Testing chromatic adaption models using object colors

The objective of this research was to determine which published chromatic adaptation model performed best under a single set of conditions. Previous research has been conducted to study chromatic adaptation, develop models and to indirectly test those models. This research directly tested the performance of these models using printed, simple-field, object colors through a successive-ganzfe/cf haploscopic, paired comparison, matching experiment. The chromatic adaptation models tested were CIELAB, CIELUV, Fairchild \u2791, Hunt \u2791, LABHNU2, Nayatani et al. \u2790 and von Kries. The test illuminant was incandescent at 231 lux. Model predictions were calculated for the reference simulated daylight at 2,396 lux. The Hunt model was found to predict the best matches for each color sample, and across all ten color centers. The other models\u27 performances were significantly different, but not nearly as good. However, two versions of the Hunt model were tested, and neither performed consistently, although they both performed better than the other models. For a wide chromatic range of object colors, an alternative form of the Hunt model is suggested for implementing the prediction of corresponding colors

Clinicians’ Perceptions of The Health Status of Formerly Detained Immigrants

Background In the past decade, the U.S. immigration detention system regularly detained more than 30,000 people; in 2019 prior to the pandemic, the detention population exceeded 52,000 people. Inhumane detention conditions have been documented by internal government watchdogs, news media and human rights groups, finding over-crowding, poor hygiene and sanitation and poor and delayed medical care, as well as verbal, physical and sexual abuse. Methods This study surveyed health professionals across the United States who had provided care for immigrants who were recently released from immigration detention to assess clinician perceptions about the adverse health impact of immigration detention on migrant populations based on real-life clinical encounters. There were 150 survey responses, of which 85 clinicians observed medical conditions attributed to detention. Results These 85 clinicians reported seeing a combined 1300 patients with a medical issue related to their time in detention, including patients with delayed access to medical care or medicine in detention, patients with new or acute health conditions including infection and injury attributed to detention and patients with worsened chronic conditions or special needs conditions. Clinicians also provided details regarding sentinel cases, categorized into the following themes: Pregnant women, Children, Mentally Ill, COVID-19, and Other serious health issue. Conclusions This is the first survey, to our knowledge, of health care professionals treating individuals upon release from detention. Due to the lack of transparency by federal entities and limited access to detainees, this survey serves as a source of credible information about conditions experienced within immigration detention facilities and is a means of corroborating immigrant testimonials and media reports. These findings can help inform policy discussions regarding systematic changes to the delivery of healthcare in detention, quality assurance and transparent reporting

Epidemiology of patients presenting to a pediatric emergency department in Karachi, Pakistan

Background: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan.Methods: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants’ chief complaints and medical care were documented. Patients were followed-up at 48-h and 14-days via telephone. Results: Of 3115 participants, 1846 were triaged to the outpatient department and 1269 to the ED. Patients triaged to the ED had a median age of 2.0 years (IQR 0.5–4.0); 30% were neonates (\u3c 28 days). Top chief complaints were fever (45.5%), diarrhea/vomiting (32.3%), respiratory (23.1%), abdominal (7.5%), and otolaryngological problems (5.8%). Temperature, pulse and respiratory rate, and blood glucose were documented for 66, 42, and 1.5% of patients, respectively. Interventions included medications (92%), IV fluids (83%), oxygen (35%), and advanced airway management (5%). Forty-five percent of patients were admitted; 11 % left against medical advice. Outcome data was available at time of ED disposition, 48-h, and 14 days for 83, 62, and 54% of patients, respectively. Of participants followed-up, 4.3% died in the ED, 11.5% within 48 h, and 19.6% within 14 days.Conclusions: This first epidemiological study at Pakistan’s largest pediatric ED reveals dramatically high mortality, particularly among neonates. Future research in developing countries should focus on characterizing reasons for high mortality through pre-ED arrival tracking, ED care quality assessment, and post-ED follow-up

Correction to: Epidemiology of patients presenting to a pediatric emergency department in Karachi, Pakistan

An amendment to this paper has been published and can be accessed via the original article

Emergency Department Access During COVID-19: Disparities in Utilization by Race/Ethnicity, Insurance, and Income

