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The present eye-tracking study investigates whether individuals with different levels of contamination fear are more likely to focus their attention on disgusting stimuli to explore them or to pull their attention away to avoid them. Ninety-two nonclinical participants with varying degrees of contamination fear performed a dot probe task. Eye-tracking methodology was employed to record gaze patterns during the task. In each trial participants looked at two pictures (disgust-neutral, fear-neutral, or neutral-neutral). Participants were further asked about the contents of the picture and the confidence of their answer. The results show that reaction times were slower and fixations were longer and more frequent for disgust targets compared with fear and neutral targets, which was further amplified in individuals with high contamination fear. However, image details of disgusting pictures were remembered less correctly than details of fearful pictures. These findings confirm the idea that attention on disgusting stimuli is maintained. Further, the findings indicate that disgust is processed more superficially and might also be related to disgust-associated uncertainty and ambiguity. The results may help to understand the difficult-to-change nature of disgust, which could be relevant to habituation and extinction processes in exposure therapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rapid and accurate diagnostics of bacterial infections are necessary for efficient treatment of antibiotic-resistant pathogens. Cultivation-based methods, such as antibiotic susceptibility testing (AST), are slow, resource-demanding, and can fail to produce results before the treatment needs to start. This increases patient risks and antibiotic overprescription. Here, we present a deep-learning method that uses transformers to merge patient data with available AST results to predict antibiotic susceptibilities that have not been measured. The method is combined with conformal prediction (CP) to enable the estimation of uncertainty at the patient-level. After training on three million AST results from thirty European countries, the method made accurate predictions for most antibiotics while controlling the error rates, even when limited diagnostic information was available. We conclude that transformers and CP enables confidence-based decision support for bacterial infections and, thereby, offer new means to meet the growing burden of antibiotic resistance.

Like for many enteric bacteria, flagella are a crucial virulence factor for the foodborne pathogenCampylobacter jejuni, allowing the bacteria to move through the viscous mucus of the human intestine. Assembly of the complex flagellar machinery and filament requires hierarchical regulation via transcriptional control of each component. InC. jejuni, class I genes are transcribed from σ70-dependent promoters and class II/III genes with the help of the alternative sigma factors RpoN (σ54) and FliA (σ28). In contrast to transcriptional control, less is known about post-transcriptional regulation of flagellar biosynthesis cascades via small regulatory RNAs (sRNAs). Here, we characterized two sRNAs with opposing effects on the cascade that fine-tuneC. jejuniflagellar filament assembly and thereby impact motility. We demonstrate that the highly conservedCampylobactersRNA CJnc230 (FlmE, flagellar length andmotilityenhancer), encoded downstream of the flagellar hook structural protein FlgE, is dependent on RpoN and that RNase III processes CJnc230 from theflgEmRNA, while RNase Y and PNPase mature its 3’ end. We identify mRNAs encoding a regulator of flagella-flagella interactions and the anti-σ28factor FlgM as direct targets of CJnc230 repression. Overexpression of CJnc230 de-represses FliA activity and upregulates class III flagellar genes, such as the major flagellinflaA, culminating in longer flagella and increased motility. In contrast, overexpression of the FliA-dependent sRNA CJnc170 (FlmR, flagellar length andmotilityrepressor) reduces flagellar length and motility. Overall, our study demonstrates sRNA-mediated post-transcriptional regulation fine-tunesC. jejuniflagellar biosynthesis through balancing of the hierarchically expressed components.

In contrast to extensively studied prokaryotic ‘small’ transcriptomes (encompassing all small noncoding RNAs), small proteomes (here defined as including proteins ≤70 aa) are only now entering the limelight. The absence of a complete small protein catalogue in most prokaryotes precludes our understanding of how these molecules affect physiology. So far, archaeal genomes have not yet been analyzed broadly with a dedicated focus on small proteins. Here, we present a combinatorial approach, integrating experimental data from small protein-optimized mass spectrometry (MS) and ribosome profiling (Ribo-seq), to generate a high confidence inventory of small proteins in the model archaeon Haloferax volcanii. We demonstrate by MS and Ribo-seq that 67% of the 317 annotated small open reading frames (sORFs) are translated under standard growth conditions. Furthermore, annotation-independent analysis of Ribo-seq data showed ribosomal engagement for 47 novel sORFs in intergenic regions. A total of seven of these were also detected by proteomics, in addition to an eighth novel small protein solely identified by MS. We also provide independent experimental evidence in vivo for the translation of 12 sORFs (annotated and novel) using epitope tagging and western blotting, underlining the validity of our identification scheme. Several novel sORFs are conserved in Haloferax species and might have important functions. Based on our findings, we conclude that the small proteome of H. volcanii is larger than previously appreciated, and that combining MS with Ribo-seq is a powerful approach for the discovery of novel small protein coding genes in archaea.

Drowning is a global health problem and deeper knowledge about the extent and causes is of utmost importance for implementing preventative actions. The aim of this study was to describe the incidence and characteristics of drowning in Sweden over time, including both non-fatal and fatal cases.All cases identified as drowning (ICD-10 coding) at a national level in Sweden between 2003-2017 were collected. Three sources of data from the Swedish National Board of Health and Welfare were extracted via the Cause of Death Register and the National Patient Register.Over 15 years, a total of 6609 cases occurred, resulting in an annual incidence of 4.66 per 100 000. The median age was 49 years (IQR 23-67) and 67% were males. Non-fatal drownings represented 51% (n = 3363), with an overall non-fatal to fatal ratio of 1:1, this being 8:1 for children (0-17 years of age). Non-fatal cases were more often female (36% vs. 30%; p 0.001), younger 30 (IQR 10-56) vs. 60 (IQR: 45-72) (p 0.001) and of unintentional nature (81% vs. 55%; p 0.001). The overall incidence decreased over time from 5.6 to 4.1 per 100 000 (p 0.001). The highest rate of 30-day survival was found in females 0-17 years (94%, 95% CI 91.1-95.5) and the lowest in males66 years (28.7%, 95% CI 26.2-31.2). Although the incidence in children 0-4 years increased from 7.4 to 8.1 per 100 000 (p 0.001), they demonstrated the highest non-fatal to fatal ratio (13:1).Drowning is declining but remains a consistent and underestimated public-health problem. Non-fatal drowning cases represent about half of the burden and characteristics differ from fatal drowning cases, being younger, more often female and of unintentional nature.

