Epidemiologic study of traffic crash mortality among motorcycle users in Iran (2011-2017)

Extremity Injuries in Pillion Riders of Fatal 2-Wheeler Road Traffic Accidents: An Autopsy-Based Study

ABSTRACT

The extremities are the important anatomical regions that are disproportionately injured during road traffic accidents in poor and medium-income countries. The data regarding extremity injuries, particularly in pillion passengers, are minimal globally. We analyzed the pattern of extremity injuries and their association with various parameters such as collision type, seating position, road type, and type of vehicle. This was a hospital-based cross-sectional study. The pillion riders of fatal motorized 2-wheeler road accident cases that were subjected to autopsy were studied over a period of 2 years. We analyzed 73 cases of pillion riders. Females (60%) were the most commonly affected group. The upper extremities were injured in 55 cases (75.3%) and the lower extremities in 49 cases (67.1%). The shoulder (41%), hand (31.3%), and elbow (23.2%) were the predominantly injured anatomical regions of the upper limb. In the lower extremity, knee (41%) and foot (21.9%) were mostly affected. Forty-nine (67.1%) and 48 (65.8%) cases had abrasions in the upper limbs and lower limbs, respectively, followed by lacerations and contusions. Upper extremity injuries are more common compared with lower extremity. The majority of the pillion riders were seated in a side-saddle position, and self-fall from the bike without any collision with other vehicles was the most common mode of injury. Thus, appropriate seating posture with safety gear can be used to reduce extremity injuries.

Overview of road traffic injuries among migrant workers in Guangzhou, China, from 2017 to 2021

INTRODUCTION

There are many migrant workers in China's first-tier cities, but little is known about road safety. This paper systematically analysed road traffic injuries and risk factors among migrant workers in Guangzhou, China.

METHODS

Road traffic crash data from 2017 to 2021 were obtained from the Guangzhou Public Security Traffic Management Integrated System. We plotted the crash network of road users in road traffic crashes and used logistic regression to analyse the risk factors for migrant workers of motorcycle and four-wheeled vehicle crashes. Moreover, the roles of migrant workers and control individuals as perpetrators in road traffic crashes were also analysed.

RESULTS

Between 2017 and 2021, 76% of road traffic injuries were migrant workers in Guangzhou. Migrant workers who were motorcyclist drivers most commonly experienced road traffic injuries. Crashes between motorcyclists and car occupants were the most common. The illegal behaviours of migrant worker motorcyclists were closely related to casualties, with driving without a licence only and driving without a licence and drunk driving accounting for the greatest number. Migrant workers were responsible for many injuries of other road users. Motorcycle drivers have a higher proportion of drunk driving.

DISCUSSION

Migrant workers play an important role in road traffic safety. They were both the leading source of road traffic injuries and the main perpetrators of road traffic crashes. Measures such as strict requirements for migrant workers to drive motorcycles with licences, prohibit drunk driving, greater publicity of road safety regulations, and combining compulsory education with punishment for illegal behaviours.

Fatal motorcycle straddle injury consolidated with traumatic testicular dislocation: A case report

Straddle injuries are those to the perineum region brought on by straddling or riding over something, such as a horse, vehicle, or other object. The motorcycle fuel tank or handlebars are primarily responsible for the typical injury to the perineum area in motorcycle accidents. Motorcycle straddle injury usually manifest as abrasions to the scrotum or penis, and severe cases can cause pelvic fractures or even testicular dislocation. Because these injuries are usually closed with unclear internal damage, diagnosis presents a significant challenge and can easily lead to misdiagnosis. However, pelvic fractures and the bleeding and nerve damage associated with perineal injury are often fatal, and testicular dislocation can also have serious consequences for patients. Therefore, a clear diagnosis and timely treatment are crucial for patients with this type of injury. This article reports the case of a motorcycle rider who died 4 h after a traffic accident with only minor surface injury visible, showing only bruising in the waist and scrotum. A forensic examination revealed multiple fractures throughout the patient's body, with a slightly more severe pelvic fracture and testicular dislocation on the left side in the left inguinal area. This article analyzes the cause of death and related issues in this case, aiming to provide assistance to clinical physicians and forensic practitioners and to emphasize the importance of handling straddle injury in treatment and related investigations to avoid serious consequences.

Epidemiological characteristics of crashes and pattern of motorcycle injuries presenting to hospitals in Kisumu City, Kenya: a cross-sectional study

Introduction

motorcycle injuries comprise considerable morbidity, disability and mortality of road traffic casualties. The study aimed to assess the pattern and characteristics of motorcycle crash injuries that sought care at the Emergency Departments in Tier III hospitals in Kisumu City during a six-month period from May to November 2019.

