Search Results (33)

Objectives: Subway-related accidents have risen with advancements in the system. We aim to study the injury patterns from these incidents. Methods: This is a retrospective study from a single center, covering patients from 1 January 2016 to 31 December 2023. Patients were identified using International Classification of Diseases (ICD) injury descriptions and Abbreviated Injury Scale (AIS) body regions. Results: Out of 360 patients (total), 23.5% presented with head injuries with an AIS score ≥ 3. Patients with blunt trauma (93.99%) were in higher numbers than penetrating (5.74%) and burn trauma (0.3%). Overall, the mean Injury Severity Score (ISS) was 10.69, suggesting a broad range of traumatic injuries. ISSs for severe injuries (17–24) comprised 9.2%, moderate injuries (10–16) comprised 17.5%, and minor injuries (1–9) comprised 60.8%. Falls had the highest percentage of traumatic brain injuries (TBI) (65.60%) and fractures (67.50%). Assaults showed a significant occurrence of traumatic thoracic injuries (28.90%). Suicide attempts demonstrated a high percentage of traumatic amputations (30.80%). In the emergency department (ED), most patients (69.4%) were admitted for further care, such as trauma, neurosurgery, or other care. Of these patients, 0.5% died in the ED, 0.5% died on arrival, and 1.04% died within 15 min of arrival. The mortality rate among serious fall patients was 17.20% compared to the suicide and train-struck groups at 37.90% each. Conclusions: There were high occurrences of TBIs, and fractures, thoracic injuries, and amputations. Numbers of patients with blunt trauma were a lot higher than those with penetrating and burn trauma. The mortality rates observed in the suicide and train-struck groups were higher than those in patients with severe falls. Full article

Objective: In some regions of the globe, accidental food confusion regarding plants can cause severe poisoning events and deaths. The aim of this study was to report on those confusions from the Marseille Poison Control Centre’s (PCC) experience from 2002 to 2023. Results: Over 22 years, 2197 food confusion events were managed with 321 different species. The most frequently involved plant was Nerium oleander (289 cases, 13.1%), then Cucurbitaceae genus (3.3%), Colchicum autumnale (3.3%), Prunus amygdalus (3%), Mahinot esculenta (3%), Cytisus laburnum (2.6%), Aesculus hippocastanum (2.5%) and Narcissus Jonquilla (2%). Many botanical confusion events were also reported (n = 1386, 63%), but with fewer than five identical species. Only one death was reported for this review, in an event involving Aconitum napellus. Two antidotes were used for all the series: Datura genus and Prunus dulcis. Discussion: The most implicated plant was Nerium oleander. This is explained by its distribution. This rate is very low compared to that of suicide attempts with this plant. Many cases were symptomatic (53.6%), but very few of them described severe symptoms (only 0.5% severe poisonings). Few patients needed to be admitted to intensive care (0.4%), and even fewer needed an antidote (two cases). Only one death occurred, involving Aconitum napellus. Food confusions were more common than suicide attempts with plants, but seem to be less severe. However, death and serious complications can occur, so it is important to identify and manage the plants concerned. Material and Methods: For each food confusion event managed between 2002 and 2023 at the Southeastern France PCC based in Marseille, we performed a retrospective review. This PCC is responsible for the Provence–Alpes–Côte d’Azur Region, Corsica Island and Indian Ocean French overseas territories. For each case, severity was calculated with the Poison Severity Score (PSS). Full article

