledge and skills of CPR. We recommend that CPR courses/campaigns should be provided to the public and be included in high school curricula.

Preliminary VHF radar and high-data-rate optical turbulence profile observations using a balloon-ring platform

NASA Astrophysics Data System (ADS)

Eaton, Frank D.; Nastrom, Gregory D.; Kyrazis, Demos T.; Black, Don G.; Black, Wiley T.; Black, R. Alastair

2009-08-01

A recent measurement campaign at Vandenberg Air Force Base, Calif. involved taking simultaneous observations with a VHF radar and high-data-rate (1-micron diameter) platinum wires to sense optical turbulence (from temperature fluctuations). The radar observations produce profiles of the refractive index structure parameter (C2n ), the turbulent kinetic energy (σ2t ), the eddy dissipation rate (ɛ), the inner scale (lo ), the outer scale (Lo ) of turbulence, and wind speed and direction to an altitude of 20 km AGL. The fine wire measurements were taken from the surface with several sensors mounted on a balloon-ring platform sampling in excess of 3 kHz to balloon burst altitudes (typically above 25 km AGL). The main objectives of this effort are to compare the two measurement techniques and to obtain observations that can address several fundamental turbulence issues of the real turbulent atmosphere related to laser beam propagation. To date, modeling and simulation of laser beam propagation through atmospheric turbulence have relied upon a traditional theoretical basis that assumes the existence of homogeneous, isotropic, stationary, and Kolmogorov turbulence. Results presented from the radar observations include C2n, σ2t, ɛ, lo, and the standard deviation of vertical velocity (σw). A comparison of the profiles of C2n obtained from the two measurement techniques is shown and discussed. A time series of temperature data obtained from a fine wire probe traversing one radar range gate is presented and discussed. Future measurement and analysis efforts are presented.

Return of consciousness during ongoing cardiopulmonary resuscitation: A systematic review.

PubMed

Olaussen, Alexander; Shepherd, Matthew; Nehme, Ziad; Smith, Karen; Bernard, Stephen; Mitra, Biswadev

2015-01-01

Cardio-pulmonary resuscitation (CPR) may generate sufficient cerebral perfusion pressure to make the patient conscious. The incidence and management of this phenomenon are not well described. This systematic review aims to identifying cases where CPR-induced consciousness is mentioned in the literature and explore its management options. The databases Medline, PubMed, EMBASE, Cinahl and the Cochrane Library were searched from their commencement to the 8th July 2014. We also searched Google (scholar) for grey literature. We combined MeSH terms and text words for consciousness and CPR, and included studies of all types. The search yielded 1997 unique records, of which 50 abstracts were reviewed. Nine reports, describing 10 patients, were relevant. Six of the patients had CPR performed by mechanical devices, three of these patients were sedated. Four patients arrested in the out-of-hospital setting and six arrested in hospital. There were four survivors. Varying levels of consciousness were described in all reports, including purposeful arm movements, verbal communication, and resuscitation interference. Management strategies directed at consciousness were offered to six patients and included both physical and chemical restraints. CPR-induced consciousness was infrequently reported in the medical literature, and varied in management. Given the increasing use of mechanical CPR, guidelines to identify and manage consciousness during CPR are required. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Utility of a simple lighting device to improve chest compressions learning.

PubMed

González-Calvete, L; Barcala-Furelos, R; Moure-González, J D; Abelairas-Gómez, C; Rodríguez-Núñez, A

2017-11-01

The recommendations on cardiopulmonary resuscitation (CPR) emphasize the quality of the manoeuvres, especially chest compressions (CC). Audiovisual feedback devices could improve the quality of the CC during CPR. The aim of this study was to evaluate the usefulness of a simple lighting device as a visual aid during CPR on a mannequin. Twenty-two paediatricians who attended an accredited paediatric CPR course performed, in random order, 2min of CPR on a mannequin without and with the help of a simple lighting device, which flashes at a frequency of 100 cycles per minute. The following CC variables were analyzed using a validated compression quality meter (CPRmeter ® ): depth, decompression, rate, CPR time and percentage of compressions. With the lighting device, participants increased average quality (60.23±54.50 vs. 79.24±9.80%; P=.005), percentage in target depth (48.86±42.67 vs. 72.95±20.25%; P=.036) and rate (35.82±37.54 vs. 67.09±31.95%; P=.024). A simple light device that flashes at the recommended frequency improves the quality of CC performed by paediatric residents on a mannequin. The usefulness of this CPR aid system should be assessed in real patients. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

High dose naloxone does not improve cerebral or myocardial blood flow during cardiopulmonary resuscitation in pigs.

PubMed

Gervais, H W; Eberle, B; Hennes, H J; Grimm, W; Kilian, A; Konietzke, D; Massing, C; Dick, W

1997-06-01

In a prospective, randomized, placebo-controlled, double-blind trial we tested the hypothesis that naloxone given during cardiopulmonary resuscitation (CPR) enhances cerebral and myocardial blood flow. Twenty-one anesthetized, normoventilated pigs were instrumented for measurements of right atrial and aortic pressures, and regional organ blood flow (radiolabeled microspheres). After 5 min of untreated fibrillatory arrest, CPR was commenced using a pneumatic chest compressor/ventilator. With onset of CPR, an i.v. bolus of 40 micrograms/kg b.w. of epinephrine was given, followed by an infusion of 0.4 micrograms/kg per min. After 5 min of CPR, either naloxone, 10 mg/kg b.w. (group N, n = 11) or normal saline (group S, n = 10) was given i.v. Prior to, and after 1, 15, and 30 min of CPR, hemodynamic and blood flow measurements were obtained. After 30 min of CPR, mean arterial pressure was significantly higher in group N (26 +/- 5 vs. 13 +/- 3 mmHg, P < 0.05). Groups did not differ with respect to myocardial perfusion pressure or arterial blood gases at any time during the observation period. Regional brain and heart blood flows were not different between N and S at any point of measurement. We conclude that high-dose naloxone does not augment cerebral or myocardial blood flow during prolonged closed-chest CPR.

Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray.

PubMed

Lederer, Wolfgang; Mair, Dieter; Rabl, Walter; Baubin, Michael

2004-02-01

Fractured ribs and sternum are frequent complications of thoracic compression during CPR in adults. This study was conducted to determine whether findings of plain chest radiography (CXR) correlate with post-mortem findings in patients who underwent cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest. CXR findings and autopsy results of CPR-related chest injuries comprising rib and sternum fractures were compared prospectively in 19 patients. Fractures were diagnosed in nine of 19 patients by means of radiology and in 18 of 19 patients by autopsy (rib fractures in 6/19 versus 17/19, P=0.002; sternum fractures in 5/19 versus in 9/19, P=0.227. The total number of isolated bone fractures detected by CXR was 18 (12 rib and six sternum fractures) and by autopsy 92 (83 rib and nine sternum fractures). The majority of rib fractures was located in the anterior part of the thoracic cage. Sternum fractures predominantly occurred in the lower third. Eight of 19 patients received either thrombolytic or antithrombotic treatment during CPR but no major bleeding complication associated with CPR was detected by autopsy. The findings of this study indicate that fractures associated with CPR are underreported in conventional radiographic investigations. No major bleeding complications related to CPR-associated fractures was detected.

