Creating a Highway Information System for Safety Roadway Features

Roadway departures are the leading cause of roadside fatalities. The Kentucky Transportation Cabinet (KYTC) has undertaken a number of roadside safety measures to reduce roadway departures. Specifically, KYTC has installed several low-cost, systemic roadway safety treatments to Kentucky’s roadways in recent years. These treatments include cable barriers, high friction surface treatments, rumble stripes, and Safety Edges. KYTC has installed approximately 44 cable barrier systems over 265 miles of roadway,112 HFST applications over 20 miles of roadway, 750 rumble stripe installations over 2,500 miles of roadway, and 147 Safety Edge treatments on 580 miles of roadway. The project team developed a complete inventory for safety measure installations, including their locations and select characteristics. This information was collected through interviews, KYTC databases, KYTC contract proposals, KTC studies, and onsite assessments. These data served as inputs into KYTC’s statewide highway model. ArcMap was used to reference locations of the inventoried safety treatments. All safety measure installations were compiled into a comprehensive Excel database. The database is a tool that will allow policy makers and transportation agencies to evaluate the effectiveness, cost, and benefits of roadway safety treatments

Work Vehicle Warning Lights: Color Options and Effectiveness

KTC reviewed existing regulations, guidance, and practices to assess the Kentucky Transportation Cabinet’s warning lights program on highway work vehicles. The Kentucky Revised Statutes categorizes KYTC vehicles as “public safety vehicles” and requires their use of amber lights. Because the use of red can be confused with emergency vehicles, KYTC prohibits the use of red on work vehicles. At the national level, standards for warning light colors do not exist. Rather, AASHTO provides guidance on roadway operations equipment and recommends the use of amber and white lights as the primary warning light colors for highway vehicles. AASHTO guidance also prescribes the use of slow, asynchronous flash frequencies; LED light sources; and placement of lights at high elevations and against solid-colored backgrounds. The MUTCD provides little guidance in terms of warning light specifications, including color preferences. A review of existing state agencies, including DOTs, concluded that amber and white are the primary light colors currently in use across highway operations vehicles. KTC conducted two external surveys to assess warning light products and practices within the U.S. The first survey reviewed vendor LED products and revealed that LED lights are primarily available in the colors of amber, blue, green, red, and white. Fluorescent yellow-green is not available. The second survey requested state DOT information related to lighting systems’ colors, sources, intensity, and placement; responding agency names and policies; and previous state DOT studies related to warning lights. Survey responses indicated 100 percent use of the color amber (as a color type) as well as use of LED light sources. More than 75 percent of reporting agencies place warning lights on their highway work vehicle’s roof to maximize visibility to motorists. Survey results varied dramatically on the differentiation of warning light colors by vehicle type and the differentiation of light intensities for daytime versus nighttime conditions. KTC researchers recommend the use of amber and white colors for KYTC work vehicles, an asynchronous flashing pattern with slow flash frequencies, and LED bulbs. Other recommendations include placement of warning lights at high elevations on the vehicle, placement of warning lights against a solid-colored background, and investigation on feasibility of yellow-green LED lights

Evaluation of Alternative Rumble Strip Designs

Since Kentucky’s initial rumble strip designs were adopted, there has been additional research and experimentation in other states with alternative designs as a response to complaints from the public about noise pollution caused by rumble strips. The new research indicates that other rumble strip designs might provide increased interior noise/vibration with decreased exterior noise. Application of these alternative designs in Kentucky could result in improved rumble performance, reduced damage to new pavement, decreased noise pollution, installation on roadways with lower speed limits, and allow reinstallation of rumbles on thin overlays/microsurfacing. The research team reviewed national and state guidelines for conventional and alternative rumble strip designs and compiled a synthesis of current rumble strip practices. A series of site visits to rumble strip installations across the state revealed many findings about Kentucky’s current rumble strip practices. This research provides recommendations for conventional, sinusoidal, and shallow rumble strips as well as for rumble strip maintenance, rumble strips on thin overlays, and the use of edgeline and centerline rumble strips

In-Service Evaluation of High Tension Cable Barrier Systems

The Kentucky Transportation Cabinet has installed hundreds of miles of high-tension cable median barrier (CMB) as a safety innovation. The usage of CMB aids in the prevention of crossover crashes, where a vehicle departs the roadway on the left shoulder, crosses the median, and enters the opposing lane(s) of traffic. KYTC officials have questioned whether all three barrier products perform similarly. Some installed cable barrier systems have lost tension across the entire cable length after a single vehicle impact. If a second vehicle were to strike the cable barrier system in a location other than the damaged area of the first vehicle’s crash, ideally, the high-tension cable barrier system should continue to prevent errant vehicles from crossing the median and causing a head-on collision. The goal of this research was to improve the safety and effectiveness of Kentucky’s cable barrier systems by reviewing state DOT best practices for cable barrier, conducting on-site evaluation of current cable barrier installations, and examining crash data. The research team analyzed each CMB vendor product’s performance and maintenance requirements, and recommended modifications to KYTC policies, specifications, and maintenance procedures. The study showed that CMB systems have decreased crossover crashes in Kentucky, which warrants the continued use of high-tension cable barrier across the state. One recommendation of the study is to institute and enforce tension-monitoring programs, as applicable, for both annual inspections and after repairs

The Priming Function of In-car Audio Instruction

Studies to date have focused on the priming power of visual road signs, but not the priming potential of audio road scene instruction. Here, the relative priming power of visual, audio and multisensory road scene instructions were assessed. In a lab-based study, participants responded to target road scene turns following visual, audio or multisensory road turn primes which were congruent or incongruent to the primes in direction, or control primes. All types of instruction (visual, audio, multisensory) were successful in priming responses to a road scene. Responses to multisensory-primed targets (both audio and visual) were faster than responses to either audio or visual primes alone. Incongruent audio primes did not affect performance negatively in the manner of incongruent visual or multisensory primes. Results suggest that audio instructions have the potential to prime drivers to respond quickly and safely to their road environment. Peak performance will be observed if audio and visual road instruction primes can be timed to co-occur

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

BACKGROUND: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. METHODS: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). FINDINGS: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). INTERPRETATION: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research