Search results for: emergency medicine

Authors: D. Tedesco, G. Feletti, P. Trucco

Abstract:

The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: H. Bevrani, A. G. Tikdari, T. Hiyama

Abstract:

Optimal load shedding (LS) design as an emergency plan is one of the main control challenges posed by emerging new uncertainties and numerous distributed generators including renewable energy sources in a modern power system. This paper presents an overview of the key issues and new challenges on optimal LS synthesis concerning the integration of wind turbine units into the power systems. Following a brief survey on the existing LS methods, the impact of power fluctuation produced by wind powers on system frequency and voltage performance is presented. The most LS schemas proposed so far used voltage or frequency parameter via under-frequency or under-voltage LS schemes. Here, the necessity of considering both voltage and frequency indices to achieve a more effective and comprehensive LS strategy is emphasized. Then it is clarified that this problem will be more dominated in the presence of wind turbines.

Keywords: Load shedding, emergency control, voltage, frequency, wind turbine.

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Authors: Thanapol Wisuttikul, Choochart Haruechaiyasak, Santipong Thaiprayoon

Abstract:

Thailand has evolved many unique culture and knowledge, and the leading is the Thai traditional medicine (TTM). Recently, a number of researchers have tried to save this indigenous knowledge. However, the system to do so has still been scant. To preserve this ancient knowledge, we therefore invented and integrated multi-linguistic techniques to create the system of the collected all of recipes. This application extracted the medical recipes from antique scriptures then normalized antiquarian words, primitive grammar and antiquated measurement of them to the modern ones. Then, we applied ingredient-duplication-calculation, proportion-similarity-calculation and score-ranking to examine duplicate recipes. We collected the questionnaires from registrants and people to investigate the users’ satisfaction. The satisfactory results were found. This application assists not only registrants to validating the copyright violation in TTM registration process but also people to cure their illness that aids both Thai people and all mankind to fight for intractable diseases.

Keywords: Medicine Registration, Search Engine, Text Approximation, Traditional Medicine.

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Authors: Frantisek Bozek, Lenka Jesonkova, Jiri Dvorak, Milos Bozek, Eduard Bakos

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The contents of nitrates and nitrites were monitored in 15 ground water resources of a selected region earmarked for the emergency supply of population. The resources have been selected on the basis of previous assessment of natural conditions and the exploitation of territory in the infiltration area as well as the surroundings of water resources. The health risk analysis carried out in relation to nitrates and nitrites, which were found to be the most serious water contaminants, proved, that 14 resources met the health standards in relation to the assessed criterion and could be included in crisis plans. Water quality of ground resources may be assessed in the same way with regard to other contaminants.

Keywords: Drinking water, health risks, methemoglobinemia, nitrates, nitrites, water pollution.

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Authors: Nevena Stolba, A Min Tjoa

Abstract:

Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: Sheikh I. Azid, Bibhya Sharma

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A low cost Short Message System (SMS) based Home security system equipped with motion, smoke, temperature, humidity and light sensors has been studied and tested. The sensors are controlled by a microprocessor PIC 18F4520 through the SMS having password protection code for the secure operation. The user is able to switch light and the appliances and get instant feedback. Also in cases of emergencies such as fire or robbery the system will send alert message to occupant and relevant civil authorities. The operation of the home security has been tested on Vodafone- Fiji network and Digicel Fiji Network for emergency and feedback responses for 25 samples. The experiment showed that it takes about 8-10s for the security system to respond in case of emergency. It takes about 18-22s for the occupant to switch and monitor lights and appliances and then get feedback depending upon the network traffic.

Keywords: Smart Home, SMS, Sensors, Microprocessor.

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Authors: Taha Landolsi, A. R. Al-Ali, Tarik Ozkul, Mohammad A. Al-Rousan

Abstract:

In this paper, we present a cost-effective wireless distributed load shedding system for non-emergency scenarios. In power transformer locations where SCADA system cannot be used, the proposed solution provides a reasonable alternative that combines the use of microcontrollers and existing GSM infrastructure to send early warning SMS messages to users advising them to proactively reduce their power consumption before system capacity is reached and systematic power shutdown takes place. A novel communication protocol and message set have been devised to handle the messaging between the transformer sites, where the microcontrollers are located and where the measurements take place, and the central processing site where the database server is hosted. Moreover, the system sends warning messages to the endusers mobile devices that are used as communication terminals. The system has been implemented and tested via different experimental results.

