bluuebunny/crossref_metadata_2025_split huggingface dataset:
World Organization for Animal Health Platform on Animal Welfare for Europe Survey on Veterinary Service Preparedness for Natural Disasters
Authors: Vroegindewey Gary 
Published: June 2023

Introduction:National Veterinary Services of World Organization for Animal Health (WOAH) are responsible for a wide range of activities including animal health, animal welfare and veterinary public health. The WOAH European Region member countries were surveyed to determine and quantify the level of capacity to respond to natural disasters, determine the types of disasters experienced, determine their levels of education and training and identify gaps in capacity and specific needs of Member Countries for disaster response.Method:A web-based Qualtrics survey on Animal Welfare in Natural Disasters was conducted by Lincoln Memorial University in conjunction with the World Organization for Animal Health (OIE) Platform on Animal Welfare for Europe. The 50 question survey was distributed by email link to Member Countries points of contact provide by OIE. The survey was emailed to 53 OIE European Member Countries with reminder emails to complete. Survey results were compiled and tabulated. Only aggregate data is published and presented.Results:Forty-nine countries responded to the survey for a 92% completion rate. Floods, earthquakes and fire were the three most commonly encountered disasters. Fifty-two percent indicated they incorporated animal welfare into their disaster planning. Thirty-one percent indicated they had no or limited legal authority to manage animal emergencies in natural disasters. The species covered in the national response plan ranged from laboratory animals at 17% to livestock at 48%. Eighty-two percent had no or limited standard operating procedures and 73% had no training to respond to animal welfare in disasters. Budgets, trained personnel, equipment/supplies and legal authority were the most frequently identified gapsConclusion:The survey demonstrated there is a wide range of European Member Countries capacity to respond to animal welfare in natural disasters. This provides the baseline for the OIE Platform for Animal Welfare Europe to provide focused and actionable support to Member Countries
One Health: How to Build an Italian Model
Authors: Rossodivita Alessandra , Paganoni Catia , Rizzardini Giuliano , Saporito Tommaso , Zucchi Patrizia 
Published: June 2023

Introduction:The Concept of One Health is a cross-sectoral approach that aims at the protection of humans, animals, and the environment acknowledging their interconnection at a global, regional and local level.The "One Health" approach is officially recognized by the Italian Ministry of Health, and in the Lombardy Region, which has included it as a pillar of the new reform law of the regional health system (LR n.22 of 2021). All international organizations, as a relevant strategy in all sectors, benefit from the collaboration between different disciplines (doctors, veterinarians, environmentalists, economists, sociologists, etc.).Method:Disseminating basic knowledge of the "One Health" public health approach among the hospital staff of the hospital’s Complex of Valtellina and Alto Lario (with three hospitals), in consideration of the geographic location, far from urban Hospital centers and in the Alpine Mountain area.Promoting the culture of “One Health” through a hospital information and training campaign in recognizing the health of people, animals and ecosystems are interconnected, involving the population in cultural change. To create the basis for networks of collaboration in a multidisciplinary approach, especially at the level of human-animal interface, such as the surveillance of the emerging zoonoses in the light of the climate changes, using models from research to complex networks.Results:Promoting the application of an approach collaborative, multidisciplinary, inter-sectorial, and coordinated to address potential or existing risks, which originate from the interface between animal-human ecosystems. To disseminate a new public health culture based on “One Health" concepts and on future planning prospects and vision to the population as well.Conclusion:One Health represents a new paradigm of the vision of public health on a global level, which implies an awareness and a challenge of cultural change for the development of a more sustainable future.
Managing Hajj Mass Gathering Throughout the Pandemic
Authors: Khan Anas , Alahmari Ahmed 
Published: June 2023

Introduction:The rise of the COVID-19 pandemic caused significant concerns due to the risk of transmission in such mass gatherings. Too many variables for such a critical challenge made it more of a complex situation, with an enormous negative impact on either decision. In this paper, we aimed to summarize the experience of Saudi Arabia in hosting and managing Hajj throughout the pandemic for three seasons, the public health strategies to control the COVID-19 transmission during Hajj, and the policies and regulations that were implemented for the safe return of Hajj.Method:This is a summary of our experience in managing Hajj seasons throughout the COVID-19 pandemic for the period 2020, 2021, and 2022. A description of the factors, models, and tools used to assess the situation for each year, and the bundles of measures followed to mitigate the events aiming to hold a "Safe Hajj".Results:2020 was a unique year, with the pandemic at its height with no vaccination available. So, the decision was to hold a symbolic strict Hajj of only 1,000 pilgrims residing within Saudi Arabia. In 2021, as the World was easing restrictions and distributing vaccines, around 60,000 internal pilgrims got to perform Hajj, and 2022 hosted one million international pilgrims. That is still 40% of 2019 Hajj with 2.5 million due to considerations to avoid usual overcrowding and mandating COVID-19 full vaccination status.Conclusion:Our experience with the COVID-19 pandemic over the past three years has informed us that huge MGs can be conducted safely during the pandemic if adequate measures were implemented. That would include an accurate and reliable risk assessment to inform policymakers about the most effective strategies.
Management of Uncomplicated Acute Alcohol Intoxication at a Mass Gathering Event: Stop the Intravenous Fluids
Authors: Ranse Jamie , Crilly Julia , Keijzers Gerben , Mickan Sharon , Munn Matthew , Hutton Alison , Sweeny Amy , Buckland Michelle , Hamill Laura , Catherine Delany , East Katie , Hagan Stephanie 
Published: June 2023

