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BACKGROUND: The effectiveness of crisis response can be influenced by various structural, cultural, and functional aspects within a social system. This study uses a configurational approach to identify combinations of sociopolitical conditions that lead to a high case fatality rate (CFR) of COVID-19 in OECD countries. METHODS: A Fuzzy set qualitative comparative analysis (QCA) is conducted on a sample of 38 OECD countries. The outcome to be explained is high COVID-19 CFR. The five potentially causal conditions are level of democracy, state capacity, trust in government, health expenditure per capita, and the median age of population. A comprehensive QCA robustness test protocol is applied, which includes sensitivity ranges, fit-oriented robustness, and case-oriented robustness tests. RESULTS: None of the causal conditions in both the presence and negation form were found to be necessary for high or low levels of COVID-19 CFR. Two different combinations of sociopolitical conditions were usually sufficient for the occurrence of a high CFR of COVID-19 in OECD countries. Low state capacity and low trust in government are part of both recipes. The entire solution formula covers 84 percent of the outcome.  Some countries have been identified as contradictory cases. The explanations for their COVID-19 CFR require more in-depth case studies. CONCLUSIONS: From a governance perspective, the weakness of government in effectively implementing policies, and the citizens' lack of confidence in their government, combined with other structural conditions, serve as barriers to mounting an effective response to COVID-19. These findings can support the idea that the effects of social determinants of COVID-19 outcomes are interconnected and reinforcing.

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BACKGROUND: Post-COVID-19 conditions (PCCs), also known as long COVID, is persistently debilitating disorders that need investigation on their incidence, morbidity, and case-fatality rate. PURPOSE: The objectives of this cohort study were to determine the incidence, characteristics, case-fatality, morbidity, and recovery of post-COVID-19 symptoms throughout a two-year period of observation. METHODS: This was a population-based cohort study of post-COVID-19 cases among 12,925 SARS-CoV-2 positive individuals in eight administrative districts of Bangladesh between July and December 2021-2023. PCC was diagnosed according to WHO clinical diagnostic criteria, and the screening procedure was completed through a household screening process. RESULTS: The incidence of PCC was 3.6%, the case-fatality rate was 1.92%, and the recovery rate was 9.0%. The significant predictors of PCC morbidity were geographical distribution, vaccination, comorbidities, and a longer duration of symptoms or multiple symptoms (p < 0.05). CONCLUSION: Nearly 465 out of 522 people suffering from PCC are persistent and have a significant disability. However, the rate of recovery was 9.0%. It is necessary to investigate approaches to improve the recovery of PCC in Bangladesh.

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INTRODUCTION: Vehicles play an important role in pedestrian injury risk in crashes. This study examined the association between vehicle front-end geometry and the risk of fatal pedestrian injuries in motor vehicle crashes. METHOD: A total of 17,897 police-reported crashes involving a single passenger vehicle and a single pedestrian in seven states were used in the analysis. Front-end profile parameters of vehicles (2,958 vehicle makes, series, and model years) involved in these crashes were measured from vehicle profile photos, including hood leading edge height, bumper lead angle, hood length, hood angle, and windshield angle. We defined a front-end-shape indicator based on the hood leading edge height and bumper lead angle. Logistic regression analysis evaluated the effects of these parameters on the risk that a pedestrian was fatally injured in a single-vehicle crash. RESULTS: Vehicles with tall and blunt, tall and sloped, and medium-height and blunt front ends were associated with significant increases of 43.6%, 45.4%, and 25.6% in pedestrian fatality risk, respectively, when compared with low and sloped front ends. There was a significant 25.1% increase in the risk if a hood was relatively flat as defined in this study. A relatively long hood and a relatively large windshield angle were associated with 5.9% and 10.7% increases in the risk, respectively, but the increases were not significant. CONCLUSIONS: Vehicle front-end profiles that were significantly associated with increased pedestrian fatal injury risk were identified. PRACTICAL APPLICATIONS: Automakers can make vehicles more pedestrian friendly by designing vehicle front ends that are lower and more sloped. The National Highway Traffic Safety Administration (NHTSA) can consider evaluations that account for the growing hood heights and blunt front ends of the vehicle fleet in the New Car Assessment Program or regulation.

