Risk Of Head Injury Research Articles

Head injuries related to bicycle collisions and helmet use – an observational study

Objectives In Denmark, the use of bicycles is widespread, and head injuries are often seen in cyclists involved in collisions. Despite the well-known effects of using a helmet to reduce head injuries, using helmets is not mandatory in Denmark. The primary objective of this study was to provide data regarding injury outcomes and helmet usage. Methods Participants were bicyclists who sustained head injuries in bicycle collisions and were assessed by the Copenhagen Emergency Medical Services between 1 January 2016; and 15 June 2019. Patients with suspected head injury were identified in an electronic prehospital patient record. Data were linked to the Danish National Patient Registry to retrieve the diagnosis and were categorized into head injury or no head injury based on the diagnosis. Adjusted logistic regression analyses were reported with odds ratios and corresponding confidence intervals to assess the risk of head injury while adjusting for risk factors like age, sex, alcohol consumption, occurrence during weekends and traumatic brain injury. Results A total of 407 patients were included in this study. Within this entity, 247 (61%) had sustained a head injury. The use of a helmet was reported in one-third of the included patients. Among the head-injured patients, 13% sustained moderate to severe head injuries. Patients with suspected alcohol involvement were significantly less likely to report the use of a helmet. Helmet use reduced the risk of head injury with an odds ratio of 0.52, (95% CI 0.31 − 0.86). In high-energy trauma, the use of a helmet showed a significant reduction in the risk of sustaining a head injury with an odds ratio of 0.28, (95% CI 0.12 − 0.80). Conclusions In this study, using a helmet was associated with a significantly decreased risk of head injury; this association was even more significant in high-energy trauma.

A Contemporary analysis of tackle height: Implications for head injury risk and tackler technique in Rugby Union

Rugby tackles pose significant head injury risks, raising concerns for players' well-being. Despite advocating for lower tackle heights for safety, limited research exists explaining how tackle height influences head characteristics and tackler technique. This study aimed to investigate the effects of two tackle heights, aligned with recent law changes in the community game, on head and joint kinematics for both tackler and the ball carrier. To strengthen ecological validity, innovative techniques were employed, including markerless motion capture and Inertial Measurement Units (IMUs), for tracking of the tackler's joint kinematics and head accelerations until ground contact, addressing a key limitation in previous research. Ethical approval was granted by Cardiff Metropolitan University. Ten male participants (mean ± SD age: 22 ± 3 years, stature: 184 ± 10 cm, mean mass: 94 ± 15 kg) alternated between tackler and ball carrier roles, executing upper and lower body tackles. Theia3D markerless motion capture software (Theia3Dv2022.1.0.2309, Theia Markerless, Inc., Kingston, ON, Canada) and Vicon IMeasureU Blue Trident dual-G IMUs measured tackle height's impact on head and joint kinematics. Discrete joint angles at key events and continuous joint angles normalised from 0% at Step 1 to 100% at Contact were exported. Peak head accelerations and continuous normalised head acceleration data were exported. Statistical analyses included a paired t-test for discrete joint angle data and the Wilcoxon Rank Sum Test for peak linear and angular accelerations. Cohen’s d and effect sizes were calculated for respective analyses. One-dimensional statistical parametric mapping (SPM) and one-dimensional statistical non-parametric mapping (SnPM) facilitated statistical differences across continuous variables of interest. Significant increases (P < 0.05) were noted in ball carriers' inertial head kinematics in the upper body tackle, while no such distinctions were observed for tacklers. The low tackle condition consistently exhibited substantial reductions in bilateral hip flexion, particularly during contact (Effect size; lead: −1.866; rear: −1.977). Lumbopelvic flexion significantly decreased in each event for the low tackle condition, with the largest effect size during contact (−3.91). These findings underscore the heightened inertial loading with higher tackles, indicating an elevated risk of head injury, despite current tackle height regulations. The adjustments made by the tackler in response to varying tackle heights are not evident in knee flexion. Increased knee flexion during the preparatory phase could alleviate the necessity for such a flexed lumbopelvic angle. This study, utilising innovative techniques, highlights the potential for more ecologically valid approaches to biomechanical research in rugby tackling.

