Motorcycle helmet use and the risk of head, neck, and fatal injury: Revisiting the Hurt Study.

Science.gov (United States)

Rice, Thomas M; Troszak, Lara; Ouellet, James V; Erhardt, Taryn; Smith, Gordon S; Tsai, Bor-Wen

2016-06-01

Most studies find strong evidence that motorcycle helmets protect against injury, but a small number of controversial studies have reported a positive association between helmet use and neck injury. The most commonly cited paper is that of Goldstein (1986). Goldstein obtained and reanalyzed data from the Hurt Study, a prospective, on-scene investigation of 900 motorcycle collisions in the city of Los Angeles. The Goldstein results have been adopted by the anti-helmet community to justify resistance to compulsory motorcycle helmet use on the grounds that helmets may cause neck injuries due to their mass. In the current study, we replicated Goldstein's models to understand how he obtained his unexpected results, and we then applied modern statistical methods to estimate the association of motorcycle helmet use with head injury, fatal injury, and neck injury among collision-involved motorcyclists. We found Goldstein's analysis to be critically flawed due to improper data imputation, modeling of extremely sparse data, and misinterpretation of model coefficients. Our new analysis showed that motorcycle helmets were associated with markedly lower risk of head injury (RR 0.40, 95% CI 0.31-0.52) and fatal injury (RR 0.44, 95% CI 0.26-0.74) and with moderately lower but statistically significant risk of neck injury (RR 0.63, 95% CI 0.40-0.99), after controlling for multiple potential confounders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Neuroimaging of nonaccidental head trauma: pitfalls and controversies

Energy Technology Data Exchange (ETDEWEB)

Fernando, Sujan [University of Missouri-Kansas School of Medicine, Department of Medicine, Kansas City, MO (United States); Obaldo, Ruby E. [The University of Kansas Medical Center, Department of Radiology, Kansas City, MO (United States); Walsh, Irene R. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Emergency Medicine, Kansas City, MO (United States); Lowe, Lisa H. [The University of Missouri-Kansas City, Children' s Mercy Hospitals and Clinics, Department of Radiology, Kansas City, MO (United States)

2008-08-15

Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

Neuroimaging of nonaccidental head trauma: pitfalls and controversies

International Nuclear Information System (INIS)

Fernando, Sujan; Obaldo, Ruby E.; Walsh, Irene R.; Lowe, Lisa H.

2008-01-01

Although certain neuroimaging appearances are highly suggestive of abuse, radiological findings are often nonspecific. The objective of this review is to discuss pitfalls, controversies, and mimics occurring in neuroimaging of nonaccidental head trauma in order to allow the reader to establish an increased level of comfort in distinguishing between nonaccidental and accidental head trauma. Specific topics discussed include risk factors, general biomechanics and imaging strategies in nonaccidental head trauma, followed by the characteristics of skull fractures, normal prominent tentorium and falx versus subdural hematoma, birth trauma versus nonaccidental head trauma, hyperacute versus acute on chronic subdural hematomas, expanded subarachnoid space versus subdural hemorrhage, controversy regarding subdural hematomas associated with benign enlarged subarachnoid spaces, controversy regarding hypoxia as a cause of subdural hematoma and/or retinal hemorrhages without trauma, controversy regarding the significance of retinal hemorrhages related to nonaccidental head trauma, controversy regarding the significance of subdural hematomas in general, and pitfalls of glutaric aciduria type 1 and hemophagocytic lymphohistiocytosis mimicking nonaccidental head trauma. (orig.)

Laryngeal Fracture after Blunt Cervical Trauma in Motorcycle Accident and Its Management

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Nuno Ribeiro-Costa

2017-01-01

Full Text Available Laryngeal fracture is a rare traumatic injury, potentially fatal, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centers. Because of the rarity of this injury, physician may be not aware of its existence, leading to a late diagnosis of this entity. We report a case of a 59-year-old woman admitted to the emergency room after a motorcycle accident with cervical trauma. The patient presented with dysphonia, hemoptysis, cervical subcutaneous emphysema, and increasing respiratory distress that led to the intubation of the patient. CT-scan demonstrated displaced fracture of the cricoid and thyroid cartilage. The patient was submitted to tracheostomy and the fracture was surgically repaired. Tracheostomy was removed in third postoperative month. The patient presented a good recovery, reporting only hoarseness but without swallowing or breathing problems at 6-month follow-up.

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

International Nuclear Information System (INIS)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y.; Hibbard, Roberta A.; Hicks, Ralph A.

2017-01-01

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

Energy Technology Data Exchange (ETDEWEB)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Hibbard, Roberta A.; Hicks, Ralph A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Indianapolis, IN (United States)

2017-07-15

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

The burden of motorcycle-related neuro-trauma in Ireland and associated helmet usage.

LENUS (Irish Health Repository)

Murphy, R K J

2009-04-01

Motorcycles represent less than 2% of the licensed vehicles but motorcyclists account for 12% of road deaths in Ireland. The British Road Safety Authority has introduced the Sharp programme, which hopes to save 50 lives in the U.K. each year alone by helping riders to choose the best-fitting and safest helmets. We evaluated the pattern of head injuries sustained by motorcyclists referred to the two neurosurgical centres Beaumont Hospital and Cork University Hospital in Ireland and ascertained if the new SHARP guidelines could be of benefit in reducing the burden of motorcycle related neurotrauma and disability in Ireland. Despite Ireland having mandatory helmet laws almost a quarter of our motorcyclists with traumatic brain injury were unhelmeted. A significant reduction in mortality and morbidity is predicted if all motorcyclists in Ireland were to wear helmets that satisfied the SHARP criteria.

Nutrition in Patients with Head Trauma

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Burcu Totur

2013-01-01

Full Text Available The need of energy increases by 40% in patients with a head trauma, when compared to people who are living a normal life. This ratio reaches to 200% in some cases. It is important to give a nutrition support which can satisfy the energy need resulted from the hypermetabolic and hypercatabolic states and that is enough to help to fix the immunologic state and achieve a better result in healing the injury. When oral nutrition is not possible in the patient with a head trauma, their energy need is satisfied through enteral and parenteral nutrition. Though parenteral nutrition had held an important role in feeding patients with head trauma, enteral nutrition is applied much more widely today. Enteral and parenteral nutrition both has their own advantages and disadvantages. In the clinical and laboratory studies that had been held, it was found that enteral nutrition improved the systemic immunity, decreased the incidence of the major infectious complications, decreased the metabolic response to trauma, protected the intestinal mucosa, and protected the ecologic balance of the microflora. In this article, it is investigated through the importance of the feeding in patients with a head trauma and reasons to chose enteral nutrition

Otolith function in patients with head trauma.

Science.gov (United States)

Lee, Jong Dae; Park, Moo Kyun; Lee, Byung Don; Park, Ji Yun; Lee, Tae Kyung; Sung, Ki-Bum

2011-10-01

This study evaluates the otolith function of patients with head trauma, postulating that otolith dysfunction is a cause of nonspecific dizziness after head trauma. We prospectively enrolled 28 patients referred within 3 months after head trauma between March 2007 and December 2009. Pure tone audiometry, caloric testing and otolith function tests, including cervical vestibular evoked myogenic potential (cVEMP) and subjective visual vertical (SVV) tests, were performed on all patients. The relationship between otolith function and otologic symptoms was analyzed. Of the 28 patients with head trauma, 18 complained of dizziness and 12 experienced hearing loss, including 6 patients who complained of both. On defining otolith dysfunction as an abnormal cVEMP or abnormal SVV, a significant difference in otolith dysfunction existed between the groups with and without dizziness [72 (13/18) vs. 20% (2/10)]. In contrast, no significant difference in otolith dysfunction was detected between the abnormal and normal hearing groups. A significant number of the patients who complained of nonspecific dizziness after trauma had abnormal otolith function. After trauma, when patients complain of dizziness, vestibular function tests, including otolith function tests, should be considered.

Effects of repealing the motorcycle helmet law in Michigan.

Science.gov (United States)

Hothem, Zachary; Simon, Robert; Barnes, Wesley; Mohammad, Azmath; Sevak, Shruti; Ziegler, Kathryn; Iacco, Anthony; Janczyk, Randy

2017-09-01

In 2012, Michigan repealed its universal helmet law. Our study assessed the clinical impact of this repeal. Our trauma database was queried retrospectively for 2 motorcycle riding seasons before and 3 seasons after repeal. On-scene death data was obtained from the Medical Examiner. Helmet use in hospitalized patients decreased after the helmet law repeal. Non-helmeted patients had a significant increased rate of head injury. Non-helmeted patients were more likely to die during hospitalization. While, helmet use and drugs/alcohol status significantly affected the risk for head injury, only drug/alcohol had a significant effect on overall mortality. Following helmet law repeal, helmet use has decreased. Helmet status and drug/alcohol use was found to significantly increase risk of head injury. Although overall mortality was only affected by drug/alcohol use, non-helmeted patients did have a higher inpatient mortality. These findings deserve furthermore study and may provide a basis for reinstating the universal helmet law. Copyright © 2016 Elsevier Inc. All rights reserved.

Federally mandating motorcycle helmets in the United States.

Science.gov (United States)

Eltorai, Adam E M; Simon, Chad; Choi, Ariel; Hsia, Katie; Born, Christopher T; Daniels, Alan H

2016-03-09

Motorcycle helmets reduce both motorcycle-related fatalities and head injuries. Motorcycle crashes are a major public health concern which place economic stress on the U.S. healthcare system. Although statewide universal motorcycle helmet laws effectively increase helmet use, most state helmet laws do not require every motorcycle rider to wear a helmet. Herein, we propose and outline the solution of implementing federal motorcycle helmet law, while addressing potential counterarguments. The decision to ride a motorcycle without a helmet has consequences that affect more than just the motorcyclist. In an effort to prevent unnecessary healthcare costs, injuries, and deaths, public health efforts to increase helmet use through education and legislation should be strongly considered. Helmet use on motorcycles fits squarely within the purview of the federal government public health and economic considerations.

Neuroimaging differential diagnoses to abusive head trauma

Energy Technology Data Exchange (ETDEWEB)

Girard, Nadine [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Aix Marseille University, UMR CNRS 7339, Marseille (France); Brunel, Herve; Dory-Lautrec, Philippe [AP-HM Timone 2, Department of Neuroradiology, Marseille cedex 05 (France); Chabrol, Brigitte [AP-HM Timone, Department of Pediatric Neurology, Marseille (France)

2016-05-15

Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

Neuroimaging differential diagnoses to abusive head trauma

International Nuclear Information System (INIS)

Girard, Nadine; Brunel, Herve; Dory-Lautrec, Philippe; Chabrol, Brigitte

2016-01-01

Trauma is the most common cause of death in childhood, and abusive head trauma is the most common cause of traumatic death and morbidity in infants younger than 1 year. The main differential diagnosis of abusive head trauma is accidental traumatic brain injury, which is usually witnessed. This paper also discusses more uncommon diagnoses such as congenital and acquired disorders of hemostasis, cerebral arteriovenous malformations and metabolic diseases, all of which are extremely rare. Diagnostic imaging including CT and MRI is very important for the distinction of non-accidental from accidental traumatic injury. (orig.)

Clinical Symptoms of Minor Head Trauma and Abnormal Computed Tomography Scan

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Maghsoudi

2015-11-01

Full Text Available Background Minor head trauma accounts for 70% to 90% of all head traumas. Previous studies stated that minor head traumas were associated with 7% - 20% significant abnormal findings in brain computed tomography (CT-scans. Objectives The aim of this study was to reevaluate clinical criteria of taking brain CT scan in patients who suffered from minor head trauma. Patients and Methods We enrolled 680 patients presented to an academic trauma hospital with minor head trauma in a prospective manner. All participants underwent brain CT scan if they met the inclusion criteria and the results of scans were compared with clinical examination finding. Results Loss of consciousness (GCS drop or amnesia was markedly associated with abnormal brain CT scan (P < 0.05. Interestingly, we found 7 patients with normal clinical examination but significant abnormal brain CT scan. Conclusions According to the results of our study, we recommend that all patients with minor head trauma underwent brain CT scan in order not to miss any life-threatening head injuries.

Burden of motorcycle-related injury in Malaysia.

Science.gov (United States)

Rahman, Nik Hisamuddin Na; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

2015-01-01

Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. The cross-sectional survey involves data searching related to RTI in Malaysia from the relevant agencies such as the Ministry of Health Malaysia, Royal Police Force, and Malaysia Institute of Road Safety Research (MIROS) through their official websites and PubMed search. The three agencies are well established and recognized by the Malaysian government in dealing with data collection for the injury nationwide. The primary aim is to determine the prevalence of motorcycle-related RTI, and secondary outcomes are the overall mortality and the contributing factors. Of the cause of trauma, 80 % is due to RTI, and the most vulnerable road users such as pedestrians and motorcyclists are affected the most. Of all RTI, 70 % is contributed by the motorcycle crash, and there are a significant number of deaths for both rider and pillion rider of the motorcycle than for other types of vehicles. Human error is the main reason to be blamed, specifically the attitude of the riders on the road. Trauma is one of the common reasons for death and hospitalization in Malaysia. Motorcycle-related RTI in Malaysia contributes significantly to the health burden in Malaysia. The Malaysian government and non-government agencies have worked together seriously in implementing a preventive measure to reduce the incidence and aftermath of motorcycle-related RTI. However, data is still lacking, and every effort is made to increase the amount of research in the field. Strengths of the article are as follows:Latest alarming data on motorcycle

Risk factors for mortality in children with abusive head trauma.

Science.gov (United States)

Shein, Steven L; Bell, Michael J; Kochanek, Patrick M; Tyler-Kabara, Elizabeth C; Wisniewski, Stephen R; Feldman, Kenneth; Makoroff, Kathi; Scribano, Philip V; Berger, Rachel P

2012-10-01

We sought to identify risk factors for mortality in a large clinical cohort of children with abusive head trauma. Bivariate analysis and multivariable logistic regression models identified demographic, physical examination, and radiologic findings associated with in-hospital mortality of children with abusive head trauma at 4 pediatric centers. An initial Glasgow Coma Scale (GCS) ≤ 8 defined severe abusive head trauma. Data are shown as OR (95% CI). Analysis included 386 children with abusive head trauma. Multivariable analysis showed children with initial GCS either 3 or 4-5 had increased mortality vs children with GCS 12-15 (OR = 57.8; 95% CI, 12.1-277.6 and OR = 15.6; 95% CI, 2.6-95.1, respectively, P < .001). Additionally, retinal hemorrhage (RH), intraparenchymal hemorrhage, and cerebral edema were independently associated with mortality. In the subgroup with severe abusive head trauma and RH (n = 117), cerebral edema and initial GCS of 3 or 4-5 were independently associated with mortality. Chronic subdural hematoma was independently associated with survival. Low initial GCS score, RH, intraparenchymal hemorrhage, and cerebral edema are independently associated with mortality in abusive head trauma. Knowledge of these risk factors may enable researchers and clinicians to improve the care of these vulnerable children. Copyright © 2012 Mosby, Inc. All rights reserved.

Computerized tomographic findings in children with head trauma in ...

African Journals Online (AJOL)

Objective: To describe the computerized tomographic findings in children with head trauma who presented at the University of Benin Teaching Hospital, Benin City, Nigeria. Methods: It is a retrospective review of patients aged 0 – 15 years with suspected intracranial injury (ICI) following head trauma, who presented for CT ...

Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis.

Science.gov (United States)

Passmore, Jonathon; Tu, Nguyen Thi Hong; Luong, Mai Anh; Chinh, Nguyen Duc; Nam, Nguyen Phuong

2010-04-01

To compare estimated prevalence of head injuries among road traffic injury patients admitted to hospitals, before and after the introduction of a mandatory helmet law in the Socialist Republic of Viet Nam. Before and after study of all road traffic injury patients with head injuries admitted to 20 provincial and central hospitals 3 months before and after the new law came into effect on 15 December 2007. Relative risk was computed and comparison made for the periods of 3 months before and after the new law. The study found a 16 percent reduction in the risk of road traffic head injuries (4683 to 3522; relative risk [RR] 0.84; 95% confidence interval [CI] 0.81-0.87) and an 18 percent reduction in the risk of road traffic death (deaths in hospital plus injured patients discharged to die at home; 566 to 417; RR 0.82; 95% CI 0.73-0.93). Over the first 3 months of the comprehensive mandatory helmet legislation there has been a significant reduction in the risk of road traffic head injuries among patients admitted to 20 hospitals. The Viet Nam Government's decision to require all motorcycle riders and passengers to wear helmets is suspected of leading to positive road safety benefits and should be seen as a policy example for other low- and middle-income countries with a high utilization of motorcycles for transport.

diagnostic imaging of acute head trauma

International Nuclear Information System (INIS)

Prayer, D.; Rametsteiner, C.

2001-01-01

Computed tomography (CT) is the primary modality of choice for imaging patients with acute head trauma. Lesions of the soft tissues and of the bones can be assessed more precisely than with other imaging modalities. With magnetic resonance imaging (MRI) additional information may be gained especially in subacute and chronic posttraumatic conditions. Urgent indication to perform a CT examination depends on the patient's history and on the mechanism of trauma. Imaging interpretation has been performed in the context of typical pathologic effects of trauma and with respect to potential therapy. (author)

Head Trauma in Mixed Martial Arts.

Science.gov (United States)

Hutchison, Michael G; Lawrence, David W; Cusimano, Michael D; Schweizer, Tom A

2014-06-01

Mixed martial arts (MMA) is a full combative sport with a recent global increase in popularity despite significant scrutiny from medical associations. To date, the empirical research of the risk of head injuries associated with this sport is limited. Youth and amateur participation is growing, warranting investigation into the burden and mechanism of injuries associated with this sport. (1) To determine the incidence, risk factors, and characteristics of knockouts (KOs) and technical knockouts (TKOs) from repetitive strikes in professional MMA; and (2) to identify the mechanisms of head trauma and the situational factors that lead to KOs and TKOs secondary to repetitive strikes through video analysis. Descriptive epidemiology study. Competition data and video records for all KOs and TKOs from numbered Ultimate Fighting Championship MMA events (n = 844) between 2006 to 2012. Analyses included (1) multivariate logistic regression to investigate factors associated with an increased risk of sustaining a KO or TKO secondary to repetitive strikes and (2) video analysis of all KOs and TKOs secondary to repetitive strikes with descriptive statistics. During the study period, the KO rate was 6.4 per 100 athlete-exposures (AEs) (12.7% of matches), and the rate of TKOs secondary to repetitive strikes was 9.5 per 100 AEs (19.1% of matches), for a combined incidence of match-ending head trauma of 15.9 per 100 AEs (31.9% of matches). Logistic regression identified that weight class, earlier time in a round, earlier round in a match, and older age were risk factors for both KOs and TKOs secondary to repetitive strikes. Match significance and previously sustained KOs or TKOs were also risk factors for KOs. Video analysis identified that all KOs were the result of direct impact to the head, most frequently a strike to the mandibular region (53.9%). The average time between the KO-strike and match stoppage was 3.5 seconds (range, 0-20 seconds), with losers sustaining an average of 2

Blunt Head Trauma and Headache

Directory of Open Access Journals (Sweden)

Ana B Chelse

2015-04-01

Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

Trauma pattern in a level I east-European trauma center

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Bogdan Stoica

2015-10-01

Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

Facial trauma among victims of terrestrial transport accidents.

Science.gov (United States)

d'Avila, Sérgio; Barbosa, Kevan Guilherme Nóbrega; Bernardino, Ítalo de Macedo; da Nóbrega, Lorena Marques; Bento, Patrícia Meira; E Ferreira, Efigênia Ferreira

2016-01-01

In developing countries, terrestrial transport accidents - TTA, especially those involving automobiles and motorcycles - are a major cause of facial trauma, surpassing urban violence. This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims' socio-demographic characteristics. Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n=103). The most affected age group was 20-29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Evaluation of Head Trauma Cases in the Emergency Department

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Alim Cokuk

2013-02-01

Full Text Available Aim: In this study, we aimed to determine the epidemiological characteristics, morbidity and mortality rates of patients admitted to the emergency department with head trauma. Material and Methods: In this study, ambulatory and hospitalized patients over the age of 18 brought to the Emergency Department because of head trauma between 01.12.2009 - 31.12.2010 were analyzed retrospectively. Patient data were recorded to standard data entry form. SPSS 17.0 package program was used for statistical analysis of data. The statistical significance level of all tests was p <0.05. Results: 5200 patients were included in this study. The average age of the patients was 39.97 ± 16.66 years. 4682'si patients (90 % were discharged from the emergency department. The most common reason for admission to the emergency department was falls (41.81 % in the discharged patients. 518 (10 % patients were hospitalized. Gender of these patients was 110 female (21:24% and 408 male (78.76%. 256 patients (48.35% were injured as a result of a traffic accident. 201(38.8% of the cerebral CT were reported as normal and 89 (17.2% of the cerebral CT were reported as traumatic subarachnoid hemorrhage (SAH in hospitalized patients. The fracture of lumbar spine (12 % was detected as an additional pathological disease in patients. 75 patients hospitalized because of head trauma (14.5% had died (1.44 % of all patients. Cervical spine fracture was the most common (14 patients, 18.68 % additional pathology in patients who died. Thoracic trauma was detected as the second most common (13 patients, 17.33 % additional pathology. Conclusion: Most of the patients admitted to the emergency department with head injury had a minor trauma. Patients can be discharged from the emergency department after a thorough physical examination and simple medical intervention. Most of the head injury patients admitted to hospital were male. The most common reason of the patients with head injury admitted to

Posterior urethral injuries associated with motorcycle accidents and pelvic trauma in adolescents: analysis of urethral lesions occurring prior to a bony fracture using a computerized finite-element model.

Science.gov (United States)

Bréaud, J; Montoro, J; Lecompte, J F; Valla, J S; Loeffler, J; Baqué, P; Brunet, C; Thollon, L

2013-02-01

Adolescent males involved in motorcycle accidents are particularly at risk for pelvic injury, which may provoke a posterior urethral injury. The aim of this study was to develop a model to analyze the association between injuries and fractures of the pelvic ring and the risk of posterior urethral injury. Based on experience with traffic accident modeling, a computerized finite-element model was extrapolated from a computerized tomography scan of a 15-year-old boy. The anatomic structures concerned in urethral and pelvic ring trauma were isolated, rendered in 3D and given biomechanical properties. The model was verified according to available experiments on pelvic ring trauma. To apply the model, we recreated three impact mechanisms on the pelvic ring: lateral impact, antero-posterior impact and a real car‒motorcycle accident situation (postero-lateral impact). In all three situations, stretching of the posterior urethra was identified prior to bony fracture visualization. Application of this model allowed us to analyze precisely the link between trauma of the pelvic ring and lesions of the posterior urethra. The results should help to establish guidelines for urethral catheterization in male adolescents in cases of pelvic trauma, even when no bony fracture is present, in order to prevent iatrogenic worsening of a misdiagnosed posterior urethral trauma. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Economic burden of motorcycle accidents in Northern Ghana.

Science.gov (United States)

Kudebong, M; Wurapa, F; Nonvignon, J; Norman, I; Awoonor-Williams, J K; Aikins, M

2011-12-01

Motorcycles are the most popular means of transportation in northern Ghana, and their accidents are major causes of out-patient attendance and admissions in the Bolgatanga Municipality. This paper estimates the economic burden of motorcycle accidents in the Bolgatanga Municipality in Northern Ghana. Retrospective cross-sectional cost study. Data were collected from Drivers and Vehicle Licensing Authority, the Police, health facilities and motorcycle accident victims. Both quantitative and qualitative approaches were used for data collection. Cost analysis was based on the standard road accident cost conceptual framework. Ninety-eight percent of vehicles registered in the municipality in 2004 - 2008 were motorcycles. The motorcycles were significantly more than the cars registered. The economic burden of motorcycle accidents was estimated to be about US$1.2 million, of which, 52% were accident-related costs (i.e. property damage and administration) and 48% casualty-related costs (i.e. medical costs, out-of-pocket expenses, lost labour outputs, intangible costs and funeral expenses). Most motorcycle accident victims were in their productive ages and were males. Only a third of the motorcycles were insured. Majority of the riders (71%) did not possess valid driving license and would want to avoid the police. Main motorcycle injuries were head injuries, fractures, lacerations and contusions. Majority of the accidents were caused by lack of formal motorcycle riding training, abuse of alcohol, unrestrained animals and donkey carts. Motorcycle accidents could be reduced through law enforcement, continuous mass education and helmet use.

Abusive head trauma in children: a literature review

Directory of Open Access Journals (Sweden)

Nahara R.L. Lopes

2013-09-01

Full Text Available Objective: To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. Data source: The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms “shaken baby syndrome” and “abusive head trauma” in English, Spanish, and Portuguese. Data synthesis: Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. Conclusions: Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level. Resumo: Objetivo: Fornecer uma revisão de literatura científica sobre trauma craniano violento pediátrico enquanto forma de maus-tratos físicos contra bebês e crianças, ressaltando prevalência, sinais e sintomas, consequências, fatores de risco para sua ocorrência e, principalmente, estratégias de prevenção. Fontes dos dados: Revisão nas bases de dados MEDLINE, SciELO, LILACS e Web of Science no período de 2001 a 2012 utilizando os termos �

Obese motorcycle riders have a different injury pattern and longer hospital length of stay than the normal-weight patients.

Science.gov (United States)

Liu, Hang-Tsung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2016-04-14

The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center. Detailed data of 466 obese adult patients with a body mass index (BMI) ≥30 kg/m(2) and 2701 normal-weight patients (25 > BMI ≥18.5 kg/m(2)) who had sustained motorcycle accident-related injuries were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2013. We used the Pearson's chi-squared test, Fisher's exact test, and independent Student's t-test to analyze differences between the two groups. Compared to normal-weight motorcycle riders, more obese riders were men and drivers as opposed to pillions. In addition, fewer obese motorcycle riders showed alcohol intoxication. Analyses of the patients' Abbreviated Injury Scale (AIS) scores revealed that obese motorcycle riders presented with a higher rate of injury to the thorax, but a lower rate of injury to the face than normal-weight patients. In addition, obese motorcycle riders had a 2.7-fold greater incidence of humeral, 1.9-fold greater incidence of pelvic, and 1.5-fold greater incidence of rib fractures. In contrast, normal-weight motorcycle riders sustained a significantly higher rate of maxillary and clavicle fractures. Obese motorcycle riders had a significant longer in-hospital LOS than normal-weight motorcycle riders did (10.6 days vs. 9.5 days, respectively; p = 0.044), with an increase in in-hospital LOS of 0.82 days associated with every 10-unit increase in BMI. No statistically significant differences in Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma

MRI in head trauma

International Nuclear Information System (INIS)

Hong, Jin Kyo

1986-01-01

In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

MRI in head trauma

Energy Technology Data Exchange (ETDEWEB)

Hong, Jin Kyo [Shin Wha Hospital, Seoul (Korea, Republic of)

1986-02-15

In the diagnosis of head injury, Magnetic Resonance Imaging (MRI), like CT, is an effective method of distinguishing between intracerebral and extracerebral lesions. In our experience of MRI, early hematomas are almost isointense by Saturation Recovery (SR) method, so these must be performed with Spin Echo (SE) method for better visualization of hematomas. Isodense subdural hematomas, which is a diagnostic dilemma on CT images, are clearly seen on MRI. Delayed hematomas or residual parenchymal lesions are better demonstrated on MRI than on CT. Direct cornal, sagittal images and multiplanar facility of MRI provides excellent visualization of the the location and shape of extracerebral collection of hematoma. For the screening of head traumas, SE method is a technique of choice because of its excellent sensitivity within limited time.

Venous injury in abusive head trauma

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Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

2015-11-15

Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

Venous injury in abusive head trauma

International Nuclear Information System (INIS)

Choudhary, Arabinda K.; Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B.; Dias, Mark S.

2015-01-01

Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

Imaging abusive head trauma: why use both computed tomography and magnetic resonance imaging?

Energy Technology Data Exchange (ETDEWEB)

Vazquez, Elida; Delgado, Ignacio; Sanchez-Montanez, Angel [Hospital Universitario Vall d' Hebron, UAB, Pediatric Radiology Department, Barcelona (Spain); Fabrega, Anna [Hospital Universitario Vall d' Hebron, UAB, Department of Pediatrics, Barcelona (Spain); Cano, Paola [Hospital Universitario Vall d' Hebron, UAB, Pediatric Neurosurgery, Barcelona (Spain); Martin, Nieves [Hospital Universitario Vall d' Hebron, UAB, Pediatric Ophthalmology, Barcelona (Spain)

2014-12-15

Abusive head trauma is the leading cause of death in child abuse cases. The majority of victims are infants younger than 1 year old, with the average age between 3 and 8 months, although these injuries can be seen in children up to 5 years old. Many victims have a history of previous abuse and the diagnosis is frequently delayed. Neuroimaging is often crucial for establishing the diagnosis of abusive head trauma as it detects occult injury in 37% of cases. Several imaging patterns are considered to be particularly associated with abusive head trauma. The presence of subdural hematoma, especially in multiple locations, such as the interhemispheric region, over the convexity and in the posterior fossa, is significantly associated with abusive head trauma. Although CT is the recommended first-line imaging modality for suspected abusive head trauma, early MRI is increasingly used alongside CT because it provides a better estimation of shear injuries, hypoxic-ischemic insult and the timing of lesions. This article presents a review of the use and clinical indications of the most pertinent neuroimaging modalities for the diagnosis of abusive head trauma, emphasizing the newer and more sensitive techniques that may be useful to better characterize the nature and evolution of the injury. (orig.)

Imaging abusive head trauma: why use both computed tomography and magnetic resonance imaging?

International Nuclear Information System (INIS)

Vazquez, Elida; Delgado, Ignacio; Sanchez-Montanez, Angel; Fabrega, Anna; Cano, Paola; Martin, Nieves

2014-01-01

Abusive head trauma is the leading cause of death in child abuse cases. The majority of victims are infants younger than 1 year old, with the average age between 3 and 8 months, although these injuries can be seen in children up to 5 years old. Many victims have a history of previous abuse and the diagnosis is frequently delayed. Neuroimaging is often crucial for establishing the diagnosis of abusive head trauma as it detects occult injury in 37% of cases. Several imaging patterns are considered to be particularly associated with abusive head trauma. The presence of subdural hematoma, especially in multiple locations, such as the interhemispheric region, over the convexity and in the posterior fossa, is significantly associated with abusive head trauma. Although CT is the recommended first-line imaging modality for suspected abusive head trauma, early MRI is increasingly used alongside CT because it provides a better estimation of shear injuries, hypoxic-ischemic insult and the timing of lesions. This article presents a review of the use and clinical indications of the most pertinent neuroimaging modalities for the diagnosis of abusive head trauma, emphasizing the newer and more sensitive techniques that may be useful to better characterize the nature and evolution of the injury. (orig.)

Role of motorcycle type in fatal motorcycle crashes.

Science.gov (United States)

Teoh, Eric R; Campbell, Marvin

2010-12-01

Motorcycles vary in design and performance capability, and motorcyclists may select certain motorcycle types based on driving preferences. Conversely, motorcycle performance capability may influence the likelihood of risky driving behaviors such as speeding. Both mechanisms may affect fatal crash risk when examined by motorcycle type. Although it was not possible to estimate the effect of each mechanism, the current study analyzed fatal crash data for evidence of motorcycle type differences in risky driving behaviors and risk of driver death. Street legal motorcycles were classified into 10 types based on design characteristics and then further grouped as cruiser/standard, touring, sport touring, sport/unclad sport, supersport, and all others. For each motorcycle type, driver death rates per 10,000 registered vehicle years and the prevalence of fatal crash characteristics such as speeding were analyzed. Differences among motorcycle types concerning the effect of engine displacement were examined using Poisson regression. Overall, driver death rates for supersport motorcycles were four times as high as those for cruiser/standard motorcycles. Fatally injured supersport drivers were most likely to have been speeding and most likely to have worn helmets, but least likely to have been impaired by alcohol compared with drivers of other motorcycle types. The patterns in driver factors held after accounting for the effects of age and gender. Increased engine displacement was associated with higher driver death rates for each motorcycle type. Strong effects of motorcycle type were observed on driver death rates and on the likelihood of risky driving behaviors such as speeding and alcohol impairment. Although the current study could not completely disentangle the effects of motorcycle type and rider characteristics such as age on driver death rates, the effects of both motorcycle type and rider age on the likelihood of risky driving behaviors were observed among fatally

Retroclival collections associated with abusive head trauma in children

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Silvera, V.M.; Danehy, Amy R.; Carducci, Chiara; Grant, P.E.; Kleinman, Paul K. [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Newton, Alice W. [Harvard Medical School, Child Protection Program, Department of Pediatrics, Massachusetts General Hospital, Boston, MA (United States); Stamoulis, Catherine [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Harvard Medical School, Department of Neurology, Boston Children' s Hospital, Boston, MA (United States); Wilson, Celeste R. [Harvard Medical School, Division of General Pediatrics, Department of Medicine, Boston Children' s Hospital, Boston, MA (United States)

2014-12-15

Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures. (orig.)

Retroclival collections associated with abusive head trauma in children

International Nuclear Information System (INIS)

Silvera, V.M.; Danehy, Amy R.; Carducci, Chiara; Grant, P.E.; Kleinman, Paul K.; Newton, Alice W.; Stamoulis, Catherine; Wilson, Celeste R.

2014-01-01

Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures. (orig.)

Retroclival collections associated with abusive head trauma in children.

Science.gov (United States)

Silvera, V Michelle; Danehy, Amy R; Newton, Alice W; Stamoulis, Catherine; Carducci, Chiara; Grant, P Ellen; Wilson, Celeste R; Kleinman, Paul K

2014-12-01

Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤ 3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures.

Multicystic encephalopathy in abusive head trauma

NARCIS (Netherlands)

Kubat, Bela; Bilo, Rob A. C.; van Rijn, Rick R.

2014-01-01

The proof of abusive head trauma (AHT) in infants is difficult, especially in cases with a long posttraumatic survival period. In the acute phase, injury to the cranio-cervical junction causes disturbances in respiratory and cardiac control, leading to apnea and bradycardia. Infants who survive the

Epidemiological pattern of motorcycle injuries with focus on riding purpose: Experience from a middle-income country

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leili Abedi

2015-08-01

Full Text Available Introduction: Road traffic injuries are the eighth leading cause of death worldwide which usually occurs among people aged between15-29 years. In most LAMICs, half of fatal road traffic injuries occur among motorcyclists, which little is known about purpose of riding among motorcycle riders. Objectives: To map out epidemiological aspects of motorcycle traffic injuries with a focus on purpose of riding among victims admitted to referral centers, Tabriz, Iran. Materials/Patients and Methods: A descriptive study was carried out on 200 motorcycle traumatic patients admitted to Shohada and Imam Reza trauma centers in Tabriz((because these two hospitals are referral for trauma in East Azarbyjan Province, Iran from April till November 2013. A questionnaire was filled out through face to face interview for all subjects. Statistical analysis was done using Stata version 11. Results: All subjects were male with mean age of 29 years old. Among injured riders, 70% and 22% of them used helmet and had a riding license, respectively. About 23% of motorcycle riders stated that their main purpose of motorcycle riding was only for fun. Among motorcycle riders who used the motorcycle for fun purposes, the rate of helmet wearing was 43.5% versus 78% among those riding for other purposes (P 0.05; Odd ratio=1. 56, 95% CI: 0. 67-3.4. Crashes have happened more in the summer and during the afternoon times. Conclusion: Motorcyclists who rode motorcycles for fun and amusement, not having rider licenses and helmets wearing were less than other motorcycle riders. Since motorcyclists are mainly young, the rate of risky behavior in this group is higher. Therefore, it is suggested that young motorcycle riders who ride for fun, needs the priority for safety promotion intervention.

Spinal cord injury and its association with blunt head trauma

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Paiva WS

2011-09-01

Full Text Available Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or severe head injury were enrolled. All patients were submitted to three-view spine series X-ray and thin cut axial CT scans for spine trauma investigations.Results: 112 male patients and 78 female patients, whose ages ranged from 11 to 76 years (mean age, 34 years. The most common causes of brain trauma were pedestrians struck by motor vehicles (31.1%, car crashes (27.7%, and falls (25%. Systemic lesions were present in 80 (44.4% patients and the most common were fractures, and lung and spleen injuries. 52.8% had severe and 47.2% moderate head trauma. Fourteen patients (7.8% suffered spinal cord injury (12 in cervical spine, one in lumbar, and one thoracic spine. In elderly patients, the presence of associated lesions and Glasgow Coma Scale (GCS < 9 were statistically significant as risk factors (P < 0.05 for spine injury.Conclusion: Spinal cord injury related to moderate and severe brain trauma usually affects the cervical spine. The incidence of spinal lesions and GCS < 9 points were related to greater incidence of spinal cord injury.Keywords: head injury, spine trauma, risk factors

EPIDEMIOLOGY OF SPINE FRACTURES IN MOTORCYCLE ACCIDENT VICTIMS

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Tiago Argolo Bittencourt de Oliveira

2016-03-01

Full Text Available ABSTRACT Objective: To analyze the incidence of spinal injuries between 2000-2010 due to motorcycle accidents and the relation to the increase in motorcycle sales in the same period, as well as the anatomical distribution of these spinal injuries. Methods: Data were collected from 1,295 records of patients who have suffered spinal injury resulting from motorcycle accidents admitted to the ward TRM (Spinal Cord Trauma of the Hospital Geral do Estado da Bahia from 2000 to 2010 in this retrospective study. We selected 110 medical records and collected information on sex, age, neurological deficit on admission (according to Frankel scale, diagnosis, and level of injury. Results: Between 2000 and 2010 there was an increase of almost five times in the incidence of patients who have suffered spinal injury due to motorcycle accidents. More than half (51.4% had cervical spine injury, 37.2% thoracic spine injury and 11.34% had lumbar spine injury. Only 34.3% of patients had no neurological deficit on admission and patients with thoracic spine fracture had a higher incidence and severity of lesion. The average age of patients was 30 years. Conclusions: The increased incidence of spinal injuries due motorcycle accidents occurred in the same period in which there was an increase in motorcycle sales in the country. Patients who have suffered those injuries were young, with higher incidence in the cervical and thoracic spinal levels and high rates of neurological deficit.

Reducing radiation exposure in newborns with birth head trauma

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Irina A. Kriukova

2017-12-01

Full Text Available Background. Birth head trauma causing intracranial injury is one of the most common causes of neonatal mortality and morbidity. In case of suspected cranial fractures and intracranial hematomas, diagnostic methods involving radiation, such as x-ray radiography and computed tomography, are recommended. Recently, an increasing number of studies have highlighted the risk of cancer complications associated with computed tomography in infants. Therefore, diagnostic methods that reduce radiation exposure in neonates are important. One such method is ultrasonography (US. Aim. We evaluated US as a non-ionizing radiation method for diagnosis of cranial bone fractures and epidural hematomas in newborns with cephalohematomas or other birth head traumas. Material and methods. The study group included 449 newborns with the most common variant of birth head trauma: cephalohematomas. All newborns underwent transcranial-transfontanelle US for detection of intracranial changes and cranial US for visualization of bone structure in the cephalohematoma region. Children with ultrasonic signs of cranial fractures and epidural hematomas were further examined at a children’s hospital by x-ray radiography and/or computed tomography. Results and discussion. We found that cranial US for diagnosis of cranial fractures and transcranial-transfontanelle US for diagnosis of epidural hematomas in newborns were highly effective. In newborns with parietal cephalohematomas (444 children, 17 (3.8% had US signs of linear fracture of the parietal bone, and 5 (1.1% had signs of ipsilateral epidural hematoma. Epidural hematomas were visualized only when US was performed through the temporal bone and not by using the transfontanelle approach. Sixteen cases of linear fractures and all epidural hematomas were confirmed by computed tomography. Conclusion. The use of US diagnostic methods reduced radiation exposure in newborns with birth head trauma. US methods (transcranial

Clinical Epidemiology of Head Injury from Road-Traffic Trauma in a Developing Country in the Current Era

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Amos O. Adeleye

2017-12-01

Full Text Available ObjectivesAfrica and other Asian low middle-income countries account for the greatest burden of the global road-traffic injury (RTI-related head injury (HI. This study set out to describe the incidence, causation, and severity of RTI-related HI and associated injuries in a Nigerian academic neurosurgical practice.MethodsThis is a retrospective cross-sectional analysis of RTI-related HI from a prospective HI registry in an academic neurosurgery practice in Nigeria.ResultsAll-terrain RTI accounted for 80.6% (833/1,034 of HI over a 7-year study period. All age groups were involved, mean 33.06 years (SD 18.30, mode 21–30, 231/833 (27.7%. The male:female ratio was 631:202, ≈3:1. The road trauma occurred exclusively from motorcycle-and motor-vehicle crash (MCC/MVC, MCC caused 56.8% (473/833 of these; the victims were vulnerable road users (VRU in 74%, and >90% belong in the low socioeconomic class. Using the Glasgow Coma Scale grading, the HI was moderate/severe in 52%; loss of consciousness occurred in 93%, the Abbreviated Injury Severity-head > 3 in 74%, and computed tomography (CT Rotterdam score > 3 in 52%. Significant extracranial injuries occurred in many organ systems, 421/833 (50.5% having Injury Severity Score (ISS > 25. Surgical lesions included extensive brain contusions in 157 (18.8%; acute extradural hematoma in 34 (4.1%; acute subdural hematoma in 32 (3.8%; and traumatic intracerebral hemorrhage in 27 (3.2%, but only 97 (11.6% received operative care for various logistic reasons. The in-hospital outcome was good in 71.3% and poor in 28.7%; the statistically significant (p < 0.001 determinants of this outcome profile were the severity of the HI, the CT Rotterdam score, and the ISS.ConclusionIn this study from Nigeria, RTI-related HI emanates from significant trauma to vulnerable road users and are caused exclusively by motorcycles and motor vehicles.

Head and neck trauma in Iraq and Afghanistan: different war, different surgery, lessons learned.

Science.gov (United States)

Brennan, Joseph

2013-10-01

The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice. A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records. The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care. The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned. The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Cerebral Venous Air Embolism due to a Hidden Skull Fracture Secondary to Head Trauma

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Ai Hosaka

2015-01-01

Full Text Available Cerebral venous air embolism is sometimes caused by head trauma. One of the paths of air entry is considered a skull fracture. We report a case of cerebral venous air embolism following head trauma. The patient was a 55-year-old man who fell and hit his head. A head computed tomography (CT scan showed the air in the superior sagittal sinus; however, no skull fractures were detected. Follow-up CT revealed a fracture line in the right temporal bone. Cerebral venous air embolism following head trauma might have occult skull fractures even if CT could not show the skull fractures.

Single-vehicle and Multi-vehicle Accidents Involving Motorcycles in a Small City in China: Characteristics and Injury Patterns

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Lili Xiong

2015-03-01

collision involves mass vehicle(s. Injury to the head dominated motorcycle injuries. Single-vehicle accidents have a higher correlation with head injury or internal injuries to the thorax or abdomen. Multi-vehicle accidents are more correlated with extremity injuries, especially to the lower extremities or external trauma to the thorax or abdomen.

Motorcycle related ocular injuries in Irrua Specialist Teaching ...

African Journals Online (AJOL)

This is a prospective study of all cases of motorcycle related accidents with involvement of the eyes seen at the Irrua Specialist Teaching Hospital from January 2005 to December 2005. The study was conducted to assess the severity of ocular trauma, ocular structures mostly affected and initial effect on visual acuity in such ...

Motorcycle accident injury profiles in Jamaica: an audit from the University Hospital of the West Indies.

Science.gov (United States)

Crandon, I W; Harding, H E; Cawich, S O; McDonald, A H; Fearron-Boothe, D

2009-09-01

There is little data available on the prevalence of motorcycle accidents, their resultant injuries and the demand on the health care services in Jamaica. We performed a descriptive, analytical study to evaluate the extent of this problem and the need for preventative national policy measures. Between 1 January 2000 and 1 January 2007, demographic and clinical data on all motorcycle accident victims admitted to the University Hospital of the West Indies were collected in a prospective database. The data were analysed using the SPSS version 12.0. Of 270 motorcycle accident victims, there were 257 (95.2%) males and 13 (4.8%) females. Overall, 134 (49.6%) victims wore helmets at the time of their accident. The more common injuries were as follows: soft tissue trauma 270 (100%); head injuries 143 (53.0%); long bone fractures 126 (46.7%); abdominal injuries 38 (14.1%); thoracic injuries 71 (26.3%); vascular injuries 11 (4.1%). The mean injury severity score was 9.0 (SD 9.4; Median 8; Mode 4). There were 195 patients needing surgical intervention in the form of orthopaedic operations (94), neurosurgical operations (43), abdominal operations (49) and vascular operations (14). The mean duration of hospitalisation was 10 days (SD 11.2; Range 0-115; Median 6; Mode 3). There were 12 (4.4%) deaths, 9 (75%) due to traumatic brain injuries. Fatal injuries were more common in males (11) and un-helmeted patients (10). Motorcycle accidents take a heavy toll on this health care facility in Jamaica. Measures to prevent motorcycle accidents and reduce consequent injuries may be one way in which legislators can preserve precious resources that are spent during these incidents. This can be achieved through active measures such as educational campaigns, adherence to traffic regulations and enforcement of helmet laws.

Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

Energy Technology Data Exchange (ETDEWEB)

Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Boston University Medical Center, Boston, MA (United States); Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Rice, Amy [Independent Consultant (Biostatistics), Chevy Chase, MD (United States); Hinds, Tanya [Children' s National Medical Center, Child and Adolescent Protection Center, Washington, DC (United States)

2014-07-15

In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

International Nuclear Information System (INIS)

Kadom, Nadja; Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal; Rice, Amy; Hinds, Tanya

2014-01-01

In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

Computed tomography findings in patients with mild head trauma

International Nuclear Information System (INIS)

Sanei Taheri, M.; Hemadi, H.; Sajadinasab, M.; Sharifi, G.; Jalali, A. H.; Shakiba, M.

2007-01-01

To determine the frequency of computed tomography (CT) findings in patients with mild head trauma. Patients and Methods: In this cross-sectional study conducted between September 2005 and April 2006, 708 patients with mild head trauma as defined by a Glasgow Coma Score (GCS) of 13-15, were underwent standard clinical examination and cranial CT. Results The mean±SD age of our patients was 26.8±19.03 years (range: 1 month to 89 years). 489 (68.9%) patients were male and 219 (30.8%) were female. GSC was 13 in 1%. 14 in 4.6% and 15 in 94.4% of patients. The most common mechanism of trauma was car accident and falling down, each of which happened for 132 patients (18.6%). The most common findings on CT were subgaleal hematomas in 213(30%) and intracranial lesions were seen in 41 patients(5.8%) :among them 37 were male. Among intracranial lesions, the most common finding was epidural hematoma in 18 patients followed by hemorrhagic contusion in 13 patients. lntracranial lesions were observed in 28.6% of patients with GCS of 13: in 15.25% with GCS of 14 and in 5.1% with GCS of 15 (P=.002). conclusion: Many of patients with GCS equal to 15 after head trauma have considerable intracranial and minor focal neurologic signs revealed by careful physical examination could be a good marker of these lesions

Patients with severe head trauma who talk and then deteriorate

Energy Technology Data Exchange (ETDEWEB)

Isayama, Kazuo; Nakazawa, Shozo; Kobayashi, Shiro; Yokota, Hiroyuki; Ikeda, Yukio; Yajima, Kouzo; Yano, Masami; Otsuka, Toshibumi

1987-08-01

Patients with severe head trauma who talk and then deteriorate (or die) are analyzed by means of clinical signs, computerized tomography (CT), and outcome. The twelve severely head-injured patients had an initial verbal score on the Glasgow coma scale (GCS) of 3 or more and a GCS score of 9 or more. There were 8 male and 4 female patients. The ages of these patients ranged from 23 to 85 years (average age 60.9 years); nine of the patients were older than 60 years of age. An initial CT revealed subdural hematoma in 7 cases and traumatic subarachnoid hemorrhage in 8 cases. Serial CT could be used for 9 cases; delayed intracerebral hematoma was found in 5 patients, and acute cerebral swelling, in 3 patients. The elderly tended to have the hematoma, while the young tended to have acute cerebral swelling. Concerning the Glasgow outcome scale of cases of head trauma who talk and then deteriorate three months after trauma, there was moderate disability in 2 cases and a persistent vegetative state in one, while 9 had died.

Diffuse pachymeningeal enhancement on brain MRI: spontaneous intracranial hypotension and head trauma

International Nuclear Information System (INIS)

Ryu, Chang Woo; Lee, Byung Hee; Lee, Seung Ik; Kim, Young A; Kim, Hee Jin; Ko, Young Sik

1998-01-01

We evaluated the MRI finding of pachymeningeal enhancement in patients with intracranial hypotension and head trauma with particular attention to differential findings and change in follow-up study, and in order to support the knowledge about the pathophysiology of dural enhancement. The findings of enhanced brain MRI of fifteen patients who showed diffuse pachymeningeal enhancement were retrospectively examined. Seven of fifteen patients were finally diagnosed as spontaneous intracranial hypotension (SIH). Eight of fifteen patients had a recent history of head trauma. We analyzed the shape, thickness, continuity and extent of dural enhancement, and the others concerned with positive MR findings. We also analyzed findings suggested displacement of brain parenchyma-displacement of the iter and cerebellar tonsil, and flattening of the anterior aspect of the pons-. Four of seven patients with SIH and four of eight patients with head trauma, underwent follow-up MRI. In the follow-up study, the presence of resolving pachymeningeal enhancement and symptom improvement was investigated. In all cases of SIH, the dura showed diffuse, even 3(1mm thick, global and contiguous enhancement along both cerebral convexities, both tentoria, and the falx. Displacement of the iter was noted in six cases and flattening of the anterior aspect of the pons in five. Displacement of the cerebellar tonsil was noted in one case. Five of seven cases showed small amount of subdural fluid collection. In all cases of head trauma, the dura was enhanced diffusely and asymmetrically, and showed no contiguity. Its distribution was consistent with the locations of traumatic lesions. Displacement of the iter was noted in one case. In four cases of SIH, clinical symptoms had improved, and three showed complete resolution of dural enhancement, in one patient continuously showed partial dural enhancement. Four cases of head trauma showed complete resolution of dural enhancement. Reversible diffuse

Abusive Head Trauma in Children: A Literature Review

Directory of Open Access Journals (Sweden)

Nahara R.L. Lopes

2013-09-01

Conclusions: : Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.

Motorcycles on the Move

Science.gov (United States)

McIntosh, Phyllis

2013-01-01

Motorcycles are the subject of this feature article, which explores such topics as the history of motorcycles, types of motorcycles, special interest motorcycle clubs, motorcycle rallies, the Harley-Davidson company, and Rolling Thunder. A list of websites of interest and a glossary of "motorcycle jargon" are included.

Influence of history of head trauma and epilepsy on delinquents in a juvenile classification home.

Science.gov (United States)

Miura, Hideki; Fujiki, Masumi; Shibata, Arihiro; Ishikawa, Kenji

2005-12-01

Juvenile delinquents often show poor impulse control and cognitive abnormalities, which may be related to disturbances in brain development due to head trauma and/or epilepsy. The aim of the present study was to examine the influence of head trauma and/or epilepsy on delinquent behavior. We examined 1,336 juvenile delinquents (1,151 males and 185 females) who had been admitted to the Nagoya Juvenile Classification Home, Aichi, Japan. Among them, 52 subjects with a history of epilepsy, convulsion or loss of consciousness, head injury requiring neurological assessment and/or treatment, or neurosurgical operation (head trauma/epilepsy group), were examined by electroencephalography and compared to subjects without these histories (control group) with respect to types of crime, history of amphetamine use, psychiatric treatment, child abuse, and family history. Among the 52 subjects, 43 (82.7%) showed abnormal findings. The head trauma/epilepsy group had significantly higher rates of psychiatric treatment (Phistory of drug abuse (Pdelinquents who had a history of head trauma and/or epilepsy showed a high prevalence of electroencephalograph abnormality, and higher rates of psychiatric treatment and family history of drug abuse, and were more likely to be sent to juvenile training school by the family court.

Isolated abducens nerve palsy after closed head trauma: a pediatric case report.

Science.gov (United States)

Janssen, Karen; Wojciechowski, Marek; Poot, Sandra; De Keyser, Katrien; Ceulemans, Berten

2008-09-01

Cranial nerve lessions often accompany head trauma. Nevertheless, isolated involvement of the sixth nerve without any cranial or cervical fracture is rare. Nerve injury could occur at the sites of the dural entry points and at the petrous apex during down- or upward movement of the brain caused by violent linear force to the head. Management is symptomatic. Most cases improve within three months and many resolve by six months, but spontaneous recovery does not always occur. We describe the case of a 13-year-old boy who developed isolated abducens nerve palsy after closed head trauma.

Chest trauma in children, single center experience.

