Design of Cusum Scheme for Monitoring Road Accident Fatalities

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.

A study of mining fatalities and coal price variation

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.

Assessing Healthcare Facilities Preparedness for Mass Fatalities Incident

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.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

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.

Severe aconite poisoning successfully treated with veno-arterial extracorporeal membrane oxygenation:A case report

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.

Comparison of Block Design Nonparametric Subset Selection Rules Based on Alternative Scoring Rules

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.

Country-based modelling of COVID-19 case fatality rate:A multiple regression analysis

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.

Predictors of Fatal Outcome in Hospitalised Adult Patients with Acute Kidney Injury at Two Tertiary Hospitals in Sub-Saharan Africa

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.

An In-Depth Analysis of Road Fatal Crash Patterns and Discussions in Ho Chi Minh City

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.

Quantity:a parameter deciding various health hazards

Plants are vital to the survival of life on e arth and have enormous implications for both the environment and human well-being.Plants carr y both medicinal and toxic properties.The plants were used by people traditionally for medicinal purposes.But people were not aware of the concentration of the dose s.So,excessive quantity of dose s may lead to severe toxic effects on the human body.This topic discusses the potential hazards of toxic plants on human health.There are many plants around the world that can cause adverse effects,ranging from mild irritation to severe organ damage or death.This review focuses on the plants which are available locally used as medicines carrying toxic properties too.It is essential to learn to recognize them and avoid touching or ingesting them.If exposure does occur,prompt medical attention is necessary.Understanding the risks associated with toxic plants can help individuals take the necessary precautions to protect their health.

Flood Hazards in Erbil City Kurdistan Region Iraq, 2021: A Case Study

Erbil city is constructed in a flat plain with moderate gradient increasing northwards, the plain is dissected by tens of ephemeral wadis. The maximum elevation in the high lands NE of Erbil city is 1062 m (a.s.l.), whereas the elevation of the center of Erbil city is 420 m (a.s.l.). The average gradient from the highest part to the center of the city is 2.15%, increasing towards northeast to reach 4.79%. The mean annual rainfall is 365 mm, while the average monthly rainfall is about 24.42 mm. The site of the city is mainly covered by alluvial fan sediments. Towards northeast, however, the exposures of the Bia Hassan Formation, which consists of alternation of conglomerate and claystone cover considerable areas (82 km2) and form the high lands NE of Erbil city. The exposed rocks are thick claystone alternating with coarse conglomerate. Two very heavy torrential rain events have caused flash floods in Erbil city on 30th October and 17th December 2021. The rainfall intensities were 52 mm/day and 60 mm/day, respectively, causing destructive floods. The most affected areas were Zirin (north of Erbil) and Dara Too (northeast of Erbil), respectively, with very heavy property damages and tens of fatalities. The main reasons for the floods were the partially constructed embankments of the 150 m ring-road, and the urban development within large and wide drainage basins. Different climate data were used for the purpose of this article, with field checks.

Road Traffic Accidents in Ghana: A Public Health Concern, and a Call for Action in Ghana, (and the Sub-Region)

This paper highlights the increasing problem of road traffic accident (RTA) related morbidity and mortality in Ghana, and the public health measures needed to control the problem. Descriptive data in the public domain from statutory bodies and media houses reports on country RTA information, as well as academic papers on the problem, were used as source of information about the problem. The observed trend in Ghana indicates that RTA related fatalities and injuries continue to be increasing, as morbidity and mortality factors since the year 2000. Most of the remedial measures suggested in academic papers, and state agencies measures to curb the RTA trend in Ghana to date, have discussed the problem in terms of injury and safety issues/measures. This paper suggests that the increasing RTAs with associated morbidity and mortality in Ghana need to be looked at more as a public health problem and priority that requires prompt tackling using a public health problem orientated approach and measures, than just as a safety problem due to RTAs’, as is currently done.

A Preliminary Study on the Probabilistic Estimation of Deaths from Future Earthquakes in North China

During the period from 1800 to 1989,the degree of fatalities(?from earthquakes in North China(Lat.34.0°-42.0°N,Long.107.5°-125.0°E)varied exponentially with the frequency of earthquake events(N),namely:N=37.71 exp(-0.72?(E-logD,D:deaths).For the periods from 1988 to 1998 and from 1999 to 2009,the probabilities for earthquakes to cause one thousand or more deaths in North China are estimated to be 0.37 and 0.50,respectively,by using the Gumbel’s extreme value theory.

