Proportion Of Fatalities Research Articles

Systematic review of paediatric studies of adverse drug reactions from pharmacovigilance databases

ABSTRACTObjective: To perform a systematic review of studies describing paediatric adverse drug reactions (ADRs) conducted from national pharmacovigilance databases.Methods: A systematic literature search of studies describing results for paediatric ADRs from national pharmacovigilance databases was performed. PubMed database, Embase and MEDLINE were searched up to March 2015. The descriptive studies included were analysed for country of origin, reporters, and ADR reporting rate, drugs, ADRs and number of fatalities.Results: 20 studies were identified. Doctors were the largest group of reporters in all the studies, and with more consumer reports seen in USA. The studies ranged from 3 – 37 years. The highest ADR reporting rate was 1458 reports per year per million children in Cuba. Antibiotics and vaccines were the most frequently reported drugs, in almost all the studies. The most frequent ADRs were skin and nervous system disorders. The highest proportion of fatalities and serious reports was from North America. Drugs used for treating attention deficit hyperactivity disorders (ADHD) and isotretinoin were the most frequently reported drugs for ADRs in North America.Conclusions: There were geographical differences in drugs responsible for ADRs and their seriousness, especially in North America. Very few studies were conducted in Asia and Latin America, none were found from Africa.

Fatal and serious injuries related to vulnerable road users in Canada

IntroductionThe goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users. MethodThe Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time. ResultsThe analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef.=0.16, p<0.001). The elderly (76years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively. ConclusionsWith the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries. Practical applicationsThese findings can help better inform prevention and mitigation initiatives for vulnerable road users.

Avalanche fatalities in the European Alps: long-term trends and statistics

Abstract. Avalanche accidents, particularly those resulting in fatalities, attract substantial attention from policy makers and organizations, as well as from the media and the public. Placing fatal accidents in a wider context requires long-term and robust statistics. However, avalanche accident statistics, like most other accident statistics, often rely on relatively small sample sizes, with single multi-fatality events and random effects having a potentially large influence on summary and trend statistics. Additionally, trend interpretation is challenging because statistics are generally explored at a national level, and studies vary in both the period covered and the methods. Here, we addressed these issues by combining the avalanche fatality data from the European Alps (Austria, France, Germany, Liechtenstein, Italy, Slovenia, and Switzerland) for three different periods between 1937 and 2015 and applying the same data analysis methodology. During the last four decades, about 100 people lost their lives each year in the Alps. Despite considerable inter-annual variation, this number has remained relatively constant in the last decades. However, exploring fatality numbers by the location of the victims at the time of the avalanche revealed two partly opposing trends. The number of fatalities in controlled terrain (settlements and transportation corridors) has decreased significantly since the 1970s. In contrast to this development, the number of fatalities in uncontrolled terrain (mostly recreational accidents) almost doubled between the 1960s and 1980s and has remained relatively stable since then, despite a strong increase in the number of winter backcountry recreationists. Corresponding to these trends, the proportion of fatalities in uncontrolled terrain increased from 72 to 97 %. These long-term trends were evident in most national statistics. Further, the temporal correlation between subsets of the Alpine fatality data, and between some of the national statistics, suggests that time series covering a longer period may be used as an indicator for missing years in shorter-duration datasets. Finally, statistics from countries with very few incidents should be compared to, or analysed together with, those from neighbouring countries exhibiting similar economical and structural developments and characteristics.

Modeling severity of single vehicle run-off-road crashes in rural areas: model comparison and selection

Run-off-road (ROR) crashes account for a large proportion of fatalities and serious injuries to vehicle occupants, especially in rural areas. While performing crash severity analysis using discrete choice models (DCMs), researchers may be confused by the following questions: first, should an ordered or unordered model structure be used and secondly, which modeling level is more appropriate, basic or advanced? A model selection framework is developed considering the following factors: (1) model structure — ordered or unordered; (2) intrinsic deficiency of each model; (3) computational burdens; (4) complexity of parameter interpretation; and (5) model fitness. Historical ROR crash data were utilized to illustrate how to choose an appropriate DCM based on the proposed framework. Using statistical tests and comparison of evaluation and validation measurements, both the mixed logit model and the partial proportional odds model yield a reasonable performance. All factors that significantly affect the severity level of a single-vehicle ROR crash were identified as well.

