bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Medic-Alert Foundation, International Extension Program
Authors: Hodder Alfred A. , Thompson Douglas S. 
Published: July 2016

From the Medic Alert Foundation International, PO Box 1009, Turlock, CA 95381 USA.Medic Alert Foundation International is dedicated to the thesis that one universally recognized symbol of emergency medical identification will best serve all people. This is why Medic Alert conducts an active program to expand its services internationally.Volunteer groups in 17 countries presently provide Medic Alert services to over 1.7 million people worldwide. The Foundation's purpose is to give a lifetime of fast reliable protection for a modest, one-time fee. Medic Alert is a non-profit, tax-exempt and charitable organization.The volunteer organizations in these 17 countries are affiliated with the international headquarters in the United States, but each is autonomous in providing protection to the people of its nation. National boards and staffs actually deliver the total services to their members within their country.
Risk Analysis
Authors: Nehnevajsa Jiri , Swisher Ralph B. 
Published: July 2016

Major risks to human health and life are, indeed, as old as life itself. Whether we think of epidemics, hunger and malnutrition, famines, wars, violations of human rights, crime, natural disasters and swarms of other dangers, we cannot but be struck by their pantemporality and ubiquitousness. Acute or chronic, periodic or sporadic, frequent or infrequent, these and other hazards are endemic to the very condition of human existence —unwanted but nonetheless real consequences of being alive and of being social.It is indeed quite plausible to view some of the central strands and trajectories of human history as efforts to cope with the hazardous conditions of existence: to prevent risks from actualizing, or to mitigate the consequences of hazards which do actualize—those which we have not yet as developed the capability to prevent, and those which we cannot hope to prevent.
Industrial Civil Defense
Authors: Nygaard Herluf 
Published: July 2016

Sudden illnesses, accidents, fire catastrophes, explosions, gas leakages and war damage constitute serious threats to industry and other production enterprises all over the world.To counteract the hazards resulting from such emergencies the Federation of Norwegian Industries in 1948 decided to establish an industrial civil defense organization. The Federation also decided that the industry itself should cover the cost both for operation of a central staff and for organizing and running an industrial civil defense at each individual plant or facility.In 1953, the organization was legalized through the Norwegian Civil Defense Act and a Royal Decree of 1965 decided that the Industrial Civil Defense central staff should organize and supervise self protection in all enterprises employing 40 or more persons engaged in industrial activity, manufacturing and skilled trades, etc. This applies irrespective of where the facility is situated or where the operation takes place.
Coordination of Responsibilities of Organizations in Disasters
Authors: Tiedeman C. , Oyen O. 
Published: July 2016

There are two principal aspects of disaster preparedness. First the daily around the clock routine already existing in ambulance services, hospitals, police forces, firebrigade, voluntary humanitarian organizations, etc. These organizations are occupied daily with accidents, each within their own areas of responsibility, and often in cooperation with each other.Where people are hurt, medical care will have priority over damage of materials and property. So resuscitation and transport are basic factors in most accidents.Second, according to the definition of disaster, the problems created by accidents of various types will exceed these daily operating resources. The community must take extraordinary steps to provide rescue and first aid to the victims, and provide fire control, police control, transportation, etc.
Three Fire Disasters
Authors: Layton Thomas R. , Elhauge Einer R. 
Published: July 2016

In order to better understand the conditions permitting a fire disaster to occur and to better postulate methods of fire prevention, an historic analysis of three fire disasters was performed. Journalistic accounts, official investigative studies and documents were examined concerning 3 fire disasters: (1) The General Slocum Ship Fire of 1904; (2) the Triangle Shirtwaist Factory Fire of 1911; and (3) the Coconut Grove Nightclub Fire in Boston of 1942. Although the fires occurred on a ship, in a factory, and in a nightclub, several striking similarities were found.(1) On June 15, 1904, the shipGeneral Slocumembarked on a voyage up New York's East River, that ended in death for 1031 people. The ship, which was constructed entirely of wood, had recently passed inspection. The ship's crew, mostly longshoremen with little sea experience, had never fought a fire at sea. The hatches and bulkheads were flammable, the fire hoses were old and rotten, the fire buckets were out of reach and empty.
The Three Mile Island (TMI) Accident
Authors: MacLeod Gordon K. 
Published: July 2016

