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
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
BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study w...BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study was to evaluate the level of knowledge,attitudes,and behaviors of licensed doctors in Saudi Arabia concerning IMEs,and to identify the demographic factors influencing their preparedness.METHODS:A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia.Participants completed a self-administered questionnaire assessing demographics,knowledge of IMEs,attitudes towards providing assistance,and previous experience with in-flight emergencies.Data were analyzed using SPSS 26,with statistical significance set at P<0.05.RESULTS:The results revealed a predominantly young(75.8% aged 25-34 years)and male(69.6%)participant pool.While 76.6% of respondents recognized the impact of cabin pressure on oxygen,only 45.4% correctly identified air travel risks for asthmatic patients.Although 66.8% felt confident assisting in IMEs,20.9% cited medicolegal concerns.Moreover,area of working within Saudi Arabia(P=0.020),year of experience(P=0.041),prior experience with IMEs(P=0.021),and IMEs training(P<0.001)had a significant association with levels of knowledge.CONCLUSION:The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia.展开更多
Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threateni...Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threatening and necessitate an immediate diagnosis and referral,but many others,like conjunctivitis or episcleritis,are benign and self-limiting.To prevent complications,such as irreversible vision loss or the spread of infection throughout the body,it is essential to accurately and promptly distinguish between benign and serious causes.With a broad range of etiologies covered,this review offers a thorough,evidence-based method for assessing red eye in primary care.For inflammatory,infectious,traumatic,and non-inflammatory disorders,we look at important clinical characteristics,diagnostic factors,and therapeutic approaches.Dry eye syndrome,pterygium,scleritis,episcleritis,keratitis,conjunctivitis,uveitis,blepharitis,hordeolum,endophthalmitis,orbital cellulitis,hyphema,trichiasis,and subconjunctival hemorrhage are among them.Whereas episcleritis usually responds to topical treatment,inflammatory conditions like scleritis and uveitis need systemic corticosteroids or immunosuppressive therapy.Infections such as keratitis,conjunctivitis,and endophthalmitis require treatments specific to the pathogen,while diseases like orbital cellulitis and hyphema may require hospitalization or surgery.External conditions like dry eye and blepharitis are treated conservatively with lubrication and cleanliness.This review aims to provide general practitioners with useful clinical tools for timely assessment,efficient triage,and referral by defining red flag symptoms,hallmark signs,and updated treatment protocols.Regular eye exams and patient education also improve results and lower recurrence.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern me...Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).展开更多
The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perceptio...The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perception model designed to predict emergencies and analyze their causes based on historical unstructured emergency data.To address issues related to data structuredness and missing values,we employed label encoding and an Elastic Net Regularization-based Generative Adversarial Interpolation Network(ER-GAIN)for data structuring and imputation.Additionally,to mitigate the impact of imbalanced data on the predictive performance of emergencies,we introduced an Adaptive Boosting Ensemble Model(AdaBoost)to forecast the key features of emergencies,including event types and levels.We also utilized Information Gain(IG)to analyze and rank the causes of various significant emergencies.Experimental results indicate that,compared to baseline data imputation models,ER-GAIN improved the prediction accuracy of key emergency features by 3.67%and 3.78%,respectively.Furthermore,AdaBoost enhanced the accuracy by over 4.34%and 3.25%compared to baseline predictivemodels.Through causation analysis,we identified the critical causes of train operation and fire incidents.The findings of this research will contribute to the establishment of early warning and prevention mechanisms for emergencies in URTS,potentially leading to safer and more reliable URTS operations.展开更多
Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surger...Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surgery,studies have demonstrated that minimally invasive surgery(MIS)can provide benefits in CRC emergencies,such as reduced morbidity and a shorter length of hospitalization.However,the applicability of MIS in the emergency setting is limited by factors such as compromised patient physiology,resource constraints,and the need for technical expertise.As an alternative to emergency MIS,endoscopic interventions have also been increasingly supported by emerging evidence as a bridge to surgery.This article appraises contemporary guidelines and the evidence behind their recommendations for MIS surgery in CRC emergencies,whilst highlighting the challenges to implementation and the strategies to overcome them.展开更多
在新型电力系统复杂工况下,以策略表为主体、通过“离线仿真、在线匹配”的预案式频率稳定控制方案存在较高失配风险,甚至因调控失当引发二次冲击,严重威胁电力系统的安全稳定运行。提出一种计及预案式失配冲击的响应驱动频率稳定紧急...在新型电力系统复杂工况下,以策略表为主体、通过“离线仿真、在线匹配”的预案式频率稳定控制方案存在较高失配风险,甚至因调控失当引发二次冲击,严重威胁电力系统的安全稳定运行。提出一种计及预案式失配冲击的响应驱动频率稳定紧急切负荷策略。该策略动作在预案式控制之后,是对预案式控制的有益补充,能够有效提升系统频率稳定性。首先建立了基于系统频率响应(system frequency response,SFR)模型辨识的频率稳定切负荷量计算方法。提出了基于频率稀疏量测的SFR模型辨识方法,在此基础上建立了含稳定控制的SFR模型,根据频率稳定控制目标迭代求解切负荷量。其次,建立了基于Transformer网络的频率控制敏感点挖掘模型,通过分析关键发电机母线节点频率时序值和频率控制敏感点的映射关系,实现响应驱动的频率控制敏感点在线挖掘。最后,按照敏感点排序快速分配控制措施总量,构建频率稳定紧急控制方案。在某实际交直流混联万节点仿真系统验证了所提方法的有效性。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approved by the Regional Research Ethics Committee,Qassim Province,Saudi Arabia.Number(607-45-12634).
