Reduction In Fatalities Research Articles

Integrated analyses of the transmission history of SARS-CoV-2 and its association with molecular evolution of the virus underlining the pandemic outbreaks in Italy, 2019-2023

BackgroundItaly was significantly affected by the COVID-19 pandemic, experiencing multiple waves of infection following the sequential emergence of new variants. Understanding the transmission patterns and evolution of SARS-CoV-2 is vital for future preparedness. MethodsWe conducted an analysis of viral genome sequences, integrating epidemiological and phylodynamic approaches, to characterize how SARS-CoV-2 variants have spread within the country. ResultsOur findings indicate bidirectional international transmission, with Italy transitioning between importing and exporting the virus. Italy experienced four distinct epidemic waves, each associated with a significant reduction in fatalities from 2021 to 2023. These waves were primarily driven by the emergence of VOCs such as Alpha, Delta, and Omicron, which were reflected in observed transmission dynamics and effectiveness of public health measures. ConclusionsThe changing patterns of viral spread and variant prevalence throughout Italy's pandemic response underscore the continued importance of flexible public health strategies and genomic surveillance, both of which are crucial for tracking the evolution of variants and adapting control measures effectively to ensure preparedness for future outbreaks.

The Impact of the COVID-19 Pandemic on Fatal Road-Traffic Accidents: A Five-Year Study on Medicolegal Autopsies in Timis County, Romania

Road traffic accidents (RTAs) represent the key sign of the level of road safety. Romania once held the record for road deaths among European Union (EU) countries and as of 2023, it came second place. It is of utmost importance to assess whether measures that restricted human mobility during the coronavirus disease 2019 (COVID-19) pandemic led to a significant reduction in road fatalities. This study assesses the impact of the COVID-19 pandemic on victims of fatal RTAs by analyzing medicolegal autopsies from the Timisoara Institute of Legal Medicine (TILM), Timis County, Romania. Materials and methods: Medicolegal autopsy records of RTA victims from TILM in a 5-year period (2017–2021) were analyzed. Results: 395 cases (10.5%) were represented by victims of fatal RTAs. The reduction in the number of cases in the pandemic period was not statistically significant (p = 0.061) compared to the pre-pandemic period, but the number of victims of RTAs decreased by 17.6%. This highlights the importance of understanding the role of other risk factors in fatal RTAs, since a lesser volume of traffic did not cause a significant decrease in road fatalities. Male victims were predominant, with 18–50 years being the most affected age group. In the pandemic period, the most affected age groups were 31–40 (18.5%), followed closely by 41–50 (17.6%) and 18–30 (16.7%). In the pre-pandemic period, the first place was held by people in the age interval of 61–70 (20.5%), followed by 18–30 (19.2%). Drivers were the most involved type of road user, and a slight increase in the proportion of cyclists (13.9% from 10.5%) and motorcyclists (6.5% from 5.9%) was noted. Conclusions: Our findings show that measures implemented to control the COVID-19 pandemic may have had a positive effect on the reduction of RTAs, as shown by the information based on medicolegal autopsies in Timis County, Romania, but more attention needs to be focused on other risk factors. Further studies need to identify reasons for the small reduction in fatal injuries when the volume of traffic was reduced during mandated national lockdown.

Capacity building for road safety in LMICs: the need for a sustainable local knowledge and research infrastructure