Bicycles’ Role in Road Accidents a Review of Literature

Abstract Nearly 1.3 million people die in road crashes each year, on average 3,287 deaths a day. In 2013 in the European Union more than 6 % of all who died in road traffic crashes were cyclists. The number of cyclist killed on roads in the EU has decreased by only 9 %, compared to the total fatality decrease of 18 % from 2010 to 2013. The majority of cyclist fatalities are males (78 %). For the larger countries, Belgium and The Netherlands had the highest proportion of female cyclist fatalities (&gt; 30 %). In general, 55 % of the bicycle fatalities in the EU countries were killed inside urban areas but there are large differences between the countries. In the last couple of years there has been an enormous effort on reduction in cycling fatality numbers across almost all ages in the EU. As a result of this effort, the number of accidents started to slightly decrease. This paper reviews the literature concerning cyclist-motor vehicle collision and road safety management according to the cyclist role in the accident rise. The paper examines pedestrians safety in order to determine what kind of factors of transport infrastructure, vehicle technical parameters, cyclist behavior and road or street category have the influence on cyclist and vehicle accidents and identify technical reasons of the accidents rise. A review is conducted of information in the literature on the injury outcome of a cyclist/vehicle collision for a given impact speed and the likely consequences of reducing the travelling speeds of vehicles in terms of the frequency and severity of cyclist injuries.

On the principle of host evolution in host–pathogen interactions

ABSTRACTIn this paper, we use a two-host one pathogen immuno-epidemiological model to argue that the principle for host evolution, when the host is subjected to a fatal disease, is minimization of the case fatality proportion . This principle is valid whether the disease is chronic or leads to recovery. In the case of continuum of hosts, stratified by their immune response stimulation rate a, we suggest that has a minimum because a trade-off exists between virulence to the host induced by the pathogen and virulence induced by the immune response. We find that the minimization of the case fatality proportion is an evolutionary stable strategy for the host.

Avalanche Fatalities in the United States: A Change in Demographics

To describe demographic patterns in avalanche fatalities in the United States during the past 6 decades according to geographic location and preavalanche activity. The Colorado Avalanche Information Center currently manages the National Avalanche Accident Dataset. This dataset describes deidentified avalanche fatalities beginning in 1951. Covariates included age, sex, month, state of occurrence, and preavalanche activity. Both absolute and proportional avalanche fatalities were calculated by year and by each covariate. A linear regression model was used to trend the proportion of avalanche fatalities stratified by covariate. There were 925 recorded avalanche fatalities in the United States between 1951 and 2013. There were an average of 15 ± 11 fatalities/y (mean ± SD; range, 0 to 40 fatalities/y). The mean (+/- SD) age was 29 ± 6.6 years (range, 6-67 years), and 86% were men. Total avalanche fatalities have increased linearly (R(2) = 0.68). Despite the highest number of total deaths in Colorado (n = 253), the proportion of avalanche fatalities in Colorado decreased (-5% deaths/decade; P = .01). Snowmobilers are now the largest group among fatalities and accounted for 23% of deaths (n = 213). The proportion of snowmobile fatalities has increased (+7% deaths/decade; P < .01), as has the proportion of snowboarder fatalities (+2% deaths/decade; P < .01). Avalanche fatalities have increased. This is most likely related to an overall rise in backcountry utilization. Fatalities have increased among snowmobilers and snowboarders. Despite a rise in backcountry utilization, avalanche fatalities in Colorado are decreasing. A strategy of focused training and education aimed toward at-risk groups could result in lower avalanche fatalities.

