Variations In Fatality Rates Research Articles

Carbon monoxide poisoning: a clinical case report

BackgroundCarbon monoxide (CO) poisoning is a serious yet frequently overlooked condition with diverse and nonspecific clinical presentations. The analysis of Lithuanian statistics reveals fluctuations in patient admissions and consultations through the poisoning center over a four-year period, with notable variations in fatality rates. Despite these trends, CO poisoning remains a significant public health concern due to its potential for severe long-term sequelae or death.CaseThis case report focuses on two distinct presentations of CO poisoning in a young couple, illustrating the varied manifestations and outcomes of this toxic exposure. The first case describes a 23-year-old male presenting with altered consciousness and neurological symptoms, while the second case involves a 21-year-old pregnant female presenting with cardiovascular symptoms, including Takotsubo cardiomyopathy.DiscussionHighlights include the challenges in diagnosing CO poisoning; factors influencing the severity and symptoms of CO poisoning; potential complications; and considerations for hyperbaric oxygen therapy (HBO) in severe cases and pregnancy.ConclusionThese cases illustrate the importance of recognizing CO poisoning, advocating for oxygen therapy as the first-line treatment, and calling for further research to improve understanding, treatment, and prevention of this potentially fatal condition.

Nutritional support after hospital discharge reduces long-term mortality in patients after gastric cancer surgery: Secondary analysis of a prospective randomized trial

Background and aimsNutritional support after hospital discharge was found to enhance the nutritional condition of patients after cancer surgery. However, the effect of such support on long-term clinical outcomes is controversial. We thus investigated the effect of nutritional support after hospital discharge on long-term clinical outcomes in patients after gastric cancer surgery. MethodsThis was a secondary analysis on individuals at nutritional risk who underwent gastric cancer surgery and were included in a randomized controlled trial. The intervention group received oral nutritional supplements combined with dietary advice, and the control group received dietary advice alone. The long-term mortality (primary outcome) and other clinical outcomes were compared between the groups. ResultsIn total, 321 patients were included in this analysis, with a median follow-up duration of 60.5 months. According to the Nutritional Risk Screening 2002 (NRS 2002), the presence of nutritional risk was found to be a significant predictor of death. This association remained independent even after adjusting for age, sex, comorbidity, and American Joint Committee on Cancer stage. The adjusted hazard ratio for mortality increased by 1.30 (95% confidence interval [CI] 1.05–1.60, P = 0.016) for each additional point rise in NRS. During the follow-up, a total of 64 individuals (39.5%) in the intervention group and 81 patients (50.9%) in the control group died. Consequently, the adjusted hazard ratio for mortality between the two groups was 0.69 (95% CI 0.50–0.96, P = 0.026). The results of interaction tests did not yield statistically significant variations in fatality rates across the age, sex, comorbidity, NRS, and American Joint Committee on Cancer stage subgroups. Nutritional support after hospital discharge significantly improved handgrip strength (adjusted coefficient 5.05, 95% CI 3.01–7.08, P = 0.000) in addition to other functional outcomes. ConclusionsNutritional support after hospital discharge reduced long-term mortality and improved handgrip strength among patients at nutritional risk after gastric cancer surgery. The current investigation provides evidence for the recommendation of nutritional support, for post-surgery patients after hospital discharge, in cancer management guidelines.

Findings from the first wave of Covid-19 on the different impacts of lockdown on public health and economic growth

This paper examines the impact of different durations of national lockdown measures during the first wave of the COVID-19 pandemic on the public health and economic conditions of nations. Results indicate that a) countries with shorter lockdown periods, approximately 15 days, experience a higher variation of confirmed cases/population (%) compared to countries with longer lockdowns, lasting for over one month; b) countries with shorter lockdown periods experience lower average fatality rates compared to countries with longer lockdown periods, while the variation in fatality rates indicates that countries with longer periods of lockdown achieved a more substantial reduction in fatality rates. Nevertheless, the findings of the study indicate that while longer durations of national lockdowns, implemented as a government response to the COVID-19 pandemic, appear to produce somewhat uncertain outcomes in terms of public health, they exhibit a more substantial adverse effect on a country’s economic growth, resulting in a contraction in gross domestic product growth. Extracting key lessons from this study can prove invaluable in crafting effective public responses for future COVID-19 waves and epidemics that resemble the characteristics of COVID-19.

