Pedestrian Hit Research Articles

The Impact of Autonomous Vehicle Accidents on Public Sentiment: A Decadal Analysis of Twitter Discourse Using roBERTa

In the field of autonomous vehicle (AV) acceptance and opinion studies, questionnaires are widely used. Additionally, AV experiments and driving simulations are utilized. However, few AV studies have investigated social media, and fewer studies have analyzed the impact of AV crashes on public opinion, often relying on limited social media datasets. This study aims to address this gap by exploring a comprehensive dataset of six million tweets posted over a decade (2012–2021), and neural networks, sentiment analysis and knowledge graphs are applied. The results reveal that tweets predominantly convey negative sentiment (40.86%) rather than positive (32.52%) or neutral (26.62%) sentiment. A binary segmentation algorithm was used to distinguish an initial positive sentiment period (January 2012–May 2016) followed by a negative period (June 2016–December 2021), which was initiated by a fatal Tesla accident and reinforced by a pedestrian killed by an Uber AV. The sentiment polarity exhibited in the posted tweets was statistically significant (U = 24,914,037,786; p value < 0.001). The timeline analysis revealed that the negative sentiment period was initiated by fatal accidents involving a Tesla AV driver and a pedestrian hit by an Uber AV, which was amplified by the mainstream media.

What Is the Relationship Between Maxillofacial Injury Location and Associated Injuries?

BackgroundPatients sustaining maxillofacial fractures are at risk for associated injuries to other body regions. The incidence of associated injuries (AIs) is reported to be from 20 to 35%. AIs may be life-threating and play a key role in considering first-line management at the emergency department, as well as planning the definitive treatment of maxillofacial fractures. PurposeThe study aimed to determine the frequency and risk factors for AIs in patients with maxillofacial fractures. Study design, settings, sampleThe investigators designed and implemented a retrospective cohort study of patients with facial fractures treated at Central Hospital (Lahti, Finland) from January 1, 2009 through December 31, 2019. All adult patients with verified maxillofacial fractures were included. Patients under 18 years were excluded from the study. Predictor variableThe predictor variable was the location of the maxillofacial fractures grouped into three categories, mandible alone, midface alone, both midface and mandible. Main outcome variableThe primary outcome variable was associated body region injuries coded as present or absent. The secondary outcome variable was the location of the AI categorized as skull, neck, thorax, pelvis, or extremity injuries. CovariatesOther study variables included demographic data (age, sex, alcohol use), Glasgow Coma Scale (GCS), and etiology (fall, traffic- and bicycle accident, assault, pedestrian hit by motor vehicle, work-related, or sports/free-time injuries). AnalysesContinuous variables were analyzed for normal distribution using the Shapiro-Wilks test and compared with categorical variables using the Mann-Whitney test. The univariate analyses of categorical variables were analyzed by the x2 test (P ≤ 0.05 was considered statistically significant). ResultsDuring the study period, 443 adult (≥18) patients had maxillofacial fractures. AIs were present in 88 subjects (20%). The mean age was 47.6 years (range 18-91); 52 years with AIs (range 19-91), and 47 years (range 18-92) without AIs (p = 0.03). Subjects with midface and mandible + midface fractures had greater risk to AIs compared to mandibular fractures. (RR 2.0, p=0.002, RR 2.8, p=0.009). Conclusions and RelevancyEvery fifth maxillofacial trauma patient had associated injury. Trauma patients should be evaluated in institutions with trauma protocols and imaging modalities before determining and executing the treatment plan for maxillofacial fractures.

Performance Assessment of Out-of-Hospital Use of Pelvic Circumferential Compression Devices for Severely Injured Patients in Switzerland: A Nationwide Retrospective Cross-Sectional Study.

