Sample records for explosion caused death

  1. Self-inflicted explosive death by intra-oral detonation of a firecracker: a case report.

    PubMed

    Makhoba, Musa Aubrey; du Toit-Prinsloo, Lorraine

    2017-12-01

    Self-inflicted explosive deaths due to detonation of fireworks are rare. In this case report, a peculiar case of an elderly male who discharged a firecracker inside his mouth, resulting in fatal blast induced craniofacial injuries, is described. There is paucity of published data describing fireworks-related suicidal and/or non-suicidal deaths. Even scantier data is present specifically describing fireworks-related blast induced neurotrauma and the mechanism(s) of injury involved in such cases. This case report emphasizes the severe damage that a commercially available explosive, the so-called "Gorilla Bomb", can cause, and raises questions about the relative ease of its acquisition.

  2. Causes of Death in Military Working Dogs During Operation Iraqi Freedom and Operation Enduring Freedom, 2001-2013.

    PubMed

    Miller, Laura; Pacheco, Gerardo J; C Janak, Jud; Grimm, Rose C; Dierschke, Nicole A; Baker, Janice; Orman, Jean A

    2018-03-14

    Military working dogs (MWDs) are a major asset in the theater of operations. Their unique abilities make them ideal for tasks such as tracking, patrol, and scent detection. MWDs deployed to a war zone are exposed to harsh environments and battlefield dangers that increase their risk of disease, injuries, and death. Although canines have been used extensively in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), no published studies have reported detailed causes of death among MWDs deployed to these conflicts. Potential cases were defined as U.S. military-owned MWDs that died while deployed in Iraq (OIF) or Afghanistan (OEF) from January 1, 2001 through December 31, 2013 and identified from both official sources and unofficial sources, that is, online searches. Cases included in this study were limited to MWDs with data on cause of death obtained by abstraction from official veterinary treatment records (VTRs) from the Department of Defense Military Working Dog Veterinary Service, Joint Base San Antonio-Lackland Air Force Base, San Antonio, Texas, and Special Operations Forces units. We identified 92 MWDs that died while deployed to OEF/OIF from 2001 through 2013 and had cause of death information from official VTRs. For both OEF and OIF, the most common training program was Multi-Purpose Canine (36.5% and 51.7%, respectively), followed by Improvised Explosive Detector Dog for OEF (34.9%) and Patrol Explosive Detector Dog for OIF (34.5%). Injuries were the primary cause of death for 77.2% of the MWDs for which we had cause of death data. The most frequent external injuries were gunshot wounds (GSW) (31.5%), explosion or blast (26.1%), and heat stress (9.8%). The proportion of deaths due to GSW was similar for OEF and OIF (30.2% vs. and 34.5%, respectively). However, a greater proportion of MWDs died from explosions during OEF than during OIF (30.2% vs. 17.2%, respectively). Diseases were the cause of death in 23.0% of the MWDs. The most common diseases were gastric dilation and volvulus (GDV, n = 3), pleuritis (n = 2), and sepsis (n = 3). Two deaths were associated with anesthesia-related medical procedures. A total of 8.7% of cases were missing cause of death, 8.7% were missing age, 32.6% of cases were missing data on necropsy, and 14.1% were missing data on final disposition of the body. Other variables of interest including number of deployments and duration of training had a very high proportion of missing values and thus could not be analyzed. Our study is the most comprehensive to date that reports causes of death of MWDs deployed to OIF and OEF. However, limitations in the available data lessen the potential of our results to inform improvements in training and point of injury medical care. Better documentation in VTRs and systematic data collection into an official MWD trauma registry could lead to improved training and facilitate further development and evaluation of guidelines to improve care of wounded MWDs in future conflicts.

  3. A short history of fires and explosions caused by anaesthetic agents.

    PubMed

    MacDonald, A G

    1994-06-01

    The first recorded fire resulting from the use of an anaesthetic agent occurred in 1850, when ether caught fire during a facial operation. Many subsequent fires and explosions have been reported, caused by ether, acetylene, ethylene and cyclopropane, and there has been one reported explosion involving halothane. Although some of the earlier incidents caused more consternation than injury, many of the later ones caused much death and destruction, particularly after the practice of administering oxygen, instead of air, became established. Many incidents have never been reported and many of those which have reached publication do not record essential details. The use of flammable agents has decreased significantly in recent years and although fires and explosions from nonanaesthetic causes, for example gastrointestinal gases, skin sterilizing agents and laser surgery, may continue to occur, those from gaseous and volatile anaesthetic agents may now be of historical interest only. This article reviews some of the more relevant and enlightening reports of the past 150 yr.

  4. The hazards of eruptions through lakes and seawater

    USGS Publications Warehouse

    Mastin, L.G.; Witter, J.B.

    2000-01-01

    Eruptions through crater lakes or shallow seawater, referred to here as subaqueous eruptions, present hazards from hydromagmatic explosions, such as base surges, lahars, and tsunamis, which may not exist at volcanoes on dry land. We have systematically compiled information from eruptions through surface water in order to understand the circumstances under which these hazards occur and what disastrous effects they have caused in the past. Subaqueous eruptions represent only 8% of all recorded eruptions but have produced about 20% of all fatalities associated with volcanic activity in historical time. Excluding eruptions that have resulted in about a hundred deaths or less, lahars have killed people in the largest number of historical subaqueous eruptions (8), followed by pyroclastic flows (excluding base surges; 5) tsunamis (4), and base surges (2). Subaqueous eruptions have produced lahars primarily on high (>1000 m), steep-sided volcanoes containing small (<1 km diameter) crater lakes. Tsunamis and other water waves have caused death or destroyed man-made structures only at submarine volcanoes and at Lake Taal in the Philippines. In spite of evidence that magma-water mixing makes eruptions more explosive, such explosions and their associated base surges have caused fewer deaths, and have been implicated in fewer eruptions involving large numbers of fatalities than lahars and tsunamis. The latter hazards are more deadly because they travel much farther from a volcano and inundate coastal areas and stream valleys that tend to be densely settled.

  5. Collection of trace evidence of explosive residues from the skin in a death due to a disguised letter bomb. The synergy between confocal laser scanning microscope and inductively coupled plasma atomic emission spectrometer analyses.

    PubMed

    Turillazzi, Emanuela; Monaci, Fabrizio; Neri, Margherita; Pomara, Cristoforo; Riezzo, Irene; Baroni, Davide; Fineschi, Vittorio

    2010-04-15

    In most deaths caused by explosive, the victim's body becomes a depot for fragments of explosive materials, so contributing to the collection of trace evidence which may provide clues about the specific type of device used with explosion. Improvised explosive devices are used which contain "homemade" explosives rather than high explosives because of the relative ease with which such components can be procured. Many methods such as chromatography-mass spectrometry, scanning electron microscopy, stereomicroscopy, capillary electrophoresis are available for use in the identification of explosive residues on objects and bomb fragments. Identification and reconstruction of the distribution of explosive residues on the decedent's body may give additional hints in assessing the position of the victim in relation to the device. Traditionally these residues are retrieved by swabbing the body and clothing during the early phase, at autopsy. Gas chromatography-mass spectrometry and other analytical methods may be used to analyze the material swabbed from the victim body. The histological examination of explosive residues on skin samples collected during the autopsy may reveal significant details. The information about type, quantity and particularly about anatomical distribution of explosive residues obtained utilizing confocal laser scanning microscope (CLSM) together with inductively coupled plasma atomic emission spectrometer (ICP-AES), may provide very significant evidence in the clarification and reconstruction of the explosive-related events. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  6. Patterns of accidental deaths in Kuwait: a retrospective descriptive study from 2003-2009.

    PubMed

    Al-Kandary, Nadia; Al-Waheeb, Salah

    2015-03-28

    Accidents are a preventable cause of death. Unfortunately it accounts for a large number of deaths in many societies. In Kuwait, road traffic accidents (RTA) is the leading cause of death in young people. The study investigated the patterns of accidental deaths in Kuwait, one of the Gulf States which incorporates a wide variety of multi-ethnic communities. The study was retrospective from 2003-2009. Data of forensic cases were collected from the general department of criminal evidence (GDCE) in the ministry of interior (MOI).We attempted to find out causes of accidental death and the prevelance of each cause. Furthermore, the relationship of demographic factors (eg. Age, sex, marital status and nationality) with each cause of accidental death in Kuwait were studied. The material of this study constituted a total of 4886 reported accidental deaths referred for Medico-legal examination. Road traffic accidents was by far the most prevalent cause of death (64.6%) followed by fall from height (13.1%). Poisoning and mine explosions were amongst the least common causes. The government of Kuwait needs to take strong measures to promote safety in the workplace and households by educational campaigns.

  7. 75 FR 31760 - Sunshine Act Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ..., Connecticut, experienced a catastrophic natural gas explosion that caused six deaths and at least 50 injuries... to the building was on, welders were actively working, and diesel-fueled heaters were running...

  8. Explosive death of conjugate coupled Van der Pol oscillators on networks

    NASA Astrophysics Data System (ADS)

    Zhao, Nannan; Sun, Zhongkui; Yang, Xiaoli; Xu, Wei

    2018-06-01

    Explosive death phenomenon has been gradually gaining attention of researchers due to the research boom of explosive synchronization, and it has been observed recently for the identical or nonidentical coupled systems in all-to-all network. In this work, we investigate the emergence of explosive death in networked Van der Pol (VdP) oscillators with conjugate variables coupling. It is demonstrated that the network structures play a crucial role in identifying the types of explosive death behaviors. We also observe that the damping coefficient of the VdP system not only can determine whether the explosive death state is generated but also can adjust the forward transition point. We further show that the backward transition point is independent of the network topologies and the damping coefficient, which is well confirmed by theoretical analysis. Our results reveal the generality of explosive death phenomenon in different network topologies and are propitious to promote a better comprehension for the oscillation quenching behaviors.

  9. 75 FR 49412 - Safety Zones; Fireworks Within the Captain of the Port Sector Boston Zone

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... and the explosive danger of fireworks and debris falling into the water that may cause death or... issue a rule without prior notice and opportunity to comment when the agency for good cause finds that.... 553(b)(B), the Coast Guard finds that good cause exists for not publishing a notice of proposed...

  10. 76 FR 31230 - Safety Zone; M.I.T.'s 150th Birthday Celebration Fireworks, Charles River, Boston, MA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... and the explosive danger of fireworks and debris falling into the water that may cause death or... prior notice and opportunity to comment when the agency for good cause finds that those procedures are... finds that good cause exists for not publishing a notice of proposed rulemaking (NPRM) with respect to...

  11. Deaths due to Intentional Explosions in Selected Governorates of Iraq from 2010 to 2013: Prospective Surveillance.

    PubMed

    Bilukha, Oleg O; Leidman, Eva Z; Sultan, Abdul-Salam Saleh; Jaffar Hussain, Syed

    2015-12-01

    The aim of this study was to describe the most recent trends and epidemiologic patterns of fatal injuries resulting from explosions in Iraq, one of the countries most affected by violence from explosive devices. Iraqi Ministry of Health (MoH) routine prospective injury surveillance collects information on all fatal injuries recorded by coroners from physical examinations, police reports, and family members in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. This study analyzed explosive-related fatal injuries that occurred from January 1, 2010 through December 31, 2013. Analysis included 2,803 fatal injuries. The number of fatal injuries declined from 2010 through 2012, followed by an increase in 2013. One-thousand one-hundred and one explosion-related fatalities were documented in 2013, more than twice as many as in 2012 or in 2011. Most fatalities were among men aged 20-39 years. Of all causalities, 194 (6.9%) were among females and 302 (10.8%) were among children aged less than 18 years. The majority of fatalities were caused by improvised explosive devices (IEDs): car bombs (15.3%), suicide bombs (4.0%), and other IEDs (29.6%). The highest number of fatalities occurred in streets and roads. Of all deaths, 95.6% occurred in three governorates: Baghdad, Ninevah, and Al-Anbar. Explosives continue to result in a high number of fatal injuries in Iraq. Following a period of declining violence from explosives, in 2013, fatalities increased. Most explosion-related injuries resulted from IEDs; males aged 20-39 years were at greatest risk.

  12. Petroleum pipeline explosions in sub-Saharan Africa: a comprehensive systematic review of the academic and lay literature.

    PubMed

    Carlson, Lucas C; Rogers, Tom T; Kamara, Thaim B; Rybarczyk, Megan M; Leow, Jeffrey J; Kirsch, Thomas D; Kushner, Adam L

    2015-05-01

    Experience indicates that the frequency and impact of petroleum pipeline fires and explosions in sub-Saharan Africa (SSA) is presently under-represented in the academic literature. Using adapted PRISMA guidelines, the authors reviewed both PubMed and the LexisNexis Academic news database, which includes periodicals, news transcripts and online reports. Country-by-country searches were conducted for petroleum pipeline fires and explosions in SSA occurring between June 1, 2004 and May 31, 2014. Initial search yielded 5730 articles from LexisNexis Academic and 3 from PubMed. On further review, a total of 28 separate petroleum pipeline-related incidents causing injuries and/or deaths were identified, 16 of which had not been previously reported in the academic literature. The events occurred in Nigeria (23), Kenya (2), Ghana (1), Sierra Leone (1), and Tanzania (1). A total of 1756 deaths were reported across all events. The most common cause of the original leak was intentional, either from theft or vandalism (13/20, 65%), or by militia activity (2/20, 10%). Fire disasters related to scavenging fuel from petroleum pipelines are common in SSA and cause significant morbidity and mortality. These events require better reporting tools and intervention strategies overall. Furthermore, our study demonstrates that non-academic sources can effectively supplement gaps in the academic literature. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  13. Potential dangers of accelerant use in arson.

    PubMed

    Heath, Karen; Kobus, Hilton; Byard, Roger W

    2011-02-01

    Accelerant-enhanced combustion often characterizes a fire that has been deliberately set to disguise a murder scene or to destroy property for insurance purposes. The intensity and rapidity of spread of fires where accelerants have been used are often underestimated by perpetrators who may sustain heat-related injuries. The case of a 49-year-old male who was using gasoline (petrol) as an accelerant is reported to demonstrate another danger of this type of activity. After ignition, an explosion occurred that destroyed the building and caused the death of the victim who was crushed beneath a rear wall of the commercial premises. Gasoline vapour/air mixtures are extremely volatile and may cause significant explosions if exposed to flame. Given the potential danger of explosion, arsonists using accelerants do so at significant risk to themselves and to others in the vicinity. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. A brief historical review of non-anaesthetic causes of fires and explosions in the operating room.

    PubMed

    Macdonald, A G

    1994-12-01

    Fires and explosions have occurred in the operating theatre for many years. Flammable inhalation anaesthetic agents were responsible for many incidents in the past, but these are no longer available in many countries. Other causes of fires and explosions still exist in the operating theatre and, from time to time, result in serious and occasionally fatal injury. Flammable gastrointestinal gases have been the cause of injury to patients during gastric surgery, laparoscopy and during examination of the large bowel with electrical instrumentation. Gases formed in the bladder during urological procedures have ignited, causing rupture. Alcohol-based skin cleaning agents have resulted in severe burns to the skin. Equipment used for storage and delivery of oxygen to patients has caused fires in a variety of ways. Adhesive skin drapes have resulted recently in two tragic deaths. The increasing use of laser therapy, particularly in ear, nose and throat surgery, and in oral surgery, has brought about a renewed awareness of the risk of fire. The relevant factors which should be borne in mind and the precautions which should be adopted when laser therapy is to be used in the airway are discussed.

  15. Postdischarge Cause-of-Death Analysis of Combat-Related Burn Patients

    PubMed Central

    Escolas, Sandra M.; Orman, Jean A.; Chung, Kevin K.; Renz, Evan M.

    2017-01-01

    Combat operations in Iraq and Afghanistan have resulted in up to 8.8% of combat-related casualties suffering burns. From World War I through Desert Storm, burns have been associated with approximately 4% of the combat-related deaths. Experiencing a blast injury and exposure to killing and death while deployed has been shown to increase suicide risk. Although several studies of military populations have investigated risk factors for death among burn patients during the acute phase, no studies have reported mortality rates, cause-of-death, or the prevalence of suicide after hospital discharge. This study examined the case fatality rate, causes of death, and the prevalence of suicide among 830 combat burn patients discharged from the sole burn center in the U.S. Department of Defense, between March 7, 2003 and March 6, 2013. Cause-of-death was determined through the Armed Forces Medical Examiner’s Office and the Office of the Secretary of Defense’s National Death Index. A total of 11 deaths occurred among the 830 burn survivors, for an overall case fatality rate of 1.3%. Of the 11 who died, five deaths were related to accidental poisoning by exposure to drugs; three were related to operations of war (two after returning to the war zone), and the remaining three died from other accidental causes (one explosion and two vehicle crashes). There was no indication of suicide or suspicion of suicide as a cause-of-death for the former patients included in this study, suggesting that combat burn injury did not appear to increase the risk of death by suicide in our study population. Further research is needed to understand the factors that contribute to the apparent resilience of combat burn survivors. PMID:26629656

  16. Reducing the Impact of Attacks against Healthcare by Curbing the Use of Explosive Weapons in Populated Areas: Developments at the Global Level.

    PubMed

    Bagshaw, Simon

    Attacks against healthcare in situations of armed conflict have emerged as an issue of increasing concern with explosive weapons - such as aircraft bombs, mortars and improvised explosive devices - accounting for more deaths, injuries and damage than any other type of weapon in attacks on healthcare facilities. While this is perhaps unsurprising, it offers some insight into a possible course of action for dealing with the problem of attacks against healthcare - by curbing the use of explosive weapons in populated areas. There has been growing recognition in recent years of the humanitarian problems caused by the use of such weapons in populated areas. Steps are now being taken at the global level to curb this use which could, in time, make an important contribution to reducing the incidence and devastating impact of attacks against healthcare.

  17. 75 FR 57597 - Revised Proposal for Revisions to the Schedules of Civil Penalties for a Violation of a Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... just substantially increase the likelihood that one of these events could occur. Conversely, in this..., explosions, acts of God, and other events involving the operation of on-track equipment (standing or moving... following events, but does not create an imminent hazard of death or injury to individuals or cause an...

  18. Human and fishing vessel losses in sea accidents in the UK fishing industry from 1948 to 2008.

    PubMed

    Roberts, Stephen E; Jaremin, Bogdan; Marlow, Peter B

    2010-01-01

    To investigate long-term trends in mortality rates for accidents to fishing vessels in the UK fishing industry from 1948 to 2008; to investigate the circumstances and causes of these fishing vessel accidents and trends in fishing vessel losses. Examination of paper death inquiry files, death registers, marine accident investigative files, annual casualty and death returns. Of 1039 fatalities from accidents to UK fishing vessels from 1948 to 2008, most (65%) resulted from vessels that foundered (or capsized or disappeared), followed by vessels grounding (21%), collisions (7%), and fires and explosions (5%). There was a significant increase over time of 1.04% per year in the overall fishing vessel loss rate and for vessels that foundered (5.19%), a reduction for vessels grounding (1.13%), but no trends for collisions or fires and explosions. Regarding mortality, there was a significant reduction over time for grounding (1.44%) and a non-significant reduction for vessel accidents overall, but no trends for other types of vessel accident. Mortality was highest during the winter months (for foundering and grounding), during night time (for grounding, fires and explosions), and afternoons (foundering and collisions). Since 1976, most fatalities from collisions (83%) occurred in the English Channel and North Sea, while 49% from grounding occurred off the west coast of Scotland. The mortality rate from fishing vessel casualties in UK fishing is still very high. Fatalities in recent years have often been linked to fishing vessels that are unstable, overloaded, and unseaworthy.

  19. Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004.

    PubMed

    Holcomb, John B; McMullin, Neil R; Pearse, Lisa; Caruso, Jim; Wade, Charles E; Oetjen-Gerdes, Lynne; Champion, Howard R; Lawnick, Mimi; Farr, Warner; Rodriguez, Sam; Butler, Frank K

    2007-06-01

    Effective combat trauma management strategies depend upon an understanding of the epidemiology of death on the battlefield. A panel of military medical experts reviewed photographs and autopsy and treatment records for all Special Operations Forces (SOF) who died between October 2001 and November 2004 (n = 82). Fatal wounds were classified as nonsurvivable or potentially survivable. Training and equipment available at the time of injury were taken into consideration. A structured analysis was conducted to identify equipment, training, or research requirements for improved future outcomes. Five (6%) of 82 casualties had died in an aircraft crash, and their bodies were lost at sea; autopsies had been performed on all other 77 soldiers. Nineteen deaths, including the deaths at sea were noncombat; all others were combat related. Deaths were caused by explosions (43%), gunshot wounds (28%), aircraft accidents (23%), and blunt trauma (6%). Seventy of 82 deaths (85%) were classified as nonsurvivable; 12 deaths (15%) were classified as potentially survivable. Of those with potentially survivable injuries, 16 causes of death were identified: 8 (50%) truncal hemorrhage, 3 (19%) compressible hemorrhage, 2 (13%) hemorrhage amenable to tourniquet, and 1 (6%) each from tension pneumothorax, airway obstruction, and sepsis. The population with nonsurvivable injuries was more severely injured than the population with potentially survivable injuries. Structured analysis identified improved methods of truncal hemorrhage control as a principal research requirement. The majority of deaths on the modern battlefield are nonsurvivable. Improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival.

  20. Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism

    PubMed Central

    Holcomb, John B.; McMullin, Neil R.; Pearse, Lisa; Caruso, Jim; Wade, Charles E.; Oetjen-Gerdes, Lynne; Champion, Howard R.; Lawnick, Mimi; Farr, Warner; Rodriguez, Sam; Butler, Frank K.

    2007-01-01

    Background: Effective combat trauma management strategies depend upon an understanding of the epidemiology of death on the battlefield. Methods: A panel of military medical experts reviewed photographs and autopsy and treatment records for all Special Operations Forces (SOF) who died between October 2001 and November 2004 (n = 82). Fatal wounds were classified as nonsurvivable or potentially survivable. Training and equipment available at the time of injury were taken into consideration. A structured analysis was conducted to identify equipment, training, or research requirements for improved future outcomes. Results: Five (6%) of 82 casualties had died in an aircraft crash, and their bodies were lost at sea; autopsies had been performed on all other 77 soldiers. Nineteen deaths, including the deaths at sea were noncombat; all others were combat related. Deaths were caused by explosions (43%), gunshot wounds (28%), aircraft accidents (23%), and blunt trauma (6%). Seventy of 82 deaths (85%) were classified as nonsurvivable; 12 deaths (15%) were classified as potentially survivable. Of those with potentially survivable injuries, 16 causes of death were identified: 8 (50%) truncal hemorrhage, 3 (19%) compressible hemorrhage, 2 (13%) hemorrhage amenable to tourniquet, and 1 (6%) each from tension pneumothorax, airway obstruction, and sepsis. The population with nonsurvivable injuries was more severely injured than the population with potentially survivable injuries. Structured analysis identified improved methods of truncal hemorrhage control as a principal research requirement. Conclusions: The majority of deaths on the modern battlefield are nonsurvivable. Improved methods of intravenous or intracavitary, noncompressible hemostasis combined with rapid evacuation to surgery may increase survival. PMID:17522526

  1. Earthquakes, November-December 1992

    USGS Publications Warehouse

    Person, W.J.

    1993-01-01

    There were two major earthquakes (7.0≤M<8.0) during the last two months of the year, a magntidue 7.5 earthquake on December 12 in the Flores region, Indonesia, and a magnitude 7.0 earthquake on December 20 in the Banda Sea. Earthquakes caused fatalities in China and Indonesia. The greatest number of deaths (2,500) for the year occurred in Indonesia. In Switzerland, six people were killed by an accidental explosion recoreded by seismographs. In teh United States, a magnitude 5.3 earthquake caused slight damage at Big Bear in southern California. 

  2. Misuse and modification of fireworks with fatal injury.

    PubMed

    Fulcher, James; Luttrell, Harrison; Harvey, Whit; Ward, Michael

    2015-06-01

    Fireworks deaths are a rare event in the United States with minor injuries comprising most adverse events. We report the case of misuse and modification of a large "mortar" firework with fatal results. In this case, the firework charge was modified with additional fuses and placed into the launcher upside down. The decedent then held the mortar base closely to his chest and lit the modified fuse. The resulting explosion caused severe blunt force trauma with significant hydrostatic shock damage to the heart and liver. This cause highlights the dangers of fireworks, particularly when misused.

  3. Fatalities associated with home-made pipe bombs in Northern Ireland.

    PubMed

    Lucas, James; Crane, Jack

    2008-06-01

    Pipe bombs are crudely constructed improvized explosive devices which are easily made at home. They are increasingly used by terrorists and others, and may inflict serious injuries and cause death. Four fatalities have occurred in association with their use in Northern Ireland between 1998 and 2002. In 2 cases, death was due to penetrating shrapnel injuries to the chest causing laceration of the great vessels, and a third fatality occurred due to a bomb fragment penetrating the cranial cavity. A pipe bomb exploded close to the back of the head of a fourth victim and this was associated with a severe brain injury. The pathologist was able to determine the position of the victim in relation to the explosion by interpreting the pattern of injuries. It seems likely that 2 of the victims had been involved in the construction, transport, or use of the devices. A third victim was entirely innocent and had been in the process of removing a pipe bomb, which had been thrown through the window of her home, when it exploded. The fourth victim was a member of the security forces who had been struck by a bomb fragment, in the region of the right eye, during a period of sectarian unrest.

  4. Lethal Thermal Impact at Periphery of Pyroclastic Surges: Evidences at Pompeii

    PubMed Central

    Mastrolorenzo, Giuseppe; Petrone, Pierpaolo; Pappalardo, Lucia; Guarino, Fabio M.

    2010-01-01

    Background The evaluation of mortality of pyroclastic surges and flows (PDCs) produced by explosive eruptions is a major goal in risk assessment and mitigation, particularly in distal reaches of flows that are often heavily urbanized. Pompeii and the nearby archaeological sites preserve the most complete set of evidence of the 79 AD catastrophic eruption recording its effects on structures and people. Methodology/Principal Findings Here we investigate the causes of mortality in PDCs at Pompeii and surroundings on the bases of a multidisciplinary volcanological and bio-anthropological study. Field and laboratory study of the eruption products and victims merged with numerical simulations and experiments indicate that heat was the main cause of death of people, heretofore supposed to have died by ash suffocation. Our results show that exposure to at least 250°C hot surges at a distance of 10 kilometres from the vent was sufficient to cause instant death, even if people were sheltered within buildings. Despite the fact that impact force and exposure time to dusty gas declined toward PDCs periphery up to the survival conditions, lethal temperatures were maintained up to the PDCs extreme depositional limits. Conclusions/Significance This evidence indicates that the risk in flow marginal zones could be underestimated by simply assuming that very thin distal deposits, resulting from PDCs with poor total particle load, correspond to negligible effects. Therefore our findings are essential for hazard plans development and for actions aimed to risk mitigation at Vesuvius and other explosive volcanoes. PMID:20559555

  5. Lethal thermal impact at periphery of pyroclastic surges: evidences at Pompeii.

    PubMed

    Mastrolorenzo, Giuseppe; Petrone, Pierpaolo; Pappalardo, Lucia; Guarino, Fabio M

    2010-06-15

    The evaluation of mortality of pyroclastic surges and flows (PDCs) produced by explosive eruptions is a major goal in risk assessment and mitigation, particularly in distal reaches of flows that are often heavily urbanized. Pompeii and the nearby archaeological sites preserve the most complete set of evidence of the 79 AD catastrophic eruption recording its effects on structures and people. Here we investigate the causes of mortality in PDCs at Pompeii and surroundings on the bases of a multidisciplinary volcanological and bio-anthropological study. Field and laboratory study of the eruption products and victims merged with numerical simulations and experiments indicate that heat was the main cause of death of people, heretofore supposed to have died by ash suffocation. Our results show that exposure to at least 250 degrees C hot surges at a distance of 10 kilometres from the vent was sufficient to cause instant death, even if people were sheltered within buildings. Despite the fact that impact force and exposure time to dusty gas declined toward PDCs periphery up to the survival conditions, lethal temperatures were maintained up to the PDCs extreme depositional limits. This evidence indicates that the risk in flow marginal zones could be underestimated by simply assuming that very thin distal deposits, resulting from PDCs with poor total particle load, correspond to negligible effects. Therefore our findings are essential for hazard plans development and for actions aimed to risk mitigation at Vesuvius and other explosive volcanoes.

  6. Autopsy rate in suicide is low among elderly in Denmark compared with Finland.

    PubMed

    Ylijoki-Sørensen, Seija; Boldsen, Jesper Lier; Boel, Lene Warner Thorup; Bøggild, Henrik; Lalu, Kaisa; Sajantila, Antti

    2014-11-01

    National differences in the legislation on cause and manner of death investigation are reflected in a high autopsy rate in suicides in Finland and a low corresponding rate in Denmark. The consequences for mortality statistics of these different investigation practices on deaths classified as suicides in Denmark and Finland, respectively, are not known in detail. The aim of this article was to analyse autopsy rates in deaths classified as suicides, and to identify any differences in investigation practices in deaths with a comparable cause of death, but classified as unnatural deaths other than suicide. Data from the mortality registries were summarised for the years 2000, 2005 and 2010. Autopsy rates (total, forensic and medical) were analysed with regard to deaths classified as suicide, and they were compared for three age groups (1-50 years, 51-70 years and ≥71 years) and for causes of death. Deaths classified as suicide were compared with other unnatural classifications, and comparable causes of death were coded into six subgroups: poisonings, suffocations/strangulations, firearm discharges, drowning/submersions, explosions/flames and other/unspecified causes. The total autopsy rate for suicides was 99.8% in Finland and 13.2% in Denmark. Almost all of these autopsies were conducted as forensic autopsies. In the age group ≥71 years, Danish suicides outnumbered Finnish suicides (410 versus 283). The total autopsy rate was lower in the more senior age group in Denmark (19.5%, 9.9%, 5.6%), whereas it was consistently high in Finland (99.8%, 99.9%, 99.6%). Among Danish deaths due to poisonings, the autopsy rate was 89.5% when these were classified as accidents, but only 20.7% for cases classified as suicides. The number of deaths in the two Danish subgroups was comparable (550 versus 553). In Denmark, the decision regarding the need, if any, for a forensic autopsy is made during the external forensic examination of the body. Our study showed that the limited use of forensic autopsy to confirm the cause of death in deaths classified as suicides raises doubts about the accuracy of the Danish suicide mortality statistics. Our finding is emphasised by those cases in which the cause of death was registered as intentional self-poisoning. The high number of suicides among the elderly in Denmark is striking and begs further investigation and research. Overall, our data from Finland and Denmark reveal striking differences between the two countries and warrant further comparative studies on the subject in other countries. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Quality and Safety Matter

    NASA Astrophysics Data System (ADS)

    Manha, William D.

    2010-09-01

    One to the expressions for the most demanding quality was made by a well-known rocket scientist, for which this center was named, Dr. Wernher Von Braun in the Foreword of a book about the design of rocket engines that was first published by NASA in 1967: “Success in space demands perfection. Many of the brilliant achievements made in this vast, austere environment seem almost miraculous. Behind each apparent miracle, however, stands the flawless performance of numerous highly complex systems. All are important. The failure of only one portion of a launch vehicle or spacecraft may cause failure of an entire mission. But the first to feel this awesome imperative for perfection are the propulsion systems, especially the engines. Unless they operate flawlessly first, none of the other systems will get a chance to perform in space. Perfection begins in the design of space hardware. This book emphasizes quality and reliability in the design of propulsion and engine systems. It draws deeply from the vast know-how and experience which have been the essence of several well-designed, reliable systems of the past and present. And, with a thoroughness and completeness not previously available, it tells how the present high state of reliability, gained through years of research and testing, can be maintained, and perhaps improved, in engines of the future. As man ventures deeper into space to explore the planets, the search for perfection in the design of propulsion systems will continue.” Some catastrophes with losses of life will be compared to show lapses in quality and safety and contrasted with a catastrophe without loss of life because of compliance with safety requirements. 1. October 24, 1960,(USSR) Nedelin Catastrophe, Death on the Steppes, 124 deaths 2. October 25, 1966,(USA) North American Rockwell, Apollo Block I Service Module Service(SM) Propulsion System fuel tank explosion/fire and destruction of SM and test cell, test engineer/conductor/author, Bill Manha,(the presenter) 0 injuries, 0 deaths 3. March 18, 1980,(USSR) Vostok 8A92M booster pad explosion, 48 deaths. 4. August 22, 2003,(Brazil) -Alcantara VLS -1, V03. Solid rocket ignited on pad, 21 deaths 5. Summer of 2006(USA) a payload organization inquired about requirements to fly a satellite with a new “safe” SpaceDev hybrid propulsion system using a solid polymer as the fuel and nitrous oxide as the oxidizer. The extensive titanium/nitrous oxide materials compatibility testing that was required discouraged the payload organization from further exploration of using the Shuttle as the launch vehicle. 6. July 26, 2007(USA) SpaceShipTwo nitrous oxide explosion, 3 seriously injured, 3 deaths The above listed catastrophic failures resulted in 210 deaths, but there were none on the Apollo SM explosion because of compliance with CalOSHA. This is an applied lesson learned of the Shuttle. Safety was not jeopardized without extensive materials compatibility testing. On the other hand, the nitrous oxide was erroneously identified as safe for launch from Shuttle or ISS which resulted in a catastrophic explosion and resulted in 3 major injuries, and 3 deaths. This is a testimony of a survivor of a catastrophic failure where safety rules were followed and the application of the lesson learned which confirmed safety and quality, as expressed by Von Braun, PERFECTION and SAFETY do MATTER!

  8. A series of civilian fatalities during the war in Syria.

    PubMed

    Çelikel, Adnan; Karaarslan, Bekir; Demirkıran, Dua Sümeyra; Zeren, Cem; Arslan, Muhammet Mustafa

    2014-09-01

    A considerable number of deaths due to firearm injuries have occurred during wars all over the world. In this study, it is aimed to evaluate demographic characteristics and injury properties of cases died during civil war in Syria. The postmortem examination and autopsy reports of 321 forensic deaths occurred between January and December 2012 were analyzed, retrospectively. Of the 321 forensic deaths,186 cases were injured and died in the civil war in Syria and, therefore, included in the scope of the study. Four cases died by natural causes or traffic accidents were excluded. Cases were most commonly (n=73, 39.2%) aged between 21 and 30 years, and 21.5% (n=40) of cases aged under 20 years. Of females, 68.8% (n=11) were children and young adults under 20 years of age. An overwhelming majority of deaths (n=125, 67.2%) were caused by explosive and shrapnel injuries, followed by (n=49, 26.3%) gunshot injuries related deaths. This study indicated that a significant proportion of those who died after being injured in the Syrian war were children, women and elderly people. The nature and localization of the observed injuries indicated open attacks by military forces regardless of targets being civilians and human rights violations.

  9. The aftermath of an industrial disaster.

    PubMed

    Elklit, A

    1997-01-01

    An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).

  10. Deaths Due to Accidental Air Conditioner Compressor Explosion: A Case Series.

    PubMed

    Behera, Chittaranjan; Bodwal, Jatin; Sikary, Asit K; Chauhan, Mohit Singh; Bijarnia, Manjul

    2017-01-01

    In an air-conditioning system, the compressor is a large electric pump that pressurizes the refrigerant gas as part of the process of turning it back into a liquid. The explosion of an air conditioner (AC) compressor is an uncommon event, and immediate death resulted from the blast effect is not reported in forensic literature. We report three such cases in which young AC mechanics were killed on the spot due to compressor blast, while repairing the domestic split AC unit. The autopsy findings, the circumstances leading to the explosion of the compressor, are discussed in this study. © 2016 American Academy of Forensic Sciences.

  11. [Patterns of injury in a combat environment. 2007 update].

    PubMed

    Willy, C; Voelker, H-U; Steinmann, R; Engelhardt, M

    2008-01-01

    Epidemiological analysis of injury patterns and mechanisms help in identifying the expertise that military surgeons need in a combat setting and also in adjusting training requirements accordingly. This paper attempts to assess the surgical specialties and skills of particular importance in the management of casualties in crisis areas. MEDLINE (1949-2007) and Google search were used. Causes of death among casualties in Afghanistan and the Iraq war were analyzed. The leading causes of injury were explosive devices, gunshot wounds, aircraft crashes, and terrorist attacks. Of the casualties, 55% died in hostile action and 45% in nonhostile incidents. Chest or abdominal injuries (40%) and brain injuries (35%) were the main causes of death for soldiers killed in action. The case fatality rate in Iraq was approximately half as high as in the Vietnam War. In contrast, the amputation rate was twice as high. Approximately 8-15% of the deaths appeared to be preventable. Military surgeons must have excellent skills in the fields of thoracic, visceral, and vascular surgery as well as practical skills in neurosurgery and oral and maxillofacial surgery. It also is of vital importance to ensure the availability of sufficient medical evacuation capabilities. Furthermore, there is a need for a standardized registration system for all injuries similar to the German Trauma Registry.

  12. The reality of war: wounded and fallen Norwegian soldiers in Afghanistan.

    PubMed

    Bjerkan, Geir; Iversen, Petter; Asak, Håkon; Pillgram-Larsen, Johan; Rolandsen, Bent-Åge

    2012-05-15

    Norway has been contributing military forces to Afghanistan since 2001. The following is an overview of all combat-related injuries and deaths among Norwegian soldiers in the period from 2002 to 2010. All medical records for Norwegian military personnel in Afghanistan in the period to January 2011 were reviewed and those who fell or were injured during combat were identified. The mechanism and anatomical region of the injury were registered and an injury severity score (ISS), revised trauma score (RTS) and probability of survival score were calculated. Deaths were classified according to military trauma terminology and were additionally assessed as either "non-survivable" or "potentially survivable". There were 45 injury incidents with nine deaths among 42 soldiers. The injury mechanism behind seven of the deaths was an improvised explosive device (IED). All injuries resulting in deaths were "non-survivable". Seven soldiers were severely injured. The mechanisms were bullet wounds, IED, splinters from grenades and landmine explosions. Twenty nine incidents involving 28 soldiers resulted in minor injuries. The most frequent mechanism was ricochet or splinter injury from shooting or an exploding grenade. The majority of conflict-related injuries in Afghanistan were due to explosions. The mechanism and anatomical distribution of the injuries was the same among Norwegian soldiers as among allies. The deaths were due to extensive injuries that were non-survivable.

  13. Rising threat of terrorist bomb blasts in Karachi--a 5-year study.

    PubMed

    Mirza, Farhat Hussain; Parhyar, Hamid Ali; Tirmizi, Syed Zubair Ahmed

    2013-08-01

    This study aims to determine the frequency of injuries and fatalities associated with terrorist bomb explosions in the city of Karachi from 1 January 2007 to 31 December 2011. Moreover, this study is aimed to determine age and sex vulnerability among the victims of blast explosion. A descriptive cross-sectional study was conducted. The study was carried out at mortuaries and medicolegal sections at Jinnah Postgraduate Medical Center, Civil Hospital and Abbasi-Shaheed Hospital Karachi, the three main hospitals, which cater to all these cases of Karachi. The study included all bomb blast victims examined and autopsied from January 2007 to December 2011 at Jinnah Postgraduate Medical Center, Civil Hospital and Abbassi Shaheed Hospital Karachi. Details of 1142 cases were collected for those medicolegal deaths and injured persons, identified to be the victims of bomb blasts from January 2007 to December 2011. Data were collected on a preformed proforma from the mortuaries and medicolegal sections of these three public sector hospitals. The variables investigated include age, gender, year-wise distribution of the injured and the dead along with the cause of death and body parts injured in survivors. Out of the total 11,109 autopsies during the study period, 249 (2.24%) were carried out on deaths due to bomb blasts. Similarly, 135,065 injury cases were reported during the study period out of which 893 (0.66%) cases were due to bomb blasts. An initial peak in the year 2007, followed by a decline in 2008 and since then a steady rise of bomb blast incidences with casualties and fatalities, has been observed. The highest numbers of injured victims were reported in the year 2010 and fatalities in 2007. Among 1142 cases, 95.18% were male and 4.82% female with a male to female ratio of 19.76:1. Persons of ages between 15 and 45 years were chiefly involved. Shock due to multiple injuries was the leading cause of death, followed by head injury with or without haemorrhage. The lower extremities sustained the highest number of injuries in survivors, followed by the upper extremities. Fatalities and casualties due to explosions are increasing each year. The pattern of injuries indicates open-air bombing in Karachi. Males of the age group 15-45 years are the main victims. The forensic speciality needs to understand their role of correct certification, helpful to law enforcement agencies. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  14. Agroterrorism: the risks to the United States food supply and national security.

    PubMed

    Gill, Kevin M

    2015-01-01

    Agroterrorism is a collective term that describes an intentional criminal attack against crops or mankind using viral, bacterial, fungal, or insect-borne agents. Agroterrorism also includes attacks against animals using infectious pathogens such as Burkholderia mallei (glanders), Bacillus anthracis (anthrax), viral avian influenza, foot and mouth disease, and several equine encephalitis viruses. Agents that could be used against crops include the causative agents of wheat blast, rice blast, rice brown spot disease, and wheat stem rust. The primary goal of terrorists using agroterrorism is to spread fear and cause massive economic loss. Subsequent goals include causing disease and death to humans and animals. The use of bioterrorism agents is a much more practical approach than using explosives, for example, to achieve those results since many of these biological agents are commonly found naturally in the environment and are difficult to detect with modern technology. The effective use of biological warfare dates back centuries and can still can be employed by terrorist groups, lone wolves, and political and religious groups to cause death and mayhem on a grand scale.

  15. Ascertaining the impact of catastrophic events on dengue outbreak: The 2014 gas explosions in Kaohsiung, Taiwan.

    PubMed

    Hsieh, Ying-Hen

    2017-01-01

    Infectious disease outbreaks often occur in the aftermath of catastrophic events, either natural or man-made. While natural disasters such as typhoons/hurricanes, flooding and earthquakes have been known to increase the risk of infectious disease outbreak, the impact of anthropogenic disasters is less well-understood. Kaohsiung City is located in southern Taiwan, where most dengue outbreaks had occurred in the past two decades. It is also the center of petrochemical industry in Taiwan with pipelines running underneath city streets. Multiple underground gas explosions occurred in Kaohsiung in the evening of July 31, 2014 due to chemical leaks in the pipelines. The explosions caused 32 deaths, including five firefighters and two volunteer firefighters, and injured 321 persons. Historically, dengue outbreaks in southern Taiwan occurred mostly in small numbers of around 2000 cases or less, except in 2002 with over 5000 cases. However, in the months after the gas explosions, the city reported 14528 lab-confirmed dengue cases from August to December. To investigate the possible impact, if any, of the gas explosions on this record-breaking dengue outbreak, a simple mathematical model, the Richards model, is utilized to study the temporal patterns of the spread of dengue in the districts of Kaohsiung in the proximity of the explosion sites and to pinpoint the waves of infections that had occurred in each district in the aftermath of the gas explosions. The reproduction number of each wave in each district is also computed. In the aftermath of the gas explosions, early waves occurred 4-5 days (which coincides with the minimum of human intrinsic incubation period for dengue) later in districts with multiple waves. The gas explosions likely impacted the timing of the waves, but their impact on the magnitude of the 2014 outbreak remains unclear. The modeling suggests the need for public health surveillance and preparedness in the aftermath of future disasters.

  16. Ascertaining the impact of catastrophic events on dengue outbreak: The 2014 gas explosions in Kaohsiung, Taiwan

    PubMed Central

    2017-01-01

    Infectious disease outbreaks often occur in the aftermath of catastrophic events, either natural or man-made. While natural disasters such as typhoons/hurricanes, flooding and earthquakes have been known to increase the risk of infectious disease outbreak, the impact of anthropogenic disasters is less well-understood. Kaohsiung City is located in southern Taiwan, where most dengue outbreaks had occurred in the past two decades. It is also the center of petrochemical industry in Taiwan with pipelines running underneath city streets. Multiple underground gas explosions occurred in Kaohsiung in the evening of July 31, 2014 due to chemical leaks in the pipelines. The explosions caused 32 deaths, including five firefighters and two volunteer firefighters, and injured 321 persons. Historically, dengue outbreaks in southern Taiwan occurred mostly in small numbers of around 2000 cases or less, except in 2002 with over 5000 cases. However, in the months after the gas explosions, the city reported 14528 lab-confirmed dengue cases from August to December. To investigate the possible impact, if any, of the gas explosions on this record-breaking dengue outbreak, a simple mathematical model, the Richards model, is utilized to study the temporal patterns of the spread of dengue in the districts of Kaohsiung in the proximity of the explosion sites and to pinpoint the waves of infections that had occurred in each district in the aftermath of the gas explosions. The reproduction number of each wave in each district is also computed. In the aftermath of the gas explosions, early waves occurred 4–5 days (which coincides with the minimum of human intrinsic incubation period for dengue) later in districts with multiple waves. The gas explosions likely impacted the timing of the waves, but their impact on the magnitude of the 2014 outbreak remains unclear. The modeling suggests the need for public health surveillance and preparedness in the aftermath of future disasters. PMID:28520740

  17. Work-related fatal injuries in Brescia County (Northern Italy), 1982 to 2015: A forensic analysis.

    PubMed

    Perotti, Silvia; Russo, Maria Cristina

    2018-06-06

    Work-related deaths represent an important social problem. We report all the occupational fatal injuries recorded by the Brescia Institute of Forensic Medicine from 1982 to 2015. A total of 426 post-mortem examinations due to accidental work injuries were retrospectively analysed according to temporal distribution (year, month and day of the workplace accident); workers' characteristics (sex, age, nationality); type of occupation; cause of death; anatomical region of fatal injuries and timing of death. The accidental occupational events occurred with a mean of 12.5 cases per year. Almost all the workers were male (99%) and Italians (87%), aged between 35 and 49 years old (34.27%). The occupation with more fatalities was construction (36.62%), followed by mechanical industry (19.25%) and agriculture (13.15%). Most of deaths were connected to a mechanical trauma (77.69%) such as falls, machinery-related events, blunt forces or explosions. The predominant site of the lethal wound was the head (33.56%), with a high percentage of death resulting from a traumatic brain injury. In 30.75% of cases death occurred after a short period of hospitalization. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  18. Volcano Hazards - A National Threat

    USGS Publications Warehouse

    ,

    2006-01-01

    When the violent energy of a volcano is unleashed, the results are often catastrophic. The risks to life, property, and infrastructure from volcanoes are escalating as more and more people live, work, play, and travel in volcanic regions. Since 1980, 45 eruptions and 15 cases of notable volcanic unrest have occurred at 33 U.S. volcanoes. Lava flows, debris avalanches, and explosive blasts have invaded communities, swept people to their deaths, choked major riverways, destroyed bridges, and devastated huge tracts of forest. Noxious volcanic gas emissions have caused widespread lung problems. Airborne ash clouds have disrupted the health, lives, and businesses of hundreds of thousands of people; caused millions of dollars of aircraft damage; and nearly brought down passenger flights.

  19. Two-material optimization of plate armour for blast mitigation using hybrid cellular automata

    NASA Astrophysics Data System (ADS)

    Goetz, J.; Tan, H.; Renaud, J.; Tovar, A.

    2012-08-01

    With the increased use of improvised explosive devices in regions at war, the threat to military and civilian life has risen. Cabin penetration and gross acceleration are the primary threats in an explosive event. Cabin penetration crushes occupants, damaging the lower body. Acceleration causes death at high magnitudes. This investigation develops a process of designing armour that simultaneously mitigates cabin penetration and acceleration. The hybrid cellular automaton (HCA) method of topology optimization has proven efficient and robust in problems involving large, plastic deformations such as crash impact. Here HCA is extended to the design of armour under blast loading. The ability to distribute two metallic phases, as opposed to one material and void, is also added. The blast wave energy transforms on impact into internal energy (IE) inside the solid medium. Maximum attenuation occurs with maximized IE. The resulting structures show HCA's potential for designing blast mitigating armour structures.

  20. Exposing Hierarchical Parallelism in the FLASH Code for Supernova Simulation on Summit and Other Architectures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Papatheodore, Thomas L.; Messer, Bronson

    Since roughly 100 million years after the big bang, the primordial elements hydrogen (H), helium (He), and lithium (Li) have been synthesized into heavier elements by thermonuclear reactions inside of the stars. The change in stellar composition resulting from these reactions causes stars to evolve over the course of their lives. Although most stars burn through their nuclear fuel and end their lives quietly as inert, compact objects, whereas others end in explosive deaths. These stellar explosions are called supernovae and are among the most energetic events known to occur in our universe. Supernovae themselves further process the matter ofmore » their progenitor stars and distribute this material into the interstellar medium of their host galaxies. In the process, they generate ∼1051 ergs of kinetic energy by sending shock waves into their surroundings, thereby contributing to galactic dynamics as well.« less

  1. Seen but not heard: injuries and deaths from landmines and unexploded ordnance in Chechnya, 1994-2005.

    PubMed

    Bilukha, Oleg O; Brennan, Muireann; Anderson, Mark; Tsitsaev, Zaur; Murtazaeva, Eliza; Ibragimov, Ramzan

    2007-01-01

    Due to more than a decade of armed conflict and civil unrest, Chechnya is among the regions most affected by landmines and unexploded ordnance worldwide. The study was performed to assess the magnitude of injuries and deaths due to landmines and unexploded ordnance in Chechnya between 1994 and 2005 and to describe epidemiologic patterns and risk factors for these events. Surveillance data that included 3,021 civilian non-combatants injured by landmines and unexploded ordnance in Chechnya during 1994-2005 were analyzed. Local non-governmental organizations in collaboration with the United Nations Children's Fund conducted victim data collection using trained staff to interview victims or their families. Surveillance data were used to describe injury trends, victim demographics, injury types, risk behaviors, and types of explosives related to landmine and unexploded ordnance events. The largest number of injuries occurred in 2000 (716, injury rate 6.6 per 10,000) and 2001 (640, injury rate 5.9 per 10,000). One-quarter of all victims were younger than 18 years, and 19% were females. The case-fatality rate was 23%. Approximately 40% of victims were injured by landmines, 30% by unexploded ordnance, and 7% by booby traps. A large proportion of children and adults were injured while traveling or performing activities of economic necessity; 29% of children were injured while tampering with explosives or playing in a contaminated area. The proportion of victims with lower limb amputations was similar among children and adults (14% and 17%, respectively), whereas the proportion ofvictims with upper limb amputations was three times higher in children than in adults (12% and 4%, respectively). Most accidents that occurred while the victim was traveling or performing activities of economic necessity were caused by landmines, while most accidents that occurred while the victim was playing near an explosive device or tampering with it were caused by unexploded ordnance. Civilians in Chechnya experienced the highest rates of injury from landmines and unexploded ordnance ever documented, 10 times higher than injury rates reported from such highly affected countries as Afghanistan, Angola, or Cambodia. Urgent efforts to identify, mark, and clear mined areas and/or areas contaminated with unexploded ordnance are needed to prevent further civilian injuries and deaths.

  2. Blast mines: physics, injury mechanisms and vehicle protection.

    PubMed

    Ramasamy, A; Hill, A M; Hepper, A E; Bull, A M J; Clasper, J C

    2009-12-01

    Since World War II, more vehicles have been lost to land mines than all other threats combined. Anti-vehicular (AV) mines are capable of disabling a heavy vehicle, or completely destroying a lighter vehicle. The most common form of AV mine is the blast mine, which uses a large amount of explosive to directly damage the target. In a conventional military setting, landmines are used as a defensive force-multiplier and to restrict the movements of the opposing force. They are relatively cheap to purchase and easy to acquire, hence landmines are also potent weapons in the insurgents' armamentarium. The stand-offnature of its design has allowed insurgents to cause significant injuries to security forces in current conflicts with little personal risk. As a result, AV mines and improvised explosive devices (IEDs) have become the most common cause of death and injury to Coalition and local security forces operating in Iraq and Afghanistan. Detonation of an AV mine causes an explosive, exothermic reaction which results in the formation of a shockwave followed by a rapid expansion of gases. The shockwave is mainly reflected by the soillair interface and fractures the soil cap overthe mine. The detonation products then vent through the voids in the soil, resulting in a hollow inverse cone which consists of the detonation gases surrounded by the soil ejecta. It is the combination of the detonation products and soil ejecta that interact with the target vehicle and cause injury to the vehicle occupants. A number of different strategies are required to mitigate the blast effects of an explosion. Primary blast effects can be reduced by increasing the standoff distance between the seat of the explosion and the crew compartment. Enhancement of armour on the base of the vehicle, as well as improvements in personal protection can prevent penetration of fragments. Mitigating tertiary effects can be achieved by altering the vehicle geometry and structure, increasing vehicle mass, as well as developing new strategies to reduce the transfer of the impulse through the vehicle to the occupants. Protection from thermal injury can be provided by incorporating fire resistant materials into the vehicle and in personal clothing. The challenge for the vehicle designer is the incorporation of these protective measures within an operationally effective platform.

  3. Necrosome core machinery: MLKL.

    PubMed

    Zhang, Jing; Yang, Yu; He, Wenyan; Sun, Liming

    2016-06-01

    In the study of regulated cell death, the rapidly expanding field of regulated necrosis, in particular necroptosis, has been drawing much attention. The signaling of necroptosis represents a sophisticated form of a death pathway. Anti-caspase mechanisms (e.g., using inhibitors of caspases, or genetic ablation of caspase-8) switch cell fate from apoptosis to necroptosis. The initial extracellular death signals regulate RIP1 and RIP3 kinase activation. The RIP3-associated death complex assembly is necessary and sufficient to initiate necroptosis. MLKL was initially identified as an essential mediator of RIP1/RIP3 kinase-initiated necroptosis. Recent studies on the signal transduction using chemical tools and biomarkers support the idea that MLKL is able to make more functional sense for the core machinery of the necroptosis death complex, called the necrosome, to connect to the necroptosis execution. The experimental data available now have pointed that the activated MLKL forms membrane-disrupting pores causing membrane leakage, which extends the prototypical concept of morphological and biochemical events following necroptosis happening in vivo. The key role of MLKL in necroptosis signaling thus sheds light on the logic underlying this unique "membrane-explosive" cell death pathway. In this review, we provide the general concepts and strategies that underlie signal transduction of this form of cell death, and then focus specifically on the role of MLKL in necroptosis.

  4. Injuries from roadside improvised explosive devices.

    PubMed

    Ramasamy, Arul; Harrisson, Stuart E; Clasper, Jon C; Stewart, Michael P M

    2008-10-01

    After the invasion of Iraq in April 2003, coalition forces have remained in the country in a bid to maintain stability and support the local security forces. The improvised explosive device (IED) has been widely used by the insurgents and is the leading cause of death and injury among Coalition troops in the region. From January 2006, data were prospectively collected on 100 consecutive casualties who were either injured or killed in hostile action. Mechanism of injury, new Injury Severity Score (NISS), The International Classification of Disease-9th edition diagnosis, anatomic pattern of wounding, and operative management were recorded in a trauma registry. The weapon incident reports were analyzed to ascertain the type of IED employed. Of the 100 casualties injured in hostile action, 53 casualties were injured by IEDs in 23 incidents (mean 2.3 casualties per incident). Twenty-one of 23 (91.3%) of the IEDs employed were explosive formed projectile (EFP) type. Twelve casualties (22.6%) were either killed or died of wounds. Median NISS score of survivors was 3 (range, 1-50). All fatalities sustained unsurvivable injuries with a NISS score of 75. Primary blast injuries were seen in only 2 (3.8%) and thermal injuries in 8 casualties (15.1%). Twenty (48.7%) of survivors underwent surgery by British surgeons in the field hospital. At 18 months follow, all but one of the United Kingdom Service personnel had returned to military employment. The injury profile seen with EFP-IEDs does not follow the traditional pattern of injuries seen with conventional high explosives. Primary blast injuries were uncommon despite all casualties being in close proximity to the explosion. When the EFP-IED is detonated, the EFP produced results in catastrophic injuries to casualties caught in its path, but causes relatively minor injuries to personnel sited adjacent to its trajectory. Improvements in vehicle protection may prevent the EFP from entering the passenger compartments and thereby reduce fatalities.

  5. Proximal detection of energetic materials on fabrics by UV-Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Chirico, R.; Almaviva, S.; Colao, F.; Fiorani, L.; Nuvoli, M.; Schweikert, W.; Schnürer, F.; Cassioli, L.; Grossi, S.; Mariani, L.; Angelini, F.; Menicucci, I.; Palucci, A.

    2014-05-01

    In the last decades there have been several terroristic attacks with improvised explosive devices (IED) that have raised the need for new instrumentation, for homeland security applications, to obtain a reliable and effective fight against terrorism. Public transportation has been around for about 150 years, but terroristic attacks against buses, trains, subways, etc., is a relatively recent phenomenon [1]. Since 1970, transportation has been an increasingly attractive target for terrorists. Most of the attacks to transport infrastructures take place in countries where public transportation is the primary way to move. Terrorists prefer to execute a smaller-scale attack with certainty of success rather than a complex and demanding operation to cause massive death and destruction. [1]. Many commonly available materials, such as fertilizer, gunpowder, and hydrogen peroxide, can be used as explosives and other materials, such as nails, glass, or metal fragments, can be used to increase the amount of shrapnel propelled by the explosion. The majority of substances that are classified as chemical explosives generally contain oxygen, nitrogen and oxidable elements such as carbon and hydrogen [2]. The most common functional group in military explosives is NO2. That functionality can be attached to oxygen (ONO2) in the nitrate esters (PETN), to carbon (C-NO2) in the nitroarenes (TNT) and nitroalkanes (Nitromethane), and to nitrogen (N-NO2) as in the nitramines (RDX). Some organic peroxides, such as TATP and HMTD, are popular amongst terrorists because they are powerful initiators that can be easily prepared from easily available ingredients. Azides are also powerful primary explosives commonly used as initiators (commercial detonators) in civilian and military operations, therefore they could be potentially used by terrorists as initiators for IEDs.

  6. An unusual case of carbon monoxide poisoning.

    PubMed Central

    Auger, P L; Levesque, B; Martel, R; Prud'homme, H; Bellemare, D; Barbeau, C; Lachance, P; Rhainds, M

    1999-01-01

    Carbon monoxide, a gas originating from incomplete combustion of carbon-based fuels, is an important cause of human deaths. In this paper, we describe an unusual carbon monoxide poisoning in a dwelling without obvious sources of combustion gases, for which two adults had to be treated in a hyperbaric chamber. Carbon monoxide readings were taken in the house and in the neighboring homes. Methane gas and nitrogen oxide levels were also monitored in the house air. Soil samples were collected around the house and tested for hydrocarbon residues. The investigation revealed the presence of a pocket of carbon monoxide under the foundation of the house. The first readings revealed carbon monoxide levels of 500 ppm in the basement. The contamination lasted for a week. The investigation indicated that the probable source of contamination was the use of explosives at a nearby rain sewer construction site. The use of explosives in a residential area can constitute a major source of carbon monoxide for the neighboring populations. This must be investigated, and public health authorities, primary-care physicians, governmental authorities, and users and manufacturers of explosives must be made aware of this problem. Images Figure 1 Figure 2 PMID:10379009

  7. 39 CFR 233.2 - Circulars and rewards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... robbery. (ii) Mailing or causing to be mailed bombs, explosives, poison, weapons of mass destruction, or.... Bombs or Explosives, $100,000. Mailing or causing to be mailed any bombs or explosives which may kill or harm another, or injure the mails or other property, or the placing of any bomb or explosive in a...

  8. Underbody Blast Models of TBI Caused by Hyper-Acceleration and Secondary Head Impact

    DTIC Science & Technology

    2017-10-01

    brain injury (TBI), with most of these head injuries caused by explosive munitions such as bombs , land mines, improvised explosive devices and missiles...with most of these injuries caused by explosive munitions such as bombs , land mines, improvised explosive devices (IEDs), and missiles.1,2 Little is...Neurosurg. 2008;108: 124–131. 21. Richards EM , Fiskum G, Rosenthal RE, Hopkins I, McKenna MC. Hyperoxic reperfusion after global ischemia decreases

  9. Post-Service Mortality of Air Force Veterans Occupationally Exposed to Herbicides during the Vietnam War

    DTIC Science & Technology

    2006-06-01

    workers found no excess risk of death due to cancer or all causes combined13 . More than 15 years after an accidental explosion in a plant near Seveso...Atherosclerotic heart disease 34(5.8) 316 (2.9) 1.8 1.3,2.6 0.001 Cardiomyopathy 2 (0.3) 39 (0.4) 0.9 0.2, 3.6 0.83 Cerebrovascular disease 5(0.8) 38(0.3...4280,4289, 4239, 4263, 4274), Cerebrovascular disease (430, 431, 4329, 4340, 4349, 436, 4428, 4379), Hypertensive disease (4019, 4029, 4039, 4372, 4410

  10. Death or Survival? Determining the nature of SNe IIn-P explosions

    NASA Astrophysics Data System (ADS)

    Mauerhan, Jon

    2016-10-01

    An increasing number of transients classifiable as interacting supernovae of Type IIn have become the subject of intense debate, as the death or survival of the precursor star is unclear. This is because giant non-terminal eruptions from massive luminous blue variable (LBV) stars can spectroscopically resemble SNe IIn and achieve comparable luminosities via shock interaction with pre-existing circumstellar material (CSM). The stellar origin of the new SNe IIn-P class of explosions is particularly controversial. Competing interpretations predict stellar progenitors with very different initial masses and explosion outcomes: 1) non-terminal super-Eddington eruptions from LBVs; 2) collapsars from very massive stars that should die within their natal OB associations; and 3) electron-capture SNe from super-AGB stars with dense CSM envelopes. To resolve the uncertain origin of SNe IIn-P, we propose a simple and inexpensive optical imaging experiment to see if there is a luminous surviving star remaining at the site. UV imaging is also proposed to determine the nature of a UV source detected in pre-explosion GALEX images, and to survey the progenitor's environment for sibling O-type stars.

  11. Methyl tert-butyl ether (MTBE) detected in abnormally high concentrations in postmortem blood and urine from two persons found dead inside a car containing a gasoline spill.

    PubMed

    Karinen, Ritva; Vindenes, Vigdis; Morild, Inge; Johnsen, Lene; Le Nygaard, Ilah; Christophersen, Asbjørg S

    2013-09-01

    Two deep frozen persons, a female and a male, were found dead in a car. There had been an explosive fire inside the car which had extinguished itself. On the floor inside the car were large pools of liquid which smelled of gasoline. The autopsy findings and routine toxicological analyses could not explain the cause of death. Carboxyhemoglobin levels in the blood samples were <10%. Analysis with a headspace gas chromatography revealed methyl tert-butyl ether (MTBE) concentrations of 185 mg/L (female victim) and 115 mg/L (male victim) in peripheral blood. The urine MTBE concentrations were 150 mg/L and 256 mg/L, respectively. MTBE is a synthetic chemical which is added to gasoline as a fuel oxygenate. Gasoline poisoning is likely to be the cause of the death in these two cases, and MTBE can be a suitable marker of gasoline exposure, when other volatile components have vaporized. © 2013 American Academy of Forensic Sciences.

  12. Optoelectronics sensors of hydrocarbons based on NDIR technique

    NASA Astrophysics Data System (ADS)

    Prokopiuk, Artur

    2017-08-01

    Saturated hydrocarbons are mainly nontoxic, but as extremely flammable gases forming explosive mixtures with air. The Lower Explosive Level (LEL) for methane is 4.4%, which is very dangerous in the mining industry. Methane is also an asphyxiant gas causing coma or death. Therefore, continuous monitoring of the hydrocarbons concentration is very important. Optoelectronic methods are very attractive for this application, especially nondispersive infrared (NDIR) technique. It enables a direct, fast, and selective measurement of different gas concentrations. NDIR sensors have many advantages, which make them very promising for use as hydrocarbon detectors. Despite a lot of benefits, common used NDIR sensors have some disadvantages. They need periodic calibration and have limited detection range, from 100ppm. These parameters can be improved thanks to modernization detection scheme and use of newest IR sources and detectors. During Analyses selected IR sources and detectors were taken into account. Absorption spectra of analyzed hyrdrocarbons were studied to minimize impact interfering gases like carbon dioxide and water.

  13. Health Effects of Cut Gas Lines and Other Petroleum Product Release Incidents - Seven States, 2010-2012.

    PubMed

    Anderson, Ayana R

    2015-06-12

    Large mass casualty gas explosions and catastrophic oil spills are widely reported and receive considerable regulatory attention. Smaller, less catastrophic petroleum product releases are less likely to receive publicity, although study of these incidents might help focus and prioritize prevention efforts. To describe the causes and health impacts of petroleum product release incidents (including gas explosions and oil spills), the Agency for Toxic Substances and Disease Registry (ATSDR) analyzed 2010-2012 data from the National Toxic Substance Incidents Program (NTSIP). A total of 1,369 petroleum product release incidents were reported from seven states, resulting in 512 injuries and 36 deaths. Approximately one fourth of the incidents were associated with utilities, and approximately one fifth were associated with private vehicles or residences. Approximately 10% of petroleum product releases resulted from inadvertent damage to utility lines. Understanding the characteristics of acute petroleum product releases can aid the public and utility workers in the development of preventive strategies and reduce the morbidity and mortality associated with such releases.

  14. The ODTX System for the Study of Thermal Sensitivity and Thermal Explosion Violence of Energetic Materials

    NASA Astrophysics Data System (ADS)

    Hsu, Peter; Hust, Gary; Reynolds, John; Springer, Keo; Fried, Larry; Maienschein, Jon

    2013-06-01

    Incidents caused by fire and combat operations in battlefields can expose energetic materials to unexpected heat that may cause thermal explosion, structural damage and casualty. Some explosives may thermally explode at fairly low temperatures (<100 C) and the violence from thermal explosion may cause a significant damage. Thus it is important to understand the response of energetic materials to thermal insults. The One Dimensional Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory can measure times to explosion, threshold thermal explosion temperature, and determine kinetic parameters of energetic materials. Samples of different configurations (pressed part, powder, paste, and liquid) can be tested in the system. The ODTX testing can also provide useful data for assessing the thermal explosion violence of energetic materials. In this paper, we will present some recent ODTX experimental data and compare thermal explosion violence of different energetic materials. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  15. Oil in the Water, Fire in the Sky: Responding to Technological/Environmental Disasters

    ERIC Educational Resources Information Center

    Lazarus, Philip J.; Sulkowski, Michael L.

    2010-01-01

    On April 20, 2010, a massive explosion killed 11 workers on the Deepwater Horizon oil rig. Survivors of this explosion recounted terrifying near-death experiences and mourned the loss of coworkers and friends who had perished. Shock and grief spread through small coastal communities composed mostly of fishers and oil workers. However, this was…

  16. 27 CFR 479.42 - Changes through death of owner.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2014-04-01 2014-04-01 false Changes through death of owner. 479.42 Section 479.42 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

  17. 27 CFR 479.42 - Changes through death of owner.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2012-04-01 2010-04-01 true Changes through death of owner. 479.42 Section 479.42 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

  18. 27 CFR 479.42 - Changes through death of owner.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2011-04-01 2010-04-01 true Changes through death of owner. 479.42 Section 479.42 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

  19. 27 CFR 479.42 - Changes through death of owner.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 3 2013-04-01 2013-04-01 false Changes through death of owner. 479.42 Section 479.42 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO, FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION MACHINE GUNS, DESTRUCTIVE DEVICES...

  20. Twenty-five years of violence: the epidemiology of terrorism in South America.

    PubMed

    Báez, Amado Alejandro; Sztajnkrycer, Matthew D; Zane, Richard; Giräldez, Ediza

    2008-01-01

    Terrorism is a global public health burden. South Americans have been victims of terrorism for many decades. While the causes vary, the results are the same: death, disability, and suffering. The objective of this study was to perform a comprehensive, epidemiological, descriptive study of terrorist incidents in South America. This is a cross-sectional, descriptive study. Data from January 1971 to July 2006 was selected using the RAND Terrorism Chronology 1968-1997 and RAND-Memorial Institute for Prevention of Terrorism (MIPT) Terrorism Incident database (1998-Present). Statistical significance was set at 0.05. The database reported a total of 2,997 incidents in South American countries that resulted in 3,435 victims with injuries (1.15 per incident) and 1,973 fatalities (0.66 per incident). The overall case fatality ratio (CFR) was 35.8%. Colombia had the majority of incidents with 57.9% (1,734 of 2,997), followed by Peru with 363 (12.1%), and Argentina with 267 (8.9%). The highest individual CFR occurred in Paraguay (83.3%), and the lowest in Chile with 4.8%. Of the total injuries and deaths, Colombia had 66.1% (2,269 of 2,997) of all injuries and 75.2% (1,443 out of 1,920) of all deaths. Living in the country of Colombia was associated with a 16 times greater likelihood of becoming a victim of terrorist violence [odds ratio (OR) 16.15; 95% CI 13.45 to 19.40; p < 0.0001]. The predominant method of choice for terrorist incidents was the use of conventional explosives with 2,543 of2,883 incidents (88.2%). Terrorist incidents in South America have accounted for nearly 2,000 deaths, with conventional explosive devices as the predominant method of choice. Understanding the nature of terrorist attacks and the medical consequences assist emergency preparedness and disaster management officials in allocating resources and preparing for potential future events.

  1. A new supernova light curve modeling program

    NASA Astrophysics Data System (ADS)

    Jäger, Zoltán; Nagy, Andrea P.; Biro, Barna I.; Vinkó, József

    2017-12-01

    Supernovae are extremely energetic explosions that highlight the violent deaths of various types of stars. Studying such cosmic explosions may be important because of several reasons. Supernovae play a key role in cosmic nucleosynthesis processes, and they are also the anchors of methods of measuring extragalactic distances. Several exotic physical processes take place in the expanding ejecta produced by the explosion. We have developed a fast and simple semi-analytical code to model the the light curve of core collapse supernovae. This allows the determination of their most important basic physical parameters, like the the radius of the progenitor star, the mass of the ejected envelope, the mass of the radioactive nickel synthesized during the explosion, among others.

  2. SN 1985f - Death of a Wolf-Rayet star

    NASA Technical Reports Server (NTRS)

    Begelman, M. C.; Sarazin, C. L.

    1986-01-01

    The optical spectrum of SN 1985f has been analyzed, and the supernova ejecta is shown to contain approximately 5 or more solar masses of oxygen and very little hydrogen. It is suggested that the explosion resulted from the pair instability supernova of a WO Wolf-Rayet star of about 50 solar masses, and that the optical luminosity of the supernova is powered by the radioactive decay of Co-56 synthesized in the explosion. As calculated from the rate of the optical emission decay, the explosion occurred about 350 days before its discovery in February, 1985. It is believed that some of the oxygen-rich supernova remnants may also have been produced by explosions of WO stars.

  3. Exposure to an atomic bomb explosion is a risk factor for in-hospital death after esophagectomy to treat esophageal cancer.

    PubMed

    Nakashima, Y; Takeishi, K; Guntani, A; Tsujita, E; Yoshinaga, K; Matsuyama, A; Hamatake, M; Maeda, T; Tsutsui, S; Matsuda, H; Ishida, T

    2015-01-01

    Esophagectomy, one of the most invasive of all gastrointestinal operations, is associated with a high frequency of postoperative complications and in-hospital mortality. The purpose of the present study was to determine whether exposure to the atomic bomb explosion at Hiroshima in 1945 might be a preoperative risk factor for in-hospital mortality after esophagectomy in esophageal cancer patients. We thus reviewed the outcomes of esophagectomy in 31 atomic bomb survivors with esophageal cancer and 96 controls (also with cancer but without atomic bomb exposure). We compared the incidences of postoperative complications and in-hospital mortality. Of the clinicopathological features studied, mean patient age was significantly higher in atomic bomb survivors than in controls. Of the postoperative complications noted, atomic bomb survivors experienced a longer mean period of endotracheal intubation and higher incidences of severe pulmonary complications, severe anastomotic leakage, and surgical site infection. The factors associated with in-hospital mortality were exposure to the atomic bomb explosion, pulmonary comorbidities, and electrocardiographic abnormalities. Multivariate analysis revealed that exposure to the atomic bomb explosion was an independent significant preoperative risk factor for in-hospital mortality. Exposure to the atomic bomb explosion is thus a preoperative risk factor for in-hospital death after esophagectomy to treat esophageal cancer. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  4. Uncontacted tire explosion causing trauma to bilateral lower extremities: A case report.

    PubMed

    Yu, Ming-Yang; Su, Yun; Meng, Xiang-Jun; Luan, Bo-Wu; Gu, Gui-Shan; Sun, Qiang; Zhao, De-Wei

    2017-06-01

    It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus (a comminuted fracture in the right ankle joint) and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient's feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  5. Supernova Forensics

    NASA Astrophysics Data System (ADS)

    Soderberg, Alicia M.

