Search results for: emergency response

Authors: Gianni Blasi, Daniele Perrone, Maria Antonietta Aiello

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The seismic vulnerability of non-structural components is nowadays recognized to be a key issue in performance-based earthquake engineering. Recent loss estimation studies, as well as the damage observed during past earthquakes, evidenced how non-structural damage represents the highest rate of economic loss in a building and can be in many cases crucial in a life-safety view during the post-earthquake emergency. The procedures developed to evaluate the seismic demand on non-structural components have been constantly improved and recent studies demonstrated how the existing formulations provided by main Standards generally ignore features which have a sensible influence on the definition of the seismic acceleration/displacements subjecting non-structural components. Since the influence of the infills on the dynamic behaviour of RC structures has already been evidenced by many authors, it is worth to be noted that the evaluation of the seismic demand on non-structural components should consider the presence of the infills as well as their mechanical properties. This study focuses on the evaluation of time-history floor acceleration in RC buildings; which is a useful mean to perform seismic vulnerability analyses of non-structural components through the well-known cascade method. Dynamic analyses are performed on an 8-storey RC frame, taking into account the presence of the infills; the influence of the elastic modulus of the panel on the results is investigated as well as the presence of openings. Floor accelerations obtained from the analyses are used to evaluate the floor response spectra, in order to define the demand on non-structural components depending on the properties of the infills. Finally, the results are compared with formulations provided by main International Standards, in order to assess the accuracy and eventually define the improvements required according to the results of the present research work.

Keywords: floor spectra, infilled RC frames, non-structural components, seismic demand

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Authors: Siti Juryiah Mohd Khalid, Norazlina Dol

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Academic libraries in Malaysia are still not prepared for disaster even though several occasions have been reported. The study sets out to assess the current status of preparedness in disaster management among Malaysian academic libraries in the State of Selangor and the Federal Territory of Kuala Lumpur. To obtain a base level of knowledge on disaster preparedness of current practices, a questionnaire was distributed to chief librarians or their assignees in charge of disaster or emergency preparedness at 40 academic libraries and 34 responses were received. The study revolved around the current status of preparedness, on various issues including existence of disaster preparedness plan among academic libraries in Malaysia, disaster experiences by the academic libraries, funding, risk assessment activities and involvement of library staff in disaster management. Frequency and percentage tables were used in the analysis of the data collected. Some of the academic libraries under study have experienced one form of disaster or the other. Most of the academic libraries do not have a written disaster preparedness plan. The risk assessments and staff involvement in disaster preparedness by these libraries were generally adequate.

Keywords: academic libraries, disaster preparedness plan, disaster management, emergency plan

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Authors: M. Naderi, N. Iyyer, K. Goel, N. Phan

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A micromechanical analysis of the influence of fiber-matrix interface fracture properties on the transverse tensile response of fiber-reinforced composite is investigated. Augmented finite element method (AFEM) is used to provide high-fidelity damage initiation and propagation along the micromechanical analysis. Effects of fiber volume fraction and fiber shapes are also studies in representative volume elements (RVE) to capture the stochastic behavior of the composite under loading. In addition, defects and voids influence on the composite response are investigated in micromechanical analysis. The results reveal that the response of RVE with constant interface properties overestimates the composite transverse strength. It is also seen that the damage initiation and propagation locations are controlled by the distributions of fracture properties, fibers’ shapes, and defects.

Keywords: cohesive model, fracture, computational mechanics, micromechanics

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Authors: Timur Zhukov, Yuko Yamashita

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Music as a product of hedonic consumption has been researched at least since the early 20th century, but little light has been shed on how language affects its consumption process. At the intersection of music consumption, language impact, and consumer behavior, this research explores the influence of language on music consumption in Japan. Its aim is to clarify how listening to music in different languages affects the listener’s purchase intention and sharing intention by conducting a survey where respondents listen to three versions of the same song in different languages in random order. It uses an existing framework that views the flow of music consumption as a combination of responses (emotional response, sensory response, imaginal response, analytical responses) affecting the experiential response, which then affects the overall affective response, followed by the need to reexperience and lastly the purchase intention. In this research, the sharing intention has been added to the model to better fit the modern consumption model (e.g., AISAS). This research shows how positive and negative emotions and imaginal and analytical responses change depending on the language and what impact it has on consumer behavior. It concludes by proposing how modern music businesses can learn from the language differences and cater to the needs of the audiences who speak different languages.

