Higher Levels Of Injury Research Articles

Self-Reported, Work-Related Injuries and Illnesses Among Restaurant Workers in Shiraz City, South of Iran.

Background:Restaurant sector is one of the most rapidly developing sectors in the world and there is evidence that restaurant industry has high levels of work-related diseases and injuries. This study examined the prevalence of self-reported work-related injuries and illness (WRIIs) and their association with demographic variables among restaurant workers in Shiraz, the capital of Fars Province, Iran.Methods:In this cross-sectional study, 300 randomly selected restaurant workers completed a self-statement, research-made questionnaire regarding the prevalence of self-reported WRIIs, in Shiraz, Iran. Statistical analyses were performed using SPSS version 20.Results:A high prevalence of work-related injuries (84%) and musculoskeletal disorders (70%) was reported among restaurant workers. Cuts and lacerations, arising from accidents with knives, were the most common injuries seen, followed by burns, falls, slips and trips. Moreover, the prevalence of occupational accidents had a significant association with work experience (p = 0.012), cooking (p < 0.001), as well as preparation and washing (p = 0.011). Age (p < 0.001) and work experience (p < 0.001) had a significance association with the prevalence of musculoskeletal disorders.Conclusion:Preventive measures and polices, through providing occupational health and safety services including trainings, personal protective equipment and health examinations, should be taken as to restaurants and catering industry in Iran.

An Integrative Review on Teen Distracted Driving for Model Program Development.

Distracted driving, especially driver inattention, is associated with high levels of crash-related fatalities and injury. Teen novice drivers are one of the groups most likely to drive distracted and to suffer its consequences. Teens have a higher risk of engaging in texting or secondary tasks, e.g., eating while driving. Distracted driving interventions to date aim to improve teen and societal safety, but few have achieved effectiveness. A need exists for effective evidence-based distracted driving interventions. We used an integrative review to identify rigorous evidence, and inform the development of a teen distracted driving educational intervention. This five-step review included: identifying the research problem; collecting literature; evaluating literature; synthesizing data; and presenting results. We searched 6 databases, identifying 185 articles. Following three rounds of inclusion screening (title, abstract, and full-text), captured according to a PRISMA flow chart, 17 studies met inclusion. We categorized these studies, conducted in the U.S., as five intervention types that used approaches including presentations, videos or instructional programs, education or training programs, driving simulator training, in-vehicle monitoring or feedback, and integrated programs. Study designs included randomized controlled trials pre-post, quasi-experimental, and experimental designs with prospective longitudinal cohorts. The studies were heterogeneous in design, intervention and outcome. However, three core themes emerged across studies: i.e., hazard awareness, hazard mitigation and attention maintenance are primary critically necessary skills to prevent distracted driving; engaging a parent or adult as a partner in the intervention process from classroom to car contributed to the effectiveness of the intervention; and leveraging technology in training enhanced the effectiveness of the intervention. Study limitations pertained to a focus on short-term effects; sampling distributions that did not account for gender, age, race, and/or ethnicity; types of interventions; and bias. The limitations affect the generalizability of included study findings and, potentially, the review findings, as they may not apply to populations or contexts outside those synopsized. Strengths included our team's expertise in conducting evidence-based reviews, support of a health science librarian, and use of international review guidelines. As an outcome, we are applying findings of the integrated review to develop a computer-based training addressing teen distracted driving.

Cardiovagal baroreflex gain relates to sensory but not neurological level of spinal cord injury