Automating Helmet Usage Detection: A YOLOv8 Based Framework

Abstract: The biggest threat to Powered two-wheeler(PTW) riders is a head injury. With the humongous amount of daily commuters on such PTWs, the risk only increases substantially. In such cases, helmets reduce the risk of head injuries in accidents but not every citizen is keen on their use. In India, where the use of motorcycles is widespread, ensuring helmetuse remains a challenge. This study explores the effectiveness of YOLOv8(You Only Look Once) a state-of-the-art single-stage object detection algorithm for helmet detection on Indian roads [14]. The CNN(Convolutional Neural Networks) based technologyimplements many other efficient, reliable and quick algorithmsto train, validate and predict the object’s detection, segmentationand classification task. We leverage the use of a publicly available Indian helmet dataset from Kaggle, containing 942 images with annotations. This an image dataset of real-life powered two-wheeler riders. The dataset has images and video frames for training on 5 different objects/classes along with annotations that specify thoseobjects. This multi-class approach offers valuable insight intohelmet usage patterns paves shows us the way for real-world applications for automated traffic monitoring. Real-time helmet and number plate detection can become a game changer in trafficmonitoring and can strengthen basic safety laws

Multi-Domain Smart Safety Helmet

Motorcycle accidents and head injuries are critical concerns globally, especially where helmet non-compliance is prevalent. To address this, a multi-domain smart safety helmet is proposed for rider safety and accident prevention through advanced sensor technology. This smart helmet integrates sensors like an MQ-3 alcohol sensor and helmet detection sensors to ensure safety conditions before the motorcycle engine starts. If alcohol levels exceed a threshold, the ignition system disables, preventing intoxicated riding. Helmet detection promotes helmet use, reducing head injury risk. The scalable sensor infrastructure enables multi-domain applications beyond motorcycles. This helmet can integrate into industries like coal mining and firefighting. In coal mining, it monitors environmental conditions and worker vital signs. In firefighting, it detects hazardous gases and monitors firefighter status. During motorcycle operation, the helmet continuously monitors critical parameters—speed, tilt, and environment—providing immediate feedback on unsafe behaviours. In accidents, the helmet's accelerometer detects impacts, activating GPS to pinpoint the location and GSM to alert emergency contacts. This smart helmet aims to enhance motorcycle safety, prevent accidents, and expedite emergency responses. It represents progress towards reducing motorcycle-related injuries and fatalities, with adaptable features for broader safety applications across industries and domains.

Head and neck injury risk resulting from impact with small unmanned aerial vehicles: effect of impact speed, angle, and location

It is necessary to analyse the injury risk caused by UAV to establish management standards. A lightweight quadrotor UAV was used to assess the risk of human head and neck injury, taking the impact speed, UAV position, and impact angle into account. First, the MAVIC2 UAV- Hybrid III dummy impacting FE model was developed and verified against the UAV impact tests. Second, lots of simulations were conducted under different impact scenarios to analyse the head and neck injury. Under vertical impact condition, HIC and Nij grew exponentially as the impact speed increased. While under the horizontal impact condition, HIC increased in the form of the power function and Nij increased exponentially. Under vertical impact condition at 20 m/s (maximum flight speed, corresponding to the impact energy of 181.4 J), the HIC was 54% of the threshold, while the Nij was 88% of the threshold, which illustrated that the injury risk of the neck was high, while that of the head was low. Under horizontal impact condition at 20 m/s (181.4 J), the HIC was 51% of the threshold, and the Nij was 24% of the threshold, which illustrated that the injury risk of both the head and neck was low. HIC declined exponentially as the impact angle increased, whereas Nij increased in the form of the power function. Among all the impact positions, the UAV’s arm caused the least injury risk, while the transverse falling attitude between the two arms and the reverse vertical falling attitude generated higher injury risks.

