Under-reporting bicycle accidents to police in the COST TU1101 international survey: Cross-country comparisons and associated factors

Police crash reports are often the main source for official data in many countries. However, with the exception of fatal crashes, crashes are often underreported in a biased manner. Consequently, the countermeasures adopted according to them may be inefficient. In the case of bicycle crashes, this bias is most acute and it probably varies across countries, with some of them being more prone to reporting accidents to police than others. Assessing if this bias occurs and the size of it can be of great importance for evaluating the risks associated with bicycling. This study utilized data collected in the COST TU1101 action “Towards safer bicycling through optimization of bicycle helmets and usage”. The data came from an online survey that included questions related to bicyclists' attitudes, behaviour, cycling habits, accidents, and patterns of use of helmets. The survey was filled by 8655 bicyclists from 30 different countries. After applying various exclusion factors, 7015 questionnaires filled by adult cyclists from 17 countries, each with at least 100 valid responses, remained in our sample. The results showed that across all countries, an average of only 10% of all crashes were reported to the police, with a wide range among countries: from a minimum of 0.0% (Israel) and 2.6% (Croatia) to a maximum of a 35.0% (Germany). Some factors associated with the reporting levels were type of crash, type of vehicle involved, and injury severity. No relation was found between the likelihood of reporting and the cyclist's gender, age, educational level, marital status, being a parent, use of helmet, and type of bicycle. The significant under-reporting – including injury crashes that do not lead to hospitalization – justifies the use of self-report survey data for assessment of bicycling crash patterns as they relate to (1) crash risk issues such as location, infrastructure, cyclists' characteristics, and use of helmet and (2) strategic approaches to bicycle crash prevention and injury reduction.Fil: Shinar, D.. Ben Gurion University of the Negev; IsraelFil: Valero Mora, Pedro. Universidad de Valencia; EspañaFil: van Strijp Houtenbos, M.. Institute For Road Safety Research; Países BajosFil: Haworth, N.. Queensland University of Technology; AustraliaFil: Schramm, A.. Queensland University of Technology; AustraliaFil: de Bruyne, G.. Universiteit Antwerp; BélgicaFil: Cavallo, V.. No especifíca;Fil: Chliaoutakis, J.. No especifíca;Fil: Pereira Dias, Joao. Instituto Superior Tecnico; PortugalFil: Ferraro, Ottavia Eleonora. Universita Degli Studi Di Pavia; ItaliaFil: Fyhri, Aslak. No especifíca;Fil: Sajatovic, Anika Hursa. No especifíca;Fil: Kuklane, Kalev. Lund University; SueciaFil: Ledesma, Ruben Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Psicología Básica, Aplicada y Tecnología. Universidad Nacional de Mar del Plata. Facultad de Psicología. Instituto de Psicología Básica, Aplicada y Tecnología.; ArgentinaFil: Calvé Mascarell, Oscar. Ben Gurion University of the Negev; IsraelFil: Morandi, A.. Universita Degli Studi Di Pavia; ItaliaFil: Muser, Markus. No especifíca;Fil: Otte, Diettmar. No especifíca;Fil: Papadakaki, M.. No especifíca;Fil: Sanmartín, J.. Universidad de Valencia; EspañaFil: Dulf, D.. No especifíca;Fil: Saplioglu, M.. No especifíca;Fil: Tzamalouka, Georgia. No especifíca

Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit

Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. We encountered many technical (hardware and software) implementation challenges. However there were many advantages of the system once it was operational. They include: (1) The ability to store the data for long periods of time enabling access to historical physiological data. (2) The ability to alter the time axis to contract or expand periods of interest. (3) The ability to store and review ECG morphology retrospectively. (4) Detailed post event (cardiac/respiratory arrest or other clinically significant deteriorations in patients) data can be reviewed clinically as opposed to trend data providing valuable clinical insight. Informed mortality and morbidity reviews can be conducted. (5) Storage of waveform data capture to use for algorithm development for adaptive early warning systems. Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring

