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The focus of this paper is the development of a digital escape room for pilots' training in flight safety procedures. To this end, we will discuss the methodology we used in order to make sure that each stage of the evolution of our digital platform is safe and suitable for educational use. Therefore, we will analyse the first stages towards the construction and evaluation of the scenarios incorporated in our entirely digital escape room that is intended for the T-6A Texan II pilots' education. Because of the educational character of the digital escape room, the theoretical background of our research is extremely important, since it provides the escape room with the educational aspect. As a result, for the narratives of our simulations and the development of our emergency cases, we used as our baseline the flight manual, the boldface procedures and the operating limitations of T-6A aircraft and we selected the categories of incidents/emergencies to be used as part of our virtual escape room. We, then, constructed the trial-run scenarios that we asked pilots to solve. Finally, we conducted extensive field research with the development and use of appropriate questionnaires and interviews to evaluate the realism of our scenarios. Based on the feedback we received from the field research, we will conclude this paper by discussing the limitations of this study, but also our ideas for future improvements and a timeline on our research progress, as well as on further developing our virtual escape room.

The object of the study was the gas distribution networks of various pressure categories that supply gas to municipal and industrial consumers from gas supply points, for example, gas distribution stations (GDS), during operation process the gas networks are exposed to a large range of loads and impacts, which, in combination with a long period of operation, leads to a decrease in the level of reliability. Studies have shown that the reduction of the emergency hazard for the used pressure categories in the gas distribution network in comparison with the higher category is 1.2 – 2 times, while at the same time there is decrease in the reduced costs to 40 percent or more.

An emergency operating procedure (EOP) for flooding incidents is used to assist crews in preventing ships from capsizing. However, under a flooding scenario, failure to complete the EOP within a limited time may result in the risk of capsizing. Human performance is the major factor in the EOP execution process, which is influenced by available time. There is a mutual dependence between human error and available time: (a) shorter available time will increase time pressure and the human error probability (HEP); (b) human error will either be recovered, which may require more response time and result in shortened available time, or be uncorrected, which may worsen the system state and reduce the time limitation, thereby shortening the available time. This mutual dependence can affect EOP risk, which is not considered in current studies. This paper proposes a method based on a Dynamic Bayesian Network (DBN) to assess EOP risk considering this mutual dependence. To model the mutual dependence, a continuous SPAR-H method is proposed in the intra-slice network to determine the conditional probability distribution of human error for dependence (a), and a dynamic available time model is proposed in the inter-slice network to determine the conditional probability distribution of available time for dependence (b). The Ro-Ro flooding incident is used to illustrate the proposed method.

•The COVID-19 pandemic has placed a significant strain on the United States health care system.•Healthcare workers are rapidly altering their professional responsibilities to help meet hospital needs.•Surgeons have witnessed a dramatic change in their practices with rapidly decreasing elective surgery.•Surgical leaders should develop a framework to help make decisions around elective surgery as information is evolving.

Hospital systems play a critical role in treating injuries during disaster emergency responses. Simultaneously, natural disasters hinder their ability to operate at full capacity. Thus, cities must develop strategies that enable hospitals’ effective disaster operations. Here, we present a methodology to evaluate emergency response based on a model that assesses the loss of hospital functions and quantifies multiseverity injuries as a result of earthquake damage. The proposed methodology can design effective plans for patient transfers and allocation of ambulances and mobile operating rooms. This methodology is applied to Lima, Peru, subjected to a disaster scenario following a magnitude 8.0 earthquake. Our results show that the spatial distribution of healthcare demands mismatches the post-earthquake capacities of hospitals, leaving large zones on the periphery significantly underserved. This study demonstrates how plans that leverage hospital-system coordination can address this demand-capacity mismatch, reducing waiting times of critically injured patients by factors larger than two. Hospital systems are critical, especially in providing healthcare services after disasters. Here, the authors revealed that in Lima the spatial distribution of health service demands mismatches the capacities of hospitals after earthquakes, leaving large zones on the periphery significantly underserved.

As critical equipment for electrical energy transmission and voltage transformation, power transformers are fundamental to the power grid’s safe, reliable, and economical operation. As urbanization accelerates, the contradiction between the lag in constructing power transformers and the urgent need for short-term capacity expansion becomes increasingly prominent. Existing capacity expansion methods present challenges such as high costs and significant space requirements. In order to solve the problem, this paper proposes an optimized configuration scheme for virtual capacity expansion transformers, which considers the short-term emergency load capacity. Firstly, an annual average cost model of a virtual capacity expansion transformer is proposed. Then, the optimal configuration scheme is established with the highest average effective utilization rate of the transformer and the lowest comprehensive economic cost index as the optimization goal. Finally, a 220/110 kV urban power grid system is simulated to prove the advantages of the proposed scheme compared with the existing scheme.

