In this paper,a robust and consistent COVID-19 emergency decision-making approach is proposed based on q-rung linear diophantine fuzzy set(q-RLDFS),differential evolutionary(DE)optimization principles,and evidential r...In this paper,a robust and consistent COVID-19 emergency decision-making approach is proposed based on q-rung linear diophantine fuzzy set(q-RLDFS),differential evolutionary(DE)optimization principles,and evidential reasoning(ER)methodology.The proposed approach uses q-RLDFS in order to represent the evaluating values of the alternatives corresponding to the attributes.DE optimization is used to obtain the optimal weights of the attributes,and ER methodology is used to compute the aggregated q-rung linear diophantine fuzzy values(q-RLDFVs)of each alternative.Then the score values of alternatives are computed based on the aggregated q-RLDFVs.An alternative with the maximum score value is selected as a better one.The applicability of the proposed approach has been illustrated in COVID-19 emergency decision-making system and sustainable energy planning management.Moreover,we have validated the proposed approach with a numerical example.Finally,a comparative study is provided with the existing models,where the proposed approach is found to be robust to perform better and consistent in uncertain environments.展开更多
To effectively deal with fuzzy and uncertain information in public engineering emergencies,an emergency decision-making method based on multi-granularity language information is proposed.Firstly,decision makers select...To effectively deal with fuzzy and uncertain information in public engineering emergencies,an emergency decision-making method based on multi-granularity language information is proposed.Firstly,decision makers select the appropriate language phrase set according to their own situation,give the preference information of the weight of each key indicator,and then transform the multi-granularity language information through consistency.On this basis,the sequential optimization technology of the approximately ideal scheme is introduced to obtain the weight coefficient of each key indicator.Subsequently,the weighted average operator is used to aggregate the preference information of each alternative scheme with the relative importance of decision-makers and the weight of key indicators in sequence,and the comprehensive evaluation value of each scheme is obtained to determine the optimal scheme.Lastly,the effectiveness and practicability of the method are verified by taking the earthwork collapse accident in the construction of a reservoir as an example.展开更多
With the frequent occurrences of emergency events,emergency decision making(EDM)plays an increasingly significant role in coping with such situations and has become an important and challenging research area in recent...With the frequent occurrences of emergency events,emergency decision making(EDM)plays an increasingly significant role in coping with such situations and has become an important and challenging research area in recent times.It is essential for decision makers to make reliable and reasonable emergency decisions within a short span of time,since inappropriate decisions may result in enormous economic losses and social disorder.To handle emergency effectively and quickly,this paper proposes a new EDM method based on the novel concept of q-rung orthopair fuzzy rough(q-ROPR)set.A novel list of q-ROFR aggregation information,detailed description of the fundamental characteristics of the developed aggregation operators and the q-ROFR entropy measure that determine the unknown weight information of decision makers as well as the criteria weights are specified.Further an algorithm is given to tackle the uncertain scenario in emergency to give reliable and reasonable emergency decisions.By using proposed list of q-ROFR aggregation information all emergency alternatives are ranked to get the optimal one.Besides this,the q-ROFR entropy measure method is used to determine criteria and experts’weights objectively in the EDM process.Finally,through an illustrative example of COVID-19 analysis is compared with existing EDM methods.The results verify the effectiveness and practicability of the proposed methodology.展开更多
Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs...Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs have lost their ability to accurately capture the views of decision-makers(DMs)in certain circumstances,such as when the DM hesitates between multiple linguistic terms or the decision information is incomplete,thus affecting their role in the decision-making process.Belief function theory is a leading streamof thought in uncertainty processing that is suitable for dealing with the limitations of PLTS.Therefore,the purpose of this study is to extend PLTS to incorporate belief function theory.First,we provide the basic concepts of the extended PLTS(i.e.,belief-based PLTS)through case analyses.Second,the aggregation operator of belief-based PLTS is defined with the ordered weighted average(OWA)-based soft likelihood function,which is improved by considering the reliability of the information source.Third,to measure the magnitude of different belief-based PLTSs,the belief interval of singleton is calculated,and the comparison method of belief-based PLTS is constructed based on probabilities.On the basis of the preceding discussion,we further develop an emergency decision framework that includes several novel techniques,such as attribute weight determination and decision information aggregation.Finally,the usefulness of the framework is demonstrated through a case study,and its effectiveness is illustrated through a series of comparisons.展开更多
BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to...BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to evaluate MedGo,a novel medical LLM,as a decision-support tool for clinicians managing patients with suspected sepsis.METHODS:This retrospective study included anonymized medical records of 203 patients(mean age 79.9±10.2 years)with confi rmed sepsis from a tertiary hospital ED between January 2023 and January 2024.MedGo performance across nine sepsis-related assessment tasks was compared with that of two junior(<3 years of experience)and two senior(>10 years of experience)ED physicians.Assessments were scored on a 5-point Likert scale for accuracy,comprehensiveness,readability,and case-analysis skills.RESULTS:MedGo demonstrated diagnostic performance comparable to that of senior physicians across most metrics,achieving a median Likert score of 4 in accuracy,comprehensiveness,and readability.MedGo signifi cantly outperformed junior physicians(P<0.001 for accuracy and case-analysis skills).MedGo assistance significantly enhanced both junior(P<0.001)and senior(P<0.05)physicians'diagnostic accuracy.Notably,MedGo-assisted junior physicians achieved accuracy levels comparable to those of unassisted senior physicians.MedGo maintained consistent performance across varying sepsis severities.CONCLUSION:MedGo shows significant diagnostic efficacy for sepsis and effectively supports clinicians in the ED,particularly enhancing junior physicians’performance.Our study highlights the potential of MedGo as a valuable decision-support tool for sepsis management,paving the way for specialized sepsis AI models.展开更多
The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a pati...The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare 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
To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforce...To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.展开更多
BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pP...Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.展开更多
Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the...Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.展开更多
Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribu...Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.展开更多
Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mind...Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.展开更多
Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective to...Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.展开更多
BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpfu...BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.展开更多
Introduction: Head injuries constitute a public health problem in Cameroon and everywhere else in the world. They represent 23% of admissions to the Yaounde emergency center (CURY), which is a center exclusively dedic...Introduction: Head injuries constitute a public health problem in Cameroon and everywhere else in the world. They represent 23% of admissions to the Yaounde emergency center (CURY), which is a center exclusively dedicated, since 2014, to emergency care in Yaounde. In the management of trauma brain injuries at CURY, several are operated on. However, to date, no evaluation of these operated patients has yet been made. Goals: The objective of this study was to highlight the prognostic factors in patients operated for TBI at CURY. Methodology: We conducted a descriptive study whose data collection was done retrospectively over 2 years (01 January 2021 to 31 December 2022) at CURY. Data was collected from the registers of operative reports. Results: We enrolled 105 medical reports of patients who were victims of TBI operated on. The male gender predominated with a sex ratio of 3/1. The average age of the patients was 37.5 ± 18.83 years. Public road accidents were the leading cause of TBI in 75.2% of cases. The means of transport of the victims were mostly non-medical 97.1%. 45.7% of patients were admitted in less than 6 hours following injury. The initial clinical evaluation found 45.8% of patients with a Glasgow Coma Score (GCS) between [14, 15], and 13.2% of patients had a GCS 8. The indications for surgery were extradural hematoma (30%), followed by acute subdural hematoma (24%). The major complication was postoperative infection (25%). The mortality rate of the series was 7.9%. Poor prognostic factors were the depth of the coma on admission, advanced age and postoperative complications. Conclusion: The results of this study suggest that most patients operated on for TBI at CURY had a favorable outcome. The poor prognostic factors were the depth of the coma on admission, advanced age, postoperative complications and comorbidities.展开更多
Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medicati...Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.展开更多
Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as t...Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as the research objects.Emergency rescue capability training was conducted from March 2023 to June 2023,once a month.The students’mastery of emergency rescue before and after the intervention was analyzed.Survey questionnaires were distributed to all college students to understand their channels and willingness to acquire emergency rescue knowledge.Results:A total of 886 valid questionnaires were collected in this study.The highest proportion of knowledge about China’s general emergency telephone number and how to dial the emergency rescue hotline was 100.00%.Among the strategies for dealing with cardiac arrest in CPR,the highest proportion was 336.34%.Among the four major first aid techniques of hemostasis,bandaging,fixation,transportation,the highest proportion of knowledge about the use of rubber band signs was 31.71%.Among the first aid techniques for heatstroke,poisoning,fire,and sharp instrument injuries,the principle of emergency treatment for severe gas poisoning had the highest proportion of 41.42%,showing significant differences.College students mainly acquire knowledge of emergency rescue capability through TV programs,health education lectures,and the internet.Around 61.40%of college students hope to learn more about prevention and control knowledge.Conclusion:After the intervention of emergency rescue capability,the emergency rescue capability of college students in this university has been significantly improved,showing a strong training effect,which is worthy of promotion.展开更多
Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses...Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.展开更多
Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues le...Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.展开更多
文摘In this paper,a robust and consistent COVID-19 emergency decision-making approach is proposed based on q-rung linear diophantine fuzzy set(q-RLDFS),differential evolutionary(DE)optimization principles,and evidential reasoning(ER)methodology.The proposed approach uses q-RLDFS in order to represent the evaluating values of the alternatives corresponding to the attributes.DE optimization is used to obtain the optimal weights of the attributes,and ER methodology is used to compute the aggregated q-rung linear diophantine fuzzy values(q-RLDFVs)of each alternative.Then the score values of alternatives are computed based on the aggregated q-RLDFVs.An alternative with the maximum score value is selected as a better one.The applicability of the proposed approach has been illustrated in COVID-19 emergency decision-making system and sustainable energy planning management.Moreover,we have validated the proposed approach with a numerical example.Finally,a comparative study is provided with the existing models,where the proposed approach is found to be robust to perform better and consistent in uncertain environments.
文摘To effectively deal with fuzzy and uncertain information in public engineering emergencies,an emergency decision-making method based on multi-granularity language information is proposed.Firstly,decision makers select the appropriate language phrase set according to their own situation,give the preference information of the weight of each key indicator,and then transform the multi-granularity language information through consistency.On this basis,the sequential optimization technology of the approximately ideal scheme is introduced to obtain the weight coefficient of each key indicator.Subsequently,the weighted average operator is used to aggregate the preference information of each alternative scheme with the relative importance of decision-makers and the weight of key indicators in sequence,and the comprehensive evaluation value of each scheme is obtained to determine the optimal scheme.Lastly,the effectiveness and practicability of the method are verified by taking the earthwork collapse accident in the construction of a reservoir as an example.
基金This Project was funded by the Deanship of Scientific Research(DSR),King Abdulaziz University,Jeddah,under the Grant No.(G:578-135-1441)The authors,therefore,acknowledge with thanks DSR for technical and financial support.
文摘With the frequent occurrences of emergency events,emergency decision making(EDM)plays an increasingly significant role in coping with such situations and has become an important and challenging research area in recent times.It is essential for decision makers to make reliable and reasonable emergency decisions within a short span of time,since inappropriate decisions may result in enormous economic losses and social disorder.To handle emergency effectively and quickly,this paper proposes a new EDM method based on the novel concept of q-rung orthopair fuzzy rough(q-ROPR)set.A novel list of q-ROFR aggregation information,detailed description of the fundamental characteristics of the developed aggregation operators and the q-ROFR entropy measure that determine the unknown weight information of decision makers as well as the criteria weights are specified.Further an algorithm is given to tackle the uncertain scenario in emergency to give reliable and reasonable emergency decisions.By using proposed list of q-ROFR aggregation information all emergency alternatives are ranked to get the optimal one.Besides this,the q-ROFR entropy measure method is used to determine criteria and experts’weights objectively in the EDM process.Finally,through an illustrative example of COVID-19 analysis is compared with existing EDM methods.The results verify the effectiveness and practicability of the proposed methodology.