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Advantages of commercial UAS-based services come with the disadvantage of posing third party risk (TPR) to overflown population on the ground. Especially challenging is that the imposed level of ground TPR tends to increase linearly with the density of potential customers of UAS services. This challenge asks for the development of complementary directions in reducing ground TPR. The first direction is to reduce the rate of a UAS crash to the ground. The second direction is to reduce overflying in more densely populated areas by developing risk-aware UAS path planning strategies. The third direction is to develop UAS designs that reduce the product A impact · P { F | impact } ${{A}_{{\mathrm{impact}}}} \cdot \mathbb{P}\{ F| {{\mathrm{impact}}\} } $ in case of a crashing UAS, where A impact ${{A}_{{\mathrm{impact}}}}$ is the size of the crash impact area on the ground, and P { F | impact } $\mathbb{P}\{ F| {{\mathrm{impact}}\} } $ is the probability of fatality for a person in the crash impact area. Because small UAS accident and incident data are scarce, each of these three developments is in need of predictive models regarding their contribution to ground TPR. Such models have been well developed for UAS crash event rate and risk-aware UAS path planning. The objective of this article is to develop an improved model and assessment method for the product A impact · P { F | impact } . ${{A}_{{\mathrm{impact}}}} \cdot \mathbb{P}\{ F| {{\mathrm{impact}}\} } .$ In literature, the model development and assessment of the latter two terms is accomplished along separate routes. The objective of this article is to develop an integrated approach. The first step is the development of an integrated model for the product A impact · P { F | impact } ${{A}_{{\mathrm{impact}}}} \cdot \mathbb{P}\{ F| {{\mathrm{impact}}\} } $ . The second step is to show that this integrated model can be assessed by conducting dynamical simulations of Finite Element (FE) or Multi-Body System (MBS) models of collision between a UAS and a human body. Application of this novel method is illustrated and compared to existing methods for a DJI Phantom III UAS crashing to the ground.

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BACKGROUND: Severely underweight (SUW) children contribute significantly to under-five mortality and morbidity. There are WHO guidelines for the management of severe acute malnutrition but no specific guidelines for SUW management. OBJECTIVE: The objectives were to achieve a recovery rate of 30% at 90 days of treatment for severe underweight (SUW) children aged 6-60 months, compare changes in weight-for-age Z (WAZ) scores, growth patterns, and case fatality rates between intervention and reference arms (RA), and reduce the prevalence of SUW in the intervention arm (IA). The target of a 30% recovery rate was achievable and significant based on our past research conducted in similar settings. METHODS: Design: A prospective controlled community-based, longitudinal, two arms (IA, RA), intervention study with long follow-up was conducted between January 2011 and October 2023. SETTING: Primary care for participants from 14 villages in rural Melghat, India. PARTICIPANTS: The study participants included SUW children aged 6-60 months and age-matched (±2 weeks) normal controls. The SAMMAN (Acronym for SAM-Management) intervention was comprised of local therapeutic food-micronutrient (LTF-MN) therapy for 90 days, intensive behavior change communication, infection treatment, and quarterly anthropometric records. SUW recovery, growth patterns, case fatality rate, prevalence at 90 days of therapy and at 60 months of age, and survival until early adolescence were assessed. ANCOVA analysis was used to obtain changes in Z-scores. RESULTS: In the IA, the recovery rate was 36.8% at 90 days and 78.2% at 60 months of age. The mean difference in change in WAZ scores between the intervention arm and the reference arm was statistically significant (p < 0.0001). Growth patterns were similar between the two arms up to early adolescence. The SUW case fatality rate was significantly lower in the IA (0.9%) as compared to 4.62% in the RA at 60 months (p = 0.022). The reduction in SUW prevalence in intervention villages was higher than in the control villages (p < 0.001). The cost of management per SUW child was 3888 INR (47 USD) less than RUTF. CONCLUSION: The SAMMAN intervention is safe and cost-effective for significantly improving WAZ scores, sustainable, and hence replicable in resource-limited areas.