Science.gov (United States)

Ismail, Mohamed Fouad; al-Refaie, Reda Ibrahim

2012-10-01

Trauma is the leading cause of mortality in children over one year of age in industrialized countries. In this retrospective study we reviewed all chest trauma in pediatric patients admitted to Mansoura University Emergency Hospital from January 1997 to January 2007. Our hospital received 472 patients under the age of 18. Male patients were 374 with a mean age of 9.2±4.9 years. Causes were penetrating trauma (2.1%) and blunt trauma (97.9%). The trauma was pedestrian injuries (38.3%), motor vehicle (28.1%), motorcycle crash (19.9%), falling from height (6.7%), animal trauma (2.9%), and sports injury (1.2%). Type of injury was pulmonary contusions (27.1%) and lacerations (6.9%), rib fractures (23.9%), flail chest (2.5%), hemothorax (18%), hemopneumothorax (11.8%), pneumothorax (23.7%), surgical emphysema (6.1%), tracheobronchial injury (5.3%), and diaphragm injury (2.1%). Associated lesions were head injuries (38.9%), bone fractures (33.5%), and abdominal injuries (16.7%). Management was conservative (29.9%), tube thoracostomy (58.1%), and thoracotomy (12.1%). Mortality rate was 7.2% and multiple trauma was the main cause of death (82.3%) (Ptrauma is the most common cause of pediatric chest trauma and often due to pedestrian injuries. Rib fractures and pulmonary contusions are the most frequent injuries. Delay in diagnosis and multiple trauma are associated with high incidence of mortality. Copyright © 2011 SEPAR. Published by Elsevier España, S.L. All rights reserved.

MRI of head trauma. Serial changes and comparison with CT

Energy Technology Data Exchange (ETDEWEB)

Fukuda, Osamu; Sato, Shuji; Suzuki, Takashi; Endo, Shunro; Takaku, Akira.

1988-08-01

Sequential changes in magnetic resonance imaging (MRI) were investigated in comparison with computed tomography (CT) in 31 cases of head trauma. Twenty-one of them were of acute head trauma; the first MRI study was performed within 48 hours after the accident. Forty-two intracranial lesions were observed in these cases on MRI. The other 10 cases were of chronic subdural hematoma, two cases of which had bilateral lesions. Fourteen lesions of acute head trauma and two lesions of chronic subdural hematoma were detected only by MRI. MRI was superior to CT for the detection of small contusions and thin extra-axial collections, especially those which were located near the bony structures. The abnormal lesions were visualized in MRI during a longer period than in CT. Because the signal intensity of a hematoma changed sequentially, the detection of brain edema was easier than that of a subarachnoid and parenchimal hemorrhage. Judging from this experience, it seems that careful attention should be taken in the diagnosis of hemorrhagic lesions. However, MRI was poor in tissue characterization because of the too-high tissue sensitivity. T/sub 2/-weight SE imaging was essentially sensitive and useful in the early stage.

causes and consequences of commercial motorcycle accidents

African Journals Online (AJOL)

PROF EKWUEME

Accident associated with the use of motorcycle for commercial transportation in Makurdi metropolis was ... deaths, over speeding accounted for 27 percent of accidents and deaths respectively, .... 10. 7. 5. (a). (b). Possession of wing mirror and Crash helmet. Yes. No. 12 .... reduce the risk of serious head and brain injuries.

The Financial Implication of Treating Motorcycle Limb Trauma in a ...

African Journals Online (AJOL)

Background: The total cost of care of injuries is usually much more than the cost of hospitalization. This study was designed to determine the total cost to the patient, of limb injuries sustained from motorcycle crashes. Method: The study design was based on the cost-of illness method. Only patients who were employed and ...

CSF-biomarkers in Olympic boxing: diagnosis and effects of repetitive head trauma.

Directory of Open Access Journals (Sweden)

Sanna Neselius

Full Text Available BACKGROUND: Sports-related head trauma is common but still there is no established laboratory test used in the diagnostics of minimal or mild traumatic brain injuries. Further the effects of recurrent head trauma on brain injury markers are unknown. The purpose of this study was to investigate the relationship between Olympic (amateur boxing and cerebrospinal fluid (CSF brain injury biomarkers. METHODS: The study was designed as a prospective cohort study. Thirty Olympic boxers with a minimum of 45 bouts and 25 non-boxing matched controls were included in the study. CSF samples were collected by lumbar puncture 1-6 days after a bout and after a rest period for at least 14 days. The controls were tested once. Biomarkers for acute and chronic brain injury were analysed. RESULTS: NFL (mean ± SD, 532±553 vs 135±51 ng/L p = 0.001, GFAP (496±238 vs 247±147 ng/L p80% of the boxers demonstrate that both the acute and the cumulative effect of head trauma in Olympic boxing may induce CSF biomarker changes that suggest minor central nervous injuries. The lack of normalization of NFL and GFAP after the rest period in a subgroup of boxers may indicate ongoing degeneration. The recurrent head trauma in boxing may be associated with increased risk of chronic traumatic brain injury.

Scandinavian guidelines for initial management of minor and moderate head trauma in children

DEFF Research Database (Denmark)

Astrand, Ramona; Rosenlund, Christina; Undén, Johan

2016-01-01

. CONCLUSIONS: We present new evidence and consensus based Scandinavian Neurotrauma Committee guidelines for initial management of minor and moderate head trauma in children. These guidelines should be validated before extensive clinical use and updated within four years due to rapid development of new......BACKGROUND: The management of minor and moderate head trauma in children differs widely between countries. Presently, there are no existing guidelines for management of these children in Scandinavia. The purpose of this study was to produce new evidence-based guidelines for the initial management...... of head trauma in the paediatric population in Scandinavia. The primary aim was to detect all children in need of neurosurgical intervention. Detection of any traumatic intracranial injury on CT scan was an important secondary aim. METHODS: General methodology according to the Appraisal of Guidelines...

Computed Tomography of pediatric head trauma

International Nuclear Information System (INIS)

Shin, Kyoung Hee; Cho, Bum Shin; Hahm, Chang Kok

1982-01-01

The development of Computed Tomography (CT) scanning has revolutionized the role of radiology in the management of the pediatric head trauma. The procedure is safe and can be repeated to reasses a changing neurologic picture, thereby correlation the clinical and pathologic changes. This study included evaluation of CT of 178 infants and children with head trauma during the period of 31 months from Feb. 1979 to Aug. 1981 in the Department of Radiology, College of Medicine, Hanyang University. 1. Age distribution of the total 178 pediatric patients was ranging from one month to 16 years. The pediatric patient population was comprised of 128 males and 50 females, and its male to female ratio was about 2.5 : 1. The incidence of age occurring in 3 to 6 years was 38.2% and 7 to 10 years was 29.2%. Therefore the distribution of age between 3 to 6 years and 7 to 10 years was occurred in two-thirds of all pediatric patients. 2. Of all cases of injuries, traffic accidents were 60.1% and falls were 34.8%. 3. Skull fracture were roentgenographically detected in 61 (34.3%). However, the incidence of fractures in pretoddler group (0-2 years) was 61.1% and 7 to 10 years was 37.8%, 3 to 6 years was 36.8%. More common site of skull fracture was occipital bone,next partietal bone. 4. 54.8% of pediatric head trauma due to a full had a skull fracture, as did 25.2 % of those who were injured in traffic accident. 5. Cerebral Computed Tomography (CT) of the total 178 pediatric patients were revealed as following study.: Normal was 74.2%, epidural hematoma was 8.9%, subdural hematoma was 5.1%, cerebral contusion was 4.5%, intracerebral hematoma was 2.2% etc. 6. Of 25 cases of the epidural and subdural hematoma, supratentorial area was 15 cases, infratentorial area was 10 cases. 7. Most of the epidural hematoma was demonstrated a clear mental state. 8. However, intracerebral hematoma and cerebral contusion were occurred almost impairment of mental state

Underbelly injury based identification of the driver in a three-rider motorcycle accident.

Science.gov (United States)

Liu, Shengxiong; Yin, Zhiyong; Su, Sen; Li, Kui

2016-01-01

This paper presents a three-rider motorcycle accident which took place in a suburb of Chongqing China. In the accident, the motorcycle impacted the terminal of a bridge footpath and led to two riders died and one rider injured. After the accident, one rider received injuries around the groin area including the underbelly area and the perineum area. Another rider suffered from injuries only on the perineum areas. In medico-legal judgments, injuries around the groin area also called groin injuries in victims of motorcycle accidents are usually regarded as "fuel tank injuries" which are commonly found in drivers. But, the injuries around the groin area are sometimes confused with the perineum injuries. Therefore, the perineum injuries are often wrongly reckoned as the "fuel tank injuries" and used to identify the drivers too. Actually, passengers can sometimes suffer from perineum injuries in many head-on impacting motorcycle accidents. It is of vital matters to understand the differences between groin injuries and perineum injuries so that the real driver who should be responsible for the accident can be recognized. In this paper, the three-rider motorcycle accident was presented and the injury information of the three riders was studied in order to distinguish the real driver from the riders. We consider that the groin injury has some differences with the perineum injury and the latter should not always be related to the driver especially in high-speed head-on impacting motorcycle accidents. In addition, the injury on underbelly areas is important to identify the driver. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review.

Science.gov (United States)

Peng, Yinan; Vaidya, Namita; Finnie, Ramona; Reynolds, Jeffrey; Dumitru, Cristian; Njie, Gibril; Elder, Randy; Ivers, Rebecca; Sakashita, Chika; Shults, Ruth A; Sleet, David A; Compton, Richard P

2017-06-01

Motorcycle crashes account for a disproportionate number of motor vehicle deaths and injuries in the U.S. Motorcycle helmet use can lead to an estimated 42% reduction in risk for fatal injuries and a 69% reduction in risk for head injuries. However, helmet use in the U.S. has been declining and was at 60% in 2013. The current review examines the effectiveness of motorcycle helmet laws in increasing helmet use and reducing motorcycle-related deaths and injuries. Databases relevant to health or transportation were searched from database inception to August 2012. Reference lists of reviews, reports, and gray literature were also searched. Analysis of the data was completed in 2014. A total of 60 U.S. studies qualified for inclusion in the review. Implementing universal helmet laws increased helmet use (median, 47 percentage points); reduced total deaths (median, -32%) and deaths per registered motorcycle (median, -29%); and reduced total injuries (median, -32%) and injuries per registered motorcycle (median, -24%). Repealing universal helmet laws decreased helmet use (median, -39 percentage points); increased total deaths (median, 42%) and deaths per registered motorcycle (median, 24%); and increased total injuries (median, 41%) and injuries per registered motorcycle (median, 8%). Universal helmet laws are effective in increasing motorcycle helmet use and reducing deaths and injuries. These laws are effective for motorcyclists of all ages, including younger operators and passengers who would have already been covered by partial helmet laws. Repealing universal helmet laws decreased helmet use and increased deaths and injuries. Published by Elsevier Inc.

Educational paper Abusive Head Trauma Part II: Radiological aspects

NARCIS (Netherlands)

Sieswerda-Hoogendoorn, Tessa; Boos, Stephen; Spivack, Betty; Bilo, Rob A. C.; van Rijn, Rick R.

2012-01-01

Abusive head trauma (AHT) is a relatively common cause of neurotrauma in young children. Radiology plays an important role in establishing a diagnosis and assessing a prognosis. Computed tomography (CT), followed by magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI), is the

Necrotizing Fasciitis Secondary to a Primary Suture for Anoperineal Trauma by Motorcycle Accident in a Healthy Adult

Directory of Open Access Journals (Sweden)

Susumu Saigusa

2015-01-01

Full Text Available A 41-year-old man experienced a swollen scrotum three days after a motorcycle accident and presented to our hospital. He had had a primary suture repair for anoperineal trauma in an outside hospital at the time of the injury. He presented to us with general fatigue, low grade fevers, and perineal pain. Abdominal computed tomography showed subcutaneous emphysema from the scrotum to the left chest. The sutured wound had foul-smelling discharge and white exudate. We made the diagnosis of necrotizing fasciitis and immediately opened the sutured wound and performed initial debridement and lavage with copious irrigation. We continued antibiotics and lavage of the wound until the infection was controlled. Fortunately, the necrotizing fasciitis did not worsen and he was discharged after 15 days. Our experience indicates that anoperineal injuries should not be closed without careful and intensive follow-up due to the potential of developing necrotizing fasciitis.

The effects of dynamic friction in oblique motorcycle helmet impacts

Science.gov (United States)

Bonugli, Enrique

The purpose of this study was to determine the frictional properties between the exterior surface of a motorcycle helmet and 'typical' roadway surfaces. These values were compared to abrasive papers currently recommended by government helmet safety standards and widely used by researchers in the field of oblique motorcycle helmet impacts. A guided freefall test fixture was utilized to obtain nominal impact velocities of 5, 7 and 9 m/s. The impacting surfaces were mounted to an angled anvil to simulate off-centered oblique collision. Head accelerations and impact forces were measured for each test. Analysis of the normal and tangential forces imparted to the contact surface indicated that the frictional properties of abrasive papers differ from asphalt and cement in magnitude, duration and onset. Reduction in head acceleration, both linear and angular, were observed when asphalt and cement were used as the impacting surface. Roofing shingle was determined to be a more suitable material to simulate 'typical' roadway surfaces however, this may not be ideal for use in a controlled laboratory setting. In a laboratory setting, the author recommends cement as a best-fit material to simulate roadway surface for use in oblique motorcycle helmet impacts since this material displayed characteristics that closely resemble asphalt and is currently used as a roadway construction material.

Global aphasia without hemiparesis may be caused by blunt head trauma: An adolescent boy with transient aphasia.

Science.gov (United States)

Şahin, Sevim; Türkdoğan, Dilşad; Hacıfazlıoğlu, Nilüfer Eldeş; Yalçın, Emek Uyur; Eksen, Zehra Yılmaz; Ekinci, Gazanfer

2017-05-01

Global aphasia without hemiparesis is a rare condition often associated with embolic stroke. Posttraumatic causes have not been reported, in the literature, to our knowledge. We report a 15-year old boy with transient global aphasia without hemiparesis due to blunt head trauma. In our case, clinical findings occurred 1week later following head trauma. Emergence of the symptoms after a period of the first mechanical head trauma, draws attention to the importance of secondary process in traumatic brain injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clinical diagnosis versus autopsy diagnosis in head trauma

Directory of Open Access Journals (Sweden)

Velnic Andreea-Alexandra

2017-12-01

Full Text Available The correct and complete diagnosis is essential for the adequate care and the favourable clinical evolution of the patients with head trauma. Purpose: To identify the error rate in the clinical diagnosis of head injuries as shown in comparison with the autopsy diagnosis and to identify the most common sources of error. Material and method: We performed a retrospective study based on data from the medical files and the autopsy reports of patients with head trauma who died in the hospital and underwent forensic autopsy. We collected: demographic data, clinical and laboratory data and autopsy findings. To quantify the concordance rate between the clinical diagnosis of death and the autopsy diagnosis we used a 4 classes classification, which ranged from 100% concordance (C1 to total discordance (C4 and two classes of partial discordance: C2 (partial discordance in favour of the clinical diagnosis- missing injuries in the autopsy reports and C3 (partial discordance in favor of the necroptic diagnosis- missing injuries in the medical files. Data were analyzed with SPSS version 20.0. Results: We analyzed 194 cases of death due to head injuries. We found a total concordance between the clinical death diagnosis and autopsy diagnosis in 30.4% of cases and at least one discrepancy in 69.6% of cases. Increasing the duration of hospitalization directly correlates with the amount of the imaging investigations and these in turn correlates with an increased rate of diagnosis concordance. Among the patients with stage 3 coma who associated a spinal cord injury, we found a partial diagnosis discordance in 50% of cases and a total discordance in 50% of cases, possibly due to the need for conducting emergency imaging investigation and the need for surgical treatment. In cases with partial and total discordant diagnosis, at least one lesion was omitted in 45.1% of the cases. The most commonly omitted injuries in C2 cases were subdural hematoma, intracerebral

A Comprehensive Approach to Motorcycle-Related Head Injury Prevention: Experiences from the Field in Vietnam, Cambodia, and Uganda.

Science.gov (United States)

Craft, Greig; Van Bui, Truong; Sidik, Mirjam; Moore, Danielle; Ederer, David J; Parker, Erin M; Ballesteros, Michael F; Sleet, David A

2017-11-30

Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury.

Multiplanar reconstructed CT images increased depiction of intracranial hemorrhages in pediatric head trauma

Energy Technology Data Exchange (ETDEWEB)

Langford, Stacey; Panigrahy, Ashok; Narayanan, Srikala; Hwang, Misun; Fitz, Charles; Flom, Lynda; Lee, Vincent Kyu; Zuccoli, Giulio [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Section of Neuroradiology, Pittsburgh, PA (United States)

2015-12-15

The benefits of multiplanar reconstructed images (MPR) of unenhanced axial head computed tomography (CT) data have not been established in trauma patients younger than 3 years old, a population in which a reliable history and physical examination may be most difficult. We retrospectively evaluated unenhanced head CTs in pediatric trauma patients to investigate the various benefits of MPR in this age group. A total of 221 unenhanced head CTs performed for any case of head trauma (HT) on children younger than 3 years old were independently reviewed by two radiologists. Studies were reviewed first in the standard axial plane alone and then with the addition of MPR. Reviewers were asked to determine if the MPR affected the ability to make findings of hemorrhage, incidental findings, and artifacts. MPR improved the detection of hemorrhage in 14 cases (6.5 %, p-value < 0.01) and incidental findings in five cases (2.3 %, p-value < 0.05) as well as helped prove artifacts in five cases (2.3 %, p-value < 0.05). Routine use of MPR in HT patients younger than 3 years old has the potential to increase the detection of acute and incidental imaging findings. (orig.)

Delayed-onset bilateral abducens paresis after head trauma

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Pravin Salunke

2012-01-01

Full Text Available Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.

CSF-biomarkers in Olympic boxing: diagnosis and effects of repetitive head trauma.

Science.gov (United States)

Neselius, Sanna; Brisby, Helena; Theodorsson, Annette; Blennow, Kaj; Zetterberg, Henrik; Marcusson, Jan

2012-01-01

Sports-related head trauma is common but still there is no established laboratory test used in the diagnostics of minimal or mild traumatic brain injuries. Further the effects of recurrent head trauma on brain injury markers are unknown. The purpose of this study was to investigate the relationship between Olympic (amateur) boxing and cerebrospinal fluid (CSF) brain injury biomarkers. The study was designed as a prospective cohort study. Thirty Olympic boxers with a minimum of 45 bouts and 25 non-boxing matched controls were included in the study. CSF samples were collected by lumbar puncture 1-6 days after a bout and after a rest period for at least 14 days. The controls were tested once. Biomarkers for acute and chronic brain injury were analysed. NFL (mean ± SD, 532±553 vs 135±51 ng/L p = 0.001), GFAP (496±238 vs 247±147 ng/L pboxing compared to controls. NFL (402±434 ng/L p = 0.004) and GFAP (369±113 ng/L p = 0.001) concentrations remained elevated after the rest period. Increased CSF levels of T-tau, NFL, GFAP, and S-100B in >80% of the boxers demonstrate that both the acute and the cumulative effect of head trauma in Olympic boxing may induce CSF biomarker changes that suggest minor central nervous injuries. The lack of normalization of NFL and GFAP after the rest period in a subgroup of boxers may indicate ongoing degeneration. The recurrent head trauma in boxing may be associated with increased risk of chronic traumatic brain injury.

CT detection of occult pneumothorax in head trauma

International Nuclear Information System (INIS)

Tocino, I.M.; Miller, M.H.; Frederick, P.R.; Bahr, A.L.; Thomas, F.

1984-01-01

A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneuomothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothorax during subsequent mechanical ventilation or emergency surgery under general anesthesia

CT detection of occult pneumothorax in head trauma

Energy Technology Data Exchange (ETDEWEB)

Tocino, I.M.; Miller, M.H.; Frederick, P.R.; Bahr, A.L.; Thomas, F.

1984-11-01

A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneuomothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothorax during subsequent mechanical ventilation or emergency surgery under general anesthesia.

Comparison of intracranial computed tomographic (CT) findings in pediatric abusive and accidental head trauma

International Nuclear Information System (INIS)

Hymel, K.P.; Rumack, C.M.; Hay, T.C.; Strain, J.D.; Jenny, C.

1997-01-01

Background. Child abuse specialists rely heavily on diagnostic neuroimaging. Objectives. Study objectives were: (1) to compare the frequencies of six specific intracranial CT abnormalities in accidental and non-accidental pediatric head trauma, and (2) to assess interobserver agreement regarding these CT findings. Materials and methods. Three pediatric radiologists blindly and independently reviewed cranial CT scans of pediatric patients who sustained closed head trauma between 1991 and 1994. All patients were less than 4 years of age. Study cases included thirty-nine (50 %) with non-accidental head trauma and thirty-nine (50 %) with accidental head trauma. Each scan was evaluated for the presence or absence of the following six intracranial findings: (1) interhemispheric falx hemorrhage, (2) subdural hemorrhage, (3) large (non-acute) extra-axial fluid, (4) basal ganglia edema, (5) posterior fossa hemorrhage, and (6) frontal-parietal shearing tear(s). Interobserver agreement was calculated as the percentage of total cases in which all reviewers agreed a specific CT finding was present or absent. Diagnosis required independent agreement by all three pediatric radiologists. The frequencies of these six intracranial CT abnormalities were compared between the two study groups by Chi-square analysis and Fisher's exact test. Results. Interobserver agreement between radiologists was greater than 80 % for all lesions evaluated, with the exception of frontal-parietal shearing tear(s). Interhemispheric falx hemorrhage, subdural hemorrhage, large (non-acute) extra-axial fluid, and basal ganglia edema were discovered significantly more frequently in non-accidental trauma (P ≤.05). Conclusion. Although not specific for child abuse, discovery of these intracranial CT abnormalities in young patients should prompt careful evaluation of family and injury circumstances for indicators of non-accidental trauma. (orig.). With 6 figs., 2 tabs

Motorcycle Physics.

Science.gov (United States)

Engel, Chuck; Girard, Barbara

1983-01-01

At the end of a secondary school science study of mechanics, a summary lab uses a motorcycle to provide students with the chance to apply some of the concepts they have studied. Exercises from this motorcycle physics lab are discussed. (Author/JN)

Head trauma in sport and neurodegenerative disease: an issue whose time has come?

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Pearce, Neil; Gallo, Valentina; McElvenny, Damien

2015-03-01

A number of small studies and anecdotal reports have been suggested that sports involving repeated head trauma may have long-term risks of neurodegenerative disease. There are now plausible mechanisms for these effects, and a recognition that these problems do not just occur in former boxers, but in a variety of sports involving repeated concussions, and possibly also in sports in which low-level head trauma is common. These neurodegenerative effects potentially include increased risks of impaired cognitive function and dementia, Parkinson's disease, and amyotrophic lateral sclerosis. Many would argue for taking a precautionary approach and immediately banning or restricting sports such as boxing. However, there are important public health issues in terms of how wide the net should be cast in terms of other sports, and what remedial measures could be taken? This in turn requires a major research effort involving both clinical and basic research to understand the underlying mechanisms, leading from head trauma to neurodegenerative disease and epidemiologic studies to assess the long-term consequences. Copyright © 2015 Elsevier Inc. All rights reserved.

Role of Motorcycle Running Lights in Reducing Motorcycle Crashes during Daytime; A Review of the Current Literature

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Davoodi, Seyed Rasoul; Hossayni, Seyed Mohamad

2015-01-01

In comparison to other transportation modes, riding motorcycle is prone to accidents. Motorcyclists are more exposed to physical injury than the car drivers. Many multi-vehicle motorcycles crashes occur, there is right-of- way violation takes place in which another vehicle turns in fronts of a motorcycle, or a sudden cross of path of an on-coming motorcycle. One main factor which leads to high rate of motorcycle crashes is lack of conspicuity of motorcycles by other road users especially during day time traffic. This paper highlights previous studies on the implementation of motorcycle DRLs, focusing on the efficacy of the DRLs to improve motorcycle conspicuity. This paper reviews the impacts of DRL by motorcyclists on multi-vehicle motorcycle crash. The three categories of effects of motorcycle DRLs were reviewed. All literature, supporting that operating headlights during daytime appears to be an influential and effective approach to reduce rate of collision by improving motorcycle’s conspicuity in traffic. The motorcycle DRLs managed to reduce about 4 to 20% of motorcycle crash risk. This paper also recommends that motorcycle DRLs must be used globally, especially in countries with high motorcycle accidents to improve the safety of the riders as well as their pillion riders. PMID:27162907

Optimal timing of tracheostomy after trauma without associated head injury.

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Keenan, Jeffrey E; Gulack, Brian C; Nussbaum, Daniel P; Green, Cindy L; Vaslef, Steven N; Shapiro, Mark L; Scarborough, John E

2015-10-01

Controversy exists over optimal timing of tracheostomy in patients with respiratory failure after blunt trauma. The study aimed to determine whether the timing of tracheostomy affects mortality in this population. The 2008-2011 National Trauma Data Bank was queried to identify blunt trauma patients without concomitant head injury who required tracheostomy for respiratory failure between hospital days 4 and 21. Restricted cubic spline analysis was performed to evaluate the relationship between tracheostomy timing and the odds of inhospital mortality. The cohort was stratified based on this analysis. Unadjusted characteristics and outcomes were compared. Multivariable logistic regression was used to evaluate the effect of tracheostomy timing on mortality after adjustment for age, gender, race, payor status, level of trauma center, injury severity score, presentation Glasgow coma scale, and thoracic and abdominal abbreviated injury score. There were 9662 patients included in the study. Restricted cubic spline analysis demonstrated a nonlinear relationship between timing of tracheostomy and mortality, with higher odds of mortality occurring with tracheostomy placement within 10 d of admission compared with later time points. The cohort was therefore stratified into early and delayed tracheostomy groups relative to this time point. The resulting groups contained 5402 (55.9%) and 4260 (44.1%) patients, respectively. After multivariable adjustment, the delayed tracheostomy group continued to have significantly reduced odds of mortality (Adjusted odds ratio, 0.82, 95% confidence interval, 0.71-0.95, C-statistic, 0.700). Among non-head injured blunt trauma patients with prolonged respiratory failure, tracheostomy placement within 10 d of admission may result in increased mortality compared with later time points. Copyright © 2015 Elsevier Inc. All rights reserved.

The effects of motorcycle helmets on hearing and the detection of warning signals

Science.gov (United States)

Van Moorhem, W. K.; Shepherd, K. P.; Magleby, T. D.; Torian, G. E.

1981-07-01

Measurements of the at-ear helmet-generated aerodynamic noise and helmet insertion loss were carried out for the two major types of motorcycle helmets. From these data and existing information on noise generation by flow around a bare head it was found that for quiet motorcycles at typical operating speeds a significant part of the riders at-ear noise is generated by the air flow. An assessment of the possibility of hearing damage was then carried out. It was found that only with extremely high usage would there be a significant risk of hearing damage for either the bare headed or helmeted rider. Helmets did, however, give significant protection. Detection of warning signals was then considered. It was found that under none of the conditions investigated here did the helmet put its wearer at a disadvantage compared with the bare headed rider, and at typical constant speeds the helmet gave a rider an advantage in the detection of warning signals.

Early insulin resistance in severe trauma without head injury as outcome predictor? A prospective, monocentric pilot study

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Bonizzoli Manuela

2012-10-01

Full Text Available Abstract Background Hyperglycemia following major trauma is a well know phenomenon related to stress-induced systemic reaction. Reports on glucose level management in patients with head trauma have been published, but the development of insulin resistance in trauma patients without head injury has not been extensively studied. The aim of this study was therefore to investigate the prognostic role of acute insulin-resistance, assessed by the HOMA model, in patients with severe trauma without head injury. Methods All patients consecutively admitted to the Intensive Care Unit (ICU of a tertiary referral center (Careggi Teaching Hospital, Florence, IT for major trauma without head injury (Jan-Dec 2010 were enrolled. Patients with a previous diagnosis of diabetes mellitus requiring insulin therapy or metabolism alteration were excluded from the analysis. Patients were divided into “insulin resistant” and “non-insulin resistant” based on the Homeostasis Model Assessment index (HOMA IR. Results are expressed as medians. Results Out of 175 trauma patients admitted to the ICU during the study period, a total of 54 patients without head trauma were considered for the study, 37 of whom met the inclusion criteria. In total, 23 patients (62.2% resulted insulin resistant, whereas 14 patients (37.8% were non-insulin resistant. Groups were comparable in demographic, clinical/laboratory characteristics, and severity of injury. Insulin resistant patients had a significantly higher BMI (P=0.0416, C-reactive protein (P=0.0265, and leukocytes count (0.0301, compared to non-insulin resistant patients. Also ICU length of stay was longer in insulin resistant patients (P=0.0381. Conclusions Our data suggest that admission insulin resistance might be used as an early outcome predictor.

Failure to Obtain Computed Tomography Imaging in Head Trauma: A Review of Relevant Case Law.

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Lindor, Rachel A; Boie, Eric T; Campbell, Ronna L; Hess, Erik P; Sadosty, Annie T

2015-12-01

The objectives were to describe lawsuits against providers for failing to order head computed tomography (CT) in cases of head trauma and to determine the potential effects of available clinical decision rules (CDRs) on each lawsuit. The authors collected jury verdicts, settlements, and court opinions regarding alleged malpractice for failure to order head CT in the setting of head trauma from 1972 through February 2014 from an online legal research tool (WestlawNext). Data were abstracted onto a standardized data form. The performance of five CDRs was evaluated. Sixty relevant cases were identified (52 adult, eight children). Of 48 cases with known outcomes, providers were found negligent in 10 cases (six adult, four pediatric), settled in 11 cases (nine adult, two pediatric), and were found not liable in 27 cases. In all 10 cases in which providers were found negligent, every applicable CDR studied would have indicated the need for head CT. In all eight cases involving children, the applicable CDR would have suggested the need for head CT or observation. A review of legal cases reported in a major online legal research system revealed 60 lawsuits in which providers were sued for failing to order head CTs in cases of head trauma. In all cases in which providers were found negligent, CT imaging or observation would have been indicated by every applicable CDR. © 2015 by the Society for Academic Emergency Medicine.

The effect of motorcycle helmet fit on estimating head impact kinematics from residual liner crush.

Science.gov (United States)

Bonin, Stephanie J; Gardiner, John C; Onar-Thomas, Arzu; Asfour, Shihab S; Siegmund, Gunter P

2017-09-01

Proper helmet fit is important for optimizing head protection during an impact, yet many motorcyclists wear helmets that do not properly fit their heads. The goals of this study are i) to quantify how a mismatch in headform size and motorcycle helmet size affects headform peak acceleration and head injury criteria (HIC), and ii) to determine if peak acceleration, HIC, and impact speed can be estimated from the foam liner's maximum residual crush depth or residual crush volume. Shorty-style helmets (4 sizes of a single model) were tested on instrumented headforms (4 sizes) during linear impacts between 2.0 and 10.5m/s to the forehead region. Helmets were CT scanned to quantify residual crush depth and volume. Separate linear regression models were used to quantify how the response variables (peak acceleration (g), HIC, and impact speed (m/s)) were related to the predictor variables (maximum crush depth (mm), crush volume (cm 3 ), and the difference in circumference between the helmet and headform (cm)). Overall, we found that increasingly oversized helmets reduced peak headform acceleration and HIC for a given impact speed for maximum residual crush depths less than 7.9mm and residual crush volume less than 40cm 3 . Below these levels of residual crush, we found that peak headform acceleration, HIC, and impact speed can be estimated from a helmet's residual crush. Above these crush thresholds, large variations in headform kinematics are present, possibly related to densification of the foam liner during the impact. Copyright © 2017 Elsevier Ltd. All rights reserved.

Motorcycle Mechanic. Teacher Edition.

Science.gov (United States)

Baugus, Mickey; Fulkerson, Dan, Ed.

These teacher's materials are for a 19-unit competency-based course on entry-level motorcycle mechanics at the secondary and postsecondary levels. The 19 units are: (1) introduction to motorcycle repair; (2) general safety; (3) tools and equipment; (4) metric measurements; (5) fasteners; (6) service department operations; (7) motorcycle engines;…

Retrospective analysis of whole-body multislice computed tomography findings taken in trauma patients

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Ozlem Bingol

2015-09-01

Full Text Available Objectives: Using whole-body multislice computed tomography (MSCT excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department. Methods: Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images have been taken, were evaluated using the “Nucleus Medical Information System”. Results: The most frequent type of trauma was traffic accidents in 61.4%, falling down from the height in 22.4%, and motorcycle accidents in 11.4% of patients. Of the patients, 25.2% were discharged from the emergency, while 73.8% were hospitalized. At least one CT findings associated with trauma was present in 61.4% of our patients. Pathological findings in MSCT were most frequently detected in the head and face (35.3% and thoracic (28.6% regions, respectively. The most common finding in the head and face region was fractures. The most common pathological findings in the thoracic region were pulmonary contusion and rib fractures. A significant relationship was detected between trauma type and spinal MSCT result (p < 0.001. In a large percentage of the patients, MSCT findings were normal in the abdominal region and genitourinary system. Vertebral fractures were most frequently detected in the thoracolumbar region. Conclusions: In our study, our rate of negative CT was found to be 38.6%, which is a higher ratio compared to other studies conducte on this topic. Keywords: Emergency, Trauma, Whole-body multislice computed tomography

Minor head trauma – when does it become a major headache?

African Journals Online (AJOL)

Head trauma is a very common problem – most parents will agree .... Tinnitus and hearing impairment. This may present ... take longer to recover than professional athletes, who are ... Training drills specific to sport, non-contact. 5. Full-contact ...

Head trauma and CT

International Nuclear Information System (INIS)

Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

1979-01-01

In our cases of acute and subacute subdural hematoma, the use of CT was evaluated. In our department of surgery, acute subdural hematoma was found in 46 of 388 patients of head trauma who underwent CT. Acute subdural hematoma, like epidural hematoma was usually visualized as a high-density area along the cranial inner table, and this was easily differenciated from epidural hematoma because of difference in shape from the other. The picture of acute subdural hematoma was occasionally confused with that of intracerebral hematoma or cerebral contusion. Single use of CT does not differenciate subacute subdural hematoma from chronic subdural hematoma. However, CT usually visualized acute hematoma as a high-density area, showing the extent of hematoma. Comparison of the thickness of hematoma with the axis deviation of the median part such as the 3rd cerebral ventricle suggested severity of cerebral edema. CT also revealed bilateral or multiple lesions of cerebral contusion or intracerebral hematoma. (Ueda, J.)

Does trauma team activation associate with the time to CT scan for those suspected of serious head injuries?

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Rados, Alma; Tiruta, Corina; Xiao, Zhengwen; Kortbeek, John B; Tourigny, Paul; Ball, Chad G; Kirkpatrick, Andrew W

2013-11-18

Traumatic brain injury (TBI) constitutes the leading cause of posttraumatic mortality. Practically, the major interventions required to treat TBI predicate expedited transfer to CT after excluding other immediately life-threatening conditions. At our center, trauma responses variably consist of either full trauma activation (FTA) including an attending trauma surgeon or a non-trauma team response (NTTR). We sought to explore whether FTAs expedited the time to CT head (TTCTH). Retrospective review of augmented demographics of 88 serious head injuries identified from a Regional Trauma Registry within one year at a level I trauma center. The inclusion criteria consisted of a diagnosis of head injury recorded as intubated or GCS FTA (median 50 vs. 26 minutes, p FTA). Without FTA, most delays (69%) were for emergency intubation. TTCTH after securing the airway was longer for NTTR group (median 38 vs. 26 minutes, p =0.0013). Even with no requirements for ED interventions, TTCTH for FTA was less than half versus NTTR (25 vs. 61 minutes, p =0.0013). Multivariate regression analysis indicated age and FTA with an attending surgeon as significant predictors of TTCTH, although the majority of variability in TTCTH was not explained by these two variables (R² = 0.33). Full trauma activations involving attending trauma surgeons were quicker at transferring serious head injury patients to CT. Patients with FTA were younger and more seriously injured. Discerning the reasons for delays to CT should be used to refine protocols aimed at minimizing unnecessary delays and enhancing workforce efficiency and clinical outcome.

Adult attention-deficit hyperactivity disorder, risky behaviors, and motorcycle injuries: a case-control study

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Sadeghi-Bazargani H

2015-08-01

Full Text Available Homayoun Sadeghi-Bazargani,1,2 Leili Abedi,3 Minoo Mahini,4 Shahrokh Amiri,5 Davoud Khorasani-Zavareh6 1Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2World Health Organization Collaborating Center on Safe Community Promotion, Stockholm, Sweden; 3Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, 4Department of Counseling, Aras International Campus, University of Tehran, Jolfa, 5Research Center of Psychiatry and Behavioral Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, 6Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran Background: The aim of this study was to assess the association of motorcycle traffic injuries with motorcycle riding behavior and subtypes of attention-deficit hyperactivity disorder (ADHD while controlling for individual correlates of motorcycle traffic injuries.Methods: A case-control study was carried out in 298 patients with motorcycle trauma along with 151 control patients admitted to the Shohada and Imam Reza university hospitals as the two referral specialty centers in the East Azarbyjan Province of Iran in 2013. The Persian version of the Motorcycle Riding Behavior Questionnaire and the Persian version of Conner’s Adult ADHD Rating Scales (the self-report short version were used to assess riding behavior and screen for adult ADHD, respectively. The scale has four subscales, comprising subscale A (inattention, subscale B (hyperactivity, impulsivity, subscale C (A + C, and subscale D (ADHD index. The statistical analysis was done using Stata version 11.Results: All subjects were male and aged 13–79 years. Approximately 54% of the participants were married and 13% had academic education. Approximately 18% of the motorcycle riders stated that their motorcycle riding was only for fun purposes. More than two thirds of the participants did not

A data mining approach to investigate the factors influencing the crash severity of motorcycle pillion passengers.

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Tavakoli Kashani, Ali; Rabieyan, Rahim; Besharati, Mohammad Mehdi

2014-12-01

Motorcycle passengers comprise a considerable proportion of traffic crash victims. During a 5 year period (2006-2010) in Iran, an average of 3.4 pillion passengers are killed daily due to motorcycle crashes. This study investigated the main factors influencing crash severity of this group of road users. The Classification and Regression Trees (CART) method was employed to analyze the injury severity of pillion passengers in Iran over a 4 y ear period (2009-2012). The predictive accuracy of the model built with a total of 16 variables was 74%, which showed a considerable improvement compared to previous studies. The results indicate that area type, land use, and injured part of the body (head, neck, etc.) are the most influential factors affecting the fatality of motorcycle passengers. Results also show that helmet usage could reduce the fatality risk among motorcycle passengers by 28%. The findings of this study might help develop more targeted countermeasures to reduce the death rate of motorcycle pillion passengers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Coronary artery dissection following chest trauma

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Manoj K Agarwala

2016-01-01

Full Text Available Chest trauma has a high rate of mortality. Coronary dissection causing myocardial infarction (MI following blunt chest trauma is rare. We describe the case of an anterior MI following blunt chest trauma. A 39-year-old male was received in our hospital following a motorcycle accident. The patient was asymptomatic before the accident. The patient underwent craniotomy for evacuation of hematoma. He developed severe chest pain and an electrocardiogram (ECG revealed anterior ST segment elevation following surgery. Acute coronary event was medically managed; subsequently, coronary angiogram was performed that showed dissection in the left anterior coronary artery, which was stented.

Cranial computed tomography utilization in head trauma in a Southern Nigerian tertiary hospital

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Ehimwenma Ogbeide

2015-01-01

Full Text Available Background: Computed tomography (CT is the imaging modality of choice in evaluating patients with acute head trauma. Objective: The objective of this study is to assess CT utilization in head trauma in University of Benin Teaching Hospital (UBTH with reference to sociodemographic characteristics and cause of injury. Materials and Methods: A retrospective study of patients who had CT scanning done for head trauma in the UBTH, from 2011 to 2013 was undertaken. Medical Records of patients with special emphasis on the patient′s demographic characteristics and detailed information about the cause of injury of the patients were obtained from the accident and emergency department of the hospital. Data were analyzed using SPSS version 17. Results: A total of 1387 patients with male: female ratio of 3.7:1 were studied. The mean age of the patients was 33.2 ± 18.8 years. Road traffic accidents (RTA were the predominant cause of injury among the patients accounting for 62.6% of the cases. Gunshot injury (GSI and patients struck by objects accounted for only 2.7% and 1.3% of the cases, respectively. The Glasgow coma score (GCS of the patients revealed that 42.0%, 26.1%, and 31.9% of patients had severe head injury, moderate injury, and mild injury, respectively. Conclusion: Road traffic accidents involving young adult males constituted the predominant cause of injury in patients that had brain CT in UBTH. There is an urgent need for improvement in the condition of roads and enforcement of the use of protective devices by road users to curb the epidemic of head injury resulting from RTAs.

The epidemiological trends of head injury in the largest Canadian adult trauma center from 1986 to 2007.

Science.gov (United States)

Cadotte, David W; Vachhrajani, Shobhan; Pirouzmand, Farhad

2011-06-01

This study documents the epidemiology of head injury over the course of 22 years in the largest Level I adult trauma center in Canada. This information defines the current state, changing pattern, and relative distribution of demographic factors in a defined group of trauma patients. It will aid in hypothesis generation to direct etiological research, administrative resource allocation, and preventative strategies. Data on all the trauma patients treated at Sunnybrook Health Sciences Centre (SHSC) from 1986 to 2007 were collected in a consecutive, prospective fashion. The authors reviewed these data from the Sunnybrook Trauma Registry Database in a retrospective fashion. The aggregate data on head injury included demographic data, cause of injury, and Injury Severity Score (ISS). The collected data were analyzed using univariate techniques to depict the trend of variables over years. The authors used the length of stay (LOS) and number of deaths per year (case fatality rate) as crude measures of outcome. A total of 16,678 patients were treated through the Level I trauma center at SHSC from January 1986 to December 2007. Of these, 9315 patients met the inclusion criteria (ISS > 12, head Abbreviated Injury Scale score > 0). The median age of all trauma patients was 36 years, and 69.6% were male. The median ISS of the head-injury patients was 27. The median age of this group of patients increased by 12 years over the study period. Motorized vehicle accidents accounted for the greatest number of head injuries (60.3%) although the relative percentage decreased over the study period. The median transfer time of patients sustaining a head injury was 2.58 hours, and there was an approximately 45 minute improvement over the 22-year study period. The median LOS in our center decreased from 19 to 10 days over the study period. The average case fatality rate was 17.4% over the study period. In multivariate analysis, more severe injuries were associated with increased LOS as

Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter?

Science.gov (United States)

Aiolfi, Alberto; Khor, Desmond; Cho, Jayun; Benjamin, Elizabeth; Inaba, Kenji; Demetriades, Demetrios

2018-03-01

OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma. METHODS This retrospective observational study was based on the American College of Surgeons Trauma Quality Improvement Program database, which was searched for all patients with isolated severe blunt head injury who had an ICP monitor placed in the 2-year period from 2013 to 2014. Extracted variables included demographics, comorbidities, mechanisms of injury, head injury specifics (epidural, subdural, subarachnoid, intracranial hemorrhage, and diffuse axonal injury), Abbreviated Injury Scale (AIS) score for each body area, Injury Severity Score (ISS), vital signs in the emergency department, and craniectomy. Outcomes included 30-day mortality, complications, number of ventilation days, intensive care unit and hospital lengths of stay, and functional independence. RESULTS During the study period, 105,721 patients had isolated severe traumatic brain injury (head AIS score ≥ 3). Overall, an ICP monitoring device was placed in 2562 patients (2.4%): 1358 (53%) had an IVD and 1204 (47%) had an IPD. The severity of the head AIS score did not affect the type of ICP monitoring selected. There was no difference in the median ISS; ISS > 15; head AIS Score 3, 4, or 5; or the need for craniectomy between the 2 device groups. Unadjusted 30-day mortality was significantly higher in the group with IVDs (29% vs 25.5%, p = 0.046); however, stepwise logistic regression analysis showed that the type of ICP monitoring was not an independent risk factor for death

Trauma in Guilan (North of Iran: An Epidemiologic Study

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Dehnadimoghadam Anoosh

2009-10-01

Full Text Available Injuries, especially traffic accidents are so important causes of death, disability, hospital expenses, economic damages to the society which World Health Organization selected them as the main subjects for investigation and research. We have done an epidemiologic study about trauma in Guilan, a province in north of Iran. This is  a descriptive study carried out on patients with traumatic injuries, admitted in Poursina Teaching Hospital, during September 2005 to July 2006. Data were collected prospectively using a data collection form including demographic information, mechanism of trauma, anatomical site of injuries, according to AIS90 and severity of head trauma according to glasgow coma scale (GCS. Data were processed by SPSS 11.5 and are shown in tables and figures. Overall 3598 patients admitted. Mean age was 31.85 ± 17.76 years with male to female ratio  about 3.5:1. Most of patients were 25-44 years old (33.9%. Traffic accidents were the leading  cause of injuries (73.84% and then fall (15.7%. Motorcycle was the most common mode of transport in our patients (47.07% after that car (24.3%. Occurrence of traffic accidents increased through evening. Forty six percent of patients transported to hospital by people or came themselves (46.42%. Head and neck were the most common injured part of body (82.4 %, however about in 81.66% of patients were mild and then limb and pelvis (34.7%. Finally about 2.8% of them died. A trauma especially traffic accidents are an important public health issue in Guilan, we recommend conducting other studies focusing on risk factors in details, and considering injury prevention in local decision making.

Assessment of cognitive recovery following sports related head trauma in boxers.

Science.gov (United States)

Ravdin, Lisa D; Barr, William B; Jordan, Barry; Lathan, William E; Relkin, Norman R

2003-01-01

To prospectively examine recovery of cognitive function within one month following subconcussive sports related head trauma. A prospective study of New York State licensed professional boxers who underwent testing of cognitive functioning before and after (within days, one week, and one month) a professional bout. Male professional athletes recruited from the New York State Athletic Commission and local boxing gyms. Twenty-six licensed professional boxers were enrolled in the protocol. Data is presented on the 18 participants who completed testing on at least three of the four time points. Serial neuropsychological assessment before and after the athletes engaged in competition. Neuropsychological measures of cognitive functioning, including new learning and memory, information processing speed, and mental flexibility. A series of repeated measures MANOVAS revealed significant within subject differences across testing on complex information processing and verbal fluency. Post hoc analyses indicated significant differences between time 1 (baseline) and time 4 (one month post), with scores one month following the bout indicating significantly improved performance. Memory scores did not change significantly across testing; however, prior boxing exposure measured by total number of professional bouts was associated with poorer memory performance. Cognitive testing one month following participation in a professional boxing bout yielded scores suggestive of recovery to a level above the baseline. We conclude that baseline assessment taken during periods of intense training are likely confounded by other pre-bout conditions (i.e., sparring, rapid weight loss, pre-bout anxiety) and do not represent true baseline abilities. Instability of performance associated with mild head injury may complicate the interpretation of post-injury assessments. Practice effects may also confound the interpretation of serial assessments, leading to underestimation of the effects of sports

Traction Control System for Motorcycles

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Cardinale Pascal

2009-01-01

Full Text Available Traction control is a widely used control system to increase stability and safety of four wheel vehicles. Automatic stability control is used in the BMW K1200R motorcycle and in motoGP competition, but not in other motorcycles. This paper presents an algorithm and a low-cost real-time hardware implementation for motorcycles. A prototype has been developed, applied on a commercial motorcycle, and tested in a real track. The control system that can be tuned by the driver during the race has been appreciated by the test driver.

Spasm of accommodation associated with closed head trauma.

Science.gov (United States)

Chan, R V Paul; Trobe, Jonathan D

2002-03-01

Spasm of accommodation, creating pseudomyopia, is generally associated with miosis and excess convergence as part of spasm of the near reflex. It may also exist as an isolated entity, usually attributed to psychogenic causes. We present six cases of accommodative spasm associated with closed head injury. All patients were male, ranging in age between 16 and 37 years. The degree of pseudomyopia, defined as the difference between manifest and cycloplegic refraction, was 1.5 to 2 diopters. A 3-year trial of pharmacologically induced cycloplegia in one patient did not lead to reversal of the spasm when the cycloplegia was stopped. All patients required the manifest refraction to see clearly at distance. The pseudomyopia endured for at least 7 years following head trauma. This phenomenon may represent traumatic activation or disinhibition of putative brain stem accommodation centers in young individuals.

Seizure Severity Is Correlated With Severity of Hypoxic-Ischemic Injury in Abusive Head Trauma.

Science.gov (United States)

Dingman, Andra L; Stence, Nicholas V; O'Neill, Brent R; Sillau, Stefan H; Chapman, Kevin E

2017-12-12

The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma. We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored. Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (r s =0.61, P interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03). Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury. Published by Elsevier Inc.

Innovative motorcycle headlight design as a short-term solution for improving motorcycle visibility

OpenAIRE

CAVALLO, Viola; RANCHET, Maud; ESPIE, Stéphane; VIENNE, Fabrice; DANG, Nguyen-Thong

2015-01-01

The most frequent motorcycle accidents involve another vehicle violating the motorcycle's right-of-way at an intersection. In-depth accident studies have shown that perceptual errors made by other vehicle drivers are a very frequent cause of motorcyclists' accidents and fatalities. Two kinds of perceptual errors can be distinguished. The first one is no or late detection of the motorcycle, which is mainly due to its low visual conspicuity (especially because of their small size). The principa...

Total retinal detachment occurring after minor head trauma.

Science.gov (United States)

Mircea, Pienaru; Ramona, Serban; Mircea, Filip; Andrei, Filip

2015-01-01

The objective of this article is to present the case of a patient with a severe decrease of visual acuity that occurred after an apparently minor head injury. Following the investigations, the patient was diagnosed with rhegmatogenous retinal detachment that was triggered by a fall from the same level and which occurred on a background of lattice degeneration. In this case, a minor trauma caused a severe complication because the patient had a contributing factor for the complication. The patient was operated and the end result was satisfactory.

Issues in motorcycle sensory and cognitive conspicuity: the impact of motorcycle low-beam headlights and riding experience on drivers' decisions to turn across the path of a motorcycle.

Science.gov (United States)

Mitsopoulos-Rubens, Eve; Lenné, Michael G

2012-11-01

Crashes involving a passenger car and a motorcycle, where the car is turning across the path of the motorcycle, are a major crash type of motorcycle riders. It has been proposed that the incidence of such crashes could be reduced through improvements in motorcycle conspicuity. Operation of low-beam headlights on motorcycles has been discussed as one approach for improving the "sensory conspicuity" of motorcycles during daylight hours, whilst previous experience as a rider may serve to heighten "cognitive conspicuity" through raised awareness of motorcyclists on our roads. Twenty-three experienced car drivers with no riding experience ("drivers") and 20 experienced car drivers who were also motorcycle riders ("driver-riders") completed a series of trials in a driving simulator where their task in each trial was to turn ahead of an oncoming vehicle if they felt that they had sufficient room to do so safely. A key manipulation across trials was whether the oncoming vehicle was a motorcycle with headlights on, or a motorcycle with headlights off. Time gap (short, medium, long) was also manipulated. Results indicate that, at time gaps defined in the current study as short, low-beam headlights may confer some benefit in gap acceptance by encouraging drivers to accept fewer gaps ahead of a motorcycle with headlights on than ahead of a motorcycle with headlights off. No statistically significant differences in gap acceptance between the headlight conditions were found at either the medium or long time gaps. Irrespective of time gap, driver-riders were found to adopt a more efficient turn strategy than drivers with no direct riding experience. Overall, the present research provides support for the use of low-beam headlights and riding experience as tools through which to augment the sensory and cognitive conspicuity of motorcycles, respectively. It is proposed that further research aim to explore directly the precise mechanisms underlying the observed effects. Copyright �

Head and face injuries and helmet use among injured motorcyclists with road accidents in Isfahan, Iran

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Azam Dadkhah

2015-10-01

Full Text Available BACKGROUND AND AIM: The study aimed to assess the frequency of head and face injuries in motorcyclists who had an accident and to find out the relationship between helmet use and frequency of these injuries. METHODS: A cross-sectional study with multi-stage sampling method provides data on the injured motorcyclists with road accidents. Data came from a registration form which has documented information of each injured person who had a road accident and hospitalized in the biggest hospital of Isfahan University of Medical Sciences, Iran (Al-Zahra. All the registration forms were surveyed for hospitalization period, treatment costs, severity of injury, and date of accident during 2010 (n = 1626. Later, among the list of injured motorcyclists during the last 3 months of the registration form, 125 cases were randomly selected and interviewed by phone regarding occurrence of the head and face injuries and whether wearing helmet during the accident. Confidence intervals (CI, Chi-square, and Phi and Cramer’s correlation coefficient were applied. The ethical approval was provided. RESULTS: Accident by motorcycle was 31.0% of all road accidents. The frequency of motorcycle accidents was higher in the autumn and among 21-25 year olds. The mean period of hospitalization was 4.3 days and the mean of hospital costs was about 9000000 Rials [about 8200 United States dollar (USD, in 2010]. Of motorcyclist, 35.0% reported they were helmeted when they had the accident. The frequency of head and face injuries was 51.0% among all the injured motorcyclists, 22.0% and 78.0% among the helmeted and non-helmeted motorcyclists, respectively (P = 0.009, r = -0.267. CONCLUSION: Motorcycle accidents comprise a large number of road accidents and cause substantial morbidity and financial impact for the community members. Head and face injuries are the most common trauma in motorcyclists, and the injury rate is higher among non-helmeted motorcyclists.

