Surveillance Methodology Research Articles

EDNA Metabarcoding Analysis as Tool to Assess the Presence of Non-Indigenous Species (NIS): A Case Study in the Bilge Water

One of the most important causes of biodiversity loss are non-indigenous species (NIS), in particular invasive ones. The dispersion of NIS mainly depends on anthropogenic activities such as maritime traffic, which account for almost half of the total NIS introduction in the European seas, as reported by the European Environmental Agency. For this reason, NIS management measures are mainly focused on commercial ports (i.e., ballast water management and Marine Strategy Framework Directive monitoring), underestimating the role of marinas and tourist harbors; these host small vessels (<20 m), such as recreational, fishery, and sail ones without ballast waters, but are also responsible for NIS arrival and spread through the bilge water as well as from hull fouling. With the aim of paying attention to marinas and tourist harbors and validating an innovative molecular methodology for NIS surveillance and monitoring, in the present work, eDNA metabarcoding of cytochrome oxidase subunit I (COI) was applied to both bilge waters and adjacent ones to assess species composition and particularly NIS presence. A total of 140 OTUs/species with extra-Mediterranean distribution were found in the bilge samples; several of these are most likely ascribed to food contamination (e.g., Salmo salar). Excluding food contamination species, twelve of these found in the bilge waters were already known as NIS in the Mediterranean Sea, belonging to algae, mollusks, crustaceans, annelids, echinoderms, and fishes. Nine of these species are new to Italian waters. The results obtained in the present work support the importance of NIS monitoring in marinas and small harbors, particularly in the bilge waters, through eDNA metabarcoding, having detected several potential NIS that otherwise would not have been discovered.

Investigation of cancer incidence in ELSA-Brasil

Low- and middle-income countries have high cancer-related mortality rates, and Brazil has one of the highest incidences of all cancers in South America. Since 2008, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) follows up 15,105 civil adult servants of college education and research institutions in six Brazilian capitals, collecting relevant information on risk factors for the incidence of cancer and other noncommunicable diseases. This study aimed to describe the methodology for surveillance and investigation of the incidence of primary cancers in ELSA-Brasil. The surveillance and investigation involve annual telephone interviews, data collection of medical registries (biopsy records, chemotherapy/radiotherapy reports, hospital records or death certificates/autopsy statements), eligibility and final classification, date and basis of diagnosis, tumor topography and histological type. The cumulative incidence of all types of cancer in ELSA-Brasil during the first five years of follow-up (2009–2013) was 2.27 %. The challenges encountered in the investigation process are related to the lack of data on the occurrence of distant metastasis and essential details regarding diagnoses. However, the quality control and the adequacy of the methods adopted enables the construction of a solid and pioneering database in the country, which will contribute to advance in research on the natural history of the most frequent types of cancer.

Forecasting glycaemia for type 1 diabetes mellitus patients by means of IoMT devices

The chronic metabolic condition, Type 1 diabetes mellitus (DM1), is marked by consistent hyperglycemia due to the body's inability to produce sufficient insulin. This necessitates the patient's daily monitoring of blood glucose fluctuations to discern a trend and predict future glycemia, subsequently dictating the amount of external insulin needed to regulate glycemia effectively. However, this technique often grapples with a degree of inaccuracy, presenting potential hazards. Nonetheless, contemporary advancements in information and communication technologies (ICT) coupled with novel biological signal sensors offer a refreshing perspective for DM1 management by enabling comprehensive, continual patient health evaluation. Herein, burgeoning technological disruptions such as Big Data, the internet of medical things (IoMT), cloud computing, and machine learning algorithms (ML) could serve pivotal roles in the effective control of DM1. This paper delves into the exploration of the latest IoMT-based methodologies for the unbroken surveillance of DM1 management, facilitating a profound characterization of diabetic patients. The fusion of wearable technologies with machine learning strategies has the potential to yield robust models for short-term blood glucose prediction. The ambition of this study is to develop precise, individual-centric prediction models harnessing an array of pertinent factors. The study applied modeling techniques to a comprehensive dataset comprising glycaemia-associated biological attributes, sourced from an expansive passive monitoring campaign involving 40 DM1 patients. Leveraging the Random Forest method, the resulting models can predict glucose levels over a 30-min time span with an average error as minimal as 18.60 mg/dL for six-hour data and 26.21 mg/dL for a 45-minute prediction horizon, offering also a good performance in the prediction delay.

