Seat belt use among pregnant women in the United Arab Emirates: the Mutaba'ah Study

INTRODUCTION

Motor vehicle collisions are a major cause of death and injury among pregnant women and their fetuses. Seat belt use compliance during pregnancy varies in different populations. We aimed to study seat belt use among pregnant women and factors affecting seat belt use during pregnancy in Al Ain City, the United Arab Emirates.

METHODS

This cross-sectional analysis used the baseline data collected from pregnant women participating in the Mutaba'ah Study from May 2017 to November 2022. Data were collected using self-administered questionnaires. Variables included sociodemographic, gestation periods and seat belt-related information. All pregnant women who responded to the questions related to seat belt use were included (N=2354).

RESULTS

Seat belt use before and during pregnancy was estimated at 69.7% (95% CI 67.9% to 71.6%) and 65.5% (95% CI 63.6% to 67.4%), respectively. The reasons for not using seat belts during pregnancy included being uncomfortable to wear, habitual non-use and considering them unsafe for pregnancy. Age, higher levels of education of the pregnant woman or her spouse, being employed, having a sufficient household income, lower gestational age, and using a seat belt before pregnancy were positively associated with using a seat belt during pregnancy in the bivariate analyses. Pregnant women in their third trimester had independently significant lower odds of using a seat belt compared with those in the first trimester (OR 0.42, 95% CI 0.24 to 0.76).

CONCLUSIONS

The findings indicate decreased compliance with seat belt use during pregnancy and as gestation progressed. The decrease was related to several reasons, including feeling uncomfortable wearing seat belts, habitual non-use and unsafe for pregnancy, necessitating appropriate measures to increase awareness. Raising public awareness about the advantages of wearing seat belts during pregnancy and the involvement of healthcare professionals in educating pregnant women are warranted.

Buckle me up! A randomised controlled trial using a tablet-based emergency department intervention for child car safety education

BACKGROUND AND OBJECTIVES

Correct child car restraint use significantly reduces risk of death and serious injury in motor vehicle crashes, but millions of US children ride with improper restraints. We created a tablet-based car restraint educational intervention using Computer Intervention Authoring Software (CIAS) and examined its impact on knowledge and behaviours among parents in the paediatric emergency department (PED).

METHODS

This was a non-blinded, randomised controlled trial of parents of PED patients ages 0-12 years. Participants were evaluated for baseline car restraint knowledge and behaviour. The intervention group completed an interactive tablet-based module, while the control group received printed handouts on car restraint safety. After 1 week, both groups received a follow-up survey assessing changes in car restraint knowledge and behaviour. Logistic regressions determined predictors of knowledge retention and behavioural changes. Parents in the CIAS group were also surveyed on programme acceptability.

RESULTS

211 parents completed the study with follow-up data. There was no significant difference in baseline car restraint knowledge (74.3% correct in intervention, 61.8% in control, p=0.15), or increase in follow-up restraint knowledge. Significantly more intervention-group caregivers reported modifying their child's car restraint at follow-up (52.5% vs 31.8%,p=0.003), and 93.7% of them found CIAS helpful in learning to improve car safety.

CONCLUSION

Parents had overall high levels of car restraint knowledge. Using CIAS led to positive behavioural changes regarding child car restraint safety, with the vast majority reporting positive attitudes towards CIAS. This novel, interactive, tablet-based tool is a useful PED intervention for behavioural change in parents.

TRIAL REGISTRATION NUMBER

NCT03799393.

Injury patterns and outcomes in motorcycle passengers

INTRODUCTION

Contemporary trauma literature on injuries to motorcycle passengers is scarce. The aim of this study was to examine the injury patterns and outcomes of motorcycle passengers with regard to helmet use. We hypothesized that helmet utilization affects both injury type and outcomes.

METHODS

The National Trauma Data Bank was queried for all motorcycle passengers who were injured in traffic accidents. Participants were stratified according to helmet utilization into helmeted (HM) and nonhelmeted (NHM) groups. Univariate and multivariate analyses were performed to compare the injury patterns and outcomes between the groups.

