Overdosing in a Motor Vehicle: Examination of Human, Geographic, and Environmental Factors.

BACKGROUND: Fentanyl, a type of opioid, in impaired driving cases increased across cities in the United States. OBJECTIVES: No empirical studies have examined motor vehicle overdoses with fentanyl use. We investigated the magnitude of the motor vehicle overdose problem in Providence, RI, and the environmental, socioeconomic, and geographic conditions associated with motor vehicle overdose occurrence. METHODS: This was a retrospective observational study of emergency medical services data on all suspected opioid overdoses between January 1, 2017, and October 31, 2020. The data contain forced-choice fields, such as age and biological sex, and an open-ended narrative in which the paramedic documented clinical and situational information. The overdoses were geocoded, allowing for the extraction of sociodemographic data from the U.S. Census Bureau's American Community Survey. Seven other data sources were included in a logistic regression to understand key risk factors and spatial patterns of motor vehicle overdoses. RESULTS: Of the 1,357 opioid overdose cases in this analysis, 15.2% were defined as motor vehicle overdoses. In adjusted models, we found a 61% increase in the odds of a motor vehicle overdose involvement for men versus women, a 16.8% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to the nearest gas station, and a 10.7% decrease in the odds of a motor vehicle overdose for a one-unit increase in distance to a buprenorphine clinic. CONCLUSION: There is a need to understand the interaction between drug use in vehicles to design interventions for decreasing driving after illicit drug use.

Guiding decisions on the future of dams: A GIS database characterizing ecological and social considerations of Dam decisions.

In the United States and elsewhere, there are a growing number of dams which have exceeded their design life and will need to be repaired or removed in the coming decades. Most of these dams no longer serve their original purpose and removal can provide ecological benefits and eliminate future maintenance costs and hazards. However, many decision-makers have been ill-prepared by community resistance to proposals to remove dams. Given the number of dam removal initiatives that have failed or been delayed due to community resistance, both ecological and social attributes of dams need to be better mapped and conveyed in understandable ways. The goal of this study was to support future decisions regarding dams by 1) developing a set of metrics to assess the social and ecological dimensions of dams, and 2) using these metrics to develop a GIS database, for the 1000+ dams in the Narragansett Bay/Rhode Island area of southern New England. The database characterizes the ecological benefits of dam removal or modification, in terms of fish passage, and the social dimensions that may need to be considered when engaging a community in discussions about the future of a dam. Our emphasis was on small-head dams (i.e. <5 m tall) which comprise most dams in the study area. We created social value metrics that used GIS data to assess dams and their impoundments for potential benefits to waterfront properties, history, sense-of-place, and recreation. We modeled our ecological metrics and ranking system after the Nature Conservancy's Northeast Aquatic Connectivity study which considered factors relating to river connectivity and watershed quality. We evaluated our social and ecological metrics using case studies of dams in the study area that had been previously removed or modified. We assumed that both sets of dams were ecologically important, but the modified dams had higher social value that prohibited their removal. Dams that had been removed or modified were both ranked as high priority in terms of value for fish passage, particularly for diadromous fish. Dams that were modified to include fish passage had substantially larger impoundments, more waterfront properties, and more features associated with recreational or cultural value (e.g. boating opportunity, visibility, etc.). Our social metrics were consistent with expectations based on the limited case studies (7 removals, 19 modifications) available in the study area. We made the dam assessment metrics readily accessible to stakeholders through an interactive ArcGIS Online web map.

An analysis of enhanced tree trimming effectiveness on reducing power outages.

We evaluated the effectiveness of an enhanced tree trimming (ETT) program for its ability to reduce tree-related power outages, and thereby improve resilience, on an electric utility distribution system during storm events. Evaluations encompassed thirteen years of trimming (i.e. 2005-2017) data and were performed for both backbone and lateral utility lines. Backbones included all three phase lines between a substation and a faultable device whereas all other lines were considered laterals. The study site spanned the entire state of Connecticut, where the dominant vegetation is temperate deciduous forest. We controlled for variations in weather, tree cover, and wire type, by pairing ETT-treated zones with nearby untreated zones. ETT-treated conductors had storm outage rates that were 0.07-0.36 outages/km/year lower than untreated conductors or 35-180% lower than the service-area's average annual outage rate for untreated conductors. ETT-treatment was associated with lower outage rates for "minor" outage types (i.e., blown fuse, tripped recloser, etc.) but the treatment effect was not statistically significant for "major" outage types (damaged poles or wires). System-wide ETT application, for the approximately 27,000 km of conductors in the study area, was predicted to reduce annual storm-related outages by an average of 81-104 and 318-759 outages/year for backbone and lateral lines, respectively. Our study provided a robust empirical evaluation of ETT and also proposes a geospatial methodology that controls for variations in weather and environment.

Using Deep Learning to Identify Utility Poles with Crossarms and Estimate Their Locations from Google Street View Images.

