ライフサイエンスコーパス: resuscitation

1 uced to 30 mm Hg for 90 minutes, followed by resuscitation.

2 me points spanning baseline, hemorrhage, and resuscitation.

3 ohol intoxication plus hemorrhagic shock and resuscitation.

4 ation; and 3) fully autonomous (closed loop) resuscitation.

5 minutes of untreated arrest was followed by resuscitation.

6 y failure and extracorporeal cardiopulmonary resuscitation.

7 unction were monitored during hemorrhage and resuscitation.

8 412 underwent extracorporeal cardiopulmonary resuscitation.

9 nate (2.4 or 4.8 mg/kg i.v.) or vehicle upon resuscitation.

10 of hemorrhagic shock in the absence of fluid resuscitation.

11 of two clinical trials of early septic shock resuscitation.

12 and were significantly increased under bolus resuscitation.

13 defibrillation as compared with no bystander resuscitation.

14 thcare providers who perform cardiopulmonary resuscitation.

15 likely to receive bystander cardiopulmonary resuscitation.

16 less ventricular tachycardia [VF/VT]) during resuscitation.

17 lood pressure less than 90 mm Hg after fluid resuscitation.

18 shock, and 3) extracorporeal cardiopulmonary resuscitation.

19 was monitored for additional 3.5 h following resuscitation.

20 fter more than 30 minutes of cardiopulmonary resuscitation.

21 uced to 30 mm Hg for 90 minutes, followed by resuscitation.

22 w these components determine teamwork during resuscitation.

23 30 minutes of extracorporeal cardiopulmonary resuscitation.

24 subjected to cardiac arrest/cardiopulmonary resuscitation.

25 t from RBC transfusion during cardiovascular resuscitation.

26 nate (2.4 or 4.8 mg/kg i.v.) or vehicle upon resuscitation.

27 al units), started as soon as possible after resuscitation.

28 6 suffered blunt injuries and required rapid resuscitation.

29 0 (0-0)] (P = 0.041) in the first 2 hours of resuscitation.

30 xygenation monitoring during cardiopulmonary resuscitation.

31 in the control group 1 h after the start of resuscitation.

32 tems and compare them to formula-based bolus resuscitation.

33 adult porcine model of hemorrhagic shock and resuscitation.

34 y to use vasopressors or fluids during usual resuscitation.

35 ower than those associated with no bystander resuscitation.

36 ardiac arrest, untreated cardiac arrest, and resuscitation.

37 e the de novo protein synthesis required for resuscitation.

38 Experimental human hemorrhage and resuscitation.

39 rmance which may improve future education in resuscitation.

40 experimental cardiac arrest/cardiopulmonary resuscitation: 1) continuous hypertonic saline therapy m

41 sure initially decreased further under bolus resuscitation (-10 mm Hg; p < 0.001) and was lower under

42 , plasma volume, extravascular volume (bolus resuscitation: 17 +/- 4 mL/kg, decision assist: 3 +/- 1

43 Colloid osmotic pressure (bolus resuscitation: 19.3 +/- 2 mm Hg, decision assist, closed

44 cardiac arrest to assist in cardiopulmonary resuscitation (1B-2C depending on rhythm), status in acu

45 lar (RV) infarct (1C), the efficacy of fluid resuscitation (1C) and inotropic therapy (2C), presence

46 me on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid

47 ge, the total amount of infused fluid (bolus resuscitation: 30 mL/kg, decision assist: 5.6 +/- 3 mL/k

48 a had a higher prevalence of seizures during resuscitation (31.4 vs 9.7%; p = 0.002).

49 Postshock resuscitation (48 hr) comprised retransfusion of shed bl

50 tation than closed loop at 20 minutes (bolus resuscitation: 57 +/- 2 mm Hg, closed loop: 69 +/- 4 mm

51 subjected to cardiac arrest/cardiopulmonary resuscitation, 7.5% hypertonic saline treatment did not

52 ndpoint was survival to the end of 60 min of resuscitation, a simulated prehospital phase.

