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South Korea is ranked as 4th among 34 nations of the Organization for Economic Cooperation and Development with 102 deaths in road accidents per one million population. This paper aims to investigate the factors associated with road accidents in South Korea. The rainfall data of the Korea Meteorological Administration and road accidents data of Traffic Accident Analysis System of Korea Road Traffic Authority is analyzed for this purpose. In this connection, multivariate regression analysis and ratio analysis with the descriptive analysis are performed to uncover the catastrophic factors involved. In turn, the results reveal that traffic volume is the leading factor in road accidents. The limited road extension of 1.47% compared to the 4.14% per annum growth of the vehicles is resulting in road accidents at such a large scale. The increasing proportion of passenger cars accelerate road accidents as well. 56% of accidents occur by the infringement of safety driving violations. The drivers with higher driving experience tend to have a higher accident ratio. The collected data is analyzed in terms of gender, driver experience, type of violations and accidents as well as the associated time of the accidents when they happen. The results indicate that 36.29% and 53.01% of accidents happen by male drivers in the day and night time, respectively. 29.15% of crashes happen due to safety infringement and violations of 41 to 60 years old drivers. The results demonstrate that population density is associated with the accidents frequency and lower density results in an increased number of accidents. The necessity of the state-of-the-art regulations to govern the urban road traffic is beyond dispute, and it becomes even more crucial for citizens’ relief since in our daily lives road accidents are getting more diverse. [ABSTRACT FROM AUTHOR]

Background: Road Traffic Accidents have become an enormous global public health problem killing approximately 1.25 million people and injuring 20 to 50 million others yearly. It is the 10th leading cause of death universally and the number one cause of mortality of the young population between the ages of 5 and 29. Only few studies have been conducted on the severity of road traffic injuries in Ethiopia hence the need for the study. Objective: To assess injury severity level and associated factors among road traffic accident victims. Methods: A cross-sectional study of patients involved in road traffic accident and attended Tirunesh Beijing hospital, Addis Ababa, Ethiopia. Victims were consecutively recruited until sample size (164) attained during the study period. Data collectors administered a structured questionnaire. The collected data was then entered and cleaned using Epi info and exported to IBM SPSS for statistical analysis. Independent factors associated with injury severity were assessed using bivariate and multivariate logistic regression. Results: A total of 164 road traffic injury victims were included to the study. Prevalence of severe injury accounted for 36.6% of cases. “can read and write” educational status OR 35.194(95% CI; 3.325–372.539), sustaining multiple injury OR 18.400(95% CI; 5.402–62.671), sustaining multiple injury type OR 6.955(95% CI; 1.716–28.185) and being transported by ambulance from the scene of accident OR 13.800(95% CI; 1.481–128.635) were the explanatory variables found to have a statistically significant association with severe injury. Conclusion: This study showed road traffic accident is predominantly affecting the economically active, male young population. Not a single victim received pre-hospital care, majority were extracted by bystanders and most used commercial vehicle to be transported to a health institution reflecting the need for improvements in pre-hospital emergency services and socio-economic related infrastructures. [ABSTRACT FROM AUTHOR]

This paper quantifies the effect of speed cameras on road traffic collisions using an approximate Bayesian doubly-robust (DR) causal inference estimation method. Previous empirical work on this topic, which shows a diverse range of estimated effects, is based largely on outcome regression (OR) models using the Empirical Bayes approach or on simple before and after comparisons. Issues of causality and confounding have received little formal attention. A causal DR approach combines propensity score (PS) and OR models to give an average treatment effect (ATE) estimator that is consistent and asymptotically normal under correct specification of either of the two component models. We develop this approach within a novel approximate Bayesian framework to derive posterior predictive distributions for the ATE of speed cameras on road traffic collisions. Our results for England indicate significant reductions in the number of collisions at speed cameras sites (mean ATE = -15%). Our proposed method offers a promising approach for evaluation of transport safety interventions. [ABSTRACT FROM AUTHOR]

In this paper, from the practical point of view, we focus on modeling traumatic brain injury data considering different stages of hospitalization, related to patients’ survival rates following traumatic brain injury caused by traffic accidents. From the statistical point of view, the primary objective is related to overcoming the limited number of traumatic brain injury patients available for studying by considering different estimation methods to obtain improved estimators of the model parameters, which can be recommended to be used in the presence of small samples. To have a general methodology, at least in principle, we consider the very flexible Generalized Gamma distribution. We compare various estimation methods using extensive numerical simulations. The results reveal that the penalized maximum likelihood estimators have the smallest mean square errors and biases, proving to be the most efficient method among the investigated ones, mainly to be used in the presence of small samples. The Simulated Annealing technique is used to avoid numerical problems during the optimization process, as well as the need for good initial values. Overall, we considered an amount of three real data sets related to traumatic brain injury caused by traffic accidents to demonstrate that the Generalized Gamma distribution is a simple alternative to be used in this type of applications for different occurrence rates and risks, and in the presence of small samples. [ABSTRACT FROM AUTHOR]

Introduction: The fixation of unstable zygomaticomaxillary complex (ZMC) fractures can be achieved by open reduction with rigid internal fixation (ORIF) and/or by closed reduction with percutaneous transfacial Kirschner wire fixation (CRWF). The aim of this study was to tomographically assess the symmetry and the protrusion of the cheekbone with unstable ZMC fractures that had been treated by ORIF vs. CRWF. Materials and methods: Sixty patients exhibiting a surgically unstable tetrapodal ZMC fracture were included in this multicenter retrospective study. The coordinates of 5 landmarks representing the zygomatic protrusion were comparatively studied on the healthy and on the broken side using preoperative and postoperative tridimensional computed tomography (CT) scans or cone beam CT. Results: No significant difference was found in the zygomatic protrusion irrespective of the surgical technique that was used. The zygomatico-maxillary ansa was found to be the most complicated area to reduce, particularly in the frontal plane with both the CRWF and the ORIF technique (p1 = 0.001 and p2 = 0.0009, respectively). There was no difference in terms of the level of complications, while the mean duration of the surgery was significantly less for the CRWF group. Conclusion: With good postoperative radiographic outcomes, the CRWF can be proposed as an alternative or in association with the ORIF technique for fixation of tetrapodal fractures of the ZMC. [ABSTRACT FROM AUTHOR]

