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%.
Crack-free AlGaN/GaN high-electron-mobility transistors (HEMTs) grown on a 200 mm Si substrate by metal–organic chemical vapor deposition (MOCVD) is presented. As grown epitaxial layers show good surface uniformity throughout the wafer. The AlGaN/GaN HEMT with the gate length of 1.5 µm exhibits a high drain current density of 856 mA/mm and a transconductance of 153 mS/mm. The 3.8-µm-thick device demonstrates a high breakdown voltage of 1.1 kV and a low specific on-resistance of 2.3 mΩ cm2 for the gate–drain spacing of 20 µm. The figure of merit of our device is calculated as 5.3×108 V2 Ω-1 cm-2.
We report recessed-gate Al2O3/AlGaN/GaN normally-OFF metal–oxide–semiconductor high-electron-mobility transistors (MOS-HEMTs) on 8 in. Si. The MOS-HEMTs showed a maximum drain current of 300 mA/mm with a high threshold voltage of +2.4 V. The quite low subthreshold leakage current (∼10−8 mA/mm) yielded an excellent ON/OFF current ratio (9 × 108) with a small, stable subthreshold slope of 74 mV/dec. An atomic-layer-deposited Al2O3 layer effectively passivates, as no significant drain current dispersions were observed. A high OFF-state breakdown voltage of 825 V was achieved for a device with a gate-to-drain distance of 20 µm at a gate bias of 0 V.
X-ray crystal analysis for d-psicose (C3-position epimer of d-fructose) crystallized from aqueous solution was successfully performed for the first time. It was confirmed that d-psicose crystallized solely as β-d-pyranose with 1C (1C4 (d)) conformation. The crystal system (orthorhombic), space group (#19, P212121), and number of molecules per unit cell (Z = 4) are the same as those for β-d-fructopyranose, α-l-sorbopyranose, and α-d-tagatopyranose. Solubility of d-psicose at 25 °C was 291 g per 100 g water. Mutarotation was further investigated recording the time course of specific rotation [α] at 589 nm after the dissolution of d-psicose in water. It is thought that [α] for β-d-psicopyranose in water may be ca. −85 deg dm−1 g−1 cm3. The time course of absorbance at 280 nm after the dissolution of d-psicose was also measured to see the development of open-chain carbonyl-form in the solution, and the first-order kinetic behavior with the rate constant k = 4.44 ms−1 was confirmed. Assuming the equilibrium content of carbonyl-form of d-psicose as 0.2%, the molar absorption coefficient, ε, for the carbonyl-form was estimated to be 160 cm−1 M−1.
Simultaneous detection of vertical and lateral forces at nanoscale by atomic force microscopy (AFM) provides important knowledge in nanotribology. Although silicon (Si) cantilevers are capable of detecting both the forces, it has not been achieved by quartz tuning fork (QTF) sensors including qPlus sensors. In this study, we found that the tip apex of the qPlus sensor with a long tip oscillates vertically at the lowest resonance frequency (ƒ1) and laterally at the second lowest resonance frequency (ƒ2) by the finite element method (FEM) simulation. The lateral oscillation was experimentally confirmed by atomic resolution imaging, where the imaged atoms were apparently connected as increasing the oscillating amplitude at ƒ2. We also demonstrated the nanometer-scale friction force measurement by using the developed bimodal AFM. The obtained result was in good agreement with the contact-mode lateral force microscopy utilizing a Si cantilever.
Water-in-salt electrolytes (WiSEs), which contain salt with extremely high concentration (>20 mol kg−1), are attracting much interest as new electrolytes for energy storage systems, especially for lithium-ion batteries (LIBs), because they are considered to be suitable for developing safer systems. Structural analysis on WiSE/solid interfaces would provide beneficial information for developing LIBs. Whereas the interfacial structures of diluted aqueous electrolytes (less than 1 mol kg−1) have been intensively studied by high-resolution atomic force microscopy (AFM), those of WiSEs have not. In this study, we demonstrated AFM investigations on WiSE/mica interfaces, where FM-AFM utilizing a quartz tuning fork sensor was used. We studied the surface topography on atomic resolution and the interfacial solvation structure by frequency shift (Δf)–distance curve measurement and two-dimensional Δf mapping. In addition, we investigated the salt molality dependence of the solvation structure and compared the AFM results with Raman spectra.
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