Prevention of Drowning by Community-Based Intervention: Implications for Low- and Middle- Income Countries

Background: Drowning is a serious but neglected health problem in low-and middle-income countries. Objectives: To describe the effectiveness of drowning prevention program on the reduction of drowning mortality rates in rural settings at the north of Iran, and guide its replication elsewhere. Patients and Methods: This interventional design included pre- and post-intervention observations in the rural area of the Caspian Sea coastline without a comparison community. Cross-sectional data were collected at pre- and post-intervention phases. Outcome evaluation was based on a four-year period (March 2005-March 2009) utilizing drowning registry data for the north of Iran. Results: The implementation program increased the rate of membership in an organization responsible for promoting safety in high risk areas near the Caspian Sea. Compared to a WHO standardized population, drowning incidence in rural areas of the study demonstrated a continuous decrease in age-specific drowning rate among the oldest victims with a gradual decline during the implementation. In the study area, the epidemiological aspects of the study population were exposed and contributing factors were highlighted. Conclusions: This study showed that the promotion of passive interventions had a greater effect on drowning rate than that of active interventions

Surface wave non-reciprocity via time-modulated metamaterials

We investigate how Rayleigh waves interact with time-modulated resonators located on the free surface of a semi-infinite elastic medium. We begin by studying the dynamics of a single resonator with time-modulated stiffness, we evaluate the accuracy of an analytical approximation of the resonator response and identify the parameter ranges in which its behavior remains stable. Then, we develop an analytical model to describe the interaction between surface waves and an array of resonators with spatio-temporally modulated stiffness. By combining our analytical models with full-scale numerical simulations, we demonstrate that spatio-temporal stiffness modulation of this elastic metasurface leads to the emergence of non-reciprocal features in the Rayleigh wave spectrum. Specifically, we show how the frequency content of a propagating signal can be filtered and converted when traveling through the modulated medium, and illustrate how surface-to-bulk wave conversion plays a role in these phenomena. Throughout this article, we indicate bounds of modulation parameters for which our theory is reliable, thus providing guidelines for future experimental studies on the topic

A Time Series Model for Assessing the Trend and Forecasting the Road Traffic Accident Mortality

Background: Road traffic accident (RTA) is one of the main causes of trauma and known as a growing public health concern worldwide, especially in developing countries. Assessing the trend of fatalities in the past years and forecasting it enables us to make the appropriate planning for prevention and control. Objectives: This study aimed to assess the trend of RTAs and forecast it in the next years by using time series modeling. Materials and Methods: In this historical analytical study, the RTA mortalities in Zanjan Province, Iran, were evaluated during 2007 - 2013. The time series analyses including Box-Jenkins models were used to assess the trend of accident fatalities in previous years and forecast it for the next 4 years. Results: The mean age of the victims was 37.22 years (SD = 20.01). From a total of 2571 deaths, 77.5% (n = 1992) were males and 22.5% (n = 579) were females. The study models showed a descending trend of fatalities in the study years. The SARIMA (1, 1, 3) (0, 1, 0) 12 model was recognized as a best fit model in forecasting the trend of fatalities. Forecasting model also showed a descending trend of traffic accident mortalities in the next 4 years. Conclusions: There was a decreasing trend in the study and the future years. It seems that implementation of some interventions in the recent decade has had a positive effect on the decline of RTA fatalities. Nevertheless, there is still a need to pay more attention in order to prevent the occurrence and the mortalities related to traffic accidents

Does B-type natriuretic peptide level predict outcome after arterial switch operation ?

Evaluation the predictive value of perioperative Plasma B-type natriuretic peptide level in arterial switch operation. Plasma B-type natriuretic peptide level was measured before and and 24 hours after surgery in 29 patients with arterial switch operation. We evaluated 29 patients (22 male,76,7 female 24) with mean age 67.93±84.09 days (range 6 days to 14months).The mean of BNP level before surgery was 7989.96±9691.94 and increased after surgery to 22391.35±11898.67 and difference between two groups was significant (P=0.003).In linear regression test the BNP did not correlate with sex(r=0.33, P=0.085) and age(r=0.14,P=0.45). Furthermore, BNP did not correlate with duration of mechanical ventilation (r=0.132,P=0.53), ICU stay (r=0.137,P=0.52) and with lactate level (r=0.41,P=0.054)after operation. During the study 4 patients(13.8) died and the mean of BNP 24h after operation among them was 35000.00±00.00.using chai-square and fisher exact test the correlation between BNP and death was significant(P=0.001). We implied that BNP level increased 24 hours after arterial switch operation, moreover we denoted it correlated well with the death rate and an increase in B-type natriuretic peptide 24 hours after surgery predicts poor postoperative outcome. However it did not correlate with duration of mechanical ventilation, ICU stay and lactate level in this patients

Live Demonstration: Multiplexing AER Asynchronous Channels over LVDS Links with Flow-Control and Clock- Correction for Scalable Neuromorphic Systems

