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Background: Polytrauma was defined as a severe traumatic injury and believed that it was a sudden and unpredictable incident. Is polytrauma really just a simple accident? In order to comprehensively answer this question, the study sought to determine the frequency and specific risk factors associated with polytrauma recidivism, while also comparing the initial and subsequent injury events among recidivists. Methods: A multicenter, retrospective cohort study was conducted at four Advanced Trauma Centers' emergency surgery or traumatic intensive care units (TICUs) between August 2020 and July 2023. A total of 2490 consecutive trauma patients who met the criteria consecutively were recruited and analyzed in the study. Risk factors for recurrent polytrauma were identified through the use of logistic regression analysis. A nomogram was created using the results from a multivariate logistic regression analysis and the rms package in R. Results: In polytrauma, the rate of recidivism was 44.6% (672/1507), then recidivists were predominantly male (80.4%) and frequently within the 45 to 54 year-old age range (51.3%). Recidivists in polytrauma patients overall had a median time to reinjury of 27 months, as measured by the interquartile range (IQR). The polytrauma patients in the recent traumatic event were often more severe than that in the initial event, as patients had higher ISS scores and lower GCS scores (P < 0.01). Moreover, polytrauma recidivism were associated with poorer prognosis and increased healthcare costs. Polytrauma patients with the specific characteristics were found to have a higher likelihood of experiencing a subsequent recurrence, including being male (OR = 3.82,95% CI: 2.21–6.83), aged 45–54 years old (OR = 2.62,95% CI: 2.13–6.32),experiencing sleep deprivation (OR = 2.38,95% CI: 1.32–4.25), working in construction (OR = 2.72,95% CI: 1.44–5.42), working as delivery staff (OR = 3.65,95% CI: 1.51–7.96) and being involved in an electric bicycle collision (OR = 2.85,95% CI: 1.31–5.64). Conclusion: Polytrauma recidivism is associated with a high recurrence rate, poorer clinical outcomes, and elevated healthcare costs. Key predictive markers for recidivism include being male, aged 45–54 years, experiencing sleep deprivation, employment in construction or delivery roles, and involvement in electric bicycle collisions. These findings highlight polytrauma recidivists as a critical target for primary prevention efforts. Public health strategies should prioritize tailored interventions to reduce recidivism, aiming to mitigate morbidity, mortality, and associated healthcare burdens in this high-risk population. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusions and RelevanceElectric scooters (e-scooters) have rapidly become a mainstream method of transportation in the U.S. but there is consequently limited data on their safety profile. This study evaluates ophthalmic injuries related to e-scooters compared to non-motorized scooters and off-road vehicles (ORV).This retrospective study uses the National Electronic Injury Surveillance System (2014 to 2023). Ocular injury profiles associated with conventional scooters, e-scooters, and off-road vehicles were included.E-scooter ocular injuries rose by 1950% between 2014 and 2023. E-scooter riders were 4.3 times more likely to sustain orbital fractures and 2.7 times more likely to be hospitalized than non-motorized scooter riders. ORV and e-scooter riders had comparable injury and hospitalization patterns. Alcohol use and lack of helmet use were significant contributors to injury severity.Injury patterns and hospitalization rates in e-scooter accidents resemble those of ORV incidents. Findings highlight the need for public health interventions to reduce the burden of e-scooter-related injuries. [ABSTRACT FROM AUTHOR]

The widespread acceptance of electric scooters has transformed the landscape of urban transportation. Yet, the emerging phenomenon of intoxicated scootering poses unanswered questions of liability and accountability. New research indicates that a third of traumatic electric scooter injuries are associated with intoxicated scootering. This statistic is particularly alarming given that there are over fifty million scooter trips per year in the United States. In Washington State, the State Legislature has not enacted a state-wide policy against intoxicated scootering. Instead, the Legislature delegates the authority to regulate the operation of electric scooters to local governments. Due to the ambiguity of whether electric scooters qualify as “vehicles” for purposes of the DUI statute, intoxicated scooterers either face no liability or full DUI penalties depending on their local jurisdiction’s regulations. The State’s fragmented approach to intoxicated scootering either overcriminalizes or fails to deter intoxicated scootering. This Comment proposes a statutory carve-out for intoxicated scootering, facilitating deterrence by imposing civil penalties on offenders. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E‐Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E‐Scooter accident. Methods: A retrospective single‐centre observational study at a metropolitan tertiary ED of patients presenting after an E‐Scooter accident comparing 6 months before and after legislative change. Results: Four hundred and forty‐three patients presented following an E‐Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty‐two patients pre‐ and 217 patients post‐legislative change had negative CT studies. Twenty‐nine patients pre‐ and 35 patients post‐legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi‐factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures. Conclusion: This single‐centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large‐scale, multicentre studies will need to be undertaken to understand the true impact of legislative change. [ABSTRACT FROM AUTHOR]

(1) Introduction: Since electric scooters were launched in 2017, they have become increasingly popular worldwide and a cause of childhood trauma. (2) Case reports: This paper has a double-fold purpose: it reports two cases of epidural hematomas and compares them with electric scooter-related head trauma in the literature. An overview of the literature on this topic was performed to make such a comparison. Our cases are one of almost 52 cm3 and one of 129 cm3, both in two eight-year-olds. (3) Discussion: Although usually mild, traumatic brain injuries following e-scooter falls can also be moderate and severe. Reduced helmet use, high speed, and a lack of experience are the perfect set-up for potential severe injuries. Intracranial bleeds are not frequent, and epidural hematomas are rare in such cases, but they can significantly impact the individual, community, and healthcare system. No other medium- or large-sized epidural hematomas were reported in children sustaining electric scooter-related head trauma. (4) Conclusions: Our review parallels the literature and our hospital's experience. Although there are both similarities and discrepancies between our cases and the literature, mild trauma should not be disregarded, for it may hide serious complications requiring immediate surgery. [ABSTRACT FROM AUTHOR]

A 28-year-old male presented to the emergency room suffering an ocular burn injury from a welding rod. Given the mechanism of injury, severe delayed injury of the ocular adnexa occurred, requiring enucleation, partial exenteration of the superior orbit, and extensive reconstruction. Histopathology of the affected tissue was analyzed. This is the first report that details the clinical course of a patient with delayed high amperage and low voltage electrical burn injury. [ABSTRACT FROM AUTHOR]

Background and aim: Electrocution is a well-documented preventative cause of unnatural death globally. The demographic profile and trends of fatal electrocutions in the eThekwini district, KwaZulu Natal, South Africa were analyzed and aimed to identify regional factors for targeted prevention. Methods: A retrospective descriptive study analyzed all fatal electrocutions autopsied at three medico-legal mortuaries in eThekwini from 1st January 2006 to 31st December 2016. Clinical, postmortem and police findings were collated, categorized and statistically analyzed. Results: A total of 512 electrocution fatalities were identified at autopsy during the 11 year study period (1,35 fatal electrocutions/ 100 000 population). Cases escalated until 2013 and then gradually decreased, with significant difference between the number of cases per study year (p