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PURPOSE OF REVIEW: To discuss if all patients who use self-injectable epinephrine outside the hospital setting require immediate emergency care. RECENT FINDINGS: Prior to 2023, anaphylaxis management guidance universally recommended that patients who use self-injectable epinephrine outside of the hospital or clinic setting immediately activate emergency medical services and seek further care. Additional food-induced anaphylaxis management recommendations specified that all patients always carry 2 auto-injector devices and give a second dose of epinephrine if there was not immediate response within 5 min of injection. Patients presenting for emergency care after epinephrine are often observed for up to 4-6 h afterwards, even when completely asymptomatic. These management steps have lacked evidence for improving outcomes, and universal implementation of these approaches is not cost-effective as guidance for food allergic patients. Epinephrine pharmacokinetics and pharmacodynamics suggest that peak physiologic response is more likely to occur closer to 15 min than before 5 min, that few patients require a second dose of epinephrine as most stabilize within 15 min of use, that 60 min of observation after a patient stabilizes after epinephrine use may be adequate as patients infrequently have further sequelae, and that not everyone needs to carry 2 epinephrine auto-injectors on their person at all times. The most recent anaphylaxis practice parameter promotes a contextualized approach to these management questions, outlining the option for watchful waiting to gauge response to epinephrine before seeking emergency care, which has been proven as a more cost-effective management strategy. The recent updated anaphylaxis care guidelines support the evolution of anaphylaxis care, in that universal, immediate activation of emergency services is not required for using self-injectable epinephrine outside the hospital setting.

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OBJECTIVE: Storytelling engages audiences, passes down traditions and history, educates, and helps people understand and interpret their environment. Many of those who work in agriculture have been part of the storytelling tradition since childhood. Research has demonstrated the emotional impact of personal stories and how prevention information is conveyed effectively "farmer to farmer" through this method of communication. METHODS: Since 2016, the Telling the Story Project has provided a space for those directly or indirectly involved in an agricultural incident to share their story and unique perspectives on how similar incidents can be avoided. RESULTS: This collaborative project, developed between the National Institute for Occupational Safety and Health (NIOSH) Agriculture Safety Centers, has resulted in 11 stories on a dedicated website, safety and health resources, and educational guides. The stories and educational guidelines have been marketed extensively through traditional and social media sources, employed in safety training, and embraced by educators in agricultural programs. The website has provided a national and international reach with more than 35,000 visits. CONCLUSION: Qualitative thematic analysis of the stories provided data on the circumstances leading up to each incident, valuable information on how the storytellers interpreted the aftermath, and a novel perspective on how safety professionals can create messaging that will resonate with the farming community.

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INTRODUCTION AND OBJECTIVES: Primary percutaneous coronary intervention (pPCI) is recommended for ST elevation myocardial infarction (STEMI). Countries have designed various STEMI network models to optimize out-of-hospital triage, timely treatment, and patient outcomes. The aim of this study was to evaluate the effectiveness of STEMI network implementation including out-of-hospital triage in improving STEMI case-fatality and long-term mortality, and its effect on the proportion of patients presenting with heart failure, their ischemia time, and time to pPCI. METHODS: Systematic review and meta-analysis. Searches of PubMed, Scopus, and Web of Science databases covering January 2000 to December 2023, study selection, and data extraction were completed by 3 independent reviewers. RESULTS: A total of 32 articles were selected. STEMI network implementation with out-of-hospital triage was associated with reductions of 35% in case-fatality (95%CI, -23% to -45%), 27% in long-term mortality (95%CI, -22% to -32%), and in the proportion of patients with Killip III-IV at admission, ischemia, time and time to pPCI (-17%, 95%CI, -35% +6%; -19%, 95%CI, -6% to -31%; -33%, 95%CI, -16% to -47%, respectively). Networks based on emergency transport systems and those involving the entire health system, including primary care centers and hospitals without pPCI capabilities, showed similar effectiveness. Greater effectiveness was observed in urban vs rural areas and high-income vs middle- and low-income countries. CONCLUSIONS: The implementation of out-of-hospital triage-based STEMI networks is effective in reducing STEMI case-fatality and long-term mortality, independently of the geographic and socioeconomic conditions of the region. Participation of the emergency transport system is the key element of successful networks.

