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    <title>Transport Research International Documentation (TRID)</title>
    <link>https://trid.trb.org/</link>
    <atom:link href="https://trid.trb.org/Record/RSS?s=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" rel="self" type="application/rss+xml" />
    <description></description>
    <language>en-us</language>
    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
    <docs>http://blogs.law.harvard.edu/tech/rss</docs>
    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
    <image>
      <title>Transport Research International Documentation (TRID)</title>
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      <link>https://trid.trb.org/</link>
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    <item>
      <title>Effective measures for evaluating safe driving ability with a driving simulator and eye movement tracking</title>
      <link>https://trid.trb.org/View/2704810</link>
      <description><![CDATA[Stroke survivors often wish to resume driving, but objective and reliable indicators for assessing fitness to drive are lacking. The authors aimed to establish effective measures for evaluating safe driving ability in brain-injured patients by integrating driving simulator (DS) performance and eye movement analysis. Participants included brain-injured patients, classified into mild and severe groups using Trail Making Test-B scores and the presence of visual field defects, neglect, or aphasia, alongside healthy controls. Neuropsychological assessments (Trail Making Test-A/B, Kohs Block Design Test, Mini-Mental State Examination) were conducted. Driving performance was evaluated using the Honda Safety Navi DS, focusing on the standard deviation (SD) of steering angle on straight roads and the SD of velocity on curved roads. Eye movements were recorded with Tobii Pro Glasses 2 during hazard detection and dangerous situation scenes, with particular attention to saccade amplitude. Group differences were analyzed using Kruskal–Wallis and Mann–Whitney U tests. The SD of steering angle on straight roads and the SD of velocity on curved roads were significantly higher in mild or severe brain-injured groups compared with healthy controls. However, saccade amplitude was significantly lower in both mild and severe brain-injured groups than in healthy controls during hazard detection scenes, indicating impaired visual exploration. To measure driving ability in both mild and severe brain-injured patients, saccade amplitude provided a promising objective indicator for evaluating driving ability instead of DS alone. These findings support the development of evidence-based fitness to drive assessments for clinical and rehabilitation applications.]]></description>
      <pubDate>Thu, 04 Jun 2026 15:13:32 GMT</pubDate>
      <guid>https://trid.trb.org/View/2704810</guid>
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    <item>
      <title>Demographic and causal patterns in child cyclist head Injuries: Informing helmet test methods</title>
      <link>https://trid.trb.org/View/2694786</link>
      <description><![CDATA[Children’s cycle helmets are certified using the same impact conditions as adult helmets, which can overlook important factors contributing to child head injuries. The objective is to identify common patterns in traumatic brain injury pathologies, age, sex, riding environment, cause of injury, helmet use, and helmet injury reduction in child cyclists to inform child-specific test methods. The authors reviewed 48,074 head injury cases in cyclists under 17 years across 24 studies. An aggregate data meta-analysis was conducted to identify recurring patterns overall and in studies with a high proportion of severe injuries (n = 3,542 cases).Cases most often involved male riders (71.8%, CI: 71.6–72.1%), aged 10–13 years (40.2%, CI: 39.1–41.3%), occurring on paved roads (75.0%, CI: 74.2–75.9%) without prior collision (84.4%, CI: 84.1–84.8%). Injuries were predominantly intracranial (73.7%, CI: 71.6–75.8%). Studies with mostly severe injuries included significantly more males, on-road incidents, motor vehicle collisions, intracranial hemorrhages, and skull fractures. Helmets reduced odds of head injuries (OR = 0.44, CI = 0.41–0.47), but the efficacy was lower for severe injuries (OR = 0.61, CI = 0.58–0.65), which contrasts most findings for adult helmets. The identified factors associated with severe injuries in child cyclists, such as vehicle collisions and intracranial injuries with rotational mechanisms, are not represented in current child helmet test procedures. This work provides a foundation for further work aimed at quantifying representative head impact biomechanics in typical and severe child cycling incidents, with the ultimate goal of developing helmet test procedures tailored specifically to children.]]></description>