This paper designs a safe, low-cost, and efficient permanent magnet synchronous motor (PMSM) booster pump system. The aim is to enhance the pump's safety and reduce the incidence of electric shock accidents, while also achieving cost reduction and efficiency improvement. The pump components are made of a plastic material, and a safe voltage of 36 V is used as the operating voltage. Additionally, the PMSM is chosen to replace the induction motor (IM) as the pump's driving device, utilizing sensorless control and field-weakening control strategies. The study results show that when the flow rate is 1.51 m3/h, the efficiency of the PMSM low-voltage pump can reach up to 20.86%. At the same flow rate of 1 m3/h, compared to other pumps, the PMSM low-voltage pump exhibits higher head, energy savings, and efficiency. The proposed PMSM low-voltage pump offers advantages such as high efficiency, energy savings, safety, and low cost. This study provides a reference for the domestic PMSM pump industry. [ABSTRACT FROM AUTHOR]

The prevalence of skeletal muscle atrophy, caused by disease and aging, is rising as life expectancy increases. Exercise is the most effective treatment option; however, it is often impractical for individuals suffering from disease or bedridden. The formulation of non-exercise-based interventions is necessary. This study assessed the impact of acupuncture (AC), electro-acupuncture (EA), and electrical stimulation (ES) on muscle mass and contractile properties in a model of casting-induced muscle atrophy. Sprague-Dawley rats (n = 40) were assigned to five groups: control (CON), cast (CT), cast receiving AC (CT-AC), cast receiving EA (CT-EA), and cast receiving ES (CT-ES) (n = 8 each). Treatments were 15 min and three times/week for 14 days. Contractile properties and protein markers of atrophy and inflammation were measured. Casting decreased muscle mass and fiber cross-sectional area, but AC, EA, and ES attenuated cast-induced muscle atrophy. All treatments increased peak twitch tension compared to CT. CT increased the protein levels of MAFbx and MuRF1, while AC, EA, and ES mitigated the elevation of these proteins. Our results indicate that acupuncture, electro-acupuncture, and electrical stimulation show promise as therapeutic strategies to counteract skeletal muscle loss and dysfunction resulting from disuse atrophy caused by injury, disease, and aging. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Topical papaverine is an effective vasodilator that can be used for dilating small veins to accept venous couplers for thumb replantation. This technique corrects size mismatches for successful venous anastomosis and minimizes postoperative complications. Thumb replantation is a complex microsurgical procedure used to restore function and appearance after amputation. A successful venous anastomosis is essential in replantations; however, venous couplers can mismatch the size of veins and lead to obstacles. A 26‐year‐old male presented with a left thumb amputation caused by an electric saw injury. The amputated thumb was preserved and replantation surgery was performed 9 h post‐injury. The digital artery and veins were repaired but a size mismatch was found between the only salvageable superficial vein (0.7 mm) and the smallest available venous coupler (1 mm). The vein was dilated to accept the coupler by a series of applications of topical papaverine (1 mg/mL). This allowed venous anastomosis to be accomplished in 25 min. Postoperative follow‐up showed good thumb function, sensation, and circulation. Venous anastomosis is vital in thumb replantation to avoid venous congestion hence survival of the replanted thumb. Venous couplers shorten operative time and decrease the risk of postoperative complications. Papaverine is a vasodilator and facilitates venous anastomosis when veins and couplers are mismatched. This case demonstrates how papaverine, a vasodilator, may be used to improve surgical outcome during thumb replantation when small veins prevent venous coupler use. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths. [ABSTRACT FROM AUTHOR]

Objective : Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient’s rehabilitation and in turn, affects the patients’ quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. Methods : This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Results : Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL. [ABSTRACT FROM AUTHOR]

Atrioventricular (AV) accessory pathways (APs) provide additional electrical connections between the atria and ventricles, resulting in severe electrical disturbances. It is generally accepted that APs originate in the altered annulus fibrosus maturation in the late prenatal and perinatal period. However, current experimental methods cannot address their development in specific locations around the annulus fibrosus because of the inaccessibility of late fetal hearts for electrophysiological investigation under physiological conditions. In this study, we describe an approach for optical mapping of the retrogradely perfused chick heart in the last third of the incubation period. This system showed stability for electrophysiological measurement for several hours. This feature allowed analysis of the number and functionality of the APs separately in each clinically relevant position. Under physiological conditions, we also recorded the shortening of the AV delay with annulus fibrosus maturation and analyzed ventricular activation patterns after conduction through APs at specific locations. We observed a gradual regression of AP with an area-specific rate (left-sided APs disappeared first). The results also revealed a sudden drop in the number of active APs between embryonic days 16 and 18. Accessory myocardial AV connections were histologically documented in all positions around the annulus fibrosus even after hatching. The fact that no electrically active AP was present at this stage highlights the necessity of electrophysiological evaluation of accessory atrioventricular connections in studying AP formation. NEW & NOTEWORTHY: We present the use of retrograde perfusion and optical mapping to investigate, for the first time, the regression of accessory pathways during annulus fibrosus maturation, separately examining each clinically relevant location. The system enables measurements under physiological conditions and demonstrates long-lasting stability compared with other approaches. This study offers applications of the model to investigate electrical and/or functional development in late embryonic development without concern about heart viability. [ABSTRACT FROM AUTHOR]

This is an epidemiological review of electrical burns admitted to the Service of Burns and Plastic Surgery, UHC "Mother Theresa" of Tirana, Albania, covering a four-year period, from 2019 to 2022. Twenty-seven patients were identified as having sustained an electrical burn injury, all of them males and most of them, namely 85%, belonging to the "working force" age group 19-65 years old. Most of the accidents, 70% of them, occurred at work, and these were all high voltage electrical burns. A total 65% of the cases had at least one of the upper limbs involved and the mean surface area burned was estimated at around 20% TBSA, mortality rate 11.1%, and all the fatal cases were from occupational burns. Serum level of BUN, creatinine and liver enzymes were evaluated on admission and at least 7 days after, with no significant changes. WBC count was found to be elevated in almost all the patients, and remained elevated in the second week and even longer for patients with sepsis. Four of our patients needed amputations. Besides these, no other serious complications were registered. [ABSTRACT FROM AUTHOR]