Transportation Disaster Trends and Impacts in Western Asia: A Comprehensive Analysis from 2003 to 2023

This research undertakes a focused analysis of transportation disasters in Western Asia from 2003 to 2023. Utilizing a curated dataset from the EM-DAT database, we delve into the patterns and outcomes of these significant events, categorizing by modality such as air, rail, road, and water. The results highlight a concerning surge in mishaps between 2003 and 2010, followed by a welcome decline. Road-related incidents emerge as a dominant category, but a large portion (73.8%) remains ambiguously categorized as “Unknown”, underscoring potential data gaps or reporting inconsistencies. Turkey stands out, accounting for nearly 45% of all documented incidents, emphasizing its central role in the regional transportation disaster landscape. Advanced ANOVA analyses illustrate variations in fatality rates across years and countries, although differences in injury rates across disaster types did not exhibit statistical significance. The study underscores the importance of continuous safety enhancements, public awareness efforts, and regional cooperation. Ultimately, it underscores the pressing need for strengthened safety frameworks and the value of inter-regional collaboration to uplift transportation safety standards in Western Asia.

Defining geographic emergency medical services coverage in trauma systems.

Geographic distribution of trauma system resources including trauma centers and helicopter bases correlate with outcomes. However, ground emergency medical services (EMS) coverage is dynamic and more difficult to quantify. Our objective was to evaluate measures that describe ground EMS coverage in trauma systems and correlate with outcome. Trauma system resources in Pennsylvania were mapped. Primary outcome was county age-adjusted transportation injury fatality rate. Measures of county EMS coverage included average distance to the nearest trauma center, number of basic life support and advanced life support units/100 square miles, distance differential between the nearest trauma center and nearest helicopter base, and nearest neighbor ratio (dispersed or clustered geographic pattern of agencies). Spatial-lag regression determined association between fatality rates and these measures, adjusted for prehospital time, Injury Severity Score, and socioeconomic factors. Relative importance of these measures was determined by assessing the loss in R value from the full model by removing each measure. A Geographic Emergency Medical Services Index (GEMSI) was created based on these measures for each county. Median fatality rate was higher in counties with fewer trauma system resources. Decreasing distance to nearest trauma center, increasing advanced life support units/100 square miles, greater distance reduction due to helicopter bases, and dispersed geographic pattern of county EMS agencies were associated with lower fatality rates. The GEMSI ranged from -6.6 to 16.4 and accounted for 49% of variation in fatality rates. Adding an EMS agency to a single county that produced a dispersed pattern of EMS coverage reduced predicted fatality rate by 6%, while moving a helicopter base into the same county reduced predicted fatality rate by 22%. The GEMSI uses several measures of ground EMS coverage and correlates with outcome. This tool may be used to describe and compare ground EMS coverage across trauma system geographies, as well as help optimize the geographic distribution of trauma system resources. Ecological study, level IV.

The Estimation of Compensating Wage Differentials: Lessons From the Deadliest Catch

ABSTRACTI use longitudinal survey data from commercial fishing deckhands in the Alaskan Bering Sea to provide new insights on empirical methods commonly used to estimate compensating wage differentials and the value of statistical life (VSL). The unique setting exploits intertemporal variation in fatality rates and wages within worker-vessel pairs caused by a combination of weather patterns and policy changes, allowing identification of parameters and biases that it has only been possible to speculate about in more general settings. I show that estimation strategies common in the literature produce biased estimates in this setting, and decompose the bias components due to latent worker, establishment, and job-match heterogeneity. The estimates also remove the confounding effects of endogenous job mobility and dynamic labor market search, narrowing a conceptual gap between search-based hedonic wage theory and its empirical applications. I find that workers’ marginal aversion to fatal risk falls as risk levels rise, which suggests complementarities in the benefits of public safety policies. Supplementary materials for this article are available online.

