Background The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.
An experimental investigation is described of the velocity field in a steady, spillingtype breaker, generated on a steady current by a submerged hydrofoil. Velocities have been measured with a laser–doppler system, and analysed with respect to mean and r.m.s. values as well as Reynolds stresses. The results indicate that the turbulent flow field downstream of the initiation of the separation at the surface resembles that in a self-similar turbulent wake.
The ultimate degradation (i.e. complete mineralization) of biodegradable polymers proceeds through hydrolysis to the production of degradation intermediates (primary degradation) that are then taken into the microbial cell and further degraded to CO2 and water. We first isolated thermophilic actinomycete (Streptomyces thermonitrificans PDS‐1), which has the activity of ultimate degradability, from compost in which poly‐ɛ‐caprolactone (PCL) degraded vigorously. We next tried to investigate the detailed mechanisms of degradation of the PCL in compost by developing a new experimental method in which isolated microorganisms are used to inoculate sterilized compost raw materials containing PCL. It was confirmed that the ultimate degradation of PCL could not be achieved by the action of the strain PDS‐1 alone, and that a supplementary microorganism (Bacillus licheniformis HA1) isolated from compost utilizes the degradation intermediates and also increases the activity of the other primary microorganism (PDS‐1) by adjusting the pH. We could thus show experimental proof of synergy between two thermophiles in the ultimate degradation of a biodegradable polymer in compost.
Fukuoka District Meteorological Observatory has continued seismic observations at Satsuma-Iojima volcano since September 1997. Of the daily number of seismic events at the volcano, which sometimes exceeded 100, several different types have been observed. Hypocenters of A-type earthquakes mostly existed in a shallow area within the volcanic island. Numerous peculiar earthquakes that have waveforms different from usual volcanic earthquakes were observed with the ascent of seismic activity. They have an emergent phase that precedes the appearance of the high-amplitude main phase by 5-8 seconds and consists of weak seismic waves increasing gradually in amplitude. This type of earthquakes is considered to be excited by a bubbling of gas and a succeeding shear fracture within the highly viscous rhyolitic magma.
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