Prehospital factors associated with mortality among road traffic injury patients: analysis of Cameroon trauma registry data.

BACKGROUND: Cameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon. METHODS: We included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI. RESULTS: RTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08-2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1-3.67) and scene care (AOR = 0.25, 95%CI = 0.04-0.80). CONCLUSIONS: Receiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

Behaviour of motorcyclists and bicyclists before and after a road safety campaign, China.

Objective: To examine changes in red-light running and distracted riding among motorcyclists and cyclists before and after the 2020 implementation of the One Helmet, One Seatbelt campaign in China. Methods: We obtained 192 hours of film before (2019) and after (2021) implementation of the campaign in eight road intersections in Changsha. We calculated percentages and ratios of red-light running and distracted riding. To assess the associations between these traffic behaviours and the campaign, we used multivariable logistic regression models to calculate adjusted odds ratios (aOR). Findings: We filmed 5256 motorcyclists and cyclists in 2019 and 6269 in 2021. Red-light running decreased from 45.1% to 41.5% during this period (ratio: 0.92; 95% confidence interval, CI: 0.88-0.96), while distracted riding increased from 3.5% to 5.0% (ratio: 1.42; 95% CI: 1.19-1.69). After adjusting for covariates, male riders were more likely to run a red light compared to female riders (aOR: 1.28; 95% CI: 1.06-1.55). Red-light running was also more likely among electric bicycle riders (aOR: 1.46; 95% CI: 1.10-1.95) and motorcyclists (aOR: 1.47; 95% CI: 1.13-1.90) compared to traditional cyclists. All types of riders were less prone to run a red light during peak hours than off-peak hours (aOR: 0.85; 95% CI: 0.73-0.99). Distracted riding was more common on weekends compared to weekdays (aOR: 3.01; 95% CI: 2.02-4.49). Conclusion: China's national road safety campaign, which focuses on helmet and seatbelt use, was associated with reduced red-light running. Strict enforcement and targeted modifications could improve the campaign's effectiveness.

Head, face and neck injury patterns for electric scooter accidents identified on computed tomography scanning: Does legislative change enforcing safer riding practices have an impact on morbidity for significant head, face and neck trauma?

INTRODUCTION: The purpose of this study is to review whether legislative change enforcing safer riding conditions for Electric Scooters (E-Scooter), regardless of other factors, had an impact on reducing significant head, facial and neck trauma. Additionally, to identify the radiological injury patterns for head, face and neck injuries identified on CT imaging for a patient's initial presentation to the emergency department (ED) resulting from an E-Scooter accident. METHODS: A retrospective single-centre observational study at a metropolitan tertiary ED of patients presenting after an E-Scooter accident comparing 6 months before and after legislative change. RESULTS: Four hundred and forty-three patients presented following an E-Scooter accident: 191 patients 6 months before and 252 patients 6 months after legislative change. One hundred and sixty-two patients pre- and 217 patients post-legislative change had negative CT studies. Twenty-nine patients pre- and 35 patients post-legislative change had CT studies demonstrating significant head, face or neck trauma. The most common type of intracranial bleeding was subarachnoid haemorrhage followed by subdural haemorrhage with a significant proportion (41%) presenting with multi-factorial intracranial bleeding. There was no specific injury pattern involving the cranial vault or cervical spine. Of the patients presenting with a significant injury, facial bones were the most common injury site (84% (n = 54)). The most common site of facial fractures was the nasal bones followed by dental trauma and maxillary fractures. CONCLUSION: This single-centre, retrospective observational study has shown no reduction in serious head, neck and facial injuries. Large-scale, multicentre studies will need to be undertaken to understand the true impact of legislative change.

Driving after alcohol consumption among residents of Northeastern Brazil: National Health Survey 2019.

