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To compare intraosseous access with peripheral venous access on adults out-of-hospital cardiac arrest (OHCA) patients’ clinical outcomes. A national retrospective multicentre study was conducted based on the French National Cardiac Arrest Registry. Comparison of patients (intraosseous vs. peripheral venous access) was conducted before and after a matching using a propensity score. The propensity score included confounding factors: age, time between the call (T0) to epinephrine (to take account of how quickly vascular access was achieved), the aetiology of OHCA, the shock and the patient initial rhythm at MMT arrival. A total of 1576 patients received intraosseous access, and 27,280 received peripheral intravenous access. Before matching, OHCA patients with intraosseous access were less likely to survive at all stages (return of spontaneous circulation (ROSC), 0-day survival and 30-day survival). No significant difference in neurological outcome was observed. After propensity score matching, no significant differences in 30-day survival rates (OR = 0.763 [0.473;1.231]) and neurological outcome (OR = 1.296 [0.973;1.726]) were observed. However, intraosseous patients still showed lower likelihood of short-term survival (ROSC and 0-day survival) even after propensity score matching was implemented. The populations we investigated were similar to those of other studies suggesting that intraosseous access is associated with reduced survival and poorer neurological outcome. Our findings suggest that intraosseous access is a comparably effective alternative to peripheral intravenous access for treating OHCA patients on matched populations.

Background The COVID-19 outbreak requires a permanent adaptation of practices. Cardiopulmonary resuscitation (CPR) is also involved and we evaluated these changes in the management of out-of-hospital cardiac arrest (OHCA). Methods OHCA of medical origins identified from the French National Cardiac Arrest Registry between March 1st and April 31st 2020 (COVID-19 period), were analysed. Different resuscitation characteristics were compared with the same period from the previous year (non-COVID-19 period). Results Overall, 1005 OHCA during the COVID-19 period and 1620 during the non-COVID-19 period were compared. During the COVID-19 period, bystanders and first aid providers initiated CPR less frequently (49.8% versus 54.9%; difference, − 5.1 percentage points [95% CI, − 9.1 to − 1.2]; and 84.3% vs. 88.7%; difference, − 4.4 percentage points [95% CI, − 7.1 to − 1.6]; respectively) as did mobile medical teams (67.3% vs. 75.0%; difference, − 7.7 percentage points [95% CI, − 11.3 to − 4.1]). First aid providers used defibrillators less often (66.0% vs. 74.1%; difference, − 8.2 percentage points [95% CI, − 11.8 to − 4.6]). Return of spontaneous circulation (ROSC) and D30 survival were lower during the COVID-19 period (19.5% vs. 25.3%; difference, − 5.8 percentage points [95% CI, − 9.0 to − 2.5]; and 2.8% vs. 6.4%; difference, − 3.6 percentage points [95% CI, − 5.2 to − 1.9]; respectively). Conclusions During the COVID-19 period, we observed a decrease in CPR initiation regardless of whether patients were suspected of SARS-CoV-2 infection or not. In the current atmosphere, it is important to communicate good resuscitation practices to avoid drastic and lasting reductions in survival rates after an OHCA.

Metabolic syndrome (MetS) is increasingly reported in children, mainly in the presence of overweight/obesity. From the most recent report, up to 60% of overweight and obese children can be affected by this syndrome. MetS acquired during childhood has been shown to track into adulthood, including its clinical complications, such as type 2 diabetes and cardiovascular diseases. Among the practical preventive and therapeutic measures to be taken in children, physical activity (PA) appears to be at least as efficient as the most adequate pharmacology. The current literature suggests that exercise programs based either on aerobic-or resistance-type exercises, or a combination of these 2 types of structured activity, may promote insulin sensitivity and weaken or suppress MetS in children. Furthermore, daily-living activities such as brisk walking were found to substantially reduce the risk of MetS among children. Regardless of their weight status, PA needs to be promoted among children as early as possible.

