Search Results (462)

Improving construction site safety remains a critical challenge in Saudi Arabia’s rapidly growing construction sector, where high accident rates and diverse labor forces demand evidence-based managerial interventions. This study investigated the influence of Managers’ Safety Perceptions and Practices (MSP) on Workers’ Safety Behaviors (WSB) in the Saudi construction industry, emphasizing the mediating roles of Workers’ Safety Awareness (WSA), Safety Competency (WSC), and Safety Actions (SA). The conceptual framework integrates these three mediators to explain how managerial attitudes and practices translate into frontline safety outcomes. A quantitative, cross-sectional design was adopted using a structured questionnaire distributed among construction workers, supervisors, and project managers. A total of 352 from 384 valid responses were collected, and the data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) via SmartPLS 4. The findings revealed that MSP does not directly influence WSB but has significant indirect effects through WSA, WSC, and SA. Among these, WSC emerged as the most powerful mediator, followed by WSA and SA, indicating that competency is the most critical driver of safe worker behavior. These results provide robust empirical support for a multidimensional mediation model, highlighting the need for managers to enhance safety behaviors not merely through supervision but through fostering awareness and competency, providing technical training, and implementing proactive safety measures. Theoretically, this study contributes a novel and integrative framework to the occupational safety literature, particularly within underexplored Middle Eastern construction contexts. Practically, it offers actionable insights for safety managers, industry practitioners, and policymakers seeking to improve construction safety performance in alignment with Saudi Vision 2030. Full article

Background and Clinical Significance: Traumatic dental injuries, particularly complicated crown fractures of permanent incisors, are common in adolescents, with maxillary central incisors most frequently affected due to their prominent position. These injuries, often resulting from sports or accidents, require prompt management to prevent complications such as pulp necrosis or infection, which can compromise long-term prognosis. Fragment reattachment offers a conservative, esthetically favorable approach when the fractured segment is intact, with outcomes comparable to composite restorations. This case report underscores the importance of timely intervention and advanced restorative techniques in pediatric dentistry. Case Presentation: A 16-year-old male presented with a complicated crown fracture of the upper left central incisor sustained during a soccer game. The fracture extended subgingivally with pulp exposure. The patient preserved the fragment in saline. Treatment involved fragment reattachment using a dentin bonding agent and flowable composite resin, followed by single-visit root canal therapy due to delayed presentation (48 h). A glass fiber post was placed to reinforce the restoration due to significant coronal loss. Three years of follow-up visits (1, 3, 6, 12, 24, and 36 months) revealed no clinical or radiographic complications, with the tooth remaining asymptomatic and functional. Conclusions: This case underscores the effectiveness of fragment reattachment when combined with meticulous technique and long-term monitoring. Full article

Traffic accidents pose a significant threat to public safety, resulting in numerous fatalities, injuries, and a substantial economic burden each year. The development of predictive models capable of the real-time forecasting of post-accident impact using readily available data can play a crucial role in preventing adverse outcomes and enhancing overall safety. However, existing accident predictive models encounter two main challenges: first, a reliance on either costly or non-real-time data, and second, the absence of a comprehensive metric to measure post-accident impact accurately. To address these limitations, this study proposes a deep neural network model known as the cascade model. It leverages readily available real-world data from Los Angeles County to predict post-accident impacts. The model consists of two components: Long Short-Term Memory (LSTM) and a Convolutional Neural Network (CNN). The LSTM model captures temporal patterns, while the CNN extracts patterns from the sparse accident dataset. Furthermore, an external traffic congestion dataset is incorporated to derive a new feature called the “accident impact” factor, which quantifies the influence of an accident on surrounding traffic flow. Extensive experiments were conducted to demonstrate the effectiveness of the proposed hybrid machine learning method in predicting the post-accident impact compared to state-of-the-art baselines. The results reveal a higher precision in predicting minimal impacts (i.e., cases with no reported accidents) and a higher recall in predicting more significant impacts (i.e., cases with reported accidents). Full article

