Pedestrian Injuries: Emergency Care Considerations

Traffic-related pedestrian injuries are a growing public health threat worldwide. The global economic burden of motor vehicle collisions and pedestrian injuries totals $500 billion.1 In 2004, there were 4,641 pedestrian deaths and over 70,000 injuries in the United States.2 Injury patterns vary depending on the age, gender and socioeconomic status of the individual. Children, older adults, and those of lower socioeconomic status are most affected. The burden of injury upon the individual, families and society is frequently overwhelming. Although pedestrian injuries and deaths are relatively on the decline in the United States, this is not universally true throughout the world. It requires particular attention by emergency medicine physicians, public health experts and policy makers

Need for Injury-Prevention Education in Medical School Curriculum

Injury is the leading cause of death and disability among the U.S. population aged 1 to 44 years. In 2006 more than 179,000 fatalities were attributed to injury. Despite increasing awareness of the global epidemic of injury and violence, a considerable gap remains between advances in injury-prevention research and prevention knowledge that is taught to medical students. This article discusses the growing need for U.S medical schools to train future physicians in the fundamentals of injury prevention and control. Teaching medical students to implement injury prevention in their future practice should help reduce injury morbidity and mortality. Deliberate efforts should be made to integrate injury-prevention education into existing curriculum. Key resources are available to do this. Emergency physicians can be essential advocates in establishing injury prevention training because of their clinical expertise in treating injury. Increasing the number of physicians with injury- and violence- prevention knowledge and skills is ultimately an important strategy to reduce the national and global burden of injury

An Intelligence Representation in Agent Systems: An Extended π-Calculus

Intelligent mobile agent technology is one of the most promising of the newer software paradigms for providing solutions to complex, distributed computing problems. Agent properties of autonomy, intelligence and mobility provide a powerful platform for implementations that can utilize techniques involving collaborative problem solving and adaptive behavior. Although the technological tools and capabilities have advanced to this point, research into formal models and extensions to support representations of this new computing paradigm has not been kept pace. Specifically, we find that current formal processing models are lacking in representation abilities for: (1) intelligence capabilities, (2) team-based problem-solving approaches, and (3) mobility. In this paper, we present an extension of π-calculus that addresses the first of these deficiencies, the representation of intelligence

An Inexact Inferencing Strategy for Spatial Objects with Determined and Indeterminate Boundaries

For many years, spatial querying has been of interest for the researchers in the GIS community. Any successful implementation and long-term viability of the GIS technology depends on the issue of accuracy of spatial queries. In order to improve the accuracy and quality of spatial querying, the problems associated with the areas of fuzziness and uncertainty need to be addressed. There has been a strong demand to provide approaches that deal with inaccuracy and uncertainty in GIS. In this paper, we develop an approach that can perform fuzzy spatial querying under uncertainty. An inexact inferencing strategy for objects with determined and indeterminate boundaries is investigated, using type-2 fuzzy set theory

Echocardiography to Supplement Stress Electrocardiography in Emergency Department Chest Pain Patients

Introduction: Chest pain (CP) patients in the Emergency Department (ED) present a diagnostic dilemma, with a low prevalence of coronary disease but grave consequences with misdiagnosis. A common diagnostic strategy involves ED cardiac monitoring while excluding myocardial necrosis, followed by stress testing. We sought to describe the use of stress echocardiography (echo) at our institution, to identify cardiac pathology compared with stress electrocardiography (ECG) alone.Methods: Retrospective cohort study of 57 urban ED Chest Pain Unit (CPU) patients from 2002-2005 with stress testing suggesting ischemia. Our main descriptive outcome was proportion and type of discordant findings between stress ECG testing and stress echo. The secondary outcome was whether stress echo results appeared to change management.Results: Thirty-four of 57 patients [59.7%, 95% confidence interval (CI) 46.9-72.4%] had stress echo results discordant with stress ECG results. The most common discordance was an abnormal stress ECG with a normal stress echo (n=17/57, 29.8%, CI 17.9-41.7%), followed by normal stress ECG but with reversible regional wall-motion abnormality on stress echo (n = 10/57, 17.5%, CI 7.7-27.4%). The remaining seven patients (12.3%, CI 3.8-20.8%) had non-diagnostic stress ECG due to sub-maximal effort. Stress echo showed reversible wall-motion abnormality in two, and five were normal. Twenty-five of the 34 patients (73.5%, CI 56.8-85.4%) with discordant results had a different diagnostic strategy than predicted from their stress ECG alone.Conclusion: The addition of echo to stress ECG testing in ED CPU patients altered diagnosis in 34/57 (59.7%, CI 46.9-72.4%) patients, and appeared to change management in 25/57 (43.9%, CI 31.8-57.6%) patients. [West J Emerg Med. 2010; 11(4):379-383.

Fuzzy Spatial Querying with Inexact Inference

The issue of spatial querying accuracy has been viewed as critical to the successful implementation and long-term viability of the GIS technology. In order to improve the spatial querying accuracy and quality, the problems associated with the areas of fuzziness and uncertainty are of great concern in the spatial database community. There has been a strong demand to provide approaches that deal with inaccuracy and uncertainty in GIS. In this paper, we are dedicated to develop an approach that can perform fuzzy spatial querying under uncertainty. An inexact inferring strategy is investigated. The study shows that the fuzzy set and the certainty factor can work together to deal with spatial querying. Querying examples implemented by FuzzyClips are also provided

III-V-on-silicon anti-colliding pulse-type mode-locked laser

An anti-colliding pulse-type III–V-on-silicon passively mode-locked laser is presented for the first time based on a III–V-on-silicon distributed Bragg reflector as outcoupling mirror implemented partially underneath the III–V saturable absorber. Passive mode-locking at 4.83 GHz repetition rate generating 3 ps pulses is demonstrated. The generated fundamental RF tone shows a 1.7 kHz 3 dB linewidth. Over 9 mW waveguide coupled output power is demonstrated

Mitigating Cognitive Biases in Risk Identification: Practitioner Checklist for the Aerospace Sector

This research contributes an operational checklist for mitigating cognitive biases in the aerospace sector risk management process. The Risk Identification and Evaluation Bias Reduction Checklist includes steps for grounding the risk identification and evaluation activities in past project experiences, through historical data, and the importance of incorporating multiple methods and perspectives to guard against optimism and a singular project instantiation focused view. The authors developed a survey to elicit subject matter expert (SME) judgment on the value of the checklist to support its use in government and industry as a risk management tool. The survey also provided insights on bias mitigation strategies and lessons learned. This checklist addresses the deficiency in the literature in providing operational steps for the practitioner for bias reduction in risk management in the aerospace sector

Non-commutative multi-dimensional cosmology

A non-commutative multi-dimensional cosmological model is introduced and used to address the issues of compactification and stabilization of extra dimensions and the cosmological constant problem. We show that in such a scenario these problems find natural solutions in a universe described by an increasing time parameter.Comment: 9 pages, 1 figure, to appear in JHE