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1.
PLoS One ; 19(8): e0307950, 2024.
Article in English | MEDLINE | ID: mdl-39172983

ABSTRACT

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.


Subject(s)
Accidents, Traffic , Cytomegalovirus Infections , Herpes Simplex , Motorcycles , Toxoplasmosis , Humans , Iran/epidemiology , Accidents, Traffic/statistics & numerical data , Case-Control Studies , Male , Toxoplasmosis/epidemiology , Adult , Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/complications , Herpes Simplex/epidemiology , Herpes Simplex/complications , Cytomegalovirus , Young Adult , Middle Aged , Simplexvirus/pathogenicity , Toxoplasma , Risk Factors , Latent Infection/epidemiology , Adolescent
2.
PLoS One ; 19(8): e0309117, 2024.
Article in English | MEDLINE | ID: mdl-39178214

ABSTRACT

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.


Subject(s)
Accidents, Traffic , Motorcycles , Safety , Humans , Male , Adult , Accidents, Traffic/prevention & control , Accidents, Traffic/psychology , Female , Ghana , Surveys and Questionnaires , Young Adult , Middle Aged , Head Protective Devices/statistics & numerical data , Internal-External Control , Adolescent , Attitude , Health Knowledge, Attitudes, Practice
3.
Acta Chir Plast ; 66(2): 86-89, 2024.
Article in English | MEDLINE | ID: mdl-39174344

ABSTRACT

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.


Subject(s)
Accidents, Traffic , Motorcycles , Musculocutaneous Nerve , Humans , Musculocutaneous Nerve/injuries , Musculocutaneous Nerve/surgery , Male , Adult , Peripheral Nerve Injuries/surgery , Sural Nerve/transplantation
4.
JAMA Netw Open ; 7(7): e2424131, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-39042404

ABSTRACT

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.


Subject(s)
Accidents, Traffic , Bicycling , Hospitalization , Humans , Male , Female , Cross-Sectional Studies , Adult , Middle Aged , Adolescent , Bicycling/injuries , Bicycling/statistics & numerical data , United States/epidemiology , Young Adult , Child , Accidents, Traffic/statistics & numerical data , Hospitalization/statistics & numerical data , Wounds and Injuries/epidemiology , Aged , Motorcycles/statistics & numerical data , Child, Preschool
5.
Injury ; 55(9): 111724, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39054232

ABSTRACT

Severe burns related to fires and explosions of lithium-ion batteries of electric motorcycles have not been reported to date. We retrospectively studied 419 patients admitted to our burn intensive care unit from January 2016 to December 2021. Of these 419 patients, 26 (22 male, 4 female; median age, 42 years) had burns related to lithium-ion battery fires and explosions, and all of their injury characteristics were similar to those of traditional flame burns. Lithium-ion battery-related burns were the eighth most common cause of burn injuries among all hospitalized patients. The 26 patients comprised 10 unemployed and 16 employed individuals. Twenty-three patients were injured at home during the battery charging process, and three were injured outdoors (one by a fire while the electric motorcycle was stationary and the others two by a fire while riding the motorcycle). The burn sites were distributed over the whole body; the burn area ranged from 10 % to 100 % of the total body surface area, and the burn depth ranged from superficial second-degree burns to third-degree burns. Twenty-three patients had inhalation injuries, and ten underwent prophylactic tracheostomy and intubation. Multiple operations were required for wound repair. Although convenient, lithium-ion electric motorcycles can also cause severe burns. To prevent these injuries, we must increase public safety awareness and education, develop new battery energy storage systems and battery management systems, and ensure the safety of batteries. Consumers should be aware of the potential dangers of lithium-ion batteries and comply with related security measures.