Background: Midfacial fractures are common outcomes of facial trauma. While younger individuals typically sustain these injuries through high-energy events like assaults and traffic or sports accidents, elderly patients increasingly present with fractures from low-energy mechanisms, primarily falls. Purpose: The aim of this study was to analyze age- and gender-specific patterns in midfacial fractures over a 10-year period, with emphasis on elderly individuals and low-energy trauma. Methods: A retrospective review was performed of proven midfacial fractures between 2013 and 2022 at the Department of Oral and Maxillofacial Surgery (University of Pécs, Hungary). The patients were stratified by age (<65 vs. ≥65 years) and gender. The variables included the injury mechanism, fracture localization, the dental status, hospitalization, and the presence of associated injuries. Bivariate analyses were performed, and the significance level was set to p < 0.05. Results: A total of 957 radiologically confirmed midfacial fracture cases were evaluated, of whom 344 (35.9%) were ≥65 years old. In the elderly group, females had a 19-fold higher risk for midfacial trauma than younger females (OR: 19.1, 95%CI: 9.30–39.21). In the older group, a fall was significantly the most frequent injury mechanism (OR: 14.5; 95%CI: 9.9–21.3), responsible for 89.5% of the cases, while hospitalization (OR: 0.36; 95%CI: 0.23–0.56) was less characteristic. Most of the fractures occurred in the zygomatic bone, in the zygomaticomaxillary complex, or in the anterior wall of the maxilla. Associated injuries in the elderly group included mostly lower limb injuries—particularly pertrochanteric femoral fractures in females—and upper limb injuries, with a slight male dominance. Conclusions: Low-energy falls are the primary cause of midfacial fractures in elderly patients, particularly in women. Tailored prevention and management strategies are essential for improving the outcomes in this growing demographic group. Full article

The aim of this study was to evaluate the relationship between visual functions and road traffic accidents (RTAs) by meta-analysis of observational studies. The analysis included all drivers of motor vehicles, regardless of age, and those using private or public transport. Self-reported visual outcomes were excluded. The risk of RTA in patients with reduced visual acuity was observed in commercial drivers in cross-sectional studies (PR 1.54, 95% CI 1.26–1.88), but not in private drivers in cohort (RR 1.04, 95% CI 0.74–1.46) or case–control studies (OR 1.04, 95% CI 0.78–1.40). A non-statistically significant association between colour vision defects and RTA was observed in cross-sectional studies (PR 1.50, 95% CI 0.91–2.45). No evidence was found for an increased risk of accidents in people with reduced stereopsis. In older adults with abnormal contrast sensitivity, a weak risk of RTA was observed in cohort studies. Evidence from low-quality cross-sectional studies suggests an increased risk of RTAs among commercial drivers with reduced visual acuity. The few case–control and cohort studies identified did not show an association between accident occurrence and visual function. Attention needs to be paid to this issue to facilitate the conduct of high-quality research that can support the development of road safety policies. Full article

Background/Objectives: Providing appropriate treatment for pediatric patients after traffic accidents remains a significant challenge. Furthermore, limited studies have validated the long-term effectiveness and safety of integrative Korean medicine treatment (IKMT) based on follow-up periods of 6 months or longer for pediatric patients. Methods: A retrospective chart review was conducted, focused on children aged 0–6 years who visited one of seven Korean medicine hospitals after traffic accident injuries and received IKMT between 1 January 2019 and 30 June 2023. The primary outcome was the Numeric Rating Scale (NRS) scores of chief complaints, and the secondary outcomes were quality of life, adverse events, and satisfaction with IKMT. Statistical analyses were conducted using paired t-tests and descriptive statistics, with a significance level of 5%. Results: Sixty-four participants were included in the retrospective chart review, and fifty-seven guardians responded to the surveys (mean age: 4.84 ± 1.26 years; mean duration of treatment: 19.20 ± 25.38 days). Among the immediate symptoms after the accidents, flashbacks and intrusive symptoms as well as nightmares and crying were the most common (50.9%). Following treatment, the NRS scores for flashbacks and intrusive symptoms and for nightmares and crying showed meaningful improvements from the time right after the accidents to the survey period. Follow-up confirmed that quality of life scores on all dimensions corresponded with those of healthy children. Nine adverse events were reported, and the participants fully recovered without the need for additional treatment. Furthermore, 91.2% of the survey respondents were satisfied with IKMT. Conclusions: IKMT was effective and safe for alleviating the post-accident symptoms in infants and young children aged 0–6 years involved in traffic accidents. Full article

