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1.
J Environ Radioact ; 255: 106968, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36148707

RESUMEN

In 2015 and 2016, atmospheric transport modeling challenges were conducted in the context of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) verification, however, with a more limited scope with respect to emission inventories, simulation period and number of relevant samples (i.e., those above the Minimum Detectable Concentration (MDC)) involved. Therefore, a more comprehensive atmospheric transport modeling challenge was organized in 2019. Stack release data of Xe-133 were provided by the Institut National des Radioéléments/IRE (Belgium) and the Canadian Nuclear Laboratories/CNL (Canada) and accounted for in the simulations over a three (mandatory) or six (optional) months period. Best estimate emissions of additional facilities (radiopharmaceutical production and nuclear research facilities, commercial reactors or relevant research reactors) of the Northern Hemisphere were included as well. Model results were compared with observed atmospheric activity concentrations at four International Monitoring System (IMS) stations located in Europe and North America with overall considerable influence of IRE and/or CNL emissions for evaluation of the participants' runs. Participants were prompted to work with controlled and harmonized model set-ups to make runs more comparable, but also to increase diversity. It was found that using the stack emissions of IRE and CNL with daily resolution does not lead to better results than disaggregating annual emissions of these two facilities taken from the literature if an overall score for all stations covering all valid observed samples is considered. A moderate benefit of roughly 10% is visible in statistical scores for samples influenced by IRE and/or CNL to at least 50% and there can be considerable benefit for individual samples. Effects of transport errors, not properly characterized remaining emitters and long IMS sampling times (12-24 h) undoubtedly are in contrast to and reduce the benefit of high-quality IRE and CNL stack data. Complementary best estimates for remaining emitters push the scores up by 18% compared to just considering IRE and CNL emissions alone. Despite the efforts undertaken the full multi-model ensemble built is highly redundant. An ensemble based on a few arbitrary runs is sufficient to model the Xe-133 background at the stations investigated. The effective ensemble size is below five. An optimized ensemble at each station has on average slightly higher skill compared to the full ensemble. However, the improvement (maximum of 20% and minimum of 3% in RMSE) in skill is likely being too small for being exploited for an independent period.


Asunto(s)
Contaminantes Radiactivos del Aire , Monitoreo de Radiación , Humanos , Radioisótopos de Xenón/análisis , Contaminantes Radiactivos del Aire/análisis , Monitoreo de Radiación/métodos , Canadá , Cooperación Internacional
2.
Clin. transl. oncol. (Print) ; 23(9): 1752-1760, sept. 2021. graf, tab
Artículo en Inglés | IBECS | ID: ibc-222174

RESUMEN

Purpose Radiotherapy (RT) causes an inflammatory reaction of the tissue which leads to fibrosis and reduced functioning of the pelvic organs. Few studies have shown significant relationships between side effects and RT in uterine tumors. Here, the urological, lymphedema, pelvic pain and gastrointestinal (GI) symptoms were studied before and after RT in patients with primary uterine tumors using the EORTC QLQ-EN24, specifically designed for uterine cancer patients. Methods This prospective cohort study comprised patients with primary uterine tumors who received pelvic radiotherapy (RT). A total of 43 patients were included from May 2014 to February 2019. Patients completed the questionnaires for global health status and functioning before the start of RT and at 3 and 12 months after RT. Results We found a significant worsening of the urological symptoms 3 months after RT which persisted up to 12 months after RT compared to baseline values prior to start of RT (p = 0.007). An exacerbation of the urinary symptoms was seen in patients with vaginal brachytherapy/boost compared to patients with pelvic RT at 12 months after RT (p = 0.053). The severity of lymphedema symptoms increased from RT start to 12 months after RT (p = 0.019) and the pelvic pain were higher at 3 months after RT compared to before RT (p = 0.004). Also, the level of GI symptoms was significantly higher 12 months after RT compared to the RT start (p < 0.001). Conclusions The urologic, lymphedema, pelvic pain and GI symptoms all increase after RT (AU)


