Temporal instability of the determinants of fatal/severe elderly pedestrian injury outcomes in intersections and non-intersections before, during, and after the COVID-19 pandemic.

This study examines the variability in the impacts of factors influencing injury severity outcomes of elderly pedestrians (age >64) involved in vehicular crashes at intersections and non-intersections before, during, and after the COVID-19 pandemic. To account for unobserved heterogeneity in the crash data, a random parameters logit model with heterogeneity in the means approach is utilized to analyze vehicle-elderly pedestrian crash data from Seoul, South Korea, occurring between 2018 and 2022. Preliminary transferability tests revealed instability in factor impacts on injury severity outcomes, highlighting the need to estimate individual models across various road segments and time periods. Thus, the dataset was segregated by crash location (intersection/non-intersection) and period (before, during, and after COVID-19), with individual models estimated for each group. Results obtained from the analyses revealed that back injuries positively influenced fatalities at non-intersections after the pandemic and was negatively associated with fatalities at intersections before the pandemic. Additionally, several indicators demonstrated significant instability in their impact magnitudes across different road segments and crash years. During the pandemic, head injuries increased the probability of fatalities higher at non-intersections. After the pandemic, crosswalk locations decreased the possibility of fatalities more at intersections. Compared to intersection segments, the female indicator reduced the likelihood of fatal injuries at non-intersections more before, during, and after the pandemic. Before the pandemic, much older pedestrians experienced a greater decline in fatalities at intersections than non-intersections. This instability could be attributed to altered mobility patterns stemming from the COVID-19 pandemic. Overall, the study findings highlight the variability of determinants of fatal/severe injury outcomes among elderly pedestrians across various road segments and years, with the underlying cause of this fluctuation remaining unclear. Furthermore, the findings revealed that accounting for heterogeneity in the means of random parameters enhances model fit and provides valuable insights for safety professionals. The factor impact variability in the estimated models carries significant implications for elderly pedestrian safety, especially in scenarios where precise projections of the effects of alternative safety measures are essential. Road safety experts can leverage these findings to refine or update current policies to enhance elderly pedestrian safety at intersections and non-intersections.

Critical risk factors associated with fatal/severe crash outcomes in personal mobility device rider at-fault crashes: A two-step inter-cluster rule mining technique.

Personal Mobility Devices (PMDs) have witnessed an extraordinary surge in popularity, emerging as a favored mode of urban transportation. This has sparked significant safety concerns, paralleled by a stark increase in PMD-involved crashes. Research indicates that PMD user behavior, especially in urban areas, is crucial in these crashes, underscoring the need for an extensive investigation into key factors, particularly those causing fatal/severe outcomes. Remarkably, there exists a noticeable gap in the research concerning the analysis of determinants behind fatal/severe PMD crashes, specifically in PMD rider-at-fault collisions. This study addresses this gap by identifying uniform groups of PMD rider-at-fault crashes and investigating cluster-specific key factor associations and determinants of fatal/severe crash outcomes using Seoul's PMD rider-at-fault crash data from 2017 to 2021. A comprehensive two-step framework, integrating Cluster Correspondence Analysis (CCA) and Association Rules Mining (ARM) techniques is employed to segment PMD rider-at-fault crash data into homogeneous groups, revealing unique risk factor patterns within each cluster and further exploring the combination of factors associated with fatal/severe PMD rider-at-fault crash outcomes. CCA revealed three distinct groups: PMD-vehicle, PMD-pedestrian, and single-PMD crashes. From the ARM, it was found that fatal/severe crashes were linked to dry road conditions, male PMD users, and weekdays, irrespective of the cluster. Whereas speeding violations and side collisions were associated with fatal/severe PMD-vehicle rider-at-fault crashes, traffic control violations were related to fatal/severe PMD-pedestrian rider-at-fault crashes at pedestrian crossings. Unsafe riding practices predominantly caused single-PMD crashes during daytime hours. From the findings, engineering improvements, awareness campaigns, education, and law enforcement actions are recommended. The new insights gleaned from this research provide a foundation for informed decision-making and the implementation of policies designed to enhance PMD safety.

