Titan submersible hearing begins as questions over what went wrong linger

Titan submersible hearing begins as questions over what went wrong linger

An image of debris of the Titan submersible recovered from the ocean floor and the crew’s final message — “all good here” — were among the details shared Monday during the U.S. Coast Guard’s investigatory hearing into what caused the deep-water vessel to implode last year, killing all five people on board.

The Titan had suffered more than 100 equipment issues in the two years before the calamity, investigators also revealed as concerns over safety standards came to light during the first day of testimony.

Tony Nissen, who was hired in 2016 as the engineering director at OceanGate, an underwater exploration company, testified that his relationship with its CEO, Stockton Rush, “soured” as the Titan was being completed in early 2018 and set to undergo testing. That year, the submersible was struck by lightning, Nissen said, compromising its experimental carbon fiber hull.

The Titan's tail cone on the sea floor.
The Titan’s tail cone on the sea floor.Pelagic Research Services via USCG

Nissen said there was also a crack in the hull, which he didn’t believe was salvageable, and so he declined to greenlight a planned expedition for the following year.

“I wouldn’t sign off on it,” Nissen testified, “so I got terminated.”

While Nissen was no longer with OceanGate when it made its doomed journey in the North Atlantic Ocean on June 18, 2023, during a trip to view the Titanic wreck site, his recollections are among the first public comments that will be used to help investigators piece together what led the Titan to implode on its voyage.

Rush, 61, who was piloting the Titan, was killed alongside a French mariner, two businessmen and one of their sons — the youngest passenger at 19 — who took his Rubik’s Cube on board in hope of breaking a world record.

Officials said several aspects surrounding the cause of the failure will be examined during the two-week Coast Guard investigatory hearing in North Charleston, South Carolina. Among the scheduled witnesses before the Marine Board of Investigation are engineers and executives at OceanGate, the Washington state company that developed and operated the Titan, including its co-founder Guillermo Söhnlein.

Jason Neubauer, the chairman of the Marine Board of Investigation, said the hearing’s purpose is to provide necessary safety recommendations for federal and international agencies to consider so “no family will experience such a loss again.” The board will also determine the extent of any negligence or misconduct, and potential criminality would be referred to the Justice Department, he said.

Before he was fired, Nissen testified, he and Rush had argued over putting the word “experiment” in the waivers that Titan passengers had to sign before they could go on an expedition.

“I made him put it in there,” Nissen said Monday.

He also said that Rush had asked him to be the Titan’s pilot on missions to tour the Titanic but that he refused.

“I told him, ‘I’m not getting in it,'” Nissen said, because he didn’t trust the operations crew.

“But I didn’t trust Stockton, either,” he added.

Nissen told investigators that OceanGate had no designated safety officer and that Rush got his way at the expense of safety: “Most people would eventually just back down to Stockton.”

On its website before last year’s catastrophe, OceanGate touted that the Titan was made of “titanium and filament wound carbon fiber” and that it had been “proven to be a safe and comfortable vessel” that could “withstand the enormous pressures of the deep ocean.”

On its website now, OceanGate simply says it “has suspended all exploration and commercial operations.”

Lawyers representing OceanGate were permitted to ask questions at the hearing.

The Titan had lost contact with the Polar Prince, its support ship, almost two hours into its descent to view the Titanic wreckage, which lies at a depth of about 13,000 feet.

OceanGate came under heavy scrutiny as a result of the disaster — an almost unheard-of occurrence in the submersible industry. (Submersibles differ from submarines because they are typically smaller and require support ships or platforms from which to launch and return.)

Experts familiar with the Titan’s design spoke publicly about several potential cost-cutting factors that may have led to the implosion. They include the 23,000-pound vessel’s being made with experimental materials such as carbon fiber, which they say has not been pressure-tested over time in such extreme depths, and that the submersible’s hull was fashioned to fit more passengers instead of in a better-known spherical shape.

OceanGate promised voyagers a trip of about 2½ hours to the site, with four more hours of touring the famed sunken ocean liner before it returned.

After the Titan didn’t come back at its scheduled time, the Polar Prince contacted the Coast Guard. Debris from the Titan was found four days later during a search, and while there was a public fascination with how long its passengers could sustain themselves in a cramped tube running out of air, officials said they most likely perished instantaneously in a “catastrophic implosion” because the craft couldn’t handle the deep-sea water pressure.

