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Biomedical subjects

A K Lund

Publications and source records attributed to A K Lund.

At least 19 recordsLinked to original sources

Insulin regulation in AhR-null mice: embryonic cardiac enlargement, neonatal macrosomia, and altered insulin regulation and response in pregnant and aging AhR-null females.

The aryl hydrocarbon receptor (AhR) was originally characterized because of its high affinity binding of 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin. However, studies using AhR-null mice have demonstrated the importance of this protein in normal physiology and development. Here we demonstrate that AhR-null embryos develop cardiac enlargement, and that this phenotype is dependent, at least in part, on the maternal genotype. Neonates born to AhR-null females had increased heart weights regardless of the neonatal genotype, an outcome also observed in gestational diabetes. The cardiac hypertrophy markers, beta-myosin heavy chain and atrial natriuretic factor, and the cardiac proliferative index were increased in AhR-null embryos, indicating that the cardiac enlargement is associated with myocyte hypertrophy and hyperplasia, which begin prior to birth. Importantly, two- to three-month-old pregnant and seven-month-old nonpregnant females, but not nonpregnant three-month-old AhR-null females had significantly decreased fasting plasma insulin levels and a reduced ability to respond to exogenous insulin compared to controls. Despite these alterations in insulin regulation and responsiveness, pregnant AhR females did not have abnormal glucose tolerance tests and did not develop hyperglycemia, classic characteristics of gestational diabetes. However, twenty-three percent of seven-month-old AhR-null females did have altered glucose tolerance tests, but did not show hyperglycemia or increased hemoglobin A1C concentration under normal feeding conditions. While the ultimate cause of the neonatal phenotype remains unclear, these studies establish that the AhR is required for normal insulin regulation in pregnant and older mice and for cardiac development in embryonic mice.

Age Factors↗

Neck pain and head restraint position relative to the driver's head in rear-end collisions.

This two-year investigation was designed to estimate the incidence of driver neck pain in rear-struck vehicles involved in two-vehicle collisions and to determine the relationship between neck pain and specific vehicle, human, and environmental factors. Neck pain percentages were significantly higher for female (45%) than for male (28%) drivers. For female and male drivers, neck pain likelihood increased as head restraint height decreased below the head's center of gravity, although this effect was significant only for females. Head restraint backset, the horizontal distance measured from the back of the driver's head to the front of the head restraint, was not found to be related to neck pain for female drivers. Backset trends for male drivers could not be evaluated because few male drivers had head restraints that were high enough for backset to be relevant. Reported neck pain decreased for older drivers (females only), drivers in less severe crashes, and drivers in heavier cars (females only); all head restraint analyses were adjusted for these characteristics. Women, and most likely men, in the United States would benefit greatly from international harmonization to European head restraint standards. Until then, both women and men should be encouraged to adjust their adjustable head restraints, if possible, behind their heads' centers of gravity and to sit with the backs of their heads as close as possible to their head restraints.

Accidents, Traffic↗

Changes in motor vehicle occupant fatalities after repeal of the national maximum speed limit.

Trends in motor vehicle occupant deaths over 8 years were studied for 24 states that raised interstate speed limits and seven states that did not following the 1995 repeal of the US National Maximum Speed Limit. Fatalities on interstates increased 15% in the 24 states that raised speed limits. After accounting for changes in vehicle miles of travel, fatality rates were 17% higher following the speed limit increases. Similar increases were reported following the 1987 speed limit increases on rural interstates. Deaths on roads other than interstates were essentially unchanged.

Accidents, Traffic↗

A photograph-based study of the incidence of fatal truck underride crashes in Indiana.

