Abstract

A retrospective review of the literature was performed to determine the natural history, prevalence, prognosis and management of adrenal injury associated with blunt abdominal trauma in pediatric population. Blunt adrenal injury in children is uncommon, rarely isolated, and typically present as part of a multi organ trauma. Adrenal hemorrhage is being diagnosed more frequently since the emergence of computed tomography in modern emergency rooms. Obstetric birth trauma during vaginal delivery of a macrosomic fetus may result in neonatal adrenal hemorrhage. In children appear to be an incidental finding that resolves on follow-up imaging. Most of these injuries are self-limited and do not require intervention. The differential diagnosis of an adrenal neoplasm, especially in children with an isolated adrenal hemorrhage, must be considered. The presence of adrenal hemorrhage in the absence of a trauma history should alert to the possibility of pediatric inflicted injury.

Abstract

KGUNGOR, ALI PAYIDAR/0000-0003-0669-5715; DOGAN, Erdem/0000-0001-7802-641X WOS: 000267724800007 This study proposes an Artificial Neural Network (ANN) model and a Genetic Algorithm (GA) model to estimate the number of accidents (A), fatalities (F) and injuries (I) in Ankara, Turkey, utilizing the data obtained between 1986 and 2005. For model development, the number of vehicles (N), fatalities, injuries, accidents and population (P) were selected as model parameters. In the ANN model, the sigmoid and linear functions were used as activation functions with the feed forward-back propagation algorithm. In the GA approach, two forms of genetic algorithm models including a linear and an exponential form of mathematical expressions were developed. The results of the GA model showed that the exponential model form was suitable to estimate the number of accidents and fatalities while the linear form was the most appropriate for predicting the number of injuries. The best fit model with the lowest mean absolute errors (MAE) between the observed and estimated values is selected for future estimations. The comparison of the model results indicated that the performance of the ANN model was better than that of the GA model. To investigate the performance of the ANN model for future estimations, a fifteen year period from 2006 to 2020 with two possible scenarios was employed. In the first scenario, the annual average growth rates of population and the number of vehicles are assumed to be 2.0 % and 7.5%, respectively. In the second scenario, the average number of vehicles per capita is assumed to reach 0.60, which represents approximately two and a half-fold increase in fifteen years. The results obtained from both scenarios reveal the suitability of the current methods for road safety applications.

Abstract

Road Traffic Crashes (RTCs) are the third highest cause of death in Zambia, claiming about 2000 lives annually, with pedestrians and cyclists being the most vulnerable. Human error accounts for 87.3% of RTCs. Minibus and big bus public service vehicles (PSVs) are among the common vehicle types involved in these crashes. Given the alarmingly high rate of road traffic crashes involving PSV minibuses and big buses within Zambia, there is a need to mitigate this through innovative solutions. In other settings, it has been shown that stickers in PSVs encouraging passengers to speak out against reckless driving can reduce RTCs, but it is unclear whether such an intervention could work in Zambia. Based on this evidence, the Zambia Road Transport and Safety Agency (RTSA) has developed a road safety bus sticker campaign for PSVs and before national scale-up, RTSA is interested in evidence of the impact of these stickers. This evaluation will be a stratified two-arm randomized controlled trial with a one-to-one ratio. The sample will be stratified by vehicle type, thus creating a two-arm trial for minibuses and a separate two-arm trial for big buses. The sample will include 2110 minibuses and 300 big buses from four towns in Zambia. The primary outcome of interest will be the difference in the rate of RTCs over a 14-month period (7-months before the intervention and 7 months after) between buses with and without the new RTSA road safety bus stickers. This study will provide evidence on the impact of the Zambian sticker program on road traffic crashes as implemented through minibuses and big buses, that can help inform the scale up of a national ‘Zambia road safety bus sticker campaign’. PACT-R, PACTR201711002758216 . Registered 13 November 2017-Retrospectively registered. Document type: Article