Methods

this was a cross-sectional study of all motorcycle injury patients presenting to three tier III public and private hospitals in Kisumu City. Using a structured questionnaire, data were collected on human and injury characteristics. Multiple logistic regression model was used to determine the predictors of fatality. Statistical significance was set at p<0.05.

Results

a total of 1073 of motorcycle crash injury patients sought and obtained care at the hospitals. The majority (73.6%) were males. Seventy-three cases resulted in death (case-fatality rate of 6.80%. The age range was 2-84 years, with a mean of 29.6 years (± SD 12.19). Majority, (43.3%) were aged 21-30 years. Most of the crashes occurred during the daytime (79.1%). Of all motorcycle riders and pillion passengers 30.6% wore helmets at the time of the crash. Head injuries (43.6%) were the most common. Injury seventy scores (ISS) ranged from 1 to 51. Glasgow comma scale <3, un-helmeted patients and major trauma (ISS > 16), significantly influenced mortality (P< 0.001).

Conclusion

these findings confirmed and strengthened the documented substantial morbidity, mortality that motorcycle crashes place on individuals and society, contribute to the body of literature on motorcycle injuries and potentially assist in policy decisions on motorcycle transport safety.

Over 30-year retrospective analyses of moped-motorcycle fatal road accidents in the northern area of the Italian region of Emilia Romagna and review of the literature: Aiming for further preventive measures in the future

Road traffic injuries are a major cause of morbidity and mortality worldwide, with pedestrians and riders of two-wheeled motor vehicles being the most vulnerable. The present study aims to determine the epidemiological characteristics of fatal motorcycle crashes in a portion of the Italian region of Emilia Romagna, and to compare them with the data available in literature. Data were retrieved from autopsy reports on 350 subjects who died following road accidents involving moped or motorcycle in the cities of Parma, Piacenza, and Reggio Emilia. Two types of data were extrapolated: circumstantial and traumatological. The population was divided into subgroups according to gender, crash time, alcohol positivity, presence or absence of the helmet, and the period elapsed between the accident and death. Most of the considered road accidents occurred during the day and on weekends. 25.5 % of the victims tested positive for alcohol. As far as traumas are concerned, the limbs resulted to be the most affected body segment, followed by the head (87.4 %), the thorax (85.7 %), the abdomen (65.7 %), and lastly the neck (50.3 %). According to similar studies, the sample victim of a moped/ motorcycle accident is a young male subject. The results obtained allow us to demonstrate that the mandatory use of the helmet has reduced skull and brain injury over the years. At present, no law regulates the use of protections for other body parts. Regulatory interventions in this sense would be desirable given the ever more rapid technical evolutions in the field of motorcycles.

Tendência da taxa de mortalidade por acidentes de trânsito entre motociclistas no estado de São Paulo, Brasil, de 2015 a 2020

RESUMO Objetivo: Avaliar a tendência da taxa de mortalidade de motociclistas decorrentes de lesões por acidentes de trânsito no estado de São Paulo, Brasil, nos anos de 2015 a 2020. Métodos: Estudo ecológico de delineamento de série temporal com dados secundários provenientes do Sistema de Informações Gerenciais de Acidentes de Trânsito do Estado de São Paulo (INFOSIGA), referentes aos óbitos de motociclistas decorrentes de lesões por acidentes de trânsito no estado de São Paulo, de 2015 a 2020. A variação percentual anual foi calculada pelo modelo de regressão de Prais-Winsten, utilizando o programa STATA 14.0. Resultados: Foram notificados 11.343 óbitos de motociclistas resultantes de lesões por acidentes de trânsito. A maior proporção de óbitos ocorreu entre indivíduos do sexo masculino (88,1%), entre 18 e 24 anos de idade (27,9%), nas duas regiões mais populosas e urbanizadas do estado. A distribuição da taxa de mortalidade apresentou mínima variação no período analisado, de 4,22 a 4,42 óbitos/100 mil habitantes. Entre as variáveis sociodemográficas analisadas, a tendência da mortalidade de motociclistas foi estacionária em sua maioria. Conclusão: A análise da taxa de mortalidade de motociclistas decorrentes de lesões por acidentes de trânsito no estado de São Paulo apresentou tendência estacionária.

