Identifying interactions among factors related to death occurred at the scene of traffic accidents: Application of "logic regression" method.

Aim: Traffic accidents are caused by several interacting risk factors. This study aimed to investigate the interactions among risk factors associated with death at the accident scene (DATAS) as an indicator of the crash severity, for pedestrians, passengers, and drivers by adopting "Logic Regression" as a novel approach in the traffic field. Method: A case-control study was designed based on the police data from the Road Traffic Injury Registry in northwest of Iran during 2014-2016. For each of the pedestrians, passengers, and drivers' datasets, logic regression with "logit" link function was fitted and interactions were identified using Annealing algorithm. Model selection was performed using the cross-validation and the null model randomization procedure. Results: regarding pedestrians, "The occurrence of the accident outside a city in a situation where there was insufficient light" (OR = 6.87, P-value<0.001) and "the age over 65 years" (OR = 2.97, P-value<0.001) increased the chance of DATAS. "Accidents happening in residential inner-city areas with a light vehicle, and presence of the pedestrians in the safe zone or on the non-separate two-way road" combination lowered the chance of DATAS (OR = 0.14, P-value<0.001). For passengers, "Accidents happening in outside the city or overturn of the vehicle" combination (OR = 8.55, P-value<0.001), and "accidents happening on defective roads" (OR = 2.18, P-value<0.001) increased the odds of DATAS; When "driver was not injured or the vehicle was two-wheeled", chance of DATAS decreased for passengers (OR = 0.25, p-value<0.001). The odds of DATAS were higher for "drivers who had a head-on accident, or drove a two-wheeler vehicle, or overturned the vehicle" (OR = 4.03, P-value<0.001). "Accident on the roads other than runway or the absence of a multi-car accident or an accident in a non-residential area" (OR = 6.04, P-value<0.001), as well "the accident which occurred outside the city or on defective roads, and the drivers were male" had a higher risk of DATAS for drivers (OR = 5.40, P-value<0.001). Conclusion: By focusing on identifying interaction effects among risk factors associated with DATAS through logic regression, this study contributes to the understanding of the complex nature of traffic accidents and the potential for reducing their occurrence rate or severity. According to the results, the simultaneous presence of some risk factors such as the quality of roads, skill of drivers, physical ability of pedestrians, and compliance with traffic rules play an important role in the severity of the accident. The revealed interactions have practical significance and can play a significant role in the problem-solving process and facilitate breaking the chain of combinations among the risk factors. Therefore, practical suggestions of this study are to control at least one of the risk factors present in each of the identified combinations in order to break the combination to reduce the severity of accidents. This may have, in turn, help the policy-makers, road users, and healthcare professionals to promote road safety through prioritizing interventions focusing on effect size of simultaneous coexistence of crash severity determinants and not just the main effects of single risk factors or their simple two-way interactions.

Drink and drive? Understanding the dynamics of youth risk-taking.

We exploit a reduction in the minimum legal drinking age (MLDA) in New Zealand from 20 to 18 to study the dynamics of youth risk-taking. Using the universe of road accidents over 15 years and an event history approach, we find no evidence that lowering the drinking age increased alcohol-related accidents among teens. Complementary results of a cohort analysis suggest that reducing the drinking age even led to a short-term decline in risky driving among youths directly affected by the MLDA change but had no longer-run impacts on youth risky driving and drinking behaviors.

Analysis of pedestrian accident severity by considering temporal instability and heterogeneity.

The aim of this study was to investigate the effects of temporal instability and possible heterogeneity on pedestrian accident severity, 48786 accident data from 2018 to 2021 in the UK STATS database were used as the study object, and accident severity was used as the dependent variable, and 49 accident characteristics were selected as independent variables from 6 characteristics of accident pedestrian, driver, vehicle, road, environment and time to construct the pedestrian accident mean heterogeneity random-parameter logit model and examined its temporal stability. The results of model estimation and likelihood ratio tests indicate that the variables affecting pedestrian injury severity are highly variable and not stable over the years. And further demonstrates the potential of models that address unobserved heterogeneity for significant relationships in pedestrian accident severity analyses.