Keywords: AISAS, consumer behavior, first language, music consumption, second language

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Authors: Nahid H. Hajrah, Jamal S. M. Sabir, Neil Hall

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The jasmonic pathway is ubiquitous in plants and is crucial to plant development. It Is involved in fertility, ripening, and sex determination as well as in response to environmental stresses such as herbivory, pathogen drought or temperature shock. Essentially the jasmonic pathway acts to shut down growth in order to induce defence pathways. These pathways include the production of secondary metabolites which have evolved to defend against herbivores and pathogens but are of increasing interest due to their roll in medicine and biotechnology. Here we describe the transcriptional response of Rhazia stricta (a poisonous shrub widely used in traditional medicine) to jasmonic acid, in order to better characterize the genes involved in secondary metabolite production and its response to stress. We observe coordinated upregulation of flavonoid biosynthesis pathway leading to flavonols, flavones and anthocyanins but no similar coordination of the monoterpene indole alkaloid pathway.

Keywords: medicinal plants, Rhazia stricta, jasmonic acid, transcriptional analysis

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Authors: F. D. Konstandakopoulou, G. A. Papagiannopoulos, N. G. Pnevmatikos, G. D. Hatzigeorgiou

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This paper examines the effects of pile-soil-structure interaction on the dynamic response of offshore platforms under the action of near-fault earthquakes. Two offshore platforms models are investigated, one with completely fixed supports and one with piles which are clamped into deformable layered soil. The soil deformability for the second model is simulated using non-linear springs. These platform models are subjected to near-fault seismic ground motions. The role of fault mechanism on platforms’ response is additionally investigated, while the study also examines the effects of different angles of incidence of seismic records on the maximum response of each platform.

Keywords: hazard analysis, offshore platforms, earthquakes, safety

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Authors: Krishna Mohan Bathula, Fatou Bintou Loucoubar, FNU Kaleemunnisa, Christelle Scharff, Mark Anthony De Castro

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Voice recognition algorithms such as automatic speech recognition and text-to-speech systems with African languages can play an important role in bridging the digital divide of Artificial Intelligence in Africa, contributing to the establishment of a fully inclusive information society. This paper proposes a Deep Learning model that can classify the user responses as inputs for an interactive voice response system. A dataset with Wolof language words ‘yes’ and ‘no’ is collected as audio recordings. A two stage Data Augmentation approach is adopted for enhancing the dataset size required by the deep neural network. Data preprocessing and feature engineering with Mel-Frequency Cepstral Coefficients are implemented. Convolutional Neural Networks (CNNs) have proven to be very powerful in image classification and are promising for audio processing when sounds are transformed into spectra. For performing voice response classification, the recordings are transformed into sound frequency feature spectra and then applied image classification methodology using a deep CNN model. The inference model of this trained and reusable Wolof voice response recognition system can be integrated with many applications associated with both web and mobile platforms.

Keywords: automatic speech recognition, interactive voice response, voice response recognition, wolof word classification

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Authors: Razi Khalafi

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Brain is the information processing center of the human body. Stimuli in form of information are transferred to the brain and then brain makes the decision on how to respond to them. In this research we propose a new partial differential equation which analyses the EEG signals and make a relationship between the incoming stimuli and the brain response to them. In order to test the proposed model, a set of external stimuli applied to the model and the model’s outputs were checked versus the real EEG data. The results show that this model can model the EEG signal well. The proposed model is useful not only for modeling of the EEG signal in case external stimuli but it can be used for the modeling of brain response in case of internal stimuli.

Keywords: Brain, stimuli, partial differential equation, response, eeg signal

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Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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Authors: Wissam Aljundi, Loay Daas, Yaser Abu Dail, Barbara Käsmann-Kellner, Berthold Seitz, Alaa Din Abdin