Background: Renal trauma accounts for approximately 3–5% of all trauma cases, predominantly affecting young males. The most common etiology is blunt trauma, particularly due to road traffic accidents, and it frequently occurs as part of polytrauma involving multiple organ systems. Management strategies are primarily dictated by hemodynamic stability, overall clinical condition, comorbidities, and injury severity graded according to the AAST classification. This study aimed to evaluate the effectiveness of non-operative management (NOM) in high-grade renal trauma (AAST grades III–V), beyond its established role in low-grade injuries (grades I–II). Secondary endpoints included the identification of independent prognostic factors for NOM failure and in-hospital mortality. Methods: We conducted a retrospective observational study including patients diagnosed with blunt renal trauma who presented to the Emergency Department of Policlinico Umberto I in Rome between 1 January 2013 and 30 April 2024. Collected data comprised demographics, trauma mechanism, vital signs, hemodynamic status (shock index), laboratory tests, blood gas analysis, hematuria, number of transfused RBC units in the first 24 h, AAST renal injury grade, ISS, associated injuries, treatment approach, hospital length of stay, and mortality. Statistical analyses, including multivariable logistic regression, were performed using SPSS v28.0. Results: A total of 244 patients were included. Low-grade injuries (AAST I–II) accounted for 43% (n = 105), while high-grade injuries (AAST III–V) represented 57% (n = 139). All patients with low-grade injuries were managed non-operatively. Among high-grade injuries, 124 patients (89%) were treated with NOM, including observation, angiography ± angioembolization, stenting, or nephrostomy. Only 15 patients (11%) required nephrectomy, primarily due to persistent hemodynamic instability. The overall mortality rate was 13.5% (33 patients) and was more closely associated with the overall injury burden than with renal injury severity. Multivariable analysis identified shock index and active bleeding on CT as independent predictors of NOM failure, whereas ISS and age were significant predictors of in-hospital mortality. Notably, AAST grade did not independently predict either outcome. Conclusions: In line with the current international literature, our study confirms that NOM is the treatment of choice not only for low-grade renal injuries but also for carefully selected hemodynamically stable patients with high-grade trauma. Our findings highlight the critical role of physiological parameters and overall ISS in guiding management decisions and underscore the need for individualized assessment to minimize unnecessary nephrectomies and optimize patient outcomes. Full article

Traumatic liver injury remains a significant contributor to trauma-related morbidity and mortality worldwide. In Saudi Arabia, motor vehicle accidents (MVAs) are the predominant mechanism of injury, particularly among young adults. This study aimed to evaluate the clinical characteristics, management strategies, and outcomes of patients with liver trauma over a ten-year period at a tertiary academic level-one trauma center. A retrospective cohort study was conducted from January 2015 to December 2024. All adult patients (aged 18–65 years) who sustained blunt or penetrating liver injuries and underwent a pan-CT trauma survey were included. Demographic data, Injury Severity Scores (ISSs), imaging timelines, management approach, and clinical outcomes were analyzed. Statistical analysis was performed using JASP software with a significance threshold set at p < 0.05. A total of 111 patients were included, with a mean age of 33 ± 12.4 years; 78.1% were male. MVAs were the leading cause of injury (75.7%). Most patients (80.2%) had low-grade liver injuries and received non-operative management (NOM), with a high NOM success rate of 94.5%. The median time to CT was 55 ± 64 min, and the mean time to operative or IR intervention was 159.9 ± 78.8 min. Complications occurred in 32.4% of patients, with ventilator-associated pneumonia (19.8%) being most common. The overall mortality was 6.3%. Multivariate analysis revealed that shorter time to CT significantly reduced mortality risk (OR = 0.5, p < 0.05), while a positive e-FAST result was strongly associated with increased mortality (OR = 3.3, p < 0.05). Higher ISSs correlated with longer monitored unit stays (ρ = 0.3, p = 0.0014). Traumatic liver injuries in this cohort were predominantly low-grade and effectively managed conservatively, with favorable outcomes. However, delays in imaging and operative intervention were observed, underscoring the requirement for streamlined trauma workflows. These findings highlight the requirement for continuous trauma system improvement, including protocol optimization and timely access to imaging and surgical intervention. Full article

