Likelihood Of Injury Research Articles

Assessing motorcyclist injury severity on curved road segments with temporal dynamics and unobserved heterogeneity

Motorcyclists face an increased risk of injury severity at curved roadway segments due to a wide range of factors. Given the complex and evolving nature of factors influencing motorcyclist injury severity on curved roadway segments, there is a need for research that not only captures these contributing factors dynamics but also considers temporal variations and unobserved heterogeneity. The study used mixed logit models to analyze 8815 motorcycle crashes that occurred on curved segments in Texas between 2017 and 2022. Several normally distributed random parameters were identified, including clear weather, fixed objects, a 40–60 mph speed limit, White ethnicity, and riders aged 25–54 years old. Average marginal effects indicated increased fatal injury likelihood during cloudy weather, on marked lanes, roads without median, and collisions with fixed objects. Consistent factors affecting fatal injury severity across yearly models included cloudy weather and fixed-object collisions (increasing), daylight (decreasing), and riders aged 15–24 (decreasing). Interestingly, darkness in 2020 showed reduced fatal injury likelihood, likely due to lower traffic volumes and increased rider caution during the COVID-19 pandemic, contributing to less severe crash outcomes. These findings emphasize the need to consider temporal variations to understand changing risk factors and dynamics in motorcycle injury severity on curved road segments.

Influence of running speed, inclination, and fatigue on calcaneus angle in female runners

Running is a popular form of physical activity with significant health benefits, but improper technique can lead to running-related injuries. This study investigates the influence of running speed, incline, and fatigue on calcaneus eversion/inversion angle at heel strike, maximum eversion angle, and range of motion, factors associated with lower limb injuries. Fifteen injury-free female runners participated in this study. Kinematic data were collected using a 3D motion capture system with reflective markers placed directly on the skin through specially modified running shoes. The runners performed treadmill trials at varying speeds (10, 12, and 14 km/h) and inclines (0°, 5°, and 10°), both before and after a fatigue-inducing 30-min run. The results indicate that higher speeds were associated with an increase in inversion angle at heel strike (p = 0.05) and range of motion (p = 0.02 before fatigue), both of which are linked to chronic ankle instability and Achilles tendinopathy. Running at an incline reduced both maximum eversion angle (p = 0.002 after fatigue) and range of motion (p = 0.003 after fatigue), suggesting a protective effect against excessive eversion. Fatigue increased range of motion (p = 0.05), which is a risk factor for instability and overuse injuries. These findings suggest that running at higher speeds and in a fatigued state may increase the likelihood of injuries due to increased range of motion, whereas incline running may mitigate this risk by reducing excessive eversion and range of motion. Understanding these biomechanical changes can inform injury prevention strategies for runners.

Examining fatal and non-fatal injuries of drivers in single-vehicle-involved crashes on urban roadways using random parameter logit model

Urban areas significantly impact crash injury severity due to high traffic density and complex road patterns. This study analysed factors influencing fatal and non-fatal injuries in single-vehicle crashes on urban roads in Ghana from 2017 to 2020, using data from the Driver and Vehicle Licensing Authority (DVLA). The Random Parameter Logit Model revealed that younger drivers (under 20) are at higher risk for both fatal and non-fatal injuries. Crashes involving saloon cars, pickups, and minibuses had higher injury risks. Severe frontal damage increases the likelihood of both non-fatal and fatal injuries. Newer vehicles (under 5 years) showed lower injury risks. Crashes at controlled intersections and daytime crashes were less likely to result in fatal injuries. Failure to yield the right of way and mechanical failures were significant contributors to injury severity. The study highlights the need for targeted road safety interventions.