    2014-01-01

    For decades, the study of stellar explosions -- supernovae -- have focused almost exclusively on the strong optical emission that dominates the bolometric luminosity in the days following the ultimate demise of the star. Yet many of the leading breakthroughs in our understanding of stellar death have been enabled by obtaining data at other wavelengths. For example, I have shown that 1% of all supernovae give rise to powerful relativistic jets, representing the biggest bangs in the Universe since the Big Bang. My recent serendipitous X-ray discovery of a supernova in the act of exploding (“in flagrante delicto”) revealed a novel technique to discover new events and provide clues on the shock physics at the heart of the explosion. With the advent of sensitive new radio telescopes, my research group combines clues from across the electromagnetic spectrum (radio to gamma-ray), leading us to a holistic study of stellar death, the physics of the explosions, and their role in fertilizing the Universe with new elements, by providing the community with cosmic autopsy reports.

  6. Study of thermal sensitivity and thermal explosion violence of energetic materials in the LLNL ODTX system

    NASA Astrophysics Data System (ADS)

    Hsu, P. C.; Hust, G.; Zhang, M. X.; Lorenz, T. K.; Reynolds, J. G.; Fried, L.; Springer, H. K.; Maienschein, J. L.

    2014-05-01

    Incidents caused by fire and combat operations can heat energetic materials that may lead to thermal explosion and result in structural damage and casualty. Some explosives may thermally explode at fairly low temperatures (< 100 °C) and the violence from thermal explosion may cause significant damage. Thus it is important to understand the response of energetic materials to thermal insults. The One Dimensional Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory has been used for decades to measure times to explosion, threshold thermal explosion temperature, and determine kinetic parameters of energetic materials. Samples of different configurations (pressed part, powder, paste, and liquid) can be tested in the system. The ODTX testing can also provide useful data for assessing the thermal explosion violence of energetic materials. Recent ODTX experimental data are reported in the paper.

  7. One-Dimensional Time to Explosion (Thermal Sensitivity) of ANPZ

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hsu, P.; Hust, G.; McClelland, M.

    Incidents caused by fire and combat operations can heat energetic materials that may lead to thermal explosion and result in structural damage and casualty. Some explosives may thermally explode at fairly low temperatures (< 100 C) and the violence from thermal explosion may cause a significant damage. Thus it is important to understand the response of energetic materials to thermal insults. The One Dimensional Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory has been used for decades to measure times to explosion, threshold thermal explosion temperature, and determine kinetic parameters of energetic materials. Samples of different configurationsmore » (pressed part, powder, paste, and liquid) can be tested in the system. The ODTX testing can also provide useful data for assessing the thermal explosion violence of energetic materials. This report summarizes the recent ODTX experimental data and modeling results for 2,6-diamino-3,5-dintropyrazine (ANPZ).« less

  8. Dementia resulting from traumatic brain injury

    PubMed Central

    Ramalho, Joana; Castillo, Mauricio

    2015-01-01

    Traumatic brain injury (TBI) represents a significant public health problem in modern societies. It is primarily a consequence of traffic-related accidents and falls. Other recently recognized causes include sports injuries and indirect forces such as shock waves from battlefield explosions. TBI is an important cause of death and lifelong disability and represents the most well-established environmental risk factor for dementia. With the growing recognition that even mild head injury can lead to neurocognitive deficits, imaging of brain injury has assumed greater importance. However, there is no single imaging modality capable of characterizing TBI. Current advances, particularly in MR imaging, enable visualization and quantification of structural and functional brain changes not hitherto possible. In this review, we summarize data linking TBI with dementia, emphasizing the imaging techniques currently available in clinical practice along with some advances in medical knowledge. PMID:29213985

  9. [Epidemiology of war injuries, about two conflicts: Iraq and Afghanistan].

    PubMed

    Pasquier, P; de Rudnicki, S; Donat, N; Auroy, Y; Merat, S

    2011-11-01

    Since March 2003, military operations in Iraq "Operation Iraqi Freedom" (OIF) and in Afghanistan "Operation Enduring Freedom" (OEF), have made many wounded and killed in action (KIA). This article proposes to highlight the specific epidemiology of combat casualties, met in these both non-conventional and asymmetric conflicts. Personal protective equipments, Kevlar helmet and body armor, proved their efficiency in changing features of war injuries. Health Force Services organized trauma care system in different levels, with three main objectives: immediate basic medical care in battalion aid station, forward surgery and early aeromedical evacuation. The Joint Theater Trauma Registry (JTTR), a war injury registry, provides medical data, analyzed from the combat theater to the military hospital in United States. This analysis concluded that during modern conflicts, most injuries are caused by explosive devices; injuries are more severe and interestingly more specifically the head region and extremities than the trunk. Hemorrhage is the first cause of death, leading to the concept of avoidable death. Specific databases focused on mechanisms and severity of injuries, diagnostic and treatment difficulties, outcomes can guide research programs to improve war injuries prevention and treatment. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  10. Cause and Prevention of Explosions Involving DC Casting of Aluminum Sheet Ingot

    NASA Astrophysics Data System (ADS)

    Richter, Ray T.; Ekenes, J. Martin

    The casting of aluminum alloy sheet ingot and T-bar presents the potential for some of the most volatile situations that can occur in DC (direct chill) and EMC (Electromagnetic) casting processes. Aluminum Association explosion incident data from over 300 explosions spanning a twenty-year period were reviewed and analyzed looking for common factors and repetitive reasons for explosions. Analysis of explosions occurring during the three stages of sheet ingot casting, `start of cast', `steady state' and `end of cast', were examined and prioritized. Case studies illustrate the need for understanding both technical and non-technical factors contributing to explosions involving molten metal. This paper identifies the major causes of explosions involving DC casting of aluminum alloy sheet ingot and makes recommendations for how to prevent the recurrence of such events and minimize the risk of injury.

  11. Patterns of civilian and child deaths due to war-related violence in Syria: a comparative analysis from the Violation Documentation Center dataset, 2011-16.

    PubMed

    Guha-Sapir, Debarati; Schlüter, Benjamin; Rodriguez-Llanes, Jose Manuel; Lillywhite, Louis; Hicks, Madelyn Hsiao-Rei

    2018-01-01

    Since March, 2011, the Syrian civil war has lowered life expectancy by as much as 20 years. We describe demographic, spatial, and temporal patterns of direct deaths of civilians and opposition combatants from conflict-related violence in 6 years of war. We analysed conflict-related violent deaths with complete information on date, place, and cause of death and demographic group occurring from March 18, 2011, to Dec 31, 2016, recorded by the Violation Documentation Center (VDC). We included civilian and combatant deaths in all Syrian governorates, excluding government-controlled areas. We did not include detainees and missing persons, nor deaths from siege conditions or insufficient medical care. We categorised deaths based on VDC weapon type. We used χ 2 testing to compare deaths from different weapons in civilian men, women, boys, and girls and adult and child combatants. We analysed deaths by governorate and over time. The VDC recorded 143 630 conflict-related violent deaths with complete information between March 18, 2011, and Dec 31, 2016. Syrian civilians constituted 101 453 (70·6%) of the deaths compared with 42 177 (29·4%) opposition combatants. Direct deaths were caused by wide-area weapons of shelling and air bombardments in 58 099 (57·3%) civilians, including 8285 (74·6%) civilian women and 13 810 (79·4%) civilian children, and in 4058 (9·6%) opposition combatants. Proportions of children among civilian deaths increased from 8·9% (388 of 4254 civilian deaths) in 2011 to 19·0% (4927 of 25 972) in 2013 and to 23·3% (2662 of 11 444) in 2016. Of 7566 deaths from barrel bombs, 7351 (97·2%) were civilians, of whom 2007 (27·3%) were children. Of 20 281 deaths by execution, 18 747 (92·4%) were civilians and 1534 (7·6%) were opposition combatants. Compared with opposition child soldiers who were male (n=333), deaths of civilian male children (n=11 730) were caused more often by air bombardments (39·2% vs 5·4%, p<0·0001) and shelling (37·3% vs 13·2%, p<0·0001) and less often by shooting (12·5% vs 76·0%, p<0·0001). Aerial bombing and shelling rapidly became primary causes of direct deaths of women and children and had disproportionate lethal effects on civilians, calling into question the use of wide-area explosive weapons in urban areas. Increased reliance on aerial bombing by the Syrian Government and international partners is likely to have contributed to findings that children were killed in increasing proportions over time, ultimately comprising a quarter of civilian deaths in 2016. The inordinate proportion of civilians among the executed is consistent with deliberate tactics to terrorise civilians. Deaths from barrel bombs were overwhelmingly civilian rather than opposition combatants, suggesting indiscriminate or targeted warfare contrary to international humanitarian law and possibly constituting a war crime. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  12. DOE explosives safety manual

    NASA Astrophysics Data System (ADS)

    1990-05-01

    The Department of Energy (DOE) policy requires that all activities be conducted in a manner that protects the safety of the public and provides a safe and healthful workplace for employees. DOE has also prescribed that all personnel be protected in any explosives operation undertaken. The level of safety provided shall be at least equivalent to that of the best industrial practice. The risk of death or serious injury shall be limited to the lowest practicable minimum. DOE and contractors shall continually review their explosives operations with the aim of achieving further refinements and improvements in safety practices and protective features. This manual describes the Department's explosive safety requirements applicable to operations involving the development, testing, handling, and processing of explosives or assemblies containing explosives. It is intended to reflect the state-of-the-art in explosives safety. In addition, it is essential that applicable criteria and requirements for implementing this policy be readily available and known to those responsible for conducting DOE programs. This document shall be periodically reviewed and updated to establish new requirements as appropriate. Users are requested to submit suggestions for improving the DOE Explosives Safety Manual through their appropriate Operations Office to the Office of Quality Programs.

  13. Impact of the AD 79 explosive eruption on Pompeii, II. Causes of death of the inhabitants inferred by stratigraphic analysis and areal distribution of the human casualties

    NASA Astrophysics Data System (ADS)

    Luongo, Giuseppe; Perrotta, Annamaria; Scarpati, Claudio; De Carolis, Ernesto; Patricelli, Giovanni; Ciarallo, Annamaria

    2003-08-01

    Detailed descriptions of the effects of explosive eruptions on urban settlements available to volcanologists are relatively rare. Apart from disease and starvation, the largest number of human deaths caused by explosive eruptions in the twentieth century are due to pyroclastic flows. The relationship between the number of victims related to a specific hazard and the presence of urban settlements in the area covered by the eruption has been shown. However, pyroclastic falls are also extremely dangerous under certain conditions. These conclusions are based on archaeological and volcanological studies carried out on the victims of the well-known AD 79 eruption of Vesuvius that destroyed and buried the Roman city of Pompeii. The stratigraphic level in the pyroclastic deposit and the location of all the casualties found are described and discussed. The total number of victims recovered during the archaeological excavations amounts to 1150. Of these, 1044 well recognisable bodies plus an additional group of 100 individuals were identified based on the analysis of several groups of scattered bones. Of the former, 394 were found in the lower pumice lapilli fall deposit and 650 in the upper stratified ash and pumice lapilli pyroclastic density currents (PDCs) deposits. In addition, a tentative evaluation suggests that 464 corpses may still be buried in the unexcavated part of the city. According to the reconstruction presented in this paper, during the first phase of the eruption (August 24, AD 79) a huge quantity of pumice lapilli fell on Pompeii burying the city under 3 m of pyroclastic material. During this eruptive phase, most of the inhabitants managed to leave the city. However, 38% of the known victims were killed during this phase mainly as a consequence of roofs and walls collapsing under the increasing weight of the pumice lapilli deposit. During the second phase of the eruption (August 25, AD 79) 49% of the total victims were on the roadways and 51% inside buildings. All of these inhabitants, regardless of their location, were killed by the unanticipated PDCs overrunning the city. New data concerning the stratigraphic level of the victims in the pyroclastic succession allow us to discriminate between the sequential events responsible for their deaths. In fact, casts of some recently excavated corpses lay well above the lower PDCs deposit, testifying that some of the inhabitants survived the first pyroclastic current. Finally, during the PDCs phase the victims died quite rapidly by ash asphyxiation. From the attitude of some casts, it seems that some people survived the initial impact of the second pyroclastic current and tried to support head and bust during the progressive aggradation of the deposit at the base of the current.

  14. Acoustic and tephra records of explosive eruptions at West Mata submarine volcano, NE Lau Basin

    NASA Astrophysics Data System (ADS)

    Dziak, R. P.; Bohnenstiehl, D. R.; Baker, E. T.; Matsumoto, H.; Caplan-Auerbach, J.; Mack, C. J.; Embley, R. W.; Merle, S. G.; Walker, S. L.; Lau, T. A.

    2013-12-01

    West Mata is a 1200 m deep submarine volcano where explosive boninite eruptions were directly observed in May 2009. Here we present long-term acoustic and tephra records of West Mata explosion activity from three deployments of hydrophone and particle sensor moorings beginning on 8 January 2009. These records provide insights into the character of explosive magma degassing occurring at the volcano's summit vent until the decline and eventual cessation of the eruption during late 2010 and early 2011. The detailed acoustic records show three types of volcanic signals, 1) discrete explosions, 2) diffuse explosions, and 3) volcanic tremor. Discrete explosions are short duration, high amplitude broad-band signals caused by rapid gas bubble release. Diffuse signals are likely a result of 'trap-door' explosions where a quench cap of cooled lava forms over the magmatic vent but gas pressure builds underneath the cap. This pressure eventually causes the cap to breach and gas is explosively released until pressure reduces and the cap once again forms. Volcanic tremor is typified by narrow-band, long-duration signals with overtones, as well as narrow-band tones that vary frequency over time between 60-100 Hz. The harmonic tremor is thought to be caused by modulation of rapid, short duration gas explosion pulses and not a magma resonance phenomenon. The variable frequency tones may be caused by focused degassing or hydrothermal fluid flow from a narrow volcanic vent or conduit. High frequency (>30 Hz) tremor-like bands of energy are a result of interference caused by multipath wide-band signals, including sea-surface reflected acoustic phases, that arrive at the hydrophone with small time delays. Acoustic data suggest that eruption velocities for a single explosion range from 4-50 m s-1, although synchronous arrival of explosion signals has complicated our efforts to estimate long-term gas flux. Single explosions exhibit ~4-40 m3 s-1 of total volume flux (gas and rock) but with durations of only 20-30 ms. Interestingly, explosion activity increased at West Mata for several months, observed at more distant hydrophone stations, following the September 2009 8.1 Mw Samoan earthquake. The tephra and hydrophone data were only synchronously recorded from January to May 2010, but these data indicate a repeated record of summit explosions followed by down flank debris flows, an important process in the construction of the volcanic edifice. Bathymetric differencing between 2010 and 2011 shows two large negative anomalies at the summit and a broad positive anomaly on the east flank, interpreted as a major slump that removed part of the summit during the final magma withdrawal related to formation of the summit pit crater.

  15. [Smallpox--in the past or not?].

    PubMed

    Kuljić-Kapulica, Nada

    2004-01-01

    Smallpox is a potentially deadly illness caused by the variola virus, an orthopoxvirus. Severe illness followed by blister-like body rash is the sign of smallpox. Smallpox symptoms develop about 12 days after exposure. V. variole can spread very readily by aerosol, which may lead to explosive epidemics. For centuries, smallpox has been a worldwide cause of death, killing about 30% of the infected people. In 1972, the epidemic of smallpox in ex-Yugoslavia was the largest postwar smallpox epidemic in Europe. The total number of the affected was 175, out of whom 35 with fatal outcome, accounting for 20% of mortality. However, after a decade-long vaccination effort, the last natural case of smallpox occurred in 1977. The only way to prevent smallpox epidemic is by vaccination and patients' isolation. The possibility of future bioterrorism attacks, which may cause a new outbreak of smallpox and return variola, is very serious. World population is not immune, because of lack of vaccination. In 1980, the World Health Organization (WHO) declared the disease fully eradicated.

  16. Microcantilever detector for explosives

    DOEpatents

    Thundat, Thomas G.

    1999-01-01

    Methods and apparatus for detecting the presence of explosives by analyzing a vapor sample from the suspect vicinity utilize at least one microcantilever. Explosive gas molecules which have been adsorbed onto the microcantilever are subsequently heated to cause combustion. Heat, along with momentum transfer from combustion, causes bending and a transient resonance response of the microcantilever which may be detected by a laser diode which is focused on the microcantilever and a photodetector which detects deflection of the reflected laser beam caused by heat-induced deflection and resonance response of the microcantilever.

  17. Microcantilever detector for explosives

    DOEpatents

    Thundat, T.G.

    1999-06-29

    Methods and apparatus for detecting the presence of explosives by analyzing a vapor sample from the suspect vicinity utilize at least one microcantilever. Explosive gas molecules which have been adsorbed onto the microcantilever are subsequently heated to cause combustion. Heat, along with momentum transfer from combustion, causes bending and a transient resonance response of the microcantilever which may be detected by a laser diode which is focused on the microcantilever and a photodetector which detects deflection of the reflected laser beam caused by heat-induced deflection and resonance response of the microcantilever. 2 figs.

  18. Suicide in Serbia.

    PubMed

    Ilic, M; Ilic, I

    2016-03-15

    Suicide remains a significant public health problem worldwide. The aim of this study was to assess the mortality trend of suicide in Serbia for the years 1991-2014. Data on persons who died of suicide and self-inflicted injury (site codes E950-E959 revision 9 and X60-X84 revision 10 of the International Classification of Diseases to classify death, injury and cause of death) were obtained from the Statistical Office of the Republic of Serbia. The age standardized rate was calculated by direct method (per 100,000 persons, using Segi's World population as standard population). Average annual percentage change (AAPC) with the corresponding 95% confidence interval (CI) was computed for trend using the joinpoint regression analysis. Total 33,930 (24,016 men and 9914 women) suicide deaths occurred in Serbia during the observed period, with the average annual age-standardized mortality rate being 12.7 per 100,000 inhabitants (19.5 per 100,000 in men and 6.7 per 100,000 in women). Suicide mortality in all age groups was higher among men than women. In both genders, suicide rates were highest in the oldest age group. Significantly decreased trend in suicide mortality was recorded continuously from 1991 to 2014 (AAPC=-1.9%, 95%CI -2.2 to -1.6). The most frequently used suicide method in both genders was hanging, strangulation or suffocation with 61.2% off all suicides. Changes in mortality rates were significant both for suicide by firearms, air guns and explosives (AAPC=-1.5% (AAPC=-1.5% in men and -3.1%-3.1% in women) and for suicide by hanging, strangulation, and suffocation (AAPC=-1.2% (AAPC=-1.2% in men and -3.0%-3.0% in women). In men, nonsignificant increase in suicide by firearms, air guns and explosives observed during the period 1991-1997 (by +6.1% per year) was followed by a significant decrease until 2014 (by -3.1% per year). The significantly increased mortality in suicide by firearms, air guns, and explosives was observed in older men (aged 40-69 years and 80 years and over). The low rate of autopsies in Serbia, as well as the accuracy, reliability and comparability of the suicide mortality data is always a question. Downward trend in suicide mortality occurred in Serbia in last two decades. However, suicide rates are still very high in Serbia compared with the rates of suicides in developed countries. Particularly worrisome is the increase in mortality in older men, especially due to firearm suicides, air rifles, and explosives. Thus, additional efforts in the prevention of suicide are very important. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. 14 CFR 1204.1005 - Unauthorized introduction of firearms or weapons, explosives, or other dangerous materials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... weapons, explosives, or other dangerous materials. 1204.1005 Section 1204.1005 Aeronautics and Space... Weapons or Dangerous Materials § 1204.1005 Unauthorized introduction of firearms or weapons, explosives... or causing to be introduced, or using firearms or other dangerous weapons, explosives or other...

  20. 14 CFR 1204.1005 - Unauthorized introduction of firearms or weapons, explosives, or other dangerous materials.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... weapons, explosives, or other dangerous materials. 1204.1005 Section 1204.1005 Aeronautics and Space... Weapons or Dangerous Materials § 1204.1005 Unauthorized introduction of firearms or weapons, explosives... or causing to be introduced, or using firearms or other dangerous weapons, explosives or other...

  1. 14 CFR 1204.1005 - Unauthorized introduction of firearms or weapons, explosives, or other dangerous materials.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... weapons, explosives, or other dangerous materials. 1204.1005 Section 1204.1005 Aeronautics and Space... Weapons or Dangerous Materials § 1204.1005 Unauthorized introduction of firearms or weapons, explosives... or causing to be introduced, or using firearms or other dangerous weapons, explosives or other...

  2. 14 CFR 1204.1005 - Unauthorized introduction of firearms or weapons, explosives, or other dangerous materials.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... weapons, explosives, or other dangerous materials. 1204.1005 Section 1204.1005 Aeronautics and Space... Weapons or Dangerous Materials § 1204.1005 Unauthorized introduction of firearms or weapons, explosives... or causing to be introduced, or using firearms or other dangerous weapons, explosives or other...

  3. Explosive detonation causes an increase in soil porosity leading to increased TNT transformation.

    PubMed

    Yu, Holly A; Nic Daeid, Niamh; Dawson, Lorna A; DeTata, David A; Lewis, Simon W

    2017-01-01

    Explosives are a common soil contaminant at a range of sites, including explosives manufacturing plants and areas associated with landmine detonations. As many explosives are toxic and may cause adverse environmental effects, a large body of research has targeted the remediation of explosives residues in soil. Studies in this area have largely involved spiking 'pristine' soils using explosives solutions. Here we investigate the fate of explosives present in soils following an actual detonation process and compare this to the fate of explosives spiked into 'pristine' undetonated soils. We also assess the effects of the detonations on the physical properties of the soils. Our scanning electron microscopy analyses reveal that detonations result in newly-fractured planes within the soil aggregates, and novel micro Computed Tomography analyses of the soils reveal, for the first time, the effect of the detonations on the internal architecture of the soils. We demonstrate that detonations cause an increase in soil porosity, and this correlates to an increased rate of TNT transformation and loss within the detonated soils, compared to spiked pristine soils. We propose that this increased TNT transformation is due to an increased bioavailability of the TNT within the now more porous post-detonation soils, making the TNT more easily accessible by soil-borne bacteria for potential biodegradation. This new discovery potentially exposes novel remediation methods for explosive contaminated soils where actual detonation of the soil significantly promotes subsequent TNT degradation. This work also suggests previously unexplored ramifications associated with high energy soil disruption.

  4. Managing traumatic brain injury secondary to explosions.

    PubMed

    Burgess, Paula; E Sullivent, Ernest; M Sasser, Scott; M Wald, Marlena; Ossmann, Eric; Kapil, Vikas

    2010-04-01

    Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI) caused by explosions and bombings. The history, physics, and treatment of TBI are outlined.

  5. Firework Nova

    NASA Image and Video Library

    2015-07-02

    In Hollywood blockbusters, explosions are often among the stars of the show. In space, explosions of actual stars are a focus for scientists who hope to better understand their births, lives, and deaths and how they interact with their surroundings. Using NASA’s Chandra X-ray Observatory, astronomers have studied one particular explosion that may provide clues to the dynamics of other, much larger stellar eruptions. A team of researchers pointed the telescope at GK Persei, an object that became a sensation in the astronomical world in 1901 when it suddenly appeared as one of the brightest stars in the sky for a few days, before gradually fading away in brightness. Today, astronomers cite GK Persei as an example of a “classical nova,” an outburst produced by a thermonuclear explosion on the surface of a white dwarf star, the dense remnant of a Sun-like star.

  6. Managing traumatic brain injury secondary to explosions

    PubMed Central

    Burgess, Paula; E Sullivent, Ernest; M Sasser, Scott; M Wald, Marlena; Ossmann, Eric; Kapil, Vikas

    2010-01-01

    Explosions and bombings are the most common deliberate cause of disasters with large numbers of casualties. Despite this fact, disaster medical response training has traditionally focused on the management of injuries following natural disasters and terrorist attacks with biological, chemical, and nuclear agents. The following article is a clinical primer for physicians regarding traumatic brain injury (TBI) caused by explosions and bombings. The history, physics, and treatment of TBI are outlined. PMID:20606794

  7. Wheelbarrow tire explosion causing trauma to the forearm and hand: a case report

    PubMed Central

    2009-01-01

    Introduction Tire explosion injuries are rare, but they may result in a severe injury pattern. Case reports and statistics from injuries caused by exploded truck tires during servicing are established, but trauma from exploded small tires seems to be unknown. Case presentation A 47-year-old german man inflated a wheelbarrow tire. The tire exploded during inflation and caused an open, multiple forearm and hand injury. Conclusion Even small tires can cause severe injury patterns in the case of an explosion. High inflating pressures and low safety distances are the main factors responsible for this occurrence. Broad safety information and suitable filling devices are indispensable for preventing these occurrences. PMID:19946543

  8. Explosive detonation causes an increase in soil porosity leading to increased TNT transformation

    PubMed Central

    Yu, Holly A.; Nic Daeid, Niamh; Dawson, Lorna A.; DeTata, David A.; Lewis, Simon W.

    2017-01-01

    Explosives are a common soil contaminant at a range of sites, including explosives manufacturing plants and areas associated with landmine detonations. As many explosives are toxic and may cause adverse environmental effects, a large body of research has targeted the remediation of explosives residues in soil. Studies in this area have largely involved spiking ‘pristine’ soils using explosives solutions. Here we investigate the fate of explosives present in soils following an actual detonation process and compare this to the fate of explosives spiked into ‘pristine’ undetonated soils. We also assess the effects of the detonations on the physical properties of the soils. Our scanning electron microscopy analyses reveal that detonations result in newly-fractured planes within the soil aggregates, and novel micro Computed Tomography analyses of the soils reveal, for the first time, the effect of the detonations on the internal architecture of the soils. We demonstrate that detonations cause an increase in soil porosity, and this correlates to an increased rate of TNT transformation and loss within the detonated soils, compared to spiked pristine soils. We propose that this increased TNT transformation is due to an increased bioavailability of the TNT within the now more porous post-detonation soils, making the TNT more easily accessible by soil-borne bacteria for potential biodegradation. This new discovery potentially exposes novel remediation methods for explosive contaminated soils where actual detonation of the soil significantly promotes subsequent TNT degradation. This work also suggests previously unexplored ramifications associated with high energy soil disruption. PMID:29281650

  9. Numerical Simulation on Smoke Spread and Temperature Distribution in a Corn Starch Explosion

    NASA Astrophysics Data System (ADS)

    Lin, CherngShing; Hsu, JuiPei

    2018-01-01

    It is discovered from dust explosion accidents in recent years that deep causes of the accidents lies in insufficient cognition of dust explosion danger, and no understanding on danger and information of the dust explosion. In the study, Fire Dynamics Simulator (FDS) evaluation tool is used aiming at Taiwan Formosa Fun Coast explosion accidents. The calculator is used for rebuilding the explosion situation. The factors affecting casualties under explosion are studied. The injured personnel participating in the party are evaluated according to smoke diffusion and temperature distribution for numerical simulation results. Some problems noted in the fire disaster after actual explosion are proposed, rational site analysis is given, thereby reducing dust explosion risk grade.

  10. [Initial medical management in radiological accidents and nuclear disaster].

    PubMed

    Tanigawa, Koichi

    2012-03-01

    Major radiological emergencies include criticality in nuclear power plants or terrorist attacks using dirty bombs or nuclear device detonation. Because irradiation itself does not cause any immediate death of the victims, and there is a minimum risk of secondary irradiation to medical personnel during decontamination procedures, lifesaving treatments should be prioritized. When a major radiological accident occurs, information is scarce and/or becomes intricate. We might face with significant difficulties in determining the exact culprits of the event, i.e., radiological or chemical or others. Therefore, it is strongly recommended for the national and local governments, related organizations and hospitals to develop comprehensive systems to cope with all hazards(chemical, biological, radiation, nuclear, and explosion) under the common incident command system.

  11. How fast can stellar death throes go?

    NASA Astrophysics Data System (ADS)

    Eldridge, J. J.

    2018-04-01

    Using evolving observing strategies and technologies we are catching supernovae closer and closer to the `b' of the `bang', thus unveiling new types of explosion mechanism that have not been studied in depth before.

  12. Propane tank explosion (2 deaths, 7 injuries) at Herrig Brothers Feather Creek Farm, Albert City, Iowa, April 9, 1998. Investigation report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1999-09-01

    This report explains the explosion/BLEVE that took place on April 9, 1998, at the Herrig Brothers Feather Creek Farm, located in Albert City, Iowa. Two volunteer fire fighters were killed and seven other emergency response personnel were injured. Safety issues covered in the report include protection of propane storage tanks and piping, state regulatory oversight of such installations, and fire fighter response to propane storage tank fires.

  13. Resource recycling technique of abandoned TNT-RDX-AL mixed explosive

    NASA Astrophysics Data System (ADS)

    Chen, Siyang; Ding, Yukui

    2017-08-01

    TNT-RDX-AL mixed explosive is a kind of high energy mixed explosive. It has the detonation characteristics even when reaching the scrapping standard. Inappropriate disposal often causes serious accident. Employing the resource recycling technique, the abandoned TNT-RDX-AL mixed explosive can be recycled. This paper summarized the progress of recycling of abandoned mixed explosive. What's more, three kinds of technological process of resource recycling abandoned TNT-RDX-AL mixed explosives are introduced. The author analysis of the current recovery processes and provided a reference for the recycling of the other same type explosive.

  14. The Impacts of Dust Storm Particles on Human Lung Cells - an Analysis at the Single Cell Level

    NASA Astrophysics Data System (ADS)

    Ardon-Dryer, K.; Mock, C.; Reyes, J.; Lahav, G.

    2017-12-01

    Aerosols particles (Natural and anthropogenic) are a key component of our atmosphere, their presence defines air quality levels and they can affect our health. Small particles penetrate into our lungs and this exposure can cause our lung cells to stress and in some cases leads to the death of the cells and to inflammation. During dust storm events there is an increase in particle concentration, many of them are breathable particles that can penetrate deep into our lungs. Exposure to dust particles can lead to respiratory problems, particularly for people with asthma. Therefore, during and after a dust storm event the number of people who are hospitalized with inflammation and respiratory problems increase. However, the exact mechanism that causes these health problems is still unclear. In this project, we are investigating the impacts that dust storm particles from different sources and of different concentrations (doses) have on human lung cells, performing a new and unique analysis at the single cell level. To accomplish this, each individual lung cell is continuously tracked after being exposed to dust particles. We monitor the behavior of the cell over time, identify the cells time of death and type of death (e.g. cell explosion). With this analysis, we can quantify cell death as a function of dust concertation (doses); to our surprise, an increase in cells death was not observed only as a function of an increase of dust concertation. In addition, we noticed that the way particles come in contact with cells, by sticking to or being engulfed by, and the interaction duration has an effect; cells that interact with dust particles for a longer period died earlier compared to cells with a shorter interaction period. These findings will help us to better understand the health related consequences of exposure to dust storm events and serve as a baseline for when evaluating other aerosol.

  15. Despite Appearances, Cosmic Explosions Have Common Origin, Astronomers Discover

    NASA Astrophysics Data System (ADS)

    2003-11-01

    A Fourth of July fireworks display features bright explosions that light the sky with different colors, yet all have the same cause. They just put their explosive energy into different colors of light. Similarly, astronomers have discovered, a variety of bright cosmic explosions all have the same origin and the same amount of total energy. This is the conclusion of an international team of astronomers that used the National Science Foundation's Very Large Array (VLA) radio telescope to study the closest known gamma-ray burst earlier this year. Artist's conception of burst Artist's Conception of Twin Jets in Energetic Cosmic Explosion CREDIT: Dana Berry, SkyWorks Digital (Click on Image for Larger Version) "For some reason we don't yet understand, these explosions put greatly varying percentages of their explosive energy into the gamma-ray portion of their output," said Dale Frail, of the National Radio Astronomy Observatory (NRAO) in Socorro, NM. That means, he said, that both strong and weak gamma-ray bursts, along with X-ray flashes, which emit almost no gamma rays, are just different forms of the same cosmic beast. The research team reported their results in the November 13 issue of the scientific journal Nature. The scientists trained the VLA on a gamma-ray burst discovered using NASA's HETE-2 satellite last March 29. This burst, dubbed GRB 030329, was the closest such burst yet seen, about 2.6 billion light-years from Earth. Because of this relative proximity, the burst was bright, with visible light from its explosion reaching a level that could be seen in amateur telescopes. As the burst faded, astronomers noted an underlying distinctive signature of a supernova explosion, confirming that the event was associated with the death of a massive star. Since 1999, astronomers have known that the strong outbursts of gamma rays, X-rays, visible light and radio waves from these bursts form beams, like those from a flashlight, rather than spreading in all directions, like light from a bare bulb. The surprising result from the VLA studies of GRB 030329 is that there are two beams, not one. The scientists found that the gamma rays and the early visible-light and X-ray emission were coming from a narrow beam, while the radio waves and later visible-light emission came from another, wider beam. "The strange thing is that some explosions seem to put most of their energy into the narrow beam, while others put most or nearly all their energy into the wider beam," Frail said. "This is telling us something very fundamental about the inner workings that drive these explosions," Frail added. The mechanism producing these explosions is what scientists call a collapsar, which occurs when a giant star collapses of its own weight at the end of its normal, nuclear fusion-powered lifetime. In an ordinary supernova, such a collapse produces a neutron star. A collapsar, however, marks the death of a more-massive star and results in a black hole, a concentration of mass so dense that not even light can escape it. After the black hole forms, its powerful gravitational pull sucks the star's remaining material toward it. This material forms a spinning disk around the black hole that lasts only a few seconds. During that time, the disk ejects material outward from its poles. A jet of material moving at nearly the speed of light emits gamma rays; slower material emits radio waves and visible light. "Despite the differences in how much energy comes out in gamma rays, all these things seem to be caused by the same basic mechanism," said Edo Berger, a graduate student at Caltech and lead author of the Nature paper. "Our observations now give the data that will help us understand what causes the differences," he added. "It was astounding to suddenly realize that these apparently very different cosmic beasts all are really the same thing," said Berger. The next job, Frail said, is to learn if there are, in fact, two jets, or a single jet in which the central part encounters less resistance and thus can move outward at greater speeds. Frail pointed out that the radio observations alone had the ability to show the total energy output of the burst, thus providing the breakthrough in understanding the common thread among the different types of explosions. "The key fact is that the optical, X-Ray and gamma-ray telescopes missed 90 percent of the energy put out by this burst," Frail added. "As the VLA Expansion Project progresses and the sensitivity of the VLA improves in the coming years, it will become an even more important tool in unravelling this mystery," Frail said. "The exciting part of this new discovery is that explosions that we once thought were quite different now appear to all have a common origin," Frail concluded. "That insight, of course, gives us the new challenge of explaining how a single mechanism can make itself look so different," he added. In addition to Berger and Frail, the other authors of the paper are Professor Shri Kulkarni of Caltech; Guy Pooley of Cambridge University's Mullard Radio Astronomy Observatory; Vince McIntyre and Robin Wark, both of the Australia Telescope National Facility; Re'em Sari, associate professor of astrophysics and planetary science at Caltech; Derek Fox, a postdoctoral scholar in astronomy at Caltech; Alicia Soderberg, a graduate student in astrophysics at Caltech; Sarah Yost, a graduate student in physics at Caltech; and Paul Price, a postdoctoral scholar at the University of Hawaii's Institute for Astronomy. Berger and Soderberg earlier worked on gamma-ray-burst studies as summer students at NRAO. The National Radio Astronomy Observatory is a facility of the National Science Foundation, operated under cooperative agreement by Associated Universities, Inc.

  16. Injury and death during the ISIS occupation of Mosul and its liberation: Results from a 40-cluster household survey.

    PubMed

    Lafta, Riyadh; Al-Nuaimi, Maha A; Burnham, Gilbert

    2018-05-01

    Measurement of mortality and injury in conflict situations presents many challenges compared with stable situations. However, providing information is important to assess the impact of conflict on populations and to estimate humanitarian needs, both in the immediate and longer term. Mosul, Iraq's second largest city, was overrun by fighters of the Islamic State of Iraq and Syria (ISIS) on June 4, 2014. In this study, we conducted household surveys to measure reported deaths, injuries, and kidnappings in Mosul, Iraq, both during the occupation of the city by fighters of ISIS and the months of Iraqi military action known as the liberation. Mosul was overrun by ISIS forces on June 4, 2014, and was under exclusive ISIS control for 29 months. The military offensive by Iraqi forces, supported by coalition artillery and airstrikes, began on October 17, 2016, in east Mosul and concluded in west Mosul with the defeat of ISIS on June 29, 2017. We conducted a 40-cluster population-based survey as soon as the security forces permitted access for the survey team. The objective of the survey was to measure reported deaths, injuries, and kidnappings in Mosul households during 29 months of ISIS-exclusive control (June 2014-October 2016) and the nine months of Iraqi military action known as the liberation (October 2016-June 2017). In east Mosul, the survey was conducted from March 23 to March 31, 2017, and in west Mosul from July 18 to July 31, 2017. Sampling was based on pre-ISIS population distribution, with revisions made following the extensive destruction in west Mosul. The 1,202 sampled households included 7,559 persons: 4,867 in east Mosul and 2,692 in west Mosul. No households declined to participate. During the time from June 4, 2014, to the time of the survey, there were 628 deaths reported from the sampled households, of which 505 were due to intentional violence, a mortality rate of 2.09 deaths per 1,000 person-months. Over the entire time period, the group with the highest mortality rates from intentional violence was adults aged 20 to 39: 1.69 deaths per 1,000 person-months among women and 3.55 among men. In the 29 months of ISIS-exclusive control, mortality rates among all males were 0.71 reported deaths per 1,000 person-months and for all females were 0.50 deaths per 1,000 person-months. During the nine months of the military liberation, the mortality rates jumped to 13.36 deaths per 1,000 person-months for males and 8.33 for females. The increase was particularly dramatic in west Mosul. The leading cause of reported deaths from intentional violence was airstrikes-accounting for 201 civilian deaths-followed by 172 deaths from explosions. Reported deaths from airstrikes were most common in west Mosul, while reported deaths from explosions were similar on both sides of Mosul. Gunshots accounted for 86 cases, predominantly in west Mosul where ISIS snipers were particularly active. There were 35 persons who were reported to have been kidnapped, almost entirely prior to the military offensive. By the time of the survey, 20 had been released, 8 were dead, and 7 still missing, according to household reports. Almost all of the 223 injuries reported were due to intentional violence. Limitations to population-based surveys include a probable large survivor bias, the reliance on preconflict population distribution figures for sampling, and potential recall bias among respondents. Death and injuries during the military offensive to liberate Mosul considerably exceeded those during ISIS occupation. Airstrikes were the major reported cause of deaths, with the majority occurring in west Mosul. The extensive use of airstrikes and heavy artillery risks an extensive loss of life in densely populated urban areas. The high probability of survivor bias in this survey suggests that the actual number of injuries, kidnappings, and deaths in the neighborhoods sampled is likely to be higher than we report here.

  17. Supernova Dust Factory in M74

    NASA Image and Video Library

    2006-06-09

    Astronomers using NASA Spitzer Space Telescope have spotted a dust factory 30 million light-years away in the spiral galaxy M74. The factory is located at the scene of a massive star explosive death, or supernova.

  18. Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions

    PubMed Central

    Paley, Grace L.; Echalier, Elizabeth; Eck, Thomas W.; Hong, Augustine R.; Gregory, Darren G.; Lubniewski, Anthony J.

    2016-01-01

    Purpose: To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. Methods: Case series. Results: We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries. Conclusions: Given these cases and the number of recent media reports, ECs pose a significant public health risk. Users should be warned regarding the possibility of severe injury, including sight-threatening ocular injuries ranging from corneal burns to full-thickness corneoscleral laceration. PMID:27191672

  19. TIMING OF SHOCK WAVES

    DOEpatents

    Tuck, J.L.

    1955-03-01

    This patent relates to means for ascertaining the instant of arrival of a shock wave in an exploslve charge and apparatus utilizing this means to coordinate the timing of two operations involving a short lnterval of time. A pair of spaced electrodes are inserted along the line of an explosive train with a voltage applied there-across which is insufficient to cause discharge. When it is desired to initiate operation of a device at the time the explosive shock wave reaches a particular point on the explosive line, the device having an inherent time delay, the electrodes are located ahead of the point such that the ionization of the area between the electrodes caused by the traveling explosive shock wave sends a signal to initiate operation of the device to cause it to operate at the proper time. The operated device may be photographic equipment consisting of an x-ray illuminating tube.

  20. Injury and death during the ISIS occupation of Mosul and its liberation: Results from a 40-cluster household survey

    PubMed Central

    Lafta, Riyadh; Al-Nuaimi, Maha A.

    2018-01-01

    Background Measurement of mortality and injury in conflict situations presents many challenges compared with stable situations. However, providing information is important to assess the impact of conflict on populations and to estimate humanitarian needs, both in the immediate and longer term. Mosul, Iraq’s second largest city, was overrun by fighters of the Islamic State of Iraq and Syria (ISIS) on June 4, 2014. In this study, we conducted household surveys to measure reported deaths, injuries, and kidnappings in Mosul, Iraq, both during the occupation of the city by fighters of ISIS and the months of Iraqi military action known as the liberation. Methods and findings Mosul was overrun by ISIS forces on June 4, 2014, and was under exclusive ISIS control for 29 months. The military offensive by Iraqi forces, supported by coalition artillery and airstrikes, began on October 17, 2016, in east Mosul and concluded in west Mosul with the defeat of ISIS on June 29, 2017. We conducted a 40-cluster population-based survey as soon as the security forces permitted access for the survey team. The objective of the survey was to measure reported deaths, injuries, and kidnappings in Mosul households during 29 months of ISIS-exclusive control (June 2014–October 2016) and the nine months of Iraqi military action known as the liberation (October 2016–June 2017). In east Mosul, the survey was conducted from March 23 to March 31, 2017, and in west Mosul from July 18 to July 31, 2017. Sampling was based on pre-ISIS population distribution, with revisions made following the extensive destruction in west Mosul. The 1,202 sampled households included 7,559 persons: 4,867 in east Mosul and 2,692 in west Mosul. No households declined to participate. During the time from June 4, 2014, to the time of the survey, there were 628 deaths reported from the sampled households, of which 505 were due to intentional violence, a mortality rate of 2.09 deaths per 1,000 person-months. Over the entire time period, the group with the highest mortality rates from intentional violence was adults aged 20 to 39: 1.69 deaths per 1,000 person-months among women and 3.55 among men. In the 29 months of ISIS-exclusive control, mortality rates among all males were 0.71 reported deaths per 1,000 person-months and for all females were 0.50 deaths per 1,000 person-months. During the nine months of the military liberation, the mortality rates jumped to 13.36 deaths per 1,000 person-months for males and 8.33 for females. The increase was particularly dramatic in west Mosul. The leading cause of reported deaths from intentional violence was airstrikes—accounting for 201 civilian deaths—followed by 172 deaths from explosions. Reported deaths from airstrikes were most common in west Mosul, while reported deaths from explosions were similar on both sides of Mosul. Gunshots accounted for 86 cases, predominantly in west Mosul where ISIS snipers were particularly active. There were 35 persons who were reported to have been kidnapped, almost entirely prior to the military offensive. By the time of the survey, 20 had been released, 8 were dead, and 7 still missing, according to household reports. Almost all of the 223 injuries reported were due to intentional violence. Limitations to population-based surveys include a probable large survivor bias, the reliance on preconflict population distribution figures for sampling, and potential recall bias among respondents. Conclusions Death and injuries during the military offensive to liberate Mosul considerably exceeded those during ISIS occupation. Airstrikes were the major reported cause of deaths, with the majority occurring in west Mosul. The extensive use of airstrikes and heavy artillery risks an extensive loss of life in densely populated urban areas. The high probability of survivor bias in this survey suggests that the actual number of injuries, kidnappings, and deaths in the neighborhoods sampled is likely to be higher than we report here. PMID:29763433

  1. Front to back ocular injury from a vaping-related explosion.

    PubMed

    Khairudin, Muhammad Najmi; Mohd Zahidin, Aida Zairani; Bastion, Mae-Lynn Catherine

    2016-04-05

    We describe a case of extensive ocular injury secondary to an electronic cigarette (e-cigarette)-related explosion. The explosion was the result of modifications made to a heating element of the e-cigarette device by a non-professional. Extensive ocular injuries that result from an explosion of an e-cigarette device can potentially cause significant and permanent visual impairment. 2016 BMJ Publishing Group Ltd.

  2. A Supernova Shockwaves

    NASA Image and Video Library

    2007-06-13

    Supernovae are the explosive deaths of the universe most massive stars. This false-color composite from NASA Spitzer Space Telescope and NASA Chandra X-ray Observatory shows the remnant of N132D, the wispy pink shell of gas at center.

  3. Injuries from combat explosions in Iraq: injury type, location, and severity.

    PubMed

    Eskridge, Susan L; Macera, Caroline A; Galarneau, Michael R; Holbrook, Troy L; Woodruff, Susan I; MacGregor, Andrew J; Morton, Deborah J; Shaffer, Richard A

    2012-10-01

    Explosions have caused a greater percentage of injuries in Iraq and Afghanistan than in any other large-scale conflict. Improvements in body armour and field medical care have improved survival and changed the injury profile of service personnel. This study's objective was to determine the nature, body region, and severity of injuries caused by an explosion episode in male service personnel. A descriptive analysis was conducted of 4623 combat explosion episodes in Iraq between March 2004 and December 2007. The Barell matrix was used to describe the nature and body regions of injuries due to a combat explosion. A total of 17,637 International Classification of Diseases, Ninth Revision (ICD-9) codes were assigned to the 4623 explosion episodes, with an average of 3.8 ICD-9 codes per episode. The most frequent single injury type was a mild traumatic brain injury (TBI; 10.8%). Other frequent injuries were open wounds in the lower extremity (8.8%) and open wounds of the face (8.2%), which includes tympanic membrane rupture. The extremities were the body regions most often injured (41.3%), followed by head and neck (37.4%) and torso (8.8%). The results of this study support previous observations of TBI as a pre-eminent injury of the wars in Iraq and Afghanistan, with mild TBI as the most common single injury in this large cohort of explosion episodes. The extremities had the highest frequency of injuries for any one body region. The majority of the explosion episodes resulted in more than one injury, and the variety of injuries across nearly every body region and injury type suggests a complex nature of explosion injuries. Understanding the constellation of injuries commonly caused by explosions will assist in the mitigation, treatment, and rehabilitation of the effects of these injuries. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Escherichia coli O104:H4 Pathogenesis: an Enteroaggregative E. coli/Shiga Toxin-Producing E. coli Explosive Cocktail of High Virulence.

    PubMed

    Navarro-Garcia, Fernando

    2014-12-01

    A major outbreak caused by Escherichia coli of serotype O104:H4 spread throughout Europe in 2011. This large outbreak was caused by an unusual strain that is most similar to enteroaggregative E. coli (EAEC) of serotype O104:H4. A significant difference, however, is the presence of a prophage encoding the Shiga toxin, which is characteristic of enterohemorrhagic E. coli (EHEC) strains. This combination of genomic features, associating characteristics from both EAEC and EHEC, represents a new pathotype. The 2011 E. coli O104:H4 outbreak of hemorrhagic diarrhea in Germany is an example of the explosive cocktail of high virulence and resistance that can emerge in this species. A total of 46 deaths, 782 cases of hemolytic-uremic syndrome, and 3,128 cases of acute gastroenteritis were attributed to this new clone of EAEC/EHEC. In addition, recent identification in France of similar O104:H4 clones exhibiting the same virulence factors suggests that the EHEC O104:H4 pathogen has become endemically established in Europe after the end of the outbreak. EAEC strains of serotype O104:H4 contain a large set of virulence-associated genes regulated by the AggR transcription factor. They include, among other factors, the pAA plasmid genes encoding the aggregative adherence fimbriae, which anchor the bacterium to the intestinal mucosa (stacked-brick adherence pattern on epithelial cells). Furthermore, sequencing studies showed that horizontal genetic exchange allowed for the emergence of the highly virulent Shiga toxin-producing EAEC O104:H4 strain that caused the German outbreak. This article discusses the role these virulence factors could have in EAEC/EHEC O104:H4 pathogenesis.

  5. Risk assessment for stonecutting enterprises Accidental risks in the course of petroleum production and stone extraction

    NASA Astrophysics Data System (ADS)

    Aleksandrova, A. J.; Timofeeva, S. S.

    2018-01-01

    The paper is devoted to the assessment of accidental risks occurring at the works engaged in stone extracting and petroleum production. Two basic kinds of accidents common for stone extracting and petroleum production have been chosen to be discussed in the part under consideration. The most dangerous accidental situation characteristic for a stone milling line is an unsanctioned explosion, UE, of blasting agents used for the development of stone deposits. The analysis of a risk occurrence in certain accidental situations is to be carried out. With reference to petroleum extraction, a combustibles and lubricants (C & L) explosion is the most dangerous of characteristic accidental situations. To reveal the most probable causes of accidental situations to be realized, a graph of cause and effect relations has been constructed for each of the accidental situations most probable causes to real situation of an accident. Disasters of a natural origin are the most probable causes of unsanctioned explosions at the deposits of stone raw materials. Technology related natural disasters are the most probable causes of unsanctioned explosions to be realized at multiple well platforms engaged in petroleum production.

  6. Explosively pumped laser light

    DOEpatents

    Piltch, Martin S.; Michelotti, Roy A.

    1991-01-01

    A single shot laser pumped by detonation of an explosive in a shell casing. The shock wave from detonation of the explosive causes a rare gas to luminesce. The high intensity light from the gas enters a lasing medium, which thereafter outputs a pulse of laser light to disable optical sensors and personnel.

  7. 10 CFR 36.69 - Irradiation of explosive or flammable materials.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Irradiation of explosive or flammable materials. 36.69... IRRADIATORS Operation of Irradiators § 36.69 Irradiation of explosive or flammable materials. (a) Irradiation... cause radiation overexposures of personnel. (b) Irradiation of more than small quantities of flammable...

  8. 10 CFR 36.69 - Irradiation of explosive or flammable materials.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Irradiation of explosive or flammable materials. 36.69... IRRADIATORS Operation of Irradiators § 36.69 Irradiation of explosive or flammable materials. (a) Irradiation... cause radiation overexposures of personnel. (b) Irradiation of more than small quantities of flammable...

  9. 10 CFR 36.69 - Irradiation of explosive or flammable materials.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Irradiation of explosive or flammable materials. 36.69... IRRADIATORS Operation of Irradiators § 36.69 Irradiation of explosive or flammable materials. (a) Irradiation... cause radiation overexposures of personnel. (b) Irradiation of more than small quantities of flammable...

  10. 10 CFR 36.69 - Irradiation of explosive or flammable materials.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Irradiation of explosive or flammable materials. 36.69... IRRADIATORS Operation of Irradiators § 36.69 Irradiation of explosive or flammable materials. (a) Irradiation... cause radiation overexposures of personnel. (b) Irradiation of more than small quantities of flammable...

  11. 10 CFR 36.69 - Irradiation of explosive or flammable materials.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Irradiation of explosive or flammable materials. 36.69... IRRADIATORS Operation of Irradiators § 36.69 Irradiation of explosive or flammable materials. (a) Irradiation... cause radiation overexposures of personnel. (b) Irradiation of more than small quantities of flammable...

  12. ONE-DIMENSIONAL TIME TO EXPLOSION (THERMAL SENSITIVITY) TESTS ON PETN, PBX-9407, LX-10, AND LX-17

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hsu, Peter C.; Strout, Steve; McClelland, Matthew

    Incidents caused by fire and combat operations can heat energetic materials that may lead to thermal explosion and result in structural damage and casualty. Some explosives may thermally explode at fairly low temperatures (< 100 C) and the violence from thermal explosion may cause a significant damage. Thus it is important to understand the response of energetic materials to thermal insults. The One Dimensional Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory has been used for decades to measure times to thermal explosion, threshold thermal explosion temperature, and determine the kinetic parameters of thermal decomposition of energeticmore » materials. Samples of different configurations (pressed part, powder, paste, and liquid) can be tested in the system. The ODTX testing can also provide useful data for assessing the thermal explosion violence of energetic materials. This report summarizes the results of our recent ODTX experiments on PETN powder, PBX-9407 pressed part, LX-10 pressed part, LX-17 pressed part and compares the test data that were obtained decades ago with the older version of ODTX system. Test results show the thermal sensitivity of various materials tested in the following order: PETN> PBX-9407 > LX-10 > LX-17.« less

  13. The acoustic field in the ionosphere caused by an underground nuclear explosion

    NASA Astrophysics Data System (ADS)

    Krasnov, V. M.; Drobzheva, Ya. V.

    2005-07-01

    The problem of describing the generation and propagation of an infrasonic wave emitted by a finite extended source in the inhomogeneous absorbing atmosphere is the focus of this paper. It is of interest since the role of infrasonic waves in the energy balance of the upper atmosphere remains largely unknown. We present an algorithm, which allows adaptation of a point source model for calculating the infrasonic field from an underground nuclear explosion at ionospheric altitudes. Our calculations appear to agree remarkably well with HF Doppler sounding data measured for underground nuclear explosions at the Semipalatinsk Test Site. We show that the temperature and ionospheric electron density perturbation caused by an acoustic wave from underground nuclear explosion can reach 10% of background levels.

  14. Toxicity of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) in three vertebrate species.

    PubMed

    Johnson, Mark S; McFarland, Craig A; Bazar, Matthew A; Quinn, Michael J; LaFiandra, Emily May; Talent, Larry G

    2010-04-01

    The explosive, octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine or high-melting explosive (HMX), has been found in soils in areas used for testing and training by the military. Many of these areas contain habitat for valued wildlife species. In an effort to better understand the environmental consequences from exposure, a reptilian (western fence lizard [Sceloporus occidentalis]), an amphibian (red-backed salamander [Plethodon cinereus]), and a mammalian species (rabbit [Oryctolagus cuniculus]) were exposed to HMX under controlled laboratory conditions. Lizards and rabbits were exposed to HMX by way of corn oil through gavage, and salamanders were exposed to HMX in soil. Two deaths occurred from acute oral exposures to lizards to 5000 mg HMX/kg BW. Histological and gross pathologic assessment suggested gut impaction as a possible cause of death. Salamanders exposed to concentrations of HMX in soil < or = 1970 mg HMX/kg soil for 10 days did not show adverse effects. Rabbits, however, showed neurologic effects manifested as hyperkinetic events with convulsions at > 24 h after oral exposures. An LD(50) for rabbits was calculated as 93 mg/kg (95% confidence interval 76-117). A subacute 14-day testing regime found a lowest observed effect level of 10 mg/kg-d and a no observed adverse effect level of 5 mg/kg-d based on hyperkinesia and seizure incidence, although changes suggesting functional hepatic alterations were also found. These data suggest that physiologic differences between species, particularly in gastrointestinal structure and function, can affect the absorption of HMX and hence lead to marked differences in toxicity from exposure to the same compound.

  15. Pipeline monitoring with unmanned aerial vehicles

    NASA Astrophysics Data System (ADS)

    Kochetkova, L. I.

    2018-05-01

    Pipeline leakage during transportation of combustible substances leads to explosion and fire thus causing death of people and destruction of production and accommodation facilities. Continuous pipeline monitoring allows identifying leaks in due time and quickly taking measures for their elimination. The paper describes the solution of identification of pipeline leakage using unmanned aerial vehicles. It is recommended to apply the spectral analysis with input RGB signal to identify pipeline damages. The application of multi-zone digital images allows defining potential spill of oil hydrocarbons as well as possible soil pollution. The method of multi-temporal digital images within the visible region makes it possible to define changes in soil morphology for its subsequent analysis. The given solution is cost efficient and reliable thus allowing reducing timing and labor resources in comparison with other methods of pipeline monitoring.

  16. The Study of the Relationship between Probabilistic Design and Axiomatic Design Methodology. Volume 3

    NASA Technical Reports Server (NTRS)

    Onwubiko, Chin-Yere; Onyebueke, Landon

    1996-01-01

    Structural failure is rarely a "sudden death" type of event, such sudden failures may occur only under abnormal loadings like bomb or gas explosions and very strong earthquakes. In most cases, structures fail due to damage accumulated under normal loadings such as wind loads, dead and live loads. The consequence of cumulative damage will affect the reliability of surviving components and finally causes collapse of the system. The cumulative damage effects on system reliability under time-invariant loadings are of practical interest in structural design and therefore will be investigated in this study. The scope of this study is, however, restricted to the consideration of damage accumulation as the increase in the number of failed components due to the violation of their strength limits.

  17. Medical aspects of the Iraqi missile attacks on Israel.

    PubMed

    Karsenty, E; Shemer, J; Alshech, I; Cojocaru, B; Moscovitz, M; Shapiro, Y; Danon, Y L

    1991-01-01

    During the period 18 January-28 February 1991, a total of 39 Iraqi modified Scud missiles landed in Israel, most of them in the densely populated Tel Aviv area. There were 23 missile attack alerts. These attacks caused 1,059 cases of injury; there were two deaths and 232 patients were admitted to emergency rooms for injuries directly related to the explosions, only one of which was severe. A survey among 91 of the injured showed that 46.6% of the wounds were caused by glass splinters, 31.1% were blunt contusions, and 22.2% were acute psychological reactions. No case of blast injury was reported. Inappropriate injection of atropine was reported in 230 cases. Acute anxiety was the reason for admission of 544 patients to emergency rooms. Another 40 patients sustained various traumas while rushing to the sealed room. The relatively low number of injured people is striking in view of the density of population in the areas hit. Various explanations are discussed.

  18. System for fracturing an underground geologic formation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mace, Jonathan L.; Tappan, Bryce C.; Seitz, Gerald J.

    2017-03-14

    An explosive system for fracturing an underground geologic formation adjacent to a wellbore can comprise a plurality of explosive units comprising an explosive material contained within the casing, and detonation control modules electrically coupled to the plurality of explosive units and configured to cause a power pulse to be transmitted to at least one detonator of at least one of the plurality of explosive units for detonation of the explosive material. The explosive units are configured to be positioned within a wellbore in spaced apart positions relative to one another along a string with the detonation control modules positioned adjacentmore » to the plurality of explosive units in the wellbore, such that the axial positions of the explosive units relative to the wellbore are at least partially based on geologic properties of the geologic formation adjacent the wellbore.« less

  19. Causes of death in US Special Operations Forces in the global war on terrorism: 2001-2004.

    PubMed

    Holcomb, John; Caruso, James; McMullin, Neil; Wade, Charles E; Pearse, Lisa; Oetjen-Gerdes, Lynne; Champion, Howard R; Lawnick, Mary; Farr, Warner; Rodriguez, Sammy; Butler, Frank

    2007-01-01

    Effective combat trauma management strategies depend on an understanding of the epidemiology of death on the battlefield, resulting in evidence-based equipment, training, and research requirements. All Special Operations Forces (SOF) fatalities (combat and noncombat) in Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) from October 2001 until November 2004 were reviewed. All available autopsy and treatment records and photographs were used. In most cases, the immediate tactical situation was unknown. The review was performed by a multidisciplinary group including forensic pathologists, an SOF combat medic, and trauma surgeons. Fatalities were classified as having wounds that were either nonsurvivable or potentially survivable with existing training, equipment, and expertise on the battlefield. A structured review was performed evaluating the need for new equipment, training, or research requirements. Results were compared to autopsy data from Vietnam and modern civilian trauma center data. The study was approved by the Institutional Review Boards of the Armed Forces Institute of Pathology and the US Army Institute of Surgical Research. During the study period, 82 SOF fatalities were identified. Autopsies were performed on 77 Soldiers. Five casualties died secondary to aircraft crash, their bodies were not recovered from the ocean. For the purposes of this study they were considered nonsurvivable. Eighty-five percent (n = 70) of the fatalities sustained wounds that were nonsurvivable, while the remaining 15% (n = 12) had wounds that were potentially survivable. Injury Severity Score (ISS) was higher in the nonsurvivable group (p < 0.05). Truncal hemorrhage accounted for 47% of deaths while extremity hemorrhage accounted for 33%. One casualty was noted at autopsy to have a tension pneumothorax as well as multiple sources of internal hemorrhage, one suffered an airway death, while another died of sepsis 56 days after injury. Of those casualties deemed to be nonsurvivable, there were 31 patients with 40 Abbreviated Injury Score (AIS) 6 injuries (p = .0011), and 53 patients with 104 AIS 5 injuries. Among the 12 deaths deemed to be potentially survivable, there were only 8 AIS 5 injuries. Deaths were largely caused by explosions (n = 35), gunshot wounds (n = 23), and aircraft accidents (n = 19). No new training or equipment needs were identified for 53% of the potentially survivable deaths while improved methods of truncal hemorrhage control need to be developed for the remainder. The review panel concluded that 85% of the deaths would not have been prevented at a civilian Level I facility. Available records, in most cases, did not contain information about the use of body armor, time to death after injury, or the ongoing tactical situation. The majority of deaths on the modern battlefield are nonsurvivable. Current results are not different from previous conflicts. In Vietnam, reported potentially preventable death rates range from 5% to 35% and civilian data reports potentially preventable death rates ranging from 12% to 22%. Military munitions cause multiple lethal injuries. Current trauma training and equipment is sufficient to care for 53% of the potentially survivable deaths. Improved methods of intravenous or intracavitary noncompressible hemostasis combined with rapid surgery are required for the remaining 47% of the decedents.

  20. Wireless sensor for detecting explosive material

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lamberti, Vincent E; Howell, Jr., Layton N; Mee, David K

    Disclosed is a sensor for detecting explosive devices. The sensor includes a ferromagnetic metal and a molecular recognition reagent coupled to the ferromagnetic metal. The molecular recognition reagent is operable to expand upon absorption of vapor from an explosive material such that the molecular recognition reagent changes a tensile stress upon the ferromagnetic metal. The explosive device is detected based on changes in the magnetic switching characteristics of the ferromagnetic metal caused by the tensile stress.

  1. Concern About Petrochemical Health Risk Before and After a Refinery Explosion

    PubMed Central

    Cutchin, Malcolm P.; Martin, Kathryn Remmes; Owen, Steven V.; Goodwin, James S.

    2014-01-01

    On March 23, 2005, a large explosion at an oil refinery in Texas City, Texas caused 15 deaths and approximately 170 injuries. Little is known about how such an industrial accident influences concern about environmental health risks. We used measures of environmental health concern about nearby petrochemical production with a sample of Texas City residents to understand patterns of concern and change in concern after an industrial accident, as well as individual and contextual factors associated with those patterns. Survey interviews with residents of Texas City, Texas (N =315) both pre- and postexplosion using a brief Concern About Petrochemical Health Risk Scale (CAPHRS) and other questions were used to collect pertinent predictor information. CAPHRS baseline, postexplosion, and change scores were compared and modeled using ordinary least squares (OLS) regression and a mixed model. Higher preexplosion CAPHRS scores were predicted by younger adults, foreign-born Hispanics, non-Hispanic blacks, lower- and middle-income groups, and those who live with someone who has worked at the petrochemical plants. Higher CAPHRS change scores are predicted by the same variables (except income), as well as proximity to, or perception of, the explosion, and reports of neighborhood damage. Findings suggest these groups’ concern scores could indicate a greater vulnerability to psychological and physical harm generated by concern and stress arising from local petrochemical activities. A clearer understanding of concern about actual environmental health risks in exposed populations may enhance the evolving theory of stress and coping and eventually enable public health professionals to develop appropriate mitigation strategies. PMID:18643817

  2. Preliminary analysis of facial hair follicle distribution for forensic identification using OCT

    NASA Astrophysics Data System (ADS)

    Zhang, Ning; Wang, Chengming; Li, Zhigang; Xie, Lanchi; Guo, Jingjing; Xu, Lei; Yan, Yuwen; Li, Zhihui; Huang, Wei; Xu, Xiaojing

    2018-02-01

    In most deaths caused by explosions, the fragment of explosive remained on the victim's body can provide valuable clues to forensic investigation. However, the examination of the skin and appendages at the scene of explosion, which may reveal clue to the identity of an individual, has not been extensively studied. Compared with visual appearance of the epidermis surface that affected by various wounds, skin adnexa embedded in the dermis has a more stable morphology as an inner biometric. Hair follicles are formed when a fetus is 5 months old and distributed fairly evenly throughout the body, with the exception of hairless palms and soles. Therefore, we focus on the distribution of hair follicles in order to infer information of age, gender, and race/ethnicity. Optical coherence tomography (OCT) is a novel forensic imaging method, which achieves non-destructive, high-resolution and most importantly cross-sectional imaging. In this study, we design and develop a custom-built spectral-domain three-dimensional (3D) OCT system with a portable handheld probe to detect and reconstruct the hair follicles in the facial skin. We test our system on the forehead and preauricular skin of 2 adult volunteers and demonstrate the high quality visualization of hair follicles beneath the epidermis. The diameter, orientation, density and shape of hair follicles can be extracted from the 3D volume data. The preliminary analysis suggests that these parameters vary from different part of body and have individual difference. Eventually, we believe 3D OCT is promising tool for the examination of hair follicles for forensic purpose.

  3. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    In fiscal 1982, the mine safety record improved in several categories over the previous year, but declined in others. There were 220 mining deaths in fiscal year 1982 compared to 222 fatalities in 1981. In coal mining, there were 160 fatalities in fiscal 1982 compared with 131 the previous year. In metal and nonmetal mining in fiscal 1982, there were 60 fatalities, compared to 91 deaths recorded in fiscal 1981. In coal mining, the fatality rate, which factors in employment variations, was .07 per 200,000 employee-hours worked in fiscal 1982 compared to a .06 rate during the previous year. Inmore » metal and nonmetal mining, the fatality rate per 200,000 employee-hours was .04 in fiscal 1982 compared with .03 the previous year. In both industries, the rates of all injuries declined. On Dec. 7, 1981, an underground coal mine dust explosion took the lives of eight miners at the Adkins Coal Co,'s No. 11 mine at Kite, Knott County, KY. A day later, Dec. 8, 1981, an underground coal mine explosion killed 13 miners at Grundy Mining Co.'s No. 21 mine at Whitwell, Marion County, Tenn. During the following month, on Jan. 20, 1982, another coal mine dust explosion killed seven underground coal miners at the RFH mine in Craynor, Floyd County, KY. 7 figs., 33 tabs.« less

  4. Challenges of the Scientific Age

    ERIC Educational Resources Information Center

    Rabinowitch, Eugene

    1973-01-01

    The author, who was working on this article at the time of his death, expresses his views on the energy crisis and the problems of environmental pollution associated with it. In his estimation, both problems are products of the population explosion. (Editor/JR)

  5. Explosion in boiler closes Arkansas utility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1993-08-23

    A major boiler explosion Aug. 11 that seriously injured one worker at the Independence Unit 2 coal-fired powerplant in Newark, Ark., caused extensive damage that will keep the plant closed for several months. The plant is owned by Arkansas Power Light Co., Little Rock. Officials are still trying to determine cause and are assessing damage, though they expect the boiler can be repaired. Etienne Senac, plant manager, says the explosion [open quotes]puffed out[close quotes] but did not rupture the 271-ft-tall boiler and also buckled several buck stays, which hold the boiler to a steel superstructure. The accident took place atmore » 8:30 a.m. as the 842-Mw unit was operating close to full capacity. Senac says the concussion knocked down workers standing 50 ft from the boiler. The explosion pushed ash and molten material out of the bottom of the unit, causing a small fire. One contract worker was seriously burned and hospitalized. Four AP L workers received minor burns.« less

  6. Successful management of esophageal perforation diagnosed 3 days after injury caused by an explosion in the workplace: report of a case.

    PubMed

    Sawada, Shigeaki; Kusama, Akio; Shimakage, Naohiro; Tanabe, Tadashi; Okamura, Takanao; Uchida, Katsuyuki; Tsukada, Kazuhiro; Tajima, Kenzo

    2006-01-01

    We report a case of esophageal perforation caused by an explosion, but which was not diagnosed until 3 days after the injury. A 53-year-old worker sustained superficial dermal burns to his trachea, face, neck, and legs during an explosion. The burns were treated conservatively at a local hospital, but he was transferred to our hospital 3 days after the injury, when mediastinal emphysema and bilateral pleural effusion became evident. An esophagogram followed by computed tomography showed an esophageal perforation caused by the blast injury, and we performed an esophagectomy with recontruction of the gastric tube. After the operation, an X-ray showed a foreign body in the lower abdomen, which we found in the upper thoracic esophagus on the day of injury. We surmised that the patient had inadvertently swallowed a foreign body, which had been heated and scattered by the explosion, and it had melted the upper thoracic esophagus.

  7. Totally confined explosive welding

    NASA Technical Reports Server (NTRS)

    Bement, L. J. (Inventor)

    1978-01-01

    The undesirable by-products of explosive welding are confined and the association noise is reduced by the use of a simple enclosure into which the explosive is placed and in which the explosion occurs. An infrangible enclosure is removably attached to one of the members to be bonded at the point directly opposite the bond area. An explosive is completely confined within the enclosure at a point in close proximity to the member to be bonded and a detonating means is attached to the explosive. The balance of the enclosure, not occupied by explosive, is filled with a shaped material which directs the explosive pressure toward the bond area. A detonator adaptor controls the expansion of the enclosure by the explosive force so that the enclosure at no point experiences a discontinuity in expansion which causes rupture. The use of the technique is practical in the restricted area of a space station.

  8. Seismic Energy Generation and Partitioning into Various Regional Phases from Different Seismic Sources in the Middle East Region

    DTIC Science & Technology

    2007-09-20

    phases. The power law parameter values were found to be in close agreement with the constants for nuclear explosions in Nevada and chemical explosions in...caused by the difference of lithostatic pressures between top and bottom of a vertical cylindrical explosive source, typical for borehole chemical ...NORSAR recorded several decoupled chemical explosions in large chambers of underground mines in Sweden (Stevens et al., 2003), however a reference

  9. Injuries, Death, and Disability Associated with 11 Years of Conflict in Baghdad, Iraq: A Randomized Household Cluster Survey.

    PubMed

    Lafta, Riyadh; Al-Shatari, Sahar; Cherewick, Megan; Galway, Lindsay; Mock, Charles; Hagopian, Amy; Flaxman, Abraham; Takaro, Tim; Greer, Anna; Kushner, Adam; Burnham, Gilbert

    2015-01-01

    The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad. Using satellite imagery and administrative population estimated size for Baghdad, 30 clusters were selected, proportionate to population size estimates. Interviews were conducted during April and May 2014 in 900 households containing 5148 persons. Details about injuries and disabilities occurring from 2003 through May 2014 and resultant disabilities were recorded. There were 553 injuries reported by Baghdad residents, 225 of which were intentional, and 328 unintentional. For intentional injuries, the fatality rate was 39.1% and the disability rate 56.0%. Gunshots where the major cause of injury through 2006 when blasts/explosions became the most common cause and remained so through 2014. Among unintentional injuries, the fatality rate was 7.3% and the disability rate 77.1%. The major cause of unintentional injuries was falls (131) which have increased dramatically since 2008, followed by traffic related injuries (81), which have steadily increased. The proportion of injuries ending in disabilities remained fairly constant through the survey period. Intentional injuries added substantially to the burden of unintentional injuries for the population. For Baghdad, the phases of the Iraqi conflict are reflected in the patterns of injuries and consequent deaths reported. The scale of injuries during conflict is most certainly under-reported. Difficulties recalling injuries in a survey covering 11 years is a limitation, but it is likely that minor injuries were under-reported more than severe injuries. The in- and out-migration of Baghdad populations likely had effects on the events reported which we could not measure or estimate. Damage to the health infrastructure and the flight of health workers may have contributed to mortality and morbidity. Civilian injuries as well as mortality should be measured during conflicts, though not currently done.

