Accident Injury Research Articles

Use of Augmentative and Alternative Communication Technology to Retrain Attention and Enhance Functional Communication Following Severe Traumatic Brain Injury: A Clinical Case Report

Purpose: This case report outlines the use of high-tech assistive technology in the form of an augmentative and alternative communication device to assess and treat a veteran with severe speech, language, and cognitive impairments status post severe blast injury. Method: The patient is a right-handed male Veteran of the United States Marine Corps who sustained catastrophic injury after stepping on a dismounted improvised explosive device. He presented to the outpatient clinic 4 years status post injury for continued speech, language, and cognitive interventions. Based on assessments and observations, the patient was diagnosed with spastic anarthria, probable apraxia of speech, aphasia, and attentional impairments. His functional communication was restricted to limited facial expression and eye movements interpreted by those who knew him well. This case reviews the detailed informal and novel assessment techniques and training methods used to implement high-tech assistive technologies as part of the rehabilitation plan designed to enhance functional communication. Results: Through systematic instruction and retraining visual and sustained attention, the patient was able to engage meaningfully with a high-tech device to increase functional personal choice when supported by a partner. Conclusion: This case demonstrates the role high-tech assistive technologies can play in the rehabilitation and functional communication efforts for persons with severe traumatic brain injury and cerebrovascular accidents.

A study on Modeling and Simulation of Sports Training Injury Optimization from a Biomechanical Perspective

With the development of artificial intelligence technology today, sports training is one of the important ways to keep people healthy. Reasonable sports training can keep people happy, and can also improve the physical quality of athletes. However, because the intensity of sports training is greater than the physical endurance, it may lead to physical injury. The sports training injury model can collect the physical data of athletes, and simulate whether the actions that athletes want to practice are standard and correct through the collected data. If there are errors in the simulated exercise actions, the wrong exercise actions can be corrected in time, so as to reduce the incidence of sports injury accidents. The construction of the experimental model and the calculation and analysis process of the construction data are very complex, and the existing simulation models are difficult to achieve this, which has a significant impact on the subsequent development of the simulation model. In view of this phenomenon, this paper, on the basis of the sports training injury model, combined with the neural network method, conducted an effective research on the construction of the sports training injury model, and inspected the performance of the model by testing the accuracy of the evaluation of the injury risk level, the degree of sports training injury, and the accuracy of the evaluation of the prediction results of the sports training injury model. The experimental data shows that the maximum accuracy of the sports training injury model in the horizontal and vertical directions was 94.43% and 95.26% respectively, and the maximum accuracy of the single injury degree and the composite injury degree was 48.68% and 55.01% respectively, which had high accuracy and operational efficiency, and can effectively avoid the occurrence of training injury.

Treatment of Renal Capsule Lesion in a Transplanted Kidney: A Case Report and Literature Review

Expanded donor criteria have been established to reduce organ wastage, as various factors can lead the disposal of kidneys, such as anatomical abnormalities, traumatic injuries, and iatrogenic injuries during organ retrieval surgery. We report a case of kidney transplantation in which a capsular lesion was identi!ed and repaired during organ preparation (back table) and review of the literature regarding transplant kidney injuries. A diabetic and hypertensive 52-year-old patient with chronic kidney disease undergoing dialysis therapy for 2 years was admitted for a deceased donor kidney transplant. "e donor was a 35-year-old man with brain death secondary to traumatic brain injury in a car accident. During the kidney preparation on the back table, a capsular lesion was visualized on the upper pole of the right kidney. Continuous suture of the renal capsule was performed using a 3-0 CatGut suture to correct the defect and reconstruct the renal surface. After renal reperfusion, no active bleeding was observed from the sutured area. "e patient had a good postoperative course with no complications. "e main complications associated with capsular lesions and complete capsular denudation are bleeding and hematoma formation, as well as urinary and lymphatic extravasation through the exposed renal parenchyma. Treatment may involve direct cauterization using electrocautery or argon plasma, or the use of hemostatic agents. Successful repair of capsular lesions not only prevents complications such as bleeding during reperfusion and urinary !stulae but also plays a crucial role in expanding the pool of organs available for transplantation.