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Diarrea/etiología , Linfedema/etiología , Dolor Pélvico/etiología , Trastornos Urinarios/etiología , Trastornos Urinarios/radioterapia , Braquiterapia/métodos , Braquiterapia/efectos adversos , Dosis de Radiación , Encuestas Epidemiológicas , Estudios Prospectivos , Estudios Longitudinales , Calidad de Vida , Radioterapia/efectos adversos , Reirradiación , Suiza
3.
Clin Transl Oncol ; 23(9): 1752-1760, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33686481

RESUMEN

PURPOSE: Radiotherapy (RT) causes an inflammatory reaction of the tissue which leads to fibrosis and reduced functioning of the pelvic organs. Few studies have shown significant relationships between side effects and RT in uterine tumors. Here, the urological, lymphedema, pelvic pain and gastrointestinal (GI) symptoms were studied before and after RT in patients with primary uterine tumors using the EORTC QLQ-EN24, specifically designed for uterine cancer patients. METHODS: This prospective cohort study comprised patients with primary uterine tumors who received pelvic radiotherapy (RT). A total of 43 patients were included from May 2014 to February 2019. Patients completed the questionnaires for global health status and functioning before the start of RT and at 3 and 12 months after RT. RESULTS: We found a significant worsening of the urological symptoms 3 months after RT which persisted up to 12 months after RT compared to baseline values prior to start of RT (p = 0.007). An exacerbation of the urinary symptoms was seen in patients with vaginal brachytherapy/boost compared to patients with pelvic RT at 12 months after RT (p = 0.053). The severity of lymphedema symptoms increased from RT start to 12 months after RT (p = 0.019) and the pelvic pain were higher at 3 months after RT compared to before RT (p = 0.004). Also, the level of GI symptoms was significantly higher 12 months after RT compared to the RT start (p < 0.001). CONCLUSIONS: The urologic, lymphedema, pelvic pain and GI symptoms all increase after RT.


Asunto(s)
Diarrea/etiología , Linfedema/etiología , Dolor Pélvico/etiología , Trastornos Urinarios/etiología , Neoplasias Uterinas/radioterapia , Adulto , Anciano , Braquiterapia/efectos adversos , Braquiterapia/métodos , Fraccionamiento de la Dosis de Radiación , Femenino , Encuestas Epidemiológicas , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Radioterapia/efectos adversos , Reirradiación/efectos adversos , Suecia , Evaluación de Síntomas , Neoplasias Uterinas/complicaciones , Neoplasias Uterinas/patología
4.
J Environ Radioact ; 226: 106458, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33202288

RESUMEN

Over 40 soil gas samples were collected both in post-industrial areas as well as in undisturbed areas in the region of Kvarntorp, Sweden. Radioxenon (133Xe) was detected in 15 samples and radioargon was detected in 7 from 10 samples analysed. The concentration of radioxenon and radioargon in soil gas ranged up to 109 mBq/m3 and 19 mBq/m3, respectively. During sample collection other soil gases such as radon, CO2 and O2 were also measured and soil samples were taken along with dose rate measurements. The field experiment presented here shows that it is possible to detect naturally occurring radioxenon and radioargon in soil gas simultaneously.


Asunto(s)
Contaminantes Radiactivos del Aire/análisis , Monitoreo de Radiación , Radón/análisis , Contaminantes Radiactivos del Suelo/análisis , Radioisótopos de Xenón/análisis , Gases/análisis , Suelo , Suecia
5.
Appl Radiat Isot ; 156: 108950, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31665651

RESUMEN

A new method for calculation of isotope-specific activities and activity concentrations in measurement systems for atmospheric radioxenon is presented. The method results in simple matrix-vector equations, and requires the definition of fewer spectral regions-of-interest than previous algorithms. The most important difference compared to the current method is however the calculation of decision limits, which results in false detection rates closer to the selected confidence level of 95% compared to the methods used today. This is achieved by introducing a Bayesian correction of the background estimate. The results have implications for the understanding of the atmospheric radioxenon background, for example for the observed low levels of 133mXe, an important isotope in the area of nuclear explosion detection.