Patients with severe pelvic fractures carry a greater risk of severe bleeding, and pelvic compression devices (PCCD) are used to stabilize the pelvis on the pre-hospital scene. The aim of this study was to describe the use of PCCD in the pre-hospital setting on a nationwide scale (Switzerland) and determine the sensitivity, specificity and rates of over- and under-triage of the current application practices. The secondary objective was to identify pre-hospital factors associated with unstable pelvic fractures. Retrospective cross-sectional study using anonymized patient data (1 January 2015-31 December 2020) from the Swiss Trauma Registry (STR). Based on AIS scores, patients were assigned a unique principal diagnosis among three categories (unstable pelvic fracture-stable pelvic fracture-other) and assessed for use or not of PCCD. Secondarily, patient characteristics, initial pre-hospital vital signs, means of pre-hospital transport and trauma mechanism were also extracted from the database. 2790 patients were included for analysis. A PCCD was used in 387 (13.9%) patients. In the PCCD group, 176 (45.5%) had an unstable pelvic fracture, 52 (13.4%) a stable pelvic fracture and 159 (41.1%) an injury unrelated to the pelvic region. In the group who did not receive a PCCD, 214 (8.9%) had an unstable pelvic fracture, 182 (7.6%) a stable pelvic fracture and 2007 (83.5%) an injury unrelated to the pelvic region. The nationwide sensitivity of PCCD application was 45.1% (95% CI 40.1-50.2), the specificity 91.2% (95% CI 90-92.3), with both over- and under-triage rates of 55%. The prevalence of unstable fractures in our population was 14% (390/2790). We identified female sex, younger age, lower systolic blood pressure, higher shock index, pedestrian hit and fall ≥3 m as possible risk factors for an unstable pelvic fracture. Our results demonstrate a nationwide both over- and under-triage rate of 55% for out-of-hospital PCCD application. Female gender, younger age, lower blood pressure, higher shock index, pedestrian hit and fall >3 m are possible risk factors for unstable pelvic fracture, but it remains unclear if those parameters are relevant clinically to perform pre-hospital triage.

Effects of Impact Location, Impact Angle and Impact Speed on Head Injury Risk of Vietnamese Pedestrian Hit by a Sedan

Effects of Impact Location, Impact Angle and Impact Speed on Head Injury Risk of Vietnamese Pedestrian Hit by a Sedan

Older pedestrians hit by motor vehicles in South Australia

Older pedestrians are vulnerable road users. To highlight the road safety issues for older pedestrians and identify countermeasures to improve their safety, this study examined the number of older pedestrians hit by motor vehicles in South Australia, the characteristics of their collisions and their injury outcomes. Police-reported data (2008-2017) for 3,493 pedestrians hit by vehicles were analysed, along with hospital data (January 2008-November 2010 and June 2014-August 2017) for 360 pedestrians hit by vehicles and seriously injured. Fewer older pedestrians (two age groups: 65-74 and ≥75) were hit by motor vehicles between 2008 and 2017 than younger adult pedestrians (18-64). However, they had higher rates of being seriously or fatally injured and those aged ≥75 had higher rates of being hit per 100,000 population than younger adult pedestrians (18-64). Older pedestrians were less likely than younger adult pedestrians to have consumed alcohol (≥75=5%, 65-74=9%, 18-64=37%) or be responsible for the crash (≥75=36%, 65-74=30%, 18-64=48%). They were also more commonly walking on the footpath when hit than younger adult pedestrians (≥75=17%, 65-74=15%, 18-64=10%), who were more commonly walking on the road (≥75=9%, 65-74=9%, 18-64=15%). Older pedestrians were more likely to be hit between 6am and 6pm (≥75=88%, 65-74=79%, 18-64=58%) than younger adult pedestrians, who were more likely hit between 6pm and 6am (≥75=12%, 65-74=21%, 18-64=42%). Seriously injured pedestrians in the three age groups did not differ in injury severity (Injury Severity Scale, p=.062), but older pedestrians were more likely to spend longer than 10 days in hospital (≥75=46%, 65-74=44%, 18-64=25%, p=.031). Infrastructure, speed, and vehicle-based countermeasures are discussed.

