Search results for: emergency response system

Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

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Authors: B. P. G. Figueira, I. C. Pinto, D. Ferro, F. C. M. Zacharias

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The absenteeism at work constitutes in a temporary absence of labor functions resulting from various reasons, bringing damage to production, increasing costs of care and overburdening other workers, has its principal cause due to illness, often due exposure to several risks in the workplace. This study aims to know, identify and analyze the types and causes of absenteeism, such as the frequency at which it occurs by professional category, for employment contract and days not worked in Emergency Care Public in a city in the interior of São Paulo. We conducted exploratory and descriptive study with a quantitative approach, with nursing professionals, after selection of inclusion criteria was reached a universe of 208 subjects, the data collected are for the years from 2010-2013. Research has shown that the professional category of nursing assistant had 88,11% of total absenteeism, absenteeism lasting 1 day was the with the highest frequency, the women were responsible for 74,80% of absenteeism disease. It was concluded that absenteeism shall be monitored to plan control actions, establishing better political for the management of human resources, because it can be an aggravating factor in the quality of care.

Keywords: absenteeism; nursing; emergency medical services, human resource

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Authors: Peng Li, Er-xiang Song

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Numerical analysis of longitudinal tunnel seismic response due to spatial variation of earthquake ground motion is an important issue that cannot be ignored in the design and safety evaluation of tunnel structures. In this paper, numerical methods for analysis of tunnel longitudinal response under asynchronous seismic wave is extensively studied, including the improvement of the 1D time-domain finite element method, three dimensional numerical simulation technique for the site asynchronous earthquake response as well as the 3-D soil-tunnel structure interaction analysis. The study outcome will be beneficial to aid further research on the nonlinear meticulous numerical analysis and seismic response mechanism of tunnel structures under asynchronous earthquake motion.

Keywords: asynchronous input, longitudinal seismic response, tunnel structure, numerical simulation, traveling wave effect

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Authors: Dana M. Ragab, Jasim A. Ghaeb

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The three-phase power system suffers from different challenging problems, e.g. voltage unbalance conditions at the load side. The voltage unbalance usually degrades the power quality of the electric power system. Several techniques can be considered for load balancing including load reconfiguration, static synchronous compensator and static reactive power compensator. In this work an efficient neural network is designed to control the unbalanced condition in the Aqaba-Qatrana-South Amman (AQSA) electric power system. It is designed for highly enhanced response time of the reactive compensator for voltage balancing. The neural network is developed to determine the appropriate set of firing angles required for the thyristor-controlled reactor to balance the three load voltages accurately and quickly. The parameters of AQSA power system are considered in the laboratory model, and several test cases have been conducted to test and validate the proposed technique capabilities. The results have shown a high performance of the proposed Neural Network Control (NNC) technique for correcting the voltage unbalance conditions at three-phase load based on accuracy and response time.

Keywords: three-phase power system, reactive power control, voltage unbalance factor, neural network, power quality

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Authors: E. Menga, S. Hernandez

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Finite Element Models (FEMs) are widely used in order to study and predict the dynamic properties of structures and usually, the prediction can be obtained with much more accuracy in the case of a single component than in the case of assemblies. Especially for structural dynamics studies, in the low and middle frequency range, most complex FEMs can be seen as assemblies made by linear components joined together at interfaces. From a modelling and computational point of view, these types of joints can be seen as localized sources of stiffness and damping and can be modelled as lumped spring/damper elements, most of time, characterized by nonlinear constitutive laws. On the other side, most of FE programs are able to run nonlinear analysis in time-domain. They treat the whole structure as nonlinear, even if there is one nonlinear degree of freedom (DOF) out of thousands of linear ones, making the analysis unnecessarily expensive from a computational point of view. In this work, a methodology in order to obtain the nonlinear frequency response of structures, whose nonlinearities can be considered as localized sources, is presented. The work extends the well-known Structural Dynamic Modification Method (SDMM) to a nonlinear set of modifications, and allows getting the Nonlinear Frequency Response Functions (NLFRFs), through an ‘updating’ process of the Linear Frequency Response Functions (LFRFs). A brief summary of the analytical concepts is given, starting from the linear formulation and understanding what the implications of the nonlinear one, are. The response of the system is formulated in both: time and frequency domain. First the Modal Database is extracted and the linear response is calculated. Secondly the nonlinear response is obtained thru the NL SDMM, by updating the underlying linear behavior of the system. The methodology, implemented in MATLAB, has been successfully applied to estimate the nonlinear frequency response of two systems. The first one is a two DOFs spring-mass-damper system, and the second example takes into account a full aircraft FE Model. In spite of the different levels of complexity, both examples show the reliability and effectiveness of the method. The results highlight a feasible and robust procedure, which allows a quick estimation of the effect of localized nonlinearities on the dynamic behavior. The method is particularly powerful when most of the FE Model can be considered as acting linearly and the nonlinear behavior is restricted to few degrees of freedom. The procedure is very attractive from a computational point of view because the FEM needs to be run just once, which allows faster nonlinear sensitivity analysis and easier implementation of optimization procedures for the calibration of nonlinear models.