53 model stratified patients immediately after resuscitation according to risk of a circulatory-etiolog

54 Decision-assist and closed-loop resuscitation algorithms are promising technological sol

55 nty-level rates of bystander cardiopulmonary resuscitation and automated external defibrillator use w

56 he lowest rates of bystander cardiopulmonary resuscitation and automatic external defibrillation use

57 etween bystander treatments (cardiopulmonary resuscitation and automatic external defibrillation) and

58 Variability in fluid resuscitation and difficulty recognizing early sepsis ar

59 Consensus protocols for initial burn resuscitation and early sepsis recognition and treatment

60 Importance: The 2015 cardiopulmonary resuscitation and emergency cardiovascular care guidelin

61 d 1 pediatric Consensuses on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science

62 f International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science

63 iation Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care." Two de

64 LHWs, trained in basic newborn resuscitation and in recognition and treatment (with ora

65 , evidence in support of home-based neonatal resuscitation and infection management is mixed.

66 vorable conditions for the avoidance of over-resuscitation and its adverse clinical sequelae.

67 d male rescuers in regard to cardiopulmonary resuscitation and leadership performance.

68 of adding training in neonatal bag and mask resuscitation and oral antibiotic therapy for suspected

69 ication of patients with septic shock, 2) a "resuscitation and stabilization bundle" to help adherenc

70 To describe patient experiences of trauma resuscitation and to identify opportunities to improve p

71 speaking patients who had experienced trauma resuscitation and were clinically stable with no alterat

72 ent (IE) counts, estimated blood loss, fluid resuscitation, and blood transfusions.

73 ogy of SCD and to strategies for prevention, resuscitation, and identification of those at greatest r

74 the use of positive inotropic agents, volume resuscitation, and pacing.

75 osteroid and antihistamine infusions, volume resuscitation, and salbutamol sulfate inhalation, which

76 ver, contrary to expectation, protocol-based resuscitation appeared to be superior in patients with l

77 However, the consequences of under-resuscitation are not well-studied.

78 re workers' knowledge and skills in neonatal resuscitation as long as 12 months after introduction.

79 here were 4 precipitous deaths (7%), despite resuscitation at presentation.

80 within the same minute (ie, still receiving resuscitation) based on a time-dependent propensity scor

81 within the same minute (ie, still receiving resuscitation) based on a time-dependent propensity scor

82 eams in their native pediatric or general ED resuscitation bays caring for a series of 3 simulated cr

83 ence or outcome of bystander cardiopulmonary resuscitation (BCPR) in children 18 years and younger.

84 disease (odds ratio, 1.99), cardiopulmonary resuscitation before ICU admission (odds ratio, 1.63), I

85 were age (odds ratio, 1.02), cardiopulmonary resuscitation before ICU admission (odds ratio, 1.90), I

86 tion greater than 50% during cardiopulmonary resuscitation best predicted cerebral performance catego

87 during the last 5 minutes of cardiopulmonary resuscitation best predicted the return of spontaneous c

88 In comparison with formula-based bolus resuscitation, both semiautonomous and autonomous approa

89 Compliance with resuscitation bundle elements was significantly improved

90 m antiinfective therapy, and compliance with resuscitation bundle elements.

91 evere sepsis and septic shock focused on the resuscitation bundle on 90-day mortality.

92 uality improvement initiative focused on the resuscitation bundle was associated with increased compl

93 In addition, compliance with the resuscitation bundle was worse in those undergoing sourc

94 e greater severity and worse compliance with resuscitation bundles, mortality was lower in septic pat

95 ion, but FIO2, 1.0), "hypothermia" (standard resuscitation, but core temperature 34 degrees C), or "c

96 gen saturation > 90%), "hyperoxia" (standard resuscitation, but FIO2, 1.0), "hypothermia" (standard r

97 , and control extracorporeal cardiopulmonary resuscitation (c-ECPR), which did not receive streptokin

98 We examined whether resuscitation care and outcomes vary by the racial compo

99 ished an in vivo model of cardiac arrest and resuscitation, characterized the biology of the associat

100 ues were lower in the hyperoxia group during resuscitation coinciding with significantly improved ren

101 ensus process, endorsed by the international resuscitation community, to facilitate and structure res

102 tality during extracorporeal cardiopulmonary resuscitation compared with normoxia (odds ratio, 1.77;

103 mes but are not influenced by protocol-based resuscitation compared with usual care.

