Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.
중대재해 처벌 등에 관한 법률의 등장으로 사업주와 경영책임자 및 법인 등은 산업현장에서 안전사고를 예방하기 위해 안전관리자를 대폭 늘리고, ISO 취득 등 많은 투자와 노력을 하고 있다. 또한 SSMS(Smart Safety Management System)을 도입하여, 인원의 관리 및 안전보호구의 관리 또한 진행되고 있다. 작업자의 생명을 보호하는 안전보호구에서 안전모, 안전고리, 안전복에는 IoT 기반의 관리 시스템이 적용되고 있지만 안전화의 경우 현장 관리자와 개인에게 맡겨지고 있고 여전히 안전사고에 취약한 상황이다. 이에 따라 본 연구에서는 현장 출입 시 작업자의 안전화 또한 착용 여부를 사전에 파악할 수 있도록 Raspberry PI 기반의 Sensor 인식 장비를 구현해 착용 여부를 확인하고 안전화 미착용으로 발생될 수 있는 사고를 예방하는 것을 목표로 한다.
Andy Darma;Katsuhiro Arai;Jia-feng Wu;Nuthapong Ukarapol;Shin-ichiro Hagiwara;Seak Hee Oh;Suporn Treepongkaruna;Endoscopy Subcommittee of the Scientific Committee Asian Pan-Pacific Society of Pediatric Gastroenterology and Hepatology and Nutrition (APPSPGHAN)
Purpose: The impact of coronavirus 2019 (COVID-19) on gastrointestinal (GI) endoscopy procedures in adults has been reported, with a drastic reduction in the number of procedures. However, there are no sufficient data regarding the impact on pediatric GI endoscopy. Here, we aimed to report that impact in the Asia-Pacific region. Methods: A questionnaire-based internet survey was conducted from June to November 2021 among pediatric endoscopy institutions in the Asia-Pacific region, with each institution providing a single response. Overall, 25 questions focused on the impact of the number of procedures conducted, the usage of personal protective equipment (PPE), and endoscopy training programs during the pandemic. Results: A total of 162 institutions across 13 countries in the Asia-Pacific region participated in the study, and 133 (82.1%) institutions underwent procedure changes since the emergence of COVID-19. The number of esophagogastroduodenoscopy and ileocolonoscopy procedures decreased in 118/133 (88.7%) and 112/133 (84.2%) institutions, respectively. Endoscopy for patient with positive COVID-19 in an emergency or urgent cases still carried out in 102/162 (62.9%) institutions. Screening of COVID-19 for all patients before endoscopy was done across 110/162 (67.9%) institutions. PPE recommendations varied among institutions. Pediatric gastrointestinal endoscopy training programs were discontinued in 127/162 (78.4%) institutions. Conclusion: This study reports the impact of the COVID-19 pandemic on pediatric gastrointestinal endoscopy in the Asia-Pacific region. There has been a significant reduction in the number of endoscopic procedures and relevant training programs.
In this study, 50 ABE-type hard hats were procured from five certified commercial manufacturers, and shock absorption tests were conducted in accordance with Protective Equipment Safety Certification Notice No. 2020-35. The tests were performed under both high- and low-temperature conditions, adhering to safety helmet testing standards. The highest shock transmission ranges were recorded in the tests, with an average energy range of 2,600-4,108 N at high temperatures and 2,316-3,991 N at low temperatures. All five hard hat models demonstrated a maximum transmitted impact force below 4,450 N, without any loss of cap and attachment functionality, confirming their compliance with performance standards. Furthermore, we evaluated the side impact performance of the safety helmets of each company, with an average range of 4,722-5,267 N. Company A exhibited the lowest measurement at 4,722 N. Comparing these results with international safety standards and the national shock absorption test criteria, it was observed that the maximum transmitted shock value using government-specified impact weight falls within the range of 4,450-5,000 N. However, it was noted that developed countries have established specific standards for the side impact forces on safety helmets, which are legally mandated. Consequently, it is imperative for South Korea to enhance its safety helmet side impact performance test methodology to align with domestic standards in the future.
