UNASSIGNED: Pediatric farm injuries tend to be more severe and have poorer outcomes compared to injuries sustained in non-farm settings. Timely emergency medical service (EMS) response and transport to definitive care is crucial for optimizing outcomes for trauma patients. We aimed to determine if pediatric farm injuries were associated with longer EMS response and transport times compared to pediatric non-farm injuries in rural communities.
UNASSIGNED: The 2021 National EMS Information System (NEMSIS) database was used to identify rural EMS activations where injured pediatric patients who were transported to a hospital. Median transport times for farm and non-farm injuries, as well as other components of prehospital time and use of air EMS transport, were compared between injuries on farms and injuries in non-farm rural settings.
UNASSIGNED: The analytic sample included 22,248 rural EMS activations for pediatric injuries, of which 156 (1%) were for pediatric farm injuries. For non-farm and farm injuries, the median transport times were 20 minutes and 28 minutes, respectively. Median total prehospital time was 50 minutes compared to 62 minutes, and 9.8% of patients with non-farm injuries versus 20.5% of those with farm injuries were transported to a hospital by air EMS units. After multivariable adjustment, farm vs. non-farm injury location was associated with a 4 minute increase in EMS transport time, but no difference in initial EMS response time, EMS time on scene, or use of air EMS units.
UNASSIGNED: Among children sustaining an injury that resulted in rural EMS activation, farm injuries were associated with prolonged transport time compared to non-farm injuries, which may contribute to worse in-hospital outcomes described to pediatric farm injuries in prior research.

UNASSIGNED: China\'s medical system has not yet issued quality control indicators related to the transfer of critically ill children, and when transport teams receive a transfer request for these children, due to various reasons, the time to arrive at the bedside varies. The aim of this study was to investigate the effect of the time taken by the pediatric intensive care transport team to reach the bedside of children after receiving a transport request on the prognosis of these children.
UNASSIGNED: Clinical data of 298 critically ill children admitted to Anhui Children\'s Hospital through long-distance transport from March 2020 to February 2022 were retrospectively analyzed. Pediatric patients were divided into three groups according to the time taken by the transport team to reach the bedside after receipt of a transport request: the ≤60, >60 to ≤180, and >180 min groups. The 30-day mortality of children after admission (0= no, 1= yes) was used as the dependent variable for multivariate logistic regression analysis, with the odds ratio (OR) and 95% confidence interval (CI) indicating the relation between the time taken by the transport team to reach the bedside and the 30-day mortality rate after admission. P<0.05 indicated a statistically significant difference.
UNASSIGNED: During the study period, there were 298 children for whom transports were requested, 50 (16.8%) of whom died within 30 days after admission. The limited evidence revealed that the time taken by the transport team to reach the bedside of children was not significantly related to the 30-day mortality rate after admission in Anhui Children\'s Hospital (P>0.05).
UNASSIGNED: The time taken by the transport team to reach the bedside of children is not associated with the 30-day mortality rate after admission into the pediatric intensive care unit (PICU).

A comprehensive emergency medical service (EMS) system significantly enhances a city\'s capacity to prevent and mitigate disasters. Using Huangshi as a case study, this research evaluated the service radium coverage rate of the current EMS system by examining its transport capacity, population density, and prevalence rate, finding it to be only 61.49% with an inefficient spatial layout. To address this, we proposed transforming urban brownfields into EMS parks. By selecting the most suitable brownfields based on capacity and service radius, we increased the coverage rate to 90.21%. We introduced a new \"consultation-referral\" model, where existing EMS facilities serve as pre-diagnosis and triage centers, and the urban brownfield EMS parks function as isolation and centralized treatment centers. GIS network analysis confirmed the feasibility, showing all transit times to be under 30 min. The methodology outlined in this study-comprising \"demand assessment, supply optimization, and feasibility verification\"-not only strengthens the city\'s EMS system but also facilitates the renewal of urban brownfields. This approach can serve as a valuable reference for enhancing EMS systems in other cities.