文摘BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study was to evaluate the level of knowledge,attitudes,and behaviors of licensed doctors in Saudi Arabia concerning IMEs,and to identify the demographic factors influencing their preparedness.METHODS:A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia.Participants completed a self-administered questionnaire assessing demographics,knowledge of IMEs,attitudes towards providing assistance,and previous experience with in-flight emergencies.Data were analyzed using SPSS 26,with statistical significance set at P<0.05.RESULTS:The results revealed a predominantly young(75.8% aged 25-34 years)and male(69.6%)participant pool.While 76.6% of respondents recognized the impact of cabin pressure on oxygen,only 45.4% correctly identified air travel risks for asthmatic patients.Although 66.8% felt confident assisting in IMEs,20.9% cited medicolegal concerns.Moreover,area of working within Saudi Arabia(P=0.020),year of experience(P=0.041),prior experience with IMEs(P=0.021),and IMEs training(P<0.001)had a significant association with levels of knowledge.CONCLUSION:The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia.
文摘Red eye affects patients of all ages and is one of the most common ocular complaints seen in primary care and emergency rooms.Some conditions,like scleritis,keratitis,uveitis,or endophthalmitis,can be vision-threatening and necessitate an immediate diagnosis and referral,but many others,like conjunctivitis or episcleritis,are benign and self-limiting.To prevent complications,such as irreversible vision loss or the spread of infection throughout the body,it is essential to accurately and promptly distinguish between benign and serious causes.With a broad range of etiologies covered,this review offers a thorough,evidence-based method for assessing red eye in primary care.For inflammatory,infectious,traumatic,and non-inflammatory disorders,we look at important clinical characteristics,diagnostic factors,and therapeutic approaches.Dry eye syndrome,pterygium,scleritis,episcleritis,keratitis,conjunctivitis,uveitis,blepharitis,hordeolum,endophthalmitis,orbital cellulitis,hyphema,trichiasis,and subconjunctival hemorrhage are among them.Whereas episcleritis usually responds to topical treatment,inflammatory conditions like scleritis and uveitis need systemic corticosteroids or immunosuppressive therapy.Infections such as keratitis,conjunctivitis,and endophthalmitis require treatments specific to the pathogen,while diseases like orbital cellulitis and hyphema may require hospitalization or surgery.External conditions like dry eye and blepharitis are treated conservatively with lubrication and cleanliness.This review aims to provide general practitioners with useful clinical tools for timely assessment,efficient triage,and referral by defining red flag symptoms,hallmark signs,and updated treatment protocols.Regular eye exams and patient education also improve results and lower recurrence.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
文摘Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).
基金supported by the Fundamental Research Funds for the Central Universities(grant number 2024YJS096)National Natural Science Foundation of China(grant numbers 62433005,62272036,62173167).
文摘The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perception model designed to predict emergencies and analyze their causes based on historical unstructured emergency data.To address issues related to data structuredness and missing values,we employed label encoding and an Elastic Net Regularization-based Generative Adversarial Interpolation Network(ER-GAIN)for data structuring and imputation.Additionally,to mitigate the impact of imbalanced data on the predictive performance of emergencies,we introduced an Adaptive Boosting Ensemble Model(AdaBoost)to forecast the key features of emergencies,including event types and levels.We also utilized Information Gain(IG)to analyze and rank the causes of various significant emergencies.Experimental results indicate that,compared to baseline data imputation models,ER-GAIN improved the prediction accuracy of key emergency features by 3.67%and 3.78%,respectively.Furthermore,AdaBoost enhanced the accuracy by over 4.34%and 3.25%compared to baseline predictivemodels.Through causation analysis,we identified the critical causes of train operation and fire incidents.The findings of this research will contribute to the establishment of early warning and prevention mechanisms for emergencies in URTS,potentially leading to safer and more reliable URTS operations.
文摘Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surgery,studies have demonstrated that minimally invasive surgery(MIS)can provide benefits in CRC emergencies,such as reduced morbidity and a shorter length of hospitalization.However,the applicability of MIS in the emergency setting is limited by factors such as compromised patient physiology,resource constraints,and the need for technical expertise.As an alternative to emergency MIS,endoscopic interventions have also been increasingly supported by emerging evidence as a bridge to surgery.This article appraises contemporary guidelines and the evidence behind their recommendations for MIS surgery in CRC emergencies,whilst highlighting the challenges to implementation and the strategies to overcome them.
文摘在新型电力系统复杂工况下,以策略表为主体、通过“离线仿真、在线匹配”的预案式频率稳定控制方案存在较高失配风险,甚至因调控失当引发二次冲击,严重威胁电力系统的安全稳定运行。提出一种计及预案式失配冲击的响应驱动频率稳定紧急切负荷策略。该策略动作在预案式控制之后,是对预案式控制的有益补充,能够有效提升系统频率稳定性。首先建立了基于系统频率响应(system frequency response,SFR)模型辨识的频率稳定切负荷量计算方法。提出了基于频率稀疏量测的SFR模型辨识方法,在此基础上建立了含稳定控制的SFR模型,根据频率稳定控制目标迭代求解切负荷量。其次,建立了基于Transformer网络的频率控制敏感点挖掘模型,通过分析关键发电机母线节点频率时序值和频率控制敏感点的映射关系,实现响应驱动的频率控制敏感点在线挖掘。最后,按照敏感点排序快速分配控制措施总量,构建频率稳定紧急控制方案。在某实际交直流混联万节点仿真系统验证了所提方法的有效性。
