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1. Assessing trauma center accessibility in the Southeastern region of the U.S. to improve healthcare efficacy using an anti-covering approach

   https://doi.org/10.1371/journal.pgph.0002230  

   Chea, Heewon; Kim, Hyun (August 2023, PLOS Global Public Health)

   Jhunjhunwala, Rashi (Ed.)

   Accessibility to trauma centers is vital for the patients of severe motor vehicle crashes. Many vehicle crash fatalities failed to reach the proper emergency medical services since the accident location was far away from trauma centers. The spatial discordance between the service coverage area of trauma centers and actual locations of motor vehicle accidents delays the definitive medical care and results in death or disability. Many fatalities would have been prevented if the patients had a chance to get proper treatment in time at Southeastern region of the U.S. Also, the accessibility to trauma centers from the actual locations of motor vehicle accidents is different in the Southeastern region. This research aimed to facilitate the accessibility to trauma centers for severe motor vehicle crash patients in the Southeastern region. The analyses are conducted to assess current trauma center accessibility and suggest the optimal locations of future trauma centers using the Anti-covering location model for trauma centers (TraCtmodel). This study found that existing trauma centers failed to serve many demands, and the actual coverages of the current locations of trauma centers over potential demands are highly different in each Southeastern state.TraCtmodel is applied to each Southeastern state, and its solutions provide better coverage for demand locations. However, theTraCtmodel for each state tends to choose too many facilities, with excessively supplied facilities across the Southeastern region. The excessive service supply issue is addressed by applying theTraCtModel to a broader spatial extent.TraCtmodel applied to the entire Southeastern region and most of the demand, over 98% covered by the service coverage of optimal facility locations with 15 additional facilities. This research proves that the GIS andTraCtmodel applied to the broader spatial extent works well with increasing trauma medical service beneficiaries while providing a minimum number of additional facilities. 

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2. Engineering Low Volume Resuscitants for the Prehospital Care of Severe Hemorrhagic Shock

   https://doi.org/10.1002/anie.202402078  

   Pichon, Trey J; Wang, Xu; Mickelson, Ethan E; Huang, Wen-Chia; Hilburg, Shayna L; Stucky, Sarah; Ling, Melissa; St_John, Alexander E; Ringgold, Kristyn M; Snyder, Jessica M; et al (May 2024, Angewandte Chemie International Edition)

   Globally, traumatic injury is a leading cause of suffering and death. The ability to curtail damage and ensure survival after major injury requires a time‐sensitive response balancing organ perfusion, blood loss, and portability, underscoring the need for novel therapies for the prehospital environment. Currently, there are few options available for damage control resuscitation (DCR) of trauma victims. We hypothesize that synthetic polymers, which are tunable, portable, and stable under austere conditions, can be developed as effective injectable therapies for trauma medicine. In this work, we design injectable polymers for use as low volume resuscitants (LVRs). Using RAFT polymerization, we evaluate the effect of polymer size, architecture, and chemical composition upon both blood coagulation and resuscitation in a rat hemorrhagic shock model. Our therapy is evaluated against a clinically used colloid resuscitant, Hextend. We demonstrate that a radiant star poly(glycerol monomethacrylate) polymer did not interfere with coagulation while successfully correcting metabolic deficit and resuscitating animals from hemorrhagic shock to the desired mean arterial pressure range for DCR – correcting a 60% total blood volume (TBV) loss when given at only 10% TBV. This highly portable and non‐coagulopathic resuscitant has profound potential for application in trauma medicine. 

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3. Comprehensive survey of body weight estimation: techniques, datasets, and applications

   https://doi.org/10.1007/s11042-024-20318-4  

   Jan, Muhammad Tanveer; Kumar, Aditya; Sonar, Vivek Ganesh; Wells, Mike; Pandya, Abhijit; Engstrom, Gabriella; Shih, Richard; Furht, Borko (October 2024, Multimedia Tools and Applications)

   Furht, Borko (Ed.)

   Accurate weight measurement is critical in emergency medicine, particularly for the precise administration of medications and treatments. However, traditional methods of weight estimation can be unreliable, especially in time-sensitive or resource-limited environments. This study provides a comprehensive review of the advancements and techniques in body weight estimation, with a focus on modern approaches leveraging contactless sensors, such as 3D cameras, and AI-powered computational models. The research evaluates the accuracy, reliability, and practical applicability of these methods across different contexts, including healthcare, forensic sciences, and emergency response. Additionally, this study identifies the limitations of current methodologies and uncovers gaps in the literature that warrant further investigation. Our findings aim to guide future research efforts and the development of more precise and scalable weight estimation solutions, ultimately enhancing their applicability in a variety of sectors. 