Background/Objectives: Splenic torsion is a well-known and reported clinical problem. Splenic torsions after abdominal trauma represent a small group of cases that involve surgical management. They manifest primarily as abdominal pain, and the diagnosis is made based on imaging studies—ultrasound, CT, and MRI. Methods: This work aimed to analyze traumatic splenic torsions in terms of their clinical course, symptoms, timing, involvement of imaging techniques in the diagnosis, histopathological examination, and overall outcome. We searched databases using the desk research method under the keywords “splenic torsion”, “torsion”, and “spleen”, as well as in combination with “traumatic”, finding a total of eight cases, which we included in our analysis. Results: The eight cases were analyzed, comprising four females and four males, with an average age of 16.25 years (range 5–29 years). Traffic accidents were the most frequent cause of injury (five cases), while the circumstances were unclear in the remaining three. Immediate abdominal symptoms appeared in six patients. Splenic torsion was preoperatively diagnosed in five out of seven confirmed cases. A total of seven patients underwent laparotomy with splenectomy. In one case, laparoscopy converted to laparotomy with splenopexy preserved the spleen. Histopathology, performed in only two cases, confirmed splenic infarction in one patient; infarction status could not be determined in the remaining five due to missing data. Conclusions: Post-traumatic splenic torsions are a group of atypical injuries as the primary and immediate consequence of the trauma suffered is not anatomical–structural damage to the organ, such as a rupture. Mostly affecting young people, the cases described in the professional literature involve the main spleen, which was considered to be “wandering”, suggesting that this is a key predisposing factor for splenic torsion following blunt trauma and requiring diagnostic imaging for diagnosis. Full article

The secondary sex ratio (SSR), defined as the ratio of male to female births in a population, has long been a subject of scientific inquiry due to its potential as a health indicator. The interplay between catastrophic events and the delicate balance of male and female births presents a nuanced and compelling study area. Natural disasters, such as earthquakes, hurricanes, floods, and volcanic eruptions, have been known to disrupt ecosystems and human populations, leading to both short-term and long-term consequences. Studies have suggested a potential influence of these disasters on the SSR, with varying degrees of impact observed across different regions and disaster types. Similarly, nuclear accidents, such as the infamous Chernobyl disaster, have sparked interest in their potential effects on human health and development. The release of radioactive materials into the environment can have far-reaching consequences, including impacts on reproductive outcomes. Through a rigorous examination of the existing literature, the present review aims to synthesize current knowledge on the impacts of natural disasters and nuclear accidents on the SSR and unravel the mechanisms that explain SSR fluctuations. By shedding light on the diverse influences shaping the SSR, this narrative review contributes to a deeper appreciation of the intricate interplay between environmental, biological, and societal factors that determines the SSR, calling for targeted strategies to mitigate potential adverse effects on sex ratios in the aftermath of such events. Full article

Concrete is a fundamental material in structural engineering, widely used in critical infrastructure such as bridges, nuclear power plants, and dams. These structures may be subjected to extreme dynamic loads resulting from natural disasters, industrial accidents, or missile impacts. Therefore, a comprehensive understanding of concrete behavior under high strain rates is essential for safe and resilient design. Experimental investigations, particularly spalling tests, have highlighted the strain-rate sensitivity of concrete in dynamic tensile loading conditions. This study presents a macroscopic 3D discrete element model specifically developed to simulate the dynamic response of concrete subjected to extreme loading. Unlike conventional continuum-based models, the proposed discrete element framework is particularly suited to capturing damage and fracture mechanisms in cohesive materials. A key innovation lies in incorporating a physically grounded strain-rate dependency directly into the local cohesive laws that govern inter-element interactions. The originality of this work is further underlined by the validation of the discrete element model under dynamic tensile loading through the simulation of spalling tests on normalstrength concrete at strain rates representative of severe impact scenarios (30–115 s⁻¹). After calibrating the model under quasi-static loading, the simulations accurately reproduce key experimental outcomes, including rear-face velocity profiles and failure characteristics. Combined with prior validations under high confining pressure, this study reinforces the capability of the discrete element method for modeling concrete subjected to extreme dynamic loading, offering a robust tool for predictive structural assessment and design. Full article

