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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 248-251, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33017975

RESUMO

Accurate and reliable detecting of driving fatigue using Electroencephalography (EEG) signals is a method to reduce traffic accidents. So far, it is natural to cut the part of operating the steering wheel data away for achieving the relatively high accuracy in detecting driving fatigue using EEG data. However, the data segment during operating the steering wheel also contains valuable information. Moreover, operating the steering wheel is a common practice during actual driving. In this study, we utilize the part of data operating the steering wheel to detecting fatigue. The feature used is the spectral band power calculates from the data. For each experiment and each experimental participant, the data and features are divided into sessions and subjects. Using the divided features, this work performs cross-session and cross-subject verification and comparison on the two classification methods of logistic regression and multi-layer perceptron. To compare the effect, the experiment is conducted on the data both operating the steering wheel and not operating the steering wheel. The result shows that the bias between the average accuracy of two types of data is only 2.27%, and the effect of using multi-layer perceptron is 10.37% better than using logistic regression. This proves that the data segment during operating the steering wheel also contains valid information and can be used for driving fatigue detection.


Assuntos
Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Eletroencefalografia , Técnicas Histológicas , Humanos , Equipamentos de Proteção
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 252-255, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33017976

RESUMO

Drowsy driving is one of the major causes in traffic accidents worldwide. Various electroencephalography (EEG)-based feature extraction methods are proposed to detect driving drowsiness, to name a few, spectral power features and fuzzy entropy features. However, most existing studies only concentrate on features in each channel separately to identify drowsiness, making them vulnerable to variability across different sessions and subjects without sufficient data. In this paper, we propose a method called Tensor Network Features (TNF) to exploit underlying structure of drowsiness patterns and extract features based on tensor network. This TNF method first introduces Tucker decomposition to tensorized EEG channel data of training set, then features of training and testing tensor samples are extracted from the corresponding subspace matrices through tensor network summation. The performance of the proposed TNF method was evaluated through a recently published EEG dataset during a sustained-attention driving task. Compared with spectral power features and fuzzy entropy features, the accuracy of TNF method is improved by 6.7% and 10.3% on average with maximum value 17.3% and 29.7% respectively, which is promising in developing practical and robust cross-session driving drowsiness detection system.


Assuntos
Condução de Veículo , Processamento de Sinais Assistido por Computador , Acidentes de Trânsito/prevenção & controle , Eletroencefalografia , Vigília
3.
Ann Palliat Med ; 9(5): 3710-3715, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33065808

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified strain of coronavirus in the human body and was reported in Wuhan at the end of 2019. So far, the epidemic is continuing and very serious, with the number of infections and deaths increasing. Despite active investigations around the world to better understand the dynamics of transmission and the scope of clinical disease, COVID-19 continues to spread rapidly from person to person. The common signs and symptoms of SARS-CoV-2 infection include fever, fatigue, dry cough, and dyspnea; in severe cases, patients may have acute respiratory distress syndrome, septic shock, metabolic acidosis difficult to treat and coagulation disorder. However, some patients who test positive for SARS-CoV-2 in their respiratory tract may not have such clinical signs and symptoms. This report presents a case study analysis of a patient admitted in the Fourth Taiyuan People's Hospital, who had suffered traumatic injuries from a car accident and survived COVID-19, with pleural effusion as the initial symptom. We report a case of 2019-NCOV with pleural effusion as the first symptom. Describe in detail the differential diagnosis, diagnosis, clinical management, and cure of this case. In order to combat the novel CoronaviruscoVID-19 in the process to provide lessons and help.


Assuntos
Acidentes de Trânsito , Infecções por Coronavirus/diagnóstico , Traumatismo Múltiplo/diagnóstico , Derrame Pleural/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Betacoronavirus , Otorreia de Líquido Cefalorraquidiano/complicações , Otorreia de Líquido Cefalorraquidiano/diagnóstico , Infecções por Coronavirus/complicações , Progressão da Doença , Sinusite Etmoidal/complicações , Sinusite Etmoidal/diagnóstico , Feminino , Traumatismos do Pé/complicações , Traumatismos do Pé/diagnóstico , Humanos , Pulmão/diagnóstico por imagem , Fraturas Maxilares/complicações , Fraturas Maxilares/diagnóstico , Seio Maxilar/lesões , Traumatismo Múltiplo/complicações , Fraturas Orbitárias/complicações , Pandemias , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Fraturas das Costelas/complicações , Fraturas das Costelas/diagnóstico , Falanges dos Dedos do Pé/lesões , Tomografia Computadorizada por Raios X , Fraturas da Ulna/complicações , Fraturas da Ulna/diagnóstico
4.
Chirurgia (Bucur) ; 115(4): 530-536, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876028