Functional Outcomes of Proximal Hamstring Tendon Repair in Patients Over 40 Treated Without Postoperative Bracing

Background: Degenerative tendon changes are common as people age, which can increase the likelihood of tendinous injuries. The outcomes of repairing hamstring tendon avulsions in patients >40 years after a rehabilitation protocol without postoperative bracing are relatively unknown. Purpose: To assess the functional outcomes of patients >40 years and determine the rerupture rate after surgical repair of complete proximal hamstring tendon avulsions while following a nonbracing rehabilitation protocol. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients >40 years with acute, complete proximal hamstring avulsions underwent surgical repair between 2012 and 2022 and completed follow-up assessments. Postoperative patient-reported outcome measures (PROMs) included the Single Assessment Numeric Evaluation (SANE), Physical (PCS) and Mental (MCS) Short Form 12 (SF-12), Marx Activity Rating Scale (Marx), Lower Extremity Functional Score (LEFS), Perth Hamstring Assessment Tool (PHAT), patient satisfaction (0-10 scale), and return to sports (RTS). Surgical repair integrity was assessed with physical and ultrasound examinations. Results: A total of 27 patients—including 10 men and 17 women—and 28 hips—including 10 right-leg and 18 left-leg hamstring avulsions—were included in this study. The mean age was 55.9 ± 8.3 years, and the mean body mass index was 27.1 ± 6.5 kg/m 2 at the time of surgery. All 28 injuries were complete avulsions involving 3 hamstring tendons. The mean time from injury to surgery was 17.9 ± 12.4 days; 25 avulsions were repaired early (time to surgery <6 weeks), and 3 hamstrings were repaired delayed (6 to 8 weeks). All 28 avulsions were retracted at a mean distance of 4.9 ± 2.9 cm from the ischial tuberosity. The mean follow-up time was 67 ± 28.5 months. The mean follow-up PROMs included a SANE of 85.9 ± 18.1, SF-12 PCS of 49 ± 8.3, and SF-12 MCS of 54.7 ± 7.1, Marx of 6.3 ± 5.6, LEFS of 69.9 ± 12.7 (completed for 27 hips), PHAT of 82.1 ± 16.3 (completed for 26 hips), patient satisfaction of 9.1 ± 2, and 22 patients returned to sports (78.6%). At the last follow-up, all tendon repairs appeared intact and reinserted at the ischial tuberosity after ultrasound and physical examinations, and there were no signs of rerupture. Conclusion: Surgical repair of complete proximal hamstring tendon avulsions with a nonbracing rehabilitation protocol for patients >40 years demonstrated intact repairs with no reruptures. Some patients reported pain during follow-up functional testing, but the overall results highlighted positive functional and patient-reported outcomes, high levels of satisfaction, and a high RTS rate.

Joint analysis of crash injury severities for autonomous and conventional vehicles in mixed traffic environments: Application of random parameter bivariate probit model.

Joint analysis of crash injury severities for autonomous and conventional vehicles in mixed traffic environments: Application of random parameter bivariate probit model.

Assessing the interdependence of rider fault-status and injury severity in motorcycle rear-end crashes: insights from bivariate probit and XGBoost-SHAP models

This study examines the interdependent relationship between fault status and injury severity in motorcycle rear-end crashes in Thailand using data from 1,549 crashes (2011–2015) integrated from the Department of Highway’s Accident Information Management System and Traffic Information Movement System. This article employs a bivariate probit model alongside various boosting techniques for simultaneous estimation of injury severity and at-fault status. Among the tested models (AdaBoost, CatBoost and LightGBM), both the bivariate probit and XGBoost-Endogenous models demonstrate superior performance in accuracy and F1-score. The bivariate probit model reveals that injury severity is significantly influenced by rider characteristics (age, gender), road features, and traffic conditions. Riders under 55 years old, female riders and those on roads with depressed medians or higher traffic volume show lower injury severity risk. Conversely, drunk riding, nighttime crashes on unlit roads, and higher truck traffic percentages increase severe injury likelihood. The XGBoost model corroborates these findings, identifying traffic volume, truck percentage and nighttime conditions on unlit roads as the most crucial predictors of injury severity. Regarding fault status, younger riders and those using safety equipment show a higher probability of being at-fault. This novel analytical approach provides valuable insights for motorcycle safety policy development and future research directions.