The arterial baroreflex is a primary regulator of autonomic outflow to effectively regulate acute blood pressure changes. After a spinal cord injury (SCI), damage to the autonomic nervous system results in cardiovascular dysregulation. Higher level of injury results in greater loss of sympathetic control, while cardiac parasympathetic control remains intact regardless of injury level. Thus, it is possible that those with high level SCI, and hence extensive sympathetic disruption, will require greater cardiac parasympathetic compensation to control blood pressure. However, the effect of an SCI on cardiovagal baroreflex gain remains unclear. Baroreflex control of blood pressure in those with SCI has been reported to be greater, lesser, and no different compared to able‐bodied individuals. Moreover, the effect of injury level on baroreflex gain remains unclear as most studies that examined the effect of lesion level treated it as a discrete variable – high, usually cervical level lesions, and low, usually thoracic level lesions. Therefore, we assessed baroreflex sensitivity using the neck chamber techniques in those with SCI (N = 29) across a range of injury levels (neurological level of injury C1 – T10, sensory score C4 – S4/5), within 2 years of injury, and compared them to able‐bodied (N = 14). Injury level was assessed by both neurological level of injury and sensory score. We assessed baroreflex gain during 5 trials of 4 levels of neck chamber pressure (corresponding to −15, −25, −35, and −45 mmHg). We found no difference in baroreflex gain between those with SCI and able‐bodied (p&gt;0.1). Neurological level of injury was not correlated to baroreflex gain, but sensory score and resting RR‐interval were (r = 0.47, p&lt;0.01; r = 0.57, p&lt;0.01). Multiple regression showed that both sensory score and resting RR‐interval were strongly predictive of baroreflex gain (r2 = 0.47, p&lt;0.01): gain increased with lower sensory score and higher resting RR‐interval. Moreover, baroreflex gain was not different between those with high and low neurological level of injury; but higher in those with lower compared to higher sensory score (both p&lt;0.01). Hence, sensory score is more predictive of baroreflex gain than the widely used neurological level of injury. This might be understood in the context of vagal‐sympathetic accentuated antagonism: those with high level injuries have the lowest likelihood of intact cardiac sympathetic innervation depressing cardiac vagal responsiveness.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Knockdown of Cytochrome P450 Genes Gh_D07G1197 and Gh_A13G2057 on Chromosomes D07 and A13 Reveals Their Putative Role in Enhancing Drought and Salt Stress Tolerance in Gossypium hirsutum.

We identified 672, 374, and 379 CYPs proteins encoded by the CYPs genes in Gossypium hirsutum, Gossypium raimondii, and Gossypium arboreum, respectively. The genes were found to be distributed in all 26 chromosomes of the tetraploid cotton, with chrA05, chrA12, and their homeolog chromosomes harboring the highest number of genes. The physiochemical properties of the proteins encoded by the CYP450 genes varied in terms of their protein lengths, molecular weight, isoelectric points (pI), and even grand hydropathy values (GRAVY). However, over 99% of the cotton proteins had GRAVY values below 0, which indicated that the majority of the proteins encoded by the CYP450 genes were hydrophilic in nature, a common property of proteins encoded by stress-responsive genes. Moreover, through the RNA interference (RNAi) technique, the expression levels of Gh_D07G1197 and Gh_A13G2057 were suppressed, and the silenced plants showed a higher concentration of hydrogen peroxide (H2O2) with a significant reduction in the concentration levels of glutathione (GSH), ascorbate peroxidase (APX), and proline compared to the wild types under drought and salt stress conditions. Furthermore, the stress-responsive genes 1-Pyrroline–5-Carboxylate Synthetase (GhP5CS), superoxide dismutase (GhSOD), and myeloblastosis (GhMYB) were downregulated in VIGS plants, but showed upregulation in the leaf tissues of the wild types under drought and salt stress conditions. In addition, CYP450-silenced cotton plants exhibited a high level of oxidative injury due to high levels of oxidant enzymes, in addition to negative effects on CMS, ELWL, RLWC, and chlorophyll content The results provide the basic foundation for future exploration of the proteins encoded by the CYP450 genes in order to understand the physiological and biochemical mechanisms in enhancing drought and salt stress tolerance in plants.

Genome wide identification of the trihelix transcription factors and overexpression of Gh_A05G2067 (GT-2), a novel gene contributing to increased drought and salt stresses tolerance in cotton.

