Objective: The purpose of this systematic review was to evaluate the effectiveness of roll-over protection structures (ROPS) as an engineering control for prevention of fatalities from farm tractor roll-overs.
Methods: Using a systematic approach to literature searching, relevant studies from peer-reviewed journals, technical and government reports, and unpublished reports were retrieved. Studies meeting initial criteria for possible inclusion were screened to determine whether they addressed the review topic (ROPS), included comparison data and included outcomes data such as injury or fatality. Articles that evaluated the use and impact of ROPS on operators of agricultural tractors were reviewed. Outcomes included two primary categories: implementation of ROPS and fatalities.
Main Results: Of a total 207 citations reviewed, 53 met initial screening criteria and 21 studies were included in this review. Farm tractor roll-overs result in approximately 200 fatalities per year in the United States. ROPS or crush-proof cabs, which are designed to protect the farmer during a roll-over incident, are currently used on only about 50% of the estimated 4.8 million tractors in the United States. A significant proportion of tractors built after 1985 (when manufacturers began implementing a voluntary ROPS standard) have had ROPS removed. Evidence from Sweden and other Northern European countries clearly demonstrates that ROPS can essentially eliminate roll-over fatalities. In the United States, the only fatalities associated with roll-overs of ROPS-equipped tractors occurred when farmers did not use a seatbelt to hold them within the protective envelope of the ROPS. Estimates of costs of programs to retrofit older tractors with ROPS range from approximately $500,000 to $900,000 per life saved, which is comparable to other accepted life-saving interventions.
Conclusions: Future research efforts should include the development of collapsible and telescoping ROPS that can be used in low clearance areas such as dairy barns and fruit orchards. ROPS retrofits also need to be developed for many older tractor models. Effective educational and incentive programs need to be developed to increase the acceptance and use of ROPS among U.S. farmers. A national policy should be implemented to ensure that all tractors operated in the United States are equipped with ROPS or crush-proof cabs.
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http://dx.doi.org/10.1016/s0749-3797(00)00142-2 | DOI Listing |
JAMA
January 2025
Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT, Washington, DC.
Importance: Health information technology, such as electronic health records (EHRs), has been widely adopted, yet accessing and exchanging data in the fragmented US health care system remains challenging. To unlock the potential of EHR data to improve patient health, public health, and health care, it is essential to streamline the exchange of health data. As leaders across the US Department of Health and Human Services (DHHS), we describe how DHHS has implemented fundamental building blocks to achieve this vision.
View Article and Find Full Text PDFJpn J Ophthalmol
January 2025
Institute for Photon Science and Technology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan.
Purpose: There is no established method for visualizing the three-dimensional (3D) structure of the aqueous humor outflow tract. This study attempted to visualize the 3D structures of porcine and human ocular tissues, particularly the aqueous humor outflow tract using a transparency reagent composed of 2, 2-thiodiethanol.
Study Design: Clinical and experimental.
Dig Dis Sci
January 2025
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Background: Chronic constipation, diarrhea, and fecal incontinence (FI) are prevalent with significant impact on quality of life and healthcare utilization. Thyroid dysfunction was recognized as a potential contributor to bowel disturbances in selected populations, but the strength/consistency of this association remain unclear.
Aims: To investigate the relationship between thyroid function and bowel health measures (constipation, diarrhea, and FI) in a nationally representative sample of the U.
Biomol NMR Assign
January 2025
Department of Molecular Biology and Biophysics, University of Connecticut Health Center, Farmington, CT, 06030, USA.
The nutrient germinant receptors (GRs) in spores of Bacillus species consist of a cluster of three proteins- designated A, B, and C subunits- that play a critical role in initiating the germination of dormant spores in response to specific nutrient molecules. The Bacillus cereus GerI GR is essential for inosine-induced germination; however, the roles of the individual subunits and the mechanism by which germinant binding activates GR function remain unclear. In this study, we report the backbone chemical shift assignments of the N-terminal domain (NTD) of the A subunit of GerI (GerIA).
View Article and Find Full Text PDFDrugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
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