Mass-Casualty, Terrorist Bombings: Epidemiological Outcomes, Resource Utilization, and Time Course of Emergency Needs (Part I)

2003 ◽  
Vol 18 (3) ◽  
pp. 220-234 ◽  
Author(s):  
Jeffrey L. Arnold ◽  
Ming-Che Tsai ◽  
Pinchas Halpern ◽  
Howard Smithline ◽  
Edita Stok ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Resource Utilization ◽  
Time Course ◽  
Mass Casualty ◽  
Time Interval ◽  
Confined Space ◽  
Structural Collapse ◽  
Structural Fire ◽  
Injury Frequency ◽  
Vehicle Delivery

AbstractIntroduction:This article characterizes the epidemiological outcomes, resource utilization, and time course of emergency needs in mass-casualty, terrorist bombings producing 30 or more casualties.Methods:Eligible bombings were identified using a MEDLINE search of articles published between 1996 and October 2002 and a manual search of published references. Mortality, injury frequency, injury severity, emergency department (ED) utilization, hospital admission, and time interval data were abstracted and relevant rates were determined for each bombing. Median values for the rates and the inter-quartile ranges (IQR) were determined for bombing subgroups associated with: (1) vehicle delivery; (2) terrorist suicide; (3) confined-space setting; (4) open-air setting; (5) structural collapse sequela; and (6) structural fire sequela.Results:Inclusion criteria were met by 44 mass-casualty, terrorist bombings reported in 61 articles. Median values for the immediate mortality rates and IQRs were: vehicle-delivery, 4% (1–25%); terrorist-suicide, 19% (7–44%); confined-space 4% (1–11%); open-air, 1% (0–5%); structural-collapse, 18% (5–26%); structural fire 17% (1–17%); and overall, 3% (1–14%). A biphasic pattern of mortality and unique patterns of injury frequency were noted in all subgroups. Median values for the hospital admission rates and IQRs were: vehicle-delivery, 19% (14–50%); terrorist-suicide, 58% (38–77%); confined-space, 52% (36–71%); open-air, 13% (11–27%); structural-collapse, 41% (23–74%); structural-fire, 34% (25–44%); and overall, 34% (14–53%). The shortest reported time interval from detonation to the arrival of the first patient at an ED was five minutes. The shortest reported time interval from detonation to the arrival of the last patient at an ED was 15 minutes. The longest reported time interval from detonation to extrication of a live victim from a structural collapse was 36 hours.Conclusion:Epidemiological outcomes and resource utilization in mass-casualty, terrorist bombings vary with the characteristics of the event.

scholarly journals Importance of experimental information (metadata) for archived sequence data: case of specific gene bias due to lag time between sample harvest and RNA protection in RNA sequencing

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11875
Author(s):  
Tomoko Matsuda
Keyword(s):  
Gene Expression ◽  
Rna Sequencing ◽  
Time Course ◽  
Sequence Data ◽  
Specific Gene ◽  
Time Interval ◽  
Short Time Interval ◽  
Rna Seq ◽  
Lysis Buffer ◽  
Rna Protection

Large volumes of high-throughput sequencing data have been submitted to the Sequencing Read Archive (SRA). The lack of experimental metadata associated with the data makes reuse and understanding data quality very difficult. In the case of RNA sequencing (RNA-Seq), which reveals the presence and quantity of RNA in a biological sample at any moment, it is necessary to consider that gene expression responds over a short time interval (several seconds to a few minutes) in many organisms. Therefore, to isolate RNA that accurately reflects the transcriptome at the point of harvest, raw biological samples should be processed by freezing in liquid nitrogen, immersing in RNA stabilization reagent or lysing and homogenizing in RNA lysis buffer containing guanidine thiocyanate as soon as possible. As the number of samples handled simultaneously increases, the time until the RNA is protected can increase. Here, to evaluate the effect of different lag times in RNA protection on RNA-Seq data, we harvested CHO-S cells after 3, 5, 6, and 7 days of cultivation, added RNA lysis buffer in a time course of 15, 30, 45, and 60 min after harvest, and conducted RNA-Seq. These RNA samples showed high RNA integrity number (RIN) values indicating non-degraded RNA, and sequence data from libraries prepared with these RNA samples was of high quality according to FastQC. We observed that, at the same cultivation day, global trends of gene expression were similar across the time course of addition of RNA lysis buffer; however, the expression of some genes was significantly different between the time-course samples of the same cultivation day; most of these differentially expressed genes were related to apoptosis. We conclude that the time lag between sample harvest and RNA protection influences gene expression of specific genes. It is, therefore, necessary to know not only RIN values of RNA and the quality of the sequence data but also how the experiment was performed when acquiring RNA-Seq data from the database.

