Multi-casualty incidents (MCIs) continue to occur throughout the world, whether they be mass shootings or natural disasters. Prehospital emergency services have done a professional job at stabilizing and transporting the victims to local hospitals. When there are multiple casualties, there may not be enough professional responders to care for the injured. Bystanders and organized volunteer first responders have often helped in extricating the victims, stopping the bleeding, and aiding in the evacuation of the victims. Magen David Adom (MDA translated as "Red Shield of David"), the national Emergency Medical Services (EMS) provider for Israel, has successfully introduced a program for volunteer first responders that includes both a mobile-phone-based application and appropriate life-saving equipment. Most of the responders, known as Life Guardians, are already medical professionals such as physicians, nurses, or off-duty medics. They are notified by a global positioning system application if there is a nearby life-threatening incident such as respiratory or cardiac arrest, major trauma, or an MCI. They are given a kit that includes a bag-valve mask device, oropharyngeal airways, tourniquets, and bandages. There are currently 17,000 Life Guardians, and in the first-half of 2017, they responded to 253 events.The Life Guardians are essentially an out-of-hospital manpower multiplier using a simple crowdsourcing application who have the necessary skills and equipment to treat those in cardiopulmonary arrest, or victims of trauma, including MCIs. Such a model can be integrated into other systems throughout the world to save lives.Jaffe E, Dadon Z, Alpert EA. Wisdom of the crowd in saving lives: the Life Guardians app.

In this study, the adsorption behavior of CaAl-Cl layered double hydroxide (CaAl-Cl-LDH) with a controlled pH value (pH = 6) on Co(II) ions ([Co] = 8 mM) is investigated. The comprehensively accepted mechanism of cobalt adsorption on LDH is considered to be co-precipitation, and the final adsorbed products are normally crystalline Co-LDH. One unanticipated finding is that crystalline/amorphous blends are found in the X-ray diffraction (XRD) pattern of Co-adsorbed LDH. To shed light on the adsorption products and the mechanisms in the adsorption process of Co(II) in an aqueous solution by CaAl-Cl-LDH, a series of testing methods including Fourier-transform infrared spectroscopy (FT-IR), Scanning electron microscope (SEM), High-resolution transmission electron microscopy (HR-TEM), X-ray photoelectron spectroscopy (XPS), and inductively coupled plasma (ICP) are applied to clarify the interaction between cobalt and CaAl-Cl-LDH. According to the comprehensive analysis, the formation of the crystalline/amorphous blends corresponds to two adsorption mechanisms. The crystalline phases are identified as Co₆Al₂CO₃(OH)16·4H₂O, which is attributed to the co-precipitation process occurring in the interaction between Co(II) and CaAl-Cl-LDH. The formation of the amorphous phases is due to surface complexation on amorphous Al(OH)₃ hydrolyzed from CaAl-Cl-LDH.

We focus on a Bayesian inference framework for finite element (FE) model updating of a long-span cable-stayed bridge using long-term monitoring data collected from a wireless sensor network (WSN). A robust Bayesian inference method is proposed which marginalizes the prediction-error precisions and applies Transitional Markov Chain Monte Carlo (TMCMC) algorithm. The proposed marginalizing error precision is compared with other two treatments of prediction-error precisions, including the constant error precisions and updating error precisions through theoretical analysis and numerical investigation based on a bridge FE model. TMCMC is employed to draw samples from the posterior probability density function (PDF) of the structural model parameters and the uncertain prediction-error precision parameters if required. It is found that the proposed Bayesian inference method with prediction-error precisions marginalized as "nuisance" parameters produces an FE model with more accurate posterior uncertainty quantification and robust modal property prediction. When applying the identified modal parameters from acceleration data collected during a one-year period from the large-scale WSN on the bridge, we choose two candidate model classes using different parameter grouping based on the clustering results from a sensitivity analysis and apply Bayes' Theorem at the model class level. By implementing the TMCMC sampler, both the posterior distributions of the structural model parameters and the plausibility of the two model classes are characterized given the real data. Computation of the posterior probabilities over the candidate model classes provides a procedure for Bayesian model class assessment, where the computation automatically implements Bayesian Ockham razor that trades off between data-fitting and model complexity, which penalizes model classes that "over-fit" the data. The results of FE model updating and assessment based on the real data using the proposed method show that the updated FE model can successfully predict modal properties of the structural system with high accuracy.

