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Serious-to-fatal injury was analyzed for second-row children aged 0–14 years and adults aged 15 and older in rear impacts by body region, restraint use, and injury mechanism using field data collected by NHTSA. 1994–2015 NASS-CDS and 2017–2020 CISS data were used to investigate the rate for Maximum Abbreviated Injury Scale (MAIS) 3 + F injury in rear crashes involving 1994+ model year vehicles. All second-row occupants were included, irrespective of restraint use and ejection status. The data were analyzed by group: children (0–14 years old) and adults (15+ years old). All available electronic files for seriously injured second-row occupants in the rear impacts were reviewed for mechanism of injury. The rate of serious injury (MAIS 3 + F) for second-row occupants was 0.93% ± 0.36% in rear crashes; it was 0.76% ± 0.39% for children and 1.22% ± 0.40% for adults. There were 2.8 AIS 3+ injuries per seriously to fatally injured occupant on average. Most serious injuries occurred to the head in children and to the head and chest in adults. Restraint use was only 31.3% for all seriously injured second-row occupants in the rear impacts. It was 45.1% for children and 17.8% for adults. The overall rate of serious injury in rear impacts was 10.0 times higher when unrestrained than restrained overall; it was 5.6 times higher for children and 20.2 times higher in adults. The case review indicated that many young children were improperly restrained or placed in the incorrect child seat. More than 17% of second-row adults were ejected; all were unrestrained. The primary mechanism for child injury was related to intrusion (86.0%). About 14% was not related to intrusion; 12.3% involved the front seat rotating rearward into the child. The primary mechanisms for adult injury differed from those for children; 68.0% was related to intrusion, 21.6% was not related to intrusion, and 10.4% involved ground impact with ejection. Of the non-intrusion-related cases, 19.1% involved acceleration forces injuring the adult and 2.5% involved the front seat rotating rearward. The primary mechanism for serious injury to second-row occupants in rear crashes was intrusion either by direct force, compression into front components, or acceleration into forward components. The front seat moving rearward was an infrequent cause for injury.

Objective: The objective of this study was to determine the physical characteristics of fatal drivers in motor vehicle crashes with focus on rear impacts. Methods: 1998 to 2020 FARS data was analyzed for height, weight, and age of fatal drivers. The data was queried by gender, crash type and vehicle type. Results: The average fatal driver weighed 80.4 kg, was 173.4 cm tall, and was 43 years old. Females were 16.0 kg lighter and 14.2 cm shorter than males on average. The height was 151.2 cm for the 5th percentile female, 177.0 cm for the 50th male and 188.9 cm for the 95th male. The weight of fatal drivers increased linearly with calendar year. The increase rate was greater in females than in males. About 3% of fatal drivers were involved in rear crashes, 39.9% in frontal crashes and 36.8% in rollovers. The average fatal driver was 172.5 cm tall and weighed 81.0 kg in rear impacts. They were similar in height and weight to the overall sample. The average fatal driver in rear impacts was 46 years old, 3 years older than the overall average. Pickup truck drivers weighed 85.4 kg and were 176.8 cm tall on average. They were heavier and taller than passenger car drivers on average, which were 78.0 kg and 172.2 cm. Fatally injured minivan drivers were 10 years older than fatally injured passenger car drivers on average. The findings are compared with ATDs (anthropometric test devices) used in sled and crash testing. Conclusion: The average weight of fatal drivers increased with calendar year. The average size of fatal drivers was similar by crash types. Fatal drivers were older in rear impacts.

This study assesses the effects of seat deflection in severe oblique rear impacts with laterally out-of-position ATDs where the head is not supported by the head restraint. Six high-speed rear sled tests were conducted at 48 km/h with a 195 degree PDOF. A lap-shoulder belted 50th percentile Hybrid III ATD was leaned inboard and seated in six different front passenger seats (A-F); five of the seats were selected from mid-sized sedans and one was a non-production rigidified Seat Integrated Restraint (SIR) seat. FRED-III pull tests resulted in seat stiffnesses that varied from 73 to 172 N/mm. Seat F had the greatest stiffness. The seat and ATD responses were assessed. The biomechanical responses were evaluated and compared to relevant IARVs. In all tests the ATD moved rearward and twisted the seat. There was limited differential motion of the torso relative to the seatback. The ATD position and PDOF prevented head restraint engagement allowing head and neck extension over the seatback. The seatback angle was measured on the inboard side. At maximum yield, it was greatest with Seat E, followed by Seat A and Seat D, at 71, 67 and 62 degrees, respectively. The duration of rearward deformation was also greatest with Seat A, Seat D and Seat E providing longer ride-down. The head, chest and upper neck responses were below IARVs. Lower-neck extension moments were above injury threshold with Seat B, C and F. Seat F had the highest lower-neck moment. Seats with greater deformation provided the greatest ride-down durations and the lowest overall biomechanical responses. The combination of high impact severity and lack of head support resulted in high lower-neck responses, highlighting the potential benefit of energy management from deforming seat structures.

This study determined the risk for fetal death and maternal injury in the same sample of motor-vehicle crashes. The frequency and risk of serious injury (MAIS 3 + F) were also assessed by sex, pregnancy, seating position and crash type.The 2008-2015 NASS-CDS and 2017-2020 CISS are representative samples that were analyzed for the risk of fetal death and the risk of maternal injury grouped by MAIS 0-2, MAIS 3 + F and death (F) in 2000+ model year (MY) light vehicles. All electronic cases involving fetal mortality were reviewed for mechanism of injury. Separately, the 2000-2015 NASS-CDS and 2017-2020 CISS data was analyzed for the risk of serious injury for male, female and pregnant female occupants by seating position and crash type in 2000+ MY light vehicles. All calculations are made with weighted data. The significance of differences in risk was determined by the Rao-Scott chi-square test in SAS and z-test for differences in proportions.There were 2,467 ± 1,407 fetal deaths in light vehicle crashes from 2008-2015 and 2016-2020 with an annual occurrence of 206/yr. The risk for fetal death was 1.25% ± 0.74% of exposed pregnant females. There were 127 ± 67 deaths of pregnant females, or 11/yr in the same sample. The fatality risk was 0.065% ± 0.035%. The difference in proportions was statistically significant (z = 46.1,Fetal deaths occurred 19.4-times more often than deaths of pregnant females in a 12-year sample of motor-vehicle crashes. The most common mechanism was a minor crash that resulted in a fetal death without serious injury to the pregnant female and involved side or oblique loading of the pregnant female.

Corridors for the biofidelity of blunt impact to the back are important for sled and crash testing with Anthropomorphic Test Devices (ATDs). The Hybrid III is used in rear sled tests as part of Federal Motor Vehicle Safety Standards (FMVSS) 202a. The only corridor for biofidelity is the neck extension. Eight Post Mortem Human Subjects (PMHS) were subjected to 20 blunt impacts with a 15.2 cm (6 in.) diameter pendulum weighing 23.4 kg. The impact was below T1 at 4.5 m/s and 6.7 m/s and below T6 at 4.5 m/s centered on the back. Head, neck, and chest responses were reported in 2001 [8]. In this study, the responses were scaled to the 50th male Hybrid III, and corridors were determined defining biofidelity for blunt impacts to the back. The scaled data gives an average peak force of 3.44 kN ± 0.74 kN at T1 and 4.5 m/s, 5.08 kN ± 1.35 kN at T1 and 6.7 ms, and 3.4 kN ± 1.2 kN at T6 and 4.5 m/s. The corresponding scaled deflection was 44.0 ± 19.7 mm, 60.2 ± 21.2 mm, and 53.1 ± 16.5 mm. The average stiffness of the back was 1.21 kN/cm at T1 and 4.5 m/s, 1.17 kN/cm at T1 and 6.7 m/s, and 1.14 kN/cm at T6 and 4.5 m/s. The corridors help to define biofidelity and can be used to assess the performance of the Hybrid III, Biofidelic Rear Impact Dummy (BioRID) II, and other ATDs.