Adverse weather conditions and fatal motor vehicle crashes in the United States, 1994-2012.

BackgroundMotor vehicle crashes are a leading cause of injury mortality. Adverse weather and road conditions have the potential to affect the likelihood of motor vehicle fatalities through several pathways. However, there remains a dearth of assessments associating adverse weather conditions to fatal crashes in the United States. We assessed trends in motor vehicle fatalities associated with adverse weather and present spatial variation in fatality rates by state.MethodsWe analyzed the Fatality Analysis Reporting System (FARS) datasets from 1994 to 2012 produced by the National Highway Traffic Safety Administration (NHTSA) that contains reported weather information for each fatal crash. For each year, we estimated the fatal crashes that were associated with adverse weather conditions. We stratified these fatalities by months to examine seasonal patterns. We calculated state-specific rates using annual vehicle miles traveled data for all fatalities and for those related to adverse weather to examine spatial variations in fatality rates. To investigate the role of adverse weather as an independent risk factor for fatal crashes, we calculated odds ratios for known risk factors (e.g., alcohol and drug use, no restraint use, poor driving records, poor light conditions, highway driving) to be reported along with adverse weather.ResultsTotal and adverse weather-related fatalities decreased over 1994–2012. Adverse weather-related fatalities constituted about 16 % of total fatalities on average over the study period. On average, 65 % of adverse weather-related fatalities happened between November and April, with rain/wet conditions more frequently reported than snow/icy conditions. The spatial distribution of fatalities associated with adverse weather by state was different than the distribution of total fatalities. Involvement of alcohol or drugs, no restraint use, and speeding were less likely to co-occur with fatalities during adverse weather conditions.ConclusionsWhile adverse weather is reported for a large number of motor vehicle fatalities for the US, the type of adverse weather and the rate of associated fatality vary geographically. These fatalities may be addressed and potentially prevented by modifying speed limits during inclement weather, improving road surfacing, ice and snow removal, and providing transit alternatives, but the impact of potential interventions requires further research.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0189-x) contains supplementary material, which is available to authorized users.

Estimation of bird fatalities at wind farms with complex topography and vegetation in Hokkaido, Japan

AbstractWorldwide expansion in wind‐energy generation has raised concerns about bird collisions—in particular, protected species. Bird collision studies are common in Europe and USA, but none had been done in Japan to date. We studied bird fatalities at 42 turbines (52.8 MW) in Tomamae, northern Hokkaido, Japan. For 17 months from July 2007 to November 2008, we performed 24 fatality surveys at an average 21‐day interval and ≤100 m from the wind turbines. We found 52 fatalities, including 4 white‐tailed eagles (Haliaeetus albicilla). Our estimate of the adjusted annual mortality at Tomamae, which used a modified equation to factor in the complex topography and dense vegetation spread generically over Japan, was 2.20 bird fatalities/MW/year and 0.36 raptor fatalities/MW/year. Bird utilization rates explained most of the variation in fatality rates among species and among locations. The highest fatality rates occurred at the turbines on a costal cliff where the rotor zones of wind turbines overlapped the frequent flight paths of large birds. The development of generalized models can be useful for predicting the impacts of other wind projects on birds, with the exceptions of high‐risk situations. However, more surveys of fatality rates and utilization rates are required at this and additional study sites, and over a longer period with shorter search intervals, to develop predictive models of bird collisions with general applicability. © 2013 The Wildlife Society.

ROAD SAFETY CHALLENGES FOR THE 21ST CENTURY

International road traffic fatality data show that low-income and middle-income countries on an average have higher road traffic fatality rates than high-income countries. However, neither the number reported by countries...

