Injuries Worldwide Research Articles

Dental Trauma following Animal Attack: A Case Report

Animal attacks are a common cause of human injuries worldwide, with human-leopard encounters frequently reported in India. Animal attack injuries are increasingly common in trauma centres due to human encroachment into wildlife habitats, leading to more human-animal interactions. These attacks, especially to the face, can cause significant functional, cosmetic, and structural damage. A 40-year-old woman was attacked by a leopard, resulting in tooth mobility, pain, and orofacial lacerations. Initial treatment and primary wound closure were performed in Ratlam, Madhya Pradesh, India. On further examination, necrosis with blackish discolouration of the left ala of the nose was observed, along with scarring on the lips. Tooth 22 exhibited luxation without alveolar bone involvement, leading to proclination. A multidisciplinary treatment approach was adopted, beginning with manual manipulation and repositioning of tooth 22, followed by stabilisation and endodontic treatment. For extraoral management, plastic surgery was performed, involving a paramedian forehead flap and alar cartilage remodelling using left auricular cartilage. The patient underwent follow-ups at one, three, six months and one year. In conclusion, managing dental trauma from animal attacks requires a multidisciplinary approach and ongoing follow-up. By fostering collaboration among healthcare professionals and ensuring vigilant care, we can significantly improve patient outcomes and recovery.

Smart Rumble Strip System to Prevent Over-Height Vehicle Collisions.

Collisions of over-height vehicles with low clearance bridges is commonly encountered worldwide. They have caused damage to bridge structures, interruption to traffic, injuries or even fatalities to road users. To mitigate such risks, passive systems that involve warning gantries, flashing lights and illuminated signage are commonly installed. Semi-active systems using laser- or infrared-based detection systems in conjunction with visual warnings have been implemented. Nevertheless, some drivers ignore these visual warnings and collisions continue to occur. This paper presents a novel concept for a collision prevention system, which makes use of a series of sensor-activated, motorized rumble strips. These rumble strips span across a certain distance ahead of a low clearance bridge. When an over-height vehicle is detected, a mechanism is triggered which elevates the rumble strips. The noise and vibrations produce a vigorous alert to the offending driver. They also increase effective friction of the road surface, thus assisting to slow down the vehicle and shorten the stopping distance. The strips will be lowered after a certain time has elapsed, thus minimizing their effects on other vehicles. This article presents a conceptual framework and quantifies the vibration and noise caused by rumble strips in road tests. Road tests indicated that the vibration level typically exceeded 1 g and noise level reached approximately 90 dB in the cabin of a 3.5-ton truck. Fabrication of a proof-of-concept mechanized rumble strip model was presented and verified in an outdoor environment. The circuitry and mechanical design, and requirements in actual implementation, are discussed. The proposed event-triggered rumble strip system could significantly mitigate over-height vehicle collisions that cause major disruptions and injuries worldwide. Further works, including a comprehensive road test involving various types of vehicles, are envisaged.

Global burden of fracture of sternum and/or ribs: An analysis of 204 countries and territories between 1990 and 2019

BackgroundSternum and rib fractures represent a significant global health concern, contributing to morbidity and disability on a worldwide scale. However, there is a notable lack of recent epidemiological data detailing the global and regional burden of these fractures. MethodsWe undertook a systematic analysis of the prevalence of sternum and rib fractures at the global, regional, and national levels in 2019, while also examining time trends spanning from 1990 to 2019. To achieve this, we extracted data from the Global Burden of Disease Study 2019, enabling us to determine incidence, prevalence, years lived with disability (YLDs), and their corresponding age-standardized rates. ResultsIn 2019, there were 4.1 million incident cases and 2 million prevalent cases of sternum and rib fractures worldwide. These figures represent increases of 43.7 % and 64.1 %, respectively, since 1990. YLDs also exhibited a notable increase, rising by 62.4 % to reach 190,834 cases. However, since 1990, their equivalent age-standardized rates, which ranged from 5.5 % to 7.1 %, have decreased. Notably, China had the greatest incidence (1.2 million cases), prevalence (573,000 cases), and number of YLDs (55,400 cases), all in 2019. The greatest age-standardized incidence rate (143/100,000) and age-standardized prevalence rate (65/100,000) were both recorded in Greenland in the same year. It's critical to emphasize that men experience these fractures at considerably higher rates than women. Around 70 % of incident instances included unintentional injuries worldwide and across all regions. High-socioeconomic regions had the highest rates of incidence, prevalence, and YLDs, albeit these rates have declined by 6.4 % to 7.1 % since 1990, whereas low-middle and low-income areas have had rises. ConclusionsThis study, which spans the years 1990 to 2019, provides a thorough and current assessment of the global burden attributed to sternum and rib fractures. In terms of nations, regions, sociodemographic index (SDI) levels, age groups, genders, and reasons, it reveals significant variances and trends. The knowledge obtained from this study can be extremely useful in formulating health policy, allocating resources, and developing methods to prevent these injuries.

