bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimax optimization for handling range and setup uncertainties in proton therapy
Authors: Fredriksson Albin , Forsgren Anders , Hårdemark Björn
Published: March 2011

Purpose:

Intensity modulated proton therapy (IMPT) is sensitive to errors, mainly due to high stopping power dependency and steep beam dose gradients. Conventional margins are often insufficient to ensure robustness of treatment plans. In this article, a method is developed that takes the uncertainties into account during the plan optimization.

Methods:

Dose contributions for a number of range and setup errors are calculated and a minimax optimization is performed. The minimax optimization aims at minimizing the penalty of the worst case scenario. Any optimization function from conventional treatment planning can be utilized by the method. By considering only scenarios that are physically realizable, the unnecessary conservativeness of other robust optimization methods is avoided. Minimax optimization is related to stochastic programming by the more general minimax stochastic programming formulation, which enables accounting for uncertainties in the probability distributions of the errors.

Results:

The minimax optimization method is applied to a lung case, a paraspinal case with titanium implants, and a prostate case. It is compared to conventional methods that use margins, single field uniform dose (SFUD), and material override (MO) to handle the uncertainties. For the lung case, the minimax method and the SFUD with MO method yield robust target coverage. The minimax method yields better sparing of the lung than the other methods. For the paraspinal case, the minimax method yields more robust target coverage and better sparing of the spinal cord than the other methods. For the prostate case, the minimax method and the SFUD method yield robust target coverage and the minimax method yields better sparing of the rectum than the other methods.

Conclusions:

Minimax optimization provides robust target coverage without sacrificing the sparing of healthy tissues, even in the presence of low density lung tissue and high density titanium implants. Conventional methods using margins, SFUD, and MO do not utilize the full potential of IMPT and deliver unnecessarily high doses to healthy tissues.
Dosimetry protocol for the forthcoming clinical trials in synchrotron stereotactic radiation therapy (SSRT)
Authors: Prezado Y. , Vautrin M. , Martínez‐Rovira I. , Bravin A. , Estève F. , Elleaume H. , Berkvens P. , Adam J. F.
Published: March 2011

Purpose:

An adequate dosimetry protocol for synchrotron radiation and the specific features of the ID17 Biomedical Beamline at the European Synchrotron Radiation Facility are essential for the preparation of the forthcoming clinical trials in the synchrotron stereotactic radiation therapy (SSRT). The main aim of this work is the definition of a suitable protocol based on standards of dose absorbed to water. It must allow measuring the absolute dose with an uncertainty within the recommended limits for patient treatment of 2%–5%.

Methods:

Absolute dosimetry is performed with a thimble ionization chamber (PTW semiflex 31002) whose center is positioned at equivalent depth in water. Since the available synchrotron beam at the ESRF Biomedical Beamline has a maximum height of 3 mm, a scanning method was employed to mimic a uniform exposition of the ionization chamber. The scanning method has been shown to be equivalent to a broad beam irradiation. Different correction factors have been assessed by using Monte Carlo simulations.

Results:

The absolute dose absorbed to water at 80 keV was measured in reference conditions with a 2% global uncertainty, within the recommended limits. The dose rate was determined to be in the range between 14 and 18 Gy/min, that is to say, a factor two to three times higher than the 6 Gy/min achievable in RapidArc or VMAT machines. The dose absorbed to water was also measured in a RW3 solid water phantom. This phantom is suitable for quality assurance purposes since less than 2% average difference with respect to the water phantom measurements was found. In addition, output factors were assessed for different field sizes.

Conclusions:

A dosimetry protocol adequate for the specific features of the SSRT technique has been developed. This protocol allows measuring the absolute dose absorbed to water with an accuracy of 2%. It is therefore satisfactory for patient treatment.
Model‐based optoacoustic inversions with incomplete projection data
Authors: Buehler Andreas , Rosenthal Amir , Jetzfellner Thomas , Dima Alexander , Razansky Daniel , Ntziachristos Vasilis
Published: March 2011

Purpose:

Optoacoustic imaging is an emerging noninvasive imaging modality that can resolve optical contrast through several millimeters to centimeters of tissue with diffraction‐limited resolution of ultrasound. Yet, quantified reconstruction of tissue absorption maps requires optoacoustic signals to be collected from as many locations around the object as possible. In many tomographic imaging scenarios, however, only limited‐view or partial projection data are available, which has been shown to generate image artifacts and overall loss of quantification accuracy.

Methods:

In this article, the recently introduced interpolated‐matrix‐model optoacoustic inversion method is tested in different limited‐view scenarios and compared to the standard backprojection algorithm. Both direct (TGSVD) and iterative (PLSQR) regularization methods are proposed to improve the accuracy of image reconstructions with their performance tested on simulated and experimental data.

Results:

While for full‐view tomographic data the model‐based inversion has been generally shown to attain higher reconstruction accuracy compared to backprojection algorithms, the incomplete tomographic datasets lead to ill‐conditioned forward matrices and, consequently, to error‐prone inversions, with strong artifacts following a distinct ripple‐type pattern. The proposed regularization techniques are shown to stabilize the inversion and eliminate the artifacts.