6.
Nat Commun ; 8: 15652, 2017 06 06.
Artículo en Inglés | MEDLINE | ID: mdl-28585545

RESUMEN

Type 2 diabetes (T2D) is characterized by insulin resistance and impaired insulin secretion, but the mechanisms underlying insulin secretion failure are not completely understood. Here, we show that a set of co-expressed genes, which is enriched for genes with islet-selective open chromatin, is associated with T2D. These genes are perturbed in T2D and have a similar expression pattern to that of dedifferentiated islets. We identify Sox5 as a regulator of the module. Sox5 knockdown induces gene expression changes similar to those observed in T2D and diabetic animals and has profound effects on insulin secretion, including reduced depolarization-evoked Ca2+-influx and ß-cell exocytosis. SOX5 overexpression reverses the expression perturbations observed in a mouse model of T2D, increases the expression of key ß-cell genes and improves glucose-stimulated insulin secretion in human islets from donors with T2D. We suggest that human islets in T2D display changes reminiscent of dedifferentiation and highlight SOX5 as a regulator of ß-cell phenotype and function.


Asunto(s)
Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Células Secretoras de Insulina/metabolismo , Factores de Transcripción SOXD/metabolismo , Animales , Calcio/metabolismo , Canales de Calcio/metabolismo , Cromatina/metabolismo , Exocitosis , Femenino , Regulación de la Expresión Génica , Humanos , Insulina/metabolismo , Islotes Pancreáticos/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Análisis de Secuencia por Matrices de Oligonucleótidos , Fenotipo , Florizina/química , ARN Interferente Pequeño/metabolismo , Ratas , Ácido Valproico/química
7.
Chem Commun (Camb) ; 52(77): 11571-4, 2016 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-27604573

RESUMEN

In the context of green chemistry, the replacement of high molecular weight stoichiometric oxidants with O2 is most desirable but difficult. Here, we report the asymmetric aerobic oxidative synthesis of dihydropyranones. The oxidation is aided by a system of electron transfer mediators and is selective toward the homoenolate. The dihydropyranones can be isolated in high to excellent yields, with high ee (up to 95%).

8.
Appl Radiat Isot ; 92: 12-7, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24972162

RESUMEN

Motivated by the need for consistent use of concepts central to the reporting of results from measurements of atmospheric radioactivity, we discuss some properties of the methods commonly used. Different expressions for decay correction of the activity concentration for parent-daughter decay pairs are presented, and it is suggested that this correction should be performed assuming parent-daughter ingrowth in the sample during the entire measurement process. We note that, as has already been suggested by others, activities rather than activity concentrations should be used when nuclide ratios are calculated. In addition, expressions that can be used to transform activity concentrations to activity ratios are presented. Finally we note that statistical uncertainties for nuclide ratios can be properly calculated using the exact solution to the problem of confidence intervals for a ratio of two jointly normally distributed variables, the so-called Fieller׳s theorem.


Asunto(s)
Contaminantes Radiactivos del Aire/análisis , Contaminantes Radiactivos del Aire/química , Algoritmos , Artefactos , Modelos Químicos , Monitoreo de Radiación/métodos , Radioisótopos/análisis , Radioisótopos/química , Simulación por Computador , Semivida , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
9.
J Environ Radioact ; 128: 47-63, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24316684

RESUMEN

Observations made in April 2013 of the radioxenon isotopes (133)Xe and (131m)Xe at measurement stations in Japan and Russia, belonging to the International Monitoring System for verification of the Comprehensive Nuclear-Test-Ban Treaty, are unique with respect to the measurement history of these stations. Comparison of measured data with calculated isotopic ratios as well as analysis using atmospheric transport modeling indicate that it is likely that the xenon measured was created in the underground nuclear test conducted by North Korea on February 12, 2013, and released 7-8 weeks later. More than one release is required to explain all observations. The (131m)Xe source terms for each release were calculated to 0.7 TBq, corresponding to about 1-10% of the total xenon inventory for a 10 kt explosion, depending on fractionation and release scenario. The observed ratios could not be used to obtain any information regarding the fissile material that was used in the test.


