Dangerous Emergencies Research Articles

Analysis of High-Risk Factors and Mortality Prediction of Ruptured Abdominal Aortic Aneurysm

Ruptured abdominal aortic aneurysms (RAAAs) are among the most dangerous emergencies in vascular surgery, with a high death rate and numerous risk factors influencing perioperative death. Therefore, identifying the critical risk factors for RAAAs is crucial to increasing their survival rate. Our aim was to identify those risk factors from a wide range of parameters. Retrospective analysis of hospitalised RAAA patients treated at this center between May 2004 and January 2023. After comparing the preoperative data of patients who survived and those who died, high-risk characteristics influencing the perioperative care of RAAA patients were identified, and logistic regression analysis was carried out. The mean follow-up time was 45.34 months. During the study period, a total of 155 patients (average age 67.4±71.93 years, 123 (78.85%)males, 32 (20.51%)females) were enrolled. The patients participating in the group were divided into survival group (n = 123) and death group (n = 27). The main differences included hemodynamic instability (51.9% vs 28.5%; P=0.019), sudden cardiac arrest (14.8% vs 1.6%; P=0.010), deterioration of consciousness (40.7% vs 17.1%; P=0.007), renal impairment (22.2% vs 2.4%; P=0.001), chronic kidney disease (18.5% vs3.2%; P=0.010). There is also a history of cancer (Ca) (18.5% vs 4.1%; P=0.021). Risk factors for Endovascular aneurysm repair (EVAR) include diastolic blood pressure ≤ 50 mmHg (36.4% vs 8.0%; P=0.025), renal function impairment (18.2% vs 0; P=0.015), and chronic kidney disease (27.3% vs 4.0%; P=0.028). Risk factors for open surgical repair (OSR) include diastolic blood pressure ≤ 50 mmHg (40.0% vs 6.3%; P=0.014). Finally, the above statistically significant factors were analyzed by Logistic regression analysis, and it was found that diastolic blood pressure ≤ 50mmHg, cardiac arrest, renal function damage and Ca history were independent risk factors. We followed 123 individuals and 14 were lost to follow-up, with an overall survival rate of 43.8%. Hemodynamics, which includes shock, blood pressure, cardiac arrest, deterioration of consciousness, and other conditions, are the primary risk factors for the perioperative death of a ruptured abdominal aortic aneurysm. Simultaneously, diastolic blood pressure ≤50mmHg was found to be associated with risk factors for OSR, whereas renal function impairment, chronic renal illness, and diastolic blood pressure ≤50mmHg were associated with risk for EVAR.

The Mutual Effect Study of Horizontal and Vertical Loads on the Elastic Tank Partially Filled with Liquid

Modern equipment elements in the energy, chemical industry, transport, aviation, and space engineering work under conditions of increased technological loads, at high temperatures and pressure levels. At the same time, the equipment is usually exposed to external loads of various natures. Hydroelastic phenomena must also be taken into account in designing and modernizing tanks and storage facilities for flammable and combustible substances. Flammable and combustible liquid accumulation leads to the increased environmental and fire hazard of such objects. The possible dangerous liquid leakage and tank depressurization negatively affect the surrounding area environment state. A fire in the tank is one of the most dangerous emergencies that could lead both to significant material and environmental damage and to human casualties. The paper treats the environmental hazards reducing problem from liquid hydrocarbon spills from storage tanks, which lead to destructive effects on all environment components especially during emergency situations. It has been established for sufficiently thin tank elastic walls, the fundamental frequency during coupled oscillations could be much lower than the frequency of the fluid in the shell with rigid walls. As the thickness of the tank wall increases, this effect becomes insignificant, and the lower oscillation frequency of the shell with liquid approaches the oscillation frequency of the liquid in a rigid tank. Parametric resonance and sub-resonance effects have been treated.