      <pubDate>Tue, 19 May 2026 15:12:27 GMT</pubDate>
      <guid>https://trid.trb.org/View/2694786</guid>
    </item>
    <item>
      <title>Longitudinal assessment of post-concussion driving reaction time</title>
      <link>https://trid.trb.org/View/2680640</link>
      <description><![CDATA[ObjectivesConcussed patients present multiple neurocognitive and motor impairments including slowed reaction time (RT), a function essential to driving. We compared driving RT between concussed and non-concussed individuals across their concussion recovery (aim 1) and explored whether clinical concussion outcomes were correlated with driving RT uniquely in the concussion group (aim 2).MethodsWe recruited collegiate athletes (26 concussed and 23 age- and sex-matched controls) to complete the sport concussion assessment tool (SCAT5), a computerized neurocognitive test (CNS Vital Signs), and a driving simulation across 3 timepoints: =72?h, asymptomatic, and unrestricted medical clearance. RTs were recorded in response to 4 unanticipated driving events. CNSVS included 10 measures of cognitive function. General linear mixed models assessed interaction between group and time for aim 1 and group and concussion assessment outcome for aim 2 (a?=?0.05). Pairwise comparisons with Cohen’s d values were used following significant interactions and main effects.ResultsThere was a significant main effect for timepoint, such that pedestrian RT was slower at the =72-h timepoint relative to both the asymptomatic (p value = 0.023) and unrestricted medical clearance (p- value = 0.022). There were no other significant group-by-timepoint interaction or timepoint main effects for yellow stoplight RT (p-value range = 0.334–0.798), vehicle incursion RT (p-value range = 0.234–0.925) or vehicle cross RT (p-value range = 0.177–0.364). There was no significant group main effect (p-value range = 0.077–0.955), assessment outcome main effect (p-value range = 0.099–0.999) or interaction (p-value range = 0.103–0.998) for predicting any of the RTs, except for executive function (p?=?0.046), motor speed (p?=?0.006), and psychomotor speed (p?=?0.027) predicting vehicle cross RT regardless of group.ConclusionThis study demonstrates that driving RT may not differ between acutely concussed and healthy individuals or may not be detected on a short, simulated drive. Current clinical concussion outcomes poorly relate to driving RT. More research is needed to determine when it is safe to return to driving post-concussion.]]></description>
      <pubDate>Wed, 15 Apr 2026 10:29:29 GMT</pubDate>
      <guid>https://trid.trb.org/View/2680640</guid>
    </item>
    <item>
      <title>The difference in the ability to perceive danger while driving and when crossing a road between patients after a stroke and a healthy population</title>
      <link>https://trid.trb.org/View/2663652</link>
      <description><![CDATA[Clinicians should be aware of the decrease in driving as well as road-crossing abilities of post-stroke patients as they often resume driving and crossing roads while they have impaired skills. So, they should examine road-crossing and ensure safe crossing as they evaluate driving abilities before approving them to drive again.]]></description>
      <pubDate>Wed, 18 Mar 2026 09:00:16 GMT</pubDate>
      <guid>https://trid.trb.org/View/2663652</guid>
    </item>
    <item>
      <title>Crash typology of professional cycling crashes</title>
      <link>https://trid.trb.org/View/2636598</link>
      <description><![CDATA[Mild traumatic brain injury (mTBI) is a frequent but underreported consequence of professional cycling crashes, yet current helmet testing standards primarily simulate head-first impacts, and their representation of real-world head impact scenarios is unclear. This study explores crash typology of professional cycling crashes involving head-ground contact through systematic video analysis of 128 head impacts occurring between 2012 and 2024. Most head impacts occurred during road races (113/128, 88%) and were associated with multi-cyclist collisions rather than single-cyclist crashes, with topple-over crashes representing the most common mechanism (49%), followed by skid-outs. Riders predominantly landed front or front-side relative to their direction of travel, with 66% of impacts occurring in a sideways body posture, and head contact most frequently involved the helmet’s side and rim regions (>50% of impacts). Notably, body-first head impacts dominated the crash profiles (92%), with the torso or arms contacting the ground before the head, while direct head-first impacts comprised 8 % of cases. Impact severity was distributed relatively evenly across low (30 %), medium (33%), and high (36%) categories, with collision-related crashes being more likely to result in high-severity outcomes than non-contact crashes. These findings reveal a potential mismatch between current helmet testing protocols and the predominant mechanisms observed in professional cycling crashes. Video-based analysis provides critical insights into impact mechanisms that are overlooked by traditional injury reporting methods, particularly highlighting the prevalence of body-first impacts and side-rim head impacts. This crash typology may provide a foundation for future biomechanical studies and could support the development of helmet testing methods that better represent real-world cycling impact scenarios.]]></description>
