Along with the rapid development of industrial and commercial industries, the extent of disasters in Kaohsiung city in recent years due to highly concentrated population, newly erected skyscrapers and factories is far beyond one's imagination. By using the Kaohsiung Emergency Operation Center (KEOC) as an example, this study investigates practical operations, including disaster prevention, disaster emergency action, restoration and reconstruction after disaster, etc., of the emergency operation center at a special municipality level. Methodologies utilized in this study include literature review, direct observation, questionnaire survey, and statistical analysis by using the SPSS software package for Windows (Version 8.0). Main conclusions of this study are summarized as follows: 1. The regional plan for disaster prevention and response needs to be specified. 2. Manpower for disaster prevention and response of Kaohsiung city needs to be increased and the duties need to be specified. 3. Budgets for disaster prevention and response need to be prepared liberally. More equipments and devices for disaster prevention and response need to be purchased. 4. Personnel training, exercise and teamwork/cooperation for disaster prevention and response should be conducted seriously. 5. Persuade the public that prevention is better than rescue. 6. Actions for disaster prevention and response should be incorporated into the local communities. 7. Modern emergency operation centers need to be well constructed. 8. Data for disaster prevention and response need to be integrated and processed into useful information. 9. Set up standard operating procedures (SOP) for disaster rescue and crisis management. 10. Integration and utilization of volunteers for disaster prevention and response need to be institutionalized. 11. Task schedules need to be well controlled, supervised, and checked. Recommendations from this study are summarized as follows: 1. Set up short, medium, and long-term objectives properly for disaster prevention and response. 2. Set up a duty-oriented unit for disaster prevention and response according to the law. 3. It is more appropriate than the current organizational system to combine the KEOC and Rescue Command Center, Fire Bureau into one task force and fulfill the services at one site. 4. It is recommended that Kaohsiung city government should actively pursue the establishment of the Southern Stand-by Supporting Unit, Central Emergency Operation Center in Kaohsiung city . 5. Amend related laws and regulations for disaster prevention and response as soon as possible. All recommendations mentioned above provide not only Kaohsiung city, but other counties and cities as well, with valuable references pertaining to establishing and operating the most efficient emergency operation center.

Emergency response is a time critical work that needs team work from different organizations with various specialties. It also needs to integrate existing information system to collect and assemble necessary knowledge and resources for critical emerging tasks and use it to plan for collaborative problem solving In this study, we propose the methodology to automate the traditional emergency patient transfer process by connecting different organization¡¦s information systems through Web services with BPEL4WS. Via Web services, the medical resources information can be requested according to patient conditions, and resource reservation decision can be made online. Via BPEL4WS, heterogeneous information systems in different organizations can be connected and executed automatically in any predefined process without limit human intervention. The willingness of hospitals to share various levels of resource availability information to Emergency Operation Center (EOC) to coordinate regional medical resource distribution is critical to make Web service platform work. Therefore, this study examines the correlation of individual hospitals¡¦ performance in terms of resource utilization with hospital¡¦s information sharing with EOC. We investigate the effects from sharing information to EOC which adopts three policies of releasing hospital status information through simulation under different conditions in emergency occurrence and occupied hospital resources. Our findings from the simulations imply that the best policy for EOC to adopt in order to make Web services workable in handling medical emergency is to accord different conditions to adopt different suitable policies. For hospitals, if they want to get the maximum resources utilization, it had better to refer to different condition to adopt different information sharing strategies.

