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Background: The incidence of cardiac arrest (CA) during percutaneous coronary intervention (PCI) is relatively rare. However, when it does occur, the mortality rate is extremely high. Extracorporeal cardiopulmonary resuscitation (ECPR) has shown promising survival rates for in-hospital cardiac arrests (IHCA), with low-flow time being an independent prognostic factor for CA. However, there is no definitive answer on how to reduce low-flow time. Methods: This retrospective study, conducted at a single center, included 39 patients who underwent ECPR during PCI between January 2016 and December 2022. The patients were divided into two cohorts based on whether standby extracorporeal membrane oxygenation (ECMO) was utilized during PCI: standby ECPR (SBE) (n = 13) and extemporaneous ECPR (EE) (n = 26). We compared the 30-day mortality rates between these two cohorts and investigated factors associated with survival. Results: Compared to the EE cohort, the SBE cohort showed significantly lower low-flow time (P < 0.01), ECMO operation time (P < 0.01), and a lower incidence of acute kidney injury (AKI) (P = 0.017), as well as peak lactate (P < 0.01). Stand-by ECMO was associated with improved 30-day survival (p = 0.036), while prolonged low-flow time (p = 0.004) and a higher SYNTAX II score (p = 0.062) predicted death at 30 days. Conclusions: Standby ECMO can provide significant benefits for patients who undergo ECPR for CA during PCI. It is a viable option for high-risk PCI cases and may enhance the overall prognosis. The low-flow time remains a critical determinant of survival.

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Chylous ascites is infrequently observed following lymph node dissection in surgeries for gynecological malignancies. If symptoms develop, they can severely debilitate patients and increase the risk of infection, particularly those with a low performance status following the primary operation. Treatment of chylous ascites is often challenging and protracted, with no treatment currently guaranteeing a complete cure. This study explores the efficacy of standby therapy for refractory chylous ascites in a 46-year-old woman with gynecological malignancies who did not respond to multiple lymphangiographic interventions. Due to a suspicion of left ovarian cancer, she underwent surgery including lymph node dissection. On the following day, significant amounts of ascites were confirmed in the abdominal cavity. Despite performing lymphangiography twice, the chylous ascites persisted. During follow-up in the outpatient ward, on the 142nd post-surgery day, the ascites had spontaneously resolved. In cases like this, where symptoms are relatively mild and surgical intervention is not preferred due to complications or patient preference following lymphangiography, it may be beneficial to use standby therapy in combination with dietary management during outpatient follow-up. Such an approach could yield medium- to long-term improvements and should be considered. However, if further treatment is planned following the initial surgery, the patient's long-term prognosis should be considered, and treatment should be administered promptly. Various methods exist for treating refractory chylous ascites, including expectant therapy, dietary management, percutaneous drainage, lymphangiography and embolization, and surgical lymphatic ligation. Tailoring individualized treatment plans for each patient and pursuing a multidisciplinary approach is advisable. Although initiating adjuvant chemotherapy may not be feasible, long-term standby therapy is beneficial, even if lymphangiography proves ineffective in the short term.

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BACKGROUND: Energy consumption awareness is a known concern, and radiology departments have energy-intensive consuming machines. The means of energy consumption management in MRI scanners have yet to be evaluated. PURPOSE: To measure the MRI energy consumption and to evaluate the means to reduce it. MATERIALS AND METHODS: Data was retrieved for two MRI scanners through the hospital's automated energy consumption measurement software. After correlation with picture archiving and communication system (PACS) files, they were segmented by machine and mode (as follows: stand-by, idle and active) and analyzed. Active mode data for a specific brain MRI protocol have been isolated, and equivalent low energy consuming protocol was made. Both were performed on phantom and compared. Same protocol was performed on a phantom using 3.0T 16 and 32 head channels coils. Multiples sequences were acquired on phantom to evaluate power consumption. RESULTS: Stand-by mode accounted for 60 % of machine time and 40 % of energy consumption, active mode accounted for 20 % machine time and 40 % energy consumption, idle mode for 20 % imachine time and 20 % consumption. DWI and TOF sequences were the most consuming in our brain-MRI protocol. The low energy consuming protocol allowed a saving of approximately 10 % of energy consumption, which amounted for 0.20€ for each examination. This difference was mainly due to an energy consumption reduction of the DWI sequence. There were no difference in consumption between a 3.0T 16 and 32 channels head coils. Sequence's active power and duration (especially considering slice thickness) have to be taken into account when trying to optimize energy consumption. CONCLUSION: There are two key factors to consider when trying to reduce MRI scan energy consumption. Stand-by mode energy consumption has to be taken into account when choosing an MRI scan, as it can't be changed further on. Active mode energy consumption is dependent of the MRI protocols used, and can be reduced with sequences adaptation, which must take into account sequence's active power and duration, on top of image quality.

