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Our institution has recently experienced an increase in sledding-related injuries, particularly when towed behind motorized vehicles. The purpose of this study was to characterize injury severity and clinical outcomes between pediatric patients who sustain injuries owing to motorized sledding accidents to aid in injury prevention messaging.This retrospective study queried all patients who presented with a sledding-related injury to a single ACS-verified Level 1 Pediatric Trauma Center located in the Southeastern United States between 01/2015 and 01/2022. Demographics, injury details, and clinical outcomes were compared between two groups: patients towed behind a motorized vehicle (MOTOR) and those who were not (GRAVITY).Of the 67 patients included in our analysis, 15 (22%) were in the MOTOR group. Patients in the MOTOR group presented with significantly higher injury severity (ISS) and lower Glasgow coma scale (GCS) scores. Additionally, patients in this MOTOR group more often received a blood transfusion and intubation, had longer intensive care and overall hospital lengths of stay, and incurred higher hospital costs. In a multivariate analysis, the use of a motorized vehicle to sled was independently associated with increased ISS (OR: 9.7, 95% CI 1.9-17.5; p = 0.02). Two deaths occurred after sledding while being towed behind a motorized vehicle.Children experiencing sledding accidents while being towed by motorized vehicles sustain significantly more severe injuries and require more intensive treatments that together lead to increased hospital costs. These findings provide the framework for community educational initiatives and injury prevention measures to mitigate risk among children engaged in sledding.IV retrospective cohort study.

ATV (All-Terrain Vehicle) related open fractures are often high energy and may be highly contaminated. We asked whether they were more complicated than other open fractures in pediatric patients.A retrospective chart review was performed comparing ATV associated open fractures to open fractures sustained in non-ATV related accidents. 97 pediatric open fractures from 2015 to 2021 were identified based on ICD-10 codes. Of these fractures, 62 were non-ATV related and 35 were ATV related. Charts were reviewed to collect basic demographics, fracture pattern, Gustilo-Anderson classification, procedures performed, operative findings, and complications.Our cohort was predominantly male (71% in the ATV group and 76% in the non-ATV group). White race was more common in both the ATV (28 (80%)) and non-ATV (50(78%)) groups. The distribution of AO/OTA fractures was significantly different (p = 0.046), with humerus fractures being more common in the ATV group (8 (22%)) vs. non-ATV group (6 (9.3%)). The ATV group had a higher proportion of more severe type II and III open fractures with 77.1% (n = 27), versus 56% (n = 35) in the non-ATV group (p = 0.020).. Revision and reoperation were more likely in the ATV group (16 (23%)) vs. the non-ATV group (12 (15%)), as was malunion (ATV group 3 (4.3%) Vs. non-ATV 0 (0%)).Open fractures resulting from ATV injuries tend to be more complex and have higher rates of revision and malunion. This information supports the large body of evidence on the dangers of ATVs to children and can help guide expectations of both clinicians and family members of patients presenting with these injuries.

BACKGROUND: Epidemiologic patterns of all-terrain vehicle (ATV)-related emergency department (ED) visits by male and female individuals may vary at different ages. To our knowledge, this has not been researched previously. OBJECTIVE: The purpose of this study was to determine the interaction of sex and age differences in their association with ATV-related ED visits. METHODS: Data from the 2019 National Electronic Injury Surveillance System were extracted for ATV-related ED visits, including sex, age, race, location of crash, injured body part, and whether alcohol was involved. Descriptive statistics and logistic regression analyses were conducted. We modeled sex in separate multivariable models, adjusting for the same independent variables. RESULTS: There were an estimated 95,995 (unweighted n = 1999) ATV-related ED visits. There was a significant age-by-sex interaction in the association between ATV-related ED visits vs. other ED injuries, indicating that the effect of age on ATV-related ED visits differed by sex and vice versa. Overall, male individuals were 1.7 times as likely to have an ATV-related ED visit as female individuals. In the stratified analysis for female individuals, odds were substantially greater for girls younger than 18 years (adjusted odds ratio [AOR] 2.33; 95% confidence interval [CI] 1.61–3.69) and women aged 18–35 years (AOR 4.76; 95% CI 3.48–6.51) compared with woman older than 35 years. For men, odds were significant for ages 18–35 years (AOR 2.21; 95% CI 1.72–2.85) compared with men older than 35 years. CONCLUSIONS: As newer ATVs become more powerful and faster, there is a need to know who is at greatest risk for ATV-related ED visits to develop policies and safety measures.

