Occupant dynamics in rollover crashes: influence of roof deformation and seat belt performance on probable spinal column injury.
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ABSTRACT:
SUBMITTER: Bidez MW
PROVIDER: S-EPMC2040176 | biostudies-other | 2007 Nov
REPOSITORIES: biostudies-other
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Project description:INTRODUCTION:The use of seat belts could prevent severe collision damage to people in vehicle accidents and keep passengers safe from sustaining serious injuries; for instance, it could prevent passengers from being thrown out of a vehicle after the collision. The current systematic review will identify and analyse the determinants of seat belt use behaviour. METHODS AND ANALYSIS:We will include qualitative, quantitative and mixed methods studies reporting the acquired data from passengers aged more than 12 years and drivers, from both commercial and personal vehicles. Online databases including MEDLINE/PubMed, Scopus, Web of Science, Embase, Cochrane Database of Systematic Reviews and PsycINFO will be investigated in the current study. Published and available articles will be evaluated according to their titles and abstracts. Published papers conforming to the inclusion criteria will be organised for a complete review. Next, the full text of the remaining articles will be studied independently for eligibility by two authors. The quality of the selected studies will be assessed with appropriate tools. Based on the information obtained from the data extraction, the type of determinants of seat belt use will be classified. ETHICS AND DISSEMINATION:Ethics approval is not required, because this is a protocol for a systematic review and no primary data will be collected. The authors will ensure to maintain the rights of the used and included articles in the present systematic review. The findings of this review will be published in a relevant peer-reviewed journal. PROSPERO REGISTRATION NUMBER:CRD42017067511.
| S-EPMC5942405 | biostudies-literature
Project description:The objective was to evaluate the effectiveness of belt-positioning booster seats, compared with no restraint use and with seat belt use only, during motor vehicle crashes among U.S. children.This was a retrospective matched cohort study with data from the 1998 through 2009 National Automotive Sampling System (NASS) Crashworthiness Data System (CDS). The study sample consisted of children aged 0 to 10 years who were not seated in the front seat of the vehicle. We used Cox proportional hazards models to estimate the risk of overall, fatal, and regional body injury.Children using seat belts in belt-positioning booster seats experienced less overall injury (Injury Severity Score [ISS] > 0, adjusted risk ratio [RR] = 0.73, 95% confidence interval [CI] = 0.55 to 0.96; Abbreviated Injury Scale [AIS] score of 2 or higher, adjusted RR = 0.30, 95% CI = 0.16 to 0.58; ISS > 8, adjusted RR = 0.19, 95% CI = 0.06 to 0.56), and less injury in most body regions except the neck (adjusted RR = 4.79, 95% CI = 1.43 to 16.00) than did children with no restraint use. Children using seat belts in belt-positioning booster seats had an equal risk of injury but higher risks of neck (adjusted RR = 1.86, 95% CI = 1.02 to 3.40) and thorax (adjusted RR = 2.86, 95% CI = 1.33 to 6.15) injury than did children restrained by seat belts only.Children using belt-positioning booster seats appear to experience a higher risk of AIS > 0 injury to the neck and thorax than do children using seat belts only. Future research should examine whether the observed increase in neck and thorax injuries can be attributed to improper use of booster seats.
| S-EPMC3798005 | biostudies-literature
Project description:IntroductionAppendiceal injuries following a blunt abdominal trauma are rare. Upon literature review, several cases have been reported to develop appendicitis following blunt abdominal trauma, but total transection of the appendix is extremely rare.Case presentationOur case involves a 24-year-old male restrained driver who was involved in a motor vehicle accident. He had bruising corresponding to the pattern of the seatbelt, the 'seatbelt sign', on admission. On his second day of admission, he was found to have a rigid abdomen. On exploratory laparotomy, the patient had a completely transected appendix with a 10?×?10 cm piece of transected omentum lying in the pelvic cavity.DiscussionLiterature suggests that seat belts may play a role in the mechanism of injury leading to transection.ConclusionSince the introduction of seatbelt in the 1970s, fatalities from road traffic accidents have fallen by up to 60%. However, the seat belt itself is associated with a unique injury profile, including intestinal tears, perforations, and transections, collectively termed "the seatbelt syndrome". Seat belt syndrome injuries may sometimes have a delayed presentation, thus repeated abdominal examination is recommended even if the patient is initially stable. Appendiceal transection is rare but may occur. A thorough inspection of the abdominal soft tissue to look for accompanying injuries is important if case an exploratory laparotomy is warranted.
