Disparities in incidence and severity of electric scooter injuries in children.

Background:Thumb amputation due to high-voltage electrical injury represents a unique challenge to the reconstructive microsurgeon due to the uncertain reliability of recipient vessels. The zone of injury in these particular burns is often difficult to elucidate from physical examination, and the ideal time for reconstruction has not yet been well characterized. We present 3 cases of successful microsurgical reconstruction in 2 patients via toe-to-thumb transfer following electrical injury resulting in thumb amputation.Methods:Retrospective review of a single surgeon’s experience identified 2 patients who sustained electrical injuries resulting in thumb amputation (1 bilateral and 1 unilateral), with subsequent successful reconstruction via free toe-to-thumb transfer.Results:Both patients had successful thumb reconstruction after microvascular toe-to-thumb transfer. Both patients regained sensibility, motion, and sufficient pinch strength to use their reconstructed thumbs in everyday activities, with minimal donor-site morbidity.Conclusions:Microsurgical reconstruction of the thumb following amputation as a result of electrical burn can be particularly challenging due to extensive soft-tissue injury. We report 3 cases of successful thumb reconstruction using this technique with good functional outcomes. Microsurgical reconstruction of the thumb should be considered even in patients who have experienced thumb amputation as a result of electrical injury.

Motivational decision-making is most adaptive when exploitation of known rewards is effectively balanced against exploration of uncertain alternatives. Trait anxiety influences this balance across individuals, yet less is known about the dynamic effects of acute anxiety on behaviour. This study combined a decision-making task, the multi-armed bandit Maggie's Farm task, with fMRI and computational modelling to examine how experimentally induced anxiety modulates exploration strategies (random, value-free exploration versus directed, novelty-seeking exploration) and their neural correlates. Forty-seven healthy participants (24 female; 23 male) completed the task under alternating conditions of safety and anxiety induced by unpredictable electric shocks. Exploratory behaviour was promoted through different task decision horizons and modelled using parameters capturing random value-free exploration (ε) and novelty seeking (η). Acute anxiety impaired performance and decision consistency, selectively increasing random, value-free exploration without affecting novelty-driven exploration. Reaction times decreased, indicating faster, less deliberative responding. Neuroimaging revealed that horizon manipulations recruited circumscribed frontoparietal regions. Value and policy signals were dissociable, with ventromedial prefrontal cortex encoding expected value and superior parietal lobule mediating exploratory control. Critically, acute anxiety increased activation in right superior parietal lobule and frontopolar cortex specifically during random, value-free exploration, independently of value processing. Together with the behavioural findings, this pattern identifies a neural signature of anxiety-related decision noise. In conclusion, acute anxiety increases random, value-independent exploration, promoting less goal-directed, more stochastic behaviour. These findings link anxiety-induced decision noise to frontoparietal activation and identify random exploration as a computational marker of dysregulated anxiety-related decision-making.Significance statement Understanding how anxiety alters decision-making is crucial because anxious states are common and often impair flexible behaviour. Exploration is a key component of adaptive decisions, yet different forms of exploration serve different functions. Using experimental anxiety induction, computational modelling, and fMRI, we show that acute anxiety does not increase all exploratory behaviour uniformly. Instead, it selectively boosts random, value-free exploration, choices driven by noise rather than information seeking, while leaving goal-directed, novelty-driven exploration unchanged. This shift reflects altered engagement of frontoparietal brain regions involved in control and uncertainty processing. These findings highlight a specific computational pathway through which acute anxiety disrupts decision-making, offering mechanistic insight relevant to both basic neuroscience and anxiety-related disorders.