Coal Mine Solid Waste Backfill Process in China: Current Status and Challenges

Coal mine solid waste backfill is a coal mining method employed to safeguard subterranean and surface geological formations, as well as water resources, against impairment. It stands as a pivotal technical approach for realizing ecologically sustainable mining endeavors, aiming to address China’s predicament of ’three down’ coal pressure, coal gangue emissions, and land resource scarcity. This manuscript delves into an in-depth exploration of the evolution and research status pertaining to solid backfill technology, encompassing backfill materials, rock mechanics, backfill processes, and their application across China’s coal sector. The developmental challenges and technical intricacies linked to solid backfill technology within coal mines are meticulously scrutinized. Building upon these challenges and complexities, this study sets forth a progressive trajectory for solid backfill technology within the contemporary era. This trajectory envisions the synchronized advancement of novel solid backfill materials, intelligent surveillance and regulation methodologies, and machine learning technologies for backfill quality assessment. By doing so, the overarching aim of achieving superlative quality, heightened efficiency, and automation in solid backfill practices can be effectively realized.

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic.

(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a high burden of COVID-19 infections, and hospitals faced greater challenges in preventing and managing CLABSI; (2) Methods: A retrospective analysis of CLABSI data from all patients admitted to adult respiratory intensive care units before and during COVID-19 pandemic was conducted. We followed the guidelines of the Center for Disease Control surveillance methodology for CLABSI. Data were analyzed using STATISTICA 13.1; (3) Results: We analyzed the data of 803 ICU patients hospitalized for 8385 bed days, with 7803 central line days. Forty-five CLABSI events were identified. The CLABSI rate significantly increased during the COVID-19 pandemic compared to before the COVID-19 pandemic (2.81 versus 7.47 events per 1000 central line days, (p < 0.001). The most frequently identified pathogens causing CLABSI were Gram-negative organisms (60.20%). The risk factors found to increase the probability of developing CLABSI were length of stay (OR = 1.080; 95% Cl: 1.057-1.103; p < 0.001) and COVID-19 (OR = 5.485; 95% Cl: 32.706-11.116; p < 0.001). (4) Conclusions: The COVID-19 pandemic was associated with increases in CLABSI in ICUs. These data underscore the need to increase efforts in providing surveillance of CLABSI and implementing infection prevention measures.

National Healthcare-Associated Infections Report 2022 – Saudi Arabia

BackgroundSurveillance data are very essential for the effective use of available resources, the prioritization of infection control practices, and setting goals for intervention. The aim was to present the current rates of healthcare-associated infections (HAIs) and device utilization ratios (DUR) among the Saudi Ministry of health (MOH) hospitals. MethodsMOH analyzed the surveillance data collected from 106 MOH hospitals enrolled in the health electronic surveillance network (HESN) between January 2022 and December 2022. The surveillance methodology was similar to the methods of the US National Healthcare Safety Network (NHSN) and the Gulf Cooperation Council (GCC) center for infection control. ResultsMore than one million device-days of surveillance were analyzed. The rate of central line associated bloodstream infection (CLABSI) was 2.57 per 1000 central lines days. The rate of catheter-associated urinary tract infection (CAUTI) was 1.08 per 1000 urinary catheter days. The rate of ventilator-associated events (VAE) was 4.21 per 1000 ventilator days. The average rate of pediatric/neonatal ventilator-associated pneumonia (VAP) was 1.53 per 1000 ventilator days. The average DURs were 0.33 for central line, 0.61 for urinary catheter, 0.44 for ventilator in adult patients, and 0.26 in ventilator in pediatric/neonatal patients. In 238632 months of surveillance, the rate of dialysis events (DE) was 0.97 per 100 patient-months. In 86324 surgeries monitored, the rate of surgical site infection (SSI) was 0.87 per 100 surgeries surveyed. ConclusionsThe current report can serve as a national benchmark for MOH hospitals and a regional benchmark for similar hospitals in the region.

