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E M Nyberg, J R Cox, R G Kowalski, D V Duarte, B Schimpf, W J Jones
Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy...
May 17, 2018: AJNR. American Journal of Neuroradiology
Weirong Liu, Peng Zhuang, Hao Liang, Jun Peng, Zhiwu Huang
Microgrids incorporated with distributed generation (DG) units and energy storage (ES) devices are expected to play more and more important roles in the future power systems. Yet, achieving efficient distributed economic dispatch in microgrids is a challenging issue due to the randomness and nonlinear characteristics of DG units and loads. This paper proposes a cooperative reinforcement learning algorithm for distributed economic dispatch in microgrids. Utilizing the learning algorithm can avoid the difficulty of stochastic modeling and high computational complexity...
June 2018: IEEE Transactions on Neural Networks and Learning Systems
Eddie Kane, Emily Evans, Jurgen Mitsch, Tahseen Jilani, Philip Quinlan, Jack Cattell, Najat Khalifa
BACKGROUND: Interactions between individuals experiencing mental health (MH) problems and the police are complex, and effectiveness of innovative support and diversion models in England and Wales not yet fully evaluated. AIMS/HYPOTHESES: Our aims were to examine police interactions with suspects and to measure the immediate effectiveness of police/NHS MH interventions, including liaison and diversion and embedded staff in police contact and control rooms. We hypothesised that those with an MH flag would have significantly greater benefit from such interventions than those without in terms of how far they are taken down the criminal justice pathway and how long they spend in police custody...
May 16, 2018: Criminal Behaviour and Mental Health: CBMH
Sun Young Lee, Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, So Yeon Kong
BACKGROUND: For an effective dispatcher-assisted cardiopulmonary resuscitation (CPR) program, recognition of out-of-hospital cardiac arrest (OHCA) by a dispatcher is the first step in initiating bystander CPR. This study evaluated whether CPR awareness in the community is associated with recognition of arrest, dispatcher-provided CPR instructions, and bystander CPR. METHODS: All emergency medical services (EMS)-treated adult OHCAs with cardiac etiology were enrolled between 2013 and 2015, excluding cases witnessed by EMS providers...
May 7, 2018: Resuscitation
Johno Breeze, C E J Langford
No abstract text is available yet for this article.
May 7, 2018: Journal of the Royal Army Medical Corps
Maryse C Cnossen, Ruben van den Brande, Hester Lingsma, Suzanne Polinder, Fiona Lecky, Andrew Maas
The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is however not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the CENTER-TBI study...
May 5, 2018: Journal of Neurotrauma
Thomas Jepsen
Disclosures about electronic surveillance by the U.S. National Security Agency have revived interest in issues of communications privacy and Fourth Amendment rights. In the early days of the telegraph, there was no legal protection afforded to the privacy of telegraphic communication, and seizures of telegraphic dispatches figured in major events of the nineteenth century in the United States. Attempts to protect the content of telegrams by defining a customer/operator "privilege" under common law were rejected by the courts, as were attempts to protect the confidentiality of telegraphic communications through an analogy with the postal service...
2018: Technology and Culture
Marc L Schröder, Marlies P de Wispelaere, Victor E Staartjes
BACKGROUND CONTEXT: Long-term follow-up of patient-reported outcome measures (PROM) is essential in both modern spinal care as well as in research. Lack of time and staff are commonly reported barriers to implementing long-term follow-up of PROM. Automated and digital follow-up systems for PROM collection are seeing widespread use, yet their validity and comparative effectiveness have never been evaluated. PURPOSE: To assess the validity of digital follow-up systems in comparison with the conventional paper-based follow-up...
May 3, 2018: Spine Journal: Official Journal of the North American Spine Society
Mark Levitan, Madelyn P Law, Richard Ferron, Karen Lutz-Graul
IntroductionAccording to Ontario, Canada's Basic Life Support Patient Care Standards, Emergency Medical Services (EMS) on-scene time (OST) for trauma calls should not exceed 10 minutes, unless there are extenuating circumstances. The time to definitive care can have a significant impact on the morbidity and mortality of trauma patients. This is the first Canadian study to investigate why this is the case by giving a voice to those most involved in prehospital care: the paramedics themselves. It is also the first study to explore this issue from a complex, adaptive systems approach which recognizes that OSTs may be impacted by local, contextual features...
May 6, 2018: Prehospital and Disaster Medicine
Zheng Duan, Ting Peng, Shiming Zhu, Ming Lian, Yiyun Li, Fu Wei, Jiabao Xiong, Sune Svanberg, Quanzhi Zhao, Jiandong Hu, Guangyu Zhao
Chinese hybrid rice of different varieties, growing in paddies in the Pingqiao district, north of Xinyang city, Henan province, China, was studied in detailed spectroscopic characteristics using laser-induced fluorescence. The base for the studies was the new South China Normal University mobile lidar laboratory, which was dispatched on site, providing facilities both for laboratory studies using a 405 nm excitation source as well as remote sensing measurements at ranges from around 40 m-120 m, mostly employing the 532 nm output from a Nd:YAG laser...
May 1, 2018: Applied Optics
Scott A Goldberg, Daniel A Dworkis, Vincent T Liao, Andrew J Eyre, Jack Albert, Meghan M Fawcett, Conor M Narovec, James DiClemente, Scott G Weiner
OBJECTIVE: Pre-stationing naloxone, a competitive antagonist that can reverse the effects of opioid overdose, in public spaces may expedite antidote delivery. Our study aimed to determine the feasibility of bystander-assisted overdose treatment using pre-stationed naloxone. METHODS: Convenience sample of bystanders in Cambridge, Massachusetts in April 2017. Subjects assisted a simulated patient described as unconscious. Subjects interacted with simulated EMS dispatch to locate a nearby box, unlock it, and administer naloxone...