Quality of Life and Socioeconomic Status in Northwest of Iran: First Wave of the Persian Traffic Cohort Study.

This study aimed to evaluate the association between Quality of Life (QOL) and independent factors, emphasizing Socio Economic Status (SES) in northwestern Iran. A population-based cross-sectional study was performed within the Persian Traffic safety and health Cohort in 2020. Participants were chosen using stratified random sampling method. The majority of participants (69%) were aged between 30 and 65. Around half of the participants were males (54.44%). Most of the female respondents were categorized as very low and medium levels of SES Based on multiple linear regression analysis, the QOL among females was lower compared to males (ß: - 0.92, 95% CI - 1.82 to - 0.22). There was a negative association between SES and QOL; individuals with low and very low levels of SES had a lower QOL than those with a medium level of SES (ß: - 4.38, 95% CI - 5.9 to - 2.86) (ß: - 2.65, 95% CI - 4.08 to - 1.22). The current study highlights that higher SES and educational levels are positively associated with higher QOL. Conversely, older age, females, and widowed individuals are linked with lower QOL.

Comparison of Traumatic Spinal Fracture Patterns Between Motorcyclists and Occupants of Other Nonheavy Motor Vehicles: A Report from the National Spinal Cord and Column Injury Registry of Iran.

OBJECTIVE: To compare traumatic spinal injury patterns between motorcyclists and occupants of other nonheavy motor vehicles using data from the National Spinal Cord and Column Injury Registry of Iran. METHODS: All drivers/riders and passengers of motorcycles, cars, pick-up trucks, and vans registered between January 2017 to July 2023, met the inclusion criteria for the present study. The logistic regression models were used to compare the patterns of vertebral fracture between the 2 groups. RESULTS: One thousand seven hundred twenty-six spinal fracture patients were identified, 385 (22.3%) motorcyclists and 1341 (77.7%) car occupants with mean ages 33.2 ± 14.3 and 36.1 ± 13.6 years, respectively (P < 0.001). Only 45 (11.7%) motorcyclists used helmets, whereas 856 (63.8%) car occupants used seat belts (P < 0.001). The average numbers of fractured vertebrae were 3.9 ± 1.4 and 3.7 ± 1.1 among car occupants and motorcyclists, respectively (P = 0.004). The proportions of motorcyclists and car occupants with injuries in each spinal region are as follows: lumbar (50.5% of motorcyclists vs. 40.4% of car occupants; P = 0.003), thoracic (39.2% vs. 30.9%; P = 0.01), cervical (24.3% vs. 37.0%; P < 0.001), and sacral (1.3% vs. 7.5%; P < 0.001). The AO Spine type C injuries were present in 6.1% of motorcyclists and 10.1% of car occupants (P = 0.03). CONCLUSIONS: Motorcyclists were younger, less educated, had a higher proportion of males, and less commonly used safety devices than car occupants. The most commonly fractured spine region among both groups was the lumbar region. The cervical and sacral vertebrae fractures were significantly more common in car occupants, whereas the thoracic and lumbar vertebrae fractures were significantly more common in motorcyclists.

Road traffic accidents and the contributing factors among drivers of public transportation in Mizan Aman town, Ethiopia: a Community-Based Cross-Sectional Study.

