Research on Public Engineering Emergency Decision-Making Based on Multi-Granularity Language Information

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.

Analysis of the Role of Problem-Based Independent Learning Model in Teaching Cerebral Ischemic Stroke First Aid in Emergency Medicine

Objective:To analyze the effect of using a problem-based(PBL)independent learning model in teaching cerebral ischemic stroke(CIS)first aid in emergency medicine.Methods:90 interns in the emergency department of our hospital from May 2022 to May 2023 were selected for the study.They were divided into Group A(45,conventional teaching method)and Group B(45 cases,PBL independent learning model)by randomized numerical table method to compare the effects of the two groups.Results:The teaching effect indicators and student satisfaction scores in Group B were higher than those in Group A(P<0.05).Conclusion:The use of the PBL independent learning model in the teaching of CIS first aid can significantly improve the teaching effect and student satisfaction.

Information Aggregation of Group Decision-Making in Emergency Events

Information is a key factor in emergency management, which helps decision makers to make effective decisions. In this paper, aiming at clarifying the information aggregation laws, and according to the characteristic of emergency information, information relative entropy is applied in the information aggregation to establish the information aggregation model of emergency group decision-making. The analysis shows that support and credibility of decision rule are the two factors in information aggregation. The results of four emergency decision-making groups in case study support the analysis in the paper.

Characteristics of Decision-Making by Family Members When Older Adults Are Hospitalized in Emergency Cases with Life-Threatening Conditions

Aim: This study aims to elucidate decision-making characteristics based on interviews with family members with experience in having to select treatments for older adult patients who have been hospitalized following emergency transport to the hospital. Design: Semi-structured interviews were conducted with 10 individuals with experience in surrogate decision-making for an older adult family member. Methods: The recorded interview data were transcribed verbatim, divided into minimum semantic units, and coded. Next, categories and subcategories were abstracted. A comparison was made with the conceptual constructs of a previous study that examined decision-making by families in a life-threatening crisis. Results: Four categories were extracted from 489 antecedents, 370 attributes, and 388 consequences. One new category was abstracted for each of: 1) antecedents: observing abnormalities and responding, while being worried about death;2) attributes: deliberating on the patient prognosis, the relationship with the patient, and what they believe the patient would want;and 3) consequences: continuing support during convalescence. It is desirable to provide support based on the characteristics of families of older adults, including considering the psychological burden on the families who make surrogate decisions, and also the burden of subsequent caregiving because it is not and in the present environment has not been common for patients to express their wishes beforehand.

Construction of an Index System for Earthquake Emergency Loss Assessment and Decision-making

Loss assessment and decision-making are essential for earthquake emergency rescues,and for scientific prediction of seismic damage and determination of rescue objectives.In practice,however,there exist some problems,such as basic data not being precise and rich enough and decision making not having systematic and complete criteria.This paper tries to solve these problems using the method of data indexation by constructing an index system for earthquake emergency loss assessment and decision-making.

An overview of the construction of emergency and pre-hospital first aid platform

To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.

Don’t forget emergency surgery! Lessons to learn from elective indocyanine green-guided gastrointestinal interventions

Fluorescence-based imaging has found application in several fields of elective surgery,but there is still a lack of evidence in the literature about its use in the emergency setting.Clinical trials have consistently shown that indocyanine green(ICG)-guided surgery can dramatically reduce the risk of postoperative complic-ations,length of in-hospital stay and total healthcare costs in the elective setting.It is well-known that emergency surgery has a higher complication rate than its elective counterpart,therefore an impelling need for research studies to explore,validate and develop this issue has been highlighted.The present editorial aims to provide a critical overview of currently available applications and pitfalls of ICG fluorescence in abdominal emergencies.Furthermore,we evidenced how the experience of ICG-fluorescence in elective surgery might be of great help in implementing its use in acute situations.In the first paragraph we analyzed the tips and tricks of ICG-guided cancer surgery that might be exploited in acute cases.We then deepened the two most described topics in ICG-guided emergency surgery:Acute cholecystitis and intestinal ischemia,focusing on both the advantages and limitations of green-fluorescence application in these two fields.In emergency situations,ICG fluorescence demonstrates a promising role in preventing undue intestinal resections or their entity,facilitating the detection of intestinal ischemic zones,identifying biliary tree anatomy,reducing post-operative complications,and mitigating high mortality rates.The need to improve its application still exists,therefore we strongly believe that the elective and routinary use of the dye is the best way to acquire the necessary skills for emer-gency procedures.