BACKGROUND Electrical burn injuries are more severe than thermal burns as they often extend into the subcutaneous tissue and cause necrosis of muscle, tendon and bone. Moreover electrical burns can occur at multiple sites requiring multiple staged procedures and reconstruction of soft tissue defects. Managing these defects, which expose vital structures, is challenging and must be tailored to the individual patients situation. Among various options for resurfacing the electrical burn wounds, pedicled loco-regional flaps offer simplest solution to cover exposed vital structures such as bones, tendons and vessels. AIMS AND OBJECTIVES 1. To find out simple loco-regional pedicled flap options to cover complex soft tissue defects caused by electrical burns involving different anatomical regions. 2. To study versatility and utility of pedicled flaps in electrical burn reconstruction. 3. To study the complications and management of pedicled flaps. METHODS The present study was conducted in the Department of Plastic Surgery, King George hospital, Vishakhapatnam from March 2024 to May 2024 for a period of 3 months. Electrical burns patients with soft tissue defects exposing vital structures, reconstructed by pedicled loco-regional flaps were included in the study. Patients requiring different resurfacing options from skin grafting to free flaps were excluded in the study. Electrical burns patients not giving consent for the study and patients who require amputations are excluded from study. A total number of 30 patients of electrical burns who require loco-regional pedicled flaps were included in the study after preoperative consent and necessary documentation. RESULTS Among 30 patients included in our study, males were more prevalent (25 men and 5 women) with a male to female ratio of 5:1, as trauma requiring flap cover was dominantly high in males. The median age was 33.6 years (range 16- 60). The median duration of hospital stay was 8 days (range 4-18). Among these upper limb defects (13) are more in number, scalp defects are 9, upper back and shoulder defects are 4, and lower limb defects are 4 in number. For reconstruction of these defects we have used 9 pedicled flaps for scalp defects, 5 groin flaps for hand and wrist defects, 2 abdominal flaps for forearm defects, 2 cross finger flaps for finger defects (entry wounds), 2 louvre flaps for multiple defects of palmar surface of fingers (contact burn), 2 thenar flaps for pulp defects of finger (entry wounds) and 3 reverse sural artery flaps for plantar defects (exit wounds) 1 medial plantar artery flap for exit wound on plantar aspect of foot. 4 out of 30 flaps (6.6%) were infected in the postoperative period, managed by appropriate antibiotics. In 2 out of 30 flaps (3.3%) we have encountered venous congestion which settled in late post-operative period. Marginal flap necrosis of 2-4 cm was seen in 4 out of 30 flaps (6.6%). CONCLUSION An effective and dependable method for rebuilding intricate soft tissue abnormalities resulting from electrical burns is the loco-regional pedicled flap. These can be particularly useful for patients in the hands of young plastic surgeons in emerging burn centers where higher surgical facilities are not available. [ABSTRACT FROM AUTHOR]

The electric power industry is a high-risk industry with frequent accidents. To ensure the life safety of employees and reduce the probability of accidents, it is necessary to utilize certain technical means to identify the main causative factors in electric fatal accident reports. This research proposes an accident causation identification method that combines text categorization and catastrophe association analysis. First, an improved text feature extraction method (TF-IDF-GloVe-LDA) is proposed by fusing term frequency-inverse document frequency (TF-IDF), global vectors for word representation (GloVe), and latent dirichlet allocation (LDA) algorithms. Then, an SVM classifier was used to categorize the 473 accident report texts into five categories, ACCIDENT, PROCESS, CAUSE, PROBLEM, and RESPONSE, based on the extracted text feature vectors. Second, for the 461 CAUSEs categorized from the accident report texts, the TF-IDF algorithm is utilized to mine them to obtain 62 accident causative factors. Using the word cloud map and semantic network, a visualization analysis is performed to reveal the intrinsic connection between causative factors. The human factor analysis and classification system (HFACS) is combined to construct a framework and a Boolean dataset for electric power fatal accident causative factors. Finally, the catastrophe progression method is utilized to improve the FP-growth algorithm and propose a catastrophe association analysis method. It is utilized to mine the Boolean dataset to obtain 28 association rules and construct the accident causal network. The main causative factors were ultimately identified by analyzing the critical causal chains within the network and examining the frequency and sensitivity of each node. The findings of this study indicate that a lack of effective management, supervision, and training serves as the fundamental cause of fatal accidents in the electric power industry when compared to equipment and environmental factors. This paper offered a fresh perspective on identifying primary accident causative factors in non-standardized text and exploring their intricate mechanisms of interaction, which holds significant implications for the pre-control management of accidents in the power industry. [ABSTRACT FROM AUTHOR]

Electric vehicle accidents on the road occur frequently, and head injuries are often the cause of serious casualties. However, most electric vehicle riders seldom wear helmets. Therefore, combining target detection algorithms with road cameras to intelligently monitor helmet-wearing has extremely important research significance. Therefore, a helmet-wearing detection algorithm based on the improved YOLOv8n model, PRE-YOLO, is proposed. First, we add small target detection layers and prune large target detection layers. The sophisticated algorithm considerably boosts the effectiveness of data manipulation while significantly reducing model parameters and size. Secondly, we introduce a convolutional module that integrates receptive field attention convolution and CA mechanisms into the backbone network, enhancing feature extraction capabilities by enhancing attention weights within both channel and spatial aspects. Lastly, we incorporate an EMA mechanism into the C2f module, which strengthens feature perception and captures more characteristic information while maintaining the same model parameter size. The experimental outcomes indicate that in comparison to the original model, the proposed PRE-YOLO model in this paper has improved by 1.3%, 1.7%, 2.2%, and 2.6% in terms of precision P, recall R, mAP@0.5, and mAP@0.5:0.95, respectively. At the same time, the number of model parameters has been reduced by 33.3%, and the model size has been reduced by 1.8 MB. Generalization experiments are conducted on the TWHD and EBHD datasets to further verify the versatility of the model. The research findings provide solutions for further improving the accuracy and efficiency of helmet-wearing detection on complex traffic roads, offering references for enhancing safety and intelligence in traffic. [ABSTRACT FROM AUTHOR]

The development of electric vehicles (EVs) has introduced novel technologies and manufacturing processes that expose workers to new risks of burn injury. We identified 6 patients who were admitted to our burn center for injuries that occurred while working in EV manufacturing facilities. The burns fell into 3 categories: flash flame burns due to lithium-ion battery explosions, high-voltage electrical injuries, and burns caused by contact with molten metal. Recognizing these recurrent patterns of injury should inform future prevention efforts and prepare health systems to evaluate and treat patients burned in EV manufacturing. [ABSTRACT FROM AUTHOR]

