Mirko Junge - Academia.edu (original) (raw)

Papers by Mirko Junge

Traffic Injury Prevention, Mar 18, 2019

Objective: The objective of this study was to quantify the population-based effects of a lower sh... more Objective: The objective of this study was to quantify the population-based effects of a lower shoulder belt load limit on front row occupants in frontal car crashes. Method: Crashes of modern vehicles from the GIDAS (German In-Depth Accident Study) are corrected for bias and projected to the national level. Injury risk functions are computed for the injury severity levels Maximum Abbreviated Injury Scale (MAIS) 2þ, MAIS 3þ, and fatal, stratified by 2 age cohorts (16-44 years of age and 45 years or older). To assess the field effectivity of a "softer belt," the projected crash frequency data are modified separately for the 2 age cohorts such that its risk structure represents the risk of a softer belt. Given those 2 samples, the field effectivity of a softer belt is derived for several shares of the younger age cohort according to the injury severity levels MAIS 2þ, MAIS 3þ, and fatal. Results: The injury risk distribution of the projected crash frequency data, represented here by the injury risk functions obtained, fits well into the injury risk distribution of other data sets (Sweden, United States, and Japan) given in the literature. The relative effects of a lower belt force are stable over the different ratios of the younger and old age cohorts. At the MAIS 2þ level, a lower belt force can significantly reduce the number of injuries (about 10%). A lower belt force does not significantly affect the number of MAIS 3þ injuries. A lower belt force can, however, more than double the number of fatal injuries. Conclusions: Because the number of fatal injuries rises dramatically due to lower belt force, the reduction in the number of MAIS 2þ injuries comes at a very high cost. Therefore, whether reducing the belt force limit is the right approach is questionable.

Traffic Injury Prevention, Apr 11, 2018

Objective: Thoracic side airbags (tSAB) were integrated into the vehicle fleet to attenuate and d... more Objective: Thoracic side airbags (tSAB) were integrated into the vehicle fleet to attenuate and distribute forces on the occupant's chest and abdomen, dissipate the impact energy, and move the occupant away from the intruding structure, all of which reduce the risk of injury. The research piece investigates and evaluates the safety performance of the airbag unit by cross-correlating data from a controlled collision environment with field data. Method: We focus exclusively on vehicle-vehicle lateral impacts from the NHTSA's Vehicle Crash Test Database and NASS-CDS database, which are replicated in the controlled environment by the (crabbed) barrier impact. Similar collisions with and without seat-embedded tSAB are matched to each other and the injury risks compared. Results: Results indicated that dummy-based thoracic injury metrics were significantly lower with tSAB exposure (p<0.001). Yet, when the controlled collision environment data was cross-correlated with NASS-CDS collisions, deployment of the tSAB indicated no association with thoracic injury (tho.MAIS2+ unadjusted RR = 1.14, 90%CI 0.80-1.62; tho.MAIS3+ unadjusted RR = 1.12, 90%CI 0.76-1.65). Conclusion: The data from the controlled collision environment indicated an unequivocal benefit provided by the thoracic side airbag for the crash dummy however the real-world collisions demonstrate no benefit is provided to the occupant. This has resulted from a non-correlation between the crash test/dummy based design taking the abstracting process too far as to represent the real-world collision scenario.

Journal of Bone and Mineral Metabolism, Apr 18, 2005

Resorption lacunae (RL) are discussed as stressors that can increase the risk of mechanical failu... more Resorption lacunae (RL) are discussed as stressors that can increase the risk of mechanical failure in a trabecular network. Quantification of RL has previously been described through the parameter eroded surface/bone surface (ES/BS) as established by light microscopy (LM) analysis, but the results have been inconsistent and contradictory. Using scanning electron microscopy (SEM), a new study design for quantitative evaluation is introduced. To test its applicability a pilot study was executed with trabecular bone dissected from a femoral head of 28 autopsy subjects (14 female and 14 male). A 2.4 ϫ 2.8 ϫ 1.0 mm sample was excised 1.5 cm below the joint surface of each specimen in coronal medial slices of the femoral head and examined. A virtual grid with 1050 squares superimposed over the generated SEM image allowed determination of the ratio of squares containing RL to squares with an unaffected trabecular surface (RL/U). Classical ES/BS was assessed in parallel sections of the samples. The SEM, and to a lesser extent the qualitative different LM analysis, indicated a gender independent predominance of RL in subjects older than 50 years. This pilot study suggests that the new study design could be useful for acquiring quantitative RL data.