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Respiratory syncytial virus (RSV) is an important cause of severe respiratory disease in older adults. Understanding the disease burden is crucial for guiding vaccination policy and raising disease awareness. We estimated the burden of RSV hospitalizations and deaths in adults in five middle-income countries: Argentina, Brazil, Chile, Mexico, and Malaysia. Hospital discharge and death statistics due to any respiratory disease (ICD-10 codes: J00-99) from 2010 to 2022 were obtained. The RSV attributable burden on hospitalizations and deaths by age group was determined for 2019 using previously published estimates. Latin American countries showed distinct annual peaks in respiratory-related hospitalizations and deaths during winter months that were absent in Malaysia. Among ≥20-year-olds in 2019, there were 14,604 RSV-attributable hospitalizations nationally in Argentina, 44,323 in Brazil, 4529 in Chile, 7416 in Malaysia, and 8651 in Mexico, and 60-74% in ≥65-year-olds. There were also 3518 RSV-attributable deaths in Argentina, 9115 in Brazil, 801 in Chile, 704 in Malaysia, and 3806 in Mexico 79-88% in ≥65-year-olds. Incidences of RSV-attributable hospitalizations in ≥75-year-olds ranged between 256.3 and 294.3 per 100,000 population, and deaths between 33.6 and 112.9 per 100,000 population. RSV is associated with a substantial disease burden beyond pediatric age groups, and preventive vaccines could have a major impact on this burden, especially in older adults.

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OBJECTIVE: Among motor vehicle crashes (MVCs), little is known about whether the characteristics and collision features involving drivers with epilepsy differ from those involving drivers without any history of epilepsy. We assessed MVC features and the effect of epilepsy diagnosis on the risk of severe crash-related injuries among drivers. METHODS: A total of 33 174 MVC events among people with epilepsy (PWE) and 663 480 MVC events of age- and sex-matched non-PWE (1:20) were selected. Crash-related features that involved drivers with and without epilepsy were compared, including driver eligibility, medical history of comorbidities and medications, road and environmental conditions, and accident causes. Cox and logistic regression analyses were used to examine the risks of fatality and severe injury among drivers with and without epilepsy. RESULTS: PWE involved in MVCs were more likely to have lower socioeconomic status, comorbidities, scooter drivers without a qualified driver's license, driving under the influence of alcohol, and be involved in single-vehicle accidents than non-PWE. Drivers with epilepsy also had a higher risk of fatality within 30 days of MVC, with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI], 1.20-1.57) and a higher risk of hospital admission within 3 days after MVC (aHR, 1.33; 95% CI, 1.29-1.38) compared to that of non-PWE. SIGNIFICANCE: The characteristics of MVCs of drivers with epilepsy were distinct from those of non-affected drivers. And higher fatality and injury rates were observed among drivers with epilepsy, which should be considered in further policymaking regarding safe driving of PWE.