Asunto(s)
Armas Nucleares , Xenón/análisis , República Popular Democrática de Corea , Japón , Monitoreo de Radiación , Federación de Rusia , Radioisótopos de Xenón/análisis
10.
Child Care Health Dev ; 39(4): 523-34, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23763253

RESUMEN

BACKGROUND: Participation is known to be of great importance for children's development and emotional well-being as well as for their families. In the International Classification of Functioning, Disability and Health - Children and Youth version participation is defined as a person's 'involvement in a life situation'. Engagement is closely related to involvement and can be seen as expressions of involvement or degree of involvement within a situation. This study focuses on children's engagement in family activities; one group of families with a child with profound intellectual and multiple disabilities (PIMD) and one group of families with children with typical development (TD) were compared. METHODS: A descriptive study using questionnaires. Analyses were mainly performed by using Mann-Whitney U-test and Spearman's rank correlation test. RESULTS: Engagement in family activities differed in the two groups of children. The children with PIMD had a lower level of engagement in most family activities even though the activities that engaged the children to a higher or lesser extent were the same in both groups. Child engagement was found to correlate with family characteristics mostly in the children with TD and in the children with PIMD only negative correlations occurred. In the children with PIMD child engagement correlated with cognition in a high number of listed family activities and the children had a low engagement in routines in spite of these being frequently occurring activities. CONCLUSIONS: Level of engagement in family activities in the group of children with PIMD was lower compared with that in the group of children with TD. Families with a child with PIMD spend much time and effort to adapt family living patterns to the child's functioning.


Asunto(s)
Discapacidad Intelectual/psicología , Discapacidad Intelectual/rehabilitación , Participación Social/psicología , Adolescente , Desarrollo del Adolescente , Niño , Desarrollo Infantil , Preescolar , Cognición , Estudios de Evaluación como Asunto , Composición Familiar , Femenino , Humanos , Lactante , Recién Nacido , Actividades Recreativas/psicología , Masculino , Estadísticas no Paramétricas
11.
Resuscitation ; 84(7): 952-6, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23313425

RESUMEN

AIM: To describe differences and similarities between reported and non-reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden. METHODS: Prospective and retrospective data for treated OHCA patients in Sweden, 2008-2010, were compared in the Swedish Cardiac Arrest Register. Data were investigated in three Swedish counties, which represented one third of the population. The recording models varied. Prospective data are those reported by the emergency medical service (EMS) crews, while retrospective data are those missed by the EMS crews but discovered afterwards by cross-checking with the local ambulance register. RESULT: In 2008-2010, the number of prospectively (n=2398) and retrospectively (n=800) reported OHCA cases was n=3198, which indicates a 25% missing rate. When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years vs. 67 years; p=0.003). There was no difference between groups with regard to gender, time of day and year of OHCA, witnessed status or initial rhythm. Bystander cardiopulmonary resuscitation (CPR) was more frequent among patients who were reported prospectively (65% vs. 60%; p=0.023), whereas survival to one month was higher among patients who were reported retrospectively (9.2% vs. 11.9%; p=0.035). CONCLUSION: Among 3198 cases of OHCA in three counties in Sweden, 800 (25%) were not reported prospectively by the EMS crews but were discovered retrospectively as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, having less frequently received bystander CPR but having a higher survival rate. Our data suggest that reports on OHCA from national quality registers which are based on prospectively recorded data may be influenced by selection bias.