Purpose To describe the epidemiology, patterns, seasonality and outcome of all-terrain vehicle-related injuries (ATVRIs) among different age groups in Qatar. Methods A retrospective analysis of all patients hospitalized with ATVRI from 2010 to 2018 was conducted. Data were analyzed by age, gender, seasonality, and Injury severity Score (ISS). Chi-square, Student t and ANOVA tests were used for analysis. Multivariate regression analysis was performed to find out predictors of head injury and severe injury among ATV users. Results Out of 15,000 trauma admissions, 521 had ATVRI (4%) with a mean age of 23.3 ± 12.3. The male-to-female ratio was 4:1 and the pediatric population represented 40%. The compliance with helmet use was 3.6%. The most injured regions were chest (29.8%), upper extremities (28.8%) and the head (25.9%). The mean ISS was 10.6 ± 7.7. Fracture fixation was the most operative intervention. Among hospitalized patients, 7.7% were transferred to rehabilitation . ATVRIs occurred more frequently between October and April and a large proportion (57.8%) occurred during weekends. The overall ATV-related hospital mortality rate was 2.1%. Young and older ATV users were more likely to suffer spine injuries than the pediatric population (p = 0.001). The mean ISS was greater in the older groups (p = 0.03). There were no statistically significant differences regarding the use of protective devices, mortality, or length of hospital stay between the different age groups. On multivariate analysis, young age and ISS were predictors of head injury among ATV users after adjusting for gender and helmet use. Conclusion This is a nationwide study looking at all age groups who sustained ATVRI in Qatar. ATVRIs were observed in all age groups following leisure and recreational use. It follows a seasonal pattern with poor protective measures compliance. There is a need to reinforce helmet use and raise public awareness.

Transportation sector is one of the major contributors to GHG emissions, and it is essential to investigate the role of electric vehicles in economic and environmental performance of developing countries. In this research work, the authors seek to investigate the usage pattern of three-wheeler vehicle by taking a Pakistan-based survey approach and analyzing the responses from various three-wheeler drivers across the country. The survey results indicate that the adoption of hybrid and electric three-wheelers in Pakistan would be welcomed by the users due to increased economic benefits, despite having a high initial capital cost. On an average basis, the regular three-wheeler is run for more than 5 days a week, 101-150 km daily across more than 10 h, and enables the owner to make around PKR 20,000-25,000 (~ US $119-US $149) after approximately PKR 15,000 (~ USD $89) is spent every month on fuel and maintenance. The adoption of hybrid or electric three-wheelers can easily improve the monthly earnings by 50%. In addition to this, the GHG emissions from the transportation sector will be considerably lowered around 3-6 tonnes of CO

HighlightsParents did not see themselves as role models for children regarding use of quad bikes.Parents seemed to misjudge their children’s maturity and capabilities.Risk acceptance was a common issue, due to risk normalization.There is a need for an age limit for drivers of adult-size quad bikes.Abstract.When seeking to explain the many accidents involving children on quad bikes, it is critical to understand the norms and risk perceptions of their parents, because parents are responsible for their children’s safety. This study explored attitudes and behavior among parents of rural children using quad bikes and their experiences of incidents and injuries. Information obtained from two focus group discussions, one with young adults and one with parents, and an in-depth interview with a quad bike distributor was used to develop an interview guide. The guide was used in telephone interviews with Swedish parents (n = 41) and some children ages 5 to 14 (n = 9) between autumn 2015 and spring 2016. Analysis of the results revealed eight themes: (1) how quad bikes are used, (2) risk awareness, (3) safety information could help other parents, (4) parents’ perception of children’s abilities, (5) children’s learning, (6) children`s perspective, (7) rules and responsibilities, and (8) risk acceptance. Major findings were that parents were aware of the risks and had a strong commitment to children’s safety, but also showed risk acceptance. To increase the safety of quad bike use, recommendations to organizations and authorities are presented, such as an age limit for drivers of all adult-size quad bikes and safety labeling of quad bikes, with information clarifying the rules for specific vehicles. Keywords: Acceptance, Accident, Agriculture, All-terrain vehicle, ATV, Awareness, Farm, Child, Incident, Parent, Quad bike, Risk, Rural, Sweden, Youth.

