Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly rel...Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly related to both the degree and duration of hyperthermia,timely recognition and management of heat exhaustion and heat stroke are critical for preventing death and reducing healthcare burdens.展开更多
Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff...Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.展开更多
BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergenc...BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergency departments(EDs) are scarce.We conducted a multicenter prospective registry study in Thuringia,to characterize indications,techniques,success rates,and complications of ED intubations.METHODS:From February 2023 to January 2024,six Thuringian EDs participated in a prospective observational registry(www.airwayregistry.eu).All consecutive intubations were documented anonymously using a standardized digital form.Demographics,indications,methods,equipment,operator characteristics,first pass success(FPS),overall success,and complications were captured.Descriptive statistics were used.RESULTS:We analyzed 117 intubations(63.2% male;mean age 68.4 years,range 2–98 years).FPS was 88.9%(104/117),second pass success was 4.3% and third pass success was 6.8%;overall success was 100%.Rapid sequence intubation(RSI) was used in 77.8% of intubations and delayed sequence intubation(DSI) in 21.4%;10.3% were performed without medication.Direct laryngoscopy(DL) was used in 65.0% and videolaryngoscopy(VL) in 34.2%.FPS was higher with VL than DL(92.5% vs.88.2%).The most common indications were cardiopulmonary resuscitation(14.5%) and stroke/ischemia(13.7%);intracranial hemorrhage accounted for 13.7%.Complications occurred in 39% of cases,most frequently hypotension(23.9%) and catecholamine requirement(12.0%).A difficult airway was anticipated in 30.8%.CONCLUSION:In this multicenter snapshot from German EDs,overall intubation success was high but complications—especially peri-intubation hypotension—were common.VL yielded higher FPS yet was used less frequently than DL.Standardized protocols,hemodynamic optimization,and broader VL adoption may improve safety and performance.展开更多
Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:...Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:emergency trauma patients in our hospital.Sample size:92 cases.Using computer-based grouping,the 92 patients were divided into two equally sized groups:a control group of 46 patients who received conventional emergency nursing care,and an observation group of 46 patients who underwent an improved emergency integrated nursing model.The treatment-related indicators,treatment effectiveness,and incidence of adverse events were evaluated in both groups.Results:After intervention,the pre-hospital emergency care time,emergency diagnosis time,total emergency rescue duration,and examination waiting time in the control group were all longer than those in the observation group(p<0.05);the treatment effectiveness in the control group(effective rate:82.61%)was worse than that in the observation group(effective rate:95.65%),p<0.05;compared with the control group,the observation group had a lower incidence of adverse events,p<0.05.Conclusion:Implementing an improved emergency integrated nursing model for emergency trauma patients helps streamline the treatment process,enhance treatment effectiveness,and reduce the incidence of adverse events.展开更多
Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized ...Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.展开更多
Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to...Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and...BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A to...Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A total of 50 critically ill patients admitted to the Emergency Department from October 2022 to October 2023 were randomly divided into the experimental group (25 cases) and the control group (25 cases). The control group received routine nursing, while the experimental group received whole-process nursing. The rescue success rate and nursing satisfaction were compared between the two groups. Results: In the experimental group, 24 patients were rescued successfully, with a success rate of 96%;in the control group, 19 patients were rescued successfully, with a success rate of 76%, showing a significant difference (χ2 = 4.1528, p = 0.0415 < 0.05). The nursing satisfaction was 92% in the experimental group and 68% in the control group. Conclusion: Whole-process nursing can effectively improve the rescue success rate of critically ill patients, enhance the satisfaction of patients and their families, and improve patients’ quality of life.展开更多
Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer e...Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer efficiency of current catalysts,the further application of AOPs technology is limited.Here,it is proposed that the interfacial electric field can be controlled by bor(B)-doped FeNC catalysts,which shows significant advantages in the efficient generation,release and participation of reactive oxygen species(ROS)in the reaction.The super exchange interaction between Fe sites and N and B sites is realized through the directional transfer of electrons in the interfacial electric field,which ensures the high efficiency and stability of the PMS catalytic process.B doping increases the d orbitals distribution at Fermi level,which facilitates enhanced electron transition activity,thereby promoting the effective generation of (1)^O_(2).At the same time,orbital hybridization causes the center of the d band to move to a lower energy level,which not only contributes to the desorption process of (1)^O_(2),but also accelerates its release.In addition,B-doping also improved the adsorption capacity of organic pollutants and shortened the migration distance of ROS,thereby significantly improving the degradation efficiency of ECs.The B-doping strategy outlined offers a novel approach to the development of FeNC catalysts,it lays a theoretical foundation and offers technical insights for the integration of PMS/AOPs technology in the ECs management.展开更多
Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching t...Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.展开更多
The rise of portable electronic devices and Internet of Things(IoT)has spurred significant interest in flexible triboelectric nanogenerators(TENGs)as sustainable energy solutions.The electrical performance of TENGs is...The rise of portable electronic devices and Internet of Things(IoT)has spurred significant interest in flexible triboelectric nanogenerators(TENGs)as sustainable energy solutions.The electrical performance of TENGs is profoundly influenced by nanoscale factors,including interface properties and material characteristics,highlighting the critical need for a comprehensive understanding of these parameters to unlock their full potential.This paper summarizes the recent advances in advanced fiber composite TENGs(FC-TENGs),especially electrospun nanofibers,with a focus on key nanoscale properties,covering triboelectric layer interface characteristics,dielectric constant,electron affinity,and crystal phase,all of which are fundamental to optimizing their output performance.Additionally,it explores emerging applications of FC-TENGs in wearable electronics,self-powered sensors,wireless communication systems,human-machine interfaces,and modern healthcare technologies.The review concludes by addressing existing challenges,evaluating future opportunities,and outlining research directions for advancing FC-TENGs.By bridging foundational material science with innovative applications,this review seeks to inspire the development of high-performance,self-powered electrospun composite tribovoltaic nanogenerators,paving the way for a wireless,artificial intelligence(AI)-enabled IoT era.展开更多
Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelli...Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelligent question answering,decision support,and fault diagnosis.As high-speed train systems become increasingly intelligent and interconnected,fault patterns have grown more complex and dynamic.Knowledge graphs offer a promising solution to support the structured management and real-time reasoning of fault knowledge,addressing key requirements such as interpretability,accuracy,and continuous evolution in intelligent diagnostic systems.However,conventional knowledge graph construction relies heavily on domain expertise and specialized tools,resulting in high entry barriers for non-experts and limiting their practical application in frontline maintenance scenarios.To address this limitation,this paper proposes a fault knowledge modeling approach for high-speed trains that integrates structured logic diagrams with knowledge graphs.The method employs a seven-layer logic structure—comprising fault name,applicable vehicles,diagnostic logic,signal parameters,verification conditions,fault causes,and emergency measures—to transform unstructured knowledge into a visual and hierarchical representation.A semantic mapping mechanism is then used to automatically convert logic diagrams into machine-interpretable knowledge graphs,enabling dynamic reasoning and knowledge reuse.Furthermore,the proposed method establishes a three-layer architecture—logic structuring,knowledge graph transformation,and dynamic inference—to bridge human-expert logic with machinebased reasoning.Experimental validation and system implementation demonstrate that this approach not only improves knowledge interpretability and inference precision but also significantly enhances modeling efficiency and system maintainability.It provides a scalable and adaptable solution for intelligent operation and maintenance platforms in the high-speed rail domain.展开更多