Legal Medicine, Mar 1, 2003

Cardiac pacemakers usually are very reliable, but sometimes malfunctions of the system occur. We ... more Cardiac pacemakers usually are very reliable, but sometimes malfunctions of the system occur. We conceived and developed a method to judge the functionality of pacemaker systems in deceased patients. The idea was to verify the hypothesis that more dysfunctions of implanted pacemaker systems go undetected than are detected and corrected. With the aid of a pre-amplifier and a digital storage oscilloscope, pacemaker pulse signals are derived from the surface of the thorax. The derived pulse shape offers information on the functionality of pacemakers and electrodes. Additionally the lead impedance is measured with a test pacemaker and its corresponding hand-held programmer. Synchronization properties can also be assessed with an external test pacemaker. So far 262 pacemakers have been investigated yielding an anomaly rate of 15%, comprising life threatening to annoying malfunctions. These results emphasize the forensic relevance and give reason for a discussion about the natural cause of death in these cases.

Anaesthesist, Nov 1, 1995

Zusammenfassung 90 Kinder der ASA-Klassen I und II im Alter zwischen 6 und 16 Jahren mit Strabi... more Zusammenfassung 90 Kinder der ASA-Klassen I und II im Alter zwischen 6 und 16 Jahren mit Strabismusoperation wurden randomisiert einer der folgenden Gruppen zugeteilt: Gruppe 1 (n=30): Thiopental 4–6 mg/kg i.v., Halothan (0,8–1,5%), N O, O 2 (2:1), Verzicht auf Opioide, Droperidol 75 μg/kg, Gruppe 2 (n=30): Propofol 2–3 mg/kg i.v., Propofol 6–9 mg/kg/h, Alfentanil 30 μg/kg/h, N 2O, O

Rechtsmedizin, Jun 1, 2003

Die Herzschrittmachertherapie ist eine wertvolle und weltweit verbreitete Behandlungsmethode, die... more Die Herzschrittmachertherapie ist eine wertvolle und weltweit verbreitete Behandlungsmethode, die in den meisten Fällen zu einer deutlichen Anhebung der Lebensqualität und Lebenserwartung der betroffenen Patienten führt. Statistiken bezüglich des Erstimplantationsindex zeigen, dass in Deutschland etwa bis zu 850 Patienten auf 1 Mio. Einwohner jährlich einen Schrittmacher bekommen und aufgrund dessen ein normales Leben führen können. Deutschland weist vermutlich eine der höchsten Implantationsraten weltweit auf [14].In Anbetracht der wachsenden Zahl älterer Menschen in der Bevölkerung der Industriestaaten, besonders jener über 75 Jahre,wird die benötigte Anzahl an Herzschrittmachern weltweit weiter ansteigen [3]. Die Indikationen zur Herzschrittmacherimplantation sind vielfältig und lassen sich von der Art der vorliegenden Reizbildungs-bzw.Reizleitungsstörung ableiten. Die therapeutischen Möglichkeiten reichen vom absoluten Ersatz der Sinusfrequenz bei ausfallender Reizbildung bzw. vollständig unterbrochener Reizleitung (Sinusknotenstillstand, totale sinusartriale oder atrioventrikuläre Blockierung) bis hin zur intermittierenden Impulsgabe bei Stö-Originalarbeit