In this live demonstration we exploit the use of a serial link for fast asynchronous communication in massively parallel processing platforms connected to a DVS for realtime implementation of bio-inspired vision processing on spiking neural networks

Plasma Brain Natriuretic Peptide (BNP) as an Indicator of Left Ventricular Function, Early Outcome and Mechanical Complications after Acute Myocardial Infarction

Aims This study investigated the prognostic value of B type natriuretic peptide (BNP) in acute myocardial infarction (AMI) patients and its relation with left ventricular function and post-myocardial infarction complications. Methods In this cross-sectional study, plasma BNP level was measured for 42 consecutive patients (mean ± SD: 61.6 ± 10.85 years old) with acute ST elevation myocardial infarction (MI) and 42 healthy, age and gender matched subjects. Result BNP level in AMI patients were significantly higher than control group (@ P < 0.001). Regarding to infarct location, the highest BNP level measured in inferoposterior MI (BNP = 4436.63 ± 6188.159 pg/ml) and the lowest one indicated in standalone inferior MI (BNP = 598.83 ± 309.867 pg/ml ( P = 0.071). There was significant reverse relation between BNP and EF ( P = 0.006, OR = −0.47) and a significant relationship between BNP and killip classification ( P = 0.036). There was no significant relation between diastolic and right-ventricular function and BNP level ( P = 0.61, P = 0.21). The highest BNP level was detected in LV septal rupture and false aneurysm ( P = 0.02) and in ventricular tachycardia, but without significant relationship ( P = 0.25). Conclusion After the onset of AMI, BNP blood level can be used as an important predictor for left ventricular dysfunction, killip classification, early mechanical complications and cardiac death

Asynchronous spiking neurons, the natural key to exploit temporal sparsity

Inference of Deep Neural Networks for stream signal (Video/Audio) processing in edge devices is still challenging. Unlike the most state of the art inference engines which are efficient for static signals, our brain is optimized for real-time dynamic signal processing. We believe one important feature of the brain (asynchronous state-full processing) is the key to its excellence in this domain. In this work, we show how asynchronous processing with state-full neurons allows exploitation of the existing sparsity in natural signals. This paper explains three different types of sparsity and proposes an inference algorithm which exploits all types of sparsities in the execution of already trained networks. Our experiments in three different applications (Handwritten digit recognition, Autonomous Steering and Hand-Gesture recognition) show that this model of inference reduces the number of required operations for sparse input data by a factor of one to two orders of magnitudes. Additionally, due to fully asynchronous processing this type of inference can be run on fully distributed and scalable neuromorphic hardware platforms

A Cost-Minimization Analysis of Day-Care Versus in-Patient Surgery for Five Most Common General Surgical Procedures

Objective: This study aimed to compare costs of Day-care versus in-patient surgery for five most common general surgical proce-dures in a general hospital in Iran. Methods: In this retrospective study the records of all patients who underwent five most common general surgical operations (in-cluding Hernia, Hemorrhoid, Fistula, Pilonidal Sinus and Varicocele) between March 2011 and March 2013 were reviewed. The data about costs of these procedures was collected by a checklist, designed by the authors, one year before and one year after establishing the Day-Care ward in the hospital. The checklist was designed on the basis of 14 financial items related to surgical patients. All costs were measured from the provider's perspective. Results: The results of this study showed that after implementing day-care surgery ward, inpatient care costs, such as medi-cine/drugs, physician visits, medical consumable, personnel and hotel, reduced significantly per each procedure. However, the costs directly associated with each surgery, such as drugs and consumable, surgeon's wage and anesthesia costs, between these two periods was not significantly different. The highest amount of savings was related to the personnel costs, with 997,000 IRR reductions. On average, total cost of each procedure was reduced by 2,031,358 IRR after implementation of day-care ward. Conclusion: The findings from this study demonstrate that day-care surgery is a cost saving method compared to in-patient surgery for five most common general surgical procedures. It is recommended that hospital managers consider establishing day-care ward and conducting surgical procedures, in particular elective general surgical procedures, in this regimen, to decrease hospital costs and to make hospital beds free, for other patients who are more in need of specialized medical and nursing skills

Structure of the Helicase Domain of DNA Polymerase Theta Reveals a Possible Role in the Microhomology-Mediated End-Joining Pathway

DNA polymerase theta (Polθ) has been identified as a crucial alternative non-homologous end-joining factor in mammalian cells. Polθ is upregulated in a range of cancer cell types defective in homologous recombination, and knockdown has been shown to inhibit cell survival in a subset of these, making it an attractive target for cancer treatment. We present crystal structures of the helicase domain of human Polθ in the presence and absence of bound nucleotides, and a characterization of its DNA-binding and DNA-stimulated ATPase activities. Comparisons with related helicases from the Hel308 family identify several unique features. Polθ exists as a tetramer both in the crystals and in solution. We propose a model for DNA binding to the Polθ helicase domain in the context of the Polθ tetramer, which suggests a role for the helicase domain in strand annealing of DNA templates for subsequent processing by the polymerase domain