Design and evaluation of a rural intersection conflict warning system and alternative designs among various driver age groups

Abstract Background Most western countries are facing relevant demographic changes, and the percentage of older people is destined to rise in the next decades. This fact is likely to affect the sustainability of healthcare systems significantly, mainly due to the connected issue of chronicity. Methods In this paper, using an extensive and comprehensive administrative dataset, we analyse the phenomenon of frequent use of emergency departments (ED) in the oldest region in Europe (i.e. Liguria) over 4 years (2013–2016). Two alternative approaches are used to define categories of ED users based on the intensity and frequency of accesses and splitting patients into different age groups. Results Results allow identifying clinical and socio-demographic risk-factors connected to different levels of ED utilisation and highlight the influential role played by chronic conditions (particularly mental disorders, respiratory diseases) and by multiple chronic conditions. Conclusions The study aims at representing an informative tool to support policy-makers in setting proper policies addressed, on the one side, towards the potentially preventable frequent users and, on the other, towards those accessing due to complex medical conditions. The results can help in building a warning system to help general practitioners in the identification of potential frequent users and to develop preventive policies.

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Impact of different heat wave definitions on daily mortality in Bandafassi, Senegal

PLoS ONE ◽

10.1371/journal.pone.0249199 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249199

Author(s):

Mbaye Faye ◽

Abdoulaye Dème ◽

Abdou Kâ Diongue ◽

Ibrahima Diouf

Keyword(s):

Heat Wave ◽

Heat Waves ◽

Age Groups ◽

Additive Model ◽

Total Mortality ◽

Warning System ◽

Decision Makers ◽

Maximum Temperature ◽

Climate Services ◽

The Impact

Objective The aim of this study is to find the most suitable heat wave definition among 15 different ones and to evaluate its impact on total, age-, and gender-specific mortality for Bandafassi, Senegal. Methods Daily weather station data were obtained from Kedougou situated at 17 km from Bandafassi from 1973 to 2012. Poisson generalized additive model (GAM) and distributed lag non-linear model (DLNM) are used to investigate the effect of heat wave on mortality and to evaluate the nonlinear association of heat wave definitions at different lag days, respectively. Results Heat wave definitions, based on three or more consecutive days with both daily minimum and maximum temperatures greater than the 90th percentile, provided the best model fit. A statistically significant increase in the relative risk (RRs 1.4 (95% Confidence Interval (CI): 1.2–1.6), 1.7 (95% CI: 1.5–1.9), 1.21 (95% CI: 1.08–1.3), 1.2 (95% CI: 1.04–1.5), 1.5 (95% CI: 1.3–1.8), 1.4 (95% CI: 1.2–1.5), 1.5 (95% CI: 1.07–1.6), and 1.5 (95% CI: 1.3–1.8)) of total mortality was observed for eight definitions. By using the definition based on the 90th percentile of minimum and maximum temperature with a 3-day duration, we also found that females and people aged ≥ 55 years old were at higher risks than males and other different age groups to heat wave related mortality. Conclusion The impact of heat waves was associated with total-, age-, gender-mortality. These results are expected to be useful for decision makers who conceive of public health policies in Senegal and elsewhere. Climate parameters, including temperatures and humidity, could be used to forecast heat wave risks as an early warning system in the area where we conduct this research. More broadly, our findings should be highly beneficial to climate services, researchers, clinicians, end-users and decision-makers.

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"Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis" (Preprint)

10.2196/preprints.27224 ◽

2021 ◽

Author(s):

Mohammed Alamad ◽

Yousef S. Khader, Khader

Keyword(s):

Surveillance System ◽

Case Fatality Rate ◽

Age Groups ◽

Case Fatality ◽

Warning System ◽

Daily Basis ◽

Vaccination Status ◽

Age Group ◽

Fatality Rate ◽

Probable Case

BACKGROUND As a consequence of war and collapse of health system in Yemen, diphtheria fatal epidemic occurred at the end of 2017 OBJECTIVE This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate METHODS Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case RESULTS A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which were Raymah, Abyan , Sa'ada, Lahj, Al Jawf. CONCLUSIONS : Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.