How well does the Continuous Plankton Recorder (CPR) sample zooplankton? A comparison with the Longhurst Hardy Plankton Recorder (LHPR) in the northeast Atlantic

NASA Astrophysics Data System (ADS)

Richardson, Anthony J.; John, Eurgain H.; Irigoien, Xabier; Harris, Roger P.; Hays, Graeme C.

2004-09-01

The Continuous Plankton Recorder (CPR) survey has collected data on basin-scale zooplankton abundance in the North Atlantic since the 1930s. These data have been used in many studies to elucidate seasonal patterns and long-term change in plankton populations, as well as more recently to validate ecosystem models. There has, however, been relatively little comparison of the data from the CPR with that from other samplers. In this study we compare zooplankton abundance estimated from the CPR in the northeast Atlantic with near-surface samples collected by a Longhurst-Hardy Plankton Recorder (LHPR) at Ocean Weather Station India (59°N, 19°W) between 1971 and 1975. Comparisons were made for six common copepods in the region: Acartia clausi, Calanus finmarchicus, Euchaeta norvegica, Metridia lucens, Oithona sp., and Pleuromamma robusta. Seasonal cycles based on CPR data were similar to those recorded by the LHPR. Differences in absolute abundances were apparent, however, with the CPR underestimating abundances by a factor of between 5 and 40, with the exception of A. clausi. Active avoidance by zooplankton is thought to be responsible. This avoidance is species specific, so that care must be taken describing communities, as the CPR emphasises those species that are preferentially caught, a problem common to many plankton samplers.

Education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council CPR/AED course.

PubMed

Papalexopoulou, Konstantina; Chalkias, Athanasios; Dontas, Ioannis; Pliatsika, Paraskevi; Giannakakos, Charalampos; Papapanagiotou, Panagiotis; Aggelina, Afroditi; Moumouris, Theodoros; Papadopoulos, Georgios; Xanthos, Theodoros

2014-01-01

To examine whether education and age affect skill acquisition and retention in lay rescuers after a European Resuscitation Council (ERC) CPR/AED course. Because of the importance of bystander CPR/AED skills in the setting of cardiac arrest, acquisition and retention of resuscitation skills has gained a great amount of interest. The ERC CPR/AED course format for written and practical evaluation was used. Eighty lay people were trained and evaluated at the end of the course, as well as at one, three, and six months. Retention of CPR/AED skills improved over time, recording the lowest practical scores at one month after initial training and the lowest written scores at initial training. In practical evaluation scores, when examined longitudinally, age presented a significant adverse effect and higher background education presented a non-significant positive effect. Moreover, regarding written evaluation scores, when examined longitudinally, education presented a significant positive effect while age did not significantly correlate with written scores. Education and age affected retention of CPR/AED skills in lay rescuers. Also, our results suggest that the ERC CPR/AED course format may be poorly designed to discriminate between participants with different levels of practical and written resuscitation skills and merit a thorough investigation in future studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Determination of rain rate from a spaceborne radar using measurements of total attenuation

NASA Technical Reports Server (NTRS)

Meneghini, R.; Eckerman, J.; Atlas, D.

1981-01-01

Studies shows that path-integrated rain rates can be determined by means of a direct measurement of attenuation. For ground based radars this is done by measuring the backscattering cross section of a fixed target in the presence and absence of rain along the radar beam. A ratio of the two measurements yields a factor proportional to the attenuation from which the average rain rate is deduced. The technique is extended to spaceborne radars by choosing the ground as reference target. The technique is also generalized so that both the average and range-profiled rain rates are determined. The accuracies of the resulting estimates are evaluated for a narrow beam radar located on a low earth orbiting satellite.

Performance and Norms of Time for Adult Learners Instructed in CPR by an Interactive Videodisc System.

ERIC Educational Resources Information Center

Lyness, Ann L.

A computer system using interactive videodisc was developed and used by the American Heart Association to teach nursing students and others cardiopulmonary resuscitation (CPR). Two studies were made of the use of the system. Between September 1982 and April 1983, 48 participants received CPR instruction by interactive videodisc and 51 by…

Application of Calibrated Peer Review (CPR) Writing Assignments to Enhance Experiments with an Environmental Chemistry Focus

ERIC Educational Resources Information Center

Margerum, Lawrence D.; Gulsrud, Maren; Manlapez, Ronald; Rebong, Rachelle; Love, Austin

2007-01-01

The browser-based software program, Calibrated Peer Review (CPR) developed by the Molecular Science Project enables instructors to create structured writing assignments in which students learn by writing and reading for content. Though the CPR project covers only one experiment in general chemistry, it might provide lab instructors with a method…

Guidelines for CPR Training in Louisiana Schools. Bulletin No. 1638.

ERIC Educational Resources Information Center

Louisiana State Dept. of Education, Baton Rouge.

Completion of a course in cardiopulmonary resuscitation (CPR) is required for graduation from high school in Louisiana. This bulletin presents the guidelines for a course in CPR and was prepared with the cooperation of the American Red Cross (ARC) and the American Heart Association (AHA). At the conclusion of the course, students will be prepared…

An Analysis of Calibrated Peer Review (CPR) in a Science Lecture Classroom

ERIC Educational Resources Information Center

Walvoord, Mark E.; Hoefnagels, Marielle H.; Gaffin, Douglas D.; Chumchal, Matthew M.; Long, David A.

2008-01-01

Calibrated Peer Review (CPR) is an online tool being used to integrate a writing component in classrooms. In an introductory zoology lecture class, the authors found that CPR-assigned scores were significantly higher than instructor-assigned scores on two of three essay assignments. They also found that neither students' technical-writing skills…

Functions of standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival.

