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Crashes on a roadway are influenced by various factors, including but not limited to road geometries, traffic volume, and environmental conditions. Among these factors, traffic volume and segment length are commonly used to predict crashes. Recently, the role of speed in crashes has been recognized as a significant factor, prompting its incorporation as a variable in crash modeling. Nevertheless, previous research studies that examined speed-related factors are mostly concentrated on higher functional class roads where speed data are abundant. Lack of actual speed data has limited the scope of such a study on rural two-lane highways. Due to recent advancements in data collection methodologies, there has been a significant increase in the accessibility of speed data pertaining to these roads. This study aims to assess the significance of speed as a predictor of crashes on rural two-lane highways, utilizing actual speed data. The results of this study showed a negative correlation between speed and crash frequency on rural two-lane roadways. In addition, it was observed that the impact of speed in the crash model becomes more pronounced at higher operating speed conditions of these roads. The aforementioned observation prompted us to consider a categorizer based on speed and, afterwards, separating crash prediction models for various speed ranges. This approach ultimately resulted in enhanced accuracy in crash prediction. Based on our analysis, developing separate models at different speed levels is recommended to better evaluate the safety performance of these roads under various conditions. Such models can also be useful for transportation planners and policymakers to identify high-risk segments and allocate resources to improve the safety of these roads., Author(s): Fahmida Rahman (corresponding author) [1]; Xu Zhang [2]; Mei Chen [3] 1. Background According to a study conducted in the United States, rural two-lane highways account for a significant [...]

It is of practical significance to understand the specific impact of weather events on the operating condition of the surface transportation system so that proactive and reactive strategies can be quickly implemented by transportation agencies to minimize the negativity resulted from adverse weather events. Many studies have been conducted on quantifying such effects yet suffer from limitations such as subjectively defining a time window under uncongested conditions and not being able to account for the severe impact from weather events which result in travel time unreliability. To overcome those shortcomings in existing literature, an integrated data mining framework based on decision tree and quantile regression techniques is developed in this study. The results demonstrate that the approach is effective in characterizing time periods with different traffic characteristics and quantifying the impact of rain and snow events on both congestion and reliability aspects of the transportation system. It is observed that snow events impose more significant impact on travel times than that from rain events. In addition, the impact from weather events is even more severe on travel time reliability than average delay. The impact magnitude is directly related to the level of recurrent congestion under study. Other insights with regard to the capability of quantile regression and future improvement on the methodological design are also offered., 1. Introduction It is well recognized that the transportation system may be significantly disrupted by adverse weather events. Aside from extreme events like floods, tornados, and hurricanes that can be [...]

Objective: The aim of this study was to evaluate the cerebral outcomes of patients underwent novel triple-branched stent graft implantation combined with the intraoperative monitoring of regional cerebral oxygen saturation.Methods: One hundred thirty-seven consecutive patients who underwent the surgery of triple-branched stent graft implantation in our department were enrolled in this retrospective case-control study. The patients in group A received brain protection based on the intraoperative monitoring of regional cerebral oxygen saturation and the patients in group B received conventional brain protection. The general clinical data, the types of corrective surgeries, the intraoperative situations, the postoperative complications, and the midterm outcomes of the patients were analyzed.Results: The incidence of postoperative cerebral dysfunction in the patients of group A was significantly lower than that in the patients in group B (3.2% vs 14.9%, P = .020). We found significant differences in the incubation times (30.3 ± 22.1 vs 42.3 ± 27.9 hours, P = .014), the lengths of intensive care unit stay (58.0 ± 54.3 vs 79.7 ± 55.5 hours, P = .004), and the hospital stays (19.3 ± 6.7 vs 24.9 ± 17.3 days, P = .045). A descending trend in the mortality rates was observed between the patients in the two groups based on the 20 months of observation; however, this trend was not statistically significant (1.6% vs 6.8%, P = .218).Conclusions: The novel triple-branched stent graft implantation procedure combined with intraoperative monitoring of the regional cerebral oxygen saturation was an effective treatment for Stanford type A aortic dissection, with a relatively low incidence of postoperative cerebral dysfunction. [ABSTRACT FROM AUTHOR]

Background: Household incense burning is a common ritual behavior in the Asia‐Pacific region but has been associated with inferior developmental outcomes in term infants. We aimed to examine these associations among preterm infants. Methods: Information from 1190 mother‐infant pairs during 6‐ and 18‐month follow‐up to the Taiwan Birth Cohort Study was examined for associations between household incense burning exposure and infant neurodevelopmental milestone achievement using multivariable Cox proportional hazard model with propensity score weighting, along with stratified, sensitivity, and decomposition analysis. Results: Household incense burning exposure was associated with delayed gross motor milestone achievement among all preterm infants according to the Cox model and after propensity score weighting. Meanwhile, associations for delayed development were found in gross motor domain milestones among late preterm infants, while fine motor domain delay was found among other preterm infants. Furthermore, the associations between household incense burning status and gross motor milestone delays were attenuated by the interaction between higher education level and household incense burning exposure status. Conclusions: Household incense burning exposure was associated with delays, and the motor domains affected differed according to degree of prematurity. These associations were modified by the attenuation upon higher maternal educational status and exposure status interaction. [ABSTRACT FROM AUTHOR]