A study on the application of diffuse axonal multi-axis general evaluation for brain injury assessment in small overlap barrier crash test

PurposeHead injury criterion (HIC) companied by a rotation-based metric was widely believed to be helpful for head injury prediction in road traffic accidents. Recently, the Euro-New Car Assessment Program utilized a newly developed metric called diffuse axonal multi-axis general evaluation (DAMAGE) to explain test device for human occupant restraint (THOR) head injury, which demonstrated excellent ability in capturing concussions and diffuse axonal injuries. However, there is still a lack of comprehensive understanding regarding the effectiveness of using DAMAGE for Hybrid Ⅲ 50th percentile male dummy (H50th) head injury assessment. The objective of this study is to determine whether the DAMAGE could capture the risk of H50th brain injury during small overlap barrier tests. MethodsTo achieve this objective, a total of 24 vehicle crash loading curves were collected as input data for the multi-body simulation. Two commercially available mathematical dynamic models, namely H50th and THOR, were utilized to investigate the differences in head injury response. Subsequently, a decision method known as simple additive weighting was employed to establish a comprehensive brain injury metric by incorporating the weighted HIC and either DAMAGE or brain injury criterion. Furthermore, 35 sets of vehicle crash test data were used to analyze these brain injury metrics. ResultsThe rotational displacement of the THOR head is significantly greater than that of the H50th head. The maximum linear and rotational head accelerations experienced by H50th and THOR models were (544.6 ± 341.7) m/s2, (2468.2 ± 1309.4) rad/s2 and (715.2 ± 332.8) m/s2, (3778.7 ± 1660.6) rad/s2, respectively. Under the same loading condition during small overlap barrier (SOB) tests, THOR exhibits a higher risk of head injury compared to the H50th model. It was observed that the overall head injury response during the small overlap left test condition is greater than that during the small overlap right test. Additionally, an equation was formulated to establish the necessary relationship between the DAMAGE values of THOR and H50th. ConclusionIf H50th rather than THOR is employed as an evaluation tool in SOB crash tests, newly designed vehicles are more likely to achieve superior performance scores. According to the current injury curve for DAMAGE and brain injury criterion, it is highly recommended that HIC along with DAMAGE was prioritized for brain injury assessment in SOB tests.

Tackle Risk Factors for Head Injury Assessments (HIAs) in Sub-Elite Rugby League and Recommendations for Prevention: Head Contacts from Upright Tackles Increase the HIA Risk to Both Ball Carrier and Tackler

BackgroundThe rugby league tackle has been identified as the game event with the greatest propensity for a clinically diagnosed concussion. This study aims to replicate the work conducted in professional rugby league and rugby union by examining Head Injury Assessment (HIA) events to determine the associated tackle characteristics that increase concussion risk in sub-elite rugby league players. This comparison between competition levels is important due to the less developed physiological and tackle proficiency characteristics of sub-elite rugby league players and the fewer resources available for an on-field diagnosis, compared to the elite level of the sport.ResultsTackles resulting in Head Injury Assessments (HIAs, n = 131) and 2,088 tackles that did not result in a head injury were identified and coded from one season of the 2019 Queensland Cup. The body position of both ball carrier and tackler, tackle height, and body contact areas were evaluated. The propensity for tacklers to undergo a head injury assessment was 1.49 HIAs per 1,000 tackles, equating to a 2.5-fold higher risk than that of the ball carrier (0.59 HIAs per 1,000 tackles). The risk for an HIA was 2.75-fold greater when the tackler was upright (2.89 HIAs per 1,000 tackles) compared to a bent-at-the-waist tackler (1.05 HIAs per 1,000 tackles). The greatest risk for the tackler and ball carrier sustaining an HIA occurred when the tackle height was high, with head-to-head contact having the greatest propensity for an HIA (44.37 HIAs per 1,000 tackles). HIA risk was also greater for both players when the ball carrier did not employ an evasion strategy (3.73 HIAs per 1,000 tackles).ConclusionsThe study replicates results from research in elite rugby league and rugby union. A combination of higher head contact/proximity and upright body position significantly increase an HIA risk. Tackler head position and ball carrier evasion behaviours also affect risk, suggesting that injury prevention strategies designed to reduce tackle height and improve tackle technique by focusing on head position, body position, and in a novel finding, ball carrier evasion, may reduce head injury risk in sub-elite rugby league players.

