Emergency Route Research Articles

Vascular surgery receipt and outcomes for people with serious mental illnesses: Retrospective cohort study using a large mental healthcare database in South London

ObjectiveVascular surgery can be common among people with serious mental illness (SMI) given the high prevalence of cardiovascular disease. However, post-operative outcomes following vascular surgery have received little investigation, particularly in a subpopulation of SMI. MethodsWe conducted a retrospective observational study using data from the South London and Maudsley NHS Foundation Trust (SLaM) via its Clinical Record Interactive Search (CRIS) platform and linkage with Hospital Episode Statistic (HES). Vascular surgery recipients were identified using OPCS version 4 codes. Length of stay (LOS) was modelled using Incidence Rate Ratios (IRRs), and 30-day emergency hospital readmissions using Odds Ratios (ORs) for people with SMI compared with the general population. ResultsVascular surgery was received by 152 patients with SMI diagnoses (schizophrenia, schizoaffective disorder, bipolar disorder) and 8821 catchment residents without any mental health conditions. People with active SMI symptoms more likely to be admitted to hospital via emergency route OR: 1.80 (95% CI: 1.06, 3.07) and more likely to stay longer in the hospital for vascular surgery IRR: 1.35 (1.01, 1.80) and more likely to be readmitted to hospital via emergency route within 30 days OR: 1.53 (1.02, 2.67). People with SMI who had major open vascular surgery and peripheral endovascular surgery more likely to have worse post-operative outcomes. ConclusionOur study highlights the risks faced by people with SMI following vascular surgery. These suggest tailored guidelines and policies are needed, based on the identification of pre-operative risk factors, allowing for focused post-vascular surgery care to minimise adverse outcomes.

Fire safety and emergency evacuation guidelines for intensive care units and operating theatres: for use in the event of fire, flood, power cut, oxygen supply failure, noxious gas, structural collapse or other critical incidents: Guidelines from the Association of Anaesthetists and the Intensive Care Society.

The need to evacuate an ICU or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: Not only is there a risk that patients may come to harm but also that staff may be injured and unable to work. Designing newly-built or refurbished ICUs and operating theatre suites is an opportunity to incorporate mandatory fire safety features and improve the management and outcomes of such emergencies: These include well-marked manual fire call points and oxygen shut off valves (area valve service units); the ability to isolate individual zones; multiple clear exit routes; small bays or side rooms; preference for ground floor ICU location and interconnecting routes with operating theatres; separate clinical and non-clinical areas. ICUs and operating theatre suites should have a bespoke emergency evacuation plan and route map that is readily available. Staff should receive practical fire and evacuation training in their clinical area of work on induction and annually as part of mandatory training, including 'walk-through practice' or simulation training and location of manual fire call points and fire extinguishers, evacuation routes and location and operation of area valve service units. The staff member in charge of each shift should be able to select and operate fire extinguishers and lead an evacuation. Following an emergency evacuation, a network-wide response should be activated, including retrieval and transport of patients to other ICUs if needed. A full investigation should take place and ongoing support and follow-up of staff provided.

IMPROVED PARTICLE SWAM OPTIMIZATION FOR CROWD SIMULATION USING HYBRID AGENT REINFORCEMENT LEARNING ALGORITHM

In an emergency route planning technique, simulating the dynamic crowd has route capacity constraints and global target of evacuating all crowd evacuees. To stimulate the crowd, the new arena is developed to know the real-time situation to face the crowd evacuation on exit point. The crowd evacuation is done with the process of Hybrid Agent Reinforcement Learning (HARL) algorithm consisting of Improved Multi-Agent Reinforcement Learning (IMARL) and State-Action-Reward-State-Action (SARSA). In the proposed work, the appropriate route selection mechanism focused on finding optimum evacuation route(s) is done in the first phase. Dynamic crowd can also be evacuated to find its way with the support of the HARL process in the second phase. The proposed HARL method can also be implemented with multi-objective improved particle swarm optimization (IPSO) technique for crowd simulation. The experimented results demonstrate the effectiveness of stability in the HARL process, which provides an improved performance for crowd simulation

Optimising an Infusion Protocol Containing Cefepime to Limit Particulate Load to Newborns in a Neonatal Intensive Care Unit.

