Background and Objective Low-dose acetylsalicylic acid (ASA, aspirin) is a well-known and frequently studied drug for primary and secondary prevention of disease due to its anti-inflammatory and coagulopathic effects. COVID-19 complications are attributed to the role of thrombo-inflammation. Studies regarding the use of low-dose ASA in COVID-19 are limited. For this reason, we propose that the use of low-dose ASA may have protective effects in COVID-19-related thromboembolism and lung injury. This study was conducted to assess the efficacy of low-dose ASA compared with enoxaparin, an anticoagulant, for the prevention of thrombosis and mechanical ventilation. Methods We conducted a retrospective cohort study on COVID-19-confirmed hospitalized patients at the Mansoura University Quarantine Hospital, outpatients, and home-isolated patients from September to December 2020 in Mansoura governorate, Egypt. Binary logistic regression analysis was used to assess the effect of ASA compared with enoxaparin on thromboembolism, and mechanical ventilation needs. Results This study included 225 COVID-19 patients. Use of ASA-only (81-162 mg orally daily) was significantly associated with reduced thromboembolism (OR 0.163, p = 0.020), but both low-dose ASA and enoxaparin, and enoxaparin-only (0.5 mg/kg subcutaneously (SC) daily as prophylactic dose or 1 mg/kg SC every 12 hours as therapeutic dose) were more protective (odds ratio [OR] 0.010, OR 0.071, respectively, p < 0.001). Neither ASA-only nor enoxaparin-only were associated with a reduction in mechanical ventilation needs. Concomitant use of low-dose ASA and enoxaparin was associated with reduced mechanical ventilation (OR 0.032, 95% CI 0.004-0.226, p = 0.001). Conclusions Low-dose ASA-only use may reduce the incidence of COVID-19-associated thromboembolism, but the reduction may be less than that of enoxaparin-only, and both ASA and enoxaparin. Concomitant use of ASA and enoxaparin demonstrates promising results with regard to the reduction of thrombotic events, and mechanical ventilation needs.

Alternative innovative designs for intersections were defined to enhance traffic operation and safety. Median U-turn (MUT) and restricted crossing U-turn (RCUT) intersections are among the types of alternative intersections that enable drivers to make left-turn movements at median U-turn crossovers downstream of the main intersection. Recently, municipalities and transport agencies have tended to implement these types of intersections. However, their effectiveness in crash reduction has not been adequately determined in previous studies. This is because of the limited number of alternative intersections that were considered in these studies. In addition, there was no consideration for the unusual new geometric design of these intersections. In this study, a safety evaluation was conducted while considering the new intersection-related areas at MUT and RCUT intersections to clarify and quantify their effectiveness in crash reduction. This study considered 73 MUT and 12 RCUT intersections. Two types of MUT intersections were considered in this study. Crash modification factors for MUT and RCUT intersections were estimated by using before–after and cross-sectional methods. The results indicated that MUT and RCUT intersections are safer than conventional intersections. MUT intersections are effective in reducing total, property damage only (PDO), rear-end, and opposite-direction sideswipe crashes, although they significantly increase single-vehicle and non-motorized crashes. RCUT intersections are effective in reducing fatal-and-injury, injury, head-on, and angle crashes. Findings of this research provide clear evaluation for decision makers about the effectiveness of MUT and RCUT intersections in crash reduction.

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Diverging diamond interchanges (DDIs) are designed as an alternative to the conventional diamond interchanges to enhance operational and safety performance. As the popularity of the DDI is increasing and more DDIs are being constructed and proposed, the need has arisen to measure the actual safety benefits of DDIs as compared with the traditional diamond interchanges. This study evaluates the safety of DDIs using three methods: before–after study with comparison group, Empirical Bayes before–after method, and cross-sectional analysis. This study collected a nationwide sample of 80 DDIs in 24 states. The estimated crash modification factors indicated that converting conventional diamond interchange to DDIs could significantly decrease the total, fatal-and-injury, rear-end, and angle/left-turn crashes by 14%, 44%, 11%, and 55%, respectively. Moreover, the developed safety performance functions implied that a longer distance between crossovers/ramp terminals and a lower speed limit on freeway exit ramps are significantly associated with lower crash frequency at diamond interchanges. This study contributes to the existing literature using a relatively large representative sample size, which provides more reliable evaluation results. In addition, this study also explored the effects of different traffic and geometric characteristics on the safety performance of DDIs.

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