Fatal Injuries Research Articles

ANALYSIS OF INJURIES AND DEATH OF PEOPLE AS A RESULT OF VIOLATION REQUIREMENTS IN UKRAINE

Problem statement. The exploring reseach shaws that physical wear and tear of technological equipment, machines and mechanisms that fail to meet safety requirements causes the main number of injuries at coal, chemical, construction industry, etc. A large share of work- and non-workplace injuries with fatal consequences occur on the wear and tear of buildings and structures that are in an emergency state. The injuries are mostly common caused due to violation of fire safety rules, rules of labor protection, and unappropriate sanitary and hygienic working conditions. Thus, there are more than 50 thousand fires in Ukraine every year, in which people die, and material damage exceeds hundreds of millions of hryvnias, incidental losses are 20 times bigger. The reseach shows that a significant part of accidents happens to whokers who perform one-time jobs working under subcontract, without an employment. An average of 140−180 people in Ukraine are injured at work every day, 20 of them become disabled, 4−5 of those people die. The purpose of the article is to reseach the causes and consequences of violations’ requirements of regulatory and legislative acts, safety, which lead to injuries and deaths. And to analyse the statistics of industrial injuries in Ukraine. Conclusions. The analysis revealed that a significant part of the injuries and deaths of people is caused by the operations and maintenance of buildings and structures, violations by enterprise owners of regulatory and legislative acts on labor protection, safety, and sanitary and hygienic working conditions. Also, at the enterprises of Ukraine, work is carried out on worn-out technological equipment, which leads to serious consequences in the form of fatal injuries.

Vision Zero and Impaired Driving: Near and Longer-Term Opportunities for Preventing Death and Injuries

Vision Zero involves the use of a systems approach to eliminate fatal and serious injuries from motor vehicle crashes by accommodating basic human limitations that lead to crashes through fundamental behavioral expectations, together with sound vehicle and road design.Alcohol-related crashes account for a significant proportion of motor vehicle crash death and injury and can be addressed in a safe road transport system. We look at near-term policy and program interventions that are known to motivate drivers to make safe drinking and driving decisions, and possibilities for using technology over the longer term to address risks resulting from driver impairment that is either inadvertent or willful high-risk behavior.From the Vision Zero perspective,”normal driving” refers to a situation where traffic and road users are operating as desired and planned. A driver in this normal driving envelope operates at a safe speed, wears a seat belt, focuses on the driving task, and is not impaired. A safe system accommodates human errors, mistakes, and misjudgments in the normal driving envelope. However, it may not be capable of compensating for deliberate violations and rule-breaking.A critical role of behavioral programs and policies is to motivate safe decisions by drivers and other road users and keep them in the normal driving envelope where they can be protected from unintentional errors by a safe system. While much progress has been made in developing and implementing impaired driving policies and programs, much potential remains in the their ability to motivate drivers to meet the fundamental expectations required in a safe system. Examples of behavioral programs and policies that have strong evidence of effectiveness but are underutilized in the U.S. include conducting periodic sobriety checkpoints, lowering the blood alcohol concentration limit for driving, and mandating the use of ignition interlock devices. While the specific interventions may differ, it is likely that the same situation of incomplete implementation of behavioral programs and policies - and consequent unrealized value to a comprehensive safe system - applies to many other nations.To reach the goal of zero deaths, a comprehensive Vision Zero program needs to address the problem of deliberate risk-taking, which can include driver impairment from alcohol or other causes and extend to dangerous and reckless driving. Advanced safety technologies offer a range of opportunities for this purpose. Cars available today and in the future will have a plethora of sensors that monitor circumstances inside and around the car. These systems can identify whether a driver is in their safe driving envelope and respond with interventions that are appropriate for the severity and nature of the risk. Interventions could range from those that are not perceivable to the driver, such as putting driver assist systems into active mode, to stronger steps such as limiting or preventing vehicle operation.Zero fatalities or serious injuries in motor vehicle crashes is possible with a systems approach that accommodates human errors and mistakes that occur with the normal driving envelope and incorporates effective responses to deliberate risk-taking outside of this envelope.

