An Investigation of Drivers’ Comprehension of Distracted Driving Slogans

Distracted driving occurs when a driver diverts the primary attention from driving to another task. Using mobile devices such as a cellphone for texting, calls, or other manipulation while driving has the highest potential for distraction because it combines both forms of distractions, manual, visual, and cognitive. Some states in the US have posted slogans including “W8 2 TXT, it’s a law”, “Don’t Drive inTEXTicated”, “PLS dnt txt n drv”, “Don’t tempt F8 that txt can w8”, and “DNT TXT & DRV” along highways to convey the dangers and laws regarding distracted driving to minimize incidences of distracted-related crashes This study surveyed 347 people using the five distraction slogans in a college town. The results showed that younger drivers have a higher level of comprehension compared to older drivers. Further, the results showed that drivers with university education or more years of driving experience have a higher comprehension level of distraction signs compared to their counterparts.

Analysis of HAZMAT truck driver fatigue and distracted driving with warning-based data and association rules mining

Professional drivers are more frequently exposed to longer driving distance and travel time,leading to a higher possibility of safety risk for distraction and fatigue.The widespread and common use of commercial driver monitoring systems(DMS)provides a potential for data collection.It increases the amount of data characterizing driver behavior that can be used for further safety research.This study utilized DMS warning-based data and applied an association rule mining approach to explore risk factors contributing to hazardous materials(HAZMAT)truck driver inattention.A total of 499 HAZMAT truck driver inattentive warning events were used to find rules that will predict the occurrence of driver’s fatigue and distraction.First,Fisher’s exact tests were performed to examine the association between the frequency of driver inattentive behavior warnings and risk factors.Second,support,confidence,and lift values were used as measurements to quantify the relative strength of the association rules generated by the Apriori algorithm.Results show that speed between 40and 49 km/h,relatively longer travel time(3-6 h),freeway,tangent section,off-peak hour and clear weather condition are found to be highly associated with fatigue driving,while nighttime during 18:00 to 23:59,speed between 70 and 80 km/h,travel time between 1 and 3 h,freeways,acceleration less than 0.5 m/s^(2),visibility greater than 1000 m,and tangent roadway section are found to be highly associated with distracted driving.By focusing on the specific feature groups,these association rules would help in the development of mitigating distraction and fatigue driving countermeasures and enforcement approaches.

Neurophysiological, histological, and behavioral characterization of animal models of distraction spinal cord injury: a systematic review

Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.

Investigating the trip configured causal effect of distracted driving on aggressive driving behavior for e-hailing taxi drivers

Risky driving behavior of taxi drivers typically evaluated for full operation or sometimes sorted into occupied and empty running trips.In this paper,we simultaneously analyze aggressive driving and distracted driving of taxi drivers under three different trip categories.Trip origin is considered a transition from without ride-order to with ride-order travelling or from with ride-order to occupied travelling,and a destination as a transition from occupied to without ride-order travelling and vice versa.Distracted driving is characterized by driver interference,driver mobile use and some entertainment aspects,while specific harmful and risky actions are considered for aggressive driving.High-resolution and real-time kinematic parameters of taxis were recorded by the in-vehicle recorder VBOX for overall 562 trips.The distracted driving parameters and aggressive driving actions were monitored through python data collector web application that was specially programmed for this particular research.Besides dual dash cam(i.e.,front and inside car camera),drivers’ whole day driving history from their Chinese ride-hailing Di Di smart application was used to differentiate occupied trips,unoccupied trips with ride-order and unoccupied trips without ride-order.Structural equation modeling(SEM) is practiced in this paper to understand the influence of distracted driving indicators on aggressive driving behaviors.The multi-group model analysis of SEM indicated that handling distracted risky driving could control aggressive driving behavior up to 96% and 98% inunoccupied without ride-order trips and unoccupied trips with ride-order respectively.The model has also identified the sensitive risky driving indicators for each group separately.

