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Background: Fentanyl, a type of opioid, in impaired driving cases increased across cities in the United States. Objectives: No empirical studies have examined motor vehicle overdoses with fentanyl use. We investigated the magnitude of the motor vehicle overdose problem in Providence, RI, and the environmental, socioeconomic, and geographic conditions associated with motor vehicle overdose occurrence. Methods: This was a retrospective observational study of emergency medical services data on all suspected opioid overdoses between January 1, 2017, and October 31, 2020. The data contain forced-choice fields, such as age and biological sex, and an open-ended narrative in which the paramedic documented clinical and situational information. The overdoses were geocoded, allowing for the extraction of sociodemographic data from the U.S. Census Bureau's American Community Survey. Seven other data sources were included in a logistic regression to understand key risk factors and spatial patterns of motor vehicle overdoses. Results: Of the 1,357 opioid overdose cases in this analysis, 15.2% were defined as motor vehicle overdoses. In adjusted models, we found a 61% increase in the odds of a motor vehicle overdose involvement for men versus women, a 16.8% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to the nearest gas station, and a 10.7% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to a buprenorphine clinic. Conclusion: There is a need to understand the interaction between drug use in vehicles to design interventions for decreasing driving after illicit drug use. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aimed to assess the incidence and pattern of maxillofacial fractures and related demographic data in the victims of rollover crashes. Patients and Methods: This retrospective study was based on medical records of patients who sustained maxillofacial injuries following rollover accidents. Investigated data included age, gender, accident date and time, accident cause, seat belt usage, airbag deployment, road type, anatomical location of the facial fracture, and treatment approach. Results: Among the 147 patients who met the inclusion criteria, the most prevalent age groups were 20–30 (36.7%) and 30–40 (32.7%) years, with a mean age of 33.6 ± 9.7 years. The male‐to‐female ratio was 6:1. Most crashes occurred in March, August, and July. These accidents involved 69.4% light vehicles and 39.6% heavy vehicles. The leading causes of rollover crashes were speeding (58.5%) followed by distracted driving (21.1%) and traffic rule violations (13.6%). The most prevalent injuries were fractures of the maxillary sinus wall (40.8%), nasal bones (39.5%), zygomaticomaxillary complex (36.1%), and the mandible (32.6%). Surgical intervention was necessary for 44.2% of patients, while 12.9% of cases underwent close reduction, and 42.9% did not require any surgical intervention. The occurrence of nasal bone fractures was significantly lower in cases where seat belts were worn and zygomatic arch fractures were less frequent in incidents with airbag deployment. Conclusions: In rollover crashes, the midface is the most vulnerable anatomical location. Utilization of seat belts and airbag deployment has the potential to prevent nasal bone and zygomatic arch fractures. [ABSTRACT FROM AUTHOR]

This study combined the real-time monitoring and investigation of traffic flows to comprehensively analyze the road traffic flow and vehicle structure in downtown Beijing. A dynamic emission inventory of motor vehicle air pollutants in downtown Beijing in 2021 was established, and the impact of these emissions on air quality was simulated and quantified, and different emission reduction control scenarios were proposed to evaluate their environmental improvement effects and explore measures to mitigate the impact of pollution emissions. The results show that the high traffic flow and the structure of the motor vehicle emissions in downtown Beijing are the main causes of severe motor vehicle pollution. Monitoring data shows that traffic flow in central Beijing is dominated by small passenger vehicles, while the vehicle mix is better than in other regions, with 72.0% of vehicles meeting "National V" or higher emission standards. However, to achieve higher air quality goals, further reducing vehicle emissions is necessary. Based on dynamic traffic flow, the average daily emissions of nitrogen oxides (NO X), particulate matters(PM 2.5) and volatile organic compounds(VOC) from motor vehicles in central Beijing are 17.7 tons, 0.6 tons and 14.0 tons, respectively, accounting for 23.0% of the city's average daily motor vehicle emissions. If a zero-emission zone for motor vehicles were implemented in central Beijing, the annual average emission level of pollutants will be reduced by 10.4% to 21.0%. The designation of ultra-low emission zones for motor vehicles could be effective in improving the air quality in the center of Beijing. [Display omitted] [ABSTRACT FROM AUTHOR]

Forensic engineers and crash safety researchers sometimes use the injuries of a seatbelted occupant to infer the injury risk of an unbelted occupant in the same crash, had they instead been wearing a seatbelt. It is unclear, however, whether this inference is valid or how often two occupants in the same collision have similar injuries. Here, we sought to compare the injury outcomes between drivers and front‐seat passengers in frontal collisions using real‐world collision data. We compared the injury severity, quantified using the Abbreviated Injury Scale (AIS), of 22 injury categories between front‐seat occupants with matching seatbelt use and airbag deployment in single‐event frontal collisions recorded in the publicly available National Automotive Sampling System, Crashworthiness Data System (years 1993–2015) database to assess whether they had similar severity injuries. We analyzed the four combinations of seatbelt use and airbag deployment and all seatbelt/airbag conditions combined. In only 3 of 88 combinations of injuries and seatbelt/airbag conditions did more than 50% of occupant pairs have the same AIS score, although the related confidence intervals showed these proportions were not significantly greater than 50%. In contrast, we found 19 combinations of injuries and seatbelt/airbag conditions where one occupant was consistently injured more severely than the other. Our findings show that injury outcome is not similar for both front‐seat occupants in the same frontal collision with similar seatbelt and airbag conditions; however, one may be able to predict that one occupant would be more severely injured than their fellow occupant. [ABSTRACT FROM AUTHOR]

Aims: We conducted this review to characterize the quality of evidence about associations between diabetes and safe driving and to evaluate how these findings are reflected within current guidelines available to support clinicians and their patients with diabetes. Methods: The first stage entailed a systematic search and review of the literature. Evidence surrounding harms associated with diabetes and driving was identified, screened, extracted and appraised for quality utilizing the Newcastle Ottawa Scales (NOS). Next, relevant guidelines regarding driving and diabetes were sourced and summarized. Finally, the identified guidelines were cross‐referenced with the results of the systematic search and review. Results: The systematic search yielded 12,461 unique citations; 52 met the criteria for appraisal. Fourteen studies were rated as 'high', two as 'medium' and 36 as 'low'. Studies with ratings of 'high' or 'medium' were extracted, revealing a body of inconsistent methods and findings. These results, cross‐referenced with the guidelines, suggest a lack of agreement and a limited evidence base to justify recommendations. Conclusions: The results presented emphasize the need for a better understanding of the impacts of diabetes on safe driving to inform evidence‐based guidelines. [ABSTRACT FROM AUTHOR]

This paper presents comparative characteristics of the aluminum and magnesium alloys in the context of their utilization in the metallurgical and automotive industry. The studies carried out in our work help to solve the problem of reducing the weight of automotive devices to reduce fuel consumption through the use of aluminum-magnesium alloys. The originality of our article lies in a comprehensive study of the stated problem: development of a research methodology, testing of the alloys under study for uniaxial tension, quantitative analysis of the Portevin-Le Chatelier effect, development of a mathematical model for optimizing parts, computer simulation of the viscoplastic properties of a model sample. Analysis of the obtained strength parameters demonstrates that the flow characteristics of the two-phase alloy of aluminum and magnesium exceed the ultimate tensile strength by 50 %. Rate of extension was inversely proportional to the intensity of the Portevin-Le Chatelier effect. [ABSTRACT FROM AUTHOR]