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4. Statewide Assessment of Emergency Response Officials:Best Practices and Recommendations for Inclusive Emergency Alerts in Colorado

   https://doi.org/10.17603/ds2-j51w-sb88  

   MacPherson-Krutsky, Carson; Painter, Mary Angelica; Villarreal, Melissa; Peek, Lori (January 2024, Designsafe-CI)

   This mission includes research materials developed by the Natural Hazards Center at the University of Colorado Boulder in accordance with Colorado House Bill 23-1237 (see related work). For this mission, we collected information using a statewide survey of emergency response personnel (222 responses) and meetings with key partners (37 people). Included here are the survey recruitment materials, survey instrument, raw survey data. We also include a partner meeting question bank that we used to conduct partner meetings. Lastly, we include two annotated bibliographies as documents. We anticipate these materials may be useful in developing future surveys on alerts and warnings and developing interview questions for emergency alert officials. This data could also be reproduced to compare alert and warning services across other states.Included here are data and research materials that supported the investigation of emergency alert and warning systems in Colorado developed in accordance with Colorado House Bill 23-1237 (https://leg.colorado.gov/bills/hb23-1237). The aim of the project was to identify how to improve emergency alerting for people who speak non-English languages and have auditory or visual disabilities. First, we include two annotated bibliographies with over 60 publications on topics related to alert and warning systems, disability access, and language access published in the last 20 years. Second, we include a dataset of survey questions, along with the 222 responses from emergency response personnel in Colorado involved in alert and warning activities. Lastly, we also include a data dictionary, partner meeting questionnaire, recruitment materials, and a sample letter of support from a key partner. These data and materials could be used to review relevant publications on this topic and to aid in developing future surveys focused on alert and warning systems. For final report and additional project context, see project webpage: https://hazards.colorado.edu/research-projects/colorado-inclusive-language-and-access-in-emergency-alerts. 

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5. Predictability and stability testing to assess clinical decision instrument performance for children after blunt torso trauma

   https://doi.org/10.1371/journal.pdig.0000076  

   Kornblith, Aaron E.; Singh, Chandan; Devlin, Gabriel; Addo, Newton; Streck, Christian J.; Holmes, James F.; Kuppermann, Nathan; Grupp-Phelan, Jacqueline; Fineman, Jeffrey; Butte, Atul J.; et al (August 2022, PLOS Digital Health)

   Li-Jessen, Nicole Yee-Key (Ed.)

   Objective The Pediatric Emergency Care Applied Research Network (PECARN) has developed a clinical-decision instrument (CDI) to identify children at very low risk of intra-abdominal injury. However, the CDI has not been externally validated. We sought to vet the PECARN CDI with the Predictability Computability Stability (PCS) data science framework, potentially increasing its chance of a successful external validation. Materials & methods We performed a secondary analysis of two prospectively collected datasets: PECARN (12,044 children from 20 emergency departments) and an independent external validation dataset from the Pediatric Surgical Research Collaborative (PedSRC; 2,188 children from 14 emergency departments). We used PCS to reanalyze the original PECARN CDI along with new interpretable PCS CDIs developed using the PECARN dataset. External validation was then measured on the PedSRC dataset. Results Three predictor variables (abdominal wall trauma, Glasgow Coma Scale Score <14, and abdominal tenderness) were found to be stable. A CDI using only these three variables would achieve lower sensitivity than the original PECARN CDI with seven variables on internal PECARN validation but achieve the same performance on external PedSRC validation (sensitivity 96.8% and specificity 44%). Using only these variables, we developed a PCS CDI which had a lower sensitivity than the original PECARN CDI on internal PECARN validation but performed the same on external PedSRC validation (sensitivity 96.8% and specificity 44%). Conclusion The PCS data science framework vetted the PECARN CDI and its constituent predictor variables prior to external validation. We found that the 3 stable predictor variables represented all of the PECARN CDI’s predictive performance on independent external validation. The PCS framework offers a less resource-intensive method than prospective validation to vet CDIs before external validation. We also found that the PECARN CDI will generalize well to new populations and should be prospectively externally validated. The PCS framework offers a potential strategy to increase the chance of a successful (costly) prospective validation. 

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