scholarly journals The impact of commercial drivers with type 2 diabetes on the risk for road traffic collisions in TBDCS study

2020 ◽  
Author(s):  
Ying Chuan Wang ◽  
Yu-Jen Lin ◽  
Trong-Neng Wu ◽  
Saou-Hsing Liou ◽  
Wei-Te Wu
Keyword(s):  
Health Care Professionals ◽  
Hospital Admissions ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Cox Model ◽  
Cox Models ◽  
Road Traffic Collision ◽  
Glucose Lowering Therapy ◽  
The Impact

Abstract Background : Identification of the relationship between diabetes mellitus (DM) and road traffic collision (RTC) that lead to hospital admissions and death in commercial motor vehicle (CMV) drivers is crucial to develop preventive strategies. A cohort study was used to follow up the outcomes of DM and receiving blood glucose-lowering therapy to assess the 6-year risk of RTCs in CMV drivers. Methods: This cohort recruited 1,650 CMV drivers in 2005. Each subject completed the basic and working patterns questionnaire. Researchers found 84 DM cases in 2005, and 152 RTC events between 2005 and 2010. The data analysis was conducted in 2015. The Cox model and the extended Cox model were used to estimate the hazard ratio (HR) for first RTC events only and recurrent RTC events. Results: Type 2 DM ( T2DM) increased the 6-year RTC risks among CMV drivers (HR: 2.39, 95% CI: 1.35 to 4.24), after adjusting for confounders. The extended Cox models were used and showed that T2DM increased HR of the recurrent RTC events. Conclusion: T2DM and oral antidiabetic drugs (OADs) used days pose possible risk factors for RTCs in CMV drivers. Labor or health care professionals and authorities should be aware of the risks and contribute in establishing effective RTC- prevention strategies for DM drivers with or without insulin treatment.

scholarly journals Impact of the COVID-19 Pandemic on Road Traffic Collision Injury Patterns and Severity in Al-Ain City, United Arab Emirates

2021 ◽  
Author(s):  
Yasin J Yasin ◽  
David O Alao ◽  
Michal Grivna ◽  
Fikri Abu-Zidan
Keyword(s):  
United Arab Emirates ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Trauma Patients ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Al Ain ◽  
Fisher’S Exact Test ◽  
Road Traffic Collision ◽  
Motorcycle Injuries

Abstract Background: The COVID-19 pandemic lockdowns restricted human and traffic mobility impacting the patterns and severity of road traffic collisions (RTCs). We aimed to study the effects of the COVID-19 Pandemic on incidence, patterns, severity of the injury, and outcomes of hospitalized RTCs trauma patients in Al-Ain City, United Arab Emirates. Methods: We compared the data of two cohorts of patients which were collected over two periods; the pandemic period (28 March 2020 to 27 March 202) and the pre-pandemic period (28 March 2019 to 27 March 2020). All RTCs trauma patients who were hospitalized in the two major trauma centers (Al-Ain and Tawam Hospitals) of Al-Ain City were studied. Results: Overall, the incidence of hospitalized RTC trauma patients significantly reduced by 33.5% during the Pandemic compared with the pre-pandemic period. The mechanism of injury was significantly different between the two periods (p< 0.0001, Fisher’s Exact test). MVCs were less during the Pandemic (60.5% compared with 72%), while motorcycle injuries were more (23.3 % compared with 11.2 %). The mortality of hospitalized RTC patients was significantly higher during the Pandemic (4.4 % compared with 2.3 %, p=0.045, Fisher’s Exact test). Conclusions: Our study has shown that the numbers of hospitalized RTC trauma patients reduced by 33.5% during the COVID-19 Pandemic compared with the pre-pandemic period in our setting. This was attributed to the reduced motor vehicle, pedestrian and bicycle injuries while motorcycle injuries increased. Mortality was significantly higher during the Pandemic, which was attributed to increased ISS and reduced GCS.

scholarly journals Using the Interval Type-2 Fuzzy Inference Systems to Compare the Impact of Speed and Space Perception on the Occurrence of Road Traffic Accidents