Background: In neonatal intensive care units (NICUs), the simultaneous administration of drugs requires complex infusion methods. Such practices can increase the risk of drug incompatibilities resulting in the formation of a particulate load with possible clinical consequences. Methods: This paper evaluates strategies to reduce the particulate load of a protocol commonly used in NICUs with a potential medical incompatibility (vancomycin/cefepime combination). The protocol was reproduced in the laboratory and the infusion line directly connected to a dynamic particle counter to evaluate the particulate matter administered during infusion. A spectrophotometry UV assay of cefepime evaluated the impact of filters on the concentration of cefepime administered. Results: A significant difference was observed between the two infusion line configurations used in the NICU, with higher particulate load for cefepime infused via the emergency route. There was no change in particulate load in the absence of vancomycin. A filter on the emergency route significantly reduced this load without decreasing the cefepime concentration infused. Preparation of cefepime seemed to be a critical issue in the protocol as the solution initially contained a high level of particles. Conclusion: This study demonstrated the impact of a reconstitution method, drug dilution and choice of infusion line configuration on particulate load.

Evaluation of TSP for Emergency Routing

The paper considers the symmetric traveling salesman problem and applies it to sixty-four (64) districts of Bangladesh (with geographic coordinates) as a new instance of the problem of finding an optimized route in need of emergency. It approached three different algorithms namely Integer Linear Programming, Nearest-neighbor, and Metric TSP as exact, heuristic, or approximate methods of solving the NP-hard class of problem to model the emergency route planning. These algorithms have been implanted using computer codes, used IBM ILOG CPLEX parallel optimization, visualized using Geographic Information System tools. The performance of these algorithms also has been evaluated in terms of computational complexity, their run-time, and resulted tour distance using exact, approximate, and heuristic methods to find the best fit of route optimization in emergence thus contributing to the field of combinatorial optimization.

First-Time Diagnosis After an Emergency Presentation in Children With Cancer.

To determine the prevalence rate of cancer diagnoses by an emergency route, the related risk factors and whether the emergency diagnosis was associated with poorer outcome. Retrospective observational study with identification of patients diagnosed at the Pediatric Oncology Unit of "Sapienza" University between 2008 and 2018. The percentage of patients who received a first-time diagnosis after an emergency presentation was determined. Two-year survival and clinical factors, such as sex, age and histology, associated to emergency presentation were evaluated. Of 207 patients (109 girls and 98 boys; median age, 120 months), with a first-time diagnosis of solid tumor, 5.8% were diagnosed during an emergency admission after a median latency time of 2.5 days. Cases with an emergency diagnosis were younger compared with those who were diagnosed electively (median age, 30 months vs 120 months, P < 0.005). Higher prevalence rate of emergency presentation was detected in patients with lymphoma compared with those with no lymphoma disease (28.6% vs 4.1%; P < 0.0001). All patients were managed to overcome their emergency presentation, 33.3% of these died later. No statistically significant difference for 2-year overall survival was found between patients with an emergency diagnosis and those with elective diagnosis (66.7% vs 81.0%; odds ratio, 2.1; confidence interval, 0.6-7.5; P = 0.22). A minor but not negligible number of pediatric patients come to a first-time diagnosis of cancer as result of a life-threatening event; risk factors were younger age and lymphoma disease. The emergency event can be successfully treated, and it was not related to a poorer survival.

Federal-State Partnership: How the Federal Government Should Better Support Its State Unemployment Insurance Offices in Times of Crisis

In March 2020, the COVID-19 pandemic caused millions of people to lose their jobs and become dependent on unemployment benefits. State unemployment offices were not prepared for this sudden onslaught of claims. Offices could not increase staffing levels because they were not given money by the federal government to do so. As offices were overwhelmed, a scammer group named Scattered Canary took this opportunity to fraudulently claim millions of dollars from several states. Because the federal government supplies administrative funds to states based on average previous need, the system is not designed to support states’ increased needs during sudden economic downturns. This Note argues that the federal government should allot a portion of money within the currently existing Federal Unemployment Fund to create a source of emergency money for states during emergencies. These funds would provide as-requested grants to states to increase staffing more quickly than would otherwise be possible through existing emergency routes. Through the creation of this fund, the federal government would fulfill its part of the federal-state partnership and prevent widespread harm to states during economic crises.

Proposal a road recovery method Considering the Number of Selection for Emergency Route and Restoration Date: A Case Study of Road Recovery Plan in Kochi Prefecture

Proposal a road recovery method Considering the Number of Selection for Emergency Route and Restoration Date: A Case Study of Road Recovery Plan in Kochi Prefecture

A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London.

