199 results on '"Bray, JE"'
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2. 2021 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations
- Author
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Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Costa-Nobre, DT, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Hansen, CM, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O’Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Sakamoto, T, Sandroni, C, Considine, Julie, Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Costa-Nobre, DT, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Hansen, CM, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O’Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Sakamoto, T, Sandroni, C, and Considine, Julie
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- 2022
3. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group
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Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, Sandroni, C (ORCID:0000-0002-8878-2611), Wyckoff, Mh, Singletary, Em, Soar, J, Olasveengen, Tm, Greif, R, Liley, Hg, Zideman, D, Bhanji, F, Andersen, Lw, Avis, Sr, Aziz, K, Bendall, Jc, Berry, Dc, Borra, V, Bottiger, Bw, Bradley, R, Bray, Je, Breckwoldt, J, Carlson, Jn, Cassan, P, Castren, M, Chang, Wt, Charlton, Np, Cheng, A, Chung, Sp, Considine, J, Costa-Nobre, Dt, Couper, K, Dainty, Kn, Davis, Pg, de Almeida, Mf, de Caen, Ar, de Paiva, Ef, Deakin, Cd, Djarv, T, Douma, Mj, Drennan, Ir, Duff, Jp, Eastwood, Kj, El-Naggar, W, Epstein, Jl, Escalante, R, Fabres, Jg, Fawke, J, Finn, Jc, Foglia, Ee, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, Ca, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, Mf, Heriot, G, Hirsch, Kg, Holmberg, Mj, Hosono, S, Hsieh, Mj, Hung, Kkc, Hsu, Ch, Ikeyama, T, Isayama, T, Kapadia, V, Kawakami, Md, Kim, H, Kloeck, Da, Kudenchuk, Pj, Lagina, At, Lauridsen, Kg, Lavonas, Ej, Lockey, A, Hansen, Cm, Markenson, D, Matsuyama, T, McKinlay, Cjd, Mehrabian, A, Merchant, Rm, Meyran, D, Morley, Pt, Morrison, Lj, Nation, Kj, Nemeth, M, Neumar, Rw, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, Bj, Orkin, Am, Osemeke, O, Parr, Mj, Patocka, C, Pellegrino, Jl, Perkins, Gd, Perlman, Jm, Rabi, Y, Reynolds, Jc, Ristagno, G, Roehr, Cc, Sakamoto, T, Sandroni, C, Sawyer, T, Schmolzer, Gm, Schnaubelt, S, Semeraro, F, Skrifvars, Mb, Smith, Cm, Smyth, Ma, Soll, Rf, Sugiura, T, Taylor-Phillips, S, Trevisanuto, D, Vaillancourt, C, Wang, Tl, Weiner, Gm, Welsford, M, Wigginton, J, Wyllie, Jp, Yeung, J, Nolan, Jp, Berg, Km, and Sandroni, C (ORCID:0000-0002-8878-2611)
- Abstract
The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.
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- 2022
4. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams
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Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Considine, Julie, Costa-Nobre, DT, Couper, K, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Malta Hansen, C, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, Roehr, CC, Wyckoff, MH, Singletary, EM, Soar, J, Olasveengen, TM, Greif, R, Liley, HG, Zideman, D, Bhanji, F, Andersen, LW, Avis, SR, Aziz, K, Bendall, JC, Berry, DC, Borra, V, Böttiger, BW, Bradley, R, Bray, JE, Breckwoldt, J, Carlson, JN, Cassan, P, Castrén, M, Chang, WT, Charlton, NP, Cheng, A, Chung, SP, Considine, Julie, Costa-Nobre, DT, Couper, K, Dainty, KN, Davis, PG, de Almeida, MF, de Caen, AR, de Paiva, EF, Deakin, CD, Djärv, T, Douma, MJ, Drennan, IR, Duff, JP, Eastwood, KJ, El-Naggar, W, Epstein, JL, Escalante, R, Fabres, JG, Fawke, J, Finn, JC, Foglia, EE, Folke, F, Freeman, K, Gilfoyle, E, Goolsby, CA, Grove, A, Guinsburg, R, Hatanaka, T, Hazinski, MF, Heriot, GS, Hirsch, KG, Holmberg, MJ, Hosono, S, Hsieh, MJ, Hung, KKC, Hsu, CH, Ikeyama, T, Isayama, T, Kapadia, VS, Kawakami, MD, Kim, HS, Kloeck, DA, Kudenchuk, PJ, Lagina, AT, Lauridsen, KG, Lavonas, EJ, Lockey, AS, Malta Hansen, C, Markenson, D, Matsuyama, T, McKinlay, CJD, Mehrabian, A, Merchant, RM, Meyran, D, Morley, PT, Morrison, LJ, Nation, KJ, Nemeth, M, Neumar, RW, Nicholson, T, Niermeyer, S, Nikolaou, N, Nishiyama, C, O'Neil, BJ, Orkin, AM, Osemeke, O, Parr, MJ, Patocka, C, Pellegrino, JL, Perkins, GD, Perlman, JM, Rabi, Y, Reynolds, JC, Ristagno, G, and Roehr, CC
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- 2021
5. Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study
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Fernando, H, Nehme, Z, Peter, K, Bernard, S, Stephenson, M, Bray, JE, Myles, PS, Stub, R, Cameron, P, Ellims, AH, Taylor, AJ, Kaye, DM, Smith, K, Stub, D, Fernando, H, Nehme, Z, Peter, K, Bernard, S, Stephenson, M, Bray, JE, Myles, PS, Stub, R, Cameron, P, Ellims, AH, Taylor, AJ, Kaye, DM, Smith, K, and Stub, D
- Abstract
BACKGROUND: We sought to determine if an association exists between prehospital chest pain severity and markers of myocardial injury. METHODS AND RESULTS: Patients with confirmed ST elevation myocardial infarction (STEMI) treated by emergency medical services were included in this retrospective cohort analysis of the AVOID study. The primary endpoint was the association of pre-hospital initial chest pain severity, cardiac biomarkers and infarct size based on cardiac magnetic resonance imaging. Groups were categorized based on moderate to severe chest pain (numerical rating scale pain ≥ 5/10) or less than moderate severity to compare procedural and clinical outcomes. 414 patients were included in the analysis. There was a weak correlation between initial pre-hospital chest pain severity and peak creatine kinase (r = 0.16, p = 0.001) and peak cardiac troponin I (r = 0.14, p = 0.005). Both were no longer significant after adjusting for known confounders. There was no association between moderate to severe chest pain on arrival and major adverse cardiac events at 6 months (20% vs. 14%, p=0.12). There was a weak correlation between history of ischemic heart disease (r = 0.16, p = 0.001), percutaneous coronary intervention (r = 0.16, p = 0.001), left anterior descending artery (r = 0.12, p = 0.012) as the culprit vessel and a weak negative correlation between age (r = -0.14, p = 0.039) and chest pain. CONCLUSION: Only a weak association between pre-hospital chest pain severity and markers of myocardial injury was identified, supporting more judicious use of opioid analgesia with a focus on patient comfort.
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- 2021
6. The current temperature: A survey of post-resuscitation care across Australian and New Zealand intensive care units
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Bray, JE, Cartledge, Susie, Finn, J, Eastwood, GM, McKenzie, N, Stub, D, Straney, L, Bernard, S, Bray, JE, Cartledge, Susie, Finn, J, Eastwood, GM, McKenzie, N, Stub, D, Straney, L, and Bernard, S
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- 2020
7. Australia's awareness of cardiac arrest and rates of CPR training: Results from the Heart Foundation's HeartWatch survey
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Cartledge, S, Saxton, D, Finn, J, Bray, JE, Cartledge, S, Saxton, D, Finn, J, and Bray, JE
- Abstract
Objective: We aimed to provide the first national estimates of cardiopulmonary resuscitation (CPR) training and awareness of cardiac arrest. Design: A retrospective analysis of a national cross-sectional survey was undertaken. Data were collected online from adults in July 2017 as part of the Heart Foundation of Australia’s HeartWatch survey. We used logistic regression to examine demographic factors associated with CPR training. Participants: A national cohort was invited to participate in the survey using purposive, non-probability sampling methods with quotas for age, gender and area of residence, in order to reflect the wider Australian population. The final sample consisted of 1076 respondents. Main outcome measure: To determine an estimation of the prevalence of cardiac arrest awareness and CPR training at a national level and the relationship of training to demographic factors. Results: The majority (76%) of respondents were born in Australia with 51% female and 66% aged between 35 and 64 years. Only 16% of respondents could identify the difference between a cardiac arrest and a heart attack. While 56% reported previous CPR training, only 22% were currently trained (within 1 year). CPR training was associated with younger age (35 to 54 years) (OR 1.45, 95% CI 1.06 to 2.0), being born in Australia (OR 1.59, 95% CI 1.17 to 2.17) and higher levels of education (university, OR 1.86, 95% CI 1.35 to 2.57). CPR training increased confidence in respondents ability to perform effective CPR and use a defibrillator. Lack of CPR training was the most common reason why respondents would not provide CPR to a stranger. Conclusions: There is a need to improve the community’s understanding of cardiac arrest, and to increase awareness and training in CPR. CPR training rates have not changed over the past decades—new initiatives are needed.