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Purpose: To investigate the effectiveness of nonsteroidal anti-inflammatory eye drops (NSAIDs) combined with oral acetazolamide for postoperative macular edema (PME) after uncomplicated phacoemulsification (PE) and to identify predictors of non-response. Methods: We analyzed data of uncomplicated PE and identified eyes with PME. First-line therapy included topical NSAIDs combined with oral acetazolamide. In case of non-response, triamcinolone was administered subtenonally. Outcome measures included best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: 94 eyes out of 9750 uncomplicated PE developed PME, of which 60 eyes were included. Follow-ups occurred 6.4±1.8, 12.5±3.7, and 18.6±6.0 weeks after diagnosis. BCVA and CMT improved significantly in all follow-ups. 40 eyes showed response to first-line therapy at first follow-up (G1). The remaining 20 eyes showed no response and required subtenon triamcinolone (G2), of which 11 eyes showed complete regression at the second follow-up and 4 eyes at the third follow-up. 5 eyes showed no response and required intravitreal injection. Multivariate linear regression model showed that diabetes mellitus (DM) and increased cumulative dissipated energy (CDE) are predictors of non-response. Conclusion: Topical NSAIDs with acetazolamide resulted in complete regression of PME in 67% of all cases. DM and increased CDE might be considered as predictors of nonresponse to this treatment.

Keywords: postoperative macular edema, intravitreal injection, cumulative energy, irvine gass syndrome, pseudophakie

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Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

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Authors: Song Ni, Junxiang Xu

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This paper concerns quasi-periodic perturbations with parameters of 2-dimensional degenerate systems. If the equilibrium point of the unperturbed system is elliptic-type degenerate. Assume that the perturbation is real analytic quasi-periodic with diophantine frequency. Without imposing any assumption on the perturbation, we can use a path of equilibrium points to tackle with the Melnikov non-resonance condition, then by the Leray-Schauder Continuation Theorem and the Kolmogorov-Arnold-Moser technique, it is proved that the equation has a small response solution for many sufficiently small parameters.

Keywords: quasi-periodic systems, KAM-iteration, degenerate equilibrium point, response solution

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Sukant Mehra, Parth Gupta, Varun Arora, Sarvoday Singh, Amit Kohli

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The study was emphasised on dry sliding wear behavior of AISI 1042 steel. Dry sliding wear tests were performed using pin-on-disk apparatus under normal loads of 5, 7.5 and 10 kgf and at speeds 600, 750 and 900 rpm. Response surface methodology (RSM) was utilized for finding optimal values of process parameter and experiment was based on rotatable, central composite design (CCD). It was found that the wear followed linear pattern with the load and rpm. The obtained optimal process parameters have been predicted and verified by confirmation experiments.

Keywords: central composite design (CCD), optimization, response surface methodology (RSM), wear

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Authors: Jyoti Jaiswal, Satyendra Mourya, Gaurav Malik, Ramesh Chandra

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In the present work, we have fabricated and studied a resistive H₂ gas sensor based on Pd-Pt decorated room temperature sputter grown nanocrystalline porous titanium dioxide (p-TiO₂) thin film on porous silicon (p-Si) substrate for fast H₂ detection. The gas sensing performance of Pd-Pt/p-TiO₂/p-Si sensing electrode towards H₂ gas under low (10-500 ppm) detection limit and operating temperature regime (25-200 °C) was discussed. The sensor is highly sensitive even at room temperature, with response (Ra/Rg) reaching ~102 for 500 ppm H₂ in dry air and its capability of sensing H₂ concentrations as low as ~10 ppm was demonstrated. At elevated temperature of 200 ℃, the response reached more than ~103 for 500 ppm H₂. Overall the fabricated resistive gas sensor exhibited high selectivity, good sensing response, and fast response/recovery time with good stability towards H₂.

Keywords: sputtering, porous silicon (p-Si), TiO₂ thin film, hydrogen gas sensor

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Authors: Syed Ali Taqi, Muhammad Ismail

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A comparative study of estimators of population means in two phase sampling in the presence of non-response when Unknown population means of the auxiliary variable(s) and incomplete information of study variable y as well as of auxiliary variable(s) is made. Three real data sets of University students, hospital and unemployment are used for comparison of all the available techniques in two phase sampling in the presence of non-response with the newly generalized ratio estimators.