Keywords: frequency response, nonlinear dynamics, structural dynamic modification, softening effect, rubber

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Authors: Elena Carcano, James Ball

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This work details the strategies adopted by the Italian Water Utilities during the distribution of water in emergency conditions which glide from earthquakes and droughts to floods and fires. Several water bureaus located over the national territory have been interviewed, and the collected information has been used in a database of potential interventions to be taken. The work discusses the actions adopted by water utilities. These are generally prioritized in order to minimize the social, temporal, and economic burden that the damaged and nearby areas need to support. Actions are defined relying on the Bayesian Network Approach, which constitutes the hard core of any decision support system. The Bayesian Networks give answers to interventions to real and most likely risky cases. The added value of this research consists in supplying the National Bureau, namely Protezione Civile, in charge of managing havoc and catastrophic situations with a univocal plot outline so as to be able to handle actions uniformly at the expense of different local laws or contradictory customs which squander any recovery conditions, proper technical service, and economic aids. The paper is organized as follows: in section 1, the introduction is stated; section 2 provides a brief discussion of BNNs (Bayesian Networks), section 3 introduces the adopted methodology; and in the last sections, results are presented, and conclusions are drawn.

Keywords: hierarchical process, strategic plan, water emergency conditions, water supply

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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Authors: Volkan Isbuga, Joman M. Mahmood, Ali Firat Cabalar

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This study presents the site response analysis of mica-sand mixtures available in certain parts of the world including Izmir, a highly populated city and located in a seismically active region in western part of Turkey. We performed site response analyses by employing SHAKE, an equivalent linear approach, for the micaceous soil deposits consisting of layers with different amount of mica contents and thicknesses. Dynamic behavior of micaceous sands such as shear modulus reduction and damping ratio curves are input for the ground response analyses. Micaceous sands exhibit a unique dynamic response under a scenario earthquake with a magnitude of Mw=6. Results showed that higher amount of mica caused higher spectral accelerations.

Keywords: micaceous sands, site response, equivalent linear approach, SHAKE

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Authors: Raymond Li

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In this project a web-based classroom response system (CRS) was used in the teaching an intermediate level economics course. This system allows the instructor to post a question on the screen and students to answer questions using their own electronic mobile devices. The questions and the results summarizing student responses can be shown to students simultaneously and the instructor can make timely feedback to students in class. CRS gives students a chance to respond to the instructor’s question privately, encouraging students who might not typically speak up in class to express their thoughts and opinions. There is a vast literature on the advantages and challenges of using CRS. However, empirical evidence on the student attributes that increase the effectiveness of CRS in improving student learning outcomes is sparse. The purpose of this project is to (1) find out if the use of CRS is beneficial to students taking economics, and (2) discover key student attributes that will likely make CRS more effective. Students’ performance in examinations and an end-of-semester questionnaire were used to assess the effectiveness of CRS in this project. Comparing the examination scores of the CRS treatment group and control group, the treatment group performed considerably better and statistically significant differences were found basing on paired t-tests on the differences. According to the questionnaire results, around 75% of the students in the treatment group generally agreed that CRS allowed them to express their views more freely. We also observed that students who prefer to use instant messaging rather than making conversations are generally more positive towards CRS. The use of CRS also benefits the instructor – students’ rating of the instructor in the teaching evaluation was significantly higher for the CRS treatment group.

