Traffic Accidents Research Articles

Examining the relationship between road service quality and road traffic accidents: a case study on an expressway in Malaysia

Examining the relationship between road service quality and road traffic accidents: a case study on an expressway in Malaysia

Change in the collision avoidance performance of autonomous emergency braking systems

Objective This study quantifies the change in collision avoidance performance of autonomous emergency braking (AEB) systems for traffic accidents in Japan since 2015. Method This study used data on Japanese traffic accidents compiled by Japan’s National Police Agency. The data included only accidents involving loss of or injury to human life; accidents involving only property damage were excluded. We restricted our analysis to collisions between two 4-wheel vehicles and considered only collisions for which we could determine whether the primary party’s car was equipped with an AEB system. Both Poisson and negative binomial mixed-effects regression analyses were conducted using the data for 2021 and 2022 to measure the collision avoidance performance of first registered cars in 2015 to 2020 equipped with AEB systems compared with cars without AEB systems first registered in 2015. Collision avoidance performance was measured for 2 types of intervehicle collisions: rear-end collisions and right-turn collisions. Collision avoidance performance for rear-end collisions was also measured for each of the 3 car types—Standard, small, and light cars. Results The collision reduction rate for rear-end collisions increases with the year of first registration and for cars equipped with AEB systems first registered in 2020 compared with non-AEB-equipped cars first registered in 2015 is 69.2% (95% confidence interval [CI] 67.0%–71.1%), indicating that the performance of AEB systems has dramatically improved in terms of preventing rear-end collisions. For right-turn collisions, the rate increased to 20.4% (95% CI 5.9%–32.6%) for cars equipped with AEB systems first registered in 2019. However, no clear trend is observed. Conclusions This study evaluated a time series of the collision reduction performance of AEB systems using an original methodology. Japan’s New Car Assessment Program (JNCAP) has included AEB’s effectiveness in reducing damage from traffic collisions as an evaluation item since FY2014. The results could demonstrate the effectiveness of JNCAP.

TIBIAL DIAPHYSEAL FRACTURE, PANORAMIC REVISION

Introduction: Tibial fractures are quite common injuries. Since the tibia has a subcutaneous location, it is more likely to show exposed fractures. Exposed fractures of the tibial diaphysis are serious injuries that can result in significant long-term disability if not managed correctly. Objective: to detail current information related to tibial diaphysis fractures, etiology, epidemiology, anamnesis, physical examination, assessment, treatment, differential diagnosis, prognosis and complications. Methodology: a total of 29 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: tibia fractures, osteosynthesis, tibia fracture, intramedullary nails, leg trauma, exposed fractures. Results: tibial diaphysis fractures present an incidence of 16.9 per 100,000 individuals per year, being more common in the male sex, with 21.5 per 100,000 individuals per year, compared to 12.3 per 100,000 in the female sex. The most common triggers in males of tibial diaphysis fractures are motor vehicle accident injuries and sports. Conclusions: It is important to recognize the management of tibial fractures since they have a relatively high incidence. It is not uncommon to encounter an exposed tibial diaphysis fracture, so it is essential to identify, as well as perform damage control and appropriate management. The individual should undergo a complete examination and it may be necessary to implement the trauma life support protocol. In this type of fracture it is crucial to assess the neurovascular situation. In addition, complementary examinations should be requested to allow the best diagnosis, classification and treatment of the injuries. The treatment of tibia diaphysis fractures will depend on the specific situation and the patient's condition; however, external fixators are usually used for damage control and later intramedullary nails are used. Tibial diaphysis fractures may be accompanied by compartment syndrome and other complications. KEY WORDS: trauma, fractures, tibia, treatment.