On March 28,1979, a near nuclear catastrophe occurred at Three Mile Island (TMI) near Harrisburgh, Pennsylvania, USA. I was at that time Pennsylvania's Secretary of Health. It was an accident that just “could not happen.” After all, nuclear power plants were built so safely that they could not possibly affect public health.As a physician, lam compelled to say that I am unalterably opposed to nuclear warfare. I am sure that most physicians would agree that there can be no adequate preparedness for the devastating medical consequences of nuclear war. Prevention of nuclear war is the only reasonable medical response to the hazards posed by nuclear weapons.By contrast, many of you may not share my position on nuclear power. Nuclear power can be made relatively safe if we do not ignore the public health lessons of the past. I belive that physicians need to increase and update their understandings of the medical consequences of radiation accidents and be trained to triage and to treat blast, radiation, and burn injuries.
Respiratory Injuries in Earthquakes in Latin America in the 1970's — A Personal Experience in Peru, 1970; Nicaragua, 1972–73; and Guatemala, 1976.
Authors: Hingson Robert A. , Hingson Luke 
Published: July 2016

Of the more than one million earthquakes which occur each year on our planet, very few involve areas of major population concentration. During the last decade, however, a significantly large number of earthquakes involved populations in cities or areas of large population density. The injuries, therefore, are multiplied by the collapse of large buildings or of walls of houses of poor design and construction of adobe brick. Crashing upon people asleep, they entrap, entomb or mutilate defenseless and often aged, ill, and diseased and helpless pediatric victims. The three earthquakes we witnessed recently have resulted in 70,000 deaths inPeru;, 12,000 inManagua, Nicaragua;, and 22,000 inGuatemala Cityand large suburban cities.Most of the injuries are orthopedic fractures. Fatalities often occur from compression and permanent restriction of respiratory movement. These megaton disruptions of the environment cause the following types of respiratory challenge: (l) The unbelievably large and dense dust clouds from falling buildings, created by pulverization of the walls of mud, straw, and limestone, create suffocating chemical damage of some degree to the nasal mucosa, the bronchial tree and the respiratory bronchioles, immediately initiating endothelial edema, airway obstruction and collapse, and irritational bronchitis.
Fatalities from Volcanic Activity
Authors: Dice William H. , Bascom James F. 
Published: July 2016

The eruption of Mount Saint Helens in the Cascade Mountain Range of Washington State on 18 May 1980 resulted in a life-threatening and economically disruptive natural disaster that required the mobilization of supportive agencies from the State and Federal government for control. Because of the potential for further eruptions, the mechanism of death for those persons exposed to the initial blast was examined to aid in contingency planning.Fatalities as a result of the eruption could be attributed to lack of understanding of the danger in the area of the mountain. Although several scientists were killed during the eruption, most were sight-seers who ignored the warning seismic activity and the precautionary blockade of the area. A few were outside of the well-publicized danger zone, but were caught in the rapidly moving mudslides or the ash cloud.
38. Incidence and Nature of Complaints Received in an Urban Fire Rescue System
Authors: LeDuc Todd J. , Goellner William E. , El Sanadi Nabil 
Published: July 2016