Asunto(s)
Paro Cardíaco Extrahospitalario/epidemiología , Sistema de Registros/normas , Anciano , Reanimación Cardiopulmonar , Servicios Médicos de Urgencia , Femenino , Humanos , Masculino , Paro Cardíaco Extrahospitalario/terapia , Estudios Prospectivos , Estudios Retrospectivos , Tasa de Supervivencia , Suecia/epidemiología
12.
Int J Pharm ; 409(1-2): 30-7, 2011 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-21354465

RESUMEN

Thin, free films based on Kollicoat SR:Eudragit NE blends were prepared by casting or spraying aqueous dispersions of these polymers, and were thoroughly characterized with respect to their water uptake behavior, water permeability, dry mass loss kinetics, mechanical properties and drug release patterns. A mechanistic mathematical model based on Fick's law of diffusion was used to quantify the experimentally measured release of metoprolol succinate from various types of systems. With increasing Eudragit NE content the films became more hydrophobic, resulting in decreased water permeability as well as water uptake rates and extents. In addition, the dry mass loss upon exposure to the release medium decreased. Consequently, the films' permeability for the drug decreased. Importantly, metoprolol succinate release from thin films was mainly controlled by pure diffusion, allowing for the determination of the apparent diffusion coefficient of the drug in the different polymeric systems. Knowing these values, drug release from coated pellets could be quantitatively predicted, assuming intact film coatings throughout the observation period. Comparison with independent experimental results showed that crack formation set on very rapidly in the polymeric membranes upon exposure to the release medium in the case of sugar starter cores, irrespective of the polymer:polymer blend ratio and investigated coating level. In contrast, the onset of crack formation was delayed as a function of the blend ratio and coating thickness in the case of microcrystalline cellulose starter cores, attracting less water into the pellets core. The obtained new insight into the underlying drug release mechanisms can be very helpful during device optimization and improve the safety of this type of advanced drug delivery systems.


Asunto(s)
Metacrilatos/química , Metoprolol/análogos & derivados , Modelos Teóricos , Polímeros/química , Polivinilos/química , Celulosa/química , Preparaciones de Acción Retardada , Sistemas de Liberación de Medicamentos , Excipientes/química , Interacciones Hidrofóbicas e Hidrofílicas , Metoprolol/administración & dosificación , Permeabilidad , Agua/química
13.
Resuscitation ; 81(12): 1615-20, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20843594

RESUMEN

BACKGROUND: Passive leg raising (PLR), to augment the artificial circulation, was deleted from cardiopulmonary resuscitation (CPR) guidelines in 1992. Increases in end-tidal carbon dioxide (P(ET)CO(2)) during CPR have been associated with increased pulmonary blood flow reflecting cardiac output. Measurements of P(ET)CO(2) after PLR might therefore increase our understanding of its potential value in CPR. We also observed the alteration in P(ET)CO(2) in relation to the return of spontaneous circulation (ROSC) and no ROSC. METHODS AND RESULTS: The P(ET)CO(2) was measured, subsequent to intubation, in 126 patients suffering an out-of-hospital cardiac arrest (OHCA), during 15 min or until ROSC. Forty-four patients were selected by the study protocol to PLR 35 cm; 21 patients received manual chest compressions and 23 mechanical compressions. The PLR was initiated during uninterrupted CPR, 5 min from the start of P(ET)CO(2) measurements. During PLR, an increase in P(ET)CO(2) was found in all 44 patients within 15 s (p=0.003), 45 s (p=0.002) and 75 s (p=0.0001). Survival to hospital discharge was 7% among patients with PLR and 1% among those without PLR (p=0.12). Among patients experiencing ROSC (60 of 126), we found a marked increase in P(ET)CO(2) 1 min before the detection of a palpable pulse. CONCLUSION: Since PLR during CPR appears to increase P(ET)CO(2) after OHCA, larger studies are needed to evaluate its potential effects on survival. Further, the measurement of P(ET)CO(2) could help to minimise the hands-off periods and pulse checks.


