Research on the Rescue Time of the Taiwan Marathon Emergency Medical Service System Between 2013 and 2021.

BACKGROUND: While there are several studies on marathon injuries worldwide, there are no related studies on the Taipei Marathon regarding the rescue time of onsite injury cases, the incidence of out-of-hospital cardiac arrest (OHCA) cases, and the success rate of recovery of spontaneous circulation (ROSC). This study aims to fill that gap. HYPOTHESIS: The rescue time onsite of contact injury cases was in the prime time for lifesaving. STUDY DESIGN: Descriptive epidemiological study. LEVEL OF EVIDENCE: Level 2c. METHODS: This is a retrospective study of numerical and timeflow data using descriptive statistics. Our data were obtained from records of the Taipei Marathon from 2013 to 2021. These included (1) notification data, (2) the time record of the emergency care personnel in contact with patients, (3) incidence of OHCA, (4) the success rate of ROSC, (5) the location of occurrence of OHCA, and (6) emergency medical service capacity and configuration. RESULTS: The average time taken for first contact was 1.56 minutes in OHCA cases, and the total incidence rate of OHCA in 9 years was 4 people per 100,000 people, with a 100% ROSC success rate. Further, the location of OHCA cases was mostly in Q4 of the race (66.67%), followed by Q3 (22.22%) and Q2 (1.11%). The average number of emergency care personnel per marathon was 78, spread across 6 rescue and 6 medical stations and equipped with 8 ambulances and 35 automated external defibrillators. CONCLUSION: Shortening the arrival time of medical personnel to the scene and implementing a complete chain of survival can improve survival rates. Other ways to provide faster and more timely emergency rescue services require further study. CLINICAL RELEVANCE: Contact with patients as soon as possible, timely implementation of cardiopulmonary resuscitation, and use of an automated external defibrillator are the basic requirements of the chain of survival theory.

Relationships among phthalate exposure, oxidative stress, and insulin resistance in young military soldiers: A cumulative risk assessment and mediation approach.

BACKGROUND: Epidemiological studies concerning whether oxidative stress mediates phthalate exposure-insulin resistance (IR) associations in young adults are limited. Therefore, we investigated this potential mediation by using a cumulative risk approach involving daily intake (DI) and a hazard index (HIRfD). METHODS: The participants were 391 Taiwanese military personnel. This study measured their IR (as homeostatic model assessment of estimated IR [HOMA-IR]), levels of oxidative stress biomarkers (8-hydroxy-2-deoxyguanosine, 8-nitroguanine, 8-iso-prostaglandin F2α, and N-acetyl-S-[tetrahydro-5-hydroxy-2-pentyl-3-furanyl]-L-cysteine [HNE-MA]), the sum of these four biomarkers (ΣOS), and urinary phthalate metabolite concentrations. The HIRfD was estimated on the basis of urinary levels of phthalate metabolite, and the DI of five phthalates was determined: dimethyl phthalate, benzyl butyl phthalate (BBzP), diethyl phthalate, dibutyl phthalate (DBP), and di (2-ethylhexyl) phthalate (DEHP). Logistic regression models were employed to explore associations among DI, HIRfD, oxidative stress biomarkers, and HOMA-IR values. The role played by oxidative stress in the phthalate exposure-HOMA-IR association was determined using mediation analysis. RESULTS: We discovered positive associations between high DI of DBP, BBzP, and DEHP; high HIRfD; and high ΣOS. High ΣOS and HNE-MA were associated with a higher likelihood of a high HOMA-IR value. Mediation analysis indicated that high ΣOS and HNE-MA were significant mediators of the associations between phthalates and IR. CONCLUSION: Oxidative stress may partially mediate the phthalate-IR relationship in young adults.