Ambulance crash risk dynamics: a baseline (2017–2019) vs. pandemic-era (2020–2022) comparative study using a random parameter logit model

This research addresses the critical need to investigate ambulance-involved person injuries by comparing the baseline (2017–2019) and pandemic era (2020–2022) periods. By using crash data from Texas State (8,859 crashes) and employing the Random Parameter Logit model with the Heterogeneity in Means (RPLHM) model, this study captures unobserved heterogeneity within the crash data. Several variables showed heterogeneous impact on person injury severity during the baseline period (wet surface conditions, 1 pm – 6 pm), and pandemic era (male, dark-with-streetlight, segment). Few variables showed fixed impact on the likelihood of fatal person injury including the first harmful event as ’both vehicles going straight, and involved in a sideswipe collision’, ’collision with parked car’, and ’rural settings.’ Clear weather conditions were found to consistently reduce the likelihood of severe injuries. This study provides insights into how the pandemic influenced ambulance operations, offering a foundation for targeted safety measures and policy interventions.

Biomarkers in Contrast-Induced Nephropathy: Advances in Early Detection, Risk Assessment, and Prevention Strategies.

Contrast-induced nephropathy (CIN) represents a significant complication associated with the use of iodinated contrast media (ICM), especially in individuals with preexisting renal impairment. The pathophysiology of CIN encompasses oxidative stress, inflammation, endothelial dysfunction, and hemodynamic disturbances, resulting in acute kidney injury (AKI). Early detection is essential for effective management; however, conventional markers like serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) exhibit limitations in sensitivity and timeliness. This review emphasizes the increasing significance of novel biomarkers in enhancing early detection and risk stratification of contrast-induced nephropathy (CIN). Recent advancements in artificial intelligence and computational analytics have improved the predictive capabilities of these biomarkers, enabling personalized risk assessment and precision medicine strategies. Additionally, we discuss mitigation strategies, including hydration protocols, pharmacological interventions, and procedural modifications, aimed at reducing CIN incidence. Incorporating biomarker-driven assessments into clinical decision-making can enhance patient management and outcomes. Future research must prioritize the standardization of biomarker assays, the validation of predictive models across diverse patient populations, and the exploration of novel therapeutic targets. Utilizing advancements in biomarkers and risk mitigation strategies allows clinicians to improve the safety of contrast-enhanced imaging and reduce the likelihood of renal injury.

The role of proteinuria on a simple urinalysis in neonatal hypoxic-ischemic encephalopathy: association with clinical and neurodevelopmental outcomes.

Early diagnosis and initiation of hypothermia therapy for neonatal hypoxic-ischemic encephalopathy (HIE) are critical within the first 6 h after birth. Collecting urine, especially from neonates with HIE, can be challenging and time-consuming post-birth due to the likelihood of renal injury. We assessed whether urine protein levels, measured via a simple urinalysis on the first day, could correlate with the outcomes of neonatal HIE. We conducted urine analyses of patients with neonatal HIE on the first day to establish a correlation between the severity of HIE and neurodevelopmental outcomes at ≥1 year of age. Eighty-three patients were enrolled, encompassing cases of mild (n = 37), moderate (n = 30), and severe (n = 16) HIE. Three cases were excluded due to mortality caused by severe HIE with associated auria. Based on urine protein levels, patients were grouped as 0 to 30 mg/dL (group 1), 30 to 100 mg/dL (group 2), 100 to 300 mg/dL (group 3), and ≥ 300 mg (group 4). Urine protein levels were correlated with serum lactic acid levels [p = 0.006; r (81) = 0.304; n = 83], clinical staging [p = 0.001; r (81) = 0.36], and neurodevelopmental outcomes at ≥1 year of age [X 2 (3, n = 83) = 11.35; p = 0.009]. The odds ratio for moderate-to-severe HIE in group 4 patients was 7.66 [p = 0.010; 95% confidence interval (CI), 1.61-36.33] compared with those in groups 1-3. Those in group 4 had a high positive predictive value (87.50%) and high specificity (94.59%). Elevated urine protein levels observed in the first urinalysis conducted on the day after birth were found to be associated with serum lactic acid levels, clinical staging, and neurodevelopmental outcomes at ≥1 year of age.

Increased internal tibiofemoral rotation is associated with anterolateral ligament injury and high-grade pivot-shift in ACL-injured patients.