Although self-relevance is widely acknowledged to enhance stimulus processing, the exclusivity of this effect remains open to question. In particular, in commonly adopted experimental paradigms, the prioritisation of self-relevant (vs. other-relevant) material may reflect the operation of a task-specific strategy rather than an obligatory facet of social-cognitive functioning. By changing basic aspects of the decisional context, it may therefore be possible to generate stimulus-prioritisation effects for targets other than the self. Based on the demonstration that ownership facilitates object categorisation (i.e., self-ownership effect), here we showed that stimulus prioritisation is sensitive to prior expectations about the prevalence of forthcoming objects (owned-by-self vs. owned-by-friend) and whether these beliefs are supported during the task. Under conditions of stimulus uncertainty (i.e., no prior beliefs), replicating previous research, objects were classified more rapidly when owned-by-self compared with owned-by-friend (Experiment 1). When, however, the frequency of stimulus presentation either confirmed (Experiment 2) or disconfirmed (Experiment 3) prior expectations, stimulus prioritisation was observed for the most prevalent objects regardless of their owner. A hierarchical drift diffusion model (HDDM) analysis further revealed that decisional bias was underpinned by differences in the evidential requirements of response generation. These findings underscore the flexibility of ownership effects (i.e., stimulus prioritisation) during object processing.

The US Food and Drug Administration (FDA) has recently added a new ‘black box warning’ on all currently approved Janus kinase (JAK) inhibitors indicated for the treatment of arthritis and other inflammatory conditions based on results from the ORAL Surveillance study of tofacitinib versus tumour necrosis factor alpha inhibitors in rheumatoid arthritis. This is a warning difficult to ignore because the data, being from a randomised controlled trial, are of high fidelity and hard to reproach. It is especially problematic because safety data for all the other JAK inhibitors will be pending for several years. So how might we proceed, without being bound by our stasis? The lack of absolute certainty seems to require a pragmatic approach to the routine care use of JAK inhibitors. The patients who were at greatest risk were older and had other risk factors for the corresponding adverse events, in keeping with effect modification. This highlights the need to focus on risk stratification when tailoring therapy. In this viewpoint, we propose a simple illustration to guide clinical decision-making. First, identify general risk factors for venous thromboembolic event (VTE), major adverse cardiac event (MACE) and cancer (age>65 years and smoking) and whether there is a previous history of VTE, MACE or cancer. Then, evaluate risk based on the number of other risk factors for VTE and the number of other risk factors for MACE. Ultimately, ‘treat-to-target’ will in the end always be ‘treat-to-agreement’. As we have done in the past, and will do in the future, the optimal treatment strategy will have to be tailored based on individual patient risk factors and preferences in a shared-decision process.

Bacterial small RNAs (sRNAs) are widespread post-transcriptional regulators that control bacterial stress responses and virulence. Nevertheless, little is known about how they arise and evolve. Homologs can be difficult to identify beyond the strain level using sequence-based approaches, and similar functionalities can arise by convergent evolution. Here, we found that the virulence-associated CJnc190 sRNA of the foodborne pathogen Campylobacter jejuni resembles the RepG sRNA from the gastric pathogen Helicobacter pylori. However, while both sRNAs bind G-rich sites in their target mRNAs using a C/U-rich loop, they largely differ in their biogenesis. RepG is transcribed from a stand-alone gene and does not require processing, whereas CJnc190 is transcribed from two promoters as precursors that are processed by RNase III and also has a cis-encoded antagonist, CJnc180. By comparing CJnc190 homologs in diverse Campylobacter species, we show that RNase III-dependent processing of CJnc190 appears to be a conserved feature even outside of C. jejuni. We also demonstrate the CJnc180 antisense partner is expressed in C. coli, yet here might be derived from the 3'UTR (untranslated region) of an upstream flagella-related gene. Our analysis of G-tract targeting sRNAs in Epsilonproteobacteria demonstrates that similar sRNAs can have markedly different biogenesis pathways.

CRISPR-Cas systems store fragments of foreign DNA, called spacers, as immunological recordings used to combat future infections. Of the many spacers stored in a CRISPR array, the most recent are known to be prioritized for immune defence. However, the underlying mechanism remains unclear. Here we show that the leader region upstream of CRISPR arrays in CRISPR-Cas9 systems enhances CRISPR RNA (crRNA) processing from the newest spacer, prioritizing defence against the matching invader. Using the CRISPR-Cas9 system from Streptococcus pyogenes as a model, we found that the transcribed leader interacts with the conserved repeats bordering the newest spacer. The resulting interaction promotes transactivating crRNA (tracrRNA) hybridization with the second of the two repeats, accelerating crRNA processing. Accordingly, disruption of this structure reduces the abundance of the associated crRNA and immune defence against targeted plasmids and bacteriophages. Beyond the S. pyogenes system, bioinformatics analyses revealed that leader-repeat structures appear across CRISPR-Cas9 systems. CRISPR-Cas systems thus possess an RNA-based mechanism to prioritize defence against the most recently encountered invaders.

Background Early defibrillation is critical for the chance of survival in in out-of-hospital cardiac arrest (OHCA). Drones, used to deliver automated external defibrillators (AEDs), may shorten time to defibrillation, but this has never been evaluated in real-life emergencies. Purpose The aim of this study was to investigate the feasibility of AED-delivery by drones in real-life cases of OHCA. Methods In this prospective clinical trial, three AED-equipped drones were placed within controlled airspace in Sweden, covering approximately 80,000 inhabitants (125km2). Drones were integrated in the emergency medical services for automated deployment in beyond-visual-line-of-sight flights in; a) consecutive real-life suspected OHCAs b) test-flights from 06–01–20 to 09–30–20. Primary outcome was the proportion of successful AED-deliveries when drones were dispatched in cases of suspected OHCA. Among secondary outcomes were the proportion of cases where AED-drones arrived prior to ambulance and time benefit vs. ambulance. Results Totally 14 cases were eligible for dispatch during the study period in which AED-drones took off in 12 alerts to suspected OHCA; with a median distance to location 3,1 km (IQR:2,8–3,4). AED-delivery was feasible within 9 meters (IQR:7,5–10,5) from the location and successful in 11 alerts, 92%. AED-drones arrived prior to ambulances in 64%, with a median time benefit of 01:52 minutes (IQR:01:35–04:54). In an additional 61 test-flights the AED-delivery success rate was 90% (55/61). Conclusion In this pilot study, we have shown that AED-delivery by drones in real-life cases of OHCA is feasible with a substantial time benefit and a successful delivery rate of 92%. Further technological improvements are needed to increase dispatch rate and time gains. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Swedish heart-lung foundation

Carnivores play an important role in ecosystem functioning as apex predators. However, most carnivore species are threatened or have been extirpated in human-dominated landscapes. The Mediterranean region of central Chile is a biodiversity hotspot, but expansion of agricultural areas such as vineyards is degrading wildlife habitat. We estimated the species richness and composition of carnivore communities in remnant fragments of sclerophyllous forest-shrubland in the vineyard landscapes of central Chile to evaluate the effects of human disturbance at different spatial scales. We tested two hypotheses: (1) vineyard landscapes with higher levels of human disturbance support a lower diversity of native carnivores in fragments of remnant native vegetation compared to landscapes with larger areas of natural habitat, and (2) habitat specialists and generalists respond differentially to human influence at the habitat vs landscape spatial scale. We used camera traps at 12 sites across the study area and evaluated the impact of human disturbance indicators on the richness and detection frequency of carnivore species. We found that human population density negatively affected carnivore richness and was associated with a lower detection frequency of the Vulnerable guiñaLeopardus guigna. The presence of domestic dogs also had a negative effect on the detection frequency of the guiña and the two native species of foxes, the culpeoLycalopex culpaeusand South American grey foxLycalopex griseus. We conclude that protecting remnants of native forest in vineyard landscapes is crucial for carnivore conservation in central Chile.