  10. Injuries, Death, and Disability Associated with 11 Years of Conflict in Baghdad, Iraq: A Randomized Household Cluster Survey

    PubMed Central

    Lafta, Riyadh; Al-Shatari, Sahar; Cherewick, Megan; Galway, Lindsay; Mock, Charles; Hagopian, Amy; Flaxman, Abraham; Takaro, Tim; Greer, Anna; Kushner, Adam; Burnham, Gilbert

    2015-01-01

    Background The objective of this study was to characterize injuries, deaths, and disabilities arising during 11 years of conflict in Baghdad. Methods Using satellite imagery and administrative population estimated size for Baghdad, 30 clusters were selected, proportionate to population size estimates. Interviews were conducted during April and May 2014 in 900 households containing 5148 persons. Details about injuries and disabilities occurring from 2003 through May 2014 and resultant disabilities were recorded. Findings There were 553 injuries reported by Baghdad residents, 225 of which were intentional, and 328 unintentional. For intentional injuries, the fatality rate was 39.1% and the disability rate 56.0%. Gunshots where the major cause of injury through 2006 when blasts/explosions became the most common cause and remained so through 2014. Among unintentional injuries, the fatality rate was 7.3% and the disability rate 77.1%. The major cause of unintentional injuries was falls (131) which have increased dramatically since 2008, followed by traffic related injuries (81), which have steadily increased. The proportion of injuries ending in disabilities remained fairly constant through the survey period. Interpretation Intentional injuries added substantially to the burden of unintentional injuries for the population. For Baghdad, the phases of the Iraqi conflict are reflected in the patterns of injuries and consequent deaths reported. The scale of injuries during conflict is most certainly under-reported. Difficulties recalling injuries in a survey covering 11 years is a limitation, but it is likely that minor injuries were under-reported more than severe injuries. The in- and out-migration of Baghdad populations likely had effects on the events reported which we could not measure or estimate. Damage to the health infrastructure and the flight of health workers may have contributed to mortality and morbidity. Civilian injuries as well as mortality should be measured during conflicts, though not currently done. PMID:26252879

  11. Did death certificates and a death review process agree on lung cancer cause of death in the National Lung Screening Trial?

    PubMed

    Marcus, Pamela M; Doria-Rose, Vincent Paul; Gareen, Ilana F; Brewer, Brenda; Clingan, Kathy; Keating, Kristen; Rosenbaum, Jennifer; Rozjabek, Heather M; Rathmell, Joshua; Sicks, JoRean; Miller, Anthony B

    2016-08-01

    Randomized controlled trials frequently use death review committees to assign a cause of death rather than relying on cause of death information from death certificates. The National Lung Screening Trial, a randomized controlled trial of lung cancer screening with low-dose computed tomography versus chest X-ray for heavy and/or long-term smokers ages 55-74 years at enrollment, used a committee blinded to arm assignment for a subset of deaths to determine whether cause of death was due to lung cancer. Deaths were selected for review using a pre-determined computerized algorithm. The algorithm, which considered cancers diagnosed during the trial, causes and significant conditions listed on the death certificate, and the underlying cause of death derived from death certificate information by trained nosologists, selected deaths that were most likely to represent a death due to lung cancer (either directly or indirectly) and deaths that might have been erroneously assigned lung cancer as the cause of death. The algorithm also selected deaths that might be due to adverse events of diagnostic evaluation for lung cancer. Using the review cause of death as the gold standard and lung cancer cause of death as the outcome of interest (dichotomized as lung cancer versus not lung cancer), we calculated performance measures of the death certificate cause of death. We also recalculated the trial primary endpoint using the death certificate cause of death. In all, 1642 deaths were reviewed and assigned a cause of death (42% of the 3877 National Lung Screening Trial deaths). Sensitivity of death certificate cause of death was 91%; specificity, 97%; positive predictive value, 98%; and negative predictive value, 89%. About 40% of the deaths reclassified to lung cancer cause of death had a death certificate cause of death of a neoplasm other than lung. Using the death certificate cause of death, the lung cancer mortality reduction was 18% (95% confidence interval: 4.2-25.0), as compared with the published finding of 20% (95% confidence interval: 6.7-26.7). Death review may not be necessary for primary-outcome analyses in lung cancer screening trials. If deemed necessary, researchers should strive to streamline the death review process as much as possible. © The Author(s) 2016.

  12. A comparison of robust principal component analysis techniques for buried object detection in downward looking GPR sensor data

    NASA Astrophysics Data System (ADS)

    Pinar, Anthony; Havens, Timothy C.; Rice, Joseph; Masarik, Matthew; Burns, Joseph; Thelen, Brian

    2016-05-01

    Explosive hazards are a deadly threat in modern conflicts; hence, detecting them before they cause injury or death is of paramount importance. One method of buried explosive hazard discovery relies on data collected from ground penetrating radar (GPR) sensors. Threat detection with downward looking GPR is challenging due to large returns from non-target objects and clutter. This leads to a large number of false alarms (FAs), and since the responses of clutter and targets can form very similar signatures, classifier design is not trivial. One approach to combat these issues uses robust principal component analysis (RPCA) to enhance target signatures while suppressing clutter and background responses, though there are many versions of RPCA. This work applies some of these RPCA techniques to GPR sensor data and evaluates their merit using the peak signal-to-clutter ratio (SCR) of the RPCA-processed B-scans. Experimental results on government furnished data show that while some of the RPCA methods yield similar results, there are indeed some methods that outperform others. Furthermore, we show that the computation time required by the different RPCA methods varies widely, and the selection of tuning parameters in the RPCA algorithms has a major effect on the peak SCR.

  13. Moment-Tensor Spectra of Source Physics Experiments (SPE) Explosions in Granite

    NASA Astrophysics Data System (ADS)

    Yang, X.; Cleveland, M.

    2016-12-01

    We perform frequency-domain moment tensor inversions of Source Physics Experiments (SPE) explosions conducted in granite during Phase I of the experiment. We test the sensitivity of source moment-tensor spectra to factors such as the velocity model, selected dataset and smoothing and damping parameters used in the inversion to constrain the error bound of inverted source spectra. Using source moments and corner frequencies measured from inverted source spectra of these explosions, we develop a new explosion P-wave source model that better describes observed source spectra of these small and over-buried chemical explosions detonated in granite than classical explosion source models derived mainly from nuclear-explosion data. In addition to source moment and corner frequency, we analyze other features in the source spectra to investigate their physical causes.

  14. Blast overpressure after tire explosion: a fatal case.

    PubMed

    Pomara, Cristoforo; D'Errico, Stefano; Riezzo, Irene; Perilli, Gabriela; Volpe, Umberto; Fineschi, Vittorio

    2013-12-01

    Fatal blast injuries are generally reported in literature as a consequence of the detonation of explosives in war settings. The pattern of lesion depends on the position of the victim in relation to the explosion, on whether the blast tracks through air or water, and whether it happens in the open air or within an enclosed space and the distance from the explosion. Tire explosion-related injuries are rarely reported in literature. This study presents a fatal case of blast overpressure due to the accidental explosion of a truck tire occurring in a tire repair shop. A multidisciplinary approach to the fatality involving forensic pathologists and engineers revealed that the accidental explosion, which caused a series of primary and tertiary blast wave injuries, was due to tire deterioration.

  15. Explosive cyclogenesis of extra-tropical cyclone Klaus and its effects in Catalonia. A case study of hurricane force gusts.

    NASA Astrophysics Data System (ADS)

    Calvo, J.; López, J. A.; Martín, F.; Morales, G.; Pascual, R.

    2009-09-01

    On 23th and 24th of January 2009, the extra-tropical cyclone Klaus crossed the north of Spain and the south of France producing several deaths and generalized damages. The cyclone of Atlantic origin underwent an explosive deepening of more than 1 hPa per hour at the surface level. Catalonia region was affected by gale-force winds and hurricane gusts. The Atlantic depression underwent a process called explosive cyclogenesis (when a surface cyclone deepens at a rate higher than 1 hPa/hr over 24 hours, approximately) in front of the Spanish Atlantic coasts. In this study we focus on its impact in the Catalonia areas where both synoptic and local effects were important. Also we evaluate the performance of the numerical weather prediction model outputs against observed data.

  16. Using multiple cause-of-death data to investigate associations and causality between conditions listed on the death certificate.

    PubMed

    Redelings, Matthew D; Wise, Matthew; Sorvillo, Frank

    2007-07-01

    Death rarely results from only one cause, and it can be caused by a variety of factors. Multiple cause-of-death data files can list as many as 20 contributing causes of death in addition to the reported underlying cause of death. Analysis of multiple cause-of-death data can provide information on associations between causes of death, revealing common combinations of events or conditions which lead to death. Additionally, physicians report the causal train of events through which they believe that different conditions or events may have led to each other and ultimately caused death. In this paper, the authors discuss methods used in studying associations between reported causes of death and in investigating commonly reported causal pathways between events or conditions listed on the death certificate.

  17. Explosive laser light initiation of propellants

    DOEpatents

    Piltch, Martin S.

    1993-01-01

    A improved initiator for artillery shell using an explosively generated laser light to uniformly initiate the propellent. A small quantity of a high explosive, when detonated, creates a high pressure and temperature, causing the surrounding noble gas to fluoresce. This fluorescence is directed into a lasing material, which lases, and directs laser light into a cavity in the propellant, uniformly initiating the propellant.

  18. Explosive laser light initiation of propellants

    DOEpatents

    Piltch, M.S.

    1993-05-18

    A improved initiator for artillery shell using an explosively generated laser light to uniformly initiate the propellent. A small quantity of a high explosive, when detonated, creates a high pressure and temperature, causing the surrounding noble gas to fluoresce. This fluorescence is directed into a lasing material, which lases, and directs laser light into a cavity in the propellant, uniformly initiating the propellant.

  19. ASTRONOMY: Neighborhood Gamma Ray Burst Boosts Theory.

    PubMed

    Schilling, G

    2000-07-07

    Titanic explosions that emit powerful flashes of energetic gamma rays are one of astronomy's hottest mysteries. Now an analysis of the nearest gamma ray burst yet detected has added weight to the popular theory that they are expelled during the death throes of supermassive stars.

  20. Three Dimensional Analysis of Induced Detonation of Cased Explosive

    DTIC Science & Technology

    2014-10-16

    hardness and ductility . RHA steel is largely used in military applications to manufacture armoured vehicles. The Johnson Cook (JC) constitutive...armour (RHA) steel were investigated through the LS-DYNA. The investigation focused on shock to detonation simulations of Composition B, with the... hot spots caused by the compression of the explosive from the initial shockwave. Detonation was also caused by pressure waves reflecting against the

  1. A review on several key problems of standoff trace explosives detection by optical-related technology

    NASA Astrophysics Data System (ADS)

    Chen, Zhibin; Xiao, Cheng; Xiao, Wenjian; Qin, Mengze; Liu, Xianhong

    2016-01-01

    To prevent tragic disasters caused by terror acts and warfare threats, security check personnel must be capable of discovering, distinguishing and eliminating the explosives at multiple circumstances. Standoff technology for the remote detection of explosives and their traces on contaminated surfaces is a research field that has become a heightened priority in recent years for homeland security and counter-terrorism applications. There has been a huge increase in research within this area, the improvement of standoff trace explosives detection by optical-related technology. This paper provides a consolidation of information relating to recent advances in several key problems of, without being limited to one specific research area or explosive type. Working laser wavelength of detection system is discussed. Generation and collection of explosives spectra signal are summarized. Techniques for analysing explosives spectra signal are summed up.

  2. Interacting Supernovae: Types IIn and Ibn

    NASA Astrophysics Data System (ADS)

    Smith, Nathan

    Supernovae that show evidence of strong shock interaction between their ejecta and pre-existing slower circumstellar material (CSM) constitute an interesting, diverse, and still poorly understood category of explosive transients. The chief reason they are extremely interesting is because they tell us that in a subset of stellar deaths, the progenitor star becomes wildly unstable in the years, decades, or centuries before explosion. This is something that has not been included in standard stellar evolution models but may significantly change the end product and yield of that evolution and complicates our attempts to map SNe to their progenitors. Another reason they are interesting is because CSM interaction is an efficient engine for making bright transients, allowing superluminous transients to arise from normal SN explosion energy, and transients of normal supernova luminosity to arise from sub-energetic explosions or low radioactivity yield. CSM interaction shrouds the fast ejecta in bright shock emission, obscuring our view of the underlying explosion, and the radiation hydrodynamics is challenging to model. The CSM interaction may also be highly nonspherical, perhaps linked to binary interaction in the progenitor system. In some cases, these complications make it difficult to tell the difference between a core-collapse and thermonuclear explosion or to discern between a nonterminal eruption, failed supernova, or weak supernova. Efforts to uncover the physical parameters of individual events and connections to progenitor stars make this a rapidly evolving topic that challenges paradigms of stellar evolution.

  3. 40 years of terrorist bombings - A meta-analysis of the casualty and injury profile.

    PubMed

    Edwards, D S; McMenemy, L; Stapley, S A; Patel, H D L; Clasper, J C

    2016-03-01

    Terrorists have used the explosive device successfully globally, with their effects extending beyond the resulting injuries. Suicide bombings, in particular, are being increasingly deployed due to the devastating effect of a combination of high lethality and target accuracy. The aim of this study was to identify trends and analyse the demographics and casualty figures of terrorist bombings worldwide. Analysis of the Global Terrorism Database (GTD) and a PubMed/Embase literature search (keywords "terrorist", and/or "suicide", and/or "bombing") from 1970 to 2014 was performed. 58,095 terrorist explosions worldwide were identified in the GTD. 5.08% were suicide bombings. Incidents per year are increasing (P<0.01). Mean casualty statistics per incidents was 1.14 deaths and 3.45 wounded from non-suicide incidents, and 10.16 and 24.16 from suicide bombings (p<0.05). The kill:wounded ratio was statistically higher in suicide attacks than non-suicide attacks, 1:1.3 and 1:1.24 respectively (p<0.05). The Middle East witnessed the most incidents (26.9%), with Europe (13.2%) ranked 4th. The literature search identified 41 publications reporting 167 incidents of which 3.9% detailed building collapse (BC), 60.8% confined space (CS), 23.5% open space (OS) and 11.8% semi-confined space (SC) attacks. 60.4% reported on suicide terrorist attacks. Overall 32 deaths and 180 injuries per incident were seen, however significantly more deaths occurred in explosions associated with a BC. Comparing OS and CS no difference in the deaths per incident was seen, 14.2(SD±17.828) and 15.63 (SD±10.071) respectively. However OS explosions resulted in significantly more injuries, 192.7 (SD±141.147), compared to CS, 79.20 (SD±59.8). Extremity related wounds were the commonest injuries seen (32%). Terrorist bombings continue to be a threat and are increasing particularly in the Middle East. Initial reports, generated immediately at the scene by experienced coordination, on the type of detonation (suicide versus non-suicide), the environment of detonation (confined, open, building collapse) and the number of fatalities, and utilising the Kill:Wounded ratios found in this meta-analysis, can be used to predict the number of casualties and their likely injury profile of survivors to guide the immediate response by the medical services and the workload in the coming days. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Dynamic strength of cylindrical fiber-glass shells and basalt plastic shells under multiple explosive loading

    NASA Astrophysics Data System (ADS)

    Syrunin, M. A.; Fedorenko, A. G.

    2006-08-01

    We have shown experimentally that, for cylindrical shells made of oriented fiberglass platic and basalt plastic there exists a critical level of deformations, at which a structure sustains a given number of explosions from the inside. The magnitude of critical deformation for cylindrical fiberglass shells depends linearly on the logarithm of the number of loads that cause failure. For a given type of fiberglass, there is a limiting level of explosive action, at which the number of loads that do not lead to failure can be sufficiently large (more than ˜ 102). This level is attained under loads, which are an order of magnitude lower than the limiting loads under a single explosive action. Basalt plastic shells can be repeatedly used even at the loads, which cause deformation by ˜ 30-50% lower than the safe value ˜ 3.3.5% at single loading.

  5. Semiconductor bridge (SCB) detonator

    DOEpatents

    Bickes, Jr., Robert W.; Grubelich, Mark C.

    1999-01-01

    The present invention is a low-energy detonator for high-density secondary-explosive materials initiated by a semiconductor bridge igniter that comprises a pair of electrically conductive lands connected by a semiconductor bridge. The semiconductor bridge is in operational or direct contact with the explosive material, whereby current flowing through the semiconductor bridge causes initiation of the explosive material. Header wires connected to the electrically-conductive lands and electrical feed-throughs of the header posts of explosive devices, are substantially coaxial to the direction of current flow through the SCB, i.e., substantially coaxial to the SCB length.

  6. Probability of in-vessel steam explosion-induced containment failure for a KWU PWR

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Esmaili, H.; Khatib-Rahbar, M.; Zuchuat, O.

    During postulated core meltdown accidents in light water reactors, there is a likelihood for an in-vessel steam explosion when the melt contacts the coolant in the lower plenum. The objective of the work described in this paper is to determine the conditional probability of in-vessel steam explosion-induced containment failure for a Kraftwerk Union (KWU) pressurized water reactor (PWR). The energetics of the explosion depends on the mass of the molten fuel that mixes with the coolant and participates in the explosion and on the conversion of fuel thermal energy into mechanical work. The work can result in the generation ofmore » dynamic pressures that affect the lower head (and possibly lead to its failure), and it can cause acceleration of a slug (fuel and coolant material) upward that can affect the upper internal structures and vessel head and ultimately cause the failure of the upper head. If the upper head missile has sufficient energy, it can reach the containment shell and penetrate it. The analysis, must therefore, take into account all possible dissipation mechanisms.« less

  7. Burn injuries related to liquefied petroleum gas-powered cars.

    PubMed

    Bozkurt, Mehmet; Kulahci, Yalcin; Zor, Fatih; Kapi, Emin

    2008-01-01

    Liquefied petroleum gas (LPG), which is used as a type of fuel, is stored as a liquid under high pressure in tanks. Immediate and sudden explosion of these tanks can release a large amount of gas and energy into the environment and can result in serious burns. In this study, the cases of 18 patients injured due to LPG burns in five incidents were examined, along with their epidemiologic features. The authors also investigated the causes of the LPG tank explosions. Inhalation injury was present in 11 cases with varying degrees of severity, and 7 patients subsequently required mechanical ventilation. The explosions resulted from weakening of the tank wall (n = 2), crash impact (n = 2), and gas leakage from the tank (n = 1). LPG-powered cars are becoming more popular because of their lower operational costs. However, LPG tanks can be hazardous in the event of a tank explosion. Burns caused by explosions of the LPG tanks in cars have significant mortality and morbidity. This danger must be taken into account and public awareness must be increased.

  8. Causes of adult female deaths in Bangladesh: findings from two National Surveys.

    PubMed

    Nahar, Quamrun; El Arifeen, Shams; Jamil, Kanta; Streatfield, Peter Kim

    2015-09-18

    Assessment of causes of death and changes in pattern of causes of death over time are needed for programmatic purposes. Limited national level data exist on the adult female causes of death in Bangladesh. Using data from two nationally representation surveys, the 2001 and 2010 Bangladesh Maternal Mortality Surveys (BMMS), the paper examines the causes of adult female death, aged 15-49 years, and changes in the patterns of these deaths. In both surveys, all household deaths three years prior to the survey were identified. Adult female deaths were then followed by a verbal autopsy (VA) using the WHO structured questionnaire. Two physicians independently reviewed the VA forms to assign a cause of death using the ICD-10; in case of disagreement, a third physician made an independent review and assigned a cause of death. The overall mortality rates for women aged 15-49 in 2001 and 2010 were 182 per 100,000 and 120 per 100,000 respectively. There is a shift in the pattern of causes of death during the period covered by the two surveys. In the 2001 survey, the main causes of death were maternal (20 %), followed by diseases of the circulatory system (15 %), malignancy (14 %) and infectious diseases (13 %). However, in the 2010 survey, malignancies were the leading cause (21 %), followed by diseases of the circulatory system (16 %), maternal causes (14 %) and infectious diseases (8 %). While maternal deaths remained the number one cause of death among 20-34 years old in both surveys, unnatural deaths were the main cause for teenage deaths, and malignancies were the main cause of death for older women. Although there is an increasing trend in the proportion of women who died in hospitals, in both surveys most women died at home (74 % in 2001 and 62 % in 2010). The shift in the pattern of causes of adult female deaths is in agreement with the overall change in the disease pattern from communicable to non-communicable diseases in Bangladesh. Suicide and other violent deaths as the primary cause of deaths among teenage girls demands specific interventions to prevent such premature deaths. Prevention of deaths due to non-communicable diseases should also be a priority.

  9. Galaxy formation in an intergalactic medium dominated by explosions

    NASA Technical Reports Server (NTRS)

    Ostriker, J. P.; Cowie, L. L.

    1981-01-01

    The evolution of galaxies in an intergalactic medium dominated by explosions of star systems is considered analogously to star formation by nonlinearly interacting processes in the interstellar medium. Conditions for the existence of a hydrodynamic instability by which galaxy formation leads to more galaxy formation due to the propagation of the energy released at the death of massive stars are examined, and it is shown that such an explosive amplification is possible at redshifts less than about 5 and stellar system masses between 10 to the 8th and 10 to the 12th solar masses. Explosions before a redshift of about 5 are found to lead primarily to the formation of massive stars rather than galaxies, while those at a redshift close to 5 will result in objects of normal galactic scale. The model also predicts a dusty interstellar medium preventing the detection of objects of redshift greater than 3, numbers and luminosities of protogalaxies comparable to present observations, unvirialized groups of galaxies lying on two-dimensional surfaces, and a significant number of black holes in the mass range 1000-10,000 solar masses.

  10. Quantifying cause-related mortality by weighting multiple causes of death

    PubMed Central

    Moreno-Betancur, Margarita; Lamarche-Vadel, Agathe; Rey, Grégoire

    2016-01-01

    Abstract Objective To investigate a new approach to calculating cause-related standardized mortality rates that involves assigning weights to each cause of death reported on death certificates. Methods We derived cause-related standardized mortality rates from death certificate data for France in 2010 using: (i) the classic method, which considered only the underlying cause of death; and (ii) three novel multiple-cause-of-death weighting methods, which assigned weights to multiple causes of death mentioned on death certificates: the first two multiple-cause-of-death methods assigned non-zero weights to all causes mentioned and the third assigned non-zero weights to only the underlying cause and other contributing causes that were not part of the main morbid process. As the sum of the weights for each death certificate was 1, each death had an equal influence on mortality estimates and the total number of deaths was unchanged. Mortality rates derived using the different methods were compared. Findings On average, 3.4 causes per death were listed on each certificate. The standardized mortality rate calculated using the third multiple-cause-of-death weighting method was more than 20% higher than that calculated using the classic method for five disease categories: skin diseases, mental disorders, endocrine and nutritional diseases, blood diseases and genitourinary diseases. Moreover, this method highlighted the mortality burden associated with certain diseases in specific age groups. Conclusion A multiple-cause-of-death weighting approach to calculating cause-related standardized mortality rates from death certificate data identified conditions that contributed more to mortality than indicated by the classic method. This new approach holds promise for identifying underrecognized contributors to mortality. PMID:27994280

  11. Pacemaker explosions in crematoria: problems and possible solutions

    PubMed Central

    Gale, Christopher P; Mulley, Graham P

    2002-01-01

    The number of artificial cardiac pacemakers is increasing, as is the number of bodies being cremated. Because of the explosive potential of pacemakers when heated, a statutory question on the cremation form asks whether the deceased has a pacemaker and if so whether it has been removed. We sent a questionnaire to all the crematoria in the UK enquiring about the frequency, consequences and prevention of pacemaker explosions. We found that about half of all crematoria in the UK experience pacemaker explosions, that pacemaker explosions may cause structural damage and injury and that most crematoria staff are unaware of the explosive potential of implantable cardiac defibrillators. Crematoria staff rely on the accurate completion of cremation forms, and doctors who sign cremation forms have a legal obligation to provide such information. PMID:12091510

  12. Drought, Mortality and Social Structure.

    ERIC Educational Resources Information Center

    Sharma, Sanjay

    1995-01-01

    Examines the relationship between the human population explosion, resource depletion, drought, malnutrition, and disease. As a sample study, mortality trends in Rajasthan State in India in the 1980s were analyzed to correlate the increased death rate with the drought of 1987. It is demonstrated that drought-induced malnutrition was the root cause…

  13. CTC Sentinel. Volume 3, Issue 3, March 2010

    DTIC Science & Technology

    2010-03-01

    of the Soul” audio lecture, for example, al-`Awlaqi discussed the period of waiting (al-Ihtidhar) between death and the afterlife . In the eight...trainees are told that a suicide bomber wins paradise for giving up his life for Allah, and enters the afterlife the moment the explosives detonate

  14. Youngest Stellar Explosion in Our Galaxy Discovered

    NASA Astrophysics Data System (ADS)

    2008-05-01

    Astronomers have found the remains of the youngest supernova, or exploded star, in our Galaxy. The supernova remnant, hidden behind a thick veil of gas and dust, was revealed by the National Science Foundation's Very Large Array (VLA) and NASA's Chandra X-Ray Observatory, which could see through the murk. The object is the first example of a "missing population" of young supernova remnants. 1985 and 2008 VLA Images Move cursor over image to blink. VLA Images of G1.9+0.3 in 1985 and 2008: Circle for size comparison. CREDIT: Green, et al., NRAO/AUI/NSF From observing supernovae in other galaxies, astronomers have estimated that about three such stellar explosions should occur in our Milky Way every century. However, the most recent one known until now occurred around 1680, creating the remnant called Cassiopeia A. The newly-discovered object is the remnant of an explosion only about 140 years ago. "If the supernova rate estimates are correct, there should be the remnants of about 10 supernova explosions in the Milky Way that are younger than Cassiopeia A," said David Green of the University of Cambridge in the UK, who led the VLA study. "It's great to finally track one of them down." Supernova explosions, which mark the violent death of a star, release tremendous amounts of energy and spew heavy elements such as calcium and iron into interstellar space. They thus seed the clouds of gas and dust from which new stars and planets are formed and, through their blast shocks, can even trigger such formation. The lack of evidence for young supernova remnants in the Milky Way had caused astronomers to wonder if our Galaxy, which appears otherwise normal, differed in some unknown way from others. Alternatively, scientists thought that the "missing" Milky Way supernovae perhaps indicated that their understanding of the relationship between supernovae and other galactic processes was in error. The astronomers made their discovery by measuring the expansion of the debris from the star's explosion. They did this by comparing images of the object, called G1.9+0.3, made more than two decades apart. In 1985, astronomers led by Green observed G1.9+0.3 with the VLA and identified it as a supernova remnant. At that time, they estimated its age as between 400 and 1,000 years. It is near the center of our Galaxy, roughly 25,000 light-years from Earth. In 2007, another team of astronomers, led by Stephen Reynolds of North Carolina State University, observed the object with the Chandra X-Ray Observatory. To their surprise, their image showed the object to be about 16 percent larger than in the 1985 VLA image. "This is a huge difference. It means the explosion debris is expanding very quickly, which in turn means the object is much younger than we originally thought," Reynolds explained. However, this expansion measurement came from comparing a radio image to an X-ray image. To make an "apples to apples" comparison, the scientists sought and were quickly granted observing time on the VLA. "I've never seen a large astronomical institution move so fast," said Reynolds. Their new VLA observations confirmed the supernova remnant's rapid expansion. The discovery provides scientists with a valuable source of new information about exploding stars. "Our previous situation was as if someone studying humans could look at babies and at adults, but could not study teenagers. Now, we're filling in that gap," said Reynolds. The object already has provided surprises. The velocities of its explosion debris and extreme energies of its particles are unprecedented. "No other object in the Galaxy has properties like this," said Reynolds. "Finding G1.9+0.3 is extremely important for learning more about how some stars explode and what happens in the aftermath," he added. The discovery was possible because radio and X-ray telescopes, unlike visible-light telescopes, can penetrate the thick clouds of gas and dust in our Galaxy. "Looking out of the Milky Way, we can see some supernova explosions with optical telescopes across half of the Universe, but when they're in this murk, we can miss them in our own cosmic back yard," Reynolds said. "Fortunately, the expanding gas cloud from the explosion shines brightly in radio waves and X-rays for thousands of years. X-ray and radio telescopes can see through all that obscuration and show us what we've been missing," he added. Because of the obscuration, no one could have seen the original explosion 140 years ago. The astronomers are reporting their results in papers published in the Astrophysical Journal Letters and Monthly Notices of the Royal Astronomical Society. Background Information: Supernova Explosions Supernova explosions are the violent death throes of stars. These explosions release in one event as much energy as is being released by all the rest of the stars in a galaxy -- typically 100 billion or so. Supernovae seen in other galaxies can outshine the rest of their galaxy for days. The supernovae that have occurred in our own Galaxy and were not obscured by the gas and dust that obscured G1.9+0.3 have often provided a spectacular sight. Historical records indicate that ancient astronomers noted supernova explosions at least as early as A.D. 393, and probably earlier. The pre-telescopic astronomers Tycho Brahe and Johannes Kepler made extensive observations of supernovae in 1572 and 1604. Chinese astronomers noted that a supernova in 1054 was bright enough to be seen in the daytime. A supernova in 1006 remained visible for two years. Supernovae that result from the deaths of stars much more massive than the Sun enrich the galaxy with chemical elements that are produced in the cores of those stars before they explode. The heavy elements, such as carbon, oxygen, iron, siicon and calcium, that make up planets and their inhabitants were made available by supernova explosions. In addition to enriching the material between stars with heavy elements, supernovae stir up that material through the shock energy of the explosion. This is thought to help trigger the process of star formation in interstellar clouds of gas and dust. Many astronomers believe that our own Solar System is the result of such a supernova shock. The National Radio Astronomy Observatory is a facility of the National Science Foundation, operated under cooperative agreement by Associated Universities, Inc.

  15. UV-B Radiation Contributes to Amphibian Population Declines

    NASA Astrophysics Data System (ADS)

    Blaustein, Andrew

    2007-05-01

    UV-B (280-315 nm) radiation is the most significant biologically damaging radiation at the terrestrial surface. At the organismal level, UV-B radiation can slow growth rates, cause immune dysfunction and result in sublethal damage. UV-B radiation can lead to mutations and cell death. Over evolutionary time, UV radiation has been an important stressor on living organisms. Natural events, including impacts from comets and asteroids, volcanic activity, supernova explosions and solar flares, can cause large-scale ozone depletion with accompanying increases in UV radiation. However, these natural events are transient. Moreover, the amount of ozone damage due to natural events depends upon a number of variables, including the magnitude of the event. This is different from modern-day human-induced production of chlorofluorocarbons (CFCs) and other chemicals that deplete stratospheric ozone continuously, resulting in long-term increases in UV-B radiation at the surface of the earth. We will briefly review the effects of UV-B exposure in one group of aquatic organisms_amphibians. UV-B has been implicated as a possible factor contributing to global declines and range reductions in amphibian populations.

  16. Broadband Evaluation of DPRK Explosions, Collapse Event, and Induced Aftershocks

    NASA Astrophysics Data System (ADS)

    Mayeda, K.; Roman-Nieves, J. I.; Wagner, G.; Jeon, Y. S.

    2017-12-01

    We report on the past 6 declared DPRK nuclear explosions, a collapse event, and recent associated induced shear dislocation sources using long-period waveform modeling, direct regional phases, and stable P-coda and S-coda spectral ratios. We find that the recent September 3rd, 2017 explosion is well modeled with an MM71 explosion source model at normal scale depth, but the previous 5 smaller yield explosions exhibit much larger relative high frequency radiation, strongly suggesting they are all over buried by varying amounts. The collapse event that occurred 8 minutes following the September 3rd DPRK explosion shares significant similarities with a number of NTS collapse events for explosions of comparable yield, both in absolute amplitude and spectral fall-off. A large number of smaller sources have been observed, which from stable coda spectral analysis and waveform modeling, are consistent with shallow shear dislocations likely caused by stress redistribution following the past nuclear explosions. We conclude with testing of a new discriminant that is specific to this region.

  17. Apollo 13 Case Study

    NASA Technical Reports Server (NTRS)

    Anderson, Brenda Lindley

    2011-01-01

    The dramatic journey of the crippled Apollo 13 vehicle has been heavily documented and popularized. Many people know there was an explosion in the service module which caused the vehicle to lose its oxygen supply. Less well known is the set of circumstances which led to the explosion. This paper examines the manufacturing, processing and testing history of oxygen tank #2, detailing the additive effects which caused the oxygen to ignite and to overpressure the tank.

  18. Preventable causes of death in Wisconsin, 2004.

    PubMed

    Vila, Peter M; Booske, Bridget C; Wegner, Mark V; Remington, Patrick L

    2007-10-01

    While heart disease, cancer, and injuries are leading proximate causes of death, research has demonstrated that about half of all deaths in the United States are actually due to preventable causes, including tobacco use, poor diet, and physical inactivity. Using state vital statistics data and findings from national studies, we report on the trends in the preventable causes of death in Wisconsin from 1992 to 2004. The leading proximate causes of death in Wisconsin were obtained from Wisconsin Interactive Statistics on Health (WISH) data derived from individual death certificates. Information on the preventable causes of death was either obtained from the underlying cause information on the death certificate or from peer-reviewed epidemiologic studies. While the overall age-adjusted death rate declined from 837 to 744 per 100,000 from 1992 to 2004, the top 10 causes of death remain largely unchanged. Nearly half of the deaths in Wisconsin in 2004 resulted from 11 preventable causes, similar to the findings in 1992. Epidemiologic research demonstrates that nearly half of all deaths in Wisconsin are due to preventable causes. Programs and policies must continue to address these preventable causes of disease if Wisconsin is to meet its goal of promoting and protecting population health.

  19. Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011.

    PubMed

    Adih, William K; Selik, Richard M; Hall, H Irene; Babu, Aruna Surendera; Song, Ruiguang

    2016-01-01

    Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased.

  20. A comparison of sisterhood information on causes of maternal death with the registration causes of maternal death in Matlab, Bangladesh.

    PubMed

    Shahidullah, M

    1995-10-01

    To explore whether causes of maternal death can be investigated using the sisterhood method, an indirect method for providing a community-based estimate of the level of maternal mortality, this study compares the sisterhood causes of maternal death with the Matlab Demographic Surveillance System's (DSS) causes of maternal death. Data for this study came from the Matlab DSS, which has been in operation since 1966 as a field site of the International Centre for Diarrhoeal Disease Research, Bangladesh. The maternal deaths that occurred during the 15-year period from 1976 to 1990 in the Matlab DSS area are the basis of this study. A sisterhood survey was conducted in Matlab in November and December 1991 to collect information on conditions, events and symptoms that preceded death. The collected information was evaluated to assign a most likely cause of maternal death. The sisterhood survey cause of maternal death was then compared with the DSS cause of maternal death. Cause of death could not be assigned with reasonable confidence for 34 (11%) of the 305 maternal deaths for which information was collected. For the remaining deaths, the agreement between the two classification systems was generally high for most cause-of-death categories considered. Though cause-of-death information obtained by the sisterhood method will always be subject to some error, it can provide an indication of an overall distribution of causes of maternal deaths. This data can be used for the planning of programmes aimed at reducing maternal mortality and for the evaluation of such programmes over time.

  1. Local perceptions of causes of death in rural South Africa: a comparison of perceived and verbal autopsy causes of death.

    PubMed

    Hussain-Alkhateeb, Laith; Fottrell, Edward; Petzold, Max; Kahn, Kathleen; Byass, Peter

    2015-01-01

    Understanding how lay people perceive the causes of mortality and their associated risk factors is important for public health. In resource-limited settings, where verbal autopsy (VA) is used as the most expedient method of determining cause of death, it is important to understand how pre-existing concepts of cause of death among VA-informants may influence their VA-responses and the consequential impact on cause of death assessment. This study describes the agreement between VA-derived causes of death and informant-perceived causes and associated influential factors, which also reflects lay health literacy in this setting. Using 20 years of VA data (n=11,228) from the Agincourt Health and Demographic Surveillance System (HDSS) site in rural South Africa, we explored the agreement between the causes of death perceived by the VA-informants and those assigned by the automated Inter-VA tool. Kappa statistics and concordance correlation coefficients were applied to measure agreement at individual and population levels, respectively. Multivariable regression models were used to explore factors associated with recognised lay perceptions of causes of mortality. Agreement between informant-perceived and VA-derived causes of death at the individual level was limited, but varied substantially by cause of death. However, agreement at the population level, comparing cause-specific mortality fractions was higher, with the notable exception of bewitchment as a cause. More recent deaths, those in adults aged 15-49 years, deaths outside the home, and those associated with external causes showed higher concordance with InterVA. Overall, informant perception of causes of death was limited, but depended on informant characteristics and causes of death, and to some extent involved non-biomedical constructs. Understanding discordance between perceived and recognised causes of death is important for public health planning; low community understanding of causes of death may be detrimental to public health. These findings also illustrate the importance of using rigorous and standardised VA methods rather than relying on informants' reported causes of death.

  2. Impact of a hospital-level intervention to reduce heart disease overreporting on leading causes of death.

    PubMed

    Al-Samarrai, Teeb; Madsen, Ann; Zimmerman, Regina; Maduro, Gil; Li, Wenhui; Greene, Carolyn; Begier, Elizabeth

    2013-05-16

    The quality of cause-of-death reporting on death certificates affects the usefulness of vital statistics for public health action. Heart disease deaths are overreported in the United States. We evaluated the impact of an intervention to reduce heart disease overreporting on other leading causes of death. A multicomponent intervention comprising training and communication with hospital staff was implemented during July through December 2009 at 8 New York City hospitals reporting excessive heart disease deaths. We compared crude, age-adjusted, and race/ethnicity-adjusted proportions of leading, underlying causes of death reported during death certification by intervention and nonintervention hospitals during preintervention (January-June 2009) and postintervention (January-June 2010) periods. We also examined trends in leading causes of death for 2000 through 2010. At intervention hospitals, heart disease deaths declined by 54% postintervention; other leading causes of death (ie, malignant neoplasms, influenza and pneumonia, cerebrovascular disease, and chronic lower respiratory diseases) increased by 48% to 232%. Leading causes of death at nonintervention hospitals changed by 6% or less. In the preintervention period, differences in leading causes of death between intervention and nonintervention hospitals persisted after controlling for race/ethnicity and age; in the postintervention period, age accounted for most differences observed between intervention and nonintervention hospitals. Postintervention, malignant neoplasms became the leading cause of premature death (ie, deaths among patients aged 35-74 y) at intervention hospitals. A hospital-level intervention to reduce heart disease overreporting led to substantial changes to other leading causes of death, changing the leading cause of premature death. Heart disease overreporting is likely obscuring the true levels of cause-specific mortality.

  3. On the Violence of High Explosive Reactions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tarver, C M; Chidester, S K

    High explosive reactions can be caused by three general energy deposition processes: impact ignition by frictional and/or shear heating; bulk thermal heating; and shock compression. The violence of the subsequent reaction varies from benign slow combustion to catastrophic detonation of the entire charge. The degree of violence depends on many variables, including the rate of energy delivery, the physical and chemical properties of the explosive, and the strength of the confinement surrounding the explosive charge. The current state of experimental and computer modeling research on the violence of impact, thermal, and shock-induced reactions is reviewed.

  4. Semiconductor bridge (SCB) detonator

    DOEpatents

    Bickes, R.W. Jr.; Grubelich, M.C.

    1999-01-19

    The present invention is a low-energy detonator for high-density secondary-explosive materials initiated by a semiconductor bridge (SCB) igniter that comprises a pair of electrically conductive lands connected by a semiconductor bridge. The semiconductor bridge is in operational or direct contact with the explosive material, whereby current flowing through the semiconductor bridge causes initiation of the explosive material. Header wires connected to the electrically-conductive lands and electrical feed-throughs of the header posts of explosive devices, are substantially coaxial to the direction of current flow through the SCB, i.e., substantially coaxial to the SCB length. 3 figs.

  5. Gravitational Wave Detection in the Introductory Lab

    NASA Astrophysics Data System (ADS)

    Burko, Lior M.

    2017-05-01

    A long time ago in a galaxy far, far away, two black holes, one of mass 36 solar masses and the other of mass 29 solar masses, were dancing their death waltz, leading to their coalescence and the emission of gravitational waves carrying away with them three solar masses of energy. More precisely, it happened 1.3 billion years ago at a distance of 410 Mpc. When the waves were emitted, the most complex life forms on Earth were eukaryotes. As the gravitational waves propagated toward Earth, it changed much. Five hundred million years after the waves were emitted, or 800 million years ago, the first multicellular life forms emerged on Earth. Earth saw the Cambrian explosion 500 million years ago. Sixty-six million years ago the Cretaceous-Paleogene extinction event caused the disappearance of the dinosaurs. The first modern humans appeared 250,000 years ago.

  6. Severe Dengue Fever Outbreak in Taiwan

    PubMed Central

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005–2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. PMID:26572871

  7. Severe Dengue Fever Outbreak in Taiwan.

    PubMed

    Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

    2016-01-01

    Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.

  8. The primary culture of mirror carp snout and caudal fin tissues and the isolation of Koi herpesvirus.

    PubMed

    Zhou, Jingxiang; Wang, Hao; Zhu, Xia; Li, Xingwei; Lv, Wenliang; Zhang, Dongming

    2013-10-01

    The explosive Koi herpesvirus (KHV) epidemic has caused the deaths of a large number of carp and carp variants and has produced serious economic losses. The mirror carp (Cyprinus carpio var. specularis) exhibits strong environmental adaptability and its primary cells can be used to isolate KHV. This study utilized the tissue explant method to systematically investigate primary cell culture conditions for mirror carp snout and caudal fin tissues. We demonstrated that cells from these two tissue types had strong adaptability, and when cultured in Medium 199 (M199) containing 20% serum at 26 to 30°C, the cells from the snout and caudal fin tissues exhibited the fastest egress and proliferation. Inoculation of these two cell types with KHV-infected fish kidney tissues produced typical cytopathic effects; additionally, identification by electron microscopy, and PCR indicated that KHV could be isolated from both cell types.

  9. Paris terrorist attack: early lessons from the intensivists.

    PubMed

    2016-04-08

    During the night of 13-14 November, the city of Paris was exposed, within a few hours, to three bomb explosions, four shooting scenes, and one 3-hour hostage-taking of several hundred people causing at least 130 deaths and more than 250 injured victims. Most unstable patients were transferred to the six trauma centers of the Paris area, all members of the TRAUMABASE Group. A rapid adaptation of the organization of trauma patients' admittance was required in all centers to face the particular needs of the situation. Everything went relatively well in all centers, with overall hospital mortality below 2 %. Nevertheless, most physicians nowadays agree that anticipation, teaching, and training are crucial to appropriately face such events. All of us have learned many additional issues from this experience. Following a meeting of the TRAUMABASE Group, the most relevant issues are detailed in the following.

  10. Unusual planned complex suicide committed with a muzzle-loading pistol in combination with subsequent hanging.

    PubMed

    Ondruschka, Benjamin; Morgenthal, Sylvia; Dreβler, Jan; Bayer, Ronny

    2016-11-01

    In Germany, suicides by firearms are not very common in contrast to deaths by hanging and intoxications. The use of historical muzzle-loading firearms in the context of suicides is a rarity. Contact shots from muzzle loaders cause an unusual wound morphology with extensive soot soiling. We report the case of a 59-year-old man, who committed a planned complex suicide by shooting into his mouth with a replica percussion gun in combination with hanging. The gunshot injury showed strong explosive effects in the oral cavity with fractures of the facial bones and the skull associated with cerebral evisceration (so-called Krönlein shot). Due to the special constellation of the case with hanging immediately after the shot, external bleeding from the head injuries was only moderate. Therefore, the head injuries could be assessed and partially reconstructed already at the scene.

  11. Microbial bioreporters of trace explosives.

    PubMed

    Shemer, Benjamin; Koshet, Ori; Yagur-Kroll, Sharon; Belkin, Shimshon

    2017-06-01

    Since its introduction as an explosive in the late 19th century, 2,4,6-trinitrotoluene (TNT), along with other explosive compounds, has left numerous environmental marks. One of these is widespread soil and water pollution by trace explosives in military proving grounds, manufacturing facilities, or actual battlefields. Another dramatic impact is that exerted by the millions of landmines and other explosive devices buried in large parts of the world, causing extensive loss of life, injuries, and economical damage. In this review we highlight recent advances in the design and construction of microbial bioreporters, molecularly engineered to generate a quantifiable dose-dependent signal in the presence of trace amounts of explosives. Such sensor strains may be employed for monitoring environmental pollution as well as for the remote detection of buried landmines. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. AIDS and population "control".

    PubMed

    Piel, G

    1994-02-01

    Many people believe that the AIDS pandemic will end the population explosion, especially in Africa, where population growth is very high and poverty reigns. Africans make up 10 million of all 15 million HIV- infected persons worldwide. Yet, the proposition that AIDS will sole population explosion does not stand up to reason. About 200 million people in Africa will be HIV infected by 2010, but the loss of 200 million people would not slow population growth. The 14th century's Black Death killed more than 50% of the European population, but by 1750 Europe had reached the population size it would have reached without the Black Death. The 200 million people who died violent deaths between the start and end of the two World Wars did not stop world population growth from peaking in 1970 at about 2%. When Malthus made his prediction that human population would crash, the industrial revolution had already helped production outrun population growth. Today all industrial countries are either at or near zero population growth and have completed the demographic transition (from near zero growth in 1600 with high births and death rates and a 25-year life expectancy, to near zero growth in 1990s at low death and birth rates with a 75-year life expectancy). Mass education, sanitation, primary medicine, and the green revolution have already reduced death rates and increased life expectancy in developing countries. Thus, they have entered the first phase of the demographic transition. Some developing countries are in the second phase; birth rate decline For example, in India and China, fertility has fallen from 6 to 4 in India and is at 2.3 in China. The AIDS pandemic is a diversion of physical and human resources from helping developing countries pass through the demographic transition more quickly to achieve sustainable development. This delay is likely to effect a larger maximum population. The industrial revolution has shifted the key to stopping population growth the people dying to people living.

  13. [Cause of death: from primary disease to direct cause of death].

    PubMed

    Oppewal, F; Smedts, F M M; Meyboom-de Jong, B

    2005-07-23

    Following the death of a patient, the treating physician in the Netherlands is required to fill out two forms. Form A, which is the certificate of death and Form B, which is used by the Statistics Netherlands to compile data on causes ofdeath. The latter form often poses difficulty for the physician with respect to the primary cause of death. This applies particularly to cases of sudden death, which account for one third of all deaths in the Netherlands. As a result, the statistical analyses appear to lead to an incorrect representation of the distribution of causes of death. A more thorough investigation into the primary cause of death is desirable, if necessary, supported by a request for an autopsy. The primary cause of death is to be regarded as the basic disease from which the cascade of changes ultimately leading to death originated.

  14. On high explosive launching of projectiles for shock physics experiments

    NASA Astrophysics Data System (ADS)

    Swift, Damian C.; Forest, Charles A.; Clark, David A.; Buttler, William T.; Marr-Lyon, Mark; Rightley, Paul

    2007-06-01

    The hydrodynamic operation of the "Forest Flyer" type of explosive launching system for shock physics projectiles was investigated in detail using one and two dimensional continuum dynamics simulations. The simulations were numerically converged and insensitive to uncertainties in the material properties; they reproduced the speed of the projectile and the shape of its rear surface. The most commonly used variant, with an Al alloy case, was predicted to produce a slightly curved projectile, subjected to some shock heating and likely exhibiting some porosity from tensile damage. The curvature is caused by a shock reflected from the case; tensile damage is caused by the interaction of the Taylor wave pressure profile from the detonation wave with the free surface of the projectile. The simulations gave only an indication of tensile damage in the projectile, as damage is not understood well enough for predictions in this loading regime. The flatness can be improved by using a case of lower shock impedance, such as polymethyl methacrylate. High-impedance cases, including Al alloys but with denser materials improving the launching efficiency, can be used if designed according to the physics of oblique shock reflection, which indicates an appropriate case taper for any combination of explosive and case material. The tensile stress induced in the projectile depends on the relative thickness of the explosive, expansion gap, and projectile. The thinner the projectile with respect to the explosive, the smaller the tensile stress. Thus if the explosive is initiated with a plane wave lens, the tensile stress is lower than that for initiation with multiple detonators over a plane. The previous plane wave lens designs did, however, induce a tensile stress close to the spall strength of the projectile. The tensile stress can be reduced by changes in the component thicknesses. Experiments verifying the operation of explosively launched projectiles should attempt to measure porosity induced in the projectile: arrival time measurements are likely to be insensitive to porous regions caused by damaged or recollected material.

  15. Using National Inpatient Death Rates as a Benchmark to Identify Hospitals with Inaccurate Cause of Death Reporting - Missouri, 2009-2012.

    PubMed

    Lloyd, Jennifer; Jahanpour, Ehsan; Angell, Brian; Ward, Craig; Hunter, Andy; Baysinger, Cherri; Turabelidze, George

    2017-01-13

    Reporting causes of death accurately is essential to public health and hospital-based programs; however, some U.S. studies have identified substantial inaccuracies in cause of death reporting. Using CDC's national inpatient hospital death rates as a benchmark, the Missouri Department of Health and Senior Services (DHSS) analyzed inpatient death rates reported by hospitals with high inpatient death rates in St. Louis and Kansas City metro areas. Among the selected hospitals with high inpatient death rates, 45.8% of death certificates indicated an underlying cause of death that was inconsistent with CDC's Guidelines for Death Certificate completion. Selected hospitals with high inpatient death rates were more likely to overreport heart disease and renal disease, and underreport cancer as an underlying cause of death. Based on these findings, the Missouri DHSS initiated a new web-based training module for death certificate completion based on the CDC guidelines in an effort to improve accuracy in cause of death reporting.

  16. Therapeutic milestone: stroke declines from the second to the third leading organ- and disease-specific cause of death in the United States.

    PubMed

    Towfighi, Amytis; Ovbiagele, Bruce; Saver, Jeffrey L

    2010-03-01

    Stroke mortality rates declined for much of the second half of the 20th century, but recent trends and their relation to other organ- and disease-specific causes of death have not been characterized. Using the National Center for Health Statistics mortality data, leading organ- and disease-specific causes of death were assessed for the most recent 10-year period (1996 to 2005) in the United States with a specific focus on stroke deaths. Age-adjusted stroke death rates declined by 25.4%; as a result, lung cancer (which only declined by 9.2%) surpassed stroke as the second leading cause of death in 2003. Despite a 31.9% decline in age-adjusted ischemic heart disease death rates, it remains the leading cause of death. Stroke is now the fifth leading cause of death in men and the fourth leading cause of death in whites but remains the second leading cause of death in women and blacks. With stroke death rates decreasing substantially in the United States from 1996 to 2005, stroke moved from the second to the third leading organ- and disease-specific cause of death. Women and blacks may warrant attention for targeted stroke prevention and treatment because they continue to have disproportionately high stroke death rates.

  17. Maternal mortality in Syria: causes, contributing factors and preventability.

    PubMed

    Bashour, Hyam; Abdulsalam, Asmaa; Jabr, Aisha; Cheikha, Salah; Tabbaa, Mohammed; Lahham, Moataz; Dihman, Reem; Khadra, Mazen; Campbell, Oona M R

    2009-09-01

    To describe the biomedical and other causes of maternal death in Syria and to assess their preventability. A reproductive age mortality study (RAMOS) design was used to identify pregnancy related deaths. All deaths among women aged 15-49 reported to the national civil register for 2003 were investigated through home interviews. Verbal autopsies were used to ascertain the cause of death among pregnancy related maternal deaths, and causes and preventability of deaths were assessed by a panel of doctors. A total of 129 maternal deaths were identified and reviewed. Direct medical causes accounted for 88%, and haemorrhage was the main cause of death (65%). Sixty nine deaths (54%) occurred during labour or delivery. Poor clinical skills and lack of clinical competency were behind 54% of maternal deaths. Ninety one percent of maternal deaths were preventable. The causes of maternal death in Syria and their contributing factors reflect serious defects in the quality of maternal care that need to be urgently rectified.

  18. The ionospheric disturbances caused by the explosion of the Mount Tongariro volcano in 2012

    NASA Astrophysics Data System (ADS)

    Po Cheng, C.; Lin, C.; Chang, L. C.; Chen, C.

    2013-12-01

    Volcanic explosions are known to trigger acoustic waves that propagate in the atmosphere at infrasonic speeds. At ionospheric heights, coupling between neutral particles and free electrons induces variations of electron density detectable by dual-frequency Global Positioning System (GPS) measurements. In November 21 2012, the explosion of the Mount Tongariro volcano in New Zealand occurred at UT 0:20, when there were active synoptic waves passing over north New Zealand. The New Zealand dense array of Global Positioning System recorded ionospheric disturbances reflected in total electron content (TEC) ~10 minutes after the eruption, and the concentric spread of disturbances also can be observed this day. The velocity of disturbances varies from 130m/s to 700m/s. A spectral analysis of the rTEC time series shows two peaks. The larger amplitudes are centered at 800 and 1500 seconds, in the frequency range of acoustic waves and gravity waves. On the other hand, to model the rTEC perturbation created by the acoustic wave caused by the explosive eruption of the Mount Tongariro, we perform acoustic ray tracing and obtain sound speed at subionospheric height in a horizontally stratified atmosphere model (MSIS-E-90). The result show that the velocity of the disturbances is slower than sound speed range. Through using the MSIS-E-90 Atmosphere Model and Horizontal Wind Model(HWM), we obtain the vertical wave number and indicate that the gravity waves could propagate at subionospheric height for this event, suggesting that the ionospheric disturbances caused by the explosive eruption is gravity-wave type. This work demonstrates that GPS are useful for near real-time ionospheric disturbances monitoring, and help to understand the mechanism of the gravity wave caused by volcano eruption in the future.

  19. Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

    PubMed

    Kebede, Yigzaw; Andargie, Gashaw; Gebeyehu, Abebaw; Awoke, Tadesse; Yitayal, Mezgebu; Mekonnen, Solomon; Wubshet, Mamo; Azmeraw, Temesgen; Lakew, Yihunie; Alemu, Kassahun

    2017-01-01

    Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

  20. Tuberculosis and HIV are the leading causes of adult death in northwest Ethiopia: evidence from verbal autopsy data of Dabat health and demographic surveillance system, 2007-2013.

    PubMed

    Kebede, Yigzaw; Andargie, Gashaw; Gebeyehu, Abebaw; Awoke, Tadesse; Yitayal, Mezgebu; Mekonnen, Solomon; Wubshet, Mamo; Azmeraw, Temesgen; Lakew, Yihunie; Alemu, Kassahun

    2017-07-17

    Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system. Causes of death were classified and prepared based on the International Classification of Diseases (ICD-10). The cause of a death was ascertained based on an interview with next of kin or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history, and circumstances preceding death. The cause of death, or the sequence of causes that led to death, is assigned based on the data collected by the questionnaire. The complete VA questionnaires were given to two blinded physicians and reviewed independently. A third physician was assigned to review the case when disagreements in diagnosis arose. Communicable diseases (519 deaths [48.0%]), non-communicable diseases (377 deaths [34.8%]), and external causes (113 deaths [10.4%]) were the main causes of death between 2007 and 2013. Of communicable diseases, tuberculosis (207 deaths [19.7%]), HIV/AIDS (96 deaths [8.9%]) and meningitis (76 deaths [7.0%]) were the most common causes of death. Tuberculosis, HIV/AIDS, and meningitis were the most common causes of deaths among adults. Death due to non-communicable diseases showed an increasing trend. Increasing community awareness of infections and their interrelationships, tuberculosis case finding, effective local TB programs, successful treatment, and interventions for HIV are supremely important.

  1. Effect of W/O Emulsion Fuel Properties on Spray Combustion

    NASA Astrophysics Data System (ADS)

    Ida, Tamio; Fuchihata, Manabu; Takeda, Shuuco

    This study proposes a realizable technology for an emulsion combustion method that can reduce environmental loading. This paper discusses the effect on spray combustion for W/O emulsion fuel properties with an added agent, and the ratio between water and emulsifier added to a liquid fuel. The addition of water or emulsifier to a liquid fuel affected the spray combustion by causing micro-explosions in the flame due to geometric changes in the sprayed flame and changes to the temperature distribution. Experimental results revealed that the flame length shortened by almost 40% upon the addition of the water. Furthermore, it was found that water was effective in enhancing combustion due to its promoting micro-explosions. Results also showed that when the emulsifier was added to the spray flame, the additive burned in the flame's wake, producing a bright red flame. The flame length was observed to be long as a result. The micro-explosion phenomenon, caused by emulsifier dosage differences, was observed using time-dependent images at a generated frequency and an explosion scale with a high-speed photography method. Results indicated that the micro-explosion phenomenon in the W/O emulsion combustion method effectively promoted the combustion reaction and suppressed soot formation.

  2. Causes of death among females-investigating beyond maternal causes: a community-based longitudinal study.

    PubMed

    Melaku, Yohannes Adama; Weldearegawi, Berhe; Aregay, Alemseged; Tesfay, Fisaha Haile; Abreha, Loko; Abera, Semaw Ferede; Bezabih, Afework Mulugeta

    2014-09-10

    In developing countries, investigating mortality levels and causes of death among all age female population despite the childhood and maternal related deaths is important to design appropriate and tailored interventions and to improve survival of female residents. Under Kilite-Awlealo Health and Demographic Surveillance System, we investigated mortality rates and causes of death in a cohort of female population from 1st of January 2010 to 31st of December 2012. At the baseline, 33,688 females were involved for the prospective follow-up study. Households under the study were updated every six months by fulltime surveillance data collectors to identify vital events, including deaths. Verbal Autopsy (VA) data were collected by separate trained data collectors for all identified deaths in the surveillance site. Trained physicians assigned underlining causes of death using the 10th edition of International Classification of Diseases (ICD). We assessed overall, age- and cause-specific mortality rates per 1000 person-years. Causes of death among all deceased females and by age groups were ranked based on cause specific mortality rates. Analysis was performed using Stata Version 11.1. During the follow-up period, 105,793.9 person-years of observation were generated, and 398 female deaths were recorded. This gave an overall mortality rate of 3.76 (95% confidence interval (CI): 3.41, 4.15) per 1,000 person-years. The top three broad causes of death were infectious and parasitic diseases (1.40 deaths per 1000 person-years), non-communicable diseases (0.98 deaths per 1000 person-years) and external causes (0.36 per 1000 person-years). Most deaths among reproductive age female were caused by Human Deficiency Virus/Acquired Immune Deficiency Virus (HIV/AIDS) and tuberculosis (0.14 per 1000 person-years for each cause). Pregnancy and childbirth related causes were responsible for few deaths among women of reproductive age--3 out of 73 deaths (4.1%) or 5.34 deaths per 1,000 person-years. Communicable diseases are continued to be the leading causes of death among all age females. HIV/AIDS and tuberculosis were major causes of death among women of reproductive age. Together with existing efforts to prevent pregnancy and childbirth related deaths, public health and curative interventions on other causes, particularly on HIV/AIDS and tuberculosis, should be strengthened.

  3. Associations and Trends in Cause-Specific Rates of Death Among Persons Reported with HIV Infection, 23 U.S. Jurisdictions, Through 2011

    PubMed Central

    Adih, William K.; Selik, Richard M.; Hall, H. Irene; Babu, Aruna Surendera; Song, Ruiguang

    2016-01-01

    Background: Published death rates for persons with HIV have not distinguished deaths due to HIV from deaths due to other causes. Cause-specific death rates would allow better assessment of care needs. Methods: Using data reported to the US national HIV surveillance system, we examined a) associations between selected decedent characteristics and causes of death during 2007-2011, b) trends in rates of death due to underlying causes among persons with AIDS during 1990-2011, and among all persons with diagnosed HIV infection (with or without AIDS) during 2000-2011. Results: During 2007-2011, non-HIV-attributable causes of death with the highest rates per 1,000 person-years were heart disease (2.0), non-AIDS cancers other than lung cancer (1.4), and accidents (0.8). During 1990-2011, among persons with AIDS, the annual rate of death due to HIV-attributable causes decreased by 89% (from 122.0 to 13.2), and the rate due to non-HIV-attributable-causes decreased by 57% (from 20.0 to 8.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 11% to 43%. During 2000-2011, among persons with HIV infection, the rate of death due to HIV-attributable causes decreased by 69% (from 26.4 to 8.3), and the rate due to non-HIV-attributable causes decreased by 28% (from 10.5 to 7.6), while the percentage of deaths caused by non-HIV-attributable causes increased from 25% to 48%. Conclusion: Among HIV-infected persons, as rates of death due to HIV-attributable causes decreased, rates due to non-HIV-attributable causes also decreased, but the percentages of deaths due to non-HIV-attributable causes, such as heart disease and non-AIDS cancers increased. PMID:27708746

  4. Constraining the Energetics of Explosive Lava-Water Interactions

    NASA Astrophysics Data System (ADS)

    Fitch, E. P.; Fagents, S. A.

    2017-12-01

    During volcanic eruptions, water, such as groundwater or melted ice or snow, may interact with magma within the conduit during eruption, generating explosions when the heat of the magma causes the water to rapidly turn to steam and expand, resulting in what we call a "phreatomagmatic" eruption. In 2010, the eruption of Eyjafjallajökull volcano in Iceland produced a plume of fine ash, through the interaction between magma and glacial melt water, which resulted in the closure of substantial airspace, ultimately costing a total of almost 5 billion dollars. Although an important area of study, it is difficult to quantify the effect of eternal water on eruption intensity when the gas inside of magma is also expanding and fragmenting the magma. In an attempt to understand the energetics of magma-water interactions, small-scale laboratory experiments have been performed. Explosion energy is found to depend mostly on kinetic energy, which is proportional to dispersal distance, and fragmentation energy, which is proportional to the mean grain size of the ejecta, and the mass percent of ash-sized grains. It is thought that in order to generate heat transfer rates sufficiently rapid to cause explosive detonation, the source melt must be finely fragmented, producing ash-sized grains. Those grains undergo brittle fragmentation due to rapid cooling and weak shock waves generated by the vaporization of superheated water. We take the novel approach of studying explosive interactions between lava and water to obtain additional explosion energy constraints. We identified and analyzed numerous beds of lava-water explosion ejecta of varying explosion energy, and we analyzed the ash-sized grains of these beds in detail. We verified that the mass of ash-sized grains increases with increasing explosion energy, and can form at the interface between lava and water. We found that brittle fragmentation occurs to a greater degree as grain size decreases and that the ash of highly-energetic explosions undergoes the most brittle fragmentation. Therefore, our next steps will be to use these results to constrain the fragmentation and kinetic energy, in order to calculate the total energy and heat-transfer rate of lava-water explosions as important analogs for phreatomagmatic eruptions.

  5. Comparison of cause of death between anzdata and the australian national death index.

    PubMed

    Sypek, Matthew P; Dansie, Kathryn B; Clayton, Phil; Webster, Angela C; McDonald, Stephen

    2018-03-01

    To understand the differences in how cause of death for patients receiving renal replacement therapy in Australia is recorded in The Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) compared to the National Death Index (NDI). Data linkage was performed between ANZDATA and NDI for all deaths in the period 1980-2013. Cause of death was classified according to ICD-10 chapter. Overall and chapter specific agreement were assessed using the Kappa statistic. Descriptive analysis was used to explore differences where there was disagreement on primary cause of death. The analysis cohort included 28,675 patients. Ninety five percent of ANZDATA reported deaths fell within +/- 3 days of the date recorded by NDI. Circulatory death was the most common cause of death in both databases (ANZDATA 48%, NDI 32%). Overall agreement at ICD chapter level of primary cause was poor (36%, kappa 0.22). Agreement was best for malignancy (kappa 0.71). When there was disagreement on primary cause of death these were most commonly coded as genitourinary (35%) and endocrine (25.0%) in NDI, and circulatory (39%) and withdrawal (24%) in ANZDATA. Sixty-nine percent of patients had a renal related cause documented as either primary or a contributing cause of death in the NDI. There is poor agreement in primary cause of death between ANZDATA and NDI which is in part explained by the absence of diabetes and renal failure as causes of death in ANZDATA and the absence of 'withdrawal' in NDI. These differences should be appreciated when interpreting epidemiological data on cause of death in the Australian end stage kidney disease population. This article is protected by copyright. All rights reserved.

  6. Explosion characteristics of flammable organic vapors in nitrous oxide atmosphere.

    PubMed

    Koshiba, Yusuke; Takigawa, Tomihisa; Matsuoka, Yusaku; Ohtani, Hideo

    2010-11-15

    Despite unexpected explosion accidents caused by nitrous oxide have occurred, few systematic studies have been reported on explosion characteristics of flammable gases in nitrous oxide atmosphere compared to those in air or oxygen. The objective of this paper is to characterize explosion properties of mixtures of n-pentane, diethyl ether, diethylamine, or n-butyraldehyde with nitrous oxide and nitrogen using three parameters: explosion limit, peak explosion pressure, and time to the peak explosion pressure. Then, similar mixtures of n-pentane, diethyl ether, diethylamine, or n-butyraldehyde with oxygen and nitrogen were prepared to compare their explosion characteristics with the mixtures containing nitrous oxide. The explosion experiments were performed in a cylindrical vessel at atmospheric pressure and room temperature. The measurements showed that explosion ranges of the mixtures containing nitrous oxide were narrow compared to those of the mixtures containing oxygen. On the other hand, the maximum explosion pressures of the mixtures containing nitrous oxide were higher than those of the mixtures containing oxygen. Moreover, our experiments revealed that these mixtures differed in equivalence ratios at which the maximum explosion pressures were observed: the pressures of the mixtures containing nitrous oxide were observed at stoichiometry; in contrast, those of the mixtures containing oxygen were found at fuel-rich area. Chemical equilibrium calculations confirmed these behaviors. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Development of Nanothermite Projectile for Improvised Explosive Device (IED) and Vehicle-Borne Improvised Explosive Device (VBIED) Neutralization. National Institute of Justice Final Report

    DTIC Science & Technology

    2008-09-01

    projectiles containing small amounts of a reactive material. The mechanism is that limited deflagration of the ANFO creates sufficient pressure to...resulting pressurization of the container causes the container to rupture, thus producing a render-safe solution. Several free-field shots demonstrated...the ANFO creates sufficient pressure to rupture plastic or steel containers. 1 Introduction Vehicle-borne improvised explosive devices (VBIEDs) have

  8. Source Amplitudes of NTS Explosions Inferred from Rayleigh Waves at Albuquerque and Tucson

    DTIC Science & Technology

    1978-06-01

    explosions almost always cause spallation near the free surface (e.g., Eisler and Chilton, 1964). When the spalled material falls back to the surface...spall closure), some impulse is delivered and a large signal associated with spall closure can often be observed on near- field recordings (e.g., Eisler ...made for the extent of the spall region ( Eisler and Chilton, 1964; Viecelli, 1973; Sobel, 1978). Viecelli (1973) studied the data for six explosions

  9. A Classical Nova Explosion in a Binary System with B[e] Star

    NASA Astrophysics Data System (ADS)

    Filippova, E.; Revnivtsev, M.; Lutovinov, A.

    2011-09-01

    The description of a thermonuclear runaway on a white dwarf, which causes a Classical Nova (CN) explosion, has several uncertainties. Observational tests of models are challenging because the majority of CNe are observed in optical and NIR spectral bands days after the onset of the explosion. We propose to use the properties of the X-ray emission of CNe for these tests. We have developed a model for the 1998 CN explosion in the binary system CI Cam. According to the adopted model the stellar wind from the optical component (a B[e] star), heated by a strong shock wave that was produced when matter was ejected from the white dwarf as the result of a thermonuclear explosion on its surface, is the source of X-ray emission in the standard X-ray band (˜ 2 - 10 keV). We use this model to explain the behaviour of the X-ray luminosity and of the mean temperature of the heated material during the explosion, and obtain velocity and mass estimates of the ejected matter from the WD surface. Discrepancies between model and observations, for example the slower decline of the theoretical luminosity compared to the observed one, are likely caused by the rough assumption of spherical symmetry. Using 3D calculations we find possible density perturbations (accretion wakes) that can reconcile theory with observations.

  10. Reliability of cause of death coding: an international comparison.

    PubMed

    Antini, Carmen; Rajs, Danuta; Muñoz-Quezada, María Teresa; Mondaca, Boris Andrés Lucero; Heiss, Gerardo

    2015-07-01

    This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries.

  11. Characterization of high explosive particles using cluster secondary ion mass spectrometry.

    PubMed

    Gillen, Greg; Mahoney, Christine; Wight, Scott; Lareau, Richard

    2006-01-01

    The use of secondary ion mass spectrometry (SIMS) for the detection and spatially resolved analysis of individual high explosive particles is described. A C(8) (-) carbon cluster primary ion beam was used in a commercial SIMS instrument to analyze samples of high explosives dispersed as particles on silicon substrates. In comparison with monatomic primary ion bombardment, the carbon cluster primary ion beam was found to greatly enhance characteristic secondary ion signals from the explosive compounds while causing minimal beam-induced degradation. The resistance of these compounds to degradation under ion bombardment allows explosive particles to be analyzed under high primary ion dose bombardment (dynamic SIMS) conditions, facilitating the rapid acquisition of spatially resolved molecular information. The use of cluster SIMS combined with computer control of the sample stage position allows for the automated identification and counting of explosive particle distributions on silicon surfaces. This will be useful for characterizing the efficiency of transfer of particulates in trace explosive detection portal collectors and/or swipes utilized for ion mobility spectrometry applications.

  12. Transurethral Resection of the Prostate, Bladder Explosion and Hyponatremic Encephalopathy: A Rare Case Report of Malpractice.

    PubMed

    Vacchiano, Giuseppe; Rocca, Aldo; Compagna, Rita; Zamboli, Anna Ginevra Immacolata; Cirillo, Vera; Di Domenico, Lorenza; Di Nardo, Veronica; Servillo, Giuseppe; Amato, Bruno

    2017-01-01

    We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.

  13. Transurethral Resection of the Prostate, Bladder Explosion and Hyponatremic Encephalopathy: A Rare Case Report of Malpractice

    PubMed Central

    Vacchiano, Giuseppe; Rocca, Aldo; Compagna, Rita; Zamboli, Anna Ginevra Immacolata; Cirillo, Vera; Di Domenico, Lorenza; Di Nardo, Veronica; Servillo, Giuseppe; Amato, Bruno

    2017-01-01

    Abstract We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability. PMID:28435905

  14. Investigation of charge weight and shock factor effect on non-linear transient structural response of rectangular plates subjected to underwater explosion (UNDEX) shock loading

    NASA Astrophysics Data System (ADS)

    Demir, Ozgur; Sahin, Abdurrahman; Yilmaz, Tamer

    2012-09-01

    Underwater explosion induced shock loads are capable of causing considerable structural damage. Investigations of the underwater explosion (UNDEX) effects on structures have seen continuous developments because of security risks. Most of the earlier experimental investigations were performed by military since the World War I. Subsequently; Cole [1] established mathematical relations for modeling underwater explosion shock loading, which were the outcome of many experimental investigations This study predicts and establishes the transient responses of a panel structure to underwater explosion shock loads using non-linear finite element code Ls-Dyna. Accordingly, in this study a new MATLAB code has been developed for predicting shock loading profile for different weight of explosive and different shock factors. Numerical analysis was performed for various test conditions and results are compared with Ramajeyathilagam's experimental study [8].

  15. STUDY OF THERMAL SENSITIVITY AND THERMAL EXPLOSION VIOLENCE OF ENERGETIC MATERIALS IN THE LLNL ODTX SYSTEM

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    HSU, P C; Hust, G; May, C

    Some energetic materials may explode at fairly low temperatures and the violence from thermal explosion may cause a significant damage. Thus it is important to understand the response of energetic materials to thermal insults for safe handling and storage of energetic materials. The One Dimensional Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory can measure times to explosion, lowest explosion temperatures, and determine kinetic parameters of energetic materials. Samples of different configurations can be tested in the system. The ODTX testing can also generate useful data for determining thermal explosion violence of energetic materials. We also performedmore » detonation experiments of LX-10 in aluminum anvils to determine the detonation violence and validated the Zerilli Armstrong aluminum model. Results of the detonation experiments agreed well with the model prediction.« less

  16. Stress-induced activation of decomposition of organic explosives: a simple way to understand.

    PubMed

    Zhang, Chaoyang

    2013-01-01

    We provide a very simply way to understand the stress-induced activation of decomposition of organic explosives by taking the simplest explosive molecule nitromethane (NM) as a prototype and constraining one or two NM molecules in a shell to represent the condensed phrase of NM against the stress caused by tension and compression, sliding and rotational shear, and imperfection. The results show that the stress loaded on NM molecule can always reduce the barriers of its decomposition. We think the origin of this stress-induced activation is due to the increased repulsive intra- and/or inter- molecular interaction potentials in explosives resulted from the stress, whose release is positive to accelerate the decomposition. Besides, by these models, we can understand that the explosives in gaseous state are easier to analyze than those in condensed state and the voids in condensed explosives make them more sensitive to external stimuli relative to the perfect crystals.

  17. Investigation Of Vapor Explosion Mechanisms Using High Speed Photography

    NASA Astrophysics Data System (ADS)

    Armstrong, Donn R.; Anderson, Richard P.

    1983-03-01

    The vapor explosion, a physical interaction between hot and cold liquids that causes the explosive vaporization of the cold liquid, is a hazard of concern in such diverse industries as metal smelting and casting, paper manufacture, and nuclear power generation. Intensive work on this problem worldwide, for the past 25 years has generated a number of theories and mechanisms proposed to explain vapor explosions. High speed photography has been the major instrument used to test the validity of the theories and to provide the observations that have lead to new theories. Examples are given of experimental techniques that have been used to investigate vapor explosions. Detailed studies of specific mechanisms have included microsecond flash photograph of contact boiling and high speed cinematography of shock driven breakup of liquid drops. Other studies looked at the explosivity of various liquid pairs using cinematography inside a pulsed nuclear reactor and x-ray cinematography of a thermite-sodium interaction.