Patients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health outcomes for vascular surgical patients. A retrospective observational study was conducted using data from a large mental healthcare provider and linked national hospitalization data for the same south London geographic catchment. OPCS-4 codes were used to identify vascular procedures. Health outcomes were compared between those with/without depression including length of hospital stay (LOS), inpatient mortality, and 30day emergency hospital readmissions. Predictors of these health outcomes were also assessed. Vascular surgery was received by 9,267 patients, including 446 diagnosed with depression. Patients with depression had a higher risk of emergency admission for vascular surgery (odds ratio [OR] 1.28; 1.03, 1.59), longer index LOS (IRR 1.38; 1.33-1.42), and a higher risk of 30-day emergency readmission (OR 1.82; 1.35-2.47). Patients with depression had higher inpatient mortality after adjustment for sociodemographic status (1.51; 1.03, 2.23) but not on full adjustment, and had longer emergency readmission LOS (1.13; 1.04, 1.22) after adjustment for sociodemographic factors and cardiovascular disease. Correlates of vascular surgery hospitalization among patients with depression included admission through emergency route for longer LOS, inpatient mortality, and 30-day hospital readmission. Patients with depression undergoing vascular surgery have substantially poorer health outcomes. Screening for depression prior to surgery might be indicated to target preventative measures.

Route Selection and Disaster Risk Evaluation in the Whole Shikoku Region Starting from Takamatsu, Kagawa Assumed Immediately After the Catastrophe

In order to fulfill the purpose of logistic support for transporting commodities from Kagawa to other prefectures in Shikoku at the catastrophe, the characteristics of an existing emergency routes were clarified. Morever, alternative route selections to avoid the tsunami, landslide and liquefaction of the ground damage caused by the Nankai metathrust earthquakes were examined, and it revealed the disater risks included in the selected route quantitatively. In mountain areas, the necessity to develop the widely-enough roads which are expected to be transported by the large trucks was indicated because current road network has narrow parts intermittently. From the route selection results under multiple scenarios, the importance of considering by comprehensively judging the relationship among ensuring safety, extending the total distance to the destination and making a decision were indicated in case of emergency response.

Dynamic emergency route planning for major chemical accidents: Models and application

Combining scenario construction with the characteristics of individual emergency behavior is necessary for the emergency route planning of major chemical accidents. We investigated this challenging decision problem and constructed a multi-indicator emergency risk assessment method that considers the evacuation speed of different population types and health consequences caused by various risk components. We also designed a modified Dijkstra algorithm to solve this dynamic multi-objective route planning problem. The comparative experiment results demonstrated that the proposed algorithm performs relatively better than the traditional Dijkstra algorithm. Finally, we performed extensive case studies where our simulation results demonstrate that the proposed model provides reliable and practical emergency route planning services for various personnel types under different accident scenarios. Compared with the commonly used single-dimensional assessment method, this comprehensive and informative assessment of the emergency risks faced by the population in different regions could serve as a useful reference for the formulation and implementation of emergency plans in case of major chemical accidents.

Genomic Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2, Colombia.

Coronavirus disease (COVID-19) in Colombia was first diagnosed in a traveler arriving from Italy on February 26, 2020. However, limited data are available on the origins and number of introductions of COVID-19 into the country. We sequenced the causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from 43 clinical samples we collected, along with another 79 genome sequences available from Colombia. We investigated the emergence and importation routes for SARS-CoV-2 into Colombia by using epidemiologic, historical air travel, and phylogenetic observations. Our study provides evidence of multiple introductions, mostly from Europe, and documents >12 lineages. Phylogenetic findings validate the lineage diversity, support multiple importation events, and demonstrate the evolutionary relationship of epidemiologically linked transmission chains. Our results reconstruct the early evolutionary history of SARS-CoV-2 in Colombia and highlight the advantages of genome sequencing to complement COVID-19 outbreak investigations.

IDENTIFIKASI BANGUNAN KUMUH YANG MEMPENGARUHI KUALITAS LINGKUNGAN PERMUKIMAN TAMANSARI KOTA BANDUNG

The density of urban settlements has resulted in poor visualization of the city, the need to improve the quality of buildings and rearrangement of the area which aims to improve the quality of visualization of the face of the city of Bandung for the better. Moreover, the area is located near one of Bandung's landmarks, namely the Pasopati bridge which is also an access to the city of Bandung. The high price of land and building materials causes a very dense residential environment, every existing land will be built as much as possible with bad construction values, of the many slum settlements in Bandung City, Tamansari is one of the settlements that are still slum. The buildings in the Tamansari area have various forms, the building area is relatively narrow and the material is minimal, and the construction is minimal. The tightness of the building distance makes road access in this area very narrow so that it cannot be used for evacuation routes and other emergency routes, another result of the density of the building is a lack of green open space or public facilities. This is what makes the visualization of this area worse and if you look at it from above the Pasopati bridge. The Pasopati Bridge is a bridge that stretches over this village and has become one of the city's icons, a bridge that connects the Pasteur area which is one of the access points to Bandung City to the center of Bandung City and across an area that has history and has even become an icon of the city of Bandung, namely Satay tower. This makes observers interested in researching slum buildings that have been built for a long time. The purpose of this study is to determine the level of slums on the banks of the Cikapundung river which is clearly visible from the bridge which is the access to the city gate of Bandung.