A characteristic feature of daily life is encountering people in groups. Surprisingly, however, at least during the initial stages of processing, research has focused almost exclusively on the construal of single individuals. As such, it remains unclear whether person and people (i.e., group) perception yield comparable or divergent outcomes. Addressing this issue, here we explored a core social-cognitive topic—stereotype activation—by presenting both single and multiple facial primes in a sequential-priming task. In addition, the processes underlying task performance were probed using a drift diffusion model analysis. Based on prior work, it was hypothesised that multiple (vs. single) primes would increase stereotype-based responding. Across two experiments, a consistent pattern of results emerged. First, stereotype priming was insensitive to the number of primes that were presented and occurred only at a short prime-target stimulus onset asynchrony (i.e., 250 ms). Second, priming was underpinned by a bias towards congruent (vs. incongruent) prime-target responses. Collectively these findings advance understanding of the emergence and origin of stereotype priming during person and people perception.

Small proteins, those encoded by open reading frames, with less than or equal to 50 codons, are emerging as an important class of cellular macromolecules in all kingdoms of life. However, they are recalcitrant to detection by proteomics or in silico methods. Ribosome profiling (Ribo-seq) has revealed widespread translation of sORFs in diverse species, and this has driven the development of ORF detection tools using Ribo-seq read signals. However, only a handful of tools have been designed for bacterial data, and have not yet been systematically compared. Here, we have performed a comprehensive benchmark of ORF prediction tools which handle bacterial Ribo-seq data. For this, we created a novel Ribo-seq dataset for E. coli, and based on this plus three publicly available datasets for different bacteria, we created a benchmark set by manual labeling of translated ORFs using their Ribo-seq expression profile. This was then used to investigate the predictive performance of four Ribo-seq-based ORF detection tools we found are compatible with bacterial data (Reparation_blast, DeepRibo, Ribo-TISH and SPECtre). The tool IRSOM was also included as a comparison for tools using coding potential and RNA-seq coverage only. DeepRibo and Reparation_blast robustly predicted translated ORFs, including sORFs, with no significant difference for those inside or outside of operons. However, none of the tools was able to predict a set of recently identified, novel, experimentally-verified sORFs with high sensitivity. Overall, we find there is potential for improving the performance, applicability, usability, and reproducibility of prokaryotic ORF prediction tools that use Ribo-Seq as input.Key pointsCreated a benchmark set for Ribo-seq based ORF prediction in bacteriaDeepRibo the first choice for bacterial ORF prediction tasksTool performance is comparable between operon vs single gene regionsIdentification of novel sORF with DeepRibo is, with restrictions, possible, by using the top 100 novel sORFs sorted by rank.Experimental results show that considering translation initiation site data could boost the detection of novel small ORFsDetermination of novel sORFs in E. coli using a new experimental protocol to enrich for translation initiation site. These data-set shows that still a significant part (here 8 out 24, so 1/3) are not detected dispute sufficient Ribo-seq signal. An additional 7 could be recovered using translation initiation site protocols.Tools should embrace the use of replicate data and improve packaging, usability and documentation.

Bacterial small RNAs (sRNAs) are important post-transcriptional regulators in stress responses and virulence. They can be derived from an expanding list of genomic contexts, such as processing from parental transcripts by RNase E. The role of RNase III in sRNA biogenesis is less well understood despite its well-known roles in rRNA processing, RNA decay, and cleavage of sRNA-mRNA duplexes. Here, we show that RNase III processes a pair of cis-encoded sRNAs (CJnc190 and CJnc180) of the foodborne pathogen Campylobacter jejuni. While CJnc180 processing by RNase III requires CJnc190, In contrast, RNase III processes CJnc190 independent of CJnc180 via cleavage of an intramolecular duplex. We also show that CJnc190 directly represses translation of the colonization factor PtmG by targeting a G-rich ribosome binding site, and uncover that CJnc180 is a cis-acting antagonist of CJnc190, indirectly affecting ptmG regulation. Our study highlights a role for RNase III in sRNA biogenesis and adds cis-encoded RNAs to the expanding diversity of transcripts that antagonize bacterial sRNAs.

Early defibrillation is essential for increasing the chance of survival in out-of-hospital-cardiac-arrest (OHCA). Automated external defibrillator (AED)-equipped drones have a substantial potential to shorten times to defibrillation in OHCA patients. However, optimal locations for drone deployment are unknown. Our aims were to find areas of high incidence of OHCA on a national level for placement of AED-drones, and to quantify the number of drones needed to reach 50, 80, 90 and 100% of the target population within eight minutes.This is a retrospective observational study of OHCAs reported to the Swedish Registry for Cardiopulmonary Resuscitation between 2010-2018. Spatial analyses of optimal drone placement were performed using geographical information system (GIS)-analyses covering high-incidence areas (100 OHCAs in 2010-2018) and response times.39,246 OHCAs were included. To reach all OHCAs in high-incidence areas with AEDs delivered by drone or ambulance within eight minutes, 61 drone systems would be needed, resulting in overall OHCA coverage of 58.2%, and median timesaving of 05:01 (min:sec) [IQR 03:22-06:19]. To reach 50% of the historically reported OHCAs in8 min, 21 drone systems would be needed; for 80%, 366; for 90%, 784, and for 100%, 2408.At a national level, GIS-analyses can identify high incidence areas of OHCA and serve as tools to quantify the need of AED-equipped drones. Use of only a small number of drone systems can increase national coverage of OHCA substantially. Prospective real-life studies are needed to evaluate theoretically optimized suggestions for drone placement.