      <pubDate>Thu, 15 Jan 2026 14:31:02 GMT</pubDate>
      <guid>https://trid.trb.org/View/2636598</guid>
    </item>
    <item>
      <title>Factors associated with mortality of hospitalized road traffic injury patients in 4 low- and middle-income countries</title>
      <link>https://trid.trb.org/View/2625330</link>
      <description><![CDATA[Road traffic injuries (RTIs) are an important public health problem, especially in low- and middle-income countries (LMICs), and are highly preventable with evidence-based interventions. This study aimed to describe the sociodemographic characteristics, risk factors, and patterns of injury that are associated with in-hospital mortality among patients with RTIs. A prospective observational study was conducted at 8 hospitals in Cambodia, Ethiopia, Mexico, and Zambia with adult patients who sustained moderate to severe RTIs and were admitted to participating hospitals for at least 24 h. Bivariate and multivariable logistic regression models were used to examine the association between relevant variables and death in-hospital. The majority of RTI deaths occurred among males aged 18 to 44 who were pedestrians or riders of 2- or 3-wheeled vehicles. The following variables were associated with in-hospital mortality: Riding a 2- or 3-wheeler (adjusted odds ratio [AOR] 3.30, 95% confidence interval [CI] 1.06–10.23), moderate–severe Glasgow Coma Scale (GCS; AOR 10.27, 95% CI 4.72–22.33), and low systolic blood pressure (AOR 5.97, 95% CI 1.97–18.04). The findings reinforce the important role of traumatic brain injury (TBI) in RTI deaths and highlight the need for capacity building to develop local neurosurgery expertise to manage and treat TBI in LMICs. Evidence-based prevention strategies such as lowering speed limits in urban areas, protecting users via dedicated footpaths and cycle paths, and increasing helmet use are recommended to mitigate the impact of RTIs and reduce mortality among vulnerable road users. In addition, triage systems should be in place to identify patients with moderate–severe GCS and low systolic blood pressure for immediate and intensive care.]]></description>
      <pubDate>Thu, 18 Dec 2025 15:37:24 GMT</pubDate>
      <guid>https://trid.trb.org/View/2625330</guid>
    </item>
    <item>
      <title>Brain injury metrics and their risk functions in frontal automotive collisions</title>
      <link>https://trid.trb.org/View/2625328</link>
      <description><![CDATA[The objective of this study was to develop abbreviated injury scale (AIS) 1, AIS2, AIS3 and AIS4+ injury risk functions (IRFs) for traumatic brain injuries (TBIs) as estimated by the rotational kinematics of the head, in accordance with AIS1998. The effectiveness of the IRFs was investigated by comparisons with real-world accident data of frontal crash configurations. In addition, links of the IRFs developed in accordance with AIS1998 to other AIS versions were discussed. AIS1, AIS2, AIS3 and AIS4+ IRFs based on finite element analysis (FEA)-based metrics in this study were developed using a TBI database used for developing mild TBI (concussion) and severe TBI (diffuse axonal injury (DAI) and intracerebral hemorrhage (ICH)) IRFs in the previous study. The TBI database includes head kinematics, clinical outcomes, and FEA-based metrics such as maximum principal strain (MPS) obtained from reconstructions using harmonized species-specific finite element (FE) brain models. In this study, TBI severities in the TBI database were reclassified in accordance with AIS1998 to evaluate IRFs in comparison with field accident data for application to automotive safety. IRFs based on kinematics-based metrics were developed by transforming FEA-based IRFs via linear regression models between the FEA-based and kinematics-based metrics. The FEA-based and kinematics-based IRFs were evaluated by comparing TBI risk predictions using frontal crash test data with real-world TBI rates in similar crash configurations. The MPS95 IRFs exhibited better quality (lower quality index (QI) values) and better goodness of fit with the TBI database (lower AIC value) among the