Introduction:Uncomplicated acute alcohol intoxication (UAAI) requiring medical management is common at some mass gathering events. Most of the mass gathering literature reporting on medical management involving UAAI are single case studies. The common clinical practice for UAAI at mass gatherings reported in the literature involves intravenous fluids and antiemetics. However, emergency department evidence suggests that administration of intravenous fluids does not enhance patient outcomes, and in some cases extends emergency department length of stay and costs.Method:Using a retrospective cohort design of routinely collected data over a nine-year period (2010-2013 and 2016-2020), this study was set at an annual end-of-year ‘schoolies’ youth mass gathering event. The primary study aim was to determine the intravenous fluid management practices of UAAI at this event. Secondary study outcomes included patient demographic, clinical characteristics, and patient outcomes. Data were analyzed using time series and descriptive statistics. Ethical approval was obtained.Results:In total, 378 patients were identified with UAAI at the event over the nine-year period. The median patient age was 17 years (IQR: 17-18), with 47.2% (n=179) being male. Overall, the median length of stay was 74 minutes (IQR: 40 – 144). Only 7.9% (n=30) patients received intravenous cannulation and 6.3% (n=24) patients received intravenous fluids. Proportionately, the use of intravenous fluids for the management of UAAI decreased over the study years [2010, 28.6%; 2011, 32.1%; 2012, 15.6%; 2013, 6.3%; 2016, 2.6%; 2017, 0%; 2018, 1.8%; 2019, 0%; 2020, 0%].Conclusion:Some mass gathering events have a higher incidence of UAAI presentations. This is particularly true for those mass gathering events with young adults and at music festivals. Knowledge translation from the emergency department context regarding UAAI clinical management could be applied to the mass gathering event setting. This clinical management should include a conservative approach to the management of UAAI.
Feasibility of Live Video Feed Transmission from UAVs for Medical Surveillance During the 2022 Montreal Marathon
Authors: Lafortune Raphaël , Afram Eddy , Iannuzzi David , Champlain François de , Homier Valérie 
Published: June 2023

Introduction:In recent years, unmanned aerial vehicles (UAVs) have been increasingly used for medical surveillance purposes in mass gathering events. No studies have investigated the reliability of live video transmission from UAVs for accurate identification of distressed race participants in need of medical attention. During the 2022 Montreal marathon, the aim of this study was to determine the proportion of data collection time during which live medical surveillance UAV video feed was successfully transmitted and considered of sufficient quality to identify acute illness.Method:Four UAVs equipped with high resolution cameras were deployed at two predefined high-risk areas for medical incidents located within the last 800m of the race. The video footage was transmitted in real-time during four consecutive hours to a remote viewing station where four research assistants monitored it on large screens. Interruptions in live feed transmission and moments with inadequate field of view on runners were documented.Results:On September 25, 2022, 8,577 athletes registered in the Montreal marathon and half marathon. Out of the eight hours of video footage analyzed (four hours per high-risk area), 91.7% represented uninterrupted live video feed with an adequate view of the runners passing through the high-risk areas. The total interruption time was 22 minutes and 19 seconds, and the field of view was considered inadequate for a total of 17 minutes and 33 seconds. Active surveillance of drone-captured footage allowed identification of two race participants in need of medical attention. Appropriate resources were dispatched, and UAV repositioning allowed for real-time viewing of the medical response.Conclusion:Live video transmission from UAVs for medical surveillance of runners passing through higher-risk segments of a marathon race for four consecutive hours is feasible. Live feed interruptions and segments with an inadequate field of view could be minimized through practice and additional equipment redundancy.
Emergency Care to the Sound of Music
Authors: Varshney Kavita , Friend Caren 
Published: June 2023

