The wound mechanism, injury characteristics and treatment principles of anti-armored vehicle ammunition against armored crew in the past 20 years are summarized in this paper. Shock vibration, metal jet, depleted uranium aerosol and post armor breaking effect are the main factors for wounding armored crew. Their prominent characteristics are severe injury, high incidence of bone fracture, high rate of depleted uranium injury, and high incidence of multiple/combined injuries. During the treatment, attention must be paid on that the space of armored vehicle is limited, and the casualties should be moved outside of the cabin for comprehensive treatment. Especially, the management of depleted uranium injury and burn/inhalation injury are more important than other injuries for the armored wounds.
Humans ; Uranium/analysis* ; Respiratory Aerosols and Droplets ; Motor Vehicles ; Burns/therapy* ; Multiple Trauma

Introduction: Road traffic accidents are a growing public health burden, especially in the low- and middle-income countries (LMICs). With resource scarcity, road traffic injuries may lead to poor quality of life among survivors, or deaths at worst. Victims of crashes involving transportations are gendered; therefore, there may be differences in the trends and characteristics of injuries sustained by men and women related to road crash. Objectives: This study aimed to determine the factors related to severity of road crashes among women road users in the Philippines from 2008 to 2017. Methods: We conducted a retrospective review of clinical records of women patients involved in road crash at the Trauma Division, Department of Surgery of the Philippine General Hospital (PGH) for the ten-year period, January 1, 2008 to December 31, 2017. Data were extracted from the electronic patient records in Integrated Surgical Information System (ISIS). Results: From 2008 to 2017, 926 of the road crash victims brought to PGH were women. There was an increasing trend, with the years 2015 to 2017 accounting for half of the total cases (55.62%). The highest cases of women patient admissions were also recorded during the months of June and July (5.61%). The CALABARZON region (11.23%) and National Capital Region (8.21%) had the highest admissions. The patients were most commonly pedestrians (12.20%) and involved in collisions (13.50%) or vehicle involvement (13.17%). The most common vehicle involved was a motorcycle (9.72%) followed by car and vans (1.62%). Only a small proportion of women patients used helmets (3.33%) and seatbelts (0.12%). The median length of hospital stay of women patients was 5 days. The most commonly sustained injuries among patients were multiple (83.65%), external (43.72%), extremity (33.15%), head and neck (23.47%), and face (21.58%) injuries. Among these, injuries to the extremity had the highest average length of hospital stay (16.04 ± 31.28 days) while external and head and neck injuries had the shortest (10.81 ± 33.42 days). Multinomial regression showed that women patients who suffered from head and neck, and abdominal injuries had increased odds of dying by 4.94 times (CI: 2.158-11.302, p < 0.05), and 3.33 times (CI:1.235-9.02, p < 0.05), respectively, compared to those who did not suffer said injuries. Conclusion There is a significant number of women involved in road crashes in the Philippines, and therefore, there is a need for directed policies on female road users as vulnerable road users.
Accidents ; Women ; Motor Vehicles ; Length of Stay ; Hospitalization

Objective: To analyze the mortality level and tendency of road traffic injury in Shandong province from 2012 to 2020. Methods: Based on the data of road traffic deaths from the cause of death registration system in Shandong province from 2012 to 2020, the mortality rates of road traffic injury were calculated by sex, age, area, and injury type. The mortality was standardized based on the age structure of the Chinese population in the sixth Population Census in 2010. The annual percent change (APC) and average annual percent change (AAPC) of the mortalities and the standarized mortalities were calculated by using Joinpoint regression model, and the trends were also examined. Results: In 2020, the crude mortality of road traffic injury in Shandong Province was 15.58/100 000, and the standardized mortality was 12.90/100 000. From 2012 to 2020, the standardized mortality of road traffic injury in Shandong province showed a downward trend with AAPC of -5.4%. The standardized mortality of middle-south mountain areas, male and children aged 0-14 years in Shandong showed a significantly decreasing trend with AAPC of -6.8%, -6.1% and -6.0%, respectively. The standardized mortality of people aged 65 years and over did not decrease significantly, but the number of deaths increased significantly by 50.96% in 2020 (5 780 cases), compared with those in 2012 (3 829 cases). The standardized mortality of pedestrian and motorcyclists decreased significantly with AAPC of -7.5% and -6.7%, respectively. There was no significant change in the standardized mortality among people who rode motor vehicles or bicycles. Conclusion: From 2012 to 2020, the standardized mortality of road traffic injury in Shandong Province showed an obvious downward trend, but the standardized mortality of people aged 65 years and over did not decrease significantly. In the future, it is still necessary to take government-led, multi-sectoral collaboration, with a focus on comprehensive preventive measures, to further reduce road traffic injury mortality.
Accidents, Traffic ; Asian People ; Child ; Government ; Humans ; Male ; Mortality ; Motor Vehicles