Keywords: Smart Grid, Load shedding, Demand SideManagement, GSM Wireless Networks, SCADA systems.

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Authors: A.Gjukaj, G.Kabashi, G.Pula, N.Avdiu, B.Prebreza

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This paper discusses aspects of re-design of loadshedding schemes with respect to actual developments in the Kosovo power system. Load-shedding is a type of emergency control that is designed to ensure system stability by reducing power system load to match the power generation supply. This paper presents a new adaptive load-shedding scheme that provides emergency protection against excess frequency decline, in cases when the Kosovo power system might be disconnected from the regional transmission network. The proposed load-shedding scheme uses the local frequency rate information to adapt the load-shedding pattern to suit the size and location of the occurring disturbance. The proposed scheme is tested in a software simulation on a large scale PSS/E model which represents nine power system areas of Southeast Europe including the Kosovo power system.

Keywords: About Load Shedding, Power System Transient, PSS/E Dynamic Simulation, Under-frequency Protection

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Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: Water and sanitation, emergency response, education and training, building resilience.

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Authors: Young S. Bang, Dong H. Yoon, Seung H. Yoo

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Emergency Core Coolant Bypass (ECC Bypass) has been regarded as an important phenomenon to peak cladding temperature of large-break loss-of-coolant-accidents (LBLOCA) in nuclear power plants (NPP). A modeling scheme to address the ECC Bypass phenomena and the calculation of LBLOCA using that scheme are discussed in the present paper. A hydraulic form loss coefficient (HFLC) from the reactor vessel downcomer to the broken cold leg is predicted by the computational fluid dynamics (CFD) code with a variation of the void fraction incoming from the downcomer. The maximum, mean, and minimum values of FLC are derived from the CFD results and are incorporated into the LBLOCA calculation using a system thermal-hydraulic code, MARS-KS. As a relevant parameter addressing the ECC Bypass phenomena, the FLC to the break and its range are proposed.

Keywords: CFD analysis, ECC Bypass, hydraulic form loss coefficient, system thermal-hydraulic code.

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Authors: T. Penkova, A. Korobko, V. Nicheporchuk., L. Nozhenkova, A. Metus

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This paper presents an approach of on-line control of the state of technosphere and environment objects based on the integration of Data Warehouse, OLAP and Expert systems technologies. It looks at the structure and content of data warehouse that provides consolidation and storage of monitoring data. There is a description of OLAP-models that provide a multidimensional analysis of monitoring data and dynamic analysis of principal parameters of controlled objects. The authors suggest some criteria of emergency risk assessment using expert knowledge about danger levels. It is demonstrated now some of the proposed solutions could be adopted in territorial decision making support systems. Operational control allows authorities to detect threat, prevent natural and anthropogenic emergencies and ensure a comprehensive safety of territory.

Keywords: Decision making support systems, Emergency risk assessment, Natural and anthropogenic safety, On-line control, Territory.

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Authors: A. Kourou, S. Kyriakopoulos, N. Anyfanti

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A lot of children under the age of five spend their daytime hours away from their home, in a kindergarten. Caring for children is a serious subject, and their safety in case of earthquake is the first priority. Being aware of earthquakes helps to prioritize the needs and take the appropriate actions to limit the effects. Earthquakes occurring anywhere at any time require emergency planning. Earthquake planning is a cooperative effort and childcare providers have unique roles and responsibilities. Greece has high seismicity and Ionian Islands Region has the highest seismic activity of the country. Earthquake Planning and Protection Organization (EPPO) is a national organization in Greece. The mission of EPPO is the seismic risk reduction by designing an earthquake management program of mitigation and preparedness. Among other actions EPPO has analyzed the needs and requirements of kindergartens on earthquake protection issues and has designed specific activities to familiarize the day care centers staff being prepared for earthquakes.  This research presents the results of a survey that detects the level of earthquake preparedness of kindergartens in all over the country and Ionian Islands too. A closed-form questionnaire of 20 main questions was developed for the survey in order to detect the aspects of participants concerning the earthquake preparedness actions at individual, family and day care environment level. 2668 questionnaires were gathered from March 2014 to May 2019, and analyzed by EPPO’s Department of Education. Moreover, this paper presents the EPPO’s educational activities targeted to the Ionian Islands Region that implemented in the framework of “Telemachus” Project. To provide safe environment for children to learn, and staff to work is the foremost goal of any State, community and kindergarten. This project is funded under the Priority Axis “Environmental Protection and Sustainable Development” of Operational Plan “Ionian Islands 2014-2020”. It is increasingly accepted that emergency preparedness should be thought of as an ongoing process rather than a one-time activity. Creating an earthquake safe daycare environment that facilitates learning is a challenging task. Training, drills, and update of emergency plan should take place throughout the year at kindergartens to identify any gaps and to ensure the emergency procedures. EPPO will continue to work closely with regional and local authorities to actively address the needs of children and kindergartens before, during and after earthquakes.