FEA-based IRFs. Kinematics-based metrics exhibited the greatest coefficients of determination (R2) with MPS95. The accident data evaluation demonstrated that the MPS95 IRFs and kinematics-based IRFs derived from the MPS95 IRFs generally overpredicted most frontal crash configurations, with the full engagement conditions tending to have smaller errors and the oblique crash conditions having the largest overprediction. The TBI risks predicted by the MPS95 IRFs and kinematics-based IRFs derived from the MPS95 IRFs were relatively more aligned with the real-world TBI rates for drivers in the full engagement crash configuration. However, further investigations are needed to minimize the gap between predicted TBI risks and real-world TIB rates. In addition, AIS coding of TBIs has changed through version upgrades, especially for concussion. This change in AIS coding has affected IRFs for AIS1 and AIS2. Further revisions of TBI IRFs will be required in the future if the AIS definitions change.]]></description>
      <pubDate>Thu, 18 Dec 2025 15:37:24 GMT</pubDate>
      <guid>https://trid.trb.org/View/2625328</guid>
    </item>
    <item>
      <title>Predicting head impact conditions in vehicle-to-pedestrian impacts through computational human modeling</title>
      <link>https://trid.trb.org/View/2617084</link>
      <description><![CDATA[This study aimed to use finite element (FE) pedestrian and vehicle models to generate a virtual database of pedestrian impacts and develop prediction models for pedestrian head impact conditions, which are important to evaluate the effects of vehicle front-end designs on pedestrian head injury responses. The generic vehicle (GV) models used in Euro NCAP originally developed based on European vehicles were morphed into 20 U.S. vehicle front-end geometries across a wide range of vehicle types and characteristics. A total of 240 FE pedestrian impact simulations were conducted using the 20 morphed GV models with four sizes of pedestrian human body models (6-year-old, small female, midsize male, and large male) at three impact speeds (30, 40, and 50 kph). A set of predictors, including vehicle front-end geometry, pedestrian size, vehicle impact speed, and pedestrian wrap around distance (WAD) were selected based on literature to predict head impact time (HIT), head contact velocity, and head contact angle. R2 values and root-mean-square-error (RMSE) were used to evaluate the quality of the prediction models. High correlations and good accuracies were achieved in the prediction models for HIT (R2 = 0.979 and RMSE = 6.61 ms), head impact velocity (R2 = 0.799 and RMSE = 1.39 m/s), and head impact angle (R2 = 0.846 and RMSE = 7.95 deg for adult pedestrians). It was found that impact speed, WAD, hood angle, and hood height are statistically significant variables for predicting the pedestrian head impact conditions. HIT is highly predictable in pedestrian impacts, while the head impact velocity and head impact angle are associated with larger variations in the selected impact conditions. This indicates a potential need of varying impact velocity and angle for future vehicle evaluations of pedestrian head protection. This study generated a virtual database of pedestrian impacts with a wide range of vehicle front-end geometries, and developed prediction models to use vehicle front-end geometry, pedestrian size, impact speed, and WAD to predict pedestrian HIT, head contact velocity, and head contact angle.]]></description>
      <pubDate>Wed, 19 Nov 2025 17:09:39 GMT</pubDate>
      <guid>https://trid.trb.org/View/2617084</guid>
    </item>
    <item>
      <title>E-bikers at risk for severe traumatic brain injury and skull fractures</title>
      <link>https://trid.trb.org/View/2563875</link>
      <description><![CDATA[The popularity of electric bicycles (E-bikes) in The Netherlands has surged in recent years. Simultaneously, bicycle-related traffic injuries in The Netherlands have reached record levels. Given the significant societal and individual impact of traumatic brain injury (TBI) the authors investigated the relationship between E-bike usage and the occurrence of severe TBI.   All bicycle crash victims aged twelve years and older admitted to the Isala Hospital from 1 January 2018 to 31 December 2022, were included from the National Trauma Registry. Data on bicycle type, anticoagulants, alcohol intoxication, and helmet use, was obtained from the hospitals' electronic patient record. The primary outcome variable was severe TBI verified on CT- or MRI-imaging. The secondary outcome variable was a skull fracture verified on X-ray or CT-imaging. Adjusted odds ratios (ORs) and 95 %-confidence intervals (CIs) were calculated using multivariable binary logistic regression analyses, adjusting for the risk factors alcohol intoxication, anticoagulant use, not wearing a helmet, health status before the accident, age and gender.   From 1 January 2018 to 31 December 2022, a total of 1878 patients were admitted following a bicycle crash. This group consisted of 1359 (73.4 %) regular cyclists and 519 (27.6 %) E-bikers. Multivariable regression analyses resulted in an OR of 1.64 (CI 1.20-2.22) for severe TBI and an OR of 1.50 (CI 1.08-2.08) for skull fractures. In the study sample, E-bike usage was found to be an independent predictor for severe traumatic brain injury and skull fractures following a bicycle crash.]]></description>
