Measuring the impact of data center failures on a cloud-based emergency medical call system

2019 ◽  
Vol 31 (15) ◽  
pp. e5156 ◽  
Author(s):  
Demis Gomes ◽  
Guto Leoni Santos ◽  
Daniel Rosendo ◽  
Glauco Gonçalves ◽  
Andre Moreira ◽  
...  
Keyword(s):  
Data Center ◽  
Emergency Medical ◽  
Call System ◽  
The Impact

scholarly journals HTPC: heterogeneous traffic-aware partition coding for random packet spraying in data center networks

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jiawei Huang ◽  
Shiqi Wang ◽  
Shuping Li ◽  
Shaojun Zou ◽  
Jinbin Hu ◽  
...  
Keyword(s):  
Data Center ◽  
Large Scale ◽  
Network Performance ◽  
Rooted Tree ◽  
Heterogeneous Traffic ◽  
Data Center Networks ◽  
Packet Reordering ◽  
Traffic Characteristics ◽  
Network Utilization ◽  
The Impact

AbstractModern data center networks typically adopt multi-rooted tree topologies such leaf-spine and fat-tree to provide high bisection bandwidth. Load balancing is critical to achieve low latency and high throughput. Although the per-packet schemes such as Random Packet Spraying (RPS) can achieve high network utilization and near-optimal tail latency in symmetric topologies, they are prone to cause significant packet reordering and degrade the network performance. Moreover, some coding-based schemes are proposed to alleviate the problem of packet reordering and loss. Unfortunately, these schemes ignore the traffic characteristics of data center network and cannot achieve good network performance. In this paper, we propose a Heterogeneous Traffic-aware Partition Coding named HTPC to eliminate the impact of packet reordering and improve the performance of short and long flows. HTPC smoothly adjusts the number of redundant packets based on the multi-path congestion information and the traffic characteristics so that the tailing probability of short flows and the timeout probability of long flows can be reduced. Through a series of large-scale NS2 simulations, we demonstrate that HTPC reduces average flow completion time by up to 60% compared with the state-of-the-art mechanisms.

scholarly journals The Regional Snowfall Index

2014 ◽  
Vol 95 (12) ◽  
pp. 1835-1848 ◽  
Author(s):  
Michael F. Squires ◽  
Jay H. Lawrimore ◽  
Richard R. Heim ◽  
David A. Robinson ◽  
Mathieu R. Gerbush ◽  
...  
Keyword(s):  
United States ◽  
Data Center ◽  
Historical Perspective ◽  
The United States ◽  
Climatic Data ◽  
National Climatic Data Center ◽  
Impact Scale ◽  
Population Information ◽  
Regional Index ◽  
The Impact

This paper describes a new snowfall index that quantifies the impact of snowstorms within six climate regions in the United States. The regional snowfall index (RSI) is based on the spatial extent of snowfall accumulation, the amount of snowfall, and the juxtaposition of these elements with population. Including population information provides a measure of the societal susceptibility for each region. The RSI is an evolution of the Northeast snowfall impact scale (NESIS), which NOAA's National Climatic Data Center began producing operationally in 2006. While NESIS was developed for storms that had a major impact in the Northeast, it includes all snowfall during the lifetime of a storm across the United States and as such can be thought of as a quasi-national index that is calibrated to Northeast snowstorms. By contrast, the RSI is a regional index calibrated to specific regions using only the snow that falls within that region. This paper describes the methodology used to compute the RSI, which requires region-specific parameters and thresholds, and its application within six climate regions in the eastern two-thirds of the nation. The process used to select the region-specific parameters and thresholds is explained. The new index has been calculated for over 580 snowstorms that occurred between 1900 and 2013 providing a century-scale historical perspective for these snowstorms. The RSI is computed for category 1 or greater storms in near–real time, usually a day after the storm has ended.

scholarly journals The Administration of Prehospital Ketamine for Chemical Restraint does not Prolong On-Scene Times Compared to Haloperidol Based Sedation

2015 ◽  
Vol 12 (1) ◽  
Author(s):  
Aaron Burnett ◽  
Dolly Panchal ◽  
Bjorn Peterson ◽  
Eric Ernest ◽  
Kent Griffith ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
T Test ◽  
Medical Services ◽  
Demographic Differences ◽  
Chemical Restraint ◽  
Emergency Medical ◽  
Clinically Significant ◽  
The Impact