Introduction:There are known higher rates of drug and alcohol consumption in music festival attendees. Patterns of MDMA use had been changing over a number of years however the festival season (Sept 2018 - May 2019) in NSW saw a dramatic rise in drug related mortality and morbidity which had not been seen in other states in Australia although similar instances had been noted overseas.With over 70 music festivals in NSW in this period, five deaths in four months and 29 severely unwell patrons transported to NSW hospitals, the impact was significant.To support both the festival site and NSW hospitals a Health Response Team (HRT) deployment model was implementedMethod:The planning and intervention strategies included provision of onsite specialist critical care teams to complement existing event management and paid healthcare providers. Disaster management principles, although documented, had not previously been used in the music festival setting. To deploy such a team, guidance on equipment, pharmaceutical and physical requirements were scarce. Our team developed processes and protocols for all aspects of this unique deployment.Operational procedures included specific equipment, medications, documentation processes, and clinical protocols were developed and reviewed and refined after each festival.Results:The effectiveness of the teams was evidenced through the early recognition and management of severe drug toxicity seen at the five festivals to which WSLHD deployed HRTs. This management resulted in good outcomes with minimal morbidity and no deaths of the 29 festival patrons treated by the HRT noting 25 required intensive care admission.Conclusion:Innovative processes and collaborative arrangements enabled effective deployment to NSW music festivals. Expert HRTs were key in preventing drug related morbidity and mortality through early recognition and management of complications. Team members gained unique and invaluable experience as a result of their deployments and patients transported to hospital were managed more effectively.
Increasing Patient Tracking Compliance by Harnessing Frontline Clinician Engagement
Authors: Gabaldo Molly , Daniels Mackenzie 
Published: June 2023

Introduction:A large urban jurisdiction identified a lack of experience and knowledge in use of the established regional patient tracking system among frontline emergency department employees. Lack of nursing retention, shifted departmental priorities throughout the pandemic response, and decreased opportunities for exercising were notable causes of this identified knowledge gap. Effective patient tracking has a significant impact during response to any event with the capacity to strain the hospital and healthcare system. Mass casualty incidents pose a global threat to all jurisdictions. Recognition of this threat magnifies the importance of establishing a patient tracking system and empowering frontline staff, through education and training, to immediately implement the exercised patient tracking platform.Method:Bolstering hospital readiness through site visits and first-receiver clinician engagement during special event planning improved effective use of a citywide patient tracking system during planned events. “Just-in-time” training tools were developed and distributed during site visits. Notably, identification of key clinical staff at each institution was an important step in meaningful clinician engagement. Utilization of these systems during special events is an opportunity to exercise a high stakes procedure during a low stakes incident.Results:Site visits and training material distribution effectively enhanced first-receiver participation in patient tracking during a special event in comparison to previous special events. Users required less prompting throughout the response, and the post-intervention survey indicated an increase in user confidence levels. Increased utilization of the system improved visibility into the hospital's lived experience while engaged in the response.Conclusion:Targeted site visits and educational material tailored to first-receiver clinicians during special events improved patient tracking efforts throughout a large urban healthcare system. During real and planned events, person and patient tracking allows for patient load balancing across the healthcare system, assists with patient and family reunification, and directs future planning, funding, and first responder and receiver education.
Fast EMR: An Online and Offline Mobile Electronic Medical Record for Disaster Settings
Authors: Draugelis Sarah , Brown Erik , Donahue Donald , Hickman Justin , Smith Sean , Sutherland Philip , Yendewa George , Mohareb Amir 
Published: June 2023

Introduction:The absence of clinical information in the aftermath of disasters in resource-constrained environments costs lives. fEMR– fast Electronic Medical Records–is a medical records system designed for mobile clinics and has proven useful in post-disaster settings. While the original version of the system was developed for areas without access to the Internet, a new version of this system was developed in 2019 to accommodate regions with connectivity.Method:We reviewed the design, implementation, and usage of fEMR from June 2014 to October 2022. We used logged data of the number of users, patient encounters, and the circumstances of each deployment. We compared usage between the original fEMR system and fEMR-on-chain.Results:The original fEMR system was created in an iterative process by students in Computer Science classes at three different American universities. The system creates a closed intranet signal to which clinicians connect their own device to access the software. The hardware is transported to the medical team in a carry-on suitcase prior to deployment. All data are stored on a laptop that acts as a server. The online version, fEMR On-Chain, was developed under a grant, but is sustained in development through academic partnerships. Both versions are designed so that the provider can complete an encounter with as few clicks as possible and with as little input as necessary to identify patients.The original fEMR system has been deployed to mobile clinics worldwide since 2014. The system has about 14,181 patients and 16,021 clinical encounters from 12 different countries. fEMR On-Chain has been deployed to refugee and migrant settings since 2019, containing about 18,000 patients and 22,000 encounters in two different countries.Conclusion:Successive versions of the fEMR system have been used in a variety of conditions and settings, with usage accelerating since 2019 in refugee and migrant health centers.
Developing a Statewide System for Prehospital Routing of Burn Injuries
Authors: Kearns Randy , Short Tracee , Barrios David , Sittig Kevin , Hargrove Paige , Hector Chris , Carter Jeffrey 
Published: June 2023