The self-protection standards of the vehicle fleet were hypothesized to have decreased as a funct... more The self-protection standards of the vehicle fleet were hypothesized to have decreased as a function of manufacturing year. The hypothesis was tested using GIDAS data from 2000-2015, for both the belted and unbelted populations. Occupant injury was assessed using an iteration of the New Injury Severity Score, the NISSx. Injury rates were described by point estimates and were plotted against vehicle manufacturing year. Vehicle mileage was considered an exposure measure when determining injury rates. For a given sample of injured occupants, the greatest decrease in injury rate was associated with a NISSx>1 (MAIS2+) injury. The reason for the strong reduction to this injury severity was attributable to the mitigation of 1≤NISSx<2.5 injuries. Logistic regression models were developed to identify factors that have caused this injury mitigation. Euro NCAP compliancy and a deployed frontal airbag for the belted population had significantly reduced effects of mitigating injury. Results also indicated the rate of 2.5≤NISSx<5 injuries has remained constant. Future development of vehicle platforms should consider safety measures to mitigate injuries of these severities.

Annals of advances in automotive medicine / Annual Scientific Conference ... Association for the Advancement of Automotive Medicine. Association for the Advancement of Automotive Medicine. Scientific Conference, 2013

Injury risk assessment plays a pivotal role in the assessment of the effectiveness of Advanced Dr... more Injury risk assessment plays a pivotal role in the assessment of the effectiveness of Advanced Driver Assistance Systems (ADAS) as they specify the injury reduction potential of the system. The usual way to describe injury risks is by use of injury risk functions, i.e. specifying the probability of an injury of a given severity occurring at a specific technical accident severity (collision speed). A method for the generation of a family of risk functions for different levels of injury severity is developed. The injury severity levels are determined by use of a rescaled version of the Injury Severity Score (ISS) namely the ISSx. The injury risk curves for each collision speed is then obtained by fixing the boundary conditions and use of a case-by-case validated GIDAS subset of pedestrian-car accidents (N=852). The resultant functions are of exponential form as opposed to the frequently used logistic regression form. The exponential approach in combination with the critical speed value creates a new injury risk pattern better fitting for high speed/high energy crashes. Presented is a family of pedestrian injury risk functions for an arbitrary injury severity. Thus, the effectiveness of an ADAS can be assessed for mitigation of different injury severities using the same injury risk function and relying on the internal soundness of the risk function with regard to different injury severity levels. For the assessment of emergency braking ADAS, a Zone of Effective Endangerment Increase (ZEEI), the speed interval in which a one percent speed increase results at least in a one percent of injury risk increase, is defined. The methodology presented is kept in such general terms that a direct adaption to other accident configurations is easily done.

Traffic Injury Prevention, Mar 31, 2021

Abstract Objectives Modern vehicles generally use steel fabricated or alloy blended rims. The man... more Abstract Objectives Modern vehicles generally use steel fabricated or alloy blended rims. The manufacturing process and atomic structure of the rim both yield different responses under destructive loading. The aim of this research was to investigate to what extend the type of vehicle rim may influence occupant injury risk. Methods A matched cohort study of frontal German In-Depth Accident Study collisions was devised. The risk of injury to various body regions was compared between vehicles with steel and alloy rims. Results Occupants in vehicles with alloy rims were at a greater risk of thoracic injury (relative risk [RR] = 1.57; 95% confidence interval [CI], 1.01–2.42) and thoracic abdomen injury (RR = 1.62; 95% CI, 1.10–2.39) at the Maximum Abbreviations Injury Scale (MAIS) 2+ severity. Risk of thoracic injury was greatest for the cluster of occupants seated on the nonimpacted side in frontal collisions (RR = 2.21; 95% CI, 1.01–4.86). MAIS 2+ injury to the head/face/neck yielded no association (RR = 0.98; 95% CI, 0.66–1.47). Conclusion Alloy rims are more brittle and, as a result, destructive loading is realized with less severe impact. The critical failure increases the amount of loading that needs to be distributed by the restraint system and results in injury.