Objective: To determine the frequency and nature of patient complaints in a large urban Fire Rescue system.Methods: A two year retrospective review of all unsolicited patient complaints received from any source either internal or external, through our full-time customer service personnel. All customer complaints, concerns and interactions are documented on an interaction form which we reviewed. All complaints were resolved with disposition related to the customer prior to our retrospective study inclusion.Results: During the study period our Fire Rescue system responded to a total of 169,651 calls for medical assistance. Our division customer service personnel received a total of 87 unsolicited customer complaints (n = 87) regarding the service encounter with Fire Rescue/EMS. This accounts for a 0.0005% rate of customer complaints captured in correlation to total incidents during the study period. The majority of complaints, 27% were related to lost or missing goods. Service that was perceived as uncourteous or inconsiderate after calling 911, accounted for 25% of complaints. Complaints regarding not being transported after calling 911 accounted for 18%. Uncourteous driving or noise of sirens accounted for 7% of complaints. 7% of complaints resulted from not being transported to the hospital of their choice. Actual care received concerns were only 3% of total. Leaving medical objects behind was 2% of the total volume and 4% fit no specific trend.
56. Managed Care Organization Enrollee Utilization of 911 Emergency Medical Services
Authors: Dickinson Edward T. , Verdile Vincent P. , Duncan Timothy B. , Bryant Kerry A. 
Published: July 2016

Purpose: The accessibility of emergency medical services (EMS) for enrollees of managed care organizations (MCOs) is currently a topic of national debate. The mechanisms by which enrollees currently enter the EMS system have not been well described. The purpose of this study was to determine how these patients enter our EMS system.Methods: All enrollees who belong to the region's largest MCO and who were transported to hospital EDs by the paramedic level municipal EMS department were identified from billing records. Members of the MCO are mandated to call the MCO prior to seeking any emergency care. Dispatch logs were then examined to determine the time and origin of the call to the 911 communications center. Patient care records were used to obtain patient age, the level of care (ALS vs. BLS), and whether the ALS patient received medications (ALS Meds).Results: Over a six month period 195 enrollees were transported to EDs, Three modes of system entry were identified: Group I—enrollees who called 911 directly; Group II—enrollees who called the MCO triage center who then called 911 for the patient; and Group III—enrollees who were sent to the MCO center for evaluation and subsequently the MCO called 911 to transport the patient to the hospital.
02. Flight Paramedics Scope of Practice: Current Level and Breadth
Authors: Hatley Todd , Ma O. John , Weaver Nancy , Strong Donna 
Published: July 2016

Objective: The scope of practice (SOP) for flight paramedics (FPs) remains a controversial issue for air medical directors. This study's objective was to determine the current level and breadth of FPs'SOP.Methods: A 6-item survey of lead FPs in all 158 air medical programs throughout the U.S. The survey addressed five issues: 1)Certifications required of FPs above state certification; 2) Procedures included in SOP; 3) Medications FPs are allowed to administer; and 4) Requirements needed to expand FPs’ SOP. Views on establishing a National FP certification (NFPC) to alter their current SOP.Results: Survey response was 57% (90/158). Ten responding programs (11%) did not utilize FPs. Of the 80 programs (89%) that utilize FPs, 76 programs (95%) required certification in ACLS, 65 (81%) in PALS, and 50 (63%) in BCLS. Paramedics were allowed to perform cricothyroidotomy in 68 programs (85%), pericardiocentesis in 24 programs (30%), and tube thoracostomy in 23 programs (29%). A wide spectrum of medications were approved for administration by FPs, including streptokinase in 37 programs (46%), r-TPA in 51 (64%), and succinylcholine in 50 (63%). In 61 programs (76%), the SOP was determined solely by the air medical director. Eighteen respondents (23%) believed that the development of a NFPC program would alter their SOP.
03. How Are We Doing? A Survey of Private Internists
Authors: Schneider SM. , Cobaugh DJ , Leahey NF 
Published: July 2016