Keywords: education technology, classroom response system, student attributes, economics education

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Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: K. Karuppasamy

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In this paper analysis of an infinite beam resting on multilayer tensionless extensible geosynthetic reinforced granular fill - poor soil system overlying soft soil strata under moving the load with constant velocity is presented. The beam is subjected to a concentrated load moving with constant velocity. The upper reinforced granular bed is modeled by a rough membrane embedded in Pasternak shear layer overlying a series of compressible nonlinear Winkler springs representing the underlying the very poor soil. The multilayer tensionless extensible geosynthetic layer has been assumed to deform such that at the interface the geosynthetic and the soil have some deformation. Nonlinear behavior of granular fill and the very poor soil has been considered in the analysis by means of hyperbolic constitutive relationships. Governing differential equations of the soil foundation system have been obtained and solved with the help of appropriate boundary conditions. The solution has been obtained by employing finite difference method by means of Gauss-Siedel iterative scheme. Detailed parametric study has been conducted to study the influence of various parameters on the response of soil – foundation system under consideration by means of deflection and bending moment in the beam and tension mobilized in the geosynthetic layer. These parameters include the magnitude of applied load, the velocity of the load, damping, the ultimate resistance of the poor soil and granular fill layer. The range of values of parameters has been considered as per Indian Railways conditions. This study clearly observed that the comparisons of multilayer tensionless extensible geosynthetic reinforcement with poor foundation soil and magnitude of applied load, relative compressibility of granular fill and ultimate resistance of poor soil has significant influence on the response of soil – foundation system. However, for the considered range of velocity, the response has been found to be insensitive towards velocity. The ultimate resistance of granular fill layer has also been found to have no significant influence on the response of the system.

Keywords: infinite beams, multilayer tensionless extensible geosynthetic, granular layer, moving load and nonlinear behavior of poor soil

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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Authors: Jiri Barta

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This paper deals with the prevention and management of emergencies. It focuses on the protection of assets of the critical infrastructure entities that are important to preventing, preparing for and management of emergencies and crisis situations. The paper defines assets and specifies their use and place in the process of crisis management and planning. Critical assets that are protected from the negative effects of emergency or crisis situation we can use in crisis management and response. This basic rule applies mainly to the substantial assets used in the protection of critical infrastructure processes.

Keywords: asset, continuity, critical infrastructure, crisis management process

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Authors: Van Thien NGO

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The purpose of the study is to examine the effect of student response systems in computer-based formative assessment on learning outcomes. The backward design course is a tool to be applied for collecting necessary assessment evidence. The quasi-experimental research design involves collecting pre and posttest data on students assigned to the control group and the experimental group. The sample group consists of 150 college students randomly selected from two of the eight classes of electrical and electronics students at Cao Thang Technical College in Ho Chi Minh City, Vietnam. Findings from this research revealed that the experimental group, in which student response systems were applied, got better results than the controlled group, who did not apply them. Results show that using student response systems for technology-based formative assessment is vital and meaningful not only for teachers but also for students in the teaching and learning process.

Keywords: student response system, computer-based formative assessment, learning outcome, backward design course

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Authors: İrem Yetkin, Feray Maden, Seda Tosun, Yenal Akgün, Özgür Kilit, Koray Korkmaz, Gökhan Kiper, Mustafa Gündüzalp