Subject(s)
Burns , Electric Power Supplies , Explosions , Fires , Lithium , Motorcycles , Humans , Male , Female , Adult , Retrospective Studies , Burns/etiology , Lithium/adverse effects , Middle Aged , Electric Power Supplies/adverse effects , Young Adult , Burn Units , Intensive Care Units
6.
Am J Case Rep ; 25: e944431, 2024 Jul 31.
Article in English | MEDLINE | ID: mdl-39083451

ABSTRACT

BACKGROUND A traumatic coronary artery dissection is a rare but severe complication of chest trauma that can result in blockage of the coronary artery. The clinical symptoms can vary considerably, from asymptomatic arrhythmia to acute myocardial infarction and sudden death. This report describes a young man with coronary artery dissection following blunt chest trauma from a motorcycle accident presenting with ventricular fibrillation due to acute myocardial infarction, which was treated with percutaneous transluminal coronary angioplasty and extracorporeal membrane oxygenation. CASE REPORT We present a 21-year-old man with chest contusion from a motorcycle accident who experienced sudden collapse due to ventricular fibrillation and acute myocardial infarction. The patient was resuscitated with extracorporeal membrane oxygenation, and 12-lead electrocardiogram showed sinus tachycardia with a hyperacute T-wave and ST elevation in leads V2-V6. Percutaneous coronary intervention revealed dissection from the ostial to proximal portion of the left anterior descending artery, and traumatic coronary artery dissection was confirmed. He was successfully treated with percutaneous transluminal coronary angioplasty, in which a drug-eluting stent was inserted to enhance blood flow in the left anterior descending artery, resulting in TIMI 2 flow restoration. After 16 days of intensive care, he was discharged and was well at a 3-month follow-up. CONCLUSIONS This report describes a case with the rare association between blunt chest trauma and coronary artery dissection and highlights that coronary artery dissection can result in ST-elevation myocardial infarction. Extracorporeal membrane oxygenation can protect the patient's circulation for coronary angioplasty. Therefore, early detection and intensive resuscitation can prevent disastrous outcomes.


Subject(s)
Accidents, Traffic , Motorcycles , Myocardial Infarction , Wounds, Nonpenetrating , Humans , Male , Myocardial Infarction/therapy , Young Adult , Wounds, Nonpenetrating/complications , Wounds, Nonpenetrating/therapy , Extracorporeal Membrane Oxygenation , Coronary Vessels/injuries , Percutaneous Coronary Intervention , Electrocardiography , Thoracic Injuries/complications , Aortic Dissection/complications , Aortic Dissection/therapy , Drug-Eluting Stents , Coronary Aneurysm/therapy , Coronary Aneurysm/etiology , Angioplasty, Balloon, Coronary
7.
BMJ Case Rep ; 17(6)2024 Jun 25.
Article in English | MEDLINE | ID: mdl-38925669

ABSTRACT

This brief report discusses the diagnosis, management and surgical intervention of a man in his 30s presenting with a rare traumatic sternal manubrium dislocation following a motorcycle crash, accompanied by multiple concomitant rib fractures. The severity and complexity of the patient's injuries necessitated an operative approach for his sternomanubrial dislocation, emphasising the importance of multidisciplinary coordination, accurate diagnosis and prompt surgical intervention. The report provides valuable insights into the successful application of open reduction and internal fixation with plating in a real-world setting, which resulted in positive patient outcomes, despite the rarity and severity of this type of trauma. It further underscores the need for additional research to advance best practices for managing traumatic sternal manubrium dislocations in the context of high-impact injuries.


Subject(s)
Accidents, Traffic , Fracture Fixation, Internal , Joint Dislocations , Manubrium , Motorcycles , Rib Fractures , Sternum , Humans , Male , Rib Fractures/surgery , Rib Fractures/diagnostic imaging , Joint Dislocations/surgery , Joint Dislocations/diagnostic imaging , Fracture Fixation, Internal/methods , Adult , Manubrium/injuries , Manubrium/surgery , Sternum/injuries , Sternum/surgery , Sternum/diagnostic imaging
8.
Accid Anal Prev ; 205: 107668, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38889599

