Age Impacts Speech-in-Noise Recognition Differently for Nonnative and Native Listeners.

PURPOSE: The purpose of this study was to explore potential differences in suprathreshold auditory function among native and nonnative speakers of English as a function of age. METHOD: Retrospective analyses were performed on three large data sets containing suprathreshold auditory tests completed by 5,572 participants who were self-identified native and nonnative speakers of English between the ages of 18-65 years, including a binaural tone detection test, a digit identification test, and a sentence recognition test. RESULTS: The analyses show a significant interaction between increasing age and participant group on tests involving speech-based stimuli (digit strings, sentences) but not on the binaural tone detection test. For both speech tests, differences in speech recognition emerged between groups during early adulthood, and increasing age had a more negative impact on word recognition for nonnative compared to native participants. Age-related declines in performance were 2.9 times faster for digit strings and 3.3 times faster for sentences for nonnative participants compared to native participants. CONCLUSIONS: This set of analyses extends the existing literature by examining interactions between aging and self-identified native English speaker status in several auditory domains in a cohort of adults spanning young adulthood through middle age. The finding that older nonnative English speakers in this age cohort may have greater-than-expected deficits on speech-in-noise perception may have clinical implications on how these individuals should be diagnosed and treated for hearing difficulties.

Experimental comparison of E-band BDFA and Raman amplifier performance over 50 km G.652.D fiber using 30 GBaud DP-16-QAM and DP-64-QAM signals.

We compare the performance of three optical amplifiers in the E-band: a bismuth-doped fiber amplifier (BDFA), a distributed Raman amplifier, and a discrete Raman amplifier (RA). Data transmission performance of 30 GBaud DP-16-QAM and DP-64-QAM signals transmitted over 50 km of G.652.D fiber is compared in terms of achieved signal-to-noise (SNR). In this specific case of relatively short distance, single-span transmission, the BDFA outperforms the distributed and discrete Raman amplifiers due to the impact of fiber nonlinear penalties at high input signal powers.

Living with trimethylaminuria and body and breath malodour: personal perspectives.

BACKGROUND: Many people suffer from body and breath malodour syndromes. One of these is trimethylaminuria, a condition characterized by excretion in breath and bodily fluids of trimethylamine, a volatile and odorous chemical that has the smell of rotting fish. Trimethylaminuria can be primary, due to mutations in the gene encoding flavin-containing monooxygenase 3, or secondary, due to various causes. To gain a better understanding of problems faced by United Kingdom residents affected by body and breath malodour conditions, we conducted a survey. METHODS: Two anonymous online surveys, one for adults and one for parents/guardians of affected children, were conducted using the Opinio platform. Participants were invited via a trimethylaminuria advisory website. Questions were a mix of dropdown, checkbox and open-ended responses. Forty-four adults and three parents/guardians participated. The dropdown and checkbox responses were analysed using the Opinio platform. RESULTS: All participants reported symptoms of body/breath odour. However, not all answered every question. Twenty-three respondents experienced difficulties in being offered a diagnostic test for trimethylaminuria. Problems encountered included lack of awareness of the disorder by medical professionals and reluctance to recognise symptoms. Of those tested, 52% were diagnosed with trimethylaminuria. The main problems associated with living with body/breath malodours were bullying, harassment and ostracism in either the workplace (90%) or in social settings (88%). All respondents thought their condition had disadvantaged them in their daily lives. Open-ended responses included loss of confidence, stress, exclusion, isolation, loneliness, depression and suicidal thoughts. Respondents thought their lives could be improved by greater awareness and understanding of malodour conditions by medical professionals, employers and the general public, and appreciation that the malodour was due to a medical condition and not their fault. CONCLUSIONS: Breath and body malodour conditions can cause immense hardship and distress, both mentally and socially, having devastating effects on quality of life. It would be advantageous to establish a standardised pathway from primary care to a specialist unit with access to a robust and reliable test and diagnostic criteria. There is a need to recognise malodour disorders as a disability, giving affected individuals the same rights as those with currently recognised disabilities.

The value of plasma metanephrine measurements during adrenal vein sampling.

