Bicycle helmets are associated with fewer and less severe head injuries and fewer neurosurgical procedures.

PURPOSE: This study explores the protective capabilities of bicycle helmets on serious head injury among bicyclists hospitalized in a Norwegian level 1 trauma centre. METHOD: Information on helmet use, demographic variables, Abbreviated Injury Scale (AIS) and surgical procedure codes was retrieved from the Oslo University Hospital Trauma Registry for patients with bicycle-related injuries from 2005 through 2016. Outcomes were serious head injury defined as maximum AIS severity score ≥ 3 in the AIS region Head, any cranial neurosurgical procedure, and 30-day mortality. RESULTS: A total of 1256 hospitalized bicyclists were included. The median age was 41 years (quartiles 26-53), 73% were male, 5.3% had severe pre-injury comorbidities, and 54% wore a helmet at the time of injury. Serious head injury occurred in 30%, 9% underwent a cranial neurosurgical procedure, and 30-day mortality was 2%. Compared to non-helmeted bicyclists, helmeted bicyclists were older (43 years, quartiles 27-54, vs. 38 years, quartiles 23-53, p = 0.05), less often crashed during night-time (21% vs. 38%, p < 0.001), less frequently had serious head injury (22% vs. 38%, OR 0.29, 95% CI 0.22-0.39), and less often underwent cranial neurosurgery (6% vs. 14%, OR 0.36, 95% CI 0.24-0.54). No statistically significant difference in 30-day mortality between the two groups was found (1.5% vs. 2.9%, OR 0.50, 95% CI 0.22-1.11). CONCLUSION: Helmet use was associated with fewer and less severe head injuries and fewer neurosurgical procedures. This adds evidence to the protective capabilities of bicycle helmets.

Abdominal impacts of handlebar injuries in the PIPER child model: a prevention study.

Aim: Analysis of data from bicycle accidents reveals that handlebar impacts are a significant cause of injury, particularly among children. Despite existing safety regulations, such as helmet requirements, little attention is given to abdominal injuries. The aim of this study is to investigate the influence of handlebar ends on abdominal loading during bicycle crashes. Methods: This study delves into the impact of five different handlebar designs on abdominal injuries during bicycle crashes, using finite element simulations with detailed Human Body Models (HBMs) of a six-year-old child (PIPER child model, Version 0.99.0). Four impact locations were identified in the injury scenario, selected according to the anatomical location of the most commonly injured organs, liver, pancreas, spleen and abdomen. Results: Grip design features, such as shape and rigidity, significantly influence injury outcomes. Grips designed specifically for children demonstrate superior performance in reducing abdominal loading and injury metrics compared to standard grips. The highest injury potential was seen in a damaged handlebar end. Conclusion: These findings underscore the importance of improved handlebar designs and standardized safety measures, especially for children. Implementation of such measures could mitigate the significant health and economic burden associated with handlebar-related injuries and enhance overall bicycle safety for children.

Trends and Costs of Non-Fatal Micromobility-Related Injuries Treated in Emergency Departments in Rhode Island, 2016-2021.

BACKGROUND: Micromobility devices like e-scooters have become popular for short trips. Providence, Rhode Island, introduced these devices in 2018. We examine non-fatal injury trends and ED care costs for micromobility-related injuries in Rhode Island (RI) from 2016 to 2021. METHODS: Data were obtained from the Healthcare Cost and Utilization Project (HCUP) and the RI State ED Databases (SEDD). Using ICD-10 codes, we identified micromobility-related injuries. The analysis spanned two waves: pre-implementation (2016-2018) and post- implementation (2019-2021). Poisson regression was performed on age-adjusted rates of micromobility injuries to evaluate change over time. RESULTS: From 2016 to 2021, micromobility-related ED visits rose 600%. Bicycle injuries decreased by 20%, while pedestrian and motor vehicle injuries increased by 9% and 13%, respectively. CONCLUSION: The dramatic rise in micromobility- related injuries reflects their growing usage and the associated risks. Micromobility offers benefits and challenges for cities. Safety measures are crucial for their safe, sustainable use.

