Modelando la Supervivencia a la COVID-19 en México

Background: Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods: Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results: In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion: Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44 years in this study has not been noted previously. The high case fatality rate prior to admission to the hospital requires urgent attention.

Urban street structure and traffic safety

Road traffic accidents occur daily caused by different factors leading to varying degrees of injury severity. Considering this, many studies have been developed to identify and understand these factors to implement preventive actions. A Decision Tree (DT) is one of the techniques that can generate classifications and predictions by detecting a priori unknown patterns. This study aims to identify the characteristics of municipalities with high and very high fatality rates caused by traffic accidents, using a macro level dataset and a DT algorithm (CART - Classification And Regression Tree). Therefore, macro level data from the municipalities of São Paulo state (Brazil) were used, such as demographic and socioeconomic data, fatality rates and other variables related to traffic. The results indicated the Gross Domestic Product (GDP) as the most important variable, and the municipalities were characterized mainly considering the size of the highway network and vehicle fleet (trucks, minibuses, cars, motorcycles). These characteristics could provide support to the government to plan mitigating actions in municipalities with the highest tendency to high traffic fatality rates.

The aim of this study was to assess the relationship between the ratification status of occupational safety and health (OSH)-related ILO conventions and reported occupational fatality rates of ILO member countries, while controlling for possible confounding factors. ILO member states were divided into 4 levels of income status, based on the gross national income per capita. Seventeen conventions designated as OSH-related were examined. Reported country occupational fatality rates were compared according to the ratification status of these 17 conventions and multiple regression analyses were conducted to assess the relationship between the fatality rates, ratification status, income level and length of ILO membership. Fatality rates were inversely and significantly related to income levels. In general, non-ratifying countries had higher work-related fatality rates than ratifying countries. A statistical model for identifying predictors of fatal injury rates showed that a larger number of conventions ratified was significantly associated with lower fatality rates. The fact that non-ratifying countries generally have higher fatality rates than ratifying ones supports the notion that all countries should promote ratification of ILO conventions aimed at improving OSH conditions.

Decision letter: Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022

Editor's evaluation: Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022

Lassa fever (LF) is indeed a significant public health concern, particularly in parts of Africa. This viral infection, caused by the Lassa virus (LASV), is known for its high prevalence and fatality rates in certain regions, including North Africa. Research indicates that the estimated case fatality rate of Lassa fever in North Africa ranges from 16.5% to as high as 50% in some areas. For example, in Plateau State, North Central Nigeria, the case fatality rate was reported to be 57%. Across Western Africa, up to 300,000 new infections and 5,000 deaths are estimated to occur annually, with fatality rates reaching up to 25.4% in recent Nigerian outbreaks. The high fatality rates, especially among hospitalized patients, highlight the severity of this disease. For instance, in Nigeria, the overall mortality rate has been reported to be around 19%, with higher rates among health workers.

Fatal occupational injuries in Jordan during the period 1980 through 1993

Mortality After Osteoporotic Fractures: What Proportion Is Caused by Fracture and Is Preventable?

Understanding the spatial distribution patterns (SDPs) of natural disasters plays an essential role in reducing and minimizing natural disaster risks. An integrated discussion on the SDPs of multiple global disasters is still lacking. In addition, due to their high quantity and complexity, natural disasters constitute high-dimensional data that represent a challenge for an analysis of SDPs. This paper analyzed the SDPs of global disasters from 1980 to 2016 through biclustering. The results indicate that the SDPs of fatality rates are more uneven than those of occurrence rates. Based on the occurrence rates, the selected countries were clustered into four classes. (1) The major disasters along the northern Pacific and in the Caribbean Sea and Madagascar are storms, followed by floods. (2) Most of Africa is mainly affected by floods, epidemics, and droughts. (3) The primary disaster types in the Alpine-Himalayan belt and the western Andes are floods and earthquakes. (4) Europe, America, Oceania, and South and Southeast Asia are predominantly influenced by floods. In addition, according to the fatality rates, the selected countries were clustered into eight classes. (1) Extreme high temperatures mostly result in high fatality rates (HFRs) in developed countries. (2) Epidemics lead to HFRs in parts of Africa. (3) Droughts produce HFRs in East Africa. (4) Earthquakes result in HFRs along the eastern Pacific coastline and the Alpine-Himalayan belt. (5) Tsunamis mainly cause HFRs in Thailand, Indonesia, and Japan. (6) Storms result in scattered but distinct HFRs along the coastal regions of the Pacific and Indian Oceans. (7) Floods cause concentrated HFRs in South Asia and northeastern South America. (8) Finally, volcanoes cause HFRs in Colombia, while extreme low temperatures cause HFRs in Ukraine and Poland.