Burns affect 11 million people worldwide annually. Electrical burns (EBs) are renowned for inflicting extensive harm and long-term consequences that can lead to severe illnesses and fatalities. People in both occupational and nonoccupational settings may be exposed to EBs, leading to functional or anatomical consequences. We identified sociodemographic features related to EBs in both settings. A cross-sectional design, using an open dataset of electrical shock injuries that occurred in Colombia during the 2010-2021 period, was carried out. Sociodemographic features of people injured in occupational and nonoccupational settings were described in counts (%), incidence per 100 000 people (I 0; 95% CI). To identify related factors (age-sex adjusted) with injuries in occupational and nonoccupational settings, we applied a binary logistic regression. Over the 12-year period, there were 1.274 EBs (I 0: 2.47; 2.34-2.61), 287 in the occupational setting (I 0: 1.35; 1.20-1.51), and 987 in the nonoccupational setting (I 0: 3.25; 3.05-3.46). Age median was 31 years, and most cases were distributed in middle adulthood (52.8%), males (88.1%), high school/technician (42.8%), urban location (73.7%), weekdays (95.3%), and daytime hours (85.5%). Factors related to EBs in the occupational setting were males, middle adulthood, high school/technician, Thursday, and daytime hours. Other factors related to EBs in the nonoccupational setting were early childhood, primary school, urban location, and weekends. Both settings pose a risk of injuries to individuals. We have identified sociodemographic factors related to these injuries in both occupational and nonoccupational settings, which could aid in preventing damages and long-term complications, especially among vulnerable subgroups such as those determined above. [ABSTRACT FROM AUTHOR]

Traumatic spinal cord injury is a major cause of disability for which there are currently no fully effective treatments. Recent studies using epidural electrical stimulation have shown significant advances in motor rehabilitation, even when applied during chronic phases of the disease. The present study aimed to investigate the effectiveness of epidural electric stimulation in the motor recovery of rats with spinal cord injury. Furthermore, we aimed to elucidate the neurophysiological mechanisms underlying motor recovery. First, we improved upon the impact spinal cord injury model to cause severe and permanent motor deficits lasting up to 2 months. Next, we developed and tested an implantable epidural spinal cord stimulator device for rats containing an electrode and an implantable generator. Finally, we evaluated the efficacy of epidural electrical stimulation on motor recovery after spinal cord injury in Wistar rats. A total of 60 animals were divided into the following groups: (i) severe injury with epidural electrical stimulation (injury + stim, n = 15), (ii) severe injury without stimulation (group injury, n = 15), (iii) sham implantation without battery (sham, n = 15), and (iv) a control group, without surgical intervention (control, n = 15). All animals underwent weekly evaluations using the Basso, Beattie, Bresnahan (BBB) locomotor rating scale index, inclined plane, and OpenField test starting one week before the lesion and continuing for eight weeks. After this period, the animals were sacrificed and their spinal cords were explanted and prepared for histological analysis (hematoxylin–eosin) and immunohistochemistry for NeuN, β-III-tubulin, synaptophysin, and Caspase 3. Finally, NeuN-positive neuronal nuclei were quantified through stereology; fluorescence signal intensities for β-tubulin, synaptophyin, and Caspase 3 were quantified using an epifluorescence microscope. The injury + stim group showed significant improvement on the BBB scale compared with the injured group after the 5th week (p < 0.05). Stereological analysis showed a significantly higher average count of neural cells in the injury + stim group in relation to the injury group (1783 ± 2 vs. 897 ± 3, p < 0.001). Additionally, fluorescence signal intensity for synaptophysin was significantly higher in the injury + stim group in relation to the injury group (1294 ± 46 vs. 1198 ± 23, p < 0.01); no statistically significant difference was found in β-III-tubulin signal intensity. Finally, Caspase 3 signal intensity was significantly lower in the stim group (727 ± 123) compared with the injury group (1225 ± 87 p < 0.05), approaching levels observed in the sham and control groups. Our data suggest a regenerative and protective effect of epidural electrical stimulation in rats subjected to impact-induced traumatic spinal cord injury. [ABSTRACT FROM AUTHOR]

Background: Electrical burns are potentially devastating injuries. Scalp defects following electrical burns present as a reconstructive challenge. The factors influencing decision-making in the repair of scalp defects are their size, depth and location, and integrity of surroundings. A successful reconstruction must result in less morbidity, decreased hospitalization time, and good aesthetic appearance preserving the hairline. The rationale for the study is to study the epidemiology of post-electrical burns scalp defects and to propose an algorithm for their reconstruction. Methods: This retrospective study includes 95 patients with post-electrical burns scalp defects from Jan 2013 to Dec 2022. Patients admitted with scalp defects resulting from electrical injuries were initially resuscitated. Once deemed fit for surgery, they underwent wound debridement. Due to the progressive tissue necrosis associated with electrical burns, multiple debridements were necessary. Various methods were employed to reconstruct the scalp defects based on the specific nature of the defect, including primary closure, skin grafting, and the use of flaps. Follow-up visits were scheduled weekly for the first month and then monthly for the subsequent six months. Results: 52 patients had pericranium intact for which SSG was performed. 43 cases had loss of pericranium for which local flaps were given in 36 cases. In 2 patients skin traction by stainless steel wires was done. Sequestrectomy + Tensor fascia lata Graft with Bipedicle Advancement Flap cover was done for a patient with osteomyelitis of bone. Regional Vertically placed Trapezius Myocutaneous flap was done in 3 cases and for one case Free Anterolateral thigh flap was given. Conclusion: Reconstruction of post-electrical burn scalp defects should follow the reconstructive ladder. Reconstructive strategies are to be adapted based on defect size, depth, presence or absence of pericranium. If pericranium is intact - split-thickness skin grafting can be done. If pericranium is lost - a flap cover is to be given. Local flaps are the ideal choice for the reconstruction of scalp defects due to their easy availability, and minimal complications. [ABSTRACT FROM AUTHOR]

Numerous studies have demonstrated the potential of non-invasive brain stimulation (NIBS) techniques as a viable treatment option for cerebellar ataxia. However, there is a notable dearth of research investigating the efficacy of NIBS specifically for hereditary ataxia (HA), a distinct subgroup within the broader category of cerebellar ataxia. This study aims to conduct a comprehensive systematic review and meta-analysis in order to assess the efficacy of various NIBS methods for the treatment of HA. A thorough review of the literature was conducted, encompassing both English and Chinese articles, across eight electrical databases. The focus was on original articles investigating the therapeutic effectiveness of non-invasive brain stimulation for hereditary ataxia, with a publication date prior to March 2023. Subsequently, a meta-analysis was performed specifically on randomized controlled trials (RCTs) that fulfilled the eligibility criteria, taking into account the various modalities of non-invasive brain stimulation. A meta-analysis was conducted, comprising five RCTs, which utilized the Scale for the Assessment and Rating of Ataxia (SARA) as the outcome measure to evaluate the effects of transcranial magnetic stimulation (TMS). The findings revealed a statistically significant mean decrease of 1.77 in the total SARA score following repetitive TMS (rTMS) (p=0.006). Subgroup analysis based on frequency demonstrated a mean decrease of 1.61 in the total SARA score after high-frequency rTMS (p=0.05), while no improvement effects were observed after low-frequency rTMS (p=0.48). Another meta-analysis was performed on three studies, utilizing ICARS scores, to assess the impact of rTMS. The results indicated that there were no statistically significant differences in pooled ICARS scores between the rTMS group and the sham group (MD=0.51, 95%CI: -5.38 to 6.39; p=0.87). These findings align with the pooled results of two studies that evaluated alterations in post-intervention BBS scores (MD=0.74, 95%CI: -5.48 to 6.95; p=0.82). Despite the limited number of studies available, this systematic review and meta-analysis have revealed promising potential benefits of rTMS for hereditary ataxia. However, it is strongly recommended that further high-quality investigations be conducted in this area. Furthermore, the significance of standardized protocols for NIBS in future studies was also emphasized. [ABSTRACT FROM AUTHOR]