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Forced migration, whether caused by conflicts or other factors, frequently places individuals in vulnerable situations, necessitating immediate access to shelter. To promptly address the immediate needs of affected individuals, temporary shelters are often established. These shelters are characterized by their adaptable and functional nature, encompassing lightweight and sustainable structural systems, rapid assembly capabilities, modularity, and transportability. The shelter design is contingent upon demand, resulting in distinct phases for different structural forms. A multi-phased shelter approach covers emergency response, temporary shelter, and permanent reconstruction. Emergency shelters play a critical role in providing immediate life-saving aid, while temporary and transitional shelters, which are also called “t-shelters,” offer longer-term living environments during the recovery and rebuilding phases. Among these, temporary shelters are more extensively covered in the literature due to their diverse inhabiting functions. The roles of emergency shelters and temporary shelters are inherently separate, addressing distinct aspects of sheltering processes. Given their prolonged usage, temporary shelters are built for greater durability compared to emergency shelters. Nonetheless, inadequacies in temporary shelters can lead to challenges in ensuring habitability. Issues like non-expandable structures unsuitable for accommodating large families, the use of short-term shelters that worsen conditions, non-waterproof materials providing insufficient protection against bad weather conditions, and complex installation systems contribute to these problems. Given the aforementioned problems, there arises a need to develop adaptive shelters featuring lightweight components for ease of transport, possess the ability for rapid assembly, and utilize durable materials to withstand adverse weather conditions. In this study, first, the state-of-the-art on temporary shelters is presented. Then, an adaptive temporary shelter composed of foldable plates is proposed, which can easily be assembled and transportable. The proposed shelter is deliberated upon its movement capacity, transportability, and flexibility. This study makes a valuable contribution to the literature since it not only offers a systematic analysis of temporary shelters utilizing kinetic systems but also presents a practical solution that meets the necessary design requirements.

Keywords: deployable structures, foldable plates, forced migration, temporary shelters

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Authors: Waddah Abdelbagi Talha, Mohammed Abdullah Elmaleeh, John Ojur Dennis

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This paper focuses on the simulation and implementation of a resonator micro-sensor for low magnetic field sensing based on a U-shaped cantilever and piezoresistive configuration, which works based on Lorentz force physical phenomena. The resonance frequency is an important parameter that depends upon the highest response and sensitivity through the frequency domain (frequency response) of any vibrated micro-scale of an electromechanical system (MEMS) device. And it is important to determine the direction of the detected magnetic field. The deflection of the cantilever is considered for vibrated mode with different frequencies in the range of (0 Hz to 7000 Hz); for the purpose of observing the frequency response. A simple electronic circuit-based polysilicon piezoresistors in Wheatstone's bridge configuration are used to transduce the response of the cantilever to electrical measurements at various voltages. Microcontroller-based Arduino program and PROTEUS electronic software are used to analyze the output signals from the sensor. The highest output voltage amplitude of about 4.7 mV is spotted at about 3 kHz of the frequency domain, indicating the highest sensitivity, which can be called resonant sensitivity. Based on the resonant frequency value, the mode of vibration is determined (up-down vibration), and based on that, the vector of the magnetic field is also determined.

Keywords: resonant frequency, sensitivity, Wheatstone bridge, UNO-microcontroller

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

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Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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Authors: John Hardy

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The domestic security environment in Europe has changed dramatically in recent years. Since January 2015, a significant number of domestic security threats that emerged in Europe were located in Belgium, France and the United Kingdom. While some threats were detected in the planning phase, many also resulted in terrorist attacks. Authorities in all three countries instituted special or emergency measures to provide additional security to their populations. Each country combined an additional policing presence with a specific military operation to contribute to a comprehensive security response to domestic threats. This study presents a cross-case analysis of three countries’ civilian and military responses to domestic security threats in Europe. Each case study features a unique approach to combining civilian and military capabilities in similar domestic security operations during the same time period and threat environment. The research design focuses on five variables relevant to the relationship between civilian and military roles in each security response. These are the distinction between policing and military roles, the legal framework for the domestic deployment of military forces, prior experience in civil-military coordination, the institutional framework for threat assessments, and the level of public support for the domestic use of military forces. These variables examine the influence of domestic social, political, and legal factors on the design of combined civil-military operations in response to domestic security threats. Each case study focuses on a specific operation: Operation Vigilant Guard in Belgium, Operation Sentinel in France, and Operation Temperer in the United Kingdom. The results demonstrate that the level of distinction between policing and military roles and the existence of a clear and robust legal framework for the domestic use force by military personnel significantly influence the design and implementation of civilian and military roles in domestic security operations. The findings of this study indicate that Belgium, France and the United Kingdom experienced different design and implementation challenges for their domestic security operations. Belgium and France initially had less-developed legal frameworks for deploying the military in domestic security operations than the United Kingdom. This was offset by public support for enacting emergency measures and the strength of existing civil-military coordination mechanisms. The United Kingdom had a well-developed legal framework for integrating civilian and military capabilities in domestic security operations. However, its experiences in Ireland also made the government more sensitive to public perceptions regarding the domestic deployment of military forces.