Preparedness training programs improved the emergency response and crucial outcomes among nursing students:a scoping review

Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.

Value of Emergency Nursing Procedures in Improving the First Aid Efficiency and Outcomes of Comatose Patients with Cerebral Hemorrhage

Objective:To determine the application value of emergency nursing in improving the efficiency and outcomes of first aid for comatose patients with cerebral hemorrhage.Methods:Forty comatose patients with cerebral hemorrhage treated in Suzhou Hospital of Traditional Chinese Medicine from August 2018 to June 2019 were selected as the research subjects in this study;the patients were divided into two groups,a control group and a study group,by lot;the patients in the control group received nursing by conventional means,while emergency nursing procedures were provided to the patients in the study group;the efficiency of first aid and the outcomes of the two groups were compared;the application value of emergency nursing procedures was analyzed.Results:The first aid efficiency of the study group was significantly higher than that of the control group;the condition evaluation,reception time,triage time,and rescue time of the study group were significantly lower than those of the control group;the treatment outcomes of the study group were significantly better than those of the control group(P<0.05).Conclusion:Based on the results,compared with conventional nursing methods,the implementation of emergency nursing procedures for comatose patients with cerebral hemorrhage helps to improve the efficiency of first aid and the outcomes of the treatment;it has high clinical application value and is worthy of popularization as well as application in clinical practice.

A comparison of perspectives on costs in emergency care among emergency department patients and residents

BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department(ED). We compare ED resident and patient perspectives surrounding costs in emergency care.METHODS: We conducted a mixed methods study using surveys and qualitative interviews at a single, academic ED in the United States. The two study populations were a convenience sample of adult ED patients(>17 years of age) and ED residents training at the same institution. Participants answered open- and closed-ended questions on costs, medical decision making, cost-related compliance, and communication about costs. Closed-ended data were tabulated and described using standard statistics while open-ended responses were analyzed using grounded theory.RESULTS: Thirty ED patients and 24 ED residents participated in the study. Both patients and residents generally did not have knowledge of medical costs. Patients were comfortable discussing costs while residents were less comfortable. Residents agreed that doctors should consider costs when making medical decisions whereas patients somewhat disagreed. Additionally, residents generally took costs into consideration during clinical decision-making, yet nearly all residents agreed that they had too little education on costs.CONCLUSION: There were several notable differences in ED patient and resident perspectives on costs in this U.S. sample. While patients somewhat disagree that cost should factor into decision making, generally they are comfortable discussing costs yet report having insuf? cient knowledge of what care costs. Conversely, ED residents view costs as important and agree that cost should factor into decision making but lack education on what emergency care costs.

The concept of narrative evidence-based medicine and shared decision-making in traditional Chinese medical practice

For the explosive development of emerging diagnostic and therapeutic technologies brought by the advancement of precision medicine strategy, shared decision-making could improve the quality of clinical decision-making and promote the transformation of clinical research evidence in TCM. Paying attention to patients＇ narrative needs and strengthening medical humanistic concerns could improve clinical outcome and patient satisfaction. We described the origins and development of evidence-based medicine, narrative medicine and shared decision-making, and analyzed the existing problems in TCM clinical decision-making. Further, we put forward the model of shared decision-making between clinicians and patients under the guidance of narrative evidence-based medicine concepts and methods.

Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China

BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

Use of Male Condoms among Adolescents with Free Access at Emergency Contraception—Study among Students from the Public Education System of the Sao Paulo, Brazil

The research conducted in public schools in Sao Paulo city, Brazil, studied the awareness and use of emergency contraception (EC) and its possible implications on the condoms use. Among the 4929 students, 55.6% had already had sex, 19.5% had got pregnant and 7.3% had had abortions. Condoms were used by 88.6% and were options for those who did not have a steady relationship. The EC was used by 30.3% after a faulty condom usage, and by the older ones, with a steady partner. It is needed to be given contraceptive alternatives to reduce the risk and provide access to other contraceptives.