Edge-Empowered Communication-Based Vehicle and Pedestrian Trajectory Perception System for Smart Cities

Road traffic crashes are one of the prime issues in the world. Every year 1.35 million people die, 20 to 50 million fatal injuries, and many incur a disability due to road traffic crashes. 50% of the total death, injuries, and disabilities are among vulnerable road users (VRUs), such as motorcyclists, cyclists, and pedestrians. Among these VRUs, highly vulnerable is pedestrians. In this paper, we are dealing with providing safety and alert system to pedestrians and vehicles to reduce and/or avoid the causes of road traffic crashes in metropolitan areas. In this paper, we develop a cooperative communication framework between pedestrians and nearby vehicles as well as traffic light systems using mobile agent systems and apps. The proposed cooperative communication framework controls the mobility of vehicles as well as pedestrians to avoid accidents. We have developed an application that will notify the pedestrian if there is any automobile within the range of 200 meters of the pedestrian. If there are any vehicles in this range, using direct Wi-Fi, connect the vehicles and pedestrians to notify them about their presence of them. The proposed system is implemented and tested in real-time as well as simulated in the SUMO, Veins, OMNeT++, and MiXiM simulator. The proposed systems results (real-time, simulation, and comparison) show real-time deployability, accuracy, and reliability.

Analysis of factors that influence injury severity of single and multivehicle crashes involving at-fault older drivers: A random parameters logit with heterogeneity in means and variances approach

The number of older drivers on our roads have been increasing given the upward shift of older people in the population. It is well-known that older drivers are more susceptible to injury given a crash. They are also likely to be at-fault in certain types of crashes due to health conditions associated with old age. This paper identifies factors that influence the severity of crashes involving at-fault older drivers at a disaggregated level for single and multivehicle crashes. Two random parameters multinomial logit with heterogeneity in means and variances models of injury severity were developed to assess the impact of various crash factors on crash outcomes based on the crash type. The study used five years of crash data from Alabama. The model estimations show that rainy weather and dark roadways were associated with an increased likelihood of serious injuries for single-vehicle crashes. Older male drivers were also found to have a higher probability of being at-fault in fatal single-vehicle crashes. For multivehicle older driver crashes, the model estimation results revealed that fatal injury was more likely to occur when the airbags were deployed. In addition, drivers between 65 and 75 years are less likely to be involved in fatal injury crashes for both single and multivehicle crashes. It was further found that older driver at-fault crashes that occurred in the open country were more likely to be fatal regardless of the manner of collision. The findings of this study are expected to help policymakers and transportation stakeholders to implement countermeasures that will make the road safer for older drivers and all other road users.

Causal Analysis of Fall Accidents in Hydraulic Engineering Based on Text Mining and Decision-Making Trial and Evaluation Laboratory and Interpretative Structural Modeling

Hydraulic engineering construction safety has become a major concern in engineering sustainability. Fall accidents, as a common type of accident during the hydraulic engineering construction process, have caused physical and fatal injuries and property losses on an individual and societal scale. With a sizable workforce, complex operational structures and demanding construction conditions, hydraulic engineering projects present more pronounced safety management challenges than other infrastructure initiatives. As a result, the risk of accidents, particularly fall accidents, is heightened in this domain. To prevent fall accidents and minimize losses, this study used the investigation reports of 389 cases of fall accidents as the analyzed corpus, and 16 contributing factors of fall accidents were extracted with the utilization of text mining. Accident feature terms were visualized through word clouds and ring bar graphs. The logical relationship among the influencing factors was quantified based on Decision-Making Trial and Evaluation Laboratory and Interpretative Structural Modeling (DEMATEL-ISM). The contributing factors and occurrence mechanism of fall accidents in hydraulic engineering were analyzed by establishing a multilevel hierarchical hybrid model. The results showed that the multilevel hierarchical hybrid model was divided into five levels. Thirteen causal chains were obtained. Chaotic security management, weak safety awareness and an inadequate safety system were the most critical factors, while the remaining eleven transitional factors and four surface factors also contributed significantly to the occurrence of accidents. Human and management factors dominated the overall factor transfer pathway. This study proposes countermeasures to the above-mentioned factors and provides a theoretical basis for the sustainable and safe construction of hydraulic engineering.

