Objective: The objective of this study was to discuss the challenges in estimating bicycle helmet effectiveness from case–control studies of injured cyclists and to estimate helmet effectiveness from cases and available exposure data.
Methods: Data were extracted from studies of cyclists in Seattle; Victoria and New South Wales, Australia; and The Netherlands. Estimates of helmet use were used as exposure to compute relative risks for Seattle and Victorian data. Cycling distance data are routinely collected in The Netherlands; however, these data cannot be disaggregated by helmet use, which makes it unsuitable for estimating helmet effectiveness. Alternative controls were identified from larger cohorts for the Seattle and New South Wales cases.
Results: Estimates of helmet effectiveness were similar from odds ratios (ORs) using hospital controls or from relative risks (RRs) using helmet use estimates (Seattle: OR = 0.339, RR = 0.444; Victoria: OR = 0.500, RR = 0.353). Additionally, the odds ratios using hospital controls were similar when controls were taken from a larger cohort for head injury of any severity (Seattle: OR = 0.250, alt OR = 0.257; NSW: OR = 0.446, alt OR = 0.411) and for serious head injury (Seattle: OR = 0.135, alt OR = 0.139; NSW: OR = 0.335, alt OR = 0.308). Although relevant exposure data were unavailable for The Netherlands, the odds ratio for helmet effectiveness of those using racing, mountain, or hybrid bikes was similar to other estimates (OR = 0.371).
Conclusions: Despite potential weaknesses with case–control study designs, the best available evidence suggests that helmet use is an effective measure of reducing cycling head injury. 相似文献
Dissolved oxygen (DO) concentration is regarded as one of the crucial factors to influence partial nitrification process. However, achieving and keeping stable partial nitrification under different DO concentrations were widely reported. The mechanism of DO concentration influencing partial nitrification is still unclear. Therefore, in this study two same sequencing batch reactors (SBRs) cultivated same seeding sludge were built up with real-time control strategy. Different DO concentrations were controlled in SBRs to explore the effect of DO concentration on the long-term stability of partial nitrification process at room temperature. It was discovered that ammonium oxidation rate (AOR) was inhibited when DO concentration decreased from 2.5 to 0.5 mg/L. The abundance of Nitrospira increased from 1011.5 to 1013.7 copies/g DNA, and its relative percentage increased from 0.056% to 3.2% during 190 operational cycles, causing partial nitrification gradually turning into complete nitrification process. However, when DO was 2.5 mg/L the abundance of Nitrospira was stable and AOB was always kept at 1010.7 copies/g DNA. High AOR was maintained, and stable partial nitrification process was kept. Ammonia oxidizing bacteria (AOB) activity was significantly higher than nitrite oxidizing bacteria (NOB) activity at DO of 2.5 mg/L, which was crucial to maintain excellent nitrite accumulation performance. 相似文献