Keywords: counter-terrorism, democracy, homeland security, intelligence, militarization, policing

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Authors: Traci A. Hefner

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Limited research exists on the readiness of emergency departments to respond to human trafficking (HT). The purpose of this qualitative case study was to improve the readiness of a Department of Emergency Medicine (ED), located in the southeast region of the United States, in identifying, assessing, and responding to trafficked individuals. The research objectives were to 1) provide an organizing framework to understand the ED’s readiness to respond to HT, using the Transtheoretical Model’s stages of change construct, 2) explain the readiness of the ED through a three-pronged contextual approach that included policies and procedures, patient data collection processes, and clinical practice methods, and 3) develop recommendations to respond to HT. Content analysis was used for document reviews and on-site observations, while thematic analysis identified themes of staff perceptions of the ED’s readiness in interviews of over 30 clinical and non-clinical healthcare professionals. Results demonstrated low levels of readiness to identify HT through the ED’s policies and procedures, data collection processes, and clinical practice methods. Clinical practice-related factors consisted of limited awareness of HT warning signs and low-levels of knowledge about community resources for possible HT referrals. Policy and practice recommendations to increase the ED’s readiness to respond to HT included: developing staff trainings across the ED system to enhance awareness of HT warning signs, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses policies and procedures, screening tools, and community referrals.

Keywords: emergency medicine, human trafficking, organizational assessment, stages of change

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Authors: Mary Holstein

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Objective: The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness in the state of Texas. My project was a replication study of a survey conducted in 2022 by Reedy et al, for members of the Northwest Organization for Nurse Leaders (NONL). Background: In 2022, the American Association of Colleges of Nursing (AACN) approved new essentials for academic nursing education programs to demonstrate competencies in disaster management, yet no integration of such information into nursing curriculum had been reported in the literature. Research replicated by members of the Texas Organization for Nursing Leadership suggested significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to lead in a crisis. Methods: An exploratory, cross-sectional survey used a sample of 86 RNs who were members of TONL. Results: Results replicated comparable results with significant variance in nurse leader confidence across roles, experience, and previous disaster-related education. Positive associations regarding nurse leaders' confidence in managing disasters were obvious with more advanced positions, further education, and mandatory training. Conclusions: Nursing leaders in Texas lack mandatory and structured education to prepare for emergency and disaster management. The call for mandatory emergency management training and disaster preparedness for nurse leaders remains unmet.

Keywords: confidence, disaster, education, emergency

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Authors: Graham Hancox, Saydia Razak, Sue Hignett, Jo Barnes, Jyri Silmari, Florian Kading

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In the event of a Chemical, Biological, Radiological and Nuclear (CBRN) incident rapidly gaining, situational awareness is of paramount importance and advanced technologies have an important role to play in improving detection, identification, monitoring (DIM) and patient tracking. Understanding how these advanced technologies can fit into current response systems is essential to ensure they are optimally designed, usable and meet end-users’ needs. For this reason, Human Factors (Ergonomics) methods have been used within an EU Horizon 2020 project (TOXI-Triage) to firstly describe (map) the hierarchical structure in a CBRN response with adapted Accident Map (AcciMap) methodology. Secondly, Hierarchical Task Analysis (HTA) has been used to describe and review the sequence of steps (sub-tasks) in a CBRN scenario response as a task system. HTA methodology was then used to map one advanced technology, ‘Tag and Trace’, which tags an element (people, sample and equipment) with a Near Field Communication (NFC) chip in the Hot Zone to allow tracing of (monitoring), for example casualty progress through the response. This HTA mapping of the Tag and Trace system showed how the provider envisaged the technology being used, allowing for review and fit with the current CBRN response systems. These methodologies have been found to be very effective in promoting and supporting a dialogue between end-users and technology providers. The Human Factors methods have given clear diagrammatic (visual) representations of how providers see their technology being used and how end users would actually use it in the field; allowing for a more user centered approach to the design process. For CBRN events usability is critical as sub-optimum design of technology could add to a responders’ workload in what is already a chaotic, ambiguous and safety critical environment.