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- 2020
8. Genomic Analyses of >3,100 Nasopharyngeal Pneumococci Revealed Significant Differences Between Pneumococci Recovered in Four Different Geographical Regions
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Van Tonder, AJ, Bray, JE, Jolley, KA, Van Rensburg, MJ, Quirk, SJ, Haraldsson, G, Maidens, MCJ, Bentley, SD, Haraldsson, A, Erlendsdottir, H, Kristinsson, KG, Brueggemann, AB, Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, and University of Iceland
- Subjects
SEROTYPE REPLACEMENT ,VACCINE ,CHILDREN ,Core genome ,accessory genome ,Pan-genome ,Microbiology ,DISEASE ,Next generation sequencing ,Pneumókokkar ,next generation sequencing ,Örverufræði ,Science & Technology ,SEQUENCES ,Accessory genome ,Bacterial population structure ,Pneumococcus ,Genarannsóknir ,core genome ,CARRIAGE ,Gerlar ,pan-genome ,Erfðarannsóknir ,Life Sciences & Biomedicine ,bacterial population structure ,pneumococcus - Abstract
Publisher's version (útgefin grein), Understanding the structure of a bacterial population is essential in order to understand bacterial evolution. Estimating the core genome (those genes common to all, or nearly all, strains of a species) is a key component of such analyses. The size and composition of the core genome varies by dataset, but we hypothesized that the variation between different collections of the same bacterial species would be minimal. To investigate this, we analyzed the genome sequences of 3,118 pneumococci recovered from healthy individuals in Reykjavik (Iceland), Southampton (United Kingdom), Boston (United States), and Maela (Thailand). The analyses revealed a "supercore" genome (genes shared by all 3,118 pneumococci) of 558 genes, although an additional 354 core genes were shared by pneumococci from Reykjavik, Southampton, and Boston. Overall, the size and composition of the core and pan-genomes among pneumococci recovered in Reykjavik, Southampton, and Boston were similar. Maela pneumococci were distinctly different in that they had a smaller core genome and larger pan-genome. The pan-genome of Maela pneumococci contained several >25 Kb sequence regions (flanked by pneumococcal genes) that were homologous to genomic regions found in other bacterial species. Overall, our work revealed that some subsets of the global pneumococcal population are highly heterogeneous, and our hypothesis was rejected. This is an important finding in terms of understanding genetic variation among pneumococci and is also an essential point of consideration before generalizing the findings from a single dataset to the wider pneumococcal population., This work was supported by a Wellcome Trust Biomedical Research Fund award (04992/Z/14/Z) to MM, KJ, and AB; a Wellcome Trust Research Fellowship (083511/Z/07/Z) to AB; and a University of Oxford John Fell Fund award (123/734) to AB. Core funding for the Sanger Institute was provided by the Wellcome Trust (098051). Support from the Eimskipa University Fund was received by SQ and KK. The Icelandic vaccine impact study was an investigator-initiated study funded by GlaxoSmithKline Biologicals SA and the Landspítali University Hospital Research Fund to KK, AH, HE, SB, and AB.
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- 2019
9. Heavy metal susceptibility on Escherichia coli from urine samples from Sweden, Germany and Spain
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Suetterlin, S, Tellez-Castillo, CJ, Anselem, L, Yin, H, Bray, JE, and Maiden, MCJ
- Abstract
Antimicrobial resistance is a major health care problem, with the intensive use of heavy metals and biocides recently being identified as potential contributing factors to the aggravation of this situation. This study investigated heavy metal susceptibility and genetic resistance determinants in Escherichia coli isolated from clinical urine samples from Sweden, Germany and Spain. A total of 186 isolates were tested for minimal inhibition concentration to sodium arsenite, silver nitrate and copper (II) sulphate. In addition, 88 of these isolates were whole genome sequenced for the characterization of their genetic resistance determinants and epidemiology. For sodium arsenite, the isolates could be categorized into a resistant and a non-resistant group, based on MIC values: isolates of the resistant group exhibited the chromosomal ars operon and belonged to non-B2 phylogenetic groups; in contrast, within the B2 phylogroup, no ars operon was found and the isolates were susceptible to sodium arsenite. Two isolates also harbored the silver/copper resistance determinant pco/sil and belonged to sequence types ST10 (phylogroup A) and ST295 (phylogroup C). The ST295 isolate had a silver nitrate MIC ≥ 512 mg/L and additionally produced extended spectrum beta-lactamases. To our knowledge, this is the first study that describes the distribution of the arsenic resistance operon ars within phylogroups of E. coli isolated from patients with urinary tract infections. The arsenic operon ars was only present in all non-B2 clades, which have previously been associated with the environment and commensalism in both humans and animals, while B2-clades lacked the ars operon.
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- 2018
10. Heavy Metal Susceptibility of Escherichia coli Isolated from Urine Samples from Sweden, Germany, and Spain
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Sütterlin S, Téllez-Castillo CJ, Anselem L, Yin H, Bray JE, and Maiden MCJ
- Subjects
antibiotic resistance ,arsenic ,Escherichia coli ,silver ,heavy metal resistance - Abstract
Antimicrobial resistance is a major health care problem, with the intensive use of heavy metals and biocides recently identified as a potential factor contributing to the aggravation of this situation. The present study investigated heavy metal susceptibility and genetic resistance determinants in Escherichia coli isolated from clinical urine samples from Sweden, Germany, and Spain. A total of 186 isolates were tested for their sodium arsenite, silver nitrate, and copper(II) sulfate MICs. In addition, 88 of these isolates were subjected to whole-genome sequencing for characterization of their genetic resistance determinants and epidemiology. For sodium arsenite, the isolates could be categorized into a resistant and a nonresistant group based on MIC values. Isolates of the resistant group exhibited the chromosomal ars operon and belonged to non-B2 phylogenetic groups; in contrast, within the B2 phylogroup, no ars operon was found, and the isolates were susceptible to sodium arsenite. Two isolates also harbored the silver/copper resistance determinant pco/sil, and they belonged to sequence types ST10 (phylogroup A) and ST295 (phylogroup C). The ST295 isolate had a silver nitrate MIC of >= 512 mg/liter and additionally produced extended-spectrum beta-lactamases. To our knowledge, this is the first study to describe the distribution of the arsenic resistance ars operon within phylogroups of E. coli strains isolated from patients with urinary tract infections. The arsenic resistance ars operon was present only in all non-B2 clades, which have previously been associated with the environment and commensalism in both humans and animals, while B2 clades lacked the ars operon.
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- 2018
11. Neisseria genomics: current status and future perspectives
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Harrison, OB, Schoen, C, Retchless, AC, Wang, X, Jolley, KA, Bray, JE, and Maiden, MC
- Abstract
High-throughput whole genome sequencing has unlocked a multitude of possibilities enabling members of the Neisseria genus to be examined with unprecedented detail, including the human pathogens Neisseria meningitidis and Neisseria gonorrhoeae. To maximise the potential benefit of this for public health, it is becoming increasingly important to ensure that this plethora of data are adequately stored, disseminated and made readily accessible. Investigations facilitating cross-species comparisons as well as the analysis of global datasets will allow differences among and within species and across geographic locations and different times to be identified, improving our understanding of the distinct phenotypes observed. Recent advances in high-throughput platforms that measure the transcriptome, proteome and/or epigenome are also becoming increasingly employed to explore the complexities of Neisseria biology. An integrated approach to the analysis of these is essential to fully understand the impact these may have in the Neisseria genus. This article reviews the current status of some of the tools available for next generation sequence analysis at the dawn of the 'post-genomic' era.