Traffic Injury Prevention, Jun 13, 2019

Objective: In the development of restraint systems, anthropomorphic test devices (ATDs) and human... more Objective: In the development of restraint systems, anthropomorphic test devices (ATDs) and human body models (HBMs) are used to estimate occupant injury risks. Due to conflicting objectives, this approach limits an injury severity risk tradeoff between the different body regions. Therefore, we present and validate a protocol for the aggregation of injury risks of body regions to a probability of survival (PoS). Methods: Injuries were clustered in regions similar to ATD or HBM investigations and the most severe injury as rated by the Maximum Abbreviated Injury Scale (MAIS) per body region was determined. Each injury was transformed into a dichotomous variable with regard to the injury severity level (e.g., MAIS 3þ) whose injury risk was computed using the German In-Depth Accident Study (GIDAS) and NASS-CDS databases. Without loss of generality, we focus on 2 body regions-Head/face/neck (HFN) and chest (C)-at the MAIS 3þ level. The PoS was calculated using injury outcomes from the databases. The method of predicting PoS was validated by stratifying the database by crash type and technical crash severity. Results: The PoS of occupants injured in both HFN and C at the AIS 3þ level was found to be lower, at a statistically significant level, than that of occupants with AIS 3þ injuries to just one of the body regions. Focusing on occupants with only one body region injured at the AIS 3þ level, HFN injuries tended to decrease PoS more than chest injuries. For the validation cases, observed PoS could be reproduced in the majority of cases. When comparing predicted to observed values, a correlation of R 2 ¼ 0.92 was observed when not taking the restraint system into account. Focusing on frontal crashes, the correlation was R 2 ¼ 0.89. Considering only belted occupants, R 2 increased to 0.93, whereas for cases with deployed airbag systems the R 2 decreased to 0.68. The PoS for side crashes is reproduced with R 2 ¼ 0.97 independent of the restraint system; it was 0.95 with belted occupants and 0.55 when also factoring in airbag deployment. Conclusions: The method showed an excellent predictive capability when disregarding the restraint system, or restraint-specific subgroups, for the considered validation cases.

Journal für Kardiologie - Austrian Journal of Cardiology, 2002

Accident Analysis & Prevention, Feb 1, 2021

Currently, advanced driver assistance systems (ADAS) and automated vehicles (AV) are designed for... more Currently, advanced driver assistance systems (ADAS) and automated vehicles (AV) are designed for use in the existing road infrastructure. These partially and fully automated vehicles will be operated in a shared space not only with other vehicles but also with vulnerable road users (VRU). Even though crashes between ADAS equipped vehicles or AV and VRU seem inevitable in such a scenario, functional safety, i.e., the assessment of the quality and safety level of the automation system, plays a crucial role in minimizing the crash frequency and the injury severity. We develop a data-driven approach to injury severity estimation for functional safety, i.e., ISO 26262 S-parameters, for four types of VRU: pedestrians, bicyclists, scooterists, and motorcycle riders. To estimate the S-parameter, the 90th-percentile of the injury severity distribution in the S-scale, a population-based data set (Germany's national data set DESTATIS) is used. Since the description of the injury severity in DESTATIS is not detailed enough for a direct one-to-one mapping to the S-scale, we enhance the level of detail in the population-based data set by using additional information from the German in-depth accident study (GIDAS), an in-depth, size-limited survey of part of the same population. Thus, we are able to transform the 4-level injury scale (uninjured, slightly injures, severely injured, and fatal) of the police reports found in DESTATIS into the three breakpoints of the injury severity scale (ISS) (ISS ≥{4, 9, 16}) which in turn directly translate to the four levels of the S-scale. Furthermore, the ISS ≥9 breakpoint more or less equates to MAIS 3+, the definition of 'severe injury' in nearly all international road safety goals that look beyond fatalities. The derived injury scale transformation can be utilized to translate the injury severities of the police-reported cases to the politically needed MAIS 3+ distribution. Thus, population-based data can be directly used to estimate the proportion of these 'severely injured.' The crashes are analyzed from the perspective of the VRU as well as from the vehicle type involved. We stratified the opposing vehicles by injury mechanism: wrap projection for bonnet type passenger vehicles (BTV), forward projection for box type vehicles like light trucks (LTV), as well as single-vehicle crashes. We cluster the crash data into traffic domains based on the speed limit: shared zone, residential streets, city roads, arterial thoroughfares, rural roads, and autobahn. For each VRU type, injury mechanism, and traffic domain, the S-parameters, i.e., the 90th-percentile of the injury severity measured in S-scale, are calculated with a one-sided 95% confidence level. Exemplary applications of the results are given in the discussion: an evaluation of an AV hitting a crossing pedestrian, an in-lane swerving ADAS system for VRU avoidance, and the rating of the nominal performance of an inflatable helmet for pedestrians.