  18. The Use of Explosive Forming for Fastening and Joining Structural and Pressure Components

    NASA Technical Reports Server (NTRS)

    Schroeder, J. W.

    1985-01-01

    Explosive expansion of tubes into tubesheets has been used for over 20 years in the fabrication and repair of shell and tube heat exchangers. The use of explosives to perform these expansions has offered several distinct advantages over other methods. First, the process is fast and economical and can be performed with minimal training of personnel. Secondly, explosive forming does not cause the deleterious metallurgical effects which often result from other forming operations. In addition, the process can be performed remotely without the need for sophisticated handling equipment. The expansion of tubes into tubesheets is only one of many possible fastening and joining applications for which explosive forming can be used to achieve highly successful results. The explosive forming process and where it has been used are described. In addition, some possible adaptations to other joining applications are identified and discussed.

  19. Causes of death of prisoners of war during the Korean War (1950-1953).

    PubMed

    Lee, Myoung-Soon; Kang, Min-Jung; Huh, Sun

    2013-03-01

    This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war.

  20. Deaths: Leading Causes for 2012.

    PubMed

    Heron, Melonie

    2015-08-31

    This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2012," the National Center for Health Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2012. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2012, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2012 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  1. A Case Study of the Failure on Apollo 13: Based on TMX-65270, Report of Apollo 13 Review Board

    NASA Technical Reports Server (NTRS)

    Anderson, Brenda Lindley

    2011-01-01

    The dramatic journey of the crippled Apollo 13 vehicle has been heavily documented and popularized. Many people know there was an explosion in the service module which caused the vehicle to lose its oxygen supply. Less well known is the set of circumstances which led to the explosion. This paper examines the manufacturing, processing and testing history of oxygen tank #2, detailing the additive effects which caused the oxygen to ignite and to overpressure the tank.

  2. Fish kill from underwater explosions

    USGS Publications Warehouse

    Stuart, David J.

    1962-01-01

    The U.S. Geological Survey has used 23 different shotpoints during two seasons of field work in our seismic study of crustal structure in western United States. Without exception, it has been found that under-water shotpoints result in a more efficient conversion of explosive energy into seismic energy than do drilled-hole shotpoints. This experience, together with elimination of drilling costs, has led to the use of underwater shotpoints wherever possible. Three of the 23 shotpoints were in the Pacific Ocean, and for these we have no detailed information on the fish kill. Another six shotpoints were located in inland bodies of water. These are: * Soda Lake near Fallon, Nevada * Mono Lake near Lee Vining, California * Lake Mead near Boulder City, Nevada * Shasta Lake near Redding, California * C.J. Strike Reservoir near Bruneau, Idaho * Lucky Peak Reservoir near Boise, Idaho The 22 high-explosive charges, weighing a total of 95,100 pounds, that were fired in lakes containing fish life resulted in the known death of 2,413 game fish with a total weight of 759 pounds. The average mortality was 110 game fish or 34.5 pounds of game fish killed per average shot of 4,325 pounds of high-explosives.

  3. Fatal and non-fatal injuries due to intentional explosions in Nepal, 2008-2011: analysis of surveillance data

    PubMed Central

    2013-01-01

    Background Nepal is one of the post-conflict countries affected by violence from explosive devices. We undertook this study to assess the magnitude of injuries due to intentional explosions in Nepal during 2008-2011 and to describe time trends and epidemiologic patterns for these events. Methods We analyzed surveillance data on fatal and non-fatal injuries due to intentional explosions in Nepal that occurred between 1 January 2008 and 31 December 2011. The case definition included casualties injured or killed by explosive devices knowingly activated by an individual or a group of individuals with the intent to harm, hurt or terrorize. Data were collected through media-based and active community-based surveillance. Results Analysis included 437 casualties injured or killed in 131 intentional explosion incidents. A decrease in the number of incidents and casualties between January 2008 and June 2009 was followed by a pronounced increase between July 2010 and June 2011. Eighty-four (19.2%) casualties were among females and 40 (9.2%) were among children under 18 years of age. Fifty-nine (45.3%) incidents involved one casualty, 47 (35.9%) involved 2 to 4 casualties, and 6 involved more than 10 casualties. The overall case-fatality ratio was 7.8%. The highest numbers of incidents occurred in streets or at crossroads, in victims’ homes, and in shops or markets. Incidents on buses and near stadiums claimed the highest numbers of casualties per incident. Socket, sutali, and pressure cooker bombs caused the highest numbers of incidents. Conclusions Intentional explosion incidents still pose a threat to the civilian population of Nepal. Most incidents are caused by small homemade explosive devices and occur in public places, and males aged 20 to 39 account for a plurality of casualties. Stakeholders addressing the explosive device problem in Nepal should continue to use surveillance data to plan interventions. PMID:23514664

  4. Ten Leading Causes of Death and Injury

    MedlinePlus

    ... Brain Injury Violence Prevention Ten Leading Causes of Death and Injury Recommend on Facebook Tweet Share Compartir ... Emergency Departments, United States – 2014 Leading Causes of Death Charts Causes of Death by Age Group 2016 [ ...

  5. A luminous, blue progenitor system for the type Iax supernova 2012Z

    NASA Astrophysics Data System (ADS)

    McCully, Curtis; Jha, Saurabh W.; Foley, Ryan J.; Bildsten, Lars; Fong, Wen-Fai; Kirshner, Robert P.; Marion, G. H.; Riess, Adam G.; Stritzinger, Maximilian D.

    2014-08-01

    Type Iax supernovae are stellar explosions that are spectroscopically similar to some type Ia supernovae at the time of maximum light emission, except with lower ejecta velocities. They are also distinguished by lower luminosities. At late times, their spectroscopic properties diverge from those of other supernovae, but their composition (dominated by iron-group and intermediate-mass elements) suggests a physical connection to normal type Ia supernovae. Supernovae of type Iax are not rare; they occur at a rate between 5 and 30 per cent of the normal type Ia rate. The leading models for type Iax supernovae are thermonuclear explosions of accreting carbon-oxygen white dwarfs that do not completely unbind the star, implying that they are `less successful' versions of normal type Ia supernovae, where complete stellar disruption is observed. Here we report the detection of the luminous, blue progenitor system of the type Iax SN 2012Z in deep pre-explosion imaging. The progenitor system's luminosity, colours, environment and similarity to the progenitor of the Galactic helium nova V445 Puppis suggest that SN 2012Z was the explosion of a white dwarf accreting material from a helium-star companion. Observations over the next few years, after SN 2012Z has faded, will either confirm this hypothesis or perhaps show that this supernova was actually the explosive death of a massive star.

  6. A luminous, blue progenitor system for the type Iax supernova 2012Z.

    PubMed

    McCully, Curtis; Jha, Saurabh W; Foley, Ryan J; Bildsten, Lars; Fong, Wen-fai; Kirshner, Robert P; Marion, G H; Riess, Adam G; Stritzinger, Maximilian D

    2014-08-07

    Type Iax supernovae are stellar explosions that are spectroscopically similar to some type Ia supernovae at the time of maximum light emission, except with lower ejecta velocities. They are also distinguished by lower luminosities. At late times, their spectroscopic properties diverge from those of other supernovae, but their composition (dominated by iron-group and intermediate-mass elements) suggests a physical connection to normal type Ia supernovae. Supernovae of type Iax are not rare; they occur at a rate between 5 and 30 per cent of the normal type Ia rate. The leading models for type Iax supernovae are thermonuclear explosions of accreting carbon-oxygen white dwarfs that do not completely unbind the star, implying that they are 'less successful' versions of normal type Ia supernovae, where complete stellar disruption is observed. Here we report the detection of the luminous, blue progenitor system of the type Iax SN 2012Z in deep pre-explosion imaging. The progenitor system's luminosity, colours, environment and similarity to the progenitor of the Galactic helium nova V445 Puppis suggest that SN 2012Z was the explosion of a white dwarf accreting material from a helium-star companion. Observations over the next few years, after SN 2012Z has faded, will either confirm this hypothesis or perhaps show that this supernova was actually the explosive death of a massive star.

  7. The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death.

    PubMed

    Hazard, Riley H; Chowdhury, Hafizur Rahman; Adair, Tim; Ansar, Adnan; Quaiyum Rahman, A M; Alam, Saidul; Alam, Nurul; Rampatige, Rasika; Streatfield, Peter Kim; Riley, Ian Douglas; Lopez, Alan D

    2017-10-02

    Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies according to the personnel involved in certification, the diagnostic capacity of the hospital, and the category of hospitals. There are no published studies that have analysed how certifying doctors in Bangladesh adhere to international rules when completing the MCCD or have assessed the quality of clinical record keeping. The study took place between January 2011 and April 2014 in the Chandpur and Comilla districts of Bangladesh. We introduced the international MCCD to all study hospitals. Trained project physicians assigned an underlying cause of death, assessed the quality of the death certificate, and reported the degree of certainty of the medical records provided for a given cause. We examined the frequency of common errors in completing the MCCD, the leading causes of in-hospital deaths, and the degree of certainty in the cause of death data. The study included 4914 death certificates. 72.9% of medical records were of too poor quality to assign a cause of death, with little difference by age, hospital, and cause of death. 95.6% of death certificates did not indicate the time interval between onset and death, 31.6% required a change in sequence, 13.9% required to include a new diagnosis, 50.7% used abbreviations, 41.5% used multiple causes per line, and 33.2% used an ill-defined condition as the underlying cause of death. 99.1% of death certificates had at least one error. The leading cause of death among adults was stroke (15.8%), among children was pneumonia (31.7%), and among neonates was birth asphyxia (52.8%). Physicians in Bangladeshi hospitals had difficulties in completing the MCCD correctly. Physicians routinely made errors in death certification practices and medical record quality was poor. There is an urgent need to improve death certification practices and the quality of hospital data in Bangladesh if these data are to be useful for policy.

  8. Children's Deaths in Maine, 1976-1980 Final Report.

    ERIC Educational Resources Information Center

    Shaper, Ruth; And Others

    The final report of a statistical study of 1,737 childhood deaths in Maine from 1976-80 by cause and age also looks at distribution of deaths by cause and age in Maine's low-income population. The findings showed disease was the major cause of death (1,068 deaths) followed by accidents (578 deaths), suicide (50 deaths), and homicide (29 deaths).…

  9. [Causes of death in amyotrophic lateral sclerosis : Results from the Rhineland-Palatinate ALS registry].

    PubMed

    Wolf, J; Safer, A; Wöhrle, J C; Palm, F; Nix, W A; Maschke, M; Grau, A J

    2017-08-01

    Amyotrophic lateral sclerosis (ALS) is associated with an increased mortality. Knowledge of possible causes of death could lead to an individualization of the palliative treatment concept and result in a differentiated palliative treatment pathway. Currently, only few systematic data are available on the heterogeneity of causes of death associated with ALS. Analysis of the various causes of death in a prospective population-based German cohort of ALS patients. Analysis of data of the Rhineland-Palatinate ALS registry in which newly diagnosed patients who had been identified between October 2009 and September 2012 were prospectively enrolled and followed up at regular intervals. From this prospective cohort study the causes of death were elicited based on information provided by the attending physicians, family members and by means of death certificates registered by the regional health authorities in Rhineland-Palatinate. Out of 200 ALS patients registered 148 died between register initiation on 1 October 2009 and the end of follow-up on 30 September 2015 (78 males and 70 females, death rate 74%). The most frequent cause of death was respiratory failure as a consequence of weakness of respiratory muscles (n = 91, 61%). Less frequent causes of death were pneumonia (n = 13, 9%), terminal cachexia (n = 9, 6%) and death from cardiovascular causes including sudden death (n = 9, 6%). Cases of suicide were rare (n = 3, 2%) as were deaths due to concurrent diseases (n = 2). In 21 cases (14%) the exact cause of death could not be clarified. Differences in the causes of death only showed a tendency towards the ALS phenotype. Respiratory failure was the cause of death in all patients with a respiratory phenotype and in 78% of patients with flail arm syndrome. Despite the low number of patients (8%) with additional frontotemporal dementia (FTD) a distinct difference in causes of death between those with and without FTD could be observed. Death due to respiratory failure was less frequent in ALS patients with FTD (33% vs. 65%) while pneumonia was more frequent (27% vs. 7%). Respiratory failure was the most frequent cause of death in our cohort of ALS patients. In contrast, pneumonia and nutritional disorders played a less important role as the cause of death. The phenotypic expression of ALS might in part allow the cause of the prospective death to be predicted. Differentiation of ALS phenotypes is an important foundation for patient counseling on the process of dying to be expected and for the determination of an individual palliative concept.

  10. Detection of explosives by positive corona discharge ion mobility spectrometry.

    PubMed

    Tabrizchi, Mahmoud; Ilbeigi, Vahideh

    2010-04-15

    In this work, thermal decomposition has been used to detect explosives by IMS in positive polarity. Explosives including Pentaerythritol Tetranitrate (PETN), Cyclo-1,3,5-Trimethylene-2,4,6-Trinitramine (RDX), 2,4,6-Trinitrotoluene (TNT), 2,4-Dihydro-5-nitro-3H-1,2,4-triazol-3-one (NTO), 1,3,5,7-Tetranitro-1,3,5,7-tetrazocine (HMX), have been evaluated at temperatures between 150 and 250 degrees C in positive polarity in air. Explosives yield NO(x) which causes NO(+) peak to increase. Additional peaks may be used to identify the type of explosive. The limit of detection for RDX, HMX, PETN, NTO, and TNT were obtained to be 1, 10, 40, 1000, and 1000 ng, respectively. 2009 Elsevier B.V. All rights reserved.

  11. Deaths: leading causes for 2005.

    PubMed

    Heron, Melonie; Tejada-Vera, Betzaida

    2009-12-23

    This report presents final 2005 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2005. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2005, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Diabetes mellitus; Alzheimer's disease; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Septicemia. They accounted for about 77 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2005 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birthweight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Accidents (unintentional injuries); Respiratory distress of newborn; Bacterial sepsis of newborn; Neonatal hemorrhage; and Necrotizing enterocolitis of newborn. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  12. [Analysis of death causes among infants in Guangzhou from 2010 to 2013].

    PubMed

    Shen, Jichuan; Wang, Ming; Dong, Hang; Zhou, Qin

    2014-06-01

    To analyze the main death causes among infants in Guangzhou in 2010-2013 and to provide an objective and scientific basis for risk communication of public health emergencies in the future. Descriptive epidemiological method was used to analyze the death causes among infants reported in Guangzhou from the National Death Registration Reporting Information System. The death causes among infants were classified by the 10th international classification of diseases (ICD-10). The constitution and rank order of death causes among infants were analyzed according to the underlying causes of deaths. A total of 4 880 cases of infant deaths were reported in Guangzhou from 2010 to 2013 and infant deaths in floating population were 1.8 (3 135/1 745) times of registered population. The deaths of male infants were 1.73 (3 094/1 786) times of female infants. The neonatal group accounted for 52.32% (2 553/4 880) of total infant deaths and early neonatal group accounted for 64.86% (1 656/2 553) of total neonatal deaths. The top five causes of infant deaths followed by perinatal diseases, congenital malformations, respiratory diseases (mainly pneumonia), accidental deaths and communicable diseases. The mortality ratios were respectively 44.12% (2 153 cases) , 24.73% (1 207 cases), 6.86% (335 cases), 3.48% (170 cases), 3.01% (147 cases) , and no vaccine-related death case was reported. The primary cause of infant deaths in Guangzhou 2010-2013 was perinatal diseases.

  13. Causes of Death According to Death Certificates in Individuals with Dementia: A Cohort from the Swedish Dementia Registry.

    PubMed

    Garcia-Ptacek, Sara; Kåreholt, Ingemar; Cermakova, Pavla; Rizzuto, Debora; Religa, Dorota; Eriksdotter, Maria

    2016-11-01

    The causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses. Cohort study. Swedish Dementia Registry (SveDem), 2007-2012. Individuals with incident dementia registered in SveDem (N = 28,609); median follow-up 741 days. Observed deaths were 5,368 (19%). Information on number of deaths and causes of mortality was obtained from death certificates. Odds ratios for the presence of dementia on death certificates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox hazards regression for cause-specific mortality, using Alzheimer's dementia (AD) as reference. Hazard ratios for death for each specific cause of death were compared with hazard ratios of death from all causes (P-values from t-tests). The most frequent underlying cause of death in this cohort was cardiovascular (37%), followed by dementia (30%). Dementia and cardiovascular causes appeared as main or contributory causes on 63% of certificates, followed by respiratory (26%). Dementia was mentioned less in vascular dementia (VaD; 57%). Compared to AD, cardiovascular mortality was higher in individuals with VaD than in those with AD (HR = 1.82, 95% CI = 1.64-2.02). Respiratory death was higher in individuals with Lewy body dementia (LBD, including Parkinson's disease dementia and dementia with Lewy bodies, HR = 2.16, 95% CI = 1.71-2.71), and the risk of respiratory death was higher than expected from the risk for all-cause mortality. Participants with frontotemporal dementia were more likely to die from external causes of death than those with AD (HR = 2.86, 95% CI = 1.53-5.32). Dementia is underreported on death certificates as main and contributory causes. Individuals with LBD had a higher risk of respiratory death than those with AD. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  14. Translation from Russian to English the Book Blast Effects Caused by Explosions Authored by B. Gelfand and M. Silnikov

    DTIC Science & Technology

    2004-04-01

    ingredients were freely b ought in the popular shops of chemicals. The following facts can serve as the evidence of wide use of mine -explosive...workshop rooms etc. The HE charges weight restrictions developed for conducting of blasting operations in open-cast mines and testing areas, are...Russian) 8. Silnikov M.V., Serdtsev N.I., Nelezin P.V. On the prospects of methods of explosion localization for the increase of safety of mine

  15. 75 FR 17529 - High-Voltage Continuous Mining Machine Standard for Underground Coal Mines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ..., requires manufacturers to provide safeguards against corona on all 4,160-volt circuits in explosion-proof enclosures. Corona is a luminous discharge that occurs around electric conductors that are subject to high electric stresses. Corona can cause premature breakdown of insulating materials in explosion-proof...

  16. Simulation of Metal Particulates in High Energetic Materials

    DTIC Science & Technology

    2015-05-28

    in explosive mixtures increases the density of the shock wave, causing a higher pressure in the shock . The high pressure in the shock is devastating...19 2.3.3 Explosive Materials with Aluminum Powders . . . . . . . . . . . . . . . . . 21 2.3.4 An Analysis of Shock ...32 3.2.4 Nozzling Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 3.3

  17. Deaths: leading causes for 2009.

    PubMed

    Heron, Melonie

    2012-10-26

    This report presents final 2009 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2009. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2009, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for approximately 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2009 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  18. Agreement between underlying cause and preventability of infant deaths before and after the investigation in Recife, Pernambuco State, Brazil, 2014.

    PubMed

    Marques, Lays Janaina Prazeres; Pimentel, Dayane da Rocha; Oliveira, Conceição Maria de; Vilela, Mirella Bezerra Rodrigues; Frias, Paulo Germano; Bonfim, Cristine Vieira do

    2018-01-01

    to assess the agreement and describe the causes and preventability of infant deaths before and after the investigation. investigation files and death certificates of infants under one year, of mothers living in Recife, Brazil, in 2014 were used; the Cohen kappa index was adopted for agreement analysis of the underlying causes of death; the list of preventable causes of deaths by interventions of the Brazilian National Health System was also adopted. 183 infant deaths were analyzed, of which 117 (63.9%) had the underlying cause revised; before the investigation, 170 (92.2%) deaths were considered preventable, and after investigation, 178 (97.3%); there was reasonable agreement (0.338) regarding the underlying causes of death, and moderate (0.439) for preventability. infant mortality surveillance enabled the improvement of vital events information, contributing to the progress in the specification of underlying causes of death and in the preventability of infant death.

  19. Causes of Death of Prisoners of War during the Korean War (1950-1953)

    PubMed Central

    Lee, Myoung-Soon; Kang, Min-Jung

    2013-01-01

    Purpose This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. Materials and Methods To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. Results The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. Conclusion The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war. PMID:23364985

  20. 38 CFR 3.312 - Cause of death.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

  1. 38 CFR 3.312 - Cause of death.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

  2. 38 CFR 3.312 - Cause of death.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

  3. 38 CFR 3.312 - Cause of death.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

  4. 38 CFR 3.312 - Cause of death.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Cause of death. 3.312... Cause of death. (a) General. The death of a veteran will be considered as having been due to a service... contributory cause of death. The issue involved will be determined by exercise of sound judgment, without...

  5. [Chickenpox-related mortality trends in the state of São Paulo, Brazil, 1985-2004: a multiple cause approach].

    PubMed

    Santo, Augusto Hasiak

    2007-08-01

    To study mortality trends related to chickenpox, as either the underlying or associated cause-of-death (recorded in any field of the medical section of the death certificate), in São Paulo, Brazil. Mortality data for 1985-2004 were obtained from the multiple cause-of-death database maintained by the São Paulo State Data Analysis System (SEADE). Causes-of-death were processed using the Multiple-Causes-of-Death Tabulator. During this 20-year period, chickenpox was identified as the underlying cause-of-death in 1 037 deaths and an associated cause in 150. The mortality coefficients were higher for chickenpox as the underlying, as opposed to the associated cause, and these declined in the analyzed period; whereas a slight increase was observed in mortality due to chickenpox as an associated cause. Seventy-six percent of the deaths were of children under 10 years of age, with the highest incidence among those under 1 year. Most deaths occurred from July to January (86.8% of 1 187 deaths), with a peak in October. In the state's capital city, the mortality coefficients for chickenpox as underlying cause and as associated cause were 47% and 50% higher, respectively, than in the rest of the state. Where chickenpox was identified as the underlying cause, pneumonias and septicemias were the major associated causes; where it was the associated cause, AIDS or neoplasia were most often the underlying cause. Although chickenpox as the underlying cause-of-death has declined, the present study indicates that certain groups are at risk of chickenpox-related mortality, namely children 1-4 years of age and individuals with AIDS or neoplasia.

  6. Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults.

    PubMed

    McCarthy, Natalie L; Gee, Julianne; Sukumaran, Lakshmi; Weintraub, Eric; Duffy, Jonathan; Kharbanda, Elyse O; Baxter, Roger; Irving, Stephanie; King, Jennifer; Daley, Matthew F; Hechter, Rulin; McNeil, Michael M

    2016-03-01

    This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD). The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination. Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death. Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination. Copyright © 2016 by the American Academy of Pediatrics.

  7. A novel explosive process is required for the gamma-ray burst GRB 060614.

    PubMed

    Gal-Yam, A; Fox, D B; Price, P A; Ofek, E O; Davis, M R; Leonard, D C; Soderberg, A M; Schmidt, B P; Lewis, K M; Peterson, B A; Kulkarni, S R; Berger, E; Cenko, S B; Sari, R; Sharon, K; Frail, D; Moon, D-S; Brown, P J; Cucchiara, A; Harrison, F; Piran, T; Persson, S E; McCarthy, P J; Penprase, B E; Chevalier, R A; MacFadyen, A I

    2006-12-21

    Over the past decade, our physical understanding of gamma-ray bursts (GRBs) has progressed rapidly, thanks to the discovery and observation of their long-lived afterglow emission. Long-duration (> 2 s) GRBs are associated with the explosive deaths of massive stars ('collapsars', ref. 1), which produce accompanying supernovae; the short-duration (< or = 2 s) GRBs have a different origin, which has been argued to be the merger of two compact objects. Here we report optical observations of GRB 060614 (duration approximately 100 s, ref. 10) that rule out the presence of an associated supernova. This would seem to require a new explosive process: either a massive collapsar that powers a GRB without any associated supernova, or a new type of 'engine', as long-lived as the collapsar but without a massive star. We also show that the properties of the host galaxy (redshift z = 0.125) distinguish it from other long-duration GRB hosts and suggest that an entirely new type of GRB progenitor may be required.

  8. [Death by explosion of an aerial mine].

    PubMed

    Stockhausen, Sarah; Wöllner, Kirsten; Madea, Burkhard; Doberentz, Elke

    2014-01-01

    Civilians are rarely killed by military weapons except in times of war. In early 2014, a 50-year-old man died in an explosion of an aerial mine from the Second World War when he was crushing concrete chunks with an excavator at a recycling plant. In the burned operator's cab, the remains of a body were found on the driver's seat. The thorax and the head were missing. Still sticking in the shoe, the right foot severed at the ankle was found about 7 m from the excavator together with numerous small to tiny body parts. At autopsy, the completely disrupted, strongly charred lower torso of a male connected to the left extremities as well as a large number of small tissue fragments and calcined bones were found. According to calculations performed by the seismographical station on the basis of seismic data, only about 45-60 percent of the charge had detonated. The autopsy results illustrate all the more the massive impact of such an explosion.

  9. Exposing misclassified HIV/AIDS deaths in South Africa.

    PubMed

    Birnbaum, Jeanette Kurian; Murray, Christopher Jl; Lozano, Rafael

    2011-04-01

    To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa's death registration data and to adjust for this bias. Deaths in the World Health Organization's mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65-69, 70-74 and 75-79 years to generate "relative" global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS. In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996-2006 deaths attributed to HIV/AIDS accounted for 2.0-2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7-28%) to 48% (uncertainty range: 38-50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996-2006. Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models.

  10. Causes of death of patients with lung cancer.

    PubMed

    Nichols, Larry; Saunders, Rachel; Knollmann, Friedrich D

    2012-12-01

    The causes of death for patients with lung cancer are inadequately described. To categorize the immediate and contributing causes of death for patients with lung cancer. The autopsies from 100 patients who died of lung cancer between 1990 and February 2011 were analyzed. Tumor burden was judged the immediate cause of death in 30 cases, including 26 cases of extensive metastases and 4 cases with wholly or primarily lung tumor burden (causing respiratory failure). Infection was the immediate cause of death for 20 patients, including 8 with sepsis and 12 with pneumonia. Complications of metastatic disease were the immediate causes of death in 18 cases, including 6 cases of hemopericardium from pericardial metastases, 3 from myocardial metastases, 3 from liver metastases, and 3 from brain metastases. Other immediate causes of death were pulmonary hemorrhage (12 cases), pulmonary embolism (10 cases, 2 tumor emboli), and pulmonary diffuse alveolar damage (7 cases). From a functional (pathophysiologic) perspective, respiratory failure could be regarded as the immediate cause of death (or mechanism of death) in 38 cases, usually because of a combination of lung conditions, including emphysema, airway obstruction, pneumonia, hemorrhage, embolism, resection, and lung injury in addition to the tumor. For 94 of the 100 patients, there were contributing causes of death, with an average of 2.5 contributing causes and up to 6 contributing causes of death. The numerous and complex ways lung cancer kills patients pose a challenge for efforts to extend and improve their lives.

  11. Ocular blast injuries related to explosive military ammunition.

    PubMed

    Gundogan, Fatih Cakir; Akay, F; Yolcu, U; Uzun, S; Ilhan, A; Toyran, S; Eyi, E; Diner, O

    2016-02-01

    To report the clinical features of ocular injuries associated with explosive military ammunition in insurgent attacks in Turkey. The medical records of 48 casualties who were treated for ocular injuries sustained in insurgent attacks at the Combat Region Hospitals in Turkey were retrospectively reviewed. The reviewed data included initial visual acuity, type of explosive military ammunition (ie, improvised explosive device, mine, hand grenade and rocket-propelled grenade), type of globe injury (open-globe vs closed-globe injury), traumatised globe zones, the presence/absence of an intraocular foreign body, medical interventions, status during the explosion and injuries to other parts of the body. The visual acuity differences between different explosive materials and between 'on-foot' and 'inside-vehicle' casualties were investigated. A total of 83 injured eyes were analysed. The mean patient age was 24.5±6.6 years. The mean initial logarithm of the minimum angle of resolution visual acuity was 0.60±0.63. The injuries were due to improvised explosive devices in 28 cases (58.3%), land mines in 16 cases (33.3%), and hand grenades and rocket-propelled grenades in 2 cases each (4.2%). Forty-seven eyes (56.6%) had open-globe injuries. The most frequently involved zones were zone 1 (50.0%) in closed-globe injuries and all zones (31.9%) in open-globe injuries. Intraocular foreign bodies were present in 45/47 (95.7%) eyes with open-globe injuries. Twelve (14.4%) eyes with no light perception were enucleated, and two (2.4%) eviscerated. The difference in the visual acuities between the on-foot and inside-vehicle casualties and between the injuries that were caused by the different types of explosive ammunitions was also insignificant (p=0.271 and 0.394, respectively). The clinical results for eye injuries caused by explosive military ammunition sustained during insurgent attacks in Turkey are disappointing irrespective of the explosive material. The use of protective eyeglasses might improve the outcomes and should be encouraged. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Deaths: leading causes for 2007.

    PubMed

    Heron, Melonie

    2011-08-26

    This report presents final 2007 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2007. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2007, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Septicemia. They accounted for approximately 76 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2007 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  13. Deaths: leading causes for 2008.

    PubMed

    Heron, Melonie

    2012-06-06

    This report presents final 2008 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2008. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. in 2008, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for approximately 76 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2008 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

  14. Mortality risks in new-onset childhood epilepsy.

    PubMed

    Berg, Anne T; Nickels, Katherine; Wirrell, Elaine C; Geerts, Ada T; Callenbach, Petra M C; Arts, Willem F; Rios, Christina; Camfield, Peter R; Camfield, Carol S

    2013-07-01

    Estimate the causes and risk of death, specifically seizure related, in children followed from onset of epilepsy and to contrast the risk of seizure-related death with other common causes of death in the population. Mortality experiences from 4 pediatric cohorts of newly diagnosed patients were combined. Causes of death were classified as seizure related (including sudden unexpected death [SUDEP]), natural causes, nonnatural causes, and unknown. Of 2239 subjects followed up for >30 000 person-years, 79 died. Ten subjects with lethal neurometabolic conditions were ultimately excluded. The overall death rate (per 100 000 person-years) was 228; 743 in complicated epilepsy (with associated neurodisability or underlying brain condition) and 36 in uncomplicated epilepsy. Thirteen deaths were seizure-related (10 SUDEP, 3 other), accounting for 19% of all deaths. Seizure-related death rates were 43 overall, 122 for complicated epilepsy, and 14 for uncomplicated epilepsy. Death rates from other natural causes were 159, 561, and 9, respectively. Of 48 deaths from other natural causes, 37 were due to pneumonia or other respiratory complications. Most excess death in young people with epilepsy is not seizure-related. Mortality is significantly higher compared with the general population in children with complicated epilepsy but not uncomplicated epilepsy. The SUDEP rate was similar to or higher than sudden infant death syndrome rates. In uncomplicated epilepsy, sudden and seizure-related death rates were similar to or higher than rates for other common causes of death in young people (eg, accidents, suicides, homicides). Relating the risk of death in epilepsy to familiar risks may facilitate discussions of seizure-related mortality with patients and families.

  15. Deaths: leading causes for 2010.

    PubMed

    Heron, Melonie

    2013-12-20

    This report presents final 2010 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2010. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2010, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Nephritis, nephrotic syndrome and nephrosis; Influenza and pneumonia; and Intentional self-harm (suicide). These 10 causes accounted for 75% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2010 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Necrotizing enterocolitis of newborn. Important variations in the leading causes of infant death are noted for the neonatal and post-neonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  16. Deaths: Leading Causes for 2015.

    PubMed

    Heron, Melonie

    2017-11-01

    Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2015. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2015, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2015 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  17. Linking mortuary data improves vital statistics on cause of death of children under five years in the Western Cape Province of South Africa.

    PubMed

    Groenewald, Pam; Bradshaw, Debbie; Neethling, Ian; Martin, Lorna J; Dempers, Johan; Morden, Erna; Zinyakatira, Nesbert; Coetzee, David

    2016-01-01

    Reducing child mortality requires good information on its causes. Whilst South African vital registration data have improved, the quality of cause-of-death data remains inadequate. To improve this, data from death certificates were linked with information from forensic mortuaries in Western Cape Province. A local mortality surveillance system was established in 2007 by the Western Cape Health Department to improve data quality. Cause-of-death data were captured from copies of death notification forms collected at Department of Home Affairs Offices. Using unique identifiers, additional forensic mortuary data were linked with mortality surveillance system records. Causes of death were coded to the ICD-10 classification. Causes of death in children under five were compared with those from vital registration data for 2011. Cause-of-death data were markedly improved with additional data from forensic mortuaries. The proportion of ill-defined causes was halved (25-12%), and leading cause rankings changed. Lower respiratory tract infections moved above prematurity to rank first, accounting for 20.8% of deaths and peaking in infants aged 1-3 months. Only 11% of deaths from lower respiratory tract infections occurred in hospital, resulting in 86% being certified in forensic mortuaries. Road traffic deaths increased from 1.1-3.1% (27-75) and homicides from 3 to 28. The quality and usefulness of cause-of-death information for children in the WC was enhanced by linking mortuary and vital registration data. Given the death profile, interventions are required to prevent and manage LRTI, diarrhoea and injuries and to reduce neonatal deaths. © 2015 John Wiley & Sons Ltd.

  18. Deaths: Leading Causes for 2013.

    PubMed

    Heron, Melonie

    2016-02-16

    This report presents final 2013 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2013," the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2013. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2013, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2013 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  19. Deaths: Leading Causes for 2011.

    PubMed

    Heron, Melonie

    2015-07-27

    This report presents final 2011 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements ‘‘Deaths: Final Data for 2011,’’ the National Center for Health Statistics’ annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2011. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. In 2011, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer’s disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2011 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  20. On the low pressure shock initiation of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine based plastic bonded explosives

    NASA Astrophysics Data System (ADS)

    Vandersall, Kevin S.; Tarver, Craig M.; Garcia, Frank; Chidester, Steven K.

    2010-05-01

    In large explosive and propellant charges, relatively low shock pressures on the order of 1-2 GPa impacting large volumes and lasting tens of microseconds can cause shock initiation of detonation. The pressure buildup process requires several centimeters of shock propagation before shock to detonation transition occurs. In this paper, experimentally measured run distances to detonation for lower input shock pressures are shown to be much longer than predicted by extrapolation of high shock pressure data. Run distance to detonation and embedded manganin gauge pressure histories are measured using large diameter charges of six octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) based plastic bonded explosives (PBX's): PBX 9404; LX-04; LX-07; LX-10; PBX 9501; and EDC37. The embedded gauge records show that the lower shock pressures create fewer and less energetic "hot spot" reaction sites, which consume the surrounding explosive particles at reduced reaction rates and cause longer distances to detonation. The experimental data is analyzed using the ignition and growth reactive flow model of shock initiation in solid explosives. Using minimum values of the degrees of compression required to ignite hot spot reactions, the previously determined high shock pressure ignition and growth model parameters for the six explosives accurately simulate the much longer run distances to detonation and much slower growths of pressure behind the shock fronts measured during the shock initiation of HMX PBX's at several low shock pressures.

  1. Use of primary diagnosis during hospitalization in the Unified Health System (Sistema Único de Saúde) to qualify information regarding the underlying cause of natural deaths among the elderly.

    PubMed

    Cascão, Angela Maria; Jorge, Maria Helena Prado de Mello; Costa, Antonio José Leal; Kale, Pauline Lorena

    2016-01-01

    Ill-defined causes of death are common among the elderly owing to the high frequency of comorbidities and, consequently, to the difficulty in defining the underlying cause of death. To analyze the validity and reliability of the "primary diagnosis" in hospitalization to recover the information on the underlying cause of death in natural deaths among the elderly whose deaths were originally assigned to "ill-defined cause" in their Death Certificate. The hospitalizations occurred in the state of Rio de Janeiro, in 2006. The databases obtained in the Information Systems on Mortality and Hospitalization were probabilistically linked. The following data were calculated for hospitalizations of the elderly that evolved into deaths with a natural cause: concordance percentages, Kappa coefficient, sensitivity, specificity, and the positive predictive value of the primary diagnosis. Deaths related to "ill-defined causes" were assigned to a new cause, which was defined based on the primary diagnosis. The reliability of the primary diagnosis was good, according to the total percentage of consistency (50.2%), and fair, according to the Kappa coefficient (k = 0.4; p < 0.0001). Diseases related to the circulatory system and neoplasia occurred with the highest frequency among the deaths and the hospitalizations and presented a higher consistency of positive predictive values per chapter and grouping of the International Classification of Diseases. The recovery of the information on the primary cause occurred in 22.6% of the deaths with ill-defined causes (n = 14). The methodology developed and applied for the recovery of the information on the natural cause of death among the elderly in this study had the advantage of effectiveness and the reduction of costs compared to an investigation of the death that is recommended in situations of non-linked and low positive predictive values. Monitoring the mortality profile by the cause of death is necessary to periodically update the predictive values.

  2. Modeling causes of death: an integrated approach using CODEm

    PubMed Central

    2012-01-01

    Background Data on causes of death by age and sex are a critical input into health decision-making. Priority setting in public health should be informed not only by the current magnitude of health problems but by trends in them. However, cause of death data are often not available or are subject to substantial problems of comparability. We propose five general principles for cause of death model development, validation, and reporting. Methods We detail a specific implementation of these principles that is embodied in an analytical tool - the Cause of Death Ensemble model (CODEm) - which explores a large variety of possible models to estimate trends in causes of death. Possible models are identified using a covariate selection algorithm that yields many plausible combinations of covariates, which are then run through four model classes. The model classes include mixed effects linear models and spatial-temporal Gaussian Process Regression models for cause fractions and death rates. All models for each cause of death are then assessed using out-of-sample predictive validity and combined into an ensemble with optimal out-of-sample predictive performance. Results Ensemble models for cause of death estimation outperform any single component model in tests of root mean square error, frequency of predicting correct temporal trends, and achieving 95% coverage of the prediction interval. We present detailed results for CODEm applied to maternal mortality and summary results for several other causes of death, including cardiovascular disease and several cancers. Conclusions CODEm produces better estimates of cause of death trends than previous methods and is less susceptible to bias in model specification. We demonstrate the utility of CODEm for the estimation of several major causes of death. PMID:22226226

  3. Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

    PubMed

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

    2015-01-15

    Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality.

  4. Exposing misclassified HIV/AIDS deaths in South Africa

    PubMed Central

    Birnbaum, Jeanette Kurian; Murray, Christopher JL

    2011-01-01

    Abstract Objective To quantify the deaths from human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) that are misattributed to other causes in South Africa’s death registration data and to adjust for this bias. Methods Deaths in the World Health Organization’s mortality database were distributed among 48 mutually exclusive causes. For each cause, age- and sex-specific global death rates were compared with the average rate among people aged 65–69, 70–74 and 75–79 years to generate “relative” global death rates. Relative rates were also computed for South Africa alone. Differences between global and South African relative death rates were used to identify the causes to which deaths from HIV/AIDS were misattributed in South Africa and quantify the HIV/AIDS deaths misattributed to each. These deaths were then reattributed to HIV/AIDS. Findings In South Africa, deaths from HIV/AIDS are often misclassified as being caused by 14 other conditions. Whereas in 1996–2006 deaths attributed to HIV/AIDS accounted for 2.0–2.5% of all registered deaths in South Africa, our analysis shows that the true cause-specific mortality fraction rose from 19% (uncertainty range: 7–28%) to 48% (uncertainty range: 38–50%) over that period. More than 90% of HIV/AIDS deaths were found to have been misattributed to other causes during 1996–2006. Conclusion Adjusting for cause of death misclassification, a simple procedure that can be carried out in any country, can improve death registration data and provide empirical estimates of HIV/AIDS deaths that may be useful in assessing estimates from demographic models. PMID:21479092

  5. Potentially preventable deaths from the five leading causes of death--United States, 2008-2010.

    PubMed

    Yoon, Paula W; Bastian, Brigham; Anderson, Robert N; Collins, Janet L; Jaffe, Harold W

    2014-05-02

    In 2010, the top five causes of death in the United States were 1) diseases of the heart, 2) cancer, 3) chronic lower respiratory diseases, 4) cerebrovascular diseases (stroke), and 5) unintentional injuries. The rates of death from each cause vary greatly across the 50 states and the District of Columbia (2). An understanding of state differences in death rates for the leading causes might help state health officials establish disease prevention goals, priorities, and strategies. States with lower death rates can be used as benchmarks for setting achievable goals and calculating the number of deaths that might be prevented in states with higher rates. To determine the number of premature annual deaths for the five leading causes of death that potentially could be prevented ("potentially preventable deaths"), CDC analyzed National Vital Statistics System mortality data from 2008-2010. The number of annual potentially preventable deaths per state before age 80 years was determined by comparing the number of expected deaths (based on average death rates for the three states with the lowest rates for each cause) with the number of observed deaths. The results of this analysis indicate that, when considered separately, 91,757 deaths from diseases of the heart, 84,443 from cancer, 28,831 from chronic lower respiratory diseases, 16,973 from cerebrovascular diseases (stroke), and 36,836 from unintentional injuries potentially could be prevented each year. In addition, states in the Southeast had the highest number of potentially preventable deaths for each of the five leading causes. The findings provide disease-specific targets that states can use to measure their progress in preventing the leading causes of deaths in their populations.

  6. The epidemiology of 'bewitchment' as a lay-reported cause of death in rural South Africa.

    PubMed

    Fottrell, Edward; Tollman, Stephen; Byass, Peter; Golooba-Mutebi, Frederick; Kahn, Kathleen

    2012-08-01

    Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to 'bewitchment' by VA respondents. Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated. The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be. Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts.

  7. The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa

    PubMed Central

    Tollman, Stephen; Byass, Peter; Golooba-Mutebi, Frederick; Kahn, Kathleen

    2011-01-01

    Background Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to ‘bewitchment’ by VA respondents. Methods Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated. Results The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be. Conclusions Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts. PMID:21515546

  8. Isolator fragmentation and explosive initiation tests

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dickson, Peter; Rae, Philip John; Foley, Timothy J.

    2016-09-19

    Three tests were conducted to evaluate the effects of firing an isolator in proximity to a barrier or explosive charge. The tests with explosive were conducted without a barrier, on the basis that since any barrier will reduce the shock transmitted to the explosive, bare explosive represents the worst-case from an inadvertent initiation perspective. No reaction was observed. The shock caused by the impact of a representative plastic material on both bare and cased PBX 9501 is calculated in the worst-case, 1-D limit, and the known shock response of the HE is used to estimate minimum run-to-detonation lengths. The estimatesmore » demonstrate that even 1-D impacts would not be of concern and that, accordingly, the divergent shocks due to isolator fragment impact are of no concern as initiating stimuli.« less

  9. Isolator fragmentation and explosive initiation tests

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dickson, Peter; Rae, Philip John; Foley, Timothy J.

    2015-09-30

    Three tests were conducted to evaluate the effects of firing an isolator in proximity to a barrier or explosive charge. The tests with explosive were conducted without barrier, on the basis that since any barrier will reduce the shock transmitted to the explosive, bare explosive represents the worst-case from an inadvertent initiation perspective. No reaction was observed. The shock caused by the impact of a representative plastic material on both bare and cased PBX9501 is calculated in the worst-case, 1-D limit, and the known shock response of the HE is used to estimate minimum run-to-detonation lengths. The estimates demonstrate thatmore » even 1-D impacts would not be of concern and that, accordingly, the divergent shocks due to isolator fragment impact are of no concern as initiating stimuli.« less

  10. Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark.

    PubMed

    Basu, Millie Nguyen; Johnsen, Iben Birgit Gade; Wehberg, Sonja; Sørensen, Rikke Guldberg; Barington, Torben; Nørgård, Bente Mertz

    2018-02-23

    We examined the causes of death amongst full term stillbirths and early neonatal deaths. Our cohort includes women in the Region of Southern Denmark, who gave birth at full term to a stillborn infant or a neonate who died within the first 7 days from 2010 through 2014. Demographic, biometric and clinical variables were analyzed to assess the causes of death using two classification systems: causes of death and associated conditions (CODAC) and a Danish system based on initial causes of fetal death (INCODE). A total of 95 maternal-infant cases were included. Using the CODAC and INCODE classification systems, we found that the causes of death were unknown in 59/95 (62.1%). The second most common cause of death in CODAC was congenital anomalies in 10/95 (10.5%), similar to INCODE with fetal, genetic, structural and karyotypic anomalies in 11/95 (11.6%). The majority of the mothers were healthy, primiparous, non-smokers, aged 20-34 years and with a normal body mass index (BMI). Based on an unselected cohort from an entire region in Denmark, the cause of stillbirth and early neonatal deaths among full term infants remained unknown for the vast majority.

  11. Mortality Surveillance in the U.S. Army 20052014

    DTIC Science & Technology

    2016-07-01

    5 6.2 Causes and Categories of Death ...B-2 Causes of Accident Deaths ............................................................................. B-14 Causes...of Natural Deaths ............................................................................... B-16 Causes of Suicides

  12. Commercial fishing industry deaths - forensic issues.

    PubMed

    Byard, Roger W

    2013-04-01

    The commercial fishing industry has one of the highest injury and mortality rates of all occupational areas. This results from the nature of the work involving vessels often manned by only a few individuals who are working with heavy-duty equipment in dangerous environments at all hours. Economic pressures may force inappropriately geared vessels to operate further out to sea than is safe. Deaths result from a wide variety of situations involving vessel loss, falls overboard, fire and explosions, cable entanglements and gas exposure. Autopsies are often difficult as there are no diagnostic features of either drowning or hypothermia and features may be obscured by putrefaction and postmortem animal predation. The forensic implications of deaths in the fishing industry are reviewed. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Study of Vapour Cloud Explosion Impact from Pressure Changes in the Liquefied Petroleum Gas Sphere Tank Storage Leakage

    NASA Astrophysics Data System (ADS)

    Rashid, Z. A.; Suhaimi Yeong, A. F. Mohd; Alias, A. B.; Ahmad, M. A.; AbdulBari Ali, S.

    2018-05-01

    This research was carried out to determine the risk impact of Liquefied Petroleum Gas (LPG) storage facilities, especially in the event of LPG tank explosion. In order to prevent the LPG tank explosion from occurring, it is important to decide the most suitable operating condition for the LPG tank itself, as the explosion of LPG tank could affect and cause extensive damage to the surrounding. The explosion of LPG tank usually occurs due to the rise of pressure in the tank. Thus, in this research, a method called Planas-Cuchi was applied to determine the Peak Side-On Overpressure (Po) of the LPG tank during the occurrence of explosion. Thermodynamic properties of saturated propane, (C3H8) have been chosen as a reference and basis of calculation to determine the parameters such as Explosion Energy (E), Equivalent Mass of TNT (WTNT), and Scaled Overpressure (PS ). A cylindrical LPG tank in Feyzin Refinery, France was selected as a case study in this research and at the end of this research, the most suitable operating pressure of the LPG tank was determined.

  14. The Explosive Counterparts of Gravitational Waves

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    Astronomy collaborations like the Dark Energy Survey, which Fermilab leads, can track down the visible sources of gravitational waves caused by binary neutron stars. This animation takes you through the collision of two neutron stars, and shows you the explosion of light and energy seen by the Dark Energy Camera on August 17, 2017.

  15. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9809, Mar. 8, 1983...

  16. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9809, Mar. 8, 1983...

  17. 30 CFR 816.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 816.67(e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9809, Mar. 8, 1983...

  18. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9811, Mar. 8, 1983] ...

  19. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9811, Mar. 8, 1983] ...

  20. 30 CFR 817.68 - Use of explosives: Records of blasting operations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 817.67 (e). (e) Weather conditions, including those which may cause possible adverse blasting effects..., spacing, decks, and delay pattern. (h) Diameter and depth of holes. (i) Types of explosives used. (j... airblast level recorded. (p) Reasons and conditions for each unscheduled blast. [48 FR 9811, Mar. 8, 1983] ...

  1. Changes in causes of death among persons with AIDS: San Francisco, California, 1996-2011.

    PubMed

    Schwarcz, Sandra K; Vu, Annie; Hsu, Ling Chin; Hessol, Nancy A

    2014-10-01

    The increased life expectancy among HIV-infected persons treated with combination antiretroviral therapy (ART), risk behaviors, and co-morbidities associated with ART place HIV-infected persons at risk for non-HIV-related causes of death. We used the San Francisco HIV/AIDS registry to identify deaths that occurred from January 1996 through December 2011. Temporal trends in AIDS- and non-AIDS-related mortality rates, the proportion of underlying and contributory causes of death, and the ratio of observed deaths in the study population to expected number of deaths among California men aged 20-79 (standardized mortality ratio [SMR]) of underlying causes of death were examined. A total of 5338 deaths were identified. The annual AIDS-related death rate (per 100 deaths) declined from 10.8 in 1996 to 0.9 in 2011 (p<0.0001), while the annual death rate from non-AIDS-related causes declined from 2.1 in 1996 to 0.9 in 2011 (p<0.0001). The proportion of deaths due to all types of heart disease combined, all non-AIDS cancers combined, mental disorders resulting from substance abuse, drug overdose, suicide and chronic obstructive pulmonary disease increased significantly over time. The SMRs for liver diseased decreased significantly over time but remained elevated. Our data highlight the importance of age-related causes of death as well as deaths from causes that are, at least in part, preventable.

  2. Quantitative and Qualitative Analyzes of the Explosive Cyclones that Reached the Antarctic Coast in the First Half of 2017

    NASA Astrophysics Data System (ADS)

    Pires, L. B. M.; Romao, M.; Freitas, A. C. V.

    2017-12-01

    An explosive cyclone is a kind of extratropical cyclone which shows a drop in pressure of at least 24 hPa in 24 hours. These are usually intense and they have rapid displacement which hinders their predictability. It is likely that climate change is causing an increase in this type of event in the Antarctic coast and, if this increase is confirmed, the regime of winds and temperatures may be changing. If there are more incidences of explosive cyclones, probably the Antarctic winds are becoming more intense and the temperatures in some places are becoming lower and in others are becoming higher. In the northern portion of the Antarctic Peninsula a decrease in temperature already has been recorded over the last 15 years, while a higher incidence of explosive cyclones over the region also has been found during this period. Studies also have suggested that the drop in temperatures in the Antarctic may be associated with the changes in wind direction, but the cause of these wind direction changes is unknown. Explosive cyclones, which change the wind patterns when they reach certain areas therefore may be contributing to this change in the Antarctic climate. This study is part of the "Explosive Cyclones on the Antarctic Coast" (EXCANC) Project conducted by the World Environmental Conservancy organization. This project analyzes data from meteorological stations strategically scattered throughout the coast and operated by various international Antarctic programs, and also utilizes satellite images. Results show that during the first half of 2017 the highest number of events were recorded at the Australian Casey station with 10 cases, followed by the French station of Dumont D'Urville with 7 cases. Halley's English station recorded its first explosive cyclone this year. Intensity analyzes also are shown.

  3. An introductory characterization of a combat-casualty-care relevant swine model of closed head injury resulting from exposure to explosive blast.

    PubMed

    Bauman, Richard A; Ling, Geoffrey; Tong, Lawrence; Januszkiewicz, Adolph; Agoston, Dennis; Delanerolle, Nihal; Kim, Young; Ritzel, Dave; Bell, Randy; Ecklund, James; Armonda, Rocco; Bandak, Faris; Parks, Steven

    2009-06-01

    Explosive blast has been extensively used as a tactical weapon in Operation Iraqi Freedom (OIF) and more recently in Operation Enduring Freedom(OEF). The polytraumatic nature of blast injuries is evidence of their effectiveness,and brain injury is a frequent and debilitating form of this trauma. In-theater clinical observations of brain-injured casualties have shown that edema, intracranial hemorrhage, and vasospasm are the most salient pathophysiological characteristics of blast injury to the brain. Unfortunately, little is known about exactly how an explosion produces these sequelae as well as others that are less well documented. Consequently, the principal objective of the current report is to present a swine model of explosive blast injury to the brain. This model was developed during Phase I of the DARPA (Defense Advanced Research Projects Agency) PREVENT (Preventing Violent Explosive Neurotrauma) blast research program. A second objective is to present data that illustrate the capabilities of this model to study the proximal biomechanical causes and the resulting pathophysiological, biochemical,neuropathological, and neurological consequences of explosive blast injury to the swine brain. In the concluding section of this article, the advantages and limitations of the model are considered, explosive and air-overpressure models are compared, and the physical properties of an explosion are identified that potentially contributed to the in-theater closed head injuries resulting from explosions of improvised explosive devices (IEDs).

  4. Long-Term Consequences of Radioactive Fallout From Conflicts Involving Nuclear Explosions

    NASA Astrophysics Data System (ADS)

    Simon, S. L.; Bouville, A.

    2006-12-01

    This presentation will summarize past exposures of the public to radioactive fallout from nuclear testing and extrapolate to the possible fallout-related consequences from detonation of multiple warheads that might accompany international conflicts. Long-term consequences could be of three distinct types: (1) the abandonment of living areas that might be heavily contaminated; (2) the necessity to curtail use of particular agricultural products and foods, and (3) life-shortening due to increased rates of cancer and possibly some non-cancer diseases among the exposed populations. While the actual health and economic impact on the surviving public after such conflicts could vary tremendously depending on the number and sizes of explosions (fission yields), height of detonations, and the public's proximity to explosion sites, it is clear that multiple detonations would disperse radioactive products over large geographic areas. Our understanding of radioactive fallout is based on studies carried out for more than five decades on weapons testing fallout that originated from sites worldwide including Nevada, the Soviet Union, four locations in the Pacific, and elsewhere. Those studies have led to an understanding of the composition of radioactive fallout, of its radioactive qualities, and of its capacity to contaminate ground and agricultural products, as well as dwellings and workplaces located from a few km to tens of thousands of km from the explosion site. Though the most severe individual health consequences from exposure to fallout would most likely develop relatively close to the detonation sites (within a few hundred km), wide geographic distribution of fallout, well beyond the borders of the nations involved in the conflict, would affect much larger populations and would likely cause elevated cancer rates and cancer-related deaths among them for many decades following. While acute radiation symptoms (and even death) can result from very high short-term exposures (on the order of a few thousand times the annual dose from natural background radiation), the increase in the long-term rate of cancer development as a result of lower, chronic exposures due to the contamination of the habitat and of the dietary foodstuffs, will pose very difficult scientific, economic, political, and societal problems. Most areas close to sites of detonation (i.e., within about 1000 km) would be primarily impacted by radionuclides with shorter half-lives (i.e., less than 2 months), e.g., Zirconium-95, Niobium-95, Iodine-131, Iodine-132, Iodine-133, Barium-140, Lanthanum-140, and Strontium-89. Conversely, most areas at further distances would be primarily impacted by radionuclides with longer half-lives, e.g., Strontium-90 and Cesium-137 (each with half-lives of 30 years). Contaminating radionuclides with very long half-lives, e.g., Plutonium-239, which has a half-life of 24,000 years, will almost never limit habitation despite widespread fear of them.

  5. From Vulcanian explosions to sustained explosive eruptions: The role of diffusive mass transfer in conduit flow dynamics

    NASA Astrophysics Data System (ADS)

    Mason, R. M.; Starostin, A. B.; Melnik, O. E.; Sparks, R. S. J.

    2006-05-01

    Magmatic explosive eruptions are influenced by mass transfer processes of gas diffusion into bubbles caused by decompression. Melnik and Sparks [Melnik, O.E., Sparks, R.S.J. 2002, Modelling of conduit flow dynamic during explosive activity at Soufriere Hills Volcano, Montserrat. In: Druitt, T.H., Kokelaar, B.P. (eds). The Eruption of Soufriere Hills Volcano, Montserrat, from 1995 to 1999. Geological Society, London, Memoirs, 21, 307-317] proposed two end member cases corresponding to complete equilibrium and complete disequilibrium. In the first case, diffusion is fast enough to maintain the system near equilibrium and a long-lived explosive eruption develops. In the latter case, pre-existing bubbles expand under conditions of explosive eruption and decompression, but diffusive gas transfer is negligible. This leads to a much shorter eruption. Here we develop this model to consider the role of mass transfer by investigating transient flows at the start of an explosive eruption triggered by a sudden decompression. The simulations reveal a spectrum of behaviours from sustained to short-lived highly non-equilibrium Vulcanian-style explosions lasting a few tens of seconds, through longer lasting eruptions that can be sustained for tens of minutes and finally to eruptions that can last hours or even days. Behaviour is controlled by a mass-transfer parameter, ω, which equals n*2/3D, where n* is the bubble number density and D is the diffusivity. The parameter ω is expected to vary between 10 - 5 and 1 s - 1 in nature and reflects a time-scale for efficient diffusion. The spectrum of model behaviours is consistent with variations in styles of explosive eruptions of silicic volcanoes. In the initial stages peak discharges occur over 10-20 s and then decline to low discharges. If a critical bubble overpressure is assumed to be the criterion for fragmentation then fragmentation may stop and start several times in the declining period causing several pulses of high-intensity discharge. For the cases of strong disequilibria, the fluxes can decrease to negligible values where other processes, such as gas escape through permeable magma, prevents explosive conditions becoming re-established so that explosive activity stops and dome growth can start. For cases closer to the equilibrium the eruption can evolve towards a quasi-steady sustained flow, never declining sufficiently for gas escape to become dominant.

  6. [Detection of underlying causes of death among the deceased of Yusho patients by linkage to the national vital statistics data].

    PubMed

    Kaneko, S; Yoshimura, T; Ikeda, M; Nishisaka, K

    2001-05-01

    As of January 31, 1996, 292 deaths among registered patients of Yusho were identified by three follow-up studies conducted in 1986, 1990, and 1996. In this study, we attempted to identify underlying causes of death by linkage of the registered data to the National Vital Statistics Data provided by the Management and Coordination Agency of Japan, which included 15 million deaths between 1978 and 1996. The two datasets were linked by matching for six variables; birth year/month/day, death year/month, and sex, along with a variable of death day or death place, or both. The matched cases were 203 among 235 deaths between 1978 and 1996 (matching rate was 86%). Among the 203 deaths, 58 underlying causes of death were newly identified, 146 causes of death were already grasped by the follow-up studies, and 31 deaths did not have matching pair in the National Vital Statistics data. Among the 146 deaths, 110 causes of death were concordant with each other, however, 35 causes of death were completely discord. The reason of the discordance and the unmatched deaths might be due to difference in information of the matching variables in the two datasets. In order to conduct an efficient follow-up study of Yusho patients, identification of underlying causes of death by linkage to the National Vital Statistics Date is evitable. For that, we need to substitute basic information in the Yusho database to those compatible to the National civil registration system.

  7. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles.

    PubMed

    Caulfield, Laura E; de Onis, Mercedes; Blössner, Monika; Black, Robert E

    2004-07-01

    Previous analyses derived the relative risk (RR) of dying as a result of low weight-for-age and calculated the proportion of child deaths worldwide attributable to underweight. The objectives were to examine whether the risk of dying because of underweight varies by cause of death and to estimate the fraction of deaths by cause attributable to underweight. Data were obtained from investigators of 10 cohort studies with both weight-for-age category (<-3 SDs, -3 to <-2 SDs, -2 to <-1 SD, and >-1 SD) and cause of death information. All 10 studies contributed information on weight-for-age and risk of diarrhea, pneumonia, and all-cause mortality; however, only 6 studies contributed information on deaths because of measles, and only 3 studies contributed information on deaths because of malaria or fever. With use of weighted random effects models, we related the log mortality rate by cause and anthropometric status in each study to derive cause-specific RRs of dying because of undernutrition. Prevalences of each weight-for-age category were obtained from analyses of 310 national nutrition surveys. With use of the RR and prevalence information, we then calculated the fraction of deaths by cause attributable to undernutrition. The RR of mortality because of low weight-for-age was elevated for each cause of death and for all-cause mortality. Overall, 52.5% of all deaths in young children were attributable to undernutrition, varying from 44.8% for deaths because of measles to 60.7% for deaths because of diarrhea. A significant proportion of deaths in young children worldwide is attributable to low weight-for-age, and efforts to reduce malnutrition should be a policy priority.

  8. [Maternal deaths due to infectious cause, results from the French confidential enquiry into maternal deaths, 2010-2012].

    PubMed

    Rigouzzo, A; Tessier, V; Zieleskiewicz, L

    2017-12-01

    Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period. The main infectious agents involved in maternal deaths from direct causes were Streptococcus A, Escherichia Coli and Clostridium perfringens: these bacterias were responsible for toxic shock syndrome, severe sepsis, secondary in some cases to cellulitis or necrotizing fasciitis. Of the 6 deaths due to direct infection, 4 were considered avoidable because of inadequate management: delayed or missed diagnosis, delayed or inadequate initiation of a specific medical and/or surgical treatment. Of the 16 indirect maternal deaths due to infection causes, the most often involved infectious agents were influenza A (H1N1) virus and Streptococcus pneumonia with induced purpura fulminans: the absence of influenza vaccination during pregnancy, delayed diagnosis and emergency initiation of a specific treatment, were the main contributory factors to these deaths and their avoidability in 70% of the cases analyzed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Causes of death in 2877 patients with myelodysplastic syndromes.

    PubMed

    Nachtkamp, Kathrin; Stark, Romina; Strupp, Corinna; Kündgen, Andrea; Giagounidis, Aristoteles; Aul, Carlo; Hildebrandt, Barbara; Haas, Rainer; Gattermann, Norbert; Germing, Ulrich

    2016-05-01

    Patients with myelodysplastic syndromes face a poor prognosis. The exact causes of death have not been described properly in the past. We performed a retrospective analysis of causes of death using data of 3792 patients in the Düsseldorf registry who have been followed up for a median time of 21 months. Medical files as well as death certificates were screened and primary care physicians were contacted. Death after AML evolution, infection, and bleeding was considered to be clearly disease-related. Further categories of causes of death were heart failure, other possibly disease-related reasons, such as hemochromatosis, disease-independent reasons as well as cases with unclear causes of death. Median age at the time of diagnosis was 71 years. At the time of analysis, 2877 patients (75.9 %) had deceased. In 1212 cases (42.1 %), the exact cause of death could not be ascertained. From 1665 patients with a clearly documented cause of death, 1388 patients (83.4 %) succumbed directly disease-related (AML (46.6 %), infection (27.0 %), bleeding (9.8 %)), whereas 277 patients (16.6 %) died for reasons not directly related with myelodysplastic syndromes (MDS), including 132 patients with cardiac failure, 77 non-disease-related reasons, 23 patients with solid tumors, and 45 patients with possibly disease-related causes like hemochromatosis. Correlation with IPSS, IPSS-R, and WPSS categories showed a proportional increase of disease-related causes of death with increasing IPSS/IPSS-R/WPSS risk category. Likewise, therapy-related MDS were associated with a higher percentage of disease-related causes of death than primary MDS. This reflects the increasing influence of the underlying disease on the cause of death with increasing aggressiveness of the disease.

  10. Trends in Disparity by Sex and Race/Ethnicity for the Leading Causes of Death in the United States-1999-2010.

    PubMed

    Chang, Man-Huei; Moonesinghe, Ramal; Athar, Heba M; Truman, Benedict I

    2016-01-01

    Temporal trends in disparities in the leading causes of death within and between US demographic subgroups indicate the need for and success of interventions to prevent premature death in vulnerable populations. Studies that report recent trends are limited and outdated. To describe temporal trends in disparities in death rates by sex and race/ethnicity for the 10 leading causes of death in the United States during 1999-2010. We used underlying cause of death data and population estimates from the National Vital Statistics System to calculate age-adjusted death rates for the 10 leading causes of death during 1999-2010. We measured absolute and relative disparities by sex and race/ethnicity for each cause and year of death; we used weighted linear regression to test for significance of trends over time. Of the 10 leading causes of death, age-adjusted death rates by sex and race/ethnicity declined during 1999-2010 for 6 causes and increased for 4 causes. But sex and racial/ethnic disparities between groups persisted for each year and cause of death. In the US population, the decreasing trend during 1999-2010 was greatest for cerebrovascular disease (-36.5%) and the increasing trend was greatest for Alzheimer disease (52.4%). For each sex and year, the disparity in death rates between Asian/Pacific Islanders (API) and other groups varied significantly by cause of death. In 2010, the API-non-Hispanic black disparity was largest for heart disease, malignant neoplasms, cerebrovascular diseases, and nephritis; the API-American Indian/Alaska Native disparity was largest for unintentional injury, diabetes mellitus, influenza and pneumonia, and suicide; and the API-non-Hispanic white disparity was largest for chronic lower respiratory diseases and Alzheimer disease. Public health practitioners can use these findings to improve policies and practices and to evaluate progress in eliminating disparities and their social determinants in vulnerable populations.

  11. The role of atmospheric nuclear explosions on the stagnation of global warming in the mid 20th century

    NASA Astrophysics Data System (ADS)

    Fujii, Yoshiaki

    2011-04-01

    This study suggests that the cause of the stagnation in global warming in the mid 20th century was the atmospheric nuclear explosions detonated between 1945 and 1980. The estimated GST drop due to fine dust from the actual atmospheric nuclear explosions based on the published simulation results by other researchers (a single column model and Atmosphere-Ocean General Circulation Model) has served to explain the stagnation in global warming. Atmospheric nuclear explosions can be regarded as full-scale in situ tests for nuclear winter. The non-negligible amount of GST drop from the actual atmospheric explosions suggests that nuclear winter is not just a theory but has actually occurred, albeit on a small scale. The accuracy of the simulations of GST by IPCC would also be improved significantly by introducing the influence of fine dust from the actual atmospheric nuclear explosions into their climate models; thus, global warming behavior could be more accurately predicted.

  12. Explosion containment device

    DOEpatents

    Benedick, William B.; Daniel, Charles J.

    1977-01-01

    The disclosure relates to an explosives storage container for absorbing and containing the blast, fragments and detonation products from a possible detonation of a contained explosive. The container comprises a layer of distended material having sufficient thickness to convert a portion of the kinetic energy of the explosion into thermal energy therein. A continuous wall of steel sufficiently thick to absorb most of the remaining kinetic energy by stretching and expanding, thereby reducing the momentum of detonation products and high velocity fragments, surrounds the layer of distended material. A crushable layer surrounds the continuous steel wall and accommodates the stretching and expanding thereof, transmitting a moderate load to the outer enclosure. These layers reduce the forces of the explosion and the momentum of the products thereof to zero. The outer enclosure comprises a continuous pressure wall enclosing all of the layers. In one embodiment, detonation of the contained explosive causes the outer enclosure to expand which indicates to a visual observer that a detonation has occurred.

  13. Distinct mortality profile in systemic sclerosis: a death certificate study in Rio de Janeiro, Brazil (2006-2015) using a multiple causes of death analysis.

    PubMed

    de Rezende, Rodrigo Poubel Vieira; Gismondi, Ronaldo Altenburg; Maleh, Haim Cesar; de Miranda Coelho, Elisa Mendes; Vieira, Carol Sartori; Rosa, Maria Luiza Garcia; Mocarzel, Luis Otavio

    2017-12-16

    The objective of this study was to assess the mortality profile related to SSc in the state of Rio de Janeiro, Brazil. We retrospectively examined all registered deaths in the region (2006-2015 period) in which the diagnosis of SSc was mentioned on any line of the death certificates (underlying cause of death [UCD], n = 223; non-UCD, n = 151). Besides the analysis of gender, age, and the causes of death, we also compared the mortality from UCDs between individuals whose death causes included SSc (cases) and those whose death causes did not include SSc (deceased controls). For the latter comparison, we used the mortality odds ratio to approximate the cause-specific standardized mortality ratio. We identified 1495 death causes among the 374 SSc cases. The mean age at death of the SSc cases (85% women) was significantly lower than that of the controls (n = 1,294,117) (58.7 vs. 65.5 years, respectively). The main death causes were circulatory system diseases, infections, and respiratory diseases (36%, 34%, and 21% of SSc cases, respectively). Compared to the deceased controls, there were proportionally more deaths among the SSc cases from pulmonary arterial hypertension, lung fibrosis, septicemia, gastrointestinal hemorrhage, other systemic connective tissue diseases, and heart failure (for death age < 50 years). We confirmed the high burden of cardiovascular, respiratory, and infectious causes in this predominantly non-Caucasian sample of SSc patients. Of interest, the percentage of infection-related deaths in our report was about three times higher than that in SSc studies with predominantly Caucasian populations.

  14. Psychic trauma as cause of death.

    PubMed

    Terranova, C; Snenghi, R; Thiene, G; Ferrara, S D

    2011-01-01

    of study Psychic trauma is described as the action of 'an emotionally overwhelming factor' capable of causing neurovegetative alterations leading to transitory or persisting bodily changes. The medico-legal concept of psychic trauma and its definition as a cause in penal cases is debated. The authors present three cases of death after psychic trauma, and discuss the definition of cause within the penal ambit of identified 'emotionally overwhelming factors'. The methodological approach to ascertainment and criterion-based assessment in each case involved the following phases: (1) examination of circumstantial evidence, clinical records and documentation; (2) autopsy; (3) ascertainment of cause of death; and (4) ascertainment of psychic trauma, and its coexisting relationship with the cause of death. The results and assessment of each of the three cases are discussed from the viewpoint of the causal connotation of psychic trauma. In the cases presented, psychic trauma caused death, as deduced from assessment of the type of externally caused emotional insult, the subjects' personal characteristics and the circumstances of the event causing death. In cases of death due to psychic trauma, careful methodological ascertainment is essential, with the double aim of defining 'emotionally overwhelming factors' as a significant cause of death from the penal point of view, and of identifying the responsibility of third parties involved in the death event and associated dynamics of homicide.

  15. The reliability of cause-of-death coding in The Netherlands.

    PubMed

    Harteloh, Peter; de Bruin, Kim; Kardaun, Jan

    2010-08-01

    Cause-of-death statistics are a major source of information for epidemiological research or policy decisions. Information on the reliability of these statistics is important for interpreting trends in time or differences between populations. Variations in coding the underlying cause of death could hinder the attribution of observed differences to determinants of health. Therefore we studied the reliability of cause-of-death statistics in The Netherlands. We performed a double coding study. Death certificates from the month of May 2005 were coded again in 2007. Each death certificate was coded manually by four coders. Reliability was measured by calculating agreement between coders (intercoder agreement) and by calculating the consistency of each individual coder in time (intracoder agreement). Our analysis covered an amount of 10,833 death certificates. The intercoder agreement of four coders on the underlying cause of death was 78%. In 2.2% of the cases coders agreed on a change of the code assigned in 2005. The (mean) intracoder agreement of four coders was 89%. Agreement was associated with the specificity of the ICD-10 code (chapter, three digits, four digits), the age of the deceased, the number of coders and the number of diseases reported on the death certificate. The reliability of cause-of-death statistics turned out to be high (>90%) for major causes of death such as cancers and acute myocardial infarction. For chronic diseases, such as diabetes and renal insufficiency, reliability was low (<70%). The reliability of cause-of-death statistics varies by ICD-10 code/chapter. A statistical office should provide coders with (additional) rules for coding diseases with a low reliability and evaluate these rules regularly. Users of cause-of-death statistics should exercise caution when interpreting causes of death with a low reliability. Studies of reliability should take into account the number of coders involved and the number of codes on a death certificate.

  16. A 10 year study of the cause of death in children under 15 years in Manhiça, Mozambique

    PubMed Central

    Sacarlal, Jahit; Nhacolo, Ariel Q; Sigaúque, Betuel; Nhalungo, Delino A; Abacassamo, Fatima; Sacoor, Charfudin N; Aide, Pedro; Machevo, Sonia; Nhampossa, Tacilta; Macete, Eusébio V; Bassat, Quique; David, Catarina; Bardají, Azucena; Letang, Emili; Saúte, Francisco; Aponte, John J; Thompson, Ricardo; Alonso, Pedro L

    2009-01-01

    Background Approximately 46 million of the estimated 60 million deaths that occur in the world each year take place in developing countries. Further, this mortality is highest in Sub-Saharan Africa, although causes of mortality in this region are not well documented. The objective of this study is to describe the most frequent causes of mortality in children under 15 years of age in the demographic surveillance area of the Manhiça Health Research Centre, between 1997 and 2006, using the verbal autopsy tool. Methods Verbal autopsy interviews for causes of death in children began in 1997. Each questionnaire was reviewed independently by three physicians with experience in tropical paediatrics, who assigned the cause of death according to the International Classification of Diseases (ICD-10). Each medical doctor attributed a minimum of one and a maximum of 2 causes. A final diagnosis is reached when at least two physicians agreed on the cause of death. Results From January 1997 to December 2006, 568499 person-year at risk (pyrs) and 10037 deaths were recorded in the Manhiça DSS. 3730 deaths with 246658 pyrs were recorded for children under 15 years of age. Verbal autopsy interviews were conducted on 3002 (80.4%) of these deaths. 73.6% of deaths were attributed to communicable diseases, non-communicable diseases accounted for 9.5% of the defined causes of death, and injuries for 3.9% of causes of deaths. Malaria was the single largest cause, accounting for 21.8% of cases. Pneumonia with 9.8% was the second leading cause of death, followed by HIV/AIDS (8.3%) and diarrhoeal diseases with 8%. Conclusion The results of this study stand out the big challenges that lie ahead in the fight against infectious diseases in the study area. The pattern of childhood mortality in Manhiça area is typical of developing countries where malaria, pneumonia and HIV/AIDS are important causes of death. PMID:19236726

  17. Investigation of Mechanism of Potential Aircraft Fuel Tank Vent Fires and Explosions Caused by Atmospheric Electricity

    NASA Technical Reports Server (NTRS)

    1961-01-01

    The nature of the potential fuel tank vent fire and explosion hazard is discussed in relation to present vent exit design practice, available knowledge of atmospheric electricity as a source of ignition energy, and the vent system vapor space environment. Flammable mixtures and possible ignition sources may occur simultaneously as a rare phenomena according to existing knowledge. There is a need to extend the state of science in order to make possible vent design which is aimed specifically at minimizing fire and explosion hazards.

