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BACKGROUND: Wearing hip protectors is a measure used to prevent hip fractures caused by falls. However, its protective effect has remained controversial in previous studies. This study provides a rationale for the use of hip protectors by pooling all the current meta-analysis evidence. METHODS: We conducted an umbrella review of all the current meta-analysis articles about the efficacy of hip protectors to reduce hip fractures and falls in communities and/or institutions. Major databases including EMBASE, Cochrane Library, PubMed and Web of Science, were searched up to June 2022. Two reviewers screened the studies, extracted the data, and conducted the methodological quality assessment independently. The primary outcome was the association statistic (odds ratio (OR), relative risk (RR), etc.) reported in the meta-analysis that quantified the influence of the intervention on hip fractures and falls compared to that of the control group. Narrative synthesis was also conducted. Forest plots and the AMSTAR score were used to describe the results and quality of the pooled literature, respectively. RESULTS: A total of six meta-analysis articles were included in the study. Hip protectors were effective at reducing hip fractures in older individuals who were in institutions (nursing or residential care settings) but not in communities (RR = 0.70, 95% CI 0.58 to 0.85, I2 = 42%, P < 0.001) (RR = 1.12, 95% CI 0.94 to 1.34, I2 = 0%, P = 0.20), and they did not reduce falls (RR = 1.01, 95% CI 0.90 to 1.13, I2 = 0%, P = 0.89). CONCLUSIONS: Hip protectors are effective at preventing hip fractures in institutionalized older adults but not in community-dwelling older adults. TRIAL REGISTRATION: This study has been registered in PROSPERO (PROSPERO ID: CRD42022351773).
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Accidentes por Caídas , Fracturas de Cadera , Equipos de Seguridad , Humanos , Fracturas de Cadera/prevención & control , Fracturas de Cadera/epidemiología , Accidentes por Caídas/prevención & control , Anciano , Metaanálisis como AsuntoRESUMEN
OBJECTIVES: Publicizing safety ratings of vehicles can motivate manufacturers to prioritize safety and help consumers choose safer vehicles, leading to safer fleets. The benefits of primary safety technologies that prevent crash occurrence are not currently incorporated in current ratings in a way that values their safety benefits consistently. We aimed to propose a method for assigning weights for each safety technology to account for established safety benefits using published effectiveness and prevalence from real-life data. METHODS: To illustrate this method, we present a worked example calculated using crash and injury data from Australia and New Zealand. The method proposed attenuates the weights for given safety technologies where two or more safety technologies fitted to the same vehicle are effective for the same types of crashes. RESULTS: In the worked example using Australasian data, large SUVs were estimated to have the largest safety increment from the fitment of all the technologies considered compared to vehicles without these primary safety technologies, with an almost 17% reduction in crash occurrence. Cars with all the technologies fitted had estimated average crash reduction of between 11% and 12%. CONCLUSIONS: Different market groups have different crash patterns, so the safety attributable to safety technology fitment differs at the market group level. This study presents an approach for providing a summary measure of crash avoidance according to the fitment of safety technologies. If this measure is combined with an estimate of secondary safety (whether derived from existing crash and injury data or from new car crash assessment programs), the combined estimate then represents the important elements of safety provided by the vehicle. The methods presented here form a rational basis for assigning safety ratings to represent the benefits of swiftly developing safety technologies.
