bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Mapping of Coastal Cities that Sinking Faster than Sea-Level Rise by 2050: The Case of Jakarta and Semarang
Authors: Pradana Atha , Yew Ying , Demetriou Christiana , Prayitno Harun , Delgado Rafael , González Pedro , Utami Ratnasari Dyah 
Published: June 2023

Introduction:Coastal area cities Jakarta and Semarang in Indonesia portray higher hazard that links to an annual sinking rate of up to 20cm. Four main factors have been determined to contribute: groundwater extraction, sea-level rise (SLR), land subsidence, and coastal floods. It accounts for people living in those high-risk regions to prevent the exacerbating situation.Method:This study’s main objective is to generate risk mapping in Jakarta and Semarang using Geographic Information System (GIS) from three open-source websites: Surging Seas, OpenStreetMap (OSM), and Healthsites.io. Through GIS analysis, prediction can be analyzed more accurately with precision when the sinking hits slowly to identify the risks involved.Results:Satellite data geographical analysis risk mapping done via Surging Seas, OpenStreetMap (OSM), and Healthsites.io showed that by 2050, North, West, part of Central Jakarta and Semarang will sink 5.6 meters below sea level with an annual sinking rate up to 20cm. Critical infrastructure will be affected in Jakarta, including Soekarno-Hatta International Airport and Tanjung Priok Port. Similarly, in Semarang, the Jenderal Ahmad Yani International Airport, Tanjung Mas Port, and Terboyo Bus Station are affected as well. Consequently, it will situate 13 million at both coastal cities as the worst impacted, categorized by the World Bank data, updated Sept 2022 as Urban Poverty, the population living at 2.15 US Dollar a day poverty line. Those living below the poverty line are also deprived of education and access to infrastructure, mainly electricity, water and sanitation hygiene indicators measured by the World Bank 2021 and 2022, Multidimensional Poverty Measure.Conclusion:As a conclusion, GIS mapping of Jakarta and Semarang by 2050 using Surging Seas, OpenStreetMap, and Healthsites.io showed a high risk of sinking, especially in the northern areas of both cities, with the mapping done as of April 2022.
All the Sickly People, Where Do They All Come From? An OLD Problem (Off Load Delay) Rising Ambulance Presentations to an Irish Emergency Department
Authors: Jordaan Phillip , Smit Marco , Andrews Robin , Jordaan Phillip , Kennedy Keith , Abraham Ria , Orsmond Brendan , Rensburg Rochelle Jansen van , Fayyaz Fahd , Neduchelyn Yuni , Vegte Andrea van der , Dowle Ashleigh , Vythilingam Darshini , Wickham Bryce , Kelly Thomas , Molloy Michael 
Published: June 2023

Introduction:Demand for prehospital emergency services has been increasing worldwide. Significant challenges exist in meeting response times in rural environments when faced with surges in demand related to weather events or sustained demand surge such as the pandemic environment. Significant pressure also exists in the hospital environment receiving such large volumes of patients with short duration handovers to allow prehospital assets return to their primary roles. The aim of this study is to determine trends for ambulance presentations in a rural emergency department over seven years with absolute numbers and percentage of overall attendances.Method:A retrospective analysis of anonymized electronic registration data on the iPMS system from initiation in 2014 to 2022 including total registration numbers, presentation by ambulance, and handover times. Excel is used to record and examine data.Results:ED attendances rose from 29,236 in 2014 to 43,184 in 2021 with total ambulance presentations ranging from 4,859 in 2014 (16.62% of attendances), maxing in 2019 at 10,326 out of total attendances of 42,637 (24.22% of attendances).Lowest monthly ambulance presentations occurred in April 2014 (441 or 15.82% of 2788 attendances) and maximal monthly presentations was 1,023 in May 2022 (23.38% of 4376 attendances). Lowest percentage of attendances arriving by ambulance occurred in May 2014 with 14.97% (468) out of 3,127 ED presentations. Highest percentage of attendances arriving by ambulance occurred in January 2021 with 33.67% (875) of 2,599 ED presentations which was during the lockdown phase of COVID in Ireland.Conclusion:Overall total numbers of patients arriving by ambulance has been steadily increasing for years but numbers (and percentages) dramatically increased during COVID and this has been sustained in the POST Lockdown pandemic phase. Strategies are required to manage demand, increase turnaround and educate the public on appropriate use of prehospital emergency services.
Emergency Medical Service Facilitated Geriatric Emergency Department Visits in Hamilton, Ontario, Canada During the COVID-19 Pandemic
Authors: Jazuli Farah , Mulla Ali , Weingarten Laura , deWit Kerstin , Franc Jeffrey 
Published: June 2023