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Objectives: Data on anesthetic proceedings during cardiac implantable electronic device (CIED) implant procedures are scarce and it remains unclear whether anesthetic care is still required in selected patients. Methods: In this retrospective, single center study we assessed the prevalence of intraoperative anesthetic management comprising anesthetic standby, sedation or general anesthesia as well as anesthetic and procedural complications. We analyzed pre-existing and perioperative risk factors related to procedure-related adverse outcome such as perioperative cardiopulmonary resuscitation (CPR) and 30-day mortality in a uni- and multivariable analysis. Results: In total, PM and ICD insertion were performed in up to 85% and 58% under anesthetic standby, with an increasing tendency over time.Overall, Cardiopulmonary resuscitation (CPR) was required in 59 patients. Acute heart failure (AHF) was the only independent pre-existing risk factor for CPR and for 30-day mortality. Sedation and general anesthesia had a significantly increased odds ratio for CPR compared to anesthetic standby. The risk for CPR significantly decreased during the study period. Conclusions: Over the years anesthetic practice during CIED implant procedures shifted from mixed anesthetic proceedings to mainly standby duties. The prevalence of complications and emergency measures is low, however not uncommon. Accordingly, the presence of an anesthesiologist should be further guaranteed when sedatives were titrated and in AHF patients. However, in patients receiving local anesthetic infiltration only, it seems safe to perform CIED implant procedures without anesthetic standby.

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Recently, one of the primary concerns in e-textile-based healthcare monitoring systems for chronic illness patients has been reducing wasted power consumption, as the system should be always-on to capture diverse biochemical and physiological characteristics. However, the general conductive fibers, a major component of the existing wearable monitoring systems, have a positive gauge-factor (GF) that increases electrical resistance when stretched, so that the systems have no choice but to consume power continuously. Herein, a twisted conductive-fiber-based negatively responsive switch-type (NRS) strain-sensor with an extremely high negative GF (resistance change ratio ≈ 3.9 × 108 ) that can significantly increase its conductivity from insulating to conducting properties is developed. To this end, a precision cracking technology is devised, which could induce a difference in the Young's modulus of the encapsulated layer on the fiber through selective ultraviolet-irradiation treatment. Owing to this technology, the NRS strain-sensors can allow for effective regulation of the mutual contact resistance under tensile strain while maintaining superior durability for over 5000 stretching cycles. For further practical demonstrations, three healthcare monitoring systems (E-fitness pants, smart-masks, and posture correction T-shirts) with near-zero standby power are also developed, which opens up advancements in electronic textiles by expanding the utilization range of fiber strain-sensors.

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BACKGROUND & PROBLEMS: Readiness process effectiveness significantly impacts the safety of high-risk neonates and requires an immediately responsive and well-trained healthcare team. Analysis of our unit found the high-risk neonatal standby process completion rate among nursing staff to be very low. Reasons for this poor level of performance included absence of standardized procedures for high-risk neonatal standby, lack of an auditing system, inadequate education and training, multiple medical supplies in the standby kits, absence of a checklist for the kits, and failure to regularly inventory the contents of these kits. PURPOSE: This study was designed to improve the high-risk neonatal standby process completion rate among nursing staff. RESOLUTION: We developed standardized procedures and videos for high-risk neonatal standby situations, established an auditing system, conducted regular scenario-based training, organized medical supplies in the standby kits, designed a checklist, and defined procedures for stocking and using the supplies. RESULTS: The high-risk neonatal care completion rate among nursing staff increased to 100%, and the satisfaction rate with the standby procedure for high-risk neonates rose from 59.5% to 96.5%. CONCLUSIONS: Following proper standardized procedures and conducting education and training can ensure effective and high-quality care in critical healthcare situations.