OBJECTIVE All-terrain vehicle (ATV) and dirt bike crashes frequently result in traumatic brain injury. The authors performed a retrospective study to evaluate the role of helmets in the neurosurgical outcomes of pediatric patients involved in ATV and dirt bike crashes who were treated at their institution during the last decade. METHODS The authors analyzed data on all pediatric patients involved in ATV or dirt bike crashes who were evaluated at a single regional level I pediatric trauma center between 2010 and 2019. Patients were excluded if the crash occurred in a competition (n = 70) or if helmet status could not be determined (n = 18). Multivariable logistic regression was used to analyze the association of helmet status with the primary outcomes of 1) neurosurgical consultation, 2) intracranial injury (including skull fracture), and 3) moderate or severe traumatic brain injury (MSTBI) and to control for literature-based, potentially confounding variables. RESULTS In total, 680 patients were included (230 [34%] helmeted patients and 450 [66%] unhelmeted patients). Helmeted patients were more frequently male (81% vs 66%). Drivers were more frequently helmeted (44.3%) than passengers (10.5%, p < 0.001). Head imaging was performed to evaluate 70.9% of unhelmeted patients and 48.3% of helmeted patients (p < 0.001). MSTBI (8.0% vs 1.7%, p = 0.001) and neurosurgical consultation (26.2% vs 9.1%, p < 0.001) were more frequent among unhelmeted patients. Neurosurgical injuries, including intracranial hemorrhage (16% vs 4%, p < 0.001) and skull fracture (18% vs 4%, p < 0.001), were more common in unhelmeted patients. Neurosurgical procedures were required by 2.7% of unhelmeted patients. One helmeted patient (0.4%) required placement of an intracranial pressure monitor, and no other helmeted patients required neurosurgical procedures. After adjustment for age, sex, driver status, vehicle type, and injury mechanism, helmet use significantly reduced the odds of neurosurgical consultation (OR 0.250, 95% CI 0.140–0.447, p < 0.001), intracranial injury (OR 0.172, 95% CI 0.087–0.337, p < 0.001), and MSTBI (OR 0.244, 95% CI 0.079–0.758, p = 0.015). The unadjusted absolute risk reduction provided by helmet use equated to a number-needed-to-helmet of 6 riders to prevent 1 neurosurgical consultation, 4 riders to prevent 1 intracranial injury, and 16 riders to prevent 1 MSTBI. CONCLUSIONS Helmet use remains problematically low among young ATV and dirt bike riders, especially passengers. Expanding helmet use among these children could significantly reduce the rates of intracranial injury and MSTBI, as well as the subsequent need for neurosurgical procedures. Promoting helmet use among recreational ATV and dirt bike riders must remain a priority for neurosurgeons, public health officials, and injury prevention professionals.

ProblemUtility All-Terrain Vehicles (ATVs) are one major cause of youth injuries and fatalities on farms. Utility ATVs have heavy weights and fast speeds that require complex maneuvering. Youth's physical capabilities may not be sufficient to perform those complex maneuvers correctly. Therefore, it is hypothesized that most youth engage in ATV-related incidents because they ride vehicles unfit for them. There is a need to assess ATV-youth fit based on youth anthropometry.MethodThis study focused on evaluating potential inconsistencies between the operational requirements of utility ATVs and the anthropometric measures of youth through virtual simulations. Virtual simulations were performed to assess 11 youth-ATV fit guidelines proposed by several ATV safety advocacy organizations (National 4-H council, CPSC, IPCH, and FReSH). In total, 17 utility ATVs along with male-and-female-youth of nine ages (8 to 16 years old) and three height percentiles (5th, 50th, and 95th) were evaluated.ResultsThe results demonstrated a physical mismatch between ATVs' operational requirements and youth's anthropometry. For example, male-youth aged 16 of the 95th height percentile failed to pass at least 1 out of the 11 fit guidelines for 35 % of all vehicles evaluated. The results were even more concerning for females. Female youth 10 years old and younger (from all height percentiles) failed to pass at least one fit guideline for all ATVs evaluated.DiscussionYouth are not recommended to ride utility ATVs.Practical applicationsThis study provides quantitative and systematic evidence to modify current ATV safety guidelines. Furthermore, youth occupational health professionals could use the present findings to prevent ATV-related incidents in agricultural settings.

All-terrain vehicle (ATV) incidents are one of the leading causes of injuries and fatalities among youth in the agricultural industry. It has been hypothesized that many youth-related ATV incidents occur because children ride ATVs that do not fit their capabilities and are not following basic safe riding practices. In addition, various ATV safety guidelines regarding youth (e.g., CPSC, ANSI/SVIA, ASI) are inconsistent and may not align with state or local laws. To the best of our knowledge, no comprehensive studies have compared the physical and mental requirements for riding ATVs and the youth's capabilities to ride ATVs safely. Consequently, there are no scientific-based recommendations for age limitation, physical and mental capabilities, and safety requirements for youth to ride ATVs safely. Thus, there is a need to review the available sources related to youth safety and ATVs in the agricultural industry, identify the research voids, and recommend modifications to current ATV guidelines. This study conducted a systematic review of available ATV-related studies, standards, guidelines, and laws to establish better-informed minimum age, physical and mental capabilities, and safety requirements for youths to ride ATVs on the farm.