ABSTRACT

The safety of two-wheelers is a serious public safety issue nowadays. Two-wheelers usually have severe conflict interaction with vehicles at intersections, such as running red lights, which is very likely to cause traffic accidents. Therefore, a model of two-wheeler driving behavior in conflicting interactions can provide guidance for traffic safety management on one hand, and can be used for the development and testing of autonomous vehicles on the other. However, the existing models perform poorly when interacting with vehicles. To address the problems, this paper proposes a modeling method (an improved social force model, ISFM) for two-dimensional two-wheeler driving simulation for conflict interaction at intersections. Based on analysis of naturalistic driving study data, when two-wheelers encounter with vehicles, their driving intentions and trajectories can be categorized into two groups, which are yielding and overtaking. Therefore, the vehicle-related social forces are designed to be a set of two forces rather than a repulsion force in original SFM, which is a yielding force based on the relative distance between the two-wheeler and the vehicle, and an overtaking force based on the velocity of the two-wheeler itself. This opens up the possibilities for modeling the multi-modal driving intention of two-wheelers encountering with cross traffic. Based on ISFM, a bicycle model, a powered two-wheeler (PTW) model and a model of a group of PTWs, are then constructed. Compared to the original SFM, ISFM increases the precision of driving intention prediction by 19.7 % (yielding situation) and 25.0 % (overtaking situation), and reduces the root mean square error between simulated and actual trajectories by 7.8 % and 14.8 % on the bicycle model and the PTW model, respectively. Meanwhile, the model of a group of PTWs also performs well. Finally, the results of ablation experiments also validate the effectiveness of the social force designed based on velocity.


Subject(s)
Accidents, Traffic , Automobile Driving , Humans , Automobile Driving/psychology , Accidents, Traffic/prevention & control , Male , Models, Theoretical , Adult , Intention , Motorcycles , Female , Safety , Young Adult
9.
Accid Anal Prev ; 204: 107648, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38833986

ABSTRACT

Illegal lane-transgressing is a typical aberrant riding behavior of riders of two-wheelers, i.e., motorcycles, bicycles, and e-bikes, which is highly frequent in accident reports. However, there is insufficient attention to this behavior at present. This study aims to explore the socio-psychologic factors that influence the illegal lane-transgressing behavior of two-wheeler riders when overtaking. For this purpose, a questionnaire was first composed. The questionnaire included the behavioral intention of two-wheeler riders towards illegal overtaking behavior and five influencing factors: safety knowledge, descriptive norms, injunctive norms, perceived behavior control, and risk perception. Second, a survey was conducted on different two-wheeler riders in Xi'an. Third, various types of two-wheelers were analyzed jointly and separately by structural equation models and analyses of variance. Results show that e-bike riders were more similar to motorcycle riders in behavioral intentions, with their risk perception weaker than other riders. Descriptive norms and perceived behavior control played the most significant roles in the structural equation model. It was also found that two-wheeler riders with a car license had better traffic safety performance. Based on the above results, it is recommended that attention be paid to illegal lane-transgression in the process of law enforcement and education, and a higher level of safety training should be provided for two-wheeler riders.


Subject(s)
Accidents, Traffic , Intention , Motorcycles , Humans , Motorcycles/legislation & jurisprudence , Male , Adult , Female , Surveys and Questionnaires , Accidents, Traffic/prevention & control , Young Adult , Bicycling , Automobile Driving/legislation & jurisprudence , Automobile Driving/psychology , Safety , Social Norms , China , Middle Aged , Adolescent , Risk-Taking
10.
Accid Anal Prev ; 204: 107651, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38833987

ABSTRACT

Traffic crashes involving three-wheeler motorized rickshaw (3-WMR) are alarming public health and socioeconomic concerns in developing countries. While most of the earlier studies have dealt with safety analysis of four- and two-wheelers, there is a noticeable gap in understanding the safety dynamics, especially the risk factors affecting the crashes involving 3-WMR. The present study aims to address this gap by exploring potential risk factors influencing 3-WMR crashes, utilizing a correlated random parameters multinomial logit model with heterogeneity in means (CRPMNLMHM). This modeling framework advances the classic random parameters model by capturing associations among random parameters, providing a more comprehensive understanding of crash risks associated with 3-WMR. The empirical analysis draws on three years of traffic crash records (2017-2019) maintained by RESCUE 1122 in Rawalpindi city, Pakistan. A comparative assessment between the modeling frameworks demonstrated that CRPMNLMHM outperformed its counterparts. Model assessment for heterogeneity in the means identifies two significant variables, i.e., young age and nighttime, which yield statistically significant random parameters. In addition, the model's results suggest that fatal and severe injury outcomes in 3-WMR crashes are affected by several attributes related to temporal characteristics (weekend, nighttime, and off-peak indicators), driver profiles (young, older aged, and speeding), posted speed limits (>70 kmph), weather conditions (raining), and crash characteristics (collision with pedestrians, trucks, or 3-WMR overturning). The present study's findings offer invaluable insights, emphasizing the significance of considering for unobserved heterogeneity in variables contributing to the injury severity of 3-WMR crashes. Moreover, in light of the findings, a set of policy implications are suggested, which will guide safety practitioners to develop more effective countermeasures to address safety issues associated with 3-WMRs.


