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This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes).
Methods
A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed.
Results
The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study’s location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent.
Conclusions
Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.
Members of the genus Maritrema Nicoll, 1907 include endoparasites of aquatic birds and mammals, distributed worldwide. Adult specimens were collected from the intestines of three bird species (the great black hawks, Buteogallus urubitinga Gmelin; laughing gull, Leucophaeus atricilla Linnaeus; and the willet, Tringa semipalmata Gmelin) in three localities along the Gulf of Mexico. Photogenophores were sequenced for the large subunit (LSU) from nuclear rDNA, and the new sequences were aligned with other microphalloid sequences available in GenBank. The maximum likelihood and Bayesian inference analyses revealed three independent lineages, one corresponding to a previously described species, Maritrema corai Hernández-Orts, Pinacho-Pinacho, García-Varela & Kostadinova, 2016, and two representing two undescribed species. These two new species are described in the current study. Maritrema itzamnai n. sp. can be morphologically differentiated from its four congeneric species occurring in coastal areas of Mexico by having smaller oral (20–29 × 20–38 μm) and ventral (20–39 × 19–33 μm) suckers. In addition, Maritrema itzamnai n. sp. possess annular vitellarium instead of a horseshoe-shaped vitellarium. Maritrema kukulkanni n. sp. can be distinguished from its congeneric species reported from Mexico by possessing a larger oesophagus (44–117μm) and by having a vitellarium distributed in both the hindbody and forebody. Maritrema corai is the third species recorded in this study parasitizing the great black hawk (Buteogallus urubitinga); this represents a new host and locality record, expanding its distribution range from the Mexican Pacific Ocean to the Gulf of Mexico.
Fluorescence correlation spectroscopy (FCS) is a well-known and established non-invasive method for quantification of physical parameters that preside over molecular mechanisms and dynamics. It combines maximum sensitivity and statistical confidence for the analysis of speed, size, and number of fluorescent molecules and interactions with surrounding molecules by time-averaging fluctuation analysis in a well-defined volume element. The narrow compass of this study is to acquaint the basic principle of diffusion and the FCS method in general regarding variable magnitudes and standardization adjustment. In this review, we give a theoretical introduction, examples of experimental applications, and utensils in solution systems with future perspectives.
Slum clearances expose hostility between municipal authorities and residents fighting to claim urban space. In colonial contexts, these processes created conflicts between rulers and the ruled. Focusing on the ‘semi-colonial’ Shanghai International Settlement, this article examines interactions between the Shanghai Municipal Police (SMP) and slum-dwellers amid an evolving crisis of urban governance in the 1930s. This case-study, grounded in Shanghai’s complex socio-political climate, reveals how ordinary Chinese residents negotiated with the authorities and points to the frailties of semi-colonial governance, showing how the SMP deployed coercion only when it was unavoidable in slum clearances.
There is an increasing emphasis worldwide on breeding wheat cultivars with higher biomass and grain yield, whilst reducing excessive input of N fertilizers. Modern plant breeding has narrowed the genetic base of bread wheat, so exploring new sources of genetic variation for leaf photosynthesis traits and biomass to underpin grain yield improvement has become necessary. Our objectives were to quantify the genetic variability in a range of landrace-derived lines and elite bread wheat genotypes in flag-leaf photosynthesis traits, biomass and N-use efficiency for potential application in pre-breeding. Sixteen bread wheat genotypes including elite spring wheat cultivar Paragon × landrace crosses were tested in two field experiments in the UK. Averaging across years, pre-anthesis flag-leaf photosynthesis rate ranged amongst genotypes from 26.0 to 31.5 μmol/m2/s (P < 0.001) and post-anthesis from 14.2 to 18.6 μmol/m2/s (P < 0.001). Two landrace-derived lines had greater post-anthesis flag-leaf photosynthesis rate (P < 0.001) than their elite parent Paragon. There was a trend for a positive correlation among genotypes between post-anthesis flag-leaf photosynthesis rate and biomass (r = 0.47, P = 0.06). Two landrace derivatives showed higher post-anthesis flag-leaf stomatal conductance than Paragon. Our results indicated that introgression of traits from wider germplasm into elite UK modern wheat germplasm offers scope to raise flag-leaf photosynthetic rate and biomass.
The possibilities for limit functions on a Fatou component for the iteration of a single polynomial or rational function are well understood and quite restricted. In non-autonomous iteration, where one considers compositions of arbitrary polynomials with suitably bounded degrees and coefficients, one should observe a far greater range of behavior. We show this is indeed the case and we exhibit a bounded sequence of quadratic polynomials which has a bounded Fatou component on which one obtains as limit functions every member of the classical Schlicht family of normalized univalent functions on the unit disc. The proof is based on quasiconformal surgery and the use of high iterates of a quadratic polynomial with a Siegel disc which closely approximate the identity on compact subsets. Careful bookkeeping using the hyperbolic metric is required to control the errors in approximating the desired limit functions and ensure that these errors ultimately tend to zero.
