Otorhinolaryngological (ORL) and Cervicofacial Injuries Resulting from Road Accidents within the Otorhinolaryngology (ORL) Department of the Regional Hospital of Mamou

Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.

Exploration of The Construction Path of Sports Injury and First Aid Course Systems for College Students

By the requirements of the Ministry of Education on life safety education, colleges, and universities have set up a course on Sports Injury and First Aid to organize relevant knowledge and increase the student’s awareness of first aid knowledge so that they can use reasonable methods to address sport-related injuries. At the same time, they can cope with first-aid situations and assist rescuers in completing resuscitation activities. This paper is based on the study of three colleges in Chongqing. This paper selected students from 3 universities in Chongqing and evaluated the mastery of first aid knowledge of college students, pointing out the value of implementing the “Sports Injury and First Aid” course in colleges and universities. This can provide opportunities to improve the theoretical content of the discipline, actively carry out practical activities, reasonably set the assessment method, and provide basic protection to ensure that the “Sports Injury and First Aid” course can be carried out normally to improve the mastery level of students’ first aid knowledge.

Incidence and Management of Occupational Blood Exposure (OBE) among Medical Students at the University of Bangui

Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.

Hepatitis B Vaccination in Medical and Dental Students: A Cross-Sectional Study

Background: Medical and dental students are at risk of Hepatitis B Virus (HBV) infection. The study aimed to assess the vaccination status against Hepatitis B Virus of students in clinical and non-clinical years of a private medical and dental college, and their knowledge, attitude, and awareness about the subject. Methods: A cross-sectional study was conducted using a pretested, self-administered questionnaire among 203 medical and dental students of CMH Lahore Medical College and Institute of Dentistry (CMH LMC & IOD) in Lahore, Pakistan. Participants were evaluated for their knowledge and vaccination status against Hepatitis B Virus. Students were considered to be fully vaccinated (recipients of 3 doses), partially vaccinated (recipients of 1 or 2 doses), and unvaccinated. Comparisons were made between students of clinical and non-clinical years. Data was entered and analysed using Statistical Package for the Social Sciences (SPSS) version 23. Results: Only 66% (n = 134) of the 203 participants had ever received a Hepatitis B Virus vaccine out of which a meagre 17.2% (n = 35) were fully vaccinated. No significant difference was found in vaccine uptake between students of clinical and non-clinical years (p-value = 0.181) despite significant differences seen in the knowledge of vaccination schedule (p-value = 0.001), the prevalence of needle-stick injuries (p-value = 0.001), and knowledge of protocols to be followed after a needle-stick injury (p-value = 0.001). Conclusion: Our study found that a large proportion of the student population is vulnerable to HBV infection. There is a need to create awareness regarding the subject to increase vaccine uptake. HBV vaccination should be offered to all currently enrolled students and be made mandatory at the time of admission in the future.

College Students’Cognition of Internet Accidental Injury Insurance:A Case Study of Guangdong Province

To explore college students'understanding and satisfaction of internet accidental injury insurance,and to analyse the factors influencing college students'awareness and satisfaction of internet accidental injury insurance.836 college students in Guangdong Province were selected by stratified random sampling.They were investigated with the self-designed questionnaire"College Students'Cognition of Internet Accidental Injury Insurance(CSCIAII)".29.67%,52.18%,10.13%and 8.02%of the college students didn't know,knew a little,knew relatively well and knew very well about internet accidental injury insurance,respectively.The percentage of college students who were very satisfied with the internet accidental injury insurance,thought the internet accidental injury insurance basically met their own needs,think it was acceptable but needed to be improved,did not agree with and were not satisfied with it at all were 9.55%,16.82%,47.73%,11.82%and 14.09%,respectively.College Students’awareness of insurance is weak,and they do not pay enough attention to accidental injury insurance.The design,publicity and sale strategies of internet insurance products may be important factors affecting college students'understanding and satisfaction with internet accidental injury insurance.

Injury patterns of seniors in traffic accidents: A technical and medical analysis

AIM:To investigate the actual injury situation of seniors in traffic accidents and to evaluate the different injury patterns.METHODS:Injury data,environmental circumstances and crash circumstances of accidents were collected shortly after the accident event at the scene.With these data,a technical and medical analysis was performed,including Injury Severity Score,Abbreviated Injury Scale and Maximum Abbreviated Injury Scale.The method of data collection is named the German InDepth Accident Study and can be seen as representative.RESULTS:A total of 4430 injured seniors in traffic accidents were evaluated.The incidence of sustaining severe injuries to extremities,head and maxillofacial region was significantly higher in the group of elderly people compared to a younger age(P<0.05).The number of accident-related injuries was higher in the group of seniors compared to other groups.CONCLUSION:Seniors are more likely to be involved in traffic injuries and to sustain serious to severe injuries compared to other groups.

