Design and application of a new transoral gastric tube for extraction and storage of gastric contents / 中华危重病急救医学

Difficulty in swallowing is a common symptom in stroke patients, and nasogastric tubes are routinely used to solve the nutritional support problem of these patients. The existing nasogastric tube have the disadvantages of causing aspiration pneumonia and patient discomfort. The traditional transoral gastric tube has no one-way valve switch and gastric content storage device, and cannot be fixed in the stomach, resulting in reflux of gastric contents, inability to fully understand the digestion and absorption of gastric contents, and accidental dislocation of the gastric tube, affecting further feeding and gastric content detection. For these reasons, the medical staff of the department of gastroenterology and colorectal surgery of Jilin University China-Japan Union Hospital designed a new transoral gastric tube that can extract and store gastric contents, and was granted a national utility model patent of China (ZL 2020 2 1704393.1). The device consists of collection, cannula and fixation modules. The collection module includes three parts. Gastric contents storage capsule, which can clearly visualize the gastric contents; three-way switch, which can be controlled by rotating the pathway, makes the pathway exist in different states, which is convenient for medical personnel to extract gastric juice, as well as perform intermittent oral tube feeding on the patient or close the pipeline, and reduce contamination and prolong the service life of the gastric tube; one-way valve, which can effectively avoid the contents of the reflux back into the stomach. The tube insertion module includes three parts. A graduated tube, which can enable the medical staff to effectively identify the insertion depth; a solid guide head, which makes the insertion of the tube through the mouth more smoothly; the gourd-shaped passageway, which effectively avoids the blockage of the tube. The fixation module is a water-filled balloon, which is properly filled with water and air. After the pipe is inserted through the mouth, it can be injected with water and gas properly to avoid accidental withdrawal of the gastric tube. Intermittent oroesophageal tube feeding of patients with dysphagia after stroke through a transoral gastric tube that can extract and store gastric contents can not only accelerate the recovery process of patients and shorten the hospitalization time, but also transoral enteral nutrition can effectively promote the recovery of patients' systemic systems, which has certain clinical use value.

The bipolarity of Alberto Santos-Dumont: flights and falls of the "Father of Aviation" / A bipolaridade de Alberto Santos-Dumont: os voos e as quedas do "Pai da Aviação"

OBJECTIVE: Discussing the psychiatric diagnosis of Alberto Santos-Dumont, considered in Brazil to be the inventor of the airplane, who was admitted to psychiatric institutions several times and committed suicide. METHODS: A narrative review was carried out on the psychopathological manifestations he presented, based on some of the most important biographies about the aviator. No scientific article on the topic was found. RESULTS: Depressive episodes were well characterized. Behavioral changes that suggest manic episodes have also been reported. CONCLUSION: He probably suffered from bipolar disorder.

OBJETIVO: Discutir o diagnóstico psiquiátrico de Alberto Santos-Dumont, considerado no Brasil o inventor do avião, que foi diversas vezes internado em instituições psiquiátricas e cometeu suicídio. MÉTODOS: Foi realizada uma revisão narrativa sobre as manifestações psicopatológicas que ele apresentou, com base em algumas das mais importantes biografias sobre o aviador. Nenhum artigo científico sobre o tema foi encontrado. RESULTADOS: Episódios depressivos ficaram bem caracterizados. Foram relatadas ainda alterações do comportamento que sugerem episódios maníacos. CONCLUSÃO: Provavelmente ele sofria de transtorno bipolar.

No momento em que a melhor decisão não faz parte das regras, pergunta-se: como a segurança na aviação é construída a partir da experiência do piloto? / When the best decision is not part of the regulations we ask: how flight safety is built from the pilot's experience?

