Evaluation of preventable trauma death in emergency department of Imam Reza hospital

BACKGROUND: Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents(MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients.METHODS: This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department(ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death def ined by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied.RESULTS: In the 100 patients, 21(21%) patients were female and 79(79%) male. Fortythree patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31% of the patients, and 33% had a hypo-volemic shock. About 80% of deaths were due to intra-cranial hemorrhage(ICH) or intra-ventricular hemorrhage(IVH), and spinal injuries were not preventable. Autopsy revealed that 28% of the patients suffered from internal injuries. Autopsy revealed that 19% of the deaths were not preventable and 81% were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services(EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2% of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6% deaths occurred between 6 and 10 minutes.CONCLUSIONS: The rate of hospital preventable deaths is about 80%, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries.

Epidemic Outbreaks in Plovdiv Region (Bulgaria) of Vaccine-Preventable Diseases: Measles, Mumps, Hepatitis A

Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A;B) To carry out periodic catch-up vaccination campaigns against measles and mumps.

Common Preventable Health and Social Problems Encountered by Elderly in Shinyanga Region in the Northern Part of Tanzania

Background: In Tanzania elders are respected as repositories of inherited wisdom, experienced and principal decision makers in the community. However, evidence shows that such repositories are no longer considered important in most societies. As a result elders are neglected with some mistreatment in terms of provision of health and social services for instance;at times they get denied and ignored of their obvious rights, ignoring their retirement benefits and the rights onto free social services as per the Tanzania National Ageing Policy of 2003. Elders are therefore faced with physical, psychological and geriatric social suffering. It is on this basis that this study tries to explore the common preventable health and social problems encountered by elderly in Shinyanga Region in northern part of Tanzania. Methods: Across sectional community based study of 465 subjects randomly selected was done in three wards of Kahama District. The district was selected randomly out of 8 districts of Shinyanga Region, structured questionnaires with both closed and opened endower used;the information was collected from house to house and other information collected from health facilities within the wards as every ward had one public health facility;subjects (respondents) were obtained using purposive sampling technique aiming at elderly with 60 years of age and above. Results: Kahama district has a population of approximately 36,014 of which 1500 (4%) are in the elderly age group of 60 years and above. The study population was 465 which is 30% (465/1500) of the geriatric population of Kahama. Among this group 5% were female while 41% were male and 53% (248/465) were married. 64% (297/465) were taking care of themselves, 32% (150/465) cared by relatives and 4% (18/465) cared by the community. Among the respondents, 40% (185/465) were affected by HIV/AIDs in one way or another either living with orphans whose parents died of HIV/AIDS or asking care of the infected patients within the family. It was also found that 73% of the geriatrics were not exempted from medical treatment fees so they had to pay for their medical care. However, only 32% were aware of getting free treatment and 61% of the study populations were not satisfied with the medical care provided at the public health facilities. The common diseases affecting this age group are: Eye problem 59% (273/465);Arthritis 52% (241/465);Dental problems 27% (124/465);Hypertension 23% (107/465);Backache 22% (105/465);Malaria 28% (132/465);Hearing problems 26% (121/645);Urinary tract Infection 35% (165/465);Depression 8% (36/465). Dementia was also a problem though we had no tools to confirm the diagnosis;some of the geriatrics had more than two diseases. Conclusion: The majority of the elderly age group in Kahama District are not aware of their rights that they deserve free treatment according to Tanzania policy, furthermore for assessment and screening of health problems. A majority of the elderly die prematurely due to preventable diseases and more than half of the diseases affecting geriatrics are preventable.

