Age-specific characteristics of road traffic injuries among children and adolescents in South Korea

OBJECTIVE

Road traffic injuries (RTIs) are the leading cause of mortality among children and adolescents. This study aimed to identify and compare the age-specific epidemiology, clinical characteristics and factors related to severe RTIs among children and adolescents who had RTIs.

METHODS

This multicenter cross-sectional study was conducted using data collected between January 2011 and December 2018 in the Emergency Department-based Injury In-depth Surveillance registry in South Korea. A total of 66,632 participants younger than 19 years who presented with RTIs to emergency departments (EDs) were classified under three age groups: preschoolers (age 0-6 years, n = 18,694), elementary school student (age 7-12 years, n = 21,251), and middle and high school student (age 13-18 years, n = 26,687). Data on demographic and injury-related factors were analyzed, and multivariate logistic regression was used to determine the factors related to severe RTIs, which were defined as the Excess Mortality Ratio-based Injury Severity Score ≥16.

RESULTS

RTIs among children and adolescents were more common in boys (71.0%), during weekdays (39.7%), in the summer (31.1%), and between 12 noon and 6 pm (47.9%). The most common type of road users were passengers (preschoolers, 46.4%) and cyclists (age 7-12 years and age 13-18 years, 50.1% and 36.2%, respectively). The proportion of head injury was highest in the preschoolers group (57.3%). The length of ED stay, Excess Mortality Ratio-adjusted Injury Severity Score, and the proportion of intensive care unit admission increased with age. Nighttime (0-6 am), vulnerable road users (motorcyclists, bicyclists, and pedestrians), and use of emergency medical services were significantly associated with severe injury.

CONCLUSIONS

The three age groups of patients younger than 19 years with RTIs differed in the types of road user, proportions of injured body regions, and clinical outcomes. In an effort to reduce RTIs to children and adolescents, age-specific focused intervention should be considered. Additionally, the injury severity was found to be associated with nighttime occurrence, vulnerable road users, ED visit through emergency medical services, and nonuse of safety devices across all age group.

SARS-CoV-2 molecular diagnostic point-of-care testing based on loop-mediated isothermal amplification: A prospective, single-center validation study

Objectives

Rapid and accurate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic tests are crucial for controlling the spread of infections in emergency settings. This study evaluated the diagnostic accuracy of a point-of-care (POC) test based on loop-mediated isothermal amplification (LAMP) that produces rapid results within 30 min.

Methods

We prospectively included adult patients (age >19 years) who were diagnosed with SARS-CoV-2 infection within the last 3 days and symptomatic patients who had visited the emergency room. Posterior nasopharyngeal (PNP) swabs and throat swabs collected by physicians were used to test the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and Cohen's Kappa coefficient (k) of the POC index and reference reverse transcription quantitative polymerase chain reaction (RT-qPCR) test devices.

Results

Of the 352 participants, 102 (29.0%) tested positive via the RT-PCR-based reference test device; the RT-LAMP-based POC test had a sensitivity of 70.6% and specificity of 98.0%, with 93.5% PPV, 89.1% NPV, 35.5% PLR, and 3.4% NLR. Cohen's k correlation of results from the two devices was 0.74. The cycle threshold value between the positive and negative POC test results differed (17.6 vs. 24.6, p < 0.001).

Conclusions

The RT-LAMP POC test in the emergency medical setting has a fair predictive value in high viral load cases in terms of infectivity.

Effects of Occupational Stress and Health Behaviors on Heart Rate Variability in Live-Fire Instructors

OBJECTIVES

This study aimed to identify the association between the healthrelated characteristics and the subscales of occupational stress of live fire instructors and heart rate variability (HRV).

METHODS

We conducted questionnaire survey on a general health checkup for 15 live fire instructors. Occupational stress and HRV parameters were measured to determine the association between health behavior, including smoking, drinking, exercise, and sleep-related disorders, and occupational stress of live fire instructors and HRV parameters using Spearman's rank correlation coefficient.

RESULTS

Smoking, insomnia, and job insecurity, a subscale of occupational stress measurement, showed negative Spearman rank correlations with HRV.

CONCLUSIONS

Insomnia, smoking, and job insecurity (due to occupational stress) among live fire instructors were associated with decreased HRV.

Comparison of the epidemiology and injury profile among injured patients involved in special purpose vehicle-related incidents in South Korea

Injuries caused by mobile machinery or special purpose vehicles (SPVs) can lead to high socio-medical cost and fatality. In this descriptive study, we compared the epidemiology and injury profile of injured patients involved in SPVs-related incidents. We analyzed a nationwide database of SPV-related injured patients between January 2011 and December 2016. Injured patients were classified into three groups: pedestrian, motor vehicle occupant (MVO), and SPV operator groups. Of 1,419 cases, the highest number of SPV-related injured patients were found in the age group 40-59 years (671 cases, 47.3%) and at transport area (771 cases, 54.3%). The injury was most severe in the SPV operator group. The lower extremities were the most common fracture site, and intrathoracic injury was the most common visceral regions for SPV-related injured patients. SPV operator could lead to fatal intrathoracic injuries.

Clinical phenomenology of mental disorders caused by Qigong exercise

One hundred and nine patients with mental disorders caused by Qigong psychophysical exercise deviation are studied. These patients were divided into schizophrenic type (47 cases) and neurotic type (62 cases) and were analyzed by standard psychiatric rating scales and improved Minnesota multiphasic personality inventory (MMPI). The results show that patients with Qigong deviation presented abnormalities in perception, thinking, and behavior of varying degree. The clinical characteristics could not be classified into extent psychiatric disease units. Most of these patients manifested specific physical symptoms of Qigong deviation. The authors suggest that this kind of mild, benign mental disorder associated with the unique culture of our country be studied to contribute to the study of the classification of mental disorders. Qigong triggered disorders usually normalized during short term follow-up.

Influence of group selective reagents in tissues containing alpha- and beta-adrenoceptors

N-ethylmaleimide which is known to react irreversibly with free -SH groups of protein when incubated with rabbit aorta (alpha-adrenoreceptor) or atria (beta-adrenoreceptor) markedly depressed the dose-response curves of norepinephrine isomers in the aorta but not in atria. Dithiothreitol, a reagent which reduces S-S linkages caused a parallel shift of the dose-response curves of both isomers to an equal degree in aorta. However, in atria the reagent drastically and selectively reduced the maximal effects of (+)-norepinephrine and dopamine. This selective alteration of the (+)-isomer by the reagent probably reflects the conformational changes at the beta-adrenoreceptor. The concentrations of N-ethylmaleimide and dithiothreitol required to alter the activity of norepinephrine isomers was higher for atria than for aorta. It may be that alpha-adrenoreceptors are more susceptible than the beta-adrenoreceptors on the -SH group selective reagents. In the highest concentration tested, two other reagents 2,4-dimethoxybenzylamine and N-acetylimidazole, did not influence the activity of the steroisomers on aorta. In the presence of dithiothreitol, the pharmacologic effects of a nonadrenoreceptor stimulant drug, histamine was potentiated on aorta (H1) and not on atria (H2). Results are discussed in the light of similarity and dissimilarity of adrenoreceptors as reflected by the group selective reagents and the stereoisomers.