Earthquakes can cause significant damage and loss of life,necessitating immediate assessment of the resulting fatalities.Rapid assessment and timely revision of fatality estimates are crucial for effective emergency d...Earthquakes can cause significant damage and loss of life,necessitating immediate assessment of the resulting fatalities.Rapid assessment and timely revision of fatality estimates are crucial for effective emergency decisionmaking.This study using the February 6,2023,M_(S)8.0 and M_(S)7.9 Kahramanmaras,Türkiye earthquakes as an example to estimate the ultimate number of fatalities.An early Quick Rough Estimate(QRE)based on the number of deaths reported by the Disaster and Emergency Management Presidency of Türkiye(AFAD)is conducted,and it dynamically adjusts these estimates as new data becomes available.The range of estimates of the final number of deaths can be calculated as 31384–56475 based on the"the QRE of the second day multiplied by 2–3" rule,which incorporates the reported final deaths 50500.The Quasi-Linear and Adaptive Estimation(QLAE)method adaptively adjusts the final fatality estimate within two days and predicts subsequent reported deaths.The correct order of magnitude of the final death toll can be estimated as early as 13 hr after the M_(S)8.0 earthquake.In addition,additional earthquakes such as May 12,2008,M_(S)8.1 Wenchuan earthquake(China),September 8,2023,M_(S)7.2 Al Haouz earthquake(Morocco),November 3,2023,M_(S)5.8 Mid-Western Nepal earthquake,December 18,2023,M_(S)6.1 Jishishan earthquake(China),January 1,2024,M_(S)7.2 Noto Peninsula earthquake(Japan)and August 8,2023,Maui,Hawaii,fires are added again to verified the correctness of the model.The fatalities from the Maui fires are found to be approximately equivalent to those resulting from an M_(S)7.4 earthquake.These methods complement existing frameworks such as Quake Loss Assessment for Response and Mitigation(QLARM)and Prompt Assessment of Global.展开更多
In recent years, road accident fatalities in Nigeria have continued to be on the increase. Thus, urgent attention is needed to reduce or eliminate road accidents fatalities. To achieve this goal, the cumulative sum (C...In recent years, road accident fatalities in Nigeria have continued to be on the increase. Thus, urgent attention is needed to reduce or eliminate road accidents fatalities. To achieve this goal, the cumulative sum (Cusum) control chart scheme was designed for monitoring the road accident fatalities using the recorded occurrence of road accident fatalities in a state in the western part of Nigeria. The designed Cusum detects the period of the years when the highest occurrence of road accident fatalities occurred. These periods were observed to be festive periods such as Christmas, Easter, Eid-el- Kabir, and Eid-el-Moluod. Therefore, the festive periods of the year should be used as benchmark by road managers as periods where more attention or precaution measure should be put in place on the roads to drastically reduce or eliminate high occurrence of road accident fatalities. The designed Cusum control chart can be adapted for other states in the country and also for the larger society for detecting the periods when the rate of death as a result of road accidents was prevalent.展开更多
It has long been postulated that a relationship exists between commodity price cycles and fatalities in the mining industry.Previous studies have found only weak correlations in this area.This study analyses the fatal...It has long been postulated that a relationship exists between commodity price cycles and fatalities in the mining industry.Previous studies have found only weak correlations in this area.This study analyses the fatalities recorded in coal mines over the period 1985-2016 in the State of Queensland as a function of thermal coal price variation.The study finds that the relationship between fatalities and coal prices is not linear.One to two fatalities occur in most years independent of the thermal coal price.When the price of coal falls below AUD 55/tonne(non-inflation adjusted),the likelihood of an incident involving multiple fatalities increases.The probability can be estimated at 2 in 18 events(equivalent to 11%).This paper postulates that in difficult economic times,mining companies react by downsizing direct employees.If not carefully managed,this can result in loss of knowledge around safety systems,and reduced effectiveness of safety supervision.Because of labour cost advantages,some jobs previously undertaken by direct employees will be replaced by contractors.Increased contractor numbers contribute to increased risk of fatalities occurring,as contractors are over-represented in accident categories involving vehicle accidents,tire handling and crushing incidents.Mine inspectorates,mining,and mining contractor companies need to be especially vigilant to enforce health and safety management systems during periods of low coal prices.展开更多
Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number...Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics;emergency plans;equipment and infrastructure;collaborative agreements;personnel trainings;emergency communications;laboratory facilities;treatment protocols;security;and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.展开更多