Anxiety during acute smoking abstinence is strongly implicated in the maintenance of and lapse/relapse to smoking. Central to anxiety is heightened sensitivity to unpredictable threat-a tendency for anxious apprehension of future, uncertain threat-with work from animal models robustly indicating its contributory role in nicotine seeking behavior during deprivation. However, the handful studies on this question in humans have yielded mixed findings, possibly due to their suboptimal usage of between-subject designs. Consequently, the present study used a within-subject laboratory design to examine whether sensitivity to unpredictable threat mediates the effect of manipulated acute smoking abstinence on smoking lapse behavior. Non-treatment-seeking adults who smoked daily (N=63) attended two counterbalanced experimental sessions under overnight smoking deprivation or smoking as usual. For both sessions, participants completed the No-Predictable-Unpredictable threat task assessing the eyeblink reflex to acoustic startle probes while anticipating electric shocks. Next, participants completed the McKee Experimental Relapse Analogue Task assessing lapse behavior, including the ability to delay smoking for monetary reward and number of cigarettes smoked once initiated. As expected, smoking deprivation (vs. smoking as usual) led to shorter time delay to smoking and more cigarettes smoked once initiated. Importantly, sensitivity to unpredictable threat partially mediated abstinence-induced lapse behavior. Deprivation was associated with an enhanced startle potentiation to unpredictable (vs. no) shock-although this effect emerged only in follow-up analyses-which, in turn, predicted increased smoking. Sensitivity to unpredictable threat may be an important, but underrecognized, biobehavioral mechanism underlying the smoking-anxiety link. Using a within-subject laboratory design, this study provided preliminary evidence that sensitivity to unpredictable threat may contribute to smoking relapse during acute abstinence. Although these findings await replication in larger samples, they indicate sensitivity to unpredictable threat as a potential biobehavioral target for evaluating anxiety-related processes in smoking cessation interventions.

Electrical facial burns are uncommon but devastating injuries that often combine skeletal and soft-tissue loss. Single-stage restoration of bone, lining, and cover remains challenging. A 27-year-old man presented with a left hemifacial composite defect after a high-voltage electrical burn. Reconstruction used virtual surgical planning (VSP) with a patient-specific polymethyl-methacrylate (PMMA) implant for skeletal contour and a chimeric anterolateral thigh (ALT) flap for coverage. The procedure achieved stable implant fixation, complete flap survival, and satisfactory malar projection without any implant-related complications. Combining PSI using VSP with an ALT flap provides precise, reliable single-stage reconstruction in complex electrical burn-related facial defects.

Action algorithm: management of electrical injury in acute and emergency medicine

Lightning strikes present a risk, resulting in deaths and injuries annually. Lightning injuries, like electrical injuries, can have brain injury and chronic pain, but unlike electrical injuries, lightning injuries do not have major burns or amputations. This study is divided into two stages. The first stage presents the mechanisms of lightning injuries, including 1) direct strike, 2) touch voltage, 3) side flash, 4) step voltage, 5) upward unconnected leader (UUL), and 6) trauma associated with the air expansion near the lightning channel. The second stage of the study is dedicated to presenting the main results of lightning safety advocacy programs, which combine engineering components, such as the protection of structures against lightning (LPS) and thunderstorm warning systems, with behavioral actions, such as training, alerts, the creation of councils, and governmental policies. The 2011 Runyanya Primary School tragedy in Uganda, where a lightning strike killed 18 students and injured 38, led to the establishment of International Lightning Safety Day (ILSD, 28 June), highlighting the need for global awareness. This study also proposes ways for government involvement, especially in developing countries, to improve lightning prevention and protection, emphasizing the importance of integrated and multidisciplinary approaches.

Virtual social interaction reveals that the dorsal habenula-IPN pathway is essential for targeting the opponent.

Impact of Posttraumatic Stress Disorder on the Behavioral and Multivariate Neural Correlates of Contextual Fear Learning.

Skin burns are a major health concern that is caused by severe electric shocks, chemical and thermal exposure. The intense skin burns can cause the fibroblast cell death which can lead to the delayed wound healing. Direct ink write (DIW) printing is a promising three-dimensional (3D) printing technology that provides availability of different polymeric solutions and incorporation of bioactive agents within the polymeric blends with low material wastage. Herein, we fabricated a promising combination of ink consisting of sodium alginate (Na-ALG), guar gum (GG), and Ficus carica (FC) for DIW printing. The formulated scaffolds showed favorable rheological properties and layer fidelity. The scaffolds depicted appropriate intercrosslinked porous morphology that supported swelling ability. Na-ALG/GG/FC scaffolds were biodegradable, released gallic acid (GA) and demonstrated antibacterial efficacy against Escherichia coli and Staphylococcus aureus. Scaffold exhibited biocompatibility of 109% on Day 7 with fibroblasts and released vascular endothelial growth factor (VEGF) which indicated formation of new blood vessels. Hence, Na-ALG/GG/FC scaffolds are a potential candidate for treating chronic wounds.

