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Author(s):  
Tim Nutbeam ◽  
Rob Fenwick ◽  
Barbara May ◽  
Willem Stassen ◽  
Jason E. Smith ◽  
...  

Abstract Background Motor vehicle collisions are a common cause of death and serious injury. Many casualties will remain in their vehicle following a collision. Trapped patients have more injuries and are more likely to die than their untrapped counterparts. Current extrication methods are time consuming and have a focus on movement minimisation and mitigation. The optimal extrication strategy and the effect this extrication method has on spinal movement is unknown. The aim of this study was to evaluate the movement at the cervical and lumbar spine for four commonly utilised extrication techniques. Methods Biomechanical data was collected using inertial Measurement Units on 6 healthy volunteers. The extrication types examined were: roof removal, b-post rip, rapid removal and self-extrication. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement (travel), maximal movement, mean, standard deviation and confidence intervals are reported for each extrication type. Results Data from a total of 230 extrications were collected for analysis. The smallest maximal and total movement (travel) were seen when the volunteer self-extricated (AP max = 2.6 mm, travel 4.9 mm). The largest maximal movement and travel were seen in rapid extrication extricated (AP max = 6.21 mm, travel 20.51 mm). The differences between self-extrication and all other methods were significant (p < 0.001), small non-significant differences existed between roof removal, b-post rip and rapid removal. Self-extrication was significantly quicker than the other extrication methods (mean 6.4 s). Conclusions In healthy volunteers, self-extrication is associated with the smallest spinal movement and the fastest time to complete extrication. Rapid, B-post rip and roof off extrication types are all associated with similar movements and time to extrication in prepared vehicles.


2021 ◽  
Vol 14 (1) ◽  
pp. 138
Author(s):  
Brendan Lawrence ◽  
Brian Fildes ◽  
Peter Cairney ◽  
Stephanie Davy ◽  
Amir Sobhani

A Raised Safety Platform (RSP) is a relatively new physical road safety intervention at major intersections. They aim to enhance road user safety by reducing vehicle speeds at intersections using an acute vertical deflection to the vehicle path. This study measured the change in speed at selected high-volume intersections treated with an RSP. It was a 12-month study based on a controlled before-and-after-treatment design, with speed and other measures assessed at six treated and five control intersections. Statistically significant and meaningful reductions in speeds were observed given the treatment and adjusted for the control group. A 15.6% reduction in the central tendency of speed was found overall. The odds of a vehicle exceeding nominal Safe System speeds of 30 km/h, 40 km/h, and 50 km/h also reduced markedly, with greater reductions observed at the higher speed thresholds (46%, 69%, and 80%, respectively). The change in speed corresponded to an estimated aggregate-level injurious crash-reduction benefit of around 26% and a reduction in the likelihood of a serious injury given a crash of between 38% to 57% depending on the crash type. It was concluded that RSP is an effective Safe System treatment to reduce speeds at major intersections to levels similar that at roundabouts. The results suggest that well designed RSPs at signalised intersections are an effective and sustainable Safe System treatment.


Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 54
Author(s):  
Barry R. Greene ◽  
Isabella Premoli ◽  
Killian McManus ◽  
Denise McGrath ◽  
Brian Caulfield

People with Parkinson’s disease (PD) experience significant impairments to gait and balance; as a result, the rate of falls in people with Parkinson’s disease is much greater than that of the general population. Falls can have a catastrophic impact on quality of life, often resulting in serious injury and even death. The number (or rate) of falls is often used as a primary outcome in clinical trials on PD. However, falls data can be unreliable, expensive and time-consuming to collect. We sought to validate and test a novel digital biomarker for PD that uses wearable sensor data obtained during the Timed Up and Go (TUG) test to predict the number of falls that will be experienced by a person with PD. Three datasets, containing a total of 1057 (671 female) participants, including 71 previously diagnosed with PD, were included in the analysis. Two statistical approaches were considered in predicting falls counts: the first based on a previously reported falls risk assessment algorithm, and the second based on elastic net and ensemble regression models. A predictive model for falls counts in PD showed a mean R2 value of 0.43, mean error of 0.42 and a mean correlation of 30% when the results were averaged across two independent sets of PD data. The results also suggest a strong association between falls counts and a previously reported inertial sensor-based falls risk estimate. In addition, significant associations were observed between falls counts and a number of individual gait and mobility parameters. Our preliminary research suggests that the falls counts predicted from the inertial sensor data obtained during a simple walking task have the potential to be developed as a novel digital biomarker for PD, and this deserves further validation in the targeted clinical population.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 448-448
Author(s):  
Stacey Schepens Niemiec ◽  
Cheryl Vigen ◽  
Jeanine Blanchard ◽  
Matthew Niemiec ◽  
Brittany Eng