Salvage options for patients with relapsed B-cell acute lymphoblastic leukemia (B-ALL) include inotuzumab ozogamicin (InO), a recombinant, humanized anti-CD22 monoclonal antibody conjugated to the cytotoxic antibiotic calicheamicin. However, the benefit of InO in patients with dim CD22 expression remains unclear. We present a case of a patient with B-ALL who responded to InO despite only dim surface expression of CD22 by flow cytometry, achieving a survival benefit concordant with that reported in the literature and maintaining a good quality of life as a transfusion-independent outpatient. Our observation has broad relevance to clinicians who manage patients with B-ALL who are candidates for InO.

This study explores parliamentary reforms related to the financial accountability of banks following the 1825–6 and 1836–7 financial crises in England. An appraisal of nineteenth-century parliamentary Hansard transcripts reveals early banking legislative pursuits. The study observes the laissez-faire and interventionist approaches towards the banking enactments of 1826, 1833 and 1844 that underpin the transformation of financial accountability during this era. The Bank Notes Act 1826 imposed financial accountability on the Bank of England by requiring the mandatory disclosure of notes issued. The Bank Notes Act 1833 extended this requirement to all other banks. The Bank Charter Act 1833 increased the financial accountability of the Bank of England by requiring it to provide an account of bullion and securities belonging to the governor and company, as well as deposits held by the bank. Thereafter, the Joint Stock Banks Act 1844 pioneered the regular publication of assets and liabilities and communication of the balance sheet and profit and loss account to shareholders. State intervention in the financial accountability of banks during the period from 1825 to 1845 appears to have been cumulative.

Field data was analyzed to assess the risk of basilar, skull and facial fractures in 2Field accident data on seriously injured (MAIS 3+) occupants was determined using 1993-2015 NASS-CDS and 2017-19 CISS by crash type identified with damage area variables for non-ejected occupants in the 2The proportion of 2While basilar skull fractures are rare in 2

This study determined the type of striking vehicle or object associated with serious injury to at least 1 occupant in the vehicle struck in the rear. The 1990–2015 NASS-CDS was analyzed for light vehicles involved in rear crashes. The type of vehicle struck in the rear resulting in serious injury to at least 1 occupant was determined. Rear impacts were identified with GAD1 = B without rollover (rollover ≤ 0). Vehicles with serious to maximum injury were identified as VAIS 3 to 6 (VAIS 3+). The type of striking vehicle or object was determined for the rear impacts causing serious injury. The risk and relative risk for serious injury were determined. Review of electronic cases was conducted for light vehicles with serious injury (VAIS 3+) in impacts by tractor-trailers or large trucks. The highest risk for serious injury to an occupant in the struck vehicle was from a tractor-trailer or large truck (2.71%), followed by a fixed object (1.49%) and van (1.00%). The average risk was 0.33%. The relative risk was 8.2 times for impact with a tractor-trailer or large truck and 4.5 times for impact with a fixed object. The highest risk impacts with a fixed object were rear impacts into a tree/bush (3.57%) and pole (2.90%). Tractor-trailers and large trucks accounted for 16.2% of serious injury in struck vehicles, followed by fixed objects at 12.9%; the 2 accounted for 29.1% of serious injury to occupants of struck vehicles. The case review identified 22 tractor-trailer and 1 large truck crashes involving 31 seriously injured occupants in the struck vehicle. There were 2 general crash scenarios associated with serious injury. One involved intrusion deforming the occupant compartment. The other involved vehicle accelerations sufficient to seriously injure an occupant in the struck vehicle without significant deformation to the occupant compartment. This study provides insight into the striking vehicle or object associated with serious injury to light vehicle occupants in rear impacts. Tractor-trailer impacts into the rear of a vehicle involved a high risk for serious injury in the struck vehicle. The use of collision mitigation technologies, such as forward collision warning or automatic emergency braking, on the tractor-trailer may support better speed control and lead to lower closing velocities of rear impacts to light vehicles.

Field data was analyzed to assess the risk of basilar, skull and facial fractures in 2nd row occupants by crash type. The study determined the rate of fractures in seriously injured (MAIS 3 + F) occupants to establish priorities for 2nd row occupant safety. Field accident data on seriously injured (MAIS 3+) occupants was determined using 1993-2015 NASS-CDS and 2017-19 CISS by crash type identified with damage area variables for non-ejected occupants in the 2nd row. Occupants with serious head and face injuries (AIS 3+) were subdivided by fractures to the skull, basilar skull and face. Moderate-to serious (AIS 2+) orbit fractures were included. The rate of injury was determined. Individual electronic cases were analyzed for occupants with basilar fracture in rear and side impacts. The proportion of 2nd row occupants with AIS 3+ head and face injury was highest at 73.7% in rear impacts followed by side impacts at 54.2% for those with MAIS 3 + F injury. Basilar fractures (AIS 3+) occurred in 53.9% of 2nd row occupants with skull fracture in rear impacts but only 20.3% in side impacts. Overall, basilar fractures occurred in 10.8% of 2nd row occupants with serious injury (MAIS 3 + F) in rear impacts and 2.7% in side impacts. The frequency of AIS 3+ facial fractures was highest in side impacts (40.2%) and lowest (7.6%) in rear impacts. While basilar skull fractures are rare in 2nd row occupants, at 0.083% in rear and 0.044% in side impacts, they represent 53.9% of 2nd row occupants with a skull fracture and serious injury in rear impacts and 20.3% in side impacts. The mechanism of injury is different in rear and side impacts, but frequently involves multi-impact crashes, severe impacts, intrusion into the seating area and head impact on hard surfaces.

Applying tenets of legal origin theory, this paper traces the origins of banking financial accountability resting behind paragraphs 78 to 82 of the First Schedule of the Companies Act 1862 (UK), wh...

Psilocybin, the prodrug of the psychoactive molecule psilocin, has demonstrated promising results in clinical trials for the treatment of addiction, depression, and post-traumatic stress disorder. The development of a psilocybin production platform in a highly engineerable microbe could lead to rapid advances towards the bioproduction of psilocybin for use in ongoing clinical trials. Here, we present the development of a modular biosynthetic production platform in the model microbe, Escherichia coli. Efforts to optimize and improve pathway performance using multiple genetic optimization techniques were evaluated, resulting in a 32-fold improvement in psilocybin titer. Further enhancements to this genetically superior strain were achieved through fermentation optimization, ultimately resulting in a fed-batch fermentation study, with a production titer of 1.16 g/L of psilocybin. This is the highest psilocybin titer achieved to date from a recombinant organism and a significant step towards demonstrating the feasibility of industrial production of biologically-derived psilocybin.

At the remote International Chemistry Olympiad 2022 hosted by China, two outstanding students from Switzerland won one bronze medal and one honorable mention. A joint remote participation to the event of the delegations from Germany, Austria, and Switzerland could be realized in Basel with the support of the University of Basel. The International Chemistry Olympiad 2023 will be hosted at ETH Zurich. This itinerary will mark the first time this annual event comes to Switzerland.

This study analyzes field accidents to identify rear-occupant exposure and injury by crash types. Occupant demographics and injury were assessed by body region and crash severity to understand rear-occupant injury mechanisms in rear crashes. The exposure and serious-to-fatal injury was determined by crash type for non-ejected second- and third- row occupants in 1994+ MY vehicles using 1994-2015 NASS-CDS. Selected occupant demographics and serious injury distributions were assessed over a range of delta V for rear crashes. Rear crashes accounted for 8.7% of exposed and 5.4% of serious-to-fatally injured rear-seat occupants. On average, rear-seat occupants were 14.3 ± 1.5 years old (median 10.3, 90th CI 0.08-29.6), weighed 44.7 ± 2.6 kg (median 44.4, 90th CI 7.9-81.7) and were 130.3 ± 4.1 cm tall (median 141.4, 90th CI 67.3-178.4). With serious injury, the average rear occupant was 18.1 ± 5.8 years old (median 13.1, 90th CI 0.0-47.2), weighed 42.6 ± 10.7 kg (median 31.4, 90th CI 7.0-82.4) and was 120.6 ± 15.4 cm tall (median 145.4, 90th CI 48.8-174.1). More than 72% of rear-seat occupants were in delta V less than 24 km/h. Less than 2% were in delta V 48 km/h or greater. The overall rate of serious-to-fatally injured (MAIS 3 + F) was 0.73% ± 0.37%. For serious-to-fatally injured rear-seat occupants, the average delta V was 37.4 ± 3.1 km/h (median 29.8, 90th CI 28.6-62.1). None were involved in delta Vs less than 24 km/h, about 78% were in a delta V between 24-48 km/h and 22% were in a delta V of 48 km/h or greater. Head and chest were most commonly injured, irrespective of crash severity. The height and weight of a 10-year old and 5th Hybrid III ATD are representative of the average rear-seat occupant involved in rear crashes based on NASS-CDS. Crash tests with a delta V of between 30 and 37 km/h represent the typical collision causing serious-to-fatal injury.