Conclusions:

Overall, it has been determined that the regularized interpolated‐matrix‐model‐based optoacoustic inversions show higher accuracy than reconstructions with the standard backprojection algorithm. Finally, the combination of model‐based inversion with PLSQR or TGSVD regularization methods can lead to an accurate reconstruction of limited‐projection angle optoacoustic data and practical systems for optoacoustic imaging in many realistic cases where the full‐view dataset is unavailable.
A novel lateral disequilibrium inclusive (LDI) pencil‐beam based dose calculation algorithm: Evaluation in inhomogeneous phantoms and comparison with Monte Carlo calculations
Authors: Wertz Hansjoerg , Jahnke Lennart , Schneider Frank , Polednik Martin , Fleckenstein Jens , Lohr Frank , Wenz Frederik
Published: March 2011

Purpose:

Pencil‐beam (PB) based dose calculation for treatment planning is limited by inaccuracies in regions of tissue inhomogeneities, particularly in situations with lateral electron disequilibrium as is present at tissue/lung interfaces. To overcome these limitations, a new “lateral disequilibrium inclusive” (LDI) PB based calculation algorithm was introduced. In this study, the authors evaluated the accuracy of the new model by film and ionization chamber measurements and Monte Carlo simulations.

Methods:

To validate the performance of the newLDI algorithm implemented in Corvus 09®, eight test plans were generated on inhomogeneous thorax and pelvis phantoms. In addition, three plans were calculated with a simple effective path length (EPL) algorithm on the inhomogeneous thorax phantom. To simulate homogeneous tissues, four test plans were evaluated in homogeneous phantoms (homogeneous dose calculation).

Results:

The mean pixel pass rates and standard deviations of the gamma 4%/4 mm test for the film measurements were for the plans calculated with LDI, for the plans calculated with EPL, and for the homogeneous plans. Ionization chamber measurements and Monte Carlo simulations confirmed the high accuracy of the new algorithm (dose deviations ; gamma 3%/3 mm )

Conclusions:

LDI represents an accurate and fast dose calculation algorithm for treatment planning.
A Virophage at the Origin of Large DNA Transposons
Authors: Fischer Matthias G. , Suttle Curtis A.
Published: March 2011

A parasite of a giant DNA virus that rescues the host has been shown to be the progenitor of a widespread transposon.
Widespread Persistent Thickening of the East Antarctic Ice Sheet by Freezing from the Base
Authors: Bell Robin E. , Ferraccioli Fausto , Creyts Timothy T. , Braaten David , Corr Hugh , Das Indrani , Damaske Detlef , Frearson Nicholas , Jordan Thomas , Rose Kathryn , Studinger Michael , Wolovick Michael
Published: March 2011

A large fraction of the ice at Dome A, Antarctica, did not form by the usual process of snowfall compaction.
Selective Inhibition of a Regulatory Subunit of Protein Phosphatase 1 Restores Proteostasis
Authors: Tsaytler Pavel , Harding Heather P. , Ron David , Bertolotti Anne
Published: March 2011

Guanabenz, a small-molecule inhibitor, protects cells from lethal accrual of misfolded proteins in the endoplasmic reticulum.
Toward the Future of Personalized Medicine
Authors: Lin Richard J.
Published: March 2011

NF-κB inhibitor-α, in combination with
MGMT
status, may help contribute to personalized treatments for glioblastoma multiforme.
Phosphatidylinositol 3-Kinase Signaling Delays Sendai Virus-Induced Apoptosis by Preventing XIAP Degradation
Authors: White Christine L. , Chattopadhyay Saurabh , Sen Ganes C.
Published: March 2011

Sendai virus (SeV) infection causes apoptosis, which is manifested only late after infection; however, inhibition of phosphatidylinositol 3-kinase (PI3K) dramatically accelerates the process. We report here that rapid apoptosis uses the same mitochondrial apoptotic pathway as slow apoptosis. Cytoplasmic cytochrome
c
(cyt
c
) was released early in both cases, but the antiapoptotic protein XIAP prevented early activation of the caspases in cells with active PI3K. When the enzyme was inhibited, XIAP was degraded rapidly in infected cells, allowing cyt
c
to cause caspase activation and early apoptosis. Thus, SeV infection-mediated apoptosis is temporally regulated by the prevention of XIAP degradation by PI3K.
Treatment of a Human Papillomavirus Type 31b-Positive Cell Line with Benzo[a]Pyrene Increases Viral Titer through Activation of the Erk1/2 Signaling Pathway
Authors: Bowser Brian S. , Alam Samina , Meyers Craig
Published: March 2011

