He attributes his survival to the rapid defibrillation he received from first responders — but not everybody is so fortunate.

Now, as lead author on a new observational study published in the journal JAMA Network Open, he and co-authors from Oregon Health & Science University say the study suggests the position in which responders initially place the two defibrillator pads on the body may make a significant difference in returning spontaneous blood circulation after shock from a defibrillator.

“The less time that you’re in cardiac arrest, the better,” said Lupton, assistant professor of emergency medicine in the OHSU School of Medicine. “The longer your brain has low blood flow, the lower your chances of having a good outcome.”

Researchers used data from the Portland Cardiac Arrest Epidemiologic Registry, which comprehensively recorded the placement position of defibrillation pads from July 1, 2019, through June 30, 2023. For purposes of the study, researchers reviewed 255 cases treated by Tualatin Valley Fire & Rescue, where the two pads were placed either at the front and side or front and back.

They found placing the pads in front and back had 2.64-fold greater odds of returning spontaneous blood circulation, compared with placing the pads on the person’s front and side.

The current common knowledge among health care professionals is that pad placement — whether front and side, or front and back — is equally beneficial in cardiac arrest. The researchers cautioned that their new study is only observational and not a definitive clinical trial. Yet, given the crucial importance of reviving the heartbeat as quickly as possible, the results do suggest a benefit from placing the pads on the front and back rather than the front and side.

“The key is, you want energy that goes from one pad to the other through the heart,” said senior author Mohamud Daya, M.D., professor of emergency medicine in the OHSU School of Medicine.

Placing the pads in the front and back may effectively “sandwich” the heart, raising the possibility that the electrical current will be delivered more comprehensively to the organ.

However, that’s not readily possible in many cases. For example, the patient may be overweight or positioned in such a way that they can’t be easily moved.

“It can be hard to roll people,” said Daya, who also serves as medical director for Tualatin Valley Fire & Rescue. “Emergency medical responders can often do it, but the lay public may not be able to move a person. It’s also important to deliver the electrical current as quickly as possible.”

In that respect, pad placement is only one factor among many in successfully treating cardiac arrest.

Lupton survived his cardiac arrest and went on to complete medical school at the very hospital where he spent several days recovering in the intensive care unit — Johns Hopkins University in Baltimore. The episode led him to alter the focus of his research so that he could examine ways to optimize early care for cardiac arrest patients.

The results of the new study surprised him.

“I didn’t expect to see such a big difference,” he said. “The fact that we did may light a fire in the medical community to fund some additional research to learn more.”

The research was supported by the Zoll Foundation, grant award 1018439; the Society for Academic Emergency Medicine Foundation, grant award RE2020-0000000167; and the National Institute of Neurological Disorders and Stroke of the National Institutes of Health, award U24NS100657 and National Center for Advancing Translational Sciences, award UL1TR002369. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

The researchers, led by Natalie Bareis, Ph.D., with Columbia University Irving Medical Center and New York State Psychiatric Institute, examined national data that were collected from Oct. 2020 to Oct. 2022 on 4,764 adults aged 18 to 65 in the Substance Abuse and Mental Health Services Agency-sponsored U.S. Mental and Substance Use Disorders Prevalence Study (MDPS). Using sampling weights, the authors compared sociodemographic characteristics and comorbid behavioral health conditions of individuals with or without schizophrenia spectrum disorders (schizophrenia, schizoaffective, and schizophreniform disorders).

Among 114 adults with schizophrenia spectrum disorders, the most common comorbid conditions were major depressive episode (52%) and alcohol use (23%), cannabis use (20%), and posttraumatic stress disorders (17%). Both suicidal ideation and suicide attempts in the past year were significantly more likely among individuals with schizophrenia spectrum disorders than among those without them.

While almost everyone with schizophrenia spectrum disorders in this sample had health care coverage, about 70% had any type of mental health treatment in the past year and only about 30% were currently taking an antipsychotic. While many individuals with schizophrenia spectrum disorders may recover, most of the individuals in the survey were unemployed and most had serious functional impairment.

Available, effective treatments and services include antipsychotic medications, individual placement and support, programs to promote employment, assertive community treatment, and coordinated specialty care for first-episode psychosis.

“The MDPS is an update to decades old surveys of psychiatric disorders in the U.S. It had a focus on identifying schizophrenia spectrum disorders by administering the Structured Clinical Interview for the DSM-5 to all participants,” Bareis noted. “We had hoped that during this period, with the advent of new treatments and services, the circumstances of individuals with schizophrenia spectrum disorders would have improved. Instead, persistent high rates of poverty, unemployment, and poor functioning suggest that existing treatment and social welfare approaches are not meeting the needs of many people with schizophrenia spectrum disorders. Policies to improve access to and use of existing evidence-based interventions are essential.”

Ling Li, an associate professor in the MSU Department of Biological Sciences, has spent more than a decade studying rice and soybean crops, with the goal of providing a new strategy for crop improvement to increase protein content. Her work offers a potential solution to combat global protein deficiency, a condition affecting millions, particularly children, contributing to cognitive impairments, stunted growth and susceptibility to diseases like Kwashiorkor, a severe form of malnutrition caused primarily by a deficiency in dietary protein.

“With rising concerns about protein deficiency and the environmental impact of animal-based protein sources, boosting plant protein content is crucial for improving both human health and sustainability,” Li said.

Li’s research — which includes more than 10 years of field work and field data to support her findings — focuses on optimizing the genetic expression of rice and soybean plants, resulting in increased protein levels and reduced carbohydrate content. Her novel approach uses gene editing to remove repressor elements from noncoding DNA sequences, unlocking the potential for higher protein production in crops. This strategy not only offers improved nutritional value but also promotes more sustainable agricultural practices by reducing the reliance on animal-derived proteins.

The U.S. Department of Agriculture’s Animal Plant Health Inspection Service determined Li’s gene-edited high-protein crops can be listed as nonregulatory soybean and rice, she said.

The findings provide a promising blueprint for enhancing crop productivity and nutritional quality through precise genome editing, with far-reaching implications for global food security and environmental sustainability.

Li’s research includes collaboration with the Bing Yang Lab at the University of Missouri and the Dan Voytas Lab at the University of Minnesota.