  18. Modelling Public Security Operations: Analysis of the Effect of Key Social, Cognitive, and Informational Factors with Security System Relationship Configurations for Goal Achievement

    DTIC Science & Technology

    2012-12-01

    of MARSEC 2 13 Causing a fire or explosion, conducting blasting or setting off fireworks , including setting a flare or other signalling device...or explosion, conducting blasting or setting off fireworks , including setting a flare or other signalling device without port approval X X X X X X...explosion, conducting blasting or setting off fireworks , including setting a flare or other signalling device without port approval X X X X X X X Non

  19. [Death rate by malnutrition in children under the age of five, Colombia].

    PubMed

    Quiroga, Edwin Fernando

    2012-01-01

    Much higher mortalities occur in children under five in developing countries with high poverty rates compared with developed countries. Causes of death are related to perinatal conditions, measles, HIV/AIDS, diarrhea, respiratory diseases and others. Throughout the world, malnutrition has been identified as the underlying cause of approximately half of these deaths. Death rate due to malnutrition was described using an adjusted method that takes into account the difficulties of identifying malnutrition as a direct cause of death. A descriptive study included analysis of the International Classification of Diseases (ICD-10) vital statistics from 2003-2007. Death rates were estimated, a method of analysis of multiple causes was applied for infectious diseases, along with calculations of death probabilities. Malnutrition was associated with infectious diseases. The frequency of infectious disease as a direct cause of death was almost seven times higher in cases with the antecedent of malnutrition. When adjusted death rate values were used, the initial value increased nearly five times. The probability of death after the adjustment for inadequate classification increased approximately four times. The Analysis of Multiple Causes Method was established as an effective method in analyzing malnutrition and infectious diesease mortality in Colombia. Malnutrition may be a direct underlying cause of death in one of eight deaths in children <1 year old and one of three deaths in 1-4-year-olds.

  20. Burns in mobile home fires--descriptive study at a regional burn center.

    PubMed

    Mullins, Robert F; Alarm, Badrul; Huq Mian, Mohammad Anwarul; Samples, Jancie M; Friedman, Bruce C; Shaver, Joseph R; Brandigi, Claus; Hassan, Zaheed

    2009-01-01

    Death from fires and burns are the sixth most common cause of unintentional injury death in the United States. More than (3/4) of burn deaths occurring in the United States are in the home. Mobile home fires carry twice the death rate as other dwellings. The aim of the study was to describe the characteristics of deaths and injuries in mobile home fire admitted in a regional Burn Center and to identify possible risk factors. A cross-sectional retrospective study was carried out among all burn patients admitted to a regional Burn Center between January 2002 and December 2004 (3469 patients). The study included patients who suffered a burn injury from a mobile home fire. The demographic characteristics of the patients, location of mobile home, associated inhalation injury, source of fire, comorbidity of the victims, employment status, insurance status, family history of burns, and outcomes of the treatment were incorporated in a data collection record. There were 65 burn patients in mobile home fires admitted to the Burn Center during the studied period. The average age of the patients was 39 years (ranging from 2 to 81 years, SD=16.06), 77% were male, 67% were white, and 79% were the residents in the suburban areas of Georgia, South Carolina, North Carolina, and Florida. The average TBSA of burns was about 21% (ranging from 1 to 63%, SD=17.66), 63% of the patients had associated inhalation, three inhalation injury only, and 69% patients required ventilator support. The average length of stay per TBSA percentage of burn was 1.01 days (P=0.00), controlling for age, preexisting medical comorbidities, and inhalation injury. About 88% of the patients had preexisting medical comorbid conditions, 74% were smokers, 64% reported as alcoholic, and 72% had at least some form of health insurance coverage. In 40% of the cases, the cause of the fire was unknown, 31% were caused by accidental explosions, such as electric, gasoline, or kerosene appliances, and 29% were due to other causes. About 40% of burns took place between December and February. Among the studied cohorts, 32% were unemployed, 15% were disabled, and 14% did not have any information about their employment status. One in every four patients had a family history of a burn. Eight (12%) died in the hospital during treatment. There was a higher prevalence of inhalation injury and higher case fatality among the burn patients in mobile home fires compared with the statistics of the Burn Center. Observation showed a higher number of smokers and alcoholics among the burn patients. The main sources of fire were from home appliances. Fewer people had health insurance coverage than the national standard and more people suffered from some sort of chronic illness compared with the national morbidity data.

  1. [Death causes in 428 alcoholic patients: a descriptive study].

    PubMed

    Martínez Lanz, P; Días Coto, C

    1992-12-01

    Several studies have demonstrated either a direct or an indirect relationship between alcoholism and death causes. The present paper is a descriptive study about death causes in 428 alcoholic patients from San José, Costa Rica, metropolitan area, whose death occurred between 1978 and 1988. Sample subjects were males, under 90-year-old at death time. It was found out that basic death causes were: Traumatism and poisoning, 25%; circulatory system illnesses, 20%; digestive system illnesses, 18.5%, and tumors, 15%.

  2. A multicenter study of outcome in systemic lupus erythematosus. II. Causes of death.

    PubMed

    Rosner, S; Ginzler, E M; Diamond, H S; Weiner, M; Schlesinger, M; Fries, J F; Wasner, C; Medsger, T A; Ziegler, G; Klippel, J H; Hadler, N M; Albert, D A; Hess, E V; Spencer-Green, G; Grayzel, A; Worth, D; Hahn, B H; Barnett, E V

    1982-06-01

    Causes of death were examined for 1,103 systemic lupus erythematosus patients who were followed from 1965 to 1978 at 9 centers that participated in the Lupus Survival Study Group. A total of 222 patients (20%) died. Lupus-related organ system involvement (mainly active nephritis) and infection were the most frequent primary causes of death. Causes of death were similar throughout the followup period. Hemodialysis had little impact on the length of survival for patients with nephritis. Active central nervous system disease and myocardial infarction were infrequent causes of death. There were no deaths from malignancy.

  3. Confronting the Urban Nightmare: "La Pared Transparente" by Ernestina De Champourcin

    ERIC Educational Resources Information Center

    de Champourcin, Ernestina

    2014-01-01

    After thirty-three years of exile in Mexico, Ernestina de Champourcin returned to Madrid in 1972, in time to witness the profound political changes in Spain prompted by the death of Franco and by the cultural revolution originating in the capital known as the "movida madrileña." Between 1979 and 1980, she responded to the explosion of…

  4. FastStats: Leading Causes of Death

    MedlinePlus

    ... Births Teen Births Unmarried Childbearing Deaths Deaths and Mortality Leading Causes of Death Life Expectancy Race and ... Data are for 2015) Related FastStats Deaths and mortality More data Deaths: Final Data for 2015 [PDF – ...

  5. [Cause of late death in liver transplant recipients].

    PubMed

    Coelho, Júlio Cézar Uili; Parolin, Mônica B; Matias, Jorge Eduardo Fouto; Jorge, Fernando Marcus Felipe; Canan Júnior, Lady Wilson

    2003-01-01

    The objective is to present the causes of late death in patients subjected to liver transplantation. A total of 209 patients were subjected to 223 liver transplantations (14 retransplantations). The computerized study protocol sheets were evaluated to determine the causes of late death (> 6 months after transplantation). Of the 209 patients, 30 had late death. Ductopenic rejection (chronic rejection) was the most common cause and it was observed in 10 patients. Time after transplantation at the moment of death of this group of patients varied from 11 to 57 months, with an average of 29 months. Seven patients died at the hospital admission of hepatic retransplantation. Other causes of late death were sepsis, lymphoproliferative disease, chronic renal insufficiency, and hepatic insufficiency. The most common cause of late death after liver transplantation is ductopenic rejection, followed by complications of retransplantation and sepsis. Death owing to ductopenic rejection may occur even many years after transplantation.

  6. Doctors and the causes of neonatal death in Scotland in the second half of the nineteenth century

    PubMed Central

    Reid, Alice; Garrett, Eilidh

    2015-01-01

    This paper examines causes of neonatal death in two contrasting Scottish communities in the second half of the nineteenth century. Individual death certificates allow comparison of the causes as recorded by different doctors and by lay informants. The paper finds that doctors almost always offer a medical-sounding cause of death, but that causes offered by individual doctors varied according to the nature of their practice, developments in medical terminology, and individual preference. Lay people were much more likely to offer no cause at all, or to suggest a non-medical term. Large percentages of deaths in the not-known category can therefore indicate poor medical provision, and are more likely to be found in remote rural areas and may be accompanied by an under-registration of very early neonatal infant deaths and their corresponding births, and by ‘disguise’ of certain causes of death. The paper examines the unusual age pattern of neonatal deaths on Skye and concludes that, although there is no mention of neonatal tetanus in the death registers, there is a substantial probability that the disease was present on the island. Comparisons of cause-of-death statistics between places and over time should therefore be made with extreme caution. PMID:26166908

  7. Obesity-related mortality in France, Italy, and the United States: a comparison using multiple cause-of-death analysis

    PubMed Central

    Barbieri, Magali; Egidi, Viviana; Demuru, Elena; Frova, Luisa; Meslé, France; Pappagallo, Marilena

    2018-01-01

    Objectives We investigate the reporting of obesity on death certificates in three countries (France, Italy, and the United States) with different levels of prevalence, and we examine which causes are frequently associated with obesity. Methods We use cause-of-death data for all deaths at ages 50–89 in 2010–2011. Since obesity may not be the underlying cause (UC) of death, we compute age- and sex- standardized death rates considering all mentions of obesity (multiple causes or MC). We use cluster analyses to identify patterns of cause-of-death combinations. Results Obesity is selected as UC in no more than 20% of the deaths with a mention of obesity. Mortality levels, whether measured from the UC or the MC, are weakly related to levels of prevalence. Patterns of cause-of-death combinations are similar across the countries. In addition to strong links with cardiovascular diseases and diabetes, we identify several less familiar associations. Conclusions Considering all mentions on the deaths certificates reduces the underestimation of obesity-related mortality based on the UC only. It also enables us to describe the various mortality patterns involving obesity. PMID:28497238

  8. Obesity-related mortality in France, Italy, and the United States: a comparison using multiple cause-of-death analysis.

    PubMed

    Barbieri, Magali; Désesquelles, Aline; Egidi, Viviana; Demuru, Elena; Frova, Luisa; Meslé, France; Pappagallo, Marilena

    2017-07-01

    We investigate the reporting of obesity on death certificates in three countries (France, Italy, and the United States) with different levels of prevalence, and we examine which causes are frequently associated with obesity. We use cause-of-death data for all deaths at ages 50-89 in 2010-2011. Since obesity may not be the underlying cause (UC) of death, we compute age- and sex-standardized death rates considering all mentions of obesity (multiple causes or MC). We use cluster analyses to identify patterns of cause-of-death combinations. Obesity is selected as UC in no more than 20% of the deaths with a mention of obesity. Mortality levels, whether measured from the UC or the MC, are weakly related to levels of prevalence. Patterns of cause-of-death combinations are similar across the countries. In addition to strong links with cardiovascular diseases and diabetes, we identify several less familiar associations. Considering all mentions on the deaths certificates reduces the underestimation of obesity-related mortality based on the UC only. It also enables us to describe the various mortality patterns involving obesity.

  9. Difference of the Climatological Monthly Frequency of the Explosive Cyclones in the Northwestern Part of the Pacific and the Atlantic

    NASA Astrophysics Data System (ADS)

    Tsukijihara, T.; Tomita, T.; Iwao, K.

    2015-12-01

     This study examined the climatological monthly frequency of the explosive cyclones over the northwestern(NW) part of the Pacific and the Atlantic in boreal cold season (October-April) from 1979/80 to 2012/13, using the long-term objective analysis data. The climatological monthly frequency of the NW Atlantic is on a normal distribution with a maximum in January, while it deviates from a normal distribution in the NW Pacific, in particular, the deviation is large in March. Low-level meridional temperature gradient decreases linearly from February to April in the Gulf stream region. However, the gradient is maintained through February to March to the east of Japan, and it sharply weakens in April. This feature is in good agreement with the climatological monthly frequency of the explosive cyclones in the two regions. The difference in the seasonal change of the low-level meridional temperature gradient in the two regions is caused by the positional relation of the gradient and continents. In particular, the difference of warmed area in the eastern part of the Eurasian and the North American continents causes the difference of the low-level meridional temperature gradient, and it causes the difference in the climatological monthly frequency of the explosive cyclones between the two regions from February to April.

  10. Childhood death rates declined in Sweden from 2000 to 2014 but deaths from external causes were not always investigated.

    PubMed

    Otterman, Gabriel; Lahne, Klara; Arkema, Elizabeth V; Lucas, Steven; Janson, Staffan; Hellström-Westas, Lena

    2018-03-08

    Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-17 (0.9%). Childhood deaths showed a sustained decline from 2000 to 2014 in Sweden and a quarter were from external, ill-defined or unknown causes. Systematic, interagency death reviews could yield information that could prevent future deaths. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities.

    PubMed

    Main, Elliott K; McCain, Christy L; Morton, Christine H; Holtby, Susan; Lawton, Elizabeth S

    2015-04-01

    To compare specific maternal and clinical characteristics and contributing factors among the five leading causes of pregnancy-related mortality to develop focused clinical and public health prevention programs. California pregnancy-related deaths from 2002-2005 were identified with enhanced surveillance using linked birth and death certificates. A multidisciplinary committee reviewed medical records, autopsy reports, and coroner reports to determine cause of death, clinical and demographic characteristics, chance to alter outcome, contributing factors (at health care provider, facility, and patient levels), and quality improvement opportunities. The five leading causes of death were compared with each other and with the overall California birth population. Among the 207 pregnancy-related deaths, the five leading causes were cardiovascular disease, preeclampsia or eclampsia, hemorrhage, venous thromboembolism, and amniotic fluid embolism. Among the leading causes of death, we identified differing patterns for race, maternal age, body mass index, timing of death, and method of delivery. Overall, there was a good-to-strong chance to alter the outcome in 41% of deaths, with the highest rates of preventability among hemorrhage (70%) and preeclampsia (60%) deaths. Health care provider, facility, and patient contributing factors also varied by cause of death. Pregnancy-related mortality should not be considered a single clinical entity. Reducing mortality requires in-depth examination of individual causes of death. The five leading causes exhibit different characteristics, degrees of preventability, and contributing factors, with the greatest improvement opportunities identified for hemorrhage and preeclampsia. These findings provide additional support for hospital, state, and national maternal safety programs.

  12. Surveillance of US Death Rates from Chronic Diseases Related to Excessive Alcohol Use.

    PubMed

    Polednak, Anthony P

    2016-01-01

    To assess the utility of multiple-cause (MC) death records for surveillance of US mortality rates from chronic causes related to excessive alcohol use. The Alcohol-Related Disease Impact (ARDI) resource produced estimates of the population 'alcohol attributable fraction' (AAF) due to excessive drinking for each alcohol-related (AAF > 0%) cause of death, and used AAFs to estimate numbers of alcohol-related deaths from alcohol-related underlying causes (UC) in adults age 20-64 and 65+ years in 2006-2010. For surveillance, this study used MC death file to identify individual deaths (2006-2010) with an 'alcohol-induced' cause (AAF = 100%) anywhere on the certificate, and to obtain US rates of premature death (ages 15-64 and 65-74 years) for 1999-2012. Using the selected MC records, numbers of deaths from alcohol-related chronic UC (2006-2010) were 81% of ARDI estimates for age 20-64, but only 40% for 65+ years. The MC records identified substantial numbers of deaths from causes (e.g. certain infectious diseases) not included as alcohol-related in ARDI, but included in surveillance of premature death rates for chronic UC. Also, premature death rates for chronic alcohol-induced causes using only the UC (as in routine mortality statistics) were only about half the rates based on MC; all rates increased in recent years but some reached statistical significance only by using MC. Using MC records underestimated total US deaths from alcohol-related chronic causes as the UC, but enhanced surveillance of rates for premature deaths involving chronic causes that may be related to excessive alcohol use. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  13. Exercise-Related Sudden Death: Risks and Causes (Part 1 of 2).

    ERIC Educational Resources Information Center

    Van Camp, Steven P.

    1988-01-01

    The causes of exercise-related sudden death are discussed. Multiple structural cardiovascular diseases are the primary cause of death in athletes under 30; severe coronary artery disease is the culprit in deaths of those over 30. These diseases and the mechanisms of sudden death, as well as preventive measures, are detailed. (JL)

  14. Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

    PubMed Central

    Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

    2015-01-01

    Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality. PMID:25590598

  15. Electronic cigarette explosions involving the oral cavity.

    PubMed

    Harrison, Rebecca; Hicklin, David

    2016-11-01

    The use of electronic cigarettes (e-cigarettes) is a rapidly growing trend throughout the United States. E-cigarettes have been linked to the risk of causing explosion and fire. Data are limited on the associated health hazards of e-cigarette use, particularly long-term effects, and available information often presents conflicting conclusions. In addition, an e-cigarette explosion and fire can pose a unique treatment challenge to the dental care provider because the oral cavity may be affected heavily. In this particular case, the patient's injuries included intraoral burns, luxation injuries, and alveolar fractures. This case report aims to help clinicians gain an increased knowledge about e-cigarette design, use, and risks; discuss the risk of spontaneous failure and explosion of e-cigarettes with patients; and understand the treatment challenges posed by an e-cigarette explosion. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  16. The Explosive Counterparts of Gravitational Waves (Silent Animation)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    Astronomy collaborations like the Dark Energy Survey, which Fermilab leads, can track down the visible sources of gravitational waves caused by binary neutron stars. This animation, presented here without sound, takes you through the collision of two neutron stars, and shows you the explosion of light and energy seen by the Dark Energy Camera on August 17, 2017.

  17. 77 FR 55108 - Explosive Siting Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ... against hazardous fragments, which are defined as having a kinetic energy of 58 foot-pounds, which is a level of kinetic energy capable of causing a fatality. The probability of a person six feet tall and one.... Explosions are due to the sudden release of energy over a short period of time and may or may not involve...

  18. Hypervelocity Impact Analysis of International Space Station Whipple and Enhanced Stuffed Whipple Shields

    DTIC Science & Technology

    2004-12-01

    29 Figure 6. Flash Radiography Images of the Debris Cloud and Ejecta...hand, are not predictable. Explosions can occur because of the inadvertent mixing of propellant and oxidizer or the over-pressurization of...residual propellant due to spacecraft heating. Over-pressurized batteries may also cause explosions. Based on statistical analysis of known hypervelocity

  19. Potentially Preventable Deaths Among the Five Leading Causes of Death - United States, 2010 and 2014.

    PubMed

    García, Macarena C; Bastian, Brigham; Rossen, Lauren M; Anderson, Robert; Miniño, Arialdi; Yoon, Paula W; Faul, Mark; Massetti, Greta; Thomas, Cheryll C; Hong, Yuling; Iademarco, Michael F

    2016-11-18

    Death rates by specific causes vary across the 50 states and the District of Columbia.* Information on differences in rates for the leading causes of death among states might help state health officials determine prevention goals, priorities, and strategies. CDC analyzed National Vital Statistics System data to provide national and state-specific estimates of potentially preventable deaths among the five leading causes of death in 2014 and compared these estimates with estimates previously published for 2010. Compared with 2010, the estimated number of potentially preventable deaths changed (supplemental material at https://stacks.cdc.gov/view/cdc/42472); cancer deaths decreased 25% (from 84,443 to 63,209), stroke deaths decreased 11% (from 16,973 to 15,175), heart disease deaths decreased 4% (from 91,757 to 87,950), chronic lower respiratory disease (CLRD) (e.g., asthma, bronchitis, and emphysema) deaths increased 1% (from 28,831 to 29,232), and deaths from unintentional injuries increased 23% (from 36,836 to 45,331). A better understanding of progress made in reducing potentially preventable deaths in the United States might inform state and regional efforts targeting the prevention of premature deaths from the five leading causes in the United States.

  20. The Shape of Superluminous Supernovae

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-11-01

    What causes the tremendous explosions of superluminous supernovae? New observations reveal the geometry of one such explosion, SN 2015bn, providing clues as to its source.A New Class of ExplosionsImage of a type Ia supernova in the galaxy NGC 4526. [NASA/ESA]Supernovae are powerful explosions that can briefly outshine the galaxies that host them. There are several different classifications of supernovae, each with a different physical source such as thermonuclear instability in a white dwarf, caused by accretion of too much mass, or the exhaustion of fuel in the core of a massive star, leading to the cores collapse and expulsion of its outer layers.In recent years, however, weve detected another type of supernovae, referred to as superluminous supernovae. These particularly energetic explosions last longer months instead of weeks and are brighter at their peaks than normal supernovae by factors of tens to hundreds.The physical cause of these unusual explosions is still a topic of debate. Recently, however, a team of scientists led by Cosimo Inserra (Queens University Belfast) has obtained new observations of a superluminous supernova that might help address this question.The flux and the polarization level (black lines) along the dominant axis of SN 2015bn, 24 days before peak flux (left) and 28 days after peak flux (right). Blue lines show the authors best-fitting model. [Inserra et al. 2016]Probing GeometryInserra and collaborators obtained two sets of observations of SN 2015bn one roughly a month before and one a month after the superluminous supernovas peak brightness using a spectrograph on the Very Large Telescope in Chile. These observations mark the first spectropolarimetric data for a superluminous supernova.Spectropolarimetry is the practice of obtaining information about the polarization of radiation from an objects spectrum. Polarization carries information about broken spatial symmetries in the object: only if the object is perfectly symmetric can it emit an unpolarized spectrum. Otherwise, the polarization of an objects spectrum reveals information about its geometry.Modeling EjectaThe authors best model of the geometry of SN 2015bn 24 days before (top) and 28 days after (bottom) peak flux. The model consists of two ellipsoidal layers of ejecta material. [Inserra et al. 2016]Based on their observations, Inserra and collaborators find that SN 2015bn is not spherically symmetric but it does appear to be axisymmetric around a single dominant axis. They also find that the polarization level of the object changes both with wavelength and over time.To explain these dependencies, the authors produce a simple toy model of SN 2015bn. In the best-fitting model, the supernova has a two-layered ellipsoidal or bipolar geometry. The inner region becomes more and more aspherical as time passes.What does this model tell us about the physical cause of this superluminous supernova? Inserra and collaborators argue that the axisymmetric shape favors a core-collapse explosion. A central inner engine of a spinning magnetar (a highly magnetized neutron star) or black hole then remains at the center of this explosion, pumping energy into it and causing the increase of the inner asymmetry over time.The authors caution that their models are very preliminary but these observations should drive future, more detailed modeling, as well as further spectropolarimetric observations of future nearby superluminous supernovae. With luck, we will soon better understand what drives these unusual explosions.CitationC. Inserra et al 2016 ApJ 831 79. doi:10.3847/0004-637X/831/1/79

  1. Studies on formation of unconfined detonable vapor cloud using explosive means.

    PubMed

    Apparao, A; Rao, C R; Tewari, S P

    2013-06-15

    Certain organic liquid fuels like hydrocarbons, hydrocarbon oxides, when dispersed in air in the form of small droplets, mix with surrounding atmosphere forming vapor cloud (aerosol) and acquire explosive properties. This paper describes the studies on establishment of conditions for dispersion of fuels in air using explosive means resulting in formation of detonable aerosols of propylene oxide and ethylene oxide. Burster charges based on different explosives were evaluated for the capability to disperse the fuels without causing ignition. Parameters like design of canister, burster tube, burster charge type, etc. have been studied based on dispersion experiments. The detonability of the aerosol formed by the optimized burster charge system was also tested. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Causes of Mortality for Indonesian Hajj Pilgrims: Comparison between Routine Death Certificate and Verbal Autopsy Findings

    PubMed Central

    Pane, Masdalina; Imari, Sholah; Alwi, Qomariah; Nyoman Kandun, I; Cook, Alex R.; Samaan, Gina

    2013-01-01

    Background Indonesia provides the largest single source of pilgrims for the Hajj (10%). In the last two decades, mortality rates for Indonesian pilgrims ranged between 200–380 deaths per 100,000 pilgrims over the 10-week Hajj period. Reasons for high mortality are not well understood. In 2008, verbal autopsy was introduced to complement routine death certificates to explore cause of death diagnoses. This study presents the patterns and causes of death for Indonesian pilgrims, and compares routine death certificates to verbal autopsy findings. Methods Public health surveillance was conducted by Indonesian public health authorities accompanying pilgrims to Saudi Arabia, with daily reporting of hospitalizations and deaths. Surveillance data from 2008 were analyzed for timing, geographic location and site of death. Percentages for each cause of death category from death certificates were compared to that from verbal autopsy. Results In 2008, 206,831 Indonesian undertook the Hajj. There were 446 deaths, equivalent to 1,968 deaths per 100,000 pilgrim years. Most pilgrims died in Mecca (68%) and Medinah (24%). There was no statistically discernible difference in the total mortality risk for the two pilgrimage routes (Mecca or Medinah first), but the number of deaths peaked earlier for those traveling to Mecca first (p=0.002). Most deaths were due to cardiovascular (66%) and respiratory (28%) diseases. A greater proportion of deaths were attributed to cardiovascular disease by death certificate compared to the verbal autopsy method (p<0.001). Significantly more deaths had ill-defined cause based on verbal autopsy method (p<0.001). Conclusions Despite pre-departure health screening and other medical services, Indonesian pilgrim mortality rates were very high. Correct classification of cause of death is critical for the development of risk mitigation strategies. Since verbal autopsy classified causes of death differently to death certificates, further studies are needed to assess the method’s utility in this setting. PMID:23991182

  3. Near-Death and Other Transpersonal Experiences Occurring During Catastrophic Events.

    PubMed

    Lawrence, Madelaine

    2017-06-01

    The purpose of this article is to describe examples of near-death and other transpersonal experiences occurring during catastrophic events like floods, wars, bombings, and death camps. To date, researchers have limited their investigations of these transpersonal events to those occurring to seriously ill patients in hospitals, those dying from terminal illnesses, or to individuals experiencing a period of grief after the death of a loved one. Missing is awareness by first responders and emergency healthcare professionals about these transpersonal experiences and what to say to the individuals who have them. Some responders experience not only deaths of the victims they assist, but also deaths of their colleagues. Information about these transpersonal experiences can also be of comfort to them. The examples in this article include a near-death experience during the Vietnam War, an out-of-body experience after a bomb explosion during the Iraq War, a near-death visit to a woman imprisoned at Auschwitz, and two after-death communications, one from a person killed in Auschwitz and another from a soldier during World War I. Also included are interviews with two New York City policemen who were September 11, 2001 responders. It is hoped the information will provide knowledge of these experiences to those who care for those near death, or dying, or grieving because of catastrophic events, and encourage researchers to further investigate these experiences during disasters.

  4. Sudden death victims <45 years: Agreement between cause of death established by the forensic physician and autopsy results.

    PubMed

    Ceelen, Manon; van der Werf, Christian; Hendrix, Anneke; Naujocks, Tatjana; Woonink, Frits; de Vries, Philip; van der Wal, Allard; Das, Kees

    2015-08-01

    The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands. Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also underwent an autopsy between January 2006 and December 2011 were included (n = 70). Cause of death established by the forensic physician based on the external medicolegal examination was compared with autopsy findings using the ICD10-classification. Autopsy findings revealed that the majority of sudden death victims have died from a cardiac disease (n = 51, 73%). Most of the presumed heart disease related cases were confirmed by autopsy (n = 13, 87%). On the contrary, a large number of deaths caused by circulatory diseases were not recognised by the forensic physician (n = 38, 75%). In most of these cases, the forensic physician was forced to report an undetermined cause due to the lack of a solid explanation for death. Cause of death reported by the forensic physician appeared to be in agreement with the autopsy results in 12 cases (17%). Cause of death determination in young sudden death victims is a difficult task for forensic physicians due to the limited tools available during the medicolegal examination. An effort should be made to standardize extensive post-mortem investigation after sudden death in the young. Autopsy can provide valuable information regarding the cause of death, which is of great importance in view of the identification of inheritable diseases among decedents and their families. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. Meteorite Falls and the Fragmentation of Meteorites

    NASA Technical Reports Server (NTRS)

    Momeni, Daniel

    2016-01-01

    In order to understand the fragmentation of objects entering the atmosphere and why some produce more fragments than others, I have searched the Meteoritical Society database for meteorites greater than 20 kilograms that fell in the USA, China, and India. I also studied the video and film records of 21 fireballs that produced meteorites. A spreadsheet was prepared that noted smell, fireball, explosion, whistling, rumbling, the number of fragments, light, and impact sounds. Falls with large numbers of fragments were examined to look for common traits. These were: the Norton County aubrite, explosion and a flare greater than 100 fragments; the Forest City H5 chondrite explosion, a flare, a dust trail, 505 specimens; the Richardton H5 chondrite explosion and light, 71 specimens; the Juancheng H5 chondrite explosion, a rumbling, a flare, a dust trail,1000 specimens; the Tagish Lake C2 chondrite explosion, flare, dust trail, 500 specimens. I conclude that fragmentation is governed by the following: (1) Bigger meteors undergo more stress which results in more specimens; (2) Harder meteorites also require more force to break them up which will cause greater fragmentation; (3) Force and pressure are directly proportional during falls. General observations made were; (1) Meteorites produce fireballs sooner due to high friction; (2) Meteors tend to explode as well because of high stress; (3) Softer meteorites tend to cause dust trails; (4) Some falls produce light as they fall at high velocity. I am grateful to NASA Ames for this opportunity and Derek Sears, Katie Bryson, and Dan Ostrowski for discussions.

  6. Rapid laccolith intrusion driven by explosive volcanic eruption

    NASA Astrophysics Data System (ADS)

    Castro, Jonathan M.; Cordonnier, Benoit; Schipper, C. Ian; Tuffen, Hugh; Baumann, Tobias S.; Feisel, Yves

    2016-11-01

    Magmatic intrusions and volcanic eruptions are intimately related phenomena. Shallow magma intrusion builds subsurface reservoirs that are drained by volcanic eruptions. Thus, the long-held view is that intrusions must precede and feed eruptions. Here we show that explosive eruptions can also cause magma intrusion. We provide an account of a rapidly emplaced laccolith during the 2011 rhyolite eruption of Cordón Caulle, Chile. Remote sensing indicates that an intrusion began after eruption onset and caused severe (>200 m) uplift over 1 month. Digital terrain models resolve a laccolith-shaped body ~0.8 km3. Deformation and conduit flow models indicate laccolith depths of only ~20-200 m and overpressures (~1-10 MPa) that likely stemmed from conduit blockage. Our results show that explosive eruptions may rapidly force significant quantities of magma in the crust to build laccoliths. These iconic intrusions can thus be interpreted as eruptive features that pose unique and previously unrecognized volcanic hazards.

  7. Facial trauma caused by electronic cigarette explosion.

    PubMed

    Vaught, Brian; Spellman, Joseph; Shah, Anil; Stewart, Alexander; Mullin, David

    2017-03-01

    Electronic cigarettes are increasingly popular as a supposed safer alternative to tobacco cigarettes or a smoking cessation tool. Research and debate have focused primarily on possible adverse effects caused by the inhaled aerosol produced by electronic cigarettes and on smoking cessation efficacy. Few reports in the medical literature describe injuries secondary to device malfunction. We present a case of electronic cigarette explosion, with a projectile fracturing the patient's right naso-orbital-ethmoid complex and anterior and posterior frontal sinus tables, with frontal sinus outflow tract involvement. The patient underwent combined open and endoscopic repair, including open reduction internal fixation, with reconstitution and preservation of the frontal sinus and frontal sinus outflow tract. Additionally, we review the available data on electronic cigarette malfunction-including fires, explosions, associated injuries, and possible reasons for device malfunction-and discuss new 2016 U.S. Food and Drug Administration regulations pertaining to electronic cigarettes.

  8. Effect of Velocity of Detonation of Explosives on Seismic Radiation

    NASA Astrophysics Data System (ADS)

    Stroujkova, A. F.; Leidig, M.; Bonner, J. L.

    2014-12-01

    We studied seismic body wave generation from four fully contained explosions of approximately the same yields (68 kg of TNT equivalent) conducted in anisotropic granite in Barre, VT. The explosions were detonated using three types of explosives with different velocities of detonation (VOD): Black Powder (BP), Ammonium Nitrate Fuel Oil/Emulsion (ANFO), and Composition B (COMP B). The main objective of the experiment was to study differences in seismic wave generation among different types of explosives, and to determine the mechanism responsible for these differences. The explosives with slow burn rate (BP) produced lower P-wave amplitude and lower corner frequency, which resulted in lower seismic efficiency (0.35%) in comparison with high burn rate explosives (2.2% for ANFO and 3% for COMP B). The seismic efficiency estimates for ANFO and COMP B agree with previous studies for nuclear explosions in granite. The body wave radiation pattern is consistent with an isotropic explosion with an added azimuthal component caused by vertical tensile fractures oriented along pre-existing micro-fracturing in the granite, although the complexities in the P- and S-wave radiation patterns suggest that more than one fracture orientation could be responsible for their generation. High S/P amplitude ratios and low P-wave amplitudes suggest that a significant fraction of the BP source mechanism can be explained by opening of the tensile fractures as a result of the slow energy release.

  9. Elaboration of the Charge Constructions of Explosives for the Structure of Facing Stone

    NASA Astrophysics Data System (ADS)

    Khomeriki, Sergo; Mataradze, Edgar; Chikhradze, Nikoloz; Losaberidze, Marine; Khomeriki, Davit; Shatberashvili, Grigol

    2017-12-01

    Increased demand for high-strength facing material caused the enhancement of the volume of explosives use in modern technologies of blocks production. The volume of broken rocks and crushing quality depends on the rock characteristics and on the properties of the explosive, in particular on its brisance and serviceability. Therefore, the correct selection of the explosive for the specific massif is of a considerable practical importance. For efficient mining of facing materials by explosion method the solving of such problems as determination of the method of blasthole drilling as well as of the regime and charge values, selection of the explosive, blastholes distribution in the face and their order is necessary. This paper focuses on technical solutions for conservation of rock natural structure in the blocks of facing material, mined by the use of the explosives. It has been established that the efficient solving of mentioned problem is attained by reducing of shock pulse duration. In such conditions the rigidity of crystalline lattice increases in high pressure area. As a result, the hazard if crack formation in structural unites and the increases of natural cracks are excluded. Short-time action of explosion pulse is possible only by linear charges of the explosives, characterized by high detonation velocity which detonate by the velocity of 7-7.5 km/sec and are characterized by very small critical diameter.

  10. Leading Causes of Death among Asian American Subgroups (2003-2011).

    PubMed

    Hastings, Katherine G; Jose, Powell O; Kapphahn, Kristopher I; Frank, Ariel T H; Goldstein, Benjamin A; Thompson, Caroline A; Eggleston, Karen; Cullen, Mark R; Palaniappan, Latha P

    2015-01-01

    Our current understanding of Asian American mortality patterns has been distorted by the historical aggregation of diverse Asian subgroups on death certificates, masking important differences in the leading causes of death across subgroups. In this analysis, we aim to fill an important knowledge gap in Asian American health by reporting leading causes of mortality by disaggregated Asian American subgroups. We examined national mortality records for the six largest Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and non-Hispanic Whites (NHWs) from 2003-2011, and ranked the leading causes of death. We calculated all-cause and cause-specific age-adjusted rates, temporal trends with annual percent changes, and rate ratios by race/ethnicity and sex. Rankings revealed that as an aggregated group, cancer was the leading cause of death for Asian Americans. When disaggregated, there was notable heterogeneity. Among women, cancer was the leading cause of death for every group except Asian Indians. In men, cancer was the leading cause of death among Chinese, Korean, and Vietnamese men, while heart disease was the leading cause of death among Asian Indians, Filipino and Japanese men. The proportion of death due to heart disease for Asian Indian males was nearly double that of cancer (31% vs. 18%). Temporal trends showed increased mortality of cancer and diabetes in Asian Indians and Vietnamese; increased stroke mortality in Asian Indians; increased suicide mortality in Koreans; and increased mortality from Alzheimer's disease for all racial/ethnic groups from 2003-2011. All-cause rate ratios revealed that overall mortality is lower in Asian Americans compared to NHWs. Our findings show heterogeneity in the leading causes of death among Asian American subgroups. Additional research should focus on culturally competent and cost-effective approaches to prevent and treat specific diseases among these growing diverse populations.

  11. Late Maternal Deaths and Deaths from Sequelae of Obstetric Causes in the Americas from 1999 to 2013: A Trend Analysis.

    PubMed

    de Cosio, Federico G; Jiwani, Safia S; Sanhueza, Antonio; Soliz, Patricia N; Becerra-Posada, Francisco; Espinal, Marcos A

    2016-01-01

    Data on maternal deaths occurring after the 42 days postpartum reference time is scarce; the objective of this analysis is to explore the trend and magnitude of late maternal deaths and deaths from sequelae of obstetric causes in the Americas between 1999 and 2013, and to recommend including these deaths in the monitoring of the Sustainable Development Goals (SDGs). Exploratory data analysis enabled analyzing the magnitude and trend of late maternal deaths and deaths from sequelae of obstetric causes for seven countries of the Americas: Argentina, Brazil, Canada, Colombia, Cuba, Mexico and the United States. A Poisson regression model was developed to compare trends of late maternal deaths and deaths from sequelae of obstetric causes between two periods of time: 1999 to 2005 and 2006 to 2013; and to estimate the relative increase of these deaths in the two periods of time. The proportion of late maternal deaths and deaths from sequelae of obstetric causes ranged between 2.40% (CI 0.85% - 5.48%) and 18.68% (CI 17.06% - 20.47%) in the seven countries. The ratio of late maternal deaths and deaths from sequelae of obstetric causes per 100,000 live births has increased by two times in the region of the Americas in the period 2006-2013 compared to the period 1999-2005. The regional relative increase of late maternal death was 2.46 (p<0.0001) times higher in the second period compared to the first. Ascertainment of late maternal deaths and deaths from sequelae of obstetric causes has improved in the Americas since the early 2000's due to improvements in the quality of information and the obstetric transition. Late and obstetric sequelae maternal deaths should be included in the monitoring of the SDGs as well as in the revision of the International Classification of Diseases' 11th version (ICD-11).

  12. Late Maternal Deaths and Deaths from Sequelae of Obstetric Causes in the Americas from 1999 to 2013: A Trend Analysis

    PubMed Central

    de Cosio, Federico G.; Sanhueza, Antonio; Soliz, Patricia N.; Becerra-Posada, Francisco; Espinal, Marcos A.

    2016-01-01

    Background Data on maternal deaths occurring after the 42 days postpartum reference time is scarce; the objective of this analysis is to explore the trend and magnitude of late maternal deaths and deaths from sequelae of obstetric causes in the Americas between 1999 and 2013, and to recommend including these deaths in the monitoring of the Sustainable Development Goals (SDGs). Methods Exploratory data analysis enabled analyzing the magnitude and trend of late maternal deaths and deaths from sequelae of obstetric causes for seven countries of the Americas: Argentina, Brazil, Canada, Colombia, Cuba, Mexico and the United States. A Poisson regression model was developed to compare trends of late maternal deaths and deaths from sequelae of obstetric causes between two periods of time: 1999 to 2005 and 2006 to 2013; and to estimate the relative increase of these deaths in the two periods of time. Findings The proportion of late maternal deaths and deaths from sequelae of obstetric causes ranged between 2.40% (CI 0.85% – 5.48%) and 18.68% (CI 17.06% – 20.47%) in the seven countries. The ratio of late maternal deaths and deaths from sequelae of obstetric causes per 100,000 live births has increased by two times in the region of the Americas in the period 2006-2013 compared to the period 1999-2005. The regional relative increase of late maternal death was 2.46 (p<0.0001) times higher in the second period compared to the first. Interpretation Ascertainment of late maternal deaths and deaths from sequelae of obstetric causes has improved in the Americas since the early 2000’s due to improvements in the quality of information and the obstetric transition. Late and obstetric sequelae maternal deaths should be included in the monitoring of the SDGs as well as in the revision of the International Classification of Diseases’ 11th version (ICD-11). PMID:27626277

  13. Cerebrovascular and hypertensive diseases as multiple causes of death in Brazil from 2004 to 2013.

    PubMed

    Villela, P B; Klein, C H; Oliveira, G M M

    2018-06-02

    The proportion of deaths attributed to hypertensive diseases (HYPDs) was only 50% of that registered for cerebrovascular diseases (CBVDs) in 2013 in Brazil. This article aims to evaluate mortality related to HYPDs and CBVDs as multiple causes of death, in Brazil from 2004 to 2013. Analysis of historical series of secondary data obtained from Brazilian official registries. Data about the deaths were obtained from the Mortality Information System of the Brazilian Ministry of Health, available on the DATASUS website. CBVDs and HYPDs were evaluated according to their mentions as the underlying cause of death or entry in any line of the death certificates (DCs), according to their International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. When CBVDs were the underlying causes of death, HYPDs were mentioned in 40.9% of the DCs. When HYPDs were the underlying causes of death, CBVDs were mentioned in only 5.0%. When CBVDs were mentioned without HYPDs, they were selected as the underlying cause of death 74.4% of the time. When HYPDs were mentioned in DCs without CBVDs, HYPDs were selected 30.0% of the time. In 2004, the frequency of any mention of HYPDs relative to the frequency of HYPDs cited as underlying causes increased fourfold and was followed by a plateau until 2013. In contrast, the frequency of any mention of CBVDs relative to the frequency of CBVDs as underlying causes decreased in the same period. Because this study was based on DC records, it was limited by the way these documents were completed, which may have included lack of record of the causes related to the sequence that culminated in death. When deaths related to HYPDs were evaluated as multiple causes of death, they were mentioned up to four times more often than when they were selected as underlying causes of death. This reinforces the need for better control of hypertension to prevent deaths. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. Causes of death in a contemporary adult congenital heart disease cohort.

    PubMed

    Yu, Christopher; Moore, Benjamin M; Kotchetkova, Irina; Cordina, Rachael L; Celermajer, David S

    2018-04-17

    The life expectancy of patients with congenital heart disease (CHD) has significantly improved with advances in their paediatric medical care. Mortality patterns are changing as a result. Our study aims to describe survival and causes of death in a contemporary cohort of adult patients with CHD. We reviewed 3068 patients in our adult CHD database (age ≥16 years, seen at least once in our centre between 2000 and 2015), and documented the number and causes of death, via Australia's National Death Index. Survival and mortality patterns were analysed by complexity of CHD and by underlying congenital diagnosis. Our cohort comprised 3068 adult patients (53% male). The distribution of patients (per the Bethesda classification) was 47% simple, 34% moderate and 18% complex (1% not classifiable). Over a median follow-up of 6.2 years (IQR 3.5-10.4), 341 patients (11%) died with an incidence of 0.4 deaths/100 patient years (py). Survival was significantly worse with increasing complexity of CHD (p<0.001); mortality rate in the simple group was 0.3 deaths/100 py with a median age of death 70 years, and in the complex group was 1.0 death/100 py with a median age of death 34 years. Overall, non-cardiac causes of death outnumbered cardiac causes, at 54% and 46%, respectively. The leading single cause of death was heart failure (17%), followed by malignancy (13%). Simple adult CHD patients mostly died due to non-cardiac causes such as malignancy. Perioperative mortality only accounted for 5% of deaths. Premature death is common in adults with CHD. Although heart failure remains the most common cause of death, in the contemporary era in a specialist CHD centre, non-cardiac related deaths outnumber cardiac deaths, particularly in those with simple CHD lesions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Injury-related gaining momentum as external causes of deaths in Ethiopian health and demographic surveillance sites: evidence from verbal autopsy study

    PubMed Central

    Gelaye, Kassahun Alemu; Tessema, Fasil; Tariku, Befikadu; Abera, Semaw Ferede; Gebru, Alemseged Aregay; Assefa, Nega; Zelalem, Desalew; Dedefo, Melkamu; Kondal, Mekdes; Kote, Mesfin; Sisay, Mitike Molla; Mekonnen, Wubegzier; Terefe, Mamo Wubshet; Biks, Gashaw Andargie; Eshetu, Firehywot; Abera, Mulumebet; Fekadu, Yoseph; Hailu, Gessessew Bugssa; Tilahun, Etsehiwot; Lakew, Yihunie

    2018-01-01

    ABSTRACT Background: In Ethiopia, though all kinds of mortality due to external causes are an important component of overall mortality often not counted or documented on an individual basis. Objective: The aim of this study was to describe the patterns of mortality from external causes using verbal autopsy (VA) method at the Ethiopian HDSS Network sites. Methods: All deaths at Ethiopian HDSS sites were routinely registered and followed up with VA interviews. The VA forms comprised deaths up to 28 days, between four weeks and 14 years and 15 years and above. The cause of a death was ascertained based on an interview with next of families or other caregivers using a standardized questionnaire that draws information on signs, symptoms, medical history and circumstances preceding death after 45 days mourning period. Two physician assigned probable causes of death as underlying, immediate and contributing factors independently using information in VA forms based on the WHO ICD-10 and VA code system. Disagreed cases sent to third physician for independent review and diagnosis. The final cause of death considered when two of the three physicians assigned underlying cause of death; otherwise, labeled as undetermined. Results: In the period from 2009 to 2013, a total of 9719 deaths were registered. Of the total deaths, 623 (6.4%) were from external causes. Of these, accidental drowning and submersion, 136 (21.8%), accidental fall, 113 (18.1%) and transport-related accidents, 112 (18.0%) were the topmost three leading external causes of deaths. About 436 (70.0%) of deaths were from the age group above 15 years old. Drowning and submersion and transport-related accidents were high in age group between 5 and 14 years old. Conclusion: In this study, external causes of death are significant public health problems and require attention as one of prior health agenda. PMID:29471744

  16. Core-collapse supernova simulations

    NASA Astrophysics Data System (ADS)

    Mueller, Bernhard

    2017-01-01

    Core-collapse supernovae, the deaths of massive stars, are among the most spectacular phenomena in astrophysics: Not only can supernovae outshine their host galaxy for weeks; they are also laboratories for the behavior of matter at supranuclear densities, and one of the few environments where collective neutrino effects can become important. Moreover, supernovae play a central role in the cosmic matter cycle, e.g., as the dominant producers of oxygen in the Universe. Yet the mechanism by which massive stars explode has eluded us for decades, partly because classical astronomical observations across the electromagnetic spectrum cannot directly probe the supernovae ``engine''. Numerical simulations are thus our primary tool for understanding the explosion mechanism(s) of massive stars. Rigorous modeling needs to take a host of important physical ingredients into account, such as the emission and partial reabsorption of neutrinos from the young proto-neutron star, multi-dimensional fluid motions, general relativistic gravity, the equation of state of nuclear matter, and magnetic fields. This is a challenging multi-physics problem that has not been fully solved yet. Nonetheless, as I shall argue in this talk, recent first-principle 3D simulations have gone a long way towards demonstrating the viability of the most popular explosion scenario, the ``neutrino-driven mechanism''. Focusing on successful explosion models of the MPA-QUB-Monash collaboration, I will discuss possible requirements for robust explosions across a wide range of progenitors, such as accurate neutrino opacities, stellar rotation, and seed asymmetries from convective shell burning. With the advent of successful explosion models, supernova theory can also be confronted with astronomical observations. I will show that recent 3D models come closer to matching observed explosion parameters (explosion energies, neutron star kicks) than older 2D models, although there are still discrepancies. This work has been supported by the ARC (grant DE150101145), NSF (PHY-1430152, JINA-CEE) and the supercomputing centers/initiatives NCI, Pawsey, and DiRAC.

  17. Global and regional cause-of-death patterns in 1990.

    PubMed Central

    Murray, C. J.; Lopez, A. D.

    1994-01-01

    Demographic estimation techniques suggest that worldwide about 50 million deaths occur each year, of which about 39 million are in the developing countries. In countries with adequate registration of vital statistics, the age at death and the cause can be reliably determined. Only about 30-35% of all deaths are captured by vital registration (excluding sample registration schemes); for the remainder, cause-of-death estimation procedures are required. Indirect methods which model the cause-of-death structure as a function of the level of mortality can provide reasonable estimates for broad cause-of-death groups. Such methods are generally unreliable for more specific causes. In this case, estimates can be constructed from community-level mortality surveillance systems or from epidemiological evidence on specific diseases. Some check on the plausibility of the estimates is possible in view of the hierarchical structure of cause-of-death lists and the well-known age-specific patterns of diseases and injuries. The results of applying these methods to estimate the cause of death for over 120 diseases or injuries, by age, sex and region, are described. The estimates have been derived in order to calculate the years of life lost due to premature death, one of the two components of overall disability-adjusted life years (DALYs) calculated for the 1993 World development report. Previous attempts at cause-of-death estimation have been limited to a few diseases only, with little age-specific detail. The estimates reported in detail here should serve as a useful reference for further public health research to support the determination of health sector priorities. PMID:8062402

  18. Distribution of Ejecta in Analog Tephra Rings from Discrete Single and Multiple Subsurface Explosions

    NASA Astrophysics Data System (ADS)

    Graettinger, A. H.; Valentine, G. A.; Sonder, I.; Ross, P. S.; White, J. D. L.

    2015-12-01

    Buried-explosion experiments were used to investigate the spatial and volumetric distribution of extra-crater ejecta resulting from a range of explosion configurations with and without a crater present. Explosion configuration is defined in terms of scaled depth, the relationship between depth of burial and the cube root of explosion energy, where an optimal scaled depth explosion produces the largest crater diameter for a given energy. The multiple explosion experiments provide an analog for the formation of maar-diatreme ejecta deposits and the deposits of discrete explosions through existing conduits and hydrothermal systems. Experiments produced meter-sized craters with ejecta distributed between three major facies based on morphology and distance from the crater center. The proximal deposits form a constructional steep-sided ring that extends no more than two-times the crater radius away from center. The medial deposits form a low-angle continuous blanket that transitions with distance into the isolated clasts of the distal ejecta. Single explosion experiments produce a trend of increasing volume proportion of proximal ejecta as scaled depth increases (from 20-90% vol.). Multiple explosion experiments are dominated by proximal deposits (>90% vol.) for all but optimal scaled depth conditions (40-70% vol.). In addition to scaled depth, the presence of a crater influences jet shape and how the jet collapses, resulting in two end-member depositional mechanisms that produce distinctive facies. The experiments use one well-constrained explosion mechanism and, consequently, the variations in depositional facies and distribution are the result of conditions independent of that mechanism. Previous interpretations have invoked variations in fragmentation as the cause of this variability, but these experiments should help with a more complete reconstruction of the configuration and number of explosions that produce a tephra ring.

  19. Deaths: leading causes for 2002.

    PubMed

    Anderson, Robert N; Smith, Betty L

    2005-03-07

    This report presents final 2002 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 States and the District of Columbia in 2002. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. In 2002, the 10 leading causes of death were (in rank order) Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Diabetes mellitus; Influenza and pneumonia; Alzheimer's disease; Nephritis, nephrotic syndrome and nephrosis; and Septicemia and accounted for about 79 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2002 were (in rank order) Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birthweight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Accidents (unintentional injuries); Respiratory distress of newborn; Bacterial sepsis of newborn; Diseases of the circulatory system; and Intrauterine hypoxia and birth asphyxia. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.

  20. Deaths: leading causes for 2003.

    PubMed

    Heron, Melonie P; Smith, Betty L

    2007-03-15

    This report presents final 2003 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2003. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. In 2003, the 10 leading causes of death were (in rank order): Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Diabetes mellitus; Influenza and pneumonia; Alzheimer's disease; Nephritis, nephrotic syndrome and nephrosis; and Septicemia and accounted for about 78 percent of all deaths occurring in the United States. Differences in the ranking are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2003 were (in rank order): Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Accidents (unintentional injuries); Respiratory distress of newborn; Bacterial sepsis of newborn; Neonatal hemorrhage; and Diseases of the circulatory system. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.

  1. Deaths: leading causes for 2004.

    PubMed

    Heron, Melonie

    2007-11-20

    This report presents final 2004 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics. Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2004. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. In 2004, the 10 leading causes of death were (in rank order) Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Diabetes mellitus; Alzheimer's disease; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Septicemia and accounted for about 78 percent of all deaths occurring in the United States. Differences in the ranking are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2004 were (in rank order) Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Respiratory distress of newborn; Bacterial sepsis of newborn; Neonatal hemorrhage; and Diseases of the circulatory system. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.

  2. Automatic coding and selection of causes of death: an adaptation of Iris software for using in Brazil.

    PubMed

    Martins, Renata Cristófani; Buchalla, Cassia Maria

    2015-01-01

    To prepare a dictionary in Portuguese for using in Iris and to evaluate its completeness for coding causes of death. Iniatially, a dictionary with all illness and injuries was created based on the International Classification of Diseases - tenth revision (ICD-10) codes. This dictionary was based on two sources: the electronic file of ICD-10 volume 1 and the data from Thesaurus of the International Classification of Primary Care (ICPC-2). Then, a death certificate sample from the Program of Improvement of Mortality Information in São Paulo (PRO-AIM) was coded manually and by Iris version V4.0.34, and the causes of death were compared. Whenever Iris was not able to code the causes of death, adjustments were made in the dictionary. Iris was able to code all causes of death in 94.4% death certificates, but only 50.6% were directly coded, without adjustments. Among death certificates that the software was unable to fully code, 89.2% had a diagnosis of external causes (chapter XX of ICD-10). This group of causes of death showed less agreement when comparing the coding by Iris to the manual one. The software performed well, but it needs adjustments and improvement in its dictionary. In the upcoming versions of the software, its developers are trying to solve the external causes of death problem.

  3. Pregnancy-associated Death - Clarifying the Cause of Death and Medico-legal Assessments in Accusations of Malpractice.

    PubMed

    Dettmeyer, Reinhard; Lang, Juliane; Amberg, Rainer; Zedler, Barbara; Schulz, Ronald; Birngruber, Christoph

    2018-02-01

    Pregnancy-associated deaths are extremely rare in Germany. Most deaths are from natural causes, and a range of causes are possible. The deaths of 22 women who died of pregnancy-associated causes and who were autopsied in the Institute of Forensic Medicine of Justus-Liebig University Gießen between 1992 and 2016 were analyzed. The autopsy results and histological examinations for the majority of women who died of pregnancy-associated causes between 1992 and 2016 showed that they had died of natural causes, although complications of pregnancy were a leading cause of death. The death of a pregnant woman should not automatically raise the suspicion of malpractice, although the question does arise in cases of bleeding complications only detected at very late stages. Experts must prove that a real mistake was made during treatment and provide evidence of the causality between malpractice and patient death. Particularly when well-known complications of pregnancy were present, this is only the case if poor monitoring resulted in the complication being detected too late or if treatment was not in accordance with accepted standards of care. The majority of pregnancy-associated deaths are from natural causes and the death of a pregnant woman does not mean that medical malpractice was involved, although this accusation is often levelled in cases where rupture was not immediately diagnosed or in cases of fatal postpartum hemorrhage.

  4. Nucleosynthesis in Primordial Hypernovae

    NASA Astrophysics Data System (ADS)

    Grimmett, J. J.; Heger, Alexander; Karakas, Amanda I.; Müller, Bernhard

    2018-06-01

    We investigate the relationship between explosion energy and nucleosynthesis in Population III supernovae and provide nucleosynthetic results for the explosions of stars with progenitor masses of 15 M⊙, 20 M⊙, 30 M⊙, 40 M⊙, 60 M⊙, and 80 M⊙, and explosion energies between approximately 1050 erg and 1053 erg. We find that the typical abundance pattern observed in metal-poor stars are best matched by supernovae with progenitor mass in the range 15 M⊙ - 30 M⊙, and explosion energy of ˜(5 - 10) × 1051 erg. In these models, a reverse shock caused by jumps in density between shells of different composition serves to decrease synthesis of chromium and manganese, which is favourable to matching the observed abundances in metal-poor stars. Spherically symmetric explosions of our models with progenitor mass ≥40 M⊙ do not provide yields that are compatible with the iron-peak abundances that are typically observed in metal-poor stars, however, by approximating the yields that we might expect from these models in highly aspherical explosions, we find indications that explosions of stars 40 M⊙ - 80 M⊙ with bipolar jets may be good candidates for the enrichment sources of metal-poor stars with enhanced carbon abundances.

  5. What factors control superficial lava dome explosivity?

    PubMed

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoît; Morgan, Daniel J

    2015-09-30

    Dome-forming eruption is a frequent eruptive style and a major hazard on numerous volcanoes worldwide. Lava domes are built by slow extrusion of degassed, viscous magma and may be destroyed by gravitational collapse or explosion. The triggering of lava dome explosions is poorly understood: here we propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite precipitation. Both processes generate an impermeable and rigid carapace allowing overpressurisation of the inner parts of the lava dome by the rapid input of vesiculated magma batches. The relative thickness of the cristobalite-rich carapace is an inverse function of the external lava dome surface area. Explosive activity is thus more likely to occur at the onset of lava dome extrusion, in agreement with observations, as the likelihood of superficial lava dome explosions depends inversely on lava dome volume. This new result is of interest for the whole volcanological community and for risk management.

  6. What factors control superficial lava dome explosivity?

    PubMed Central

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoît; Morgan, Daniel J.

    2015-01-01

    Dome-forming eruption is a frequent eruptive style and a major hazard on numerous volcanoes worldwide. Lava domes are built by slow extrusion of degassed, viscous magma and may be destroyed by gravitational collapse or explosion. The triggering of lava dome explosions is poorly understood: here we propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite precipitation. Both processes generate an impermeable and rigid carapace allowing overpressurisation of the inner parts of the lava dome by the rapid input of vesiculated magma batches. The relative thickness of the cristobalite-rich carapace is an inverse function of the external lava dome surface area. Explosive activity is thus more likely to occur at the onset of lava dome extrusion, in agreement with observations, as the likelihood of superficial lava dome explosions depends inversely on lava dome volume. This new result is of interest for the whole volcanological community and for risk management. PMID:26420069

  7. Deaths on board ships assisted by the Centro Internazionale Radio Medico in the last 25 years.

    PubMed

    Grappasonni, Iolanda; Petrelli, Fabio; Amenta, Francesco

    2012-07-01

    Data on occupational diseases of seafarers and of causes of death during their career are sparse. The causes of deaths on board ships assisted by Centro Internazionale Radio Medico (CIRM), the Italian Telemedical Maritime Assistance Service (TMAS) were reviewed by examining 29,146 files of patients treated from 1986 to 2010. In the 25 years, 383 deaths occurred (1.31%). Diseases of the circulation were the most frequent, followed by external causes such as accidents and violence, infectious and parasitic diseases, alcohol and drug addiction, respiratory system diseases. Cardiovascular and external causes were the principal causes of deaths among seafarers. This investigation is the first study on the causes of death on board ships obtained from data of a maritime telemedical centre, that has assisted seafarers when they were alive or immediately after their death. The fact that diseases of the circulatory system are the first cause of death of sailing seafarers deserves specific initiatives. They should include campaigns for adequate lifestyles and the availability on ships of medical devices useful for diagnostic purposes, resuscitation as well as for verification of death. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Impact of documentation errors on accuracy of cause of death coding in an educational hospital in Southern Iran.

    PubMed

    Haghighi, Mohammad Hosein Hayavi; Dehghani, Mohammad; Teshnizi, Saeid Hoseini; Mahmoodi, Hamid

    2014-01-01

    Accurate cause of death coding leads to organised and usable death information but there are some factors that influence documentation on death certificates and therefore affect the coding. We reviewed the role of documentation errors on the accuracy of death coding at Shahid Mohammadi Hospital (SMH), Bandar Abbas, Iran. We studied the death certificates of all deceased patients in SMH from October 2010 to March 2011. Researchers determined and coded the underlying cause of death on the death certificates according to the guidelines issued by the World Health Organization in Volume 2 of the International Statistical Classification of Diseases and Health Related Problems-10th revision (ICD-10). Necessary ICD coding rules (such as the General Principle, Rules 1-3, the modification rules and other instructions about death coding) were applied to select the underlying cause of death on each certificate. Demographic details and documentation errors were then extracted. Data were analysed with descriptive statistics and chi square tests. The accuracy rate of causes of death coding was 51.7%, demonstrating a statistically significant relationship (p=.001) with major errors but not such a relationship with minor errors. Factors that result in poor quality of Cause of Death coding in SMH are lack of coder training, documentation errors and the undesirable structure of death certificates.

  9. All-cause and cause-specific mortality among Black and White North Carolina state prisoners, 1995-2005

    PubMed Central

    Wohl, David A.; Schoenbach, Victor J.

    2011-01-01

    Purpose We compared mortality rates among state prisoners and other state residents to identify prisoners’ healthcare needs Methods We linked North Carolina prison records with state death records for 1995-2005 to estimate all-cause and cause-specific death rates among Black and White male prisoners aged 20-79 years, and used standardized mortality ratios (SMRs) to compare these observed deaths with the expected number based on death rates among state residents Results The all-cause SMR of Black prisoners was 0.52 (95%CI: 0.48 0.57), with fewer deaths than expected from accidents, homicides, cardiovascular disease and cancer. The all-cause SMR of White prisoners was 1.12 (95%CI: 1.01, 1.25) with fewer deaths than expected for accidents, but more deaths than expected from viral hepatitis, liver disease, cancer, chronic lower respiratory disease, and HIV. Conclusions Mortality of Black prisoners was lower than that of Black state residents for both traumatic and chronic causes of death. Mortality of White prisoners was lower than that of White state residents for accidents, but higher for several chronic causes of death. Future studies should investigate the effect of prisoners’ pre-incarceration and in-prison morbidity, the prison environment, and prison healthcare on prisoners’ patterns of mortality. PMID:21737304

  10. Socio-demographic Characteristics and Leading Causes of Death Among the Casualties of Meteorological Events Compared With All-cause Deaths in Korea, 2000-2011

    PubMed Central

    Lee, Kyung Eun; Myung, Hyung-Nam; Na, Wonwoong

    2013-01-01

    Objectives This study investigated the socio-demographic characteristics and medical causes of death among meteorological disaster casualties and compared them with deaths from all causes. Methods Based on the death data provided by the National Statistical Office from 2000 to 2011, the authors analyzed the gender, age, and region of 709 casualties whose external causes were recorded as natural events (X330-X389). Exact matching was applied to compare between deaths from meteorological disasters and all deaths. Results The total number of deaths for last 12 years was 2 728 505. After exact matching, 642 casualties of meteorological disasters were matched to 6815 all-cause deaths, which were defined as general deaths. The mean age of the meteorological disaster casualties was 51.56, which was lower than that of the general deaths by 17.02 (p<0.001). As for the gender ratio, 62.34% of the meteorological event casualties were male. While 54.09% of the matched all-cause deaths occurred at a medical institution, only 7.6% of casualties from meteorological events did. As for occupation, the rate of those working in agriculture, forestry, and fishery jobs was twice as high in the casualties from meteorological disasters as that in the general deaths (p<0.001). Meteorological disaster-related injuries like drowning were more prevalent in the casualties of meteorological events (57.48%). The rate of amputation and crushing injury in deaths from meteorological disasters was three times as high as in the general deaths. Conclusions The new information gained on the particular characteristics contributing to casualties from meteorological events will be useful for developing prevention policies. PMID:24137528

  11. Trends in the leading causes of death in the United States, 1970-2002.

    PubMed

    Jemal, Ahmedin; Ward, Elizabeth; Hao, Yongping; Thun, Michael

    2005-09-14

    The decrease in overall death rates in the United States may mask changes in death rates from specific conditions. To examine temporal trends in the age-standardized death rates and in the number of deaths from the 6 leading causes of death in the United States. Analyses of vital statistics data on mortality in the United States from 1970 to 2002. The age-standardized death rate and number of deaths (coded as underlying cause) from each of the 6 leading causes of death: heart disease, stroke, cancer, chronic obstructive pulmonary disease, accidents (ie, related to transportation [motor vehicle, other land vehicles, and water, air, and space] and not related to transportation [falls, fire, and accidental posioning]), and diabetes mellitus. The age-standardized death rate (per 100,000 per year) from all causes combined decreased from 1242 in 1970 to 845 in 2002. The largest percentage decreases were in death rates from stroke (63%), heart disease (52%), and accidents (41%). The largest absolute decreases in death rates were from heart disease (262 deaths per 100,000), stroke (96 deaths per 100,000), and accidents (26 deaths per 100,000).The death rate from all types of cancer combined increased between 1970 and 1990 and then decreased through 2002, yielding a net decline of 2.7%. In contrast, death rates doubled from chronic obstructive pulmonary disease over the entire time interval and increased by 45% for diabetes since 1987. Despite decreases in age-standardized death rates from 4 of the 6 leading causes of death, the absolute number of deaths from these conditions continues to increase, although these deaths occur at older ages. The absolute number of deaths and age at death continue to increase in the United States. These temporal trends have major implications for health care and health care costs in an aging population.

  12. Emerging chronic non-communicable diseases in rural communities of Northern Ethiopia: evidence using population-based verbal autopsy method in Kilite Awlaelo surveillance site.

    PubMed

    Weldearegawi, Berhe; Ashebir, Yemane; Gebeye, Ejigu; Gebregziabiher, Tesfay; Yohannes, Mekonnen; Mussa, Seid; Berhe, Haftu; Abebe, Zerihun

    2013-12-01

    In countries where most deaths are outside health institutions and medical certification of death is absent, verbal autopsy (VA) method is used to estimate population level causes of death. VA data were collected by trained lay interviewers for 409 deaths in the surveillance site. Two physicians independently assigned cause of death using the International Classification of Diseases manual. In general, infectious and parasitic diseases accounted for 35.9% of death, external causes 15.9%, diseases of the circulatory system 13.4% and perinatal causes 12.5% of total deaths. Mortalities attributed to maternal causes and malnutrition were low, 0.2 and 1.5%, respectively. Causes of death varied by age category. About 22.1, 12.6 and 8.4% of all deaths of under 5-year-old children were due to bacterial sepsis of the newborn, acute lower respiratory infections such as neonatal pneumonia and prematurity including respiratory distress, respectively. For 5-15-year-old children, accidental drowning and submersion, accounting for 34.4% of all deaths in this age category, and accidental fall, accounting for 18.8%, were leading causes of death. Among 15-49-year-old adults, HIV/AIDS (16.3%) and tuberculosis (12.8%) were commonest causes of death, whereas tuberculosis and cerebrovascular diseases were major killers of those aged 50 years and above. In the rural district, mortality due to chronic non-communicable diseases was very high. The observed magnitude of death from chronic non-communicable disease is unlikely to be unique to this district. Thus, formulation of chronic disease prevention and control strategies is recommended.

  13. Frequency of forensic toxicological analysis in external cause deaths among nursing home residents: an analysis of trends.

    PubMed

    Aitken, Georgia; Murphy, Briony; Pilgrim, Jennifer; Bugeja, Lyndal; Ranson, David; Ibrahim, Joseph Elias

    2017-03-01

    There is a paucity of research examining the utility of forensic toxicology in the investigation of premature external cause deaths of residents in nursing homes. The aim of this study is to describe the frequency and characteristics of toxicological analysis conducted in external cause (injury-related) deaths amongst nursing home residents in Victoria, Australia. This study was a retrospective cohort study examining external cause deaths among nursing home residents during the period July 1, 2000 to December 31, 2012 in Victoria, Australia, using the National Coronial Information System (NCIS). The variables examined comprised: sex, age group, year-of-death, cause and manner of death. One-third of deaths among nursing home residents in Victoria resulted from external causes (n = 1296, 33.3%) of which just over one-quarter (361, 27.9%) underwent toxicological analysis as part of the medical death investigation. The use of toxicological analysis varied by cause of death with a relatively low proportion conducted in deaths from unintentional falls (n = 286, 24.9%) and choking (n = 36, 40.4%). The use of toxicological analysis decreased as the decedents age increased. Forensic toxicology has the potential to contribute to improving our understanding of premature deaths in nursing home residents however it remains under used and is possibly undervalued.

  14. Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers.

    PubMed

    Rampatige, Rasika; Mikkelsen, Lene; Hernandez, Bernardo; Riley, Ian; Lopez, Alan D

    2014-11-01

    To systematically review the reliability of hospital data on cause of death and encourage periodic reviews of these data using a standard method. We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We analysed the results of 199 studies that had used medical record reviews to validate the cause of death reported on death certificates or by the vital registration system. The screened studies had been published between 1983 and 2013 and their results had been reported in English (n = 124), Portuguese (n = 25) or Spanish (n = 50). Only 29 of the studies met our inclusion criteria. Of these, 13 had examined cause of death patterns at the population level - with a view to correcting cause-specific mortality fractions - while the other 16 had been undertaken to identify discrepancies in the diagnosis for specific diseases before and after medical record review. Most of the selected studies reported substantial misdiagnosis of causes of death in hospitals. There was wide variation in study methodologies. Many studies did not describe the methods used in sufficient detail to be able to assess the reproducibility or comparability of their results. The assumption that causes of death are being accurately reported in hospitals is unfounded. To improve the reliability and usefulness of reported causes of death, national governments should do periodic medical record reviews to validate the quality of their hospital cause of death data, using a standard.

  15. Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers

    PubMed Central

    Rampatige, Rasika; Mikkelsen, Lene; Hernandez, Bernardo; Riley, Ian

    2014-01-01

    Abstract Objective To systematically review the reliability of hospital data on cause of death and encourage periodic reviews of these data using a standard method. Methods We searched Google Scholar, Pubmed and Biblioteca Virtual de la Salud for articles in English, Spanish and Portuguese that reported validation studies of data on cause of death. We analysed the results of 199 studies that had used medical record reviews to validate the cause of death reported on death certificates or by the vital registration system. Findings The screened studies had been published between 1983 and 2013 and their results had been reported in English (n = 124), Portuguese (n = 25) or Spanish (n = 50). Only 29 of the studies met our inclusion criteria. Of these, 13 had examined cause of death patterns at the population level – with a view to correcting cause-specific mortality fractions – while the other 16 had been undertaken to identify discrepancies in the diagnosis for specific diseases before and after medical record review. Most of the selected studies reported substantial misdiagnosis of causes of death in hospitals. There was wide variation in study methodologies. Many studies did not describe the methods used in sufficient detail to be able to assess the reproducibility or comparability of their results. Conclusion The assumption that causes of death are being accurately reported in hospitals is unfounded. To improve the reliability and usefulness of reported causes of death, national governments should do periodic medical record reviews to validate the quality of their hospital cause of death data, using a standard. PMID:25378742

  16. Overseas visitor deaths in Australia, 2001 to 2003.

    PubMed

    Leggat, Peter A; Wilks, Jeff

    2009-01-01

    The health and safety of international visitors remain an important issue for Australia and other tourist destinations. The death of visitors remains an important indicator of safety. The aim of this study was to provide updated figures on deaths of overseas travelers in Australia. Data were sourced from the Australian Bureau of Statistics concerning deaths of overseas visitors for the years 2001 to 2003. There were 1,068 overseas visitor deaths (701 males, 66%) during the study period 2001 to 2003. Death by natural causes increased with age, while deaths associated with accidents were more frequent among younger age groups. The majority of deaths were from natural causes (782, 73%), particularly ischemic heart diseases (26%). There were a total of 247 accidental deaths (23% of all deaths) with the main causes being transportation accidents (14% of all deaths) and accidental drowning/submersion (5% of all deaths). The countries contributing the most deaths were the UK (247, 23%), New Zealand (108, 10%) Melanesia/Micronesia (95, 9%), and the United States (57, 5%). Australia remains a relatively safe destination for international travelers, at least in terms of fatalities, which appear to be declining. Most deaths of overseas tourists in Australia are due to natural causes with cardiovascular disease being the predominant cause of death in this group. Accidents remain the most common preventable cause of death of travelers, with road and water safety being the major issues. It is important that tourism and travel medicine groups continue to advocate for improved health and safety of international travelers visiting Australia.