Nursing students'knowledge,willingness,and attitudes toward the first aid behavior as bystanders in traffic accident trauma:A cross-sectional survey

Objectives:The purpose of the study was to investigate the nursing students'levels of the knowledge,willingness,and attitudes toward first aid behavior as bystanders in road traffic accident and the related factors.Methods:A total of 475 nursing students were recruited by convenience choosing in Tianjin University of Traditional Chinese Medicine.The nursing students'self-efficacy,core self-evaluation,knowledge,willingness and attitudes toward first aid behavior as bystanders in traffic accidents were investigated with a self-designed questionnaire.Results:The scores of knowledge,willingness,and attitudes toward first aid behavior in traffic accident trauma were 7.51±1.93,15.54±5.03,and 7.73±1.56,respectively.Students who once gained training of first aid showed lower levels of attitude toward first aid behavior than those untrained(t=-2.345,P=0.019).It was found that self-efficacy was correlated to the knowledge(r=0.150,P<0.001),willingness(r=0.182,P<0.004)and attitudes toward behavior of the first aid(r=0.371,P<0.001)among nursing students.Core self-evaluation was correlated to knowledge(r=0.193,P<0.001)and attitudes toward behavior of the first aid(r=0.199,P<0.001).Conclusions:The first aid knowledge among nursing students was not satisfactory.The study suggested that an unsustainable short first-aid training program may bring negative effects.Countermeasures should be taken to ensure both quality and continuity of first aid training.Meanwhile,more attention should be paid to improving the self-efficacy and core self-evaluation of the nursing students.

High rate of injuries among students in Southern Nigeria: An urgent call to action

Addressing injury and its associated effects is a multi-dimensional and ongoing challenge. This includes recognizing that injury is a significant public health problem capable of affecting the health and wellbeing of all populations over short and longer terms, albeit in varied ways and intensities. That recognition has drawn attention to the need to take actions to avert its rate of occurrence particularly in developed nations. While in low-income countries, despite the growing burden of injury, there are few school-based studies from which to develop prevention initiatives. Thus this study describes the cause, nature and types and prevalence of injuries in a cross sectional population of students in Southern Nigeria, in order to provide data for use in developing priorities for injury prevention efforts. An interviewer-administered school-based survey of students attending schools in Southern Nigeria was conducted in 2013. The study sample involved 585 students (60.9% male, 39.2% female and overall mean age of 15 years). We inquired about participants self-reported injuries in the past one year (all injury inclusive). When reported, injuries were further assessed according to cause, intent, nature, type, place, and number of days absent from school due to injury. Overall, there were 549 self-reported injuries in the past one year (93.8%) among the respondents (95.5% for males and 90.8% for females, p = 0.6696). Sex wise, prevalence of injury differ by age, school setting and parents’ occupation (p higher in males compared to females [206 (60.4%) vs 87 (41.8%) p = 0.002, and 10 (2.9%) vs 0 (0.0) p = 0.016] respectively. Traffic injuries and falls decrease progressively with age. Homes and schools were settings injuries occurred mostly. Over 68% of the reported injuries were unintentional. On the average, 2 days of normal school activity were lost per injured persons because of an injury. Given the high prevalence of injury reported in this study, injury like tropical diseases, should be considered a significant public health problem in Nigeria. We expect that this school-based information will be useful in establishing rational priorities for prevention, and the targeting of interventions toward responsible authorities. Also, there is a high need for safety education aiming to educate this young population on how to prevent injury.