Abstract Falls in older adults have significant consequences—a single fall can lead to serious injury, psychological trauma, activity restriction, and increased mortality. This study describes differences in mobility-related characteristics of underactive (&lt;150 minutes/week of physical activity), racially diverse, older adults (65–84 years) classified by self-reported fall status (0, 1, 2+ falls in previous 12mo) and fear of falling (yes/no). We analyzed baseline data from 105 individuals (mean age=72.1 years; 73% female; 64% white, 29% Black, 12% Asian) who participated in a trial of a physical activity smartphone intervention for older people. Total minutes of daily stepping and medium-to-brisk (≥75 steps/min) and brisk (≥100) cadence bouts in free-living conditions was gathered over 3 days via ActivPal activity monitor. Gait speed was determined from a 4-meter walk test for those pretested prior to COVID-19 mandates (n=60). Of the median 81.8 minutes spent stepping daily, very few minutes involved moderate-to-brisk (14.0) or brisk cadence (10.1). Groups classified by fall status (non-fallers n=74, 1x fallers n=18, repeat fallers n=13) differed significantly in daily minutes spent in medium-to-brisk (p=0.04) and brisk cadence (p=0.02), but not in 4-meter gait speed or total minutes stepping. Individuals who reported fear of falling versus those with no fear did not differ significantly on any mobility-related parameters. Four-meter gait speed was significantly negatively correlated with both cadence measures (p=0.02) but not total minutes stepping. This study indicates that faster walking behaviors in everyday activity may be a useful target for intervention to prevent falls in underactive older adults.


2021 ◽  
Vol 8 (S2) ◽  
Author(s):  
Kyle M. Knight

Abstract Background Although falls are common and can cause serious injury to older adults, many health care facilities do not have falls prevention resources available. Falls prevention resources can reduce injury and mortality rates. Using the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) model, a falls risk clinic was implemented in a rural Indian Health Service (IHS) facility. Methods A Fall Risk Questionnaire was created and implemented into the Provider’s Electronic Health Records system interface to streamline provider screening and referral of patients who may be at risk for falls to a group falls risk reduction class. Results Participants exhibited average improvements in the Timed Up and Go (6.8 s) (P = 0.0001), Five-Time Sit-to-Stand (5.1 s) (P = 0.0002), and Functional Reach (3.6 inches) (P = 1.0) tests as compared to their own baseline. Results were analyzed via paired t test. 71% of participants advanced out of an “increased risk for falls” category in at least one outcome measure. Of the participants to complete the clinic, all were successfully contacted and three (18%) reported one or more falls at the 90-day mark, of which one (6%) required a visit to the Emergency Department but did not require hospital admission. Conclusions In regards to reducing falls in the community, per the CDC STEADI model, an integrated approach is best. All clinicians can play a part in reducing elder falls.


2021 ◽  
Vol 2 (2) ◽  
pp. 118-123
Author(s):  
Muhammad Husnul Khuluqi ◽  
Meily L Kurniawidjaja

The study aimed to determine epidemiological characteristics of road traffic accidents in Japan during the year 2010-2019. A cross-sectional descriptive study depended on a retrospective analysis of road traffic accident data that were obtained from the National Police Agency (NPA) for the years 2010 – 2019 in Japan. The relationship of road traffic accident consequences as dependent variables with age, road user type, helmet, and seatbelt use as independent variables during the studied years was analyzed with Chi-square test. The case fatality rate has been declining every year from 3.88 in 2010 to 2.54 per 100,000 persons. More than half of fatality cases have occurred among the elderly. There was a statistically significant relationship between road user type and accident severities. 36.21% fatality occurred in pedestrians. Otherwise, 27.61% of motor vehicle occupants were dominant in serious injury cases and 66.87% in slight injury cases. Most of the casualties revealed for fatality cases were in the head, whereas the leg part was dominant in serious injury cases and the neck region was raised in slight injuries. There was a significant relationship between the use of helmets and seat belt use with casualties of road traffic accidents. There was a declined trend of road traffic accidents in Japan during 10 years of study. The result of the epidemiological study could be a valid consideration for the design of road safety policy in the future.