Children presenting in delayed fashion after minor head trauma with scalp swelling: do they require further workup?

Science.gov (United States)

Sellin, Jonathan N; Moreno, Amee; Ryan, Sheila L; Lam, Sandi K; Donaruma-Kwoh, Marcella; Luerssen, Thomas G; Jea, Andrew

2017-04-01

It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma. Cases were collected over a 2-year study period from June 1, 2014 to May 31, 2016. Seventy-six patients comprising 78 patient encounters were included in our study. The mean age at presentation was 8.8 months (range 3 days-24 months). All patients had noncontrast CT of the head as part of their evaluation by emergency medicine, as well as screening for nonaccidental trauma (NAT) by the Child Protection Team. The most common finding on CT head was a linear/nondisplaced skull fracture (SF) with associated extra-axial hemorrhage (epidural or subdural hematoma), which was found in 31/78 patient encounters (40%). Of all 78 patient encounters, 43 patients (55%) were discharged from the emergency room (ER), 17 patients (22%) were admitted for neurologic monitoring, and 18 patients (23%) were admitted solely to allow further NAT evaluation. Of those patients admitted, none experienced a neurologic decline and all had nonfocal neurologic exams on discharge. No patient returned to the ER in delayed fashion for a neurologic decline. Of all the patient encounters, no patient required surgery. Pediatric patients ≤24 months of age presenting to the ER in delayed fashion with scalp swelling after minor head trauma-who were otherwise nonfocal on examination-did not require surgical intervention and did not experience any neurologic decline. Further radiographic

MOTORCYCLE CRASH PREDICTION MODEL FOR NON-SIGNALIZED INTERSECTIONS

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S. HARNEN

2003-01-01

Full Text Available This paper attempts to develop a prediction model for motorcycle crashes at non-signalized intersections on urban roads in Malaysia. The Generalized Linear Modeling approach was used to develop the model. The final model revealed that an increase in motorcycle and non-motorcycle flows entering an intersection is associated with an increase in motorcycle crashes. Non-motorcycle flow on major road had the greatest effect on the probability of motorcycle crashes. Approach speed, lane width, number of lanes, shoulder width and land use were also found to be significant in explaining motorcycle crashes. The model should assist traffic engineers to decide the need for appropriate intersection treatment that specifically designed for non-exclusive motorcycle lane facilities.

Motorcycle trends in the United States

Science.gov (United States)

2009-05-01

During the last decade there has been a significant increase in the number of motorcycle sales and registrations in the United States. At the same time there has been a shift in the demographics of motorcycle users and increased focus on motorcycle s...

Modeling the effect of operator and passenger characteristics on the fatality risk of motorcycle crashes.

Science.gov (United States)

Tavakoli Kashani, Ali; Rabieyan, Rahim; Besharati, Mohammad Mehdi

2016-01-01

In Iran more than 25% of crash fatalities belong to motorcycle operators and passengers in the recent years, from which about 20% are related to passenger fatalities. The aim of this study was to investigate the motorcycle operator and passenger characteristics as well as other contributory factors that may affect the fatality risk of motorcyclists involved in traffic crashes. To this end, motorcycle crash data between 2009 and 2012 was extracted from Iran traffic crash database and a logistic regression analysis was performed to obtain odds ratio estimates for each of the study variables. The fatality risk of motorcyclists has a direct relationship with the number of pillion passengers carried. Results also indicate that the amount of increase in the likelihood of having a fatality in a motorcycles crash is considerably higher when the operator is accompanied by a male passenger of the same age. Furthermore, results showed that if the crash is occurred in the darkness, on curves, in rural areas and on highways, then the crash would be more likely to be fatal. Moreover, the head-on collisions, older operators, unlicensed operators and not using a safety helmet were found to increase the likelihood of a fatality in a motorcycle crash. Preventative measures such as, imposing stricter rules regarding safety helmet usage and confining the number of pillion passengers to one, might be implemented to reduce the fatality risk in motorcycle crashes. In addition, more appropriate infrastructures for penalizing offending motorcyclists could also reduce the frequency of law violations such as not wearing helmet or riding without motorcycle license, which in turn, would result into a reduction in the fatality risk of motorcycle crashes. © 2016 KUMS, All rights reserved.

Imaging of Neonatal Child Abuse with an Emphasis on Abusive Head Trauma

NARCIS (Netherlands)

van Rijn, Rick R.; Spevak, Melissa R.

2011-01-01

Child abuse and neglect is a serious clinical and socioeconomic problem that is sometimes underestimated. One of the most devastating forms is abusive head trauma. This review addresses the radiological workup in cases of suspected child abuse. The use of all modalities, and their advantages and

Motorcycle state estimation for lateral dynamics

NARCIS (Netherlands)

Teerhuis, A.P.; Jansen, S.T.H.

2012-01-01

The motorcycle lean (or roll) angle development is one of the main characteristics of motorcycle lateral dynamics. Control of motorcycle motions requires an accurate assessment of this quantity and for safety applications also the risk of sliding needs to be considered. Direct measurement of the

Head trauma and CT

International Nuclear Information System (INIS)

Samejima, Kanji; Yoshii, Nobuo; Tobari, Chitoshi

1979-01-01

It has been said that chronic subdural hematoma cannot be diagnosed by CT. In our cases, CT was used, and the results were described. According to the density of the picture, CT findings of chronic subdural hematoma could be classified into 3 types, those of higher density than that of the cerebral paranchyma, those of isodensity, and those of lower density than that of the cerebral parenchyma. The difference among them appeared to be due to variation in the fluid in hematoma, especially that in hemoglobin concentration. Chronic subdural hematoma was found in 27 of 388 cases of head trauma in which CT was undertaken in our department of surgery for last 2 years. It is difficult to differenciate this disease from subdural edema or subarachnoideal retention of the cerebrospinal fluid. In many cases, use of contrast medium added no change to the CT picture. Cerebral angiography is necessary for definite diagnosis of the disease. Chronic subdural hematoma gives more varieties of findings than other intracranial hematomas. However, if the film is very carefully read, CT is still useful for diagnosing this disease in spite of initially remarked difficulties. (Ueda, J.)

Guardian availability in children evaluated in the emergency department for blunt head trauma.

Science.gov (United States)

Holmes, James F; Holubkov, Richard; Kuppermann, Nathan

2009-01-01

Enrolling children in research studies in the emergency department (ED) is typically dependent on the presence of a guardian to provide written informed consent. The objectives were to determine the rate of guardian availability during the initial ED evaluation of children with nontrivial blunt head trauma, to identify the reasons why a guardian is unavailable, and to compare clinical factors in patients with and without a guardian present during initial ED evaluation. This was a prospective study of children (guardian during the initial ED evaluation. For those children for whom the guardian was not available during the initial ED evaluation, the physicians completing the data forms documented the reasons for the absence. The authors enrolled 602 patients, of whom 271 (45%, 95% confidence interval [CI] = 41% to 49%) did not have a guardian available during the initial ED evaluation. In these 271 patients, 261 had reasons documented for lack of guardian availability, 43 of whom had multiple reasons. The most common of these was that the guardian did not ride in the ambulance (51%). Those patients without a guardian available were more likely to be older (mean age, 11.4 years vs. 7.6 years; p guardian presence. Nearly one-half of children with nontrivial blunt head trauma evaluated in the ED may not have a guardian available during their initial ED evaluation. Patients whose guardians are not available at the time of initial ED evaluation are older and have more severe mechanisms of injury and more serious head trauma. ED research studies of pediatric trauma patients that require written informed consent from a guardian at the time of initial ED evaluation and treatment may have difficulty enrolling targeted sample size numbers and will likely be limited by enrollment bias.

Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography-based scoring system.

Science.gov (United States)

Chai, Orit; Peery, Dana; Bdolah-Abram, Tali; Moscovich, Efrat; Kelmer, Efrat; Klainbart, Sigal; Milgram, Joshua; Shamir, Merav H

2017-09-01

OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale. ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head. PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results. RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points). CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

Brain Single Photon Emission Computed Tomography in Anosmic Subjects Ater Closed Head Trauma

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Roozbeh Banan

2011-01-01

Full Text Available Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusion- before and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001. Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004. The difference between all the measures in cases and controls were statistically significant (P < 0.0001. There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities

Motorcycle right-of-way accidents--a literature review.

Science.gov (United States)

Pai, Chih-Wei

2011-05-01

The most typical automobile-motorcycle collision take places when an automobile manoeuvres into the path of an approaching motorcycle by violating the motorcycle's right of way (ROW). The present paper provides a comprehensive review of past research that examined motorcycle ROW accidents. Articles and publications were selected for relevance and research strength through a comprehensive search of major databases such as Transportation Research Information Services (TRIS), Compendex, and Medline. Two major causes of such a crash scenario are the lack of motorcycle conspicuity and motorist's speed/distance judgment error, respectively. A substantial number of studies have manipulated physical characteristics of motorcycles and motorcyclists to enhance conspicuity, along with research addressing motorists' gap-acceptance behaviours and arrival time judgments when confronting motorcycles. Although various conspicuity aids have proven effective, some researchers reported that motorcyclist's/motorcycle's brightness per se may be less important as a determinant of conspicuity than brightness contrast between the motorcyclists and the surroundings. Larger vehicles tended to be judged to arrive sooner than motorcycles. Such a speed/distance judgment error is likely attributable to some psychological effects such that larger automobiles appear more threatening than motorcycles. Older motorists particularly have difficulties in accurately estimating the distance and the speed of an approaching motorcycle. Research examining the effects of conspicuity measures on motorists' speed/distance judgments when confronting motorcycles has been rather inconclusive. Past research offers valuable insight into the underlying motorcycle ROW crash mechanisms. However, with ageing society and a rapid change in traffic composition (e.g., more larger motorcycles) in recent years, prior research findings should be updated. The present study finally provides recommendations for future research

Rising gasoline prices increase new motorcycle sales and fatalities.

Science.gov (United States)

Zhu, He; Wilson, Fernando A; Stimpson, Jim P; Hilsenrath, Peter E

2015-12-01

We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984-2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02-1.28) when gasoline prices increase. Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders.

Motorcycle safety among motorcycle taxi drivers and nonoccupational motorcyclists in developing countries: A case study of Maoming, South China.

Science.gov (United States)

Wu, Connor Y H; Loo, Becky P Y

2016-01-01

An increasing number of motorcycle taxis have been involved in traffic crashes in many developing countries. This study examines the characteristics of both motorcycle taxi drivers and nonoccupational motorcyclists, investigates the risks they pose to road safety, and provides recommendations to minimize their risks. Based on the data collected from a questionnaire survey of 867 motorcycle taxi drivers and 2,029 nonoccupational motorcyclists in Maoming, South China, comparisons were made to analyze differences of personal attributes, attitudes toward road safety, and self-reported behavior of the 2 groups. Results of the chi-square tests show that not only motorcycle taxi drivers but also nonoccupational motorcyclists in Maoming held poor attitudes toward road safety and both groups reported unsafe driving behavior. There is much room for improving local road safety education among all motorcyclists in Maoming. Yet, motorcycle taxi drivers were more likely to pose road safety risks than nonoccupational motorcyclists under some circumstances, such as speeding late at night or early in the morning, not requiring passengers to wear helmets, and running a red light. The results of the binary logistic regression model show that possessing a vehicle license for a motorcycle or not was the common significant predictor for unsafe driving behavior of motorcycle taxi drivers and nonoccupational motorcyclists. Therefore, enforcement against all motorcyclists not showing vehicle licenses for their motorcycles should be stepped up. Motorcycle safety is largely poor in Maoming. Therefore, efforts to improve motorcycle safety should be strengthened by targeting not only motorcycle taxi drivers but also nonoccupational motorcyclists.

Magnesium motorcycle applications

International Nuclear Information System (INIS)

Jianyong Cao; Zonghe Zhang; Dongxia Xiang; Jun Wang

2005-01-01

Magnesium, the lightest engineering structural metal, has been comprehensively used in castings of aviation and aerospace, communication and transportation, and IT components. This paper introduced the history, advantages and difficulties of magnesium castings for motorcycle application as well as its application state in China. It also indicated the production situation of magnesium motorcycle components in CQMST and difficulties need to overcome for further development. (orig.)

The profile of CT scan findings in acute head trauma in Orotta ...

African Journals Online (AJOL)

The use of investigation modalities are influenced by socioeconomic and cost effectiveness of the tests. Objective and methods: The purpose of the present five months observational study was to describe the profile of cranial computed tomography (CT) scan findings of 110 cases of acute head trauma in Orotta Hospital.

A Systematic Review of the Usefulness of Glial Fibrillary Acidic Protein for Predicting Acute Intracranial Lesions following Head Trauma

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Teemu M. Luoto

2017-12-01

Full Text Available BackgroundThe extensive use of computed tomography (CT after acute head injury is costly and carries potential iatrogenic risk. This systematic review examined the usefulness of blood-based glial fibrillary acidic protein (GFAP for predicting acute trauma-related CT-positive intracranial lesions following head trauma. The main objective was to summarize the current evidence on blood-based GFAP as a potential screening test for acute CT-positive intracranial lesions following head trauma.MethodsWe screened MEDLINE, EMBASE, PsychInfo, CINAHL, Web of Science, the Cochrane Database, Scopus, Clinical Trials, OpenGrey, ResearchGate, and the reference lists of eligible publications for original contributions published between January 1980 and January 2017. Eligibility criteria included: (i population: human head and brain injuries of all severities and ages; (ii intervention: blood-based GFAP measurement ≤24 h post-injury; and (iii outcome: acute traumatic lesion on non-contrast head CT ≤24 h post-injury. Three authors completed the publication screening, data extraction, and quality assessment of eligible articles.ResultsThe initial search identified 4,706 articles, with 51 eligible for subsequent full-text assessment. Twenty-seven articles were ultimately included. Twenty-four (89% studies reported a positive association between GFAP level and acute trauma-related intracranial lesions on head CT. The area under the receiver operating characteristic curve for GFAP prediction of intracranial pathology ranged from 0.74 to 0.98 indicating good to excellent discrimination. GFAP seemed to discriminate mass lesions and diffuse injury, with mass lesions having significantly higher GFAP levels. There was considerable variability between the measured GFAP averages between studies and assays. No well-designed diagnostic studies with specific GFAP cutoff values predictive of acute traumatic intracranial lesions have been published

KEY COMPONENTS OF A MOTORCYCLE-TRAFFIC SYSTEM

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H. HUSSAIN

2005-01-01

The small- and medium-sized type motorcycles (150c.c. and below made up 99% of the motorcycles population in Malaysia. A static motorcyclist measured about 0.8m in width, 2.0m in length, and requires an operating width of 1.3m. At a lane width of 1.7m or below, motorcycle flow applies the lane or headway concept. Above this optimum value, motorcycle flow adopted the space concept. This implied that a motorcycle path should be more than 1.7m wide to allow two motorcyclists to pass each other.

Head injury in asylum seekers and refugees referred with psychological trauma.

Science.gov (United States)

Doherty, S M; Craig, R; Gardani, M; McMillan, T M

2016-01-01

Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required. The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate-severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases. The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

Effectiveness of motorcycle antilock braking systems (ABS) in reducing crashes, the first cross-national study.

Science.gov (United States)

Rizzi, Matteo; Strandroth, Johan; Kullgren, Anders; Tingvall, Claes; Fildes, Brian

2015-01-01

This study set out to evaluate the effectiveness of motorcycle antilock braking systems (ABS) in reducing real-life crashes. Since the European Parliament has voted on legislation making ABS mandatory on all new motorcycles over 125 cc from 2016, the fitment rate in Europe is likely to increase in the coming years. Though previous research has focused on mostly large displacement motorcycles, this study used police reports from Spain (2006-2009), Italy (2009), and Sweden (2003-2012) in order to analyze a wide range of motorcycles, including scooters, and compare countries with different motorcycling habits. The statistical analysis used odds ratio calculations with an induced exposure approach. Previous research found that head-on crashes were the least ABS-affected crash type and was therefore used as the nonsensitive crash type for ABS in these calculations. The same motorcycle models, with and without ABS, were compared and the calculations were carried out for each country separately. Crashes involving only scooters were further analyzed. The effectiveness of motorcycle ABS in reducing injury crashes ranged from 24% (95% confidence interval [CI], 12-36) in Italy to 29% (95% CI, 20-38) in Spain, and 34% (95% CI, 16-52) in Sweden. The reductions in severe and fatal crashes were even greater, at 34% (95% CI, 24-44) in Spain and 42% (95% CI, 23-61) in Sweden. The overall reductions of crashes involving ABS-equipped scooters (at least 250 cc) were 27% (95% CI, 12-42) in Italy and 22% (95% CI, 2-42) in Spain. ABS on scooters with at least a 250 cc engine reduced severe and fatal crashes by 31% (95% CI, 12-50), based on Spanish data alone. At this stage, there is more than sufficient scientific-based evidence to support the implementation of ABS on all motorcycles, even light ones. Further research should aim at understanding the injury mitigating effects of motorcycle ABS, possibly in combination with combined braking systems.

Criteria for applying imaging diagnosis and initial management for pediatric head trauma

International Nuclear Information System (INIS)

Shiomi, Naoto; Okada, Michiko; Echigo, Tadashi; Oka, Hideki; Hino, Akihiko

2010-01-01

It may be difficult to perform CT for pediatric head trauma because of body movement and radiation exposure. Imaging application criteria were established, in which patients diagnosed as less likely to have an intracranial lesion meeting the criteria were not indicated for imaging and subjected to course observation at home, and this policy was explained to the parents. When consent was obtained, patients were followed up at home, and we checked on the condition by making a phone call 4-8 hours after injury. The patients were 103 infants aged 15 years or younger brought to the emergency medical care center of our hospital between May and August 2008. Imaging was basically indicated for cases of traffic accidents, falls from a high level, those brought in by ambulance, referred cases, and cases with disturbance of consciousness, neurologically abnormal findings, vomiting on examination, and trauma requiring X-ray examination in addition to that for the head. However, apart from these cases, imaging was not required. Imaging was not necessary for 94% of infant cases. The parents were convinced by the explanation and selected course observation at home in 94% of cases for which imaging was judged as unnecessary. None of the patients required re-examination based on the conditions reported in phone calls to homes. Imaging diagnosis for pediatric head trauma is not always necessary, and its application should be decided on after consultation. When no imaging is performed, this should be fully explained at the initial treatment before selecting course observation at home. Checking on the child's condition by making a phone call several hours after injury is useful for both patients and physicians. (author)

Head Trauma from Falling Increases Subsequent Emergency Department Visits More Than Other Fall-Related Injuries in Older Adults.

Science.gov (United States)

Southerland, Lauren T; Stephens, Julie A; Robinson, Shari; Falk, James; Phieffer, Laura; Rosenthal, Joseph A; Caterino, Jeffrey M

2016-04-01

To determine whether fall-related injuries affect return to the ED after the initial visit. Retrospective chart review. Academic Level 1 trauma center ED. Individuals aged 65 and older evaluated for a fall from standing height or less and discharged (N = 263, average age 77, 70% female). After institutional review board approval, electronic medical record data were queried. Univariate and multivariable logistic regression models were used to determine factors associated with risk of returning to the ED within 90 days. Injuries included fractures (45%, n = 117); head trauma (22%, n = 58); abrasions, lacerations, or contusions (34%, n = 88); and none (22%, n = 57). Emergency care was frequently required, with 13 (5%, 95% confidence interval (CI) = 2.3-7.6%) returning within 72 hours, 35 (13%, 95% CI = 9.2-17%] within 30 days, and 57 (22%, 95% CI = 17-27%) within 90 days. Univariately, the odds of returning to the ED within 90 days was more than two times as high for those with head trauma as for those without (odds ratio = 2.66). This remained significant in the multivariable model, which controlled for Charlson Comorbidity Index, fractures, soft tissue injuries, and ED observation unit use. More than one-third of older adults with minor head trauma from a fall will need to return to the ED in the following 90 days. These individuals should receive close attention from primary care providers. The link between minor head trauma and ED recidivism is a new finding. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Motorcycle fuel tanks and pelvic fractures: A motorcycle fuel tank syndrome.

Science.gov (United States)

Meredith, Lauren; Baldock, Matthew; Fitzharris, Michael; Duflou, Johan; Dal Nevo, Ross; Griffiths, Michael; Brown, Julie

2016-08-17

Pelvic injuries are a serious and commonly occurring injury to motorcycle riders involved in crashes, yet there has been limited research investigating the mechanisms involved in these injuries. This study aimed to investigate the mechanisms involved in pelvic injuries to crashed motorcyclists. This study involved in-depth crash investigation and 2 convenience-based data sets were used. These data sets investigated motorcycle crashes in the Sydney, Newcastle, and Adelaide regions. Participants included motorcycle riders who had crashed either on a public road or private property within the study areas. The mechanism of injury and the type of injuries were investigated. The most frequent cause of pelvic injuries in crashed motorcyclists was due to contact with the motorcycle fuel tank during the crash (85%). For riders who had come into contact with the fuel tank, the injury types were able to be grouped into 3 categories based on the complexity of the injury. The complexity of the injury appeared to increase with impact speed but this was a nonsignificant trend. The pelvic injuries that did not occur from contact with the fuel tank in this sample differed in asymmetry of loading and did not commonly involve injury to the bladder. They were commonly one-sided injuries but this differed based on the point of loading; however, a larger sample of these injuries needs to be investigated. Overall improvements in road safety have not been replicated in the amelioration of pelvic injuries in motorcyclists and improvements in the design of crashworthy motorcycle fuel tanks appear to be required.

ROADSIDE BARRIER AND PASSIVE SAFETY OF MOTORCYCLISTS ALONG EXCLUSIVE MOTORCYCLE LANES

Directory of Open Access Journals (Sweden)

A.B. IBITOYE

2007-04-01

Full Text Available The tremendous increase in number of motorcycles and fatalities in some ASEAN countries is becoming a main concern for the safety of motorcyclists along exclusive motorcycle lanes. The existing w-beam guardrail system along exclusive motorcycle lanes was originally designed to reduce severity of a crash when cars and trucks involve in run-off road accident – but not specifically to protect motorcyclists during such accident. However, the consequences of this guardrail design on the passive safety of motorcyclist have been given little consideration. Thus, Probability of the motorcyclists getting injured on collision with guardrail is higher compared to other motor vehicle’s driver. In order to investigate the passive safety of motorcyclists while in collision with this guardrail, this study carried out computer simulation of typical crash scenario and conducted a physical crash test to validate the simulation model. The study examines the crash mechanism as related to injury severity when motorcyclist interacts with W-beam guardrail. A three-dimensional computer simulation of a scaled Hybrid III 50th percentile Male dummy mounted on a motorcycle and colliding with W-beam guardrail was carried out. Multi-body model of motorcycle and finite element model of guardrail were developed with commercially available software called MADYMO. The simulation model is validated with a simple crash test conducted with same initial impact configuration. The subsequent simulations were set up for impacting the existing w-beam guardrail with 110 kg motorcycle using eighteen impact conditions that consist of impact angles 15o, 30o and 45o, impact speeds of 32, 48 and 60km/h as well as post spacing of 2m and 4m. The predicted rider’s injury risk criteria were used to assess safety of guardrail response to motorcyclists. The obtained results confirmed that the existing w-beam guardrail is not safe to motorcyclist, especially for the head injury at impact speed

Motorcycle and scooter speeds approaching urban intersections.

Science.gov (United States)

Walton, D; Buchanan, J

2012-09-01

Five urban, uncontrolled T-intersections known to be motorcycle crash 'black spots' were monitored using instrumentation and a roadside observer. Two sets of twelve-hour observations were collected for each site (N≈100,000). Instrumentation recorded the 'events' of vehicles passing to measure, speed, direction, lane position, vehicle type (broadly characterised) and headway. Observers further recorded times of bicycle events, type of motorcycle (scooters or motorcycles), the behaviour of motorcycles and the use of 'high conspicuity' gear such as clothing or helmets. Results establish that motorcycles travel around 10% faster than the other traffic (car mean speed=34.97 km/h), with motorcycles travelling on average 3.3 km/h faster than cars. Motorcycles were 3.4 times more likely to be exceeding the speed limit than cars. Similar results are described for scooters. Also examined are the influences on mean speeds such as the time of day, the presence of a car at the t-intersection, and the influence of free headway. The results are compared for robustness across locations and days. It is concluded that in urban areas motorcycles are travelling significantly faster than other traffic. These findings are discussed against a concern to reduce motorcycle crashes by improving conspicuity and previous research that implicates a 'looked-but-failed-to-see' effect for car drivers. Copyright © 2012 Elsevier Ltd. All rights reserved.

Va-Room: Motorcycle Safety.

Science.gov (United States)

Keller, Rosanne

One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about motorcycle safety. Using a simplified vocabulary and shorter sentences, it offers statistics concerning motorcycle accidents; information on how to choose the proper machine; basic information about the operation of the…

Motorcycle Safety Education. Bulletin No. 21.

Science.gov (United States)

Alabama State Dept. of Education, Montgomery. Div. of Instructional Services.

This guide for motorcycle safety instructors is intended to provide essential information in a usable format for teaching the basic knowledge and skills to (1) maintain the motorcycle in a safe riding condition; (2) develop an ability to handle the motorcycle in a safe and sane manner; (3) develop defensive driving techniques; and (4) understand…

Spinal cord injury and its association with blunt head trauma

OpenAIRE

Paiva, Wellingson S; Oliveira, Arthur MP; Andrade, Almir F; Amorim, Robson LO; Lourenço, Leonardo JO; Teixeira, Manoel J

2011-01-01

Wellingson S Paiva, Arthur MP Oliveira, Almir F Andrade, Robson LO Amorim, Leonardo JO Lourenço, Manoel J TeixeiraDivision of Neurosurgery, University of São Paulo, BrazilBackground: Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury.Methods: A prospective study involving 1617 patien...

Sim-based detection tools to minimize motorcycle theft

Science.gov (United States)

Triansyah, F. A.; Mudhafar, Z.; Lestari, C.; Amilia, S.; Ruswana, N. D.; Junaeti, E.

2018-05-01

The number of motorcycles in Indonesia spurs the increased criminal acts of motorcycle theft. In addition, the number of motorcycles increases the number of traffic accidents caused by improper motorists. The purpose of this research is to make METEOR (SIM Detector) which is a tool to detect the feasibility of SIM (driver license) which is used to operate and protect motorcycle against theft. METEOR is made through the assembly, encoding, testing, and sequencing stages of the motorcycle. Based on the research that has been done, METEOR generated that can detect the SIM by using additional RFID chip and can be set on the motorcycle. Without the proper SIM, motorized chests coupled with METEOR cannot be turned on. So it can be concluded that motorcycles with additional METEOR is able to be a safety device against theft and as a tool to test the feasibility of motorcycle riders.

Innovative motorcycle headlight design as a means of improving motorcycle perceptibility for car drivers

OpenAIRE

CAVALLO, Viola; ESPIE, Stéphane; RANCHET, Maud; VIENNE, Fabrice; DANG, Nguyen-Thong

2014-01-01

Les travaux présentés portent sur l'évaluation de différentes configurations de feux avant de moto destinées à améliorer la perceptibilité des motocycles pour les automobilistes. The most frequent motorcycle accidents involve another vehicle violating the motorcycle's right-of-way at an intersection. The low visual conspicuity of motorcycles is the primary reason why they are often not detected or seen or too late. The main safety measure in the past has been the compulsory use of daytime ...

Effect of the Earned Income Tax Credit on Hospital Admissions for Pediatric Abusive Head Trauma, 1995-2013.

Science.gov (United States)

Klevens, Joanne; Schmidt, Brian; Luo, Feijun; Xu, Likang; Ports, Katie A; Lee, Rosalyn D

Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged tax filer gets money even if taxes are not owed) from nonrefundable EITCs (ie, tax filer gets credit only for any tax owed), controlling for state rates of child poverty, unemployment, high school graduation, and percentage of non-Latino white people. A refundable EITC was associated with a decrease of 3.1 abusive head trauma admissions per 100 000 population in children aged Tax refunds ranged from $108 to $1014 and $165 to $1648 for a single parent working full-time at minimum wage with 1 child or 2 children, respectively. Our findings with others suggest that policies such as the EITC that increase household income may prevent serious abusive head trauma.

A different perspective on conspicuity related motorcycle crashes.

Science.gov (United States)

de Craen, Saskia; Doumen, Michelle J A; van Norden, Yvette

2014-02-01

The most common type of conflict in which a motorcyclist is injured or killed is a collision between a motorcycle and a car, often in priority situations. Many studies on motorcycle safety focus on the question why car drivers fail to give priority and on the poor conspicuity of motorcycles. The concept of 'looked-but-failed-to-see' crashes is a recurring item. On the other hand, it is not entirely unexpected that motorcycles have many conflicts with cars; there simply are so many cars on the road. This paper tries to unravel whether - acknowledging the differences in exposure - car drivers indeed fail to yield for motorcycles more often than for other cars. For this purpose we compared the causes of crashes on intersections (e.g. failing to give priority, speeding, etc.) between different crash types (car-motorcycle or car-car). In addition, we compared the crash causes of dual drivers (i.e. car drivers who also have their motorcycle licence) with regular car drivers. Our crash analysis suggests that car drivers do not fail to give priority to motorcycles relatively more often than to another car when this car/motorcycle approaches from a perpendicular angle. There is only one priority situation where motorcycles seem to be at a disadvantage compared to cars. This is when a car makes a left turn, and fails to give priority to an oncoming motorcycle. This specific crash scenario occurs more often when the oncoming vehicle is a motorcycle than when it is a car. We did not find a significant difference between dual drivers and regular car drivers in how often they give priority to motorcycles compared to cars. Copyright © 2013 Elsevier Ltd. All rights reserved.

Direct medical costs of motorcycle crashes in Ontario.

Science.gov (United States)

Pincus, Daniel; Wasserstein, David; Nathens, Avery B; Bai, Yu Qing; Redelmeier, Donald A; Wodchis, Walter P

2017-11-20

There is no reliable estimate of costs incurred by motorcycle crashes. Our objective was to calculate the direct costs of all publicly funded medical care provided to individuals after motorcycle crashes compared with automobile crashes. We conducted a population-based, matched cohort study of adults in Ontario who presented to hospital because of a motorcycle or automobile crash from 2007 through 2013. For each case, we identified 1 control absent a motor vehicle crash during the study period. Direct costs for each case and control were estimated in 2013 Canadian dollars from the payer perspective using methodology that links health care use to individuals over time. We calculated costs attributable to motorcycle and automobile crashes within 2 years using a difference-in-differences approach. We identified 26 831 patients injured in motorcycle crashes and 281 826 injured in automobile crashes. Mean costs attributable to motorcycle and automobile crashes were $5825 and $2995, respectively ( p motorcycle crashes compared with automobile crashes (2194 injured annually/100 000 registered motorcycles v. 718 injured annually/100 000 registered automobiles; incidence rate ratio [IRR] 3.1, 95% confidence interval [CI] 2.8 to 3.3, p motorcycles v. 12 severe injuries annually/100 000 registered automobiles; IRR 10.4, 95% CI 8.3 to 13.1, p motorcycle in Ontario costs the public health care system 6 times the amount of each registered automobile. Medical costs may provide an additional incentive to improve motorcycle safety. © 2017 Joule Inc. or its licensors.

Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

International Nuclear Information System (INIS)

McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagulle, Ayse; Kiragu, Andrew

2008-01-01

Abusive head trauma (AHT) in young children usually has a severe outcome when associated with hypoxic-ischemic encephalopathy (HIE), which is best characterized by MRI in the acute or subacute phase utilizing diffusion-weighted imaging (DWI). HIE in this setting has been hypothesized to result from stretching of the spinal cord, brainstem, or vasculature. To provide clinical correlation in patients with unilateral HIE and to postulate a mechanism in the setting of suspected AHT. IRB approval was obtained. Over a 5-year period, the medical records and images were reviewed of the 53 children ≤3 years of age who presented with acute head trauma according to the hospital registry. The children were subselected in order to determine how many suffered either HIE or AHT, and to detect those with unilateral HIE. In 11 of the 53 children, the etiology of the head trauma was highly suspicious for abuse. In 38 the head trauma was accidental and in 4 the trauma was of unknown etiology and at the time of this report was unresolved legally. Of the 53, 4 suffered HIE confirmed by CT or MRI. In three of these four with HIE the trauma was considered highly suspicious for AHT. Two of these three were the only patients with unilateral HIE, and both (7 months and 14 months of age) presented with early subacute phase HIE seen on DW MRI (range 4-7 days) and are described in detail with clinical correlation. The third child with AHT and HIE had bilateral findings. In the fourth patient the HIE was bilateral and was considered accidental. The work-up for both patients with unilateral HIE included head CT, craniocervical MRI, and craniocervical MR angiography (MRA). In both, there was mostly unilateral, deep white matter restricted diffusion, with subdural hematomas that were small compared to the extent of hypoxic-ischemic insult, and no skull fracture. Craniocervical MRA and axial thin-section fat-saturation images were negative for dissection, brainstem, or cord injury. Legal

Unilateral hypoxic-ischemic injury in young children from abusive head trauma, lacking craniocervical vascular dissection or cord injury

Energy Technology Data Exchange (ETDEWEB)

McKinney, Alexander M.; Thompson, Linda R.; Truwit, Charles L.; Velders, Scott; Karagulle, Ayse; Kiragu, Andrew [University of Minnesota Medical School, Department of Radiology, Hennepin County Medical Center, Minneapolis, MN (United States)

2008-02-15

Abusive head trauma (AHT) in young children usually has a severe outcome when associated with hypoxic-ischemic encephalopathy (HIE), which is best characterized by MRI in the acute or subacute phase utilizing diffusion-weighted imaging (DWI). HIE in this setting has been hypothesized to result from stretching of the spinal cord, brainstem, or vasculature. To provide clinical correlation in patients with unilateral HIE and to postulate a mechanism in the setting of suspected AHT. IRB approval was obtained. Over a 5-year period, the medical records and images were reviewed of the 53 children {<=}3 years of age who presented with acute head trauma according to the hospital registry. The children were subselected in order to determine how many suffered either HIE or AHT, and to detect those with unilateral HIE. In 11 of the 53 children, the etiology of the head trauma was highly suspicious for abuse. In 38 the head trauma was accidental and in 4 the trauma was of unknown etiology and at the time of this report was unresolved legally. Of the 53, 4 suffered HIE confirmed by CT or MRI. In three of these four with HIE the trauma was considered highly suspicious for AHT. Two of these three were the only patients with unilateral HIE, and both (7 months and 14 months of age) presented with early subacute phase HIE seen on DW MRI (range 4-7 days) and are described in detail with clinical correlation. The third child with AHT and HIE had bilateral findings. In the fourth patient the HIE was bilateral and was considered accidental. The work-up for both patients with unilateral HIE included head CT, craniocervical MRI, and craniocervical MR angiography (MRA). In both, there was mostly unilateral, deep white matter restricted diffusion, with subdural hematomas that were small compared to the extent of hypoxic-ischemic insult, and no skull fracture. Craniocervical MRA and axial thin-section fat-saturation images were negative for dissection, brainstem, or cord injury. Legal

Psychological models for development of motorcycle helmet use among students in Vietnam

Science.gov (United States)

Kumphong, J.; Satiennam, T.; Satiennam, W.; Trinh, Tu Anh

2018-04-01

A helmet can reduce head accident severity. The aim of this research study was to study the intention for helmet use of students who ride motorcycles in Vietnam, by Structural Equation Modeling (SEM). Questionnaires developed by several traffic psychology modules, including the Theory of Planned Behaviour (TPB), Traffic Locus of Control (T-LOC), and Health Belief Model (HBM), were distributed to students at Ton Thang University and University of Architecture, Ho Chi Minh City. SEM was used to explain helmet use behaviour. The results indicate that TPB, T-LOC and HBM could explain the variance in helmet use behaviour. However, TPB can explain behaviour (helmet use intention) better than T-LOC and HBM. The outcome of this study is useful for the agencies responsible to improve motorcycle safety.

Functional survival after acute care for severe head injury at a designated trauma center in Hong Kong.

Science.gov (United States)

Taw, Benedict B T; Lam, Alan C S; Ho, Faith L Y; Hung, K N; Lui, W M; Leung, Gilberto K K

2012-07-01

Severe head injury is known to be a major cause of early mortalities and morbidities. Patients' long-term outcome after acute care, however, has not been widely studied. We aim to review the outcome of severely head-injured patients after discharge from acute care at a designated trauma center in Hong Kong. This is a retrospective study of prospectively collected data of patients admitted with severe head injuries between 2004 and 2008. Patients' functional status post-discharge was assessed using the Extended Glasgow Outcome Score (GOSE). Of a total of 1565 trauma patients, 116 had severe head injuries and 41 of them survived acute hospital care. Upon the last follow-up, 23 (56.1%) of the acute-care survivors had improvements in their GOSE, six (11.8%) experienced deteriorations, and 12 (23.5%) did not exhibit any change. The greatest improvement was observed in patients with GOSE of 5 and 6 upon discharge, but two of the 16 patients with GOSE 2 or 3 also had a good recovery. On logistic regression analysis, old age and prolonged acute hospital stay were found to be independent predictors of poor functional outcome after a mean follow-up duration of 42 months. Multidisciplinary neurorehabilitation service is an important component of comprehensive trauma care. Despite significant early mortalities, a proportion of severely head-injured patients who survive acute care may achieve good long-term functional recovery. Copyright © 2012, Asian Surgical Association. Published by Elsevier Taiwan LLC. All rights reserved.

SU-F-SPS-03: Direct Measurement of Organ Doses Resulting From Head and Cervical Spine Trauma CT Protocols

Energy Technology Data Exchange (ETDEWEB)

Carranza, C; Lipnharski, I; Quails, N; Correa, N; Rill, L; Arreola, M [University of Florida, Gainesville, FL (United States)

2016-06-15

Purpose: This retrospective study analyzes the exposure history of emergency department (ED) patients undergoing head and cervical spine trauma computed tomography (CT) studies. This study investigated dose levels received by trauma patients and addressed any potential concerns regarding radiation dose issues. Methods: Under proper IRB approval, a cohort of 300 trauma cases of head and cervical spine trauma CT scans received in the ED was studied. The radiological image viewing software of the hospital was used to view patient images and image data. The following parameters were extracted: the imaging history of patients, the reported dose metrics from the scanner including the volumetric CT Dose Index (CTDIvol) and Dose Length Product (DLP). A postmortem subject was scanned using the same scan techniques utilized in a standard clinical head and cervical spine trauma CT protocol with 120 kVp and 280 mAs. The CTDIvol was recorded for the subject and the organ doses were measured using optically stimulated luminescent (OSL) dosimeters. Typical organ doses to the brain, thyroid, lens, salivary glands, and skin, based on the cadaver studies, were then calculated and reported for the cohort. Results: The CTDIvol reported by the CT scanner was 25.5 mGy for the postmortem subject. The average CTDIvol from the patient cohort was 34.1 mGy. From these metrics, typical average organ doses in mGy were found to be: Brain (44.57), Thyroid (33.40), Lens (82.45), Salivary Glands (61.29), Skin (47.50). The imaging history of the cohort showed that on average trauma patients received 26.1 scans over a lifetime. Conclusion: The average number of scans received on average by trauma ED patients shows that radiation doses in trauma patients may be a concern. Available dose tracking software would be helpful to track doses in trauma ED patients, highlighting the importance of minimizing unnecessary scans and keeping doses ALARA.

Alcohol and brief intervention for trauma victims

Directory of Open Access Journals (Sweden)

KARINA DINIZ OLIVEIRA

Full Text Available Objective:to describe the causes and severities of trauma in patients who met the criteria for alcohol abuse or dependence according to Mini International Neuropsychiatric Interview, and to display the pattern of alcohol consumption and subsequent changes one year after trauma.Methods:a transversal and longitudinal quantitative study carried out between November 2012 and September 2013 in the ED. Medical and nursing students collected blood samples, applied the J section of the Mini International Neuropsychiatric Interview (MINI and submitted alcohol abusers and dependents to BI. One year after admission, patients were contacted and asked about their patterns of alcohol use and their reasons for any changes.Results:from a sample of 507 patients admitted to the ED for trauma, 348 responded to MINI, 90 (25.9% being abusers and 36 (10.3% dependent on alcohol. Among the abusers, the most frequent cause of injury was motorcycle accident (35.6% and among the dependents it was predominantly interpersonal violence (22.2%. Positive blood samples for alcohol were identified in 31.7% of the abusers and 53.1% of the dependents. One year after trauma, 66 abusers and 31 dependents were contacted, and it was ascertained that 36.4% of the abusers and 19.4% of the dependents had decreased alcohol consumption. The main reported reason for the reduction was the experienced trauma.Conclusion:the motorcycle accident was the most common cause of injury. The detection of problematic alcohol use and implementation of BI are important strategies in the ED, however for alcohol abusers and dependents, BI was not the most reported reason for any changes in patterns of alcohol use.

Fatal motorcycle accidents and alcohol

DEFF Research Database (Denmark)

Larsen, C F; Hardt-Madsen, M

1987-01-01

A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

Capsular and thalamic infarction caused by tentorial herniation subsequent to head trauma

International Nuclear Information System (INIS)

Endo, M.; Ichikawa, F.; Miyasaka, Y.; Yada, K.; Ohwada, T.

1991-01-01

Five patients (4 male and 1 female) were observed to have capsular and thalamic infarction ascribed to descending transtentorial herniation (DTH) caused by head injury. A lucid interval immediately after the trauma and the presence of an epidural hematoma (EDH) characterized all five case. The low attenuation implicated the perforating arteries, that is the anterior thalamoperforating and anterior choroidal arteries, suggesting infarcted regions caused by occlusion of these arteries. Findings in the present study suggest that arterial occlusion in closed head injury may result from DTH. Moreover, infarction may be attributed to the delayed effects of injury. (orig./GDG)

Texas motorcycle crash countermeasure workshop.

Science.gov (United States)

2013-06-01

The Texas Department of Transportation (TxDOT) contracted with the Texas A&M : Transportation Institute (TTI) to develop a 5-year strategic plan for improving motorcycle safety : in the State of Texas. The Texas Strategic Action Plan for Motorcycl...

The full moon and motorcycle related mortality: population based double control study.

Science.gov (United States)

Redelmeier, Donald A; Shafir, Eldar

2017-12-11

To test whether a full moon contributes to motorcycle related deaths. Population based, individual level, double control, cross sectional analysis. Nighttime (4 pm to 8 am), United States. 13 029 motorcycle fatalities throughout the United States, 1975 to 2014 (40 years). Motorcycle fatalities during a full moon. 13 029 motorcyclists were in fatal crashes during 1482 relevant nights. The typical motorcyclist was a middle aged man (mean age 32 years) riding a street motorcycle with a large engine in a rural location who experienced a head-on frontal impact and was not wearing a helmet. 4494 fatal crashes occurred on the 494 nights with a full moon (9.10/night) and 8535 on the 988 control nights without a full moon (8.64/night). Comparisons yielded a relative risk of 1.05 associated with the full moon (95% confidence interval 1.02 to 1.09, P=0.005), a conditional odds ratio of 1.26 (95% confidence interval 1.17 to 1.37, Pmotorcycle crashes, although potential confounders cannot be excluded. An awareness of the risk might encourage motorcyclists to ride with extra care during a full moon and, more generally, to appreciate the power of seemingly minor distractions at all times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Examining the impact of age and multitasking on motorcycle conspicuity.

Science.gov (United States)

Ledbetter, Jonathan L; Boyce, Michael W; Fekety, Drea K; Sawyer, Ben; Smither, Janan A

2012-01-01

This poster presents a study to assess one's ability to detect motorcycles under different conditions of conspicuity while performing a secondary visual load task. Previous research in which participants were required to detect motorcycles revealed differences in age (young adults/older adult) as well as differences associated with motorcycle conspicuity conditions. Past research has specifically found motorcycles with headlights ON and modulating headlights (flashing) to be more conspicuous than motorcycles with headlights OFF within traffic conditions. The present study seeks to provide more information on the effects of multitasking on motorcycle conspicuity and safety. The current study seeks to determine the degree to which multitasking limits the conspicuity of a motorcycle within traffic. We expect our results will indicate main effects for distraction task, age, gender, motorcycle lighting conditions, and vehicular DRLs on one's ability to effectively detect a motorcycle. The results have implications for motorcycle safety in general and through this research, a better understanding of motorcycle conspicuity can be established so as to minimize the risk involved with motorcycle operation.

Characteristics of associated craniofacial trauma in patients with head injuries: An experience with 100 cases

Directory of Open Access Journals (Sweden)

Rajendra Prasad

2009-01-01

Full Text Available Background: Facial fractures and concomitant cranial injuries carry the significant potential for mortality and neurological morbidity mainly in young adults. Aims and Objectives: To analyze the characteristics of head injuries and associated facial injuries, the management options and outcome following cranio-facial trauma. Methods: This retrospective review was performed at Justice K. S. Hegde Charitable Hospital, and associated A. B. Shetty Memorial Institute of Dental sciences, Deralakatte, Mangalore. Following Ethical Committee approval, hospital charts and radiographs of 100 consecutive patients of cranio-facial trauma managed at the Department of Oral and Maxillofacial Surgery and Neurosurgery between January 2004 and December 2004 were reviewed. Results: Majority of the patients were in the 2nd to 4th decade (79% with a male to female ratio of -8.09:1. Road traffic accidents were the common cause of craniofacial trauma in present study (54% followed by fall from height (30%. Loss of consciousness was the most common clinical symptom (62% followed by headache (33%. Zygoma was the most commonly fractured facial bone 48.2% (alone 21.2%, in combination 27.2%. Majority of patients had mild head injury and managed conservatively in present series. Causes of surgical intervention for intracranial lesions were compound depressed fracture, contusion and intracranial hematoma. Operative indications for facial fractures were displaced facial bone fractures. Major causes of mortality were associated systemic injuries. Conclusion: Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures.

Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

Science.gov (United States)

John, Simon; Vincent, Andrea L; Reed, Peter

2015-01-01

Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

Security Alarm for Motorcycle

Directory of Open Access Journals (Sweden)

Ismail Ismail

2015-11-01

Full Text Available A security alarm for motorcycle has been developed. This equipment consists of two parts. Part one is as a remote control, where it produces a radio signal with frequency of 37.5 MHz to turn on (activate or to turn off alarm. Part two consists of sensor, receiver to receive signal from part one, and alarm. This part two will be attached to motorcycle while part one will be kept as a key by the owner of motorcycle. This equipment has been tested in the laboratory and it worked well. When part two is activated by pushing the “set button” in part one, then any movement of part two (as a movement of motor cycle by about 20 cm from initial position will cause the alarm sounds continuously. The alarm will be off whenever the “reset button” in part one is pushed. Part one (a remote control can activate part two with a maximum of twelve meter separation apart. This shows that the equipment can be used as a security alarm to prevent the motorcycle to be stolen in the future.

Intracranial hemorrhage after blunt head trauma in children with bleeding disorders.

Science.gov (United States)

Lee, Lois K; Dayan, Peter S; Gerardi, Michael J; Borgialli, Dominic A; Badawy, Mohamed K; Callahan, James M; Lillis, Kathleen A; Stanley, Rachel M; Gorelick, Marc H; Dong, Li; Zuspan, Sally Jo; Holmes, James F; Kuppermann, Nathan

2011-06-01

To determine computerized tomography (CT) use and prevalence of traumatic intracranial hemorrhage (ICH) in children with and without congenital and acquired bleeding disorders. We compared CT use and ICH prevalence in children with and without bleeding disorders in a multicenter cohort study of 43 904 children bleeding disorders; all had Glasgow Coma Scale (GCS) scores of 14 to 15. These children had higher CT rates than children without bleeding disorders and GCS scores of 14 to 15 (risk ratio, 2.29; 95% CI, 2.15 to 2.44). Of the children who underwent imaging with CT, 2 of 186 children with bleeding disorders had ICH (1.1%; 95% CI, 0.1 to 3.8) , compared with 655 of 14 969 children without bleeding disorders (4.4%; 95% CI, 4.1-4.7; rate ratio, 0.25; 95% CI, 0.06 to 0.98). Both children with bleeding disorders and ICHs had symptoms; none of the children required neurosurgery. In children with head trauma, CTs are obtained twice as often in children with bleeding disorders, although ICHs occurred in only 1.1%, and these patients had symptoms. Routine CT imaging after head trauma may not be required in children without symptoms who have congenital and acquired bleeding disorders. Copyright © 2011 Mosby, Inc. All rights reserved.

40 CFR 205.171-3 - Test motorcycle sample selection.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Test motorcycle sample selection. 205... ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycle Exhaust Systems § 205.171-3 Test motorcycle sample selection. A test motorcycle to be used for selective enforcement audit testing...

Head injury in asylum seekers and refugees referred with psychological trauma

OpenAIRE

Doherty, S.M.; Craig, R.; Gardani, M.; McMillan, T.M.

2016-01-01

Objective. Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Method. Participants were 115 adult ASR referred ...

Impact of the effect of economic crisis and the targeted motorcycle safety programme on motorcycle-related accidents, injuries and fatalities in Malaysia.

Science.gov (United States)

Law, T H; Umar, R S Radin; Zulkaurnain, S; Kulanthayan, S

2005-03-01

In 1997, a Motorcycle Safety Programme (MSP) was introduced to address the motorcycle-related accident problem. The MSP was specifically targeted at motorcyclists. In addition to the MSP, the recent economic recession has significantly contributed to a reduction of traffic-related incidents. This paper examines the effects of the recent economic crisis and the MSP on motorcycle-related accidents, casualties and fatalities in Malaysia. The autocorrelation integrated moving average model with transfer function was used to evaluate the overall effects of the interventions. The variables used in developing the model were gross domestic product and MSPs. The analysis found a 25% reduction in the number of motorcycle-related accidents, a 27% reduction in motorcycle casualties and a 38% reduction in motorcycle fatalities after the implementation of MSP. Findings indicate that the MSP has been one of the effective measures in reducing motorcycle safety problems in Malaysia. Apart from that, the performance of the country's economy was also found to be significant in explaining the number of motorcycle-related accidents, casualties and fatalities in Malaysia.

Evaluation of Motorcycle Safety in Kansas : Technical Summary

Science.gov (United States)

2012-01-01

Over the past several years, motorcycle fatalities have increased at an alarming rate in the United States. Motorcycle safety issues in Kansas are no different from the national scenario. Accordingly, this study attempted to investigate motorcycle cr...

Performance of computed tomography of the head to evaluate for skull fractures in infants with suspected non-accidental trauma

Energy Technology Data Exchange (ETDEWEB)

Culotta, Paige A.; Tran, Quynh-Anh; Donaruma-Kwoh, Marcella [Texas Children' s Hospital, Section of Public Health Pediatrics, Baylor College of Medicine, Houston, TX (United States); Crowe, James E.; Jones, Jeremy Y.; Mehollin-Ray, Amy R.; Tran, H.B.; Dodge, Cristina T. [Texas Children' s Hospital, The Edward B. Singleton, MD, Department of Pediatric Radiology, Baylor College of Medicine, Houston, TX (United States); Camp, Elizabeth A. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Cruz, Andrea T. [Texas Children' s Hospital, Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States); Texas Children' s Hospital, Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, TX (United States)

2017-01-15

Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma. This was a retrospective (2013-2014) cross-sectional study of infants evaluated for abusive head trauma via both skull radiographs and CT with 3-D reconstruction. The reference standard was skull radiography. All studies were read by pediatric radiologists and neuroradiologists, with ten percent read by a second radiologist to evaluate for interobserver reliability. One hundred seventy-seven children (47% female; mean/median age: 5 months) were included. Sixty-two (35%) had skull fractures by radiography. CT with 3-D reconstruction was 97% sensitive (95% confidence interval [CI]: 89-100%) and 94% specific (CI: 87-97%) for skull fracture. There was no significant difference between plain radiographs and 3-D CT scan results (P-value = 0.18). Kappa was 1 (P-value <0.001) between radiologist readings of CTs and 0.77 (P = 0.001) for skull radiographs. CT with 3-D reconstruction is equivalent to skull radiographs in identifying skull fractures. When a head CT is indicated, skull radiographs add little diagnostic value. (orig.)

Motorcycle Training for California Driver Licensing Personnel. Final Report.

Science.gov (United States)

California State Dept. of Motor Vehicles, Sacramento.