Keratoacanthoma and keratoacanthoma-like squamous cell carcinoma similar morphology but different pathogenesis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Differential diagnosis between keratoacanthoma (KA) and squamous cell carcinoma (SCC) is difficult due to their similarities. The mechanisms that drive their distinct biological behavior are poorly understood.To investigate whether the assessment of microvessel density (MVD) could be helpful in KA and SCC differential diagnosis and to gain insight into the pathogenesis of KA-like neoplasms, we compared the density of CD105- and CD34-stained vessels in KAs and SCCs and their relation to the expression of the p53 oncoprotein and proliferation marker Ki67.This is an observational retrospective cohort study. Forty lesions with clinical appearance of KAs (29 KAs and 11 SCCs) entered the study. A biopsy was taken from each lesion at presentation and the natural clinical course was monitored for at least 1 month. Growing or minimally regressing lesions were submitted to complete surgical excision. The diagnoses were established on combined clinical, histological, and follow-up evaluations. The MVD and p53 or Ki67 expression in neoplastic cells were assessed through morphometry.The MVD did not show discriminating power between KAs and SCCs. The Ki67 proliferation rate was significantly higher in SCCs. Although neoangiogenesis (CD105-MVD) in KAs was associated with cell proliferation, in SCCs it was not. There was significant correlation between p53 expression and neoplasia size in SCCs but not in KAs.From our results, we may conclude that KA and SCC have similarities, as CD105- and CD34-MVD. However, the low Ki67 proliferation index and the positive correlation between Ki-67 index and neovascularization in KA suggest a dependence in neovascularization to grow in KA, pointing to involvement of distinct pathogenesis.Differential diagnosis between keratoacanthoma (KA) and squamous cell carcinoma (SCC) is difficult due to their similarities. The mechanisms that drive their distinct biological behavior are poorly understood.To investigate whether the assessment of micro9423FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2007/52603-0]2007/52603-0Funding from National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI) or other(s): non

International forum. an investigation of iron status in blood donors

No abstract availabl

Homelessness in autistic women: defining the research agenda

Background: Current evidence suggests that autistic individuals are at high risk for becoming and remaining in a cycle of homelessness. Key risk factors for homelessness disproportionately affect autistic people; however, we have limited understanding of how to best support autistic individuals accessing services. This gap in the evidence base is particularly acute for autistic women. Objective: As a first step to address this gap, we aimed to (1) map gaps in knowledge and practice; (2) identify priority areas for research and (3) develop recommendations for how to implement novel research and practice in this area. Methods: We conducted a collaborative workshop with an interdisciplinary group of 26 stakeholders to address our aims. Stakeholders included autistic women with experience of homelessness, researchers, health professionals, NGO representatives, and service providers. Results and recommendations: Two research priority areas were identified to map the prevalence and demographics of autistic women experiencing homelessness, and to delineate risk and protective factors for homelessness. Priority areas for improving provision of support included staff training to improve communication, awareness of autism and building trust with service providers, and recommendations for practical provision of support by services. Conclusions: Future research is critical to increase our knowledge of the pathways leading to homelessness for autistic women, and barriers to engaging with homelessness and social services. We need to use this knowledge to develop new ways of delivering targeted and inclusive support for autistic women, which could prevent or shorten periods of homelessness