We introduce a rapid deterministic algorithm for identification of the most critical links which are capable of causing network disruptions. The algorithm is based on searching for the shortest cycles in the network and provides a significant time improvement compared with a common brute-force algorithm which scans the entire network. We used a simple measure, based on standard deviation, as a vulnerability measure. It takes into account the importance of nodes in particular network components. We demonstrate this approach on a real network with 734 nodes and 990 links. We found the worst scenarios for the cases with and without people living in the nodes. The evaluation of all network breakups can provide transportation planners and administrators with plenty of data for further statistical analyses. The presented approach provides an alternative approach to the recent research assessing the impacts of simultaneous interruptions of multiple links. [ABSTRACT FROM AUTHOR]

Long working hours and a lack of sleep have been suggested to negatively affect the safety of workers. Here, we examined the association between long working hours/sleep-related problems and near-misses/injuries in industrial settings using a nationally representative sample of workers in Japan. Based on the composition ratio of workers by industry, sex, and age in Japan, data from a web-based cross-sectional survey for 18,682 participant full-time workers (7,098 female and 11,584 male; mean age, 43.7 [standard deviation 11.1] years) were analyzed. Nearly 30% and 5% of participants reported any types of near-misses during the past six months and injuries during the past year, respectively. For all types of near-misses and some types of injuries, a significant difference in frequency distribution was observed by industry. After adjustment for demographic, job-, and life-related variables, participants who worked long hours (i.e., more than 51 hours per week) were more likely to report job-related near-misses/injuries than those who worked 35–40 hours per week. The presence of sleep-related problems was also significantly related to near-misses and injuries. However, while sleep-related problems were significantly associated with near-misses/injuries in all industries, the association between long working hours and near-misses/injuries differed by industry. Odds ratios for near-misses/injuries were strongly significant in the “transport/postal services” industry for those who worked more than 51 hours per week compared to those who worked 35–40 hours per week. Comprehensive protective measures for workers, including (1) reducing total hours of service/job-related fatigue, (2) maintaining sufficient sleep hours/good sleep, and (3) increasing awareness about the impact of overwork/long working hours and sleep-related problems on workers’ safety among employers, workers, clients/customers, and the general public might be effective for preventing near-misses and injuries in industrial settings among workers, especially those who work long hours in the “transport/postal services” industry. [ABSTRACT FROM AUTHOR]

Objective: To analyze trends in external mortality in Hungary between 1995 and 2014 by sex. Methods: Data on the numbers of deaths due to external causes were obtained from the published nationwide population register. Negative binomial regression was applied to investigate the yearly trends in external-cause mortality rates. Cyclic trends were investigated using the Walter-Elwood method. Results: Suicide and accidents accounted for approximately 84% of the all-external-cause of deaths in Hungary. Annual suicide, unintentional falls and traffic accidents mortality declined significantly (p-value for annual trend: p < 0.001) from 30.5 (95% CI: 29.5–31.5) to 15.8 (15.1–16.5), from 31.2 (30.2–32.2) to 12.2 (11.7–12.8) and from 17.2 (16.4–18) to 5.4 (5–5.8) per 100 000 persons per year, respectively, during the study period. A significant declining trend in annual mortality was also found for assault, cold/heating-related accidents and accidents caused by electric current. However, the declining trend for drowning-related accidents was significant only for males. Significant winter-peak seasonality was found in the mortality rates from accidental falls, cold/heat-related accidents, other accidents caused by submersion/obstruction and other causes. Seasonal trends with a peak from June to July were observed in death rates from suicide/self-harm, accidental drowning/submersion and accidents caused by electric current. A significant seasonal variation with a peak in September was revealed in the mortality due to traffic accidents. Conclusions: This Hungarian study suggests that there was a significant seasonal effect on almost all kinds of deaths from external causes between 1995 and 2014. Environmental effects are involved in the aetiology of suicide and accidents. [ABSTRACT FROM AUTHOR]

Estimating and selecting risk factors with extremely low prevalences of exposure for a binary outcome is a challenge because classical standard techniques, markedly logistic regression, often fail to provide meaningful results in such settings. While penalized regression methods are widely used in high-dimensional settings, we were able to show their usefulness in low-dimensional settings as well. Specifically, we demonstrate that Firth correction, ridge, the lasso and boosting all improve the estimation for low-prevalence risk factors. While the methods themselves are well-established, comparison studies are needed to assess their potential benefits in this context. This is done here using the dataset of a large unmatched case-control study from France (2005-2008) about the relationship between prescription medicines and road traffic accidents and an accompanying simulation study. Results show that the estimation of risk factors with prevalences below 0.1% can be drastically improved by using Firth correction and boosting in particular, especially for ultra-low prevalences. When a moderate number of low prevalence exposures is available, we recommend the use of penalized techniques. [ABSTRACT FROM AUTHOR]

Objectives: Every day, an average of 3,400 deaths and tens of millions of injuries occur as a result of traffic accidents. This study aims to model and validate road traffic injury (RTI) times series, specifically considering gender. Study design: Time trend studies of monthly road traffic injuries (RTI) in Iran from March 2005 to February 2016, as well as those of males and females from March 2009 to February 2016 were performed. Methods: The seasonal auto-regressive integrated moving average method (SARIMA) was employed to predict RTI time series. The final model was selected from various SARIMA models based on the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). To examine whether the residuals were white noise, the Ljung-Box (LB) test and residuals plots were used for un-correlation, and the zero mean and stationarity, respectively. Additionally, smoothing methods were utilized to validate the SARIMA models for fitting and out-of-range prediction of the time series models under study. The sample auto-correlation function (ACF) and the partial autocorrelation function (PACF) with 20 lags were employed to determine the order of models and to ascertain if the residuals of the model were uncorrelated. Results: Based on the obtained results, SARIMA (2,1,0)(0,1,1)12, SARIMA (0,1,1)(0,1,1)12, SARIMA (1,1,1)(0,0,1)12, and SARIMA (2,0,0)(1,0,0)12 were chosen for the time series including incidence rates of total road traffic injuries (IRTI), IRTI of males, females, and males-to-females, respectively. The AIC values were -87.57, 413.38, -732.91, and -85.32, respectively. The LB test for the residuals of the time series models of (0.539) IRTI, (0.3) IRTI of males, (0.23) females, and (0.237) males-to-females indicated that residuals were uncorrelated. Furthermore, prediction values for the next 24 months (2016 to 2018) showed no decline in the incidence rate of male and female traffic injuries. Results of the predictions using exponential smoothing methods indicated out-of-range prediction validity of the SARIMA models. Conclusion: This study exemplified the high efficiency of SARIMA models in predicting road traffic injuries (RTIs). Based on observations, the IRTI mean in Iran was 35.57 in 2016. The predicted values of the IRTI for 2016–2018 by the SARIMA model showed no decreasing trend. During the studied period, the observed values of IRTI for males were two to three times the female values. Thus, prediction of RTI can provide a useful tool for traffic safety policymaking by simulating interrupted time series when applying new traffic enforcement interventions and regulations in the future. Additionally, IRTI analysis of males and females showed that men had a non-increasing trend but higher incidence of traffic injuries, whereas the IRTI for women revealed an increasing trend from 2009 to 2012 with a lower incidence of injuries. This growth could be attributed to the impact of increased outdoor activities of women and the increased number of issued driving licenses in the period of 2009–2012. [ABSTRACT FROM AUTHOR]

