scholarly journals An Analysis of the Effects of Crash Factors and Precrash Actions on Side Impact Crashes at Unsignalized Intersections

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Emmanuel Kofi Adanu ◽  
Xiaobing Li ◽  
Jun Liu ◽  
Steven Jones
Keyword(s):  
Path Analysis ◽  
Injury Severity ◽  
Significant Proportion ◽  
Side Impact ◽  
Model Estimation ◽  
Contributing Factors ◽  
Right Of Way ◽  
Unsignalized Intersections ◽  
Stop Sign ◽  
Traffic Violations

Annually, side impact crashes contribute to a significant proportion of road fatalities. These crashes typically occur as a result of traffic violations at intersections. This study contributes to efforts in addressing side impact crashes at unsignalized intersections by performing a path analysis to unravel some behavioral trajectories through which these crashes occur. The study further investigated how these behavioral pathways influence the severity of the crashes. Crashes that occurred at unsignalized four-way intersections and T-junctions in Alabama were used for model estimations. Three precrash actions, failed to yield right-of-way at the stop sign, failed to yield right-of-way at a turn, and running stop sign, were considered. The model estimation results reveal that some of the crash factors were more associated with certain precrash factors but not others at either four-way intersections or T-junctions or both. It was observed that side impact crashes that occurred under daylight conditions at four-way intersections, for instance, were less likely to involve running a stop sign but more likely to involve failure to yield at the stop sign and failure to yield right-of-way at a turn, but under dark and unlit roadway conditions, the at-fault drivers were more likely to run a stop sign or fail to yield at a stop sign but less likely to be involved in failure to yield right-of-way at a turn. This approach to injury severity analysis uncovers complex underlying relationships between precrash actions, other contributing factors, and crash outcomes.

scholarly journals Examining Injury Severity of Pedestrians in Vehicle–Pedestrian Crashes at Mid-Blocks Using Path Analysis

2020 ◽  
Vol 17 (17) ◽  
pp. 6170 ◽  
Author(s):  
Haorong Peng ◽  
Xiaoxiang Ma ◽  
Feng Chen
Keyword(s):  
Path Analysis ◽  
Indirect Effects ◽  
Injury Severity ◽  
Road Traffic ◽  
Environmental Benefits ◽  
Direct And Indirect Effects ◽  
Contributing Factors ◽  
Explanatory Variables ◽  
Pedestrian Injury ◽  
Pedestrian Crashes

Walking is a sustainable mode of transport which has well established health and environmental benefits. Unfortunately, hundreds of thousands of pedestrians lose their lives each year over the world due to involvement in road traffic crashes, and mid-blocks witness a significant portion of pedestrian fatalities. This study examined the direct and indirect effects of various contributing factors on the pedestrian injury severity in vehicle–pedestrian crashes at mid-blocks. Data of vehicle–pedestrian crashes during 2002–2009 were extracted from the NASS-GES, with pre-crash behaviors and injury severity included. The SEM path analysis method was applied to uncover the inter-relationships between the pedestrian injury severity and various explanatory variables. Both the direct and indirect effects of these explanatory variables on the pedestrian injury severity were calculated based on the marginal effects in the multinomial and ordered logit models. The results indicate some variables including number of road lanes and the age of pedestrian have indirect impacts on the injury severity through influencing the pre-crash behaviors. Although most indirect effects are relatively small compared with the direct effects, the results in this study still provide some valuable information to improve the overall understanding of pedestrian injury severity at mid-blocks.