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In Sinorhizobium meliloti, the methionine biosynthesis genes metA and metZ are preceded by S-adenosyl-L-methionine (SAM) riboswitches of the SAM-II class. Upon SAM binding, structural changes in the metZ riboswitch were predicted to cause transcriptional termination, generating the sRNA RZ. By contrast, the metA riboswitch was predicted to regulate translation from an AUG1 codon. However, downstream of the metA riboswitch, we found a putative Rho-independent terminator and an in-frame AUG2 codon, which may contribute to metA regulation. We validated the terminator between AUG1 and AUG2, which generates the sRNA RA1 that is processed to RA2. Under high SAM conditions, the activities of the metA and metZ promoters and the steady-state levels of the read-through metA and metZ mRNAs were decreased, while the levels of the RZ and RA2 sRNAs were increased. Under these conditions, the sRNAs and the mRNAs were stabilized. Reporter fusion experiments revealed that the Shine-Dalgarno (SD) sequence in the metA riboswitch is required for translation, which, however, starts 74 nucleotides downstream at AUG2, suggesting a novel translation initiation mechanism. Further, the reporter fusion data supported the following model of RNA-based regulation: Upon SAM binding by the riboswitch, the SD sequence is sequestered to downregulate metA translation, while the mRNA is stabilized. Thus, the SAM-II riboswitches fulfil incoherent, dual regulation, which probably serves to ensure basal metA and metZ mRNA levels under high SAM conditions. This probably helps to adapt to changing conditions and maintain SAM homoeostasis.

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Translational riboswitches are bacterial gene regulatory elements found in the 5'-untranslated region of mRNAs. They operate through a conformational refolding reaction that is triggered by a concentration change of a modulating small molecular ligand. The translation initiation region (TIR) is either released from or incorporated into base pairing interactions through the conformational switch. Hence, initiation of translation is regulated by the accessibility of the Shine-Dalgarno sequence and start codon. Interaction with the 30S ribosome is indispensable for the structural switch between functional OFF and ON states. However, on a molecular level it is still not fully resolved how the ribosome is accommodated near or at the translation initiation region in the context of translational riboswitches. The standby model of translation initiation postulates a binding site where the mRNA enters the ribosome and where it resides until the initiation site becomes unstructured and accessible. We here investigated the adenine-sensing riboswitch from Vibrio vulnificus. By application of a 19F labelling strategy for NMR spectroscopy that utilizes ligation techniques to synthesize differentially 19F labelled riboswitch molecules we show that nucleotides directly downstream of the riboswitch domain are first involved in productive interaction with the 30S ribosomal subunit. Upon the concerted action of ligand and the ribosomal protein rS1 the TIR becomes available and subsequently the 30S ribosome can slide towards the TIR. It will be interesting to see whether this is a general feature in translational riboswitches or if riboswitches exist where this region is structured and represent yet another layer of regulation.

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A zero-power wakeup scheme for energy-efficient sensor applications is presented in this study based on a piezoelectric MEMS energy harvester featuring wafer-level-integrated micromagnets. The proposed setup overcomes a hybrid assembly of magnets on a chip-level, a major drawback of similar existing solutions. The wakeup device can be excited at low frequencies by frequency up-conversion, both in mechanical contact and contactless methods due to magnetic force coupling, allowing various application scenarios. In a discrete circuit, a wakeup within 30−50 ms is realized in frequency up-conversion at excitation frequencies < 50 Hz. A power loss in the off state of 0.1 nW renders the scheme virtually lossless. The potential extension of battery lifetime compared to cyclical wakeup schemes is discussed for a typical wireless sensor node configuration.

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Due to the unpredictable nature of working time arrangements, on-call workers experience regular disruption to sleep, particularly if woken by calls. Sleep disruption can impact long term physical and mental health, next day performance, and importantly, performance immediately after waking. To reduce the impact of performance impairments upon waking (i.e., reducing sleep inertia), research has investigated strategies to promote alertness (e.g., bright light, caffeine, and exercise). This review puts forth on-call workers who are likely to return to sleep after a call, it is also important to consider the impact of these sleep inertia countermeasures on subsequent sleep. Future research should build on the preliminary evidence base for sleep inertia countermeasures by examining the impact on subsequent sleep. This research is key for both supporting alertness and performance during a call ("switching on") and for allowing the on-call worker to return to sleep after a call ("switching off").

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This study focuses on oil pollution response services performed by the European Maritime Safety Agency (EMSA). In this context, the annual reports on all drills and exercises published between 2006 and 2020 were analyzed in detail. The main goal of the study is to identify the impact of the Covid-19 pandemic that broke out in 2020 on the oil pollution response services carried out in the last 15 years. Due to the outbreak of the Covid-19 pandemic at the beginning of 2020 and the resulting travel restrictions, EMSA was unable to participate directly in drills, exercises and tests, and it audited the services remotely. As a result, the Covid-19 pandemic, has been seen disrupted the oil pollution response services of the agency.