UNASSIGNED: Despite limited supporting data, hospitals continue to apply ambulance diversion (AD). Thus, we examined the impact of three different diversion policies on diversion hours, transport time (TT; leaving scene to arrival at the hospital), and ambulance patient offload time (APOT; arrival at the hospital to patient turnover to hospital staff) for 9-1-1 transports in a 22-hospital county Emergency Medical Services (EMS) system.
UNASSIGNED: This retrospective study evaluated metrics during periods of three AD policies, each 27 days long: hospital-initiated (Period 1), complete suspension (Period 2), and County EMS-initiated (Period 3). We described the median transports and diversion hours, and compared the daily average and daily 90th percentile TT and APOT during the three study periods.
UNASSIGNED: Over the study period, there were 50,992 total transports in the county; Period 3 had fewer median transports per day than Period 1 (581 vs 623, p < 0.001), while Period 2 was similar to Period 1 (606 vs 623, p = 0.108). Median average daily diversion hours decreased from 98.1 h during Period 1 to zero hours during both Periods 2 (p < 0.001) and 3 (p < 0.001). Median daily average TT decreased from 18.3 min in Period 1 to 16.9 min in both Periods 2 (p < 0.001) and 3 (p < 0.001). Median daily 90th percentile TT showed a similar decrease from 30.2 min in Period 1 to 27.5 in Period 2 (p < 0.001), and to 28.1 in Period 3 (p = 0.001). Median average daily APOT was 26.0 min during Period 1, similar at 25.2 min during Period 2 (p = 0.826) and decreased to 20.4 min during Period 3 (p < 0.001). The median daily 90th percentile APOT was 53.9 min during Period 1, similar at 51.7 min during Period 2 (p = 0.553) and decreased to 40.3 min during Period 3 (p < 0.001).
UNASSIGNED: Compared to hospital-initiated AD, enacting no AD or County EMS-initiated AD was associated with less diversion time; TT and APOT showed statistically significant improvement without hospital-initiated AD but were of unclear clinical significance. EMS-initiated AD was difficult to interpret as that period had significantly fewer transports. EMS systems should consider these findings when developing strategies to improve TT, APOT, and system use of diversion.

Kinetic models of solvent transport behaviors are widely used in rubber-solvent systems, and some key points are still worthy of attention. In this work, the Korsmeyer-Peppas and Peppas-Sahlin models were chosen to fit the transport behaviors of three aromatic solvents, benzene, toluene and p-xylene, in the hydrogenated nitrile rubber (HNBR)/ethylene propylene diene monomer (EPDM)-based vulcanizates. The different effects of the various selected transport times (ti) used for fitting on the results of the mathematical models were compared. Moreover, a method to obtain the n parameter for the Korsmeyer-Peppas model and the m parameter for the Peppas-Sahlin model at ti = 0 was discussed. It was found that the differences in values of ti greatly influenced the impact on the fitting results of all the parameters for the two models. In addition, the n parameter for the Korsmeyer-Peppas model along with the m parameter for the Peppas-Sahlin model, which can characterize the transport mechanism, showed differing applicability. But the n and m parameters at ti = 0 obtained by linear fitting showed similar rules with some differences in values. These discussions give important guidance for the application of kinetic transport models in rubber-solvent systems.

Previous rural vascular trauma research has focused on case series dating back two decades. The current research aims to measure clinical decline in comparison to time to care in rural vascular trauma. This single-center retrospective cohort study included adult trauma patients with vascular injury who were admitted to a level II trauma center. Multivariable logistic regression assessed the effect of clinical decline based on arrival within the golden hour. 149 patients were included. For every 1 unit increase in the shock index ratio, there was 99.9% reduction in odds that the patient would arrive to the trauma center within the golden hour. This study is the first of its kind within the last two decades to comprehensively review rural vascular trauma. Our research showed clinical decline in SIR associated with prolonged time to care and will allow us to optimize pre-hospital care and transport in regions with prolonged arrival times.

UNASSIGNED: Potential nutrient losses and mycotoxin accumulation caused by abnormal fermentation during transportation from cropland to dairy farms leads to the diseases incidence and threatens the health of dairy cows, then further causes financial losses. The aim of this study was to investigate the effects of different transportation times on the nutritional composition, mycotoxins, and microbial communities in whole-plant corn silage (WPCS).
UNASSIGNED: Three groups were subjected to different transport times: DY, short (<200 min); ZY, medium time (300-500 min); and CY, long transport time (>600 min). WPCS were collected from the same field, and nutrient composition and microbial composition before and after transportation were analyzed.
UNASSIGNED: Our results showed that the temperature of WPCS was higher in the ZY and CY groups than in the DY group (P < 0.01). There were no significant differences in dry matter (DM), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), ether extract (EE) and starch contents after different transportation times (P > 0.05), whereas the starch and water-soluble carbohydrates (WSC) contents in the CY group was significantly decreased after transport (P < 0.05). Similarly, the concentration of vomitoxin in the DY and CY groups declined markedly (P < 0.05) and the zearalenone content in the DY group also significantly decreased after transportation (P < 0.05). Regarding the analysis of microorganisms in WPCS, UniFrac-distance matrices and Shannon indices showed differences in the ZY group (P < 0.05), but fungal diversities were not influenced by the transport time (P > 0.05). In the ZY group, the relative abundance of Lactiplantibacillus decreased significantly after transportation (P > 0.05), but the relative abundances of unidentified_Chloroplast, Pantoea, Gluconobacter, unidentified Acetobacter and Acinetobacter increased markedly (P < 0.05). In addition, the relative abundances of Acetobacter and Gluconobacter in the CY group increased after transport (P < 0.05). Among fungal communities, a total of three, nine, and ten different fungal flora were observed in the DY, ZY, and CY groups, respectively, although no difference was found in fungal diversity. In conclusion, increased temperature, loss of starch, and mycotoxin variation were found with increased transport time. This might be the result of competition between bacteria and fungi, and novel technologies will need to be utilized for further exploration of the mechanism.