Self-relevance exerts a powerful influence on information processing. Compared to material associated with other people, personally meaningful stimuli are prioritized during decision-making. Further exploring the character of this effect, here we considered the extent to which stimulus enhancement is impacted by the frequency of self-relevant versus friend-relevant material. In a matching task, participants reported whether shape-label stimulus pairs corresponded to previously learned associations (e.g., triangle = self, square = friend). Crucially however, before the task commenced, stimulus-based expectancies were provided indicating the probability with which both self- and friend-related shapes would be encountered. The results revealed that task performance was impacted by the frequency of stimulus presentation in combination with the personal relevance of the items. When self- and friend-related shapes appeared with equal frequencies, a self-prioritization effect emerged (Expt. 1). Additionally, in both confirmatory (Expt. 2) and dis-confirmatory (Expt. 3) task contexts, stimuli that were encountered frequently (vs. infrequently) were prioritized, an effect that was most pronounced for self-relevant (vs. friend-relevant) items. Further computational analyses indicated that, in each of the reported experiments, differences in performance were underpinned by variation in the rate of information uptake, with evidence extracted more rapidly from self-relevant compared to friend-relevant stimuli. These findings advance our understanding of the emergence and origin of stimulus-prioritization effects during decisional processing.

The escalating emergence of multidrug-resistant (MDR) bacteria, together with the paucity of novel antimicrobial agents in antibiotic development, is recognized as a worldwide public health crisis. Kisameet clay (KC), found in British Columbia (BC), Canada, is a clay mineral with a long history of therapeutic applications among people of the First Nations. We previously reported the antibacterial activity of KC against a group of MDR clinical pathogens. Here, we demonstrate its activity against two major human-pathogenic fungal species, as well as against bacterial biofilms, which underlie many recalcitrant bacterial infections. In these studies, we also identified several geochemical characteristics of KC, such as metal ions and low pH, which are involved in its antibacterial activity. These findings provide a better understanding of the components of KC antibacterial activity and a basis for developing defined preparations of this clay mineral for therapeutic applications., Worldwide increases in antibiotic resistance and the dearth of new antibiotics have created a global crisis in the treatment of infectious diseases. These concerns highlight the pressing need for novel antimicrobial agents. Natural clay minerals have a long history of therapeutic and biomedical applications and have lately received specific attention for their potent antimicrobial properties. In particular, Kisameet clay (KC) has strong antibacterial activity against a variety of multidrug-resistant (MDR) bacterial pathogens in vitro. Here, we have extended the known spectrum of activity of KC by demonstrating its efficacy against two major fungal pathogens, Candida albicans and Cryptococcus neoformans. In addition, KC also exhibits potent activity against the opportunistic bacterial pathogen Mycobacterium marinum, a model organism for M. ulcerans infection. Moreover, aqueous KC leachates (KC-L) exhibited broad-spectrum antibacterial activity, eradicated Gram-negative and Gram-positive biofilms, and prevented their formation. The mechanism(s) underlying KC antibacterial activity appears to be complex. Adjusting KC-L to neutral pH rendered it inactive, indicating a contribution of pH, although low pH alone was insufficient for its antibacterial activity. Treatment of KC minerals with cation-chelating agents such as EDTA, 2,2′-bipyridyl, and deferoxamine reduced the antibacterial activity, while supplementation of KC-L with these chelating agents eliminated the inhibitory activity. Together, the data suggest a positive role for divalent and trivalent cations, including iron and aluminum, in bacterial inhibition by KC. Collectively, these studies demonstrate the range of KC bioactivity and provide a better understanding of the mechanism underlying its antibacterial effects.

Background The vector-borne human viral zoonosis tick-borne encephalitis (TBE) is of growing concern in Sweden. The area where TBE is considered endemic has expanded, with an increasing geographical distribution of Ixodes ricinus as the tick vector and a rising number of reported TBE cases in humans. Efforts to map TBE risk areas have been carried out by sentinel monitoring, mainly based on individual sampling and analysis of wild and domestic animals, as well as ticks, for tick-borne encephalitis virus (TBEV). However, the interpretation of the geographical distribution has been hampered by the patchy and focal nature of TBEV occurrence. This study presents TBEV surveillance data based on antibody analysis of bulk tank milk collected from dairy herds located throughout Sweden before (May) and after (November) the vector season. A commercial TBEV antibody ELISA was modified and evaluated for use in this study. Results The initial comparative TBEV antibody analysis revealed a good correlation between milk and serum antibody levels from individually sampled cows. Also, the TBEV-antibody levels for the mean-herd serum showed good comparability with TBEV antibody levels from bulk tank milk, thus indicating good predictability of seroprevalence when analysing bulk tank milk from a herd. Analyses of bulk tank milk samples collected from 616 herds in May and 560 herds in November showed a geographical distribution of TBEV seropositive herds that was largely consistent with reported human TBE cases. A few TBEV-reactive herds were also found outside known locations of human TBE cases. Conclusion Serological examination of bulk tank milk from dairy cattle herds may be a useful sentinel surveillance method to identify geographical presence of TBEV. In contrast to individual sampling this method allows a large number of animals to be monitored. TBEV seropositive herds were mainly found in coastal areas of southern Sweden similar to human TBE cases. However, some antibody-reactive herds were found outside known TBE areas at the time of the study.

Motivation Ribosome profiling (Ribo-seq) is a powerful approach based on deep sequencing of cDNA libraries generated from ribosome-protected RNA fragments to explore the translatome of a cell, and is especially useful for the detection of small proteins (50–100 amino acids) that are recalcitrant to many standard biochemical and in silico approaches. While pipelines are available to analyze Ribo-seq data, none are designed explicitly for the automatic processing and analysis of data from bacteria, nor are they focused on the discovery of unannotated open reading frames (ORFs). Results We present HRIBO (High-throughput annotation by Ribo-seq), a workflow to enable reproducible and high-throughput analysis of bacterial Ribo-seq data. The workflow performs all required pre-processing and quality control steps. Importantly, HRIBO outputs annotation-independent ORF predictions based on two complementary bacteria-focused tools, and integrates them with additional feature information and expression values. This facilitates the rapid and high-confidence discovery of novel ORFs and their prioritization for functional characterization. Availability and implementation HRIBO is a free and open source project available under the GPL-3 license at: https://github.com/RickGelhausen/HRIBO.

Despite repeated demonstrations that self-relevant material is prioritized during stimulus appraisal, a number of unresolved issues remain. In particular, it is unclear if self-relevance facilitates task performance when stimuli are encountered under challenging processing conditions. To explore this issue, using a backward masking procedure, here participants were required to report if briefly presented objects (pencils and pens) had previously been assigned to the self or a best friend (i.e., object-ownership task). The results yielded a standard self-ownership effect, such that responses were faster and more accurate to self-owned (vs. friend-owned) objects. In addition, a drift diffusion model analysis indicated that this effect was underpinned by a stimulus bias. Specifically, evidence was accumulated more rapidly from self-owned compared to friend-owned stimuli. These findings further elucidate the extent and origin of self-prioritization during decisional processing.

