Seat Belt Research Articles

AI In Advance Driver Assistance System

Perhaps of the most encouraging sub-capability in the field of savvy traffic frameworks is the High-level Driver Help Framework which is termed as ADAS. Many high-level wellbeing highlights are accessible in new vehicles. Airbags, safety belts and any remaining essential aloof wellbeing highlights are standard. Vehicles are currently frequently furnished with cutting edge dynamic wellbeing frameworks that can forestall mishaps. The conceivable outcomes of cutting-edge help frameworks are continually growing. People assume a significant part in this cycle and are additionally the most vulnerable connection as 90% of mishaps are brought about by human mistake and lack of regard. Various mishaps are accounted for each year because of unnecessary speed and unfortunate driving choices. The vast majority of these can now be tried not to by use the wellbeing highlights remembered for cutting edge driver help frameworks.

Virthuman Application: Is an Autonomous Vehicle with Non-standard Seating Safe in a Side Crash?

Highly Automated Vehicles (HAVs) will be more comfortable for their occupants than common cars from different aspects. For instance, their occupants can access extra spaces to adjust their seats as there will be no steering wheel and gearbox transmission handle in the interior. Among a wide range of seating configuration possibilities, the majority of passengers prefer to be in the Face-to-Face or the Living room configurations that are known as non-standard seating configurations. The present survey investigated how safe are these non-standard seating configurations in a side crash in comparison with the standard one in which all seats are facing the front windshield. Four identical 50th percentile Virthuman models were integrated into a schematic of automated vehicle's interior. Standard three-point seatbelts fastened bodies to up-right seats made from Polyurethane foam. A 30 km/h crash acceleration pulse was applied to the model for simulating side crash with a virtual sledge test in the Virtual Performance Solution (VPS) environment, PAMCRASH module. Results revealed that the Living room configuration was safer for the Rear Left occupant in comparison with the Standard one. Also, the Front Left occupant did not experience safer occasions in non-standard configurations from a Head & Neck injury point of view.

Investigating the role of health belief model on seat belt use for front seat passengers on urban and rural roads

What makes a vehicle user buckle up? Considering the strong effect of seat belt use in reducing injuries and fatalities in a vehicle crash, we investigated the role of the health belief model on seat belt use among front-seat passengers on urban and rural roads. A questionnaire based on the theory components was randomly distributed in public areas of Sari, Iran. Structural equation model was used to test the study hypotheses. The results revealed that anticipated severity and perceived susceptibility directly affected seat belt use on urban roads, whereas perceived barriers had a reverse effect on seat belt use on urban roads. Perceived barriers with an indirect and perceived susceptibility with a direct effect, played an essential role in explaining seat belts use on rural roads. Outcomes of this study extend the knowledge of seat belts use behavior among front seat passengers by introducing new factors of potential influence, which could lead to practical solutions aimed to enhance seat belts utilization among these vehicle users and decrease the rate of injuries and fatalities in road crashes.

METONYMIES AND METAPHORS: IMAGES OF THE SEAT BELT AND NUMBER PLATE

Cognitive linguists argue that many metaphors have a metonymic basis, and frequently it is not easy to tell them apart [see Gibbs [1994] 2002: 449–451, Barcelona 2003: 8–12, Semino 2008: 20]. The aim of this article is to examine this claim on the material of advertisements in Latvian. The paper gives an insight into the history of seat belt development and analyses particular instances in advertising and other visual material, and their stylistic development in discourse. Development means not only interaction of the image with the text (visual and verbal) and its interpretation in one context, but also cases of use when the image exceeds the borders of one advertisement and is employed in several advertisements either in the same (discoursal use), or another advertising campaign (interdiscoursal use). My aim is to establish whether metonymic images are sustainable and whether they can be used for other purposes by employing allusion to the original advertisements. When analysing the material of social campaigns, it is important to reveal the development of figurative thought in verbal and visual discourse in order to reveal the role of metonymy in thinking and conceptualisation of human experience.

Injury Biomechanics Evaluation of a Driver with Disabilities during a Road Accident-A Numerical Approach.