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Accidentes de Tránsito , Automóviles , Accidentes de Tránsito/estadística & datos numéricos , Humanos , Nueva Zelanda/epidemiología , Australia/epidemiología , Seguridad , Heridas y Lesiones/epidemiología , Equipos de SeguridadRESUMEN
OBJECTIVE: Mountain highways are linearly complex, with extensive curves and high accident injury rates, how to improve driving safety is the key to traffic safety management on mountain highways, and it also meets the need for harmonious and sustainable development of the society. Therefore, this study investigates the effects of different guardrail color configurations on the driving behavior of different styles of drivers when driving on mountainous curves from the perspective of improving road aids - guardrails. METHODS: A virtual reality experiment was designed using a driving simulator and VR technology, and 64 subjects were recruited to participate and complete the experiment. RESULTS: Drivers with non-adaptive driving styles (Reckless, Angry, Anxious) traveled at significantly higher speeds than subjects with adaptive driving styles (Cautious) on mountainous roads; drivers with Cautious styles had better lane-keeping ability when passing through different radii of curves as compared to non-adaptive drivers; and the red and yellow guardrails were more effective in decreasing the speeds at which drivers passed and in increasing the stability of lane-keeping. CONCLUSIONS: The results of the study show that the effectiveness of red and yellow guardrails is better, which provides a reference for the traffic management department to propose a standardized color setting of guardrails in mountainous areas, which is conducive to the development of more precise traffic management measures to reduce the occurrence of traffic accidents.
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Conducción de Automóvil , Color , Realidad Virtual , Humanos , Conducción de Automóvil/psicología , Masculino , Femenino , Adulto Joven , Adulto , Accidentes de Tránsito/prevención & control , Simulación por Computador , Equipos de SeguridadRESUMEN
OBJECTIVES: In Poland, there are numerous cases of injuries caused by sharp instruments annually, still significantly more than in other European Union countries. The aim of this study was to analyze work-related injuries among healthcare workers in a selected hospital before and after the implementation of safety-engineered devices (SED). MATERIAL AND METHODS: Retrospective analysis of medical documentation regarding occupational needlestick and sharps injuries (NSSI) in a tertiary referral surgical hospital in 1998-2018. The study group consisted of nurses and doctors who had been injured and reported the incident. The frequency of injury reports, injury rate, and characterization of circumstances surrounding NSSI are presented. RESULTS: Over the period of 20 years, a total of 257 NSSI incidents were reported. The average injury rate was statistically significant for nurses (p = 0.004) and was higher before the introduction of SED. Moreover, the number of injuries among nurses showed a downward trend during the study period. However, for doctors, there was no statistically significant difference in the median puncture rate (p = 0.099), and the number of injuries showed an increasing trend. CONCLUSIONS: In this study, the authors' have demonstrated not only the occurrence of injuries and punctures in the daily work of medical personnel but also the potential for their reduction through the use of safety equipment at every workstation where healthcare services are provided using sharp medical instruments. Int J Occup Med Environ Health. 2024;37(2):234-43.
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Lesiones por Pinchazo de Aguja , Centros de Atención Terciaria , Lesiones por Pinchazo de Aguja/epidemiología , Lesiones por Pinchazo de Aguja/prevención & control , Humanos , Estudios Retrospectivos , Polonia/epidemiología , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/prevención & control , Masculino , Femenino , Adulto , Equipos de Seguridad/estadística & datos numéricosRESUMEN
This paper presents an enhanced probabilistic approach to estimate the real-world safety performance of new device concepts for road safety applications from the perspective of Powered Two-Wheeler (PTW) riders who suffer multiple injuries in different body regions. The proposed method estimates the overall effectiveness of safety devices for PTW riders by correlating computer simulations with various levels of actual injuries collected worldwide from accident databases. The study further develops the methodology initially presented by Johnny Korner in 1989 by introducing a new indicator, Global Potential Damage (GPD), that overcomes the limitations of the original method, encompassing six biomechanical injury indices estimated in five body regions. A Weibull regression model was fit to the field data using the Maximum Likelihood Method with boundaries at the 90% confidence level for the construction of novel injury risk curves for PTW riders. The modified methodology was applied for the holistic evaluation of the effectiveness of a new safety system, the Belted Safety Jacket (BSJ), in head-on collisions across multiple injury indices, body regions, vehicle types, and speed pairs without sub-optimizing it at specific crash severities. A virtual multi-body environment was employed to reproduce a selected set of crashes. The BSJ is a device concept comprising a vest with safety belts to restrict the rider's movements relative to the PTW during crashes. The BSJ exhibited 59% effectiveness, with an undoubted benefit to the head, neck, chest, and lower extremities. The results show that the proposed methodology enables an overall assessment of the injuries, thus improving the protection of PTW users. The novel indicator supports a robust evaluation of safety systems, specifically relevant in the context of PTW accidents.