Floods are among the most devastating natural hazards worldwide.While rainfall is the primary trigger of floods,human activities and climate change can exacerbate the impacts of floods and lead to more significant eco...Floods are among the most devastating natural hazards worldwide.While rainfall is the primary trigger of floods,human activities and climate change can exacerbate the impacts of floods and lead to more significant economic and social consequences.In this research,fluvial flood fatalities in the 1951–2020 period have been studied,analyzing the information reported in the Emergency Database(EM-DAT).The EM-DAT data were classified into five categories in terms of the number of events and fatalities connected with riverine floods,considering only events that caused more than 10 fatalities.The results show that the severity of flood-related fatalities is not equally distributed worldwide,but presents specific geographical patterns.The flood fatality coefficient,which represents the ratio between the total number of fatalities and the number of flood events,calculated for different countries,identified that the Southern,Eastern,and South-Eastern regions of Asia have the deadliest floods in the world.The number of flood events has been increasing since 1951 and peaked in 2007,following a relative decline since then.Though,the resulting fatalities do not follow a statistically significant trend.An analysis of the number of flood events in different decades shows that the 2001–2010 decade saw the highest number of events,which corresponds to the largest precipitation anomaly in the world.The lethality of riverine floods decreased over time,from 412 per flood in 1951–1960 to 67 in the 2011–2020 decade.This declining trend is probably a consequence of a more resilient environment and better risk reduction strategies.Based on the presented data and using regression analysis,relationships between flood fatalities and the number of flood events with population density and gross domestic product are developed and discussed.展开更多
Purpose:Road traffic injuries(RTIs)have been one of the most serious public health problems in China.The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in Ch...Purpose:Road traffic injuries(RTIs)have been one of the most serious public health problems in China.The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in China as well as regional differences.Methods:The cohort study analyzed the correlation between traffic investment and traffic fatalities,incorporating additional factors such as economic conditions,road infrastructure,population density,and lighting.The selected variables included the number of traffic fatalities,traffic investment,urban per capita road area,urban road length,road mileage,urban road lighting,population size,and per capita gross domestic product.Relevant data between 2004 and 2020 were collected for an analysis using a fixed effect regression model.Ap<0.05 is considered statistically significant.To reduce the heterogeneity caused by regional differences,the provinces were divided into 6 groups according to administrative districts,and the clustering standard error analysis was carried out.Results:Overall,there has been a significant improvement in road safety in China from 2004 to 2020,but some regions show an increase in traffic fatalities.The model reveals that traffic investment is significantly and positively correlated with the number of traffic fatalities.Holding all other factors constant,each 10,000 yuan increase in transport investment was associated with an average increase of 0.22 road traffic fatalities.In the analysis of regional differences,there was a significant positive correlation between traffic investment and traffic fatalities in the Northwest region and an increase of 10,000 yuan leads to an increase of 0.47.There was a significant negative correlation between road mileage,urban road lighting system,and population and traffic fatalities.For example,holding other factors constant,a 10,000 km reduction in road length would increase the number of traffic deaths by 45.56.The model results of urban per capita road area,urban road length,per capita gross domestic product,and the explained variables showed thatp>0.100,which was not statistically significant.Conclusions:Therefore,traffic investments are essential for governments to develop measures to enhance road safety and reduce the risk of road fatalities.Adjusting traffic road investment and other covariates is conducive to improving traffic safety and reducing the risk of road fatalities.The road safety situation in different regions of China varies greatly.Local governments should consider the actual conditions to provide better road safety configuration policies.展开更多
Objective： To analyze the crash and injury data in forensic medicine for years of 2004-2007. Methods： A sample of over 567 accident cases （9 pedestrians, 116 bicyclists, and 442 motor vehicle occupants） was consi...Objective： To analyze the crash and injury data in forensic medicine for years of 2004-2007. Methods： A sample of over 567 accident cases （9 pedestrians, 116 bicyclists, and 442 motor vehicle occupants） was considered from the Department of Forensic Medicine, Shahid Bahonar University of Kerman, involving drivers of all ages and covering a four-year period. Results： The male fatality rates were significantly higher than female ones. The groups at 15-30 years old and at 30-55 years old had the first and second highest numbers of deaths （40% and 34%, respectively）. There were substantial differences in distribution of injuries in motor vehicle occupants and pedestrians and bicyclists. Among motor vehicle occupants, there were more head injuries, such as skull fracture, brain contusion, subdural haemorrhage, and epidural haemorrhage. Nearly 77% of fatalities occurred during 08：00-22：00 in Sirjan. Internal bleeding was also higher in motor vehicle occupants. Pedestrians and bicyclists also had head injuries frequently. Conclusions： In spite of reduction of road traffic fatalities in Sirjan in 2007, it is still one of the cities with high road traffic fatality in the world. These results underline the importance of preventive strategies in transportation, suggesting that different methods are necessary to reduce fatalities of various traffic participants.展开更多
This article attempts to trace the status and many manifestations of erōs in Xenophon’s ethical and political thought.It examines its meaning in the narrow sense of“love and desire”and the broad sense of“affectiv...This article attempts to trace the status and many manifestations of erōs in Xenophon’s ethical and political thought.It examines its meaning in the narrow sense of“love and desire”and the broad sense of“affective feelings and friendship in the life of the family and the polis.”The principal goal is to demonstrate the remarkable coherence of Xenophon’s concept of erōs despite the diversity of the types of manifestation and visible differences in framing between male-male and male-female relationships.In addition,it will be shown that the principle of self-mastery as a vital criterion for the evaluation of sexual conduct is subordinated to what Xenophon perceives as the primary purpose of sexual intercourse:the procreation of progeny.展开更多
