京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第20289号 / 社医博第78号 / 社新制||医||9(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 山田 亮, 教授 中山 健夫, 教授 古川 壽亮 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

Since 2015, there have been more than 35,000 fatalities annually due to crashes on United States roads [1], [2]. Typically, road departure crashes account for less than 10% of all annual crash occupants yet comprise nearly one third of all crash fatalities in the US [3]. In the year 2020, road departure crashes accounted for 50% of crash fatalities [2]. Road departure crashes are characterized by a vehicle leaving the intended lane of travel, departing the roadway, and striking a roadside object, such as a tree or pole, or roadside condition, such as a slope or body of water. One strategy currently implemented to mitigate these types of crashes is the use of roadside barriers. Roadside barriers, such as metal guardrails, concrete barriers, and cable barriers, are designed to reduce the severity of road departure crashes by acting as a shield between the departed vehicle and more hazardous roadside obstacles. Much like new vehicles undergo regulatory crash tests, barriers must adhere to a set of crash test procedures to ensure the barriers perform as intended. Currently, the procedures for full-scale roadside barrier crash tests used to evaluate the crash performance of roadside safety hardware are outlined in The Manual for Assessing Safety Hardware (MASH) [4]. During roadside barrier tests, the assessment of occupant injury risk is crucial, as the purpose of the hardware is to prevent the vehicle from colliding with a more detrimental roadside object, all the while minimizing, and not posing additional, risk to the occupants. Unlike the new vehicle regulatory crash tests conducted by the National Highway Traffic Safety Administration (NHTSA), MASH does not require the use of instrumented anthropomorphic test devices (ATD). Instead, one of the prescribed occupant risk assessment methods in MASH is the flail space model (FSM), which was introduced in 1981 and models an occupant as an unrestrained point mass. The FSM is comprised of two crash severity metrics that can be calculated using acceleration data from the test vehicle. Each metric is prescribed a maximum threshold in MASH and if either threshold is exceeded during a crash test the test fails due to high occupant injury risk. Since the inception of the FSM metrics and their thresholds, the injury prediction capabilities of these metrics have only been re-investigated in the frontal crash mode, despite MASH prescribing an oblique 25-degree impact angle for passenger vehicle barrier tests. The focus of this dissertation was to use EDR data from real-world crashes to assess the current relevance of roadside barrier crash test occupant risk assessment methods to the modern vehicle fleet and occupant population. Injury risk prediction models were constructed for the two FSM-based metrics and five additional crash severity metrics for three crash modes: frontal, side, and oblique. For each crash mode and metric combination, four injury prediction models were constructed: one to predict probability of injury to any region of the body and three to predict probability of injury to the head/face, neck, and thorax regions. While the direct application of these models is to inform future revisions of MASH crash test procedures, the developed models have valuable applications for other areas of transportation safety besides just roadside safety. The final two chapters of this dissertation explore these additional applications: 1) assessing the injury mitigation effectiveness of an advanced automatic emergency braking system, and 2) informing speed limit selection that supports the safe system approach. The findings in this dissertation indicate that both the FSM and additional crash severity metrics do a reasonable job predicting occupant injury risk in oblique crashes. One of the additional metrics performs better than the two FSM metrics. Additionally, several occupant factors, such as belt status and age, play significant roles in occupant risk prediction. These findings have important implications for future revisions of MASH, which could benefit from considering additional metrics and occupant factors in the occupant risk assessment procedures. / Doctor of Philosophy / Every year, there are more than 35,000 fatalities due to crashes on United States roads. While there are many different types of crashes, there is a small collection of crash types that are responsible for the majority of these fatalities. One of the worst crash types is a road departure crash. Road departure crashes describe when a vehicle leaves the roadway and collides with an object off the roadway (such as a tree, pole, or ditch). Road departure crashes typically comprise 10% of crashes but are responsible for more than 30% of the annual crash fatalities. In 2020, road departure crashes were responsible for 50% of the 39,000 fatalities. One strategy that is currently used to reduce road departure fatalities is the use of roadside barriers. Common roadside barrier types include metal guardrails, concrete barriers, and cable guardrails, and are used to prevent vehicles that are departing the roadway from hitting an object that would be more dangerous than the barrier. To ensure barriers successfully protect the vehicle and vehicle occupants from heightened danger, they are crash tested in scenarios that are designed to mimic real-world crashes. The Manual for Assessing Safety Hardware (MASH) is the document that currently outlines the details necessary to conduct one of these crash tests. During roadside barrier tests, it is crucial to determine whether occupants are at risk of injury or fatality. For a variety of reasons, barrier tests do not use the traditional crash test dummies, which are designed to replicate human presence in a crash vehicle. Instead, MASH recommends using vehicle velocity data to assess how much risk is posed to an occupant. Using this velocity data, two values can be computed and if either value exceeds the maximum values provided in MASH, the crash test fails due to high occupant risk. The suggestion to use velocity data to assess occupant risk was first introduced in 1981. Since then, there have been significant advances in vehicle design, barrier design, and occupants' willingness to partake in safe habits, such as wearing seatbelts. Therefore, it is necessary to determine if the occupant risk values used in MASH are still applicable today. The focus of this dissertation was to use real-world crash data to assess the current relevance of roadside barrier crash test occupant risk values. The results presented in this dissertation can be used to select new occupant risk values in future versions of MASH. The findings within this dissertation show that the current methods in MASH do a good job estimating an occupant's risk of injury. Additionally, the findings show that certain occupant factors, such as the age of an occupant and whether the occupant is belted, help to more accurately estimate occupant injury risk. This finding has important implications for MASH, which does not currently consider different occupant conditions.