Whiplash-associated disorder (WAD) causes substantial social and economic burden, with ≥70% patients classified as WADII (neck complaint and musculoskeletal sign(s)). Effective management in the acute stage is required to prevent development of chronicity; an issue for 60% of patients. An Active Behavioural Physiotherapy Intervention (ABPI) was developed to address both physical and psychological components of WAD. The ABPI is a novel complex intervention designed through a rigorous sequential multiphase project to prevent transition of acute WAD to chronicity. An external pilot and feasibility cluster randomised double-blind (assessor, participants) parallel two-arm clinical trial was conducted in the UK private sector. The trial compared ABPI versus standard physiotherapy to evaluate trial procedures and feasibility of the ABPI for managing acute WADII in preparation for a future definitive trial. Six private physiotherapy clinics were recruited and cluster randomised using a computer-generated randomisation sequence. Twenty-eight (20 ABPI, 8 standard physiotherapy) participants [median age 38.00 (IQR = 21.50) years] were recruited. Data were analysed descriptively with a priori establishment of success criteria. Ninety-five percent of participants in the ABPI arm fully recovered (Neck Disability Index ≤4, compared to 17% in the standard physiotherapy arm); required fewer treatment sessions; and demonstrated greater improvement in all outcome measures (pain intensity, Cervical Range of Motion, Pressure Pain Threshold, EuroQol-5 Dimensions) except for the Impact of Events Scale and Fear Avoidance Beliefs Questionnaire. The findings support the potential value of the ABPI, and that an adequately powered definitive trial to evaluate effectiveness (clinical, cost) is feasible with minor modifications to procedures. [ABSTRACT FROM AUTHOR]

China's rapid urbanization and high traffic accident frequency have received many researchers’ attention. It is important to reveal how urban infrastructures and other risk factors affects the traffic accident frequency. A growing amount of research has examined the local risk factors impact on traffic accident frequency at certain time. Some studies considered these spatial influences but overlooked the temporal correlation/heterogeneity of traffic accidents and related risk factors. This study explores risk factors’ influence on urban traffic accidents frequency while considering both the spatial and temporal correlation/heterogeneity of traffic accidents. The study area is split into 100 equally sized rectangle traffic analysis zones (TAZs), and the urban traffic accident frequency and attributes in each TAZ are extracted. The linear regression model, spatial lag model (SLM), spatial error model (SEM) and time-fixed effects error model (T-FEEM) are established and compared respectively. The proposed methodologies are illustrated using ten-month traffic accident data from the urban area of Guiyang City, China. The results reveal that the time-fixed effects error model, which considers both spatial and temporal correlation/heterogeneity of traffic accidents, is superior to other models. More traffic accidents will happen in those TAZs that have more hospitals or schools. Moreover, hospitals have a greater influence on traffic accidents than schools. Because of the location in the margin of the city, those TAZs that have passenger stations have more traffic accidents. This study provides policy makers with more detailed characterization about the impact of related risk factors on traffic accident frequencies, and it is suggested that not only the spatial correlation/heterogeneity but also the temporal correlation/heterogeneity should be taken into account in guiding traffic accident control of urban area. [ABSTRACT FROM AUTHOR]

The primary purpose of the present study was to examine the effectiveness of threat appeals in influencing impulsive decision making associated with texting while driving. The participants in the treatment group were exposed to a threatening message about the danger of texting while driving, whereas those in the control group were exposed to a non-threatening message. Following the exposure to either message, the participants completed a delay-discounting task that assessed the degree of impulsive decision making in a hypothetical texting-while-driving scenario. A comparison between the groups revealed that the threat appeals reduced the degree of impulsive decision making associated with texting while driving. In addition, the threat appeals led to greater anticipated regret from texting while driving, less favorable attitudes toward texting while driving, and decreased intentions to text while driving in the future in the treatment group. These results suggest that video-based threat appeals are promising intervention strategies for the public health challenge of texting while driving. Implications from the behavioral economic perspective are discussed. [ABSTRACT FROM AUTHOR]

Road Traffic Accidents (RTA) are a major worldwide public health problem. The aim of this study was to use the growth mixture model for clustering countries on the basis of the mortality rate patterns of RTAs from 2007 to 2013. We obtained the data on RTA death rates from World Health Organization reports and Human Development Index (HDI) of United Nations Development Programme reports for the years 2007, 2010 and 2013. Simple Latent Growth Models (LGM) in 181 countries were applied to estimate overall RTA mortality rate growth trajectories and the latent growth mixture modeling utilized to cluster them. According to non-linear LGM, the overall mortality rate of RTAs showed a decrease from 2007 to 2010 followed by an increase from 2010 to 2013. The HDI covariate had a significant negative and positive effect on intercept and slope of the LGM, respectively. The extracted mixture model appeared to have seven classes with different trends in RTA mortality rates. The worldwide countries were clustered into seven classes. Further studies on each of the seven classes are suggested to provide recommendations for reducing the mortality rate of the RTAs. Additionally, increasing HDI in some countries could have a significant effect on reducing the RTA death rates. [ABSTRACT FROM AUTHOR]

Background: In many developing countries there is paucity of evidence regarding the epidemiology of road traffic accidents (RTAs). The study determines the rates of injuries and fatalities associated with RTAs in Ethiopia based on the data of a recent national survey. Methods: The study is based on the secondary data of the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about occurrence injuries and accidents including RTAs in the past 12 months among 75,271 members of 16,650 households. Households were selected from nine regions and two city administrations of Ethiopia using stratified cluster sampling procedure. Results: Of the 75,271 household members enumerated, 123 encountered RTAs in the reference period and rate of RTA-related injury was 163 (95% confidence interval (CI): 136–195) per 100,000 population. Of the 123 causalities, 28 were fatal, making the fatality rate 37 (95% CI: 25–54) per 100,000 population. The RTA-related injuries and fatalities per 100,000 motor vehicles were estimated as 21,681 (95% CI: 18,090–25,938) and 4,922 (95% CI: 3325–7183), respectively. Next to accidental falls, RTAs were the second most common form of accidents and injuries accounting for 22.8% of all such incidents. RTAs contributed to 43.8% of all fatalities secondary to accidents and injuries. Among RTA causalities, 21.9% were drivers, 35.0% were passenger vehicle occupants and 36.0% were vulnerable road users including: motorcyclists (21.0%), pedestrians (12.1%) and cyclists (2.9%). Approximately half (47.1%) of the causalities were between 15–29 years of age and 15.3% were either minors younger than 15 years or seniors older than 64 years of age. Nearly two-thirds (65.0%) of the victims were males. Conclusion: RTA-related causalities are extremely high in Ethiopia. Male young adults and vulnerable road users are at increased risk of RTAs. There is a urgent need for bringing road safety to the country's public health agenda. [ABSTRACT FROM AUTHOR]