Introdução: Pilotar uma aeronave é uma atividade que requer um conjunto de habilidades especializadas. Existem muitos procedimentos padronizados, porém é necessário também fazer julgamentos na presença de incertezas, considerando os riscos e tomando decisões de maneira rápida e prudente. A atividade de um piloto de linha aérea se desenvolve em um sistema complexo, com múltiplas interações. Para tanto, necessita ter capacidade de reconhecer padrões de interação e saber o que fazer em situações imprevisíveis. Diante das imprevisibilidades é importante compreender quais são os recursos e estratégias utilizados para lidar com os eventos. Objetivo: Esta tese tem como objetivo analisar quais são os fatores determinantes da tomada de decisão bem-sucedida de pilotos de linha aérea em situação não prescritas de trabalho e considerando o modelo de decisão utilizado e os aspectos cognitivos envolvidos. Métodos: Foram estudados pilotos de linha aérea que vivenciaram durante a atividade um evento crítico, onde não havia procedimentos previstos ou regras convencionadas. Para compreender as estratégias foram entrevistados 10 pilotos de linha aérea. As entrevistas semiestruturadas seguiram a metodologia da Análise Cognitiva da Tarefa. Posteriormente as informações de 12 eventos relatados foram analisadas e classificadas segundo a taxonomia Schema World Action Research Method (SWARM). A metodologia adotada para a análise de decisão empregada na pesquisa serve para ampliar a capacidade de organizar estratégias de conhecimento dos pilotos de linha área, fazendo com que possam avaliar e responder às situações não prescritas durante o voo de forma mais rápida e segura. Resultados: Observamos que existe pressão de tempo nas decisões, em situações nas quais as interações são complexas. Nestes casos, as consequências das decisões podem ser graves para o decisor. Essas são tomadas com base na experiência e nos processos de decisão naturalista. Os processos de treinamento convencionais foram reconhecidos como fatores que contribuíram para as decisões em eventos críticos. A compreensão dos processos envolvidos na decisão naturalista pode enriquecer as possibilidades de aprendizagem e melhorar a segurança da operação aérea. Conclusão: o estudo permitiu verificar que a compreensão dos processos de decisão naturalista em situações não prescritas pelas regras, foi um fator preditivo para a segurança de voo.

Introduction: Flying an aircraft is an activity that requires a set of specialized skills. There are many standardized procedures, but it is also necessary to make judgments in the presence of uncertainties, considering the risks and making decisions quickly and prudently. The activity of an airline pilot develops in a complex system, with multiple interactions, therefore, he/she needs to be able to recognize interaction patterns and know what to do in unpredictable situations. Faced with unpredictability, it is important to understand the resources and strategies used to deal with events. Objective: This thesis aims to analyze what are the determining factors of successful decision-making by airline pilots in non-prescribed work situations, considering the decision model used and the cognitive aspects involved. Methods: Airline pilots who experienced a critical event during the activity, where there were no procedures or agreed rules, were studied. To understand the strategies, 10 airline pilots were interviewed, the semistructured interviews followed the Cognitive Task Analysis methodology. Later the information from 12 reported events were analyzed and classified using the Schema World Action Research Method (SWARM) taxonomy. The methodology adopted for the decision analysis used in the research serves to expand the ability to organize knowledge strategies of the airline pilots, making them able to evaluate and respond to non-prescribed situations during the flight in a faster and safer way. Results: We observed that there is time pressure on decisions, in scenarios where interactions are complex. In these cases, the consequences of the decisions can be serious for the decision maker. Those are taken on the basis of experience and naturalistic decision processes. Conventional training processes were recognized as factors that contributed to decisions in critical events. Understanding the processes involved in the naturalistic decision can enrich the learning possibilities and improve the safety of the air operations. Conclusion: The study made it possible to verify that the understanding of naturalistic decision processes in scenarios not formal prescribed by the rules is a predictive factor for flight safety.

Los viajes en avión y las enfermedades respiratorias / Air travel and respiratory diseases

Los aviones son medios de transporte habitual, y de uso cada vez más frecuente hasta el inicio de la pandemia COVID-19. La trasmisión del virus SARS-CoV2 se ve favorecida por el ambiente cerrado durante las horas del vuelo. A causa de esta pandemia se espera una disminución de entre el 58 y el 78% de los aproximadamente 3000 millones de pasajeros anuales, con una recuperación que también será variable según la evolución de dicha pandemia .

Henrique Dumont: how a traumatic brain injury contributed to the development of the airplane / Henrique Dumont: como um traumatismo cranioencefálico contribuiu para o desenvolvimento do avião

ABSTRACT The life and death of Henrique Dumont (1832-1892) is little known, being usually remembered as Alberto Santos-Dumont's father. This report describes the history of this Brazilian engineer, also known as the King of Coffee, who achieved enormous business success and fortune in the late nineteenth century. In 1890, during the inspection of his farm, the world's largest coffee plantation at that time, he fell from a carriage, which left him a hemiplegic. This forced him to sell the farm and move to France for treatment. Before his death two years later, he gave his 18-year-old son bits of advice, and distributed his inheritance, which allowed Alberto to study in Paris and finance his experiments that would culminate in the development of the airplane. The diagnostic and therapeutic possibilities are also discussed.

