Urban and rural variation in walking patterns and pedestrian crashes

OBJECTIVE

To examine the urban and rural variation in walking patterns and pedestrian crashes.

DESIGN

The rates of pedestrians being struck by motor vehicles was estimated according to miles walked and resident years.

SETTING

New York State, USA during 2001 through 2002.

PARTICIPANTS

35 732 pedestrians struck by vehicles.

MAIN OUTCOME MEASURES

The adjusted rate ratio (aRR) of pedestrian-vehicle crash and pedestrian injury based on resident years and miles walked according to urban and rural areas.

RESULTS

Compared with rural areas, the aRR for a pedestrian-vehicle collision, based on resident years, was 2.0 (95% CI 1.7 to 2.3) in small urban areas, 1.8 (95% CI 1.5 to 2.3) in mid-size urban areas, and 4.2 (95% CI 3.6 to 4.8) in the large urban area. The aRR based on miles walked was 2.3 (95% CI 1.6 to 3.2) in small urban areas, 2.0 (95% CI 1.4 to 2.9) in mid-size urban areas, and 1.9 (95% CI 1.4 to 2.7) in the large area. The aRR for a fatal pedestrian injury, based on miles walked, was 2.1 (95% CI 1.3 to 3.6) in small urban areas, 1.9 (95% CI 1.3 to 2.9) in mid-size urban areas, and 0.9 (95% CI 0.6 to 1.3) in the large urban area.

CONCLUSIONS

The rate of pedestrian crashes and injuries in small and mid-size urban areas was twice that in rural areas, whether based on resident years or miles walked. The high rate of pedestrian crashes in the large urban area based on resident years could be partly explained by the fact that residents in such areas walk about twice as much as residents in rural areas. The rate of fatal pedestrian injury based on miles walked was similar in the large urban area and rural areas.

Farm work-related injury among middle school students in rural China

Farm work-related injuries are considered an important issue facing rural area adolescents. However, little research has been done in developing countries, including China. This study evaluated agricultural work-related injuries among Chinese middle school adolescents, focusing on the potential association between farm work hours, sleep patterns, school-related stress, and farm work-related injuries. This cross-sectional study surveyed 1,551 middle school students in Hunan Province who reported working on farms. The surveys assessed their involvement in farm work, sleep patterns, school activities, and farm work-related injuries during a three-month recall period. The cumulative incidence of farm work-related injury was 15.6% among the 1187 students who reported working on a farm. Average days per month farming, number of pesticide applications per month, sleep disturbances, and school-related stress were significantly associated with farm work-related injuries (p < 0.05). Multivariable logistic regression analysis revealed that after adjusting for possible confounding effects of age, gender, and farm work days per month, sleep disturbance (less than 7 hours of sleep: OR = 2.36, 95% CI = 1.07-5.22; awakening at night and having trouble falling back to sleep: OR = 2.70, 95% CI = 1.36-5.37; having nightmares: OR = 2.24, 95% CI = 1.18-4.24) and school-related stress (difficult homework: OR = 2.45, 95% CI = 1.21-4.99; extra homework assigned often by parents: OR = 3.62, 95% CI = 1.88-6.97; and scolded/chastised by parents for poor school performance: OR = 2.53, 95% CI = 1.75-3.65) were statistically significant risk factors for farm work-related injuries (p < 0.05).

Improving auscultatory blood pressure measurement with electronic and computer technology: the visual auscultation method

BACKGROUND

The auscultatory method is used as the reference standard in all prevalent protocols for validation of noninvasive blood pressure measuring devices, and a validation study is essentially based on the comparison between the device and observer measurements. Thus, the objectivity and accuracy of observer measurements are crucial to the validation result.

METHODS

To provide observers with more objective information about an auscultatory measurement so that sufficient information to make measurements with greater potential objectivity and accuracy can be available, a computerized data acquisition and analysis system has been developed. It cannot only acquire and store Korotkoff sound, cuff pressure, and oscillometric pulse signals, as well as the sphygmomanometer image, but it also can display the waveforms of the three signals and the sphygmomanometer video while playing the synchronous Korotkoff sounds. With this system, observers can make their measurements via the visual auscultation method, that is to say, by watching those waveforms, instead of the sphygmomanometer, while listening for synchronized Korotkoff sounds. The system was validated according to the International Protocol (IP).

RESULTS

The result showed that all the differences between system measurements by the visual auscultation method and observer measurements by the conventional auscultatory method were within 4 mm Hg.

CONCLUSIONS

The visual auscultation method achieved a high degree of accuracy, and human observers can be replaced by the system in the validation study of blood pressure measuring devices.