Mathematics ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 1548
Author(s):  
Marjana Čubranić-Dobrodolac ◽  
Libor Švadlenka ◽  
Svetlana Čičević ◽  
Aleksandar Trifunović ◽  
Momčilo Dobrodolac
Keyword(s):  
Traffic Accidents ◽  
Driving Simulator ◽  
Fuzzy Inference ◽  
Road Traffic ◽  
Space Perception ◽  
Road Traffic Accidents ◽  
Inference System ◽  
Interval Type ◽  
The Impact

A constantly increasing number of deaths on roads forces analysts to search for models that predict the driver’s propensity for road traffic accidents (RTAs). This paper aims to examine a relationship between the speed and space assessment capabilities of drivers in terms of their association with the occurrence of RTAs. The method used for this purpose is based on the implementation of the interval Type-2 Fuzzy Inference System (T2FIS). The inputs to the first T2FIS relate to the speed assessment capabilities of drivers. These capabilities were measured in the experiment with 178 young drivers, with test speeds of 30, 50, and 70 km/h. The participants assessed the aforementioned speed values from four different observation positions in the driving simulator. On the other hand, the inputs of the second T2FIS are space assessment capabilities. The same group of drivers took two types of space assessment tests—2D and 3D. The third considered T2FIS sublimates of all previously mentioned inputs in one model. The output in all three T2FIS structures is the number of RTAs experienced by a driver. By testing three proposed T2FISs on the empirical data, the result of the research indicates that the space assessment characteristics better explain participation in RTAs compared to the speed assessment capabilities. The results obtained are further confirmed by implementing a multiple regression analysis.

scholarly journals A comparison of approaches for investigating the impact of ambient light on road traffic collisions

2020 ◽  
pp. 147715352092406 ◽  
Author(s):  
S Fotios ◽  
CJ Robbins ◽  
J Uttley
Keyword(s):  
Detrimental Effect ◽  
Road Traffic ◽  
Previous Analysis ◽  
Ambient Light ◽  
Collision Risk ◽  
Road Traffic Collision ◽  
Repeated Analysis ◽  
Traffic Collision ◽  
The Uk ◽  
The Impact

A recent paper proposed a more precise approach for investigating the impact of ambient light (daylight versus after dark) on road traffic collisions. The present paper first repeated that analysis of road traffic collisions in the UK to test reproducibility; it then extended the analysis to determine whether the greater precision affected the outcome of road traffic collision analyses. Results of the previous analysis were reproduced in terms of the direction of the effect, but the repeated analysis found greater differences between daylight and darkness. The odds ratio determined using the new method led to higher odds ratios than the analyses used in some past studies, suggesting that past studies may have underestimated the detrimental effect of darkness on road traffic collision risk.

scholarly journals Cannabinoid Concentrations Detected in Fatal Road Traffic Collision Victims Compared with a Population of Other Postmortem Cases

2015 ◽  
Vol 61 (10) ◽  
pp. 1256-1264 ◽  
Author(s):  
Rebecca Andrews ◽  
Kevin G Murphy ◽  
Limon Nahar ◽  
Sue Paterson
Keyword(s):  
Carboxylic Acid ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Limited Data ◽  
Drugs And Alcohol ◽  
Vehicle Collision ◽  
Significant Difference ◽  
Postmortem Blood ◽  
Cannabis Consumption ◽  
Road Traffic Collision

Abstract BACKGROUND Acute cannabis consumption nearly doubles the risk of motor vehicle collision resulting in injury or death. Limited data have been published regarding the concentrations of cannabinoids associated with fatal road traffic collisions (RTCs), and these have not previously been compared to a population of other postmortem cases. METHODS We conducted analysis for cannabinoids [Δ9-tetrahydrocannabinol (THC), 11-hydroxy-THC, 11-nor-THC-9-carboxylic acid, cannabidiol, and cannabinol], drugs, and alcohol on consecutive fatal RTC cases (100) and non-RTC cases (114) from coroners' jurisdictions in London and southeast England and compared the data. RESULTS The incidence of cannabinoids detected in non-RTC and RTC cases was similar (25% vs 21%, P = 0.44), but THC was detected more frequently (90% vs 59%, P = 0.01) and at significantly higher concentrations in the cannabinoid-positive RTC cases than the non-RTC cases (P = 0.01). The distribution of non-RTC and RTC cases over 4 categories of THC concentration was significantly different (P = 0.004). There was no significant difference in the concentrations of other cannabinoids detected between the 2 groups. Cannabinoids were detected in more fatal RTC cases (21) than alcohol &gt;80 mg/dL (17). Detection of other drugs was low compared to cannabis and alcohol. CONCLUSIONS These first data on the concentrations of cannabinoids in the postmortem blood of fatal RTC victims compared with a population of other routine coroners' cases highlight the importance of specifically measuring THC concentrations in the blood to aid interpretation of postmortem cases where cannabis may be implicated.