Patterns of activity and fatality of migratory bats at a wind energy facility in Alberta, Canada

AbstractStudying migratory behavior of bats is challenging. Thus, most information regarding their migratory behavior is anecdotal. Recently, however, fatalities of migratory bats at some wind energy facilities across North America have provided the opportunity and impetus to study bat migration at fine spatial and temporal scales. Using acoustic monitoring and carcass searches, we examined temporal and spatial variation in activity levels and fatality rates of bats at a wind energy facility in southern Alberta, Canada. Our goals were to better understand the influence of weather variables and turbine location on the activity and fatality of hoary bats (Lasiurus cinereus) and silver‐haired bats (Lasionycteris noctivagans), and to use that understanding to predict variation in fatality rates at wind energy facilities and recommend measures to reduce fatalities. Overall activity of migratory bats and of silver‐haired bats increased in low wind speeds and warm ambient temperatures, and was reduced when the wind was from the North or Northeast, whereas hoary bat activity increased with falling barometric pressure. Fatalities of migratory bats in general increased with increased activity of migratory bats, increased moon illumination, and falling barometric pressure and were influenced by the interaction between barometric pressure change and activity. Fatalities of silver‐haired bats increased with increased activity, moon illumination, and winds from the south‐east. Hoary bat fatalities increased with falling barometric pressure. Our results indicate that both the activity and fatality of migratory bats are affected by weather variables, but that species differ in their responses to environmental conditions. Spatially, fatalities were not influenced by the position of turbines within a turbine row, but were influenced by the location of turbines within the facility. Our findings have implications for our understanding of bat migration and efforts to reduce fatalities at wind energy facilities. To maximize the reduction of bat fatalities, operators of wind energy facilities could incorporate migratory bats' response to environmental variables, such as barometric pressure and fraction of moon illuminated, into their existing mitigation strategies. © 2011 The Wildlife Society.

Tick-borne rickettsioses in America: Unanswered questions and emerging diseases

During most of the 20th century, Rickettsia rickettsii, the agent of Rocky Mountain spotted fever, was considered the only tick-borne rickettsia associated with human diseases in the Americas. This dogma suggested that the other characterized and noncharacterized rickettsiae isolated from ticks were not pathogenic to humans. This concept has been modified extensively in the past 10 years with the identification of at least three additional rickettsial species that cause human tick-borne rickettsioses and that are prevalent in the Americas, including Rickettsia parkeri, Rickettsia massiliae, and Rickettsia africae. Moreover, the genetic variability of R. rickettsii and the milder forms of Rocky Mountain spotted fever reactivate the hypothesis that some circulating genotypes of R. rickettsii may be more virulent than others and may explain the wide variations in fatality rates of the disease.

Traffic safety and city structure: lessons for the future

To understand the critical factors that are likely to influence road traffic fatality rates in large cities around the world in the next few decades. Road traffic fatality data for 56 cities around the world and for cities with a population of greater than 100,000 in the USA were collected and analysed to understand factors affecting differences in fatality rates. There are wide variations in fatality rates across income levels and within similar incomes levels. The risk varies by a factor of about 20 between the best and the worst cities. These patterns appear to indicate that it is not enough to have the safest vehicle and road technology to ensure low road traffic fatality rates. City structure, modal share split, and exposure of motorists and pedestrians may have a significant role in determining fatality rates, in addition to enforcement, vehicle crashworthiness and road design.

Deterrent Aspects of No-Fault Automobile Insurance: Some Empirical Findings

Will no-fault automobile insurance lead to a deterioration of driver attitudes, to a weakening of police enforcement efforts and to a tragic increase in deaths and injuries? Proponents of no-fault insurance argue no; opponents argue yes; and some analysts argue that automobile insurance, regardless of type, is unrelated to driving behavior. In this study, the authors analyze the driving behavior consequences of no-fault automobile insurance by formulating a model of traffic fatality rates and estimating the parameters of this model using cross-sectional state data for the years 1975, 1976 and 1977. The model explains approximately 60 percent of the state to state variation in fatality rates. Generally, state characteristics and driving environment variables are related to fatality rates as hypothesized. In addition, the results indicate that fears of a dramatic escalation of fatal accidents because of no-fault insurance are unfounded. Even on a theoretical basis such fears have weak underpinnings. On an empirical basis, they appear to have no foundation whatsoever.