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BACKGROUND: Incidence, clinical course, and fatality of spontaneous subarachnoid haemorrhage (SAH) are evolving, with prevalence of risk factors diminishing, implementation of early detection programs and strategies for priority aneurysm exclusion, technical refinement towards less invasive procedures, and improvements in neurocritical care. Modern epidemiological and prognostic data are lacking, especially in southern European and Mediterranean populations. METHODS: A prospective multicentre observational study on SAH was held in Catalonia, Northeast Spain, 2020-2022 (HSACat project). All public tertiary hospitals participated in a common registry. Primary endpoints were functional outcomes (modified Rankin Scale, mRS) and mortality at 12-months. Secondary aims included epidemiological data, flux of patients between referral and tertiary hospitals, diagnostic and treatment delays, and in-hospital complications. RESULTS: Of 550 SAH cases reported in Catalonia (2020-2022), 474 had a complete registry for analysis. Death rate was 20.6% during hospital admission and 26.9% at one year. Good functional outcome (mRS 0-2) was observed in 63.4%, 70.1% and 76.0% at 3, 6 and 12 months. Age at presentation was lower in men, smokers, and hypertensives (p<0.05). The female:male ratio was 3:2, except in non-aneurysmal group. Time from onset to tertiary-hospital admission was longer in rural than metropolitan zones (7.0h vs 4.7h, p<0.01). Aneurysm occlusion in the first 72h was achieved in 83.3%; mainly endovascularly (77.5%) than microsurgically (19.3%). CONCLUSION: Even when most patients received timely aneurysmal treatment, rates of case fatality are considerably high. Data provided by the HSAcat project may have public health repercussions and be used to guide prevention programs and screening strategies.

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Objectives: Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. Methods: We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. Results: The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. Conclusions: COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

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There is a lack of research that investigates the risk factors of cycling in low- and middle-income countries. We present descriptive epidemiology of crashes that involved at least one fatal cyclist, over a three-year period (2016-2018) in Delhi, India. Next, we used an unmatched case-control approach to identify road design risk factors of cycle fatalities. Cases were road segments with at least one cycle fatality, and controls were those with none. We developed logistic regression models with cases and controls as binary outcomes to estimate the odds ratio of site characteristics. There were 167 crashes involving at least one cyclist fatality over the study period. Fatal cyclists were almost all males. They were less likely to be children or young adults and less likely to be residents of high-income localities, compared to the general population. One in ten crashes included more than one occupant on a cycle and 5% of fatal victims were pillion riders. Seventy percent crashes occurred at midblock, and majority were backend collisions. Regression shows that road width, traffic speed, and volume of heavy vehicles have strong positive effects on the fatality risk of cyclists. These results can inform strategies to design interventions for safety of cyclists.

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OBJECTIVE: Using alcohol or psychoactive drugs before driving a motor vehicle may increase the risk of crash involvement, injury, and death. This is better documented for alcohol than for drugs. The aim of this study was to expand a previous case-control study on substance use and driver fatality by doubling the number of cases and controls, and hence improve the statistical power and enable the analysis of combined substance use. METHODS: We collected data on alcohol and drug use from all 1197 drivers of cars and vans who were fatally injured in road traffic crashes in Norway between 2005 and 2020 ('cases') by analyzing blood samples or reviewing other information on substance use. We also collected data on alcohol and drug use among 17,219 drivers in random road traffic ('controls') by analyzing oral fluid samples. Substance use was converted to dichotomous variables (no use/use). We used unconditional logistic regression to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) of driver fatality for mutually exclusive substance groups, adjusted for sex, age, geographic region, urban centrality class, and time interval of the week. RESULTS: Compared to no substance use, the aOR (95% CI) for driver fatality was for alcohol 91 (61-137), stimulants (primarily amphetamines) aOR 22 (9-56), benzodiazepines and z-hypnotics (BZDs) aOR 4.0 (2.7-5.9), tetrahydrocannabinol (THC) aOR 3.4 (1.7-6.7), and opioids aOR 1.4 (0.4-4.9). The aOR for any polysubstance use was 168 (96-297). The combinations of BZDs with stimulants or THC were associated with markedly higher aORs for driver fatality than the use of single substance groups. CONCLUSIONS: Alcohol and polysubstance use are the most important predictors of fatal injury, followed by stimulants.