Asunto(s)
Circulación Sanguínea/fisiología , Reanimación Cardiopulmonar , Pierna/fisiología , Paro Cardíaco Extrahospitalario/terapia , Anciano , Dióxido de Carbono/análisis , Femenino , Humanos , Masculino , Postura , Circulación Pulmonar/efectos de los fármacos , Volumen de Ventilación Pulmonar , Resultado del Tratamiento
14.
Resuscitation ; 81(2): 211-6, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19926389

RESUMEN

AIM: To describe the use of cardiopulmonary resuscitation (CPR) training programmes in Sweden for 25 years and relate those to changes in the percentage of patients with out of hospital cardiac arrest (OHCA) who receive bystander CPR. METHODS: Information was gathered from (a) the Swedish CPR training registry established in 1983 and includes most Swedish education programmes in CPR and (b) the Swedish Cardiac Arrest Register (SCAR) established in 1990 and currently covers about 70% of ambulance districts in Sweden. RESULTS: CPR education in Sweden functions according to a cascade principle (instructor-trainers who train instructors who then train rescuers in CPR). Since 1989, 5000 instructor-trainers have taught more than 50,000 instructors who have taught nearly 2 million of Sweden's 9 million inhabitants adult CPR. This is equivalent to one new rescuer per 100 inhabitants every year in Sweden. In addition, since 1989, there are 51,000 new rescuers in Advanced Life Support (ALS), since 1996, 41,000 new Basic Life Support (BLS) rescuers with Automated External Defibrillation (AED) training, and since 1998, there are 93,000 new rescuers in child CPR. As a result of this CPR training the number of bystander CPR attempts for OHCA in Sweden increased from 31% in 1992 to 55% in 2007. CONCLUSION: By using a cascade principle for CPR education nearly 2 million rescuers were educated in Sweden (9 million inhabitants) between 1989 and 2007. This resulted in a marked increase in bystander CPR attempts.


Asunto(s)
Reanimación Cardiopulmonar/educación , Adulto , Niño , Humanos , Estudios Retrospectivos , Suecia
15.
Resuscitation ; 80(10): 1099-103, 2009 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19716640

RESUMEN

AIM: In animal and human studies, measuring the pressure of end tidal carbon dioxide (P(ET)CO2) has been shown to be a practical non-invasive method that correlates well with the pulmonary blood flow and cardiac output (CO) generated during cardiopulmonary resuscitation (CPR). This study aims to compare mechanical active compression-decompression (ACD) CPR with standard CPR according to P(ET)CO2 among patients with out-of-hospital cardiac arrest (OHCA), during CPR and with standardised ventilation. METHODS: This prospective, on a cluster level, pseudo-randomised pilot trial took place in the Municipality of Göteborg. During a 2-year period, all patients aged >18 years suffering an out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology were enrolled. The present analysis included only tracheally intubated patients in whom P(ET)CO2 was measured for 15 min or until the detection of a pulse-giving rhythm. RESULTS: In all, 126 patients participated in the evaluation, 64 patients in the mechanical chest compression group and 62 patients in the control group. The group receiving mechanical ACD-CPR obtained the significantly highest P(ET)CO2 values according to the average (p=0.04), initial (p=0.01) and minimum (p=0.01) values. We found no significant difference according to the maximum value between groups. CONCLUSION: In this hypothesis generating study mechanical ACD-CPR compared with manual CPR generated the highest initial, minimum and average value of P(ET)CO2. Whether these data can be repeated and furthermore be associated with an improved outcome after OHCA need to be confirmed in a large prospective randomised trial.


Asunto(s)
Capnografía , Reanimación Cardiopulmonar/instrumentación , Reanimación Cardiopulmonar/métodos , Servicios Médicos de Urgencia , Paro Cardíaco/terapia , Anciano , Femenino , Paro Cardíaco/fisiopatología , Humanos , Masculino
16.
J Chem Inf Model ; 48(2): 449-55, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18232678

RESUMEN

We present work on the creation of a ceramic materials database which contains data gleaned from literature data sets as well as new data obtained from combinatorial experiments on the London University Search Instrument. At the time of this writing, the database contains data related to two main groups of materials, mainly in the perovskite family. Permittivity measurements of electroceramic materials are the first area of interest, while ion diffusion measurements of oxygen ion conductors are the second. The nature of the database design does not restrict the type of measurements which can be stored; as the available data increase, the database may become a generic, publicly available ceramic materials resource.