A comparison of heat effects on road injury frequency between active travelers and motorized transportation users in six tropical and subtropical cities in Taiwan.

Road traffic injuries (RTIs) pose significant public health threats, particularly for vulnerable road users such as pedestrians and cyclists. While recent studies have revealed adverse impacts of heat exposure on RTI frequency among motorized road users, a research gap persists in understanding these impacts on non-motorized road users, especially in tropical regions where their vulnerability can be heightened due to differential thermal exposure, adaptive capacity, and biological sensitivity. In this study, we compared associations between high temperatures and RTIs across four different crash-involved modes of transportation-pedestrians, cyclists, motorcyclists, and car drivers in Taiwan. Leveraging data on RTI records and temperature conditions in Taiwan's six municipalities from 2018 to 2022, we conducted a city-time-stratified case-crossover analysis. We employed distributed lag non-linear models with conditional Poisson regression models to estimate temperature-RTI associations for each mode of transportation, adjusting for various weather factors and unmeasured spatio-temporal patterns. Our findings reveal that individuals using exposed, open transportation modes (i.e., pedestrians, cyclists, and motorcyclists) exhibited higher relative risks of heat-induced RTIs than car drivers, with non-motorized mode users showing greater susceptibility compared to their motorized counterparts. These elevated risks can be attributed to the absence of built-in cooling systems in open travel modes and the increased exertional heat stress implied in active travel. Our study contributes novel insights to a global concern related to climate change, extending its impact to road safety, a health outcome rarely studied in the context of a changing climate. Our findings are thus important, especially for regions where rising temperatures regularly approach or exceed human physiological limits related to heat tolerance in the coming decades. Additionally, our findings hold significance in the existing urban health literature, particularly within the context of the emerging era of micromobility-a category of low-speed, non-enclosed, and lightweight vehicles increasingly integrated into urban activities worldwide.

A population-based study of severity of injuries in recreational mountain biking - Discontinued rise following efforts.

BACKGROUND: During the recent years, an increase in the number of people practicing recreational mountain biking has been observed. The high-risk sport can cause severe injuries. The most severe injuries involve paralysis and head traumas. These injuries occur to recreational bikers as well as professionals. The purpose of this study is to describe the development in severe injuries and the effort of increasing the safety of mountain biking for recreational bikers. METHOD: Register-based study with the population of residents in the municipality of Odense who were injured in a mountain bike incident between 2005 and 2021. Data was obtained from the register of the emergency department, where all contacts are registered. The incidence risk for men and women has been calculated, as well as the distribution between age groups and the mechanism of the fall. RESULTS: A total of 303 severe injuries during the study period illustrates an increase in both the number of injuries and the number of severe injuries. Most of the injuries occur among men aged 40-49. The proportion of severe injuries rises to around 40 % after 2015. The incidence risk was 59 per 10.000 (95 % CI: 53-66) in total, for men 68 per 10.000 (95 % CI: 61-77), and for women 22,6 per 10.000 (95 % CI: 16-31,5). CONCLUSION: There has been an increase in the number of severe injuries, non-severe injuries, and the proportion of MTB injuries from 2005 to 2020. After 2020, there is a decrease in the number of severe injuries.

Identifying factors related to pedestrian and cyclist crashes in ACT, Australia with an extended crash dataset.