Introduction/purpose: Motor vehicles are complex dynamic systems due to spatial displacements, changes in the characteristics of components during their lifetime, a large number of influences and disturbances, the appearance of backlash, friction, hysteresis, etc. The aforementioned dynamic phenomena, especially vibrations, cause driver and passenger fatigue, reduce the lifetime of the vehicle and its systems, etc. Methods: In general, the movement of vehicles is carried out on uneven roads and curvilinear paths in the road. Not only do oscillatory movements cause material fatigue of vehicle parts, but they also have a negative effect on people's health. That is why special attention must be paid to the coordination of the mutual movement of the subsystems, and in particular, the vehicle suspension system, even at the stage of the motor vehicle design. For these purposes, theoretical, experimental or combined methods can be used. Therefore, it is very useful to have the experimental results of the oscillations of the vehicle subsystem in operating conditions, so the aim of this work was to use the movement of the 4x4 drive FAP 1118 vehicle in operating conditions (due to higher speeds - in road conditions) to define the conditions for testing oscillatory loads in laboratory conditions. Results:This is made possible by registering and identifying statistical parameters of registered quantities. Conclusion: Based on the measured data, the research can be programmed on shakers in laboratory conditions, and, at the same time, the size to be reproduced can be chosen as well. [ABSTRACT FROM AUTHOR]

Methamphetamine (METH) and 3,4‐methylenedioxymethamphetamine (MDMA) are common drugs of abuse and driving under their influence may occur in 1 million people yearly in the United States. This systematic review fills the currently unmet need in understanding the effects of METH and MDMA on motor vehicle driving performance (MVP) and provides insight into the forensic community. A PubMed search on September 24, 2020, for experimental and observational studies, which evaluated the impact of METH and MDMA on MVP was performed. After a review of 208 abstracts, 103 were considered potentially interesting and full texts were obtained. After the exclusion of non‐English articles, review articles, single case reports, and articles which did not evaluate METH or MDMA on MVP, a total of nine experimental studies, 10 traditional observational studies, and 35 case series were included. The clinical rigor of experimental studies was evaluated using the Jadad scale. Experimental studies often demonstrated no significant MVP safety signals for METH or MDMA use, which was contrary to the overwhelming MVP safety risks found in observational studies. Common driving behaviors while using METH or MDMA include: errors in judgment, traveling at high speeds, failure to stop, merging inappropriately, lane weaving, and crashes. Limitations of experimental studies that led to dissimilar MVP outcomes from observational studies include: the common use of driving simulators, as opposed to actual driving examinations, and doses of METH or MDMA administered may not be representative of blood concentrations seen in observational studies. This systematic review has no funding source and was not registered. [ABSTRACT FROM AUTHOR]

Objectives: This study derives the statistical power of the common hit rates test of taste-based discrimination in police searches. It also identifies search intensity as a source of bias in the test and proposes a simple empirical adjustment to account for the bias. Methods: Data simulations, along with two empirical applications to motor vehicle search data, display the practical importance of both statistical power and search intensity bias in the hit rates test. Results: Statistical power varies markedly with the parameters of the application. Differential search intensity across groups will bias results, but the simple empirical adjustment provides a valid test when the data contain a discrete indicator of search intensity. In the empirical applications, unadjusted and adjusted tests differ in their conclusion of whether police discrimination exists. Conclusions: For the presentation of multiple hit rates tests, statistical power should be reported with p-values. Theoretical bounds on search intensity bias are wide, and the bias can persist for any sample size. Hit rates tests should therefore be interpreted with caution when data contain no indicator of search intensity. [ABSTRACT FROM AUTHOR]

Inconsistent access to healthcare for people with epilepsy results in reduced adherence to antiseizure medications, increased seizure frequency, and fewer appropriate referrals for epilepsy surgery. Identifying and addressing factors that impede access to care should consequently improve patient outcomes. We hypothesized that health insurance and transportation affect access to outpatient neurology care for adults living with epilepsy in the United States (US). We conducted a retrospective cross-sectional study of US adults with active epilepsy surveyed via the National Health Interview Survey (NHIS) in 2015 and 2017. We established whether patients reported seeing a neurologist in the past year and used multiple logistic regression to determine whether health insurance status and transportation access were associated with this outcome. We identified 735 respondents from 2015 and 2017, representing an estimated 2.98 million US adults with active epilepsy. After adjusting for socioeconomic and seizure-related co-variates, we found that a lack of health insurance coverage was associated with no epilepsy care in the past year (adjusted odds ratio [aOR] 0.22; 95 % confidence interval [CI]: 0.09 – 0.54). Delayed care due to inadequate transportation (aOR 0.42; 95 % CI: 0.19 – 0.93) also resulted in reduced patient access to a neurologist. Due to the inherent nature of their condition, people with epilepsy are less likely to have employer-sponsored health insurance or consistent driving privileges. Yet, these factors also impact patient access to neurological care. We must address transportation and insurance barriers through long-term investment and partnership between community, healthcare, and government stakeholders. • 64.8 % of US adults with active epilepsy saw a neurologist in 2015 and 2017. • Patients without insurance were less likely to see a neurologist. • Transportation barriers also contribute to decreased access to epilepsy care. [ABSTRACT FROM AUTHOR]

In vehicular accident reconstruction, a number of parameters need to be estimated, as commonly no specific measurement data or convenient measurement methods are available. One of these parameters is the position of a car's centre of gravity. Depending on the impact configuration, the centre of gravity may have a significant influence on the reconstruction result. A number of regression models and rules of thumb have already been developed in the past to calculate the position of the centre of gravity. The further automotive vehicle development in recent years has led to different vehicle architectures with larger masses. This study therefore deals with developing and testing a new regression model for vehicles, distinguishing between conventional and electric drives. That is based on the analysis of 147 rollover stability measurements of road vehicles from the years 2016–2022. The model developed from these tests for the centre of gravity height shows a good fit with the measurement data and only requires knowledge of the roof height. • Evaluation of latest rollover stability measurement data • Development of an regression model for approximation of CG height of CEVs • Development of an regression model for approximation of CG height of BEVs [ABSTRACT FROM AUTHOR]

In this paper the dynamical analysis of a vehicle to trailer connection during braking is presented. At first both the vehicles, motor vehicle and trailer are analysed as a separate vehicles, driving with same starting velocity and same braking force applied but no connection between them. Than the dynamic analysis is conducted for two types of connection, one rigid and second one with inertial brake between. The chronology of the study is to find the displacement of the vehicles as separate systems and to conduct the dynamic analysis of the two connections as a difference in the travel till zero velocity. The aim of the paper is to acknowledge the stiffness of the vehicle to trailer connection during braking. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) in pediatric patients is a major burden to public health. Understanding clinical associations with severity and short hospitalization (≤ 1 day length of stay) is needed to better inform management paradigms and optimize triage. Methods: A retrospective review of the Kids' Inpatient Database (KID) was performed for all data reported between 2006 and 2012 for TBI patients aged ≤ 20 years. Univariate and multivariate regression analyses were performed to identify predictive factors of trauma severity and short hospitalization. Results: A total of 220,777 pediatric TBI cases were identified, with the majority of cases being boys (66%) with a mean age of 11.5 years. Mean length of stay was 5.0 days, with 25% discharged within 1 day, and 83% routinely discharged home. In-hospital mortality occurred in 4% of cases. More severe TBI presentations were significantly and independently associated with older age, weekend admissions, hospital transfers, and in patients with chronic conditions and neurological issues (all P < 0.01). There were 38% of admission that were short hospitalizations. Younger age, male gender, less chronic conditions, fall and assault etiologies, and with milder injury severity all significantly and independently predicted greater likelihood of short hospitalization. Conclusions: The severity of pediatric TBI admissions to the hospital can be impacted by a number of parameters. Furthermore, there exists a subset of clinical associations for short hospitalization admissions. Proactive identification of these parameters at time of presentation will assist in optimizing the management of pediatric TBI]. [ABSTRACT FROM AUTHOR]

