ImportanceBoarding in the emergency department (ED) is a critical indicator of quality of care for hospitals. It is defined as the time between the admission decision and departure from the ED. As a result of boarding, patients stay in the ED until inpatient beds are available; moreover, boarding is associated with various adverse events.

The effect of emergency department (ED) length of stay (EDLOS) on in-hospital mortality (IHM) remains unclear. The aim of this systematic review and meta-analysis was to determine the association between EDLOS and IHM. We searched the PubMed, Medline, Embase, Web of Science, Cochrane Controlled Register of Trials, CINAHL, PsycInfo, and Scopus databases from their inception until 14–15 January 2022. We included studies reporting the association between EDLOS and IHM. A total of 11,337 references were identified, and 52 studies (total of 1,718,518 ED patients) were included in the systematic review and 33 in the meta-analysis. A statistically significant association between EDLOS and IHM was observed for EDLOS over 24 h in patients admitted to an intensive care unit (ICU) (OR = 1.396, 95% confidence interval [CI]: 1.147 to 1.701; p < 0.001, I2 = 0%) and for low EDLOS in non-ICU-admitted patients (OR = 0.583, 95% CI: 0.453 to 0.745; p < 0.001, I2 = 0%). No associations were detected for the other cut-offs. Our findings suggest that there is an association between IHM low EDLOS and EDLOS exceeding 24 h and IHM. Long stays in the ED should not be allowed and special attention should be given to patients admitted after a short stay in the ED.

Background Child injury is a global public health problem. Children spend 25–50% of their daytime in school and risks of school accidents are high. The purpose of this study is to perform a comprehensive analysis of game-related injuries. Methods A nationwide dataset of 36,002 school injury events that occurred in Israel between 2013 and 2019 and were served by the National EMS, was used. The relations between different variables were demonstrated using multidimensional frequency tables. Z-tests, chi-square tests, ANOVA tests, and J48 classification trees were used to analyze the data. Results The prevailing injury cause (36.8%) was “game”, 44.8% of which occur during breaks, and the most frequently injured body regions were head, hand, and leg/foot (47.2%, 26.7%, and 19.7%, respectively). Age was negatively correlated with head injuries and positively correlated with limb injuries. 33% of all injuries occur in the playground and 20.1% occur in the sports field. About 33.3% of game-related injuries in elementary schools occur during the 10:00 a.m. break and an additional 24.7% during the 12:00 p.m. lunch break. Conclusion Games are the prevailing cause of school injuries in Israel. Gender and age differences, and seasonal and circadian trends were observed. Understanding the patterns and the trends of school injuries can enable the development of effective prevention policies on the national, municipal, and local levels, focusing the efforts on the key factors affecting injury incidence. Efficient use of resources is necessary, taking into account resource and budget constraints. Efforts can include education of teachers and pupils in relation to school accidents, promoting a safer physical environment, safety education, staff development and family and community involvement, and coordinative training with a focus on proprioception.

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Background Medical emergencies such as anaphylaxis may require immediate use of emergency medication. Because of the low adherence of chronic patients (ie, carrying anti-anaphylactic medication) and the potentially long response time of emergency medical services (EMSs), alternative approaches to provide immediate first aid are required. A smartphone-based emergency response community (ERC) was established for patients with allergies to enable members to share their automatic adrenaline injector (AAI) with other patients who do not have their AAI at the onset of anaphylactic symptoms. The community is operated by a national EMS. In the first stage of the trial, children with food allergies and their parents were invited to join. Objective This study aimed to identify the factors that influence the willingness to join an ERC for a group of patients at risk of anaphylaxis. Methods The willingness to join an ERC was studied from different perspectives: the willingness of children with severe allergies to join an ERC, the willingness of their parents to join an ERC, the willingness of parents to enroll their children in an ERC, and the opinions of parents and children about the minimum age to join an ERC. Several types of independent variables were used: demographics, medical data, adherence, parenting style, and children's autonomy. A convenience sample of children and their parents who attended an annual meeting of a nonprofit organization for patients with food allergies was used. Results A total of 96 questionnaires, 73 by parents and 23 by children, were collected. Response rates were approximately 95%. Adherence was high: 22 out of 23 children (96%) and 22 out of 52 parents (42%) had their AAI when asked. Willingness to join the community was high among parents (95%) and among children (78%). Willingness of parents to enroll their children was 49% (36/73). The minimum age to join an ERC was 12.27 years (SD 3.02) in the parents’ opinion and 13.15 years (SD 3.44) in the children’s opinion. Conclusions Parents’ willingness to join an ERC was negatively correlated with parents’ age, child’s age, and parents’ adherence. This can be explained by the free-rider effect: parents who carried an AAI for their young child, but had low adherence, wanted to join the ERC to get an additional layer of emergency response. Children’s willingness to join the community was positively correlated with age and negatively correlated with the child’s emotional autonomy. Parents’ willingness to enroll their children in an ERC was positively correlated with child’s age and negatively correlated with parents’ adherence: again, this can be explained by the aforementioned free-rider effect. Parents’ and children’s opinions about the minimum age to join an ERC were negatively correlated with protective parenting style and positively correlated with monitoring parenting style.

The ever‐growing data acquisition speed represents a challenge for data analysis in materials sciences in general and the field of solar cells in particular. This is because many unsupervised and supervised learning algorithms require model re‐derivation when presented with new samples which are markedly different from those used for model construction. Dynamic segmentation addresses this problem by continuously updating the clusters structure, for example, by splitting old clusters or opening new ones, as new samples are presented. In this work we present the application of a Dynamic Classification Unit (DCU) to the study of the photovoltaic space. Using a database of 1165 metal oxide‐based solar cells, constructed from five libraries, we demonstrate that the DCU algorithm, when initiated with only 10 % of the database, correctly classified 82 % of the remaining, 90 % samples. At the same time the algorithm unveiled the presence of interesting trends, outliers and compositional activity cliffs. These abilities may prove useful for the analysis of the photovoltaic space and in turn may contribute to the design of solar cells with improved properties. We suggest that DCU and other dynamic clustering methods will find wide applications in the rapidly developing field of materials informatics.

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The association between emergency department (ED) length of stay (EDLOS) with in-hospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From the ED patients (n = 383,586) who visited an urban academic tertiary care medical center from January 2010 to December 2016, 78,478 older patients (age ≥60 years) were identified and stratified into three age subgroups: 60–74 (early elderly), 75–89 (late elderly), and ≥90 years (longevous elderly). We applied multiple machine learning approaches to identify the risk correlation trends between EDLOS and IHM, as well as boarding time (BT) and IHM. The incidence of IHM increased with age: 60–74 (2.7%), 75–89 (4.5%), and ≥90 years (6.3%). The best area under the receiver operating characteristic curve was obtained by Light Gradient Boosting Machine model for age groups 60–74, 75–89, and ≥90 years, which were 0.892 (95% CI, 0.870–0.916), 0.886 (95% CI, 0.861–0.911), and 0.838 (95% CI, 0.782–0.887), respectively. Our study showed that EDLOS and BT were statistically correlated with IHM (p < 0.001), and a significantly higher risk of IHM was found in low EDLOS and high BT. The flagged rate of quality assurance issues was higher in lower EDLOS ≤1 h (9.96%) vs. higher EDLOS 7 h <t≤ 8 h (1.84%). Special attention should be given to patients admitted after a short stay in the ED and a long BT, and new concepts of ED care processes including specific areas and teams dedicated to older patients care could be proposed to policymakers.