This study addressed the potential effect of higher seat stiffness with ABTS (All-Belt-to-Seat) compared to conventional seats in rear impacts. It analyzed field accidents and sled tests over a wide range in delta V and estimated the change in number of injured occupants if front-seats were replaced with stiffer ABTS. The rear-impact exposures and serious-to-fatal injury rates were determined for 15+ year old non-ejected drivers and right-front passengers in 1994+ model year vehicles using 1994-2015 NASS-CDS. More than 50 rear sled tests were analyzed using conventional and ABTS seats. An injury risk was calculated for selected ATD biomechanical responses. The results obtained with the ABTS and conventional seats were compared for matched tests based on head restraint position, ATD size and initial position and delta V. The change in risk was used to estimate the change in injury in the field by adjusting the injury rate by delta V. On average, front seat occupants were 39 years old, weighed 78 kg and were 171 cm tall. About 29.3% of serious-to-fatally injured (MAIS 3 + F) front seat occupants were involved in delta Vs less than 24 km/h and about 28.4% in a delta V of 48 km/h or greater. The average biomechanical response and injury risk in sled tests were higher with an ABTS seat than with a conventional seat. The average maximum injury risk was assessed by delta V groups for conventional and ABTS seats. The relative risk of ABTS to conventional seats was 1.34 in less than 16 km/h, 1.69 in 16-24 km/h, 1.65 in 24-32 km/h, 1.33 in 32-40 km/h, 5.77 in 40-48 km/h and 48.24 in the 56-64 km/h delta V category. The estimated relative risk was 11.90 in 48-56 km/h and 34.11 in 64+ km/h. The number of serious-to-fatally injured occupants was estimated to increase by up to 6.88-times if stiffer ABTS seats replaced conventional seats. The field data indicate that the 50th percentile male Hybrid III size is representative of an average occupant involved in rear crashes. ABTS seats used in this study are stiffer than conventional seats and increase ATD responses and injury risks over a wide range of crash severities.

This study compared dummy kinematics and biomechanical responses with and without retractor pretensioning in a severe rear sled test. It compliments an earlier study with buckle pretensioning. Three rear tests were run at 40 km/h (25 mph) delta V with a lap-shoulder belted Hybrid III 50th male dummy on a 2013-18 Ford Escape driver seat and belt restraint. One test was with the lap-shoulder belts only, a second with retractor and anchor pretensioning and a third with only retractor pretensioning. The head, chest and pelvis were instrumented with triaxial accelerometers. The upper and lower neck, thoracic spine and lumbar spine had transducers measuring triaxial loads and moments. Lap belt load was measured. High-speed video recorded different views of the dummy motion. Dummy kinematics and biomechanical responses were compared to determine the influence of retractor belt pretensioning. The dummy kinematics and biomechanical responses were essentially similar with and without retractor or retractor and anchor pretensioning in rear sled tests. There was an initial spike in lap belt load with pretensioning, but it did not result in different dummy head, neck or chest responses. In the tests, the dummy moved rearward away from the shoulder belt. The belts were tightened with the rapid pull on the webbing by pretensioning. The dummy loaded the seat, which yielded rearward restraining its motion. There was no significant effect of pretensioning on the dynamics of the dummy until late in rebound. There were no significant differences in dynamics of the Hybrid III with and without retractor or retractor and anchor pretensioning in a 40 km/h (25 mph) rear sled test. Belt pretensioning did not influence biomechanical responses in the rear impact because the seat supported the dummy.

Occupant kinematics and biomechanical responses are assessed with and without pretensioning of normally seated and out-of-position front-seat occupants in rear sled tests. The results are compared to recent studies. Three series of rear sled tests were conducted at 24 and 40 km/h with a 2001 Ford Taurus. Series I consisted of two sled tests with a lap-shoulder belted 50th Hybrid III in the driver seat. Series II included four sled tests with a lap-shoulder belted 50th Hybrid III in both front seats. Two soft foam blocks were added, one was placed on the chest centerline under the shoulder belt and one on the pelvis under the lap belt providing additional webbing. Series III consisted of 8 runs and 16 ATD tests to assess the effect of pretensioning with out-of-positioned (OOP) occupants. The biomechanical responses were normalized with Injury Assessment Reference Values (IARV) for head, neck and chest. The ATD kinematics and biomechanical responses were similar in the yielding phase when the occupant was normally seated with and without pretensioning. The rebound displacement was greater with pretensioning in the 40 km/h tests due to the shoulder belt slipping off the shoulder. The hip displacement was similar, irrespective of pretensioning. All biomechanical responses were below IARVs. The highest response was for lower neck extension. The normalized response was at about 32% for the 24 km/h tests, irrespective of pretensioning. It was up to 59% in the 40 km/h tests with pretensioning. With the OOP occupants, there were no differences in the kinematics and biomechanical response with pretensioning. Testing of the effect of retractor pretensioning with out-of-position occupants and additional belt webbing in moderate to high-speed rear sled tests shows no effect on occupant kinematics and biomechanical responses. The displacement of the hips in a rear impact depends on the compliance of the seatback and amount of pocketing, the stiffness of the seat frame limiting rearward rotation, and the dynamic friction between the occupant and the seatback.

BACKGROUND: Studies have demonstrated an inverse relationship between body mass index (BMI) and the risk of developing lung cancer. We conducted a retrospective cohort study evaluating baseline quantitative computed tomography (CT) measurements of body composition, specifically muscle and fat area in a large CT lung screening cohort (CTLS). We hypothesized that quantitative measurements of baseline body composition may aid in risk stratification for lung cancer. METHODS: Patients who underwent baseline CTLS between January 1st, 2012 and September 30th, 2014 and who had an in-network primary care physician were included. All patients met NCCN Guidelines eligibility criteria for CTLS. Quantitative measurements of pectoralis muscle area (PMA) and subcutaneous fat area (SFA) were performed on a single axial slice of the CT above the aortic arch with the Chest Imaging Platform Workstation software. Cox multivariable proportional hazards model for cancer was adjusted for variables with a univariate p < 0.2. Data were dichotomized by sex and then combined to account for baseline differences between sexes. RESULTS: One thousand six hundred and ninety six patients were included in this study. A total of 79 (4.7%) patients developed lung cancer. There was an association between the 25th percentile of PMA and the development of lung cancer [HR 1.71 (1.07, 2.75), p < 0.025] after adjusting for age, BMI, qualitative emphysema, qualitative coronary artery calcification, and baseline Lung-RADS® score. CONCLUSIONS: Quantitative assessment of PMA on baseline CTLS was associated with the development of lung cancer. Quantitative PMA has the potential to be incorporated as a variable in future lung cancer risk models.

Objective: This study analyzed thoracic and lumbar spine responses with “in position” and OOP (out-of-position) seated dummies in 40.2 km/h (25 mph) rear sled tests with conventional and ABTS (all belts to seat) seats. Occupant kinematics and spinal responses were determined with modern (≥2000 MY), older (Methods: The seats were fixed in a sled buck subjected to a 40.2 km/h (25 mph) rear sled test. The pulse was a 15 g double-peak acceleration with 150 ms duration. The 50th Hybrid III was lap-shoulder belted in the FMVSS 208 design position or OOP, including leaning forward and leaning inboard and forward. There were 26 “in position” tests with 11 Results: The extension moments were higher in the thoracic than lumbar spine in the “in position” tests. For Conclusions: The design and performance of seats have significantly changed over the past 20 years. Modern seats use a perimeter frame allowing the occupant to pocket into the seatback. Higher and more forward head restraints allow a stronger frame as the head, neck and torso are more uniformly supported with the seat more upright in severe rear impacts. The overall effect has been a reduction in thoracic and lumbar loads and risks for injury.