基金supported by National Social Science Foundation of China (Grant No.17ZDA030).
文摘Probabilistic linguistic term sets(PLTSs)are an effective tool for expressing subjective human cognition that offer advantages in the field ofmulti-attribute decision-making(MADM).However,studies have found that PLTSs have lost their ability to accurately capture the views of decision-makers(DMs)in certain circumstances,such as when the DM hesitates between multiple linguistic terms or the decision information is incomplete,thus affecting their role in the decision-making process.Belief function theory is a leading streamof thought in uncertainty processing that is suitable for dealing with the limitations of PLTS.Therefore,the purpose of this study is to extend PLTS to incorporate belief function theory.First,we provide the basic concepts of the extended PLTS(i.e.,belief-based PLTS)through case analyses.Second,the aggregation operator of belief-based PLTS is defined with the ordered weighted average(OWA)-based soft likelihood function,which is improved by considering the reliability of the information source.Third,to measure the magnitude of different belief-based PLTSs,the belief interval of singleton is calculated,and the comparison method of belief-based PLTS is constructed based on probabilities.On the basis of the preceding discussion,we further develop an emergency decision framework that includes several novel techniques,such as attribute weight determination and decision information aggregation.Finally,the usefulness of the framework is demonstrated through a case study,and its effectiveness is illustrated through a series of comparisons.
基金supported by grants from the National Natural Science Foundation of China(82470074 to LT)the municipal Natural Science Foundation of Shanghai Scientific Committee of China(22ZR1451000 to LT)+6 种基金the Peak Supporting Clinical Discipline of Shanghai Health Bureau(2023ZDFC0104 to LT)the Medical Discipline Construction Program of Shanghai Pudong New Area Health Commission(the Key Disciplines Program,PWZxk2022-17 to LT)the Scientifi c Research Program of Shanghai Pudong New Area Health Commission(the Joint Research and Development Program,PW2023D-07 to LT)the Healthcare Talents Elite Program of Shanghai Pudong New Area(2025PDWSYCBJ-03 to LT)the Youth Science and Technology Program of Shanghai Pudong New Area(PW2024B-11 to CX)the People’s Livelihood Research Project of Shanghai Pudong Science and Economy Commission(PKJ2023-Y39 to DZ)the Scientifi c Research Program of Shanghai Pudong New Area Health Commission(the Science Popularization Program,PWKP2024B-19 to XL).
文摘BACKGROUND:Large language models(LLMs)are being explored for disease prediction and diagnosis;however,their effi cacy for early sepsis identifi cation in emergency departments(EDs)remains unexplored.This study aims to evaluate MedGo,a novel medical LLM,as a decision-support tool for clinicians managing patients with suspected sepsis.METHODS:This retrospective study included anonymized medical records of 203 patients(mean age 79.9±10.2 years)with confi rmed sepsis from a tertiary hospital ED between January 2023 and January 2024.MedGo performance across nine sepsis-related assessment tasks was compared with that of two junior(<3 years of experience)and two senior(>10 years of experience)ED physicians.Assessments were scored on a 5-point Likert scale for accuracy,comprehensiveness,readability,and case-analysis skills.RESULTS:MedGo demonstrated diagnostic performance comparable to that of senior physicians across most metrics,achieving a median Likert score of 4 in accuracy,comprehensiveness,and readability.MedGo signifi cantly outperformed junior physicians(P<0.001 for accuracy and case-analysis skills).MedGo assistance significantly enhanced both junior(P<0.001)and senior(P<0.05)physicians'diagnostic accuracy.Notably,MedGo-assisted junior physicians achieved accuracy levels comparable to those of unassisted senior physicians.MedGo maintained consistent performance across varying sepsis severities.CONCLUSION:MedGo shows significant diagnostic efficacy for sepsis and effectively supports clinicians in the ED,particularly enhancing junior physicians’performance.Our study highlights the potential of MedGo as a valuable decision-support tool for sepsis management,paving the way for specialized sepsis AI models.
文摘The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific research.PROMs encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of life.By integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments accordingly.The deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment plans.Moreover,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health conditions.However,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and providers.Overcoming these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of PROMs.The paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare 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.