IntroductionAgitated patients who present a danger to themselves or emergency medical services (EMS) providers may require chemical restraints.  Haloperidol is employed for chemical restraint in many EMS services.  Recently, ketamine has been introduced as an alternate option for prehospital sedation.  On-scene time is a unique metric in prehospital medicine which has been linked to outcomes in multiple patient populations. When used for chemical restraint, the impact of ketamine relative to haloperidol on on-scene time is unknown.Objective: To evaluate whether the use of ketamine for chemical restraint was associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.MethodsPatients who received haloperidol or ketamine for chemical restraint were identified by retrospective chart review.  On-scene time was compared between groups using an unadjusted Student t-test powered to 80% to detect a ≥5 minute difference in on-scene time.Results110 cases were abstracted (Haloperidol = 55; Ketamine = 55). Of the patients receiving haloperidol, 11/55 (20%) were co-administered a benzodiazepine, 4/55 (7%) received diphenhydramine and 34/55 (62%) received the three drugs in combination. There were no demographic differences between the haloperidol and ketamine groups.  On-scene time was not statistically different for patients receiving a haloperidol based regimen compared to ketamine (18.2 minutes, [95% CI 15.7-20.8] vs. 17.6 minutes, [95% CI 15.1-20.0]; p = 0.71).ConclusionsThe use of prehospital ketamine for chemical restraint was not associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.  

scholarly journals Emergency Stroke Calls: Obtaining Rapid Telephone Triage (ESCORTT) – a programme of research to facilitate recognition of stroke by emergency medical dispatchers

2014 ◽  
Vol 2 (1) ◽  
pp. 1-124 ◽  
Author(s):  
Caroline L Watkins ◽  
Stephanie P Jones ◽  
Michael J Leathley ◽  
Gary A Ford ◽  
Tom Quinn ◽  
...  
Keyword(s):  
Phase 1 ◽  
Research Programme ◽  
Online Training ◽  
Final Diagnosis ◽  
Phase 2 ◽  
The Public ◽  
Training Package ◽  
Emergency Medical ◽  
Emergency Medical Dispatchers ◽  
The Impact

BackgroundRapid access to emergency stroke care can reduce death and disability by enabling immediate provision of interventions such as thrombolysis, physiological monitoring and stabilisation. One of the ways that access to services can be facilitated is through emergency medical service (EMS) dispatchers. The sensitivity of EMS dispatchers for identifying stroke is < 50%. Studies have shown that activation of the EMSs is the single most important factor in the rapid triage and treatment of acute stroke patients.ObjectivesTo facilitate recognition of stroke by emergency medical dispatchers (EMDs).DesignAn eight-phase mixed-methods study. Phase 1: a retrospective cohort study exploring stroke diagnosis. Phase 2: semi-structured interviews exploring public and EMS interactions. Phases 3 and 4: a content analysis of 999 calls exploring the interaction between the public and EMDs. Phases 5–7: development and implementation of stroke-specific online training (based on phases 1–4). Phase 8: an interrupted time series exploring the impact of the online training.SettingOne ambulance service and four hospitals.ParticipantsPatients arriving at hospital by ambulance with stroke suspected somewhere on the stroke pathway (phases 1 and 8). Patients arriving at hospital by ambulance with a final diagnosis of stroke (phase 2). Calls to the EMSs relating to phase 1 patients (phases 3 and 4). EMDs (phase 7).InterventionsStroke-specific online training package, designed to improve recognition of stroke for EMDs.Main outcome measuresPhase 1: symptoms indicative of a final and dispatch diagnosis of stroke. Phase 2: factors involved in the decision to call the EMSs when stroke is suspected. Phases 3 and 4: keywords used by the public when describing stroke and non-stroke symptoms to EMDs. Phase 8: proportion of patients with a final diagnosis of stroke correctly dispatched as stroke by EMDs.ResultsPhase 1: for patients with a final diagnosis of stroke, facial weakness and speech problems were significantly associated with an EMD code of stroke. Phase 2: four factors were identified – perceived seriousness; seeking and receiving lay or professional advice; caller’s description of symptoms and emotional response to symptoms. Phases 3 and 4: mention of ‘stroke’ or one or more Face Arm Speech Test (FAST) items is much more common in stroke compared with non-stroke calls. Consciousness level was often difficult for callers to determine and/or communicate. Phase 8: there was a significant difference (p = 0.003) in proportions correctly dispatched as stroke – before the training was implemented 58 out of 92 (63%); during implementation of training 42 out of 48 (88%); and after training implemented 47 out of 59 (80%).ConclusionsEMDs should be aware that callers are likely to describe loss of function (e.g. unable to grip) rather than symptoms (e.g. weakness) and that callers using the word ‘stroke’ or describing facial weakness, limb weakness or speech problems are likely to be calling about a stroke. Ambiguities and contradictions in dialogue about consciousness level arise during ambulance calls for suspected and confirmed stroke. The online training package improved recognition of stroke by EMDs. Recommendations for future research include testing the effectiveness of the Emergency Stroke Calls: Obtaining Rapid Telephone Triage (ESCORTT) training package on the recognition of stroke across other EMSs in England; and exploring the impact of the early identification of stroke by call handlers on patient and process outcomes.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

