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Background: Bystander behaviors can be an important key for preventing all forms of violence against women. Identifying their facilitators and barriers becomes a priority. The aim of this research is to analyze the impact of the previous experiences of women (as sexual harassment victim or bystander) on their perceived responsibility to intervene as bystander in a case of workplace sexual harassment and to determine the possible mediating role of certain attitudinal and evaluative factors. Method: A non-probability convenience sample of 633 Spanish women answered a sociodemographic data questionnaire, a victimization questionnaire designed ad hoc, and the Questionnaire of Intention to Help in VAW Cases. Results: The results obtained indicate that previous victimization experiences as a victim or witness of sexual harassment impact the responsibility to intervene, mediated by the acceptance of sexual harassment myths and the perceived severity of workplace sexual harassment. Conclusions: These results may help to understand how to design prevention programs and which key variables to incorporate.

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BACKGROUND: The opioid crisis is a serious public health issue in Canada. There have been many surveillance programs and research studies on opioid-related emergency department (ED) visits at a national, provincial, regional or municipal level. However, no published studies have investigated the in-depth contexts surrounding opioid-related ED visits. In addition, few studies have examined injuries other than poisonings in those visits. The objective of this study is to investigate the contextual factors and co-occurrence of poisonings and injuries among the opioid-related ED visits in a Canadian sentinel surveillance system on injuries and poisonings from 2011 to 2022. METHODS: This study used a mixed methods design. The data source was the Canadian Hospitals Injury Reporting and Prevention Program. We first selected all opioid-related ED visits during our study period and then identified the contextual factors through a content analysis of the combination of the narrative description and other variables in the patients' records. The contextual factors were organized into themes as opioid use context, social resource utilization, bystander involvement, and prior naloxone use. The opioid use context was used as a co-variable to examine the other themes and ED presentations (poisonings and other injuries). Quantitative descriptive approach was used to analyze all the contexts and ED presentations. RESULTS: The most common opioid use context was non-prescribed opioid use without intention to cause harm, followed by self-poisoning, children's exposure, and medication error. Various rare contexts occurred. Paramedics participated in 27.9% of visits. Police and security guards were involved in 5.1% and 2.3% of visits, respectively. Child welfare or social workers were involved in 0.4% of visits. Bystanders initiated 18.9% of the ED visits. Naloxone use before arriving at the ED occurred in 23.4% of the visits with a variety of administrators. The majority of patients presented with poisoning effects, either with poisoning effects only or with other injuries or conditions. CONCLUSIONS: Our study has provided an in-depth analysis of contextual factors and co-occurrence of poisonings and injuries among opioid-related ED visits in Canada. This information is important for ED programming and opioid-related poisoning and injury intervention and prevention.

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The "bystander effect," in which the presence of others inhibits rescue actions, has not been specifically examined in the context of cardiac arrest; understanding this effect in relation to rescue with automated external defibrillators (AEDs) is important. This study aims to identify the presence of others as a factor inhibiting rescue actions using an AED, from a social psychology perspective. We collected data through a web-based questionnaire involving registered residents in all 47 prefectures of Japan. The participants were presented with hypothetical scenarios of witnessing cardiac arrest events at train stations, under sparse or crowded conditions, and with or without the presence of competent parties (e.g., station staff or security guards). Their willingness to intervene was assessed across three levels of rescue behavior: (1) running and calling for help, (2) retrieving an AED, and (3) using an AED. This study found evidence of the bystander effect, indicating that the presence of competent others reduced behavioral interventions by bystanders during out-of-hospital cardiac arrest (OHCA) events. Moreover, the perceived presence of competent parties at the scene of a cardiac arrest reduced bystanders' willingness to initiate rescue under certain circumstances. While many bystanders were willing to initiate rescue efforts in response to calls for help, they resisted rescues involving an AED. This study observes that a bystander effect occurs among bystanders witnessing OHCA, explores the inhibiting effects of identifying competent parties on the initiation of rescue efforts, and suggests that there are significant invisible barriers to using AEDs in rescuing patients with OHCA.

