CRASH 2

INTRODUCTION: Screening for chronic kidney disease relies on accurate and precise creatinine measurements. Traditionally, creatinine is measured in serum or plasma using high-throughput chemistry analyzers. However, dried blood spots (DBS) can also be utilized to improve testing access. METHODS: Samples were obtained from a 6 mm DBS punch, which was reconstituted in water before undergoing an acetonitrile crash. The resulting supernatant was diluted using an 80:20 acetonitrile: water before injection...

INTRODUCTION: Treatment-limiting decisions (TLDs) can be inevitable severe traumatic brain injury (s-TBI) patients, but data on their use remain scarce. RESEARCH QUESTION: To investigate the prevalence, timing and considerations of TLDs in s-TBI patients. MATERIAL AND METHODS: s-TBI patients between 2008 and 2017 were analysed retrospecively. Patient data, timing, location, involvement of proxies, and reasons for TLDs were collected. Baseline characteristics and in-hospital outcomes were compared between s-TBI patients with and without TLDs...

The pioneering work of John Barkley Rosser Jr. (1948-2023) in various subfields of economics emphasizes the fact that economic and social phenomena are inherently nonlinear and often discontinuous. From this standpoint, Barkley has contributed substantially to a paradigm shift in economic theory and modelling. Both his influential research work and his unceasing survey work on different approaches and schools of thought in economics and social science, carried out through the lens of complexity theory, have succeeded to develop a broader view on economic thinking and continue to inspire many researchers worldwide...

Background  Carpometacarpal dislocations are rare injuries whose diagnosis is often missed initially. These injuries can be treated conservatively, as long as an anatomical closed reduction is achieved. However, in most cases, open reduction followed by internal or external fixation is necessary to reach a stable anatomical reduction. Case Description  A 32-year-old male was referred to our institution due to excess swelling of his right hand, 2 months after a motorcycle crash he sustained. During our imaging workup, a dorsal carpometacarpal dislocation of all four ulnar metacarpals was found accompanied by a fracture of the base of the fifth metacarpal...

We use a difference-in-differences design to study the effect of opioid use on traffic fatalities. Following Alpert et al., we focus on the 1996 introduction and marketing of OxyContin, and we examine its long-term impacts on traffic fatalities involving Schedule II drugs or heroin. Based on the national fatal vehicle crash database, we find that the states heavily targeted by the initial marketing of OxyContin (i.e., non-triplicate states) experienced 2.4 times more traffic fatalities (1.6 additional deaths per million individuals) involving Schedule II drugs or heroin during 2011-2019, when overdose deaths from heroin and fentanyl became more prominent...

In this article we contemplate the dynamics of an additional food-provided prey-predator system. We assume that the behavior of cooperative predators induces fear in prey, which radically affects the prey's birth and death rates. We observe that the structural instability imposed by strong cooperative hunting among predators goes away with higher intensities of fear levels affecting the prey's reproductive output and mortality. High levels of prey refuge are not conducive to the survival of predators. In such a situation, adequate supply of high-quality additional food is favorable regarding the persistence and stability of the system...

OBJECTIVE: The International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) and Corticosteroid Randomization After Significant Head Injury (CRASH) prognostic models for mortality and outcome after traumatic brain injury (TBI) were developed using data from 1984 to 2004. This study examined IMPACT and CRASH model performances in a contemporary cohort of US patients. METHODS: The prospective 18-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study (enrollment years 2014-2018) enrolled subjects aged ≥ 17 years who presented to level I trauma centers and received head CT within 24 hours of TBI...

Background: Information on recent alcohol-related non-fatal motor vehicle crash (MVC) injuries is limited. Objectives: To analyze alcohol-related non-fatal MVC injuries, 2019-2022, considering COVID-19 and Stay-at-Home policies. Methods: State-level counts of alcohol-related non-fatal MVC injuries (involving individuals age 15+) from Emergency Medical Services data in 18 US states, chosen for comprehensive coverage, were analyzed for the annual rate. The total non-fatal MVC injury count in each state served as the denominator...

INTRODUCTION: This article addresses the impact of policy measures on the number of alcohol-related crashes and fatalities in European Union countries. In particular, it assesses (1) whether mild or severe penalty measures should be used to reduce the number of crashes and fatalities caused by alcohol; and (2) whether alcoholic beverages should be treated differently or proportionally to their alcohol content. METHODS: This study analyzed the number of alcohol-related crashes and fatalities in 24 European Union countries between 2002 and 2014...