Quality evaluation of the usefulness of an emergency department fall risk assessment tool

IntroductionFalls that occur within a hospital setting are difficult to predict, however, are preventable adverse events with the potential to negatively impact patient care. Falls have the potential to cause serious or fatal injuries and may increase patient morbidity. Many hospitals utilize fall “predictor tools” to categorize a patient's fall risk, however, these tools are primarily studied within in-patient units. The emergency department (ED) presents a unique environment with a distinct patient population and demographic. The Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT) has shown to be effective with predicting a patient's fall risk in the ED. This IRB-approved study aims to assess the predictive validity of the MEDFRAT by evaluating the sensitivity and specificity for predicting a patient's fall risk in an emergency department at a level 1 trauma center. MethodsA retrospective cohort analysis was conducted using an electronic medical record (EMR) for patients who met study inclusion criteria at a level 1 trauma center ED. Extracted data includes MEDFRAT components, demographic information, and data from the Moving Safely Risk Assessment (MSRA) Tool, our institution's current fall assessment tool. A receiver operating characteristic (ROC) curve was constructed to determine the best cutoff for identifying any fall risk. Sensitivity, specificity, accuracy, positive likelihood ratio (LR+) and negative LR (LR-), with 95% CIs were then calculated for the cutoff value determined from the ROC curve. To compare overall tool performance, the areas under the ROC curves (AUC) were determined and compared with a z-test. ResultsThe MEDFRAT had a significantly higher sensitivity compared to the MSRA (83.1% vs. 66.1%, p = 0.002), while the MSRA had a significantly higher specificity (84.5% vs. 69.0%, p = 0.012). For identifying any level of fall risk, ROC curve analysis showed that the cutoff providing the best trade-off between sensitivity and specificity for the MEDFRAT was a score of ≥1. Additionally, area under the curve was determined for the MEDFRAT and MSRA (0.817 vs. 0.737). ConclusionThis study confirms the validity of the MEDFRAT as an acceptable tool to predict in-hospital falls in a level 1 trauma center ED. Accurate identification of patients at a high risk of falling is critical for decreasing healthcare costs and improving health outcomes and patient safety.

Mass shootings, firearm injuries, and mental health

IntroductionThe correlation between mass shootings, firearm injuries, and mental health is an ongoing polarized debate within the U.S., making it essential to develop public policy on mental illness and firearm injuries exacerbated by a significant increase in firearm sales in March 2020. Although many mass shooters are labeled “mentally ill,” mental illness is only present in a small minority of cases. Most mentally ill people are never violent but are more likely to be the victims of violence.Easy access to firearms and a triggering event deriving from social and economic inequalities are primary causes of mass shootings and growing online radicalization. Radicalization can easily lead to fatal firearm injuries, particularly for individuals with diagnosed or undiagnosed mental illness. RecommendationsProposed solutions include permits for firearms purchase, including a 25-year-old age limit, universal background checks, and banning large-capacity magazines. Additionally, a speedy and effective law enforcement response is the sole factor and the most reliable way to stop a mass shooting once it has started. The research identified several other recommendations, including expanding Medicare and mental health care access, expanding school safety and law enforcement training, and promoting public education about mental health and firearm safety.

Factors affecting pedestrian injury severity in pedestrian-vehicle crashes: Insights from a data mining and mixed logit model approach

There has been a concerning rise in pedestrian fatalities resulting from traffic accidents. This study conducts an in-depth analysis of the factors that contribute to the injury severity of pedestrians considering human, vehicle, roadway, and environmental characteristics of the crashes. A novel approach is proposed by combing a data mining technique and mixed logit models. First, the Apriori algorithm is employed to uncover patterns between fatal and incapacitating injury outcomes and their influencing factors. Then, mixed logit models are developed to investigate heterogeneity across all observations under two different lighting conditions. It is found that eight variables show heterogeneity affecting the injury severity of crash outcomes. Results also indicate that drivers older than 65 years old will increase the probability of pedestrian injury severity at dark-unlighted roads. Additionally, the present of signal and double yellow line has could increase the injury severity. Creating optimal lighting conditions at pedestrian crossings during nighttime hours and enhancing safety education initiatives for pedestrians are critical factors to improve pedestrian safety. The finding of this study will benefit policymakers and road safety professionals develop more effective strategies for preventing pedestrian injuries in vehicle crashes.

Itaconate inhibits SYK through alkylation and suppresses inflammation against hvKP induced intestinal dysbiosis.