Work stressors and aggressive driving: The mediating roles of stress appraisals

While the association between work stressors and the risk of traffic accidents and driving lapses has been established, there is a lack of research exploring the relationship between work stressors and aggressive driving—a notable contributor to traffic incidents and injuries. To fill this gap, the present study utilized the challenge-hindrance stressor framework and the transactional theory of stress to investigate the effects of these stressors on aggressive driving behaviors, with a particular focus on the mediating roles of challenge and hindrance appraisals. We used time-lagged design and gathered self-reported data from 247 employees at a Chinese company over three distinct time points. The results of structural equation modeling indicated that both challenge and hindrance stressors are positively associated with aggressive driving, with their effects mediated by corresponding appraisals of challenge and hindrance. Notably, challenge appraisals were inversely related to aggressive driving. Our study is one of the first attempts to explore the relationship between work stressors and aggressive driving, underscoring the critical role of stress appraisals in understanding responses to stressors.

A Stochastic Model to Predict Road Accidents in Albania

The importance of predicting accident rates lies in the improvement of road infrastructure and the effective implementation of laws and traffic regulations. The statistical change of many phenomena over time is described by time series. This paper aims to forecast the number of individuals involved in road accidents in Albania by applying SARIMA model approach. This study used monthly number of individuals involved in road traffic accidents in Albania from 2016 to 2023. Using forecasting techniques for the number of traffic accidents can serve as a valuable strategy for achieving various objectives including the implementation of traffic safety campaigns, strategies, and action plans outlined in traffic safety initiatives. The model was found to be effective in capturing the underlying patterns and trends in the data, providing valuable insights for understanding and forecasting traffic accident occurrences in Albania.

Epidemiological analysis of a 10-year retrospective study of pediatric trauma in intensive care

Pediatric trauma plays a crucial role in pediatric mortality, with traffic injuries and falls frequently cited as leading causes of significant injuries among children. A comprehensive investigation, including geographical factors, is essential for developing effective strategies to prevent injuries and alleviate the burden of pediatric trauma. This study involved a retrospective analysis of clinical data from pediatric patients admitted to our hospital’s intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. This retrospective study included 951 pediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 h). Among these patients, 422 (44.4%) underwent emergency surgery, and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 h. The mean duration of ICU stay was 6.24 ± 8.01 days, and the overall mean hospitalization duration was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0–6 years (70.7%), with males comprising 60.0% of patients. Injury incidents predominantly occurred between 12 and 6 PM (44.5%) and on non-workdays (37.6%). The most common locations where injuries occurred were roadsides (49%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, while 80 (8.41%) succumbed to their injuries. Traffic injuries remain the primary cause of pediatric trauma leading to ICU admission, underscoring the importance of using appropriate child restraint systems and protective gear as fundamental preventive measures. The increased incidence of injuries among children aged < 6 years and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that address these high-risk populations.

Investigating Factors Influencing Crash Severity on Mountainous Two-Lane Roads: Machine Learning Versus Statistical Models

Due to poor road design, challenging terrain, and difficult geological conditions, traffic accidents on mountainous two-lane roads are more frequent and severe. This study aims to address the lack of understanding of key factors affecting accident severity with the goal of improving mountainous traffic safety, thereby contributing to sustainable transportation systems. The focus of this study is to compare the interpretability of model performances with three statistical models (Ordered Logit, Partial Proportional Odds Model, and Multinomial Logit) and six machine learning models (Decision Tree, Random Forest, Gradient Boosting, Extra Trees, AdaBoost, and XGBoost) on two-lane mountain roads in Yunnan Province, China. Additionally, we assessed the ability of these models to uncover underlying causal relationships, particularly how accident causes affect severity. Using the SHapley Additive exPlanations (SHAP) method, we interpreted the influence of risk factors in the machine learning models. Our findings indicate that machine learning models, especially XGBoost, outperform statistical models in predicting accident severity. The results highlight that accident patterns are the most significant determinants of severity, followed by road-related factors and the type of colliding vehicles. Environmental factors like weather, however, have minimal impact. Notably, vehicle falling, head-on collisions, and longitudinal slope sections are linked to more severe accidents, while minor accidents are more frequent on horizontal curve sections and areas that combine curves and slopes. These insights can help traffic management agencies develop targeted measures to reduce accident rates and enhance road safety, which is critical for promoting sustainable transportation in mountainous regions.