The main objective of this research is to devise a risk-based methodology for developing emergency operation schedules (EOS). EOS are decision tools that provide guidance to reservoir operators in charge of making real-time release decisions during major flood events. A computer program named REOS was created to perform the computations to develop risk-based EOS. The computational algorithm in REOS is divided in three major components: (1) synthetic streamflow generation, (2) mass balance computations, and (3) frequency analysis. The methodology computes the required releases to limit storage to the capacity available based on the probabilistic properties of future flows, conditional to current streamflow conditions. The final product is a series of alternative risk-based EOS in which releases, specified as a function of reservoir storage level, current and past inflows, and time of year, are associated with a certain risk of failing to attain the emergency operations objectives. The assumption is that once emergency operations are triggered by a flood event, the risk associated with a particular EOS reflects the probability of exceeding a pre-established critical storage level given that the same EOS is followed throughout the event. This provides reservoir operators with a mechanism for evaluating the tradeoffs and potential consequences of release decisions. The methodology was applied and tested using the Addicks and Barker Reservoir system in Houston, TX as a case study. Upstream flooding is also a major concern for these reservoirs. Modifications to the current emergency policies that would allow emergency releases based on the probability of upstream flooding are evaluated. Riskbased EOS were tested through a series of flood control simulations. The simulations were performed using the HEC-ResSim reservoir simulation model. Rainfall data recorded from Tropical Storm Allison was transposed over the Addicks and Barker watersheds to compute hypothetical hydrographs using HEC-HMS. Repeated runs of the HEC-ResSim model were made using different flooding and residual storage scenarios to compare regulation of the floods under alternative operating policies. An alternative application of the risk-based EOS in which their associated risk was used to help quantify the actual probability of upstream flooding in Addicks and Barker was also presented.

The evacuation planning has become an important issue addressed by many research studies and publications aiming to improve the security of the daily life for our public inside the United States of America. The main objective of this research was to address the growing need for evacuation planning using traffic simulation. With increased interests and awareness in emergency evacuation and first responder access to emergencies in public locations (airports, transit stations, ports or stadiums), the traffic simulation can be helpful in orchestrating the traffic flow during emergencies. Related to this issue, Federal Transit Administration has issued a large number of publications and guidelines concerning emergency preparedness and incident management. These guidelines are used to develop a simulation-based activity to evaluate the current plan and alternative plans for the deployment of transit during an emergency situation. A major task for this project is to study the effect of evacuation on the surrounding traffic network and help the local transit company (LYNX) to evaluate their evacuation plan and consider different possibilities without the risk and cost of actual evacuation drills. A set of different scenarios and alternatives for each scenario were simulated and studied to reach the best possible evacuation strategy. The main findings were evacuation as pedestrians have less impact on traffic network and rerouting decreases the congestion resulting from the evacuation process.

The main purpose of this thesis is to study the emergency power-supply system analysis for red and orange lines of Kaohsiung Mass Rapid Transit(KMRT). First of all, the configurations of KMRT power-supply were introduced. Then the traction power required and station substation demand were analyzed by computer program. The suitability of planning and the power-supply system were examined by considering their target year requirements based on the headways of both 2 and 3 minutes. The dispatch strategic is investigated when one of Bulk Supply Substation(BSS) was outaged. To analyze the system transient stability for the islanding operation of KMRT system when all 161kV circuits tripped, the mathematical models of the standby diesel generators with excitation system and governor system as well as the loads are considered in the computer simulation. The Ferranti effect due to 22.8kV cables for the transmission of energy backup power to send the critical loads in the train station is investigated, it is found that the shunt reactors is required for the mitigation of over voltage problem introduced by the Ferranti effect.