As vulnerable road users, pedestrians and cyclists are facing a growing number of injuries and fatalities, which has raised increasing safety concerns globally. Based on the crash records collected in the Australian Capital Territory (ACT) in Australia from 2012 to 2021, this research firstly establishes an extended crash dataset by integrating road network features, land use features, and other features. With the extended dataset, we further explore pedestrian and cyclist crashes at macro- and micro-levels. At the macro-level, random parameters negative binomial (RPNB) model is applied to evaluate the effects of Suburbs and Localities Zones (SLZs) based variables on the frequency of pedestrian and cyclist crashes. At the micro-level, binary logit model is adopted to evaluate the effects of event-based variables on the severity of pedestrian and cyclist crashes. The research findings show that multiple factors are associated with high frequency of pedestrian total crashes and fatal/injury crashes, including high population density, high percentage of urban arterial road, low on-road cycleway density, high number of traffic signals and high number of schools. Meanwhile, many factors have positive relations with high frequency of cyclist total crashes and fatal/injury crashes, including high population density, high percentage of residents cycling to work, high median household income, high percentage of households with no motor vehicle, high percentage of urban arterial road and rural road, high number of bus stops and high number of schools. Additionally, it is found that more severe pedestrian crashes occur: (i) at non-signal intersections, (ii) in suburb areas, (iii) in early morning, and (iv) on weekdays. More severe cyclist crashes are observed when the crash type is overturned or struck object/pedestrian/animal; when more than one cyclist is involved; and when crash occurs at park/green space/nature reserve areas.

A novel framework for crash frequency prediction: Geographic support vector regression based on agent-based activity models in Greater Melbourne.

The field of spatial analysis in traffic crash studies can often enhance predictive performance by addressing the inherent spatial dependence and heterogeneity in crash data. This research introduces the Geographical Support Vector Regression (GSVR) framework, which incorporates generated distance matrices, to assess spatial variations and evaluate the influence of a wide range of factors, including traffic, infrastructure, socio-demographic, travel demand, and land use, on the incidence of total and fatal-or-serious injury (FSI) crashes across Greater Melbourne's zones. Utilizing data from the Melbourne Activity-Based Model (MABM), the study examines 50 indicators related to peak hour traffic and various commuting modes, offering a detailed analysis of the multifaceted factors affecting road safety. The study shows that active transportation modes such as walking and cycling emerge as significant indicators, reflecting a disparity in safety that heightens the vulnerability of these road users. In contrast, car commuting, while a consistent factor in crash risks, has a comparatively lower impact, pointing to an inherent imbalance in the road environment. This could be interpreted as an unequal distribution of risk and safety measures among different types of road users, where the infrastructure and policies may not adequately address the needs and vulnerabilities of pedestrians and cyclists compared to those of car drivers. Public transportation generally offers safer travel, yet associated risks near train stations and tram stops in city center areas cannot be overlooked. Tram stops profoundly affect total crashes in these areas, while intersection counts more significantly impact FSI crashes in the broader metropolitan area. The study also uncovers the contrasting roles of land use mix in influencing FSI versus total crashes. The proposed framework presents an approach for dynamically extracting distance matrices of varying sizes tailored to the specific dataset, providing a fresh method to incorporate spatial impacts into the development of machine learning models. Additionally, the framework extends a feature selection technique to enhance machine learning models that typically lack comprehensive feature selection capabilities.

Quantifying the heterogeneity impact of risk factors on regional bicycle crash frequency: A hybrid approach of clustering and random parameter model.

The existence of internal and external heterogeneity has been established by numerous studies across various fields, including transportation and safety analysis. The findings from these studies underscore the complexity of crash data and the multifaceted nature of risk factors involved in accidents. However, most studies consider the effects of unobserved heterogeneity from one perspective -- either within clusters (internal) or between clusters (external) -- and do not investigate the biases from both simultaneously on crash frequency analysis. To fill this gap, this study proposes a hybrid approach combining latent class cluster analysis with the random parameter negative binomial regression model (LCA-RPNB) to explore the association between risk factors and bicycle crash frequency. First, the bicycle crash data is categorized into three clusters using LCA based on crash features such as gender, trip purposes, weather, and light conditions. Then, the separated crash frequency models for different clusters and the overall model are developed based on RPNB using regional factors of crash locations as independent variables and the crash frequency of different clusters respectively as dependent variables. The hybrid approach enables a comprehensive examination of internal and external heterogeneities among bicycle crash frequency factors simultaneously. Results suggest that the proposed hybrid approach exhibits superior fitting and predictive performance compared to the model only considers the effects of unobserved heterogeneity from one perspective with the lower values of Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). This approach can help policymakers and urban planners to design more effective safety interventions by understanding the distinct needs of different bicyclist clusters and the specific factors that contribute to crash risk in each group.