Road crashes continue to be a major cause of death and serious injury for low- and middle-income countries (LMICs). At the global level, 90% of traffic fatalities occur in these countries with a dramatic daily amount of 3 260 road deaths, many of whom are children. The first UN Decade of Action for Road Safety 2011–2020 was designed to develop a massive movement towards a decrease of these numbers. This resulted in many initiatives to introduce the safe system approach in LMICs, i.e. to implement road safety management, make roads, road users, and vehicles safer, and improve post-crash health care. International organisations together with NGOs and universities prepared road safety guides and manuals, gave courses and webinars, introduced auditing and inspection systems, with the overall intention to build capacity in LMICs. Together these actions contributed to a variety of road safety developments in LMICs but the overall results were still modest. At the third Global Ministerial Conference on Road Safety in Stockholm, 2020, and in the Global Status report by the World Health Organization, 2023, the results of all efforts were presented and evaluated. Many countries made progress through road safety management and better legislation addressing risk factors such as speeding, drinking and driving, failing to use seatbelts, and poor infrastructure design. However, the reduction in road deaths strongly lagged behind the original goals. Continued implementation of programs and development of new approaches are needed to make a breakthrough, and to reach the goals of the 2nd Decade of Action, i.e. a 50% reduction in fatalities by 2030, and the same percentage reduction in injuries. The present position paper argues that despite the enormous amount of road safety information, which has been and is ‘sent’ to LMICs, and despite the quality and robustness of international organisations behind these programs, there is a shortfall in the scale of the knowledge and research infrastructure currently existing in LMICs, which is needed to ‘receive and transfer’ this knowledge. In order to develop evidence-based policy, LMICs need research programs that are able to transfer safe system principles to the local context and culture. Several literature overviews illustrate the lack of such research in LMICs, i.e. the limited number of programs at local universities and research institutes. Although recently initiatives have been taken in some countries, the implementation of such programs is urgently needed. Based on this observation we call on international organisations to establish a special program for the development of a sustainable road safety knowledge and research infrastructure in LMICs. Such structural local capacity is a prerequisite to translate international road safety knowledge into local guidelines and to develop an evidence-based road safety policy. Most importantly, this local infrastructure will give countries a national knowledge bank, thus providing them with an urgently needed sustainable road safety memory.

Road crash dynamics in Malaysia: Analysis of trends and patterns

Road crashes represent a significant public health and safety concern globally, and Malaysia is no exception. Understanding the trends and patterns of road crashes is essential for devising effective strategies to mitigate risks and enhance road safety. This study presents a comprehensive analysis of road crash dynamics, focusing on road users, severity patterns and geographical patterns in Malaysia from 2012 to 2022. Data sourced from the Royal Malaysian Police (RMP) are utilized to examine various aspects of road crashes. Road crash trend, geographical patterns, linear trend analysis and K-means clustering are employed to explore patterns of road crash in Malaysia. The findings reveal that motorcycles consistently emerged as the most involved road user. Geographical patterns discovered that Selangor exhibits higher crash number. Linear trend analysis revealed significant upward trends in crash frequency prior to the pandemic, while the number of fatalities resulting from road crash showed a downward trend over the observed period. K-means clustering identified that Selangor recorded high total crashes and high total of fatalities. This study also considers the influence of the Covid-19 pandemic on road crash dynamics, highlighting changes in travel patterns and behaviour. There also have been notable successes, such as the reduction in total fatalities and the effectiveness of targeted interventions via the accomplishments of initiatives of Malaysian Road Safety Plan 2014–2022.

Reviewing Ivermectin’s Efficacy in Treating COVID-19 Infection

Background: The use of antiviral therapies in addressing COVID-19 infection has been subject to varying approaches across different jurisdictions during the initial two years of the pandemic, with ivermectin being permitted in some regions, while banned in others. Objective: This study aimed to comprehensively review the evidence surrounding the efficacy of ivermectin, specifically in combating COVID-19 infection. Method: The efficacy of ivermectin has been assessed through an extensive review of scientific literature. Additionally, a comparative analysis has been conducted, evaluating cases and fatalities in states and countries that either have embraced or rejected ivermectin and other antiviral treatments. Results: A thorough examination of the scientific literature has revealed a predominantly positive trend supporting the utilization of ivermectin, evident in works published up to October 2021 and continuing in subsequent publications. Insights drawn from 217 studies have indicated improvements of 85%, 62%, and 41% for prophylaxis, early treatment, and late treatment, respectively. This positive effect, particularly in prophylaxis, has been further substantiated by analyzing cases and fatalities during the mid-2021 Indian outbreak. The success of the ivermectin-based Uttar Pradesh kit has been highlighted by the notably expedited reduction in cases and fatalities compared to other Indian states employing alternative approaches. Moreover, when contrasting countries that have prohibited ivermectin and other antivirals (e.g., the United States and the United Kingdom) with nations endorsing various antiviral strategies, including ivermectin, or with historical use of ivermectin (e.g., Africa, India, Saudi Arabia, or the United Arab Emirates), the advantages of endorsing rather than discouraging antiviral therapies have become evident. Conclusion: The majority of scientific literature has been found to support the use of ivermectin against COVID-19 infection, consistent with the lesser impact of COVID-19 infections observed in Indian states that have either utilized or abstained from ivermectin, as well as in countries that have either adopted or rejected antiviral treatments.