Background Early cardiopulmonary resuscitation (CPR) and defibrillation with an Automated External Defibrillator (AED) increase survival from out-of-hospital cardiac arrest (OHCA). Although international guidelines recommend the use of AED registries to increase AED use, little is known about implementation. The aim of this paper is to describe the development of a national AED registry, to analyse the coverage and barriers to register AEDs. Methods The Swedish AED Registry (SAEDREG) was initiated in 2009 with the purpose of gathering the data of all public AEDs in Sweden. Data on all AEDs between 2013 and 2016 were included in the study. Additionally, data of non-registered AEDs was collected in one region using a survey to AED owners focusing on AED functionality. Results The number of AEDs doubled between 2013–2016. A total of 6703 AEDs (30%) were removed due to unavailability of validation. At the end of 2016, AEDs were most frequently registered in offices and workplaces, 45% (n = 7241) followed by shops, 7% (n = 1200). In the Gotland region, 218 AEDs, 57% (n = 124) were registered in the SAEDREG. Of n = 94 Non-registered AED functionality was high, the main reason not to register was unawareness of the SAEDREG, 74.5%. Of those aware of the register but not having registered, 25% stated “hard to register” as cause. Conclusions A national AED registry may gather information of AEDs on a national level. Although numbers have doubled between 2013–2016 in Sweden, a large proportion is still non-registered. More awareness of the registry and easier registration process is needed. General AED functionality seems high regardless of registered or non-registered AEDs. A key area for future research may be to use AED-registers to ascertain effectiveness of AED programs in terms of actual patient outcome.

The Darwin’s fox is one of the most threatened carnivores worldwide and was thought to occur in only two isolated areas. Recently this canid was found in the Valdivian Coastal Range, between the previously known populations, but other than their presence, little is known about these populations. Here we report the results of camera trap surveys conducted between 2012 and 2016 (18,872 camera days), including surveys in 30 different sites—distributed along c. 400 km—and monitoring in two contiguous protected areas. Darwin’s fox detection rate was higher when forest cover was higher or when domestic dog (Canis familiaris) detection rate was lower. Given confirmed presence, the detection rate was higher for sites in Chiloe Island, than in the mainland’s Coastal Range. In mainland, we found evidence of dogs’ presence in most of the sites we detected Darwin’s foxes. In the protected areas monitored, Darwin’s foxes were found to use 12% and 15% of the area sampled in 2015 and 2016 respectively, although there was high uncertainty in the 2016 estimates due to low probability of detection. We did not detect Darwin’s foxes in forestry plantations. Our findings provide support for a continuous distribution along the mainland’s Coastal Range and Chiloe Island but we hypothesize—based on the major differences observed in detection rates between these areas—that local densities are lower in mainland than in Chiloe Island. Finally, Darwin’s fox appears to be sensitive to human disturbance and these disturbances, especially dogs, are ubiquitous within its newly discovered range.

The manufacturing process gives cast iron castings properties which are dependent on component design, metallurgy and casting method. Factors such as local wall thickness influences the coarseness and type of microstructure and the castings will have local properties depending on the local metallurgical and thermal history. The stress/strain behaviour of cast materials is typically determined by performing a tensile test in a tensile test machine. The deformation behaviour will normally be determined by two mechanisms, namely, elastic and plastic phenomena. The plastic behaviour is based on dislocation movements in the lattice. Commonly, the deformation history of cast iron involves elastic, plastic and crack phases. The cast iron material has a complex microstructure and first order equations cannot be used to predict the deformation during loading. Until methods have been developed, the characterization of complex microstructure materials such as cast iron has to be determined by use of empirical methods. The empirical methods have to couple the internal microstructure and composition of the material with deformation phenomena during loading. The paper will show a method to characterize tensile test curves of cast iron materials which can be used to couple deformation phenomena with for example microstructure. The equations are aimed to make the tensile test curve ready for curve fitting and optimization in two steps. Each stress/strain curve is like a finger print of the material and requires well performed tests and some advices are given. The paper also wants to encourage researchers and people working with tensile testing to get out more of their effort to measure strength of cast iron materials and connect the result to the microstructure of the specimens. CC BY 4.0

Eeffect of Boron addition on the microstructure and mechanical properties of ductile iron, GJS-500-7 grade was studied. Three cast batches with the Boron content of 10, 49 and 131ppm were cast in a casting geometry containing plates with thicknesses of 7, 15, 30, 50 and 75mm. Microstructure analysis, tensile test, and hardness test were performed on the samples which were machined from the casting plates. Addition of 49 ppm Boron decreased pearlite fraction by an average of 34±6% in all the cast plates. However, minor changes were observed in the pearlite fraction by increasing Boron from 49 to 131 ppm. Variation in the plate thickness did not affect the pearlite fraction. The 0.2% offset yield and ultimate tensile strength was decreased by an average of 11±1% and 18±2%, respectively. Addition of 49 ppm Boron decreased Brinell hardness by 16±1%, while 11±2% reduction was obtained by addition of 131ppm Boron.

Out‐of‐hospital cardiac arrest (OHCA) is a major health problem that affects approximately four hundred and thousand patients annually in the United States alone. It is a major challenge for the emergency medical system as decreased survival rates are directly proportional to the time delay from collapse to defibrillation. Historically, defibrillation has only been performed by physicians and in‐hospital. With the development of automated external defibrillators (AEDs), rapid defibrillation by nonmedical professionals and subsequently by trained or untrained lay bystanders has become possible. Much hope has been put to the concept of Public Access Defibrillation with a massive dissemination of public available AEDs throughout most Western countries. Accordingly, current guidelines recommend that AEDs should be deployed in places with a high likelihood of OHCA. Despite these efforts, AED use is in most settings anecdotal with little effect on overall OHCA survival. The major reasons for low use of public AEDs are that most OHCAs take place outside high incidence sites of cardiac arrest and that most OHCAs take place in residential settings, currently defined as not suitable for Public Access Defibrillation. However, the use of new technology for identification and recruitment of lay bystanders and nearby AEDs to the scene of the cardiac arrest as well as new methods for strategic AED placement redefines and challenges the current concept and definitions of Public Access Defibrillation. Existing evidence of Public Access Defibrillation and knowledge gaps and future directions to improve outcomes for OHCA are discussed. In addition, a new definition of the different levels of Public Access Defibrillation is offered as well as new strategies for increasing AED use in the society. This article has been accepted and published in Journal of Internal Medicine.