Background: Suicidal behaviour, defined as acting with the intention of killing oneself and thinking about doing so, is a serious public health problem. Being able to list the risk factors in the process from suicidal ideation to suicidal behaviour is important in preventing suicide. Objectives: The study was conducted to examine the psychological variables that discriminate between individuals who attempt suicide and those who only have suicidal ideation. Methods: The sample of the study consisted of 108 individuals who attempted suicide and 197 individuals with suicidal ideation, aged 18–25 years. Data were collected using the Demographic Information Form, Anger/Impulsivity (A/I) and Hopelessness/Loneliness (H/L) subscales of the Suicide Probability Scale (SPS), Psychological Pain Scale (PPS), State and Trait Anxiety Scale (STAS), Beck Depression Inventory (BDI), Interpersonal Needs Questionnaire (INQ), Acquired Suicide Efficacy/Death Fearlessness Scale (ASE/DFS) and General Attitudes and Beliefs Scale Short Form (GABS-SF). Results: Results showed that anger/impulsivity (Wald = 4.827; p < 0.05), perceived burden on others (Wald = 8.613; p < 0.05), acquired suicide efficacy/death fearlessness (Wald = 13.377; p < 0.001), being female (Wald = 3.925; p < 0.05), presence of diagnosed psychiatric illness in the family (Wald = 5.705; p < 0.05), and receiving psychological support (Wald = 4.381. p < 0.05) variables are significant predictors of the transition from suicidal ideation to suicidal action. Conclusions: The identification of psychological factors between suicide attempters and suicide ideation groups may guide clinicians in the follow-up and treatment of individuals at risk of attempting suicide. In addition, the results may contribute to the development of new intervention, education and treatment programmes for suicide. Full article

Background: Seriously injured persons with pre-existing psychiatric conditions or those injured due to violent crimes represent a particularly vulnerable treatment group. Methods: All patients with injuries from suicidal attempts (PSAs) or patients with injuries from violent offenses (PVOs) that presented to the university emergency room of a Level 1 trauma center in Germany between 1 January 2017 and 31 November 2022 were retrospectively investigated. Results: It can be seen that PVOs were significantly younger compared to PSAs (p = 0.03). Total hospital stay was significantly longer for PSAs compared to PVOs (p < 0.001). PSAs were also significantly more severely injured than PVOs (p < 0.001). Our study was able to show a significant difference between both patient groups in the region of injury (p < 0.001). PSAs had a significantly more extensive psychiatric history than PVOs (p < 0.001). Conclusion: Injuries from suicide attempts and violent offenses are a serious and growing public health problem, but one that can be addressed through timely, evidence-based, and often cost-effective interventions. It requires early interaction among multiple disciplines and a standardized approach. Full article

Developmental, clinical, and epidemiological research have demonstrated the salience of perceived racial discrimination (PRD) as a contributor to negative mental health outcomes in adolescence. This article summarizes secondary analyses of cross-sectional data from a large-scale youth survey within a predominantly rural state, to estimate the prevalence and strength of the association between PRD and serious psychological distress (SPD), suicidal ideation, and prior suicidal attempts. Data from 93,812 students enrolled in 6th, 8th, 10th, or 12th grade within 129 school districts across Kentucky were examined, to determine prevalence rates for subgroups within the cohort. Logistic regression analyses assessed the differences and established comparative strength of the association among these variables for racial/ethnic subgroups. PRD was self-reported at high rates across several demographic subgroups and was most evident among Black (24.5%) and Asian (22.1%) students. Multiracial students experienced the highest rates of both SPD and suicidality (ideation and prior attempt). Both for the entire cohort and for each racial/ethnic subgroup, PRD was significantly associated with an increased likelihood of negative mental health outcomes, although the strength of these associations varied across the subgroups and developmental levels. The implications for early intervention and prevention are discussed. Full article

Background: In 2022, suicide was the second leading cause of external death in Spain (the first among young people aged 15–29 years). This study aims to analyze the presence of myths among emergency first responders and identify the most prevalent false beliefs among them. Methods: The research is a observational and descriptive study carried out using a questionnaire composed of a total of 25 myths, with the response options being true or false. A total of 543 professionals took part in the study. All of them could intervene before, during, and after a suicide attempt. Results: The main finding of the study is that more than 50% of the participants accept as true the statement "There are more serious and less serious problems", underlining the idea that caring for patients could be related to the importance the health professional gives to the patients’ problem. Myths such as “The suicidal person wants to die” and “The suicidal person is determined to die” are also evident. Conclusion: The subjective thought the first responder has about suicide could affect their acts, and there is a need to train first responders in suicidal behavior to be able to create an adequate approach. Full article

