Telematics boxes integrated into vehicles are instrumental in capturing driving data encompassing behavioral and contextual information, including speed, distance travelled by road type, and time of day. These data can be amalgamated with drivers\' individual attributes and reported accident occurrences to their respective insurance providers. Our study analyzes a substantial sample size of 19,214 individual drivers over a span of 55 weeks, covering a cumulative distance of 181.4 million kilometers driven. Utilizing this dataset, we develop predictive models for weekly accident frequency. As anticipated based on prior research with yearly data, our findings affirm that behavioral traits, such as instances of excessive speed, and contextual data pertaining to road type and time of day significantly aid in ratemaking design. The predictive models enable the creation of driving scores and personalized warnings, presenting a potential to enhance traffic safety by alerting drivers to perilous conditions. Our discussion delves into the construction of multiplicative scores derived from Poisson regression, contrasting them with additive scores resulting from a linear probability model approach, which offer greater communicability. Furthermore, we demonstrate that the inclusion of lagged behavioral and contextual factors not only enhances prediction accuracy but also lays the foundation for a diverse range of usage-based insurance schemes for weekly payments.

With the introduction of mobile applications that allow short-term rentals, electric scooters (e-scooters) are gaining popularity as a means of micromobility in urban areas. The aim of the study was to assess the circumstances and causes of death in traffic accidents involving electric scooters in Poland. The inclusion criteria for the study were met by 9 cases (7 M,2F; mean age: 40.3 years). Accidents usually occur during working days during the warm months, especially during the morning traffic rush hour. Usually, these accidents involved another vehicle (4/9 cases). In addition, the victim was most often the driver (8/9 cases) and rarely uses a helmet (1/9 cases). In only two cases did the test reveal the presence of alcohol in the blood at the time of the accident. In studied cases, head injuries occurred in every case, and injuries to the limbs and chest occurred in more than half of the cases. Within the head, in addition to minor injuries like bruises and epidermal abrasions, skull fractures, and intracranial bleedings predominated. Similar minor injuries were also observed in the extremities, with significant fractures observed only in the lower extremities. Among chest injuries, lung contusions predominated. The most common cause of death was craniocerebral injury (6/9 cases), but there were two deaths each from chest injuries and polytrauma. To increase the safety of e-scooter users, it is recommended that measures be taken to educate users about the potential risks of using the vehicle and that measures be taken to increase the use of helmets, e.g. through legislative action. Further studies involving larger study groups are needed to assess the correlation between potential risk factors and the fatal outcome of the accident.

OBJECTIVE: Among motor vehicle crashes (MVCs), little is known about whether the characteristics and collision features involving drivers with epilepsy differ from those involving drivers without any history of epilepsy. We assessed MVC features and the effect of epilepsy diagnosis on the risk of severe crash-related injuries among drivers.
METHODS: A total of 33 174 MVC events among people with epilepsy (PWE) and 663 480 MVC events of age- and sex-matched non-PWE (1:20) were selected. Crash-related features that involved drivers with and without epilepsy were compared, including driver eligibility, medical history of comorbidities and medications, road and environmental conditions, and accident causes. Cox and logistic regression analyses were used to examine the risks of fatality and severe injury among drivers with and without epilepsy.
RESULTS: PWE involved in MVCs were more likely to have lower socioeconomic status, comorbidities, scooter drivers without a qualified driver\'s license, driving under the influence of alcohol, and be involved in single-vehicle accidents than non-PWE. Drivers with epilepsy also had a higher risk of fatality within 30 days of MVC, with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI], 1.20-1.57) and a higher risk of hospital admission within 3 days after MVC (aHR, 1.33; 95% CI, 1.29-1.38) compared to that of non-PWE.
CONCLUSIONS: The characteristics of MVCs of drivers with epilepsy were distinct from those of non-affected drivers. And higher fatality and injury rates were observed among drivers with epilepsy, which should be considered in further policymaking regarding safe driving of PWE.