Objective: The assessment of primary aldosteronism incorporates adrenal vein sampling (AVS) to lateralize aldosterone excess. Current adrenal vein sampling protocols rely on concurrent cortisol measurements to assess successful cannulation and lateralization and may be inaccurate in the setting of autonomous cortisol secretion. We aimed to compare the measurement of plasma cortisol and metanephrine concentrations to assess cannulation and lateralization during AVS. Design: This is a diagnostic accuracy study in a tertiary referral endocrinology department. Methods: Forty-one consecutive patients with confirmed primary aldosteronism undergoing AVS (49 procedures) were included. None had cortisol autonomy. The use of plasma metanephrine-based ratios were compared with standard cortisol-based ratios to assess cannulation and lateralization during ACTH-stimulated AVS. Results: There was strong agreement between a cortisol selectivity index (SI) ≥5.0 and an adrenal vein (AV) to peripheral vein (PV) plasma metanephrine ratio (AVmet-PVmet) of ≥12.0 to indicate successful cannulation of the AV (n = 117, sensitivity 98%, specificity 89%, positive predictive value (PPV) 95%, negative predictive value (NPV) 94%). There was strong agreement between the standard cortisol-based SI and an AV plasma metanephrine-to-normetanephrine ratio (AVmet-AVnormet) of ≥2.0 to indicate successful cannulation (n = 117, sensitivity 93%, specificity 86%, PPV 94%, NPV 84%). There was strong agreement between the cortisol- or metanephrine-derived lateralization index (LI) > 4.0 for determining lateralization (n = 26, sensitivity 100%, specificity 94.1%, PPV 91.6%, NPV 100%). Conclusions: Ratios incorporating plasma metanephrines provide comparable outcomes to standard cortisol-based measurements for interpretation of AVS. Further studies are required to assess the use of metanephrine-derived ratios in the context of confirmed cortisol autonomy. Significance statement: Primary aldosteronism is a common cause of secondary hypertension, and adrenal vein sampling remains the gold standard test to assess lateralization. Cortisol-derived ratios to assess cannulation and lateralization may be affected by concurrent cortisol dysfunction, which is not uncommon in the context of primary aldosteronism. Our study showed comparable outcomes when using accepted cortisol-derived or metanephrine-derived ratios to determine cannulation and lateralization during adrenal vein sampling. Further research is required to validate these findings and to assess the use of metanephrine-derived ratios in the context of confirmed concurrent cortisol dysfunction.

Chasing an equation for awarenessPutting Ourselves Back in the Equation George Musser Farrar, Straus and Giroux, 2023. 336 pp.

A writer seeks connections between consciousness and fundamental physics.

Six ways of failing to see (and why the differences matter).

Sometimes we look but fail to see: our car keys on a cluttered desk, a repeated word in a carefully proofread email, or a motorcycle at an intersection. Wolfe and colleagues present a unifying, mechanistic framework for understanding these "Looked But Failed to See" errors, explaining how such misses arise from natural constraints on human visual processing. Here, we offer a conceptual taxonomy of six distinct ways we might be said to fail to see, and explore: how these relate to processes in Wolfe et al.'s model; how they can be distinguished experimentally; and, why the differences matter.

The effect of weather conditions on scores at the United States Masters golf tournament.

This paper investigates the sensitivity of golfers' performance to meteorological conditions at the men's US Masters tournament over the 40-year period 1980-2019. The mean and standard deviation of round scores are related to local temperature, humidity, wind speed and direction, and concurrent and antecedent precipitation. Mean scores are more dependent on weather conditions than the variability of scores in a given round. The best predictor of mean scores is the wet-bulb temperature in rounds one and two, and the zonal wind speed in rounds three and four. Across both sets of rounds (1 and 2, and 3 and 4), the wet-bulb temperature is a better predictor of mean scores than the air temperature, which implies that atmospheric moisture content affects scores. In general, golfers take fewer shots and so perform better in warmer and calmer conditions. The synergestic effect of several weather variables explains over 44% of the variance in mean scores. Mean meteorological conditions during play are a much better predictor of the players' average performance than the standard deviation of the weather variables. The golfers' performance becomes more variable in cooler conditions with a wider range of scores. Precipitation during play and the dampness of the ground (as quantified by rainfall up to ten days before play) do not have a consistent and statistically significant effect on the competitors' performance. In short, this paper demonstrates that golf scores are dependent on weather conditions.

The perception of silence.