Urban traffic safety assessment: A case study of six Indian cities

This study reports the results of fatal road traffic fatal crash data from six mid-sized cities in India: Agra, Amritsar, Bhopal, Ludhiana, Vadodara, and Vishakhapatnam. Relative to total road fatalities, the percentage of vulnerable road user deaths in all six cities range between 84% and 93%, car occupant fatalities between 2% and 4%, and TST occupants less than 5%. The largest proportion of fatalities for all road user categories (especially vulnerable road users) is associated with collisions with buses and trucks, followed by collisions with cars; however, the proportion of pedestrian fatalities associated with MTW collisions ranges from 8% to 25% of the total. The data indicate that the 0–14 age group is underrepresented in proportion to its share of the population, including children riding motorcycles. Occupant fatality rates per 100,000 vehicles for MTW and TST occupants are 2–3 and 3–5 times higher, respectively, than for cars. However, estimates of association with fatal crashes show that MTWs and cars pose a similar risk to society, with TSTs representing a slightly smaller risk. Confirming some of these results will require data with a higher level of detail.

Injury-related fatalities in selected governorates of Iraq from 2010 to 2013: Prospective surveillance.

After several years of relative stability in Iraq, the emergence of the Islamic State militant group has spurred a resurgence of violence. This study explores the impact of the conflict on the overall injury profile to estimate the proportion of injury fatalities related to conflict and better understand how violence has affected nonconflict-related injuries. Routine prospective injury surveillance operated by the Iraqi Ministry of Health. Surveillance data were collected from coroner offices in eight pilot governorates: Al-Anbar, Baghdad, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. We analyzed all fatalities from external injury causes recorded between January 1, 2010 and December 31, 2013. Analysis included 32,664 fatal injuries. Of all injury fatalities reported, 27.1 percent were conflict-related fatalities, approximately the same proportion as road traffic-related fatalities (24.4 percent) and other unintentional injuries (27.5 percent). The proportion of fatalities from conflict was approximately three times higher among males than females (33.0 percent and 10.3 percent, respectively) and four times higher among adults than children (29.8 percent and 7.3 percent, respectively). The total number of injury fatalities remained stable between 2010 and 2012; an increase in injury fatalities in 2013 was driven primarily by increases in fatalities from both interpersonal violence and conflict. From 2010 to 2013, nearly one in four injury fatalities in Iraq was attributable to conflict, a notably higher proportion than other conflict-affected countries in the region. The overall profile of nonconflict injuries in Iraq is also distinct from other countries of similar socioeconomic level that have not experienced violence.

Mere overrepresentation? Using cross-occupational injury and job analysis data to explain men’s risk for workplace fatalities

Historically, male workers have comprised a large proportion of occupational fatalities in the US. A common explanation for this has been that men are overrepresented in more physically hazardous occupations. Yet another potential explanation is that prescribed gender roles and norms contribute to higher rates of male worker fatalities compared with female workers. The purpose of this study was to test the assumption of the overrepresentation explanation, first, by testing the degree to which overrepresentation adequately accounts for men and women’s differing fatality frequencies across various occupations, and second, by exploring gendered worker, occupation, and organizational attributes which may explain variance in the severity of men’s fatality disparity between occupational titles. We used data from the Bureau of Labor Statistics and Occupational Information Network (O∗NET). Results indicate that more than 25% of the total occupational fatalities in 2012 occurred outside of what would be expected for equivalent fatality ratios for men and women working in the same occupation. Further, gendered job and worker characteristics significantly predicted variance in men’s relative risk for workplace fatalities across occupations (these characteristics, combined with sex representation, explained 10% of the total variance in men’s relative fatality risk). The results suggest that men may be at increased risk for occupational fatalities when compared to women in the same occupations, and advocate for investigating the role of gender for future research on injury and fatality discrepancies between male and female workers.