IntroductionThere is widespread use of all-terrain vehicles (ATVs) in the USA for both work-related and recreational activities. In this study, we aimed to determine the difference in injury severity, Glasgow Coma scales and length of stay between ATV-related injuries and injuries sustained from motorcycles (MOTOs) and automobiles (AUTOs).MethodsWe retrospectively analysed ATV, MOTO and AUTO injuries from a Level 2 Trauma Center between 01 January 2015 and 31 August 2020. Proportional odds regression analyses, as well as multivariable regression models, were used to analyse the data.ResultsThere were significantly more male and paediatric patients that suffered ATV-related injuries compared with MOTO or AUTO injuries. Victims of ATV-related injuries were also more likely to have open fractures. Paediatric patients were less likely to sustain an injury from either AUTO or MOTO accidents compared with ATV accidents. Patients with no drug use during injury and those who used protective equipment such as seat belts and child seats were significantly associated with lower Injury Severity Scores and higher Glasgow Coma Scale scores, indicating less severe injuries.DiscussionPaediatric patients are very likely to suffer sequela and long-term disability due to the severity of ATV-related injuries. Public awareness campaigns to educate our population, especially our youth, about the danger of ATV use are highly needed.

Since all-terrain vehicles (ATVs) were introduced in the mid-1970s, regulatory agencies, injury prevention researchers, and pediatricians have documented their dangers to youth. Major risk factors, crash mechanisms, and injury patterns for children and adolescents have been well characterized. Despite this knowledge, preventing pediatric ATV-related deaths and injuries has proven difficult and has had limited success. This policy statement broadly summarizes key background information and provides detailed recommendations based on best practices. These recommendations are designed to provide all stakeholders with strategies that can be used to reduce the number of pediatric deaths and injuries resulting from youth riding on ATVs.

The purpose was to evaluate the characteristics of off-highway vehicle (OHV) crashes correlated with neurological injury and accident severity in the pediatric population in El Paso, Texas.A retrospective review of 213 patients who were victims of an OHV crash attended at a regional Level I trauma center from 2012 to 2020 was performed. OHVs were defined as vehicles designated for use outside public roads. Neurological outcomes included any traumatic brain injury (TBI) or a brain hemorrhage/hematoma. Severe injury was defined as a Glasgow Coma Scale less than 8, a length of stay longer than 7 days, a Pediatric Trauma Score lower than 8, and requiring pediatric intensive care unit admission. Bivariate and multivariate analyses by logistic regression models were conducted to determine the factors related to the neurological outcomes and accident severity.Of 213 OHV crash patients, 104 (48.8%) had TBI and 22 (10.3%) had brain hemorrhages or hematomas. Risk analyses demonstrated that children younger than age 6 years and occupants of recreational OHVs have a significantly higher risk of severe injuries. Off-highway motorcycles and all-terrain vehicles were risk factors for TBI, whereas helmets were a protective factor.OHVs are associated with both TBIs and severe injuries. Stricter laws requiring helmets and forbidding children younger than 6 to ride are required, as modifying these factors could reduce the incidence of OHV crashes and their complications.

A web-based injury surveillance system was implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA) to better understand injury characteristics in mountain biking. Data were collected from NICA leagues during the 2018 and 2019 seasons. Injuries were tracked in 41,327 student-athlete-years, identifying 1750 unique injuries during 1155 injury events. Rider-dependent and rider-independent variables were analyzed. The most commonly reported injuries were concussion (23.6%), injuries to the wrist/hand (22.3%), and shoulder (15.6%). Half of all injury events occurred on downhills. Men and women reported similar yet significantly different injury rates (2.69% and 3.21%, respectively; P = 0.009). Women sustained more lower-limb injuries (37.8% vs 28.3%; P = 0.003). Nearly 50% of crashes resulted in an emergency room visit. Youth mountain bike racing is a rapidly growing sport. Acute traumatic injuries are common. Injury surveillance system data are now being used to inform injury prevention strategies and direct future research.