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- 2017
12. Clonal expansion of new penicillin-resistant clade of serogroup W, clonal complex 11 Neisseria meningitidis, Western Australia
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Mowlaboccus, S, Jolley, KA, Bray, JE, Pang, S, Thin Lee, Y, Bew, JD, Speers, DJ, Keil, AD, Coombs, GW, and Kahler, CM
- Abstract
In Western Australia, Neisseria meningitidis serogroup W clonal complex 11 became the predominant cause of invasive meningococcal disease in 2016. We used core-genome analysis to show emergence of a penicillin-resistant clade that had the penA_253 allele. This new penicillin-resistant clade might affect treatment regimens for this disease.
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- 2017
13. Strategic framework improves access to stroke reperfusion across the state of Victoria Australia
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Bray, JE, Denisenko, S, Campbell, BCV, Stephenson, M, Muller, J, Hocking, G, Hand, PJ, Bladin, CF, Bray, JE, Denisenko, S, Campbell, BCV, Stephenson, M, Muller, J, Hocking, G, Hand, PJ, and Bladin, CF
- Abstract
BACKGROUND: In 2010, rapid access to stroke thrombolysis centres was limited in some regional areas in the Australian state of Victoria. These results, and planning for endovascular clot retrieval (ECR), have led to the implementation of strategies by the Victorian Stroke Clinical Network, the Victorian Stroke Telemedicine Program and local health services to improve state-wide access. AIMS: To examine whether access to stroke reperfusion services (thrombolysis and ECR) in regional Victoria have subsequently improved. METHODS: The locations of suspected stroke patients attended by ambulance in 2015 were mapped, and drive times to the nearest reperfusion services were calculated. We then calculated the proportion of cases with transport times within: (i) 60 min to thrombolysis centres; and (ii) 180 min to two ECR centres designated to receive regional patients. Statistical comparisons to existing 2010 data were made. RESULTS: In 2015, Ambulance Victoria attended 16 418 cases of suspected stroke (2.9% of all emergency calls), of whom 4597 (28%) were located in regional Victoria. Compared to 2010, a greater proportion of regional suspected stroke patients in 2015 were located within 60 min of a thrombolysis centre by road (77-95%, P < 0.001). A 3-h road travel time to the two ECR centres is currently possible for 88% of regional patients. CONCLUSION: A strategic and region-specific approach has resulted in improved access by road transport to reperfusion therapies for stroke patients across Victoria.
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- 2017
14. Defining the estimated core genome of bacterial populations using a Bayesian decision model
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Van Tonder, AJ, Mistry, S, Bray, JE, Hill, DMC, Cody, AJ, Farmer, CL, Klugman, KP, Von Gottberg, A, Bentley, SD, Parkhill, J, Jolley, KA, Maiden, MCJ, and Brueggemann, AB
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MECHANISM ,Bacterial Diseases ,Biochemistry & Molecular Biology ,STRAIN ,GENES ,Bioinformatics ,QH301-705.5 ,Microbial Genomics ,Neisseria meningitidis ,Microbiology ,Biochemical Research Methods ,Campylobacter jejuni ,Bacterial Proteins ,Databases, Genetic ,ELEMENTS ,Genetics ,Medicine and Health Sciences ,EPIDEMIOLOGY ,Biology (General) ,01 Mathematical Sciences ,STAPHYLOCOCCUS-AUREUS ,08 Information And Computing Sciences ,Science & Technology ,Models, Genetic ,PHYLOGENETIC NETWORKS ,Biology and Life Sciences ,Bacteriology ,Bayes Theorem ,Genomics ,06 Biological Sciences ,PAN-GENOME ,EVOLUTION ,Infectious Diseases ,Mathematical & Computational Biology ,SPREAD ,Life Sciences & Biomedicine ,Genome, Bacterial ,Research Article - Abstract
The bacterial core genome is of intense interest and the volume of whole genome sequence data in the public domain available to investigate it has increased dramatically. The aim of our study was to develop a model to estimate the bacterial core genome from next-generation whole genome sequencing data and use this model to identify novel genes associated with important biological functions. Five bacterial datasets were analysed, comprising 2096 genomes in total. We developed a Bayesian decision model to estimate the number of core genes, calculated pairwise evolutionary distances (p-distances) based on nucleotide sequence diversity, and plotted the median p-distance for each core gene relative to its genome location. We designed visually-informative genome diagrams to depict areas of interest in genomes. Case studies demonstrated how the model could identify areas for further study, e.g. 25% of the core genes with higher sequence diversity in the Campylobacter jejuni and Neisseria meningitidis genomes encoded hypothetical proteins. The core gene with the highest p-distance value in C. jejuni was annotated in the reference genome as a putative hydrolase, but further work revealed that it shared sequence homology with beta-lactamase/metallo-beta-lactamases (enzymes that provide resistance to a range of broad-spectrum antibiotics) and thioredoxin reductase genes (which reduce oxidative stress and are essential for DNA replication) in other C. jejuni genomes. Our Bayesian model of estimating the core genome is principled, easy to use and can be applied to large genome datasets. This study also highlighted the lack of knowledge currently available for many core genes in bacterial genomes of significant global public health importance., Author Summary Whole genome sequencing has revolutionised the study of pathogenic microorganisms. It has also become so affordable that hundreds of samples can reasonably be sequenced in an individual project, creating a wealth of data. Estimating the bacterial core genome – traditionally defined as those genes present in all genomes – is an important initial step in population genomics analyses. We developed a simple statistical model to estimate the number of core genes in a bacterial genome dataset, calculated pairwise evolutionary distances (p-distances) based on differences among nucleotide sequences, and plotted the median p-distance for each core gene relative to its genome location. Low p-distance values indicate highly-conserved genes; high values suggest genes under selection and/or undergoing recombination. The genome diagrams depict areas of interest in genomes that can be explored in further detail. Using our method, we analysed five bacterial species comprising a total of 2096 genomes. This revealed new information related to antibiotic resistance and virulence for two bacterial species and demonstrated that the function of many core genes in bacteria is still unknown. Our model provides a highly-accessible, publicly-available tool to use on the vast quantities of genome sequence data now available.
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- 2016
15. Are sociodemographic characteristics associated with spatial variation in the incidence of OHCA and bystander CPR rates? A population-based observational study in Victoria, Australia
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Straney, LD, Bray, JE, Beck, B, Bernard, S, Lijovic, M, Smith, K, Straney, LD, Bray, JE, Beck, B, Bernard, S, Lijovic, M, and Smith, K
- Abstract
BACKGROUND: Rates of out-of-hospital cardiac arrest (OHCA) and bystander cardiopulmonary resuscitation (CPR) have been shown to vary considerably in Victoria. We examined the extent to which this variation could be explained by the sociodemographic and population health characteristics of the region. METHODS: Using the Victorian Ambulance Cardiac Arrest Registry, we extracted OHCA cases occurring between 2011 and 2013. We restricted the calculation of bystander CPR rates to those arrests that were witnessed by a bystander. To estimate the level of variation between Victorian local government areas (LGAs), we used a two-stage modelling approach using random-effects modelling. RESULTS: Between 2011 and 2013, there were 15 830 adult OHCA in Victoria. Incidence rates varied across the state between 41.9 to 104.0 cases/100 000 population. The proportion of the population over 65, socioeconomic status, smoking prevalence and education level were significant predictors of incidence in the multivariable model, explaining 93.9% of the variation in incidence among LGAs. Estimates of bystander CPR rates for bystander witnessed arrests varied from 62.7% to 73.2%. Only population density was a significant predictor of rates in a multivariable model, explaining 73% of the variation in the odds of receiving bystander CPR among LGAs. CONCLUSIONS: Our results show that the regional characteristics which underlie the variation seen in rates of bystander CPR may be region specific and may require study in smaller areas. However, characteristics associated with high incidence and low bystander CPR rates can be identified and will help to target regions and inform local interventions to increase bystander CPR rates.
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- 2016
16. Regions of High Out-Of-Hospital Cardiac Arrest Incidence and Low Bystander CPR Rates in Victoria, Australia
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Lazzeri, C, Straney, LD, Bray, JE, Beck, B, Finn, J, Bernard, S, Dyson, K, Lijovic, M, Smith, K, Lazzeri, C, Straney, LD, Bray, JE, Beck, B, Finn, J, Bernard, S, Dyson, K, Lijovic, M, and Smith, K
- Abstract
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.
