Search Results (2)

To meet the preference demands of the crew members of high-speed railway trains while forming a crew team, and to automate the compilation of adaptable crew member schemes, a bilateral matching decision method for crew members is proposed based on complete preference order information. This method first describes the mutual selection process between the chief stewards and stewards of a high-speed railway train as a one-to-many bilateral matching decision process between the chief stewards and stewards Subsequently, by constructing a virtual train chief stewards, the original one-to-many bilateral matching relationship between the chief stewards and stewards is transformed into a one-to-one bilateral matching relationship between the virtual chief stewards for modeling. Then, a dual-objective integer programming model is established with the minimum sum of preference order values as the objective. Finally, an optimization solver is used to calculate the problem under different scales, and a genetic algorithm is designed for large-scale scenarios. The analysis results of numerical examples show that the model and algorithm of train crew members based on bilateral matching decisions can meet the actual requirements of the crew department and have good application value. Full article

The performance of ambulance crew affects the quality of pre-hospital treatment, which is vital to the survival for out-of-hospital cardiac arrest (OHCA) patients, yet remains suboptimal in China. In this retrospective analysis study, we aimed to examine the effect of a citywide quality improvement programme on provision of prehospital advanced life support (ALS) by emergency medical service (EMS) system. EMS-treated adult OHCA patients after the implementation of the programme (1 January 2021 to 30 June 2022) were compared with historical controls (1 June 2019 to 31 August 2020) in Suzhou. Multivariable logistic regression analysis and propensity score matching procedures were applied to compare the outcomes between two periods for total OHCA cases and subgroup of cases treated by fixed or non-fixed ambulance crews. A total of 1465 patients (pre-period/post-period: 610/855) were included. In the 1:1 matched analysis of 591 cases for each period, significant improvement (p < 0.05) was observed for the proportion of intravenous (IV) access (23.4% vs. 68.2%), advanced airway management (49.2% vs. 57.0%), and return of spontaneous circulation (ROSC) at handover (5.4% vs. 9.0%). The fixed ambulance crews performed better than non-fixed group in IV access and advanced airway management for both periods. There were significant increases in IV access (AOR 12.66, 95%CI 9.02–18.10, p < 0.001), advanced airway management (AOR 1.67, 95% CI 1.30–2.16, p < 0.001) and ROSC at handover (AOR 2.37, 95%CI 1.38–4.23, p = 0.002) after intervention in unfixed group, while no significant improvement was observed in fixed group except for IV access (AOR 7.65, 95%CI 9.02–18.10, p < 0.001). In conclusion, the quality improvement program was positively associated with the provision of prehospital ALS interventions and prehospital ROSC following OHCA. The fixed ambulance crews performed better in critical care provision and prehospital outcome, yet increased protocol adherence and targeted training could fill the underperformance of non-fixed crews efficaciously. Full article