This paper investigates the effect of the solidification conditions and silicon content on the mechanical properties of ductile iron and presents empirical models for predicting the tensile behavior based on the microstructural characterizations. Two ductile iron grades of GJS-500-7 and GJS-500-14 were cast with silicon content of 2.36% and 3.71%, respectively. The cast geometry consisted of six plates with different thicknesses that provided different cooling rates during the solidification. Microstructure analysis, tensile and hardness tests were performed on the as-cast material. Tensile behavior was characterized by the Ludwigson equation. The tensile fracture surfaces were analyzed to quantify the fraction of porosity. The results showed that graphite content, graphite nodule count, ferrite fraction and yield strength were increased by increasing the silicon content. A higher silicon content resulted in lower work hardening exponent and strength coefficient on the Ludwigson equation. The results for 0.2% offset yield and the Ludwigson equation parameters were modeled based on microstructural characteristics, with influence of silicon content as the main contributing factor. The models were implemented into a casting process simulation to enable prediction of microstructure-based tensile behavior. A good agreement was obtained between measured and simulated tensile behavior, validating the predictions of simulation in cast components with similar microstructural characteristics.

Small proteins are an emerging class of gene products with diverse roles in bacterial physiology. However, a full understanding of their importance has been hampered by insufficient genome annotations and a lack of comprehensive characterization in microbes other than Escherichia coli. We have taken an integrative approach to accelerate the discovery of small proteins and their putative virulence-associated functions in Salmonella Typhimurium. We merged the annotated small proteome of Salmonella with new small proteins predicted with in silico and experimental approaches. We then exploited existing and newly generated global datasets that provide information on small open reading frame expression during infection of epithelial cells (dual RNA-seq), contribution to bacterial fitness inside macrophages (TraDIS), and potential engagement in molecular interactions (Grad-seq). This integrative approach suggested a new role for the small protein MgrB beyond its known function in regulating PhoQ. We demonstrate a virulence and motility defect of a Salmonella ΔmgrB mutant and reveal an effect of MgrB in regulating the Salmonella transcriptome and proteome under infection-relevant conditions. Our study highlights the power of interpreting available “omics” datasets with a focus on small proteins, and may serve as a blueprint for a data integration-based survey of small proteins in diverse bacteria.

Background In diabetes, there is an interaction between hyperglycaemia and cellular hypoxia, which may induce oxidative stress. Oxygen therapy in patients with diabetes and myocardial infarction (MI) has not been studied. Purpose Our aim was to determine the effects of supplemental oxygen in MI patients with or without diabetes. Methods The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomised 6629 patients with suspected myocardial infarction (MI) to receive oxygen at 6 L/min for 6–12 hours or ambient air. In this prespecified analysis involving 5010 patients with confirmed MI, 934 had known diabetes (19%). The main composite endpoint was the effect of supplemental oxygen on all-cause death, rehospitalisation with MI, or heart failure at one year in patients with diabetes. Key secondary endpoint was the comparison between patients with or without diabetes. Results In patients with diabetes, the main composite endpoint occurred in 16.2% (72 of 445) of patients allocated to oxygen compared to 16.6% (81 of 489) allocated to ambient air (hazard ratio [HR] 0.93; 95% confidence interval [CI], 0.67–1.27, P=0.81) at one year (figure). There was no statistically significant difference for the individual components of the main composite endpoint, or the rate of cardiovascular death up to one year. In comparison, corresponding endpoints in patients without diabetes were similar between the treatment groups. However, when comparing patients according to diabetes status, event rates were significantly higher in the diabetic population (main composite endpoint: HR 1.60; 95% CI, 1.32–1.93, P Kaplan-Meier curves for main endpoint Conclusions Oxygen therapy in normoxemic MI patients did not significantly affect 1-year all-cause death, cardiovascular death, rehospitalisation with MI or heart failure, irrespective of underlying diabetes. Noteworthy, despite that the incidence of cardiovascular outcomes has declined substantially in patients with diabetes over the last decades, we still observed markedly increased event rates in patients with diabetes. Acknowledgement/Funding Swedish Heart-Lung Foundation; Swedish Research Council; Stockholm County Council

Aims The purposes were to evaluate the detection of low levels of Campylobacter in water by dead‐end ultrafiltration (DEUF) to determine the sensitivity and suitability for use under field condition. Methods and Results The DEUF technique followed by detection according to ISO 10272 was tested on artificially and naturally contaminated water. Campylobacter were detected in all samples spiked with more than 10 CFU 60 l−1 and in four of nine samples with a concentration below 10 CFU 60 l−1 water. Naturally contaminated water from five different broiler producers was analysed. Campylobacter were detected in four of 12 samples from ponds near the houses and in three of 24 samples from water pipes inside the broiler houses, but not in tap water sampled at the entrance of the broiler houses. Conclusions The results indicate that DEUF is useful for detection of low numbers of Campylobacter in large volumes of water. Significance and Impact of the Study Contaminated water is an important source for transmission of Campylobacter to broilers and humans. The concentration of Campylobacter is usually low with a high level of background microbiota. This study shows the advantages of DEUF both in the laboratory and under field conditions.

Introduction The relations between specific ECG patterns and coronary angiographic findings in cardiac arrest patients with different comorbidities are not properly assessed. More evidence is needed to identify patients with the highest risk for acute coronary artery disease as a cause of the cardiac arrest. This study aims to describe the coronary artery findings after cardiac arrest in relation to ECG and comorbidity. Method A retrospective study of out-of-hospital cardiac arrest patients, with coronary angiography performed within 28 days. ECG on admission, comorbidity, PCI attempts and angiographic findings are described. Data were retrieved from national registries in Sweden. Results Among 1133 patients with available ECG and angiography information the mean age was 64 years. The rate of shockable rhythm was 79%. The total incidence of any significant stenosis in cardiac arrest patients without ST-elevation who underwent coronary angiography within 28 days was 71%. The incidence of any stenosis in patients with normal ECG was 62.1% and in patients with LBBB, 59.3%. In patients with ST-depression or RBBB, PCI attempts were made in 47.1% and 42.4% respectively, compared with 33.3% in patients with normal ECG. Among patients without ST-elevation, those with diabetes mellitus and those with initial shockable rhythm respectively, 84.8% and 71.5 had at least one significant stenosis. Conclusion Our study suggests, that evaluation of ECG patterns and comorbidities in out-of-hospital cardiac arrest patients without ST-segment elevation may be important to identify those with a high risk of coronary artery lesions that could benefit from early revascularization.

This study focuses on the modelling and simulation of local mechanical properties of compacted graphite iron cast at different section thicknesses and three different levels of silicon, ranging from about 3.6% up to 4.6%. The relationship between tensile properties and microstructure is investigated using microstructural analysis and statistical evaluation. Models are generated using response surface methodology, which reveal that silicon level and nodularity mainly affect tensile strength and 0.2% offset yield strength, while Young′s modulus is primarily affected by nodularity. Increase in Si content improves both the yield and tensile strength, while reduces elongation to failure. Furthermore, mechanical properties enhance substantially in thinner section due to the high nodularity. The obtained models have been implemented into a casting process simulation, which enables prediction of local mechanical properties of castings with complex geometries. Very good agreement is observed between the me...

