The Coronavirus Disease 2019 (COVID-19) pandemic negatively impacted global healthcare. Consequences in Pediatric and Congenital Heart Surgery programmes and mortality of congenital heart patients ...infected with severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) is still to be determined.
To study the COVID-19 pandemic implications in Brazilian Pediatric and Congenital Heart Surgery programmes.
We conducted a national online survey covering all states that perform Pediatric and Congenital Heart Surgery from 10 November to 22 November, 2020, using a Google forms questionnaire. We formulated questions related to impact on surgical volume, case-mix, and mortality. Then we asked about short-term post-operative COVID-19 infection and outcomes.
We received responses from 46 centres representing all states where there were a Pediatric and Congenital Heart Surgery programme and all high-volume centres across the country. All but one centre experienced a significant decrease in surgical volume, and 23.9% of the responders revealed less than one-quarter of volume decrement. On the other hand, in over 70% of the centres, there was a significant surgical volume reduction. In addition to this, there was a shift in case-mix in 41 centres (89.1%) towards more complex cases. More than one-third of the responders revealed increased mortality in 2020 compared to previous years, and 43.5% of the programmes (20 centres) had at least one patient contaminated by SARS-Cov-2, accounting for 48 patients. Mortality in post-operative infected patients was 45.8% (22 patients).
In general, Brazilian Pediatric and Congenital Heart Surgery programmes were severely affected by decreased surgical volume, unbalanced case-mix towards more complex cases, and increased mortality. Almost half of the programmes related post-operative COVID-19 contamination with high mortality.
The rising popularity of e-scooters in urban areas highlights the importance of understanding potential collision dynamics and consequences to enhance rider safety, especially since 80% of fatalities ...for these vulnerable road users result from incidents involving motor vehicles. This study aims to identify potential injury mechanisms of e-scooter riders involved in frontal impacts against Sports Utility Vehicles (SUVs) using Finite Element Analysis (FEA) and a Human Body Model (HBM). Six impact scenarios at 25 km/h were simulated: on the passenger's side door (1-SD), on the trunk door (2-TD), on the bonnet (3-FB), on the bonnet from the side (4-SB), on the windshield from the side (5-SW), and finally, on the bonnet with an offset (6-FO). A wide range of Injury Risk Criteria (IRCs) was analyzed, including A3MS, HIC15, BrIC, DAMAGE, Cmax and PC Score, and head contact forces were output. Injury Risk Curves were then used to calculate the probability and severity of the sustained injuries predicted by the mentioned IRCs. Overall, the results corresponding to the most injurious scenarios suggested serious (30% to 40% overall probability) and critical (45% probability for the 4-SB scenario) brain, moderate head (30% probability for scenarios 1-SD and 2-TD), and serious thoracic (26% to 78% overall probability) injuries. Additionally, in two scenarios (1-SD and 2-TD), the e-scooter rider's mandible impacted against the vehicle's roof side rail and rear spoiler, involving potential anterior-posterior serious mandible fractures. The conclusions reached in this study help to understand potential injury sources and provide valuable information for the design of specific safety systems or the creation or improvement of e-scooter legislation.
•Novel insight into e-scooter rider injuries.•Six comprehensive simulation scenarios of impacts between e-scooter and SUVs.•In-depth injury risk analysis in brain, head, thorax and face regions.•Insight into e-scooter injury mechanisms for the design of specific safety systems or modification of current legislation.
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