Ílio-femoral suture with polyglecaprone thread to stabilize traumatic hip dislocation in a dog

Traumatic hip dislocations are orthopedic injuries commonly seen in the routine of the surgical clinic in pets such as dogs and cats. The aim of this study is to report a clinical case of the ilio-femoral suture technique with polyglecaprone thread to stabilize traumatic coxofemoral luxation in dogs. A mixed breed dog, three years old, with a body weight of 8.90 kg, was taken to the Veterinary Hospital of the Faculty of Veterinary Medicine and Zootechnics, presenting as a main complaint, a pedestrian hit over ten days ago and since then without support of the left pelvic limb. During the initial evaluation, it was found that the animal had functional impotence of the aforementioned limb. As a complementary examination, a ventro-dorsal and latero-lateral radiography of the pelvis region was requested. After diagnosing the hip dislocation with cranio-dorsal displacement of the femur, surgical treatment was instituted using the iliofemoral suture technique. The use of the ilio-femoral suture technique with absorbable suture was efficient in the treatment of craniodorsal hip dislocation in the patient in the present report, with return of limb functionality and regression of clinical signs.

Patterns, management, and outcomes of traumatic pelvic fracture: insights from a multicenter study

BackgroundTraumatic pelvic fracture (TPF) is a significant injury that results from high energy impact and has a high morbidity and mortality.PurposeWe aimed to describe the epidemiology, incidence, patterns, management, and outcomes of TPF in multinational level 1 trauma centers.MethodsWe conducted a retrospective analysis of all patients with TPF between 2010 and 2016 at two trauma centers in Qatar and Germany.ResultsA total of 2112 patients presented with traumatic pelvic injuries, of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41 ± 21 years. In unstable pelvic fracture, the frequent mechanism of injury was motor vehicle crash (41%) followed by falls (35%) and pedestrian hit by vehicle (24%). Apart from both extremities, the chest (37.3%) was the most commonly associated injured region. The mean injury severity score (ISS) of 16.5 ± 13.3. Hemodynamic instability was observed in 44%. Blood transfusion was needed in one third while massive transfusion and intensive care admission were required in a tenth and a quarter of cases, respectively. Tile classification was possible in 1228 patients (type A in 60%, B in 30%, and C in 10%). Patients with type C fractures had higher rates of associated injuries, higher ISS, greater pelvis abbreviated injury score (AIS), massive transfusion protocol activation, prolonged hospital stay, complications, and mortality (p value < 0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stays were 15 and 5 days, respectively. The overall mortality rate was 4.7% (86 patients).ConclusionTPF is a common injury among polytrauma patients. It needs a careful, systematic management approach to address the associated complexities and the polytrauma nature.

Isolated condylar fractures diagnosed by post mortem computed tomography

Due to their anatomical location, occipital condylar fractures (OCFs) are usually not observed during traditional autopsies and are therefore considered a rare injury. The aim of this study was to determine the true frequency of OCFs using post-mortem computed tomography (PMCT) in traumatic casualties. We retrospectively analyzed 438 PMCT studies of victims of traffic accidents, falls from height, violence, and low-energy head injuries (324 males and 114 females). OCFs were present in 22.6% of cases (n = 99), mostly in victims of railway accidents (48.5%, n = 17), falls from height (26.6%, n = 29), cyclists (24%, n = 6), and pedestrians hit by cars (22.5%, n = 29). Isolated OCFs were found in 5.5% of cases (n = 24), most often in cyclists (12%, n = 3) and pedestrians (9.3%, n = 12) hit by cars. There were no OCFs in the cases of fatalities caused by violence or accidental low-energy head injury. PMCT scans revealed that OCFs are common in high-energy injury fatalities and can be useful for determining the mechanism of trauma more precisely.

An Epidemiological Analysis of Head Injuries in Taiwan.