BACKGROUND Systemic immunoinflammatory diseases can affect multiple systems and organs.They have a severe course and severe complications,causing multiple organ failure and death.Quite often these patients are require...BACKGROUND Systemic immunoinflammatory diseases can affect multiple systems and organs.They have a severe course and severe complications,causing multiple organ failure and death.Quite often these patients are required to be hospitalized in the intensive care unit(ICU).Approximately 50% of patients with multisystem inflammatory syndrome associated with coronavirus disease 2019 in children and systemic lupus erythematosus need admission to the ICU.AIM To find early predictors of death in patients with immunoinflammatory diseases who are hospitalized in the ICU.METHODS The retrospective continuous cohort study included 51 patients(23 males,28 females)with immunoinflammatory diseases,including multisystem inflammatory syndrome associated with coronavirus disease 2019(n=18),systemic rheumatic diseases(n=24),and generalized infections(n=9).The patients ranged in age from 7 months to 17 years old and were admitted to the ICU of the clinic of Saint Petersburg State Pediatric Medical University from 2007 to 2023.RESULTS Thirteen patients(25.5%)died within 39(17;62)days after ICU admission.Patients with an unfavorable outcome were significantly older and were admitted to the ICU later than patients who survived(30 days vs 7 days,P=0.013)and had a longer stay in the ICU(30 days vs 6 days,P=0.003).The main predictors of the fatal outcome were age>162 months[odds ratio(OR)=10.7;95%confidence interval(CI):2.4-47.2,P=0.0006],time to ICU admission>26 days from the disease onset(OR=12.0;95%CI:2.6-55.3,P=0.008),preceding immune suppression treatment(OR=6.2;95%CI:1.6-24.0,P=0.013),invasive mycosis during the ICU stay(OR=18.8;95%CI:1.9-184.1,P=0.0005),systemic rheumatic diseases(OR=7.2;95%CI:1.7-31.1,P=0.004),and ICU stay over 15 days(OR=19.1;95%CI:4.0-91.8,P=0.00003).Multiple regression analysis(r^(2)=0.422,P<0.000002)identified two predictors of the fatal outcomes:Systemic rheumatic diseases(P=0.015)and ICU stay over 15 days(P=0.00002).CONCLUSION Identifying patients at high risk of an unfavorable outcome is the subject of the most careful monitoring and appropriate treatment program.Avoiding ICU stays for patients with systemic rheumatic diseases,close monitoring,and preventing invasive mycosis might improve the outcome in children with systemic immunemediated diseases.展开更多
Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 ...Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 during concurrent outbreaks in Marburg and Frankfurt,Germany,and in Belgrade,Serbia,linked to laboratory use of African green monkeys imported from Uganda.Subsequent outbreaks and isolated cases have been reported in various African countries,including Angola,the Democratic Republic of the Congo,Equatorial Guinea,Ghana,Guinea,Kenya,Rwanda,South Africa(in an individual with recent travel to Zimbabwe),Tanzania,and Uganda.Initial human MVD infections typically occur due to prolonged exposure to mines or caves inhabited by Rousettus aegyptiacus fruit bats,the natural hosts of the virus.展开更多
Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, r...Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.展开更多
Motorcycle ownership in Vietnam has increased exponentially during the last two decades.As a result,traffic congestion,emissions,and traffic safety have been on the rise.Of particular concern is the significant increa...Motorcycle ownership in Vietnam has increased exponentially during the last two decades.As a result,traffic congestion,emissions,and traffic safety have been on the rise.Of particular concern is the significant increase in the number of traffic accidents due to higher traffic volume that is stimulated by economic development and improved households’economic mobility.During this time frame,many programs,such as traffic safety awareness campaign,have been developed and implemented by transportation agencies to reduce traffic fatalities.This study seeks to understand the long-term effect of policy intervention on traffic fatalities.This is accomplished by developing a log-linear regression model which the response variable is the number of traffic fatalities between 1990 and 2019 and the independent variables include Human Development Index(HDI),motorcycle ownership,and policy interventions.The model estimation results indicate that:(1)a higher degree of economic development(HDI)corresponds to lower traffic fatalities,(2)the motorcycle helmet law has lowered the number of annual traffic fatalities since its enactment,and(3)a higher number of motorcycle trips corresponds to a higher number of traffic fatalities.Based on this study’s findings,it is recommended that transportation agencies in Vietnam develop and promote an alternative transportation mode.展开更多
Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada...Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.展开更多
BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was ...BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was successfully treated through venoarterial extracorporeal membrane oxygenation(VA-ECMO)and in which detailed toxicological analyses of the aconite roots and biological samples were performed using liquid chromatography-tandem mass spectrometry(LC-MS/MS).CASE SUMMARY A 23-year-old male presented to the emergency room with circulatory collapse and ventricular arrhythmia after ingesting approximately half of a root labeled,“Aconitum japonicum Thunb”.Two hours after arrival,VA-ECMO was initiated as circulatory collapse became refractory to antiarrhythmics and vasopressors.Nine hours after arrival,an electrocardiogram revealed a return to sinus rhythm.The patient was weaned off VA-ECMO and the ventilator on hospital days 3 and 5,respectively.On hospital day 15,he was transferred to a psychiatric hospital.The other half of the root and his biological samples were toxicologically analyzed using LC-MS/MS,revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in the root.Serum on admission contained 1.50 ng/mL of aconitine.Beyond hospital day 2,neither were detected.Urine on admission showed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine,but these rapidly decreased after hospital day 3.CONCLUSION The key to saving the life of a patient with severe aconite poisoning is to introduce VA-ECMO as soon as possible.展开更多