Optimizing vehicle Front-End structure for e-bike rider Safety: An advanced Multi-Objective approach using injury prediction models.

A multi-objective optimization method based on an injury prediction model is proposed to address the increasingly prominent safety issues for e-bike riders in Chinese road traffic. This method aims to enhance the protective effect of vehicle front-end for e-bike riders by encompassing a broader range of test scenarios. Initially, large-scale rider injury response data were collected using automated Madymo simulations. A machine learning model was then trained to accurately predict the risk of rider injury under varied crash conditions. Subsequently, this model was integrated into a multi-objective optimization framework, combined with multi-criteria decision analysis, to effectively evaluate and rank various design alternatives on the Pareto frontier. This process entailed a comparative analysis of the design in a baseline scenario before and after optimization, focusing on both kinematic and injury responses of riders. Through detailed injury mechanism analysis, key design variables such as the height of the hood front and the width of the bumper were identified. This led to the proposal of specific optimization strategies for these structural parameters. The results from this study demonstrate that the proposed optimization method not only guides the design process accurately and efficiently but also balances the injury risks across different body parts. This approach significantly reduces the injury risk for riders in car-to-e-bike collisions and provides actionable insights for vehicle design enhancements.

Injuries With Electric vs Conventional Scooters and Bicycles.

Importance: Micromobility, the use of small vehicles (primarily scooters and bicycles), has become a standard transportation method in the US. Despite broad adoption of electric micromobility vehicles, there is a paucity of data regarding the injury profiles of these vehicles, particularly in the US. Objective: To characterize micromobility injury trends in the US, identify demographic characteristic differences in users of electric and conventional vehicles, and identify factors associated with hospitalization. Design, Setting, and Participants: This cross-sectional study queried the National Electronic Injury Surveillance System, a comprehensive database that collates injury data associated with consumer products from emergency departments across the US to provide national estimates, from calendar year 2017 to 2022. Data on micromobility vehicle injuries (bicycles, scooters, electric bicycles [e-bicycles], and electric scooters [e-scooters]) were obtained. Main Outcomes and Measures: Trends in injury and hospitalization counts, injury characteristics, and factors associated with hospitalization. Results: From 2017 to 2022, the US recorded 2 499 843 bicycle (95% CI, 1 948 539-3 051 147), 304 783 scooter (95% CI, 232 466-377 099), 45 586 e-bicycle (95% CI, 17 684-73 488), and 189 517 e-scooter (95% CI, 126 101-252 932) injuries. The median age of the riders was 28 (IQR, 12-51) years; 72% were male, 1.5% Asian, 13% Black, 12% Hispanic, and 49% White. Annual e-bicycle and e-scooter injuries increased from 751 (95% CI, 0-1586) to 23 493 (95% CI, 11 043-35 944) and injuries increased from 8566 (95% CI, 5522-11 611) to 56 847 (95% CI, 39 673-74 022). Compared with conventional vehicles, electric vehicle accidents involved older individuals (median age, 31 vs 27 years; P < .001) and a higher proportion of Black riders (25% vs 12%; P < .001). Helmet use was less in electric vehicle incidents compared with conventional vehicles (43% vs 52%; P = .02), and injuries were more common in urban settings (83% vs 71%; P = .008). Age-adjusted odds of hospitalization among all Black individuals compared with White individuals was 0.76 (95% CI, 0.59-0.98; P = .04). Conclusions and Relevance: In this cross-sectional study of micromobility vehicles, an increased number of injuries and hospitalizations was observed with electric vehicles compared with conventional vehicles from 2017 to 2022. These findings suggest the need for change in educational policies, infrastructure, and law to recenter on safety with the use of micromobility vehicles.