Background: Many older adults face the difficult decision of when to stop driving. We sought to test whether an online driving decision aid (DDA) would improve decision quality. Methods: This prospective two‐arm randomized trial enrolled English‐speaking licensed drivers (age ≥70 years) without significant cognitive impairment but with ≥1 diagnosis associated with increased likelihood of driving cessation; all participants received primary care in clinics associated with study sites in three states. The intervention was the online Healthwise® DDA for older adults addressing "Is it time to stop driving?"; control was web‐based information for older drivers only. The primary outcome was decision conflict as estimated by the Decisional Conflict Scale (DCS; lower scores indicate higher quality). Secondary outcomes were knowledge and decision self‐efficacy about driving decisions. We examined postrandomization differences in primary and secondary outcomes by study arm using generalized linear mixed‐effects models with adjustment for site and prerandomization scores. Results: Among 301 participants (mean age: 77.1 years), 51.2% identified as female and the majority as non‐Hispanic (99.0%) and white (95.3%); 98.0% lived in an urban area. Participant characteristics were similar by study arm but differed across sites. Intervention participants had a lower mean DCS score (12.3 DDA vs 15.2 control; adjusted mean ratio [AMR] 0.76, 95%CI 0.61–0.95; p = 0.017). Intervention participants had higher mean knowledge scores (88.9 DDA vs. 79.9 control; OR 1.13, 95%CI 1.01–1.27, p = 0.038); there was no difference between groups in self‐efficacy scores. The DDA had high acceptability; 86.9% of those who viewed it said they would recommend it to others in similar situations. Conclusions: The online Healthwise® DDA decreased decision conflict and increased knowledge in this sample of English‐speaking, older adults without significant cognitive impairment, although most chose to continue driving. Use of such resources in clinical or community settings may support older adults as they transition from driving to other forms of mobility. Trial registration: ClinicalTrials.gov identifier "Advancing Understanding of Transportation Options (AUTO)" NCT04141891. [ABSTRACT FROM AUTHOR]

Background and Aims: Sobriety checkpoints are an effective strategy to reduce alcohol‐impaired driving, motor vehicle crashes, injuries and fatalities. The aim of this study was to identify the geographic extent over which individual sobriety checkpoints affect alcohol‐impaired driving. Design, Setting, Participants: Spatial ecological panel analysis using geolocated breath test data from the Queensland Police Service, Australia, for January 2012 to June 2018. Data were aggregated over 338 weeks within 528 Statistical Area level 2 (SA2) units (n = 178 464 SA2‐weeks) and 84 Statistical Area level 3 (SA3) units (n = 28 392 SA3‐weeks). SA2 units in Queensland contain a mean population of 8883.5 (SD = 55 018.3) and encompass 468.9 roadway kilometers (SD = 1490.0); SA3 units contain a mean population of 57 201.6 (SD = 29521.6) and encompass 2936.0 roadway kilometers (SD = 7025.0). Measurements Independent measures were the density of sobriety checkpoints conducted per 500 roadway kilometers within local and spatially adjacent space–time units. The dependent measure was the rate of tests that detected breath alcohol concentration (a proxy for blood alcohol concentration [BAC]) greater than the legal maximum value of 0.05% for fully licensed drivers in Queensland. Bayesian hierarchical spatial negative binomial models‐related sobriety checkpoints to the rate of breath tests with BAC ≥ 0.05% within and between space–time units. Findings One additional sobriety checkpoint conducted per 500 roadway kilometers was associated with 2.5% reduction in the rate of breath tests with BAC ≥ 0.05% within local SA2 units (incidence rate ratio [IRR] = 0.975; 95% credibility interval (CrI): 0.973–0.978), and with 5.5% reduction in the rate of breath tests with BAC ≥ 0.05% within local SA3 units (IRR = 0.945; 95%CrI: 0.937–0.953). Associations were attenuated towards null in spatially adjacent units and in temporally lagged units (e.g. SA3‐weeks; adjacent lagged 1 week: IRR = 0.969; 95%CrI: 0.937–1.003). Conclusions: Individual sobriety checkpoints appear to be associated with reductions in nearby alcohol‐impaired driving. Relationships decay after approximately 1 week and beyond local areas containing approximately 60 000 residents and 3000 kilometers of roadway. [ABSTRACT FROM AUTHOR]

We report 2 episodes of potential SARS-CoV-2 transmission from infected van drivers to passengers despite masking and physical distancing. Whole-genome sequencing confirmed relatedness of driver and passenger SARS-CoV-2. With the heater operating, fluorescent microspheres were transported by airflow >3 meters from the front to the back of the van. [ABSTRACT FROM AUTHOR]

BACKGROUND: Road traffic injuries (RTIs) are the second leading cause of mortality in Saudi Arabia. The high rate of RTIs puts a strain on rehabilitation services. Yet, little is known of the economic burden of nonfatal RTIs and rehabilitation services. This study, therefore, aims to describe the annual rehabilitation costs associated with RTIs at a local trauma center. MATERIALS AND METHODS: This study was conducted among all the 17 years or older patients hospitalized at King Abdulaziz Medical City in Riyadh following RTIs and required rehabilitation care. We included 299 patients who met the inclusion criteria and were followed for one year after discharge from the index hospital. The data was abstracted through retrospective review of patients' medical records. All rehabilitative services utilized by the healthcare system were recorded. To describe the economic burden, the mean, median, standard deviation, and interquartile range (IQR) were calculated. Total costs were aggregated for all patients to estimate overall costs. RESULTS: The study population was relatively young (31 years ± 14.4). The total annual rehabilitation cost of patients was Saudi Riyals (SAR) 6,113,781 (IQR: 20,589.3 − 3,125 = 17,464.3), and the average for each patient was SAR 20,447 (median = 7875). Patients aged 40–59 years and ≥60 years accounted for the highest average rehabilitation cost of SAR 31,563.99 and 32,639.21, respectively. Rehabilitation visits incurred the highest cost (mean SAR 1,494,124), followed by bed utilization which cost SAR 1,311,972 and radiology examination at SAR 1,032,261. The cost of motorcycle injuries was relatively higher (SAR 44,441.0) than other injury mechanisms. CONCLUSION: This study underlines the economic burden of rehabilitation services resulting from RTIs. Public health interventions are needed to reduce the burden of RTIs by dealing with their preventable causes and improving road safety measures. These findings may be useful to policymakers and researchers to support and improve rehabilitation services in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Congestion pricing policies (CPPs) are a common strategy for addressing urban traffic congestion. Research has explored several impacts of these policies (e.g., air quality, equity, congestion relief). The purpose of this review was to synthesize findings from publications examining CPP impacts on road user safety outcomes. We conducted a systematic search of relevant literature in four large research databases (Transport Research International Documentation, Web of Science, PubMed, and Scopus), searching from database inception through January 2021. We identified 18 eligible publications. Safety-related outcomes included overall crashes and injury crashes with stratification by injury severity and road user type (e.g., bicyclist, pedestrian). A majority of the publications examined zone-based CPPs (n = 13) and used observed data involving real policies (n = 10), as compared to a predicted or simulated analysis. Decreases in overall crashes and injuries for some road users were observed (e.g., car occupants). While some studies estimated short-term increases in injuries and crashes for bicyclists and motorcyclists (likely due to shifts from personal vehicle use to other transportation modes and increased exposure), most analyses focused on longer-term impacts and generally found a reversal and eventual decrease in injuries and crashes after a few years. The relative scarcity of safety outcomes in published literature, along with the wide breadth of CPP types, implementation contexts, and outcomes measured, demonstrates that more research on safety outcomes is needed. Cities and regions planning to implement CPPs should consider potential mode shifts and safety supports for all road users (e.g., bicycle and pedestrian infrastructure). [ABSTRACT FROM AUTHOR]