scholarly journals Benchmark of lasso-like penalties in the Cox model for TCGA datasets reveal improved performance with pre-filtering and wide differences between cancers

2020 ◽  
Author(s):  
Rémy Jardillier ◽  
Florent Chatelain ◽  
Laurent Guyon
Keyword(s):  
Cox Model ◽  
Elastic Net ◽  
Prognostic Biomarkers ◽  
Supplementary Information ◽  
Cox Models ◽  
Rna Profiling ◽  
Improved Performance ◽  
Parsimonious Model ◽  
Gene Variability ◽  
The Impact

AbstractMotivationPrediction of patient survival from tumor molecular ‘omics’ data is a key step toward personalized medicine. With this aim, the databases available are growing, with the collection of various ‘omics’ characterizations of patient tumors, together with their associated clinical outcomes for weeks to years of follow-up. Cox models with variable selection used with RNA profiling datasets are popular for identification of prognostic biomarkers and for clinical predictions. However, these models are confronted with the ‘curse of dimensionality’, as the number p of covariates (genes) can greatly exceed the number n of patients. To tackle this problem, variance-based pre-filtering and penalization methods are popular for dimension reduction. In the present paper, we study the impact of a pre-filtering step based on gene variability, and we evaluate the performance of the lasso penalization of the Cox model and four variants (i.e., elastic net, adaptive elastic net, ridge, univariate Cox) in terms of prediction, selection and stability.ResultsFirst, we show that the prediction capacity with the Cox penalties method is cancer dependent. Second, we develop a methodology to fix a threshold to filter out genes with low variability without losing prediction capacity. Third, we show that it is best not to use the Cox model to select prognostic biomarkers, as its false discovery proportion is always ≥ 50%. Finally, to predict overall survival, we can suggest the use of the ridge penalty, or the elastic net if a more parsimonious model is needed, after the pre-filtering step.AvailabilityWe provide the R script generated to reproduce all of the figures presented in this article.Supplementary informationSupplementary Figures and R scripts are available.

scholarly journals Metabolic and Clinical Significance of Diabetes Mellitus Type 2; Implication for Rising Prevalence in Nigeria

2018 ◽  
Vol 1 (2) ◽  
pp. 108-117
Author(s):  
E K Oghagbon
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Hospital Admissions ◽  
African Ancestry ◽  
Global Epidemic ◽  
Appropriate Treatment ◽  
Body Sodium ◽  
Clinical Conditions ◽  
The Impact

Type 2 diabetes mellitus (DM2) is now a global epidemic which is also ravaging developing countries including Nigeria. Its impact in the country is significant with the disease found to impact on hospital admissions, mortality and life expectancy of patients. Previous investigations done in Nigeria showed that DM2 patients have poor glycaemic controls with resultant high levels of disease morbidity and mortality. This was demonstrated by consistently elevated mean HbA1c levels (> 8.0%) in Nigerian diabetics over a decade of assessment of care of the patients. Similarly the prevalence of diabetic retinopathy rose by more than 200% between 1989 and 2008. Diabetic morbidity which is underpinned by hyperglycaemia is associated with diabetic retinopathy, nephropathy, foot ulcers and other clinical conditions such as hyperlipidaemia, altered sympathetic system, bone disorders, infertility, defective body sodium handling and renal compromise. Some investigators believe that persons of African ancestry are more susceptible to some diseases associated with DM2. This includes documented increased renal glomerular hyperfiltration in patients of African ancestry. The disease complications are linked to metabolic derangements which if properly understood and managed, may help to reduce the impact of the rising prevalence of DM2 in Nigeria. Furthermore, if the Nigerian medical team is aware of the peculiar susceptibility of blacks to DM2 complications, they will be able to apply appropriate treatment for improved care, despite rising disease prevalence.