Objective: In our community the majority of patients presenting to the ED with acute chest pain come by car and do not recall their MD suggesting EMS. How do private MD's (our customers) view EMS?Methods: Single mailing survey to all 238 physicians with admitting privileges in Medicine at an urban, tertiary care hospital (722 beds). EMS services provided by 2 private ALS systems and 35 volunteer ALS services operating under one physician medical director and identical protocols. Survey consisted of a scenario with a cardiac patient in the home of the MD, followed by opinions regarding EMS.Results: 50% return. Respondents were 79% male, mean age 44 ±14yr, 68% internal medicine, 11% cardiologists. Given a patient with acute chest pain at the MD's home, 90% would call EMS, 10% would drive patient. 16% chose to drive for safety concerns, 83% because it was faster. Of those who chose EMS, 10% made negative comments regarding paramedics “playing doctor”. The following perceptions were noted: 3% of respondents indicated paramedics take “too long” to respond to calls, 26% indicated paramedics delay patient arrival to the hospital, and 6% indicated patients get too nervous if told to take an ambulance. On the other hand, 59% indicated EMS prevents cardiac arrests, 83% indicated paramedics can appropriately treat cardiac arrest, and 13% agreed paramedics can provide similar treatment for chest pain patients as hospitals.
21. Prolonged QT Intervals in Patients with Out-of-Hospital Ventricular Tachycardia Cardiac Arrest
Authors: Brady William , DeBehnke Daniel , Laundrie Dennis , Skiles Jeffrey A. 
Published: July 2016

Objective: To determine the prevalence and outcome of out-of-hospital ventricular tachycardia (VT) cardiac arrest with a prolonged QT interval and to identify the subset with torsades de pointes (TdP).Methods: Design: Retrospective review. Setting: Fire department-based paramedic system. Participants: Non-traumatic VT cardiac arrest (1/91-12/94) with a supraventricular perfusing rhythm (SVPR) and a measurable QT interval. Interventions: QT interval was measured from a SVPR and corrected QT interval (QTc) was calculated (prolonged if ≥0.45 sec). VT was classified as polymorphic or monomorphic.Results: 190 patients met inclusion criteria. 51% of patients had a prolonged QTc (PQTc). The overall hospital discharge rate was 28.4%. No difference with respect to paramedic-witnessed arrests in each QTc group was found (25.8% normal QTc [NQTc] vs. 27.8% PQTc; p = 0.752). Patients with PQTc were less likely to be discharged from the hospital (19.6% vs. 37.6%; p = 0.01). Patients with PQTc were not more likely to have PVT (37% vs. 40%; p = 0.705). 16 (8.4%) patients had TdP. 27.8% of TdP and 26.8% of non-TdP patients were discharged (p = 0.912).
45. The Impact of an Alert Tone on On-Scene Time in Trauma Patients
Authors: Le Duc Todd J. , Goellner William E. , Sanadi Nabil E. 
Published: July 2016

Objective: Determine whether radio alerts to paramedics after 7 minutes of on-scene time reduces total on-scene time for trauma patients.Methods: Paramedics radio base once they determine ACS criteria were met. Paramedics were informed by radio when 7 minutes lapsed on-scene. Dispatch times were recorded.Results: The control group (Nov. 1-30, 1995) of 135 consecutive patients were reviewed without a radio alert. The test group (Dec. 1-31, 1995) of 103 consecutive patients, with a radio alert message 7 minutes after scene arrival were also reviewed. Groups were matched for extrication times, blunt versus penetrating trauma, age, etc. We analyzed both groups for the interval of time from announcement of “trauma alert,” (when paramedics determined the patient met ACS criteria or from the time extrication was complete (if applicable) to the time en route to the hospital. Average on-scene time for the control group was 13.7 minutes [range 4-35] versus test group 9.3 minutes [range 2-26] (p <0.001).
49. Waveform Design Based on Cardiac Electrophysiology Can Improve Transchest Defibrillation
Authors: Brewer James , Olson Ken , Steinkogler Gary , Tay Sew-Wah 
Published: July 2016

Introduction: Monophasic defibrillation waveforms are presently the standard of care in clinical use for trans-thoracic defibrillation. Recently, there has been renewed interest in biphasic waveforms. This interest reflects the superior performance demonstrated with biphasic waveforms in implantable defibrillators (ICD). External defibrillation research on two biphasic truncated exponential waveforms has been reported in which the waveforms were compared clinically to a damped sine waveform. A limitation of these transthoracic waveforms is the insufficiency of fundamental design principles used to determine the waveform characteristics.Methods: We developed design principles to determine the optimal waveform characteristics of an external biphasic truncated exponential waveform based on myocardial cell response model. The cell response model incorporates critical transthoracic elements into a recently published and experimentally validated intracardiac model used to design ICD waveforms. We determined the optimal leading-edge voltage (LEV), phase durations (in milliseconds, Ph1 D, Ph2 D), and delivered energies (ED) for the reported external biphasic waveforms (WF) using the model with 78 W for trans-chest resistance. We compared our results against those reported for the biphasic waveforms.
SolarLeaf: The world's first bioreactive façade
Authors: Wurm Jan , Pauli Martin 
Published: July 2016