All-terrain vehicles (ATVs) represent a serious and ongoing public health and safety concern for children and adolescents. Survey studies indicate that high proportions of youth ride ATVs in both rural and nonrural populations. The significant human and economic costs of pediatric ATV-related deaths and injuries result from a number of major risk factors that are highly common in pediatric ATV crashes: operating adult-size vehicles, riding with or as passengers, lack of protective equipment, and riding on public roads. Other less well-studied but potentially significant risk factors are speed, riding at night, alcohol use among older teenagers, and lack of training and supervision. Although potentially safer than adult ATVs, youth models present a number of safety concerns that have not been addressed with rigorous study. The most common ATV crash mechanism is a noncollision event—for example, a rollover. Common injury mechanisms include ejection from the vehicle, resulting in extremity and head injuries, and being pinned or crushed by the vehicle with resulting multiorgan trauma and/or compression asphyxia. Traumatic brain injury and multisystem trauma are the 2 most common causes of death and disabling injury. Taken together, a large multidecade body of evidence is the basis for the American Academy of Pediatrics policy statement recommendation that no child younger than 16 years of age ride on an ATV. Because children continue to be allowed to ride these vehicles, however, efforts to prevent pediatric ATV-related deaths and injuries require multipronged strategies, including education of both youth and parents, safety-based engineering, and enforcement of evidence-based safety laws.

Background During the past decade, all-terrain vehicle (ATV)-related injuries treated in US emergency departments decreased by 33%, down to approximately 100,000 injuries in 2016. In comparison, the number of children evaluated for ATV injuries in the Children's of Alabama emergency department more than doubled between 2006 and 2016, counter to the national trend. The American Academy of Pediatrics guidelines state that ATV operators should be at least 16 years old; however, children younger than 16 continue to represent almost one-third of all ATV-related injuries nationwide, and nearly all of the injuries to children in Alabama. Methods Using surveillance data from the Children's of Alabama hospital electronic medical record database, several Alabama counties near Birmingham were identified as having an increased number of children with ATV-related injuries in 2016. The Safety Tips for ATV Riders (STARs) program, developed in Iowa, was provided to middle school students in these counties by pediatric residents. Surveys were anonymously administered to children before and after the program and included information about demographics, knowledge of safe ATV practices, and the likelihood of using the education afterward. Results In total, 525 students participated in January 2019; their ages ranged from 11 to 15 years and the proportion of males and females was equivalent. More than 50% of the children reported riding ATVs in the last 12 months, and of these riders, 47% reported never wearing a helmet when riding. Initially, only 20% of the overall participants knew ATVs were not intended for passengers, 20% knew the recommended engine size for their age, and 57% knew that Alabama law prohibits riding on public roads. After education, this increased to 91%, 90%, and 89%, respectively. Before the STARs program, only 6% knew all three correct answers, whereas 80% answered all of the questions correctly on the postprogram survey. After the program, 34% reported they were very likely/likely to use this information in the future. Conclusions The STARs program dramatically improved short-term ATV safety knowledge, and many participants reported they were likely to subsequently use the safe practices presented. School-based programs, such as STARs, may help increase ATV safety awareness and change behaviors in high-risk age groups. This training may be successfully provided by various motivated individuals, including medical residents.

Highlights Rollovers are the leading cause of injury and fatality in farm all-terrain vehicle (ATV) incidents. Engineering technologies to prevent rollovers or protect the operator in ATV crashes were reviewed in this study. The advances in safety for ATVs are correlated with improvements in stability, handling, and crashworthiness. Operator protection devices and crash notification systems can protect the operator in ATV rollover incidents. Abstract . All-terrain vehicles (ATVs) are the second most common source of injury, following tractors, in U.S. agriculture. Rollovers are the leading cause of death in farm ATV incidents, constituting about 85% of ATV-related deaths. There is neither a significant practical solution for ATV rollover crashes in the U.S. nor standards and rules for implementing such a solution. Behavior-based control methods have been used for several decades but have reached their limit of success. Hence, engineering controls are needed to significantly decrease the severity of injuries in ATV rollover incidents (as in tractor incidents). In this study, engineering technologies to protect the operator in agricultural ATV crashes were reviewed. The discussion includes improving crash testing and stability ratings, evaluating static stability of ATVs, dynamic handling tests of ATVs, using automatic systems to notify first responders of a crash, and testing and applying operator protection devices. The available standards, rules, and recommendations related to these technologies around the world are also discussed. Keywords: . Agriculture, All-terrain vehicle, ATV, CPD, Crush protection device, OPD, Quad bike, Safety.