104 given minute during the first 15 minutes of resuscitation, compared with no intubation during that m

105 when the International Liaison Committee on Resuscitation completes a literature review based on new

106 t Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care fo

107 temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation f

108 in the United States receive cardiopulmonary resuscitation (CPR) annually.

109 Bystander-initiated cardiopulmonary resuscitation (CPR) increases patient survival after out

110 On the basis of laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult dat

111 cording to whether bystander cardiopulmonary resuscitation (CPR) or defibrillation was performed and

112 Cardiopulmonary resuscitation (CPR) training in high schools is required

113 ation and circulation during cardiopulmonary resuscitation (CPR).

114 osporine A in Out-of-Hospital Cardiac Arrest Resuscitation [CYRUS]).

115 e, at the end of shock and every 12 hours of resuscitation, datasets comprising hemodynamics, calorim

116 is potentially reversible by cardiopulmonary resuscitation, defibrillation, cardioversion, cardiac pa

117 ied patients who received large-volume fluid resuscitation, defined as greater than 60 mL/kg over a 2

118 ession models tested the association between resuscitation duration and survival with favorable outco

119 Distribution of cardiopulmonary resuscitation duration differed by outcome (P<0.00001).

120 We estimated the impact of resuscitation duration on the probability of favorable f

121 For cardiopulmonary resuscitation duration up to 37.0 minutes (95% confidenc

122 Shorter resuscitation duration was associated with likelihood of

123 confidence interval, 0.95-0.99) covariates, resuscitation duration was associated with survival to d

124 Subject accrual was plotted as a function of resuscitation duration, and the dynamic probability of f

125 of 0 to 3 at discharge declined over elapsed resuscitation duration, but subjects with initial shocka

126 Although extracorporeal cardiopulmonary resuscitation (E-CPR) can result in survival after faile

127 Treatment modalities were compared based on resuscitation efficacy and efficiency.

128 (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically bee

129 Association of resuscitation efforts with survival and neurological out

130 Despite resuscitation efforts, the patient died.

131 nd dispatcher-assisted guidance of bystander resuscitation efforts.

132 n particular, measurement of cardiopulmonary resuscitation elements and neurological outcomes reporti

133 The relative incidence of cardiopulmonary resuscitation events was higher for cardiac patients com

134 ics, injury-related scores, prehospital, and resuscitation events were analyzed.

135 ce of the International Liaison Committee on Resuscitation evidence review.

136 Fluid resuscitation following hemorrhagic shock is often probl

137 Animals received manual cardiopulmonary resuscitation for 10 minutes before the first defibrilla

138 t followed by extracorporeal cardiopulmonary resuscitation for 6 hours.

139 d to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia,

140 The right ventricle was dilated during resuscitation from cardiac arrest caused by hypovolemia,

141 t the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary em

142 uidelines for reporting data from studies of resuscitation from drowning.

143 ted in scientific articles on the subject of resuscitation from drowning.

144 in-vivo marker of mitochondrial injury after resuscitation from heart failure and chemotherapy.

145 stigation of the effects of hyperoxia during resuscitation from hemorrhagic shock in swine with preex

146 Hyperoxia during resuscitation from hemorrhagic shock in swine with preex

147 l hours after out-of-hospital cardiac arrest resuscitation, function scores at hospital discharge and

148 to intensive care who required acute volume resuscitation, goal-directed therapy guided by assessmen

149 Influence of cardiopulmonary resuscitation guidelines on nationwide survival after IC

150 0 American Heart Association cardiopulmonary resuscitation guidelines on survival.

151 International resuscitation guidelines recommend targeted temperature

152 ts for 2 process-of-care measures in current resuscitation guidelines.

153 trends before and after 2010 cardiopulmonary resuscitation guidelines.

154 rvival before and after 2010 cardiopulmonary resuscitation guidelines.