Chemotherapy of malignant tumors

The application of chemotherapy against malignant tumors might control the malignant disease but harbours many pitfalls. The chemotherapy type is chosen depending on the entity and stage of the tumor as well as on the patient's characteristics and fitness. Patients under therapy should be informed on the potential side effects and should be closely monitored by physicians, familiar with the common as well as the substance specific side effects of the drugs used. Preventive or timely application of supportive medication can prevent or diminish drug-induced toxicities. The attending physician has to be aware of the potential treatment-related emergency situations during application as well as several days after. One of the most common and dangerous emergencies that requires immediate medical attention is fever in neutropenia.The use of new medical drug classes, targeted molecular and immune therapies has changed and improved disease control in many tumor entities in a revolutionary manner. Overall, combination treatments including targeted drugs, immunotherapy and/or classical chemotherapy show improved efficacy in tumor control. These novel (combination) therapies may provoke different side effects that physicians need to be familiar with and take into account.

ТЕХНОЛОГИЯ МОНИТОРИНГА ПОДВИЖНОГО СОСТАВА НА ОСНОВЕ ДИСТАНЦИОННОГО АКУСТИЧЕСКОГО ЗОНДИРОВАНИЯ

The functionality of information-measuring systems for remote detection of faulty parts of the undercarriage of cars in motion is considered. The features of the use of fiber-optic cables laid along the railway tracks as sensors for detecting defects in the rolling stock and infrastructure of railway lines are evaluated. The functional features of the influence of external physical influences impact on the length of the reflected wave fiber Bragg gratings. The possibility of using remote acoustic sensing to determine defects in parts and assemblies of rolling stock while the train is in motion is shown, the possibilities of joint application of the remote acoustic sounding technology with axle counters and a wheel passage registration system are noted. An assessment of the conditions for ensuring the operability and adjustment of a distributed fiberoptic line of sensors for a railway section is proposed. A scheme for the planned placement of remote acoustic sounding devices at the training ground of the Belarusian Railways has been developed. The possibility of immediate detection of defective wheelsets with a maximum allowable value of sliders exceeding 1.0 mm, as well as a break in the side frame of a wagon bogie to prevent dangerous emergencies, has been established. A method is proposed for continuous monitoring of the technical condition of rolling stock in motion, providing increased control over the serviceability of parts and units of the rolling stock.

TLR4/NF-κB/TNFα and cAMP/SIRT1 signaling cascade involved in mediating the dose-dependent effect of cilostazol in ovarian ischemia reperfusion-induced injury

Background One of the most dangerous gynecological emergencies is ovarian ischemia that commonly occurs during surgical manipulation or presence of ovarian masses. Objectives finding new therapies to prevent the associated harmful effects of ischemia/reperfusion-induced damage is still a critical need. For the first time, we aimed to evaluate the possible role of phosphodiesterase (PDE) 3 A inhibitor (PDEI), cilostazol (CLZ) in the treatment of ovarian ischemia reperfusion induced damage (OIR). Methods Rats were divided into five groups; sham, OIR group; CLZ (5, 10, 20 mg/kg) was given orally with induced OIR. Different biochemical parameters were detected such as total anti-oxidant capacity (TAC), reduced glutathione (GSH), malondialdehyde (MDA), cyclic adenosine monophosphate (cAMP), sirtuin1 (SIRT1), toll like receptor 4 (TLR4), nuclear factor kappa b (NF-κB) and tumor necrosis factor alpha (TNFα). In addition, histopathological features, ovarian weight changes and casapse3 immunoexpression were detected. Results Data revealed significant increase in ovarian weight changes, MDA, TLR4, TNFα, NF-κB and caspase 3 expressions in OIR induced group. Moreover, OIR group had histopathological features of ovarian damage with depletion of cAMP, SIRT1, TAC and GSH. Conclusion CLZ could ameliorate OIR-induced damage due to PDE inhibition, anti-oxidant, anti-inflammatory and anti-apoptotic properties with modulation of TLR4/NF-κB/TNFα and cAMP/SIRT1 signaling pathways.