Prevention and control of risk factors in metabolic and alcohol-associated steatotic liver disease

Steatotic liver disease (SLD), including metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD), is the primary cause of illness and mortality. In particular, MASLD affects more than 30% of the global population, while ALD accounts for 5.1% of all diseases and injuries worldwide. The SLD spectrum includes a variety of clinical conditions, from mild fatty liver and inflammation to different stages of liver fibrosis. Additionally, both conditions (MASLD and ALD) can be complicated by hepatocellular carcinoma (HCC), while around one-third of ALD patients can also develop at least one alcohol‐associated hepatitis (AH) episode. Both of these diseases are also associated with multiple extrahepatic complications, such as cardiovascular disease, chronic kidney disease, and malignancies. In MASLD, the rapid rise in global obesity and type 2 diabetes mellitus (T2DM) prevalence due to Westernized lifestyles has led to an increase in the prevalence of MASLD. Thus, the prevention and control of cardiometabolic risk factors (CMRFs) are the cornerstone of its treatment. Hypertension and atherogenic dyslipidemia are also important CMRFs associated with MASLD. Susceptible individuals with MASLD are adversely affected by even a small amount of alcohol consumption (though there is no agreed definition of a small amount), increasing the risk of severe outcomes and a faster progression of liver disease. This review explores factors that play a role in the development of SLD, especially focusing on the management of CMRFs and levels of alcohol use to prevent liver disease progression.

A phenomenological exploration of experience of Syrian dentists with online Course “Traumatic dental injuries”

BackgroundSeveral learning modalities have been implemented to improve learning about Traumatic Dental Injuries (TDIs) worldwide. Free online courses about TDIs might be an effective and convenient approach for equipping Syrian dentists with essential competencies during the Syrian crisis. Therefore, this qualitative study with a descriptive phenomenological method was undertaken to explore the lived experience of Syrian dentists enrolled in an online course about TDIs and investigate areas requiring improvement. MethodsEthical approval was obtained from the Faculty of Dentistry, Damascus University, and the University of Dundee. Educational contents of the TDI course were developed. About 10 dentists who completed the TDI course, were interviewed. The interviews were recorded, transcribed, and analyzed to identify emerging themes. Inductive thematic analysis was performed to extract all data. ResultsAbout 10 clustered categories were first developed and this has led to the emergence of 3 themes that represent the lived experience including usefulness, challenges, and recommendations. Participants were so motivated and keen to take advantage of the course despite the personal, technical problems, and crisis-related challenges. TDIs course was effective for general and specialists despite the challenges they experienced. Factors that lead to effective TDIs courses as reported by participants were flexibility in time and location, interactivity with colleagues, other commitments, quantity and quality of content, easiness, and variety of virtual environment tools. Conversely, negative attitudes were linked to factors like lack of interest, unfamiliarity with the learning environment and tools, late participation, lack of confidence, anxiety about independent learning and insufficient interactivity and engagement tools. ConclusionSyrian dentists can benefit from online courses if constraints and various learning needs are addressed during the design and delivery of online courses. Future work is still required to identify other effective instructional modalities that equip Syrian dentists to overcome challenges and enhance their learning.