Forensic Science International, Sep 1, 2000

Between 1997 and 1999 a steady increase in cornea donations was achieved, but the number of trans... more Between 1997 and 1999 a steady increase in cornea donations was achieved, but the number of transplantations remained stable because many grafts did not pass quality control. Intermediate organ culture of entire bulbi was examined as a possible solution to reduce post-mortem times and increase suitability for transplantation.

Accident Analysis & Prevention, Oct 1, 2021

It is widely believed that with higher levels of vehicle automation and especially with the adven... more It is widely believed that with higher levels of vehicle automation and especially with the advent of fully automatic vehicles, the currently typical forward-facing, upright position will give way to a more relaxed and reclined seating posture. Therefore, the current study investigates the influence of a reclined sitting position on crash injury severity by analyzing real-world crash data from the German in-depth accident study (GIDAS). We compared reclined to upright occupants and focused on effect sizes regarding odds ratios at different injury severity levels. We used the abbreviated injury scale (AIS 2015) for injury scaling and the maximum AIS (MAIS) at the levels 2+, 3+, and 4+ to convert injury severity into a dichotomous metric. Two different analyses were conducted, one looking at the occupant MAIS and one focusing on selected body regions. The body regions investigated are head/face/neck (HFN), thorax, abdomen, pelvis/hip/lower extremities (PHL), and upper extremities. We computed odds ratios greater than one indicating a higher odds of injury at a given injury severity level in the reclined group compared to the upright group. The odds ratios for belted, reclined occupants compared to belted, upright sitting occupants are 2.07, 3.09, and 3.66 for the injury severity levels MAIS2+, MAIS3+, and MAIS4+, respectively. When looking at the body regions, the spread of the odds ratios is wider: At the MAIS2+ level, the odds ratios range between 1.6 and 7.1; at the MAIS3+ level, the odds ratios span from 1.5 to 8.7, with the latter value representing the PHL region. No odds ratio could be computed for the upper extremity injuries at this level. At the MAIS4+ injury severity level, only the HFN odds ratio was statistically significant with a value of 5.6. This study is among the first to show an association between body posture and injury severity at MAIS3+ and MAIS4+ injury level in real-world crashes for reclined seating postures.