The development of a 6-hour motorcycle course of instruction for personnel responsible for motorcycle licensing is described in this project report. The primary goals are stated and include (1) training driver licensing personnel in motorcycle safety and principles of operation, and (2) purchasing and installing appropriate motorcycle skill…

Improving motorcycle conspicuity through innovative headlight configurations.

Science.gov (United States)

Ranchet, Maud; Cavallo, Viola; Dang, Nguyen-Thong; Vienne, Fabrice

2016-09-01

Most motorcycle crashes involve another vehicle that violated the motorcycle's right-of-way at an intersection. Two kinds of perceptual failures of other road users are often the cause of such accidents: motorcycle-detection failures and motion-perception errors. The aim of this study is to investigate the effect of different headlight configurations on motorcycle detectability when the motorcycle is in visual competition with cars. Three innovative headlight configurations were tested: (1) standard yellow (central yellow headlight), (2) vertical white (one white light on the motorcyclist's helmet and two white lights on the fork in addition to the central white headlight), and (3) vertical yellow (same configuration as (2) with yellow lights instead of white). These three headlight configurations were evaluated in comparison to the standard configuration (central white headlight) in three environments containing visual distractors formed by car lights: (1) daytime running lights (DRLs), (2) low beams, or (3) DRLs and low beams. Video clips of computer-generated traffic situations were displayed briefly (250ms) to 57 drivers. The results revealed a beneficial effect of standard yellow configuration and the vertical yellow configuration on motorcycle detectability. However, this effect was modulated by the car-DRL environment. Findings and practical recommendations are discussed with regard to possible applications for motorcycles. Copyright © 2016 Elsevier Ltd. All rights reserved.

The ACT Alert: preliminary results of a novel protocol to assess geriatric head trauma patients on anticoagulation.

Science.gov (United States)

Rittenhouse, Katelyn; Rogers, Amelia; Clark, Elizabeth; Horst, Michael; Adams, William; Bupp, Katherine; Shertzer, Weston; Miller, Jo Ann; Chandler, Roxanne; Rogers, Frederick B

2015-04-01

In busy emergency departments (EDs), elderly patients on anticoagulation (AC) sustaining minor injuries who are triaged to a lower priority for evaluation are at risk for potentially serious consequences. We sought to determine if a novel ED protocol prioritizes workup and improves outcome. In a Pennsylvania-verified Level II trauma center, the ACT (AntiCoagulation and Trauma) Alert was implemented in March 2012. Triage parameters include: age 65 years or older, AC agents, Glasgow Coma Score (GCS) 13 or greater, and head trauma 24 hours or less. ACT Alerts are announced overhead in the ED and require assessment by an ED physician, nurse, and phlebotomist in 15 minutes or less. Furthermore, they necessitate Point of Care international normalized ratio (INR) 20 minutes or less and head computed tomography (CT) scan 30 minutes or less. Positive CT findings mandate trauma service consultation. ACT Alert patients from March to December 2012 were compared with ED patients 65 years or older, GCS 13 or greater, on AC with the same chief complaints as ACT Alerts from June 2011 to February 2012 (control). A P value ≤ 0.05 was considered significant. Of 752 study patients, 415 were ACT and 337 were controls. There were no significant differences between groups in age, elevated INR, or head bleeds. ACT patients had significantly shorter median times from ED arrival to INR (ACT 13 minutes vs control 80 minutes; P ACT 35 minutes vs control 65 minutes; P ACT had a significantly shorter median length of stay (LOS) (ACT 3.7 days vs control 5.0 days; P ACT Alert improves ED throughput and reduces hospital LOS while effectively identifying at-risk, mildly head injured geriatric patients on AC.

The Prospect of Motorcycle Safety Education in Secondary Schools.

Science.gov (United States)

King, Alfred S.

Motorcycle safety education will become a necessity in the near future due to the growing demands of secondary students for education in this area. The Motorcycle Safety Foundation is sponsored by major motorcycle industries and is involved with developing programs and materials to promote motorcycle safety education. The high rate of motorcycle…

CT scanning in pediatric head trauma: correlation of clinical features with CT scan diagnosis

International Nuclear Information System (INIS)

Arkoncel, Mary Ann P.; Posadas, Ma. Belen A.

1997-01-01

A retrospective review was conducted on 205 cases of pediatric head trauma for which cranial computed tomography scans were done at the Makati Medical Center, to determine which clinical features might positively predict an abnormality on CT scan. The clinical findings of loss of consciousness, GCS < 12, vomiting headache, seizures, and focal abnormalities on Neurologic Examination were significantly associated with abnormal findings on CT scan. However, a significant discrepancy does exist as to how accurately clinical findings do in fact predict normal and abnormal CT scan findings. Such a discrepancy allows us to conclude that a more liberal use of CT Scanning in cases of pediatric head trauma must be stressed to insure proper diagnosis. This study shows that when a patient presents with the aforementioned positive signs and symptoms, or with a focal neurologic deficit, or in combination, a 60-100 % positive prediction of abnormal CT Scan can be made. However, prediction of normal CT Scan is only 0-40%. (Author)

Head injury predictors in sports trauma--a state-of-the-art review.

Science.gov (United States)

Fernandes, Fábio A O; de Sousa, Ricardo J Alves

2015-08-01

Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds. © IMechE 2015.

Motorcycle noise in a park environment

Science.gov (United States)

2013-06-01

The Blue Ridge Parkway National Park provided an environment where sound level : measurements could be made for numerous motorcycle pass-by events. Data were examined : for five motorcycle categories: cruiser, sport, dual purpose, touring, and : mope...

Emergency department visits by pediatric patients sustained as a passenger on a motorcycle.

Science.gov (United States)

Tadros, Allison; Owen, Stephanie; Hoffman, Shelley M; Davis, Stephen M; Sharon, Melinda J

2018-01-02

Currently only 5 out of the 50 states in the United States have laws restricting the age of passengers permitted to ride on a motorcycle. This study sought to characterize the visits by patients under the age of 16 to U.S. emergency departments (EDs) for injuries sustained as a passenger on a motorcycle. In this retrospective cohort study, data were obtained from the Nationwide Emergency Department Sample (NEDS) for the years 2006 to 2011. Pediatric patients who were passengers on a motorcycle that was involved in a crash were identified using International Classification of Diseases, Ninth Revision (ICD-9) External Cause of Injury codes. We also examined gender, age, disposition, regional differences, common injuries, and charges. Between 2006 and 2011 there were an estimated 9,689 visits to U.S. EDs by patients under the age of 16 who were passengers on a motorcycle involved in a crash. The overall average patient age was 9.4 years, and they were predominately male (54.5%). The majority (85%) of these patients were treated and released. The average charges for discharged patients were $2,116.50 and amounted to roughly $17,500,000 during the 6 years. The average cost for admission was $51,446 per patient and totaled over $54 million. The most common primary injuries included superficial contusions; sprains and strains; upper limb fractures; open wounds of head, neck, and trunk; and intracranial injuries. Although there were only about 9,700 visits to U.S. EDs for motorcycle crashes involving passengers less than 16 years old for 2006 to 2011, the total cost of visits that resulted in either ED discharge or hospital admission amounted to over $71 million.

Motorcycle Safety Education. A Curriculum Guide.

Science.gov (United States)

Ohio State Board of Education, Columbus.

This curriculum guide was produced to assist instructors of educational programs for novice motorcycle operators, automobile drivers, and all highway users. An introductory section discusses program implementation concerns, such as public relations, legal considerations, scheduling, staff, students, facilities, motorcycles, insurance, financial…

Fatal motorcycle accidents in the county of Funen (Denmark)

DEFF Research Database (Denmark)

Larsen, C F; Hardt-Madsen, M

1988-01-01

A study of motorcycle fatalities in the period 1977-1983 in the county of Funen, Denmark was compared with an analysis of data obtained from the Accident Register at the Odense University Hospital. Among the operators killed one fifth were illegally operating the motorcycle. A remarkable statisti......A study of motorcycle fatalities in the period 1977-1983 in the county of Funen, Denmark was compared with an analysis of data obtained from the Accident Register at the Odense University Hospital. Among the operators killed one fifth were illegally operating the motorcycle. A remarkable...... statistical difference in distribution of accidents involved motorcycles and the total distribution of motorcycles in the county was reported, thus finding an over-representation of heavy motorcycles in the present study. No important differences were found in the distribution of type of accidents compared...... to other studies. In the present study all but one victim were tested for blood-alcohol concentration (BAC). The results differ from previous studies in as much as 50% of the killed operators of an accident involving motorcycles had a BAC above 0.08%. The reported distribution by age, licensing experience...

Experimental investigations on the cooling of a motorcycle helmet with phase change material (PCM

Directory of Open Access Journals (Sweden)

Fok S.C.

2011-01-01

Full Text Available The thermal comfort of motorcycle helmet during hot weather is important as it can affect the physiological and psychological condition of the rider. This paper examines the use of phase change material (PCM to cool a motorcycle helmet and presents the experimental investigations on the influences of the simulated solar radiation, wind speed, and heat generation rate on the cooling system. The result shows that the PCM-cooled helmet is able to prolong the thermal comfort period compared to a normal helmet. The findings also indicate that the heat generation from the head is the predominant factor that will affect the PCM melting time. Simulated solar radiation and ram-air due to vehicle motion under adiabatic condition can have very little influences on the PCM melting time. The results suggested that the helmet usage time would be influenced by the amount of heat generated from the head. Some major design considerations based on these findings have been included. Although this investigation focuses on the cooling of a motorcyclist helmet, the findings would also be useful for the development of PCM-cooling systems in other applications.

Indications of CT scan after minor head trauma in children. Can age younger than 2 years be a risk factor?

International Nuclear Information System (INIS)

Ozaki, Mitsunori; Seo, Yoshinobu; Nakamura, Hirohiko

2010-01-01

The indications of CT scan after minor head trauma in children are often discussed, including risks of radiation-induced malignancy. Our aim is to identify whether children younger than 2 years have greater risk of traumatic brain injury compared to older children. We enrolled and analysed 1,830 patients younger than 7 years who underwent CT scans after head trauma in our institute. Patients without any symptoms (n=916) were defined as Group A (age<2: n=391, age 2-6: n=525). Patients with extracranial traumatic findings such as scalp hematoma or laceration, and without any neurological symptoms (n=600) were defined as Group B (age<2: n=163, age 2-6: n=437). In order to analyze whether children younger than 2 years have risks of abnormal CT findings due to head trauma, we used the chi-square test in both Group A and Group B. A P-value of less than 0.05 was considered statistically significant. In Group A, there was no significant difference in the frequency of abnormal CT findings between the younger and older groups (p=0.526). In Group B, however, there was a significant difference between those groups (p=0.0186). We suggest that, based on our findings, children younger than 2 years without any symptoms don't have a greater risk of brain injury compared to older children after minor head trauma. This study might contribute to save those children from receiving unnecessary radiation. (author)

A different perspective on conspicuity related motorcycle crashes.

NARCIS (Netherlands)

Craen, S. de Doumen, M.J.A. & Norden, Y. van

2013-01-01

The most common type of conflict in which a motorcyclist is injured or killed is a collision between a motorcycle and a car, often in priority situations. Many studies on motorcycle safety focus on the question why car drivers fail to give priority and on the poor conspicuity of motorcycles. The

Admissions for isolated nonoperative mild head injuries: Sharing the burden among trauma surgery, neurosurgery, and neurology.

Science.gov (United States)

Zhao, Ting; Mejaddam, Ali Y; Chang, Yuchiao; DeMoya, Marc A; King, David R; Yeh, Daniel D; Kaafarani, Haytham M A; Alam, Hasan B; Velmahos, George C

2016-10-01

Isolated nonoperative mild head injuries (INOMHI) occur with increasing frequency in an aging population. These patients often have multiple social, discharge, and rehabilitation issues, which far exceed the acute component of their care. This study was aimed to compare the outcomes of patients with INOMHI admitted to three services: trauma surgery, neurosurgery, and neurology. Retrospective case series (January 1, 2009 to August 31, 2013) at an academic Level I trauma center. According to an institutional protocol, INOMHI patients with Glasgow Coma Scale (GCS) of 13 to 15 were admitted on a weekly rotational basis to trauma surgery, neurosurgery, and neurology. The three populations were compared, and the primary outcomes were survival rate to discharge, neurological status at hospital discharge as measured by the Glasgow Outcome Score (GOS), and discharge disposition. Four hundred eighty-eight INOMHI patients were admitted (trauma surgery, 172; neurosurgery, 131; neurology, 185). The mean age of the study population was 65.3 years, and 58.8% of patients were male. Seventy-seven percent of patients has a GCS score of 15. Age, sex, mechanism of injury, Charlson Comorbidity Index, Injury Severity Score, Abbreviated Injury Scale in head and neck, and GCS were similar among the three groups. Patients who were admitted to trauma surgery, neurosurgery and neurology services had similar proportions of survivors (98.8% vs 95.7% vs 94.7%), and discharge disposition (home, 57.0% vs 61.6% vs 55.7%). The proportion of patients with GOS of 4 or 5 on discharge was slightly higher among patients admitted to trauma (97.7% vs 93.0% vs 92.4%). In a logistic regression model adjusting for Charlson Comorbidity Index CCI and Abbreviated Injury Scale head and neck scores, patients who were admitted to neurology or neurosurgery had significantly lower odds being discharged with GOS 4 or 5. While the trauma group had the lowest proportion of repeats of brain computed tomography (61

Head trauma due to earthquake october, 2005 - experience of 300 cases at the combined military hospital rawalpindi

International Nuclear Information System (INIS)

Bhatti, S.H.; Ahmed, I.; Qureshi, N.A.; Akram, A.; Khan, J.

2008-01-01

To assess the spectrum and management of head injuries among earthquake victims. Three hundred consecutive cases of head injury, secondary to earthquake were included in the study. Plain X-rays of skulls were undertaken in clinically stable patients with head injuries. Cases with altered level of consciousness and compound depressed fractures were advised CT scan of head. Pus swabs were taken from open wounds. Proformas were maintained for every patient. Head injury was classified as mild, moderate and severe, and each patient was treated accordingly. One hundred and twenty three (41%) patients were children under 10 years of age. Adults below 55 years were 69 (23%) and above 55 years were 108 (36%). Mean age was 32.2 years (SD + 6.7). Female to male ratio was 1.1:1. One hundred and sixty five (55%) cases were of mild head injury, 103 (34.3%) patients had moderate head injury and 32 (10.7%) patients had severe head injury. Majority (48.7%) of patients was managed conservatively. Minor surgeries were done in 17% of patients and major surgeries were done in 34.3% of patients. Glasgow Outcome Scale assessment was made at the end of 6 months and 1 year. Mortality increased from 3.3% to 7% in one year time. Patients at the extremes of age are more vulnerable to trauma and should be given timely attention in disaster management plans. General and trauma surgeons should be well-versed with the techniques and indications of burr hole evacuation of life threatening intracranial haematomas in situations, where early evacuation is unattainable. (author)

Burden of motorcycle-related injury in Malaysia

OpenAIRE

Rahman, Nik Hisamuddin NA; Baharuddin, Kamarul A; Mohamad, Syarifah Mastura S

2015-01-01

Background Road traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country. Methods The cross-sectiona...

Circularity bias in abusive head trauma studies could be diminished with a new ranking scale

DEFF Research Database (Denmark)

Högberg, Göran; Colville-Ebeling, Bonnie; Högberg, Ulf

2016-01-01

Causality in abusive head trauma has never been fully established and hence no gold standard exists for the diagnosis. Implications hereof include bias introduced by circular reasoning and a shift from a trustful doctor patient relationship to a distrustful one when the caregiver statement...

"Stuttering" after minor head trauma.

Science.gov (United States)

Strasberg, Stephen; Johnson, Elizabeth J; Parry, Thomas

2016-03-01

Traumatic brain injury (TBI) is defined as impairment in brain function as a result of mechanical force. It is classified based on clinical findings using the Glasgow Coma Scale (GCS). Mild TBI is defined as GCS 14-15; moderate, 9-13; and severe, 3-8. Patients with the same TBI classification may have very different underlying pathology. In moderate to severe TBI, the primary pathology may include contusions, hemorrhage, diffuse axonal injury, direct cellular damage, "tearing and shearing of the tissues, loss of the blood-brain barrier, disruption of the neurochemical homeostasis and loss of the electrochemical function". Although the primary pathology associated with mild TBI may be milder versions of the same pathology associated with moderate and severe TBI, it is generally a metabolic injury. However, it is reported that 15% of patients with mild TBI and a GCS score of 14 or 15 will have an intracranial lesion; less than 1% of these require neurosurgical intervention. Although patients with mild TBI may have intracranial lesions, it is rare that the presenting and only physical examination finding is an isolated neurologic finding. Here we present a case of isolated head trauma with a single physical examination finding--expressive aphasia.

Impact of Helmet Use on Injury and Financial Burden of Motorcycle and Moped Crashes in Hawai‘i: Analysis of a Linked Statewide Database

Science.gov (United States)

Castel, Nikki A; Wong, Linda L; Steinemann, Susan

2016-01-01

Helmet use reduces injury severity, disability, hospital length of stay, and hospital charges in motorcycle riders. The public absorbs billions of dollars annually in hospital charges for unhelmeted, uninsured motorcycle riders. We sought to quantify, on a statewide level, the healthcare burden of unhelmeted motorcycle and moped riders. We examined 1,965 emergency medical service (EMS) reports from motorcycle and moped crashes in Hawai‘i between 2007–2009. EMS records were linked to hospital medical records to assess associations between vehicle type, helmet use, medical charges, diagnoses, and final disposition. Unhelmeted riders of either type of vehicle suffered more head injuries, especially skull fractures (adjusted odds ratio (OR) of 4.48, P motorcycle and moped riders, with a significant (P = .006) difference between helmeted ($27,176) and unhelmeted ($40,217) motorcycle riders. Unhelmeted riders were twice as likely to self-pay (19.3%, versus 9.8% of helmeted riders), and more likely to have Medicaid or a similar income-qualifying insurance plan (13.5% versus 5.0%, respectively). Protective associations with helmet use are stronger among motorcyclists than moped riders, suggesting the protective effect is augmented in higher speed crashes. The public financial burden is higher from unhelmeted riders who sustain more severe injuries and are less likely to be insured. PMID:27980882

Motorcycle Education Curriculum Specifications. Final Report.

Science.gov (United States)

McKnight, A. James; And Others

This report contains specifications for a motorcycle safety education curriculum designed to reduce the incidence and severity of motorcycle accidents. The specifications prescribe objectives, prerequisites, methods, materials, equipment, facilities, and proficiency measures for six units of instruction: (1) basic riding skills, (2) street riding…

Effective Factors in Severity of Traffic Accident-Related Traumas; an Epidemiologic Study Based on the Haddon Matrix

Directory of Open Access Journals (Sweden)

Kambiz Masoumi

2016-04-01

Full Text Available Introduction: Traffic accidents are the 8th cause of mortality in different countries and are expected to rise to the 3rd rank by 2020. Based on the Haddon matrix numerous factors such as environment, host, and agent can affect the severity of traffic-related traumas. Therefore, the present study aimed to evaluate the effective factors in severity of these traumas based on Haddon matrix. Methods: In the present 1-month cross-sectional study, all the patients injured in traffic accidents, who were referred to the ED of Imam Khomeini and Golestan Hospitals, Ahvaz, Iran, during March 2013 were evaluated. Based on the Haddon matrix, effective factors in accident occurrence were defined in 3 groups of host, agent, and environment. Demographic data of the patients and data regarding Haddon risk factors were extracted and analyzed using SPSS version 20. Results: 700 injured people with the mean age of 29.66 ± 12.64 years (3-82 were evaluated (92.4% male. Trauma mechanism was car-pedestrian in 308 (44% of the cases and car-motorcycle in 175 (25%. 610 (87.1% cases were traffic accidents and 371 (53% occurred in the time between 2 pm and 8 pm. Violation of speed limit was the most common violation with 570 (81.4% cases, followed by violation of right-of-way in 57 (8.1% patients. 59.9% of the severe and critical injuries had occurred on road accidents, while 61.3% of the injuries caused by traffic accidents were mild to moderate (p < 0.001. The most common mechanisms of trauma for critical injuries were rollover (72.5%, motorcycle-pedestrian (23.8%, and car-motorcycle (13.14% accidents (p < 0.001. Conclusion: Based on the results of the present study, the most important effective factors in severity of traffic accident-related traumas were age over 50, not using safety tools, and undertaking among host-related factors; insufficient environment safety, road accidents and time between 2 pm and 8 pm among environmental factors; and finally, rollover, car

Educational paper: Abusive Head Trauma part I. Clinical aspects.

Science.gov (United States)

Sieswerda-Hoogendoorn, Tessa; Boos, Stephen; Spivack, Betty; Bilo, Rob A C; van Rijn, Rick R

2012-03-01

Abusive Head Trauma (AHT) refers to the combination of findings formerly described as shaken baby syndrome. Although these findings can be caused by shaking, it has become clear that in many cases there may have been impact trauma as well. Therefore a less specific term has been adopted by the American Academy of Pediatrics. AHT is a relatively common cause of childhood neurotrauma with an estimated incidence of 14-40 cases per 100,000 children under the age of 1 year. About 15-23% of these children die within hours or days after the incident. Studies among AHT survivors demonstrate that approximately one-third of the children are severely disabled, one-third of them are moderately disabled and one-third have no or only mild symptoms. Other publications suggest that neurological problems can occur after a symptom-free interval and that half of these children have IQs below the 10th percentile. Clinical findings are depending on the definitions used, but AHT should be considered in all children with neurological signs and symptoms especially if no or only mild trauma is described. Subdural haematomas are the most reported finding. The only feature that has been identified discriminating AHT from accidental injury is apnoea. AHT should be approached with a structured approach, as in any other (potentially lethal) disease. The clinician can only establish this diagnosis if he/she has knowledge of the signs and symptoms of AHT, risk factors, the differential diagnosis and which additional investigations to perform, the more so since parents seldom will describe the true state of affairs spontaneously.

New Jersey motorcycle fatality rates : final report, December 2009.

Science.gov (United States)

2009-12-01

Motorcycle crashes have been increasing in recent years, more than doubling since 1991. In 2007 there were 84 fatal motorcycle crashes in New Jersey. This report describes the methods and findings of an investigation of motorcycle crashes in New Jers...

Risk Factors for Motorcycle-related Severe Injuries in a Medium-sized City in China

Science.gov (United States)

Xiong, Lili; Zhu, Yao; Li, Liping

2016-01-01

Background Motorcycle vehicles are frequent in China, especially in the small and medium sized cities. Road traffic collisions involving motorcycles often result in severe injuries. We aimed to identify risk factors for severe injuries in inpatients sustaining motorcycle collisions. Methods Patients with road traffic injuries involving motorcycles who presented to the neurosurgery and orthopedic departments of three major comprehensive hospitals in Shantou city were reviewed from October 2012 to June 2013. Data from 349 patients was investigated. Crash and injury characteristics were documented by interviewing patients, their family members, and their doctors. Binary logistic regression was used to determine risk factors for severe injuries. Results There were 253 males (72.49%) and 96 females (27.51%), with a male to female ratio of 2.64:1. The mean age was 38.21±17.32 years. One-hundred and fifty patients were in the severe injury group with a mean injury severity score (ISS) of 15.34±9.13. The simple and multiple logistic model showed that males, lack of safeguards, morning and night hours, non-urban areas, collision of a motorcycle with a cycle, ambulance transportation to hospital, admission to a neurosurgery department, lack of traffic control, unobstructed traffic, and poor visibility were all the risk factors. Conclusions This research highlights some problems: less helmet wearing in motorcyclists and cyclists, rural injuries being more serious than urban ones, and head injuries being the main diagnosis in severe injuries. The result of this research is predictable. If the safety equipment is required to be used, such as helmets, and the traffic environment is improved, such as traffic flow, medical resources to injuries and deaths is seasonable, then traffic safety will be improved and accidents will be reduced. PMID:29546203

Associations between drug use and motorcycle helmet use in fatal crashes.

Science.gov (United States)

Rossheim, Matthew E; Wilson, Fernando; Suzuki, Sumihiro; Rodriguez, Mayra; Walters, Scott; Thombs, Dennis L

2014-01-01

Helmet use reduces mortality risk for motorcyclists, regardless of drug and alcohol use. However, the association between drug use and motorcycle helmet utilization is not well known. This study examines the relationship between drug use and motorcycle helmet use among fatally injured motorcycle riders. Using data from the 2005-2009 Fatality Analysis Reporting System (FARS), we examined the association between drug use and motorcycle helmet use in a multivariable logistic regression analysis of 9861 fatally injured motorcycle riders in the United States. For fatally injured motorcycle riders, use of alcohol, marijuana, or other drugs was associated with increased odds of not wearing a motorcycle helmet, controlling for the effects of state motorcycle helmet laws and other confounding variables. Predicted probabilities indicate that helmet use substantially decreases among fatally injured riders mixing alcohol with marijuana and other drugs. Furthermore, the likelihood of helmet use between marijuana-only users and other drug users is virtually the same across all blood alcohol content (BAC) levels. This study provides evidence that alcohol, marijuana, and other drug use is associated with not wearing a motorcycle helmet in fatal motorcycle crashes. There is a clear need for additional prevention and intervention efforts that seek to change helmet and drug use norms among motorcycle riders.

Functional survival after acute care for severe head injury at a designated trauma center in Hong Kong

Directory of Open Access Journals (Sweden)

Benedict B.T. Taw

2012-07-01

Conclusion: Multidisciplinary neurorehabilitation service is an important component of comprehensive trauma care. Despite significant early mortalities, a proportion of severely head-injured patients who survive acute care may achieve good long-term functional recovery.

Improving motorcycle conspicuity through innovative headlight configurations

OpenAIRE

RANCHET, Maud; CAVALLO, Viola; DANG, Nguyen-Thong; VIENNE, Fabrice

2016-01-01

L'article décrit une expérimentation qui évalue différentes configurations de feux avant de moto susceptibles d'améliorer la détectabilité des motocycles dans des environnements comportant des distracteurs visuels (constitués par les feux de circulation diurne des voitures). Most motorcycle crashes involve another vehicle that violated the motorcycle's right-of-way at an inter-section. Two kinds of perceptual failures of other road users are often the cause of such accidents:motorcycle-det...

Comparison of External and Internal Injury in Cases of Fatal Blunt Trauma Head Injury Autopsied at Tertiary Care Centre in Eastern Nepal

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Bikash Sah

2017-07-01

Full Text Available Background & Objectives: Blunt trauma is more likely to be missed because clinical signs are less obvious in many regions of the body. This study was done with an objective to compare external and internal injuries of autopsy cases with fatal blunt trauma head injuries.Materials & Methods: This was a hospital based, cross sectional and analytical study done on the autopsy cases at B. P. Koirala Institute of Health Sciences, Dharan, Nepal (tertiary hospital in eastern Nepal from 13th April 2012 to 13th April 2013 with Head injuries by blunt trauma with or without concomitant non-head injuries. The decomposed bodies and the bodies where cause of trauma could not be differentiated were excluded. Postmortem examination was conducted on all the cases and the injuries present on all the body parts were noted. Abbreviated Injury Scale (AIS score was given for each injury. Appropriate statistical tool was used to compare the AIS scores of external and internal injuries. The test of significance was fixed at p < 0.01. Results: The correlation of scalp injuries with that of skull fracture, intracranial hemorrhage, cerebral injury and overall internal head injury were 0.591, 0.772, 0.439 and 0.600 respectively and all these correlations were statistically significant whereas the correlation between concomitant external and internal non-head injuries is -0.092 which is statistically not significant.Conclusion: Within the limits of this study it is possible to conclude that there was significant association between periodontitis and anxiety, and depression.

Effectiveness of antilock braking systems in reducing motorcycle fatal crash rates.

Science.gov (United States)

Teoh, Eric R

2011-04-01

Overbraking and underbraking have been shown to be common factors in motorcycle crashes. Antilock braking systems (ABS) prevent wheels from locking during braking and may make riders less reluctant to apply full braking force. The objective of this study was to evaluate the effect of ABS in fatal motorcycle crashes. Motorcycle drivers involved in fatal crashes per 10,000 registered vehicle years were compared for 13 motorcycle models with optional ABS and those same models without the option during 2003-2008. Motorcycles with optional ABS were included only if the presence of the option could be identified from the vehicle identification number. The rate of fatal motorcycle crashes per 10,000 registered vehicle years was 37 percent lower for ABS models than for their non-ABS versions. ABS appears to be highly effective in preventing fatal motorcycle crashes based on some early adopters of motorcycle ABS technology.

AIR QUALITY DETERIORATION IN TEHRAN DUE TO MOTORCYCLES

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M. Shafiepour and H. Kamalan

2005-07-01

Full Text Available Since there is a rise of motorcycles population as well as other motor vehicles, it seems that air Pollution deterioration should be studied as one of its environmental impacts. The main objective of this study was to develop a number of scenarios in order to determine the amount of Tehran's air pollution attributable to motorcycles and select the best and the most probable case to be recommended for implementation. The first step was to collect data such as the number of active motorcycles, daily traffic volume, average traveling speed and actual emission factors. For this purpose, a detailed questionnaire was designed to be completed by field surveys and measurements. The collected data were compared with traffic volume data, manufacturing statistics and the latest production capacity forecast in this field. Finally, with this data and emission factors for each type of motorcycle, an emissions inventory model was chosen to provide annual emissions from motorcycles in Tehran in different scenarios. The results showed that in 2002, there has been about 450'000 active motorcycles (4-stroke 58%, 2-stroke 28%, and moped 14% with average speed of 40 km/h and average mileage of 110 km/d. Five scenarios were developed. The best scenario was "Changing all motorcycles to 4-strokes under EU-97 standard" which would result in reduction of NMVOC by 75%, CO by 35% and PM10 by 88%.

Association of perpetrator relationship to abusive head trauma clinical outcomes.

Science.gov (United States)

Scribano, Philip V; Makoroff, Kathi L; Feldman, Kenneth W; Berger, Rachel P

2013-10-01

The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥ 1 year (77% vs. 23%, p<0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries

Energy Technology Data Exchange (ETDEWEB)

Psoter, Kevin J., E-mail: kevinp2@u.washington.edu [Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 (United States); Roudsari, Bahman S., E-mail: roudsari@u.washington.edu [Department of Radiology, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Graves, Janessa M., E-mail: janessa@u.washington.edu [Department of Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Mack, Christopher, E-mail: cdmack@uw.edu [Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Jarvik, Jeffrey G., E-mail: jarvikj@u.washington.edu [Department of Radiology and Department of Neurological Surgery, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States)

2013-06-15

Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.

A case series of closed head trauma with pituitary stalk disruption resulting in hypopituitarism

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Khuram Khan

Full Text Available Introduction: Traumatic brain injury (TBI is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction. We present a case series of two patients diagnosed with hypopituitarism after TBI and treated appropriately with favorable outcome. Case presentations: The first case is a 34 year-old male, who presented to the emergency department with blunt head trauma after a motor vehicle accident while riding his bicycle. He suffered from severe cranio-facial injuries, resulting in multifocal hemorrhagic contusions, epidural hematoma, and extensive cranio-facial fractures involving the sinuses. The patient developed persistent hypotension with a blood pressure as low as 60/40 mmHg on hospital day three.The second case is a 56 year-old male with a history of schizophrenia, who suffered traumatic brain injury after he was hit by a train. The patient sustained multiple facial fractures, pneumocephalus and C2/7 transverse processes fractures. He also had persistent hypotension, unresponsive to standard treatment. Investigation revealed a deficiency of anterior pituitary hormones resulting from pituitary axis disruption. Discussion: Hypopituitarism is becoming an increasingly recognized complication following TBI, ranging from total to isolated deficiencies. Traumatic Brain Injury is a major public health problem and is one of the leading causes of disability. Understanding and recognizing pituitary dysfunction after TBI can lead to better outcomes and improved quality of life

Motorcycle Repair.

Science.gov (United States)

Hein, Jim; Bundy, Mike

This motorcycle repair curriculum guide contains the following ten areas of study: brake systems, clutches, constant mesh transmissions, final drives, suspension, mechanical starting mechanisms, electrical systems, fuel systems, lubrication systems, and overhead camshafts. Each area consists of one or more units of instruction. Each instructional…

The Economic Impact of Helmet Use on Motorcycle Accidents: A Systematic Review and Meta-analysis of the Literature from the Past 20 Years.

Science.gov (United States)

Kim, Chang-Yeon; Wiznia, Daniel H; Averbukh, Leon; Dai, Feng; Leslie, Michael P

2015-01-01

The incidence and cost of motorcycle accidents are projected to increase. Motorcycle helmets are accepted as an effective strategy for reducing the morbidity and therefore the cost of motorcycle accidents. Despite this, states have continued to repeal helmet laws in the past 20 years. In addition, variations in the methodologies and outcomes of published reports have contributed to uncertainty regarding the health care dollars saved due to motorcycle helmet use. The purpose of this systematic review and meta-analysis is to clarify the economic impact of motorcycle helmet use. Our primary source was Medline. Search terms included "motorcycle," "motorbike," "motorcycle helmet," "head protective devices," and "cost and cost analysis." The review only included articles that were primary studies, written in English, evaluations of periods after 1994, and published in a peer-reviewed journal. Two independent authors extracted data using predefined data fields. Meta-analysis was done using the R-metafor package. Twelve papers met the criteria for inclusion. Meta-analysis demonstrated that nonhelmeted patients required $12,239 more in hospital costs per patient. Nonhelmeted patients also required more postdischarge care and were more likely to use publicly funded insurance. Studies also found lower injury severity and better hospital course in the helmeted population. Study limitations included selection bias, unclear statistical assumptions, lack of precision measures, confounding variables, and lack of standardization to a common year. Meta-analysis demonstrated an I2 of 67%, attributing a significant proportion of outcome variation to study differences. Motorcycle helmet use reduces morbidity and contributes to significant health care cost savings. Continuing antihelmet legislation will impose a substantial economic burden to the health care system, the government, and the public.

Burn injuries related to motorcycle exhaust pipes: a study in Greece.

Science.gov (United States)

Matzavakis, Ioannis; Frangakis, Constantine E; Charalampopoulou, Ava; Petridou, Eleni

2005-05-01

To identify measures that should reduce the incidence of burn injuries resulting from motorcycle exhaust pipes through epidemiological analysis of such injuries. During a 5-year period, 251 persons who suffered burn injuries related to motorcycle exhaust pipes have contacted four major hospitals belonging to the Emergency Department Injury Surveillance System (EDISS) operating since 1996 in Greece. These burn injuries were studied in relation to person, environment and vehicle characteristics. The estimated countrywide incidence of burns from motorcycle exhaust pipes was 17 per 100,000 person-years (208 per 100,000 motorcycle-years). The incidence was two times higher for children than for older persons and among the latter it was 60% higher among females than among males. Most of burn injuries (70.5%) concerned motorcycle passengers, mainly when getting on or off motorcycle, with peak incidence during summer. The most frequent location of burn wounds was below the knee and particularly the right leg. It was estimated that the risk of motorcycle exhaust pipe burns when wearing shorts could be reduced by 46% through wearing long pants. Among the victims 65.3% experienced second degree burns. Motorcycle exhaust burns could be substantially reduced by systematically wearing long pants, by incorporating in the design of motorcycles external thermo resistant shields with adequate distance to the exhaust pipe, and by avoiding riding with children on motorcycles.

Crash sequence based risk matrix for motorcycle crashes.

Science.gov (United States)

Wu, Kun-Feng; Sasidharan, Lekshmi; Thor, Craig P; Chen, Sheng-Yin

2018-04-05

included in this study, weighted to represent 338,655 motorcyclists involved in traffic crashes in three years (2011-2013)(NHTSA, 2013). The top five most frequent and severe types of crash sequences were identified, accounting for 23 percent of all the motorcycle crashes included in the study, and they are (1) run-off-road crashes on the right, and hitting roadside objects, (2) cross-median crashes, and rollover, (3) left-turn oncoming crashes, and head-on, (4) crossing over (passing through) or turning into opposite direction at intersections, and (5) side-impacted. In addition to crash sequences, several other factors were also identified to have effects on crash severity: use of helmet, presence of horizontal curves, alcohol consumption, road surface condition, roadway functional class, and nighttime condition. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Four-Ball Gyro and Motorcycle Countersteering

Science.gov (United States)

Galli, J. Ronald; Carroll, Bradley W.

2017-04-01

Most two-wheel motorcycle riders know that, at highway speeds, if you want to turn left you push on the left handlebar and pull on the right handlebar. This is called countersteering. Countersteering is counterintuitive since pushing left and pulling right when the front wheel is not spinning would turn the wheel to the right. All good motorcycle instructors teach countersteering but few understand the physics of why it works, even though there is considerable discussion about it among motorcycle riders. This paper gives a simplified explanation of gyroscopic precession and then applies this to the front wheel of a motorcycle using two steps: 1) explaining how the wheel's lean is initiated, and 2) explaining how the lean will cause the wheel to turn. To assist with this discussion and to demonstrate the conclusions, a "wheel" was constructed using copper pipe, a bicycle wheel hub, and one pound of lead in each of four "balls" at the end of the spokes (see Fig. 1).

Safety system for child pillion riders of underbone motorcycles in Malaysia.

Science.gov (United States)

Sivasankar, S; Karmegam, K; Bahri, M T Shamsul; Naeini, H Sadeghi; Kulanthayan, S

2014-01-01

Motorcycles are a common mode of transport for most Malaysians. Underbone motorcycles are one of the most common types of motorcycle used in Malaysia due to their affordable price and ease of use, especially in heavy traffic in the major cities. In Malaysia, it is common to see a young or child pillion rider clinging on to an adult at the front of the motorcycle. One of the main issues facing young pillion riders is that their safety is often not taken into account when they are riding on a motorcycle. This article reviews the legally available systems in child safety for underbone motorcycles in Malaysia while putting forth the need for a safety system for child pillion riders. Various databases were searched for underbone motorcycle safety systems, related legislation, motorcycle accident data, and types of injuries and these were reviewed to put forth the need for a new safety system. In motorcycle-related accidents, children usually sustain lower limb injuries, which could temporarily or permanently inhibit the child's movements. Accident statistics in Malaysia, especially those involving motorcycles, reflect a pressing need for a reduction in the number of accidents. In Malaysia, the legislation does not go beyond the mandatory use of safety helmets for young pillion users. There is a pressing need for another safety system or mechanism(s) for young pillion riders of underbone motorcycles. Enforcement of laws to enforce the usage of passive safety systems such as helmets and protective gear is difficult in underdeveloped and developing countries. The intervention of new technology is inevitable. Therefore, this article highlights the need for a new safety backrest system for child pillion riders to ensure their safety.

77 FR 48105 - Federal Motor Vehicle Safety Standards; Motorcycle Helmets

Science.gov (United States)

2012-08-13

... [Docket No. NHTSA-2012-0112] Federal Motor Vehicle Safety Standards; Motorcycle Helmets AGENCY: National... Vehicle Safety Standard for motorcycle helmets. Specifically, the final rule amended the helmet labeling... compliance test procedures of FMVSS No. 218, Motorcycle helmets, in order to make it more difficult to...

Using travel socialization and underlying motivations to better understand motorcycle usage in Taiwan.

Science.gov (United States)

Chang, Hsin-Li; Lai, Chi-Yen

2015-06-01

This study introduces self-determination theory (SDT) to refine previous models of vehicle usage motivation. We add travel socialization theory regarding parental influence on vehicle usage to enhance previous structural models describing motorcycle usage behavior. Our newly developed model was empirically verified in a sample of 721 motorcycle users in Taiwan. In addition to instrumental, symbolic, and affective motivations, perceived parental attitudes (PPAs) towards motorcycle riding were found to have a significant effect on individuals' motorcycle use habits. Additionally, participants who perceived their parents to have more positive attitudes toward motorcycles were found to have more experience being chauffeured on motorcycles by their parents. Based on these results, we suggest means to confront the challenges brought on by the rapid growth of motorcycle usage, especially serious motorcycle traffic accidents. These results improve our understanding motorcycle usage in Taiwan and can be used by transportation professionals who are seeking solutions to the rapid growth of motorcycle usage. Copyright © 2015 Elsevier Ltd. All rights reserved.

Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score.

Science.gov (United States)

Casale, Garrett G A; Fishero, Brian A; Park, Stephen S; Sochor, Mark; Heltzel, Sara B; Christophel, J Jared

2017-01-01

The practice of facial trauma surgery would benefit from a useful quantitative scale that measures the extent of injury. To develop a facial trauma scale that incorporates only reducible fractures and is able to be reliably communicated to health care professionals. A cadaveric tissue study was conducted from October 1 to 3, 2014. Ten cadaveric heads were subjected to various degrees of facial trauma by dropping a fixed mass onto each head. The heads were then imaged with fine-cut computed tomography. A Bony Facial Trauma Scale (BFTS) for grading facial trauma was developed based only on clinically relevant (reducible) fractures. The traumatized cadaveric heads were then scored using this scale as well as 3 existing scoring systems. Regression analysis was used to determine correlation between degree of incursion of the fixed mass on the cadaveric heads and trauma severity as rated by the scoring systems. Statistical analysis was performed to determine correlation of the scores obtained using the BFTS with those of the 3 existing scoring systems. Scores obtained using the BFTS were not correlated with dentition (95% CI, -0.087 to 1.053; P = .08; measured as absolute number of teeth) or age of the cadaveric donor (95% CI, -0.068 to 0.944; P = .08). Facial trauma scores. Among all 10 cadaveric specimens (9 male donors and 1 female donor; age range, 41-87 years; mean age, 57.2 years), the facial trauma scores obtained using the BFTS correlated with depth of penetration of the mass into the face (odds ratio, 4.071; 95% CI, 1.676-6.448) P = .007) when controlling for presence of dentition and age. The BFTS scores also correlated with scores obtained using 3 existing facial trauma models (Facial Fracture Severity Scale, rs = 0.920; Craniofacial Disruption Score, rs = 0.945; and ZS Score, rs = 0.902; P trauma scales. Scores obtained using the BFTS were not correlated with dentition (odds ratio, .482; 95% CI, -0.087 to 1.053; P = .08; measured

Motorcycle detection and counting using stereo camera, IR camera, and microphone array

Science.gov (United States)

Ling, Bo; Gibson, David R. P.; Middleton, Dan

2013-03-01

Detection, classification, and characterization are the key to enhancing motorcycle safety, motorcycle operations and motorcycle travel estimation. Average motorcycle fatalities per Vehicle Mile Traveled (VMT) are currently estimated at 30 times those of auto fatalities. Although it has been an active research area for many years, motorcycle detection still remains a challenging task. Working with FHWA, we have developed a hybrid motorcycle detection and counting system using a suite of sensors including stereo camera, thermal IR camera and unidirectional microphone array. The IR thermal camera can capture the unique thermal signatures associated with the motorcycle's exhaust pipes that often show bright elongated blobs in IR images. The stereo camera in the system is used to detect the motorcyclist who can be easily windowed out in the stereo disparity map. If the motorcyclist is detected through his or her 3D body recognition, motorcycle is detected. Microphones are used to detect motorcycles that often produce low frequency acoustic signals. All three microphones in the microphone array are placed in strategic locations on the sensor platform to minimize the interferences of background noises from sources such as rain and wind. Field test results show that this hybrid motorcycle detection and counting system has an excellent performance.

Passengers' attitudes and behaviour towards motorcycle helmet use ...

African Journals Online (AJOL)

Passengers' attitudes and behaviour towards motorcycle helmet use in Ilorin, ... Remember me ... The purpose of this study was to examine the attitudes, knowledge, and behavior of motorcycle passengers to helmet use in Ilorin metropolis, ...

Improving car drivers' perception of motorcycle motion through innovative headlight configurations.

Science.gov (United States)

Cavallo, Viola; Ranchet, Maud; Pinto, Maria; Espié, Stéphane; Vienne, Fabrice; Dang, Nguyen-Thong

2015-08-01

The most frequent cause of motorcycle accidents occurs when another vehicle violates the motorcycle's right-of-way at an intersection. In addition to detection errors, misperception of the approaching motorcycle's speed and time-to-arrival is another driver error that accounts for these accidents, although this error has been studied less often. Such misperceptions have been shown to be related to the small size of motorcycles and to their small angular velocity when approaching. In two experiments we tested the impact of different motorcycle headlight configurations in various ambient lighting conditions (daytime, dusk, and nighttime). The participants drove on a driving simulator and had to turn left across a line of vehicles composed of motorcycles and cars. The motorcycles were approaching at different speeds and were equipped with either a "standard" headlight, a "horizontal" configuration (added to the standard headlight were two lights on the rearview mirrors so as to visually increase the horizontal dimension of the motorcycle), a "vertical" configuration (one light on the rider's helmet and two lights on the fork were added to the standard headlight so as to increase the vertical dimension of the motorcycle), or a "combined" configuration (combining the horizontal and vertical configurations). The findings of the first experiment in nighttime conditions indicated that both the vertical and combined configurations significantly increased the gap car drivers accepted with respect to the motorcycle as compared to the standard configuration, and that the accepted gaps did not differ significantly from those accepted for cars. The advantage of the vertical and combined configurations showed up especially when the motorcycle's approach speed was high. The findings of the second experiment in dusk and daytime conditions indicated similar patterns, but the headlight-configuration effect was less pronounced at dusk, and nonsignificant during the day. The results

Motorcycle crashes potentially preventable by three crash avoidance technologies on passenger vehicles.

Science.gov (United States)

Teoh, Eric R

2018-07-04

The objective of this study was to identify and quantify the motorcycle crash population that would be potential beneficiaries of 3 crash avoidance technologies recently available on passenger vehicles. Two-vehicle crashes between a motorcycle and a passenger vehicle that occurred in the United States during 2011-2015 were classified by type, with consideration of the functionality of 3 classes of passenger vehicle crash avoidance technologies: frontal crash prevention, lane maintenance, and blind spot detection. Results were expressed as the percentage of crashes potentially preventable by each type of technology, based on all known types of 2-vehicle crashes and based on all crashes involving motorcycles. Frontal crash prevention had the largest potential to prevent 2-vehicle motorcycle crashes with passenger vehicles. The 3 technologies in sum had the potential to prevent 10% of fatal 2-vehicle crashes and 23% of police-reported crashes. However, because 2-vehicle crashes with a passenger vehicle represent fewer than half of all motorcycle crashes, these technologies represent a potential to avoid 4% of all fatal motorcycle crashes and 10% of all police-reported motorcycle crashes. Refining the ability of passenger vehicle crash avoidance systems to detect motorcycles represents an opportunity to improve motorcycle safety. Expanding the capabilities of these technologies represents an even greater opportunity. However, even fully realizing these opportunities can affect only a minority of motorcycle crashes and does not change the need for other motorcycle safety countermeasures such as helmets, universal helmet laws, and antilock braking systems.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles.

Science.gov (United States)

Oliveira, Amanda Lima de; Petroianu, Andy; Gonçalves, Dafne Maria Villar; Pereira, Gisele Araújo; Alberti, Luiz Ronaldo

2015-01-01

traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver's license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver's license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver's license for at least one year. among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

Gasoline Prices and Their Relationship to Rising Motorcycle Fatalities, 1990–2007

Science.gov (United States)

Stimpson, Jim P.; Hilsenrath, Peter E.

2009-01-01

Motor vehicle accidents are the leading cause of death among young adults. Although automobile fatalities have declined in recent years, motorcycle fatalities are rapidly increasing. The purpose of our research was to quantify the relationship between changing fuel prices and motorcycle fatalities. Our findings suggest that people increasingly rely on motorcycles to reduce their fuel costs in response to rising gasoline prices. We estimate that use of motorcycles and scooters instead of 4-wheeled vehicles results in over 1500 additional motorcycle fatalities annually for each dollar increase in gas prices. Motorcycle safety should receive more attention as a leading public health issue. PMID:19696374

Self-Reported Loss of Consciousness After Head Trauma Does Not Predispose to Hypopituitarism in an Older Population

NARCIS (Netherlands)

Rabelink, N.M.; Peeters, G.M.E.E.; van Schoor, N.M.; Drent, M.L.; Lips, P.T.A.M.

2011-01-01

Objective: This population study examines the prevalence of hypopituitarism and low bone mineral density (BMD) in older persons reporting loss of consciousness after head trauma (HT). Methods: Data from the Longitudinal Aging Study Amsterdam were used pertaining to 630 women (53 HT) and 533 men (63

Partial Avulsion of Common Bile Duct and Duodenal Perforation in a Blunt Abdominal Trauma

OpenAIRE

Mirza, Bilal; Ijaz, Lubna; Iqbal, Shahid; Sheikh, Afzal

2010-01-01

Complete or partial avulsion of common bile duct is a very rare injury following blunt abdominal trauma in children. A 7-year old boy presented to ER following blunt abdominal trauma by a moving motorcycle. X ray abdomen revealed free air under diaphragm and CT scan showed pancreatic contusion injury. At operation anterior wall of common bile duct (CBD) along with a 2mm rim of duodenal tissue on either side of anterior wall of CBD were found avulsed from the duodenum. The avulsed portion of C...

How similar are two-unit bicycle and motorcycle crashes?

Science.gov (United States)

Haworth, Narelle; Debnath, Ashim Kumar

2013-09-01

This paper explores the similarities and differences between bicycle and motorcycle crashes with other motor vehicles. If similar treatments can be effective for both bicycle and motorcycle crashes, then greater benefits in terms of crash costs saved may be possible for the same investment in treatments. To reduce the biases associated with under-reporting of these crashes to police, property damage and minor injury crashes were excluded. The most common crash type for both bicycles (31.1%) and motorcycles (24.5%) was intersection from adjacent approaches. Drivers of other vehicles were coded most at fault in the majority of two-unit bicycle (57.0%) and motorcycle crashes (62.7%). The crash types, patterns of fault and factors affecting fault were generally similar for bicycle and motorcycle crashes. This confirms the need to combat the factors contributing to failure of other drivers to yield right of way to two-wheelers, and suggest that some of these actions should prove beneficial to the safety of both motorized and non-motorized two-wheelers. In contrast, child bicyclists were more often at fault, particularly in crashes involving a vehicle leaving the driveway or footpath. The greater reporting of violations by riders and drivers in motorcycle crashes also deserves further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Case studies in contact burns caused by exhaust pipes of motorcycles.

Science.gov (United States)

Lai, Chung-Sheng; Lin, Tsai-Ming; Lee, Su-Shin; Tu, Chao-Hung; Chen, I-Heng; Chang, Kao-Ping C; Tsai, Chih-Cheng; Lin, Sin-Daw

2002-06-01

Contact burns caused by the exhaust pipe of motorcycles are rarely reported. We performed retrospective studies of such cases in 78 patients with complete records. The majority of victims were unmarried (75.7%), young (exhaust pipe and its outside cover on moving motorcycles showed that the temperature reached 170-250 and 40-60 degrees C, respectively. For the prevention of these injuries, our suggestions include well-designed external shield with adequate separation from the exhaust pipe, motorcycle parking lots of adequate width (>120cm), the wearing of trousers by motorcyclists, decrease of the density of motorcycle traffic, and development of the electric assisted cycle in place of the fuel-driven motorcycle.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles

Directory of Open Access Journals (Sweden)

Amanda Lima de Oliveira

2015-02-01

Full Text Available Introduction: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. Objective: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. Method: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver’s license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. Results: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11 years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%. Of the motorcyclists who held a car driver’s license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver’s license for at least one year. Conclusion: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon.

