Abstract Taiwan is a small island country located in East Asia. From around 1995 modern concepts of the EMS were imported and supported by legislation. Considerable progress has since been made ...towards the construction of an effective pre-hospital care system. This article introduces the current status of the EMS in Taiwan, including the systems, response configurations, funding, personnel, medical directorship, and outcome research. The features and problems of in-hospital emergency care are also discussed. Key areas for further development in the country vary depending on regional differences in available resource and population density. An analysis of the strength, weakness, opportunity, and threats of the evolving EMS in Taiwan could be an example for other countries where the EMS is undergoing a similar process of development and optimisation.
Abstract Aims High quality cardiopulmonary resuscitation (CPR) plays an important role in survival of out-of-hospital cardiac arrests (OHCAs). We have developed an algorithm to automatically identify ...the quality of chest compressions from data retrieved from automatic external defibrillators (AEDs). Methods Electrocardiographic (ECG) signals retrieved from AEDs were analyzed by a newly developed algorithm to identify fluctuations in CPR. The algorithm contained three steps. First, it decomposed the AED signals into several intrinsic mode fluctuations (IMFs) by empirical mode decomposition (EMD). Second, it identified the dominant IMFs that carried the chest compression signals and weighted the IMFs to both enhance the chest compression oscillations and filter the noise. Third, it calculated the autocorrelation function (ACF) of the reconstructed signals and tested their periodicity. Using this algorithm, several CPR quality indicators were automatically calculated minute-by-minute and compared with those derived by audio and visual review of AED data by experienced physicians. Results A total of 77 (29 women, 48 men) OHCA patients were enrolled, and 351 one-min segments were analyzed. The results showed that the CPR quality parameters calculated from the algorithm were highly correlated with those from the manual review (all P < 0.001). The limits of agreement by Bland–Altman analysis were acceptable for chest compression number, total flow time, and no flow time, but not for CPR rate. We also demonstrated that only 41.8 ± 29.8% of time was spent in chest compressions and only 7.5 ± 16.8% was spent in adequate chest compressions. Conclusion Our results demonstrated that several indicators of CPR quality can be precisely and automatically determined by analyzing the ECG signals from AEDs using EMD and autocorrelograms.
Due to the high capacity of large buildings, any defective designs in their evacuation facilities may result in massive casualties. In the past, many disasters were caused by ineffective emergency ...evacuation of large crowds. However, presently, related evacuation studies all have their limitations and problems, such as difficulties and financial constraints for executing full-scale evacuation exercise, moral issues arose from real-life simulation exercises, and neglecting software analysis processes. This research focused on emergency evacuation for large-space gymnasiums and addressed to three major issues: unreliability of computer software simulations, moral risk of real-life exercises and whether or not the scale of large crowd evacuation equivalent to that of the same size crowd exiting. Then, computerized simulation analyses are conducted with two commonly used softwares, such as Simulex and Exodus. Results showed a great variance of risk-bearing value is yielded from different software analysis processes. Also, the authors propose the concept of 'Hot Area' replacement exercise to decrease the impact of moral and economic issues. Ultimately, it is found that the exiting time of 2089 people differed 45% from software simulation results. Hence, it is concluded that large-scale crowd exiting does not equal to evacuation of the same number of people.
Execution difficulties and financial constraints are encountered when conducting experiments of full scale evacuation exercises in large scale building. This study focuses on large gymnasiums. The ...concept of ‘Hot Area’ is proposed by focus groups of fire experts. The most dangerous spot in a building, Hot Area, is selected and analyzed based on the ranking method. Then, a Hot Area evacuation exercise is carried out to replace a full-scale evacuation exercise. In addition to simulating the Hot Area evacuation in Taipei Arena with Exodus software, an observation of a real life exiting of 2089 people is also conducted. Next, the observation result is compared with the software-simulated result. Finally, suggestions are made to provide a set of reference criteria for inspecting the same type of buildings when their construction works are completed.
Santrauka
Evakuacijos iš didelių pastatų eksperimentai yra sunkiai atliekami ir brangūs. Straipsnyje nagrinėjama evakuacija iš didelių gimnazijos pastatų. Tyrimas grindžiamas karštosios zonos sąvoka, pasiūlyta gaisrinės saugos ekspertų grupės. Karštoji zona yra pavojingiausia vieta pastate. Straipsnyje ši zona parenkama ir analizuojama taikant rikiavimo metodą. Parinkus pavojingają zoną, evakuacijos eksperimentas atliekamas iš jos, o ne iš viso pastato. Evakuacija modeliuota Taipėjaus arenos pastate taikant Exodus programą, modeliavimo rezultatai lyginti su tikraja 2089 žmonių evakuacija. Remiantis tyrimo rezultatais pasiūlyta keletas kriterijų, panašių pastatų inspekcijai atlikti baigus jų statybą.