  17. Mortality from Fungal Disease in the US Air Force from 1970 to 2013

    DTIC Science & Technology

    2016-10-06

    We review a unique set of documents, death certificates, catalogued in the US Air Force Mortality Registry, which tracks deaths for current and...retired Air Force service members. We screened the records for all deaths caused by fungal diseases between 1970 and 2013. There were 216 deaths caused...pneumocystosis, sporotrichosis, and zygomycosis. The single most common identified cause of death was opportunistic candidiasis. Of the total 216 deaths

  18. Glucose sensor excludes hypoglycaemia as cause of death.

    PubMed

    Schmidt, Signe; Nørgaard, Kirsten

    2012-05-01

    The cause of death can be difficult to verify post-mortem in unexpected deaths in patients with Type 1 diabetes. This report describes an unexpected death in a 44-year-old man with Type 1 diabetes treated with sensor-augmented pump therapy. Continuous glucose monitoring data proved useful in determining the cause of death. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. A comparison of physicians and medical assistants in interpreting verbal autopsy interviews for allocating cause of neonatal death in Matlab, Bangladesh: can medical assistants be considered an alternative to physicians?

    PubMed Central

    2010-01-01

    Objective This study assessed the agreement between medical physicians in their interpretation of verbal autopsy (VA) interview data for identifying causes of neonatal deaths in rural Bangladesh. Methods The study was carried out in Matlab, a rural sub-district in eastern Bangladesh. Trained persons conducted the VA interview with the mother or another family member at the home of the deceased. Three physicians and a medical assistant independently reviewed the VA interviews to assign causes of death using the International Classification of Diseases - Tenth Revision (ICD-10) codes. A physician assigned cause was decided when at least two physicians agreed on a cause of death. Cause-specific mortality fraction (CSMF), kappa (k) statistic, sensitivity, specificity, and positive predictive values were applied to compare agreement between the reviewers. Results Of the 365 neonatal deaths reviewed, agreement on a direct cause of death was reached by at least two physicians in 339 (93%) of cases. Physician and medical assistant reviews of causes of death demonstrated the following levels of diagnostic agreement for the main causes of deaths: for birth asphyxia the sensitivity was 84%, specificity 93%, and kappa 0.77. For prematurity/low birth weight, the sensitivity, specificity, and kappa statistics were, respectively, 53%, 96%, and 0.55, for sepsis/meningitis they were 48%, 98%, and 0.53, and for pneumonia they were 75%, 94%, and 0.51. Conclusion This study revealed a moderate to strong agreement between physician- assigned and medical assistant- assigned major causes of neonatal death. A well-trained medical assistant could be considered an alternative for assigning major causes of neonatal deaths in rural Bangladesh and in similar settings where physicians are scarce and their time costs more. A validation study with medically confirmed diagnosis will improve the performance of VA for assigning cause of neonatal death. PMID:20712906

  20. Earth, Wind, Flu, Flood and Fire: Early Evolution of U.S. National Policy for Natural Disaster Response

    DTIC Science & Technology

    2009-12-11

    Man-made disasters include engineering failures, transportation accidents, industrial accidents, or weapons of mass destruction. Historical...chemical, biological , radiological, nuclear, and high yield explosive incidents. Another exemption is Commander’s Emergency Authority, which authorizes...Pandemic.” In From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns. ed. Mary

  1. The Inglorious Death of Jumbo

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Meade, Roger Allen

    In the summer of 1944, J. Robert Oppenheimer and Los Alamos faced a crisis. An isotopic impurity in Plutonium rendered the metal unusable in a gun-assembled atomic bomb (i.e., Little Boy). Making this situation worse was a shortage of Uranium. The combination of these two problems threatened the entire wartime project. The answer to this dilemma, in part, was to develop a novel assembly method for Plutonium using the supersonic shock waves created by several tons of high explosives to compress a ball of Plutonium into a supercritical state. Since this method, implosion, was not much more than a theoreticalmore » construct, the Trinity test was devised to proof test the process. Given the speculative nature of implosion, Trinity was a gamble of sorts. If the test failed (i.e., little or no nuclear yield), the blast of the high explosives would scatter the scarce and expensive Plutonium over the surrounding desert. Since the probability of failure remained high into the early summer of 1945, some method of containing a failed nuclear explosion was needed. Jumbo was the answer.« less

  2. Global and regional causes of death.

    PubMed

    Mathers, Colin D; Boerma, Ties; Ma Fat, Doris

    2009-01-01

    Assessing the causes of death across all regions of the world requires a framework for integrating, and analysing, the fragmentary information that is available on numbers of deaths and their cause distributions. This paper provides an overview of the met and methods used by the World Health Organization to develop global-, regional- and country-level estimates of mortality for a comprehensive set of causes, and provides an overview of global and regional levels and patterns of causes of death for the year 2004. The paper also examines some of the data gaps, uncertainties and limitations in the resulting mortality estimates. Deaths for 136 disease and injury causes were estimated from available death registration data (111 countries), sample death registration data (India and China), and for the remaining countries from census and survey information, and cause-of-death models. Population-based epidemiological studies and notifications systems also contributed to estimating mortality for 21 of these causes (representing 28% of deaths globally, 58% in Africa). Ischaemic heart disease and cerebrovascular disease are the leading causes of death, followed by lower respiratory infections, chronic obstructive pulmonary disease and diarrhoeal diseases. AIDS and TB are the sixth and seventh most common causes of death, respectively, lower than in previous estimates. One-half of all child deaths are from four preventable and treatable communicable diseases. Globally, around 6 in 10 deaths are from non-communicable diseases, 3 from communicable diseases and 1 from injuries. Injury mortality is highest in South-East Asia, Latin America and the Eastern Mediterranean region. These results illustrate continuing huge disparities in risks and causes of death across the world. Global mortality analyses of the type reported here have been criticized for making estimates of mortality for regions with limited, incomplete and uncertain data. Estimates presented here use a range of techniques depending on the type and quality of evidence. Better evidence on levels of adult mortality is needed for African countries. Considerable gaps and deficiencies remain in the information available on causes of death. Nine of 10 deaths in 2004 occurred in low- and middle-income countries, reinforcing the fundamental importance of improving mortality statistics as a measure of health status in the developing world. Acknowledging the controversies around use of incomplete and uncertain data, systematic assessments and synthesis of the available evidence will continue to provide important inputs for global health planning. Innovative methods involving sample registration, and the use of verbal autopsy questionnaires in surveys, are needed to address these gaps. Research on strategies to improve comparability of cause-of-death certification and coding practices across countries is also a high priority.

  3. Causes of death in patients with chronic sarcoidosis.

    PubMed

    Hu, Xiaowen; Carmona, Eva M; Yi, Eunhee S; Pellikka, Patricia A; Ryu, Jay

    2016-10-07

    Sarcoidosis is a multi-system, granulomatous disorder of unknown etiology that is associated with a variable prognosis and sometimes results in death. There are conflicting reports regarding the causes of death in patients with sarcoidosis. Forty-four consecutive patients with sarcoidosis who underwent an autopsy (35 patients) or died at Mayo Clinic (Rochester, MN, USA) over a 20-yr period, from January 1, 1994 to December 31, 2013 were analyzed. The median age at death was 63 years (range, 33-94 years) and there were 22 (50%) women. Sarcoidosis had not been clinically diagnosed in 16 (36%) patients before death. Fifteen deaths (34%) were related to sarcoidosis and included seven deaths (16%) from cardiac sarcoidosis and four deaths (9%) from progressive pulmonary sarcoidosis. Other sarcoidosis-related causes of death included advanced hepatic sarcoidosis (5%) and opportunistic infections (5%) related to immunosuppressive therapy for treating sarcoidosis. Among seven patients dying from cardiac sarcoidosis, three had been diagnosed with sarcoidosis during life and cardiac involvement was known in two of them. Six of seven deaths from cardiac sarcoidosis occurred in the autopsied cohort while all four deaths from pulmonary sarcoidosis occurred in those not autopsied. In the majority of patients dying with sarcoidosis the cause of death is unrelated to sarcoidosis. Cardiac involvement is the most common cause of sarcoidosis-related deaths in patients subjected to postmortem examination and was usually undiagnosed during life. The cause distribution of death in patients with sarcoidosis differed depending on whether autopsy was performed.

  4. Field repair of AH-16 helicopter window cutting assemblies

    NASA Technical Reports Server (NTRS)

    Bement, L. J.

    1984-01-01

    The U.S. Army uses explosively actuated window cutting assemblies to provide emergency crew ground egress. Gaps between the system's explosive cords and acrylic windows caused a concern about functional reliability for a fleet of several hundred aircraft. A field repair method, using room temperature vulcanizing silicone compound (RTV), was developed and demonstrated to fill gaps as large as 0.250 inch.

  5. The Detection And Analysis Of Blasting Problems Encountered In A Colliery Using High Speed Photography

    NASA Astrophysics Data System (ADS)

    Rorke, A. J.; Kohler, E. W.

    1987-09-01

    Premature initiation of ANFO (an explosive mixture of Ammonium Nitrate and Fuel Oil) at a large colliery, near Witbank, was first detected from routine high speed films taken of large mid-burden, and overburden blasts. The analysis of these films shows that the rapid migration of very hot gasses through cracks ahead of the blast may have caused the explosive to initiate prematurely. The problem was not seen in the less competent overburden rocks. A less sensitive explosive has been successfully tried. The assessment of these blasts using high speed photography is discussed.

  6. Trend (1999-2009) in U.S. death rates from myelodysplastic syndromes: utility of multiple causes of death in surveillance.

    PubMed

    Polednak, Anthony P

    2013-10-01

    For myelodysplastic syndromes (MDS) (formerly known as preleukemia), a diverse group of myeloid neoplasms usually involving anemia in elderly persons, trends in U.S. death rates apparently have not been reported. Trends in annual age-standardized rates per 100,000 from 1999 to 2009 were examined for MDS using multiple causes vs. underlying cause alone, coded on death certificates for U.S. residents. The death rate (all ages combined) for MDS increased from 1999 to 2009, from 1.62 to 1.84 using underlying cause alone and from 2.89 to 3.27 using multiple causes. Rates using multiple causes were about 80% higher than those based on underlying cause alone. From 2001 to 2004 the rate for MDS using underlying cause alone (but not using multiple causes) declined, accompanied by an increase in the rate for deaths from leukemia as underlying cause with mention of MDS; this trend coincided with the advent of the 2001 World Health Organization's reclassification of certain MDS as leukemia. The MDS rate for age 65+ years increased after 2005, whereas the rate for age 25-64 years was low but declined from 2001 to 2003 and then stabilized. For deaths with MDS coded as other than underlying cause, rates did not decline for deaths from each of the two most common causes (i.e., cardiovascular diseases and leukemia). Evidence for decreases in MDS-related mortality rates was limited; the increase at age 65+ years is consistent with increases in incidence rates reported from cancer registries. Using multiple causes of death vs. only the underlying cause results in substantially higher MDS-related death rates, shows the impact of changes in the classification of myeloid neoplasms and emphasizes the importance of reducing cardiovascular disease mortality in MDS patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Causes of Death Among 379 Patients With Hemophilia: A Developing Country's Report.

    PubMed

    Mansouritorghabeh, Hassan; Rahimi, Hossein; Mohades, Seyed Tahereh; Behboudi, Maryam

    2018-05-01

    There are steps to achieve an optimum life for patients with hemophilia in developing countries, and awareness of the pattern of death in patients with hemophilia is a prerequisite for any health-care program. Owing to the lack of any data on the pattern of death in patients with hemophilia from developing countries, the current study was done to address common causes of death, and the spectrum of causes of death among individuals with hemophilia A and B. To address the pattern of death in northeast of Iran, we retrospectively collected demographic data regarding deceased patients with hemophilia A and B. Overall, among 379 people with hemophilia A and B, there were 46 deaths. Thirty-two deaths happened in the severe forms of the diseases. The obtained results show the patterns of death in the patients studied are not as parallel as some reports from the developed countries. Traumatic and spontaneous bleeding events were the main causes of death. The trend of death shows a decrease in the current decade post better therapeutic facilities. Evaluation of causes of death in hemophilia can be a useful indicator for managing the efficacy of health care in the current patients.

  8. Underlying causes of the emerging nonmetropolitan mortality penalty.

    PubMed

    Cossman, Jeralynn S; James, Wesley L; Cosby, Arthur G; Cossman, Ronald E

    2010-08-01

    The nonmetropolitan mortality penalty results in an estimated 40 201 excessive US deaths per year, deaths that would not occur if nonmetropolitan and metropolitan residents died at the same rate. We explored the underlying causes of the nonmetropolitan mortality penalty by examining variation in cause of death. Declines in heart disease and cancer death rates in metropolitan areas drive the nonmetropolitan mortality penalty. Future work should explore why the top causes of death are higher in nonmetropolitan areas than they are in metropolitan areas.

  9. Underlying Causes of the Emerging Nonmetropolitan Mortality Penalty

    PubMed Central

    James, Wesley L.; Cosby, Arthur G.; Cossman, Ronald E.

    2010-01-01

    The nonmetropolitan mortality penalty results in an estimated 40 201 excessive US deaths per year, deaths that would not occur if nonmetropolitan and metropolitan residents died at the same rate. We explored the underlying causes of the nonmetropolitan mortality penalty by examining variation in cause of death. Declines in heart disease and cancer death rates in metropolitan areas drive the nonmetropolitan mortality penalty. Future work should explore why the top causes of death are higher in nonmetropolitan areas than they are in metropolitan areas. PMID:20558803

  10. Reclassifying causes of obstetric death in Mexico: a repeated cross-sectional study.

    PubMed

    Hogan, Margaret C; Saavedra-Avendano, Biani; Darney, Blair G; Torres-Palacios, Luis M; Rhenals-Osorio, Ana L; Sierra, Bertha L Vázquez; Soliz-Sánchez, Patricia N; Gakidou, Emmanuela; Lozano, Rafael

    2016-05-01

    To describe causes of maternal mortality in Mexico over eight years, with particular attention to indirect obstetric deaths and socioeconomic disparities. We conducted a repeated cross-sectional study using the 2006-2013 Búsqueda intencionada y reclasificación de muertes maternas (BIRMM) data set. We used frequencies to describe new cases, cause distributions and the reclassification of maternal mortality cases by the BIRMM process. We used statistical tests to analyse differences in sociodemographic characteristics between direct and indirect deaths and differences in the proportion of overall direct and indirect deaths, by year and by municipality poverty level. A total of 9043 maternal deaths were subjected to the review process. There was a 13% increase (from 7829 to 9043) in overall identified maternal deaths and a threefold increase in the proportion of maternal deaths classified as late maternal deaths (from 2.1% to 6.9%). Over the study period direct obstetric deaths declined, while there was no change in deaths from indirect obstetric causes. Direct deaths were concentrated in women who lived in the poorest municipalities. When compared to those dying of direct causes, women dying of indirect causes had fewer pregnancies and were slightly younger, better educated and more likely to live in wealthier municipalities. The BIRMM is one approach to correct maternal death statistics in settings with poor resources. The approach could help the health system to rethink its strategy to reduce maternal deaths from indirect obstetric causes, including prevention of unwanted pregnancies and improvement of antenatal and post-obstetric care.

  11. Reclassifying causes of obstetric death in Mexico: a repeated cross-sectional study

    PubMed Central

    Hogan, Margaret C; Saavedra-Avendano, Biani; Darney, Blair G; Torres-Palacios, Luis M; Rhenals-Osorio, Ana L; Sierra, Bertha L Vázquez; Soliz-Sánchez, Patricia N; Gakidou, Emmanuela

    2016-01-01

    Abstract Objective To describe causes of maternal mortality in Mexico over eight years, with particular attention to indirect obstetric deaths and socioeconomic disparities. Methods We conducted a repeated cross-sectional study using the 2006–2013 Búsqueda intencionada y reclasificación de muertes maternas (BIRMM) data set. We used frequencies to describe new cases, cause distributions and the reclassification of maternal mortality cases by the BIRMM process. We used statistical tests to analyse differences in sociodemographic characteristics between direct and indirect deaths and differences in the proportion of overall direct and indirect deaths, by year and by municipality poverty level. Findings A total of 9043 maternal deaths were subjected to the review process. There was a 13% increase (from 7829 to 9043) in overall identified maternal deaths and a threefold increase in the proportion of maternal deaths classified as late maternal deaths (from 2.1% to 6.9%). Over the study period direct obstetric deaths declined, while there was no change in deaths from indirect obstetric causes. Direct deaths were concentrated in women who lived in the poorest municipalities. When compared to those dying of direct causes, women dying of indirect causes had fewer pregnancies and were slightly younger, better educated and more likely to live in wealthier municipalities. Conclusion The BIRMM is one approach to correct maternal death statistics in settings with poor resources. The approach could help the health system to rethink its strategy to reduce maternal deaths from indirect obstetric causes, including prevention of unwanted pregnancies and improvement of antenatal and post-obstetric care. PMID:27147766

  12. Causes and circumstances of death in pulmonary arterial hypertension.

    PubMed

    Tonelli, Adriano R; Arelli, Vineesha; Minai, Omar A; Newman, Jennie; Bair, Nancy; Heresi, Gustavo A; Dweik, Raed A

    2013-08-01

    The causes and circumstances surrounding death are understudied in patients with pulmonary arterial hypertension (PAH). We sought to determine the specific reasons and characteristics surrounding the death of patients with PAH. All deaths of patients with pulmonary hypertension (PH) followed in the Cleveland Clinic Pulmonary Vascular Program were prospectively reviewed by the PH team. A total of 84 patients with PAH (age 58 ± 14 yr; 73% females) who died between June 2008 and May 2012 were included. PH was determined to be the direct cause of death (right heart failure or sudden death) in 37 (44%) patients; PH contributed to but did not directly cause death in 37 (44%) patients; and the death was not related to PH in the remaining cases (n = 7; 8.3%). In three (3.6%) patients the final cause of death could not be adequately assessed. Most patients died in a healthcare environment and most received PH-specific therapies. In our cohort, 50% of all patients with PAH and 75.7% of those who died of right heart failure received parenteral prostanoid therapy. Less than half of patients had advanced healthcare directives. Most patients with PAH in our cohort died of their disease; however, right ventricular failure or sudden death was the sole cause of death in less than half of patients.

  13. A Physical Basis for M s-Yield Scaling in Hard Rock and Implications for Late-Time Damage of the Source Medium

    DOE PAGES

    Patton, Howard John

    2016-04-11

    Surface wave magnitude M s for a compilation of 72 nuclear tests detonated in hard rock media for which yields and burial depths have been reported in the literature is shown to scale with yield W as a + b × log[W], where a = 2.50 ± 0.08 and b = 0.80 ± 0.05. While the exponent b is consistent with an M s scaling model for fully coupled, normal containment-depth explosions, the intercept a is offset 0.45 magnitude units lower than the model. The cause of offset is important to understand in terms of the explosion source. Hard rockmore » explosions conducted in extensional and compressional stress regimes show similar offsets, an indication that the tectonic setting in which an explosion occurs plays no role causing the offset. The scaling model accounts for the effects of source medium material properties on the generation of 20-s period Rayleigh wave amplitudes. Aided by thorough characterizations of the explosion and tectonic release sources, an extensive analysis of the 1963 October 26 Shoal nuclear test detonated in granite 27 miles southeast of Fallon NV shows that the offset is consistent with the predictions of a material damage source model related to non-linear stress wave interactions with the free surface. This source emits Rayleigh waves with polarity opposite to waves emitted by the explosion. The Shoal results were extended to analyse surface waves from the 1962 February 15 Hardhat nuclear test, the 1988 September 14 Soviet Joint Verification Experiment, and the anomalous 1979 August 18 northeast Balapan explosion which exhibits opposite polarity, azimuth-independent source component U1 compared to an explosion. Modelling these tests shows that Rayleigh wave amplitudes generated by the damage source are nearly as large as or larger than amplitudes from the explosion. As such, destructive interference can be drastic, introducing metastable conditions due to the sensitivity of reduced amplitudes to Rayleigh wave initial phase angles of the explosion and damage sources. This meta-stability is a likely source of scatter in M s-yield scaling observations. The agreement of observed scaling exponent b with the model suggests that the damage source strength does not vary much with yield, in contrast to explosions conducted in weak media where Ms scaling rates are greater than the model predicts, and the yield dependence of the damage source strength is significant. This difference in scaling behaviour is a consequence of source medium material properties.« less

  14. A Physical Basis for M s-Yield Scaling in Hard Rock and Implications for Late-Time Damage of the Source Medium

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Patton, Howard John

    Surface wave magnitude M s for a compilation of 72 nuclear tests detonated in hard rock media for which yields and burial depths have been reported in the literature is shown to scale with yield W as a + b × log[W], where a = 2.50 ± 0.08 and b = 0.80 ± 0.05. While the exponent b is consistent with an M s scaling model for fully coupled, normal containment-depth explosions, the intercept a is offset 0.45 magnitude units lower than the model. The cause of offset is important to understand in terms of the explosion source. Hard rockmore » explosions conducted in extensional and compressional stress regimes show similar offsets, an indication that the tectonic setting in which an explosion occurs plays no role causing the offset. The scaling model accounts for the effects of source medium material properties on the generation of 20-s period Rayleigh wave amplitudes. Aided by thorough characterizations of the explosion and tectonic release sources, an extensive analysis of the 1963 October 26 Shoal nuclear test detonated in granite 27 miles southeast of Fallon NV shows that the offset is consistent with the predictions of a material damage source model related to non-linear stress wave interactions with the free surface. This source emits Rayleigh waves with polarity opposite to waves emitted by the explosion. The Shoal results were extended to analyse surface waves from the 1962 February 15 Hardhat nuclear test, the 1988 September 14 Soviet Joint Verification Experiment, and the anomalous 1979 August 18 northeast Balapan explosion which exhibits opposite polarity, azimuth-independent source component U1 compared to an explosion. Modelling these tests shows that Rayleigh wave amplitudes generated by the damage source are nearly as large as or larger than amplitudes from the explosion. As such, destructive interference can be drastic, introducing metastable conditions due to the sensitivity of reduced amplitudes to Rayleigh wave initial phase angles of the explosion and damage sources. This meta-stability is a likely source of scatter in M s-yield scaling observations. The agreement of observed scaling exponent b with the model suggests that the damage source strength does not vary much with yield, in contrast to explosions conducted in weak media where Ms scaling rates are greater than the model predicts, and the yield dependence of the damage source strength is significant. This difference in scaling behaviour is a consequence of source medium material properties.« less

  15. Prospective study of one million deaths in India: rationale, design, and validation results.

    PubMed

    Jha, Prabhat; Gajalakshmi, Vendhan; Gupta, Prakash C; Kumar, Rajesh; Mony, Prem; Dhingra, Neeraj; Peto, Richard

    2006-02-01

    Over 75% of the annual estimated 9.5 million deaths in India occur in the home, and the large majority of these do not have a certified cause. India and other developing countries urgently need reliable quantification of the causes of death. They also need better epidemiological evidence about the relevance of physical (such as blood pressure and obesity), behavioral (such as smoking, alcohol, HIV-1 risk taking, and immunization history), and biological (such as blood lipids and gene polymorphisms) measurements to the development of disease in individuals or disease rates in populations. We report here on the rationale, design, and implementation of the world's largest prospective study of the causes and correlates of mortality. We will monitor nearly 14 million people in 2.4 million nationally representative Indian households (6.3 million people in 1.1 million households in the 1998-2003 sample frame and 7.6 million people in 1.3 million households in the 2004-2014 sample frame) for vital status and, if dead, the causes of death through a well-validated verbal autopsy (VA) instrument. About 300,000 deaths from 1998-2003 and some 700,000 deaths from 2004-2014 are expected; of these about 850,000 will be coded by two physicians to provide causes of death by gender, age, socioeconomic status, and geographical region. Pilot studies will evaluate the addition of physical and biological measurements, specifically dried blood spots. Preliminary results from over 35,000 deaths suggest that VA can ascertain the leading causes of death, reduce the misclassification of causes, and derive the probable underlying cause of death when it has not been reported. VA yields broad classification of the underlying causes in about 90% of deaths before age 70. In old age, however, the proportion of classifiable deaths is lower. By tracking underlying demographic denominators, the study permits quantification of absolute mortality rates. Household case-control, proportional mortality, and nested case-control methods permit quantification of risk factors. This study will reliably document not only the underlying cause of child and adult deaths but also key risk factors (behavioral, physical, environmental, and eventually, genetic). It offers a globally replicable model for reliably estimating cause-specific mortality using VA and strengthens India's flagship mortality monitoring system. Despite the misclassification that is still expected, the new cause-of-death data will be substantially better than that available previously.

  16. Explosives detection and identification using surface plasmon-coupled emission

    NASA Astrophysics Data System (ADS)

    Ja, Shiou-Jyh

    2012-06-01

    To fight against the explosives-related threats in defense and homeland security applications, a smarter sensing device that not only detects but differentiates multiple true threats from false positives caused by environmental interferents is essential. A new optical detection system is proposed to address these issues by using the temporal and spectroscopic information generated by the surface plasmon coupling emission (SPCE) effect. Innovative SPCE optics have been designed using Zemax software to project the fluorescence signal into clear "rainbow rings" on a CCD with subnanometer wavelength resolution. The spectroscopic change of the fluorescence signal and the time history of such changes due to the presence of a certain explosive analyte are unique and can be used to identify explosives. Thanks to high optical efficiency, reporter depositions as small as 160-μm in diameter can generate a sufficient signal, allowing a dense array of different reporters to be interrogated with wavelength multiplexing and detect a wide range of explosives. We have demonstrated detection and classification of explosives, such as TNT, NT, NM, RDX, PETN, and AN, with two sensing materials in a prototype.

  17. Explosion and/or fire risk assessment methodology: a common approach, structured for underground coalmine environments / Metoda szacowania ryzyka wybuchu i pożarów: podejście ogólne, dostosowane do środowiska kopalni podziemnej

    NASA Astrophysics Data System (ADS)

    Cioca, Ionel-Lucian; Moraru, Roland Iosif

    2012-10-01

    In order to meet statutory requirements concerning the workers health and safety, it is necessary for mine managers within Valea Jiului coal basin in Romania to address the potential for underground fires and explosions and their impact on the workforce and the mine ventilation systems. Highlighting the need for a unified and systematic approach of the specific risks, the authors are developing a general framework for fire/explosion risk assessment in gassy mines, based on the quantification of the likelihood of occurrence and gravity of the consequences of such undesired events and employing Root-Cause analysis method. It is emphasized that even a small fire should be regarded as being a major hazard from the point of view of explosion initiation, should a combustible atmosphere arise. The developed methodology, for the assessment of underground fire and explosion risks, is based on the known underground explosion hazards, fire engineering principles and fire test criteria for potentially combustible materials employed in mines.

  18. Improvised explosive devices: pathophysiology, injury profiles and current medical management.

    PubMed

    Ramasamy, A; Hill, A M; Clasper, J C

    2009-12-01

    The improvised explosive device (IED), in all its forms, has become the most significant threat to troops operating in Afghanistan and Iraq. These devices range from rudimentary home made explosives to sophisticated weapon systems containing high-grade explosives. Within this broad definition they may be classified as roadside explosives and blast mines, explosive formed pojectile (EFP) devices and suicide bombings. Each of these groups causeinjury through a number of different mechanisms and can result in vastly different injury profiles. The "Global War on Terror" has meant that incidents which were previously exclusively seen in conflict areas, can occur anywhere, and clinicians who are involved in emergency trauma care may be required to manage casualties from similar terrorist attacks. An understanding of the types of devices and their pathophysiological effects is necessary to allow proper planning of mass casualty events and to allow appropriate management of the complex poly-trauma casualties they invariably cause. The aim of this review article is to firstly describe the physics and injury profile from these different devices and secondly to present the current clinical evidence that underpins their medical management.

  19. Are amino groups advantageous to insensitive high explosives (IHEs)?

    PubMed

    Cao, Xia; Wen, Yushi; Xiang, Bin; Long, Xinping; Zhang, Chaoyang

    2012-10-01

    There is usually a contradiction between increasing energy densities and reducing sensitivities of explosives. The explosives with both high energy densities and low sensitivities, or the so-called insensitive high explosives (IHEs), are desirable in most cases. It seems from applied explosives that amino groups are advantageous to IHE but the amount of amino groups contained IHEs is very limited. To make this clear, we present systemic examinations of the effects on the two properties stressed in IHEs after introducing amino groups to different molecular skeletons. As a result, the amino groups on resonant sites to nitro groups in conjugated systems can improve distinctly sensitivities and change energy densities in terms of oxygen balance; while the amino groups in unconjugated systems can hardly increase energy densities and usually cause increased sensitivities. It agrees well with a fact that almost all the molecules of applied amino group contained explosives possess conjugated skeletons. We therefore confirm that if amino groups are introduced resonantly to a nitro group in a conjugated system and the introduction improves OB, they are advantageous to IHEs.

  20. Cardiac and Noncardiac Causes of Long-Term Mortality in ST-Segment-Elevation Acute Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention.

    PubMed

    Yamashita, Yugo; Shiomi, Hiroki; Morimoto, Takeshi; Yaku, Hidenori; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ando, Kenji; Kadota, Kazushige; Abe, Mitsuru; Nagao, Kazuya; Shizuta, Satoshi; Ono, Koh; Kimura, Takeshi

    2017-01-01

    In patients with ST-segment-elevation acute myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention, long-term risks for cardiac and noncardiac death beyond acute phase of STEMI have not been thoroughly evaluated yet. We identified 3942 STEMI patients who had primary percutaneous coronary intervention within 24 hours after onset between January 2005 and December 2007 in the CREDO-Kyoto AMI registry (Coronary Revascularization Demonstrating Outcome study in Kyoto Acute Myocardial Infarction) and evaluated their short-term (within 6-month) and long-term (beyond 6-month) incidences and causes of deaths. The cumulative 5-year incidence of all-cause death in the current study population was 20.4% (cardiac death, 12.2% and noncardiac death, 9.4%, respectively). The vast majority of deaths were cardiac in origin within 6-month (cardiac death, 8.0% and noncardiac death, 0.9%), whereas noncardiac death accounted for nearly two thirds of all-cause death beyond 6-month (cardiac death, 4.6% and noncardiac death, 8.5%). In the stratified analysis according to age, the proportion of noncardiac death was similar regardless of age although the absolute mortality rate was higher with increasing age. By the multivariable Cox regression models, the independent risk factors of all-cause death were advanced age, cardiogenic shock, renal dysfunction, large infarct size, and anterior wall infarction within 6 months after STEMI, and advanced age, previous heart failure, renal dysfunction, and liver cirrhosis beyond 6 months after STEMI, respectively. In STEMI patients who underwent primary percutaneous coronary intervention, the long-term risk for cardiac death was relatively low compared with that for noncardiac death, which accounted for nearly two thirds of all-cause death beyond 6 months. © 2017 American Heart Association, Inc.

  1. Calculating expected years of life lost for assessing local ethnic disparities in causes of premature death.

    PubMed

    Aragón, Tomás J; Lichtensztajn, Daphne Y; Katcher, Brian S; Reiter, Randy; Katz, Mitchell H

    2008-04-10

    A core function of local health departments is to conduct health assessments. The analysis of death certificates provides information on diseases, conditions, and injuries that are likely to cause death - an important outcome indicator of population health. The expected years of life lost (YLL) measure is a valid, stand-alone measure for identifying and ranking the underlying causes of premature death. The purpose of this study was to rank the leading causes of premature death among San Francisco residents, and to share detailed methods so that these analyses can be used in other local health jurisdictions. Using death registry data and population estimates for San Francisco deaths in 2003-2004, we calculated the number of deaths, YLL, and age-standardized YLL rates (ASYRs). The results were stratified by sex, ethnicity, and underlying cause of death. The YLL values were used to rank the leading causes of premature death for men and women, and by ethnicity. In the years 2003-2004, 6312 men died (73,627 years of life lost), and 5726 women died (51,194 years of life lost). The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year). The leading causes of premature deaths are those with the largest average YLLs and are largely preventable. Among men, these were HIV/AIDS, suicide, drug overdose, homicide, and alcohol use disorder; and among women, these were lung cancer, breast cancer, hypertensive heart disease, colon cancer, and diabetes mellitus. A large health disparity exists between African Americans and other ethnic groups: African American age-adjusted overall and cause-specific YLL rates were higher, especially for homicide among men. Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites. Local death registry data can be used to measure, rank, and monitor the leading causes of premature death, and to measure and monitor ethnic health disparities.

  2. Disability status, mortality, and leading causes of death in the United States community population.

    PubMed

    Forman-Hoffman, Valerie L; Ault, Kimberly L; Anderson, Wayne L; Weiner, Joshua M; Stevens, Alissa; Campbell, Vincent A; Armour, Brian S

    2015-04-01

    We examined the effect of functional disability on all-cause mortality and cause-specific deaths among community-dwelling US adults. We used data from 142,636 adults who participated in the 1994-1995 National Health Interview Survey-Disability Supplement eligible for linkage to National Death Index records from 1994 to 2006 to estimate the effects of disability on mortality and leading causes of death. Adults with any disability were more likely to die than adults without disability (19.92% vs. 10.94%; hazard ratio=1.51, 95% confidence interval, 1.45-1.57). This association was statistically significant for most causes of death and for most types of disability studied. The leading cause of death for adults with and without disability differed (heart disease and malignant neoplasms, respectively). Our results suggest that all-cause mortality rates are higher among adults with disabilities than among adults without disabilities and that significant associations exist between several types of disability and cause-specific mortality. Interventions are needed that effectively address the poorer health status of people with disabilities and reduce the risk of death.

  3. Medical death certification by forensic physicians in the Netherlands: Validity and interdoctorvariation.

    PubMed

    Dorn, Tina; Ceelen, Manon; Reijnders, Udo; Das, Kees

    2016-10-01

    The aim of the study was to assess interdoctorvariation and validity in death certification by forensic physicians using 19 written scenarios. The scenarios described typical cases from forensic-medical practice. Physicians were asked to determine the manner of death (natural/unnatural) and to provide an ICD-10 code for the cause of death. In contrast to most studies on this topic, the measure of agreement among physicians was chance-corrected and a standard was used to assess the correctness of the assigned cause and manner of death. Forty-seven physicians participated in the survey. The study demonstrated that forensic physicians varied widely in their conclusions. With respect to manner of death, adequate agreement (defined as kappa>0.70) was achieved in six scenarios (32% of all scenarios). Concerning the underlying cause of death, adequate agreement was reached in three cases (16% of all scenarios). Furthermore, predictors for the correctness of manner and cause of death were studied using logistic regression. Years of experience as a forensic physician significantly predicted the correctness of cause of death (p < 0.05). Other predictors remained insignificant. With regard to manner of death, none of the studied predictors proved to be significant. To conclude, there appears to be a lack of consistency among forensic physicians regarding death certification. The ICD-10 coding of causes of death applied by forensic physicians is questionable. Less experienced physicians need supervision by more experienced colleagues when making judgments concerning the cause of death. Altogether, there is an urgent need to work out consensus-based guidelines for forensic physicians on how to certify deaths. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  4. Mortality after prison release: opioid overdose and other causes of death, risk factors, and time trends from 1999 to 2009.

    PubMed

    Binswanger, Ingrid A; Blatchford, Patrick J; Mueller, Shane R; Stern, Marc F

    2013-11-05

    Among former prisoners, a high rate of death has been documented in the early postrelease period, particularly from drug-related causes. Little is known about risk factors and trends in postrelease mortality in the past decade, especially given general population increases in overdose deaths from pharmaceutical opioids. To determine postrelease mortality between 1999 and 2009; cause-specific mortality rates; and whether sex, calendar year, and custody factors were risk factors for all-cause, overdose, and opioid-related deaths. Cohort study. Prison system of the Washington State Department of Corrections. 76 208 persons released from prison. Identities were linked probabilistically to the National Death Index to identify deaths and causes of death, and mortality rates were calculated. Cox proportional hazards regression estimated the effect of age, sex, race or ethnicity, whether the incarceration resulted from a violation of terms of the person's community supervision, length of incarceration, release type, and calendar year on the hazard ratio (HR) for death. The all-cause mortality rate was 737 per 100 000 person-years (95% CI, 708 to 766) (n = 2462 deaths). Opioids were involved in 14.8% of all deaths. Overdose was the leading cause of death (167 per 100 000 person-years [CI, 153 to 181]), and overdose deaths in former prisoners accounted for 8.3% of the overdose deaths among persons aged 15 to 84 years in Washington from 2000 to 2009. Women were at increased risk for overdose (HR, 1.38 [CI, 1.12 to 1.69]) and opioid-related deaths (HR, 1.39 [CI, 1.09 to 1.79]). The study was done in only 1 state. Innovation is needed to reduce the risk for overdose among former prisoners. National Institute on Drug Abuse and the Robert Wood Johnson Foundation.

  5. Status of volcanic hazard studies for the Nevada Nuclear Waste Storage Investigations. Volume II

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Crowe, B.M.; Wohletz, K.H.; Vaniman, D.T.

    1986-01-01

    Volcanic hazard investigations during FY 1984 focused on five topics: the emplacement mechanism of shallow basalt intrusions, geochemical trends through time for volcanic fields of the Death Valley-Pancake Range volcanic zone, the possibility of bimodal basalt-rhyolite volcanism, the age and process of enrichment for incompatible elements in young basalts of the Nevada Test Site (NTS) region, and the possibility of hydrovolcanic activity. The stress regime of Yucca Mountain may favor formation of shallow basalt intrusions. However, combined field and drill-hole studies suggest shallow basalt intrusions are rare in the geologic record of the southern Great Basin. The geochemical patterns ofmore » basaltic volcanism through time in the NTS region provide no evidence for evolution toward a large-volume volcanic field or increases in future rates of volcanism. Existing data are consistent with a declining volcanic system comparable to the late stages of the southern Death Valley volcanic field. The hazards of bimodal volcanism in this area are judged to be low. The source of a 6-Myr pumice discovered in alluvial deposits of Crater Flat has not been found. Geochemical studies show that the enrichment of trace elements in the younger rift basalts must be related to an enrichment of their mantle source rocks. This geochemical enrichment event, which may have been metasomatic alteration, predates the basalts of the silicic episode and is, therefore, not a young event. Studies of crater dimensions of hydrovolcanic landforms indicate that the worst case scenario (exhumation of a repository at Yucca Mountain by hydrovolcanic explosions) is unlikely. Theoretical models of melt-water vapor explosions, particularly the thermal detonation model, suggest hydrovolcanic explosion are possible at Yucca Mountain. 80 refs., 21 figs., 5 tabs.« less

  6. Inaccuracies in oral cavity-pharynx cancer coded as the underlying cause of death on U.S. death certificates, and trends in mortality rates (1999-2010).

    PubMed

    Polednak, Anthony P

    2014-08-01

    To enhance surveillance of mortality from oral cavity-pharynx cancer (OCPC) by considering inaccuracies in the cancer site coded as the underlying cause of death on death certificates vs. cancer site in a population-based cancer registry (as the gold standard). A database was used for 9 population-based cancer registries of the Surveillance, Epidemiology and End Results (SEER) Program, including deaths in 1999-2010 for patients diagnosed in 1973-2010. Numbers of deaths and death rates for OCPC in the SEER population were modified for apparent inaccuracies in the cancer site coded as the underlying cause of death. For age groups <65 years, deaths from OCPC were underestimated by 22-35% by using unmodified (vs. modified) numbers, but temporal declines in death rates were still evident in the SEER population and were similar to declines using routine mortality data for the entire U.S. population. Deaths were underestimated by about 70-80% using underlying cause for tonsillar cancers, strongly associated with human papillomavirus (HPV) infection, but a lack of decline in death rates was still evident. Routine mortality statistics based on underlying cause of death underestimate OCPC deaths but demonstrate trends in OCPC death rates that require continued surveillance in view of increasing incidence rates for HPV-related OCPC. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System.

    PubMed

    Tian, Niu; Shaw, Esther C; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M

    2015-04-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28days to 24years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. Published by Elsevier Inc.

  8. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System ☆

    PubMed Central

    Tian, Niu; Shaw, Esther C.; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M.

    2015-01-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28 days to 24 years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended. PMID:25794682

  9. [Impact of heat waves on non-accidental deaths in Jinan, China].

    PubMed

    Zhang, J; Liu, S Q; Zhou, L; Gong, S P; Liu, Y L; Zhang, Y; Zhang, J

    2016-02-20

    To assess the impact of heat waves on non-accidental deaths, and to investigate the influencing factors for deaths caused by heat waves in Jinan, China. Daily death data and meteorological data for summer days with or without heat waves in Jinan from 2012 to 2014 were collected, and a cross-over analysis was conducted to evaluate the influence of heat waves on non-accidental deaths and deaths caused by other reasons. The univariate and multivariate logistic regression models were used to investigate the influencing factors for deaths caused by heat waves. The risks of non-accidental deaths and deaths caused by circulation system diseases during the days with heat waves were 1.82 times(95% CI: 1.47~2.36) and 1.53 times(95% CI: 1.14~2.07) those during the days without heat waves. The multivariate logistic regression analysis showed that old age(≥75 years)(OR=1.184, 95% CI: 1.068~1.313), low educational level(OR=1.187, 95% CI: 1.064~1.324), and deaths outside hospital(OR=1.105, 95% CI: 1.009~1.210) were associated with the high risk of deaths during the days with heat waves. Heat waves significantly increase the risk of non-accidental deaths and deaths caused by circulation system diseases in Jinan, and the deaths during the days with heat waves are related to age, educational level, and place of death.

  10. Initiation disruptor systems and methods of initiation disruption

    DOEpatents

    Baum, Dennis W

    2014-09-23

    A system that may be used as an initiation disruption system (IDS) according to one embodiment includes an explosive charge; a plurality of particles in a layer at least partially surrounding the explosive charge; and a fire suppressant adjacent the plurality of particles. A method for disabling an object according to one embodiment includes placing the system as recited above near an object; and causing the explosive charge to initiate, thereby applying mechanical loading to the object such that the object becomes disabled. Additional systems and methods are also presented. A device according to another embodiment includes a plurality of particles bound by a binder thereby defining a sidewall having an interior for receiving an explosive; and a fire suppressant adjacent the plurality of particles and binder. Additional systems and methods are also presented.

  11. Spherization of the remnants of asymmetrical SN explosions in a uniform medium

    NASA Astrophysics Data System (ADS)

    Bisnovatyi-Kogan, G. S.; Blinnikov, S. I.

    A 'snow-plow' approximation is used to project a spherical shape for a supernova remnant (SNR) after a shock wave has traveled through a uniform medium following an asymmetrical SN explosion. The asymmetry arises as magnetorotation causes the explosion. It is assumed that the main part of the mass remains in a thin layer after the explosion and that the layer can be described by 1,5-dimensional hydrodynamics. The cavity pressure inside the shock is assumed much greater than the pressure of the outside medium. The snow-plow model accounts for asymmetrical particle velocities in the expanding layer and the tangential velocity averaged across the shock. The equations are configured to conserve mass and momentum and have specific initial conditions. The calculations are in agreement with observations of Cas A.

  12. Causes of death and demographic characteristics of victims of meteorological disasters in Korea from 1990 to 2008

    PubMed Central

    2011-01-01

    Background Meteorological disasters are an important component when considering climate change issues that impact morbidity and mortality rates. However, there are few epidemiological studies assessing the causes and characteristics of deaths from meteorological disasters. The present study aimed to analyze the causes of death associated with meteorological disasters in Korea, as well as demographic and geographic vulnerabilities and their changing trends, to establish effective measures for the adaptation to meteorological disasters. Methods Deaths associated with meteorological disasters were examined from 2,045 cases in Victim Survey Reports prepared by 16 local governments from 1990 to 2008. Specific causes of death were categorized as drowning, structural collapse, electrocution, lightning, fall, collision, landslide, avalanche, deterioration of disease by disaster, and others. Death rates were analyzed according to the meteorological type, specific causes of death, and demographic and geographic characteristics. Results Drowning (60.3%) caused the greatest number of deaths in total, followed by landslide (19.7%) and structural collapse (10.1%). However, the causes of deaths differed between disaster types. The meteorological disaster associated with the greatest number of deaths has changed from flood to typhoon. Factors that raised vulnerability included living in coastal provinces (11.3 times higher than inland metropolitan), male gender (1.9 times higher than female), and older age. Conclusions Epidemiological analyses of the causes of death and vulnerability associated with meteorological disasters can provide the necessary information for establishing future adaptation measures against climate change. A more comprehensive system for assessing disaster epidemiology needs to be established. PMID:21943038

  13. Mortality rates and the causes of death related to diabetes mellitus in Shanghai Songjiang District: an 11-year retrospective analysis of death certificates.

    PubMed

    Zhu, Meiying; Li, Jiang; Li, Zhiyuan; Luo, Wei; Dai, Dajun; Weaver, Scott R; Stauber, Christine; Luo, Ruiyan; Fu, Hua

    2015-09-04

    China is one of the countries with the highest prevalence of diabetes in the world. We analysed all the death certificates mentioning diabetes from 2002 to 2012 in Songjiang District of Shanghai to estimate morality rates and examine cause of death patterns. Mortality data of 2654 diabetics were collected from the database of local CDC. The data set comprises all causes of death, contributing causes and the underlying cause, thereby the mortality rates of diabetes and its specified complications were analysed. The leading underlying causes of death were various cardiovascular diseases (CVD), which collectively accounted for about 30% of the collected death certificates. Diabetes was determined as the underlying cause of death on 28.7%. The trends in mortality showed that the diabetes related death rate increased about 1.78 fold in the total population during the 11-year period, and the death rate of diabetes and CVD comorbidity increased 2.66 fold. In all the diabetes related deaths, the proportion of people dying of ischaemic heart disease or cerebrovascular disease increased from 18.0% in 2002 to 30.5% in 2012. But the proportions attributed directly to diabetes showed a downtrend, from 46.7-22.0%. The increasing diabetes related mortality could be chiefly due to the expanding prevalence of CVD, but has nothing to do with diabetes as the underlying cause. Policy makers should pay more attention to primary prevention of diabetes and on the prevention of cardiovascular complications to reduce the burden of diabetes on survival.

  14. Trends in aortic aneurysm- and dissection-related mortality in the state of São Paulo, Brazil, 1985–2009: multiple-cause-of-death analysis

    PubMed Central

    2012-01-01

    Background Aortic aneurysm and dissection are important causes of death in older people. Ruptured aneurysms show catastrophic fatality rates reaching near 80%. Few population-based mortality studies have been published in the world and none in Brazil. The objective of the present study was to use multiple-cause-of-death methodology in the analysis of mortality trends related to aortic aneurysm and dissection in the state of Sao Paulo, between 1985 and 2009. Methods We analyzed mortality data from the Sao Paulo State Data Analysis System, selecting all death certificates on which aortic aneurysm and dissection were listed as a cause-of-death. The variables sex, age, season of the year, and underlying, associated or total mentions of causes of death were studied using standardized mortality rates, proportions and historical trends. Statistical analyses were performed by chi-square goodness-of-fit and H Kruskal-Wallis tests, and variance analysis. The joinpoint regression model was used to evaluate changes in age-standardized rates trends. A p value less than 0.05 was regarded as significant. Results Over a 25-year period, there were 42,615 deaths related to aortic aneurysm and dissection, of which 36,088 (84.7%) were identified as underlying cause and 6,527 (15.3%) as an associated cause-of-death. Dissection and ruptured aneurysms were considered as an underlying cause of death in 93% of the deaths. For the entire period, a significant increased trend of age-standardized death rates was observed in men and women, while certain non-significant decreases occurred from 1996/2004 until 2009. Abdominal aortic aneurysms and aortic dissections prevailed among men and aortic dissections and aortic aneurysms of unspecified site among women. In 1985 and 2009 death rates ratios of men to women were respectively 2.86 and 2.19, corresponding to a difference decrease between rates of 23.4%. For aortic dissection, ruptured and non-ruptured aneurysms, the overall mean ages at death were, respectively, 63.2, 68.4 and 71.6 years; while, as the underlying cause, the main associated causes of death were as follows: hemorrhages (in 43.8%/40.5%/13.9%); hypertensive diseases (in 49.2%/22.43%/24.5%) and atherosclerosis (in 14.8%/25.5%/15.3%); and, as associated causes, their principal overall underlying causes of death were diseases of the circulatory (55.7%), and respiratory (13.8%) systems and neoplasms (7.8%). A significant seasonal variation, with highest frequency in winter, occurred in deaths identified as underlying cause for aortic dissection, ruptured and non-ruptured aneurysms. Conclusions This study introduces the methodology of multiple-causes-of-death to enhance epidemiologic knowledge of aortic aneurysm and dissection in São Paulo, Brazil. The results presented confer light to the importance of mortality statistics and the need for epidemiologic studies to understand unique trends in our own population. PMID:23046791

  15. Chronological shifts and changing causes of death after radiotherapy for early-stage oral cancer.

    PubMed

    Fujisawa, Rina; Shibuya, Hitoshi; Harata, Naoki; Yuasa-Nakagawa, Keiko; Toda, Kazuma; Hayashi, Keiji

    2014-02-01

    Following recent improvements in the curability of oral cancer, chronological shifts and changes in the causes of death after treatment have been observed. We conducted a review of the post-treatment causes of death following radiotherapy for oral cancers. The medical records of 966 patients with early-stage (stage I and II) oral cancer treated at our institute between 1980 and 2001 were reviewed, and the chronological shifts and changes in the causes of death after radiotherapy were assessed. Of the 966 patients enrolled in this study, 365 have died to date. Two hundred and eleven patients died of their primary malignancy; 193 of these deaths occurred within 5 years of treatment for the primary oral cancer. The second most frequent cause of death was second primary cancer (n = 90). Twenty-three patients with head and neck cancers and 18 patients with esophageal cancers died within 10 years of radiotherapy, and six patients with lung cancers died after more than 10 years. Within the first 5 years following treatment, the major cause of death was the primary oral cancer. After 5-10 years, a second primary cancer, such as head and neck cancer or esophageal cancer, became the leading cause of death. Over a 10-year period, the proportion of deaths from a second primary cancer in the lung was significant. We have demonstrated that there are chronological shifts and changes in the causes of death following treatment for early-stage oral cancer.

  16. Temporal changes in causes of death among HIV-infected patients in the HAART era in Rio de Janeiro, Brazil.

    PubMed

    Pacheco, Antonio G; Tuboi, Suely H; May, Silvia B; Moreira, Luiz F S; Ramadas, Luciana; Nunes, Estevão P; Merçon, Mônica; Faulhaber, José C; Harrison, Lee H; Schechter, Mauro

    2009-08-15

    The widespread use of highly active antiretroviral therapy (HAART) has led to marked decreases in death rates in Brazil in HIV-infected individuals. Nonetheless, there are scarce data on specific causes of death. Death rates from a cohort of HIV-infected patients in Rio de Janeiro, Brazil, were analyzed in 2-year periods, from 1997 to 2006. Poisson models and survival models accounting for competing risks were used to assess association of covariables. A standardized validated algorithm was used to ascertain specific causes of death. Of the 1538 eligible patients, 226 (14.7%) died during the study period, corresponding to a mortality rate of 3.2 per 100 person-years. The median follow-up time was 4.61 years (interquartile range = 5.63 years) and the loss to follow-up rate was 2.4 per 100 person-years. Overall, 98 (43.4%) were classified as non-AIDS-related causes. Although opportunistic infections were the leading causes of death (37.6%), deaths due to AIDS-related causes declined significantly over time (P < 0.01). In the most recent period (2005-2006), the rate of non-AIDS-related causes of deaths was higher than that of AIDS-related causes of death. In the HAART era, there has been a significant change in causes of death among HIV-infected patients in Rio de Janeiro. As access to HAART improves, integration with other public programs will become critically important for the long-term success of HIV/AIDS programs in developing countries.

  17. Factors Associated with Pneumonia-caused Death in Older Adults with Autopsy-confirmed Dementia

    PubMed Central

    Manabe, Toshie; Mizukami, Katsuyoshi; Akatsu, Hiroyasu; Hashizume, Yoshio; Ohkubo, Takayoshi; Kudo, Koichiro; Hizawa, Nobuyuki

    2017-01-01

    Objective A better understanding of risk factors for pneumonia-caused death may help to improve the clinical management of dementia. Methods A retrospective observational study was conducted by reviewing the medical charts and autopsy reports of 204 patients who were admitted to hospital, underwent a post-mortem examination, and who were neuropathologically diagnosed with dementia. The risk factors for pneumonia-caused death were examined both as underlying and immediate causes of death using logistic regression models. Results A high frequency of pneumonia-caused death was observed both in underlying- (37.3%) and immediate- (44.1%) cause of death, but varied according to the subtypes of dementia. The factors related to pneumonia-caused death (underlying) were subtypes of dementia; Alzheimer's disease (odds ratio [OR], 2.891; 95% confidence interval [CI], 1.459-5.730); argyrophilic grain disease (OR, 3.148; 95% CI, 0.937-10.577); and progressive supranuclear palsy (OR, 34.921; 95% CI, 3.826-318.775), dysphagia (OR, 2.045; 95% CI, 1.047-3.994), diabetes mellitus (OR, 3.084; 95% CI, 1.180-8.061) and conversely related with heart failure (OR, 0.149; 95% CI, 0.026-0.861). Factors relating to pneumonia-caused death (immediate) were incidence of pneumonia during hospitalizations (OR, 32.579; 95%CI, 4.308-246.370), gender-male (OR, 2.060; 95% CI, 1.098-3.864), and conversely related with malignant neoplasm (OR, 0.220; 95% CI, 0.058-0.840). Conclusion The different factors relating to the pneumonia-caused death were evaluated depending on whether pneumonia was the underlying- or immediate-cause of death. Strengthening clinical management on dysphagia and diabetes mellitus, and preventing incidence of pneumonia during hospitalization appear to be the important for the terminal stage of hospitalized patients with dementia. PMID:28420838

  18. Factors Associated with Pneumonia-caused Death in Older Adults with Autopsy-confirmed Dementia.

    PubMed

    Manabe, Toshie; Mizukami, Katsuyoshi; Akatsu, Hiroyasu; Hashizume, Yoshio; Ohkubo, Takayoshi; Kudo, Koichiro; Hizawa, Nobuyuki

    2017-01-01

    Objective A better understanding of risk factors for pneumonia-caused death may help to improve the clinical management of dementia. Methods A retrospective observational study was conducted by reviewing the medical charts and autopsy reports of 204 patients who were admitted to hospital, underwent a post-mortem examination, and who were neuropathologically diagnosed with dementia. The risk factors for pneumonia-caused death were examined both as underlying and immediate causes of death using logistic regression models. Results A high frequency of pneumonia-caused death was observed both in underlying- (37.3%) and immediate- (44.1%) cause of death, but varied according to the subtypes of dementia. The factors related to pneumonia-caused death (underlying) were subtypes of dementia; Alzheimer's disease (odds ratio [OR], 2.891; 95% confidence interval [CI], 1.459-5.730); argyrophilic grain disease (OR, 3.148; 95% CI, 0.937-10.577); and progressive supranuclear palsy (OR, 34.921; 95% CI, 3.826-318.775), dysphagia (OR, 2.045; 95% CI, 1.047-3.994), diabetes mellitus (OR, 3.084; 95% CI, 1.180-8.061) and conversely related with heart failure (OR, 0.149; 95% CI, 0.026-0.861). Factors relating to pneumonia-caused death (immediate) were incidence of pneumonia during hospitalizations (OR, 32.579; 95%CI, 4.308-246.370), gender-male (OR, 2.060; 95% CI, 1.098-3.864), and conversely related with malignant neoplasm (OR, 0.220; 95% CI, 0.058-0.840). Conclusion The different factors relating to the pneumonia-caused death were evaluated depending on whether pneumonia was the underlying- or immediate-cause of death. Strengthening clinical management on dysphagia and diabetes mellitus, and preventing incidence of pneumonia during hospitalization appear to be the important for the terminal stage of hospitalized patients with dementia.

  19. Estimating cause of adult (15+ years) death using InterVA-4 in a rural district of southern Ghana.

    PubMed

    Awini, Elizabeth; Sarpong, Doris; Adjei, Alexander; Manyeh, Alfred Kwesi; Amu, Alberta; Akweongo, Patricia; Adongo, Philip; Kukula, Vida; Odonkor, Gabriel; Narh, Solomon; Gyapong, Margaret

    2014-01-01

    Data needed to estimate causes of death and the pattern of these deaths are scarce in sub-Saharan Africa. Such data are very important for targeting, monitoring, and evaluating health interventions. To estimate the mortality rate and determine causes of death among adults (aged 15 years and older) in a rural district of southern Ghana, using the InterVA-4 model. Data used were generated from verbal autopsies conducted for registered adult members of the Dodowa Health and Demographic Surveillance System who died between 2006 and 2010. The InterVA-4 model was used to assign the cause of death. Overall, the mortality rate for the period under review was 7.5/1,000 person-years (py) for the general population and 10.4/1,000 py for those aged 15 and older. The leading cause of death was communicable diseases (CDs), with a malaria-specific mortality rate of 1.06/1,000 py. Pulmonary tuberculosis (TB)-specific mortality rate was the next highest (1.01/1,000 py). HIV/AIDS attributed deaths were lower among males than females. Non-communicable diseases (NCDs) contributed to 28.3% of the deaths with cause-specific mortality rate of 2.93/1,000 py. Stroke topped the list with cause-specific mortality rate of 0.69/1,000 py. As expected, young males (15-49 years) contributed to more road traffic accident (RTA) deaths; they had a lower RTA cause-specific mortality rate than older males (50-64 years). Data indicate that CDs (e.g. malaria and TB) remain the major cause of death with NCDs (e.g. stroke) following closely behind. Verbal autopsy data can provide the causes of mortality in poorly resourced settings where access to timely and accurate data is scarce.

  20. Causes of death in the Taabo health and demographic surveillance system, Côte d'Ivoire, from 2009 to 2011.

    PubMed

    Koné, Siaka; Fürst, Thomas; Jaeger, Fabienne N; Esso, Emmanuel L J C; Baïkoro, Nahoua; Kouadio, Kouamé A; Adiossan, Lukas G; Zouzou, Fabien; Boti, Louis I; Tanner, Marcel; Utzinger, Jürg; Bonfoh, Bassirou; Dao, Daouda; N'Goran, Eliézer K

    2015-01-01

    Current vital statistics from governmental institutions in Côte d'Ivoire are incomplete. This problem is particularly notable for remote rural areas that have limited access to the health system. To record all deaths from 2009 to 2011 and to identify the leading causes of death in the Taabo health and demographic surveillance system (HDSS) in south-central Côte d'Ivoire. Deaths recorded in the first 3 years of operation of the Taabo HDSS were investigated by verbal autopsy (VA), using the InterVA-4 model. InterVA-4 is based on the World Health Organization 2012 VA tool in terms of input indicators and categories of causes of death. Overall, 948 deaths were recorded, of which 236 (24.9%) had incomplete VA data. Among the 712 deaths analyzed, communicable diseases represented the leading causes (58.9%), with most deaths attributed to malaria (n=129), acute respiratory tract infections (n=110), HIV/AIDS (n=80), and pulmonary tuberculosis (n=46). Non-communicable diseases accounted for 18.9% of the deaths and included mainly acute abdomen (n=38), unspecified cardiac diseases (n=15), and digestive neoplasms (n=13). Maternal and neonatal conditions accounted for 8.3% of deaths, primarily pneumonia (n=19) and birth asphyxia (n=16) in newborns. Among the 3.8% of deaths linked to trauma and injury, the main causes were assault (n=6), accidental drowning (n=4), contact with venomous plants/animals (n=4), and traffic-related accidents (n=4). No clear causes were determined in 10.0% of the analyzed deaths. Communicable diseases remain the predominant cause of death in rural Côte d'Ivoire. Based on these findings, measures are now being implemented in the Taabo HDSS. It will be interesting to monitor patterns of mortality and causes of death in the face of rapid demographic and epidemiological transitions in this part of West Africa.

  1. Causes of Death Following PCI Versus CABG in Complex CAD: 5-Year Follow-Up of SYNTAX.

    PubMed

    Milojevic, Milan; Head, Stuart J; Parasca, Catalina A; Serruys, Patrick W; Mohr, Friedrich W; Morice, Marie-Claude; Mack, Michael J; Ståhle, Elisabeth; Feldman, Ted E; Dawkins, Keith D; Colombo, Antonio; Kappetein, A Pieter; Holmes, David R

    2016-01-05

    There are no data available on specific causes of death from randomized trials that have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI). The purpose of this study was to investigate specific causes of death, and its predictors, after revascularization for complex coronary disease in patients. An independent Clinical Events Committee consisting of expert physicians who were blinded to the study treatment subclassified causes of death as cardiovascular (cardiac and vascular), noncardiovascular, or undetermined according to the trial protocol. Cardiac deaths were classified as sudden cardiac, related to myocardial infarction (MI), and other cardiac deaths. In the randomized cohort, there were 97 deaths after CABG and 123 deaths after PCI during a 5-year follow-up. After CABG, 49.4% of deaths were cardiovascular, with the greatest cause being heart failure, arrhythmia, or other causes (24.6%), whereas after PCI, the majority of deaths were cardiovascular (67.5%) and as a result of MI (29.3%). The cumulative incidence rates of all-cause death were not significantly different between CABG and PCI (11.4% vs. 13.9%, respectively; p = 0.10), whereas there were significant differences in terms of cardiovascular (5.8% vs. 9.6%, respectively; p = 0.008) and cardiac death (5.3% vs. 9.0%, respectively; p = 0.003), which were caused primarily by a reduction in MI-related death with CABG compared with PCI (0.4% vs. 4.1%, respectively; p <0.0001). Treatment with PCI versus CABG was an independent predictor of cardiac death (hazard ratio: 1.55; 95% confidence interval: 1.09 to 2.33; p = 0.045). The difference in MI-related death was seen largely in patients with diabetes, 3-vessel disease, or high SYNTAX (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries) trial scores. During a 5-year follow-up, CABG in comparison with PCI was associated with a significantly reduced rate of MI-related death, which was the leading cause of death after PCI. Treatments following PCI should target reducing post-revascularization spontaneous MI. Furthermore, secondary preventive medication remains essential in reducing events post-revascularization. (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. The role of histology in forensic autopsies: is histological examination always necessary to determine a cause of death?

    PubMed

    Fronczek, Judith; Hollingbury, Frances; Biggs, Michael; Rutty, Guy

    2014-03-01

    In England and Wales there is a conflict between the law and advice from regulatory bodies in relation to the sampling of human tissue for histological examination following medico-legal post-mortem examinations. Considering the results of previous publications, we performed a specific study to investigate the role of histology in determining the cause of death in cases at a forensic unit. A retrospective study of 500 adult forensic cases was performed. Cases were categorized by the role the histological examination played in determining a cause of death and its contributory factors. Furthermore, cause of death, manner of death, organ systems involved, and discrepancies were assessed. Of the 500 cases, histology was undertaken in 287 cases (58 %). Microscopic examination provided the cause of death in 2 % of cases where histology had been undertaken, and it added to the cause of death in 8 %. In 61 % of cases microscopy confirmed the macroscopic findings, and in 30 % it did not influence the medical cause of death. Histological examination of all organs in all forensic cases for the purpose of providing a medical cause of death is not supported. Practice guidance should be adjusted to reflect that, while histological examination is essential in certain circumstances, the decision to retain material for histology should be made on a case by case basis at the pathologist's discretion.

  3. Species-specific differences in peroxisome proliferation, catalase, and SOD2 upregulation as well as toxicity in human, mouse, and rat hepatoma cells induced by the explosive and environmental pollutant 2,4,6-trinitrotoluene.

    PubMed

    Naumenko, Ekaterina Anatolevna; Ahlemeyer, Barbara; Baumgart-Vogt, Eveline

    2017-03-01

    2,4,6-Trinitrotoluene (TNT) has been widely used as an explosive substance and its toxicity is still of interest as it persisted in polluted areas. TNT is metabolized in hepatocytes which are prone to its toxicity. Since analysis of the human liver or hepatocytes is restricted due to ethical reasons, we investigated the effects of TNT on cell viability, reactive oxygen species (ROS) production, peroxisome proliferation, and antioxidative enzymes in human (HepG2), mouse (Hepa 1-6), and rat (H4IIEC3) hepatoma cell lines. Under control conditions, hepatoma cells of all three species were highly comparable exhibiting identical proliferation rates and distribution of their cell cycle phases. However, we found strong differences in TNT toxicity with the lowest IC 50 values (highest cell death rate) for rat cells, whereas human and mouse cells were three to sevenfold less sensitive. Moreover, a strong decrease in cellular dehydrogenase activity (MTT assay) and increased ROS levels were noted. TNT caused peroxisome proliferation with rat hepatoma cells being most responsive followed by those from mouse and human. Under control conditions, rat cells contained fivefold higher peroxisomal catalase and mitochondrial SOD2 activities and a twofold higher capacity to reduce MTT than human and mouse cells. TNT treatment caused an increase in catalase and SOD2 mRNA and protein levels in human and mouse, but not in rat cells. Similarly, human and mouse cells upregulated SOD2 activity, whereas rat cells failed therein. We conclude that TNT induced oxidative stress, peroxisome proliferation and mitochondrial damage which are highest in rat cells rendering them most susceptible toward TNT. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 989-1006, 2017. © 2016 Wiley Periodicals, Inc.

  4. Concussive brain injury from explosive blast

    PubMed Central

    de Lanerolle, Nihal C; Hamid, Hamada; Kulas, Joseph; Pan, Jullie W; Czlapinski, Rebecca; Rinaldi, Anthony; Ling, Geoffrey; Bandak, Faris A; Hetherington, Hoby P

    2014-01-01

    Objective Explosive blast mild traumatic brain injury (mTBI) is associated with a variety of symptoms including memory impairment and posttraumatic stress disorder (PTSD). Explosive shock waves can cause hippocampal injury in a large animal model. We recently reported a method for detecting brain injury in soldiers with explosive blast mTBI using magnetic resonance spectroscopic imaging (MRSI). This method is applied in the study of veterans exposed to blast. Methods The hippocampus of 25 veterans with explosive blast mTBI, 20 controls, and 12 subjects with PTSD but without exposure to explosive blast were studied using MRSI at 7 Tesla. Psychiatric and cognitive assessments were administered to characterize the neuropsychiatric deficits and compare with findings from MRSI. Results Significant reductions in the ratio of N-acetyl aspartate to choline (NAA/Ch) and N-acetyl aspartate to creatine (NAA/Cr) (P < 0.05) were found in the anterior portions of the hippocampus with explosive blast mTBI in comparison to control subjects and were more pronounced in the right hippocampus, which was 15% smaller in volume (P < 0.05). Decreased NAA/Ch and NAA/Cr were not influenced by comorbidities – PTSD, depression, or anxiety. Subjects with PTSD without blast had lesser injury, which tended to be in the posterior hippocampus. Explosive blast mTBI subjects had a reduction in visual memory compared to PTSD without blast. Interpretation The region of the hippocampus injured differentiates explosive blast mTBI from PTSD. MRSI is quite sensitive in detecting and localizing regions of neuronal injury from explosive blast associated with memory impairment. PMID:25493283

  5. On the violence of thermal explosion in solid explosives

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chidester, S.K.; Tarver, C.M.; Green, L.G.

    Heavily confined cylinders of octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) and triaminotrinitrobenzene (TATB) were heated at rates varying from 2 C/min to 3.3 C/h. Fourteen of the cylinders were hollow, and inner metallic liners with small heaters attached were used to produce uniform temperatures just prior to explosion. A complex thermocouple pattern was used to measure the temperature history throughout the charge and to determine the approximate location where the runaway exothermic reaction first occurred. The violence of the resulting explosion was measured using velocity pin arrays placed inside and outside of the metal confinement cylinders, flash x-rays, overpressure gauges, and fragment collection techniques.more » Five cylinders were intentionally detonated for violence comparisons. The measured temperature histories, times to explosion, and the locations of first reaction agreed closely with those calculated by a two-dimensional heat transfer code using multistep chemical decomposition models. The acceleration of the confining metal cylinders by the explosion process was accurately simulated using a two-dimensional pressure dependent deflagration reactive flow hydrodynamic mode. The most violent HMX thermal explosions gradually accelerated their outer cases to velocities approaching those of intentional detonations approximately 120 {micro}m after the onset of explosion. The measured inner cylinder collapse velocities from thermal explosions were considerably lower than those produced by detonations. In contrast to the HMX thermal reactions, no violent thermal explosions were produced by the TATB-based explosive LX-17. A heavily confined, slowly heated LX-17 test produced sufficient pressure to cause a 0.1 cm bend in a 2 cm thick steel plate.« less

  6. Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

    PubMed

    Jacobs-Wingo, Jasmine L; Espey, David K; Groom, Amy V; Phillips, Leslie E; Haverkamp, Donald S; Stanley, Sandte L

    2016-05-01

    To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

  7. Immediate public health concerns and actions in volcanic eruptions: lessons from the Mount St. Helens eruptions, May 18-October 18, 1980.

    PubMed Central

    Bernstein, R S; Baxter, P J; Falk, H; Ing, R; Foster, L; Frost, F

    1986-01-01

    A comprehensive epidemiological evaluation of mortality and short-term morbidity associated with explosive volcanic activity was carried out by the Centers for Disease Control in collaboration with affected state and local health departments, clinicians, and private institutions. Following the May 18, 1980 eruption of Mount St. Helens, a series of public health actions were rapidly instituted to develop accurate information about volcanic hazards and to recommend methods for prevention or control of adverse effects on safety and health. These public health actions included: establishing a system of active surveillance of cause-specific emergency room (ER) visits and hospital admissions in affected and unaffected communities for comparison; assessing the causes of death and factors associated with survival or death among persons located near the crater; analyzing the mineralogy and toxicology of sedimented ash and the airborne concentration of resuspended dusts; investigating reported excesses of ash-related adverse respiratory effects by epidemiological methods such as cross-sectional and case-control studies; and controlling rumors and disseminating accurate, timely information about volcanic hazards and recommended preventive or control measures by means of press briefings and health bulletins. Surveillance and observational studies indicated that: excess in morbidity were limited to transient increases in ER visits and hospital admissions for traumatic injuries and respiratory problems (but not for communicable disease or mental health problems) which were associated in time, place, and person with exposures to volcanic ash; excessive mortality due to suffocation (76 per cent), thermal injuries (12 per cent), or trauma (12 per cent) by ash and other volcanic hazards was directly proportional to the degree of environmental damage--that is, it was more pronounced among those persons (48/65, or about 74 per cent) who, at the time of the eruption, were residing, camping, or sightseeing (despite restrictions) or working (with permission) closer to the crater in areas affected by the explosive blast, pyroclastic and mud flows, and heavy ashfall; and de novo appearance of ash-related asthma was not observed, but transient excesses in adverse respiratory effects occurred in two high-risk groups--hypersusceptibles (with preexisting asthma or chronic bronchitis) and heavily exposed workers. Laboratory and field studies indicated that: volcanic ash had mild to moderate fibrogenic potential, consisting of greater than 90 per cent (by count) respirable size particles which contained 4-7 per cent (by weight) crystalline free silica (SiO2).(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3946727

  8. FastStats: Adolescent Health

    MedlinePlus

    ... 2 [PDF – 2.7 MB] Leading causes of death Leading causes of deaths among adolescents aged 15–19 years: Accidents (unintentional injuries) Suicide Homicide Source: Deaths: Leading Causes for 2015, table 1 [PDF – 2. ...

  9. Causes of 30-day bariatric surgery mortality: with emphasis on bypass obstruction.

    PubMed

    Mason, Edward E; Renquist, Kathleen E; Huang, Yu-Hui; Jamal, Mohammad; Samuel, Isaac

    2007-01-01

    This is a study of the causes of 30-day postoperative death following surgical treatment for obesity and a search for ways to decrease an already low mortality rate. Data were contributed from 1986-2004 to the International Bariatric Surgery Registry by 85 sites, representing 137 surgeons. A spread-sheet was prepared with rows for causes and columns for patients. The 251 causes contributing to 93 deaths were then marked in cells wherever a patient was noted to have one of the causes. Rows and columns were then moved into positions that provided patterns of best fit. 11 patterns were found. 10 had well known initiating causes of death. Overall operative 30-day mortality was 0.24% (93 / 38,501). The most common cause of death was pulmonary embolism (32%, 30/93). 14 deaths were caused by leaks (15%, 14/93), and were equally prevalent after simple (15%, 2/14) or complex (15%, 12/79) operations. Small bowel obstruction caused 8 deaths, exclusively after complex operations. 5 of these involved the bypassed biliopancreatic limb and were defined as "bypass obstruction". A spread-sheet study of cause of 30-day postoperative death revealed a rapidly lethal initiating complication of Roux-en-Y gastric bypass obstruction that requires the earliest possible recognition and treatment. Bypass obstruction needs a name and code to facilitate recognition, study, prevention and early treatment. Spread-sheet pattern analysis of all available data helped identify the initiating cause of death for individual patients when multiple data elements were present.