RESULTS

A total of 22,855 patients were included for analysis, of which 57.1% (13,049) used helmet. The median age was 41 years (IQR 26-51), 81% were female, and 16% of patients required urgent operation. NHM had higher risk of major trauma (ISS > 15: 26.8% vs 31.6%, p < 0.001). The most frequently injured body region in NHM was the head (34.6% vs 56.9%, p < 0.001), whereas in HM patients was the lower extremities (65.3% vs 56.7%, p < 0.001). NHM patients were more likely to require admission to the ICU, mechanical ventilation, and had significantly higher mortality rate (3.0% vs 6.3%, p < 0.001). The strongest predictors of mortality were GCS < 9 on admission, hypotension on admission, and severe head injury. Helmet utilization was associated with decreased odds of death (OR 0.636; 95% CI 0.531-0.762; p < 0.001).

CONCLUSION

Motorcycle collisions can lead to significant injury burden and high mortality in motorcycle passengers. Middle-age females are disproportionally affected. Traumatic brain injury is the leading cause of death. Helmet use is associated with decreased risk of head injury and death.

Pediatric lawn mower-related injuries and contributing factors for bystander injuries

BACKGROUND

Riding lawn mower injuries are the most common cause of major limb loss in young U.S. children. Our study objective was to investigate the circumstances surrounding pediatric riding lawn mower injuries and to identify potential contributing risk factors and behaviors leading to these events.

METHODS

Followers/members of both a public and a private lawn mower injury support and prevention Facebook page who had or were aware of children who had suffered a lawn mower-related injury were invited to complete an electronic survey on Qualtrics. Duplicate cases and those involving push mowers were removed. Frequencies and chi-square analyses were performed.

RESULTS

140 injured children were identified with 71% of surveys completed by parents and 19% by an adult survivor of a childhood incident. The majority of injured children were Caucasian (94%), male (64%), and ≤ 5 years of age at the time of the incident (63%). Bystanders were 69% of those injured, 24% were lawn mower riders, and mower operators and others accounted for 7%. The lawn mower operator was usually male (77%), being the father/stepfather in almost half. Overall, 59% of injuries occurred while traveling in reverse, 29% while moving forward. Nearly all (92%) had an amputation and/or permanent disability. Subgroup analysis (n = 130) found injured bystanders were younger than injured passengers with 71% versus 45% being < 5 years of age, respectively (p = 0.01). Over three-quarters of bystander incidents occurred while moving in reverse as compared to 17% of passenger incidents (p < 0.01). Amputations and/or permanent disabilities were greater among bystanders (97%) as compared to passengers (79%, p = 0.01). Only 3% of bystanders had an upper extremity injury as compared to 21% of passengers (p = 0.01). Seventy-three percent of bystander victims had received at least one ride on a lawn mower prior to their injury incident.

CONCLUSIONS

Child bystanders seriously injured by riding lawn mowers were frequently given prior rides likely desensitizing them to their inherent dangers and leading them to seek rides when mowers were being used. Engineering changes preventing blade rotation when traveling in reverse and not giving children rides (both when and when not mowing) may be critical in preventing mower-related injuries.

10 city analysis of child passenger helmet use

INTRODUCTION

Road traffic injuries are the leading cause of death in children over age five. Most of these deaths occur in low- and middle-income countries. Vulnerable road users, such as motorcyclists and their passengers, are at higher risk. Helmets have significantly decreased morbidity and mortality for motorcyclists; however, they are often unused. The second phase of the Bloomberg Philanthropies Initiative for Global Road Safety was launched in 2015 to improve road safety in 10 cities. This study focuses on child passenger helmet use data from that study to understand the prevalence of helmet use and factors that are associated with helmet use.

METHODS

The 10 cities selected were Accra, Addis Ababa, Bandung, Bangkok, Bogota, Fortaleza, Ho Chi Minh City, Mumbai, Sao Paulo, and Shanghai. Eight rounds of roadside observational data were collected from February 2015 to April 2019. Observers noted correct child motorcycle passenger helmet use and other site observations including weather patterns, traffic volume, and road surface conditions. A multivariable Poisson regression model was used to examine correct helmet use trends over time. A multivariable logistic regression model was fitted for correct child passenger helmet use in all cities controlling for weather, observation time, number of passengers, and driver's correct helmet use.

RESULTS

This dataset contained 99,846 motorcycle child passenger observations across the 10 cities. The highest prevalence of correct child passenger helmet use was in Sao Paulo at 97.33%. Six cities had under 25% correct helmet use for child passengers. Examining helmet use over time, only five cities had a significant increase, four cities had no change, and Ho Chi Minh City demonstrated a decrease. In the multivariable regression model, child passengers had higher odds of wearing helmets in adverse weather conditions, early mornings, if the driver wore a helmet, and if there were fewer passengers.