The passengers were deep sea explorer Paul-Henri Nargeolet, 77, who was experienced in visiting the Titanic wreck site; British tycoon Hamish Harding, 58; and Pakistani businessman Shahzada Dawood, 48, and his teenage son, Suleman.

The passengers paid $250,000 apiece for the opportunity to visit the Titanic wreckage, The Associated Press reported.

In the aftermath of the implosion, Söhnlein, the OceanGate co-founder, who left the company in 2013, insisted that Rush was “very committed to safety.”

“Stockton was one of the most astute risk managers I’d ever met,” Söhnlein said, adding: “When I was there, we always were very transparent with anyone who was going to join us on expeditions about the risks involved.”

But others had raised warnings.

Former employee David Lochridge, who was hired to run crewed tests of submersibles, claimed in a 2018 counterclaim lawsuit against OceanGate that he was fired after he warned that the Titan’s carbon shell wasn’t properly tested to ensure it could descend as far as the Titanic.

Lochridge said in the court papers that after he complained that passengers’ lives would be at risk, he was given “10 minutes to immediately clear out his desk.”

OceanGate initially sued Lochridge alleging breach of contract, but the two sides later settled their dispute. Lochridge is expected to testify Tuesday at the hearing.

More on the Titan submersible implosion

Meanwhile, Nargeolet’s estate filed a $50 million wrongful death lawsuit last month alleging persistent carelessness, recklessness and negligence by OceanGate and others who played a role in its construction. The suit continues, and Nissen is among those named as defendants.

Neubauer, the Marine Board of Investigation chairman, said Sunday that the investigation has been one of the most complex for the Coast Guard, because of the nature of the incident and the extreme depths at which it occurred, making evidence recovery difficult.

Peter Girguis, a Harvard University professor and adjunct oceanographer in applied ocean engineering and physics at the Woods Hole Oceanographic Institution, said he hopes the hearing will yield an “honest conversation about what led to this tragedy” while making it clear that OceanGate’s Titan isn’t typical of how members of the submersible industry adhere to best practices in design and safety.

The deep ocean should continue to be explored, he added, but he said there’s also a larger conversation to be had about whether activities on the high seas outside U.S. jurisdiction, such as the Titanic tour promoted by OceanGate, should be regulated.

“We need to support innovators who do think outside of the box, but we have to make sure they don’t bring bodily harm or it results in the loss of life of others who are not complicit in this action,” Girguis said. “The Titan submersible did not just go down with its inventor — it went down with paying passengers.”


Source link

Drug-Resistant Bacteria Deaths Projected to Rise 70% by 2050

Drug-Resistant Bacteria Deaths Projected to Rise 70% by 2050

Antimicrobial-resistant bacterial infections directly caused more than 1 million deaths worldwide annually from 1990 to 2021, and that number is projected to increase by almost 70% over the next 25 years, according to a systematic analysis.

In 2021, 1.14 million deaths that were attributable to bacterial antimicrobial resistance (AMR) occurred across the globe, slightly higher than the 1.06 million AMR-attributable deaths in 1990, reported Christopher Murray, MD, DPhil, of the University of Washington in Seattle, and colleagues in The Lancet.

Bacterial AMR was also associated with an estimated 4.71 million deaths in 2021, about the same as in 1990.

By 2050, Murray and colleagues forecasted that an estimated 1.91 million AMR-attributable deaths and 8.22 million AMR-associated deaths could occur every year worldwide. From 2025 to 2050, a cumulative 39.1 million deaths attributable to AMR could occur.

However, improved access to healthcare and antibiotics could save an estimated 92 million lives from 2025 to 2050, they posited.

“These findings highlight that AMR has been a significant global health threat for decades and that this threat is growing,” co-author Mohsen Naghavi, MD, PhD, MPH, also of the University of Washington, commented in a press release.

On a more positive note, AMR-attributable deaths among children under the age of 5 years decreased by 60.4% from 1990 to 2021, and deaths associated with AMR decreased by 63.3%. Sepsis deaths among children younger than 5 also decreased by more than 60% over this time period.

However, among people 70 and older, deaths directly attributable to AMR increased by 89.5%, and AMR-associated deaths increased by 81.3%, from 1990 to 2021.

“The fall in deaths from sepsis and AMR among young children over the past three decades is an incredible achievement,” co-author Kevin Ikuta, MD, MPH, of the University of California Los Angeles, said in the press release.