Preventable readmission to intensive care unit in critically ill cancer patients

BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer patients.METHODS:Data of patients who readmitted to intensive care unit(ICU)at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences(CAMS)and Peking Union Medical College(PUMC)between January 2013 and November 2016 were retrospectively collected and reviewed.RESULTS:A total of 39 patients were included in the final analysis,and the overall readmission rate between 2013 and 2016 was 1.32%(39/2,961).Of 39 patients,32(82.1%)patients were judged as unpreventable and 7(17.9%)patients were preventable.There were no significant differences in duration of mechanical ventilation,ICU LOS,hospital LOS,ICU mortality and in-hospital mortality between patients who were unpreventable and preventable.For 24 early readmission patients,7(29.2%)patients were preventable and 17(70.8%)patients were unpreventable.Patients who were late readmission were all unpreventable.There was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable(100%vs.66.8%,log rank=1.668,P=0.196).CONCLUSION:Most readmission patients were unpreventable,and all preventable readmissions occurred in early period after discharge to ward.There were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.

An Unexpected Presentation of Tuberculosis in the Surgical Field with a Preventable Disease Transmission

Tuberculosis (TB) incidence within Healthcare workers remains one of the lowest occupation specific rates in the United States. We report a case of a 33-year-old African American male presented with a right chest mass and without fever, chills or cough. Bacterial and Fungal cultures were sent during the initial visit and were negative throughout the entire management of his care. After several months of surgical interventions, the patient appeared positive for TB;however a staff member contracted the disease. The patient was managed successfully with the four-drug regimen of Isoniazid, Rifampin, Pyrazinamide and Ethambutol and recovered well from his surgeries.

儿童抗逆转录病毒治疗耐药研究进展

2020年底全球有170万名14岁以下的儿童感染艾滋病,艾滋病病毒/艾滋病感染儿童的数量将持续增加。随着抗逆转录病毒疗法(anti-retroviral therapy,ART)的出现和发展,全球艾滋病相关死亡人数有所下降。截至2020年6月,有2 750万艾滋病病毒感染者正在接受抗逆转录病毒治疗,但随着预防母婴传播(prevention of mother to child transmission,PMTCT)的普及,可能出现HIV-1耐药性(HIVDR),儿童ART计划的成功率面临挑战。有报告显示[1],在一线方案失败的儿童中有90%可检测到耐药突变,突变的频率随治疗时间的延长而增高。

Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

Experimental study on the effect of water absorption level on rockburst occurrence of sandstone

To investigate the mechanism of rockburst prevention by spraying water onto the surrounding rocks,15 experiments are performed considering different water absorption levels on a single face.High-speed photography and acoustic emission(AE)system are used to monitor the rockburst process.The effect of water on sandstone rockburst and the prevention mechanism of water on sandstone rockburst are analyzed from the perspective of energy and failure mode.The results show that the higher the ab-sorption degree,the lower the intensity of the rockburst after absorbing water on single side of sand-stone.This is reflected in the fact that with the increase in the water absorption level,the ejection velocity of rockburst fragments is smaller,the depth of the rockburst pit is shallower,and the AE energy is smaller.Under the water absorption level of 100%,the magnitude of rockburst intensity changes from medium to slight.The prevention mechanism of water on sandstone rockburst is that water reduces the capacity of sandstone to store strain energy and accelerates the expansion of shear cracks,which is not conducive to the occurrence of plate cracking before rockburst,and destroys the conditions for rockburst incubation.

Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes:Cross-country comparison of cohort studies

Purpose:This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity(PA)to prevent mortality and cardiovascular disease in adults with type 2 diabetes.Methods:Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China.Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week(MET-h/week)according to World Health Organization recommendations:none,below recommendation(>0-7.49 MET-h/week);at recommended level(7.5-14.9 MET-h/week);above recommendation(>15 MET-h/week).Mortality and cardiovascular disease data were obtained from national registries.Results:During a median follow-up of 12.4 and 9.7 years,in the UK and China cohorts,repectively,higher levels of leisure-time PA were inversely associated with all-cause(1571 and 2351 events)and cardiovascular mortality(392 and 1060 events),mostly consistent with a linear dose-response relationship.PA below,at,and above recommendations,compared with no activity,yielded all-cause mortality hazard ratios of0.94(95%confidence interval(95%CI):0.79-1.12),0.90(95%CI:0.74-1.10),and 0.85(95%CI:0.70-1.02)in British adults and 0.87(95%CI:0.68-1.10),0.88(95%CI:0.74-1.03),and 0.77(95%CI:0.70-0.85)in Chinese adults.Associations with cardiovascular mortality were more pronounced in British adults(0.80(95%CI:0.58-1.11),0.75(95%CI:0.52-1.09),and 0.69(95%CI:0.48-0.97))but less pronounced in Chinese adults(1.06(95%CI:0.76-1.47),1.01(95%CI:0.80-1.28),and 0.79(95%CI:0.69-0.92)).PA at recommended levels was not associated with lower rates of major adverse cardiovascular events(2345 and 4458 events).Conclusion:Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes.Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.

