Suchergebnisse

Free-text information is still widely used in emergency department (ED) records. Machine learning techniques are useful for analyzing narratives, but they have been used mostly for English-language data sets. Considering such a framework, the performance of an ML classification task of a Spanish-language ED visits database was tested. ED visits collected in the EDs of nine hospitals in Nicaragua were analyzed. Spanish-language, free-text discharge diagnoses were considered in the analysis. Five-hundred random forests were trained on a set of bootstrap samples of the whole data set (1,789 ED visits) to perform the classification task. For each one, after having identified optimal parameter value, the final validated model was trained on the whole bootstrapped data set and tested. The classification accuracies had a median of 0.783 (95% CI [0.779, 0.796]). Machine learning techniques seemed to be a promising opportunity for the exploitation of unstructured information reported in ED records in low- and middle-income Spanish-speaking countries.

The entry of a small item into the upper airways is one of the leading causes of injuries in children up to 14 years old. The aim of this study is to characterize types of objects causing choking along with the features of the children involved in the accident and compare results with current standards. The European Survey on Foreign Bodies Injuries Study (ESFBI) collected data on foreign body injuries from 19 European countries. The data from ESFBI were selected according to the ICD‐9‐CM codes 933 (foreign body in the pharynx and larynx) and 934 (foreign body in the trachea, bronchi, and lungs). Both a classification tree and a linear discriminant analysis (LDA) have been set up to predict the probability that an injured child experiences a hospitalization. The classification tree provides flowchart‐type decision rules and allows for analyzing the impact of the item features, the children characteristics, and the circumstances of the accidents on the severity of the foreign body injuries. Results showed that children younger than 3.5 who are involved in an accident have a high probability to experience a hospitalization.

AbstractAir pollution has been linked to an increased risk of several respiratory diseases in children, especially respiratory tract infections. The present study aims to evaluate the association between pediatric emergency department (PED) presentations for bronchiolitis and air pollution. PED presentations due to bronchiolitis in children aged less than 1 year were retrospectively collected from 2007 to 2018 in Padova, Italy, together with daily environmental data. A conditional logistic regression based on a time‐stratified case‐crossover design was performed to evaluate the association between PED presentations and exposure to NO2, PM2.5, and PM10. Models were adjusted for temperature, relative humidity, atmospheric pressure, and public holidays. Delayed effects in time were evaluated using distributed lag non‐linear models. Odds ratio for lagged exposure from 0 to 14 days were obtained. Overall, 2251 children presented to the PED for bronchiolitis. Infants' exposure to higher concentrations of PM10 and PM2.5 in the 5 days before the presentation to the PED increased the risk of accessing the PED by more than 10%, whereas high concentrations of NO2 between 2 and 12 days before the PED presentation were associated with an increased risk of up to 30%. The association between pollutants and infants who required hospitalization was even greater. A cumulative effect of NO2 among the 2 weeks preceding the presentation was also observed. In summary, PM and NO2 concentrations are associated with PED presentations and hospitalizations for bronchiolitis. Exposure of infants to air pollution could damage the respiratory tract mucosa, facilitating viral infections and exacerbating symptoms.

Choking injuries are one of the major causes of death among children ages 0–3, and most of these injuries are related to food. This work provides an overview of the current recommendations for food choking prevention and educational targets as a basis for developing a unified common set of knowledge for primary prevention policies development. Guidelines published by professional membership organizations and national governments in the English language were considered. All of these guidelines provide lists of hazardous food items and recommendations for food preparation to minimize choking hazard. Together with recommendations for food preparation, also recommendations aimed at stakeholders (food manufacturers, health care providers, and public authorities) are provided, underlining that this severe public health problem should be further addressed by adopting integrated public health interventions. Our overview stressed the importance of developing educational and primary prevention policies to sensitize adult supervisors and to regulate dangerous food products in the market.