Asunto(s)
Cerámica/química , Bases de Datos Factuales , Conductividad Eléctrica , Iones , Londres , Oxígeno
17.
Resuscitation ; 75(3): 460-8, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17767992

RESUMEN

AIM: To describe all patients treated for out-of-hospital cardiac arrest (OHCA) according to the Utstein criteria and their characteristics and outcome with emphasis on whether they were available for early intervention trials. DESIGN: Retrospective analysis of a study where data were collected prospectively. SETTING: The Municipality of Göteborg/Mölndal in Sweden. PATIENTS: All patients suffering from out-of-hospital cardiac arrest in the Municipality of Göteborg/Mölndal in whom cardiopulmonary resuscitation (CPR) was attempted between May 2003 and May 2005. INTERVENTIONS: Part of the study cohort, i.e. patients with a witnessed, non-traumatic, out-of-hospital cardiac arrest were distributed (cluster) to mechanical (LUCAS) or manual chest compression. RESULTS: The overall survival to discharge from hospital among the 508 patients was 8.5%. The corresponding value for non-cardiac cases was 5.1% and for cardiac cases if crew witnessed 16.1%, bystander witnessed 12.7% and non-witnessed 1.4%. Fifty-nine percent of the patients fulfilled the inclusion criteria for the trial and had no exclusion criteria and 9.7% of these survived to discharge. Ten percent of patients fulfilled the inclusion criteria but were excluded and 20.4% survived to discharge. Thirty-one percent of patients did not fulfil the inclusion criteria and 2.5% survived. Among patients included in the LUCAS group, many of the survivors, 10/13 (77%), experienced a rapid return of spontaneous circulation (ROSC) before the application of the device. CONCLUSION: Among patients with OHCA in whom CPR was started 8.5% survived to hospital discharge and 59% were theoretically available for an early intervention trial. These patients have a different outcome compared with patients not available. However, among those available, the majority of survivors had a rapid ROSC before the application of the intervention (LUCAS). This raises concerns about the potential for early intervention trials to improve outcome after OHCA.


Asunto(s)
Reanimación Cardiopulmonar , Servicios Médicos de Urgencia/estadística & datos numéricos , Paro Cardíaco/epidemiología , Paro Cardíaco/terapia , Masaje Cardíaco , Anciano , Anciano de 80 o más Años , Reanimación Cardiopulmonar/métodos , Ensayos Clínicos como Asunto , Estudios de Factibilidad , Femenino , Masaje Cardíaco/métodos , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Estudios Prospectivos , Estudios Retrospectivos
18.
Respiration ; 74(2): 196-201, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17108670

RESUMEN

BACKGROUND: Various formulations of nicotine replacement therapy are commercially available. OBJECTIVES: It was the aim of this study to test preference, safety and efficacy of a new nicotine mouth spray (1 mg/actuation; NicoNovum). METHODS: One hundred healthy smokers wanting to quit (mean age 43.1 +/- 11.2 years) were included. They were given the mouth spray, as well as 2-mg nicotine gums and nicotine oral inhalers to try out for 1 week. Subsequently, all participants were randomized into 3 groups - mouth spray (n = 50), gum (n = 25) and inhaler (n = 25) - and treated for 3 months. RESULTS: Fifty-four of the hundred smokers preferred the spray, compared with 28 and 18 who preferred the gum and inhaler, respectively (p < 0.01 for spray vs. both the gum and inhaler). At 6 months, the sustained abstinence rates were 8 (16%), 5 (20%) and 2 (8%) for the mouth spray, gum and inhaler, respectively (p values = n.s.). Adverse effects (AEs) were mostly drug-related local symptoms, most frequently reported at the end of the tryout period: out of 106 drug-related AEs, 90 were due to the spray, 11 and 5 to the inhaler and gum, respectively. The three most frequent AEs were almost exclusively caused by the spray: burning of the tongue/throat reported by 35, nausea by 18, and hiccup by 16 participants. CONCLUSIONS: Participants preferred the mouth spray over the gum and inhaler, but its use was coupled with a high rate of local AEs. The efficacy of the mouth spray seemed comparable with the one obtained by the gum and inhaler. Further studies are necessary to show whether a reduction in the dose per actuation to about 0.5 mg would result in less side effects, which in turn might yield higher long-term drug compliance and possibly higher success rates than the ones achieved with other forms of nicotine replacement therapy.