Implementation of the new acts on driving under the influence of alcohol and clinical outcomes for patients severely injured in road traffic crashes

Objective Driving under the influence (DUI) of alcohol is a major risk factor for fatal road traffic injuries (RTIs) worldwide. This study aimed to investigate the relationship between the implementation of new acts on DUI of alcohol and the clinical outcomes of patients with severe RTIs in Korea. Methods This is a community-based cross-sectional study using a nationwide severe trauma registry in Korea. In 2018, 2 acts with the Yoon Chang-Ho Act (Yoon’s Act) were passed to strengthen the punishment for drunk driving fatal RTIs (first Yoon’s act) and lower the blood alcohol concentration limit to restrict driver’s licenses (second Yoon’s act). The first Yoon’s act was implemented on December 18, 2018, and the second Yoon’s act was implemented on June 25, 2019. The study periods were categorized as pre-Act-1, pre-Act-2, Act-1, and Act-2 according to the application of Yoon’s Act, and the study outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to estimate the relationship of the new acts and in-hospital mortality. Results Among a total of 20,376 patients with severe RTIs and 7,928 patients (drivers) with RTIs (hereafter drivers), the in-hospital mortality rates were 20.8% and 17.0%, and alcohol-related RTIs accounted for 9.7% and 8.1%, respectively. Severe RTIs tended to increase with each period (25.5 cases/day, 24.5 cases/day, 26.8 cases/day, and 30.4 cases/day, P for trend <.01). In-hospital mortality significantly decreased during the Act-2 period compared to the pre-Act-2 period for all patients with severe RTIs (adjusted odds ratio = 0.54, 95% confidence interval 0.43–0.67) and drivers with RTIs (adjusted odds ratio = 0.50, 95% confidence interval 0.34–0.73). Conclusions Implementation of the new acts on DUI of alcohol was associated with lower odds for in-hospital mortality for patients with severe RTIs. Further studies are needed to evaluate the long-term impact of the new acts on reducing alcohol-related RTIs.

Comprehensive investigation of crashes associated with citywide speed limit reduction in Seattle, Washington

Road traffic crashes are a leading cause of fatalities and injuries worldwide, prompting authorities to implement various strategies to enhance road safety. One common approach involves lowering speed limits in an effort to mitigate the severity of crashes and improve overall traffic safety. Seattle, Washington has been lowering its citywide default speed limits on municipal roads since 2016, among several cities in the US. This research paper presents a comprehensive investigation of the impact of these speed limit reductions on various safety indicators, such as the crash frequency, crash severity, crash characteristics, crash type, crash location, contributing factors, and overall traffic safety performance. The study employs a comprehensive dataset encompassing several years before and after the implementation of lower speed limits. Data analyses indicate varying changes in crash severity distribution between before and after periods in Seattle. Fatal and incapacitating crashes in Seattle decreased by 19% after the initial speed limit lowering in 2016 and further decreased by 3% after the second speed limit lowering in 2018. Pedestrian-involved crashes experienced a 26% significant decrease while speeding-related had a 16% decrease after the city implemented lowering speed limits. There was also a statistically significant 4% decrease in property damage only collisions and a 7% decrease in parked car crashes. Distracted driving / inattention-related crashes also decreased by 4%. The Mid-Block (but intersection related) crashes saw a significant decrease by 6%, and Driveway Junction related crashes decreased by 1%. The findings provide insights into the effectiveness of speed limit reductions in enhancing road safety in urban environments. The findings contribute to the existing body of knowledge on speed management strategies and their impact on traffic safety. The outcomes of this study can inform transportation policymakers and practitioners in Seattle and other urban areas as they make informed decisions regarding speed limit regulations and road safety measures.