Numerous epidemiological studies have implicated cigarette smoking as a cofactor in the progression to cervical cancer. Tobacco-associated hydrocarbons have been found in cervical mucus, suggesting a possible interaction with human papillomavirus (HPV)-infected cells. The polycyclic aromatic hydrocarbon benzo[a]pyrene (BaP) is a major component of cigarette smoke condensate that has received significant attention due to its ability to induce carcinogenesis. We have previously demonstrated by conventional methods for determining viral titer that high concentrations of BaP increase HPV31b titers within the context of organotypic raft cultures compared with the level for vehicle controls. However, a definitive mechanism for explaining this increase in viral titer was lacking. Here, we show that BaP treatment activates the Ras-Raf-Mek1/2-Erk1/2 signaling pathway. The importance of Erk1/2 pathway activation to the BaP-mediated increase in viral titer was determined by Erk pathway inhibition with multiple Erk1/2 pathway inhibitors. Finally, BaP treatment activated p90RSK and its downstream target CDK1. These data indicate that the Erk1/2 signaling pathway plays an important role in mediating the response to BaP treatment that ultimately leads to increased viral titers.
Regulation of Antinucleoprotein IgG by Systemic Vaccination and Its Effect on Influenza Virus Clearance
Authors: LaMere Mark W. , Moquin Amy , Lee F. Eun-Hyung , Misra Ravi S. , Blair Patrick J. , Haynes Laura , Randall Troy D. , Lund Frances E. , Kaminski Denise A.
Published: March 2011

Seasonal influenza epidemics recur due to antigenic drift of envelope glycoprotein antigens and immune evasion of circulating viruses. Additionally, antigenic shift can lead to influenza pandemics. Thus, a universal vaccine that protects against multiple influenza virus strains could alleviate the continuing impact of this virus on human health. In mice, accelerated clearance of a new viral strain (cross-protection) can be elicited by prior infection (heterosubtypic immunity) or by immunization with the highly conserved internal nucleoprotein (NP). Both heterosubtypic immunity and NP-immune protection require antibody production. Here, we show that systemic immunization with NP readily accelerated clearance of a 2009 pandemic H1N1 influenza virus isolate in an antibody-dependent manner. However, human immunization with trivalent inactivated influenza virus vaccine (TIV) only rarely and modestly boosted existing levels of anti-NP IgG. Similar results were observed in mice, although the reaction could be enhanced with adjuvants, by adjusting the stoichiometry among NP and other vaccine components, and by increasing the interval between TIV prime and boost. Importantly, mouse heterosubtypic immunity that had waned over several months could be enhanced by injecting purified anti-NP IgG or by boosting with NP protein, correlating with a long-lived increase in anti-NP antibody titers. Thus, current immunization strategies poorly induce NP-immune antibody that is nonetheless capable of contributing to long-lived cross-protection. The high conservation of NP antigen and the known longevity of antibody responses suggest that the antiviral activity of anti-NP IgG may provide a critically needed component of a universal influenza vaccine.
Role of Nrf2 in Host Defense against Influenza Virus in Cigarette Smoke-Exposed Mice
Authors: Yageta Yuichi , Ishii Yukio , Morishima Yuko , Masuko Hironori , Ano Satoshi , Yamadori Tadahiro , Itoh Ken , Takeuchi Kaoru , Yamamoto Masayuki , Hizawa Nobuyuki
Published: March 2011

Influenza virus is a common respiratory tract viral infection. Although influenza can be fatal in patients with chronic pulmonary diseases such as chronic obstructive pulmonary disease, its pathogenesis is not fully understood. The Nrf2-mediated antioxidant system is essential to protect the lungs from oxidative injury and inflammation. In the present study, we investigated the role of Nrf2 in protection against influenza virus-induced pulmonary inflammation after cigarette smoke exposure with both
in vitro
and
in vivo
approaches. For
in vitro
analyses, peritoneal macrophages isolated from wild-type and
Nrf2
-deficient mice were treated with poly(I:C) and/or cigarette smoke extract. For
in vivo
analysis, these mice were infected with influenza A virus with or without exposure to cigarette smoke. In
Nrf2
-deficient macrophages, NF-κB activation and the induction of its target inflammatory genes were enhanced after costimulation with cigarette smoke extract and poly(I:C) compared with wild-type macrophages. The induction of antioxidant genes was observed for the lungs of wild-type mice but not those of
Nrf2
-deficient mice after cigarette smoke exposure. Cigarette smoke-exposed
Nrf2
-deficient mice showed higher rates of mortality than did wild-type mice after influenza virus infection, with enhanced peribronchial inflammation, lung permeability damage, and mucus hypersecretion. Lung oxidant levels and NF-κB-mediated inflammatory gene expression in the lungs were also enhanced in
Nrf2
-deficient mice. Our data indicate that the antioxidant pathway controlled by Nrf2 is pivotal for protection against the development of influenza virus-induced pulmonary inflammation and injury under oxidative conditions.
Demographic risk factors of self-immolation
Authors: Ahmadi A , Mohammadi R , Schwebel D C , Khazaie H , Yeganeh N , Almasi A , Kassani I
Published: March 2011

Objective

To investigate demographic risk factors for self-immolation patients.