Characterizing Natural Frequencies of the Hybrid III and NOCSAE Headforms

The vibrational characteristics of the Hybrid III and NOCSAE headforms are not well understood. It is hypothesized that they may perform differently in certain loading environments due to their structural differences; their frequency responses may differ depending on the impact characteristics. Short-duration impacts excite a wider range of headform frequencies than longer-duration (padded) impacts. While headforms generally perform similarly during padded head impacts where resonant frequencies are avoided, excitation of resonant frequencies during short-duration impacts can result in differences in kinematic measurements between headforms for the matched impacts. This study aimed to identify the natural frequencies of each headform through experimental modal analysis techniques. An impulse hammer was used to excite various locations on both the Hybrid III and NOCSAE headforms. The resulting frequency response functions were analyzed to determine the first natural frequencies. The average first natural frequency of the NOCSAE headform was 812 Hz. The Hybrid III headform did not exhibit any natural frequencies below 1000 Hz. Comparisons of our results with previous studies of the human head suggest that the NOCSAE headform’s vibrational response aligns more closely with that of the human head, as it exhibits lower natural frequencies. This insight is particularly relevant for assessing head injury risk in short-duration impact scenarios, where resonant frequencies can influence the injury outcome.

Comparison of Kinematics for Head Impacts Initiated by Helmets and Shoulder Pads Among High School American Football Athletes.

Helmets and shoulder pads are required equipment intended to protect American football athletes by attenuating collision forces during participation. Surprisingly, research differentiating kinematics from head impactsinitiated by helmets from those initiated by shoulder pads among adolescent athletes has not been completed. The current study's purpose was to determine the effects of equipment on head impact kinematics. Sixty-nine male American football athletes from three high schools worehelmets equipped with Head Impact Telemetry (HIT) System instrumentation to quantify peak linear (g) and rotational (rad/s2) accelerations. Data were extracted for video-confirmed impacts during two competitions. Separate multivariable linear regressions using ordinary least squares were conducted to determine if equipment type (helmet vs. shoulder pad) was associated with log-transformed linear and rotational accelerations. In total, 1150 video-confirmed impacts involved helmet (N = 960) or shoulder pad (N = 190) initiated contact. Linear (p = 0.809) and rotational (p = 0.351) acceleration were not associated with equipment type. Head impact kinematics were similar between impacts initiated by either helmets or shoulder pads and suggests an opponent's shoulder pads and helmet can deliver comparable forces to the struck player. Equipment manufacturers may need to consider the unintended role shoulder pads maycontribute to head injury risk.

Head Protection Device for Individuals at Risk for Head Injury due to Ground-Level Falls: Single Trauma Center User Experience Investigation.

Falls represent a large percentage of hospitalized patients with trauma as they may result in head injuries. Brain injury from ground-level falls (GLFs) in patients is common and has substantial mortality. As fall prevention initiatives have been inconclusive, we changed our strategy to injury prevention. We identified a head protection device (HPD) with impact-resistant technology, which meets head impact criteria sustained in a GLF. HPDs such as helmets are ubiquitous in preventing head injuries in sports and industrial activities; yet, they have not been studied for daily activities. We investigated the usability of a novel HPD on patients with head injury in acute care and home contexts to predict future compliance. A total of 26 individuals who sustained head injuries, wore an HPD in the hospital, while ambulatory and were evaluated at baseline and 2 months post discharge. Clinical and demographic data were collected; a usability survey captured HPD domains. This user experience design revealed patient perceptions, satisfaction, and compliance. Nonparametric tests were used for intragroup comparisons (Wilcoxon signed rank test). Differences between categorical variables including sex, race, and age (age group 1: 55-77 years; age group 2: 78+ years) and compliance were tested using the chi-square test. Of the 26 patients enrolled, 12 (46%) were female, 18 (69%) were on anticoagulants, and 25 (96%) were admitted with a head injury due to a GLF. The median age was 77 (IQR 55-92) years. After 2 months, 22 (85%) wore the device with 0 falls and no GLF hospital readmissions. Usability assessment with 26 patients revealed positive scores for the HPD post discharge regarding satisfaction (mean 4.8, SD 0.89), usability (mean 4.23, SD 0.86), effectiveness (mean 4.69, SD 0.54), and relevance (mean 4.12, SD 1.10). Nonparametric tests showed positive results with no significant differences between 2 observations. One issue emerged in the domain of aesthetics; post discharge, 8 (30%) patients had a concern about device weight. Analysis showed differences in patient compliance regarding age (χ12=4.27; P=.04) but not sex (χ12=1.58; P=.23) or race (χ12=0.75; P=.60). Age group 1 was more likely to wear the device for normal daily activities. Patients most often wore the device ambulating, and protection was identified as the primary benefit. The HPD intervention is likely to have reasonably high compliance in a population at risk for GLFs as it was considered usable, protective, and relevant. The feasibility and wearability of the device in patients who are at risk for GLFs will inform future directions, which includes a multicenter study to evaluate device compliance and effectiveness. Our work will guide other institutions in pursuing technologies and interventions that are effective in mitigating injury in the event of a fall in this high-risk population.