Background:Emerging adulthood is a critical period for ego identity exploration and consolidation,and self-presentation on social media constitutes a salient online context for this developmental process.However,limit...Background:Emerging adulthood is a critical period for ego identity exploration and consolidation,and self-presentation on social media constitutes a salient online context for this developmental process.However,limited research has explored the associations between self-presentation on WeChat Moments and ego identity.This study aims to examine these associations,focusing on the mediating role of online positive feedback and the moderating role of gender.Methods:Using a three-wave longitudinal design,this study followed 767 Chinese college students(Mean age=18.96 years)through cluster sampling.Participants completed self-report questionnaires assessing self-presentation on WeChat Moments,online positive feedback,and ego identity status.Data analyses were conducted using mediation modeling and multi-group structural equation modeling.Results:Authentic self-presentation was positively associated with identity achievement and negatively associated with identity diffusion,whereas positive self-presentation was linked to higher levels of identity foreclosure.Online positive feedback played a significant mediating role in the associations between self-presentation strategies and identity statuses,and gender differences were observed in this mediating pathway.For both males and females,authentic self-presentation was associated with higher identity achievement through online positive feedback.However,indirect associations with identity foreclosure and diffusion were observed only among females:authentic self-presentation was linked to lower levels,whereas positive self-presentation was linked to higher levels of foreclosure and diffusion through online positive feedback.No comparable indirect associations were detected among males.Conclusions:Online positive feedback is closely linked to self-presentation strategies and ego identity statuses,with these associations varying by gender.展开更多
Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances ...Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.展开更多
Current research primarily focuses on emerging organic pollutants,with limited attention to emerging inorganic pollutants (EIPs).However,due to advances in detection technology and the escalating environmental and hea...Current research primarily focuses on emerging organic pollutants,with limited attention to emerging inorganic pollutants (EIPs).However,due to advances in detection technology and the escalating environmental and health challenges posed by pollution,there is a growing interest in treating waters contaminated with EIPs.This paper explores biochar characteristics and modification methods,encompassing physical,chemical,and biological approaches for adsorbing EIPs.It offers a comprehensive review of research advancements in employing biochar for EIPs remediation in water,outlines the adsorption mechanisms of EIPs by biochar,and presents an environmental and economic analysis.It can be concluded that using biochar for the adsorption of EIPs in wastewater exhibits promising potential.Nonetheless,it is noteworthy that certain EIPs like Au(III),Rh(III),Ir(III),Ru(III),Os(III),Sc(III),and Y(III),have not been extensively investigated regarding their adsorption onto biochar.This comprehensive review will catalyze further inquiry into the biochar-based adsorption of EIPs,addressing current research deficiencies and advancing the practical implementation of biochar as a potent substrate for EIP removal from wastewater streams.展开更多
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement ...This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.展开更多
There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range o...There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range of sectors,one of which is healthcare,where it is being used to enhance clinical diagnostics.AI solutions have enormous untapped potential to improve healthcare efficiency and quality,thus researchers have focused heavily on emergency medicine(EM).Many individuals without prior experience with any physician often receive their initial medical care in the emergency room.Two areas that could benefit from the implementation of AI are reducing waiting times and enhancing diagnostic capabilities.This study provides further explanation of how AI is used in emergency rooms.Several machine learning‐based algorithms are also addressed.In this research,we summarise recent developments in the use of AI in EM.This research tries to summarise the usefulness of AI in EM by looking at recent developments in emergency department operations and clinical patient management.展开更多
文摘Extreme heat events contribute to high mortality[1,2]and overwhelm emergency medical services through increased ambulance calls and overcrowded emergency departments.[3]Because morbidity and mortality are directly related to both the degree and duration of hyperthermia,timely recognition and management of heat exhaustion and heat stroke are critical for preventing death and reducing healthcare burdens.
文摘Physician well-being is vital to delivering high-quality emergency care.A supported and healthy emergency medicine workforce leads to better patient outcomes,fewer medical errors,and greater job satisfaction and staff retention.[1,2]Emergency physicians(EPs)face unique pressures,including shift work,high patient volumes and acuities,overcrowding,and systemic inefficiencies that escalate their risk of burnout.As a result,EPs have reported the highest rates of burnout among physician specialties.