Isolated posterolateral corner (PLC) injury associated with a Schatzker type 2 fracture is a very rare combination of injuries. A male who was driving a motor vehicle was injured after a collision accident. The plain radiographs and computed tomography scans of the knee showed a Schatzker type 2 fracture of the tibial plateau, mostly in the anterolateral portion of tibial plateau, and an avulsion fragment on the fibular tip. Magnetic resonance imaging showed no injury to cruciate ligaments, medial collateral ligament, or any meniscal injury. We performed an open reduction operation and internal fixation for treating the fracture. Six months later, he complained of instability. At 11 months later after initial operation, we performed the second operation for stabilizing the PLC. We present here a rare case of an isolated PLC injury associated with a Schatzker type 2 fracture. We discuss the mechanism of injury and review similar cases.
Collateral Ligaments ; Humans ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Male ; Motor Vehicles ; Tibial Fractures

PURPOSE: Vehicle-pedestrian conflicts are common at road intersections when traffic lights change. However, the impact of traffic light on transportation safety and efficiency remains poorly understood. METHODS: A two-stage study was used to survey the proportion of intersections with conflicting traffic lights and the related transportation efficiency and safety were evaluated as well. First, a cross-sectional study estimated the proportion of signalized intersections with conflicting left-turning vehicle-pedestrian traffic lights in Changsha city, China. Second, a natural experiment compared transportation efficiency and safety between intersections with and without conflicting left-turning vehicle-pedestrian traffic lights. Risky conflicts, where motor vehicles violated laws and failed to yield to pedestrians in crosswalk were used as a surrogate for transportation safety. The number of motor vehicles and pedestrians passing through the intersections per second and per meter were used to estimate transportation efficiency. Data were collected and analyzed in 2015 (from March to December). A search of online news from domestic media sources was also conducted to collect pedestrian injury data occurring at the intersections. RESULTS: About one-fourth (57/216) intersections had conflicting left-turning traffic lights (95% CI: 20.5%, 32.3%). Risky vehicle-pedestrian conflicts were more frequently observed at intersections with conflicting lights compared to those without (incidence rate ratio (IRR) = 3.13; pedestrians: IRR = 4.02), after adjusting for type of day (weekday vs. weekend), the time period of observation, and motor vehicles traffic flow. Intersections without conflicting vehicle-pedestrian traffic lights had similar transportation efficiency to those with conflicting lights after controlling for covariates (p > 0.05). The systematic review of news media reports yielded 10 left-turning vehicle-pedestrian crash events between 2011 and 2017, involving 11 moderate or severe pedestrian injuries and 3 fatal pedestrian injuries. CONCLUSION Over one-fourth of road intersections in Changsha city, China have conflicting left-turning traffic lights. Conflicting traffic lights cannot improve transportation efficiency, but increase risky conflicts between vehicles and pedestrians.
Accidents, Traffic ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Cross-Sectional Studies ; Humans ; Motor Vehicles ; statistics & numerical data ; Pedestrians ; statistics & numerical data ; Safety ; Time Factors ; Wounds and Injuries ; epidemiology

Late-onset Brown-Séquard syndrome (BSS) is a rare condition resulting from a spinal cord injury that develops weeks to years after a blunt trauma. Acute-onset BSS after a blunt injury has been rarely reported. Here, we report on a case of BSS, in a 58-year-old man, that developed immediately after a motor vehicle accident. Upon admission, loss of right thoracic motion, complete right paresis, and loss of pain and temperature sensations below the C3 level on the left side were observed. Magnetic resonance imaging showed hyperintensities within the cervical spinal cord at the C2–C3 level, confirming the diagnosis of BSS. Thoracic motion rapidly recovered, but other neurological sequelae persisted. BSS related to cervical cord injury should be suspected when patients develop hemiparesis and contralateral sensory loss immediately after a blunt trauma. Likewise, clinicians should be aware that unilateral loss of thoracic motion could be an important sign of BSS.
Brown-Sequard Syndrome ; Cervical Cord ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Motor Vehicles ; Paresis ; Sensation ; Spinal Cord Injuries ; Wounds, Nonpenetrating

