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1.
There is no better place to test life-saving resuscitation interventions than in the prehospital setting. Patients rarely survive cardiac arrest if resuscitation techniques have failed before leaving the scene. Also, paramedics are usually very experienced in key initial resuscitative techniques, and they routinely operate under strict paramilitary protocol, resulting in better study compliance. In addition, the large study populations that are derived from emergency medical services (EMS) systems lead to faster study completion and statistically stronger data. Most important, by reinforcing standardized care, rigidly scrutinized trials improve patient care, regardless of the effect of the study intervention. The success of productive EMS research centers requires routine communication between hospital and EMS administrators and their medical directors, designation of mutually acceptable data collectors who guarantee confidentiality, reciprocal exchange of study data provided as educational seminars to the hospitals, commitments to support the budget requests of an EMS program and appropriate system modifications, inclusion of EMS personnel in study design from the very beginning, prospective education of the medical community and media before protocol implementation, an authoritative grassroots medical director, and a paramedic supervisor system.  相似文献   
2.
Fetal and maternal data were monitored serially at 6 gestational ages from 20 to 38 weeks in 195 Peruvian fetuses. Digitized data included fetal heart rate and motor activity, as well as maternal heart rate and electrodermal conductance. Time series analysis evaluated the development of synchrony in 2 streams of fetal functioning and between mothers and fetuses. Intrafetal synchrony between heart rate and motor activity developed in an orderly fashion, with peak cross-correlation approaching an asymptote at 5 s at 28 weeks. Synchrony was not observed between fetal heart rate and maternal measures. Fetal motor activity exhibited synchrony with both maternal electrodermal and heart rate activity. Implications for revealing fundamental properties of neural development prior to birth are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
3.
We used a potent and specific monoclonal antibody to somatostatin to test the physiologic inhibitory role of the tetradecapeptide somatostatin on pancreatic secretion. Somatostatin immunoneutralization increased both the total amylase and volume of pancreatic secretion. Cholecystokinin-A receptor antagonism abolished the stimulatory effect of somatostatin immunoneutralization. We conclude that somatostatin tonically inhibits, pancreatic secretion in fasted rats via inhibition of the release or action of cholecystokinin. Furthermore, the source of these peptides is likely islet delta cells and intrapancreatic neurons, respectively.  相似文献   
4.
The world is on the verge of a major antibiotic crisis as the emergence of resistant bacteria is increasing, and very few novel molecules have been discovered since the 1960s. In this context, scientists have been exploring alternatives to conventional antibiotics, such as ribosomally synthesized and post-translationally modified peptides (RiPPs). Interestingly, the highly potent in vitro antibacterial activity and safety of ruminococcin C1, a recently discovered RiPP belonging to the sactipeptide subclass, has been demonstrated. The present results show that ruminococcin C1 is efficient at curing infection and at protecting challenged mice from Clostridium perfringens with a lower dose than the conventional antibiotic vancomycin. Moreover, antimicrobial peptide (AMP) is also effective against this pathogen in the complex microbial community of the gut environment, with a selective impact on a few bacterial genera, while maintaining a global homeostasis of the microbiome. In addition, ruminococcin C1 exhibits other biological activities that could be beneficial for human health, as well as other fields of applications. Overall, this study, by using an in vivo infection approach, confirms the antimicrobial clinical potential and highlights the multiple functional properties of ruminococcin C1, thus extending its therapeutic interest.  相似文献   
5.
Context: Prompt injection of epinephrine (adrenaline) from epinephrine auto-injectors (EAIs) is the primary treatment for anaphylaxis in out-of-hospital settings. Storage of EAIs at room temperature (25?°C) is advised; however, storage at excessively high temperatures sometimes occurs. To our knowledge, there are no previous publications on the doses of epinephrine ejected from EAIs after storage at such temperatures.

Objective: We examined the epinephrine doses delivered from activated EAIs stored constantly or cyclically at 70?°C.

Methods: Twenty-five in-date EAIs were stored constantly or cyclically at 70?°C (excessive heat) or 25?°C (controls) for 5?d or 10?d. EAIs were activated and the epinephrine doses in the ejected solutions were measured using HPLC-UV. The enantiomeric purity of epinephrine was also measured by HPLC-UV.