Subject(s)
Accidents, Traffic , Humans , Accidents, Traffic/statistics & numerical data , Male , Adult , Risk Factors , Female , Pakistan/epidemiology , Middle Aged , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Motorcycles , Young Adult , Adolescent , Logistic Models , Age Factors , Injury Severity Score
11.
J Occup Health ; 66(1)2024 Jan 04.
Article in English | MEDLINE | ID: mdl-38782720

ABSTRACT

OBJECTIVE: The health benefits of active commuting have been reported. However, few studies have assessed commuting modes using objective methods. This study clarified the association between changes in objectively measured commuting modes and body weight among Japanese workers. METHODS: This longitudinal study used data from the annual health examinations and personnel records of a company with branches in all prefectures of Japan. Data from 2018 and 2019 were used as the baseline and follow-up data, respectively. The commuting mode was assessed using the commuting mode code included in the personnel records and classified into 3 types: walking, public transport, and car or motorcycle. The participants were classified into 9 categories based on the combination of their commuting modes in 2018 and 2019. Body weight was measured objectively during health examinations. The 1-year changes in body weight were calculated for the 9 categories and assessed using an analysis of covariance with adjustments for covariates. RESULTS: The analysis included 6551 workers (men: 86.8%; mean age: 42.8 years). Overall, body weights tended to increase (+0.40 kg/y). The participants who switched to more active commuting, such as from car or motorcycle to walking (-0.13 kg/y), from car or motorcycle to public transport (+0.10 kg/y), and from public transport to walking (-0.07 kg/y), exhibited small weight gains or losses. A similar trend was observed even after adjustment. CONCLUSIONS: Changing to a more active commuting mode may prevent weight gain among workers.


Subject(s)
Body Weight , Transportation , Walking , Humans , Longitudinal Studies , Male , Adult , Japan , Transportation/methods , Female , Middle Aged , Motorcycles , East Asian People
12.
Traffic Inj Prev ; 25(6): 852-859, 2024.
Article in English | MEDLINE | ID: mdl-38768387

ABSTRACT

OBJECTIVE: The present study focuses on understanding the behavior of motorized 2-wheeler (MTW) riders at urban unsignalized intersections in India. In the Indian context, over 60% of road crash fatalities are attributed to vulnerable road users, with MTWs serving as the predominant contributors, accounting for 44% of total fatalities. Notably, unsignalized intersections have emerged as critical sites for accidents involving vulnerable road users. METHODS: Postencroachment time is used to assess traffic conflicts of MTW users. Furthermore, the study employs the exceedance property of extreme value theory to calculate crash probabilities. Tobit and grouped random parameters Tobit regression models are developed to model crash probabilities, incorporating variables such as traffic volume, traffic composition, gap acceptance time, intersection characteristics, and intersection conflict area at 4 urban unsignalized intersections in Surat, India. RESULTS: MTW riders have the lowest gap acceptance time among vehicles in the traffic stream. Cars and other heavy vehicles readily accept gaps when MTWs are in the conflicting stream at unsignalized intersections, which increases traffic conflicts. MTWs have the highest crash rates in the traffic stream. Among the developed models, the grouped random parameters Tobit regression captures the spatial unobserved heterogeneity of the study sites and outperforms the simple Tobit regression model. The results also indicate that MTW riders are exposed to a higher risk of crashes while turning at unsignalized intersections. The presence of a central traffic island has varied implications; it raises crash rates at 3-legged intersections but lowers them at 4-legged intersections for 2-wheelers. CONCLUSION: The study concludes that MTW crash rates are influenced by traffic and intersectional factors. Increased gap acceptance time correlates with lower crash rates. Countermeasure selections require detailed investigations, because it was observed that the presence of central traffic islands has varied effects on crash rates at 3-legged and 4-legged unsignalized intersections.