Keywords: two-phase sampling, ratio estimator, product estimator, generalized estimators

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Authors: M. Eskandarighadi, C. R. McGann

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It is observed from past experiences of earthquakes that local site conditions can significantly affect the strong ground motion characteristicssuch as frequency content, amplitude, and duration of seismic waves. The most common method for investigating site response is one-dimensional seismic site response analysis. The infinite horizontal length of the model and the homogeneous characteristic of the soil are crucial assumptions of this method. One boundary condition that can be used in the sides is tying the sides horizontally for vertical 1D wave propagation. However, 1D analysis cannot account for the 2D nature of wave propagation in the condition where the soil profile is not fully horizontal or has heterogeneity within layers. Therefore, 2D seismic site response analysis can be used to take all of these limitations into account for a better understanding of local site conditions. Different types of boundary conditions can be appliedin 2D site response models, such as tied boundary condition, massive columns, and free-field boundary condition. The tied boundary condition has been used in 1D analysis, which is useful for 1D wave propagation. Employing two massive columns at the sides is another approach for capturing the 2D nature of wave propagation. Free-field boundary condition can simulate the free-field motion that would exist far from the domain of interest. The goal for free-field boundary condition is to minimize the unwanted reflection from sides. This research focuses on the comparison between these methods with examples and discusses the details and limitations of each of these boundary conditions.

Keywords: boundary condition, free-field, massive columns, opensees, site response analysis, wave propagation

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Authors: Zayd Parekh, Amish Prasad, Baraa Souman

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Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.

Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia

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Authors: S. Nasri, H. Bouziri

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Disasters are quite experienced in our days. They are caused by floods, landslides, and building fires that is the main objective of this study. To cope with these unexpected events, precautions must be taken to protect human lives. The emphasis on disposal work focuses on the resolution of the evacuation problem in case of no-notice disaster. The problem of evacuation is listed as a dynamic network flow problem. Particularly, we model the evacuation problem as an earliest arrival flow problem with load dependent transit time. This problem is classified as NP-Hard. Our challenge here is to propose a metaheuristic solution for solving the evacuation problem. We define our objective as the maximization of evacuees during earliest periods of a time horizon T. The objective provides the evacuation of persons as soon as possible. We performed an experimental study on emergency evacuation from the tunisian children’s hospital. This work prompts us to look for evacuation plans corresponding to several situations where the network dynamically changes.

Keywords: dynamic network flow, load dependent transit time, evacuation strategy, earliest arrival flow problem, tabu search metaheuristic

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Authors: J. R. Wang, J. H. Yang, Y. Chiang, H. C. Chen, C. Shih, S. W. Chen, S. C. Chiang, T. Y. Yu

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In this study of ultimate response guideline (URG), Kuosheng BWR/6 nuclear power plant (NPP) TRACE model was established. The reactor depressurization, low pressure water injection, and containment venting are the main actions of URG. This research focuses to evaluate the efficiency of URG under Fukushima-like conditions. Additionally, the sensitivity study of URG was also performed in this research. The analysis results of TRACE present that URG can keep the peak cladding temperature (PCT) below 1088.7 K (the failure criteria) under Fukushima-like conditions. It implied that Kuosheng NPP was at the safe situation.

Keywords: BWR, TRACE, safety analysis, ultimate response guideline (URG)

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Authors: Willy Mbenza, Sho Kenjiro

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Increasing efforts are directed towards a better understanding and foreknowledge of extreme precipitation likelihood, given the adverse effects associated with their occurrence. This knowledge plays a crucial role in long-term planning and the formulation of effective emergency response. However, predicting extreme events reliably presents a challenge to conventional empirical/statistics due to the involvement of numerous variables spanning different time and space scales. In the recent time, Machine Learning has emerged as a promising tool for predicting the dynamics of extreme precipitation. ML techniques enables the consideration of both local and regional physical variables that have a strong influence on the likelihood of extreme precipitation. These variables encompasses factors such as air temperature, soil moisture, specific humidity, aerosol concentration, among others. In this study, we develop an ML model that incorporates both local and regional variables while establishing a robust relationship between physical variables and precipitation during the downscaling process. Furthermore, the model provides valuable information on the frequency and duration of a given intensity of precipitation.

Keywords: machine learning (ML), predictions, rainfall events, regional variables

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Authors: Fatemeh Torabi, Jamal El-Den, Narumon Sriratanviriyakul

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Perpetual changes in the workplace and daily business activities bring a need for imbedding organizational knowledge sharing within the organizations’ culture, routines and processes. Organizations should adapt to the changing in the environment in order to survive. Accordingly, the management should promote a knowledge sharing culture which might result in knowledge accumulation, hence better response to these changing environmental conditions. Researchers in the field of strategy and marketing stressed that employees’, as well as the overall performance of the organization, would improve as a result of implementing a knowledge-oriented culture. The research investigated the significant impact of knowledge sharing on market response and the competitiveness of organizations. A knowledge sharing framework was developed based on current literary frameworks with additional constructs such as employees’ learning commitments, experiences and prior knowledge. Linear regression was used to analyze the relationships among dependent and independent variables. The research’s results indicated strong positive correlation between the dependent and independent variables, especially in organizational market sharing. We anticipate that this correlation would improve organizational knowledge sharing related practices and the associated knowledge entities. The research posits the introduced framework could be a solid ground for further investigations on how some organizational factors would influence the organization’s response to the market as well as on competitiveness. Final results support all hypotheses. Finding of this research show that knowledge sharing intention had the significant and positive effect on market response and competitiveness of organizations.