Assessment of factors of technogenic and environmental risks at paticular stages of the life cycle of oil and gaswells

The conditions of ecologically dangerous emergencies in the oil and gas industry have been investigated in the work. The high degree of environmental risk that is present in case of emergency requires measures to prevent their occurrence.To improve the environmental risk management system in the oil and gas industry, a comprehensive study of both internal technological processes and the state of equipment, as well as external influences has been conducted. The analysis of the causes of emergency oil and gas fountains at different stages of the life cycle of oil and gas wells have been carried out. The factors preceding the occurrence of gas-oil-water manifestations and open fountains in more than 100 wells in different conditions of their operation are given. Factors are grouped into separate areas and the most influential are highlighted. The main types of environmental hazards that occur during emergency oil and gas fountains have been identified.

A Survey of Emergencies Management Systems in Smart Cities

The rapid urbanization process in the last hundred of years has deeply changed the way we live and interact with each other. As most people now live in urban areas, cities are experiencing growing demands for more efficient and sustainable public services that may improve the perceived quality of life, specially with the anticipated impacts of climatic changes. In this already complex scenario with increasingly overcrowded urban areas, different types of emergency situations may happen anywhere and anytime, with unpredictable costs in human lives and properties damages. In order to cope with often unexpected and potentially dangerous emergencies, smart cities initiatives have been developed in different cities, addressing multiple aspects of emergencies detection, alerting, and mitigation. In this scenario, this article surveys recent smart city solutions for crisis management, proposing definitions for emergencies-oriented systems and classifying them according to the employed technologies and provided services. Additionally, recent developments in the domains of Internet of Things, Artificial Intelligence and Big Data are also highlighted when associated to the management of urban emergencies, potentially paving the way for new developments while classifying and organizing them according to different criteria. Finally, open research challenges will be identified, indicating promising trends and research directions for the coming years.

Foreign Body (Safety Pin) in Airway in a 2-month-old Baby

Respiratory tract foreign bodies are most dangerous emergencies in children. There are various types of foreign bodies removed from airway like-peanuts, metallic foreign bodies, sharp foreign bodies, led bulbs and different part of toys. Most commonly they present with proper history of aspiration and symptoms of respiratory distress, but not always. It should be diagnosed immediately either with the history and clinical examination or with the help of radiological investigations. High resolution computed tomography of chest gives the exact location of the foreign body. These patients should be managed promptly to reduce the morbidity and mortality. Rigid bronchoscopy with optical forceps under general anaesthesia is the procedure of choice to retrieve the foreign bodies. We are presenting a case of 2 months old child which has aspirated a safety pin into her airway accidentally. The location was confirmed by HRCT chest and it was removed using optical forceps. Child was discharged under stable conditions.

Revisiting the gender-relations debate in the violent murder of Kitty Genovese: Another side of gender-bias favoring women in bystander reactions to emergencies

The murder of Catherine (Kitty) Genovese in New York in 1964 by Winston Moseley has generated numerous academic publications. One of the major focal points in the debates is the role of gender in bystanders' reactions to violent incidents. Some analysts drew on experiments that found that men did not intervene in incidents involving a man as a perpetrator and a woman as a victim to explain the lack of intervention in the incident by the so-called 38 bystanders falsely reported by The New York Times in 1964. This current article analyzed three videos containing four different assaults that occurred on the busy streets of Argentina, the United States and the United Kingdom to assess whether the gender of the perpetrators and victims affected bystanders' reactions or not. In Incident 1 and Incident 2 involving men as perpetrators with female victims, none of the male and female bystanders physically intervened. In Incident 3 involving a man as a perpetrator and a woman as his victim, both male and female bystanders intervened to save the victim. However, in Incident 4 involving a woman as a perpetrator with a male victim, nobody intervened instead, some of the bystanders laughed at the male victim. The article concludes that whilst gender seemed to have determined intervention in Incident 3 (saving a female victim from a violent man) and its lack in Incident 4 (leaving a male victim to save himself from a violent woman), other factors could be responsible for lack of intervention in Incident 1 and Incident 2 and these include the duration of the assault, the level of violence applied by the perpetrator and bystanders' perception of their own safety. The implications of the bystanders' reactions were highlighted. • Gender does not always affect bystanders' reactions to physical assaults. • Bystanders are more sympathetic of female victims of physical assault than male victims. • Dangerous emergencies do not always affect diffusion of responsibility as extant research suggests.