We identified 102, 51 and 51 proteins encoded by the trihelix genes in Gossypium hirsutum, Gossypium arboreum and Gossypium raimondii, respectively. RNA sequence data and real‐time quantitative polymerase chain reaction analysis showed that Gh_A05G2067 (GT‐2) was highly upregulated under drought and salt stress conditions. Transient expression of GT‐2‐green fluorescent protein fusion protein in protoplast showed that GT‐2 was localized in the nucleus. The overexpression of GT‐2 conferred an enhanced drought tolerance to cotton, with lower malondialdehyde, hydrogen peroxide contents and higher reactive oxygen scavenging enzyme activities. Moreover, chlorophyll content, relative leaf water content (RLWC), excised leaf water loss (ELWL) and cell membrane stability (CMS) were relatively stable in the GT‐2‐overexpressed lines compared to wild‐type (WT). Similarly, stress‐responsive genes RD29A, SOS1, ABF4 and CBL1 were highly upregulated in the GT‐2‐overexpressed lines but were significantly downregulated in WT. In addition, the GT‐2‐silenced cotton plants exhibited a high level of oxidation injury, due to high levels of oxidant enzymes, in addition to negative effects on CMS, ELWL, RLWC and chlorophyll content. These results mark the foundation for future exploration of the trihelix genes in cotton, with an aim of developing more resilient, versatile and highly tolerant cotton genotypes.

Survival in 222 Patients With Severe CSCI: An 8-Year Epidemiologic Survey in Western China

ObjectiveTo assess the survival and the predictors of mortality in patients with severe cervical spinal cord injuries (CSCI). DesignRetrospective study. ParticipantsFrom January 1, 2010, to May 31, 2018, patients who suffered from severe CSCIs in Western China were enrolled in this study (N=222). InterventionsNot applicable. Main Outcome MeasuresSurvival rates and mortality risk factors. Measures were calculated by the product-limit method (Kaplan-Meier) and the Cox model. ResultsThe overall 1-year, 3-year, 5-year, and 8-year postoperative mortalities were 24.4%, 30.6%, 33.3%, 36.2%, and 39.0%, respectively. Most deaths occurred within 36 months after the injury. According to the Cox proportional hazards model, the significant predictors of survival were as follows: (1) age; (2) neurologic level; (3) treatment options (surgical or conservative); (4) ventilator support (P<.05). The 8-year mortality for older patients (>50y) was 50.2%, which was significantly higher than that for younger patients (32.4%, <50y). The risk of death was 2.053 times higher in higher levels of injury (C1-C4) than in lower levels of injury (C5-C8) (P<.05). Compared with conservative treatment, patients who received surgical treatment (either anterior or posterior decompression) had a lower risk of death (P<.05). No significant difference was detected in the risk of death between early surgery (<3d) and mid-term surgery (3-7d) (P>.05). However, patients who received late-term surgery (>7d) had a higher mortality risk (P<.05). The overall 8-year mortality risk of patients who needed ventilator support was much higher than those who did not need ventilator support (P<.05). ConclusionsAge, neurologic level, ventilator dependence, treatment options, and timing to surgery were main risk factors for mortality in patients with severe CSCIs. Better understanding of the predictors for survival could possibly contribute to the improvement of survival rates.

Basic Dimensions of Resilient Coping in Paramedics and Dispatchers

Introduction Paramedics and dispatchers are exposed to high levels of stress and consequent psychological injury. Resilience training enhances the capacity to cope with stress and be resilient. It is widely recommended that resilience training be customised to specific occupational groups, but there is no established method for achieving such customisation. Exploratory factor analysis was used to identify dimensions underlying resilient coping in paramedics and dispatchers. The objective was to provide a basis for customised resilience training in this population. Methods The Resilient Coping Survey (RCS) was developed on the basis of interviews with paramedics and dispatchers as well as scoping review to identify coping items relevant to this occupational group. The RCS included scales of coping (Resilience at Work and the Self-Compassion Scale – Short Form), a scale of self-perceived resilience (the Brief Resilience Scale) and a set of items reflecting coping skills specific to paramedic service work. The survey was administered to paramedics and dispatchers in British Columbia, Canada. Results 703 paramedics and dispatchers responded to the survey. Analysis of the survey data identified five resilient coping factors: balance, self-acceptance, trusted social support, meaningful work and physical self-care. Each of these factors predicted resilience. No difference was found overall in resilience across gender; but only for male workers did resilience fall steadily with years of service. Conclusion Resilience training for paramedics and dispatchers would appropriately target the five resilient coping factors and be delivered throughout the paramedic service career.