Introduction: In Lao People’s Democratic Republic (PDR), community-based health insurance (CBHI) is the only voluntary insurance scheme; it typically targets self-employed people, most of whom reside in rural areas and are dependent on agricultural activities for subsistence. However, until very recently, the enrollment rate has fallen short and failed to reach a large percentage of the target group. To promote the CBHI scheme and increase demand, some supporting components should be considered for inclusion together with the health infrastructure component. Objectives: This paper provides empirical evidence that the benefit package components of hypothetical CBHI schemes have causal effects on enrollment probabilities. Furthermore, we examine the distribution of willingness to pay (WTP) in response to policy changes based on a sample of 5,800 observations. Methods: A randomized conjoint experiment is conducted in rural villages in Savannakhet Province, Lao PDR, to elicit stated preference data. Each respondent ranks three options—two hypothetical alternatives and the CBHI status quo scheme. The levels of seven attributes—insurance coverage for medical consultations, hospitalizations, traffic accidents, pharmaceuticals and transportation; premiums; and prepaid discounts—are randomly and simultaneously assigned to the two alternatives. Results: The findings suggest that the average WTP is at least as large as 10.9% of the per capita income of those who live in rural areas, which is higher than the WTP for health insurance averaged across low- and middle-income countries (LMICs) in the literature. The component of round-trip transportation insurance coverage has a significant effect on WTP distribution, particularly increasing the share of the highest bin. Conclusion: Therefore, the low CBHI scheme enrollment rate in Lao PDR does not necessarily imply low demand among the targeted population, as the finding from the WTP analysis illustrates potential demand for the CBHI scheme. Specifically, if transportation is addressed, enrollment is likely to significantly increase. [ABSTRACT FROM AUTHOR]

Introduction: About 1.25 million people worldwide die every year because of road accidents. Risk is higher when drivers use mobile phones, whereas seat belts help to prevent crash-related injury. We aimed to evaluate the prevalence, associated factors, and temporal trend of the use of seat belts and mobile phones among drivers and passengers in Florence, Italy (2005–2015). Methods: Use of seat belts and mobile phones use was monitored via direct observation in four areas in the province of Florence. We fitted Poisson regression models with robust variance to investigate the factors associated with the use of seat belts and mobile phones use by the drivers and to explore long-term trends and seasonal patterns in the two time-series. Results: We observed a total of an overall 134,775 vehicles: seat belts were worn by 71.8% of drivers and front-seat passengers and 27.6% of back-seat passengers, while mobile phones were being used by 4.8% of drivers. Drivers were more likely to wear seat belt when transporting passengers (≥2 vs none: prevalence ratio [PR] 1.21, 95% confidence intervals [CI] 1.14–1.29) and while driving in the afternoon (PR 1.04, 95% CI 1.03–1.05), and less likely when the front-seat passenger was not wearing seat belts (PR 0.33, 95% CI 0.32–0.34). After an initial increase, seat belts use by the driver decreased over time (-0.5% each year during 2010–2015), with significant peaks and troughs in July and January, respectively. Mobile phone use by the driver was inversely associated with wearing seat belts (PR 0.67, 95% CI 0.64–0.70) and carrying passengers (≥2 vs. none PR 0.20, 95% CI 0.07–0.52). The proportion of drivers using mobile phones did not vary over time nor showed any clear seasonality. Conclusions: Drivers’ risky behaviours (not wearing a seat belt and using a mobile phone) are associated, showing a global misperception of risk among a subset of drivers. The number of passengers and their behaviour is also associated with the driver’s attitude. The effectiveness of primary enforcement laws has declined in Italy in recent years; therefore, other strategies should be devised and implemented. [ABSTRACT FROM AUTHOR]

Road traffic accidents are the major cause of mortality among people aged 15–29 years in Africa. World Health Organisation (WHO) and the World Bank launched a Decade of Action for Road Safety in 2011 with the goal of halving the number of injuries and deaths on the roads. No progress has been reported in Low and Middle Income Countries (LMICs) and the number of deaths remains very high. To reach the target set, there is a need for interventions in several areas. This scoping review proposes to produce a synthesis by identifying the kinds of interventions and outcomes which have been carried out on the African continent. Using the scoping studies method, 23 articles were selected and analysed. The study shows that interventions were developed in four fields: road safety policy, health education, safety equipment and data collection. It shows also that there were records of interventions in only twelve countries, mostly in Eastern and Southern Africa. The main conclusion of this study reveals both a lack of road safety interventions and shortcomings in the assessment of those performed and selected for our study. [ABSTRACT FROM AUTHOR]

Despite downward trends, driving under the influence (DUI) remains one of the most salient traffic safety problems. It is crucial to identify the processes behind a problem behaviour to target the most effective measures to address it. One way of exploring precursors of behaviour is measuring attitudes. All persons hold two types of attitudes, explicit and implicit. Although only one of these (explicit) lays the groundwork for current understandings of DUI, it is imperative to explore both types of attitudes. We explore the relationship between explicit and implicit attitudes towards DUI for the first time in the field. Explicit attitudes (what we say we mean) are measured by a questionnaire. Implicit attitudes (which are introspectively unidentified or inaccurately identified traces of past experience) are measured by the Go/No-go Association Task (GNAT) in a sample of young male drivers (n = 101). The results show a relationship between the two types of attitudes, but not completely in the expected way. Depending whether the amount of alcohol is over or under the legal limit, the relationship between explicit and implicit attitudes varies. We discuss the findings and provide directions for future investigations. [ABSTRACT FROM AUTHOR]