Birth prevalence of selected external structural birth defects at four hospitals in Dar es Salaam, Tanzania, 2011–2012

Background94% of all birth defects (BD) and 95% of deaths due to the BD occur in low and middle income countries, many of which are preventable. In Tanzania, there is currently a paucity of BD data necessary to develop data informed prevention activities.MethodsA cross-sectional analysis was conducted of deliveries identified with BD in the labor ward registers at four Dar es Salaam hospitals between October, 2011 and February, 2012. The birth prevalence of structural BD, case fatality proportion, and the distribution of structural defects associated deaths within total deaths were calculated.ResultsA total of 28 217 resident births were encountered during the study period. Overall birth prevalence of selected defects was 28.3/10 000 live births. Neural tube defects and indeterminate sex were the most and least common defects at birth (9.9 and 1.1/10 000 live births, respectively). Among stillbirths (66.7%) and deaths that occurred within less than 5 days of an affected live birth (18.5%), neural tube defects were the most frequently associated structural defect.ConclusionStructural BD is common and contributes to perinatal mortality in Dar es Salaam. More than half of perinatal deaths encountered among the studied selected external structural BD are associated with neural tube defects, a birth defect with well–established evidence based prevention interventions. By establishing a population–based BD surveillance program, Tanzania would have the information about neural tube defects and other major structural BD needed to develop and monitor prevention activities.

Safety around schools

Around schools, increases in walking and cycling help to reduce traffic congestion and improve the road safety and neighborhood navigation skills of children. Physical activity and independent mobility may also have a positive effect on children’s behavioural and cognitive development. Child pedestrians, however, are a vulnerable road user groups, experiencing an increased crash and injury risk relative to older pedestrians, constituting a substantial proportion of all pedestrian fatalities and serious injuries, with children below the age of 10 years of age shown to have four to 11 times greater risk of collision compared to other pedestrians, and they frequently occur around schools. In fact, vehicle collisions involving children pedestrians are considered as the most serious health risk facing children in developed worlds. School safety evaluations were conducted involving four components: i) site visits providing physical assessments of current road conditions, ii) consultation with key groups including school principals and Local Council representatives, iii) desk-top review of available behavioural and training programs, iv) workshops to develop recommendations for appropriate and sustainable conceptual solutions. Using a number of case studies, the findings suggest that evidence-based and consultative selection of initiatives can be effective in encouraging walking and cycling while providing a safer environment around schools. This can be achieved through implementation of multi-faceted initiatives including engineering treatments to enhance the safety of the physical environment around the school and on popular routes to school, as well as sustainable educational/training programs for both students and parents. Evidence-based safety assessments are useful to develop a Safe System environment around schools. A combination of improvements to road design and operation, especially vehicle speed reductions and separation of vehicles and pedestrians, and behavioural programs to improved education and training, along with enhanced supervision can achieve sustainable reductions in child pedestrian trauma around schools.

Trends in local newspaper reporting of London cyclist fatalities 1992-2012: the role of the media in shaping the systems dynamics of cycling

BackgroundSuccessfully increasing cycling across a broad range of the population would confer important health benefits, but many potential cyclists are deterred by fears about traffic danger. Media coverage of road traffic crashes may reinforce this perception. As part of a wider effort to model the system dynamics of urban cycling, in this paper we examined how media coverage of cyclist fatalities in London changed across a period when the prevalence of cycling doubled. We compared this with changes in the coverage of motorcyclist fatalities as a control group. MethodsPolice records of traffic crashes (STATS19) were used to identify all cyclist and motorcyclist fatalities in London between 1992 and 2012. We searched electronic archives of London's largest local newspaper to identify relevant articles (January 1992–April 2014), and sought to identify which police-reported fatalities received any media coverage. We repeated this in three smaller English cities. ResultsAcross the period when cycling trips doubled in London, the proportion of fatalities covered in the local media increased from 6% in 1992–1994 to 75% in 2010–2012. By contrast, the coverage of motorcyclist fatalities remained low (4% in 1992–1994 versus 5% in 2010–2012; p=0.007 for interaction between mode and time period). Comparisons with other English cities suggested that the changes observed in London might not occur in smaller cities with lower absolute numbers of crashes, as in these settings fatalities are almost always covered regardless of mode share (79–100% coverage for both cyclist and motorcyclist fatalities). ConclusionIn large cities, an increase in the popularity (and therefore ‘newsworthiness’) of cycling may increase the propensity of the media to cover cyclist fatalities. This has the potential to give the public the impression that cycling has become more dangerous, and thereby initiate a negative feedback loop that dampens down further increases in cycling. Understanding these complex roles of the media in shaping cycling trends may help identify effective policy levers to achieve sustained growth in cycling.