Traumatic head injuries occur frequently in Taiwan, having catastrophic consequences for the victims, their families, and society as a whole. However, little is known about the risk factors at the population level in Taiwan. The primary aim of this study was to obtain more information on these variables and their relationships. Another aim was to analyze the effects of independent variables such as sex, age, residency, pre-existing conditions, mechanisms of injury, associated injuries, and severity on the probability of in-hospital death. Using the 2007–2008 total admissions claim dataset from Taiwan’s National Health Insurance system, total admissions due to acute head injury were selected for further analysis. The obtained data included patient demographics and trauma hospitalization rate. A total of 99,391 patients were admitted with head injury, 48,792 of which had moderate-to-severe head injury. There were 4935 cases recorded as in-hospital mortality and the standardized in-hospital mortality rate was 10.7 deaths per 100,000 person-years. The mortality rate increased with age. After adjustments, male sex, age older than 54 years, living in a rural area, lower monthly income, a Charlson comorbidity index greater than one, being a pedestrian hit by a motor vehicle, fall from a height, and having significant chest, abdominal, or lower extremity injury increased the risk of death during admission. This population-based analysis provides information about the incidence rate and death rate for admissions in Taiwan due to acute head injury and the factors that affect in-hospital mortality. Our results that highlight the risk factors for adverse outcome can help us prevent or improve rural area trauma care of head injury patients in the future.

Effects of chronic marijuana use on driving performance

Objectives: The effects of marijuana on driving pose a significant public health concern. More studies on chronic marijuana use in driving are needed. The study objectives were to (1) assess differences in the Standardized Field Sobriety Test (SFST) and driving performance outcomes between chronic medical marijuana users and nonusers and (2) identify a cutoff tetrahydrocannabinol (THC) concentration above which chronic medical marijuana users demonstrate driving impairment.Methods: This prospective cross-sectional study assessed 31 chronic marijuana users and 41 nonusers. Rapid Detect Saliva Drug Screen 10-panel was administered to all participants. Participants were given a simple visual reaction time test (SVRT) and SFST consisting of the horizontal gaze nystagmus (HGN), the one leg stand (OLS), and the walk and turn (WAT) tests. The STISIM Drive M100 driving simulator assessed driving performance. Driving parameters included standard deviation of speed (SDS), deviation of mean lane position, off-road accidents, collisions, pedestrians hit, and car-following modulus, delay, and coherence. Cannabinoid blood plasma was obtained from marijuana users.Results: Marijuana users and nonusers did not differ in age (40.06 ± 13.92 vs. 41.53 ± 15.49, P = .6782). Marijuana users were more likely to fail the SFST (P = .005) and the WAT (P = .012) and HGN (P = .001) components. Marijuana users had slower SVRT (P = .031), less SDS (P = .039), and lower modulus (P = .003). Participants with THC >2 ng/mL (P = .017) and TCH >5 ng/mL (P = .008) had lower SDS. Participants with THC >2 ng/mL (P = .021) and THC >5 ng/mL (P = .044) had decreased modulus.Conclusion: Chronic marijuana users had slower reaction times, deviated less in speed, and had difficulty matching a lead vehicle’s speed compared to nonusers. The effects on SDS and modulus were present at cutoffs of 2 and 5 ng/mL.

Anatomic Location and Mechanism of Injury Correlating with Prehospital Deaths in Sub-Saharan Africa.

Trauma is a large contributor to morbidity and mortality in developing countries. We sought to determine which anatomic injury locations and mechanisms of injury predispose to prehospital mortality in Malawi to help target preventive and therapeutic interventions. We hypothesized that head injury would result in the highest prehospital mortality. This was a retrospective analysis of all trauma patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi, from 2008 to 2015. Independent variables included baseline characteristics, anatomic location of primary injury, mechanism of injury, and severity of secondary injuries. Multivariable logistic regression was used to assess the effect of primary injury location and injury mechanism on prehospital death, after adjusting for confounders. Effect measure modification of the primary injury site/prehospital death relationship by injury mechanism (stratified into intentional and unintentional injury) was assessed. Of 85,806 patients, 701 died in transit (0.8%). Five hundred and five (72%) of these patients sustained a primary head injury. After adjustment, head injury was the anatomic location most associated with prehospital death (OR 11.81 (95% CI 6.96-20.06, p < 0.0001). The mechanisms of injury most associated with prehospital death were gunshot wounds (OR 38.23, 95% CI 17.66-87.78, p < 0.0001) and pedestrian hit by vehicle (OR 2.62, 95% CI 1.92-3.55, p < 0.0001). Among head injury patients, the odds of prehospital mortality were higher with unintentional injuries. Head injuries are the most common causes of prehospital death in Malawi, while pedestrians hit by vehicles are the most common mechanisms. In a resource-poor setting, preventive measures are critical in averting mortality.

