Impact of device sales representatives in the operating room on clinical outcomes during standard endovascular aneurysm repair: A retrospective case-control study.

In the United States (U.S.), approximately one million vertebrates are killed by animal-vehicle collisions (AVCs) every day, while in Europe, 194 million birds and 29 million mammals are killed annually [,]. Despite imperfect tracking systems, existing data show an upward trend associated with urbanization and traffic density, with mammal deaths from AVCs rising fourfold over the past fifty years [,]. The increasing prevalence of AVCs poses interconnected risks to animal, ecosystem, and human health [,]. Research attention to roadkilled animals—those struck and killed by vehicles—has increased in recent years, particularly in studies examining wildlife and ecosystem impacts, human injury or fatality risks, economic costs, and mitigation strategies [,–]. AVCs reduce wildlife population sizes, diminish genetic diversity, and compromise ecosystem structure and balance []. Road mortality is one of the leading sources of anthropogenic mortality for many vertebrates and the single greatest cause of death for approximately 28% of studied populations []. Beyond direct mortality, roads fragment the habitats and movement of animals, contributing to population isolation and subsequently higher local extinction risk [,]. Roadkilled animals can also serve as hosts for environmental contaminants and disease, posing additional possible physical health risks and stressors distinct from the collision event itself []. These impacts are not limited to ecological systems. In the U.S., AVCs result in over 440 human fatalities and 59,000 injuries annually, along with an estimated economic cost of over $8 billion per year [,]. Greater attention is needed to understand how involvement with AVCs and exposure to roadkilled animals affect other dimensions of human health, including psychological, emotional, psychosocial, and community-level outcomes [,,]. Research indicates that up to 25% of patients severely injured in AVCs experience psychological reactions, including 3-6% that develop long-term post-traumatic stress disorder []. Impacts also extend to wildlife professionals, who report grief when responding to AVC incidents []. Even indirect exposure can affect well-being, as tourists in Tasmania reported sadness, anger, and disgust when encountering roadkilled animals, which impacted their likelihood of repeat tourism []. Women participants reported greater emotional distress, highlighting the need for demographic comparisons within the exploration of AVCs and human health. As evidence develops, increased scholarly attention is warranted to examine the role of roadkilled animals within human-animal relations and well-being.