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Comprehensive Epilepsy Early Warning System and Seizure Alarm

ASME 2009 4th Frontiers in Biomedical Devices ◽

10.1115/biomed2009-83042 ◽

2009 ◽

Author(s):

Neeraj K. Singh ◽

Ravindra Kumar Singh

Keyword(s):

Early Warning ◽

Early Warning System ◽

Abdominal Cavity ◽

Age Groups ◽

Warning System ◽

Unexpected Death ◽

Risk Of Death ◽

Increased Risk ◽

Physical Dysfunction ◽

General Movement

Epilepsy is characterized by unprovoked, recurring seizures that disrupt the nervous system and can cause mental and physical dysfunction. It affects all age groups. About 14% of epilepsy patients are under 15 years old and 24% are over 64, with 62% being between those ages. There is an increased risk of death due to accidents, suicide and other medical conditions. There are also cases where the death appears to be directly related to epilepsy itself, usually referred to as Sudden Unexpected Death in Epilepsy (SUDEP). This information is not always passed from doctor to patient, for various reasons. Epilepsy share is an uncontrolled electrical discharge from nerve cells in the cerebral cortex. This is the part of the brain that integrates higher mental functions, general movement, and the functions of the internal organs in the abdominal cavity, perception, and behavioral reactions. The early warning system will be based on three factors: 1. Detection of abnormal electrical activity of brain. 2. Detection of abnormal breathing (too fast or too slow) that almost always accompanies the onset of an attack. 3. Unusual sensations or movements of parts of body such as muscles relaxation and tightening.

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Nosocomial Infection Control in the Children's and Maternity Hospital ''Harapan Kita''. Early Warning System

Paediatrica Indonesiana ◽

10.14238/pi28.1-2.1988.36-48 ◽

2019 ◽

Vol 28 (1-2) ◽

pp. 36-48

Author(s):

Aliamran Rasjid ◽

H. A. M. Yusuf ◽

Diwyo Soegondo ◽

Leonard Napitupulu

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Age Groups ◽

Warning System ◽

Epidemiological Data ◽

Antibiotic Use ◽

Final Diagnosis ◽

Maternity Hospital ◽

Hospital Policy ◽

Control Programmes

In a children's and maternity hospital, where many high risk patients are hospitalized, a comprehensive but cheap surveillance system is of paramount importance for the improvement of hospital administration, formulation of hospital policy on antibiotic use and the nosocomial infection control programmes. The epidemiological data were primarily collected in a comprehensive built-in monitoring and surveillance programmes of this hospital, and had been distributed throughout the hospital periodically. The collected data had been broken down into (1) summary of ten leading infectious cases of hospitalized patient by tentative and final diagnosis; (2) types of culture by ward; (3) number of culture by sex and age group; (4) types of bacteria by ward; and (5) types of bacteria by culture. The classification of wards is indirectly inherent to the social- strata of the patients. For the refinement of information, they were broken down into data on bed-occupancy by ward, and data on hospitalized patients by sex and age groups as well.

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Effect of Dust Storms on Non-Accidental, Cardiovascular, and Respiratory Mortality: A Case of Dezful City in Iran

Environmental Health Insights ◽

10.1177/11786302211060152 ◽

2021 ◽

Vol 15 ◽

pp. 117863022110601

Author(s):

Hamidreza Aghababaeian ◽

Abbas Ostadtaghizadeh ◽

Ali Ardalan ◽

Ali Asgary ◽

Mehry Akbary ◽

...

