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UNASSIGNED: Maxillofacial injuries in children and adolescents always present a challenge due to the peculiar facial anatomy in children. This study aimed to determine the characteristics and pattern of traumatic maxillofacial injuries in children and adolescents reported to outpatient departments of two tertiary care health centers.
UNASSIGNED: Present study had a retrospective design, and the hospital records of all children and adolescent patients aged between 0 and 18 years, who had undergone maxillofacial fractures and were admitted for the same to two tertiary care health centers between January 2012 and May 2022 were reviewed.
UNASSIGNED: 77 patients suffered maxillofacial trauma with 115 fractures. The leading cause of maxillofacial trauma in the study was found to be road traffic accidents (RTA) followed by falls and sports-related injuries. Maxillofacial trauma was observed more in boys than girls, with an M: F ratio of 3.8:1. Out of 77 patients in the present study, more than half (51.9%) suffered maxillofacial trauma involving the lower one-third of the face, followed by the middle third (45.5%) and upper third (2.6%). A total of 11 patients (14.2%) were treated within 24 hr of sustaining injury. The majority of the patients, (n = 68; 88.3%) underwent open reduction and rigid internal fixation (ORIF), while 9 patients (11.7%) underwent closed reduction.
UNASSIGNED: Pediatric maxillofacial trauma was mainly attributed to road traffic accidents. Lower one-third of faces were more commonly affected and an increasing trend of maxillofacial trauma was observed with age.

UNASSIGNED: There are several trauma scoring systems with varying levels of accuracy and reliability that have been developed to predict and classify mortality in trauma patients in the hospital admission. Considering the importance of the country\'s emergency organization and the World Health Organization in the category of traffic accidents, we used this information in the study. The objective of this study is to evaluate and compare the predictive power of three scoring systems (R-GAP, GAP, and NTS) on traffic accident injuries.
UNASSIGNED: In an analytical cross-sectional study, all the data related to the mission of traffic accidents at the pre-hospital emergency management of Mashhad University of Medical Sciences in 2022 were extracted from the automation system, and the outcome of the patients in the hospital was recorded from the integrated hospital system. Then, GAP, R-GAP, and New Trauma Scores (NTS) were calculated, and their results were compared using ROC curve and logistic regression.
UNASSIGNED: In this study, 47,971 injuries from traffic accidents were evaluated. Their average age was 30.16 ± 10.93 years. R-GAP showed negligible difference than GAP and NTS scores (the area under the curve equals 0.904, 0.935, and 0.884, respectively), and the average scores of R-GAP, GAP, and NTS are equal to 22.45/45 ± 1/9, 22.25 ± 1.5, and 22.49 ± 1.3, respectively. Injury severity based on R-GAP, GAP, and NTS scores was mild in most patients. The effect of these models on the patient outcome based on OR values, R-GAP, GAP, and NTS models showed high values. All analysis was performed in SPSS 26.
UNASSIGNED: According to the study results, it seems that R-GAP, GAP, and NTS, have the highest power to predict death in traffic accident injuries. It is recommended to include these points in the electronic file of the pre-hospital emergency for the injured. Also, the severity and outcome of the patient can be predicted by these scores, which play an important role in the triage of the injured and determining the appropriate treatment center.

This study aimed to propose a novel method for dynamic risk assessment using a Bayesian network (BN) based on fuzzy data to decrease uncertainty compared to traditional methods by integrating Interval Type-2 Fuzzy Sets (IT2FS) and Z-numbers. A bow-tie diagram was constructed by employing the System Hazard Identification, Prediction, and Prevention (SHIPP) approach, the Top Event Fault Tree, and the Barriers Failure Fault Tree. The experts then provided their opinions and confidence levels on the prior probabilities of the basic events, which were then quantified utilizing the IT2FS and combined using the Z-number to reduce the uncertainty of the prior probability. The posterior probability of the critical basic events (CBEs) was obtained using the beta distribution based on recorded data on their requirements and failure rates over five years. This information was then fed into the BN. Updating the BN allowed calculating the posterior probability of barrier failure and consequences. Spherical tanks were used as a case study to demonstrate and confirm the significant benefits of the methodology. The results indicated that the overall posterior probability of Consequences after the failure probability of barriers displayed an upward trend over the 5-year period. This rise in IT2FS-Z calculation outcomes exhibited a shallower slope compared to the IT2FS mode, attributed to the impact of experts\' confidence levels in the IT2FS-Z mode. These differences became more evident by considering the 10-4 variance compared to the 10-5. This study offers industry managers a more comprehensive and reliable understanding of achieving the most effective accident prevention performance.

This research examines the seismic hazard impact on railway infrastructure along the U.S. West Coast (Washington, Oregon and California), using machine learning to explore how measures of seismic hazard such as fault density, earthquake frequency, and ground shaking relate to railway infrastructure accidents. By comparing linear and non-linear models, it finds non-linear approaches superior, particularly noting that higher fault densities and stronger peak ground shaking correlate with increased infrastructure accident rates. Shallow earthquakes with magnitudes of 3.5 or greater and hypocentral depths <20 km also exhibit a pronounced correlation with the incidence of railway infrastructure accidents The study extends to financial impact analysis through Net Present Value and Monte Carlo Simulation, and evaluates damage costs from 2000-2023 to guide financial planning and risk management strategies. It highlights the crucial role of advanced financial tools in optimizing maintenance and long-term planning that could result in better preparedness in high seismic hazard regions and emphasizes the need for robust risk management strategies in enhancing railway operational safety that considers the local and regional tectonic and seismic activity and local ground shaking intensity.