Numerical methods are often a robust way to predict how external mechanical loads affect individual biological structures. Computational models of biological systems have been developed over the years, reaching high levels of detail, complexity, and precision. In this study, two cases were analysed, differing in the airbag operation; in the first, the airbag was normally activated, and in the second case, the airbag was disabled. We analysed a model of a disabled person without a left leg who steers a vehicle using a specialized knob on the steering wheel. In both cases, a head-on collision between a car moving at an initial speed of 50 km/h and a rigid obstacle was analysed. We concluded that the activated airbag for a person with disabilities reduces the effects of asymmetries in the positioning of the belts and body support points. Moreover, all the biomechanical parameters, analysed on the 50th percentile dummy, i.e., HIC, seat belt contact force and neck injury criterion (Nij) support the use of an airbag. The resulting accelerations, measured in the head of the dummy, were induced into a finite element head model (YEAHM) to kinematically drive the head and simulate both accidents, with and without the airbag. In the latter, the subsequent head injury prediction revealed a form of contrecoup injury, more specifically cerebral contusion based on the intracranial pressure levels that were achieved. Therefore, based on the in-depth investigation, a frontal airbag can significantly lower the possibility of injuries for disabled drivers, including cerebral contusions.

The Impact of Protective Devices Across the Spectrum of Trauma Care and Across Racial Groupings.

Protective devices such as seat belts and helmets save lives. Most studies only address one aspect of the injury profile - compliance or mortality - not the entire spectrum of trauma care, and little attention is paid to racial differences in the use or impact of protective devices. Patients with blunt mechanisms where using protective devices would be expected were included and were divided into utilizing (P) vs not utilizing protection (Non-P). Chart review included demographics, injuries sustained, hemodynamics, and blood alcohol level. Outcomes included need for emergent operation, complications and death. Non-P patients were more likely male, presented at night and intoxicated. Highest risk behavior (intoxicated Non-P) presented at night (25.7% of nighttime presentations), and rarely during daytime (6.7% daytime presentations). Non-P were more likely hypotensive and sustain a traumatic brain injury. No race related differences were noted among young patients. Among older (>/=50years) patients, White patients were least likely Non-P and least likely presented at night. Non-P required more emergent operative intervention, ICU admission, and longer hospital stay. Overall, Non-P was associated with increased risk of death (OR = 1.6 (95% CI = 1.28 - 2.11). Given unique age and racial differences, we advocate for culturally and age specific public service campaigns.

Trend towards Helmet Usage and the Behavior of Riders While Wearing Helmets

Nowadays, it is relatively common to follow traffic rules, such as wearing a helmet and fastening seat belts, but accidents are increasing daily. Concerned with these traffic safety issues, this study focuses on the psychology of bike riders. First, a brief questionnaire is prepared by filtering some significant traffic safety factors. For effective results and analysis, a questionnaire survey (i.e., interviews) is conducted across different road junctions in Sargodha, Pakistan, with the assistance of traffic police. The data is analyzed through a multiple regression analysis, forming a different model for effective outcomes. A risk compensation hypothesis theory is considered; based on the questionnaire designed and the input received from participants, three models are developed with significant variables. The first two models evaluate the physical impact of helmets on riders/cyclists, while the third observes changes (in terms of obeying traffic laws) in behavior when wearing a helmet. It has been observed that cyclists wearing helmets may follow zigzag patterns while wearing helmets, which may cause accidents. Moreover, it has been observed that cyclists wearing helmets may be more responsible regarding traffic rules. These problems should be considered in creating effective traffic safety campaigns and policy making.

A STUDY ON BASIC KNOWLEDGE AND PRACTICES FOR ROAD TRAFFIC SAFETY MEASURES AMONG UNDERGRADUATE MEDICAL STUDENTS OF UTTAR PRADESH