The role of posted speed limit on pedestrian and bicycle injury severities: An investigation into systematic and unobserved heterogeneities

The posted speed limit, as a proxy of actual speed, is one of the most fundamental predictors of active travelers’ (pedestrian and bicyclist) injury outcomes when involved in crashes with motor vehicles. Although earlier studies predominantly considered posted speed limit as an exogenous variable and provided highly insightful findings, majorities of them assume the effects of active traveler behavior to remain the same across different posted speed limits, which in turn neglect the heterogeneity in active traveler behaviors on high-speed roads vs. low-speed roads. This study proposes to develop a latent segmentation-based active traveler injury severity model to relax the homogeneity assumption of the posted speed limit by active traveler behavior. Specifically, this study proposes to estimate a latent segmentation-based correlated random parameters generalized ordered logit model to examine active travel injury severity mechanisms. The proposed model accommodates systematic heterogeneity in the effects of posted speed limit, crash year and active traveler group by using a piecewise linear function in injury severity component of the latent segment model. The model is demonstrated by using active traveler crash data from Queensland, Australia, for the years 2015 through 2019. To demonstrate the implications of the estimated models, a number of hypothetical scenario analyses are performed with a specific focus on active traveler behavior and reduction in posted speed limits. The outcomes from the hypothetical scenario analysis highlighted that a 76 % (73 %) reduction in active traveler fatalities can be achieved by converting 50–60 km/hr roadways to 10–40 km/hr roadways in the urban areas (rural areas) of Queensland. The outcomes of the study will allow us to identify effective speed management strategies while targeting those with high-risk behavior.

An individual-based dynamic model to assess interventions to mitigate opioid overdose risk

BackgroundIllicit opioid overdose continues to rise in North America and is a leading cause of death. Mathematical modeling is a valuable tool to investigate the epidemiology of this public health issue, as it can characterize key features of population outcomes and quantify the broader effect of structural and interventional changes on overdose mortality. The aim of this study is to quantify and predict the impact of key harm reduction strategies at differing levels of scale-up on fatal and nonfatal overdose among a population of people engaging in unregulated opioid use in Toronto.MethodsAn individual-based model for opioid overdose was built featuring demographic and behavioural variation among members of the population. Key individual attributes known to scale the risk of fatal and nonfatal overdose were identified and incorporated into a dynamic modeling framework, wherein every member of the simulated population encompasses a set of distinct characteristics that govern demographics, intervention usage, and overdose incidence. The model was parametrized to fatal and nonfatal overdose events reported in Toronto in 2019. The interventions considered were opioid agonist therapy (OAT), supervised consumption sites (SCS), take-home naloxone (THN), drug-checking, and reducing fentanyl in the drug supply. Harm reduction scenarios were explored relative to a baseline model to examine the impact of each intervention being scaled from 0% use to 100% use on overdose events.ResultsModel simulations resulted in 3690.6 nonfatal and 295.4 fatal overdoses, coinciding with 2019 data from Toronto. From this baseline, at full scale-up, 290 deaths were averted by THN, 248 from eliminating fentanyl from the drug supply, 124 from SCS use, 173 from OAT, and 100 by drug-checking services. Drug-checking and reducing fentanyl in the drug supply were the only harm reduction strategies that reduced the number of nonfatal overdoses.ConclusionsWithin a multi-faceted harm reduction approach, scaling up take-home naloxone, and reducing fentanyl in the drug supply led to the largest reduction in opioid overdose fatality in Toronto. Detailed model simulation studies provide an additional tool to assess and inform public health policy on harm reduction.