First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands.

Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands.

Cardiac Fatalities in Firefighters: An Analysis of the U.S. Fire Administration Database.

Cardiac fatalities are the leading cause of death among all firefighters. Increasing age has been linked to increased cardiac fatalities in firefighters; however, circumstances surrounding in-line-of-duty cardiac firefighter deaths can also increase the risk of a cardiac death. The authors hypothesize that cardiac fatalities among firefighters will be related to the type of duty and level of physical exertion. The authors analyzed the Firefighter Fatalities and Statistics data collected by the U.S. Fire Administration (http://apps.usfa.fema.gov/firefighter-fatalities/fatalityData/statistics) from January 2002 to December 2012. Data were analyzed for associations between age, firefighter classification, duty-type, and cause of fatal cardiac event. A total of 1153 firefighter fatalities occurred during the 10-year period reviewed. Of these, 47% were cardiac fatalities. Mean age was significantly higher in firefighters who suffered a cardiac fatality (52.0 ± 11.4 ± 40.8 ± 14.7 years; P < .05). Volunteer firefighters suffered significantly higher proportion of cardiac fatalities (62%; P < .05) followed by career firefighters (32%). Additionally, cardiac fatalities were the leading cause of death for volunteer firefighters (54%; P < .05). The highest proportion of cardiac fatalities occurred on-the-scene (29%; P < .05) followed by after-duty fatalities (25%). Stress and overexertion accounted for 98% of the cause of cardiac fatalities. Adjusting for rank and firefighter classification, age (odds ratio, 1.06; 95% confidence interval, 1.05-1.08) and stress or overexertion (odds ratio, 11.9; 95% confidence interval, 1.7-83.4) were independent predictors of a firefighter cardiac fatality. Both career and volunteer firefighters are at significantly higher risk of a fatal cardiac event as they age. These fatalities occur in a significant proportion on-the-scene. National efforts should be aimed at these high-risk populations to improve cardiovascular health.

Injury patterns and features of cycling fatalities in South Australia

There has been an increase in cycling in Australia. This means that more cyclists are at risk of injuries, which account for a proportion of transport-related fatalities. In this study, all cyclist fatalities from 2002 to 2013 in South Australia where post-mortem examinations were performed were investigated. There were 42 deaths representing 3% of the total road fatalities over the same time. Of this total number of cases, 13 deaths (31%) involved collapse (mostly natural causes from an underlying medical condition) and 29 (69%) resulted from trauma. There were no cases of hyperthermia. Of the decedents 95% were male, and the mean age at death was 47 years. Fatal incidents were more likely to occur during April and November, and on a Monday. However, statistical analysis was not possible due to the small number of cases. Fatalities (traumatic and collapse) predominantly occurred whilst the cyclist was riding (86%). The majority of riding fatalities were as a result of collision with vehicles (81%). Drugs (including alcohol) were detected in two (15%) of the 13 cases of the collapses, and in seven (26%) of the 27 trauma cases tested. In trauma cases, death was most often due to multiple injuries. The most frequent area for injury was the head (found in 90% of traumatic deaths). Despite the increasing numbers of cyclists on South Australian roads over the last decade, death rates have trended downwards suggesting that road safety campaigns and the provision of more dedicated bicycle lanes have had a positive outcome.

Acceptance of drinking and driving and alcohol-involved driving crashes in California

BackgroundAlcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one’s residential city) were related to individual-level perceptions and behavior. MethodsUsing data from a 2012 cross-sectional roadside survey of 1147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving. ResultsA non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home. DiscussionThe present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of these crashes may serve as an environmental cue which informs drinking and driving perceptions. Perceptual information on traffic safety can be used to identify places where people may be at greater risk for drinking and driving. Community-level traffic fatalities may be a salient cue for tailoring risk communication.

