Command Center Research Articles

How Taiwan has responded to COVID-19 and how COVID-19 has affected Taiwan, 2020-2022.

From January 2020 to December 2022, there was a total of 8,872,955 confirmed COVID-19 cases in Taiwan. In addition, a total of 15,253 COVID-19 related deaths were reported. During these three years, the government and health authority did many efforts to response this pandemic. In the early pandemic, Taiwan Central Epidemic Command Center was established in the early 2020 to organize associated resource, develop effective policy and implement strict intervention. In response to COVID-19 pandemic, many infection control policy and interventions, including universal mask wearing with increasing production of face mask, hand hygiene, border control, introduce of digital technology incorporating big data, quarantine of COVID-19 cases, travel and gathering restriction, were implemented. In the meanwhile, two COVID-19 vaccines, namely MVC-COV1901 and UB-612, have been developed under the support of government. Furthermore, MVC-COV1901 was taken into clinical practice after received emergency use approval. In addition, two traditional Chinese medicines, including NRICM101 and NRICM102 showed their promising effect against SARS-CoV-2 infection and were recommended as potential therapeutic options for COVID-19. During the pandemic, the nonpharmacologic intervention help reduce many infectious diseases, especially for airborne/droplet-transmitted diseases. However, COVID-19 exhibited some adverse impacts on the healthcare systems, such as emergency medical service on out of hospital cardiac arrest, cancer screening, HIV screening and prevention services, and public health, namely the psychosocial status of healthcare workers. Although the outbreak of SARS-CoV-2 infections may gradually subsided, we should keep monitoring its associated impact and appropriately response to this pandemic.

IoT Based System for Accident Detection, Monitoring and Landslide Detection Using GSM in Hilly Areas

This paper described the detailed study for the detection and monitoring of accidents in hilly areas. In the past few decades, road accidents are a major cause of death in suburban hilly areas. These accidents not only affect the life of the destitute but also affect the lives of others. Over the last few decades, hilly areas are now ideal locations for holidays, hence an adequate number of travellers are moving towards hill stations for enjoying free time. This movement also invites accidents to occur due to bad driving skills, blind turns, overspeeding, etc. Also, during the peak time of holidays, abrupt climate change occurs and leads to heavy rainfalls, which are the major cause of landslides. As a result, the loss of life of travellers and blocked roads affecting transportation of necessary goods occur in hilly areas which affect the development and living of other people. Internet of Things (IoT) system may be a better solution to detect monitor and prevent these accidents and landslides. IoT system consists of sensors, actuators, a powerful micro-controller, and a network interface. This system detects and monitors accidents and landslides and informs the command centre about the location. Implementation of the IoT system helps us to lower the accident rate and easily locate the affected areas of landslides using global service for mobile (GSM) or Wireless Fidelity (Wi-Fi) connectivity. It is always a challenging task for a rescue team to locate the exact area of an accident and carry out life-saving operations.

Understanding decision making in security operations centres: building the case for cyber deception technology.

A Security Operations Centre (SOC) is a command centre where analysts monitor network activity, analyse alerts, investigate potential threats, and respond to incidents. By analysing data activities around the clock, SOC teams are crucial in ensuring the prompt detection and response to security incidents. SOC analysts work under considerable pressure to triage and respond to alerts in very short time frames. Cyber deception technology offers the promise of buying SOC analysts more time to respond by wasting the resources and time of attackers, yet such technology remains underutilised. We carried out a series of interviews with experts to uncover the barriers which prevent the effective implementation of cyber deception in SOCs. By using thematic analysis on the data, it was clear that while cyber deception technology is promising it is hindered by a lack of use cases, limited empirical research that demonstrates the efficacy of the technology, hesitancy to embrace a more active form of cyber defence, issues surrounding the over promising of results by off-the-shelf vendors, and an aversion to interrupting the decision-making processes of SOC analysts. Taking this last point about the decision-making processes of SOC analysts we make the case that naturalistic decision making (NDM) would help us better understand how SOC analysts make decisions and how cyber deception technology could be used to best effect.