Distracted walking:Examining the extent to pedestrian safety problems

Pedestrians, much like drivers, have always been engaged in multi-tasking like using handheld devices, listening to music, snacking, or reading while walking. The effects are similar to those experienced by distracted drivers. However, distracted walking has not received similar policies and effective interventions as distracted driving to improve pedestrian safety. This study reviewed the state-of-practice on policies, campaigns, available data, identified research needs, and opportunities pertaining to distracted walking. A comprehensive review of literature revealed that some of the agencies/organizations disseminate useful information about certain distracting activities that pedestrians should avoid while walking to improve their safety. Various walking safety rules/tips have been given, such as not wearing headphones or talking on a cell phone while crossing a street, keeping the volume down, hanging up the phone while walking, being aware of traffic, and avoiding distractions like walking with texting. The majority of the past observational-based and experimental-based studies reviewed in this study on distracted walking is in agreement that there is a positive correlation between distraction and unsafe walking behavior. However, limitations of the existing crash data suggest that distracted walking may not be a severe threat to the public health. Current pedestrian crash data provide insufficient information for researchers to examine the extent to which distracted walking causes and/ or contributes to actual pedestrian safety problems.

Correlates of Coping Styles

Five hundred participants completed a short, ten-item measure of coping along with measures of self-esteem, intelligence, belief in a just world (BJW) and conspiracy theories (CT). The scale factored into four recognisable coping styles labelled socio-emotional, cognitive, internalisation and distraction. Correlations showed all factors were related to self-esteem and trait optimism. Regressions onto each factor indicated that self-esteem was the most consistent factor being associated positively with all factors, except internalisation. Younger females with low self-esteem tended to use socio-emotional coping, optimists with high self-esteem cognitive coping, younger, less optimistic people with low self-esteem internalisation and high self-esteem, less intelligent people with BJW distraction as a coping strategy. Implications and limitations are acknowledged.

An investigation on the link between driver demographic characteristics and distracted driving by using the SHRP 2 naturalistic driving data

Purpose–The purpose of this paper is to investigate the influence of driver demographic characteristics on the driving safety involving cell phone usages.Design/methodology/approach–A total of 1,432 crashes and 19,714 baselines were collected for the Strategic Highway Research Program 2 naturalistic driving research.The authors used a case-control approach to estimate the prevalence and the population attributable risk percentage.The mixed logistic regression model is used to evaluate the correlation between different driver demographic characteristics(age,driving experience or their combination)and the crash risk regarding cell phone engagements,as well as the correlation among the likelihood of the cell phone engagement during the driving,multiple driver demographic characteristics(gender,age and driving experience)and environment conditions.Findings–Senior drivers face an extremely high crash risk when distracted by cell phone during driving,but they are not involved in crashes at a large scale.On the contrary,cell phone usages account for a far larger percentage of total crashes for young drivers.Similarly,experienced drivers and experienced-middle-aged drivers seem less likely to be impacted by the cell phone while driving,and cell phone engagements are attributed to a lower percentage of total crashes for them.Furthermore,experienced,senior or male drivers are less likely to engage in cell phone-related secondary tasks while driving.Originality/value–The results provide support to guide countermeasures and vehicle design.

Effect of nerve growth factor and Schwann cells on axon regeneration of distracted inferior alveolar nerve following mandibular lengthening

Objective:To study the effect of nerve growth f actor (NGF) and Schwann cells on axon regeneration of the inferior alveolar nerv e following mandibular lengthening with distraction osteogenesis. Methods:Unilateral mandibular osteodistraction was performed i n 9 healthy adult male goats with a distraction rate of 1 mm/d. Every 3 goats we re killed on days 7, 14 and 28 after mandibular lengthening, respectively. The i nferior alveolar nerves in the distraction callus were harvested and processed f or ultrastructural and NGF immunohistochemical study. The inferior alveolar nerv es from the contralateral side were used as controls. Results:On day 7 after distraction, axon degeneration and Schw ann cell proliferation were observed, and very strong staining of NGF in the dis tracted nerve was detected. On day 14 after distraction, axon regeneration and r emyelination were easily observed, and NGF expression started to decline. On day 28 after distraction, the gray scale of NGF immunoreactivity recovered to the n ormal value and the Schwann cells almost recovered to their normal state. Conclusions:Gradual mandibular osteodistraction can result in mild or moderate axon degeneration of the inferior alveolar nerve. Nerve trauma may stimulate the proliferation of Schwann cells and promote the synthesis and s ecretion of NGF in the Schwann cells. Schwann cells and NGF might play important roles in axon regeneration of the injured inferior alveolar nerve following man dibular lengthening.