Background: This study investigated the effectiveness and safety of pharmacopuncture for pain relief and functional improvement in patients with traffic accident (TA)-induced acute tension headaches. Methods: The study employed a parallel, single-centered, pragmatic, randomized controlled trial design. Eighty patients complaining of acute tension headaches were randomized into the integrative Korean medicine treatment (IKM treatment) group and the pharmacopuncture group on suboccipital muscles (suboccipital muscles pharmacopuncture + IKM treatment), with 40 participants assigned to each group. The patients in the pharmacopuncture group underwent pharmacopuncture as an add-on therapy, consisting of three sessions. Both groups were reassessed 2 months post-intervention. To assess the outcomes, the Numeric Rating Scale (NRS) for Headache, NRS for Neck Pain, Headache Disability Index, Headache Impact Test-6, EuroQol 5-Dimension, and Patient Global Impression of Change were used. Results: The improvement in the outcomes of the pharmacopuncture group was significantly greater than that of the comparison group on day 4 of hospitalization in terms of pain (difference in NRS of headache -2.59, 95% CI -3.06 to -2.12; NRS of Neck pain -1.05, 95% CI -1.50 to -0.59) and function (difference in HDI -24.78, 95% CI, -31.79 to -17.76; HIT-6 -6.13, 95% CI, -9.47 to -2.78). Additionally, in 2 months of follow-up, the recovery rate of headache was significantly higher in the pharmacopuncture group than in the comparison group. Conclusions: The pharmacopuncture group demonstrated superior outcomes in symptom improvement than the comparison group did, providing insights into novel and useful applications of pharmacopuncture in the clinical practice of Korean medicine.

UNASSIGNED: The aim of the study is to quantify the main ways in which the sex of the driver/occupant of a passenger car affects the severity of road crashes.
UNASSIGNED: All 171 230 cars occupied by the driver and one or more passengers included in the Spanish Register of Victims of Road Crashes from 2014 to 2020 were included. We designed two cohort studies: In the first one, we estimated the Incidence Rate Ratios (IRR) between the sex of the drivers and the occurrence of any death and/or severe injuries among their passengers. In the second one we estimated the conditioned IRR between the sex of the occupants of the same car and their risk of death and/or severe injuries. We used fixed Poisson models to obtain IRR estimates, crude and adjusted by individual- environment- and vehicle-related variables.
UNASSIGNED: A consistent inverse relationship between driver\'s female sex and passenger\'s severity was found, (IRR 0.72, 95 % CI 0.68-0.77), stronger for single crashes (IRR 0.67, 95 % CI 0.60-0.65). The magnitude decreased after adjusting for vehicle- and environment-related variables (IRR 0.82, 95 % CI 0.73-0.92). In the second study, the risk of death or hospitalization was higher for occupants of female sex (IRR 1.23, 95 % CI 1.17-1.30).
UNASSIGNED: The risk of death or severe injuries among passengers of cars involved in single crashes is lower for female drivers, probably due to safer driving. On the contrary, in similar crashes, the risk of injuries leading to hospitalization is higher for females.

Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.

UNASSIGNED: Recent studies have revealed that sleep apnea syndrome (SAS) increases the risk of cardiovascular diseases and their risk factors, as well as the risk of traffic accidents. Although SAS screening and early treatment are important, truck drivers may avoid SAS screening to prevent the denial of their application for life insurance due to receiving continuous positive airway pressure (CPAP) treatment. Thus, this study investigated how life insurance companies handle patients on SAS treatment.
UNASSIGNED: We conducted a questionnaire survey on how they handle life insurance applications of patients with SAS on CPAP treatment for 46, 41, and 42 companies in 2009, 2015, and 2021, respectively, and analyzed the changes in their handling of life insurance applications of patients with SAS.
UNASSIGNED: The results revealed that while about 10 life insurance companies handle the application of life insurance of patients on CPAP treatment in the same way as healthy individuals, many life insurance companies handle them differently. This survey also revealed the differences in handling patients with SAS on CPAP treatment among companies and their policies regarding the reasons.
UNASSIGNED: The survey revealed that there are differences among life insurance companies in handling patients with SAS on CPAP treatment. It is important to provide information about the companies that would not give disadvantages to patients with SAS on CPAP treatment who purchase life insurance. It is also crucial to provide life insurance companies with evidence of reduced risk of traffic accidents in patients with SAS on CPAP treatment.

