Analysis of good practice of Public Health Emergency Operations Centers

Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.

Cross-regional emergency scheduling planning for petroleum based on the supernetwork model

Petroleum, the most important energy source in the world, plays an essential role in securing economic development. If a petroleum shortage happens, it will severely disrupt production and life. Cross-regional emergency scheduling can effectively alleviate a petroleum shortage and further enhance the efficiency of the emergency response. Considering the general lack of focus on cross-regional petroleum dispatching management, we propose a three-layer emergency scheduling network for petroleum based on a supernetwork model that can increase the regional emergency correlation by adding a transfer management process. Then, we compare the total demand for petroleum and the emergency costs considered in the petroleum emergency scheduling supernetwork model（the single-region and the cross-region scenarios）.The result shows that the cross-regional emergency scheduling pattern can effectively enhance the efficiency of the emergency preparations and reduce the emergency costs in most cases. However, when the vulnerabilities in the crossregional link grow or the regional linkage decreases, the effect of single-regional scheduling is better. In addition, the advantages of the cross-regional emergency scheduling network will be strengthened with an increase in its maximum emergency capability. Nonetheless, this advantage will disappear when the petroleum demand in the crisis layer reaches the maximum emergency response capacity. Finally, according to the comparative analysis simulation among scenarios,certain strategic policy recommendations are suggested to improve the petroleum emergency scheduling ability in regions.These recommendations include strengthening the cross-regional coordination mechanism, increasing the modes of petroleum transportation and enhancing the carrying capacity of regional emergency routes.

Emergency department operations and management education in emergency medicine training

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

Leveraging the Public Health Emergency Operation Center (PHEOC)for pandemic response: opportunities and challenges

Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.

An approach to timing selection of emergency operation for acute cholangitis of severe type

This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.

Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients

BACKGROUND Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery.Emergence agitation(EA)is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications.Pre-anesthetic anxiety may be associated with the development of EA,but studies in this area are lacking.AIM To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer(NSCLC).METHODS Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled.We used the Hospital Anxiety and Depression Scale’s(HADS)anxiety subscale(HADS-A)to determine patients’anxiety at four time points(T1-T4):Patients’preoperative visit,waiting period in the surgical waiting room,after entering the operating room,and before anesthesia induction,respectively.The Riker Sedation-Agitation Scale(RSAS)examined EA after surgery.Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’pre-anesthesia anxiety status and EA.We performed a partial correlation analysis of HADS-A scores with RSAS scores.RESULTS NSCLC patients’HADS-A scores gradually increased at the four time points:7.33±2.03 at T1,7.99±2.22 at T2,8.05±2.81 at T3,and 8.36±4.17 at T4.The patients’postoperative RSAS score was 4.49±1.18,and 27 patients scored≥5,indicating that 33.75%patients had EA.HADS-A scores at T3 and T4 were significantly higher in patients with EA(9.67±3.02 vs 7.23±2.31,12.56±4.10 vs 6.23±2.05,P<0.001).Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4.Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4(r=0.296,0.314,P<0.01).CONCLUSION Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.

Optimization of Urban Rail Transportation in Emerging Countries Using Operational Research Techniques

Rail systems are gradually becoming the most desirable form of transit infrastructure around the world, partly because they are becoming more environmentally friendly compared with airplanes and automobiles. This paper examines the place of emerging countries in this move of implementing modern rail system that will eventually enhance the realization of a low-carbon society. Network model, transportation model and linear programming algorithms are used to model the present urban rail transport system in Nigeria, as an emerging country, in order to optimize it. Operational research methods, including simplex method and MODI, with the aids of computer software (excel solver and LIP solver) were adopted to solve the resulting models. The results showed that optimization of rail transport system will not only reduce carbon emission but also bring about economic development which is required for the eradication of prevalent poverty in these emerging countries.

Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

Emergency Treatment of Testicular Torsion and Postoperative Follow-up: A 71 Case Report

This study presented our experience in the treatment of testicular torsion,which may help achieve early diagnosis and improve therapeutic effects.A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011.The age of the patients ranged from 16 days to 34 years.All the patients had unilateral testicular torsion,which took place on the left side in 43 cases and on the right side in 28 cases.The course of the disease varied between three hours to 30 days.Post-operative follow-up was conducted until October 2011.Items examined included signs and symptoms at their first clinical visit,ultrasound findings,treatment in emergency surgery,and post-operative follow-up.In this study,the 71 patients were diagnosed with testicular torsion by color Doppler sonography,7 had testicular fixation,63 patients received orchiectomy,while 1 patient did not undergo surgery due to pressure from family members.Post-operative follow-up showed that the one patient’s testicle,which had been reserved,atrophied,while all the other survived.No recurrence was found during the follow-up visits.It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion,and the diagnosis and treatment by the first attending clinician is of critical importance.

Midwives’ Adherence to Preoperative Care Guidelines Prior to Emergency Caesarean Section at Bwaila Maternity Hospital in Malawi

A study was conducted to describe midwives’ adherence to preoperative care during emergency caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive prospective and retrospective design. A structured questionnaire was administered to all 28 midwives who were directly involved in the preparation of clients for emergency caesarean section. Clients charts were also reviewed using a standard checklist to determine adherence to preoperative care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies and percentages were computed for the dataset. A midwife was supposed to score at least 80% on each component of preoperative care guidelines to be compliant to the stipulated pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative care guidelines which were;bladder catheterization (100%, n = 14), obtaining informed consent (92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics (82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4);Pulse rate check (25%, n = 3.5);respiration check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was also below standard at 60.7%, n = 8. Other components of psychological support such as surgery information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’ questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative care was below standard at the facility. Most of the midwives were new graduates, who had never received any in-service training on preoperative care. Therefore in service training it is recommended for the midwives to provide good quality of care.

A Review on the Research Progress in Operational Earthquake Forecasting(OEF)in the World

In this paper,the research progress of the Operational Earthquake Forecasting( OEF) is introduced from the major areas of concern,the concept of probability gain,hybrid model development,and the application to earthquake disaster reduction. Due to the development of OEF based on the global "Collaboratory for the Study of Earthquake Predictability( CSEP) " plan,it provides a significant technical foundation for earthquake forecast modeling and a practical foundation for solving the actual problems in earthquake preparedness and disaster mitigation. Therefore, related research and technical ideas provide inspirational and referential significance for earthquake forecasting/prediction.

The Approach of Major Players in Retail in Expanding Their Operations into Developing Markets-Taking Walmart as an Example

This research investigates the expansion behavior of international(giant)retailers,with a specific focus on the determinants of the entry mode choice in emerging markets based on the performance of Walmart in its venture into less developed markets.This research investigates the approach in which major players in retail are expanding their operations into other developing markets,specifically focusing on how the entry mode decisions of giant retailers moderate the risks and difficulties in making business in emerging countries.The objective of this study is to analyze and evaluate the potential causes and antecedents of large merchants's entry mode(EM)choices by assessing Walmart's business performance in less advanced nations in recent years.

Digestive Surgical Emergencies in the General Surgery Department of the Reference Health Center in Commune I of the District of Bamako in Mali

Digestive surgical emergencies concern all patients admitted urgently and for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work we have set ourselves the following objectives: Study digestive surgical emergencies in the general surgery department of the Cs ref CI of Bamako;Determine the frequency of digestive surgical emergencies;Describe the clinical and therapeutic aspects, and Analyze the results of treatment. From January 2016 to December 2016, the general surgery department of the Cs ref CI of Bamako carried out 200 digestive surgical emergencies whose files were usable;119 men and 81 women, a sex ratio of 1.5. The average age was 32.67 years;66% medical evacuation. Abdominal pain was the main reason for consultation. In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain doubtful cases, we requested paraclinical examinations (ultrasound, ASP and the rhesus group). The main etiology was acute appendicitis with 59% of cases. The frequency of digestive surgical emergencies was 35.1% of all activities of the general surgery department of the Cs ref CI of Bamako. The postoperative course was complicated in 4% of cases. Surgical site infections were the most common postoperative complications, accounting for 3% of our patients. One death was noted, i.e. 0.5% of our sample. Acute peritonitis was the cause of death in 100% of cases.