To evaluate whether tibiofemoral rotation is associated with a concurrent anterolateral ligament (ALL) injury and pivot-shift grading in patients with a primary anterior cruciate ligament (ACL) tear. In this multicenter cross-sectional study constituting a secondary analysis of previous studies, medical records and magnetic resonance imaging (MRI) scans of patients with unilateral primary ACL injury were reviewed. Demographics and pivot-shift grading were collected. ALL was identified on MRI coronal images and categorized as intact or injured. Tibiofemoral rotation angle (TFA) was measured on axial MRI. Optimal TFA cut-off associated with ALL injury was identified by a receiver operating characteristic (ROC) curve. Of 206 included patients, 152 (73.8%) exhibited signs of ALL injury. Pivot-shift tests were predominantly graded as 2 (71.4%), and notably, all Grade 3 pivot-shift assessments were associated with ALL injury. Mean TFA was significantly higher in cases with ALL injury (5.2 ± 3.6°) compared to intact ALL cases (2.7 ± 3.5°; p < 0.001). A positive correlation was observed between pivot-shift grading and TFA (r = 0.204, p = 0.003). Optimal TFA cut-off value, based on the absolute measurement, for predicting ALL injury was 2.5° (sensitivity: 0.77; specificity: 0.55). Patients with TFA ≥ 2.5° had a significantly higher risk of ALL injury (odds ratio: 3.34, 95% confidence interval [CI]: 1.74-6.42, p < 0.001); when combined with pivot-shift Grade 2 or 3, this risk substantially increased to 13.68 (95% CI: 6.29-29.84, p < 0.001). Higher TFA was associated with an increased prevalence of ALL injuries and a high-grade pivot-shift in ACL-deficient patients. Patients with a TFA ≥ 2.5° showed a threefold higher likelihood of ALL injuries, and this risk further escalated with a higher-grade pivot-shift. Level 3 cross-sectional study.

Exploring determinants of motorcyclist non-violation crash injury severities on suburban roads of China: a random parameter logit model with heterogeneity in means and variances

ABSTRACT Motorcyclist non-violation (MN-V) crashes were confirmed to be more closely associated with roadway and environmental factors. However, limited studies have explored how these determinants affect injury severity in MN-V crashes. Using motorcycle crash data from Xi’an, China, this study developed multiple random parameters logit models, incorporating heterogeneity in means and variances for investigating the impact of risk determinants on the injury severities sustained by motorcyclists involved in MN-V crashes. An overall temporal instability in the injury severity determinants was revealed via likelihood ratio tests. Several factors were observed to increase the likelihood of severe injuries, including old (age >55), collision with heavy vehicles, head-on collision, curves, dry road surfaces, and holidays. Additionally, unfavorable riding conditions were demonstrated to decrease the probability of severe injuries, which was attributed to the riders’ risk compensation mechanism in adverse conditions. This study provides new insights into the mechanism of motorcyclist injury severity in MN-V crashes.

Novel adaptive machine-learning-based smart wearable biosensors: Revolutionizing athlete health monitoring in biomedical perspective

This study introduces novel Adaptive Machine-Learning-Based Smart Wearable Biosensors (AML-SWB) for real-time monitoring of athletes’ health. By integrating accelerometers, gyroscopes, and biometric sensors, AML-SWB can collect comprehensive physiological data. Machine learning algorithms, especially Recurrent Neural Networks (RNNs) and Long Short-Term Memory (LSTM) units, are incorporated to analyze the data, enabling accurate assessment of athletes’ health status, injury risk prediction, and performance optimization. An evaluation of motion efficiency, identification of gait asymmetry, and measurement of joint stress are all parts of the biomechanical analysis that the proposed AML-SWB incorporates to improve conventional monitoring. These findings pave the way for individualized training modifications and early intervention to reduce the likelihood of injuries. Despite challenges such as data accuracy and user acceptance, continuous technological advancements and algorithm refinement are expected to overcome these obstacles.

How does distraction affect cyclists' severe crashes? A hybrid CatBoost-SHAP and random parameters binary logit approach.

How does distraction affect cyclists' severe crashes? A hybrid CatBoost-SHAP and random parameters binary logit approach.

Rethinking the Schenck Classification for Multiligament Knee Injuries: Evaluating Whether the Schenck KD Grade Is Associated With the Presence of Vascular or Neurological Injuries in a Multicenter Study With 144 Patients.

