bluuebunny/crossref_metadata_2025_split huggingface dataset:
An empirical model of noise sources in subsonic jets
Authors: Karban U. , Bugeat B. , Towne A. , Lesshafft L. , Agarwal A. , Jordan P. 
Published: June 2023

Modelling the noise emitted by turbulent jets is made difficult by their acoustic inefficiency: only a tiny fraction of the near-field turbulent kinetic energy is propagated to the far field as acoustic waves. As a result, jet-noise models must accurately capture this small, acoustically efficient component hidden among comparatively inefficient fluctuations. In this paper, we identify this acoustically efficient near-field source from large-eddy simulation data and use it to inform a predictive model. Our approach uses the resolvent framework, in which the source takes the form of nonlinear fluctuation terms that act as a forcing on the linearised Navier–Stokes equations. First, we identify the forcing that, when acted on by the resolvent operator, produces the leading spectral proper orthogonal decomposition modes in the acoustic field for a Mach 0.4 jet. Second, the radiating components of this forcing are isolated by retaining only portions with a supersonic phase speed. This component makes up less than 0.05 % of the total forcing energy but generates most of the acoustic response, especially at peak (downstream) radiation angles. Finally, we propose an empirical model for the identified acoustically efficient forcing components. The model is tested at other Mach numbers and flight-stream conditions and predicts noise within 2 dB accuracy for a range of frequencies, downstream angles and flight conditions.
Competition and childcare quality: Evidence from Quebec
Authors: Chandler Vincent , Dilmaghani Maryam 
Published: June 2023

Abstract
Since 1997, the Canadian province of Quebec has put in place a heavily subsidized universal childcare program for all children under the school age. The present paper examines how the level of competition among individual providers associates with the quality of childcare in Quebec. The quality of childcare is measured by the number of violations and penalties recorded in the inspections conducted by the Quebec Ministry of Family Affairs. The analysis indicates that the intensity of parental competition for daycare spots, as opposed to childcare centres’ competition to attract parents, negatively associates with the quality of childcare. Critically, this association is mainly driven by less affluent neighbourhoods. In addition, these associations are found to be stronger for more serious violations. The policy implications for both childcare quality and childcare equality are discussed.
Injury Outcomes of the 2017 Charlottesville TARMAC Attack
Authors: Phillips James , Young Jeffrey , Brady William 
Published: June 2023

Introduction:Targeted Automobile Ramming Mass Casualty attacks (TARMAC) have occurred worldwide since 2010. The dramatic increase in incidence warrants special attention to the unique pattern of injury associated with such attacks as they are unlike any other type of intentional trauma. This study characterizes the resulting injuries from the 2017 Charlottesville, Virginia TARMAC attack.Method:Patient records of victims were identified and analyzed for injuries, demographics, and surgical needs. The data were evaluated for patterns.Results:Nineteen TARMAC victims were treated in the UVAHS Emergency Department. Most were female (68%). Average age was 29.4 years (range 13 – 72 years). Data showed seven ICU admissions, four standard admissions, and seven discharges. There was one fatality and the specific injury data was unavailable. Most injuries were orthopedic: lower extremity fractures (n=7) [2 open], upper extremity fractures (n=7), axial skeleton fractures (n=6), and a facial fracture (n=1). Arterial injuries required interventional radiology (n=1) or observation (n=2). Organ injuries included a Grade 1 spleen laceration (n=1) and pneumomediastinum (n=1). six victims required one or more operative interventions during admission: emergent procedures (n=6) and delayed procedures (n=4). In the Emergency Department, two bony reductions were performed, five lacerations were repaired, and one thoracotomy was performed. Injury Severity Scores were calculated (mean=11.5; median 6; range 1-75).Conclusion:Due to the mechanism of injury, TARMAC attacks inflict a unique wounding pattern. Intentional mass blunt trauma is previously unknown to emergency medicine. Vehicle variables including weight, speed, and bumper height affect the injury location and severity. This vehicle, a low-height sports car, inflicted primarily lower extremity injuries. Mortality rates have been higher in attacks involving taller, heavier vehicles, as seen in France, Germany, and Sweden. Analysis of victim data from TARMAC attacks will help emergency medicine physicians, surgeons, and disaster medicine specialists to prepare, train, and mitigate against this increasingly frequent tactic.
A Scoping Review of the Literature on Landmines in Egypt and their Resultant Disaster Impact
Authors: Abdel-Fattah Areej , Alexakis Lykourgos , Issa Fadi 
Published: June 2023