With the recent legalization of recreational cannabis in Canada and 11 states of the U.S., the interest surrounding cannabis use is increasing. However, many people and even clinicians in Korea do not have exact knowledge about the psychiatric consequences of cannabis use. In this narrative review, the characteristics of cannabis, the endocannabinoid system, and the psychiatric consequences of cannabis use were provided. Cannabis contains more than 80 cannabinoids in the native plant. Psychotropic properties of Δ-9-tetrahydrocannabinol and cannabidiol are most well studied. The two main receptors are cannabinoid-1 receptor and cannabinoid-2 receptor. Several endocannabinoids, such as anandamide and 2-arachidonoylglycerol, act on the receptors as the endogenous ligands. Cannabis influences mood, cognitive functions, and psychomotor functions in acute phase responses, increasing the odds ratio for motor vehicle crashes. Long-term cannabis use is associated with various psychotic outcomes, including the development of schizophrenia, although there is interindividual variability. Cannabis adversely influences learning, memory, and attention. More frequent, persistent, and earlier onset cannabis use is associated with greater cognitive impairment. The chronic cognitive effects of cannabis are complex and controversial. Cannabis has addictive potential, and cannabis use disorder is common. Clinicians should have evidence-based knowledge about the consequences of cannabis use and communicate accurate information about cannabis use and its associated risks to the public.
Canada ; Cannabidiol ; Cannabinoids ; Cannabis ; Cognition ; Cognition Disorders ; Endocannabinoids ; Korea ; Learning ; Ligands ; Marijuana Abuse ; Memory ; Motor Vehicles ; Odds Ratio ; Plants ; Psychoses, Substance-Induced ; Schizophrenia

BACKGROUND: In a cluster-randomized trial, the Safety and Health Involvement For Truck drivers intervention produced statistically significant and medically meaningful weight loss at 6 months (−3.31 kg between-group difference). The current manuscript evaluates the relative impact of intervention components on study outcomes among participants in the intervention condition who reported for a postintervention health assessment (n = 134) to encourage the adoption of effective tactics and inform future replications, tailoring, and enhancements. METHODS: The Safety and Health Involvement For Truck drivers intervention was implemented in a Web-based computer and smartphone-accessible format and included a group weight loss competition and body weight and behavioral self-monitoring with feedback, computer-based training, and motivational interviewing. Indices were calculated to reflect engagement patterns for these components, and generalized linear models quantified predictive relationships between participation in intervention components and outcomes. RESULTS: Participants who completed the full program-defined dose of the intervention had significantly greater weight loss than those who did not. Behavioral self-monitoring, computer-based training, and health coaching were significant predictors of dietary changes, whereas behavioral and body weight self-monitoring was the only significant predictor of changes in physical activity. Behavioral and body weight self-monitoring was the strongest predictor of weight loss. CONCLUSION: Web-based self-monitoring of body weight and health behaviors was a particularly impactful tactic in our mobile health intervention. Findings advance the science of behavior change in mobile health intervention delivery and inform the development of health programs for dispersed populations.
Body Weight ; Health Behavior ; Linear Models ; Motivational Interviewing ; Motor Activity ; Motor Vehicles ; Occupational Health ; Telemedicine ; Weight Loss

BACKGROUND: Since the presence of a co-driver can be considered as a companion, partner, or friend for a driver through eliminating driver's loneliness, it plays a significant role in health and safety of drivers. The objective of this study was to investigate the effect of co-drivers on depression and occupational stress on male truck drivers. METHODS: This study was an interventional case-control study. Seventy truck drivers were selected and divided into two groups: case (33 truck drivers with co-drivers) and control (37 truck drivers without co-drivers). Two Goldberg depression inventories (for evaluating driver's depression) and the Karasek job content questionnaire (for evaluating driver's job stress) were used to collect data which were completed by interview. RESULTS: The results showed that job content values for the case group were higher in all dimensions except job nature. The comparison of the percentages showed significant difference between two groups. Depression rate in drivers with co-driver is truly less than depression rate in drivers without co-driver. There was significant positive relationship between dimensions of job content and depression rate. CONCLUSION: According to the results of this study, it can be claimed that a co-driver decreases stress and loneliness of drivers, as well as increases work performance and job satisfaction, and, in turn, leads to a decrease in job-related depression.
Case-Control Studies ; Depression ; Equipment and Supplies ; Friends ; Humans ; Job Satisfaction ; Loneliness ; Male ; Motor Vehicles ; Work Performance

BACKGROUND: Despite improvements in safety performance, the number and severity of mining-related injuries remain high and unacceptable, indicating that further reduction can be achieved. This study examines occupational accident statistics of the Ghanaian mining industry and identifies priority areas, warranting intervention measures and further investigations. METHODS: A total of 202 fatal and nonfatal injury reports over a 10-year period were obtained from five mines and the Inspectorate Division of the Minerals Commission of Ghana, and they were analyzed. RESULTS: Results of the analyses show that the involvement of mining equipment, the task being performed, the injury type, and the mechanism of injury remain as priorities. For instance, mining equipment was associated with 85% of all injuries and 90% of all fatalities, with mobile equipment, component/part, and hand tools being the leading equipment types. In addition, mechanics/repairmen, truck operators, and laborers were the most affected ones, and the most dangerous activities included maintenance, operating mobile equipment, and clean up/clearing. CONCLUSION: Results of this analysis will enable authorities of mines to develop targeted interventions to improve their safety performance. To improve the safety of the mines, further research and prevention efforts are recommended.
Accidents, Occupational ; Ghana ; Hand ; Minerals ; Miners ; Mining ; Motor Vehicles