Asunto(s)
Nicotina/administración & dosificación , Agonistas Nicotínicos/administración & dosificación , Cese del Hábito de Fumar/métodos , Administración por Inhalación , Administración Tópica , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Boca , Proyectos Piloto , Resultado del Tratamiento
19.
Resuscitation ; 72(2): 264-9, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17113208

RESUMEN

INTRODUCTION: Construction of an effective in-hospital resuscitation programme is challenging. To document and analyse resuscitation skills assessment must provide reliable data. Benchmarking with a hospital having documented excellent results of in-hospital resuscitation is beneficial. The purpose of this study was to assess the resuscitation skills to facilitate construction of an educational programme. MATERIALS AND METHODS: Nurses working in a university hospital Jorvi, Espoo (n=110), Finland and Sahlgrenska University Hospital, Göteborg (n=40), Sweden were compared. The nurses were trained in the same way in both hospitals except for the defining and teaching of leadership applied in Sahlgrenska. Jorvi nurses are not trained to be, nor do they act as, leaders in a resuscitation situation. Their cardiopulmonary resuscitation (CPR) skills using an automated external defibrillator (AED) were assessed using Objective Structured Clinical Examination (OSCE) which was build up as a case of cardiac arrest with ventricular fibrillation (VF) as the initial rhythm. The subjects were tested in pairs, each pair alone. Group-working skills were registered. RESULTS: All Sahlgrenska nurses, but only 49% of Jorvi nurses, were able to defibrillate. Seventy percent of the nurses working in the Sahlgrenska hospital (mean score 35/49) and 27% of the nurses in Jorvi (mean score 26/49) would have passed the OSCE test. Statistically significant differences were found in activating the alarm (P<0.001), activating the AED without delay (P<0.01), setting the lower defibrillation electrode correctly (P<0.001) and using the correct resuscitation technique (P<0.05). The group-working skills of Sahlgrenska nurses were also significantly better than those of Jorvi nurses. CONCLUSIONS: Assessment of CPR-D skills gave valuable information for further education in both hospitals. Defining and teaching leadership seems to improve resuscitation performance.


Asunto(s)
Reanimación Cardiopulmonar/educación , Desfibriladores , Cardioversión Eléctrica , Liderazgo , Enfermeras y Enfermeros , Enseñanza , Evaluación Educacional , Finlandia , Humanos , Suecia
20.
Appl Radiat Isot ; 60(6): 863-77, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15110352

RESUMEN

Radioactive xenon monitoring is one of the main technologies used for the detection of underground nuclear explosions. Precise and reliable measurements of (131m)Xe, (133g)Xe, (133m)Xe, and (135g)Xe are required as part of the International Monitoring System for compliance with the Comprehensive Nuclear-Test-Ban Treaty (CTBT). For the first time, simultaneous testing of four highly sensitive and automated fieldable radioxenon measurement systems has been performed and compared to established laboratory techniques. In addition to an intercomparison of radioxenon monitoring equipment of different design, this paper also presents a set of more than 2000 measurements of activity concentrations of radioactive xenon made in the city of Freiburg, Germany in 2000. The intercomparison experiment showed, that the results from the newly developed systems agree with each other and the equipment fulfills the fundamental requirements for their use in the verification regime of the CTBT. For 24-h measurements, concentrations as low as 0.1 mBqm(-3) were measured for atmospheric samples ranging in size from 10 to 80 m(3). The (133)Xe activity concentrations detected in the ambient air ranged from below 1 mBqm(-3) to above 100 mBqm(-3).


Asunto(s)
Contaminantes Radiactivos del Aire/análisis , Monitoreo de Radiación/métodos , Radioisótopos de Xenón/análisis , Cooperación Internacional , Energía Nuclear , Monitoreo de Radiación/instrumentación , Reproducibilidad de los Resultados
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