Background: Traffic accidents on the road is an accident is a terrible accident that causes death, injury, and property damage. However, limited studies were addressed to investigate the prevalence of traffic accidents on the road and the contributing factors among drivers that help in developing strategies to cop-up the incidence within the research domain in Ethiopia, particularly in the study area. Objective: This study aimed to assess the prevalence of road traffic accidents and the contributing factors among drivers of public transportation in Mizan Aman town, Ethiopia. Methods: A community-based cross-sectional survey was employed among 376 drivers of public transportation. Every research subject was selected by using a simple random sampling technique. Semi-structured and open-ended questionnaires which comprised demographic characteristics, risky personal behaviors and lifestyles, driver's factors, vehicle condition, and environmental conditions were used to gather data. And then after, data was collected through interviewer-administered using KoBo Collect tools. Completed data were edited and cleaned in the Kobo collect toolbox and then exported for additional analysis to a statistical tool for social science statistics version 26. The descriptive statistics were displayed as figures, tables, and texts. Binary logistic regression was analyzed to identify the contributing factors. Statistically significant was decided with a p-value of ≤ 0.05. Results: The results showed that the prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was 17%. The study identified factors influencing traffic accidents on the roads including marital status (being single), employee condition (permanent), monthly income (1001-2500 Ethiopia Birr), alcohol use, vehicle maintenance (not), road type (non-asphalt), and weather conditions (being windy). Conclusion: The overall prevalence of road traffic accidents among drivers of public transportation in Mizan Aman town was relatively low. Despite this, sociodemographic characteristics, driver factors, vehicle conditions, and environmental conditions [road type and weather conditions] were the predicting factors of traffic accidents in town. Therefore, reduction strategies should be the highest priority duty for concerned bodies like Mizan Aman town road and transport office, Bench Sheko zone transport and logistics office, and Southwest Ethiopia People Regional State (SWEPRS) transport bureau in the study area.

Navigating Road Traffic Accidents in Jordan: A Retrospective Exploration of the Health and Economic Impacts.

Background Road traffic accidents (RTAs) are considered a major public health threat. The causes of RTAs are multifactorial, comprising both human and non-human factors. RTAs may result not only in detrimental health consequences but also in serious economic burdens. This study aimed to provide a retrospective overview of the health and economic impacts of RTAs in Jordan during the period 2013-2021, including the implemented multisectoral mitigation strategies. Methodology This study presents a retrospective chart review of the traffic reports published by the Public Security Directorate (PSD) in Jordan during the period 2013-2021. The examined variables were the total number of road accidents involving human injuries per year, average road accidents per day, annual deaths, average deaths per day, deaths per 100,000 population, annual number of injuries, average number of injuries per day, severity of human injury, number of registered vehicles, and the annual financial costs. Data were extracted from PSD reports and presented descriptively. Results The number of registered vehicles has risen from 1,263,754 in 2013 to 1,795,215 in 2021 with a 42.1% increase. This was also associated with an increase in the average RTAs per day from 28.0 in 2013 to 30.8 in 2021. The total number of RTAs that involved human injuries during the period 2013-2021 fluctuated with 8,451 in 2020 (lowest) and 11,241 in 2021 (highest). In the same period, annual deaths caused by RTAs peaked in 2013 with 768 deaths (highest) compared to 461 in 2020 (lowest). In the five years from 2017 to 2021, the total financial cost of RTAs in Jordan was nearly 1.561 billion Jordanian Dinars (~2.2 billion U.S. dollars) compared to 1.363 billion Jordanian Dinars (~1.92 billion U.S. dollars) in the five years from 2012 to 2016. Conclusions Targeting human and road infrastructure factors through effective government-society partnerships is crucial in mitigating the health and economic burden of RTAs in Jordan. More strict enforcement of traffic laws, along with incremental increases in the penalties for dangerous traffic violations, and regular road safety campaigns are expected to provide more control over the human factors of RTAs. Further research is needed to evaluate the impact of the recently amended traffic law on the trends of RTAs in the country.

Fabrication of Implant-Supported Auricular Prosthesis Using Artificial Intelligence.