Methods

In a case–control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional Burn centre (Imam Khomeini hospital in Kermanshah province, Iran) were compared with 30 controls who were selected from the community and matched by gender, age and living area. All cases and controls were reviewed for demographic variables, including: age, gender, living area, family size, marital status, bearing and number of children, body mass index (BMI), birth order, employment state, educational status, early school drop-out and parent/guardian employment status.

Results

Two variables emerged as related to risk of self-immolation. Being the first or last child in family birth order was associated with increased risk of self-immolation. Moreover, among the married participants, having children was associated with decreased risk of self-immolation. The comparisons of other variables were not statistically significant. In multivariate analyses, none of the variables predicted risk for self-immolation.

Conclusion

This study suggests that being the first or last child of a family might be a risk factor for self-immolation. For married persons, having children might serve as a protective factor from self-immolation. Other variables such as family size, marital status, number of children, BMI, employment state, educational status, early school drop-out and parent/guardian employment status did not play a role as individually protective or risk factors for self-immolation.
Injury prevention: global progress and next steps
Authors: Krug E
Published: March 2011

Over the last decade injury prevention has made great strides. Governments are starting to take some actions; the importance of the problem and the potential for prevention are increasingly recognised; the evidence on effectiveness of interventions is steadily being developed and implemented. All areas of injury prevention have made progress, but some more than others. The progress has been particularly striking in road safety, where in a few years, international consensus emerged, a global multi-sectoral alliance was created, governments started taking action and civil society organisations grew stronger, a first status report was developed, major funding was pledged and a Decade of Action was declared by the United Nations. Are there lessons to be learned from this area for other parts of the field? How can we best position the injury field in these times of economic crisis when attention to other important health problems is also needed? What are some of the main challenges and emerging issues we face? What areas of our work can be strengthened internationally? For its part, the World Health Organization will continue its efforts, focusing particularly on supporting the development of prevention programmes and trauma care at a national and local level and building capacity. It will support multisectoral partnerships in view of sharing best practices and advocating for more action. How can the international violence and injury prevention community collaborate more to continue increasing attention and action to address some of the challenges we face? This plenary address will provide some reflections on the above questions and hopefully stimulate discussion.
Pilot program at Litel elementary school
Authors: Sullivan J , Bayless L , Cook C , Cowles S
Published: March 2011

The short film is about a pilot program done at an elementary school where children receive safety instruction through interaction and song. For 4 days children received safety instructions via an instructor, in fire safety, stranger awareness, neighbourhood watch and school safety. On the fifth day, a singing group called the safety girls preformed songs that backed up the instructions given to the children. The children had a high percentage of retention due to the combination of instruction, interaction and song. The film is a combination of the songs and still photography that shows the children and their interactions with the instructor and singing group.
What defines the trend of violence-related injuries?
Authors: Rozenfeld M , Peleg K
Published: March 2011

Background

Previous studies established a clear connection between unemployment and violence rates trends, but little is known about influence of such factors on trends in severity of violence-related injuries. As the severity of those injuries is known to be connected to types of violence, this study will look for correlation between the trends of all abovementioned factors.

Methods

A retrospective study based on the National Trauma Registry data on patients hospitalised between 1 January 1998 and 31 December 2006 due to trauma. It consisted of 167 142, patient records of which 9839 (5.9%) sustained violence-related injury. Descriptive statistics and bivariate analyses were used to characterise trends and injury patterns.

Results

Unemployment trend had a significant correlation with violence rates and stabbing trends, but no connection to injury severity trend was found. Injury severity trend correlated positively with firearms trend and negatively with ‘unarmed brawling’ trend. Stabbing trend correlates negatively with firearms and ‘assault with an object’ trends. Despite polar differences in injury severity between stabbing and firearms, both types of violence have similar distribution in most demographic groups in distinction from ‘unarmed brawling’ and ‘assault with an object’.

Conclusions

Despite the connection to violence rates and stabbing, unemployment has no linear connection to the severity of violence-related injuries. Nevertheless, the correlation of stabbing trend with firearms trend, which, in turn, had strong correlation with injury severity trend, suggests that a non-linear relationship could be present.
Lifewise
Authors:   Diva Creative (Sheffield) on behalf of South Yorkshire Police and South Yorkshire Fire & Rescue
Published: March 2011

The Lifewise Centre DVD seeks to raise awareness of the excellent scenario facilities available. The Lifewise Centre is a purpose built community engagement facility which provides a variety of environments to public, voluntary and private sector organisations wishing to raise public awareness or enter into educational activity which centres on community safety and staying safe issues. The centrepiece of the facility is a realistic film set environment which allows for the development of interactive scenario based activity such as the following events: * crucial crew * special educational needs crucial crew * over 50's safety event * drive 4 life (young drivers event) * point 7 Gun, knife and gang initiative * Staying Safe in Sheffield (international student safety event) Since the centre opened in 2005, in excess of 84 000 attendees have benefited from the facilities and the events held at the centre. The Lifewise film encourages all members of the community to become involved in a variety of ways – attending one of the impactive safety events, facilitating a safety scenario or event (as an organisation) or taking up the opportunity to become a Police Support Volunteer. Events which take place at the centre need to demonstrate a clear link to one or more of the following objectives, in line with the Centre's booking criteria: * community safety * personal safety * personal responsibility * citizenship and * community awareness. Further information about Lifewise can be found on the website –http://www.lifewise.southyorks.police.uk
Sin Casco (without a helmet)
Authors: Gerson Samuel
Published: March 2011