Background Out-of-hospital cardiac arrest (OHCA) affects some 275,000 individuals in Europe each year. Time from collapse to defibrillation is essential for survival. As emergency medical services (EMS) response times in Sweden have increased, novel methods are needed to facilitate early treatment. Unmanned aerial vehicles (i.e. drones) have potential to deliver automated external defibrillators (AED). The aim of this simulation study was to explore bystanders’ experience of a simulated OHCA-situation where a drone delivers an AED and how the situation is affected by having one or two bystanders onsite. Methods This explorative simulation study used a mixed methodology describing bystanders’ experiences of retrieving an AED delivered by a drone in simulated OHCA situations. Totally eight participants were divided in two groups of bystanders a) alone or b) in pairs and performed CPR on a manikin for 5 minutes after which an AED was delivered by a drone at 50 m from the location. Qualitative data from observations, interviews of participants and video recordings were analysed using content analysis alongside descriptive data on time delays during bystander interaction. Results Three categories of bystander experiences emerged: 1) technique and preparedness, 2) support through conversation with the dispatcher, and 3) aid and decision-making. The main finding was that retrieval of an AED as delivered by a drone was experienced as safe and feasible for bystanders. None of the participants hesitated to retrieve the AED; instead they experienced it positive, helpful and felt relief upon AED-drone arrival and were able to retrieve and attach the AED to a manikin. Interacting with the AED-drone was perceived as less difficult than performing CPR or handling their own mobile phone during T-CPR. Single bystander simulation introduced a significant hands-off interval when retrieving the AED, a period lasting 94 s (range 75 s–110 s) with one participant compared to 0 s with two participants. Conclusion The study shows that it made good sense for bystanders to interact with a drone in this simulated suspected OHCA. Bystanders experienced delivery of AED as safe and feasible. This has potential implications, and further studies on bystanders’ experiences in real cases of OHCA in which a drone delivers an AED are therefore necessary.

The aim of this study was to investigate lymph circulation before and after breast reduction mammaplasty in different parts of the breast and with two different carriers of the radiopharmaceutical. Nine patients with breast hypertrophy planned for bilateral breast reduction mammaplasty were prospectively included in the study. The breast operation procedure was decided on intraoperatively. The regional lymph circulation in the breast was measured preoperatively by Technetium (99mTc) clearance in 4 different locations in each breast 1, 2 and 3 hours after injection. The procedure was repeated at one month and in six of the nine women also five years postoperatively with injection sites chosen to correspond to the preoperative location of that breast pedicle. Two different types of carriers of the radiopharmaceutical were tested, dextran in the right and nanocoll in the left breast. Dextran had a much more rapid clearance than nanocoll. There was no significant regional difference in lymph drainage up to five years after the mammaplasty, independent of dextran or nanocoll as being the carrier of the radiopharmaceutical.

The ITER baseline foresees 2 Heating Neutral Beams (HNB’s) operating at 1 MeV 40 A D0, each capable of delivering 16.5 MW of deuterium neutrals to the plasma, with a 3rd HNB injector foreseen as an upgrade option that would bring up the total neutral beam power to 50MW [1]. In addition a dedicated Diagnostic Neutral Beam (DNB) will be injecting 100 keV 60 A of H0 for charge exchange recombination spectroscopy (CXRS) [2]. This paper highlights the impact of the staged approach on the ITER NBI, presents the new installation strategy and reports on the status of the adopted design refinements and the integration of the HNB’s and the DNB into the ITER plant.The ITER baseline foresees 2 Heating Neutral Beams (HNB’s) operating at 1 MeV 40 A D0, each capable of delivering 16.5 MW of deuterium neutrals to the plasma, with a 3rd HNB injector foreseen as an upgrade option that would bring up the total neutral beam power to 50MW [1]. In addition a dedicated Diagnostic Neutral Beam (DNB) will be injecting 100 keV 60 A of H0 for charge exchange recombination spectroscopy (CXRS) [2]. This paper highlights the impact of the staged approach on the ITER NBI, presents the new installation strategy and reports on the status of the adopted design refinements and the integration of the HNB’s and the DNB into the ITER plant.

Summary Campylobacter jejuni is a leading cause of food-borne gastroenteritis in humans. It lives commensally in the gastrointestinal tract of animals, and tolerates variable conditions during transit/colonization of susceptible hosts. The C. jejuni CprRS two-component system contains an essential response regulator (CprR), and deletion of the cprS sensor kinase enhances biofilms. We sought to identify CprRS-regulated genes and better understand how the system affects survival. Expression from the cprR promoter was highest during logarithmic growth and dependent on CprS. CprRD52A did not support viability, indicating that CprR phosphorylation is essential despite the dispensability of CprS. We identified a GTAAAC consensus bound by the CprR C-terminus; the Asp52 residue of full-length CprR was required for binding, suggesting phosphorylation is required. Transcripts differing in expression in ΔcprS compared with wildtype (WT) contained a putative CprR binding site upstream of their promoter region and encoded htrA (periplasmic protease upstream of cprRS) and peb4 (SurA-like chaperone). Consistent with direct regulation, the CprR consensus in the htrA promoter was bound by CprRCTD. Finally, ΔhtrA formed enhanced biofilms, and ΔcprS biofilms were suppressed by Mg2+. CprRS is the first C. jejuni regulatory system shown to control genes related to the cell envelope, the first line of interaction between pathogen and changing environments.

Background Oxygen therapy has been used routinely in normoxemic patients with suspected acute myocardial infarction (AMI) despite limited evidence supporting a beneficial effect. AMI is associated with a systemic inflammation. Here, we hypothesized that the inflammatory response to AMI is potentiated by oxygen therapy. Methods The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) multicentre trial randomized patients with suspected AMI to receive oxygen at 6 L min-1 for 6-12 h or ambient air. For this prespecified subgroup analysis, we recruited patients with confirmed AMI from two sites for evaluation of inflammatory biomarkers at randomization and 5-7 h later. Ninety-two inflammatory biomarkers were analysed using proximity extension assay technology, to evaluate the effect of oxygen on the systemic inflammatory response to AMI. Results Plasma from 144 AMI patients was analysed whereof 76 (53%) were randomized to oxygen and 68 (47%) to air. Eight biomarkers showed a significant increase, whereas 13 were decreased 5-7 h after randomization. The inflammatory response did not differ between the two treatment groups neither did plasma troponin T levels. After adjustment for increase in troponin T over time, age and sex, the release of inflammation-related biomarkers was still similar in the groups. Conclusions In a randomized controlled setting of normoxemic patients with AMI, the use of supplemental oxygen did not have any significant impact on the early release of systemic inflammatory markers.