Subject(s)
Accidents, Traffic , Environment Design , Motorcycles , Accidents, Traffic/statistics & numerical data , India/epidemiology , Humans , Automobile Driving/statistics & numerical data , Models, Statistical
13.
JMIR Res Protoc ; 13: e55297, 2024 May 07.
Article in English | MEDLINE | ID: mdl-38713507

ABSTRACT

BACKGROUND: Injury is a global health concern, and injury-related mortality disproportionately impacts low- and middle-income countries (LMICs). Compelling evidence from observational studies in high-income countries shows that trauma education programs, such as the Rural Trauma Team Development Course (RTTDC), increase clinician knowledge of injury care. There is a dearth of such evidence from controlled clinical trials to demonstrate the effect of the RTTDC on process and patient outcomes in LMICs. OBJECTIVE: This multicenter cluster randomized controlled clinical trial aims to examine the impact of the RTTDC on process and patient outcomes associated with motorcycle accident-related injuries in an African low-resource setting. METHODS: This is a 2-arm, parallel, multi-period, cluster randomized, controlled, clinical trial in Uganda, where rural trauma team development training is not routinely conducted. We will recruit regional referral hospitals and include patients with motorcycle accident-related injuries, interns, medical trainees, and road traffic law enforcement professionals. The intervention group (RTTDC) and control group (standard care) will include 3 hospitals each. The primary outcomes will be the interval from the accident to hospital admission and the interval from the referral decision to hospital discharge. The secondary outcomes will be all-cause mortality and morbidity associated with neurological and orthopedic injuries at 90 days after injury. All outcomes will be measured as final values. We will compare baseline characteristics and outcomes at both individual and cluster levels between the intervention and control groups. We will use mixed effects regression models to report any absolute or relative differences along with 95% CIs. We will perform subgroup analyses to evaluate and control confounding due to injury mechanisms and injury severity. We will establish a motorcycle trauma outcome (MOTOR) registry in consultation with community traffic police. RESULTS: The trial was approved on August 27, 2019. The actual recruitment of the first patient participant began on September 01, 2019. The last follow-up was on August 27, 2023. Posttrial care, including linkage to clinical, social support, and referral services, is to be completed by November 27, 2023. Data analyses will be performed in Spring 2024, and the results are expected to be published in Autumn 2024. CONCLUSIONS: This trial will unveil how a locally contextualized rural trauma team development program impacts organizational efficiency in a continent challenged with limited infrastructure and human resources. Moreover, this trial will uncover how rural trauma team coordination impacts clinical outcomes, such as mortality and morbidity associated with neurological and orthopedic injuries, which are the key targets for strengthening trauma systems in LMICs where prehospital care is in the early stage. Our results could inform the design, implementation, and scalability of future rural trauma teams and trauma education programs in LMICs. TRIAL REGISTRATION: Pan African Clinical Trials Registry (PACTR202308851460352); https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25763. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55297.


Subject(s)
Accidents, Traffic , Motorcycles , Adult , Female , Humans , Male , Accidents, Traffic/mortality , Patient Care Team/organization & administration , Registries , Rural Health Services/organization & administration , Rural Population , Uganda/epidemiology , Wounds and Injuries/therapy , Wounds and Injuries/mortality , Randomized Controlled Trials as Topic , Multicenter Studies as Topic
14.
Arch Environ Occup Health ; 79(1): 23-31, 2024.
Article in English | MEDLINE | ID: mdl-38736426