STANDAR PELAYANAN TANGGAP DARURAT BENCANA MELALUI COMMAND CENTER 112 DI BADAN PENANGGULANGAN BENCANA DAERAH KOTA SURABAYA

There are various emergency events experienced by the community, so that in this case emergency treatment is needed to minimize fatalities and damage to fatal facilities. To get emergency treatment, the community will contact the Regional Apparatus Organization (RAO) related to the type of emergency that exists. Therefore, the 112 Emergency Call Number Service was created, a service that can be used if an emergency occurs by dialing 112. Then, it will connect the caller to the Emergency Call Center (Call Center 112) in the District/City. Likewise, the Regional Disaster Management Agency for the City of Surabaya formed the Command Center 112 service, which was launched on July 26, 2016, as a result of the many emergency incidents previously faced and officers in the related RAO, unable to respond quickly. In this regard, this study aims to explain the standard of disaster emergency response services provided by Command Center 112 at RDMA of Surabaya City. Descriptive qualitative research is the methodology used. In this case, the researcher collected data through various methods, including interviews, field observations, documentation and literature studies. Furthermore, data reduction, data display and data verification are also used in this study along with the conclusions. In this study, source triangulation, technique triangulation and time triangulation were combined as data validity methodologies. This research gives the result that, in terms of the need for emergency response services, Command Center 112 at RDMA of Surabaya City has been running quite well.
 Keywords: Public Service, Service Standards, Emergency Handling, 112 Command Center Services

An Innovative Mobile Hospital for the Management of a Massive Flow of Victims.

Introduction:In order to deal with disastrous situations needing massive healthcare support, a new tool, financed by FEDER European funds (Interreg POCTEFA program) has been designed: the multipurpose mobile hospital Europe Occitanie (UMPEO). It is a projectable, foldable, versatile and autonomous truck with an interchangeable function from advanced medical post to operational command center, for acute events involving mass gathering or during multiple victims disasters. This study aims to show the usefulness of this structure during the COVID-19 health crisis.Method:The UMPEO is a shelter deployable in an emergency ward or intensive care unit, mobilizable in one hour, projectable by truck and autonomous for the first two hours. A descriptive, transversal, European study was carried out to describe its use in the cross-border countries of the Pyrenees (France, Spain and Andorra). When applicable, demographic data were gathered and/or a satisfaction questionnaire was given to the caregivers involved.Results:Between September 8, 2020 andFebruary 25, 2021, UMPEO was mobilized as a COVID-19 testing center, emergency department, vaccination center or as a command center at a political summit. Thus, 1322 screening tests were carried out over the screening three weeks deployment and 91% of the volunteers considered the screening operation useful. Used as a hospitalization ward, UMPEO was able to accommodate 266 patients over a period of four weeks. Eight hundred people were able to benefit from two doses of vaccines during the six weeks of the mobile vaccination campaign.Conclusion:This tool, initially designed to be used in the event of a catastrophic event of an accidental or terrorist type or as a help station during mass gathering, has been diverted without any modification of its structure to meet the challenges of the global health crisis and provide a solution adapted to the population of countries bordering the Pyrenees.

Sudden Cardiac Arrests During the 2021 Taipei Marathon after COVID-19 Confinement in Taiwan