The vehicular ad hoc network (VANET) has been identified as one of the most promising technologies for managing future intelligent transportation systems. This paper proposes a distributed transmission power adjustment algorithm for communication congestion control and awareness enhancement to address communication congestion problems that can arise in VANETs. The objective of the proposed algorithm is to provide maximum awareness of surrounding vehicles’ status while maintaining a communications channel load below the allowed threshold. The proposed algorithm accomplishes this by adjusting the transmission range of each vehicle in the network progressively and gradually, while monitoring the communications channel load of each vehicle. By changing the transmission range of a vehicle little by little according to the communications channel load of its neighboring vehicles, the algorithm finds the optimal transmission range that provides maximum awareness without resulting in communications congestion. In addition, the proposed algorithm appropriately controls the channel load in a fair manner without sacrificing awareness of specific vehicles in the congested situation. This allows nearby vehicles to obtain more peripheral information to help them stay away from potential hazards and maintain safety. The proposed algorithm was implemented in a simulation environment, and its performance was validated in various traffic scenarios. The simulation results show that the proposed algorithm can deal with communication congestion by controlling the transmission power fairly to a target threshold in various traffic situations. [ABSTRACT FROM AUTHOR]

Background: Road accidents are one of the main causes of death around the world and yet, from a time-space perspective, they are a rare event. To help us prevent accidents, a metric to determine the level of concentration of road accidents in a city could aid us to determine whether most of the accidents are constrained in a small number of places (hence, the environment plays a leading role) or whether accidents are dispersed over a city as a whole (hence, the driver has the biggest influence). Methods: Here, we apply a new metric, the Rare Event Concentration Coefficient (RECC), to measure the concentration of road accidents based on a mixture model applied to the counts of road accidents over a discretised space. A test application of a tessellation of the space and mixture model is shown using two types of road accident data: an urban environment recorded in London between 2005 and 2014 and a motorway environment recorded in Mexico between 2015 and 2016. Findings: In terms of their concentration, about 5% of the road junctions are the site of 50% of the accidents while around 80% of the road junctions expect close to zero accidents. Accidents which occur in regions with a high accident rate can be considered to have a strong component related to the environment and therefore changes, such as a road intervention or a change in the speed limit, might be introduced and their impact measured by changes to the RECC metric. This new procedure helps us identify regions with a high accident rate and determine whether the observed number of road accidents at a road junction has decreased over time and hence track structural changes in the road accident settings. [ABSTRACT FROM AUTHOR]

Tremendous volumes of messages on social media platforms provide supplementary traffic information and encapsulate crowd wisdom for solving transportation problems. However, social media messages manifested in human languages are usually characterized with redundant, fuzzy and subjective features. Here, we develop a data fusion framework to identify social media messages reporting non-recurring traffic events by connecting the traffic events with traffic states inferred from taxi global positioning system (GPS) data. Temporal-spatial information of traffic anomalies caused by the traffic events are then retrieved from anomalous traffic states. The proposed framework successfully identified accidental traffic events with various scales and exhibited strong performance in event descriptions. Even though social media messages are generally posted after the occurrence of anomalous traffic states, resourceful event descriptions in the messages are helpful in explaining traffic anomalies and for deploying suitable countermeasures. [ABSTRACT FROM AUTHOR]

Background: In the past decades, extremely serious road accidents with a death toll over ten in each have become a severe public health problem in China. This study investigates risk factors contributing to extremely serious road accidents, which will be crucial for accident prevention. Methods: Collecting data from The Road Accident Statistical Annual Report openly issued by China’s Traffic Management Bureau of the Public Security Ministry for the time period 2004–2015, we used the monthly case number of extreme serious road accidents as the dependent variable. We then selected ten risk factors as primary independent variables: professional driver, driving under influence (alcohol or drug), fatigue, vehicle type, overload, brake problem, weather, road classification, terrain, and region. The method of negative binominal regression was implemented to investigate the association between these risk factors and extremely serious road accidents. Results: A total of 346 extremely serious road accidents were included in our analysis. On a national scale, we found that professional driver [incidence rate ratio (IRR): 1.10, 95% CI: 1.02–1.19], fatigue (IRR: 1.15, 95% CI: 1.03–1.29), large vehicle type (IRR: 1.11, 95% CI: 1.03–1.21), overload (IRR: 1.09, 95% CI: 1.03–1.16), and terrain (IRR: 1.09, 95% CI: 1.01–1.18) were significantly associated with extremely serious road accidents. Besides, separate analyses on western and non-western region indicated that both regions had shared risk factors as well as distinct factors. Conclusions: Our study identifies professional driver, fatigue, large vehicle type, overload, and terrain as significant risk factors of extremely serious road accidents in China, and targeted and preventative measures could be taken based on our findings. [ABSTRACT FROM AUTHOR]

A multi-objective optimization model is proposed to allocate the location of VMSs by maximizing the average traffic guidance utility of VMSs and the number of benefited links, while minimizing information redundancy. The traffic guidance utility is defined to quantitatively measure the value of an installed VMS, which is calculated from passively collected GPS data and the physical topology of road network. The number of benefited links is to measure how many links are covered by upstream VMS to disseminate information. Information redundancy is introduced to quantify the mutual impairing between any two VMSs. A heuristic search algorithm is developed to solve the optimization model, which can calculate the saturated number of VMS for a road network and optimize the project schedule of VMS installation process based on the proposed objectives. A real-world case study is conducted in Beijing to illustrate the validity of the proposed approach, where taxis are used as probe vehicles to provide GPS data. The results show the effectiveness of the proposed multi-objective optimization model and it is promising to use the emerging GPS data to help agencies to allocate the locations of VMSs on both urban roads and highway networks, instead of relying on the subjective judgment from practitioners. [ABSTRACT FROM AUTHOR]

The purpose of this study is to analyze how the spatiotemporal characteristics of traffic accidents involving the elderly population in Seoul are changing by time period. We applied kernel density estimation and hotspot analyses to analyze the spatial characteristics of elderly people’s traffic accidents, and the space-time cube, emerging hotspot, and space-time kernel density estimation analyses to analyze the spatiotemporal characteristics. In addition, we analyzed elderly people’s traffic accidents by dividing cases into those in which the drivers were elderly people and those in which elderly people were victims of traffic accidents, and used the traffic accidents data in Seoul for 2013 for analysis. The main findings were as follows: (1) the hotspots for elderly people’s traffic accidents differed according to whether they were drivers or victims. (2) The hourly analysis showed that the hotspots for elderly drivers’ traffic accidents are in specific areas north of the Han River during the period from morning to afternoon, whereas the hotspots for elderly victims are distributed over a wide area from daytime to evening. (3) Monthly analysis showed that the hotspots are weak during winter and summer, whereas they are strong in the hiking and climbing areas in Seoul during spring and fall. Further, elderly victims’ hotspots are more sporadic than elderly drivers’ hotspots. (4) The analysis for the entire period of 2013 indicates that traffic accidents involving elderly people are increasing in specific areas on the north side of the Han River. We expect the results of this study to aid in reducing the number of traffic accidents involving elderly people in the future. [ABSTRACT FROM AUTHOR]