Factors Affecting Driver Injury Severity in the Wrong-Way Crash: Accounting for Potential Heterogeneity in Means and Variances of Random Parameters

2021 ◽  
pp. 036119812110098
Author(s):  
Miao Yu ◽  
Jinxing Shen ◽  
Changxi Ma
Keyword(s):  
High Speed ◽  
Injury Severity ◽  
Unobserved Heterogeneity ◽  
Research Effort ◽  
Random Parameter ◽  
Policy Implications ◽  
Contributing Factors ◽  
Severe Injuries ◽  
Data Set ◽  
Severity Levels

Because of the high percentage of fatalities and severe injuries in wrong-way driving (WWD) crashes, numerous studies have focused on identifying contributing factors to the occurrence of WWD crashes. However, a limited number of research effort has investigated the factors associated with driver injury-severity in WWD crashes. This study intends to bridge the gap using a random parameter logit model with heterogeneity in means and variances approach that can account for the unobserved heterogeneity in the data set. Police-reported crash data collected from 2014 to 2017 in North Carolina are used. Four injury-severity levels are defined: fatal injury, severe injury, possible injury, and no injury. Explanatory variables, including driver characteristics, roadway characteristics, environmental characteristics, and crash characteristics, are used. Estimation results demonstrate that factors, including the involvement of alcohol, rural area, principal arterial, high speed limit (>60 mph), dark-lighted conditions, run-off-road collision, and head-on collision, significantly increase the severity levels in WWD crashes. Several policy implications are designed and recommended based on findings.

Understanding Gap Acceptance Behavior at Unsignalized Intersections using Naturalistic Driving Study Data

2021 ◽  
pp. 036119812110071
Author(s):  
Yingfeng (Eric) Li ◽  
Haiyan Hao ◽  
Ronald B. Gibbons ◽  
Alejandra Medina
Keyword(s):  
Road Traffic ◽  
Wait Time ◽  
Study Data ◽  
Gap Acceptance ◽  
Factors Affecting ◽  
Unsignalized Intersections ◽  
Research Activities ◽  
Stop Sign ◽  
Naturalistic Driving Study ◽  
Naturalistic Driving

Even though drivers disregarding a stop sign is widely considered a major contributing factor for crashes at unsignalized intersections, an equally important problem that leads to severe crashes at such locations is misjudgment of gaps. This paper presents the results of an effort to fully understand gap acceptance behavior at unsignalized intersections using SHPR2 Naturalistic Driving Study data. The paper focuses on the findings of two research activities: the identification of critical gaps for common traffic/roadway scenarios at unsignalized intersections, and the investigation of significant factors affecting driver gap acceptance behaviors at such intersections. The study used multiple statistical and machine learning methods, allowing a comprehensive understanding of gap acceptance behavior while demonstrating the advantages of each method. Overall, the study showed an average critical gap of 5.25 s for right-turn and 6.19 s for left-turn movements. Although a variety of factors affected gap acceptance behaviors, gap size, wait time, major-road traffic volume, and how frequently the driver drives annually were examples of the most significant.

Developing and Implementing Manual on Uniform Traffic Control Devices Criteria for Selecting Traffic Control for Unsignalized Intersections

2019 ◽  
Vol 2673 (11) ◽  
pp. 319-331
Author(s):  
H. Gene Hawkins ◽  
Kay Fitzpatrick ◽  
Marcus A. Brewer
Keyword(s):  
Traffic Control ◽  
Traffic Engineering ◽  
High Speed ◽  
Research Team ◽  
Right Of Way ◽  
Unsignalized Intersections ◽  
Control Devices ◽  
Traffic Control Devices ◽  
Urban Conditions ◽  
Selection Of

The 2009 United States Manual on Uniform Traffic Control Devices (MUTCD) includes guidance for the use of various types of traffic control at unsignalized intersections. Despite changes and advances in traffic engineering in recent decades, the MUTCD content related to selection of traffic control in Part 2B has seen only minor changes since 1971. The types of unsignalized traffic control addressed in the current research included no control, yield control, two-way stop control, and all-way stop control. The research team developed recommendations using information available from reviews of existing literature, policies, guidelines, and findings from an economic analysis along with the engineering judgment of the research team and panel. The researchers then developed recommended language for the next edition of the MUTCD for unsignalized intersections. This includes consideration of high-speed (rural) and low-speed (urban) conditions along with the number of legs at the intersection. Because the number of expected crashes at an intersection is a function of the number of legs, the decision on appropriate traffic control should also be sensitive to the number of legs present. The proposed language includes introductory general considerations, discusses alternatives to changing right-of-way control, and steps through the various forms of unsignalized control from least restrictive to most restrictive, beginning with no control and concluding with all-way stop control.