This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statisti...This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.展开更多
BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale c...BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale cannot be fully understood due to lack of information.AIM To identify key factors that may explain the variability in case lethality across countries.METHODS We identified 21 Potential risk factors for coronavirus disease 2019(COVID-19)case fatality rate for all the countries with available data.We examined univariate relationships of each variable with case fatality rate(CFR),and all independent variables to identify candidate variables for our final multiple model.Multiple regression analysis technique was used to assess the strength of relationship.RESULTS The mean of COVID-19 mortality was 1.52±1.72%.There was a statistically significant inverse correlation between health expenditure,and number of computed tomography scanners per 1 million with CFR,and significant direct correlation was found between literacy,and air pollution with CFR.This final model can predict approximately 97%of the changes in CFR.CONCLUSION The current study recommends some new predictors explaining affect mortality rate.Thus,it could help decision-makers develop health policies to fight COVID-19.展开更多
Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Sahara...Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.展开更多
Rationale:Paraquat,a highly toxic bipyridyl herbicide lacking a specific antidote,poses severe risks upon ingestion.However,the diagnosis of paraquat poisoning is complicated by its nonspecific initial symptoms,partic...Rationale:Paraquat,a highly toxic bipyridyl herbicide lacking a specific antidote,poses severe risks upon ingestion.However,the diagnosis of paraquat poisoning is complicated by its nonspecific initial symptoms,particularly when a detailed exposure history is not provided.Patient’s Concern:A 33-year-old man inadvertently ingested an unknown liquid and presented to medical services a day later with complaints of ongoing nausea,vomiting,and diarrhea.The assessment revealed elevated serum creatinine,signaling acute kidney injury,initially thought due to gastroenteritis and dehydration.Diagnosis:Acute renal insufficiency due to paraquat poisoning.Interventions:The treatment involved fluid resuscitation and antibiotics,but his decline led to intensive care unit transfer.Subsequent chest computed tomography scans indicated lung changes indicative of paraquat poisoning.A detailed history review and comprehensive blood and urine toxicology screens confirmed the diagnosis.Subsequently,aggressive interventions such as hemoperfusion and continuous renal replacement therapy were initiated,yet there was a further decline in respiratory function,necessitating mechanical ventilation.The prognosis was poor,and ultimately,the family chose to withdraw care.Outcomes:The patient succumbed to his illness.Lessons:This case underscores the importance of promptly and accurately diagnosing paraquat poisoning,as its vague early signs can lead to diagnostic delays,crucial due to the condition’s rapid progression.Alertness to paraquat poisoning is essential in patients with sudden gastrointestinal and renal symptoms post-exposure.Additionally,it underscores the necessity for public health measures to avert paraquat ingestion and advance therapeutic approaches.展开更多
This paper examines the relationship between fatal road traffic accidents and potential predictors using multilayer perceptron artificial neural network (MLANN) models. The initial analysis employed twelve potential p...This paper examines the relationship between fatal road traffic accidents and potential predictors using multilayer perceptron artificial neural network (MLANN) models. The initial analysis employed twelve potential predictors, including traffic volume, prevailing weather conditions, roadway characteristics and features, drivers’ age and gender, and number of lanes. Based on the output of the model and the variables’ importance factors, seven significant variables are identified and used for further analysis to improve the performance of models. The model is optimized by systematically changing the parameters, including the number of hidden layers and the activation function of both the hidden and output layers. The performances of the MLANN models are evaluated using the percentage of the achieved accuracy, R-squared, and Sum of Square Error (SSE) functions.展开更多
Although there has been a slight decrease in road traffic crashes, fatalities, and injuries in recent years, HCMC (Ho Chi Minh City) will continue to encounter challenges in mitigating and preventing road crashes. Thi...Although there has been a slight decrease in road traffic crashes, fatalities, and injuries in recent years, HCMC (Ho Chi Minh City) will continue to encounter challenges in mitigating and preventing road crashes. This study analyzes road crash data from the past five years, obtained from the Road-Railway Police Bureau (PC08) and TSB (Traffic Safety Board) in HCMC. This analysis gives us valuable insights into road crash patterns, characteristics, and underlying causes. This comprehensive understanding serves as a scientific foundation for developing cohesive strategies and implementing targeted solutions to address road traffic safety issues more effectively in the future.展开更多
基金supported by the National Natural Science Foundation of China(NSFC,grant number U2039207).