RESUMO

The enlarged number of powerful vehicles in our country led to an increased speed of travel and hence the high number of traffic accidents with severe consequences, even death. Along with polytrauma caused by occupational accidents, these types of traumas require complex and often multidisciplinary surgical therapy against the clock, which places the surgeon in front of situations that are not found in the everyday practice. Injuries involving damage to the thoracic-phreno-abdominal region fall into this specific category that we have chosen to discuss in the present work. We will further present three clinical cases of patients with thoraco-phreno-abdominal injuries produced by different mechanisms. A work-accident wound produced by an angle grinder, causing left thoracoabdominal injuries; a polytrauma caused by a road accident, with a thoraco-phreno abdominal wound produced by a piece of wood that penetrated obliquely through the right thorax, in the 5th and 6th intercostal spaces, crossed the right lower lung lobe, the diaphragm, the 7th liver segment, and stopped in the right posterior costal grid, and a polytrauma following a fall from a height, with a torn diaphragm and mesentery.


Assuntos
Traumatismos Abdominais/cirurgia , Traumatismo Múltiplo/cirurgia , Traumatismos Torácicos/cirurgia , Ferimentos Penetrantes/cirurgia , Traumatismos Abdominais/complicações , Acidentes por Quedas , Acidentes de Trânsito , Humanos , Traumatismo Múltiplo/complicações , Traumatismos Ocupacionais/complicações , Traumatismos Ocupacionais/cirurgia , Traumatismos Torácicos/complicações , Resultado do Tratamento , Ferimentos Penetrantes/complicações
5.
Niger J Clin Pract ; 23(9): 1221-1228, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913160

RESUMO

Background: : Vascular injuries are commonly seen in both emergency services and forensic medicine practise. They are often life-threatening, with high morbidity and mortality rates. Aims: This study aimed to retrospectively evaluate extremity vascular injuries and the associated treatment approaches. Methods: After obtaining approval from the ethics committee of the university, those patients admitted to the emergency department of Adiyaman between 1 February 2013 and 31 August 2018 were included in this study. The patients' data were obtained through the electronic records system, and the cases were evaluated according to the age, gender and cause of injury, including blunt force trauma injuries (accidents, traffic accidents, crush injuries and occupational accidents) and penetrating injuries (stabbing, gunshot wounds, suicide attempts and assaults). Additionally, the injuries were evaluated based on the extremity, according to the anatomical location and whether the injury was life-threatening. Results: This study included 76 patients with extremity vascular injuries; 65 were males (85.52%), 11 were females (14.48%) and their average age was 33.24 ± 15.85 years. Forty-five (59.2%) of the patients had upper extremity vascular injuries, and 31 (40.3%) had lower extremity vascular injuries. In addition to arterial injuries, 26 (34.21%) of the patients had venous injuries and 22 (28.94%) had nerve injuries. Nine of these patients had neurological deficits due to their nerve injuries. All of the patients were revascularized within 3-5 hours, and none of the patients required amputations. Conclusion: The primary goals in extremity vessel injury cases are to prevent mortality, especially after major vascular injuries, and save the extremity from amputation. With a fast, effective and multi-disciplinary approach, an accurate diagnosis and effective surgical intervention can prevent morbidity and mortality as well as reduce the rate of undesirable complications.


Assuntos
Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/lesões , Procedimentos Cirúrgicos Vasculares/métodos , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/cirurgia , Ferimentos Penetrantes/diagnóstico por imagem , Acidentes de Trânsito , Adolescente , Adulto , Artérias/diagnóstico por imagem , Artérias/lesões , Angiografia por Tomografia Computadorizada , Extremidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/cirurgia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/epidemiologia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/cirurgia , Adulto Jovem
6.
Ther Umsch ; 77(7): 328-332, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32996423

RESUMO

Diabetes, hypoglycemia and driving instructions in Switzerland Abstract. Many individuals with diabetes participate in road traffic in a regular and safe manner. Studies suggest that type 1 diabetes leads to more traffic accidents. Hypoglycemia is a risk factor for driving mishaps. Therefore, patients with diabetes medication, which can cause hypoglycemia, have to be informed and adhere to the guidelines regarding suitability for driving. These guidelines are summarized in this review.