| S-EPMC6120345 | biostudies-literature
Project description:BackgroundSeat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers.MethodsThe databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis.ResultsSixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis.ConclusionsIn general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.
| S-EPMC10393920 | biostudies-literature
Project description:While isolated traumatic urinary bladder injuries are rare, combined intra- and extraperitoneal traumatic urinary bladder ruptures without an underlying fracture are an absolute rarity.We report a case of combined intra- and extraperitoneal urinary bladder rupture without an underlying fracture resulting from blunt abdominal trauma during a high velocity car accident. A midline laparotomy was performed, and the intra- and extraperitoneal bladder ruptures were surgically treated.Based on the presented case the anatomical peculiarities of the urinary bladder and the different trauma mechanisms as well as the resulting lesions, the diagnostic modalities and the treatment options are discussed.Despite the rarity of traumatic urinary bladder injuries, and especially in the absence of an underlying fracture, physicians should maintain a high level of suspicion for urologic injuries in the presence of nonspecific lower abdominal pain, gross haematuria and the inability to urinate.
| S-EPMC5537388 | biostudies-other
Project description:BackgroundMiddle-column gap balancing (MCGB) is a reference measurement of the path of the posterior longitudinal ligament (PLL), which is reconstructed under tension and balanced by the combined height of the posterior one-third of the vertebral bodies and the posterior one-third of the disks, including any intervening load-sharing spacers. This measurement allows for a comparison of the ligamentous component of the middle column (PLL) with the load-sharing components (posterior one-third vertebral body?+?disk ). This difference gives rise to a "middle-column mismatch," which provides a linear measurement of the redundancy of the ligaments and neural elements, which relates to the correct cage, spacer, or load-bearing height, which is optimized.MethodsFor phase 1 measurement testing, 24 consecutive patients underwent reliable flexion, extension, and neutral lateral radiographic studies with a calibrated marker. The anterior, middle, and posterior columns were measured using a custom software program capable of measuring the length of curved lines specifically written for this purpose. For phase 2 measurement testing, 21 consecutive patients undergoing surgery with multilevel deformities for cervical, thoracic, and lumbar procedures had MCGB height pre- and postoperatively measured by 3 blinded observers. The preoperative and postoperative measurements were compared using a linear regression analysis and Pearson product-moment correlation.ResultsIn phase 1 measurement testing the flexion, extension, and neutral bending radiographs of spinal segments not containing deformities showed that the middle column had the most reliable measurements of spinal axial height both in the actual measurements of change from flexion to extension (mm) and in percentage of change. In phase 2 measurement testing, a Pearson product-moment correlation was run between each individual's pre- and postoperative middle-column measurements. There was a strong positive correlation between preoperative and postoperative measurements, which was statistically significant (r?=?0.983, n?=?21, P?<?.01).ConclusionsThis consecutive series of 21 deformity patients demonstrated the utility of measuring the preoperative middle-column length in predicting the optimal height of the spacers and intervertebral disks, and posterior vertebral body height, simultaneously restoring sagittal and coronal plane alignment. Key points of this study include the following: (1) Spinal balance requires optimizing spinal height, which is a curved line in order to accommodate cervical lordosis, thoracic kyphosis, and lumbar lordosis. (2) Software programs can allow measurement of the preoperative curved circuitous course of the PLL and vertebral body misalignment; this curved length is predictive of the optimal postoperative middle-column height after spinal osteotomies and intervertebral spacer insertion. (3) All 3 dimensions are important to optimize in deformity correction: sagittal plane, coronal plane, and axial spinal height.