Keyword(s):

Linear Model ◽

Health Effects ◽

Age Groups ◽

Warning System ◽

Dust Storms ◽

Khuzestan Province ◽

Respiratory Mortality ◽

Distributed Lag ◽

Risk Of Mortality ◽

Study Results

Background: Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019. Methods: In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality. Results: During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag4: 34.17% and 15-64 years of age groups, lag5: 32.19%, lag6: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag6: 5.49%). Conclusion: The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

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An Ultrastructural Study of the Proliferation Patterns of the Reserve Cells of the Human Cervix Uteri

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100093651 ◽

1972 ◽

Vol 30 ◽

pp. 80-81

Author(s):

Takanori Sohda ◽

Hiroshi Saito ◽

Goro Asano ◽

Katsunari Fukushi ◽

Katsuya Suzuki ◽

...

Keyword(s):

Ultrastructural Study ◽

Age Groups ◽

Point Of View ◽

University Hospital ◽

Cervix Uteri ◽

Morphological Aspect ◽

Functional Aspect ◽

Pathological Conditions ◽

Human Cervix ◽

Morphological Patterns

Recently, the functional aspect as well as morphological aspect of the reserve cells in the cervix uteri drew much attention in view of the carcinogenesis in squamocolumunar junction. In this communication, the authors elucidate the ultrastructural features of the reserve cells in patients of various age groups visiting our university hospital and affiliated hospital.From conventional light microscopic point of view, the reserve cells tend to be pronounced in various pathological conditions, such as the persisting inflammation, proliferative disorders and irritation of hormones. The morphological patterns of the reserve cells from various stage and degree of irritation were observed.

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Effects of aging on axon terminals in the dentate molecular layer

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100128924 ◽

1987 ◽

Vol 45 ◽

pp. 928-929

Author(s):

K. Cullen-Dockstader ◽

E. Fifkova

Keyword(s):

Granule Cells ◽

Molecular Layer ◽

Age Groups ◽

Long Term Potentiation ◽

Male Rats ◽

Perforant Path ◽

Axon Terminals ◽

Fischer 344 ◽

Spatial Memory Deficit ◽

Effects Of Aging

Normal aging results in a pronounced spatial memory deficit associated with a rapid decay of long-term potentiation at the synapses between the perforant path and spines in the medial and distal thirds of the dentate molecular layer (DML), suggesting the alteration of synaptic transmission in the dentate fascia. While the number of dentate granule cells remains unchanged, and there are no obvious pathological changes in these cells associated with increasing age, the density of their axospinous contacts has been shown to decrease. There are indications that the presynaptic element is affected by senescence before the postsynaptic element, yet little attention has been given to the fine structure of the remaining axon terminals. Therefore, we studied the axon terminals of the perforant path in the DML across three age groups.5 Male rats (Fischer 344) of each age group (3, 24 and 30 months), were perfused through the aorta.

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RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

Emerging Topics in Life Sciences ◽

10.1042/etls20170101 ◽

2017 ◽

Vol 1 (6) ◽

pp. 533-537

Author(s):

Lorenz von Seidlein ◽

Borimas Hanboonkunupakarn ◽

Podjanee Jittmala ◽

Sasithon Pukrittayakamee

Keyword(s):

Protective Efficacy ◽

Age Groups ◽

Sub Saharan Africa ◽

Phase Iii ◽

European Medicines Agency ◽

Older Children ◽

Pivotal Phase ◽

Malaria Epidemiology ◽

Maximum Benefit ◽

Sub Saharan

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

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Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

Journal of Speech Language and Hearing Research ◽

10.1044/2018_jslhr-s-17-0222 ◽

2019 ◽

Vol 62 (5) ◽

pp. 1258-1277 ◽

Cited By ~ 1

Author(s):

Megan K. MacPherson

Keyword(s):

Older Adults ◽

Cognitive Load ◽

Motor Performance ◽

Age Groups ◽

Incongruent Condition ◽

Sentence Production ◽

Movement Duration ◽

Production Task ◽

Younger Adults ◽

Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

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