The aim of this study was to discuss the differences in pre-hospital time intervals between rural and urban communities regarding emergency medical services (EMS). A systematic search was conducted through various relevant databases, together with a manual search to find relevant articles that compared rural and urban communities in terms of response time, on-scene time, and transport time. A total of 37 articles were ultimately included in this review. The sample sizes of the included studies was also remarkably variable, ranging between 137 and 239,464,121. Twenty-nine (78.4%) reported a difference in response time between rural and urban areas. Among these studies, the reported response times for patients were remarkably variable. However, most of them (number (n) = 27, 93.1%) indicate that response times are significantly longer in rural areas than in urban areas. Regarding transport time, 14 studies (37.8%) compared this outcome between rural and urban populations. All of these studies indicate the superiority of EMS in urban over rural communities. In another context, 10 studies (27%) reported on-scene time. Most of these studies (n = 8, 80%) reported that the mean on-scene time for their populations is significantly longer in rural areas than in urban areas. On the other hand, two studies (5.4%) reported that on-scene time is similar in urban and rural communities. Finally, only eight studies (21.6%) reported pre-hospital times for rural and urban populations. All studies reported a significantly shorter pre-hospital time in urban communities compared to rural communities. Conclusions: Even with the recently added data, short pre-hospital time intervals are still superior in urban over rural communities.

Quantitative assessments of long-term, national-scale responses of groundwater quality to pesticide applications are essential to evaluate the effectiveness of pesticide regulations. Retardation time in the unsaturated zone (Ru) was estimated for selected herbicides (atrazine, simazine, and bentazon) and degradation products (desethylatrazine (DEA), desisopropylatrazine (DIA), desethyldesisopropylatrazine (DEIA), and BAM) using a multidecadal time series of groundwater solute chemistry (∼30 years) and herbicide sales (∼60 years). The sampling year was converted to recharge year using groundwater age. Then, Ru was estimated using a cross-correlation analysis of the sales and the frequencies of detection and exceedance of the drinking water standard (0.1 μg/L) of each selected compound. The results showed no retardation of the highly polar, thus mobile, parent compounds (i.e., bentazon), while Ru of the moderately polar compounds (i.e., simazine) was about a decade, and their degradation products showed even longer Ru. The temporal trends of the degradation products did not mirror those of the sale data, which were attributed to the various sale periods of the parent compounds, sorption of the parent compounds, and complex degradation pathways. The longer Ru in clayey/organic sediments than in sandy sediments further confirmed the role of soil-specific retardation as an important factor to consider in groundwater protection.

BACKGROUND: This study investigated the use of fixed-wing air ambulance in Iceland between 2012 and 2020.
METHODS: Medical records were filled out during each flight and information afterwards entered into an electronic database.
METHODS: The annual number of patient transports nationwide; triage scale category; reason for transportation, age and gender; and departure and arrival airports were analyzed. Response time and total transport time were compared between years and locations. Poisson regression analysis was used to compare the yearly number of transports. One-way ANOVA was used to compare response time and total transport time by year and departure site.
RESULTS: In total, 6011 patients were transported in fixed-wing air ambulances during the study period. Majority were male (54.3%). Median age was 64 years (range 0-99 years). Most patients were transported due to medical conditions; 15.8% due to trauma. Thirty percent of women aged 20 to 44 years were transported due to pregnancy or childbirth. Two-thirds of patients were transported to Reykjavik (n=3937), and one-fifth to Akureyri (n=1139). Median response time for acute transports was 84 minutes (range 0-2870 minutes). Median total transport time was 150 minutes (range 50-2930 minutes). Differences were found in total transport time from departure locations (F=32.19; DF 9, 2678; p<0,001). Egilsstaðir, Norðfjörður, Höfn, and, partly, Ísafjörður had the longest total transport times.
CONCLUSIONS: Icelandic air ambulance flights are often long, likely affecting outcomes for patients with time-sensitive medical conditions. Access to specialized healthcare is unequal among places of residence, and it is important to address this.