There has been a repeal of the universal helmet law in several states despite definitive evidence that helmets reduce mortality, traumatic brain injury, and hospital expenditures. Opponents of the universal helmet law have successfully claimed that helmets should not be required because of greater torque on the neck, which is thought to increase the likelihood of a cervical spine injury. There is currently insufficient evidence to counter claims that helmets do not increase the risk of cervical spine injury after a motorcycle collision. The objective of this study was to determine the impact of motorcycle helmets on the likelihood of developing a cervical spine injury after a motorcycle collision. We reviewed cases in the National Trauma Databank (NTDB) v7.0 involving motorcycle collisions. Multiple logistic regression was used to analyze the independent effect of helmets on cervical spine injury. Cases were adjusted for age, race, sex, insurance status, anatomic (Injury Severity Score) and physiologic injury severity (systolic blood pressure < 90 mmHg), and head injury (Abbreviated Injury Score > 3). Between 2002 and 2006, 62,840 cases of motorcycle collision were entered into the NTDB; 40,588 had complete data and were included in the adjusted analysis. Helmeted riders had a lower adjusted odds (0.80 [CI 0.72 to 0.90]) and a lower proportion of cervical spine injury (3.5% vs 4.4%, p < 0.05) compared with nonhelmeted riders. Helmeted motorcyclists are less likely to suffer a cervical spine injury after a motorcycle collision. This finding challenges a long-standing objection to mandatory helmet use that claims helmets are associated with cervical spine injury. Re-enactment of the universal helmet law should be considered in states where it has been repealed.

Motorcycle collisions are increasing at a precipitous rate, and reliable and valid data regarding all aspects of helmet safety are needed to better inform ongoing debates on mandatory helmet laws. The objective of this study was to determine the effect of motorcycle helmets on the likelihood of a facial injury after motorcycle collisions, using data from the National Trauma Data Bank, version 7.0, on 46 362 patients from January 1, 2002, through December 31, 2006. Multiple logistic regression was used to analyze the independent association between helmets and facial injury with adjustment for potential confounders. Helmeted motorcyclists were less likely to suffer facial injuries after a motorcycle collision, with a lower adjusted odds ratio of facial injury (0.40; 95% CI, 0.37-0.43) and a lower prevalence of specific types of facial injury compared with their nonhelmeted counterparts.

Despite being one of the first types of cancers studied that hinted at a major role of the immune system in pro- and anti-tumor biology, little is known about the immune microenvironment in sarcoma. Few types of sarcoma have shown major responses to immunotherapy, and its rarity and heterogeneity makes it challenging to study. With limited systemic treatment options, further understanding of the underlying mechanisms in sarcoma immunity may prove crucial in advancing sarcoma care. While great strides have been made in the field of immunotherapy over the last few decades, most of these efforts have focused on harnessing the T cell response, with little attention on the role B cells may play in the tumor microenvironment. A growing body of evidence suggests that B cells have both pro- and anti-tumoral effects in a large variety of cancers, and in the age of bioinformatics and multi-omic analysis, the complexity of the humoral response is just being appreciated. This review explores what is currently known about the role of B cells in sarcoma, including understanding the various B cell populations associated with sarcoma, the organization of intra-tumoral B cells in tertiary lymphoid structures, recent trials in immunotherapy in sarcoma, intra-tumoral immunoglobulin, the pro-tumor effects of B cells, and exciting future areas for research.