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.

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.

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.

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.

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.

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.

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.

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).

Online Decision-Making and Control of Power System Stability Based on Super-Real-Time Simulation

During power grid cascading failure,the operating point changes frequently,resulting in a mismatch or inaccuracy of online pre-decision making emergency control strategy.To solve this problem,an online power system stability decisionmaking and control method based on super-real-time simulation is presented in this paper.A decision-making and control system is developed in which the three main operation modes,offline pre-decision-making,online pre-decision-making,and real-time control,are all coordinated.To verify the method,ADPSS(advanced digital power system simulator)is used to simulate a digital power grid with about 20,000 buses.The closed-loop operation of the digital power grid and the online decisionmaking and control system are implemented.Test results show that when online pre-decision making control strategies are mismatched,aided real-time control works well and can prevent power grid stability loss.

Concept of Yager operators with the picture fuzzy set environment and its application to emergency program selection

Purpose-The aim of this study as to find out an approach for emergency program selection.Design/methodology/approach-The authors have generated six aggregation operators(AOs),namely picture fuzzy Yager weighted average(PFYWA),picture fuzzy Yager ordered weighted average,picture fuzzy Yager hybrid weighted average,picture fuzzy Yager weighted geometric(PFYWG),picture fuzzy Yager ordered weighted geometric and picture fuzzy Yager hybrid weighted geometric aggregations operators.Findings-First of all,the authors defined the score and accuracy function for picture fuzzy set(FS),and some fundamental operational laws for picture FS using the Yager aggregation operation.After that,using the developed operational laws,developed some AOs,namely PFYWA,picture fuzzy Yager ordered weighted average,picture fuzzy Yager hybrid weighted average,PFYWG,picture fuzzy Yager ordered weighted geometric and picture fuzzy Yager hybrid weighted geometric aggregations operators,have been proposed along with their desirable properties.A decision-making(DM)approach based on these operators has also been presented.An illustrative example has been given for demonstrating the approach.Finally,discussed the comparison of the proposed method with the other existing methods and write the conclusion of the article.Originality/value-To find the best alternative for emergency program selection.

Sharing the post-earthquake situation for emergency response management in transborder areas: The e-Atlas tool

Usually,the response after a disastrous event requires decision-makers in emergency operative rooms to quickly outline and understand the current post-event situation,for planning and defining strategies for a contextualized response.Moreover,in many cases,disastrous events affect cross-border territories and/or involve multiple orga-nizations in responding to the demand generated by the event.These cases require a harmonized and coordinated response by all the institutions/subjects involved in emergency management.To address this challenge,this pa-per proposes the e-Atlas(emergency atlas)tool for showing and sharing information that embraces a response management perspective to explicitly support decision-makers in managing the criticalities of a post-earthquake situation.The e-Atlas has been designed and tested to:i)acquire sensible information for allowing decision-makers to understand in almost real-time the post-earthquake situational picture,and ii)share the representation of the situational picture among different users,allowing each of them to use it according to its specific require-ments.Applications of the tool are illustrated,to show how it is used in a transborder context in the North-East area of Italy.

SCHEDULING ALGORITHM BASED ON FOLLOW-UP SHARING CHARACTER FOR POST-EVENT RESPONSE RESOURCE DISTRIBUTION IN LARGE-SCAL DISASTERS

Post-event response planners must develop effective and efficient plans for the proper allocation and distribution of resources to impacted areas （IAs） within a critical time window. To determine the effectiveness and efficiency of distribution plans, this study addresses resource allocation effectiveness losses （RAEL, or losses caused by the mismatch between supply and demand in IAs） and emergency logistics time costs （ELTC, or transportation time of logistics processes under emergency conditions）. Moreover, this study examines a follow-up sharing character （FSC） that coordinates resources among different phases. This research proposes an integrated model （IM） based on this character. This model aims to minimize RAEL and ELTC. Furthermore, the IM combines the time dimension model （TDM）, which coordinates the demands and supplies of all phases in the planning horizon, and the space dimension model （SDM）, which generates a specific distribution plan for the first phase. An analytical solution is obtained for the TDM as per the definition of FSC, after which the SDM is solved through a single-objective linear programming model. After solving the IM effectively, we fred that the proposed methodology fits the emergency circumstance well. Insights derived from the model are also presented in the conclusion.）