Assuntos
Condução de Veículo , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemia/induzido quimicamente , Acidentes de Trânsito/prevenção & controle , Humanos , Suíça
7.
Epidemiol Infect ; 148: e223, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32958089

RESUMO

The coronavirus disease (COVID-19), while mild in most cases, has nevertheless caused significant mortality. The measures adopted in most countries to contain it have led to colossal social and economic disruptions, which will impact the medium- and long-term health outcomes for many communities. In this paper, we deliberate on the reality and facts surrounding the disease. For comparison, we present data from past pandemics, some of which claimed more lives than COVID-19. Mortality data on road traffic crashes and other non-communicable diseases, which cause more deaths each year than COVID-19 has so far, is also provided. The indirect, serious health and social effects are briefly discussed. We also deliberate on how misinformation, confusion stemming from contrasting expert statements, and lack of international coordination may have influenced the public perception of the illness and increased fear and uncertainty. With pandemics and similar problems likely to re-occur, we call for evidence-based decisions, the restoration of responsible journalism and communication built on a solid scientific foundation.


Assuntos
Infecções por Coronavirus/epidemiologia , Recessão Econômica , Saúde Mental , Pneumonia Viral/epidemiologia , Saúde Pública , Acidentes de Trânsito/mortalidade , Betacoronavirus , Comunicação , Infecções por Coronavirus/mortalidade , Surtos de Doenças , Humanos , Influenza Pandêmica, 1918-1919/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Risco , Distância Social
8.
Accid Anal Prev ; 146: 105747, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32911131

RESUMO

BACKGROUND: The effect of mandated societal lockdown to reduce the transmission of coronavirus disease 2019 (COVID-19) on road traffic accidents is not known. For this reason, we performed an in-depth analysis using data from Statewide Traffic Accident Records System. MATERIALS AND METHODS: We reviewed data on total 2292 road traffic accident records in Missouri from January 1, 2020 through May 15, 2020. We treated March 23 as the first day of mandated societal lockdown and May 3 as the first day of re-opening. RESULTS: We have found that there was a significant reduction in road traffic accidents resulting in minor or no injuries (mean 14.5 versus 10.8, p < 0.0001) but not in accidents resulting in serious or fatal injuries (mean 3.4 versus 3.7, p = 0.42) after mandated societal lockdown. Furthermore, there was a significant reduction in road traffic accidents resulting in minor or no injuries after the mandated social lockdown (parameter estimate -5.9, p = 0.0028) in the time series analysis. There was an increase in road traffic accidents resulting in minor or no injuries after expiration of mandatory societal lockdown (mean 10.8 versus 13.7, p = 0.04). CONCLUSION: The mandated societal lockdown policies led to reduction in road traffic accidents resulting in non-serious or no injuries but not those resulting in serious or fatal injuries.


Assuntos
Acidentes de Trânsito/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Humanos , Missouri
9.
Harefuah ; 159(9): 659-665, 2020 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-32955808

RESUMO

INTRODUCTION: The population is ageing. This trend is expected to cause an increase in the number of driver licenses among the elderly, and in their mobility. The effect of medications on driving capability may be significant. OBJECTIVES: To characterize the comorbidities among elderly patients involved in traffic accidents who were hospitalized at Beilinson Hospital and the psychotropic drugs taken prior to the accident, to assess the prevalence of anticholinergic drug load in this population and to examine its effect on clinical outcomes after the accident among the drivers. METHODS: This is a retrospective cross-sectional study of the elderly over the age of 65, who were involved in a traffic accident between the years 2005-2015 (drivers and pedestrians) and were hospitalized. For each patient, a Charlson comorbidity index score was calculated and 3 months pre-accident drug dispensing data were extracted. The evaluation of the anticholinergic drug load for each patient was performed using the Anticholinergic Cognitive Burden (ACB) scale. RESULTS: The study included 291 patients (98 drivers, 193 pedestrians). Pedestrians were injured more severely in comparison to the drivers' subgroup. The population received an average of 8.1 systemic drugs during the 3 months period prior to the accident. Approximately 36.7% were prescribed psychotropic medication (27.1%, 16.4% and 2.4% benzodiazepines, antidepressants and antipsychotics respectively); 32.3% had significant anticholinergic load (ACB score> 1). No significant differences were found in the prevalence of use of psychotropic drugs and/or ACB score between pedestrian and drivers or with post-accident clinical outcomes between drivers with high versus low anticholinergic drug load. CONCLUSIONS: The prevalence of psychotropic and anticholinergic drug burden is high among elderly involved in traffic accidents. Pre-accident anti-cholinergic drug load does not affect clinical outcomes after the accident. Elderly pedestrians are injured more severely than elderly drivers.