Objectives: The objectives of this study were to assess the knowledge and practices of road traffic safety measures among undergraduate medical students and recommendation to prevent road traffic accident. Methods: It was an institutional-based cross-sectional study among undergraduate medical students who knew driving. Total 138 study subjects were purposively selected from three batches. A self-structured questionnaire based on knowledge and practices related to road traffic safety measures with Yes/No answer pattern. Data were collected, compiled, and analyzed using appropriate software. Results: Overall level of knowledge for road traffic safety measures was good/moderate among 37.7% of medical students each while poor among 24.6% students (more among 1st year/39.3% than 2nd year/19.0%, 3rd year/10.0%) (statistically significant X2 =13.304, p-value=0.01). Road traffic safety practices were followed by students (%), namely, wearing a seat belt while driving/seating in four-wheeler’ by 84.1% and neither keep specified speed limit on road/2.9% nor obey all traffic signals/lights/signs’/2.9%. Few students use mobile phone while driving, namely, 2nd year/19.0% and 3rd year/10.0%. Some students “Not Wear Helmet while driving a two-wheeler”/21.7%; “Wrong overtaking from left side”/17.4%; and “drive even when alcoholic”/4.3% of participants. Conclusions: Knowledge for road traffic rules/regulation was good/moderate among average number of students. Majority of medical students’ obey all traffic rules/light signal and signs while some students still did not follow it; use mobile phone while driving/not stop at zebra crossing and neither use indicators while turning nor keep valid DL. To improve the current scenario, road traffic safety rules/measures should be added in our medical curriculum and there is need of frequent awareness campaign related to road safety measures to change their behavior while driving and save their precious life.

Airline Point-of-Care System on Seat Belt for Hybrid Physiological Signal Monitoring.

With a focus on disease prevention and health promotion, a reactive and disease-centric healthcare system is revolutionized to a point-of-care model by the application of wearable devices. The convenience and low cost made it possible for long-term monitoring of health problems in long-distance traveling such as flights. While most of the existing health monitoring systems on aircrafts are limited for pilots, point-of-care systems provide choices for passengers to enjoy healthcare at the same level. Here in this paper, an airline point-of-care system containing hybrid electrocardiogram (ECG), breathing, and motion signals detection is proposed. At the same time, we propose the diagnosis of sleep apnea-hypopnea syndrome (SAHS) on flights as an application of this system to satisfy the inevitable demands for sleeping on long-haul flights. The hardware design includes ECG electrodes, flexible piezoelectric belts, and a control box, which enables the system to detect the original data of ECG, breathing, and motion signals. By processing these data with interval extraction-based feature selection method, the signals would be characterized and then provided for the long short-term memory recurrent neural network (LSTM-RNN) to classify the SAHS. Compared with other machine learning methods, our model shows high accuracy up to 84-85% with the lowest overfit problem, which proves its potential application in other related fields.

Crash characteristics for classic/historic vehicles and comparisons to newer vehicles

Introduction: Older vehicles, commonly referred to as “classic,” “vintage,” or “historic” vehicles (CVH), share the roadways with newer vehicles. Older vehicles lacking safety systems likely come with an increased risk of fatality, however there is no study examining the typical conditions for crashes involving CVH. Method: This study utilized information from crashes occurring in 2012 to 2019 to estimate fatal crash rates for vehicles grouped by model year deciles. Data from crashes documented in the National Highway Traffic Safety Administration’s (NHTSA) FARS and GES/CRSS data sets were utilized to examine roadway, temporal, and crash types for passenger vehicles produced in 1970 or earlier (CVH). Results: These data show CVH crashes are rare (<1% of crashes), but carry a relative risk of fatality from 6.70 (95th CI: 5.44–8.26) for impacts with other vehicles, which was the most common crash, to 9.53 (7.28–12.47) for rollovers. Most crashes occurred in dry weather, typically during summer, in rural areas, most frequently on two lane roads, and in areas with speed limits between 30 and 55 mph. Factors associated with fatality for occupants in CVH included alcohol use, lack of seat belt use, and older age. Conclusions and Practical Applications: Crashes involving a CVH are a rare event but have catastrophic consequences when they do occur. Regulations that limit driving to daylight hours may lower the risk of crash involvement, and safety messaging to promote belt use and sober driving may also help. Additionally, as new “smart” vehicles are developed, engineers should keep in mind that older vehicles remain on the roadway. New driving technologies will need to safely interact with these older, less safe vehicles.

Severity of Placental Abruption in Restrained Pregnant Vehicle Drivers: Correct Seat Belt Use Confirmed by Finite Element Model Analysis.