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Accidentes de Tránsito , Simulación por Computador , Equipos de Seguridad , Seguridad , Humanos , Accidentes de Tránsito/prevención & control , Motocicletas , Heridas y Lesiones/prevención & control , Funciones de Verosimilitud , Fenómenos Biomecánicos , Cinturones de SeguridadRESUMEN
Modern vehicles are vulnerable to cyberattacks and the consequences can be severe. While technological efforts have attempted to address the problem, the role of human drivers is understudied. This study aims to assess the effectiveness of training and warning systems on drivers' response behavior to vehicle cyberattacks. Thirty-two participants completed a driving simulator study to assess the effectiveness of training and warning system according to their velocity, deceleration events, and count of cautionary behaviors. Participants, who held a valid United States driving license and had a mean age of 20.4 years old, were equally assigned to one of four groups: control (n = 8), training-only (n = 8), warning-only (n = 8), training and warning groups (n = 8). For each drive, mixed ANOVAs were implemented on the velocity variables and Poisson regression was conducted on the normalized time with large deceleration events and cautionary behavior variables. Overall, the results suggest that drivers' response behaviors were moderately affected by the training programs and the warning messages. Most drivers who received training or warning messages responded safely and appropriately to cyberattacks, e.g., by slowing down, pulling over, or performing cautionary behaviors, but only in specific cyberattack events. Training programs show promise in improving drivers' responses toward vehicle cyberattacks, and warning messages show rather moderate improvement but can be further refined to yield consistent behavior.
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Conducción de Automóvil , Simulación por Computador , Desaceleración , Humanos , Conducción de Automóvil/educación , Conducción de Automóvil/psicología , Masculino , Femenino , Adulto Joven , Accidentes de Tránsito/prevención & control , Adulto , Adolescente , Tiempo de Reacción , Equipos de Seguridad , SeguridadRESUMEN
Objective: Multiple studies evaluate relative risk of female vs. male crash injury; clinical data may offer a more direct injury-specific evaluation of sex disparity in vehicle safety. This study sought to evaluate trauma injury patterns in a large trauma database to identify sex-related differences in crash injury victims. Methods: Data on lap and shoulder belt wearing patients age 16 and up with abdominal and pelvic injuries from 2018 to 2021 were extracted from the National Trauma Data Bank for descriptive analysis using injuries, vital signs, International Classification of Disease (ICD) coding, age, and injury severity using AIS (Abbreviated Injury Scale) and ISS (Injury Severity Score). Multiple linear regression was used to assess the relationship of shock index (SI) and ISS, sex, age, and sex*age interaction. Regression analysis was performed on multiple injury regions to assess patient characteristics related to increased shock index. Results: Sex, age, and ISS are strongly related to shock index for most injury regions. Women had greater overall SI than men, even in less severe injuries; women had greater numbers of pelvis and liver injuries across severity categories; men had greater numbers of injury in other abdominal/pelvis injury regions. Conclusions: Female crash injury victims' tendency for higher (AIS) severity of pelvis and liver injuries may relate to how their bodies interact with safety equipment. Females are entering shock states (SI > 1.0) with lesser injury severity (ISS) than male crash injury victims, which may suggest that female crash patients are somehow more susceptible to compromised hemodynamics than males. These findings indicate an urgent need to conduct vehicle crash injury research within a sex-equity framework; evaluating sex-related clinical data may hold the key to reducing disparities in vehicle crash injury.