PubMed

Fanshan, Meng; Lin, Zhao; Wenqing, Liu; Chunlei, Lu; Yongqiang, Liu; Naiyi, Li

2013-01-01

Cardiopulmonary resuscitation (CPR) is a sudden emergency procedure that requires a rapid and efficient response, and personnel training in lifesaving procedures. Regular practice and training are necessary to improve resuscitation skills and reduce anxiety among the staff. As one of the most important skills mastered by medical volunteers serving for Mt. Taishan International Mounting Festival, we randomly selected some of them to evaluate the quality of CPR operation and compared the result with that of the untrained doctors and nurses. In order to evaluate the functions of repeating standard CPR training on performance qualities of medical volunteers for Mt. Taishan International Mounting Festival, their performance qualities of CPR were compared with those of the untrained medical workers working in emergency departments of hospitals in Taian. The CPR performance qualities of 52 medical volunteers (Standard Training Group), who had continually taken part in standard CPR technical training for six months, were tested at random and were compared with those of 68 medical workers (Compared Group) working in emergency departments of hospitals in Taian who hadn't attended CPR training within a year. The QCPR 3535 monitor (provided by Philips Company) was used to measure the standard degree of single simulated CPR performance, including the chest compression depth, frequency, released pressure between compressions and performance time of compression and ventilation, the results of which were recorded in the table and the number of practical compression per minute was calculated. The data were analyzed by x2 Test and t Test. The factors which would influence CPR performance, including gender, age, placement, hand skill, posture of compression and frequency of training, were classified and given parameters, and were put to Logistic repression analysis. The CPR performance qualities of volunteers were much higher than those of the compared group. The overall pass rates were respectively 86.4% and 31.9%; the pass rates of medical volunteers in terms of the chest compression depth, frequency, released pressure between compressions were higher than those of the compared group, which were 89.6%, 94.2%, 95.8% vs 50.3%, 53.0%, 83.1%, P<0.01; there were few differences in overall performance time, which were (118.4 ± 13.5s) vs (116.0 ± 10.4s), P>0.05; the duration time of ventilation in each performance section was much shorter than that in the compared group, which were (6.38 ± 1.2) vs (7.47 ± 1.7), P<0.01; there were few differences in the number of practical compression per minute, which were (78.2 ± 3.5) vs (78.8 ± 12.2), P>0.05); the time proportion of compression and ventilation was 2.6:1 vs 2.1:1. The Logistic repression analysis showed that CPR performance qualities were clearly related to hand skill, posture of compression and repeating standard training, which were respectively OR 13.12 and 95%CI (2.35~73.2); OR 30.89, 95%CI (3.62~263.5); OR 4.07,95%CI (1.16~14.2). The CPR performance qualities of volunteers who had had repeating standard training were much higher than those of untrained medical workers, which proved that standard training helped improve CPR performance qualities.

The duration of cardiopulmonary resuscitation in emergency departments after out-of-hospital cardiac arrest is associated with the outcome: A nationwide observational study.

PubMed

Cha, Won Chul; Lee, Eui Jung; Hwang, Seung-Sik

2015-11-01

The appropriate duration of cardiopulmonary resuscitation (CPR) for patients who experience out-of-hospital cardiac arrest (OHCA) remains unknown. This study aimed to evaluate the duration of CPR in emergency departments (EDs) and to determine whether the institutions' median duration of CPR was associated with survival-to-discharge rate. A cohort of adult patients from a nationwide OHCA registry was retrospectively evaluated. The main variable was the median duration of CPR for each ED (institutional duration), and the main outcome was survival to discharge. Multivariable logistic regression analysis was performed to adjust for individual and aggregated confounders. Among the 107,736 patients who experienced OHCA between 2006 and 2010, 30,716 (28.5%) were selected for analysis. The median age was 65 years, and 67.1% were men. The median duration of CPR for all EDs was 28 min, ranging from 11 to 45 min. EDs were categorized into 3 groups according to their institutional duration of CPR: groups A (< 20 min), B (20-29 min), C (≥ 30 min). The observed survival rates of the 3 groups were 2.11%, 5.20%, and 5.62%, respectively. Compared with group B, the adjusted difference (95% confidence interval) for survival to discharge was 3.01% (1.90-4.11, P<0.001) for group A, and 0.33% (-0.64 to 1.30, P=0.51) for group C. The duration of CPR varied widely among hospitals. The institutional duration of CPR less than 20 min was significantly associated with lower survival-to-discharge rate. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A comparison of the outcome of CPR according to AHA 2005 ACLS and AHA 2010 ACLS guidelines in cardiac arrest: multicenter study.

PubMed

Ocal, Oktay; Ozucelik, Dogac Niyazi; Avci, Akkan; Yazicioglu, Mustafa; Aydin, Yilmaz; Ayvaci, Baris Murat; Dogan, Halil; Aciksari, Kurtulus; Cukurova, Zafer

2015-01-01

The aim of this study was to evaluate whether there is a difference in the return of spontaneous circulation (ROSC) and survival with sequel-free recovery rates between the patients who underwent cardiopulmonary resuscitation (CPR) according to 2005 and 2010 guidelines. This study was conducted in the Bakırköy Dr. Sadi Konuk and Kartal Lütfi Kırdar Training and Research Hospital between dates of October 2010 and 28 February 2011 after approval of Ethics Committee. In the first months of the study, CPR was performed according to AHA 2005 ACLS guidelines (Group-1), while CPR was performed according to AHA 2010 ACLS guidelines after November 2010 (Group-2). Patients were assessed for neurological deficit with Cerebral Performance Categories Scale. Mean age was found as 69.01±13.05 (minimum: 21, maximum: 92) in 86 patients included. Of the 33 patients underwent CPR in the Group 1, ROSC was achieved in 51.5%; and 6.1% of these patients were discharged. Of the 53 patients underwent CPR in the Group 2, ROSC was achieved in 37.7%; and 9.4% of these patients were discharged. Although the number of living patients in Group 2 was higher than Group 1, the difference was not found statistically significant (5 versus 2), (P>0.05). But, neurological outcomes were found better with 2010 compared to 2005 guidelines (3/7 versus 0/2 good cerebral performance). It was found that the 2005 CPR guidelines practices in ED were more successful than the 2010 CPR guidelines practices in ROSC, but less successful in the rate of discharge from hospital and neurological sequel-free discharge rate.

Neonatal outcomes following extensive cardiopulmonary resuscitation in the delivery room for infants born at less than 33 weeks gestational age.

PubMed

Soraisham, Amuchou Singh; Lodha, Abhay Kumar; Singhal, Nalini; Aziz, Khalid; Yang, Junmin; Lee, Shoo K; Shah, Prakesh S

2014-02-01

To examine the neonatal mortality and morbidity of infants born at <33 weeks gestational age (GA) who received extensive delivery room cardiopulmonary resuscitation (DR-CPR) immediately after birth. In this retrospective cohort study, we performed secondary analyses of data from infants born at <33 weeks GA and admitted to participating NICUs in the Canadian Neonatal Network between January 2010 and December 2011. Infants were divided into two groups based on birth weight (<1000 g and ≥1000 g) and neonatal morbidity and mortality compared using bivariate and multivariate analyses. Of the 8033 eligible infants, 419 (5.2%) received DR-CPR. For infants weighing <1000 g at birth, 10.9% (outborn: 21.6%, inborn: 7.6%) received DR-CPR, whereas 3.4% (outborn: 9.6%, inborn: 2.2%) of those weighing ≥1000 g received DR-CPR. If infants received DR-CPR there was increased risk of mortality, bronchopulmonary dysplasia (BPD) and severe brain injury. Logistic regression analysis showed DR-CPR was associated with increased mortality (adjusted odds ratio [aOR]: 2.09, 95% CI [1.39, 3.14]) in infants born weighing <1000 g. Among infants born weighing ≥1000 g, DR-CPR was associated with increased mortality (aOR: 7.16, 95% CI [3.88, 13.2]), severe brain injury (aOR: 3.08, 95% CI [1.82, 5.22]), BPD (aOR: 2.14, 95% CI [1.25, 3.65]), pneumothorax (aOR: 3.11, 95% CI [1.53, 6.31]) and intestinal perforation (aOR: 3.47, 95% CI [1.46, 8.24]). DR-CPR is associated with increased risk of mortality and morbidity especially in preterm infants born weighing ≥1000 g. Long-term neurodevelopmental follow up is warranted for these infants.