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- 2015
17. Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia
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Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, Davidson, PM, and Cameron, P
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Aged, 80 and over ,Male ,Urban Population ,Victoria ,Resuscitation ,Incidence ,Middle Aged ,Emergency & Critical Care Medicine ,Survival Rate ,Humans ,Homes for the Aged ,Female ,Registries ,Out-of-Hospital Cardiac Arrest ,Retrospective Studies ,Follow-Up Studies ,Aged - Abstract
Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF.A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p=0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff. © 2011 Elsevier Ireland Ltd.
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- 2011
18. Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia
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Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, Davidson, PM, Cameron, P, Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, Davidson, PM, and Cameron, P
- Abstract
Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF.A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p=0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff. © 2011 Elsevier Ireland Ltd.
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- 2012
19. Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia.
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Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Davidson PM, and Cameron P
- Published
- 2012
20. Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates.
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Bray JE, Deasy C, Walsh J, Bacon A, Currell A, and Smith K
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- 2011
21. Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry.
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Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, and Cameron P
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- 2011
22. Hospital characteristics are associated with patient outcomes following out-of-hospital cardiac arrest.
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Stub D, Smith K, Bray JE, Bernard S, Duffy SJ, and Kaye DM
- Abstract
Objective Post-resuscitation care may influence outcome following transport to hospital after resuscitation from out-of-hospital cardiac arrest (OHCA). This study aimed to determine whether receiving hospital characteristics such as 24-h cardiac catheterisation services, total bed number or OHCA patient volume influence the rate of survival. Setting Data were analysed from the Victorian Ambulance Cardiac Arrest Registry of patients from January 2003 to March 2010 who were transported to hospital with return of spontaneous circulation (ROSC) after OHCA. Results Ambulance paramedics attended 9971 patients with OHCA of suspected cardiac cause during the study period. Of these, 2902 (29%) achieved ROSC and were transported to one of 70 hospitals. 1816 (63%) were treated at hospitals with 24-h cardiac interventional services. After adjusting for differences in baseline characteristics, hospital factors significantly associated with survival were treatment at hospitals with 24-h cardiac interventional services (OR 1.40; 95% CI 1.12 to 1.74, p=0.003) and patient reception between 08:00 and 17:00 hours (OR 1.34; 95% CI 1.10 to 1.64, p=0.004). OHCA patient volume and total hospital bed number were not independently associated with outcome. Conclusion Hospital characteristics are associated with improved survival in patients with OHCA. This finding has implications for the establishment of regionalised systems of care for patients who have been resuscitated from OHCA. [ABSTRACT FROM AUTHOR]
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- 2011
23. Cardiac arrest outcomes before and after the 2005 resuscitation guidelines implementation: Evidence of improvement?
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Deasy C, Bray JE, Smith K, Wolfe R, Harriss LR, Bernard SA, and Cameron P
- Published
- 2011
24. Paramedic diagnosis of stroke: examining long-term use of the Melbourne Ambulance Stroke Screen (MASS) in the field.
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Bray JE, Coughlan K, Barger B, Bladin C, Bray, Janet E, Coughlan, Kelly, Barger, Bill, and Bladin, Chris
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- 2010
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25. Hierarchical genomic analysis of carried and invasive serogroup A Neisseria meningitidis during the 2011 epidemic in Chad
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Diallo, K, Gamougam, K, Daugla, DM, Harrison, OB, Bray, JE, Caugant, DA, Lucidarme, J, Trotter, CL, Hassan-King, M, Stuart, JM, Manigart, O, Greenwood, BM, and Maiden, MCJ
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African meningitis belt ,Pharyngeal carriage ,Whole genome sequencing ,Serogroup A Neisseria meningitidis ,Meningitis epidemic ,3. Good health - Abstract
BACKGROUND: Serogroup A Neisseria meningitidis (NmA) was the cause of the 2011 meningitis epidemics in Chad. This bacterium, often carried asymptomatically, is considered to be an "accidental pathogen"; however, the transition from carriage to disease phenotype remains poorly understood. This study examined the role genetic diversity might play in this transition by comparing genomes from geographically and temporally matched invasive and carried NmA isolates. RESULTS: All 23 NmA isolates belonged to the ST-5 clonal complex (cc5). Ribosomal MLST comparison with other publically available NmA:cc5 showed that isolates were closely related, although those from Chad formed two distinct branches and did not cluster with other NmA, based on their MLST profile, geographical and temporal location. Whole genome MLST (wgMLST) comparison identified 242 variable genes among all Chadian isolates and clustered them into three distinct phylogenetic groups (Clusters 1, 2, and 3): no systematic clustering by disease or carriage source was observed. There was a significant difference (p = 0.0070) between the mean age of the individuals from which isolates from Cluster 1 and Cluster 2 were obtained, irrespective of whether the person was a case or a carrier. CONCLUSIONS: Whole genome sequencing provided high-resolution characterization of the genetic diversity of these closely related NmA isolates. The invasive meningococcal isolates obtained during the epidemic were not homogeneous; rather, a variety of closely related but distinct clones were circulating in the human population with some clones preferentially colonizing specific age groups, reflecting a potential age-related niche adaptation. Systematic genetic differences were not identified between carriage and disease isolates consistent with invasive meningococcal disease being a multi-factorial event resulting from changes in host-pathogen interactions along with the bacterium.
26. A letter to my replacement: To the Marine who replaced me as an advisor
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Bray, Jerry E., Sgt
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OPERATION - Iraqi Freedom - Personal Narratives ,ARMY - Iraq - Training ,UNITED STATES - Military Relations - Iraq ,IRAQ - Military Relations - United States ,OPERATION - Iraqi Freedom - Lessons Learned - Published
- 2007
27. Those darn rabbits
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Bray, Jeremy
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- 1999
28. A randomized controlled trial of oxygen therapy in acute myocardial infarction Air Verses Oxygen In myocarDial infarction study (AVOID Study)
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Stub D, Smith K, Bernard S, Bray JE, Stephenson M, Cameron P, Meredith I, and Kaye DM
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- 2012
29. Success with paramedic diagnosis of stroke.
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Bray JE, Bladin C, Bray, Janet E, and Bladin, Chris
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- 2009
- Full Text
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30. Mine awareness
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Bray, Jeffrey K., GMG1
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MINES AND MINE-LAYING ,NAVAL BASES - United States - Norfolk, VA - Abstract
illus
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- 1987
31. Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-adding coronial data to a cardiac arrest registry
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Janet Bray, Conor Deasy, Peter Cameron, Linton Harriss, Stephen Bernard, Karen Smith, Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, and Cameron, P
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young adults ,Adult ,Male ,medicine.medical_specialty ,Myocarditis ,Heart disease ,Adolescent ,medicine.medical_treatment ,Cardiomyopathy ,cardiac arrest ,Emergency Nursing ,cardiopulmonary resuscitation ,Young Adult ,autopsy ,Internal medicine ,Cardiac tamponade ,coroner ,medicine ,Humans ,Cardiopulmonary resuscitation ,Registries ,Cause of death ,Retrospective Studies ,business.industry ,EMS ,Australia ,out-of-hospital ,medicine.disease ,Pulmonary embolism ,Emergency Medicine ,Cardiology ,Etiology ,CPR ,Female ,Cardiology and Cardiovascular Medicine ,business ,Coroners and Medical Examiners ,Out-of-Hospital Cardiac Arrest - Abstract
Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was 'presumed cardiac'. Discussion: Linking OHCA registries with coronial databases for aetiology of the arrest will improve the quality of the data and should be considered by all OHCA registries, particularly for young adult OHCA. Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16-39 years were identified using the Victorian Ambulance Cardiac Arrest Registry (VACAR) and available coronial findings reviewed. Results: We identified 841 young adult OHCAs where the Utstein aetiology was 'presumed cardiac'. Of these 740 died and 572 (77%) OHCAs were matched to coroner's findings. On review of the coroner's cause of death, 230 (40.2%) had a 'confirmed cardiac' aetiology, 221 (38.6%) were proven 'non-cardiac', 97 (17%) were inconclusive and 24 (4.2%) cases remained 'open'. 'Confirmed cardiac' causes of OHCA were ischemic heart disease (n = 126, 55%), cardiomegaly (n = 26, 11.3%), cardiomyopathy (n = 25, 11%), congenital heart disease (n = 15, 6.5%), cardiac tamponade due to dissecting thoracic aorta aneurysm (n = 10, 4.3%), myocarditis (n = 8, 3.5%), arrhythmia (n = 7, 3%), others (n = 13, 5.7%). 'Non-cardiac' causes of OHCA were epilepsy/sudden unexplained death in epilepsy (SUDEP) (n = 56, 25%), pulmonary embolism (n = 29, 13%), subarachnoid haemorrhage (n = 17, 7.7%), other intracranial bleed (n = 7, 3.2%), pneumonia (n = 17, 7.7%), DKA (n = 16, 7.2%), other complications of diabetes mellitus (n = 8, 3.6%), complications of obesity (n = 9, 4%), haemorrhage (n = 12, 5.4%), sepsis (n = 8, 3.6%), peritonitis (n = 6, 2.7%), aspiration (n = 6, 2.7%), renal failure (n = 5, 2.3%), asthma (n = 5, 2.3%), complications of anorexia (n = 3) and alcohol abuse (n =2), thyrotoxicosis (n = 2), meningitis (n = 1) and others (n = 12). Compared with coroner's diagnosed 'non-cardiac' OHCAs, 'confirmed cardiac' were more likely to be witnessed (41% vs 23%, p ≤ 0.01), receive bystander CPR (35% vs 20%, p ≤ 0.001), have a shockable rhythm (27% vs 6.3%, p < 0.001) and have EMS attempted resuscitation (62% vs 44%, p < 0.001). Refereed/Peer-reviewed
