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1.
Otolaryngol Clin North Am ; 55(1): 193-203, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34823717

RESUMO

Diversity impacts performance of our teams, fosters innovation, and improves outcomes of our patients in otolaryngology head and neck surgery. In addition to the moral imperative, increasing the otolaryngology diversity workforce will decrease health care disparities while equity and justice can increase the culture humility to take care of an increasingly diverse patient population. To move toward justice, otolaryngology departments need to end biases in faculty hiring, development, research evaluations, and publication practices. The more intentional our efforts, the more benefit to our patients, providers, staff, learners, and society.

2.
Environ Health Insights ; 15: 11786302211059722, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34819732

RESUMO

No studies have investigated the cancer outcomes from high level medium duration coal mine fire fine particulate matter ⩽2.5 µm in diameter (PM2.5) exposure. We included 2208 Morwell residents (exposed) and 646 Sale residents (unexposed) who participated in the Hazelwood Health Study Adult Survey. Competing risk regression models were used to evaluate relationships between coal mine fire exposure and cancer incidence, adjusting for known confounders. There were 137 cancers in the exposed and 27 in the unexposed over 14 849 person-years of follow-up. A higher risk of cancer incidence was observed for Morwell participants (HR = 1.67 [95% CI 1.05-2.67]), but no evidence to suggest associations between PM2.5 exposure and incidence of all cancers (HR = 1.02 [95% CI 0.91-1.13]), or site-specific cancers. There is no strong evidence that exposure to high concentrations of mine fire-related PM2.5 over a prolonged period could explain the higher risk in exposed population in this study.

3.
J Cheminform ; 13(1): 91, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819133

RESUMO

With the development of advanced technologies in cell-based phenotypic screening, phenotypic drug discovery (PDD) strategies have re-emerged as promising approaches in the identification and development of novel and safe drugs. However, phenotypic screening does not rely on knowledge of specific drug targets and needs to be combined with chemical biology approaches to identify therapeutic targets and mechanisms of actions induced by drugs and associated with an observable phenotype. In this study, we developed a system pharmacology network integrating drug-target-pathway-disease relationships as well as morphological profile from an existing high content imaging-based high-throughput phenotypic profiling assay known as "Cell Painting". Furthermore, from this network, a chemogenomic library of 5000 small molecules that represent a large and diverse panel of drug targets involved in diverse biological effects and diseases has been developed. Such a platform and a chemogenomic library could assist in the target identification and mechanism deconvolution of some phenotypic assays. The usefulness of the platform is illustrated through examples.

5.
Opt Express ; 29(21): 33818-33835, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34809186

RESUMO

We have obtained the absolute absorption cross-sections of Yb-doped phosphate QX laser glass at 300 K from 800-1100 nm, and generated the emission cross-sections via the standard method of reciprocity. By generating nine detailed high-confidence fitting functions for the absorption cross-sections, we then applied reciprocity to the individual absorption functions and obtain, for the first time to our knowledge, nine corresponding detailed emission functions that when summed, display a more accurate representation of the emission cross-sections as a function of wavelength than the standard method. A deeper mathematical understanding of reciprocity is also presented, along with derived Yb:QX Stark levels.

6.
Front Endocrinol (Lausanne) ; 12: 764138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34803927

RESUMO

Immune checkpoint inhibitors have transformed the landscape of oncological therapy, but at the price of a new array of immune related adverse events. Among these is ß-cell failure, leading to checkpoint inhibitor-related autoimmune diabetes (CIADM) which entails substantial long-term morbidity. As our understanding of this novel disease grows, parallels and differences between CIADM and classic type 1 diabetes (T1D) may provide insights into the development of diabetes and identify novel potential therapeutic strategies. In this review, we outline the knowledge across the disciplines of endocrinology, oncology and immunology regarding the pathogenesis of CIADM and identify possible management strategies.

7.
Artigo em Inglês | MEDLINE | ID: mdl-34767134

RESUMO

The chronic coronary syndromes (CCS) include patients with a classic history of angina pectoris in the presence of either risk factors for or known atherosclerotic coronary artery disease. Randomized, controlled trials conducted in the optimal medical therapy (OMT) era have convincingly demonstrated that adherence to the outdated paradigm focused on treatment of obstructive coronary disease with initial revascularization fails to reduce death or myocardial infarction and inconsistently reduces angina symptoms. Rather, OMT reduces events and improves symptoms and should be considered first-line treatment for patients with CCS.