"Please. Don't. Die.": A Grounded Theory Study of Bystander Cardiopulmonary Resuscitation.

PubMed

Mausz, Justin; Snobelen, Paul; Tavares, Walter

2018-02-01

Bystander cardiopulmonary resuscitation (CPR) is an important determinant of survival from out-of-hospital cardiac arrest (OHCA), yet rates of bystander CPR are highly variable. In an effort to promote bystander CPR, the procedure has been streamlined, and ultrashort teaching modalities have been introduced. CPR has been increasingly reconceptualized as simple, safe, and easy to perform; however, current methods of CPR instruction may not adequately prepare lay rescuers for the various logistical, conceptual, and emotional challenges of resuscitating a victim of cardiac arrest. We adopted a constructivist grounded theory methodology to qualitatively explore bystander CPR and invited lay rescuers who had recently (ie, within 1 week) intervened in an OHCA to participate in semistructured interviews and focus groups. We used constant comparative analysis until theoretical saturation to derive a midrange explanatory theory of bystander CPR. We constructed a 3-stage theoretical model describing a common experiential process for lay rescuer intervention in OHCA: Being called to act is disturbing, causing panic, shock, and disbelief that must ultimately be overcome. Taking action to save the victim is complicated by several misconceptions about cardiac arrest, where victims are mistakenly believed to be choking, and agonal respirations are misinterpreted to mean the victim is alive. Making sense of the experience is challenging, at least in the short term, where lay rescuers have to contend with self-doubt, unanswered questions, and uncomfortable emotional reactions to a traumatic event. Our study suggests that current CPR training programs may not adequately prepare lay rescuers for the reality of an OHCA and identifies several key knowledge gaps that should be addressed. The long-term psychological consequences of bystander intervention in OHCA remain poorly understood and warrant further study. © 2018 American Heart Association, Inc.

Different Impacts of Time From Collapse to First Cardiopulmonary Resuscitation on Outcomes After Witnessed Out-of-Hospital Cardiac Arrest in Adults.

PubMed

Hara, Masahiko; Hayashi, Kenichi; Hikoso, Shungo; Sakata, Yasushi; Kitamura, Tetsuhisa

2015-05-01

It is well known that cardiopulmonary resuscitation (CPR) should be attempted as early as possible after out-of-hospital cardiac arrest (OHCA). However, it is unclear about the impact of time to CPR on OHCA outcome by first documented rhythm (pulseless ventricular tachycardia/ventricular fibrillation [pVT/VF], pulseless electric activity [PEA], and asystole). We enrolled 257,354 adult witnessed OHCA patients between 2007 and 2012 from a prospective nationwide population-based cohort database in Japan. We evaluated relationships between time from collapse to first CPR and neurologically favorable 1-month survival defined as Glasgow-Pittsburg cerebral performance category 1 or 2 by first documented rhythm after witnessed OHCA. We used logistic model for the estimation of prognosis. The number of OHCA patients with pVT/VF, PEA, and asystole were 38,661, 96,906, and 121,787, respectively. The overall neurologically favorable 1-month survival rates were 21.3% in patients with pVT/VF, 2.7% PEA, and 0.6% asystole. The proportion of asystole increased as the time from collapse to CPR delayed, whereas those of pVT/VF and PEA decreased (trend P<0.001). Estimated incidences of end-point after OHCA became lower as first CPR delayed irrespective of type of first documented rhythm, but were different by the rhythm. The average percentage point decreases in neurologically favorable 1-month survival probability for each incremental minute of CPR delay were 8.3%, 4.4%, and 6.4% for patients with pVT/VF, PEA, and asystole, respectively. The OHCA outcome differed by time to first CPR and first documented rhythm. Shortening of time to first CPR is crucial for improving the OHCA outcome. © 2015 American Heart Association, Inc.

Ventilation/perfusion ratios measured by multiple inert gas elimination during experimental cardiopulmonary resuscitation.

PubMed

Hartmann, E K; Duenges, B; Boehme, S; Szczyrba, M; Liu, T; Klein, K U; Baumgardner, J E; Markstaller, K; David, M

2014-09-01

During cardiopulmonary resuscitation (CPR) the ventilation/perfusion distribution (VA /Q) within the lung is difficult to assess. This experimental study examines the capability of multiple inert gas elimination (MIGET) to determine VA /Q under CPR conditions in a pig model. Twenty-one anaesthetised pigs were randomised to three fractions of inspired oxygen (1.0, 0.7 or 0.21). VA/ Q by micropore membrane inlet mass spectrometry-derived MIGET was determined at baseline and during CPR following induction of ventricular fibrillation. Haemodynamics, blood gases, ventilation distribution by electrical impedance tomography and return of spontaneous circulation were assessed. Intergroup differences were analysed by non-parametric testing. MIGET measurements were feasible in all animals with an excellent correlation of measured and predicted arterial oxygen partial pressure (R(2)  = 0.96, n = 21 for baseline; R(2)  = 0.82, n = 21 for CPR). CPR induces a significant shift from normal VA /Q ratios to the high VA /Q range. Electrical impedance tomography indicates a dorsal to ventral shift of the ventilation distribution. Diverging pulmonary shunt fractions induced by the three inspired oxygen levels considerably increased during CPR and were traceable by MIGET, while 100% oxygen most negatively influenced the VA /Q. Return of spontaneous circulation were achieved in 52% of the animals. VA /Q assessment by MIGET is feasible during CPR and provides a novel tool for experimental purposes. Changes in VA /Q caused by different oxygen fractions are traceable during CPR. Beyond pulmonary perfusion deficits, these data imply an influence of the inspired oxygen level on VA /Q. Higher oxygen levels significantly increase shunt fractions and impair the normal VA /Q ratio. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

A clinical observational study analysing the factors associated with hyperventilation during actual cardiopulmonary resuscitation in the emergency department.