OBJECTIVE: To estimate the prevalence of factors associated with drinking and driving in Northeastern Brazil. METHODS: This was a cross-sectional study conducted with participants from the 2019 National Health Survey, aged ≥ 18 years; the analysis of the association between sociodemographic variables and the outcome, stratified by sex, was performed using Poisson regression. RESULTS: The prevalence of drinking and driving was 21.0% ( 95%CI 19.9;23.2), with 24.6% ( 95%CI 22.7;26.5), in males and 10.1 % ( 95%CI 7.9;12.7), in females (p-value < 0.001); among men, younger age groups (PR = 1.70 - 95%CI 1.29;2.24), higher household income (PR = 1.74 - 95%CI 1.33;2.28), rural residence (PR = 1.48 - 95%CI 1.26;1.74) and motorcycle riding (PR = 1.29 - 95%CI 1.05;1.58) were associated with the event, while no association was observed among women. CONCLUSION: Prevalence of drinking and driving was high in the Northeast region, especially among the male population; preventive measures targeting this group and intensified enforcement are necessary. MAIN RESULTS: The prevalence of drinking and driving was high, significantly greater in males when compared to females; positive associations between sociodemographic variables and the event were observed only in the male population. IMPLICATIONS FOR SERVICES: Intersectoral actions, involving health services and regulatory bodies, are essential to reduce the habit of drinking and driving, especially among males, in addition to promoting a safer road environment in the Northeast region. PERSPECTIVES: It is necessary to strengthen enforcement measures for alcohol consumption and driving, especially in rural areas and among motorcycle riders, in addition to implementing traffic education programs and awareness campaigns.

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.

Investigating the immediate and mid-term effect of a gamified e-learning platform for the enhancement of traffic knowledge and skills among Vietnamese adolescents operating powered two-wheelers.

INTRODUCTION: Traffic crashes caused by adolescents are being assessed as particularly serious and a common concern of society as a whole. Improving traffic knowledge and skills is crucial in reducing adolescent traffic crashes. OBJECTIVES: This study aimed to investigate the effects of a gamified e-learning platform on traffic knowledge and skills among adolescents (aged 15-18) in Vietnam. METHOD: Using a pretest-posttest design, this quasi-experimental study, included 350 participants within the intervention group and 350 participants within the control group. All participants were selected from three high schools in Ho Chi Minh City in Vietnam. Intervention group participants got a gamified traffic safety learning experience with a gamified e-learning platform, while control group participants received general traffic safety education through conventional methods using short videos. The effect was measured via tests focusing on traffic knowledge and skills. Data were subsequently collected from both groups before (i.e., pretest) and immediately after (i.e., posttest 1) following the education. In addition, within the intervention group also a second posttest (i.e., posttest 2) was conducted six months after following the education. RESULTS: A significant increase in scores on posttest 1 compared to the pretest was found in the intervention group but not in the control group. Also, among the intervention group, the scores in posttest 2 were significantly better than those in the pretest, however, there was no difference in scores between posttest 1 and posttest 2. CONCLUSION: The results of this study indicated that the gamified e-learning platform cannot only improve participants' knowledge of traffic safety but also help participants retain such knowledge for at least six months. PRACTICAL IMPLICATIONS: The study findings can reinforce the important role of traffic safety education in improving adolescent traffic knowledge and skills.

Effects of within-day intervals on adaptation to visually induced motion sickness in a virtual-reality motorcycling simulator.

This study investigated the effects of the time interval between virtual reality (VR) sessions on visually induced motion sickness (VIMS) reduction to better understand adaptation to and recovery from a nauseating VR experience. The participants experienced two 6-min VR sessions of a first-person motorcycle ride through a head-mounted display with (1) a 6-min interval, (2) an interval until the VIMS score reached zero, and (3) a 60-min interval. The results showed that for each condition, VIMS in the second session was aggravated, unchanged, or attenuated, respectively, indicating that additional resting time was necessary for VIMS adaptation. This study suggests that a certain type of multisensory learning attenuates VIMS symptoms within a relatively short time, requiring at least 20 min of additional resting time after subjective recovery from VIMS symptoms. This finding has important implications for reducing the time interval between repeated challenges when adapting to nauseating stimuli during VR experiences.

Exploring the barriers and underlying factors of utilizing a motorcycle without a license among adolescent boys: a qualitative study in Iran.