Background This study investigates the impact of standing electric scooter-related injuries within an entire integrated hospital system. Methods We performed a retrospective review of patients involved in standing electric scooter incidents presenting throughout an urban hospital network over a 10 month period. Rates of Google searches of scooter-related terms performed locally were used as a surrogate for ride frequency. Injury, mechanism, and cost data were analyzed. Results Data on 248 patients were reviewed. Twenty-three (9%) were under 18 years old. Loss of balance was the most common cause of injury accounting for nearly half, while tripping over a scooter 14 (6%) affected the elderly disproportionately. Eight (3%) riders wore helmets. All TBI and closed head injuries occurred in unhelmeted patients. Most incidents occurred in the street, only one in a bicycle lane. Facilities costs were greater for patients under the influence of alcohol and marijuana. Conclusion Policies related to the use of mandated safety equipment, dedicated bicycle lanes, and the proper storage of empty vehicles should be further investigated.

Background Quadbikes or all-terrain vehicles are known for their propensity for crashes resulting in injury, disability, and death. The control of these needless losses resulting from quadbike crashes has become an essential contributor to sustainable development goals. Understanding the risk factors for such injuries is essential for developing preventive policies and strategies. The aim of this review was to identify the risk factors associated with quadbike crashes at multiple levels through a systematic review of a wide range of study designs. Methods The study incorporated a mixed-method systematic review approach and followed the PRISMA 2020 guidelines for reporting systematic reviews, including a peer reviewed protocol. This systematic review included observational studies investigating the risk factors associated with quadbike crashes, injuries, or deaths. Seven electronic databases were searched from inception to October 2021. Studies were screened and extracted by three researchers. Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). Due to extensive heterogeneity, meta-analysis was not conducted. All the risk factors have been presented in a narrative synthesis for discussion following the guidelines for Synthesis without Meta-analysis (SWiM). Results Thirty-nine studies combining an aggregate of 65,170 participants were included in this systematic review. The results indicate that modifiable risk factors, such as the increasing age of driving initiation, reducing substance use, and the use of organized riding parks, could reduce quadbike injuries. Riding practices such as avoiding passengers, avoiding nighttime riding, and using helmets could significantly reduce crashes and injuries among riders. Vehicle modifications such as increasing the wheelbase and limiting engine displacement could also help reduce crash incidence. Traditional interventional methods, such as legislation and training, had a weak influence on reducing quadbike injuries. Conclusion Multiple risk factors are associated with quadbike injuries, with most of them modifiable. Strengthening policies and awareness to minimize risk factors would help in reducing accidents associated with quadbikes. PROSPERO registration number CRD42020170245

Socio-economic status (SES) is a well-established predictor of health outcomes; however, there is a dearth of evidence on the relationship between SES and off-road vehicle (ORV) injuries. In Ontario, all-terrain vehicles (ATVs) and snowmobiles present a serious risk for preventable injury. This study assessed the association between area-level material deprivation and the risk of ATV- and snowmobile-related injuries in Ontario, as well as the impact of sex and age.A population-based, repeat cross-sectional study was conducted using administrative data of ATV- and snowmobile-related emergency room visits from 2003 to 2018. Material deprivation was measured using the Ontario Marginalization Index, which assigned a score and quintile of deprivation to each dissemination area in Ontario. Age-standardized incidence rates and relative index of inequality values were calculated, stratified by quintile of deprivation, sex, age group, vehicle type, and health region.We found a significant, positive relationship between ORV-related injuries and quintile of material deprivation (RII = 1.28, 95% CI: 1.01-1.63). Rates of ATV- and snowmobile-related injuries remained stable over time. Across all age groups, sex, and rural categories, we found an inverse u-shaped relationship between rates of injuries and quintile material deprivation. Males, individuals living in rural areas, and adolescents and young adults experienced the highest rates of injuries.Despite the positive relationship between ORV-related injuries and quintiles of deprivation, the inverse u-shaped relationship suggests that this increased risk of injury is likely related to exposure to ORVs. These results contribute to an understanding of the prevalence of the injury problem at a local level in Ontario. Stable rates of injury over time suggest that current public health programs are not sufficient in reducing these injuries, and further research should determine which factors amenable to intervention are contributing to increased risk of injury.RéSUMé: OBJECTIFS: Le statut socioéconomique (SSE) est un prédicteur bien établi des résultats pour la santé, mais il existe une pénurie de preuves sur la relation entre le SSE et les blessures des véhicules hors route. En Ontario, les véhicules tout-terrain (VTT) et les motoneiges présentent un risque sérieux de blessures évitables. Cette étude a évalué l’association entre la privation matérielle au niveau de la zone et le risque de blessures liées aux VTT et aux motoneiges en Ontario, ainsi que l’impact du sexe et de l’âge. MéTHODES: Une étude transversale répétée basée sur la population a été menée à l’aide des données administratives des visites aux urgences liées aux VTT et aux motoneiges de 2003 à 2018. La privation matérielle a été mesurée à l’aide de l’Ontario Marginalization Index, qui a attribué un score et un quintile de privation à chaque aire de diffusion en Ontario. Les taux d’incidence normalisés selon l’âge et l’indice relatif des valeurs d’inégalité ont été calculés, stratifiés par quintile de privation, sexe, groupe d’âge, type de véhicule et région sanitaire. RéSULTATS: Nous avons trouvé une relation positive significative entre les blessures liées aux VTT et le quintile de privation matérielle (RII = 1,28, IC à 95% : 1,01 – 1,63). Les taux de blessures liées aux VTT et aux motoneiges sont demeurés élevés au fil du temps. Dans tous les groupes d’âge, sexe et catégories rurales, nous avons trouvé une relation en forme de U inverse entre les taux de blessures et les quintiles de privation matérielle. Les hommes, les personnes vivant dans les zones rurales, les adolescents et les jeunes adultes ont connu les taux de blessures les plus élevés. CONCLUSION: Malgré la relation positive entre les blessures liées aux VTT et les quintiles de privation, la relation en forme de U suggère que ce risque accru de blessures est probablement lié à l’exposition aux VTT. Ces résultats contribuent à une compréhension de la prévalence du problème de blessures au niveau local en Ontario. Des taux stables de blessures au fil du temps suggèrent que les programmes de santé publique actuels ne sont pas suffisants pour réduire ces blessures, et des recherches plus poussées devraient déterminer quels facteurs susceptibles d’intervenir contribuent à augmenter le risque de blessures.

