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Rear-end crashes constitute the predominant type of crashes on highways and may lead to severe injuries and high property damage. Available statistical models primarily focus on injury severity and analyze potential factors that affect it. However, rear-end crashes may also be potentially correlated to vehicle, roadway, environmental, temporal, spatial, traffic, and crash characteristics. Additionally, unobserved heterogeneity regarding the effects may be present, which may be different in different crashes. In this context, multiple generalized estimating equation (GEE)-based models, developed using different working matrices and distributions, are proposed in this study to examine factors that affect injury severity. The proposed models account for both crash-related correlations and unobserved heterogeneity, thereby outperforming traditional models in terms of prediction accuracy. Among the explanatory variables considered in this study, the passenger car, minibus, curvature ratio, rainy weather, foggy weather, early morning, Thursday, autumn, winter, and average annual daily traffic volume were identified as contributing factors. However, significant differences were observed between the elasticity effects measured by different models, especially in terms of minibus and foggy weather. Thus, this study verifies that GEE-based models account for a greater amount of unobserved heterogeneity, yield better performance in terms of precision, and exhibit more consistent explanatory power compared to traditional models. Key words: rear-end crash, injury severity, generalized estimating equation, elasticity effect Les collisions par l'arriere constituent le type de collisions predominant sur les routes et peuvent entrainer des blessures graves et des dommages materiels importants. Les modeles statistiques disponibles sont axes principalement sur la gravite des blessures et analysent les facteurs potentiels qui influent sur celle-ci. Toutefois, les collisions par l'arriere peuvent aussi etre potentiellement correlees aux caracteristiques des vehicules, des routes, de l'environnement, du temps, de l'espace, de la circulation et des collisions. En outre, une heterogeneite non observee concernant les effets peut etre presente, ce qui peut etre different dans differentes collisions. Dans ce contexte, plusieurs modeles fondes sur l'equation d'estimation generalisee (EEG), elabores a l'aide de differentes matrices et distributions, sont proposes dans cette etude pour examiner les facteurs qui influent sur la gravite des blessures. Les modeles proposes tiennent compte a la fois des correlations liees aux collisions et de l'heterogeneite non observee, surpassant ainsi les modeles traditionnels en termes d'exactitude des previsions. Parmi les variables explicatives prises en compte dans cette etude, l'automobile, le minibus, le rapport de courbure, le temps pluvieux, le temps brumeux, tot le matin, le jeudi, l'automne, l'hiver, le debit journalier moyen annuel (DJMA) ont ete identifies comme facteurs contributifs. Cependant, des differences significatives ont ete observees entre les effets d'elasticite mesures par differents modeles, en particulier au niveau des minibus et du temps brumeux. Ainsi, cette etude verifie que les modeles fondes sur l'EEG representent une plus grande quantite d'heterogeneite non observee, produisent de meilleures performances en termes de precision, et presentent une puissance explicative plus coherente par rapport aux modeles traditionnels. [Traduit par la Redaction] Mots-cles : collision arriere, gravite des blessures, equation d'estimation generalisee, effet d'elasticite, 1. Introduction With constant development in the volume and modes of transportation and the progressive increase in the cumulative distance traveled throughout the world, instances of injury, death, and damage [...]

Road traffic accident is a major problem worldwide resulting in significant morbidity and mortality. Advanced driver assistance systems are one of the salient features of intelligent systems in transportation. They improve vehicle safety by providing real-time traffic information to the driver. Road signs play an important role in road safety. To be effective, road signs must be visible at a distance that enables drivers to take the necessary actions. However, static road signs are often seen too late for a driver to respond accordingly. In this study, a system for alerting drivers about road signs has been developed and tested using a smart mobile phone. The study was carried out in Tanzania along an 80km highway stretch from Arusha to Moshi town. The Haversine formula was used to measure and estimate the distance between two pairs of coordinates using the smartphone-based navigation application, Google Map. The application provides a voice alert to a needed action that enhances driver's attention. We propose an alternative method that identifies and modifies a specific class of energy inefficiencies. According to the experimental results, the proposed methodology has the benefits of high accuracy within a user radius of 10 meters, minimum bandwidth, and low-cost application. Furthermore, the system application was secured by limiting access to the application program interface key to avoid unauthorized access to sensitive information., Author(s): Eric M. Masatu (corresponding author) [1]; Ramadhani Sinde [1]; Anael Sam [1] 1. Introduction Road traffic accidents (RTA) are defined as accidents that occurred or originated on a way [...]