文摘BACKGROUND:Airway management is a core competence in emergency medicine.International registries have described indications,techniques,and outcomes of endotracheal intubation,yet contemporary data from German emergency departments(EDs) are scarce.We conducted a multicenter prospective registry study in Thuringia,to characterize indications,techniques,success rates,and complications of ED intubations.METHODS:From February 2023 to January 2024,six Thuringian EDs participated in a prospective observational registry(www.airwayregistry.eu).All consecutive intubations were documented anonymously using a standardized digital form.Demographics,indications,methods,equipment,operator characteristics,first pass success(FPS),overall success,and complications were captured.Descriptive statistics were used.RESULTS:We analyzed 117 intubations(63.2% male;mean age 68.4 years,range 2–98 years).FPS was 88.9%(104/117),second pass success was 4.3% and third pass success was 6.8%;overall success was 100%.Rapid sequence intubation(RSI) was used in 77.8% of intubations and delayed sequence intubation(DSI) in 21.4%;10.3% were performed without medication.Direct laryngoscopy(DL) was used in 65.0% and videolaryngoscopy(VL) in 34.2%.FPS was higher with VL than DL(92.5% vs.88.2%).The most common indications were cardiopulmonary resuscitation(14.5%) and stroke/ischemia(13.7%);intracranial hemorrhage accounted for 13.7%.Complications occurred in 39% of cases,most frequently hypotension(23.9%) and catecholamine requirement(12.0%).A difficult airway was anticipated in 30.8%.CONCLUSION:In this multicenter snapshot from German EDs,overall intubation success was high but complications—especially peri-intubation hypotension—were common.VL yielded higher FPS yet was used less frequently than DL.Standardized protocols,hemodynamic optimization,and broader VL adoption may improve safety and performance.
文摘Objective:To analyze the impact of improved emergency integrated nursing on the treatment effectiveness and safety of emergency trauma patients.Methods:Study duration:December 2024 to December 2025.Observation target:emergency trauma patients in our hospital.Sample size:92 cases.Using computer-based grouping,the 92 patients were divided into two equally sized groups:a control group of 46 patients who received conventional emergency nursing care,and an observation group of 46 patients who underwent an improved emergency integrated nursing model.The treatment-related indicators,treatment effectiveness,and incidence of adverse events were evaluated in both groups.Results:After intervention,the pre-hospital emergency care time,emergency diagnosis time,total emergency rescue duration,and examination waiting time in the control group were all longer than those in the observation group(p<0.05);the treatment effectiveness in the control group(effective rate:82.61%)was worse than that in the observation group(effective rate:95.65%),p<0.05;compared with the control group,the observation group had a lower incidence of adverse events,p<0.05.Conclusion:Implementing an improved emergency integrated nursing model for emergency trauma patients helps streamline the treatment process,enhance treatment effectiveness,and reduce the incidence of adverse events.
文摘Objective:To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department.Methods:In this triple-blind randomized clinical trial,eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine.Block randomization was used,and patients,treating physicians,and outcome assessors were blinded to treatment allocation.Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration.Results:Eighty patients were enrolled,with a mean age of 36.6 years(SD,15.0),and 42.5%were male.Mean pain scores decreased significantly over time in both treatment groups.In the pantoprazole group,pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes,whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54,respectively.There was no significant difference in baseline pain scores between groups(P=.92).Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes(P=.04)and 60 minutes(P=.05).Conclusions:Both medications were effective in relieving epigastric pain;however,pantoprazole provided greater and more sustained pain reduction,supporting its preferential use in emergency settings.