The antitumor effects of CIK cells combined with docetaxel against drug-resistant lung adenocarcinoma cell line SPC-A1/DTX in vitro and in vivo

3039

Background: Cytokine-induced killer (CIK) cells transfer is now being considered the most promising adoptive cellular therapy strategy. Multidrug resistance (MDR) phenomenon is a major hindrance to the successful chemotherapy of cancer. In this study, the anti-tumor activity of CIK cells combined with docetaxel (DTX) against multidrug resistance SPC-A1/DTX cell line was evaluated in vitro and in vivo. Methods: MTT assay was employed to evaluate the cytotoxic activity of DTX, CIK cells, and DTX plused CIK cells against SPC-A1/DTX cells in vitro. In vivo assay, SPC-A1/DTX cells were injected to nude mice subcutaneously to establish tumor-bearing mice model. On the 14th day, normal saline, docetaxel, CIK cells, and CIK cells combined with docetaxel were administered intraperitoneally respectively. All the nude mice were sacrificed at day 15 after treatment and the tumor were weight out. Results: MTT assay showed that CIK cells possessed a higher antitumor cytotoxic activity against SPC-A1/DTX cells than SPC-A1 cells in vitro (p <0.05). The synergetic anti-tumor activity positively correlated with the E:T ratio and the concertration of docetaxel. The animal data also suggested that CIK cells combined with DTX had a stronger suppressive effect on the tumor growth in vivo. Conclusions: CIK cells plused with docetaxel demonstrated a prominent augmentation of anti-tumor activity against MDR lung adenocarcinoma cell lines both in vitro and in vivo.

No significant financial relationships to disclose.

Unintentional pediatric submersion-injury-related hospitalizations in the United States, 2003

The objective of this study was to examine the demographic characteristics and hospital resource utilization of submersion-injury-related hospitalizations among persons < or =20 years of age in the USA in 2003. All 1475 pediatric submersion-injury-related hospital discharges in the Kids' Inpatient Database were identified by ICD-9-CM diagnosis code or external cause of injury code. These cases represent an estimated 2490 pediatric submersion-injury-related hospitalizations nationwide. Inpatient costs for these estimated hospitalizations were approximately $10 million. The overall pediatric submersion-injury-related rate of hospitalization was 3.0 per 100,000 persons. Children aged 0-4 years had the highest rate of hospitalization (7.7 per 100,000 persons). Children with permanent submersion-injury-related morbidity accounted for 5.8% of hospital admissions and 37.3% of hospital costs in our study, and children with submersion-injury-related in-hospital death accounted for 11.6% of hospital admissions and 20.0% of hospital costs in our study. Prevention of submersion injury using focused, proven strategies deserves increased attention.

Fine mapping of E(kp)-1, a locus associated with silkworm (Bombyx mori) proleg development

The silkworm homeotic mutant E(kp) has a pair of rudimentary abdominal legs, called prolegs, in its A2 segment. This phenotype is caused by a single dominant mutation at the E(kp)-1 locus, which was previously mapped to chromosome 6. To explore the possible association of Hox genes with proleg development in the silkworm, a map-based cloning strategy was used to isolate the E(kp)-1 locus. Five E(kp)-1-linked simple sequence repeat markers on chromosome 6 were used to generate a low-resolution map with a total genetic distance of 39.5 cM. Four additional cleaved amplified polymorphic sequence markers were developed based on the initial map. The closest marker to E(kp)-1 was at a genetic distance of 2.7 cM. A high-resolution genetic map was constructed using nine BC1 segregating populations consisting of 2396 individuals. Recombination suppression was observed in the vicinity of E(kp)-1. Four molecular markers were tightly linked to E(kp)-1, and three were clustered with it. These markers were used to screen a BAC library. A single bacterial artificial chromosome (BAC) clone spanning the E(kp)-1 locus was identified, and E(kp)-1 was delimited to a region less than 220 kb long that included the Hox gene abdominal-A and a non-coding locus, iab-4. These results provide essential information for the isolation of this locus, which may shed light on the mechanism of proleg development in the silkworm and possibly in Lepidoptera.

Hospitalisations for sport-related concussions in US children aged 5 to 18 years during 2000-2004

OBJECTIVES

To describe patient and hospital characteristics associated with hospitalisation for a diagnosis of non-fatal sport-related concussion, and to determine factors associated with these hospitalisations.

METHODS

Children aged 5-18 years with a primary diagnosis of a sport-related concussion in the Nationwide Inpatient Sample (2000-2004) were identified. Length of stay and hospital charges for sport-related concussions were documented. Logistic regression was used to assess the association of patient or hospital characteristics with hospitalisations for sport-related concussion.

RESULTS

Between 2000 and 2004, a total of 755 non-fatal paediatric sport-related hospitalisations for concussion were identified. Nationwide, this represents 3712 hospitalisations and over US$29 million total hospital charges, with nearly US$6 million in total hospital charges per year. Over half (52.3%) of patients with concussion experienced loss of consciousness. Over 80% of the patients hospitalised for concussion received no procedures during their average 1.1 day (median 0.8 day) of hospital stay. Older age, but not gender, was associated with increased odds of sport-related hospitalisations for concussion. Non-teaching hospitals or hospitals in rural areas had significantly greater odds of admitting sport-related concussions versus other sport-related traumatic brain injuries compared with teaching or urban hospitals.