Assuntos
Acidentes de Trânsito , Antagonistas Colinérgicos/metabolismo , Psicotrópicos/metabolismo , Idoso , Condução de Veículo , Estudos Transversais , Humanos , Estudos Retrospectivos
10.
Cochrane Database Syst Rev ; 9: CD013738, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32966589

RESUMO

BACKGROUND: Road traffic suicides are common. However, due to the difficulty in distinguishing between motor vehicle crash fatalities and actual suicides, no official figures exist for this method of suicide. Restricting access to means is an important universal or population-based approach to suicide prevention with clear evidence of its effectiveness. However, the evidence with respect to means restriction for the prevention of suicide on roads is not well established. We conducted a systematic review to assess the impact of restrictions on the availability of, or access to, means of suicide on roads. OBJECTIVES: To evaluate the effectiveness of interventions to restrict the availability of, or access to, means of suicide on roads. SEARCH METHODS: We searched the Cochrane Library, MEDLINE, Embase, PsycINFO, and the Transport Research International Documentation (TRID) Database from the date of database inception to March 2020. We conducted searches of the World Health Organization International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov to identify unpublished and ongoing studies. We applied no date, language, or publication status restrictions to these searches. SELECTION CRITERIA: Eligible studies were randomised or quasi-randomised controlled trials, controlled intervention studies without randomisation, before-after studies, or studies using interrupted time series designs, which evaluated interventions to restrict the availability of, or access to, means of suicide on roads. DATA COLLECTION AND ANALYSIS: Two review authors screened abstracts and full-text publications against the inclusion criteria. Two review authors planned to independently extract data and assess risk of bias of included studies. However, we identified no studies eligible for inclusion. MAIN RESULTS: We identified no studies that met the inclusion criteria for this review. AUTHORS' CONCLUSIONS: This systematic review highlights the paucity of research around road traffic suicides and the need for future robust studies that aim to investigate the effectiveness of interventions to prevent suicide on roads. Suicide ascertainment is a key issue; therefore, clear objective criteria are necessary in order to scale up and study this method more accurately. In the absence of any substantial evidence, we advocate for more awareness on road traffic suicides and its inclusion in future government suicide prevention policies. Further research exploring effective measures, particularly those that do not require driver compliance, are also needed.


Assuntos
Acidentes de Trânsito/prevenção & controle , Suicídio/prevenção & controle , Acidentes de Trânsito/psicologia , Humanos , Fatores de Risco
11.
J Environ Manage ; 273: 111172, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32768765

RESUMO

Wildlife mortality caused by vehicles is a serious conservation and economic problem as collisions with large mammals are global, pervasive and increasing. We analysed 14,989 reports of ungulate-vehicle collisions (UVC) that occurred in Lithuania from 2002 to 2017. We analysed UVC data for four major ungulate species (roe deer, red deer, moose and wild boar) and checked for potential seasonal or daily trends. The temporal distribution of collisions was species-dependent. UVC analysis showed strong monthly and hourly pattern. Most occurrences took place before or during sunrise (dawn) and after or during sunset (dusk) during the year. In spring, the highest UVC peaks occurred early in the morning and late in the evening, while in winter these peaks occurred in late mornings and early evenings. With most UVC occurring on Fridays, daily variations were weak. We conclude that temporal variations of UVC distributions are result of a complex interaction of phenological factors and animal behaviour. The information provided in this study reinforces the knowledge on the dynamics and patterns of UVC and represents an important element for the identification of mitigation measures. Our findings suggest that efforts to reduce UVC should also focus on driver attitudes considering the seasonal and daily variations in UVC.