As the population ages, trauma centers are seeing a significant volume of injured geriatric patients. However, there is limited data on geriatric off-roading incidents. We investigated the injury patterns, severity and outcomes of geriatric versus younger adult all-terrain vehicle (ATV) and snowmobile related trauma with the hypothesis that geriatric patients will have higher mortality and worsened outcomes.The trauma registry at a New England Level 1 trauma center was queried by ICD 9/10 code for adult ATV and/or snowmobile-related trauma from 2011-2019. Data reviewed included demographic, admission, injury, and outcomes data including injury severity score (ISS), abbreviated injury scale (AIS) score, hospital disposition, and mortality. Patients were stratified by age into younger adults (18-64 years old) versus geriatric (65 years and older). Univariate analysis was performed to compare groups.Over the study period, we identified 390 adult ATV or snowmobile-related trauma patients, of whom 38 were geriatric. The mean ages for the younger adult vs. geriatric cohorts were 41(SD 13) and 73(SD 5), respectively. The majority of patients were male (77%). Compared to younger adults, geriatric patients were more often unhelmeted (66 v 38%, p=0.004) and more likely to present after ATV as opposed to snowmobile trauma (71 v 51%, p=0.028). Geriatric patients more often sustained both any chest trauma (68 v 41%, p=0.003) and severe chest trauma (AIS≥3, 55 v 31%, p=0.022), and more often required tube thoracostomy (26 v 12%, p=0.042). Geriatric patients were also more often discharged to a facility (39 v 14%, p0.001) compared to younger patients. There were no differences between age cohorts regarding arrival Glasgow coma scale scores, ISS15, length of stay, ventilator days, complications, or mortality.Following ATV or snowmobile-related trauma, geriatric patients were more likely to sustain severe chest trauma and to require additional care upon hospital discharge as compared to younger adults. Primary prevention should focus on encouraging helmet and chest protective clothing use in this geriatric population.

The aim of the European Space Agency’s ExoMars rover mission is to search for potential traces of present or past life in the swallow subsurface (2m depth) of Mars. The ExoMars rover mission relies on a suite of analytical instruments envisioned to identify organic compounds with biological value (biomarkers) associated with a mineralogical matrix in a highly oxidative environment. We investigated the feasibility of detecting basic organics (linear and branched lipid molecules) with Raman laser spectroscopy, an instrument onboard the ExoMars rover, when exposed to oxidant conditions. We compared the detectability of six lipid molecules (alkanes, alkanols, fatty acid, and isoprenoid) before and after an oxidation treatment (15 days with hydrogen peroxide), with and without mineral matrix support (amorphous silica rich vs. iron rich). Raman and infrared spectrometry was combined with gas chromatography–mass spectrometry to determine detection limits and technical constraints. We observed different spectral responses to degradation depending on the lipid molecule and mineral substrate, with the silica-rich material showing better preservation of organic signals. These findings will contribute to the interpretation of Raman laser spectroscopy results on cores from the ExoMars rover landing site, the hydrated silica-enriched delta fan on Cogoon Vallis (Oxia Planum)., Proyecto MINECO Retos de la Sociedad. Ref. ESP2017-87690-C3-1-R