CONCLUSIONS

The prevalence of correct child passenger helmet utilization shows large variation globally and is concerningly low overall. Enhanced enforcement in combination with media campaigns may have contributed to increasing helmet use prevalence over time. Further research is needed to understand reasons for low child passenger helmet use in most cities.

A naturalistic study of passenger seating position, posture, and restraint use in second-row seats

OBJECTIVE

The objective of the current study was to increase scientific understanding of rear-seat passenger seating position, postures, CRS use, and belt use through a naturalistic study. A secondary objective was to compare data from vehicles used in ride-hailing with data from other vehicles.

METHOD

Video cameras were installed in the passenger cabins of the vehicles of 75 drivers near the center of the windshield. The video data were downloaded after the vehicles were operated by their owners for two weeks. Video frames were sampled from near the ends and in the middle of each trip, and at five-minute intervals in trips longer than 15 min. A total of 7,323 frames with second-row passengers were manually coded.

RESULTS

A total of 444 unique second-row passengers were identified in video frames from 1,188 trips taken in 65 of the 75 vehicles in the study. Two of the vehicles that were driven for commercial ride-hailing during the study period accounted for 199 (45%) of the passengers. Considering multiple passengers in some trips, a total of 1,899 passenger-trips were identified. For passengers not using child restraint systems (CRS), the belt use rate was 65% in the non-ride-hailing vehicles versus 32% among passengers in the ride-hailing vehicles. No CRS use was observed in the ride-hailing vehicles. Among children using backless boosters, the shoulder belt was lateral to the clavicle or under the arm in 26% of frames. Among belted passengers not using CRS, the belt was lateral to the clavicle or on the neck about 6% of the time. Belted passengers not using CRS were observed leaning to the left or right about 27% of the time, with leaning away from the shoulder belt more common than leaning into the belt.

CONCLUSIONS

This study is the first to report seating position, posture, and belt fit observations for a large naturalistic sample of second-row passengers that includes adult occupants. The data suggest that low rear seat belt use rates remain a concern, particularly in ride-hailing vehicles. Non-nominal belt placement and posture may also be common in second-row seating positions.

Conflicts between bus drivers and passengers in Changsha, China

Bus safety represents an important topic for injury prevention. When drivers experience conflict with their passengers, it likely distracts them from the driving task, both physically and mentally, and jeopardizes the safety of all passengers. However, detailed information concerning the frequency and type of conflicts between bus drivers and passengers is unavailable. We conducted a driver-reported cross-sectional survey to investigate the characteristics of driver-passenger conflict in the past month. The survey was completed in Changsha city, China in August 2019. In total, 779 bus drivers were surveyed. Of 732 drivers who completed the questionnaire, 635 (86.7%; 95% confidence interval: 84.3-89.1%) drivers reported experiencing at least one conflict with passengers in the past month. After adjusting for other demographic variables, drivers who were male, younger, less educated, less experienced as a bus driver, and with a comparatively high self-reported work intensity were more likely to report experiencing conflicts. Of the reported conflicts, verbal quarrels and abuses were most common, followed by "passengers attacked driver with physical objects like sticks or knives" and "passengers spat on or threw objects toward the driver". Most drivers reported that they had experienced only conflicts causing no physical injury or financial loss in the past month, but a small portion experienced conflicts causing injuries to themselves. The most frequent reasons for driver-passenger conflicts were "passenger refused to pay fare", "passenger requested to get off the bus at a location that was not a bus stop", and "passenger was drunk or deliriously attacked the driver". Bus drivers responded to some of the passengers' verbal or physical attacks, but not all. Some preventive measures were adopted frequently by bus companies (e.g., bus alarms, protective shields for drivers) but others were not. Least often adopted were efforts to offer safety training for drivers (46.6%) and to offer psychological counseling services for drivers (39.1%). We conclude that bus driver-passenger conflicts are common in Changsha city, China. The conflicts impose a substantial threat to the safety of both drivers and passengers. We recommend multiple preventive actions to reduce driver-passenger conflicts and improve bus safety.