155 Heart Association's Get With the Guidelines-Resuscitation (GWTG-R) program, we analyzed 35283 patien

156 Although balanced resuscitation has become integrated into massive transfu

157 Hemostatic resuscitation has been shown to be beneficial for patien

158 The International Liaison Committee on Resuscitation has initiated a near-continuous review of

159 r knowledge, patients' experiences of trauma resuscitation have not been explored.

160 lower than that associated with no bystander resuscitation (hazard ratio, 0.62; 95% confidence interv

161 4,710 patients receiving large-volume fluid resuscitation, hyperchloremic acidosis was documented in

162 val trends after in-hospital cardiopulmonary resuscitation (ICPR) for cardiac arrest in nonelderly ad

163 siveness with standard care for acute volume resuscitation in adults admitted to the ICU.

164 dy was to describe variations in blood-based resuscitation in an injured cohort.

165 are consistent with evidence that isovolemic resuscitation in enhanced recovery protocols accelerates

166 efficacy of decision-assist and closed-loop resuscitation in human hemorrhage.

167 of cardiac output produced by hemorrhage and resuscitation in large pigs, noninvasive cardiac output

168 ed to notable changes in the volume of fluid resuscitation in patients with heart failure and/or kidn

169 immediately after successful cardiopulmonary resuscitation in patients without ST-segment-elevation m

170 To identify whether ratio-based resuscitation in patients without trauma is associated w

171 es in patients receiving balanced fluids for resuscitation in pediatric severe sepsis.

172 arrest who also met criteria for continuing resuscitation in the CCL.

173 severe sepsis receiving balanced fluids for resuscitation in the first 24 and 72 hours of treatment

174 last 30 days of life, and no cardiopulmonary resuscitation in the last 30 days of life.

175 ed by the International Liaison Committee on Resuscitation in the previous year.

176 ient aspects of patient experience of trauma resuscitation included emotional responses, physical exp

177 ients and patients requiring cardiopulmonary resuscitation indicates that less invasive therapeutic o

178 toxication exacerbated hemorrhagic shock and resuscitation-induced hypotension and microvascular leak

179 l intoxication impacts hemorrhagic shock and resuscitation-induced microvascular leakage using a rat

180 uring hemorrhagic shock is a key mediator of resuscitation injury, which can be prevented by cell imp

181 Cardiopulmonary resuscitation is a lifesaving technique for victims of s

182 ause of acute kidney injury (AKI), and fluid resuscitation is a major part of therapy.

183 higher regional cerebral oxygenation during resuscitation is associated with improved return of spon

184 Restrictive resuscitation is associated with increased AKI, without

185 whether previous paramedic exposure to OHCA resuscitation is associated with patient survival.

186 cerebral oxygenation during cardiopulmonary resuscitation is associated with return of spontaneous c

187 atation on ultrasound during cardiopulmonary resuscitation is particularly associated with pulmonary

188 Therefore, following the initial fluid resuscitation, it is important to identify which patient

189 as a consequence of overly aggressive fluid resuscitation may adversely affect outcome in hemodynami

190 he right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather t

191 plained by fewer unsolicited cardiopulmonary resuscitation measures and inferior female leadership.

192 omains and fewer unsolicited cardiopulmonary resuscitation measures compared with male-only teams.

193 In separate experiments, using a fluid resuscitation model we studied mitochondrial functional

194 uids they received during large-volume fluid resuscitation multiplied by the volume of fluids.

195 rest mimics this variability as requests for resuscitation, neonatal intensive care, and surgical int

196 th new emphasis on measurement of quality of resuscitation, neurological outcomes, and deletion of da

197 citation: retransfusion of shed blood, fluid resuscitation, norepinephrine titrated to maintain mean

198 roaches were more efficient in goal-directed resuscitation of hemorrhage.

199 he activation of chemical mechanisms and the resuscitation of soil microbial processes upon rewetting

200 barriers to providing better outcomes after resuscitation of young SCD patients.

201 the 62 patients met criteria for continuing resuscitation on CCL arrival; 5 had return of spontaneou

202 ith OHCA receiving bystander cardiopulmonary resuscitation or a lay automatic external defibrillation

203 bleeding-related mortality, cardiopulmonary resuscitation, or intensive care unit admission.