Do Bicycle Helmets Protect Against Facial Fractures? An Observational Study From a Level 1 Trauma Centre.

This study investigates the impact of helmet use on the incidence of facial fractures in bicycle accidents. Analyzing data from hospitalized bicyclists between 2005 and 2016, the research focused on the correlation between helmet usage and various facial fractures. The study included 1256 bicyclists with known helmet use, among whom 277 individuals (22%) were identified with a total of 521 facial fractures. The findings revealed a significant reduction in the likelihood of facial fractures among helmeted cyclists compared with those without helmets (odds ratio, 0.65; confidence interval, 0.50-0.85; P=0.002). Specifically, the odds of sustaining fractures in the zygoma, orbit, nose, and maxilla were decreased by 47%, 46%, 43%, and 33%, respectively, among helmeted cyclists. However, helmet use did not significantly alter the odds of mandible fractures. Overall, the use of helmets in bicycling significantly lowered the risk of midface fractures but showed no notable effect on mandible fractures in severe cycling incidents.

The epidemiology and outcomes of severe road traffic injury by road user type in Korea: A nationwide retrospective observational study.

OBJECTIVES: Road traffic injuries (RTIs) pose a significant public health burden, and more than half of these fatalities are attributed to vulnerable road users (VRUs). This study aimed to evaluate the epidemiology and outcomes of severe RTIs in Korea by focusing on different types of road users. METHODS: This is nationwide retrospective observational study. Using data from the Korean Nationwide Severe Trauma Registry, this study analyzed severe RTI cases from 2016 to 2020. The study included EMS-treated severe trauma patients, defining severe RTI as cases with an injury severity score (ISS) ≥16 or out-of-hospital cardiac arrest (OHCA). The main variable of interest was the road user type, classified as motor vehicle occupants (MVOs), pedestrians, motorcyclists, and bicyclists. Trends and injury characteristics by road user type were analyzed, and multivariate logistic regression was conducted to calculate the adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) of road user type for in-hospital mortality. RESULTS: Of the 143,021 EMS-treated severe trauma cases, 24,464 were included in this study. Pedestrians represented the largest group (n = 8,782; 35.9 %). More than half of the patients died (n = 12,620, 51.6 %), and a high proportion of patients had OHCA (n = 10,048, 41.1 %). There was no significant change in the overall severe RTI numbers from 2016 to 2020, but a decrease in pedestrian cases and an increase in motorcyclist cases were noted (both p for trend<0.05). Low usage of safety devices was observed (28.2 % of motor vehicle occupants used seat belts, 35.9 % of motorcyclists used helmets, and 9.6 % of bicyclists used helmets). Head injuries were most common, particularly among bicyclists (77.0 %) and motorcyclists (69.8 %). Compared to motor vehicle occupants, pedestrians (AOR [95 % CI] 1.12 [1.04-1.20]) and others (AOR [95 % CI] 1.30 [1.02-1.65]) had higher odds of mortality, while motorcyclists (AOR [95 % CI] 0.64 [0.59-0.69]) and bicyclists (AOR [95 % CI] 0.68 [0.60-0.76]) had lower odds of mortality. CONCLUSION: We found varying trends and injury characteristics in severe RTIs according to road user type. Adapting prevention strategies for evolving road user patterns, with particular attention to increasing safety device usage and addressing the high mortality associated with severe RTIs are warranted.

Cycling safely: Examining the factors associated with bicycle accidents in Seoul, South Korea.