The first steam-powered vehicle is attributed to Ferdinand Verbiest in China made in 1672 for the Kangxi Emperor. The first recorded automobile death was Mary Ward in Ireland who was thrown from a steam-powered car and fell under its wheels in 1869. The first person killed in the United States is recorded as Henry Bliss in New York City on Wednesday, September 13, 1899. As the automobile became popular among all groups of humans, motor vehicle crashes became the major cause of death and disability among children and adolescents. Research initially focused on the physical trauma that motor vehicle accidents or crashes induced, but eventually the psychological toll of motor vehicle crashes (MVCs) in the pediatric population became appreciated. This discussion reflects on how this occurred taking the entire 20th century to be acknowledged by researchers, clinicians, parents, and the general society. [ABSTRACT FROM AUTHOR]

The motor vehicle crash is the main cause of death and destruction in children and adolescents. One of the major psychological consequences to those who survive a motor vehicle crash (MCV) is post-traumatic stress disorder (PTSD). This discussion considers the future of research in this field that may also involve the use of artificial intelligence in control of motor vehicles that will take human error out of motor vehicle operation. It is important to consider all means in lowering the death and destruction faced by our children and adolescents on the killing fields of the roads in the United States and the world. [ABSTRACT FROM AUTHOR]

This review considers the teenage driver and the high risk of injury as well as death that these young drivers represent for themselves and others because of automobile crashes in the United States and around the world. Research suggests that half a million teenagers will die as motor vehicle drivers or passengers in the 21st century, that 35 million adolescents will be injured as drivers in the 21st century, and untold millions of car passengers are at risk of death and/or injury when exposed to teenage drivers in this century. Reasons for the high prevalence of motor vehicle crashes with injuries and deaths are considered as well as measures that have been instituted over the past few decades to improve this situation. From a viewpoint of prospicience, it is hoped that more preventive measures along with more research will help to reverse this tragic trend in the 21st century [ABSTRACT FROM AUTHOR]

Comme il existe une jurisprudence condamnant le défaut d'information au patient conducteur, nous proposons aux patients cliniquement stabilisés des séances d'éducation thérapeutique. Un simulateur de conduite d'auto-école est utilisé comme outil. Cependant, il n'existe pas de moyen pour différencier l'influence du traitement médicamenteux de l'influence de la pathologie sur la conduite et aider l'équipe médicale à proposer un avis. Un score appelé score des pictogrammes, qui est le total des niveaux de risque conduite de tous les médicaments prescrit, est calculé. Le score pictogramme est ensuite comparé pour chaque patient au score de conduite obtenu sur le simulateur. Quinze patients ambulatoires stabilisés (dépressifs, bipolaires ou schizophrènes), (8H, 7F, de 50,67 ± 6,53 ans), possédant un permis de conduire B depuis 29,53 ± 8,16 ans, sans pathologie somatique et ne recevant que des psychotropes à des posologies thérapeutiques, ont donné leur consentement. Le score de conduite obtenu sur le simulateur est comparé à la moyenne d'un groupe de 15 sujets sains témoins (8H et 7F de 32 ± 8,67 ans et 13,07 ± 7,94 ans de permis) ne prenant aucun médicament à l'exception d'une contraception hormonale pour les femmes. La formule du score du total des pictogrammes est la somme des niveaux réglementaires des « pictogrammes conduite » pondérés de tous les médicaments psychotropes présents sur l'ordonnance de chaque patient. La moyenne des scores sur simulateur de conduite du groupe des patients est significativement inférieure à celles du groupe de sujets sains témoins avec respectivement 64,67 ± 10,40 (32 à 82) et 79,67 ± 6,84 (62 à 92) (p = 0,0018). Si 20 % des patients de notre échantillon ont échoué (score ≤ 50/100), 74 % ont des capacités de conduite sur simulateur comparables aux témoins. Sur les 12 derniers mois précédant l'étude, les patients n'ont comme antécédents que des accidents de la voie publique alors que les témoins n'ont que des contraventions pour excès de vitesse. Les médecins psychiatres, dont un médecin certifié pour le contrôle médical du permis de conduire, estiment que la séance pousse le patient à progresser « à contresens », il surmonte ses propres « interdits » intériorisés par ses appréhensions en situation de conduite. Le score des pictogrammes de l'ordonnance peut permettre de mesurer le niveau de risque de la polymédication. Il est analysé en tenant compte du type de molécule, de la posologie, du délai écoulé depuis l'initiation du traitement, du délai écoulé depuis la dernière prise, de l'âge du patient et du diagnostic. Pour un score psychotrope supérieur à 17, on observe une dégradation du score sur simulateur de conduite et potentiellement un seuil de risque à prendre en compte. Au total, la prise de médicaments psychotropes n'est pas obligatoirement synonyme d'inaptitude à conduire, y compris pour des traitements de niveau 3. Le score des pictogrammes de l'ordonnance systématiquement effectué par questionnement de données (data mining) permet au patient de se situer sur une échelle de risque. Il permet d'orienter les patients avec un score supérieur ou égal à 17 vers une séance d'éducation thérapeutique. Le score des pictogrammes de l'ordonnance ne rend compte que de l'effet traitement. Comparé au score de conduite sur simulateur, il peut permettre de différencier les effets liés à la pathologie de ceux des psychotropes. Il peut permettre une réévaluation du traitement pour les patients devant conduire. Il ne se substitue pas aux tests psychotechniques, mais peut les compléter dans un dimensionnement élargi et médicalisé. Les personnels soignants sont sensibilisés au risque conduite et disposent d'un critère objectif pour informer les patients avant leur sortie temporaire ou définitive d'hospitalisation. Il permet aussi de les orienter vers un avis médical, pharmaceutique complémentaire. As there is a case-law sentencing the lack of information to the patients who drive, we propose to clinically stabilized patients, sessions of therapeutic education. A driving simulator was used as therapeutic education tool and driving assessment tool. At the same time we calculated a score called pictograms' score corresponding to the sum of risk level of each psychotropic driving-impairing medicine of the patient's prescription. Driving skill scores were then compared to the calculated pictograms' score. 15 stabilized outpatients (depressive, bipolar or schizophrenic), (8M, 7F, 50.67 ± 6.53 years old), having a French B driving license since 29.53 ± 8.16 years, without somatic pathology and receiving psychotropic medications at usual dosages gave their consent and entered the study. 15 healthy control subjects (8H and 7F of 32 ± 8.67 years and 13.07 ± 7.94 years of license) taking no medication (with exception for hormonal contraception for women) were also tested for driving skills on the driving simulator used by the French Driving Schools ran on a desktop computer. The pictograms' score is the weighted sum of the regulatory levels of harmonized warning pictograms for all the psychotropic prescribed. The average simulator driving skills scores of the patient group are significantly lower than those of the healthy control group with 64.67 ± 10.40 (32 to 82) and 79.67 ± 6.84 (62 to 92), respectively (P = 0.0018). While 20% of the patients in our sample failed (score ≤ 50/100), 74% have comparable simulator driving skills as to the healthy subjects. In the previous 12 months before the study, their background was some road accidents among patients but only excess speed tickets for the healthy control subjects. The psychiatrists, including a doctor certified for the medical check of driving license, observed that the therapeutic education sessions are useful in moving the patient "in the right way" by overcoming his "innner conflicts", and fears when driving. The pictograms' score of the prescription allow us to measure the risk of multiple medications. It is analyzed taking into account the type of molecule, the dosage, the time passed since the initiation of treatment and since the last dose, the age of the patient and the diagnosis. For a psychotropic score greater than 17, we observed a worsening of the driving simulator score and potentially a risk threshold to be taken into account. Guidelines that physicians use to assess fitness for driving are limited in their currency, and applicability. All in all, the pictograms' score of the patient's prescription help him to understand the risk scale and act more safely. We use the pictograms' score calculated by data mining in our health institution to refer patients with a score greater than or equal to 17 to a therapeutic education session. The pictograms' score reflects only the treatment effect. With regards to the simulator' driving score, the pictograms' score differentiates the effects of the pathology from side effects of psychotropic medications on driving. Thus, it can help medication checking and reduce risk for patients who needed to drive. [ABSTRACT FROM AUTHOR]