Multi-walled carbon nanotubes reversing the bone formation of bone marrow stromal cells by activating M2 macrophage polarization.

Multi-walled carbon nanotubes (MWCNTs) are an excellent bone tissue repair material both in vitro and in vivo. The interactions between MWCNTs and single type of cells of bone tissue, including osteoblasts, bone marrow stromal cells (BMSCs) or osteoclasts, have been extensively studied. However, the interactions between MWCNTs with different types of cells in the bone microenvironment remain elusive. Bone microenvironment is a complex system composed of different types of cells, which have interactions between each other. In this work, the effects of MWCNTs on bone microenvironment were firstly studied by culture of MWCNTs with BMSCs, osteoblasts, osteoclasts, macrophages and vascular endothelial cells, respectively. Then, co-culture systems of macrophages-BMSCs, macrophages-calvaria and macrophages-BMSCs-vascular endothelial cells were treated with MWCNTs, respectively. The osteogenic differentiation of BMSCs and osteoblasts was inhibited when these two types of cells were cultured with MWCNTs, respectively. Strikingly, when co-culture MWCNTs with BMSCs and macrophages, the osteogenesis of BMSCs was promoted by inducing the M2 polymerization of macrophages. Meanwhile, MWCNTs promoted the bone formation in the osteolysis model of calvaria ex vivo. In addition, the formation of osteoclasts was inhibited, and angiogenesis was increased when treated with MWCNTs. This study revealed the inconsistent effects of MWCNTs on single type of bone cells and on the bone microenvironment. The results provided basic research data for the application of MWCNTs in bone tissue repair.

Separable Microneedles with Photosynthesis-Driven Oxygen Manufactory for Diabetic Wound Healing.

Oxygen plays an important role in diabetic chronic wound healing by regulating various life activities such as cell proliferation, migration, and angiogenesis. Therefore, oxygen-delivering systems have drawn much attention and evolved continuously. Here, we propose that an active Chlorella vulgaris (Cv)-loaded separable microneedle (MN) can be used to control oxygen delivery, which then promotes wound healing. The Cv-loaded microneedles (CvMN) consist of a polyvinyl acetate (PVA) substrate and gelatin methacryloyl (GelMA) tips with encapsulated Cv. Once CvMN is applied to diabetic wound, the PVA basal layer is rapidly dissolved in a short time, while the noncytotoxic and biocompatible GelMA tips remain in the skin. By taking advantage of the photosynthesis of Cv, oxygen would be continuously produced in a green way and released from CvMN in a controlled manner. Both in vitro and in vivo results showed that CvMN could promote cell proliferation, migration, and angiogenesis and enhance wound healing in diabetic mice effectively. The remarkable therapeutic effect is mainly attributed to the continuous generation of dissolved oxygen in CvMN and the presence of antioxidant vitamins, γ-linolenic acid, and linoleic acid in Cv. Thus, CvMN provides a promising strategy for diabetic wound healing with more possibility of clinical transformations.

Decoy Exosomes Offer Protection Against Chemotherapy-Induced Toxicity.

Cancer patients often face severe organ toxicity caused by chemotherapy. Among these, chemotherapy-induced hepatotoxicity and cardiotoxicity are the main causes of death of cancer patients. Chemotherapy-induced cardiotoxicity even creates a new discipline termed "cardio-oncology". Therefore, relieving toxicities induced by chemotherapy has become a key issue for improving the survival and quality of life in cancer patients. In this work, mesenchymal stem cell exosomes with the "G-C" abundant tetrahedral DNA nanostructure (TDN) are modified to form a decoy exosome (Exo-TDN). Exo-TDN reduces DOX-induced hepatotoxicity as the "G-C" base pairs scavenge DOX. Furthermore, Exo-TDN with cardiomyopathic peptide (Exo-TDN-PCM) is engineered for specific targeting to cardiomyocytes. Injection of Exo-TDN-PCM significantly reduces DOX-induced cardiotoxicity. Interestingly, Exo-TDN-PCM can also promote macrophage polarization into the M2 type for tissue repair. In addition, those decoy exosomes do not affect the anticancer effects of DOX. This decoy exosome strategy serves as a promising therapy to reduce chemo-induced toxicity.