Photobioreactors (pbr) are transparent containers for the controlled cultivation of microorganisms such as algae. The BIQ house is the worlds first architectural project realised featuring flat panel pbr, generating biomass and heat as part of an integrated energy concept. The project is part of the International Building Exhibition (IBA) in Hamburg.In order to implement this potential disruptive technological innovation, technical, ecological and social aspects have been looked at holistically to optimise and develop the system towards market maturity.At the foreground of this monitoring project has been the intensive evaluation and optimisation of the energy efficiency of the technology in relation to the acceptance and reception of the building users.After the successful implementation of the pilot project, a big step towards the market maturity of the system has been taken. Further improvements with respect to the efficiency and a closed value chain are required to demonstrate commercial feasibility and attract investors to implement the system more widely.
Hypoxia-driven splicing into noncoding isoforms regulates the DNA damage response
Authors: Memon Danish , Dawson Keren , Smowton Christopher SF , Xing Wei , Dive Caroline , Miller Crispin J 
Published: July 2016

AbstractTumour hypoxia is associated with poor patient outcome and resistance to therapy. It is accompanied by widespread changes in gene expression mediated largely through the transcription factors HIF1/2/3α. Hypoxia impacts on multiple pathways throughout the cell and has widespread effects on phenotype. Here we use sample-specific annotation approaches to determine the changes in transcript architecture that arise as result of alternative splicing in hypoxic cells. Using in vivo data generated from a time course in reduced oxygenation we identified genome-wide switching between coding and noncoding isoforms, including a significant number of components of the DNA damage response pathway. Notably, HDAC6, a master regulator of the cytotoxic response, and TP53BP1, which sits at the nexus of the double-strand break repair pathway, both underwent a marked transition towards an intron-retention pattern with a concomitant decline in protein levels. These transitions from coding to noncoding isoforms were recapitulated in a large and independent cohort of 499 colorectal samples taken from The Cancer Genome Atlas (TCGA). The set of altered genes was enriched for multiple components of the Fanconi Anaemia, nucleotide excision and double-strand break repair pathways, and together correlating with tumour status at last contact. Altogether, these data demonstrate a new role for hypoxia-driven alternative splicing in regulating DNA damage response, and highlight the importance of considering alternative splicing as a critical factor in our understanding of human disease.
Modulation Instability and Phase-Shifted Fermi-Pasta-Ulam Recurrence
Authors: Kimmoun O. , Hsu H. C. , Branger H. , Li M. S. , Chen Y. Y. , Kharif C. , Onorato M. , Kelleher E. J. R. , Kibler B. , Akhmediev N. , Chabchoub A. 
Published: July 2016

AbstractInstabilities are common phenomena frequently observed in nature, sometimes leading to unexpected catastrophes and disasters in seemingly normal conditions. One prominent form of instability in a distributed system is its response to a harmonic modulation. Such instability has special names in various branches of physics and is generally known as modulation instability (MI). The MI leads to a growth-decay cycle of unstable waves and is therefore related to Fermi-Pasta-Ulam (FPU) recurrence since breather solutions of the nonlinear Schrödinger equation (NLSE) are known to accurately describe growth and decay of modulationally unstable waves in conservative systems. Here, we report theoretical, numerical and experimental evidence of the effect of dissipation on FPU cycles in a super wave tank, namely their shift in a determined order. In showing that ideal NLSE breather solutions can describe such dissipative nonlinear dynamics, our results may impact the interpretation of a wide range of new physics scenarios.