Objective: Sobriety checkpoints have strong empirical and theoretical support as an intervention to reduce alcohol‐involved motor vehicle crashes. The purpose of this study was to examine whether checkpoint size (the number of police officers) and checkpoint duration (the amount of time in operation) affect associations between individual checkpoints and subsequent alcohol‐related crash incidence. Method: Queensland Police Service provided latitude–longitude coordinates and date and time data for all breath tests that occurred in Brisbane, Australia, from January 2012 to June 2018. We applied hierarchical cluster analysis to the latitude–longitude coordinates for breath tests, identifying checkpoints as clusters of ≥25 breath tests conducted by ≥3 breath testing devices over a duration of 3 to 8 hours. Generalized linear autoregressive moving average (GLARMA) models related counts of alcohol‐involved motor vehicle crashes to the number of checkpoints conducted per week, as well as 1 week prior and 2 weeks prior. Results: A total of 3420 alcohol‐related crashes occurred and 2069 checkpoints were conducted in Brisbane over the 6.5‐year (339‐week) study period. On average, checkpoints included a mean of 266.0 breath tests (SD = 216.3), 16.4 devices (SD = 13.7), and were 286.3 minutes in duration (SD = 104.2). Each 10 additional checkpoints were associated with a 12% decrease in crash incidence at a lag of 1 week (IRR = 0.88; 95%CI: 0.80, 0.97). We detected no differential associations according to checkpoint size or duration. Conclusions: Sobriety checkpoints are associated with fewer alcohol‐related motor vehicle crashes for around 1 week. Checkpoint size and duration do not appear to affect this relationship. [ABSTRACT FROM AUTHOR]

To explore the effects of different traffic structures and wind speeds on concentration distribution of multi-component pollutants, CO, C4H8, and NO2 with proportions of 81%, 12%, and 7%, respectively, were selected for computational fluid dynamics simulations. Their concentrations were estimated in a reference scenario and five contrast scenarios. When the number of cars is reduced by 15%, their concentrations at point 1 (–28, 1.5) and point 2 (28, 1.5) will decrease by more than 10%. When the number of cars is reduced by 25%, their concentrations will decrease by 20%. The largest concentration in 1.5 m above the ground level under six scenarios is measured on the leeward side when x=–3.3 m. Even if the wind speed increases to 3.0 m/s, the position where the largest concentration occurs remains the same. When wind speed increased to 3.0 m/s, the pollutants concentration on the leeward side decreased by an average of 4%, whereas that on the windward side decreased by an average of 11%. An additional 3.2%, 3.4%, 3.4%, 2.8%, 3.3%, and 3.1% reduction in CO concentration on the leeward side occurred. These results can help to strengthen the policy-making to create a good travel environment for pedestrians. [ABSTRACT FROM AUTHOR]

Motor vehicles passing through natural areas could contribute to the air pollution that most likely causes biodiversity losses and decreases air quality. This study assessed the impact of tourism on atmospheric metal pollution in Khao Yai National Park (KYNP), Thailand. Native thalli of the epiphytic lichen Parmotrema tinctorum were collected during the rainy period at a total of eleven sampling sites: three sites in forested (no traffic), four sites in accommodation (low-moderate traffic) and four sites in parking (moderate-high traffic) areas in KYNP. Nine traffic-related metals, including As, Cd, Cr, Cu, Fe, Pb, Sb, V and Zn, were detected using inductively coupled plasma mass spectrometry (ICPMS). The concentrations of most metals did not show significant differences between the higher traffic intensity areas and the no traffic area, and the concentrations of the metals were in the range of their background concentrations. Only Cr and V, metals related to motor vehicles, were identified at the accommodation sites at significantly higher concentrations (Cr=3.4 µg/g, V=1.33 µg/g) than their baseline concentrations (Cr=1.4 µg/g, V=0.96 µg/g). These two metals have adverse effects on humans, plants, lichens and other organisms. Bioaccumulation ratios (B ratios) indicated that most metals at most sampling sites did not bioaccumulate. No metal demonstrated high or severe bioaccumulation. This result suggests that the impact of tourism on atmospheric metal pollution in the rainy period at the KYNP was modest. It also affirms the ability of lichen as an effective tool for assessing atmospheric contamination in natural areas. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to characterize the population prevalence of pain and mental health problems postinjury and to identify risk factors that could improve service delivery to optimize recovery of at-risk patients. Methods This population-based registry cohort study included 5,350 adult survivors of transport-related major trauma injuries from the Victorian State Trauma Registry. Outcome profiles were generated separately for pain and mental health outcomes using the "pain or discomfort" and "anxiety or depression" items of the EuroQol Five Dimensions Three-Level questionnaire at six, 12, and 24 months postinjury. Profiles were "resilient" (no problems at every follow-up), "recovered" (problems at six- and/or 12-month follow-up that later resolved), "worsening" (problems at 12 and/or 24 months after no problems at six and/or 12 months), and "persistent" (problems at every follow-up). Results Most participants had persistent (pain/discomfort, N = 2,171, 39.7%; anxiety/depression, N = 1,428, 26.2%) and resilient profiles (pain/discomfort, N = 1,220, 22.3%; anxiety/depression, N = 2,055, 37.7%), followed by recovered (pain/discomfort, N = 1,116, 20.4%; anxiety/depression, N = 1,025, 18.8%) and worsening profiles (pain/discomfort, N = 956, 17.5%; anxiety/depression, N = 948, 17.4%). Adjusted multinomial logistic regressions showed increased risk of problems (persistent, worsening, or resolved) vs no problems (resilient) in relation to female sex, middle age, neighborhood disadvantage, pre-injury unemployment, pre-injury disability, and spinal cord injury. People living in rural areas, motorcyclists, pedal cyclists, and people with head, chest, and abdominal injuries had lower risk of problems. Discussion Targeted interventions delivered to people with the risk factors identified may help to attenuate the severity and impact of pain and mental health problems after transport injury. [ABSTRACT FROM AUTHOR]

Introduction: Trauma related to car accidents are among the most common type of trauma. The purpose of this study was to investigate the two-year road accidents of Maragheh-Hashtroud in terms of causes and factors lead to accidents. Method: This is a retrospective descriptive study. Sample size includes all patients with traffic accident in 2017 and 2018 consecutive years hospitalized in Amiralmomenin Hospital of Maragheh, Iran. Convenient Sampling was done. Data were analyzed using SPSS version 19. Result: 150 injured cases were investigated. Accidents occur more often in young people and men. Failure to pay attention to traffic rules and attention and concentration disorder is the most important cause of accidents. Conclusion: The human factor is the most important cause of traffic accidents, which occurs mostly due to non-observance of traffic rules and drowsiness. [ABSTRACT FROM AUTHOR]