Development of a Decision Aid for Family Surrogate Decision Makers of Critically Ill Patients Requiring Renal Replacement Therapy in ICU:A User-Centered Design for Rapid Prototyping

Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.

Intelligent decision-making method for vehicles in emergency conditions based on artificial potential fields and finite state machines

This study aims to propose a decision-making method based on artificial potential fields(APFs)and finite state machines(FSMs)in emergency conditions.This study presents a decision-making method based on APFs and FSMs for emergency conditions.By modeling the longitudinal and lateral potential energy fields of the vehicle,the driving state is identified,and the trigger conditions are provided for path planning during lane changing.In addition,this study also designed the state transition rules based on the longitudinal and lateral virtual forces.It established the vehicle decision-making model based on the finite state machine to ensure driving safety in emergency situations.To illustrate the performance of the decision-making model by considering APFs and finite state machines.The version of the model in the co-simulation platform of MATLAB and CarSim shows that the developed decision model in this study accurately generates driving behaviors of the vehicle at different time intervals.The contributions of this study are two-fold.A hierarchical vehicle state machine decision model is proposed to enhance driving safety in emergency scenarios.Mathematical models for determining the transition thresholds of lateral and longitudinal vehicle states are established based on the vehicle potential field model,leading to the formulation of transition rules between different states of autonomous vehicles(AVs).

Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals

Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.

Clinical decision-making by the emergency department resident physicians for critically ill patients

The application of main methodologies for clinical decision-making by residents in emergency medical practice was assessed,and issues in this area were investigated.The treatments provided to 2611 critical patients by the Emergency Department of Peking Union Medical College Hospital were analyzed by independent investigators who evaluated the main clinical decision-making processes applied by the hospital residents.The application of decision-making strategies by PG1 and PG3 groups,which means the residents in first year and the third year,were compared.The patients were treated according to pattern recognition(43.0%),hypotheticodeductive reasoning(23.4%),event-driven models(19.3%),and rule-using algorithms(5.9%).A significant difference was found between PG1 and PG3 groups(χ^(2)=498.01,P<0.001).Pattern recognition and hypotheticdeductive methods were the most common techniques applied by emergency physicians in evaluating critically ill patients.The decision-making processes applied by junior and senior residents were significantly different,although neither group adequately applied rule-using algorithms.Inclusion of clinical decision-making in medical curricula is needed to improve decision-making in critical care.

Role of decision aids in orthopaedic surgery

Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction.

A method for emergency response alternative decision-making under uncertainty

In this paper,an emergency decision-making method,based on case-based reasoning and cloud model,is proposed to solve the risk decision-making problem in emergency response.Casebased reasoning,by allowing the decision-maker to referring to past decisions,introduces a short-cut to formulate feasible emergency alternatives.Cloud model is used to evaluate and optimise the emergency response alternatives.To evaluate emergency response alternatives,the decision criterion must be determined according to the aim and characteristics of emergency rescue in disasters or accidents.Then,the weight cloud and evaluation cloud of the decision criterion are determined by the Delphi method combined with backward cloud generator,and the synthesised cloud of each alternative is calculated through arithmetic rules of cloud.Finally,a ranking of all response alternatives can be determined,and the best alternative is selected.Case study shows that the method makes the conversion between qualitative description and quantitative indication more effective.

China＇s Development Aid Strategies

The article studies China＇s development assistance policy during the last decades. It shows the evolution of Chinese approach to providing foreign aid. The analysis is based on White Papers on China＇s Foreign Aid from 2011 and 2014, theoretical studies, and reports on China＇s foreign aid. From the beginning of the 21st century, China has become one of the most important emerging donors. Chinese aid is primarily provided to Africa, Latin America, Asia, and the Pacific. Depending on the region, the assistance is directed to large-scale infrastructure projects, energy facilities, or natural resource development activities. The aid is combined with investments and trade arrangements. Generally, China＇s aid programme is driven by economic, diplomatic, and strategic objectives. The rules according to which Chinese assistance is provided to developing countries differ significantly from the rules established by Development Assistance Committee （DAC） members. Aid-receiving countries do not have to fulfil strict development assistance regimes and adopt specific economic policies and targets.