Real-World Performance of Longitudinal Barriers Struck by Large Trucks

Outside of relatively limited crash testing with large trucks, very little is known regarding the performance of traffic barriers subjected to real-world large truck impacts. The purpose of this study was to investigate real-world large truck impacts into traffic barriers to determine barrier crash involvement rates, the impact performance of barriers not specifically designed to redirect large trucks, and the real-world performance of large-truck-specific barriers. Data sources included the Fatality Analysis Reporting System (2000-2009), the General Estimates System (2000-2009) and 155 in-depth large truck-to-barrier crashes from the Large Truck Crash Causation Study. Large truck impacts with a longitudinal barrier were found to comprise 3 percent of all police-reported longitudinal barrier impacts and roughly the same proportion of barrier fatalities. Based on a logistic regression model predicting barrier penetration, large truck barrier penetration risk was found to increase by a factor of 6 for impacts with barriers designed primarily for passenger vehicles. Although large-truck-specific barriers were found to perform better than non-heavy vehicle specific barriers, the penetration rate of these barriers were found to be 17 percent. This penetration rate is especially a concern because the higher test level barriers are designed to protect other road users, not the occupants of the large truck. Surprisingly, barriers not specifically designed for large truck impacts were found to prevent large truck penetration approximately half of the time. This suggests that adding costlier higher test level barriers may not always be warranted, especially on roadways with lower truck volumes.

Statewide Heavy-Truck Crash Assessment, 2014

In 2010, 16.5 percent of all fatal vehicle crashes in Iowa involved large trucks compared to the national average of 7.8 percent. Only about 16 percent of these fatalities involved the occupants of the heavy vehicles, meaning that a majority of the fatalities in fatal crashes involve non-heavy-truck occupants. These statistics demonstrate the severe nature of heavy-truck crashes and underscore the serious impact that these crashes can have on the traveling public. These statistics also indicate Iowa may have a disproportionately higher safety risk compared to the nation with respect to heavy-truck safety. Several national studies, and a few statewide studies, have investigated large-truck crashes; however, no rigorous analysis of heavy-truck crashes has been conducted for Iowa. The objective of this study was to investigate and identify the causes, locations, and other factors related to heavy-truck crashes in Iowa with the goal of reducing crashes and promoting safety. To achieve this objective, this study used the most current statewide data of heavy-truck crashes in Iowa. This study also attempted to assess crash experience with respect to length of commercial driver’s license (CDL) licensure using the most recent five years of CDL data linked to the before mentioned crash data. In addition, this study used inspection and citation data from the Iowa Department of Transportation (DOT) Motor Vehicle Division and Iowa State Patrol to investigate the relationship between enforcement activities and crash experience.

Preliminary findings from the National Crash Severity Study (NCSS).

Mode of access: Internet.

The medical consequences of car crashes: an automobile crash trauma study. Final report. Volume III.

National Highway Traffic Safety Administration, Washington, D.C.

The medical consequences of car crashes: an automobile crash trauma study. Final report. Volume IV.

National Highway Traffic Safety Administration, Washington, D.C.

The medical consequences of car crashes: an automobile crash trauma study. Final report. Volume I.

National Highway Traffic Safety Administration, Washington, D.C.

The medical consequences of car crashes: an automobile crash trauma study. Final report. Volume II.

National Highway Traffic Safety Administration, Washington, D.C.

Phenotypic and genetic analyses of a short measure of psychosis-proneness in a large-scale Australian twin study

Previous genetic analyses of psychosis proneness have been limited by their small sample size. For the purposes of large-scale screening, a 12-item questionnaire was developed through a two-stage process of reduction from the full Chapman and Chapman scales. 3685 individuals (including 1438 complete twin pairs) aged 18–25 years and enrolled in the volunteer Australian Twin Registry returned a mail questionnaire which included this psychosis proneness scale and the Eysenck Personality Questionnaire. Despite the brevity of the questionnaire, item and factor analysis identified four unambiguous and essentially uncorrelated scales. There were (1) Perceptual Aberration – Magical Ideation; (2) Hypomania – Impulsivity/Nonconformity; (3) Social Anhedonia and (4) Physical Anhedonia. Model-fitting analyses showed additive genetic and specific environmental factors were sufficient for three of the four scales, with the Social Anhedonia scale requiring also a parameter for genetic dominance. There was no evidence for the previously hypothesised sex differences in the genetic determination of psychosis-proneness. The potential value of multivariate genetic analysis to examine the relationship between these four scales and dimensions of personality is discussed. The growing body of longitudinal evidence on psychosis-proneness suggests the value of incorporating this brief measure into developmental twin studies.

Serrated polyps of the large intestine: a molecular study comparing sessile serrated adenomas and hyperplastic polyps.