May 3, 2018: Prehospital Emergency Care
Hendrika Meischke, Michelle Lilly, Randal Beaton, Rebecca Calhoun, Ann Tu, Scott Stangenes, Ian Painter, Debra Revere, Janet Baseman
BACKGROUND: Nationwide, emergency response systems depend on 9-1-1 telecommunicators to prioritize, triage, and dispatch assistance to those in distress. 9-1-1 call center telecommunicators (TCs) are challenged by acute and chronic workplace stressors: tense interactions with citizen callers in crisis; overtime; shift-work; ever-changing technologies; and negative work culture, including co-worker conflict. This workforce is also subject to routine exposures to secondary traumatization while handling calls involving emergency situations and while making time urgent, high stake decisions over the phone...
May 2, 2018: BMC Public Health
Hualiang Lin, Jun Tao, Haidong Kan, Zhengmin Qian, Ailan Chen, Yaodong Du, Tao Liu, Yonghui Zhang, Yongqing Qi, Jianjun Ye, Shuangming Li, Wanglin Li, Jianpeng Xiao, Weilin Zeng, Xing Li, Katherine A Stamatakis, Xinyu Chen, Wenjun Ma
Limited evidence exists concerning the impact of particulate pollution on acute respiratory distress syndrome (ARDS). We examined the effects of particulate pollution on emergency ambulance dispatches (EAD) for ARDS in Guangzhou, China. Daily air pollution concentrations for PM10 , PM2.5 , and PM1 , as well as PM2.5 chemical compositions, were available from a central air monitoring station. The association between incident ARDS and air pollution on the concurrent and previous 5 days was estimated by an over-dispersed Poisson generalized additive model controlling for meteorological factors, temporal trends, public holidays and day of the week...
April 30, 2018: Journal of Exposure Science & Environmental Epidemiology
Akihito Hagihara, Daisuke Onozuka, Hidetoshi Shibuta, Manabu Hasegawa, Takashi Nagata
INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA. METHODS: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs...
April 19, 2018: International Journal of Cardiology
XiaoKe Li, DaNan Gan, Ying Li, Peng Zhang, ZhiGuo Li, HongBo Du, LuDan Zhang, Yuan Cheng, YaQiang Zhang, YiJun Liang, YongAn Ye
BACKGROUND: Minimal hepatic encephalopathy (MHE) is a subclinical state of hepatic encephalopathy with the possibility of developing into overt hepatic encephalopathy (OHE) and having adverse outcomes. However, no preventative medicine for MHE has been recommended so far. The aim is to evaluate the therapeutic effect of the JianPi HuaZhuo XingNao formula (JPHZXN) on MHE, specifically whether JPHZXN decreases OHE occurrence, through a randomized controlled trial. METHOD: Seventy-two patients with MHE are enrolled and allocated in a 1:1 ratio in an experimental group and a control group...
April 2018: Medicine (Baltimore)
Kristi L Weinmeister, E Brooke Lerner, Clare E Guse, Khalid A Ateyyah, Ronald G Pirrallo
BACKGROUND: Survival rates following out-of-hospital cardiac arrest (OHCA) increase two to three times when cardiopulmonary resuscitation (CPR) is started by bystanders, as compared to starting CPR when Emergency Medical Services (EMS) arrives. Municipalities that have implemented dispatcher-assisted bystander CPR programs have seen increased rates of bystander CPR. Cardiopulmonary resuscitation instructions are given for victims of all ages, but it is unknown if offering instructions results in similar rates of EMS-documented bystander CPR across the age continuum in these municipalities...
April 26, 2018: Prehospital and Disaster Medicine
Jeremy A Miller, Christian Freund, Liselotte Rambonnet, Lianne Koets, Nadine Barth, Corné van der Linden, József Geml, Menno Schilthuizen, Richard Burger, Benoit Goossens
Background: Males of Opadometa are difficult to associate with conspecific females, and sex-matching errors may persist in the taxonomic literature. Recommended best practices for definitive sex matching in this genus suggest finding a male in the web of a female, or better yet, mating pairs. New information: A male Opadometa was observed hanging on a frame line of the web of a female Opadometa sarawakensis , a species for which the male was previously undescribed...
2018: Biodiversity Data Journal
Abja Sapkota, Sabitra Poudel, Arun Sedhain, Niru Khatiwada
Background: The complications associated with errors in transfusion practice can be minimized by assessing transfusion practices. In Nepal, there is no standard protocol on blood transfusion. So, this study was conducted with an aim to assess the blood transfusion practice among healthcare personnel. Methods: A descriptive observational study was conducted in two tertiary hospitals in Kathmandu, Nepal, over a period of 10 months. Bedside blood transfusion procedures were observed using structured checklist...
2018: Journal of Blood Transfusion
Akira Yamashita, Tetsuo Maeda, Yasuhiro Myojo, Yukihiro Wato, Keisuke Ohta, Hideo Inaba
PURPOSE: To investigate temporal variations in dispatcher-assisted and bystander-initiated resuscitation efforts and their association with survival after bystander-witnessed out-of-hospital cardiac arrests (OHCAs). METHODS: We retrospectively analyzed the neurologically favorable 1-month survival and the parameters related to dispatcher assisted cardiopulmonary resuscitation (DA-CPR) and bystander CPR (BCPR) for 227,524 OHCA patients between 2007 and 2013 in Japan...
April 3, 2018: American Journal of Emergency Medicine
Hideki Asai, Hidetada Fukushima, Francesco Bolstad, Kazuo Okuchi
Aim: Bystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch-assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study. Methods: We recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation...
April 2018: Acute Medicine & Surgery
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