Assessment of Pedestrians' Head and Lower Limb Injuries in Tram-Pedestrian Collisions.

Analysis of pedestrians' head and lower limb injuries at the tissue level is lacking in studies of tram-pedestrian collisions. The purpose of this paper therefore to investigate the impact response process and severity of pedestrians' injuries in tram-pedestrian collisions, using the Total Human Model for Safety (THUMS) pedestrian human body model together with the tram FE model. Two full-scale tram-pedestrian dummy crash tests were performed to validate the FE model, and the total correlation and analysis (CORA) score of head acceleration yielded values of 0.840 and 0.734, confirming a strong agreement between the FE-simulated head responses and the experimental head kinematics. The effects of different tram speeds and impact angles on pedestrians' impact response injuries and the differences were further analyzed. The results indicate that direct impact of the lower limb with the tram's obstacle deflector leads to lower limb bone shaft fractures and knee tissue damage. Neck fling contributed to worsened head injury. Coup contusions were the predominant type of brain contusion, surpassing contrecoup contusions, while diffuse axonal injury was mainly concentrated in the collision-side region of the brain. Pedestrians' injuries are influenced by tram velocity and impact angle: higher tram velocities increase the risk of lower limb and head injuries. The risk of head injury for pedestrians is higher when the impact angle is negative, while lower limb injuries are more significant when the impact angle is 0°. This study provides practical guidance for enhancing tram safety and protecting pedestrians.

Effectiveness of FIFA 11+ Injury Prevention Programs in Reducing Head and Neck Injuries, Including Concussion, Among Soccer Players: A Systematic Review and Meta-Analysis.

To evaluate the effectiveness of FIFA 11+ and 11+ Kids injury prevention programs in reducing the incidence of head and neck injuries among soccer players. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 2 investigators independently conducted searches in databases (Cochrane Library, PubMed, Web of Science, and PEDro) using keywords like "FIFA 11+," "football," "soccer," and "injury prevention." Only randomized controlled trials assessing FIFA 11+ programs in soccer players were included. Data analysis used the random effects model with RevMan Meta-Analysis software (version 5). Among 397 studies, 4 met inclusion criteria. Pooled results from 7109 players and 532,341 exposure hours indicated a significant 40% reduction in head and neck injuries per 1000hours of exposure in the intervention group compared to the control group (injury risk ratio 0.60, 95% CI, 0.41-0.88). Implementing FIFA 11+ injury prevention programs significantly reduces the risk of head and neck injuries in soccer players, offering a compelling alternative to traditional warm-ups. This study contributes valuable evidence for optimizing injury prevention strategies in soccer training regimens.

Did court dismiss football player's negligence claim?

A first‐year football player at Ithaca College signed an “acknowledgment of risk form,” acknowledging the risk of head injury and concussion during football activities. Shortly thereafter, the football player participated in preseason football practices with other first‐year players. He was identified as a “top prospect” and asked to participate in practice sessions with the returning players.

МЕТОДИКА ФОРМИРОВАНИЯ ГРАНИЦ УРОВНЕЙ ПАССИВНОЙ БЕЗОПАСНОСТИ В ЗАДАЧАХ ЭКСПЕРТНОЙ ПРОФИЛАКТИКИ ДТП

The existing methodological apparatus of expert prevention of accidents related to collision with poles and supports of road signs is considered, the problems are revealed. The methodology of forming the boundaries of passive safety levels is proposed on the example of expert prevention of accidents associated with collision with obstacles with a small area of the contact zone. The data on on-board event registration devices are analyzed, a series of numerical experi-ments, a series of experimental numerical simulations (collisions) are performed. The use of ranking into groups of protection against the risk of head injury of the HIC index is proposed.