Factors Associated With Concussion Rates in Youth Ice Hockey Players: Data From the Largest Longitudinal Cohort Study in Canadian Youth Ice Hockey.

To examine factors associated with rates of game and practice-related concussion in youth ice hockey. Five-year prospective cohort (Safe2Play). Community arenas (2013-2018). Four thousand eighteen male and 405 female ice hockey players (6584 player-seasons) participating in Under-13 (ages 11-12), Under-15 (ages 13-14), and Under-18 (ages 15-17) age groups. Bodychecking policy, age group, year of play, level of play, previous injury in the previous year, lifetime concussion history, sex, player weight, and playing position. All game-related concussions were identified using validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician for diagnosis and management. Multilevel Poisson regression analysis including multiple imputation of missing covariates estimated incidence rate ratios (IRRs). A total of 554 game and 63 practice-related concussions were sustained over the 5 years. Female players (IRR Female/Male = 1.79; 95% CI: 1.26-2.53), playing in lower levels of play (IRR = 1.40; 95% CI: 1.10-1.77), and those with a previous injury (IRR = 1.46; 95% CI: 1.13, 1.88) or lifetime concussion history (IRR = 1.64; 95% CI: 1.34-2.00) had higher rates of game-related concussion. Policy disallowing bodychecking in games (IRR = 0.54; 95% CI: 0.40-0.72) and being a goaltender (IRR Goaltenders/Forwards = 0.57; 95% CI: 0.38-0.87) were protective against game-related concussion. Female sex was also associated with a higher practice-related concussion rate (IRR Female/Male = 2.63; 95% CI: 1.24-5.59). In the largest Canadian youth ice hockey longitudinal cohort to date, female players (despite policy disallowing bodychecking), players participating in lower levels of play, and those with an injury or concussion history had higher rates of concussion. Goalies and players in leagues that disallowed bodychecking had lower rates. Policy prohibiting bodychecking remains an effective concussion prevention strategy in youth ice hockey.

What is the appropriate antimicrobial use surveillance tool at the health facility level for Uganda and other low- and middle-income countries?

An appropriate antimicrobial use (AMU) surveillance system provides critical data and evidence on which antimicrobial stewardship interventions are based. However, Uganda and most other low- and middle-income countries (LMICs) lack efficient systems for monitoring AMU due to unique health system challenges. We reviewed the key tools available for AMU surveillance in health facilities. Based on our implementation experience, we present arguments on the need for country authorities to adapt a customized and standardized tool for national uses. Despite ongoing efforts to set up AMU surveillance programs in Uganda, AMU data remain sparse, with most of the available data collected through antimicrobial stewardship related continuous quality improvement efforts implemented by global AMR control programs. There is variability in the interpretation of available AMU surveillance tools and a need to identify the most appropriate AMU surveillance methodologies and tools for Uganda and other LMICs. Data fields for sex and gender are incorrectly categorized and there is no tool that records pregnancy variable. Based on the past four years of practical implementation experience since the launch of the World Health Organization's Point Prevalence Survey methodology in 2018 for inpatient settings, we believe that the tool should be modified in cognizance of existing capacity and priorities in resource-constrained settings. The World Health Organization, regional experts, ministry of health authorities, and other stakeholders should urgently review available tools with a view to adopting a customized and standardized facility AMU surveillance methodology suitable for national-level rollout in LMICs.

Stillbirth and early neonatal mortality rates may be underestimated using recall information: A comparison of demographic surveillance methodologies.