Introduction: In March 2020, shelter-in-place orders were enacted to attenuate the spread of coronavirus 2019 (COVID-19). Emergency departments (EDs) experienced unexpected and dramatic decreases in patient volume, raising concerns about exacerbating health disparities.Methods: We queried our electronic health record to describe the overall change in visits to a two-ED healthcare system in Northern California from March–June 2020 compared to 2019. We compared weekly absolute numbers and proportional change in visits focusing on race/ethnicity, insurance, household income, and acuity. We calculated the z-score to identify whether there was a statistically significant difference in proportions between 2020 and 2019.Results: Overall ED volume declined 28% during the study period. The nadir of volume was 52% of 2019 levels and occurred five weeks after a shelter-in-place order was enacted. Patient demographics also shifted. By week 4 (April 5), the proportion of Hispanic patients decreased by 3.3 percentage points (pp) (P = 0.0053) compared to a 6.2 pp increase in White patients (P = 0.000005). The proportion of patients with commercial insurance increased by 11.6 pp, while Medicaid visits decreased by 9.5 pp (P < 0.00001) at the initiation of shelter-in-place orders. For patients from neighborhoods <300% federal poverty levels (FPL), visits were –3.8 pp (P = 0.000046) of baseline compared to +2.9 pp (P = 0.0044) for patients from ZIP codes at >400% FPL the week of the shelter-in-place order. Overall, 2020 evidenced a consistently elevated proportion of high-acuity Emergency Severity Index (ESI) level 1 patients compared to 2019. Increased acuity was also demonstrated by an increase in the admission rate, with a 10.8 pp increase from 2019. Although there was an increased proportion of high-acuity patients, the overall census was decreased.Conclusion: Our results demonstrate changing ED utilization patterns circa the shelter-in-place orders. Those from historically vulnerable populations such as Hispanics, those from lower socioeconomic areas, and Medicaid users presented at disproportionately lower rates and numbers than other groups. As the pandemic continues, hospitals should use operations data to monitor utilization patterns by demographic, in addition to clinical indicators. Messaging about availability of emergency care and other services should include vulnerable populations to avoid exacerbating healthcare disparities

Data from: Reducing early infant mortality in India: results of a prospective cohort of pregnant women utilizing emergency medical services

Objectives: To describe the demographic characteristics and clinical outcomes of neonates born within 7 days of public ambulance transport to hospitals across five states in India. Design: Prospective observational study. Setting: Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. Participants: Over 6 weeks in 2014, this study followed a convenience sample of 1,431 neonates born to women utilizing a public-private ambulance service for a ‘pregnancy related’ problem. Initial calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival, refusal of care, and neonates born to women beyond 7 days of using the service were excluded. Main outcome measures: Death at 2, 7 and 42 days after delivery. Results: Among 1,684 women, 1,411 gave birth to 1,431 newborns within 7 days of initial ambulance transport. Median maternal age at delivery was 23 years (IQR: 21-25). Most mothers were from rural/tribal areas (92.5%) and lower social (79.9%) and economic status (69.9%). Follow-up rates at 2, 7 and 42 days were 99.8%, 99.3% and 94.1%, respectively. Cumulative mortality rates at 2, 7 and 42-days follow-up were 41, 53 and 62 per 1000 births, respectively. The perinatal mortality rate (PMR) was 53 per 1000. Preterm birth [OR: 2.89, 95% CI: 1.67-5.00], twin deliveries (OR: 2.80, 95% CI: 1.10-7.15), and cesarean section (2.21, 95% CI: 1.15-4.23) were the strongest predictors of mortality. Conclusions: The perinatal mortality rate associated with this cohort of patients with high-acuity conditions of pregnancy was nearly two times the most recent rate for India as a whole (28 per 1000 births). EMS data has the potential to provide more robust estimates of PMR, reduce inequities in timely access to healthcare, and increase facility-based care through service of marginalized populations

Neonatal cohort India

Cohort of neonates born to mothers utilizing prehospital ambulance services within 7 days of birt

Additional file 2: of Epidemiology of patients presenting to a pediatric emergency department in Karachi, Pakistan

Table S2. Logistic regression model for predictors of mortality for all patients (N = 679, c-statistic = 0.82): 85% of followed patients were included in this model, of which 17% of patients died. Model was controlled for gender. (DOCX 15 kb