Assuntos
Acidentes de Trânsito , Cervos , Animais , Animais Selvagens , Lituânia , Estações do Ano , Suínos
12.
J Orthop Trauma ; 34(9): e336-e342, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32815848

RESUMO

OBJECTIVES: To evaluate the effect of the COVID-19 pandemic and the "shelter-in-place" order on orthopaedic trauma presenting to a community level II trauma center. It is hypothesized that the overall number of orthopaedic trauma encounters (OTEs), the number of OTEs related to both high and low severity injuries, and the proportion of OTEs related to high severity versus low severity injuries decreased compared with previous years. METHODS: A retrospective analysis was conducted of OTEs between 2016 and 2020. High and low severity OTEs were classified according to an algorithm created by the researchers. Data were statistically analyzed and compared with external data for traffic counts, motor vehicle accidents, and Transportation Security Administration checkpoints. RESULTS: A 45.1% decrease (P = 0.0005) was seen in OTEs from March and April 2016-2019 compared with 2020. The decrease began approximately 12 days before the shelter-in-place order. There was a 58.8% decrease in high severity injuries with a fracture (P = 0.013) and a 42.9% decrease in low severities injuries (P = 0.0003). The proportion of high to low severity OTEs was unchanged. CONCLUSIONS: The quantity of OTEs was significantly affected by the COVID-19 pandemic and Michigan shelter-in-place order. A decrease in both high and low severity OTEs was found; however, there was no statistically significant change in the ratio of high to low severity OTEs compared with previous years. Although it is difficult to determine what portion of the decrease in OTE is attributable to the shelter-in-place order versus the COVID-19 pandemic in general, data suggest both play a role. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis , Infecções por Coronavirus/prevenção & controle , Fraturas Ósseas/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Algoritmos , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Isolamento Social , Centros de Traumatologia , Índices de Gravidade do Trauma
13.
J Orthop Trauma ; 34(9): e343-e348, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32815849

RESUMO

OBJECTIVES: To compare orthopaedic trauma volume and mechanism of injury before and during statewide social distancing and stay-at-home directives. DESIGN: Retrospective. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: One thousand one hundred thirteen patients sustaining orthopaedic trauma injuries between March 17 and April 30 of years 2018, 2019, and 2020. INTERVENTION: Statewide social distancing and stay-at-home directives. MAIN OUTCOME MEASUREMENTS: Number of consults, mechanism of injury frequency, and type of injury frequency. RESULTS: During the COVID-19 pandemic, orthopaedic trauma consult number decreased. Injuries due to gunshot wounds increased and those due to automobile versus pedestrian accidents decreased. Time-to-presentation increased and length of stay decreased. Operative consults remained unchanged. CONCLUSIONS: Orthopaedic trauma injuries continued to occur during the COVID-19 pandemic at an overall decreased rate, however, with a different distribution in mechanism and type of injury. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Betacoronavirus , Controle de Doenças Transmissíveis , Infecções por Coronavirus/prevenção & controle , Fraturas Ósseas/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Centros de Traumatologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Idoso , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Adulto Jovem
14.
BMC Public Health ; 20(1): 1294, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847576

RESUMO

BACKGROUND: Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia. METHODS: A qualitative study using content analysis was undertaken. Participants aged 65 or more years were purposively selected from a larger inception cohort study of health outcomes following mild to moderate RTI conducted in New South Wales, Australia. Semi-structured interviews were undertaken at approximately 12 or 24 months post-injury. Content analysis was used to code and analyse the data, with methodological rigour obtained by double-coding and discussing findings to reach consensus. Results were reported using the consolidated criteria for reporting qualitative research (COREQ). RESULTS: Nineteen participants were invited to participate in the study of which 12 completed interviews. Data saturation was reached at the twelfth interview. Recovery experiences were diverse. Five main themes were identified: recovery is regaining independence; injury and disability in older age; the burden of non-obvious disability; the importance of support; and positive personal approaches. Key facilitators of recovery were: regaining independence; support from family and friends; and positive personal approaches. Key barriers were: threats to independence; passive coping behaviours; non-obvious disabilities (chronic pain, psychological impacts); and reluctance to raise ongoing issues with General Practitioners. Threats to independence, especially not driving and self-care, appeared to have a more profound effect on recovery than physical functioning. CONCLUSION: Older people view injury as a threat to independent functioning. This is somewhat different to what younger people report. Regaining independence is key to older people's recovery and health-related quality of life following RTI, and should be a key consideration for health professionals, services and supports working with this unique cohort. Greater efforts to help older people regain their independence following RTI are needed and can be facilitated by health professionals and appropriate service provision. TRIAL REGISTRATION: Australia New Zealand clinical trial registry identification number ACTRN12613000889752 .