The role and importance of helmet use in the prevention of traumatic brain injury – a literature review

Protective helmets are used in a wide range of professional, sport and recreational activities. They undoubtedly play a very important role in the prevention of head injuries, including traumatic brain injury. There is no doubt that they improve user safety. The main aim of the following paper is to analyse recent publications and studies describing to what extent a helmet can protect against traumatic brain injury and its consequences. Traumatic brain injury is the disruption of brain function or the presence of any other pathology in the brain caused by physical force. There are many head injuries worldwide that result in traumatic brain injury. The effects of these accidents can be reduced by using safety helmets. Statistics quite clearly show that helmets realistically reduce the number of traumatic brain injuries, as well as their consequences. Injuries sustained by people who wore a helmet on their head at the time of the accident were less severe, gave less serious complications and were also less likely to be fatal compared to injuries acquired when a helmet was not worn on the head. The wearing of helmets has been made compulsory in many places and this has had a significant impact on the decrease in the incidence of severe brain injuries. The use of protective helmets is correlated with milder and less frequent head injuries and fewer complications of these injuries. Public awareness of traumatic brain injury is still low. Although the benefits of wearing helmets are widely known, there are still many people who do not use this method of head injury prevention. Awareness campaigns, notification systems or other innovative methods are just a few of the many ways in which attempts are made to draw the public’s attention to the need to wear a helmet during activities with a higher risk of head injury.

Finite Element Analysis of Energy-Absorbing Floors for Reducing Head Injury Risk during Fall Accidents

Energy-absorbing floor (EAF) has been proposed as one of several biomechanically effective strategies to mitigate the risk of fall-related injuries by decreasing peak loads and enhancing system energy absorption. This study aims to compare the protective capacity of four commercially available EAF products (Igelkott Floor, Kradal, SmartCells, and OmniSports) in terms of head impacts using the finite element (FE) method. The stress–strain curves acquired from mechanical tests were applied to material models in LS-Dyna. The established FE models were then validated using Hybrid III or hemispheric drop tests to compare the acceleration–time curves between experiments and simulations. Finally, the validated FE models were utilized to simulate a typical pedestrian fall accident scenario. It was demonstrated that EAFs can substantially reduce the peak forces, acceleration, and velocity changes during fall-related head impacts. Specifically, in the accident reconstruction scenario, SmartCells provided the largest reduction in peak linear acceleration and skull fracture risk, while Igelkott Floor provided the largest reduction in peak angular velocity and concussion risk. This performance was caused by different energy absorption mechanisms. Consequently, the results can contribute to supporting the implementation of EAFs and determine the effectiveness of various protective strategies for fall-related head injury prevention.

Development of a Restraint System for Rear-Facing Car Seats

In self-driving vehicles, passengers can set their seats in an unconventional seating position, such as rear-facing. Sitting in such an orientation can increase the risk of whiplash in the head-and-neck system in a frontal impact, as frontal crashes usually have higher severities compared with rear-end crashes. This paper shows that a forward-facing front seat optimised for rear-impact protection needs to be redesigned to be used as a rear-facing seat. In the second and main part of this paper, a restraint system for rear-facing car seats is developed, and frontal impact simulations with 64 km/h of delta-V are used to evaluate its performance. The designed seating system comprises two rigid torso plates, a fixed recliner and an energy absorber under the seat pan. Without using the developed restraint system, the 50th percentile male human model is exposed to neck shear forces exceeding 600 N. With the developed restraint system, neck shear forces are less than 350 N in frontal impacts with 64 km/h of delta-V. Apart from whiplash, the risk of head, chest, lower extremity and lower back injuries are also evaluated. The results confirm that the developed restraint system successfully protects the occupant since all assessment criteria values are lower than the injury assessment reference values.

Head Injuries Induced by Tennis Ball Impacts: A Computational Study

Abstract Head injuries induced by tennis ball impacts are computationally studied. The impact of a two-piece tennis ball on a human head is simulated by using an established full body model and a newly constructed tennis ball model. The new tennis ball model is validated against existing experimental data. The frontal impact of a tennis ball on a human head at a velocity of 25 m/s is first studied as the baseline case. The effects of the impact location, velocity, and angle as well as the ball spinning are then examined. It is revealed that the lateral impact results in a higher risk of head injury than the frontal and crown impacts. In addition, it is found that the impact force and von Mises stress in the skull, the intracranial pressure and first principal strain in the brain, and the translational and rotational accelerations at the center of gravity of the head all increase with the increase of the impact velocity. Moreover, the normal (90-deg) impact has the highest risk of head injury, which is followed by the 60-deg, 45-deg and 30-deg impacts. Further, it is observed that the spinning of the tennis ball has insignificant effects on the head response. The simulation results show that there will be no skull fracture or mild brain injury in the baseline case. However, traumatic brain injuries may occur after the impact velocity exceeds 40 m/s. The findings of the current study provide new insights into the risks of head injuries induced by tennis ball impacts.