Animal models of hepatitis E infection: Advances and challenges

Hepatitis E virus(HEV)is one of the leading causes of acute viral hepatitis worldwide.Although most of HEV infections are asymptomatic,some patients will develop the symptoms,especially pregnant women,the elderly,and patients with preexisting liver diseases,who often experience anorexia,nausea,vom-iting,malaise,abdominal pain,and jaundice.HEV infection may become chronic in immunosuppressed individuals.In addition,HEV infection can also cause several extrahepatic manifestations.HEV exists in a wide range of hosts in nature and can be transmitted across species.Hence,animals susceptible to HEV can be used as models.The establishment of animal models is of great significance for studying HEV transmission,clinical symptoms,extrahepatic manifestations,and therapeutic strategies,which will help us understand the pathogenesis,prevention,and treatment of hepatitis E.This review summarized the animal models of HEV,including pigs,monkeys,rabbits,mice,rats,and other animals.For each animal species,we provided a concise summary of the HEV genotypes that they can be infected with,the cross-species transmission pathways,as well as their role in studying extrahepatic manifestations,prevention,and treatment of HEV infection.The advantages and disadvantages of these animal models were also emphasized.This review offers new perspectives to enhance the current understanding of the research landscape surrounding HEV animal models.

Journal of Sport and Health Science Guide for Authors

Please visit https://www.sciencedirect.com/journal/journal-of-sport-and-health-science for the detailed version of Guide for Authors.Aims The Journal of Sport and Health Science(JSHS)is a peer-reviewed,international,multidisciplinary scientific journal dedicated to the advancement of sport,exercise,physical activity,and health sciences.JSHS publishes original and impactful research,topical reviews,editorials,opinion,and commentary papers relating physical and mental health,injury and disease prevention,traditional Chinese exercise,and human performance.Through a distinguished,carefully selected international editorial board,JSHS has adopted the highest academic standards,impeccable integrity,and an efficient publication platform.

Commentary on“The deterministic condition for the ground reaction force acting point on the combined knee valgus and tibial internal rotation moments in the early phase of cutting maneuvers in female athletes”

1.Introduction For decades,substantial disagreement has persisted as to whether dynamic knee valgus is the cause of the majority of anterior cruciate ligament(ACL)injuries or rather the result of the ACL rupture.1 Consequently,great effort and expense has gone into capturing 3-dimensional kinetics and kinematics from live athletes to drive in vitro and in silico models of ACL injury in order to elucidate the actual mechanism of injury,as these factors have been demonstrated to be surrogates of intraarticular structural loading on the ACL.2,3 The elucidation of injury mechanisms for non-contact ACL injuries is of great medical value as such knowledge consequently permits quantified examination and validation of interventions and their respective effectiveness in both prevention and rehabilitation of these traumatic knee injuries.

Molecular biomarkers for vascular cognitive impairment and dementia:the current status and directions for the future

Dementia is a syndrome with various underlying pathologies acting independently or in concert to cause cognitive dysfunction.The development of disease-specific treatments and targeted prevention strategies requires precise clinical sub-typing via etiology and pathophysiological processes.Furthermore,recent research advances in biomarkers,especially for Alzheimer's disease(AD)diagnosis,have improved diagnostic precision for dementia.