Intrusion of hazardous objects into critical transmission lines can directly cause severe accidents, including large-area power outages and even electric shock casualties. However, current monitoring systems remain constrained by single-sensing modalities, such as monocular/binocular vision or Light Detection and Ranging. They fail to achieve reliable real-time three-dimensional perception and lack correlative analysis between external hazard intrusions and the safe clearance distances of transmission lines across complex multi-terrain scene. This study proposes a lightweight vision framework. By fusing pose estimation, visual detection, and depth transformation, this framework achieves high-precision ranging and early warning of external hazards within transmission corridors across all terrains. The architecture employs the lightweight transmission line hazard detection model, by introducing a positive-negative sample dynamic balancing mechanism, thereby improving the detection performance of the model. Furthermore, an improved pose estimation algorithm is proposed to achieve high-precision spatial mapping. Further combined with the depth transformation and point cloud reconstruction, this enables refined ranging for hazards relative to transmission lines under arbitrary terrain conditions. The proposed method has been validated on terminal AI platforms and deployed on on-site camera terminals along transmission lines, showing excellent inference performance and deployment adaptability on terminal devices.

Background and Objectives: Simultaneous bilateral scapular fractures are exceptionally rare injuries and are most commonly associated with high-energy trauma, convulsions, or electrical injury. Their occurrence following low-energy trauma is extremely uncommon. This study aimed to conduct a scoping review of the literature on simultaneous bilateral scapular fractures, with emphasis on demographic characteristics, mechanisms of injury, fracture patterns, treatment strategies, and clinical outcomes. To provide clinical context, the findings are illustrated by a case of a 43-year-old previously healthy recreational athlete who sustained simultaneous bilateral scapular fractures after a low-energy fall directly onto the back. Materials and Methods: A scoping review of the literature was conducted in accordance with PRISMA-ScR guidelines using the PubMed/MEDLINE and Scopus databases. Studies reporting simultaneous bilateral scapular fractures were identified and analyzed with respect to demographic characteristics, mechanisms of injury, fracture patterns, treatment modalities, and outcomes. Results: Thirty-seven studies published between 1946 and 2025 were included, comprising a total of 43 patients. Most cases resulted from high-energy trauma (41.9%), convulsions (25.6%), or electrical injury (16.3%). Low-energy trauma and spontaneous fractures were rare. The scapular body was the most commonly involved anatomical region. Conservative treatment predominated and was generally associated with favorable functional outcomes, while surgical intervention was reserved for displaced or intra-articular fractures. The illustrative case involved bilateral comminuted extra-articular fractures of the scapular bodies and spines without associated injuries and was managed conservatively, resulting in complete fracture healing and full, painless shoulder range of motion. Conclusions: The findings of this scoping review, illustrated by the representative clinical case, indicate that simultaneous bilateral scapular fractures may occur even after low-energy trauma in otherwise healthy individuals. Bilaterality alone should not be interpreted as an independent indication for surgical treatment when fractures are stable and minimally displaced. A high index of clinical suspicion and appropriate radiological evaluation are therefore warranted, particularly in emergency and trauma settings, in order to avoid missed or delayed diagnosis, even in cases with seemingly benign mechanisms of injury.

Electrical injuries are associated with multiple factors, including the current itself, the amount of current flowing through the body during electrocution, the duration of the flow, and the duration of exposure. The instances of bone fracture following electrocution are limited. This article such a rare incident, where an elderly woman suffered an electrical shock at her residence while switching off the refrigerator. The woman complained of intense pain around her left shoulder, with restricted movement of the shoulder joint, without any history of a fall or other trauma. Detailed physical and radiologic examinations revealed an electrical entry wound on the left palm and a proximal humerus fracture. The patient underwent surgery and was discharged without complications. This case highlights bone fracture as a rare manifestation of electrocution resulting from violent muscular contractions as electricity passes through the body, even in cases of domestic low-voltage electrical shock. The authors recommend a meticulous general physical examination and radiologic imaging with X-rays and computed tomography (CT) scans, which may assist forensic assessment of how such injuries may occur.