On 21 September 1999, the Ji Ji earthquake killed 2,347 people. In the immediate aftermath the international community mobilised rapidly and sent urban search‐and‐rescue (US&R) teams to the scene. ...This paper will present an annotated survey of the expertise and standard of equipment of international US&R teams following that earthquake which could serve as a blueprint for the establishment of US&R teams elsewhere at risk from earthquakes.
Execution difficulties and financial constraints are encountered when conducting experiments of full scale evacuation exercises in large scale building. This study focuses on large gymnasiums. The ...concept of 'Hot Area' is proposed by focus groups of fire experts. The most dangerous spot in a building, Hot Area, is selected and analyzed based on the ranking method. Then, a Hot Area evacuation exercise is carried out to replace a full-scale evacuation exercise. In addition to simulating the Hot Area evacuation in Taipei Arena with Exodus software, an observation of a real life exiting of 2089 people is also conducted. Next, the observation result is compared with the software-simulated result. Finally, suggestions are made to provide a set of reference criteria for inspecting the same type of buildings when their construction works are completed.
There are two major building structure damages caused by fire: the reduction of fire resistance and the reduction of strength. Both are important factors in determining the reusability of a structure ...after it has been exposed to fire. An experimentally validated analytical technique for evaluating the residual fire endurance of structural elements after fire is currently unavailable. Although nondestructive test methods have been used for evaluating the residual strength of concrete structural members, no systematic analysis has ever been done. The purpose of this dissertation is to conduct a comprehensive pilot study of residual fire endurance and strength of concrete slabs after exposure to fire. A small-scale fire test, two nondestructive tests, and a destructive test were conducted to evaluate the effects of three factors, i.e., exposure severity, re-curing condition, and re-curing time lapse, on the residual fire endurance, Schmidt hammer rebound number, pulse velocity, and compressive strength of concrete slabs made of typical Florida porous limestone and Type I Portland cement. A statistical model was established to investigate the effects of test factors on the results and the correlation between nondestructive and destructive test results. It was found that when concrete slabs are exposed to fire more than thirty minutes, the environmental factors do not affect the test results significantly, but the reduction of fire endurance is obvious. Therefore, the consideration of fire endurance is critical for fire damage evaluation and should not be overlooked. A preliminary investigation on using nondestructive test methods to evaluate both the residual fire endurance and strength of concrete slabs after exposure to fire is presented, and further studies to validate these methods are evidently needed. A reference is established for applications and further research.
Aims
To examine changes in health‐related quality of life throughout the course of pregnancy and among three pairs of consecutive periods (pre‐pregnancy to early pregnancy, early to middle pregnancy ...and middle to late pregnancy), as well as to identify associated obstetric factors during the entire period of pregnancy.
Background
Only sparse data are available concerning the profiles of health‐related quality of life throughout pregnancy.
Design
A within‐subject comparison was undertaken.
Methods
In total, 358 women completed the Taiwanese version of the Medical Outcomes Study Short Form‐36 Health Questionnaire and a demographic‐obstetric questionnaire at three stages of pregnancy at a medical centre. The participants were recruited between 2009–2010. A generalized estimating equation regression model was employed for the repeated measures.
Results
The scores for physical component summary decreased significantly throughout early, middle and late pregnancy. The scores for mental component summary increased. The scores for physical, mental component summary and the eight domains of health‐related quality of life decreased significantly from pre‐pregnancy to early pregnancy. After adjusting for demographic and clinical factors, significant factors predicting physical component summary during pregnancy included stage of pregnancy and previous infertility. The factors predicting mental component summary included stage of pregnancy, parity and medical condition.
Conclusions
The results revealed the dynamic pattern of perceived health status by the Taiwanese pregnant women in their surrounding socio‐cultural context and identified the stage of pregnancy and obstetric factors predicting health‐related quality of life.
Gold nanoparticles have been attracting attention due to their extensive application in chemistry, physics, material science, electronics, catalysis and bionanotechnology. Synthesis of gold ...nanoparticles often involves toxic and expensive physical-chemistry methods. Preparation of gold nanoparticles by arc discharge in water is proposed for the first time. Fabrication of gold nanostructures in deionized water has been successfully established. The evidence of gold particles’ light absorbance reveals a unique surface plasmon resonance for Au nanoparticles suspended in deionized water. Gold nanostructures uniformly dispersed in water, their UV–Vis absorption and crystalline size are shown. Our experimental results demonstrate that fabrication of gold nanoparticles by arc discharge in water is an alternative, cheap, effective and environmentally friendly method.
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