BACKGROUND: Motorcyclists constitute the highest proportion of victims of road traffic accidents. Riding a motorcycle without a license in teenagers is one of the accident-causing behaviors. Therefore, the current study was conducted with the aim of qualitatively investigating the obstacles and underlying factors of utilizing a motorcycle without a license among adolescent boys in Iran. METHODOLOGY: The present research qualitative research employed the grounded theory approach. The study population of the current research included all teenagers aged 10-18 years old in Farsan City of Chaharmahal and Bakhtiari province in 2023. The sample size was 14 obtained on the principle of data saturation using the purposeful sampling method. Interviews with participants using a semi-structured questionnaire were conducted. For data coding, MAXQDA 2022 software was used, and data analysis was done with open, axial, and selective coding methods. RESULTS: The lowest age at the first experience riding a motorcycle was 10 years old. Most of the cases had their first experience of riding a motorcycle at the age of 14 years. By achieving theoretical saturation in the interviews, 51 open codes were identified, and our qualitative data analyses resulted in 7 obstacles to unlicensed motorcycling in 4 categories. "Traffic rules and the desire to get a license", "accidents and financial, life and insurance losses", "the existence of a suitable structure for motorcycle riding training", and "opposition of families and unavailability of motorcycles". Also, regarding the 15 factors underlying driving a motorcycle without a license, 7 categories, "disregarding traffic rules", "inappropriate educational structure", "excitement and pleasant feeling", "spending life and free time", "enthusiasm and love" Youth", "Encouragement and support of significant others and availability of motorcycles", "Economic problems" were obtained. CONCLUSIONS: According to the findings, the obstacles and underlying factors of riding motorcycles without a license were identified from the perspective of teenagers, by focusing on these factors and also changing or modifying the things that can be changed, the occurrence of this behavior and ultimately the resulting injuries can be reduced.

Fatal traffic accidents involving electric scooters in Poland in 2019-2023.

With the introduction of mobile applications that allow short-term rentals, electric scooters (e-scooters) are gaining popularity as a means of micromobility in urban areas. The aim of the study was to assess the circumstances and causes of death in traffic accidents involving electric scooters in Poland. The inclusion criteria for the study were met by 9 cases (7 M,2F; mean age: 40.3 years). Accidents usually occur during working days during the warm months, especially during the morning traffic rush hour. Usually, these accidents involved another vehicle (4/9 cases). In addition, the victim was most often the driver (8/9 cases) and rarely uses a helmet (1/9 cases). In only two cases did the test reveal the presence of alcohol in the blood at the time of the accident. In studied cases, head injuries occurred in every case, and injuries to the limbs and chest occurred in more than half of the cases. Within the head, in addition to minor injuries like bruises and epidermal abrasions, skull fractures, and intracranial bleedings predominated. Similar minor injuries were also observed in the extremities, with significant fractures observed only in the lower extremities. Among chest injuries, lung contusions predominated. The most common cause of death was craniocerebral injury (6/9 cases), but there were two deaths each from chest injuries and polytrauma. To increase the safety of e-scooter users, it is recommended that measures be taken to educate users about the potential risks of using the vehicle and that measures be taken to increase the use of helmets, e.g. through legislative action. Further studies involving larger study groups are needed to assess the correlation between potential risk factors and the fatal outcome of the accident.

Real-time conflict risk at signalized intersection using drone video: A random parameters logit model with heterogeneity in means and variances.

Signalized intersections are crash prone. This can be attributed to driver errors, red light running behaviour, and poor coordination of conflicting traffic. It is anticipated that overall crash risk at signalized intersection would increase when mixed traffic like motorcycles is involved. In this study, a real-time prediction model for motorcycle and non-motorcycle involved conflict risk at the signalized intersection is proposed. For example, high-resolution vehicle and motorcycle trajectory data are extracted from drone videos using advanced computer vision techniques. Additionally, conflict types including rear-end, angle, and head-on conflicts are also considered. Then, the multinomial logit approach is adopted to model the propensity of severe and slight vehicle-vehicle and vehicle-motorcycle conflicts. Furthermore, the problem of unobserved heterogeneity is addressed using the random parameters model with heterogeneity in means and variances. Results indicate that risk of vehicle-vehicle conflict is significantly associated with vehicle speed and acceleration, and conflict type, and that of vehicle-motorcycle conflict is associated with vehicle speed and acceleration, motorcycle lateral speed, conflict type, and time to green signal. Findings should shed light to the development and implementation of optimal traffic signal time plan and traffic management strategy that can mitigate the potential crash risk, especially involving motorcycles, at the signalized intersection.