One of the six core functions of the World Health Organization (WHO) is monitoring the health situation, trends, and determinants in the world. Global, regional, and country statistics on population and health indicators are important for assessing progress toward goals for development and health and for guiding the allocation of resources. Timely data are needed to monitor progress on increasing life expectancy and reducing age- and cause-specific mortality rates. In particular, timely data are needed to monitor progress toward reaching the health-related targets within the Sustainable Development Goals (SDGs), which will require regular reporting on child mortality; maternal mortality; and mortality owing to noncommunicable diseases (NCDs), suicide, air pollution, road traffic injuries, homicide, natural disasters, and conflict. This chapter summarizes global and regional patterns of causes of death for 2015 and trends for 2000–15 using the 2015 Global Health Estimates (GHE 2015) released by the WHO at the beginning of 2017 (WHO 2017a). The GHE 2015 statistics provide a comprehensive, comparable set of cause-of-death estimates from 2000 onward, consistent with and incorporating estimates from the United Nations (UN) and interagency and the WHO data for population, births, all-cause deaths, and specific causes of death. The GHE 2015 present results for 183 WHO member states with a population of 90,000 or greater in 2015. The GHE 2015 cause-of-death estimates by country, region, and world for 2000–15 confirm and expand previous WHO analyses of global health trends. In particular, the WHO published an assessment of progress toward achievement of the UN Millennium Development Goals (MDGs) at the end of 2015 (WHO 2015b), followed by the World Health Statistics 2016: Monitoring Health for the SDGs (WHO 2016d), which focused on progress and challenges for achieving the SDGs for 2030. The SDGs expand the focus of health targets from the unfinished MDG agenda for child and maternal mortality and priority infectious diseases to a broader agenda including NCDs, injuries, health emergencies, and health risk factors as well as a strong focus on universal health coverage (UN Statistics Division 2017; WHO 2016d). The GHE 2015 estimates of trends and levels of mortality by cause will contribute to WHO and UN monitoring and reporting of progress toward the SDG health goals and targets.

Though not an ethical principle per se, benefit sharing is still an important tool to achieve justice in international research. It comes back as a transversal issue through the revised Indian Ethical Guidelines for Biomedical and Health Research Involving Human Participants (hereafter referred to as "the Guidelines"). The Guidelines invoke this principle with reference to the responsible conduct of research, ownership of biobanks and data repositories, informed consent process, community engagement, international collaborative research, and research in emergency or disasters, while using the phrase "maximization of benefit" instead of "benefit sharing". This approach may be seen as quite innovative, in that it sees benefit sharing (ie, maximisation of benefit) as a key ethical requirement. Unfortunately, it does not explicitly state that the principle is relevant to all research involving human participants, not only to specific situations such as biobanks, research in emergencies and international collaborations; rather it appears to consider the risk of lack of benefit sharing as mainly related to international collaborations. Another important drawback is the frequent use of noncommittal language such as "could be considered" and "may be offered". This suggests that the provisions with respect to benefit sharing are not mandatory and thus open to the discretion of different Ethics Committees. Therefore, for the Guidelines to become a positive model for other countries and ethics bodies, further elaboration of the principle and mode of implementation is needed.

Background: Natural disasters take a heavy toll not only on their victims, but also on physicians who suffer vicarious trauma and burnout. New trainees in Houston, from entering PGY1 residents to entering fellows, underwent even more upheaval and stress during Hurricane Harvey. Many responded to calls for volunteer help. Objective: To investigate the impact of Hurricane Harvey on new trainees at our institution, and correlate volunteerism with measures of burnout and resilience. Methodology: Thirty three new trainees out of 90 (43% of population) from all specialties in our institution voluntarily responded to an online survey on the impact of Hurricane Harvey on their lives, whether or not they volunteered and in what form, and answered questions drawing from the abbreviated Maslach burnout survey and Resiliency Quiz. Statistical analyses were conducted using GraphPad Prism and Excel data analysis. Results: The top areas impacted were emotional health (32%), eating habits (29%), family (25%) and finances (25%). The main voluntary activities were covering for colleagues who could not make it to hospital (50%), donating money and supplies (36%), and cleaning and rebuilding (36%). Volunteering was associated with feelings of appreciation (76%), happiness (62%), thankfulness (57%), purposefulness (43%) and pride (33%). Fewer volunteers scored lowly in personal achievement as compared to non-volunteers (10 vs. 38%, p = 0.05). Significance: Hurricane Harvey affected health, finances and family of new trainees, more than half of whom volunteered to help. Volunteers had a greater sense of personal achievement as compared to non-volunteers. This may be due to having more volunteers among less burnt-out trainees or because volunteering reduced burnout and stress responses/trauma. These results suggest that volunteer opportunities should be made available in programs targeting resident burnout.

As a species, dogs are particularly suited to working with as well as working for humankind on a variety of tasks, including searching for victims of natural disasters. Their abilities are deeply seated within their genetic make-up and their domestication over thousands of years. Dogs display not only a natural ability to find people, but also to aid and protect them. Military organisations throughout the ages have recognised these traits and shaped canine behaviour to help them in their endeavours on and off the battlefield. Scientific discovery, genetics and breeding, as well as advances in positive training methods, combine to create a unique and unsurpassed search team - canine and handler. Nature and nurture have created more than a living mechanism for rescue workers, however. The emotional benefits and support provided by dogs for responders and victims alike are a profound adjunct to their work as search dogs.

More than half of the world's households are thought to contain at least one companion animal. Animals can affect how humans are impacted by natural disasters, how they respond to such events and how well they can recover from them. For this reason alone, there is a real need to keep animals safe before, during and after natural disasters, and to do so in ways that contribute to, rather than compromise, human safety. This paper outlines the negative implications of failing to account for animals in disaster plans and/or to accommodate them in shelters. It also outlines how including animals in disaster response can provide benefits for the physical and mental health and well-being of humans that extend well beyond the disaster event. These implications are discussed in broad terms for the guardians of small and large companion animals, livestock producers and emergency responders with examples drawn from a variety of natural and human-made hazards. Finally, this paper suggests that research on people who do not attempt to save, rescue or evacuate with animals could provide important insights into natural disaster behaviour and human-animal relations.