The effects of war on patients with Parkinson's disease.

According to the World Health Organization (WHO), Road Traffic Accidents (RTAs) are the 8th leading cause of death globally and the leading cause of death among people aged 5-29 years []. Over 1.35 million people succumb each year to road traffic crashes. Furthermore, over 28% of all worldwide RTA fatalities consist of motor two-wheel (MTW) collisions, while in low- and middle-income countries (Vietnam, Indonesia, and parts of India), this number shoots up to 50% []. Differences in socioeconomic status are important, since high-income countries tend to have fewer fatalities, probably due to stricter mandatory helmet laws, better road-maintenance infrastructure, and mandatory insurance and licensing []. Two-wheelers include bicycles (pedal- or electric-powered) and powered two-wheelers (PTWs), such as mopeds and motorcycles []. This review focuses specifically on motorcycle-related fatalities, while focusing specifically on fatal motorcyclist incidents and combining epidemiological, toxicological, and forensic data. Helmet use can reduce mortality by 42%, suggesting it is a major preventive factor in two-wheeled vehicle casualties []. In terms of cause of death, the most common fatal injuries include craniocerebral injuries, thoracic trauma, and femoral fractures []. Alcohol/substance use is another important factor in the causation as well as mortality. Throughout the literature, 20-40% of casualty cases tested positive for alcohol [,]. It is important to establish preventive measures such as random breath testing, universal helmet regulations, and a thorough review of licensing policies, as these appear to reduce motorcycle fatalities []. Despite extensive literature on motorcycle crashes and helmet effectiveness, fatal motorcycle injuries remain inconsistently synthesized across epidemiological, clinical, toxicological, and forensic domains. By integrating evidence from diverse study designs, this review aims to provide a more comprehensive understanding of the factors associated with fatal outcomes and to identify gaps relevant to prevention, forensic evaluation, and future research. Consequently, there is a need for a systematic synthesis focused specifically on motorcycle-related fatalities. No protocol was registered with PROSPERO or any other prospective registry. This has been acknowledged as a limitation of the review. We conducted a systematic literature review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Guidelines [].