In this day and age, depression is still one of the biggest problems in the world. If left untreated, it can lead to suicidal thoughts and attempts. There is a need for proper diagnoses of Major Depressive Disorder (MDD) and evaluation of the early stages to stop the side effects. Early detection is critical to identify a variety of serious conditions. In order to provide safe and effective protection to MDD patients, it is crucial to automate diagnoses and make decision-making tools widely available. Although there are various classification systems for the diagnosis of MDD, no reliable, secure method that meets these requirements has been established to date. In this paper, a federated deep learning-based multimodal system for MDD classification using electroencephalography (EEG) and audio datasets is presented while meeting data privacy requirements. The performance of the federated learning (FL) model was tested on independent and identically distributed (IID) and non-IID data. The study began by extracting features from several pre-trained models and ultimately decided to use bidirectional short-term memory (Bi-LSTM) as the base model, as it had the highest validation accuracy of 91% compared to a convolutional neural network and LSTM with 85% and 89% validation accuracy on audio data, respectively. The Bi-LSTM model also achieved a validation accuracy of 98.9% for EEG data. The FL method was then used to perform experiments on IID and non-IID datasets. The FL-based multimodal model achieved an exceptional training and validation accuracy of 99.9% when trained and evaluated on both IID and non-IIID datasets. These results show that the FL multimodal system performs almost as well as the Bi-LSTM multimodal system and emphasize its suitability for processing IID and non-IIID data. Several clients were found to perform better than conventional pre-trained models in a multimodal framework for federated learning using EEG and audio datasets. The proposed framework stands out from other classification techniques for MDD due to its special features, such as multimodality and data privacy for edge machines with limited resources. Due to these additional features, the framework concept is the most suitable alternative approach for the early classification of MDD patients. Full article

Suicide is a serious global public health problem, with a worrying recent increase in suicide rates in both adolescent and adult populations. However, it is essential to recognize that suicide is preventable. A myriad of factors contributes to an individual’s vulnerability to suicide. These factors include various potential causes, from psychiatric disorders to genetic and epigenetic alterations. These changes can induce dysfunctions in crucial systems such as the serotonergic, cannabinoid, and hypothalamic–pituitary–adrenal axes. In addition, early life experiences of abuse can profoundly impact an individual’s ability to cope with stress, ultimately leading to changes in the inflammatory system, which is a significant risk factor for suicidal behavior. Thus, it is clear that suicidal behavior may result from a confluence of multiple factors. This review examines the primary risk factors associated with suicidal behavior, including psychiatric disorders, early life adversities, and epigenetic modifications. Our goal is to elucidate the molecular changes at the genetic, epigenetic, and molecular levels in the brains of individuals who have taken their own lives and in the plasma and peripheral mononuclear cells of suicide attempters and how these changes may serve as predisposing factors for suicidal tendencies. Full article

Guyana’s colonial past has left a trail of economic instability, racial polarization, and physical and mental trauma. Despite the progress made since Guyana’s independence in 1966, the remnants of this colonial past continue to shape present-day Guyana. As a result, violence and trauma continue to impact the mental health of the population. This is manifest in endemic problems of domestic violence and racialized social divisions which have created the conditions for rates of suicide which are amongst the highest in the world. The formal mental health provision which exists in Guyana is based primarily on an individualized and largely biomedical model of care. Despite valuable attempts to develop this provision, the difficulty of physically accessing this for some people and the stigma which surround this means that the capacity of this system to address the serious problems which exist is limited. It is also the case that in times of emotional and psychic distress, and in the context of Guyana being a very religious country, many people turn to traditional supernatural healers and remedies for support. In this paper, we discuss what is known as “Obeah”, noting that while this is widely practiced, it remains something of a taboo subject in Guyana. We consider the reasons why these practices and beliefs continue to be influential. However, what neither these biomedical or supernatural perceptions of mental health are able to address is the sociogenic nature of Guyana’s mental health issues, which we argue emerges out of the historic trauma of Guyana’s experience of colonialism and the violence which it engendered. We argue that profound forms of mental distress which exist in Guyana call for an integrative and holistic practice model that contextualizes these problems through a sociogenic lens. Social workers, working collaboratively with other health-related professions, can occupy a critical role in integrating these different conceptions through developing a rights-based model of mental health where the causes of mental ill-health are understood as socially determined. Full article