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Event data recorders (EDRs) are an invaluable data source that have begun to, and will increasingly, provide novel insight into motor vehicle crash characteristics. The "black boxes" in automobiles, EDRs directly measure precrash and crash kinematics. This data has the potential to eclipse the many traditional surrogate measures used in vehicle safety that often rely upon assumptions and simplifications of real world crashes. Although EDRs have been equipped in passenger vehicles for over two decades, the recent establishment of regulation has greatly affected the quantity, resolution, duration, and accuracy of the recorded data elements. Thus, there was not only a demand to reestablish confidence in the data, but a need to demonstrate the potential of the data. The objectives of the research presented in this dissertation were to (1) validate EDR data accuracy in full-frontal, side-impact moving deformable barrier, and small overlap crash tests; (2) evaluate EDR survivability beyond regulatory crash tests, (3) determine the seat belt accuracy of current databases, and (4) assess the merits of other vehicle-based crash severity metrics relative to delta-v. This dissertation firstly assessed the capabilities of EDRs. Chapter 2 demonstrated the accuracy of 176 crash tests, corresponding to 29 module types, 5 model years, 9 manufacturers, and 4 testing configurations from 2 regulatory agencies. Beyond accuracy, Chapter 3 established that EDRs are anecdotally capable of surviving extreme events of vehicle fire, vehicle immersion, and high delta; although the frequency of these events are very rare on U.S. highways. The studies in Chapters 4 and 5 evaluated specific applications intended to showcase the potential of EDR data. Even single value data elements from EDRs were shown to be advantageous. In particular, the seat belt use status may become a useful tool to supplement crash investigators, especially in low severity crashes that provide little forensic evidence. Moreover, time-series data from EDRs broadens the number of available vehicle-based crash severity metrics that can be utilized. In particular, EDR data was used to calculate vehicle pulse index (VPI), which was shown to have modestly increased predictive abilities of serious injury compared to the widely used delta-v among belted occupants. Ultimately, this work has strong implications for EDR users, regulatory agencies, and future technologies. / Ph. D.

Understanding the conflict potential of climate variability is critical for assessing and dealing with the societal implications of climate change. Yet, it remains poorly understood under what circumstances – and how – extreme weather events and variation in precipitation patterns affect organized violence. This dissertation suggests that the impacts of climate variability on organized violence are conditional on specific climate patterns, the sensitivity of livelihoods, and state governance. These theoretical conjectures are subjected to novel empirical tests in four individual essays. Three essays investigate the relationship between climate variability and communal and civil conflict through sub-national quantitative analysis focusing on Sub-Saharan Africa. The fourth essay sheds light on causal mechanisms leading to participation in land-related conflict based on interview material on 75 ex-participants in violence from Mt. Elgon, Kenya. Essay I suggests that the exposure of vulnerable agricultural livelihoods to sustained drought increases the risk of civil conflict violence. Essay II indicates that rainfall anomalies increase the risk of communal violence, an effect which is amplified by political marginalization. Essay III finds support for the proposition that volatility in resource supply increases the risk of communal conflict over land and water in remote regions, which tend to have limited state presence. Essay IV proposes that individuals depending on agriculture are prone to participate in land-related conflict as they face impediments to leaving a conflict zone, and additionally have high incentives to partake in fighting for land. Taken together, the dissertation furthers our understanding of the specific economic and political context under which climate variability impacts armed conflict. This knowledge is important for conflict-sensitive adaptation to climate change and conflict prevention efforts.