Keywords: Child care centers, education on earthquake issues, emergency planning, Ionian Islands Region of Greece, kindergartens, preparedness.

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Authors: Blandina Šramová, Gabriela Kučeráková

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The paper is intended to declare and apply ethics, i. e. moral principles, rules in marketing environment. Ethical behavior of selected pharmaceutical companies in the Slovak Republic is the object of our research. The aim of our research is to determine perception of ethical behavior of the pharmaceutical industry in Slovakia by the medicine representatives in comparison with the assessment of doctors and patients. The experimental sample included 90 participants who were divided into three groups: medicine representatives of the pharmaceutical companies (N=30), doctors (N=30) and patients (N=30). The research method was a Questionnaire of ethical behavior, created by us, that describes individual areas included in the Code of ethics of the pharmaceutical industry in Slovakia. The results showed influence of professional status on ethical behavior perception, not gender. Higher perception was indicated at patients rather than doctors and medicine representatives.

Keywords: Ethics, corporate social responsibility, marketing, pharmaceutical industry.

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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.

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Authors: R. Sinthavalai, N. Memongkol, N. Patthanaprechawong, J. Viriyanantavong, C. Choosuk

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In Thailand, the practice of pre-hospital Emergency Medical Service (EMS) in each area reveals the different growth rates and effectiveness of the practices. Those can be found as the diverse quality and quantity. To shorten the learning curve prior to speed-up the practices in other areas, story telling and lessons learnt from the effective practices are valued as meaningful knowledge. To this paper, it was to ascertain the factors, lessons learnt and best practices that have impact as contributing to the success of prehospital EMS system. Those were formulized as model prior to speedup the practice in other areas. To develop the model, Malcolm Baldrige National Quality Award (MBNQA), which is widely recognized as a framework for organizational quality assessment and improvement, was chosen as the discussion framework. Remarkably, this study was based on the consideration of knowledge capture; however it was not to complete the loop of knowledge activities. Nevertheless, it was to highlight the recognition of knowledge capture, which is the initiation of knowledge management.

Keywords: Emergency Medical Service, Modeling, MBNQA, Thailand.

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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: Gilmanov M. K., Gilmanova S. M.

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Article devoted to the development of technologies for medicine and agroecology by using plant organelle – spherosome. Technological method of purification and isolation of this organelle by using novel nanostructured carbon sorbent – “nanocarbosorb" ARK type are presented. Also the methods of preparation of nanocontainers based on using of spherosome with loaded isosorbide dinitrate, piroxicam or diclofenak are exhibited. We found that the spherosome could be applied for ecological aims as bioregulator and also as biosensor for determination of ammonia ions in water reservoirs at concentration range 1mM to 100mM.

Keywords: Biosensor, nanocontainer, phosphatidylinositol, spherosome, vegetative reproduction.

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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Over the past decade, the non-elective admissions in the UK have increased significantly. Taking into account limited resources (i.e. beds), the related service managers are obliged to manage their resources effectively due to the non-elective admissions which are mostly admitted to inpatient specialities via A&E departments. Geriatric medicine is one of specialities that have long length of stay for the non-elective admissions. This study aims to develop a discrete event simulation model to understand how possible increases on non-elective demand over the next 12 months affect the bed occupancy rate and to determine required number of beds in a geriatric medicine speciality in a UK hospital. In our validated simulation model, we take into account observed frequency distributions which are derived from a big data covering the period April, 2009 to January, 2013, for the non-elective admission and the length of stay. An experimental analysis, which consists of 16 experiments, is carried out to better understand possible effects of case studies and scenarios related to increase on demand and number of bed. As a result, the speciality does not achieve the target level in the base model although the bed occupancy rate decreases from 125.94% to 96.41% by increasing the number of beds by 30%. In addition, the number of required beds is more than the number of beds considered in the scenario analysis in order to meet the bed requirement. This paper sheds light on bed management for service managers in geriatric medicine specialities.