  10. Epitome of China's unnatural deaths: a historically retrospective study of forensic autopsy cases in Shanghai Public Security Bureau from 1990 to 1999.

    PubMed

    He, Meng; Li, Wen-Can; Sun, Da-Ming; Ma, Kai-Jun; Zhao, Zi-Qin; Li, Bei-Xu; Li, Ling

    2014-09-01

    The unnatural death investigation in China seems vague to the world. Shanghai is one of the largest city located in Yangtze River Delta in the East China. This study is committed to lift the veil of unnatural death investigation and describe the epitome of China's unnatural deaths. Based on the 7302 forensic report archives from 1990 to 1999 in Shanghai Public Security Bureau, statistics were carried out in 5 areas according to the manner of death. In 3502 accidental deaths, there was a rapid increase during the 1990s, and 71.6% were involved in traffic accidents whose major cause of death was head and neck injuries. The first 3 causes of death in nontraffic accidents (994) were head and neck injuries (42.8%), poisoning (11.8%), and drowning (9.0%). In 2456 homicides, sharp force injury (36.7%), blunt force injury (35.8%), and manual strangulation (12.9%) were the first 3 causes of death. In 563 suicides, drug/chemical intoxication (40.1%), hanging (23.4%), and injuries because of fall from height (11.4%) were the 3 leading causes of death, especially pesticides ingestion. The causes of natural deaths were diseases mainly in circulatory system (23.1%), central nervous system (12.8%), and respiratory system (6.4%). However, the cause of death remained undetermined in 500 victims. Childhood fatalities were different. The victims of accidents and homicides were nearly equal, and the main cause of homicide was manual strangulation. Besides, 1997 was the landmark year when drug abuse began to emerge in Shanghai.

  11. One thousand consecutive in-hospital deaths following severe injury: Has the etiology of traumatic inpatient death changed in Canada?

    PubMed Central

    Roberts, Derek J.; Harzan, Christina; Kirkpatrick, Andrew W.; Dixon, Elijah; Grondin, Sean C.; McBeth, Paul B.; Kaplan, Gilaad G.

    2018-01-01

    Summary A wide range of factors have traditionally led to early in-hospital death following severe injury. The primary goal of this commentary was to evaluate the causes of early posttraumatic inpatient deaths over an extended period. Although early posttraumatic in-hospital death remains multifactorial, severe traumatic brain injuries are the dominant cause and have increased in proportion over time. Other traditional causes of death have also decreased owing to improved clinical care. PMID:29806810

  12. Design optimization of Cassegrain telescope for remote explosive trace detection

    NASA Astrophysics Data System (ADS)

    Bhavsar, Kaushalkumar; Eseller, K. E.; Prabhu, Radhakrishna

    2017-10-01

    The past three years have seen a global increase in explosive-based terror attacks. The widespread use of improvised explosives and anti-personnel landmines have caused thousands of civilian casualties across the world. Current scenario of globalized civilization threat from terror drives the need to improve the performance and capabilities of standoff explosive trace detection devices to be able to anticipate the threat from a safe distance to prevent explosions and save human lives. In recent years, laser-induced breakdown spectroscopy (LIBS) is an emerging approach for material or elemental investigations. All the principle elements on the surface are detectable in a single measurement using LIBS and hence, a standoff LIBS based method has been used to remotely detect explosive traces from several to tens of metres distance. The most important component of LIBS based standoff explosive trace detection system is the telescope which enables remote identification of chemical constituents of the explosives. However, in a compact LIBS system where Cassegrain telescope serves the purpose of laser beam delivery and light collection, need a design optimization of the telescope system. This paper reports design optimization of a Cassegrain telescope to detect explosives remotely for LIBS system. A design optimization of Schmidt corrector plate was carried out for Nd:YAG laser. Effect of different design parameters was investigated to eliminate spherical aberration in the system. Effect of different laser wavelengths on the Schmidt corrector design was also investigated for the standoff LIBS system.

  13. Recent trends in mortality in Australia--an analysis of the causes of death through the application of life table techniques.

    PubMed

    Jain, S K

    1992-05-01

    "The paper examines the post-1971 reduction in Australian mortality in light of data on causes of death. Multiple-decrement life tables for eleven leading causes of death by sex are calculated and the incidence of each cause of death is presented in terms of the values of the life table functions. The study found that in the overall decline in mortality over the last 20 years significant changes occurred in the contribution of the various causes to total mortality.... The sex-age-cause-specific incidence of mortality changed and the median age at death increased for all causes except for deaths due to motor-vehicle accidents for both sexes and suicide for males. The paper also deciphers the gains in the expectation of life at birth over various time periods and the sex-differentials in the expectation of life at birth at a point in time in terms of the contributions made by the various sex-age-cause-specific mortality rates." excerpt

  14. Risk factors for kerosene stove explosion burns seen at Kenyatta National Hospital in Kenya.

    PubMed

    Ombati, Alex N; Ndaguatha, Peter L W; Wanjeri, Joseph K

    2013-05-01

    The kerosene stove is a common cooking appliance in lower and middle income households in Kenya and if it explodes, life threatening thermal burn injuries may be sustained by those using the appliance. Women tend to be victims more frequently since traditionally they are the ones who are involved in cooking. The aim of this study was to determine risk factors predisposing to kerosene stove explosion burns seen at Kenyatta National Hospital. The study was a prospective longitudinal descriptive study carried out at the Kenyatta National Hospital. Forty-eight patients who met the inclusion criteria were recruited into the study over a period of 6 months from November 2010 to April 2011 and the data was collected using a structured questionnaire. The analysis, using SPSS version 17.0 was done by associating occurrence of injury to: age, sex, socioeconomic status and level of education of patient. Charts and tables were used to present the results. The mean age of patients who sustained kerosene stove explosion burns was 23.6 years (SD ± 11.7) with the commonest age group being 20-39 years. More females were affected than males by a ratio of 7:3 and ninety two percent of those who sustained these burns were either from poor or lower middle socio-economic class. Stove explosions occurred mainly during cooking and when kerosene refill was being done. Most of the patients (63%) reported having bought kerosene from fuel vendors and almost all explosions were caused by the wick type of stove (98%). Young females from poor socioeconomic background were found to be at a higher risk for kerosene stove explosion burns. The wick stove is a common cause of burns especially when users unwittingly refill it with kerosene when already lit resulting in an explosion. Prevention can be done through evidence based public health education targeting the groups at risk and enactment of relevant laws. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  15. Causes of electrical deaths and injuries among construction workers.

    PubMed

    McCann, Michael; Hunting, Katherine L; Murawski, Judith; Chowdhury, Risana; Welch, Laura

    2003-04-01

    Contact with electrical current is the fourth leading cause of deaths of construction workers. This study evaluates electrical deaths and injuries to construction workers. Two sources of data were analyzed in detail: (1) 1,019 electrical deaths identified by the Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) for the years 1992-1998; and (2) 61 electrical injuries identified between November 1, 1990 and December 31, 1998 from a George Washington University Emergency Department injury surveillance database. Contact with "live" electrical wiring, equipment, and light fixtures was the main cause of electrical deaths and injuries among electrical workers, followed by contact with overhead power lines. Among non-electrical workers, contact with overhead power lines was the major cause of death. Other causes included contact with energized metal objects, machinery, power tools, and portable lights. Arc flash or blast caused 31% of electrical injuries among construction workers, but less than 2% of electrical deaths. Adoption of a lockout/tagout standard for construction, and training for non-electrical workers in basic electrical safety would reduce the risk of electrical deaths and injuries in construction. Further research is needed on ways to prevent electrical deaths and injuries while working "live". Copyright 2003 Wiley-Liss, Inc.

  16. Causes of Death among Children Aged 5 to 14 Years Old from 2008 to 2013 in Kersa Health and Demographic Surveillance System (Kersa HDSS), Ethiopia.

    PubMed

    Dedefo, Melkamu; Zelalem, Desalew; Eskinder, Biniyam; Assefa, Nega; Ashenafi, Wondimye; Baraki, Negga; Damena Tesfatsion, Melake; Oljira, Lemessa; Haile, Ashenafi

    2016-01-01

    The global burden of mortality among children is still very huge though its trend has started declining following the improvements in the living standard. It presents serious challenges to the well-being of children in many African countries. Today, Sub-Saharan Africa alone accounts for about 50% of global child mortality. The overall objective of this study was to determine the magnitude and distribution of causes of death among children aged 5 to 14 year olds in the population of Kersa HDSS using verbal autopsy method for the period 2008 to 2013. Kersa Health and Demographic Surveillance System(Kersa HDSS) was established in September 2007. The center consists of 10 rural and 2 urban kebeles which were selected randomly from 38 kebeles in the district. Thus this study was conducted in Kersa HDSS and data was taken from Kersa HDSS database. The study population included all children aged 5 to 14 years registered during the period of 2008 to 2013 in Kersa HDSS using age specific VA questionnaires. Data were extracted from SPSS database and analyzed using STATA. A total of 229 deaths were recorded over the period of six years with a crude death rate of 219.6 per 100,000 population of this age group over the study period. This death rate was 217.5 and 221.5 per 100,000 populations for females and males, respectively. 75% of deaths took place at home. The study identified severe malnutrition(33.9%), intestinal infectious diseases(13.8%) and acute lower respiratory infections(9.2%) to be the three most leading causes of death. In broad causes of death classification, injuries have been found to be the second most cause of death next to communicable diseases(56.3%) attributing to 13.1% of the total deaths. In specific causes of death classification severe malnutrition, intestinal infectious diseases and acute lower respiratory infections were the three leading causes of death where, in broad causes of death communicable diseases and injuries were among the leading causes of death. Hence, concerned bodies should take measures to avert the situation of mortality from these causes of death and further inferential analysis into the prevention and management of infectious diseases should also be taken.

  17. Lung Cancer Awareness Week

    ERIC Educational Resources Information Center

    Glennon, Catherine; Laczko, Lori

    2003-01-01

    Smoking is the most preventable cause of death in our society. Tobacco use is responsible for nearly one in five deaths in the United States and the cause of premature death of approximately 2 million individuals in developed countries. Smoking accounts for at least 30% of all cancer deaths and is a major cause of heart disease, cerebrovascular…

  18. Motor Vehicle Traffic Crashes as a Leading Cause of Death in the U. S., 1994

    DOT National Transportation Integrated Search

    1998-03-01

    Motor vehicle traffic crashes ranked 9th behind heart disease, cancer, and : stroke as a leading cause of death in the United States in 1994, accounting for : 41,507 lives or 1.8% of all deaths in 1994. Data on the leading causes of death : from the ...

  19. 26 CFR 1.4-4 - Short taxable year caused by death.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 1 2010-04-01 2010-04-01 true Short taxable year caused by death. 1.4-4 Section... Normal Taxes and Surtaxes § 1.4-4 Short taxable year caused by death. An individual making a return for a... results from the death of the taxpayer. Tax on Corporations ...

  20. 26 CFR 1.4-4 - Short taxable year caused by death.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Short taxable year caused by death. 1.4-4... TAXES Normal Taxes and Surtaxes § 1.4-4 Short taxable year caused by death. An individual making a... taxable year results from the death of the taxpayer. Tax on Corporations ...

  1. 26 CFR 1.4-4 - Short taxable year caused by death.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Short taxable year caused by death. 1.4-4... TAXES Normal Taxes and Surtaxes § 1.4-4 Short taxable year caused by death. An individual making a... taxable year results from the death of the taxpayer. Tax on Corporations ...

  2. 26 CFR 1.4-4 - Short taxable year caused by death.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Short taxable year caused by death. 1.4-4 Section... Normal Taxes and Surtaxes § 1.4-4 Short taxable year caused by death. An individual making a return for a... results from the death of the taxpayer. Tax on Corporations ...

  3. Reliable mortality statistics for Turkey: Are we there yet?

    PubMed

    Özdemir, Raziye; Rao, Chalapati; Öcek, Zeliha; Dinç Horasan, Gönül

    2015-06-10

    The Turkish government has implemented several reforms to improve the Turkish Statistical Institute Death Reporting System (TURKSTAT-DRS) since 2009. However, there has been no assessment to evaluate the impact of these reforms on causes of death statistics. This study attempted to analyse the impact of these reforms on the TURKSTAT-DRS for Turkey, and in the case of Izmir, one of the most developed provinces in Turkey. The evaluation framework comprised three main components each with specific criteria. Firstly, data from TURKSTAT for Turkey and Izmir for the periods 2001-2008 and 2009-2013 were assessed in terms of the following dimensions that represent quality of mortality statistics (a. completeness of death registration, b. trends in proportions of deaths with ill-defined causes). Secondly, the quality of information recorded on individual death certificates from Izmir in 2010 was analysed for a. missing information, b. timeliness of death notifications and c. characteristics of deaths with ill-defined causes. Finally, TURKSTAT data were analysed to estimate life tables and summary mortality indicators for Turkey and Izmir, as well as the leading causes-of-death in Turkey in 2013. Registration of adult deaths in Izmir as well as at the national level for Turkey has considerably improved since the introduction of reforms in 2009, along with marked decline in the proportions of deaths assigned ill-defined causes. Death certificates from Izmir indicated significant gaps in recorded information for demographic as well as epidemiological variables, particularly for infant deaths, and in the detailed recording of causes of death. Life expectancy at birth estimated from local data is 3-4 years higher than similar estimates for Turkey from international studies, and this requires further investigation and confirmation. The TURKSTAT-DRS is now an improved source of mortality and cause of death statistics for Turkey. The reliability and validity of TURKSTAT data needs to be established through a detailed research program to evaluate completeness of death registration and validity of registered causes of death. Similar evaluation and data analysis of mortality indicators is required at regular intervals at national and sub-national level, to increase confidence in their utility as primary data for epidemiology and health policy.

  4. [Quality of information analysis on basic causes of neonatal deaths recorded in the Mortality Information System: a study in Maceió, Alagoas State, Brazil, 2001-2002].

    PubMed

    Pedrosa, Linda Délia C O; Sarinho, Silvia W; Ordonha, Manoelina R

    2007-10-01

    Analysis of the quality of information on basic causes of neonatal deaths in Brazil is crucially important, since it allows one to estimate how many deaths are avoidable and provide support for policies to decrease neonatal mortality. The current study aimed to evaluate the reliability and validity of the Mortality Information System (MIS) for discriminating between basic causes of neonatal deaths and defining percentages of reducible causes. The basic causes of early neonatal deaths in hospitals in Maceió, Alagoas State, were analyzed, and the causes recorded in medical records were compared to the MIS data in order to measure reliability and validity. The modified SEADE Foundation and Wigglesworth classifications were compared to analyze the capacity for reduction of neonatal mortality. Maternal causes predominated in the medical records, as compared to respiratory disorders on the death certificates and in the MIS. The percentage of avoidable deaths may be much higher than observed from the MIS, due to imprecision in completing death certificates. Based on the MIS, the greatest problems are in early diagnosis and treatment of neonatal causes. However, the results show that the most pressing problems relate to failures in prenatal care and lack of control of diseases.

  5. Most common causes of natural and injury-related deaths in Addis Ababa, Ethiopia.

    PubMed

    Gemechu, Tufa; Tinsae, Mihrete; Ashenafi, Senait; Rodriguez, Victor Manuel; Lori, Alfredo; Collins, Michelle; Hurford, Rosemary; Haimanot, Rahel; Sandoval, Melissa; Mehari, Enawgaw; Langford, T Dianne

    2009-01-01

    In Ethiopia, like many developing countries, autopsy is rare unless conducted in the medico-legal arena, making vital statistics that include pathological diagnoses sparse. To determine the most common factors contributing to death among individuals who died from natural or injury-related events in Ethiopia 200 consecutive autopsies were conducted in 2006 at the Forensic Medico-legal Pathology Department, Menelik II Hospital, Addis Ababa, Ethiopia. The results describe significant pathological observations, putative cause of death, age distribution, and gender ratios. Eighty-one percent of the cases were male, and the mean age was 38.9 (+/-15.5 years). Fifty-two percent of the individuals died from natural causes, including infections, and 48% died from injury-related events. In the natural deaths group, as determined by gross examination at autopsy pulmonary complications were the most commonly reported cause of death, with suspected tuberculosis accounting for 12%. Tuberculosis (21, 8%) and liver disease (14, 5%) were the most common histopathological findings in the natural and injury-related causes groups, respectively. In the injury-related group, automobile accident was the most common cause of accidental death (80%), and homicide by beating was the most common cause of death in the intentional injury group (31%). These data provide valuable unbiased analyses of causes of death among individuals in Addis Ababa, Ethiopia.

  6. Vital statistics and early death predictors of North American professional basketball players: A historical examination.

    PubMed

    Lemez, Srdjan; Wattie, Nick; Lawler, Tyler; Baker, Joseph

    2018-07-01

    While empirical evidence suggests that elite athletes have superior lifespan outcomes relative to the general population, less is known regarding their causes of death. The purpose of this study was to critically examine the mortality outcomes of deceased National Basketball Association and American Basketball Association players. Death data were collected from publicly available sources until 11 December 2015, and causes of death were categorized using the International Classification of Diseases, Tenth Revision (ICD). Mortality was measured through: i) cause-specific crude death rates (CDR), ii) estimates of death rates per athlete-year (AY), and iii) binary and multinomial regression analyses. We identified 514 causes of death from 787 deceased players (M = 68.1 y ± 16.0) from 16 different ICD groups, 432 of which were from natural causes. Findings showed similar leading causes of death and CDRs to sex- and race-matched controls, higher death rate differences per AY within time-dependent variables (i.e., birth decade, race, and height), and a higher likelihood of dying below the median age of death for black and taller players, although this was highly confounded by birth decade. More complete knowledge of mortality outcomes would provide broad public health applications and disarm harmful stereotypes of elite athlete health.

  7. Causes of death after traumatic spinal cord injury-a 70-year British study.

    PubMed

    Savic, G; DeVivo, M J; Frankel, H L; Jamous, M A; Soni, B M; Charlifue, S

    2017-10-01

    Retrospective and prospective observational. Analyse causes of death after traumatic spinal cord injury (tSCI) in persons surviving the first year post injury, and establish any trend over time. Two spinal centres in Great Britain. The sample consisted of 5483 patients with tSCI admitted to Stoke Mandeville and Southport spinal centres who were injured between 1943 and 2010, survived first year post injury, had residual neurological deficit on discharge and were British residents. Mortality information, including causes of death, was collected up to 31 December 2014. Age-standardised cause-specific mortality rates were calculated for selected causes of death, and included trends over time and comparison with the general population. In total, 2322 persons (42.3% of the sample) died, with 2170 (93.5%) having a reliable cause of death established. The most frequent causes of death were respiratory (29.3% of all certified causes), circulatory, including cardiovascular and cerebrovascular diseases (26.7%), neoplasms (13.9%), urogenital (11.5%), digestive (5.3%) and external causes, including suicides (4.5%). Compared to the general population, age-standardised cause-specific mortality rates were higher for all causes, especially skin, urogenital and respiratory; rates showed improvement over time for suicides, circulatory and urogenital causes, no significant change for neoplasms, and increase for skin and respiratory causes. Leading causes of death after tSCI in persons surviving the first year post injury were respiratory, circulatory, neoplasms and urogenital. Cause-specific mortality rates showed improvement over time for most causes, but were still higher than the general population rates, especially for skin, urinary and respiratory causes.

  8. Applying verbal autopsy to determine cause of death in rural Vietnam.

    PubMed

    Huong, Dao Lan; Minh, Hoang Van; Byass, Peter

    2003-01-01

    Verbal autopsy (VA) is an attractive method for ascertaining causes of death in settings where the proportion of people who die under medical care is low. VA has been widely used to determine causes of childhood and maternal deaths, but has had limited use in assessing causes in adults and across all age groups. The objective was to test the feasibility of using VA to determine causes of death for all ages in Bavi District, Vietnam, in 1999, leading to an initial analysis of the mortality pattern in this area. Trained lay field workers interviewed a close caretaker of the deceased using a combination closed/open-ended questionnaire. A total of 189 deaths were studied. Diagnoses were made by two physicians separately, with good agreement (kappa = 0.84) and then combined to reach one single underlying cause of death for each case. The leading causes of death were cardiovascular and infectious diseases (accounting for 20.6% and 17.9% of the total respectively). Drowning was very prevalent in children under 15 (seven out of nine cases of drowning were in this age group). One month seemed an acceptable minimum recall period to ensure mourning procedures were over. A combination VA questionnaire was an appropriate instrument provided it was supported by adequate training of interviewers. Two physicians were appropriate for making the diagnoses but predefined diagnostic methods for common causes should be developed to ensure more replicable results and comparisons, as well as to observe trends of mortality over time. The causes of death in this study area reflect a typical pattern for developing countries that are in epidemiological transition. No maternal deaths and a low infant mortality rate may be the result of improvements in maternal and child health in this study area. Using the VA gave more precise causes of death than those reported at death registration. Although the validity of the VA method used has not been fully assessed, it appeared to be an appropriate method for ascertaining causes of death in the study area.

  9. Secular Trends in Infection-Related Mortality after Kidney Transplantation.

    PubMed

    Kinnunen, Susanna; Karhapää, Pauli; Juutilainen, Auni; Finne, Patrik; Helanterä, Ilkka

    2018-05-07

    Infections are the most common noncardiovascular causes of death after kidney transplantation. We analyzed the current infection-related mortality among kidney transplant recipients in a nationwide cohort in Finland. Altogether, 3249 adult recipients of a first kidney transplant from 1990 to 2012 were included. Infectious causes of death were analyzed, and the mortality rates for infections were compared between two eras (1990-1999 and 2000-2012). Risk factors for infectious deaths were analyzed with Cox regression and competing risk analyses. Altogether, 953 patients (29%) died during the follow-up, with 204 infection-related deaths. Mortality rate (per 1000 patient-years) due to infections was lower in the more recent cohort (4.6; 95% confidence interval, 3.5 to 6.1) compared with the older cohort (9.1; 95% confidence interval, 7.6 to 10.7); the incidence rate ratio of infectious mortality was 0.51 (95% confidence interval, 0.30 to 0.68). The main causes of infectious deaths were common bacterial infections: septicemia in 38% and pulmonary infections in 45%. Viral and fungal infections caused only 2% and 3% of infectious deaths, respectively (such as individual patients with Cytomegalovirus pneumonia, Herpes simplex virus meningoencephalitis, Varicella zoster virus encephalitis, and Pneumocystis jirovecii infection). Similarly, opportunistic bacterial infections rarely caused death; only one death was caused by Listeria monocytogenes , and two were caused by Mycobacterium tuberculosis . Only 23 (11%) of infection-related deaths occurred during the first post-transplant year. Older recipient age, higher plasma creatinine concentration at the end of the first post-transplant year, diabetes as a cause of ESKD, longer pretransplant dialysis duration, acute rejection, low albumin level, and earlier era of transplantation were associated with increased risk of infectious death in multivariable analysis. The risk of death due to infectious causes after kidney transplantation in Finland dropped by one half since the 1990s. Common bacterial infections remained the most frequent cause of infection-related mortality, whereas opportunistic viral, fungal, or unconventional bacterial infections rarely caused deaths after kidney transplantation. Copyright © 2018 by the American Society of Nephrology.

  10. Isolation and structural characterization of sugarcane bagasse lignin after dilute phosphoric acid plus steam explosion pretreatment and its effect on cellulose hydrolysis

    Treesearch

    Jijiao Zeng; Zhaohui Tong; Letian Wang; J.Y. Zhu; Lonnie Ingram

    2014-01-01

    The structure of lignin after dilute phosphoric acid plus steam explosion pretreatment process of sugarcane bagasse in a pilot scale and the effect of the lignin extracted by ethanol on subsequent cellulose hydrolysis were investigated. The lignin structural changes caused by pretreatment were identified using advanced nondestructive techniques such as gel permeation...

  11. Use and Complications of Operative Control of Arterial Inflow in Combat Casualties with Traumatic Lower-extremity Amputations Caused by Improvised Explosive Devices

    DTIC Science & Technology

    2013-08-01

    explosive devices Henrietta Poon, MRCS, Jonathan J. Morrison, MRCS, Jon C. Clasper, DPhil, FRCSEd(Orth), Mark J. Midwinter, MD, FRCS, and Jan O. Jansen...the IP group, compared with the EP, although this does not achieve statistical significance, likely owing to a lack of power within the study. The war

  12. Leading Causes of Death in Females United States

    MedlinePlus

    ... Issues at Work Health Equity Leading Causes of Death in Females, United States Recommend on Facebook Tweet ... and previous listings for the leading causes of death in females in the United States. Please note ...

  13. Blast waves from detonated military explosive reduce GluR1 and synaptophysin levels in hippocampal slice cultures✩

    PubMed Central

    Smith, Marquitta; Piehler, Thuvan; Benjamin, Richard; Farizatto, Karen L.; Pait, Morgan C.; Almeida, Michael F.; Ghukasyan, Vladimir V.; Bahr, Ben A.

    2017-01-01

    Explosives create shockwaves that cause blast-induced neurotrauma, one of the most common types of traumatic brain injury (TBI) linked to military service. Blast-induced TBIs are often associated with reduced cognitive and behavioral functions due to a variety of factors. To study the direct effects of military explosive blasts on brain tissue, we removed systemic factors by utilizing rat hippocampal slice cultures. The long-term slice cultures were briefly sealed air-tight in serum-free medium, lowered into a 37 °C water-filled tank, and small 1.7-gram assemblies of cyclotrimethylene trinitramine (RDX) were detonated 15 cm outside the tank, creating a distinct shockwave recorded at the culture plate position. Compared to control mock-treated groups of slices that received equal submerge time, 1–3 blast impacts caused a dose-dependent reduction in the AMPA receptor subunit GluR1. While only a small reduction was found in hippocampal slices exposed to a single RDX blast and harvested 1–2 days later, slices that received two consecutive RDX blasts 4 min apart exhibited a 26–40% reduction in GluR1, and the receptor subunit was further reduced by 64–72% after three consecutive blasts. Such loss correlated with increased levels of HDAC2, a histone deacetylase implicated in stress-induced reduction of glutamatergic transmission. No evidence of synaptic marker recovery was found at 72 h post-blast. The presynaptic marker synaptophysin was found to have similar susceptibility as GluR1 to the multiple explosive detonations. In contrast to the synaptic protein reductions, actin levels were unchanged, spectrin breakdown was not detected, and Fluoro-Jade B staining found no indication of degenerating neurons in slices exposed to three RDX blasts, suggesting that small, sub-lethal explosives are capable of producing selective alterations to synaptic integrity. Together, these results indicate that blast waves from military explosive cause signs of synaptic compromise without producing severe neurodegeneration, perhaps explaining the cognitive and behavioral changes in those blast-induced TBI sufferers that have no detectable neuropathology. PMID:27720798

  14. Comparison of crude and adjusted mortality rates from leading causes of death in northeastern Brazil.

    PubMed

    França, Elisabeth; Rao, Chalapati; Abreu, Daisy Maria Xavier de; Souza, Maria de Fátima Marinho de; Lopez, Alan D

    2012-04-01

    To present how the adjustment of incompleteness and misclassification of causes of death in the vital registration (VR) system can contribute to more accurate estimates of the risk of mortality from leading causes of death in northeastern Brazil. After estimating the total numbers of deaths by age and sex in Brazil's Northeast region in 2002-2004 by correcting for undercount in the VR data, adjustment algorithms were applied to the reported cause-of-death structure. Average annual age-standardized mortality rates were computed by cause, with and without the corrections, and compared to death rates for Brazil's South region after adjustments for potential misdiagnosis. Death rates from ischemic heart disease, lower respiratory infections, chronic obstructive pulmonary disease, and perinatal conditions were more than 100% higher for both sexes than what was suggested by the routine VR data. Corrected cause-specific mortality rates were higher in the Northeast region versus the South region for the majority of causes of death, including several noncommunicable conditions. Failure to adjust VR data for undercount of cases reported and misdiagnoses will cause underestimation of mortality risks for the populations of the Northeast region, which are more vulnerable than those in other regions of the country. In order to more reliably understand the pattern of disease, all cause-specific mortality rates in poor populations should be adjusted.

  15. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    PubMed

    2015-01-10

    Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100,000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade. Bill & Melinda Gates Foundation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Sudden and unexpected childhood deaths investigated at the Pretoria Medico-Legal Laboratory, South Africa, 2007 - 2011.

    PubMed

    Van Deventer, B S; Rossouw, S H; Du Toit-Prinsloo, L

    2016-09-06

     Sudden and unexpected death is well known to occur in infants, and although sudden deaths are less frequent after the first birthday, they still account for a significant proportion of childhood deaths. In 2009, 1.9% of the total deaths in the USA were childhood deaths. In South Africa (SA) this proportion was much higher at 11.85%. According to the law, sudden and unexpected deaths are generally investigated as unnatural deaths. Establishing an exact underlying anatomical cause of death will depend on available resources and can be difficult in a substantial proportion of cases.  A retrospective descriptive case audit was conducted at the Pretoria Medico-Legal Laboratory (PMLL), SA, from 1 January 2007 through to 31 December 2011. All children aged 1 - 18 years who died suddenly and unexpectedly were included.  Ninety-eight cases were identified, which constituted nearly 1% of total admissions to the PMLL. The majority of the deaths were of children aged 1 - 5 years, and the male/female ratio was 1.04:1. In the largest proportion of cases (n=28, 28.6%), the medicolegal investigation, including autopsy and ancillary investigations, did not establish an underlying anatomical cause of death. In the cases where a cause of death was established, pneumonia was the most common diagnosis (n=22, 22.4%).  The fact that the cause of the largest proportion of deaths could not be ascertained emphasises the need for consideration of additional investigative techniques, such as molecular/genetic screening, which have provided an underlying cause of death in a significant number of cases in other countries. There is a lack of published research on the causes and incidence of sudden unexpected deaths in children in SA, and further research in this area is needed.

  17. Magnitude of discordance between registry data and death certificate when evaluating leading causes of death in dialysis patients.

    PubMed

    Lafrance, Jean-Philippe; Rahme, Elham; Iqbal, Sameena; Leblanc, Martine; Pichette, Vincent; Elftouh, Naoual; Vallée, Michel

    2013-03-27

    Discordance between dialysis registry and death certificate reported death has been demonstrated. Since cause of death is measured using registry data in dialysis patients and death certificate data in the general population, comparisons of cause of death proportions between dialysis patients and the general population may be biased. Our aim was to compare the proportion of deaths attributed to cardiovascular disease (CVD), malignancy, and infections between patients receiving dialysis and the general population using death certificates for both, and to quantify the magnitude of discrepancy between registry and death certificate estimates in dialysis patients. A retrospective cohort study of 5858 patients initiating maintenance dialysis between 2001 and 2007 was conducted. Cause of death was obtained from both registry and death certificate data for dialysis patients, and from death certificate data for the general population. Compared to the general population, use of death certificate data in dialysis patients resulted in smaller differences in the proportion of deaths attributed to CVD or infection than that from the registry. In the general population, the proportion of deaths due to CVD is 29.3% for men and 28.2% for women, and the proportion of deaths due to infection is 3.3% for men and 3.6% for women. For men, the proportion of deaths in dialysis patients due to CVD using registry data is 41.5%, compared with a proportion of 32.1% using death certificate data. Similarly for women, the proportion of deaths due to CVD using registry data is 35.2% and that using death certificate data 24.3%. The proportion of deaths due to infection in dialysis patients follows the same pattern: for men, the proportion of deaths due to infection using registry data is 9.9% and that from death certificate data at 5.0%; while for women the proportions are 11.6% and 4.8%, respectively. While absolute cause-specific mortality rates did differ, evaluation of causes of death using death certificate in dialysis patients in Quebec revealed that they do not have substantially different proportion of death due to CVD or infections than the general population. Infections appeared to be a frequent complication leading to death, suggesting that infections are an important target to consider for reducing mortality in dialysis populations.

  18. Brief Report: Association Between Pregnancy Outcomes and Death From Cardiovascular Causes in Parous Women With Systemic Lupus Erythematosus: A Study Using Swedish Population Registries.

    PubMed

    Soh, May Ching; Nelson-Piercy, Catherine; Dib, Fadia; Westgren, Magnus; McCowan, Lesley; Pasupathy, Dharmintra

    2015-09-01

    To determine if maternal placental syndromes (MPS) are associated with an increased risk of death from cardiovascular causes in women with systemic lupus erythematosus (SLE). Between 1973 and 2011, women with SLE and a history of pregnancy were identified using linked Swedish population registries. The outcome was death from primarily cardiovascular causes, defined as death from acute coronary syndrome or coronary artery disease, stroke, or peripheral vascular disease. The exposure was MPS, defined as any hypertensive disorders in pregnancy, stillbirth, placental abruption, or delivery of a small-for-gestational-age infant. The association of preterm delivery (delivery at <34 weeks of gestation) with death from cardiovascular causes was also explored. Risk of death from cardiovascular causes was determined using logistic regression, adjusting for the year of first delivery, duration of SLE, number of inpatient admissions, and cardiovascular risk factors. A total of 3,977 women with SLE had 7,410 pregnancies during the study interval. Death from primarily cardiovascular causes occurred in 44 of the 325 women who died (13.5%). The median age at death from cardiovascular causes was 54 years (interquartile range 48-58 years), and these women were more likely to have had hypertension and renal disease. MPS was associated with an increased risk of death from primarily cardiovascular causes (adjusted odds ratio [OR] 2.19 [95% confidence interval (95% CI) 1.14-4.22]), specifically, a history of placental abruption (adjusted OR 5.78 [95% CI 1.61-20.72]). Delivery at <34 weeks of gestation, particularly when combined with MPS, was also associated with an increased risk of death from primarily cardiovascular causes (adjusted OR 2.49 [95% CI 1.06-5.85]). MPS in pregnancy is associated with a higher risk of death from primarily cardiovascular causes in women with SLE. © 2015, American College of Rheumatology.

  19. Causes of death in Vanuatu.

    PubMed

    Carter, Karen; Tovu, Viran; Langati, Jeffrey Tila; Buttsworth, Michael; Dingley, Lester; Calo, Andy; Harrison, Griffith; Rao, Chalapati; Lopez, Alan D; Taylor, Richard

    2016-01-01

    The population of the Pacific Melanesian country of Vanuatu was 234,000 at the 2009 census. Apart from subsistence activities, economic activity includes tourism and agriculture. Current completeness of vital registration is considered too low to be usable for national statistics; mortality and life expectancy (LE) are derived from indirect demographic estimates from censuses/surveys. Some cause of death (CoD) data are available to provide information on major causes of premature death. Deaths 2001-2007 were coded for cause (ICDv10) for ages 0-59 years from: hospital separations (HS) (n = 636), hospital medical certificates (MC) of death (n = 1,169), and monthly reports from community health facilities (CHF) (n = 1,212). Ill-defined causes were 3 % for hospital deaths and 20 % from CHF. Proportional mortality was calculated by cause (excluding ill-defined) and age group (0-4, 5-14 years), and also by sex for 15-59 years. From total deaths by broad age group and sex from 1999 and 2009 census analyses, community deaths were estimated by deduction of hospital deaths MC. National proportional mortality by cause was estimated by a weighted average of MC and CHF deaths. National estimates indicate main causes of deaths <5 years were: perinatal disorders (45 %) and malaria, diarrhea, and pneumonia (27 %). For 15-59 years, main causes of male deaths were: circulatory disease 27 %, neoplasms 13 %, injury 13 %, liver disease 10 %, infection 10 %, diabetes 7 %, and chronic respiratory disease 7 %; and for females: neoplasms 29 %, circulatory disease 15 %, diabetes 10 %, infection 9 %, and maternal deaths 8 %. Infection included tuberculosis, malaria, and viral hepatitis. Liver disease (including hepatitis and cancer) accounted for 18 % of deaths in adult males and 9 % in females. Non-communicable disease (NCD), including circulatory disease, diabetes, neoplasm, and chronic respiratory disease, accounted for 52 % of premature deaths in adult males and 60 % in females. Injuries accounted for 13 % in adult males and 6 % in females. Maternal deaths translate into an annual maternal mortality ratio of 130/100,000 for the period. Vanuatu manifests a double burden of disease with significant proportional mortality from perinatal disorders and infection/pneumonia <5 years and maternal mortality, coupled with significant proportional mortality in adults (15-59 years) from cardiovascular disease (CVD), neoplasms, and diabetes.

  20. Two Sources of Nonisotropic Radiation From Underground Explosions in Granite

    DOE PAGES

    Vorobiev, O. Yu.

    2017-10-23

    Significant tangential ground motion observed during underground explosions makes it difficult to distinguish them from natural earthquakes. Such motion can be generated by the source geometry and emplacement conditions, by the heterogeneous nature of the rock mass (mechanical properties may vary in space due to the presence of cracks, joints, faults, and various geologic layers) and also by the nonuniform in situ stress state. The last mechanism is increasingly important with depth when the difference in main principal stresses becomes significant. This paper is focused on the role of material strength of the rock mass in generation of nonradial motionmore » during explosions in prestressed media. Numerical modeling of underground chemical explosions in granite at various depths has been conducted to compare two possible mechanisms of shear wave generation. The first, caused by rock mass anisotropy, is important at shallow depth. The second is related to elastic-plastic relaxation around the cavity created by the explosion. As a result, tangential motions for these two mechanisms have different signatures.« less

  1. Two Sources of Nonisotropic Radiation From Underground Explosions in Granite

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vorobiev, O. Yu.

    Significant tangential ground motion observed during underground explosions makes it difficult to distinguish them from natural earthquakes. Such motion can be generated by the source geometry and emplacement conditions, by the heterogeneous nature of the rock mass (mechanical properties may vary in space due to the presence of cracks, joints, faults, and various geologic layers) and also by the nonuniform in situ stress state. The last mechanism is increasingly important with depth when the difference in main principal stresses becomes significant. This paper is focused on the role of material strength of the rock mass in generation of nonradial motionmore » during explosions in prestressed media. Numerical modeling of underground chemical explosions in granite at various depths has been conducted to compare two possible mechanisms of shear wave generation. The first, caused by rock mass anisotropy, is important at shallow depth. The second is related to elastic-plastic relaxation around the cavity created by the explosion. As a result, tangential motions for these two mechanisms have different signatures.« less

  2. Leading medical causes of mortality among male prisoners in Texas, 1992--2003.

    PubMed

    Harzke, Amy J; Baillargeon, Jacques G; Kelley, Michael F; Pruitt, Sandi L; Pulvino, John S; Paar, David P

    2011-07-01

    Data from the Texas prison system and the Texas Vital Statistics Bureau were used to identify and assess the leading medical causes of death from 1992 to 2003 among male prisoners in Texas (N = 4,026). The leading medical causes of death were infection, cancer, cardiovascular disease (CVD), liver disease, and respiratory disease. Of these, only cancer showed a significant average annual increase in crude death rates (2.5% [0.2% to 4.9%]). Among prisoners aged 55 to 84 years, crude average annual death rates due to cancer and CVD were high and substantially exceeded death rates due to other causes. Among prisoners aged 25 to 44 years, crude average annual death rates due to infection exceeded death rates due to other causes. Continued improvements in the prevention, screening, and treatment of these conditions are warranted in correctional health care settings.

  3. The Explosion Mechanism of Core-Collapse Supernovae: Progress in Supernova Theory and Experiments

    DOE PAGES

    Foglizzo, Thierry; Kazeroni, Rémi; Guilet, Jérôme; ...

    2015-01-01

    The explosion of core-collapse supernova depends on a sequence of events taking place in less than a second in a region of a few hundred kilometers at the center of a supergiant star, after the stellar core approaches the Chandrasekhar mass and collapses into a proto-neutron star, and before a shock wave is launched across the stellar envelope. Theoretical efforts to understand stellar death focus on the mechanism which transforms the collapse into an explosion. Progress in understanding this mechanism is reviewed with particular attention to its asymmetric character. We highlight a series of successful studies connecting observations of supernovamore » remnants and pulsars properties to the theory of core-collapse using numerical simulations. The encouraging results from first principles models in axisymmetric simulations is tempered by new puzzles in 3D. The diversity of explosion paths and the dependence on the pre-collapse stellar structure is stressed, as well as the need to gain a better understanding of hydrodynamical and MHD instabilities such as SASI and neutrino-driven convection. The shallow water analogy of shock dynamics is presented as a comparative system where buoyancy effects are absent. This dynamical system can be studied numerically and also experimentally with a water fountain. Lastly, we analyse the potential of this complementary research tool for supernova theory. We also review its potential for public outreach in science museums.« less

  4. The Explosion Mechanism of Core-Collapse Supernovae: Progress in Supernova Theory and Experiments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Foglizzo, Thierry; Kazeroni, Rémi; Guilet, Jérôme

    The explosion of core-collapse supernova depends on a sequence of events taking place in less than a second in a region of a few hundred kilometers at the center of a supergiant star, after the stellar core approaches the Chandrasekhar mass and collapses into a proto-neutron star, and before a shock wave is launched across the stellar envelope. Theoretical efforts to understand stellar death focus on the mechanism which transforms the collapse into an explosion. Progress in understanding this mechanism is reviewed with particular attention to its asymmetric character. We highlight a series of successful studies connecting observations of supernovamore » remnants and pulsars properties to the theory of core-collapse using numerical simulations. The encouraging results from first principles models in axisymmetric simulations is tempered by new puzzles in 3D. The diversity of explosion paths and the dependence on the pre-collapse stellar structure is stressed, as well as the need to gain a better understanding of hydrodynamical and MHD instabilities such as SASI and neutrino-driven convection. The shallow water analogy of shock dynamics is presented as a comparative system where buoyancy effects are absent. This dynamical system can be studied numerically and also experimentally with a water fountain. Lastly, we analyse the potential of this complementary research tool for supernova theory. We also review its potential for public outreach in science museums.« less

  5. Children and adolescents deaths from trauma-related causes in a Brazilian City.

    PubMed

    Fraga, Andrea Melo Alexandre; Bustorff-Silva, Joaquim Murray; Fernandez, Thais Marconi; Fraga, Gustavo Pereira; Reis, Marcelo Conrado; Baracat, Emilio Carlos Elias; Coimbra, Raul

    2013-12-05

    Injury is the first cause of death worldwide in the population aged 1 to 44. In developed countries, the most common trauma-related injuries resulting in death during childhood are traffic accidents, followed by drowning. This retrospective study based on autopsy examinations describes the epidemiology profile of deaths by trauma-related causes in individuals younger than 18 years from 2001 to 2008 in the city of Campinas. The aim is to identify epidemiology changes throughout the years in order to develop strategies of prevention. There were 2,170 deaths from all causes in children < 18 years old, 530 of which were due to trauma-related causes, with a male predominance of 3.4:1. The age distribution revealed that 76% of deaths occurred in the 10-17 age group. The most predominant trauma cause was firearm injury (47%). Other frequent causes were transport-related injuries (138 cases-26%; pedestrians were struck in 57.2% of these cases) and drowning (55 cases-10.4%). Asphyxia/suffocation was the cause of death in 72% of cases in children < 1 year old; drowning (30.8%) was predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (56%) and the 10-14 age group (40.4%). Gun-related deaths were predominant (68%) in the 14-17 age group. 51% of deaths occurred at the scene. There was a predominance of deaths in children and adolescents males, between 15-17 years old, mainly from gun-related homicides, and the frequency has decreased since 2004 after the disarmament statute and the combating of violence.

  6. [Cause-of-death statistics and ICD, quo vadis?

    PubMed

    Eckert, Olaf; Vogel, Ulrich

    2018-07-01

    The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

  7. Children and adolescents deaths from trauma-related causes in a Brazilian City

    PubMed Central

    2013-01-01

    Introduction Injury is the first cause of death worldwide in the population aged 1 to 44. In developed countries, the most common trauma-related injuries resulting in death during childhood are traffic accidents, followed by drowning. Methods This retrospective study based on autopsy examinations describes the epidemiology profile of deaths by trauma-related causes in individuals younger than 18 years from 2001 to 2008 in the city of Campinas. The aim is to identify epidemiology changes throughout the years in order to develop strategies of prevention. Results There were 2,170 deaths from all causes in children < 18 years old, 530 of which were due to trauma-related causes, with a male predominance of 3.4:1. The age distribution revealed that 76% of deaths occurred in the 10-17 age group. The most predominant trauma cause was firearm injury (47%). Other frequent causes were transport-related injuries (138 cases-26%; pedestrians were struck in 57.2% of these cases) and drowning (55 cases-10.4%). Asphyxia/suffocation was the cause of death in 72% of cases in children < 1 year old; drowning (30.8%) was predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (56%) and the 10-14 age group (40.4%). Gun-related deaths were predominant (68%) in the 14-17 age group. 51% of deaths occurred at the scene. Conclusions There was a predominance of deaths in children and adolescents males, between 15-17 years old, mainly from gun-related homicides, and the frequency has decreased since 2004 after the disarmament statute and the combating of violence. PMID:24305495

  8. Causes of maternal and child mortality among Cambodian sex workers and their children: a cross sectional study.

    PubMed

    Willis, Brian; Onda, Saki; Stoklosa, Hanni Marie

    2016-11-21

    To reach global and national goals for maternal and child mortality, countries must identify vulnerable populations, which includes sex workers and their children. The objective of this study was to identify and describe maternal deaths of female sex workers in Cambodia and causes of death among their children. A convenience sample of female sex workers were recruited by local NGOs that provide support to sex workers. We modified the maternal mortality section of the 2010 Cambodia Demographic and Health Survey and collected reports of all deaths of female sex workers. For each death we ask the 'sisterhood' methodology questions to identify maternal deaths. For child deaths we asked each mother who reported the death of a child about the cause of death. We also asked all participants about the cause of deaths of children of other female sex workers. We interviewed 271 female sex workers in the four largest Cambodian cities between May and September 2013. Participants reported 32 deaths of other female sex workers that met criteria for maternal death. The most common reported causes of maternal deaths were abortion (n = 13;40%) and HIV (n = 5;16%). Participants report deaths of 8 of their children and 50 deaths of children of other female sex workers. HIV was the reported cause of death for 13 (36%) children under age five. This is the first report of maternal deaths of sex workers in Cambodia or any other country. This modification of the sisterhood methodology has not been validated and did not allow us to calculate maternal mortality rates so the results are not generalizable, however these deaths may represent unrecognized maternal deaths in Cambodia. The results also indicate that children of sex workers in Cambodia are at risk of HIV and may not be accessing treatment. These issues require additional studies but in the meantime we must assure that sex workers in Cambodia and their children have access to quality health services.

  9. 5 CFR 843.303 - Marriage duration requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cause of death for criminal or insurance purposes is conclusive evidence of whether a death is accidental. (3) A death certificate showing the cause of death as accident or homicide is prima facie... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES RETIREMENT SYSTEM-DEATH BENEFITS AND EMPLOYEE REFUNDS Current and...

  10. Disability Status, Mortality, and Leading Causes of Death in the United States Community Population

    PubMed Central

    Forman-Hoffman, Valerie L.; Ault, Kimberly L.; Anderson, Wayne L.; Weiner, Joshua M.; Stevens, Alissa; Campbell, Vincent A.; Armour, Brian S.

    2015-01-01

    Objective We examined the effect of functional disability on all-cause mortality and cause-specific deaths among community-dwelling US adults. Methods We used data from 142,636 adults who participated in the 1994–1995 National Health Interview Survey-Disability Supplement eligible for linkage to National Death Index records from 1994 to 2006 to estimate the effects of disability on mortality and leading causes of death. Results Adults with any disability were more likely to die than adults without disability (19.92% vs. 10.94%; hazard ratio = 1.51, 95% confidence interval, 1.45–1.57). This association was statistically significant for most causes of death and for most types of disability studied. The leading cause of death for adults with and without disability differed (heart disease and malignant neoplasms, respectively). Conclusions Our results suggest that all-cause mortality rates are higher among adults with disabilities than among adults without disabilities and that significant associations exist between several types of disability and cause-specific mortality. Interventions are needed that effectively address the poorer health status of people with disabilities and reduce the risk of death. PMID:25719432

  11. Cannabis, possible cardiac deaths and the coroner in Ireland.

    PubMed

    Tormey, W P

    2012-12-01

    The elevated risk of triggering a myocardial infarction by smoking cannabis is limited to the first 2 h after smoking. To examine the possible role of cannabis in cardiac deaths. CASES AND RESULTS: From 3,193 coroners' cases over 2 years, there were 13 cases where the clinical information was compatible with a primary cardiac cause of death. An inquest was held in three cases. Myocardial infarction was the primary cause of death in 54%. Other causes were sudden adult death syndrome, sudden death in epilepsy, and poisoning by alcohol and diazepam. Cannabis was mentioned once only on a death certificate, but not as a cause of death. Blood delta9-tetrahydrocannabinol-carboxylic acid was recorded in one case and in no case was plasma tetrahydrocannabinol (THC) measured. To attribute sudden cardiac death to cannabis, plasma THC should be measured in the toxicology screen in coroners' cases where urine cannabinoids are positive. A positive urine cannabinoids immunoassay alone is insufficient evidence in the linkage of acute cardiac death and cannabis.

  12. Survey of New York City Resident Physicians on Cause-of-Death Reporting, 2010

    PubMed Central

    Wexelman, Barbara A.; Eden, Edward

    2013-01-01

    Introduction Death certificates contain critical information for epidemiology, public health research, disease surveillance, and community health programs. In most teaching hospitals, resident physicians complete death certificates. The objective of this study was to examine the experiences and opinions of physician residents in New York City on the accuracy of the cause-of-death reporting system. Methods In May and June 2010, we conducted an anonymous, Internet-based, 32-question survey of all internal medicine, emergency medicine, and general surgery residency programs (n = 70) in New York City. We analyzed data by type of residency and by resident experience in reporting deaths. We defined high-volume respondents as those who completed 11 or more death certificates in the last 3 years. Results A total of 521 residents from 38 residency programs participated (program response rate, 54%). We identified 178 (34%) high-volume respondents. Only 33.3% of all respondents and 22.7% of high-volume residents believed that cause-of-death reporting is accurate. Of all respondents, 48.6% had knowingly reported an inaccurate cause of death; 58.4% of high-volume residents had done so. Of respondents who indicated they reported an inaccurate cause, 76.8% said the system would not accept the correct cause, 40.5% said admitting office personnel instructed them to “put something else,” and 30.7% said the medical examiner instructed them to do so; 64.6% cited cardiovascular disease as the most frequent diagnosis inaccurately reported. Conclusion Most resident physicians believed the current cause-of-death reporting system is inaccurate, often knowingly documenting incorrect causes. The system should be improved to allow reporting of more causes, and residents should receive better training on completing death certificates. PMID:23660118

  13. NASA's Chandra Sees Brightest Supernova Ever

    NASA Astrophysics Data System (ADS)

    2007-05-01

    WASHINGTON - The brightest stellar explosion ever recorded may be a long-sought new type of supernova, according to observations by NASA's Chandra X-ray Observatory and ground-based optical telescopes. This discovery indicates that violent explosions of extremely massive stars were relatively common in the early universe, and that a similar explosion may be ready to go off in our own galaxy. "This was a truly monstrous explosion, a hundred times more energetic than a typical supernova," said Nathan Smith of the University of California at Berkeley, who led a team of astronomers from California and the University of Texas in Austin. "That means the star that exploded might have been as massive as a star can get, about 150 times that of our sun. We've never seen that before." Chandra X-ray Image of SN 2006gy Chandra X-ray Image of SN 2006gy Astronomers think many of the first generation of stars were this massive, and this new supernova may thus provide a rare glimpse of how the first stars died. It is unprecedented, however, to find such a massive star and witness its death. The discovery of the supernova, known as SN 2006gy, provides evidence that the death of such massive stars is fundamentally different from theoretical predictions. "Of all exploding stars ever observed, this was the king," said Alex Filippenko, leader of the ground-based observations at the Lick Observatory at Mt. Hamilton, Calif., and the Keck Observatory in Mauna Kea, Hawaii. "We were astonished to see how bright it got, and how long it lasted." The Chandra observation allowed the team to rule out the most likely alternative explanation for the supernova: that a white dwarf star with a mass only slightly higher than the sun exploded into a dense, hydrogen-rich environment. In that event, SN 2006gy should have been 1,000 times brighter in X-rays than what Chandra detected. Animation of SN 2006gy Animation of SN 2006gy "This provides strong evidence that SN 2006gy was, in fact, the death of an extremely massive star," said Dave Pooley of the University of California at Berkeley, who led the Chandra observations. The star that produced SN 2006gy apparently expelled a large amount of mass prior to exploding. This large mass loss is similar to that seen from Eta Carinae, a massive star in our galaxy, raising suspicion that Eta Carinae may be poised to explode as a supernova. Although SN 2006gy is intrinsically the brightest supernova ever, it is in the galaxy NGC 1260, some 240 million light years away. However, Eta Carinae is only about 7,500 light years away in our own Milky Way galaxy. "We don't know for sure if Eta Carinae will explode soon, but we had better keep a close eye on it just in case," said Mario Livio of the Space Telescope Science Institute in Baltimore, who was not involved in the research. "Eta Carinae's explosion could be the best star-show in the history of modern civilization." A New Line of Stellar Evolution A New Line of Stellar Evolution Supernovas usually occur when massive stars exhaust their fuel and collapse under their own gravity. In the case of SN 2006gy, astronomers think that a very different effect may have triggered the explosion. Under some conditions, the core of a massive star produces so much gamma ray radiation that some of the energy from the radiation converts into particle and anti-particle pairs. The resulting drop in energy causes the star to collapse under its own huge gravity. After this violent collapse, runaway thermonuclear reactions ensue and the star explodes, spewing the remains into space. The SN 2006gy data suggest that spectacular supernovas from the first stars - rather than completely collapsing to a black hole as theorized - may be more common than previously believed. "In terms of the effect on the early universe, there's a huge difference between these two possibilities," said Smith. "One pollutes the galaxy with large quantities of newly made elements and the other locks them up forever in a black hole." The results from Smith and his colleagues will appear in The Astrophysical Journal. NASA's Marshall Space Flight Center, Huntsville, Ala., manages the Chandra program for the agency's Science Mission Directorate. The Smithsonian Astrophysical Observatory controls science and flight operations from the Chandra X-ray Center in Cambridge, Mass. Additional information and images are available at: http://chandra.harvard.edu and http://chandra.nasa.gov

  14. Leading Causes of Death in Males United States, 2010

    MedlinePlus

    ... Submit What’s this? Submit Button Leading Causes of Death in Males and Females, United States Recommend on ... and previous listings for the leading causes of death for males and females in the United States. ...

  15. Aetiology of sudden cardiac death in sport: a histopathologist's perspective.

    PubMed

    Sheppard, Mary N

    2012-11-01

    In the UK, when a young person dies suddenly, the coroner is responsible for establishing the cause of death. They will ask a consultant pathologist to carry out an autopsy in order to ascertain when, where and how that person died. Once the cause of death is established and is due to natural causes, the coroner can issue a death certificate. Importantly, the coroner is not particularly interested in the cause of death as long as it is due to natural causes, which avoids the need for an inquest (a public hearing about the death). However, if no identifiable cause is established at the initial autopsy, the coroner can refer the heart to a cardiac pathologist, since the cause of death is usually due to heart disease in most cases. Consultant histopathologists are responsible for the analysis of human tissue from both living individuals and the dead in order to make a diagnosis of disease. With recent advancements in the management protocols for routine autopsy practice and assessment following the sudden death of a young individual, this review describes the role of the consultant histopathologist in the event of a sudden death of a young athletic individual, together with the older middle-aged 'weekend warrior' athlete. It provides concise mechanisms for the main causes of sudden cardiac death (including coronary artery disease, cardiomyopathies, valve abnormalities, major vessel ruptures and electrical conduction abnormalities) based on detailed autopsy data from our specialised cardiac pathology laboratory. Finally, the review will discuss the role of the histopathologist in the event of a 'negative' autopsy.

  16. Prediction of ground motion and dynamic stress change in Baekdusan (Changbaishan) volcano caused by a North Korean nuclear explosion.

    PubMed

    Hong, Tae-Kyung; Choi, Eunseo; Park, Seongjun; Shin, Jin Soo

    2016-02-17

    Strong ground motions induce large dynamic stress changes that may disturb the magma chamber of a volcano, thus accelerating the volcanic activity. An underground nuclear explosion test near an active volcano constitutes a direct treat to the volcano. This study examined the dynamic stress changes of the magma chamber of Baekdusan (Changbaishan) that can be induced by hypothetical North Korean nuclear explosions. Seismic waveforms for hypothetical underground nuclear explosions at North Korean test site were calculated by using an empirical Green's function approach based on a source-spectral model of a nuclear explosion; such a technique is efficient for regions containing poorly constrained velocity structures. The peak ground motions around the volcano were estimated from empirical strong-motion attenuation curves. A hypothetical M7.0 North Korean underground nuclear explosion may produce peak ground accelerations of 0.1684 m/s(2) in the horizontal direction and 0.0917 m/s(2) in the vertical direction around the volcano, inducing peak dynamic stress change of 67 kPa on the volcano surface and ~120 kPa in the spherical magma chamber. North Korean underground nuclear explosions with magnitudes of 5.0-7.6 may induce overpressure in the magma chamber of several tens to hundreds of kilopascals.

  17. 46 CFR 148.11 - Hazardous or potentially dangerous characteristics.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Contact with water may cause evolution of flammable gases, which may form explosive mixtures with air. 3 Contact with water may cause evolution of toxic gases. 4 If involved in a fire, will greatly intensify the...

  18. 46 CFR 148.11 - Hazardous or potentially dangerous characteristics.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Contact with water may cause evolution of flammable gases, which may form explosive mixtures with air. 3 Contact with water may cause evolution of toxic gases. 4 If involved in a fire, will greatly intensify the...

  19. 46 CFR 148.11 - Hazardous or potentially dangerous characteristics.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Contact with water may cause evolution of flammable gases, which may form explosive mixtures with air. 3 Contact with water may cause evolution of toxic gases. 4 If involved in a fire, will greatly intensify the...

  20. 46 CFR 148.11 - Hazardous or potentially dangerous characteristics.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Contact with water may cause evolution of flammable gases, which may form explosive mixtures with air. 3 Contact with water may cause evolution of toxic gases. 4 If involved in a fire, will greatly intensify the...

  1. Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment.

    PubMed

    Yaghmour, Nicholas A; Brigham, Timothy P; Richter, Thomas; Miller, Rebecca S; Philibert, Ingrid; Baldwin, DeWitt C; Nasca, Thomas J

    2017-07-01

    To systematically study the number of U.S. resident deaths from all causes, including suicide. The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death. Person-year calculations were used to establish resident death rates and compare them with those in the general population. Between 2000 and 2014, 324 individuals (220 men, 104 women) died while in residency. The leading cause of death was neoplastic disease, followed by suicide, accidents, and other diseases. For male residents the leading cause was suicide, and for female residents, malignancies. Resident death rates were lower than in the age- and gender-matched general population. Temporal patterns showed higher rates of death early in residency. Deaths by suicide were higher early in training, and during the first and third quarters of the academic year. There was no upward or downward trend in resident deaths over the 15 years of this study. Neoplastic disease and suicide were the leading causes of death in residents. Data for death by suicide suggest added risk early in residency and during certain months of the academic year. Providing trainees with a supportive environment and with medical and mental health services is integral to reducing preventable deaths and fostering a healthy physician workforce.

  2. Prostate cancer, prostate cancer death, and death from other causes, among men with metabolic aberrations.

    PubMed

    Häggström, Christel; Stocks, Tanja; Nagel, Gabriele; Manjer, Jonas; Bjørge, Tone; Hallmans, Göran; Engeland, Anders; Ulmer, Hanno; Lindkvist, Björn; Selmer, Randi; Concin, Hans; Tretli, Steinar; Jonsson, Håkan; Stattin, Pär

    2014-11-01

    Few previous studies of metabolic aberrations and prostate cancer risk have taken into account the fact that men with metabolic aberrations have an increased risk of death from causes other than prostate cancer. The aim of this study was to calculate, in a real-life scenario, the risk of prostate cancer diagnosis, prostate cancer death, and death from other causes. In the Metabolic Syndrome and Cancer Project, prospective data on body mass index, blood pressure, glucose, cholesterol, and triglycerides were collected from 285,040 men. Risks of prostate cancer diagnosis, prostate cancer death, and death from other causes were calculated by use of competing risk analysis for men with normal (bottom 84%) and high (top 16%) levels of each factor, and a composite score. During a mean follow-up period of 12 years, 5,893 men were diagnosed with prostate cancer, 1,013 died of prostate cancer, and 26,328 died of other causes. After 1996, when prostate-specific antigen testing was introduced, men up to age 80 years with normal metabolic levels had 13% risk of prostate cancer, 2% risk of prostate cancer death, and 30% risk of death from other causes, whereas men with metabolic aberrations had corresponding risks of 11%, 2%, and 44%. In contrast to recent studies using conventional survival analysis, in a real-world scenario taking risk of competing events into account, men with metabolic aberrations had lower risk of prostate cancer diagnosis, similar risk of prostate cancer death, and substantially higher risk of death from other causes compared with men who had normal metabolic levels.

  3. Causes of Death Following Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis.

    PubMed

    Xiong, Tian-Yuan; Liao, Yan-Biao; Zhao, Zhen-Gang; Xu, Yuan-Ning; Wei, Xin; Zuo, Zhi-Liang; Li, Yi-Jian; Cao, Jia-Yu; Tang, Hong; Jilaihawi, Hasan; Feng, Yuan; Chen, Mao

    2015-09-21

    Transcatheter aortic valve replacement (TAVR) is an effective alternative to surgical aortic valve replacement in patients at high surgical risk. However, there is little published literature on the exact causes of death. The PubMed database was systematically searched for studies reporting causes of death within and after 30 days following TAVR. Twenty-eight studies out of 3934 results retrieved were identified. In the overall analysis, 46.4% and 51.6% of deaths were related to noncardiovascular causes within and after the first 30 days, respectively. Within 30 days of TAVR, infection/sepsis (18.5%), heart failure (14.7%), and multiorgan failure (13.2%) were the top 3 causes of death. Beyond 30 days, infection/sepsis (14.3%), heart failure (14.1%), and sudden death (10.8%) were the most common causes. All possible subgroup analyses were made. No significant differences were seen for proportions of cardiovascular deaths except the comparison between moderate (mean STS score 4 to 8) and high (mean STS score >8) -risk patients after 30 days post-TAVR (56.0% versus 33.5%, P=0.005). Cardiovascular and noncardiovascular causes of death are evenly balanced both in the perioperative period and at long-term follow-up after TAVR. Infection/sepsis and heart failure were the most frequent noncardiovascular and cardiovascular causes of death. This study highlights important areas of clinical focus that could further improve outcomes after TAVR. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. [More than a decade improving medical and judicial certification in mortality statistics of death causes].

    PubMed

    Cirera, Lluís; Salmerón, Diego; Martínez, Consuelo; Bañón, Rafael María; Navarro, Carmen

    2018-06-06

    After the return of Spain to democracy and the regional assumption of government powers, actions were initiated to improve the mortality statistics of death causes. The objective of this work was to describe the evolution of the quality activities improvements into the statistics of death causes on Murcia's region during 1989 to 2011. Descriptive epidemiological study of all death documents processed by the Murcia mortality registry. Use of indicators related to the quality of the completion of death in medical and judicial notification; recovery of information on the causes and circumstances of death; and impact on the statistics of ill-defined, unspecific and less specific causes. During the study period, the medical notification without a temporary sequence on the death certificate (DC) has decreased from 46% initial to 21% final (p less than 0.001). Information retrieval from sources was successful in 93% of the cases in 2001 compared to 38%, at the beginning of the period (p less than 0.001). Regional rates of ill-defined and unspecific causes fell more than national ones, and they were in the last year with a differential of 10.3 (p less than 0.001) and 2.8 points (p=0.001), respectively. The medical death certification improved in form and suitability. Regulated recovery of the causes of death and circumstances corrected medical and judicial information. The Murcia's region presented lower rates in less specified causes and ill-defined entities than national averages.

  5. [Mind the explosion? The evolution of safety at work in anaesthesiology].

    PubMed

    Petermann, Heike

    2015-11-01

    The evolution of safety in anaesthesiology is characterized by 2 aspects: exposure of anaesthetic staff by volatile anaesthetics and fire as well as explosions in combination with those. In the 20th century, the exposure of staff in the operating room became more and more important. Trigger for the fatal complications were gas lights in combination with chloroform. Later oxygen and inhalation anaesthetics caused explosions and fires. Therefore safety rules were implemented in the 1980s in the Federal Republic of Germany. These were valid for application anaesthetics including apparatus and configuration of operating rooms. The only imponderability is still the human factor.

  6. Explosive electromagnetic radiation by the relaxation of a multimode magnon system.

    PubMed

    Vasyuchka, V I; Serga, A A; Sandweg, C W; Slobodianiuk, D V; Melkov, G A; Hillebrands, B

    2013-11-01

    Microwave emission from a parametrically pumped ferrimagnetic film of yttrium iron garnet was studied versus the magnon density evolution, which was detected by Brillouin light scattering spectroscopy. It has been found that the shutdown of external microwave pumping leads to an unexpected effect: The conventional monotonic decrease of the population of parametrically injected magnons is accompanied by an explosive behavior of electromagnetic radiation at the magnon frequency. The developed theory shows that this explosion is caused by a nonlinear energy transfer from parametrically driven short-wavelength dipolar-exchange magnons to a long-wavelength dipolar magnon mode effectively coupled to an electromagnetic wave.

  7. Impact of age and sex on survival and causes of death in adults with congenital heart disease.

    PubMed

    Oliver, Jose Maria; Gallego, Pastora; Gonzalez, Ana Elvira; Garcia-Hamilton, Diego; Avila, Pablo; Alonso, Andres; Ruiz-Cantador, Jose; Peinado, Rafael; Yotti, Raquel; Fernandez-Aviles, Francisco

    2017-10-15

    The impact of gender and aging on relative survival and causes of death in adults with congenital heart disease (ACHD) are not well known. Single center observational longitudinal study of 3311 consecutive ACHD (50.5% males) followed up to 25years. Patients were divided by the age at last follow-up into three groups: <40, 40-65 and >65years old. Their vital status was verified by crosschecking the Spanish National Death Index. Regression model for relative survival from reference population was performed. Cause of death was classified according to the International Classification of Diseases (ICD-10). Patients who died from cardiovascular (CV) causes were further investigated on a case-by-case basis. During a cumulative follow-up time of 37,608 person-years 336 patients died (10%). Age-adjusted relative survival in females was significantly worse than in males (hazard ratio [HR] 1.25; 95% confidence interval [CI] 1.0-1.6; p=0.046), and sex-adjusted relative survival improved across the three group of ages (HR 0.98; 95% CI 0.97-0.99; p<0.001). There was a temporal decline of CV deaths with aging in both genders (p<0.001). The leading cause of CV death was heart failure but sudden death prevailed in subjects <40years (p=0.004). While sudden death progressively declined with aging heart failure significantly increased (p<0.001). Women with CHD fare worse than men. There are a decline in CV deaths and a major temporal shift in the causes of CV deaths with aging. Heart failure surpasses sudden death as the primary cause of death in survivors over 40years. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Trends in Causes of Adult Deaths among the Urban Poor: Evidence from Nairobi Urban Health and Demographic Surveillance System, 2003-2012.

    PubMed

    Mberu, Blessing; Wamukoya, Marylene; Oti, Samuel; Kyobutungi, Catherine

    2015-06-01

    What kills people around the world and how it varies from place to place and over time is critical in mapping the global burden of disease and therefore, a relevant public health question, especially in developing countries. While more than two thirds of deaths worldwide are in developing countries, little is known about the causes of death in these nations. In many instances, vital registration systems are nonexistent or at best rudimentary, and even when deaths are registered, data on the cause of death in particular local contexts, which is an important step toward improving context-specific public health, are lacking. In this paper, we examine the trends in the causes of death among the urban poor in two informal settlements in Nairobi by applying the InterVA-4 software to verbal autopsy data. We examine cause of death data from 2646 verbal autopsies of deaths that occurred in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) between 1 January 2003 and 31 December 2012 among residents aged 15 years and above. The data is entered into the InterVA-4 computer program, which assigns cause of death using probabilistic modeling. The results are presented as annualized trends from 2003 to 2012 and disaggregated by gender and age. Over the 10-year period, the three major causes of death are tuberculosis (TB), injuries, and HIV/AIDS, accounting for 26.9, 20.9, and 17.3% of all deaths, respectively. In 2003, HIV/AIDS was the highest cause of death followed by TB and then injuries. However, by 2012, TB and injuries had overtaken HIV/AIDS as the major causes of death. When this is examined by gender, HIV/AIDS was consistently higher for women than men across all the years generally by a ratio of 2 to 1. In terms of TB, it was more evenly distributed across the years for both males and females. We find that there is significant gender variation in deaths linked to injuries, with male deaths being higher than female deaths by a ratio of about 4 to 1. We also find a fifteen percentage point increase in the incidences of male deaths due to injuries between 2003 and 2012. For women, the corresponding deaths due to injuries remain fairly stable throughout the period. We find cardiovascular diseases as a significant cause of death over the period, with overall mortality increasing steadily from 1.6% in 2003 to 8.1% in 2012, and peaking at 13.7% in 2005 and at 12.0% in 2009. These deaths were consistently higher among women. We identified substantial variations in causes of death by age, with TB, HIV/AIDS, and CVD deaths lowest among younger residents and increasing with age, while injury-related deaths are highest among the youngest adults 15-19 and steadily declined with age. Also, deaths related to neoplasms and respiratory tract infections (RTIs) were prominent among older adults 50 years and above, especially since 2005. Emerging at this stage is evidence that HIV/AIDS, TB, injuries, and cardiovascular disease are linked to approximately 73% of all adult deaths among the urban poor in Nairobi slums of Korogocho and Viwandani in the last 10 years. While mortality related to HIV/AIDS is generally declining, we see an increasing proportion of deaths due to TB, injuries, and cardiovascular diseases. In sum, substantial epidemiological transition is ongoing in this local context, with deaths linked to communicable diseases declining from 66% in 2003 to 53% in 2012, while deaths due to noncommunicable causes experienced a four-fold increase from 5% in 2003 to 21.3% in 2012, together with another two-fold increase in deaths due to external causes (injuries) from 11% in 2003 to 22% in 2012. It is important to also underscore the gender dimensions of the epidemiological transition clearly visible in the mix. Finally, the elevated levels of disadvantage of slum dwellers in our analysis relative to other population subgroups in Kenya continue to demonstrate appreciable deterioration of key urban health and social indicators, highlighting the need for a deliberate strategic focus on the health needs of the urban poor in policy and program efforts toward achieving international goals and national health and development targets.

  9. Changes in the Leading Cause of Death: Recent Patterns in Heart Disease and Cancer Mortality.

    PubMed

    Heron, Melonie; Anderson, Robert N

    2016-08-01

    Data from the National Vital Statistics System •Heart disease has consistently been the leading cause of death in the United States and remained so in 2014. •The gap between the number of heart disease and cancer deaths generally widened from 1950 through 1968, narrowed from 1968 through 2012, and then slightly widened again from 2012 through 2014. •The mortality burden of cancer has surpassed that of heart disease in several states. In 2000, there were only 2 states where cancer was the leading cause of death; in 2014, there were 22. •Heart disease remained the leading cause of death for the non-Hispanic white and non-Hispanic black populations in 2014. •Cancer is now the leading cause of death for the non-Hispanic Asian or Pacific Islander and Hispanic populations. The timing of the leading-cause crossover varied by group. For the total U.S. population, heart disease has been the leading cause of death for decades, with cancer the second leading cause (1). However, the ranking of these causes has varied across demographic group and geographic unit over time. Rankings are based on the number of deaths and reflect mortality burden rather than risk of death (2). This report highlights changes in the mortality burden of heart disease and cancer and presents findings by state, race, and Hispanic origin. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  10. Oral Trauma and Tooth Avulsion Following Explosion of E-Cigarette.