Abstract 13027: Risk of Sudden Cardiac Arrest According to the Time of STEMI Occurrence: the e-MUST Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicole Karam ◽  
Sophie Bataille ◽  
Muriel Tafflet ◽  
Eloi Marijon ◽  
Jean Philippe Empana ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Sudden Cardiac Arrest ◽  
Progressive Increase ◽  
Time Interval ◽  
Main Mode ◽  
Time Intervals ◽  
Circadian Change ◽  
Hospital Study ◽  
Suspected Acute Myocardial Infarction

Introduction: STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main mode of death. The risk of out-of-hospital SCA according to the timing of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA, prior to hospital admission, differs according to the timing of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on all STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send, in the field, an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed the rate of SCA, prior to hospital admission, according to the timing of STEMI occurrence (4 hours-time intervals starting at midnight). Results: Among the 8,112 STEMI patients enrolled (mean age (SD) 61.6 (14.3) years, 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant circadian change in the rate of SCA per STEMI, with a progressive increase between 4am and 8pm, followed by a decrease between 8pm and 4am (P=0.0009). The peak rate of SCA per STEMI occurred in the 4pm-8pm time interval (7.7%), while the lowest rate was seen between 4am and 8am (4.2%) (Figure). Conclusions: The risk of STEMI-related SCA is almost 2-fold higher in STEMI occurring in the late afternoon hours. A better understanding of patients’ characteristics, circumstances of occurrence, and pre-hospital care is needed to eventually reduce the risk of SCA promptly after STEMI diagnosis in the field.

Time course of ureteral changes with obstruction

1976 ◽  
Vol 231 (2) ◽  
pp. 393-398 ◽  
Author(s):  
P Biancani ◽  
MP Zabinski ◽  
RM Weiss
Keyword(s):  
Tensile Stress ◽  
Time Course ◽  
Intraluminal Pressure ◽  
Time Interval ◽  
Wall Tension ◽  
Resting Pressure ◽  
Ureteral Dilatation

Chronic obstruction is characterized by a marked degree of ureteral dilatation and tortuosity which develops in the presence of a relatively low intraluminal pressure. To define the mechanism for the development of this relationship, the pressure-tension-deformation relationships of acute and chronically obstructed ureters were investigated. Rabbit ureters, in vivo, were obstructed and deformation correlated with intraluminal pressure. During the initial 3 h of obstruction, ureteral resting pressure increased from approximately 0 to 42 cm H2O, and diameter increased 16% with a slight increase in length. Subsequently, average wall tension (tensile stress) and intraluminal pressure declined, although deformation persisted. Between 6 h and 8 days after the onset of obstruction, intraluminal pressure remained essentially unchanged. During this time interval, ureteral deformation continued gradually and progressively as the ureter underwent creep both circumferentially and longitudinally. This was associated with a marked increase in average wall tension. At 8 days the diameter had increased by 170% and the length by 25%.

scholarly journals Consumer segmentation and time interval between types of hospital admission: a clinical linkage database study

2017 ◽  
Vol 40 (1) ◽  
pp. 154-162 ◽  
Author(s):  
Umesh T Kadam ◽  
Claire A Lawson ◽  
Dawn K Moody ◽  
Lucy Teece ◽  
John Uttley ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Time Interval ◽  
Database Study ◽  
Consumer Segmentation

Prognosis and survival of 128 patients with severe avian influenza A(H7N9) infection in Zhejiang province, China

2014 ◽  
Vol 143 (9) ◽  
pp. 1833-1838 ◽  
Author(s):  
Y. Y. XIAO ◽  
J. CAI ◽  
X. Y. WANG ◽  
F. D. LI ◽  
X. P. SHANG ◽  
...  
Keyword(s):  
Avian Influenza ◽  
Hospital Admission ◽  
Odds Ratio ◽  
Influenza A ◽  
Mainland China ◽  
Zhejiang Province ◽  
Time Interval ◽  
Clinical Visit ◽  
Severe Influenza ◽  
H7n9 Infection