Environmental, Geographical, and Economic Impacts of Inbound Tourism in China: A Mixed-Effects Gravity Model Approach

This study examines the dynamics of inbound tourism in China, utilizing a mixed-effects gravity model to analyze data from urban clusters around China’s three major airports. The research methodology of the study includes applying advanced econometric techniques, such as the Poisson pseudo-maximum likelihood estimation, to ensure robust and accurate results. The study focuses on international tourist arrivals and foreign exchange earnings, identifying key drivers such as tourism resources, transportation safety, and service quality. Our findings indicate a 10% increase in per capita GDP correlates with a 0.88% rise in inbound tourist numbers. Additionally, proximity to major urban centers like Beijing, Shanghai, and Guangzhou significantly influences tourist arrivals, with every 100 km increase in distance resulting in a 5.56% decrease in tourist numbers. The study also explores the impact of environmental factors on tourism, suggesting that improvements in green coverage and reductions in industrial waste and traffic fatalities could enhance tourist arrivals. Conversely, environmental protection measures can both positively and negatively impact tourism. This research provides a strategic blueprint for policymakers and professionals in tourism and environmental sustainability, emphasizing the importance of integrated environmental sustainability in tourism development strategies. The model accounts for up to 79% of the variability in inbound tourism flows, offering robust evidence that economic and policy dimensions impact tourism.

Universal Background Checks, Permit Requirements, and Firearm Homicide Rates

A loophole in US gun policy is that people can purchase guns from private sellers without going through any background check. Some states have addressed this loophole by requiring universal background checks for all gun sales, either at the point of sale or through a permit system; however, most studies on the effectiveness of universal background checks have not analyzed these 2 policy mechanisms separately. To assess the association of point-of-sale background check law and gun permit law, separately, with firearm homicide rates from 1976 through 2022 using the same methods and model specification. This cross-sectional study used a difference-in-differences, fixed-effects regression model to evaluate firearm laws and firearm homicide rates in 48 states from 1976 through 2022. Data were obtained for 48 states except New Hampshire and Vermont and were analyzed in January 2024. Implementation of either the law requiring a universal background check at point of sale for all firearms without a permit or the laws combining universal background checks and a state permit requirement for all gun purchasers. Annual, state-specific rates of firearm homicide per 100 000 people. From 1976 through 2022, 12 states adopted the universal background check laws without permitting requirements and 7 states implemented gun permit laws covering all firearms. The mean (SD) firearm homicide rate was 4.3 (0.1) per 100 000 people. Universal background checks for all firearms alone (without a state permitting system) were not associated with overall homicide rates (percentage change, 1.3%; 95% CI, -6.9% to 10.4%) or firearm homicide rates (percentage change, 3.7%; 95% CI, -5.3% to 13.6%). A law requiring a permit for the purchase of all firearms was associated with significantly lower overall homicide rates (percentage change, -15.4%; 95% CI, -28.5% to -0.01%) and firearm homicide rates (percentage change, -18.3%; 95% CI, -32.0% to -1.9%). This cross-sectional study found that universal background checks alone were not associated with firearm homicide rates, but a permit requirement for the purchase and possession of firearms was associated with substantially reduced rates of firearm homicide. The findings suggest that combining universal background checks and permit-to-purchase requirements is an effective strategy for firearm-related fatality reduction.

Ethiopia National Cholera Elimination Plan 2022-2028: Experiences, Challenges, and the Way Forward.