Introduction:Large-scale mass-sporting events pose unique challenges for emergency health teams. Data is limited in athletes with sudden cardiac arrests (SCAs) and the emergency medical services (EMS) in major sporting events that took place after the coronavirus pandemic.Method:This retrospective observational study describes data from the Taipei Marathon event that took place on December 19, 2021, in Taiwan. The temperature was about 15.2–19.3°C. Four SCAs among 18,144 half-marathoners and the EMS were enrolled.A medical command center was set up 100 meters from the finish line. Ten medical tents, one first-aid station, and nine event ambulances were distributed along the course, and one medical tent was placed near the baggage storage area. Each medical tent comprised: 1 doctor, 1–3 nurses, and 1–3 paramedics. The in-event EMS also comprised a mobile first-aid team. Thirty paramedics rode motorcycles and carried automated external defibrillators and emergency medical kits throughout the racecourse.Results:Among the 7,811 full- and 18,144 half-marathoners, the total number of SCAs was four male half-marathoners. Three runners (75%) stated that they decreased their weekly running volume during the pandemic restrictions’ period. Two runners (50%) experienced cardiac arrest in the final quarter of the race. The median interval of time between SCA occurrence and EMS arrival was 2.5 minutes (interquartile range, 0.5–4 minutes). Electric shocks were delivered to all the four runners (100%) experiencing ventricular fibrillation, and all of them were successfully resuscitated in the field. The median interval of cardiopulmonary resuscitation duration before return of spontaneous circulation was 8.5 minutes (interquartile range, 6–9.5 minutes).Conclusion:4/18144 is a significantly high number of SCA compared to data from the annual Taipei Half-Marathon between 2016 and 2020 and past half-marathons worldwide. The high prevalence rate of SCA (22 per 100,000) may be due to inadequate acclimation and training volumes.

What Goes Up, Must Come Down: A State-of-the-Art Electronic Health Record Downtime and Uptime Procedure in a Metropolitan Health Setting.

Electronic health records (EHRs) are used at most hospitals around the world, and downtime events are inevitable and common. Downtime represents a risky time for patients because patient information and critical EHR functionality are unavailable. Many institutions have used EHRs for years, with health professionals less likely to be familiar or comfortable with paper-based processes, resulting in an increased risk of errors during downtimes. There is currently limited guidance available on how to develop and operationalize downtime procedure at a local level. In this paper, we fill this gap by describing our state-of-the-art downtime and uptime procedure and its evaluation. A district-wide downtime and uptime procedure was revised and standardized based on lessons learned from other health care organizations. The procedure outlines downtime and uptime preparations including downtime drills, downtime viewer auditing, and downtime education; downtime response including activating downtime and tracking patient changes; and uptime recovery including medication reconciliation and uptime documentation. We implemented our new procedure across the district during an 8-hour planned downtime. A district downtime planning committee was formed, and a virtual command center was established to coordinate the downtime and uptime events. During downtime and uptime, onsite support was provided by the district's health informatics teams and clinicians. Data recovery was completed safely and efficiently with the revised uptime process. Following the event, we gathered staff feedback and reflections on implementing the procedure which highlighted its success but also revealed some areas for further improvement. In this paper, we describe a state-of-the-art EHR downtime and uptime procedure and lessons learned from its implementation. The implementation was successful with staff well prepared and information reconciled efficiently ensuring safe continuity of care. It was only through extensive planning, significant commitment, and engagement of all stakeholders that this outcome was possible.

Mass Hospital Evacuation During COVID-19 Pandemic: Experience of Hospital Cluster Infection in Taiwan

Introduction:A mass hospital evacuation occurred in Taiwan in 2021 due to the clustered COVID-19 infection in Hospitals. To maintain essential services with limited manpower, 74 patients are triaged and evacuated to 12 hospitals in 6 cities in 16 hrs for further treatment.Method:All patients were evaluated by physicians for discharge. The patients who still needed hospitalization were classified into three groups according to the risk of infection1. The high-risk group of patients were cared for by infected staff directly; the moderate-risk group were patients admitted to the same ward but didn’t receive care from infected staff. The low-risk group were patients avoiding infection outbreak. Only the low-risk group patients were transferred, excluding patients with unstable vital signs, hospice, and prison. Command Center of HICS of TGH set up a transfer execution team to handle this task.Results:There were 74 patients transferred, including 56 from internal medicine and 18 from the surgery ward. Most of the transfers are concentrated within 16 hours. These patients were transferred to 12 emergency hospitals in 6 cities. The average transport time was 1.5 hours and the longest was about 3 hours due to the distance and traffic.The 17 private ambulances and 11 Fire Department ambulances were dispatched and transferred 60 patients. In addition, there were 14 patients evacuated by small buses. No mortality or COVID-19 infection had been reported within 3 days after this mass evacuation, only one patient had been intubated after one hour of arrival to hospital due to condition deterioration.Conclusion:A hospital evacuation is a complicated process, especially during a pandemic. All infection control measures create difficulties in the patient transfer process. Well-prepared evacuation plans, regular drills, well-trained personnel, an organized command system, and regional cooperation are the keys to mass evacuation in a disaster.