Auditory perception is traditionally conceived as the perception of sounds-a friend's voice, a clap of thunder, a minor chord. However, daily life also seems to present us with experiences characterized by the absence of sound-a moment of silence, a gap between thunderclaps, the hush after a musical performance. In these cases, do we positively hear silence? Or do we just fail to hear, and merely judge or infer that it is silent? This longstanding question remains controversial in both the philosophy and science of perception, with prominent theories holding that sounds are the only objects of auditory experience and thus that our encounter with silence is cognitive, not perceptual. However, this debate has largely remained theoretical, without a key empirical test. Here, we introduce an empirical approach to this theoretical dispute, presenting experimental evidence that silence can be genuinely perceived (not just cognitively inferred). We ask whether silences can "substitute" for sounds in event-based auditory illusions-empirical signatures of auditory event representation in which auditory events distort perceived duration. Seven experiments introduce three "silence illusions"-the one-silence-is-more illusion, silence-based warping, and the oddball-silence illusion-each adapted from a prominent perceptual illusion previously thought to arise only from sounds. Subjects were immersed in ambient noise interrupted by silences structurally identical to the sounds in the original illusions. In all cases, silences elicited temporal distortions perfectly analogous to the illusions produced by sounds. Our results suggest that silence is truly heard, not merely inferred, introducing a general approach for studying the perception of absence.

Metabolomic and transcriptomic analyses of Fmo5-/- mice reveal roles for flavin-containing monooxygenase 5 (FMO5) in NRF2-mediated oxidative stress response, unfolded protein response, lipid homeostasis, and carbohydrate and one-carbon metabolism.

Flavin-containing monooxygenase 5 (FMO5) is a member of the FMO family of proteins, best known for their roles in the detoxification of foreign chemicals and, more recently, in endogenous metabolism. We have previously shown that Fmo5-/- mice display an age-related lean phenotype, with much reduced weight gain from 20 weeks of age. The phenotype is characterized by decreased fat deposition, lower plasma concentrations of glucose, insulin and cholesterol, higher glucose tolerance and insulin sensitivity, and resistance to diet-induced obesity. In the present study we report the use of metabolomic and transcriptomic analyses of livers of Fmo5-/- and wild-type mice to identify factors underlying the lean phenotype of Fmo5-/- mice and gain insights into the function of FMO5. Metabolomics was performed by the Metabolon platform, utilising ultrahigh performance liquid chromatography-tandem mass spectroscopy. Transcriptomics was performed by RNA-Seq and results analysed by DESeq2. Disruption of the Fmo5 gene has wide-ranging effects on the abundance of metabolites and expression of genes in the liver. Metabolites whose concentration differed between Fmo5-/- and wild-type mice include several saturated and monounsaturated fatty acids, complex lipids, amino acids, one-carbon intermediates and ADP-ribose. Among the genes most significantly and/or highly differentially expressed are Apoa4, Cd36, Fitm1, Hspa5, Hyou1, Ide, Me1 and Mme. The results reveal that FMO5 is involved in upregulating the NRF2-mediated oxidative stress response, the unfolded protein response and response to hypoxia and cellular stress, indicating a role for the enzyme in adaptation to oxidative and metabolic stress. FMO5 also plays a role in stimulating a wide range of metabolic pathways and processes, particularly ones involved in lipid homeostasis, the uptake and metabolism of glucose, the generation of cytosolic NADPH, and in one-carbon metabolism. The results predict that FMO5 acts by stimulating the NRF2, XBP1, PPARA and PPARG regulatory pathways, while inhibiting STAT1 and IRF7 pathways.

Seeing fast and thinking slowThe Border Between Seeing and Thinking Ned Block Oxford University Press, 2023. 560 pp.

A philosopher explores perception and cognition.

Performance on stochastic figure-ground perception varies with individual differences in speech-in-noise recognition and working memory capacity.