An Assessment of an Urban Development-Flood-Impact Relationship in a Near Millionaire City of Cameroon (Bamenda)

Since the 1990s flood water hazards have recurrently created reason vexing moments on the Cameroonian urban folk of major and minor towns by inflicting fatality toll beating-off manned efforts to mitigate the ugliness unleashed. Flood catastrophe in frequency and toll in towns sited on more inland highland towns like Bamenda has given birth to dynamic survival strategies since impacts change in space and time. Northern Bamenda has emerged as haven for ravaging River Mezam with rising forms of flood havoc on humans and their investments. Primary and secondary data collected from related stakeholders (government and municipal officials concerned with abating the flood occurrence and managing its aftermath as well as individuals who consciously or not trigger the floods). The aim of this study was to relativize flood water bearing on urban population reactions in the wake of the rising calamity. Results reveal that flood trends are advancing yearly in the like of fatalities that systematically make nonsense of urban setup human endeavours to tame floods. This study considers that an urgent urban flood hazard perception revolution must be engaged for this unplanned urban front that is developing where the topography presents a funnelling effect to stream water and so obviously has no respect for the existing flood countering socio-economic and engineering adaptations. Such flood disrespect for urban humans call for man-centred innovative and comprehensive paradigms should there be any hope for less hazardous sustainable city growth in Cameroon.

Indicators of fatal outcome in severe Plasmodium falciparum malaria:a study in a tertiary-care hospital in Thailand

Objective:To illustrate the clinical features and investigate the indicators associated with a fatal outcome in adult patients with severe Plasmodium falciparum malaria admitted to the Hospital for Tropical Diseases,Bangkok,Thailand.Methods:We studied 202 adult malaria patients admitted to the Intensive Care Unit.A total of 43 clinical variables were identified by univariate and logistic regression analyses,to eliminate confounding factors.Results:Regarding the statistical methods,only 6 variables-jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate,and white blood cell count-were significant indicators of death, with adjusted odds ratios(95%CI) of 15.2(2.1-32.3).4.3(2.3-12.6),3.3(2.3-5.7),2.4(1.9-3.5),2.2 (1.5-2.6),and 1.7(1.2-3.1),respectively.Conclusions:Our study found that jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate and white blood cell count were indicators of fatal outcome in severe Plasmodium falciparum malaria.Further studies on the fatal indicators in severe malaria need to be compared with data from different geographical areas,to construct practical measures to address potentially fatal indicators in different settings.

Clinical and Familial Characteristics of Ten Chinese Patients with Fatal Family Insomnia

Objective Fatal familial insomnia （FFI） is an autosomal dominant prion disease characterized clinically by inattention, sleep loss, dysautonomia, and motor signs. This study is aimed to investigate clinical and familial characteristics often Chinese Patients with FFI. Methods We identified ten FFI cases from the surveillance network for Creutafeldt- Jakob disease （CJD） in China.Final diagnosis of FFI cases was made in accordance with the WHO criteria for CJD.The main clinical features and family histories of these ten FFI cases were analyzed. Results The median age of ten cases at onset was 38 years （from 19 to 55）. The foremost symptoms seemed to be various, including sleep disturbances, vision disorder, dizziness and anorexia. Sleep disturbances appeared in all cases and lasted in the whole clinical courses. Progressive sympathetic symptoms, memory loss, movement disturbances, myoclonus and hypertension were also frequently observed. The median duration of the disease was 9.5 months. EEG and MRI did not figure out special abnormality. 14-3-3 protein in CSF was positive in five out of eight tested patients. Clear family histories were identified in 8 patients. Conclusion The data from our study confirm that the Chinese FFI cases have similar clinical characteristics as that of the Caucasian cases. Compared with other genetic CJD associated mutations, the genetic frequencies of D178N in PRNP are apparently high among the Chinese cases.