Comparative Characteristics of Mortality of Children Due to Road Traffic Injuries in the Kyrgyz Republic

High death rates due to road accidents are characteristic of most countries of the world and the problem is global. The United Nations General Assembly has adopted an ambitious goal to halve the number of road traffic fatalities and injuries worldwide by 2030. In the Kyrgyz Republic, the number of traffic accidents increased from 5868 in 2016 to 7041 cases in 2022. In the dynamics of road accidents in the regions of the republic, an increase trend in 2019-2020 was revealed, which was replaced by a decrease in 2022, with the exception of the city of Bishkek with a sharp increase of +70.2%. Regions with a high frequency of road accidents were Chui, Issyk-Kul regions and the cities of Bishkek and Osh. Starting from 2018, 2019 and 2021, with road accidents due to the fault of the driver, injuries to children increased, especially in 2021 in all regions of the republic. In 2022, injuries decreased, only in the Batken, Naryn and Chui regions there was an increase. By region, Batken, Talas, Jalal-Abad and Issyk-Kul regions prevail. The highest rates of increase in mortality of children in road accidents due to the fault of the driver were observed in 2019-2022. Regions with a high mortality rate of children in traffic accidents due to the fault of the driver include the Chui, Talas, Naryn and Issyk-Kul regions. It is necessary in road safety policy to ensure a holistic (systemic) approach to solving the problem of reducing road traffic injuries and mortality.

Road Accident Prediction Using Machine Learning

Road accidents are a significant cause of fatalities and injuries worldwide. Predicting road accidents is crucial for implementing preventive measures and saving lives. This paper presents a deep learning-based road accident prediction system utilizing various factors such as speed, traffic condition, weather, and more. By leveraging publicly available datasets and external data sources, the model aims to accurately predict road accidents, ultimately contributing to enhancing road safety.

The ground is the limit: epidemiology of skydiving accidents over 25 years and in 2.1 million jumps in the Netherlands with sub-analysis of injuries reported by medical professionals in the past five years

BackgroundSkydiving is the fastest nonmotorized sport; and consequently is not without risk. In the last decades, skydiving has become considerably safer but injuries and fatalities still occur. Incidents are reported to and administered by the Royal Netherlands Aeronautical Association (KNVvL). From 1995 to 2020, 2715 incidents were reported; of which 1503 resulted in injury and 26 in fatality. There is a need for more information available on the particular type, severity, and factors which contribute to skydiving-related injuries worldwide. This study aims to investigate patterns in occurrence rates, examine demographic and skydiving-related factors linked to injuries, and analyze the types and severity of injuries relating to these contributing factors.MethodsThe Dutch KNVvL database – covering more than 25 years of data – was examined for contributing factors. An analysis of the severity and types of injury resulting from incidents over the last five years were matched with a search of hospital databases.ResultsThe rate of injuries pattern increases starting from 2016, with novice jumpers having the highest risk of injury. Most injuries occur during the landing phase. The lower extremities and the spine are most affected, with fractures being the most prevalent type of injury. More than half of the patients were admitted to hospital, with 10% requiring surgery, resulting in months of rehabilitation.ConclusionThis study is the first in the Netherlands, and only the second worldwide to analyze technical incident databases in combination with data from medical information systems. Skydiving accidents of experienced jumpers should be considered as ‘high-energy trauma,’ therefore treatment should follow standard trauma guidelines. In less experienced skydivers, it is critical to conduct a secondary survey to assess the extremities adequately. Clinicians should also pay attention to friction burns that can arise due to friction between the skin and skydive equipment, a phenomenom that is already known in road traffic accidents.

Global Patterns of Agricultural Machine and Equipment Injuries- A Systematic Literature Review

ABSTRACT Objectives Agriculture is the one of the hazardous industries in the world. Though there is significant investment in agricultural safety, machine injuries continue to be the leading cause of agriculture injuries worldwide. The objective of this study was to provide a comprehensive literature review on global patterns in agricultural machine injuries and establish a framework for future research aimed at addressing safety concerns in the agriculture sector. Methods The existing scholarship on farm machine injuries can be categorized into three main areas: a) farming machine/equipment injuries, b) factors associated with these injuries, and c) injury patterns. Results Overall, the findings highlight that farm tractors are the primary source of injuries for both fatal and non-fatal incidents regardless of region. Other common sources of injuries were harvesting machinery and hand/power tools in Asia, ATVs in North America and woodworking machinery in Europe. Inadequate training in operating farm equipment was reported as the most likely factor contributing to machine-related injuries. Lastly, the patterns of injuries vary based on the interaction between humans and machinery. For instance, rollovers often result in severe head and fracture injuries, while thresher incidents can lead to amputation of hands, arms, and other body parts. Conclusion Addressing these injuries by implementing safety protocols will not only enhance the well-being of farm workers but potentially attract more workers to the sector, which is currently experiencing labor shortages due to machine-related injuries.