SUMMARYNo published studies have discussed details of the prognosis and survival of patients with severe avian influenza A(H7N9) infection. In this study we analysed 128 laboratory-confirmed cases of severe H7N9 infection in Zhejiang province, the most affected region during the H7N9 epidemic in mainland China. We found that an increase in patient age by 5 years was associated with a 1·41 [95% confidence interval (CI) 1·19–1·67] times odds ratio for fatality. In addition, the time interval between the first clinical visit after symptom onset and hospital admission was inversely associated with survival time since admission. Of the 47 patients who died of the disease, when the time interval between the first clinical visit and hospital admission increased by 1 day, the duration of survival was 0·78 times (95% CI 0·62–0·98) as long. Our results suggest that patients with severe influenza H7N9 infection at older ages were at a higher risk of fatality, and that a delay in hospital admission was associated with more rapid death. More studies are required to corroborate our major findings.

scholarly journals Assembly and suppression of endogenous Kv1.3 channels in human T cells.

1996 ◽  
Vol 107 (3) ◽  
pp. 409-420 ◽  
Author(s):  
G Panyi ◽  
C Deutsch
Keyword(s):  
Binomial Distribution ◽  
Time Course ◽  
K Channel ◽  
Time Interval ◽  
Transmembrane Segments ◽  
Human T Cells ◽  
Subunit Expression ◽  
Human T Lymphocyte ◽  
A Cell ◽  
Lymphocyte Cell

The predominant K+ channel in human T lymphocytes is Kv1.3, which inactivates by a C-type mechanism. To study assembly of these tetrameric channels in Jurkat, a human T-lymphocyte cell line, we have characterized the formation of heterotetrameric channels between endogenous wild-type (WT) Kv1.3 subunits and heterologously expressed mutant (A413V) Kv1.3 subunits. We use a kinetic analysis of C-type inactivation of currents produced by homotetrameric channels and heterotetrameric channels to determine the distribution of channels with different subunit stoichiometries. The distributions are well-described by either a binomial distribution or a binomial distribution plus a fraction of WT homotetramers, indicating that subunit assembly is a random process and that tetramers expressed in the plasma membrane do not dissociate and reassemble. Additionally, endogenous Kv1.3 current is suppressed by a heterologously expressed truncated Kv1.3 that contains the amino terminus and the first two transmembrane segments. The time course for suppression, which is maximal at 48 h after transfection, overlaps with the time interval for heterotetramer formation between heterologously expressed A413V and endogenous WT channels. Our findings suggest that diversity of K+ channel subtypes in a cell is regulated not by spatial segregation of monomeric pools, but rather by the degree of temporal overlap and the kinetics of subunit expression.

scholarly journals Wait a second! Delayed impact of argument roles on on-line verb prediction

2017 ◽  
Author(s):  
Wing Yee Chow ◽  
Ellen Lau ◽  
Suiping Wang ◽  
Colin Phillips
Keyword(s):  
Time Course ◽  
Contextual Information ◽  
Time Interval ◽  
N400 Effect ◽  
Lexical Information ◽  
Key Factor ◽  
On Line ◽  
N400 Component ◽  
Adverbial Phrase ◽  
Argument Roles

Comprehenders can use rich contextual information to anticipate upcoming input on the fly, but recent findings suggest that salient information about argument roles may not impact verb prediction. We took advantage of the word order properties of Mandarin Chinese to examine the time course with which argument role information impacts verb prediction. We isolated the contribution of argument role information by manipulating the order of pre-verbal noun phrase arguments while holding lexical information constant, and we examined its effects on accessing the verb in long-term semantic memory by measuring the amplitude of the N400 component. Experiment 1 showed when the verb appeared immediately after its arguments, even strongly constraining argument role information failed to modulate the N400 response to the verb. An N400 effect emerged in Experiment 2 when the verb appeared at a greater delay. Experiment 3 corroborated the contrast between the first two experiments through a within-participants manipulation of the time interval between the arguments and the verb, by varying the position of an adverbial phrase. These results suggest time is a key factor governing how diverse contextual information contributes to predictions. Here argument role information is shown to impact verb prediction, but its effect is not immediate.