Introduction:A scoping review of the literature available on landmines in Egypt and their resultant disaster impact (human losses, material losses, economic losses and environmental losses) on the Bedouin communities inhabiting contaminated regions and on Egypt is presented. A narrative approach is taken to map the data extracted from the available literature to: the domains of losses; evidence of external assistance; and progress, revealing the widespread impacts of the hazard of landmine contamination.Method:The review question was mapped based on the JBI and the Arksey and O’Malley Frameworks with reference to Aromataris and Munn (2020), and Peters (2022). The research question was identified starting with the search strategy, and is broken down using PCC as recommended for Scoping Reviews (Peters, 2022).Searches of scientific literature were conducted using multiple databases, further searches of search engines, social media and of grey literature were conducted. The search results were then screened over two stages to determine their relevance. Data was then extracted using the PRISMA-ScR checklist before being tabulated and charted.Results:The data collated evidently shows human losses manifest as mortality, physical disability, psychological trauma, financial instability and social impacts; while material losses include blocks to considerable areas of the country’s landmass suitable for urban housing, agricultural and touristic potential, as well as mineral, and oil and gas reserves; economic losses include impedance to development, lost revenues and deterrence from investment; environmental losses comprise extensive contamination of Egypt’s land.Conclusion:Evidence of external assistance being sought and provided is ample, signifying the overwhelm of Egypt’s coping capacity; rather, positive steps to de-mine the land and provide mine risk education and survivor assistance are beneficial in risk reduction. While landmine contamination is not classically considered to carry a disaster risk, this study proposes it does.
Regional Program for Knowledge Co-creation on Disaster Health Management in ASEAN and Japan
Authors: Kita Taro , Silapunt Phumin , Yanasan Alisa , Ito Yusuke , Ikeda Shuichi , Aono Mika , Katsube Tsukasa , Koido Yuichi , Kai Tatsuro 
Published: June 2023

Introduction:Knowledge management on Disaster Health Management (DHM) is one of the priority areas in the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM (POA/ ALD DHM) (2019-2025). The Japan International Cooperation Agency (JICA) has been implementing the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) since 2016 to assist the ASEAN region in strengthening coordination capacity on DHM. A regional training course on DHM for ASEAN member states (AMS) in Japan was proposed to be implemented in 2022 as a JICA’s Knowledge Co-creation Program (KCCP).Method:The training curriculum of the KCCP included emergency and disaster medicine in Japan, international trends on DHM, and underwent reviews by AMS representatives of the ARCH Project. Prior to the training, participants were required to prepare country reports (CRs) outlining information on legislation, system and structure related to emergency and disaster medicine, as well as systems to receive international emergency medical teams (I-EMTs).Results:The four-week KCCP course contained a trial implementation of a four-day training program for receiving I-EMTs and coordination among stakeholders in ASEAN disaster response, based on the regional standard curriculum developed by the ARCH Project, and invited experts in DHM not only from Japan but also from AMS as instructors. Participants analyzed and identified challenges on DHM in their countries, and developed draft action plans (APs) to improve the situation through the knowledge obtained from the program.Conclusion:The draft APs, the training deliverables, will be shared with the ARCH Project, and used to build a support mechanism to achieve national level targets of the POA/ ALD DHM, and the progress will be reflected in the CR in the subsequent year. The KCCP on DHM is expected to facilitate knowledge sharing in AMS and Japan, and contribute to fostering the culture of mutual learning.
Impact of a Simulation Game (MASS) on the Undergraduate’s Experience and Performance in Triage Training–A Pilot Study
Authors: Cao Yu , Wang Zhi-yuan 
Published: June 2023

Introduction:The use of simulation games in education has been rising in recent years. Triage is not only a major content among the EMS (emergency medical services) but also a necessary skill for students to improve their first-aid ability. This study aims to investigate a game for education called MASS (movement, assessment, sort, and sending), which attempts to enhance students’ capability of disaster response.Method:A randomized controlled trial was conducted among students who took the course: “Understanding Disaster and Surviving Risk” during the term and volunteered to participate in teaching research from different faculties in Sichuan University. Participants were trained by using the simulation game or the online course before class. The simulation game is MASS, which uses virtual reality techniques to create a realistic 3D tanker explosion scene, and the online course is a Massive Open Online Course created by the teaching team. In the class, questionnaires with subjective and objective multiple choices were carried out after a discussion. With SPSS version 27.0, statistical significance among groups was determined by Mann-Whitney U-test for rank variables, Fisher’s exact test for binary variables.Results:73 students were included in this study, including 45 in the online course group and 28 in the simulation game group. The qualitative experience survey showed the two groups were significantly different in experience of disaster scene challenges, application scenes, and method of triage (P=0.031, 0.007, 0.031, respectively). Students in the simulation game group showed significantly better performance in knowledge acquisition including application scene of triage, key of the expectant’s assessment, and rescue condition for thoracentesis than in the Online game group (P=0.048, 0.020, 0.010, respectively).Conclusion:Simulation games can improve students’ experience and performance in triage training. Due to the unrepeatability of disaster, the study suggests that games can be used to conduct simulation education for disaster medicine.
Evaluation of the Degree of Crisis Awareness and Behavioral Change Through Disaster Exercise: A Case Study of a Disaster Response Exercise in a Pharmacy Department
Authors: Kajihara Chisato , Kashiwabara Michishi , Yamao Makiko , Aoki Yuki , Yabe Katsushige , Kaneko Masaaki , Sano Masataka , Munechika Masahiko 
Published: June 2023