“However, these findings show that while infections have become less common in young children, they have become harder to treat when they occur. Further, the threat to older people from AMR will only increase as populations age,” Ikuta pointed out.

In an accompanying editorial, Samuel Kariuki, PhD, MSc, of the Kenya Medical Research Institute in Nairobi, noted that the reduction in deaths among young children “coincides with widespread vaccination efforts and improved access to WASH [water, sanitation, and hygiene], and infection prevention and control strategies that proved highly effective in reducing AMR burden.”

Improved access to WASH infrastructure and practice coupled with use of pediatric vaccines could prevent approximately 430,000 AMR-associated deaths, “from both direct prevention of resistant infections and reductions in antibiotic consumption,” Kariuki wrote.

In their predictions for 2050, Murray and colleagues projected that South Asia, Latin America, and the Caribbean will be the regions with the highest all-age AMR mortality rate. Increases in deaths attributable to AMR will be largest among those 70 and older (65.9%).

However, improved access to antibiotics and better care could have the greatest benefits in South Asia, sub-Saharan Africa, and parts of Southeast Asia, East Asia, and Oceania, they noted.

The researchers also documented increases in AMR-attributable deaths for 12 pathogens from 1990 to 2021. In 2021, the six pathogens associated with at least 100,000 AMR-attributable deaths annually were Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, and Pseudomonas aeruginosa.

Deaths due to methicillin-resistant S. aureus increased the most globally, leading to 130,000 AMR-attributable deaths in 2021 — doubling from 57,200 in 1990.

Among Gram-negative bacteria, which are some of the most resistant to antimicrobial drugs, resistance to carbapenems increased more than any other type of antibiotic, from 127,000 in 1990 to 216,000 in 2021. “If new antimicrobials are developed for currently antimicrobial-resistant Gram-negative bacteria, a forecasted 11.1 million AMR deaths could be averted by 2050,” Kariuki noted.

S. pneumoniae had the most substantial decline in both AMR-associated and -attributable deaths, with AMR-attributable deaths dropping from 258,000 in 1990 to 155,000 in 2021.

Deaths attributable to AMR also varied across regions. Five regions — western sub-Saharan Africa, tropical Latin America, high-income North America, Southeast Asia, and South Asia — had increases of more than 10,000 AMR-attributable deaths over the 31-year period. However, among children younger than 5 years, AMR-attributable and -associated deaths decreased in all regions except Oceania. Among those ages 5 and older, AMR mortality increased in all regions except western and central Europe.

This global study relied on a statistical modeling approach using 520 million individual records from a variety of sources, including hospital data, death records, antibiotic use surveys, pharmaceutical sales data, insurance claims data, and published scientific studies, among others. Murray and colleagues looked at 22 pathogens, 84 pathogen-drug combinations, and 11 infectious syndromes from 204 countries and territories.

The authors acknowledged some limitations to the analysis. Scarcity of data in many low- to middle-income countries was a major drawback. Also, analytical errors and selection bias may have occurred when consolidating data from a large variety of sources. Forecast scenarios of AMR burden are also dependent on the quality and availability of historical data, and do not consider the emergence of new resistant strains of bacteria.

  • author['full_name']

    Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.

Disclosures

The study was funded by the UK Department of Health and Social Care’s Fleming Fund and the Wellcome Trust.

Murray, Naghavi, and Ikuta reported no conflicts of interest; several co-authors reported ties to industry.

Kariuki reported no conflicts of interest.

Primary Source

The Lancet

Source Reference: Naghavi M, et al “Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050” Lancet 2024; DOI: 10.1016/S0140-6736(24)01867-1.

Secondary Source

The Lancet

Source Reference: Kariuki S “Global burden of antimicrobial resistance and forecasts to 2050” Lancet 2024; DOI: 10.1016/S0140-6736(24)01885-3.


Source link

World Patient Safety Day 2024: History, significance, theme and more | Health News

World Patient Safety Day 2024: History, significance, theme and more | Health News


Every year, World Patient Safety Day is observed on September 17. The World Health Organisation (WHO) established this day to spread awareness about patient safety, promoting actions to enhance safety in healthcare. This day aims to encourage people to unite for safer healthcare practices and address the worldwide problem of the significant burden of harm caused by unsafe medical practices.