In-hospital outcomes of ventricular tachycardia catheter ablation in the presence of intra-cardiac thrombus

Abstract Background Ventricular tachycardia (VT) catheter ablation in the presence of intracardiac thrombi was evaluated in very few studies. Objectives To investigate in-hospital outcomes of VT ablation in the presence of an intracardiac thrombus, in a large inpatient US registry. Methods Using the National Inpatient Sample (NIS) database, patients who underwent non-elective VT catheter ablations in the US between 2016 and 2019 were identified using ICD-10 codes. Sociodemographic, clinical data, in-hospital procedures and outcomes as well as in-hospital mortality were collected. In-hospital outcomes were compared using propensity score (PS) matching analysis with a 1:3 ratio between patients with and without intracardiac thrombus. Results A weighted total of 15,725 admissions for non-elective VT ablation were included in the study, of which 190 (1.2%) had a discharge diagnosis of intracardiac thrombus. Patients with intracardiac thrombus had a higher comorbidity burden and were more likely to have ischemic cardiomyopathy and a diagnosis of cardiac aneurysm. In PS analysis, the presence of intracardiac thrombus was significantly associated with higher rates of any in-hospital complications (42.1% vs 19.3%, P<0.009), driven by higher periprocedural cerebrovascular accident and vascular injury events. In-hospital mortality rates were not significantly different between the groups. Conclusions In patients undergoing non-elective VT ablation, intracardiac thrombus was associated with higher rates of in-hospital complications, but not higher in-hospital mortality. These findings suggest that intracardiac thrombus should not contraindicate VT ablation when deemed necessary, while efforts should be made to decrease potential complications.

Determinants of driver injury severity in electric vehicle crashes: A random parameters binary probit model with heterogeneity in means and variances

This study aims to investigate the factors significantly affecting occupant injury severity in electric vehicle (EV) accidents, with a particular focus on traffic flow characteristics before accidents, which have often been overlooked in previous research. Using data on EV accidents from January 1, 2021, to December 31, 2021, in Guangdong Province, China, this study considers various vehicle, road, weather, and pre-accident traffic flow characteristics. The research employs the random parameters binary probit model with heterogeneity in means and variances, comparing it with the binary probit model and the random parameters binary probit model to comprehensively address unobserved heterogeneity and further explain the factors contributing to the randomness of random variables. The results indicate that the random parameters binary probit model with heterogeneity in means and variances provides a superior fit. The findings reveal that variables such as the time of day, type of vehicle involved in the collision, color of EV, average morning/evening peak traveling hours significantly impact the severity of injuries in EV accidents. Additionally, the black indicator exhibits heterogeneity in mean and variance during the afternoon period. This study offers an in-depth understanding of the mechanisms behind driver injury severity in EV accidents and contributes to the development of effective countermeasures to protect drivers from severe injuries.

Unveiling and modelling the impact of safety drivers on the overall success of construction projects in developing countries

The construction industry faces significant risks, leading to high accident rates and injuries, underscoring the urgent need for effective safety implementation. In developing countries, safety implementation is often inadequate, leading to increased incidents and project failures. This study investigates how implementing safety drivers (SDs) can enhance overall project success (OPS) in construction through a five-step process. Initially, systematic searches and scientometric analyses are conducted to review existing literature and establish a foundational understanding. A questionnaire is then distributed to experts in the Egyptian construction sector. The third step involves exploratory factor analysis (EFA) to categorize relevant variables. Following this, partial least squares-structural equation modeling (PLS-SEM) tests the proposed conceptual model and analyzes relationships among the variables. The final step employs Fuzzy Synthetic Evaluation (FSE) to rank SDs categories. Findings from PLS-SEM indicate that SDs have a medium to high impact on OPS, accounting for 58.8% of the total influence. The FSE results reveal that the planning and implementation group ranks as the most significant at 3.48 on evaluation matrix. This research contributes to the limited literature on safety in developing countries like Egypt by proposing a novel model that links SDs to OPS, offering practical insights for the construction industry.

Transport Safety and Quality of Life in Developing Cities: An Analytical Study of Amman's Urban Transport System

Transport safety is crucial for social sustainability, especially in rapidly urbanizing developing cities. This study evaluates the safety of Amman, Jordan's urban transport system, and its impact on residents' quality of life. Using the Analytic Hierarchy Process (AHP), we identified and prioritized five key safety indicators: accident rates, fatalities and injuries, pedestrian safety, public perceptions of safety, and the presence of safety infrastructure. The findings revealed high accident rates, inadequate pedestrian infrastructure, and poor public perceptions of safety. These issues lead to high-stress levels, limited mobility, and increased reliance on private vehicles, exacerbating traffic congestion and environmental pollution. Recommendations include stricter road safety measures, upgraded pedestrian infrastructure, public awareness campaigns, and enhanced public transport services. This research highlights the need for coordinated efforts among government agencies, private sector partners, and the community to improve transport safety and quality of life in developing cities.

