近年火车创伤中关节损伤变化的特点

目的 探讨与分析快速列车所致火车创伤中关节损伤的变化特点。方法 集1997～2000年火车提速后10214例火车创伤中1279例关节损伤病例，分析在特定条件下的致伤因素、损伤严重程度、损伤类型特点，经AIS-ISS评分证实与预后的关系。结果 提速后关节损伤发生率由提速前33.54％上升到34.12％，死亡率由28.88％上升到30.33％，多关节离断伤由19.84％上升到34.13％，开放性关节损伤由31.71％上升到63.65％，关节离断伤的死亡率由21.19％上升到49.07％。结论 火车创伤无疑是十分严重的损伤，多发伤率远高于其他损伤，治疗棘手，多器官功能不全综合征(MODS)是致死的主要因素。     

Taste preferences induced by trains of rewarding lateral hypothalamic stimulation of differing durations

The question of whether prolonged stimulation of the lateral hypothalamic area (LH) simply diminishes in rewarding effect or becomes aversive was tested in 32 rats using a taste preference technique. The animals were allowed to drink novel, coffee-flavoured water for 10 min, and then received 60 trains of LH stimulation with differing durations, at an intensity proven to be rewarding at 0.5 sec duration. In a test 24 hours later, those animals that had been stimulated with 1 or 5 sec trains showed a shift in preference from tap water to coffee water, but those stimulated with 10 sec trains did not. The results show that prolonged stimulation not only loses its positive reinforcement effect but becomes negative.     

4个铁路区段提速列车噪声影响调查

为探讨提速列车噪声对铁路两侧环境及居民健康影响,依据声源,环境噪声等固定标准,对４个铁路运行区段进行了调查。     

Driver Sleepiness and Risk of Car Crashes in Shenyang, a Chinese Northeastern City： Population-based Case-control Study

Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sl     

Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden

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The effectiveness of a 0.05 blood alcohol concentration (BAC) limit for driving in the United States

The National Transportation Safety Board recently recommended that states establish a per se blood alcohol concentration (BAC) limit of 0.05 or lower for all drivers who are not already required to adhere to lower BAC limits in a national effort to reduce alcohol‐impaired driving. There is strong evidence for adopting this recommendation. A comprehensive review of the literature on BAC limits was conducted. The research indicates that virtually all drivers are impaired regarding at least some driving performance measures at a 0.05 BAC. The risk of being involved in a crash increases significantly at 0.05 BAC and above. The relative risk of being killed in a single‐vehicle crash with BACs of 0.05–0.079 is 7–21 times higher than for drivers at 0.00 BAC. Lowering the BAC limit from 0.08 to 0.05 has been a proven effective countermeasure in numerous countries around the world. Most Americans do not believe a person should drive after having two or three drinks in 2 hours. It takes at least four drinks for the average 170‐pound male to exceed 0.05 BAC in 2 hours (three drinks for the 137‐pound female). Most industrialized nations have established a 0.05 BAC limit or lower for driving. Progress in reducing the proportion of drivers in fatal crashes with illegal BACs has stalled over the past 15 years. Lowering the BAC limit for driving from the current 0.08 to 0.05 has substantial potential to reduce the number of people who drink and drive in the United States and get involved in fatal crashes.     

A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors

Posttraumatic stress disorder (PTSD) is one of the most common psychological consequences for adult road traffic crash (RTC) survivors and can have serious and long-lasting consequences for recovery if left untreated. Prevalence rates of PTSD following a RTC vary from 6% to 45% (based on 51 prevalence estimates across 35 studies). Explanations for this wide variance are explored. A systematic review of published studies found 49 papers (44 unique studies) investigating predictors of later PTSD in RTC survivors. Consistent predictors of PTSD include rumination about the trauma, perceived threat to life, a lack of social support, higher Acute Stress Disorder symptom severity, persistent physical problems, previous emotional problems, previous anxiety disorder and involvement in litigation/compensation. Moderate predictors of PTSD are discussed, as well as factors, which consistently do not predict PTSD in RTC survivors. The results inform future models of post-RTC traumatic stress aetiology.     

Predictors of health-related quality of life after non-catastrophic injury sustained in a road traffic crash

BackgroundHealth-related quality of life (HRQoL) is an important patient-reported outcome that warrants greater attention in individuals who sustained a non-catastrophic injury in a road traffic crash. Additional robust data on HRQoL outcomes after a non-catastrophic injury are needed to effectively identify potential targets for studies of tertiary prevention of poor recovery after a crash.ObjectiveWe assessed the association between non-catastrophic road traffic crash injuries and HRQoL and factors that independently affect long-term HRQoL.MethodsIn this inception cohort study, injured participants (≥ 17 years old) were identified from various sources including hospital emergency departments by a medical examination by a registered healthcare professional in New South Wales (Australia) and followed up after 12 months. HRQoL was measured by the European Quality of Life–5 Dimensions (EQ-5D-3L) and Medical Outcomes Survey Short Form 12 items (SF-12). A range of socio-demographic, pre-injury health, psychological, and injury-related factors were considered potential predictors of HRQoL in regression analyses.ResultsAmong 2019 individuals identified, 1201 (59.5%) were followed up after 12 months. HRQoL significantly improved between baseline and 12-month follow-up: EQ-5D-3L summary score (0.41-unit difference); SF-12 physical component summary score (PCS; 13.6-unit difference) and mental component summary score (MCS; 3.5-unit difference). Over 12 months, HRQoL score was lower for people claiming compensation than others (P < 0.0001). Key predictors of better 12-month EQ-5D-3L summary score and visual analogue scale score for pain were age, not claiming compensation, reduced body mass index, less pain severity, less pain-related disability, and less general psychological distress. Significant predictors of SF-12 PCS score were injury to the neck (P = 0.02) or head or face (P = 0.01), being a driver or passenger at the time of the crash (P < 0.0001), hospital admission (P < 0.0001) and pain severity (P < 0.0001). Baseline variables associated with 12-month SF-12 MCS scores were head or face injury (P = 0.02), pre-injury health (P = 0.04), pre-injury psychological conditions (P = 0.04), trauma-related distress (P = 0.0002) and general psychological distress (P < 0.0001).ConclusionsA wide spectrum of biopsychosocial factors contribute to HRQoL after a road traffic crash injury. These epidemiological data are potentially important because they could identify potential targets for studies of tertiary prevention of persistently poor HRQoL after such an injury.     

Assessing Roadside Hybrid Energy Absorbers Using the Example of SafeEnd

A combination of crash cushion and end-terminal, hybrid energy absorbing devices have been in use worldwide for a few years already. They include SafeEnd, a system Poland has recently introduced. Some road authorities have raised concerns as regards the operating conditions of the devices and how they work together with safety barriers. The objective of this research is to clarify the concerns and answer the following questions: (1) Can SafeEnd devices be used as hybrid devices and combine the roles of end-terminal and crash cushion placed before an obstacle? (2) What should be the rules for installing crash cushions at diverging roads and at the start of an off-ramp? The article presents characteristics of SafeEnd devices, defines the doubts raised by road safety auditors, discusses the results of field and numerical tests of the devices and explains the design principles for interchange ramps where crash cushions are required. The study results have helped to answer the research questions: SafeEnd devices fulfil the role of end-terminal and crash cushion, it is possible to make them more visible and principles have been defined for how the devices should be used at road interchanges. Further research should help to define general principles of deploying road restraint systems such as crashworthy terminals, crash cushions or hybrid devices.