Results: Control EAIs ejected a volume of 0.300?±?0.006?mL containing 103.7?±?3.3% of labeled dose (LD). After 5?d or 10?d of constant storage at 70?°C and activation at 70?°C, EAIs ejected a volume of 0.367?±?0.008?mL containing 96.8?±?3.8% LD and 0.373?±?0.007?mL containing 77.7?±?3.3% LD, respectively. After 5?d of cyclic storage at 70?°C and cooling to 25?°C before activation, EAIs ejected a volume of 0.311?±?0.008?mL containing 87.2?±?1.9% LD. Under the experimental conditions of this study, the resultant chromatographic peaks of epinephrine solutions from all EAIs represented only the pure l-enantiomer of epinephrine.

Conclusion: EAIs should be stored under recommended conditions of the manufacturer. EAIs stored at excessively high temperatures cannot be used to treat humans while still hot, and when cooled, cannot be relied on to deliver the labeled epinephrine dose in anaphylaxis.  相似文献   
6.
Summary The configurational analysis of racemic and optically active stereoisomers of 4-[(1-methylpropyl)oxycarbonyl]-2-oxetanone has been carried out by using chiral gas chromatography. This technique has been successful in the stereoisomers composition determination of these -substituted -lactones prepared by two different routes and used as monomers in the preparation of malic acid stereocopolymers. Result are in good agreement with those obtained from high resolution 1H NMR, in the presence of an Europium salt, as chiral shift reagent. This method has been extended to 3-methyl-4-[(1,2,2-trimethyl propyl)oxycarbonyl]-2-oxetanone. The exact knowledge of precursors configurational structure is very important in regard to the obtention of the corresponding polystereoisomers with a strictly controlled enantiomeric or diastereoisomeric composition and consequently with predictable properties.  相似文献   
7.
Identifying the Cost-To-Serve (CTS) of customers is one of the most challenging problems in Supply Chain Management because of the diversity in their business activities. For the particular case of the industrial gas business, we are interested in predicting the cost to deliver bulk (liquefied) gas to new customers using a multifactor linear regression model. Developing a single model, i.e. analyzing the observations all at once, produces poor prediction results. Therefore prior to the regression analysis, a new supervised learning technique is used to group customers who are similar in some sense. Classes of customers are represented by hyper-boxes and a linear regression model is subsequently built within each class. The combination of data classification and regression is proven to increase the accuracy of the prediction.Two Mixed-Integer-Linear Programming (MILP) models are developed for data classification purposes. Although we are dealing with a supervised learning method, classes are not predefined in our case. Rather, we input a continuous “classification” attribute that is optimally discretized by the MILP’s in order to minimize the number of misclassifications. Therefore our data classification model offers a broader range of applications. A number of illustrative examples are used to prove the effectiveness of the proposed approach.  相似文献   
8.
In spite of the efforts by government agencies, labor organizations, and researchers in the field of health and safety, injuries and fatalities continue to affect the construction industry. In 2002 the construction industry had the undesirable distinction of having two of the most dangerous occupations in the United States, with fatalities among structural steel workers at 58.2 per 100,000 workers (fourth highest rate) and among construction laborers at 27.7 per 100,000 workers (ninth highest rate). Costs associated with construction accidents, such as increased insurance premiums and medical expenses, and loss of productivity are also concerns in the industry. It has not been demonstrated how unsafe working conditions affect worker performance, and the impact of unsafe work practices on worker performance has not been quantified. This paper describes a methodology that included direct observation of steel erection activities and statistical analysis of task duration data. The data collected at steel erection sites included safety conditions such as the use of personal protective equipment (PPE), elevation of the work area, environmental conditions such as temperature and humidity, and worker performance in the form of task durations. Analysis of variance (ANOVA) analysis of 186 of steel erection task durations collected over a six-month period showed that the use of personal protective equipment (PPE), the time of day during which the operation was being performed, the elevation at which the work was being performed, and the presence of decking below the work area had statistically significant effects on the durations of steel erection tasks.  相似文献   
9.
In this paper, our concern is with deforestation as a global environmental issue. Foreign transfers from developed or Northern countries to developing or Southern countries have been proposed to deal with that issue. We use a Stackelberg differential game approach where the two players are: a donor community (the leader) and a recipient country (the follower). We study the impact of different specifications for the transfer function, related to the different information structures the players can consider when playing the Stackelberg game. The different scenarios are compared both from the environmental and economic points of view.  相似文献   
10.
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