PENGARUH BESAR CU CHI TUNNELS DALAM KEMENANGAN PERANG GERILYA BANGSA VIETNAM

The Vietnamese guerrilla war lasted from 1953-1954 culminating in victory at Dien Bien Phu, the end of nearly a century of French colonial rule over Indochina. The Vietnamese people led by Ho Chi Minh launched massive attacks on French outposts using a combination of conventional and guerrilla warfare tactics. Equally important in supporting the Vietnamese army's guerrilla warfare victory were the Cu Chi Tunnels, which served as a base of operations against French forces. The methodology in writing this journal by analysing the making of Cu Chi Tunnels which includes structure, development pattern, room composition using descriptive analysis method supported by literature study, literature, national and international scientific journals. The results and discussion in this research are Cu Chi Tunnels played an important role in the military strategy of the Vietnamese army, as a means of communication and logistics transport, as well as a storage place for weapons and ammunition. The structure of the tunnel has the natural advantage of being near the Saigon River which allows for air penetration, in the form of lateritic clay (iron soil). Meanwhile, the pattern of tunnel construction as a secret passage for fighting and escaping was made zigzagging, not straight "like a snake". For the composition of the tunnel room, three levels were built separately but interconnected, designed to serve various functions as living quarters, weapons and ammunition storage facilities, hospitals, as well as communication and command centres.

The Early Warning System Effectiveness of the Maritime Security Agency of the Republic of Indonesia (Bakamla RI) in the Prevention of Drug Invention through the Sea Lane

<p>The Republic of Indonesia Maritime Security Agency (Bakamla RI) was formed based on the mandate of Article 59 Paragraph 3 of Law Number 32 of 2014 concerning Maritime Affairs. Bakamla RI has implemented an early warning system to ensure security and safety in Indonesian waters and jurisdiction. The Bakamla RI Early Warning System (EWS), known as a choke point for maritime security and safety, has already been built and spread throughout Indonesian waters. However, in reality, drug smuggling by sea is still common. Drug smuggling by sea is still dominant today. The United Nations Office on Drugs and Crime (UNODC) revealed that 80% of drug trafficking is carried out by sea. Narcotics transactions in the middle of the sea are very safe transactions, this is due to very weak supervision in the middle of the sea by officers. The purpose of this study is to analyze the mechanism and effectiveness of an early-stage warning system in preventing drug smuggling by sea. This study uses a qualitative descriptive method with interview data collection techniques. Research shows that the Early Warning System Series produces ship detection and assistance data that can be processed into ship anomaly information. The application of the Bakamla RI early warning system to prevent drug smuggling by sea has not been effective. The difficulty of realizing information between agencies and the weak synergy in exchanging information are the main obstacles to the efficiency of the early warning system. Therefore, it is recommended to increase the capability of the Bakamla RI Early Warning System by integrating the Command and Control Center (Puskodal) or Control Center (Pusdal) of related agencies, as well as equipping it with monitoring equipment that integrates the Early Warning System.</p>