Keywords: Bed management, bed occupancy rate, discrete event simulation, geriatric medicine, non-elective admission.

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Authors: Essam Abd-Elrazek

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With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.

Keywords: Medical Informatics, telemedicine, e-health systems.

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Authors: Kosmas Dimitropoulos, Athanasios Manitsaris, Ioannis Mavridis

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The paper presents an investigation into the role of virtual reality and web technologies in the field of distance education. Within this frame, special emphasis is given on the building of web-based virtual learning environments so as to successfully fulfill their educational objectives. In particular, basic pedagogical methods are studied, focusing mainly on the efficient preparation, approach and presentation of learning content, and specific designing rules are presented considering the hypermedia, virtual and educational nature of this kind of applications. The paper also aims to highlight the educational benefits arising from the use of virtual reality technology in medicine and study the emerging area of web-based medical simulations. Finally, an innovative virtual reality environment for distance education in medicine is demonstrated. The proposed environment reproduces conditions of the real learning process and enhances learning through a real-time interactive simulator.

Keywords: Distance education, medicine, virtual reality, web.

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Authors: Badarch Tuyatsetseg

Abstract:

This paper presents parametric probability density models for call holding times (CHTs) into emergency call center based on the actual data collected for over a week in the public Emergency Information Network (EIN) in Mongolia. When the set of chosen candidates of Gamma distribution family is fitted to the call holding time data, it is observed that the whole area in the CHT empirical histogram is underestimated due to spikes of higher probability and long tails of lower probability in the histogram. Therefore, we provide the Gaussian parametric model of a mixture of lognormal distributions with explicit analytical expressions for the modeling of CHTs of PSNs. Finally, we show that the CHTs for PSNs are fitted reasonably by a mixture of lognormal distributions via the simulation of expectation maximization algorithm. This result is significant as it expresses a useful mathematical tool in an explicit manner of a mixture of lognormal distributions.

Keywords: A mixture of lognormal distributions, modeling call holding times, public safety network.

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Authors: R. Hajkova, J. Palecek, H. Malachova, A. Oulehlova

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Ensuring of continuity of business is basic strategy of every company. Continuity of organization activities includes comprehensive procedures that help in solving unexpected situations of natural and anthropogenic character (for example flood, blaze, economic situations). Planning of continuity operations is a process that helps identify critical processes and implement plans for the security and recovery of key processes. The aim of this article is to demonstrate application of system approach to managing business continuity called business continuity management systems in military issues. This article describes the life cycle of business continuity management which is based on the established cycle PDCA (Plan- Do-Check-Act). After this is carried out by activities which are making by University of Defence during activation of forces and means of the integrated rescue system in case of emergencies - accidents at a nuclear power plant in Czech Republic. Activities of various stages of deployment earmarked forces and resources are managed and evaluated by using MCMS application (Military Continuity Management System).

Keywords: Business continuity management system, emergency management, military, nuclear safety.

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: Acute hepatitis, Medical resource cost, Artificial neural network, Support vector regression.

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Authors: F. Titouna, S. Benferhat, K. Aksa, C. Titouna

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A traffic light gives security from traffic congestion,reducing the traffic jam, and organizing the traffic flow. Furthermore,increasing congestion level in public road networks is a growingproblem in many countries. Using Intelligent Transportation Systemsto provide emergency vehicles a green light at intersections canreduce driver confusion, reduce conflicts, and improve emergencyresponse times. Nowadays, the technology of wireless sensornetworks can solve many problems and can offer a good managementof the crossroad. In this paper, we develop a new approach based onthe technique of clustering and the graphical possibilistic fusionmodeling. So, the proposed model is elaborated in three phases. Thefirst one consists to decompose the environment into clusters,following by the fusion intra and inter clusters processes. Finally, wewill show some experimental results by simulation that proves theefficiency of our proposed approach.KeywordsTraffic light, Wireless sensor network, Controller,Possibilistic network/Bayesain network.

Keywords: Traffic light, Wireless sensor network, Controller, Possibilistic network/Bayesain network.