Traffic Injury Prevention, Jul 31, 2017

ABSTRACT Objective: Thoracic side airbags (tSABs) deploy within close proximity to the occupant. ... more ABSTRACT Objective: Thoracic side airbags (tSABs) deploy within close proximity to the occupant. Their primary purpose is to provide a protective cushion between the occupant and the intruding door. To date, various field studies investigating their injury mitigation has been limited and contradicting. The research develops efficacy estimations associated for seat-mounted tSABs in their ability to mitigate injury risk from the German collision environment. Methods: A matched cohort study using German In-Depth Accident Study (GIDAS) data was implemented and aims to investigate the efficacy of seat-mounted tSAB units in preventing thoracic injury. Inclusion in the study required a nearside occupant involved in a lateral collision where the target vehicle exhibited a design year succeeding 1990. Collisions whereby a tSAB deployed were matched on a 1:n basis to collisions of similar severity where no airbag was available in the target vehicle. The outcome of interest was an incurred bodily or thoracic regional injury. Through conditional logistic regression, an estimated efficacy value for the deployed tSAB was determined. Results: A total of 255 collisions with the deployed tSAB matched with 414 collisions where no tSAB was present. For the given sample, results indicated that the deployed tSAB was not able to provide an unequivocal benefit to the occupant thoracic region, because individuals exposed to the deployed tSAB were at equal risk of injury (Thorax Maximum Abbreviated Injury Scale (Tho.MAIS)2+ odds ratio [OR] = 1.04, 95% confidence interval [CI], 0.41–2.62; Tho.MAIS3+ OR = 1.15, 95% CI, 0.41–3.18). When attempting to isolate an effect for skeletal injuries, a similar result was obtained. Yet, when the tSAB was coupled with a head curtain airbag, a protective effect became apparent, most noticeable for head/face/neck (HFN) injuries (OR = 0.59, 95% CI, 0.21–1.65). Conclusion: The reduction in occupant HFN injury risk associated with the coupled tSAB and curtain airbag may be attributable to its ability to provide coverage over previous mechanisms of injury. Yet, the sole presence of the tSAB showed no ability to provide additional benefit for the occupant's thoracic region. Future work should identify mechanisms of injury in tSAB cases and attempt to quantify improvements in the vehicle's ability to resist intrusion.

Forensic Science International, Feb 1, 2002

A 66-year-old patient with terminal heart insufficiency (NYHA IV) received maximum medical therap... more A 66-year-old patient with terminal heart insufficiency (NYHA IV) received maximum medical therapy, but was also in need of an implantable-cardioverter-defibrillator (ICD). The ICD functioned flawlessly for the whole duration of implantation. It reverted several ventricular tachycardias with anti-tachycardial pacing alone, whereas some needed cardioversion as well. The patient died on the fourth day of hospitalization for a routine check of his ICD. The post-mortem examination revealed, that the ICD was deactivated and that the data had been erased after the patient's death. By reading off the raw data still stored within the ICD, the erased information could be restored. The stored EGMs showed traces of old ICD interventions as well as a permanent deactivation provoked by exposition to a magnetic field just hours before the patient's death. The problem of archiving and documenting the volatile electronic data inside the ICD is discussed. The need of a full autopsy after telemetric reading of the ICD data, including the explantation of the ICD aggregate and electrodes, as a means of quality assurance and under forensic aspects is emphasized.

The invention relates to a method and an apparatus for determining a Vigilanzzustandes a motor ve... more The invention relates to a method and an apparatus for determining a Vigilanzzustandes a motor vehicle driver (1), wherein - a noise signal (RA) and generates a noise signal from the (RA) dependent additional moment (CM) is applied to a steering system, - a response signal (RE) of the motor vehicle driver (1) is determined - and the state of alertness of a temporal course of the noise signal (RA) and a time course of the response signal (RE) is determined, wherein at least one parameter of a parameterized transfer function of the noise signal (RA) to the reaction signal (RE) is determined, wherein the alertness depending on an absolute value of at least one parameter and / or is determined at least a previous parameter depending on a relative change of said at least one parameter, wherein the one previous parameter at an earlier time point was determined at least.

The invention relates to a method for controlling a vehicle (3), wherein an actual collision of t... more The invention relates to a method for controlling a vehicle (3), wherein an actual collision of the vehicle (3) is monitored during an avoidance maneuver of the vehicle (3) to reduce collision sequences, a compensation maneuver is displayed and / or is carried out if the actual collision is not detected.

A 68 year old non-diabetic physician with a known psychiatric history was found dead in his home.... more A 68 year old non-diabetic physician with a known psychiatric history was found dead in his home. The death scene investigation revealed 3 used insulin syringes on the coffee table next to the body. The autopsy and the consecutive chemicaltoxicological investigation revealed that the deceased committed suicide by injecting an overdose of insulin in combination with a high therapeutic oral bolus application of a β-blocker (Metoprolol). A surprising morphological finding was a terminal pulmonary thrombembolism in the right pulmonary artery.