Elevated Platelet Activating Factor Level in Ischemia-Related Arrhythmia and Its Electrophysiological Effect on Myocardium

Objective The mechanism through which platelet activating factor （PAF） induces cardiac electrical activity and arrhythmia is not well understood and previous studies have suggested a potential involvement of ion channels in its action. The present study was aimed to clarify the role of PAF in fatal arrhythmias following acute myocardia infarction （AMI） and the underlying mechanism. Methods （1） Blood PAF levels were measured among 72 AMI patients at the time of diagnosis with AMI and 48 h later, and their electrocardiogram （ECG） was recorded continuously. （2） Ischemia simulation and surface electrocardiogram were conducted in 20 pigs and their PAF levels were measured. （3） PAF perfusion and standard microelectrode recording were performed on guinea pig papillarymuscles. Results In both humans and pigs, elevated PAF levels were detected in AMI and simulated ischemia, respectively, and even higher PAF levels were found when fatal arrhythmias occurred. In guinea pig myocardium, PAF induced a shortening of action potential duration at 90% level of repolarization （APD 90 ）under non-ischemic conditions and a more pronounced shortening under early simulated ischemic conditions. Conclusion AMI and ischemia are associated with increased PAF levels in humans and pigs, which are further raised when fatal arrhythmia follows. The effects of PAF on the myocardium may be mediated by multiple ion channels.

Fox- and raccoon-dog–associated rabies outbreaks in northern China

Dear Editor,Rabies is a generally fatal disease caused by the rabies virus(RABV),and is transmitted mainly by Carnivora and Chiroptera(Fooks A R,et al.,2014;Tao X,et al.,2013).In China,stray dogs and some wild animals(e.g.,Chinese ferret badgers,foxes,and raccoon dogs)are the principal reservoirs for RABV(Hu R L,et al.,2009).Historically,rabies in wild foxes and raccoon dogs(Nyctereutes procyonoides)was recorded in the

Resuscitation on the K-1 Yongquan: Ethical and Methodological Aspects of Its Pilot Study

K-1 Yongquan complementary resuscitation maneuver, systematized since 1987, has been consistently performed in sudden death and cardiac arrest conditions as a final resource in both basic and advanced CPR failure. Experimental analytical studies identify the prevention, control and assessment of treatments set up as well as the determination of their efficiency offering;in that way, there are more possibilities than risks during the trial period. That type of study refers to the random criterion in order to measure differences and, in that way, it establishes causal associations which may better determine the intervention mechanism. As inferred by this criterion, control groups would not profit from the benefit of providing a second chance by means of the proposed maneuver during rescue. Such determination leaves those included in the control group deserted to their own ill-fate, adding—consequently—a certain lethal risk, which should basic and advanced CPR fail. In view of this panorama, we tried to find a methodology that should ensure the validation process according to the model presented;to that end, we propose the Cohort Retrospective Study. All of the above has given evidence that there is a difference if one takes into consideration as control the group of “deceased patients” instead of considering among them “patients that may be deceased”. Such apparently simple consideration—thanks to the Cohort Retrospective model—manages to efface the high possibility of a “fatal damage”, as proposed by the randomness principle upon a prospective non-intervention group. Beyond the scientific methodology that supports it the efficiency of the maneuver derives mainly from the sustained increase in survival rates presented in the successive statistics published since its application.

Fatality in Kikuchi-Fujimoto disease: A rare phenomenon

Kikuchi-Fujimoto disease(KFD), also known as histiocytic necrotizing lymphadenitis, is an uncommon condition, typically characterized by lymphadenopathy and fevers. It usually has a benign course; however, it may progress to fatality in extremely rare occasions. The diagnosis is made via lymph node biopsy and histopathology. Our patient was a young female who presented with shortness of breath, fever, and malaise. Physical examination revealed significant cervical and axillary lymphadenopathy. Chest X-ray displayed multilobar pneumonia. She required intubation and mechanical ventilation for progressive respiratory distress. Histopathology of lymph nodes demonstrated variable involvement of patchy areas of necrosis within the paracortex composed of karyorrhectic debris with abundant histiocytes consistent with KFD. After initial stabilization, the patient's condition quickly deteriorated with acute anemia, thrombocytopenia and elevated prothrombin time, partial prothrombin time, and D-dimer levels. Disseminated intravascular coagulopathy(DIC) ensued resulting in the patient's fatality. DIC in KFD is not well understood, but it is an important cause of mortality in patients with aggressive disease.