Methods for calculating the reliability of power supply systems

The aim was to determine the reliability indicators of a power supply system using an artificial neural network model. A model for calculating technical reliability was developed using the following methods: an algorithm for calculating reliability indicators of power supply systems, the method of failure rate of a power supply system and a forecasting model using artificial neural networks. It was established that a power supply system is formed by an open radial power supply circuit. The failure rate of the power supply subsystem was determined by calculating the failure rate of i-th element of the subsystem. As a result of calculating the probability of failure-free operation of the subsystem for various conditions (5 time intervals), it was found that with an increase in the operating time from 100 to 500 h, a linear increase in the rate of system failures occurs from 0.0051 to 0.0073 1/h. A comparison of the obtained mean-to-failure values of the main and the same backup subsystem in the unloaded mode with an absolutely reliable switch (269.62 h) with the main and the same backup subsystem in the loaded mode (202.21 h) was carried out. The results differ by 67.41 h, which indicates a higher degree of reliability of the first method. The software package Prognoz_INS_2020 was developed. An acceptable accuracy of no more than 2.17% was obtained by comparing the results of the conventional calculation of the failure rate of power supply systems and using the Prognoz_INS_2020 software package. This indicates the efficiency of the proposed software package in reliability calculations at operating energy enterprises. The proposed methods for assessing technical reliability both using the conventional model and a model based on an artificial neural network made it possible to assess the state of power supply systems, which helps to prevent dangerous emergencies.

HISTORY TEACHES: SOME ASPECTS OF THE APPLICATION OF THE LEGAL REGIMES OF WAR AND SIEVE IN THE PERIOD OF THE GREAT PATRIOTIC WAR OF 1941-1945

The article attempts to give a short but objective assessment of the activities of Soviet state bodies during the Great Patriotic War on the formation and development of the legal basis for the functioning of the military organization of the state and its further restructuring in a military manner to ensure victory over the enemy. The relevance of the study is determined by the urgent need to study the emergency legislation that regulates, with the outbreak of hostilities or during a threatened period, relations in the field of organizing the armed defense of the state, since war is inherently one of the most dangerous emergencies for society. From the standpoint of the principle of historicism, the article reveals the legal structure of such legal phenomena of wartime as martial law and siege regimes. The specific historical reasons for the establishment of these extraordinary legal regimes, their content and characteristics are briefly shown. Based on historical sources, the article substantiates the conclusion that the purpose of introducing the regimes under consideration is to ensure the protection of the constitutional order and the security of citizens by creating conditions for repelling or preventing aggression, as well as for eliminating the consequences of armed confrontation. With the help of the legal regimes of martial law and the state of siege, which acted as constituent elements of the mechanism for ensuring the military security of the state, during the Great Patriotic War, the protection of the country’s territorial integrity was ensured, its sovereignty was preserved, and a complete military victory over the enemy was achieved. In conclusion, the authors formulate some conclusions and recommendations aimed at improving the modern Russian emergency military legislation.

A fuzzy analytic hierarchy process-TOPSIS framework for prioritizing emergency in a petrochemical industry

Background: Petrochemical industry has experienced a variety of accidents and the number of emergency situation in this industry is high. Therefore, prioritizing these situations is important. The aim of this study was to determine the effective criteria for the selection of emergency scenario and prioritize them for corrective actions. Subjects and Methods: Delphi technique was used to determine and prioritize the appropriate criteria for the selection of high-risk emergency scenarios. Then, the weights of selected criteria were obtained using fuzzy hierarchical analysis and finally, using the fuzzy TOPSIS technique, the criteria for emergency scenarios were prioritized for corrective actions. Results: The most important criteria for the selection of dangerous emergencies included the amount of loss, damage, and probability. According to the weight of these criteria, emergency situations were prioritized. The most important emergencies included fire in the chemical storage, hydrogen leakage at the cylinder fitting in the Alfin unit, and extreme gas leakage in one of the power plant turbines. Conclusions: Using this approach, high-priority emergencies can be identified, and it is suggested that planning for controlling these situations and preventing crises should be prioritized by managers.