Iris Detection Using Deep Learning and OpenCV

The proposed system's efficacy is evaluated through extensive simulations and real- world testing, demonstrating high accuracy in accident detection and timely activation of the emergency response. This integration of deep learning with OpenCV and an automated alert system aims to reduce response times and enhance the chances of survival and support in the critical moments following a car accident. Keywords--- Deep Learning, OpenCV

SP6.12 - Do Pregnant Females Experiencing Physical Traumatic Injury have Different Mortality Outcomes Compared to Non-pregnant Females? A Systematic Review and Metanalysis

Abstract Aims To collate and analyse literature capturing mortality rates in pregnant and non-pregnant individuals of childbearing age who experienced physical trauma. Additionally, to identify any statistically significant differences in interventions received. Methods Comprehensive searches of PubMed, MEDLINE, and grey literature were conducted using MeSH terms. Data extraction by two independent reviewers was followed by quality assessments using the Newcastle-Ottawa Scale. A random effects meta-analysis assessed the effect of pregnancy on mortality post-physical trauma, employing risk ratios (RR) and 95% confidence intervals. Publication bias was evaluated through linear regression, Eggers test, and funnel plots. Results Twelve studies met eligibility criteria, yielding 1,113,376 pregnant and 18,185,789 non-pregnant females of childbearing age who experienced physical trauma. Low publication bias was observed. Pregnant females demonstrated a 35% mortality reduction vs. non-pregnant females (pooled RR: 0.65 [0.47-0.89], p=0.008), though significant heterogeneity existed across studies (I2 = 77%). A subgroup analysis focusing on mechanism of injury found the mortality reduction in pregnancy increased to 59% in motor vehicle accidents (pooled RR = 0.41 [0.32-0.52], p&amp;lt;0.001) with minimal study heterogeneity (I2 = 0%). Pregnant (vs. non-pregnant) females were less likely to be intubated (pooled RR = 0.69 [0.58, 0.81], p=&amp;lt;0.001, I2 = 9), but there were no other significant differences in the types of intervention received. Conclusions Pregnant females have a lower mortality risk from physical trauma than non-pregnant counterparts, particularly where the mechanism of injury is a motor vehicle accident. Additional research is warranted to elucidate the underlying factors contributing to this observed difference.

Time Horizon for Forecasting the Number of Traffic Accidents

On Polish roads, there are more and more automobiles each year. This results in more people using the roadways. Because of this, the threat posed by traffic accidents, which involve the loss of human life and financial resources, is quickly expanding. The rise of motorization and the quickening expansion of the human population are to blame for this. The tiny amount of the dataset that may be utilized for research in this respect is the major problem in anticipating and evaluating data on road accidents. Despite the fact that road accidents result in millions of lives and injuries worldwide each year, they are not very common. Traffic accidents are still quite common despite the pandemic's reduction. The aim of the essay is to evaluate the temporal horizon of the predicted number of traffic accidents. For this reason, an estimate of the expected number of traffic accidents in the future years was made, and its effect on the average percentage error of the projection was computed. Based on the analysis of the input data on the number of road accidents (annual and monthly), the results show that monthly and annual data can be forecast up to six years in advance.

Head and Neck Airbag Penetrating Injuries.