Su Su Hlaing;Satoko Kubota;Kohei Makita;Ye Tun Win;Hnin Thidar Myint;Hiroichi Kono
Animal Bioscience
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제37권3호
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pp.547-554
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2024
Objective: This study aimed to identify the relationship between bovine brucellosis prevalence, farmers' knowledge, attitude, practice (KAP), and social factors on migratory draft cattle and smallholder dairy farms in the central dry zone of Myanmar. Methods: This cross-sectional study was conducted on 54 migratory and 38 dairy cattle farms between August 2020 and February 2021. A structured questionnaire was used to identify farmers' behaviors. Bulk milk was sampled and tested using indirect enzyme-linked immunosorbent assay (I-ELISA). STATA 17 was used for all the analyses. Results: Migratory cattle farms had a higher farm level brucellosis prevalence (14.8%) than dairy farms (2.6%; χ2 = 3.75; df = 1; p = 0.05). Only 2.8% of the farmers had knowledge about brucellosis, while 39.1% and 41.6% had attitudes and farm practices with respect to brucellosis, respectively in the study area. Socio-economic attribute of training in animal husbandry (p<0.01), raising system (p<0.01), practice of separating the aborted cow (p<0.01) were negatively associated to brucellosis. The overall farm level brucellosis prevalence was strongly associated with cattle herd size (p = 0.01), free movement grazing practices (p<0.01), practice of self-removal of placental debris without using personal protective equipment (p<0.01) and farmers' attitudes towards eating cow placenta debris (p<0.01). Conclusion: Farmers had little knowledge of brucellosis. Attitudes and practices differed significantly between migratory and dairy farmers. Training and extension programs are necessary to make farmers aware of their KAP situation since livestock migration and the custom of eating cow placental debris contribute to the spread of brucellosis. Persistent efforts are required to reduce the adverse effects of brucellosis. Therefore, the study suggests that a feasible control intervention and public awareness campaigns need to be conducted regarding methods of preventing human exposure to brucellosis.
We analyzed risk factors of coastal gillnet fishers during fishing process and considered work safety measures to reduce safety accidents during fishing using a UWB (ultra wideband) based positioning system. The static position accuracy of the UWB based positioning system was 45 cm. When entering a port, there is a risk of falling overboard. When casting a net, there was a risk of falling overboard due to being hit by fishing gear or guards, or getting caught in a buoy line or sinker line. When hauling a net, there is a risk of getting caught between fishing gear and net hauler, and the risk of musculoskeletal disorders due to repetitive work over a long period of time. Most safety accidents during work on fishing boats are blamed on human errors of the fisher and skipper, but safety accidents occur due to a mixture of mechanical and equipment factors, work and environmental factors, and management factors in addition to human errors. Therefore, the 4E were presented as countermeasures against the 4M, which are causes of safety accidents, and the proposed measures were used to identify risk factors for operation process, comply with work safety rules, and ensure the wearing of personal protective equipments. We need to reduce safety accidents during work by making it part of our daily routine. These research results can be used in the future for optimal placement of fishing gear and fishing nets in other coastal industries where safety accidents occur frequently.
Objectives: This study aims to identify and analyze the exposure status of welding students in specialized high school welding labratories, compare it with the exposure to welding hazards of industrial workers, and seek to improve the educational environment for youth through domestic and international exposure standards. Methods: This study compares the level of exposure to hazardous factors in a welding laboratory of a vocational high school in Jeollanam-do and a welding process in a general industrial site by measuring the work environment. A 10-question survey was conducted to review the effects of welding hazards on the human body, carcinogenicity information, international (US, UK, France) exposure standards, general characteristics between the two groups, and awareness of occupational health. Results: Exposure to hazardous factors in both groups was below the standards set by MOEL. Specialized high school students were exposed to higher levels than workers, and some hazardous factors exceeded the standards when compared to international exposure standards. During the survey, students were less aware of the hazards of welding, safety and health education, and the need for work environment measurement than workers. Conclusions: For the respiratory protection of students in vocational high school welding labs, it is necessary to create a comfortable training environment. Exposure standards for harmful factors should be strictly applied, such as overseas standards, or exposure should be limited by setting a limit on the number of hours of welding practice per week. In addition, it is necessary to conduct safety and health education for welding students to raise their awareness of the importance of measuring the working environment and wearing appropriate protective equipment.
Adalva V. Couto Lopes;Cleide F. Teixeira;Mirella B.R. Vilela;Maria L.L.T. de Lima
Safety and Health at Work
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제15권2호
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pp.181-186
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2024
Background: This study aimed to analyze the trend of occupational noise-induced hearing loss (ONIHL) in Brazilian workers at a metallurgical plant with a hearing conservation program (HCP), which has been addressed in a previous study. Methods: All 152 workers in this time series (20032018) participated in the HCP and used personal protective equipment. All annual audiometry records in the company's software were collected from the electronic database. The trend of ONIHL was analyzed with the joinpoint regression model. The hearing thresholds of ONIHL cases at the end of the series were compared with those found in a national reference study. Results: The binaural mean hearing thresholds at 3, 4, and 6 kHz at the end of the series were higher for ages ≥50 years, exposures ≥85 dB (A), time since admission >20 years, and maintenance workers. Significance was found only in the group divided by age. There was an increasing time trend of ONIHL, though with a low percentage variation for the period (AAPC = 3.5%; p = 0.01). Hearing thresholds in this study differed from the reference one. Conclusion: Despite the unmet expectation of a stationary trend in the study period, the time pace of ONIHL evolution did not follow what was expected for a population exposed to noise. These findings signal to the scientific community and public authorities that good ONIHL control is possible when HCP is well implemented.