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BACKGROUND: Limited data are available on locations of public access defibrillation programs across communities in the United States, despite their widespread presence. Our goal was to determine publicly available AED locations of large businesses in a mixed urban-rural county. We then compared our survey results to a NC state-mandated AED registry and the county's emergency medical dispatch center AED registry. METHODS: We conducted structured phone surveys of all large businesses (>19 employees) and select small businesses (healthcare, government, childcare, educational, and religious organizations with 1-19 employees) in Forsyth County, NC (n = 1702) to determine AED ownership and location. In addition, AED lists were elicited from multi-building organizations (e.g., health systems, universities, and local government), the NC Office of Emergency Medical Services (OEMS), and the Forsyth County emergency medical dispatch center. RESULTS: Our survey yielded a response rate of 79.1 % and identified 411 businesses with ≥ 1 AEDs. An additional 162 AED locations were contained in AED lists from multi-building organizations and registries. In total, our canvas identified 963 AEDs at 573 unique locations. The majority of AEDs (65.1 % [627/963]) were not previously registered in the NC OEMS AED registry. Few identified AEDs (11.8 % [114/963]) were listed in the county emergency medical dispatch center registry.

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Out-of-hospital cardiac arrest (OHCA) is a global public health problem. Lay bystanders witness almost half of OHCA, so early recognition is critical to allow immediate initiation of cardiopulmonary resuscitation (CPR) by the bystander. The present investigation aims to analyze the most recent scientific evidence of the effect of bystander CPR on survival after an OHCA. A systematic literature review was carried out at "Web of Science", "Scopus" and "PubMed" databases, including publications from the last 20 years. After inclusion/exclusion criteria, 37 articles were identified. Results indicate that patients who receive CPR are more likely to survive than those who don't, and CPR is associated with a good quality of life post-OHCA. Emphasis should be placed on practicing chest compressions only when the bystander has not mastered the artificial ventilation technique. Finding an AED is the first step to using it in an OHCA situation. Correct use of an AED by laypeople is associated with nearly double the survival rate after an OHCA when compared to standard CPR. It is important to promote CPR and AED training to non-professionals, such as community residents and youth, as training is associated with higher success rates of effective CPR-AED. A mobile phone positioning system to recruit trained laypeople or text message alert to send citizen volunteers, as well as assistance through a mobile app, appear to have significant advantages in practicing effective CPR. The benefits of bystander CPR outweigh the risk of injury to victims, highlighting the need to disseminate training to lay people.

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Socioecological models of bystander intervention suggest that a complex decision-making process is required for a prosocial bystander to intervene, starting with intrapersonal variables of cognition and personality. This study investigates how rape myth acceptance, personality, and just world beliefs impact the frequency of positive bystander intention. The study's sample size consisted of 139 college students. Participants completed an online survey in which they read a vignette and indicated whether they would intervene as a bystander at 25 different instances throughout the vignette. Correlational analyses showed that agreeableness and openness were positively associated with prosocial bystander behavioral intention. A multiple regression analysis found only the belief that the world was a safe and good place was predictive of prosocial bystander behavioral intention. The results suggest that bystander intervention education programs should be revised to address just world beliefs.

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AIM: The association between out-of-hospital cardiac arrest (OHCA) and the appropriate provision of public access defibrillation (PAD) remains unclear. This study aimed to evaluate the factors associated with whether or not PAD was provided. METHODS: This retrospective cohort study utilized the All-Japan Utstein and Emergency Transport Registries in 2021. We included OHCA patients who were applied to automated external defibrillators (AEDs) by bystanders and were deemed eligible for defibrillation by an AED. We defined PAD provided or no PAD provided based on bystander defibrillation. Multivariable logistic regression analysis with the Firth bias adjustment method was employed to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the exploratory evaluation of factors associated with PAD provided. RESULTS: 1949 patients were eligible for analysis (PAD provided, n = 1696 [87.0%]; no PAD provided, n = 253 [13.0%]). Factors positively associated with PAD provided were male (AOR [95% CI], 1.61 [1.17-2.21]; vs. female), other public place incidence (AOR [95% CI], 10.65 [1.40-1367.54]; vs. public place), non-family member witnessed (AOR [95% CI], 2.51 [1.86-3.42]; vs. unwitnessed) and conventional cardiopulmonary resuscitation (CPR), (AOR [95% CI], 1.75 [1.17-2.67]; vs. hands-only CPR). Conversely, factors negatively associated with no PAD provided were over 65 years old (AOR [95% CI], 0.48 [0.28-0.80]; vs. 19-64 yr), night-time onset (AOR [95% CI], 0.61 [0.45-0.83]; vs. daytime), non-cardiogenic (AOR [95% CI], 0.43 [0.31-0.61]; vs. cardiogenic), home setting (AOR [95% CI], 0.33 [0.14-0.83]; vs. public place), healthcare facility setting (AOR [95% CI], 0.40 [0.23-0.66]; vs. public place), no bystander CPR (AOR [95% CI], 0.31 [0.14-0.71]; vs. hands-only CPR), and dispatcher-assistance (AOR [95% CI], 0.72 [0.53-0.97]; vs. no dispatcher-assistance). CONCLUSION: Male patients, other public place onset, witnessed by non-family and conventional CPR were associated with PAD provide. Therefore, training skilled first responders to use AEDs appropriately is necessary.