Speech recognition in noisy environments can be challenging and requires listeners to accurately segregate a target speaker from irrelevant background noise. Stochastic figure-ground (SFG) tasks in which temporally coherent inharmonic pure-tones must be identified from a background have been used to probe the non-linguistic auditory stream segregation processes important for speech-in-noise processing. However, little is known about the relationship between performance on SFG tasks and speech-in-noise tasks nor the individual differences that may modulate such relationships. In this study, 37 younger normal-hearing adults performed an SFG task with target figure chords consisting of four, six, eight, or ten temporally coherent tones amongst a background of randomly varying tones. Stimuli were designed to be spectrally and temporally flat. An increased number of temporally coherent tones resulted in higher accuracy and faster reaction times (RTs). For ten target tones, faster RTs were associated with better scores on the Quick Speech-in-Noise task. Individual differences in working memory capacity and self-reported musicianship further modulated these relationships. Overall, results demonstrate that the SFG task could serve as an assessment of auditory stream segregation accuracy and RT that is sensitive to individual differences in cognitive and auditory abilities, even among younger normal-hearing adults.

Eccentricity advances arrival to visual perception.

We investigated temporal properties of visual perception as a function of eccentricity, that is, spatial position relative to the fovea. Our experiments were motivated by well-characterized non-uniformities in neuron distribution in the human eye and early visual pathways. These non-uniformities have been extensively studied in the context of spatial perception, while largely neglected in relation to temporal perception. In Experiment 1, participants fixated the rapid serial visual presentation letter stream and were instructed to report the letter which appeared simultaneously with a brief cue presented at different locations along the horizontal meridian. Participants exhibited a tendency to report earlier letters with more peripheral as compared to central cues, indicating that they misperceived differently located stimuli as simultaneous even though they were never presented together. Experiment 2 conceptually replicated the findings of Experiment 1. Experiment 3 further demonstrated that the effect is specifically due to eccentricity, and not the relative distance between the stimuli. We argue that such location-based misperceptions of simultaneity arise because transient stimuli at more eccentric locations advance to perception faster than stimuli at or near the fovea. Collectively, these experiments show, for the first time, how processing speed differences across the visual field translate into differences in perceived simultaneity. They also demonstrate, for the first time, location-based misperceptions of simultaneity for stimuli never presented together. Finally, Experiment 4 showed that greater eccentricity also increased the perceived duration of a stimulus compared to fovea. These results reveal the breadth of perceptual effects driven by temporal processing differences across the visual field. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The predictive value of the sFlt-1/PlGF ratio in suspected preeclampsia in a New Zealand population: A prospective cohort study.

BACKGROUND: Internationally, placental growth factor (PlGF)-based tests are used as prognostic markers in suspected preeclampsia. However, Ministry of Health guidelines do not currently endorse PlGF-based tests in New Zealand (NZ). AIMS: To investigate the predictive value of soluble fms-like tyrosine kinase 1 (sFlt-1)/PlGF ratio in suspected preeclampsia in a NZ population. MATERIALS AND METHODS: A prospective cohort study of singleton pregnancies at 20+0 -36+6 weeks gestation with suspected preeclampsia as defined by Society of Obstetric Medicine Australia and NZ (SOMANZ) criteria. PRIMARY OBJECTIVE: to evaluate a sFlt-1/PlGF ratio >38 at ≤35+0 weeks gestation to predict birth ≤14 days. SECONDARY OBJECTIVES: to assess a sFlt-1/PlGF ratio cut-off of 38 at ≤37+0 weeks gestation, to rule out preeclampsia ≤1 week, rule in preeclampsia ≤4 weeks, and to predict perinatal outcome. Clinicians were blinded to sFlt-1/PlGF ratio results. RESULTS: Included were 222 participants, 19.4% Maori and 10.4% Pasifika. A sFlt-1/PlGF >38 predicted birth ≤14 days, positive predictive value (PPV) 51.4% (95% CI, 39.6-63.0) and negative predictive value (NPV) 95.9% (95% CI, 91.4-98.1), median (interquartile range) days to birth 14 (2-27) vs 49 (33-70), P < 0.000. A sFlt-1/PlGF cut-off of 38 ruled out preeclampsia ≤1 week (NPV 96.2% (95% CI, 92.3-98.2)) and ruled in preeclampsia ≤4 weeks (PPV 75.0% (95% CI, 65.0-82.9)). A sFlt-1/PlGF >38 was associated with greater perinatal morbidity. CONCLUSIONS: The predictive value of the sFlt-1/PlGF ratio in NZ is comparable to that reported in international trials. Used in clinical practice the sFlt-1/PlGF ratio may aid risk stratification in suspected preeclampsia, directing limited resources to those pregnancies at highest risk.

Performance evaluation of discrete Raman amplifiers in coherent transmission systems.