Journal of Sport and Health Science Guide for Authors

Aims The Journal of Sport and Health Science(JSHS)is a peer-reviewed,international,multidisciplinary scientific journal dedicated to the advancement of sport,exercise,physical activity,and health sciences.JSHS publishes original and impactful research,topical reviews,editorials,opinion,and commentary papers relating physical and mental health,injury and disease prevention,traditional Chinese exercise,and human performance.Through a distinguished,carefully selected international editorial board,JSHS has adopted the highest academic standards,impeccable integrity,and an efficient publication platform.

Journal of Sport and Health Science Guide for Authors

Aims The Journal of Sport and Health Science(JSHS)is a peer-reviewed,international,multidisciplinary scientific journal dedicated to the advancement of sport,exercise,physical activity,and health sciences.JSHS publishes original and impactful research,topical reviews,editorials,opinion,and commentary papers relating physical and mental health,injury and disease prevention,traditional Chinese exercise,and human performance.Through a distinguished,carefully selected international editorial board,JSHS has adopted the highest academic standards,impeccable integrity,and an efficient publication platform.

Beyond dentistry:could prevention and screening for neurodegenerative diseases start in the dental office?

The differential diagnosis of neurodegenerative diseases is complex and relies on clinical assessment,biomarker levels in cerebrospinal fluid,neuroimaging and neuropsychological assessment.The efforts of the scientific community are focused on two aspects:a)the discovery of minimally invasive biomarkers;b)the discovery of early biomarkers that can predict the progression to clinical disease in the presymptomatic stage of a disease.Considering the impact of the number of patients affected by chronic neurodegenerative diseases on public health expenditures,early diagnosis seems to be a primary need of our society.

Standards of Basic Dataset of Chronic Disease Behavior Risk Factor Surveillance in Adults

1 Scope This document specifies the metadata attributes and data element attributes for the adult chronic disease behavior risk factor surveillance dataset.It is applicable to the collection of data for the surveillance,survey,intervention and assessment of chronic disease behavior risk factors by health administrative departments,disease prevention and control institutions.

An exo Probe-based Reverse Transcription and Recombinase Polymerase Amplification for Rapid Detection of Feline Calicivirus in Cats

Feline calicivirus(FCV)was a highly prevalent RNA virus causing upper respiratory tract infections in cats through the mouth and nose around the world,result in the death of cats especially under 1 year old with upper respiratory tract disease(URTD)and virulent systemic disease(FCV-VSD)[1].Infected cats usually presented with mouth ulcers,salivation and gingivitis-stomatitis.Furthermore,both recovered cats and asymptomatic carriers can still carry and spread the FCV virus for extended periods of time,contributing to the potential for outbreak.This presented a significant threat to the health and lives of cats,and rare wildlife and took a heavy financial loss on the pet industry,making the prevention and control of the virus difficult.Hence,rapid identification of FCV in clinical samples was necessary to prevent the spread of FCV and avoid financial loss.

Journal of Sport and Health Science Guide for Authors

Please visit https://www.sciencedirect.com/journal/journal-of-sport-and-health-science for the detailed version of Guide for Authors.Aims The Journal of Sport and Health Science (JSHS) is a peer-reviewed,international,multidisciplinary scientific journal dedicated to the advancement of sport,exercise,physical activity,and health sciences.JSHS publishes original and impactful research,topical reviews,editorials,opinion,and commentary papers relating physical and mental health,injury and disease prevention,traditional Chinese exercise,and human performance.Through a distinguished,carefully selected international editorial board,JSHS has adopted the highest academic standards,impeccable integrity,and an efficient publication platform.

重组生物技术制品生产工艺变更的病毒安全性风险再评估策略

In the manufacturing of biotechnology drug products,the viral safety control strategy is a critical pharmaceutical quality management framework that contains three key elements:prevention,testing,and clearance.The prevention strategy involves rigorous screening for any adventitious virus contamination in the raw materials,reagents,and endogenous/adventitious virus contamination in the cell banks.