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This scoping review collates evidence for sex biases in the receipt of bystander cardiopulmonary resuscitation (BCPR) among patients with out-of-hospital cardiac arrest patients globally. The MEDLINE, PsycINFO, CENTRAL, and Embase databases were screened for relevant literature, dated from inception to March 9, 2022. Studies evaluating the association between BCPR and sex/gender in patients with out-of-hospital cardiac arrest, except for pediatric populations and cardiac arrest cases with traumatic cause, were included. The review included 80 articles on BCPR in men and women globally; 58 of these studies evaluated sex differences in BCPR outcomes. Fifty-nine percent of the relevant studies (34/58) indicated that women are less likely recipients of BCPR, 36% (21/58) observed no significant sex differences, and 5% (3/58) reported that women are more likely to receive BCPR. In other studies, women were found to be less likely to receive BCPR in public but equally or more likely to receive BCPR in residential settings. The general reluctance to perform BCPR on women in the Western countries was attributed to perceived frailty of women, chest exposure, pregnancy, gender stereotypes, oversexualization of women's bodies, and belief that women are unlikely to experience a cardiac arrest. Most studies worldwide indicated that women were less likely to receive BCPR than men. Further research from non-Western countries is needed to understand the impact of cultural and socioeconomic settings on such biases and design customized interventions accordingly.

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While numerous studies have revealed the impact of different bullying behaviors, such as victimization and perpetration, on the psychological development of adolescents, the exploration of the correlates of positive/negative bystander behaviors and their potential underlying mechanisms remains scarce in China. The present study aims to compare the relationships between mental health and positive versus negative bystander behavior and to clarify whether self-efficacy and coping styles mediate the relationships between mental health and bullying dynamics. The current study was conducted on 11,734 students from 18 secondary schools in Suzhou, China (Meanage = 15.00, SDage = 1.47; 53.8% boys). The information on bullying victimization, perpetration, positive/negative bystander behaviors, as well as self-efficacy, coping styles and mental health variables (including depression, anxiety, sleep disturbance, suicide risk), were collected. Negative bystander behavior was positively associated with mental health problems, while positive bystander behavior was negatively associated with these factors. Also, further analysis showed that coping styles and self-efficacy mediated the relationship between different bullying behaviors and mental health outcomes. The results highlighted the comparison of the correlates of positive and negative bystander behaviors, which were comparably crucial to those of victims and perpetrators for prevention and intervention efforts. Promoting adaptive coping styles and self-efficacy to buffer the deleterious psychological consequences of bullying behavior in adolescents was also important.

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Campus sexual assault is a problem that overwhelmingly affects cisgender women and transgender, genderqueer/questioning, and nonbinary (TGQN) students. Yet, students of any gender may be perpetrators or victims of assault. Thus, it is important that prevention programs incorporate a range of scenarios that depict different genders as both perpetrators and victims, while also acknowledging the differential risk between gender groups. Gender-specific programming is one way of achieving this goal. In this systematic review and meta-analysis, we synthesized studies evaluating campus sexual assault prevention programs implemented with specified gender groups in the United States. Through a comprehensive literature search, we identified 38 studies that met eligibility criteria and were disseminated through 2021 (N = 22 women's studies; N = 16 men's studies; N = 0 TGQN studies). Programs overwhelmingly portrayed women as victims and men as perpetrators or bystanders while largely ignoring experiences of TGQN students. A greater proportion of women's programs included risk reduction content that relayed tactics participants may use to avoid victimization. A greater proportion of men's programs included bystander content that emphasized ways participants may stop others from committing sexual assault. Women's programs had a small but significant and favorable effect on victimization, but studies evaluating these programs did not measure perpetration outcomes. Men's programs had a non-significant effect on perpetration but victimization outcomes were not measured. Gender-specific prevention programming should begin to reflect the differential risks of perpetration and victimization across gender identities, and the effects of this program content should be rigorously evaluated.