Airbags have significantly decreased fatalities in frontal vehicle accidents, but their deployment can lead to more severe injuries and rarely death. The authors present a case of a penetrating injury causing tissue loss in the left cheek, an "explosion" of the zygomatic arch, and facial nerve damage, discussing the management in the contest of literature examining similar injuries in the head and neck region. Reviewing English literature from 1995 to 2023, 9 patients experienced severe airbag-related penetrating head and neck injuries, in 3 cases resulting in death. In addition, we describe the case of a young male reporting a deep cheek laceration with facial nerve damage, tissue loss, and comminuted maxilla-zygomatic fracture; 48 hours after trauma, he underwent surgical reconstruction using a bilobed flap, direct suture of the resected masseter muscle, closed reduction of the comminuted zygomatic arch fracture, and direct neurorrhaphy of the lacerated facial nerve. Five months after surgery, facial nerve function recovery was observed. Mouth opening was restored, but a mixed low-medium hearing loss persisted for high frequencies. In another case marginal nerve damage was reported, but management is not described. The use of seat belts and airbags has led to a significant reduction in the incidence of facial fractures and fatalities after motor vehicle accidents, but at the same time, in some cases, complex facial trauma and/or penetrating injury can be observed. In case of suspected or certain facial nerve damage, it is mandatory to perform exploration and eventual reconstruction within 72 hours.

Asuhan Keperawatan pada Tn. M dengan Post Operasi Craniotomy : Cedera Kepala Sedang di Ruang Mawar 2 RSUD Dr. Soeselo Kabupaten Tegal

Head injury is a health problem, one of the main factors of which is traffic accidents. Head injuries occur when the head structure experiences an external impact that has the potential to disrupt brain function. The severity varies, from minor injuries, bruising, swelling, bleeding, dislocation, skull fractures, to concussions. The mechanism of impact and the severity of the injury are determining factors in the type of injury experienced (Poniati &amp; Dani Saputro, 2023). Head injuries can range from minor injuries to the scalp to serious damage to the brain. This injury is usually caused by impact, such as falling, accidents, being hit by sharp objects, being hit or the head hitting something (Rahmawan, 2023).

Influence of Road Infrastructure Design over the Traffic Accidents: A Simulated Case Study

The influence of road infrastructure over the severity of road accidents, in particular some specific features of it, represents the subject of this study. Generally, when an accident occurs, its causes are represented by a number of factors such as driver experience, fatigue, driving under the influence of alcohol and other psychoactive substances, road configuration, weather conditions, speeding, distracted driving, and unsafe road infrastructure. Road design is a key factor regarding the safety of all traffic participants. In this paper, the influence of unsafe roadside element designs on the incidence of traffic accidents, the degree of vehicle passenger injury, and the level of car damage were investigated. The present study was inspired by the high number of accidents produced on European route E68 (DN1) in Romania, a significant part of which was generated and accentuated by the effects of improper roadside design.

Primary Open Reduction and Internal Fixation of Isolated Compound Depressed Nasal Fractures.

The aim of this study was to assess the efficacy of primary open reduction and internal fixation (ORIF) utilizing the existing dorsal wound for the management of isolated nasal fractures characterized by significant depression and to determine its effectiveness in preventing the need for subsequent nasal revisions. A retrospective review was conducted on patients who underwent ORIF of nasal bone for isolated compound depressed nasal fractures from January 2018 to January 2024. The primary outcomes included the assessment of clinical and radiographic results postoperatively, focusing on nasal symmetry, projection, airway patency, and the incidence of secondary surgical interventions. The study included 15 patients, predominantly males (60%), with an average age of 39.33 years. The mechanisms of injury included motor vehicle accidents (40%), falls (26.7%), interpersonal violence (20%), and occupational injuries (13.3%). All patients were treated on the first (73.3%) or second day (26.7%) after the injury. All patients had satisfactory esthetic and functional outcomes and did not require secondary rhinoplasty. The hardware was removed in 4 patients (26.7%). Primary ORIF through an existing dorsal wound for significantly depressed isolated nasal fractures was effective in obviating the necessity for subsequent nasal revisions.