Introduction:The authors developed an evaluation tool to measure changes in exercise participants' awareness of disaster risk and their disaster preparedness behaviors. To create the tool, a mechanism was modeled to visualize the process of changing people's crisis awareness and behavior and questions were developed for each of the twelve factors and two outcomes within the mechanism. In this study, we conducted a disaster exercise in the pharmacy department of Hospital A, one of the disaster base hospitals, and measured the effectiveness of the exercise using the tool.Method:In the disaster exercise, participants were asked to perform dispensing tasks on five dummy prescriptions using actual medicines, based on the assumption that the dispensing support system was out of order due to a major earthquake. Participants were paired up and dispensed as much as possible within a time limit of 30 minutes. Pre- and post-education sessions were conducted before and after the exercise. Respondents were asked to score each question on a 5-point scale at three time points: before the pre-education, immediately after the disaster exercise, and after post-education.Results:59 people, including 16 participants, responded to the questionnaire using the evaluation tool. The analysis of the evaluation results revealed that the disaster exercise increased the participants' crisis awareness. Furthermore, participants improved their scores on the questions on feelings of anxiety about the current situation, assumptions about the impact, sense of ownership, and fear of not acting, but no change was observed among non-participants. However, there was no significant difference in scores between the two groups regarding whether they had taken action for disaster preparedness in the period following the exercise.Conclusion:The exercise raised the participants' crisis awareness, but did not encourage them to change their behavior. Future research should consider ways to encourage staff members to take action to prepare for disasters.
Disaster Management Simulation–A Novel Virtual Exercise
Authors: El-Baba Mazen , Mazurik Laurie 
Published: June 2023

Introduction:Disaster management and emergency preparedness relies on the collaboration, communication, and expertise of a multidisciplinary team. Skills in preparation, communication, and management of disasters are core competencies of an emergency physician. To learn the principles of disaster management, simulations are critical as mass casualty/rapid surge events seldom occur. The COVID-19 pandemic resulted in the cancellation of in-person events. In response to these restrictions, the University of Toronto, EM Program developed a successful virtual interprofessional mass casualty simulation.Method:The novel online simulation event was piloted in 2021 and ran for three-hours. The exercise focused on developing soft skills (e.g., communication, team-work, and debriefing) and hard skills (e.g., triage, casualty distribution, and activation of plans). Groups were composed of members of each post-graduate year to facilitate near-peer learning. A total of six groups were formed: Adult, Children, Community Hospitals, EMS, Government, and Media. Each Team used multiple communication tools (i.e., Whatsapp groups, Zoom breakout rooms, Shared Google Documents) to swiftly pivot and manage a mass casualty event. Post-exercise debriefing and anonymous evaluations were gathered.Results:A total of 28-residents (nine PGY1, ten PGY2, and eight PGY3 learners) and 11-staff observers participated (25-respondents). Nineteen participants rated the simulation exercise as excellent and six as “very good”. Twenty participants rated the workshop as “very useful” and five as “useful”. Positive feedback centered around content applicability, exercise creativity, level of engagement, and learning value. Constructive feedback included the need for more pre-exercise orientation time, increasing disaster management time, and inviting allied-health staff.Conclusion:There is a clear need for EM residents to learn and develop skills related to disaster management and emergency preparedness. This exercise showed that disaster management and emergency preparedness competencies can be learned in a virtual format. This virtual format has encouraged its continuation and further inspired the curation of a four-year program.
Past, Present, and Future of Korea National Radiation Emergency Medicine Education
Authors: Kim Jungjin , Nam Hyungwoo , Cho Minsu 
Published: June 2023