Feline head trauma: a CT analysis of skull fractures and their management in 75 cats.

The aim of this study was to describe and evaluate the configurations and management of feline skull fractures and concurrent injuries following head trauma. Medical records and CT images were reviewed for cats with skull fractures confirmed by CT that were managed conservatively or with surgery. Details of signalment, presentation, skull fracture configuration, management, re-examination, and complications or mortality were recorded and analysed. Seventy-five cats (53 males, 22 females) with a mean age of 4.8 ± 3 years met the inclusion criteria. Eighty-nine percent of cats had fractures in multiple bones of the skull, with the mandible, upper jaw (maxilla, incisive and nasal bones) and craniofacial regions most commonly affected. Temporomandibular joint injury occurred in 56% of cats. Road traffic accidents (RTAs) were the most common cause of skull fractures, occurring in 89% of cats, and caused fractures of multiple regions of the skull. RTAs were also associated with high levels of concurrent injuries, particularly ophthalmic, neurological and thoracic injuries. A more limited distribution of injuries was seen in non-RTA cats. Equal numbers of cats were managed conservatively or surgically (47%). Mortality rate was 8% and complications were reported in 22% of cats. Increasing age at presentation and presence of internal upper jaw fractures were risk factors for development of complications. No risk factors were identified for mortality. RTAs were the most common cause of feline skull fractures and resulted in fractures in multiple regions of the skull and concurrent injuries occurred frequently. Problems with dental occlusion were uncommon post-treatment. An increased risk of implant loosening and malocclusion was seen with palatine and pterygoid bone fractures and hard palate injuries. This study provides useful additional information regarding feline skull fractures, concurrent injuries and management techniques following head trauma.

Disaster medicine: object of study and scientometric analysis of domestic scientific articles (2005–2017)

Relevance.Despite the decrease in the absolute indicators of emergencies, accidents and catastrophes, and the reduction of related injuries in Russia, there is still a high level of mortality and injuries associated with the impact of external causes, surpassing similar indicators in the leading countries of the world. Therefore, research to optimize the provision of first aid and emergency medical care to the injured is needed.Intention.To conduct a content analysis of domestic articles within the branch of knowledge “Disaster Medicine. Service of Disaster Medicine” and to reveal their scientometric indicators.Methodology.The object of research was an electronic database of domestic publications (scientific articles, reviews and brief reports) indexed in the Russian Scientific Citation Index in 2005–2017.Results and Discussion.During the electronic search, 2431 publications on the disaster medicine were found. The polynomial trend with a high coefficient of determination (R2 = 0.90) showed an increase in indicators. Over the research period, the average annual number of publications was (186 ± 23) articles. The general provisions of the disaster medicine were covered in 10.1 % , tasks and organization of the service of disaster medicine – in 5.8 %. forecasting and modeling of health consequences in emergencies – in 16.6 %, organization of health care – in 25.3 %, medical care and treatment of injured – in 13.5 %, medical control, examination and rehabilitation of rescuers – in 4.1 % , training of specialists in disaster medicine – in 9.4 %, biological problems – in 5.3%, psychiatric and psychological aspects – in 9.9 % of articles. The average weighted impact-factor of the journals in which the articles were published is 0.302, the average number of articles per 1 co-author was 0.40, the average number of citations per article is 1.54, for 1 co-author 0.55, the number articles quoted at least once, 43.8 %, the number of self-citations, 19.2 %, the Hirsch index was 19. The median of the chronology of citations was 4.5 years. Scientometric analysis of articles on leading authors, journals and organizations was conducted.Conclusion. The performed analysis helps to optimize scientific research on disaster medicine. The electronic database of the Scientific Electronic Library provides great information opportunities, for example, on May 12, 2018, 70.5 % of articles within the created collection of publications had the full text, including 60.2% of articles that were provided free charge to registered readers of the library.