This study was designed to examine the hourly variation in and the interplay between physical activity and sedentary behavior (SB) in order to highlight key time periods for physical activity interventions for children. Data for physical activity and SB obtained with ActiGraph in 56 boys and 47 girls aged from 8 to 11 years. These data were divided into sixty minute-time samples for moderate-to-vigorous physical activity (MVPA) and SB, and analyzed using a principal component analysis (PCA) and correlation statistics. The PCA provides 10 factors which account for 80.4% of the inertia. Only two of these factors did not display competition between MVPA and SB. Contrary to some reports, a coefficient of correlation of —.68 (p

Objects with icosahedral symmetry (Ih) bear a special fascination; natural examples are rare, but include radiolaria1 and virus particles (virions)2. The discovery3 of C60, a molecule in the shape of a truncated icosahedron with Ih symmetry, has aroused widespread interest. In 1962, Mackay4 described a radiating packing of spheres in Ih symmetry, in which the centres of successive shells of spheres lie on the surfaces of icosahedra. There has been extensive investigation of the conditions under which such packing might be realized in assemblies of atoms or of molecules such as C60 (ref. 5). Here we report the preparation, at high temperatures and pressures, of boron suboxide (B6O) in which the preferred form of the material is as macroscopic, near-perfect, regular icosahedra, similar to the multiply-twinned particles observed in some cubic materials. A major difference is that B6O has a rhombohedral structure that nearly exactly fits the geometrical requirements needed to obtain icosahedral twins. These icosahedral particles have a structure that can be described as a Mackay packing of icosahedral B12 units, and thus has long-ranged order without translational symmetry.

The stoichiometry of boron suboxide (B6O1-x) synthesized at high pressure lies closer to the nominal composition (x = 0) than materials obtained at atmospheric pressure. The crystallinity of materials obtained in the presence of molten B2O3 is also higher than for sintered powders. Further, for syntheses at 1700–1800 °C between 4 and approximately 5–6 GPa, the well-crystallized particles are dominated by large (up to ∼40 μm in diameter) icosahedral multiply-twinned particles. This unusual morphology is obtained by Mackay packing; i.e., by assembly of successive shells of icosahedral B12 units around a central icosahedral nucleus. The result is a multiply-twinned particle in which each of the 20 elements has the R 3 m space group of the α-B structure.

We prepared α-rhombohedral (α-rh.) B-rich materials in the B-C-N-O system at high-pressures and temperatures. Samples were synthesized using a multianvil device and characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and parallel electron energy-loss spectroscopy (PEELS). The B-C-O compounds were obtained by reducing B2O3 with B, or mixtures of B and C between 1 to 10 GPa and 1200° and 1800° C In the B-O system we synthesized boron suboxide (nominally B6O) of high purity, crystallinity, and close to stoichiometric. Quantitative analyses give B6O0.95 and B6O0.77 for high-pressure and room-pressure samples, respectively. Between 4 to 5.5 GPa, B6O formed as macroscopic near-perfect regular icosahedra (to 30 μm in diameter). In the B-C-O system, intermediate phases were prepared showing evidence of solid solution between B4C and B6O. Boron carbide crystals, to 20 μm, containing a significant amount of O, typically B6C1.1O0.33 and B6C1.28O0.31, were grown for mixtures in which B and C were reacted with excess B2O3 at 7.5 GPa and 1700 °C. We also report the first conclusive bulk synthesis of a new boron nitride, B6N1-x. This subnitride was synthesized from B and hexagonal BN at 7.5 GPa and 1700 °C. XRD and PEELS shows that the boron subnitride has the α-rh. B structure and average composition B6N0.92

A multianvil device was used to investigate the formation of BxO phases produced in the 2 to 10 GPa pressure range with temperatures between 1000 and 1800 °C.Amorphous and crystalline B and BP were oxidized using B2O3 and CrO3. Using powder X-ray diffraction and parallel electron energy-loss spectroscopy (PEELS), we were unable to detect graphitic or diamondstructured B2O, reported in previous studies. The refractory boride B6O, which has the α-rhombohedral boron structure, is the dominant suboxide in the P and T range of our investigation. PEELS with a transmission electron microscope was used to characterize the boron oxides.

We investigated whether the respiratory changes in arterial pulse pressure (ΔPP), an accurate indicator during mechanical ventilation (MV), and in arterial systolic pressure (ΔPS), easy to calculate, could predict fluid responsiveness in spontaneously breathing patients. The respiratory changes in intrathoracic pressure during spontaneous breathing, reversed compared with MV, could be insufficient to modify loading conditions of ventricles. We thus also tested those indicators during a forced respiratory cycle.