Does the 80 km/h speed limit save lives in France?

Introduction: Speeding is considered to be a major contributor to road fatalities and injuries worldwide. Inappropriate speeding behavior is associated with a high casualty burden. It could be responsible for at least 30% of road accidents. Method: In 2018, the French authorities decided to introduce a new speed limit. They lowered the speed limit to 80 km/h on the unseparated interurban network. The aim was to reduce the number of fatalities and injuries and to implement some measures in line with international commitments. This paper uses different econometric models applied to time series for different groups of counties. Results: The results show a significant positive contribution of the new speed limit. The estimated number of lives saved is between 300 and 350. The overall reduction in the number of fatalities is 10%. The results also show a differentiated impact according to the local context and the different dynamics at play. Conclusions and Practical Applications: The results of this paper are in line with the scientific literature on speed limit reductions. They represent a validation of a debated public decision, while at the same time consolidating the body of knowledge on the subject, helping the decision-maker to adopt an appropriate measure to improve road safety performance.

Online cognitive-behavioral intervention for stress among English as a second language teachers: implications for school health policy

IntroductionStress is one of the highest-ranked work-related injuries worldwide and has become almost universal among the Nigerian workforce. English as a Second Language (ESL) teachers face enormous work-related threats that lead to occupational stress. When ESL teachers are stressed, students' language development and entire educational progress are at risk. This is mostly underscored as English, though a second language, serves as the language of instruction in Nigerian schools. As a result, managing occupational stress is particularly important for ESL teachers, as it is among the definitive ways of improving ESL learning and overall educational outcomes. This study examined the effectiveness of online cognitive behavioral intervention (o-CBI) in lowering occupational stress among ESL teachers.MethodESL teachers with at least 1 year of experience were among the participants (N = 89). Participants were divided into two groups: the intervention group (N = 44) and the control group (N = 45). For 9 weeks, the experimental group engaged in nine sessions of 2 h of the o-CBI program. The Single Item Stress Questionnaire (SISQ), the Satisfaction with Therapy and Therapist Scale-Revised (STTS–R), and the Teachers' Stress Inventory (TSI) were the measures used to collect primary and secondary data. Four sets of data were collected at baseline, post-test, and follow-up 1 and 2 evaluations. The data were analyzed using mean, standard deviation, t-test statistics, repeated measures ANOVA, and bar charts.Results and discussionCompared to the control group, the o-CBT group had significantly lower TSI scores at the post-test (Time 2) and follow-up evaluations (Times 3 and 4). Between pre-, post-, and follow-up 1 and 2 measurements, there were no significant differences in occupational stress index scores in the control group. It was concluded that o-CBI is effective in job-stress treatment among ESL teachers. In addition, implications for school health policy are discussed. The o-CBI for occupational stress was well received by the participants, showing high acceptability among ESL teachers.

Physical and Biological Characterizations of Injectable Thermosensitive Poly(N-Isopropylacrylamide)-Collagen I Hydrogels Intended for Meniscus Repair