Introduction:In Korea, there are various medical and industrial researchers who use radiation as part of their research. But radiation can cause extensive long-term damage in case of an accident. Therefore, national-level policy and training for the response workforce have been established for a professional response. Since 2002, the KIRAMS has been providing emergency medical response education based on the five mandatory contents (including legislation, protection measures, and emergency medicine).Method:The training content can be divided into theoretical and practical courses. Early education included theoretical courses on cases of accidents and their effects on the human body, as well as practical courses on treatment for contaminated patients. The current education program offers group practice using a HPS and mobile learning. As for the future of national radiation emergency education, the paradigm of education will change with the fourth industrial revolution, the advancement of the IT industry, and the advent of the ‘untact’ era. Therefore, research and development on XR technology–based educational content that can overcome reality’s constraints, is being conducted. Simulation-based education courses to increase effectiveness and immersion will be implemented.Results:Currently, there are approximately 900 radiation emergency medical personnel, and more than 30 new and supplementary education contents are provided each year to improve their proficiency and response abilities. Approximately eight types of content using XR technology will be developed and tested (2021-2023) before being implemented in actual education programs (2024). Advancements in education reflecting special conditions, such as COVID-19, and technological advancements will continue indefinitely.Conclusion:Efforts are ongoing to improve the educational content and to train excellent radiation emergency medical personnel. With the implementation of XR technologies and new education trends, the future of national Korean radiation emergency medical education is expected to advance and diversify, and further improvements in the educational content can be expected.
Feasibility and Effectiveness Assessment of the New Triage System Adopted by the Disaster Medicine Service of Regione Piemonte: Results of a Controlled Randomized Study
Authors: Goldschmidt Nicole , Donati Maria Chiara , Roasio Agostino , Vaselli Giorgio , Raviolo Mario 
Published: June 2023

Introduction:Validation of the new MCI Triage protocol of Regione Piemonte by comparing it with the already published and internationally used START/Jump START protocol. Compare its accuracy, execution time, over and under triage indices and the influence of any rescuer characteristics in reference to adult and pediatric victims when in use in a simulated multi-casualties event setting.Method:We conducted a randomized controlled experimental study in a simulation setting. A group of 35 people involved in an incident (volunteer participants) was assessed by a population of trained and untrained healthcare professionals (nursing students and nurses). The participants were randomly divided into two homogenous groups to which the two protocols were explained separately and carried out the simulation in single-blind. Evaluation data were collected and statistically processed. The resulting items were used to compare the accuracy, over- and under-triage rates and any items related to rescuer characteristics for each triage system.Results:74 subjects were included in the study. Of these, 56.7% were healthcare professionals in training and 43.4% were trained nurses. Compared to standard criterion definitions, the MCI triage protocol showed a higher accuracy rate than START (88.4% vs 80.4%, p<0.01). MCI triage had a significant lower rate of underestimation compared to START (8.9 vs 13.6%, p< 0.01) as well as overestimation (3.2% vs. 6.8%, p< 0.01). Time is only correlated with the performance of MCI triage, influencing its accuracy. There were no significant differences in the accuracy of diagnosis in pediatric patients.Conclusion:We found that MCI method triaged adult patients more often correctly than START method. Underestimation and overestimation were lower than in the control method, although there tended to be a significant overestimation of white codes which were not present in the START system. In the assessment of pediatric patients, the protocols are equivalent.
Using a Tabletop Game to Teach Emergency Department Nurses Comprehensive Emergency Management and Hazard Vulnerability Analysis: Influences and Possible Reasons
Authors: Chou Wei-Kuo , Liu Hung-Chieh , Lin Chien-Hao 
Published: June 2023

Introduction:Comprehensive emergency management (CEM) and hazard vulnerability analysis (HVA) are two vital concepts in hospital emergency management (EM). Teaching these two concepts by lectures may be less effective and interesting. Therefore, a tabletop game was used to teach CEM and HVA. This study aimed to evaluate the effect of teaching and possible reasons.Method:A tabletop game was created based on the concepts of CEM and HVA. Players of the game needed to manage hospitals against six kinds of emergencies. The impact of each emergency is different. Each hospital in the game has its vulnerability. The game players needed to use different strategies of prevention, mitigation, preparedness, response, and recovery to win the game.The player’s knowledge was tested by 15 yes-no questions (10 points for each question). The interest in further learning and willingness of hospital EM participation were evaluated by questionnaire. The test and questionnaire were conducted before and after the game. Possible reasons for learning by the game were surveyed after the game.Results:Fifteen emergency department (ED) nurses were taught by the game and completed both pre- and post-game tests and questionnaires. The post-game test average score (103) was significantly higher than the pre-game average score (84) (p=0.008). The participants’ interest and willingness also increased significantly after the game. The most frequently mentioned reasons for learning by the game were “the game is more interesting than lectures”, “the chance to discuss with other participants in the game”, “the chance to see many CEM methods in the game”, and “ability to compare with other players”.Conclusion:A well-designed tabletop game can be an effective tool to teach CEM and HVA. The game can increase knowledge, interest in learning, and willingness of CEM participation, and it should be promoted in the future.