| S-EPMC6159728 | biostudies-literature
Project description:UnlabelledThe ability to treat severe pediatric and adult spinal deformities through an all-posterior vertebral column resection (VCR) has obviated the need for a circumferential approach in primary and revision surgery, but there is limited literature evaluating this new approach. Our purpose was therefore to provide further support of this technique. We reviewed 43 patients who underwent a posterior-only VCR using pedicle screws, anteriorly positioned cages, and intraoperative spinal cord monitoring between 2002 and 2006. Diagnoses included severe scoliosis, global kyphosis, angular kyphosis, or kyphoscoliosis. Forty (93%) procedures were performed at L1 or cephalad in the spinal cord (SC) territory. Seven patients (18%) lost intraoperative neurogenic monitoring evoked potentials (NMEPs) data during correction with data returning to baseline after prompt surgical intervention. All patients after surgery were at their baseline or showed improved SC function, whereas no one worsened. Two patients had nerve root palsies postoperatively, which resolved spontaneously at 6 months and 2 weeks. Spinal cord monitoring (specifically NMEP) is mandatory to prevent neurologic complications. Although technically challenging, a single-stage approach offers dramatic correction in both primary and revision surgery of severe spinal deformities.Level of evidenceLevel IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
| S-EPMC2816784 | biostudies-literature
Project description:Pumpable roof supports are currently being used to provide a safe working environment for longwall mining. Because different pumpable supports are visually similar and installed fundamentally in the same manner as other supports, there is a tendency to believe they all perform the same way. However, there are several design parameters that can affect their performance, including the cementitious material properties and the bag construction practices that influence the degree of confinement provided. A full understanding of the impact of these design parameters is necessary to optimize the support application and to provide a foundation for making further improvements in the support performance. This paper evaluates the impact of various support design parameters by examining full-scale performance tests conducted using the National Institute for Occupational Safety and Health (NIOSH) Mine Roof Simulator (MRS) as part of manufacturers' developmental and quality control testing. These tests were analyzed to identify correlations between the support design parameters and the resulting performance. Based on more than 160 tests over 7 years, quantifiable patterns were examined to assess the correlation between the support dimensions, cementitious material type, wire pitch, and single-wall vs. dual-walled bag designs to the support capacity, stiffness, load shedding events, and yield characteristics.
| S-EPMC5538587 | biostudies-other
Project description:BackgroundUndisputedly, traffic crashes constitute a public health concern whose impact and importance have been increasing during the past few decades. Specifically, road safety data have systematically shown how cyclists are highly vulnerable to suffering traffic crashes and severe injuries derived from them. Furthermore, although the empirical evidence is still very limited in this regard, in addition to other human factors involved in cycling crashes, distractions while cycling appear to be a major contributor to the road risk of cyclists.ObjectivesThe main objectives of this study were, first, to explore the prevalence and trends of cycling distractions within an international sample of bike users, and second, to determine the influence of such distractions on road crashes suffered by cyclists, simultaneously considering the explanatory role of risky behaviors (errors and traffic violations) as potentially mediating variables between cycling distractions and traffic crashes.MethodsFor this cross-sectional study, we analyzed the data obtained from 1,064 cyclists-61.2% male and 38.8% female-from 20 different countries, who answered an on-line questionnaire on cycling-related features, habits, behaviors and accidents.ResultsThe prevalence of different cycling distractions oscillated between 34.7% and 83.6%. The most common distractions were those related to the behavior of other users, physical elements of the road, weather conditions and phone calls. Age trends and differences were also found, thus establishing a positive association between age and distractibility during cycling. Furthermore, the effect of distractions on traffic crashes of cyclists was significant when tested together with age, risk perception and risky behaviors on the road.ConclusionThe results of this study support the hypotheses that distractions have a major prevalence among bike users, and that they play a significant role in the prediction of the traffic crash rates of cyclists, through the mediation of risky behaviors.
| S-EPMC6139010 | biostudies-literature
Project description:Analyzing the seismic performance and flexural capacity of beam-column joints is crucial in structural design phase. The purpose of this paper is to investigate the seismic performance and flexural capacity of precast prestressed efficiently fabricated frame (PPEFF) joints. Reverse cyclic load tests and flexural capacity analysis are conducted. The damage modes, hysteresis curves, skeleton curves, stiffness degradation, ductility, and energy dissipation capacity of five PPEFF joint specimens with different reinforcement rates of the energy-dissipating bars and shear reinforcement are obtained. The results show that the damage pattern of the specimen is ideal, i.e., the plastic hinge region at the end of the beam is severely damaged, whereas the remainder of the beam is slightly damaged. Increasing the reinforcement rate of the energy-consuming steel bars enhances the load capacity, energy dissipation capacity, and initial stiffness of the joint but reduces the ductility performance. The maximum change in ductility was 5.31 for the reinforcement rate of energy-consuming steel bars ranging from 0.38% to 0.59%. In addition, the flexural capacity of the PPEFF joint is evaluated, considering the influence of the shear steel on the yielding and ultimate states. An equation of the flexural capacity is derived. A good agreement is observed between the experimental and calculation results, verifying the correctness of the proposed flexural capacity equation.
| S-EPMC9292129 | biostudies-literature