The Vision Zero strategy and its goals

The relevance of studying the Vision Zero strategy is driven by the growing challenges in road traffic safety faced by modern societies. Despite advances in technology and infrastructure, the number of fatalities and injuries in road accidents remains a significant issue, requiring new approaches for resolution. In the context of increased attention to sustainable development and reducing the negative impact on the environment, Vision Zero offers innovative solutions aimed at harmonizing human safety with the ecological and economic demands of modern transportation systems. The Vision Zero strategy represents a modern and ambitious approach to road safety, aiming for the complete elimination of deaths and serious injuries on the roads. This study is dedicated to a comprehensive analysis of the main goals and principles of the Vision Zero strategy, as well as its application in the context of road safety within the European Union. The aim of the study is to thoroughly examine the key objectives of Vision Zero, such as achieving zero fatalities in traffic accidents and reducing serious injuries. Special attention is given to defining serious injuries and methods to reduce them, including both technical and infrastructural solutions. The paper discusses the core principles of the strategy, including ensuring the safety of vehicles, infrastructure, and driver behavior, as well as the principles of a systems approach and proactive risk management. The findings of the study confirm that the Vision Zero strategy is an effective tool for reducing the number of traffic accidents and serious injuries, due to its comprehensive approach to road safety. Specifically, the research shows that achieving Vision Zero’s goals has a significant socio-economic impact, including reduced medical costs and improved quality of life for citizens. The realization of these goals also promotes the implementation of new technologies and innovations in the field of safety, making transportation systems more efficient and reliable. By analyzing and justifying the importance of achieving the Vision Zero goals, the study underscores the need for a comprehensive approach to managing road safety and demonstrates the potential of this strategy to ensure a safer and more sustainable transportation environment in the European Union.

Asphyxialdeath due to fracture of thyroid cartilage, cricoid cartilage and arytenoid cartilage as result of blunt trauma of neck in a motorcycle accident:An Autopsy report

Laryngeal fracture is rare but fatal traumatic injury which is mainly caused by severe blunt trauma from interpersonal violence, motor vehicle accident or sports injuries. Laryngeal fracture can lead to severe airway collapse and death.Mortality decreases to less than 5% once the airways made patent and laryngeal injuries are corrected.People must take motorcycle riding safety course to learn how to ride safely. Always follow traffic rules. The motor vehicle accident can be prevented largely through public awareness and education

Fatal road traffic accidents and injuries: a preliminary study.

Road traffic accidents (RTAs) are a major public health problem globally and cause deaths, disability, and significant economic costs. In Italy, there was an increased number of road accidents, deaths, and injuries in 2022 compared to 2021, although still below pre-pandemic levels. A retrospective observational study was performed on a case series of 53 consecutive fatal RTAs examined by the Section of Forensic Medicine of Verona. The case series was divided, according to the type of victims involved, into pedestrians, car drivers, car passengers, and motorcyclists. For each, the times and causes of death, the distribution of external and internal injuries, and toxicological data were analysed, and the results were compared with those in the literature. Although this is a preliminary study on a small case series and lacks statistical validation, so more cases are needed, the preliminary results seem to provide a useful tool for assessing injuries in complex fatal road accidents.

Clinical Feasibility of Applying Immersive Virtual Reality during Robot-Assisted Gait Training for Individuals with Neurological Diseases: A Pilot Study.