Hypervirulent Klebsiella pneumoniae (hvKP) is a highly lethal opportunistic pathogen that elicits more severe inflammatory responses compared to classical Klebsiella pneumoniae (cKP). In this study, we investigated the interaction between hvKP infection and the anti-inflammatory immune response gene 1 (IRG1)-itaconate axis. Firstly, we demonstrated the activation of the IRG1-itaconate axis induced by hvKP, with a dependency on SYK signaling rather than STING. Importantly, we discovered that exogenous supplementation of itaconate effectively inhibited excessive inflammation by directly inhibiting SYK kinase at the 593 site through alkylation. Furthermore, our study revealed that itaconate effectively suppressed the classical activation phenotype (M1 phenotype) and macrophage cell death induced by hvKP. In vivo experiments demonstrated that itaconate administration mitigated hvKP-induced disturbances in intestinal immunopathology and homeostasis, including the restoration of intestinal barrier integrity and alleviation of dysbiosis in the gut microbiota, ultimately preventing fatal injury. Overall, our study expands the current understanding of the IRG1-itaconate axis in hvKP infection, providing a promising foundation for the development of innovative therapeutic strategies utilizing itaconate for the treatment of hvKP infections.

Review of Airbag Injuries: A Sri Lankan Case Series

The deployment of airbags in vehicles has significantly contributed to occupant safety during accidents. This review article discusses their history, evolution, types, chemical composition, mechanisms, defects, safety issues and hazardous practices by vehicle occupants. The evolution of airbags, from early designs to advanced designs is presented highlighting their life-saving impact and defects. The article addresses common hazardous practices by vehicle occupants that could lead to airbag-related injuries such as resting hands or feet on the dashboard. A series of typical and atypical airbag-related injuries from Sri Lanka is given in the latter part of the article. These cases include incidents of metal objects detaching from airbags causing fatal injuries, fractures resulting from improper hand placement during airbag deployment, burns, cranio-facial and dental injuries and so on.

Effect of helmet-wearing regulation on electric-bike riders: a case study of two cities in China

Abstract Objectives Electric bikes (e-bikes) are widely used for commuting and delivery in China. With the rapid increase in e-bikes on the road, related accidents have become crucial issues threatening the public. This research aims to explore the protective effect of helmet-wearing regulation and to investigate some factors influencing head injury with reference to two case cities in China, obtaining information to protect e-bike riders. Methods The traffic police-reported crash data cover the periods before and after the implementation of helmet-wearing regulations in Taizhou (with data from 2017 to 2019) and Nanning (with data in 2020) of China. Preliminary statistical analysis, logistic regression and chi-square test with a Bonferroni correction were applied in the research. Results A lack of helmets was common among victims in the context of a high helmet-wearing rate among general e-bike riders in Taizhou, indicating that fatality could be avoided to some extent by wearing helmets. Specifically, helmet wearing could reduce the probability of suffering fatal head injury by 6.4%. After the regulation implementation in Taizhou, the proportion of fatal head injuries decreased from 89% to 79%, remaining at a high level, which indicates that other measures in addition to helmet-wearing regulations should be taken. According to the results from Nanning, mandatory regulation worked more effectively than encouraged regulation in terms of reducing head injury. Conclusions Mandatory helmet-wearing regulations are highly recommended to policymakers to reduce head injury among e-bike riders. Measures in addition to helmet-wearing regulation, e.g. enhancing law-abiding awareness and improving road infrastructure, should be considered to further protect e-bike riders.

Substance use and pre-hospital crash injury severity among U.S. older adults: A five-year national cross-sectional study.

Alcohol and drug use (substance use) is a risk factor for crash involvement. To assess the association between substance use and crash injury severity among older adults and how the relationship differs by rurality/urbanicity. We pooled 2017-2021 cross-sectional data from the United States National Emergency Medical Service (EMS) Information System. We measured injury severity (low acuity, emergent, critical, and fatal) predicted by substance use, defined as self-reported or officer-reported alcohol and/or drug use. We controlled for age, sex, race/ethnicity, road user type, anatomical injured region, roadway crash, rurality/urbanicity, time of the day, and EMS response time. We performed a partial proportional ordinal logistic regression and reported the odds of worse injury outcomes (emergent, critical, and fatal injuries) compared to low acuity injuries, and the predicted probabilities by rurality/urbanicity. Our sample consisted of 252,790 older adults (65 years and older) road users. Approximately 67%, 25%, 6%, and 1% sustained low acuity, emergent, critical, and fatal injuries, respectively. Substance use was reported in approximately 3% of the population, and this proportion did not significantly differ by rurality/urbanicity. After controlling for patient, crash, and injury characteristics, substance use was associated with 36% increased odds of worse injury severity. Compared to urban areas, the predicted probabilities of emergent, critical, and fatal injuries were higher in rural and suburban areas. Substance use is associated with worse older adult crash injury severity and the injury severity is higher in rural and suburban areas compared to urban areas.