Effects of COVID-19 on mobility GHG emissions: Case of the city of Lahti, Finland

The coronavirus disease COVID-19 has spread worldwide since early 2020, and it has impacted mobility emissions due to mobility restrictions and e.g. increased remote work. This creates a good opportunity to assess how mobility emissions have reduced due to COVID-19. This research is based on data related to mobility distances and modes that have been automatically collected by using a mobile phone application in the city of Lahti, Finland. The results show that mobility decreased in total by approximately 40% during the first wave of COVID-19 in spring 2020. The global warming potential decreased at the same time by approximately 36%. In addition, a considerable shift in modal shares could be seen. The relative modal share of passenger cars increased by 6 percentage points while the share of public transport decreased by 18 percentage points. Despite the considerable reduction, further reductions in emissions from mobility are needed to meet the 1.5 degree climate targets in the urban mobility sector. However, further reductions can be reached also by increasingly using renewable mobility energy sources.

Effects of physical driving experience on body movement and motion sickness among passengers in a virtual vehicle

Virtual vehicles (e.g., driving video games) can give rise to visually induced motion sickness. Typically, people drive virtual vehicles. In the present study, we investigated motion sickness among participants who were exposed to virtual vehicles as passengers; that is, they observed vehicle motion, but did not control it. We also asked how motion sickness and the postural precursors of motion sickness might be influenced by participants' previous experience of driving physical vehicles. Participants viewed a recording of a virtual automobile in a driving video game. Drivers were young adults with several years of experience driving physical automobiles, while non-drivers were individuals in the same age group who did not have a driver's license and had never driven an automobile. During exposure to the virtual vehicle, we monitored movement of the head and torso. The independent measures included the incidence and severity of motion sickness. After exposure to the virtual vehicle, the incidence and severity of motion sickness did not differ between Drivers and Non-Drivers. By contrast, postural movement differed between participants who later became motion sick and those who did not. In addition, during exposure to the virtual vehicle, physical driving experience was related to patterns of postural activity that preceded motion sickness. The results are consistent with the postural instability theory of motion sickness, and illuminate relations between the control of physical and virtual vehicles.

The influence of passenger air traffic on the spread of COVID-19 in the world

Countries in the world are suffering from COVID-19 and would like to control it. Thus, some authorities voted for new policies and even stopped passenger air traffic. Those decisions were not uniform, and this study focuses on how passenger air traffic might influence the spread of COVID-19 in the world. We used data sets of cases from the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University and air transport (passengers carried) from the World Bank. Besides, we computed Poisson, QuasiPoisson, Negative binomial, zero-inflated Poisson, and zero-inflated negative binomial models with cross-validation to make sure that our findings are robust. Actually, when passenger air traffic increases by one unit, the number of cases increases by one new infection.

Prevalence of non-nominal seat positions and postures among front-seat passengers

OBJECTIVE

Recent studies have suggested that a relationship exists between crash injury risk and occupant posture, particularly in postures different from those used with anthropomorphic test devices (ATDs) in crash testing. The objective of this study was to increase scientific understanding of typical front-seat passenger postures through a naturalistic study.

METHOD

Video cameras were installed in the passenger cabins of the vehicles of 75 drivers. Reflective targets were attached to the seats and the seat position and seat back angle was moved through their available ranges during instrumentation. The video data, along with vehicle acceleration and location data, were downloaded after the vehicles were operated as usual by their owners for two weeks. Video frames were manually coded to identify characteristics of front-seat passenger posture and position. Seat position and seat back angle were estimated using the calibration data obtained during vehicle instrumentation.

RESULTS

Video frames from a total of 2733 trips were coded for 306 unique front-seat passengers. For these trips, a total of 13638 frames were coded; each frame represents about four minutes of travel time. The head was rotated left or right in 33% of frames, and the torso was rotated left or right about 10% of the time and pitched forward in almost 10% of frames. No seat position or seat back angle change was noted in 40 (53%) of vehicles and the distributions of seat position and seat back angle on arrival were essentially unchanged during travel. The seat was positioned full-rear on the seat track about 23% of the time and rearward of the mid-track position in 92% of frames. The mean seat back angle was 25.4 degrees (standard deviation 6.4 degrees); seat back angle was greater than 30 degrees in 15% of frames and greater than 35 degrees in less than 1% of frames.

CONCLUSIONS

This study is the first to report distributions of postures, seat positions, and seat back angles for front-seat passengers. Seat positions rearward of the middle of the seat adjustment range are common, but highly reclined postures are infrequent. Non-nominal torso and head postures also are nontrivial.