This photograph depicts a typical scene on a city road in the Dominican Republic (DR) – another bright, sunny day on a congested stretch of pavement in the capital, Santo Domingo. From a vantage point by the street, an observer becomes vertiginous watching the endless, dizzying parade of vehicles streaming by. Two lanes evaporate into three or four, as drivers jockey for the leading position. Merengue music blasts out of a nearby grocery store, adding to the deafening cacophony of broken mufflers and blaring horns. Live electrical wires sag down between crumbling cement poles, at times reaching dangerously close to the top of passing cargo trucks. Suddenly, a motorcycle darts through the centre of the image, carrying three men – none wearing helmets or protective gear. Weaving in and out of oncoming traffic, they quickly disappear down the road behind a cloud of thick exhaust. While safe for the moment, this scenario too often ends tragically for these riders, in a pile of twisted metal and broken bones. In 2004 the WHO released the world report on road traffic injury prevention identifying roadway mortality as a major global health problem that claims an estimated 3000 lives daily. Ninety percent of these deaths occur in developing countries. In the DR, road traffic injuries are the top cause of death among males of working age. According to police records, motorcycle accidents account for the majority of these fatalities, most involving multiple un-helmeted passengers. Images like this inspired a group of New York-based physicians working in a Dominican neighbourhood – where the burden of trauma is felt emotionally and economically among friends and relatives of victims from their native country – to launch an initiative aimed at helmet use and roadway injury prevention in the DR.
Safety on pedestrian crossing
Authors: Hemasiri A G , Edirisinghe J
Published: March 2011

Major road traffic accident victim category on Sri Lankan roads is pedestrians. There are many reasons for high pedestrian casualties. Pedestrian behaviour, pedestrian facilities, law enforcement and driver behaviour are some of those. The attached photograph is a good example on all effect of all the above factors on pedestrians safety. Here the pedestrian is trying to get in to the bus on a pedestrian crossing while that particular bus is trying to overtake another bus parked at pedestrian crossing to pick passengers.
Carrying capacity on a motor bicycle
Authors: Hemasiri A G , Edirisinghe J
Published: March 2011

Driver behaviour and attitude contributes significantly towards road traffic accidents and congestion. Due to poor transport facilities, and due to cost, many tend to use motor bicycles for their day to day needs. Sometimes, riders tend to carryout dangerous activities on roads. Here in this picture a rider with a pillion rider carrying a large board risking their lives as well as lives of others on the road.
Do you really need lights for vehicles
Authors: Hemasiri A G , Edirisinghe J
Published: March 2011

Road worthy vehicles can reduce accidents and congestion in great numbers. Lack of law enforcement contributes significantly to enter many bad vehicles to roads. This photo is a good example on how much bad vehicles without lights, number plates etc. enter to roads.
Maneuvering on bends
Authors: Hemasiri A G , Edirisinghe J
Published: March 2011

Driver ability is one of the key factors to improve road safety situation. The driver should be aware about the capacity of the vehicle, of the road and many other factors to drive a vehicle safely on roads. This image shows an accident due to driving high speed on a bend.
Parental love
Authors: Edirisinghe J
Published: March 2011

A photograph taken using a digital camera is used for this. Motor bicycle riders are among main accident victim categories on Sri Lankan roads. Due to various reasons, riders carry the whole family on a bicycle. One of the main problems is carrying small children and infants on motor bicycles risking the life of the person carrying the infant as well as infant. There are many reports on injuries and deaths due to this careless behaviour. This photograph is a good example of it.
The danger of poor visibility
Authors: Adenusi P
Published: March 2011

The growing trend of road crashes all over the world has become a major concern to all. Over the years emphasis has been on speed, seat belt, tyres, road conditions, etc. The low/middle income countries (LMIC) contribute the larger number of casualties. There is a major disconnect of attributing some cases to speed rather than poor visibility. In the LMIC, about 90% of heavy goods vehicles does not have retro-reflective tape fixed to their trucks. On several occasions, the trucks breakdown and what is used as warning signs to warn other road users are: (1) leaves (2) used tyres (3) wood (4) stones (5) bush lamps (6) empty drums, etc. None of the aforementioned is ideal to warn road users. Crashes becomes inevitable when night falls. The greater number of casualties in Nigeria is as a result of rear impact to stalled trucks and articulated vehicles. This has led to multiple death of innocent road users. Our photographs highlight one of the hidden causes of road death in LMIC. You will see pictures of the described scenarios and that of the victims. We have had 1, 2, 5 18, 45, 70 death at once due to poor visibility of obstructions on the highways. Before we begin the decade of action (2011–2020), if LMIC works on enhanced visibility, we would cut down road death by about 45%. The concluding part will show pictures of how the advanced countries curbed the menace. The LMIC should copy best practices.
Tune into traffic – earphone advert
Authors: Darroch M
Published: March 2011

