Thoracic aortic dissection (TAD) is estimated to occur at a rate of 3-4 cases per 100,000 persons per year and is associated with a high mortality. Reported rates are probably underestimates of the true incidence of TAD because of difficulties in diagnosis. The incidence of TAD appears to have been increasing over time. TAD is most common in men and older individuals. Aortic dilatation is a well-established risk factor for TAD but is not a prerequisite; most ascending aortic dissections occur when aortic diameter is <5.5 cm. Although atherosclerosis and typical cardiovascular risk factors, such as hypertension and smoking, are associated with TAD, evidence supporting their direct causal role is lacking. Notably, diabetes mellitus is remarkably uncommon in patients with TAD. Other risk factors for TAD include inflammatory diseases, iatrogenic aortic injury, and drug use. Congenital cardiovascular defects, such as bicuspid aortic valve, and certain genetic syndromes, such as Marfan syndrome, are the genetic factors most commonly associated with TAD. Specific nonsyndromic genetic mutations in families and single nucleotide polymorphisms have also been identified as possible risk factors for TAD.

Epidemiology of thoracic aortic dissection

Effectiveness of low speed autonomous emergency braking in real-world rear-end crashes.

Trends in young driver risk and countermeasures in European countries.

Motor vehicle crashes remain elevated among novice teen drivers for at least several years after licensure. Licensing policies and driver education are the two primary countermeasures employed to decrease young driver crash risks. Graduated driver licensing policies have proved to be effective in reducing crash rates where evaluated. Driver education is an essential part of teaching teens the rules of the road and operating a vehicle, but requires few hours of professional driver training, relying mainly on parents to provide most of the supervised practice driving teens obtain before independent driving licensure. The few studies that have been conducted to increase parent supervised practice driving have not shown positive results. Moreover, it is unclear that increases in practice would improve independent driving safety. Recent research has shown that parent management of the early independent driving experience of novice teens improves safety outcomes, and other research has shown that it is possible to increase parent management practices. This paper provides a review of the literature on parent involvement in supervised practice and independent driving, and efforts to increase parental management.

https://injuryprevention.bmj.com/content/injuryprev/12/suppl_1/i30.full.pdf

Parent involvement in novice teen driving: a review of the literature.

The purpose of this paper is to develop a recently proposed framework of human–machine cooperation (Hoc, J.M., 2001. Towards a cognitive approach to human–machine cooperation in dynamic situations. International Journal of Human–Computer Studies, 54, 509–540) and apply it to the domain of in-car automation. Previous models of automation (e.g. Sheridan, T.B. and Verplanck, W.L., 1978. Human and computer control of undersea teleoperators. Cambridge, MA: MIT Man–Machine Systems Laboratory) delineate the roles of human and machine in a task-based manner and primarily from the viewpoint of machine requirements. However, with increasing arguments that automation should support the human operator rather than replace them (e.g. Young, M.S., Stanton, N.A., and Harris, D., 2007. Driving automation: learning from aviation about design philosophies. International Journal of Vehicle Design, 45(3), 323–338), Hoc's (2001) framework offers a means of modelling the interaction from the perspective of teamwork–that is, fro...

Cooperation between drivers and automation: implications for safety

Traumatic Rupture of Thoracic Aorta in Real-World Motor Vehicle Crashes

Is Electronic Stability Program Effective on French Roads

This paper proposes to estimate and to compare the expected and the observed effectiveness of the Emergency Brake Assist (EBA) in terms of reduction in injury accidents in France. The evaluation of the expected effectiveness of EBA is based on the simulation of the reduction in injuries in non-EBA cars which could result in lower collision speeds resulting themselves in higher mean deceleration, would EBA have been available and applied in those cars. A sample of fatal police reports, for which most of the vehicles involved in an accident, braking distance, collision speed and injuries outcome are available, is used for the simulation. The evaluation of the observed effectiveness of EBA follows a 3-steps process: (1) The identification, in the French National injury accident census, of accident-involved cars for which the determination of whether or not the car was fitted with EBA is possible. A sample of 917 cars involved in injury accidents that occurred from January 2000 to June 2004 was selected. (2) The identification of accident situations for which we can determine whether or not EBA is pertinent. (3) The calculation, via a logistic regression, of the relative risk of being involved in an EBA-pertinent accident for EBA equipped cars versus unequipped cars, divided by the relative risk of being involved in a non EBA-pertinent accident for EBA equipped cars versus unequipped cars. This relative risk is assumed to be the best estimator of EBA effectiveness. Both evaluations result in a good effectiveness of EBA. Furthermore, the rather consistent estimations out coming from expected (-7.5 % of car occupants fatalities, -10 % of pedestrian fatalities) and observed (-11 % of overall injuries) effectiveness of EBA validates the methodology used for the expected effectiveness.

Are expected and observed effectiveness of emergency brake assist in preventing road injury accidents consistent

An in-depth study was conducted through the analysis of medical reports and crash data from real world accidents. The objective was to investigate the abdominal injury patterns among car occupants in frontal crashes. The influence of the type of restraint system, the occupant seat, the age and the crash severity was investigated. The results indicate that the risk of abdominal AIS 3+ injuries increased with crash severity and decreased with the introduction of belt retractors. Rear belted passengers were observed to be more likely injured than front belted occupants. The organs injured in frontal crashes for belted occupants were mainly hollow organs especially jejunum, ileum and mesentery.

Abdominal Injury Patterns in Real Frontal Crashes: Influence of Crash Conditions, Occupant Seat and Restraint Systems

This paper presents an evaluation of the effectiveness of the French Apprentissage Anticipe de la Conduite (AAC), which is an optional initial driver training that seeks to reduce accident risk by novice drivers. The effectiveness of the AAC is estimated using a Case-Control study (521 Cases and 624 Controls) and the adjusted Odds ratio (AAC versus regular) from a multivariate logistic regression. Thirteen risk factors are retained as explanatory variables in the regression. An Odds ratio of 0.9 indicates a non-significant reduction in accident involvement of AAC participants in the two years following the acquisition of their driver's license. The discussion addresses the possible reasons underlying the lack of result, e.g. an absence of varied experience during the AAC period and possible undesirable effects under supervision such as a partial delegation of responsibility for driving tasks by the young driver to the supervisor. Our recommendations include that AAC be integrated into a gradual licensing scheme, and should focus on the gradual acquisition of various driving experiences (in terms of variety of driving situations).

Sophie Cuny

Papers

Traumatic Rupture of Thoracic Aorta in Real-World Motor Vehicle Crashes

Is Electronic Stability Program Effective on French Roads

Are expected and observed effectiveness of emergency brake assist in preventing road injury accidents consistent

Abdominal Injury Patterns in Real Frontal Crashes: Influence of Crash Conditions, Occupant Seat and Restraint Systems

An evaluation of the effectiveness of the supervised driver-training system in France