This study uses legal origin theory to consider the influence of the British imperial government on financial statement presentation of early Western Australian banks. Accountability and patterns of financial presentation were explored through an examination of 192 quarterly returns and three annual returns for the Bank of Western Australia, Western Australian Bank and National Bank of Australia over the years 1837–1880. Findings from the study suggest the banks demonstrated a willingness to prepare forms of Western-narrow and Western-broad accounts. Early Western Australian banks consistently prepared timely financial statements to keep stakeholders informed of the banks’ quarterly returns. Despite the harsh economic conditions, Western Australian banks appeared to keep pace with the changing legal, political and fiscal accountability reforms carried out by the colonial government during this early settlement period of Western Australia.

We aimed to assess patient-, tooth- and treatment-level covariates on the failure of root canal treatments (RT) and to predict failure using machine learning (ML).Teeth receiving RT at one large university hospital from 2016 to 2020 with a minimum follow-up of ≥6 months were included. Failure compromised absent radiographic healing and/or the presence of clinical symptoms. Covariates were selected on tooth-, treatment- and patient-level. We used logistic regression (logR) to determine associations in the full dataset, and logR as well as more advanced ML (random forests (RF), gradient boosting machine (GBM) and extremely gradient boosting (XGB)) for predictive modeling (area-under-the-receiver operating characteristic-curve (ROCAUC)) and testing on a separate test dataset.458 patients (female/male 47.2/52.8%) with 591 permanent teeth were included (overall success rate 79.5%). In logR, tooth-level covariates showed strong associations with failure: Alveolar bone loss 66-100% (ABL, OR 6.48, 95% CI [2.86, 14.89], p0.001); Periapical index (PAI) score≥4 (OR 4.59, [2.44, 8.79], p0.001); ABL 33-66% (OR 2.59 [1.49, 4.49], p0.001); PAI=3 (OR 2.45, [1.43, 4.34], p0.01); Treatment type "retreatment" (OR 1.77, [1.01, 2.86], p0.01). On patient level only smoking (OR 2.05, [1.18, 3.53], p0.05) was significantly associated with risk of failure. For predictive modeling, the predictive power of all models was limited (ROCAUC: logR 0.63, [0.53, 0.73]; GBM 0.59, [0.50, 0.68]; RF 0.59, [0.50, 0.68]; XGB 0.60, [0.50, 0.70]).Failure of RT was associated mainly with tooth-level covariates. Predicting failure was only limitedly possible, also with more complex ML.Identifying specific risk factors for failure of RT and predicting the outcome of RT is relevant for treatment planning and informed shared decision-making. The present study found tooth-level factors to be associated with failure. Notably, predicting failure was only limitedly possible.

This is a descriptive study. It determined the annual, national incidence of head injuries (traumatic brain injury, TBI) to adults and children in motor vehicle crashes. It evaluated NASS-CDS for exposure and incidence of various head injuries in towaway crashes. It evaluated 3 health databases for emergency department (ED) visits, hospitalizations, and deaths due to TBI in motor vehicle occupants.Four databases were evaluated using 1997-2010 data on adult (15+ years old) and child (0-14 years old) occupants in motor vehicle crashes: (1) NASS-CDS estimated the annual incidence of various head injuries and outcomes in towaway crashes, (2) National Hospital Ambulatory Medical Care Survey (NHAMCS)-estimated ED visits for TBI, (3) National Hospital Discharge Survey (NHDS) estimated hospitalizations for TBI, and (4) National Vital Statistics System (NVSS) estimated TBI deaths. The 4 databases provide annual national totals for TBI related injury and death in motor vehicle crashes based on differing definitions with TBI coded by the Abbreviated Injury Scale (AIS) in NASS-CDS and by International Classification of Diseases (ICD) in the health data.Adults: NASS-CDS had 16,980 ± 2,411 (risk = 0.43 ± 0.06%) with severe head injury (AIS 4+) out of 3,930,543 exposed adults in towaway crashes annually. There were 49,881 ± 9,729 (risk = 1.27 ± 0.25%) hospitalized with AIS 2+ head injury, without death. There were 6,753 ± 882 (risk = 0.17 ± 0.02%) fatalities with a head injury cause. The public health data had 89,331 ± 6,870 ED visits, 33,598 ± 1,052 hospitalizations, and 6,682 ± 22 deaths with TBI. NASS-CDS estimated 48% more hospitalized with AIS 2+ head injury without death than NHDS occupants hospitalized with TBI. NASS-CDS estimated 29% more deaths with AIS 3+ head injury than NVSS occupant TBI deaths but only 1% more deaths with a head injury cause. Children: NASS-CDS had 1,453 ± 318 (risk = 0.32 ± 0.07%) with severe head injury (AIS 4+) out of 454,973 exposed children annually. There were 2,581 ± 683 (risk = 0.57 ± 0.15%) hospitalized with AIS 2+ head injury, without death. There were 466 ± 132 (risk = 0.10 ± 0.03%) fatalities with a head injury cause. The public health data had 19,251 ± 2,803 ED visits, 3,363 ± 255 hospitalizations, and 488 ± 6 deaths with TBI. NASS-CDS estimated 24% fewer hospitalized children with AIS 2+ head injury without death than NHDS hospitalization with TBI. NASS-CDS estimated 31% more deaths with AIS 3+ head injury than NVSS child deaths but 5% fewer deaths with a head injury cause.The annual national incidence of motor vehicle-related head injury (TBI) was estimated using 1997-2010 NASS-CDS from the Department of Transportation and NHAMCS (ED visits), NHDS (hospitalizations), and NVSS (deaths) from the Department of Health and Human Services. The transportation and health databases use different definitions and coding, which complicates direct comparisons. Future work is needed where ICD to AIS translators are used if comparisons of serious head injuries in NASS and health data sets are to be made.

Purpose: This is a study that updates earlier research on the influence of a front passenger on the risk for severe driver injury in near-side and far-side impacts. It includes the effects of belt use by the driver and passenger, identifies body regions involved in driver injury, and identifies the sources for severe driver head injury. Methods: 1997–2015 NASS-CDS data were used to investigate the risk for Maximum Abbreviated Injury Scale (MAIS) 4 + F driver injury in near-side and far-side impacts by front passenger belt use and as a sole occupant in the driver seat. Side impacts were identified with GAD1 = L or R without rollover (rollover ≤ 0). Front-outboard occupants were included without ejection (ejection = 0). Injury severity was defined by MAIS and fatality (F) by TREATMNT = 1 or INJSEV = 4. Weighted data were determined. The risk for MAIS 4 + F was determined using the number of occupants with known injury status MAIS 0 + F. Standard errors were determined. Results: Overall, belted drivers had greater risks for severe injury in near-side than far-side impacts. As a sole driver, the risk was 0.969 ± 0.212% for near-side and 0.313 ± 0.069% for far-side impacts (P < .005). The driver's risk was 0.933 ± 0.430% with an unbelted passenger and 0.596 ± 0.144% with a belted passenger in near-side impacts. The risk was 2.17 times greater with an unbelted passenger (NS). The driver's risk was 0.782 ± 0.431% with an unbelted passenger and 0.361% ± 0.114% with a belted passenger in far-side impacts. The risk was 1.57 times greater with an unbelted passenger (P < .10). Seat belt use was 66 to 95% effective in preventing MAIS 4 + F injury in the driver. For belted drivers, the head and thorax were the leading body regions for Abbreviated Injury Scale (AIS) 4+ injury. For near-side impacts, the leading sources for AIS 4+ head injury were the left B-pillar, roof, and other vehicle. For far-side impacts, the leading sources were the other occupant, right interior, and roof (8.5%). Conclusions: Seat belt use by a passenger lowered the risk of severe driver injury in side impacts. The reduction was 54% in near-side impacts and 36% in far-side impacts. Belted drivers experienced mostly head and thoracic AIS 4+ injuries. Head injuries in the belted drivers were from contact with the side interior and the other occupant, even with a belted passenger.

