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The aim of this study was to summarize the literature on the applications of machine learning (ML) and their performance in Emergency Medical Services (EMS).
Methods:
Four relevant electronic databases were searched (from inception through January 2024) for all original studies that employed EMS-guided ML algorithms to enhance the clinical and operational performance of EMS. Two reviewers screened the retrieved studies and extracted relevant data from the included studies. The characteristics of included studies, employed ML algorithms, and their performance were quantitively described across primary domains and subdomains.
Results:
This review included a total of 164 studies published from 2005 through 2024. Of those, 125 were clinical domain focused and 39 were operational. The characteristics of ML algorithms such as sample size, number and type of input features, and performance varied between and within domains and subdomains of applications. Clinical applications of ML algorithms involved triage or diagnosis classification (n = 62), treatment prediction (n = 12), or clinical outcome prediction (n = 50), mainly for out-of-hospital cardiac arrest/OHCA (n = 62), cardiovascular diseases/CVDs (n = 19), and trauma (n = 24). The performance of these ML algorithms varied, with a median area under the receiver operating characteristic curve (AUC) of 85.6%, accuracy of 88.1%, sensitivity of 86.05%, and specificity of 86.5%. Within the operational studies, the operational task of most ML algorithms was ambulance allocation (n = 21), followed by ambulance detection (n = 5), ambulance deployment (n = 5), route optimization (n = 5), and quality assurance (n = 3). The performance of all operational ML algorithms varied and had a median AUC of 96.1%, accuracy of 90.0%, sensitivity of 94.4%, and specificity of 87.7%. Generally, neural network and ensemble algorithms, to some degree, out-performed other ML algorithms.
Conclusion:
Triaging and managing different prehospital medical conditions and augmenting ambulance performance can be improved by ML algorithms. Future reports should focus on a specific clinical condition or operational task to improve the precision of the performance metrics of ML models.
This Editorial explores organizational travel risk management and advocates for a comprehensive approach to fortify health security for travelers, emphasizing proactive risk management, robust assessments, and strategic planning. Leveraging insights from very important persons (VIP) protocols, organizations can enhance duty of care and ensure personnel safety amidst global travel complexities.
Large language models (LLMs) offer new research possibilities for social scientists, but their potential as “synthetic data” is still largely unknown. In this paper, we investigate how accurately the popular LLM ChatGPT can recover public opinion, prompting the LLM to adopt different “personas” and then provide feeling thermometer scores for 11 sociopolitical groups. The average scores generated by ChatGPT correspond closely to the averages in our baseline survey, the 2016–2020 American National Election Study (ANES). Nevertheless, sampling by ChatGPT is not reliable for statistical inference: there is less variation in responses than in the real surveys, and regression coefficients often differ significantly from equivalent estimates obtained using ANES data. We also document how the distribution of synthetic responses varies with minor changes in prompt wording, and we show how the same prompt yields significantly different results over a 3-month period. Altogether, our findings raise serious concerns about the quality, reliability, and reproducibility of synthetic survey data generated by LLMs.
Contrast, adversative and corrective can all be represented by er in Classical Chinese, but they are lexicalized respectively by er, danshi and ershi in Modern Chinese. The two lexicalization systems suggest that the opposition relations have commonalities as well as differences. In the framework of relevance theory and ‘three domains’, this study argues that the three opposition relations are in different cognitive domains, at different representational levels, and trigger different inferences, which accounts for their diverse lexicalizations in Modern Chinese. The opposition relations also have cognitive or metaphorical connections with each other, which justifies their unified actualization in Classical Chinese. The pragmatics-cognitive framework could also account for interlinguistic data.
Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials.
Objective
This study employed a design thinking framework to examine Chinese immigrant caregivers’ (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs.
Methods
Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases.
Findings
Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs’ interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens.
Discussion
The co-design process appears to be beneficial in having participants voice both barriers and preferences.