文摘Objective:Early sepsis can be treated if recognised early,but progression to severe sepsis and septic shock and multiple organ dysfunction syndrome substantially increases mortality.The objectives of our study were to assess morbidity and mortality of patients with sepsis and to compare the effectiveness of a simple bedside satisfiable Quick Sequential Organ Failure Assessment(qSOFA)score with National Early Warning Score(NEWS)in prognosticating sepsis.Methods:This prospective observational study was conducted among patients>18 years old presenting with sepsis at B.J.Medical College.The SOFA,qSOFA and NEWS scores were calculated.The effectiveness in predicting mortality was evaluated using receiver operating characteristic curve analysis.Results:A total of 200 patients were evaluated(56%male)with a mean age of 51.7 years.The mortality rate was 23%.Patients categorized under high risk according to SOFA score>8,qSOFA score of 2-3 and NEWS>7 had a mortality rate of 33.3%,27.5%and 28.4%,respectively.AUC for mortality prediction was 0.695 using SOFA score,0.665 using qSOFA and 0.725 using NEWS.At a cut off of 7.50,NEWS demonstrated a sensitivity of 97.8%with a specificity of 28.0%and outperformed both SOFA and qSOFA which yielded a sensitivity of 43.5%and 91.3%and a specificity of 77.9%and 27.9%,respectively.Conclusions:The NEWS score outperforms SOFA and qSOFA in predicting mortality among sepsis patients.However,qSOFA is more helpful in identifying high risk patients and performs better in intensive care setting.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘BACKGROUND Appropriate care for individuals who attempt suicide and are admitted to the emergency department(ED)can prevent future suicidal behavior.It is vital to understand their sociodemographic characteristics and the effects of targeted psychological care.AIM To analyze sociodemographic characteristics of suicide attempters treated in the ED and evaluate the efficacy of psychological care.METHODS Data from 239 suicide attempters treated in the ED of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture(Hubei Province,China)between January 2021 and February 2025 were divided into 2:Control(n=108)and psychological care(n=131).The demographic characteristics and effects of the psychological care were analyzed.RESULTS The mean(±SD)age of the 239 patients[114 male(47.7%),125 female(52.3%)]was 26.25±9.3 years,of whom 122(45.2%)were single,117(48.9%)were married,and 106(44.4%)had secondary education.Thirty-eight(15.9%)patients had suicidal intent,with a mean of 1.26±0.59 suicide attempts each.Twenty-two(9.21%)patients had a family history of suicide,while 8(3.34%)had a family history of suicide attempt(s).Before intervention,mean Suicidal Intent Scale scores in the psychological nursing and control groups were 21.57±5.28 and 19.86±5.92,respectively(P>0.05).After 1 month of nursing intervention,the respective scores were 10.09±1.11 and 16.48±0.87(P<0.001);and the re-suicide rates were 11.45%(15/131)and 24.07%(26/108)(P<0.001).CONCLUSION Psychological care significantly reduces suicide risk;EDs should provide comprehensive mental health care.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
文摘Objective: To analyze the impact of whole-process nursing on the rescue of emergency critically ill patients by setting a control group and an experimental group and comparing their experimental results. Methods: A total of 50 critically ill patients admitted to the Emergency Department from October 2022 to October 2023 were randomly divided into the experimental group (25 cases) and the control group (25 cases). The control group received routine nursing, while the experimental group received whole-process nursing. The rescue success rate and nursing satisfaction were compared between the two groups. Results: In the experimental group, 24 patients were rescued successfully, with a success rate of 96%;in the control group, 19 patients were rescued successfully, with a success rate of 76%, showing a significant difference (χ2 = 4.1528, p = 0.0415 < 0.05). The nursing satisfaction was 92% in the experimental group and 68% in the control group. Conclusion: Whole-process nursing can effectively improve the rescue success rate of critically ill patients, enhance the satisfaction of patients and their families, and improve patients’ quality of life.
基金supported by the National Natural Science Foundation of China(No.22278156)the Guangdong Special Support Program Project(No.2021JC060580)+1 种基金the Young Elite Scientists Sponsorship Program by CAST-Doctoral Student Special Plan,the China Scholarship Council Program(No.202406150148)the Natural Science Foundation of Guangdong Province(No.2023A1515011186).
文摘Peroxymonosulfate(PMS)-based advanced oxidation processes(AOPs)are an effective way to remove emerging contaminants(ECs)from water.The catalytic process involving PMS is hindered by the suboptimal electron trans-fer efficiency of current catalysts,the further application of AOPs technology is limited.Here,it is proposed that the interfacial electric field can be controlled by bor(B)-doped FeNC catalysts,which shows significant advantages in the efficient generation,release and participation of reactive oxygen species(ROS)in the reaction.The super exchange interaction between Fe sites and N and B sites is realized through the directional transfer of electrons in the interfacial electric field,which ensures the high efficiency and stability of the PMS catalytic process.B doping increases the d orbitals distribution at Fermi level,which facilitates enhanced electron transition activity,thereby promoting the effective generation of (1)^O_(2).At the same time,orbital hybridization causes the center of the d band to move to a lower energy level,which not only contributes to the desorption process of (1)^O_(2),but also accelerates its release.In addition,B-doping also improved the adsorption capacity of organic pollutants and shortened the migration distance of ROS,thereby significantly improving the degradation efficiency of ECs.The B-doping strategy outlined offers a novel approach to the development of FeNC catalysts,it lays a theoretical foundation and offers technical insights for the integration of PMS/AOPs technology in the ECs management.
