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An introduction to the use of helicopters in rescue situations.

Emergency Operations Centers (EOCs) have been credited with driving the recent successes achieved in the Nigeria polio eradication program. EOC concept was also applied to the Ebola virus disease outbreak and is applicable to a range of other public health emergencies. This article outlines the structure and functionality of a typical EOC in addressing public health emergencies in low-resource settings. It ascribes the successful polio and Ebola responses in Nigeria to several factors including political commitment, population willingness to engage, accountability, and operational and strategic changes made by the effective use of an EOC and Incident Management System. In countries such as Nigeria where the central or federal government does not directly hold states accountable, the EOC provides a means to improve performance and use data to hold health workers accountable by using innovative technologies such as geographic position systems, dashboards, and scorecards.

\"With Obama's election to the presidency in 2008, many believed the United States had entered a new era: Obama came into office with high expectations that he would end the war in Iraq and initiate a new foreign policy that would reestablish American values and the United States' leadership role in the world. In this shattering new assessment, historian Lloyd C. Gardner argues that, despite cosmetic changes, Obama has simply built on the expanding power base of presidential power that reaches back across decades and through multiple administrations. The new president ended the \"enhanced interrogation\" policy of the Bush administration but did not abandon the concept of preemption. Obama withdrew from Iraq but has institutionalized drone warfare--including the White House's central role in selecting targets. What has come into view, Gardner argues, is the new face of American presidential power: high-tech, secretive, global, and lethal. Killing Machine skillfully narrates the drawdown in Iraq, the counterinsurgency warfare in Afghanistan, the rise of the use of drones, and targeted assassinations from al-Awlaki to Bin Laden--drawing from the words of key players in these actions as well as their major public critics. With unparalleled historical perspective, Gardner's book is the new touchstone for understanding not only the Obama administration but the American presidency itself\"-- Provided by publisher.

Background： Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin （Hb） level between 7 and 10 g/dl. As a restdt, the trigger point of blood transtiision may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. Methods： From June 2013 to June 2014, patients were randomly divided into the experimental group （Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group） and the control group （control group）. The between-group differences in the patients＇ demography and baseline inlbrmation, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell （RBC） transiiision standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. Results： During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of（34.8 ± 14.6） years. 50 tmderwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline inlbrmation. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transliision-related complications and mortality. Only tile POTTS-E group on the 1st postoperative day Hb was lower than group control, P 〈 0.05. POTTS-E group was totally （100%） conlbrmed to the requirements of the transfusion guideline to RBC inliision, which was higher than that of the control group （81.25%）, P 〈 0.01.There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates ofallogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group （84.3%, 84.3%, and 96.8%） P 〈 0.05 or P 〈 0.01. Per capita consumption of intraoperative allogeneic RBC. total allogeneic RBC and total RBC were 0 （0, 3.0）, 2.0 （0, 4.0）, and 3.1 （0.81, 6.0） in POTTS-E groups were all lower than those of control group （4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]）, P 〈 0.05 or P 〈 0.00 I. Conclusions： Peri-operative Transfilsion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is sate; Compared with doctor experience-based sub iective assessment, the scoring scheme was closer to patient physiological needs lbr transfusion and more reasonable： Utilization rate and the per capita consumption of RBC are obviously declined, which has clinical significance and is feasible. Based on the abovementioned three points, POTTS-E scores scheme is safe, reasonable, and practicable and has the value tbr carrying out multicenter and large sample clinical researches.

The practice of emergency operations often involves the travelling of medical teams and the distribution of medical supplies. In an emergency, such as an earthquake, a medical team often has to visit various hospitals (the customers) one after another in a predetermined sequence in order to perform on-site operations that require certain amounts of medical supplies. Because of their perishable nature, the medical supplies are typically shipped in batches from upstream suppliers and kept at multiple distribution centers during the disaster relief process. The scheduling of the medical teams and the provisioning of the medical supplies give rise to a scheduling problem that involves the timely dispatching of supplies from distribution centers to hospitals in coordination with the scheduling of medical teams so as to minimize the total tardiness of the completions of the operations to be performed. We introduce a mathematical programming based rolling horizon heuristic that is able to find near optimal solutions for networks of up to 80 hospitals very fast. We also report on empirical observations with regard to the computational performance of the heuristic; we consider 5420 randomly generated test cases as well as a case that is based on an actual hospital-distribution center network in the greater New York metropolitan area. Managerial insights are drawn from numerical studies regarding the benefits of pre-positioning medical supplies at the distribution centers.

Facing an emerging COVID-19 outbreak in our city, we feared that the same situation could overwhelm our ED resources [1]. [...]we sought to create an area adjacent to our existing ED where patients not requiring emergency level care could be evaluated, tested for COVID-19, and safely discharged home. CDM provided strategic planning for the Clinic's interface with the COVID-response of the health system and facilitated infection control recommendations. Transforming the ambulance bay into a functional Clinic required close and rapid collaboration with hospital leadership, the environmental services department, buildings and grounds staff, infection control experts, and a materials management team.

The COVID-19 pandemic has significantly changed life and work patterns and reshaped the healthcare industry and public health strategies. It posed considerable challenges to public health emergency operations centers (PHEOCs). In this period, digital technologies such as modeling, simulation, visualization, and mapping (MSVM) emerged as vital tools in these centers. Despite their perceived importance, the potential and adaptation of digital tools in PHEOCs remain underexplored. This study investigated the application of MSVM in the PHEOCs during the pandemic in Canada using a questionnaire survey. The results show that digital tools, particularly visualization and mapping, are frequently used in PHEOCs. However, critical gaps, including data management issues, technical and capacity issues, and limitations in the policy-making sphere, still hinder the effective use of these tools. Key areas identified in this study for future investigation include collaboration, interoperability, and various supports for information sharing and capacity building.

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

The coronavirus disease 2019 (COVID-19) pandemic has provided a great lesson for the globe about the necessity and significance of pandemics-related preparedness in all settings. Public health emergency operation centers play critical roles in preparing for and responding to public health events and emergencies by coordinating and pooling resources. In this article, we aimed to share lessons learnt from the public health response to the louse-borne relapsing fever (LBRF) outbreak coordinated by the emergency operation center established to respond to the COVID-19 pandemic in Jimma, Ethiopia. After the major waves of COVID-19 outbreaks in Ethiopia were over, Jimma University Medical Center (JUMC) reported clusters of louse-borne relapsing fever cases from Jimma Main Prison. Accordingly, Jimma Emergency Operation Center (JEOC) established for the COVID-19 pandemic was immediately alerted and effectively coordinated the overall response. As a result, the outbreak was contained within the prison without spreading to the community and the outbreak ended within a shorter period compared to previous LBRF outbreaks in Ethiopia. This indicates the necessity of establishing and sustaining public health emergency operation centers to prepare for and combat potential future public health emergencies.

Artificial intelligence (AI) is the study of computer systems capable of performing tasks that traditionally require human intelligence, and machine learning (ML) is one mechanism through which an AI system can be developed by creating algorithms that modify themselves in response to patterns and make inferences when applied to new data [1-4]. Rapidly interpreting clinical data to classify patients and predict outcomes is paramount to emergency department (ED) operations, with direct impacts on cost, efficiency, and quality of care. The future of medicine is poised to harness the potential of AI to aid medical providers, and the ED stands to benefit greatly by reducing inefficiencies, streamlining processes, and improving patient care.Source of Support This research did not receive any specific grant from funding agencies in the public, commercials, or not-for-profit sectors.