IntroductionThe deployment of first responders in a public place is one of the interventions that is used for increasing bystander cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrests (OHCA). We studied the association between the presence of a first responder and the survival of OHCA that occurred during a period of exercise in a public place.MethodsAll of the adult OHCAs of a presumed cardiac etiology that occurred during a period of exercise in a public place and that were witnessed by a bystander between 2013 and 2015 were analyzed. The main exposure of interest was the characteristics of the bystander (first responder vs. layperson). The endpoints were the provision of bystander CPR and good neurological recovery. Multivariable logistic regression analysis, adjusting for patient-environment and prehospital factors, was performed.ResultsA total of 870 patients had a cardiac arrest during a period of exercise in a public place, and 58 (6.7%) patients were witnessed by the first responder. The OHCAs witnessed by first responders were more likely to result in bystander CPR than those witnessed by laypersons (89.7% vs. 75.4%, p = 0.01, adjusted OR (95% CI): 3.51 (1.44–8.55)). In terms of good neurological recovery, the OHCAs witnessed by first responders had a higher likelihood than the patients witnessed by laypersons (37.9% vs, 24.0%, p = 0.02, adjusted OR (95% CI): 2.92 (1.33–6.40)).ConclusionThe OHCAs occurred during a period of exercise in a public place and whom first responders witnessed were more likely to receive bystander CPR and to have a neurologically intact survival.

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a b s t r a c tBackground: Whether or not short-term exposure to particulate matter b2.5 μm in diameter (PM 2.5 ) increases the risk of psychiatric emergency diseases is unclear. Methods: The study was performed in a metropolis from January 2015 to December 2016. The exposure was PM 2.5 , and the confounders were weather (temperature and humidity) and other pollutants (PM 10 , SO 2 , CO, O 3 , and NO 2 ). The outcomes were emergency department (ED) visits with psychiatric disease codes (F00-F99 in ICD10 codes). General additive models were used for the statistical analysis to calculate the adjusted relative risks (ARRs) and 95% confidence intervals (95% CIs) for the daily number of ED visits with a lag of 1 to 3 days following a 10 μg/m 3 increase in PM 2.5 . Results: During the study period, a total of 67,561 ED visits for psychiatric diseases were identified and tested for association with PM 2.5 . Daily ED visits for all psychiatric diseases were not associated with PM 2.5 in the model that was not adjusted for other pollutants. The ARR (95% CI) in the model adjusted for SO 2 was 1.011 (1.002-1.021) by 10 μg/m 3 of PM 2.5 on Lag 1 for all psychiatric diseases (F00-F99). The ARR (95% CI) in the model adjusted for O 3 was 1.015 (1.003-1.029) by 10 μg/m 3 of PM 2.5 on Lag 1 for F40-F49 (Neurotic, stress-related and somatoform disorders). Conclusion: An increase in PM 2.5 showed a significant association with an increase in ED visits for all psychiatric diseases (F00-F99) and for neurotic, stress-related and somatoform disorders (F40-F49) on lag day 1.

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