Background The recent Lancet Commission on Legal Determinants of Global Health argues that governance can provide the framework for achieving sustainable development goals. Even though over 90% of fatal road traffic injuries occur in low- and middle-income countries (LMICs) primarily affecting motorcyclists, the utility of helmet laws outside of high-income settings has not been well characterized. We sought to evaluate the differences in outcomes of mandatory motorcycle helmet legislation and determine whether these varied across country income levels. Methods and findings A systematic review and meta-analysis were completed using the PRISMA checklist. A search for relevant articles was conducted using the PubMed, Embase, and Web of Science databases from January 1, 1990 to August 8, 2021. Studies were included if they evaluated helmet usage, mortality from motorcycle crash, or traumatic brain injury (TBI) incidence, with and without enactment of a mandatory helmet law as the intervention. The Newcastle-Ottawa Scale (NOS) was used to rate study quality and funnel plots, and Begg's and Egger's tests were used to assess for small study bias. Pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were stratified by high-income countries (HICs) versus LMICs using the random-effects model. Twenty-five articles were included in the final analysis encompassing a total study population of 31,949,418 people. There were 17 retrospective cohort studies, 2 prospective cohort studies, 1 case-control study, and 5 pre-post design studies. There were 16 studies from HICs and 9 from LMICs. The median NOS score was 6 with a range of 4 to 9. All studies demonstrated higher odds of helmet usage after implementation of helmet law; however, the results were statistically significantly greater in HICs (OR: 53.5; 95% CI: 28.4; 100.7) than in LMICs (OR: 4.82; 95% CI: 3.58; 6.49), p-value comparing both strata < 0.0001. There were significantly lower odds of motorcycle fatalities after enactment of helmet legislation (OR: 0.71; 95% CI: 0.61; 0.83) with no significant difference by income classification, p-value: 0.27. Odds of TBI were statistically significantly lower in HICs (OR: 0.61, 95% CI 0.54 to 0.69) than in LMICs (0.79, 95% CI 0.72 to 0.86) after enactment of law (p-value: 0.0001). Limitations of this study include variability in the methodologies and data sources in the studies included in the meta-analysis as well as the lack of available literature from the lowest income countries or from the African WHO region, in which helmet laws are least commonly present. Conclusions In this study, we observed that mandatory helmet laws had substantial public health benefits in all income contexts, but some outcomes were diminished in LMIC settings where additional measures such as public education and law enforcement might play critical roles., Author(s): Jacob R. Lepard 1,2,*, Riccardo Spagiari 3, Jacquelyn Corley 2,4, Ernest J. Barthélemy 2,5, Eliana Kim 2,6, Rolvix Patterson 2,7, Sara Venturini 8, Megan E. H. Still 9, Yu [...]

Objectives. We assessed the effectiveness of the penalty points system (PPS) introduced in Spain in July 2006 in reducing traffic injuries. Methods. We performed an evaluation study with an interrupted time-series design. We stratified dependent variables--numbers of drivers involved in injury collisions and people injured in traffic collisions in Spain from 2000 to 2007 (police data)--by age, injury severity, type of road user, road type, and time of collision, and analyzed variables separately by gender. The explanatory variable (the PPS) compared the postintervention period (July 2006 to December 2007) with the preintervention period (January 2000 to June 2006). We used quasi-Poisson regression, controlling for time trend and seasonality. Results. Among men, we observed a significant risk reduction in the post-intervention period for seriously injured drivers (relative risk [RR]=0.89) and seriously injured people (RR=0.89). The RRs among women were 0.91 (P=.095) and 0.88 (P Conclusions. The PPS was associated with reduced numbers of drivers involved in injury collisions and people injured by traffic collisions in Spain. (Am J Public Health. 2010;100:2220-2227. doi: 10.2105/AJPH.2010.192104)

Background: Stroke impacts the domains known to be important for driving and is a primary condition for driving evaluation referrals. Given the high prevalence of stroke, the objective was to [...]