Child mortality and stillbirth rates (SBR) remain high in low-income countries but may be underestimated due to incomplete reporting of child deaths in retrospective pregnancy/birth histories. The aim of this study is to compare stillbirth and mortality estimates derived using two different methods: the method assuming full information and the prospective method. Bandim Health Project's Health and Demographic Surveillance Systems (HDSS) follows women of reproductive age and children under five through routine home visits every 1, 2 or 6 months. Between 2012 and 2020, we estimated and compared early neonatal (ENMR, <7 days), neonatal (NMR, <28 days), and infant mortality (IMR, <1 year) per 1000 live births and SBR per 1000 births. Risk time for children born to registered women was calculated from birth (the method assuming full information) versus date of first observation in the HDSS (the prospective method), either at birth (for pregnancy registration) or registration. Rates were calculated using the Kaplan-Meier estimator and compared in generalised linear models allowing for within-child correlation obtaining relative risks (RR). We registered and followed 29,413 infants (1380 deaths; 1459 stillbirths) prospectively. An additional 164 infant deaths and 129 stillbirths were registered retrospectively and included in the method assuming full information. The ENMR was 24.5 (95%CI: 22.6-26.4) for the method assuming full information and 25.8 (23.7-27.8) for the prospective method, RR = 0.96 (0.93-0.99). Differences were smaller for the NMRs and IMRs. For SBRs, the estimates were 53.5 (50.9-56.0) and 58.6 (55.7-61.5); RR = 0.91 (0.90-0.93). The difference between methods became more pronounced when the analysis was limited to areas visited every 6 months: RR for ENMR: 0.91 (0.86-0.96) and RR for SBR: 0.85 (0.83-0.87). Assuming full information underestimates SBR and ENMR. Accounting for omissions of stillbirths and early neonatal deaths may lead to more accurate estimates and improved ability to monitor mortality.

Automated Traffic Surveillance Using Existing Cameras on Transit Buses.

Millions of commuters face congestion as a part of their daily routines. Mitigating traffic congestion requires effective transportation planning, design, and management. Accurate traffic data are needed for informed decision making. As such, operating agencies deploy fixed-location and often temporary detectors on public roads to count passing vehicles. This traffic flow measurement is key to estimating demand throughout the network. However, fixed-location detectors are spatially sparse and do not cover the entirety of the road network, and temporary detectors are temporally sparse, providing often only a few days of measurements every few years. Against this backdrop, previous studies proposed that public transit bus fleets could be used as surveillance agents if additional sensors were installed, and the viability and accuracy of this methodology was established by manually processing video imagery recorded by cameras mounted on transit buses. In this paper, we propose to operationalize this traffic surveillance methodology for practical applications, leveraging the perception and localization sensors already deployed on these vehicles. We present an automatic, vision-based vehicle counting method applied to the video imagery recorded by cameras mounted on transit buses. First, a state-of-the-art 2D deep learning model detects objects frame by frame. Then, detected objects are tracked with the commonly used SORT method. The proposed counting logic converts tracking results to vehicle counts and real-world bird's-eye-view trajectories. Using multiple hours of real-world video imagery obtained from in-service transit buses, we demonstrate that the proposed system can detect and track vehicles, distinguish parked vehicles from traffic participants, and count vehicles bidirectionally. Through an exhaustive ablation study and analysis under various weather conditions, it is shown that the proposed method can achieve high-accuracy vehicle counts.

Elimination of HDV: Epidemiologic implications and public health perspectives.

Hepatitis delta virus (HDV) infection causes the severest form of viral hepatitis in humans. Discovered in 1977, it was considered an infection prevalent in the eastern Mediterranean region. Today it is recognized as a global infection of public health importance, however accurate prevalence remains uncertain because of lack of good epidemiological studies. Under-screening for HDV is the single most important factor in under-estimating the true burden of infection. Urgent efforts are therefore needed to apply reliable screening tools and robust surveillance methodologies to study HDV. There is now a move by major hepatology societies to recommend HDV antibody testing in all persons with HBV infection. Important differences also need to be recognized between countries considered endemic or non-endemic countries. While the endemic infections likely spread horizontally in the general population, and is quite often nosocomial, in non-endemic countries special populations may carry the greater burden, such as persons with injection drug use and various sexual exposures. Even in endemic countries, HDV often exists in significant pockets of the general population. HDV has been categorized as an orphan infection due to lack of approved therapies. Recently there have significant advances in therapy and further clinical trials continue. However, as new therapies are approved, equitable access to the medications will become a major public health issue, particularly because most HDV patients live in low or low middle income countries.

Surveillance of the Initiation of, Participation in, and Completion of Cardiac Rehabilitation in Minnesota, 2017-2018.