This paper introduces the development of an integrated data-based Electric Vehicle Accident Alert System (EVAAS), which is powered by Machine Learning, the Internet of Things(IoT), and cloud computing for better road safety & emergency handling by electric vehicles. The ESP8266-based system processes real-time GPS data using a K-Nearest Neighbors (KNN) classification algorithm to determine the likelihood of accidents in particular regions. When a crash happens, the EVAAS system will automatically send an SOS alert with accurate positioning data to one's pasted emergency contacts. EVAAS features a modular, plug-and-play design with an intuitive web interface for device registration and cloud integrations. Every device has a unique identifier linked to it on registration, so setup is easy and if need be quickly deployed in cars. Information from accidents is recorded continuously, and accident locations that are found get included in the ML model to increase prediction accuracy over time (the system teaches itself). This involves the use of Google Firebase for cloud services to enable enterprisegrade scalable and consistent data management. By converging the powers of IoT, ML and cloud technologies, we deliver resilient technology that is adaptable to changing EV-specific safety requirements, offering a human-centred approach. This paper also presents the architecture of EVAAS; model developments, IoT, and cloud integration are the focus of this study. We will also show performance measurements, detailing how accurate/fast/and scalable the system is. We end by discussing potential future improvements and externalities of such systems to enhance road safety in the era of electric mobility. [ABSTRACT FROM AUTHOR]

We sought to investigate the value of combining intrauterine cerebral blood flow changes with brain electrical activity examination in evaluating the prognosis of brain injury. A total of 90 preterm infants were enrolled and divided into 2 groups: the brain damaged preterm infants group (n = 55) and the nonbrain damaged preterm infants group (n = 35). The diagnostic efficacy of combining intrauterine cerebral blood flow changes with electroencephalogram (EEG) activity examination in predicting the prognosis of preterm infants with brain injury was evaluated using T-test. Pearson linear correlation was applied to analyze the relationship between fetal intrauterine cerebral blood flow changes combined with electrical activity examination and the prognosis of brain injury. Significant differences were seen in pulse index, the ratio of peak systolic velocity to end diastolic velocity ratio, and other indexes between the 2 groups (P < 0.05). The combined approach of intrauterine cerebral blood flow changes with EEG activity examination demonstrated significantly higher values for area under the curve, sensitivity and negative predictive value compared to using intrauterine cerebral blood flow changes or EEG activity examination alone (P < 0.05). A positive correlation was found between fetal intrauterine cerebral blood flow and electrical activity examination (P < 0.05). Combining the assessment of intrauterine cerebral blood flow changes with cerebral electrical activity examination proved beneficial in diagnosing the prognosis of brain injury and provided an important reference for early clinical intervention. [ABSTRACT FROM AUTHOR]

Background: One of the main causes of injury and death in children under 5 years of age is accidents. Lack of awareness about preventive measures against these accidents and having a belief that these accidents are inevitable are major issues in Iran. This study aims to investigate and categorize the interventions recommended for preventing accidents in children under 5 years of age. Materials and Methods: This scoping review was conducted in 2023. A search was conducted for the related studies in databases including Scopus, ISI, MEDLINE, Embase, Proquest, Cochrane Library, Emerald, MagIran, IranDoc, MoH thesis database and MoH articles database using the keywords "incident", "accident," "emergency," "injury," "disaster," "road traffic," "child," "intervention," "preparedness," and "prevention." The search was conducted on studies published in English or Persian, from 2000 to 2023. To assess the quality of the selected articles, the critical appraisal skills program (CASP) checklist was used. The data were analyzed using content analysis method in MAXQDA software, version 20. Results: The initial search yielded 1495 articles. After removing duplicates and irrelevant articles, and reading abstracts, and full texts, 41 studies (3 theses and 38 articles) were selected for the review. We produced 234 codes, 45 for interventions to prevent man-made disasters, 157 for interventions to prevent domestic accidents, 18 for interventions to prevent burn and electrical accidents and 14 for interventions to prevent traffic accidents. Conclusion: To prevent accidents in children under five years of age, there is a need for comprehensive efforts. Proper education for parents, teaching children about safe behaviors, installing appropriate safety equipment, and paying attention to the living environment of children can help reduce accidents in these children. [ABSTRACT FROM AUTHOR]

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Electrical burn injuries can be catastrophic, threatening severe disability or mortality. We present a patient who suffered from electrical shock, requiring bilateral above-knee amputations, right trans-radial amputation, renal replacement therapy, and veno-arterial extracorporeal life support (VA ECLS) therapy. While there exist reports of cases that have demonstrated the potential use of ECLS in burn patients with cardiogenic shock or acute respiratory distress syndrome, this is a unique case of VA ECLS use for an electrical injury patient who developed mixed distributive–obstructive shock secondary to pulmonary embolism and sepsis. Given the wide variety of morbidities that can result from electrical burns, VA ECLS is a promising tool for those who require cardiopulmonary support refractory to traditional measures. [ABSTRACT FROM AUTHOR]

Introduction and aim. Electrical injuries can be life-threatening and prompt interventions can save lives. Cardiac complications like arrhythmias and sudden cardiac death are common after electric shock. Certain ECG abnormalities can persist after successfully reviving the patient which can mimic ST-Elevation occlusive myocardial infarction. This case report aims to inform the treating emergency physicians about this rare association of ST-Elevation in anterior leads after electric shock. Introduction and aim. Electrical injuries can be life-threatening and prompt interventions can save lives. Cardiac complications like arrhythmias and sudden cardiac death are common after electric shock. Certain ECG abnormalities can persist after successfully reviving the patient which can mimic ST-Elevation occlusive myocardial infarction. This case report aims to inform the treating emergency physicians about this rare association of ST-Elevation in anterior leads after electric shock. Conclusion. ST-Elevations in ECG can occur after electric shock injury and their cause is rarely due to occlusion of the coronaries. Hence thrombolysis in such cases is rarely needed and supportive management is required. [ABSTRACT FROM AUTHOR]

The article discusses the practice of treating burns in Pakistan and highlights the belief of the common people in seeking treatment from non-medical professionals. The author shares a personal experience where a handyman insists on taking his son to a pakora vendor to apply a homemade ointment on a burn, instead of going to a hospital. The article emphasizes the importance of proper burn treatment, such as washing with tap water and applying soothing cream, and criticizes the lack of burn units in hospitals. It also suggests that effective communication and understanding patients' stories are crucial in building trust and confidence in medical professionals. [Extracted from the article]

The article focuses on investigating whether electrical impedance tomography (EIT) can detect the onset and progression of ventilator-induced lung injury (VILI) in an animal model of VILI. It is reported that the study involved a retrospective analysis of healthy female domestic pigs ventilated for 48 hours, aiming to assess changes in lung electrical impedance compared to other parameters such as oxygenation, respiratory mechanics, and lung pathology.