RESUMO A vida e especialmente a morte do brasileiro Henrique Dumont (1832-1892) são pouco conhecidas, sendo geralmente lembrado como pai de Alberto Santos Dumont. Relatamos a história deste engenheiro que obteve enorme sucesso empresarial no final do século XIX, sendo denominado Rei do Café. Em 1890, durante a inspeção da sua fazenda, maior cafeicultura do mundo na época, caiu da charrete e ficou hemiplégico. Isso o fez vender a fazenda e buscar tratamento na França, trazendo o primeiro automóvel do Brasil ao retornar. Antes de morrer dois anos após o acidente, deu valorosos conselhos e distribuiu sua herança ao filho Alberto, então com dezoito anos de idade, que pôde assim estudar em Paris e financiar seus experimentos que culminariam no desenvolvimento do avião. São discutidas e contemporizadas as possibilidades diagnósticas e terapêuticas relacionadas ao déficit neurológico.

Types of Hearing Protection Devices and Application / 대한이비인후과학회지

Since noise-induced hearing loss (NIHL) is one of prevalent issues in the occupational settings, hearing protection device (HPD) has been widely used to reduce noise exposure levels and to prevent developing NIHL. This review study aimed to introduce several types of the HPD in terms of current trends, its variety and functions, and application. Including a brief history of the HPD, we explain its two types, i.e., passive and active functions, in the first part of main body. The passive HPD has a flat attenuation across the overall frequency range, whereas the active HPD effectively preserves communication components such as meaningful speech with low intensity stimuli while filtering out the high levels of noise. In the second part of the main body, we discuss some negative issues of hearing functions when users are wearing the HPD. In detail, the active HPD does not much degrade the hearing performance for speech detection/recognition and sound source localization compared to the passive HPD. Rather, reduced sound (or music) quality is improved with active one in general. In the final part, we mention that although various applications in the special fields such as factory, mining, army, airplane, and music have been demonstrated, the usage and awareness of HPD in occupational aspect may not follow its fast technological development. Furthermore, most people do not know about either importance or use method of HPD in the non-occupational setting. For these reasons, we conclude that hearing professionals have to access the latest trends of the HPD and to increase their knowledge on it, and thus they should provide the best HPD prescription for the public as well as employees who have to protect their ears from hazard noise impacts.

The Efficiency of Ground Transport and Efficacy of Mobile Trauma Unit on the Inter-Hospital Transfer of Severe Trauma Patients

PURPOSE: The author's trauma center implemented Mobile Trauma Units (MTU), which are ground transportation automobiles constructed with advanced medical equipment, in an attempt to improve the survival rate of severe trauma patients. The purpose of this study was to examine the efficacy of MTU as a means of inter-hospital transfer of patients in urban environments. METHODS: Patients with an injury severity score (ISS) of 16 or more were enrolled in this study. The participants must also be patients who were transferred with the MTU in the 18 months between January 2017 and June 2018. To assess the survival probability, the revised trauma score (RTS), trauma and injury severity score (TRISS), and w-score were used as the outcome indices. RESULTS: Forty-four (86.3%) of the severe trauma patients with an ISS of 16 or more were male and 7 (13.7%) were female. The number of patients from the territory were 32 (62.7%), and patients from the others were 19 (37.3%). All the patients received their injury from blunt force trauma. The average time of from the scene of the accident to the trauma center was 176 minutes. In 13 deaths, 10 (76.9%) of the RTS values were below 4 points. Among the 51 patients, TRISS was more than 0.5 in 32 patients (62.7%). The w-score was 13.25 and the actual survival rate of a patient was 74.50%. CONCLUSION: Ground transportation automobiles that use MTU for severe trauma patients in urban areas are more economically beneficial and more efficient. The survival rate while using MTU was also shown to be higher than that of medical helicopter transfers.

Effectiveness of the Trauma Team-Staffed Helicopter Emergency Medical Service / 보건행정학회지

BACKGROUND: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. METHODS: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ≥15 years. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). RESULTS: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. CONCLUSION: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.