Aims: To identify key factors influencing institutional nurses' self‐perceived competencies in spiritual care. Background: In the past decade, interest in spiritual care has been increasing; however, in long‐term care facilities, limited knowledge is available about nurses' competencies in spiritual care. Methods: The cross‐sectional study was conducted with 202 nurses in 11 long‐term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. Results: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self‐satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. Conclusions: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. Implications for Nursing Management: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care. [ABSTRACT FROM AUTHOR]

Aim: To develop a mobile application (App) that enhances bed‐cleaning management. Background: Bed cleaning affects clinical work in hospitals. The nursing department needed an App to enhance bed‐cleaning management, especially one on the status of all beds to be cleaned. Methods: Bed‐Cleaning App (BedCApp) was developed. Then, a survey was administered to 50 BedCApp users. Results: BedCApp helped the administrative staff and nurse managers in adjusting their workload effectively. A complete presentation of beds to be cleaned and reminders were found to be the most satisfactory features. The average time from receiving the notice to completing bed cleaning was shortened by 25.5 min. The user satisfaction survey comprised 50 valid questionnaires, with a satisfaction rate of 3.6/5. Conclusion: BedCApp provides the actual workload status; therefore, the administrative staff and nurse managers can optimize the workload during rush hours. The software is user‐oriented, with good user acceptance. Implications for Nursing Management: Proactive workload management would improve outcomes during rush hours and avoid interference in clinical care. The user interfaces for the elderly staff has special design—simple to use, larger font size than that in the interface for non‐elderly staff and workflow reminders. [ABSTRACT FROM AUTHOR]

Genetic or epigenetic inactivation of the pathway formed by the Fanconi anemia (FA) and BRCAI proteins occurs in several cancer types, making the affected tumors potentially hypersensitive to DNA cross-linkers and other chemotherapeutic agents. It has been proposed that the inability of FA/BRCA-defective cells to form subnuclear foci of effector proteins, such as FANCD2, can be used as a biomarker to aid individualization of chemotherapy. We show that FANCD2 inactivation not only renders cells sensitive to cross-links, but also oxidative stress, a common effect of cancer therapeutics. Oxidative stress sensitivity does not correlate with FANCD2 or RAD51 foci formation, but associates with increased γH2AX foci levels and apoptosis. Therefore, FANCD2 may protect cells against cross-links and oxidative stress through distinct mechanisms, consistent with the growing notion that the pathway is not linear. Our data emphasize the need for multiple biomarkers, such as γH2AX, FANCD2, and RAD51, to capture all pathway activities. Copyright © 2008 Henning Willers et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited., 1. INTRODUCTION Fanconi anemia (FA) is a heterogeneous clinical syndrome characterized by bone marrow failure, congenital defects, and cancer predisposition [1-5]. Cells derived from FA patients exhibit multiple abnormalities including [...]

BuShenKangShuai tablet (BSKS) is a Chinese herbal compound, which has been used to treat nonalcoholic fatty liver disease and cardiovascular diseases in clinic for over four decades. This study intends to explore whether BSKS administration can alleviates hepatic steatosis via improving liver adiponectin resistance in ApoE-/- mice. ApoE-/- mice were fed with western-type diet for 6 weeks and then were administrated with BSKS or atorvastatin for 6 weeks by gavage, and then blood and liver were collected for analysis. The results showed that BSKS attenuated hepatic steatosis, decreased blood lipids, and increased the serum level of adiponectin. We also found that adiponectin resistance in the liver was improved by BSKS, while the expression of TLR4 and NF-κB p65 was inhibited, followed by the suppression of proinflammatory mediators of TNF-α. Our data provided evidence that BSKS was able to alleviate hepatic steatosis in vivo. The underlying mechanism of BSKS was focused on improving liver adiponectin resistance, thereby regulating dyslipidemia and inhibiting inflammatory signaling pathway. [ABSTRACT FROM AUTHOR]

This study developed composite electrodes used in a semi-vanadium/iodine redox flow battery (semi-V-I RFB) system and designed semi-V-I RFB stacks to provide performance comparable to that of an all-vanadium redox flow battery (all-VRFB) system. These electrodes were modified using the electroless plating method and sol-gel process. The basic characteristics of the composited electrodes, such as the surface structural morphology, metal crystal phases, and electrochemical properties, were verified through cyclic voltammetry, field emission-scanning electron microscopy, energy-dispersive X-ray spectrometry, and X-ray diffraction. The results show that the sintering C–TiO2–Pd electrode improved the electrocatalytic activity of the semi-V-I RFB system, thereby effectively increasing the energy storage ability of the system. The C–TiO2–Pd electrode was used as a negative electrode in a single semi-V-I RFB and exhibited excellent cyclic performance in a charge-discharge test of 50 cycles. The average values for coulomb efficiency, voltage efficiency, and energy efficiency were approximately 96.56%, 84.12%, and 81.23%, respectively. Moreover, the semi-V-I RFB stacks were designed using series or parallel combination methods that can effectively provide the desired operating voltage and linearly increase the power capacity. The amount of vanadium salt required to fabricate the semi-V-I RFB system can be reduced by combining large stack modules of the system. Therefore, this system not only reduced costs but also exhibited potential for applications in energy storage systems. [ABSTRACT FROM AUTHOR]