CYBER ATTACKS FOR DATA BREACH AND POSSIBLE DEFENSE STRATEGIES IN INTERNET OF HEALTHCARE THINGS ECOSYSTEM

The widespread use of the Internet and the increase in Internet of Things (IoT) equipment paved the way for the development of user-friendly systems. The inclusion of many electronic systems in the IoT ecosystem, especially in homes, has improved remote control and monitoring features. In general, within the concept of smart home, voice, control and joint movements are used as command center and WIFI, Bluetooth, Zigbee and GSM etc. technologies are used for communication. Regular monitoring of some health problems of individuals occurs in some situations that require instant intervention. In this context, individuals in need of home care or under surveillance at home are checked with Internet of Healthcare Things equipment in the company of experts. The rapid spread of the IoT ecosystem has also increased data production. Especially sensitive health data is at the beginning of critical data and requires security measures to be taken. In this study, the IoT devices used for home patient care have been evaluated for the sources of data leaks and possible security measures that may be experienced in the process from the data owner to the data storage stage. In order to identify possible risks and threats, 4 different target scenarios were created. These scenarios include home internet connection resources, data transfer, data storage and access. 8 different attacks (Deauth, DDOS, brute force, hashcat, Man-in-the-middle, Injection, Short Address Attack, Smart Contract Overflow) were applied to these possible scenarios where data leakage could occur. In addition, recently, blockchain applications and smart contract transmissions are preferred for data security. Among the attack scenarios, Short Address Attack and Smart Contract Overflow are attack methodologies used for blockchain security. In particular, denial of service was encountered in all attacks on wireless networks. Configuration errors, wrong product selection, use of weak passwords and default configurations in the IOT ecosystem seem to be the main sources of data leaks. As a result, the study includes possible attacker scenarios and possible vulnerabilities have been extracted within the scope of real scenarios. In addition, the measures to be taken against these vulnerabilities were evaluated and recommendations were given to take maximum security measures to prevent data leaks from within the IoT ecosystem.

Learning multi-modal brain tumor segmentation from privileged semi-paired MRI images with curriculum disentanglement learning

Since the brain is the human body’s primary command and control center, brain cancer is one of the most dangerous cancers. Automatic segmentation of brain tumors from multi-modal images is important in diagnosis and treatment. Due to the difficulties in obtaining multi-modal paired images in clinical practice, recent studies segment brain tumors solely relying on unpaired images and discarding the available paired images. Although these models solve the dependence on paired images, they cannot fully exploit the complementary information from different modalities, resulting in low unimodal segmentation accuracy. Hence, this work studies the unimodal segmentation with privileged semi-paired images, i.e., limited paired images are introduced to the training phase. Specifically, we present a novel two-step (intra-modality and inter-modality) curriculum disentanglement learning framework. The modality-specific style codes describe the attenuation of tissue features and image contrast, and modality-invariant content codes contain anatomical and functional information extracted from the input images. Besides, we address the problem of unthorough decoupling by introducing constraints on the style and content spaces. Experiments on the BraTS2020 dataset highlight that our model outperforms the competing models on unimodal segmentation, achieving average dice scores of 82.91%, 72.62%, and 54.80% for WT (the whole tumor), TC (the tumor core), and ET (the enhancing tumor), respectively. Finally, we further evaluate our model’s variable multi-modal brain tumor segmentation performance by introducing a fusion block (TFusion). The experimental results reveal that our model achieves the best WT segmentation performance for all 15 possible modality combinations with 87.31% average accuracy. In summary, we propose a curriculum disentanglement learning framework for unimodal segmentation with privileged semi-paired images. Moreover, the benefits of the improved unimodal segmentation extend to variable multi-modal segmentation, demonstrating that improving the unimodal segmentation performance is significant for brain tumor segmentation with missing modalities. Our code is available at https://github.com/scut-cszcl/SpBTS.

ПИТАННЯ СУЧАСНОЇ ЗБРОЇ МАСОВОГО УРАЖЕННЯ ПРИ ВИВЧЕННІ ЦИВІЛЬНОГО ЗАХИСТУ, БЕЗПЕКИ ЖИТТЄДІЯЛЬНОСТІ ТА ОХОРОНИ ПРАЦІ В ГАЛУЗІ