Venom alkaloids against Chagas disease parasite: search for effective therapies

Chagas disease is an important disease affecting millions of patients in the New World and is caused by a protozoan transmitted by haematophagous kissing bugs. It can be treated with drugs during the early acute phase; however, effective therapy against the chronic form of Chagas disease has yet to be discovered and developed. We herein tested the activity of solenopsin alkaloids extracted from two species of fire ants against the protozoan parasite Trypanosoma cruzi, the aetiologic agent of Chagas disease. Although IC50 determinations showed that solenopsins are more toxic to the parasite than benznidazole, the drug of choice for Chagas disease treatment, the ant alkaloids presented a lower selectivity index. As a result of exposure to the alkaloids, the parasites became swollen and rounded in shape, with hypertrophied contractile vacuoles and intense cytoplasmic vacuolization, possibly resulting in osmotic stress; no accumulation of multiple kinetoplasts and/or nuclei was detected. Overexpressing phosphatidylinositol 3-kinase—an enzyme essential for osmoregulation that is a known target of solenopsins in mammalian cells—did not prevent swelling and vacuolization, nor did it counteract the toxic effects of alkaloids on the parasites. Additional experimental results suggested that solenopsins induced a type of autophagic and programmed cell death in T. cruzi. Solenopsins also reduced the intracellular proliferation of T. cruzi amastigotes in infected macrophages in a concentration-dependent manner and demonstrated activity against Trypanosoma brucei rhodesiense bloodstream forms, which is another important aetiological kinetoplastid parasite. The results suggest the potential of solenopsins as novel natural drugs against neglected parasitic diseases caused by kinetoplastids.Fil: Silva, Rafael C. M. Costa. Universidade Federal do Rio de Janeiro; BrasilFil: Fox, Eduardo G. P.. Universidade Federal do Rio de Janeiro; Brasil. South China Agricultural University; ChinaFil: Gomes, Fabio M.. Universidade Federal do Rio de Janeiro; Brasil. National Institutes of Health; Estados UnidosFil: Feijó, Daniel F.. Universidade Federal do Rio de Janeiro; BrasilFil: Ramos, Isabela. Universidade Federal do Rio de Janeiro; BrasilFil: Koeller, Carolina M.. Universidade Federal do Rio de Janeiro; Brasil. University at Buffalo; Estados UnidosFil: Costa, Tatiana F. R.. Universidade Federal do Rio de Janeiro; BrasilFil: Rodrigues, Nathalia S.. Universidade Federal do Rio de Janeiro; BrasilFil: Lima, Ana P.. Universidade Federal do Rio de Janeiro; BrasilFil: Atella, Georgia C.. Universidade Federal do Rio de Janeiro; BrasilFil: Rocha de Miranda, Kildare. Universidade Federal do Rio de Janeiro; Brasil. Instituto Nacional de Ciência e Tecnologia em Biologia Estrutural e Bioimagem; BrasilFil: Schoijet, Alejandra Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Alonso, Guillermo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: de Alcântara Machado, Ednildo. Universidade Federal do Rio de Janeiro; BrasilFil: Heise, Norton. Universidade Federal do Rio de Janeiro; Brasi

The patient journey : a report of skin cancer care across Europe

Summary - Background: There are poorly documented variations in the journey a skin cancer patient will follow from diagnosis to treatment in the European Union. Objectives: To investigate the possible difficulties or obstacles that a person with a skin malignancy in the European Union may have to overcome in order to receive adequate medical screening and care for his/her condition. In addition, we wished to explore differences in European health systems, which may lead to health inequalities and health inequities within Europe. Methods: Ten European countries took part in this investigation (in alphabetical order): Finland, Germany, Greece, Italy, Malta, Poland, Romania, Spain, the Netherlands and the U.K. The individual participants undertook local and national enquiries within their own country and completed a questionnaire. Results This exercise has identified important differences in the management of a skin cancer patient, reflecting major disparities in health care between European countries. Conclusions: Further investigation of health disparities and efforts to address health inequalities should lead to improvements in European health care quality and reduction in morbidity from skin cancer.This publication arises from the EPIDERM project, which was funded by the European Commission’s Executive Agency for Health and Consumers (EPIDERM project: PHEA 2007- A ⁄100994 HI). Funding for publication of this supplement was provided by the European Skin Cancer Foundation (ESCF).peer-reviewe

Energetic proton back-precipitation onto the solar atmosphere in relation to long-duration gamma-ray flares

Context. Gamma-ray emission during long-duration gamma-ray flare (LDGRF) events is thought to be caused mainly by >300 MeV protons interacting with the ambient plasma at or near the photosphere. Prolonged periods of the gamma-ray emission have prompted the suggestion that the source of the energetic protons is acceleration at a coronal mass ejection (CME)-driven shock, followed by particle back-precipitation onto the solar atmosphere over extended times. Aims. We study the latter hypothesis using test particle simulations, which allow us to investigate whether scattering associated with turbulence aids particles in overcoming the effect of magnetic mirroring, which impedes back-precipitation by reflecting particles as they travel sunwards. Methods. The instantaneous precipitation fraction, P, the proportion of protons that successfully precipitate for injection at a fixed height, r_i, is studied as a function of scattering mean free path, lambda, and r_i. Upper limits to the total precipitation fraction, P_bar, were calculated for eight LDGRF events for moderate scattering conditions lambda=0.1 au). Results. We find that the presence of scattering helps back-precipitation compared to the scatter-free case, although at very low lambda values outward convection with the solar wind ultimately dominates. For eight LDGRF events, due to strong mirroring, P_bar is very small, between 0.56 and 0.93% even in the presence of scattering. Conclusions. Time-extended acceleration and large total precipitation fractions, as seen in the observations, cannot be reconciled for a moving shock source according to our simulations. Therefore, it is not possible to obtain both long duration gamma ray emission and efficient precipitation within this scenario. These results challenge the CME shock source scenario as the main mechanism for gamma ray production in LDGRFs