ABSTRACT

This study aimed to explore the prevalence of work-related musculoskeletal disorders (WMSDs) and to investigate factors associated with WMSDs in commercial motorcyclists in Indonesia. This cross-sectional study involved commercial motorcyclists operating in Indonesia. Data were collected using an anonymous questionnaire, including the Indonesian Version of the Nordic Musculoskeletal Questionnaire, occupational driving posture questionnaire, and occupational factor-related questions. The questionnaire was distributed at four rest stops located in Central Jakarta, Indonesia. The result showed that 40% of participants (129/322) were having WMSDs. Older age, overweight body mass index (BMI), obese body mass index, nonregular physical activity, driving duration (> 8 h/day), seniority (≥5 years), and poor driving posture were significant risk factors for WMSDs in commercial motorcyclists. Based on the risk factors identified in this study, the development of preventive strategies among commercial motorcyclists is warranted.


Subject(s)
Motorcycles , Musculoskeletal Diseases , Occupational Diseases , Humans , Musculoskeletal Diseases/epidemiology , Musculoskeletal Diseases/etiology , Adult , Male , Cross-Sectional Studies , Risk Factors , Occupational Diseases/epidemiology , Occupational Diseases/etiology , Indonesia/epidemiology , Female , Middle Aged , Motorcycles/statistics & numerical data , Prevalence , Young Adult , Posture , Surveys and Questionnaires , Body Mass Index
15.
Accid Anal Prev ; 203: 107615, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38718663

ABSTRACT

This paper presents an enhanced probabilistic approach to estimate the real-world safety performance of new device concepts for road safety applications from the perspective of Powered Two-Wheeler (PTW) riders who suffer multiple injuries in different body regions. The proposed method estimates the overall effectiveness of safety devices for PTW riders by correlating computer simulations with various levels of actual injuries collected worldwide from accident databases. The study further develops the methodology initially presented by Johnny Korner in 1989 by introducing a new indicator, Global Potential Damage (GPD), that overcomes the limitations of the original method, encompassing six biomechanical injury indices estimated in five body regions. A Weibull regression model was fit to the field data using the Maximum Likelihood Method with boundaries at the 90% confidence level for the construction of novel injury risk curves for PTW riders. The modified methodology was applied for the holistic evaluation of the effectiveness of a new safety system, the Belted Safety Jacket (BSJ), in head-on collisions across multiple injury indices, body regions, vehicle types, and speed pairs without sub-optimizing it at specific crash severities. A virtual multi-body environment was employed to reproduce a selected set of crashes. The BSJ is a device concept comprising a vest with safety belts to restrict the rider's movements relative to the PTW during crashes. The BSJ exhibited 59% effectiveness, with an undoubted benefit to the head, neck, chest, and lower extremities. The results show that the proposed methodology enables an overall assessment of the injuries, thus improving the protection of PTW users. The novel indicator supports a robust evaluation of safety systems, specifically relevant in the context of PTW accidents.


Subject(s)
Accidents, Traffic , Computer Simulation , Protective Devices , Safety , Humans , Accidents, Traffic/prevention & control , Motorcycles , Wounds and Injuries/prevention & control , Likelihood Functions , Biomechanical Phenomena , Seat Belts
16.
Accid Anal Prev ; 203: 107610, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38749269