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Pessoas com Deficiência/psicologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/reabilitação , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Vida Independente/psicologia , Masculino , New South Wales/epidemiologia , Pesquisa Qualitativa , Qualidade de Vida/psicologia
15.
Medicine (Baltimore) ; 99(31): e21528, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756199

RESUMO

RATIONALE: Massive retropharyngeal hematoma secondary to a minor blunt trauma is rare and easy to be missed in emergency settings due to the absence of visible tissue injury, especially in young patients. However, missing this pathology is dangerous and can result in airway obstruction and even death. Therefore, an effective diagnostic strategy must be developed and thoroughly performed to minimize missed retropharyngeal hematoma. PATIENT CONCERNS: A 49-year-old man with a brief cervical hyperextension secondary to a minor collision presented with mild respiratory discomfort. No externally visible injuries were found; however, dyspnea was persistent and aggravating. DIAGNOSIS: Lateral neck X-ray, neck computed tomography, and spine magnetic resonance imaging revealed a huge retropharyngeal hematoma obstructing the upper airway, without any severe fracture or ligament injury. INTERVENTIONS: An emergent orotracheal intubation followed by imaging studies was performed to resolve the aggravating dyspnea. Neck exploration surgery was immediately performed for rapid absorption of the hematoma, bleeding control, and identification of the reason of the pathology. OUTCOMES: The surgery was successful, and the patient was discharged without any postoperative sequelae on the 30 postoperative day. CONCLUSION: Retropharyngeal hematoma that develops in young patients without visible injuries or severe symptoms after a minor trauma can easily go undetected. Although most hematomas under observation resolve spontaneously, the retropharyngeal hematomas missed at initial assessment may result in critical complications. High level of suspicion, repeated neck CT, and thorough tertiary survey in emergency rooms are helpful in avoiding missed life-threatening retropharyngeal hematoma.


Assuntos
Vértebras Cervicais/lesões , Dispneia/etiologia , Hematoma/etiologia , Doenças Faríngeas/etiologia , Ferimentos não Penetrantes/complicações , Acidentes de Trânsito , Humanos , Masculino , Pessoa de Meia-Idade
16.
Artigo em Russo | MEDLINE | ID: mdl-32827380

RESUMO

The organization of accounting frequency, scope and effectiveness of first medical aid measures could significantly affect improvement of the first aid system in the Russian Federation. According to the score of severity of injury - Abbreviated Injury Scale (AIS-90) and the Injury Severity Scale (ISS) and experts review 23.4% of road accident victims who died before the arrival of emergency medical care had survival probability of more than 50%. The total number of first aid cases before the arrival of the ambulance is only 4.4% of all victims of road traffic crashes. More than 60% of victims needed first aid care and treatment. All reporting statistical forms in force in the Russian Federation at the moment do not provide data for accounting cases of first aid. The developed and tested new registration form "First Aid Registration Card", containing necessary indicators of first aid effectiveness, permits quickly to fill out main indicators data of the victim condition and to complete first aid measures. Also it allows to assess the impact of first aid on mortality, disability and timing of temporary disability loss.


Assuntos
Serviços Médicos de Emergência , Ferimentos e Lesões , Acidentes de Trânsito , Ambulâncias , Primeiros Socorros , Federação Russa
17.
PLoS One ; 15(8): e0237408, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776981

RESUMO

Mountainous freeways with high bridge and tunnel ratios are a new type of road that rarely contain many special road sections formed by various structures. The crash characteristics of the road are still unclear, but it also provides conditions for studying how various road environments affect traffic. In view of the various structures and differences in the driving environments, a scenario-based discretization method for such a road was established. The traffic-influence areas of elementary and composite structures were proposed and defined. Actual data were analyzed to investigate the crash patterns in an entire freeway and in each special section through statistical and comparative research. The results demonstrate the applicability and validity of this method. The crash rates were found to be the highest in interchange and service areas, lower in ordinary sections, and the lowest in tunnels, being mostly attributed to collisions with fixtures. The crash severity on bridges and bridge groups was significantly higher than that on the other types of road sections, being mostly attributed to single-vehicle crashes. The annual average daily traffic and driving adaptability were found to be related to crashes. The findings shed some light on the road design and traffic management implications for strengthening the traffic safety of mountainous freeways.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo , Planejamento Ambiental , Humanos , Fatores de Risco , Segurança
18.
Cranio ; 38(5): 281-283, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32835648
19.
J Environ Manage ; 275: 111254, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32841791

