Analysis of road traffic accidents and casualties associated with electric bikes and bicycles in Guangzhou, China: A retrospective descriptive analysis.

Introduction: Electric bicycles (e-bikes) and bicycles in large Chinese cities have recently witnessed substantial growth in ridership. According to related accident trends, this study analyzed characteristics and spatial distribution in the period when e-bike-related accidents rapidly increased to propose priority measures to reduce accident casualties. Methods: For e-bike- and bicycle-related accident data from the Guangzhou Public Security Traffic Management Integrated System, linear regression was used to examine the trends in the number of accidents and age-adjusted road traffic casualties from 2011 to 2021. Then, for the period when e-bike-related accidents rapidly increased, descriptive statistics were computed regarding rider characteristics, illegal behaviors, road types, collision objects and their accident liability. One-way analysis of variance (ANOVA) followed by Bonferroni's multiple comparison test. P < 0.05 was considered statistically significant. Finally, the density distribution of accidents was presented, and Moran's I (MI) was used for assessing spatial autocorrelation. Hotspots were identified based on an optimized hotspot analysis tool. Results: Between 2011 and 2021, the number of accidents and casualty rate (per 100,000 population) increased for e-bikes but decreased for bicycles. After 2018, e-bike-related accidents increased rapidly, and bicycle-related accidents plateaued. Accident hotspots were concentrated in central city areas and suburban areas close to the former. Three-quarters of accidents occurred in motorized vehicle lanes. Most occurred on roads without physically segregated nonmotorized vehicle lanes. More than three-fifths of the accidents involved motor vehicles with at least four wheels. The prevalence (per 100 people) of casualties among e-bike rider victims and cyclist victims accounted for 92.0 % and 96.5 %, respectively. A total of 71.6 % of e-bike-related accidents involved migrant workers. Riding in motorized vehicle lanes was the most common illegal behavior. Conclusions: Although e-bike-related and bicycle-related accidents presented similar characteristics, the sharp increase in e-bike-related accidents requires attention. To improve e-bike safety, governments should develop appropriate countermeasures to prevent riders from riding on motorways, such as improving road infrastructure, adjusting the driver's license system and addressing priority control areas.

Two cases of driver death caused by airbag rupture.

OBJECTIVE: This article reports two accidents caused by defective Takata airbags ruptured, which led to the deaths of the drivers. This is the first public report on the deaths caused by Takata airbags in China. METHODS: Determine the relationship between the driver death and airbag rupture through autopsy indings and vehicle inspection. RESULTS: Due to defects in the design of Takata's inflator, moist air was permitted to slowly enter the inflator, resulting the PSAN slowly degraded physically. The damaged propellant burned more rapidly than intended and overpressurized the inflator's steel housing, causing fragmentation and flying debris at high speed, killing or injuring vehicle occupants. CONCLUSIONS: To date, there are still tens of millions of defective Takata airbags that have not been recalled for repair, posing safety risks. This article suggests taking preventive measures to avoid the occurrence of similar accidents.

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.

Characteristics of road traffic accident types and casualties in Guangzhou, China, from 2007 to 2020: A retrospective cohort study based on the general population.

Introduction: This study aimed to explore the trend and main influencing factors of road traffic accidents in Guangzhou, China, from 2007 to 2020 and to provide a reference and guidance for government decision-making. Methods: A retrospective cohort study was used to describe road traffic accidents in Guangzhou. According to the population types, all people with road traffic accidents were divided into migrant workers and the control population. We divided road users, administrative districts, motorcycle types and injury levels into subgroups to investigate the characteristics of road traffic accidents in Guangzhou. The road traffic accident data were derived from the Guangzhou Public Security Traffic Management Integrated System. Results: The incidence rate of road traffic accidents per 10,000 vehicles in Guangzhou decreased from 36.55 in 2007 to 10.07 in 2012, remained relatively stable at 9.47 in 2017, and finally rose to 11.12 in 2020. The injury rate showed the same trend as the incidence rate, while the mortality rate gradually decreased from 14.21 in 2007 to 5.19 in 2020. Vulnerable road users such as motorized two-to-three-wheeler drivers and migrant workers were casualties in more than 80% of the cases. The proportion of casualties involving mopeds and electric bicycles increased rapidly after 2018. Motor vehicle drivers frequently caused road traffic accidents and were most often uninjured. Conclusion: Road safety in Guangzhou has shown a clear trend of improvement, but casualties are uneven across administrative districts. More attention should be given to motorized two-to-three-wheelers, migrant workers, and road traffic violations by uninjured individuals.