Recent Advances in Glycerol Catalytic Valorization: A Review

Once a biorefinery is ready to operate, the main processed materials need to be completely evaluated in terms of many different factors, including disposal regulations, technological limitations of installation, the market, and other societal considerations. In biorefinery, glycerol is the main by-product, representing around 10% of biodiesel production. In the last few decades, the large-scale production of biodiesel and glycerol has promoted research on a wide range of strategies in an attempt to valorize this by-product, with its transformation into added value chemicals being the strategy that exhibits the most promising route. Among them, C3 compounds obtained from routes such as hydrogenation, oxidation, esterification, etc. represent an alternative to petroleum-based routes for chemicals such as acrolein, propanediols, or carboxylic acids of interest for the polymer industry. Another widely studied and developed strategy includes processes such as reforming or pyrolysis for energy, clean fuels, and materials such as activated carbon. This review covers recent advances in catalysts used in the most promising strategies considering both chemicals and energy or fuel obtention. Due to the large variety in biorefinery industries, several potential emergent valorization routes are briefly summarized.

Cluster-based location service schemes in VANETs: current state, challenges and future directions

Vehicular Ad hoc Networks (VANETs) have drawn incredible interest in both academic and industrial sectors due to their potential applications and services. Vehicles’ position plays a significant role in many location-based applications and services such as public emergency, vehicles tracking, resource discovery, traffic monitoring and position-based routing. A location service is used to keep up-to-date records of current positions of vehicles. However, locating vehicles’ positions and maintaining an accurate view of the entire network are quite challenging tasks due to the high number of nodes, and high and fast nodes mobility which results in rapid topological changes and sudden network disconnections. In the past literature, various location-based services have been proposed to solve the above mentioned issues. Moreover, the cluster-based location service schemes have gained a growing interest due to their advantages over non-cluster-based schemes. The cluster-based schemes improve the network scalability, reduce the communications overhead and resolve the mobility issues within the clusters preventing them from propagating in the whole network. Therefore, this paper presents the taxonomy of the existing location service schemes, inspects the cluster-based location service by highlighting their strengths and limitations, and provides a comparison between location-based clustering and application specific clustering such as the one used in routing, information dissemination, channel access management and security. In addition, the existing clustering schemes, challenges and future directions for efficient cluster-based location service are also discussed.

Promoting built-for-disaster-purpose mobile applications: An interdisciplinary literature review to increase their penetration rate among tourists

This study focuses on the promotion and use of tourist-oriented built-for-disasterpurpose mobile applications. The investigation relies on two trends that are characterizing modern societies. The first trend refers to the fact that recently, rapidly, and worldwide, the number of mobile applications users increased. The second trend refers to the fact that, worldwide, international tourism demand highly increased from the beginning of the 1960s to the mid-years of 2010s. These travelers are also users of mobile applications, and they use apps for several reasons, including those related to security/emergency issues. International travelers may need information such as risks at the destination, warnings, shelter locator services, emergency routes information, and traveler telephone hotline to be used in the case of earthquakes, tsunamis, infectious diseases, or other disasters. We considered the role of built-for-disasterpurpose mobile applications as a tool to provide information to tourists, increase their risk-awareness, and improve their disaster-preparedness. Previous studies suggest that these tools may have a high impact in that sense. However, the number of users informed about these applications tends to be very low. We systematically reviewed interdisciplinary academic contributions to analyze research on apps-users’ intention to adopt mobile applications. Findings suggest opportunities for future tourism-oriented studies aiming at increasing the number of users of built-for-disasters mobile applications. In particular, we provide a research agenda taking into consideration the geographical spread of the studies, the used research techniques, and the adopted theories.