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Accidentes de Tránsito , Hígado , Humanos , Masculino , Femenino , Adolescente , Puntaje de Gravedad del Traumatismo , Equipos de Seguridad , HemodinámicaRESUMEN
PURPOSE: We examined collision warning systems with different modalities and timing thresholds, assessing their impact on responses to pedestrian hazards by drivers with impaired contrast sensitivity (ICS). METHODS: Seventeen ICS (70-84 y, median CS 1.35 log units) and 17 normal vision (NV: 68-73 y, median CS 1.95) participants completed 6 city drives in a simulator with 3 bimodal warnings: visual-auditory, visual-directional-tactile, and visual-non-directional-tactile. Each modality had one drive with early and one with late warnings, triggered at 3.5 s and 2 s time-to-collision, respectively. RESULTS: ICS participants triggered more early (43 vs 37 %) and late warnings (12 vs 6 %) than NV participants and had more collisions (3 vs 0 %). Early warnings reduced time to fixate hazards (late 1.9 vs early 1.2 s, p < 0.001), brake response times (2.8 vs 1.8 s, p < 0.001) and collision rates (1.2 vs 0.02 %). With late warnings, ICS participants took 0.7 s longer to brake than NV (p < 0.001) and had an 11 % collision rate (vs 0.7 % with early warnings). Non-directional-tactile warnings yielded the lowest collision rates for ICS participants (4 vs auditory 12 vs directional-tactile 15.2 %) in late warning scenarios. All ICS participants preferred early warnings. CONCLUSIONS: While early warnings improved hazard responses and reduced collisions for ICS participants, late warnings did not, resulting in high collision rates. In contrast, both early and late warnings were helpful for NV drivers. Non-directional-tactile warnings were the most effective in reducing collisions. The findings provide insights relevant to the development of hazard warnings tailored for drivers with impaired vision.
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Accidentes de Tránsito , Conducción de Automóvil , Sensibilidad de Contraste , Tiempo de Reacción , Humanos , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Accidentes de Tránsito/prevención & control , Simulación por Computador , Trastornos de la Visión , Estudios de Casos y Controles , Equipos de Seguridad , Factores de TiempoRESUMEN
Background: In the United States, 33% of households with children contain firearms, however only one-third reportedly store firearms securely. It's estimated that 31% of unintentional firearm injury deaths can be prevented with safety devices. Our objective was to distribute safe storage devices, provide safe storage education, evaluate receptivity, and assess impact of intervention at follow-up. Method: At five independent, community safety events, parents received a safe storage device after completing a survey that assessed firearms storage methods and parental comfort with discussions regarding firearm safety. Follow-up surveys collected 4 weeks later. Data were evaluated using descriptive analysis. Result: 320 participants completed the surveys, and 288 participants were gunowners living with children. Most participants were comfortable discussing safe storage with healthcare providers and were willing to talk with friends about firearm safety. 54% reported inquiring about firearm storage in homes their children visit, 39% stored all their firearms locked-up and unloaded, 32% stored firearms/ammunition separately. 121 (37%0.8) of participants completed the follow-up survey, 84% reported using the distributed safety device and 23% had purchased additional locks for other firearms. Conclusion: Participants were receptive to firearm safe storage education by a healthcare provider and distribution of a safe storage device. Our follow up survey results showed that pairing firearm safety education with device distribution increased overall use of safe storage devices which in turn has the potential to reduce the incidence of unintentional and intentional self-inflicted firearm injuries. Providing messaging to promote utilization of safe storage will impact a firearm safety culture change.
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Armas de Fuego , Heridas por Arma de Fuego , Niño , Humanos , Estados Unidos , Heridas por Arma de Fuego/prevención & control , Heridas por Arma de Fuego/epidemiología , Equipos de Seguridad , Padres , Administración de la SeguridadRESUMEN
The Guiana Shield, a small region of South America, is currently one of the main hotspots of malaria transmission on the continent. This Amazonian area is characterised by remarkable socioeconomic, cultural, health, and political heterogeneity and a high degree of regional and cross-border population mobility, which has contributed to the increase of malaria in the region in the past few years. In this context, regional cooperation to control malaria represents both a challenge and an indispensable initiative. This Viewpoint advocates for the creation of a regional cooperative mechanism for the elimination of malaria in the Guiana Shield. This strategy would help address operational and political obstacles to successful technical cooperation in the region and could contribute to reversing the regional upsurge in malaria incidence through creating a functional international control and elimination partnership.