Cholera remains a significant public health concern in Ethiopia. More than 15.9 million Ethiopians, constituting 15% of the total population, live in areas with a history of recurrent cholera outbreaks. The last 9 years of national cholera surveillance data show the country has been experiencing cholera outbreaks every year. The current cholera outbreak, starting in August 2022, has affected the entire country, with 841 reported cases and a 3.13% case fatality rate (CFR) in 2022, and >30 000 cases with nearly a 1.4% CFR in 2023. In line with "Ending Cholera-A Global Roadmap to 2030," the government of Ethiopia is committed to eliminate cholera in the country and has prepared its "National Cholera Elimination Plan (NCP): 2022-2028" with aims to achieve zero local transmission in cholera hotspot areas by 2028 and 90% fatality reduction from the recent (2020-2022) average of 1.8% CFR. The plan is multisectoral, has a clear coordination platform, contains all interventions with in-depth situational analysis, is concordant with existing plans and strategies, and is cascaded at the regional level and implemented with existing government and public structures. Nationwide, total 118 cholera hotspot woredas (districts) were identified, and a comprehensive situation analysis of the existing cholera outbreak response capacity was assessed. This multisectoral and multiyear NCP has forecasted around US$404 million budget estimates with >90% allocated to improving the country's water, sanitation, and hygiene (US$222 million; 55% of total NCP budget) and case management (US$149 million; 37%). The cholera vaccination strategy included in the NCP exhibited a 5-year oral cholera vaccine (OCV) introduction plan with 2 doses (30 604 889 doses) and single dose (3 031 266 doses) in selected cholera hotspot areas. However, its implementation is challenged due to a lack of financial support, inability to get the requested vaccine for targeted hotspot woredas (due to the current shortage of doses in the OCV global stockpile), recurrent cholera outbreaks, and high humanitarian needs in the country. It is recommended to have a sustainable financial mechanism to support implementation, follow the requested vaccine doses, and reorganize the planned coordination platform to foster the implementation.

A decade of curtailment studies demonstrates a consistent and effective strategy to reduce bat fatalities at wind turbines in North America

Abstract There is a rapid, global push for wind energy installation. However, large numbers of bats are killed by turbines each year, raising concerns about the impacts of wind energy expansion on bat populations. Preventing turbine blades from spinning at low wind speeds, referred to as curtailment, is a method to reduce bat fatalities, but drawing consistent inference across studies has been challenging. We compiled publicly available studies that evaluated curtailment at six wind energy facilities in North America across 10 years. We used meta‐regression of 29 implemented treatments to determine fatality reduction efficacy as well as sources of variation influencing efficacy. We also estimated species‐specific fatality reduction for three species that comprise most fatalities in North America: hoary bat (Lasiurus cinereus), eastern red bat (Lasiurus borealis) and silver‐haired bat (Lasionycteris noctivagans). We found that curtailment reduced total bat fatalities by 33% with every 1.0 ms−1 increase in curtailment wind speed. Estimates of the efficacy for the three target species were similar (hoary bats: 28% per ms−1, 95% CI: 0.4%–48%, eastern red bats: 32% per ms−1, 95% CI: 13%–47% and silver‐haired bats: 32% per ms−1, 95% CI: 3%–53%). Across multiple facilities and years, a 5.0 ms−1 cut‐in speed was estimated to reduce total bat fatalities by an average of 62% (95% CI: 54%–69%). Mortality reductions at individual facilities in any given year were estimated to fall between 33%–79% (95% prediction interval). Inter‐annual differences rather than inter‐site or turbine characteristics accounted for most of the variation in efficacy rates. Species‐specific average mortality reduction at 5.0 ms−1 curtailment wind speed was 48% (95% CI: 24%–64%) for hoary bats, 61% (95% CI: 42%–74%) for eastern red bats and 52% (95% CI: 30%–66%) for silver‐haired bats. Practical implication. curtailment reduced bat mortality at wind turbines in this North American study. Efficacy increased proportionally as curtailment speed is raised, and patterns and rates of efficacy were similar across species. This indicates that curtailment is an effective strategy to reduce bat fatalities at wind energy facilities, but exploration of further refinements could both minimize bat mortality and maximize energy production.

Impact analysis of Advanced Driver Assistance Systems (ADAS) regarding road safety – computing reduction potentials

In the present study road safety impact analysis for certain advanced driver assistance systems (ADAS) was conducted. Based on a literature review, expert interviews and current adaptations in legislation, the most promising nine ADAS were selected. The impact was analysed based on statistical crash data from Austria. Factors such as infrastructure and weather conditions, market penetration, expected functionality of sensors, user acceptance and risk homeostasis were considered. A software tool was developed to calculate the crash reduction potential of the selected ADAS for the scenarios 2025, 2030 and 2040.The results show that the ADAS related to warning/braking have the greatest future reduction potential and could lead to a reduction of up to 8,700 crashes and 70 fatalities in Austria in 2040. In addition, the Intelligent Speed Assistance system would lead to an overall crash reduction of 8% compared to current crash numbers in Austria in 2040. The Turning Assistant for heavy goods vehicles shows the lowest reduction in crashes and casualties, but due to the highest severity per crash (93 fatalities per 1,000 crashes), it nevertheless provides an important contribution to the reduction of fatalities in road traffic.However, to benefit from the ADAS safety potential, it is highly relevant that these systems are used in a correct manner. In the future, it will be necessary to provide users with more information on the correct use, benefits and limitations of the respective ADAS and to integrate the use of these systems into driver education procedures and tests.