The article deals with the peculiarities of teaching issues about modern types of weapon of mass destruction in the study of civil protection, safety of life and labor protection in the industry, as a necessary element of improvement of the educational process in the conditions of a full-scale long-term war with the country-aggressor-terrorist Russian Federation. The peculiarities of layout and lecture material on biological and chemical weapons of mass destruction by their main components and specific topical examples of use against combatants and civilians are shown. The current state of strategic nuclear forces of the main countries of "Nuclear club" (United States, Russian Federation, People's Republic of China, France, The United Kingdom of Great Britain and Northern Ireland, India) and the main tactical and technical characteristics of their dry and marine components of "nuclear triad" as the most dangerous types Weapons that can lead to full-scale catastrophic consequences, including "Nuclear autumn" and "Nuclear winter", even to "local" use. It is stated that in 2021 the total expenses of the countries of the world for nuclear weapons have already reached $ 85 billion. In the first place in terms of expenses for maintaining its nuclear arsenal is the United States – $ 45 billion. The United States is planned to spend $ 550 billion in the 1922-2040 years. In the second place of the PRC, which spends up to $ 12 billion every year, and launched a long-term program of modernization and qualitative improvement of the nuclear arsenal. In the third place of the Russian Federation, which spends up to $ 9 billion on the maintenance and re-equipment of its strategic and tactical nuclear forces. The following are: UK – up to $ 7 billion; France – up to $ 6 billion; India – up to $ 2.5 billion; Israel – up to $ 1.5 billion; Pakistan – up to $ 1.2 billion; and DPRK – up to $ 0.7 billion. This nine actual "Nuclear club" member countries can have up to 24,000 nuclear and thermonuclear warlouses in its arsenal, the total explosion capacity of which is equivalent to the explosion force of more than 10 billion tons of TNT: the USA is ~ 11,000 warriors; Russian Federation – ~ 10 thousand warriors; China – ~ 1,5 thousand warriors; France – ~ 400 warriors; UK – ~ 250 warriors; Israel – ~ 200 warriors; India – ~ 200 warriors; Pakistan – ~ 165 warriors; DPRK – ~ 60 warriors. At the same time, only in the US and the Russian Federation together there are up to 21 thousand nuclear and thermonuclear warheads, the power of the explosion of many of which is much exceeding the power of the explosion of atomic bombs, dumped on 6 and 9 August 1945 by US aviation in Japanese cities of Hiroshima and Nagasaki. They also consider the possibility of preventive nuclear stroke "low -power" (<50 CT) of the battleships on command centers and strategic objects of the enemy for "only paralyzing damage".

Parallel Emergency Management of Incidents by Integrating OODA and PREA Loops: The C2 Mechanism and Modes

Given the differences of command and control (C2) activities between the field command center and the emergency operations center (EOC), this article combined the edge C2 theory with the parallel C2 theory, and proposed a parallel incident C2 mode based on the observe–orient–decide–act (OODA) loop and planning–readiness–execution–assessment (PREA) loop. The aim is to build up a PREA loop-based parallel incident C2 mode and its related operating mechanism of edge empowerment and energy release in parallel incident C2 mode. The parallel incident C2 mode based on the PREA loop and OODA loop supports the co-existence and connection of the two roles of the incident C2 agent at the emergency scene. The two roles are the executive role of emergency response and operation and the command and organization role of the edge emergency system. This article initiates a deep integration of two different C2 process mechanisms in the emergency response and operation process, taking into account the local emergency scene and the global emergency system. Taken together, a key issue has been well addressed regarding the contradiction that the traditional emergency response cannot be reconciled in terms of rapidity and thoroughness.

Hospital Capacity Command Centers: A Benchmarking Survey on an Emerging Mechanism to Manage Patient Flow.