This study investigates the factors contributing to bicycle accidents, focusing on four types of bicycle lanes and other exposure and built environment characteristics of census blocks. Using Seoul as a case study, three years of bicycle accident spot data from 2018 to 2020 was collected, resulting in 1,330 bicycle accident spots and a total of 2,072 accidents. The geographically weighted Poisson regression (GWPR) model was used as a methodological approach to investigate the spatially varying relationships between the accident frequency and explanatory variables across the space, as opposed to the Poisson regression model. The results indicated that the GWPR model outperforms the global Poisson regression model in capturing unobserved spatial heterogeneity. For example, the value of deviance that determines the goodness of fit for a model was 0.244 for the Poisson regression model and 0.500 for the far better-fitting GWPR model. Further findings revealed that the factors affecting bicycle accidents have varying impacts depending on the location and distribution of accidents. For example, despite the presence of bicycle lanes, some census blocks, particularly in the northeast part of the city, still pose a risk for bicycle accidents. These findings can provide valuable insights for urban planners and policymakers in developing bicycle safety measures and regulations.

Successfully saving a child with destuctive iliac artery damage by hybrid surgery.

Non-iatrogenic trauma of the iliac artery is rarely reported but is always life-threatening. In this report, we describe the case of a child with complete transection and partial disappearance of the iliac artery caused by bicycle handlebar impalement. He experienced catastrophic hemorrhage, malignant arrhythmia, and difficulty in exploring transected vessel stumps. Aggressive infusion, blood transfusion in time, and pediatric vascular characteristics help delay the deterioration during anesthesia induction. Eventually he was successfully rescued by performing interventional balloon occlusion and open revascularization after more than 7 h post-trauma. A series of interventions and precautionary methods may benefit such severely injured patients; thus, these methods should be highlighted.

Cyclist safety around trams: A market survey.

Tram systems present safety risks to cyclists, however only limited research has explored this topic, of which most has focused on crash and hospital data, and severe crash events. This paper presents the first known cyclist market survey focused specifically on the experience of cyclists related to safety around trams, including unreported incidents and those that did not result in hospital attendance. Findings suggest that track-skid incidents are more common than track-wedge incidents, in contrast to previous research that emphasizes track-wedging as a larger issue than skidding. This is may be explained by the differing outcomes, with track-wedging more likely to result in injury. This research is thus significant in identifying track skidding as a major risk concern, causing a majority of crashes, while also confirming that track wedging is the major severity concern. In the last five years, 21% of respondents were involved in at least one tram-track-related crash. This was less than the share of respondents involved in falls (50%), crashes relating to road defects (36%) or collisions with motor vehicles (29%). However, half of survey respondents (52%) reported cycling on roads with tram tracks for 0-20% of their cycling, which might suggest that tram track-related crash rates are high given that most inner-city cycling occurs on roads without tracks. Track-skidding was found to be associated with wet conditions. Those involved in at least one track-skid in the last five years where more likely to have been cycling more than 3 years, but involvement in track-wedging was more likely amongst those cycling > 10 years and aged < 45 years. Implications for research and practice are suggested.

Unpacking the perceived cycling safety of road environment using street view imagery and cycle accident data.

Cycling, as a routine mode of travel, offers significant benefits in promoting health, eliminating emissions, and alleviating traffic congestion. Many cities, including London, have introduced various policies and measures to promote 'active travel' in view of its manifold advantages. Nevertheless, the reality is not as desirable as expected. Existing studies suggest that cyclists' perceptions of cycling safety significantly hinder the broader adoption of cycling. Our study investigates the perceived cycling safety and unpacks the association between the cycling safety level and the road environment, taking London as a case study. First, we proposed novel cycling safety level indicators that incorporate both collision and injury risks, based on which a tri-tiered cycling safety level prediction spanning the entirety of London's road network has been generated with good accuracy. Second, we assessed the road environment by harnessing imagery features of street view reflecting the cyclist's perception of space and combined it with road features of cycle accident sites. Finally, associations between road environment features and cycling safety levels have been explained using SHAP values, leading to tailored policy recommendations. Our research has identified several key factors that contribute to a risky environment for cycling. Among these, the "second road effects," which refers to roads intersecting with the road where the accident occurred, is the most critical to cycling safety levels. This would also support and further contribute to the literature on road safety. Other results related to road greenery, speed limits, etc, are also discussed in detail. In summary, our study offers insights into urban design and transport planning, emphasising the perceived cycling safety of road environment.

