Finite Element Based Injury Metrics for Pulmonary Contusion From Vehicle to Vehicle Crash Simulations

Author(s):  
Kerry A. Danelson ◽  
Joel D. Stitzel

Motor Vehicle Crashes (MVCs) are a public health problem in the United States. In 2009, 33,808 Americans were killed in a MVC and 2.22 million more were injured.4 Pulmonary contusion (PC) is a common injury following MVC with over 38% of the Abbreviated Injury Scale (AIS) 3+ thoracic injuries identified as some form of PC in a recent National Automotive Sampling System (NASS) study.5 Miller et al. correlated the percent injured lung to the possibility of developing Acute Respiratory Distress Syndrome (ARDS). The results indicated that if 20% of the lung was injured, the incidence of ARDS sharply increased with seventy-eight percent of those patients developing ARDS.2 The significance of these findings is that the volumetric measurement of PC can predict possible clinical outcomes.

2021 ◽  

Distracted driving is defined in the Oxford English Dictionary as “the practice of driving a motor vehicle while engaged in another activity, typically one that involves the use of a mobile phone or other electronic device.” However, other distractions not involving the use of a cell phone or texting are important as well, contributing to this burgeoning public health problem in the United States. Examples include talking to other passengers, adjusting the radio or other controls in the car, and daydreaming. Distracted driving has been linked to increased risk of motor vehicle crashes (MVCs) in the United States, representing one of the most preventable leading causes of death for youth ages 16 to 24 years. Undoubtedly, the proliferation of cell phone, global positioning system (GPS), and other in-vehicle and personal electronic device use while driving has led to this rise in distracted driving prevalence. This behavior has impacted society—including individual and commercial drivers, passengers, pedestrians—in countless numbers of ways, ranging from increased MVCs and deaths to the enactment of new driving laws. In 2016, for example, 20 percent of all US pediatric deaths (nearly 4,000 children and adolescents) were due to fatal MVCs. It has been estimated that at any given time, more than 650,000 drivers are using cell phones or manipulating electronic devices while driving. In the United States, efforts are underway to reduce this driving behavior. In the past two decades, state and federal laws have specifically targeted cell phone use and texting while driving as priority areas for legal intervention. Distracted driving laws have become “strategies of choice” for tackling this public health problem, though their enforcement has emerged as a major challenge and varies by jurisdiction and location. Multimodal interventions using models such as the “three Es” framework—Enactment of a law, Education of the public about the law and safety practices, and Enforcement of the law—have become accepted practice or viewed as necessary steps to successfully change this behavior caused by distractions while driving. This Oxford Bibliographies review introduces these and other aspects (including psychological influences and road conditions) of distracted driving through a presentation of annotated resources from peer- and non-peer-reviewed literature. This selective review aims to provide policymakers, program implementers, and researchers with a reliable source of information on the past and current state of American laws, policies, and priorities for distracted driving.


Author(s):  
Peiyu Li ◽  
Chunsheng Ma ◽  
Kai Zhang ◽  
Longli Shi ◽  
Jinhuan Zhang

This paper investigates the combined effects of specific impact direction and impact location on the serious-to-maximum (AIS3–6) thoracic injuries of drivers in frontal impacts based on the 1995–2009 data from the United States Department of Transportation (US DOT) National Automotive Sampling System/Crashworthiness Data System (NASS/CDS). The selected sample is limited to three impact locations near the driver side (distributed, offset and corner) and two impact directions (pure frontal and oblique) treated as the frontal direction, resulting in a total of six crash configurations. The risks of thoracic injury for drivers in all frontal crash configurations are evaluated. The relative risks with 95% confidence intervals are calculated. Binary logistic regressions are fitted to the datasets for further examination of the effects of impact direction and impact location on the serious-to-maximum thoracic injuries. Occupant characteristics and crash severity are also included as explanatory variables. Overall, impact location and impact direction have considerable influences on thoracic injury pattern and severity for drivers. For distributed and corner deformation, oblique loading is approximately 3 times more likely to lead to thoracic injures than pure frontal loading. Conversely, the relative risk is 3.44 for offset deformation, which indicates that, for this impact location, frontal impact is more associated thoracic injuries compared to oblique impact. The effects of impact location and impact direction on serious-to-maximum injuries for three types of anatomical structures (organ, skeletal and vessel) are assessed as well. In addition to crash related variables (impact location and impact direction), results of the binary logistic regressions also indicate that crash severity (OR, 7.67–81.35) and occupant characteristics, including age (OR, 4.80–20.83), gender (OR, 1.16) and BMI (OR, 1.81), significantly affect the risks of thoracic injuries in frontal motor vehicle collisions.