The day highlights the need to improve healthcare systems and practices prioritising the well-being of the patients. An estimated 134 million adverse events occur annually in hospitals in low- and middle-income countries making it crucial to reduce preventable harm and deaths. 

 


World Patient Safety Day 2024: Theme


World Patient Safety Day aims to bolster patient safety by raising public awareness and promoting collaboration among patients, healthcare workers, policymakers and leaders. The theme for World Patient Safety Day 2024 is “Improving Diagnosis for Patient Safety” emphasising the vital role of accurate and timely diagnosis in safeguarding patients and improving healthcare outcomes. The slogan for this day is  “Get it Right, Make it Safe!” enhancing the need for precise diagnoses and ensuring patient safety.


A diagnosis determines a patient’s health condition and it is crucial to provide the necessary care and treatment. An error in a patient’s diagnosis occurs when there is some error in providing an accurate and timely explanation of a patient’s health issues, like delays, incorrect or missed diagnoses or failure to communicate the diagnosis to the patient. 


World Patient Safety Day 2024: History


The 72nd World Health Assembly passed a resolution in 2019 establishing World Patient Day as a global health priority. The WHO begins a global campaign each year focusing on different themes and patient safety, such as safe childbirth, medication safety, and empowering patients and caregivers. 


The movement aims to gain momentum recognising the unsafe healthcare practices contributing significantly to avoidable harm and costs to health systems globally. 


World Patient Safety Day 2024: Significance


World Patient Day 2024 aims to highlight the importance of patient safety, educating healthcare providers, patients and the public, reducing risks and preventing medical errors. This day brings attention to unsafe healthcare practices. It also highlights the global collaboration between countries, healthcare organisations, policymakers and professionals and encourages people to improve safety standards across the world.


This day also offers the opportunity to highlight some critical safety concerns like medication errors or maternal and newborn health. It helps address critical areas where improvements can reduce the harm to patients. This day also encourages patients to take part in their important healthcare decisions, thereby improving communication with medical professionals making informed decisions. 


Another significance of World Patient Day is to advocate stronger policies and regulations to prioritise healthcare safety and call for change leading to better and safer healthcare environments. It also raises awareness in promoting actionable strategies aiming to reduce preventable harm, thereby improving health outcomes and saving lives. 

First Published: Sep 17 2024 | 11:37 AM IST


Source link

The Best Blonde Hair Colours for Autumn

The Best Blonde Hair Colours for Autumn

New season, new hair colour? If you’re not in the mood for a whole new haircut, then refreshing your hair colour is one way to change things up as we head into autumn. And of course, colouring your hair doesn’t have to mean a drastic all-over dye job. Sometimes just going a shade or two lighter or darker or adding in some highlights or lowlights can be enough to satisfy the need for change, without the risk of regret later down the line…

Since I already opted to cut my waist-length hair into a bob earlier in the year, I’m definitely done with dramatic hair changes for 2024—but that doesn’t mean I’m not considering making some more subtle tweaks. I’m naturally a brunette, but have had balayage and highlights in the past and love the idea of experimenting with blonde now that my hair is shorter.

There really are so many more options when it comes to blonde hair colours—and if you’re looking for something that feels particularly appropriate for autumn, you’re in luck. From honey blonde to cowboy copper, the latest blonde hair colour trends are perfect for this time of year. Scroll down for all the inspiration you need.

blonde hair colours for autumn

The Best Blonde Hair Colours for Autumn

1. Honey Blonde

blonde hair colours for autumn

“I foresee this classic blonde coming back for autumn and winter 2024—it’s easy going and the perfect transition shade from summer to winter,” says Stéphane Ferreira, senior colourist at Live True London.

blonde hair colours for autumn

“It’s ideal for people looking to move to a darker blonde from their summer shade, but keeping it warm and glossy,” she adds.

2. Pearlescent White

blonde hair colours for autumn

While warm-toned shades like honey and caramel are more obvious autumn favourites, experts predict that in 2024 we’ll see a rise in cooler tones and brighter shades of blonde. Hair stylist at Live True London, Tyler Moore says, “To get this look, bleach is painted all over the hair to make the hair one shade. The hair will need to be lifted very brightly and may take two or more sessions.”

blonde hair colours for autumn

“Ask your stylist for an icy platinum all over colour, but make sure to bring reference images,” Moore adds. “Your stylist will advise you on the process of achieving this colour, but it could be a big commitment and take a long time to get that bright.”