Revealing driver psychophysiological response to emergency braking in distracted driving based on field experiments

Purpose–The purpose of this paper is to characterize distracted driving by quantifying the response time and response intensity to an emergency stop using the driver’s physiological states.Design/methodology/approach–Field tests with 17 participants were conducted in the connected and automated vehicle test field.All participants were required to prioritize their primary driving tasks while a secondary nondriving task was asked to be executed.Demographic data,vehicle trajectory data and various physiological data were recorded through a biosignalsplux signal data acquisition toolkit,such as electrocardiograph for heart rate,electromyography for muscle strength,electrodermal activity for skin conductance and force-sensing resistor for braking pressure.Findings–This study quantified the psychophysiological responses of the driver who returns to the primary driving task from the secondary nondriving task when an emergency occurs.The results provided a prototype analysis of the time required for making a decision in the context of advanced driver assistance systems or for rebuilding the situational awareness in future automated vehicles when a driver’s take-over maneuver is needed.Originality/value–The hypothesis is that the secondary task will result in a higher mental workload and a prolonged reaction time.Therefore,the driver states in distracted driving are significantly different than in regular driving,the physiological signal improves measuring the brake response time and distraction levels and brake intensity can be expressed as functions of driver demographics.To the best of the authors’knowledge,this is the first study using psychophysiological measures to quantify a driver’s response to an emergency stop during distracted driving.

Identification of injury type using somatosensory and motor evoked potentials in a rat spinal cord injury model

The spinal cord is at risk of injury during spinal surgery.If intraoperative spinal co rd injury is identified early,irreve rsible impairment or loss of neurological function can be prevented.Different types of spinal cord injury result in damage to diffe rent spinal cord regions,which may cause diffe rent somatosensory and motor evoked potential signal res ponses.In this study,we examined electrophysiological and histopathological changes between contusion,distra ction,and dislocation spinal cord injuries in a rat model.We found that contusion led to the most severe dorsal white matter injury and caused considerable attenuation of both somatosensory and motor evoked potentials.Dislocation resulted in loss of myelinated axons in the lateral region of the injured spinal cord along the rostrocaudal axis.The amplitude of attenuation in motor evoked potential responses caused by dislocation was greater than that caused by contusion.After distraction injury,extracellular spaces were slightly but not significantly enlarged;somatosensory evoked potential res ponses slightly decreased and motor evoked potential responses were lost.Correlation analysis showed that histological and electrophysiological findings we re significantly correlated and related to injury type.Intraope rative monitoring of both somatosensory and motor evoked potentials has the potential to identify iatrogenic spinal cord injury type during surgery.

A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports

Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic deformities.Current reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress fractures.To reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short limbs.We present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was used.In the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone defect.In the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone grafts.Both patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and reliable.The entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,respectively.These findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe LLD.Further studies are needed to validate these results and assess the long-term outcomes of this approach.

Assessing the Influence of Roadside Advertising on Traffic Distraction and Its Interplay with Inside Vehicle Distractions: A Cross-Cultural Study in Jordan and Kuwait

Limited research has explored roadside advertisements’ effects on road user behavior in Middle Eastern countries. This study aims to understand distraction perceptions, including advertisements, their impact on behavior, and potential influences from advertisement type, in-vehicle distraction, and country factors (reflecting culture and environment). A standardized questionnaire was administered in Jordan and Kuwait, complemented by observations across three segment types: roadside advertisements, commercial signs, and road signs as control segments. Descriptive and inferential statistics were used. Results indicated a significant disparity in distraction perception between the two groups. Advertisement presence influenced Kuwaiti but not Jordanian behavior. Behavior varied by advertisement type in Jordan, not Kuwait, and in-vehicle distraction did not impact driver behavior. The study suggests explicitly revising advertising policies with a traffic safety focus. Overall, the study contributes insights into road user perceptions and behaviors, highlighting the complex interplay of distractions and advertising on road safety. Further research is required to validate these findings and shape road safety regulations.

