Pedestrian Safety in Compact and Mixed-Use Urban Environments: Evaluation of 5D Measures on Pedestrian Crashes

This study examined the impact of density, diversity, design, distance to transit, and destination accessibility, five measures, known as the 5Ds, that characterize the built environment, on pedestrian–vehicle crashes in Seoul, Korea. Using spatial analysis based on 500-m grid cells, this study employed negative binomial regression models on the frequencies of three specific types of pedestrian–vehicle crashes: crashes causing death, major injury, and minor injury to pedestrians. Analysis shows that compact and mixed-use urban environments represented by 5D measures have mixed effects on pedestrian safety. Trade-off effects are found between a higher risk for all types of pedestrian crashes, and a lower risk for fatal pedestrian crashes in 5D urban environments. As a design variable, a higher number of intersections is more likely to increase some types of pedestrian crashes, including fatal crashes, a finding which warrants policy attention to promote pedestrian safety near intersection areas. This study also confirms an urgent need to secure the travel safety of pedestrians near public transit stations due to the higher risk of pedestrian crashes near such facilities. Various destinations, such as retail stores, traditional markets, and hospitals, are associated with pedestrian crashes. Pedestrian safety measures should be implemented to reduce the likelihood of pedestrian crashes near major destination facilities.

Endovascular Treatment of Innominate Artery Bifurcation Injury with Balloon-Expandable Covered Stents Utilizing Kissing Stent Technique

Major injury of the innominate artery is traditionally treated with an open repair which is technically challenging, associated with large volumes of blood loss and prolonged operative times. Endovascular treatment with covered stent placement across the injury is an attractive alternative. However, placement of a single covered stent across the innominate artery bifurcation into one of its distal branches will not prevent bleeding because of retrograde perfusion from the unstented branch distal to the bifurcation. Here, we report a case of successful endovascular repair of one such injury involving the innominate artery bifurcation with ongoing extravasation into the mediastinum. The injury was successfully treated by utilizing 2 balloon-expandable covered stents placed in kissing fashion from the innominate artery into both of its distal branches. This technique of parallel covered stent placement across a bifurcation could effectively repair bifurcation injuries while maintaining patency of both distal branches.

A Cross-Sectional Observation on Maximal Eccentric Hamstring Strength in 7- to 15-Year-Old Competitive Alpine Skiers

Severe knee injuries are common in alpine skiing and the hamstring muscles are known to counteract the anterior tibial displacement that typically accompanies major injury mechanisms. This study aimed to assess the Maximal Eccentric Hamstring Strength (MEHS) of youth competitive alpine skiers during Nordic Hamstring Exercise (NHE) in terms of dependence of sex, age and biological maturation. A total of 246 7- to 15-year-old skiers were tested with respect to their MEHS using an NHE-based measurement device (Vald Performance, Newstead, Australia). Significantly greater absolute MEHS was observed in skiers of the under 15 years (U15) category compared to skiers under 10 years old (U10) (227.9 ± 61.1 N vs. 142.6 ± 28.9 N; p < 0.001), also when grouped by sex. Absolute MEHS was revealed to be lower in U15 females compared to males (213.5 ± 49.0 N vs. 241.9 ± 68.4 N; p = 0.001); in U10 skiers there was no sex difference. For all age groups and sexes, absolute MEHS values were significantly correlated with age and biological maturation (p < 0.001). However, when normalized to body weight such associations disappeared, which is why this is strongly recommended when testing around their growth spurt. Overall, this study established sport-specific normative reference data that may be of interest to researchers and sport practitioners alike.

A Unique Marine-Derived Collagen: Its Characterization towards Biocompatibility Applications for Tissue Regeneration

Biomedical engineering combines engineering and materials methods to restore, maintain, improve, or replace different types of biological tissues. In tissue engineering, following major injury, a scaffold is designed to support the local growth of cells, enabling the development of new viable tissue. To provide the conditions, for the mechanical and structural properties needed for the restored tissue and its appropriate functioning, the scaffold requires specific biochemical properties in order to ensure a correct healing process. The scaffold creates a support system and requires a suitable material that will transduce the appropriate signals for the regenerative process to take place. A scaffold composed of material that mimics natural tissue, rather than a synthetic material, will achieve better results. Here, we provide an overview of natural components of marine-derived origin, the collagen fibers characterization schematic is summarized in the graphical abstract. The use of collagen fibers for biomedical applications and their performances in cell support are demonstrated in an in vitro system and in tissue regeneration in vivo.