Firearm injuries treated at trauma centers in the United States.

While firearm injuries and deaths continue to be a major public health problem, the number of nonfatal firearm injuries and the characteristics of patients are not well-known. The American College of Surgeons Committee on Trauma leveraged an existing data system to collect additional data on fatal and nonfatal firearm injuries presenting to trauma centers. This report provides an overview of this initiative and highlights the challenges associated with capturing actionable data on firearm-injured patients. A total of 128 trauma centers that are part of the American College of Surgeons Trauma Quality Improvement Program collected data on individuals of any age arriving alive between March 1, 2021, and February 28, 2022, with a firearm injury. In addition to the standard data collected for Trauma Quality Improvement Program, abstractors also extracted additional data specific to this study. We linked data from the Distressed Community Index to patient records using zip code of residence. A total of 17,395 patients were included, with mean (SD) age of 30.2 (13.5) years, 82.5% were male, and the majority were Black and non-Hispanic. The mean proportion of variables with missing data varied among trauma centers, with a mean of 20.7% missing data. Injuries occurred most commonly in homes (31.2%) or on the street (26.6%); 70.4% of injuries were due to assaults. Nearly one third of patients were discharged from the emergency department, 25.9% were admitted directly to the operating room, and 10.9% were admitted to the intensive care unit; 5.9% died in the emergency department, and 10.3% died overall during their course of care. Nearly two thirds of patients lived in the two highest distressed categories of communities; only 7.5% lived in the least distressed quintile. Using trauma center data can be a valuable tool to improve our knowledge of firearm injuries if clinical practices and documentation of patient risks and circumstances are standardized. Prognostic and Epidemiological; Level III.

Data collection and analysis on the burden of injuries: Lessons learned from the IDB network

Abstract The EU-IDB (European Injury Database) contains cross-national data on the external causes and circumstances of injuries treated in the emergency departments of hospitals. Its primary purpose is to facilitate the development and evaluation of injury prevention policies and programmes, which aim to control external risks. The information is complementary to death and hospital discharge statistics and specific surveillance systems on road and workplace accidents. Unique is the wealth of information about external circumstances of injuries as needed for evidence-based prevention actions. The IDB data are collected by dedicated national agencies and provided to the Italian National Institute of Health (ISS) which hosts the databank. As part of the EU BRIDGE-Health initiative 2017 (WP9-Injury Surveillance Platform), the EU-IDB Network was commissioned to generate comparable burden of injury estimates across Europe: “Disability Adjusted Life Year (DALY) estimates for injury utilising the European Injury Data Base (IDB)”. DALY estimates were generated for IDB countries and years where both fatal and non-fatal injury data were available. Non-fatal injury data were acquired from Emergency Department data recorded in the IDB Minimum Data Set (MDS), fatal data were obtained from the European Detailed Mortality Database (EDMD). The general approach to calculating DALYs followed that of the Global Burden of Disease (GBD) study but utilised new and different disability weights created by the the Injury-VIBES cohort and detailed injury incidence data from nineteen countries. DALY estimates were between 2-10 times larger than estimates generated by previous studies such as the GBD study, due to much higher incidence figures and larger disability weights. In the workshop, the most recent results of the EU-IDB and the respective DALY estimates will be presented and discussed.