Rethinking the Bystander Effect in Violence Reduction Training Programs

AbstractMany violence prevention programs include a focus on the role of bystanders and third parties in violence prevention training. Central to this work has been the classic social psychological research on the “bystander effect”. However, recent research on bystander behavior shows that the bystander effect does not hold in violent or dangerous emergencies. Meta‐analyses of the literature show that the presence of others can facilitate as well as inhibit intervention in emergencies. Studies of real‐life bystander behavior captured on CCTV cameras shows that some bystander intervention is the norm and that the likelihood of bystanders being victimized is low. One reason for the limited effectiveness of violence reduction programs may be their approach to bystanders. We argue that violence reduction programs should: recognize that some intervention is likely (although it may not always be successful); see the group as a route to successful intervention rather than a threat to the likelihood of any single individual becoming an intervener; inform bystanders of the real risks of victimization; utilize the power of social relations between bystanders, victims, and perpetrators to enhance successful intervention; seek to deliver bystander intervention training in situ, rather than away from the context of the aggression or violence.

Monitoring infrastructure facilities of territories in agricultural sector

The paper is devoted to topical issues of monitoring infrastructure facilities. The aim of the study is to compare the already established traditional method of ground-based laser scanning and its aerial analogue based on the use of compact drones in collecting data on road structures. The question was raised about the possible ways to modernize the existing monitoring procedure for the timely detection and prevention of dangerous emergencies at engineering structures. The most effective technologies for obtaining comprehensive information on the technical condition of such structures are analyzed. It was determined that the most rational method from the point of view of information content, mobility and examination time is the method of using airborne laser scanners in conjunction with unmanned small-sized aircraft. The procedure of the entire cycle of obtaining information, including its subsequent processing, is described. The analysis of stationary and other applied methods of monitoring infrastructure facilities is made, their advantages and disadvantages are described. A question was raised about the prospect of creating software that uses artificial neural networks as a means of automating the processes of subsequent processing of primary scan data and analysis of the obtained object model. Conclusions are made about the appropriateness and prospects of using similar tools and methods for the needs of monitoring engineering infrastructure facilities, as well as the need for further development of software that will automatically analyze the accumulated data on the same infrastructure object.

Caring collectives and other forms of bystander helping behavior in violent situations

Social science research has traditionally described bystanders in violent emergencies as being passive. Recent evidence, however, stresses that bystanders typically intervene proactively and successfully in violent, dangerous emergencies. This article examines the multiple ways bystanders act in situations of violence, with the aim of moving beyond the understanding of bystanders as being either passive or active. Based on a qualitative analysis of surveillance camera recordings of urban public assaults, the study maps different types of bystander behaviors as they unfold in real-life violent events. The first part of the analysis is summarized in a typology that covers three types of bystander action: distancing, ambivalence, and involvement. The second part shows that the involvement action also unfolds through coordinated interactions between the bystanders, what the article characterizes as a ‘caring collective.’ This interactional aspect of bystander involvement has rarely been examined in the bystander literature, which tends to focus on individual bystander actions and motivations.

On the Actual Risk of Bystander Intervention

Objectives: Bystander studies have rarely considered the victimization risk associated with intervention into violent, dangerous emergencies. To address this gap, we aim to identify factors that influence bystanders’ risk of being physically victimized. Method: We observed bystander behavior from video surveillance footage of naturally occurring violence in nighttime economy settings, and data were analyzed with a logistic regression model. Results: Data show that approximately one of the six interventions results in some type of victimization, typically with a relatively low degree of severity. The bystander’s social group membership, the setting of the emergency, and the bystander’s intervention type are estimated as risk factors for victimization. Conclusions: Previous research suggests that a bystander’s social group membership with victims promotes intervention behavior. Our results expand the role of social group membership as being a factor that also influences whether the intervening bystander is victimized.