The reduction of the clinker content in concrete by replacing cement with supplementary cementitious materials (SCM) is widely used to lower the environmental impact of concrete. However, for some SCMs such as calcined clay this often leads to higher water requirements for the same concrete consistence. This severely limits the widespread implementation of green concrete technologies, both in practical terms, and in meeting the requirements of relevant concrete standards such as the national annexes to EN 206. In order to overcome this, a shift in mind-set from prescriptive to performance-based design criteria would be beneficial. Thus, we have proposed a performance-based design approach for the selection of binder systems, which we have successfully applied it to several combinations of SCMs. In this paper the procedure is described for a binder system consisting of calcined clay, limestone filler and fly ash. A parametric study was carried out on mortars, which included rheological properties, compressive strength and chloride migration. The requirements for each parameter was chosen based on the intended concrete application (highway bridge) and values obtained for a reference mix typically used for the application, i.e. a concrete that fulfils current Danish regulations. The proposed alternative binder system features a CO2 footprint reduction of 30% compared to the reference concrete mix. However, the alternative concrete mix does not conform with current Danish regulation on the minimum w/c ratio.

Widespread antibiotic resistance among bacterial pathogens is providing the impetus to explore novel sources of antimicrobial agents. Recently, the potent antibacterial activity of certain clay minerals has stimulated scientific interest in these materials. One such example is Kisameet glacial clay (KC), an antibacterial clay from a deposit on the central coast of British Columbia, Canada. However, our understanding of the active principles of these complex natural substances is incomplete. Like soils, clays may possess complex mixtures of bacterial taxa, including the Actinobacteria, a clade known to be rich in antibiotic-producing organisms. Here, we present the first characterization of both the microbial and geochemical characteristics of a glacial clay deposit. KC harbors surprising bacterial species richness, with at least three distinct community types. We show that the deposit has clines of inorganic elements that can be leached by pH, which may be drivers of community structure. We also note the prevalence of Gallionellaceae in samples recovered near the surface, as well as taxa that include medically or economically important bacteria such as Actinomycetes and Paenibacillus. These results provide insight into the microbial taxa that may be the source of KC antibacterial activity and suggest that natural clays may be rich sources of microbial and molecular diversity., IMPORTANCE Identifying and characterizing the resident microbial populations (bacteria, viruses, protozoa, and fungi) is key to understanding the ecology, chemistry, and homeostasis of virtually all sites on Earth. The Kisameet Bay deposit in British Columbia, Canada, holds a novel glacial clay with a history of medicinal use by local indigenous people. We previously showed that it has potent activity against a variety of antibiotic-resistant bacteria, suggesting it could complement our dwindling arsenal of antibiotics. Here, we have characterized the microbiome of this deposit to gain insight into what might make the clay antibacterial. Our analyses suggest that the deposit contains a surprising diversity of bacteria, which live in at least three distinct environments. In addition, the clay harbors bacteria that may have interesting potential as biocontrol/bioremediation agents or producers of novel bioactive compounds.

Aim To describe changes in rate of CPR, Compression Only CPR (CO-CPR), and 30–day survival over 3 different time-periods of CPR guidelines in Sweden. We hypothesised that increased use of CO-CPR would be associated with increased CPR-rates and similar survival compared to standard CPR. Methods Registry based cohort study including all bystander witnessed cases of out-of-hospital cardiac arrests reported to the Swedish register for cardio-pulmonary resuscitation in 2000–2014. Exposure was categorised as bystander CPR or No-CPR. Bystander CPR was further categorised into Standard CPR with rescue breathing and ventilation (S-CPR) or CO-CPR. Primary outcome was 30 day survival. Results 23620 patients were included. Total rates of bystander CPR increased from 36% in 2000 to 68% in 2014. S-CPR increased from 31% in 2000 to 38% in 2014. CO-CPR increased from 5% in 2000 to 30% 2014. Overall, there was no significant difference in survival among patients receiving CO-CPR or S-CPR (13.6% vs. 12.9% p=0.3). Conclusion Increase in bystander CPR during the last 15 years in Sweden was associated with an increase in CO-CPR. Overall 30 day survival was not different when comparing CO-CPR to S-CPR. Conflict of interest None declared. Funding None declared.

Aim Dual dispatch of cardiopulmonary resuscitation (CPR) -trained fire-fighters or police officers equipped with automated external defibrillators (AEDs) in addition to emergency medical services (EMS) in out-of-hospital cardiac arrest (OHCA) has in some minor cohort studies been associated with improved survival. The aim of this study was to evaluate the association between dual dispatch and survival in OHCA at a national level. Methods This prospective, cohort study was conducted January 1st, 2012, to December 31st, 2014. OHCA victims in nine Swedish counties covered by dual dispatch and resuscitation by first responders and EMSs were compared with a propensity-matched contemporary control group of OHCA victims in 12 counties where only EMS were dispatched. The primary outcome was survival to 30 days. Results 8698 OHCA were included of which 2786 in each group (intervention and control) were matched. The median time from emergency call to arrival of EMSs or first responder was nine minutes in the intervention group vs. ten minutes in the controls (p Conclusion Dual dispatch of first responders in addition to EMSs in OHCA was associated with a moderate but significant increase in 30 day survival. References Myerburg RJ, Fenster J, Velez M, Rosenberg D, Lai S, Kurlansky P, Newton S, Knox M and Castellanos A. Impact of community-wide police car deployment of automated external defibrillators on survival from out-of-hospital cardiac arrest. Circulation. 2002;106:1058–64. PMID: 12196329 Hollenberg J, Riva G, Bohm K, Nordberg P, Larsen R, Herlitz J, Pettersson H, Rosenqvist M and Svensson L. Dual dispatch early defibrillation in out-of-hospital cardiac arrest: the SALSA-pilot dagger. European Heart Journal. 2009;30:1781–1789. doi:10.1093/eurheartj/ehp177. Malta Hansen C, Kragholm K, Pearson DA, Tyson C, Monk L, Myers B, Nelson D, Dupre ME, Fosbol EL, Jollis JG, Strauss B, Anderson ML, McNally B and Granger CB. Association of Bystander and First-Responder Intervention With Survival After Out-of-Hospital Cardiac Arrest in North Carolina, 2010–2013. JAMA: the journal of the American Medical Association. 2015;314:255–64. doi: 10.1001/jama.2015.7938. Conflict of interest None declared. Funding The Swedish Heart–Lung Foundation, the National Board of Health and Welfare, and the Laerdal Foundation for Acute Medicine in Norway.