Cardiac rehabilitation (CR) is an evidence-based secondary prevention program designed to improve cardiovascular health after a cardiac event. The objective of our study was to identify gaps in CR use among publicly and privately insured people in Minnesota to assist in developing shared goals among public health, cardiac rehabilitation professionals, and program delivery sites to improve CR delivery. We applied a published claims-based surveillance methodology to the Minnesota All Payer Claims Database to assess eligibility for, initiation of, participation in, and completion of CR by patients with qualifying events in 2017. We stratified results by sociodemographic and geographic factors and qualifying condition and used adjusted prevalence ratios to make statistical comparisons. Less than half (47.6%) of qualifying patients initiated CR within 1 year of their qualifying event; the rate was higher among men (vs women), adults aged 45 to 64 years (vs ≥65 y), and patients with commercial or Medicaid insurance coverage (vs Medicare). Among those who initiated CR, only 14.0% completed the full series of 36 sessions. Participation in at least 12 sessions and completion of 36 sessions was less likely among adults aged 18 to 64 (vs 65-74 y) and among patients covered by Medicaid (vs Medicare). Patterns of CR initiation, participation, and completion also varied geographically. This analysis expands on previous Medicare fee-for-service population CR surveillance and provides a first detailed look at the CR landscape in Minnesota, renewing attention to CR as a key secondary prevention strategy. Collaboration and sharing with partners has established the Minnesota Department of Health as a valuable partner in driving health system change to improve equitable provision of CR in Minnesota.

Bone flap infections after craniotomy: a review of 63 cases and the implications for definitions, classification and surveillance methodologies

Bone flap infections (BFIs) occur following neurosurgical procedures such as craniotomies. However, they are poorly defined and often not clearly differentiated from other surgical site infection in neurosurgery. To review data from a national adult neurosurgical centre to explore some clinical aspects to better inform definitions, classification and surveillance methodologies. We retrospectively reviewed data on clinical samples sent for culture from patients with suspected BFI. We also accessed information recorded prospectively from national and local databases for evidence of BFI or related conditions based on terms used in surgical operative notes or discharge summaries and documented monomicrobial and polymicrobial infections related to craniotomy sites. Between January 2016 and December 2020, we documented 63 patients with a mean age of 45 years (16-80). Craniectomy for infection of the skull was the most common terminology used to describe BFI in the coding used in a national database, 40/63 (63%), but other terms were used. A malignant neoplasm was the most common underlying condition necessitating craniectomy in 28/63 (44%) cases. Specimens submitted for microbiological investigation included 48/63 (76%) bone flaps, 38/63 (60%) fluid/pus, and 29/63 (46%) tissue. Fifty-eight (92%) patients had at least one culture-positive specimen; 32 (55%) were monomicrobial and 26 (45%) were polymicrobial. Gram-positive bacteria predominated and Staphylococcus aureus was the most common. Greater clarity on how to define BFI is required to enable better classification and the carrying out of appropriate surveillance. This will inform preventative strategies and more effective patient management.

Antibiotic consumption trends in Ghana: analysis of six-years pharmacy issue data from a secondary healthcare facility.

Surveillance of hospital antibiotic consumption provides data to inform corrective action and for monitoring antimicrobial stewardship activities. This study described antibiotic consumption patterns from 2016 through 2021 at a secondary healthcare facility in Ghana. Using the WHO methodology for surveillance of antimicrobial consumption in hospitals, we analysed a 6-year pharmacy issue data at the Eastern Regional Hospital. We report on the defined daily dose (DDD) per 100 patients, types of antibiotics consumed according to Anatomic Therapeutic Classification (ATC), WHO AWaRe classification; trends in antibiotic consumption and expenditure per DDD of antibiotics consumed. Over the period, the mean (±standard deviation) antibiotic consumption rate was 256.7 ± 33 DDD/100 patients per year. A linear regression model showed an insignificant decreasing trend in antibiotic consumption (coefficient for time -0.561; P = 0.247). The top three consumed antibiotics in DDD/100 patients at ATC level 5 were amoxicillin-clavulanate (n = 372.6), cefuroxime (n = 287.4) and sulfamethoxazole-trimethoprim (n = 145.8). The yearly Access-to-Watch ratio decreased from 2.4 in 2016 to 1.2 in 2021. The mean yearly cost of antibiotics was $394 206 ± 57 618 US dollars. The top three antibiotics consumed in terms of cost were clindamycin $718 366.3, amoxicillin-clavulanate $650 928.3 and ceftriaxone $283 648.5. This study showed a sturdy rate of antibiotic consumption over the 6-year period with a year-on-year decrease in the Access-to-Watch antibiotic ratio. Data from pharmacy drug issues offer an opportunity to conduct antibiotic consumption surveillance at the hospital and national level in Ghana.