PubMed

Park, Sang O; Shin, Dong Hyuk; Baek, Kwang Je; Hong, Dae Young; Kim, Eun Jung; Kim, Sang Chul; Lee, Kyeong Ryong

2013-03-01

This is the first study to identify the factors associated with hyperventilation during actual cardiopulmonary resuscitation (CPR) in the emergency department (ED). All CPR events in the ED were recorded by video from April 2011 to December 2011. The following variables were analysed using review of the recorded CPR data: ventilation rate (VR) during each minute and its associated factors including provider factors (experience, advanced cardiovascular life support (ACLS) certification), clinical factors (auscultation to confirm successful intubation, suctioning, and comments by the team leader) and time factors (time or day of CPR). Fifty-five adult CPR cases including a total of 673 min sectors were analysed. The higher rates of hyperventilation (VR>10/min) were delivered by inexperienced (53.3% versus 14.2%) or uncertified ACLS provider (52.2% versus 10.8%), during night time (61.0 versus 34.5%) or weekend CPR (53.1% versus 35.6%) and when auscultation to confirm successful intubation was performed (93.5% versus 52.8%) than not (all p<0.0001). However, experienced (25.3% versus 29.7%; p=0.448) or certified ACLS provider (20.6% versus 31.3%; p<0.0001) could not deliver high rate of proper ventilation (VR 8-10/min). Comment by the team leader was most strongly associated with the proper ventilation (odds ratio 7.035, 95% confidence interval 4.512-10.967). Hyperventilation during CPR was associated with inexperienced or uncertified ACLS provider, auscultation to confirm intubation, and night time or weekend CPR. And to deliver proper ventilation, comments by the team leader should be given regardless of providers' expert level. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Current and Future Status of Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest.

PubMed

Singal, Rohit K; Singal, Deepa; Bednarczyk, Joseph; Lamarche, Yoan; Singh, Gurmeet; Rao, Vivek; Kanji, Hussein D; Arora, Rakesh C; Manji, Rizwan A; Fan, Eddy; Nagpal, A Dave

2017-01-01

Numerous series, propensity-matched trials, and meta-analyses suggest that appropriate use of extracorporeal cardiopulmonary resuscitation (E-CPR) for in-hospital cardiac arrest (IHCA) can be lifesaving. Even with an antecedent cardiopulmonary resuscitation (CPR) duration in excess of 45 minutes, 30-day survival with favourable neurologic outcome using E-CPR is approximately 35%-45%. Survival may be related to age, duration of CPR, or etiology. Associated complications include sepsis, renal failure, limb and neurologic complications, hemorrhage, and thrombosis. However, methodological biases-including small sample size, selection bias, publication bias, and inability to control for confounders-in these series prevent definitive conclusions. As such, the 2015 American Heart Association Advanced Cardiac Life Support guidelines update recommended E-CPR as a Level of Evidence IIb recommendation in appropriate cases. The absence of high-quality evidence presents an opportunity for clinician/scientists to generate practice-defining data through collaborative investigation and prospective trials. A multidisciplinary dialogue is required to standardize the field and promote multicentre investigation of E-CPR with data sharing and the development of a foundation for high-quality trials. The objectives of this review are to (1) provide an overview of the strengths and limitations of currently available studies investigating the use of E-CPR in patients with IHCA and highlight knowledge gaps; (2) create a framework for the standardization of terminology, clinical practice, data collection, and investigation of E-CPR for patients with IHCA that will help ensure congruence in future work in this area; and (3) propose suggestions to guide future research by the cardiovascular community to advance this important field. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Basic and advanced paediatric cardiopulmonary resuscitation - guidelines of the Australian and New Zealand Resuscitation Councils 2010.

PubMed

Tibballs, James; Aickin, Richard; Nuthall, Gabrielle

2012-07-01

Guidelines for basic and advanced paediatric cardiopulmonary resuscitation (CPR) have been revised by Australian and New Zealand Resuscitation Councils. Changes encourage CPR out-of-hospital and aim to improve the quality of CPR in-hospital. Features of basic CPR include: omission of abdominal thrusts for foreign body airway obstruction; commencement with chest compression followed by ventilation in a ratio of 30:2 or compression-only CPR if the rescuer is unwilling/unable to give expired-air breathing when the victim is 'unresponsive and not breathing normally'. Use of automated external defibrillators is encouraged. Features of advanced CPR include: prevention of cardiac arrest by rapid response systems; restriction of pulse palpation to 10 s to diagnosis cardiac arrest; affirmation of 15:2 compression-ventilation ratio for children and for infants other than newly born; initial bag-mask ventilation before tracheal intubation; a single direct current shock of 4 J/kg for ventricular fibrillation (VF) and pulseless ventricular tachycardia followed by immediate resumption of CPR for 2 min without analysis of cardiac rhythm and avoidance of unnecessary interruption of continuous external cardiac compressions. Monitoring of exhaled carbon dioxide is recommended to detect non-tracheal intubation, assess quality of CPR, and to help match ventilation to reduced cardiac output. The intraosseous route is recommended if immediate intravenous access is impossible. Amiodarone is strongly favoured over lignocaine for refractory VF and adrenaline over atropine for severe bradycardia, asystole and pulseless electrical activity. Family presence at resuscitation is encouraged. Therapeutic hypothermia is acceptable after resuscitation to improve neurological outcome. Extracorporeal circulatory support for in-hospital cardiac arrest may be used in equipped centres. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Tracheal intubation during pediatric cardiopulmonary resuscitation: A videography-based assessment in an emergency department resuscitation room.

PubMed

Donoghue, Aaron; Hsieh, Ting-Chang; Nishisaki, Akira; Myers, Sage

2016-02-01

To describe procedural characteristics of tracheal intubation (TI) during cardiopulmonary resuscitation (CPR) in a pediatric emergency department, and to characterize interruptions in CPR associated with TI performance. Retrospective single center case series. Resuscitations in a pediatric ED are videorecorded for quality improvement. Children who underwent TI while receiving chest compressions were eligible for inclusion. Intubations done by methods other than direct laryngoscopy were excluded. Background data included patient age and training background of intubator. Data on intubation attempts (success, laryngoscopy time) and chest compressions (interruptions, duration of pauses) were collected. Between December 2012 and February 2014, 32 patients had 59 TI attempts performed during CPR. Overall first attempt success at TI was 15/32 (47%); a median of 2 attempts were made per patient (range 1 to 4). Median laryngoscopy time was 47s (range 8-115s). 32/59 (54%) TI attempts had an associated interruption in CPR; the median interruption duration was 25s (range 3-64s). TI attempts without interruption in CPR were successful in 20/32 (63%) compared to 11/27 (41%) when CPR was paused (p=0.09). Laryngoscopy time was not significantly different between TI attempts with (47±21s) and without (47±26s; p=0.2) interruptions in compressions. 25/32 (78%) of pauses exceeded 10s in duration. TI during pediatric CPR results in significant interruptions in chest compressions. Procedural outcomes were not significantly different between attempts with and without compressions paused. In children receiving CPR, TI should be performed without pausing chest compressions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The chance of survival and the functional outcome after in-hospital cardiopulmonary resuscitation in older people: a systematic review.