Road safety attitude and behaviour among motorcycle riders in Ghana: A focus on traffic locus of control and health belief.

Road traffic accident is a leading cause of death and various life deformities worldwide. This burden is even higher among motorcycle riders in lower-to-middle-income countries. Despite the various interventions made to address the menace, the fatalities continue to be on the ascendency. One major area that has received little attention is the attitude and behaviour of motorcycle riders. The present study aimed to examine the contribution of traffic Locus of Control (LoC) and health belief on road safety attitude and behaviour. 317 motorcycle riders participated in the study. The participants completed a questionnaire comprising various sections such as motorcycle riding behaviour, road safety attitude, risk perception, the intention to use helmets, and traffic LoC. The results showed a significant positive correlation between road safety attitude and behaviour (r (295) = .33, p < .001). Drifting towards internal LoC was associated with more positive behaviour on the roads (r (295) = -.23, p < .001). Intention to use helmet, health motivation, perceived susceptibility, perceived benefits, and perceived barriers were the factors in the health belief model that were associated with road safety attitude (r (295) = .404, p < .001). Finally, the multiple linear regression model showed that road safety attitude and traffic LoC made significant contributions to road user behaviour [F(3, 293) = 13.73, p < .001]. These findings have important implications towards shaping responsible behaviour among motorcycle riders.

Questioning penalties and road safety Policies: Are they enough to deter risky motorcyclist Behavior?

Reducing risky behaviors and traffic violations is crucial for preventing road trauma among private and commercial motorcyclists. While legal interventions such as road rules and police enforcement have been somewhat effective, there is a gap in understanding how motorcyclists perceive these deterrents and the psycho-social factors influencing their effectiveness. This research aims to explore the interplay between motorcyclists' psycho-social predispositions and their responses to legal interventions. It also compares two distinct groups of riders - private and commercial motorcyclists - within the urban environment of Da Nang, Vietnam, providing a nuanced consideration of the influence of work-related impacts on risky behavior, which can enable targeted interventions. We propose a theoretical model integrating the Theory of Planned Behavior and Deterrence Theory to analyze how psycho-social and punitive factors influence riders' traffic violations. A total of 423 delivery riders and 411 private riders in Da Nang participated in the study. The results show that attitude, perceived behavioral control, and perceptions of deterrence significantly impact riders' intentions to engage in risky behaviors, with delivery riders being particularly responsive to law enforcement and penalties. To enhance policy effectiveness, interventions should employ tailored enforcement strategies that account for the unique motivations and perceptions of each rider group. For example, increasing the visibility and consistency of law enforcement could be particularly impactful for delivery riders, who are more sensitive to immediate deterrents. Policy adjustments should also focus on reshaping riders' attitudes toward safety and adjusting their perceived control over riding situations. By tailoring interventions to effectively influence each group's behavior, we can ultimately reduce traffic incidents.

Association between e-scooter temporal usage patterns with injuries resulting in admission to a level one trauma center.

BACKGROUND: As e-scooters have become common modes of transportations in urban environments, riding e-scooters has become a common mechanism of injury. This study examines the relationship between when riders are using these devices (i.e. day of week, and time of the day) and injury incidence based on data from a large U.S. city. METHODS: This study is a retrospective cohort study of patients in the trauma registry at a level one trauma center. Registry data were combined with a publicly available dataset of all e-scooter trips that occurred during the study period. Frequency of injuries and trips were analyzed using ANOVA. Poisson regressions were conducted to calculate incidence rate ratios associated with injury incidence by day of the week and time of day. RESULTS: A total of 194 injured e-scooter patients were admitted to the trauma center during the study period. Patients were injured most often on Fridays (21%) and most often presented between 18:00-23:59 (38%). E-Scooter riders in general, most often rode on Saturdays (20%) and between 12:00-17:59 (44%). There was no significant relationship between day of week and injury. Riders in the early morning (IRR = 16.7, p < .001 95% CI: 10.5, 26.6), afternoon (IRR = 2.0, p = .01 95% CI: 1.2, 3.4), and evening (IRR = 3.7, p < .001 95% CI: 2.3, 6.2) had significant increased injury incidence compared to morning riders. CONCLUSION: E-Scooter injury incidence varies by the time of day. The time of day in which a person rides an e-scooter can have a significant impact on the likelihood that the person will sustain an injury.