Pneumonia as a modifiable risk factor of mechanical ventilation in cervical spinal cord injuries

RATIONALE: Spinal cord injuries greatly impact morbidity and mortality. High cervical injury level often leads to the need of definitive airway. Whether pneumonia is a modifiable risk factor for mechanical ventilation (MV) and prolonged MV in this population is unclear in the literature.OBJECTIVES: The objective of this study was to determine whether pneumonia is an independent risk factor for MV and prolonged MV.METHODS: We conducted a retrospective chart review of consecutive cervical spinal cord injuries admitted to the Hôpital Sacré-Coeur de Montreal in the last 10 years. Eligible patients were identified using the local spinal trauma registry. We recorded data related to the mechanism and type of injury, patient demographics, duration of MV, respiratory complications, intensive care unit and hospital length of stay, and patients’ outcomes. Univariate logistic regression and multivariate logistic regression were performed to determine statistically significant predictors of MV and prolonged MV.MEASUREMENTS AND MAIN RESULTS: Between 2005 and 2014, 348 consecutive cervical injured patients were included. In the multivariate analysis, the presence of pneumonia (odds ratio (OR) 7.42; 3.02–18.27) was independently associated with the need for intubation and the presence of ventilator-associated pneumonia (OR 5.16; 2.00–13.27), was significantly associated with prolonged MV. The median duration of MV was 32.0 days (interquartile range [IQR] = 48.0) in patients with ventilator acquired pneumonia (VAP) compared to 7.0 days (IQR =20.0) in patients without VAP (p < 0.01).CONCLUSIONS: In conclusion, respiratory infection in the cervical spinal injured population is an important factor leading to intubation and prolonged MV.

Effects of respiratory rehabilitation exercise for high level of cervical spinal cord injury: Novel approach

People with high level of spinal cord injury feel a lot of discomfort in breathing ability. However, the rehabilitation exercise program to solve this problem is not activated. Also, the respiratory rehabilitation exercise program developed specifically for those is very scarce. Existing breathing exercises are uncomfortable because the method is tedious and cannot see the degree of improvement. Therefore, it is important to develop a variety of exercise programs that can effectively enhance the respiratory muscle. The purpose of this study was to investigate the effect of respiratory rehabilitation exercise to improve pulmonary function. The subject were 7 people with high level of spinal cord injury (C3-6, ASIA A, B). The exercise program developed was consist of 8 weeks of 1-h exercise session 2 days a week. Each session included warm up (stretching), respiratory rehabilitation exercise, and cool down (flexibility and relaxation). The pulmonary functions were measured with digital spirometry meter (Pony FX, Cosmed, Italy). The pulmonary function tests were conducted before and after the 16 sessions of respiratory rehabilitation exercise program. As a result of respiratory rehabilitation exercise during 8-week for subjects, pulmonary function showed significant changes in inspiratory capacity, vital capacity and inspiratory reserve volume. We confirmed the positive effect of the respiratory rehabilitation exercise program developed for people with high level of spinal cord injury. The results of this study are expected to be used as basic data for the development of specialized programs for each degree of severity.

Around the concept of classification in para sport: Involvement of physical and rehabilitation medecine (close-up on athletics)