Analysis of Thorax Injuries in 112 Death Cases Caused by Traffic Accidents

Objective: To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. Methods: Totally 112 autopsy cases with chest injuries in the urban of Jingzhou road traffic accidents were collected. Systematic review and analysis of the general information, postmortem examinations and assessments of chest injury had carried out from Feb. 2016 to Mar. 2018. Results: Average age of the victims was 52.2 years and the ratio of male to female deaths was 2.39:1. The proportion of motor-cyclists and pedestrians increased significantly. The overwhelming majority of accident vehicles were motorcycles and bicycles. Fractures of ribs and pulmonary contusion were the most common injuries. Craniocerebral and abdominal injuries were the most common associated injuries. Conclusion: Fractures of ribs and pulmonary contusion were the most common features of fatal road traffic injuries, often associated with vitreoretinal damage and serious multiple damages. These features reflect the characteristics of great violence in traffic accidents, which provides the evidence of identification of violent injuries.

Epidemiology of work-related hand and wrist injuries in a referral center: A descriptive study

BACKGROUND Occupational hand and wrist injuries(OHWIs)account for 25%of work-related accidents in low-and middle-income countries.In Colombia,more than 500000 occupational accidents occurred in 2021,and although the rate declined to less than 5%in 2020 and 2021,at least one in four accidents involved a hand or wrist injury.AIM To describe the OHWIs in workers seen at the emergency room at a second-level hospital in Colombia.METHODS An observational study was performed using data from workers who experienced OHWIs and attended a second-level hospital,between June,2020 and May,2021.The overall frequency of OHWIs,as well as their distribution by sociodemo-graphic,clinical,and occupational variables,are described.Furthermore,association patterns between sex,anatomical area(fingers,hand,wrist),and type of job were analyzed by correspondence analysis(CA).RESULTS There were 2.101 workers treated for occupational accidents,423(20.3%)were cases of OHWIs,which mainly affected men(93.9%)with a median age of 31 years and who worked mainly in mining(75.9%).OHWIs were more common in the right upper extremity(55.3%)and comprised different types of injuries,such as contusion(42.1%),laceration(27.9%),fracture(18.7%),and crush injury(15.6%).They primarily affected the phalanges(95.2%),especially those of the first finger(25.7%).The CAs showed associations between the injured anatomical area and the worker’s job that differed in men and women(explained variance>90%).CONCLUSION One out of five workers who suffered occupational accidents in Cundinamarca,Columbia had an OHWI,affecting mainly males employed in mining.This occupational profile is likely to lead to prolonged rehabilitation,and permanent functional limitations.Our results might be useful for adjusting preventive measures in cluster risk groups.

Management of Traumatic Brain Injuries at the Kara Regional Hospital

Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.

Factors and Pattern of Injuries Associated with Road Traffic Accidents in Hilly District of Nepal

Introduction: In 21st century, road traffic accidents (RTA) are considered as increasing epidemic of non-communicable disease which is abandoned and needs special attention to prevent them. The aim of this study was to assess the factors and pattern of injuries associated with road traffic accidents. Methods: A cross sectional study was conducted among 112 RTA victims and 56 drivers in Palpa District of Nepal. The association of factors and pattern of injuries with exposure to accidents was assessed using Fisher’s exact test. Bivariate logistic regression examined the association between driving and socio-demographics factors and exposure to road accidents. Results: Of 112 RTA victims, 50% were in the age group of 21 to 40 years and 71.4% were male. Drivers who were in the age less than or equal to 30 years were more likely (OR: 3.6;95% CI: 1.0, 14.3) to expose to an accident than those who were above 30 years. Similarly, those having driving speed less than 40 km/hr were less likely to expose to an accident than those with speed 40 - 60 km/hr (OR: 6.0;95% CI: 0.8, 73.5) and those with speed more than 60 km/hr (OR 7.8;95% CI: 1.0, 100.1). Moreover, the driving experience was also found positively associated (OR: 5.6;95% CI: 1.1, 35.5) with the exposure to an accident. Conclusion: Being in younger age group, male gender, morning time, the driving speed, driving experiences, and driving hours on the road were positively associated with RTA. The efforts should be made to enforce laws in control of speed targeting experienced drivers and those with younger age groups.