Depression is a serious mental disorder and the most prevalent cause of disability and suicide worldwide. Quercetin (QER) demonstrated antidepressant effects in rats exhibiting anxiety and depressive-like behaviors. In an attempt to improve QER’s antidepressant activity, a QER-loaded transferosome (QER-TFS) thermosensitive gel for intranasal administration was formulated and optimized. The therapeutic effectiveness of the optimized formulation was assessed in a depressed rat model by conducting a behavioral analysis. Behavioral study criteria such as immobility, swimming, climbing, sucrose intake, number of crossed lines, rearing, active interaction, and latency to feed were all considerably enhanced by intranasal treatment with the QER-TFS in situ gel in contrast to other formulations. A nasal histopathological study indicated that the QER-TFS thermosensitive gel was safe for the nasal mucosa. An immunohistochemical analysis showed that the animals treated with the QER-TFS thermosensitive gel had the lowest levels of c-fos protein expression, and brain histopathological changes in the depressed rats were alleviated. According to pharmacodynamic, immunohistochemical, and histopathological experiments, the intranasal administration of the QER-TFS thermosensitive gel substantially alleviated depressive symptoms in rats. However, extensive preclinical investigations in higher animal models are needed to anticipate its effectiveness in humans. Full article

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on the treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. Full article

Suicide is one of the main causes of death among the adolescent population, which is why it is considered an important mental-health problem. In addition to this situation, for each suicide, the group of people who survive it (known as suicide survivors) can present serious emotional affectations, becoming a population at risk for this problem. The purpose of this study was to analyze the effect of suicide-survivor status on risk factors and protective factors for suicide. A total of 440 adolescents with a mean age of 15.78 (SD = 1.74) participated, who were divided according to survivor status, identified as the SV group (79 cases), and non-survivors, identified as the NSV group—adolescents that did not have experience or contact with a suicide attempt (361 cases). A questionnaire of sociodemographic characterization and risk conditions, the Alexian Brother Urge to Self-Injure (ABUSI), the Plutchik Suicide Risk Scale, the Multidimensional Scale of Perceived Social Support, and the Cognitive and Affective Empathy Test (TECA) were applied. Descriptive statistics, mean difference for independent samples, contingency tables, X2 statistic, Fisher’s exact statistic, and Cohen’s d coefficient were used. The results show significant differences between SV and NSV participants in risk and protective factors regarding the presence of a greater adoption of perspective and emotional understanding. On the other hand, NSV adolescents presented higher scores of perceived social supports regarding risk factors, and there was a higher proportion of a history of suicide attempt, severity/hospitalization, impulse to self-harm, and level of suicidal risk in the SV group. The need to incorporate forms of suicide prevention with the survivor population is discussed, increasing the possibilities of postvention. Full article