Characteristics of human movement and injury in a side collision between the front of a small car and a bicycle.

OBJECTIVE: Our research groups have studied the movement and injury characteristics of the human body in a side collision between the front of a small car and a pedestrian. This study discusses the movement and injury characteristics of the human body in a side collision between the front of a small car and bicycle. METHODS: A total of 31 cases of traffic accidents caused by small car collisions when riding a bicycle across a road were collected. Through on-site inspection and trace inspection of the accident vehicles and bicycles, the speed of the car during the collision was calculated, the collision relationship between the small car and bicycle was determined, and the injury site and degree were determined through autopsy. The car speed was divided into two groups: <60 km/h and >60 km/h. Injuries of the skull, cervical spine, ribs, pelvis, femur and tibiofibular were analysed, and the correlations with the height of the bicycle controller, the height of the bicycle seat, the height of the car hood and the length of hood were discussed. PC-Crash was used for simulation analysis to further clarify the injury process. RESULTS: The ratio of the height of the bicycle seat to the height of the hood plus the length of the hood in the windshield-damaged group was larger than that in the undamaged windshield group (P < 0.05). No cervical fracture was found when V < 60 km/h, and 52.94% of cases had cervical fracture when V > 60 km/h. The ratio of the height of the bicycle seat to the height of the hood in the pelvic fracture group was smaller than that in the nonpelvic fracture group (P < 0.05). The incidence of tibiofibular fracture was less than 65%. CONCLUSIONS: When a side impact between a car front and a bicycle occurs, the resulting human injury is related not only to the speed but also to the height of the bicycle seat and the height and length of the hood of the car. The incidence of tibiofibular fractures was significantly lower than that of small car front-pedestrian side impacts.

Mechanism of transverse fracture of the skull base caused by blunt force to the mandible.

Transverse fracture of the skull base is common both in the crushing of temporal regions of the skull and in the case of force acting on one temporal region. However, the mechanism of transverse skull base fracture caused by maxillofacial force has not been fully clarified. To provide an injury identification basis for forensic pathologists and clinicians, this paper combines accident reconstruction and finite element analysis methods to study the injury mechanism of an incomplete transverse fracture of skull base after the injured individual's mandible was subjected to violence in a traffic accident. The results show that after the injured individual's mandible was subjected to violence, forces in the direction of the left mandibular fossa and the right mandibular fossa were generated, creating the component forces. The combination of the two forces can produce a crushing effect toward the center of the skull base, as if the left and right temporal regions are being crushed, and the stress is concentrated at the joint of the mandible, the middle cranial fossa and the hypophyseal fossa. When the stress exceeds a certain limit, it will cause a transverse fracture of the skull base.

Analysis of Pedestrian Fractures in Collisions Between Small Cars and Pedestrians Based on Surveillance Videos.

OBJECTIVE: To discuss the collision relationship and the cause of the fracture caused by traffic accidents in which the front of a small car collides with the side of a pedestrian while braking. METHODS: The surveillance videos of 42 traffic accidents involving the front of a small car colliding with the side of a pedestrian while braking were collected. By analyzing the surveillance videos and the paths, the speed of the collision, the relationship between the vehicle and the pedestrian upon collision, and the movement trajectory of the human body were clearly identified. The type and severity of the injuries were also determined through autopsy. The characteristics of the human injuries and vehicle paths were analyzed according to the collision speed (<40 km/h, 40-60 km/h, 60-90 km/h), and the correlations between the fracture and the height of the pedestrian, the height of the hood and the length of the hood were discussed. RESULTS: When a small car hits the side of a pedestrian, the front bumper first hits the lower limbs of the pedestrian, and then, the human body falls to the side of the vehicle, causing a secondary collision with the hood and front windshield; thus, the pedestrian is thrown at a speed similar to the speed of the vehicle, finally falling to the ground and sliding forward a certain distance. (1) When V is less than 40 km/h (n = 10), the pedestrian's head did not collide with the windshield, and the fatal injuries were caused by the individual striking the ground. (2) When V is greater than 40 km/h (n = 32), the majority (97%) of cases showed collision with the windshield. (3) When 40 to 60 km/h (n = 16), the pedestrian's head collided with the windshield, which can cause fatal injuries, and pelvic fractures and rib fractures occurred in 56.25% of patients. (4) When V is less than 60 km/h (n = 26), the ratio of the height of the pedestrian to the height of the hood was significantly smaller in the pelvic fracture group than in the nonpelvic fracture group (P < 0.01). (5) When 60 to 90 km/h (n = 16), there were holes in the windshield, and the pedestrians experienced severe head injuries, with cervical spine fracture occurring in 37.5% of patients, pelvic fractures occurring in 43.75% of patients, and rib fractures occurring in 31.25% of patients. CONCLUSIONS: When V is less than 40 km/h, the vehicle does not cause severe injuries in pedestrians; when V is greater than 40 km/h, the collisions of the pedestrian's head with the windshield lead to severe head injuries and the accident can cause severe pelvic and rib fractures; when V is greater than 60 km/h, the collisions of the pedestrian's head with the windshield can cause cervical spine fracture in addition to head injuries. The occurrence of human injuries is related to not only the vehicle speed but also factors such as the height of the pedestrian, the height of the hood and the length of the hood.