There are many different types of automatic data collection technologies that have been used in transportation system applications such as pneumatic tubes, radar, video cameras, inductive loops detectors, wireless toll tags, and global positioning systems (GPS). Nevertheless, there are still multiple examples of important and helpful transportation system data that still require manual data collection. In this research, the automatic transportation system data collection capabilities are expanded by enhancements in the use of wireless communications technology. In recent years, smartphones and electronic peripherals with wireless communication capabilities have become very popular. Many of these electronic devices include a Bluetooth or Wi-Fi wireless radio, whose presence in a vehicle can be used as a vehicle identifier. With wireless on-board devices available now and in the future, this research explores how roadside data collection units (DCUs) communicating with on-board devices can be used for the automated data collection of important road system data such as intersection performance data. To this end, two approaches for wirelessly collecting vehicle movement over a short road segment were explored. One approach utilized the collection and triangulation of wireless signal strength data, and demonstrated the capabilities and limitations of this approach. The second approach focused on developing methods for utilizing wireless signal strength data for vehicle point detection and identification. The vehicle point detection methods developed were applied to collect travel time data over signalized arterial roads, and to collect intersection delay data for a three way stop controlled intersection. The results from these case studies indicate a significant advantage in the proposed data collection system over the existing data collection approaches presented in the literature. / Graduation date: 2013

V této práci se zabýváme metodami pro regresní analýzu výskytu opako- vaných událostí, při které je třeba se vypořádat se závislostí čas· do události v rámci jednoho subjektu. V první části práce se zabýváme možným rozšířením Coxova modelu proporcionálního rizika, který se využívá při analýze cenzoro- vaných dat, pro analýzu výskytu opakovaných událostí. Hlavní část práce je věnována odhadu parametr· v marginálních modelech a jejich asymptotickým vlastnostem. Následně se zabýváme i odhadem parametr· v marginálních mo- delech pro mnohorozměrná cenzorovaná data. Vhodnost použití marginálních model· je zkoumána pomocí simulací. 1