PubMed

van Gijn, Myke S; Frijns, Dionne; van de Glind, Esther M M; C van Munster, Barbara; Hamaker, Marije E

2014-07-01

physicians are frequently confronted with the question whether cardiopulmonary resuscitation (CPR) is a medically appropriate treatment for older people. For physicians, patients and relatives, it is important to know the chance of survival and the functional outcome after CPR in order to make an informed decision. a systematic search was performed in MEDLINE, Embase and Cochrane up to November 2012. Studies that were included described the chance of survival, the social status and functional outcome after in-hospital CPR in older people aged 70 years and above. we identified 11,377 publications of which 29 were included in this review; 38.6% of the patients who were 70 years and older had a return of spontaneous circulation. More than half of the patients who initially survived resuscitation died in the hospital before hospital discharge. The pooled survival to discharge after in-hospital CPR was 18.7% for patients between 70 and 79 years old, 15.4% for patients between 80 and 89 years old and 11.6% for patients of 90 years and older. Data on social and functional outcome after surviving CPR were scarce and contradictory. the chance of survival to hospital discharge for in-hospital CPR in older people is low to moderate (11.6-18.7%) and decreases with age. However, evidence about functional or social outcomes after surviving CPR is scarce. Prospective studies are needed to address this issue and to identify pre-arrest factors that can predict survival in the older people in order to define subgroups that could benefit from CPR. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Are YouTube videos accurate and reliable on basic life support and cardiopulmonary resuscitation?

PubMed

Yaylaci, Serpil; Serinken, Mustafa; Eken, Cenker; Karcioglu, Ozgur; Yilmaz, Atakan; Elicabuk, Hayri; Dal, Onur

2014-10-01

The objective of this study is to investigate reliability and accuracy of the information on YouTube videos related to CPR and BLS in accord with 2010 CPR guidelines. YouTube was queried using four search terms 'CPR', 'cardiopulmonary resuscitation', 'BLS' and 'basic life support' between 2011 and 2013. Sources that uploaded the videos, the record time, the number of viewers in the study period, inclusion of human or manikins were recorded. The videos were rated if they displayed the correct order of resuscitative efforts in full accord with 2010 CPR guidelines or not. Two hundred and nine videos meeting the inclusion criteria after the search in YouTube with four search terms ('CPR', 'cardiopulmonary resuscitation', 'BLS' and 'basic life support') comprised the study sample subjected to the analysis. Median score of the videos is 5 (IQR: 3.5-6). Only 11.5% (n = 24) of the videos were found to be compatible with 2010 CPR guidelines with regard to sequence of interventions. Videos uploaded by 'Guideline bodies' had significantly higher rates of download when compared with the videos uploaded by other sources. Sources of the videos and date of upload (year) were not shown to have any significant effect on the scores received (P = 0.615 and 0.513, respectively). The videos' number of downloads did not differ according to the videos compatible with the guidelines (P = 0.832). The videos downloaded more than 10,000 times had a higher score than the others (P = 0.001). The majority of You-Tube video clips purporting to be about CPR are not relevant educational material. Of those that are focused on teaching CPR, only a small minority optimally meet the 2010 Resucitation Guidelines. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Prospective evaluation of tools to assess the psychological response of CPR provision to a relative who has suffered a cardiac arrest: a pilot project.

PubMed

Nunnink, Leo; Williamson, Fran; Broome, Annette; McNeill, Iain

2011-02-01

We aimed to evaluate assessment tools to measure the psychological impact of providing CPR to a relative. We set out to evaluate the Revised Impact of Event Scale (IES-R) and Texas Inventory of Grief (TIG) for comparing CPR providers and non-providers, and to establish whether research of this nature had a negative impact on the participants. We also collected narrative data from CPR providers. Prospective sampling of relatives of patients presenting to hospital who had witnessed their relative have a cardiac arrest and who had performed or witnessed CPR. Participants performed two interviews and completed the IES-R and the TIG. Twenty-nine cardiac arrest victims presented, with ten relatives enrolled. The IES-R and TIG were feasible, and registered moderate responses from CPR providers and non-providers. There was no significant difference in the IES-R score between CPR providers and non-providers (1.96 vs. 1.04, p=0.3). There was no significant difference between scores obtained at two different time points (1.75 vs. 1.63, p=0.43). Participants demonstrated a moderate response on the TIG (mean TIG score 2.8, SD 1.7). Participants did not have a negative perception of study involvement, and actually perceived a benefit from discussion with a health professional. It is acceptable and achievable to prospectively assess the response of a cardiac arrest victim's relatives to the provision of CPR. The test instruments used were appropriate and feasible. Results suggested a sample size of 48 to achieve a statistically significant result. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

A Wild Weasel Penetration Model.

DTIC Science & Technology

1982-03-01

event 13, and node WM. Global variable XX(48) counts the WWs as they reach the home point. The network logic for WWI and WW2 is identical. Each WW...the same no matter if the aircraft is WWI or WW2 . Radar-Attack Profile In the radar-attack po. tion of the network threat radars engage both attack...Systems Dispersion on LOC XX(52) *State Variable--see text. * 94 variable. (The entry positions of WW1 and WW2 are changed with state variables SS(25) and

Observations of mesospheric turbulence by rocket probe and VHF radar, part 2.4A

NASA Astrophysics Data System (ADS)

Royrvik, O.; Smith, L. G.

1984-12-01

Data from the Jicamarca VHF radar and from a Languir probe fine-structure on a Nike Orion rocket launched from Punto Lobos, Peru, have been compared. A single mesospheric scattering layer was observed by the radar. The Langmuir probe detected irregularities in the electron-density profile in a narrow region between 85.2 and 86.6 km. It appears from a comparison between these two data sets that turbulence in the neutral atmosphere is the mechanism generating the refractive index irregularities.

Observations of Mesospheric Turbulence by Rocket Probe and VHF Radar, Part 2.4A

NASA Technical Reports Server (NTRS)

Royrvik, O.; Smith, L. G.

1984-01-01

Data from the Jicamarca VHF radar and from a Languir probe fine-structure on a Nike Orion rocket launched from Punto Lobos, Peru, have been compared. A single mesospheric scattering layer was observed by the radar. The Langmuir probe detected irregularities in the electron-density profile in a narrow region between 85.2 and 86.6 km. It appears from a comparison between these two data sets that turbulence in the neutral atmosphere is the mechanism generating the refractive index irregularities.

MitoCPR-A surveillance pathway that protects mitochondria in response to protein import stress.

PubMed

Weidberg, Hilla; Amon, Angelika

2018-04-13

Mitochondrial functions are essential for cell viability and rely on protein import into the organelle. Various disease and stress conditions can lead to mitochondrial import defects. We found that inhibition of mitochondrial import in budding yeast activated a surveillance mechanism, mitoCPR, that improved mitochondrial import and protected mitochondria during import stress. mitoCPR induced expression of Cis1, which associated with the mitochondrial translocase to reduce the accumulation of mitochondrial precursor proteins at the mitochondrial translocase. Clearance of precursor proteins depended on the Cis1-interacting AAA + adenosine triphosphatase Msp1 and the proteasome, suggesting that Cis1 facilitates degradation of unimported proteins. mitoCPR was required for maintaining mitochondrial functions when protein import was compromised, demonstrating the importance of mitoCPR in protecting the mitochondrial compartment. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

[Training program on cardiopulmonary resuscitation with the use of automated external defibrillator in a university].