SP7.4 - Analyzing Geriatric Trauma Patterns: Prevalence, Injury Types, and Transfer Delays in Riyadh, Saudi Arabia

Abstract Aim To analyze geriatric trauma prevalence, injury pattern, transfer delays to trauma centers, and assess undertriage to non-trauma centers in Riyadh City. Method We conducted a retrospective review of 11,140 incident reports from 50 Red crescent Center in Riyadh City from the official data registry of the Red Crescent of Saudi Arabia from January 2021 to March 2023. Cases meeting "red criteria" (SBP &amp;lt; 110 mmHg or HR &amp;gt; SBP) were identified. Using QGIS, we mapped the regional distribution of dispatch and non-trauma centers. Network service zone analysis delineated level 1 and 2 trauma center service areas reachable within 15-, 30-, 45-, and 60-minute intervals. Dispatch centers were grouped to assess mistriaging of red criteria cases. Delays were defined as travel time &amp;gt;60 minutes to a non-trauma center. Data were analyzed using SPSS 26 and R statistics. Results Majority of geriatric trauma patients (65.6%, n=7312/11140) were classified under red criteria. Penetrating injuries were the most common (51.2%, n=5704/11140), followed by fall-related injuries (38%, n=4234/11140), and finally motor vehicle accidents (6%, n=669/11140). Among red criteria cases, majority of the patients (65.6%, n=2360/3419) transferred to level 1 and 2 trauma centers were delayed, most commonly seen in the 15-minute area of south and middle Riyadh and the 45-minute service area of northern and southern Riyadh. Nearly of quarter of the red criteria patients (23.54%, n=1721/7312) were transferred to a non-trauma center. Conclusions Addressing delays in accessing trauma centers and transfers to non-trauma facilities is imperative, warranting focused intervention. Addressing preventable delays and enhancing the capabilities of Red Crescent centers are vital for improving geriatric trauma care in Riyadh.

Epidemiological Aspects of Road Accidents in the Middle East and North Africa (MENA) Countries from 1990 to 2019

Background: Road accidents are a major public health concern globally and are expected to become the fifth leading cause of death worldwide by 2030. Objectives: This study aimed to compare the consequences of road accidents in the Middle East and North Africa (MENA) region by analyzing data from 21 countries and approximately 400 million people Methods: The data used was from the Global Burden of Diseases (GBD) in 2019, which defines traffic accidents as deaths resulting from external injury causes based on the international classification of diseases (ICD). Results: Road traffic injuries (RTIs) in the MENA region have decreased from 1990 to 2019. Motor vehicles have the highest death rate from RTIs at 15.32 per 100,000, followed by pedestrians at 8.37 per 100,000, motorcyclists at 2.16 per 100,000, and cyclists at 0.35 per 100,000. Saudi Arabia (46.7 per 100,000) and Oman (25.5 per 100,000) have the highest death rates for motor vehicle-related road injuries, while Oman (17.7 per 100,000) and Yemen (12.95 per 100,000) have the highest rates for pedestrian-related road injuries. Conclusions: Given the significant impact of road accidents in the countries of the region, it is crucial to address this issue through various measures. These should include training initiatives, preventive measures, and a review of traffic laws and regulations.

Integrating Eye Movement, Finger Pressure, and Foot Pressure Information to Build an Intelligent Driving Fatigue Detection System

Fatigued driving is a problem that every driver will face, and traffic accidents caused by drowsy driving often occur involuntarily. If there is a fatigue detection and warning system, it is generally believed that the occurrence of some incidents can be reduced. However, everyone’s driving habits and methods may differ, so it is not easy to establish a suitable general detection system. If a customized intelligent fatigue detection system can be established, it may reduce unfortunate accidents. With its potential to mitigate unfortunate accidents, this study offers hope for a safer driving environment. Thus, on the one hand, this research hopes to integrate the information obtained from three different sensing devices (eye movement, finger pressure, and plantar pressure), which are chosen for their ability to provide comprehensive and reliable data on a driver’s physical and mental state. On the other hand, it uses an autonomous learning architecture to integrate these three data types to build a customized fatigued driving detection system. This study used a system that simulated a car driving environment and then invited subjects to conduct tests on fixed driving routes. First, we demonstrated that the system established in this study could be used to learn and classify different driving clips. Then, we showed that it was possible to judge whether the driver was fatigued through a series of driving behaviors, such as lane drifting, sudden braking, and irregular acceleration, rather than a single momentary behavior. Finally, we tested the hypothesized situation in which drivers were experiencing three cases of different distractions. The results show that the entire system can establish a personal driving system through autonomous learning behavior and further detect whether fatigued driving abnormalities occur.