Introduction:To determine if lockdown measures related to the COVID-19 pandemic changed the frequency and epidemiology of geriatric patient emergency medical service (EMS) facilitated visits to the emergency department (ED) in Hamilton, Ontario, Canada.Method:A retrospective chart review was conducted comparing ED presentations of patients over 65 years of age presenting to two academic hospitals in Hamilton, Ontario via EMS between March 17, 2020, and July 15, 2020 (the first wave of the COVID-19 pandemic) to March 17, 2019, and July 15, 2019 (pre-pandemic).Results:Total EMS facilitated geriatric ED number of visits decreased by 17.3% during the first wave of COVID-19 in 2020, relative to the same seasonal time frame in 2019 (March 17- July 15). Visits were more dramatically decreased in the first 8 weeks after the pandemic was declared but then recovered to pre-pandemic levels thereafter. More geriatric patients visiting the ED via EMS were admitted during the initial stages of the COVID-19 pandemic, relative to 2019. However, the acuity and epidemiology of visits remained the same during the first wave of the COVID-19 pandemic, relative to 2019.Conclusion:Lockdown measures during the first wave of the COVID-19 pandemic coincided with decreased geriatric EMS ED visits in the initial two months after the pandemic was declared. Visit numbers recovered as the first wave ended. The epidemiology, as well as the overall acuity, did not change.
Case Report of an Irish NGO Providing Educational Support in Establishing a Major Trauma Center in a Low-Middle-Income Country
Authors: Mulcaire Jeffrey , O'Leary Anna , Breslin Deirdre , Murphy David , O'Sullivan Jean , Eager Robert 
Published: June 2023

Introduction:St. Joseph's Mission Hospital, Nyabonda, Kenya is the site chosen for a new Trauma Response Center as part of a new national highway development scheme. This highway will significantly increase in traffic volume expected in the region. With increased traffic volume, there will be an expected increase in trauma presentations as well as medical presentations due to increased populations in the area. This center is expected to serve a population of four million people. To date, the majority of nurses, medical officers and doctors in the pre-existing facility received no formal post graduate training in medical and surgical emergencies.Method:Global Emergency Medical Skills (GECS) is a registered charity, with an aim to provide medical education for the management of both trauma and medical emergencies for both adults and children. GECS was invited to attend St. Joseph's Missionary Hospital to provide education to nurses, medical officers and doctors. A curriculum encompassing the management of medical and surgical emergencies through both didactic lectures, practical skills training and simulation based workshops was composed and delivered by a group of 11 faculty, crossing Emergency Medicine, Intensive Care, Anesthesia and General Medicine. This curriculum had 28 participants and was conducted over a five day period. A "train the trainer" model was employed to ensure the strongest candidates were chosen for further training on how to deliver course material and organized simulations for future colleagues in St. Josephs Trauma Center.Results:Questionnaires of both staff and students have highlighted the utility of GECS and its curriculum in preparing staff for the opening of this new trauma center.Conclusion:This program was the first of its kind undertaken in St. Joseph's Hospital and has provided valuable education to the staff of this new trauma center. This project has enabled the continuity of this knowledge through chosen trainers.
Emergency Medical Team Deployment Modalities: A Delphi Study
Authors: Yeung Tiffany 
Published: June 2023

Introduction:The COVID-19 pandemic presented obstacles to Emergency Medical Teams (EMT) deployment, including concern of exposure to COVID-19 and travel restriction in many areas of the world. Recognizing these challenges, EMTs sought alternatives to physical deployment, such as virtual deployment. However, concerns have been raised regarding access to internet in aid recipient countries, as well as patient privacy and data leakage in general due to insecure internet connections and intentional data hacking. There is limited literature, and no internationally agreed set of criteria, on the evaluation of deployment including the recipient countries’ ministries of health’s opinion on the deployments. In order to compare alternative deployment modalities, a set of criteria to evaluate an EMT deployment must be established.Method:The research will identify a set of criteria that can be used to evaluate a deployment; to identify the possible alternative modalities to traditional physical deployment; and to explore perceptions of acceptability and ability to meet the goals of international humanitarian assistance. A stakeholder analysis will be conducted to identify the key informants and relevant stakeholders, and the Delphi Approach will be utilized to seek experts’ opinions and reach consensus.Results:This research will help to establish a set of criteria for evaluating deployments, and to identify the alternative deployment modalities, the advantages, and disadvantages, and to evaluate each alternative modality, with the hopes of guiding EMTs to plan their future deployments, as well as to provide alternatives should there be further restrictions in the future.Conclusion:At this moment, this research is at the planning stage and ethical approval has not yet been sought. Should this abstract be accepted, ethical approval will have been obtained, and data collection will have just started in May. The presentation will include a summary of relevant literature, the methods, and any preliminary results.
The Utility of a Hospital System-Specific Emergency Medicine Residency Orientation
Authors: Katirji Linda , Cruz Angelo 
Published: June 2023