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Malaria , Humanos , Malaria/epidemiología , Malaria/prevención & control , Equipos de SeguridadRESUMEN
The bulkhead additional thrust during shield tunneling, the force of friction between shield and soil, and the additional grouting pressure can cause additional stress in the surrounding soil, thereby disturbing existing buildings and structures. However, few studies focused on the disturbance situation when the shield tunneling machine approaches the receiving well. If the additional stress and deformation of the receiving well are too excessive, it could result in the collapse of the receiving well. Based on the two-stage method, this study derived the calculation formula of the additional stress and deformation of the receiving well enclosure structure caused by shield tunneling. Taking a shield machine receiving engineering as the context, this study established a numerical simulation model and compared theoretical calculation, the results of numerical simulation model and on-site monitoring data. Finally, the additional stress of the receiving well is analyzed. The research findings demonstrate that the theoretical prediction results, numerical simulation calculation results, and on-site monitoring data exhibit relatively small calculation errors, which validated the applicability of the theoretical prediction formula and numerical simulation model. As the distance between the shield machine and the receiving well decreases, the disturbance to the receiving well increases sharply. When the distance between the cutter head and the receiving well is less than three times the shield length, it is crucial to enhance the deformation monitoring of the receiving well. The primary factors affecting the additional load and deformation of the receiving well enclosure structure are the force of friction between shield and soil and the additional thrust of the cutterhead. The disturbance caused by the additional grouting pressure on the enclosure structure can be ignored.
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Ingeniería , Equipos de Seguridad , Simulación por Computador , Fricción , SueloRESUMEN
Arctic miners face significant risks from diesel exhaust and dust exposure, potentially leading to adverse respiratory health. Employers must limit harmful exposures, using personal protective equipment (PPE) as a last line of defense. This study explored the association between reported respiratory exposure and symptoms, and PPE training and usage. Data from the MineHealth study (2012-2014) included a total of 453 Arctic open pit miners in Norway, Sweden, and Finland. Participants answered questions on exposure to dust and diesel exhaust, respiratory symptoms, and PPE use, in addition to age, gender, BMI, smoking, and self-rated health. Estimated exposure to dust was common, reported by 91%, 80%, and 82% and that of diesel exhaust by 84%, 43%, and 47% of workers in Sweden, Finland, and Norway, respectively. Reported dust exposure was significantly related to respiratory symptoms (OR 2.2, 95% CI 1.3-3.7), diesel exposure increased the occurrence of wheezing (OR 2.6, 95% CI 1.3-5.4). PPE use varied between the studied mines. Non-use was common and related to reduced visibility, wetness, skin irritation and fogging of the respiratory PPE. Future research should employ more precise exposure assessment, respiratory function as well as explore the reasons behind the non-compliance of PPE use.
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Contaminantes Ocupacionales del Aire , Enfermedades Pulmonares , Exposición Profesional , Humanos , Polvo/análisis , Emisiones de Vehículos/análisis , Exposición Profesional/efectos adversos , Contaminantes Ocupacionales del Aire/análisis , Autoinforme , Equipos de SeguridadRESUMEN
INTRODUCTION: Popularity of crash avoidance features is growing, but so too is confusion around how to repair them, how much repairs should cost, and who should pay for those repairs. This study's purpose was to capture how these issues are affecting consumers. METHOD: A total of 496 vehicle owners in the United States were surveyed online and by phone about their experiences repairing front crash prevention (n = 359), blind spot detection (n = 317), and/or driver assistance cameras (n = 348) equipped on their personal vehicles. RESULTS: Owners tended to have multiple reasons for repairs. Repairs due to vehicle (i.e., crash or windshield) damage corresponded with the greatest likelihood of post-repair issues, especially if calibration was performed, and higher out-of-pocket costs (possibly because of deductibles or other repair work). About half of respondents who had calibrations performed on features repaired because of vehicle damage reported persisting issues with the features after repair. Post-repair issues were more common for repairs performed at independent repairers than dealership service centers, yet similar feature calibration rates were reported for both types of repairers. More people went to dealership service centers than independent repairers, and these respondents were more likely to say they would return to this type of facility for a similar repair in the future. Although most repairers explained why repairs occurred, less than half of respondents said they completely understood the reasons given. CONCLUSIONS: There are new complications in the repair cycle affecting consumers. Post-repair issues are more prevalent than previously assumed, regardless of the crash avoidance feature repaired. PRACTICAL APPLICATIONS: Post-repair issues risk undermining consumer acceptance and the safety potential of critical features. Simplifying the repair process and establishing affordable and accessible centralized databases with repair specifications and instructions from the manufacturers would be a start to addressing industry-wide challenges.