Keywords: AcciMap, CBRN, ergonomics, hierarchical task analysis, human factors

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Authors: Ambuj Kumar, Sunil Kumar Singh, Shrikant Singh, Zakir Husain, R. K. Jarial

Abstract:

Sweep frequency response analysis has been turning out a powerful tool for investigation of mechanical as well as electrical integration of transformers. In this paper various aspect of practical application of SFRA has been studied. Open circuit and short circuit measurement were done on different phases of high voltage and low voltage winding. A case study was presented for the transformer of rating 31.5 MVA for various frequency ranges. A clear picture was presented for sub- frequency ranges for HV as well as LV winding. The main motive of work is to investigate high voltage short circuit response. The theoretical concept about SFRA responses is validated with expert system software results.

Keywords: transformer winding, SFRA, OCT & SCT, frequency deviation

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Authors: Asadullah I. Qazi, Mansoor Ahsan, Zahir Ashraf, Uzair Ahmad

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System identification of an Unmanned Aerial Vehicle (UAV), to acquire its mathematical model, is a significant step in the process of aircraft flight automation. The need for reliable mathematical model is an established requirement for autopilot design, flight simulator development, aircraft performance appraisal, analysis of aircraft modifications, preflight testing of prototype aircraft and investigation of fatigue life and stress distribution etc.  This research is aimed at system identification of a fixed wing UAV by means of specifically designed flight experiment. The purposely designed flight maneuvers were performed on the UAV and aircraft states were recorded during these flights. Acquired data were preprocessed for noise filtering and bias removal followed by parameter estimation of longitudinal dynamics transfer functions using MATLAB system identification toolbox. Black box identification based transfer function models, in response to elevator and throttle inputs, were estimated using least square error   technique. The identification results show a high confidence level and goodness of fit between the estimated model and actual aircraft response.

Keywords: fixed wing UAV, system identification, black box modeling, longitudinal dynamics, least square error

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Authors: M. Khalid, G. N. Singh

Abstract:

In this paper, we have considered the problem of estimation for population mean, on current (second) occasion in the presence of random non response in two-occasion successive sampling under two phase set-up. Modified exponential type estimators have been proposed, and their properties are studied under the assumptions that numbers of sampling units follow a distribution due to random non response situations. The performances of the proposed estimators are compared with linear combinations of two estimators, (a) sample mean estimator for fresh sample and (b) ratio estimator for matched sample under the complete response situations. Results are demonstrated through empirical studies which present the effectiveness of the proposed estimators. Suitable recommendations have been made to the survey practitioners.

Keywords: successive sampling, random non-response, auxiliary variable, bias, mean square error

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Authors: Hyon I. Paek, Sang Rim Kim, Hyon A. Ryu

Abstract:

In functional linear regression, one typical problem is to reduce dimension. Compared with multivariate linear regression, functional linear regression is regarded as an infinite-dimensional case, and the main task is to reduce dimensions of functional response and functional predictors. One common approach is to adapt functional principal component analysis (FPCA) on functional predictors and then use a few leading functional principal components (FPC) to predict the functional model. The leading FPCs estimated by the typical FPCA explain a major variation of the functional predictor, but these leading FPCs may not be mostly correlated with the functional response, so they may not be significant in the prediction for response. In this paper, we propose a supervised functional principal component analysis method for a functional response model with FPCs obtained by considering the correlation of the functional response. Our method would have a better prediction accuracy than the typical FPCA method.

Keywords: supervised, functional principal component analysis, functional response, functional linear regression

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Authors: Ahmed Guerine, Ali El Hafidi, Bruno Martin, Philippe Leclaire

Abstract:

This paper investigates the nonlinear dynamic response of a mechanical torque limiter which is used to protect drive parts from overload (helical transmission gears). The system is driven by four excitations: two external excitations (aerodynamics torque and force) and two internal excitations (two mesh stiffness fluctuations). In this work, we develop a dynamic model with lumped components and 28 degrees of freedom. We use the Runge Kutta step-by-step time integration numerical algorithm to solve the equations of motion obtained by Lagrange formalism. The numerical results have allowed us to identify the sources of vibration in the wind turbine. Also, they are useful to help the designer to make the right design and correctly choose the times for maintenance.