Introduction:The transition to residency is a challenging time in the medical trainee’s career. In addition to learning and implementing knowledge specific to emergency medicine, logistics and system nuances can initially impede a learner’s ability to begin the process of mastering their profession. In an attempt to ameliorate this transition to residency an orientation was created to introduce concepts of local ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits.Method:Interns were given a pre-workshop survey on comfort level (1-5 Likert) of ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits. They rotated through four workshop stations in small groups. The first was an ultrasound workshop showcasing our commonly used ultrasound and how we capture images and videos into our medical system for review. The next was institution specific protocols for medical and trauma resuscitation using simulation. Third was a workshop on how to navigate our electronic medical record with simple overviews of documentation and order entry. Lastly, they went through arterial and central line kits to familiarize themselves with the contents. A post-workshop survey was given.Results:Comfort with ultrasound documentation pre-workshop mean was 4.0 with a post-workshop mean of 4.45 (p=0.068). Comfort with resuscitation pre-workshop mean of 2.91 increased to 3.91 (p=0.008). Electronic medical record documentation comfort rose from a mean of 3.5 to 4.27 (p=0.007). Comfort navigating procedural kits increased to a mean of 4.09 from 3 (p=0.002).Conclusion:There was a statistically significant increase in comfort level with ultrasound documentation, resuscitation protocols, EMR navigation, and procedural kits after completion of the workshops. Only ultrasound documentation had a p value less than 0.05. It can be reasonably deduced that focusing on institutionally specific aspects of workflow can help interns expedite their education by familiarizing them with these nuances prior to their first shift.
Compliance with The National Institute for Health and Care Excellence (NICE) Guideline (NG158) Venous Thromboembolic Diseases: Diagnosis, Management, and Thrombophilia Testing; Proximal Lower Limb Venous Ultrasound Time Standards at Wexford General Hospital
Authors: Abraham Ria , Orsmond Brendan , Dowle Ashleigh , Vythilingam Darshini , Andrews Robin , Smit Marco , Kennedy Keith , Rensburg Rochelle Janse van , Vegte Andrea van der , Conradie Maria , Jordaan Philip , Wickham Bryce , Kelly T , Molloy Michael 
Published: June 2023

Introduction:The consequences of missed lower-limb deep vein thromboses (DVT) can be life-threatening. Similarly, inappropriate treatment with anticoagulation in low-risk patients carries a significant risk of harm. Early diagnosis and appropriate treatment with anticoagulation rely on timely ultrasound access. The National Institute for Health and Care Excellence (NICE) recommends timeframes for ultrasound acquisition based on Well’s score and D-dimer value.If rapid ultrasound (Point of care Ultrasound POCUS in our context) demonstrates no features of DVT, it is safe to arrange follow-up scan within eight days without empiric anticoagulation. If, however, no bedside ultrasound is performed, anticoagulation is commenced until a formal scan excludes DVT. NG158 recommends this scan be performed within 24 hours. This audit investigated our compliance with NG158 time standards at Wexford General Hospital (WGH) emergency department (ED).Method:Electronic records for patients undergoing formal ultrasound for suspected DVT between 08/01/2022-10/13/2022 were reviewed using the hospital’s databases. Charts were reviewed to determine if POCUS was performed. In total, 42 records met selection criteria. Audit Committee governance review was obtained. Fisher’s exact test was used to compare compliance rates between those that underwent bedside ultrasound and those that did not.Results:Overall compliance with NG158 was 40.5%. Compliance rates for those offered bedside ultrasound were significantly higher than those that weren’t (58.3% vs. 16.7% p<0.0106). The mean waiting time for a radiology department ultrasound is six days, 12 hours, and 16 minutes.Conclusion:Overall compliance is low, and delays to obtaining formal ultrasound are long. We observed that compliance rates for those who underwent bedside ultrasound were significantly higher than for those who did not. This suggests that bedside ultrasound is under-utilized in our ED. Training more staff to perform bedside scans would alleviate current delays to ultrasound diagnosis and reduce risks associated with empiric anticoagulation.
Children's Welfare Concern in a Full-scale Disaster Pediatric Drill
Authors: Ribera-Cano Anna , Houze-Cerfon Vanessa , Sangay Virginie , Viault Benoit , Bounes Vincent 
Published: June 2023

