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Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) significantly improves CPR performance by bystanders, increasing the survival of patients. However, emotional stress among family members witnessing out-of-hospital cardiac arrest (OHCA) may hinder their ability to effectively perform CPR, leading to delayed and poorer quality CPR. The influence of the relationships of callers to patients (i.e., family members, friends, and strangers) on DA-CPR outcomes remains insufficiently explored.
Materials And Methods: This retrospective observational study analyzed the data of nontraumatic OHCA cases in Taoyuan City, Taiwan, from August 2021 to January 2023. Data from the registries of emergency medical services and emergency call recordings were examined. Relationships of callers to patients, emotional barriers, time metrics (time to CPR instruction initiation and first compression), and barriers to DA-CPR success were evaluated. Associations between callers' relationships to patients and DA-CPR performance were analyzed through multivariable logistic regression.
Results: Among 1,036 nontraumatic OHCA cases, 59.3% of callers were family members, 13.6% were friends, and 27.1% were strangers. Cardiac arrest recognition rates were lower for family members (68.2%) than for strangers (84.0%) (p < 0.001). Time to CPR instruction (117 vs. 91 s, p = 0.034) and the first chest compression (200 vs. 179 s, p = 0.018) were significantly delayed for family members. For family members, emotional stress and protocol nonadherence were the main barriers to CPR performance.
Conclusion: The relationship of the caller to the patient significantly influences DA-CPR outcomes. Family members experience increased emotional stress, resulting in delays and decreased recognition rates. Targeted family-centered education and enhanced dispatcher support are essential to address these challenges and improve the survival outcomes of patients with OHCA.
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http://dx.doi.org/10.1186/s12873-025-01244-6 | DOI Listing |
Proc Natl Acad Sci U S A
September 2025
State Key Laboratory of Bioactive Molecules and Druggability Assessment, Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug De
Proliferative retinopathy is a leading cause of irreversible blindness in humans; however, the molecular mechanisms behind the immune cell-mediated retinal angiogenesis remain poorly elucidated. Here, using single-cell RNA sequencing in an oxygen-induced retinopathy (OIR) model, we identified an enrichment of sorting nexin (SNX)-related pathways, with SNX3, a member of the SNX family that is involved in endosomal sorting and trafficking, being significantly upregulated in the myeloid cell subpopulations of OIR retinas. Immunostaining showed that SNX3 expression is markedly increased in the retinal microglia/macrophages of mice with OIR, which is mainly located within and around the neovascular tufts.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
September 2025
Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202.
Retinal ganglion cells (RGCs) are highly compartmentalized neurons whose long axons serve as the sole connection between the eye and the brain. In both injury and disease, RGC degeneration occurs in a similarly compartmentalized manner, with distinct molecular and cellular responses in the axonal and somatodendritic regions. The goal of this study was to establish a microfluidic-based platform to investigate RGC compartmentalization in both health and disease states.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
September 2025
Florida Museum of Natural History, University of Florida, Gainesville, FL 32611.
The origin and phylogenetic distribution of symbiotic associations between nodulating angiosperms and nitrogen-fixing bacteria have long intrigued biologists. Recent comparative evolutionary analyses have yielded alternative hypotheses: a multistep pathway of independent gains and losses of root nodule symbiosis vs. a single gain followed by numerous losses.
View Article and Find Full Text PDFObstet Gynecol
July 2025
UMN Family Medicine, Minneapolis, Minnesota.
JAMA Netw Open
September 2025
Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City.
Importance: Advances in diagnostics have enabled the detection of more gastrointestinal pathogens, but misuse of diagnostics can lead to inappropriate antibiotic use and excess financial burdens. Ensuring appropriate use of diagnostics is crucial for optimizing patient care and promoting stewardship of health care resources.
Objective: To elicit parents' and clinicians' perspectives on expectations for care of pediatric diarrhea with a focus on diagnostic testing and to evaluate the potential for an electronic clinical decision support tool (ECDST) to improve appropriate use of diagnostics.