OBJECTIVE: This study aimed to explore how various factors affect older people\'s vehicle speed perception to enhance their road safety as pedestrians, focusing on the impact of their cognitive and perceptual abilities on road-crossing decisions.
METHODS: The study evaluated the effects of brightness contrast (high, medium and low), road complexity (high and low) and vehicle travel direction (same and opposite) on speed perception errors in simulated traffic settings. It involved 38 older participants who estimated the speed of a comparison vehicle under two judgement conditions.
RESULTS: Findings showed a consistent underestimation of speed in all conditions. A repeated-measure ANOVA revealed that speed perception errors were significantly higher with low brightness contrast, in simpler road environments, with vehicles travelling in the same direction, and when using absolute judgements.
CONCLUSIONS: These results have practical importance for public safety initiatives, traffic regulation and road design catering to older adults\' perceptual needs. They also provide valuable insights for driver training programs for older adults, aimed at enhancing their understanding and management of perceptual biases.

UNASSIGNED: The surge in vehicles has escalated traffic volume, leading to an upswing in traffic accidents and subsequent disorders. Complex symptoms often characterize post-traumatic syndrome from these accidents. Traditional Korean medicine (TKM), increasingly used in car insurance, forms a substantial part of treatment costs. However, the current system lacks explicit fee guidelines and approval criteria for non-reimbursable TKM procedures, relying heavily on practitioners\' judgment without robust evidence-based decision-making. This scenario raises concerns about treatment appropriateness and transparency. We aim to explore physicians\' perspectives on utilizing TKM in emergency medicine, their participation sentiments, and their session selection process post-traffic accident.
UNASSIGNED: We collected TKM practitioners\' opinions regarding their role in clinical environment and involvement in treating patients after traffic accidents. The need for comprehensive and standardized protocols for the diagnosis, treatment, management, and prognosis of patients with post-traumatic syndrome is evident. Additionally, improvements that facilitate rational decision-making by medical consumers and protect the treatment rights of healthcare providers are necessary. Results has emphasized the importance of evidence-based decision-making, establishing appropriate fee structures and detailed criteria for non-reimbursable TKM-based procedures, and enhancing regulations for the reliability and transparency of TKM-based treatments in the context of car insurance.
UNASSIGNED: The perspective of healthcare providers directly involved in TKM-based treatments must be considered to maintain a sustainable vehicular insurance system, transcending administrative policy discourse. We highlighted the challenges and potential solutions for improving the effectiveness and appropriateness of TKM-based treatments in the context of car insurance.