Photographs were used to estimate the incidence of fatal crashes in which passenger vehicles underrode the fronts, sides and rears of large trucks in Indiana during 1993. The photographs were obtained for 98 of the 107 eligible fatal crashes between large trucks and passenger vehicles in 1993. A protocol was developed to judge the presence and extent of underride, the presence of intrusion into the passenger vehicle compartment, and the likelihood of death or serious injury if underride had been prevented. The incidence of fatal underride was compared with the incidence reported in the Fatality Analysis Reporting System (FARS), a census of fatal crashes on public roads in the U.S.A. For the same 107 fatal large truck-passenger vehicle crashes, the incidence of underride reported in FARS was much lower than in the photograph-based study: 6 versus 63%. Photographs contain details absent from police reports, the primary data source for FARS, and thus enable more complete identification of underride crashes. Preventing underride would have substantially reduced the likelihood of death or serious injury in ca 20% of the underride crashes.

Accident Prevention↗

Reductions in deaths in frontal crashes among right front passengers in vehicles equipped with passenger air bags.

CONTEXT: Virtually all new cars now are equipped with passenger air bags. Determining whether passenger air bags are saving lives is important, particularly because passenger air bags have caused some deaths among children and adults. OBJECTIVE: To assess the effectiveness of passenger air bags in reducing the risk of death in frontal crashes for right front passengers. DESIGN: Air bags are designed to protect occupants in frontal crashes. Using Fatality Analysis Reporting System data for calendar years 1992 through 1995, the relative frequency of right front passenger deaths in frontal vs nonfrontal fatal crashes was compared for cars with dual air bags and for cars with driver-only air bags. MAIN OUTCOME MEASURES: Odds of right front passengers dying in frontal compared with nonfrontal fatal crashes were computed for 1992 through 1995 model year cars with dual air bags and for cars with driver-only air bags. Percentage reductions in right front passenger deaths in dual air bag vehicles were estimated. RESULTS: Right front passenger fatalities were 18% lower than expected in frontal crashes of cars with dual air bags and 11% lower in all crashes. An estimated 73 fewer than expected right front passengers died in 1992 through 1995 model cars with dual air bags during 1992 through 1995. The risk of frontal crash death for right front passengers in cars with dual air bags was reduced 14% among those reported to be using belts and 23% among belt nonusers. Children younger than 10 years in cars with dual air bags had a 34% increased risk of dying in frontal crashes. CONCLUSIONS: Passenger air bags were associated with substantial reductions in fatalities among right front passengers in frontal crashes. However, more children are being killed than are being saved by air bags. Immediate countermeasures to reduce the dangers of air bags to children and adults are suggested.

Accidents, Traffic↗

Fatal crashes of passenger vehicles before and after adding antilock braking systems.

Fatal crash rates of passenger cars and vans were compared for the last model year before four-wheel antilock brakes were introduced and the first model year for which antilock brakes were standard equipment. Vehicles selected for analysis had no other significant design changes between the model years being compared, and the model years with and without antilocks were no more than two years apart. The overall fatal crash rates were similar for the two model years. However, the vehicles with antilocks were significantly more likely to be involved in crashes fatal to their own occupants, particularly single-vehicle crashes. Conversely, antilock vehicles were less likely to be involved in crashes fatal to occupants of other vehicles or nonoccupants (pedestrians, bicyclists). Overall, antilock brakes appear to have had little effect on fatal crash involvement. Further study is needed to better understand why fatality risk has increased for occupants of antilock vehicles.

Accidents, Traffic↗

Driver fatalities in 1985-1993 cars with airbags.

OBJECTIVE: Analyses were conducted to estimate the effectiveness of airbags in reducing driver fatalities in motor vehicle crashes. DESIGN: Airbag effectiveness was estimated by (1) comparing driver fatalities in frontal crashes with driver fatalities in nonfrontal crashes for cars with airbags and manual belts and cars with manual belts only, and (2) by comparing driver fatal crash rates per 10,000 registered vehicles for cars with airbags and manual belts and cars with manual belts only. MATERIALS AND METHODS: Fatal Accident Reporting System data for 1985-1993 model year cars were compared. MEASUREMENTS AND MAIN RESULTS: The two methods yielded similar results. In the analysis based on location of damage, driver fatalities in airbag equipped cars were reduced by 24 percent in frontal crashes relative to comparable cars with manual belts only and by 16 percent in all crashes. In the analyses based on vehicle registration data, fatality rates for frontal crashes were reduced by 23 percent for cars with airbags and manual belts compared with the same cars equipped with manual belts only and by 16 percent for all crashes. CONCLUSIONS: Various estimates of airbag effectiveness are beginning to yield consistent results. These analyses confirm that driver airbags are reducing fatalities in the frontal crashes for which they are designed.