Miedo a volar: Componentes y formas de afrontamiento de un grupo de patagones que viven en aislamiento relativo / Fear of flying: Components and forms of coping with a group of Patagonians living in relative isolation

Resumen El presente estudio trata del temor a volar, las expectativas de peligro y las estrategias de afrontamiento que las personas dicen utilizar al momento de volar en avión. Un total de 287 participantes, habitantes de una zona aislada geográficamente, que utilizan habitualmente el avión, fueron medidos en las variables ya señaladas. El muestreo fue no probabilístico accidental y el diseño utilizado fue no experimental transversal correlacional. Los principales resultados indican que las personas dicen temer principalmente a situaciones que provocan en ellos la pérdida del control emocional aunque sus estrategias de afrontamiento más comunes suelen estar orientadas a la resolución de problemas. Estas estrategias, orientadas a recuperar simbólicamente el control psicológico, no apuntan al afrontamiento de las emociones. También se describen algunas diferencias en el uso de estas estrategias según género. Se discuten estos resultados en términos de su sincronía con los estudios previos y sus potenciales implicancias para los actuales programas terapéuticos de intervención de dicho problema.

Abstract This study is about the fear of flight, the danger expectations and the coping strategies that people say to use when flying on an airplane. A total of 287 participants, people from a graphically isolated zone that usually use planes, were measured according to the already mentioned variables. The sampling was not accidental probabilistic and the designed used was not experimental transversal correlational. The principal results indicate that people say to be afraid principally of situations that cause in them the loss of the emotional control, although, their most common coping strategies use to be oriented to affront anxiety. This strategy, aimed to regain the psychological control symbolically, does not point to the emotions coping. Also, some differences in the use of these strategies according to gender are described. These results are discussed regarding its timing with previous studies and their potential implications for current therapeutic intervention programs for this problem.

The Balance Between Safety and Productivity and its Relationship with Human Factors and Safety Awareness and Communication in Aircraft Manufacturing

BACKGROUND: This paper presents the findings of a pilot research survey which assessed the degree of balance between safety and productivity, and its relationship with awareness and communication of human factors and safety rules in the aircraft manufacturing environment. METHODS: The study was carried out at two Australian aircraft manufacturing facilities where a Likert-scale questionnaire was administered to a representative sample. The research instrument included topics relevant to the safety and human factors training provided to the target workforce. The answers were processed in overall, and against demographic characteristics of the sample population. RESULTS: The workers were sufficiently aware of how human factors and safety rules influence their performance and acknowledged that supervisors had adequately communicated such topics. Safety and productivity seemed equally balanced across the sample. A preference for the former over the latter was associated with a higher awareness about human factors and safety rules, but not linked with safety communication. The size of the facility and the length and type of employment were occasionally correlated with responses to some communication and human factors topics and the equilibrium between productivity and safety. CONCLUSION: Although human factors training had been provided and sufficient bidirectional communication was present across the sample, it seems that quality and complexity factors might have influenced the effects of those safety related practices on the safety–productivity balance for specific parts of the population studied. Customization of safety training and communication to specific characteristics of employees may be necessary to achieve the desired outcomes.

Reduced Mortality in Severely Injured Patients Using Hospital-based Helicopter Emergency Medical Services in Interhospital Transport

Recent evidence has demonstrated the survival benefits of helicopter transport for trauma patients. The purpose of this study was to evaluate the effectiveness of hospital-based helicopter emergency medical services (H-HEMS) in comparison with ground ambulance transport in improving mortality outcomes in patients with major trauma. Study participants were divided into 2 groups according to type of transport to the trauma center; that is, either via ground emergency medical services (GEMS) or via H-HEMS. The study was conducted from October 2013 to July 2015. Mortality outcomes in the H-HEMS group were compared with those in the GEMS group by using the Trauma and Injury Severity Score (TRISS) analysis. The number of participants finally included in the study was 312. Among these patients, 63 were adult major trauma patients transported via H-HEMS, and 47.6% were involved in traffic accidents. For interhospital transport, the Z and W statistics revealed significantly higher scores in the H-HEMS group than in the GEMS group (Z statistic, 2.02 vs. 1.16; P = 0.043 vs. 0.246; W statistic, 8.87 vs. 2.85), and 6.02 more patients could be saved per 100 patients when H-HEMS was used for transportation. TRISS analysis revealed that the use of H-HEMS for transporting adult major trauma patients was associated with significantly improved survival compared to the use of GEMS.