scholarly journals Self-management interventions for Type 2 Diabetes: systematic review protocol focusing on patient workload and capacity support

2021 ◽  
Vol 6 ◽  
pp. 257
Author(s):  
Peter Hanlon ◽  
Iona Bryson ◽  
Holly Morrison ◽  
Qasim Rafiq ◽  
Kasey Boehmer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Hospital Admissions ◽  
Macrovascular Disease ◽  
Self Management ◽  
Management Support ◽  
Patient Capacity ◽  
Management Interventions ◽  
The Impact

Introduction: People living with type 2 diabetes undertake a range of tasks to manage their condition, collectively referred to as self-management. Interventions designed to support self-management vary in their content, and efficacy. This systematic review will analyse self-management interventions for type 2 diabetes drawing on theoretical models of patient workload and capacity. Methods and analysis: Five electronic databases (Medline, Embase, CENTRAL, CINAHL and PsycINFO) will be searched from inception to 27th April 2021, supplemented by citation searching and hand-searching of reference lists. Two reviewers will independently review titles, abstracts and full texts. Inclusion criteria include Population: Adults with type 2 diabetes mellitus; Intervention: Randomised controlled trials of self-management support interventions; Comparison: Usual care; Outcomes: HbA1c (primary outcome) health-related quality of life (QOL), medication adherence, self-efficacy, treatment burden, healthcare utilization (e.g. number of appointment, hospital admissions), complications of type 2 diabetes (e.g. nephropathy, retinopathy, neuropathy, macrovascular disease) and mortality; Setting: Community. Study quality will be assessed using the Effective Practice and Organisation of Care (EPOC) risk of bias tool. Interventions will be classified according to the EPOC taxonomy and the PRISMS self-management taxonomy and grouped into similar interventions for analysis. Clinical and methodological heterogeneity will be assessed within subgroups, and random effects meta-analyses performed if appropriate. Otherwise, a narrative synthesis will be performed. Interventions will be graded on their likely impact on patient workload and support for patient capacity. The impact of these theoretical constructs on study outcomes will be explored using meta-regression. Conclusion This review will provide a broad overview of self-management interventions, analysed within the cumulative complexity model theoretical framework. Analyses will explore how the workload associated with self-management, and support for patient capacity, impact on outcomes of self-management interventions. Registration number: PROSPERO CRD42021236980.

scholarly journals Improper Driver Action as a Cause of Road Accidents / Niewłaściwe Działania Kierowców Jako Przyczyna Powstawania Zdarzeń Drogowych

2012 ◽  
Vol 21 (1) ◽  
pp. 87-98
Author(s):  
Łukasz Muślewski
Keyword(s):  
Motor Vehicle ◽  
Road Traffic ◽  
Road Accident ◽  
Process Safety ◽  
Driving Experience ◽  
The Road ◽  
Human Driver ◽  
Proper Estimation ◽  
The Impact

Abstract Road traffic is inseparably connected with road accident. This is the human-driver whose role in the transportation process safety is of key importance. Driving a motor vehicle requires from the driver not only knowledge but also physical and psychical fitness. They need to have the ability of quick reaction, proper estimation of the road situation and doing maneuvers adequate to it. In this study, an assessment of the impact of improper behaviors of drivers on occurrence of road collisions and accidents, has been analyzed on the basis of literature analysis and the authors’ own research. In effect of the carried out tests there has been made a classification of the road events with a division into: cause, place, date, and time of their occurrence as well as drivers’ age and their driving experience. The whole study has been performed on the basis of a real transportation company, operating on the territory of an urban agglomeration with the population of 500 inhabitants.