Background: Although several complications of transcranial motor-evoked potentials (Tc-MEPs) have been reported, reports of arrhythmias during Tc-MEP are very rare. Case presentation: A 71-year-old woman underwent transforaminal lumbar interbody fusion under general anesthesia, with intraoperative Tc-MEP monitoring. Preoperative electrocardiography showed an incomplete right bundle branch block but no cardiovascular events in her life. After induction of anesthesia, Tc-MEP was recorded prior to the surgery. During the Tc-MEP monitoring, electrocardiography and arterial blood pressure showed a second-degree atrioventricular block, but it improved rapidly at the end of the stimulation, and the patient was hemodynamically stable. Tc-MEP was recorded seven times during surgery; the incidence of P waves without QRS complexes was significantly higher than before stimulation. The surgery was uneventful, and she was discharged eight days postoperatively without complications. Conclusions: Our case suggests that electrical stimulation for Tc-MEP can cause arrhythmia. Electrocardiography and blood pressure must be closely monitored during Tc-MEP monitoring. [ABSTRACT FROM AUTHOR]

Background/Objectives: The anxiolytic effect of transcutaneous electrical nerve stimulation (TENS) is associated with the activation of endogenous inhibitory mechanisms in the central nervous system. Both low-frequency, high-amplitude TENS (LF-TENS) and high-frequency, low-amplitude TENS (HF-TENS) are capable of activating opioid, GABA, serotonin, muscarinic, and cannabinoid receptors. However, there has been no comparative analysis of the effectiveness of HF-TENS and LF-TENS in the treatment of GAD. The purpose of our research was to study the effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of patients with GAD compared with sham TENS. Methods: The effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of GAD was studied using Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hamilton Anxiety Rating Scale (HAM-A). 40 patients underwent sham TENS, 40 patients passed HF-TENS (50 Hz—50 μs—sensory response) and 41 patients completed LF –TENS (1 Hz—200 μs—motor response) for 30 days daily. After completion of treatment, half of the patients received weekly maintenance therapy for 6 months. Electroencephalography was performed before and after treatment. Results: Our study showed that a significant reduction in the clinical symptoms of GAD as assessed by GAD-7 and HAM-A was observed after HF-TENS and LF-TENS by an average of 42.4%, and after sham stimulation only by 13.5% for at least 2 months after the end of treatment. However, LF-TENS turned out to be superior in effectiveness to HF-TENS by 51% and only on electroencephalography leads to an increase in PSD for the alpha rhythm in the occipital regions by 24% and a decrease in PSD for the beta I rhythm in the temporal and frontal regions by 28%. The prolonged effect of HF-TENS and LF-TENS was maintained without negative dynamics when TENS treatment was continued weekly throughout the entire six-month observation period. Conclusions: A prolonged anxiolytic effect of direct TENS of the right median nerve has been proven with greater regression of clinical and neurophysiological manifestations of GAD after LF-TENS compared to HF-TENS. Minimal side effects, low cost, safety, and simplicity of TENS procedures are appropriate as a home treatment modality. [ABSTRACT FROM AUTHOR]

Electric scooter (ES)-related injuries are increasing but poorly described. Clinicians need more information to be prepared for these patients. We supposed two prevalent patterns of patients: mildly injured (predominant upper-limb injuries) and severely injured (predominant head trauma). This study aims to understand the frequency of ES-related injuries and patients' characteristics despite the heterogeneity of data currently available. A systematic review with a proportion meta-analysis was conducted on studies with a multidisciplinary description of ES-related injuries in adult patients (PROSPERO-ID: CRD42022341241). Articles from inception to April 2023 were identified in MEDLINE, Embase, and Cochrane's databases. The risk of bias was evaluated using ROBINS-I. Twenty-five observational studies with 5387 patients were included in the meta-analysis, depending on reported data. Upper-limb (31.8%) and head (19.5%) injuries are the most frequent (25/25 studies included). When injured while riding, 19.5% of patients are intoxicated with drugs/alcohol, and only 3.9% use a helmet, increasing the possibility of severe injuries. About 80% of patients are victims of spontaneous falls. Half of the patients self-present to the ED, and 69.4% of cases are discharged directly from the ED. Studies' limitations include an overall moderate risk of bias and high heterogeneity. Electric scooter-related accidents are commonly associated with upper-limb injuries but often involve the head. Spontaneous falls are the most common mechanism of injury, probably related to frequent substance abuse and helmet misuse. This hot topic is not adequately investigated due to a lack of data. A prospective registry could fill this gap. [ABSTRACT FROM AUTHOR]

Electrical burn injuries (EBIs) represent an important subset of burn injuries, but the information on them from the global level is limited. We aimed to investigate the characteristics and risk factors for EBIs reported to the World Health Organization Global Burn Registry. Patients with EBIs and non-EBIs were identified from the registry. Patient demographics, income of the country, setting of the injury occurred, and outcomes were described and compared. Multivariable analysis was performed to identify risk factors associated with the EBIs and their outcomes. Of the 9276 patients, 814 (8.8%) were grouped as EBIs. EBIs patients had a median age of 28 years, and they were predominantly males (89.2%). EBIs were more likely to occur in lower-middle- and low-income countries (60.9% versus 43.4%) and in an occupational setting (49.1% versus 6.7%) than the non-EBIs. Older age, male, lower-income, and occupational and public setting were risk factors for EBIs. For EBIs patients, adolescents and young adults, those from low-middle and low-income countries, and those injured by high-voltage electricity were more likely to have more than 15% of the total body surface area. In addition, those from low-middle and low-income countries and those injured by high-voltage electricity were more likely to die. The characteristics of EBIs are significantly different from that of non-EBIs. To prevent EBIs and avoid unpleasant outcomes, particular attention should be given to adolescent boys and young adult men who are employed in electrical jobs in lower-income countries. • Characteristics and risk factors for EBIs were reported from a global scale. • The characteristics of EBIs are significantly different from that of non-EBIs. • Special attention should be paid to male electrical workers from low-income countries. [ABSTRACT FROM AUTHOR]