In the interaction of water waves with marine structures, the interplay between wave diffraction and drag-induced dissipation is seldom, if ever, considered. In particular, linear hydrodynamic models, and extensions thereof through the addition of a quadratic force term, do not represent the change in amplitude of the waves diffracted and radiated to the far field, which should result from local energy dissipation in the vicinity of the structure. In this work, a series of wave flume experiments is carried out, whereby waves of increasing amplitude impinge upon a vertical barrier, extending partway through the flume width. As the wave amplitude increases, the effect of drag – which is known to increase quadratically with the flow velocity – is enhanced, thus allowing the examination of the far-field effect of drag-induced dissipation, in terms of wave reflection and transmission. A potential flow model is proposed, with a simple quadratic pressure drop condition through a virtual porous surface, located on the sides of the barrier (where dissipation occurs). Experimental results confirm that drag-induced dissipation has a marked effect on the diffracted flow, i.e. on wave reflection and transmission, which is appropriately captured in the proposed model. Conversely, when diffraction becomes dominant as the barrier width becomes comparable to the incoming wavelength, the diffracted flow must be accounted for in predicting drag-induced forces and dissipation.
Surface tension and wetting are dominating physical effects in microscale and nanoscale flows. We present an efficient and reliable model of surface tension and equilibrium contact angles in smoothed particle hydrodynamics for free-surface problems. We demonstrate its robustness and accuracy by simulating several three-dimensional free-surface flow problems driven by interfacial tension.
Survey experiments on probability samples are a popular method for investigating population-level causal questions due to their strong internal validity. However, lower survey response rates and an increased reliance on online convenience samples raise questions about the generalizability of survey experiments. We examine this concern using data from a collection of 50 survey experiments which represent a wide range of social science studies. Recruitment for these studies employed a unique double sampling strategy that first obtains a sample of “eager” respondents and then employs much more aggressive recruitment methods with the goal of adding “reluctant” respondents to the sample in a second sampling wave. This approach substantially increases the number of reluctant respondents who participate and also allows for straightforward categorization of eager and reluctant survey respondents within each sample. We find no evidence that treatment effects for eager and reluctant respondents differ substantially. Within demographic categories often used for weighting surveys, there is also little evidence of response heterogeneity between eager and reluctant respondents. Our results suggest that social science findings based on survey experiments, even in the modern era of very low response rates, provide reasonable estimates of population average treatment effects among a deeper pool of survey respondents in a wide range of settings.
Statolith growth increments were analysed in the bigfin reef squid, Sepioteuthis lessoniana lineage B, for estimating the age and growth in the Gulf of Mannar Biosphere Reserve (GOM), southeast coast of India. The identification of S. lessoniana lineage B was determined by mitochondrial cytochrome c oxidase I gene sequence. The statolith increment age analysis indicated that the wild-captured squid population of S. lessoniana in the study area undergoes rapid growth. The age of S. lessoniana in males ranged from 61 (95 mm dorsal mantle length (DML)) to 220 d (390 mm DML), while it was 64 (98 mm DML) to 199 d (340 mm DML) in females. The average daily growth rate in males and females was 1.63 and 1.55 mm DML d−1, respectively. The instantaneous growth rate varied from 0.85 (210 d) to 4.1% (110 d) for males and 0.65 (190 d) to 3.7% (110 d) for females. The age at first maturity was 114 and 120 d for males and females, respectively. Back-calculated hatching dates and the attainment of maturity in females suggested that the reproduction of S. lessoniana is year-round, with two distinct spawning peaks during July–August and February months; accordingly, the hatching dates were spread throughout the year, with the presence of two cohorts. Based on the statolith data, it can be concluded that S. lessoniana lineage B in the GOM has a potential lifespan of up to 7 months. This finding contradicts the previous growth estimates based on length-frequency data, which underestimated the true growth potential of this species.
Drawing on their own field studies, the authors examine how state and local actors involved in resource management and peacebuilding activities are implicated in the conflict between farmers and herders in Plateau State, Nigeria, and Central Darfur State, Sudan. The authors show that state officials, traditional chiefs, and security agents intensified the conflict by perpetuating the inequitable distribution of resources needed for the survival of farmers and herders, while promoting a peacebuilding process that empowered some groups and disempowered others. The divisive role state and local actors played accentuated the socio-political grievances underlying the conflict and enervated the peacebuilding process.
In response to the invasion of Ukraine, the EU and most other advanced economies imposed extensive sanctions on Russia, intending to harm its production capabilities and hinder its economic activities by restricting its access to international trade and financial markets. This paper develops an empirical framework based on the synthetic control method to assess the impact of the war and the following sanctions on bilateral and sectoral exports to Russia almost in real time. The war and the following sanctions reduced aggregate exports to Russia by a third between March and December 2022, with the effects being stronger for sanctioning countries than for non-sanctioning ones, albeit with substantial country-level heterogeneity within each group. Exports to Russia in high-tech sectors – relatively more targeted by trade sanctions – have been disproportionately affected.