2021 ◽  
Author(s):  
Tim Nutbeam ◽  
Rob Fenwick ◽  
Barbara May ◽  
Willem Stassen ◽  
Jason Smith ◽  
...  

Abstract BackgroundMotor vehicle collisions are a common cause of death and serious injury. Many casualties will remain in their vehicle following a collision. Trapped patients have more injuries and are more likely to die than their untrapped counterparts. Current extrication methods are time consuming and have a focus on movement minimisation and mitigation. The optimal extrication strategy and the effect this extrication method has on spinal movement is unknown. The aim of this study was to evaluate the movement at the cervical and lumbar spine for four commonly utilised extrication techniques. MethodsBiomechanical data was collected using inertial Measurement Units on 6 healthy volunteers. The extrication types examined were: roof removal, b-post rip, rapid removal and self-extrication. Measurements were recorded at the cervical and lumbar spine, and in the anteroposterior (AP) and lateral (LAT) planes. Total movement (travel), maximal movement, mean, standard deviation and confidence intervals are reported for each extrication type.ResultsData from a total of 230 extrications were collected for analysis. The smallest maximal and total movement (travel) were seen when the volunteer self-extricated (AP max = 2.6mm, travel 4.9mm). The largest maximal movement and travel were seen in rapid extrication extricated (AP max = 6.21mm, travel 20.51 mm). The differences between self-extrication and all other methods were significant (p<0.001), small non-significant differences existed between roof removal, b-post rip and rapid removal.Self-extrication was significantly quicker than the other extrication methods (mean 6.4s).ConclusionsIn healthy volunteers, self-extrication is associated with the smallest spinal movement and the fastest time to complete extrication. Rapid, B-post rip and roof off extrication types are all associated with similar movements and time to extrication in prepared vehicles.


2021 ◽  
Vol 2 ◽  
Author(s):  
Rikard Fredriksson ◽  
Michael G. Lenné ◽  
Sjef van Montfort ◽  
Colin Grover

Driver distraction and drowsiness remain significant contributors to death and serious injury on our roads and are long standing issues in road safety strategies around the world. With developments in automotive technology, including driver monitoring, there are now more options available for automotive manufactures to mitigate risks associated with driver state. Such developments in Occupant Status Monitoring (OSM) are being incorporated into the European New Car Assessment Programme (Euro NCAP) Safety Assist protocols. The requirements for OSM technologies are discussed along two dimensions: detection difficulty and behavioral complexity. More capable solutions will be able to provide higher levels of system availability, being the proportion of time a system could provide protection to the driver, and will be able to capture a greater proportion of complex real-word driver behavior. The testing approach could initially propose testing using both a dossier of evidence provided by the Original Equipment Manufacturer (OEM) alongside selected use of track testing. More capable systems will not rely only on warning strategies but will also include intervention strategies when a driver is not attentive. The roadmap for future OSM protocol development could consider a range of known and emerging safety risks including driving while intoxicated by alcohol or drugs, cognitive distraction, and the driver engagement requirements for supervision and take-over performance with assisted and automated driving features.


2021 ◽  
Author(s):  
Xiaxin Tao ◽  
Zhengru Tao ◽  
Liyuan Wang ◽  
Ming Zhang

The PSHA map must be tested, since hypothesis testing is the heart of a scientific method, and it is inappropriate to adopt the map as the basis of seismic fortification in whole country without any test. Two paths of testing are suggested in this paper. The test result by counting up positive intensity difference shows that up to 2015 the percentages of total underestimation areas on 1990 and 2001 maps of China are equivalences of 5.6% and 6.0% in 50 years, both less than the exceeding probability 10% adopted in the map compiling procedure. The result of a case study of the common buildings with brick-concrete structure and frame structure in Sichuan region by evaluating the benefit of seismic fortification according to the two maps shows that the PSHA maps contribute benefits as economic loss reduction 67.9 and 79.7 billion RMB, death reduction 19439 and 17504 persons, and serious injury reduction 42632 and 37700 persons respectively during 2008 great Wenchuan Earthquake.


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