The Granger-causality between wealth and transportation: A panel data approach

This study examines the causal relationship between wealth and transportation. The study first develops two alternating theoretical frameworks between wealth and transportation: one in which transportation is demand-driven and one in which transportation has dual role, demand-driven and supply-driving. Next, the study undertakes Granger-causality estimations for a panel of 18 countries over the period 1970-2017. It is found that the dominant Granger-causality relationship is bidirectional for majority of countries. The study also shows that there is high consistency in the Granger-causality relationship between wealth and transportation, and income and transportation. The study has three important contributions: First, the relationship between wealth and transportation is shown both theoretically and empirically. Second, transportation is shown to have dual role in an economy. Finally, it is shown that the wealth-transportation relationship and the transport-income relationship are equally robust and consistent.

Passenger Lymphocyte Syndrome; a Review of the Diagnosis, Treatment, and Proposed Detection Protocol

Passenger lymphocyte syndrome (PLS) is caused by the transfer of B-lymphocytes present in the donor graft into the recipient circulation following solid organ or hematopoietic stem cell transplantation. These cells may produce antibodies against the recipient's red blood cells, thereby triggering antibody dependent cytotoxicity and erythroid clearance, with potential resulting hemolysis and jaundice. Although uncommon, the true incidence is unknown because many cases are subclinical, with only serologic findings or with non significant levels of hemolysis detectable clinically or by laboratory monitoring. Thus, these cases may not be detected in the immediate perioperative period. No standardized consensus exists on screening for PLS in patients. Through a review of the literature from 2009 to 2019, we aim to approximate the incidence of this condition in different solid organ transplant settings, as well as to streamline recognition, detection, and management of PLS early in the disease course to prevent adverse outcomes and minimize invasive therapy. The resultant literature review yielded 22 case reports and 8 case series comprising 71 solid organ transplant patients. Hematopoietic stem cell transplant cases were excluded, as PLS cases related to solid organ transplant were the primary focus of this review. Our institution has traditionally handled PLS on a case-by-case basis, although we hope to improve this process through an introduction of an algorithm based on review of the literature and formalized communication with primary caregivers.

The role of control in risk perception on rural roads

Risk perception plays an important role in driver behaviour, particularly for speed choice. Risk perception studies use a range of techniques from on-road data collection to ratings of still photos, however participants' ratings differ depending on the study methodology, possibly due to their perception of control. To explore this we conducted a multiple methods study to investigate drivers' perceptions of risk on rural roads. One group of participants drove (Drivers, n = 13) a 180 km route along rural roads (accompanied by a research assistant) and provided verbal risk ratings at thirteen locations of interest. A second group (Passengers, n = 10) provided ratings at the same points when travelling as a passenger in a vehicle (driven by a research assistant). The third group (Observers, n = 14) were shown videos of the same rural roads (filmed from the drivers' perspective) and also provided risk ratings at the same locations. A week later participants were invited to the laboratory to review the video footage and comment on factors that contributed to the risk ratings. Overall, the Observers gave the highest risk ratings and Drivers the lowest. The Observers also provided twice the number of comments to justify their risk rating compared to the other two groups. The results suggest that control, and on-road experience play a significant role in how perceptions of driving risk are formed and the degree of risk experienced. These findings also bring into question the accuracy of using video-based tasks to assess drivers' risk perception (and speed choice), particularly if the findings are used to inform on-road safety interventions.

Alcohol is a predictor of mortality in motor vehicle collisions

INTRODUCTION

It is well recognized that driving while intoxicated increases the probability of a motor-vehicle collision (MVC). The effect of alcohol on the chance of surviving the MVC is less clear.

METHOD

Using data from the Fatality Analysis Reporting System (FARS) we conducted analyses for the outcome of mortality using alcohol and other variables as predictors. We also selected alcohol positive (AP) and alcohol negative (AN) persons from the same MVC and vehicle to control for confounding characteristics.

RESULTS

The odds ratio (OR) for mortality for alcohol positive drivers was 2.57, (p < 0.001 for all the following OR). Other harmful predictive factors were age OR 1.01 per year, vehicle age OR 1.05 per year, male sex OR 1.23, avoidance maneuver OR 1.09, speed related OR 2.89, rollover mechanism OR 2.75, and collision with a fixed object OR 6.70. Protective factors were proper restraint use - OR 0.19 and collision with another moving vehicle, OR 0.21. In the multivariate analysis the OR of mortality for AP vs AN was 1.46. Proper restraint use (OR 0.27) remained protective along with collision with another moving vehicle. When AP and AN persons from the same MVC and the same vehicle were compared, the adjusted OR's for mortality were 1.46 and 2.08, respectively.