Impact of COVID-19 pandemic on road traffic injuries in Iran: An interrupted time-series analysis.

Globally, the COVID-19 pandemic has affected the number of road accidents and deaths caused by them. The present study aimed to identify the effect of this epidemic on traffic accidents and their casualties in Iran. In this study, Interrupted Time Series Analysis (ITSA) was used in a semi-experimental design to measure the impact of the restrictive policies of COVID-19 on road accidents. Data were collected retrospectively from the Iran Red Crescent Society data set for 31 provinces from March 2017 to February 2022. The information related to the number of road accidents, injuries, deaths, and deaths in the hospital was collected. The Newey-West method is used for estimation. Statistical analyses were carried out using R software version 3.6.1. Since February 2020 in Iran, the reduction in the number of road accidents and the number of injuries and deaths in these accidents was significant at 5% but the reduction of deaths in the scene and hospital was significant at 10%. In general, for all variables, the reduction trend was established only in the first months, and then it had an upward trend. In the early months of the COVID-19 epidemic in Iran, the number of road accidents and their casualties decreased. Policies restricting traffic, quarantine, and fines for violators can be reasons for changing people's behavior and travel patterns and also lead to a reduction in traffic accidents and fatalities. Such studies can explain the importance of the policies in changing behavioural patterns and can be used as a guide in future policies.

Safe Driving Analytics

Abstract: Are you aware that violations of safe driving regulations account for over half of all traffic accidents? However, what if we gave drivers who adhere to those guidelines rewards? It might significantly impact the number of accidents brought on by careless driving. To improve our understanding of how people drive, researchers are also examining how data from automobile cameras may be used. However, the amount of data we collect makes it more difficult to use data science and artificial intelligence to examine it all. In this article, we discuss how we're creating tools to support that analysis and how we might use the data to comprehend the factors that affect people's driving behaviors. We are essentially developing a system that receives video from automobile cameras, interprets it, and then assists us in determining which types of driving pose a risk. To be able to identify dangerous drivers could significantly contribute to making our roads safer for everyone, as driving behavior plays a major role in the majority of crashes. Therefore, improving our understanding of driving behavior could have a revolutionary impact on road safety and the reduction of fatalities and accidents.

Review of City-Wide 30 km/h Speed Limit Benefits in Europe

To date, more and more European cities are systematically working to expand the proportion of their street network with a speed limit of 30 km/h. This paper endeavored to assess the effectiveness of city-wide 30 km/h speed limits in Europe. In an effort to condense research outputs, a quantitative approach along with qualitative assessments were implemented. This study described the changes in safety, environment, energy, traffic, livability, and health before and after the phased implementation of city-wide 30 km/h speed limits. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results from 40 different cities across Europe, including Brussels, Paris, and Zurich, indicated that reductions in speed limits improved road safety by decreasing the likelihood of crash risk and the severity of crashes that do occur. On average, the implementation of 30 km/h speed limits in European cities demonstrated a 23%, 37%, and 38% reduction in road crashes, fatalities, and injuries, respectively. Lower speed limits also yielded environmental benefits, with emissions decreasing on average by 18%, noise pollution levels by 2.5 dB, and fuel consumption by 7%, indicating enhanced fuel efficiency and reduced environmental impact. Encouraging citizens to embrace walking, cycling and utilizing public transit services can further contribute to a safer and environmentally sustainable urban environment.

Is Metformin Use Associated with a More Favorable COVID-19 Course in People with Diabetes?