Author(s):  
Kristofer D. Kusano ◽  
Hampton C. Gabler

Opposite-direction crashes can be extremely severe because opposing vehicles often have high relative speeds. The objective of this study was to characterize the overall frequency of opposite-direction crashes as well as the frequency of crashes involving fatalities and serious injuries. The results of the study will guide future research and investment in infrastructure-based countermeasures to opposite-direction crashes, such as centerline rumble strips. The study used data from the National Automotive Sampling System (NASS) General Estimates System for 2010, the NASS Crashworthiness Data System for 2006 to 2010, and the Fatality Analysis Reporting System for 2010. The most common opposite-direction crash scenario was a driver departing the road driving over the centerline or the road edge to the left, which accounted for only 5% of nonjunction vehicle-to-vehicle crashes but 44% of serious injury and 49% of fatal crashes of the same type. Of the cross-over-to-left crashes, 72% of fatal crashes occurred on rural, undivided, two-lane roads and accounted for 1,659 fatal crashes in 2010. In cross-over-to-left crashes on rural two-lane roads, the driver was going straight or negotiating a curve in 88% to 94% of the crashes. The driver was overtaking another vehicle in only 2% of serious injury crashes and 6% of fatal crashes. Cross-over-to-left crashes on curves were to the outside of the curve more often than to the inside of the curve. This research suggests that countermeasures to opposite-direction crashes should focus on rural two-lane roads.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 967-971
Author(s):  
Poonam Thakre ◽  
Waqar M. Naqvi ◽  
Trupti Deshmukh ◽  
Nikhil Ingole ◽  
Sourabh Deshmukh

The emergence in China of 2019 of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) previously provisionally names 2019-nCoV disease (COVID19) caused major global outbreak and is a major public health problem. On 30 January 2020, the WHO declared COVID19 to be the sixth international public health emergency. This present pandemic has engrossed the globe with a high rate of mortality. As a front line practitioner, physiotherapists are expected to be getting in direct contact with patients infected with the virus. That’s why it is necessary for understanding the many aspects of their role in the identification, contains, reduces and treats the symptoms of this disease. The main presentation is the involvement of respiratory system with symptoms like fever, cough, sore throat, sneezing and characteristics of pneumonia leads to ARDS(Acute respiratory distress syndrome) also land up in multiorgan dysfunction syndrome. This text describes and suggests physiotherapy management of acute COVID-19 patients. It also includes recommendations and guidelines for physiotherapy planning and management. It also covers the guidelines regarding personal care and equipment used for treatment which can be used in the treatment of acute adult patients with suspected or confirmed COVID-19.


2021 ◽  
Vol 13 (9) ◽  
pp. 5096
Author(s):  
Eui-Yul Choi ◽  
Woo Jeong Cho

A personal watercraft (PWC) is a vessel that uses an inboard motor powering a water jet pump as a source of power and is operated by a person sitting, standing, or kneeling. Maneuvering a PWC is different from operating a motor vehicle or boat. An obstacle cannot be avoided by slowing down and turning the watercraft; throttle power is required to turn or maneuver the PWC. The watercraft stops only by drifting or turning sharply. The study examined sixty court decisions published in LexisNexis databases of the United States over the last decade. Cases included individuals injured while operating a PWC as a driver, passenger, or as a result of contact with a watercraft. A content analysis identified items to be used in the study. Crosstab and logistic regression analyses were used to identify demographic information and the characteristics of those who succeeded in a court of law. One-third of the cases were successful; adults, males, and the party who sustained a severe injury were more successful in a court of law with the exception of the statistically significant factors (high risk maneuvers and sharp turns). Among the additional results, we should be aware that insurance companies may not pay; additionally, it is unwise to loan a PWC to a female who has no experience.


2021 ◽  
Vol 30 ◽  
pp. 096368972199621
Author(s):  
Hong-Meng Chuang ◽  
Li-Ing Ho ◽  
Horng-Jyh Harn ◽  
Ching-Ann Liu

COVID-19 has spread worldwide, including the United States, United Kingdom, and Italy, along with its site of origin in China, since 2020. The virus was first found in the Wuhan seafood market at the end of 2019, with a controversial source. The clinical symptoms of COVID-19 include fever, cough, and respiratory tract inflammation, with some severe patients developing an acute and chronic lung injury, such as acute respiratory distress syndrome (ARDS) and pulmonary fibrosis (PF). It has already claimed approximately 300 thousand human lives and the number is still on the rise; the only way to prevent the infection is to be safe till vaccines and reliable treatments develop. In previous studies, the use of mesenchymal stem cells (MSCs) in clinical trials had been proven to be effective in immune modulation and tissue repair promotion; however, their efficacy in treating COVID-19 remains underestimated. Here, we report the findings from past experiences of SARS and MSCs, and how SARS could also induce PF. Such studies may help to understand the rationale for the recent cell-based therapies for COVID-19.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p< 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p< 0.0001) and during non-summer months (OR 2.2, p< 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures


2008 ◽  
Vol 3 (3) ◽  
pp. 189-200 ◽  
Author(s):  
Timothy Schmutte ◽  
Maria O'Connell ◽  
Melissa Weiland ◽  
Samuel Lawless ◽  
Larry Davidson

Preventing suicide has been identified as a national priority by recent commissions in the United States. Despite increased awareness of suicide as a public health problem, suicide in older adults remains a neglected topic in prevention strategies and research. This is especially true regarding elderly White men, who in terms of suicide rates have represented the most at-risk age group for the past half century. In light of the unprecedented aging of the United States as the baby boom generation enters late adulthood, suicide prevention initiatives that focus on aging males are needed to prevent a national crisis in geriatric mental health. This article provides a brief review of the perennially under-recognized reality of suicide in older men and prevention strategies that, if implemented, might help stem this rising tide of suicide in this vulnerable population.


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