The absence of any organ of the facial region causes an asymmetrical appearance. This asymmetrical appearance can cause social dilemmas for the patient. The maxillofacial technician, the prosthodontist, and the patient must work closely together to fabricate an epithesis. On the implants, a superstructure is first constructed. Most of it is made up of rings and a bar that joins the implants. The firm acrylic resin base of the epithesis is equipped with clips that serve as the epithesis's retention mechanism. The actual epithesis is made of silicone rubber. The epithesis has to be shaped and colored with extreme caution. An appropriate substitute is an auricular prosthesis that is implant-retained. Microtia, deformity, malformation, and loss of the external ear, either partially or completely, can result from a variety of inherited genetic conditions. To evaluate the symmetry of both ears, artificial intelligence (AI) software is used. An Instagram lens Gridset by crystalwavesxx was used to correct and verify the bilateral symmetry of the patient. This case report primarily focuses on the fabrication of implant-supported auricular prostheses using AI.

Management of physical and psychological trauma resulting from motor vehicle crashes in Australian general practice: a mixed-methods approach.

BACKGROUND: In Australia, motor vehicle crashes (MVC)-related health data are available from insurance claims and hospitals but not from primary care settings. This study aimed to identify the frequency of MVC-related consultations in Australian general practices, explore the pharmacological management of health conditions related to those crashes, and investigate general practitioners' (GPs) perceived barriers and enablers in managing these patients. METHODS: Mixed-methods study. The quantitative component explored annual MVC-related consultation rates over seven years, the frequency of chronic pain, depression, anxiety or sleep issues after MVC, and management with opioids, antidepressants, anxiolytics or sedatives in a sample of 1,438,864 patients aged 16 + years attending 402 Australian general practices (MedicineInsight). Subsequently, we used content analysis of 81 GPs' qualitative responses to an online survey that included some of our quantitative findings to explore their experiences and attitudes to managing patients after MVC. RESULTS: MVC-related consultation rates remained stable between 2012 and 2018 at around 9.0 per 10,000 consultations. In 2017/2018 compared to their peers, those experiencing a MVC had a higher frequency of chronic pain (48% vs. 26%), depression/anxiety (20% vs. 13%) and sleep issues (7% vs. 4%). In general, medications were prescribed more after MVC. Opioid prescribing was much higher among patients after MVC than their peers, whether they consulted for chronic pain (23.8% 95%CI 21.6;26.0 vs. 15.2%, 95%CI 14.5;15.8 in 2017/2018, respectively) or not (15.8%, 95%CI 13.9;17.6 vs. 6.7%, 95% CI 6.4;7.0 in 2017/2018). Qualitative analyses identified a lack of guidelines, local referral pathways and decision frameworks as critical barriers for GPs to manage patients after MVC. GPs also expressed interest in having better access to management tools for specific MVC-related consequences (e.g., whiplash/seatbelt injuries, acute/chronic pain management, mental health issues). CONCLUSION: Chronic pain, mental health issues and the prescription of opioids were more frequent among patients experiencing MVC. This reinforces the relevance of appropriate management to limit the physical and psychological impact of MVC. GPs identified a lack of available resources (e.g. education, checklists and management support tools) for managing MVC-related consequences, and the need for local referral pathways and specific guidelines to escalate treatments.

Analysis of road traffic accidents and casualties associated with electric bikes and bicycles in Guangzhou, China: A retrospective descriptive analysis.