Self-reported Motorcycle Riding Behavior in Southeast of Iran

Background: Motorcyclists are among the greatest vulnerable individuals of road accident victims. Their behavior has a significant correlation with increased injury and mortality rate. Determining the risky and unsafe behaviors of motorcycle drivers is necessary for preventing riders and other citizen from potential accident risks. Objectives: The aim of this study was to determine the risky driving behaviors of motorcyclists in Iran. Methods: A cross-sectional study was done in 2019 in Sistan and Baluchestan Province as the second widest province of Iran. Using randomized sampling method, we included 613 motorcyclists from the province. To collect data, the Persian version of Motorcycle Riding Behavior Questionnaire (MRBQ), as a standard questionnaire, was used. For data analysis, descriptive and analytical statistics such as one-way analysis of variance (ANOVA), t-test, and linear regression were used by SPSS software version 21. Results: The age range of 57% of the motor riders was 15 - 30 years, and 50% of them did not use any safety equipment. About 58% of the subjects had started motorcycle riding under 18 years old, and 73% of them did not have a motorcycle riding license. Moreover, more than 50% of motorcyclists used mobile phones while driving. The mean score of driving behavior (106 ± 22) was desirable. Based on multivariate analysis, job, average amount of riding, lacking a riding license, type of motor, alert from police, non-fasting helmet band, exceeding speed limits, fatigue, and hand-free riding were the main predictors of risky riding score (P < 0.05). Conclusions: According to our results, the riding behavior of motorcyclists was desirable; however, many people used motorcycles without a license and safety equipment, which increases high-risk behaviors. Considering the potential dangers of motor riders, it seems necessary to hold training courses to obtain motorcycle certification and how to use safety equipment.

Tissue engineering of mouse uterus using menstrual blood stem cells (MenSCs) and decellularized uterine scaffold

Background

Uterine tissue engineering can provide the opportunity for curing female infertility. Natural scaffold is a good choice to recapitulate the architecture and functionality of the native tissue. In this study, we purposed the potential of uterine decellularized scaffolds as an adequate natural niche for MenSCs differentiation toward uterus-specific cell lineages.

Methods

Mouse’s uterus was decellularized by immersion of hypo and hypertonic salts or freeze–thaw cycle followed by immersion in Triton X-100 and SDS solutions. MenSCs were isolated from the menstrual blood of 6 healthy women. The decellularized and recellularized samples were prepared for further in vitro and in vivo analyses.

Results

Histochemical studies and Raman spectroscopy revealed uterine ECM was preserved well, and the cells were completely removed after decellularization. Scanning electron microscopy (SEM) showed that the 3D ultrastructure of the uterus remained intact. Flowcytometric examination with CD34, CD44, CD105, CD106, CD144 markers revealed stem cell characters of cells that isolated from menstrual blood. MTT assay confirmed the bioavailability of MenSCs cultured scaffolds after 7 and 10 days.

Conclusion

Histochemical studies, SEM images, and Raman spectra showed MenSCs seeded and growth in uterine scaffolds. Immunostaining using anti-cytokeratin (CK), anti-desmin (Des), anti-vimentin (Vim), and anti-smooth muscle actin (SMA) antibodies showed MenSCs differentiation to epithelial and smooth muscle tissues. The Raman spectroscopy revealed the extracellular matrix (ECM) of decellularized uterine scaffolds was well preserved. The decellularized uterus can be considered a promising vehicle to support cell transplantation and differentiation. MenSCs are a good choice for uterine tissue engineering. The complete decellularization from mice uterine tissue was done by combining chemical agents

Comparing the Severity of Injury and Trauma Pattern between Scooter and Street Motorcycle Riders; a Prospective Cohort Study

Introduction:

The popularity of motorcycle riding in Iran is increasing. However, there is a lack of information about the safety of different motorcycle types. This study aimed to compare the severity of injury and trauma pattern between scooter (vespa) and street (standard) motorcycle riders.

Method:

In a prospective cohort study, a comparison of demographics, injury severity, trauma pattern, and clinical characteristics between 324 riders (162 Vespa and 162 standard motorcycles) admitted to emergency departments was undertaken. The risk factors associated with severe injuries in the two groups were also determined. An emergency medicine specialist determined the severity of trauma based on the abbreviated injury scale (AIS).

Results:

The Odds Ratio (OR) of severe injuries was significantly higher in the standard motorcycle riders’ group (OR: 3.09; 95% CI: 1.9-4.21; p: 0.013). The frequency of lower extremity fractures was significantly lower in the Vespa group (OR: 4.11; 95% CI: 2.01-6.25; p = 0.012). The frequency of admission to the intensive care unit was significantly higher in the standard motorbike riders’ group (OR: 1.64; 95% CI: 1.11-2.51; p = 0.033). The multivariate analysis indicated that motorcycle type, the speed at the time of the accident, use of helmet, and age of riders are the most important predictors of trauma severity in riders (p<0.05).

Conclusion:

The pattern of injury varies between standard and Vespa motorcycles. The standard motorcycle riders were prone to a higher risk of adverse outcomes such as severe injuries. Due to the particular structure of scooters, the rate of lower limb injuries was significantly lower than standard motorcycles.