Characterization of severe hand, foot, and mouth disease in Shenzhen, China, 2009-2013.

Hand, foot, and mouth disease (HFMD) is caused by human enteroviruses, especially by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). Patients infected with different enteroviruses show varied clinical symptoms. The aim of this study was to determine whether the etiological spectrum of mild and severe HFMD changed, and the association between pathogens and clinical features. From 2009 to 2013, a total of 2,299 stool or rectal specimens were collected with corresponding patient data. A dynamic view of the etiological spectrum of mild and severe HFMD in Shenzhen city of China was provided. EV71 accounted for the majority proportion of severe HFMD cases and fatalities during 2009-2013. CA16 and EV71 were gradually replaced by coxsackievirus A6 (CA6) as the most common serotype for mild HFMD since 2010. Myoclonic jerk and vomiting were the most frequent severe symptoms. Nervous system complications, including aseptic encephalitis and aseptic meningitis were observed mainly in patients infected by EV71. Among EV71, CA16, CA6, and CA10 infection, fever and pharyngalgia were more likely to develop, vesicles on the hand, foot, elbow, knee and buttock were less likely to develop in patients infected with CA10. Vesicles on the mouth more frequently occurred in the patients with CA6, but less in the patient with EV71. Associations between diverse enterovirus serotypes and various clinical features were discovered in the present study, which may offer further insight into early detection, diagnosis and treatment of HFMD.

Optimization-based excavator pose estimation using real-time location systems

Of various types of equipment engaged in earthwork projects, excavators account for the largest proportion of fatalities on site, with 36 reported incidents in the U.S. only in 2012. Furthermore, the operations of excavators play a defining role in the productivity of earthwork projects. Thus, it is of a crucial importance to constantly monitor the operations of excavators to ensure the smooth progress of the work, early detection of anomalies and prompt corrective measures. The first step in the monitoring of an excavator is estimating its pose. Real-time location systems (RTLSs) provide a robust and reliable technology to track and monitor excavators in near real-time. Location data captured by RTLSs can contribute to the identification of machine-induced safety hazards and the analysis of operation productivity. Nevertheless, while high-accuracy RTLSs require a considerable financial commitment, the more affordable variations of the technology, e.g. Ultra-Wideband (UWB), does not generate accurate enough data that can be readily used for the excavator pose estimation. As a result, the location data generated from such RTLSs require some processing before they can be effectively deployed for the pose estimation. The present research proposes a robust optimization-based method that uses geometric and operational characteristics of an excavator to improve the quality of the pose estimation through maximizing the compliance with the machine-imposed constraints and minimizing the amount of required corrections. The feasibility of the proposed method is validated through two laboratory case studies. The method generates very promising results in terms of maintaining the geometric integrity of the equipment data and estimating the pose of the equipment.

Multi-level hot zone identification for pedestrian safety

According to the National Highway Traffic Safety Administration (NHTSA), while fatalities from traffic crashes have decreased, the proportion of pedestrian fatalities has steadily increased from 11% to 14% over the past decade. This study aims at identifying two zonal levels factors. The first is to identify hot zones at which pedestrian crashes occurs, while the second are zones where crash-involved pedestrians came from. Bayesian Poisson lognormal simultaneous equation spatial error model (BPLSESEM) was estimated and revealed significant factors for the two target variables. Then, PSIs (potential for safety improvements) were computed using the model. Subsequently, a novel hot zone identification method was suggested to combine both hot zones from where vulnerable pedestrians originated with hot zones where many pedestrian crashes occur. For the former zones, targeted safety education and awareness campaigns can be provided as countermeasures whereas area-wide engineering treatments and enforcement may be effective safety treatments for the latter ones. Thus, it is expected that practitioners are able to suggest appropriate safety treatments for pedestrian crashes using the method and results from this study.