Introduction: Electric bicycles (e-bikes) and bicycles in large Chinese cities have recently witnessed substantial growth in ridership. According to related accident trends, this study analyzed characteristics and spatial distribution in the period when e-bike-related accidents rapidly increased to propose priority measures to reduce accident casualties. Methods: For e-bike- and bicycle-related accident data from the Guangzhou Public Security Traffic Management Integrated System, linear regression was used to examine the trends in the number of accidents and age-adjusted road traffic casualties from 2011 to 2021. Then, for the period when e-bike-related accidents rapidly increased, descriptive statistics were computed regarding rider characteristics, illegal behaviors, road types, collision objects and their accident liability. One-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test. P < 0.05 was considered statistically significant. Finally, the density distribution of accidents was presented, and Moran's I (MI) was used for assessing spatial autocorrelation. Hotspots were identified based on an optimized hotspot analysis tool. Results: Between 2011 and 2021, the number of accidents and casualty rate (per 100,000 population) increased for e-bikes but decreased for bicycles. After 2018, e-bike-related accidents increased rapidly, and bicycle-related accidents plateaued. Accident hotspots were concentrated in central city areas and suburban areas close to the former. Three-quarters of accidents occurred in motorized vehicle lanes. Most occurred on roads without physically segregated nonmotorized vehicle lanes. More than three-fifths of the accidents involved motor vehicles with at least four wheels. The prevalence (per 100 people) of casualties among e-bike rider victims and cyclist victims accounted for 92.0 % and 96.5 %, respectively. A total of 71.6 % of e-bike-related accidents involved migrant workers. Riding in motorized vehicle lanes was the most common illegal behavior. Conclusions: Although e-bike-related and bicycle-related accidents presented similar characteristics, the sharp increase in e-bike-related accidents requires attention. To improve e-bike safety, governments should develop appropriate countermeasures to prevent riders from riding on motorways, such as improving road infrastructure, adjusting the driver's license system and addressing priority control areas.

Comparative Evaluation of Mortality Predictors in Trauma Patients: A Prospective Single-center Observational Study Assessing Injury Severity Score Revised Trauma Score Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evaluation II Scores.

Aim: This prospective cohort study aimed to compare the predictive accuracy of outcome (survival/death) among trauma patients using various prognostic scores. Methods: Over 3 months, 240 trauma patients in a tertiary care hospital were assessed for demographic details, trauma characteristics, vital signs, Glasgow coma scale, arterial blood gas values, and lab markers. Injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS), and acute physiology and chronic health evaluation II (APACHE II) were applied at admission, 24 hours, and 48 hours post-admission. Results: Road traffic accidents (55.83%) were the primary cause of trauma, followed by falls (33.75%) and violence (10.41%). The all-cause mortality rate was 23.33%, with 34.16% requiring ICU admission. Head injuries (65.83%) were both the most frequent injury site and cause of mortality. Conclusion: Analysis indicated that APACHE II outperformed other scores in predicting outcomes, with ISS following closely. The study concludes that trauma severity correlates with ICU admission and mortality, emphasizing APACHE II as a superior predictor, particularly for traumatic brain injuries leading to ICU admission and mortality. Clinical significance: This study contributes to the existing body of knowledge by addressing the gap in comparing prognostic abilities among scoring systems for trauma patients. The unexpected superiority of APACHE II suggests its potential as a valuable tool in predicting outcomes in this specific patient population. How to cite this article: Gupta J, Kshirsagar S, Naik S, Pande A. Comparative Evaluation of Mortality Predictors in Trauma Patients: A Prospective Single-center Observational Study Assessing Injury Severity Score Revised Trauma Score Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evaluation II Scores. Indian J Crit Care Med 2024;28(5):475-482.

Use of Child Safety Seat and its Determinants in Jeddah, Saudi Arabia: A Cross-sectional Study.

Background: A child safety seat protects children from injury during motor vehicle accidents (MVAs). However, there is a lack of enforcement of regulation regarding its use in Saudi Arabia. Objectives: This study aimed to determine the use of child safety seat and its determinants and barriers in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was based on a structured face-to-face interview across Jeddah among families who drove in cars with children aged ≤5 years. The study used stratified multistage random sampling across the population of the governorate of Jeddah. Results: A total of 675 parents were included, of which 311 (46.1%) reported having a child safety seat in their vehicle, and only 165 (24.4%) reported its regular use. Awareness levels among parents regarding child safety seat use and its benefits, parents' level of education, family size, family income, and the belief in the need for laws governing child safety seat were key determinants of child safety seat use. Poor awareness among parents regarding the utility of child safety seat in reducing child injuries, low education levels among parents, larger families with multiple children, poor affordability, low family income, and a clear lack of laws mandating the use of child safety seat were identified as key barriers. Conclusions: The regular use of child safety seat for children aged ≤5 years is low in even one of the most urban populations of Saudi Arabia. This indicates the need for large-scale awareness drives and stricter implementation of laws enforcing the use of child safety seat in Saudi Arabia.