文摘Against the backdrop of continuous social development and growing public health demands,the efficiency and scientific nature of the emergency care system are of paramount importance.This paper focuses on researching the construction of an emergency care system based on the concept of“linkage”,delving into its theoretical foundations,exploring innovative construction models,and analyzing practical cases.The study indicates that an emergency care system under the“linkage”concept can effectively integrate resources and enhance efficiency,providing new insights for improving the construction of the emergency care system.It aims to promote the development of the emergency care system towards a more scientific,efficient,and collaborative direction.
基金financially supported by the National Natural Science Foundation of China(52127811,51975120)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(SJCX25_0096)。
文摘The rise of portable electronic devices and Internet of Things(IoT)has spurred significant interest in flexible triboelectric nanogenerators(TENGs)as sustainable energy solutions.The electrical performance of TENGs is profoundly influenced by nanoscale factors,including interface properties and material characteristics,highlighting the critical need for a comprehensive understanding of these parameters to unlock their full potential.This paper summarizes the recent advances in advanced fiber composite TENGs(FC-TENGs),especially electrospun nanofibers,with a focus on key nanoscale properties,covering triboelectric layer interface characteristics,dielectric constant,electron affinity,and crystal phase,all of which are fundamental to optimizing their output performance.Additionally,it explores emerging applications of FC-TENGs in wearable electronics,self-powered sensors,wireless communication systems,human-machine interfaces,and modern healthcare technologies.The review concludes by addressing existing challenges,evaluating future opportunities,and outlining research directions for advancing FC-TENGs.By bridging foundational material science with innovative applications,this review seeks to inspire the development of high-performance,self-powered electrospun composite tribovoltaic nanogenerators,paving the way for a wireless,artificial intelligence(AI)-enabled IoT era.
基金support from the Scientific Funding for the Center of National Railway Intelligent Transportation System Engineering and Technology,China Academy of Railway Sciences Corporation Limited(Grant No.2023YJ354)。
文摘Knowledge graphs,which combine structured representation with semantic modeling,have shown great potential in knowledge expression,causal inference,and automated reasoning,and are widely used in fields such as intelligent question answering,decision support,and fault diagnosis.As high-speed train systems become increasingly intelligent and interconnected,fault patterns have grown more complex and dynamic.Knowledge graphs offer a promising solution to support the structured management and real-time reasoning of fault knowledge,addressing key requirements such as interpretability,accuracy,and continuous evolution in intelligent diagnostic systems.However,conventional knowledge graph construction relies heavily on domain expertise and specialized tools,resulting in high entry barriers for non-experts and limiting their practical application in frontline maintenance scenarios.To address this limitation,this paper proposes a fault knowledge modeling approach for high-speed trains that integrates structured logic diagrams with knowledge graphs.The method employs a seven-layer logic structure—comprising fault name,applicable vehicles,diagnostic logic,signal parameters,verification conditions,fault causes,and emergency measures—to transform unstructured knowledge into a visual and hierarchical representation.A semantic mapping mechanism is then used to automatically convert logic diagrams into machine-interpretable knowledge graphs,enabling dynamic reasoning and knowledge reuse.Furthermore,the proposed method establishes a three-layer architecture—logic structuring,knowledge graph transformation,and dynamic inference—to bridge human-expert logic with machinebased reasoning.Experimental validation and system implementation demonstrate that this approach not only improves knowledge interpretability and inference precision but also significantly enhances modeling efficiency and system maintainability.It provides a scalable and adaptable solution for intelligent operation and maintenance platforms in the high-speed rail domain.