The Use of Chest Computed Tomographic Angiography in Blunt Trauma Pediatric Population.

Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed tomographic angiography use in this population. A retrospective cohort study was conducted including all blunt pediatric (age < 14 y) trauma victims registered in Israeli National Trauma Registry maintained by Gertner Institute for Epidemiology and Health Policy Research between the years 1997 and 2015. Data collected included age, sex, mechanism of injury, Glasgow Coma Scale, Injury Severity Score, and incidence of chest named vessel injuries. Statistical analysis was performed using SAS statistical software version 9.2 (SAS Institute Inc, Cary, NC). Among 433,325 blunt trauma victims, 119,821patients were younger than 14 years. Twelve (0.0001%, 12/119821) of these children were diagnosed with TVI. The most common mechanism in this group was pedestrian hit by a car. Mortality was 41.7% (5/12). Thoracic vascular injury is exceptionally rare among pediatric blunt trauma victims but does contribute to the high morbidity and mortality seen with blunt chest trauma. Computed tomographic angiography, with its associated radiation exposure risk, should not be used as a standard tool after trauma in injured children. Clinical protocols are needed in this population to minimize radiation risk while allowing prompt identification of life-threatening injuries.

Vehicle-pedestrian collisions – Aspects regarding pedestrian kinematics, dynamics and biomechanics

Vehicle-pedestrian collisions result in a substantial number of pedestrian fatalities and injuries worldwide. Concern continues to limit and reduce the tragic consequences suffered by pedestrians involved in road accidents, caused the vehicle-pedestrian accident reconstruction become an important area and distinctly outlined in the reconstruction of road incidents involving vehicle. This paper analyzes the dynamics of vehicle-pedestrian impact influence over pedestrian biomechanics, which is directly connected with the severity of injury after contact with the vehicle profile and with the place where the pedestrian is projected. The main goal of this paper is to highlight some features of reconstruction of road accidents involving pedestrian, looking at the kinematics and dynamics of pedestrian impact for a better understanding of the phenomena that occur. The study on the dynamics and biomechanics of the pedestrian hit by the vehicle is useful in order to understand how the injuries, including the lethal ones, are generated in the collision, what is essential in road accidents reconstruction.

A comparison study of pelvic fractures and associated abdominal injuries between pediatric and adult blunt trauma patients

PurposePelvic fractures are a marker of severe injury, mandating a thorough investigation for the presence of associated injuries. Anatomical and physiological differences between adults and children may lead to a different impact of pelvic fractures on these populations. The purpose of this study is to compare pelvic fractures between pediatric and adult blunt trauma victims, mainly regarding their severity and associated intraabdominal injuries. MethodsA retrospective study involving blunt trauma patients suffering pelvic fractures, according to the records of the Israeli National Trauma Registry. Patients included children, aged 0–14years, and adults between 15 and 64years. The presence and severity of associated injuries were assessed. ResultsOverall, 7621 patients aged 0–64years were identified with pelvic fractures following blunt trauma. The incidence of pelvic fractures in children was (0.8%), as compared to 4.3% in adults, p <0.0001. The most common mechanism of injury was motor vehicle accident (MVA) in adults, and pedestrian hit by car (PHBC) in children. About a quarter of the patients in both groups had an ISS >25. Adults sustained significantly more moderate to severe pelvic fractures (AIS≥3) than children (26.7% vs. 17.4%, p<0.0001). The overall mortality rate was similar among the two groups (5.4% in adults, 5.2% in children, p=0.7554). The only associated injury with statistically significant difference in incidence among the two groups was rectal injury (1.2% among children, 0.2% among adults, p<0.0001). Among adult patients, there was a clear correlation between the severity of pelvic fractures and the severity of concomitant splenic and hepatic injuries (p=0.026, p=0.0004, respectively). Among children, a similar correlation was not demonstrated. ConclusionsAdults involved in blunt trauma are more likely to sustain pelvic fractures, and these are generally more severe fractures, as compared to children suffering from blunt trauma. Nonetheless, mortality rates were found similar in both groups. The only associated injury with statistically significant difference in incidence among the two groups was rectal injury. In adults, but not in children, higher grade pelvic fractures correlated with more severe concomitant splenic or hepatic injuries. Level of evidenceThe level of evidence for this study is III (3).