- Published
- 2011
32. Cardiac arrest outcomes before and after the 2005 resuscitation guidelines implementation: evidence of improvement?
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Conor Deasy, Peter Cameron, Janet Bray, Rory Wolfe, Linton Harriss, Stephen Bernard, Karen Smith, Deasy, C, Bray, JE, Smith, K, Wolfe, R, Harriss, Linton Robert, Bernardes, SA, and Cameron, P
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Adult ,Male ,medicine.medical_specialty ,Resuscitation ,Emergency Medical Services ,Victoria ,medicine.medical_treatment ,Emergency Nursing ,Statistics, Nonparametric ,Outcome Assessment, Health Care ,medicine ,Emergency medical services ,Humans ,Cardiopulmonary resuscitation ,Registries ,Asystole ,Intensive care medicine ,Prehospital ,Survival analysis ,Univariate analysis ,business.industry ,Guideline ,medicine.disease ,Cardiac arrest ,Survival Analysis ,Cardiopulmonary Resuscitation ,Patient Discharge ,Emergency medicine ,Practice Guidelines as Topic ,Emergency Medicine ,Etiology ,Regression Analysis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Background: Previous studies have reported improvements in out-of-hospital cardiac arrest (OHCA) outcomes with the introduction of the 2005 cardiopulmonary resuscitation guidelines however they have not adjusted for underlying trends in OHCA survival. We compare outcomes before and after the 2005 guideline changes adjusting for underlying trends in OHCA survival. Conclusions: OHCA outcomes have improved since introduction of the 2005 CPR guidelines, but multivariable segmented regression analysis adjusting for pre-existing trends in survival suggests that this improvement may not be due to implementation of the 2005 resuscitation guidelines. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for adult (≥16 years) OHCA of presumed cardiac aetiology, unwitnessed by paramedics with attempted resuscitation. Outcomes for OHCA occurring between 2003 and 2005 were compared with 2007-2009. Segmented regression analysis of interrupted time series data was performed, adjusting for known predictors, to examine changes in survival to hospital and survival to hospital discharge. Results: For the pre- and post- guideline periods there were 3115 and 3248 OHCAs, respectively. Asystole increased as presenting rhythm (33-43%, p < 0.001) as did median EMS response times (7.1-7.8 min, p < 0.001) over the two periods. VF/VT arrests decreased (40-35.5%, p = 0.001) as did bystander witnessed arrests (63-59%, p = 0.002). On univariate analysis survival to hospital discharge improved between the two periods (9.4-11.8%, p = 0.002) due to improved outcomes in VF/VT (19-28%, p < 0.001). Segmented regression analysis of interrupted time series data showed improvement in the rate of survival to get to hospital for shockable and non-shockable rhythms [OR (95% CI) = 1.54 (1.10-2.15, p = 0.01) and 1.45 (1.10-2.00, p = 0.02), respectively] following implementation of the guidelines however survival to hospital discharge did not improve [OR = 1.07 (0.70-1.62, p = 0.70) and 1.40 (0.69-2.85, p = 0.40), respectively]. Refereed/Peer-reviewed
- Published
- 2011
33. Out-of-hospital cardiac arrests in young adults in Melbourne, Australia
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Stephen Bernard, Peter Cameron, Karen Smith, Conor Deasy, Janet Bray, Linton Harriss, Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, and Cameron, P
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Adult ,Male ,young adults ,Emergency Medical Services ,medicine.medical_specialty ,Resuscitation ,Adolescent ,Victoria ,out of hospital cardiac arrest ,cardiac arrest registry ,Emergency Nursing ,Drug overdose ,Young Adult ,Epidemiology ,Humans ,Medicine ,Young adult ,Asystole ,Intensive care medicine ,Retrospective Studies ,business.industry ,Incidence ,Incidence (epidemiology) ,ambulance service ,Australia ,Retrospective cohort study ,medicine.disease ,Cardiopulmonary Resuscitation ,Survival Rate ,Ventricular Fibrillation ,Emergency medicine ,Emergency Medicine ,Etiology ,Female ,epidemiology ,Drug Overdose ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Background: Characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in young adults are not well described in Australia. Conclusion: Survival to hospital discharge rates from OHCA due to a 'presumed cardiac' precipitant in young adults is much better than older adults, however, all cause OHCA survival is similar. Multi agency novel upstream preventive strategies aimed at tackling drug overdose may reduce this aetiology of OHCA and save lives. Methods: A 10-year retrospective case review of all OHCA in young adults (aged 16-39) and not witnessed by EMS, was performed using data from the Victorian Ambulance Cardiac Arrest Registry (VACAR). Results: Between 2000 and 2009 there were 30,006 adult cardiac arrests of which 3912 (13%) were in this age group. The median (IQR) age was 30 (25-35) years for both sexes with a 3:1 male to female ratio. Overdose was the most common precipitant (33.5%) followed by presumed cardiac (20%). Bystander CPR occurred in 21.2%, EMS median response time was 7 min and resuscitation was attempted in 36% of OHCAs. The presenting rhythm was asystole in 84.6%, PEA in 8.8% and VF/VT in 6.6%. Survival to hospital discharge, for all cause OHCA where resuscitation was attempted, was similar for young adult and older adults (8.8% vs 8.4%, p = 0.2). However, for presumed cardiac aetiology OHCA, young adults had a greater proportion of survivors (14.8% vs 9.0%, p < 0.001). Cardiac arrest with shockable rhythm (VF/pulseless VT) had a survival rate of 31.2% for young adults compared to 18.5% for older adults (p < 0.001). Refereed/Peer-reviewed
- Published
- 2011
34. Out-of-hospital cardiac arrests in the older age groups in Melbourne, Australia
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Karen Smith, Stephen Bernard, Janet Bray, Peter Cameron, Linton Harriss, Conor Deasy, Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, and Cameron, P
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Male ,Emergency Medical Services ,medicine.medical_specialty ,Resuscitation ,octogenarians ,Urban Population ,Victoria ,medicine.medical_treatment ,resuscitation ,cardiac arrest ,Emergency Nursing ,Return of spontaneous circulation ,Logistic regression ,outcomes ,cardiopulmonary resuscitation ,elderly ,Age Distribution ,Quality of life ,Intensive care ,Emergency medical services ,Humans ,Medicine ,Cardiopulmonary resuscitation ,Sex Distribution ,Asystole ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,emergency ,Incidence ,emergency medical services ,Middle Aged ,medicine.disease ,out-of-hospital ,Cardiopulmonary Resuscitation ,Surgery ,Survival Rate ,Treatment Outcome ,nonagenarians ,Emergency medicine ,Emergency Medicine ,CPR ,Female ,centenarians ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Follow-Up Studies - Abstract
Background: Controversy exists around CPR in the elderly. The characteristics and outcomes of out-ofhospital cardiac arrest (OHCA) in this age group were studied in Melbourne, Australia. Conclusion: Outcomes for OHCA with shockable rhythm have improved over the last 10 years for people aged 65 years and over. Quality of life studies should be performed to help inform the community and EMS on appropriate resuscitative efforts. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs not witnessed by Emergency Medical Services (EMS) occurring in those aged 65 years and older. Results: Between 2000 and 2009 there were 30,006 OHCAs of which 9703 (32%) were in people 65-79 years of age, 6430 (21%) in octogenarians, 1530 (5%) in nonagenarian and 40 (0.1%) in centenarians. Rates of attempted resuscitation decreased with advancing age: 48% for those aged 65-79 years, 39% for octogenarians, 31% for nonagenarians and 17% for centenarians. Similarly rates of survival to hospital discharge decreased with age: 8% for those aged 65-79 years, 4% for octogenarians, 2% for nonagenarians; for 65-79 year olds, octogenarians and nonagenarians survival if in VF/VT was - 17%, 10% and 4%; asystole - 1%, 1% and 0.5%; and PEA - 6%, 3% and 3%, respectively. Multivariable logistic regression shows that between 2000 and 2009 rates of transportation with return of spontaneous circulation have improved for both shockable and non-shockable rhythms [OR 95% CI 1.07(1.04-1.10) and 1.16(1.12-1.20), respectively] but survival to hospital discharge has improved in the shockable rhythm group only [OR 1.12(1.07-1.16)]. Refereed/Peer-reviewed
- Published
- 2011
35. Knowledge of Acute Coronary Syndrome Symptoms and the Intention to Call Emergency Medical Services in Culturally and Linguistically Diverse Australians.