Directory of Open Access Journals (Sweden)

Alain Chichom-Mefire

Full Text Available Trauma is a leading cause of morbidity and mortality worldwide. Data characterizing the burden of trauma in Cameroon is limited. Regular, prospective injury surveillance can address the shortcomings of existing hospital administrative logs and medical records. This study aims to characterize trauma as seen at the emergency department (ED of Limbe Regional Hospital (LRH and assess the completeness of data obtained by a trauma registry.From January 2008 to October 2013, we prospectively captured data on injured patients using a strategically designed, context-relevant trauma registry instrument. Indicators around patient demographics, injury characteristics, delays in accessing care, and treatment outcomes were recorded. Descriptive, bivariate, and multivariate statistical analyses were conducted. About 5,617 patients, aged from 0.5-95years (median age of 26 years, visited the LRH ED with an injury; 67% were male. Students (27% were the most affected occupation category. Road traffic injuries (RTIs (56%, assault (22%, and domestic injuries (13% were the leading causes of injury. Two-thirds of RTIs were motorcycle-related. Working in transportation (AOR 4.42, p<0.001 and law enforcement (AOR 1.73, p = 0.004 were significant predictors of having a RTI. The trauma registry showed a significant improvement in completeness of all data (p<0.001 and it improved over time compared with previous administrative records. However, proportions of missing data still ranged from 0.5% to 8.2% and involved respiratory rate or Glasgow Coma scale.Implementation of a context-appropriate trauma registry in resource-constrained settings is feasible. Providing valuable, high-quality data, the trauma registry can inform trauma care quality improvement efforts and policy development. Study findings indicate the need for injury prevention interventions and policies that will prioritize high-risks groups, such as those aged 20-29 years, and those in occupations requiring

Polycyclic aromatic hydrocarbons and nitropolycyclic aromatic hydrocarbons in particulates emitted by motorcycles

International Nuclear Information System (INIS)

Pham, Chau Thuy; Kameda, Takayuki; Toriba, Akira; Hayakawa, Kazuichi

2013-01-01

We determined eleven PAHs and four NPAHs in particulates and regulated pollutants (CO, CO 2 , HC, NO x , PM) exhausted from motorcycles to figure out the characteristics of motorcycle exhausts. Fluoranthene and pyrene accounted for more than 50% of the total detected PAHs. Among four detected NPAHs, 6-nitrochrysene and 7-nitrobenz[a]anthracene were the predominant NPAHs and were highly correlated relationship with their parent PAHs (R = 0.93 and 0.97, respectively). The PM and HC emissions tended to be close to the PAH emissions. NO x and NPAHs were negatively correlated. Despite their small engine size, motorcycles emitted much more PM and PAHs, showed stronger PAH-related carcinogenicity and indirect-acting mutagenicity, but weaker NPAH-related direct-acting mutagenic potency than automobiles. This is the first study to analyze both PAHs and NPAHs emitted by motorcycles, which could provide useful information to design the emission regulations and standards for motorcycles such as PM. -- Highlights: ► We characterized PAHs and NPAHs distribution in motorcycle exhausts. ► NPAHs concentrations were about three orders of magnitude lower than those of PAHs. ► We found larger amounts of PM and PAHs in exhaust of motorcycles than of automobiles. ► Motorcycles showed stronger PAH-related toxicity than automobiles. ► Motorcycles showed weaker NPAH-related direct-acting mutagenicity than automobiles. -- Control polycyclic aromatic hydrocarbons and nitropolycyclic aromatic hydrocarbon in particulates emitted by motorcycles due to their toxic potency

Macroeconomic fluctuations and motorcycle fatalities in the U.S.

Science.gov (United States)

French, Michael T; Gumus, Gulcin

2014-03-01

The effects of business cycles on health outcomes in general, and on traffic fatalities in particular, have received much attention recently. In this paper, we focus on motorcycle safety and examine the impact of changing levels of economic activity on fatal crashes by motorcyclists in the United States. We analyze state-level longitudinal data with 1,104 state/year observations from the 1988-2010 Fatality Analysis Reporting System (FARS). Using the extensive motorcycle crash characteristics available in FARS, we examine not only total fatality rates but also rates decomposed by crash type, day, time, and the level of the motorcycle operator's blood alcohol content. Our results are consistent with much of the existing literature showing that traffic fatality rates are pro-cyclical. The estimates suggest that a 10% increase in real income per capita is associated with a 10.4% rise in the total motorcycle fatality rate. Along with potential mechanisms, policymakers and public health officials should consider the effects of business cycles on motorcycle safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

77 FR 51649 - Federal Motor Vehicle Safety Standards; Motorcycle Brake Systems

Science.gov (United States)

2012-08-24

... motorcycle braking regulations from around the world, including the U.S. motorcycle brake systems standard.... Partial Failure Test--Split Service Brake System I. Power-Assisted Braking System Failure Test V. Other... motorcycle brake system technologies. In order to address modern braking technologies, the agency sought to...

Economic burden of motorcycle accidents in Northern Ghana ...

African Journals Online (AJOL)

Background: Motorcycles are the most popular means of transportation in northern Ghana, and their accidents are major causes of out-patient attendance and admis-sions in the Bolgatanga Municipality. Objective: This paper estimates the economic burden of motorcycle accidents in the Bolgatanga Municipality in Northern ...

Analysis of motorcycle exhaust regular testing data--a case study of Taipei City.

Science.gov (United States)

Chen, Yi-Chi; Chen, Lu-Yen; Jeng, Fu-Tien

2009-06-01

In Taiwan, a continuous increase in the number of motorcycles has made exhaust pollution one of the major emission sources of air pollutants. The regular testing program carried out by the Republic of China Environmental Protection Agency was designed to reduce air pollutant emissions by enhancing maintenance and repair. During the execution period, abundant testing results were accumulated to discuss pollutant emissions from motorcycles. Exhaust testing data of motorcycles in Taipei City from 1996 to 2005 were chosen as the basic data to survey changes in motorcycle exhaust. Effects of motorcycle age and mileage on exhaust pollution were studied. The introduction of advanced emission standards enhances the elimination of high-emitting motorcycles. The testing data indicate that the testing rate rose from approximately 50 to 70% and the failure rate changed from approximately 15 to 10%. The operation cycles of two-stroke motorcycles make them high-emitting vehicles. Concentrations of carbon monoxide and hydrocarbons are higher in two-stroke motorcycle exhaust than that in four-stroke motorcycles. In contrast, the concentration of carbon dioxide produced from complete oxidation processes is lower in exhaust from two-stroke motorcycles. Therefore, failure rates of two-stroke motorcycles are higher than those of four-stroke motorcycles and were also observed to deactivate more easily. On the basis of analytical results of testing data, we found that failure rates show a gradually increasing trend for motorcycles older than 3 yr or used for mileages greater than 10,000 km, and failure rates are highly correlated to the age/mileage of motorcycles. We reason that the accumulation of age or mileage means accumulating usage time of engines and emission control systems. Concentrations of pollutant emissions would increase because of engine wear and emission control system deactivation. After discussing changes of failure rates and pollutant emissions, some suggestions are

Motorcycle helmets in Vietnam: ownership, quality, purchase price, and affordability.

Science.gov (United States)

Hung, Dang Viet; Stevenson, Mark R; Ivers, Rebecca Q

2008-06-01

This study investigated motorcycle helmet ownership, quality, purchase price, and affordability in Vietnam. A random sample of motorcyclists was interviewed to investigate aspects of helmet ownership, the purchase price, and affordability of a motorcycle helmet. Multivariate modeling conducted to determine factors associated with the purchase price and affordability of motorcycle helmets. Helmet quality was assessed based on current legal requirements in Vietnam. The prevalence of helmet use in Vietnam remains low (23.3%) despite a high level of helmet ownership (94%), indicating that this is an important area for public health intervention. Overall the quality of helmets appeared to be good; however, few helmets displayed legally required information. Motorcyclists with a high income purchase more helmets for their household rather than more expensive helmets. To ensure that helmets are accessible to the community, policy-makers need to consider pricing motorcycle helmets at a price indicated by the results of this study. Prior to universal motorcycle helmet legislation, the government will also need to ensure that standard helmets are available and that enforcement is at a level to ensure that motorcycle helmets are actually used.

Acute trauma-induced Budd-Chiari syndrome

International Nuclear Information System (INIS)

Izard, G.; Houri, R.; Randrianasolo, S.; Gailleton, R.

1995-01-01

The diagnosis of Budd-Chiari syndrome is based on clinical signs including liver enlargement and ascites and findings of complementary examinations: echography, echo-Doppler, cat scanning (CT-scan), magnetic resonance imaging, angiography, pressure readings, laparoscopy and biopsy. Trauma is rarely reported as a cause of acute Budd-Chiari syndrome. In some cases, the trauma is so violent the supra-hepatic veins are ruptured and the dramatic outcome leaves no time for the syndrome to develop. In others, the resulting haematomas form a compression block of the supra hepatic vessels. The mechanism of the trauma in our case appears to have been unreported to date. Four days after a violent motorcycle accident, a 33-year-old man developed an acute Budd-Chiari syndrome probably due to partial and temporary thrombosis of the left and middle supra hepatic veins. A side-to-side porto-cava anastomosis with a calibrated venous graft was performed in an emergency procedure. Outcome was quite favourable and after a 4 year follow-up, the patient is in good health. (authors). 13 refs

Motorcycle Accident injuries seen at Kakamega Provincial Hospital ...

African Journals Online (AJOL)

Background: Injuries related to motorcycles contribute significantly to the number of road traffic injuries This study was aimed at determining the pattern of injuries caused by motorcycle crash among patients seen at Kakamega provincial hospital in Kenya... Methods: This was a cross sectional study which was conducted in ...

Childhood motorcycle-related injuries in a Nigerian city ...

African Journals Online (AJOL)

Motorcycle crashes account for a disproportionate share of the deaths and disabilities that result from road traffic accidents. We undertook ... death and disability among children aged 1 - 14 years.2 In developing countries motorcycle .... represent a global phenomenon, but poor countries bear the brunt of the ensuing higher ...

40 CFR Appendix I to Subparts D and E - Motorcycle Noise Emission Test Procedures [Note

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Motorcycle Noise Emission Test... (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Motorcycles Recall of noncomplying motorcycles; relabeling of mislabeled motorcycles. Appendix I to Subparts D and E—Motorcycle Noise...

Lower Limb Injuries Arising From Motorcycle Crashes | Kortor ...

African Journals Online (AJOL)

Background: Motorcycle accidents are the second most common cause of road traffic accidents in both developing and developed countries. In this study we aim to look at the pattern and characteristics of lower limb injuries arising from motorcycle accidents and evaluate early outcome of treatment. Methods: All the patients ...

Motorcycle injuries in north-central Nigeria | Nwadiaro | Nigerian ...

African Journals Online (AJOL)

Background: The increasing use of commercial motorcycle as mode of transportation in urban cities in Nigeria has become important source of morbidity and mortality. This is coupled with poor helmet use, narrow roads, increasing traffic, and poor licensing of the motorcycle riders. The objectives of this study are to ...

A comprehensive engineering analysis of motorcycle crashes in Maryland.

Science.gov (United States)

2010-12-01

The goal of this study was to identify recurring or common road characteristics of motorcycle crashes : in Maryland from 1998 to 2007. Motorcycle crash data was obtained from the National Highway : Traffic Safety Administrations Crash Outcome Data...

Re-estimation of acute subdural hematoma in children caused by trivial household head trauma

International Nuclear Information System (INIS)

Nishimoto, Hiroshi; Kurihara, Jun

2006-01-01

The objective of this study was to identify characteristics of acute subdural hematoma in children caused by a trivial household head trauma from a modem neurosurgical and medicolegal standpoint. We performed a retrospective study of 25 children younger than 48 months hospitalized for acute subdural hematoma from December 1, 1993, through February 28, 2003. Inclusion criteria were as follows: acute subdural hematoma caused by trivial household trauma and a history of trauma corroborated by a caretaker, absence of physical injuries consistent with child abuse, fundoscopic examinations performed by a pediatric ophthalmologist, absence of fractures on general bone survey, and child abuse ruled out by long-term follow-up (more than 5 years). Twenty-one of the patients were boys, and 4 were girls. The patients ranged in age from 6 to 17 months, with an average age of 8.5 months. In 17 of 25 patients trauma had been caused by falls to the floor while standing with support or while sitting. Most of the patients were admitted to the hospital because of generalized convulsions or seizures that had developed soon after a trivial household trauma. Fifteen of the 25 (60%) patients had retinal or preretinal hemorrhage and 9 patients had bilateral retinal hemorrhage. Computed tomography showed fluid-type acute subdural hematomas at the frontal convexity or in the interhemispheric fissure in 18 of 25 (72%) patients. Fourteen of 25 (56%) patients had pre-existing external hydrocephalus (enlargements of the subarachnoid space). The long-term outcomes included normal mental development (IQ≥80) in 18 cases, mild mental retardation (IQ<80) in 7 cases, and epilepsy in 3 cases. Acute subdural hematoma in children caused by trivial household trauma is a clinical entity distinct from acute subdural hematoma caused by child abuse or shaken-baby syndrome. (author)

Profiles and Outcomes of Head Injury at Nakuru Level 5 Hospital

African Journals Online (AJOL)

multiruka1

An eleven months' prospective cross sectional descriptive ... In females, domestic violence was the common mode of violence and it was perpetrated by a spouse. Motorcycle ... with other studies that majority of head injured victims are young ...

Successful management of severe blunt hepatic trauma by angiographic embolization.

Science.gov (United States)

Kanakis, Meletios A; Thomas, Theodoros; Martinakis, Vassilios G; Brountzos, Elias; Varsamidakis, Nicholas

2012-12-01

We present the case of an 18-year-old female with severe liver trauma after a motorcycle accident. Due to initial hemodynamic instability, fluid resuscitation and transfusion of two units of red packed cells was required. After stabilization, a CT scan was performed, showing grade V liver injuries according to the American Association for the Surgery of Trauma grading system. Angiography revealed multiple extravasations during the early arterial phase, as well as active extravasation from the proximal left hepatic artery in the late arterial phase. The patient was successfully treated by arterial embolization using metal microcoils, after which no further need for blood transfusion ensued. This report highlights that, in carefully selected cases, arterial embolization can improve the clinical condition of patients, reduce the need for blood transfusion and lessen the possibility of an operation, even if severe liver trauma has ensued.

Offsetting or Enhancing Behavior: An Empirical Analysis of Motorcycle Helmet Safety Legislation.

Science.gov (United States)

Lee, Jonathan M

2015-10-01

This study uses state-level panel data from a 33-year period to test the hypotheses of offsetting and enhancing behavior with regards to motorcycle helmet legislation. Results presented in this article find no evidence of offsetting behavior and are consistent with the presence of enhancing behavior. State motorcycle helmet laws are estimated to reduce motorcycle crashes by 18.4% to 31.9%. In the absence of any behavioral adaptations among motorcyclists mandatory helmet laws are not expected to have any significant impact on motorcycle crash rates. The estimated motorcycle crash reductions do not appear to be driven by omitted variable bias or nonclassical measurement error in reported crashes. Overall, the results strongly suggest that mandatory helmet laws yield significant changes in motorcycle mobility in the form of reduced risk taking and/or decreased utilization. © 2015 Society for Risk Analysis.

Clear lens extraction for the treatment of persistent accommodative spasm after head trauma.

Science.gov (United States)

McMurray, Catherine J; Burley, Celeste D; Elder, Mark J

2004-12-01

We report the case of a 28-year-old man with decreased visual acuity after closed head trauma sustained in a motor vehicle accident 16 weeks earlier. Several structures thought to be associated with the control of accommodation were injured. The patient had a persistent accommodative spasm causing up to 7.0 diopters of pseudomyopia. We present the patient's progress through the clinic, including manifest and cycloplegic refractions and results of a trial with atropine drops, and successful transition to bilateral pseudophakia 2 years and 9 months after the accident.

Vulnerability of motorcycle riders and co-riders to injuries in multi-occupant crashes.

Science.gov (United States)

Oluwadiya, Kehinde Sunday; Ojo, Owolabi Dele; Adegbehingbe, Olayinka Oladiran; Mock, Charles; Popoola, Ogunsuyi Sunday

2016-01-01

In developing countries, most motorcycles are ridden with more than one occupant. The objective of this study was to establish the relative vulnerability of riders and co-riders to injury and determine the injury risk factors in multi-occupant motorcycle crashes. Between January and December 2010, we collected crash and injury data from victims of multi-occupant motorcycle. It is a hospital-based study. The probability of sustaining injuries was similar for co-riders and riders, but co-riders were more likely to sustain severe injuries. Occupants of >2-occupant motorcycles were also more likely to be involved in risky behaviours like not wearing helmet and speeding than those on 2-occupant motorcycles. Occupants of motorcycles on which there were more than two occupants were at an increased risk of sustaining injuries compared with occupants of motorcycles with only two occupants (OR: 2.1, 95% CI: 1.1-4.3). Motorcycle co-riders were more vulnerable to severe injuries than riders. The significance of the study finding to prevention was discussed.

Highway Safety Program Manual: Volume 3: Motorcycle Safety.

Science.gov (United States)

National Highway Traffic Safety Administration (DOT), Washington, DC.

Volume 3 of the 19-volume Highway Safety Program Manual (which provides guidance to State and local governments on preferred highway safety practices) concentrates on aspects of motorcycle safety. The purpose and specific objectives of a State motorcycle safety program are outlined. Federal authority in the highway safety area and general policies…

Connected motorcycle system performance.

Science.gov (United States)

2016-01-15

This project characterized the performance of Connected Vehicle Systems (CVS) on motorcycles based on two key components: global positioning and wireless communication systems. Considering that Global Positioning System (GPS) and 5.9 GHz Dedicated Sh...

Traffic tech: Examination of changes to the motorcycle law in Puerto Rico.

Science.gov (United States)

2017-04-01

Puerto Rico enacted a comprehensive motorcycle safety law in 2007 to address the rise in fatal motorcycle crashes. Prior to the enactment of the law, the popularity of motorcycle riding increased rapidly from 47,920 registrations in 2000, to 89,379 i...

Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report.

Science.gov (United States)

Yilmaz, Ali; Kizilay, Zahir; Ozkul, Ayca; Çirak, Bayram

2016-03-15

The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood. Here we report the case of an 11-year-old boy with pure motor stroke. The brain MRI showed an acute ischemia in the recurrent artery of Heubner supply area following mild head trauma. His fasciobrachial hemiparesis and dysarthria were thought to be secondary to the stretching of deep perforating arteries leading to occlusion of the recurrent artery of Heubner. Post-traumatic pure motor ischemic stroke can be secondary to stretching of the deep perforating arteries especially in childhood.

Effect of gasoline/methanol blends on motorcycle emissions: Exhaust and evaporative emissions

Science.gov (United States)

Li, Lan; Ge, Yunshan; Wang, Mingda; Li, Jiaqiang; Peng, Zihang; Song, Yanan; Zhang, Liwei

2015-02-01

The emission characteristics of motorcycles using gasoline and M15 (consisting of 85% gasoline and 15% methanol by volume) were investigated in this article. Exhaust and evaporative emissions, including regulated and unregulated emissions, of three motorcycles were investigated on the chassis dynamometer over the Urban Driving Cycle (UDC) and in the Sealed Housing for Evaporative Determination (SHED), respectively. The regulated emissions were detected by an exhaust gas analyzer directly. The unregulated emissions, including carbonyls, volatile organic compounds (VOCs) and methanol, were sampled through battery-operated air pumps using tubes coated with 2,4-dintrophenylhydrazine (DNPH), Tenax TA and silica gel, respectively. The experimental results showed that, for exhaust emission, compared with those from gasoline fueled motorcycles, the concentration of total hydrocarbons (THC) and CO from motorcycles fueled with M15 decreased by 11%-34.5% and 63%-84% respectively, while the concentration of NOx increased by 76.9%-107.7%. Compared with those from gasoline fueled motorcycles, BTEX from motorcycles fueled with M15 decreased by 16%-60% while formaldehyde increased by 16.4%-52.5%. For evaporative emission, diurnal losses were more than hot soak losses and turned out to be dominated in evaporative emissions. In addition, compared with gasoline fueling motorcycles, the evaporative emissions of THC, carbonyls and VOCs from motorcycles fueled with M15 increased by 11.7%-37%, 38%-45% and 16%-42%, respectively. It should be noted that the growth rate of methanol was as high as 297%-1429%. It is important to reduce the evaporative emissions of methanol fueling motorcycles.

The roles of motorcyclists and car drivers in conspicuity-related motorcycle crashes.

NARCIS (Netherlands)

Craen, S. de Doumen, M. Bos, N. & Norden, Y. van

2012-01-01

This report gives an overview of the available research on the different factors of influence on the perception of motorcycles. It also presents analyses of Dutch motorcycle crashes which provide a description of the relative occurrence of car-motorcycle crashes in the Netherlands. Finally, this

Delayed Rebleeding of Cerebral Aneurysm Misdiagnosed as Traumatic Subarachnoid Hemorrhage

OpenAIRE

Song, Seung-Yoon; Kim, Dae-Won; Park, Jong-Tae; Kang, Sung-Don

2016-01-01

An intracranial saccular aneurysm is uncommonly diagnosed in a patient with closed head trauma. We herein present a patient with delayed rebleeding of a cerebral aneurysm misdiagnosed as traumatic subarachnoid hemorrhage (SAH). A 26-year-old female visited our emergency department because of headache after a motorcycle accident. Brain computed tomography (CT) showed a right-side dominant SAH in Sylvian fissure. Although traumatic SAH was strongly suggested because of the history of head traum...

Delayed post-traumatic spinal cord infarction in an adult after minor head and neck trauma: a case report

Directory of Open Access Journals (Sweden)

Bartanusz Viktor

2012-09-01

Full Text Available Abstract Introduction Delayed post-traumatic spinal cord infarction is a devastating complication described in children. In adults, spinal cord ischemia after cardiovascular interventions, scoliosis correction, or profound hypotension has been reported in the literature. However, delayed spinal cord infarction after minor head trauma has not been described yet. Case presentation We report the case of a 45-year-old Hispanic man who had a minor head trauma. He was admitted to our hospital because of paresthesias in his hands and neck pain. A radiological workup showed cervical spinal canal stenosis and chronic cervical spondylotic myelopathy. Twelve hours after admission, our patient became unresponsive and, despite full resuscitation efforts, died. The autopsy revealed spinal cord necrosis involving the entire cervical spinal cord and upper thoracic region. Conclusions This case illustrates the extreme fragility of spinal cord hemodynamics in patients with chronic cervical spinal canal stenosis, in which any further perturbations, such as cervical hyperflexion related to a minor head injury, can have catastrophic consequences. Furthermore, the delayed onset of spinal cord infarction in this case shows that meticulous maintenance of blood pressure in the acute post-traumatic period is of paramount importance, even in patients with minimal post-traumatic symptoms.

Fatal motorcycle crashes: a growing public health problem in Cambodia.

Science.gov (United States)

Roehler, Douglas R; Ear, Chariya; Parker, Erin M; Sem, Panhavuth; Ballesteros, Michael F

2015-01-01

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007-2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.

Motorcycle injury among secondary school students in the Tiko municipality, Cameroon.

Science.gov (United States)

Nyagwui, Asonganyi Edwin; Fredinah, Namatovu; Che, Longho Bernard; Yulia, Blomstedt

2016-01-01

Injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study the risk-factors of the motorcycle-related accidents and injuries among secondary school students' in the Tiko municipality, Cameroon. A cross sectional study was conducted in January 2012 on 391 students age 16-24 from public and private schools in the Tiko Municipality. Logistic regression was used to estimate the association between risk factors and injuries. A closed-ended and few open-ended questionnaire was used to collect data. The study showed that over 70% of students used motorcycles always or often. Few had undergone any formal training for driving a motorcycle. The vast majority reported not wearing protective gear while driving or riding a motorcycle. Usage of protective gear was particularly low among girls. Over 16% reported using a motorbike always or occasionally under the influence of alcohol or drugs. Over 58% of respondents reported having an accident and over 35% were injured when driving or riding a motorcycle. Those who lived at the Tiko-Douala road have three times higher probability to sustain accidents and injuries than students residing elsewhere (OR 3.19 (1.20-8.46). It is deeply alarming that every second respondent in the study reported having been in an accident and every third motorcycle user was somehow injured. We therefore call for an immediate attention and a deeper investigation into the highlighted situation, particularly at Tiko-Douala road.

Epidemiology and patterns of musculoskeletal motorcycle injuries in the USA [v1; ref status: indexed, http://f1000r.es/444

Directory of Open Access Journals (Sweden)

Sean T. Burns

2015-05-01

Full Text Available Introduction: Motorcycles have become an increasingly popular mode of transportation despite their association with a greater risk for injury compared with automobiles. Whereas the recent incidence of annual passenger vehicle fatalities in the United States of America (USA has progressively declined, motorcycle fatalities have steadily increased in the past 11 years. Although motorcycle injuries (MIs have been studied, to the author’s knowledge there are no published reports on MIs in the USA during this 11-year period. Methods: Study data were derived from a prospectively collected Level I trauma center database. Data sampling included motorcycle crash injury evaluations for the 10-year period ending on 31 August 2008. This retrospective analysis included patient demographic and medical data, helmet use, Glasgow coma scale (GCS score, injury severity score (ISS, length of hospital stay (LOS, specific injury diagnosis, and death. Data statistics were analyzed using the Spearman correlation coefficient, Kruskal-Wallis tests, and logistic regression. Results: The study identified 1252 motorcycle crash injuries. Helmets were worn by 40.7% of patients for which helmet data were available. The rates of the most common orthopedic injuries were tibia/fibula (19.01%, spine (16.21%, and forearm (10.14% fractures. The most common non-orthopedic motorcycle crash injuries were concussions (21.09%, skull fractures (8.23%, face fractures (13.66%, and hemo- and pneumothorax (8.79%. There was a significant correlation between greater age and higher ISS (r=0.21, P<0.0001 and longer LOS (r=0.22, P<0.0001. Older patients were also less likely to wear a helmet (OR=0.99, 95% CI: 0.98, 0.997, associated with a significantly higher risk for death (after adjustment for helmet use OR=1.03, 95% CI: 1.00, 1.05. All patients without helmets had a significantly lower GCS score (P=0.0001 and a higher mortality rate (after adjustment for patient demographic data OR=2.28, 95

Motorcycle crash-related emergency department visits and hospitalizations for traumatic brain injury in North Carolina.

Science.gov (United States)

Harmon, Katherine J; Marshall, Stephen W; Proescholdbell, Scott K; Naumann, Rebecca B; Waller, Anna E

2015-01-01

To examine statewide emergency department (ED) visit data for motorcycle crash morbidity and healthcare utilization due to traumatic brain injuries (TBIs) and non-TBIs. North Carolina ED data (2010-2012) and hospital discharge data (2009-2011). Statewide ED visits and hospitalizations due to injuries from traffic-related motorcycle crashes stratified by TBI status. Descriptive study. Descriptive statistics include age, sex, mode of transport, disposition, expected source of payment, hospital length of stay, and hospital charges. Over the study period, there were 18 780 ED visits and 3737 hospitalizations due to motorcycle crashes. Twelve percent of ED visits for motorcycle crashes and 26% of hospitalizations for motorcycle crashes had a diagnosis of TBI. Motorcycle crash-related hospitalizations with a TBI diagnosis had median hospital charges that were nearly $9000 greater than hospitalizations without a TBI diagnosis. Emergency department visits and hospitalizations due to motorcycle crashes with a TBI diagnosis consumed more healthcare resources than motorcycle crash-related ED visits and hospitalizations without a TBI diagnosis. Increased awareness of motorcyclists by other road users and increased use of motorcycle helmets are 2 strategies to mitigate the incidence and severity of motorcycle crash injuries, including TBIs.

Louisiana motorcycle fatalities in the wake of governmentally implemented change: a retrospective analysis of the motorcycle morbidity and mortality before, during, and after the repeal of a statewide helmet mandate.

Science.gov (United States)

Strom, Shane F; Ambekar, Sudheer; Madhugiri, Venkatesh S; Nanda, Anil

2013-06-01

On August 15, 2004, Louisiana's universal motorcycle helmet mandate was reinstated. Previous studies have shown that mortality and morbidity of motorcycle riders who crashed had increased during the 5 years the mandate was repealed. The objective of this study was to discern whether the reinstatement of the universal helmet mandate has resulted in a subsequent decrease in motorcycle-related mortality and morbidity in the state of Louisiana. A retrospective analysis was performed observing the regularity of helmet use and the associated morbidity and mortality of motorcycle traffic accidents from the time before, during, and after the universal motorcycle helmet mandate was repealed in the state of Louisiana. Fatality statistics were obtained through the National Highway Safety Traffic Association. Injury, helmet use, and collision data were obtained from the Louisiana Highway Safety Commission. Motorcycle registration data were obtained from the Federal Highway Administration. Motorcycle crash-related fatalities increased significantly when the statewide helmet mandate was repealed, and interestingly, after reinstatement, these fatality rates never returned to their previous lows. Motorcycle fatalities have increased out of proportion to the increase in motorbike registrations, even when yearly fatalities are normalized to fatalities per 10,000 registered bikes. An all-time high in fatalities was seen in 2006, a year subsequent to the mandate's reinstatement. Fatalities per collision were elevated significantly after the mandate's repeal but did not return to prerepeal lows after the mandate's reinstatement. Although helmet use after reinstatement has reached all-time highs, fatality rates have remained elevated since the original mandate repeal in 1999. Other achievable changes in state policy and law enforcement should be explored to quell this heightened risk to motorcycle enthusiasts in Louisiana, and states considering changing their own motorcycle helmet

Study of vibration and its effect on health of the motorcycle rider

Directory of Open Access Journals (Sweden)

Shivakumara BS

2010-07-01

Full Text Available The motorcycle riders are subjected to extreme vibrations due to the vibrations of its engine, improper structural design of the motorcycle and the bad road conditions. The literature review reveals that the vibrations are most hazardous to the health if it exceeds the limit. The experiments were conducted to measure the magnitude of the vibrations acting on the rider during motorcycle riding under various road conditions. Experimental values of accelerations and frequencies which are beyond permissible limits according to the literature confirm that vibration certainly affects health of the motorcycle rider

A dynamic analysis of motorcycle ownership and usage: a panel data modeling approach.

Science.gov (United States)

Wen, Chieh-Hua; Chiou, Yu-Chiun; Huang, Wan-Ling

2012-11-01

This study aims to develop motorcycle ownership and usage models with consideration of the state dependence and heterogeneity effects based on a large-scale questionnaire panel survey on vehicle owners. To account for the independence among alternatives and heterogeneity among individuals, the modeling structure of motorcycle ownership adopts disaggregate choice models considering the multinomial, nested, and mixed logit formulations. Three types of panel data regression models--ordinary, fixed, and random effects--are developed and compared for motorcycle usage. The estimation results show that motorcycle ownership in the previous year does exercise a significantly positive effect on the number of motorcycles owned by households in the current year, suggesting that the state dependence effect does exist in motorcycle ownership decisions. In addition, the fixed effects model is the preferred specification for modeling motorcycle usage, indicating strong evidence for existence of heterogeneity. Among various management strategies evaluated under different scenarios, increasing gas prices and parking fees will lead to larger reductions in total kilometers traveled. Copyright © 2011 Elsevier Ltd. All rights reserved.

A mixed logit analysis of two-vehicle crash severities involving a motorcycle.

Science.gov (United States)

Shaheed, Mohammad Saad B; Gkritza, Konstantina; Zhang, Wei; Hans, Zachary

2013-12-01

Using motorcycle crash data for Iowa from 2001 to 2008, this paper estimates a mixed logit model to investigate the factors that affect crash severity outcomes in a collision between a motorcycle and another vehicle. These include crash-specific factors (such as manner of collision, motorcycle rider and non-motorcycle driver and vehicle actions), roadway and environmental conditions, location and time, motorcycle rider and non-motorcycle driver and vehicle attributes. The methodological approach allows the parameters to vary across observations as opposed to a single parameter representing all observations. Our results showed non-uniform effects of rear-end collisions on minor injury crashes, as well as of the roadway speed limit greater or equal to 55mph, the type of area (urban), the riding season (summer) and motorcyclist's gender on low severity crashes. We also found significant effects of the roadway surface condition, clear vision (not obscured by moving vehicles, trees, buildings, or other), light conditions, speed limit, and helmet use on severe injury outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Motorcycle injury among secondary school students in the Tiko ...

African Journals Online (AJOL)

Introduction: injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study ...

Design, simulation, and prototype production of a through the road parallel hybrid electric motorcycle

International Nuclear Information System (INIS)

Asaei, Behzad; Habibidoost, Mahdi

2013-01-01

Highlights: • Design, simulation, and manufacturing of a hybrid electric motorcycle are explained. • The electric machine is mounted in the front wheel hub of an ordinary motorcycle. • Two different energy control strategy are implemented. • The simulation results show that the motorcycle performance is improved. • The acceleration is improved and the fuel consumption and pollutions are decreased. - Abstract: In this paper, design, simulation, and conversion of a normal motorcycle to a Hybrid Electric Motorcycle (HEM) is described. At first, a simple model designed and simulated using ADVISOR2002. Then, the controller schematic and its optimized control strategy are described. A 125 cc ICE motorcycle is selected and converted into a HEM. A brushless DC (BLDC) motor assembled in the front wheel and a normal internal combustion engine in the rear wheel propel the motorcycle. The nominal powers are 6.6 kW and 500 W for the ICE and BLDC respectively. The original motorcycle has a Continuous Variable Transmission (CVT) that is the best choice for a HEM power transmission because it can operate in the automatic handling mode and has high efficiency. Moreover, by using the CVT, the ICE can be started while motorcycle is running. Finally, three operating modes of HEM, two implemented energy control strategies, and HEM engine control system by servomotors, and LCD display are explained

Association of a Guardian's Report of a Child Acting Abnormally With Traumatic Brain Injury After Minor Blunt Head Trauma.

Science.gov (United States)

Nishijima, Daniel K; Holmes, James F; Dayan, Peter S; Kuppermann, Nathan

2015-12-01

Increased use of computed tomography (CT) in children is concerning owing to the cancer risk from ionizing radiation, particularly in children younger than 2 years. A guardian report that a child is acting abnormally is a risk factor for clinically important traumatic brain injury (ciTBI) and may be a driving factor for CT use in the emergency department. To determine the prevalence of ciTBIs and TBIs in children younger than 2 years with minor blunt head trauma and a guardian report of acting abnormally with (1) no other findings or (2) other concerning findings for TBI. Secondary analysis of a large, prospective, multicenter cohort study that included 43 399 children younger than 18 years with minor blunt head trauma evaluated in 25 emergency departments. The study was conducted on data obtained between June 2004 and September 2006. Data analysis was performed between August 21, 2014, and March 9, 2015. A guardian report that the child was acting abnormally after minor blunt head trauma. The prevalence of ciTBI (defined as death, neurosurgery, intubation for >24 hours, or hospitalization for ≥2 nights in association with TBI on CT imaging) and TBI on CT imaging in children with a guardian report of acting abnormally with (1) no other findings and (2) other concerning findings for TBI. Of 43 399 children in the cohort study, a total of 1297 children had reports of acting abnormally, of whom 411 (31.7%) had this report as their only finding. Reported as percentage (95% CI), 1 of 411 (0.2% [0-1.3%]) had a ciTBI, and 4 TBIs were noted on the CT scans in 185 children who underwent imaging (2.2% [0.6%-5.4%]). In children with reports of acting abnormally and other concerning findings for TBI, 29 of 886 (3.3% [2.2%-4.7%]) had ciTBIs and 66 of 674 (9.8% [7.7%-12.3%]) had TBIs on CT. Clinically important TBIs are very uncommon, and TBIs noted on CT are uncommon in children younger than 2 years with minor blunt head trauma and guardian reports of the child acting

Injury severity in delivery-motorcycle to vehicle crashes in the Seoul metropolitan area.

Science.gov (United States)

Chung, Younshik; Song, Tai-Jin; Yoon, Byoung-Jo

2014-01-01

More than 56% of motorcycles in Korea are used for the purpose of delivering parcels and food. Since such delivery requires quick service, most motorcyclists commit traffic violations while delivering, such as crossing the centerline, speeding, running a red light, and driving in the opposite direction down one-way streets. In addition, the fatality rate for motorcycle crashes is about 12% of the fatality rate for road traffic crashes, which is considered to be high, although motorcycle crashes account for only 5% of road traffic crashes in South Korea. Therefore, the objective of this study is to analyze the injury severity of vehicle-to-motorcycle crashes that have occurred during delivery. To examine the risk of different injury levels sustained under all crash types of vehicle-to-motorcycle, this study applied an ordered probit model. Based on the results, this study proposes policy implications to reduce the injury severity of vehicle-to-motorcycle crashes during delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.

Motorcycle protective clothing: protection from injury or just the weather?

Science.gov (United States)

de Rome, Liz; Ivers, Rebecca; Fitzharris, Michael; Du, Wei; Haworth, Narelle; Heritier, Stephane; Richardson, Drew

2011-11-01

Apart from helmets, little is known about the effectiveness of motorcycle protective clothing in reducing injuries in crashes. The study aimed to quantify the association between usage of motorcycle clothing and injury in crashes. Cross-sectional analytic study. Crashed motorcyclists (n=212, 71% of identified eligible cases) were recruited through hospitals and motorcycle repair services. Data was obtained through structured face-to-face interviews. The main outcome was hospitalization and motorcycle crash-related injury. Poisson regression was used to estimate relative risk (RR) and 95% confidence intervals for injury adjusting for potential confounders. Motorcyclists were significantly less likely to be admitted to hospital if they crashed wearing motorcycle jackets (RR=0.79, 95% CI: 0.69-0.91), pants (RR=0.49, 95% CI: 0.25-0.94), or gloves (RR=0.41, 95% CI: 0.26-0.66). When garments included fitted body armour there was a significantly reduced risk of injury to the upper body (RR=0.77, 95% CI: 0.66-0.89), hands and wrists (RR=0.55, 95% CI: 0.38-0.81), legs (RR=0.60, 95% CI: 0.40-0.90), feet and ankles (RR=0.54, 95% CI: 0.35-0.83). Non-motorcycle boots were also associated with a reduced risk of injury compared to shoes or joggers (RR=0.46, 95% CI: 0.28-0.75). No association between use of body armour and risk of fracture injuries was detected. A substantial proportion of motorcycle designed gloves (25.7%), jackets (29.7%) and pants (28.1%) were assessed to have failed due to material damage in the crash. Motorcycle protective clothing is associated with reduced risk and severity of crash related injury and hospitalization, particularly when fitted with body armour. The proportion of clothing items that failed under crash conditions indicates a need for improved quality control. While mandating usage of protective clothing is not recommended, consideration could be given to providing incentives for usage of protective clothing, such as tax exemptions for safety

Isolated posterior capsular rupture following blunt head trauma

Directory of Open Access Journals (Sweden)

Mansour AM

2014-11-01

Full Text Available Ahmad M Mansour, Mahmoud O Jaroudi, Rola N Hamam, Fadi C Maalouf Department of Ophthalmology, American University of Beirut, Beirut, Lebanon Abstract: Closed-globe traumatic cataract is not uncommon in males in the pediatric age group. However, there is a relative paucity of literature on isolated posterior lens capsule rupture associated with closed-globe traumatic cataract. We report a case of a 6-year-old boy who presented with white cataract 1 day after blunt trauma to the forehead associated with posterior capsular rupture that was detected by B-scan ultrasonography preoperatively. No stigmata of trauma outside the posterior capsule could be detected by slit-lamp exam, funduscopy, and optical coherence tomography. Phacoemulsification with posterior chamber intraocular lens implant was performed 24 hours after trauma, with the patient achieving 6/6 visual acuity 1 week and 6 months after surgery. Our case is unique, being the youngest (amblyogenic age to be reported, with prompt surgical intervention, and with no signs of trauma outside the posterior capsule. Keywords: posterior capsule rupture, forehead trauma, traumatic cataract, pediatric cataract

The impact of mandatory helmet law on the outcome of maxillo facial trauma: a comparative study in kerala.

Science.gov (United States)

Usha, M; Ravindran, V; Soumithran, C S; Ravindran Nair, K S

2014-06-01

Motorcyclists comprise the majority of road-traffic victims in low and middle income countries,and consequently, the majority of the road-traffic victims globally. Simple measures can be taken to make safer on the roads, which include enforcement of safety measures like seat belt and helmets. The compulsory Helmet law was enforced in Kerala on 18/06/07. Resistance to legislation on motorcycle helmets still coexists world wide with debate on the effectiveness of helmets. In an attempt to analyze the protective effect of helmets on facial injuries a comparative study was conducted in Government Dental College, Calicut, which is a major trauma centre in northern Kerala. Data for the present study was obtained from the patients who have reported to the Emergency Department of Oral and Maxillofacial Surgery, Government Dental College, Calicut, for a period of 6 months immediately after the implementation of strict helmet rule in Kerala. For the study all patients with a history of nonfatal motor cycle accident sustaining facial injuries were included. The results were compared with the study conducted in the same institution in the pre law period. The study demonstrates the protective effect of motorcycle helmets in decreasing the morbidity of maxillofacial trauma.There was a marked decrease in incidence of motorcycle-related injuries, remarkable increase in helmet usage and better outcome in helmeted individuals in the post law period. Road traffic injury control is a public health problem. Health and medical professionals have an ethical responsibility to educate and arrange for the safety of individuals. Helmets are effective in preventing or reducing the severity of motorcycle-related injuries and in a developing country like India, enforced mandatory motor cycle helmet law is potentially one of the most cost effective interventions available.

Development of a screening MRI for infants at risk for abusive head trauma

Energy Technology Data Exchange (ETDEWEB)

Flom, Lynda; Panigrahy, Ashok [Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Fromkin, Janet [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); Tyler-Kabara, Elizabeth [University of Pittsburgh, Department of Neurosurgery, Children' s Hospital of Pittsburgh of UPMC, McGowan Institute for Regenerative Medicine, Pittsburgh, PA (United States); Berger, Rachel P. [University of Pittsburgh, Department of Pediatrics, Children' s Hospital of Pittsburgh of UPMC, Pittsburgh, PA (United States); University of Pittsburgh, Safar Center for Resuscitation Research, Pittsburgh, PA (United States)

2016-04-15

Abusive head trauma (AHT) is an important cause of morbidity in infants. Identifying which well-appearing infants are at risk for AHT and need neuroimaging is challenging, and concern about radiation exposure limits the use of head CT. Availability of an MRI protocol that is highly sensitive for intracranial hemorrhage would allow for AHT screening of well-appearing infants without exposing them to radiation. To develop a screening MRI protocol to identify intracranial hemorrhage in well-appearing infants at risk for AHT. Infants enrolled in a parent study of well-appearing infants at increased risk for AHT were eligible for the current study if they underwent both head CT and conventional brain MRI. A derivation cohort of nine infants with AHT was used to identify sequences that provided the highest sensitivity for intracranial hemorrhage. A validation cohort of 78 infants including both controls with normal neuroimaging and cases with AHT was used to evaluate the accuracy of the selected sequences. Three pulse sequences - axial T2, axial gradient recalled echo (GRE) and coronal T1-W inversion recovery - were 100% sensitive for intracranial hemorrhage in the derivation cohort. The same sequences were 100% sensitive (25/25) and 83% specific (44/53) for intracranial hemorrhage in the validation cohort. A screening MRI protocol including axial T2, axial GRE and coronal T1-W inversion recovery sequences is highly sensitive for intracranial hemorrhage and may be useful as a screening tool to differentiate well-appearing infants at risk for AHT who should undergo head CT from those who can safely be discharged without head CT. Additional research is needed to evaluate the feasibility of this approach in clinical practice. (orig.)

[Traffic accidents from the motorcycle couriers' perspective: feedback for health promotion].

Science.gov (United States)

Veronese, Andréa Márian; de Oliveira, Dora Lúcia Leidens Corrêa

2006-12-01

This research note is the result of a qualitative study in Porto Alegre, Rio Grande do Sul, Brazil, aimed at exploring traffic accident risk from the motorcycle couriers' point of view. The research results highlight the importance of accident prevention and health promotion for these workers. The study was based on sociological theories of risk, especially those emphasizing the social and cultural nature of its meanings. Information was gathered through focus groups and analyzed according to the Data-Based Theory. According to the research subjects, all motorcycle couriers, the traffic accident risk is inherent to their daily work duties and is produced by personal and social interests like money, speed, and urgency. Motorcycle couriers attempt to control such risks by using self-defense strategies. Considering the high incidence of traffic accidents with motorcycle couriers in Porto Alegre, these strategies have apparently not been effective. This note emphasizes that traffic accidents involving motorcycle couriers are work-related accidents, and that health promotion measures to prevent them should target not only the couriers themselves but also their employers and customers.

A Comparative Study of SPECT, q-EEG and CT in Patients with Mild, Acute Head Trauma

International Nuclear Information System (INIS)

Lee, Suk Ho; Kim, Jin Seok; Moon, Hee Seung

1993-01-01

Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes cannot be detected by the brain CT or MRI. Brain SPECT using 99m Tc-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT. SPECT would be more useful method than brain CT to investigate cerebral function after head injury

Electric motorcycle charging station powered by solar energy

Science.gov (United States)

Siriwattanapong, Akarawat; Chantharasenawong, Chawin

2018-01-01

This research proposes a design and verification of an off-grid photovoltaic system (PVS) for electric motorcycle charging station to be located in King’s Mongkut’s University of Technology Thonburi, Bangkok, Thailand. The system is designed to work independently (off-grid) and it must be able to fully charge the batteries of a typical passenger electric motorcycle every evening. A 1,000W Toyotron electric motorcycle is chosen for this study. It carries five units of 12.8V 20Ah batteries in series; hence its maximum energy requirement per day is 1,200Wh. An assessment of solar irradiation data and the Generation Factor in Bangkok, Thailand suggests that the charging system consists of one 500W PV panel, an MPPT charge controller, 48V 150Ah battery, a 1,000W DC to AC inverter and other safety devices such as fuses and breakers. An experiment is conducted to verify the viability of the off-grid PVS charging station by collecting the total daily energy generation data in the raining season and winter. The data suggests that the designed off-grid solar power charging station for electric motorcycle is able to supply sufficient energy for daily charging requirements.

Design and implementation of a hybrid electric motorcycle

Energy Technology Data Exchange (ETDEWEB)

Tong, C.C.; Jwo, W.S.; Chien, W.L.; Liu, Y.L.; Chen, S.W.; Hsu, C.Y. [Chienkuo Technology Univ., Changhua, Taiwan (China). Dept. of Electrical Engineering

2005-07-01

A hybrid electric motorcycle (HEM) was described. The HEM was developed from a modified 50 cc motorcycle currently available on the market. The motorcycle gearbox was attached to the back wheel. A master-slave tracking control method was used to expedite the HEM's development phases and cost. A 600 watt DC servo-motor was used to track the speed of the rear wheel of the HEM as well as to increase torque. The real time master-slave composite was comprised of a gearbox, a frequency-voltage converter, and a proportional, integrative, and derivative (PID) speed tracking controller. The frequency-voltage converter was used to convert the frequency signals of the rear wheels and electric motor rotational speeds into voltage signals. A Hall was used to sense 4 permanent magnets place along the rear wheel. A Schmitt trigger gate was used to detect signals from the rear wheel. An actuation system consisted of a motor driving circuit, a current-limiting protection circuit, and a low battery voltage protection circuit. It was concluded that the HEM design is both feasible and highly marketable. Artificial intelligence will be used to build a high performance hybrid motorcycle in the future. 10 refs., 1 tab., 11 figs.

FLAIR images of mild head trauma with transient amnesia

Energy Technology Data Exchange (ETDEWEB)

Wakamoto, Hirooki; Miyazaki, Hiromichi; Inaba, Makoto; Ishiyama, Naomi [Hiratsuka City Hospital, Kanagawa (Japan); Kawase, Takeshi

1998-11-01

A newly advanced MRI pulse sequence, the FLAIR (fluid-attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no signal intensity area. We examined 45 cases of mild head trauma with posttraumatic amnesia by FLAIR images and could detect some findings which could not be detected by CT scan and conventional MR images. These findings could be detected in many patients with long posttraumatic amnesia (over 2 hours), but they could not be detected in patients with short posttraumatic amnesia (within 30 mins). These findings existed surrounding lateral ventricles and we classified them into 3 types: type 1 is anterior horn of lateral ventricle, type 2 is the base of frontal lobe, and type 3 is cerebral deep white matter. Some of them were examined again by FLAIR images a month later, and these findings had disappeared. We suspect that these lesions were brain edema or mild contusion without hemorrhage. (author)

FLAIR images of mild head trauma with transient amnesia

International Nuclear Information System (INIS)

Wakamoto, Hirooki; Miyazaki, Hiromichi; Inaba, Makoto; Ishiyama, Naomi; Kawase, Takeshi

1998-01-01

A newly advanced MRI pulse sequence, the FLAIR (fluid-attenuated inversion recovery) imaging, in which a long TE spin echo sequence is used with suppression of the CSF with an inversion pulse, displays the CSF space as a no signal intensity area. We examined 45 cases of mild head trauma with posttraumatic amnesia by FLAIR images and could detect some findings which could not be detected by CT scan and conventional MR images. These findings could be detected in many patients with long posttraumatic amnesia (over 2 hours), but they could not be detected in patients with short posttraumatic amnesia (within 30 mins). These findings existed surrounding lateral ventricles and we classified them into 3 types: type 1 is anterior horn of lateral ventricle, type 2 is the base of frontal lobe, and type 3 is cerebral deep white matter. Some of them were examined again by FLAIR images a month later, and these findings had disappeared. We suspect that these lesions were brain edema or mild contusion without hemorrhage. (author)

3D reconstruction of emergency cranial computed tomography scans as a tool in clinical forensic radiology after survived blunt head trauma--report of two cases.

Science.gov (United States)

Grassberger, M; Gehl, A; Püschel, K; Turk, E E

2011-04-15

When requested to evaluate surviving victims of blunt head trauma the forensic expert has to draw mainly on medical documentation from the time of hospital admission. In many cases these consist of written clinical records, radiographs and in some cases photographic documentation of the injuries. We report two cases of survived severe blunt head trauma where CT images, which had primarily been obtained for clinical diagnostic purposes, were used for forensic assessment. 3D reconstructions of the clinical CT-images yielded valuable information regarding the sequence, number and direction of the impacts to the head, their gross morphology and the inflicting weapon. We conclude that computed tomography and related imaging methods, along with their 3D reconstruction capabilities, provide a useful tool to approach questions in clinical forensic casework. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Speed-volume relationship and headway distribution analysis of motorcycle (case study: Teuku Nyak Arief Road)

Science.gov (United States)

Prahara, E.; Prasetya, R. A.

2018-01-01

In many developing countries, transportation modes are more varied than the other country. For example, in Jakarta, Indonesia, in some roadway, motorcycle is the most dominant vehicle, with total volume is four times higher than a passenger car. Thus, the traffic characteristic in motorcycle-dominated traffic differs from a common traffic situation. The purpose of this study is to apply the concept and theory developed to analyze motorcycle behaviour under motorcycle-dominated traffic condition. The survey is applied by recording the traffic flow movement of research location at specified time period. The macroscopic characteristic analyzed in this research is a speed-flow relationship based on motorcycle equivalent unit (MCU). Furthermore, a detail microscopic characteristic analyzed that is motorcycle time headway regarding traffic flow. MCU values computed were consists of motorcycle (MC), light vehicle (LV) and heavy vehicle (HV). Those values were calculated 1.00, 6.13 and 10.71 respectively. The speed and volume relationship result is showing a linear regression model with R2 value is 0.58, it can be explained that the correlation between two variables is intermediate. The headway distribution of motorcycle is compatible with the negative exponential distribution which fitted with the proposed theory for a small vehicle such as a motorcycle.

Craniocerebral trauma in the child abuse syndrome: Radiological observations

International Nuclear Information System (INIS)

Merten, D.F.; Osborne, D.R.S.; Leonidas, J.C.

1984-01-01

Experience with craniocerebral trauma in 712 physically abused children is reviewed. Ninety-three (13%) had evidence of head trauma (cranial and/or intracranial). Seventy-seven of these patients had computed tomography (CT) of the head, and 47 had CT evidence of intracranial injury. Extracerebral fluid collections, predominantly convexity subdural hemorrhage, were the most common acute intracranial lesions. Concurrent intracranial and skeletal trauma (cranial and/or ectracranial) was present in 33 of the 47 patients (70%) with intracranial injury. A high incidence of skull fractures (45%) in those children with intracranial lesions suggest a significant role for impact head injuries (''battering'') in the pathogenesis of craniocerebral trauma in the child abuse syndrome. Greater emphasis on CT examination in evaluation of the abuse infant and child is recommended. (orig.)

Improving car drivers' perception of motorcycles: innovative headlight design as a short-term solution to mitigate accidents

OpenAIRE

Espie , Stéphane; Cavallo , Viola; RANCHET , Maud; PINTO , Maria; Vienne , Fabrice; DANG , NT

2014-01-01

10th International Motorcycle Conference, COLOGNE, ALLEMAGNE, 29-/09/2014 - 30/09/2014; The most frequent motorcycle accidents involve another vehicle violating the motorcycle's right-of-way at an intersection. The low visual conspicuity of motorcycles (especially because of their small size) is the primary reason why motorcycles are often not detected or seen or too late. The main safety measure in the past has been the use of daytime running lights (DRLs) by motorcycles, which became compul...

Motorcycle lane-sharing : literature review.

Science.gov (United States)

2010-06-01

This report examines the use of lane-sharing (also sometimes referred to as lane-splitting and filtering) nationally and internationally and includes discussions on motorcycle and driver (auto) safety, and the potential benefits of lane-sharing.

The relationship between gasoline price and patterns of motorcycle fatalities and injuries.