Keywords: knowledge management, knowledge sharing, market response, organizational competitiveness

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Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

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The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

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Authors: Ridhish Kumar, Sudeep Nadukkandy, Anirban Roy

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The development of reverse osmosis happened in 1960. Along the years this technique has been widely accepted all over the world for varied applications ranging from seawater desalination to municipal water treatment. Forward osmosis (FO) is one of the foremost technologies for low energy consuming solutions for water purification. In this study, we have carried out a detailed analysis on selection, design, and pricing for a prototype of potable water system for purifying water in emergency situations. The portable and light purification system is envisaged to be driven by FO. This pouch will help to serve as an emergency water filtration device. The current effort employs a model to understand the interplay of permeability and area on the rate of purification of water from any impure source/brackish water. The draw solution for the FO pouch is considered to be a combination of salt and sugar such that dilution of the same would result in an oral rehydration solution (ORS) which is a boon for dehydrated patients. However, the effort takes an extra step to actually estimate the cost and pricing of designing such a prototype. While the mathematical model yields the best membrane (compositions are taken from literature) combination in terms of permeability and area, the pricing takes into account the feasibility of such a solution to be made available as a retail item. The product is envisaged to be a market competitor for packaged drinking water and ORS combination (costing around $0.5 combined) and thus, to be feasible has to be priced around the same range with greater margins in order to have a better distribution. Thus a proper business plan and production of the same has been formulated in order to be a feasible solution for unprecedented calamities and emergency situations.

Keywords: forward osmosis, water treatment, oral rehydration solution, prototype

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Authors: Qasim Idrees, Gao Liangtian, Liu Bo, Miao Yiran

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In order to improve the efficiency and accuracy of the pressure hull structure, optimization of underwater vehicle based on response surface methodology, a method for optimizing the design of pressure hull structure was studied. To determine the pressure shell of five dimensions as a design variable, the application of thin shell theory and the Chinese Classification Society (CCS) specification was carried on the preliminary design. In order to optimize variables of the feasible region, different methods were studied and implemented such as Opt LHD method (to determine the design test sample points in the feasible domain space), parametric ABAQUS solution for each sample point response, and the two-order polynomial response for the surface model of the limit load of structures. Based on the ultimate load of the structure and the quality of the shell, the two-generation genetic algorithm was used to solve the response surface, and the Pareto optimal solution set was obtained. The final optimization result was 41.68% higher than that of the initial design, and the shell quality was reduced by about 27.26%. The parametric method can ensure the accuracy of the test and improve the efficiency of optimization.

Keywords: parameterization, response surface, structure optimization, pressure hull

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Authors: Anne T. Herr, Clemens Lorei

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Employees of organizations with security tasks, such as emergency services, public order services, or police forces, work every day to ensure people's safety. Violence against police is, therefore, a relevant topic both socially and politically. An increase in violence is often discussed without there being any verifiable and generally valid data. So far, scientific research has mainly focused on offender characteristics and crime statistics. These surveys are mostly subjective, retrospective, and neglect the dynamics and interactions in concrete violent situations. Therefore, more recent research methods attempt to capture the issue of violence against emergency forces more comprehensively. However, the operationalization of the constructs and the methodological approach pose particular challenges. This contribution provides an overview of new perspectives on the understanding of violent assaults and identifies current research gaps. In addition, a new research project of the Hessian University of Police and Administration in Germany is presented. In the 'AMBOSafe' study, different theoretical backgrounds for understanding violence against police and emergency services personnel will be combined in order to capture as many different perspectives of violent assaults as possible in a multimodal research approach. In a retrospective as well as in a longitudinal survey, the conditions of escalation dynamics in the assaults are recorded and supplemented by the current and valid prevalence of physical and verbal assaults in a period of four months. In addition, qualitative interviews with those affected will be used to record more detailed descriptions of and the feelings during the assaults, as well as possible causes and connections between the different groups of people. In addition to the reports of the police forces, the motives of the attackers will be collected and supplemented by analyzing the criminal case files. This knowledge can contribute to a more comprehensive understanding of violent assaults against police forces in order to be able to derive scientifically based preventive measures.