8.
Comput Struct Biotechnol J ; 19: 5667-5677, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34765087

RESUMO

Nearly half of the human genome is occupied by repetitive sequences of ancient virus-like genetic elements. The largest class, comprising 17% of the genome, belong to the type 1 Long INterspersed Elements (LINE-1) and are the only class capable of autonomous propagation in the genome. When epigenetic silencing mechanisms of LINE-1 fail, the proteins encoded by LINE-1 engage in reverse transcription to make new copies of their own or other DNAs that are pasted back into the genome. To elucidate how LINE-1 is dysregulated as a result of carcinogen exposure, we developed a computational model of key elements in the LINE-1 lifecycle, namely, the role of cytosolic ribonuclease (RNase), RNA interference (RNAi) by the antisense ORF0 RNA, and sequestration of LINE-1 products into stress granules and multivesicular structures. The model showed that when carcinogen exposure is represented as either a sudden increase in LINE-1 mRNA count, or as an increase in mRNA transcription rate, the retrotransposon copy number exhibits a distinct threshold behavior above which LINE-1 enters a positive feedback loop that allows the cDNA copy number to grow exponentially. We also found that most of the LINE-1 RNA was degraded via the RNAase pathway and that neither ORF0 RNAi, nor the sequestration of LINE-1 products into granules and multivesicular structures, played a significant role in regulating the retrotransposon's life cycle. Several aspects of the prediction agree with experimental results and indicate that the model has significant potential to inform future experiments related to LINE-1 activation.

9.
Toxicol In Vitro ; : 105273, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34801683

RESUMO

Natural Layered Silicates (NLS) and Synthetic Layered Silicates (SLS) are a diverse group of clay minerals that have attracted great interest in various branches of industry. However, despite growing demand for this class of material, their impact on human health has not been fully investigated. Therefore, the aim of this study was to evaluate and compare the potential toxic effects of a wide range of commercially available SLS and NLS of varying physicochemical properties (lithium (Li) or fluoride (F) content and size). Mouse BALB/c monocyte macrophage (J774A.1) and human monocyte-derived macrophages (MDMs) were chosen as in vitro models of alveolar macrophages. Montmorillonite, hectorite, Medium (med) F/High Li and Low F/Med Li particles, were cytotoxic to cells and induced potent pro-inflammatory responses. The remaining particles (No F/Very (V)Low Li, No F/Med Li, No F/Low Li, High F/Med Li and High F/Med Li washed) were non- to relatively low- cytotoxic and inflammogenic, in both type of cells. In an acellular condition none of the tested samples increased reactive oxygen species (ROS), while ROS generation was observed following exposure to sublethal concentrations of Med F/High Li, Low F/Med Li, montmorillonite and hectorite samples, in J774A.1 cells. Based on the results obtained in this study the toxic potency of tested samples was not associated with lithium or fluoride content, but appeared to be dependent on particle size, with the platelets of larger dimension and lower surface area being more potent than the smaller platelet particles with higher surface area. In addition, the increased bioactivity of Med F/High Li and Low F/Med Li was associated with endotoxin contamination. Obtained results demonstrated that layered silicate materials have different toxicological profiles and suggest that toxicological properties of a specific layered silicate should be investigated on an individual basis.