Science.gov (United States)

Zhu, He; Wilson, Fernando A; Stimpson, Jim P

2015-06-01

Economic factors such as rising gasoline prices may contribute to the crash trends by shaping individuals' choices of transportation modalities. This study examines the relationship of gasoline prices with fatal and non-fatal motorcycle injuries. Data on fatal and non-fatal motorcycle injuries come from California's Statewide Integrated Traffic Records System for 2002-2011. Autoregressive integrated moving average (ARIMA) regressions were used to estimate the impact of inflation-adjusted gasoline price per gallon on trends of motorcycle injuries. Motorcycle fatalities and severe and minor injuries in California were highly correlated with increasing gasoline prices from 2002 to 2011 (r=0.76, 0.88 and 0.85, respectively). In 2008, the number of fatalities and injuries reached 13,457--a 34% increase since 2002, a time period in which inflation-adjusted gasoline prices increased about $0.30 per gallon every year. The majority of motorcycle riders involved in crashes were male (92.5%), middle-aged (46.2%) and non-Hispanic white (67.9%). Using ARIMA modelling, we estimated that rising gasoline prices resulted in an additional 800 fatalities and 10,290 injuries from 2002 to 2011 in California. Our findings suggest that increasing gasoline prices led to more motorcycle riders on the roads and, consequently, more injuries. Aside from mandatory helmet laws and their enforcement, other strategies may include raising risk awareness of motorcyclists and investment in public transportation as an alternative transportation modality to motorcycling. In addition, universally mandated training courses and strict licensing tests of riding skills should be emphasised to help reduce the motorcycle fatal and non-fatal injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does Mechanism of Injury Predict Trauma Center Need?

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Lerner, E. Brooke; Shah, Manish N.; Cushman, Jeremy T.; Swor, Robert; Guse, Clare E.; Brasel, Karen; Blatt, Alan; Jurkovich, Gregory J.

2011-01-01

Objective To determine the predictive value of the Mechanism of Injury step of the American College of Surgeon’s Field Triage Decision Scheme for determining trauma center need. Methods EMS providers caring for injured adult patients transported to the regional trauma center in 3 midsized communities over two years were interviewed upon ED arrival. Included was any injured patient, regardless of injury severity. The interview collected patient physiologic condition, apparent anatomic injury, and mechanism of injury. Using the 1999 Scheme, patients who met the physiologic or anatomic steps were excluded. Patients were considered to need a trauma center if they had non-orthopedic surgery within 24 hours, intensive care unit admission, or died prior to hospital discharge. Data were analyzed by calculating positive likelihood ratios (+LR) and 95% confidence intervals (CI) for each mechanism of injury criteria. Results 11,892 provider interviews were conducted. Of those, 1was excluded because outcome data were not available and 2,408 were excluded because they met the other steps of the Field Triage Decision Scheme. Of the remaining 9,483 cases, 2,363 met one of the mechanism of injury criteria, 204 (9%) of which needed the resources of a trauma center. Criteria with a +LR ≥5 were death of another occupant in the same vehicle (6.8; CI:2.7–16.7), fall >20 ft.(5.2; CI:2.4–11.3), and motor vehicle crash (MVC) extrication >20 minutes (5.0; CI:3.2–8.0). Criteria with a +LR between 2 and 12 inches (3.7; CI:2.6–5.3), ejection (3.2; CI:1.3–8.2), and deformity >20 inches (2.3; CI:1.7–3.0). The criteria with a +LR 40 mph (1.9; CI:1.5–2.2), pedestrian/bicyclist struck >5mph (1.2; CI:1.0–1.5), bicyclist/pedestrian thrown or run over (1.2; CI:0.9–1.6), motorcycle crash >20mph (1.1; CI:0.96–1.3), rider separated from motorcycle (1.0; CI:0.9–1.2), and MVC rollover (1.0; CI:0.7–1.5). Conclusion Death of another occupant, fall distance, and extrication time

Risk Factor Profile of Motorcycle Crash Victims in Rural Kenya ...

African Journals Online (AJOL)

Background: Road traffic injuries involving motorcycles are increasing especially in rural Kenya resulting in both human and economic loss. This study was done to identify the risk factors and the host characteristics associated with motorcycle injury victims in rural setting so as to institute appropriate interventions for ...

Pedestrian-motorcycle collisions: associated risks and issues

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Ariffin Aqbal Hafeez

2017-01-01

Full Text Available From the statistics, there are serious concerns over the relatively high number of fatal motor vehicle crashes involving pedestrianmotorcycle in Malaysia. The high number of motorcycle registration on road, compounded by its popularity as the major mode of transportation in the nation, imposes safety risk to pedestrians, as well as to other road users. Data from 1,626 related road crashes of Royal Malaysia Police (RMP for the 2009-2013 period were retrospectively collected via MIROS Road Accident Analysis and Database System (M-ROADS. The data were then analyzed via logistic regression method to determine associations between risks and injury severity in pedestrian-motorcycle collisions. The results indicate that five factors were significantly related to injury severity, which include age, location of body injury, as well as speed limit, road geometry and lighting condition of collision site. Subsequently, focus group discussions with stakeholders were also conducted to gather relevant data to identify related issues and suggestions on motorcycle safety technology with regards to collision with pedestrian.

What drives bikers to attend a motorcycling event?

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Martinette Kruger

2014-01-01

Full Text Available Africa Bike Week, considered South Africa’s premier biking event, attracts large numbers of bikers, especially Harley-Davidson bikers, and bike enthusiasts from across the country. This study investigated these visitors and clustered them based on their motives for attending the event. As background to the study, we provide a broad survey of the literature on what motivates people to attend motorcycling events. Motorcycle tourism has received international research attention, especially in the US, but to date has been neglected in South Africa. Our study helps to fill this gap, particularly as regards biker and attendee characteristics. We found that three distinct market segments can be identified at the event; each one being motivated by a different set of motives. Recommendations are made to attract, retain and expand each segment. Event organisers can also use this information to expand motorcycle tourism in South Africa.

Comparison of moped, scooter and motorcycle crash risk and crash severity.

Science.gov (United States)

Blackman, Ross A; Haworth, Narelle L

2013-08-01

The increased popularity of mopeds and motor scooters in Australia and elsewhere in the last decade has contributed substantially to the greater use of powered two-wheelers (PTWs) as a whole. As the exposure of mopeds and scooters has increased, so too has the number of reported crashes involving those PTW types, but there is currently little research comparing the safety of mopeds and, particularly, larger scooters with motorcycles. This study compared the crash risk and crash severity of motorcycles, mopeds and larger scooters in Queensland, Australia. Comprehensive data cleansing was undertaken to separate motorcycles, mopeds and larger scooters in police-reported crash data covering the five years to 30 June 2008. The crash rates of motorcycles (including larger scooters) and mopeds in terms of registered vehicles were similar over this period, although the moped crash rate showed a stronger downward trend. However, the crash rates in terms of distance travelled were nearly four times higher for mopeds than for motorcycles (including larger scooters). More comprehensive distance travelled data is needed to confirm these findings. The overall severity of moped and scooter crashes was significantly lower than motorcycle crashes but an ordered probit regression model showed that crash severity outcomes related to differences in crash characteristics and circumstances, rather than differences between PTW types per se. Greater motorcycle crash severity was associated with higher (>80km/h) speed zones, horizontal curves, weekend, single vehicle and nighttime crashes. Moped crashes were more severe at night and in speed zones of 90km/h or more. Larger scooter crashes were more severe in 70km/h zones (than 60km/h zones) but not in higher speed zones, and less severe on weekends than on weekdays. The findings can be used to inform potential crash and injury countermeasures tailored to users of different PTW types. Copyright © 2013 Elsevier Ltd. All rights reserved.

Marketing Mix and Purchasing Behavior for Japanese Motorcycle Brand in Indonesia

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Etty Susilowati

2018-05-01

Full Text Available The increasing population in Indonesia leads to increasing demand for motorcycles as one of transportation means. Ease of operation and affordable prices cause motorcycles as a very popular transportation means in Indonesia, especially in big cities. This is because of the traffic density and the people's desire to arrive at their destination quickly. One of the Japanese brands, Honda Beat is the highest selling motorcycle brand in Indonesia based on the data from The Indonesian Motorcycle Industry Association. In this study, we investigate the relationship of marketing mix with consumer purchasing behavior of this specific brand. A judgmental sampling was applied to 100 consumers in Greater Jakarta. Multiple linear regression was employed to analyze the data. The results indicated that promotions have the highest influence on consumer purchasing behaviors of the brand (coeff. = 0.503, then followed by products (coeff. = 0.320, and price perceptions (coeff. = 0.224. This study contributes to the marketing literature by adding a new empirical evidence on how marketing mix can generate perception and preference of brand personality, especially in motorcycle brands. The findings of this study will assist managers of motorcycle brand to maximize specific factors from marketing mix analysis to increase consumer purchasing behavior. Finally, in terms of the method employed in marketing studies, this study contributes to the literature by adding a new combination of a quantitative study of multiple linear regression and personal opinion of consumers.

Report on the Recovery of a Personality Problem in a Case with Borderline Personality Disorder after Head Trauma

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M Nasiri

2017-05-01

Full Text Available BACKGROUND AND OBJECTIVE: Borderline personality disorder which constantly changes the mood, identity and interpersonal relationship is a mental disorder classified in category B. Besides, it leads to behaviors such as drug abuse, impulsive sex and suicide which make more difficult the treatment of these patients. The aim of this study was to report the recovery of a personality problem in a case with borderline personality disorder after the head trauma. CASE REPORT: The personality signs of a 28-year-old boy who had the full criteria of borderline personality disorder including drug abuse, impulsivity, mood instability, periods of anger and aggression were significantly decreased after hitting. Personality difference and improvement of patient were shown in MMPI test and MRI indicated the structural changes in his brain. He had no problem in 4-year-follow up. CONCLUSION: This report suggested the personality and behavioral changes after head trauma. MRI results indicated that the recovery is probably caused by the destruction area in the frontal lobe and the anterior temporal lobe (near the hippocampus. Thus the importance of neuropsychological factors should be considered in creating the diagnostic criteria.

Factors associated with the relationship between motorcycle deaths and economic growth.

Science.gov (United States)

Law, Teik Hua; Noland, Robert B; Evans, Andrew W

2009-03-01

This paper examines the Kuznets curve relationship for motorcycle deaths. The Kuznets curve describes the inverted U-shape relationship between economic development and, in this case, motorcycle deaths. In early stages of development we expect deaths to increase with increasing motorization. Eventually deaths decrease as technical, policy and political institutions respond to demands for increased safety. We examine this effect as well as some of the factors which might explain the Kuznets relationship: in particular motorcycle helmet laws, medical care and technology improvements, and variables representing the quality of political institutions. We apply a fixed effects negative binomial regression analysis on a panel of 25 countries covering the period 1970-1999. Our results broadly suggest that implementation of road safety regulation, improvement in the quality of political institutions, and medical care and technology developments have contributed to reduced motorcycle deaths.

The impact of motorcycle accidents on the obstetric population in ...

African Journals Online (AJOL)

Contexts: Motorcycle accidents are very common in most cities in Nigeria since the introduction of motorcycle for public commercial transportation in the early 1980s and because most pregnant women use this popular means of transport it may contribute to non-obstetric causes of maternal and perinatal morbidity and ...

Traffic conflict assessment for non-lane-based movements of motorcycles under congested conditions

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Long Xuan Nguyen

2014-03-01

Full Text Available Traffic conflict under congested conditions is one of the main safety issues of motorcycle traffic in developing countries. Unlike cars, motorcycles often display non-lane-based movements such as swerving or oblique following of a lead vehicle when traffic becomes congested. Very few studies have quantitatively evaluated the effects of such non-lane-based movements on traffic conflict. Therefore, in this study we aim to develop an integrated model to assess the traffic conflict of motorcycles under congested conditions. The proposed model includes a concept of safety space to describe the non-lane-based movements unique to motorcycles, new features developed for traffic conflict assessment such as parameters of acceleration and deceleration, and the conditions for choosing a lead vehicle. Calibration data were extracted from video clips taken at two road segments in Ho Chi Minh City. A simulation based on the model was developed to verify the dynamic non-lane-based movements of motorcycles. Subsequently, the assessment of traffic conflict was validated by calculating the probability of sudden braking at each time interval according to the change in the density of motorcycle flow. Our findings underscore the fact that higher flow density may lead to conflicts associated with a greater probability of sudden breaking. Three types of motorcycle traffic conflicts were confirmed, and the proportions of each type were calculated and discussed.

Craniocerebral trauma in the child abuse syndrome: Radiological observations

Energy Technology Data Exchange (ETDEWEB)

Merten, D.F.; Osborne, D.R.S.; Radkowski, M.A.; Leonidas, J.C.

1984-07-01

Experience with craniocerebral trauma in 712 physically abused children is reviewed. Ninety-three (13%) had evidence of head trauma (cranial and/or intracranial). Seventy-seven of these patients had computed tomography (CT) of the head, and 47 had CT evidence of intracranial injury. Extracerebral fluid collections, predominantly convexity subdural hemorrhage, were the most common acute intracranial lesions. Concurrent intracranial and skeletal trauma (cranial and/or ectracranial) was present in 33 of the 47 patients (70%) with intracranial injury. A high incidence of skull fractures (45%) in those children with intracranial lesions suggest a significant role for impact head injuries (''battering'') in the pathogenesis of craniocerebral trauma in the child abuse syndrome. Greater emphasis on CT examination in evaluation of the abuse infant and child is recommended.

Characteristics of Motorcycle Ownership and Use of University Students in Malaysian and Indonesian Cities

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Putranto L.S.

2015-01-01

Full Text Available Motorcycle ownership and use increased rapidly in Indonesian cities in recent years. People could not cope with severe congestion due to unsatisfactory public transport and uncontrolled land use delopment. This led to motorcycle use for almost any trip. However, in Malaysia motorcycles were mainly used for local short distance travel. In this paper the characteristics of motorcycle ownership and use of university students in Malaysian and Indonesian cities were discussed. A total of 398 university students in eight cities were asked to fill the questionnaires. They consist of general questions regarding their socio-economic back-ground and travel habit along with 25 perceptional questions regarding affordability/ attractiveness of owning motorcycle and practicability/safety of motorcycle use. A variance based structural equation modelling called partial least square-path modelling (PLS-PM was used for analysis. The results show that indicators explaining affordability and acceptability were exactly the same in Penang and combination of seven cities in Indonesia.

Comparative analyses of bicyclists and motorcyclists in vehicle collisions focusing on head impact responses.

Science.gov (United States)

Wang, Xinghua; Peng, Yong; Yi, Shengen

2017-11-01

To investigate the differences of the head impact responses between bicyclists and motorcyclists in vehicle collisions. A series of vehicle-bicycle and vehicle-motorcycle lateral impact simulations on four vehicle types at seven vehicle speeds (30, 35, 40, 45, 50, 55 and 60 km/h) and three two-wheeler moving speeds (5, 7.5 and 10 km/h for bicycle, 10, 12.5 and 15 km/h for motorcycle) were established based on PC-Crash software. To further comprehensively explore the differences, additional impact scenes with other initial conditions, such as impact angle (0, π/3, 2π/3 and π) and impact position (left, middle and right part of vehicle front-end), also were supplemented. And then, extensive comparisons were accomplished with regard to average head peak linear acceleration, average head impact speed, average head peak angular acceleration, average head peak angular speed and head injury severity. The results showed there were prominent differences of kinematics and body postures for bicyclists and motorcyclists even under same impact conditions. The variations of bicyclist head impact responses with the changing of impact conditions were a far cry from that of motorcyclists. The average head peak linear acceleration, average head impact speed and average head peak angular acceleration values were higher for motorcyclists than for bicyclists in most cases, while the bicyclists received greater average head peak angular speed values. And the head injuries of motorcyclists worsened faster with increased vehicle speed. The results may provide even deeper understanding of two-wheeler safety and contribute to improve the public health affected by road traffic accidents.

Motorcycle Mechanic: Apprenticeship Course Outline. Apprenticeship and Industry Training. 4912

Science.gov (United States)

Alberta Enterprise and Advanced Education, 2012

2012-01-01

The graduate of the Motorcycle Mechanic apprenticeship program is a certified journeyperson who will be able to: (1) repair and maintain motorcycles and ATVs which are powered with internal combustion engines; (2) comprehend work orders, technical bulletins and estimates, and relate the information to the job at hand; (3) interpret warranty policy…

Blunt splenic trauma in children: are we too careful?

Science.gov (United States)

De Jong, W J J; Nellensteijn, D R; Ten Duis, H J; Albers, M J I J; Moumni, M El; Hulscher, J B F

2011-08-01

There has been a shift from operative treatment (OT) to non-operative treatment (NOT) of splenic injury. We evaluated the outcomes of treatment of pediatric patients with blunt splenic trauma in our hospital, with special focus on the outcomes after NOT. The data of all patients splenic injury admitted between 1988 and 2007 were retrospectively analyzed. Mechanism of injury, type of treatment, ICU stay, total hospital stay, morbidity and mortality were assessed. Patients suffering isolated splenic injuries were assessed separately from patients with multiple injuries. Patients were subsequently divided into those admitted before and after 2000. There were 64 patients: 49 males and 15 females with a mean age of 13 years (range 0-18). 3 patients died shortly after admission due to severe neurological injury and were excluded. In the remaining 61 patients concomitant injuries, present in 62%, included long bone fractures (36%), chest injuries (16%), abdominal injuries (33%) and head injuries (30%). Mechanisms of injury were: car accidents (26%), motorcycle (20%), bicycle (19%), fall from height (17%) and pedestrians struck by a moving vehicle (8%). A change in treatment strategy was evident for the pre- and post-2000 periods. Significantly more patients had NOT after 2000 in both the isolated splenic injury group and the multi-trauma group [4/11 (36%) before vs. 10/11 (91%) after (p=0.009); 15/19 (79%) before vs. 8/20 (40%) after 2000 (p=0.03)]. There was also a significant shift to spleen-preserving operations. All life-threatening complications occurred within trauma group. Splenic injury in children is associated with substantial mortality. This is due to concomitant injuries and not to the splenic injury. Non-operative treatment is increasingly preferred to operative procedures when treating splenic injuries in hemodynamically, stable children. ICU and hospital stay have, despite the change from OT to NOT, remained the same. Complications after NOT are rare. We

Connected motorcycle crash warning interfaces.

Science.gov (United States)

2016-01-15

Crash warning systems have been deployed in the high-end vehicle market segment for some time and are trickling down to additional motor vehicle industry segments each year. The motorcycle segment, however, has no deployed crash warning system to dat...

Population based case–control study of serious non-fatal motorcycle crashes

Science.gov (United States)

2013-01-01

Background Motorcycle sales, registration and use are increasing in many countries. The epidemiological literature on risk factors for motorcycle injury is becoming outdated, due to changes in rider demography, licensing regulations, traffic mix and density, road environments, and motorcycle designs and technologies. Further, the potential contribution of road infrastructure and travel speed has not yet been examined. Methods/design A population based case–control study together with a nested case-crossover study is planned. Cases will be motorcycle riders who are injured but not killed in a motorcycle crash on a public road within 150 km radius of Melbourne, Australia, and admitted to one of the study hospitals. Controls will be motorcycle riders who ride through the crash site on the same type of day (weekday or weekend) within an hour of the crash time. Data on rider, bike, and trip characteristics will be collected from the participants by questionnaire. Data on crash site characteristics will be collected in a structured site inspection, and travel speed for the cases will be estimated from these data. Travel speed for the controls will be measured prior to recruitment with a radar traffic detection device as they ride through the crash site. Control sites for the case-crossover study will be selected 1 km upstream from the crash site and matched on either intersection status or road curvature (either straight or cornered). If the initial site selected does not match the case site on these characteristics, then the closest matching site on the case route will be selected. Conditional multivariate logistic regression models will be used to compare risk between the matched case and control riders and to examine associations between road infrastructure and road environment characteristics and crash occurrence. Interactions between type of site and speed will be tested to determine if site type is an effect modifier of the relationship between speed and crash

Perioperative care of a pregnant trauma victim: a review of ...

African Journals Online (AJOL)

Adele

2004-05-03

May 3, 2004 ... (until proven otherwise) in any female trauma patient of child- ... The perioperative management of pregnant trauma victims re- ... trauma, abdominal trauma, head injury, cervical spine injury, fetal injury, gun shot wounds, blunt.

Effectiveness of Motorcycle speed controlled by speed hump

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Pornsiri Urapa

2014-09-01

Full Text Available Speed humps are one of the traffic calming measures widely accepted to control vehicle speed in the local road. Humps standards from the western countries are designed mainly for the passenger car. This study, therefore, aims to reveal the effectiveness of speed hump to control the motorcycle speed. This study observes the free-flow speed of the riders at the total of 20 speed bumps and humps. They are 0.3-14.8 meter in width and 5-18 centimeter in height. The results reveal that the 85th percentile speeds reduce 15-65 percent when crossing the speed bumps and speed humps. Besides, this study develops the speed model to predict the motorcycle mean speed and 85th percentile speed. It is found that speed humps follow the ITE standard can control motorcycle crossing speeds to be 25-30 Kph which are suitable to travel on the local road.

Profile of motorcycle victims from the emergency service of a university hospital

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José Luís Amim Zabeu

2013-06-01

Full Text Available OBJECTIVE: Epidemiological survey of motorcycle accidents occurring in a city with over one million inhabitants and treated at university hospital of reference between the months of July and November 2010. METHODS: Cross sectional study using structured interview (standardized form to document the data collection: age, gender, income, using time and capacity of the motorcycle. RESULTS: From 114 cases, it was observed that the profile of the victim of motorcycle accident treated at this hospital is a young person, male, possessing a driver's license for less than five years, with a monthly income average around one thousand reais (local currency, owner of a motorcycle with low capacity (less than 150 cc and low educational attainment. The accidents occurred predominantly in the urban area, in the afternoons and one third of them were considered work-related accidents, death generated in 3 per cent of cases and open fractures in 11 per cent of them. CONCLUSION: The incidence of motorcycle accidents involved mainly young men with little experience in traffic and low level of education.

Geriatric trauma.

Science.gov (United States)

Adams, Sasha D; Holcomb, John B

2015-12-01

The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

Imaging of spinal injury in abusive head trauma: a retrospective study

International Nuclear Information System (INIS)

Choudhary, Arabinda K.; Ishak, Ramsay; Zacharia, Thomas T.; Dias, Mark S.

2014-01-01

Spinal imaging has been a neglected part of abusive head trauma (AHT) imaging. As most of the radiographs and CT spine are negative in AHT in infants, the cervical spine is assumed to be normal. There is increasing evidence in the role of injury to brainstem and cervical cord in the pathogenesis of AHT. In addition, in courts of law, there is fierce debate about AHT, its mimics and other disparate nontraumatic diagnoses explaining the neuroradiological and skeletal findings. However, this discussion ignores the evidence and significance of spinal injury. We sought to study the cervical spine in an AHT cohort to understand the true prevalence of spinal injuries in AHT and contrast it with cohorts of accidental and nontraumatic groups to give the clinicians a robust diagnostic tool in evaluating AHT. The purpose of this study is to compare the relative incidence of spinal ligamentous and soft-tissue abnormalities on spinal MRI among three groups of children ages < 48 months: (1) those with AHT, (2) those with accidental trauma, and (3) those with nontraumatic conditions. This comparative study included 183 children who underwent spine MRI: 67 with AHT, 46 with accidental trauma and a clinical suspicion of spinal injury, and 70 with nontraumatic conditions. Clinical and radiographic findings were collected in all cases and were analyzed retrospectively to identify MRI evidence of traumatic spinal injuries. The incidence of spinal injuries among the three groups was compared. The incidence of spinal ligamentous injuries was calculated for those with and without radiographic evidence of hypoxic-ischemic encephalopathy. All comparisons were performed using Fisher exact test with P < 0.05 considered statistically significant. Cervical spine ligamentous injuries (predominantly the nuchal, atlanto-occipital and atlanto-axial ligaments) were present in 78% of the AHT group, 46% of the accidental trauma group and 1% of the nontraumatic group; all of these differences were

Imaging of spinal injury in abusive head trauma: a retrospective study

Energy Technology Data Exchange (ETDEWEB)

Choudhary, Arabinda K. [Nemours A.I. DuPont Children Hospital, Department of Radiology, Wilmington, DE (United States); Ishak, Ramsay; Zacharia, Thomas T. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

2014-09-15

Spinal imaging has been a neglected part of abusive head trauma (AHT) imaging. As most of the radiographs and CT spine are negative in AHT in infants, the cervical spine is assumed to be normal. There is increasing evidence in the role of injury to brainstem and cervical cord in the pathogenesis of AHT. In addition, in courts of law, there is fierce debate about AHT, its mimics and other disparate nontraumatic diagnoses explaining the neuroradiological and skeletal findings. However, this discussion ignores the evidence and significance of spinal injury. We sought to study the cervical spine in an AHT cohort to understand the true prevalence of spinal injuries in AHT and contrast it with cohorts of accidental and nontraumatic groups to give the clinicians a robust diagnostic tool in evaluating AHT. The purpose of this study is to compare the relative incidence of spinal ligamentous and soft-tissue abnormalities on spinal MRI among three groups of children ages < 48 months: (1) those with AHT, (2) those with accidental trauma, and (3) those with nontraumatic conditions. This comparative study included 183 children who underwent spine MRI: 67 with AHT, 46 with accidental trauma and a clinical suspicion of spinal injury, and 70 with nontraumatic conditions. Clinical and radiographic findings were collected in all cases and were analyzed retrospectively to identify MRI evidence of traumatic spinal injuries. The incidence of spinal injuries among the three groups was compared. The incidence of spinal ligamentous injuries was calculated for those with and without radiographic evidence of hypoxic-ischemic encephalopathy. All comparisons were performed using Fisher exact test with P < 0.05 considered statistically significant. Cervical spine ligamentous injuries (predominantly the nuchal, atlanto-occipital and atlanto-axial ligaments) were present in 78% of the AHT group, 46% of the accidental trauma group and 1% of the nontraumatic group; all of these differences were

Computed tomography in the evaluation of trauma

International Nuclear Information System (INIS)

Federle, M.P.; Brant-Zawadzki, M.

1982-01-01

This book is intended to be the current standard for computed tomography in the evaluation of trauma. It summarizes two years of experience at San Francisco General Hospital. The book is organized into seven chapters, covering head, maxillofacial, laryngeal, spinal, chest, abdominal, acetabular, and pelvic trauma. Extremity trauma is not discussed

Trauma Imaging: A Literature Review.

Science.gov (United States)

Vela, Jason Heath; Wertz, Christopher Ira; Onstott, Kimberly L; Wertz, Joss R

2017-01-01

To inform radiologic technologists about which imaging modalities and examinations are best suited for evaluating specific anatomical structures in patients who have sustained a traumatic injury. Two scholarly research databases were searched to identify articles focused on trauma imaging of the head, cervical spine, thorax, abdomen, and pelvis. Articles focused on trauma diagnosis were excluded. Thirty-two articles were selected for analysis. Physical examination and plain-film radiographs typically are used to assess nasal bone fracures. Computed tomography (CT) can be used to assess zygomaticomaxillary complex, mandibular, and temporal bone fractures. Traumatic brain injuries are difficult to assess, and broad classifications are used. Depending on the severity of cervical spine trauma, plain-film radiographs or CT imaging is adequate, with magnetic resonance imaging used as a means for further evaluation. Trauma to the thorax typically is assessed with radiography and CT, and CT is recommended for assesment of abdominal and pelvic trauma. The literature was consistent regarding which examinations to perform to best evaluate suspected injuries to the chest, abdomen, and pelvis. The need for, and correct use of, imaging in evaluating trauma to the head and cervical spine is more controversial. Despite the need for additional research, emergency department care providers should be familiar with the structures most commonly injured during trauma and the role of medical imaging for diagnosis.

Toxicity assessment of volatile organic compounds and polycyclic aromatic hydrocarbons in motorcycle exhaust.

Science.gov (United States)

Chang, Chang-Tang; Chen, Bor-Yann

2008-05-30

This study investigates the toxicity of various pollutant species from motorcycle exhaust via dose-response analysis and margin of safety using Escherichia coli DH5 alpha. The toxicity evaluation of the major components of motorcycle exhaust volatile organic compounds (VOCs), collected with impinger, and polycyclic aromatic hydrocarbons (PAHs), collected with filter and XAD-2, is essential to determine emission standards for motorcycles. The toxicity of benzene (B), toluene (T), ethyl benzene (E) and xylene (X) was selected for comparison as standard VOCs emitted from motorcycles. In addition, three types of reformulated gasoline (high oxygenate and high benzene content (No. 1), low oxygen and high benzene (No. 2), and low oxygen and low benzene (No. 3) were prepared to reveal combined toxicity of individual compositions. Motorcycle exhaust is significantly more toxic than BTEX due to the highly toxic VOCs generated from incomplete combustion. Overall toxicity evaluation showed that the toxicity, indicated as EC50, was approximately as follows: PAHs>two-stroke engines>four-stroke engines>BTEX.

Toxicity assessment of volatile organic compounds and polycyclic aromatic hydrocarbons in motorcycle exhaust

International Nuclear Information System (INIS)

Chang, C.-T.; Chen, B.-Y.

2008-01-01

This study investigates the toxicity of various pollutant species from motorcycle exhaust via dose-response analysis and margin of safety using Escherichia coli DH5α. The toxicity evaluation of the major components of motorcycle exhaust volatile organic compounds (VOCs), collected with impinger, and polycyclic aromatic hydrocarbons (PAHs), collected with filter and XAD-2, is essential to determine emission standards for motorcycles. The toxicity of benzene (B), toluene (T), ethyl benzene (E) and xylene (X) was selected for comparison as standard VOCs emitted from motorcycles. In addition, three types of reformulated gasoline (high oxygenate and high benzene content (No. 1), low oxygen and high benzene (No. 2), and low oxygen and low benzene (No. 3) were prepared to reveal combined toxicity of individual compositions. Motorcycle exhaust is significantly more toxic than BTEX due to the highly toxic VOCs generated from incomplete combustion. Overall toxicity evaluation showed that the toxicity, indicated as EC 50 , was approximately as follows: PAHs > two-stroke engines > four-stroke engines > BTEX

Risky driving and the perception of motorcycle accident causes among Chinese motorcyclists in Hong Kong.

Science.gov (United States)

Cheng, Andy S K; Ng, Terry C K

2012-09-01

The primary purposes of this study were to explore the relationship between risk-taking acts while driving motorcycles and perceived causes of motorcycle accidents, as well as their contribution to active involvement in traffic accidents among Chinese motorcyclists in Hong Kong. Active involvement means the riders was likely at fault for the crash. A total of 774 motorcyclists were recruited, of whom 292 had been involved in active motorcycle accident in the previous 3 years. All were asked to fill in a questionnaire, which was developed to assess their risk-taking acts while driving a motorcycle and perception of motorcycle accident causes. The results of the study revealed 3 dimensions of accident causes, namely, driving-related, environment-related, and belief-related causes. These motorcycle accident causes were correlated with risk-taking acts while driving a motorcycle. A multivariate logistic regression analysis showed that risk-taking acts while driving motorcycles (adjusted odds ratio [OR]: 1.036, 95% confidence interval [CI]: 1.020-1.052), perception of driving-related cause (adjusted OR: 0.941, 95% CI: 0.916-0.967), and belief-related cause (adjusted OR: 1.134, 95% CI: 1.088-1.182) were significant factors contributing to involvement in active traffic accidents by motorcycle riders after controlling for concurrent demographic variables. The study highlights that perceived causes of motorcycle accidents are multidimensional, including those areas related to driving, the environment, and beliefs. It substantiates previous studies that a higher degree of driving-related risk perception is related to a lower degree of risk-taking acts while driving. Further research is needed to understand why belief-related causes, sometimes called superstitions, lead riders to believe that it is beyond their ability to affect accident causation and prevention.

Influence of front light configuration on the visual conspicuity of motorcycles.

Science.gov (United States)

Pinto, Maria; Cavallo, Viola; Saint-Pierre, Guillaume

2014-01-01

A recent study (Cavallo and Pinto, 2012) showed that daytime running lights (DRLs) on cars create "visual noise" that interferes with the lighting of motorcycles and affects their visual conspicuity. In the present experiment, we tested three conspicuity enhancements designed to improve motorcycle detectability in a car-DRL environment: a triangle configuration (a central headlight plus two lights located on the rearview mirrors), a helmet configuration (a light located on the motorcyclist's helmet in addition to the central headlight), and a single central yellow headlight. These three front-light configurations were evaluated in comparison to the standard configuration (a single central white headlight). Photographs representing complex urban traffic scenes were presented briefly (for 250ms). The results revealed better motorcycle-detection performance for both the yellow headlight and the helmet configuration than for the standard configuration. The findings suggest some avenues for defining a new visual signature for motorcycles in car-DRL environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Unusual Case of Cerebral Penetrating Injury by a Driven Bone Fragment Secondary to Blunt Head Trauma

OpenAIRE

Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

2011-01-01

Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right t...

Role of sensory and cognitive conspicuity in the prevention of collisions between motorcycles and trucks at T-intersections.

Science.gov (United States)

Law, Teik Hua; Ghanbari, Mahshid; Hamid, Hussain; Abdul-Halin, Alfian; Ng, Choy Peng

2016-11-01

Motorcyclists are particularly vulnerable to injury in crashes with heavy vehicles due to substantial differences in vehicle mass, the degree of protection and speed. There is a considerable difference in height between motorcycles and trucks; motorcycles are viewed by truck drivers from downward angles, and shorter distances between them mean steeper downward angles. Hence, we anticipated that the effects of motorcycle conspicuity treatments would be different for truck drivers. Therefore, this study aims to evaluate the effects of motorcycle conspicuity treatments on the identification and detection of motorcycles by truck drivers. Two complementary experiments were performed; the first experiment assessed the impact of motorcycle sensory conspicuity on the ability of un-alerted truck drivers to detect motorcycles, and the second experiment assessed the motorcycle cognitive conspicuity to alerted truck drivers. The sensory conspicuity was measured in terms of motorcycle detection rates by un-alerted truck drivers when they were not anticipating a motorcycle within a realistic driving scene, while the cognitive conspicuity was determined by the time taken by alerted truck drivers to actively search for a motorcycle. In the first experiment, the participants were presented with 10 pictures and were instructed to report the kinds of vehicles that were presented in the pictures. Each picture was shown to the participants for 600ms. In the second experiment, the participants were presented with the same set of pictures and were instructed to respond by clicking the right button on a mouse as soon as they detected a motorcycle in the picture. The results indicate that the motorcycle detection rate increases, and the response time to search for a motorcycle decreases, as the distance between the targeted motorcycle and the viewer decreases. This is true regardless of the type of conspicuity treatment used. The use of daytime running headlights (DRH) was found to

Methods of estimating the effect of integral motorcycle helmets on physiological and psychological performance.

Science.gov (United States)

Bogdan, Anna; Sudoł-Szopińska, Iwona; Luczak, Anna; Konarska, Maria; Pietrowski, Piotr

2012-01-01

This article proposes a method for a comprehensive assessment of the effect of integral motorcycle helmets on physiological and cognitive responses of motorcyclists. To verify the reliability of commonly used tests, we conducted experiments with 5 motorcyclists. We recorded changes in physiological parameters (heart rate, local skin temperature, core temperature, air temperature, relative humidity in the space between the helmet and the surface of the head, and the concentration of O(2) and CO(2) under the helmet) and in psychological parameters (motorcyclists' reflexes, fatigue, perceptiveness and mood). We also studied changes in the motorcyclists' subjective sensation of thermal comfort. The results made it possible to identify reliable parameters for assessing the effect of integral helmets on performance, i.e., physiological factors (head skin temperature, internal temperature and concentration of O(2) and CO(2) under the helmet) and on psychomotor factors (reaction time, attention and vigilance, work performance, concentration and a subjective feeling of mood and fatigue).

Emergency mobile care service: trauma epidemiology in prehospital care

Directory of Open Access Journals (Sweden)

Mateus Kist Ibiapino

2017-06-01

Full Text Available Objective: to characterize trauma victims assisted by the Mobile Emergency Care Service (SAMU 192 in the city of Ilhéus, Bahia, Brazil. Method: this is a descriptive and retrospective study in which 1,588 records of traumatic events were analyzed from the following variables: sex, age, day of the week, period of the day, trauma mechanism, topography and type of injuries, revised trauma score, type of mobile unit used, professional responsible for care, time to hospital care, procedures performed and deaths. Results: there was a predominance of male victims (69.5% and age between 18 and 37 (46.5%. Occurrences were concentrated at weekends (37.8% and in the evening (52.0%. It revealed traffic accidents (41.3% as the main mechanism of trauma, among which prevailed the involvement of motorcycles (73.0%. Regarding the topographic distribution of lesions, the majority affected the limbs (58.2%. The most adopted conducts in prehospital care were immobilization (26.3% and compression dressing (25.9%. The deaths accounted for 2.7% of the total sample. Conclusion: The population most affected by traumatic events in Ilhéus shown to be composed of young men involved in traffic accidents, mainly motorcyclists, during the weekends.

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults.

Science.gov (United States)

Lin, Chien-Yu; Liao, Yung

2017-08-18

Although research has shown that numerous perceived environmental factors are supportive of physical activity, little is known about their associations with sedentary transport in motorcycle-oriented countries. This study examined the association between perceptions of Taiwan's environmental factors and urban adults' motorcycle use. Cross-sectional data from 1003 Taiwanese adults aged 20-64 years from three urban cities were collected through telephonic surveys in 2015. Data on motorcycle use, sociodemographic variables, and perceived environmental attributes were obtained. Logistic regression analyses were performed. In Model 1, adults who perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night were less likely to use motorcycles. In Model 2, in which potential covariates were additionally adjusted for, the same four environmental attributes (perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night; odds ratio [OR] = 0.46, 0.65, 0.63, 0.64, respectively) were significantly associated with motorcycle use. The investigated perceived environmental factors, which have previously been associated with facilitating active transportation, discourage sedentary modes of transport, such as motorized vehicles.

Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers.

Science.gov (United States)

Barr, Ronald G

2012-10-16

Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.

Extremes of shock index predicts death in trauma patients

Directory of Open Access Journals (Sweden)

Stephen R Odom

2016-01-01

Full Text Available Context: We noted a bimodal relationship between mortality and shock index (SI, the ratio of heart rate to systolic blood pressure. Aims: To determine if extremes of SI can predict mortality in trauma patients. Settings and Designs: Retrospective evaluation of adult trauma patients at a tertiary care center from 2000 to 2012 in the United States. Materials and Methods: We examined the SI in trauma patients and determined the adjusted mortality for patients with and without head injuries. Statistical Analysis Used: Descriptive statistics and multivariable logistic regression. Results: SI values demonstrated a U-shaped relationship with mortality. Compared with patients with a SI between 0.5 and 0.7, patients with a SI of 1.3 had an odds ratio of death of 3.1. (95% CI 1.6–5.9. Elevated SI is associated with increased mortality in patients with isolated torso injuries, and is associated with death at both low and high values in patients with head injury. Conclusion: Our data indicate a bimodal relationship between SI and mortality in head injured patients that persists after correction for various co-factors. The distribution of mortality is different between head injured patients and patients without head injuries. Elevated SI predicts death in all trauma patients, but low SI values only predict death in head injured patients.

Investigating structural and perfusion deficits due to repeated head trauma in active professional fighters.

Science.gov (United States)

Mishra, Virendra; Sreenivasan, Karthik; Banks, Sarah J; Zhuang, Xiaowei; Yang, Zhengshi; Cordes, Dietmar; Bernick, Charles

2018-01-01

Repeated head trauma experienced by active professional fighters results in various structural, functional and perfusion damage. However, whether there are common regions of structural and perfusion damage due to fighting and whether these structural and perfusion differences are associated with neuropsychological measurements in active professional fighters is still unknown. To that end, T1-weighted and pseudocontinuous arterial spin labeling MRI on a group of healthy controls and active professional fighters were acquired. Voxelwise group comparisons, in a univariate and multivariate sense, were performed to investigate differences in gray and white matter density (GMD, WMD) and cerebral blood flow (CBF) between the two groups. A significantly positive association between global GMD and WMD was obtained with psychomotor speed and reaction time, respectively, in our cohort of active professional fighters. In addition, regional WMD deficit was observed in a cluster encompassing bilateral pons, hippocampus, and thalamus in fighters (0.49 ± 0.04 arbitrary units (a.u.)) as compared to controls (0.51 ± 0.05a.u.). WMD in the cluster of active fighters was also significantly associated with reaction time. Significantly lower CBF was observed in right inferior temporal lobe with both partial volume corrected (46.9 ± 14.93 ml/100 g/min) and non-partial volume corrected CBF maps (25.91 ± 7.99 ml/100 g/min) in professional fighters, as compared to controls (65.45 ± 22.24 ml/100 g/min and 35.22 ± 12.18 ml/100 g/min respectively). A paradoxical increase in CBF accompanying right cerebellum and fusiform gyrus in the active professional fighters (29.52 ± 13.03 ml/100 g/min) as compared to controls (19.43 ± 12.56 ml/100 g/min) was observed with non-partial volume corrected CBF maps. Multivariate analysis with both structural and perfusion measurements found the same clusters as univariate analysis in addition to a cluster in right precuneus

Investigating structural and perfusion deficits due to repeated head trauma in active professional fighters

Directory of Open Access Journals (Sweden)

Virendra Mishra

2018-01-01

Full Text Available Repeated head trauma experienced by active professional fighters results in various structural, functional and perfusion damage. However, whether there are common regions of structural and perfusion damage due to fighting and whether these structural and perfusion differences are associated with neuropsychological measurements in active professional fighters is still unknown. To that end, T1-weighted and pseudocontinuous arterial spin labeling MRI on a group of healthy controls and active professional fighters were acquired. Voxelwise group comparisons, in a univariate and multivariate sense, were performed to investigate differences in gray and white matter density (GMD, WMD and cerebral blood flow (CBF between the two groups. A significantly positive association between global GMD and WMD was obtained with psychomotor speed and reaction time, respectively, in our cohort of active professional fighters. In addition, regional WMD deficit was observed in a cluster encompassing bilateral pons, hippocampus, and thalamus in fighters (0.49 ± 0.04 arbitrary units (a.u. as compared to controls (0.51 ± 0.05a.u.. WMD in the cluster of active fighters was also significantly associated with reaction time. Significantly lower CBF was observed in right inferior temporal lobe with both partial volume corrected (46.9 ± 14.93 ml/100 g/min and non-partial volume corrected CBF maps (25.91 ± 7.99 ml/100 g/min in professional fighters, as compared to controls (65.45 ± 22.24 ml/100 g/min and 35.22 ± 12.18 ml/100 g/min respectively. A paradoxical increase in CBF accompanying right cerebellum and fusiform gyrus in the active professional fighters (29.52 ± 13.03 ml/100 g/min as compared to controls (19.43 ± 12.56 ml/100 g/min was observed with non-partial volume corrected CBF maps. Multivariate analysis with both structural and perfusion measurements found the same clusters as univariate analysis in addition to a cluster in right

Factors Associated with Road Accidents among Brazilian Motorcycle Couriers

OpenAIRE

da Silva, Daniela Wosiack; Andrade, Selma Maffei de; Soares, Dorotéia Fátima Pelissari de Paula; Mathias, Thais Aidar de Freitas; Matsuo, Tiemi; de Souza, Regina Kazue Tanno

2012-01-01

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried ou...

[Motorcycle couriers: characteristics of traffic accidents in southern Brazil].

Science.gov (United States)

Soares, Dorotéia Fátima Pelissari de Paula; Mathias, Thais Aidar de Freitas; da Silva, Daniela Wosiack; de Andrade, Selma Maffei

2011-09-01

This study aimed at understanding characteristics of traffic accidents with motorcycle couriers in the cities of Londrina and Maringá, in the State of Paraná (Brazil). A total of 327 couriers who reported, in 2005/2006, motorcycle accident in the previous 12 months took part in the study (147 in Londrina and 180 in Maringá). Of all the interviewed, 39.6% reported more than one traffic accident. The accidents were perceived as serious by 21.4% of them and 56.3% reported knowing a convalescing courier due to a traffic accident. Most injuries (82.9%) occurred during work hours. Significant differences were observed between the cities concerning climatic conditions (p=0.013), time of the day (p=0.002), pre-hospital care (p=0.032) and hospital admission (paccidents highlight the susceptibility of motorcycle couriers to these events and the need for strategies and specific prevention policies.

The impact of the Thai motorcycle transition on road traffic injury: Thai Cohort Study results.

Science.gov (United States)

Berecki-Gisolf, Janneke; Yiengprugsawan, Vasoontara; Kelly, Matthew; McClure, Roderick; Seubsman, Sam-ang; Sleigh, Adrian

2015-01-01

The aim of this study was to investigate the impact of motorcycle to car transitioning and urbanisation on traffic injury rates in Thailand. Analysis of two consecutive surveys of a large national cohort study. Thailand. The data derived from 57,154 Thai Cohort Study (TCS) participants who provided relevant data on both the 2005 and 2009 surveys. Motorcycle and car traffic crash injury self-reported in 2009, with twelve months' recall. In 2009, 5608(10%) participants reported a traffic crash injury. Most crashes involved a motorcycle (74%). Car access increased and motorcycle use decreased between 2005 and 2009. Among those who used a motorcycle at both time points, traffic injury incidence was 2.8 times greater compared to those who did not use a motorcycle at either time point. Multivariable logistic regression models were used to test longitudinal and cross sectional factors associated with traffic crash injury: in the adjusted model, cars were negatively and motorcycles positively associated with injury. Living in an urban area was not injury protective in the adjusted model of traffic crash injury. Ongoing urbanisation in Thailand can be expected to lead to further reductions in road traffic injuries based on transition from motorcycles to cars in urban areas. Cities, however, do not provide an intrinsically safer traffic environment. To accommodate a safe transition to car use in Thailand, traffic infrastructural changes anticipating the growing car density in urban areas is warranted.

Cross-cultural effects on the perception and appraisal of approaching motorcycles at junctions

OpenAIRE

Lee, YM; Sheppard, E; Crundall, D

2015-01-01

Crundall et al. (2008) reported that perceptual errors (failing to perceive) and not appraisal errors (failing to make a correct judgment about safety) are likely to explain the relatively high number of right of way violation accidents involving motorcycles in relation to cars. Two experiments were conducted to investigate the effect of exposure to motorcycles on these types of errors by comparing drivers from Malaysia where motorcycles are very common with drivers from the UK where motorcyc...

Kleptomania after head trauma: two case reports and combination treatment strategies.

Science.gov (United States)

Aizer, Anat; Lowengrub, Katherine; Dannon, Pinhas N

2004-01-01

The purpose of this paper is to add to the growing number of reports about kleptomania occurring in relation to brain injury as well as to present the authors' findings regarding treatment strategies. The authors present two case reports of patients who developed the new onset of kleptomania after closed head trauma. Both patients had comorbid psychiatric symptoms associated with the kleptomania. Antidepressant monotherapy was not beneficial in reducing kleptomania in either patient. Kleptomanic behavior was successfully treated in both patients, however, through combination treatment using an antidepressant agent together with adjunctive cognitive behavioral therapy or adjunctive naltrexone. In one patient, single photon emission tomography showed a perfusion deficit in the left temporal lobe. Various hypotheses regarding this finding and the etiopathology of kleptomania are discussed. Review of current work in the field suggests that kleptomania is a heterogeneous disorder that shares features of both impulse and addiction disorders as well as affective spectrum disorders.

White LED motorcycle headlamp design

Science.gov (United States)

Sun, Wen-Shing

2015-09-01

The motorcycle headlamp is composed of a white LED module, an elliptical reflector, a parabolic reflector and a toric lens. We use non-sequential ray to improve the optical efficiency of the compound reflectors. Using the toric lens can meet ECE_113 regulation and obtain a good uniformity.

Structural optimization of a motorcycle chassis by pattern search algorithm

Science.gov (United States)

Scappaticci, Lorenzo; Bartolini, Nicola; Guglielmino, Eugenio; Risitano, Giacomo

2017-08-01

Changes to the technical regulations of the motorcycle racing world classes introduced the new Moto2 category. The vehicles are prototypes that use single-brand tyres and engines derived from series production, supplied by a single manufacturer. The stability and handling of the vehicle are highly dependent on the geometric properties of the chassis. The performance of a racing motorcycle chassis can be primarily evaluated in terms of weight and stiffness. The aim of this work is to maximize the performance of a tubular frame designed for a motorcycle racing in the Moto2 category. The goal is the implementation of an optimization algorithm that acts on the dimensions of the single pipes of the frame and involves the design of an objective function to minimize the weight of the frame by controlling its stiffnesses.

Influence of horizontally curved roadway section characteristics on motorcycle-to-barrier crash frequency.

Science.gov (United States)

Gabauer, Douglas J; Li, Xiaolong

2015-04-01

The purpose of this study was to investigate motorcycle-to-barrier crash frequency on horizontally curved roadway sections in Washington State using police-reported crash data linked with roadway data and augmented with barrier presence information. Data included 4915 horizontal curved roadway sections with 252 of these sections experiencing 329 motorcycle-to-barrier crashes between 2002 and 2011. Negative binomial regression was used to predict motorcycle-to-barrier crash frequency using horizontal curvature and other roadway characteristics. Based on the model results, the strongest predictor of crash frequency was found to be curve radius. This supports a motorcycle-to-barrier crash countermeasure placement criterion based, at the very least, on horizontal curve radius. With respect to the existing horizontal curve criterion of 820 feet or less, curves meeting this criterion were found to increase motorcycle-to-barrier crash frequency rate by a factor of 10 compared to curves not meeting this criterion. Other statistically significant predictors were curve length, traffic volume and the location of adjacent curves. Assuming curves of identical radius, the model results suggest that longer curves, those with higher traffic volume, and those that have no adjacent curved sections within 300 feet of either curve end would likely be better candidates for a motorcycle-to-barrier crash countermeasure. Copyright © 2015 Elsevier Ltd. All rights reserved.

Motorcycle safety programmes in Malaysia: how effective are they?

Science.gov (United States)

Radin Umar, R S

2006-06-01

This paper presents the approach taken by the Malaysian Government to contain motorcycle casualties in Malaysia. It involves the exposure control, crash prevention, behaviour modification and injury control related to humans, vehicles and the environment based on pre-crash, crash and post-crash scenarios of motorcycle accidents. These initiatives emanated mainly from the research and development carried out by the Road Safety Research Centre at Universiti Putra Malaysia. Recent outcomes from these initiatives are presented and their impact is highlighted.

Car and Motorcycle Show Brings “Gearheads” and Fans Together | Poster

Science.gov (United States)

By Carolynne Keenan, Contributing Writer On Sept. 24, the Building 549 parking lot was full of cars; however, unlike any regular work day, the spaces were filled with a variety of classic cars, street rods, motorcycles, and unique modern cars for display in the first car and motorcycle show hosted at NCI at Frederick.

Cranial trauma in ancient Greece: from Homer to classical authors.

Science.gov (United States)

Konsolaki, Eleni; Astyrakaki, Elisabeth; Stefanakis, George; Agouridakis, Panos; Askitopoulou, Helen

2010-12-01

This article presents literary evidence on traumatic cranio-cerebral injuries in ancient Greece from about 900 B.C. to 100 B.C. The main sources of information are epic and classic Greek texts of that period. Homer provides the first literary source of head trauma, which he portrayed in his epic poems The Iliad and The Odyssey. He describes 41 injuries of the head, face and cervical spine, of which all but two were fatal. Subsequently, other classical authors like Plato, Plutarch and others illustrate cases of cranial trauma that occurred mainly in the battlefields, during athletic games or in unusual accidents. They describe some interesting cases of head trauma in prominent men, such as the poet Aeschylos, the kings Pyrrhos and Kyros and Alexander the Great. Most of these descriptions show that the ancient Greeks possessed very good knowledge of the anatomy of the head and neck region and also of the pathophysiological consequences of trauma in the region. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Motorcycle injuries in north-central Nigeria

African Journals Online (AJOL)

2011-03-23

Mar 23, 2011 ... become important source of morbidity and mortality. This is coupled with ... traffic, and poor licensing of the motorcycle riders. The objectives of this ... In addition, there is no legislation concerning safety devices such as crash ...

Raising Barriers to 'Outlaw Motorcycle Gang-Related Events' : Underlining the Difference between Pre-Emption and Prevention

NARCIS (Netherlands)

T. van Ruitenburg (Teun)

2017-01-01

textabstractFighting outlaw motorcycle gangs is currently one of the top priorities of many governments around the world. This is due to the notion that outlaw motorcycle gangs do not consist solely of motorcycle enthusiasts. Numerous cases reveal that these clubs, or at least their members, are

Exhaust and evaporative emissions from motorcycles fueled with ethanol gasoline blends.

Science.gov (United States)

Li, Lan; Ge, Yunshan; Wang, Mingda; Peng, Zihang; Song, Yanan; Zhang, Liwei; Yuan, Wanli

2015-01-01

The emission characteristics of motorcycles using gasoline and E10 (90% gasoline and 10% ethanol by volume) were investigated in this article. Exhaust and evaporative emissions of three motorcycles were investigated on the chassis dynamometer over the Urban Driving Cycle (UDC) and in the Sealed Housing for Evaporative Determination (SHED) including regulated and unregulated emissions. The regulated emissions were detected by an exhaust gas analyzer directly. The unregulated emissions including carbonyls and volatile organic compounds (VOCs) were sampled through battery-operated air pumps using tubes coated with 2,4-dinitrophenylhydrazine (DNPH) and Tenax TA, respectively. The experimental results showed that the emission factors of total hydrocarbons (THC) and carbon monoxide (CO) from E10 fueling motorcycles decreased by 26%-45% and 63%-73%, while the emission factor of NOx increased by 36%-54% compared with those from gasoline fueling motorcycles. For unregulated emissions, the emission amount of VOCs from motorcycles fueled with E10 decreased by 18%-31% while total carbonyls were 2.6-4.5 times higher than those for gasoline. For evaporative emissions of THC and VOCs, for gasoline or E10, the diurnal breathing loss (DBL) was higher than hot soak loss (HSL). Using E10 as a fuel does not make much difference in the amount of evaporative THC, while resulted in a slightly growth of 14%-17% for evaporative BETX (benzene, toluene, ethylbenzene, xylene). Copyright © 2014 Elsevier B.V. All rights reserved.