Rapid learning of aversive stimuli is adaptive, but the persistence of the avoidance response in the absence of further reinforcement might depend on the severity of the adverse experience. For example, an experience involving injury would be expected to lead to more durable memory than the mere exposure to an unpleasant tastant, especially when new experiences indicate that the aversive stimulus is no longer present. We investigated how bumblebees (Bombus terrestris) learn and retain associations between flower colours and two types of aversive stimuli: electric shock and saturated salt (NaCl) solution. Using a conditioning paradigm, we examined how these stimuli influence avoidance learning across foraging bouts and tracked the process of extinction learning, the formation of new memory in response to the absence of the reinforcement, over two weeks. Our results show that bees rapidly learn to avoid both stimuli, and reach >90% accuracy of avoidance after six foraging bouts. We then examined how bees modified their avoidance behaviour in the absence of further aversive stimulation. Testing extinction learning on days 1, 3, 5, 7 and 14, we found that electric shock as a nociceptive stimulus induces a more persistent avoidance response, whereas exposure to the salt by engaging gustatory aversion pathways leads to a three times faster extinction rate. This suggests that although the initial training leads to equal levels of avoidance for both stimuli, bumblebees might display greater behavioural flexibility when updating the association between a colour and an unpleasant taste in comparison to a potentially injurious stimulus.

The rapid adoption of electric vehicles (EVs) has accelerated the demand for efficient charging infrastructure, with the global EV market expected to surpass 350 million vehicles by 2030 and charging-related challenges accounting for nearly 25% of user concerns, while wireless power transfer technologies are projected to grow at over 20% annually. These applications demand intelligent systems capable of automated charging, reduced human intervention, and integration with renewable energy sources. Traditional wired charging systems rely on physical connectors, which are prone to wear and tear, require manual handling, and pose safety risks such as electric shocks and cable damage. Furthermore, they lack flexibility, aesthetic integration, and seamless automation, limiting their suitability for next-generation mobility systems. To address these challenges, the proposed Wireless Electric Vehicle Charging System utilizes inductive coupling technology combined with solar energy integration and the ESP32 microcontroller to develop an intelligent and sustainable charging solution. The system employs a primary coil embedded in the ground to generate a magnetic field, inducing current in a secondary coil mounted on the vehicle, which is then rectified to charge the battery. Solar panels serve as the primary energy source, promoting green energy utilization, while the ESP32 monitors voltage, controls charging operations, and ensures system safety. This smart system enables efficient, contactless energy transfer, enhances user convenience, reduces maintenance, and supports the development of sustainable and autonomous EV charging infrastructure.

Electrical injuries represent a small proportion of burn admissions but are associated with substantial morbidity. Prior studies suggest demographic and regional disparities in burn injury incidence and outcomes. This study aimed to compare electrical versus non-electrical burn injuries and assess regional differences in patient and burn characteristics, and outcomes using the American Burn Association's Burn Care Quality Platform (BCQP). We conducted a retrospective cohort study using adult admissions from 2020 to 2022 to compare electrical to other types of burns. Outcomes included length of stay, mortality, discharge disposition, and insurance status. Regional analyses were based on the five ABA regions in the USA. Statistical comparisons used multivariate analyses, including propensity score matching. . Of a total of 63,269 patients, 2,042 (3.3%) sustained electrical injuries. These patients were younger (average age 40), predominantly male (92.2%), more likely to be injured at work (61.9%) and disproportionately Hispanic/Latino (21.9%). In the Southern region, electrical injuries resulted in significantly shorter median hospital stays than non-electrical injuries (2 vs. 3 days, p < 0.0001) shorter ICU stays (3 vs. 4 days, p ≤ 0.001). Mortality was consistently lower among electrical injury patients (2.2% vs. 3.7%, p ≤ 0.012). 52.7% of patients in the sample were treated in the Southern region, which also had the highest rate of electrical injuries in the country.The ABA Southern region bears a disproportionate burden, particularly among Hispanic/Latino and uninsured patients. These findings highlight the need for region-specific prevention, improved safety training, and equitable access to care.