Abstract Coronary artery disease is the leading cause of death in the world. The outcome of patients at a very high operative risk undergoing coronary artery bypass surgery has not been thoroughly investigated. Cohorts of patients underwent coronary surgery between January 1997 and December 2013 at the Oulu University Hospital, Finland. Data was acquired from electronic patient records. Statistical analysis was performed on the collected data to evaluate outcome and identify predictors of adverse events. Very high-risk patients who underwent isolated coronary artery bypass surgery had a high 30-day mortality (16.2%), but their 5-year survival was satisfactory (66.8%). Survivors of out-of-hospital cardiac arrest were compared to a control group. Immediate postoperative mortality was slightly higher in out-of-hospital cardiac arrest patients (6.3% vs. 0%, p = 0.24), but the overall 5-year survival rates were similar (80.7% vs. 84.5%). Patients with preoperative stage 3 chronic kidney disease have a higher mortality than patients with stage 1-2 chronic kidney disease. Kidney function decline/year was predictive of all-cause mortality, cardiovascular mortality and also tended to predict fatal and non-fatal cardiovascular events. The E-CABG postoperative complication grading system was used to stratify the severity and prognostic impact of postoperative complications and was shown to predict early and late mortality for these patients. The outcome of emergency coronary artery bypass surgery was studied in a multi-center setting. Increasing emergency classes, left ventricular ejection fraction ≤30%, on-pump surgery, and participating centers were independent predictors of in-hospital mortality. Survival rates at 1, 3 and 5 years were 86.4%, 81.6%, and 76.1%. Despite the high preoperative risk of these patients, the long-term outcome for coronary surgery is satisfactory. Patients with stage 3 chronic kidney disease may experience a significant decline in kidney function and poor outcome. Early referral to a nephrologist may be beneficial for these patients. The E-CABG complication grading system seems to be a promising tool for stratifying the severity and prognostic impact of complications occurring after coronary surgery. / Tiivistelmä Sepelvaltimotauti on johtavia kuolinsyitä Maailmassa. Ohitusleikkauksen tuloksia ei ole täysin selvitetty erittäin korkean riskin potilailla. Potilaat leikattiin vuosina 1997-2013. Potilastiedot hankittiin sairauskertomuksista ja kuolinsyytiedot kansallisista rekistereistä. Erittäin korkean riskin potilaiden välitön kuolleisuus ohitusleikkauksen jälkeen on korkea (30 päivän kuolleisuus 16,2 %). Viiden vuoden kuluttua leikkauksesta elossa oli 66,8% leikatuista. Ohitusleikkausta edeltävästi elvytettyjä potilaita verrattiin kontrolliryhmään. Välittömät leikkauksen jälkeinen kuolleisuus oli 6,3% vs. 0% (p = 0,24). Viiden vuoden kuluttua leikkauksesta elossa oli tutkimusryhmästä 80,7% ja kontrolliryhmästä 80,7%. Leikkausta edeltävästi keskivaikean munuaisten vajaatoiminnan omaavilla potilailla on korkeampi kuolleisuus verrattuna potilaisiin, joiden munuaistoiminta on normaalia tai lievästi heikentynyt. Munuaisten vajaatoiminnan eteneminen ennusti kokonaiskuolleisuutta, sydän- ja verisuonikuolleisuutta ja enteili sydän- ja verisuonitapahtumia. E-CABG leikkauksen jälkeisten komplikaatioiden luokittelujärjestelmällä luokiteltiin leikkauksen jälkeisten komplikaatioiden vaikeusastetta ja ennusteellista vaikutusta. E-CABG luokat ja pisteytys ennustivat 1kk, 3kk kuolleisuutta ja kuolleisuutta pidemmällä aikavälillä. Päivystysohitusleikkauksen tuloksia tutkittiin monikeskusasetelmassa. Sairaalakuolleisuutta ennustivat päivystysleikkausluokitteluluokan vakavuus, vasemman kammion ejektiofraktio ≤30%, perfuusiossa tehty leikkaus ja leikkaava keskus. Potilaiden elossaololuvut olivat 1, 3 ja 5 vuoden kohdalla 86,4%, 81,6%, and 76,1%. Leikkaustulokset erittäin korkean riskin potilailla ohitusleikkauksesta ovat kohtuullisia leikkausta edeltävään riskiarvioon suhteutettuna. Näin ollen tämän potilasryhmän sepelvaltimotaudin hoito leikkaamalla on perusteltua. Keskivaikean munuaisten vajaatoiminnan omaavien potilaiden munuaissairauden etenemiseen seuranta-aikana liittyy kuolleisuutta ja sydän- ja verisuonitapahtumia. Aikaisessa vaiheessa tehty nefrolgin konsultaatio voi parantaa näiden potilaiden munuaisfunktiota. E-CABG komplikaatioiden luokittelujärjestelmä vaikuttaa lupaavalta työkalulta ohitusleikkauksen jälkeisten komplikaatioiden luokitteluun ja ennustevaikutuksien arviointiin.