Trends in Traumatic Brain Injuries During the COVID-19 Pandemic: A Single-Center Review of Patient Charts From Pakistan.

Introduction A traumatic brain injury (TBI) is one of the leading causes of injury-related deaths, making it a public health concern of extreme importance. In a developing country such as Pakistan, TBIs are significantly underreported, with the treatment frequently being delayed and inadequate, especially in rural healthcare setups all across the country. This concern is further magnified by insufficient epidemiological data on TBIs available in Pakistan. The coronavirus disease 2019 (COVID-19) pandemic brought consequential changes to the healthcare system with the priority shifting toward COVID-19 patients, resulting in considerable changes to the workflow and management of TBIs. The primary objective of this study is to offer valuable insights into the epidemiology of TBIs in Pakistan and its relationship with the impact of the COVID-19 pandemic.  Methods A retrospective study was conducted at a tertiary care center in a metropolitan city in Pakistan. Patient charts were reviewed from January to August 2020, and data was extracted including demographics, clinical presentation, management, and outcomes for cases of TBI. Results The total number of patients is 2126, male 78% and female 21.4%. The mean age of the patients was 28.85. The state of admissions at the hospital is at 99.7% for EME admissions and 0.282% for OPD admissions. Participants presented with loss of consciousness (70.7%), nosebleeds, (53.2%), vomiting (69.0%), and seizures (11.5%). The majority (51.1%) were related to road traffic accidents, followed by falls (20.7%), and assaults (4%). While 1202 (58.5%) of these were managed conservatively, others underwent surgical treatment in the form of craniotomy (28.0%), Burr holes (3.20%), and fracture elevation and repair (10.5%). A decrease in the number of reported TBI cases was observed with lockdown implementation in Pakistan. Conclusion The transportation sector in Pakistan was severely affected by the COVID-19 pandemic, leading to a decline in road traffic injuries and TBIs. Stringent mobility constraints and changes in societal and cultural norms have contributed to this reduction.

A data-mining study on the prediction of head injury in traffic accidents among vulnerable road users with varying body sizes and head anatomical characteristics.

Body sizes and head anatomical characteristics play the major role in the head injuries sustained by vulnerable road users (VRU) in traffic accidents. In this study, in order to study the influence mechanism of body sizes and head anatomical characteristics on head injury, we used age, gender, height, and Body Mass Index (BMI) as characteristic parameters to develop the personalized human body multi-rigid body (MB) models and head finite element (FE) models. Next, using simulation calculations, we developed the VRU head injury dataset based on the personalized models. In the dataset, the dependent variables were the degree of head injury and the brain tissue von Mises value, while the independent variables were height, BMI, age, gender, traffic participation status, and vehicle speed. The statistical results of the dataset show that the von Mises value of VRU brain tissue during collision ranges from 4.4 kPa to 46.9 kPa at speeds between 20 and 60 km/h. The effects of anatomical characteristics on head injury include: the risk of a more serious head injury of VRU rises with age; VRU with higher BMIs has less head injury in collision accidents; height has very erratic and nonlinear impacts on the von Mises values of the VRU's brain tissue; and the severity of head injury is not significantly influenced by VRU's gender. Furthermore, we developed the classification prediction models of head injury degree and the regression prediction models of head injury response parameter by applying eight different data mining algorithms to this dataset. The classification prediction models have the best accuracy of 0.89 and the best R2 value of 0.85 for the regression prediction models.

Motorcycle injuries: a systematic review for forensic evaluation.

