Search

Supplemental digital content is available in the text. The partial weight-bearing protocol after lower limb fracture is an important issue in postoperative rehabilitation. Because it is difficult to quantify the actual weight load and provide a constant weight, the protocol is unestablished. By training with a lower-body positive-pressure treadmill and using an in-shoe pressure-measuring device, partial weight-bearing exercise can be performed with quantified loads. This case series illustrates the applicability of an early quantitative partial weight-bearing rehabilitation program using lower-body positive-pressure treadmill with an in-shoe pressure-measuring device after periarticular tibial fractures, which provides a quantitatively predetermined constant load. [ABSTRACT FROM AUTHOR]

Background: Frozen road conditions could be a factor in road traffic injuries, and seasonality and urbanisation level are potential influencing factors. However, few studies have considered this relationship. Therefore, we examined the effect of frozen road conditions on road traffic injury rates and the differences across seasons and urbanisation levels., Methods: We used nationwide data on road traffic injuries and weather from the National Emergency Medical Service Run Sheet and the Korea Meteorological Administration, respectively, from 2018 to 2021. We analysed the relationship between frozen road conditions and road traffic injuries by administrative district and day using a generalised estimating equation with log link function and Poisson distribution, stratified by season and urbanisation level., Results: After excluding summer, the analysis of 605 254 road traffic injury cases revealed a higher road crash incidence under frozen road conditions, with injuries increasing by 30% (rate ratio (RR): 1.33, 95% CI: 1.30 to 1.37). The relationship between road traffic injury rate and frozen road conditions varied significantly by season and urbanisation level. The stratification analysis showed that the relationship between these two variables was significant in the fall (RR: 2.07, 95% CI: 1.74 to 2.46) and winter (RR: 1.37, 95% CI: 1.34 to 1.40). Furthermore, the road traffic injury rate was higher on frozen road conditions in urban (RR: 1.24, 95% CI: 1.19 to 1.29) and rural areas (RR: 1.47, 95% CI: 1.42 to 1.51), not in metropolitan areas., Conclusion: The road traffic injury rate increased under frozen road conditions and varied by season and urbanisation level. These findings indicate the need for road safety strategies tailored according to season and urbanisation level., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Although stroke is commonly perceived as occurring in older adults, traumatic brain injury, one of the risk factors for stroke, is a leading cause of death in the younger adults. This study evaluated stroke risk in young-to-middle-aged adults based on traumatic brain injury severity and stroke subtypes., Methods and Results: For this retrospective, population-based, cohort study, data of adults aged 18 to 49 years who were diagnosed with traumatic brain injury were obtained from the Korean National Health Insurance Service between 2010 and 2017. Traumatic brain injury history was measured based on the International Classification of Diseases , Tenth Revision (ICD-10) , codes. Posttraumatic brain injury stroke risk was analyzed using a time-dependent Cox regression model. At baseline, 518423 patients with traumatic brain injury and 518 423 age- and sex-matched controls were included. The stroke incidence rate per 1000 person-years was 3.82 in patients with traumatic brain injury and 1.61 in controls. Stroke risk was approximately 1.89 times as high in patients with traumatic brain injury (hazard ratio, 1.89 [95% CI, 1.84-1.95]). After excluding stroke cases that occurred within 12 months following traumatic brain injury, these significant associations remained. In the subgroup analysis, patients with brain injury other than concussion had an approximately 9.34-fold risk of intracerebral hemorrhage than did the controls., Conclusions: Stroke prevention should be a priority even in young-to-middle-aged adult patients with traumatic brain injury. Managing stroke risk factors through regular health checkups and modifying health-related behaviors is necessary to prevent stroke.

Objective: This study aimed to assess the causal effect of a change in employment status on suicidal ideation and depressive symptoms by applying marginal structural models (MSM) with machine-learning (ML) algorithms., Methods: We analyzed data from the 8-15 th waves (2013-2020) of the Korean Welfare Panel Study, a nationally representative longitudinal dataset. Our analysis included 13 294 observations from 3621 participants who had standard employment at baseline (2013-2019). Based on employment status at follow-up year (2014-2020), respondents were classified into two groups: (i) maintained standard employment (reference group), (ii) changed to non-standard employment. Suicidal ideation during the past year and depressive symptoms during the past week were assessed through self-report questionnaire. To apply the ML algorithms to the MSM, we conducted eight ML algorithms to build the propensity score indicating a change in employment status. Then, we applied the MSM to examine the causal effect by using inverse probability weights calculated based on the propensity score from ML algorithms., Results: The random forest algorithm performed best among all algorithms, showing the highest area under the curve 0.702, 95% confidence interval (CI) 0.686-0.718. In the MSM with the random forest algorithm, workers who changed from standard to non-standard employment were 2.07 times more likely to report suicidal ideation compared to those who maintained standard employment (95% CI 1.16-3.70). A similar trend was observed in the analysis of depressive symptoms., Conclusions: This study found that a change in employment status could lead to a higher risk of suicidal ideation and depressive symptoms.