Purpose: This is a descriptive study of the incidence and risk for severe injury in single-impact and multi-impact crashes by belt use and crash type using NASS-CDS. Methods: 1997–2015 NASS-CDS data were used to determine the distribution of crashes by the number of impacts and severe injury (Maximum Abbreviated Injury Score [MAIS] 4+F) to >15-year-old nonejected drivers by seat belt use in 1997+ MY vehicles. It compares the risk for severe injury in a single impact and in crashes involving 2, 3, or 4+ impacts in the collision with a focus on a frontal crash followed by other impacts. Results: Most vehicle crashes involve a single impact (75.4% of 44,889,518 vehicles), followed by 2-impact crashes (19.6%), 3-impact crashes (5.0%) and 4+ impacts (2.6%). For lap–shoulder-belted drivers, the distribution of severe injury was 42.1% in a single impact, 29.3% in 2 impacts, 13.4% in 3 impacts, and 15.1% in 4+ impact crashes. The risk for a belted driver was 0.256 ± 0.031% in a single impact, 0.564 ± 0.079% in 2 impacts, 0.880 ± 0.125% in 3 impacts, and 2.121 ± 0.646% in 4+ impact. The increase in risk from a single crash to multi-impact collisions was statistically significant (P < .001). In a single impact, 53.8% of belted drivers were in a frontal crashes, 22.4% in side crashes, 20% in rear crashes, and 1.7% in rollover crashes. The risk for severe injury was highest in a rollover at 0.677 ± 0.250%, followed by near-side impact at 0.467 ± 0.084% and far-side impact at 0.237 ± 0.071%. Seat belt use was 82.4% effective in preventing severe injury (MAIS 4+F) in a rollover, 47.9% in a near-side impact, and 74.8% in a far-side impact. In 2-impact crashes with a belted driver, the most common sequence was a rear impact followed by a frontal crash at 1,843,506 (21.5%) with a risk for severe injury of 0.100 ± 0.058%. The second most common was a frontal impact followed by another frontal crash at 1,257,264 (14.7%) with a risk of 0.401 ± 0.057%. The risk was 0.658 ± 0.271% in a frontal impact followed by a rear impact. A near-side impact followed by a rear crash had the highest risk for severe injury at 2.073 ± 1.322%. Conclusions: Restraint systems are generally developed for a single crash or sled test. The risk for severe injury was significantly higher in 2-, 3-, and 4+-impact crashes than a single impact. The majority (57.9%) of severe injuries occurred in multi-impact crashes with belted drivers. The evaluation of restraint performance warrants additional study in multi-impact crashes.

Purpose: This study investigated trends in severe injury and ejection in rollover crashes involving lap-shoulder belted drivers and right-front passengers. It was conducted because of changes in 2009 to consumer information programs and regulations related to rollover protection. The data is presented by model year (MY) of the vehicle in groups from 1995-2016. NASS-CDS cases with 2010-16 MY vehicles were also evaluated to determine the crash circumstances and causes for severe injury of belted occupants in vehicles with a high strength-to-weight (SWR) roof, curtain and side airbags and other safety improvements. Methods: 1997-2015 NASS-CDS data was evaluated for severe injury and ejection of lap-shoulder belted front-outboard occupants in light vehicles. Crashes were grouped by front, side, rear and rollover. The injury and ejection data was grouped by vehicle MY: 1995-99, 2000-04, 2005-09 and 2010-16. Only drivers and right-front passengers were included if they were lap-shoulder belted and 15+ years old. Severely injured occupants were defined as those with MAIS 4-6 or fatality (MAIS 4+F). National estimates were made with weighted data using the ratio weight in NASS-CDS. All NASS-CDS electronic cases were evaluated for belted occupants with MAIS 4+F injury in rollovers involving 2010-16 MY vehicles. The crash circumstances and injuries were studied. These vehicles had high SWR roofs to meet IIHS ratings and FMVSS 216. Results: The 1997-2015 NASS-CDS included 2,083,776 belted front occupants in rollover crashes with 24,466 (1.17%) MAIS 4+F injuries. The frequency of rollover crashes has decreased with modern vehicles (p The risk for MAIS 4+F was 1.325 ± 0.347% in rollover crashes with 1995-99 MY vehicles. It was 27.2% lower in 2010-16 MY vehicles at 0.964 ± 0.331% (p < 0.001). There were 42,567 (2.002%) ejections of belted occupants in rollover crashes, irrespective of injury outcome. The risk for ejection was 3.042 ± 1.44% in rollover crashes with 1995-99 MY vehicles. It was 43.6% lower in 2004-2009 MY vehicle at 1.715 ± 0.660% (p 10 cm vertical roof deformation or substantial roof deformation based on photos. The roof strength (SWR) of 4.20 ± 1.0 was not sufficient to prevent roof deformation in these crashes. Conclusions: This study found a reduction in severe injury and ejection risk with modern vehicles. It indicates vehicle safety has improved in response to IIHS and NHTSA efforts to expand the array of safety requirements and increase performance so that newer models are safer than earlier ones. There has been an incremental improvement in safety by these advances.

This study investigated trends in severe injury and ejection in rollover crashes involving lap-shoulder-belted drivers and right-front passengers. It was conducted because of changes in 2009 to consumer information programs and regulations related to rollover protection. The data are presented by model year (MY) of the vehicle in groups from 1995 to 2016. NASS-CDS cases with 2010-2016 MY vehicles were also evaluated to determine the crash circumstances and causes for severe injury of belted occupants in vehicles with a high strength-to-weight (SWR) roof, curtain, and side airbags and other safety improvements.1997-2015 NASS-CDS data were evaluated for severe injury and ejection of lap-shoulder-belted front outboard occupants in light vehicles. Crashes were grouped by front, side, rear, and rollover. The injury and ejection data were grouped by vehicle MY: 1995-1999, 2000-2004, 2005-2009, and 2010-2016. Only drivers and right-front passengers were included if they were lap-shoulder belted and 15+ years old. Severely injured occupants were defined as those with Maximum Abbreviated Injury Scale (MAIS) 4-6 or fatality (MAIS 4 + F). National estimates were made with weighted data using the ratio weight in NASS-CDS. All NASS-CDS electronic cases were evaluated for belted occupants with MAIS 4 + F injury in rollovers involving 2010-2016 MY vehicles. The crash circumstances and injuries were studied. These vehicles had high-SWR roofs to meet Insurance Institute for Highway Safety (IIHS) ratings and FMVSS 216.The 1997-2015 NASS-CDS included 2,083,776 belted front occupants in rollover crashes with 24,466 (1.17%) MAIS 4 + F injuries. The frequency of rollover crashes has decreased with modern vehicles (P .0001). The 1995-1999 MY vehicles involved in a rollover accounted for 7.03% of all crashes (756,228/10,760,000). The corresponding proportion was 3.57% with 2010-2016 MY vehicles (81,406 vs. 2,282,062). The risk for MAIS 4 + F was 1.325 ± 0.347% in rollover crashes with 1995-1999 MY vehicles. It was 27.2% lower in 2010-2016 MY vehicles at 0.964 ± 0.331% (P .001). There were 42,567 (2.002%) ejections of belted occupants in rollover crashes, irrespective of injury outcome. The risk for ejection was 3.042 ± 1.44% in rollover crashes with 1995-1999 MY vehicles. It was 43.6% lower in 2004-2009 MY vehicle at 1.715 ± 0.660% (P .001) and 83.4% lower in 2010-2016 MY vehicle at 0.505 ± 0.336% (P .001). There were 17 rollovers with MAIS 4 + F in 2010-2016 MY vehicles in NASS-CDS. Their roof strength was SWR =4.15 ± 1.05 based on 15 vehicles. Many of the collisions involved front or side impacts and then a rollover. Four cases involved 16- to 30-year-old drivers in extremely high-speed loss-of-control crashes resulting in10-cm vertical roof deformation or substantial roof deformation based on photos. The roof strength (SWR) of 4.20 ± 1.0 was not sufficient to prevent roof deformation in these crashes.This study found a reduction in severe injury and ejection risk with modern vehicles. It indicates that vehicle safety has improved in response to IIHS and NHTSA efforts to expand the array of safety requirements and increase performance so that newer models are safer than earlier ones. There has been an incremental improvement in safety due to these advances.