Injury Pattern among Road Traffic Accidents’ Victims in Najran City, Saudi Arabia

Traffic accidents constitute the substantial cause of disability and mortality in the young Saudi individuals reaching horrible figures. The aim of this study was to review and identify the pattern of injury among road traffic accident (RTA) victims as well as the peak time of accidents and their implications. This retrospective hospital-based cross-sectional study was carried out in the period between April 2016 to March 2017 in King Khalid Hospital, Maternity and Children Hospital and Najran General Hospital, Najran, Saudi Arabia. All RTA victims admitted to the emergency departments of the pre-mentioned hospitals. Data collected from 435 Saudis and non-Saudis’ files were statistically analyzed with regard to age, gender, the timing of road traffic accidents, injury pattern, and neurological deficits incidence. Most of the RTAs’ cases (92%) were male victims with the highest peak in the age group 20 - 29 years. 58% of the RTAs happened in the evening (6:00 PM-9:00 PM) while 20% occurred in the morning. Head injury represented the most frequent pattern (36%) followed by the spinal injury (23%), lower limb injury (23%), upper limb injury (20%), thoracic injury (17%), pelvic injury and abdominal injury (8%). 4.4% of RTAs resulted in death whilst 9% of cases experienced neurological deficits. In conclusion, young male drivers in Najran recorded the highest frequency of RTAs. Initiation of road safety education and expansion of speed detectors (Saher) system deployment is highly recommended.

Characteristics of injuries caused by paragliding accidents: A cross-sectional study

BACKGROUND: This study was undertaken to analyze the characteristics and risk factors relating to fatalities and injuries caused by paragliding.METHODS: The judicial examination reports and hospital documents of 82 patients traumatized in 64 accidents during 242 355 paragliding jumps between August 2004 and September 2011 were analyzed.RESULTS: In these accidents, 18 of the 82 patients lost their lives. In the patients with a confirmed cause of accident, most of them were involved with multiple fractures and internal organ injuries(n=8, 44.4%).CONCLUSION: We investigated the incidence of paragliding injuries, the types of the injuries, and the severity of affected anatomical regions. The findings are significant for the prevention of paragliding injuries and future research.

The competence of nursing students to prevent pressure injury - ascoping review

Objective: The purpose of the present study is to review the existing literatures to understand the competency ofnursing students to prevent the pressure injury. Methods: Arksey and O'Malley’s scoping review framework havebeen applied to understand the competency of nursing students on pressure injury prevention. A variety ofdatabases have been searched in this study, including PubMed, EMBASE, Web of Science, Cochrane Library,CNKI, Wanfang databases. Results: A total of 17 articles were selected and three main themes were summarized:“Knowledge and Attitude”, “Preparation” and “Educational situation and needs”. Conclusion: Although theattitudes towards pressure injuries were positive, the knowledge of nursing students on preventing pressure injurywas insufficient and their consciousness was weak. The controversy of the readiness of nursing students to preventpressure injuries has existed for a long time. Nursing students were severely lacking in pressure sore educationcourses and needed better education methods and more clinical practice opportunities.

Investigation on Sharp Instrument Injury and Self-Protection of Internship Nursing Students

Objective： To understand the situation of nursing students was stabbed by sharp instrument,in order to provide a scientific basis to take protective measures.Method：By using a self-designed questionnaire.The 100 nursing students were randomly selected from a hospital for retrospective investigation.There are 98 valid data.Results： The data shows that sharp instrument injury is more common in nursing students. Nursing students＇ protection consciousness is low, and protective ability is poor.Conclusion： Nursing students awareness of self- protection to sharp instrument injury is not enough,in order to avoid the risk of infection of nursing students occupation.When they entered the clinics, practice of systematic pre occupation safety education is very necessary;and the school and the hospital should actively implement the management standardized operation regulations;and put up student occupation injury management regulations;to improve the safety performance of nursing equipment.

Parametric analysis of craniocerebral injury mechanism in pedestrian trafficaccidents based on finite element methods