The Para-sport Movement aims to offset the restriction of sport participation by offering fair competition and rules. As such, the classification process is fundamental and unavoidable. It determines who can compete. Following the International Classification of Functioning Disability and Health, classification groups athletes with similar activity limitations in classes depending on how their impairments impact their ability to produce the core activities in each sport. Ten physical, sensory, or intellectual impairments, are recognised and minimum impairment criteria are defined. Certain diseases or health conditions are excluded. (Ehlers Danlos, conversion disorders, fibromyalgia, pain…). Physical impairments taken into consideration are reduced muscle power, reduced passive range of movement, loss of limb or limb deficiency, leg-length difference, short stature, hypertonia, ataxia or athetosis. Physicians and Physiotherapists form panels with technical experts evaluating athletes and assigning classes following a specific procedure. The medical diagnosis has to be sent prior to the competition. Then, classifiers assess the impairment and its impact on the activity in three steps, physical and technical assessments, and if needed observation during the competition. Different issues are developed in the presentation: – evidence-based classification: most valid, reliable and reproducible tests are needed to make the decisions; – ethical aspects and controversies with potential cheating called Intentional Misrepresentation. (I.M.); – specific cases of dysautonomia for high level of Spinal Cord Injuries and Maximum Allowed Standard Height for bilateral lower limbs amputees; – training to improve expertise and develop classifiers’ skills; – problems of data protection; – status (New, Confirmed, Review, Classification Not Completed…); – non-eligible and borderline cases.

Cytotoxic Effect of Fusarium Equiseti Fungus Metabolites Against N-Nitrosodiethylamine- and CCL4-Induced Hepatocarcinogenesis in Rats

Fusarium equiseti, an endophytic fungus isolated from the marine alga Padina pavonica, displayed in vitro potent cytotoxicity and selectivity against liver cancer (HEP-G2) cells. This endophyte was therefore submitted to large-scale liquid fermentation to isolate 11 bioactive constituents. The cytotoxic effect of the extract against in vivo hepatocellular carcinoma (HCC) was evaluated in rats with HCC induced by single intraperitoneal injection of N-nitrosodiethylamine (NDEA) followed by subcutaneous injections of CCl4. After the injection of carcinogen, the fungal extract was orally administered in 25, 50 and 100 mg/kg doses once a day for 10 weeks. The high levels of liver injury and liver cancer markers after NDEA administration were significantly decreased by this treatment with the total fungal metabolites. Histological observations of the liver tissues of rats treated with NDEA and fungal extract co-administered at 100 mg/kg are correlated with the biochemical observations. These findings confirm that F. equiseti total metabolites could restore the activity of hepatic marker enzymes of NDEA-induced hepatocarcinogenesis in rats.

Cadaveric Nerve Allograft: Single Center's Experience in a Variety of Peripheral Nerve Injuries.

The purpose of this study is to report a single center's experience with cadaveric nerve allograft (CNA) for functional restoration after traumatic nerve injuries including the head and neck region. Sixteen patients were included in the current study. Ages ranged from 5 to 62 years, with a mean age of 35 years. The main indication for the use of CNA was nerve gaps of at least 10 mm in which both the proximal and distal stumps of the injured nerves were available. Only allografts from cadavers were used, and none of the patients underwent immunosuppressive treatment. Denervation time average was 12 weeks, with an average gap length of 65 mm. Most cases were located in the upper extremity (73%) and 80% were secondary to trauma. Most nerves involved were sensory, followed by mixed nerves and 2 patients with facial paralysis. Sensory recovery was graded as good and excellent in 91.7%. Motor recovery was graded as good in 33%. The results of the current study suggest that peripheral nerve injuries can successfully be treated by the use of CNA and may be used in larger nerve gaps and for unconventional uses, although caution should be used specifically in mixed or motor nerves and high level of injury. Avoiding donor site morbidity, minimizing operative time, and availability are the most important advantages of using CNA over autologous nerve grafts.

Underreporting, crash severity and fault assignment of minor crashes in China – a study based on self-reported surveys

ABSTRACTUnreported minor crashes have importance as a surrogate for more serious crashes that require infrastructure, education, and enforcement strategies; and they still inflict damages. To study factors that influence underreporting, cause, and severity of minor crashes; a survey was performed in Kunming and Beijing to collect self-reported personal characteristics and crash history data of the three major urban road users in China: automobile drivers, bicycle riders and electric bike (e-bike) riders. Underreporting rates of automobile to automobile, automobile to non-motorized vehicle, and non-motorized vehicle to non-motorized vehicle crashes are 56%, 77% and 94%, respectively. Minor crashes with higher reported injury severity levels are more likely to be reported. E-bike riders without a driver's license are more likely to cause crashes. Licensing and education could be an effective way to reduce their crashes. The party that is not at fault in a crash is more likely to sustain high level of injury.