Purpose: This is a descriptive study of the annual incidence of brain injuries in motor vehicle crashes by type, seatbelt use and crash severity (delta V) using national accident data. The risk for concussion, diffuse axonal injury (DAI) and severe head injury was determined.Methods: 1994-2011 NASS-CDS (National Automotive Sampling System - Crashworthiness Data System) was analyzed to estimate the number of brain injuries annually in non-ejected adults involved in motor vehicle crashes. Crashes were grouped by front, side, rear and rollover, and the effect of belt use was investigated. Light vehicles were included with model year 1994+. Head injuries were identified as concussion, DAI, severe head injury (AIS 4+) and skull fracture. The annual incidence, risk and rate for different types of head injury were estimated with standard errors.Results: Motor vehicle crashes involved 33,191 ± 7,815 occupants with concussion, 5,665 ± 996 with AIS 4+ head injuries, 986 ± 446 with DAI, and 3,300 ± 531 with skull fracture annually. The risk was 1.64% ± 0.39% for concussion, 0.28% ± 0.05% for severe head injury (AIS 4+), 0.05% ± 0.02% for DAI and 0.16% ± 0.03% for skull fracture in tow-away crashes. The risk for severe head injury (AIS 4+) was highest in rollovers (0.74% ± 0.16%) and lowest in rear impacts (0.17% ± 0.05%). Head injury risk depended on seatbelt use, crash type and crash severity (delta V). Seatbelt use lowered the risk for AIS 4+ head injury by 74.8% and skull fracture by 73.2%.Conclusions: Concussions occur in about one out of 61 occupants in tow-away crashes. The risk was highest in rollover crashes (4.73% ± 1.09%) and it was reduced 69.2% by seatbelt use. Severe brain injuries occurred less often and the risk was also reduced by seatbelt use.

Background. Hematologic improvement (HI) occurs in some patients with acquired anemias and transfusional iron overload receiving iron chelation therapy (ICT) but there is little information on transfusion status after stopping chelation.Case Report. A patient with low IPSS risk RARS-T evolved to myelofibrosis developed a regular red blood cell (RBC) transfusion requirement. There was no response to a six-month course of study medication or to erythropoietin for three months. At 27 months of transfusion dependence, she started deferasirox and within 6 weeks became RBC transfusion independent, with the hemoglobin normalizing by 10 weeks of chelation. After 12 months of chelation, deferasirox was stopped; she remains RBC transfusion independent with a normal hemoglobin 17 months later. We report the patient’s course in detail and review the literature on HI with chelation.Discussion. There are reports of transfusion independence with ICT, but that transfusion independence may be sustained long term after stopping chelation deserves emphasis. This observation suggests that reduction of iron overload may have a lasting favorable effect on bone marrow failure in at least some patients with acquired anemias.

Objective: This study compared biomechanical responses of a normally seated Hybrid III dummy on conventional and all belts to seat (ABTS) seats in 40.2 km/h (25 mph) rear sled tests. It determined the difference in performance with modern (≥2000 MY) seats compared to older (Methods: The seats were fixed in a sled buck subjected to a 40.2 km/h (25 mph) rear sled test. The pulse was a 15 g double-peak acceleration with 150 ms duration. The 50th percentile Hybrid III was lap–shoulder belted in the FMVSS 208 design position. The testing included 11 t test. High-speed video documented occupant kinematics. Results: Biomechanical responses were lower with modern (≥2000 MY) seats than older (P =.01). Overall, there was a 34% reduction in the comparable biomechanical responses with modern seats. Biomechanical responses were lower with modern seats than ABTS seats. The lower neck extension moment was 41.4 ± 7.8% with all MY ABTS seats compared to 32.5 ± 9.7% in modern seats (P =.07). Overall, the ABTS seats had 13% higher biomechanical responses than the modern seats. Conclusions: Modern (≥2000 MY) design seats have lower biomechanical responses in 40.2 km/h rear sled tests than older (

This is a study of the influence of an unbelted rear occupant on the risk of severe injury to the front seat occupant ahead of them in frontal crashes. It provides an update to earlier studies.1997-2015 NASS-CDS data were used to investigate the risk for severe injury (Maximum Abbreviated Injury Score [MAIS] 4+F) to belted drivers and front passengers in frontal crashes by the presence of a belted or unbelted passenger seated directly behind them or without a rear passenger. Frontal crashes were identified with GAD1 = F without rollover (rollover ≤ 0). Front and rear outboard occupants were included without ejection (ejection = 0). Injury severity was defined by MAIS and fatality (F) by TREATMNT = 1 or INJSEV = 4. Weighted data were determined. The risk for MAIS 4+F was determined using the number of occupants with known injury status MAIS 0+F. Standard errors were determined.The risk for severe injury was 0.803 ± 0.263% for the driver with an unbelted left rear occupant and 0.100 ± 0.039% with a belted left rear occupant. The driver's risk was thus 8.01 times greater with an unbelted rear occupant than with a belted occupant (P.001). With an unbelted right rear occupant behind the front passenger, the risk for severe injury was 0.277 ± 0.091% for the front passenger. The corresponding risk was 0.165 ± 0.075% when the right rear occupant was belted. The front passenger's risk was 1.68 times greater with an unbelted rear occupant behind them than a belted occupant (P.001). The driver's risk for MAIS 4+F was highest when their seat was deformed forward. The risk was 9.94 times greater with an unbelted rear occupant than with a belted rear occupant when the driver's seat deformed forward. It was 13.4 ± 12.2% with an unbelted occupant behind them and 1.35 ± 0.95% with a belted occupant behind them.Consistent with prior literature, seat belt use by a rear occupant significantly lowered the risk for severe injury to belted occupants seated in front of them. The reduction was greater for drivers than for front passengers. It was 87.5% for the driver and 40.6% for the front passenger. These results emphasize the need for belt reminders in all seating positions.

The immune system has evolved to sense invading pathogens, control infection, and restore tissue integrity. Despite symptomatic variability in patients, unequivocal evidence that an individual's immune system distinguishes between different organisms and mounts an appropriate response is lacking. We here used a systematic approach to characterize responses to microbiologically well-defined infection in a total of 83 peritoneal dialysis patients on the day of presentation with acute peritonitis. A broad range of cellular and soluble parameters was determined in peritoneal effluents, covering the majority of local immune cells, inflammatory and regulatory cytokines and chemokines as well as tissue damage–related factors. Our analyses, utilizing machine-learning algorithms, demonstrate that different groups of bacteria induce qualitatively distinct local immune fingerprints, with specific biomarker signatures associated with Gram-negative and Gram-positive organisms, and with culture-negative episodes of unclear etiology. Even more, within the Gram-positive group, unique immune biomarker combinations identified streptococcal and non-streptococcal species including coagulase-negative Staphylococcus spp. These findings have diagnostic and prognostic implications by informing patient management and treatment choice at the point of care. Thus, our data establish the power of non-linear mathematical models to analyze complex biomedical datasets and highlight key pathways involved in pathogen-specific immune responses.

Starting in 1997, General Motors (GM) introduced high retention seats in new model vehicles to improve rear impact safety. The seat allowed the occupant to pocket into the seatback and had increased strength and improved head restraint coverage. The initial 4-year safety trends were evaluated using the 1991-2000 Fatality Analysis Reporting System (FARS). The reduction in odds of fatal injury was 30.4% (95% confidence interval [CI], 0.9-51.1, P.05). This study updates the earlier one by adding 8 years of FARS data.The 2001-2008 FARS was analyzed for rear impacts of 1992 to 2008 model year GM vehicles that transitioned to high retention seats. The number of fatal and nonfatal injuries to drivers and right-front passengers was determined in vehicles with baseline (earlier designs) and high retention seats. The odds ratio for fatal injury and the change in fatality risk were determined with ±95% confidence intervals, z-statistic, and significance level. The data were further subdivided by passenger car, light truck (truck, SUV, and van) and driver-only crashes.Based on 9,570 drivers and right-front passengers in fatal rear impacts in 1991-2008 FARS data, the fatality risk was 16.6% (95% CI, 15.1-18.3) in vehicles with high retention seats and 27.1% (95% CI, 26.1-28.1) in vehicles with baseline seats. The reduction in odds for fatal injury was 46.3% (95% CI, 39.3-52.4) with high retention seats and it was statistically significant with z = 9.982, P.0001. The reduction in odds for fatal injury was similar for occupants in passenger cars at 45.4% (95% CI, 35.4-53.8) and light trucks, SUVs, and vans at 45.0% (95% CI, 28.8-57.5) using 2001-2008 FARS; however, the fatality risk was higher in passenger cars, at 23.1% (95% CI, 20.6-25.7), than in light trucks, SUVs, and vans, at 8.7% (95% CI, 7.0-10.7).Vehicles with high retention seats significantly reduced the odds for fatal injury by 46.3% (95% CI, 39.3-52.4, P.0001) in rear impacts compared to vehicles with earlier seat designs. The new generation of yielding seats has significantly improved occupant safety in rear impacts.