The intricate interplay of exposure and speed leave motorcyclists vulnerable, leading to high mortality rates. During the collision, the driver and the passenger are usually projected away from the motorcycle, with variable trajectories or final positions. Injuries resulting from the crash can exhibit distinct and specific characteristics depending on the circumstances of the occurrence.The aim of this study is to provide a systematic review of the literature on injuries sustained by motorcyclists involved in road accidents describing and analyzing elements that are useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to June 2023. Eligible studies have investigated issues of interest to forensic medicine about during traffic accidents involving motorcycle. A total of 142 studies met the inclusion criteria and were classified and analyzed based on the anatomical regions of the body affected (head, neck, thoraco-abdominal, pelvis, and limb injuries). Moreover, also the strategies for preventing lesions and assessing injuries in the reconstruction of motorcycle accidents were examined and discussed.This review highlights that, beyond injuries commonly associated with motorcycle accidents, such as head injuries, there are also unique lesions linked to the specific dynamics of accidents. These include factors like the seating position of the passenger or impact with the helmet or motorbike components. The forensic assessment of injury distribution could serve as support in reconstructing the sequence of events leading to the crash and defining the cause of death in trauma fatalities.

Hospitalization information and burden of pediatric inpatients in transport accidents.

BACKGROUND: Transport accidents are one of the leading causes of child morbidity and mortality worldwide and represent a significant public health burden. This study aimed to investigate the hospitalization information and burden of pediatric inpatients in transport accidents in China. METHODS: In this study, we collected the cover page of the medical records of pediatric inpatients in transport accidents using the Futang Research Center of Pediatric Development (FRCPD) database from January 1, 2016 to December 31, 2021. Then, we extracted the epidemiological characteristics, including demographic characteristics, cases distribution, disease information, and hospitalization burden. RESULTS: Among 36,455 included inpatients, males, aged 1-3 years, East China, July were dominant in different subgroups. In transport accidents, pedestrians were the most frequently type of injury (65.69%). Of all known lesions, craniocerebral/nerve injury was the more common results in pediatric inpatients in transport accidents (33.93%). In addition to pedal cyclists more susceptible to sport system injury, other types of injured person with transport accidents were mainly craniocerebral/nerve injury. In terms of the type of discharge, occupant of heavy transport vehicle or bus and people with craniocerebral/nerve injury had the highest mortality rate after hospitalization in all type and lesion of injured person groups, respectively. The largest hospitalization burden in the type of injured person was occupant of heavy transport vehicle or bus. CONCLUSIONS: This study revealed that epidemiological characteristics and the main factor influencing the hospitalization information and burden of children with traffic accidents in China.

Clinical spectrum of fusariosis from a tertiary care center in India- a retrospective study.

Background and Objectives: Fusarium spp. is an emerging pathogen that presents with varied clinical presentations but there are very few studies from India that elaborate on the spectrum of infection caused by the fungus. Hence, the present study was conducted in our institute to understand the clinical spectrum of fusariosis. Materials and Methods: The present study was a retrospective study conducted at a tertiary care institute, in Hyderabad, Telangana, India for four years from January 2018 to December 2022. All the patients with clinically significant isolation of Fusarium spp. from various samples were included in the study. Results: There were 25 cases of fusariosis diagnosed during the study period. Fusarium was isolated predominantly from debrided tissue following road traffic accidents in 12/25 (84%) of the cases, nails in 3/25 (12%) and superficial leg ulcer in 1/25 (4%) of the cases. Speciation was done for four patients. Three were Fusarium incarnatum and one was Fusarium solani. The patients were treated surgically and with/without antifungal therapy and were discharged in a stable condition. Conclusion: Traumatic injuries were the major cause of infections in the present study. As Fusarium is a virulent and highly resistant pathogen, an early suspicion and an appropriate diagnosis would lead to a better outcome in these patients.

Trauma Outcomes in Pediatric Nonfatal Road Traffic Accidents.