Immersive virtual reality has the potential to motivate and challenge patients who need and want to relearn movements in the process of neurorehabilitation. The aim of this study was to evaluate the feasibility and user acceptance of an innovative immersive virtual reality system (head-mounted display) used in combination with robot-assisted gait training in subjects suffering from neurological diseases. Fifteen participants suffering from cerebrovascular accident or spinal cord injury completed a single session of immersive virtual reality using a head-mounted display during a Lokomat® gait session. Training parameters and safety indicators were collected, and acceptance was investigated among participants and therapists. The results suggest that an immersive virtual reality system is feasible in terms of safety and tolerance. Furthermore, the very positive overall acceptance of the system suggests that it has the potential to be included in a robot-assisted gait training session using Lokomat®. Overall, this study demonstrates that a fully immersive virtual reality system based on a head-mounted display is both feasible and well received by cerebrovascular accident and spinal cord injury patients and their therapists during robot-assisted gait training. This study suggests that such a virtual reality system could be a viable alternative to the screen-based training games currently used in neurorehabilitation. It may be especially suitable for enhancing patient motivation and adherence to training, particularly if the application is enjoyable and not mentally taxing.

In-Hospital Outcomes of Ventricular Tachycardia Catheter Ablation in the Presence of Intra-Cardiac Thrombus.

Ventricular tachycardia (VT) catheter ablation in the presence of intracardiac thrombi was evaluated in very few studies. To investigate in-hospital outcomes of VT ablation in the presence of an intracardiac thrombus, in a large inpatient US registry. Using the National Inpatient Sample (NIS) database, patients who underwent non-elective VT catheter ablations in the United States between 2016 and 2019 were identified using ICD-10 codes. Sociodemographic, clinical data, in-hospital procedures, and outcomes as well as in-hospital mortality were collected. In-hospital outcomes were compared using propensity score (PS) matching analysis with a 1:3 ratio between patients with and without intracardiac thrombus. A weighted total of 15,725 admissions for non-elective VT ablation were included in the study, of which 190 (1.2%) had a discharge diagnosis of intracardiac thrombus. Patients with intracardiac thrombus had a higher comorbidity burden and were more likely to have ischemic cardiomyopathy and a diagnosis of cardiac aneurysm. In PS analysis, the presence of intracardiac thrombus was significantly associated with higher rates of any in-hospital complications (42.1%vs. 19.3%, p<0.009), driven by higher periprocedural cerebrovascular accident and vascular injury events. In-hospital mortality rates were not significantly different between the groups. In patients undergoing non-elective VT ablation, intracardiac thrombus was associated with higher rates of in-hospital complications, but not higher in-hospital mortality. These findings suggest that intracardiac thrombus should not contraindicate VT ablation when deemed necessary, while efforts should be made to decrease potential complications.

Outcomes of atrial fibrillation ablation in community hospitals with and without onsite cardiothoracic surgery availability.

Limited data exist on outcomes of atrial fibrillation (AF) catheter ablation based on hospital setting and, specifically, the availability of onsite cardiothoracic surgery (CTS). We aimed to describe the characteristics and outcomes of catheter ablation for AF performed at a facility with and without CTS. This was a retrospective study of consecutive patients who underwent catheter ablation for AF at hospital with (CTS) and without cardiothoracic surgery (N-CTS) from January 2011 through December 2019. Clinical and procedural characteristics, complications, and 1-year outcomes, including clinical events and AF recurrence, were collected. There were 326 unique patients who underwent an index AF ablation procedure: 206 CTS patients and 120 N-CTS patients. There were no differences inoverall cardiac complications (2.5% vs. 5.8%), including mapping catheter entrapment requiring open-heart surgery (0% vs. 0.5%), pericardial effusion requiring pericardiocentesis (0.8% vs. 0.5%), hemopericardium (1.7% vs. 0.5%), acute myocardial infarction (0% vs. 1.0%), and sinus node injury (0% versus 0.5%) (all P values > .05)between N-CTS and CTS patients. Likewise, overall noncardiac complications (20.7% vs. 19.8%, P = .85), including bleeding, cerebrovascular accident, and phrenic or vagus nerve injury, were similar between N-CTS and CTS hospitals. Also, 1-year cumulative Kaplan-Meier estimates of overall AF recurrence (11.6% vs. 16.4%; log-rank P = 0.21; HR 1.47; 95% CI, 0.79-2.74) were not statistically significant between N-CTS and CTS hospitals. Catheter ablation procedure is safe and effective regardless of onsite CTS presence, and there were no significant differences between the two hospital settings.