基金supported by the National Social Science Fund of China(No.23BSH123).
文摘Background:Emerging adulthood is a critical period for ego identity exploration and consolidation,and self-presentation on social media constitutes a salient online context for this developmental process.However,limited research has explored the associations between self-presentation on WeChat Moments and ego identity.This study aims to examine these associations,focusing on the mediating role of online positive feedback and the moderating role of gender.Methods:Using a three-wave longitudinal design,this study followed 767 Chinese college students(Mean age=18.96 years)through cluster sampling.Participants completed self-report questionnaires assessing self-presentation on WeChat Moments,online positive feedback,and ego identity status.Data analyses were conducted using mediation modeling and multi-group structural equation modeling.Results:Authentic self-presentation was positively associated with identity achievement and negatively associated with identity diffusion,whereas positive self-presentation was linked to higher levels of identity foreclosure.Online positive feedback played a significant mediating role in the associations between self-presentation strategies and identity statuses,and gender differences were observed in this mediating pathway.For both males and females,authentic self-presentation was associated with higher identity achievement through online positive feedback.However,indirect associations with identity foreclosure and diffusion were observed only among females:authentic self-presentation was linked to lower levels,whereas positive self-presentation was linked to higher levels of foreclosure and diffusion through online positive feedback.No comparable indirect associations were detected among males.Conclusions:Online positive feedback is closely linked to self-presentation strategies and ego identity statuses,with these associations varying by gender.
文摘Aortic saddle embolism(ASE)is a rare but catastrophic vascular emergency characterized by acute occlusion of the aortic bifurcation,leading to bilateral lower limb ischemia and multiorgan dysfunction.Despite advances in imaging and surgical techniques,ASE has high morbidity and mortality rates,particularly when diagnosis or intervention is delayed.Here,we report two patients admitted to our center to increase awareness among emergency physicians.
基金support from the earmarked fund for XJARS(No.XJARS-06)the Bingtuan Science and Technology Program(Nos.2021DB019,2022CB001-01)+1 种基金the National Natural Science Foundation of China(No.42275014)the Guangdong Foundation for Program of Science and Technology Research,China(No.2023B1212060044)。
文摘Current research primarily focuses on emerging organic pollutants,with limited attention to emerging inorganic pollutants (EIPs).However,due to advances in detection technology and the escalating environmental and health challenges posed by pollution,there is a growing interest in treating waters contaminated with EIPs.This paper explores biochar characteristics and modification methods,encompassing physical,chemical,and biological approaches for adsorbing EIPs.It offers a comprehensive review of research advancements in employing biochar for EIPs remediation in water,outlines the adsorption mechanisms of EIPs by biochar,and presents an environmental and economic analysis.It can be concluded that using biochar for the adsorption of EIPs in wastewater exhibits promising potential.Nonetheless,it is noteworthy that certain EIPs like Au(III),Rh(III),Ir(III),Ru(III),Os(III),Sc(III),and Y(III),have not been extensively investigated regarding their adsorption onto biochar.This comprehensive review will catalyze further inquiry into the biochar-based adsorption of EIPs,addressing current research deficiencies and advancing the practical implementation of biochar as a potent substrate for EIP removal from wastewater streams.
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
基金the National Natural Science Foundation of China(Grant No.:71771061).
文摘This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.
文摘There is increasing research into the potential benefits of incorporating artificial intelligence(AI)and machine learning algorithms into emergency medical services.AI is finding new applications across a wide range of sectors,one of which is healthcare,where it is being used to enhance clinical diagnostics.AI solutions have enormous untapped potential to improve healthcare efficiency and quality,thus researchers have focused heavily on emergency medicine(EM).Many individuals without prior experience with any physician often receive their initial medical care in the emergency room.Two areas that could benefit from the implementation of AI are reducing waiting times and enhancing diagnostic capabilities.This study provides further explanation of how AI is used in emergency rooms.Several machine learning‐based algorithms are also addressed.In this research,we summarise recent developments in the use of AI in EM.This research tries to summarise the usefulness of AI in EM by looking at recent developments in emergency department operations and clinical patient management.