BACKGROUND: By 2025, road traffic injuries are projected to rank third in the global burden of disease, posing a significant challenge that affects health, social well-being, and economic aspects. According to data from the Romanian Police National Statistics Center, there have been an average of 342 traffic accidents per year involving pediatric patients over the past 10 years. MATERIALS AND METHODS: A retrospective research study was conducted, encompassing 358 cases of road traffic accidents identified for the study, with data collected over a span of eight years, and with the aim of analyzing the types of injury and treatment methods in relation to age and sex, while also focusing on the duration of hospitalization and the occurrence of complications. RESULTS: An oscillating trend is observed from 2015 to 2020, with its lowest value recorded in 2017 at around 6.8% and its peak in 2019 at 20.1%. Notably, post-pandemic (COVID-19), the cases underwent a substantial decline of approximately 60%. At least 78.7% of those who did not undergo orthopedic reduction required surgery, whereas among those who underwent orthopedic reduction, only 23.4% needed surgery. Regarding the frequency of complications 17.3% of the total cases experienced complications. CONCLUSIONS: According to our findings, age has a significant effect on the type of accident (p < 0.05). Complications occurred in 17.3% of patients, most commonly surgical (24 cases, 38.7%), orthopedic (17 cases, 27.4%), and neurological (15 cases, 24.2%).

Hospital preparedness assessment for road traffic accidents with mass casualties: a cross-sectional study in Kurdistan Province, Iran.

BACKGROUND: Road traffic accidents (RTAs) are predicted to become the world's seventh leading cause of death by 2030. Given the significant impact of RTAs on public health, effective hospital preparedness plays a pivotal role in managing and mitigating associated health and life-threatening issues. This study aims to meticulously evaluate the preparedness of selected hospitals in western Iran to handle road traffic accidents with mass casualties (RTAs-MC). METHODS: The study employed a descriptive-analytical approach, utilizing a reliable and valid questionnaire to measure hospitals' preparedness levels. Descriptive statistics (frequency distribution and mean) were utilized to provide an overview of the data, followed by analytical statistics (Spearman correlation test) to examine the relationship between hospital preparedness and its dimensions with the hospital profile. Data analysis, performed using SPSS software, categorized preparedness levels as weak, moderate, or high. RESULTS: The study found that hospitals in Kurdistan province had a favorable preparedness level (70.30) to respond to RTAs-MC. The cooperation and coordination domain had the highest preparedness level (98.75), while the human resource management (59.44) and training and exercise (54.00) domains had the lowest preparedness levels. The analysis revealed a significant relationship between hospital preparedness and hospital profile, including factors such as hospital specialty, number of beds, ambulances, staff, and specialized personnel, such as emergency medicine specialists. CONCLUSION: Enhancing preparedness for RTAs-MC necessitates developing response plans to improve hospital profile, considering the region's geographic and topographic features, utilizing past experiences and lessons learned, implementing of Hospital Incident Command System (HICS), providing medical infrastructure and equipment, establishing communication channels, promoting cooperation and coordination, and creating training and exercise programs.

Injury Patterns and Gender in Italy.

Introduction: Globally, injuries pose significant public health challenges, with road traffic accidents in particular being responsible for considerable morbidity, mortality, and economic distress. Italy has been significantly impacted due to its high population density and frequency of road traffic and domestic incidents. Method: This study set out to investigate the incidence of self-reported road traffic and home and leisure accidents in the Italian general population. A particular emphasis was placed on exploring possible gender differences across varying age groups. The data was obtained from the European Health Interview Survey and a representative sample of the Italian population was analyzed. Results: The analysis revealed that regardless of age, women experienced a reduced risk of road traffic accidents compared to men. However, gender disparities in home-leisure accidents were observed to be age-dependent. Women under the age of 25 exhibited a lower likelihood of home-leisure accidents and serious accidents necessitating hospital admission in comparison to their male counterparts. In contrast, women aged 65 and above had an increased likelihood of home-leisure accidents as opposed to men in the same age category. Conclusions: The findings of this study highlight the importance of considering age and gender as significant factors in the occurrence of different types of accidents, offering insight into how injury rates vary between these demographic groups within Italy.