Surgical management of esophageal perforation: role of primary closure

2019 ◽  
Vol 27 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Vu Huu Vinh ◽  
Nguyen Viet Dang Quang ◽  
Nguyen Van Khoi
Keyword(s):  
Hospital Admission ◽  
Esophageal Perforation ◽  
Primary Closure ◽  
Primary Repair ◽  
Time Interval ◽  
Mortality And Morbidity ◽  
Thoracic Level ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Objective Esophageal perforation is a life-threatening condition associated with high mortality and morbidity. Ambiguous clinical presentation is one of the most common causes of delayed and difficult diagnosis of esophageal perforation. In this retrospective single-center study, we reviewed the outcome of primary closure in patients with esophageal perforation between 2009 and 2017. Methods The data of 65 patients attending our department of thoracic surgery (from 2009 to 2017) for esophageal perforation were reviewed. Primary repair was attempted in 63 patients irrespective of the site of perforation and time interval between injury and hospital admission. In intrathoracic lesions, continuous mediastinal and pleural irrigation was undertaken, whereas in cervical perforations, gauze packing and local irrigation were performed. Jejunotomy was carried out in patients with inadequate healing. Results Of the 65 patients, 63 underwent primary closure and 2 were left to heal spontaneously. The majority of patients ( n = 44) had an esophageal perforation at the thoracic level, and only one was admitted early (<24 h after injury). Among the 63 patients managed with primary closure, 55 had satisfactory healing with one surgery. Healing was delayed in the other 10 patients. No mortality was reported. Conclusions Esophageal perforation can be well managed by primary closure, irrespective of the time interval between injury and hospital admission and the site of perforation. Conservative management might lead to an increased rate of complications such as empyema or necrotizing mediastinitis, and increased morbidity and mortality.

Time-course evaluation of survival and treatment in FIRE-3 (AIO KRK0306, first-line therapy of KRAS wild-type metastatic colorectal cancer with FOLFIRI plus cetuximab or bevacizumab).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 617-617
Author(s):  
Dominik Paul Modest ◽  
Sebastian Stintzing ◽  
Ludwig Fischer von Weikersthal ◽  
Alberto F. Sobrero ◽  
Thomas Decker ◽  
...  
Keyword(s):  
Overall Survival ◽  
Time Course ◽  
Course Evaluation ◽  
Time Interval ◽  
Wild Type ◽  
Time Intervals ◽  
Number Of Patients ◽  
Significant Difference ◽  
Time Frames ◽  
In Fire

617 Background: FIRE-3 reported overall survival (OS) difference in favour of arm A (FOLFIRI plus cetuximab, N= 297 pts.) compared to arm B (FOLFIRI plus bevacizumab, N= 295 pts.) in the absence of significant differences in progression-free survival and response rate. Methods: We subdivided the study into six-month time intervals, starting at the time point of randomisation and evaluated OS in a time-wise fashion. Within each interval, OS was analyzed by Cox regression. Furthermore, systemic treatment and local interventions were investigated in the respective time-frames. Results: The time-course hazard ratios of OS are summarized in the Table. Pronounced differences in overall survival by time-interval analysis are observed between 24 and 30 months and between 30 and 36 months. Within the interval of 24-30 months, 24.6% (73/297) of pts in arm A and 25.1% (74/295) of pts in arm B received systemic therapy (any treatment-line). In the subsequent interval of 30-36 months, systemic anti-tumor treatment decreased to 18.9% (56/297) of pts in arm A and 16.3% (48/295) of pts in arm B. Median time on treatment was less than 2 months in the intervals of 24-30 months and 30-36 months. Updated data including RAS wild-type population will be presented at the meeting. Conclusions: The differences in OS observed in FIRE-3 are pronounced in time intervals between 24-30 months as well as 30-36 months after randomisation into the study. A small number of patients received rather short courses of anti-tumor therapy in these observation units. The significant difference in OS that manifests in time-frames between 24 and 30 months as well as between 30 and 36 months suggests that underlying effects on OS in FIRE-3 may include multiple factors and cannot be explained by the number of patients on active treatment alone. Clinical trial information: NCT00433927. [Table: see text]

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