10.
Retina ; 2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34803132

RESUMO

PURPOSE: To quantify changes of the retinal vascular bed area (RVBA) in mm2 on stereographically projected ultra-wide field (UWF) fluorescein angiography (FA) images by in eyes with proliferative diabetic retinopathy (PDR) following anti-vascular endothelial growth factor (VEGF) injection. METHODS: Prospective, observational study. The early-phase UWF FA images (Optos 200Tx) of 40 eyes with PDR and significant non-perfusion obtained at baseline and after 6 months (NCT02863354) were stereographically projected by correcting peripheral distortion. The global retinal vasculature on UWF FA was extracted for calculating RVBA by summing the real size (mm2) of all the pixels automatically. RESULTS: For the entire cohort, global RVBA for the entire retina decreased from 67.1 ± 15.5 mm2 to 43.6 ± 18.8 mm2 after anti-VEGF treatment at 6 months (P < 0.001). In the sub-group receiving monthly anti-VEGF injections, global RVBA decreased from 68.7 ± 16.2 mm2 to 33.9 ± 13.3 mm2 (P < 0.001). In the sub-group receiving anti-VEGF every 3 months, global RVBA decreased from 65.6 ± 15.1 mm2 to 50.8 ± 19.3 mm2 (P = 0.004). CONCLUSIONS: RVBA appears to be a new biomarker to indicate efficiency of retinal vascular changes after anti-VEGF injection. Eyes with PDR and significant non-perfusion demonstrate reduced RVBA following anti-VEGF treatment.

11.
Front Immunol ; 12: 730825, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759919

RESUMO

Engineered variants of recombinant adeno-associated viruses (rAAVs) are being developed rapidly to meet the need for gene-therapy delivery vehicles with particular cell-type and tissue tropisms. While high-throughput AAV engineering and selection methods have generated numerous variants, subsequent tropism and response characterization have remained low throughput and lack resolution across the many relevant cell and tissue types. To fully leverage the output of these large screening paradigms across multiple targets, we have developed an experimental and computational single-cell RNA sequencing (scRNA-seq) pipeline for in vivo characterization of barcoded rAAV pools at high resolution. Using this platform, we have both corroborated previously reported viral tropisms and discovered unidentified AAV capsid targeting biases. As expected, we observed that the tropism profile of AAV.CAP-B10 in mice was shifted toward neurons and away from astrocytes when compared with AAV-PHP.eB. Transcriptomic analysis revealed that this neuronal bias is due mainly to increased targeting efficiency for glutamatergic neurons, which we confirmed by RNA fluorescence in situ hybridization. We further uncovered cell subtype tropisms of AAV variants in vascular and glial cells, such as low transduction of pericytes and Myoc+ astrocytes. Additionally, we have observed cell-type-specific transitory responses to systemic AAV-PHP.eB administration, such as upregulation of genes involved in p53 signaling in endothelial cells three days post-injection, which return to control levels by day twenty-five. The presented experimental and computational approaches for parallel characterization of AAV tropism will facilitate the advancement of safe and precise gene delivery vehicles, and showcase the power of understanding responses to gene therapies at the single-cell level.

12.
J Appl Lab Med ; 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34718586

RESUMO

BACKGROUND: Myelin oligodendrocyte glycoprotein antibodies (MOG Ab) are essential in the diagnosis of MOG Ab-associated disease (MOGAD). Live cell-based assays (CBAs) are the gold standard for MOG Ab detection with improved sensitivity and specificity over fixed CBAs. A number of testing centers have used flow cytometry for its high throughput and quantitative utility. Presently, there is increasing demand to translate these research-based methods into an accredited routine diagnostic setting. METHODS: A flow cytometry live CBA was used to detect MOG Ab in patients with demyelination. Serostatuses were compared between a research-based assay and a streamlined diagnostic assay. Inter-laboratory validation of the streamlined assay was performed in an accredited diagnostic laboratory. Further streamlining was performed by introducing a borderline serostatus range and reducing the number of controls used to determine the positivity threshold. RESULTS: High serostatus agreement (98%-100%) was observed between streamlined and research-based assays. Intra- and inter-assay imprecision was improved in the streamlined assay (mean intra- and inter-assay CV = 7.3% and 27.8%, respectively) compared to the research-based assay (mean intra- and inter-assay CV = 11.8% and 33.6%, respectively). Borderline positive and clear positive serostatuses were associated with confirmed phenotypes typical of MOGAD. Compared to using 24 controls, robust serostatus classification was observed when using 13 controls without compromising analytical performance (93%-98.5% agreement). CONCLUSIONS: Flow cytometry live CBAs show robust utility in determining MOG Ab serostatus. Streamlining and standardizing use of this assay for diagnostics would improve the accuracy and reliability of routine testing to aid diagnosis and treatment of patients with demyelination.