Clinical application of iliac myocutaneous flap pedicled with deep circumflex iliac artery in repair of complex defect of lower limb with cavity

To explore the effectiveness of iliac myocutaneous flap pedicled with deep circumflex iliac artery (DCIA) on the repair of lower limb composite defect wounds with cavity. A retrospective analysis of 7 patients with lower limb composite defect wounds treated between March 2017 and September 2020 was conducted, including 4 males and 3 females, aged 24-58 years, with a median age of 37 years. The causes of injury were machine twisting injury in 2 cases, fall from height injury in 2 cases, and traffic accident injury in 3 cases. According to Gustilo-Anderson classification, there were 1 case of type Ⅲa, 4 cases of type Ⅲb, and 2 cases of type Ⅲc (combined with anterior tibial artery rupture); according to AO/Orthopaedic Trauma Association (AO/OTA) classification, there were 2 cases of type 42-C3, 2 cases of type 43-A2, and 3 cases of type 43-B1. The time from injury to admission ranged from 2 to 10 hours, with an average of 6 hours. Tibial bone defect and surrounding soft tissue defect with deep cavity were left after primary emergency debridement. In the second stage, according to the characteristics of the wound, the three-dimensional repair of the composite defect was designed with DCIA embedded iliac myocutaneous flap. The size of the iliac flap was 2.0 cm×2.0 cm×2.0 cm to 7.0 cm×3.0 cm×2.5 cm, and the size of the flap was 12.0 cm×8.0 cm to 21.0 cm×13.0 cm. The internal oblique muscle flap was harvested in size of 3.0 cm×2.0 cm×2.0 cm to 5.5 cm×4.0 cm×4.0 cm. The donor site was primarily closed. All the flaps survived after operation, except for 1 case of partial necrosis of the flap edge, which healed after secondary skin grafting, and the donor and recipient wounds healed by first intention. All patients were followed up 16-24 months, with an average of 18 months. The broken end of the bone defect healed well, and the healing time was 8-10 months, with an average of 7.3 months. At last follow-up, the shape of the flap was satisfactory, the texture was soft, and there was no abnormal hair growth, pigmentation, and so on. Only linear scar was left in the donor site, and no complication such as abdominal hernia occurred. According to Paley fracture healing scoring system, bone healing was rated as excellent in 5 cases and good in 2 cases. The limb function was satisfactory, and full weight bearing was achieved at 12-16 months after operation. According to the lower extremity functional scale (LEFS), 6 cases were excellent and 1 case was good. The iliac myocutaneous flap pedicled with DCIA is flexible in design and highly free in tissue composition, which can repair the composite defect wound of lower limbs with deep cavity in a three-dimensional way, and repair the limb shape and reconstruct weight-bearing function to the greatest extent.

Temporal Statistical Analysis and Retrospective Assessment of Mortality Rate in the United States from 1999 to 2018

Objectives: To retrospectively examine the mortality trend in the USA from 1999 to 2018 using a basic statistical model while examining multiple variables. The inferential and descriptive statistical tools will be prioritized to elucidate the mortality of both years in simple terms. Methods: We conducted a retrospective observational descriptive analysis of data on the 10 leading causes of death in the United States by age, race, and sex over 2 decades (1999 to 2018). The data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia. The causes of death are classified by the International Classification of Diseases, 10th Revision (ICD–10), which is ranked according to the number of deaths (Cause-of-death statistics are based on the underlying cause of death). This report supplements “Deaths: Final Data for 2020,” the National Center for Health Statistics’ annual report of final mortality statistics. SPSS (statistical package for social sciences) version 29 Software in Excel sheet was used to analyze the generated datasets. Descriptive and inferential (parametric and non-parametric) analyses were used. The statistically significant relationships and assumptions were made using the chi-square/t-test, Kruskal-Wallis, and Fischer's exact tests with the significance level set at p ≤ 0.05. The analysis and determination of the level of agreement between the initial diagnosis and findings from the new analysis done. Results: The proportion of age-adjusted death rates of the heart (such as coronary artery disease) account for the highest proportion of 24%, while Malignant neoplasms (cancers) represent 23%, Chronic lower respiratory diseases contribute 6%, Unintentional injuries (accidents) also play a significant role, accounting for 5% of deaths. The regression analysis reveals a strong and statistically significant relationship between the number of causes in females and males. There was a high death rate of around 60 years in 1999 and a consistent decline over the years, reaching below 40 by 2018, with a 15/100,000 death fluctuation mark. Asian or Pacific Islander has the lowest age adjustment value of 8762.4, American Indian or Alaska Native, Hispanic, or Latino(11673.2), Black or African American, Hispanic, or Latino (12992.1), White, not Hispanic or Latino(15457.1), Black or African American (15708.2), Hispanic or Latino(19624.1), American Indian or Alaska Native, not Hispanic or Latino (16287.9).Asian or Pacific Islander, not Hispanic or Latino( 8791.3), and 99.2% of the variability in the dependent variable and standard error of 6.7240. Conclusions: Cardiovascular death remains the most common cause of death, with a significant decrease in the death rate from 1999 to 2018 due to improved health care and the provision of measures to improve health care. The regression analysis reveals a strong and statistically significant relationship between the number of causes in females and males. Therefore, based on the results, the number of causes in females strongly predicts the number of causes in males.