AIMS: To compare the molecular profile of a series of sessile serrated adenomas (SSAs) and hyperplastic polyps (HPs), in order to distinguish these lesions, SSAs having a potential role in the genesis of serrated adenocarcinomas through a serrated pathway in which methylation plays a key role. METHODS AND RESULTS: Twelve HPs and sixteen SSAs of the right and left colon were investigated for microsatellite instability, DNA mismatch repair genes, p53, p16, and beta-catenin expression, MLH1 and p16 (CDKN2A) gene methylation, and KRAS and BRAF mutations. Both SSAs and HPs were microsatellite stable. MLH1 and MSH2 protein silencing, aberrant cytoplasmic expression and methylation of p16 were found to be exclusive to right-sided SSAs. The MLH1 promoter gene was frequently methylated in right-sided SSAs in contrast with HPs. Abnormal p53 and beta-catenin expression was present in both SSAs and HPs. BRAF and KRAS mutation were mutually exclusive, but KRAS mutation was present only in left-sided SSAs and HPs. CONCLUSIONS: HPs and SSAs may be related lesions. However, at least right-sided SSAs differ from left-sided SSAs and HPs in the occurrence of MLH1 and p16 methylation, supporting the hypothesis that SSAs could be precursors of serrated adenocarcinomas.

Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study.

Background: Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessement. Methods: Longitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables. Results: Overall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women. Conclusions: Diabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women.

A large-scale genetic validation study coupled with in vitro analyses reveal a role for vitamin Dsignaling in the pathogenesis and response to treatment of hepatitis C virus infection

Background and Aims: Vitamin D is an important modulatorof numerous cellular processes. Some of us recently observedan association of the 1a-hydroxylase promoter polymorphismCYP27B1-1260 rs10877012 with sustained virologic response (SVR)in a relatively small number of German patients with chronichepatitis C. In the present study, we aimed to validate thisassociation in a large and well characterized patient cohort, theSwiss Hepatitis C Cohort Study (SCCS). In addition, we examinedthe effect of vitamin D on the hepatitis C virus (HCV) life cyclein vitro.Methods: CYP27B1-1260 rs10877012 and IL28B rs12979860 singlenucleotide polymorphisms (SNPs) were genotyped in 1049 patientswith chronic hepatitis C from the SCCS, of whom 698 were treatedwith pegylated interferon-a (PEG-IFN-a) and ribavirin. In addition,112 patients with spontaneous clearance of HCV were examined.SNPs were correlated with variables reflecting the natural courseand treatment outcome of chronic hepatitis C. The effect of1,25-(OH)2D3 (calcitriol) on HCV replication and viral particleproduction was investigated in vitro using human hepatoma celllines (Huh-7.5) harbouring subgenomic replicons and cell culturederivedHCV.Results: The CYP27B1-1260 rs10877012 genotype was notassociated with SVR in patients with the good-response IL28Brs1279860 CC genotype. However, in patients with poor-responseIL28B rs1279860 genotype CT and TT, CYP27B1-1260 rs10877012was a significant independent predictor of SVR (15% difference inSVR between rs10877012 genotype AA vs. CC, p = 0.030, OR = 1.495,95% CI = 1.038-2.152). The CYPB27-1260 rs10877012 genotype wasneither associated with spontaneous clearance of HCV, nor withliver fibrosis progression rate, inflammatory activity of chronichepatitis C, or HCV viral load. Physiological doses of 1,25-(OH)2D3did not significantly affect HCVRNA replication or infectiousparticle production in vitro.Conclusions: The results of this large-scale genetic validationstudy reveal a role of vitamin D metabolism in the responseto treatment in chronic hepatitis C, but 1,25-(OH)2D3 does notexhibit a significant direct inhibitory antiviral effect. Thus, theability of vitamin D to modulate immunity against HCV shouldbe investigated.

CSF biomarkers for the differential diagnosis of Alzheimer's disease: A large-scale international multicenter study.

INTRODUCTION: The aim of this study was to test the diagnostic value of cerebrospinal fluid (CSF) beta-amyloid (Aβ1-42), phosphorylated tau, and total tau (tau) to discriminate Alzheimer's disease (AD) dementia from other forms of dementia. METHODS: A total of 675 CSF samples collected at eight memory clinics were obtained from healthy controls, AD dementia, subjective memory impairment, mild cognitive impairment, vascular dementia, Lewy body dementia (LBD), fronto-temporal dementia (FTD), depression, or other neurological diseases. RESULTS: CSF Aβ1-42 showed the best diagnostic accuracy among the CSF biomarkers. At a sensitivity of 85%, the specificity to differentiate AD dementia against other diagnoses ranged from 42% (for LBD, 95% confidence interval or CI = 32-62) to 77% (for FTD, 95% CI = 62-90). DISCUSSION: CSF Aβ1-42 discriminates AD dementia from FTD, but shows significant overlap with other non-AD forms of dementia, possibly reflecting the underlying mixed pathologies.