Introduction:In the USA, traumatic injuries are the leading cause of death before age 45 and have significantly lower mortality if treated in a verified trauma center. Burn injuries are included in trauma statistics and represent 1.1 million injured people annually seeking medical assistance. Routing of burn injuries to ABA-recognized burn centers has yet to be assessed as it has in trauma injury. Our goal was to examine the impact of prehospital routing of burn injuries on hospital length of stay, mortality, and potential costs-of-care through a statewide care coordination center.Method:Our study is a retrospective statewide analysis of burn injuries from 01/01/2017 thru 12/31/2019 using the Louisiana Hospital Inpatient Discharge Database. Routing of burn patients was implemented in 2018 using the ABA burn referral criteria. Data included: total admissions with primary burn diagnosis, region, discharge status, length of stay, and raw mortality by region and state. Descriptive and comparative statistics were performed to assess the impact of routing burn-injured patients. Cost analysis was performed using Louisiana Medicaid per diem rates from 2021 at $1,907.92/day.Results:1,288 patients were treated in Louisiana during the study period, with 855 post-routing and 433 pre-routing. The mean length of stay was reduced from 11.84 days in 2017 to 8.82 days in 2018 (p value=0.0988), with a potential savings of 761 inpatient care days or $2.17 million. Overall mortality across the state was unchanged except in the highest volume region, where it dropped from 7.9% in 2017 to 3.6% in 2019 (54%).Conclusion:Burn injuries are a time-sensitive trauma. This study marks the first analysis pre and post-implementation of routing for burn injuries by a statewide care coordination center. Our study demonstrates improvement in length of stay and mortality but a continued need to examine other contributing factors, such as injury severity and concomitant trauma.
Disaster Education in Hospitals using Metaverse: Focusing on COVID-19
Authors: Wang Soon-Joo , Park Seon Young 
Published: June 2023

Introduction:During the COVID-19 pandemic, it became difficult to conduct face-to-face training and practice for disaster medial education. As an alternative to this, it was proposed to build a metaverse world using virtual and augmented reality(XR) technology and implement disaster training education within it. Therefore, the authors investigated the process and effects.Method:The authors conducted training of healthcare workers through software implementing a metaverse called MediBase and NurseBase, which was created for doctors and nurses in hospitals to respond to disasters such as COVID-19. The trainees were given a practical orientation after basic theoretical education, attached a VR headset, and performed a medical response to a virtual disaster according to their judgment, and the records and debriefing were organized and analyzed.Results:The satisfaction of trainees with education reached a maximum of 88%. Even in the part where the correct choice was made in the theoretical evaluation, the time was delayed or the wrong choice or behavior appeared in the metaverse practical education and training.Conclusion:In disaster situations that cannot be implemented identically to reality and most disaster education and training that cannot target actual patients, metaverse-based disaster medical education and training is expected to become a more effective alternative in the future.
Emerging Technologies for the Early Location of Entrapped Victims Under Collapsed Structures and Advanced Wearables for Risk Assessment and First Responders Safety in SAR Operations, Search and Rescue Project
Authors: Cintora Ana , Colmenar Carmen , Martínez Carmen , Lozano Jose , Horrillo Cristina , Montero Carmen , García Ricardo , Morenilla Rosa , Gómez Cristina 
Published: June 2023

Introduction:Natural disasters and catastrophes are challenges faced by emergency services. These are dangerous environments in which there are life-threatening victims as in other CBRN incidents, which can add great risks for nearby populations and the environment. The main objective of this project is the development and testing of new technologies that increase the safety and efficiency of the work of first responders in disasters.Method:The SnR consortium, with 28 partners, has designed, implemented, and tested new technologies, with an advanced communication and monitoring system for professionals, victims, and other first responders, with innovative positioning and assistance ICT that facilitate the exploration and evaluation of disaster areas.These technological advances are validated and evaluated with performance, efficiency, and usability indicators, in laboratories and in real working conditions, through a total of seven case studies, in seven different countries, covering a wide range of representative disaster scenarios.Results:The development of a new communication and monitoring system for professionals and victims, coordinated on the Concorde platform, together with chemical alert sensors, synchronized with smartwatches, smart uniforms, and pediatric immobilizers, are some of the tools tested. The pilots carried out to confirm the usefulness of the 26 technological tools designed and tested in the field, which have helped to reduce the damage and casualties that can occur in S&R operations.Conclusion:In conclusion, the H2020 European Search and Rescue project (S&R), through the development of new technologies, offers a holistic approach to the effective response to emergencies and provides increased capabilities and resources to first responders in the field, increasing their effectiveness and safety. This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement (No. 882897).