Analysis of near crashes among teen, young adult, and experienced adult drivers using the SHRP2 naturalistic driving study.

OBJECTIVE: Motor vehicle crashes are the leading cause of death among young drivers. Though previous research has focused on crash events, near crashes offer additional data to help identify driver errors that could potentially lead to crashes as well as evasive maneuvers used to avoid them. The Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study (NDS) contains extensive data on real-world driving and offers a reliable methodology to quantify and study near crashes. This article presents findings on near crashes and how they compare to crash events among teen, young adult, and experienced adult drivers. METHODS: A subset from the SHRP2 database consisting of 1,653 near crashes for teen (16-19 years, n = 550), young adult (20-24 years, n = 748), and experienced adult (35-54 years, n = 591) drivers was used. Onboard instrumentation including scene cameras, accelerometers, and Global Positioning System logged time series data at 10 Hz. Scene videos were reviewed for all events to classify near crashes based on 7 types: rear-end, road departure, intersection, head-on, side-swipe, pedestrian/cyclist, and animal. Near crash rates, incident type, secondary tasks, and evasive maneuvers were compared across age groups and between crashes and near crashes. For rear-end near crashes, vehicle dynamic variables including near crash severity, headway distance, time headway, and time to collision at the time of braking were compared across age groups. Crashes and near crashes were combined to compare the frequency of critical events across age. RESULTS: Teen drivers exhibited a significantly higher (P <.01) near crash rate than young adult and experienced adult drivers. The near crash rates were 81.6, 56.6, and 37.3 near crashes per million miles for teens, young adults, and experienced adults, respectively. Teens were also involved in significantly more rear-end (P <.01), road departure (P <.01), side-swipe (P <.01), and animal (P <.05) near crashes compared to young and experienced adults. Teens exhibited a significantly greater (P <.01) critical event rate of 102.2 critical events per million miles compared to 72.4 and 40.0 critical events per million miles for young adults and experienced adults, respectively; the critical event rate ratio was 2.6 and 1.8 for teens and young adults, respectively. CONCLUSIONS: To our knowledge, this is the first study to examine near crashes among teen, young adult, and experienced adult drivers using SHRP2 naturalistic data. Near crash and critical event rates significantly decreased with increasing age and driver experience. Overall, teens were more than twice as likely to be involved in critical events compared to experienced adults. These data can be used to develop more targeted driver training programs and help manufacturers design active safety systems based on the most common driving errors for vulnerable road users.

Native Myocardial T1 as a Biomarker of Cardiac Structure in Non-Ischemic Cardiomyopathy.

Diffuse myocardial fibrosis is involved in the pathology of nonischemic cardiomyopathy (NIC). Recently, the application of native (noncontrast) myocardial T1 measurement has been proposed as a method for characterizing diffuse interstitial fibrosis. To determine the association of native T1 with myocardial structure and function, we prospectively studied 39 patients with NIC (defined as left ventricular ejection fraction (LVEF) ≤ 50% without cardiac magnetic resonance (CMR) evidence of previous infarction) and 27 subjects with normal LVEF without known overt cardiovascular disease. T1, T2, and extracellular volume fraction (ECV) were determined over 16 segments across the base, mid, and apical left ventricular (LV). NIC participants (57 ± 15 years) were predominantly men (74%), with a mean LVEF 34 ± 10%. Subjects with NIC had a greater native T1 (1,131 ± 51 vs 1,069 ± 29 ms; p <0.0001), a greater ECV (0.28 ± 0.04 vs 0.25 ± 0.02, p = 0.002), and a longer myocardial T2 (52 ± 8 vs 47 ± 5 ms; p = 0.02). After multivariate adjustment, a lower global native T1 time in NIC was associated with a greater LVEF (ß = -0.59, p = 0.0003), greater right ventricular ejection fraction (ß = -0.47, p = 0.006), and smaller left atrial volume index (ß = 0.51, p = 0.001). The regional distribution of native myocardial T1 was similar in patients with and without NIC. In NIC, native myocardial T1 is elevated in all myocardial segments, suggesting a global (not regional) abnormality of myocardial tissue composition. In conclusion, native T1 may represent a rapid, noncontrast alternative to ECV for delineating myocardial tissue remodeling in NIC.