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Olani AB, Eastwood K, Howell S, Buttery A, and Bray JE
- Abstract
Background: Prompt recognition of symptoms and response to acute coronary syndrome (ACS) are crucial for reducing pre-hospital delay. This study compares culturally and linguistically diverse (CALD) and non-CALD Australian populations in terms of their (i) ACS symptom knowledge and (ii) intention to call emergency medical services (EMS) for ACS., Method: This cross-sectional study used data from HeartWatch, an online survey collected by the National Heart Foundation of Australia between 2018 and 2020 for Australian adults aged ≥18 years. CALD respondents were defined as non-Indigenous individuals who reported speaking a language other than English at home. Characteristics associated with ACS symptom knowledge and EMS calling intentions were analysed using multivariable logistic regression., Results: Of 31,919 respondents, 16.3% were from CALD backgrounds (n=5,212). Compared with non-CALD, CALD respondents were less likely to name any ACS symptom (63.0% vs 76.0%; adjusted odds ratio [AOR] 0.66; 95% confidence interval [CI] 0.61-0.70) and were less likely to state that they would call an ambulance for ACS (50.2% vs 72.1%; AOR 0.53; 95% CI 0.50-0.57). Almost one-quarter (23.0%) of CALD respondents reported not knowing what they would do. In both groups, males, individuals aged ≤60 years, and those with diabetes were less likely to name an ACS symptom and had lower intention to call an ambulance. Those unable to list a single ACS symptom also had a lower intention to call an ambulance., Conclusions: Knowledge of ACS symptoms and intention to call an ambulance were lower among CALD respondents. The demographics of those with low ACS symptom knowledge and EMS calling intention were similar in the two groups. Future education efforts in Australia should focus on promoting ACS symptom knowledge and EMS use and should target these groups., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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36. The impact of locked cabinets for automated external defibrillators (AEDs) on cardiac arrest and AED outcomes: A scoping review.
- Author
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Oonyu L, Perkins GD, Smith CM, Vaillancourt C, Olasveengen TM, and Bray JE
- Abstract
Background: Rapid public defibrillation with automated external defibrillators (AEDs) is critical to improving out-of-hospital cardiac arrest survival. Concerns about AED theft and vandalism have led to implementing security measures, including locked cabinets. This scoping review, conducted as part of the evidence review for the International Liaison Committee on Resuscitation, explores the impact of securing AEDs in locked cabinets., Methods: Searches of Medline, Embase, Cochrane, CINAHL (from database inception to 25/5/2024) and Google Scholar (first 200 articles). Studies of any type or design, published with an English abstract, examining the impact of locked AED cabinets were included. The included studies were grouped by outcomes, and an iterative narrative synthesis was performed., Results: We screened 2,096 titles and found 10 relevant studies: 8 observational studies (4 published as conference abstracts) and 2 simulation studies. No study reported patient outcomes. Studies reported data on between 36 and 31,938 AEDs. Most studies reported low rates (<2%) of theft/missing/vandalism, including AEDs that were accessible 24/7. The only study comparing unlocked and locked cabinets showed minimal difference in theft and vandalism rates (0.3% vs. 0.1%). Two simulation studies showed significantly slower AED retrieval when additional security measures, included locked cabinets, were used. A survey of first responders reported half (25/50) were injured while accessing an AED that required breaking glass to access., Conclusion: The limited literature suggests that vandalism and the loss of AEDs are rare and occur in locked and unlocked cabinets. Research on this topic is needed that focuses on real-life retrieval and patient outcomes., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. GDP is Editor-in-Chief and JEB is an Associate Editor of Resusciation Plus., (© 2024 The Author(s).)
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- 2024
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37. A Call to Action to Improve Cardiac Arrest Outcomes: A Report From the National Summit for Cardiac Arrest.
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La Gerche A, Paratz ED, Bray JE, Jennings G, Page G, Timbs S, Vandenberg JI, Abhayaratna W, Chow CK, Dennis M, Figtree GA, Kovacic JC, Maris J, Nehme Z, Parsons S, Pflaumer A, Puranik R, Stub D, Freitas E, Zecchin R, Cartledge S, Haskins B, and Ingles J
- Abstract
Sudden cardiac arrest (SCA) represents a major cause of premature mortality globally, with enormous impact and financial cost to victims, families, and communities. SCA prevention should be considered a health priority in Australia. National Cardiac Arrest Summits were held in June 2022 and March 2023, with inclusion from multi-faceted endeavours related to SCA prevention. It was agreed to establish a multidisciplinary Australian Sudden Cardiac Arrest Alliance (AuSCAA) working group charged with developing a national unified strategy, with clear and measurable quality indicators and standardised outcome measures, to amplify the goal of SCA prevention throughout Australia. A multi-faceted prevention strategy will include i) endeavours to progress community awareness, ii) improved fundamental mechanistic understanding, iii) implementation of best-practice resuscitation strategies for all demographics and locations, iv) secondary risk assessment directed to family members, and v) development of (near) real-time registry of cardiac arrest cases to inform areas of need and effectiveness of interventions. Together, we can and should reduce the impact of SCA in Australia., Competing Interests: Declaration of Competing Interest E.D.P. has received speaker fees from Bristol Myers Squibb. All other authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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38. Prehospital treatment-seeking for acute coronary syndrome in culturally and linguistically diverse immigrant populations: a scoping review.
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Olani AB, Eastwood K, Finn J, Clark RA, and Bray JE
- Abstract
Aims: Studies consistently report longer prehospital delays in culturally and linguistically diverse (CALD) patients experiencing acute coronary syndrome (ACS). A scoping review was conducted to describe terms and methods used to define and identify CALD populations and summarise available evidence on factors related to prehospital delays in ACS studies involving CALD populations., Methods and Results: We searched six electronic databases for published studies and Google Scholar for grey literature to identify studies on prehospital treatment-seeking in CALD immigrants experiencing ACS. We followed the Joanna Briggs Institute methodological framework for scoping review. Twenty-three studies met our eligibility criteria (quantitative n=17; qualitative n=6; mixed n=1). Terms like ethnicity, migrant or expatriate defined CALD populations. Most studies used a single indicator (e.g., country of birth) to identify CALD cohorts, and only two studies used a theoretical model related to treatment-seeking delays to guide data collection. Most factors affecting prehospital delays in CALD populations were similar to those reported in general populations. A unique finding was a difference in the language used to describe symptoms, which, when translated, changes their meaning and resulted in misinterpretation by healthcare providers (e.g., asfixiarse [translates as asphyxiate/suffocate] used for dyspnoea/shortness of breath in Hispanics)., Conclusions: Terms and methods used for defining and identifying CALD populations are inconsistent. Studies on factors affecting prehospital treatment-seeking in CALD ACS patients are limited. Future studies should use theoretical models related to treatment-seeking delays to comprehensively explore factors affecting prehospital delays. Additionally, researchers should consider self-reported or multiple indicators to determine CALD status., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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39. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: 2024 Update of the Utstein Out-of-Hospital Cardiac Arrest Registry Template.