      <pubDate>Fri, 11 Jul 2025 10:00:27 GMT</pubDate>
      <guid>https://trid.trb.org/View/2563875</guid>
    </item>
    <item>
      <title>Evaluating brain injury outcomes in female subjects: A computational approach to accident reconstruction of fatal and non-fatal cases</title>
      <link>https://trid.trb.org/View/2533764</link>
      <description><![CDATA[Traumatic brain injury remains a significant concern in public health, affecting millions of individuals globally and leading to long-term cognitive and physical impairments. Historically, research in this field has primarily focused on male subjects, often neglecting to consider the substantial biomechanical and anatomical differences between genders and individuals of varying ages. The present study investigates sex-specific biomechanical responses to head impacts in real-world accidents, employing an advanced female finite element head model, with a particular focus on critical brain structures such as the corpus callosum and pituitary gland. Two real-world accident scenarios were simulated: a non-fatal e-scooter collision and a fatal work-related incident involving a falling prop. A finite element analysis was conducted to determine the strain and stress distributions within the brain in response to impact conditions, assessing the potential for injury considering established failure criteria. The analysis revealed notable discrepancies in strain and stress distributions between anthropometric models. The smallest percentiles exhibited a higher risk of strain-related injury, while larger individuals demonstrated higher strain levels in key brain regions under similar impact conditions. Additionally, it was evaluated the efficacy of a safety helmet in a work-related scenario. These findings highlight the importance of subject-specific analyses in understanding TBIs and emphasize the need for continued refinement of FEHMs to improve the accuracy of injury prediction.]]></description>
      <pubDate>Mon, 14 Apr 2025 17:08:46 GMT</pubDate>
      <guid>https://trid.trb.org/View/2533764</guid>
    </item>
    <item>
      <title>Examination of naturalistic driving behavior and risk events across concussion recovery</title>
      <link>https://trid.trb.org/View/2525436</link>
      <description><![CDATA[Driving simulator studies show that individuals with acute concussion present notable alterations in driving performance and perform better as recovery progresses. Although driving simulators create a safe environment and are capable of immersing individuals in realistic driving scenarios, they fail to capture daily naturalistic driving behavior throughout concussion recovery. Therefore, the purpose of the study was to describe naturalistic driving behaviors and risk events in individuals with concussion, relative to the control group. Twelve individuals with concussion and 17 non-concussed controls installed a GPS sensor in their personal vehicle for a 14-day period. The authors compared driving behavior (total distance driven, total duration driven, average speed, and number of trips taken per day) and risk events (number of hard brakings and sudden accelerations) captured between groups. Hedge’s g and linear mixed regression models were used to compare driving behavior and risk events. Individuals with concussion appeared to drive less and slower prior to day 3 post-concussion but displayed similar driving behavior after day 3 of post-concussion, relative to the control group. Additionally, the authors observed a pattern that the concussion group drove slower than the control group across concussion recovery. The study provides preliminary evidence that suggests a need for a return to driving strategy to ensure the safety of individuals with concussion.]]></description>
      <pubDate>Mon, 14 Apr 2025 17:08:45 GMT</pubDate>
      <guid>https://trid.trb.org/View/2525436</guid>
    </item>
    <item>
      <title>Factors affecting severity and prognosis of traumatic brain injury among Bangladeshi patients: An institution based cross-sectional study</title>
      <link>https://trid.trb.org/View/2449471</link>