Injury related hospitalization: evidence from one year retrospective study

Abstract Background Injury remains a significant global public health issue, especially in low- and middle-income countries (LMICs). According to the IHME data Georgia has slightly higher rates of Injury-related DALYs, then WHO European Region average and significantly exceed the average of the Upper Middle Income countries group, to which country belongs according to the World Bank classification. The aim of the study was to explore the epidemiological characteristics of injury in Georgia. Methods This study was designed in the framework of NIH-Fogarty International Trauma Training Program iCREATE. Hospitalization Database of the National Center for Disease Control and Public Health of Georgia for 2021 was used for the retrospective study. Hospitalization database includes data from all hospitals of the country. Injury related cases were identified using ICD-10 classifications (S and T codes). Results A total of 564411 patients, among them 29228 injured patients were admitted in all hospitals of Georgia in 2021. 61% of injured patients were males and 39% females, retrospectively with ratio 1:1.5. The mean age of injured patients was 42(±25) and the highest hospitalization was in the age group of 30-34. The leading cause of injuries was falls (51.9%) followed by accidental exposure to other and unspecified factors (15.5%) and road traffic injuries (9.5%). Most of injured patients (45%) were treated in the capital of Georgia, Tbilisi. The most common source of hospital arrival was ambulance (47%), followed by private/public transport (46%), the 7% of patients needed referral from one hospital to another. The average of LOS was 4 days. 1% of patients died, among them 67% were males and 33% females. The most common mechanism of fatal injuries was falls (47%), followed by transport accidents (24%). Conclusions This study provide baseline information about epidemiological characteristics of Injuries based on hospitalization database and identify direction for the future research. Key messages • In Georgia there is a need for elaborating relevant preventive interventions of injuries in population. • In LMICs there is a lack of data on Injuries which are essential for elaborating relevant preventive interventions.

Slip Risk Prediction Using Intelligent Insoles and a Slip Simulator

Slip and fall accidents are the leading cause of injuries for all ages, and for fatal injuries in adults over 65 years. Various factors, such as floor surface conditions and contaminants, shoe tread patterns, and gait behavior, affect the slip risk. Moreover, the friction between the shoe outsoles and the floor continuously changes as their surfaces undergo normal wear over time. However, continuous assessment of slip resistance is very challenging with conventional measurement techniques. This study addresses this challenge by introducing a novel approach that combines sensor fusion technology and machine learning techniques to create intelligent insoles designed for fall risk prediction. In addition, a state-of-the-art slip simulator, capable of mimicking the foot’s motion during a slip, was developed and utilized for the assessment of slipperiness between various shoes and floor surfaces. Data acquisition involved the collection of pressure data and three-axial accelerations using instrumented shoe insoles, complemented by friction coefficient measurements via the slip simulator. The collected dataset includes four types of shoes, three floor surfaces, and four surface conditions, including dry, wet, soapy, and oily. After preprocessing of the collected dataset, the simulator was used to train five different machine learning algorithms for slip risk classification. The trained algorithms provided promising results for slip risk prediction for different conditions, offering the potential to be employed in real-time slip risk prediction and safety enhancement.

Circumstances of falls among older adult walker users in long-term care and the associated walker design deficits

ABSTRACT Falls are the leading cause of fatal and non-fatal injuries in older adults. Walkers are often used by and prescribed to this population to reduce fall risk, however, walker users and walker non-users alike experience similar fall incidence rates. The role of walkers in preventing falls is unclear as some studies suggest walkers may be a fall-inciting factor. The purpose of this study was to analyze walker deficits by evaluating the circumstances and causes of falls in older adult walker users residing in long-term care facilities. Videos capturing 34 real-life falls involving wheeled walkers (rollators and two-wheeled walkers) in two retirement facilities were analyzed for 3 themes: walker type, fall direction, and activity at the time of fall. A frequency analysis of these themes was performed to determine common fall mechanisms. The results of this study suggest two-wheeled walker and rollator users most often fall sideways while turning and backward during weight transfer, respectively. Poor maneuverability, lateral stability, and wheel velocity control of the walkers contributed to the falls. Device improvements addressing these areas of deficiency may be necessary to mitigate falls occurring in older adult walker users.