We conducted a field test at a potential Mars analog site to provide insight into planning for future robotic missions such as Mars 2020, where science operations must facilitate efficient choice of biologically relevant sampling locations. We compared two data acquisition and decision-making protocols currently used by Mars Science Laboratory: (1) a linear approach, where sites are examined as they are encountered and (2) a walkabout approach, in which the field site is first examined with remote rover instruments to gain an understanding of regional context followed by deployment of time- and power-intensive contact and sampling instruments on a smaller subset of locations. The walkabout method was advantageous in terms of both the time required to execute and a greater confidence in results and interpretations, leading to enhanced ability to tailor follow-on observations to better address key science and sampling goals. This advantage is directly linked to the walkabout method's ability to provide broad geological context earlier in the science analysis process. For Mars 2020, and specifically for small regions to be explored (e.g.

Road fatalities are largely preventable problem with large socioeconomic impact. Due to the rapidly increasing population, transport systems and road infrastructure have not met the demand. The use of motorized two-wheeler vehicles has increased, as informal transport. However, evidence on their safety is scarce. The aim of this article is to examine the safety and social equity issues in MTW in the informal transport sector. Factors can be used to explain traffic collisions in MTW in the formal/informal transport sectors: design, rider behavior, road design, enforcement, and regulation of the informal transport sector. Evidence suggests that MTWs could be a common related to pedestrian fatalities. Informal transport drivers are typically poor, uneducated, young men who due to lack of other employment options move into the informal sector. Their vehicles are old, unmaintained and have a lack of protective equipment for themselves and their passengers. Young, male drivers speed, take risks and not use protective equipment. Users of informal transport live in the poorer peripheries of cities, which, have limited, inefficient or unaffordable public transport. The provision of transport has therefore become an often unrecognized, important social equity issue and studies are urgently needed on MTW in the informal transport sector.

Background: All-Terrain Vehicles (ATVs) have become popular for recreation use in recent years. Texas has had more ATV related fatalities than any other state in the nation, with rural Northeast Texas having even higher rates of injuries. There is limited data examining the relationship between ATV injuries and the length of hospital stay, as well as hospital costs. This paper examines both issues in children as well as adults. Methods: The regional trauma registry was analyzed for all ATV related injuries between January 2011- October 2016. Injury Severity Score, Glasgow Coma Scale and if they are seen at a Level I Trauma center are predictive for both hospital length of stay and charges. Results: Length of Stay was predicted positively by Injury Severity Score, Emergency Department Respi-ration Rate and facility at which patients were treated and negatively by Glasgow Coma Scale. Hospital charges were predicted positively by age, Injury Severity Score, facility of treatment, means of transportation, and Emergency Department pulse and negatively by Glasgow Coma Scale. Conclusions: The study found that vital signs can be useful in predicting length of stay and hospital charges. This study not only confirms the findings of other studies regarding what predictors can be used, but expands the research into rural traumatic injuries. It is hoped that this data can help contribute to the development of algorithms to predict which patients will be most likely to require resource intensive treatment.

Background All-terrain vehicle (ATV) laws regarding helmet use, alcohol involvement, and roadway riding are poorly enforced or largely ignored. We hypothesized that direct surgeon funding and leadership in injury prevention would decrease ATV crashes. To focus prevention efforts, we reviewed a rural level 1 trauma center 11-year experience with ATV crashes comparing helmeted and unhelmeted rider outcomes. Methods For the latter 6 years of the study period, a trauma surgeon sponsored an injury prevention fund promoting ATV safety using simulators and discussions for area high school students. Helmet use, alcohol avoidance, and safe ATV operating were emphasized. A trauma registry review of ATV admissions from 2009 through 2020 examined demographics, helmet use, and clinical outcomes using chi-square, t-test, and regression analysis. Results Unhelmeted ATV riders suffered more severe head and neck injuries (OR 19, CI 1.5-1.8, P < .001), worse overall Injury Severity Score (ISS), (OR 25, CI 12.1-14.2, P < .001), and higher mortality rates (OR 4.0, CI .02-.05, P < .001). Helmet use corresponded with an average decrease in AIS and increase in GCS status. Although only 15% of riders were helmeted, ATV crash admissions have decreased in the last 5 years ( P < .001). Discussion All-terrain vehicle trauma and mortality is still frequent, especially in unhelmeted riders. The recent decrease in area ATV crashes is encouraging. Trauma surgeons have an opportunity to make a difference in public awareness and education through comprehensive physician-funded and directed injury prevention and research efforts.