Physiology-Aware Rural Ambulance Routing

In emergency patient transport from rural medical facility to center tertiary hospital, real-time monitoring of the patient in the ambulance by a physician expert at the tertiary center is crucial. While telemetry healthcare services using mobile networks may enable remote real-time monitoring of transported patients, physiologic measures and tracking are at least as important and requires the existence of high-fidelity communication coverage. However, the wireless networks along the roads especially in rural areas can range from 4G to low-speed 2G, some parts with communication breakage. From a patient care perspective, transport during critical illness can make route selection patient state dependent. Prompt decisions with the relative advantage of a longer more secure bandwidth route versus a shorter, more rapid transport route but with less secure bandwidth must be made. The trade-off between route selection and the quality of wireless communication is an important optimization problem which unfortunately has remained unaddressed by prior work. In this paper, we propose a novel physiology-aware route scheduling approach for emergency ambulance transport of rural patients with acute, high risk diseases in need of continuous remote monitoring. We mathematically model the problem into an NP-hard graph theory problem, and approximate a solution based on a trade-off between communication coverage and shortest path. We profile communication along two major routes in a large rural hospital settings in Illinois, and use the traces to manifest the concept. Further, we design our algorithms and run preliminary experiments for scalability analysis. We believe that our scheduling techniques can become a compelling aid that enables an always-connected remote monitoring system in emergency patient transfer scenarios aimed to prevent morbidity and mortality with early diagnosis treatment.Comment: 6 pages, The Fifth IEEE International Conference on Healthcare Informatics (ICHI 2017), Park City, Utah, 201

The Trump Self-Coup Attempt: Comparisons and Civil–Military Relations

17 USC 105 interim-entered record; under temporary embargo.The storming of the US Capitol building in January 2021 was a presidential attempt at a self-coup. To make the case, this article reviews elements of the Capitol assault and the events leading up to it, in light of the key conceptual components of a self-coup, and how those compare to attributes of other kinds of attacks on governments. The Trump self-coup will then be compared and contrasted empirically to other self-coups perpetrated by leaders. It is found that what separates successful self-coups from those that fail is whether the military backs the undertaking. Thus, a section is included on US military behaviour in response to Trump’s attempts to gain military adherence for his political actions.U.S. Government affiliation is unstated in article text

Towards Safe and Effective Integration of Networked Medical Devices using Organ-based Semi-Autonomous Hierarchical Control

Leveraging connectivity and interoperability of medical devices promises a great benefit for patient safety and effectiveness of medical services. However, safety issues arising from coordination failures between networked medical devices pose a significant challenge to achieve such vision. In this paper, we propose an organ-based semi-autonomous hierarchical control structure as an architectural design principle to make integrated medical systems more resilient and effective against communication failures. The proposed design principle also enables the development of tools supporting rapid hierarchical composition of organ-based clusters and the verification of safety assertions. Our simulation study shows that our approach can provide the safety while minimally interrupting ongoing medical services in the face of network failures.NIH U01EB012470NSF CNS 08-34709ONR N00014-12-1-0046published or submitted for publicationnot peer reviewe