Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: Observational cohort study

Background: Internationally, hospital survival is lower for patients admitted at weekends and at night. Data from the UK National Cardiac Arrest Audit (NCAA) indicate that crude hospital survival was worse after in-hospital cardiac arrest (IHCA) at night versus day, and at weekends versus weekdays, despite similar frequency of events. Objective: To describe IHCA demographics during three day/time periods - weekday daytime (Monday to Friday, 08:00 to 19:59), weekend daytime (Saturday and Sunday, 08:00 to 19:59) and night-time (Monday to Sunday, 20:00 to 07:59) - and to compare the associated rates of return of spontaneous circulation (ROSC) for >20 min (ROSC>20 min) and survival to hospital discharge, adjusted for risk using previously developed NCAA risk models. To consider whether any observed difference could be attributed to differences in the case mix of patients resident in hospital and/or the administered care. Methods: We performed a prospectively defined analysis of NCAA data from 27 700 patients aged ≥16 years receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a resuscitation (2222) call in 146 UK acute hospitals. Results: Risk-adjusted outcomes (OR (95% CI)) were worse (p20 min 0.88 (0.81 to 0.95); hospital survival 0.72 (0.64 to 0.80)), and nighttime (ROSC>20 min 0.72 (0.68 to 0.76); hospital survival 0.58 (0.54 to 0.63)) compared with weekday daytime. The effects were stronger for non-shockable than shockable rhythms, but there was no significant interaction between day/ time of arrest and age, or day/time of arrest and arrest location. While many daytime IHCAs involved procedures, restricting the analyses to IHCAs in medical admissions with an arrest location of ward produced results that are broadly in line with the primary analyses. Conclusions: IHCAs attended by the hospital-based resuscitation team during nights and weekends have substantially worse outcomes than during weekday daytimes. Organisational or care differences at night and weekends, rather than patient case mix, appear to be responsible

The Fundamental Diagram of Pedestrian Movement Revisited

The empirical relation between density and velocity of pedestrian movement is not completely analyzed, particularly with regard to the `microscopic' causes which determine the relation at medium and high densities. The simplest system for the investigation of this dependency is the normal movement of pedestrians along a line (single-file movement). This article presents experimental results for this system under laboratory conditions and discusses the following observations: The data show a linear relation between the velocity and the inverse of the density, which can be regarded as the required length of one pedestrian to move. Furthermore we compare the results for the single-file movement with literature data for the movement in a plane. This comparison shows an unexpected conformance between the fundamental diagrams, indicating that lateral interference has negligible influence on the velocity-density relation at the density domain $1 m^{-2}<\rho<5 m^{-2}$. In addition we test a procedure for automatic recording of pedestrian flow characteristics. We present preliminary results on measurement range and accuracy of this method.Comment: 13 pages, 9 figure

Emergence of qualia from brain activity or from an interaction of proto-consciousness with the brain: which one is the weirder? Available evidence and a research agenda

This contribution to the science of consciousness aims at comparing how two different theories can explain the emergence of different qualia experiences, meta-awareness, meta-cognition, the placebo effect, out-of-body experiences, cognitive therapy and meditation-induced brain changes, etc. The first theory postulates that qualia experiences derive from specific neural patterns, the second one, that qualia experiences derive from the interaction of a proto-consciousness with the brain\u2019s neural activity. From this comparison it will be possible to judge which one seems to better explain the different qualia experiences and to offer a more promising research agenda

A glossary for research on human crowd dynamics

This article presents a glossary of terms that are frequently used in research on human crowds. This topic is inherently multidisciplinary as it includes work in and across computer science, engineering, mathematics, physics, psychology and social science, for example. We do not view the glossary presented here as a collection of finalised and formal definitions. Instead, we suggest it is a snapshot of current views and the starting point of an ongoing process that we hope will be useful in providing some guidance on the use of terminology to develop a mutual understanding across disciplines. The glossary was developed collaboratively during a multidisciplinary meeting. We deliberately allow several definitions of terms, to reflect the confluence of disciplines in the field. This also reflects the fact not all contributors necessarily agree with all definitions in this glossary

The J-value and its role in evaluating investments in fire safety schemes

Fire safety engineers endeavour to ensure that a design achieves an adequate level of fire safety. For uncommon buildings, adequate safety cannot be based on precedent and an explicit evaluation of the adequacy of proposed safety features may be required. Commonly, this requires demonstration that the residual risk associated with the design is as low as is reasonably practicable. In those situations, a measure for a safety scheme’s benefit relative to its cost is required, as more efficient safety schemes should be preferred over less efficient ones to maximize the number of lives saved under societal resource constraints. To this end, the J-value has been introduced in other engineering fields as a decision support indicator for assessing the efficacy of safety features. The J-value has been derived from societal welfare considerations (the Life Quality Index) and is adopted in the current paper for applications in fire safety engineering. It is demonstrated herein how the J-value can inform decisions on fire safety, and how it can provide a basis for assessing whether or not a proposed fire safety scheme should be implemented. Future work will focus on its implementation as a tool for assessing the benefit of real life fire safety scheme implementations, such as sprinkler installations

Crowd characteristics and egress at stadia

This paper investigates emergency egress considerations of stadia by examining occupant characteristics and discussing how effective crowd management can be used to improve evacuation procedures. The findings are based on recent research on fire protection and evacuation procedures of stadia venues primarily in New Zealand

Simulation of a single compartment flashover fire using hand calculations, zone models and a field model

A fully furnished compartment fire was conducted in a 5.2 m by 4.6 m by 2.4 m high room. Ventilation was provided through a single open doorway 0.9 m wide and 2.0 m high. Ignition of a pillow located on a loveseat was achieved with the halogen bulb of a torchiere lamp. The fire was confined to the pillow for approximately the first 5½ minutes of the test before spreading to the loveseat and thereafter taking about 4 minutes to reach flashover conditions. Temperature profiles at three locations and heat flux at floor level near the center of the room were measured. This paper discusses attempts to model the conditions within the compartment using three methods, including 1) hand calculations; 2) three zone fire models; and 3) a computational fluid dynamics model. Several fire growth scenarios were developed using visual observations and rate of heat release data from published sources. Predictions for flame height, upper layer temperature and layer interface height were developed for each methodology or model. These predictions are compared with experimental data obtained from the fire tes

Assessing the sprinkler activation predictive capability of the BRANZFIRE fire model

This paper describes an investigation into the sprinkler response time predictive capability of the BRANZFIRE fire model. A set of 22 fire/sprinkler experiments are simulated where the sprinkler activation time and the heat release rate (HRR) for each individual experiment had been determined. The experiments provided data for use in validating the sprinkler activation prediction algorithms in the BRANZFIRE zone model. A set of base case values were chosen and input files constructed for the simulations. The experiments were then simulated by the fire model using both the NIST/ JET ceiling jet and Alpert’s ceiling jet options (which are the two ceiling jet correlations available in the BRANZFIRE zone model). The fire model included a heat transfer calculation for the temperature of the heat sensitive sprinkler element. Different sprinkler operational parameters such as the conduction factor, response time index (RTI) and the sprinkler depth below ceiling were also varied to assess the sensitivity of their effect on the activation time. Results showed that using the NIST/JET ceiling jet algorithm gave a closer prediction of the sprinkler response time in a small room than Alpert’s correlation. This was expected, since the former includes the effect of a hot upper layer while the latter applies to unconfined ceilings. The experiments available for comparison had been conducted inside an enclosure with a developing hot upper layer. The findings also signified that changing the sprinkler operational parameters can change the predicted sprinkler activation time significantly