Claims (or the implicit assumption) of the inherent worth of life are pervasive and remain virtually unchallenged. I have already argued that these outright moral dictates are thinly veiled vestiges of theological ethics which, following the removal of their theological foundations, remain little more than nebulous claims supported only by fear of the consequences of a challenge. In my previous work, I rejected an a priori claim of an objective life’s worth, which is the worth that we should assign to others’ lives, and elucidated a principled framework that gives rise to the said worth immediately, as a consequence of the experiences of its sentient environment. Herein, I address the complementary question of the value of one’s own life, which is the subjective value of life and, thus, Camus’s (in)famous view that “there is but one truly serious philosophical problem, and that is suicide”. As before, I rejected the inherency of a life’s worth, showing it to be contradictio in adjecto, and instead show how this worth too can in large part be seen to emerge from sentient experiences of the subject. Many of these are innately linked to experiences of other sentient beings as objects, thus erecting a framework that is both principled and thoroughly humane with Schopenhauer’s ‘loving kindness’ running through it. Practically, my framework illuminates an understanding of suicide as a real-world phenomenon, helping those who remain living to understand a deceased one’s decision, and paving the way to answering questions, such as when there should be an attempt to prevent suicide, and what means of suicide prevention are ethically permissible. Full article

Background—Mental health conditions and substance use are linked. During the COVID-19 pandemic, mental health conditions and substance use increased, while emergency department (ED) visits decreased in the U.S. There is limited information regarding how the pandemic has affected ED visits for patients with mental health conditions and substance use. Objectives—This study examined the changes in ED visits associated with more common and serious mental health conditions (suicidal ideation, suicide attempts, and schizophrenia) and more commonly used substances (opioids, cannabis, alcohol, and cigarettes) in Nevada during the COVID-19 pandemic in 2020 and 2021 compared with the pre-pandemic period. Methods—The Nevada State ED database from 2018 to 2021 was used (n = 4,185,416 ED visits). The 10th Revision of the International Classification of Diseases identified suicidal ideation, suicide attempts, schizophrenia, and the use of opioids, cannabis, alcohol, and cigarette smoking. Seven multivariable logistic regression models were developed for each of the conditions after adjusting for age, gender, race/ethnicity, and payer source. The reference year was set as 2018. Results—During both of the pandemic years (2020 and 2021), particularly in 2020, the odds of ED visits associated with suicidal ideation, suicide attempts, schizophrenia, cigarette smoking, and alcohol use were all significantly higher than those in 2018. Conclusions—Our findings indicate the impact of the pandemic on mental health- and substance use-associated ED visits and provide empirical evidence for policymakers to direct and develop decisive public health initiatives aimed at addressing mental health and substance use-associated health service utilization, especially during the early stages of large-scale public health emergencies, such as the COVID-19 pandemic. Full article

Brain-derived neurotrophic factor (BDNF) has previously been associated with the pathogenesis of both emotionally unstable personality disorder (EUPD) and suicidal behavior. No study has yet investigated BDNF-associated epigenetic alterations in a group of severely impaired EUPD and suicidal patients. The discovery cohort consisted of 97 women with emotionally unstable personality disorder (EUPD) with at least two serious suicide attempts (SAs) and 32 healthy female controls. The genome-wide methylation pattern was measured by the Illumina EPIC BeadChip and analyzed by robust linear regression models to investigate mean BDNF methylation levels in a targeted analysis conditioned upon severity of suicide attempt. The validation cohort encompassed 60 female suicide attempters, stratified into low- (n = 45) and high-risk groups (n = 15) based on degree of intent-to-die and lethality of SA method, and occurrence of death-by-suicide at follow-up. Mean BDNF methylation levels exhibited increased methylation in relation to EUPD (p = 0.0159, percentage mean group difference ~3.8%). Similarly, this locus was confirmed as higher-methylated in an independent cohort of females with severe suicidal behavior (p = 0.0300). Results were independent of age and BMI. This is the first study to reveal emerging evidence of epigenetic dysregulation of BDNF with dependence on features known to confer increased risk of suicide deaths (lethality of suicide-attempt method and presence of EUPD diagnosis with history of recent SAs). Further studies investigating epigenetic and genetic effects of BDNF on severe suicidal behavior and EUPD are needed to further elucidate the role of epigenetic regulatory mechanisms and neurotrophic factors in relation to suicide and EUPD, and hold potential to result in novel treatment methods. Full article