Despite wearing a seat belt, pregnant drivers often suffer from negative fetal outcomes in the event of motor accidents. In order to maintain the safety of pregnant drivers and their fetuses, we assessed the severity of placental abruption caused by motor vehicle collisions using computer simulations. We employed a validated pregnant finite element model to determine the area of placental abruption. We investigated frontal vehicle collisions with a speed of 40 km/h or less involving restrained pregnant drivers with a gestational age of 30 weeks. For a crash speed of 40 km/h, the placental abruption area was 7.0% with a correctly positioned lap belt across the lower abdomen; it was 36.3% with the belt positioned at the umbilicus. The area of placental abruption depended on collision speed, but we found that with a correctly positioned belt it likely would not lead to negative fetal outcomes. We examined the effects on placental abruptions of reconfiguring seat belt width and force limiter setting. A wider lap belt and lower force limiter setting reduced the area of placental abruption to 3.5% and 1.1%, respectively; however, they allowed more forward movement upon collision. A 2.5 kN force limiter setting may be appropriate with respect to both forward movement and reduced placental abruption area. This study confirmed the importance of correctly using seat belts for pregnant drivers. It provides valuable evidence about improving safety equipment settings.

Injury Severity Analysis of Rear-End Crashes at Signalized Intersections

Signalized intersections are common hotspots for rear-end crashes, causing severe injuries and property damage. Despite recent attempts to determine the contributing causes to injury severity in this crash type, the frequency of severe rear-end crashes is still significant. Therefore, exploring commonly omitted potential risk factors is essential to proper detection of contributing factors to these crashes and planning appropriate countermeasures. This research incorporated the examination of intersection crash data in Wyoming to examine injury severity risk factors in this crash type. The study examined a set of potential roadway, driver, crash, and environmental risk factors, including pavement surface friction, which is a commonly omitted factor in relevant studies. A random-parameters ordinal probit model was developed for the analysis. The findings demonstrated that two crash attributes (motorcycle involvement and improper seat belt use), three driver’s attributes (driver’s condition, age, and gender), and two environmental and roadway characteristics (road condition and pavement friction) impacted the injury severity of rear-end crashes at signalized intersections.

Meralgia paraesthetica as complication of patient positioning : Anot fully controllable risk

Als Meralgia paraesthetica (MP) bezeichnet man eine zu den neurologischen Engpasssyndromen zählende Schädigung des aus dem Plexus lumbalis entspringenden sensiblen N. cutaneus femoris lateralis. Symptome sind temporäre oder bleibende Parästhesien und Schmerzen an der Vorder- und Außenseite des Oberschenkels. Die MP kann idiopathisch auftreten, sich genuin als z. B. „seat belt syndrome“ oder „Jeans-Syndrom“ verwirklichen, sie kann aber auch Folge eines operativen Eingriffs oder einer chirurgischen bzw. intensivmedizinischen Lagerung sein. Im Fokus stehen hierbei in der Literatur die Steinschnitt-, die Bauch- und die „Beach-chair“-Lagerung.Analysiert wurden 21 Beschwerden über eine postoperativ erstmals aufgetretene MP, die bei der Gutachterkommission für ärztliche Behandlungsfehler bei der Ärztekammer Nordrhein im Verlauf der letzten 10 Jahre eingereicht wurden. Unter diesen konnten 6 Fälle als Lagerungsschaden nach Steinschnittlagerung identifiziert werden; in 3 Fällen trat eine MP nach Rückenlagerung auf; die Ätiologie konnte nicht sicher geklärt werden. In 12 Fällen wurde die MP als direkte Operationskomplikation erkannt.Pathophysiologie, Inzidenz und Verlauf sowie juristische Implikationen der lagerungsbedingten MP werden beschrieben. Als hauptsächlicher Pathomechanismus wird eine Druckschädigung des Nervs an seiner Kreuzungsstelle mit dem Leistenband diskutiert. Wenngleich alle hier vorgestellten Fälle nach der Steinschnittlagerung auftraten, scheint sich die Komplikation nach Literaturdaten auch bei anderen Lagerungsarten, am häufigsten möglicherweise bei Bauchlagerungen, zu verwirklichen. Dies erklärt auch die zunehmenden Fallberichte einer MP nach Bauchlagerung bei COVID-19-Patient*innen. Eine sichere Vermeidung der lagerungsbedingten Komplikation erscheint aufgrund der anatomischen Variabilität des Nervenverlaufs und der unklaren Pathomechanismen nicht möglich.