Nosocomial pneumonia (NP) and ventilator associated pneumonia (VAP) have been associated with financially significant economic burden and increased case fatality rate in adult intensive care units (ICUs). This study was designed to evaluate case fatality rate among patients with NP and VAP in a respiratory ICU. In 2008-2013, VAP and NP in the ICUs were included in this retrospective single-centre cohort study. Data on demographics, co-morbidities, severity of illness, mechanical ventilation, empirical treatment, length of hospital stay and laboratory findings were recorded in each group, as were case fatality rate during ICU admission and after discharge including short-term (28-day) and long-term (a year) case fatality rate. A total of 108 patients with VAP (n = 64, median (IQR) age: 70 (61-75) years, 67.2% were men) or NP (n = 44, median (IQR) age: 68 (62-74) years, 68.2% were men) were found. Appropriate empirical antibiotic therapy was identified only in 45.2 and 42.9% of patients with VAP and NP, respectively. Overall case fatality rate in VAP and NP (81.3 vs 84.1), ICU case fatality rate (42.2 vs 45.5%), short-term case fatality rate (15.6 vs 27.3%) and long-term case fatality rate (23.4 vs 11.4%) were similar between VAP and NP groups along with occurrence 50% of case fatality rate cases in the first 2 months and 90% within the first year of discharge. Multivariate analysis showed that chronic obstructive pulmonary disease (COPD) (HR: 3.15, 95% CI: 1.06-9.38; p = 0.039) and presence of septic shock (HR: 3.83, 95% CI: 1.26-11.60; p = 0.018) were independently associated with lower survival. In conclusion, our findings in a retrospective cohort of respiratory ICU patients with VAP or NP revealed high ICU, short- and long-term case fatality rates within 1 year of diagnosis, regardless of the diagnosis of NP after 48 h of initial admission or after induction of ventilator support. COPD and presence of septic shock are associated with high fatality rate and our findings speculate that as increasing compliance with infection control programs and close monitoring especially in 2 months of discharge might reduce high-case fatality rate in patients with VAP and NP.

Policy determinants of COVID-19 pandemic–induced fatality rates across nations

State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken.

356. The eclampsia maternal mortality in Dr. Soetomo General Hospital January 2015–December 2017: Evidence from Dr. Soetomo General Hospital

Ebola virus (EBOV) is an RNA virus that can cause hemorrhagic fever with high fatality rates, and there are no approved vaccines or therapies. Typically, RNA viruses have high spontaneous mutation rates, which permit rapid adaptation to selection pressures and have other important biological consequences. However, it is unknown if filoviruses exhibit high mutation frequencies. Ultradeep sequencing and a recombinant EBOV that carries the gene encoding green fluorescent protein were used to determine the spontaneous mutation frequency of EBOV. The effects of the guanosine analogue ribavirin during EBOV infections were also assessed. Ultradeep sequencing revealed that the mutation frequency for EBOV was high and similar to those of other RNA viruses. Interestingly, significant genetic diversity was not observed in viable viruses, implying that changes were not well tolerated. We hypothesized that this could be exploited therapeutically. In vitro, the presence of ribavirin increased the error rate, and the 50% inhibitory concentration (IC50) was 27 μM. In a mouse model of ribavirin therapy given pre-EBOV exposure, ribavirin treatment corresponded with a significant delay in time to death and up to 75% survival. In mouse and monkey models of therapy given post-EBOV exposure, ribavirin treatment also delayed the time to death and increased survival. These results demonstrate that EBOV has a spontaneous mutation frequency similar to those of other RNA viruses. These data also suggest a potential for therapeutic use of ribavirin for human EBOV infections. Ebola virus (EBOV) causes a severe hemorrhagic disease with high case fatality rates; there are no approved vaccines or therapies. We determined the spontaneous mutation frequency of EBOV, which is relevant to understanding the potential for the virus to adapt. The frequency was similar to those of other RNA viruses. Significant genetic diversity was not observed in viable viruses, implying that changes were not well tolerated. We hypothesized that this could be exploited therapeutically. Ribavirin is a viral mutagen approved for treatment of several virus infections; it is also cheap and readily available. In cell culture, we showed that ribavirin was effective at reducing production of infectious EBOV. In mouse and monkey models of therapy given post-EBOV exposure, ribavirin treatment delayed the time to death and increased survival. These data provide a better understanding of EBOV spontaneous mutation and suggest that ribavirin may have great value in the context of human disease.