COVID-19 in the Federation of Bosnia and Herzegovina: Strengthening the public health surveillance using a web-based system to inform public health response, March 2020 - March 2022.

In response to the significant public health threat caused by coronavirus disease (COVID-19), real-time surveillance, containment, and mitigation measures were implemented in the Federation of Bosnia and Herzegovina (FBiH). Our objective was to describe the surveillance methodology, response measures, and epidemiology of COVID-19 cases in FBiH from March 2020 to March 2022. The surveillance system implemented across FBiH enabled health authorities and the population to monitor the development of the epidemiological situation, the daily number of reported cases, as well as basic epidemiological characteristics and geographic distribution of cases. As of 31 March 2022, 249,495 cases of COVID-19, and a total of 8,845 deaths were recorded in FBiH. Upkeeping of real-time surveillance, maintaining non-pharmaceutical interventions, and speeding up the vaccination roll-out were paramount for controlling COVID-19 in FBiH.

Comparison of Pure Tone Audiometry and Otoacoustic Emission based Hearing Assessment for Classical Music Students

Since the enforcement of the Control of Noise at Work Regulations research has been undertaken in collaboration with the Royal Academy of Music investigating the hearing acuity of more than 5000 students between 2007 and 2021. Standard pure tone audiometric screening methods were employed for both entry and exit testing of undergraduate and postgraduate students. The results of these investigations have informed a pilot study, ran in September 2021, comparing two hearing health surveillance methodologies: pure tone audiometry and otoacoustics emissions involving 256 classical music students. This comparison was necessary as music students had been found to be able to game the Bekesy test procedure as a result of their acute listening ability. The results showed that otoacoustic emissions were able to identify, at an early stage, hearing damage in an additional 3.8% of students. The test procedure itself was found to be quicker, more convenient and offered greater objectivity without learning bias. This provides reassurance that otoacoustic emissions can be an excellent tool for assessing the hearing health of classical music students and identifying hearing damage at an early stage.

A research framework for passive surveillance for food safety from social media: Identification and evaluation of customer reviews for regulatory use and case study of 30 restaurants

The primary objective of this paper is to develop a framework for continuous monitoring of the safety of food business operators without overburdening established regulatory systems through social media for food safety. A phase-wise methodology was adopted, wherein Phase 1 was dedicated to identifying available literature on Adverse Drugs Reactions (ADR) reporting using Social Media data. Phase 2 used the data from google maps review of the restaurants to replicate a similar methodology for Food Safety Surveillance. We identified 5 themes for a complete Surveillance framework, theme 1 involves data collection from social media, theme 2 involves pre-processing of data for analysis, theme 3 involves data annotations, theme 4 involves Identifying the relationship between regulatory violation and event, and theme 5 involves evaluation of the model. We were able to demonstrate the ADR reporting methodology could be adopted till theme 3, whereas theme 4 requires the development of an algorithm to assess the causality of an event with the Food Safety Code. According to our research, it is possible to develop a passive surveillance system for food safety that adheres to the principle of ADR reporting; however, the main obstacle is the absence of a causality assessment algorithm that can link an event to the food safety code and help regulators take immediate action.

A methodology for the public health surveillance and epidemiologic analysis of outdoor falls that require an emergency medical services response