There has been an increase in the incidence of meniscus injuries worldwide, as well as growing needs for injectable hydrogels with the potentials to promote in situ meniscal tissue repair. This work developed poly(N-isopropylacrylamide)-collagen I composite hydrogels, with a series of different collagen I contents. The hydrogels were injectable under room temperature and started to solidify around 32°C due to their thermosensitivities, meeting the requirements of the intended applications. The addition of collagen I to the poly(N-isopropylacrylamide) provided physical reinforcement to the hydrogels. Rheological characterizations showed that, under room temperature, the complex viscosity, the storage modulus, and the loss modulus, respectively, increased from 0.71 ± 0.35 Pa•s to 110.95 ± 23.22 Pa•s, from 3.28 ± 2.02 Pa to 658.06 ± 128.07 Pa, and from 3.30 ± 1.01 Pa to 308.78 ± 56.67 Pa, as the collagen I content in the hydrogel increased from 0% to 1%. Cell proliferation tests and high-density culture also revealed that collagen I promoted bioactivity of the hydrogels and induced fibrochondrocyte phenotype of the chondrocytes. The expressions of collagen I protein and collagen I a1 gene in the PNIPAm-0.5Coll group were 3.50-fold and 3.64-fold of those in the PNIPAm group. In contrast, the expressions of collagen II protein and collagen II a1 gene were less prominent (respectively, 2.36-fold and 3.34-fold in the PNIPAm-0.5Coll group compared with the PNIPAm group). This phenotyping was believed to be conducive to the regeneration of meniscal tissues. The findings of this study have provided an important basis for future in vivo studies and clinical applications of this type of composite hydrogels.

Heterogeneity of Functional Improvement in Patients with Spinal Tetraplegia: a Retrospective Observational Longitudinal Study

INTRODUCTION. The prevalence of severe spine and spinal cord injuries worldwide is increasing, while the structure and nature of recovery of lost functions remain poorly understood. AIM. To study the variability of functional activities during continued rehabilitation to distinguish pure rehabilitation goals MATERIAL AND METHODS. 190 patients with C4D1 tetraplegia 1860 years old whose were under clinical and functional follow up over a period for 57 years after spinal cord injury were examined. They were examed using the motor section of the FIM scale (FIMm), the VLT scale. The rehabilitation program was standardized and based on the National Clinical Guidelines for physical rehabilitation in spinal cord injured patients. RESULTS. At admission, the age of the patients was 31 (24.0; 43.0) years, the proportion of patients with DU C4C6 was 117 (62 %), with complete damage types A and B was 134 (70 %) patients, men 151 (79 %). Functional improvement was 19 (12.0; 28.0) points on the VLT scale; 14 (5.0; 21.0) points on the FIMm scale over the entire observation period, and was predominantly noted in the first rehabilitation cycle. The proportion of patients completely independent increased on FIMm activities: eating by 25 %, dressing the upper body by 33 %, dressing the lower body by 20 %, self-care domain by +34 %, wheelchair transfer by 21 %, walking by 5 %, and the proportion of patients completely dependent decreased: eating by 9 %, upper dressing by 13 %, lower dressing by 12 %, self-care domain by 7 %, wheelchair transfer by 21 %, wheelchair mobility by 11 %, and walking by 4.5 %. Changes on the VLT scale domains were balance domain 14 %, 1 finger 18 %, hand 26 %, and manipulation 11 %. The gain in food intake activity (FIM) was higher in patients with DU C6C8 (4050 %) and incomplete motor damage (43 %), on the VLT scale domains similar to C6C8 (1218 %), and incomplete motor damage (20 %). CONCLUSION. The most significant functional recovery occurred in self-care and transfer activities, as well as hand and pinch grasping.

Post-Traumatic Pulmonary Pneumatoceles: A Case Report

Road accidents are the main cause of serious injuries worldwide, accounting for over 10% of trauma cases resulting in death or significant physical impairment. Thoracic injuries, on the other hand, are responsible for a quarter of all trauma-related deaths. In such cases, pneumothorax is the most common thoracic injury, affecting 30 to 40% of patients with thoracic trauma. This injury occurs twice as often in closed traumas as in penetrating traumas. However, post-traumatic pulmonary pneumatocele is a very rare condition that occurs mostly in children and young adults. It’s often a sequelae of acute pneumonia or barotrauma resulting from alveolar hyperpressure in the context of closed glottis trauma.&#x0D; Recognizing these injuries quickly can save lives, whether the patient is outside or in a modern intensive care unit.&#x0D; The reported case is an 8-year-old female child with no medical history, no delayed growth or development, who was involved in a public road accident with a thoracic impact. She presented with hemoptysis and chest pain, and a thoracic CT scan revealed bilateral pulmonary parenchymal contusions predominantly on the right, with post-traumatic pneumatoceles on the right side and a right pneumothorax blade, with good progress under surveillance, oxygen therapy, and prophylactic antibiotic treatment.