We evaluate the performance penalty due to discrete Raman amplifier (DRA) in a long haul WDM transmission system. The investigation was primarily performed to study the impact of the accumulated nonlinear noise due to fibre chromatic dispersion and nonlinear coefficient(γ). Nonlinear fibres such as inverse dispersion fibre (IDF), dispersion compensation fibre (DCF) and a development fibre known as the Corning Raman fibre (CRF) with the opposite sign of CD to the other two, were taken as the gain fibre in the DRA stage of the long-haul transmission setup. To study the performance penalty with these Raman gain fibres a 30 GBaud 120 Gb/s DP-QPSK channel @1550 nm was combined with 9 spectrally shaped 50 GHz amplified spontaneous emission (ASE) channels for transmission over a recirculation loop with a per loop length of 63 km single mode fibre (SMF). Our modelling and experimental results show that a fibre with positive dispersion >10ps/nm/km and a nonlinear coefficient of ∼ 4W-1km-1 is a good choice of gain fibre for DRA-assisted coherent transmission system.

E-, S-, C- and L-band coherent transmission with a multistage discrete Raman amplifier.

We report for the first time an ultra-wideband coherent (UWB) WDM transmission over a 70 km standard single mode fibre (SSMF) solely using a multistage discrete Raman amplifier (DRA) over the E-, S-, C- and L-bands of the optical window. The amplifier is based on a split-combine approach of spectral bands enabling signal amplification from 1410-1605 nm over an optical bandwidth of 195 nm (25.8 THz). The proposed amplifier was characterized with 143 channelized amplified spontaneous emission (ASE) dummy channels in the S-, C- and L-bands and 4 laser sources in the E-band (1410-1605 nm). The amplification results show an average gain of 14 dB and a maximum noise figure (NF) of 7.5 dB over the entire bandwidth. Coherent transmission with the proposed amplifier was performed using a 30 Gbaud PM-16-QAM channel coupled with the ASE channels over a 70 km SMF. The ultra-wideband transmission using the tailored multistage DRA shows transmission bandwidth of 195 nm with a maximum Q2 penalty of ∼4 dB in E- and S-band, and ∼2 dB in C- and L-band.

A Real-Time Endoscope Motion Tracker.

OBJECTIVE: In colonoscopy, it is desirable to accurately localize the position of the endoscope's distal tip. Current tip localization techniques are not sufficient for recording the position and movement of the tip, nor is its rotation measured. We hypothesize that integration of multiple tracking modalities can effectively record the endoscope's motion in real time and continuously corrects cumulative errors. METHODS: A dual modality tracking method is developed to measure the motion of the endoscope's insertion tube in real time, including insertion length, rotation angle, and their velocities. Optical trackballs were used to measure the endoscope insertion tube's motion and cameras were used to correct cumulative errors. RESULTS: The accuracy of insertion length and rotational angle were measured. For speeds ≤ 10 mm/s, the median and 90th percentile insertion position errors were 0.88 mm and 2.2 mm, respectively. The insertion position error increases with the speed, reaching a maximum of 10 mm for speeds < 40 mm/s. 11° and 21° were the median and 90th percentile rotation angle errors for angular speeds < 40°/s. Cumulative errors are sufficiently reduced by the imaging modality. CONCLUSION: The prototype device can precisely measure an unmodified endoscope's position, rotation, and motion in real time without significant accumulative error. The prototype device is small and compatible with existing commercial endoscopes as an add-on accessory, which could be used for reporting, localizing the lesions in follow up procedures, operational guidance, quality assurance, and training. Clinical and Translational Impact Statement-This preclinical research develops an endoscope tracker that can be integrated into colonoscopy training, automatically record endoscope motion, and be further developed to improve polyp and tumor localization during colonoscopy.

Ultra-wideband discrete Raman amplifier optimization for single-span S-C-L-band coherent transmission systems.