Posterolateral corner (PLC) lesions and knee dislocations (KDs) have been recognized as risk factors for vascular and neurological injuries in patients with multiligament knee injury (MLKI), but an association between Schenck KD grade and neurovascular lesions has yet to be established. The ligamentous injury pattern in MLKIs with high KD grades will be associated with a higher likelihood of vascular and neurological injuries. Cross-sectional study; Level of evidence, 3. Included were 144 patients from a multicenter database with surgically treated MLKI. All patients were skeletally mature, had MLKI lesion identified on magnetic resonance imaging and confirmed intraoperatively, and did not have any previous knee surgery or previous vascular or neurological lesions. Demographic data (sex, age), injury mechanism (high energy, sports injury, low energy), ligaments injured, and neurological and vascular lesions were recorded. A new classification for MLKI based on ligamentous injury pattern, and intended for all MLKIs (with and without KD) was developed, and all patients were categorized according to this classification. Associations were evaluated between the risk of vascular and neurological lesion and demographic data, injury mechanism, and new classification grade. The mean patient age was 33.9 years (range, 15-64 years), and 72% were male. High-energy trauma was the most common injury mechanism (55.6%). Vascular injury was present in 5 patients (3.5%) and nerve injury in 17 (11.8%), with 1 patient (0.7%) having both. None of the analyzed variables were associated with the presence of vascular lesion. Univariate logistic regression showed that medial collateral ligament (MCL) lesion decreased the probability of neurological injury (odds ratio [OR], 0.29; 95% CI, 0.1-0.87; P = .03) while PLC injury increased that probability (OR, 12.66; 95% CI, 1.63-100; P = .02). Multivariate logistic regression showed that the proposed MLKI grade was significantly associated with the presence of neurological lesions, with a 2.5-fold increase in the odds of having a neurological injury for each increase in grade (OR, 2.47; 95% CI, 1.36-4.50; P = .003). PLC injuries increased the odds of neurological injury in MLKI, while MCL injuries decreased these odds. MLKI grade and presence of PLC injury was associated with the presence of neurological injury. MLKI grade was not associated with the presence of a vascular lesion.

The impact of blood flow restriction training combined with low-load resistance training on the risk of falls in patients with knee osteoarthritis in China: a single-centre, two-arm, single-blind, parallel randomised controlled trial protocol

IntroductionPatients with knee osteoarthritis are at a higher risk of falls compared to healthy individuals, thereby increasing the likelihood of accidental injury. Resistance training is an important strategy for managing...

Validation of Impact Forces Estimated by Wearable Device VERT in Volleyball.

De Bleecker, C, Vermeulen, S, Willems, T, Segers, V, Spanhove, V, Leys, R, Vanrenterghem, J, and De Ridder, R. Validation of impact forces estimated by wearable device VERT in volleyball validation impact forces VERT. J Strength Cond Res 39(3): e458-e462, 2025-As volleyball players are exposed to high volumes of forceful jump-landing actions, the risk of injuries is increased. Wearable technology such as the VERT device offers a promising avenue for load monitoring of volleyball players, potentially allowing better control of intensity of training and matches to minimize the likelihood of injuries. Although validity of jump counts and jump height is well investigated, studies validating impact forces estimated by VERT device referenced to force plate data are scarce. The objective of this study was to validate the use of VERT for the estimation of impact forces during volleyball. Twenty-one volleyball players of different levels performed countermovement jumps (CMJ), block jumps, spike jumps, and a set with a combination of several volleyball jump-landing tasks. Impact forces estimated by VERT were compared with resultant force values measured using a force plate. A total of 221 spike jumps, 286 block jumps, and 203 CMJ were analyzed. Given the identified proportional bias and heteroscedasticity, an adapted Bland-Altman plot featuring the line of best fit and V-shaped 95% confidence intervals instead of classic limits of agreement was created. Furthermore, our results suggest a proportional bias between the 2 measurements, with the VERT sensor tending to overestimate impact forces compared with the force plate, increasingly at higher mean values. Therefore, the VERT algorithm has not been proven valid for quantifying impact forces. However, a correction factor is proposed to obtain better results for impact forces estimated by VERT, making it suitable for implementation in sport contexts.