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This paper introduced a study for a new system that consists of one unit with mixed standby units. The mathematical model for the system is constructed using semi-Markov model with regenerative point technique in two cases: the first case when there is preventive maintenance provided to the main unit and the second case when there is no preventive maintenance in the system. Life and repair times of the units in the system are assumed to be generally distributed with fuzzy parameters defined by the bell-shaped membership function. A Numerical application is introduced to compare the performance of the system in the two cases.

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Drinking water on isolated islands includes treated rainwater, water shipped from the mainland, and desalinated seawater. However, marine transportation and desalination plants are vulnerable to emergencies, such as extreme weather, making self-sustaining stand-by water for emergency response essential. Rainwater is ideal for producing the stand-by water, and rainwater harvesting is sustainable and clean, and prolonged biostability can be ensured by managing biological and chemical parameters. The present study applied a stand-by drinking water purification system (primarily including nanofiltration and low-dose chlorination) to explore the feasibility of producing and storing cleaner drinking water from rainwater and the following conclusions were drawn. First, treatment of rainwaters ensures biosafety for seven days, which is longer than that for untreated rainwater; the proportion of opportunistic pathogens decreased from 23.40-7.77% after nanofiltration, and it was proposed that the microbial community converges after advanced water treatment. Second, chemical qualities were improved. Local resource coral sand prevents pH in rainwater from decreasing below 6.5, and treated rainwater had lower disinfection by-product potential and higher disinfection efficiency, allowing periodical rainwater recycling. Third, harvesting rainwater was extremely cost-effective, with an operation cost of 1.5-2.5 RMB/m3. From biosafety, chemical safety, and economic cost perspectives, self-sustaining water from rainwater can contributes to the development of sustainable and cost-effective water supply systems on isolated islands. Mixing treated rainwater and desalinated seawater reasonably guarantees sufficiency and safety.

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BACKGROUND: Standby emergency self-treatment (SBET) is often recommended as an anti-malaria strategy for travellers to low-risk endemic areas. This self-treatment enables competent malaria therapy, if medical assistance is unavailable. The World Health Organization (WHO) recommends performing reliable diagnostic tests before starting antimalarial treatment. For the self-diagnosis of malaria in travellers, rapid diagnostic tests (RDT) can be used to confirm the infection before SBET is used. The aim of this research is to assess the use of RDT and/or SBET in travellers. METHODS: We searched the databases (PubMed, Scopus, Embase, CINAHL) using terms and synonyms for 'self-diagnosis' and 'self-treatment' combined with 'malaria' and 'travel'. Articles in English, French and German were included. Potential articles were screened and extracted by two authors (KU and PS). Only original articles and case reports documenting the self-use of RDT and/or SBET in travellers were included. Data were extracted using a standardised approach. We defined 'correct use' of RDT and SBET. Data on number and performance of RDT and SBET use, as well as malaria verification were collected in an Excel table. Five meta-analyses were performed using a random effects model and calculating pooled proportions. This systematic review was conducted according to the PRISMA guidelines and registered in PROSPERO (CRD42018108874). RESULTS: The research resulted in 867 articles of possible relevance on RDT and 955 articles on SBET. After screening, a total of 4 articles on RDT use and 17 articles for SBET use in travellers were included in the systematic review. Most of the RDT were performed and interpreted properly by the travellers (pooled proportion 88%, 95% confidence interval (CI) from 64% to 97%), whereby the proportion of correct performance was increased after a pre-travel test run (97%). Major problems in the implementation such as pricking finger, placing blood drop, identifying lines and interpreting results could be discovered. We found data on 1025 SBET uses in studies of travellers to high-risk African countries. In these studies, the pooled proportion of SBET uses was 6% (95% CI from 2% to 13%). We found 545 SBET uses in studies of travellers to countries of mixed malaria risk. In these studies, the pooled proportion of SBET uses was 2% (95% CI from 1% to 7%). Furthermore, the evaluation showed a high proportion of correct SBET use (pooled proportion 69%, 95% CI from 35% to 90%). As a cause for incorrect use, errors in dosage (under- or overdose), disregard of minimal incubation period (< 7 days since first possible malaria exposure) and absence of fever were identified. Four cases of post-SBET severe adverse events were documented. In a third of travellers who used SBET, a Plasmodium spp. infection could be detected (pooled proportion 31%, 95% CI from 16% to 51%). CONCLUSIONS: This systematic review and meta-analysis showed that the majority of travellers were able to use RDT and SBET correctly. Standardised pre-travel instructions and specific training are indicated to increase the proportions of correct RDT and SBET use. With improved and user-friendly technology, RDT may become an integral part of SBET malaria recommendations for travellers. Combined use of RDT and SBET could be an appropriate strategy for selected subgroups of travellers to low-risk, remote malaria areas. Future research should focus on combined RDT and SBET strategies.