Mondor's Disease Superficial Thrombophlebitis of the Chest Wall: Case Report of a Rare Condition

Introduction: Superficial thrombophlebitis of the chest wall is referred to as Mondor's disease (MD). Other atypical locations such as abdominal, inguinal and penile regions have been described in the literature [1]. In the thoracic region, the veins mainly affected are the thoracoepigastric vein and the superior epigastric vein. Its incidence is low and it generally occurs in the middle-aged people [2]. It is a benign, self-limited lesion whose treatment is usually conservative. The resolution of the clinical picture in most cases occurs within 4 to 8 weeks [2, 5]. Clinical Case: A 41- year-old female patient, no personal pathologic history. She went to the doctor for medical consultation due to the presence of a lump in the right submammary region after thoracic trauma with a car seat belt in a traffic accident of 12 days of evolution. She reported pain and progressive increase of the lump size. Physical examination revealed the presence of a venous lump in the right chest and abdominal wall, 1 cm in diameter, solid, painful on palpation, extending from the right submammary region to the right side with a length of 13 cm. Based on the clinical and ultrasound study, a diagnosis of Mondor's disease was made. An initial conservative management was decided with the use of anti- inflammatory drugs, analgesics and clinical and ultrasound monitoring at 4 weeks. Conclusion: Mondor's disease is a clinical disease of infrequent occurrence; its diagnosis is based mainly on a detailed clinical history and can be complemented with color Doppler ultrasound. Being a self-limited disease, the treatment with the highest success rates is conservative, reserving surgery in cases of difficult pain treatment.

Longitudinal relationships between youth assets, seat belt use while driving, and the environment

Abstract Background Positive youth development theory can provide an alternative approach to promote Seat Belt Use while Driving in a Car (SBUDC) among youth. The study aims to explore the relationship between youth assets, and the neighborhood environment in predicting SBUDC. Methods The Youth Asset Study (YAS) is a 4-year (5 waves) longitudinal study of a random sample of 1,111 youth (12-17 years old) and their parents, taking place in a Midwestern city, USA from 2003-2008. Seventeen youth assets were developed. The environment was measured objectively via the broken windows survey and subjectively via parents’ interviews. Assets and environmental factors at Waves 1-4 were predicted SBUDC at Waves 4-5 while controlling for demographics. Data were analyzed via marginal logistic regression and generalized estimated equations analyses. Results The sample consisted of 1001 youth: 53% female; mean age=14.36 (SD = 1.59); 50% with income &amp;lt;$35,000; and 69% two-parent families. The proportion of youth not wearing a seat belt while driving increased from wave 4 to 5 only among African American youth. Individually, most assets had a positive relationship with SBUDC (ORs ranged from 1.3 to 2.7), with general aspirations for the future, educational aspirations for the future and positive peer role models having the largest ORs [2.7, 95% CI (1.7, 4.3); 2.2, 95% CI (1.5, 2.0); 1.9, 95% CI (1.5,2.4)] respectively. Youth with a higher (≥ 12) number of assets were almost twice as likely to use a seat belt while driving than those with a lower (&amp;lt;12) number [OR = 1.8, 95% CI (1.4, 2.3)]. Only one environmental factor had a significant effect on SBUDC [(OR = 1.32, 95% CI (1.01, 1.72)]. Assets retained their impact on SBUDC, controlling for the environmental and demographic factors. Conclusions Youth assets can be a promising approach to promote SBUDC among teens with emphasis on promoting general aspirations for the future, educational aspirations, and positive peer role modeling. Key messages • Building youth assets can be another mechanism to promote seat belt use while driving among youth. • The neighborhood environment might not be as important as other factors are in the promotion of seat belt use while driving.

Longitudinal relationships between youth assets, seat belt use as a rider, and the environment