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Accidentes de Tránsito , Equipos de Seguridad , Humanos , Estados Unidos , Accidentes de Tránsito/prevención & control , Bases de Datos Factuales , Probabilidad , Gastos en SaludRESUMEN
PURPOSE: To assess the patient gonadal shielding practices of radiologic technologists in the state of California. METHODS: A survey invitation was sent via email to registered radiologic technologists in California to collect data to determine whether there were significant associations between gonadal shielding practices and various categorical variables, including patient sex, patient age, body part, availability of gonadal shielding protocols, availability of gonadal shields, and supervisor encouragement. RESULTS: There was a significant association between gonadal shielding protocol availability and supervisor encouragement of using gonadal shielding (P = .005) and between gonadal shielding availability and supervisor encouragement of using gonadal shielding (P < .001). Contrary to other studies in the literature, there was a significant difference between patient sex and the likelihood of gonadal shielding use, with participants indicating that they shield girls and women more often than they shield boys and men (P < .001). DISCUSSION: There was a sex-based difference in the frequency of gonadal shielding usage among the sample in this study. Also, supervisors providing accessible protocols and encouraging gonadal shielding can increase technologists' use of gonadal shielding. CONCLUSION: Gonadal shielding is the current Code of Federal Regulations standard, although most professional and scientific organizations support discontinuing shielding during abdominal and pelvic radiography examinations. Shielding of these areas is more likely to occur with the availability of gonadal shielding, supervisory encouragement, protocols mandating shielding, and state regulations.
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Protección Radiológica , Masculino , Humanos , Femenino , Radiografía , Protección Radiológica/métodos , California , Equipos de Seguridad , Dosis de RadiaciónRESUMEN
OBJECTIVE: Automatic emergency braking (AEB) and forward collision warning (FCW) are effective at preventing rear-end crashes, but they may perform better in some rear-end crash scenarios than others. The goal of this study was to estimate the effects of front crash prevention systems equipped to passenger vehicles in crashes where another passenger vehicle, a medium/heavy truck, or a motorcycle is struck and compare effectiveness by struck vehicle type. METHODS: More than 160,000 two-vehicle rear-end crashes were identified where a passenger vehicle with or without FCW and AEB was the striking vehicle and another passenger vehicle, medium/heavy truck, or motorcycle was the struck vehicle. Poisson regression was used to estimate the effect of front crash prevention by struck vehicle type on rear-end crash rates per registered vehicle year, accounting for the state and year of the crash and the make, model year, class, and engine type of the striking vehicle. RESULTS: Front crash prevention was associated with a 53% reduction in rear-end crash rates when striking another passenger vehicle, which was significantly larger than the reductions of 38% when striking a medium/heavy truck and 41% when striking a motorcycle. Reductions in rear-end injury crash rates when striking a passenger vehicle also were larger than when striking a medium/heavy truck and when striking a motorcycle. DISCUSSION: If all passenger vehicles were equipped with FCW and AEB that were as effective in crashes striking a truck or motorcycle as they are in crashes with another passenger vehicle, over 5,500 additional crashes with medium/heavy trucks and 500 with motorcycles could potentially be prevented annually in the United States above what would be expected from current front crash prevention systems. Extending front crash prevention testing in consumer information programs to include motorcycle and truck targets could encourage auto manufacturers to improve performance in these crash scenarios.