Investigating vehicle-vehicle and vehicle-pedestrian crash severity at street intersections with the latent class parameterized correlation bivariate generalized ordered probit.

Street intersection crashes often involve two parties: either two vehicles hitting each other (i.e., a vehicle-vehicle crash) or a vehicle colliding with a pedestrian (i.e., a vehicle-pedestrian crash). In such crashes, the severity of injuries can vary considerably between the parties involved. It is necessary to understand the injuries of both parties simultaneously to identify the causality of a vehicle-pedestrian or two-vehicle crash. While the latent class ordinal model has been used in crash severity studies to capture heterogeneity in crash propensity, most of these studies are univariate, which is inappropriate for crashes involving two parties. This study proposes a latent class parameterized correlation bivariate generalized ordered probit (LCp-BGOP) model to examine 32,308 vehicle-vehicle and vehicle-pedestrian crashes at intersections in Taipei City, Taiwan. The model parameterizes thresholds and within-crash correlations of crash severity involving two parties and classifies these crashes into two distinct risk groups: the "Ordinary Crash Severity" (OCS) group and the "High Crash Severity" (HCS) group. The OCS group is mainly two-vehicle crashes involving motorcycles. The HCS group comprises vulnerable road users such as pedestrians and cyclists, mainly in mixed traffic with heavy volumes. The results also show that the effects of party-specific factors contributing to injury severity are greater than those of generic factors. Our study provides invaluable insight into intersection crashes, helping to reduce the severity of injuries in vehicle-vehicle and vehicle-pedestrian crashes.

Enhancing mutual understanding of e-scooter user's perspective in overtaking maneuver through replaying own driving trajectory.

The global adoption of e-scooters as a convenient mode of micro-mobility transportation is on the rise, offering a flexible solution for covering first- and last-mile journeys. However, this surge in usage brings challenges, particularly concerning road safety, as e-scooter riders often share road space with other vehicles, heightening the risk of serious accidents. While numerous studies have explored safe overtaking behaviors and safety perceptions from drivers' viewpoints, limited attention has been given to understanding the varying safety perceptions of both drivers and e-scooter riders, particularly after riding an e-scooter and being overtaken by their own vehicles. This research aims to bridge this gap by examining variations in safety perceptions and assessing behavioral changes before and after experiencing overtaking scenarios. Specifically, the study focuses on scenarios where an e-scooter rider experiences being overtaken by a vehicle they had previously driven. A Unity-based sequential simulation process is employed to replay scenarios obtained from a vehicle simulator during an e-scooter experiment involving the same participant without their awareness. This innovative approach allows e-scooter rider participants to relive their own prior vehicle overtaking maneuvers while riding an e-scooter. The findings reveal that most participants (64%) felt less safe as e-scooter riders, influenced by factors like relative speed and acceleration of overtaking vehicles. After experiencing being overtaken by their own pre-driven vehicles, a noteworthy positive correlation emerged between safety perception and lateral distance, indicating that greater distance is derived from a better understanding of e-scooter safety. The study demonstrates the effectiveness of the sequential simulation strategy in fostering safe driving behavior and raising road safety awareness. Experiencing overtaking behaviors firsthand as an e-scooter rider, previously behind the wheel of the overtaking vehicle, encourages a heightened awareness of road safety. These findings have significant implications for road safety authorities, suggesting the potential application of this approach in driver education programs. By incorporating such interventions tailored to improve the safety of vulnerable road users, authorities can take proactive steps towards mitigating risks associated with micro-mobility transportation.

Driver's license, head protection devices and severity of motorcyclists' injuries in traffic accidents.

OBJECTIVES: to describe traffic accidents involving motorcyclists and analyze the association between possession of a motorcycle driver's license and use of helmets according to the severity of injuries. METHODS: a cross-sectional study was conducted among all patients hospitalized in the traumatology and orthopedics sector of a public reference hospital in northeastern Brazil. RESULTS: 170 patients were surveyed, the majority were male (95.9%). Their ages ranged from 18 to 67 years. Most were black or brown (52.3%), had completed elementary school (58.9%) and had monthly income smaller than two minimum wages (56.5%). An association was found between being licensed to drive a motorcycle and wearing a helmet. Among those who suffered moderate injuries, this association was OR=5.66(1.85-17.23) and among those who suffered severe injuries it was OR=13.57(2.82-65.14). CONCLUSIONS: people who were licensed to drive motorcycles used a helmet as protective equipment more often and, in accidents, suffered fewer injuries.