Injury pattern in lethal motorbikes-pedestrian collisions, in the area of Barcelona, Spain

IntroductionThere are several studies about M1 type vehicle-pedestrian collision injury pattern, and based on them, there has been several changes in automobiles for pedestrian protection. However, the lack of sufficient studies about injury pattern in motorbikes-pedestrian collisions leads to a lack of optimization design of these vehicles. The objective of this research is to study the injury pattern of pedestrians involved in collisions with motorized two-wheeled vehicles. MethodsA retrospective descriptive study of pedestrian's deaths after collisions with motorcycles in an urban area, like Barcelona was performed. The cases were collected from the Forensic Pathology Service database of the Institute of Legal Medicine of Catalonia. The selected cases were categorized as pedestrian-motorcycle collision, between January 1st, 2005 and December 31st, 2014. Data were collected from the autopsy, medical, and police report. The collected information was then analyzed using Microsoft Excel statistical functions. ResultsTraumatic Brain Injury is the main cause of death in pedestrian hit by motorized two-wheeled vehicles (62.85%). The most frequent injury was the subarachnoid hemorrhage, in 71.4% of cases, followed by cerebral contusions and skull base fractures (65.7%). By contrast, pelvic fractures and tibia fractures only appeared in 28.6%. ConclusionsThe study characterizes the injury pattern of pedestrians involved in a collision with motorized two-wheeled vehicles in an urban area, like Barcelona, which has been found to be different from other vehicle-pedestrian collisions, with a higher incidence of brain injuries and minor frequency of lower extremities fractures in pelvis, tibia and fibula.

Pining for the fjords1

Pining for the fjords¹

A data mining approach to characterize road accident locations

Data mining has been proven as a reliable technique to analyze road accidents and provide productive results. Most of the road accident data analysis use data mining techniques, focusing on identifying factors that affect the severity of an accident. However, any damage resulting from road accidents is always unacceptable in terms of health, property damage and other economic factors. Sometimes, it is found that road accident occurrences are more frequent at certain specific locations. The analysis of these locations can help in identifying certain road accident features that make a road accident to occur frequently in these locations. Association rule mining is one of the popular data mining techniques that identify the correlation in various attributes of road accident. In this paper, we first applied k-means algorithm to group the accident locations into three categories, high-frequency, moderate-frequency and low-frequency accident locations. k-means algorithm takes accident frequency count as a parameter to cluster the locations. Then we used association rule mining to characterize these locations. The rules revealed different factors associated with road accidents at different locations with varying accident frequencies. The association rules for high-frequency accident location disclosed that intersections on highways are more dangerous for every type of accidents. High-frequency accident locations mostly involved two-wheeler accidents at hilly regions. In moderate-frequency accident locations, colonies near local roads and intersection on highway roads are found dangerous for pedestrian hit accidents. Low-frequency accident locations are scattered throughout the district and the most of the accidents at these locations were not critical. Although the data set was limited to some selected attributes, our approach extracted some useful hidden information from the data which can be utilized to take some preventive efforts in these locations.