Motorcycle Parts

Science.gov (United States)

1993-01-01

An article in NASA Tech Briefs describing a vacuum bagging process for forming composite parts helped a small Oklahoma Company to improve its manufacturing process. President of Performance Extremes, Larry Ortega, and his partners make motorcycle parts from carbon/epoxy to reduce weight. Using vacuum bags, parts have a better surface and fewer voids inside. When heat used in the vacuum bag process caused deformation upon cooling, a solution found in another tech brief solved the problem. A metal plate inside the vacuum bag made for more even heat transfer. A third article described a simple procedure for repairing loose connector pins, which the company has also utilized.

Influence of benzene emission from motorcycle on Bangkok air quality

Science.gov (United States)

Leong, Shing Tet; Muttamara, S.; Laortanakul, Preecha

This study investigated the influence of benzene concentration from motorcycle exhaust emissions on ambient air quality in Bangkok Metropolitan Region (BMR). Measurement of benzene concentration in exhaust emissions is performed on a standard test driving cycle through which each motorcycle to be tested is driven. The test result revealed that average benzene concentrations in exhaust emission for the test motorcycles ranged from 3.02 to 109.68 mg/m 3. The finding also indicated that two-stroke motorcycles emitted five times more benzene than that of four-stroke motorcycles. Four air monitoring sites were strategically established to determine the relationship between average benzene concentrations with different traffic configurations in each traffic zone of BMR during peak/non-peak hours, day/night times and weekday/weekend. The shape of the curve for benzene level usually shows two peaks corresponding to the morning and evening traffic rush or commuter rush hours. The finding shows that the mean concentrations for benzene in all monitoring stations in the ambient air for peak hours (07:00-09:00 and 16:00-18:00 h) ranged from 15.1 to 42.4 μg/m 3. For non-peak hour (11:30-15:00 h), benzene levels were found in the range 16.3-30.9 μg/m 3. It is observed that higher levels of benzene are found among roadside stations with slow moving traffic while lower levels are found among roadside stations with fast traffic movement. Additional factors such as temperature, wind speed, rainfall, etc. are also considered in this study to determine the relationship between traffic conditions and ambient benzene levels.

[Occupational risk factors and perceptions of air pollution by motorcycle taxi drivers in Cotonou, Benin].

Science.gov (United States)

Lawin, Hervé; Ayi Fanou, Lucie; Hinson, Vikkey; Tollo, Brice; Fayomi, Benjamin; Ouendo, Edgard-Marius

Motorcycle taxis occupy a major place in urban transport. Motorcycle taxi drivers are exposed to occupational risk factors (ORF) including air pollution. The objective of this study was to evaluate these ORF among motorcycle taxi drivers and their perceptions of air pollution. This mixed study was conducted on motorcycle taxi drivers in Cotonou. The qualitative study was based on focus groups concerning 16 items from the Participatory Occupational Risk Screening Guide (DEPARIS) until saturation and after triangulation of data. The quantitative study consisted of administering a questionnaire addressing socioeconomic and demographic characteristics, cardiopulmonary diseases, and perception of air -pollution risk factors among 397 Cotonou motorcycle taxi drivers. Drivers perceived poor road conditions, effort and handling, and lack of social security as unsatisfactory ORF. Their mean age was 40.95 ± 8.75 years and 45.84% had primary -education. They had been working as motorcycle taxi drivers for an average of 134.95 ± 101.53 months with an average income of FCFA 3138 ± 1238. These occupational factors were significantly associated with cardiopulmonary disorders, observed in 63.2% of drivers. Less than 1/3 of drivers felt that air pollution affected their personal health. Motorcycle taxi drivers have a poor perception of ORF and the severity of exposure to air pollution in this occupation. There is a need to take action to promote the health of this population.

Involvement of unendorsed motorcycle operators in fatal crashes in Cuyahoga County, Ohio, 2005-2011.

Science.gov (United States)

Connor, Susan M

2014-01-01

This study examines the role of unendorsed motorcycle operators in fatal motorcycle crashes and the interrelationships of endorsement status and motorcycle type with operator characteristics like riding impaired. Cases were drawn from a database tracking fatal crashes occurring within Cuyahoga County, Ohio, from 2005 to 2011. Analysis focused on 75 fatal motorcycle crashes in which the deceased motorcycle operators were male and coroner's reports, police crash reports, and license endorsement status were available. Analysis included comparison of means, chi square testing, and binary logistic regression. More than half of motorcyclists (53%) did not have motorcycle endorsements. Mean age of unendorsed riders was 36.8 years, compared to 44.2 years for endorsed riders. Motorcyclists were considered at fault in 69 percent of cases, most often due to reckless operation, failure to control, or speeding. Mean blood alcohol concentration for fatally injured motorcyclists was 0.06 percent. Marijuana was the most common drug identified in blood tests. Nonendorsement was associated with younger age, single-vehicle crash, and having a prior license suspension. Neither endorsement status nor bike type was associated with likelihood of testing positive for alcohol or drugs of abuse. Riders of sport motorcycles were more likely than cruiser/touring bike operators to be wearing helmets and less likely to be endorsed. The large proportion of unendorsed motorcyclists involved in fatal crashes in northeast Ohio highlights the need for more stringent licensing requirements that make it more difficult to ride without an endorsement and limit learner's permit renewals.

Injuries and absenteeism among motorcycle taxi drivers who are victims of traffic accidents.

Science.gov (United States)

Barbosa, Kevan G N; Lucas-Neto, Alfredo; Gama, Bruno D; Lima-Neto, Jose C; Lucas, Rilva Suely C C; d'Ávila, Sérgio

2014-08-01

Facial injuries frequently occur in traffic accidents involving motorcycles. The purpose of this study was to determine the prevalence of facial injuries among motorcycle drivers who perform motorcycle taxi service. The study design was cross-sectional. A total of 210 participants who served as motorcycle taxi drivers in a city in northeastern Brazil completed a survey concerning their experience of accidents involving facial injuries and consequent hospitalization and absenteeism from work. The motorcycle drivers included in the study were randomly selected from a list provided by the city. Out of the respondents, 165 (78.6%) who were involved in traffic accidents in the last 12 months, 15 (9.1%) reported facial injuries. The types of facial injury most frequently reported involved soft tissues (n = 8; 53.3%), followed by simple fracture (n = 4; 26.7%) and dentoalveolar fracture (n = 3; 20%). We found an association between facial injuries and absenteeism, as well as an association between the presence of facial injury and the need for hospitalization for a period of 2 days or more. Respondents reported that they had accidents, but due to the use of full face motorcycle helmet the number of facial injuries was low. For most of them, absenteeism was observed for a period of one month or more. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Chest trauma in children: A local experience

International Nuclear Information System (INIS)

Al-Saigh, A.; Fazili, Fiaz M.; Allam, Abdulla R.

1999-01-01

Chest trauma in childhood is relatively uncommon in clinical practice andhas been the subject of few reports in literature. This study was undertakento examine our experience in dealing with chest trauma in children. This wasa retrospective study of 74 children who sustained chest trauma and werereferred to King Fahd Hospital in Medina over a two-year period. The age,cause of injury, severity of injury, associated extrathoracic injuries,treatment and outcome were analyzed. The median age of patients was nineyears. Fifty-nine of them (80%) sustained blunt trauma in 62% of thechildren, gun shot wounds were seen in five and stab wounds in 10 children.Head injury was the most common injury associated with thoracic trauma andwas seen in 14 patients (19%) and associated intra-abdominal injuries wereseen in nine patients. Chest x-ray of the blunt trauma patients revealedfractured ribs in 24 children, pneumothorax in six, hemothorax in four,hemoneumothorax in three, and pulmonary contusions in 22 patients. Fifty onepercent of children were managed conservatively, 37% required tubethoracostomy, 8% were mechanically ventilated and 4% underwent thoractomy.The prevalence of chest trauma in children due to road traffic accidents ishigh in Saudi Arabia. Head injury is thought to be the most common associatedextrathoracic injuries, however, most of these patients can be managedconservatively. (author)

Penetrating injury caused by the gear pedal of a motor-cycle ...

African Journals Online (AJOL)

This is a case of a penetrating injury to the left lower extremity caused by the gear pedal of a motor-cycle that pierced through the foot of one of the 3 passengers on a motor-cycle involved in a road traffic accident. He had no neurovascular injury but was found radiologically to have an ipsilateral tibia fracture. The object was ...

Paid family leave's effect on hospital admissions for pediatric abusive head trauma.

Science.gov (United States)

Klevens, Joanne; Luo, Feijun; Xu, Likang; Peterson, Cora; Latzman, Natasha E

2016-12-01

Paediatric abusive head trauma (AHT) is a leading cause of fatal child maltreatment among young children. Current prevention efforts have not been consistently effective. Policies such as paid parental leave could potentially prevent AHT, given its impacts on risk factors for child maltreatment. To explore associations between California's 2004 paid family leave (PFL) policy and hospital admissions for AHT, we used difference-in-difference analyses of 1995-2011 US state-level data before and after the policy in California and seven comparison states. Compared with seven states with no PFL policies, California's 2004 PFL showed a significant decrease in AHT admissions in both <1 and <2-year-olds. Analyses using additional data years and comparators could yield different results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Switching from motorcycle taxi to walking: A case study of transit station access in Bangkok, Thailand

Directory of Open Access Journals (Sweden)

Pornraht Pongprasert

2017-12-01

Full Text Available This study aims to find the factors affecting residents near transit stations within 1000 m, who are referred to as transit-oriented development (TOD residents, to reduce motorcycle taxi use and encourage walking to stations. These two modes of commuting are the most popular among over 85% of residents. However, motorcycle taxis are the main pedestrian barriers that hinder easy access and walkability in TODs of Bangkok, because they ride, stop, and provide services on sidewalks. From 2013 to 2015, these problems substantially increased the number of motorcycle taxis that are not willing and able to follow the rules. The increasing number of pedestrian accidents on sidewalks is related to the increase in the number of motorcycle taxis. According to a survey on pedestrian safety with 249 respondents, over 25% of walkers feel unsafe to walk, while 40% of motorcycle-taxi users riding to stations do not walk because they are afraid of accidents. In modal split, the share of walking reduces from 76% for areas < 500 m, to 25% for areas between 500 and 1000 m from transit stations, respectively. Hence, the number of motorcycle taxis in the 500–1000 m range is twice as high compared to that within the 500 m area. If motorcycle taxi users would accept a longer walking distance to station by 36 m or would be willing to walk to the station within 9.15 min, 54% of them may switch to walking to stations. Moreover, based on the estimation results of the logistic regression models, middle-adult aged residents, office employees, residents owning a car, and people living far from stations are less likely to walk. Average income households and commuters during non-peak hours tend to use motorcycle taxis more. On the other hand, residents living far from stations tend to use motorcycle taxis less, because most of the motorcycle taxi services are located near transit stations. Keywords: Transit accessibility, Pedestrian, Walkability

Effective Factors in Severity of Traffic Accident-Related Traumas; an Epidemiologic Study Based on the Haddon Matrix.

Science.gov (United States)

Masoumi, Kambiz; Forouzan, Arash; Barzegari, Hassan; Asgari Darian, Ali; Rahim, Fakher; Zohrevandi, Behzad; Nabi, Somayeh

2016-01-01

Traffic accidents are the 8(th) cause of mortality in different countries and are expected to rise to the 3(rd) rank by 2020. Based on the Haddon matrix numerous factors such as environment, host, and agent can affect the severity of traffic-related traumas. Therefore, the present study aimed to evaluate the effective factors in severity of these traumas based on Haddon matrix. In the present 1-month cross-sectional study, all the patients injured in traffic accidents, who were referred to the ED of Imam Khomeini and Golestan Hospitals, Ahvaz, Iran, during March 2013 were evaluated. Based on the Haddon matrix, effective factors in accident occurrence were defined in 3 groups of host, agent, and environment. Demographic data of the patients and data regarding Haddon risk factors were extracted and analyzed using SPSS version 20. 700 injured people with the mean age of 29.66 ± 12.64 years (3-82) were evaluated (92.4% male). Trauma mechanism was car-pedestrian in 308 (44%) of the cases and car-motorcycle in 175 (25%). 610 (87.1%) cases were traffic accidents and 371 (53%) occurred in the time between 2 pm and 8 pm. Violation of speed limit was the most common violation with 570 (81.4%) cases, followed by violation of right-of-way in 57 (8.1%) patients. 59.9% of the severe and critical injuries had occurred on road accidents, while 61.3% of the injuries caused by traffic accidents were mild to moderate (p accidents (p severity of traffic accident-related traumas were age over 50, not using safety tools, and undertaking among host-related factors; insufficient environment safety, road accidents and time between 2 pm and 8 pm among environmental factors; and finally, rollover, car-pedestrian, and motorcycle-pedestrian accidents among the agent factors.

Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report

OpenAIRE

Yilmaz, Ali; Kizilay, Zahir; Ozkul, Ayca; ?irak, Bayram

2016-01-01

BACKGROUND: The recurrent Heubner's artery is the distal part of the medial striate artery. Occlusion of the recurrent artery of Heubner, classically contralateral hemiparesis with fasciobrachiocrural predominance, is attributed to the occlusion of the recurrent artery of Heubner and is widely known as a stroke syndrome in adults. However, isolated occlusion of the deep perforating arteries following mild head trauma also occurs extremely rarely in childhood. CASE REPORT: Here we report t...

AT89S52 Microcontroller Based A Speed Restraint Equipment for Motorcycle

Directory of Open Access Journals (Sweden)

Ikhsan hidayat

2009-08-01

Full Text Available Security riding is very important in the aspects of traffic. One of the main factors of traffic accidents is high speed. Therefore, it is required a speed restraint equipment for pressing the number of accidents. The car speed restraint system is available in the market, but on a motorcycle is not available yet. This paper presents a design of speed restraint equipment for motorcycle that safe for users, and is expected to reduce traffic accident. The Main idea this speed restriction is cutting off the flow of electrical signals from the pulser (the time ignition trigger sensor to the CDI for 1 second. The cutting Signal with mechanical relays controlled by microcontroller AT89S52 using the on-off algorithm. Speed sensor use optocoupler is used to detect the number of rounds wheel motorcycle. If a result of measurement is more than the speed setpoint, microcontroler make a decission to cut motorcycle ignition signal. Results of this research is a prototype speed restraint shown that it able to process data from the measurement of the speed limit on the speed of a motorcycle. This prototype safe for all users and accordance with the set value and the level of success is above 90% for speed of 10 km/hr to 40 km/hr.

Effects of sulfur and aromatic contents in gasoline on motorcycle emissions

Science.gov (United States)

Yao, Yung-Chen; Tsai, Jiun-Horng; Chang, An-Lin; Jeng, Fu-Tien

By investigating the effect of sulfur and aromatic contents in gasoline on the criteria pollutant emissions [CO, total hydrocarbons (THCs), and NO x] and on air toxics in the exhaust from a non-catalyst four-stroke motorcycle engine, inferences can be made concerning the effect of fuel composition on motorcycle emissions. The fuels were blended with different contents of sulfur (40 and 150 ppmw) and aromatics (20 and 30 vol%). The data indicate that the sulfur content does not correlate with the emissions of the criteria pollutants from the catalyst free engine. Instead, lowering aromatic content in gasoline reduced the THC emission by over 30%, especially in the cruising test. The NO x emission, however, showed an inverse correlation with the aromatic content in gasoline. While a reduction of aromatic content in gasoline may decrease emissions of benzene and toluene, it will increase the emission of aldehyde. Since the percentage changes of emission factor of THC and air toxics in the motorcycle were larger than those in passenger cars, the benefit of emission reduction due to fuel composition changes in motorcycles may have significant impacts in health risk analysis.

Motorcycle emissions and fuel consumption in urban and rural driving conditions.

Science.gov (United States)

Chen, K S; Wang, W C; Chen, H M; Lin, C F; Hsu, H C; Kao, J H; Hu, M T

2003-08-01

This work reports sampling of motorcycle on-road driving cycles in actual urban and rural environments and the development of representative driving cycles using the principle of least total variance in individual regions. Based on the representative driving cycles in individual regions, emission factors for carbon monoxide (CO), hydrocarbons (HC), nitrogen oxides (NO(x)=NO+NO(2)) and carbon dioxide (CO(2)), as well as fuel consumption, were determined using a chassis dynamometer. The measurement results show that the representative driving cycles are almost identical in the three largest cities in Taiwan, but they differ significantly from the rural driving cycle. Irrespective of driving conditions, emission factors differ insignificantly between the urban and rural regions at a 95% confidence level. However, the fuel consumption in urban centers is approximately 30% higher than in the rural regions, with driving conditions in the former usually poor compared to the latter. Two-stroke motorcycles generally have considerably higher HC emissions and quite lower NO(x) emissions than those of four-stroke motorcycles. Comparisons with other studies suggest that factors such as road characteristics, traffic volume, vehicle type, driving conditions and driver behavior may affect motorcycle emission levels in real traffic situations.

Motorcycle emissions and fuel consumption in urban and rural driving conditions

International Nuclear Information System (INIS)

Chen, K.S.; Wang, W.C.; Chen, H.M.; Lin, C.F.; Hsu, H.C.; Kao, J.H.; Hu, M.T.

2003-01-01

This work reports sampling of motorcycle on-road driving cycles in actual urban and rural environments and the development of representative driving cycles using the principle of least total variance in individual regions. Based on the representative driving cycles in individual regions, emission factors for carbon monoxide (CO), hydrocarbons (HC), nitrogen oxides (NO x =NO+NO 2 ) and carbon dioxide (CO 2 ), as well as fuel consumption, were determined using a chassis dynamometer. The measurement results show that the representative driving cycles are almost identical in the three largest cities in Taiwan, but they differ significantly from the rural driving cycle. Irrespective of driving conditions, emission factors differ insignificantly between the urban and rural regions at a 95% confidence level. However, the fuel consumption in urban centers is approximately 30% higher than in the rural regions, with driving conditions in the former usually poor compared to the latter. Two-stroke motorcycles generally have considerably higher HC emissions and quite lower NO x emissions than those of four-stroke motorcycles. Comparisons with other studies suggest that factors such as road characteristics, traffic volume, vehicle type, driving conditions and driver behavior may affect motorcycle emission levels in real traffic situations

Analysis of effects of manhole covers on motorcycle driver maneuvers: a nonparametric classification tree approach.

Science.gov (United States)

Chang, Li-Yen

2014-01-01

A manhole cover is a removable plate forming the lid over the opening of a manhole to allow traffic to pass over the manhole and to prevent people from falling in. Because most manhole covers are placed in roadway traffic lanes, if these manhole covers are not appropriately installed or maintained, they can represent unexpected hazards on the road, especially for motorcycle drivers. The objective of this study is to identify the effects of manhole cover characteristics as well as driver factors and traffic and roadway conditions on motorcycle driver maneuvers. A video camera was used to record motorcycle drivers' maneuvers when they encountered an inappropriately installed or maintained manhole cover. Information on 3059 drivers' maneuver decisions was recorded. Classification and regression tree (CART) models were applied to explore factors that can significantly affect motorcycle driver maneuvers when passing a manhole cover. Nearly 50 percent of the motorcycle drivers decelerated or changed their driving path to reduce the effects of the manhole cover. The manhole cover characteristics including the level difference between manhole cover and pavement, the pavement condition over the manhole cover, and the size of the manhole cover can significantly affect motorcycle driver maneuvers. Other factors, including traffic conditions, lane width, motorcycle speed, and loading conditions, also have significant effects on motorcycle driver maneuvers. To reduce the effects and potential risks from the manhole covers, highway authorities not only need to make sure that any newly installed manhole covers are as level as possible but also need to regularly maintain all the manhole covers to ensure that they are in good condition. In the long run, the size of manhole covers should be kept as small as possible so that the impact of manhole covers on motorcycle drivers can be effectively reduced. Supplemental materials are available for this article. Go to the publisher

A comparison of the hazard perception ability of accident-involved and accident-free motorcycle riders.

Science.gov (United States)

Cheng, Andy S K; Ng, Terry C K; Lee, Hoe C

2011-07-01

Hazard perception is the ability to read the road and is closely related to involvement in traffic accidents. It consists of both cognitive and behavioral components. Within the cognitive component, visual attention is an important function of driving whereas driving behavior, which represents the behavioral component, can affect the hazard perception of the driver. Motorcycle riders are the most vulnerable types of road user. The primary purpose of this study was to deepen our understanding of the correlation of different subtypes of visual attention and driving violation behaviors and their effect on hazard perception between accident-free and accident-involved motorcycle riders. Sixty-three accident-free and 46 accident-involved motorcycle riders undertook four neuropsychological tests of attention (Digit Vigilance Test, Color Trails Test-1, Color Trails Test-2, and Symbol Digit Modalities Test), filled out the Chinese Motorcycle Rider Driving Violation (CMRDV) Questionnaire, and viewed a road-user-based hazard situation with an eye-tracking system to record the response latencies to potentially dangerous traffic situations. The results showed that both the divided and selective attention of accident-involved motorcycle riders were significantly inferior to those of accident-free motorcycle riders, and that accident-involved riders exhibited significantly higher driving violation behaviors and took longer to identify hazardous situations compared to their accident-free counterparts. However, the results of the regression analysis showed that aggressive driving violation CMRDV score significantly predicted hazard perception and accident involvement of motorcycle riders. Given that all participants were mature and experienced motorcycle riders, the most plausible explanation for the differences between them is their driving style (influenced by an undesirable driving attitude), rather than skill deficits per se. The present study points to the importance of

Susceptibility weighted imaging depicts retinal hemorrhages in abusive head trauma

Energy Technology Data Exchange (ETDEWEB)

Zuccoli, Giulio [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States); Panigrahy, Ashok; Haldipur, Anshul; Willaman, Dennis [Children' s Hospital of Pittsburgh of UPMC, Department of Pediatric Radiology, Pittsburgh, PA (United States); Squires, Janet; Wolford, Jennifer [Children' s Hospital of Pittsburgh of UPMC, Division of Child Advocacy, Pittsburgh, PA (United States); Sylvester, Christin; Mitchell, Ellen; Lope, Lee Ann [Children' s Hospital of Pittsburgh of UPMC, Eye Center, Pittsburgh, PA (United States); Nischal, Ken K. [Children' s Hospital of Pittsburgh of UPMC, Eye Center, Pittsburgh, PA (United States); Children' s Hospital of Pittsburgh of UPMC, Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, Eye Center, Pittsburgh, PA (United States); Berger, Rachel P. [Children' s Hospital of Pittsburgh of UPMC, Division of Child Advocacy, Pittsburgh, PA (United States); University of Pittsburgh Medical Center, Safar Center for Resuscitation Research, Pittsburgh, PA (United States)

2013-07-15

This study aims to evaluate the capability of magnetic resonance imaging (MRI) susceptibility weighted images (SWI) in depicting retinal hemorrhages (RH) in abusive head trauma (AHT) compared to the gold standard dilated fundus exam (DFE). This is a retrospective, single institution, observational study on 28 patients with suspected AHT, who had a DFE and also underwent brain MRI-SWI as part of routine diagnostic protocol. Main outcome measures involved evaluation of patients to determine whether the RH could be identified on standard and high-resolution SWI sequences. Of the 21 subjects with RH on DFE, 13 (62 %) were identified by using a standard SWI sequence performed as part of brain MRI protocols. Of the 15 patients who also underwent an orbits SWI protocol, 12 (80 %) were positive for RH. None of the seven patients without RH on of DFE had RH on either standard or high-resolution SWI. Compared with DFE, the MRI standard protocol showed a sensitivity of 75 % which increased to 83 % for the orbits SWI protocol. Our study suggests the usefulness of a tailored high-resolution orbits protocol to detect RH in AHT. (orig.)

Susceptibility weighted imaging depicts retinal hemorrhages in abusive head trauma

International Nuclear Information System (INIS)

Zuccoli, Giulio; Panigrahy, Ashok; Haldipur, Anshul; Willaman, Dennis; Squires, Janet; Wolford, Jennifer; Sylvester, Christin; Mitchell, Ellen; Lope, Lee Ann; Nischal, Ken K.; Berger, Rachel P.

2013-01-01

This study aims to evaluate the capability of magnetic resonance imaging (MRI) susceptibility weighted images (SWI) in depicting retinal hemorrhages (RH) in abusive head trauma (AHT) compared to the gold standard dilated fundus exam (DFE). This is a retrospective, single institution, observational study on 28 patients with suspected AHT, who had a DFE and also underwent brain MRI-SWI as part of routine diagnostic protocol. Main outcome measures involved evaluation of patients to determine whether the RH could be identified on standard and high-resolution SWI sequences. Of the 21 subjects with RH on DFE, 13 (62 %) were identified by using a standard SWI sequence performed as part of brain MRI protocols. Of the 15 patients who also underwent an orbits SWI protocol, 12 (80 %) were positive for RH. None of the seven patients without RH on of DFE had RH on either standard or high-resolution SWI. Compared with DFE, the MRI standard protocol showed a sensitivity of 75 % which increased to 83 % for the orbits SWI protocol. Our study suggests the usefulness of a tailored high-resolution orbits protocol to detect RH in AHT. (orig.)

Thermal analysis on motorcycle disc brake geometry

Science.gov (United States)

W. M. Zurin W., S.; Talib, R. J.; Ismail, N. I.

2017-08-01

Braking is a phase of slowing and stop the movement of motorcycle. During braking, the frictional heat was generated and the energy was ideally should be faster dissipated to surrounding to prevent the built up of the excessive temperature which may lead to brake fluid vaporization, thermoelastic deformation at the contact surface, material degradation and failure. In this paper, solid and ventilated type of motorcycle disc brake are being analyse using Computational Fluid Dynamic (CFD) software. The main focus of the analysis is the thermal behaviour during braking for solid and ventilated disc brake. A comparison between both geometries is being discussed to determine the better braking performance in term of temperature distribution. It is found that ventilated disc brake is having better braking performance in terms of heat transfer compare to solid disc.

Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals.

Science.gov (United States)

Cowley, Laura E; Maguire, Sabine; Farewell, Daniel M; Quinn-Scoggins, Harriet D; Flynn, Matthew O; Kemp, Alison M

2018-05-09

The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We explored participants' evaluations of PredAHT, their opinions about the optimal way to present the calculated probabilities, and their interpretation of probabilities in the context of suspected AHT. Clinicians, child protection social workers and police thought PredAHT would be beneficial as an objective adjunct to their professional judgment, to give them greater confidence in their decisions. Lawyers and pathologists appreciated its value for prompting multidisciplinary investigations, but were uncertain of its usefulness in court. Perceived disadvantages included: possible over-reliance and false reassurance from a low score. Interpretations regarding which percentages equate to 'low', 'medium' or 'high' likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals' confidence in their decision-making when investigating suspected AHT, but may be of less value in court. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of innovative motorcycle headlight configurations: effect on car drivers’ perception of motorcyles’ motion

OpenAIRE

CAVALLO, Viola; RANCHET, Maud; PINTO, Maria; ESPIE, Stéphane; VIENNE, Fabrice; DANG, Nguyen-Thong

2014-01-01

L'expérimentation présentée étudie l'effet de 4 configurations de feux avant de moto sur l'acceptation de créneaux temporels par des automobilistes lorsqu'ils tournent à gauche face à des motocycles. The most frequent cause of motorcycle accidents involves another vehicle violating the motorcycle's right-of-way at an intersection. In addition to detection errors, the misperception of the approaching motorcycle's speed and time-to-arrival is another driver error that may account for these a...

Estimating the Influence of Accident Related Factors on Motorcycle Fatal Accidents using Logistic Regression (Case Study: Denpasar-Bali

Directory of Open Access Journals (Sweden)

Wedagama D.M.P.

2010-01-01

Full Text Available In Denpasar the capital of Bali Province, motorcycle accident contributes to about 80% of total road accidents. Out of those motorcycle accidents, 32% are fatal accidents. This study investigates the influence of accident related factors on motorcycle fatal accidents in the city of Denpasar during period 2006-2008 using a logistic regression model. The study found that the fatality of collision with pedestrians and right angle accidents were respectively about 0.44 and 0.40 times lower than collision with other vehicles and accidents due to other factors. In contrast, the odds that a motorcycle accident will be fatal due to collision with heavy and light vehicles were 1.67 times more likely than with other motorcycles. Collision with pedestrians, right angle accidents, and heavy and light vehicles were respectively accounted for 31%, 29%, and 63% of motorcycle fatal accidents.

Literature survey of motorcycle accidents with respect to the influence of engine size

NARCIS (Netherlands)

Honk, J. van; Klootwijk, C.W.; Ruijs, P.A.J.

1997-01-01

For completion of the type approval of two- or three-wheeled motor vehicles, and in particular of Directive 95/1/EC of the European Community, the Directorate General III (Industry) commissioned a study to examine wether there is a relation between motorcycle accident occurence and motorcycle engine

Effects of alcohol on motorcycle riding skills

Science.gov (United States)

2007-12-01

Alcohol is known to disrupt the effect of neurotransmitters and impair various psychomotor skills. Indeed, alcohol intoxication is a significant risk factor for fatal traffic crashes, especially when riding a motorcycle. At present, there is sparse r...

A study on the stability of a motorcycle wheel-swingarm suspension with chain transmission

Science.gov (United States)

Sorrentino, S.; Leonelli, L.

2017-11-01

The present study describes a possible driving mechanism for a self-excited oscillation observed in motorcycle dynamics, often referred to as chatter. This phenomenon, affecting the performance of road racing motorcycles, has been simulated in straight running braking manoeuvres with multibody motorcycle models. It involves rear suspension bounce and driveline oscillation in the frequency range between 17 and 22 Hz. A simplified model of a motorcycle rear suspension with chain transmission is proposed and its stability in equilibrium configurations is studied via eigenvalue analysis. The sensitivity with respect to all its governing parameters is analysed by means of stability maps and the self-excitation mechanism is explained with the aid of energy balance analysis and phase diagrams. It is found that the key role for the instability onset is played by the gradient of the nonlinear characteristic slip function of the tyre.

A multibody motorcycle model with rigid-ring tyres: formulation and validation

Science.gov (United States)

Leonelli, Luca; Mancinelli, Nicolò

2015-06-01

The aim of this paper is the development and validation of a three-dimensional multibody motorcycle model including a rigid-ring tyre model, taking into account both the slopes and elevation of the road surface. In order to achieve accurate assessment of ride and handling performances of a road racing motorcycle, a tyre model capable of reproducing the dynamic response to actual road excitation is required. While a number of vehicle models with such feature are available for car application, the extension to the motorcycle modelling has not been addressed yet. To do so, a novel parametrisation for the general motorcycle kinematics is proposed, using a mixed reference point and relative coordinates approach. The resulting description, developed in terms of dependent coordinates, makes it possible to include the rigid-ring kinematics as well as road elevation and slopes, without affecting computational efficiency. The equations of motion for the whole multibody system are derived symbolically and the constraint equations arising from the dependent coordinate formulation are handled using the position and velocity vector projection technique. The resulting system of equations is integrated in time domain using a standard ordinary differential equation (ODE) algorithm. Finally, the model is validated with respect to experimentally measured data in both time and frequency domains.

FACTORS RELATED TO MOTORCYCLE ACCIDENT RISK BEHAVIOR AMONG UNIVERSITY STUDENTS IN NORTHEASTERN THAILAND.

Science.gov (United States)

Chumpawadee, Urai; Homchampa, Pissamai; Thongkrajai, Pramote; Suwanimitr, Amorn; Chadbunchachai, Witaya

2015-07-01

Young motorcycle drivers in Thailand are at high risk for road traffic accidents. We conducted this study to identify factors associated with motorcycle accident risk behavior (MARB). We studied 372 randomly selected university students aged 18-22 years (mean 20.2 years; women comprised 68.0% of our participants), who attend a government university in northeastern Thailand. Each student was asked to fill out a questionnaire asking about MARB and factors associated with this behavior. The respondents had an average of 6.2 years (SD+3.09) motorcycle driving experience, 72.3% had a motorcycle driver's license and 83.0% had accident insurance. The prevalence of self-reported motorcycle accident injuries was 42.7%. Their major MARB were using a telephone while driving (69.3%), speeding (45.4%), driving with more than one passenger (40.1%), drunk driving (22.1%), and not wearing a helmet (23.3%). Factors related to MARB were: gender, with men engaged in risky behavior more often than women (p motorcycle driving--drivers with > 5 years experience were more likely to engage in risky behavior (p < 0.05); and knowledge of safe driving, those with a greater knowledge of safe driving were more likely to drive safely (p < 0.001). Having a greater awareness of MARB was associated with lower risk of engaging in risky behavior (p < 0.001). Students who engaged in risky behavior were more likely to view it as normal behavior (p < 0.001) and less likely to have adequate self-control (p < 0.001). Our findings indicate a need to strengthen accident prevention programs for university students in northeastern Thailand.

One Stage Emergency Pancreatoduodenectomy  for Isolated Injury to Pancreatic Head Following Blunt Abdominal Trauma: Case Report and Review of Literature.

Science.gov (United States)

Ghosh, Sumanta Kumar

2013-07-01

Major pancreatic injury following blunt abdominal trauma by itself is a relatively rare occurrence, and in vast majority of cases (95%) it is associated with injury to adjacent major vessels and organs; thus making isolated major pancreatic injury even rarer. While most pancreatic injuries are managed by simple measures like debridement and drainage, complex proximal injury poses surgical challenge regarding surgical skill and judgement. Disproportionate approach at any stage of management can contribute  to high mortality and morbidity. Emergency pancreatoduodenectomy plays a limited but important role in managing serious trauma to proximal pancreas and duodenum. Author presents a case where isolated injury to head of pancreas required emergency pancreatoduodenectomy. After a bizarre road accident, a middle aged male underwent emergency laparotomy for intraperitoneal bleeding and during exploration a deep transverse laceration with ampullary disruption was found in the head of the organ. Duodenum in all its part was intact and there was no other injury. The nature and site of injury made emergency pancreatoduodenectomy the only viable option. Leaking pancreatojejunostomy enhances infective complications that lead to late mortality. To circumvent this problem there is enthusiasm for staged surgery with resection and tube pancreatostomy in first stage, leaving the difficult anastomosis for a later date, However, if the patient is haemodynamically stable and operated reasonably early, one stage pancreatoduodenectomy gives good result and avoids repeating surgery with inherent problems and reduces hospital stay. For successful management of pancreatic trauma it is essential to make early diagnosis of duct disruption, with sound application of operative skill and judgement by treating surgeon.

Dating the abusive head trauma episode and perpetrator statements: key points for imaging

International Nuclear Information System (INIS)

Adamsbaum, Catherine; Morel, Baptiste; Ducot, Beatrice; Antoni, Guillemette; Rey-Salmon, Caroline

2014-01-01

Shaken baby syndrome/abusive head trauma is a leading cause of morbidity and mortality in infants. The presence of a diffuse subdural hematoma without evidence of accident is a key diagnostic clue. The hematoma is typically attributed to rupture of the cerebral bridging veins due to violent shaking, with or without impact. Dating the incident, however, remains controversial. The aim of this article is to review the most reliable features used for dating the incident, based on both legal statements by perpetrators and medical documentation. The key points are: 1) The high (yet likely underestimated) frequency of repeated shaking is around 50%, 2) Children do not behave normally immediately after shaking, and the time of onset of even mild symptoms appears to be the best clue for dating the incident and 3) Brain imaging provides strong indicators of ''age-different'' injuries but the ranges for dating the causal event are wide. The density pattern in a single subdural hematoma location provides no reliable clues for assessing repeated violence. Only the finding of different density in two distant subdural hematomas argues in favor of ''age-different'' injuries, i.e. repeated violence. MRI is difficult to interpret in terms of dating subdural hemorrhages and must be analyzed in conjunction with CT. Most importantly, all of the child's previous clinical and radiological data must be carefully studied and correlated to provide accurate information on the date and repetition of the trauma. (orig.)

Influence of front light configuration on the visual conspicuity of motorcycles

OpenAIRE

PINTO, Maria; CAVALLO, Viola; SAINT PIERRE, Guillaume

2014-01-01

A recent study (Cavallo and Pinto, 2012) showed that daytime running lights (DRLs) on cars create “visual noise” that interferes with the lighting of motorcycles and affects their visual conspicuity. In the present experiment, we tested three conspicuity enhancements designed to improve motorcycle detectability in a car-DRL environment: a triangle configuration (a central headlight plus two lights located on the rear view mirrors), a helmet configuration (a light located on the mo...

Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors

Directory of Open Access Journals (Sweden)

Hao Chen

2012-01-01

Full Text Available Progressive epidural hematoma (PEDH after head injury is often observed on serial computerized tomography (CT scans. Recent advances in imaging modalities and treatment might affect its incidence and outcome. In this study, PEDH was observed in 9.2% of 412 head trauma patients in whom two CT scans were obtained within 24 hours of injury, and in a majority of cases, it developed within 3 days after injury. In multivariate logistic regression, patient gender, age, Glasgow Coma Scale (GCS score at admission, and skull fracture were not associated with PEDH, whereas hypotension (odds ratio (OR 0.38, 95% confidence interval (CI 0.17–0.84, time interval of the first CT scanning (OR 0.42, 95% CI 0.19–0.83, coagulopathy (OR 0.36, 95% CI 0.15–0.85, or decompressive craniectomy (DC (OR 0.46, 95% CI 0.21–0.97 was independently associated with an increased risk of PEDH. The 3-month postinjury outcome was similar in patients with PEDH and patients without PEDH (χ2=0.07, P=0.86. In conclusion, epidural hematoma has a greater tendency to progress early after injury, often in dramatic and rapid fashion. Recognition of this important treatable cause of secondary brain injury and the associated risk factors may help identify the group at risk and tailor management of patients with TBI.

Motorcycles Health and Traffic Safety: Evidence from Commercial Motorcyclists in Gombe State, Nigeria

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Nasiru Inuwa

2017-04-01

Full Text Available Although commercial motorcyclists are gaining acceptance by all and sundry as a means of public transport which are adapted to the contemporary Nigerian society. However, expose to all hazards including accidents are further worsened by the lack of proper knowledge on road safety measures of the commercial motorcycle riders. Therefore, this study evaluates the effects of a commercial motorcycle on health and traffic safety in Gombe metropolis, Gombe State, Nigeria. The study was carried out in Gombe Metropolis with using the random sampling technique to select 500 motorcyclists sample size. The data generated were analyzed using simple percentages. The study finds that most of the motorcycles accidents were caused by reckless riding, drug abuse and disregard to traffic rules. Similarly, the study finds that Tricycles are the most important factor causing motorcycle accidents in Gombe metropolis. Furthermore, the study finds that most of the respondents suffer from at least one health challenge as a result of their continuous use of the motorcycle. The study therefore recommends that government and other relevant agencies should be equipped with materials and human resources to embark on regular and massive breath testing of motorcyclists to detect riders who ride under the influence of drugs. This can be achieved through identifying the Drunken riders and make them face the wrath of the law.

Influence of dimension box differences and time differences during operations of red box for motorcycles at signalized intersection

Science.gov (United States)

Mulyadi, Agah Muhammad

2017-11-01

Performance of signalized intersection has declined due to a large number of motorcycles. The number of motorcycles reached 98.2 million units and the composition of motorcycles has reached around 81.7% of the total composition of vehicles in Indonesia (AISI, 2017). To solve that problem, the red box for motorcycles are provided at the signalized intersection. Red box for the motorcycle at signalized intersections was developed from the concept of Advance Stop Line (ASL) for bicycles. The Red Box was developed to split the queue between motorcycles and other vehicles when waiting at red light. This paper aims to evaluate the influence of the red box dimension and red time operation differences. The survey was conducted as many as 30 cycles of traffic signals per day. The data were analyzed using software IBM SPSS Statistics 20 by using Analysis of Variance (ANOVA) to obtain p-value (significant). The analysis shows that there are insignificant influences between the occupancy rates to the dimension of Red Box. Furthermore, that there is a significant difference that shows the dependency of only motorcycles in the Red Box Area towards red time operation.

Technical feasibility for commercialization of lithium ion battery as a substitute dry battery for motorcycle

Science.gov (United States)

Kurniyati, Indah; Sutopo, Wahyudi; Zakaria, Roni; Kadir, Evizal Abdul

2017-11-01

Dry battery on a motorcycle has a rapid rate of voltage drop, life time is not too long, and a long charging time. These are problems for users of dry battery for motorcycle. When the rate in the voltage decreases, the energy storage in the battery is reduced, then at the age of one to two years of battery will be dead and cannot be used, it makes the user should replace the battery. New technology development of a motorcycle battery is lithium ion battery. Lithium ion battery has a specification that has been tested and possible to replace dry battery. Characteristics of lithium ion battery can answer the question on the dry battery service life, the rate of decrease in voltage and charging time. This paper discusses about the technical feasibility for commercialization of lithium ion battery for motorcycle battery. Our proposed methodology of technical feasibility by using a goldsmith commercialization model of the technical feasibility and reconfirm the technical standard using the national standard of motorcycle battery. The battery has been through all the stages of the technical feasibility of the goldsmith model. Based on the results of the study, lithium ion batteries have the minimum technical requirements to be commercialized and has been confirmed in accordance with the standard motorcycle battery. This paper results that the lithium ion battery is visible to commercialized by the technical aspect.

Computational analysis on plug-in hybrid electric motorcycle chassis

Science.gov (United States)

Teoh, S. J.; Bakar, R. A.; Gan, L. M.

2013-12-01

Plug-in hybrid electric motorcycle (PHEM) is an alternative to promote sustainability lower emissions. However, the PHEM overall system packaging is constrained by limited space in a motorcycle chassis. In this paper, a chassis applying the concept of a Chopper is analysed to apply in PHEM. The chassis 3dimensional (3D) modelling is built with CAD software. The PHEM power-train components and drive-train mechanisms are intergraded into the 3D modelling to ensure the chassis provides sufficient space. Besides that, a human dummy model is built into the 3D modelling to ensure the rider?s ergonomics and comfort. The chassis 3D model then undergoes stress-strain simulation. The simulation predicts the stress distribution, displacement and factor of safety (FOS). The data are used to identify the critical point, thus suggesting the chassis design is applicable or need to redesign/ modify to meet the require strength. Critical points mean highest stress which might cause the chassis to fail. This point occurs at the joints at triple tree and bracket rear absorber for a motorcycle chassis. As a conclusion, computational analysis predicts the stress distribution and guideline to develop a safe prototype chassis.

How does extracerebral trauma affect the clinical value of S100B measurements?

DEFF Research Database (Denmark)

Ohrt-Nissen, Søren; Friis-Hansen, Lennart; Dahl, Benny

2011-01-01

with head injury (MTHI), or no head injury (NHI). The primary aim was to assess if a significant difference in serum levels of S100B could be found between IHI and MTHI patients. Methods Patients (233) were primarily admitted to the trauma centre. Serum samples were drawn on admission and 6 h after...... trauma and then stored at -80°C until analysed. Variables included Abbreviated Injury Scale (AIS) for head trauma, Injury Severity Score (ISS) and 30-day survival. Results Two patients could not be classified. IHI occurred in 28, MTHI in 102 and NHI was found in 101. The median S100B concentrations...

An unusual case of cerebral penetrating injury by a driven bone fragment secondary to blunt head trauma.

Science.gov (United States)

Lee, Jae Il; Ko, Jun Kyeung; Cha, Seung Heon; Han, In Ho

2011-12-01

Temple trauma that appears initially localized to the skin might possess intracranial complications. Early diagnosis and management of such complications are important, to avoid neurologic sequelae. Non-penetrating head injuries with intracranial hemorrhage caused by a driven bone fragment are extremely rare. A 53-year-old male was referred to our hospital because of intracerebral hemorrhage. He was a mechanic and one day before admission to a local clinic, tip of metallic rod hit his right temple while cutting the rod. Initial brain computed tomography (CT) and magnetic resonance imaging demonstrated scanty subdural hematoma at right temporal lobe and left falx and intracerebral hematoma at both frontal lobes. Facial CT with 3-D reconstruction images showed a small bony defect at the right sphenoid bone's greater wing and a small bone fragment at the left frontal lobe, crossing the falx. We present the unusual case of a temple trauma patient in whom a sphenoid bone fragment migrated from its origin upward, to the contralateral frontal lobe, producing hematoma along its trajectory.

Mild head injury and attention deficit hyperactivity disorder in children.

Science.gov (United States)

Chasle, Veronique; Riffaud, Laurent; Longuet, Romain; Martineau-Curt, Marie; Collet, Yann; Le Fournier, Luc; Pladys, Patrick

2016-12-01

Post-concussion syndrome is a well-described complication following moderate and severe head trauma but whether it occurs after mild head injury in children remains unclear. The aim of this study was to evaluate whether exposure to mild head injury with potential additional risk factors (non-surgical lesion on computed tomographic, high kinetic trauma, or Glasgow Coma Scale <15) is associated with attention deficit hyperactivity disorder (ADHD) after the head trauma. This study was performed in an emergency department on children admitted between 2009 and 2013. It compared victims of mild head injury aged 6-16 years with matched children presenting isolated non-surgical forearm fracture (ratio1/2). ADHD was assessed using Conners' Global Index-Parent short version 3-40 months after the trauma. The patients were compared using chi-square test or Fisher's exact test, t test or u-test as appropriate with a p value set at 0.05. During the study period, 676 patients were admitted for mild head injury. Among them, 34 (5 %) fulfilled the inclusion criteria and were compared with 64 matched patients admitted for a forearm fracture. The groups were comparable. ADHD was observed in both groups (18 % in the mild head injury group, 11 % in the control group) with no significant differences between groups. The prevalence was high when compared to an expected frequency of 3.5-5.6 % in children aged 6-12 years in the general population. These results suggest that pre-existing ADHD may have contributed to injury proneness in both groups and does not argue for a specific risk of ADHD induced by mild head injury. The diagnosis of ADHD should be evoked at admission of children aged 6-16 years presenting with a trauma.

Instructor Revs Up Ailing Motorcycle Program

Science.gov (United States)

Stevenson, Roy

2011-01-01

Bob Monroig smiles every day on his way to work at Lake Washington Technical College (LWTC), high atop a hill overlooking the affluent Seattle suburb of Kirkland, Washington. He's created his own job within a job, where he's the Harley-Davidson University program coordinator and tenured faculty in the Motorcycle, Marine, & Power Equipment…

Predictors of abdominal injuries in blunt trauma.

Science.gov (United States)

Farrath, Samiris; Parreira, José Gustavo; Perlingeiro, Jacqueline A G; Solda, Silvia C; Assef, José Cesar

2012-01-01

To identify predictors of abdominal injuries in victims of blunt trauma. retrospective analysis of trauma protocols (collected prospectively) of adult victims of blunt trauma in a period of 15 months. Variables were compared between patients with abdominal injuries (AIS>0) detected by computed tomography or/and laparotomy (group I) and others (AIS=0, group II). Student's t, Fisher and qui-square tests were used for statistical analysis, considering p3) in head (18.5% vs. 7.9%), thorax (29.2% vs. 2.4%) and extremities (40.0% vs. 13.7%). The highest odds ratios for the diagnosis of abdominal injuries were associated flail chest (21.8) and pelvic fractures (21.0). Abdominal injuries were more frequently observed in patients with hemodynamic instability, changes in Glasgow coma scale and severe lesions to the head, chest and extremities.

[Deaths due to motorcycle accidents and their association with variables related to social reproduction in a northeastern Brazilian state].

Science.gov (United States)

Silva, Paul Hindenburg Nobre de Vasconcelos; Lima, Maria Luiza Carvalho; Souza, Wayner Vieira; Moreira, Rafael da Silveira; Oliveira, Fernando José Moreira

2015-09-01

The objective of this article was to identify the association between motorcycle deaths and variables related to Samaja's theory of social reproduction in the period 2000-2005 in the state of Pernambuco. An ecological, case-control study was carried out, with municipalities as the unit of analysis. Cases were defined as the 20% of municipalities with the highest local empirical Bayesian coefficients for mortality due to motorcycle accidents, and controls as the 40% with the lowest coefficients. The municipalities with the greatest chances of high coefficients for mortality due to motorcycle accidents showed high population growth factors and increases in the total fleet of motorcycles, with low population densities, low GDP per capita, and more than 20 motorcycles per thousand inhabitants. We conclude that the variables related to macro-policies proved to have greater force in explaining higher chances of motorcycle death.

Comparison of PCT, CRP, D-Dimer, Lactate, TNF-α, IL-1β, IL-6 and lL-10 in Development of Systemic Inflammatory Response Syndrome and Sepsis on Patients with Isolated Head Trauma and Polytrauma

Directory of Open Access Journals (Sweden)

Emine Dağlı

2012-12-01

Full Text Available Objective: In this study, it was aimed to compare the relationship between Glasgow Coma Scale (GKS, ISS values, PCT, CRP, D-Dimer, laktat, TNF-α, IL-1β, IL-6, IL-10 in patients with polytrauma and isolated head trauma in conjunction with SIRS and sepsis. Material and Method: Total of 68 patients (32 polytrauma, 36 isolated head trauma aged between 18-65 years were enrolled in the study. For 7 days of follow up, the biochemical parameters were analysed on the days 0, 1, 3, 5, 7 and the ISS, GCS score and growth rates of SIRS and sepsis were recorded. Results: It was demonstrated that for patients with isolated head trauma, SIRS (80.6%, sepsis (38.9% and mortality values (71.4% were higher and there is a statistically important linear and inverse relationship between ISS and GCS values (p<0.05. During sepsis and SIRS phases, CRP elevated in both groups, whereas PCT only in the polytrauma group. D-Dimer values were investigated high in both groups, but atypically decreased on day 3 in isolated head trauma group. Lactate, TNF-α and, IL-1β were within reference values, IL-6 and IL-10 values were elevated in both groups but were higher in the polytrauma group. Conclusion: Although multiple variations were detected in serum markers of pro-inflamatory and acute phase proteins, we thought that these are inadequate in predicting mortality and complications such as SIRS and sepsis.

Human Performance in Motorcycle Road Racing: A Review of the Literature.

Science.gov (United States)

D'Artibale, Emanuele; Laursen, Paul B; Cronin, John B

2018-03-13

Performance in motorcycle road racing is typically considered as the summation of interactions between rider, motorcycle, tires, and environment. Despite the substantial investments made towards the development of motorcycle technology and the business interests of manufacturers, published research focusing on the riders is relatively sparse, and a bike-centered mentality tends to dominate the sport. This manuscript reviews the known human performance aspects of motorcycle road racing and suggests directions for future research. In this sport, riders are exposed to a complex interaction of physiological, mechanical, and psychological stresses, alongside the ever-present potential for injury from crashes or localized muscular overload (i.e., chronic exertional forearm compartmental syndrome). The reviewed literature shows that riders involved in competitive road racing should develop proper levels of body composition, cardiovascular fitness, muscular strength, specific flexibility, and heat tolerance in addition to their all-important technical riding skills. Furthermore, specific resistance to inertial stresses, visual acuity, mental and physical resilience, psychological strategies, and behavioral awareness all appear to be meaningful contributors to successful performance. Further work is needed to profile riders according to their level to create evidence-based methodologies that improve performance. Additionally, future research should aim to improve safety for these athletes and deepen the understanding about the magnitude of metabolic, mental, technical, biomechanical, and muscular demands in relation to anthropometric characteristics, sex, categories of competition, and success rate.

Nutrition management of a trauma patient with pneumatosis ...

African Journals Online (AJOL)

Roberts K, BScDiet, Postgrad Dip Diet. Dietitian ... Keywords: developed pneumatosis intestinalis, trauma patient ... presented with blunt abdominal and chest trauma, a head injury and ... and the goal rate of 93 ml/hour was reached, providing 18% protein, .... result from the side-effects of medication, most commonly from.

[Association between psychosocial aspects of work and quality of life among motorcycle taxi drivers].