      <description><![CDATA[Traumatic brain injury (TBI) proves to be an obstacle for Bangladeshi patients due to the lack of facilities and specialist doctors in regional sections of the country. This study aimed to record different attributes of Bangladeshi TBI patients over a year i.e., their injury characteristics, treatments received and understand their impacts on the severity of TBI. This cross-sectional study was carried out among 280 TBI patients treated in a tertiary care hospital in Dhaka. The physicians determined TBI's severity and prognosis as per the Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS) respectively. Most TBI patients were male (76.1%) and aged between 18 and 50 years (52.2%), as in previous studies in South Asian countries. However, the prevalence of TBI due to road traffic accidents (RTAs) was much higher (67.9%) than in the earlier studies in South Asia. Additionally, more patients suffered from severe TBI (29.3%) and moderate TBI (35.7%), and a higher percentage of patients went through surgery (56.8%) compared to previous studies. A significant association of demographic (residence) and clinical characteristics (consciousness after injury, CT scan findings and treatment type) with the severity of TBI was found in bivariate analysis. It also revealed the significant dependence of clinical characteristics (TBI etiology, post-injury consciousness, treatment type and TBI severity) on TBI prognosis. Multivariate analysis showed that patients who were unconscious after TBI and with evident brain injury observed in CT scans have a substantially higher risk of having moderate or severe TBI than mild TBI. Moreover, patients with TBI due to RTAs or falls, evident brain injury in CT scans, post-surgical seizure, and moderate or severe TBI have a significantly higher risk of getting a more unfavorable TBI prognosis than moderate disability. In this study, RTAs were found to be the major cause of TBI. Additionally, some variables were identified as possible determinants of TBI severity and prognosis among Bangladeshi patients. The correlation of these variables with TBI should be further studied with the hopes that steps will be taken to reduce TBI incidents and improve its management to reduce the overall burden.]]></description>
      <pubDate>Mon, 27 Jan 2025 15:11:18 GMT</pubDate>
      <guid>https://trid.trb.org/View/2449471</guid>
    </item>
    <item>
      <title>Head injuries related to bicycle collisions and helmet use – an observational study</title>
      <link>https://trid.trb.org/View/2449459</link>
      <description><![CDATA[In Denmark, the use of bicycles is widespread, and head injuries are often seen in cyclists involved in collisions. Despite the well-known effects of using a helmet to reduce head injuries, using helmets is not mandatory in Denmark. The primary objective of this study was to provide data regarding injury outcomes and helmet usage. Participants were bicyclists who sustained head injuries in bicycle collisions and were assessed by the Copenhagen Emergency Medical Services between 1 January 2016; and 15 June 2019. Patients with suspected head injury were identified in an electronic prehospital patient record. Data were linked to the Danish National Patient Registry to retrieve the diagnosis and were categorized into head injury or no head injury based on the diagnosis. Adjusted logistic regression analyses were reported with odds ratios and corresponding confidence intervals to assess the risk of head injury while adjusting for risk factors like age, sex, alcohol consumption, occurrence during weekends and traumatic brain injury. A total of 407 patients were included in this study. Within this entity, 247 (61%) had sustained a head injury. The use of a helmet was reported in one-third of the included patients. Among the head-injured patients, 13% sustained moderate to severe head injuries. Patients with suspected alcohol involvement were significantly less likely to report the use of a helmet. Helmet use reduced the risk of head injury with an odds ratio of 0.52, (95% CI 0.31 − 0.86). In high-energy trauma, the use of a helmet showed a significant reduction in the risk of sustaining a head injury with an odds ratio of 0.28, (95% CI 0.12 − 0.80). In this study, using a helmet was associated with a significantly decreased risk of head injury; this association was even more significant in high-energy trauma.]]></description>
      <pubDate>Mon, 27 Jan 2025 15:11:18 GMT</pubDate>
      <guid>https://trid.trb.org/View/2449459</guid>
    </item>
    <item>
      <title>Embolic Ischemic Cortical Stroke in a Young Flight Instructor with a Small Patent Foramen Ovale</title>
      <link>https://trid.trb.org/View/2447210</link>