文摘Earthquakes can cause significant damage and loss of life,necessitating immediate assessment of the resulting fatalities.Rapid assessment and timely revision of fatality estimates are crucial for effective emergency decisionmaking.This study using the February 6,2023,M_(S)8.0 and M_(S)7.9 Kahramanmaras,Türkiye earthquakes as an example to estimate the ultimate number of fatalities.An early Quick Rough Estimate(QRE)based on the number of deaths reported by the Disaster and Emergency Management Presidency of Türkiye(AFAD)is conducted,and it dynamically adjusts these estimates as new data becomes available.The range of estimates of the final number of deaths can be calculated as 31384–56475 based on the"the QRE of the second day multiplied by 2–3" rule,which incorporates the reported final deaths 50500.The Quasi-Linear and Adaptive Estimation(QLAE)method adaptively adjusts the final fatality estimate within two days and predicts subsequent reported deaths.The correct order of magnitude of the final death toll can be estimated as early as 13 hr after the M_(S)8.0 earthquake.In addition,additional earthquakes such as May 12,2008,M_(S)8.1 Wenchuan earthquake(China),September 8,2023,M_(S)7.2 Al Haouz earthquake(Morocco),November 3,2023,M_(S)5.8 Mid-Western Nepal earthquake,December 18,2023,M_(S)6.1 Jishishan earthquake(China),January 1,2024,M_(S)7.2 Noto Peninsula earthquake(Japan)and August 8,2023,Maui,Hawaii,fires are added again to verified the correctness of the model.The fatalities from the Maui fires are found to be approximately equivalent to those resulting from an M_(S)7.4 earthquake.These methods complement existing frameworks such as Quake Loss Assessment for Response and Mitigation(QLARM)and Prompt Assessment of Global.
文摘In recent years, road accident fatalities in Nigeria have continued to be on the increase. Thus, urgent attention is needed to reduce or eliminate road accidents fatalities. To achieve this goal, the cumulative sum (Cusum) control chart scheme was designed for monitoring the road accident fatalities using the recorded occurrence of road accident fatalities in a state in the western part of Nigeria. The designed Cusum detects the period of the years when the highest occurrence of road accident fatalities occurred. These periods were observed to be festive periods such as Christmas, Easter, Eid-el- Kabir, and Eid-el-Moluod. Therefore, the festive periods of the year should be used as benchmark by road managers as periods where more attention or precaution measure should be put in place on the roads to drastically reduce or eliminate high occurrence of road accident fatalities. The designed Cusum control chart can be adapted for other states in the country and also for the larger society for detecting the periods when the rate of death as a result of road accidents was prevalent.
文摘It has long been postulated that a relationship exists between commodity price cycles and fatalities in the mining industry.Previous studies have found only weak correlations in this area.This study analyses the fatalities recorded in coal mines over the period 1985-2016 in the State of Queensland as a function of thermal coal price variation.The study finds that the relationship between fatalities and coal prices is not linear.One to two fatalities occur in most years independent of the thermal coal price.When the price of coal falls below AUD 55/tonne(non-inflation adjusted),the likelihood of an incident involving multiple fatalities increases.The probability can be estimated at 2 in 18 events(equivalent to 11%).This paper postulates that in difficult economic times,mining companies react by downsizing direct employees.If not carefully managed,this can result in loss of knowledge around safety systems,and reduced effectiveness of safety supervision.Because of labour cost advantages,some jobs previously undertaken by direct employees will be replaced by contractors.Increased contractor numbers contribute to increased risk of fatalities occurring,as contractors are over-represented in accident categories involving vehicle accidents,tire handling and crushing incidents.Mine inspectorates,mining,and mining contractor companies need to be especially vigilant to enforce health and safety management systems during periods of low coal prices.
文摘Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics;emergency plans;equipment and infrastructure;collaborative agreements;personnel trainings;emergency communications;laboratory facilities;treatment protocols;security;and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.
基金Polish Ministry of Education and Science for the Institute of Geophysics Polish Academy of Sciences.