Thanawat Khajonklin;Yih-Min Sun;Yue-Liang Leon Guo;Hsin-I Hsu;Chung Sik Yoon;Cheng-Yu Lin;Perng-Jy Tsai
Safety and Health at Work
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제15권2호
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pp.220-227
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2024
Background: Though the artificial neural network (ANN) technique has been used to predict noise-induced hearing loss (NIHL), the established prediction models have primarily relied on cross-sectional datasets, and hence, they may not comprehensively capture the chronic nature of NIHL as a disease linked to long-term noise exposure among workers. Methods: A comprehensive dataset was utilized, encompassing eight-year longitudinal personal hearing threshold levels (HTLs) as well as information on seven personal variables and two environmental variables to establish NIHL predicting models through the ANN technique. Three subdatasets were extracted from the afirementioned comprehensive dataset to assess the advantages of the present study in NIHL predictions. Results: The dataset was gathered from 170 workers employed in a steel-making industry, with a median cumulative noise exposure and HTL of 88.40 dBA-year and 19.58 dB, respectively. Utilizing the longitudinal dataset demonstrated superior prediction capabilities compared to cross-sectional datasets. Incorporating the more comprehensive dataset led to improved NIHL predictions, particularly when considering variables such as noise pattern and use of personal protective equipment. Despite fluctuations observed in the measured HTLs, the ANN predicting models consistently revealed a discernible trend. Conclusions: A consistent correlation was observed between the measured HTLs and the results obtained from the predicting models. However, it is essential to exercise caution when utilizing the model-predicted NIHLs for individual workers due to inherent personal fluctuations in HTLs. Nonetheless, these ANN models can serve as a valuable reference for the industry in effectively managing its hearing conservation program.
Objectives To evaluate the neuroprotective effects of modified Yuldahanso-tang (MYH) in a Parkinson's disease mouse model. Methods 1) Four groups (each of 8 rats per group) were used in this study. 2) The neuroprotective effect of MYH was examined in a Parkinson's disease mouse model. C57BL/6 mice treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 30 mg/kg/day), intraperitoneal (i.p.) for 5 days. 3) The brains of 2 mice per group were removed and frozen at $-20^{\circ}C$, and the striatum-substantia nigra part was seperated. The protein volume was measured by Bradford method following Bio-Rad protein analyzing kit. Using mouse/Rat Dopamine ELISA Assay Kit. 4) The brains of 2 mice per group were separated and removed. TH-immunohistochemical was examined in the MPTP-induced Parkinson's disease mice to evaluate the neuroprotective effects of MYH on ST and SNpc. 5) Two mice out of each group were anesthetized and skulls were opened from occipital to frontal direction to take out the brains. The brains added TTC solution for 20 minutes for staining. 6) The water tank used for morris water maze test was filled with $28^{\circ}C$ water, and a round platform of 10cm in diameter was installed for mice to step on. The study was carried out once a day within 30 seconds, keep exercising to step on the platform in the pool. 7) The brains of two mice out of each group were fixed in 10% formaldehyde solution and paraphillin substance was infiltrated. They were fragmented by microtome, and observed under an optical microscope after Hematoxylin & Eosin staining. 8) A round acrylic cylinder with its upper side open was filled with clean water and depressive mouse models were forced to swim for 15 minutes. After 24 hours the animals were put in the same equipment for 5 minutes and were forced to swim. 9) The convenient, simple, and accurate high-performance liquid chromatography (HPLC) method was established for simultaneous determination of Neurotransmitters in MPTP-MYH group. Results 1) MYH possess Dopamine cell protective effect on MPTP-induced injury in striatum and substantia nigra pars compacta. 2) MYH inhibits the loss of tyrosine hydroxylase-immunoreacitive (TH-IR) cells in the striatum and substantia nigra pars compacta on MPTP-induced injury in C57BL/6 mice. 3) MYH possesses improvement effect on MPTP-induced memory deterioration in C57BL/6 mice through the reduction of prolongated Sort of lost time by MPTP injection using the Morris water maze test. 4) MYH possesses hippocampal neuron protective effect on MPTP-induced injury in C57BL/6 mice. 5) MYH possesses improvement effect on MPTP-induced motor behaviour deficits and depression in C57BL/6 mice through the reduction of prolongated losing motion by MPTP injection using the Forced swimming test. 6) MYH increases serotonin product amount on MPTP-induced injury in C57BL/6 mice. Conclusions This experiment suggests that the neuroprotective effect of MYH is mediated by the increase in Dopamin, TH-ir cell, Hippocampus and Serotonin. Furthermore, MYH essential oil may serve as a potential preventive or therapeutic agent regarding Parkinson's disease.
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