Endurance Sporting Events.

Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.

Vulnerable road user injury trends following the COVID-19 pandemic in Toronto, Canada: An interrupted time series analysis.

BACKGROUND: The COVID-19 pandemic altered traffic patterns worldwide, potentially impacting pedestrian and bicyclists safety in urban areas. In Toronto, Canada, work from home policies, bicycle network expansion, and quiet streets were implemented to support walking and cycling. We examined pedestrian and bicyclist injury trends from 2012 to 2022, utilizing police-reported killed or severely injured (KSI), emergency department (ED) visits and hospitalization data. METHODS: We used an interrupted time series design, with injury counts aggregated quarterly. We fit a negative binomial regression using a Bayesian modeling approach to data prior to the pandemic that included a secular time trend, quarterly seasonal indicator variables, and autoregressive terms. The differences between observed and expected injury counts based on pre-pandemic trends with 95% credible intervals (CIs) were computed. RESULTS: There were 38% fewer pedestrian KSI (95%CI: 19%, 52%), 35% fewer ED visits (95%CI: 28%, 42%), and 19% fewer hospitalizations (95%CI: 2%, 32%) since the beginning of the COVID-19 pandemic. A reduction of 35% (95%CI: 7%, 54%) in KSI bicyclist injuries was observed, but However, ED visits and hospitalizations from bicycle-motor vehicle collisions were compatible with pre-pandemic trends. In contrast, for bicycle injuries not involving motor vehicles, large increases were observed for both ED visits, 73% (95% CI: 49%, 103%) and for hospitalization 108% (95% CI: 38%, 208%). CONCLUSION: New road safety interventions during the pandemic may have improved road safety for vulnerable road users with respect to collisions with motor vehicles; however, further investigation into the risk factors for bicycle injuries not involving motor vehicles is required.

CT scan the key to unmasking a solid pseudopapillary pancreatic neoplasm in blunt abdominal trauma.

SUMMARY: We present a previously healthy 13-year-old male, who sustained a handlebar injury after falling from his bicycle. The computerised tomography (CT) scan indicated a probable pancreatic neoplasm associated with a retroperitoneal haematoma which was, following resection, confirmed histologically to be a solid pseudopapillary neoplasm of the pancreas. These are rare tumours of the pancreas, especially in young males. The rarity of this neoplasm and the mechanism that led to its presentation make this an interesting and unique case.

Age, sex, sensation-seeking, and road-crossing: How does risk context impact children's street-crossing?

OBJECTIVE: Child pedestrian injuries are a significant public health problem, largely because children have underdeveloped cognitive-perceptual capacity to judge traffic unsupervised. This study used a virtual reality (VR) environment to examine the impact of children's age, as well as sex and sensation-seeking personality, on pedestrian behavior in different risk contexts. METHODS: 405 Norwegian children (7-10-year-olds) engaged in street-crossing scenarios within a VR environment. Children crossed a bicycle path and urban roadway six times, each with increasing density and complexity of traffic. Hits and near hits were recorded. Self-reported sensation-seeking personality was assessed. RESULTS: Children were more likely to experience crashes in the tasks that offered higher probability risk. Overall, 106 children crossed safely in all tasks. Dangerous crossings were associated with male sex, higher thrill and intensity seeking personality, and denser traffic. Age was not related to any traffic safety outcomes. CONCLUSION: As expected, children were struck by vehicles more often in complex traffic contexts than in less complex ones. The results support previous findings and suggest that boys and sensation seekers have elevated risk of pedestrian injury, and that individual differences in children, rather than age alone, must be considered when determining if children are capable of safely negotiating traffic unsupervised.