13.
Sci Rep ; 11(1): 19796, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34611283

RESUMO

We previously reported that growth promoter-induced skeletal muscle hypertrophy co-ordinately upregulated expression of genes associated with an integrated stress response (ISR), as well as potential ISR regulators. We therefore used Adeno-Associated Virus (AAV)-mediated overexpression of these genes, individually or in combination, in mouse skeletal muscle to test whether they induced muscle hypertrophy. AAV of each target gene was injected into mouse Tibialis anterior (TA) and effects on skeletal muscle growth determined 28 days later. Individually, AAV constructs for Arginase-2 (Arg2) and Activating transcription factor-5 (Atf5) reduced hindlimb muscle weights and upregulated expression of genes associated with an ISR. AAV-Atf5 also decreased Myosin heavy chain (MyHC)-IIB mRNA, but increased MyHC-IIA and isocitrate dehydrogenase-2 (Idh2) mRNA, suggesting ATF5 is a novel transcriptional regulator of Idh2. AAV-Atf5 reduced the size of both TA oxidative and glycolytic fibres, without affecting fibre-type proportions, whereas Atf5 combined with Cebpg (CCAAT enhancer binding protein-gamma) only reduced the size of glycolytic fibres and tended to increase the proportion of oxidative fibres. It is likely that persistent Atf5 overexpression maintains activation of the ISR, thereby reducing protein synthesis and/or increasing protein degradation and possibly apoptosis, resulting in inhibition of muscle growth, with overexpression of Arg2 having a similar effect.

14.
Aust Health Rev ; 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34607628

RESUMO

ObjectiveTo compare the historical staffing patterns and organisational characteristics of Australian residential aged care facilities (RACFs) against the new minimum staffing standards recommended by the Royal Commission into Aged Care Quality and Safety (RCACQS).MethodRetrospective data analysis was used to compare the staffing levels and characteristics of 1705 RACFs (for 4 years, 2016-19) with the three new mandatory staffing requirements. De-identified datasets were provided by the RCACQS, obtained under its legal authority.ResultsOnly 3.8% of RACFs have staffing levels at or above all three requirements. Although many (79.7%) already meet the requirement to have a registered nurse (RN) on-site for morning and afternoon shifts, few have staffing levels above requirements for total direct care per resident per day (10.4%) or care provided by an RN per resident per day (11.1%). Historical levels of on-site RNs, total direct care, and RN care vary significantly across facilities of different size, location and provider scale.ConclusionThe new staffing standards, to be mandatory by 2023, prescribe minimum requirements significantly higher than existing levels, particularly in care per resident per day. Each of the three requirements will likely have a differential effect for different types of RACFs.What is known about the topic?International evidence suggests that introducing mandatory minimum staffing standards tends to increase the amount of care provided by staff in residential aged care facilities (RACFs). However, the impact of staffing standards is influenced by the stringency of the minimum threshold relative to existing staffing levels, the capacity of organisations to increase their staffing levels, and the specific way the regulation is formulated.What does this paper add?This paper explores the potential implications of the three national minimum staffing standards, to be in force by October 2023, specifying total direct care, care received by a registered nurse (RN), and an RN on-site. By examining the existing staffing levels of Australian RACFs, it identifies the extent to which facilities already meet the new standards and the characteristics of facilities with staffing levels above and below the three requirements (individually and in combination).What are the implications for practitioners?The study informs both policy and practice in relation to the likely effects of implementing the national minimum staffing standards for residential aged care in Australia. It demonstrates that the new minimum thresholds are likely to require substantial increases in staffing across the sector, both in terms of all direct care workers and RNs. It also shows that the three requirements are likely to have a differential effect for RACFs of different size, location and chain affiliation, thereby guiding policy about the future needs for Australia's aged care workforce.