Accidents, Traffic↗

Daylight saving time and motor vehicle crashes: the reduction in pedestrian and vehicle occupant fatalities.

Fatal crashes were tabulated for 6-hour periods around sunrise and sunset, from 13 weeks before the fall change to standard time until 9 weeks after the spring change to daylight saving time. Fatal-crash occurrence was related to changes in daylight, whether these changes occurred abruptly with the fall and spring time changes or gradually with the changing seasons of the year. During daylight saving time, which shifts an hour of daylight to the busier evening traffic hours, there were fewer fatal crashes. An estimated 901 fewer fatal crashes (727 involving pedestrians, 174 involving vehicle occupants) might have occurred if daylight saving time had been retained year-round from 1987 through 1991.

Accidents, Traffic↗

The effects of mobile roadside speedometers on traffic speeds.

A study was conducted to evaluate mobile roadside speedometers as a means of controlling urban traffic speeds under varied schedules of deployment and speed limit law enforcement. Speeds of cars passing the roadside speedometer were measured using nondetectable radar. The data indicate that, generally, the speedometer's presence reduced average traffic speeds by about 10% alongside the speedometer and about 7% at short distances downstream. The proportion of drivers exceeding the speed limit by at least 10 mph fell dramatically from 15%-20% to only 2% at one site on days the speedometer was deployed, and the device was particularly effective when deployed in school zones. However, the effect of the speedometer was limited to the times when it was actually deployed. Associated police enforcement is a key factor, as the effect of the speedometer decayed over time but could be long lasting with a minimal amount of enforcement activity in the area of the speedometer.

Accidents, Traffic↗

The duration of speed reductions attributable to radar detectors.

The duration of speed reductions attributable to radar detector use was observed. When the entire traffic stream was exposed to police radar, the proportion of vehicles traveling more than 10 mph over the speed limit dropped initially from 42% to 28%, but by one mile after exposure, this percentage had already increased to 38%. When speeding vehicles with radar detectors (about 45% of all speeding vehicles) were exposed to police radar, speeds dropped by approximately 15%, but by one mile after exposure, nearly half of the reduction was recovered. These findings indicate that radar detector users slow only briefly when alerted to police radar and that radar detectors are use primarily to avoid speed limit enforcement.

Automobile Driving↗

The effect of laser speed-measuring devices on speed limit law enforcement in Charleston, South Carolina.

Drivers exceeding the speed limit by more than 10 mph were identified and ticketed by the Charleston County, South Carolina police using two types of speed measuring devices: conventional police radar and a new laser device. The two types of enforcement were used alternately on the same roads at similar times. Under the laser enforcement condition, the police issued 534 tickets (54%) compared with 457 (46%) under radar enforcement. The increase in tickets issued under laser enforcement was observed at three of the four study sites, and the number of tickets per traffic volume increased at two of the three sites for which traffic volumes were available. Speeders ticketed under the laser enforcement condition were four times as likely to have radar detectors as those ticketed under the radar enforcement condition. Most of the additional speeders caught by the laser were using radar detectors. These data indicate that some speeders with radar detectors are avoiding detection when the police enforce the limit with radar.

Adolescent↗

Injury control. What psychologists can contribute.

Psychologists are inadequately represented in the injury control field, despite the size of the problem and the importance of behavioral factors in injury. Using motor vehicle injuries as an example, this article discusses modern injury control principles and the role psychologists can play in injury reduction.

Accident Prevention↗

Laboratory evaluation of two passive alcohol sensors.