Purpose:The toughest challenge in pedestrian traffic accident identification lies in ascertaining injurymanners.This study aimed to systematically simulate and parameterize 3 types of craniocerebral injuryincluding impact injury,fall injury,and run-over injury,to compare the injury response outcomes ofdifferent injury manners.Methods:Based on the total human model for safety(THUMS)and its enhanced human model THUMShollow structures,a total of 84 simulations with 3 injury manners,different loading directions,andloading velocities were conducted.Von Mises stress,intracranial pressure,maximum principal strain,cumulative strain damage measure,shear stress,and cranial strain were employed to analyze the injuryresponse of all areas of the brain.To examine the association between injury conditions and injuryconsequences,correlation analysis,principal component analysis,linear regression,and stepwise linearregression were utilized.Results:There is a significant correlation observed between each criterion of skull and brain injury(p<0.01 in all Pearson correlation analysis results).A 2-phase increase of cranio-cerebral stress andstrain as impact speed increases.In high-speed impact(>40 km/h),the Von Mises stress on the skull waswith a high possibility exceed the threshold for skull fracture(100 MPa).When falling and makingtemporal and occipital contact with the ground,the opposite side of the impacted area experienceshigher frequency stress concentration than contact at other conditions.Run-over injuries tend to have amore comprehensive craniocerebral injury,with greater overall deformation due to more adequate kinetic energy conduction.The mean value of maximum principal strain of brain and Von Mises stress ofcranium at run-over condition are 1.39 and 403.8 MPa,while they were 1.31,94.11 MPa and 0.64,120.5 MPa for the impact and fall conditions,respectively.The impact velocity also plays a significant rolein craniocerebral injury in impact and fall loading conditions(the p of all F-test<0.05).A regressionequation of the craniocerebral injury manners in pedestrian accidents was established.Conclusion:The study distinguished the craniocerebral injuries caused in different manners,elucidatedthe biomechanical mechanisms of craniocerebral injury,and provided a biomechanical foundation forthe identification of craniocerebral injury in legal contexts.

Risk factors and predictive model of cerebral edema after road traffic accidents-related traumatic brain injury

Purpose:Cerebral edema(CE)is the main secondary injury following traumatic brain injury(TBI)caused by road traffic accidents(RTAs).It is challenging to be predicted timely.In this study,we aimed to develop a prediction model for CE by identifying its risk factors and comparing the timing of edema occurrence in TBI patients with varying levels of injuries.Methods:This case-control study included 218 patients with TBI caused by RTAs.The cohort was divided into CE and non-CE groups,according to CT results within 7 days.Demographic data,imaging data,and clinical data were collected and analyzed.Quantitative variables that follow normal distribution were presented as mean±standard deviation,those that do not follow normal distribution were presented as median(Q1,Q3).Categorical variables were expressed as percentages.The Chi-square test and logistic regression analysis were used to identify risk factors for CE.Logistic curve fitting was performed to predict the time to secondary CE in TBI patients with different levels of injuries.The efficacy of the model was evaluated using the receiver operator characteristic curve.Results:According to the study,almost half(47.3%)of the patients were found to have CE.The risk factors associated with CE were bilateral frontal lobe contusion,unilateral frontal lobe contusion,cerebral contusion,subarachnoid hemorrhage,and abbreviated injury scale(AIS).The odds ratio values for these factors were 7.27(95%confidence interval(CI):2.08-25.42,p=0.002),2.85(95%CI:1.11-7.31,p=0.030),2.62(95%CI:1.12-6.13,p=0.027),2.44(95%CI:1.25-4.76,p=0.009),and 1.5(95%CI:1.10-2.04,p=0.009),respectively.We also observed that patients with mild/moderate TBI(AIS≤3)had a 50%probability of developing CE 19.7 h after injury(χ^(2)=13.82,adjusted R2=0.51),while patients with severe TBI(AIS>3)developed CE after 12.5 h(χ^(2)=18.48,adjusted R2=0.54).Finally,we conducted a receiver operator characteristic curve analysis of CE time,which showed an area under the curve of 0.744 and 0.672 for severe and mild/moderate TBI,respectively.Conclusion:Our study found that the onset of CE in individuals with TBI resulting from RTAs was correlated with the severity of the injury.Specifically,those with more severe injuries experienced an earlier onset of CE.These findings suggest that there is a critical time window for clinical intervention in cases of CE secondary to TBI.

BRAIN INJURY BIOMECHANICS IN REAL WORLD VEHICLE ACCIDENT USING MATHEMATICAL MODELS

This paper aims at investigating brain injury mechanisms and predicting head injuries in real world accidents. For this purpose, a 3D human head finite element model （HBM-head） was developed based on head-brain anatomy. The HBM head model was validated with two experimental tests. Then the head finite element（FE） model and a multi-body system （MBS） model were used to carry out reconstructions of real world vehicle-pedestrian accidents and brain injuries. The MBS models were used for calculating the head impact conditions in vehicle impacts. The HBM-head model was used for calculating the injury related physical parameters, such as intracranial pressure, stress, and strain. The calculated intracranial pressure and strain distribution were correlated with the injury outcomes observed from accidents. It is shown that this model can predict the intracranial biomechanical response and calculate the injury related physical parameters. The head FE model has good biofidelity and will be a valuable tool for the study of injury mechanisms and the tolerance level of the brain.