Following a disaster, a pseudo-epidemic can occur due to redundant and duplicated data caused by infrastructure and information system disruptions. This study aims to investigate whether there have been improvements the post-disaster surveillance system in the comparison of diarrhea incidents between Central Sulawesi, Indonesia, and Cianjur, West Java, Indonesia.
Methods
We conducted an analysis of the epidemic-prone disease diarrhea before and during disasters, comparing the data with secondary data from the Early Warning Alert and Response System (EWARS) and the District Health Information System V.02 (DHIS-2).
Results
In central Sulawesi in 2018 and Cianjur in 2022, we observed an upsurge in diarrhea cases in the first week after the disaster. Although diarrhea cases increased after the disaster, they remained within acceptable outbreak criteria. Multiplication and redundant data were detected in the DHIS-2 system in Central Sulawesi, likely leading to erroneous overreporting. Changes in surveillance officers and their personal experiences during the disaster contributed to data inconsistencies. As compared to Central Sulawesi, the DHIS-2 reporting form in Cianjur was simplified as an individual form to enhance efficiency and accuracy.
Conclusions
Enhancing valid assessment and conducting thorough investigations are essential to improve surveillance protocols for epidemic-prone diseases following disasters.
Charities play a pivotal role in engaging the public in emergency management efforts. They serve to complement governmental restrictions by leveraging social resources to aid in emergency management. The involvement of charities in emergency management is likely to shape public attitudes, thereby influencing their effectiveness in this sphere. Therefore, understanding the factors that influence public attitudes toward charities in emergency management is crucial. This study sought to identify these key factors and offer recommendations for charities to enhance their participation in emergency management. The data for this study were collected from messages and comments on two prominent instant messaging platforms, WeChat Public and Sina Weibo. Content Analysis was employed to categorize the data, and the Apriori algorithm was utilized to uncover association rules and key factors. Based on the key factors, it is recommended that charities focus on collaborating with celebrities and enterprises, prioritize establishing and upholding a positive reputation, and enhance their expertise in emergency management practices.
The debate over context and neural function pits contextualists, who maintain that neural functions vary by context, against invariantists, who maintain that they do not. In this article, I defend a moderate position that permits some context sensitive yet invariant functions. I distinguish performance from competence as well as different types of contexts, accounting for many cases of variability by context. The discussion suggests changes in networks can sometimes change the competences of parts. I conclude that some context sensitivity of function is consistent with invariant functions whereas other changes in context imply changes in the competence to perform functions.
Paranosema locustae is an environmentally friendly parasitic predator with promising applications in locust control. In this study, transcriptome sequencing was conducted on gonadal tissues of Locusta migratoria males and females infected and uninfected with P. locustae at different developmental stages. A total of 18,635 differentially expressed genes (DEGs) were identified in female ovary tissue transcriptomes, with the highest number of DEGs observed at 1 day post-eclosion (7141). In male testis tissue transcriptomes, a total of 32,954 DEGs were identified, with the highest number observed at 9 days post-eclosion (11,245). Venn analysis revealed 25 common DEGs among female groups and 205 common DEGs among male groups. Gene ontology and Kyoto Encyclopaedia of Genes and Genome analyses indicated that DEGs were mainly enriched in basic metabolism such as amino acid metabolism, carbohydrate metabolism, lipid metabolism, and immune response processes. Protein–protein interaction analysis results indicated that L. migratoria regulates the expression of immune- and reproductive-related genes to meet the body's demands in different developmental stages after P. locustae infection. Immune- and reproductive-related genes in L. migratoria gonadal tissue were screened based on database annotation information and relevant literature. Genes such as Tsf, Hex1, Apolp-III, Serpin, Defense, Hsp70, Hsp90, JHBP, JHE, JHEH1, JHAMT, and VgR play important roles in the balance between immune response and reproduction in gonadal tissues. For transcriptome validation, Tsf, Hex1, and ApoLp-III were selected and verified by quantitative real-time polymerase chain reaction (qRT-PCR). Correlation analysis revealed that the qRT-PCR expression patterns were consistent with the RNA-Seq results. These findings contribute to further understanding the interaction mechanisms between locusts and P. locustae.