Passive alcohol sensors are screening devices designed to sample nonintrusively the exhaled breath of a person to determine whether or not it contains alcohol and if so approximately how much. Two production passive alcohol sensors (NPAS passive alcohol sensor and the Life-Loc PBA 2000) were evaluated in a laboratory environment to establish appropriate threshold measurements that indicate probable alcohol impairment. The laboratory evaluation was conducted using both instrument types with 12 drinking subjects. Both sensors were able to identify alcohol in exhaled breath with sufficient accuracy to identify persons with high blood alcohol concentrations (BACs). The accuracy of both sensors was related to the distance from the subject's mouth: the further away they were from a subject's mouth the greater the chance that high BACs would not be detected. Under ideal conditions, it was estimated that the Life-Loc sensor could be expected to correctly detect 80% of drivers at 0.10% BAC (99% at 0.15% BAC) as being impaired while incorrectly identifying only about one in eight drivers with BACs of 0.02% (false positives). In comparison, the NPAS sensor could be expected to correctly detect about 75% of drivers at 0.10% BAC (97% at 0.15% BAC) while incorrectly identifying one in five drivers at 0.02% BAC.

Accidents, Traffic↗

Motor vehicle crash injury patterns and the Virginia seat belt law.

Injuries to front seat occupants in tow-away crashes in the Charlottesville, Va, area were compared for 1 year before and 1 year after Virginia's seat belt use law took effect. Vehicle and occupant data were combined to examine crash and injury patterns. Reported seat belt use in crashes increased after the law, and there were substantial decreases in injuries. Front seat occupants were less likely to receive medical treatment following a crash in the postlaw period. The reduction in the number of injuries was greater for passengers in the right front seat than for drivers and for frontal crashes than for other types of crashes. The injury reduction effects occurred primarily through reductions in the number of head and face injuries, particularly those that occur from contact with windshields and instrument panels.

Accidents, Traffic↗

Characteristics of belted and unbelted drivers.

Drivers who had been observed wearing or not wearing shoulder belts were compared using vehicle registration data, driver records, and telephone interviews. The observations were made on the New York Thruway during a special seat belt publicity and enforcement program, which achieved a 75% overall belt use. The results showed that those drivers who still did not wear a shoulder belt despite New York law and the special Thruway program were more likely to be male, to be driving older vehicles, to have more prior traffic convictions, to have more prior injury crash involvements, and to say they are more likely to take risks than others. Although drivers reported that assessing points against the drivers license for belt law violations could increase belt use, citations for belt use law violations were very rare, and enforcement would probably have to increase before any new penalty could be effective.

Accidents, Traffic↗

Changes in the incidence of alcohol-impaired driving in the United States, 1973-1986.

Studies of motor vehicle fatality data have indicated that alcohol involvement in fatal crashes has declined substantially in the United States since 1980. To determine the actual incidence of alcohol-impaired drivers on U.S. roads, a national roadside survey using portable breath-testing devices was carried out in 32 localities in the spring of 1986. The same sampling design and survey procedures used in a 1973 national roadside survey were followed as much as possible. The 1986 survey found 3.1% of the late-night weekend drivers to have a blood alcohol concentration (BAC) of 0.10% or more, compared to 4.9% of drivers in 1973. Similarly, 8.3% of the 1986 drivers were at or above 0.05% BAC, compared to 13.5% in 1973. The data indicate that the incidence of alcohol-impaired driving on weekend nights has fallen by one-third or more in the United States since 1973 and that the decline affected most population subgroups.

Accidents, Traffic↗

City curfew ordinances and teenage motor vehicle injury.

Several U.S. cities have curfew ordinances that limit the late night activities of minor teenagers in public places including highways. Detroit, Cleveland, and Columbus, which have curfew ordinances, were compared to Cincinnati, which does not have such an ordinance. The curfew ordinances were associated with a 23% reduction in motor vehicle related injury for 13- to 17-year-olds as passengers, drivers, pedestrians, or bicyclists during the curfew hours. It was concluded that city curfew ordinances, like the statewide driving curfews studied in other states, can reduce motor vehicle injury to teenagers during the particularly hazardous late night hours.

Accidents, Traffic↗