Road traffic collisions are the biggest threat to young people's lives in the UK. Statistics indicate that a young people aged 15–24 is more likely to be killed by traffic than being stabbed abused or neglected. This issue is not just a matter affected young people in the UK but is a global health concern highlighted by the WHO. In contemporary society, young people are particularly vulnerable to road traffic accidents and research has shown that brain development in young people is in most cases the cause of the problem for young people. Hazard perception development in the frontal cortex of the brain is underdeveloped in young people until the age of 25, in this case, young people are more likely to be distracted on the road. Tune into Traffic is a campaign aiming to revamp the old Green Cross Code of Stop Look and Listen. In the UK, every young person hold preference to music and in using music to address a road safety concern, we have produced an internet and cinema advert that focuses on the danger of listening to music while using the road. This is of particular importance as the usage of iPods and MP3 players has increased significantly with young people. Our advert, in an extremely short and succinct manner puts forward the issue and presents a solution. In showing this to organisations such as – Youth for Road Safety (YOURS), the UK Youth Parliament, The Royal Society for the Prevention of Accidents, the response has been extremely positive and we are pushing on releasing the advert on TV after being successful on social media websites.
Faces of violence: a non-fiction story
Authors: Valenti, M ,   IPPNW members
Published: March 2011

Armed violence is hard to define but easy to recognise. The short documentary Faces of Violence: A non-fiction story examines the many dimensions of violence and its implications for the development sector. In focusing on key risk factors and symptoms of armed violence, it shows how it can be diagnosed and ultimately treated. Faces of violence features the stories of a former drug trafficker from Brazil and a former fighter from war-torn Southern Sudan. It highlights how both protagonists were once perpetrators of violence, then victims and ultimately, part of the solution to achieving lasting peace in their communities. Faces of Violence is a reminder of the poignant human stories behind the statistics, and a call to action for disarmament experts, development practitioners, public health specialists and human rights activists around the world. The film was conceived and produced by Igarapù and the Small Arms Survey with assistance from the Norwegian Ministry of Foreign Affairs.
A. Seat belts and road safety/regeneration, B. Drinking and driving and road safety and C. Speeding and road safety
Authors: Tianzhou A
Published: March 2011

All of the three pictures and films can be used for the education of road safety. A: Its a set of pictures, which uses the contrastive method to highlight the importance of seat belts. The pictures first show a crab, whose pincers were lost in a fight for food with others. At the same time, a road traffic crash happens to a driver without wearing seatbelt, then the driver loses one leg. After 6 months, the crab has its reborn pincers. However, the driver doesn't. Finally, it is showed that please buckle up when driving if you don't have the regenerated ability. B&C: these two films both use the toys to simulate the scenes of road traffic accident because of drinking driving/speeding. There is no bloody scene. And they are much more friendly to children for education. Each film has one core message. B shows that about 50–60% road traffic crashes are related to drink-driving. C shows that reducing the average speed by 1 km/h results in a 4–5% decrease in fatal crash.
Trauma 2+2=5
Authors: Marques H
Published: March 2011

An injury is the physical damage that results when a human body is suddenly subjected to energy in amounts that exceed the threshold of physiological tolerance, or the result of the lack of one or more vital elements, such as oxygen. Ec=mv2. This energy could be mechanical, thermal, chemical or radiant. Every day in the WHO European Region, injuries kill over 2000 people, put 60 000 in hospital and necessitate outpatient emergency treatment for 60 0000. They are the main cause of death for people aged up to 45 years. Evidence on road traffic injuries, drownings, poisonings, falls, fires, self-inflicted injuries and interpersonal violence indicates that they can be studied, predicted and prevented. All citizens can play an important role in the optimisation of resources and care, as health active agents, agents of civil protection and potential victims. Trauma 2+2=5 is a pedagogical tool that exposes the reality of a trauma centre in order to contribute to Mitigation, preparation, response and recovery of injuries and violence. Trauma 2+2=5 because everything that can be explained can be prevented.
Drug safety (pharmacoviglance)
Authors: Olaitan A M
Published: March 2011

Manifestation of adverse drug reactions are common occurrence in patients but poorly or never reported in our environment. They are common in antimalarial and antiretroviral drugs. Steven Johnson syndrome due to (sulpadoxine/pyrimethamine -SP) and erythema due to ACT (Artesunate/Amodiaquine)in antimalarial adverse drug reaction. The anti-retroviral adverse drug reactions include allergy, skin rash, hyperpigmentation of the palms, lipoatrophy, lipodystrophy, lipohypertrophy, dyslipidaemia/coronary heart disease and nausea.
Unforgiving roads
Authors: Olawepo O
Published: March 2011