文摘Floods are among the most devastating natural hazards worldwide.While rainfall is the primary trigger of floods,human activities and climate change can exacerbate the impacts of floods and lead to more significant economic and social consequences.In this research,fluvial flood fatalities in the 1951–2020 period have been studied,analyzing the information reported in the Emergency Database(EM-DAT).The EM-DAT data were classified into five categories in terms of the number of events and fatalities connected with riverine floods,considering only events that caused more than 10 fatalities.The results show that the severity of flood-related fatalities is not equally distributed worldwide,but presents specific geographical patterns.The flood fatality coefficient,which represents the ratio between the total number of fatalities and the number of flood events,calculated for different countries,identified that the Southern,Eastern,and South-Eastern regions of Asia have the deadliest floods in the world.The number of flood events has been increasing since 1951 and peaked in 2007,following a relative decline since then.Though,the resulting fatalities do not follow a statistically significant trend.An analysis of the number of flood events in different decades shows that the 2001–2010 decade saw the highest number of events,which corresponds to the largest precipitation anomaly in the world.The lethality of riverine floods decreased over time,from 412 per flood in 1951–1960 to 67 in the 2011–2020 decade.This declining trend is probably a consequence of a more resilient environment and better risk reduction strategies.Based on the presented data and using regression analysis,relationships between flood fatalities and the number of flood events with population density and gross domestic product are developed and discussed.
文摘Purpose:Road traffic injuries(RTIs)have been one of the most serious public health problems in China.The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in China as well as regional differences.Methods:The cohort study analyzed the correlation between traffic investment and traffic fatalities,incorporating additional factors such as economic conditions,road infrastructure,population density,and lighting.The selected variables included the number of traffic fatalities,traffic investment,urban per capita road area,urban road length,road mileage,urban road lighting,population size,and per capita gross domestic product.Relevant data between 2004 and 2020 were collected for an analysis using a fixed effect regression model.Ap<0.05 is considered statistically significant.To reduce the heterogeneity caused by regional differences,the provinces were divided into 6 groups according to administrative districts,and the clustering standard error analysis was carried out.Results:Overall,there has been a significant improvement in road safety in China from 2004 to 2020,but some regions show an increase in traffic fatalities.The model reveals that traffic investment is significantly and positively correlated with the number of traffic fatalities.Holding all other factors constant,each 10,000 yuan increase in transport investment was associated with an average increase of 0.22 road traffic fatalities.In the analysis of regional differences,there was a significant positive correlation between traffic investment and traffic fatalities in the Northwest region and an increase of 10,000 yuan leads to an increase of 0.47.There was a significant negative correlation between road mileage,urban road lighting system,and population and traffic fatalities.For example,holding other factors constant,a 10,000 km reduction in road length would increase the number of traffic deaths by 45.56.The model results of urban per capita road area,urban road length,per capita gross domestic product,and the explained variables showed thatp>0.100,which was not statistically significant.Conclusions:Therefore,traffic investments are essential for governments to develop measures to enhance road safety and reduce the risk of road fatalities.Adjusting traffic road investment and other covariates is conducive to improving traffic safety and reducing the risk of road fatalities.The road safety situation in different regions of China varies greatly.Local governments should consider the actual conditions to provide better road safety configuration policies.
文摘Objective： To analyze the crash and injury data in forensic medicine for years of 2004-2007. Methods： A sample of over 567 accident cases （9 pedestrians, 116 bicyclists, and 442 motor vehicle occupants） was considered from the Department of Forensic Medicine, Shahid Bahonar University of Kerman, involving drivers of all ages and covering a four-year period. Results： The male fatality rates were significantly higher than female ones. The groups at 15-30 years old and at 30-55 years old had the first and second highest numbers of deaths （40% and 34%, respectively）. There were substantial differences in distribution of injuries in motor vehicle occupants and pedestrians and bicyclists. Among motor vehicle occupants, there were more head injuries, such as skull fracture, brain contusion, subdural haemorrhage, and epidural haemorrhage. Nearly 77% of fatalities occurred during 08：00-22：00 in Sirjan. Internal bleeding was also higher in motor vehicle occupants. Pedestrians and bicyclists also had head injuries frequently. Conclusions： In spite of reduction of road traffic fatalities in Sirjan in 2007, it is still one of the cities with high road traffic fatality in the world. These results underline the importance of preventive strategies in transportation, suggesting that different methods are necessary to reduce fatalities of various traffic participants.
文摘This article attempts to trace the status and many manifestations of erōs in Xenophon’s ethical and political thought.It examines its meaning in the narrow sense of“love and desire”and the broad sense of“affective feelings and friendship in the life of the family and the polis.”The principal goal is to demonstrate the remarkable coherence of Xenophon’s concept of erōs despite the diversity of the types of manifestation and visible differences in framing between male-male and male-female relationships.In addition,it will be shown that the principle of self-mastery as a vital criterion for the evaluation of sexual conduct is subordinated to what Xenophon perceives as the primary purpose of sexual intercourse:the procreation of progeny.