Despite substantial progress in preclinical cannabinoid research, translational studies on cannabis use disorders (CUD) are still insufficient due to the absence of robust, validated animal models that fully recapitulate the multifactorial clinical phenotype of human CUD. The complex nature of CUD and the incomplete understanding of its underlying neurobiological mechanisms contribute to the limited availability of effective treatments. To address this gap, we developed an operant conditioning-based mouse model that enables the identification of individual vulnerability or resilience to CUD development. This highly translational model is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for substance use disorders. The model allows the assessment of addiction-like behaviors by evaluating three behavioral domains: 1) persistence of responding during periods of cannabinoid unavailability, 2) motivation for cannabinoid seeking measured using a progressive ratio schedule, and 3) compulsivity, assessed when cannabinoid reward is paired with an aversive consequence such as a mild electric foot shock. A major strength of this paradigm is its ability to quantify two phenotypic traits proposed as predisposing factors for addiction vulnerability and two parameters related to craving. In addition, the model is specifically designed to evaluate genetic and circuit-level manipulations using chemogenetic approaches, with minor modifications required by surgical viral-vector delivery. Using this protocol, we can determine whether altering the excitability of specific neural networks promotes resilience or vulnerability to developing cannabinoid addiction. Elucidating these mechanisms is expected to facilitate the identification of novel and more effective therapeutic interventions for CUD. Key features • Operant conditioning-based mouse model to study cannabis use disorders (CUD) based on DSM-5 substance use disorder criteria. • Enables assessment of addiction-like behaviors across persistence, motivation (progressive ratio), and compulsivity under punishment, allowing stratification of vulnerable versus resilient individuals. • Quantifies phenotypic traits linked to cannabinoid addiction vulnerability and behavioral signatures associated with craving for cannabinoids. • Compatible with genetic and circuit-level manipulations to test how specific neural networks modulate CUD-related behaviors.

Inappropriate Shocks From Subcutaneous vs Transvenous Implantable Cardioverter-Defibrillators: Individual Participant Data Meta-Analysis of Randomized Trials.

Decades of research in human and non-human animals has examined responses to clear valence, including stimuli that either represent a relatively clear threat (e.g., electric shock) or a clear reward (e.g., money). But daily life is replete with events or situations that are ambiguous - they could be threatening and/or rewarding. This review describes work that examines the wide inter-individual variability with which humans respond to this dual-valence ambiguity. Although some individuals more readily categorize these events as negative, others are prone to arrive at more positive categorizations. This predilection to lean in a more positive versus negative direction represents a stable, trait-like difference, and is referred to as valence bias. Valence bias is generalizable across categories of dual-valence ambiguity and has important implications for health and well-being. Here we focus on extensive findings that lend support for the Initial Negativity Hypothesis, which posits that the initial or default response is negative across people, and that positivity relies on an additional regulatory mechanism that helps to overcome the initial negativity. Together, the present review describes the cognitive and brain mechanisms underlying the valence bias, including emphasizing the importance of a broad set of systems that support human responses to ambiguity.

Overactivation of memory networks and pathways can induce post-traumatic stress disorders and memory generalization, where memories are recalled in inappropriate situations. Here, we demonstrate that age-related defects in long-term memories in Drosophila are also caused by memory generalization. Aversive memory engram cells are formed in both young and old flies trained in an odor avoidance task. However, while engrams in young flies are activated specifically by odors previously paired with electrical shocks, engrams in old flies are activated by shock-paired, unpaired, and novel odors. This enhancement of engram cell activation occurs because of increased activity of dopaminergic neurons during memory consolidation in old flies. Increased dopamine signaling results from an inability of old flies to inhibit glutamatergic activation and leads to increased activation of dopamine D2 receptors on engram cells. Our data suggest that increased dopaminergic activity after training generalizes the responsiveness of engram cells to disrupt appropriate memory recall.