A Scoping Review on the Management of Open Fractures in African Trauma and Orthopaedics Centres.

An open fracture is when the fractured part of a bone is exposed to the external environment by breaching the overlying soft tissue and skin.Open fractures often arise from high-energy injuries, and the risk of microbial contamination is high. There is a need to understand the management of open fractures in Africa by assessing the overall prevalence of open fractures, the mechanisms of injury, management approaches and outcomes. A literature search was conducted using PubMed, African Journal Online, and Google Scholar regarding open fracture management in Africa from inception till date. Thirty-nine (39) studies were included in this review. Road traffic accidents represented the majority of all mechanisms of open fractures, with the Tibia being the most affected bone. 320 cases were classified as Gustilo Anderson Type 1, with 487 classified as Type 2. Type 3 was divided into 3A (330), 3B (248), and 3C (34). Most studies recorded the immediate administration of intravenous antibiotics, but tetanus prophylaxis was only given in 13 studies, while initial debridement and washout were done in 35 studies. External fixators and Kirschner wires were most used for initial fixation. Follow-up for patients was between six weeks to 50 months. There were 645 cases of malunion, 83 cases of non-union, and 88 patients who had delayed union. There were 147 cases of wound infection and 119 cases of pin tract infections. Our findings emphasize the need for standardized protocols and robust emergency services to manage open fractures within Africa.

Family Communication With Children and Adolescents Post Parental Loss in Road Traffic Accidents: A Qualitative Study

Background: Traumatic parental loss during childhood and adolescence can have long-lasting effects on the developmental trajectory of youngsters. While there is some literature on the advantages of positive family communication fostering better adjustment in bereaved children and adolescents, patterns of family communication post parental loss have not received much attention. An understanding of these patterns can pave the way for more holistic interventions in this vulnerable group. Aim: The aim of the study was to explore parental loss-related communication in families of children and adolescents who have lost a parent to a road traffic accident. Method: The study was carried out in a tertiary hospital setting in Bengaluru. The sample comprised of 24 children and 17 surviving parents. The study employed a qualitative research design. Semi-structured in-depth interviews were conducted with surviving parents/caregivers and the children/adolescents. The interviews were analysed by using inductive thematic analysis. Results: The themes generated from the semi-structured interviews highlighted patterns of communication in parentally bereaved families. Four major themes emerged from the semi-structured interviews – mode of getting to know about the death, disclosure regarding the death, discussion regarding the death and individual needs related to communication. Conclusions: Communication regarding parental loss as a result of road traffic accidents in the family context seems to be desirable and may enable healthy grieving in youngsters. Short-term interventions aimed at enhancing family communication patterns following traumatic parental loss need to be developed in the Indian context.

Serial Case of CT Scan Imaging in Fracture of Midface Region

Background: Fractures in the face region are frequently seen in motor vehicle accidents, as the face is highly exposed during such incidents. Motor vehicle accidents are common in Bali, with fracture of the face region is the 2nd most common injury found in radiologic examination. Computed tomography (CT) scans are crucial for assessing these fractures, allowing for an accurate evaluation of severity to plan the patient treatment. Case: We present serial cases CT scan images of complex midface fractures such as Le Fort, tripod, NOE and orbital wall fracture and its characteristic imaging on CT-imaging. Conclusions: CT scan may guide treatment plans aimed at minimizing disability and enhancing the patient's quality of life. Understanding the imaging characteristics of midface fractures is thus essential for effective diagnosis and management.