scholarly journals P142: The anticoagulated trauma patient: a Canadian experience in the era of direct oral anticoagulants

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S125-S125 ◽  
Author(s):  
B. Wood ◽  
A. Ackery ◽  
S. Rizoli ◽  
B. Nascimento ◽  
M. Sholzberg ◽  
...  
Keyword(s):  
Trauma Patient ◽  
Injury Severity ◽  
Hematological Parameters ◽  
Oral Anticoagulants ◽  
Demographic Data ◽  
Direct Oral Anticoagulants ◽  
Significant Proportion ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Trauma Population

Introduction: The anticoagulated trauma patient is a particularly vulnerable population. Our current practice is guided by experience with patients taking vitamin K dependent antagonists (VKA, like warfarin). It is currently unknown how the increasing use of direct oral anticoagulants (DOACs) will change our trauma population. We collected data about this new subset of patients to compare their clinical characteristics to patients on pre-injury VKA therapy. Methods: Retrospective review of anticoagulated trauma patients presenting to Toronto’s two adult trauma centres, Saint Michael’s Hospital and Sunnybrook Health Sciences Centre, from June 2014-June 2015 was undertaken. Patients were recruited through the institutions’ trauma registries and were eligible if they suffered a traumatic injury and taking an oral anticoagulant pre-injury. Clinical and demographic data were extracted by a trained reviewer and analysed with descriptive statistics. Results: Our study recruited 85 patients, 33% were taking DOACs and 67% VKAs. Trauma patients on DOACs & VKAs respectively had similar baseline characteristics such as age (75.9 vs 77.4), initial injury severity score (ISS (16.9 vs 20.6)) and concomitant antiplatelet use (7.1% vs 5.4%). Both groups’ most common mechanism for injury was falls and the most common indication for anticoagulation was atrial fibrillation. Patients on DOACs tended to have lower average INR (1.25 vs 2.3) and serum creatinine (94.9 vs 127.4). Conclusion: Patients on DOACs pre-injury now account for a significant proportion of orally anticoagulated trauma patients. Patients on DOACs tended to have less derangement of basic hematological parameters complicating diagnosis and management of coagulopathy.

scholarly journals Analysis of the Risk Factors Affecting the Severity of Traffic Accidents on Spanish Crosstown Roads: The Driver’s Perspective

2020 ◽  
Vol 12 (6) ◽  
pp. 2237 ◽  
Author(s):  
Natalia Casado-Sanz ◽  
Begoña Guirao ◽  
Maria Attard
Keyword(s):  
Traffic Accidents ◽  
Injury Severity ◽  
Road Traffic ◽  
Fatal Outcome ◽  
Policy Support ◽  
Health Concern ◽  
Contributing Factors ◽  
Factors Affecting ◽  
Traffic Volumes ◽  
New Vision

Globally, road traffic accidents are an important public health concern which needs to be tackled. A multidisciplinary approach is required to understand what causes them and to provide the evidence for policy support. In Spain, one of the roads with the highest fatality rate is the crosstown road, a particular type of rural road in which urban and interurban traffic meet, producing conflicts and interference with the population. This paper contributes to the previous existing research on the Spanish crosstown roads, providing a new vision that had not been analyzed so far: the driver’s perspective. The main purpose of the investigation is to identify the contributing factors that increment the likelihood of a fatal outcome based on single-vehicle crashes, which occurred on Spanish crosstown roads in the period 2006-2016. In order to achieve this aim, 1064 accidents have been analyzed, applying a latent cluster analysis as an initial tool for the fragmentation of crashes. Next, a multinomial logit (MNL) model was applied to find the most important factors involved in driver injury severity. The statistical analysis reveals that factors such as lateral crosstown roads, low traffic volumes, higher percentages of heavy vehicles, wider lanes, the non-existence of road markings, and finally, infractions, increase the severity of the drivers’ injuries.