Purpose: Traffic accidents are associated with the visual function of drivers, as well as many other factors. Driving simulator systems have the advantage of controlling for traffic- and automobile-related conditions, and using pinhole glasses can control the degree of concentric concentration of the visual field. We evaluated the effect of concentric constriction of the visual field on automobile driving, using driving simulator tests. Methods: Subjects meeting criteria for normal eyesight were included in the study. Pinhole glasses with variable aperture sizes were adjusted to mimic the conditions of concentric visual field constrictions of 10° and 15°, using a CLOCK CHART®. The test contained 8 scenarios (2 oncoming right-turning cars and 6 jump-out events from the side). Results: Eighty-eight subjects were included in the study; 37 (mean age = 52.9±15.8 years) subjects were assigned to the 15° group, and 51 (mean = 48.6±15.5 years) were assigned to the 10° group. For all 8 scenarios, the number of accidents was significantly higher among pinhole wearing subjects. The average number of all types of accidents per person was significantly higher in the pinhole 10° group (4.59±1.81) than the pinhole 15° group (3.68±1.49) (P = 0.032). The number of accidents associated with jump-out scenarios, in which a vehicle approaches from the side on a straight road with a good view, was significantly higher in the pinhole 10° group than in the pinhole 15° group. Conclusions: Concentric constriction of the visual field was associated with increased number of traffic accidents. The simulation findings indicated that a visual field of 10° to 15° may be important for avoiding collisions in places where there is a straight road with a good view. [ABSTRACT FROM AUTHOR]

Background: Mortality statistics form a crucial component of national Health Management Information Systems (HMIS). However, there are limitations in the availability and quality of mortality data at national level in Viet Nam. This study assessed the completeness of recorded deaths and the reliability of recorded causes of death (COD) in the A6 death registers in the national routine HMIS in Viet Nam. Methodology and findings: 1477 identified deaths in 2014 were reviewed in two provinces. A capture-recapture method was applied to assess the completeness of the A6 death registers. 1365 household verbal autopsy (VA) interviews were successfully conducted, and these were reviewed by physicians who assigned multiple and underlying cause of death (UCOD). These UCODs from VA were then compared with the CODs recorded in the A6 death registers, using kappa scores to assess the reliability of the A6 death register diagnoses. The overall completeness of the A6 death registers in the two provinces was 89.3% (95%CI: 87.8–90.8). No COD recorded in the A6 death registers demonstrated good reliability. There is very low reliability in recording of cardiovascular deaths (kappa for stroke = 0.47 and kappa for ischaemic heart diseases = 0.42) and diabetes (kappa = 0.33). The reporting of deaths due to road traffic accidents, HIV and some cancers are at a moderate level of reliability with kappa scores ranging between 0.57–0.69 (p<0.01). VA methods identify more specific COD than the A6 death registers, and also allow identification of multiple CODs. Conclusions: The study results suggest that data completeness in HMIS A6 death registers in the study sample of communes was relatively high (nearly 90%), but triangulation with death records from other sources would improve the completeness of this system. Further, there is an urgent need to enhance the reliability of COD recorded in the A6 death registers, for which VA methods could be effective. Focussed consultation among stakeholders is needed to develop a suitable mechanism and process for integrating VA methods into the national routine HMIS A6 death registers in Viet Nam. [ABSTRACT FROM AUTHOR]

Driving behaviors play an important role in accident involvement. Concretely speaking, aberrant driving behaviors would cause more accidents, and oppositely positive driving behaviors would promote to build safety traffic environment. The main goals of this study were to explore the positive driving behavior and its relationship with personality in a Chinese sample. A total of 421 licensed drivers (286 male and 135 female) from Beijing, China completed the Positive Driver Behavior Scale (PDBS), the Driver Behavior Questionnaire (DBQ), the Dula Dangerous Driving Index (DDDI) and the Big Five Inventory (BFI) on a voluntary and anonymous basis. The results showed that the Chinese version of the PDBS has both reliability and validity and that the PDBS was significantly correlated with the BFI. Specifically, the PDBS was negatively correlated with neuroticism (r = -0.38) and positively correlated with extraversion, agreeableness, conscientiousness and openness to experience (the correlation coefficient ranged from 0.36 to 0.55). In contrast with previous research, age was negatively correlated with the PDBS (r = -0.38) in our sample, which may have resulted from less driving experience or a lack of available cognitive resources. [ABSTRACT FROM AUTHOR]

Object: We observed some cases of lung abscess (LA) in ICU patients suffering S.aureus ventilator-associated pneumonia (S.aureus-VAP). We aimed to assess which of the host and/or bacteria-related features are associated with LA. Methods: We conducted a retrospective study from January 2009 to July 2013 in a trauma surgical ICU within a teaching hospital. All adult patients presenting with S.aureus-VAP were included. We compared two groups of patients according to the formation or not of LA concomitantly to S.aureus-VAP. Results: Seventy-nine S.aureus-VAP patients, predominantly males (85%) of rather young age (mean [SD]: 35yr [21–64]) with severe trauma (initial Simplified Acute Score II = 42 [32–52]) related-ICU admission, were included. Among them, 10 (14%) developed LA. Patient’s characteristics significantly associated with LA development were: a younger age (p = 0.003), road traffic accidents admission (p = 0.017), head injury (p = 0.002), lower Glasgow Coma Scale (p = 0.009), blunt chest trauma (p = 0.01) pneumothorax (p = 0.01) and lung contusions (p = 0.002). No microbiological factors were significantly associated with LA formation. Abscesses were mostly bilateral, ≥5 cm of diameter and with a posterior location. Conclusions: Our results do not favor a specific virulence of S.aureus, but rather highlight the role of multiple insults to the lung, promoting LA formation. Despite a similar severity score, patients with LA had more serious trauma, combining severe both chest and head insults. [ABSTRACT FROM AUTHOR]

How to evaluate driver spontaneous reactions in various collision patterns in a quantitative way is one of the most important topics in vehicle safety. Firstly, this paper constructs representative numerical crash scenarios described by impact velocity, impact angle and contact position based on finite element (FE) computation platform. Secondly, a driver cabin model is extracted and described in the well validated multi-rigid body (MB) model to compute the value of weighted injury criterion to quantitatively assess drivers’ overall injury under certain circumstances. Furthermore, based on the coupling of FE and MB, parametric studies on various crash scenarios are conducted. It is revealed that the WIC (Weighted Injury Criteria) value variation law under high impact velocities is quite distinct comparing with the one in low impact velocities. In addition, the coupling effect can be elucidated by the fact that the difference of WIC value among three impact velocities under smaller impact angles tends to be distinctly higher than that under larger impact angles. Meanwhile, high impact velocity also increases the sensitivity of WIC under different collision positions and impact angles. Results may provide a new methodology to quantitatively evaluate driving behaviors and serve as a significant guiding step towards collision avoidance for autonomous driving vehicles. [ABSTRACT FROM AUTHOR]