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This study was carried out in a descriptive and cross-sectional design in order to examine the cyberbullying experiences of individuals using social media. This descriptive study was conducted online between June 16, 2022, and August 16, 2022, in Turkey. The data collection process was completed with 471 participants. Data were collected using a Personal Information Form and the Cyberbullying Triangulation Questionnaire. The mean questionnaire score was found to be 7.36 ± 6.99. Cyberbully, cybervictim, and cyberbystander scores of men were found to be higher than those of women. Also, cybervictim, cyberbully, and cyberbystander scores of those who experienced cybervictim or engaged in cyberbully were significantly higher (p < .05). A positive relationship was found between cyberbully and cybervictim (p = .000), between cyberbystander and cybervictim and cyberbully (p < .05), and between the Cyberbullying Triangulation Questionnaire total scores and cybervictim, cyberbully, and cyberbystander (p < .05). Individuals should be given training on risky internet use and the correct use of technology to prevent cyberbullying. Families should also be supported in setting an example, setting rules, applying filtering software, determining online behavior rules, and communicating with the bully or victim child. Individuals should be informed about the steps to follow when exposed to cyberbullying. Although legal sanctions are effective on cyberbullying, it is recommended that a holistic study be planned and carried out according to the people's age group and development level to increase awareness about the phenomenon.

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Introduction: Literature demonstrates the detrimental impact of discrimination and microaggressions at personal and institutional levels in the health care workplace. Residents in our program requested curricula to help with addressing manifestations of bias. In response, we designed and implemented an adaptable and reproducible 4-hour virtual simulation session aimed at helping residents identify and constructively respond to microaggressions. Methods: This curriculum, influenced by a preceding needs assessment, was delivered to 68 senior internal medicine residents. It began with a didactic overview to establish foundational knowledge of bias. This was followed by a workshop focused on strategies to address microaggressions. The session culminated with skills practice in a virtual simulation activity where learners addressed microaggressions as bystanders in realistic case scenarios employing simulated participants. We administered pre- and postevaluation individual key-linked surveys assessing learner confidence in responding to microaggressions. Results: A total of 68 residents participated in the curriculum over two academic years, 27 of whom provided complete data for analysis. Overall, there was a statistically significant increase in learner confidence identifying microaggressions. As both a bystander and target/recipient of microaggressions, there were statistically significant increases in learner confidence addressing gender-based microaggressions, race-based microaggressions, and microaggressions reflecting other types of bias. Furthermore, there were statistically significant increases in learner confidence addressing microaggressions in low-acuity contexts, high-acuity contexts, across interprofessional disciplines, with a supervisor, and with a supervisee. Discussion: Our virtual experiential curriculum on responding to microaggressions can help increase learner confidence in addressing microaggressions.

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Introduction: The Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) study evaluated the impact of an intervention developed and implemented in Singapore on attitudes towards depression in university students. We aimed to assess the likelihood of university students intervening when their peers suffer from depression, before and after the ARTEMIS intervention. Methods: 390 students were recruited from a university in Singapore. The ARTEMIS intervention comprised a lecture by a trained mental health professional, a sharing session by a person with lived experience of depression, and a question-and-answer segment with a panel. The Bystander Intervention Scale for Depression (BISD) was administered at baseline, post-intervention, and 3-month follow-up. BISD assessed four factors: acceptance of responsibility to intervene, knowledge on how to intervene, awareness of depression among peers, and vigilance towards possible symptoms of depression. Linear mixed models were conducted to investigate associations. Sociodemographic correlates were also examined. Results: A favourable shift in all factors was observed at post-intervention, which weakened at 3-month follow-up. Having past experience in the mental health field (ß=1.50) and older age (ß=0.18) were significantly associated with knowledge on how to intervene. Having social contact with mental illness (SCMI) and past experience in the mental health field (PEMHF) were significantly associated with awareness of depression among peers (SCMI ß=0.89, PEMHF ß=0.43) and vigilance towards possible symptoms of depression (SCMI ß=0.39, PEMHF ß=0.61). Discussion: The short-term results of the intervention appeared promising across all BISD factors; however, these results were not sustained after 3 months. Future research should include the impact of 'booster' interventions over time. Sociodemographic factors that were identified to be significant correlates should also be considered when planning for future interventions.