Sudden Death from Ischemic Heart Disease While Driving: Cardiac Pathology, Clinical Characteristics, and Countermeasures.

BACKGROUND Sudden death from ischemic heart disease while driving is an important cause of traffic accidents. This study discusses causes of traffic accidents in relation to risk factors for acute myocardial infarction such as hypertension and overwork and provides references for the early prevention and regulation of drivers' health conditions. MATERIAL AND METHODS Data on 21 cases of sudden death by ischemic heart disease while driving from January 2015 to December 2019 were collected. Age, symptoms, and cardiac pathological changes of patients were summarized by systematic anatomical and medical history data. RESULTS Patients were 21 men with an average age of 47±7.27 years (most aged 40 to 60 years), and the average weight of their hearts was 439.45±76.3 g. Twelve patients had a history of hypertension, 8 had previous myocardial infarction, and 4 had fatty liver. All had at least 1 severe narrowing of a major coronary artery. Twelve patients died within a short period; 9 died more than 12 h after myocardial infarction onset. Ten patients had worked more than 80 h of overtime per month, 4 patients, more than 45 h, and 7 patients, less than 45 h. CONCLUSIONS Regular physical examination and information about ischemic heart disease should be emphasized for men aged 40 to 60 years who drive frequently, especially for those with hypertension, overwork, or previous myocardial infarction. Incorporating objective evaluation criteria for the severity of ischemic heart disease and overwork into health condition-related driving regulations is needed.

A virtual reality method for digitally reconstructing traffic accidents from videos or still images.

With an increase in the number of traffic accidents and enhanced attention to the rule of law, technical appraisement to reconstruct traffic accidents is attracting increasing attention. Accident videos are important aspects in identification; however, we cannot reconstruct an accident scene onsite using video for many reasons. In this paper, we introduce a computer-based virtual reality method that can digitally reconstruct a traffic accident. This method employs accident videos to perform a three-dimensional (3D) reconstruction of accident scenes. Using video screenshots, it constructs a model of humans and vehicles in 3D space to achieve the goal of dynamic restoration. The results indicate that this method has relatively high accuracy, requires little time and is easy to use. In this paper, we analyse the sources of errors for this method and summarize the application conditions.

Transumbilical endoscopic surgery for completely enclosing inguinal hernias in children.

BACKGROUND/PURPOSE: There has been great interest in natural orifice transluminal endoscopic surgery in recent years. We report another new approach for pediatric inguinal hernia repair: transumbilical endoscopic surgery (TUES). Compared with the natural orifice transluminal endoscopic surgery technique, TUES can obtain similar scarless results on the abdomen. METHODS: In our hospital, 2-trocar TUES was the standard procedure used to repair pediatric inguinal hernias. Through 2 intraumbilical incisions, two 5-mm trocars were inserted into the abdomen under laparoscopic guidance. With the use of a needle-holding forceps, a round needle with 2-0 nonabsorbable suture material was introduced into the peritoneal cavity through the anterior abdominal wall near the internal inguinal ring. The orifice of the hernial sac was closed extraperitoneally with a purse-string suture around the internal inguinal ring, and intraperitoneal knot-tying was performed. RESULTS: A total of 76 inguinal repairs were performed in 64 children (age range, 6 months to 9 years; median, 3.8 years; 44 boys, 20 girls). All operations were completed successfully by TUES, with the exception of one case of intraoperative bleeding because the inferior epigastric vein was punctured. The mean operating time was 20 minutes (range, 15-30 minutes). No postoperative bleeding, hydrocele, or scrotal edema in this group of patients was found, and there were no known cases of postoperative testicular atrophy or hypotrophy nor hernia recurrence on the symptomatic side. CONCLUSIONS: Our preliminary experience shows satisfactory outcomes with TUES for completely enclosing inguinal hernias in children. This technique appears to be safe, effective, and reliable. The cosmetic result is excellent.