This is a picture of a road in Abuja, the federal capital city of Nigeria. It is a typical example of the new road being constructed in the city. The design of the billion Naira roads being built in Abuja, Nigeria is a source of concern. Sometimes I wonder if these roads were designed with the driver in mind. The slightest mistake on the roads leads you into the ditch (drains) lining the sides. Many drivers have fallen victim of the roads which need not be so. It is general consensus that roads should be forgiving as this reduces the incidence of road traffic crashes which causes unnecessary waste and loss of lives. The government and contractors need to review the design of these unforgiving roads.
Assessment of patient safety culture in hospitals of Hyderabad, India
Authors: Tetali S , Kannuri N K , Rao M
Published: March 2011

Background

The setting of this work is Andhra Pradesh (AP), the fourth largest state Indian state with 76 million people in which the AP patient safety alliance was recently launched. This paper describes the results of assessment of patient safety culture in select hospitals of Hyderabad during September– November 2009.

Aim

To understand the safety culture of hospitals in Hyderabad, to assess current levels of implementation and barriers to two of the Global Patient Safety Challenges, Clean Care is Safer Care Safe Surgery Saves Lives.

Methodology

Three government and four private hospital superintendents, doctors, nurses, occupational therapy staff and ward boys participated in the study. In depth interviews, focus group discussions, structured questionnaires and facility audits were conducted. Data was analysed with SAS.

Results

Hand hygiene preferences were variable. Some used hand rubs because they are less messy than soap, but others objected to strong smell of hand rubs. Hospitals locally adapted checklists for surgical procedures with private hospitals having more elaborate checklists, and government hospitals, basic ones. 60% thought their hospital is doing more for patient safety now, than last year. 25% were unable to express disagreement with physicians. Most errors here are due to ego problems and communication gaps between departments –nurse and barriers to implementation: high attrition rate and need for constant training (private hospitals), severe shortages of staff (government hospitals).

Conclusion

Management support and leadership are crucial in implementing patient safety. Private hospitals adhere to protocols better than government hospitals in Hyderabad, which are grappling with more basic problems like staff shortage.
Comparison of return to work outcome measures following transport injury
Authors: Collie A , Brion A , Barker S , Johnstone R , Pennay D
Published: March 2011

Background

Return to work (RTW) is an important marker of recovery from injury. There is substantial evidence that RTW is associated with higher levels of self-rated health, quality of life, greater social inclusion and reduction in ongoing disability. There are multiple RTW metrics reported in the literature and little consensus regarding the most appropriate.

Aim

To compare RTW rates following transport injury using a number of criterion.

Method

Six-hundred and one individuals (328 males) injured in a transport accident completed a telephone survey between 6 months and 10 years (mean 3.5 years) post injury. Four hundred and forty participants (73.2%) were working at injury, with 289 (48.1%) working >35 h per week.

Results

69.4% of those working at injury had achieved any RTW since injury, with fewer currently working (59.2%) or achieving sustained (57.6%), current and sustained (54.1%) or full RTW (37.6%). RTW rates were greater for those working >35 h per week prior to injury, with 86.9% achieving any RTW and 45.7% achieving a full RTW (defined as >35 h employment per week). In contract, rates in those not working prior to injury were much lower, with 29.2% achieving any RTW and 16.1% achieving a full RTW. RTW rates also varied significantly according to time post injury and occupation.

Conclusion

Conclusions regarding injury recovery can vary greatly depending on the RTW criterion utilised and sample characteristics.
Injury surveillance in Tarija, Bolivia
Authors: Zavala D
Published: March 2011

An injury surveillance system has been established at Hospital San Juan de Dios in November 2009, in the city of Tarija, Bolivia. This is the main hospital for the city that received close to 90% of all injury cases that require emergency service and/or hospitalisation. Therefore the data collected at this hospital can well reflect the occurrence of injuries in the city of approximately 171 000 people. Based on a 2003 health survey, 68.6% of those interviewed reported a previous incident of interpersonal violence.

We report on an analysis of the first 9 months of data collection (December 2009–August 2010) for the three most frequent injuries treated at the hospital emergency department: intentional injuries such as interpersonal violence, child and elderly abuse, youth violence, self-inflicted violence and road traffic injuries.
Kenyan village children affected by bacterial meningitis
Authors: Nyabade G
Published: March 2011

Objective

Kenyan village children are casualties to bacterial meningitis. Early diagnosis and appropriate antibiotic treatment are perhaps the most important initiatives towards eradication of this great pandemic and its management in Kenyas rural villages. The objective of this study indicates and brings to awareness that bacterial meningitis kills many children from poor and desperate Kenyan villages without access to hospitals or clinics.

Methods

Nyando Sub District Hospital, serving 300 000 people in a rural, malaria-pandemic area of the Western Kenyan, was studied. A Kenya Medical Research Institute research centre is located at Kisian near Kisumu city. All paediatric admissions aged 60 days between June 2001 and July 2002 were eligible.