204 816 adult patients with nontraumatic OHCA at Resuscitation Outcomes Consortium sites in the United St

205 8, to December 31, 2011, using data from the Resuscitation Outcomes Consortium.

206 We assessed the circumstances, resuscitation outcomes, and clinical profile of subjects

207 prevent refibrillation to ensure successful resuscitation outcomes.

208 The relative contributions of resuscitation parameters and patient characteristics wer

209 emergency medical services-initiated CPR and resuscitation, patients with home OHCA were significantl

210 le is known about the influence of gender on resuscitation performance which may improve future educa

211 le rescuers showing inferior cardiopulmonary resuscitation performance, which can partially be explai

212 is cohort study from Get With the Guidelines-Resuscitation, performed from January 1, 2000, through D

213 The association between resuscitation practices and quintiles of survival was ev

214 st varies markedly among hospitals, specific resuscitation practices that distinguish sites with high

215 logy and changing injury patterns and trauma resuscitation practices.

216 to the lack of institution-level studies of resuscitation practices.

217 more selectively in the context of improving resuscitation practices.

218 we explore the effect of unmeasured patient resuscitation preferences on issues critical for researc

219 underscore the importance of not terminating resuscitation prematurely in gasping patients and the ne

220 ferences in an acute context, such as trauma resuscitation, presents distinct challenges; however, to

221 everity of illness, previous cardiopulmonary resuscitation, previous ICU admission, metastatic diseas

222 t following implementation of a quantitative resuscitation protocol (35% vs 10%; p = 0.006).

223 s were randomized 1:1 to either (1) an early resuscitation protocol for sepsis (n = 107) that include

224 The effect of an early resuscitation protocol on sepsis outcomes in developing

225 To determine whether an early resuscitation protocol with administration of intravenou

226 Two resuscitation protocols versus usual care.

227 e to 1) assess patterns of early crystalloid resuscitation provided to sepsis and septic shock patien

228 Heart Association's Get With the Guidelines-Resuscitation registry from January 1, 2000, to December

229 within the national Get With the Guidelines-Resuscitation registry, 26183 patients successfully resu

230 2014 included in the Get With The Guidelines-Resuscitation registry, a US-based multicenter registry

231 associated with an elevated risk of newborn resuscitation (relative risk (RR) = 1.5, 99% confidence

232 g LVR, and lowered plasma lactate after full resuscitation, relative to saline.

233 ation community, to facilitate and structure resuscitation research and publication.

234 xpertise in the fields of drowning research, resuscitation research, emergency medical services, publ

235 ere randomly assigned to "control" (standard resuscitation: retransfusion of shed blood, fluid resusc

236 with the International Liaison Committee on Resuscitation's continuous evidence review process, and

237 hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based

238 During the intervening years, resuscitation science has advanced considerably, thus ma

239 ticles that will include the cardiopulmonary resuscitation science reviewed by the International Liai

240 a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year

241 Despite advances in resuscitation science, basic life support remains a crit

242 ement of hyperlactatemia, cardiac arrest and resuscitation, sepsis, reduced renal excretion, hypoxia

243 nowledge and clinical management of neonatal resuscitation (skills) of health care workers before the

244 prevented by cell impermeants in low-volume resuscitation solutions.

245 he number of patients requesting a change in resuscitation status between groups (11.2% vs 9.4%; p =

246 However, changes in resuscitation status occurred earlier and on the general

247 Documentation of resuscitation status was also greater prior to discharge

248 for Early Septic Shock) trial of alternative resuscitation strategies (two protocols vs. usual care)

249 We analyzed whether alternative resuscitation strategies affected biomarker trajectories

250 aim was to determine whether differences in resuscitation strategies affected trajectories of biomar

251 uality improvement registry, we identified 3 resuscitation strategies associated with higher hospital

252 rial found no differences across alternative resuscitation strategies in all-cause mortality.

253 d that further research to guide appropriate resuscitation strategies in nontrauma patients is warran

254 Dutch SCA victims included in the Amsterdam Resuscitation Study (ARREST).

255 rest (OHCA) is often poor, even when initial resuscitation succeeds.