Selenium (Se) deficiency among populations in Ethiopia is consistent with low concentrations of Se in soil and crops that could be addressed partly by Se-enriched fertilisers. This study examines the disease burden of Se deficiency in Ethiopia and evaluates the cost-effectiveness of Se agronomic biofortification. A disability-adjusted life years (DALY) framework was used, considering goiter, anaemia, and cognitive dysfunction among children and women. The potential efficiency of Se agronomic biofortification was calculated from baseline crop composition and response to Se fertilisers based on an application of 10 g/ha Se fertiliser under optimistic and pessimistic scenarios. The calculated cost per DALY was compared against gross domestic product (GDP; below 1–3 times national GDP) to consider as a cost-effective intervention. The existing national food basket supplies a total of 28·2 µg of Se for adults and 11·3 µg of Se for children, where the risk of inadequate dietary Se reaches 99·1 %–100 %. Cereals account for 61 % of the dietary Se supply. Human Se deficiency contributes to 0·164 million DALYs among children and women. Hence, 52 %, 43 %, and 5 % of the DALYs lost are attributed to anaemia, goiter, and cognitive dysfunction, respectively. Application of Se fertilisers to soils could avert an estimated 21·2–67·1 %, 26·6–67·5 % and 19·9–66·1 % of DALY via maize, teff and wheat at a cost of US$129·6–226·0, US$149·6–209·1 and US$99·3–181·6, respectively. Soil Se fertilisation of cereals could therefore be a cost-effective strategy to help alleviate Se deficiency in Ethiopia, with precedents in Finland.
This position paper highlights the dire impacts of environmental and household air pollution, which were responsible for 6.7 million deaths globally in 2019. These deaths occurred predominantly in low- and middle-income countries, with Afghanistan reporting the highest age-adjusted mortality rate. The situation worsens during large-scale disasters like earthquakes, which release more pollutants into the air, exacerbating health risks and leading to severe conditions such as pulmonary diseases. Because political factors may hinder foreign NGOs and similar organizations from providing direct support, the frequent occurrence of earthquakes in Afghanistan underscores the critical need for emergency response training for local residents. Consequently, it is essential to provide ERT training, including the proper use of protective equipment, to local populations as well as disseminating risk communication through online technologies and other appropriate means.
We investigate self-excited axisymmetric oscillations of a lean premixed methane–air V-flame in a laminar annular jet. The flame is anchored near the rim of the centrebody, forming an inverted cone, while the strongest vorticity is concentrated along the outer shear layer of the annular jet. Consequently, the reaction and vorticity dynamics are largely separated, except where they coalesce near the flame tip. The global eigenmodes corresponding to the linearised reacting flow equations around the steady base state are computed in an axisymmetric setting. We identify an arc branch of eigenmodes exhibiting strong oscillations at the flame tip. The associated eigenvalues are robust with respect to domain truncation and numerical discretisation, and they become destabilised as the Reynolds number increases. The frequency of the leading eigenmode is found to correspond to the Lagrangian disturbance advection time from the nozzle outlet to the flame tip. The essential role of this convective mechanism is also supported by resolvent analysis, which finds that the same flame-tip disturbance structure and frequency are optimally amplified when the flame is subjected to external white noise forcing. Strong non-modal effects in the form of pseudo-resonance are not found. Nonlinear time-resolved simulation further reveals notable hysteresis phenomena in the subcritical regime prior to instability. Hence, even when the flame is linearly stable, perturbations of sufficient amplitude can trigger limit-cycle oscillations and higher-dimensional dynamics sustained by nonlinear feedback. A Monte Carlo simulation of passive tracers in the unsteady flame suggests a nonlinear non-local instability mechanism. Notably, linear analysis of the subcritical time-averaged limit-cycle state yields eigenvalues that do not match the nonlinear periodic oscillation frequencies. This mismatch is attributed to the fundamentally nonlinear dynamics of the subcritical V-flame instability, where the dichromatic, non-local interaction between the heat release rate along the flame surface and the vortex dynamics in the jet shear layer cannot be approximated as a simple distortion of the mean flow.
Public Health is essential to disaster preparedness, mitigation, response, and recovery. This has never been more evident than during the COVID-19 pandemic when public health was the disaster response lead. However, students are graduating from accredited schools and colleges of public health with limited or no education in disaster management. This is a crisis unto itself, and it is incumbent upon The Council on Education for Public Health (CEPH) to take immediate action. Public health preparedness should be recognized as a core element in public health curricula, and practical experiences, such as drills and simulations, are necessary to equip students with the confidence and competencies needed in high-stress situations. The need for such preparedness education extends beyond the COVID-19 pandemic. It is a crucial step for creating a resilient and competent public health workforce capable of safeguarding community health in the face of complex and emerging challenges.