The aim of this article was to analyse the correlation of emission intensity of carbon monoxide, hydrocarbons, nitrogen oxides, and carbon dioxide in various conditions of operation of the automotive internal combustion engine. The operational properties of the engine were investigated on chassis dynamometer in driving test cycles simulating various real-world conditions of the vehicle drive: street congestions, urban traffic without congestions, extra-urban traffic, and high-speed traffic. The correlational dependence of the pollutant emission intensity on the non-negative effective power of the engine and the correlational interdependence between the emission intensity of individual pollutants were investigated. The coefficients of Pearson’s linear correlation, Spearman’s rank correlation, Kruskal’s gamma correlation, and Kendall’s tau correlation were calculated. It was found that the emission intensity of pollutants in the driving test cycles strongly depends on the dynamic states of operation of the engine. The time histories of the emission intensity of pollutants were strongly correlated with the non-negative effective power of the engine. There were only a few cases where this correlation can be assessed as weak. The time histories of the emission intensity of individual pollutants were also strongly correlated with each other, with only a few exemptions. [ABSTRACT FROM AUTHOR]

Objective: Non‐fatal injuries sustained from animal–vehicle collisions are a globally under‐recognised road safety issue, with limited data on these crash types. The present study aimed to quantify the number and causes of major trauma events resulting from animal–vehicle collisions. Methods: The study was a retrospective analysis of major trauma cases occurring in Victoria, Australia, between 2007 and 2016, using data from the population‐based Victorian State Trauma Registry. To identify animal–vehicle collisions, Victorian State Trauma Registry injury codes were combined with text‐mining of the text description of the injury event. Results: Over the 10 year period, there were 152 major trauma patients who were admitted to Victorian trauma‐receiving hospitals due to vehicle collisions with animals. The crude population‐based incidence rate for animal–vehicle collisions increased by 6.7% per year (incidence rate ratio 1.07; 95% confidence interval 1.01–1.13; P = 0.02). Conclusion: Development of systematic recording methods of animal–vehicle collisions will improve reporting of these crash types to assist future studies in implementing effective countermeasures. [ABSTRACT FROM AUTHOR]

A license plate (LP) can help identify a motor vehicle. However, no common standard for LP exists across countries, and even within a country, significant LP variations are observed. In addition, environmental factors cause uncontrolled plate and character variations. It is, therefore, a challenge to design a robust and universal license plate recognition (LPR) system which works for multiple countries, for different types of vehicles, and for different styles of LPs. This study presents a novel approach for locating LP based on the use of multiple clustering and filtering techniques applied to the geometrical properties of LP characters. The proposed approach is independent of the size, rotation, and colour of the LP and can be used to locate single or multiple LP of different styles of different vehicles and of different countries. The approach has been validated using the standard Media‐lab and application‐oriented license plate (AOLP) datasets as well as on datasets of vehicles from other countries. The approach achieved an average success ratio of 93.42% for locating LPs from both the Media‐lab and the AOLP dataset and is higher than the results of previously published methods which evaluated their performance over the same datasets. [ABSTRACT FROM AUTHOR]

Background: Evidence whether individuals with attention-deficit hyperactivity disorder (ADHD) are at increased risk for traffic violations/collisions is mixed. This study investigated the association between ADHD and traffic violations among youth and young adults; examined whether this association differed by age, sex, or comorbid mental or physical problems; and modelled factors associated with traffic violations among individuals with ADHD.Methods: Data come from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH), a cross-sectional epidemiological study. The sample was restricted to youth and young adults aged 15 to 39 years and categorized into 3 groups: 15 to 19 years (n = 1886), 20 to 29 years (n = 3679), and 30 to 39 years (n = 3659). Lifetime ADHD and past-year contact with police for traffic violations were self-reported. Logistic regression models quantified the association between ADHD and traffic violations, stratified by age. Interactions were included to examine moderating effects.Results: No evidence suggested an association between ADHD and past-year traffic violations (odds ratio [OR], 1.07; 95% confidence interval (CI), 0.64 to 1.79), age-specific estimates did not differ across age groups (P = 0.696), and no factors moderated the association. Three factors were found to increase odds for past-year traffic violations among individuals with ADHD: aged 20 to 29 years (OR, 3.84; 95% CI, 1.47 to 10.06), male sex (OR, 3.48; 95% CI, 1.39 to 8.59), and white ethnicity (OR, 5.62; 95% CI, 1.24 to 25.51).Conclusions: Individuals with ADHD are not an at-risk group for traffic violations but instead share similar risk factors with individuals in the general population without ADHD-information useful for health professionals. Replication studies are needed to examine the robustness of these findings. [ABSTRACT FROM AUTHOR]

Background: The cervical spine region can be especially vulnerable to concurrent injury in concussion, with research suggesting that females may be at greater risk due to their weaker and anatomically distinct necks. The main objective of our research was to study sex differences in the rate of neck injury comorbidity across the life span among patients with a concussion diagnosis in the emergency department (ED) setting, by cause of injury (motor vehicle collisions [MVC] and sports). Materials and Methods: All patients with a first concussion-related ED visit between fiscal years 2002/2003 and 2011/2012 (inclusive) in Ontario were identified in population-based health administrative data using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) codes. Age-dependent odds ratios of comorbid neck injury for sex were estimated using polynomial multivariable logistic regression models, adjusting for sociodemographic characteristics. Results: Females with a concussion had significantly higher odds of sustaining a comorbid neck injury between the ages of 5–49 years for all concussion-related ED visits, 15–49 years for MVC-related concussion ED visits, and 10–39 years for sports-related concussion ED visits, holding all other covariates in the model constant. Conclusions: These results support the consideration of increased screening for comorbid neck injuries, particularly for females, to allow for early intervention. Furthermore, the increased risk of comorbid neck injury in females with a concussion-related ED visit was age-dependent, with the interaction between sex and age following a nonlinear trend. As such, future studies on concussions should consider linear and nonlinear sex and age interactions. [ABSTRACT FROM AUTHOR]

Cold start vehicle emissions can make a significant contribution to total emission levels and local air pollution, but this depends on the proportion of cold start vehicles in traffic. This paper has examined two ways to identify cold start vehicles in the on-road fleet 1) by tracking the journeys of individual vehicles using Bluetooth technology and 2) using thermal infrared imaging. The paper demonstrates that the two methods provide useful information that can be used to understand the relevance of cold start conditions in a small road network or to better understand emissions behaviour of individual vehicles in the on-road fleet. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the outcomes of trauma patients who were injured in a motor vehicle crash and tested positive for alcohol upon hospital arrival versus those who tested negative.Methods: Study data came from the US National Trauma Data Bank (2007-2010). Any blood alcohol concentration (BAC) found at or above the legal limit (≥0.08 g/dL) was considered "alcohol positive", and if no alcohol was identified through testing, the patient was considered "alcohol negative". Patients' demographics including age > = 14, race, gender, drug test results, systolic blood pressure, heart rate, injury severity score (ISS), and Glasgow Coma Scale (GCS) were included in the study. Propensity score and exact pair matching were performed between the groups using baseline characteristics.Results: From a total of 88,794 patients, 30.9% tested positive and 69.1% tested negative for alcohol. There were significant differences found between the groups regarding age, gender, race, and GCS (all p < 0.001) as well as a significantly higher in-hospital mortality rate (3.5% vs. 2.7%, p < 0.001) and median time to patient expiration (4 vs. 3 days, p < 0.001) in the alcohol negative group. After running both matching scenarios, there was no evidence of a significant difference seen in the rates of in-hospital mortality or the median time to patient expiration between the alcohol groups in either matched comparison.Conclusion: Patients who tested positive for alcohol following a traumatic motor vehicle crash showed no significant increase in in-hospital mortality or time to expiration when compared to propensity score and exact matched patients who tested negative for alcohol. [ABSTRACT FROM AUTHOR]