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For some critical applications, successfully accomplishing the mission or surviving the system through aborting the mission and performing a rescue procedure in the event of certain deterioration condition being satisfied are both pivotal. This has motivated considerable studies on mission abort policies (MAPs) to mitigate the risk of system loss in the past several years, especially for standby systems that use one or multiple standby sparing components to continue the mission when the online component fails, improving the mission success probability. The existing MAPs are mainly based on the number of failed online components ignoring the status of the standby components. This article makes contributions by modeling standby systems subject to MAPs that depend not only on the number of failed online components but also on the number of available standby components remaining. Further, dynamic MAPs considering another additional factor, the time elapsed from the mission beginning in the event of the mission abort decision making, are investigated. The solution methodology encompasses an event-transition based numerical algorithm for evaluating the mission success probability and system survival probability of standby systems subject to the considered MAPs. Examples are provided to demonstrate the benefit of considering the state of standby components and elapsed operation time in obtaining more flexible MAPs.

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Sleep inertia, the state of reduced alertness upon waking, can negatively impact on-call workers. Anticipation of a stressful task on sleep inertia, while on-call was investigated. Young, healthy males (n = 23) spent an adaptation, control and two counterbalanced on-call nights in the laboratory. When on-call, participants were told they would be woken to a high or low stress task. Participants were not woken during the night, instead were given a 2300-0700 sleep opportunity. Participants slept ∼7.5-h in all conditions. Upon waking, sleep inertia was quantified using the Karolinska Sleepiness Scale and Psychomotor Vigilance and Spatial Configuration Tasks, administered at 15-min intervals. Compared to control, participants felt sleepier post waking when on-call and sleepiest in the low stress compared to the high stress condition (p < .001). Spatial performance was faster when on-call compared to control (p < .001). Findings suggest that anticipating a high-stress task when on-call, does not impact sleep inertia severity.

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In this paper, a system of five components is studied; one of these components is a bridge network component. Each of these components has a non-constant failure rate. The system components have linear failure rate lifetime distribution. The given system is improved by using three methods: reduction, warm standby with perfect switch and warm standby with imperfect switch. The reliability equivalence factors of the bridge structure system are obtained. The γ-fractiles are obtained to compare the original system with these improved systems. Finally, we present numerical results to show the difference between these methods.

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OBJECTIVE: This study had two specific objectives, 1) to investigate the impact of being on-call on overnight heart rate variability during sleep and; 2) to examine whether being on-call overnight impacted next-day salivary cortisol concentrations. METHODS: Data are reported from three within-subject laboratory studies (n = 24 in each study) that assessed varying on-call conditions. Healthy male participants (n = 72 total) completed a four-night laboratory protocol, comprising an adaptation night, a control night, and two counterbalanced on-call nights with varying on-call conditions. These on-call conditions were designed to determine the impact of, Study 1: the likelihood of receiving a call (definitely, maybe), Study 2: task stress (high-stress, low-stress), and Study 3: chance of missing the alarm (high-chance, low-chance), on measures of physiological stress. Overnight heart rate variability (HRV) (during sleep) was measured using two-lead electrocardiography, and time- and frequency-domain variables were analysed. Saliva samples were collected at 15-min time intervals from 0700-0800 h to determine cortisol awakening response outcomes and at four daily time points (0930 h, 1230 h, 1430 h, and 1730 h) to assess diurnal cortisol profiles. RESULTS: There were few differences in HRV measures during sleep across all three studies. The only exception was in Study 1 where the standard deviation of the time interval between consecutive heartbeats and the root mean square of consecutive differences between heartbeats were lower across all sleep stages in the definitely condition, when compared to control. Across all three studies, being on-call overnight also had little impact on next-day cortisol awakening response (CAR), with the exception of Study 2 where the 1) CAR area under the curve with respect to increase was blunted in the high-stress condition, compared to the control and low-stress conditions and, 2) CAR reactivity was higher in low-stress condition, compared with the high-stress condition. In Study 1, diurnal cortisol area under the curve with respect to ground was lower in the on-call conditions (definitely and maybe) when compared to control. There were no differences in diurnal cortisol measures in Study 3. CONCLUSION: This is the first study to investigate how different aspects of being on-call affect physiological stress responses. Overall, relatively little differences in measures of overnight heart rate variability and next-day cortisol response were recorded in all three studies. Further research utilising real on-call work tasks, not just on-call expectations (as in the current study) will help determine the impact of on-call work on the physiological stress response.