- Author
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Bray JE, Grasner JT, Nolan JP, Iwami T, Ong MEH, Finn J, McNally B, Nehme Z, Sasson C, Tijssen J, Lim SL, Tjelmeland I, Wnent J, Dicker B, Nishiyama C, Doherty Z, Welsford M, and Perkins GD
- Subjects
- Humans, Treatment Outcome, Registries, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest mortality, Cardiopulmonary Resuscitation methods, Emergency Medical Services
- Abstract
The Utstein Out-of-Hospital Cardiac Arrest Resuscitation Registry Template, introduced in 1991 and updated in 2004 and 2015, standardizes data collection to enable research, evaluation, and comparisons of systems of care. The impetus for the current update stemmed from significant advances in the field and insights from registry development and regional comparisons. This 2024 update involved representatives of the International Liaison Committee on Resuscitation and used a modified Delphi process. Every 2015 Utstein data element was reviewed for relevance, priority (core or supplemental), and improvement. New variables were proposed and refined. All changes were voted on for inclusion. The 2015 domains-system, dispatch, patient, process, and outcomes-were retained. Further clarity is provided for the definitions of out-of-hospital cardiac arrest attended resuscitation and attempted resuscitation. Changes reflect advancements in dispatch, early response systems, and resuscitation care, as well as the importance of prehospital outcomes. Time intervals such as emergency medical service response time now emphasize precise reporting of the times used. New flowcharts aid the reporting of system effectiveness for patients with an attempted resuscitation and system efficacy for the Utstein comparator group. Recognizing the varying capacities of emergency systems globally, the writing group provided a minimal dataset for settings with developing emergency medical systems. Supplementary variables are considered useful for research purposes. These revisions aim to elevate data collection and reporting transparency by registries and researchers and to advance international comparisons and collaborations. The overarching objective remains the improvement of outcomes for patients with out-of-hospital cardiac arrest.
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- 2024
- Full Text
- View/download PDF
40. Effectiveness of ultraportable automated external defibrillators: A scoping review.
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Debaty G, Perkins GD, Dainty KN, Norii T, Olasveengen TM, and Bray JE
- Abstract
Background: Ultraportable automated external defibrillators (AEDs) are a new generation of defibrillators that are small, lightweight, easy to carry on one's person, and affordable for personal and home use. They offer the opportunity to increase AED availability in case of out-of-hospital cardiac arrest (OHCA) and therefore improve outcomes.We aimed to review evidence supporting the potential effect on outcomes and the performance of these ultraportable AEDs., Methods: We searched Ovid Medline, Embase and Cochrane databases from 2012 to July 4th, 2024 to identify any studies related to ultraportable AED. The population was adult and children with OHCA who were treated with an ultra-portable AED. All outcomes were accepted. We limited study designs to randomized controlled trials and non-randomized studies. Data charting was done by the primary author using standardized data abstraction forms., Results: The search strategy identified 54 studies (Pubmed = 26, Embase = 28, with 19 duplicates). We included three articles in the final review. One study was a medico-economic simulation study including 600,000 simulated patients, one is the study protocol of cluster randomized trial of providing ultraportable AEDs to first responders and one is an abstract with preliminary results of this trial reporting 1805 community responders recruited, 903 allocated to ultraportable AED. No studies to date have reported patient outcomes., Conclusion: This review found no evidence of ultraportable AED device performance, clinical or safety outcomes. There is an urgent need for further research to determine the safety and effectiveness of ultraportable AEDs., (© 2024 The Author(s).)
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- 2024
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41. Development of the Pneumococcal Genome Library, a core genome multilocus sequence typing scheme, and a taxonomic life identification number barcoding system to investigate and define pneumococcal population structure.
- Author
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Jansen van Rensburg MJ, Berger DJ, Yassine I, Shaw D, Fohrmann A, Bray JE, Jolley KA, Maiden MCJ, and Brueggemann AB
- Subjects
- Humans, Phylogeny, Gene Library, Whole Genome Sequencing methods, Streptococcus pneumoniae genetics, Streptococcus pneumoniae classification, Streptococcus pneumoniae isolation & purification, Multilocus Sequence Typing methods, Genome, Bacterial, DNA Barcoding, Taxonomic methods, Pneumococcal Infections microbiology, Pneumococcal Infections epidemiology
- Abstract
Investigating the genomic epidemiology of major bacterial pathogens is integral to understanding transmission, evolution, colonization, disease, antimicrobial resistance and vaccine impact. Furthermore, the recent accumulation of large numbers of whole genome sequences for many bacterial species enhances the development of robust genome-wide typing schemes to define the overall bacterial population structure and lineages within it. Using the previously published data, we developed the Pneumococcal Genome Library (PGL), a curated dataset of 30 976 genomes and contextual data for carriage and disease pneumococci recovered between 1916 and 2018 in 82 countries. We leveraged the size and diversity of the PGL to develop a core genome multilocus sequence typing (cgMLST) scheme comprised of 1222 loci. Finally, using multilevel single-linkage clustering, we stratified pneumococci into hierarchical clusters based on allelic similarity thresholds and defined these with a taxonomic life identification number (LIN) barcoding system. The PGL, cgMLST scheme and LIN barcodes represent a high-quality genomic resource and fine-scale clustering approaches for the analysis of pneumococcal populations, which support the genomic epidemiology and surveillance of this leading global pathogen.
- Published
- 2024
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42. Corrigendum to "2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces" [Resuscitation 195 (2024) 109992].
- Author
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Phil Chung S, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Ko YC, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Morrison LJ, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, and Nolan JP
- Published
- 2024
- Full Text
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43. Cardiac arrest and cardiopulmonary resuscitation outcome reports: 2024 update of the Utstein Out-of-Hospital Cardiac Arrest Registry template.
- Author
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Grasner JT, Bray JE, Nolan JP, Iwami T, Ong MEH, Finn J, McNally B, Nehme Z, Sasson C, Tijssen J, Lim SL, Tjelmeland I, Wnent J, Dicker B, Nishiyama C, Doherty Z, Welsford M, and Perkins GD
- Subjects
- Humans, Delphi Technique, Out-of-Hospital Cardiac Arrest therapy, Registries, Cardiopulmonary Resuscitation methods, Emergency Medical Services methods
- Abstract
The Utstein Out-of-Hospital Cardiac Arrest Resuscitation Registry Template, introduced in 1991 and updated in 2004 and 2015, standardizes data collection to enable research, evaluation, and comparisons of systems of care. The impetus for the current update stemmed from significant advances in the field and insights from registry development and regional comparisons. This 2024 update involved representatives of the International Liaison Committee on Resuscitation and used a modified Delphi process. Every 2015 Utstein data element was reviewed for relevance, priority (core or supplemental), and improvement. New variables were proposed and refined. All changes were voted on for inclusion. The 2015 domains-system, dispatch, patient, process, and outcomes-were retained. Further clarity is provided for the definitions of out-of-hospital cardiac arrest attended resuscitation and attempted resuscitation. Changes reflect advancements in dispatch, early response systems, and resuscitation care, as well as the importance of prehospital outcomes. Time intervals such as emergency medical service response time now emphasize precise reporting of the times used. New flowcharts aid the reporting of system effectiveness for patients with an attempted resuscitation and system efficacy for the Utstein comparator group. Recognizing the varying capacities of emergency systems globally, the writing group provided a minimal dataset for settings with developing emergency medical systems. Supplementary variables are considered useful for research purposes. These revisions aim to elevate data collection and reporting transparency by registries and researchers and to advance international comparisons and collaborations. The overarching objective remains the improvement of outcomes for patients with out-of-hospital cardiac arrest., (Copyright © 2024 European Resuscitation Council, American Heart Association Inc., International Liaison Committee on Resuscitation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
44. Unlocking the key to increasing survival from out-of-hospital cardiac arrest - 24/7 accessible AEDs.
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Page G and Bray JE
- Subjects
- Humans, Emergency Medical Services methods, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest mortality, Cardiopulmonary Resuscitation methods, Defibrillators
- Abstract
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Greg Page is the founder and CEO of Heart of the Nation, which sells AEDs to the community (GP volunteers and is not paid by Heart of the Nation). Janet Bray is an Editor of Resuscitation Plus, and Editorial Board Member of Resuscitation and is funded by the Heart Foundation of Australia.