Pedal misapplication (PM) is an error in which a driver unintentionally presses the wrong pedal. When drivers mistake the accelerator pedal for the brake pedal, the vehicle experiences a sudden unintended acceleration, and the consequences can be severe. A brief history of PM is covered, and several novel studies of PM are described. The goals of these studies were as follows: 1. Identify and analyze multiple samples of PM crashes from a variety of data sources using both established and novel methods to gain new insight into the characteristics and frequency of PM crashes. 2. Use the confirmed, real-world PM crash data to develop a custom vehicle dynamics simulation and evaluate the overall potential safety benefit of a theoretical PM advanced driver assistance system. Using an established keyword search identification method and two unique crash datasets, a PM crash frequency of approximately 0.2% of all crashes was found. These PM crashes were typically rear-end or road departure crashes in moderate- to low-speed commercial or residential areas. Female drivers and elderly drivers were more often involved in these PM crashes, which generally featured slightly lower injury severities and often involved inattention or fatigue. Anecdotally, PM crash narratives contained repeated evidence of unexpected events, driver inexperience, distraction, shoe-malfunction, extreme stress, and medical conditions/emergencies. A novel PM crash identification algorithm was developed to detect PMs from time-series pre-crash data. This algorithm was applied to a sample of crashes with event data recorder data available, and a frequency of 4.3% of eligible crashes were found to have exhibited PM behavior, suggesting that PM crashes may be more prevalent than previously thought. While the data from these crashes suggested that a PM occurred, this dataset lacked sufficient data regarding driver intention, which is necessary to confirm each crash as PMs. The characteristics of these PM-like crashes were analyzed and found to be largely similar to those of previous samples, with notable exceptions for higher proportions of male drivers, higher travel speeds, and higher maximum injury severities. More robust data from a naturalistic driving study (NDS) was acquired, and the novel algorithm was applied to all of the sample’s eligible crashes. Because the NDS data contained more data elements such as driver-facing video, crashes that exhibited PM behavior were individually inspected to confirm PM. This produced a PM crash frequency of 1.1%. The characteristics of these confirmed PM crashes were investigated, but a small sample size limits the generalizability of the results. Lastly, crash data from confirmed, real-world PM crashes was used to inform a custom vehicle dynamics model into which a theoretical PM advanced driver assistance system was simulated. The effect of the accelerator suppression system on crash avoidance and mitigation was evaluated to assess its potential safety benefit, which was found to be highly dependent on system threshold values and largely underwhelming in the absence of supplemental braking. The results indicated that a system that detected PM, suppressed acceleration, and applied braking could provide a substantially higher safety benefit. / M.S. / Pedal misapplication (PM) occurs when a driver presses the wrong pedal. When drivers mistake the accelerator pedal for the brake pedal, the vehicle experiences a sudden unintended acceleration, and the consequences can be severe. A history of the controversial subject of PM is covered, and several novel studies of PM are described. In these studies, PM crashes are identified among documented real-world crashes. This is done in three phases: (1) using narratives written by law-enforcement officers or crash investigators, (2) using event data recorders, or “black boxes,” that store vehicle data prior to crashes, and (3) using naturalistic driving study data, including video recordings of subjects during daily driving. These data are analyzed to develop the understanding of how often PM crashes occur and what factors are common among them. It is discovered that the frequency of PM crashes may be an order of magnitude greater than previously estimated. In the final study, real-world PM crash data is used to virtually reconstruct PM crashes and apply an advanced driver assistance system designed to detect PM, suppress the accelerator input, and reduce the severity of the crash or prevent it altogether. By simulating a wide range of system variations, we develop a sense of the feasibility of such a system’s implementation and overall safety benefit.

Most statistical methods to design and analyze randomized controlled trials with time-to-event data, and synthesize their results in meta-analyses, use the hazard ratio (HR) as the measure of treatment effect. However, the HR relies on the proportional hazard assumption which is often violated, especially in cancer trials. In addition, the HR might be challenging to interpret and is frequently misinterpreted as a risk ratio (RR). In meta-analysis, conventional methods ignore that HRs are estimated over different time supports when the component trials have different follow-up durations. These issues also pertain to advanced statistical methods, such as network meta-analysis and surrogate endpoints validation. Novel methods that rely on the difference in restricted mean survival times (RMST) would help addressing these issues. In this dissertation, I first developed a Bayesian network meta-analysis model using the difference in RMST. This model synthesizes all the available evidence from multiple time points and treatment comparisons simultaneously through within-study covariance and between-study covariance for the differences in RMST. I proposed an estimator of the within-study covariance and estimated the model under the Bayesian framework. The simulation studies showed adequate performance in terms of mean bias and mean squared error. I illustrated the model on a network of randomized trials of second-line treatments of advanced non-small-cell lung cancer. Second, I introduced a novel two-stage meta-analytical model to evaluate trial-level surrogacy. I measured trial-level surrogacy by the coefficient of determination at multiple time points based on the differences in RMST. The model borrows strength across data available at multiple time points and enables assessing how the strength of surrogacy changes over time. Simulation studies showed that the estimates of coefficients of determination are unbiased and have high precision in almost all of the scenarios we examined. I demonstrated my model in two individual patient data meta-analyses in gastric cancer. Both methods, for network meta-analysis and surrogacy evaluation, have the advantage of not involving extrapolation beyond the observed time support in component trials and of not relying on the proportional hazard assumption. Finally, motivated by the common misinterpretation of the HR as a RR, I investigated the theoretical relationship between the HR and the RR and compared empirically the treatment effects measured by the HR and the RR in a large sample of oncology RCTs. When there is evidence of superiority for experimental group, misinterpreting the HR as the RR leads to overestimating the benefits by about 20%. / 2026-02-08T00:00:00Z