Background: Sleep-related problems are known risk factors for road accidents. However, very few studies have investigated the role played by insomnia and its components, and no data are available for a population of occupational drivers at risk, such as the truck driver category. Objective: To measure the prevalence and impact of insomnia on motor vehicle accidents (MVAs) and near-miss accidents (NMAs) in 949 truck drivers. Design: Cross-sectional survey. Results: Insomnia affected 27.5% of the sample. Compared to other drivers, in the 3 years prior to the study, truck drivers with insomnia had reported a significantly higher number of MVAs; they had also reported a greater number of NMAs in the previous 6 months. After correction for the presence of obstructive sleep apnea, excessive daytime sleepiness, short sleep duration, and other concurrent diseases, insomniac truck drivers had an almost two-fold risk of driving accidents (OR: 1.82, CI 95%:1.33–2.49) and a more than three-fold increased risk of near-miss accidents (OR: 3.35, CI95%:2.06–5.45) compared to non-insomniac drivers. Conclusion: Insomnia emerged as an independent risk factor for MVAs and NMAs. We strongly advise screening commercial drivers for signs and symptoms of insomnia in order to improve health and safety on the road. [ABSTRACT FROM AUTHOR]

Studies carried out in Moscow residents have revealed that the prevalence of chronic toxoplasmosis is very close to those in countries of Eastern and Central Europe. Our findings also demonstrated a statistically significant relationship between the rate of traffic accidents and the seroprevalence of chronic toxoplasmosis in drivers who were held responsible for accidents. The latter was 2.37 times higher in drivers who were involved in road accidents compared with control groups. These results suggest that the consequences of chronic toxoplasmosis (particularly a slower reaction time and decreased concentration) might contribute to the peculiarities of the epidemiology of road traffic accidents in the Russian Federation and might interfere with the successful implementation of the Federal Programme named “Increase road traffic safety”. Suggestions for how to address overcome this problem are discussed in this paper. [ABSTRACT FROM AUTHOR]

Autonomous Vehicle technology is quickly expanding its market and has found in Silicon Valley, California, a strong foothold for preliminary testing on public roads. In an effort to promote safety and transparency to consumers, the California Department of Motor Vehicles has mandated that reports of accidents involving autonomous vehicles be drafted and made available to the public. The present work shows an in-depth analysis of the accident reports filed by different manufacturers that are testing autonomous vehicles in California (testing data from September 2014 to March 2017). The data provides important information on autonomous vehicles accidents’ dynamics, related to the most frequent types of collisions and impacts, accident frequencies, and other contributing factors. The study also explores important implications related to future testing and validation of semi-autonomous vehicles, tracing the investigation back to current literature as well as to the current regulatory panorama. [ABSTRACT FROM AUTHOR]

Background: The World Health Organisation reports that road traffic accidents (accidents) could become the seventh leading cause of death globally by 2030. Accidents often occur in spatial clusters and, generally, there are more accidents in less advantaged areas. Infrastructure changes, such as new roads, can affect the locations and magnitude of accident clusters but evidence of impact is lacking. A new 5-mile motorway extension was opened in 2011 in Glasgow, Scotland. Previous research found no impact on the number of accidents but did not consider their spatial location or socio-economic setting. We evaluated impacts on these, both locally and city-wide. Methods: We used STATS19 data covering the period 2008 to 2014 and describing the location and details of all reported accidents involving a personal injury. Poisson-based continuous scan statistics were used to detect spatial clusters of accidents and any change in these over time. Change in the socio-economic distribution of accident cluster locations during the study period was also assessed. Results: In each year accidents were strongly clustered, with statistically significant clusters more likely to occur in socio-economically deprived areas. There was no significant shift in the magnitude or location of accident clusters during motorway construction or following opening, either locally or city-wide. There was also no impact on the socio-economic patterning of accident cluster locations. Conclusions: Although urban infrastructure changes occur constantly, all around the world, this is the first study to evaluate the impact of such changes on road accident clusters. Despite expectations to the contrary from both proponents and opponents of the M74 extension, we found no beneficial or adverse change in the socio-spatial distribution of accidents associated with its construction, opening or operation. Our approach and findings can help inform urban planning internationally. [ABSTRACT FROM AUTHOR]

Introduction: Aging has long been regarded as one of the most critical factors affecting crash injury outcomes. In South Korea, where the elderly population is projected to reach 35.9% by 2050, the implications of an increasing number of elderly vehicle users on road safety are evident. In this research, the confounding effect of occupant age in a vehicle in terms of seat position and seatbelt use was investigated. In addition, elderly occupants were divided into a younger-old group aged between 65 and 74 years and an older-old group aged 75 years and older in an effort to assess whether the conventional elderly age standard of 65 years should be reconsidered. Methods: A multinomial logit framework was adopted to predict two-level injury severity using collision data between 2008 and 2015. Predictor variables included gender, age group, seat position, seatbelt, road type, road slope, road surface, road line, and type of vehicle. Five models, a base model with no interactions and four interaction models which were combinations of age group, seatbelt use and seat position, were devised and evaluated. Results: With no interacting term, age was the most prominent predictor. Elderly occupants were most likely to suffer from severe injury without a seatbelt in all seat positions, and the use of a seatbelt reduced this likelihood the most in the elderly group as well. Front passenger seats had the highest risk to elderly occupants, while the driver seat was statistically insignificant. When the elderly group was divided into the younger-old group and the older-old group, the older-olds were found to be much more vulnerable compared to the younger-olds. In particular, older drivers were five times more likely to suffer a severe injury without a seatbelt. Conclusions: The degree of injury severity of elderly occupants was reduced the most with the use of a seatbelt, demonstrating the importance of using seat restraints. The sharp increase in the risk of injury of the older-old group suggests that the age standard of 65 years as the elderly group with regard to traffic safety may require reconsideration due to the growing number of elderly vehicle users on the road. Our results provide practical evidence with which to formulate new safety policies, including mandatory seatbelt use, driving age limits and insurance pricing. [ABSTRACT FROM AUTHOR]