Candidate genes for obesity-susceptibility show enriched association within a large genome-wide association study for BMI

Before the advent of genome-wide association studies (GWASs), hundreds of candidate genes for obesity-susceptibility had been identified through a variety of approaches. We examined whether those obesity candidate genes are enriched for associations with body mass index (BMI) compared with non-candidate genes by using data from a large-scale GWAS. A thorough literature search identified 547 candidate genes for obesity-susceptibility based on evidence from animal studies, Mendelian syndromes, linkage studies, genetic association studies and expression studies. Genomic regions were defined to include the genes ±10 kb of flanking sequence around candidate and non-candidate genes. We used summary statistics publicly available from the discovery stage of the genome-wide meta-analysis for BMI performed by the genetic investigation of anthropometric traits consortium in 123 564 individuals. Hypergeometric, rank tail-strength and gene-set enrichment analysis tests were used to test for the enrichment of association in candidate compared with non-candidate genes. The hypergeometric test of enrichment was not significant at the 5% P-value quantile (P = 0.35), but was nominally significant at the 25% quantile (P = 0.015). The rank tail-strength and gene-set enrichment tests were nominally significant for the full set of genes and borderline significant for the subset without SNPs at P < 10(-7). Taken together, the observed evidence for enrichment suggests that the candidate gene approach retains some value. However, the degree of enrichment is small despite the extensive number of candidate genes and the large sample size. Studies that focus on candidate genes have only slightly increased chances of detecting associations, and are likely to miss many true effects in non-candidate genes, at least for obesity-related traits.

Social businesses in large companies: a case study in Brazil

O ambiente econômico global tem registrado um conjunto de mutações poderosos durante a última década. A liderança dos países ocidentais tem sido contestada pelo crescimento de novos atores no interior da arena global, determinando uma mudança dos interesses das nações bem estabelecidas, para realidades que antes eram considerados subdesenvolvidos ou incapaz de desempenhar um papel de liderança dentro do contexto da economia global. Assim, os países emergentes ganharam a atenção dos teóricos e gerentes internacionais, que começaram a olhar para estes assuntos, não só pelo seu potencial econômico, mas também para a identificação de novas soluções para a criação de um mundo mais sustentável. A tese em questão, estruturada como um case study, precisamente tenta compreender e retratar os dois temas mencionados acima. Por um lado, a pesquisa irá investigar as dimensões do mercado da BoP, com um foco no mercado brasileiro, pelo outro lado, o trabalho irá descrever uma soluções possíveis para explorar os mercados em desenvolvimento por grandes empresas privadas: o modelo de negócio social. Este novo paradigma, que combina o desempenho financeiro com a realização de impactos sociais entre a comunidade selecionada, será aprofundar através de um caso concreto implementado pela Coca-Cola Company no Brasil, o Projeto Coletivo. De acordo com as observações preliminares, o estudo de caso terá como objetivo compreender os desafios, as oportunidades, os obstáculos organizacionais e os métodos que podem subir a partir da implementação de um negócio social em um país em desenvolvimento seguindo a perspectiva anteriormente. Os resultados obtidos mostraram que, embora o paradigma pode representam uma solução viável, muitas questões organizacionais e culturais precisam ser levados em consideração para a sua implementação bem sucedida.

Optimized Duration of Clopidogrel Therapy Following Treatment with the Endeavor Zotarolimus-Eluting Stent in Real-World Clinical Practice (OPTIMIZE) Trial: Rationale and design of a large-scale, randomized, multicenter study

Background Current recommendations for antithrombotic therapy after drug-eluting stent (DES) implantation include prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel >= 12 months. However, the impact of such a regimen for all patients receiving any DES system remains unclear based on scientific evidence available to date. Also, several other shortcomings have been identified with prolonged DAPT, including bleeding complications, compliance, and cost. The second-generation Endeavor zotarolimus-eluting stent (E-ZES) has demonstrated efficacy and safety, despite short duration DAPT (3 months) in the majority of studies. Still, the safety and clinical impact of short-term DAPT with E-ZES in the real world is yet to be determined. Methods The OPTIMIZE trial is a large, prospective, multicenter, randomized (1: 1) non-inferiority clinical evaluation of short-term (3 months) vs long-term (12-months) DAPT in patients undergoing E-ZES implantation in daily clinical practice. Overall, 3,120 patients were enrolled at 33 clinical sites in Brazil. The primary composite endpoint is death (any cause), myocardial infarction, cerebral vascular accident, and major bleeding at 12-month clinical follow-up post-index procedure. Conclusions The OPTIMIZE clinical trial will determine the clinical implications of DAPT duration with the second generation E-ZES in real-world patients undergoing percutaneous coronary intervention. (Am Heart J 2012;164:810-816.e3.)