Abstract Background Positive youth development theory can provide an alternative approach to promote Seat Belt Use while Riding in a Car (SBURC) among youth. The study aims to explore the relationship between youth assets, and the neighborhood environment in predicting SBURC. Methods The Youth Asset Study (YAS) is a 4-year (5 waves) longitudinal study of a random sample of 1,111 youth (12-17 years old) and their parents, taking place in a Midwestern city, USA from 2003-2008. Seventeen youth assets were developed. The environment was measured objectively via the broken windows survey and subjectively via parents’ interviews. Assets and environmental factors at Waves 1-4 predicted SBURC at Waves 4-5 while controlling for demographics. Data were analyzed via marginal logistic regression and generalized estimated equations analyses. Results The sample consisted of 1001 youth: 53% female; mean age=14.36 (SD = 1.59); 50% with income &amp;lt;$35,000; and 69% two-parent families. The proportion of youth not wearing a seat belt while riding in a car decreased from wave 4 to 5 among all youth. Individually, most assets had a positive relationship with SBURC (ORs ranged from 1.4 to 2.0), with parental monitoring, responsible choices, general aspirations for the future and good health practices having the largest ORs [2.0, 95% CI (1.5, 2.7); 1.9, 95% CI (1.5, 2.6); 1.8, 95% CI (1.2,2.8); 1.8, 95% CI (1.5,2.3)] respectively. Youth with a higher (≥ 12) number of assets were almost twice as likely to use a SBURC than those with a lower (&amp;lt;12) number [OR = 1.9, 95% CI (1.5, 2.3)]. Only one environmental factor, had a significant effect on SBURC [(OR = 0.64, 95% CI (0.45, 0.90)]. Assets retained their impact on SBURC, controlling for the environmental and demographic factors. Conclusions Youth assets can be an alternative approach to promote SBURC among teens with emphasis on promoting parental monitoring, responsible choices, general aspirations for the future, and good health practices. Key messages • Building youth assets can be another mechanism to promote seat belt use while driving among youth. • The neighborhood environment might not be as important as other factors are in the promotion of seat belt use while driving.

Motor Vehicle Crash and Hospital Charges in Front- and Rear-Seated Restrained and Unrestrained Adult Motor Vehicle Occupants.

There are reports that historically higher mortality observed for front- compared to rear-seated adult motor vehicle (MV) occupants has narrowed. Vast improvements have been made in strengthening laws and restraint use in front-, but not rear-seated occupants suggesting there may be value in expanding the science on rear-seat safety. Methods. A linked 2016–2017 hospital and MV crash data set, the Crash Outcomes Data Evaluation System (CODES), was used to compare characteristics of front-seated (n = 115,939) and rear-seated (n = 5729) adults aged 18 years and older involved in a MV crash in New York State (NYS). A primary enforced seat belt law existed for front-seated, but not rear-seated occupants. Statistical analysis employed SAS 9.4. Results. Compared to front-seated occupants, those rear-seated were more likely to be unrestrained (21.2% vs. 4.3%, p < 0.0001) and to have more moderate-to-severe injury/death (11.9% vs. 11.3%, p < 0.0001). Compared to restrained rear-seated occupants, unrestrained rear-seated occupants had higher moderate-to-severe injury/death (21.5% vs. 7.5%, p < 0.0001) and 4-fold higher hospitalization. More than 95% of ejections were unrestrained and had 7-fold higher medical charges. Unrestrained occupants’ hospital stays were longer, charges and societal financial costs higher. Conclusions. These findings extend the science of rear-seat safety in seriously injured rear-seated occupants, document increased medical charges and support the need to educate consumers and policy makers on the health and financial risks of adults riding unrestrained in the rear seat. The lack of restraint use in adult rear-seated motor vehicle occupants consumes scarce health care dollars for treatment of this serious, but largely preventable injury.

Optimization of the driver's seat belt and injury biomechanical analysis in real-world minivan small offset impact accident scenarios.

To minimize injuries and protect the safety of the driver in minivan small offset collisions, an optimized pre-tensioned force-limiting seat belt was proposed herein. An accident with detailed information, such as medical reports, vehicle inspection reports, and accident scene photographs, was reconstructed using HyperMesh software. The effectiveness of both the accident model and the pre-tensioned force-limiting seat belt was evaluated. To obtain the optimal seat belt parameters for driver protection, first, force-limiting A, pre-tensioned force B, and pre-tensioned time C factors were selected in designing an orthogonal test with different factor levels. The influence laws of each factor on the injury biomechanical characteristics of the driver were analyzed via the direct analysis method. Moreover, each kind of critical injury value of the human body was synthesized, and the radial basis function surrogate model was constructed. The three seat belt parameters were optimized using the NSGA-II multi-objective genetic algorithm. The results showed that the optimal balance variable parameter of the seat belt was 4751.618 N-2451.839 N-17.554ms (A-B-C). Finally, the optimal scheme was verified in a system simulating a minivan small offset collision. The results showed that after optimization, the skull von Mises stress was reduced by 36.9%, and the stress of the cervical vertebra cortical bone and cancellous bone decreased by 29.1% and 30.8%, respectively. In addition, the strains of the ribs and lungs decreased by 31.2% and 30.7%, respectively.