Different Central Hemodynamic Response Among Patients with Incomplete Spinal Cord Injury

The cardiovascular response to physical activity is largely regulated by the autonomic nervous system. Sympathetic innervation of the heart originates between segments T1-5, while innervation originating between segments T6-L2 affects vascular response. Injury to the spinal cord induces loss of supraspinal sympathetic control over the cardiovascular system, which may culminate in blunted speed and magnitude of central hemodynamic responses during transitions in metabolic demand. PURPOSE: To investigate the cardiac output (Qt) response in relation to oxygen consumption (VO2) in patients with incomplete spinal cord injury (iSCI). METHODS: We tested 11 subjects in 3 groups: Tetraplegic group (TG, n=4, 41 ± 21 years); Paraplegic group (PG, n=4, 47 ± 19 years) and healthy controls (HC; n=3, 27 ± 8 years). Each group performed a constant-workload test on the treadmill at a self-selected walking speed. Qt and VO2 were measured simultaneously by impedance cardiography and pulmonary gas exchange analysis. RESULTS: Despite HC walking at a greater speed (1.5 mph vs. TG at 0.6 mph and PG at 1.0 mph), there was no difference in Qt or VO2 amplitude amongst the groups. Qt kinetics (reported as the time constant, τ) was longer (p<0.05) in TG (45 ± 21s) compared to either PG or HC (17±4s; 6±5s, respectively). Phase 2 VO2 on-kinetics were not different among the groups (TG, 33±30s; PG, 25±20s; HC, 20±6s). The ratio of τQt/τVO2 was poor (>1.0) in only TG, however was correlated (r = 0.96, p =0.002) with the responsiveness of the oxidative metabolic system (ΔVO2/τVO2) across all groups. CONCLUSION: Sympathetic innervation appears to influence the temporal profile of Qt depending on the level of lesion. Tetraplegics demonstrated slower Qt adjustment to increased metabolic demand compared to paraplegics. The slow increase in Qt relative to VO2 observed in tetraplegics suggests poor matching between central hemodynamics and metabolic demand in those with a higher level of injury. SCI elicits a lesion-dependent impairment in Qt kinetic profiles that may contribute to oxygen delivery to utilization mismatch occurring during walking in people who have incomplete cervical injury.

ФАКТОРЫ CНИЖЕНИЯ РИСКА СТОЛКНОВЕНИЯ АВТОТРАНСПОРТНЫХ МАШИН И ТРАВМИРОВАНИЯ ВОДИТЕЛЕЙ

Increasing the safety of drivers of motor vehicles (MV) used in rural and forestry is an urgent task due to the high level of injuries. Analysis of injury statistics of drivers of motor vehicles and conducted studies has revealed that these ma-chines are sources of increased danger in the performance of transport operations. For the functioning of a device that re-duces traumatism and increases the safety of MV drivers in carrying out transportation of agricultural products and removal of timber, it is necessary to know the magnitude of MV braking distance in real traffic conditions, which is determined theoretically. The imperfection of the methods for determining the real stopping distance of modern VMs used in forestry and agriculture is due to the fact that they do not take into account a number of operational and constructive factors. When determining the length of the braking distance according to the existing analytical dependencies, the error can be from 25% to 35%. Reducing the risk of collision of VM during transportation of agricultural products and performing logging operations is proposed to be provided by improving the method of determining the braking distance, taking into account the actual operating conditions. The results and conclusions made in this article can be useful for improving safety of agricultural and forestry vehicles on the roads