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- 2024
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45. Bystander cardiopulmonary resuscitation differences by sex - The role of arrest recognition.
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Munot S, Bray JE, Redfern J, Bauman A, Marschner S, Semsarian C, Denniss AR, Coggins A, Middleton PM, Jennings G, Angell B, Kumar S, Kovoor P, Vukasovic M, Bendall JC, Evens T, and Chow CK
- Subjects
- Humans, Female, Male, Retrospective Studies, New South Wales epidemiology, Middle Aged, Aged, Sex Factors, Emergency Medical Services statistics & numerical data, Emergency Medical Services methods, Adult, Defibrillators statistics & numerical data, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest mortality, Cardiopulmonary Resuscitation methods, Cardiopulmonary Resuscitation statistics & numerical data
- Abstract
Purpose: To assess whether bystander cardiopulmonary resuscitation (CPR) differed by patient sex among bystander-witnessed out-of-hospital cardiac arrests (OHCA)., Methods: This study is a retrospective analysis of paramedic-attended OHCA in New South Wales (NSW) between January 2017 to December 2019 (restricted to bystander-witnessed cases). Exclusions included OHCA in aged care, medical facilities, with advance care directives, from non-medical causes. Multivariate logistic regression examined the association of patient sex with bystander CPR. Secondary outcomes were OHCA recognition, bystander AED application, initial shockable rhythm, and survival outcomes., Results: Of 4,491cases, females were less likely to receive bystander CPR in private residential (Adjusted Odds ratio [AOR]: 0.82, 95%CI: 0.70-0.95) and public locations (AOR: 0.58, 95%CI:0.39-0.88). OHCA recognition during the emergency call was lower for females arresting in public locations (84.6% vs 91.6%, p = 0.002) and this partially explained the association of sex with bystander CPR (∼44%). This difference in recognition was not observed in private residential locations (p = 0.2). Bystander AED use was lower for females (4.8% vs 9.6%, p < 0.001); however, after adjustment for location and other covariates, this relationship was no longer significant (AOR: 0.83, 95%CI: 0.60-1.12). Females were less likely to be in an initial shockable rhythm (AOR: 0.52, 95%CI: 0.44-0.61), but more likely to survive the event (AOR: 1.34, 95%CI: 1.15-1.56). There was no sex difference in survival to hospital discharge (AOR: 0.96, 95%CI: 0.77-1.19)., Conclusion: OHCA recognition and bystander CPR differ by patient sex in NSW. Research is needed to understand why this difference occurs and to raise public awareness of this issue., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. JB is an Editorial Board Member of Resuscitation., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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46. Targeted metagenomics reveals association between severity and pathogen co-detection in infants with respiratory syncytial virus.
- Author
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Lin GL, Drysdale SB, Snape MD, O'Connor D, Brown A, MacIntyre-Cockett G, Mellado-Gomez E, de Cesare M, Ansari MA, Bonsall D, Bray JE, Jolley KA, Bowden R, Aerssens J, Bont L, Openshaw PJM, Martinon-Torres F, Nair H, Golubchik T, and Pollard AJ
- Subjects
- Infant, Child, Humans, Child, Preschool, Hospitalization, Respiratory Syncytial Virus, Human genetics, Respiratory Syncytial Virus Infections diagnosis, Respiratory Syncytial Virus Infections epidemiology, Respiratory Tract Infections, Coinfection
- Abstract
Respiratory syncytial virus (RSV) is the leading cause of hospitalisation for respiratory infection in young children. RSV disease severity is known to be age-dependent and highest in young infants, but other correlates of severity, particularly the presence of additional respiratory pathogens, are less well understood. In this study, nasopharyngeal swabs were collected from two cohorts of RSV-positive infants <12 months in Spain, the UK, and the Netherlands during 2017-20. We show, using targeted metagenomic sequencing of >100 pathogens, including all common respiratory viruses and bacteria, from samples collected from 433 infants, that burden of additional viruses is common (111/433, 26%) but only modestly correlates with RSV disease severity. In contrast, there is strong evidence in both cohorts and across age groups that presence of Haemophilus bacteria (194/433, 45%) is associated with higher severity, including much higher rates of hospitalisation (odds ratio 4.25, 95% CI 2.03-9.31). There is no evidence for association between higher severity and other detected bacteria, and no difference in severity between RSV genotypes. Our findings reveal the genomic diversity of additional pathogens during RSV infection in infants, and provide an evidence base for future causal investigations of the impact of co-infection on RSV disease severity., (© 2024. The Author(s).)
- Published
- 2024
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47. Beyond numbers: The importance of detailing systems of care when reporting data on the emergency response systems for cardiac arrest.
- Author
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Bray JE and Ong MEH
- Subjects
- Humans, Heart Arrest therapy, Cardiopulmonary Resuscitation, Emergency Medical Services, Out-of-Hospital Cardiac Arrest therapy
- Abstract
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Published
- 2024
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- View/download PDF
48. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.
- Author
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, and Nolan JP
- Subjects
- Adult, Female, Child, Infant, Newborn, Humans, First Aid, Consensus, Out-of-Hospital Cardiac Arrest therapy, Premature Birth, Cardiopulmonary Resuscitation methods, Emergency Medical Services
- Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
49. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.
- Author
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, and Nolan JP
- Subjects
- Adult, Female, Child, Infant, Newborn, Humans, First Aid, Consensus, Out-of-Hospital Cardiac Arrest diagnosis, Out-of-Hospital Cardiac Arrest therapy, Premature Birth, Cardiopulmonary Resuscitation, Emergency Medical Services
- Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
- Published
- 2023
- Full Text
- View/download PDF
50. Effect of a national awareness campaign on ambulance attendances for chest pain and out-of-hospital cardiac arrest.
- Author
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Nehme Z, Cameron P, Nehme E, Finn J, Bosley E, Brink D, Ball S, Doan TN, and Bray JE
- Subjects
- Humans, Ambulances, Australia, Chest Pain epidemiology, Chest Pain etiology, Chest Pain prevention & control, Registries, Out-of-Hospital Cardiac Arrest epidemiology, Out-of-Hospital Cardiac Arrest therapy, Out-of-Hospital Cardiac Arrest diagnosis, Cardiopulmonary Resuscitation, Emergency Medical Services, Myocardial Infarction
- Abstract
Aim: Awareness of heart attack symptoms may enhance health-seeking behaviour and prevent premature deaths from out-of-hospital cardiac arrest (OHCA). We sought to investigate the impact of a national awareness campaign on emergency medical service (EMS) attendances for chest pain and OHCA., Methods: Between January 2005 and December 2017, we included registry data for 97,860 EMS-attended OHCA cases from 3 Australian regions and dispatch data for 1,631,217 EMS attendances for chest pain across 5 Australian regions. Regions were exposed to between 11 and 28 months of television, radio, and print media activity. Multivariable negative binomial models were used to explore the effect of campaign activity on the monthly incidence of EMS attendances for chest pain and OHCA., Results: Months with campaign activity were associated with an 8.8% (IRR 1.09, 95% CI: 1.07, 1.11) increase in the incidence of EMS attendances for chest pain and a 5.6% (IRR 0.94, 95% CI: 0.92, 0.97) reduction in OHCA attendances. Larger intervention effects were associated with increasing months of campaign activity, increasing monthly media spending and media exposure in 2013. In stratified analyses of OHCA cases, the largest reduction in incidence during campaign months was observed for unwitnessed arrests (IRR 0.93, 95% CI: 0.90, 0.96), initial non-shockable arrests (IRR 0.93, 95% CI: 0.90, 0.97) and arrests occurring in private residences (IRR 0.95, 95% CI: 0.91, 0.98)., Conclusion: A national awareness campaign targeting knowledge of heart attack symptoms was associated with an increase in EMS use for chest pain and a reduction in OHCA incidence and may serve as an effective primary prevention strategy for OHCA., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ZN, JF and JB are editorial board members of Resuscitation., (Copyright © 2023 Elsevier B.V. All rights reserved.)
- Published
- 2023
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