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Accidentes de Tránsito , Motocicletas , Humanos , Estados Unidos , Accidentes de Tránsito/prevención & control , Equipos de Seguridad , Vehículos a Motor , Extremidad InferiorRESUMEN
On the basis of the jet theory of airflow fields and the gas-solid two-phase flow theory, we studied the law of dust migration in a simulated dusting space. We used the control variable method and numerical simulation software to explore the airflow field and dust concentration distribution on the working surface of the dusting under different inlet wind speeds and different attached blades of the double-walled annular air curtain. We determined the speed of the inlet of the annular air curtain to be 30 m/s. When the angle of the attached blade was 30°, the dust concentration of the driver and other workers was controlled below 100 mg/m3, which produced the best dust control effect is the best. Using real data, we built a similar test platform to test the airflow field and dust concentration. Through data measurement and analysis, we proved that a dust control system with a double-wall attached-ring air curtain formed a circulating airflow field that could shield dust and effectively reduce dust concentration in the simulated space. The dust removal efficiency of total dust and exhaled dust reached 98.5% and 97.5%, respectively. We compared the test data and simulation results and concluded that the double-wall attached-ring air curtain could effectively ensure the safety of mine production and provide a better underground working environment for operators.
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Polvo , Viento , Humanos , Polvo/análisis , Equipos de SeguridadRESUMEN
The ideal bone implant would effectively prevent aseptic as well as septic loosening by minimizing stress shielding, maximizing bone ingrowth, and preventing implant-associated infections. Here, a novel gradient-pore-size titanium scaffold was designed and manufactured to address these requirements. The scaffold features a larger pore size (900 µm) on the top surface, gradually decreasing to small sizes (600 µm to 300 µm) towards the center, creating a gradient structure. To enhance its functionality, the additively manufactured scaffolds were biofunctionalized using simple chemical and heat treatments so as to incorporate calcium and iodine ions throughout the surface. This unique combination of varying pore sizes with a biofunctional surface provides highly desirable mechanical properties, bioactivity, and notably, long-lasting antibacterial activity. The target mechanical aspects, including low elastic modulus, high compression, compression-shear, and fatigue strength, were effectively achieved. Furthermore, the biofunctional surface exhibits remarkable in vitro bioactivity and potent antibacterial activity, even under conditions specifically altered to be favorable for bacterial growth. More importantly, the integration of small pores alongside larger ones ensures a sustained high release of iodine, resulting in antimicrobial activity that persisted for over three months, with full eradication of the bacteria. Taken together, this gradient structure exhibits obvious superiority in combining most of the desired properties, making it an ideal candidate for orthopedic and dental implant applications.
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Yodo , Titanio , Titanio/farmacología , Equipos de Seguridad , Antibacterianos/farmacología , Yodo/farmacología , IonesRESUMEN
During the COVID-19 pandemic, dental face shields were recommended to protect the eyes. This study aimed to examine to what extent face shield and mask contamination differ when a pre-procedural mouth rinsing with Chlorhexidine (CHX) is conducted before treatment. In this prospective, randomized study, three groups of subjects were formed (rinsing with 0.1% CHX, water, or no rinsing (control) before aerosol-producing treatments). After each of the 301 treatments, the practitioner's face shield was swabbed with eSwab and the mask was brought into contact with agar plates. Sampling was done from the exterior surface only. Samples were cultured for 48 h at 35 °C under aerobic and anaerobic conditions. Bacteria were classified by phenotypic characteristics, biochemical test methods, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Colony-forming units were counted and mean values were compared (WSR, H-test, U-test, p < 0.05). Within each subject group, face shields showed significantly more contamination than surgical masks (control group: 350 CFU, 50 CFU; intervention water: 270 CFU, 40 CFU; intervention CHX: 250 CFU, 30 CFU). Comparison of face shields of the different subject groups did not reveal any statistically significant differences. However, CHX resulted in a statistically significant bacterial reduction on surgical masks compared to the water and control group (control: 50 CFU, intervention water: 40 CFU, intervention CHX: 30 CFU). Contamination of face shields and surgical masks was highest in the control group, followed by the water group, and lowest in the intervention group with CHX. Streptococcus spp. and Staphylococcus spp. dominated, representing the oral and cutaneous flora. Contamination of masks worn with or without face shields did not differ. Presumably, face shields intercept first splashes and droplets, while the masks were mainly exposed to bioaerosol mist. Consequently, face shields protect the facial region and surroundings from splashes and droplets, but not the mask itself. A pre-procedural mouth rinse with CHX had no statistically significant reducing effect on contamination of the face shield, but a statistically significant reducing effect was observed on contamination of the mask.