Child Injury Burden and Risk Profile in a Bangladeshi Rural Community: an Age-Group Related Overview

Background:Child injury was a growing public health problem in Bangladesh. Recent information on variation in patterns of non-fatal injury, severity, and risk-profile in rural Bangladeshi children was unavailable. This study aimed to determine current burden of non-fatal injury and risks considering severity in disability-days in child age-groups in a rural community. Methods: This cross-sectional study was conducted in randomly chosen children (<18-year) from selected households of village-clusters with pretested semi-structured questionnaires and checklist for household-environment between May-June 2018 in selected sub-district. Besides descriptive analysis, Chi-square test and Odds Ratio with 95% Confidence Interval (CI) were calculated for identifying risk profiles. An injury was considered minor when regular activities were hampered <30 days and major when ≥30 days. A minor injury must have occurred in the previous three months and a major injury in previous year.Results:For 918 children, prevalence of major and minor injury were 2.4 (95% CI 1.5-3.6) and 7.4 (95% CI 5.8-9.3) with highest in 5-9 and 1-4-year respectively. Commonest pattern was fall injury, followed by cut injury, transport injury and burn for both major and minor type, with variations in age-groups. For major-injury, risks included male gender (OR 4.6, 95% CI 1.5-18.9), dumped garbage (OR 5.0, 95% CI 1.5-26.7), and exclusive/complementary use of non-electric power-source (OR 5, 95% CI 1.2-16.1). For minor-injury, risks for all age groups were ≥5 working hours/day of a mother (OR 2.8, 95% CI 1.2-7.2), supervision of <6 children during her works (OR 3.2, 95% CI 1.05-13) and open fireplaces (OR 3.2, 95% CI 1.3-7.2). When analysis of minor injury considering specific age-groups was done, mothers’ ≥5 working hours and child-supervision were particularly found risky for 1-4 year; open fireplaces for 5-9 year; along with male gender, uneducated mothers for 10-14 year. Conclusions: Prevalence of major and minor injuries were though lower, still required intervention for further reduction and the variabilities in burden, patterns, severity and risks among age-groups could be considered for prioritizing interventions. As risk characteristics were not well established in a cross-sectional study, further case-control study with a qualitative part was recommended for assimilation of risk-profile to guide policy formulation.

T Cells Plead for Rejuvenation and Amplification; With the Brain’s Neurotransmitters and Neuropeptides We Can Make It Happen

T cells are essential for eradicating microorganisms and cancer and for tissue repair, have a pro-cognitive role in the brain, and limit Central Nervous System (CNS) inflammation and damage upon injury and infection. However, in aging, chronic infections, acute SARS-CoV-2 infection, cancer, chronic stress, depression and major injury/trauma, T cells are often scarce, exhausted, senescent, impaired/biased and dysfunctional. People with impaired/dysfunctional T cells are at high risk of infections, cancer, other diseases, and eventually mortality, and become multi-level burden on other people, organizations and societies. It is suggested that “Nerve-Driven Immunity” and “Personalized Adoptive Neuro-Immunotherapy” may overcome this problem. Natural Neurotransmitters and Neuropeptides: Glutamate, Dopamine, GnRH-II, CGRP, Neuropeptide Y, Somatostatin and others, bind their well-characterized receptors expressed on the cell surface of naïve/resting T cells and induce multiple direct, beneficial, and therapeutically relevant effects. These Neurotransmitters and Neuropeptides can induce/increase: gene expression, cytokine secretion, integrin-mediated adhesion, chemotactic migration, extravasation, proliferation, and killing of cancer. Moreover, we recently found that some of these Neurotransmitters and Neuropeptides also induce rapid and profound decrease of PD-1 in human T cells. By inducing these beneficial effects in naïve/resting T cells at different times after binding their receptors (i.e. NOT by single effect/mechanism/pathway), these Neurotransmitters and Neuropeptides by themselves can activate, rejuvenate, and improve T cells. “Personalized Adaptive Neuro-Immunotherapy” is a novel method for rejuvenating and improving T cells safely and potently by Neurotransmitters and Neuropeptides, consisting of personalized diagnostic and therapeutic protocols. The patient’s scarce and/or dysfunctional T cells are activated ex vivo once by pre-selected Neurotransmitters and/or Neuropeptides, tested, and re-inoculated to the patient’s body. Neuro-Immunotherapy can be actionable and repeated whenever needed, and allows other treatments. This adoptive Neuro-Immunotherapy calls for testing its safety and efficacy in clinical trials.