Latent toxoplasmosis, Cytomegalovirus, and Herpes Simplex Virus infections and risk of motorcycle accidents: A case-control study in a county with a high rate of motorcycle injuries in Iran.

BACKGROUND: Road traffic injuries (RTIs) are among the most important issues worldwide. Several studies reported that infection with the neurotropic parasite Toxoplasma gondii (T. gondii) increased the risk of car accidents. In this study, our objective was to investigate the possible associations among latent T. gondii, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV) infections with the risk of motorcycle accidents in Jahrom (Fars Province), which is a county with a high rate of motorcycle accidents in Iran. METHODS: In the setting of a case-control study; 176 motorcyclist men, including 88 survivors of motorcycle accidents and 88 motorcyclist without accidents, were considered as case and control groups, respectively. Rates of latent infections with T. gondii, CMV, and HSV were assessed by an enzyme-linked immunosorbent assay (ELISA). RESULTS: Eleven of 88 (12.5%) in the case group and 22 of 88 (25.0%) in controls were positive for anti-T. gondii IgG antibodies, this difference was statistically significant (OR = 0.42; CI: 0.19-0.95, p = 0.03). The general seroprevalence of CMV (94.3% in the case group vs. 87.5% in the control group, OR = 2.37; CI: 0.78-7.13, p = 0.12) and HSV (63.6% in the case group vs. 62.5% in the control group, OR = 1.05; CI: 0.57-1.94, p = 0.87) were not significantly different between the case and control groups. CONCLUSIONS: Although latent toxoplasmosis has been associated with traffic accidents in recent reports, we found a negative association between latent toxoplasmosis and motorcycle accidents among survivors of these accidents. As such, latent CMV and HSV infections did not differ significantly between the cases compared to the control groups.

Isolated musculocutaneous nerve injury in a motorcyclist - a case report.

INTRODUCTION: Isolated musculocutaneous nerve injuries occur rarely due to their anatomical location. We present our patient with a musculocutaneous nerve injury in a motorcyclist. CASE: The patient was initially treated for a motorcycle accident. Further examination of the patient revealed impaired elbow flexion and numbness of the lateral forearm. Electromyography confirmed impaired function of the musculocutaneous nerve. After 3 months, the patient's condition did not show any improvement, neither electromyography confirmed recovery of the nerve activity, so surgical treatment was planned. In the surgical revision, neuroma-in-continuity was discovered and resected. The resulting nerve defect was 6 cm long. We provided nerve grafting using sural nerve from the right lower limb. After surgery, the patient began physical therapy and electrical stimulation. Two years later, the patient reached complete recovery of muscle strength. CONCLUSION: Due to the lack of improvement after a 3-month period, we proceeded with a surgical revision, which demonstrated a complete lesion of the nerve that could not heal spontaneously. Therefore, we opted for the nerve graft method and the patient regained full function of elbow flexors.

E-Scooter facial fractures: A comparative cohort study.

It was the aim of the study to analyze the distribution and pattern of facial fractures following e-scooter trauma. Prospective audit data of facial fractures were retrospectively collected to investigate the impact of e-scooter hire, specifically in the form of facial fractures associated with their use. Data collected included patient demographics, mode of injury, date of injury, facial bones involved, presence of soft tissue injury, and factors associated with injury, including intoxication and helmet use. A total of 849 patients were treated for facial fractures during the study period, of which 34 were attributed to e-scooter use. One-half of those injured riding e-scooters were intoxicated, and one-quarter were wearing helmets. There have been an increasing number of facial fractures associated with e-scooter use following the start of the shared e-scooter trial. Zygomaticomaxillary complex fractures were the most common pattern of facial fracture seen. Most patients required surgical management of their injuries. Policymakers should consider how to improve the enforcement of current regulations, given the healthcare cost associated with the management of these preventable injuries.

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.