Finite element analysis of stress distribution in knee joint structures during soccer instep kick

This observational study investigates the stress distribution in knee joint structures, specifically focusing on the meniscus and primary ligaments of the supporting leg during the support phase of a maximal-effort soccer instep kick executed by an elite-level player. Understanding these stress patterns is crucial for injury prevention and enhancing performance in high-impact soccer actions. A three-dimensional (3D) knee model was developed utilizing CT and MRI data. Finite element (FE) analysis was conducted to evaluate stress distribution patterns across the lateral and medial menisci, medial collateral ligament (MCL), and anterior cruciate ligament (ACL). The analysis revealed peak von Mises stresses of 16.127 MPa in the lateral meniscus, 10.845 MPa in the medial meniscus, 36.613 MPa in the MCL, and 22.863 MPa in the ACL. These findings indicate significant stress concentrations in the lateral meniscus, proximal MCL, and femoral insertion of the ACL. The identified stress distribution patterns specifically related to the knee joint during the instep kicking phase provide critical insights into the internal mechanical demands placed on the joint structures. This study enhances the understanding of stress concentrations in the meniscus and ligaments during soccer kicks, emphasizing the potential for targeted analysis of these stress patterns to inform injury prevention strategies. It suggests that a deeper comprehension of the stress distribution mechanics could contribute to more effective training protocols and rehabilitation approaches for athletes, ultimately improving performance and reducing the likelihood of knee injuries during soccer activities.

Risk of head and neck injuries to passengers in rollover crashes of military armoured vehicles

Rollover crashes can be highly fatal events, not only in regular passenger-cars but also in military armoured vehicles. Yet injury mechanisms specific to such rollovers remain unexplored. This study investigates injurious loadings on passengers during the rollover of a SIBMAS 6×6 military vehicle using finite element simulations. Hybrid III 50th percentile male dummies were restrained with lap belts in a typical seating posture. Head and neck injury severities were assessed using Head Injury Criterion (HIC15), Neck Injury Criterion (Nij ), and associated force and moment metrics. Results indicate a HIC15 of 2120, suggesting an 80% probability of critical injury, while Nij of 1.73 corresponds to a 15% likelihood of severe neck injury. The most severe injuries were observed in the offside passenger, particularly when the lateral hull impacted the ground. The study highlights critical injury risks in military vehicle rollovers, emphasizing the need for improved occupant protection measures.

Risky behaviours and injuries amongst Catalan children with ADHD: does pharmacological treatment improve outcomes?

BackgroundAttention-Deficit/Hyperactivity Disorder (ADHD) prevalence rates are around 5–10% of school-aged children. We test whether medication use for ADHD decreases the likelihood of risky behaviour (sexual behaviour, alcohol, tobacco, and drug consumption) and injuries amongst children aged 6–18.MethodsWe use a large administrative dataset for the whole population of Catalan children in Spain who were born between 1998 and 2012. We apply a scale that contains alternative definitions of ADHD so that over-diagnosis is also identified and estimate a count data model to explain the number of visits whilst accounting for confounding. Our identification strategy relies on instrumenting medication using an average indicator of the probability of prescribing medication for each most visited healthcare centre provider.ResultsOur results suggest that medication use significantly reduced the number of visits of children diagnosed with ADHD for injuries but not risky behaviour. This finding is robust irrespective of the considered span or the grace period after including ADHD-related comorbidities as controls.ConclusionIn line with previous literature, medication use amongst children with ADHD reduces the prevalence of injuries but not risky behaviours.

Tissue-specific and spatially dependent metabolic signatures perturbed by injury in skeletally mature male and female mice.

Osteoarthritis, the leading cause of disability worldwide, disproportionately affects females with sex being one of the strongest predictors of disease. This disparity is partly driven by sex-specific differences in injury susceptibility, increasing the likelihood of traumatic injury to the anterior cruciate ligament (ACL), other ligaments, and menisci. Using a non-invasive injury model, we demonstrate that injury perturbs the local joint environment and has systemic effects in a sex-specific manner. Furthermore, by leveraging matrix-assisted laser desorption ionization-mass spectrometry imaging of the joint, we provide new insight into the composition of osteochondral tissue at the metabolite level. These sexually dimorphic metabolic responses to joint injury advance current understanding of the complex sexual dimorphism in OA pathogenesis providing a foundation for targeted therapeutic strategies and improved patient outcomes for female patients.