    PubMed

    Rogér, James M; Abayon, Maricelle; Elad, Sharon; Kolokythas, Antonia

    2016-06-01

    Electronic cigarettes (E-cigarettes), or personal vaporizers, were introduced in 2003 and have been available in the United States since 2007. In addition to the health and safety concerns of the aerosol delivery of nicotine through E-cigarettes, during the past 8 years, reports of explosions and fires caused by the E-cigarette devices have led the US Fire Administration to evaluate the safety of these devices. These explosions have been observed frequently enough that the US Department of Transportation has recently banned E-cigarette devices in checked baggage aboard airplanes. This report contributes to existing knowledge about the hazards related to E-cigarettes by describing oral hard and soft tissue injuries from an E-cigarette explosion. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Strangulation and Its Role in Multiple Causes of Death.

    PubMed

    Hlavaty, Leigh; Sung, LokMan

    2017-12-01

    Forensic pathologists have a duty to determine the cause and manner of death and are bound by international guidelines in the completion of the death certificate. Sometimes, there are complex circumstances surrounding a death that cannot be captured in the structure of the death certificate and its requirement of listing only 1 cause of death per line. Cases may have multiple causes of death with comorbid medical conditions or inflicted injuries that equally contribute to the ultimate demise. Compared with other forms of homicide, autopsy evidence of strangulation will often be found with other life-threatening traumatic injuries. The Wayne County Medical Examiner's Office conducted a retrospective study of strangulation cases that came into the office from mid-2007 to the end of 2016. The purpose of the study was to examine patterns of injuries in strangulation cases and identify those with additional traumatic injuries of commensurate extent that required incorporation into the cause of death. A total of 43 strangulation cases were found, of which there were equal numbers of ligature and manual strangulations (19 each) and 5 cases in which the method was not specified, and decedents were divided: 63% female and 37% male. Fourteen of these cases were recognized to have multiple causes of death, where blunt force trauma was the most common additional cause, and the sex distribution weighed heavily toward the female (approximately 79%).

  12. A case of death of the driver due to environmental asphyxia by liquid nitrogen leakage in the cabin of the car during a road accident

    PubMed

    Raczkowska, Zuzanna; Samojłowicz, Dorota

    2013-01-01

    Nitrogen causes environmental asphyxia by displacing oxygen in the air leading to death. The study presents a case of a death of a driver death who was transporting flasks with liquid nitrogen that depressurized during an accident. The mechanism and cause of death were determined based on the result of the autopsy and histopathologic examination. The authors emphasize the relevance of accident scene inspection during establishing the cause of death in similar cases.

  13. Risk and Protective Factors for Cause-Specific Mortality After Spinal Cord Injury.

    PubMed

    Krause, James S; Cao, Yue; DeVivo, Michael J; DiPiro, Nicole D

    2016-10-01

    To investigate the association of multiple sets of risk and protective factors (biographic and injury, socioeconomic, health) with cause-specific mortality after spinal cord injury (SCI). Retrospective analysis of a prospectively created cohort. Spinal Cord Injury Model Systems facilities. Adults (N=8157) with traumatic SCI who were enrolled in a model systems facility after 1973 and received follow-up evaluation that included all study covariates (between November 1, 1995 and October 31, 2006). Not applicable. All-cause mortality was determined using the Social Security Death Index as of January 1, 2014. Causes of death were obtained from the National Death Index and classified as infective and parasitic diseases, neoplasms, respiratory system diseases, heart and blood vessel diseases, external causes, and other causes. Competing risk analysis, with time-dependent covariates, was performed with hazard ratios (HRs) for each cause of death. The HRs for injury severity indicators were highest for deaths due to respiratory system diseases (highest HR for injury level C1-4, 4.84) and infective and parasitic diseases (highest HR for American Spinal Injury Association Impairment Scale grade A, 5.70). In contrast, injury level and American Spinal Injury Association Impairment Scale grade were relatively unrelated to death due to neoplasms and external causes. Of the socioeconomic indicators, education and income were significantly predictive of a number of causes of death. Pressure ulcers were the only 1 of 4 secondary health condition indicators consistently related to cause of death. Injury severity was related to mortality due to infective disease and respiratory complications, suggesting that those with the most severe SCI should be targeted for prevention of these causes. Socioeconomic and health factors were more broadly related to a number of causes of death. Intervention strategies that enhance socioeconomic status and health may also result in reduced mortality due to multiple causes. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Maternal death audit in Rwanda 2009–2013: a nationwide facility-based retrospective cohort study

    PubMed Central

    Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos

    2016-01-01

    Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to inform corrective measures. PMID:26801466

  15. Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999–2009

    PubMed Central

    Espey, David K.; Groom, Amy V.; Phillips, Leslie E.; Haverkamp, Donald S.; Stanley, Sandte L.

    2016-01-01

    Objectives. To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. Methods. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999–2009 and compared those with corresponding urban White and rural AI/AN death rates. Results. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Conclusions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities. PMID:26890168

  16. Mortality and causes of death among people who inject amphetamine: A long-term follow-up cohort study from a needle exchange program in Sweden.

    PubMed

    Åhman, Ada; Jerkeman, Anna; Blomé, Marianne Alanko; Björkman, Per; Håkansson, Anders

    2018-07-01

    Abuse of amphetamines is a worldwide problem with around 34 million users, and amphetamine is commonly used by people who inject drugs (PWID). Despite this, there is relatively little research on mortality and cause of death among people who use amphetamines primarily. The present study aimed to examine mortality and causes of death among people who inject amphetamine, and compare these results to the general population. This retrospective cohort study was based on data from The Malmö Needle Exchange Program in Sweden (MNEP) and on data from The Swedish National Cause of Death Register. Participants in the MNEP, between 1987 and 2011, with registered national identity number and amphetamine as their primary drug of injection use, were included in the study. Standardized mortality ratios (SMR) was calculated for overall mortality and categories of causes of death. 2019 individuals were included (mean follow-up-time 13.7 years [range 0.02-24.2 years], a total of 27,698 person-years). Of the 448 deceased, 428 had a registered cause of death. The most common causes of death were external causes (n = 162, 38%), followed by diseases of the circulatory system (n = 67, 16%). SMR were significantly elevated (8.3, 95% CI [7.5-9.1]) for the entire study population, and for every category of causes of death respectively. People injecting amphetamine as a primary drug were found to have significantly elevated mortality compared with the general population, with high rates of both external and somatic causes of death. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Esophageal rupture caused by explosion of an automobile tire tube: a case report.

    PubMed

    Yu, Yongkang; Ding, Sheng; Zheng, Yifeng; Li, Wei; Yang, Lie; Zheng, Xiushan; Liu, Xiaoyan; Jiang, Jianqing

    2013-08-23

    There have been no reports in the literature of esophageal rupture in adults resulting from an explosion of an automobile tire. We report the first case of just such an occurrence after an individual bit into a tire, causing it to explode in his mouth. A 47-year-old Han Chinese man presented with massive hemorrhage in his left eye after he accidentally bit an automobile tire tube which burst into his mouth. He was diagnosed with esophageal rupture based on a chest computed tomography scan and barium swallow examination. Drainage of empyema (right chest), removal of thoracic esophagus, exposure of cervical esophagus, cardiac ligation and gastrostomy were performed respectively. After that, esophagogastrostomy was performed. Successful anastomosis was obtained at the neck with no postoperative complications 3 months after the surgery. The patient was discharged with satisfactory outcomes. We present this case report to bring attention to esophageal rupture in adults during the explosion of an automobile tire tube in the mouth.

  18. Rapid laccolith intrusion driven by explosive volcanic eruption

    PubMed Central

    Castro, Jonathan M.; Cordonnier, Benoit; Schipper, C. Ian; Tuffen, Hugh; Baumann, Tobias S.; Feisel, Yves

    2016-01-01

    Magmatic intrusions and volcanic eruptions are intimately related phenomena. Shallow magma intrusion builds subsurface reservoirs that are drained by volcanic eruptions. Thus, the long-held view is that intrusions must precede and feed eruptions. Here we show that explosive eruptions can also cause magma intrusion. We provide an account of a rapidly emplaced laccolith during the 2011 rhyolite eruption of Cordón Caulle, Chile. Remote sensing indicates that an intrusion began after eruption onset and caused severe (>200 m) uplift over 1 month. Digital terrain models resolve a laccolith-shaped body ∼0.8 km3. Deformation and conduit flow models indicate laccolith depths of only ∼20–200 m and overpressures (∼1–10 MPa) that likely stemmed from conduit blockage. Our results show that explosive eruptions may rapidly force significant quantities of magma in the crust to build laccoliths. These iconic intrusions can thus be interpreted as eruptive features that pose unique and previously unrecognized volcanic hazards. PMID:27876800

  19. Rapid laccolith intrusion driven by explosive volcanic eruption.

    PubMed

    Castro, Jonathan M; Cordonnier, Benoit; Schipper, C Ian; Tuffen, Hugh; Baumann, Tobias S; Feisel, Yves

    2016-11-23

    Magmatic intrusions and volcanic eruptions are intimately related phenomena. Shallow magma intrusion builds subsurface reservoirs that are drained by volcanic eruptions. Thus, the long-held view is that intrusions must precede and feed eruptions. Here we show that explosive eruptions can also cause magma intrusion. We provide an account of a rapidly emplaced laccolith during the 2011 rhyolite eruption of Cordón Caulle, Chile. Remote sensing indicates that an intrusion began after eruption onset and caused severe (>200 m) uplift over 1 month. Digital terrain models resolve a laccolith-shaped body ∼0.8 km 3 . Deformation and conduit flow models indicate laccolith depths of only ∼20-200 m and overpressures (∼1-10 MPa) that likely stemmed from conduit blockage. Our results show that explosive eruptions may rapidly force significant quantities of magma in the crust to build laccoliths. These iconic intrusions can thus be interpreted as eruptive features that pose unique and previously unrecognized volcanic hazards.

  20. Progenitor Masses for Every Nearby Historic Core-Collapse Supernova

    NASA Astrophysics Data System (ADS)

    Williams, Benjamin

    2016-10-01

    Some of the most energetic explosions in the Universe are the core-collapse supernovae (CCSNe) that arise from the death of massive stars. They herald the birth of neutron stars and black holes, are prodigious emitters of neutrinos and gravitational waves, influence galactic hydrodynamics, trigger further star formation, and are a major site for nucleosynthesis, yet even the most basic elements of CCSN theory are poorly constrained by observations. Specifically, there are too few observations to constrain the progenitor mass distribution and fewer observations still to constrain the mapping between progenitor mass and explosion type (e.g. IIP IIL, IIb, Ib/c, etc.). Combining previous measurements with 9 proposed HST pointings covering 13 historic CCSNe, we plan to obtain progenitor mass measurements for all cataloged historic CCSNe within 8 Mpc, optimizing observational mass constraints for CCSN theory.

  1. Leading causes of death and all-cause mortality in American Indians and Alaska Natives.

    PubMed

    Espey, David K; Jim, Melissa A; Cobb, Nathaniel; Bartholomew, Michael; Becker, Tom; Haverkamp, Don; Plescia, Marcus

    2014-06-01

    We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs). US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009. Results focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions.

  2. Disability Rating, Age at Death, and Cause of Death in U.S. Veterans with Service-Connected Conditions.

    PubMed

    Maynard, Charles; Trivedi, Ranak; Nelson, Karin; Fihn, Stephan D

    2018-03-26

    The association between disability and cause of death in Veterans with service-connected disabilities has not been studied. The objective of this study was to compare age at death, military service and disability characteristics, including disability rating, and cause of death by year of birth. We also examined cause of death for specific service-connected conditions. This study used information from the VETSNET file, which is a snapshot of selected items from the Veterans Benefits Administration corporate database. We also used the National Death Index (NDI) for Veterans which is part of the VA Suicide Data Repository. In VETSNET, there were 758,324 Veterans who had a service-connected condition and died between the years 2004 and 2014. Using the scrambled social security number to link the two files resulted in 605,493 (80%) deceased Veterans. Age at death, sex, and underlying cause of death were obtained from the NDI for Veterans and military service characteristics and types of disability were acquired from VETSNET. We constructed age categories corresponding to period of service; birth years 1938 and earlier corresponded to Korea and World War II ("oldest"), birth years 1939-1957 to the Vietnam era ("middle"), and birth years 1958 and later to post Vietnam, Gulf War, and the more recent conflicts in Iraq and Afghanistan ("youngest"). Sixty-two percent were in the oldest age category, 34% in the middle group, and 4% in the youngest one. The overall age at death was 75 ± 13 yr. Only 1.6% of decedents were women; among women 25% were in the youngest age group, while among men only 4% were in the youngest group. Most decedents were enlisted personnel, and 60% served in the U.S. Army. Nearly 61% had a disability rating of >50% and for the middle age group 54% had a disability rating of 100%. The most common service-connected conditions were tinnitus, hearing loss, and post-traumatic stress disorder (PTSD). In the oldest group, nearly half of deaths were due to cancer or cardiovascular conditions and <2% were due to external causes. In the youngest group, cardiovascular disease and cancer accounted for about 1/3 of deaths, whereas external causes or deaths due to accidents, suicide, or assault accounted for nearly 33% of deaths. For Veterans with service-connected PTSD or major depression; 6.5% of deaths were due to external causes whereas for Veterans without these conditions, only 3.1% were due to external causes. The finding of premature death due to external causes in the youngest age group as well as the finding of higher proportions of external causes in those with PTSD or major depression should be of great concern to those who care for Veterans.

  3. Most common causes of natural and injury-related deaths in Addis Ababa, Ethiopia

    PubMed Central

    Gemechu, Tufa; Tinsae, Mihrete; Ashenafi, Senait; Rodriguez, Victor Manuel; Lori, Alfredo; Collins, Michelle; Hurford, Rosemary; Haimanot, Rahel; Sandoval, Melissa; Mehari, Enawgaw; Langford, T. Dianne

    2009-01-01

    SUMMARY In Ethopia, like many developing countries, autopsy is rare unless conducted in the medico-legal arena, making vital statistics that include sparse pathological diagnoses. To determine the most common factors contributing to death among individuals who died from natural or injury-related events in Ethiopia in 2006, 200 consecutive autopsies were conducted at the Forensic Medico-legal Pathology Department, Menelik II Hospital, Addis Ababa, Ethiopia. The results describe significant pathological observations, putative cause of death, age distribution, and gender ratios. Eighty-one percent of the cases were male, and the mean age was 38.9 (±15.5 years). Fifty-two percent of the individuals died from natural causes, including infections, and 48% died from injury-related events. In the natural deaths group, pulmonary complications were the most commonly reported cause of death by gross examination at autopsy, with suspected tuberculosis accounting for 12%. Tuberculosis (21, 8%) and liver disease (14, 5%) were the most common histopathological findings in the natural and injury-related causes groups, respectively. In the injury-related group, automobile accident was the most common cause of accidental death (80%), and homicide by beating was the most common cause of death in the intentional injury group (31%). These data provide valuable unbiased analyses of causes of death among individuals in Addis Ababa, Ethiopia. PMID:19321271

  4. Epidemiological characteristics of cases of death from tuberculosis and vulnerable territories1

    PubMed Central

    Yamamura, Mellina; Santos-Neto, Marcelino; dos Santos, Rebeca Augusto Neman; Garcia, Maria Concebida da Cunha; Nogueira, Jordana de Almeida; Arcêncio, Ricardo Alexandre

    2015-01-01

    Objective: to characterize the differences in the clinical and epidemiological profile of cases of death that had tuberculosis as an immediate or associated cause, and to analyze the spatial distribution of the cases of death from tuberculosis within the territories of Ribeirão Preto, Brazil. Method: an ecological study, in which the population consisted of 114 cases of death from tuberculosis. Bivariate analysis was carried out, as well as point density analysis, defined with the Kernel estimate. Results: of the cases of death from tuberculosis, 50 were the immediate cause and 64 an associated cause. Age (p=.008) and sector responsible for the death certificate (p=.003) were the variables that presented statistically significant associations with the cause of death. The spatial distribution, in both events, did not occur randomly, forming clusters in areas of the municipality. Conclusion: the difference in the profiles of the cases of death from tuberculosis, as a basic cause and as an associated cause, was governed by the age and the sector responsible for the completion of the death certificate. The non-randomness of the spatial distribution of the cases suggests areas that are vulnerable to these events. Knowing these areas can contribute to the choice of disease control strategies. PMID:26487142

  5. Cardiovascular causes of maternal sudden death. Sudden arrhythmic death syndrome is leading cause in UK.

    PubMed

    Krexi, Dimitra; Sheppard, Mary N

    2017-05-01

    This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature. Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically. The mean age was 30±7 years with a range from 16 to 43 years. About 30% were 35 years old or older; 50% of deaths occurred during pregnancy and 50% during the postpartum period. About 59.18% were obese or overweight where body mass index data were available. The leading causes of death were sudden arrhythmic death syndrome (SADS) (53.75%) and cardiomyopathies (13.80%). Other causes include dissection of aorta or its branches (8.75%), congenital heart disease (2.50%) and valvular disease (3.75%). This study highlights sudden cardiac death in pregnancy or in the postpartum period, which is mainly due to SADS with underlying channelopathies and cardiomyopathy. We wish to raise awareness of these frequently under-recognised entities in maternal deaths and the need of cardiological screening of the family as a result of the diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Cardiovascular causes of maternal sudden death. Sudden Arrhythmic Death Syndrome is leading cause in UK.

    PubMed

    Krexi, Dimitra; Sheppard, Mary N

    2017-09-01

    This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature. Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically. The mean age was 30±7years with a range from 16 to 43 years. About 30% were 35 years old or older; 50% of deaths occurred during pregnancy and 50% during the postpartum period. About 59.18% were obese or overweight where body mass index data were available. The leading causes of death were sudden arrhythmic death syndrome (SADS) (53.75%) and cardiomyopathies (13.80%). Other causes include dissection of aorta or its branches (8.75%), congenital heart disease (2.50%) and valvular disease (3.75%). This study highlights sudden cardiac death in pregnancy or in the postpartum period, which is mainly due to SADS with underlying channelopathies and cardiomyopathy. We wish to raise awareness of these frequently under-recognised entities in maternal deaths and the need of cardiological screening of the family as a result of the diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type

    PubMed Central

    Chammas, N. K.; Hill, R. L. R.; Edmonds, M. E.

    2016-01-01

    Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective study on DFU patients who attended King's College Hospital Foot Clinic and subsequently died. A control group of nonulcerated diabetic patients was matched for age and type of diabetes mellitus. The cause of death was identified from death certificates (DC) and postmortem (PM) examinations. There were 243 DFU patient deaths during this period. Ischaemic heart disease (IHD) was the major cause of death in 62.5% on PM compared to 45.7% on DC. Mean age at death from IHD on PM was 5 years lower in DFU patients compared to controls (68.2 ± 8.7 years versus 73.1 ± 8.0 years, P = 0.015). IHD as a cause of death at PM was significantly linked to neuropathic foot ulcers (OR 3.064, 95% CI 1.003–9.366, and P = 0.049). Conclusions. IHD is the major cause of premature mortality in DFU patients with the neuropathic foot ulcer patients being at a greater risk. PMID:27213157

  8. Cas A and the Crab were not stellar binaries at death

    NASA Astrophysics Data System (ADS)

    Kochanek, C. S.

    2018-01-01

    The majority of massive stars are in binaries, which implies that many core collapse supernovae should be binaries at the time of the explosion. Here we show that the three most recent, local (visual) SNe (the Crab, Cas A and SN 1987A) were not stellar binaries at death, with limits on the initial mass ratios of q = M2/M1 ≲ 0.1. No quantitative limits have previously been set for Cas A and the Crab, while for SN 1987A we merely updated existing limits in view of new estimates of the dust content. The lack of stellar companions to these three ccSNe implies a 90 per cent confidence upper limit on the q ≳ 0.1 binary fraction at death of fb < 44 per cent. In a passively evolving binary model (meaning no binary interactions), with a flat mass ratio distribution and a Salpeter IMF, the resulting 90 per cent confidence upper limit on the initial binary fraction of F < 63 per cent is in tension with observed massive binary statistics. Allowing a significant fraction fM ≃ 25 per cent of stellar binaries to merge reduces the tension, with F < 63({1-f}M)^{-1}{ per cent} ˜eq 81{ per cent}, but allowing for the significant fraction in higher order systems (triples, etc.) reintroduces the tension. That Cas A was not a stellar binary at death also shows that a surviving massive binary companion at the time of the explosion is not necessary for producing a Type IIb SNe. Much larger surveys for binary companions to Galactic SNe will become feasible with the release of the full Gaia proper motion and parallax catalogues providing a powerful probe of the statistics of such binaries and their role in massive star evolution, neutron star velocity distributions and runaway stars.

  9. Predicting Large-scale Effects During Cookoff of Plastic-Bonded Explosives (PBX 9501 PBX 9502 and LX-14)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hobbs, Michael L.; Kaneshige, Michael J.; Erikson, William W.

    In this study, we have made reasonable cookoff predictions of large-scale explosive systems by using pressure-dependent kinetics determined from small-scale experiments. Scale-up is determined by properly accounting for pressure generated from gaseous decomposition products and the volume that these reactive gases occupy, e.g. trapped within the explosive, the system, or vented. The pressure effect on the decomposition rates has been determined for different explosives by using both vented and sealed experiments at low densities. Low-density explosives are usually permeable to decomposition gases and can be used in both vented and sealed configurations to determine pressure-dependent reaction rates. In contrast, explosivesmore » that are near the theoretical maximum density (TMD) are not as permeable to decomposition gases, and pressure-dependent kinetics are difficult to determine. Ignition in explosives at high densities can be predicted by using pressure-dependent rates determined from the low-density experiments as long as gas volume changes associated with bulk thermal expansion are also considered. In the current work, cookoff of the plastic-bonded explosives PBX 9501 and PBX 9502 is reviewed and new experimental work on LX-14 is presented. Reactive gases are formed inside these heated explosives causing large internal pressures. The pressure is released differently for each of these explosives. For PBX 9501, permeability is increased and internal pressure is relieved as the nitroplasticizer melts and decomposes. Internal pressure in PBX 9502 is relieved as the material is damaged by cracks and spalling. For LX-14, internal pressure is not relieved until the explosive thermally ignites. The current paper is an extension of work presented at the 26th ICDERS symposium [1].« less

  10. Gastrointestinal causes of sudden unexpected death: A review.

    PubMed

    Menezes, Ritesh G; Ahmed, Saba; Pasha, Syed Bilal; Hussain, Syed Ather; Fatima, Huda; Kharoshah, Magdy A; Madadin, Mohammed

    2018-01-01

    Gastrointestinal conditions are a less common cause of sudden unexpected death when compared to other conditions such as cardiovascular conditions, but they are equally important. Various congenital and acquired gastrointestinal conditions that have resulted in sudden unexpected death are discussed. The possible lethal mechanisms behind each condition, along with any associated risk factors or secondary diseases, have been described. Through this article, we aim to highlight the need for physicians to prevent death in such conditions by ensuring that subclinical cases are diagnosed correctly before it is too late and by providing timely and efficacious treatment to the patient concerned. In addition, this review would certainly benefit the forensic pathologist while dealing with cases of sudden unexpected death due to gastrointestinal causes. This article is a review of the major gastrointestinal causes of sudden unexpected death. In addition, related fatal cases encountered occasionally in forensic autopsy practice are also included. There are several unusual and rare causes of life-threatening gastrointestinal bleeding that may lead to sudden unexpected death to cover all the entities in detail. Nevertheless, this article is a general guide to the topic of gastrointestinal causes of sudden unexpected death.

  11. A clinical comparison of penetrating and blunt traumatic brain injuries.

    PubMed

    Santiago, Luis A; Oh, Bryan C; Dash, Pramod K; Holcomb, John B; Wade, Charles E

    2012-01-01

    Traumatic brain injury (TBI) is a leading cause of injury death and long-term disability in the USA. It commonly results from blunt (closed) or penetrating trauma. The majority of civilian TBI is caused by falls or motor vehicle collisions, whereas military TBI mainly results from explosions. Although penetrating injuries are less common than closed injuries in the civilian population, they are far more lethal. Unfortunately, the pathophysiologic differences between penetrating and closed TBI remain poorly understood due to the lack of studies on the subject. Many studies on the prognostic factors of mortality and functional outcome after TBI exclude penetrating brain injuries from their series because they are believed to have a different pathophysiology. 125 Articles regarding brain injury were reviewed and summarized for this report. Despite the absence of a clear delineation between penetrating and blunt TBI, the current guidelines for penetrating TBI suggest defaulting to management strategies used for closed TBI with limited supportive evidence. Thus, injuries that appear to have different pathophysiologies and outcomes are managed equally and perhaps not optimally. In view of the incomplete understanding of the impact of mechanism of injury on TBI outcomes, as demonstrated in the current review, new research studies are required to improve evidence-based TBI guidelines tailored especially for penetrating injuries.

  12. Temporal trends in the leading causes of death among a large national cohort of patients with colorectal cancer from 1975 to 2009 in the United States.

    PubMed

    Tong, Liyue; Ahn, Chul; Symanski, Elaine; Lai, Dejian; Du, Xianglin L

    2014-06-01

    To assess the distribution of proportion of deaths from causes other than colorectal cancer (CRC) over time and temporal trends of cause-specific cumulative incidence of death due to six leading causes in patients with CRC. Overall, 375,462 patients with CRC in nine Surveillance, Epidemiology, and End Results registries from 1975 to 2009 were included. Competing risks proportional hazards regression was used to examine the effect of diagnostic periods on the risk of cause-specific death. From 1975 to 2009 by 5-year interval, the proportion of deaths from causes other than CRC increased significantly with diagnostic periods according to the lengths of follow-up (P < .0001). The 5-year risk of death significantly decreased with diagnostic periods for all-cause, CRC, and circulation diseases among all age groups (<65, 65-74, and ≥75 years) but increased for chronic obstructive pulmonary disease, diabetes, and Alzheimer disease among patients aged 65 years or older. Deaths due to causes other than CRC increased significantly over time regardless of tumor stage and site but more sharply in those with early-stage and distal colon cancer. The increasing leading causes of death are chronic obstructive pulmonary disease, diabetes, and Alzheimer disease, which may be prevented or delayed substantially by modification or intervention in lifestyle or other factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Causes and differentials of childhood mortality in Iraq

    PubMed Central

    Awqati, Naira A; Ali, Mohamed M; Al-Ward, Nada J; Majeed, Faiza A; Salman, Khawla; Al-Alak, Mahdi; Al-Gasseer, Naeema

    2009-01-01

    Background Limited information is available in Iraq regarding the causes of under-five mortality. The vital registration system is deficient in its coverage, particularly from rural areas where access to health services is limited and most deaths occur at home, i.e. outside the health system, and hence the cause of death goes unreported. Knowledge of patterns and trends in causes of under-five mortality is essential for decision-makers in assessing programmatic needs, prioritizing interventions, and monitoring progress. The aim of this study was to identify causes of under-five children deaths using a simplified verbal autopsy questionnaire. The objective was to define the leading symptoms and cause of death among Iraqi children from all regions of Iraq during 1994–1999. Methods To determine the cause structure of child deaths, a simplified verbal autopsy questionnaire was used in interviews conducted in the Iraqi Child & Maternal Mortality Survey (ICMMS) 1999 national sample. All the mothers/caregivers of the deceased children were asked open-ended questions about the symptoms within the two weeks preceding death; they could mention more than one symptom. Results The leading cause of death among under-five children was found to be childhood illnesses in 81.2%, followed by sudden death in 8.9% and accidents in 3.3%. Among under-five children dying of illnesses, cough and difficulty in breathing were the main symptoms preceding death in 34.0%, followed by diarrhea in 24.4%. Among neonates the leading cause was cough/and or difficulty in breathing in 42.3%, followed by sudden death in 11.9%, congenital abnormalities in 10.3% and prematurity in 10.2%. Diarrhea was the leading cause of death among infants in 49.8%, followed by cough and/or difficulty in breathing in 26.6%. Among children 12–59 months diarrhea was the leading cause of death in 43.4%, followed by accidents, injuries, and poisoning in 19.3%, then cough/difficulty in breathing in 14.8%. Conclusion In Iraq Under-five child mortality is one of the highest in the Middle East region; deaths during the neonatal period accounted for more than half of under-five children deaths highlighting an urgent need to introduce health interventions to improve essential neonatal care. Priority needs to be given to the prevention, early and effective treatment of neonatal conditions, diarrheal diseases, acute respiratory infections, and accidents. This study points to the need for further standardized assessments of under-5 mortality in Iraq. PMID:19545410

  14. The changing nature of death on the trauma service.

    PubMed

    Kahl, Jessica E; Calvo, Richard Y; Sise, Michael J; Sise, C Beth; Thorndike, Jonathan F; Shackford, Steven R

    2013-08-01

    Recent innovations in care have improved survival following injury. Coincidentally, the population of elderly injured patients with preexisting comorbidities has increased. We hypothesized that this increase in elderly injured patients may have combined with recent care innovations to alter the causes of death after trauma. We reviewed demographics, injury characteristics, and cause of death of in-hospital deaths of patients admitted to our Level I trauma service from 2000 through 2011. Cause of death was classified as acute hemorrhagic shock; severe traumatic brain injury or high spinal cord injury; complications of preexisting medical condition only (PM); survivable trauma combined with complications of preexisting medical condition (TCoM); multiple-organ failure, sepsis, or adult respiratory distress syndrome (MOF/S/ARDS), or trauma not otherwise categorized (e.g., asphyxiation). Major trauma care advances implemented on our service during the period were identified, and trends in the causes of death were analyzed. Of the 27,276 admissions, 819 (3%) eligible nonsurvivors were identified for the cause-of-death analyses. Causes of death were severe traumatic brain injury or high spinal cord injury at 44%, acute hemorrhagic shock at 28%, PM at 11%, TCoM at 10%, MOF/S/ARDS at 2%, and trauma not otherwise categorized at 5%. Mean age at death increased across the study interval (range, 47-57 years), while mean Injury Severity Score (ISS) decreased (range, 28-35). There was a significant increase in deaths because of TCoM (3.3-20.9%) and PM (6.7-16.4%), while deaths caused by MOF/S/ARDS decreased from 5% to 0% by 2007. Compared with year 2000, the annual adjusted mortality rate decreased consistently starting in 2009, after the 2002 to 2007 adoption of four major trauma practice guidelines. Mortality caused by preexisting medical conditions has increased, while markedly fewer deaths resulted from the complications of injury. Future improvements in outcomes will require improvement in the management of elderly trauma patients with comorbid conditions.

  15. Chemical, Biological, Radiological, Nuclear, and High-Yield Explosives Consequences Management

    DTIC Science & Technology

    2006-10-02

    cause three types of injuries: blast, thermal and radiation, as well as electromagnetic pulse (EMP) effects described further in a later section. (1...occur with conventional explosives and are further described in the next section. (2) Thermal injuries present as flash burns (burns from direct...exposure to the thermal radiation pulse, typically ultraviolet, visible, and infrared waves) or flame burns (burns from materials set afire by the infrared

  16. Bomb Detection System Study

    DTIC Science & Technology

    1965-01-01

    cause the reduction in vapor pressure. To determine whether an explosive can be detected thi ugh its * vapor, it is necessary to know the vapor pressures...Smokeless powders are explosives normally used in shotgun powders and can vary widely in composition. Nitrocellulose is the major :oomponent. Dinitrotoluene...will not be inclined to undertake the risky process except under very unusual circum- stances. Black powder is an obvious choice and has been so in

  17. Improving the Resiliency of the Natural Gas Supply and Distribution Network

    DTIC Science & Technology

    2007-03-01

    In 1977, an accident at a terminal in Algeria killed one person. Two years later, a leak at the LNG import terminal in Cove Point, Maryland...substation, where the gas ignited and caused an explosion. More recently, a boiler explosion killed twenty seven workers at a large LNG facility in...with 54 Alonzo Plough and Sheldon Krimsky, “The Emergence of Risk Communication Studies: Social and

  18. Thermal safety characterization on PETN, PBX-9407, LX-10-2, LX-17-1 and detonator in the LLNL's P-ODTX system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hsu, P. C.; Strout, S.; Reynolds, J. G.

    Incidents caused by fire and other thermal events can heat energetic materials that may lead to thermal explosion and result in structural damage and casualty. Thus, it is important to understand the response of energetic materials to thermal insults. The One-Dimensional-Time to Explosion (ODTX) system at the Lawrence Livermore National Laboratory (LLNL) has been used for decades to characterize thermal safety of energetic materials. In this study, an integration of a pressure monitoring element has been added into the ODTX system (P-ODTX) to perform thermal explosion (cook-off) experiments (thermal runaway) on PETN powder, PBX-9407, LX-10-2, LX-17-1, and detonator samples (cupmore » tests). The P-ODTX testing generates useful data (thermal explosion temperature, thermal explosion time, and gas pressures) to assist with the thermal safety assessment of relevant energetic materials and components. This report summarizes the results of P-ODTX experiments that were performed from May 2015 to July 2017. Recent upgrades to the data acquisition system allows for rapid pressure monitoring in microsecond intervals during thermal explosion. These pressure data are also included in the report.« less

  19. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.

    PubMed

    Lozano, Rafael; Naghavi, Mohsen; Foreman, Kyle; Lim, Stephen; Shibuya, Kenji; Aboyans, Victor; Abraham, Jerry; Adair, Timothy; Aggarwal, Rakesh; Ahn, Stephanie Y; Alvarado, Miriam; Anderson, H Ross; Anderson, Laurie M; Andrews, Kathryn G; Atkinson, Charles; Baddour, Larry M; Barker-Collo, Suzanne; Bartels, David H; Bell, Michelle L; Benjamin, Emelia J; Bennett, Derrick; Bhalla, Kavi; Bikbov, Boris; Bin Abdulhak, Aref; Birbeck, Gretchen; Blyth, Fiona; Bolliger, Ian; Boufous, Soufiane; Bucello, Chiara; Burch, Michael; Burney, Peter; Carapetis, Jonathan; Chen, Honglei; Chou, David; Chugh, Sumeet S; Coffeng, Luc E; Colan, Steven D; Colquhoun, Samantha; Colson, K Ellicott; Condon, John; Connor, Myles D; Cooper, Leslie T; Corriere, Matthew; Cortinovis, Monica; de Vaccaro, Karen Courville; Couser, William; Cowie, Benjamin C; Criqui, Michael H; Cross, Marita; Dabhadkar, Kaustubh C; Dahodwala, Nabila; De Leo, Diego; Degenhardt, Louisa; Delossantos, Allyne; Denenberg, Julie; Des Jarlais, Don C; Dharmaratne, Samath D; Dorsey, E Ray; Driscoll, Tim; Duber, Herbert; Ebel, Beth; Erwin, Patricia J; Espindola, Patricia; Ezzati, Majid; Feigin, Valery; Flaxman, Abraham D; Forouzanfar, Mohammad H; Fowkes, Francis Gerry R; Franklin, Richard; Fransen, Marlene; Freeman, Michael K; Gabriel, Sherine E; Gakidou, Emmanuela; Gaspari, Flavio; Gillum, Richard F; Gonzalez-Medina, Diego; Halasa, Yara A; Haring, Diana; Harrison, James E; Havmoeller, Rasmus; Hay, Roderick J; Hoen, Bruno; Hotez, Peter J; Hoy, Damian; Jacobsen, Kathryn H; James, Spencer L; Jasrasaria, Rashmi; Jayaraman, Sudha; Johns, Nicole; Karthikeyan, Ganesan; Kassebaum, Nicholas; Keren, Andre; Khoo, Jon-Paul; Knowlton, Lisa Marie; Kobusingye, Olive; Koranteng, Adofo; Krishnamurthi, Rita; Lipnick, Michael; Lipshultz, Steven E; Ohno, Summer Lockett; Mabweijano, Jacqueline; MacIntyre, Michael F; Mallinger, Leslie; March, Lyn; Marks, Guy B; Marks, Robin; Matsumori, Akira; Matzopoulos, Richard; Mayosi, Bongani M; McAnulty, John H; McDermott, Mary M; McGrath, John; Mensah, George A; Merriman, Tony R; Michaud, Catherine; Miller, Matthew; Miller, Ted R; Mock, Charles; Mocumbi, Ana Olga; Mokdad, Ali A; Moran, Andrew; Mulholland, Kim; Nair, M Nathan; Naldi, Luigi; Narayan, K M Venkat; Nasseri, Kiumarss; Norman, Paul; O'Donnell, Martin; Omer, Saad B; Ortblad, Katrina; Osborne, Richard; Ozgediz, Doruk; Pahari, Bishnu; Pandian, Jeyaraj Durai; Rivero, Andrea Panozo; Padilla, Rogelio Perez; Perez-Ruiz, Fernando; Perico, Norberto; Phillips, David; Pierce, Kelsey; Pope, C Arden; Porrini, Esteban; Pourmalek, Farshad; Raju, Murugesan; Ranganathan, Dharani; Rehm, Jürgen T; Rein, David B; Remuzzi, Guiseppe; Rivara, Frederick P; Roberts, Thomas; De León, Felipe Rodriguez; Rosenfeld, Lisa C; Rushton, Lesley; Sacco, Ralph L; Salomon, Joshua A; Sampson, Uchechukwu; Sanman, Ella; Schwebel, David C; Segui-Gomez, Maria; Shepard, Donald S; Singh, David; Singleton, Jessica; Sliwa, Karen; Smith, Emma; Steer, Andrew; Taylor, Jennifer A; Thomas, Bernadette; Tleyjeh, Imad M; Towbin, Jeffrey A; Truelsen, Thomas; Undurraga, Eduardo A; Venketasubramanian, N; Vijayakumar, Lakshmi; Vos, Theo; Wagner, Gregory R; Wang, Mengru; Wang, Wenzhi; Watt, Kerrianne; Weinstock, Martin A; Weintraub, Robert; Wilkinson, James D; Woolf, Anthony D; Wulf, Sarah; Yeh, Pon-Hsiu; Yip, Paul; Zabetian, Azadeh; Zheng, Zhi-Jie; Lopez, Alan D; Murray, Christopher J L; AlMazroa, Mohammad A; Memish, Ziad A

    2012-12-15

    Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. Bill & Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Thermal stability and kinetics of decomposition of ammonium nitrate in the presence of pyrite.

    PubMed

    Gunawan, Richard; Zhang, Dongke

    2009-06-15

    The interaction between ammonium nitrate based industrial explosives and pyrite-rich minerals in mining operations can lead to the occurrence of spontaneous explosion of the explosives. In an effort to provide a scientific basis for safe applications of industrial explosives in reactive mining grounds containing pyrite, ammonium nitrate decomposition, with and without the presence of pyrite, was studied using a simultaneous Differential Scanning Calorimetry and Thermogravimetric Analyser (DSC-TGA) and a gas-sealed isothermal reactor, respectively. The activation energy and the pre-exponential factor of ammonium nitrate decomposition were determined to be 102.6 kJ mol(-1) and 4.55 x 10(7)s(-1) without the presence of pyrite and 101.8 kJ mol(-1) and 2.57 x 10(9)s(-1) with the presence of pyrite. The kinetics of ammonium nitrate decomposition was then used to calculate the critical temperatures for ammonium nitrate decomposition with and without the presence of pyrite, based on the Frank-Kamenetskii model of thermal explosion. It was shown that the presence of pyrite reduces the temperature for, and accelerates the rate of, decomposition of ammonium nitrate. It was further shown that pyrite can significantly reduce the critical temperature of ammonium nitrate decomposition, causing undesired premature detonation of the explosives. The critical temperature also decreases with increasing diameter of the blast holes charged with the explosive. The concept of using the critical temperature as indication of the thermal stability of the explosives to evaluate the risk of spontaneous explosion was verified in the gas-sealed isothermal reactor experiments.

  1. Green primaries: Environmentally friendly energetic complexes

    PubMed Central

    Huynh, My Hang V.; Hiskey, Michael A.; Meyer, Thomas J.; Wetzler, Modi

    2006-01-01

    Primary explosives are used in small quantities to generate a detonation wave when subjected to a flame, heat, impact, electric spark, or friction. Detonation of the primary explosive initiates the secondary booster or main-charge explosive or propellant. Long-term use of lead azide and lead styphnate as primary explosives has resulted in lead contamination at artillery and firing ranges and become a major health hazard and environmental problem for both military and civilian personnel. Devices using lead primary explosives are manufactured by the tens of millions every year in the United States from primers for bullets to detonators for mining. Although substantial synthetic efforts have long been focused on the search for greener primary explosives, this unresolved problem has become a “holy grail” of energetic materials research. Existing candidates suffer from instability or excessive sensitivity, or they possess toxic metals or perchlorate. We report here four previously undescribed green primary explosives based on complex metal dianions and environmentally benign cations, (cat)2[MII(NT)4(H2O)2] (where cat is NH4+ or Na+, M is Fe2+ or Cu2+, and NT− is 5-nitrotetrazolato-N2). They are safer to prepare, handle, and transport than lead compounds, have comparable initiation efficiencies to lead azide, and offer rapid reliable detonation comparable with lead styphnate. Remarkably, they possess all current requirements for green primary explosives and are suitable to replace lead primary explosives in detonators. More importantly, they can be synthesized more safely, do not pose health risks to personnel, and cause much less pollution to the environment. PMID:16567623

  2. Deaths among women of reproductive age: a forensic autopsy study.

    PubMed

    Padubidri, Jagadish Rao; Menezes, Ritesh G; Pant, Sadip; Shetty, Soumya B

    2013-08-01

    Unnatural deaths in women of reproductive age (range 12-49 years) have a serious psychological and social impact on the family and community. Deaths among women of reproductive age reported as medico-legal cases were investigated to see the trend in terms of cause and manner of death. The study group consisted of a series of 328 consecutive forensic autopsies on women in the reproductive age group, performed between 2009 and 2011 at the Government Wenlock District Hospital, Mangalore, India by qualified specialist forensic medicine experts. Unnatural deaths formed 93.6% of the cohort. The top three causes of death included burns, poisoning and hanging forming 69.5% of the cases. The manner of death was suicide in 45.4% cases, accident in 43.6% cases and homicide in 4.6% cases. The circumstances of death were related to alleged medical negligence in 2.4% cases. Death in 4% cases was natural mannered with a disease being the cause of death. Three-fourths of the victims were married. Married women formed 63.1% of the suicidal victims. Homicidal deaths were not reported among unmarried women. The preponderant method of suicide was by poisoning at 42.3% (63 cases), followed by hanging (34.9%), burns (11.4%) and drowning (9.4%). These four methods comprised 98% of the total suicidal deaths in this study cohort. Accidental deaths were predominantly caused by burns (62.2%) and road traffic accident (23.1%). Two-thirds of the homicidal deaths were due to assault caused by blunt-force trauma, ligature strangulation and sharp-force trauma. One-third of the homicidal victims died due to burns. With a clear understanding of the cause and manner of death, it may be possible to predict, and hopefully prevent, future cases of unnatural deaths in women of reproductive age who form a very important group of society. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  3. [Study on the disease burden of Chinese adolescent in 2015].

    PubMed

    Xu, R B; Jin, D Y; Song, Y; Wang, X J; Dong, Y H; Yang, Z G; Chen, Y J; Ma, J

    2017-10-06

    Objective: To discuss the main causes and risk factors of disability and death among current Chinese adolescents. Methods: Subnational data of China from Global Burden of Disease Study 2015 (GBD 2015) was used to rank the causes and risk factors leading to death and disability adjusted life years (DALY) in Chinese adolescents aged between 10 and 19 years old, and thereby to analyze the main cauese and risk factors of death and DALY among Chinese adolescents in different genders. Results: In 2015, among Chinese adolescents aged 10-19 years old, the total DALY was 13 million 490 thousand years, and the total number of deaths was 63 258 cases. The top 3 causes of DALY were skin and subcutaneous diseases, iron-deficiency anemia and road injuries, resulting in DALY (constituent ratio) of 1 411 (10.5%), 1 094 (8.1%) and 1 029 (7.6%) thousand years respectively. The top 3 causes of death were road injuries, drowning and leukemia, causing 13 881 (21.9%), 9 895 (15.6%) and 4 620 (7.3%) deaths (constituent ratio) respectively. The top 3 risk factors of DALY were iron deficiency, alcohol use and drug use, causing 1 094 (8.1%), 487 (3.6%) and 220 thousand years (1.6%) DALY (constituent ratio) respectively. The top 3 risk factors of death were alcohol use, occupational injuries and drug use, causing 5 957 (9.4%), 1 523 (2.4%) and 810 (1.3%) deaths respectively. Conclusion: Unintentional injury was the top cause of DALY and death in Chinese adolescents, followed by skin and subcutaneous diseases and iron-deficiency anemia. Iron deficiency and alcohol use were the top two risk factors of DALY and death.

  4. [Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)].

    PubMed

    López, Cristina; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

    2016-04-01

    The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; P<.001) and higher mortality from NAEs (68% vs 45%; P=.006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p=001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P=.06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%; P=.001). Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. The extent and distribution of inequalities in childhood mortality by cause of death according to parental socioeconomic positions: a birth cohort study in South Korea.

    PubMed

    Kim, Jongoh; Son, Mia; Kawachi, Ichiro; Oh, Juhwan

    2009-10-01

    It has been shown that childhood mortality is affected by parental socioeconomic positions; in this article, we investigate the extent and distribution of inequalities across major causes of childhood death. We built a retrospective birth cohort using individually linked national birth and death records in South Korea. 1,329,540 children were followed up to exact age eight from 1995 to 1996 and total observed person-years were 10,594,168.18. Causes of death were identified from death records while parental education, occupation and birth characteristics were identified from birth records. Survival analysis was performed according to parental socioeconomic positions. Cox proportional hazard analysis was done according to parental education and occupation with adjustment of birth characteristics such as sex, parental age, gestational age, birth weight, multiple birth, the number of total births, and previous death of children. Cumulative incidence of mortality by age was obtained through a competing-risk method in each cause according to maternal education. From these results, distribution of inequalities across major causes of death was calculated. In total, 7018 deaths occurred during the eight years and mortality rate was 66.24 per 100,000 person-years. External cause was the most common cause of death followed by congenital malformations, nervous system diseases, perinatal diseases, cancer, respiratory, cardiovascular, infectious and gastrointestinal diseases. For all-cause mortality, hazard ratios (HR) were 1.98 (95% CI: 1.83-2.13) for paternal education, 1.90 (1.75-2.07) for maternal education, 1.40 (1.33-1.47) for paternal occupation and 2.33(1.98-2.73) for maternal occupation (between middle school graduation or lower and university or more for education, between manual and non-manual for occupation). Mortality differentials were found in every cause of death. External cause, respiratory, cardiovascular and infectious diseases showed larger HR than all-cause mortality: 2.20 (1.90-2.56), 2.87 (2.02-4.08), 2.50 (1.67-3.75) and 2.12 (1.43-3.15) respectively according to maternal education. On the contrary, congenital malformations and cancer had smaller HR than all-cause mortality: 1.49 (1.22-1.82) and 1.43 (1.00-2.05) respectively according to maternal education. In all-cause mortality and most of the causes, cumulative incidence of mortality increased rapidly until one or two years after birth and then slowed down. But in external cause and cancer, cumulative incidence of mortality accumulated at a constant pace. Thus, inequalities in these causes of death consistently widened. External cause was the leading cause of overall inequalities and its proportion was 36-42% followed by congenital malformations, respiratory diseases etc. We conclude that there were inequalities of childhood mortality in every major cause of death. External cause was the leading cause of both all-cause mortality and overall inequalities. Public health interventions to reduce inequalities are necessary and external cause should be primarily considered.

  6. Mortality from cardiovascular diseases in sub-Saharan Africa, 1990-2013: a systematic analysis of data from the Global Burden of Disease Study 2013.

    PubMed

    Mensah, George A; Roth, Gregory A; Sampson, Uchechukwu K A; Moran, Andrew E; Feigin, Valery L; Forouzanfar, Mohammed H; Naghavi, Mohsen; Murray, Christopher J L

    2015-01-01

    Cardiovascular disease (CVD) has been the leading cause of death in developed countries for most of the last century. Most CVD deaths, however, occur in low- and middle-income, developing countries (LMICs) and there is great concern that CVD mortality and burden are rapidly increasing in LMICs as a result of population growth, ageing and health transitions. In sub-Saharan Africa (SSA), where all countries are part of the LMICs, the pattern, magnitude and trends in CVD deaths remain incompletely understood, which limits formulation of data-driven regional and national health policies. The aim was to estimate the number of deaths, death rates, and their trends for CVD causes of death in SSA, by age and gender for 1990 and 2013. Age- and gender-specific mortality rates for CVD were estimated using the Global Burden of Disease (GBD) 2010 methods with some refinements made by the GBD 2013 study to improve accuracy. Cause of death was estimated as in the GBD 2010 study and updated with a verbal autopsy literature review and cause of death ensemble modelling (CODEm) estimation for causes with sufficient information. For all quantities reported, 95% uncertainty intervals (UIs) were also computed. In 2013, CVD caused nearly one million deaths in SSA, constituting 38.3% of non-communicable disease deaths and 11.3% of deaths from all causes in that region. SSA contributed 5.5% of global CVD deaths. There were more deaths in women (512,269) than in men (445,445) and more deaths from stroke (409,840) than ischaemic heart disease (258,939). Compared to 1990, the number of CVD deaths in SSA increased 81% in 2013. Deaths for all component CVDs also increased, ranging from a 7% increase in incidence of rheumatic heart disease to a 196% increase in atrial fibrillation. The age-standardised mortality rate (per 100,000) in 1990 was 327.6 (CI: 306.2-351.7) and 330.2 (CI: 312.9-360.0) in 2013, representing only a 1% increase in more than two decades. In SSA, CVDs are neither epidemic nor among the leading causes of death. However, a significant increase in the number of deaths from CVDs has occurred since 1990, largely as a result of population growth, ageing and epidemiological transition. Contrary to what has been observed in other world regions, the age-adjusted mortality rate for CVD has not declined. Another important difference in CVD deaths in SSA is the predominance of stroke as the leading cause of death. Attention to aggressive efforts in cardiovascular health promotion and CVD prevention, treatment and control in both men and women are warranted. Additionally, investments to improve directly enumerated epidemiological data for refining the quantitation of risk exposures, death certification and burden of disease assessment will be crucial.

  7. Unnatural deaths in Shanghai from 2000 to 2009: a retrospective study of forensic autopsy cases at the Shanghai Public Security Bureau.

    PubMed

    He, Meng; Fang, You-Xin; Lin, Jun-Yi; Ma, Kai-Jun; Li, Bei-Xu

    2015-01-01

    Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health.

  8. Unnatural Deaths in Shanghai from 2000 to 2009: A Retrospective Study of Forensic Autopsy Cases at the Shanghai Public Security Bureau

    PubMed Central

    Lin, Jun-Yi; Ma, Kai-Jun; Li, Bei-Xu

    2015-01-01

    Shanghai is the most developed city in China and has a soaring population. This study uses forensic epidemiology to determine the relationship between unnatural deaths and the development in Shanghai, based on recently released forensic autopsy cases from the 2000s at the Shanghai Public Security Bureau (SPSB). There were 5425 accidental deaths, 2696 homicides, 429 suicides, 186 natural deaths, and 1399 deaths of undetermined cause. There was a male-to-female ratio of 2.02:1, and the average age was 40.9±18.7 years. Traffic accidents (84.2%) were the number one cause of accidental deaths, which decreased during the study period. Sharp force injury (50.6%) was the leading cause of homicides, different from Western countries, where firearms are the leading cause. Hanging (24.5%) was the leading cause of suicides, whereas drug and chemical intoxication was the leading cause in the previous decade; pesticide ingestion decreased in the 2000s. In addition to traffic accidents, manual strangulation was the leading cause of death in childhood fatalities. Children under age 2 were vulnerable to homicides. In the 2000s, there were a large number of drug overdoses, and illegal medical practices and subway-related deaths first appeared in Shanghai. A new type of terrorist attack that involved injecting people with syringes in public places was reflected in the SPSB archives. The forensic epidemiology and changes in unnatural deaths in this decade reflected their relationship with the law, policy and changes in Shanghai. Illegal medical practices, subway-related deaths and terrorist attacks were closely related to the development in Shanghai. Identifying the risks of unnatural deaths will improve public health. PMID:26110435

  9. Mortality and causes of death in Jordan 1995-96: assessment by verbal autopsy.

    PubMed Central

    Khoury, S. A.; Massad, D.; Fardous, T.

    1999-01-01

    Mortality indicators and causes of death in Jordan were assessed by verbal autopsy. A random sample of 100 clusters of ca. 300 households each were monitored for one year by notification assistants selected from the study area itself. Registered deaths were reported to research assistants who visited the family to complete the verbal autopsy form, which was structured and contained about 100 questions. Causes of death were determined by two physicians according to preset algorithms. A total of 965 deaths were reported among 198,989 persons, giving a crude death rate of 5 per 1000 population per year. The three leading causes of death were diseases of the circulatory system, malignancies and accidents. In the absence of a health information system, verbal autopsy as implemented in Jordan can serve as a reliable substitute. PMID:10516786

  10. Prosperity as a cause of death.

    PubMed

    Eyer, J

    1977-01-01

    The general death rate rises during business booms and falls during depressions. The causes of death involved in this variation range from infectious diseases through accidents to heart disease, cancer, and cirrhosis of the liver, and include the great majority of all causes of death. Less than 2 percent of the death rate-that for suicide and homicide-varies directly with unemployment. In the older historical data, deterioration of housing and rise of alcohol consumption on the boom may account for part of this variation. In twentieth-century cycles, the role of social stress is probably predominant. Overwork and fragmentation of community through migration are two important sources of stress which rise with the boom, and they are demonstrably related to the causes of death which show this variation.

  11. Measuring chronic liver disease mortality using an expanded cause of death definition and medical records in Connecticut, 2004.

    PubMed

    Ly, Kathleen N; Speers, Suzanne; Klevens, R Monina; Barry, Vaughn; Vogt, Tara M

    2014-10-16

    Chronic liver disease (CLD) is a leading cause of death and is defined based on a specific set of underlying cause-of-death codes on death certificates. This conventional approach to measuring CLD mortality underestimates the true mortality burden because it does not consider certain CLD conditions like viral hepatitis and hepatocellular carcinoma. We measured how much the conventional CLD mortality case definition will underestimate CLD mortality and described the distribution of CLD etiologies in Connecticut. We used 2004 Connecticut death certificates to estimate CLD mortality two ways. One way used the conventional definition and the other used an expanded definition that included more conditions suggestive of CLD. We compared the number of deaths identified using this expanded definition with the number identified using the conventional definition. Medical records were reviewed to confirm CLD deaths. Connecticut had 29 314 registered deaths in 2004. Of these, 282 (1.0%) were CLD deaths identified by the conventional CLD definition while 616 (2.1%) were CLD deaths defined by the expanded definition. Medical record review confirmed that most deaths identified by the expanded definition were CLD-related (550/616); this suggested a 15.8 deaths/100 000 population mortality rate. Among deaths for which hepatitis B, hepatitis C and alcoholic liver disease were identified during medical record review, only 8.6%, 45.4% and 36.5%, respectively, had that specific cause-of-death code cited on the death certificate. An expanded CLD mortality case definition that incorporates multiple causes of death and additional CLD-related conditions will better estimate CLD mortality. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  12. Maternal and pregnancy-related death: causes and frequencies in an autopsy study population.

    PubMed

    Buschmann, Claas; Schmidbauer, Martina; Tsokos, Michael

    2013-09-01

    Maternal deaths during pregnancy, both from pregnancy-related or other causes, are rare in Western industrialized countries. In this study we report maternal and pregnancy-related deaths in a large autopsy population focusing on medical history, autopsy findings and histological examinations. Medico-legal autopsy files (n = 11,270) from the Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, and the State Institute of Legal and Social Medicine, Berlin, from 2005 to 2010 were reviewed. All female cases between 15 and 49 years were checked for maternal and pregnancy-related death, and deaths of pregnant women from non-natural causes were also included. Fatalities that met the chosen criteria were classified as "direct gestational death," "indirect gestational death" or "non-gestational death." 13 female fatalities (0.12 %) met the chosen criteria (median age 28 years ± 6.87 SD). Eight (61.5 %) women died in-hospital, four (30.8 %) at home, and one woman died in public. Three cases (23.1 %) were "non-gestational deaths," and one case (7.7 %) remained unclear after autopsy and additional examinations. Of the remaining nine cases, six cases (46.5 %) were "direct gestational deaths," and two cases (15.4 %) were "indirect gestational deaths." One case (7.7 %) was not to be defined as "late maternal death," but the cause of death seemed to be directly related to previous gestation ["(very) late maternal death"]. Maternal deaths during pregnancy, both from pregnancy-related or other causes, remain an uncommon event in routine forensic autopsy practice. We report on the collection and analysis of maternal and pregnancy-related deaths in a large autopsy population, with particular attention to the phenomenology of pregnancy, pathophysiological changes in different organ systems and their detection, and the forensic autopsy assessment.

  13. Cause of death and predictors of mortality in a community-based cohort of people with epilepsy.

    PubMed

    Keezer, Mark R; Bell, Gail S; Neligan, Aidan; Novy, Jan; Sander, Josemir W

    2016-02-23

    The risk of premature mortality is increased in people with epilepsy. The reasons for this and how it may relate to epilepsy etiology remain unclear. The National General Practice Study of Epilepsy is a prospective, community-based cohort that includes 558 people with recurrent unprovoked seizures of whom 34% died during almost 25 years of follow-up. We assessed the underlying and immediate causes of death and their relationship to epilepsy etiology. Psychiatric and somatic comorbidities of epilepsy as predictors of mortality were scrutinized using adjusted Cox proportional hazards models. The 3 most common underlying causes of death were noncerebral neoplasm, cardiovascular, and cerebrovascular disease, accounting for 59% (111/189) of deaths, while epilepsy-related causes (e.g., sudden unexplained death in epilepsy) accounted for 3% (6/189) of deaths. In 23% (43/189) of individuals, the underlying cause of death was directly related to the epilepsy etiology; this was significantly more likely if death occurred within 2 years of the index seizure (percent ratio 4.28 [95% confidence interval 2.63-6.97]). Specific comorbidities independently associated with increased risk of mortality were neoplasms (primary cerebral and noncerebral neoplasm), certain neurologic diseases, and substance abuse. Comorbid diseases are important causes of death, as well as predictors of premature mortality in epilepsy. There is an especially strong relationship between cause of death and epilepsy etiology in the first 2 years after the index seizure. Addressing these issues may help stem the tide of premature mortality in epilepsy. © 2016 American Academy of Neurology.

  14. Evaluation of the autopsy report before releasing musculoskeletal tissue donors; what is the benefit? EATB International Conference, October 17-20, Budapest, Hungary.

    PubMed

    Van Wijk, Marja J; Visser, Laura; Bokhorst, Arlinke G

    2008-12-01

    EU directive 2006/17/EC requires that all available medical information, including the autopsy report, is evaluated before releasing tissues for transplantation. The study objective was to investigate whether evaluation of autopsy results of musculoskeletal tissue donors contributes to safety and availability of transplantable tissues. The files of all donors of whom musculoskeletal tissues were retrieved by BIS in 2006 were reviewed for death cause and autopsy results. Of 84 donors musculoskeletal tissues were retrieved. In 47 donors autopsy was performed (56.0%). The groups with and without autopsy were similar in sex, age, length, and weight. In one donor no autopsy results were evaluated, since the donor was already rejected because of positive blood tests. In 13 donors (28.1%) death causes before autopsy were unknown. In 12 of these donors a death cause could be established after autopsy. In nine of the donors with a clear suspected death cause (27.3%), the death cause after autopsy differed from the suspected death cause. Four donors with autopsy (8.7%) had a general contraindication for donation, a (possible) sepsis in three and a persisting unknown death cause in one. Eight donors (17.4%) had musculoskeletal-specific contraindications, i.e. local infections. In conclusion, in 26.1% of the donors with autopsy, general or musculoskeletal-specific contraindications for donation were found. Furthermore, performance of autopsies enlarges the potential donor pool, since death causes can be established in almost all autopsies done in case of an unknown death cause. Therefore, evaluation of autopsy results improves the safety and quantity of tissues for transplantation.

  15. Cause-Specific Mortality Trends in a Large Population-Based Cohort With Long-Standing Childhood-Onset Type 1 Diabetes

    PubMed Central

    Secrest, Aaron M.; Becker, Dorothy J.; Kelsey, Sheryl F.; LaPorte, Ronald E.; Orchard, Trevor J.

    2010-01-01

    OBJECTIVE Little is known concerning the primary cause(s) of mortality in type 1 diabetes responsible for the excess mortality seen in this population. RESEARCH DESIGN AND METHODS The Allegheny County (Pennsylvania) childhood-onset (age <18 years) type 1 diabetes registry (n = 1,075) with diagnosis from 1965 to 1979 was used to explore patterns in cause-specific mortality. Cause of death was determined by a mortality classification committee of at least three physician epidemiologists, based on the death certificate and additional records surrounding the death. RESULTS Vital status for 1,043 (97%) participants was ascertained as of 1 January 2008, revealing 279 (26.0%) deaths overall (141 females and 138 males). Within the first 10 years after diagnosis, the leading cause of death was acute diabetes complications (73.6%), while during the next 10 years, deaths were nearly evenly attributed to acute (15%), cardiovascular (22%), renal (20%), or infectious (18%) causes. After 20 years' duration, chronic diabetes complications (cardiovascular, renal, or infectious) accounted for >70% of all deaths, with cardiovascular disease as the leading cause of death (40%). Women (P < 0.05) and African Americans (P < 0.001) have significantly higher diabetes-related mortality rates than men and Caucasians, respectively. Standardized mortality ratios (SMRs) for non–diabetes-related causes do not significantly differ from the general population (violent deaths: SMR 1.2, 95% CI 0.6–1.8; cancer: SMR 1.2, 0.5–2.0). CONCLUSIONS The excess mortality seen in type 1 diabetes is almost entirely related to diabetes and its comorbidities but varies by duration of diabetes and particularly affects women and African Americans. PMID:20739685

  16. Causes of death in long-term survivors of head and neck cancer.

    PubMed

    Baxi, Shrujal S; Pinheiro, Laura C; Patil, Sujata M; Pfister, David G; Oeffinger, Kevin C; Elkin, Elena B

    2014-05-15

    Survivors of head and neck squamous cell carcinoma (HNSCC) face excess mortality from multiple causes. We used the population-based Surveillance, Epidemiology, and End Results (SEER) cancer registry data to evaluate the causes of death in patients with nonmetastatic HNSCC diagnosed between 1992 and 2005 who survived at least 3 years from diagnosis (long-term survivors). We used competing-risks proportional hazards regression to estimate probabilities of death from causes: HNSCC, second primary malignancy (SPM) excluding HNSCC, cardiovascular disease, and other causes. We identified 35,958 three-year survivors of HNSCC with a median age at diagnosis of 60 years (range = 18-100 years) and a median follow-up of 7.7 years (range = 3-18 years). There were 13,120 deaths during the study period. Death from any cause at 5 and 10 years was 15.4% (95% confidence interval [CI] = 15.0%-15.8%) and 41.0% (95% CI = 40.4%-41.6%), respectively. There were 3852 HNSCC deaths including both primary and subsequent head and neck tumors. The risk of death from HNSCC was greater in patients with nasopharynx or hypopharynx cancer and in patients with locally advanced disease. SPM was the leading cause of non-HNSCC death, and the most common sites of SPM death were lung (53%), esophagus (10%), and colorectal (5%) cancer. Many long-term HNSCC survivors die from cancers other than HNSCC and from noncancer causes. Routine follow-up care for HNSCC survivors should expand beyond surveillance for recurrent and new head and neck cancers. © 2014 American Cancer Society.

  17. An evaluation of stillbirths in İstanbul by examining death certificates

    PubMed Central

    Yetim, Aylin; Buzcu, Fahriye Aysun; Devecioğlu, Esra; Gökçay, Gülbin; İnce, Zeynep

    2017-01-01

    Aim Despite the fact that the frequency of stillbirth is estimated to be about the same as that of early neonatal deaths, stillbirth records and statistics are not kept on a regular basis worldwide and their causes cannot be determined. The aim of our study was to examine the causes and characteristics of stillbirths in Istanbul. Material and Methods All death certificates of 2011 archived in 8 District Cemetery Directorships, which manage 322 cemeteries within the boundaries of Istanbul Metropolitan Municipality, were examined. Based on the burial licences, weight, gestational weeks, the main cause and causes of death related to stillbirth were analyzed. Cervical insufficieny, placenta abnormalities, preeclampsia, complications of multiple pregnancy, chronic diseases of mothers, conditions including malignancy in mothers were evaluated under the title of “maternal and gestational causes.” Intrapartum infections, meconium aspiration, and asphyxia were evaluated under the title of “perinatal causes.” Results A total of 2078 stillbirths and 128 abortus records were found among the death certificates. Nineteen of the abortus records and 109 stillbirths were misidentified. A total of 1988 stillbirth records were examined, of which 68.4% were low-birth-weight babies (<2 500 g). Approximately three quarters of the stillbirths were mild preterm and extremely preterm babies, whereas 10% were at or more than 37 gestastional weeks. The cause of death was not known in 30% of the stillbirths. Conclusions The cause of death was not known in a significant portion of stillbirths in Istanbul. Recordings should be made more meticulosuly directed to the cause of death. The cause of stillbirth in term babies is another research subject. Regional and global epidemiologic studies are needed to understand the causes of stillbirths and thus to take necessary precautions. PMID:28747840

  18. An evaluation of stillbirths in İstanbul by examining death certificates.

    PubMed

    Yetim, Aylin; Buzcu, Fahriye Aysun; Devecioğlu, Esra; Gökçay, Gülbin; İnce, Zeynep

    2017-06-01

    Despite the fact that the frequency of stillbirth is estimated to be about the same as that of early neonatal deaths, stillbirth records and statistics are not kept on a regular basis worldwide and their causes cannot be determined. The aim of our study was to examine the causes and characteristics of stillbirths in Istanbul. All death certificates of 2011 archived in 8 District Cemetery Directorships, which manage 322 cemeteries within the boundaries of Istanbul Metropolitan Municipality, were examined. Based on the burial licences, weight, gestational weeks, the main cause and causes of death related to stillbirth were analyzed. Cervical insufficieny, placenta abnormalities, preeclampsia, complications of multiple pregnancy, chronic diseases of mothers, conditions including malignancy in mothers were evaluated under the title of "maternal and gestational causes." Intrapartum infections, meconium aspiration, and asphyxia were evaluated under the title of "perinatal causes." A total of 2078 stillbirths and 128 abortus records were found among the death certificates. Nineteen of the abortus records and 109 stillbirths were misidentified. A total of 1988 stillbirth records were examined, of which 68.4% were low-birth-weight babies (<2 500 g). Approximately three quarters of the stillbirths were mild preterm and extremely preterm babies, whereas 10% were at or more than 37 gestastional weeks. The cause of death was not known in 30% of the stillbirths. The cause of death was not known in a significant portion of stillbirths in Istanbul. Recordings should be made more meticulosuly directed to the cause of death. The cause of stillbirth in term babies is another research subject. Regional and global epidemiologic studies are needed to understand the causes of stillbirths and thus to take necessary precautions.

  19. Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.

    PubMed

    Kyu, Hmwe H; Pinho, Christine; Wagner, Joseph A; Brown, Jonathan C; Bertozzi-Villa, Amelia; Charlson, Fiona J; Coffeng, Luc Edgar; Dandona, Lalit; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Fleming, Thomas D; Forouzanfar, Mohammad H; Graetz, Nicholas; Guinovart, Caterina; Haagsma, Juanita; Higashi, Hideki; Kassebaum, Nicholas J; Larson, Heidi J; Lim, Stephen S; Mokdad, Ali H; Moradi-Lakeh, Maziar; Odell, Shaun V; Roth, Gregory A; Serina, Peter T; Stanaway, Jeffrey D; Misganaw, Awoke; Whiteford, Harvey A; Wolock, Timothy M; Wulf Hanson, Sarah; Abd-Allah, Foad; Abera, Semaw Ferede; Abu-Raddad, Laith J; AlBuhairan, Fadia S; Amare, Azmeraw T; Antonio, Carl Abelardo T; Artaman, Al; Barker-Collo, Suzanne L; Barrero, Lope H; Benjet, Corina; Bensenor, Isabela M; Bhutta, Zulfiqar A; Bikbov, Boris; Brazinova, Alexandra; Campos-Nonato, Ismael; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Chowdhury, Rajiv; Cooper, Cyrus; Crump, John A; Dandona, Rakhi; Degenhardt, Louisa; Dellavalle, Robert P; Dharmaratne, Samath D; Faraon, Emerito Jose A; Feigin, Valery L; Fürst, Thomas; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Goto, Atsushi; Gunnell, David; Hankey, Graeme J; Hay, Roderick J; Hornberger, John C; Hosgood, H Dean; Hu, Guoqing; Jacobsen, Kathryn H; Jayaraman, Sudha P; Jeemon, Panniyammakal; Jonas, Jost B; Karch, André; Kim, Daniel; Kim, Sungroul; Kokubo, Yoshihiro; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kumar, G Anil; Larsson, Anders; Leasher, Janet L; Leung, Ricky; Li, Yongmei; Lipshultz, Steven E; Lopez, Alan D; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan A; Majdan, Marek; Malekzadeh, Reza; Mashal, Taufiq; Mason-Jones, Amanda J; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Miller, Ted R; Mock, Charles N; Murray, Joseph; Nolte, Sandra; Oh, In-Hwan; Olusanya, Bolajoko Olubukunola; Ortblad, Katrina F; Park, Eun-Kee; Paternina Caicedo, Angel J; Patten, Scott B; Patton, George C; Pereira, David M; Perico, Norberto; Piel, Frédéric B; Polinder, Suzanne; Popova, Svetlana; Pourmalek, Farshad; Quistberg, D Alex; Remuzzi, Giuseppe; Rodriguez, Alina; Rojas-Rueda, David; Rothenbacher, Dietrich; Rothstein, David H; Sanabria, Juan; Santos, Itamar S; Schwebel, David C; Sepanlou, Sadaf G; Shaheen, Amira; Shiri, Rahman; Shiue, Ivy; Skirbekk, Vegard; Sliwa, Karen; Sreeramareddy, Chandrashekhar T; Stein, Dan J; Steiner, Timothy J; Stovner, Lars Jacob; Sykes, Bryan L; Tabb, Karen M; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Towbin, Jeffrey Allen; Ukwaja, Kingsley Nnanna; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wilkinson, James D; Woldeyohannes, Solomon Meseret; Wolfe, Charles D A; Yano, Yuichiro; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; El Sayed Zaki, Maysaa; Naghavi, Mohsen; Murray, Christopher J L; Vos, Theo

    2016-03-01

    The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce. To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study. Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14,244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35,620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates. Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905.059 deaths; 95% UI, 810,304-998,125), diarrheal diseases among older children (38,325 deaths; 95% UI, 30,365-47,678), and road injuries among adolescents (115,186 deaths; 95% UI, 105,185-124,870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the world's deaths from neonatal encephalopathy. Half of the world's diarrheal deaths among children and adolescents occurred in just 5 countries: India, Democratic Republic of the Congo, Pakistan, Nigeria, and Ethiopia. Understanding the levels and trends of the leading causes of death and disability among children and adolescents is critical to guide investment and inform policies. Monitoring these trends over time is also key to understanding where interventions are having an impact. Proven interventions exist to prevent or treat the leading causes of unnecessary death and disability among children and adolescents. The findings presented here show that these are underused and give guidance to policy makers in countries where more attention is needed.

  20. Influence of Axisymmetrically Deformed Explosions in Type II Supernovae on the Reproduction of the Solar System Abundances

    NASA Astrophysics Data System (ADS)

    Nagataki, Shigehiro

    1999-01-01

    We have tried to reproduce the solar system abundances using the nucleosynthesis products of Type Ia and Type II supernovae. In particular, we examined the effects of axisymmetrically deformed explosions in Type II supernovae. 44Ca and 47,48Ti are enhanced considerably in axisymmetrically deformed explosion models because of the active alpha-rich freezeout. The enhancement of nuclei around A=45 is a welcome result since it solves the problem of the nuclei shortage. Moreover, 59Co, 63,65Cu, and 66Zn are enhanced enough to reproduce the solar system abundances. The enhancement of Cu and Zn means the possibility that these nuclei, which have been said to be produced by the slow process, can be synthesized fairly well during the explosive nucleosynthesis. To discuss their origin quantitatively, the position of the mass cut is a very important parameter that is very difficult to determine numerically at present. We also stress that an axisymmetrically deformed explosion of Type II supernovae of the degree that is considered in this analysis is not excluded by the results of calculations of explosive nucleosynthesis, that is, the nucleosynthesis products are not extremely disturbed and the solar system abundances can be reproduced fairly well by the axisymmetrically deformed explosion models. This conclusion will be good for the theory of core collapse including the rotation of an iron core, magnetic field, and axisymmetrically modified neutrino radiation from a rotating protoneutron star, which possibly can cause an axisymmetrically deformed explosion.

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