Background: Diabetes Mellitus (DM) has been associated with a higher Coronavirus disease-19 (COVID-19) mortality, both in hospitalized patients and in the general population. A possible beneficial effect of metformin on the prognosis of COVID-19 has been reported in some observational studies, whereas other studies disagree. Methods: To investigate the possible effect of metformin on COVID-19 in-hospital mortality, we performed a retrospective study that included all SARS-CoV-2-positive patients with DM who were admitted to two Italian hospitals. In order to adjust for possible confounders accounting for the observed reduction of mortality in metformin users, we adopted the COVID-19 Mortality Risk Score (COVID-19 MRS) as a covariate. Results: Out of the 524 included patients, 33.4% died. A binomial logistic regression showed that metformin use was associated with a significant reduction in case fatality (OR 0.67 [0.45-0.98], p = 0.039), with no significant effect on the need for ventilation (OR 0.75 [0.5-1.11], p = 0.146). After adjusting for COVID-19 MRS, metformin did not retain a significant association with in-hospital mortality [OR 0.795 (0.495-1.277), p = 0.342]. Conclusions: A beneficial effect of metformin on COVID-19 was not proven after adjusting for confounding factors. The use of validated tools to stratify the risk for COVID-19 severe disease and death, such as COVID-19 MRS, may be useful to better explore the potential association of medications and comorbidities with COVID-19 prognosis.

Advancing traffic safety through the safe system approach: A systematic review

The Safe System Approach (SSA) has emerged as a comprehensive framework for enhancing traffic safety through system-wide interventions. This systematic review, conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzes 82 relevant studies categorized based on the SSA pillars: safe road users, safe vehicles, safe speeds, safe roads, and post-crash care. The review provides insights into SSA's effectiveness in reducing road traffic fatalities and injuries, exploring implementation challenges and opportunities, including policy initiatives, institutional frameworks, and stakeholder collaborations. The findings highlight the potential for SSA to create a more forgiving and resilient transportation system, offering valuable guidance for policy decisions, future research, and interventions aimed at promoting safer road environments. SSA's comprehensive strategy for Safe Road Users encompasses considerations of road system design, behavior modification, and tailored measures for vulnerable users, showcasing its versatility in addressing diverse challenges. In the realm of Safe Vehicles, SSA actively involves manufacturers in a cycle of continuous improvement, rigorous testing, and collaborative efforts to establish new safety regulations. The emphasis on managing Safe Speeds, aligning with human parameters, and involving communities reflects SSA's adaptable nature and provides insights for establishing context-specific speed limits. SSA contributes significantly to Safe Roads through its implementation of innovative countermeasures, forgiving road designs, and the integration of emerging disciplines, resulting in a notable reduction in fatalities and injuries. In the domain of Post-Crash Care, SSA's integrated perspective fosters collaboration among emergency services, medical professionals, and the justice system. It addresses challenges through standardized approaches and information sharing, ensuring a comprehensive and unified approach to road safety. This review contributes to the ongoing efforts to prioritize safety and transform the transportation landscape on a global scale.

Adoption of ride share services associated with decreased organ donor availability

IntroductionRecent single center studies have shown an association between the introduction and adoption of ride sharing services and a significant reduction in alcohol-related motor vehicle collisions and fatalities at urban trauma centers. There is a lack of studies that have evaluated the effect of the introduction and widespread adoption of ride sharing services on the number of organ donors available from motor vehicle accidents (MVAs) and the effect on the overall donor pool. We hypothesize that the number of deceased donors from MVAs has decreased with the introduction of ride sharing. MethodsThe United Network for Organ Sharing (UNOs) database was retrospectively reviewed from September 29,1987 to June 30, 2022 for deceased donors. Only pediatric donors were excluded (age<15). Donors were analyzed by circumstance of death, which included: MVA, suicide, homicide, non-MVA accidents, natural causes, and other. The launch of the major ride sharing service in the United States occurred on July 15, 2010. This service was available in 100 cities in April 2014 and in 500 cities in December 2016. Data were analyzed in a continuous manner and then 4 major adoption periods were considered: pre-launch, launch to narrow adoption, narrow to wide adoption, and post wide adoption. Results218,606 deceased donors had the circumstance of death data available and were included in our analysis. The mean deceased donor age was 42 years, 60% of donors were male, and 71% were white. MVA proportion of death decreased 5% (p<0.001) from the launch to narrow adoption period (16%) compared to pre-launch (21%). Another 2% (p<0.001) decrease occurred during the narrow to wide adoption period (14%). An additional 2% (p<0.001) drop occurred after wide adoption (12%). Figure 1 shows stacked percentages of the various circumstances of death in a continuous manner. Of note: homicides, suicides, and non-MVA accidents were not consistently recorded until 1994, and natural causes until 2001. This graph demonstrates a notable drop in MVA percentages beginning after the launch of ride sharing with steady declines continuing to the period of wide adoption. While absolute numbers of MVA donors have steadily increased since 2014 and had steady numbers before, the other deceased donor categories have increased at a higher rate. ConclusionThe invention and adoption of ride sharing services has decreased the proportion of organ donors from MVAs. The overall number of donors from MVAs, donors from all other causes, and the total number of deceased donors increases each year.