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In bacteria, stable RNA structures that sequester ribosome-binding sites (RBS) impair translation initiation, and thus protein output. In some cases, ribosome standby can overcome inhibition by structure: 30S subunits bind sequence-nonspecifically to a single-stranded region and, on breathing of the inhibitory structure, relocate to the RBS for initiation. Standby can occur over long distances, as in the active, +42 tisB mRNA, encoding a toxin. This mRNA is translationally silenced by an antitoxin sRNA, IstR-1, that base pairs to the standby site. In tisB and other cases, a direct interaction between 30S subunits and a standby site has remained elusive. Based on fluorescence anisotropy experiments, ribosome toeprinting results, in vitro translation assays, and cross-linking-immunoprecipitation (CLIP) in vitro, carried out on standby-proficient and standby-deficient tisB mRNAs, we provide a thorough characterization of the tisB standby site. 30S subunits and ribosomal protein S1 alone display high-affinity binding to standby-competent fluorescein-labeled +42 mRNA, but not to mRNAs that lack functional standby sites. Ribosomal protein S1 is essential for standby, as 30∆S1 subunits do not support standby-dependent toeprints and TisB translation in vitro. S1 alone- and 30S-CLIP followed by RNA-seq mapping shows that the functional tisB standby site consists of the expected single-stranded region, but surprisingly, also a 5'-end stem-loop structure. Removal of the latter by 5'-truncations, or disruption of the stem, abolishes 30S binding and standby activity. Based on the CLIP-read mapping, the long-distance standby effect in +42 tisB mRNA (∼100 nt) is tentatively explained by S1-dependent directional unfolding toward the downstream RBS.

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We assessed the 24-h pattern of operations-related injuries (ORI) experienced by scheduled off-site/on-call French volunteer firefighters (VFF) through analysis of an archival database. Occurrence and severity - evaluated by number of lost work days (LWD) and total medical costs (TMC) - of ORI were explored in terms of risk ratios, respectively, number of ORI/number of service operations (RRORI), number of LWD/number of ORI (RSLWD,) and TMC/number of ORI (RSTMC). Additionally, the collective work performance of all involved VFF was measured in terms of the lag time (LT) between emergency call-center firefighter-answered communication for service of observer-presumed out-of-hospital cardiac arrest (OHCA) and departure of vehicle from fire station to render aid, designated LTOHCA. Cosinor and cross-correlation statistical methods were applied. A total of 252 ORI occurred while performing 146,479 service operations. High-amplitude 24 h variation was detected in RRORI (p < .003), SRLWD (p < .001), SRTMC (p < .012), and LTOHCA (p < .001), all with nocturnal peak time. Coherence was found between the day/night variation of LTOHCA and RRORI (r = 0.7, p < .0002), SRLWD (r = 0.5, p < .02), and SRTMC (r = 0.4, p < .05). This investigation verifies the occurrence and severity of ORI of scheduled off-site/on-call VFF exhibit high-amplitude 24 h patterning with nocturnal excess that closely coincides with their day/night work performance measured by LTOHCA. These findings, which are essentially identical to ones of a previous study entailing on-site/on-call career firefighters, indicate the need for fatigue management and ORI prevention programs not yet available to VFF, who compose the majority of the field service workforce of French fire departments. Abbreviations:FF: firefighters; CFF: career firefighters; VFF: volunteer firefighters; FD: fire department; LTOHCA: lag time (LT) response in min:sec between fire department call-center-answered communication for service of presumed out-of-hospital cardiac arrest (OHCA) and departure from fire station of vehicle to render aid; LWD: lost work days; ORI: operations-related injuries; SRLWD: severity ratio of operations-related injuries in terms of number of lost work days, calculated as number of lost work days/number of operations-related injuries; RRORI: risk ratio of operations-related injuries calculated as number of operations-related injuries/number of operations; SRTMC: severity ratio of operations-related injuries in terms of total medical costs, calculated as total medical costs/number of operations-related injuries; TMC: total medical costs.

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