ABSTRACT

Due to the escalating occurrence and high casualty rates of accidents involving Electric Two-Wheelers (E2Ws), it has become a major safety concern on the roads. Additionally, with the widespread adoption of current autonomous driving technology, a greater challenge has arisen for the safety of vulnerable road participants. Most existing trajectory planning methods primarily focus on the safety, comfort, and dynamics of autonomous vehicles themselves, often overlooking the protection of vulnerable road users (VRUs), typically E2W riders. This paper aims to investigate the kinematic response of E2Ws in vehicle collisions, including the 15 ms Head Injury Criterion (HIC15). It analyzes the impact of key collision parameters on head injuries, establishes injury prediction models for anticipated scenarios, and proposes a trajectory planning framework for autonomous vehicles based on predicting head injuries of VRUs. Firstly, a multi-rigid-body model of two-wheeler-vehicle collision was established based on a real accident database, incorporating four critical collision parameters (initial collision velocity, initial collision position, and collision angle). The accuracy of the multi-rigid-body model was validated through verifications with real fatal accidents to parameterize the collision scenario. Secondly, a large-scale effective crash dataset has been established by the multi-parameterized crash simulation automation framework combined with Monte Carlo sampling algorithm. The training and testing of the injury prediction model were implemented based on the MLP + XGBoost regression algorithm on this dataset to explore the potential relationship between the head injuries of the E2W riders and the crash variables. Finally, based on the proposed injury prediction model, this paper generated a trajectory planning framework for autonomous vehicles based on head collision injury prediction for VRUs, aiming to achieve a fair distribution of collision risks among road users. The accident reconstruction results show that the maximum error in the final relative positions of the E2W, the car, and the E2W rider compared to the real accident scene is 11 %, demonstrating the reliability of the reconstructed model. The injury prediction results indicate that the MLP + XGBoost regression prediction model used in this article achieved an R2 of 0.92 on the test set. Additionally, the effectiveness and feasibility of the proposed trajectory planning algorithm were validated in a manually designed autonomous driving traffic flow scenario.


Subject(s)
Accidents, Traffic , Craniocerebral Trauma , Humans , Accidents, Traffic/statistics & numerical data , Accidents, Traffic/prevention & control , Craniocerebral Trauma/prevention & control , Craniocerebral Trauma/etiology , Biomechanical Phenomena , Computer Simulation , Automobile Driving/statistics & numerical data , Automation , Motorcycles , Models, Theoretical
17.
Accid Anal Prev ; 202: 107554, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38701558

ABSTRACT

BACKGROUND: Hazard perception (HP) has been argued to improve with experience, with numerous training programs having been developed in an attempt to fast track the development of this critical safety skill. To date, there has been little synthesis of these methods. OBJECTIVE: The present study sought to synthesise the literature for all road users to capture the breadth of methodologies and intervention types, and quantify their efficacy. DATA SOURCES: A systematic review of both peer reviewed and non-peer-reviewed literature was completed. A total of 57 papers were found to have met inclusion criteria. RESULTS: Research into hazard perception has focused primarily on drivers (with 42 studies), with a limited number of studies focusing on vulnerable road users, including motorcyclists (3 studies), cyclists (7 studies) and pedestrians (5 studies). Training was found to have a large significant effect on improving hazard perception skills for drivers (g = 0.78) and cyclists (g = 0.97), a moderate effect for pedestrians (g = 0.64) and small effect for motorcyclists (g = 0.42). There was considerable heterogeneity in the findings, with the efficacy of training varying as a function of the hazard perception skill being measured, the type of training enacted (active, passive or combined) and the number of sessions of training (single or multiple). Active training and single sessions were found to yield more consistent significant improvements in hazard perception. CONCLUSIONS: This study found that HP training improved HP skill across all road user groups with generally moderate to large effects identified. HP training should employ a training method that actively engages the participants in the training task. Preliminary results suggest that a single session of training may be sufficient to improve HP skill however more research is needed into the delivery of these single sessions and long-term retention. Further research is also required to determine whether improvements in early-stage skills translate to improvements in responses on the road, and the long-term retention of the skills developed through training.


Subject(s)
Accidents, Traffic , Automobile Driving , Humans , Accidents, Traffic/prevention & control , Automobile Driving/education , Automobile Driving/psychology , Motorcycles , Bicycling , Perception , Safety , Pedestrians
18.
Int J Legal Med ; 138(5): 1907-1924, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38763926