The article is devoted to regulation of traffic on the Baku-Sumgayit highway, which is part of the northern entrance-exit to / from Baku. İn order to normalize traffic at the peak hours of the day and to transfer vehicles that move from the north to the west of the city according to the proposed alternative route is condered. [ABSTRACT FROM AUTHOR]

Background: Unintentional injury is the leading cause of death in children and adolescents. Injuries occurring during boating and recreational water sports are poorly described in the literature. Herein, we compare injuries from water sports to those resulting from motor vehicle collisions, which are better described in existing literature.Methods: A retrospective review of 1935 consecutive pediatric trauma patients, as defined by age < 18 years, admitted to a single level-1 pediatric trauma center between January 2000 and August 2013 was performed. Patients were divided into two cohorts based on the mechanism of injury: water sports injury (WSI) or motor vehicle collision (MVC). Demographics, injury descriptors, and outcomes were reviewed for each patient. Categorical variables were compared by Chi square or Fisher's exact test, and continuous by t test or Mann-Whitney U test. Parametric data are reported as mean ± standard deviation and nonparametric as median (interquartile range). Significance was set at alpha level 0.05.Results: A total of 18 pediatric patients were admitted for WSI and 615 for MVC during the study period. Among those with WSI, mean age was 12 ± 4 years, mean Injury Severity Score (ISS) was 11 ± 10, and mean Revised Trauma Score (RTS) was 7.841(IQR 6.055-7.841). 44% of WSI occurred by personal watercraft (Jet Ski, WaveRunner), 39% by boat, and 17% by other means (e.g., diving, tubing, kite surfing). Overall, the most common WSI included skin/soft-tissue lacerations (59%), head injury/concussion (33%), tendon/ligament lacerations (28%), and extremity fractures (28%). Compared to 615 patients admitted for MVC, age, sex, race, Glasgow Coma Scale, ISS, RTS, spleen and liver laceration rates, neurosurgical consultation, ICU admission, ICU and total length of stay, and mortality were similar. Patients with WSI were more likely to be tourists (44% vs. 5%, p < 0.001). Those with WSI showed a significantly higher requirement for any surgical intervention (61% vs. 15%, p = 0.001). The rate of open fracture (28% vs. 6%, p = 0.006) and, subsequently, orthopedic procedures (39% vs. 17%, p = 0.027) were also higher in the WSI group.Conclusion: Overall, water sports injuries are similar in in-hospital mortality to motor vehicle collisions. They are more likely to result in penetrating trauma and more likely to require surgical intervention. Primary and secondary prevention strategies should specifically target personal watercraft usage and tourist populations. [ABSTRACT FROM AUTHOR]

Trauma is currently the leading cause of death in the age group 15 to 44 years globally, with road trauma now representing the sixth leading cause of death worldwide. We present a case of a young male, who was brought to the apex trauma centre of the province with a metallic roadside guardrail impaled in his neck up to his oral cavity, which had to be cut to transport him to the hospital. A meticulous local exploration resulted in the successful removal of the spiked guardrail, with no damage to critical structures. We discuss the paradigm changes in and the expertise required for the management of such penetrating neck injuries (PNIs). For family physicians, this case represents one of the wide variety of cases they will be called to help upon and administer prehospital care. Thus, utilization of principles of basic life support, recognition of the severity of road trauma cases, and ensuring urgency of referral by general practitioners are all critical. [ABSTRACT FROM AUTHOR]

Highlights • Sled tests using a short-height pregnant woman crash test dummy. • Shoulder belt compressed the neck in a rear seat. • Complex head and neck movements were observed. • Correct belt path may prevent serious neck injuries in a rear seat passenger. Abstract Introduction When considering seat belt contacts to the neck in pregnant woman of shorter height sitting in the rear seat of a vehicle, subsequent injuries after a collision must be understood in the context of both maternal and fetal outcomes. To determine likely injuries to a pregnant woman sitting in the rear seat, we determined the kinematics of a "pregnant" crash test dummy by measuring neck compression forces and biomechanical parameters acting on the head and neck. Methods Sled tests using a shorter-height pregnant woman crash test dummy (Maternal Anthropometric Measurement Apparatus, ver. 2B) were performed at the HYGE sled test facility representing full frontal impact at target velocities of 29 km/h and 48 km/h. Kinematics of the dummy and biomechanical parameters of the head, neck, and chest were measured. Pressure to the neck was measured using Prescale (Fujifilm, Tokyo, Japan). Results During frontal collision tests, the shoulder belt compressed the neck at a pressure >12.8 MPa, even during the low-velocity impact. In addition to neck flexion, right side bending and the head and chest moving in opposite directions were observed, with maximum differences of 42.4 mm at high velocity and 33.7 mm at low velocity. Conclusions This study provides data on the kinematics of pregnant women of short height sitting in the rear seat during a frontal collision using a pregnant woman crash test dummy. The knowledge gathered from this study should be useful for determining pregnant women passengers' kinematics at the time of collision and evaluating the relationship between the vehicle collision and fetal outcomes. [ABSTRACT FROM AUTHOR]

Objective One of the leading causes of non-fatal injury among children is bicycling. Past studies indicate that helmets are protective against bicycle-related injuries and involvement of motor vehicles is associated with severe injuries, but research utilizing a nationally representative data set for this population and focusing on these risk factors does not exist. The objective of this study was to describe the epidemiology of bicycle-related injuries among children treated in hospital emergency departments (EDs) in the United States (US). Methods A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System for children 5–17 years of age who were treated in US EDs from 2006 through 2015 for a bicycle-related injury. Helmet use and motor vehicle involvement were two variables that were created and coded using keyword searches of the case narratives. Rates of injuries over time were described. Multivariate logistic regression along with 95% confidence intervals (CIs) were used to contrast types of injuries sustained among injured helmet users with non-users. Results An estimated 2 219 742 (95% CI: 1 871 120-2 568 363) children 5–17 years of age were treated in US EDs for bicycle-related injuries over the 10-year study period, an average of 608 injuries per day. Most injuries (45.7%) involved children 10–14 years of age. The rate of bicycle-related injuries significantly decreased from 447.4 per 100 000 children in 2006 to 321.1 per 100 000 children in 2015 ( P < 0.001). Helmet use at the time of injury was significantly associated with lower likelihood of head and neck injuries (OR: 0.52 [95% CI: 0.40-0.59]) and hospitalizations (OR: 0.71 [95% CI: 0.54-0.94]), but there was no significant change in the rate of injury among helmet users over the study period ( P  = 0.224). Motor vehicle involvement increased the odds of bicycle-related traumatic brain injuries (TBIs) (OR: 1.98 [95% CI: 1.49–2.64]) as well as injury-related hospitalizations (OR: 4.04 [95% CI: 3.33–4.89]). Conclusions Despite decreasing injury rates, bicycling remains an important source of injury for children. Helmet use has demonstrated significant protective effects for TBIs, head and neck injuries, and hospitalizations. Motor vehicle involvement increased the risk of hospitalization. More efforts are needed to promote use of helmets and to reduce the possibility of bicycle-motor vehicle collisions to prevent bicycle-related injuries among children. [ABSTRACT FROM AUTHOR]