Human immunodeficiency virus (HIV)-associated multicentric Castleman disease (MCD) is a lymphoproliferation associated with human herpes virus-8 (HHV-8). Optimal treatment in patients not responding to antiretroviral therapy (ART) is undefined. We report 12 patients with ART refractory HIV-MCD. Patients with HIV-MCD were identified and baseline characteristics, treatment and outcome considered. Median CD4 count at HIV-MCD diagnosis was 295 (60-950) cells/mL. All patients had waxing and waning systemic symptoms, lymphadenopathy and/or splenomegaly, with non-Hodgkin lymphoma (NHL) in three. Treatment included: anti-HHV-8 therapy, n = 8; alone, n = 4; with systemic chemotherapy (CT) ± immunotherapy (IT), n = 4; CT ± IT only, n = 2. Initial median HHV-8 viral load (VL) was 7 × 10(4) copies/mL and at follow-up40 in 6/7 survivors; and 403-7.2 × 10(6) in 4/5 who died. One patient developed NHL despite an HHV-8 VL40. HIV-MCD is challenging to treat. Suppression of plasma HHV-8 VL did not prevent development of NHL. Anti-HHV-8 therapy should probably be considered adjunctive to cytotoxic therapies.

Abdominal injuries resulting from vehicle crashes can be significant, in particular when undetected. In this study, abdominal injuries for occupants involved in frontal impacts were assessed using crash and medical data.Injury rates and patterns were first assessed with respect to thoracic injuries. A statistical analysis was then conducted to predict abdominal injury outcome using 18 covariate variables, including 4 vehicle, 4 demographic, and 10 morphomic, derived from computed tomography (CT) scans. More than 260,000 logistic regression models were fitted using all possible variable combinations. The models were ranked using the Akaike information criterion (AIC) and combined through the model-averaging approach to produce the optimal predictive model. The performance of the models was then assessed using the area under the curve (AUC).The rate of serious thoracic injury was 2.49 times higher than the rate of abdominal injury. The associated odds ratio was 2.31 (P.01). These results suggest a strong association between serious abdominal and thoracic injuries. The optimal model AUC was 0.646 when using solely vehicle data, 0.696 when combining vehicle and demographic data, 0.866 when combining vehicle and morphomic data, and 0.879 when combining vehicle, demographic, and morphomic data. These results suggest that morphomic variables better predict abdominal injury outcomes than demographic variables. The most important morphomics variables included visceral fat area, trabecular bone density, and spine angulation.This study is the first to combine vehicle, demographic, and anatomical data to predict abdominal injury rates in frontal crashes.

Purpose: This study investigated the number of occupants involved and severely injured in light-vehicle crashes by vehicle and crash type. Methods: 1994–2010 NASS-CDS data were analyzed to estimate the risk of severely injured occupants involved in motor vehicle crashes. Crashes were grouped by front, side, rear, and rollovers. The effect of occupancy and vehicle type was investigated. Light vehicles were less than 4536 kg with model year 1994+. The annual number of Maximum Abbreviated Injury Scale (MAIS) 4+F injuries was estimated and the risk was determined using all occupants with known injury (MAIS 0–6+F). Results: There were 21,869 MAIS 4+F injuries annually, with 62.7 percent involving passenger cars, 15.9 percent sport utility vehicles (SUVs), 15.3 percent trucks, and 6.1 percent vans. In 36.6 percent of van crashes, MAIS 4+F occurred when there were 4+ occupants and 13.0 percent with 7+ occupants in the vehicle. Overall, 12.8 percent of severely injured were in crashes involving 4+ occupants and 1.4 percent with 7+ occupants. In addition, 30.1 percent of MAIS 4+F occurred in rollovers and only 5.8 percent of crashes were rollovers. Rollovers had the highest injury risks, irrespective of the number of occupants. There was a trend for an increased fraction of injury in frontal crashes and a lower fraction in rollovers. There were high risks in side and rear crashes with 5+ occupants. Conclusions: On average, there were 1.35 occupants involved in a crash per vehicle. Severely injured occupants were uncommon in 5+ occupancy vehicles. There was a trend for increased injury risks with occupancy. The risk was 1.65 times higher in vehicles with 7+ occupants compared to those with a driver only.

The impact force to the head and neck were measured in sled tests with and without inflation of a combo airbag for a far-side occupant to determine the risk for basilar skull fracture.Sled tests were run at 24 and 32 km/h (15 and 20 mph) with and without inflation of a combo side airbag to analyze the effect of cross-car diving into the side interior. The matched tests involved one pair at 24 km/h and another at 32 km/h. The 24 km/h pair involved a lap-shoulder-belted 5th percentile female Hybrid III and the series at 32 km/h involved an unbelted 5th percentile Hybrid III. The dummy was ballasted to 69.5 kg (153 lb) and laid on the right side. The dummy was positioned 30.5 cm (12(″)) from the far-side interior to ensure the full sled delta V occurred before head impact. The buck consisted of a 2001 Ford Taurus. The combo thorax-head side airbag was stored in the seatback. The airbag was triggered about 120 ms before the head impact. The head, chest, and pelvis were instrumented with triaxial accelerometers and the upper and lower neck, thoracic spine, and lumbar spine had transducers measuring triaxial loads and moments. High-speed video recorded different views of the dummy motion. Dummy kinematics and biomechanical responses were compared to study the influence of inflating the side airbag on the head and neck.The top of the head impacted the far side. The force of impact was similar with and without the airbag as the head compressed the airbag and loaded the vehicle interior trim behind the airbag. The peak force on the head was primarily from neck load as torso augmentation occurred. For the 24 km/h (15 mph) tests, the peak force was 4.7 kN (1055 lb) without and 4.8 kN (1088 lb) with the airbag and there was over 2.67 kN (600 lb) of lap belt load. The peak head acceleration was 93 g without and 72 g with the airbag. For the 32 km/h (20 mph) tests, the force on the head was 15.3 kN (3433 lb) without and 15.2 kN (3406 lb) with the airbag, although the instrumentation saturated. The peak head acceleration was 236 g without and 262 g with the airbag.The airbag reduced head acceleration in the belted test but did not influence the diving forces from torso augmentation through the neck of the far-side occupant. The side airbag did not reduce the risk for basilar skull fracture due to high neck compression loads in either the belted or unbelted tests.

The human body changes as it becomes older. The automotive safety community has been interested in understanding the effect of age on restraint performance. Focus has been placed on characterizing the body's structural changes associated with age and gender. In this study, spine alignment and torso depth were assessed, because both variables have been shown to affect injury risk.The data was obtained from computed tomography (CT) scans of more than 24,000 patients aged 16 and older. The data consisted of thoracic and lumbar vertebral angles relative to a fixed plane, as well as vertebra-to-front skin and spine-to-back skin distances. Angle measurements were taken in the sagittal plane at each vertebra level from T1 to L5; distance measurements were taken from T6 to L5. The data were analyzed as a function of gender and age with the young group defined as 16 to 29 years old and the older group as 75 and up.Vertebral angles were different depending on location. They varied from -24.5 ± 8.9° at T2 to 12.2 ± 5.6° at L1. The vertebral angles also varied with age. Angles in the older male group were 1.74 times larger at T1 and 2.03 times larger at T7 than in the young male group. Similar findings were observed for females. The effect of age and gender was modeled with forward/backward selection using a regression model. The vertebra-to-front skin distance also differed depending on vertebral level. It was highest at T10 at 162.5 ± 30.9 mm and lowest at L4 at 125.3 ± 37.3 mm for the entire study population. On average, males had larger distances than females. The spine-to-back distances were greatest in the lumbar area. The spine-to-back distance increased with lower vertebral level, regardless of age. The vertebral angle and distance data were analyzed for a male subgroup approximating the height and weight of a 50th percentile male dummy. The results showed that the vertebra-to-front skin distance increased with age. There was not a clear trend for the spine-to-back skin distance and L1 vertebral angle.The changes in the vertebral angles, as well as the anterior and posterior spine-to-skin distances along the sagittal plane, were determined as a function of age and gender. The effect was greatest in the mid-thoracic area. Spine alignment and body shape differences need to be considered in human mathematical models used to develop safety countermeasures for the older population, because they may affect the loading path and lead to different seating postures or belt positioning. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