Delayed hospital and emergency department (ED) patient throughput, which occurs when demand for inpatient care exceeds hospital capacity, is a critical threat to safety, quality, and hospital financial performance. In response, many hospitals are deploying capacity command centers (CCCs), which co-locate key work groups and aggregate real-time data to proactively manage patient flow. Only a narrow body of peer-reviewed articles have characterized CCCs to date. To equip health system leaders with initial insights into this emerging intervention, the authors sought to survey US health systems to benchmark CCC motivations, design, and key performance indicators. An online survey on CCC design and performance was administered to members of a hospital capacity management consortium, which included a convenience sample of capacity leaders at US health systems (N = 38). Responses were solicited through a targeted e-mail campaign. Results were summarized using descriptive statistics. The response rate was 81.6% (31/38). Twenty-five respondents were operating CCCs, varying in scope (hospital, region of a health system, or entire health system) and number of beds managed. The most frequent motivation for CCC implementation was reducing ED boarding (n = 24). The most common functions embedded in CCCs were bed management (n = 25) and interhospital transfers (n = 25). Eighteen CCCs (72.0%) tracked financial return on investment (ROI); all reported positive ROI. This survey addresses a gap in the literature by providing initial aggregate data for health system leaders to consider, plan, and benchmark CCCs. The researchers identify motivations for, functions in, and key performance indicators used to assess CCCs. Future research priorities are also proposed.

Economics of hydrogen energy of green transition in the world and Russia.Part I

Recently, the theme of the “green transition”, in which the economic and commercial prospects of the hydrogen industry play a leading role, in the global energy industry has attracted special attention from business, government and scientific circles in many countries, which is associated with its predicted impact, incl. due to the climate agenda, to the economic, technological and geopolitical redistribution of the energy map of the world at the global and regional levels. Some slowdown in the “green transition” is expected due to the need to overcome the global energy crisis in the next two or three years, which may turn out to be more serious than the crisis of the 1970s of the last century which will require eliminating the shortage of traditional non-renewable energy resources in the near future. Nevertheless, the “green transition”, in which hydrogen accents are intensifying, continues to be implemented, which will have a serious impact on the system of international and international economic relations in the world. Thanks to the financial support of the state and business, modern technologies of the entire hydrogen energy chain are actively developing, hydrogen markets are being formed in the conditions of inter-fuel competition, as well as hydrogen energy command centers at the global, regional, country and corporate levels.

The hyperthermic response to intra-preoptic area administration of agmatine in male rats

Agmatine is an endogenous biogenic amine that exerts various effects on the central nervous system. The hypothalamic preoptic area (POA, thermoregulatory command center) has high agmatine immunoreactivity. In this study, in conscious and anesthetized male rats, agmatine microinjection into the POA induced hyperthermic responses associated with increased heat production and locomotor activity. Intra-POA administration of agmatine increased the locomotor activity, the brown adipose tissue temperature and rectum temperature, and induced shivering as demonstrated by increased neck muscle electromyographic activity. However, intra-POA administration of agmatine almost had no impact on the tail temperature of anesthetized rats. Furthermore, there were regional differences in the response to agmatine in the POA. The most effective sites for the microinjection of agmatine to elicit hyperthermic responses were localized in the medial preoptic area (MPA). Agmatine microinjection into the median preoptic nucleus (MnPO) and lateral preoptic nucleus (LPO) had a minimal effect on the mean core temperature. Analysis of the in vitro discharge activity of POA neurons in brain slices when perfused with agmatine showed that agmatine inhibited most warm-sensitive but not temperature-insensitive neurons in the MPA. However, regardless of thermosensitivity, the majority of MnPO and LPO neurons were not responsive to agmatine. The results demonstrated that agmatine injection into the POA of male rats, especially the MPA, induced hyperthermic responses, which may be associated with increased BAT thermogenesis, shivering and locomotor activity by inhibiting warm-sensitive neurons.