Science.gov (United States)

Teixeira, Jules Ramon Brito; Boery, Eduardo Nagib; Casotti, Cezar Augusto; Araújo, Tânia Maria de; Pereira, Rafael; Ribeiro, Ícaro José Santos; Rios, Marcela Andrade; Amorim, Camila Rego; Moreira, Ramon Missias; Boery, Rita Narriman Silva de Oliveira; Sales, Zenilda Nogueira

2015-01-01

This study aimed to evaluate the quality of life of motorcycle taxi drivers and the association with psychosocial characteristics of their work. This was a cross-sectional epidemiological study with a sample of 400 motorcycle taxi drivers in Jequié, Bahia State, Brazil. The study used a form containing demographic and socioeconomic data, WHO Quality of Life-Bref Questionnaire (WHOQOL-Bref), and the Job Content Questionnaire (JCQ). Motorcycle taxi drivers with greater decision-making control over their work showed better self-rated quality of life in the psychological domain; those with high psychological demands presented better self-rated quality of life in the social relations and environmental domains; those with high strain and active work showed better self-rated quality of life in the social and environmental domains. The psychosocial work environment and especially decision-making autonomy were thus important determinants of self-rated quality of life in this group of motorcycle taxi drivers.

Considering the effects of ambient particulate matter on the lung function of motorcycle taxi drivers in Bangkok, Thailand.

Science.gov (United States)

Arphorn, Sara; Ishimaru, Tomohiro; Hara, Kunio; Mahasandana, Suwisa

2018-02-01

The motorcycle taxi drivers of Bangkok have been heavily exposed to high concentrations of PM 10 (particulate matter with an aerodynamic diameter ≤10 μm), and the impact of this on their lungs has been neither documented nor studied. This study examines the association between exposure to PM 10 and lung function decline among motorcycle taxi drivers. A cross-sectional study was conducted in Bangkok between two groups: a subject group of motorcycle taxi drivers and control group of enclosed vehicle taxi drivers. The findings of the Thailand Pollution Control Department were used to estimate the annual ambient PM 10 concentration levels in the metropolis. Pulmonary functions of motorcycle taxi drivers and enclosed vehicle taxi drivers were measured and compared using the Mann-Whitney test. Multiple linear regression analysis was applied to estimate the effects of PM 10 exposure on the lung function of motorcycle taxi drivers. A total of 1283 motorcycle taxi drivers and 600 taxi drivers were investigated. The mean forced expiratory volume in 1 sec/forced vital capacity (FEV 1 /FVC) of the motorcycle taxi drivers was significantly lower than that of the taxi drivers (P Organization (WHO) vehicular emission standards should be recognized and eventually enforced.

Personality change following head injury: assessment with the NEO Five-Factor Inventory.

Science.gov (United States)

Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

1997-11-01

We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

Head injury: audit of a clinical guideline to justify head CT

International Nuclear Information System (INIS)

Haydon, Nicholas B.

2013-01-01

Head injury causes significant morbidity and mortality, and there is contention about which patients to scan. The UK National Health Service Clinical Guideline (CG) 56 provides criteria for selecting patients with clinically important brain injury who may benefit from a head CT scan, while minimising the radiation and economic burden of scanning patients without significant injury. This study aims to audit the documentation of the use of these guidelines in a busy UK trauma hospital and discusses the comparison with an Australian (New South Wales (NSW) ) head injury guideline. A retrospective cohort study of 480 patients presenting with head injury to the emergency department over 2 months was performed. The patient notes were assessed for documentation of each aspect of the clinical guidelines. Criteria were established to assess the utilisation of the CG 56. A database of clinical data was amalgamated with the head CT scan results for each patient. For the UK CG 56, 73% of the criteria were documented, with the least documented being 'signs of basal skull fracture' and 'amnesia of events'. Thirty-two per cent of patients received head CT and of these, 24% (37 patients) were reported to have pathology. Twenty-four patients underwent head CT without clinical justification being documented, none of which had reported pathology on CT. The study shows that the head injury guidelines are not being fully utilised at a major UK trauma hospital, resulting in 5% of patients being exposed to ionising radiation without apparent documented clinical justification. The NSW guideline has distinct differences to the CG 56, with a more complex algorithm and an absence of specific time frames for head CT completion. The results suggest a need for further education and awareness of head injury clinical guidelines.

Recovery of injured Broca's portion of arcuate fasciculus in the dominant hemisphere in a patient with traumatic brain injury

OpenAIRE

Jang, Sung Ho; Ha, Ji Wan; Kim, Hyun Young; Seo, You Sung

2017-01-01

Abstract Rationale: Recovery of injured AF in patients with traumatic brain injury (TBI) has not been reported. In this study, we report on a patient with TBI who recovered from an injury to Broca's portion of AF in the dominant hemisphere, diagnosed by diffusion tensor tractography (DTT). Patient concerns: A 28-year-old right-handed male patient suffered head trauma resulting from sliding while riding a motorcycle. Diagnoses: He was diagnosed with a traumatic contusional hemorrhage in the le...

Dating the abusive head trauma episode and perpetrator statements: key points for imaging

Energy Technology Data Exchange (ETDEWEB)

Adamsbaum, Catherine; Morel, Baptiste [AP-HP, CHU Bicetre, Service d' Imagerie Pediatrique, Paris (France); Ducot, Beatrice [Universite Paris Sud, Faculte de Medecine, Le Kremlin Bicetre (France); INSERM CESP U 1018, Paris (France); Antoni, Guillemette [Universite Paris Sud, Faculte de Medecine, Le Kremlin Bicetre (France); Rey-Salmon, Caroline [AP-HP, CHU Hotel Dieu, Unite Medico-Judiciaire, Paris (France)

2014-12-15

Shaken baby syndrome/abusive head trauma is a leading cause of morbidity and mortality in infants. The presence of a diffuse subdural hematoma without evidence of accident is a key diagnostic clue. The hematoma is typically attributed to rupture of the cerebral bridging veins due to violent shaking, with or without impact. Dating the incident, however, remains controversial. The aim of this article is to review the most reliable features used for dating the incident, based on both legal statements by perpetrators and medical documentation. The key points are: 1) The high (yet likely underestimated) frequency of repeated shaking is around 50%, 2) Children do not behave normally immediately after shaking, and the time of onset of even mild symptoms appears to be the best clue for dating the incident and 3) Brain imaging provides strong indicators of ''age-different'' injuries but the ranges for dating the causal event are wide. The density pattern in a single subdural hematoma location provides no reliable clues for assessing repeated violence. Only the finding of different density in two distant subdural hematomas argues in favor of ''age-different'' injuries, i.e. repeated violence. MRI is difficult to interpret in terms of dating subdural hemorrhages and must be analyzed in conjunction with CT. Most importantly, all of the child's previous clinical and radiological data must be carefully studied and correlated to provide accurate information on the date and repetition of the trauma. (orig.)

Texas strategic action plan for motorcycles : 2013-2018.

Science.gov (United States)

2013-06-01

The Texas Strategic Action Plan for Motorcycles: 2013-2018 provides an integrated : approach to identify implementable strategies and action steps to make the : road environment and infrastructure safer for motorcyclists and other powered : two- and ...

Determinants of helmet use behaviour among employed motorcycle riders in Yazd, Iran based on theory of planned behaviour.

Science.gov (United States)

Ali, Mehri; Saeed, Mazloomy Mahmoodabad Seyed; Ali, Morowatisharifabad Mohammad; Haidar, Nadrian

2011-09-01

This paper reports on predictors of helmet use behaviour, using variables based on the theory of planned behaviour model among the employed motorcycle riders in Yazd-Iran, in an attempt to identify influential factors that may be addressed through intervention efforts. In 2007, a cluster random sample of 130 employed motorcycle riders in the city of Yazd in central Iran, participated in the study. Appropriate instruments were designed to measure the variables of interest (attitude, subjective norms, perceived behaviour control, intention along with helmet use behaviour). Reliability and validity of the instruments were examined and approved. The statistical analysis of the data included descriptive statistics, bivariate correlations, and multiple regression. Based on the results, 56 out of all the respondents (43.1%) had history of accident by motorcycle. Of these motorcycle riders only 10.7% were wearing their helmet at the time of their accident. Intention and perceived behavioural control showed a significant relationship with helmet use behaviour and perceived behaviour control was the strongest predictor of helmet use intention, followed by subjective norms, and attitude. It was found that that helmet use rate among motorcycle riders was very low. The findings of present study provide a preliminary support for the TPB model as an effective framework for examining helmet use in motorcycle riders. Understanding motorcycle rider's thoughts, feelings and beliefs about helmet use behaviour can assist intervention specialists to develop and implement effective programs in order to promote helmet use among motorcycle riders. Copyright © 2010 Elsevier Ltd. All rights reserved.

Factors Associated with Road Accidents among Brazilian Motorcycle Couriers

Science.gov (United States)

da Silva, Daniela Wosiack; de Andrade, Selma Maffei; Soares, Dorotéia Fátima Pelissari de Paula; Mathias, Thais Aidar de Freitas; Matsuo, Tiemi; de Souza, Regina Kazue Tanno

2012-01-01

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1 ), were included in the study. Young age (18 to 24 years compared to ≥25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents—personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)—reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists. PMID:22629158

Factors associated with road accidents among Brazilian motorcycle couriers.

Science.gov (United States)

da Silva, Daniela Wosiack; de Andrade, Selma Maffei; Soares, Dorotéia Fátima Pelissari de Paula; Mathias, Thais Aidar de Freitas; Matsuo, Tiemi; de Souza, Regina Kazue Tanno

2012-01-01

The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1 ), were included in the study. Young age (18 to 24 years compared to ≥ 25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents-personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)-reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists.

Factors associated with utilization of motorcycle ambulances by pregnant women in rural eastern Uganda: a cross-sectional study.

Science.gov (United States)

Ssebunya, Rogers; Matovu, Joseph K B

2016-03-03

Evidence suggests that use of motorcycle ambulances can help to improve health facility deliveries; however, few studies have explored the motivators for and barriers to their usage. We explored the factors associated with utilization of motorcycle ambulances by pregnant women in eastern Uganda. This was a cross-sectional, mixed-methods study conducted among 391 women who delivered at four health facilities supplied with motorcycle ambulances in Mbale district, eastern Uganda, between April and May 2014. Quantitative data were collected on socio-demographic and economic characteristics, pregnancy and delivery history, and community and health facility factors associated with utilization of motorcycle ambulances using semi-structured questionnaires. Qualitative data were collected on the knowledge and attitudes towards using motorcycle ambulances by pregnant women through six focus group discussions. Using STATA v.12, we computed the characteristics of women using motorcycle ambulances and used a logistic regression model to assess the correlates of utilization of motorcycle ambulances. Qualitative data were analyzed manually using a master sheet analysis tool. Of the 391 women, 189 (48.3%) reported that they had ever utilized motorcycle ambulances. Of these, 94.7% were currently married or living together with a partner while 50.8% earned less than 50,000 Uganda shillings (US $20) per month. Factors independently associated with use of motorcycle ambulances were: older age of the mother (≥35 years vs ≤24 years; adjusted Odds Ratio (aOR) = 4.3, 95% CI: 2.03, 9.13), sharing a birth plan with the husband (aOR = 2.5, 95% CI: 1.19, 5.26), husband participating in the decision to use the ambulance (aOR =3.22, 95% CI: 1.92, 5.38), and having discussed the use of the ambulance with a traditional birth attendant (TBA) before using it (aOR =3.12, 95% CI: 1.88, 5.19). Qualitative findings indicated that community members were aware of what motorcycle ambulances

Dynamic stability of an aerodynamically efficient motorcycle

Science.gov (United States)

Sharma, Amrit; Limebeer, David J. N.

2012-08-01

Motorcycles exhibit two potentially dangerous oscillatory modes known as 'wobble' and 'weave'. The former is reminiscent of supermarket castor shimmy, while the latter is a low frequency 'fish-tailing' motion that involves a combination of rolling, yawing, steering and side-slipping motions. These unwanted dynamic features, which can occur when two-wheeled vehicles are operated at speed, have been studied extensively. The aim of this paper is to use mathematical analysis to identify important stability trends in the on-going design of a novel aerodynamically efficient motorcycle known as the ECOSSE Spirit ES1. A mathematical model of the ES1 is developed using a multi-body dynamics software package called VehicleSim [Anon, VehicleSim Lisp Reference Manual Version 1.0, Mechanical Simulation Corporation, 2008. Available at http://www.carsim.com]. This high-fidelity motorcycle model includes realistic tyre-road contact geometry, a comprehensive tyre model, tyre relaxation and a flexible frame. A parameter set representative of a modern high-performance machine and rider is used. Local stability is investigated via the eigenvalues of the linearised models that are associated with equilibrium points of interest. A comprehensive study of the effects of frame flexibilities, acceleration, aerodynamics and tyre variations is presented, and an optimal passive steering compensator is derived. It is shown that the traditional steering damper cannot be used to stabilise the ES1 over its entire operating speed range. A simple passive compensator, involving an inerter is proposed. Flexibility can be introduced deliberately into various chassis components to change the stability characteristics of the vehicle; the implications of this idea are studied.

Radiological diagnosis in patients with head injury alone or in combination with multiple trauma

International Nuclear Information System (INIS)

Rieger, J.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.

2002-01-01

Purpose. Head injury alone or in combination with multiple trauma is the main cause of death and severe disability in individuals under 45 years old. This review is intended to describe the relevant imaging modalities, to analyze their specific value and limitations and to illustrate the most important radiologic findings. The indications for diagnostic imaging within the context of an interdisciplinary linkage of diagnostic and therapeutic measures are discussed.Material and methods. Recent publications are analyzed and compared to the experiences of our own hospital. In terms of a critical synoptic assessment the currently best standard of care is described in consideration of an interdisciplinary care concept.Results. Radiologic imaging modalities crucially contribute to the complete injury assessment and provide an indispensable basis for any therapeutic decision. Comprehensive neuromonitoring and reliable demonstration of delayed or secondary brain damage is impossible without modern imaging technology. Computed tomography (CT) further continues to be the most important imaging modality, while magnetic resonance imaging despite it's partly superior diagnostic informations remains reserved to particular diagnostic problems.Conclusions. Suitable constructive prerequisites, an interdisciplinary care concept and integration of the radiologist in hospital-adapted diagnostic and therapeutic algorithms significantly improves the outcome of patients with acute head injury. Beside the correct diagnosis itself the time to establish a diagnosis above all has a crucial impact on successful management and good outcome of these patients. (orig.) [de

Improving car drivers' perception of motorcycle motion through innovative headlight configurations.

OpenAIRE

CAVALLO, Viola; RANCHET, Maud; PINTO, Maria; ESPIE, Stéphane; VIENNE, Fabrice; DANG, Nguyen-Thong

2015-01-01

L'article présente une expérimentation sur simulateur de conduite qui examine l'effet de différentes configurations de feux avant de moto sur les créneaux temporels acceptés par des automobilistes lorsqu'ils tournent à gauche face à à des motocycles. L'impact des configurations de feux est évalué dans différentes conditions d'illumination (jour, crépuscule, nuit). The most frequent cause of motorcycle accidents occurs when another vehicle violates the motorcycle's right-of-way at an inters...

Design and implementation of a hybrid electric motorcycle management system

International Nuclear Information System (INIS)

Hsu, Yuan-Yong; Lu, Shao-Yuan

2010-01-01

This paper presents a successful design and implement of a shunt-winding hybrid electric motorcycle management system which utilizes an electronic control unit (ECU) to integrate two major subsystems together, one being the traditional system of 125 c.c. internal combustion engine and the other an electric power motor. The hybrid electric motorcycle is assembled together robustly by these two major subsystems and eventually leads to successful road tests. The hybrid power system thus implemented can recharge its own batteries with electricity provided by the electrical recharge system and thus increasing the cruising mileages largely. The testing results obtained by using the proposed experimental platform indicate that lead-acid cells can boost their state of charge (SOC) by approximately 4% when it is operated under the hybrid mode for four driving cycles (about 1600 s) with the recharger on in a standard ECE-40 testing procedure. The results of road tests also clearly show that the pollutant emissions of the engine can be reduced at a lower speed or idling condition, and the problem of insufficient cruising range for electric motorcycles can also be greatly enhanced.

Marshall properties of asphalt concrete using crumb rubber modified of motorcycle tire waste

Science.gov (United States)

Siswanto, Henri; Supriyanto, Bambang; Pranoto, Chandra, Pria Rizky; Hakim, Arief Rahman

2017-09-01

The aim of this study is to explain the effect of Crumb Rubber Modified (CRM) of motorcycle tire waste on Marshall properties of asphalt mix. Two types of aggregate gradation, asphalt concrete wearing course (ACWC) and asphalt concrete base (ACB), and CRM passing #50 sieve size were used. Seven levels of CRM content were investigated in this study, namely 0%, 0.5%, 1%, 1.5%, 3%, 4.5%, and 6% by weight of aggregate. Marshall test is conducted on Marshall specimens. The specimens are tested in their optimum binder content (OBC). The results indicate that CRM addition of motorcycle tire waste increases the Marshall stability of the both mix, ACWC and ACB. In addition, 1% CRM addition of motorcycle tire waste of the total mix weight is the best mix.

Motorcycle On-Road Driving Parameters Influencing Fuel Consumption and Emissions on Congested Signalized Urban Corridor

Directory of Open Access Journals (Sweden)

Atthapol Seedam

2017-01-01

Full Text Available This study aims to find the on-road driving parameters influencing fuel consumption and emissions of motorcycle driving on a congested signalized urban corridor. A motorcycle onboard measurement system was developed to measure instantaneously and continuously record on-road driving data, including speed-time profile, emissions, and fuel consumption, by the second. The test motorcycles were driven by 30 sample motorcyclists on a signalized urban corridor in Khon Kaen City, Thailand, to collect their on-road driving behavior during the morning peak period. Cluster analysis was applied to analyze collected driving data and to categorize the drivers by level of fuel consumption and on-road driver behavior. The on-road driving parameter influencing fuel consumption and emissions was then determined. Results revealed that proportion of idle time significantly influenced fuel consumption and emissions of motorcycle driving on a congested signalized urban corridor, though aggressive driving behavior, hard acceleration and deceleration, did not have the same kind of influence.

Clinical experience with MRI in head trauma cases

International Nuclear Information System (INIS)

Yamagami, Tatsuhito; Goto, Yasunobu; Kinuta, Yuji; Tashiro, Yuzuru; Nishihara, Kiyoshi; Hashimoto, Kenji; Minamikawa, Jun; Kikuchi, Haruhiko; Imataka, Kiyoharu.

1988-01-01

The ability to identify lesions after head trauma using magnetic resonance imaging (MRI) was tested in 199 cases. A resistive-type MRI scanner operating at a field of 0.2 Tesla was utilized in inversion-recovery (IR) and saturation-recovery (SR) radiofrequency-pulse sequences. Of the total number of cases, 54 were examined within 4 days after injury. An intracranial hematoma was removed in 47 cases. The MRI findings were normal in the cases of cerebral concussion, even in the presence of skull fracture. High intensity areas were seen in the SR images in 12 cases which were normal on X-ray CT. Both acute and subacute non-hemorrhagic contusion sites were visible as low intensity areas on the T 1 -weighted images and as high intensity areas on the SR images. Acute hemorrhagic contusion sites were visible as isointense and low intensity areas in the T 1 -weighted images and as high intensity areas in the SR images. Subacute sites appeared as high intensity areas in the T 1 -weighted, SR, and T 2 -weighted images. Direct coronal and sagittal views were adequate for the recognition of the three-dimensional brain structure. MRI was useful in the identification of brain contusion, in postoperative follow-ups, and in the detection of complications in the chronic stage. In the follow-up of 48 brain contusion cases, 13 cases showed normalized MRI findings and 9 cases showed improved findings. The recovery of cerebral function in these cases was good. The lesions demonstrated by MRI were considered to be contusional hematoma, petechiae, brain edema, shear injury, and non-hemorrhagic contusion. When they persist, such lesions are thought to change into such conditions as scar, gliosis, porencephaly, and brain atrophy. (author)

Trauma center accessibility for road traffic injuries in Hanoi, Vietnam.

Science.gov (United States)

Nagata, Takashi; Takamori, Ayako; Kimura, Yoshinari; Kimura, Akio; Hashizume, Makoto; Nakahara, Shinji

2011-09-30

Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city. We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis. We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers. Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.

Exploratory field trial of motorcycle autonomous emergency braking (MAEB): Considerations on the acceptability of unexpected automatic decelerations.

Science.gov (United States)

Savino, Giovanni; Pierini, Marco; Thompson, Jason; Fitzharris, Michael; Lenné, Michael G

2016-11-16

Autonomous emergency braking (AEB) acts to slow down a vehicle when an unavoidable impending collision is detected. In addition to documented benefits when applied to passenger cars, AEB has also shown potential when applied to motorcycles (MAEB). However, the feasibility of MAEB as practically applied to motorcycles in the real world is not well understood. In this study we performed a field trial involving 16 riders on a test motorcycle subjected to automatic decelerations, thus simulating MAEB activation. The tests were conducted along a rectilinear path at nominal speed of 40 km/h and with mean deceleration of 0.15 g (15% of full braking) deployed at random times. Riders were also exposed to one final undeclared brake activation with the aim of providing genuinely unexpected automatic braking events. Participants were consistently able to manage automatic decelerations of the vehicle with minor to moderate effort. Results of undeclared activations were consistent with those of standard runs. This study demonstrated the feasibility of a moderate automatic deceleration in a scenario of motorcycle travelling in a straight path, supporting the notion that the application of AEB on motorcycles is practicable. Furthermore, the proposed field trial can be used as a reference for future regulation or consumer tests in order to address safety and acceptability of unexpected automatic decelerations on a motorcycle.

Scottish urban versus rural trauma outcome study.

Science.gov (United States)

McGuffie, A Crawford; Graham, Colin A; Beard, Diana; Henry, Jennifer M; Fitzpatrick, Michael O; Wilkie, Stewart C; Kerr, Gary W; Parke, Timothy R J

2005-09-01

Outcome following trauma and health care access are important components of health care planning. Resources are limited and quality information is required. We set the objective of comparing the outcomes for patients suffering significant trauma in urban and rural environments in Scotland. The study was designed as a 2 year prospective observational study set in the west of Scotland, which has a population of 2.58 million persons. Primary outcome measures were defined as the total number of inpatient days, total number of intensive care unit days, and mortality. The participants were patients suffering moderate (ISS 9-15) and major (ISS>15) trauma within the region. The statistical analysis consisted of chi square test for categorical data and Mann Whitney U test for comparison of medians. There were 3,962 urban (85%) and 674 rural patients (15%). Urban patients were older (50 versus 46 years, p = 0.02), were largely male (62% versus 57%, p = 0.02), and suffered more penetrating traumas (9.9% versus 1.9%, p rural patients (p rural major trauma group (p = 0.002). There were more serious head injuries in the urban group (p = 0.04), and also a higher proportion of urban patients with head injuries transferred to the regional neurosurgical unit (p = 0.037). There were no differences in length of total inpatient stay (median 8 days, p = 0.7), total length of stay in the intensive care unit (median two days, p = 0.4), or mortality (324 deaths, moderate trauma, p = 0.13; major trauma, p = 0.8). Long prehospital times in the rural environment were not associated with differences in mortality or length of stay in moderately and severely injured patients in the west of Scotland. This may lend support to a policy of rationalization of trauma services in Scotland.

Optimization of suitable ethanol blend ratio for motorcycle engine using response surface method.

Science.gov (United States)

Chen, Yu-Liang; Chen, Suming; Tsai, Jin-Ming; Tsai, Chao-Yin; Fang, Hsin-Hsiung; Yang, I-Chang; Liu, Sen-Yuan

2012-01-01

In view of energy shortage and air pollution, ethanol-gasoline blended fuel used for motorcycle engine was studied in this work. The emissions of carbon monoxide (CO), nitrogen oxides (NO(X)) and engine performance of a 125 cc four-stroke motorcycle engine with original carburetor using ethanol-gasoline fuels were investigated. The model of three-variable Box Behnken design (BBD) was used for experimental design, the ethanol blend ratios were prepared at 0, 10, 20 vol%; the speeds of motorcycle were selected as 30, 45, 60 km/h; and the throttle positions were set at 30, 60, 90 %. Both engine performance and air pollutant emissions were then analyzed by response surface method (RSM) to yield optimum operation parameters for tolerable pollutant emissions and maximum engine performance. The RSM optimization analysis indicated that the most suitable ethanol-gasoline blended ratio was found at the range of 3.92-4.12 vol% to yield a comparable fuel conversion efficiency, while considerable reductions of exhaust pollutant emissions of CO (-29 %) and NO(X) (-12 %) when compared to pure gasoline fuel. This study demonstrated low ethanol-gasoline blended fuels could be used in motorcycle carburetor engines without any modification to keep engine power while reducing exhaust pollutants.

Driver Education for Motorcycle Operation. Final Report.

Science.gov (United States)

Council, Forrest M.; And Others

A three-year pilot project was conducted to evaluate the feasibility of implementing a statewide off-road motorcycle training program for beginning drivers in North Carolina. The first year of the program involved approximately 422 students from five locations, the second year involved seven sites across the State. The three basic criteria for the…

Helmet wearing in Kenya: prevalence, knowledge, attitude, practice and implications.

Science.gov (United States)

Bachani, A M; Hung, Y W; Mogere, S; Akunga, D; Nyamari, J; Hyder, A A

2017-03-01

In light of the increasing prevalence of motorcycles on Kenyan roads, there is a need to address the safety of individuals using this mode of transport. Helmet use has been proven to be effective in preventing head injuries and fatalities in the event of a crash. This study aims to understand the prevalence of helmet use as well as knowledge, attitudes, and practices in two districts in Kenya over a 5-year period (2010-2014). Observational studies on helmet use at randomly selected locations throughout each district were done every quarter to estimate the prevalence of helmet use. Roadside knowledge, attitude, and practice (KAP) surveys were done two times a year in each district. Helmet use among motorcycle drivers and passengers in Thika and Naivasha was assessed through systematic observations at randomly selected locations in the two districts between August 2010 and December 2014. Roadside KAP surveys were administered in both sites to motorcyclists in areas where they stopped, including motorcycle bays, petrol stations and rest areas near the helmet observation sites. Secondary analysis of trauma registries was also used. Negative binomial regressions were used to assess trends of helmet wearing among motorcyclists over time, and logistic regressions were used to analyze associated risk factors as well as association with health outcomes among those admitted to the four hospitals. A total of 256,851 motorcycles were observed in the two target districts during the study period. Overall, prevalence of helmet use among motorcycle drivers in Thika and Naivasha across all periods was 35.12% (95% confidence interval [CI]: 34.87%-35.38%) and 37.42% (95% CI: 37.15%-37.69%) respectively. Prevalence of helmet wearing remained similar after the passage of a traffic amendment bill. These results were not statistically significant in either Thika or in Naivasha. Data from the KAP survey showed that respondents recognized the life-saving effect of wearing a helmet, but

The challenges facing commercial motorcycle occupation in Etsako ...

African Journals Online (AJOL)

This study examined the challenges facing commercial motorcycle occupation in Edo State, Nigeria. A descriptive survey design was adopted. Data were collected through questionnaires and in-depth interviews (IDIs) among selected motorcyclists, police officers and road safety officials in Etsako West Local Government ...

Muscular Activities Measurements of Forward Lean and Upright Sitting Motorcycling Postures via Surface Electromyography (sEMG

Directory of Open Access Journals (Sweden)

Ma’arof Muhammad Izzat Nor

2017-01-01

Full Text Available Motorcycling postures are generically speculated to be physical and physiologically demanding – which in-turn may lead to motorcycling fatigue, and then becoming a possible factor to road accident. The objective of this study was to measure the muscular activities of various motorcycling postures. High muscular activity reading will signifies that motorcycling is indeed physically and physiologically demanding to the motorcyclist. For this particular study, the following postures were tested: i forward lean, ii upright sitting, and iii neutral sitting (as control. Surface electromyography (sEMG measurement was conducted on the following muscles: i extensor carpi radialis, ii upper trapezius iii latissimus dorsi, and iv erector spinae. The results showed that for all test subjects, the muscular activities readings for the forward lean posture was actually close to neutral sitting’s. Whilst, the upright sitting had showed much higher muscular activities measurement instead. Conclusively, this study had proven that any types of discomforts associated with the forward lean posture is not originated from muscular activities. Whereas, confirming that any discomforts in regards to the upright sitting is indeed related to muscular activities. Further studies are warranted to discover the actual risk factors that causes physical and physiological discomforts for the forward lean motorcycling posture.

Early fever after trauma: Does it matter?

Science.gov (United States)

Hinson, Holly E; Rowell, Susan; Morris, Cynthia; Lin, Amber L; Schreiber, Martin A

2018-01-01

Fever is strongly associated with poor outcome after traumatic brain injury (TBI). We hypothesized that early fever is a direct result of brain injury and thus would be more common in TBI than in patients without brain injury and associated with inflammation. We prospectively enrolled patients with major trauma with and without TBI from a busy Level I trauma center intensive care unit (ICU). Patients were assigned to one of four groups based on their presenting Head Abbreviated Injury Severity Scale scores: multiple injuries: head Abbreviated Injury Scale (AIS) score greater than 2, one other region greater than 2; isolated head: head AIS score greater than 2, all other regions less than 3; isolated body: one region greater than 2, excluding head/face; minor injury: no region with AIS greater than 2. Early fever was defined as at least one recorded temperature greater than 38.3°C in the first 48 hours after admission. Outcome measures included neurologic deterioration, length of stay in the ICU, hospital mortality, discharge Glasgow Outcome Scale-Extended, and plasma levels of seven key cytokines at admission and 24 hours (exploratory). Two hundred sixty-eight patients were enrolled, including subjects with multiple injuries (n = 59), isolated head (n = 97), isolated body (n = 100), and minor trauma (n = 12). The incidence of fever was similar in all groups irrespective of injury (11-24%). In all groups, there was a significant association between the presence of early fever and death in the hospital (6-18% vs. 0-3%), as well as longer median ICU stays (3-7 days vs. 2-3 days). Fever was significantly associated with elevated IL-6 at admission (50.7 pg/dL vs. 16.9 pg/dL, p = 0.0067) and at 24 hours (83.1 pg/dL vs. 17.1 pg/dL, p = 0.0025) in the isolated head injury group. Contrary to our hypothesis, early fever was not more common in patients with brain injury, though fever was associated with longer ICU stays and death in all groups. Additionally, fever was

Association of Pediatric Abusive Head Trauma Rates With Macroeconomic Indicators.

Science.gov (United States)

Wood, Joanne N; French, Benjamin; Fromkin, Janet; Fakeye, Oludolapo; Scribano, Philip V; Letson, Megan M; Makoroff, Kathi L; Feldman, Kenneth W; Fabio, Anthony; Berger, Rachel

2016-04-01

We aimed to examine abusive head trauma (AHT) incidence before, during and after the recession of 2007-2009 in 3 US regions and assess the association of economic measures with AHT incidence. Data for children <5 years old diagnosed with AHT between January 1, 2004, and December 31, 2012, in 3 regions were linked to county-level economic data using an ecologic time series analysis. Associations between county-level AHT rates and recession period as well as employment growth, mortgage delinquency, and foreclosure rates were examined using zero-inflated Poisson regression models. During the 9-year period, 712 children were diagnosed with AHT. The mean rate of AHT per 100,000 child-years increased from 9.8 before the recession to 15.6 during the recession before decreasing to 12.8 after the recession. The AHT rates after the recession were higher than the rates before the recession (incidence rate ratio 1.31, P = .004) but lower than rates during the recession (incidence rate ratio 0.78, P = .005). There was no association between the AHT rate and employment growth, mortgage delinquency rates, or foreclosure rates. In the period after the recession, AHT rate was lower than during the recession period yet higher than the level before the recession, suggesting a lingering effect of the economic stress of the recession on maltreatment risk. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Comparison of quality control for trauma management between Western and Eastern European trauma center

Directory of Open Access Journals (Sweden)

Gambale Giorgio

2008-11-01

Full Text Available Abstract Background Quality control of trauma care is essential to define the effectiveness of trauma center and trauma system. To identify the troublesome issues of the system is the first step for validation of the focused customized solutions. This is a comparative study of two level I trauma centers in Italy and Romania and it has been designed to give an overview of the entire trauma care program adopted in these two countries. This study was aimed to use the results as the basis for recommending and planning changes in the two trauma systems for a better trauma care. Methods We retrospectively reviewed a total of 182 major trauma patients treated in the two hospitals included in the study, between January and June 2002. Every case was analyzed according to the recommended minimal audit filters for trauma quality assurance by The American College of Surgeons Committee on Trauma (ACSCOT. Results Satisfactory yields have been reached in both centers for the management of head and abdominal trauma, airway management, Emergency Department length of stay and early diagnosis and treatment. The main significant differences between the two centers were in the patients' transfers, the leadership of trauma team and the patients' outcome. The main concerns have been in the surgical treatment of fractures, the outcome and the lacking of documentation. Conclusion The analyzed hospitals are classified as Level I trauma center and are within the group of the highest quality level centers in their own countries. Nevertheless, both of them experience major lacks and for few audit filters do not reach the mmum standard requirements of ACS Audit Filters. The differences between the western and the eastern European center were slight. The parameters not reaching the minimum requirements are probably occurring even more often in suburban settings.

PRACTICAL MANAGEMENT OF HEAD INJURY | Shehu | Annals of ...

African Journals Online (AJOL)

For an effective practical management of head injury, a clear knowledge of the various causes and mechanism of head injury is essential. The concept of the brain in a rigid cranial cavity makes the pathophysiological mechanism of head trauma unique. Most problems occur due to poor handling of patients at the site of ...

75 FR 13809 - Reclassification of Motorcycles (Two and Three Wheeled Vehicles) in the Guide to Reporting...

Science.gov (United States)

2010-03-23

... Taxation, page 3-2. Item I.E.2. Motorcycles: This item includes two-wheeled and three-wheeled motorcycles... FHWA from their motor vehicle registration systems. As a result, such data is based on the definitions... bicycles. \\4\\ American National Standards Institute, http://webstore.ansi.org/?source=google&adgroup=ansi...

40 CFR 86.447-2006 - What provisions apply to motorcycle engines below 50 cc that are certified under the Small SI...

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false What provisions apply to motorcycle... Regulations for 1978 and Later New Motorcycles, General Provisions § 86.447-2006 What provisions apply to motorcycle engines below 50 cc that are certified under the Small SI program or the Recreational-vehicle...

Dentofacial injuries in commercial motorcycle accidents in Cameroon

African Journals Online (AJOL)

Objective: To assess the pattern of dentofacial injuries in commercial motorcycle accidents among riders and passengers in Cameroon. Materials and Methods: This was a hospital based study conducted in 6 out of 10 regional capitals in the months of December 2011 to September 2012. Analyzed information included age, ...

Obesity in pediatric trauma.

Science.gov (United States)

Witt, Cordelie E; Arbabi, Saman; Nathens, Avery B; Vavilala, Monica S; Rivara, Frederick P

2017-04-01

The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated. Outcomes included injury patterns, operative procedures, complications, and hospital utilization parameters. Data from 149,817 pediatric patients were analyzed; higher BMI percentiles were associated with significantly more extremity injuries, and fewer injuries to the head, abdomen, thorax and spine (p values Obese children also had significantly longer lengths of stay and more frequent ventilator requirement. Among children admitted after trauma, increased BMI percentile is associated with increased risk of death and potentially preventable complications. These findings suggest that obese children may require different management than nonobese counterparts to prevent complications. Level III; prognosis study. Copyright © 2017 Elsevier Inc. All rights reserved.

Environmental impact of Converted Electrical Motorcycle

OpenAIRE

Xuan, Pek Yang; Henz, Martin; Weigl, Joerg

2013-01-01

This study explores the environmental impact of the conversion of an internal combustion engine (ICE) sports motorcycle into a converted battery-powered electric vehicle (CBEV). Zero tailpipe emissions might lead to the assumption that such an ICE-to-BEV conversion will always yield net positive environmental benefits in life cycle greenhouse gas (GHG) emissions and energy reductions, but energy inputs and materials impacts associated with the conversion of a CBEV are weighed against savings ...

CT scan findings in mild head trauma: a series of 2,000 patients Achados tomográficos no trauma cranioencefálico leve: análise de 2000 casos

Directory of Open Access Journals (Sweden)

Kelly C. Bordignon

2002-06-01

Full Text Available The present study describes the cranial computed tomography (CT scan findings of 2,000 cases of mild head trauma (HT in Curitiba, Southern Brazil. The mean age of the entire series was 30.8 ±19 years. The overall male to female ratio was 2:1. The most common causes of head injury were interpersonal aggression (17.9%, falls (17.4%, automobile accidents (16.2%, falls to the ground (13.1% and pedestrian injuries (13 %. Alcohol intoxication was associated with HT in 158 cases (7.9%. A normal CT scan was seen in 60.75% (1215 and an abnormal CT scan in 39.25% (785 of patients. Out of 785 abnormal CT scan, 518(65.9% lesions were related to HT. The most common CT scan HT related findings were: soft tissue swelling (8.9 %, skull fractures (4.3 %, intracranial and subgaleal hematomas (3.4% and 2.4 %, brain swelling (2 % and brain contusion (1.2%. Out of 785 abnormal CT scans, 267 (34.1% lesions were not related to head trauma. Incidental CT scan findings included brain atrophy (5.9%, one calcification (5.2% several calcifications (2.4% (probably neurocysticercosis in most cases, ischemic infarct (1.9% and leukoaraiosis (1.3%. These findings showed the importance of CT scan examination in mild head injuries. Further studies to identify mild HT patients at higher risk of significant brain injury are warranted in order to optimize its use.São descritos os achados de tomografia computadorizada craniana (TC de 2000 casos de trauma cranio-encefálico (TCE leve em Curitiba, Paraná. A idade média de toda série de pacientes foi 30,8 ± 19 anos. A razão homem/mulher foi 2:1. A causas mais comuns de TCE foram agressão interpessoal (17,9%, quedas de nível (17,4%, acidentes automobilísticos (16,2%, queda ao solo (13,1% e atropelamento (13%. Intoxicação por álcool foi um importante fator associado ao TCE e esteve presente em 158 casos (7,9% de 2000 pacientes. Uma TC normal ocorreu em 60,75% (1215 e uma TC anormal em 39,25% (785 dos pacientes. Das 785 TC

Variations of the blood gas levels and thermodilutional parameters during ICP monitoring after severe head trauma in children.

Science.gov (United States)

Lubrano, Riccardo; Elli, Marco; Stoppa, Francesca; Di Traglia, Mario; Di Nardo, Matteo; Perrotta, Daniela; David, Piero; Paoli, Sara; Cecchetti, Corrado

2015-08-01

The purpose of this study was to define, in children following head trauma and GSC ≤ 8, at which level of intracranial pressure (ICP), the thermodilutional, and gas analytic parameters implicated in secondary cerebral insults shows initial changes. We enrolled in the study 56 patients: 30 males and 26 females, mean age 71 ± 52 months. In all children, volumetric hemodynamic and blood gas parameters were monitored following initial resuscitation and every 4 h thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative hospital stay, a total of 1050 sets of measurements were done. All parameters were stratified in seven groups according to ICP (group A1 = 0-5 mmHg, group A2 = 6-10 mmHg, group A3 = 11-15 mmHg, group A4 16-20 mmHg, group A5 21-25 mmHg, group A6 26-30 mmHg, group A7 >31 mmHg). Mean values of jugular oxygen saturation (SJO2), jugular oxygen partial pressure (PJO2), extravascular lung water (EVLWi), pulmonary vascular permeability (PVPi), fluid overload (FO), and cerebral extraction of oxygen (CEO2) vary significantly from A3 (11-15 mmHg) to A4 (16-20 mmHg). They relate to ICP in a four-parameter sigmoidal function (4PS function with: r(2) = 0.90), inflection point of 15 mmHg of ICP, and a maximum curvature point on the left horizontal asymptote at 13 mmHg of ICP. Mean values of SJO2, PJO2, EVLWi, PVPi, FO, and CEO2 become pathologic at 15 mmHg of ICP; however, the curve turns steeper at 13 mmHg, possibly a warning level in children for the development of post head trauma secondary insult.

Does EMS Perceived Anatomic Injury Predict Trauma Center Need?

Science.gov (United States)

Lerner, E. Brooke; Roberts, Jennifer; Guse, Clare E.; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Blatt, Alan; Jurkovich, Gregory J.; Brasel, Karen

2013-01-01

Objective Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods EMS providers caring for injured adults transported to regional trauma centers in 3 midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon ED arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as non-orthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics including positive likelihood ratios (+LR) with 95% confidence intervals. Results 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9 - 4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1 - 19.4), paralysis (6.8; CI: 4.2 - 11.2), two or more long bone fractures (6.3; CI: 4.5 - 8.9), and amputation (6.1; CI: 1.5 - 24.4). Criteria with a +LR >2 and <5 were penetrating injury (4.8; CI: 4.2 - 5.6), and skull fracture (4.8; CI: 3.0 - 7.7). Only pelvic fracture (1.9; CI: 1.3 - 2.9) had a +LR less than 2. Conclusions The anatomic step of the Field Triage Guidelines as determined by EMS providers is a reasonable tool for determining trauma center need. Use of EMS perceived pelvic fracture as an indicator for trauma center need should be re-evaluated. PMID:23627418

Vestibular and stabilometric findings in whiplash injury and minor head trauma.

Science.gov (United States)

Nacci, A; Ferrazzi, M; Berrettini, S; Panicucci, E; Matteucci, J; Bruschini, L; Ursino, F; Fattori, B

2011-12-01

Vertigo and postural instability following whiplash and/or minor head injuries is very frequent. According to some authors, post-whiplash vertigo cannot be caused by real injury to vestibular structures; other authors maintain that vestibular damage is possible even in the case of isolated whiplash, with vascular or post-traumatic involvement. Furthermore, many of the balance disorders reported after trauma can be justified by post-traumatic modification to the cervical proprioceptive input, with consequent damage to the vestibular spinal reflex. The aim of this study was to evaluate the vestibular condition and postural status in a group of patients (Group A, n = 90) affected with balance disorders following whiplash, and in a second group (Group B, n = 20) with balance disorders after minor head injury associated with whiplash. Both groups were submitted to videonystagmography (VNG) and stabilometric investigation (open eyes - O E, closed eyes - CE, closed eyes with head retroflexed - CER) within 15 days of their injuries and repeated within 10 days after conclusion of cervical physiotherapy treatment. The VNG tests revealed vestibulopathy in 19% of cases in Group A (11% peripheral, 5% central, 3% in an undefined site) and in 60% of subjects in Group B (50% peripheral, 10% central). At the follow-up examination, all cases of non-compensated labyrinth deficit showed signs of compensation, while there were two cases (2%) in Group A and one case (5%) in Group B of PPV. As far as the altered posturographic recordings are concerned, while there was no specific pattern in the two groups, they were clearly pathologic, especially during CER. Both in OE and in CE there was an increase in the surface values and in those pertaining to shifting of the gravity centre on the sagittal plane, which was even more evident during CER. In Group A, the pre-post-physiotherapy comparison of CER results showed that there was a statistically significant improvement in the majority of the

The relationship between Motorcycle Rider Behaviour Questionnaire scores and crashes for riders in Australia.

Science.gov (United States)

Stephens, A N; Brown, J; de Rome, L; Baldock, M R J; Fernandes, R; Fitzharris, M

2017-05-01

Motorcycle riders are over-represented in road fatalities in Australia. While riders represent 18% of the road users killed each year, motorcycle registrations constitute only 4.5% of the registered vehicle fleet. The Motorcycle Rider Behaviour Questionnaire (MRBQ) was developed with a view toward understanding behaviours likely to be associated with crash risk. These include behaviours that are either intentional (such as violations of road and speed regulations and stunts) or unintentional (such as errors relating to traffic or control of the motorcycle), as well as protective behaviours related to use of safety equipment. The dual aims of the current study were, first, to determine the appropriate structure of a modified version of the MRBQ for use in a representative sample of riders in Australia and, second, to understand which MRBQ factors are associated with crash involvement. A stratified sampling procedure was undertaken to ensure the socio-economic status of local government area, age and gender of the sample was representative of the broader population of riders in New South Wales, Australia. The sample consisted of 470 riders (males=89%). Exploratory factor analysis revealed a 29-item, five factor structure was suitable on the Australian data encompassing traffic errors, speed violations, protective gear, control errors and stunts. Overall, riders reported relatively safe behaviours, with frequent use of protective gear and infrequent aberrant behaviours. However, even though infrequent, violations of speed and errors related to control of the motorcycle increased the odds of near-crash involvement, whilst stunt behaviours were associated with increased odds of crash involvement. Interventions and countermeasures need to target these specific behaviours. Copyright © 2017 Elsevier Ltd. All rights reserved.

Aerodynamic benefit for a cyclist by a following motorcycle

NARCIS (Netherlands)

Blocken, B.J.E; Toparlar, Y.; Andrianne, Th.

2016-01-01

In recent years, many accidents have occurred between cyclists and in-race motorcycles, even yielding fatal injuries. The accidents and the potential aerodynamics issues have impelled the present authors to perform dedicated wind-tunnel measurements and Computational Fluid Dynamics (CFD) simulations

Green turtle head trauma with intracerebral hemorrhage: image diagnosis and treatment Traumatismo craniano com hemorragia intracerebral em tartaruga verde: diagnóstico por imagem e tratamento

Directory of Open Access Journals (Sweden)

Daphne Wrobel Goldberg

2010-11-01

Full Text Available Sea turtles are threatened to the point of extinction. The major goal of rehabilitating injured individuals is to eventually reintroduce them back into their habitat. Sea turtles are vulnerable to anthropogenic effects, and impact traumas are a common cause of death among these animals. Carapace and skull fractures are usually related to vessel collisions or propeller impacts. However, intentional traumas inflicted by humans are also considered as a potential threat. The purpose of this article is to describe the diagnosis and rehabilitation procedures of a juvenile green turtle (Chelonia mydas after severe head trauma with brain hemorrhage. The data presented here can be used as a reference for future cases of head trauma in chelonians.Tartarugas marinhas são animais ameaçados de extinção. Por isso, o principal objetivo em reabilitar indivíduos feridos é posteriormente reintroduzi-los em seu habitat. Quelônios marinhos apresentam grande vulnerabilidade a efeitos antropogênicos, e a ocorrência de traumatismos impactantes constituem uma importante causa de óbitos entre esses animais. Fraturas de carapaça e crânio estão normalmente associadas a colisões por embarcações. No entanto, lesões intencionais provocadas por humanos também podem ser consideradas ameaças em potencial. O objetivo deste estudo é descrever o diagnóstico e a reabilitação de um indivíduo jovem de tartaruga verde (C. mydas após traumatismo craniano severo com hemorragia cerebral. Os dados apresentados poderão ser utilizados como referências para casos futuros de traumatismos afetando a região da cabeça de quelônios.

Motorcycle accidents: morbidity and associated factors in a city of ...

African Journals Online (AJOL)

Motorcycle accidents: morbidity and associated factors in a city of northeast of Brazil. Alessandro L. Cavalcanti, Belchior Lucena, Iris S. Rodrigues, Amanda L. Silva, Taua T. Lima, Alidianne Fabia C. Xavier ...

Perfil das ocorrências de politrauma em condutores motociclísticos atendidos pelo SAMU de Teresina-PI Perfil de ocurrencias de politraumatismos en conductores de motocicletas atendidos por el SAMU de Teresina-PI Profile of multiple trauma occurrences in motorcycle drivers attended by the SAMU of Teresina-PI

Directory of Open Access Journals (Sweden)

Dinah Sá Rezende Neta

2012-12-01

Full Text Available O estudo objetivou investigar o perfil das ocorrências de politrauma em condutores motociclísticos atendidos pelo Serviço de Atendimento Móvel de Urgência de Teresina-PI. Realizou-se um estudo quantitativo e documental, mediante informações colhidas das fichas de atendimento desse serviço no ano de 2009. A coleta dos dados ocorreu nos meses de fevereiro e março do ano de 2010. As motocicletas envolveram-se em 84% dos acidentes, sendo os homens de 21 a 30 anos os mais acometidos. O final de semana e a zona urbana registraram mais casos. Destacaram-se os traumas musculoesqueléticos (59%. As vítimas alcoolizadas totalizaram 12%. A mortalidade correspondeu a 1%. Conclui-se ser imprescindível a adoção de medidas socioeducativas que garantam o comportamento adequado dos indivíduos no trânsito.El objetivo del estudio fue investigar el perfil de ocurrencias de politraumatismos en conductores de motocicleta atendidos por el Servicio de Atención Móvil de Urgencia de Teresina-PI. Se realizó un estudio cuantitativo y documental, con la información siendo recopilada a través de las historias clínicas de este servicio en 2009. La recolección de datos se llevó a cabo en febrero y marzo de 2010. Las motocicletas participaron en 84% de los accidentes, y los hombres de 21 a 30 años fueron los más afectados. El fin de semana y el área urbana registraron más casos. Lo más destacado fue el trauma osteomuscular (59%. Las víctimas alcohólicas ascendieron a 12%. La mortalidad fue del 1%. Llega-se a la conclusión de que es indispensable adoptar medidas educativas para asegurar el buen comportamiento de los individuos en tránsito.The study aimed to investigate the profile of polytrauma occurrences in motorcycle drivers Service at Mobile Emergency Care of the county of Teresina-PI. We conducted a quantitative and documentary study, with information gathered through the medical records of that service, in 2009. Data collection was conducted

[Pancreatic trauma].

Science.gov (United States)

Arvieux, C; Guillon, F; Létoublon, Ch; Oughriss, M

2003-10-01

Early diagnosis of pancreatic trauma has always been challenging because of the lack of correlation between the initial clinical symptomatology, radiologic and laboratory findings, and the severity of the injury. Thanks to the improved performance of spiral CT scanning and magnetic resonance pancreatography, it is now often possible to make an early diagnosis of pancreatic contusion, to localize the site of the injury, and (most importantly) to identify injury to the main pancreatic duct which has major implications for the management of the case. When the trauma victim is unstable, radiologic work-up may be impossible and urgent laparotomy is required. Control of hemorrhage is the primary concern here and a damage control approach with packing may be appropriate; if the pancreatic head has been destroyed, a pancreaticoduodenectomy with delayed reconstruction may be required. If the trauma victim is stable, the treatment strategy will be governed by a variety of parameters--age, clinical condition, associated local anatomic findings (pancreatitis, injury to the duodenum or biliary tract), involvement of the pancreatic duct, and localization of the injury within the gland (to right or left of the mesenteric vessels).

Horizontal traumatic laceration of the pancreas head: A rare case report

OpenAIRE

Nanashima, Atsushi; Imamura, Naoya; Tsuchimochi, Yuki; Hamada, Takeomi; Yano, Kouichi; Hiyoshi, Masahide; Fujii, Yoshiro; Kawano, Fumiaki; MitsuruTamura,

2017-01-01

Introduction: This case report is intended to inform acute care surgeons about treating rare horizontal laceration of the pancreas head caused by blunt trauma. Case presentation: A 57-year-old woman who sustained blunt abdominal trauma during a car crash was transported to the emergency center of our hospital with unstable vital signs due to hemorrhagic shock. Computed tomography showed transection of the pancreas head and massive intra-abdominal hemorrhage. She was referred for emergency ...

Radiographic evaluation of hepatic trauma

International Nuclear Information System (INIS)

Federle, M.P.

1985-01-01

The incidence of significant abdominal trauma continues to rise and accounts currently for approximately 10 percent of the annual 130,000 trauma-related deaths in the United States. Over 60 percent of patients are from 10 to 40 years of age, with a striking predominance of males. Children are mostly victims of blunt trauma, while some large reviews of liver trauma in adults show a prevalence of penetrating injuries. Injury to the liver is second only to the spleen in incidence of intraperitoneal injuries. Morbidity and mortality from hepatic trauma are related to the mechanism and extent of injury. Penetrating injuries generally have a lower mortality, about 5 percent, especially if they are due to stab wounds or low velocity gunshot wounds. Shotgun and high velocity gunshot wounds may cause massive fragmentation of the liver and are associated with proportionately greater mortality. The mortality from blunt trauma is from 15 to 45 percent in many large series. Death from isolated liver injury is uncommon, but is usually due to uncontrolled hemorrhage. Injury to other abdominal organs is associated in many cases, as are injuries to the head, chest, and limbs. The extraabdominal injuries are frequently more apparent clinically, but may mask potentially life-threatening abdominal visceral injuries

Paternalism & Its Discontents: Motorcycle Helmet Laws, Libertarian Values, and Public Health

Science.gov (United States)

Jones, Marian Moser; Bayer, Ronald

2007-01-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists’ advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering. PMID:17194856

Injury patterns of child abuse: Experience of two Level 1 pediatric trauma centers.

Science.gov (United States)

Yu, Yangyang R; DeMello, Annalyn S; Greeley, Christopher S; Cox, Charles S; Naik-Mathuria, Bindi J; Wesson, David E

2018-05-01

This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0-12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6-5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4-5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8-8.8). Although 76% of head injuries occurred in infants <1year, children ages 1-4years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p<0.001). Child abuse accounts for a large proportion of trauma fatalities in children under 5years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority. Retrospective Review. II. Copyright © 2018. Published by Elsevier Inc.

Population-based study of ischemic stroke risk after trauma in children and young adults.