RESUMO

Many approaches have been developed in order to mitigate wildlife-vehicle collisions (WVC), their causes and consequences. Reliable data on the amount and location of killed animals along roads are therefore necessary. The existing WVC databases are usually, however, far from complete. This data underreporting causes problems when identifying the riskiest places along a transportation infrastructure. WVC data underreporting can distort the results of WVC hotspots determination. In this work, we simulated WVC hotspots identification and stability under various rates of WVC data underreporting. Our aim was to investigate whether WVC hotspots can be found at the original locations even when data are strongly underreported. We applied the KDE + method for WVC hotspots identification. The KDE + method also allows for hotspots ranking according to cluster strength and collective risk. These two measures were then used for detection of diminishing hotspot signals with a rising level of underreporting. We found that WVC hotspots with a greater cluster strength suffered less from underreporting whereas hotspots will lower values of both cluster strength and collective risk were not detected when underreporting in the data increased. Hotspots with a cluster strength above 0.5 were almost always detected when data underreporting remained below 50%. More than 50% of these hotspots (with cluster strength above 0.5) were detectable even when underreporting rate was between 50 and 80%. We further studied the effects of both spatial and temporal underreporting. Whereas temporal change of underreporting was not a problem in hotspots detection, spatial underreporting introduced significant errors producing both false positive and false negative results (hotspots). We conclude that both researchers and practitioners should be aware of the phenomenon of underreporting and should also try to maintain the same sampling effort of spatial reporting.


Assuntos
Acidentes de Trânsito , Animais Selvagens , Animais , Bases de Dados Factuais , Transportes
20.
J Am Acad Orthop Surg ; 28(17): 707-716, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32833389

RESUMO

INTRODUCTION: Traumatic spinal cord injury (SCI) is a life-altering event. Motor vehicle accidents and falls are common causes of traumatic SCI, and SCI outcomes may be affected by patients' ages and injury sites. This study aimed to investigate the factors associated with unfavorable in-hospital outcomes, focusing on the impact of patients' ages and SCI lesion sites. METHODS: Data of 25,988 patients hospitalized with traumatic SCI in the US National Inpatient Sample (NIS) database from 2005 to 2014 were extracted and analyzed. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with SCI outcomes, including in-hospital deaths, adverse discharge, and prolonged hospital stays. RESULTS: Multivariate analysis revealed that the oldest ages (>65 years) were significantly associated with increased in-hospital mortality compared with the youngest ages at all lesion sites (cervical, odds ratio [OR]: 5.474, 95% confidence interval [CI]: 4.465 to 6.709; thoracic, OR: 5.940, 95% CI: 3.881 to 9.091; and lumbosacral, OR: 6.254, 95% CI: 2.920 to 13.394). Older ages were also significantly associated with increased adverse outcomes at all sites (cervical, OR: 2.460, 95% CI: 2.180 to 2.777; thoracic, OR: 2.347, 95% CI: 1.900 to 2.900; and lumbosacral, OR: 2.743, 95% CI: 2.133 to 3.527). Intermediate ages (35 to 64) were also significantly associated with increased in-hospital death and adverse discharge at cervical and thoracic SCIs, but not at lumbosacral sites. DISCUSSION: For hospitalized patients with traumatic SCI, older age independently predicts worse in-hospital outcomes, with greatest effects seen in patients aged 65 years and older. Study findings suggest that extra vigilance and targeted management strategies are warranted in managing SCI patients aged 65 years and older during hospitalization.


Assuntos
Bases de Dados Factuais , Avaliação de Resultados em Cuidados de Saúde/métodos , Traumatismos da Medula Espinal/mortalidade , Traumatismos da Medula Espinal/cirurgia , Acidentes por Quedas , Acidentes de Trânsito , Adulto , Fatores Etários , Idoso , Vértebra Cervical Áxis , Feminino , Mortalidade Hospitalar , Humanos , Pacientes Internados , Tempo de Internação , Modelos Logísticos , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Vértebras Torácicas , Estados Unidos , Adulto Jovem
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