256 o elimination of racial differences in acute resuscitation survival (black individuals: 44.7% in 2000

257 y elimination of racial differences in acute resuscitation survival and greater survival improvement

258 Secondary outcomes were acute resuscitation survival and postresuscitation survival.

259 such differences could be explained by acute resuscitation survival, postresuscitation survival, and/

260 sepsis patients who received cardiopulmonary resuscitation survived to discharge.

261 consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based

262 tal groups: t-extracorporeal cardiopulmonary resuscitation (t-ECPR) group, which received streptokina

263 is study was to determine if cardiopulmonary resuscitation-targeted to arterial blood pressure and co

264 Individualized goal-directed hemodynamic resuscitation targeting systolic blood pressure of 100 m

265 ns of the International Liaison Committee on Resuscitation task force members are provided in Values

266 r their framework to the group effort within resuscitation teams to discuss for the first time how th

267 mm Hg; p < 0.001) and was lower under bolus resuscitation than closed loop at 20 minutes (bolus resu

268 One hour after full resuscitation, the rats were euthanized.

269 At the third rhythm analysis during resuscitation, the right ventricle diameter was 32 mm (9

270 of hemorrhagic shock in the absence of fluid resuscitation; therefore DCA may be a good candidate in

271 greater than or equal to 60% cardiopulmonary resuscitation time with regional cerebral oxygenation gr

272 during the first minutes of cardiopulmonary resuscitation to enable prompt orientation toward organ

273 Given intravenously at reperfusion/resuscitation to rats, ATTM significantly reduced infarc

274 uding bystander defibrillation, consisted of resuscitation training of Danish citizens, dissemination

275 atures were more likely to survive prolonged resuscitation up to 47 minutes.

276 combinations for blood pressure (BP), fluid resuscitation, vasopressors, serum lactate level, and ba

277 7.9%, 52.9%, and 3.1% requiring preoperative resuscitation, ventilation, intra-aortic balloon pump, a

278 scharge after 1-3 minutes of cardiopulmonary resuscitation versus 28% (9/32) after more than 30 minut

279 fter adjustment for confounders, restrictive resuscitation was associated with greater probability of

280 Shorter duration of cardiopulmonary resuscitation was associated with higher survival rates:

281 re sepsis patients for the first 72 hours of resuscitation was associated with improved survival, dec

282 te if the chloride content of fluids used in resuscitation was associated with short- and long-term o

283 of times a paramedic attended an OHCA where resuscitation was attempted in the 3 years preceding eac

284 at home and 2667 [32.3%] in public) for whom resuscitation was attempted using data from the Cardiac

285 In the 3 years preceding each OHCA where resuscitation was attempted, the median exposure of the

286 lactate again reached 10 mM after LVR, full resuscitation was started with crystalloid and red cells

287 Within Get With The Guidelines-Resuscitation, we identified 103 932 adult patients (>/=

288 rge survival rates following cardiopulmonary resuscitation were 28%, 23%, and 14%, respectively.

289 epsis survivors who received cardiopulmonary resuscitation were compared with those of patients who d

290 ong-term mortality following cardiopulmonary resuscitation were male sex, older age, receipt of care

291 ardiac arrest, and bystander cardiopulmonary resuscitation were more likely to survive with favorable

292 iac arrest requiring ongoing cardiopulmonary resuscitation were transported by emergency medical serv

293 The right ventricle was more dilated during resuscitation when cardiac arrest was caused by pulmonar

294 phragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still p

295 source-limited setting, a protocol for early resuscitation with administration of intravenous fluids

296 ociation between time to initial crystalloid resuscitation with hospital mortality, mechanical ventil

297 hemopexin can ameliorate adverse effects of resuscitation with SRBCs after 2 hours of hemorrhagic sh

298 Groups 4 and 5 had similar small resuscitations with distinct demographic differences.

299 c shock requiring vasopressors despite fluid resuscitation within a maximum of 6 hours after the onse

300 with HF (fc31.2%) corrected after hemostatic resuscitation without tranexamic acid.