      <description><![CDATA[Stroke in young patients is frequently associated with a patent foramen ovale (PFO). Controversy exists over whether the PFO is a cause, a risk factor, or an incidental finding. Estimating the individualized risk of stroke recurrence has been difficult to ascertain. This has implications for aeromedical certification for pilots following stroke recovery. A 28-yr-old male flight instructor presented with sudden onset unilateral facial paresthesia, hand weakness, and blurred vision, accompanied by gradual onset bilateral headache. While the cranial symptoms resolved, left hand weakness persisted for 3 d. MRI revealed two punctate ischemic foci in the right precentral gyrus and superior parietal lobe. A transesophageal echocardiogram revealed a PFO with a small bidirectional shunt. His cardiologist and neurologist advised the PFO was unlikely to have caused his stroke and estimated an annual recurrence rate of < 1.8%. He was treated medically and declined PFO closure. He was able to return to flying light-sport aircraft. However, an enduring copilot restriction for general aviation activities was placed on his Class 1 and 2 medical certificates. This case highlights the difficulty in determining individualized recurrence risks for pilots recovering from a stroke associated with a PFO. While medical treatment does reduce the risk of recurrence, PFO closure provides marginal additional benefit in certain patients with a risk of side effects. Contemporary evidence-based risk scoring systems combined with echocardiography findings may be used together to better risk stratify patients and suitability for medical aviation recertification.]]></description>
      <pubDate>Fri, 22 Nov 2024 14:27:16 GMT</pubDate>
      <guid>https://trid.trb.org/View/2447210</guid>
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    <item>
      <title>Two profiles of post-stroke drivers based on their driving perception</title>
      <link>https://trid.trb.org/View/2424304</link>
      <description><![CDATA[Stroke is the leading cause of acquired disability in adults, and can induce different sequelae which impact on abilities such as driving. This study investigated how post-stroke patients perceived their driving practice and behavior. The aim of this study was to determine different profiles of post-stroke drivers according to their driving perception. Among 86 post-stroke patients who had undergone an official fitness-to-drive assessment in 2019 in the Kerpape Center or the Henry Gabrielle Hospital (France), 69 returned to drive. These 69 participants completed a questionnaire about their socio-demographic and clinical characteristics, and driving perception, approximately three years after resuming driving. Questions about driving perception were statistically analyzed using hierarchical clustering analysis. Socio-demographic, driving, and clinical characteristics from the clusters obtained were then compared. Clustering analysis revealed two profiles of post-stroke drivers. One group consisting of 2/3 of the participants reported modified driving behavior, while the other group perceived no driving changes. A higher proportion of participants from the modified driving group reported driving significantly less, experiencing less pleasure, increased tiredness and more fear when driving post-stroke than those from the unmodified driving group. They also stated that they experienced more difficulties, avoided more situations, and implemented more driving strategies than participants in the unmodified driving group. Participants in the modified driving group were also younger (p = 0.014), lived in more rural areas (p = 0.028), and had more sequelae, including fatigue (p = 0.002), motor sequelae (p = 0.035), and cognitive sequelae (p = 0.013) than participants who did not modify their driving. Two profiles of post-stroke drivers were identified: those who had perceived the need to modify their driving behavior, and those who had perceived no driving changes. Differences in socio-demographic characteristics may partly explained the divergencies between the two groups. Other factors such as self-awareness of driving abilities may influence their driving perception. Two lines of action could be investigated to enable post-stroke drivers to better appreciate their driving abilities. The first would be to develop targeted support programs to help drivers become more aware of their own abilities, for example using video support during on-road training to replay critical situations and improve awareness of their own abilities. A second approach would be to deploy technological driving assistance systems. A monitoring system enabling the driver to adjust his driving in real time could be very useful and relevant to develop.]]></description>
      <pubDate>Mon, 16 Sep 2024 08:55:36 GMT</pubDate>
      <guid>https://trid.trb.org/View/2424304</guid>
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