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Viral coinfections are responsible for a significant portion of cases of patients hospitalized with influenza-like illness. As our awareness of viral coinfections has increased, researchers have started to experimentally examine some of the virus-virus interactions underlying these infections. One mechanism of interaction between viruses is through the innate immune response. This seems to occur primarily through the interferon response, which generates an antiviral state in nearby uninfected cells, a phenomenon know as the bystander effect. Here, we develop a mathematical model of two viruses interacting through the bystander effect. We find that when the rate of removal of cells to the protected state is high, growth of the first virus is suppressed, while the second virus enjoys sole access to the protected cells, enhancing its growth. Conversely, growth of the second virus can be fully suppressed if its ability to infect the protected cells is limited.

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Integrating a social identity approach with Cortina's (2008) theorizing about selective incivility as modern discrimination, we examine how identification-with an organization, with one's gender, and as a feminist-shapes bystanders' interpretations and responses to witnessed incivility (i.e., interpersonal acts of disrespect) and selective incivility (i.e., incivility motivated by targets' social group membership) toward women at work. We propose that bystanders with stronger organizational identification are less likely to perceive incivility toward female colleagues as discrimination and intervene, but female bystanders with stronger gender identification are more likely to do so. Results from two-wave field data in a cross-lagged panel design (Study 1, N = 336) showed that organizational identification negatively predicted observed selective incivility 1 year later but revealed no evidence of an effect of female bystanders' gender identification. We replicated and extended these results with a vignette experiment (Study 2, N = 410) and an experimental recall study (Study 3, N = 504). Findings revealed a "dark side" of organizational identification: strongly identified bystanders were less likely to perceive incivility as discrimination, but there were again no effects of women's gender identification. Study 3 also showed that bystander feminist identification increased intervention via perceived discrimination. These results raise doubts that female bystanders are more sensitive to recognizing other women's mistreatment as discrimination, but more strongly identified feminists (male or female) were more likely to intervene. Although strongly organizationally identified bystanders were more likely to overlook women's mistreatment, they were also more likely to intervene once discrimination was apparent.

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Aims: To describe and explore predictors of bystander defibrillation in Ireland during the period 2012 to 2020. To examine the relationship between bystander defibrillation and health system developments. Methods: National level Out of Hospital Cardiac Arrest (OHCA) registry data were interrogated, focusing on patients who had defibrillation performed. Bystander defibrillation (as compared to EMS initiated defibrillation) was the key outcome of concern. Logistic regression models were built and refined by fitting predictors, performing stepwise variable selection and by adding pairwise interactions that improved fit. Results: The data included 5,751 cases of OHCA where defibrillation was performed. Increasing year over time (OR 1.17, 95% CI 1.13, 1.21) was associated with increased adjusted odds of bystander defibrillation. Non-cardiac aetiology was associated with reduced adjusted odds of bystander defibrillation (OR 0.30, 95% CI 0.21, 0.42), as were increasing age in years (OR 0.99, 95% CI 0.987, 0.996) and night-time occurrence of OHCA (OR 0.67, 95% CI 0.53, 0.83). Six further variables in the final model (sex, call response interval, incident location (home or other), who witnessed collapse (bystander or not witnessed), urban or rural location, and the COVID period) were involved in significant interactions. Bystander defibrillation was in general less likely in urban settings and at home locations. Whilst women were less likely to receive bystander defibrillation overall, in witnessed OHCAs, occurring outside the home, in urban areas and outside of the COVID-19 period women were more likely, to receive bystander defibrillation. Conclusions: Defibrillation by bystanders has increased incrementally over time in Ireland. Interventions to address sex and age-based disparities, alongside interventions to increase bystander defibrillation at night, in urban settings and at home locations are required.