Clinico-Epidemiological Study of Fatal Head Injuries in an Autopsy

Introduction: Head injury is a significant public health problem worldwide. Traumatic head injury is a leading cause of death and disability in children and adults in their most productive years. The morbidity and mortality due to head injury is on the rise and is one of the prime importance in today’s medical practice. Objective: To assess the clinico-epidemiological study of fatal head injuries in an autopsy. Methods: The present study was conducted of the Department of Forensic Medicine & Toxicology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January to June 2022. Total 250 patients included in this present study. We selected only fatal head injury cases due to mechanical violence. However, we included severe facial injury cases too as these cases were associated with head injury. But, the present study doesn’t involve crushed head injury or survived cases, referred or LAMA cases brought in the hospital. Results: Maximum cases were seen in the age range of 21-30yrs, 57 cases (22.8%). Maximum cases were seen amongst males, 196 cases, 78.4%. The commonest causes of fatal head injuries are Road Traffic Accident (RTA) cases. Other important causes of fatal head injuries are fall from height, assault & railway accidents. External head injuries were mainly seen on frontal and parietal regions. Amongst the scalp injuries lacerations were very common seen in 114 cases, 36.19%. Skull bone fractures were frequently seen in fatal head injury cases. Presence of skull bone fractures are associated more frequently with fatal complications. Though linear fractures are common in general we observed the comminuted fractures as the commonest type of skull fractures in fatal head injury cases, seen in 73 cases, (58.4%). Depressed fractures were less common in fatal cases. Involvement of cranial fssa was seen in 108 cases. Linear type of fractures both transverse and horizontal type was more common seen in 66 coases amongst the 108 cases of cranial fossa involvement i.e. 61.11%. Involvement of middle cranial fossa was high seen in 45 cases of the 108 cases i.e. (41.66%). Presence of comminuted skull bone fractures is associated with higher rate of mortality. Conclusion: Most of the cases were due to road traffic c accidents and males are more prone to get Head injury. Other important causes of fatal head injuries are fall from height, railway accidents and assaults in descending order. To reduce the morbidity and mortality it’s high time for the concerned authority to take appropriate actions.

Clinical Courses and Outcome in Patients with Blast Injuries: An Observational Case Series Study

Background: Blast injuries are similar to any other burn injuries. Emphasis is given to safety measures as the treatment of burns is a painful and prolonged process that involves a loss of limb or sensory organs with a lot of expenditure. Aim: To evaluate the patient with their outcomes and management who sustained blast injuries. Patients and Methods: All patients who had blast injuries with different kinds and mechanisms were prospectively studied and clinical presentation, management and outcomes were reviewed. Results: 6 patients were studied with different age groups and different mechanisms of blast injuries of which one was female who sustained thermal injuries associated with AC Blast, two patients sustained explosive blast, and others were involved in methanol cylinder blast, improvised explosive device and mixing fertilizer as a chemical form of blast injuries respectively. All were managed and the outcome was satisfactory for 2 individuals, 3 sustained amputations and 1 sustained mortality. Conclusion: The high energy wave produced during blasts are strong enough to produce fatal injuries that will lead to high morbidity and mortality. Civilians should be aware and personal protective equipment should be worn by those who are indulged in this hazardous occupation.

Promoting transportation safety in adolescence: the drivingly randomized controlled trial

BackgroundThe impact of young drivers’ motor vehicle crashes (MVC) is substantial, with young drivers constituting only 14% of the US population, but contributing to 30% of all fatal and nonfatal injuries due to MVCs and 35% ($25 billion) of the all medical and lost productivity costs. The current best-practice policy approach, Graduated Driver Licensing (GDL) programs, are effective primarily by delaying licensure and restricting crash opportunity. There is a critical need for interventions that target families to complement GDL. Consequently, we will determine if a comprehensive parent-teen intervention, the Drivingly Program, reduces teens’ risk for a police-reported MVC in the first 12 months of licensure. Drivingly is based on strong preliminary data and targets multiple risk and protective factors by delivering intervention content to teens, and their parents, at the learner and early independent licensing phases.MethodsEligible participants are aged 16-17.33 years of age, have a learner’s permit in Pennsylvania, have practiced no more than 10 h, and have at least one parent/caregiver supervising. Participants are recruited from the general community and through the Children’s Hospital of Philadelphia’s Recruitment Enhancement Core. Teen-parent dyads are randomized 1:1 to Drivingly or usual practice control group. Drivingly participants receive access to an online curriculum which has 16 lessons for parents and 13 for teens and an online logbook; website usage is tracked. Parents receive two, brief, psychoeducational sessions with a trained health coach and teens receive an on-road driving intervention and feedback session after 4.5 months in the study and access to DriverZed, the AAA Foundation’s online hazard training program. Teens complete surveys at baseline, 3 months post-baseline, at licensure, 3months post-licensure, 6 months post-licensure, and 12 months post-licensure. Parents complete surveys at baseline, 3 months post-baseline, and at teen licensure. The primary end-point is police-reported MVCs within the first 12 months of licensure; crash data are provided by the Pennsylvania Department of Transportation.DiscussionMost evaluations of teen driver safety programs have significant methodological limitations including lack of random assignment, insufficient statistical power, and reliance on self-reported MVCs instead of police reports. Results will identify pragmatic and sustainable solutions for MVC prevention in adolescence.Trial RegistrationClinicalTrials.gov # NCT03639753.