Altitude Stress During Participation of Medical Congress / 신경중재치료의학

Medical congresses often held in highlands. We reviewed several medical issues associated with altitude stress especially while physicians have participated medical congress held in high altitude. Altitude stress, also known as an acute mountain sickness (AMS), is caused by acute exposure to low oxygen level at high altitude which is defined as elevations at or above 1,200 m and AMS commonly occurs above 2,500 m. Altitude stress with various symptoms including insomnia can also be experienced in airplane. AMS and drunken state share many common features in symptoms, neurologic manifestations and even show multiple microbleeds in corpus callosum and white matter on MRI. Children are more susceptible to altitude stress than adults. Gradual ascent is the best method for the prevention of altitude stress. Adequate nutrition (mainly carbohydrates) and hydration are recommended. Consumption of alcohol can exacerbate the altitude-induced impairments in judgment and the visual senses and promote psychomotor dysfunction. For prevention or treatment of altitude stress, acetazolamide, phosphodiesterase inhibitors, dexamethasone and erythropoietin are helpful. Altitude stress can be experienced relatively often during participation of medical congress. It is necessary to remind the harmful effect of AMS because it can cause serious permanent organ damage even though the symptoms are negligible in most cases.

Medical Problems during Participation of Medical Congress - A Long Trip to Val D'Isere from Korea / 신경중재치료의학

Since the 3rd WIN meeting in 1982 more than 500 participants join the meeting in Val D'Isere every year [1]. One of our authors has attended the meeting more than 10 times. He experienced many physical illnesses while travelling from South Korea to Val D'Isere in France, which is located in the Alps mountain near the border between France and Italy. In order to get there, it is necessary to take airplane, train, and/or bus with a heavy suitcase. During the trip which usually takes more than 15 hours, he experienced headache, gastrointestinal trouble, sleep disturbance and other additional physical illnesses. Therefore, we reviewed the itinerary to Val D'Isere and presented physical illnesses which occurred during a long trip for an academic activity by specialized professionals such as university hospital professors. In addition, we discussed the mechanism of such illnesses and offered possible solutions including medical treatment.

Reliability and Validity of the Korean Version of the Helicopter Parenting Scale

PURPOSE: Helicopter parenting is emerging in parenting as a way of rearing adolescents and adult children. The aims of this study were to develop a Korean version of the Helicopter Parenting and Autonomy Supportive Behaviors Scale (HPASB). METHODS: The HPASB questionnaire items were translated into Korean and reviewed by experts and Content Validity Index (CVI) in a preliminary study with 10 university students. During September and October, 2014 data were collected from 229 nursing students from five different universities in different locations. For data analysis, SPSS 21.0 statistics which included exploratory factor analysis, t-test, one-way ANOVA were utilized. RESULTS: Content validity was over CVI .8. The 6 factors of K-HPASB were extracted and accounted for 59.30% of variance. The Cronbach's alpha coefficient was .71 indicating high reliability. CONCLUSION: The Korean version of the HPASB was identified as a scale with a high degree of validity and reliability. The results of this study provide a valuable scale which can be useful in the study of parenting as a way of rearing adolescents and adult children in Korea. To enhance the positive aspect of helicopter parenting, we suggest the development of intervention programs on parenting.

The effect of aircraft noise on sleep disturbance among the residents near a civilian airport: a cross-sectional study

BACKGROUND: Aircraft noise is a major environmental noise problem. This study was conducted in order to investigate the relationship between sleep disturbance and exposure to aircraft noise on the residents who are living near an airport. METHODS: There were 3308 residents (1403 in the high exposure group, 1428 in the low exposure group, and 477 in the non-exposure group) selected as the subjects for this study. The Insomnia severity Index (ISI) and Epworth Sleepiness Scale (ESS) questionnaires were used to evaluate sleep disturbance. RESULTS: The mean ISI and ESS scores were 6.9 ± 6.4 and 5.5 ± 3.7, respectively, and the average scores were significantly greater in the aircraft noise exposure group, as compared to the non-exposure group. The percentage of the abnormal subjects, which were classified according to the results of the ISI and ESS, was also significantly greater in the noise exposure group, as compared to the control group. The odd ratios for insomnia and daytime hypersomnia were approximately 3 times higher in the noise exposure group, as compared to the control group. CONCLUSIONS: The prevalence of insomnia and daytime hypersomnia was higher in the aircraft noise exposure group, as compared to the control group. Further study is deemed necessary in order to clarify the causal relationship.