Using Immersive Virtual Reality to Study Road-Crossing Sustainability in Fleeting Moments of Space and Time

Despite a history of year-by-year reduction in road-crossing harm and fatality in the United States, the trend reversed course in 2009 and road-crossing has grown more hazardous since. Within this tendency, there has been a marked uptick in risk to urban crossers who are neither children nor elderly. The age group in between these extremes represents a bulk of urban crossers, for whom theoretical explanations for crossing behavior that are focused on youth and senior crossing factors often do not apply. New insight is likely required to explain why the rate of crossing harm is growing for the 20–44 age group, but declining among the young and elderly. However, it is difficult to experiment with crossing scenarios in a real-world context, where significant dangers are present and for which the uniqueness of crossers and crossing sites is abundant. In this paper, we introduce an end-to-end system for examining crossing behavior using a unique combination of real human crossing behavior, made safe through the combination of agent-based models, motion capture, virtual geographic environments, and immersive technologies from virtual reality. We demonstrate that this combination of methods can be deployed to examine very high resolution and very high specificities of crossing scenarios and behaviors, with reach to individual crossers and their judgment over tiny windows of space and time. We demonstrate that the system can reproduce known effects from the theoretical literature and from existing case studies, while also generating huge swaths of empirical and diagnostically useful data on crossing actions, interactions, and reactions relative to fleeting events and phenomena of urban geography, traffic dynamics, and ambient pedestrian crowds. To prove the concept, we deploy the system to investigate crossing judgment behavior among the 20–44 age group.

Compliance with Standard Occupational Health and Safety Measures and Associated Factors Among Small-Scale Metal Industry Workers in Central Ethiopia.

Compliance with workplace health and safety measures can result in considerable reduction in workplace injuries and fatalities and attributed economic costs. However, majority of studies conducted in small-scale industries in numerous countries, including Ethiopia focused on the prevalence of occupational injuries and there is a paucity of evidence on level of employees' adherence to safety measures and the associated factors. Therefore, this study was conducted to assess workers' compliance and factors associated with occupational health and safety practices in small-scale metal industries in Central Ethiopia. This study was conducted in Central Ethiopia. A total of 415 small-scale metal workers were included in this study. Study participants were selected using a simple random sampling technique. A structured interviewer-administered questionnaire was used to collect the data. The collected data were entered using EPI Info version 7.2 and exported to IBM-SPSS Version 22 for further cleaning and analysis. Bivariate and multivariate Binary Logistic Regression were conducted to determine association and during the multivariable regression variables with a p-value <0.05 were considered significantly associated factors. The study found a 39.3% (95% CI: 34.7, 44.1) prevalence of good compliance with safety and health measures among small-scale metal workers. Temporary employed workers were less likely to adhere [AOR=0.43, 95% CI (0.21, 0.93)] and workers who received training were more likely to adhere [AOR=5.75, 95% CI (2.56, 12.9)] to safety precautions. Other significantly associated variables included work experience, working at night, and satisfaction with the current salary. This study sheds light on small-scale metal workers' commitment to workplace safety and health procedures, indicating a compliance rate of 39.3%, which is low. Temporary employees and less experienced workers are less likely to follow health and safety precautions. Workplace health and safety training are associated with increased safety precautions.