Developing a Process for Deploying Systemic Countermeasures at Unsignalized Intersections: Case Study of Virginia

2019 ◽  
Vol 2673 (9) ◽  
pp. 538-547
Author(s):  
Benjamin H. Cottrell ◽  
In-Kyu Lim
Keyword(s):  
Traffic Engineering ◽  
Low Cost ◽  
Chi Square ◽  
Interaction Detection ◽  
Improvement Plan ◽  
Systemic Analysis ◽  
Unsignalized Intersections ◽  
Stop Sign ◽  
Safety Improvement ◽  
Potential Risk Factors

This paper discusses the process used to develop a safety improvement plan for unsignalized intersections using systemic low-cost countermeasures. The scope of this project focused on unsignalized intersections with stop sign control on the minor approaches. The first objective was to perform an assessment of Virginia’s unsignalized intersection crashes over a five-year period to determine predominant crash trends and collision types to target for treatment. The four focus collision types with the highest frequency of crashes and the greatest potential reduction in crashes were 3-leg angle, 3-leg fixed object off the road, 4-leg angle and 4-leg rear end. Chi-square automatic interaction detection decision tree analysis was used to perform a systemic analysis to identify a group of intersections associated with potential risk factors related to the focus collision types. A tiered list of systemic countermeasures to deploy was developed. The countermeasures were intended to warn of the stop ahead, make the stop sign and stop location more visible on a minor street, and to warn of the intersection ahead on a major street. The potential for safety improvement measure was used to prioritize the candidate treatment intersections. Before deployment, a study of the intersection by district traffic engineering staff was planned to finalize the plan. The output from the research was a safety improvement plan to systemically deploy treatments to unsignalized intersections as part of the safety program.

scholarly journals Repeat prescribing – reducing errors

2011 ◽  
Vol 3 (2) ◽  
pp. 153 ◽  
Author(s):  
Steven Lillis ◽  
Hayley Lord
Keyword(s):  
Error Detection ◽  
Significant Proportion ◽  
Error Rates ◽  
Electronic Prescribing ◽  
Contributing Factors ◽  
Repeat Prescribing ◽  
Cause Of Error ◽  
General Practices ◽  
Practice Assessment ◽  
The Impact

BACKGROUND AND CONTEXT: Prescribing errors account for a significant proportion of overall error in general practice. Repeat prescribing occurs commonly in New Zealand and is a likely cause of error in practice. ASSESSMENT OF PROBLEM: This paper reports on two related aspects of repeat prescribing; an audit of adherence to a repeat prescribing protocol and self-reported repeat prescribing incidents in a network of 97 general practices. RESULTS: The audit of adherence to the repeat prescribing protocol revealed that some issues persist. In particular, prescribing medication outside an approved list and exceeding specified time limits or maximal scripts before clinical review were problematic. Repeat prescribing encompassed a range of departures of process from minor (such as prescription not available on time) to major (wrong medication). Corrective measures highlighted the importance of both the pharmacist and the patient in error detection. STRATEGIES FOR IMPROVEMENT: Repeat prescribing needs to be recognised as a process potentially fraught with error. Effective practice systems, patient involvement and enhanced pharmacy communication are important contributing factors in reducing error. LESSONS: There is need for robust data regarding error rates in prescribing and the impact of changing prescribing protocols on error rates. KEYWORDS: Medication errors; electronic prescribing

scholarly journals Analyzing Factors Associated with Fatal Road Crashes: A Machine Learning Approach