Keywords: two-stage helical gear, lumped model, dynamic response, torque-limiter

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Authors: Jožef Ritonja

Abstract:

The biochemical industry is one of the most important modern industries. Biochemical reactors are crucial devices of the biochemical industry. The essential bioprocess carried out in bioreactors is the fermentation process. A thorough insight into the fermentation process and the knowledge how to control it are essential for effective use of bioreactors to produce high quality and quantitatively enough products. The development of the control system starts with the determination of a mathematical model that describes the steady state and dynamic properties of the controlled plant satisfactorily, and is suitable for the development of the control system. The paper analyses the fermentation process in bioreactors thoroughly, using existing mathematical models. Most existing mathematical models do not allow the design of a control system for controlling the fermentation process in batch bioreactors. Due to this, a mathematical model was developed and presented that allows the development of a control system for batch bioreactors. Based on the developed mathematical model, a control system was designed to ensure optimal response of the biochemical quantities in the fermentation process. Due to the time-varying and non-linear nature of the controlled plant, the conventional control system with a proportional-integral-differential controller with constant parameters does not provide the desired transient response. The improved adaptive control system was proposed to improve the dynamics of the fermentation. The use of the adaptive control is suggested because the parameters’ variations of the fermentation process are very slow. The developed control system was tested to produce dairy products in the laboratory bioreactor. A carbon dioxide concentration was chosen as the controlled variable. The carbon dioxide concentration correlates well with the other, for the quality of the fermentation process in significant quantities. The level of the carbon dioxide concentration gives important information about the fermentation process. The obtained results showed that the designed control system provides minimum error between reference and actual values of carbon dioxide concentration during a transient response and in a steady state. The recommended control system makes reference signal tracking much more efficient than the currently used conventional control systems which are based on linear control theory. The proposed control system represents a very effective solution for the improvement of the milk fermentation process.

Keywords: biochemical reactor, fermentation process, modelling, adaptive control

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Authors: Behcet Al, Mustafa Bogan, Mehmet Murat Oktay, Suat Zengin, Hasan Bayram

Abstract:

Objective: In the last two decades there is a strong scientific interest regarding the role of aerosols for the Earth’s climate and associated changes. Aerosol particles are very important to the Earth-atmosphere climate system playing a crucial role in cloud and precipitation processes, air quality and climate. Here, we evaluated the association between saharran dust and emergency department admission, hospitalization, and mortality. Method: The records of admission to emergency department of Gaziantep University and the dust stroms of 31 months were studied. Patients admitted to ED at dust strom with chronic obstructive lung disease (COLD), asthma bronchiale (AB), serebrovascular events (SVE), acute myocardial infarction (AMI), stabile and unstabile angina pectoris (SAAP andUSAP); and the days with and without dust stroms were included. The study was realized from March 2010 to October 2012. The admission of three days before strom (group 1), during strom days (group 2) and three days after strom (group 3) were determined. The mean level of dust PM10 particulate was calculated, and the results were compared. Results: 5864 patients with chronic obstructive lung disease, asthma bronchiale, serebrovascular events, acute myocardial infarction, stabile and unstabile angyina pectoris admitted during the days with and without dust stroms. 28 dust stroms ocurred during 31 months. The totaliy of stroms continiued 78 days. Of admissions, 35.5% (n=2075) were in group1, 29.8% (n=1746) in group 2, and 34.8% (n=2043) were in group 3. The mean of PM10 for groups (group 1, 2 and 3) were 78.53 mg/m3 (range 19–276) particulate, 108.7 mg/m3 (range 34–631) particulate, and 60.9 mg/m3 (range 17–160) particulate respectively. The mean admission per a day for groups were 24.86, 22.55, and 24.50 respectively. The mortality was 12 in group 1, 12 in group 2, and 17 in grou 3. The hospitalization ratio for groups were 0.24, 0.27, and 0.27 respectively. Conclusion: However, the mean level of PM10 particulate for groups 2 (in dust strom days) is significantly higher (p=0.001) than the days before (group 1) and after (group 3) dust stroms, the mean admissions/day, hostilalization and mortality related to deseases (COLD, AB, SVE, AMI, SAAP andUSA) for group 2 is lower than the group 1 and group 3.

Keywords: Saharran dust, PM10 particulate, emergency department admission, mortality

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Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

Procedia PDF Downloads 132