Access to literature on clozapine in Russian language remains strikingly limited. We aimed to identify and translate clinical evidence on clozapine-based treatment outcomes. We performed a systematic review in PubMed, Embase and scientific indexes from former USSR states searching for articles published in Russian from the database inception till January 2023 and summarized the data in a scoping review (PROSPERO Reg. Number CRD42023386737). A total of 60 papers were included comprising eight main topic categories: 1) clozapine-related intoxications (n = 20), 2) effectiveness/efficacy and safety of clozapine treatment (n = 14), 3) adverse drug-induced reactions (ADRs) related to clozapine treatment (n = 9), 4) therapeutic drug monitoring for clozapine (n = 5), 5) combination of clozapine and non-pharmacological treatments (n = 4), 6) pharmacoepidemiology of clozapine (n = 3), 7) effects of clozapine on the brain electrical activity (n = 3), and 8) novel clozapine formulations (n = 2). Among clozapine-related intoxications there were reports of criminal poisoning, which was associated with low lethality. Worse outcomes were accompanied by systemic reactions to intoxications. Clinical benefits of hemoadsorption were reported in the management of clozapine-related intoxications. Only half of studies reporting clozapine effectiveness used standardized scales to assess outcomes. Clozapine superiority in treatment-resistant schizophrenia (TRS) was replicated in one trial. No reports of clozapine-related agranulocytosis were identified. Clozapine ranked among most prescribed antipsychotics for TRS and non-TRS. As clinical research in former USSR states is advancing to adopt western clinical research standards, comparability and extrapolation of findings is expected to increase, with transfer of older findings to clinical practice being particularly challenging. [ABSTRACT FROM AUTHOR]

The use of non-lethal weapons has spread worldwide, being introduced as an alternative to firearms in many countries such as the United States or the United Kingdom. Among non-lethal weapons, conducted electrical weapons have been adopted worldwide, to control unruly suspected criminals or to neutralise violent situations. The stun gun belongs to this category and is the most widely available, with more than 140,000 units in use by police officers in the field in the US, and an additional 100,000 electrical stun guns owned by civilians worldwide. In Italy, the use of conducted electrical weapons by law enforcement has only recently been introduced, with private use and commercialisation still prohibited, mainly due to controversies related to the potential dangers of such devices. Before the official adoption, several experiments had to be carried out, with mechanisms that reproduced the ballistics of the stun gun. Here we present the case of a man who suffered a self-injury trauma to his hand during a ballistics exercise with a crossbow loaded with stun gun probes. [ABSTRACT FROM AUTHOR]

Spinal cord injury is a condition affecting the central nervous system, causing different levels of dysfunction below the point of nerve damage. A 50-year-old woman suffered a neck injury as a result of a car accident. After undergoing posterior cervical C3-C6 internal fixation with titanium plates on one side and C7 lamina decompression, the patient, who had been diagnosed with C3-C7 cervical disk herniation and spinal stenosis causing persistent compression of the spinal cord, was transferred to the rehabilitation department. After implementing the combined therapy of Virtual Reality-based arm and leg cycling along with transcutaneous electrical stimulation of the spinal cord, the patients experienced a notable enhancement in both sensory and motor abilities as per the ASIA scores. The patient's anxiety and depression were reduced as measured by the Hamilton Anxiety and Hamilton Depression Tests. As evaluated by the SCIM-III, the patient's self-reliance and capacity to carry out everyday tasks showed ongoing enhancement, leading to the restoration of their functionality. Hence, the use of Virtual Reality-based arm and leg cycling along with transcutaneous electrical spinal cord stimulation has potential to positively impact function in patients with spinal cord injury. However, as this is a case report, the small number of patients and the fact that the intervention was initiated early after the injury, we were unable to separate the recovery due to the intervention from the natural recovery that is known to occur in the initial weeks and months after SCI. Therefore, further randomized controlled trials with a large sample size is necessary. [ABSTRACT FROM AUTHOR]

Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health. [ABSTRACT FROM AUTHOR]

High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia. [ABSTRACT FROM AUTHOR]

Individuals with mental health problems are at higher risk of musculoskeletal diseases. However, the association between low muscle mass (LMM) and anxiety symptoms remains uninvestigated. This cross-sectional study enrolled 174,262 adults (73,833 women, 100,429 men), aged 18 to 89, who completed the anxiety scale and body composition analyses. Using bio-electrical impedance analysis, skeletal muscle mass index (SMI) was calculated based on appendicular skeletal muscle mass (ASM) (kg)/height (m2). LMM was defined as SMI < 7.0 kg/m2 in men and <5.4 kg/m2 in women. Anxiety symptoms were screened using the Clinical Useful Anxiety Outcome Scale (CUXOS) with cut-off scores of 20, 30, and 40. Multivariable logistic regression analyses were performed. LMM prevalence was 20.17% in women, 3.86% in men (p < 0.001). The prevalence of anxiety symptoms in LMM group decreased from mild (CUXOS > 20: women, 32.74%, men, 21.17%) to moderate (CUXOS > 30: 13.34%, 7.32%), to severe anxiety symptoms (CUXOS > 40: 4.00%, 1.73%). In multivariable-adjusted models, LMM was associated with mild (aOR (95% confidence interval)), women, 1.13 (1.08–1.17); men, 1.17 (1.08–1.27)), moderate (1.17 (1.11–1.24); 1.35 (1.19–1.53) and severe anxiety symptoms (1.18 (1.07–1.3), 1.36 (1.06–1.74)), demonstrating an increased risk of ORs with escalating anxiety severity. LMM was independently associated with a higher prevalence of anxiety symptoms. [ABSTRACT FROM AUTHOR]

Oil–paper insulation is the critical insulation element in the modern power system. Under a harsh operating environment, oil–paper insulation will deteriorate gradually, resulting in electrical accidents. Thus, it is important to evaluate and monitor the insulation state of oil–paper insulation. Firstly, this paper introduces the geometric structure and physical components of oil–paper insulation and shows the main reasons and forms of oil–paper insulation's degradation. Then, this paper reviews the existing condition assessment techniques for oil–paper insulation, such as the dissolved gas ratio analysis, aging kinetic model, cellulose–water adsorption isotherm, oil–paper moisture balance curve, and dielectric response technique. Additionally, the advantages and limitations of the above condition assessment techniques are discussed. In particular, this paper highlights the dielectric response technique and introduces its evaluation principle in detail: (1) collecting the dielectric response data, (2) extracting the feature parameters from the collected dielectric response data, and (3) establishing the condition assessment models based on the extracted feature parameters and the machine learning techniques. Finally, two full potential studies are proposed, which research hotspots' oil–paper insulation and the electrical–chemical joint evaluation technique. In summary, this paper concludes the principles, advantages and limitation of the existing condition assessment techniques for oil–paper insulation, and we put forward two potential research avenues. [ABSTRACT FROM AUTHOR]

Positive end-expiratory pressure (PEEP) is an important component of mechanical ventilation, especially in acute respiratory distress syndrome (ARDS). Optimizing PEEP is crucial for lung protection and minimizing the risk of ventilator-induced lung injury. PEEP prevents alveolar collapse and reduces stress and strain on the lungs. The response to PEEP varies among patients, so it is important to assess individual lung recruitability. The application of PEEP can have a significant impact on clinical outcomes, and different methods can be used to optimize PEEP settings. However, there is no consensus on the best method, and integrating these objectives into clinical practice can be challenging. [Extracted from the article]