A First Look at Power Attacks in Multi-Tenant Data Centers

Oversubscription increases the utilization of expensive power infrastructure in multi-tenant data centers, but it can create dangerous emergencies and outages if the designed power capacity is exceeded. Despite the safeguards in place today to prevent power outages, this extended abstract demonstrates that multi-tenant data centers are vulnerable to well-timed power attacks launched by a malicious tenant (i.e., attacker). Further, we show that there is a physical side channel -- a thermal side channel due to hot air recirculation -- that contains information about the benign tenants' runtime power usage. We develop a state-augmented Kalman filter that guides an attacker to precisely time its power attacks at moments that coincide with the benign tenants' high power demand, thus overloading the designed power capacity. Our experimental results show that an attacker can capture 53% of all attack opportunities, significantly compromising the data center availability.

A focused review of the pathogenesis, diagnosis, and management of tumor lysis syndrome for the interventional radiologist.

The tumor lysis syndrome (TLS) is one of the most frequently encountered and dangerous oncologic emergencies.1 TLS describes a constellation of laboratory and clinical findings resulting from the rapid breakdown of tumor cells releasing their intracellular contents into the systemic circulation. It occurs most commonly in hematologic malignancies at the start of antineoplastic therapy, but has also been reported in a broad variety of solid organ malignancies, as well as occurring spontaneously without chemotherapy.2 3 4 5 As a potentially fatal oncologic emergency, it is imperative to identify patients at risk for early preventative therapy, understand the pathophysiology and consequences of this syndrome, and recognize the clinical and laboratory manifestations of TLS to ensure timely and appropriate treatment.

Trajectory Management of the Unmanned Aircraft System (UAS) in Emergency Situation

Unmanned aircraft must be characterized by a level of safety, similar to that of manned aircraft, when performing flights over densely populated areas. Dangerous situations or emergencies are frequently connected with the necessity to change the profiles and parameters of a flight as well as the flight plans. The aim of this work is to present the methods used to determine an Unmanned Aircraft System’s (UAS) flight profile after a dangerous situation or emergency occurs. The analysis was limited to the possibility of an engine system emergency and further flight continuing along a trajectory of which the shape depends on the type of the emergency. The suggested method also enables the determination of an optimal flying trajectory, based on the territory of a special protection zone (for example, large populated areas), in the case of an emergency that would disable continuation of the performed task. The method used in this work allows researchers, in a simplified way, to solve a variation task using the Ritz–Galerkin method, consisting of an approximate solution of the boundary value problem to determine the optimal flight path. The worked out method can become an element of the on-board system supporting UAS flight control.

Uterine Rupture in the Second Trimester of Pregnancy as an Iatrogenic Complication of Laparoscopic Myomectomy

Uterine rupture is one of the most dangerous obstetric emergencies carrying a high risk for the mother and the fetus. Reports about uterine rupture in pregnancy following previous laparoscopic surgery have not been frequent; however, an increasing rate of the occurrence of this complication has been observed and reviewed in contemporary literature. We report a case of a spontaneous uterine rupture at 22 weeks of gestation in a 25-year old primigravida, who had had a laparoscopic removal of a small, peduncular, asymptomatic myoma located in the right uterine horn 20 months earlier. Ultrasound examination and subsequent urgent laparotomy confirmed a spontaneous uterine rupture with a nonviable fetus in the peritoneal cavity. Women planning to become pregnant should be qualified for laparoscopic myomectomy with special carefulness. Special attention must be paid to the potential solutions that limit the risk of postoperative uterine rupture, if the absolute necessity for the enucleation of myomas during the reproductive age occurs and a decision about laparoscopic intervention is made.