Introduction:Children are almost systematically involved in mass casualty events, especially in the context of terrorist attacks. Unfortunately, the emergency medical responder preparedness is quite often low when it comes to pediatrics, on both technical and emotional sides. Preliminary training is indispensable, and full-scale simulations are arguably the best solution to tackle the needs of the first responders. The purpose of the study was to describe a simulation-based pediatric training with pediatric psychological support set up for the drill.Method:A full-scale exercise involving children between five and fifteen years old was conducted in the Toulouse municipal stadium during the preparation of the 2016 UEFA (European Football Championship) in France. As children welfare was the primary concern, a psychological support team was present at each stage of the drill and assessed any mental harm that could have happened. Children were asked about their feelings at the end of the exercise with a 5-point Likert rating scale and their parents had to report any perceived changes in the following week.Results:Out of 16 children participating in the drill, four were in an immediate situation (P1), four were in an emergent situation (P2), and eight were in an urgent situation (P3). One hundred percent of them rated their experience as very good and expressed no stress to their parents in the week that followed, and no harm was detected by the psychological support team during the exercise.Conclusion:The results of the study show that involving children as victims in pediatric disaster drills is possible in these conditions without impacting the mental welfare of children.
Preparedness of Afghan Refugees for Disasters
Authors: Rizek Jamla 
Published: June 2023

Introduction:Refugees encounter many obstacles en route to the United States. Refugees face very different disasters and response resources in the US than in their home countries. On arrival to the US, refugees receive a brief introduction to disaster preparedness, but do not receive specific education based on their home country or final location of residence. This study aims to determine the preparedness levels of Afghan refugees in the United States.Method:This study used a modified General Disaster Preparedness Belief Scale (mGDPBS). The mGDPBS consists of 20 of the 45 questions from the GDPBS, selected from each of the six subscales most applicable to the refugee population. Ten Afghan refugee families were selected from the Afghan community in Virginia.Refugees were interviewed by a recorded one hour interview via Zoom. A list of the questions were provided, and a translator was available to ask the questions in the respective language of the refugee: Dari or Pashtu.Results:Data collection and analysis to be completed by January 30, 2023.Conclusion:Data collection and analysis to be completed by January 30, 2023.
Self-Injurious Thoughts & Behaviors of Firefighters: A Quantitative Descriptive Study
Authors: Weiss Mark 
Published: June 2023

Introduction:Little is known about Self-Injurious Thoughts & Behaviors and Non-Suicidal Self-Injury in firefighters in two East Coast United States metropolitan fire departments based on fire service tenure.Method:• Study comprised of two parts, a survey and a questionnaire, both conducted online. Using the Computer Adaptive Test–Suicide Scale
The only computer-based adaptive mental and behavioral health assessment clinically validated worldwide.Validated against face-to-face structured clinician-led assessment.Participants received a unique identifier and hyperlink allowing them access and confidentiality.Study was completed on participants' personal electronic devices, on their own time, at their own pace.A single-factor or One-Way ANOVA tested for a significant relationship between the variables and the four tenure groups simultaneously. Time of administration averaged 86 seconds, with a median of eleven questions.Results:The C-SSRS identified six participants triggering suicide alerts. One in the early-career category and five in the late-career category. The CAT-SS identified one participant as high-risk and 33 participants for suicidality. One participant in the early-career category.Conclusion:Early-career and late-career firefighters have more self-injurious thoughts and behaviors and mid-career firefighters have the least.
Mass Casualty Triage: What Works and Who Does it Best?
Authors: O'Sullivan Jessica Walsh , Hwang Esther , Mize Benjamin , Glassman Erik 
Published: June 2023

Introduction:There is a consensus that there lacks a standard for primary triage during mass casualty incidents. This is further compounded by a dearth of high quality research on the topic. Some studies suggest the superiority of SALT triage versus other triage systems, however, findings have not widely transitioned to clinical practice. We believe that despite specialized training including that in emergency medicine or emergency medical services (EMS), there will be significant variability amongst triage determination and use of triage methods. This study intends to analyze various provider skill levels and their accuracy of triage determination.Method:In a disaster exercise, a group of providers trained to use START triage were expected to triage, treat and determine transport order of the patients from a scenario of a simulated intentional radiological dispersal device (RDD) detonation with multiple casualties. Another group of providers trained to use SALT triage were expected to triage, treat, and determine transport order of patients from a scenario of a building collapse after a hurricane to assess SALT triage with the participating officers. Additional cohorts of EMS clinicians will be given the same case scenarios and asked to triage, treat when necessary, and determine transport order of the patients.Results:The initial data from the RDD exercise includes 102 patient case scenarios with 27 minimal (green), 40 delayed (yellow), and 35 immediate (red) patients. The providers involved in the exercise are trained at minimum to NREMT EMT level. Results showed an under-triage rate of 7.8%, an over-triage rate of 20.6% and overall accuracy of 71.6% when using START triage.Conclusion:The undertriage rate with START is 7.8% is higher than the generally acceptable rate of less than 5%. Our research is ongoing and we anticipate completion in 2023. We hope that our research provides future direction to improve triage in disaster scenarios.