Data centers as the backbone of smart cities: principal considerations for the study of facility costs and benefits

Facilities ◽  
2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Patrick T.I. Lam ◽  
Daniel Lai ◽  
Chi-Kin Leung ◽  
Wenjing Yang
Keyword(s):  
Hong Kong ◽  
Real Estate ◽  
Data Center ◽  
Data Centers ◽  
Smart Cities ◽  
Costs And Benefits ◽  
Content Type ◽  
Cost And Benefit ◽  
Mission Critical ◽  
The Impact

Purpose As smart cities flourish amidst rapid urbanization and information and communication technology development, the demand for building more and more data centers is rising. This paper aims to examine the principal issues and considerations of data center facilities from the cost and benefit dimensions, with an aim to illustrate the approaches for maximizing the net benefits and remain “green.” Design/methodology/approach A comprehensive literature review informs the costs and benefits of data center facilities, and through a case study of a developer in Hong Kong, the significance of real estate costs is demonstrated. Findings Major corporations, establishments and governments need data centers as a mission critical facility to enable countless electronic transactions to take place any minute of the day. Their functional importance ranges from health, transport, payment, etc., all the way to entertainment activities. Some enterprises own them, whilst others use data center services on a co-location basis, in which case data centers are regarded as an investment asset. Real estate costs affect their success to a great extent, as in the case of a metropolitan where land cost forms a substantial part of the overall development cost for data centers. Research limitations/implications As the financial information of data center projects are highly sensitive due to the competitive status of the industry, a full set of numerical data is not available. Instead, the principles for a typical framework are established. Originality/value Data centers are very energy intensive, and their construction is usually fast tracked costing much to build, not to mention the high-value equipment contents housed therein. Their site locations need careful selection due to stability and security concerns. As an essential business continuity tool, the return on investment is a complex consideration, but certainly the potential loss caused by any disruption would be a huge amount. The life cycle cost and benefit considerations are revealed for this type of mission-critical facilities. Externalities are expounded, with emphasis on sustainable issues. The impact of land shortage for data center development is also demonstrated through the case of Hong Kong.

The impact of a mass gathering events with an on-site medical management team on municipal 911 emergency medical services

2013 ◽  
Vol 31 (1) ◽  
pp. 256-257 ◽  
Author(s):  
Michael J. Heiby ◽  
William Barnhardt ◽  
Thomas Berry ◽  
Melanie Welcher ◽  
William J. Brady
Keyword(s):  
Emergency Medical Services ◽  
Medical Management ◽  
Management Team ◽  
Medical Services ◽  
Mass Gathering ◽  
Emergency Medical ◽  
The Impact

scholarly journals Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026591
Author(s):  
Judith Dyson ◽  
Claire Marsh ◽  
Natalie Jackson ◽  
Donald Richardson ◽  
Muhammad Faisal ◽  
...  
Keyword(s):  
Risk Score ◽  
Blood Test ◽  
Unintended Consequences ◽  
Early Warning Score ◽  
Routine Practice ◽  
Successful Implementation ◽  
Risk Of Death ◽  
Emergency Medical ◽  
Computer Aided ◽  
The Impact

ObjectivesThe Computer-Aided Risk Score (CARS) estimates the risk of death following emergency admission to medical wards using routinely collected vital signs and blood test data. Our aim was to elicit the views of healthcare practitioners (staff) and service users and carers (SU/C) on (1) the potential value, unintended consequences and concerns associated with CARS and practitioner views on (2) the issues to consider before embedding CARS into routine practice.SettingThis study was conducted in two National Health Service (NHS) hospital trusts in the North of England. Both had in-house information technology (IT) development teams, mature IT infrastructure with electronic National Early Warning Score (NEWS) and were capable of integrating NEWS with blood test results. The study focused on emergency medical and elderly admissions units. There were 60 and 39 acute medical/elderly admissions beds at the two NHS hospital trusts.ParticipantsWe conducted eight focus groups with 45 healthcare practitioners and two with 11 SU/Cs in two NHS acute hospitals.ResultsStaff and SU/Cs recognised the potential of CARS but were clear that the score should not replace or undermine clinical judgments. Staff recognised that CARS could enhance clinical decision-making/judgments and aid communication with patients. They wanted to understand the components of CARS and be reassured about its accuracy but were concerned about the impact on intensive care and blood tests.ConclusionRisk scores are widely used in healthcare, but their development and implementation do not usually involve input from practitioners and SU/Cs. We contributed to the development of CARS by eliciting views of staff and SU/Cs who provided important, often complex, insights to support the development and implementation of CARS to ensure successful implementation in routine clinical practice.

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