基金Supported by National Key Research and Development Program of China(Grant No.2022YFE0117100)National Science Foundation of China(Grant No.52102468,52325212)Fundamental Research Funds for the Central Universities。
文摘To solve problems of poor security guarantee and insufficient training efficiency in the conventional reinforcement learning methods for decision-making,this study proposes a hybrid framework to combine deep reinforcement learning with rule-based decision-making methods.A risk assessment model for lane-change maneuvers considering uncertain predictions of surrounding vehicles is established as a safety filter to improve learning efficiency while correcting dangerous actions for safety enhancement.On this basis,a Risk-fused DDQN is constructed utilizing the model-based risk assessment and supervision mechanism.The proposed reinforcement learning algorithm sets up a separate experience buffer for dangerous trials and punishes such actions,which is shown to improve the sampling efficiency and training outcomes.Compared with conventional DDQN methods,the proposed algorithm improves the convergence value of cumulated reward by 7.6%and 2.2%in the two constructed scenarios in the simulation study and reduces the number of training episodes by 52.2%and 66.8%respectively.The success rate of lane change is improved by 57.3%while the time headway is increased at least by 16.5%in real vehicle tests,which confirms the higher training efficiency,scenario adaptability,and security of the proposed Risk-fused DDQN.
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
基金supported by the Deanship of Graduate Studies and Scientific Research at Qassim University(QU-APC-2024-9/1).
文摘Due to the numerous variables to take into account as well as the inherent ambiguity and uncertainty,evaluating educational institutions can be difficult.The concept of a possibility Pythagorean fuzzy hypersoft set(pPyFHSS)is more flexible in this regard than other theoretical fuzzy set-like models,even though some attempts have been made in the literature to address such uncertainties.This study investigates the elementary notions of pPyFHSS including its set-theoretic operations union,intersection,complement,OR-and AND-operations.Some results related to these operations are also modified for pPyFHSS.Additionally,the similarity measures between pPyFHSSs are formulated with the assistance of numerical examples and results.Lastly,an intelligent decision-assisted mechanism is developed with the proposal of a robust algorithm based on similarity measures for solving multi-attribute decision-making(MADM)problems.A case study that helps the decision-makers assess the best educational institution is discussed to validate the suggested system.The algorithmic results are compared with the most pertinent model to evaluate the adaptability of pPyFHSS,as it generalizes the classical possibility fuzzy set-like theoretical models.Similarly,while considering significant evaluating factors,the flexibility of pPyFHSS is observed through structural comparison.
基金the financial support from the Fujian Science Foundation for Outstanding Youth(2023J06039)the National Natural Science Foundation of China(Grant No.41977259,U2005205,41972268)the Independent Research Project of Technology Innovation Center for Monitoring and Restoration Engineering of Ecological Fragile Zone in Southeast China(KY-090000-04-2022-019)。
文摘Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.
基金supported in part by the National Nat-ural Science Foundation of China(52177110)Key Pro-gram of the National Natural Science Foundation of China(U22B20106,U2142206)+2 种基金Shenzhen Science and Technology Program(JCYJ20210324131409026)the Science and Technology Project of the State Grid Corpo-ration of China(5200-202319382A-2-3-XG)State Grid Zhejiang Elctric Power Co.,Ltd.Science and Tech-nology Project(B311DS24001A).
文摘Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.
文摘Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.
文摘Accurate medical diagnosis,which involves identifying diseases based on patient symptoms,is often hindered by uncertainties in data interpretation and retrieval.Advanced fuzzy set theories have emerged as effective tools to address these challenges.In this paper,new mathematical approaches for handling uncertainty in medical diagnosis are introduced using q-rung orthopair fuzzy sets(q-ROFS)and interval-valued q-rung orthopair fuzzy sets(IVq-ROFS).Three aggregation operators are proposed in our methodologies:the q-ROF weighted averaging(q-ROFWA),the q-ROF weighted geometric(q-ROFWG),and the q-ROF weighted neutrality averaging(qROFWNA),which enhance decision-making under uncertainty.These operators are paired with ranking methods such as the similarity measure,score function,and inverse score function to improve the accuracy of disease identification.Additionally,the impact of varying q-rung values is explored through a sensitivity analysis,extending the analysis beyond the typical maximum value of 3.The Basic Uncertain Information(BUI)method is employed to simulate expert opinions,and aggregation operators are used to combine these opinions in a group decisionmaking context.Our results provide a comprehensive comparison of methodologies,highlighting their strengths and limitations in diagnosing diseases based on uncertain patient data.