ABSTRACT

The intricate interplay of exposure and speed leave motorcyclists vulnerable, leading to high mortality rates. During the collision, the driver and the passenger are usually projected away from the motorcycle, with variable trajectories or final positions. Injuries resulting from the crash can exhibit distinct and specific characteristics depending on the circumstances of the occurrence.The aim of this study is to provide a systematic review of the literature on injuries sustained by motorcyclists involved in road accidents describing and analyzing elements that are useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to June 2023. Eligible studies have investigated issues of interest to forensic medicine about during traffic accidents involving motorcycle. A total of 142 studies met the inclusion criteria and were classified and analyzed based on the anatomical regions of the body affected (head, neck, thoraco-abdominal, pelvis, and limb injuries). Moreover, also the strategies for preventing lesions and assessing injuries in the reconstruction of motorcycle accidents were examined and discussed.This review highlights that, beyond injuries commonly associated with motorcycle accidents, such as head injuries, there are also unique lesions linked to the specific dynamics of accidents. These include factors like the seating position of the passenger or impact with the helmet or motorbike components. The forensic assessment of injury distribution could serve as support in reconstructing the sequence of events leading to the crash and defining the cause of death in trauma fatalities.


Subject(s)
Accidents, Traffic , Motorcycles , Wounds and Injuries , Humans , Forensic Medicine , Craniocerebral Trauma
19.
Int J Inj Contr Saf Promot ; 31(3): 499-507, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38712985

ABSTRACT

This study simultaneously modelled the injury severity of motorcycle riders and their pillion passengers and determine the associated risk factors. The analysis is based on motorcycle crashes data in Ashanti region of Ghana spanning from 2017 to 2019. The study implemented bivariate ordered probit model to identify the possible risk factors under the premise that the injury severity of pillion passenger is endogenously related to that of the rider in the event of crash. The model provides more efficient estimates by considered the common unobserved factors shared between rider and pillion passenger. The result shows a significant positive relationship between the two injury severities with a correlation coefficient of 0.63. Thus, the unobservable factors that increase the probability of the rider to sustain more severe injury in the event of crash also increase that of their corresponding pillion passenger. The rider and their pillion passenger injury severities have different propensity to some of the risk factors including passengers' gender, day of week, road width and light condition. In addition, the study found that time of day, weather condition, collision type, and number of vehicles involved in the crash jointly influence the injury severity of both rider and pillion passenger significantly.


Subject(s)
Accidents, Traffic , Motorcycles , Wounds and Injuries , Humans , Accidents, Traffic/statistics & numerical data , Risk Factors , Male , Female , Adult , Ghana/epidemiology , Wounds and Injuries/epidemiology , Wounds and Injuries/etiology , Adolescent , Young Adult , Middle Aged , Models, Statistical
20.
ScientificWorldJournal ; 2024: 7090576, 2024.
Article in English | MEDLINE | ID: mdl-38756481

ABSTRACT

Methods: A cross-sectional survey was conducted using a structured questionnaire involving 402 motorcyclists from four major southeastern towns, comprising 350 (86.07%) males and 52 (12.93%) females. The chi-square test was applied in bivariate analysis, and binary multivariable logistic regression was performed to determine the risk factors of road traffic crashes. Results: This study's findings revealed that the overall reported prevalence of road traffic crashes involving motorcycle drivers over one year was 68.66%. Multivariable logistic regression analysis revealed several factors that significantly impacted road traffic crashes. These factors included driving without a valid driving license, the young age (<20) of motorcyclists, driving in rainy weather, exceeding the speed limit, per-week working hours, smoking status, motorcycle ownership, the brand of motorcycle, and not wearing a helmet while driving. Conclusion: The study findings highlight the need for improving motorcycle safety by implementing measures such as imposing per-week work hour limits for riders, enforcing traffic regulations, and promoting helmet use among motorcycle drivers. The results of this study draw attention to the Bangladesh Road Transport Authority (BRTA) and motorcycle drivers in the country to decrease motorcycle crashes and the severity of injuries by implementing efficient guidelines and strategies for driving motorcycles. The findings of this study can assist policymakers and concerned authorities in taking the essential steps to lessen road traffic crashes among motorcyclists in Bangladesh.


Subject(s)
Accidents, Traffic , Motorcycles , Humans , Accidents, Traffic/statistics & numerical data , Motorcycles/statistics & numerical data , Bangladesh/epidemiology , Female , Male , Adult , Prevalence , Risk Factors , Cross-Sectional Studies , Young Adult , Middle Aged , Adolescent , Automobile Driving/statistics & numerical data , Surveys and Questionnaires , Head Protective Devices/statistics & numerical data
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