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Pandemias , Aerosoles y Gotitas Respiratorias , Humanos , Clorhexidina/farmacología , Equipos de Seguridad , Bacterias , Agua/farmacologíaRESUMEN
Forward collision warning (FCW) systems have been widely used in trucks to alert drivers of potential road situations so they can reduce the risk of crashes. Research on FCW use shows, however, that there are differences in drivers' responses to FCW alerts under different scenarios. Existing FCW algorithms do not take differences in driver response behavior into account, with the consequence that the algorithms' minimum safe distance assessments that trigger the warnings are not always appropriate for every driver or situation. To reduce false alarms, this study analyzed truck driver behavior in response to FCW warnings, and k-means clustering was adopted to classify driver response behavior into three categories: Response Before Warning (RBW), Response After Warning (RAW), and No Response (NR). Results showed that RBW clusters tend to occur at long following distances (>19 m), and drivers applied braking before the warning. In RAW clusters, deceleration after warning is significantly more forceful than before warning. NR clusters occur at short distances, and deceleration fluctuates only slightly. To optimize the FCW algorithm, the warning distance was divided into reaction distance and braking distance. The linear support vector machine was used to fit the driver reaction distance. The long short-term memory method was used to predict braking distance based on each of the three response scenarios: R2 was 0.896 for RAW scenarios, 0.927 for RBW scenarios, and 0.980 for NR scenarios. Verification results show that the optimized truck FCW algorithm improved safety by 1 % to 5.1 %; accuracy reached 97.92 %, and the false alarm rate was 1.73 %.
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Accidentes de Tránsito , Conducción de Automóvil , Humanos , Accidentes de Tránsito/prevención & control , Equipos de Seguridad , Conductores de Camiones , Vehículos a Motor , Algoritmos , Tiempo de Reacción/fisiologíaRESUMEN
BACKGROUND: Adverse childhood experiences (ACE) have been documented to have long-term impacts on sleep disturbances. However, less is known about how ACE co-occurs with positive childhood experiences (PCE) and modulate their effects on adult sleep disturbances, particularly in the context of persistent insomnia. Building on resilience theory, this study aims to examine the interplay between ACE and PCE and their effects on persistent insomnia during emerging adulthood. METHODS: A total of 2,841 emerging adults were recruited from the Taiwan Youth Project. Persistent insomnia during emerging adulthood was assessed using two adult surveys (mean age = 19.8 and 21.9). The ACE (10 items) and PCE (7 items) were obtained from the baseline survey (mean age = 13.8). A series of logistic regression analyses were conducted. RESULTS: Among the emerging adults, 29.22% had persistent insomnia. Consistent with the compensatory model, ACE and PCE exerted opposing effects on persistent insomnia during emerging adulthood. In line with the protective model, the negative effect of ACE is mitigated when individuals have high PCE. However, consistent with the challenge model, the protective effect of PCE on persistent insomnia was inhibited in individuals with four or more ACE. CONCLUSIONS: PCE serves as a protective factor, shielding emerging adults from the adverse effects of ACE on persistent insomnia. It is essential to prioritize positive experiences during early life to promote lifelong sleep health.