Use of ergonomic principles in manual order picking systems

Abstract Successful companies are continually striving to streamline costs and optimize processes, enabling them to grow progress, develop and ensure competitiveness on the market. A large part of the costs arises in warehouses, where up to 55% of total costs are generated by order-picking, which makes it important and interesting in terms of research. The paper explores “picker to part” order-picking concept, which enables flexible work and is the optimal choice for most companies. The concept is associated with a high level of work-related injuries and work-related illnesses. Work requires physical efforts resulting from handling heavy goods, performing repetitive movements and using manipulative means. Human as the main actor of the concept affects the costs caused by picking and the quality of work done, which depends on technological support, physically and psychologically capable and motivated people. Due to the high costs of service, the focus on time planning and productivity increases. Contrary, the lack of attention is paid to the working conditions and the health status of the pickers. To overcome this gab, a review of scientific and professional literature on ergonomic principles in picking concept »picker to part« was carried out, followed by a quantitative survey of ergonomic properties in warehousing activities. Results revealed that more than 60% of the surveyed order-pickers associate problems with health with the characteristics of work, about 24% of them associate health problems with the use of a particular means of transport, and all agree that provided measures to reduce physical effort and greater support of technologies influence on increased speed of work and better health status of order-pickers.

Vascular smooth muscle cell death, autophagy and senescence in atherosclerosis.

In the present review, we describe the causes and consequences of loss of vascular smooth muscle cells (VSMCs) or their function in advanced atherosclerotic plaques and discuss possible mechanisms such as cell death or senescence, and induction of autophagy to promote cell survival. We also highlight the potential use of pharmacological modulators of these processes to limit plaque progression and/or improve plaque stability. VSMCs play a pivotal role in atherogenesis. Loss of VSMCs via initiation of cell death leads to fibrous cap thinning and promotes necrotic core formation and calcification. VSMC apoptosis is induced by pro-inflammatory cytokines, oxidized low density lipoprotein, high levels of nitric oxide and mechanical injury. Apoptotic VSMCs are characterized by a thickened basal lamina surrounding the cytoplasmic remnants of the VSMC. Inefficient clearance of apoptotic VSMCs results in secondary necrosis and subsequent inflammation. A critical determinant in the VSMC stress response and phenotypic switching is autophagy, which is activated by various stimuli, including reactive oxygen and lipid species, cytokines, growth factors and metabolic stress. Successful autophagy stimulates VSMC survival, whereas reduced autophagy promotes age-related changes in the vasculature. Recently, an interesting link between autophagy and VSMC senescence has been uncovered. Defective VSMC autophagy accelerates not only the development of stress-induced premature senescence but also atherogenesis, albeit without worsening plaque stability. VSMC senescence in atherosclerosis is likely a result of replicative senescence and/or stress-induced premature senescence in response to DNA damaging and/or oxidative stress-inducing stimuli. The finding that VSMC senescence can promote atherosclerosis further illustrates that normal, adequate VSMC function is crucial in protecting the vessel wall against atherosclerosis.

Discontinuous ventilator weaning of patients with acute SCI.

Retrospective, single centre cohort study. To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula. Data related to anthropometric details, neurological injury, respiratory outcomes, and weaning parameters were prospectively recorded in a database and retrospectively analysed. Seventy-nine percent of all patients were successfully weaned from ventilation. Average duration of the complete weaning process was 37 days. Ninety-one percent of the successfully weaned patients completed this on first attempt. Age (>56 years), level of injury (C4 and/or above), vital capacity (<1500 ml), obesity (>25 kg/m2), and chronic obstructive pulmonary disease (COPD) significantly decreased the chance of successful weaning. These factors also correlated with a higher number of weaning attempts. High level of injury, older age, and reduced vital capacity also increased the duration of the weaning process. Patients with low vital capacity and concurrent therapy with Baclofen and Dantrolene showed higher rates of pneumonia. We conclude that mentioned factors are associated with weaning outcome and useful for clinical recommendations and patient counselling. These data further support the complexity of ventilator weaning in the SCI population due to associated complications, therefore we recommend conducting weaning of patients with SCI on intensive or intermediate care units (ICU/IMCU) in specialised centres.