The role of distractions on attentional lapses that place road users in higher risk of crash remains poorly understood. We aimed to assess the respective impact of (i) mind wandering trait (propensity to mind wander in the everyday life as measured with a set of 4 questions on the proportion of time spent mind wandering in 4 different situations) and (ii) mind wandering state (disturbing thoughts just before the crash) on road crash risk using a comparison between responsible and non-responsible drivers. 954 drivers injured in a road crash were interviewed at the adult emergency department of the Bordeaux university hospital in France (2013–2015). Responsibility for the crash, mind wandering (trait/state), external distraction, alcohol use, psychotropic drug use, and sleep deprivation were evaluated. Based on questionnaire reports, 39% of respondents were classified with a mind wandering trait and 13% reported a disturbing thought just before the crash. While strongly correlated, mind wandering state and trait were independently associated with responsibility for a traffic crash (State: OR = 2.51, 95% CI: 1.64–3.83 and Trait: OR = 1.62, 95% CI: 1.22–2.16 respectively). Self-report of distracting thoughts therefore did not capture the entire risk associated with the propensity of the mind to wander, either because of under-reported thoughts and/or other deleterious mechanisms to be further explored. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is a significant global public health problem, but has received minimal attention from researchers and policy-makers in low- and middle-income countries (LMICs). Epidemiological evidence of TBI morbidity and mortality is absent at the national level for most LMICs, including China. Using data from China's Disease Surveillance Points (DSPs) system, we conducted a population-based longitudinal analysis to examine TBI mortality, and mortality differences by sex, age group, location (urban/rural), and external cause of injury, from 1 January 2006 to 31 December 2013 in China.Method and Findings: Mortality data came from the national DSPs system of China, which has coded deaths using the International Classification of Diseases-10th Revision (ICD-10) since 2004. Crude and age-standardized mortality with 95% CIs were estimated using the census population in 2010 as a reference population. The Cochran-Armitage trend test was used to examine the significance of trends in mortality from 2006 to 2013. Negative binomial models were used to examine the associations of TBI mortality with location, sex, and age group. Subgroup analysis was performed by external cause of TBI. We found the following: (1) Age-adjusted TBI mortality increased from 13.23 per 100,000 population in 2006 to 17.06 per 100,000 population in 2008 and then began to fall slightly. In 2013, age-adjusted TBI mortality was 12.99 per 100,000 population (SE = 0.13). (2) Compared to females and urban residents, males and rural residents had higher TBI mortality risk, with adjusted mortality rate ratios of 2.57 and 1.71, respectively. TBI mortality increased substantially with older age. (3) Motor vehicle crashes and falls were the 2 leading causes of TBI mortality between 2006 and 2013. TBI deaths from motor vehicle crashes in children aged 0-14 years and adults aged 65 years and older were most often in pedestrians, and motorcyclists were the first or second leading category of road user for the other age groups. (4) TBI mortality attributed to motor vehicle crashes increased for pedestrians and motorcyclists in all 7 age groups from 2006 to 2013. Our analysis was limited by the availability and quality of data in the DSPs dataset, including lack of injury-related socio-economic factors, policy factors, and individual and behavioral factors. The dataset also may be incomplete in TBI death recording or contain misclassification of mortality data.Conclusions: TBI constitutes a serious public health threat in China. Further studies should explore the reasons for the particularly high risk of TBI mortality among particular populations, as well as the reasons for recent increases in certain subgroups, and should develop solutions to address these challenges. Interventions proven to work in other cultures should be introduced and implemented nationwide. Examples of these in the domain of motor vehicle crashes include policy change and enforcement of laws concerning helmet use for motorcyclists and bicyclists, car seat and booster seat use for child motor vehicle passengers, speed limit and drunk driving laws, and alcohol ignition interlock use. Examples to prevent falls, especially among elderly individuals, include exercise programs, home modification to reduce fall risk, and multifaceted interventions to prevent falls in all age groups. [ABSTRACT FROM AUTHOR]

A generalized right truncated bivariate Poisson regression model is proposed in this paper. Estimation and tests for goodness of fit and over or under dispersion are illustrated for both untruncated and right truncated bivariate Poisson regression models using marginal-conditional approach. Estimation and test procedures are illustrated for bivariate Poisson regression models with applications to Health and Retirement Study data on number of health conditions and the number of health care services utilized. The proposed test statistics are easy to compute and it is evident from the results that the models fit the data very well. A comparison between the right truncated and untruncated bivariate Poisson regression models using the test for nonnested models clearly shows that the truncated model performs significantly better than the untruncated model. [ABSTRACT FROM AUTHOR]

Age estimation remains one of the most challenging tasks in forensic practice when establishing a biological profile of unknown skeletonised remains. Morphological methods based on developmental markers of bones can provide accurate age estimates at a young age, but become highly unreliable for ages over 35 when all developmental markers disappear. This study explores the changes in the biomechanical properties of bone tissue and matrix, which continue to change with age even after skeletal maturity, and their potential value for age estimation. As a proof of concept we investigated the relationship of 28 variables at the macroscopic and microscopic level in rib autopsy samples from 24 individuals. Stepwise regression analysis produced a number of equations one of which with seven variables showed an R2 = 0.949; a mean residual error of 2.13 yrs ±0.4 (SD) and a maximum residual error value of 2.88 yrs. For forensic purposes, by using only bench top machines in tests which can be carried out within 36 hrs, a set of just 3 variables produced an equation with an R2 = 0.902 a mean residual error of 3.38 yrs ±2.6 (SD) and a maximum observed residual error 9.26yrs. This method outstrips all existing age-at-death methods based on ribs, thus providing a novel lab based accurate tool in the forensic investigation of human remains. The present application is optimised for fresh (uncompromised by taphonomic conditions) remains, but the potential of the principle and method is vast once the trends of the biomechanical variables are established for other environmental conditions and circumstances. [ABSTRACT FROM AUTHOR]

Objective: The aim was to study gender differences in care-seeking behavior and treatment provided immediately after whiplash trauma. Methods: Participants were residents from a defined geographical area, Skaraborg County in the southwestern part of Sweden. A cohort of 3,368 persons exposed to whiplash trauma and attending a healthcare facility immediately after the trauma between 1999 and 2008 were identified in a database. Information about gender, age, time elapsed prior to seeking care, type of healthcare contact, initial treatment provided and eventual hospitalization time was retrieved. Results: Women sought care later than men (p = 0.00074). Women consulted primary healthcare first more often than men, who more often first sought hospital care (p = 0.0060). There were no gender differences regarding the type of treatment after trauma. Women had longer hospital admission than men (p = 0.022), indicating their injuries were at least similar to or worse than men’s. Conclusion: Women sought healthcare later than men after whiplash trauma. Although not directly investigated in this study, it raises the question if this may reduce their probability of getting financial compensation compared to men. [ABSTRACT FROM AUTHOR]