We experimentally compare the performance of two key ultra-wideband discrete Raman amplifier structures, a cascaded dual-stage structure and an in-parallel dual-band structure, in fully loaded S-C-L band coherent transmission systems over 70 km of single-mode fiber. Our results show that dual-band discrete Raman amplifier with minimized backreflections can effectively avoid unstable random distributed feedback lasing, reduce the noise figure, and therefore improve the transmission performance for signals at shorter wavelengths, versus the cascaded dual-stage structure. The average noise figure for S-band signals is 6.8 dB and 7.2 dB for the dual-band structure and cascaded dual-stage structure, respectively, while the average S-band Q2 factor is similarly improved by 0.6 dB. Moreover, the cascaded dual-stage discrete Raman amplifier requires guard bands around the 1485-nm and 1508-nm pumps as the signal and pump wavelengths overlap, which results in a bandwidth loss of ∼10 nm and reduces the potential net data throughput to 28.6 Tb/s for 30-GBaud DP-16QAM signals. However, the dual-band structure can utilize the bandwidth more effectively, which leads to a higher estimated net data throughput of 31.2 Tb/s.

30-GBaud DP 16-QAM transmission in the E-band enabled by bismuth-doped fiber amplifiers.

We report the transmission of five 30-GBaud dual polarization 16-QAM signals over 160 km of standard single-mode fiber in the E-band (1410-1460 nm). The transmission line consists of two 80-km spans and three independent bismuth-doped fiber amplifiers. The developed amplifiers feature a maximum gain of 27.3 dB, 33.8 dB, and 28.3 dB with a minimum noise figure of 4.8 dB, 4.7 dB, and 5.3 dB, respectively. The maximum signal Q2 factor penalty is 4.5 dB, and the overall performance of the system is above the pre-forward-error-correction (FEC) threshold for a 10-15 post-FEC bit error rate. To the best of our knowledge, this is the record experimentally demonstrated transmission length for a coherent detection signal in the E-band.

Treatment of wild-type mice with 2,3-butanediol, a urinary biomarker of Fmo5 -/- mice, decreases plasma cholesterol and epididymal fat deposition.

We previously showed that Fmo5 -/- mice exhibit a lean phenotype and slower metabolic ageing. Their characteristics include lower plasma glucose and cholesterol, greater glucose tolerance and insulin sensitivity, and a reduction in age-related weight gain and whole-body fat deposition. In this paper, nuclear magnetic resonance (NMR) spectroscopy-based metabolite analyses of the urine of Fmo5 -/- and wild-type mice identified two isomers of 2,3-butanediol as discriminating urinary biomarkers of Fmo5 -/- mice. Antibiotic-treatment of Fmo5 -/- mice increased plasma cholesterol concentration and substantially reduced urinary excretion of 2,3-butanediol isomers, indicating that the gut microbiome contributed to the lower plasma cholesterol of Fmo5 -/- mice, and that 2,3-butanediol is microbially derived. Short- and long-term treatment of wild-type mice with a 2,3-butanediol isomer mix decreased plasma cholesterol and epididymal fat deposition but had no effect on plasma concentrations of glucose or insulin, or on body weight. In the case of long-term treatment, the effects were maintained after withdrawal of 2,3-butanediol. Short-, but not long-term treatment, also decreased plasma concentrations of triglycerides and non-esterified fatty acids. Fecal transplant from Fmo5 -/- to wild-type mice had no effect on plasma cholesterol, and 2,3-butanediol was not detected in the urine of recipient mice, suggesting that the microbiota of the large intestine was not the source of 2,3-butanediol. However, 2,3-butanediol was detected in the stomach of Fmo5 -/- mice, which was enriched for Lactobacillus genera, known to produce 2,3-butanediol. Our results indicate a microbial contribution to the phenotypic characteristic of Fmo5 -/- mice of decreased plasma cholesterol and identify 2,3-butanediol as a potential agent for lowering plasma cholesterol.

Causes and prevention of mobile crane-related accidents in South Korea.

Mobile cranes account for a considerable proportion of crane-related accidents in South Korea. The authors used descriptive and non-parametric statistics to analyse 245 fatal accidents in South Korea from 2007 to 2016. The results showed that human error and crane problems were the main cause of accidents; riggers accounted for the largest number of deaths. To reduce the number of mobile crane fatalities, the authors made recommendations in four areas: educational aspects, mobile crane aspects, technical aspects and other issues. Firstly, business owners need to establish a systematic education system suitable for workers in mobile crane operations. Secondly, efforts should be made to tighten the quality of safety inspections of cranes and supervision of workplaces. Thirdly, efforts should be made to develop more human error-free equipment. Lastly, it is necessary to develop a systematic accident reporting system containing more detailed information to allow a fuller understanding of accident causation.