文摘BACKGROUND Systemic immunoinflammatory diseases can affect multiple systems and organs.They have a severe course and severe complications,causing multiple organ failure and death.Quite often these patients are required to be hospitalized in the intensive care unit(ICU).Approximately 50% of patients with multisystem inflammatory syndrome associated with coronavirus disease 2019 in children and systemic lupus erythematosus need admission to the ICU.AIM To find early predictors of death in patients with immunoinflammatory diseases who are hospitalized in the ICU.METHODS The retrospective continuous cohort study included 51 patients(23 males,28 females)with immunoinflammatory diseases,including multisystem inflammatory syndrome associated with coronavirus disease 2019(n=18),systemic rheumatic diseases(n=24),and generalized infections(n=9).The patients ranged in age from 7 months to 17 years old and were admitted to the ICU of the clinic of Saint Petersburg State Pediatric Medical University from 2007 to 2023.RESULTS Thirteen patients(25.5%)died within 39(17;62)days after ICU admission.Patients with an unfavorable outcome were significantly older and were admitted to the ICU later than patients who survived(30 days vs 7 days,P=0.013)and had a longer stay in the ICU(30 days vs 6 days,P=0.003).The main predictors of the fatal outcome were age>162 months[odds ratio(OR)=10.7;95%confidence interval(CI):2.4-47.2,P=0.0006],time to ICU admission>26 days from the disease onset(OR=12.0;95%CI:2.6-55.3,P=0.008),preceding immune suppression treatment(OR=6.2;95%CI:1.6-24.0,P=0.013),invasive mycosis during the ICU stay(OR=18.8;95%CI:1.9-184.1,P=0.0005),systemic rheumatic diseases(OR=7.2;95%CI:1.7-31.1,P=0.004),and ICU stay over 15 days(OR=19.1;95%CI:4.0-91.8,P=0.00003).Multiple regression analysis(r^(2)=0.422,P<0.000002)identified two predictors of the fatal outcomes:Systemic rheumatic diseases(P=0.015)and ICU stay over 15 days(P=0.00002).CONCLUSION Identifying patients at high risk of an unfavorable outcome is the subject of the most careful monitoring and appropriate treatment program.Avoiding ICU stays for patients with systemic rheumatic diseases,close monitoring,and preventing invasive mycosis might improve the outcome in children with systemic immunemediated diseases.
文摘Marburg virus disease(MVD)is a highly fatal illness,with a case fatality rate of up to 88%,though this rate can be significantly reduced with prompt and effective patient care.The disease was first identified in 1967 during concurrent outbreaks in Marburg and Frankfurt,Germany,and in Belgrade,Serbia,linked to laboratory use of African green monkeys imported from Uganda.Subsequent outbreaks and isolated cases have been reported in various African countries,including Angola,the Democratic Republic of the Congo,Equatorial Guinea,Ghana,Guinea,Kenya,Rwanda,South Africa(in an individual with recent travel to Zimbabwe),Tanzania,and Uganda.Initial human MVD infections typically occur due to prolonged exposure to mines or caves inhabited by Rousettus aegyptiacus fruit bats,the natural hosts of the virus.
文摘Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.
文摘Motorcycle ownership in Vietnam has increased exponentially during the last two decades.As a result,traffic congestion,emissions,and traffic safety have been on the rise.Of particular concern is the significant increase in the number of traffic accidents due to higher traffic volume that is stimulated by economic development and improved households’economic mobility.During this time frame,many programs,such as traffic safety awareness campaign,have been developed and implemented by transportation agencies to reduce traffic fatalities.This study seeks to understand the long-term effect of policy intervention on traffic fatalities.This is accomplished by developing a log-linear regression model which the response variable is the number of traffic fatalities between 1990 and 2019 and the independent variables include Human Development Index(HDI),motorcycle ownership,and policy interventions.The model estimation results indicate that:(1)a higher degree of economic development(HDI)corresponds to lower traffic fatalities,(2)the motorcycle helmet law has lowered the number of annual traffic fatalities since its enactment,and(3)a higher number of motorcycle trips corresponds to a higher number of traffic fatalities.Based on this study’s findings,it is recommended that transportation agencies in Vietnam develop and promote an alternative transportation mode.
文摘Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.
文摘BACKGROUND Most species of aconite contain highly toxic aconitines,the oral ingestion of which can be fatal,primarily because they cause ventricular arrhythmias.We describe a case of severe aconite poisoning that was successfully treated through venoarterial extracorporeal membrane oxygenation(VA-ECMO)and in which detailed toxicological analyses of the aconite roots and biological samples were performed using liquid chromatography-tandem mass spectrometry(LC-MS/MS).CASE SUMMARY A 23-year-old male presented to the emergency room with circulatory collapse and ventricular arrhythmia after ingesting approximately half of a root labeled,“Aconitum japonicum Thunb”.Two hours after arrival,VA-ECMO was initiated as circulatory collapse became refractory to antiarrhythmics and vasopressors.Nine hours after arrival,an electrocardiogram revealed a return to sinus rhythm.The patient was weaned off VA-ECMO and the ventilator on hospital days 3 and 5,respectively.On hospital day 15,he was transferred to a psychiatric hospital.The other half of the root and his biological samples were toxicologically analyzed using LC-MS/MS,revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in the root.Serum on admission contained 1.50 ng/mL of aconitine.Beyond hospital day 2,neither were detected.Urine on admission showed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine,but these rapidly decreased after hospital day 3.CONCLUSION The key to saving the life of a patient with severe aconite poisoning is to introduce VA-ECMO as soon as possible.