牵引成骨术分子生物学机制研究进展

目前的研究表明缓慢的牵张刺激可增强骨痂中各种生长因子(TGF-βs、BMPs、IGF-1、FGF-2、VEGF)表达和细胞外基质(胶原蛋白Ⅰ、骨钙素、骨桥接素和骨连接素等)的生成。本文就牵引成骨术分子生物学机制近年来的研究进展作一综述。

Predictors and Risk Perceptions of Using Cell Phones while Driving among Young Adult Drivers

The Philippines is expecting a rise in the number of drivers that use mobile phones while driving.It is known as the“texting capital of the world”.The objectives of this study were to determine the predictors,risk perceptions and the prevalence of cell phone use while driving among trainee residents of the University of the Philippines-Philippine General Hospital.This cross-sectional study employed total enumeration.A survey was first distributed to the target population,followed by a focus group discussion.Chi-square and multiple logistic regression were used to analyze data.Included in the final analysis were 175 drivers aged 25-30 years(mean=27.90+1.34).There was no significant difference in the risk perceptions of cell phone users vs.non-users,and most perceived hands-free devices safer to use(p=0.030).The reported prevalence is 90.68%;drivers have a significant overall unsafe attitude(p=0.007),and an unsafe attitude when using handsets when driving,even when this is known to be dangerous(p=0.003).In conclusion,driving with hands-free devices was perceived to be safer,although drivers have a high overall unsafe attitude.Driving for more than two years and having an unsafe attitude were found to be significant predictors of cell phone use while driving.Countermeasures must take into account these factors when instituting behavioral modification strategies and road safety policies concerning unsafe and distracted driving.

Expression of Bone-related Genes in Bone Marrow MSCs after Cyclic Mechanical Strain: Implications for Distraction Osteogenesis

Aim Understanding the response of mesenchymal stem cells （MSCs） to mechanical strain and their consequent gene expression patterns will broaden our knowledge of the mechanobiology of distraction osteogenesis. Methodology In this study, a single period of cyclic mechanical stretch （0.5 Hz, 2,000 με） was performed on rat bone marrow MSCs. Cellular proliferation and alkaline phosphatase （ALP） activity was examined. The mRNA expression of six bone-related genes （Ets-1, bFGF, IGF-Ⅱ, TGF-β, Cbfal and ALP） was detected using real-time quantitative RT-PCR. Results The results showed that mechanical strain can promote MSCs proliferation, increase ALP activity, and up-regulate the expression of these genes. A significant increase in Ets-1 expression was detected immediately after mechanical stimulation, but Cbfal expression became elevated later. The temporal expression pattem of ALP coincided perfectly with Cbfal. Conclusion The results of this study suggest that mechanical strain may act as a stimulator to induce differentiation of MSCs into osteoblasts, and that these bone-related genes may play different roles in the response of MSCs to mechanical stimulation.

Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

BACKGROUND Ilizarov non-free bone plasty is a method of distraction osteogenesis using the Ilizarov apparatus for external fixation which originated in Russia and was disseminated across the world. It has been used in long bone defect and nonunion management along with free vascularized grafting and induced membrane technique. However, the shortcomings and problems of these methods still remain the issues which restrict their overall use.AIM To study the recent available literature on the role of Ilizarov non-free bone plasty in long bone defect and nonunion management, its problems and the solutions to these problems in order to achieve better treatment outcomes.METHODS Three databases(Pub Med, Scopus, and Web of Science) were searched for literature sources on distraction osteogenesis, free vascularized grafting and induced membrane technique used in long bone defect and nonunion treatment within a five-year period(2015-2019). Full-text clinical articles in the English language were selected for analysis only if they contained treatment results,complications and described large patient samples(not less than ten cases for congenital, post-tumor resection cases or rare conditions, and more than 20 cases for the rest). Case reports were excluded.RESULTS Fifty full-text articles and reviews on distraction osteogenesis were chosen.Thirty-five clinical studies containing large series of patients treated with this method and problems with its outcome were analyzed. It was found that distraction osteogenesis techniques provide treatment for segmental bone defects and nonunion of the lower extremity in many clinical situations, especially in complex problems. The Ilizarov techniques treat the triad of problems simultaneously(bone loss, soft-tissue loss and infection). Management of tibial defects mostly utilizes the Ilizarov circular fixator. Monolateral fixators are preferable in the femur. The use of a ring fixator is recommended in patients with an infected tibial bone gap of more than 6 cm. High rates of successful treatment were reported by the authors that ranged from 77% to 100% and depended on the pathology and the type of Ilizarov technique used. Hybrid fixation and autogenous grafting are the most applicable solutions to avoid after-frame regenerate fracture or deformity and docking site nonunion.CONCLUSION The role of Ilizarov non-free bone plasty has not lost its significance in the treatment of segmental bone defects despite the shortcomings and treatment problems encountered.

