Trauma demography and clinical epidemiology of motorcycle crash–related head injury in a neurosurgery practice in an African developing country

Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.

MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).

Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.     

Job stress among resident physicians in Tanta University Hospitals,Egypt

Environmental Science and Pollution Research - Resident physicians are the first-line health service providers, subjected to prolonged working hours, sleep deprivation and high job demands. Work...     

Comparison between UVA- and zero-valent iron-activated persulfate processes for degrading propylparaben

Conventional wastewater treatments are not efficient in removing parabens, which may thus end up in surface waters, posing a threat to aquatic biota and hu     

Use of Predictive Weather Uncertainties in an Irrigation Scheduling Tool Part II: An Application of Metrics and Adjoints

We apply predictive weather metrics and land model sensitivities to improve the Colorado State University Water Irrigation Scheduler for Efficient Application (WISE). WISE is an irrigation decision aid that integrates environmental and user information for optimizing water use. Rainfall forecasts and verification performance metrics are used to estimate predictive rainfall probabilities that are used as input data within the irrigation decision aid. These input data errors are also used within a land model sensitivity study to diagnose important prognostic water movement behaviors for irrigation tool development purposes simultaneously performing the analysis in space and time. Thus, important questions such as “how long can a crop water application be delayed while maintaining crop yield production?” are addressed by evaluating crop growth stage interactions as a function of soil depth (i.e., space), rainfall events (i.e., time), and their probabilistic uncertainties. Editor’s note : This paper is part of the featured series on Optimizing Ogallala Aquifer Water Use to Sustain Food Systems. See the February 2019 issue for the introduction and background to the series.     

Computing sustainable manufacturing index with fuzzy analytic hierarchy process

The growing industrial interest in adopting sustainability programmes has ushered in studies regarding sustainability indicators which have continually flourished in current literature. However, limited attention is given to the development of priority ranking, which is an important input for any adopting firm. This paper presents a hybrid multi-criteria approach in determining priority areas in sustainable manufacturing (SM). Using fuzzy analytic hierarchy process to address uncertainty in hierarchical decision-making, this paper determines SM priority strategies and eventually identifies even lower level strategies. The computed sustainable manufacturing index is presented at both the organizational and operational levels for a real case study of an industrial plastic manufacturing firm. This work provides a detailed and transparent hierarchical decision-making approach based on SM framework, the use of which could be valuable to practicing managers across industries in their pursuit of greater sustainability.     

Coupling of the Water Cycle with Patterns of Urban Growth in the Baltimore Metropolitan Region,United States

Regional municipal water plans typically do not recognize complex coupling patterns or that increased withdrawals in one location can result in changes in water availability in others. We investigated the interaction between urban growth and water availability in the Baltimore metropolitan region where urban growth has occurred beyond the reaches of municipal water systems into areas that rely on wells in low‐productivity Piedmont aquifers. We used the urban growth model SLEUTH and the hydrologic model ParFlow.CLM to evaluate this interaction with urban growth scenarios in 2007 and 2030. We found decreasing groundwater availability outside of the municipal water service area. Within the municipal service area we found zones of increasing storage resulting from increased urban growth, where reduced vegetation cover dominated the effect of urbanization on the hydrologic cycle. We also found areas of decreasing storage, where expanding impervious surfaces played a larger role. Although the magnitude of urban growth and change in water availability for the simulation period were generally small, there was considerable spatial heterogeneity of changes in subsurface storage. This suggests that there are locally concentrated areas of groundwater sensitivity to urban growth where water shortages could occur or where drying up of headwater streams would be more likely. The simulation approach presented here could be used to identify early warning indicators of future risk.     

Hydroponic root mats for wastewater treatment—a review

Hydroponic root mats (HRMs) are ecotechnological wastewater treatment systems where aquatic vegetation forms buoyant filters by their dense interwoven roots and rhizomes, sometimes supported by rafts or other floating materials. A preferential hydraulic flow is created in the water zone between the plant root mat and the bottom of the treatment system. When the mat touches the bottom of the water body, such systems can also function as HRM filter; i.e. the hydraulic flow passes directly through the root zone. HRMs have been used for the treatment of various types of polluted water, including domestic wastewater; agricultural effluents; and polluted river, lake, stormwater and groundwater and even acid mine drainage. This article provides an overview on the concept of applying floating HRM and non-floating HRM filters for wastewater treatment. Exemplary performance data are presented, and the advantages and disadvantages of this technology are discussed in comparison to those of ponds, free-floating plant and soil-based constructed wetlands. Finally, suggestions are provided on the preferred scope of application of HRMs.     

Fluctuating asymmetry of rodent cranial structures in an industrial pollution gradient

Fluctuating asymmetry (FA) of the mandible shape has been analyzed in bank voles from the zones affected by pollution from three copper smelters in the Urals. It has been shown that there is the necessity for a detailed analysis of the material, since the level of FA may depend on population parameters. Regardless of the pollution level, FA of the mandible region including the lower part of the mandibular body, ramus and processes is higher than in the diastema region. A gradient effect of toxic exposure on FA has been revealed: an increase in its level under increasing technogenic impact is clearly manifested along local pollution gradients.