文摘This article compares the size of selected subsets using nonparametric subset selection rules with two different scoring rules for the observations. The scoring rules are based on the expected values of order statistics of the uniform distribution (yielding rank values) and of the normal distribution (yielding normal score values). The comparison is made using state motor vehicle traffic fatality rates, published in a 2016 article, with fifty-one states (including DC as a state) and over a nineteen-year period (1994 through 2012). The earlier study considered four block design selection rules—two for choosing a subset to contain the “best” population (i.e., state with lowest mean fatality rate) and two for the “worst” population (i.e., highest mean rate) with a probability of correct selection chosen to be 0.90. Two selection rules based on normal scores resulted in selected subset sizes substantially smaller than corresponding rules based on ranks (7 vs. 16 and 3 vs. 12). For two other selection rules, the subsets chosen were very close in size (within one). A comparison is also made using state homicide rates, published in a 2022 article, with fifty states and covering eight years. The results are qualitatively the same as those obtained with the motor vehicle traffic fatality rates.
文摘BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale cannot be fully understood due to lack of information.AIM To identify key factors that may explain the variability in case lethality across countries.METHODS We identified 21 Potential risk factors for coronavirus disease 2019(COVID-19)case fatality rate for all the countries with available data.We examined univariate relationships of each variable with case fatality rate(CFR),and all independent variables to identify candidate variables for our final multiple model.Multiple regression analysis technique was used to assess the strength of relationship.RESULTS The mean of COVID-19 mortality was 1.52±1.72%.There was a statistically significant inverse correlation between health expenditure,and number of computed tomography scanners per 1 million with CFR,and significant direct correlation was found between literacy,and air pollution with CFR.This final model can predict approximately 97%of the changes in CFR.CONCLUSION The current study recommends some new predictors explaining affect mortality rate.Thus,it could help decision-makers develop health policies to fight COVID-19.
文摘Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.
文摘Rationale:Paraquat,a highly toxic bipyridyl herbicide lacking a specific antidote,poses severe risks upon ingestion.However,the diagnosis of paraquat poisoning is complicated by its nonspecific initial symptoms,particularly when a detailed exposure history is not provided.Patient’s Concern:A 33-year-old man inadvertently ingested an unknown liquid and presented to medical services a day later with complaints of ongoing nausea,vomiting,and diarrhea.The assessment revealed elevated serum creatinine,signaling acute kidney injury,initially thought due to gastroenteritis and dehydration.Diagnosis:Acute renal insufficiency due to paraquat poisoning.Interventions:The treatment involved fluid resuscitation and antibiotics,but his decline led to intensive care unit transfer.Subsequent chest computed tomography scans indicated lung changes indicative of paraquat poisoning.A detailed history review and comprehensive blood and urine toxicology screens confirmed the diagnosis.Subsequently,aggressive interventions such as hemoperfusion and continuous renal replacement therapy were initiated,yet there was a further decline in respiratory function,necessitating mechanical ventilation.The prognosis was poor,and ultimately,the family chose to withdraw care.Outcomes:The patient succumbed to his illness.Lessons:This case underscores the importance of promptly and accurately diagnosing paraquat poisoning,as its vague early signs can lead to diagnostic delays,crucial due to the condition’s rapid progression.Alertness to paraquat poisoning is essential in patients with sudden gastrointestinal and renal symptoms post-exposure.Additionally,it underscores the necessity for public health measures to avert paraquat ingestion and advance therapeutic approaches.
文摘This paper examines the relationship between fatal road traffic accidents and potential predictors using multilayer perceptron artificial neural network (MLANN) models. The initial analysis employed twelve potential predictors, including traffic volume, prevailing weather conditions, roadway characteristics and features, drivers’ age and gender, and number of lanes. Based on the output of the model and the variables’ importance factors, seven significant variables are identified and used for further analysis to improve the performance of models. The model is optimized by systematically changing the parameters, including the number of hidden layers and the activation function of both the hidden and output layers. The performances of the MLANN models are evaluated using the percentage of the achieved accuracy, R-squared, and Sum of Square Error (SSE) functions.
文摘Although there has been a slight decrease in road traffic crashes, fatalities, and injuries in recent years, HCMC (Ho Chi Minh City) will continue to encounter challenges in mitigating and preventing road crashes. This study analyzes road crash data from the past five years, obtained from the Road-Railway Police Bureau (PC08) and TSB (Traffic Safety Board) in HCMC. This analysis gives us valuable insights into road crash patterns, characteristics, and underlying causes. This comprehensive understanding serves as a scientific foundation for developing cohesive strategies and implementing targeted solutions to address road traffic safety issues more effectively in the future.