Management of complex and redo cases of pelvic fracture urethral injuries

Objectives:Pelvic fracture urethral injuries(PFUI)result from traumatic disruption of the urethra.A significant proportion of cases are complex rendering their management challenging.We described management strategies for eight different complex PFUI scenarios.Methods:Our centre is a tertiary referral centre for complex PFUI cases.We maintain a prospective database(1995e2016),which we retrospectively analysed.All patients with PFUI managed at our institute were included.Results:Over two decades 1062 cases of PFUI were managed at our institute(521 primary and 541 redo cases).Most redo cases were referred to us from other centres.Redo cases had up to five prior attempts at urethroplasty.We managed complex cases,which included bulbar ischemia,young boys and girls with PFUI,PFUI with double block,concomitant PFUI and iatrogenic anterior urethral strictures.Bulbar ischemia merits substitution urethroplasty,most commonly,using pedicled preputial tube.PFUI in young girls is usually associated with urethrovaginal fistula.Young boys with PFUI commonly have a long gap necessitating trans-abdominal approach.Our success rate with individualised management is 85.60%in primary cases,79.13%in redo cases and 82.40%in cases of bulbar ischemia.Conclusion:The definition of complex PFUI is ever expanding.The best chance of success is at the first attempt.Anastomotic urethroplasty for PFUI should be performed in experienced hands at high volume centres.

Applications of stem cells in orthodontics and dentofacial orthopedics:Current trends and future perspectives

A simple overview of daily orthodontic practice involves use of brackets, wires and elastomeric modules. However, investigating the underlying effect of orthodontic forces shows various molecular and cellular changes. Also, orthodontics is in close relation with dentofacial orthopedics which involves bone regeneration. In this review current and future applications of stem cells(SCs) in orthodontics and dentofacial orthopedics have been discussed. For craniofacial anomalies, SCs have been applied to regenerate hard tissue(such as treatment of alveolar cleft) and soft tissue(such as treatment of hemifacial macrosomia). Several attempts have been done to reconstruct impaired temporomandibular joint. Also, SCs with or without bone scaffolds and growth factors have been used to regenerate bone following distraction osteogenesis of mandibular bone or maxillary expansion. Current evidence shows that SCs also have potential to be used to regenerate infrabony alveolar defects and move the teeth into regenerated areas. Future application of SCs in orthodontics could involve accelerating tooth movement, regenerating resorbed roots and expanding tooth movement limitations. However, evidence supporting these roles is weak and further studies are required to evaluate the possibility of these ideas.

Interspinous posterior devices: What is the real surgical indication?

Interspinous posterior device(IPD) is a term used to identify a relatively recent group of implants used to treat lumbar spinal degenerative disease. This kind of device is classified as part of the group of the dynamic stabilization systems of the spine. The concept of dynamic stabilization has been replaced by that of dynamic neutralization of hypermobility, with the intention of clarifying that the primary aim of this kind of system is not the preservation of the movement, but the dynamic neutralization of the segmental hypermobility which is at the root of the pathological condition. The indications for the implantation of an IPD are spinal stenosis and neurogenic claudication, assuming that its function is the enlargement of the neural foramen and the decompression of the roots forming the cauda equina in the central part of the vertebral canal. In the last 10 years, use of these implants has been very common but to date, no long-term clinical follow-up regarding clinical and radiological aspects are available. The high rate of reoperation, recurrence of symptoms and progression of degenerative changes is evident in the literature. If these devices are effectively a miracle cure for lumbar spinal stenosis, why do the utilization and implantation of IPD remain extremely controversial and should they be investigated further? Excluding theproblems related to the high cost of the device, the main problem remains the pathological substrate on which the device is explicit in its action: the degenerative pathology of the spine.

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100th birthday of G. A. Ilizarov)

The Ilizarov method is one of the current methods used in bone reconstruction.It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA.Its main merits are viable new bone formation through distraction osteogenesis,high union rates and functional use of the limb throughout the course of treatment.The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery.Since then,the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails.They gave rise to a relatively new orthopedic subspecialty termed“limb lengthening and reconstruction surgery”.Based on a comprehensive literature search,we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community.The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating.The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents.It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.