UNASSIGNED: There is strong evidence that alcohol consumption is a significant risk factor for fatal road traffic accidents. It is estimated that the number of alcohol-related road accidents remains high in the past few years in Lithuania. This study aims to examine the prevalence of alcohol in blood samples collected from the autopsy results of road traffic accident victims.
UNASSIGNED: A retrospective study of 136 road traffic accident victims was performed in State Forensic Medicine Service of Lithuania in the period of 2013 to 2023. We analyzed blood alcohol concentration (BAC) in relation to sex, age, road user type, place and time of the day at death.
UNASSIGNED: 31% of the victims were under influence of alcohol at the time of death, with mean BAC 1.99 ± 0.92‰. The mean BAC was 2.16 ± 0.8‰ in male and 1.18 ± 1.12‰ in female group. By the type of road users, 23% of the pedestrians (mean BAC 2.45 ± 0.71‰), 32% of car drivers (mean BAC 2.13 ± 0.75‰), 41% of vehicle passengers (mean BAC of 1.73 ± 1.19‰), 37% of the motorcycle riders (mean BAC of 1.28 ± 0.53‰), 37% of the cyclists (mean BAC of 1.15 ± 0.75‰) were found to be intoxicated during the time of accident. Highest mean blood alcohol concentration was found during the night time hours (9 p. m. - 5 a. m.) 2.28 ± 0.91, comparing to in afternoon hours (12 p. m. - 5 p. m.) 1.49 ± 0.99, evening hours (5 p. m. - 9 p. m.) 2.10 ± 0.73 and morning hours (5 a. m. - 12 p. m.) 1.94 ± 1.00. The mean BAC in road traffic accidents during summer was 1.48 ± 0.71‰, spring 2.25 ± 0.76‰, autumn 2.12 ± 1‰, winter 2.42 ± 1‰.
UNASSIGNED: Alcohol consumption by road users is a significant contributing factor in road traffic accidents and their outcomes in Lithuania.
UNASSIGNED: Labai svarbus veiksnys, dėl kurio dažnai įvyksta mirtinų įvykių, yra neblaivūs kelių eismo dalyviai. Pastaraisiais metais mirčių keliuose, susijusių su alkoholio vartojimu, skaičius Lietuvoje išlieka didelis. Šio tyrimo tikslas – remiantis teismo medicininių tyrimų duomenimis įvertinti žuvusių asmenų alkoholio koncentraciją kraujyje eismo įvykio metu.
UNASSIGNED: Atliktas prospektyvusis tyrimas, į kurį įtraukti 136 žuvę kelių eismo įvykių dalyviai. Tyrimas atliktas Valstybinėje teismo medicinos tarnyboje nuo 2013 iki 2023 metų. Analizuotas etilo alkoholio koncentracijos kraujyje ryšys su aukų lytimi, amžiumi, eismo dalyvio tipu, mirties vieta, paros laiku.
UNASSIGNED: Tiriamosios imties 31 % žuvusių eismo įvykio metu buvo neblaivūs – etilo alkoholio koncentracijos vidurkis 1,99±0,92 ‰. Vyrų grupės alkoholio koncentracijos kraujyje vidurkis 2,16±0,8 ‰, moterų grupės –1,18±1,12 ‰. Pagal skirtingus eismo dalyvių tipus: 23 % pėsčiųjų (alkoholio koncentracijos kraujyje vidurkis 2,45±0,71 ‰), 32 % lengvųjų automobilių vairuotojų (alkoholio koncentracijos kraujyje vidurkis 2,13±0,75 ‰), 41 % automobilių keleivių (alkoholio koncentracijos kraujyje vidurkis 1,73±1,19 ‰), 37 % motociklo vairuotojų (alkoholio koncentracijos kraujyje vidurkis 1,28±0,53 ‰), 37 % dviratininkų (alkoholio koncentracijos kraujyje vidurkis 1,15±0,75 ‰) buvo neblaivūs eismo įvykio metu. Didžiausias alkoholio koncentracijos kraujyje vidurkis nustatytas nakties laiku (21:00–05:00) 2,28±0,91, palyginti su popietės laiku (12:00–17:00) 1,49±0,99, vakaro laiku (17:00–21:00) 2,10±0,73 ir ryto laiku (05:00– 12:00) 1,94± 1,00. Alkoholio koncentracijos žuvusių vasaros metu kraujyje vidurkis buvo 1,48±0,71 ‰, pavasarį – 2,25±0,76 ‰, rudenį – 2,12±1 ‰, žiemą – 2,42±1 ‰.
UNASSIGNED: Dalyvavimas eisme apsvaigus nuo alkoholio yra reikšmingas veiksnys, lemiantis mirtiną eismo įvykių baigtį Lietuvoje.