Keywords: assaults, crime statistics, escalation dynamics, police

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Authors: Christopher Oyediran, Nicola Ubayasiri, Christopher Gough

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Splenic artery aneurysms are often clinically occult, occasionally identified incidentally with imaging. The pathogenesis of aneurysms is complex, but certain factors are thought to contribute to their development. Given the potential fatal complications of rupture, a high index of suspicion is required to make an early diagnosis. We present a case of a 36-year-old female with a history of endometriosis and multiple sclerosis who presented to the Emergency Department with sudden onset epigastric pain and collapse. On arrival, she was pale and clammy with profound tachycardia and hypotension. An ultrasound done in the resuscitation department revealed abdominal free fluid. She was resuscitated with blood and transferred for emergent laparotomy. Laparotomy revealed massive haemoperitoneum from the spleen. She underwent emergency splenectomy and inspection of the spleen revealed a splenic artery aneurysm. She received our massive transfusion protocol followed by a short stay on ITU, making a good post-operative recovery and was discharged home a week later.

Keywords: aneurysm, human chorionic gonadotrophin (hCG), resuscitation, laparotomy

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Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

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Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

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Authors: Elifcan Oztekin

Abstract:

Compliment response strategies in cross-linguistic contexts have received a considerable amount of interest in sociolinguistic research in various language settings. In this respect, a common finding of these studies indicates that speakers of different languages employ different patterns in strategies to respond to compliments. This has triggered varying theoretical approaches to compliment responses within theories of politeness and the universality of speech acts. In the light of previous studies, the present study investigates compliment response strategies that Turkish-English bilingual university students use in English and Turkish response conditions through a cross-linguistic discourse completion task and interviews. Data were analyzed using Holmes’ (1988) taxonomy and the results indicate a similar pattern to what has been observed in Turkish compliments responses in previous research. Turkish-English comparisons also display noticeable similarities in macro-level strategies, while subtle differences in micro-level strategies were also observed.

Keywords: compliment response strategies, cross-cultural differences, bilingualism, sociolinguistics

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Authors: Magdalena Igras, Joanna Grzybowska, Mariusz Ziółko

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The study of emotions expressed in emergency phone call is presented, covering both statistical analysis of emotions configurations and an attempt to automatically classify emotions. An emergency call is a situation usually accompanied by intense, authentic emotions. They influence (and may inhibit) the communication between caller and responder. In order to support responders in their responsible and psychically exhaustive work, we studied when and in which combinations emotions appeared in calls. A corpus of 45 hours of conversations (about 3300 calls) from emergency call center was collected. Each recording was manually tagged with labels of emotions valence (positive, negative or neutral), type (sadness, tiredness, anxiety, surprise, stress, anger, fury, calm, relief, compassion, satisfaction, amusement, joy) and arousal (weak, typical, varying, high) on the basis of perceptual judgment of two annotators. As we concluded, basic emotions tend to appear in specific configurations depending on the overall situational context and attitude of speaker. After performing statistical analysis we distinguished four main types of emotional behavior of callers: worry/helplessness (sadness, tiredness, compassion), alarm (anxiety, intense stress), mistake or neutral request for information (calm, surprise, sometimes with amusement) and pretension/insisting (anger, fury). The frequency of profiles was respectively: 51%, 21%, 18% and 8% of recordings. A model of presenting the complex emotional profiles on the two-dimensional (tension-insecurity) plane was introduced. In the stage of acoustic analysis, a set of prosodic parameters, as well as Mel-Frequency Cepstral Coefficients (MFCC) were used. Using these parameters, complex emotional states were modeled with machine learning techniques including Gaussian mixture models, decision trees and discriminant analysis. Results of classification with several methods will be presented and compared with the state of the art results obtained for classification of basic emotions. Future work will include optimization of the algorithm to perform in real time in order to track changes of emotions during a conversation.

Keywords: acoustic analysis, complex emotions, emotion recognition, machine learning

Procedia PDF Downloads 398