文摘BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using the χ^(2) test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.
文摘Introduction: Head injuries constitute a public health problem in Cameroon and everywhere else in the world. They represent 23% of admissions to the Yaounde emergency center (CURY), which is a center exclusively dedicated, since 2014, to emergency care in Yaounde. In the management of trauma brain injuries at CURY, several are operated on. However, to date, no evaluation of these operated patients has yet been made. Goals: The objective of this study was to highlight the prognostic factors in patients operated for TBI at CURY. Methodology: We conducted a descriptive study whose data collection was done retrospectively over 2 years (01 January 2021 to 31 December 2022) at CURY. Data was collected from the registers of operative reports. Results: We enrolled 105 medical reports of patients who were victims of TBI operated on. The male gender predominated with a sex ratio of 3/1. The average age of the patients was 37.5 ± 18.83 years. Public road accidents were the leading cause of TBI in 75.2% of cases. The means of transport of the victims were mostly non-medical 97.1%. 45.7% of patients were admitted in less than 6 hours following injury. The initial clinical evaluation found 45.8% of patients with a Glasgow Coma Score (GCS) between [14, 15], and 13.2% of patients had a GCS 8. The indications for surgery were extradural hematoma (30%), followed by acute subdural hematoma (24%). The major complication was postoperative infection (25%). The mortality rate of the series was 7.9%. Poor prognostic factors were the depth of the coma on admission, advanced age and postoperative complications. Conclusion: The results of this study suggest that most patients operated on for TBI at CURY had a favorable outcome. The poor prognostic factors were the depth of the coma on admission, advanced age, postoperative complications and comorbidities.
文摘Introduction and Problem Statement: Many medication errors occur during the community and hospital transition. Indeed, the World Health Organization launched the international “High 5S” project to implement medication reconciliation in healthcare facilities to reduce them and ensure patients a safe, high-quality healthcare pathway. Objective: This study aimed to detect medication errors by reconciling drug treatments and assess the relevance and feasibility of this standardized practice within the Medical Emergency Unit of the Teaching Pediatric Hospital of Ouagadougou (Burkina Faso). Methods: Patients whose parents gave their consent at their entrance were enrolled. For each patient, the pharmacy team completed a reconciliation form that included the patient’s usual treatment, which was taken and in progress and received upon admission to the medical emergency unit. Patients’ treatments were reviewed to detect and characterize discrepancies. The data of each form were reported and analyzed using KoboCollect, an Android application. Results: 135 records and 412 medication lines were captured over six weeks. The average time of treatment reconciliation per patient was 57 minutes. One thousand one hundred ninety-eight (1198) intentional discrepancies were detected, of which 6.09% were documented. Seventy-one (71) unintentional discrepancies were collected, including 39 omissions, 24 regimen dosing errors, and 8 pharmaceutical form dosage errors. Forty-nine (49) unintentional discrepancies, or 69.01%, were corrected by formulated pharmaceutical interventions toward physicians. Conclusion: Medical treatment reconciliation during hospital admission is critical because discrepancies can compromise the efficacy and/or safety of the patient’s hospital medication.