Introduction Teens beginning to drive independently are at significant increased risk of motor-vehicle crashes relative to their other life stages. There is, however, little guidance for parents as to how best to supervise learning to drive. Method This study sought to undertake an informed approach to development and implementation of a Parent Guide . We included a multi-stage development process, using theory, findings from a Delphi-study of young driver traffic-safety experts, and parent focus groups. This process informed the development of a Guide that was then evaluated for feasibility and acceptability, comparing a group that received the Guide with a control group of parent and teen dyads. Both members of the dyads were surveyed at baseline, again at the approximate time teens would be licensed to drive independently (post-test), and again three months later. Results We found no difference in the proportion of teens who became licensed between those given the new Guide and control teens (who received the state-developed booklet); that is the Guide did not appear to promote or delay licensure. Teens in the Guide group reported that their parents were more likely to use the provided resource compared with control teens. Responses indicated that the Parent Guide was favorably viewed, that it was easy to use, and that the logging of hours was a useful inclusion. Parents noted that the Guide helped them manage their stress, provided strategies to keep calm, and helped with planning practice. In contrast, control parents noted that their booklet helped explain rules. Among licensed teens there was no significant difference in self-reported risky driving at the three-month follow-up. We discuss the challenges in providing motivation for parents to move beyond a set number of practice hours to provide diversity of driving practice. [ABSTRACT FROM AUTHOR]

The paper gives special attention on long distance passenger transport and specific emissions related to different transport modes, particularly road and air transport sector. The goal of this research is creation and selection of appropriate methodology for modelling the cost estimation of GHG emissions in road and air transport sector for Republic of Serbia as well as the application of the methodology regarding to detailed calculation by transport mode and sub modes. Input data for road transport sector refer to the 2013 and include road and traffic conditions on the road network. Input data for air transport sector are related to the 2014 and international airport 'Nikola Tesla' Belgrade as the main hub point with the highest recorded number of aircraft operations in the Western Balkan countries. The obtained results reveal that, due to realized transport volume, diesel cars have the largest share of the costs of GreenHouse Gas (GHG) emissions within the passenger long distance road transport. Cost estimates of CO2 emissions in the air transport sector shows that A319 aircraft type have the major share in total costs. The reasons are twofold: first, a high level of Landing and Take-Off (LTO) emission factor for CO2 and second, largest number of LTO cycles. [ABSTRACT FROM AUTHOR]

This paper studies the relevant factors in mixed urban traffic that may impact the lateral spacing between bicycles and vehicles (passing distance, PD), and their resulting effect on a bicyclists’ comfort based on a study of six sites in Ottawa, Canada. The observations are: [i] the average position of bicycles from the curb is 0.57 m, and lesser ( i.e. 0.35 m) in the presence of parking; [ii] 90% of passes exceed 1.23 m; [iii] PD is positively correlated with motor vehicle speed, lane width, and bicycle position from adjacent curb edge line, whiles inversely correlated to ambient traffic density and bicycle speed; [iv] motor vehicle speed has the highest prediction of PD variability; [v] PD and ambient traffic density (ATD) are found to be the most important factors to a bicyclists’ comfort perception (BCP). Two linear regression models for PD and BCP were developed and significant variables are identified as: motor vehicle speed, bicycle speed, ATD, number of lanes, and lane width. The presence or absence of a grade slope is found to be significant to the PD model and not to BCP. The models both exhibit limited predictive ability, however residual plots and significance of included variables are indicative of correct assumptions for the models. It is recommended that speed calming, sharrows, road signs instructing road sharing, and educating road users against “dooring” crashes be considered in improving road sharing, especially for narrow lanes ( i.e. less than 3.6 m) and lanes wider than 4.5 m. It is also prudent for designers to avoid installing parking zones on narrow shared roads. [ABSTRACT FROM AUTHOR]

Introduction This study examine and applies recent empirical evidence from Mississippi and Alabama on fatal crashes and its relationship with gasoline prices and alcohol consumptions using the Louisiana Crash Data Reports between January 2005 and December 2015. Method The negative binomial models is the preferred specification for the Louisiana Crash Data. The marginal effects and related elasticities were calculated to facilitate the interpretation of the results. Results Findings suggest that higher gasoline prices reduce fatalities among young drivers. A fewer number of young drivers on the roads are believed to reduce the likelihood of fatal crashes. Underage drinking is still prominent in Louisiana. Extreme temperatures are positively associated with youth and other types of fatal crashes. Practical Applications This study highlights a huge toll on society in terms of social and economic costs, wealth destruction, and unfulfilled potential of the deceased or incapacitated. [ABSTRACT FROM AUTHOR]

Introduction Motor-vehicle crashes are a leading cause of death among children in the United States, and almost one-fourth of all trips by school-aged children are trips to and from school. This study sought to determine how children (5–18 years) travel to and from school and, among those living ≤ 1 mile of school, to explore the role of school bus service eligibility on school travel mode. Methods We used national 2012 survey data to determine prevalence of usual school travel mode, stratified by distance from school. For those living ≤ 1 mile of school, multivariable regression was conducted to assess the association between bus service eligibility and walking or bicycling. Results Almost half (46.6%) of all children rode in passenger vehicles (PV) to school and 41.8% did so for the trip home. Results were similar among those living ≤ 1 mile (48.1%, PV to school; 41.3%, PV to home). Among those living ≤ 1 mile, 21.9% and 28.4% of children walked or bicycled to and from school, respectively. Ineligibility for school bus service was strongly associated with walking or bicycling to school [adjusted prevalence ratio (aPR: 5.36; p < 0.001)] and from school (aPR: 5.36; p < 0.001). Conclusions Regardless of distance from school, passenger vehicles were a common mode of travel. For children who live close to school, the role that school bus service eligibility plays in walking or bicycling deserves further consideration. Practical applications Given the large proportion of children who use passenger vehicles for school travel, effective interventions can be adopted to increase proper child restraint and seat belt use and reduce crash risks among teen drivers. Better understanding of conditions under which bus service is offered to children who live close to school could inform efforts to improve pedestrian and bicyclist safety for school travel. [ABSTRACT FROM AUTHOR]

Problem Motor-vehicle crashes were the second leading cause of injury death for adults aged 65–84 years in 2014. Some older drivers choose to self-regulate their driving to maintain mobility while reducing driving risk, yet the process remains poorly understood. Methods Data from 729 older adults (aged ≥ 60 years) who joined an older adult ride service program between April 1, 2010 and November 8, 2013 were analyzed to define and describe classes of driving self-regulation. Latent class analysis was employed to characterize older adult driving self-regulation classes using driving frequency and avoidance of seven driving situations. Logistic regression was used to explore associations between characteristics affecting mobility and self-regulation class. Results Three classes were identified (low, medium, and high self-regulation). High self-regulating participants reported the highest proportion of always avoiding seven risky driving situations and the lowest driving frequency followed by medium and low self-regulators. Those who were female, aged 80 years or older, visually impaired, assistive device users, and those with special health needs were more likely to be high self-regulating compared with low self-regulating. Conclusions and practical applications Avoidance of certain driving situations and weekly driving frequency are valid indicators for describing driving self-regulation classes in older adults. Understanding the unique characteristics and mobility limitations of each class can guide optimal transportation strategies for older adults. [ABSTRACT FROM AUTHOR]