A Study on Heuristic Transportation Routes of Patients with Acute Dysbarism for the Best Prognosis

PURPOSE: Acute dysbarism is a potentially lethal injury associated with environmental medicine. Therefore, prompt treatment, including transportation of victims, is important for the best prognosis. The aim of this study was to examine transportation routes of patients with acute dysbarism for the best prognosis in Korea. METHODS: Geography of South Korea was analyzed using the geographic information system (GIS). The study examined two scenarios using transportation analysis, which relies on a GIS base and pressure variation during air and ground transportation. Given the practical assumptions, we propose some heuristic transportation routes based on the simulation of altitude, transportation time, and availability of related factors. RESULTS: Currently, transportation by ground to the treatment facilities always passes high altitude areas above 152 feet. Also, available helicopters for air transportation could not approach the treatment facilities due to the limitation of flying distance and insufficiency of medical staff and treatment equipment. Altitude variation and delayed time were identified during the period of transportation by ground from Ganneung or Incheon to Tongyoung. Heuristic algorism through the above facts recommends air transport along coasts as the best method for transportation from Ganneung or Incheon to Tongyoung. CONCLUSION: In Korea, transportation by ground was not expected to result in the best prognosis for patients with acute dysbarism. Transportation by air should be considered first as the method of transportation. Also, for the best treatment of patients with acute dysbarism, additional treatment facilities need to be established in the west coast region.

Reduced Mortality by Physician-Staffed HEMS Dispatch for Adult Blunt Trauma Patients in Korea

The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups. We also assessed patients who were transported to the hospital within 3 h of injury in Groups P (Group P3; n = 50) and NP (Group NP3; n = 74). The severity of injury was higher, transport time was longer, and time from hospital arrival to operation room transfer was shorter for Group P than for Group NP (P < 0.001). Although Group P patients exhibited better medical treatment outcomes compared with Group NP, the difference was not statistically significant (P = 0.134 vs. 0.730). However, the difference in outcomes was statistically significant between Groups P3 and NP3 (P = 0.035 vs. 0.546). Under the current domestic trauma patient transport system in South Korea, physician-staffed HEMS are expected to increase the survival of patients with severe trauma. In particular, better treatment outcomes are expected if dedicated trauma resuscitation teams actively intervene in the medical treatment process from the transport stage and if patients are transported to a hospital to receive definitive care within 3 hours of injury.

A Comparative Study of the Prevalence and Risk Factors of Lower Back Pain among Aircraft Technicians in Ethiopian Airlines

Lower back pain (LBP) is a global concern among workers in various occupational settings. The purpose of this cross-sectional study was to determine the prevalence of LBP and its risk factors among aircraft technicians (ACTs) in Ethiopian Airlines. A self-administered questionnaire was used to obtain data from 294 ACTs. The prevalence of LBP among ACTs was 47.1 during the past six months. Duration of employment was signifi cantly associated with experiencing LBP as ACTs with 7 - 9 years working experience were almost eight times more likely to experience LBP that those with 1- 3 years of experience (OR = 7.86; 95 CI 1.59-52.55 ). Significant associations were observed between the prevalence of LBP and pulling and pushing heavy loads (OR = 3.17; 95 CI 1.49-6.74); lifting heavy objects (OR = 1.90; 95 CI 1.01-3.60); and carrying heavy loads (OR = 2.02; 95 CI 1.15-3.57). Bending (OR = 2.13; 95 CI 1.30-3.49); lifting hard to hold loads (OR = 2.78; 95 CI 1.72-4.49); and working with twisted trunks (OR = 2.15; 95 CI 1.34-3.43) were also signifi cantly associated with LBP. Relevant occupational health and safety interventions should be designed and implemented to reduce the prevalence of LBP in these ACTs; taking into account the nature of the work conducted

Three Cases of Spine Fractures after an Airplane Crash / 대한신경손상학회지

While injuries to the spine after an airplane crash are not rare, most crashes result in fatal injuries. As such, few studies exist that reported on spine fractures sustained during airplane accidents. In this report, we demonstrate three cases of spine fractures due to crash landing of a commercial airplane. Three passengers perished from injuries after the crash landing, yet most of the passengers and crew on board survived, with injuries ranging from minor to severe. Through evaluating our three spine fracture patients, it was determined that compression fracture of the spine was the primary injury related to the airplane accident. The first patient was a 20-year-old female who sustained a T6-8 compression fracture without neurologic deterioration. The second patient was a 33-year-old female with an L2 compression fracture, and the last patient was a 49-year-old male patient with a T8 compression fracture. All three patients were managed conservatively and required spinal orthotics. During the crash, each of these patients were subjected to direct, downward high gravity z-axis (Gz) force, which gave rise to load on the spine vertically, thereby causing compression fracture. Therefore, new safety methods should be developed to prevent excessive Gz force during airplane crash landings.