CONCLUSIONS

Alcohol is an independent predictor of mortality in an MVC. Proper restraint use is the strongest protective factor. This finding allows a more complete understanding of the risks of driving while intoxicated, not only a higher probability of an MVC, but decreased survival once the MVC occurs. Practical Applications: Identification of alcohol as an independent predictor of mortality in an accident may improve risk assessment and influence drivers to avoid driving while intoxicated.

Severity and injury characteristics among matched hospitalized motorcycle drivers and their passengers

PURPOSE

After car accident, motorcycle accident ranks as the second leading cause of traffic fatality in Iran. This study aimed to compare the severity and clinical presentations between drivers and passengers under the same injury circumstance.

METHODS

This study was conducted in the trauma center of Shiraz, Iran in 2017. Data on demographics, triage level, blood pressure, respiratory rate, Glasgow coma scale (GCS), injured body region, injury severity score (ISS), revised trauma score (RTS), and result of accident were compared between pairs of drivers and passengers. The agreement of any type of injury between drivers and passengers evaluated by Kappa test.

RESULTS

This study included 143 matched pairs of drivers and passengers. Most of the pairs (84.5%) did not use helmet and 77.2% of the riders do not have driving license. ISS was significantly higher in drivers than passengers. In the unmatched pairs, drivers and passengers showed no difference in sustaining injuries in the face, head & neck, chest and soft tissue, but drivers were found more likely to suffer from injuries in the abdomen, extremities, pelvis and spine than passengers. Once one part of the matched pair suffered injury in the head & neck, face, chest, abdomen, extremities and soft tissue & skin injury, the probability that the other part had an injury in the same region was 50%, 9%, 13%, 7%, 22% and 34% respectively. Kappa value for these body regions was 0.006, 0.009, -0.006, 0.068, 0.063 and 0.001, respectively, which was significant in abdomen and extremities.

CONCLUSION

Although drivers had higher level of injury severity and some different injury distributions, we recommend equal treatment to drivers and passengers. We also recommend related authorities to develop policies on helmet use, driving license and third-party insurance.

A passenger reduces sleepy driver's activation in the right prefrontal cortex: A laboratory study using near-infrared spectroscopy

The present study aimed to examine how a passenger affects the sleepiness effect (awake vs. sleepy) on an individual's prefrontal activation during a simulated driving-game task using a wireless portable near-infrared spectroscopy (NIRS) device. Participants drove from start to goal along default routes either solely (no-passenger group) or with a friend sitting beside him/her as a passenger (with-passenger group). Sleepiness level was assessed by a five-item scale questionnaire. In the no-passenger group, there were no performance and activation differences between the sleepy and awake participants. In the with-passenger group, by contrast, the sleepy participants showed more errors and lower activations in their right prefrontal cortex than the awake participants. These results suggest that a passenger has little effect on awake participants, but may weaken the sleepy participants' vigilance and/or their cognitive abilities of action control. Practically, the present study demonstrates that NIRS may provide us a new possibility to monitor and examine the driver's mental states in the brain.

Aircraft passenger comfort experience: underlying factors and differentiation from discomfort

Previous studies defined passengers' comfort based on their concerns during the flight and a set of eight experiential factors such as 'peace of mind', 'physical wellbeing', 'pleasure', etc. One Objective of this paper was to determine whether the factors underlying the passengers' experience of comfort differ from those of discomfort. Another objective was to cross-validate those factors. In the first study, respondents provided written reports of flight comfort and discomfort experiences separately and gave ratings on the impact of the eight factors on each experience. Follow up interviews were also conducted. Significant difference was found between comfort and discomfort ratings for two factors of 'pleasure', denoted by one's concern for stimulation, ambience and exceeded expectations, and 'physical wellbeing' characterized in terms of bodily support and energy. However, there were no significant differences between the comfort and discomfort ratings on the other six factors. The evidence does not support the proposition that passenger comfort and discomfort are underline by different sets of factors. It is therefore suggested that the evaluation of overall passenger comfort experience, as a whole, employ one spectrum ranging from extreme comfort to discomfort. In study two, a pool of comfort descriptors was collected. Those that were less relevant to passenger comfort were eliminated in a number of steps. Factor analysis was used to classify the remaining descriptors, using respondents' ratings on their potential impact on passenger comfort. Seven factors corresponded to the pre-determined passenger comfort factors from previous research, validating those with an exception of 'proxemics' (concerning one's privacy and control over their situation) but it was argued that this is due to the nature of the factor itself, which is context dependent and generally perceived unconsciously.