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OBJECTIVE: To analyse hospital case fatality and mortality related to Chagas disease (CD) in Brazil, 2000-2019. METHOD: This is a mixed ecological study with spatial and temporal trends, based on national population data from the Brazilian Ministry of Health - hospital admissions (HA) and death certificates (DC). Records with CD as a primary or secondary cause of death in HA and/or as an underlying or associated cause of death in DC were evaluated. Temporal trends were analysed by Joinpoint regression and the spatial distribution of age- and gender-adjusted rates, spatial moving averages, and standardized morbidity ratios. RESULTS: There were a total of 4,376 HA due to CD resulting in death in Brazil, with a hospital case fatality rate of 0.11/100,000 inhabitants. The Southeast region had the highest rate (63.9%, n = 2,796; 0.17/100,000 inhabitants). The general trend for this indicator in Brazil is upwards (average annual percentage change [AAPC] 7.5; 95% confidence interval [CI] 5.3 to 9.9), with increases in the North, Northeast and Southeast regions. During the same period 122,275 deaths from CD were registered in DC, with a mortality rate of 3.14/100,000 inhabitants. The highest risk of CD-related death was found among men (relative risk [RR] 1.27) and Afro-Brazilians (RR 1.63). There was a downward trend in CD mortality in the country (AAPC - 0.7%, 95%CI -0.9 to -0.5), with an increase in the Northeast region (AAPC 1.1%, 95%CI 0.6 to 1.6). Municipalities with a very high Brazilian Deprivation Index tended to show an increase in mortality (AAPC 2.1%, 95%CI 1.6 to 2.7), while the others showed a decrease. CONCLUSION: Hospital case fatality and mortality due to CD are a relevant public health problem in Brazil. Differences related to gender, ethnicity, and social vulnerability reinforce the need for comprehensive care, and to ensure equity in access to health in the country. Municipalities, states, and regions with indicators that reveal higher morbidity and mortality need to be prioritized.

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BACKGROUND: Published analyses of prostate cancer nested case-control and survival data in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study cohort suggested that men with higher baseline vitamin D [25(OH)D] concentrations have both (i) increased prostate cancer risk and (ii) decreased prostate cancer-specific fatality. METHODS: To investigate possible factors responsible for a spurious association with prostate cancer fatality, we reanalysed baseline serum vitamin D associations with prostate cancer risk and prostate cancer-specific fatality in case-control data nested within the ATBC Study (1000 controls and 1000 incident prostate cancer cases). Conditional logistic regression and Cox proportion hazard models were used, respectively, to estimate odds ratios for risk and hazard ratios for prostate cancer-specific fatality, overall and by disease aggressiveness. We replicated these case-control analyses using baseline serum measurements of alpha-tocopherol (vitamin E), beta-carotene and retinol (vitamin A), and used the entire ATBC Study cohort (n = 29 085) to estimate marginal associations between these baseline vitamins and prostate cancer incidence and fatality following blood collection. RESULTS: Vitamin D analyses agreed closely with those originally published, with opposite risk and fatality associations. By contrast, the analyses of alpha-tocopherol, beta-carotene and retinol yielded concordant associations for prostate cancer incidence and prostate cancer-specific fatality. CONCLUSIONS: We found evidence of neither artefacts in the nested prostate cancer case-control data set nor detection or collider biases in the fatality analyses. The present findings therefore support a valid inverse (i.e. beneficial) association between vitamin D and prostate cancer-specific survival that warrants further evaluation, including possibly in controlled trials.

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Recent studies have linked the cardiovascular events with the exposure to ambient fine particulate matter (PM2.5); however, the impact of PM2.5 chemical components on acute myocardial infarction (AMI) case fatality remains poorly understood. To address this gap, we included 178,340 hospitalised patients with AMI utilising the inpatient discharge database from Sichuan, Shanxi, Guangxi, and Guangdong, China spanning 2014-2019. We evaluated exposure to PM2.5 and its components (black carbon (BC), organic matter (OM), sulphate (SO42-), nitrate (NO3-), and ammonium (NH4+)) using bilinear interpolation based on the patient's residential address. We used mixed-effects logistic regression models to investigate the associations of PM2.5 and its five components with in-hospital AMI case fatality. Per interquartile range (IQR) increment in short-term exposure (7-day average) to overall PM2.5 (odds ratio (OR): 1.086, 95 % confidence interval (CI): 1.045-1.128), SO42-(1.063, 1.024-1.104), BC (1.055, 1.023-1.089), OM (1.052, 1.019-1.086, and NO3- (1.045, 1.003-1.089) were significantly associated with high risk of in-hospital AMI case fatality. The ORs per IQR increment in long-term exposure (annual average) were 1.323 (95 % CI: 1.255-1.394) for PM2.5, followed by BC (1.271, 1.210-1.335), OM (1.243, 1.188-1.300), SO42- (1.212, 1.157-1.270), NO3- (1.116, 1.075-1.159), and NH4+ (1.068, 1.031-1.106). Our study suggests that PM2.5 chemical components might be important risk factors for in-hospital AMI case fatality, highlighting the importance of targeted reduction of PM2.5 emissions, particularly BC, OM, and SO42-.