A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed. Keywords: posttraumatic stress disorder, children, memory, cognitive processes, appraisals Journal of Abnormal Psychology 2009, Vol. No. 4, 778-787 [c] 2009 American Psychological Association 0021-843X/09/$12.00 DOI: 10.1037/a0016945

Endovascular stent grafts for the treatment of thoracic aortic aneurysms have become increasingly utilized and yet their locational stability in moderate chest trauma is unknown. A high speed impact system was developed to study the stability of aortic endovascular stent grafts in vitro. A straight segment of porcine descending aorta with stent graft was constrained in a custom-made transparent urethane casing. The specimen was tested in a novel impact system at an anterior inclination of 45 deg and an average deceleration of 55 G, which represented a frontal automobile crash. Due to the shock of the impact, which was shown to be below the threshold of aortic injury, the stent graft moved 0.6 mm longitudinally. This result was repeatable. The presented experimental model may be helpful in developing future grafts to withstand moderate shocks experienced in motor vehicle accidents or other dynamic loadings of the chest. [DOI: 10.1115/1.2948398] Keywords: thoracic aorta, stents, endograft, motor vehicle accidents, trauma, model

The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD. and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed. Keywords: trauma, comorbidity, posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder

Byline: Rudrarpan. Chatterjee, Vidya. Nagar, Basavaraj. Sajjan, Kruti. Patel Sir, A 22-year old male patient presented to the Orthopedic emergency facility after a road traffic accident with pain and swelling [...]

A study analyzing the prevalence of and factors associated with reduced or painful jaw movement after motor vehicle accidents, which resulted in whiplash-associated disorders, is presented.

Background: The purpose of this study was to determine how a driver's foot and ankle forces during a frontal vehicle collision depend on initial lower extremity posture and brake pedal force. Method of Approach: A 2D musculoskeletal model with seven segments and six right-side muscle groups was used. A simulation of a three-second braking task found 3647 sets of muscle activation levels that resulted in stable braking postures with realistic pedal force. These activation patterns were then used in impact simulations where vehicle deceleration was applied and driver movements and foot and ankle forces were simulated. Peak rearfoot ground reaction force ([F.sub.RF]), peak Achilles tendon force (FAT), peak calcaneal force ([F.sub.CF]) and peak ankle joint force ([F.sub.AJ]) were calculated. Results: Peak forces during the impact simulation were 476 [+ or -] 687N ([F.sub.RF]), 2934 [+ or -] 944 N ([F.sub.CF]) and 2449 [+ or -] 918 N ([F.sub.AJ]), Many simulations resulted in force levels that could cause fractures. Multivariate quadratic regression determined that the pre-impact brake pedal force (PF), knee angle (KA) and heel distance (HD) explained 72% of the variance in peak [F.sub.RF], 62% in peak [F.sub.CF] and 73% in peak [F.sub.AG]. Conclusions: Foot and ankle forces during a collision depend on initial posture and pedal force. Braking postures with increased knee flexion, while keeping the seat position fixed, are associated with higher foot and ankle forces during a collision. Keywords: Musculoskeletal Model, Simulation, Vehicle Safety, Injury, Lower Extremity

Parents can reduce the risk of injury to their young children by 59% by using belt-positioning booster seat for all children between four and seven years of age. This was the conclusion of a study of 4,243 children in this age group who were involved in a car crash. The booster seat also completely prevented injuries to the abdomen, neck, spine, and lower extremities.

Author(s): Gary Duclos [sup.1] , Laurent Muller [sup.2] , Marc Leone [sup.1] , Laurent Zieleskiewicz [sup.3] Author Affiliations: (1) 0000 0001 2176 4817, grid.5399.6, Assistance Publique Hôpitaux de Marseille, Hôpital [...]