Exploring preferred amino acid mutations in cancer genes: Applications to identify potential drug targets

Somatic mutations developed with missense, silent, insertions and deletions have varying effects on the resulting protein and are one of the important reasons for cancer development. In this study, we have systematically analysed the effect of these mutations at protein level in 41 different cancer types from COSMIC database on different perspectives: (i) Preference of residues at the mutant positions, (ii) probability of substitutions, (iii) influence of neighbouring residues in driver and passenger mutations, (iv) distribution of driver and passenger mutations around hotspot site in five typical genes and (v) distribution of silent and missense substitutions. We observed that R→H substitution is dominant in drivers followed by R→Q and R→C whereas E→K has the highest preference in passenger mutations. A set of 17 mutations including R→Y, W→A and V→R are specific to driver mutations and 31 preferred substitutions are observed only in passenger mutations. These frequencies of driver mutations vary across different cancer types and are selective to specific tissues. Further, driver missense mutations are mainly surrounded with silent driver mutations whereas the passenger missense mutations are surrounded with silent passenger mutations. This study reveals the variation of mutations at protein level in different cancer types and their preferences in cancer genes and provides new insights for understanding cancer mutations and drug development.

Young Drivers and Their Passengers: A Systematic Review of Epidemiological Studies on Crash Risk

PURPOSE

A systematic review of the literature was conducted to appraise the evidence from epidemiological studies of crash risk in young drivers accompanied by passengers, compared with solo driving.

METHODS

Databases searched were the Cochrane Library, Embase, Scopus, Transportation Research Information Services, and Web of Science for studies published between January 1, 1989 and August 1, 2013. Epidemiological studies were selected for review if they focused on crashes of young drivers (≤24 years old) and included both a no-passenger comparison group and some measure of exposure to enable calculation of estimates.

RESULTS

Fifteen articles (17 studies) were selected; seven studies reported on fatal crashes and 10 on nonfatal or combined fatal/nonfatal crashes. Studies on fatal crashes showed increased risk, compared with solo driving, for young drivers with at least one passenger (significant estimates ranging from 1.24 to 1.89) and two or more passengers versus solo driving (1.70-2.92). Increased risk was also found for fatal crashes and for combined or nonfatal crashes with male versus female passengers (1.53-2.66) and for younger versus older drivers (1.42-3.14).

CONCLUSIONS

Results more clearly indicated an increased risk for passenger presence in fatal crashes than that in nonfatal or combined fatal/nonfatal crashes. Findings of this review, based on correlational studies, support licensing policies that limit the presence and number of young passengers for young drivers.

Compliance with seat belt use in makurdi, Nigeria: an observational study

Background:

Seat belts are designed to reduce injuries due to road crash among vehicle occupants.

Aims:

This study aims to determine the availability of seat belt in vehicles and compliance with seat belt use among vehicle occupants.

Materials and methods:

This was a 24-h direct observational study of seat belt usage among vehicle occupants in Makurdi, Benue State, Nigeria. By direct surveillance and using a datasheet, we observed 500 vehicles and their occupants for seat belt availability and compliance with its use. Chi-square test was used for test of significance between variables.

Results:

Twenty-five (5.0%) of the observed 500 vehicles had no seat belt at all. Overall, compliance was 277/486 (57.0%). Use of seat belt was highest in the afternoon with 124/194 (64.4%), followed by 111/188 (59.0%) in the morning and 42/95 (44.2%) at night. Compliance was highest among car occupants [209/308 (67.9%)] and private vehicles, and lowest among commercial vehicle occupants. Compliance among female drivers was 77.1% compared with 51.4% among male drivers. Among drivers, the mean age of seat belt users was 38.4 (7.7) years, which was significantly younger than the 41.3 (8.7) years mean age of non-users. Similar figures were obtained among other vehicle occupants.

Conclusions:

Compared with previous studies, seat belt usage has improved among Nigerian road users, but there is still room for improvement, especially early in the mornings and at nights. Since these were times when law enforcement agencies were not likely to be on the roads, we advocate for improved coverage by enforcement agents to enforce better compliance.