15.
Chemosphere ; 288(Pt 1): 132339, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34628124

RESUMO

BACKGROUND: Little is known about the long-term health effects of coalmine fire smoke exposure. The 2014 Hazelwood coalmine fire event in southeast Australia released smoke into surrounding areas for 6 weeks. OBJECTIVES: We aimed to investigate whether individual-level exposure to coalmine fire-related PM2.5 was associated with a long-term increase in ambulance attendances following a coalmine fire event. METHODS: A total of 2223 residents from the most exposed town of Morwell were assessed for ambulance attendances after the Hazelwood event from April 1, 2014 to December 31, 2017. PM2.5 exposure was estimated for each individual using participant self-reported location diary data during the event and modelled PM2.5 concentrations. Recurrent event survival analysis was used to evaluate the relationship between PM2.5 exposure and ambulance attendances. RESULTS: For each 10 µg/m3 increase in mean coalmine fire-related PM2.5 exposure, there was a 10% (adjusted hazard ratio [HR]:1.10, 95%CI:1.03-1.17) increase in the overall risk of ambulance attendances within 3.5 years after the coalmine fire. Exposure to PM2.5 was also associated with increased risk of respiratory (HR: 1.21, 95%CI: 1.02-1.44) and cardiovascular (HR: 1.13, 95%CI: 1.01-1.28) related ambulance attendances. CONCLUSION: These results demonstrate that exposure to coalmine fire smoke during the Hazelwood event was associated with a long-term health risk post the fire event, specifically for respiratory and cardiovascular conditions. These findings are important for effective implementation of health care services following future extended coalmine fire PM2.5 events.

17.
JAMA Intern Med ; 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34694318

RESUMO

Importance: Although nonfatal myocardial infarction (MI) is associated with an increased risk of mortality, evidence validating nonfatal MI as a surrogate end point for all-cause or cardiovascular (CV) mortality is lacking. Objective: To examine whether nonfatal MI may be a surrogate for all-cause or CV mortality in patients with or at risk for coronary artery disease. Data Sources: In this meta-analysis, PubMed was searched from inception until December 31, 2020, for randomized clinical trials of interventions to treat or prevent coronary artery disease reporting mortality and nonfatal MI published in 3 leading journals. Study Selection: Randomized clinical trials including at least 1000 patients with 24 months of follow-up. Data Extraction and Synthesis: Trial-level correlations between nonfatal MI and all-cause or CV mortality were assessed for surrogacy using the coefficient of determination (R2). The criterion for surrogacy was set at 0.8. Subgroup analyses based on study subject (primary prevention, secondary prevention, mixed primary and secondary prevention, and revascularization), era of trial (before 2000, 2000-2009, and 2010 and after), and follow-up duration (2.0-3.9, 4.0-5.9, and ≥6.0 years) were performed. Main Outcomes and Measures: All-cause or CV mortality and nonfatal MI. Results: A total of 144 articles randomizing 1 211 897 patients met the criteria for inclusion. Nonfatal MI did not meet the threshold for surrogacy for all-cause (R2 = 0.02; 95% CI, 0.00-0.08) or CV (R2 = 0.11; 95% CI, 0.02-0.27) mortality. Nonfatal MI was not a surrogate for all-cause mortality in primary (R2 = 0.01; 95% CI, 0.001-0.26), secondary (R2 = 0.03; 95% CI, 0.00-0.20), mixed primary and secondary prevention (R2 = 0.001; 95% CI, 0.00-0.08), or revascularization trials (R2 = 0.21; 95% CI, 0.002-0.50). For trials enrolling patients before 2000 (R2 = 0.22; 95% CI, 0.08-0.36), between 2000 and 2009 (R2 = 0.02; 95% CI, 0.00-0.17), and from 2010 and after (R2 = 0.01; 95% CI, 0.00-0.09), nonfatal MI was not a surrogate for all-cause mortality. Nonfatal MI was not a surrogate for all-cause mortality in randomized clinical trials with 2.0 to 3.9 (R2 = 0.004; 95% CI, 0.00-0.08), 4.0 to 5.9 (R2 = 0.06; 95% CI, 0.001-0.16), or 6.0 or more years of follow-up (R2 = 0.30; 95% CI, 0.01-0.55). Conclusions and Relevance: The findings of this meta-analysis do not appear to establish nonfatal MI as a surrogate for all-cause or CV mortality in randomized clinical trials of interventions to treat or prevent coronary artery disease.