Early recognition of sepsis is critical for timely initiation of treatment. The first objective of this study was to assess the timeliness of diagnostic procedures for recognizing sepsis in emergency departments. We define diagnostic procedures as tests used to help diagnose the condition of patients. The second objective was to estimate associations between diagnostic procedures and time to antibiotic treatment, and to estimate associations between time to antibiotic treatment and mortality. This observational study from 24 emergency departments in Norway included 1559 patients with infection and at least two systemic inflammatory response syndrome criteria. We estimated associations using linear and logistic regression analyses. Of the study patients, 72.9% (CI 70.7-75.1) had documented triage within 15 minutes of presentation to the emergency departments, 44.9% (42.4-47.4) were examined by a physician in accordance with the triage priority, 44.4% (41.4-46.9) were adequately observed through continual monitoring of signs while in the emergency department, and 25.4% (23.2-27.7) received antibiotics within 1 hour. Delay or non-completion of these key diagnostic procedures predicted a delay of more than 2.5 hours to antibiotic treatment. Patients who received antibiotics within 1 hour had an observed 30-day all-cause mortality of 13.6% (10.1-17.1), in the timespan 2 to 3 hours after admission 5.9% (2.8-9.1), and 4 hours or later after admission 10.5% (5.7-15.3). Key procedures for recognizing sepsis were delayed or not completed in a substantial proportion of patients admitted to the emergency department with sepsis. Delay or non-completion of key diagnostic procedures was associated with prolonged time to treatment with antibiotics. This suggests a need for systematic improvement in the initial management of patients admitted to emergency departments with sepsis.

In this paper, a method of analyzing and processing information loss under a fire in nuclear power plants is proposed. By using this method, we can determine which information is valid. At the same time, this method provides a solution to management for invalid information. By screening the information used in emergency operating procedures (EOP) and analyzing its state in fire conditions, appropriate corrective measures (such as redundant information, redundant information, and forced value) are taken. It ensures that the information used by the operator is valid and reliable. It’s favorable for operators to identify the accident state of the plant and select appropriate accident strategies. Therefore, correct orientation and effective implementation of EOP in fire conditions are ensured.

Background The COVID-19 pandemic continues to demonstrate the risks and profound health impacts that result from infectious disease emergencies. Emergency preparedness has been defined as the knowledge, capacity and organizational systems that governments, response and recovery organizations, communities and individuals develop to anticipate, respond to, or recover from emergencies. This scoping review explored recent literature on priority areas and indicators for public health emergency preparedness (PHEP) with a focus on infectious disease emergencies. Methods Using scoping review methodology, a comprehensive search was conducted for indexed and grey literature with a focus on records published from 2017 to 2020 onward, respectively. Records were included if they: (a) described PHEP, (b) focused on an infectious emergency, and (c) were published in an Organization for Economic Co-operation and Development country. An evidence-based all-hazards Resilience Framework for PHEP consisting of 11 elements was used as a reference point to identify additional areas of preparedness that have emerged in recent publications. The findings were analyzed deductively and summarized thematically. Results The included publications largely aligned with the 11 elements of the all-hazards Resilience Framework for PHEP. In particular, the elements related to collaborative networks, community engagement, risk analysis and communication were frequently observed across the publications included in this review. Ten emergent themes were identified that expand on the Resilience Framework for PHEP specific to infectious diseases. Planning to mitigate inequities was a key finding of this review, it was the most frequently identified emergent theme. Additional emergent themes were: research and evidence-informed decision making, building vaccination capacity, building laboratory and diagnostic system capacity, building infection prevention and control capacity, financial investment in infrastructure, health system capacity, climate and environmental health, public health legislation and phases of preparedness. Conclusion The themes from this review contribute to the evolving understanding of critical public health emergency preparedness actions. The themes expand on the 11 elements outlined in the Resilience Framework for PHEP, specifically relevant to pandemics and infectious disease emergencies. Further research will be important to validate these findings, and expand understanding of how refinements to PHEP frameworks and indicators can support public health practice.