The isolation of high-quality RNA and DNA from various specimens is essential to perform reliable molecular diagnostic assays. In routine diagnostics of hematologic malignancies isolation of high-quality RNA is a prerequisite. We used QIAsymphony technology (QST) using a customized RNA CT 800 V6 protocol for automated semi-high-throughput isolation of RNA from human specimens and compared the results for breakpoint cluster region-c-abl oncogene 1 (BCR-ABL1) quantification by real-time quantitative polymerase chain reaction (RQ-PCR) and detection of JAK2 V617F mutations by reverse-transcriptase PCR (RT-PCR) on QST RNA with RNA isolation performed with our routine manual method using RNA-Bee (RB). QST RNA was isolated with and without the addition of β-mercaptoethanol (BME). Addition of BME to the lysis buffer RLT Plus resulted in consistently lower Ct values in analyses of the reference gene porphobilinogen deaminase (PBGD). Further, the BCR-ABL1 mRNA levels of the QST RNA isolation were highly consistent with RB RNA isolation, only when the lysis buffer RLT Plus in addition contained BME. Moreover, cases of myeloproliferative neoplasms (MPN) with low levels of JAK2 V617F mRNA were even missed in QST when lysis buffer RLT Plus was used, but they were readily detected after addition of BME.

The goals of this study were to explore the deficits in working memory associated with literacy disorders (i.e. developmental disorders of reading and/or spelling) and the developmental trajectories of these working memory deficits. The performance of 28 children with literacy disorders was compared to a non-disabled control group with the same group size at five bi-annual times of measurement in a three-year-longitudinal study beginning at the end of primary school (9.5 years of age). Storage capacity and central-executive working memory were assessed in phonological and visual-spatial modalities, the latter under static and dynamic conditions. Overall, children with literacy disorders were outperformed by their typical developing peers in all phonological and in dynamic visual-spatial storage and central-executive tasks except for the static visual-spatial storage task. Results at single times of measurement revealed that the most consistent deficit was found in the storage capacity of the phonological loop. An additional central-executive impairment is supported by low backward spans. The causes for output deficits in dynamic visual-spatial tasks and good performance under static visual-spatial condition are discussed.(DIPF/Orig.)

Objective: This is a descriptive study of the frequency and risk for brainstem injury by crash type, belt use, and crash severity (delta-V). NASS-CDS electronic cases were reviewed to see whether the transition from vehicles without advanced airbags and seat belts and side airbags and curtains to vehicles with the safety technologies has influenced the risk for brainstem injury. Methods: 1994–2013 NASS-CDS was analyzed to determine the number of brainstem injuries in nonejected adults (15+ years old) in vehicle crashes. Crashes were grouped by front, side, rear, and rollover. The effect of belt use was investigated. Light vehicles were included with model year (MY) 1994+. Occupants with severe head injury (Abbreviated Injury Scale [AIS] 4+) and Maximum Abbreviated Injury Scale (MAIS) 4+F injury were also determined. The risk for injury with standard errors was determined using the MAIS 0+F exposure by belt use and crash type. NASS-CDS electronic cases were studied with brainstem injury in 2001–2013 MY vehicles. Results: NASS-CDS indicates there are 872 ± 133 cases of brainstem injury per year. About 16.0% of AIS 4+ head injury involves the brainstem. For belted occupants, the highest risk for brainstem injury was in side impacts at 0.065 ± 0.010%. In contrast, the highest risk for brainstem injury was 0.310 ± 0.291% in rear impacts and 0.310 ± 0.170% in rollovers for unbelted occupants. The risk for brainstem injury increased with crash severity. The highest risk for brainstem injury was 3.54 ± 1.45% in crashes with >72 km/h (>45 mph) delta-V. Exponential functions fit the change in risk with delta-V. Eighteen NASS-CDS electronic cases showed that brainstem injury occurred in very severe collisions where the occupant experienced multiple injuries from intrusion or impact on vehicle structures stiffened by deformation. Conclusions: The risk for brainstem injury in belted occupants has remained essentially constant over 20 years, whereas the risk for MAIS 4+F injury has declined 38.3%. The prevention of brainstem injuries must address the extreme speed of collisions and weight mismatches that overwhelm structures, seat belts, frontal airbags, side airbags, and curtains in modern vehicles.

Purpose: This is a study of the influence of an unbelted rear occupant on the risk for severe injury to the front-seat occupant ahead of them in frontal crashes. It provides an update to earlier studies. Methods: 1997-2015 NASS-CDS data was used to investigate the risk for severe injury (MAIS 4+F) to belted drivers and front passengers in frontal crashes by the presence of a belted or unbelted passenger seated directly behind them or without a rear passenger. Frontal crashes were identified with GAD1 = ’F’ without rollover (rollover ≤ 0). Front- and rear-outboard occupants were included without ejection (ejection = 0). Injury severity was defined by MAIS and fatality (F) by TREATMNT = 1 or INJSEV = 4. Weighted data was determined. The risk for MAIS 4+F was determined using the number of occupants with known injury status MAIS 0+F. Standard errors were determined. Results: The risk for severe injury was 0.803% ± 0.263% for the driver with an unbelted left rear occupant and 0.100% ± 0.039% with a belted left rear occupant. The driver's risk was thus 8.01-times greater with an unbelted rear occupant than with a belted occupant (p < 0.001). With an unbelted right-rear occupant behind the front passenger, the risk for severe injury was 0.277% ± 0.091% for the front passenger. The corresponding risk was 0.165% ± 0.075% when the right-rear occupant was belted. The front passenger's risk was 1.68-times greater with an unbelted rear occupant behind them than a belted occupant (p < 0.001). The driver's risk for MAIS 4+F was highest when their seat was deformed forward. The risk was 9.94-times greater with an unbelted rear occupant than with a belted rear occupant when the driver's seat deformed forward. It was 13.4% ± 12.2% with an unbelted occupant behind them and 1.35% ± 0.95% with a belted occupant behind them. Conclusions: Consistent with prior literature, seatbelt use by a rear occupant significantly lowered the risk for severe injury to belted occupants seated in front of them. The reduction was greater for drivers than for front passengers. It was 87.5% for the driver and 40.6% for the front passenger. These results emphasize the need to belt reminders in all seating positions.

Objective: This is a descriptive study of the frequency and risk of occupant-to-occupant contact injury by crash type and occupant age. It focused on rear impacts because of a recent Senate inquiry. Methods: 1994–2013 NASS-CDS data were used to investigate the effects of occupant-to-occupant contact on the risk of serious-to-fatal injury (Abbreviated Injury Scale [AIS] 3+) by crash type and age group. NASS-CDS in-depth cases were analyzed to identify crash circumstances for AIS 3+ occupant-to-occupant contact injury in rear crashes. Results: Serious injury (AIS 3+) due to occupant-to-occupant contact was uncommon. It represented only 0.84% of all AIS 3+ injury for all age groups. The overall risk of AIS 3+ occupant-to-occupant contact injury was 0.042 ± 0.007%. The highest incidence was in side impacts (69.8%) followed by rollovers (22.9%). Occupant-to-occupant contact injury risk was lower in rear impacts than in other crash types, at 0.0078 ± 0.0054%. The highest risk of AIS 3+ injury with occupant-to-occupant was for the Conclusions: AIS 3+ occupant-to-occupant contact injury occurs primarily in side impacts and rollovers. Most contact injury is to adults (89.4% incidence). Occupant-to-occupant contact injury to children is rare in rear impacts.