文摘Objective:To explore the application effect of emergency rescue capability intervention among students in a university in Beijing.Methods:A total of 900 students from a university in Beijing in 2023 were selected as the research objects.Emergency rescue capability training was conducted from March 2023 to June 2023,once a month.The students’mastery of emergency rescue before and after the intervention was analyzed.Survey questionnaires were distributed to all college students to understand their channels and willingness to acquire emergency rescue knowledge.Results:A total of 886 valid questionnaires were collected in this study.The highest proportion of knowledge about China’s general emergency telephone number and how to dial the emergency rescue hotline was 100.00%.Among the strategies for dealing with cardiac arrest in CPR,the highest proportion was 336.34%.Among the four major first aid techniques of hemostasis,bandaging,fixation,transportation,the highest proportion of knowledge about the use of rubber band signs was 31.71%.Among the first aid techniques for heatstroke,poisoning,fire,and sharp instrument injuries,the principle of emergency treatment for severe gas poisoning had the highest proportion of 41.42%,showing significant differences.College students mainly acquire knowledge of emergency rescue capability through TV programs,health education lectures,and the internet.Around 61.40%of college students hope to learn more about prevention and control knowledge.Conclusion:After the intervention of emergency rescue capability,the emergency rescue capability of college students in this university has been significantly improved,showing a strong training effect,which is worthy of promotion.
文摘Pediatric emergency care(PEC)encompasses the specialized medical care delivered to infants,children,and adolescents facing urgent medical situations,addressing critical conditions such as infections,allergic responses,seizures,respiratory distress,and trauma.PEC calls for prompt,focused interventions to address each child's developmental and physiological needs.The literature was searched using Google Scholar,PubMed,and the Cochrane Library to retrieve studies assessing quality indicators and outcomes in pediatric emergencies.The search was limited to papers published in peer-reviewed journals between 01 Jan 2000 and 15 Dec 2024.This review evaluates current PEC standards such as patient safety,diagnostic precision,timeliness,and patient and family satisfaction.Patient safety is vital because children are particularly vulnerable to medical errors,such as inappropriate doses of medication.The provision of high-quality PEC is hampered by systemic issues such as inadequate training,a lack of re-sources,and restricted access to treatment.Telemedicine,pediatric transport units,artificial intelligence applications for diagnostics,and simulation-based training are suggested approaches to overcome these challenges.Research net-works and quality improvement initiatives are important steps to improve PEC care.
文摘Objectives This study aimed to clarify the relationship between the content of proxy decision-making made by families of patients with malignant brain tumors regarding treatment policies and daily care and the cues leading to those decisions.Methods Semi-structured personal interviews were used to collect data.Seven family members of patients with malignant brain tumors were selected to participate in the study by purposive sampling method from June to August 2022 in the Patient Family Association of Japan.Responses were content analyzed to explore the relationship between the content of decisions regarding“treatment policies”and“daily care”and the cues influencing those decisions.Semi-structured interviews were analyzed by using thematic analysis.Results The contents of proxy decisions regarding“treatment policies”included implementation,interruption,and termination of initial treatments,free medical treatments,use of respirators,and end-of-life sedation and included six cues:treatment policies suggested by the primary physician,information and knowledge about the disease and treatment obtained by the family from limited resources,perceived life threat from symptom worsening,words and reactions from the patient regarding treatment,patient’s personality and way of life inferred from their treatment preferences,family’s thoughts and values hoping for better treatment for the patient.Decisions for“daily care”included meal content and methods,excretion,mobility,maintaining cleanliness,rehabilitation,continuation or resignation from work,treatment settings(outpatient or inpatient),and ways to spend time outside and included seven cues:words and thoughts from the patient about their way of life,patient’s reactions and life history inferred from their preferred way of living,things the patient can do to maintain daily life and roles,awareness of the increasing inability to do things in daily life,family’s underlying thoughts and values about how to spend the remaining time,approval from family members regarding the care setting,advice from medical professionals on living at home.Conclusions For“treatment policies,”guidelines from medical professionals were a key cue,while for“daily care,”the small signs from the patients in their daily lives served as cues for proxy decision-making.This may be due to the lack of information available to families and the limited time available for discussion with the patient.Families of patients with malignant brain tumors repeatedly use multiple cues to make proxy decision-making under high uncertainty.Therefore,nurses supporting proxy decision-making should assess the family’s situation and provide cues that facilitate informed and confident decisions.