The Engine Electronic Controller (EEC), as the core component of an aircraft engine control system, is vulnerable to rapid failure when exposed to thermal shock during engine fire incidents, potentially leading to catastrophic aviation accidents. To address this issue, this study conducts both numerical simulations and experimental investigations to evaluate the thermal performance of the EEC under thermal shock conditions, exploring the weaknesses of the EEC chassis under high-temperature thermal shock and the damage to important internal electronic components. A three-dimensional finite element model of the EEC was established to simulate its behavior under a thermal shock of 1100 °C. Simulation results reveal that the aluminum alloy chassis wall cannot withstand the extreme thermal load, resulting in failure of the internal electronic components within the first 5 min of exposure, thereby rendering the EEC inoperative. In contrast, when the chassis wall is made of stainless steel, all components and internal electronics remain functional throughout the initial 5 min thermal shock period. Experimental results show that the temperature evolution and component failure patterns under both scenarios align well with the simulation outcomes, thus validating the model’s accuracy. Full article

This study explores the use of Large Language Models (LLMs), specifically GPT, for different safety management applications in the construction industry. Many studies have explored the integration of GPT in construction safety for various applications; their primary focus has been on the feasibility of such integration, often using GPT models for specific applications rather than a thorough evaluation of GPT’s limitations and capabilities. In contrast, this study aims to provide a comprehensive assessment of GPT’s performance based on established key criteria. Using structured use cases, this study explores GPT’s strength and weaknesses in four construction safety areas: (1) delivering personalized safety training and educational content tailored to individual learner needs; (2) automatically analyzing post-accident reports to identify root causes and suggest preventive measures; (3) generating customized safety guidelines and checklists to support site compliance; and (4) providing real-time assistance for managing daily safety tasks and decision-making on construction sites. LLMs and NLP have already been employed in each of these four areas for improvement, making them suitable areas for further investigation. GPT demonstrated acceptable performance in delivering evidence-based, regulation-aligned responses, making it valuable for scaling personalized training, automating accident analyses, and developing safety protocols. Additionally, it provided real-time safety support through interactive dialogues. However, the model showed limitations in deeper critical analysis, extrapolating information, and adapting to dynamic environments. The study concludes that while GPT holds significant promise for enhancing construction safety, further refinement is necessary. This includes fine-tuning for more relevant safety-specific outcomes, integrating real-time data for contextual awareness, and developing a nuanced understanding of safety risks. These improvements, coupled with human oversight, could make GPT a robust tool for safety management. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Poisoning and suffocation accidents occurred frequently in the pre-treatment pool workshops of biogas plants, so this paper provided a multi-dimensional risk analysis model: Bow-Tie-Qualitative Comparative Analysis (QCA)-Bayesian Neural Network-Consequence Simulation. First, the reasons for biogas poisoning and suffocation accidents were clarified through Bow-Tie. Then, the QCA method explored the accident cause combination paths in management. Next, the frequency distribution of biogas poisoning and suffocation accidents in the pre-treatment pool workshop was predicted to be 0.61–0.66 using the Bayesian neural network model, and the uncertainty of the forecast outcome was given. Finally, the ANSYS Fluent 16.0 simulation of biogas diffusion in three different ventilation types and a grid-independent solution of the simulation were conducted. The simulation results showed the distribution of methane, carbon dioxide and hydrogen sulfide gases and the hazards of the three gases to workers were analyzed. In addition, according to the results, this paper discussed the importance and necessity of ventilation in pre-treatment pool workshops and specified the hazard factors in biogas poisoning and suffocation accidents in the pre-treatment pool workshops. Some suggestions on gas alarms were also proposed. Full article