Young adults in motor vehicle collisions in Norway: user safety errors observed in majority of cases with severe or fatal injuries

PurposeWe performed a multidisciplinary investigation of young adults involved in motor vehicle collisions (MVCs) to elucidate injury mechanisms and the role of passive safety equipment such as seat belts and airbags.MethodsMVCs resulting in death or serious injuries to the driver or passengers aged 16–24 years in southeastern Norway during 2013–2016 were investigated upon informed consent. We assessed the crash scene, the motor vehicle (MV) interior and exterior, and analyzed data from medical records, forensic autopsies and reports from police and civil road authorities.ResultsThis study included 229 young adult occupants involved in 212 MVCs. The Maximum Abbreviated Injury Scale (MAIS) score was ≥2 in 111 occupants, of which 22 were fatalities. In 59% (65/111) of the cases with MAIS score ≥2 injuries, safety errors and occupant protection inadequacies were considered to have contributed to the injury outcome. Common errors were seatbelt non-use and misuse, carrying insecure luggage, and the seat back being too reclined. MAIS score ≥2 head/neck injuries were observed in side impacts despite correct seatbelt use, related to older MVs lacking side airbag curtains. The independent risk factors for MAIS score ≥2 injuries included not using a seatbelt, driving under the influence of alcohol or drugs, nighttime driving, side impacts, heavy collision partner, and MV deformation.ConclusionUser safety errors (not using a seatbelt, seatbelt misuse, excessive seat-back reclining, and insecure cargo) and a lack of occupant protection in older MVs resulted in young adults sustaining severe or fatal injuries in MVCs.

Abdominal Seat Belt Sign Is Associated with Similar Incidence of Hollow Viscus Injury but Increased Mortality in Trauma in Patients 65 Years and Older: A PCSA Multicenter Study

INTRODUCTION: The abdominal seat belt sign (A-SBS) is associated with increased risk of hollow viscus injury (HVI). Previous studies have shown that older age is associated with worse outcomes in trauma patients. Older adults (65 years or older) may be at increased risk of HVI with A-SBS. Hence, we hypothesized that HVI and mortality is increased in OAs compared with younger patients (younger than 65 years) with A-SBS. METHODS: This multi-institutional, prospective, observational study (August 2020 to October 2021) included patients 18 years or older with an A-SBS who underwent abdominal CT imaging. No patients were excluded. OAs were compared with younger trauma patients with bivariate analyses. RESULTS: There were 754 patients (110 OAs; 644 younger) included from 9 Level I trauma centers. OAs presented with a higher mean injury severity score (10.8 vs 9.0; p = 0.02), although the younger cohort presented with a higher abdominal abbreviated-injury scale score (2.01 vs 1.63; p = 0.02). On CT imaging, OAs were less likely to present with intra-abdominal free fluid (21.7% vs 11.9%; p = 0.02; Table) despite a similar rate of abdominal soft tissue contusion (p > 0.05). Although HVI was comparable in both groups (5.5% vs 9.8%; p =0.15), OAs experienced increased mortality (5.5% vs 1.1%; p < 0.01) and length of stay (5.9 vs 4.9 days; p < 0.01). Table. - Patient Demographics and Presentation Demographics/Presentation Younger (<65) Older Adults (≥65) p Value Age, mean (SD) 35.8 (13.9) 75.3 (7.0) <0.01 Injury Severity Score, mean (SD) 9.0 (8.2) 10.8 (8.8) 0.02 Abdomen Abbreviated Injury Scale, mean (SD) 2.01 (1.09) 1.63 (0.79) 0.02 Glasgow Coma Scale, mean (SDs) 14.6 (1.5) 14.6 (1.6) 0.73 Positive Fast Scan, n (%) 29 (4.5) 7 (6.4) 0.40 Soft Tissue Seat Belt Sign, n (%) 342 (53.9) 60 (55) 0.82 Free fluid, n (%) 139 (21.7) 13 (11.9) 0.02 Hollow viscus injury, n (%) 63 (9.8) 6 (5.5) 0.15 Mortality, n (%) 7 (1.1) 6 (5.5) <0.01 CONCLUSION: Despite a similar rate of HVI, OAs with an A-SBS had an increased rate of mortality and hospital length of stay. To improve quality of care in this population, there should be heightened vigilance when caring for OAs presenting with A-SBS.