The impact of urban speed reduction programmes on health system cost and utilities

2017 ◽  
Vol 24 (4) ◽  
pp. 262-266 ◽  
Author(s):  
Babak Mohit ◽  
Zohn Rosen ◽  
Peter A Muennig
Keyword(s):  
Motor Vehicle ◽  
Road Traffic ◽  
Vehicle Speed ◽  
Severe Injuries ◽  
Speed Reduction ◽  
Traffic Calming ◽  
Life Years ◽  
Probability Of Death ◽  
Minor Injuries ◽  
The Impact

BackgroundVehicle speed changes impact the probability of injuring a pedestrian in ways that differ from the way that it impacts the probability of a collision or of death. Therefore, return on investment in speed reduction programmes has complex and unpredictable manifests. The objective of this study is to analyse the impact of motor vehicle speed reduction on the collision-related morbidity and mortality rates of urban pedestrians.Methods and FindingsWe created a simple way to estimate the public health impacts of traffic speed changes using a Markov model. Our outcome measures include the cost of injury, quality-adjusted life years (QALYs) gained and probability of death and injury due to a road traffic collision. Our two-way sensitivity analysis of speed, both before the implementation of a speed reduction programme and after, shows that, due to key differences in the probability of injury compared with the probability of death, speed reduction programmes may decrease the probability of death while leaving the probability of injury unchanged. The net result of this difference may lead to an increase in injury costs due to the implementation of a speed reduction programme. We find that even small investments in speed reductions have the potential to produce gains in QALYs.ConclusionsOur reported costs, effects and incremental cost-effectiveness ratios may assist urban governments and stakeholders to rethink the value of local traffic calming programmes and to implement speed limits that would shift the trade-off to become between minor injuries and no injuries, rather than severe injuries and fatalities.

scholarly journals The effect of the COVID pandemic lockdown measures on surgical emergencies: experience and lessons learned from a Greek tertiary hospital

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emmanouil Pikoulis ◽  
Nikolaos Koliakos ◽  
Dimitrios Papaconstantinou ◽  
Nikolaos Pararas ◽  
Andreas Pikoulis ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Hospital Admissions ◽  
Motor Vehicle ◽  
Perianal Abscess ◽  
Lessons Learned ◽  
University Hospital ◽  
Tertiary Referral Center ◽  
Surgical Department ◽  
Number Of Patients ◽  
The Impact

Abstract Background The COVID-19 pandemic caused a rise in healthcare demands leading to significant restructuring of hospital emergency departments worldwide. The aim of the present study is twofold: firstly, to discern any differences in regard to reason for surgical emergency department (SED) attendance and hospital admission during the pandemic and pre-pandemic eras in Greece, and secondly, to assess the impact of the lockdown measures implemented during the pandemic on SED patient attendance. Methods Since the beginning of the COVID-19 pandemic in Greece (1 March 2020) and up to 15 December 2020, the charts of all adult patients arriving at the SED of the third surgical department of the “Attikon” University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A 1/3/2020 to 30/4/2020 and period D 16/10/2020 to 15/12/2020) and two interim (period B 1/5/2020 to 15/6/2020 and period C 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019. Results The total number of patients attending the SED decreased by 35.9% during the pandemic (from 2839 total patients in 2019 to 1819 in 2020). During the first lockdown, there was statistically significant reduction of motor vehicle accidents (p=0.04) and torso injuries (p=0.01). Contrarily, the rate of head injuries (p<0.001) and abdominal pain (p=0.04) were significantly increased. The same effect was observed regarding the rate of hospital admissions (p=0.002), although in terms of absolute numbers, admissions remained unchanged. During the second lockdown, there was a reduction in the number of perianal abscess cases (p=0.04) and hernia-related problems (p=0.001). An increase in the rate of fall injuries was also demonstrable (p=0.02). Overall, application of the lockdown led to a significant decrease in minor (p<0.001) and torso (p=0.001) injuries. Conclusion The burden of the new COVID-19 disease has left a noticeable imprint in the function of emergency departments worldwide. In Greece, SED attendance was significantly reduced during the pandemic, an effect that was even more pronounced during the lockdown implementation; nevertheless, the overall rate of hospital admissions remained the same, denoting that patient care was not altered.

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