The accurate evaluation of crash causal factors can provide fundamental information for effective transportation policy, vehicle design, and driver education. Naturalistic driving (ND) data collected with multiple onboard video cameras and sensors provide a unique opportunity to evaluate risk factors during the seconds leading up to a crash. This paper uses a National Academy of Sciences-sponsored ND dataset comprising 905 injurious and property damage crash events, the magnitude of which allows the first direct analysis (to our knowledge) of causal factors using crashes only. The results show that crash causation has shifted dramatically in recent years, with driver-related factors (i.e., error, impairment, fatigue, and distraction) present in almost 90% of crashes. The results also definitively show that distraction is detrimental to driver safety, with handheld electronic devices having high use rates and risk.D uring recent years, the percentage of crashes involving some type of driver error or impairment before the crash was thought to be as high as 94% (1). Factors such as vehicle failures, roadway design or condition, or environment composed lower crash percentages. Naturalistic driving studies (NDSs) offer a unique opportunity to study driver performance and behavior experienced in the real world with actual consequences and risks (2-4). The NDS research method developed at the Virginia Tech Transportation Institute (VTTI) involves equipping volunteer participants' vehicles with advanced, unobtrusive instrumentation (e.g., cameras, sensors, radar) that automatically and continuously collects driving parameters-including speed, time to collision, global positioning system (GPS) location, acceleration, and eye glance behavior-from key-on to key-off (2, 5). The recently completed Second Strategic Highway Research Program Naturalistic Driving Study (SHRP 2 NDS), sponsored by the Transportation Research Board (TRB) of the National Academy of Sciences (NAS), is the largest NDS of its kind, capturing more than 35 million miles of continuous naturalistic driving data and 2 petabytes (PB) of video, kinematic, and audio data from more than 3,500 participants (5).NDSs provide insight into the factors that cause crashes, giving researchers the opportunity to observe actual driver behavior and to accurately understand drivers' performance during the minutes or seconds leading up to a crash (6, 7). However, previous NDSs captured a relatively small number of crashes (2,8). To obtain a statistically valid sample of crash factors in earlier NDSs, surrogate measures (e.g., near-crash events) were integrated into analyses. Near-crashes are operationally defined as having the observable factors that could lead to a crash, with one difference present: the performance of a successful evasive maneuver. Although previous studies used near-crashes as a surrogate for estimating crash risk, the accuracy and validity of combining crashes and near-crashes to estimate driver risk are just beginning to be understood (9). With the com...

A B S T R A C T PurposePlasma osteopontin (OPN) levels in advanced non-small-cell lung cancer (NSCLC) correlate with therapeutic response and survival, but the utility of plasma OPN for diagnosis and monitoring of early-stage NSCLC has not been investigated. We hypothesize that plasma OPN levels are elevated in early-stage NSCLC and decrease with resection. Patients and MethodsPresurgery plasma OPN levels (in ng/mL) were measured by enzyme-linked immunosorbent assay (ELISA) in a discovery set of 60 patients with early-stage NSCLC and were compared with data from 56 cancer-free smokers. Presurgery OPN was validated in an independent cohort of 96 patients with resectable NSCLC. The presurgery levels in the latter cohort were compared with matched postsurgery levels. Perioperative OPN levels were correlated with demographics, tumor characteristics, and perioperative events. OPN was monitored during follow-up. ResultsDiscovery set presurgery NSCLC OPN (271 Ϯ 31 ng/mL) was higher than smokers (40 Ϯ 2 ng/mL; P ϭ .001). Presurgery OPN was similar in the NSCLC validation cohort (324 ng/mL Ϯ 20 ng/mL; P ϭ .134). Postsurgery OPN (256 ng/mL Ϯ 21 ng/mL) measured at mean of 9.8 weeks (range, 2 to 46 weeks) was lower than presurgery OPN (P ϭ .005). Time from surgery significantly impacted postsurgery OPN: OPN Յ 6 weeks postsurgery (303 n/mL Ϯ 26 ng/mL) was higher than OPN greater than 6 weeks postsurgery (177 ng/mL Ϯ 29 ng/mL; P ϭ .003). Multivariate analysis noted correlations between albumin and creatinine to presurgery OPN and use of thoracotomy to postsurgery OPN. Recurrence rate was 5% at 29 weeks mean follow-up. OPN at recurrence was elevated from postsurgery nadir. ConclusionPlasma OPN levels are elevated in early-stage NSCLC. They are reduced after resection and appear to increase with recurrence. Plasma OPN may have utility as a biomarker in early-stage NSCLC. J Clin

The Second Strategic Highway Research Program America's highway system is critical to meeting the mobility and economic needs of local communities, regions, and the nation. Developments in research and technology-such as advanced materials, communications technology, new data collection technologies, and human factors science-offer a new opportunity to improve the safety and reliability of this important national resource. Breakthrough resolution of significant transportation problems, however, requires concentrated resources over a short time frame. Reflecting this need, the second Strategic Highway Research Program (SHRP 2) has an intense, large-scale focus, integrates multiple fields of research and technology, and is fundamentally different from the broad, missionoriented, discipline-based research programs that have been the mainstay of the highway research industry for half a century. The need for SHRP 2 was identified in TRB Special Report 260: Strategic Highway Research: Saving Lives, Reducing Congestion, Improving Quality of Life, published in 2001 and based on a study sponsored by Congress through the Transportation Equity Act for the 21st Century (TEA-21). SHRP 2, modeled after the first Strategic Highway Research Program, is a focused, timeconstrained, management-driven program designed to complement existing highway research programs. SHRP 2 focuses on applied research in four areas: Safety, to prevent or reduce the severity of highway crashes by understanding driver behavior; Renewal, to address the aging infrastructure through rapid design and construction methods that cause minimal disruptions and produce lasting facilities; Reliability, to reduce congestion through incident reduction, management, response, and mitigation; and Capacity, to integrate mobility, economic, environmental, and community needs in the planning and designing of new transportation capacity.