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Aim: The aim of our study was to explore the effect of nomination-based social-media campaign and CPR-skill-booth on change in knowledge as well as hands-only CPR skills among young adults. Methods: A quasi-experimental study was conducted in two non-healthcare-stream colleges, one intervention and other control arm. After baseline evaluation of CPR knowledge in both colleges, a 4-week nomination-based social media campaign '#CPR challenge' was rolled out in the intervention arm which included a CPR-skill-booth that was setup for one hour every day to train interested participants in CPR. The participants were encouraged to share the same on their social media handles and data of self-reported metrics were collected. A post-intervention assessment was conducted in both arms, to assess knowledge and its translation to hands-only-CPR skills using qCPR mannequin and qCPR app® for objective assessment. Results: A total of 690 assessments were done; Intervention arm (pre-intervention-214, post intervention -155) and control arm (pre-intervention -157, post-intervention -134). The baseline knowledge scores were comparable in both groups. Knowledge score doubled in the intervention arm, (p < 0.001) from a median value of 29% (IQR:14 - 43) in the pre-intervention-cohort to 57% (IQR:29 - 71) in the post-intervention-cohort. Median CPR-skill-score was higher in the intervention arm 67.5(IQR:39-92) in comparison to control arm 21 (IQR:1-53) (p < 0.001). In terms of social media engagement, 50% of participants had watched the videos and 40.6% attended the CPR-skill-booth. Conclusion: Strategies such as a nomination-based social media campaign can improve the awareness, knowledge and also skills regarding hand-only CPR.

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Background: Defibrillation in the critical first minutes of out-of-hospital cardiac arrest (OHCA) can significantly improve survival. However, timely access to automated external defibrillators (AEDs) remains a barrier. Objectives: The authors estimated the impact of a statewide program for drone-delivered AEDs in North Carolina integrated into emergency medical service and first responder (FR) response for OHCA. Methods: Using Cardiac Arrest Registry to Enhance Survival registry data, we included 28,292 OHCA patients ≥18 years of age between 1 January 2013 and 31 December 2019 in 48 North Carolina counties. We estimated the improvement in response times (time from 9-1-1 call to AED arrival) achieved by 2 sequential interventions: 1) AEDs for all FRs; and 2) optimized placement of drones to maximize 5-minute AED arrival within each county. Interventions were evaluated with logistic regression models to estimate changes in initial shockable rhythm and survival. Results: Historical county-level median response times were 8.0 minutes (IQR: 7.0-9.0 minutes) with 16.5% of OHCAs having AED arrival times of <5 minutes (IQR: 11.2%-24.3%). Providing all FRs with AEDs improved median response to 7.0 minutes (IQR: 6.2-7.8 minutes) and increased OHCAs with <5-minute AED arrival to 22.3% (IQR: 16.4%-30.9%). Further incorporating optimized drone networks (326 drones across all 48 counties) improved median response to 4.8 minutes (IQR: 4.3-5.2 minutes) and OHCAs with <5-minute AED arrival to 56.3% (IQR: 46.9%-64.2%). Survival rates were estimated to increase by 34% for witnessed OHCAs with estimated drone arrival <5 minutes and ahead of FR and emergency medical service. Conclusions: Deployment of AEDs by FRs and optimized drone delivery can improve AED arrival times which may lead to improved clinical outcomes. Implementation studies are needed.

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OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

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Exosomes are nano-sized extracellular vesicles produced by almost all mammalian cells. They play an important role in cell-to-cell communication by transferring biologically active molecules from the cell of origin to the recipient cells. Ionizing radiation influences exosome production and molecular cargo loading. In cancer management, ionizing radiation is a form of treatment that exerts its cancer cytotoxicity by induction of DNA damage and other alterations to the targeted tissue cells. However, normal bystander non-targeted cells may exhibit the effects of ionizing radiation, a phenomenon called radiation-induced bystander effect (RIBE). The mutual communication between the two groups of cells (targeted and non-targeted) via radiation-influenced exosomes enables the exchange of radiosensitive molecules. This facilitates indirect radiation exposure, leading, among other effects, to epigenetic remodeling and subsequent adaptation to radiation. This review discusses the role exosomes play in epigenetically induced radiotherapy resistance through the mediation of RIBE.