Burn—by flame, flush, scald, electrical, and chemical types—accounts for 5%–12% of trauma injuries worldwide. In Iranian studies, females were the main victims of domestic burns with higher mortality and frequencies. This retrospective study evaluates the epidemiology and etiology of burn injuries in females aged 25–64 years between October 2007 and May 2022 in southern Iran. Demographics and burn etiology information were collected by questionnaires at admission. Univariate and multivariate regression analysis was used to determine the relationship between variables and burn mortality. Pearson's Chi-Square and One-way ANOVA tests were utilized to compare different burn etiologies. Of 3212 females with burn injuries, 1499 (46.6%) were included with a mean age of 38.5 ± 10.8 years. Flame (59.7%) and flush (28.9%) were significantly the most common injuries mechanism. Burn was most common in rural areas (53.9%) and indoor settings (62.1%) (P -value <.001). 77.9% of the population were under-diploma (P -value <.001), and 3.5% were divorced with higher burn-suicide attempts. The mean Total Body Surface Area (TBSA%) was 41.1 ± 28.3%, and the mean Length of Stay (LOS) was 14.5 ± 13.2 days with a 39.1% mortality rate. With univariate and multivariate analysis, TBSA%, indoor places, flame, flush, and urban living were risk factors for burn mortality. Briefly, flame in indoor settings is the most common type of burn injury affecting adult females with lower educational levels living in rural areas. Such epidemiological studies of burns in adult females may be helpful for health policymakers to develop burn prevention programs. [ABSTRACT FROM AUTHOR]

Chronic pain, a complex and debilitating condition, poses a significant challenge to both patients and healthcare providers worldwide. Conventional pharmacological interventions often prove inadequate in delivering satisfactory relief while carrying the risks of addiction and adverse reactions. In recent years, electric neuromodulation emerged as a promising alternative in chronic pain management. This method entails the precise administration of electrical stimulation to specific nerves or regions within the central nervous system to regulate pain signals. Through mechanisms that include the alteration of neural activity and the release of endogenous pain-relieving substances, electric neuromodulation can effectively alleviate pain and improve patients' quality of life. Several modalities of electric neuromodulation, with a different grade of invasiveness, provide tailored strategies to tackle various forms and origins of chronic pain. Through an exploration of the anatomical and physiological pathways of chronic pain, encompassing neurotransmitter involvement, this narrative review offers insights into electrical therapies' mechanisms of action, clinical utility, and future perspectives in chronic pain management. [ABSTRACT FROM AUTHOR]

Most human spinal cord injuries are anatomically incomplete, leaving some fibers still connecting the brain with the sublesional spinal cord. Spared descending fibers of the brainstem motor control system can be activated by deep brain stimulation (DBS) of the cuneiform nucleus (CnF), a subnucleus of the mesencephalic locomotor region (MLR). The MLR is an evolutionarily highly conserved structure which initiates and controls locomotion in all vertebrates. Acute electrical stimulation experiments in female adult rats with incomplete spinal cord injury conducted in our lab showed that CnF-DBS was able to reestablish a high degree of locomotion five weeks after injury, even in animals with initially very severe functional deficits and white matter lesions up to 80– 95%. Here, we analyzed whether CnF-DBS can be used to support mediumintensity locomotor training and long-term recovery in rats with large but incomplete spinal cord injuries. Rats underwent rehabilitative training sessions three times per week in an enriched environment, either with or without CnFDBS supported hindlimb stepping. After 4  weeks, animals that trained under CnF-DBS showed a higher level of locomotor performance than rats that trained comparable distances under non-stimulated conditions. The MLR does not project to the spinal cord directly; one of its main output targets is the gigantocellular reticular nucleus in the medulla oblongata. Long-term electrical stimulation of spared reticulospinal fibers after incomplete spinal cord injury via the CnF could enhance reticulospinal anatomical rearrangement and in this way lead to persistent improvement of motor function. By analyzing the spared, BDA-labeled giganto-spinal fibers we found that their gray matter arborization density after discontinuation of CnF-DBS enhanced training was lower in the lumbar L2 and L5 spinal cord in stimulated as compared to unstimulated animals, suggesting improved pruning with stimulation-enhanced training. An on-going clinical study in chronic paraplegic patients investigates the effects of CnF-DBS on locomotor capacity. [ABSTRACT FROM AUTHOR]

Background. Traumatic spinal cord injury is a medical condition which often results in disability and mortality. The most common lesion was cervical level, which is around 60-75% of all cases, where at this level there is a risk of respiratory problems which often require mechanical ventilation. Case report. In the case discussed, a 28-years-old male was referred from other hospital with traumatic cervical spinal cord injury (C5-C6) ASIA score A with a history of falling from a height of 3 meters. The patient underwent decompressive laminectomy on the tenth day of onset, followed by mechanical ventilation. During treatment, the patient received pharmacological therapy, tracheostomy, acupuncture, physiotherapy, and neuromuscular electrical stimulation for ventilator weaning. The patient was hospitalized for 66 days, with mechanical ventilation duration for 32 days. Conclusions. Factors that can influence the duration of ventilation weaning are the level and severity of spinal cord injury, time of transfer to a health facility, and complications related to ventilator installation. Multidisciplinary management, including pharmacological, physiotherapy, acupuncture, surgical, neuromuscular electrical stimulation, can increase the chances and decreasing the duration of mechanical ventilation, and reducing complications related to spinal cord injury and prolonged ventilation. [ABSTRACT FROM AUTHOR]

Background: The proliferation of electric scooters globally has been associated with an increase in related injuries and consequent economic burden. This study aims to assess the injury patterns and the economic impact associated with electric scooter use in Melbourne, Australia. Methods: A retrospective cohort study was conducted using hospital and registry data from January 2022 to January 2023. Data collected included demographic details, alcohol and helmet use, injury type and severity, operative treatment provided, and direct medical costs. The economic impact (in AUD) of the patient's emergency presentation and hospital admission was calculated. Results: During the study period, 256 electric scooter related injuries were recorded, comprising 247 riders and nine pedestrians. The majority of patients were males (69%) with a median age of 29.5 (15–78). Alcohol use was reported by 34% and helmet use by 33%. Injuries most commonly affected the upper limb (53%) and head (50%), with abrasions (75%) and fractures (48%) being the most common type of injury sustained. The total hospital cost was $1 911 062, and the median cost was $1321.66 per patient (IQR: $479.37–$5096.65). Conclusion: Electric scooter usage, as observed through patient presentations to the Royal Melbourne Hospital, is associated with a considerable number of injuries, primarily among young males, and an ensuing substantial economic burden. The findings underscore the urgent need for improved safety measures to minimize electric scooter‐related injuries and their clinical and economic repercussions. [ABSTRACT FROM AUTHOR]