PubMed

Boaventura, Ana Paula; Miyadahira, Ana Maria Kazue

2012-03-01

Early defibrillation in cardiopulmonary resuscitation (CPR) receives increasing emphasis on its priority and rapidity. This is an experience report about the implementation of a training program in CPR using a defibrillator in a private university. The training program in basic CPR maneuvers was based on global guidelines, including a theorical course with practical demonstration of CPR maneuvers with the defibrillator, individual practical training and theoretical and practical assessments. About the performance of students in the practical assessment the mean scores obtained by students in the first stage of the course was 26.4 points, while in the second stage the mean was 252.8 points, in the theoretical assessment the mean in the first stage was 3.06 points and in the second 9.0 points. The implementation of programs like this contribute to the effective acquisition of knowledge (theory) and skill (pratice) for the care of CPR victims.

Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

PubMed

Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

2016-06-01

This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals.

The 2015 Resuscitation Council of Asia (RCA) guidelines on adult basic life support for lay rescuers.

PubMed

Chung, Sung Phil; Sakamoto, Tetsuya; Lim, Swee Han; Ma, Mathew Huei-Ming; Wang, Tzong-Luen; Lavapie, Francis; Krisanarungson, Sopon; Nonogi, Hiroshi; Hwang, Sung Oh

2016-08-01

This paper introduces adult basic life support (BLS) guidelines for lay rescuers of the resuscitation council of Asia (RCA) developed for the first time. The RCA BLS guidelines for lay rescuers have been established by expert consensus among BLS Guidelines Taskforce of the RCA on the basis of the 2015 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science with Treatment Recommendations. The RCA recommends compression-only CPR for lay rescuers and emphasizes high-quality CPR with chest compression depth of approximately 5cm and chest compression rate of 100-120min(-1). Role of emergency medical dispatchers in helping lay rescuers recognize cardiac arrest and perform CPR is also emphasized. The RCA guidelines will contribute to help Asian countries establish and implement their own CPR guidelines in the context of their domestic circumstances. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Vertical radar profiles for the calibration of unsaturated flow models under dynamic water table conditions

NASA Astrophysics Data System (ADS)

Cassiani, G.; Gallotti, L.; Ventura, V.; Andreotti, G.

2003-04-01

The identification of flow and transport characteristics in the vadose zone is a fundamental step towards understanding the dynamics of contaminated sites and the resulting risk of groundwater pollution. Borehole radar has gained popularity for the monitoring of moisture content changes, thanks to its apparent simplicity and its high resolution characteristics. However, cross-hole radar requires closely spaced (a few meters), plastic-cased boreholes, that are rarely available as a standard feature in sites of practical interest. Unlike cross-hole applications, Vertical Radar Profiles (VRP) require only one borehole, with practical and financial benefits. High-resolution, time-lapse VRPs have been acquired at a crude oil contaminated site in Trecate, Northern Italy, on a few existing boreholes originally developed for remediation via bioventing. The dynamic water table conditions, with yearly oscillations of roughly 5 m from 6 to 11 m bgl, offers a good opportunity to observe via VRP a field scale drainage-imbibition process. Arrival time inversion has been carried out using a regularized tomographic algorithm, in order to overcome the noise introduced by first arrival picking. Interpretation of the vertical profiles in terms of moisture content has been based on standard models (Topp et al., 1980; Roth et al., 1990). The sedimentary sequence manifests itself as a cyclic pattern in moisture content over most of the profiles. We performed preliminary Richards' equation simulations with time varying later table boundary conditions, in order to estimate the unsaturated flow parameters, and the results have been compared with laboratory evidence from cores.

The vertical profile of radar reflectivity of convective cells: A strong indicator of storm intensity and lightning probability?

NASA Technical Reports Server (NTRS)

Zipser, Edward J.; Lutz, Kurt R.

1994-01-01

Reflectivity data from Doppler radars are used to construct vertical profiles of radar reflectivity (VPRR) of convective cells in mesoscale convective systems (MCSs) in three different environmental regimes. The National Center for Atmospheric Research CP-3 and CP-4 radars are used to calculate median VPRR for MCSs in the Oklahoma-Kansas Preliminary Regional Experiment for STORM-Central in 1985. The National Oceanic and Atmospheric Administration-Tropical Ocean Global Atmosphere radar in Darwin, Australia, is used to calculate VPRR for MCSs observed both in oceanic, monsoon regimes and in continental, break period regimes during the wet seasons of 1987/88 and 1988/89. The midlatitude and tropical continental VPRRs both exhibit maximum reflectivity somewhat above the surface and have a gradual decrease in reflectivity with height above the freezing level. In sharp contrast, the tropical oceanic profile has a maximum reflectivity at the lowest level and a very rapid decrease in reflectivity with height beginning just above the freezing level. The tropical oceanic profile in the Darwin area is almost the same shape as that for two other tropical oceanic regimes, leading to the conclustion that it is characteristic. The absolute values of reflectivity in the 0 to 20 C range are compared with values in the literature thought to represent a threshold for rapid storm electrification leading to lightning, about 40 dBZ at -10 C. The large negative vertical gradient of reflectivity in this temperature range for oceanic storms is hypothesized to be a direct result of the characteristically weaker vertical velocities observed in MCSs over tropical oceans. It is proposed, as a necessary condition for rapid electrification, that a convective cell must have its updraft speed exceed some threshold value. Based upon field program data, a tentative estimate for the magnitude of this threshold is 6-7 m/s for mean speed and 10-12 m/s for peak speed.

Exploiting Cloud Radar Doppler Spectra of Mixed-Phase Clouds during ACCEPT Field Experiment to Identify Microphysical Processes

NASA Astrophysics Data System (ADS)

Kalesse, H.; Myagkov, A.; Seifert, P.; Buehl, J.

2015-12-01

Cloud radar Doppler spectra offer much information about cloud processes. By analyzing millimeter radar Doppler spectra from cloud-top to -base in mixed-phase clouds in which super-cooled liquid-layers are present we try to tell the microphysical evolution story of particles that are present by disentangling the contributions of the solid and liquid particles to the total radar returns. Instead of considering vertical profiles, dynamical effects are taken into account by following the particle population evolution along slanted paths which are caused by horizontal advection of the cloud. The goal is to identify regions in which different microphysical processes such as new particle formation (nucleation), water vapor deposition, aggregation, riming, or sublimation occurr. Cloud radar measurements are supplemented by Doppler lidar and Raman lidar observations as well as observations with MWR, wind profiler, and radio sondes. The presence of super-cooled liquid layers is identified by positive liquid water paths in MWR measurements, the vertical location of liquid layers (in non-raining systems and below lidar extinction) is derived from regions of high-backscatter and low depolarization in Raman lidar observations. In collocated cloud radar measurements, we try to identify cloud phase in the cloud radar Doppler spectrum via location of the Doppler peak(s), the existence of multi-modalities or the spectral skewness. Additionally, within the super-cooled liquid layers, the radar-identified liquid droplets are used as air motion tracer to correct the radar Doppler spectrum for vertical air motion w. These radar-derived estimates of w are validated by independent estimates of w from collocated Doppler lidar measurements. A 35 GHz vertically pointing cloud Doppler radar (METEK MIRA-35) in linear depolarization (LDR) mode is used. Data is from the deployment of the Leipzig Aerosol and Cloud Remote Observations System (LACROS) during the Analysis of the Composition of Clouds with Extended Polarization Techniques (ACCEPT) field experiment in Cabauw, Netherlands in Fall 2014. There, another MIRA-35 was operated in simultaneous transmission and simultaneous reception (STSR) mode for obtaining measurements of differential reflectivity (ZDR) and correlation coefficient ρhv.