Epidemiology of Burn Injuries Among Adult Females in Southern Iran; A Retrospective Study from 2007 to 2022.

Burn-by flame, flush, scald, electrical, and chemical types-accounts for 5%-12% of trauma injuries worldwide. In Iranian studies, females were the main victims of domestic burns with higher mortality and frequencies. This retrospective study evaluates the epidemiology and etiology of burn injuries in females aged 25-64 years between October 2007 and May 2022 in southern Iran. Demographics and burn etiology information were collected by questionnaires at admission. Univariate and multivariate regression analysis was used to determine the relationship between variables and burn mortality. Pearson's Chi-Square and One-way ANOVA tests were utilized to compare different burn etiologies. Of 3212 females with burn injuries, 1499 (46.6%) were included with a mean age of 38.5 ± 10.8 years. Flame (59.7%) and flush (28.9%) were significantly the most common injuries mechanism. Burn was most common in rural areas (53.9%) and indoor settings (62.1%) (P-value < .001). 77.9% of the population were under-diploma (P-value < .001), and 3.5% were divorced with higher burn-suicide attempts. The mean Total Body Surface Area (TBSA%) was 41.1 ± 28.3%, and the mean Length of Stay (LOS) was 14.5 ± 13.2 days with a 39.1% mortality rate. With univariate and multivariate analysis, TBSA%, indoor places, flame, flush, and urban living were risk factors for burn mortality. Briefly, flame in indoor settings is the most common type of burn injury affecting adult females with lower educational levels living in rural areas. Such epidemiological studies of burns in adult females may be helpful for health policymakers to develop burn prevention programs.

#3475 NOVEL OPTIMISED PROTOCOL FOR ISOLATION OF PTEC AND SYSTEMATIC CHARACTERISATION FROM HUMAN KIDNEY BIOPSY

Abstract Background and Aims Human kidneys have a role in water homeostasis, acid-base control, reabsorption of compounds, and secretion of xenobiotics and endogenous metabolites, exposing them to substances that could cause harm. This results in an alarming number of acute kidney injuries (AKI) worldwide, estimated at 13%. Furthermore, one-quarter of hospitalised cases are due to drug-induced AKI [1]. Current methods for nephrotoxicity assays are based on animal testing and/or the use of simple human cell lines. Meta-analyses show that we can correctly predict human drug responses in only 10–50% [2]. Our work aimed to develop a novel and optimised protocol for isolating proximal tubular epithelial cells (PTEC) from human kidney biopsy to aid future research regarding AKI and nephrotoxicity studies. Method Isolation and cultivation of primary human adult PTEC obtained with biopsy during the regular diagnostic procedure was performed. We used a protocol consisting of micro-dissection of a tissue sample to get ∼1 mm3 fragments, enzymatic dissociation with 0.2% collagenase type 1, and use of selective culture media (Advanced DMEM/F12 with added insulin, transferrin, and selenite (all three together termed ITS), epidermal growth factor (EGF), and hydrocortisone). Light microscopy was used for morphologic characterisation. Some cells were cultured on Transwell inserts, and the transepithelial electric resistance (TEER) was measured in mature cells that formed a confluent culture. For phenotypic characterisation, several markers characteristic of PTEC were chosen [3], and immunocytochemical staining was performed using a fluorescent microscope to evaluate the PTEC phenotype. Results Following the described protocol resulted in isolating cells that formed first colonies after 24 h. Using light microscopy, the cells exhibited a cobblestone appearance, reached confluence after eight days, and showed dome (hemicysts) formation after 13 days. TEER reached 169 Ω/cm2 after 14 days. The isolated cells were marked positive using immunocytochemistry for sodium-glucose cotransporter 2 (SGLT2), multidrug-resistant protein 4 (MRP4), organic anionic transporter 1 and 3 (OAT1 and OAT3), organic cationic transporter 2 (OCT2), p-glycoprotein (p-gp), multidrug and toxin extrusion protein 1 (MATE1), and N-cadherin. Conclusion In this study, we developed a protocol for isolating and cultivating primary human PTEC from biopsy samples. To the best of our knowledge, we have performed the most extensive systematic characterisation following the isolation of PTEC from kidney biopsy reported to date.