Embedding the Safe System approach at schools in Qatar

Providing safe roads around schools is a challenge faced by all communities. Children’s behaviour is unpredictable and their safety is of particular concern in an area where there is often a mix of vulnerable road users and motor vehicles. In 2011, Ashghal commissioned a major road safety contract to conduct road safety assessments at 200 schools throughout Qatar. The results have since been collated into a comprehensive school safety improvements program and Ashghal is now constructing safe and convenient school zones for all road users throughout Qatar, based on the principles of a Safe System. The Qatar National Road Safety Strategy (2013-2022) has a vision of “a safe road transport system that protects all road users from death and serious injury” and adopts the Safe System as the guiding principle for building safe roads. The Safe System acknowledges that people make mistakes and that there is a limit to human injury tolerance. For example, a pedestrian hit at 30km/h is likely to survive (OECD, 2008). Whereas, a pedestrian hit at 60km/h is likely to be killed. Schools in Qatar are being treated with standard traffic engineering measures in a way that aims to achieve a Safe System 30km/h environment. Schools that have been completed show tremendous success and the benefits are being directly felt by parents, teachers, children and key stakeholders. Survey results show that vehicle speeds within school zones are successfully lowered to Safe System limits and that these speed reductions are being achieved over a 24 hour period without the need for Police enforcement. The improvements carried out to date have been well received and are seen as a positive step towards Qatar’s ambitious road safety vision. Site observations and speed surveys undertaken to date support the proposition of developing Safe System schools in Qatar.

Blunt traumatic celiac axis pseudoaneurysm: Multi detector computed tomography findings and endovascular management

Blunt trauma to the abdomen resulting in celiac axis injury is uncommon, and we present the case of a 28-year-old male pedestrian hit by a car. Whole body multi detector computed tomography revealed a non-bleeding celiac axis pseudoaneurysm. The subsequent successful endovascular management is described.

Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury.

To examine complications associated with the use of therapeutic temperature modulation (mild hypothermia and normothermia) in patients with severe traumatic brain injury (TBI). One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale (GCS) < 9, intensive care unit (ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation (TTM) with continuous surface cooling and indwelling bladder temperature probes. The control group received standard treatment with intermittent acetaminophen for fever. Information regarding complications during the time in the ICU was collected as follows: Pneumonia was identified using a combination of clinical and laboratory data. Pulmonary embolism, pneumothorax and deep venous thrombosis were identified based on imaging results. Cardiac arrhythmias and renal failure were extracted from the clinical documentation. acute respiratory distress syndrome and acute lung injury were determined based on chest imaging and arterial blood gas results. A logistic regression was conducted to predict hospital mortality and a multiple regression was used to assess number and type of clinical complications. One hundred and fourteen patients were included in the analysis (mean age = 41.4, SD = 19.1, 93 males), admitted to the Jackson Memorial Hospital Neuroscience ICU and Ryder Trauma Center (mean GCS = 4.67, range 3-9), were identified and included in the analysis. Method of injury included motor vehicle accident (n = 29), motor cycle crash (n = 220), blunt head trauma (n = 212), fall (n = 229), pedestrian hit by car (n = 216), and gunshot wound to the head (n = 27). Ethnicity was primarily Caucasian (n = 260), as well as Hispanic (n = 227) and African American (n = 223); four patients had unknown ethnicity. Patients received either TTM (43) or standard therapy (71). Within the TTM group eight patients were treated with normothermia after TBI and 35 patients were treated with hypothermia. A logistic regression predicting in hospital mortality with age, GCS, and TM demonstrated that GCS (Beta = 0.572, P < 0.01) and age (Beta = -0.029) but not temperature modulation (Beta = 0.797, ns) were significant predictors of in-hospital mortality [χ(2) (3) = 22.27, P < 0.01] A multiple regression predicting number of complications demonstrated that receiving TTM was the main contributor and was associated with a higher number of pulmonary complications (t = -3.425, P = 0.001). Exposure to TTM is associated with an increase in pulmonary complications. These findings support more attention to these complications in studies of TTM in TBI patients.