Analysis of Doppler radar windshear data

NASA Technical Reports Server (NTRS)

Williams, F.; Mckinney, P.; Ozmen, F.

1989-01-01

The objective of this analysis is to process Lincoln Laboratory Doppler radar data obtained during FLOWS testing at Huntsville, Alabama, in the summer of 1986, to characterize windshear events. The processing includes plotting velocity and F-factor profiles, histogram analysis to summarize statistics, and correlation analysis to demonstrate any correlation between different data fields.

The estimation of lower refractivity uncertainty from radar sea clutter using the Bayesian—MCMC method

NASA Astrophysics Data System (ADS)

Sheng, Zheng

2013-02-01

The estimation of lower atmospheric refractivity from radar sea clutter (RFC) is a complicated nonlinear optimization problem. This paper deals with the RFC problem in a Bayesian framework. It uses the unbiased Markov Chain Monte Carlo (MCMC) sampling technique, which can provide accurate posterior probability distributions of the estimated refractivity parameters by using an electromagnetic split-step fast Fourier transform terrain parabolic equation propagation model within a Bayesian inversion framework. In contrast to the global optimization algorithm, the Bayesian—MCMC can obtain not only the approximate solutions, but also the probability distributions of the solutions, that is, uncertainty analyses of solutions. The Bayesian—MCMC algorithm is implemented on the simulation radar sea-clutter data and the real radar sea-clutter data. Reference data are assumed to be simulation data and refractivity profiles are obtained using a helicopter. The inversion algorithm is assessed (i) by comparing the estimated refractivity profiles from the assumed simulation and the helicopter sounding data; (ii) the one-dimensional (1D) and two-dimensional (2D) posterior probability distribution of solutions.

Target recognition based on the moment functions of radar signatures

NASA Astrophysics Data System (ADS)

Kim, Kyung-Tae; Kim, Hyo-Tae

2002-03-01

In this paper, we present the results of target recognition research based on the moment functions of various radar signatures, such as time-frequency signatures, range profiles, and scattering centers. The proposed approach utilizes geometrical moments or central moments of the obtained radar signatures. In particular, we derived exact and closed form expressions of the geometrical moments of the adaptive Gaussian representation (AGR), which is one of the adaptive joint time-frequency techniques, and also computed the central moments of range profiles and one-dimensional (1-D) scattering centers on a target, which are obtained by various super-resolution techniques. The obtained moment functions are further processed to provide small dimensional and redundancy-free feature vectors, and classified via a neural network approach or a Bayes classifier. The performances of the proposed technique are demonstrated using a simulated radar cross section (RCS) data set, or a measured RCS data set of various scaled aircraft models, obtained at the Pohang University of Science and Technology (POSTECH) compact range facility. Results show that the techniques in this paper can not only provide reliable classification accuracy, but also save computational resources.

Comparisons of the Vertical Development of Deep Tropical Convection and Associated Lightning Activity on a Global Basis

NASA Technical Reports Server (NTRS)

Williams, E.; Lin, S.; Labrada, C.; Christian, H.; Goodman, S.; Boccippio, D.; Driscoll, K.

1999-01-01

Simultaneous radar (13.8 Ghz) and lightning (Lightning Imaging Sensor) observations from the NASA TRMM (Tropical Rainfall Measuring Mission) spacecraft afford a new opportunity to examine differences in tropical continental and oceanic convection on a global basis, The 250 meter vertical resolution of the radar data and the approximately 17 dBZ sensitivity are well suited to providing vertical profiles of radar reflectivity over the entire tropical belt. The reflectivity profile has been shown in numerous local ground-based studies to be a good indicator of both updraft velocity and electrical activity. The radar and lightning observations for multiple satellite orbits have been integrated to produce global CAPPI's for various altitudes. At 7 km altitude, where mixed phase microphysics is known to be active, the mean reflectivity in continental convection is 10-15 dB greater than the value in oceanic convection. These results provide a sound physical basis for the order-of-magnitude contrast in lightning counts between continental and oceanic convection. These observations still beg the question, however, about the contrast in updraft velocity in these distinct convective regimes.

Effects of Age, Gender, School Class on Cardiopulmonary Resuscitation Skills of Nigerian Secondary School Students

ERIC Educational Resources Information Center

Onyeaso, Adedamola Olutoyin; Onyeaso, Chukwudi Ochi

2016-01-01

Background: The need for training of schoolchildren on cardiopulmonary resuscitation (CPR) as potential bystander CPR providers is growing globally but Nigeria is still behind and lacks basic necessary data. Purpose: The purpose of this study was to investigate the effects of age, gender and school class on CPR skills of Nigerian secondary school…

A Study in Teaching CPR to a Disabled Student

ERIC Educational Resources Information Center

Brady, Bill; Sanders, Cindy

2004-01-01

This article describes a CPR training course modified for a student with cerebral palsy. Brian is a 10th grade student with cerebral palsy affecting his right side. Brian had a difficult time in the class and was not able to meet the standards required to pass his CPR training. Here, the author discusses how two adaptations were utilized, that…

The Use of a Criterion Performance Checklist to Improve Efficiency and Effectiveness in a CPR Self-Teaching Program.

ERIC Educational Resources Information Center

McSwain, Charlene; And Others

1979-01-01

Physicians need to be proficient in the administration of basic cardiac life support (BCLS) and emergency cardiac care (ECC). The introduction of a self-teaching CPR-ECC course for freshmen medical students at the University of Mississippi has greatly reduced the amount of faculty time needed to teach CPR. (Author/MLW)

A method of automatic control procedures cardiopulmonary resuscitation

NASA Astrophysics Data System (ADS)

Bureev, A. Sh.; Zhdanov, D. S.; Kiseleva, E. Yu.; Kutsov, M. S.; Trifonov, A. Yu.

2015-11-01

The study is to present the results of works on creation of methods of automatic control procedures of cardiopulmonary resuscitation (CPR). A method of automatic control procedure of CPR by evaluating the acoustic data of the dynamics of blood flow in the bifurcation of carotid arteries and the dynamics of air flow in a trachea according to the current guidelines for CPR is presented. Evaluation of the patient is carried out by analyzing the respiratory noise and blood flow in the interspaces between the chest compressions and artificial pulmonary ventilation. The device operation algorithm of automatic control procedures of CPR and its block diagram has been developed.