TIBIAL DIAPHYSEAL FRACTURE, PANORAMIC REVISION

Introduction: Tibial fractures are quite common injuries. Since the tibia has a subcutaneous location, it is more likely to show exposed fractures. Exposed fractures of the tibial diaphysis are serious injuries that can result in significant long-term disability if not managed correctly. Objective: to detail current information related to tibial diaphysis fractures, etiology, epidemiology, anamnesis, physical examination, assessment, treatment, differential diagnosis, prognosis and complications. Methodology: a total of 29 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: tibia fractures, osteosynthesis, tibia fracture, intramedullary nails, leg trauma, exposed fractures. Results: tibial diaphysis fractures present an incidence of 16.9 per 100,000 individuals per year, being more common in the male sex, with 21.5 per 100,000 individuals per year, compared to 12.3 per 100,000 in the female sex. The most common triggers in males of tibial diaphysis fractures are motor vehicle accident injuries and sports. Conclusions: It is important to recognize the management of tibial fractures since they have a relatively high incidence. It is not uncommon to encounter an exposed tibial diaphysis fracture, so it is essential to identify, as well as perform damage control and appropriate management. The individual should undergo a complete examination and it may be necessary to implement the trauma life support protocol. In this type of fracture it is crucial to assess the neurovascular situation. In addition, complementary examinations should be requested to allow the best diagnosis, classification and treatment of the injuries. The treatment of tibia diaphysis fractures will depend on the specific situation and the patient's condition; however, external fixators are usually used for damage control and later intramedullary nails are used. Tibial diaphysis fractures may be accompanied by compartment syndrome and other complications. KEY WORDS: trauma, fractures, tibia, treatment.

Effects of Early and Late Cranioplasty on Neurocognitive Outcome and Cerebral Glucose Metabolism using PET Scan - A Comparative Study.

Brain protection and cosmetic aspects are the major indications of cranioplasty (CP) after decompressive craniectomy. CP can avoid the recurrence of brain damage, achieve the plastic effect, protect the patient from seizures, and relieve the syndrome of trephine. This was a prospective, observational study done over a period of 2 years from April 2017 to April 2019 in the Department of Neurosurgery at Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati. Patients of age group 20-60 years who underwent CP after decompressive craniectomy for traumatic brain injury or cerebrovascular accidents with refractory intracranial hypertension were included. The study population was divided into two groups: early and late CP groups. Neurocognitive assessment was done 72 h before and 3 months after CP by mini-mental state examination (MMSE), Glasgow outcome score (GOS), and PGI battery of brain dysfunction (PGIBBD) scores. Cerebral glucose metabolism was assessed by 18F-FDG PET scan. In both early and late CP groups, there was a highly significant difference between the mean pre- and postoperative values of MMSE, GOS, and PGIBBD, suggesting significant improvement in neurocognitive parameters of patients postoperatively. There was no significant difference between early and late CP groups for mean standard uptake values (SUVs) on PET scan for both affected (P-value- 0.40) and nonaffected (P-value- 0.30) sides. CP improves the cerebral metabolism and neurocognitive outcome, weather it is done early or late.