INTRODUCTION: Speed is a primary contributing factor in teenage driver crashes. Yet, there are significant methodological challenges in measuring real-world speeding behavior. METHOD: This case study approach analyzed naturalistic driving data for six teenage drivers in a longitudinal study that spanned the learner and early independent driving stages of licensure in Maryland, United States. Trip duration, travel speed and length were recorded using global position system (GPS) data...

OBJECTIVE: The history of airbags for occupant protection in frontal crashes is reviewed from the perspective of a former Senior Executive at NHTSA from the early 1970's to the late 1980's. This paper summarizes the factors that led to regulatory delays as well as those that led to voluntary adoption of airbags by several manufacturers. METHODS: The regulatory history and interactions with airbag suppliers and vehicle manufactures is recounted citing key steps in the evolution of frontal airbags...

OBJECTIVES:  Investigating patterns among the outcomes of patients involved in motor vehicle accidents (MVAs) can provide information necessary to guide targeted interventions to improve road traffic safety. Our purpose is to identify any differences between passenger and driver injury severity and overall clinical course after MVAs. METHODS:  We performed a retrospective review and analysis of 3,693 patients involved in MVAs from 2016 to 2021. We divided the data into two groups, drivers and passengers, and compared the Injury Severity Score (ISS), Revised Trauma Score (RTS) on admission, days in the Intensive Care Unit (ICU), length of hospital stay (LOS), post Emergency Department (ED) disposition, discharge (DC) disposition, and signs of life on arrival (SOLA) to the ED...

Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3...

OBJECTIVE: Examine patterns and predictors of skill learning during multisession Enhanced FO rward C oncentration and A ttention L earning (FOCAL+) training. BACKGROUND: FOCAL+ teaches teens to reduce the duration of off-road glances using real-time error learning. In a randomized controlled trial, teens with ADHD received five sessions of FOCAL+ training and demonstrated significant reductions in extended glances (>2-s) away from the roadway (i.e., long-glances) and a 40% reduced risk of a crash/near-crash event...

BACKGROUND: In small US communities, golf cart utilization has become increasingly more common. In the past 3 years, the incidence and severity of pediatric golf cart-related trauma evaluated at our trauma center has noticeably increased. Thus, the aim of this study was to analyze trends, identify risk and protective factors, and provide community-level recommendations to improve golf cart safety for children in a coastal community. METHODS: A retrospective cross-sectional study of our institutional trauma registry was performed...

BACKGROUND: Paediatric vehicular hyperthermia (PVH) is the leading cause of non-crash vehicle-related death of children in the USA. Public health messaging is an important mitigation strategy, yet it is difficult to assess the effectiveness in reducing deaths. Here, we seek to better understand parent/caregiver perceptions on PVH to guide risk communication. METHODS: This pilot study focuses on a subset of participants (n=127) from a national survey, comprising parents/caregivers who met specific eligibility criteria (ie, those who both drive and have children ≤5 years of age)...

The assumption of reduced human error-related crashes with increasing levels of automation in pursuing Level 5 automation lacks empirical evidence. As automation levels rise, human error-induced safety hazards are anticipated to decrease, while machine error-induced hazards will increase. However, a quantitative index capturing this tradeoff is absent. Additionally, theoretical modeling of safety improvements during the transition to automated driving remains unexplored, particularly concerning reducing human error-related hazards...

OBJECTIVE: The objective of this paper is to provide a history of the National Highway Traffic Safety Administration's (NHTSA's) extensive efforts of incorporating advanced airbag technology capability beyond that available in first-generation airbag systems into FMVSS No. 208. METHODS: In the paper, NHTSA's actions and their collaborative efforts with automakers, automaker suppliers, insurance industry, academia, and other Federal agencies were reviewed, and the key efforts have been highlighted...

Heavy commercial vehicles (HCVs) face elevated crash risks in mountainous terrains due to the challenging topography and intricate geometry, posing a significant challenge for transportation agencies in mitigating these risks. While safety studies in such terrains traditionally rely on historical crash data, the inherent issues associated with crash data have led to a shift towards proactive safety studies using surrogate safety measures (SSM) in recent years. However, the scarcity of accurate microscopic data related to HCV drivers has limited the application of proactive safety studies in mountainous terrains...

The PbGA-DDPG algorithm, which uses a potential-based GA-optimized reward shaping function, is a versatiledeep reinforcement learning/DRLagent that can control a vehicle in a complex environment without prior knowledge. However, when compared to an established deterministic controller, it consistently falls short in terms of landing distance accuracy. To address this issue, the HYDESTOC Hybrid Deterministic-Stochastic (a combination of DDPG/deep deterministic policy gradient and PID/proportional-integral-derivative) algorithm was introduced to improve terminal distance accuracy while keeping propellant consumption low...