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Methods: 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.
Results: 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.
Conclusion: 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. 相似文献
Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P0), 1–4 weeks after the completion of project implementation (P1), and 4–5 months later (P2). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.
The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.
The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.
Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P0 and P1 (P0 = 4.8%, P1 = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P2 time period (P2 = 25.7%; P < .001, for P0 vs. P2) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P0 time period and compared to the comparison schools.
Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings. 相似文献
Methods: A Belleville desert combat boot model was assigned contacts and material properties based on previous experiments. The boot model was fit to a previously developed model of the barefoot ATD. Validation was performed through 6 matched pair component tests conducted on the Vertically Accelerated Loads Transfer System (VALTS). The load transfer capabilities of the FE model were assessed along with the force-mitigating properties of the boot. The booted lower limb subassembly was then incorporated into a whole-body model of the ATD. Two whole-body VALTS experiments were simulated to evaluate lower limb performance in the whole body.
Results: The lower limb model accurately predicted axial loads measured at heel, tibia, and knee load cells during matched pair component tests. Forces in booted simulations were compared to unbooted simulations and an amount of mitigation similar to that of experiments was observed. In a whole-body loading environment, the model kinematics match those recorded in experiments. The shape and magnitude of experimental force–time curves were accurately predicted by the model. Correlation between the experiments and simulations was backed up by high objective rating scores for all experiments.
Conclusion: The booted lower limb model is accurate in its ability to articulate and transfer loads similar to the physical dummy in simulated underbody loading experiments. The performance of the model leads to the recommendation to use it appropriately as an alternative to costly ATD experiments. 相似文献
Method: Crashes of modern vehicles from GIDAS (German In-Depth Accident Study) were used as the basis for the construction of a logistic injury risk model. Static deformation, measured via displaced voxels on the postcrash vehicles, was used to calculate the energy dissipated in the crash. This measure of accident severity was termed objective equivalent speed (oEES) because it does not depend on the accident reconstruction and thus eliminates reconstruction biases like impact direction and vehicle model year. Imputation from property damage cases was used to describe underrepresented low-severity crashes―a known shortcoming of GIDAS. Binary logistic regression was used to relate the stimuli (oEES) to the binary outcome variable (injured or not injured).
Results: IRFs for the oblique frontal impact and nonoblique frontal impact were computed for the Maximum Abbreviated Injury Scale (MAIS) 2+ and 3+ levels for adults (18–64 years). For a given stimulus, the probability of injury for a belted driver was higher in oblique crashes than in nonoblique frontal crashes. For the 25% injury risk at MAIS 2+ level, the corresponding stimulus for oblique crashes was 40 km/h but it was 64 km/h for nonoblique frontal crashes.
Conclusions: The risk of obtaining MAIS 2+ injuries is significantly higher in oblique crashes than in nonoblique crashes. In the real world, most MAIS 2+ injuries occur in an oEES range from 30 to 60 km/h. 相似文献
Methods: The AM50 THUMS PFEM was used as the baseline model, and 2 morphed PFEM were created to the anthropometric specifications of 2 obese PMHS used in a previous pedestrian impact study with a mid-size sedan. The same measurements as those obtained during the PMHS tests were calculated from the simulations (kinematics, accelerations, strains), and biofidelity metrics based on signals correlation (correlation and analysis, CORA) were established to compare the response of the models to the experiments. Injury outcomes were predicted deterministically (through strain-based threshold) and probabilistically (with injury risk functions) and compared with the injuries reported in the necropsy.
Results: The baseline model could not accurately capture all aspects of the PMHS kinematics, strain, and injury risks, whereas the morphed models reproduced biofidelic response in terms of trajectory (CORA score = 0.927 ± 0.092), velocities (0.975 ± 0.027), accelerations (0.862 ± 0.072), and strains (0.707 ± 0.143). The personalized THUMS models also generally predicted injuries consistent with those identified during posttest autopsy.
Conclusions: The study highlights the need to control for pedestrian anthropometry when validating pedestrian human body models against PMHS data. The information provided in the current study could be useful for improving model biofidelity for vehicle–pedestrian impact scenarios. 相似文献