The burden of head trauma in rural and remote North Queensland, Australia

BackgroundHead trauma is a leading cause of death and disability worldwide. Young males, Indigenous people, and rural/remote residents have been identified as high-risk populations for head trauma, however, Australian research is limited. Our aim was to define and describe the incidence, demographics, causes, prehospital interventions, and outcomes of head trauma patients transported by aeromedical services within North Queensland, Australia. We hypothesized that young, Indigenous males living remotely would be disproportionately affected by head trauma. MethodsWe conducted a retrospective study of all head trauma patients transferred by air to or between Townsville, Cairns, Mount Isa and Mackay Hospitals between January 1, 2016 and December 31, 2018. Patients were identified from the Trauma Care in the Tropics data registry and followed for a median 30-months post-injury. Primary endpoints were patient and injury characteristics. Secondary outcome measures were hospital stay and mortality. ResultsA total of 981 patients were included and 31.1 % were Indigenous. Sixty-seven percent of injuries occurred remotely and the median time from injury to hospital was 5.8-hours (range 67–3780 min). Eighty percent of severe head injuries occurred in males (p = 0.007). Indigenous and remote patients were more likely to sustain mild injuries. The most common mechanism of injury overall was vehicle accident (37.5 %), compared to assault in the Indigenous subgroup (46.6 %, p<0.001). The overall mortality rate was 4.9 %, with older age and lower initial Glasgow Coma Score significant predictors of in-hospital mortality. Prehospital intubation was associated with a 7-fold increased risk of mortality (p = 0.056), while patients that received tranexamic acid (TXA) were almost 5-times more likely to die. ConclusionsIn North Queensland, young Indigenous males are at highest risk of traumatic head injuries. Vehicle accidents are an important preventable cause of head injury in the region. TXA administration is an important consideration for remote head trauma retrievals, in which time to emergency care is prolonged. Appropriate treatment and risk stratification strategies considering time to definitive care, severity of injury, and other prehospital patient factors require further investigation.

Pedestrian Safety in Frontal Tram Collision, Part 1: Historical Overview and Experimental-Data-Based Biomechanical Study of Head Clashing in Frontal and Side Impacts.

This article represents the first paper in a two-part series dealing with safety during tram-pedestrian collisions. This research is dedicated to the safety of trams for pedestrians during collisions and is motivated by the increased number of lethal cases. The first part of this paper includes an overview of tram face development from the earliest designs to the current ones in use and, at the same time, provides a synopsis and explanation of the technical context, including a link to current and forthcoming legislation. The historical design development can be characterised by three steps, from an almost vertical front face, to leaned and pointed shapes, to the current inclined low-edged windshield without a protruding coupler. However, since most major manufacturers now export their products worldwide and customisation is only of a technically insignificant nature, our conclusions are generalisable (supported by the example of Berlin). The most advantageous shape of the tram's front, minimising the effects on pedestrians in all collision phases, has evolved rather spontaneously and was unprompted, and it is now being built into the European Commission regulations. The goal of the second part of this paper is to conduct a series of tram-pedestrian collisions with a focus on the frontal and side impacts using a crash test dummy (anthropomorphic test device-ATD). Four tram types approaching the collision at four different impact speeds (5 km/h, 10 km/h, 15 km/h, and 20 km/h) were used. The primary outcome variable was the resultant head acceleration. The risk and severity of possible head injuries were assessed using the head injury criterion (HIC15) and its linkage to the injury level on the Abbreviated Injury Scale (AIS). The results showed increasing head impacts with an increasing speed for all tram types and collision scenarios. Higher values of head acceleration were reached during the frontal impact (17-124 g) compared to the side one (2-84 g). The HIC15 values did not exceed the value of 300 for any experimental setting, and the probability of AIS4+ injuries did not exceed 10%. The outcomes of tram-pedestrian collisions can be influenced by the ATD's position and orientation, the impact speed and front-end design of trams, and the site of initial contact.