Prevalence and factors associated with psychological morbidity, phantom limb Pain in lower limb amputees

BackgroundLower limb amputation can lead to psychological problems.There is a lack of data to evaluate the psychological problems and associated factors in lower limb amputees. AimPrevalence and factors associated with psychological disorder and phantom limb pain in lower limb amputees MethodsIt was a cross-sectional study with a consecutive sampling technique. Patients were assessed on the Hospital Anxiety and Depression Scale (HADS) for the presence of depression and anxiety disorder. DSM-5 diagnostic criteria for substance use disorder were used, andphantom limb pain was diagnosed as defined by Pare. Results103 patients were included in the present study with a mean age of37.7 ± 14.5 yrs. The majorityof patients were males (87.4 %), married (69.9 %), on paid employment (95.1 %), and were of middle socioeconomic status (83.5 %). Most of the patients presented with roadside accident injuries (83.5 %)and had below-knee amputation (58.3 %). As per DSM-5, 38.8 % had a substance use disorder, out of which 35.9 % and 24.3 % had alcohol and tobacco use disorders, respectively. On HADS, 48.5 % had a presence of depressive disorder, and 30.1 % had anxiety disorder. The majority of patients (97.1 %) had phantom limb pain. Those from rural areas reported significantly more frequency of anxiety (x2-5.501; p-0.019) and depressive disorder (x2-7.009; p-0.008). Lower incomehad a significant positive association with depression (r-0.228; p-0.021) and phantom limb pain (U-22.500; p-0.008). ConclusionThe prevalence of psychiatric morbidity in lower-limb amputeeswas very high. The most common psychological morbidity was depression,followed by anxiety disorder and substance use disorders.Our findings reflect that we would benefit by including mental health professionals asintegral members of the multidisciplinary team to do an early psychological assessment and intervention, which would help prevent psychological illnesses and improve quality of life.

Research on countermeasures for safety prevention of muscle injury in sports under the background of big data and smart medicine

With the deepening of quality-oriented education and the implementation of new curriculum standards, the forms and contents of school sports activities are increasingly diversified. In this regard, special attention must be paid to sports safety. Sports is a sport to improve physical and mental health, but it is easy to cause physical injury in sports. Big data can effectively monitor the normalization of movement in the process of exercise, so as to take timely safety precautions and reduce the probability of muscle injury. Therefore, by analyzing the causes and influencing factors of muscle injury in sports, this paper puts forward some safety precautions to avoid muscle injury accidents during sports. Through the neural network algorithm, it can be seen that with the increase of time, the function width and prevention index of security are constantly rising, and the average value of function width is about 0.83. The seventh day is 0.15 higher than the first day, the average value of prevention index is 1.31, and the seventh day is 0.19 higher than the first day. The effect of the optimized safety prevention strategy is better than that of the traditional safety prevention strategy, and the probability of muscle injury of athletes is also greatly reduced by 11% compared with the traditional one; However, the rehabilitation effect has improved a lot, 9% higher than the traditional one.

Comparison of GAP, R-GAP, and new trauma score (NTS) systems in predicting mortality of traffic accidents that injure hospitals at Mashhad University of medical sciences

BackgroundThere are several trauma scoring systems with varying levels of accuracy and reliability that have been developed to predict and classify mortality in trauma patients in the hospital admission. Considering the importance of the country's emergency organization and the World Health Organization in the category of traffic accidents, we used this information in the study. The objective of this study is to evaluate and compare the predictive power of three scoring systems (R-GAP, GAP, and NTS) on traffic accident injuries. MethodsIn an analytical cross-sectional study, all the data related to the mission of traffic accidents at the pre-hospital emergency management of Mashhad University of Medical Sciences in 2022 were extracted from the automation system, and the outcome of the patients in the hospital was recorded from the integrated hospital system. Then, GAP, R-GAP, and New Trauma Scores (NTS) were calculated, and their results were compared using ROC curve and logistic regression. ResultsIn this study, 47,971 injuries from traffic accidents were evaluated. Their average age was 30.16 ± 10.93 years. R-GAP showed negligible difference than GAP and NTS scores (the area under the curve equals 0.904, 0.935, and 0.884, respectively), and the average scores of R-GAP, GAP, and NTS are equal to 22.45/45 ± 1/9, 22.25 ± 1.5, and 22.49 ± 1.3, respectively. Injury severity based on R-GAP, GAP, and NTS scores was mild in most patients. The effect of these models on the patient outcome based on OR values, R-GAP, GAP, and NTS models showed high values. All analysis was performed in SPSS 26. ConclusionAccording to the study results, it seems that R-GAP, GAP, and NTS, have the highest power to predict death in traffic accident injuries. It is recommended to include these points in the electronic file of the pre-hospital emergency for the injured. Also, the severity and outcome of the patient can be predicted by these scores, which play an important role in the triage of the injured and determining the appropriate treatment center.