Results

A total of 91(2.0%) of 4582 admissions had meningitis, including 77(4.0%) of 1929 of those who met the IMCI referral criteria for meningitis at admission (sensitivity: 85%; specificity: 59%). Independent indicators of the presence of meningitis were a bulging fontanel, neck stiffness, cyanosis, impaired consciousness, partial seizures and seizures outside the febrile convulsions age range. The area under the receiver operating characteristic curve for a set of simple screening rules based on the positive indicators identified was 0.88(95% CI 0.85 to 0.92).

Conclusions

The presence of one of a bulging fontanel, neck stiffness, cyanosis, impaired consciousness, partial seizures and seizures outside the febrile convulsions age range is a clear indication for lumbar puncture and/or presumptive treatment.
Development of an instrument that assesses individual's burn prevention knowledge
Authors: Lehna C , Myers J
Published: March 2011

Background

Currently no valid and reliable instrument to assess an individuals burn prevention knowledge exists. Therefore, it is difficult to evaluate if interventions to increase burn prevention knowledge are effective. Therefore we aimed to develop and test an instrument that assesses individuals burn prevention knowledge. As a result, the effect of interventions aimed to increase burn prevention knowledge can be investigated.

Methods

A focus group comprised of 22 American Burn Association burn prevention committee members first prioritised areas that individuals with burn prevention knowledge should be well informed about (ie, scalds, gasoline elders, abuse, juvenile fire setters). Then questions were developed to assess an individuals knowledge in these priority areas (39 questions) by the author and tested for reliability and validity. Factor analysis techniques were utilised to develop the final survey (15 questions). The final survey was administered and tested in a group of paediatric, emergency department and clinic nurses for reliability and validity.

Results

From the original survey (39 questions), the factor analysis suggests that 15 questions strongly load on a factor and explained 76% of the variance in responses. The five factors with eigenvalues greater than 1.0 were as follows: scalds, gasoline, elders, abuse and juvenile fire setters. These 15 questions represented the final survey to be administered to evaluate burn prevention knowledge in nurses. The final survey developed has moderate inter-rater reliability (Cohens κ=0.578), high intrarater reliability (ICC=0.713) and good internal consistency (Cronbach's α=0.604. In addition, the final survey was determined to have face validity as well as construct validity (five components had eigenvalues greater than 1.0).

Conclusions

The survey developed is positioned to be tested in a multi-site, multi-state and multi-investigator study. If results from this study hold consistent the survey developed can be used in future interventional studies aimed to increase burn prevention knowledge.
Low-cost and sustainable improvements in injury surveillance in Ghana
Authors: Adofo K , Donkor P , Afukaar F , Boateng K , Mock C
Published: March 2011

Introduction

Mortuary data are incomplete in many developing countries. Small investments could lead to substantial improvements.

Objective

To evaluate recent trends in injury reporting systems. To identify ways to strengthen the reporting systems and make them more useful for injury control.

Methods

We evaluated changes in data quality on fatally injured persons at KATH over a 12-year period.

Results

During 1994–95, cases in KATH's mortuary logbooks had missing information on cause of death, and only 70 injury deaths/year were reported. This was felt to be a gross under-estimate of injury among Kumasi's 1 000 000 people. A pilot program hired part-time nurses to improve recording of injury deaths. During 1996–1999, 633 deaths/year were recorded, more accurately reflecting injury's toll in Kumasi. To assess the sustainability of this improvement after funding expired, we re-assessed mortuary injury data quality in 2006. Reporting remained high, with 865 fatally injured cases recorded. However, only 80% of these cases were found in mortuary logbooks. An additional 20% were found in supplemental sources in the hospital, principally the ICU. Data quality had diminished slightly.

Conclusion

In many developing countries, important information is not recorded. Low-cost improvements could lead to improved reporting and data quality. This study has shown that such improvements are sustainable after the initial investments. Minor problems such as insufficient collation of data from multiple sources and coding of mechanism could be corrected by improved organization and training.
Risk factors for homicide by firearm discharge in night time Johannesburg
Authors: Kramer S , Ratele K , Swart L A , Seedat M , Smith M
Published: March 2011

The presence of a firearm in a violent incident massively increases the likelihood of mortality. Firearms are central to interpersonal violence and their lethality results in both non-fatal and fatal injuries that have enormous human and economic costs. This study investigates the possible risk factors for homicide by firearm discharge in night time Johannesburg, South Africa. Specifically, this study analysed data originating from the National Injury Mortality Surveillance System (NIMSS) which is an epidemiological surveillance system of fatal injuries. The sample was drawn from the NIMSS database for homicides in Johannesburg for the years 2001–2005. This database consists of 9484 subjects of which 5153 were victims of night time homicide. A binary logistic regression model was utilised in order to identify the likelihood of particular risk factors occurring in certain groups of people and contexts. This study demonstrated that sex and time at night are particularly important risk factors for night time firearm homicide. While the results were less pronounced for age, race and location, these factors still clearly place individuals at risk. Additionally, alcohol is an important factor that contributes to the variance in firearm homicide. The presentation concludes with a discussion of some of the possible implications the results might have for future preventive efforts.