BackgroundFalls are a common cause of injury with significantly associated medical costs yet public health surveillance of injuries from falls is underdeveloped. In addition, the epidemiologic understanding of outdoor falls, which have been reported to account for 47% of all injurious falls, is scant. Here we present methods to use emergency medical services (EMS) data as a public health surveillance tool for fall injuries, including those that occur secondary to syncope and heat illness, with a focus on the scope and epidemiology of outdoor fall injuries.MethodsUsing the 2019 National Emergency Medical Services Information System (NEMSIS) data, we developed an approach to identify EMS encounters for fall injuries, syncope and heat illness. NEMSIS variables used in our algorithm included the EMS respondent’s impression of the encounter, the reported major symptoms and the cause of injury. With these data we identified injuries from falls and, using the NEMSIS data on the location of the encounter, we identified fall injuries as occurring indoors or outdoors. We present the descriptive epidemiology of the identified patients.ResultsThere were 1,854,909 injuries from falls that required an EMS response identified in the NEMSIS data, with 4% of those injuries secondary to episodes of syncope (n = 73,126) and heat illness. Sufficient data were available from 94% of injurious falls that they could be assigned to indoor or outdoor locations, with 9% of these fall injuries occurring outdoors. Among fall injuries identified as occurring outdoors, 85% occurred on streets and sidewalks. Patient age was the primary sociodemographic characteristic that varied by location of the injurious fall. Sixty-six percent of fall injuries that occurred indoors were among those age 65 years or older, while this figure was 34% for fall injuries occurring outdoors on a street or sidewalk.ConclusionThe occurrence of outdoor fall injuries identified in the NEMSIS data were substantially lower than reported in other data sets. However, numerically fall injuries occurring outdoors represent a substantial public health burden. The strengths and weaknesses of using this approach for routine public health surveillance of injuries from falls, syncope and heat illness are discussed.

The influence of sociodemographic and environmental factors on wildlife carcass submissions in urban areas: Opportunities for increasing equitable and representative wildlife health surveillance

Wildlife health surveillance is important in rapidly expanding urban areas, where wildlife live in close association with humans and face unique health risks. Urban areas are not homogeneous, and social and environmental factors may affect the distribution of surveillance data we receive from these environments. The Canadian Wildlife Health Cooperative (CWHC) operates a national wildlife surveillance programme that receives carcass submissions for diagnostic evaluation. Our objective was to evaluate sociodemographic and environmental factors associated with CWHC submissions within two cities in Ontario, Canada. Submissions were mapped at two geographic scales and linked with census and environmental data. The results of mixed multivariable Poisson and negative binomial regression analyses suggest that natural (e.g., percent parkland) and anthropogenic environmental (e.g., presence of a zoo) and social variables (e.g., low income) are associated with submissions at both administratively relevant scales. Associations that are common across scales may represent robust intervention points and inform surveillance methodology/messaging. Surveillance data may influence public health policy, wildlife management, and other decision-making regarding the benefits/risks associated with coexistence with wildlife. This study highlights gaps in surveillance methodology that may prevent equal opportunity for participation in wildlife health surveillance and enable equal opportunity to benefit from the associated outputs.

Technology Focus: Digital Data Acquisition (January 2023)

With the rise of machine learning and other artificial intelligence methods, the ability to digest data for potential application in the petroleum industry has increased tremendously. Data is seen as the key to reducing uncertainty in decisions for this capital‑intensive industry where the costs of bad or delayed decisions are huge. Thus, the right data delivered at the right time can revolutionize the industry and save precious time and money. Gaining insights from digital data in the highly technical exploration and production industry requires experience, knowledge, and awareness about the acquisition of the data. The technologies presented here aim to facilitate the decision‑making process while requiring less time and lower costs without sacrificing the accuracy of the data and still decreasing the probability of human errors. They show how data collected from different vantage points can be integrated with conventional data‑acquisition methods to help visualize and reduce the uncertainty of the subsurface. Developments in other industries in automation and electronics have enabled modernization and miniaturization of oilfield instruments. Our industry seeks ideas and methods that are reliable, convenient, and practical to inform and guide operations, filling the gaps where and when conventional data is not available. Recommended additional reading at OnePetro: www.onepetro.org. OTC 31327 Density Measurement of Three-Phase Flows Inside Vertical Piping Using Planar Laser-Induced Fluorescence by Amy Brooke McCleney, Southwest Research Institute, et al. OTC 31836 Subsea Multiphase Flowmeter Measurement Performance Assurance With an Applied Data Validation and Reconciliation Surveillance Methodology by Emmelyn Graham, BP, et al. SPE 208712 IADC Code Upgrade: Data Collection and Work Flow Required To Conduct Bit Forensics and Create Effective Changes in Practices or Design by William Watson, Shell, et al.