2020 ◽  
Vol 17 (11) ◽  
pp. 4111
Author(s):  
Ali J. Ghandour ◽  
Huda Hammoud ◽  
Samar Al-Hajj
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Injury Severity ◽  
Road Traffic ◽  
Road Traffic Injury ◽  
Outcome Variable ◽  
Contributing Factors ◽  
Road Crashes ◽  
Factors Associated ◽  
Ensemble Machine Learning

Road traffic injury accounts for a substantial human and economic burden globally. Understanding risk factors contributing to fatal injuries is of paramount importance. In this study, we proposed a model that adopts a hybrid ensemble machine learning classifier structured from sequential minimal optimization and decision trees to identify risk factors contributing to fatal road injuries. The model was constructed, trained, tested, and validated using the Lebanese Road Accidents Platform (LRAP) database of 8482 road crash incidents, with fatality occurrence as the outcome variable. A sensitivity analysis was conducted to examine the influence of multiple factors on fatality occurrence. Seven out of the nine selected independent variables were significantly associated with fatality occurrence, namely, crash type, injury severity, spatial cluster-ID, and crash time (hour). Evidence gained from the model data analysis will be adopted by policymakers and key stakeholders to gain insights into major contributing factors associated with fatal road crashes and to translate knowledge into safety programs and enhanced road policies.

An underinvestigated toxicity of sunitinib: Red cell macrocytosis.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 371-371
Author(s):  
D. J. Hands ◽  
B. Eccles ◽  
T. R. Geldart
Keyword(s):  
Kinase Inhibitor ◽  
Haematological Toxicity ◽  
Significant Proportion ◽  
Case Series ◽  
Folate Deficiency ◽  
Serum Folate ◽  
Red Cell ◽  
Contributing Factors ◽  
Duration Of Treatment ◽  
Mean Cell Volume

371 Background: Sunitinib, a multitargeted receptor tyrosine kinase inhibitor represents a standard firstline therapy for advanced renal cell carcinoma. Red blood cell (RBC) macrocytosis (with or without anaemia) is a recognized haematological toxicity but its aetiology remains uncertain. Methods: The medical records of 73 patients (55 male, 18 female) patients treated with sunitinib between 2007 and 2010 at Poole and Bournemouth NHS Trusts, UK were reviewed. Patient demographics, length of treatment, response, RBC mean cell volume (MCV) indices, and known causes of macrocytosis including B12 and folate deficiency and hypothyroidism were examined. Results: Median duration of treatment was 6 months (range 0-30). 38 (51%) have died. 24 (32%) received 2 or less cycles of treatment with the majority stopping due to early progression or death. 30 patients (41%) developed macrocytosis on treatment, but a trend to macrocytosis was identified in most patients positively correlating to time on treatment. 26 (87%) had a macrocytic anaemia. Median time to onset of macrocytosis was 4 months (range 1-11 months). Of the 30 macrocytic patients; 5 were hypothyroid, 7 had untreated borderline hypothyroidism and 13 were euthryoid throughout. Of patients tested to date 1 patient was found to be serum folate deficient at 2.5 ug/L (3-17). Supplementation corrected the macrocytosis. 1 patient was found to be serum B12 deficient; 53 ng/L (180-900) without any obvious comorbid cause. Further retrospective evaluation of other parameters such as red cell folate and reticulocyte count are currently being carried out. Conclusions: A significant proportion of patients on sunitinib (41%) develop macrocytosis. On the basis of this case series, the largest to date, underlying causes of macrocytosis (with or without anaemia) appear multifactorial. Biochemical hypothyrodism is common following sunitinib treatment and is likely to represent one of several possible contributing factors. B12 and folate deficiency should not be forgotten as a potentially reversible cause of macrocytosis secondary to sunitinib. C-kit inhibition by sunitinib is a potential mechanism, paralleling the potential C-kit mediated macrocytosis commonly recognised in imatinib therapy. No significant financial relationships to disclose.

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