Traditional methods of detecting and mapping utility poles are inefficient and costly because of the demand for visual interpretation with quality data sources or intense field inspection. The advent of deep learning for object detection provides an opportunity for detecting utility poles from side-view optical images. In this study, we proposed using a deep learning-based method for automatically mapping roadside utility poles with crossarms (UPCs) from Google Street View (GSV) images. The method combines the state-of-the-art DL object detection algorithm (i.e., the RetinaNet object detection algorithm) and a modified brute-force-based line-of-bearing (LOB, a LOB stands for the ray towards the location of the target [UPC at here] from the original location of the sensor [GSV mobile platform]) measurement method to estimate the locations of detected roadside UPCs from GSV. Experimental results indicate that: (1) both the average precision (AP) and the overall accuracy (OA) are around 0.78 when the intersection-over-union (IoU) threshold is greater than 0.3, based on the testing of 500 GSV images with a total number of 937 objects; and (2) around 2.6%, 47%, and 79% of estimated locations of utility poles are within 1 m, 5 m, and 10 m buffer zones, respectively, around the referenced locations of utility poles. In general, this study indicates that even in a complex background, most utility poles can be detected with the use of DL, and the LOB measurement method can estimate the locations of most UPCs.

Immunogenicity and efficacy of flagellin-envelope fusion dengue vaccines in mice and monkeys.

The envelope (E) protein of flaviviruses includes three domains, EI, EII, and EIII, and is the major protective antigen. Because EIII is rich in type-specific and subcomplex-specific neutralizing epitopes and is easy to express, it is particularly attractive as a recombinant vaccine antigen. VaxInnate has developed a vaccine platform that genetically links vaccine antigens to bacterial flagellin, a Toll-like receptor 5 ligand. Here we report that tetravalent dengue vaccines (TDVs) consisting of four constructs, each containing two copies of EIII fused to flagellin (R3.2x format), elicited robust and long-lived neutralizing antibodies (geometric mean titers of 200 to 3,000), as measured with a 50% focus reduction neutralization test (FRNT50). In an immunogenicity study, rhesus macaques (n = 2) immunized subcutaneously with 10 µg or 90 µg of TDV three or four times, at 4- to 6-week intervals, developed neutralizing antibodies to four dengue virus (DENV) serotypes (mean post-dose 3 FRNT50 titers of 102 to 601). In an efficacy study, rhesus macaques (n = 4) were immunized intramuscularly with 16 µg or 48 µg of TDV or a placebo control three times, at 1-month intervals. The animals that received 48-µg doses of TDV developed neutralizing antibodies against the four serotypes (geometric mean titers of 49 to 258) and exhibited reduced viremia after DENV-2 challenge, with a group mean viremia duration of 1.25 days and 2 of 4 animals being completely protected, compared to the placebo-treated animals, which all developed viremia, with a mean duration of 4 days. In conclusion, flagellin-EIII fusion vaccines are immunogenic and partially protective in a nonhuman primate model.

Immunogenicity and efficacy of flagellin-fused vaccine candidates targeting 2009 pandemic H1N1 influenza in mice.

We have previously demonstrated that the globular head of the hemagglutinin (HA) antigen fused to flagellin of Salmonella typhimurium fljB (STF2, a TLR5 ligand) elicits protective immunity to H1N1 and H5N1 lethal influenza infections in mice (Song et al., 2008, PLoS ONE 3, e2257; Song et al., 2009, Vaccine 27, 5875-5888). These fusion proteins can be efficiently and economically manufactured in E. coli fermentation systems as next generation pandemic and seasonal influenza vaccines. Here we report immunogenicity and efficacy results of three vaccine candidates in which the HA globular head of A/California/07/2009 (H1N1) was fused to STF2 at the C-terminus (STF2.HA1), in replace of domain 3 (STF2R3.HA1), or in both positions (STF2R3.2xHA1). For all three vaccines, two subcutaneous immunizations of BALB/c mice with doses of either 0.3 or 3 µg elicit robust neutralizing (HAI) antibodies, that lead to > = 2 Log(10) unit reduction in day 4 lung virus titer and full protection against a lethal A/California/04/2009 challenge. Vaccination with doses as low as 0.03 µg results in partial to full protection. Each candidate, particularly the STF2R3.HA1 and STF2R3.2xHA1 candidates, elicits robust neutralizing antibody responses that last for at least 8 months. The STF2R3.HA1 candidate, which was intermediately protective in the challenge models, is more immunogenic than the H1N1 components of two commercially available trivalent inactivated influenza vaccines (TIVs) in mice. Taken together, the results demonstrate that all three vaccine candidates are highly immunogenic and efficacious in mice, and that the STF2R3.2xHA1 format is the most effective candidate vaccine format.

Superior efficacy of a recombinant flagellin:H5N1 HA globular head vaccine is determined by the placement of the globular head within flagellin.

Transmission of highly pathogenic avian influenza (HPAI) between birds and humans is an ongoing threat that holds potential for the emergence of a pandemic influenza strain. A major barrier to an effective vaccine against avian influenza has been the generally poor immunopotency of many of the HPAI strains coupled with the manufacturing constraints employing conventional methodologies. Fusion of flagellin, a toll-like receptor-5 ligand, to vaccine antigens has been shown to enhance the immune response to the fused antigen in preclinical studies. Here, we have evaluated the immunogenicity and efficacy of a panel of flagellin-based hemagglutinin (HA) globular head fusion vaccines in inbred mice. The HA globular head of these vaccines is derived from the A/Vietnam/1203/04 (VN04; H5N1) HA molecule. We find that replacement of domain D3 of flagellin with the VN04 HA globular head creates a highly effective vaccine that elicits protective HAI titers which protect mice against disease and death in a lethal challenge model.