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%.
The formation mechanism of drawing-induced E′ centers in silica optical fibers is clarified by analyzing the thermodynamic behavior of point defects during the drawing process. The E′ center concentration in the fibers is given by nd=np exp(−Ef/kTd−A/V1), where Td is the drawing temperature, V1 the drawing speed, and A a constant. The formation energy Ef is 3.8 eV while the precursor concentration np is 7×1022 g−1. The E′ center concentration at the fiber surface is greater than that at the center because of the transverse difference in the quenching rate during the drawing process. The annealing behavior of the E′ center concentration is expressed as nd(t)=nd(0)exp[−νt exp(−Ed/kTa)], where Ta is the annealing temperature. The activation energy for the motion of the E′ centers Ed is 0.2 eV while the frequency factor ν is 8×10−3 sec.−1.
This paper presents a study on drawing condition dependences of optical absorption at 630 nm and nonbridging oxygen hole centers (NBOHCs) in optical fibers drawn from low-OH-content synthetic silica glass. The intensity of the 630-nm absorption is proportional to the NBOHC concentration, and the value of the oscillator strength for the NBOHC is 4.2×10−4, which nearly equals the theoretical values. These results confirm that the 630-nm absorption is due to the NBOHCs in low-OH-content silica glass. Furthermore, the 630-nm absorption increases with increasing drawing tension. This drawing tension dependence is explained by applying kinetics of the stress-induced crack growth in metal to the formation of the NBOHCs in the drawing process.
Phase transformation of amorphous-silicon during millisecond annealing using micro-thermal-plasma-jet irradiation was directly observed using a high-speed camera with microsecond time resolution. An oval-shaped molten-silicon region adjacent to the solid phase crystallization region was clearly observed, followed by lateral large grain growth perpendicular to a liquid-solid interface. Furthermore, leading wave crystallization (LWC), which showed intermittent explosive crystallization, was discovered in front of the moving molten region. The growth mechanism of LWC has been investigated on the basis of numerical simulation implementing explosive movement of a thin liquid layer driven by released latent heat diffusion in a lateral direction.
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