Prevalence and Risk Factors Associated with Road Traffic Crash among Bus Drivers in the Southern Region of Cameroon: A Cross Sectional Study

Background: Annually, road traffic crash account for more than 1.2 million deaths and up to 50 million injuries worldwide, making it a leading cause of death globally. Given the low rate of vehicle ownership in developing countries, most of the population depends on buses for public transport. In Cameroon, buses are frequently involved in road traffic crashes. The aim of this study was to determine the prevalence of road traffic crashes and risk factors associated with road traffic crash among bus drivers in the South West Region-Cameroon. Methods: This was a cross-sectional study involving bus drivers with at least 3 years driving experience in passenger transportation. Multi-stage sampling was employed with random selection of six parks from three divisions in the South West Region of Cameroon. Proportionate sampling was done to select the bus drivers at the selected parks. Data was collected using a structured questionnaire. It was inputted and analyzed using EPI info version 3.5.4. Bivariate and multivariate analysis were used to identify risk factors associated road traffic crash history within 3 years prior to the survey with statistical significance set at p&lt;0.05. Results: Out of the total 422 participants recruited, 98 bus drivers reported, giving an overall crash prevalence of 23.2%. Among the crashed group, 72 drivers (12.1%) were involved in more than one crash within the past 3 years (2014-2017). Multivariate analysis showed excessive speed [AOR 6.98 95% CI; 3.7-12.8], drinking alcohol during driving hours [AOR 10.15, 95% CI; 4.7-21.8], phone distraction (AOR=6.48, 95% CI; 3.8-10.8], passenger distraction [AOR 8.77, 95% CI; 4.6-16.2], violating road traffic rules [AOR=2.13, 95% CI; 1.2-3.5] and fatigue [AOR 0.17, 95 &amp; CI; 0.05-.053] as factors that are significantly associated with road traffic crash among bus drivers within the past 3 years (2014-2017). Conclusion: Almost a quarter (23.2%) of bus drivers have a history of road traffic crash within the past 3 years. Many factors have been found to be associated with road traffic crash occurrence among these drivers and these calls for urgent sensitization campaigns, amelioration of road conditions and proper law enforcement on road safety issues.

Research on the Rescue Time of the Taiwan Marathon Emergency Medical Service System Between 2013 and 2021.

While there are several studies on marathon injuries worldwide, there are no related studies on the Taipei Marathon regarding the rescue time of onsite injury cases, the incidence of out-of-hospital cardiac arrest (OHCA) cases, and the success rate of recovery of spontaneous circulation (ROSC). This study aims to fill that gap. The rescue time onsite of contact injury cases was in the prime time for lifesaving. Descriptive epidemiological study. Level 2c. This is a retrospective study of numerical and timeflow data using descriptive statistics. Our data were obtained from records of the Taipei Marathon from 2013 to 2021. These included (1) notification data, (2) the time record of the emergency care personnel in contact with patients, (3) incidence of OHCA, (4) the success rate of ROSC, (5) the location of occurrence of OHCA, and (6) emergency medical service capacity and configuration. The average time taken for first contact was 1.56 minutes in OHCA cases, and the total incidence rate of OHCA in 9 years was 4 people per 100,000 people, with a 100% ROSC success rate. Further, the location of OHCA cases was mostly in Q4 of the race (66.67%), followed by Q3 (22.22%) and Q2 (1.11%). The average number of emergency care personnel per marathon was 78, spread across 6 rescue and 6 medical stations and equipped with 8 ambulances and 35 automated external defibrillators. Shortening the arrival time of medical personnel to the scene and implementing a complete chain of survival can improve survival rates. Other ways to provide faster and more timely emergency rescue services require further study. Contact with patients as soon as possible, timely implementation of cardiopulmonary resuscitation, and use of an automated external defibrillator are the basic requirements of the chain of survival theory.