继电保护远程运维系统报文合规检测及入侵阻断技术应用

继电保护远程运维中数据传输各环节存在网络入侵风险,现有安全措施未有效处理业务层风险,且存在风险阻断不及时等问题。为此,提出一种报文合规检测方法及入侵阻断技术,分析报文的对象、格式、业务逻辑和行为模式,建立报文合规规则库及不合规报文阻断策略,设计开发不合规报文阻断模块及“一键阻断”紧急控制模块。通过模拟仿真环境测试,结果表明,上述技术对不同类型异常报文进行的阻断效果与预期一致,可有效阻断非法入侵攻击,从而提高继电保护远程运维的安全性和稳定性。

飞行员应急处置能力评价模型

为提高飞行员在紧急情境下的应急处置能力,减少民航安全事故,基于决策模型和应激理论模型,分析飞行员任务过程,从飞行员运行安全能力和飞行员储备安全能力2个方面建立飞行员应急处置能力指标体系;运用模糊层次分析法(FAHP)建立包含安全运行能力B1和储备安全能力B2指标体系,结合专家意见确定二级指标的隶属度,得到飞行员应急处置能力的核心指标;通过证据推理(ER)算法合成民航安全领域相关专家综合评价飞行员应急处置能力的流程,并选取某航空公司2个机组飞行员进行实证分析。研究结果表明:评价飞行员应急处置能力模型很好地降低不确定性对评价结果的影响,从而显著提高评价结果的可靠性。

突发公共卫生事件下服务系统运营模式的选择

在全球化的进程中,有效应对和化解突发公共卫生事件已成为中国社会卫生治理和风险防范的重要议题。自新中国成立以来,我国已经历五次重大突发公共卫生事件的严峻考验。尽管在历次挑战中,国家不断完善处理机制,但劳动密集型服务业在突发公共卫生事件中仍然面临着巨大的挑战。因此,服务商们必须调整和创新原有的运营策略,以有效应对突发公共卫生事件带来的挑战。对原有模式的改善需要耗费高昂的应急成本,这使得部分服务商在承担这些成本时犹豫不决。因此,服务商对于运营模式选择的实施条件尚不明确。基于此,结合感染风险、市场容量和应急成本等多重因素,对突发公共卫生事件服务商的应急模式进行了深入探讨,以供各服务商参考。

面向大规模农田的农机跨区作业紧急调配研究

针对大规模农田的粮食抢收工作,由于抢收约束时间的限制,导致可能无法在规定时间内完成所有粮食的收割任务,此时则会出现粮食损失值。构建以粮食损失值最小化为目标的农机跨区紧急调配模型,提出基于两阶段的农机紧急调配算法(Agricultural Machinery Emergency Algorithm based on Two Stages,TSEA)。首先按照基于距离的分区策略对大规模农田进行分区,接着采用改进的遗传算法分别对各农田分区进行农机紧急作业调配。为验证算法的有效性,主要从紧急任务的粮食损失值、算法运行时间等方面将TSEA算法与GA、SA算法进行比较,试验结果表明,TSEA算法得到的紧急调度方案优于其他两种算法。为验证本文分区策略的有效性,分别采用TSEA算法和不分区的紧急调配算法从粮食损失值、算法运行时间等方面进行比较,验证分区策略的有效性。多组试验结果表明该文提出的策略和算法对于解决大规模农田的农机跨区紧急调配问题更有效,可为农机管理部门提供解决方案。

急诊床旁超声教学在住院医师培训课程中的应用

目的分析急诊床旁超声教学对住院医师临床综合能力的影响。方法选取2021年1月至2023年6月百色市人民医院的60名新入科住院医师为研究对象,通过随机数字表法分为对照组(n=30)和观察组(n=30)。所有新入科医师进入超声科后均由高年资医师培训指导,培训2周,每天8 h。对照组全天跟随导师在诊室培训;观察组上午在诊室培训,下午跟随导师参加急诊床旁超声检查。比较两组医师培训后的理论考核成绩、操作技能考核成绩、临床思维能力评分以及教学满意度。结果两组培训后的理论考核成绩比较,差异无统计学意义(P>0.05);观察组操作技能考核成绩、临床思维能力评分、自主学习能力和教学满意度均高于对照组,差异有统计学意义(P<0.05)。结论在诊室培训教学中融入急诊床旁超声教学能够显著提高住院医师的操作技能、临床思维、自主学习能力,值得推广。