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One consequence of population aging is an increase in the number of older wheelchair users. They often board the motor vehicle from the rear for moving. Recently, wheelchair user vehicle passengers have involved in motor vehicle collisions and died. A three-point seatbelt does not adequately fit most wheelchair user passengers because of the way that the wheelchair is constructed. Therefore, owing to the movement of the body immediately after the collision, the wheelchair user passengers attacked their body to the interior of the vehicle or suffered from the intrusion of the lap belt into the abdomen, subsequently suffered from severe head, chest or abdominal injuries. According to the review of all fatal motor vehicle collisions in Shiga Prefecture, Japan, which has a population of approximately 1.4 million, from 2017 to 2022, the rate of wheelchair users in fatal motor vehicle passenger increased from 3.6% in 2017 to 2019 to 7.8% in 2020 to 2022. Therefore, there is a risk that substantial numbers of wheelchair user passengers involved in motor vehicle collisions will die. However, in Japan, there are no official statistics on the involvement of wheelchair user passengers in motor vehicle collisions. Therefore, we propose a nationwide registration of injuries and fatalities in wheelchair user passengers. Investigating the mechanisms of injury in wheelchair user passengers would contribute to the development of safety measures, especially for restraint systems. Established preventive measure would contribute to the decrease of fatally or severely injured motor vehicle collision passengers.

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Status epilepticus is associated with high mortality and morbidity, both in the acute phase and over the long term. However, the long-term outcome of SE is not well studied, and there is no consensus on how to measure and predict it. Moreover, the factors that influence the long-term outcome of SE are complex and multifactorial, and may vary depending on the patient's characteristics, the SE etiology and type, and the treatment and complications. The aim of this article is to review the current literature on the mortality and morbidity of SE over the long term and to discuss the challenges and perspectives for future research. Proceedings of the 9th London-Innsbruck Colloquium on Status Epilepticus and acute seizures.

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BACKGROUND: Infectious diseases remain a major global health concern, including in China, with an estimated >10 million cases of infectious disease in 2019. We describe the burden of site-specific infectious diseases among Chinese adults. METHODS: From 2004 to 2008, the prospective China Kadoorie Biobank enrolled 512,726 adults aged 30-79 years from 10 diverse areas (5 rural, 5 urban) of China. During the 12 years of follow-up, 101,673 participants were hospitalized for any infectious disease. Descriptive analyses examined standardized incidence, mortality and case fatality of infections. FINDINGS: The incidence of any infectious disease was 1856 per 100,000 person-years; respiratory tract infections (1069) were most common. The infectious disease mortality rate was 31.8 per 100,000 person-years (20.3 and 9.4 for respiratory and non-respiratory infections, respectively) and case fatality was 2.2% (2.6% and 1.6% for respiratory and non-respiratory infections, respectively). Infectious disease incidence and mortality rates were higher at older ages and in rural areas. There were no clear sex differences in infectious disease incidence rates, but mortality and case fatality rates were twice as high in men as in women. INTERPRETATION: Infectious diseases were common in Chinese adults. The observed burden of, and disparities in, site-specific infections can inform targeted prevention efforts. FUNDING: Kadoorie Foundation, Wellcome Trust, MRC, BHF, CR-UK, MoST, NNSF.