Flight reconfiguration system – an emergency system of the future

PurposeThis paper aims to describe the idea and partial result of research on flight reconfiguration system (FRS) which is to be used in case of pilot incapacitation while performing the single-pilot operations for defining and guiding an aircraft to a safe destination.Design/methodology/approachMultiple problems with the development of emergency systems which could deal with crisis on-board occurs, e.g. definition of emergency destination which is dealing with the thread, ensuring that route to an emergency destination is safe, avoiding of air traffic and making sure that aircraft performance limitations would not be exceeded. FRS is a sophisticated hardware design, gathering data from aircraft on-board systems, commanding autopilot where to go and informing air traffic on crisis on-board. Developed algorithm analyzes data from onboard systems, internal database to calculate potential safe places and best routes to them. Multi-criteria decision-making is used to choose the best of them and execute it when needed.FindingsAlgorithms and hardware were tested in a simulated environment. An exemplary research experiment oriented on finding emergency destination and flying to it in the Software-In-The-Loop environment was presented.Research limitations/implicationsCurrently, the use of the system is limited to use on-board of well-equipped CS-23 class aircraft and is limited to use in good weather conditions.Practical implicationsThe use of FRS will in case of emergency constitute a new category of emergency maneuver, used for dealing with no-human pilot available on-board situations – autonomous emergency destination finding and route execution.Originality/valueThis study helps in the introduction of multi-stage decision-making to autonomously reconfigure route.

Crowds in front of bottlenecks at entrances from the perspective of physics and social psychology.

This article presents an interdisciplinary study of physical and social psychological effects on crowd dynamics based on a series of bottleneck experiments. Bottlenecks are of particular interest for applications such as crowd management and design of emergency routes because they limit the performance of a facility. In addition to previous work on the dynamics within the bottleneck, this study focuses on the dynamics in front of the bottleneck, more specifically, at entrances. The experimental set-up simulates an entrance scenario to a concert consisting of an entrance gate (serving as bottleneck) and a corridor formed by barriers. The parameters examined are the corridor width, degree of motivation and priming of the social norm of queuing. The analysis is based on head trajectories and questionnaires. We show that the density of persons per square metre depends on motivation and also increases continuously with increasing corridor width, meaning that a density reduction can be achieved by a reduction of space. In comparison to other corridor widths observed, the narrowest corridor is rated as being fairer, more comfortable and as showing less unfair behaviour. Pushing behaviour is seen as ambivalent: it is rated as unfair and listed as a strategy for faster access.

A Comprehensive Survey: Benefits, Services, Recent Works, Challenges, Security, and Use Cases for SDN-VANET

Vehicular communication networks is a powerful tool that enables numerous vehicular data services and applications. The rapid growth in vehicles has also resulted in the vehicular network becoming heterogeneous, dynamic, and large-scale, making it hard to meet the strict requirements, such as extremely latency, high mobility, top security, and enormous connections of the fifth-generation network. Previous studies have shown that with the increase in the application of Software-Defined Networking (SDN) on Vehicular Ad-hoc Network (VANET) in industries, researchers have exerted considerable efforts to improve vehicular communications. This study presents an exhaustive review of previous works by classifying them based on based on wireless communication, particularly VANET. First, a concise summary of the VANET structure and SDN controller with layers and details of their infrastructure is provided. Second, a description of SDN-VANET applications in different wireless communications, such as the Internet of Things (IoT) and VANET is provided with concentration on the examination and comparison of SDN-VANET works on several parameters. This paper also provides a detailed analysis of the open issues and research directions accomplished while integrating the VANET with SDN. It also highlights the current and emerging technologies with use cases in vehicular networks to address the several challenges in the VANET infrastructure. This survey acts as a catalyst in raising the emergent robustness routing protocol, latency, connectivity and security issues of future SDN-VANET architectures.

BlockChain with IoT, an Emergent Routing Scheme for Smart Agriculture

Blockchain is an emerging field of study in a number of applications and domains. Especially when combine with Internet of Things (IoT) this become truly transformative, opening up new plans of action, improving engagement and revolutionizing many sectors including agriculture. IoT devices are intelligent and have high critical capabilities but low-powered and have less storage, and face many challenges when used in isolation. Maintaining the network and consuming IoT energy by means of redundant or fabricated data transfer lead to consumption of high energy and reduce the life of IoT network. Therefore, an appropriate routing scheme should be in place to ensure consistency and energy efficiency in an IoT network. This research proposes an efficient routing scheme by integrating IoT with Blockchain for distributed nodes which work in a distributed manner to use the communicating links efficiently. The proposed protocol uses smart contracts within heterogeneous IoT networks to find a route to Base Station (BS). Each node can ensure route from an IoT node to sink then base station and permits IoT devices to collaborate during transmission. The proposed routing protocol removes redundant data and blocks IoT architecture attacks and leads to lower consumption of energy and improve the life of network. The performance of this scheme is compared with our existing scheme IoT-based Agriculture and LEACH in Agriculture. Simulation results show that integrating IoT with Blockchain scheme is more efficient, uses low energy, improves throughput and enhances network lifetime.