CONCLUSIONS

Management of paediatric sport-related concussions varied, depending on the patient and the hospital. Better guidelines are needed for the identification and management of sport-related concussions. Standardised procedures for hospitals treating concussive injuries may also be warranted.

Compton-scattering cross section on the proton at high momentum transfer

Cross-section values for Compton scattering on the proton were measured at 25 kinematic settings over the range s=5-11 and -t=2-7 GeV2 with a statistical accuracy of a few percent. The scaling power for the s dependence of the cross section at fixed center-of-mass angle was found to be 8.0+/-0.2, strongly inconsistent with the prediction of perturbative QCD. The observed cross-section values are in fair agreement with the calculations using the handbag mechanism, in which the external photons couple to a single quark.

Wheelchair related injuries treated in US emergency departments

OBJECTIVE

To characterize the trend of wheelchair related injuries over time, and describe the demographics and characteristics of wheelchair users' injuries by age group.

METHODS

Data from the National Electronic Injury Surveillance System (NEISS) were analyzed.

RESULTS

In 2003, more than 100,000 wheelchair related injuries were treated in emergency departments in the US, double the number reported in 1991. Tips and falls accounted for 65-80% of injuries across all age groups of wheelchair users. The majority of children's injuries occurred at locations outside of homes and institutions/hospitals in environments with stairs, ramps, and curbs (57.3%). In contrast, injuries among adult users were more likely to occur in homes, hospitals, and institutions (45-90%).

CONCLUSIONS

Wheelchair related injuries may have increased in the US during the past decade. Prevention efforts should address the interacting complex factors that influence risk of injury while using a wheelchair.

Psychological symptoms and nonfatal unintentional injuries among Chinese adolescents: a prospective study

PURPOSE

To describe patterns of nonfatal unintentional injuries and investigate the association of psychological symptoms with injury risk among adolescents in Guangxi, China.

METHODS

Adolescents were selected from middle and high school students in Baise City, Guangxi, China. Psychological symptoms at baseline were measured using SCL-90-R and nonfatal unintentional injuries that occurred among participants were recorded using a standardized injury surveillance questionnaire. Annual injury rates per 100 adolescents by adolescents' demographic and family characteristics were calculated. Student's t-test and the Chi-square test were used to test differences in mean raw scores of SCL-90-R subscales and injury rates. Relative risks and odds ratios of injury with 95% confidence intervals were calculated in univariate analyses and multivariate logistic models.

RESULTS

A total of 1474 middle and high school students finished the study. Of them, 442 reported nonfatal unintentional injuries during the study period, resulting in an annual injury rate of 30.3 per 100 adolescents. Boys had a significantly higher injury rate than girls (32.6% vs. 27.4%). Injury rate decreased as the adolescents' age increased. Compared with adolescents who were not injured, the injured adolescents had higher average raw scores of all subscales of SCL-90-R, with an exception of the subscale for hostility. All SCL-90-R subscales factors, except those for hostility and phobia, were associated with injury risk. After confounding effects of age, gender, and ethnicity were controlled using logistic regression models, SCL-90-R subscales for somatization (OR = 2.00, 95% CI 1.52-2.63), obsessive-compulsiveness (OR = 2.10, 95% CI 1.71-2.58), interpersonal-sensitivity (OR = 1.66, 95% CI 1.34-2.06), depression (OR = 2.00, 95% CI 1.59-2.51), anxiety (OR = 2.08, 95% CI 1.62-2.66), and psychoticism (OR = 1.60, 95% CI 1.26-2.03) were significantly associated with an elevated injury risk.

CONCLUSION

Psychological symptoms are associated with an elevated risk of nonfatal unintentional injury among middle and high school students. Mental health services, such as psychological counseling, may help reduce the risk of nonfatal unintentional injuries among Chinese adolescents.

Non-fatal injuries among adults with activity limitations and participation restrictions

OBJECTIVE

To investigate non-fatal unintentional injuries among adults with activity/participation limitations.

DESIGN

Injuries in the previous 12 months were reported by a stratified probability sample of non-institutionalized adults. Based on self reported activity/participation limitations, 2602 respondents were classified into three groups (no limitations, moderate limitations, and severe limitations) and injury characteristics were compared.

RESULTS

A total of 19.2% of respondents reported activity/participation limitations. Twenty four percent (95% confidence intervals (CI) 14.5% to 33.6%) with severe and 17.8% (95% CI 13.2% to 22.4%) with moderate limitations were injured, compared with 12.6% (95% CI 10.6% to 14.7%) of respondents without limitations. The odds ratio of injury was 3.72 (95% CI 1.94 to 7.14) for respondents with severe and 1.87 (95% CI 1.25 to 2.77) for respondents with moderate limitations. The leading cause of injuries among respondents with activity/participation limitations was falls.

CONCLUSIONS

Individuals with activity/participation limitations are at an increased risk for injuries.