Time delays to reach dispatch centres in different regions in Europe. Are we losing the window of opportunity? - The EUROCALL study

Aim: In out of hospital cardiac arrest (OHCA) the start of Cardiopulmonary Resuscitation (CPR) by a single rescuer may be delayed considerably if the total time (TT) to connect the telephone call to the Emergency Medical Communication Centre (EMCC) is prolonged. EUROCALL investigated the TT-EMCC and its components using different calling procedures. Methods: This prospective, multicentre, randomised study was performed in April 2013. Telephone calls were randomly allocated to time of call, and to those connecting directly to the EMCC (1-step procedure) and those diverted before connecting to the EMCC (2-step procedure). Results: Twenty-one EMCCs from 11 countries participated in the study. Time to first ringtone was similar between 1-step 3.7 s (IQR 1.0-5.2) and 2-step calls 4.0 s (IQR 2.4-5.2). For the 1878 1-step calls, the median TT-EMCC was 11.7 s (IQR 8.7-18.5). For the 1550 2-step calls, the median time from first ringtone to first call-taker was 7 s (IQR 4.6-11.9) and from first call-taker to EMCC was 18.7 s (IQR 13.4-29.9). Median TT-EMCC was 33.2 s (IQR 24.7-46.1) and was significantly longer than the TT-EMCC observed with the 1-step procedure (P <0.0001). Significant differences existed among participating regions between and within different countries both for 1-step and 2-step procedures. Conclusion: TT-EMCC was significantly shorter in a 1-step procedure compared to a 2-step procedure. Regional differences existed between countries but also within countries. This may be relevant in cases of OHCA and other situations where patient outcome is critically time-dependent. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Peer reviewe

Field trial on glucose-induced insulin and metabolite responses in Estonian Holstein and Estonian Red dairy cows in two herds

<p>Abstract</p> <p>Background</p> <p>Insulin secretion and tissue sensitivity to insulin is considered to be one of the factors controlling lipid metabolism <it>post partum</it>. The objective of this study was to compare glucose-induced blood insulin and metabolite responses in Estonian Holstein (EH, n = 14) and Estonian Red (ER, n = 14) cows.</p> <p>Methods</p> <p>The study was carried out using the glucose tolerance test (GTT) performed at 31 ± 1.9 days <it>post partum</it> during negative energy balance. Blood samples were obtained at -15, -5, 5, 10, 20, 30, 40, 50 and 60 min relative to infusion of 0.15 g/kg BW glucose and analysed for glucose, insulin, triglycerides (TG), non-esterified fatty acids (NEFA), cholesterol and β-hydroxybutyrate (BHB). Applying the MIXED Procedure with the SAS System the basal concentration of cholesterol, and basal concentration and concentrations at post-infusion time points for other metabolites, area under the curve (AUC) for glucose and insulin, clearance rate (CR) for glucose, and maximum increase from basal concentration for glucose and insulin were compared between breeds.</p> <p>Results</p> <p>There was a breed effect on blood NEFA (<it>P </it>< 0.05) and a time effect on all metabolites concentration (<it>P </it>< 0.01). The following differences were observed in EH compared to ER: lower blood insulin concentration 5 min after glucose infusion (<it>P </it>< 0.05), higher glucose concentration 20 (<it>P </it>< 0.01) and 30 min (<it>P </it>< 0.05) after infusion, and higher NEFA concentration before (<it>P </it>< 0.01) and 5 min after infusion (P < 0.05). Blood TG concentration in ER remained stable, while in EH there was a decrease from the basal level to the 40^thmin nadir (<it>P </it>< 0.01), followed by an increase to the 60^thmin postinfusion (<it>P </it>< 0.01).</p> <p>Conclusion</p> <p>Our results imply that glucose-induced changes in insulin concentration and metabolite responses to insulin differ between EH and ER dairy cows.</p

Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue and research has shown that large regional variation in outcomes exists. Of the interventions associated with survival, the provision of bystander CPR is one of the most important modifiable factors. The aim of this study is to identify census areas with high incidence of OHCA and low rates of bystander CPR in Victoria, Australia. METHODS: We conducted an observational study using prospectively collected population-based OHCA data from the state of Victoria in Australia. Using ArcGIS (ArcMap 10.0), we linked the location of the arrest using the dispatch coordinates (longitude and latitude) to Victorian Local Government Areas (LGAs). We used Bayesian hierarchical models with random effects on each LGA to provide shrunken estimates of the rates of bystander CPR and the incidence rates. RESULTS: Over the study period there were 31,019 adult OHCA attended, of which 21,436 (69.1%) cases were of presumed cardiac etiology. Significant variation in the incidence of OHCA among LGAs was observed. There was a 3 fold difference in the incidence rate between the lowest and highest LGAs, ranging from 38.5 to 115.1 cases per 100,000 person-years. The overall rate of bystander CPR for bystander witnessed OHCAs was 62.4%, with the rate increasing from 56.4% in 2008-2010 to 68.6% in 2010-2013. There was a 25.1% absolute difference in bystander CPR rates between the highest and lowest LGAs. CONCLUSION: Significant regional variation in OHCA incidence and bystander CPR rates exists throughout Victoria. Regions with high incidence and low bystander CPR participation can be identified and would make suitable targets for interventions to improve CPR participation rates

Kids Save Lives ERC-Position Statement on School Children Education in the Resuscitation "Hands that help Training children is Training for Life"

Peer reviewe

A dataset of acoustic measurements from soundscapes collected worldwide during the COVID-19 pandemic

Political responses to the COVID-19 pandemic led to changes in city soundscapes around the globe. From March to October 2020, a consortium of 261 contributors from 35 countries brought together by the Silent Cities project built a unique soundscape recordings collection to report on local acoustic changes in urban areas. We present this collection here, along with metadata including observational descriptions of the local areas from the contributors, open-source environmental data, open-source confinement levels and calculation of acoustic descriptors. We performed a technical validation of the dataset using statistical models run on a subset of manually annotated soundscapes. Results confirmed the large-scale usability of ecoacoustic indices and automatic sound event recognition in the Silent Cities soundscape collection. We expect this dataset to be useful for research in the multidisciplinary field of environmental sciences