Building collisions are a leading threat to wild birds; however, only those that are found dead or fatally wounded are included in current mortality estimates, with injured or stunned birds largely assumed to survive long-term. Avian building collision victims are often brought to wildlife rehabilitators for care, with the hopes they can be released and resume their natural lives. We examined the wildlife rehabilitation records of over 3,100 building collisions with 152 different avian species collected across multiple seasons to identify patterns of survival and release among patients. The number of admissions varied by season; fall migration had the highest number of cases and winter had the least number of cases, and summer having the lowest release proportion and winter having the highest. The most common reported injury was head trauma and concussion. Our logistic and Poisson models found that mass had a strong positive effect on release probability, and the season of summer had a strong negative effect on release probability. Mass and winter had a strong positive effect on treatment time, and age and the seasons of fall and winter had a strong negative effect on treatment time in these models. Ultimately, about 60% of patients died in care, either by succumbing to their injuries or by euthanasia. Patients that were released remained in care for longer than patients that died. This study reports different data than carcass studies and views bird-building collisions from the perspective of surviving victims to explore longer-term effects of these collisions on mortality. Increased communication and collaboration between wildlife rehabilitators and conservation researchers is recommended to better understand building collisions and how to respond to this leading threat to wild birds. These findings, along with our estimate of delayed mortality, suggest that overall collision mortality estimates based on carcass collection far exceed one billion birds in the U.S. each year.

BACKGROUND: Pedestrian traffic injuries are a rising public health concern worldwide. In rapidly urbanizing countries like Saudi Arabia, these injuries account for a considerable proportion of trauma cases and represent a challenge for healthcare systems. The study aims to analyze the key characteristics, seasonality, and outcomes of pedestrian traffic injuries in Riyadh, Saudi Arabia.
METHODS: This study was a retrospective cohort analysis of all pedestrian traffic injuries presented to King Saud Medical City, Riyadh, and included in the Saudi Trauma Registry (STAR) database between August 1, 2017, and December 31, 2022. The analysis of metric and nominal variables was reported as mean (standard deviation, SD) or median (interquartile range, IQR) and frequencies (%), respectively. A logistic regression analysis was performed to examine the influence of patients\' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation and in-hospital mortality.
RESULTS: During the study period, 1062 pedestrian-injured patients were included in the analysis, mostly males (89.45%) with a mean (SD) age of 33.44 (17.92) years. One-third (35.88%) of the patients were Saudi nationals. Two-thirds (67.04%) of the injuries occurred from 6 p.m. until 6 a.m. Compared to other years, a smaller % of injury events (13.28%) were noticed during the COVID-19 pandemic (2020). Half (50.19%) of the patients were transported to the emergency department by the Red Crescent ambulance, and 19.68% required intubation and mechanical ventilation. Most of the patients (87.85%) were discharged home after completion of treatment, and our cohort had a 4.89% overall mortality. The logistic regression analysis showed the influence of patients\' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation (Chi2 = 161.95, p < 0.001) and in-hospital mortality (Chi2 = 63.78, p < 0.001) as a whole significant.
CONCLUSIONS: This study details the demographic, temporal, and clinical trends of pedestrian traffic injuries at a major Saudi trauma center. Identifying high-risk individuals and injury timing is crucial for resource allocation, targeting road safety interventions like public awareness campaigns and regulatory reforms, and improving prehospital care and patient outcomes.

BACKGROUND: Trauma is a significant public health concern in Iran, with high mortality and morbidity rates. This study aimed to assess trauma patients\' profiles in Shahroud, Iran. Study Design: A cross-sectional study.
METHODS: The study involved trauma patients who met specific criteria at Imam Hossein hospital in Shahroud, Iran, between 2016 and 2023, using the National Trauma Registry of Iran (NTRI). The relationship between injury characteristics and the cause of injury was analyzed using chi-square test and post hoc analysis. Quintile regression models assessed the association of demographic and clinical variables with length of stay.
RESULTS: Among 3513 trauma patients, road traffic crashes (RTCs) had a higher percentage of injuries with the Glasgow Coma Scale (GCS) between 9 and 12 (1.7%) compared to falls (0.3%) (P<0.001). Falls caused more moderate cases with injury severity scores (ISS) ranging from 9 to 15 (22.7%) than RTCs (17.1%) (P<0.001). RTC-related injuries required more ventilation (2.7%) and intensive care unit (ICU) admissions (11.1%) than falls (P<0.001). After adjusting for age, GCS, ISS, and body region, fall had a median length of stay nine hours shorter than RTCs (95% CI = -16.2, -1.8).
CONCLUSIONS: Significant injury pattern differences were observed between RTCs and falls. RTCs had higher frequencies of injuries resulting in GCS scores between 9 and 12, while falls had higher frequencies of moderate ISS scores. In addition, patients with RTC-related injuries required more mechanical ventilation and ICU admissions. Moreover, after adjusting for various factors, patients with RTC-related injuries had a significantly longer hospital stay compared to those with fall-related injuries.

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.
OBJECTIVE: 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 sociodemographic, 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%).
CONCLUSIONS: 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.

This cohort study explores the risk of nonfatal self-harm in French adolescents and young adults hospitalized for unintentional intoxication or injury.