18.
NPJ Breast Cancer ; 7(1): 135, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635660

RESUMO

Pathogenic germline mutations in the RAD51 paralog genes RAD51C and RAD51D, are known to confer susceptibility to ovarian and triple-negative breast cancer. Here, we investigated whether germline loss-of-function variants affecting another RAD51 paralog gene, RAD51B, are also associated with breast and ovarian cancer. Among 3422 consecutively accrued breast and ovarian cancer patients consented to tumor/germline sequencing, the observed carrier frequency of loss-of-function germline RAD51B variants was significantly higher than control cases from the gnomAD population database (0.26% vs 0.09%), with an odds ratio of 2.69 (95% CI: 1.4-5.3). Furthermore, we demonstrate that tumors harboring biallelic RAD51B alteration are deficient in homologous recombination DNA repair deficiency (HRD), as evidenced by analysis of sequencing data and in vitro functional assays. Our findings suggest that RAD51B should be considered as an addition to clinical germline testing panels for breast and ovarian cancer susceptibility.

19.
Ann Thorac Surg ; 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34687658

RESUMO

BACKGROUND: Digoxin has been associated with reduced interstage mortality for patients with functional single ventricles with aortic hypoplasia/ductal-dependent systemic circulation. The NEONATE score can stratify patients by risk of death or transplant (DTx) based on clinical factors. We suspected a variable transplant-free survival benefit of digoxin in high- versus low-risk patients. METHODS: National Pediatric Cardiology Quality Improvement Collaborative patients discharged following stage 1 palliation with complete data were categorized as high- or low-risk based on a modified NEONATE score. The primary outcome of DTx was evaluated. A mixed-effect regression evaluated associations between digoxin prescription and risk factors. RESULTS: 1,199 patients were included; 399 (33%) were high-risk. Baseline demographics were similar between cohorts. Blalock-Taussig shunt (BTS)or Hybrid operation, post-operative extracorporeal membrane oxygenation, opiate prescription, and significant tricuspid regurgitation or arch obstruction were more common in high-risk patients. Odds of DTx were 65% lower in high-risk patients prescribed digoxin compared to those who were not (p = 0.001). Digoxin prescription was associated with 60.8% lower DTx in the high risk cohort (7.8% vs. 19.9%; p = 0.001). There was no significant difference in the death/transplant rate according to digoxin prescription in the low-risk cohort (4.7% vs. 5.7%; p = 0.46). BTS, aortic arch obstruction, and significant tricuspid regurgitation were most strongly associated with deriving a benefit from digoxin. CONCLUSIONS: Digoxin use is associated with a significant improvement in transplant-free survival in high- but not low-risk interstage patients. A tailored approach to the use of digoxin in interstage patients may be warranted.

20.
Accid Anal Prev ; 163: 106428, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34649013

RESUMO

With the rising number of cases and deaths from the COVID-19 pandemic, nations and local governments, including many across the U.S., imposed travel restrictions on their citizens. This travel restriction order led to a significant reduction in traffic volumes and a generally lower exposure to crashes. However, recent preliminary statistics in the US suggest an increase in fatal crashes over the period of lockdown in comparison to the same period in previous years. This study sought to investigate how the pandemic affected road crashes and crash outcomes in Alabama. Daily vehicle miles traveled and crashes were obtained and explored. To understand the factors associated with crash outcomes, four crash-severity models were developed: (1) Single-vehicle (SV) crashes prior to lockdown order (Normal times SV); (2) multi-vehicle (MV) crashes prior to lockdown order (Normal times MV); (3) Single-vehicle crashes after lockdown order (COVID times SV); and (4) Multi-vehicle crashes after lockdown order (COVID times MV). The models were developed using the first 28 weeks of crashes recorded in 2020. The findings of the study reveal that although traffic volumes and vehicle miles traveled had significantly dropped during the lockdown, there was an increase in the total number of crashes and major injury crashes compared to the period prior to the lockdown order, with speeding, DUI, and weekends accounting for a significant proportion of these crashes. These observations provide useful lessons for road safety improvements during extreme events that may require statewide lockdown, as has been done with the COVID-19 pandemic. Traffic management around shopping areas and other areas that may experience increased traffic volumes provide opportunities for road safety stakeholders to reduce the occurrence of crashes in the weeks leading to an announcement of any future statewide or local lockdowns. Additionally, increased law enforcement efforts can help to reduce risky driving activities as traffic volumes decrease.


Assuntos
COVID-19 , Pandemias , Acidentes de Trânsito , Alabama/epidemiologia , Controle de Doenças Transmissíveis , Humanos , SARS-CoV-2
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