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service, location-based services, emergency medical services information system

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Authors: Bousselessela H., Yahia M., Mahboubi A., Benbia S., Yahia Massinissa

Abstract:

In order to enhance the knowledge of certain phytochemical Algerian plants that are widely used in traditional medicine and to exploit their therapeutic potential in modern medicine, we have done a specific extraction of terpenes and alkaloids from the leaves of Euphorbia granulata to evaluate the antioxidant and antibacterial activity of this extracts. After the extraction it was found that the terpene extract gave the highest yield 59.72% compared with alkaloids extracts. The disc diffusion method was used to determine the antibacterial activity against different bacterial strains: Escherichia coli (ATCC25922), Pseudomonas aeruginosa (ATCC27853) and Staphylococcus aureus (ATCC25923). All extracts have shown inhibition of growth bacteria. The different zones of inhibition have varied from (7 -10 mm) according to the concentrations of extract used. Testing the antiradical activity on DPPH-TLC plates indicated the presence of substances that have potent anti-free radical. As against, the BC-TLC revealed that only terpenes extract which was reacted positively. These results can validate the importance of Euphorbia granulata in traditional medicine.

Keywords: Euphorbia granulata, Euphorbiaceae, alkaloids, terpenoids, antioxidant activity, antibacterial activity.

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

Abstract:

High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: Acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education.

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Authors: G. Feletti, D. Tedesco, P. Trucco

Abstract:

The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of a first phase of revision of the technical-scientific literature concerning the indicators currently in use for the performance measurement of EMS. It emerges that current studies focus on two distinct areas and independent objectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). Conversely, the perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal covers the end-to-end healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid even to EMS aspects that in current literature tend to be neglected or underestimated. In particular, the integration of the two processes enables to evaluate the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering, besides the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating firstly the ones not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draw us to exclude additional indicators due to unavailability of data required for their computation. The final dashboard, that was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness on EDs accessibility in real time. The association of each KPI to the EMS phase it refers to enabled the design of a well-balanced dashboard, covering both efficiency and effectiveness performance objectives of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient care are covered by traditional KPIs. Future developments could be directed to building a hierarchical dashboard, composed by a high-level minimal set of KPIs for measuring the basic performance of the EMS system, at an aggregate level, and lower levels of KPIs that bring additional and more detailed information on specific performance dimensions or EMS phases.

Keywords: Emergency Medical Services, Key Performance Indicators, Dashboard, Decision Support.

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Authors: Sirbu R., Negreanu-Pirjol T., Leca M., Bechir A., Maris M., Maris D.

Abstract:

In the paper we presented the possibility of application collagen gels with active principle-s from marine algae extract and chlorhexidine salt in dental medicine. The hydro-alcoholic extracts from marine algae have been used as they have been obtained. The extracts from marine algae and chlorhexidine salt (digluconate) are incorporated in type I non-denatured fibrillar collagen matrixes. In order to obtain therapeutic effects at nanostructure level, it is important to know the rheological characteristics of the relevant mixtures of collagen gels and extracts from marine algae selected for use. In this survey we have studied mixtures made of non-denatured fibrillar collagen hydro-gels where different concentrations of marine algae have been incorporated. Based on the data obtained for the shearing tensions, we have traced the rheograms – the diagrams for shearing tensions depending on the shearing speed values – from which we have calculated the apparent viscosities as ratios between shearing tension and speed values, which have been figured in relation to the shearing speed values, with a view to levelling dependency.

Keywords: rheological properties, fibrillar collagen hydro-gel, marine algae, chlorhexidine salt, dental medicine

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Authors: Mohamed Elshal, Hazim El-Mounayri, Omar El-Mounayri

Abstract:

Emergency department (ED) is considered as a complex system of interacting entities: patients, human resources, software and hardware systems, interfaces, and other systems. This paper represents a research for implementing a detailed Systems Engineering (SE) approach in a mid-size hospital in central Indiana. This methodology will be applied by “The Initiative for Product Lifecycle Innovation (IPLI)” institution at Indiana University to study and solve the crowding problem with the aim of increasing throughput of patients and enhance their treatment experience; therefore, the nature of crowding problem needs to be investigated with all other problems that leads to it. The presented SE methods are workflow analysis and systems modeling where SE tools such as Microsoft Visio are used to construct a group of system-level diagrams that demonstrate: patient’s workflow, documentation and communication flow, data systems, human resources workflow and requirements, leadership involved, and integration between ER different systems. Finally, the ultimate goal will be managing the process through implementation of an executable model using commercialized software tools, which will identify bottlenecks, improve documentation flow, and help make the process faster.

Keywords: Systems modeling, ED operation, workflow modeling, systems analysis.

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