Control of Autonomous Vehicles Via Multistage Linear Feedback Design

AbstractIn this paper, we show how autonomous vehicles performing a certain task can be controlled from one command center in order to achieve certain goals. The command center provides individual feedback gains to each vehicle in the form of one compounded feedback gain that in fact carries feedback gain information for each individual vehicle. Vehicles may be of different nature: satellites, cars, tanks, drowns, robots, unmanned aircraft, underwater vehicles, and ships. It is assumed that their dynamic is weakly coupled, namely, dynamics of each individual vehicle is weakly coupled to dynamics of all other vehicles and that they have the same control input. The weak coupling among the vehicles is represented either by physical interactions among vehicles or coordinating or communication signals. The results obtained are applicable to vehicles having different mathematical linear/linearized state space models. In the case when no interaction/coordination/communication among vehicles is present, and all feedback signals come from the command center (central controller) controller, the vehicle mathematical models can be identical. An important feature of the presented results is that different local feedback controllers can be facilitated for different vehicles using a unique global feedback controller signal designed by the command center. In this paper, we will consider cases of two and three vehicles, but the presented multistage feedback design methodology can be potentially extended to N vehicles. The presentation is done in continuous time. Similar derivations hold in the discrete-time domain.

Design and Development of ER MineTracer: A Mobile Emergency Response Application for Mining Industry

Most of the industries, especially mining companies, are facing nowadays an exciting future with growing demand as well as severe challenges. Several innovations in technology as well as in the organizational process and methods are developed in order to cope with the continuously advancing technologically-driven society and to address pressing issues that industries are facing, including emergency response-related problems. This study aimed to improve information access by developing ER MineTracer mobile emergency response application which combines web and mobile applications designed for reporters and rescuers in responding to employees’ emergency requests. It uses GPS to determine an employee’s current position and communicates the user’s name and present location straight to a web application installed in a command center for quick dispatching of emergency units. Descriptive-developmental research was employed in the study utilizing an object-oriented modeling tool in designing the ER MineTracer mobile application. Thirty (30) participants were purposefully chosen to assess the performance of the system and it was revealed that the developed ER MineTracer mobile application was efficient in terms of accessibility, accuracy, and usability. Hence, it is recommended to utilize ER MineTracer and optimize smartphones to assist individuals in saving lives during emergencies and accidents, especially in mining industries.

Implementation of a virtual and in-person hybrid hospital-at-home model in two geographically separate regions utilizing a single command center: a descriptive cohort study

BackgroundAs providers look to scale high-acuity care in the patient home setting, hospital-at-home is becoming more prevalent. The traditional model of hospital-at-home usually relies on care delivery by in-home providers, caring for patients in urban communities through academic medical centers. Our objective is to describe the process and outcomes of Mayo Clinic’s Advanced Care at Home (ACH) program, a hybrid virtual and in-person hospital-at-home model combining a single, virtual provider-staffed command center with a vendor-mediated in-person medical supply chain to simultaneously deliver care to patients living near an urban hospital-at-home command center and patients living in a rural region in a different US state and time zone.MethodsA descriptive, retrospective medical records review of all patients admitted to ACH between July 6, 2020, and December 31, 2021. Patients were admitted to ACH from an urban academic medical center in Florida and a rural community hospital in Wisconsin. We collected patient volumes, age, sex, race, ethnicity, insurance type, primary hospital diagnosis, 30-day mortality rate, in-program mortality, 30-day readmission rate, rate of return to hospital during acute phase, All Patient Refined-Diagnosis Related Groups (APR-DRG) Severity of Illness (SOI), and length of stay (LOS) in both the inpatient-equivalent acute phase and post-acute equivalent restorative phase.ResultsSix hundred and eighty-six patients were admitted to the ACH program, 408 in Florida and 278 in Wisconsin. The most common diagnosis seen were infectious pneumonia (27.0%), septicemia / bacteremia (11.5%), congestive heart failure exacerbation (11.5%), and skin and soft tissue infections (6.3%). Median LOS in the acute phase was 3 days (IQR 2–5) and median stay in the restorative phase was 22 days (IQR 11–26). In-program mortality rate was 0% and 30-day mortality was 0.6%. The mean APR-DRG SOI was 2.9 (SD 0.79) and the 30-day readmission rate was 9.7%.ConclusionsThe ACH hospital-at-home model was able to provide both high-acuity inpatient-level care and post-acute care to patients in their homes through a single command center to patients in urban and rural settings in two different geographical locations with favorable outcomes of low mortality and hospital readmissions.