Can shared surfaces be safely negotiated by blind and partially sighted people?

‘Shared Space’ schemes are designed to remove the physical distinction between pedestrian space and traffic space in the street environment to encourage more pedestrians to use the area. They may also make it easier for people with wheelchairs, prams or similar to negotiate the space. However, by removing the kerbs, blind and partially sighted people lose one of the key references that they normally use to know they are in a safe space away from vehicles and to navigate around the area. This study is intended to understand what people with visual impairments need from a surface to make it clearly detectable, given that it should not be a barrier to progress for people with other mobility limitations. With this information, some surfaces were tested to determine their suitability as a delineator. Approach and/or Methodology An experimental approach was adopted. People with mobility impairments and blind and partially sighted people were recruited. All participants used the normal street environment unaccompanied. The blind and partially sighted participants included people who use a guide dog, those who use a long cane and those who use no assistive device. The people with mobility impairments all used some form of mobility aid for example walking stick or wheelchair. The tests were run in the pedestrian testing facility PAMELA at UCL. The top surface of the test facility was predominantly concrete paving slab, but with test surfaces discretely located. The task for all participants was to travel from one designated place in the test area to another. For some of these trials the participant would encounter one of the test surfaces, but on other trials they would not. After each trial the participants were asked to rate how easy it was to detect a change in surface, or how easy it was to pass over the surface. The different surfaces included blister paving, corduroy paving, a central delineator, slopes, roughened surfaces, and traditional kerb upstands of different heights. Results or Expected Results None of the 400mm wide surfaces was detected by all participants. Changes in level through slopes were considered both positively and negatively, some people asking for steeper gradients and some less steep. Kerb heights below 60mm were not reliably detectable by blind or partially sighted people and are an obstacle to people in wheelchairs. Further tests on more surfaces are in process and the results will be incorporated into this paper. Conclusion Early suggestions for detectable surfaces – proposed in UK schemes - have been either a barrier to people with mobility impairments, or difficult to detect for blind and partially sighted people or both. The work presented in this paper shows the difficulty in finding a suitable dual purpose surface, yet clarifies the design requirements for shared space delineators for people with mobility impairments and blind or partially sighted people. This work has reinforced the point that 400mm width is insufficient to be used as a tactile surface. Further conclusions will be made after the additional surface tests. Topic Code: Ca C. Accessibility concerns and solutions for those with cognitive and sensory impairment a. Pedestrian safety at crossings and intersection

Investigation of Lighting Levels for Pedestrians - Some questions about lighting levels of current lighting standards

22-23 September, 200

Using Abbreviated Injury Scale (AIS) codes to classify Computed Tomography (CT) features in the Marshall System

<p>Abstract</p> <p>Background</p> <p>The purpose of Abbreviated Injury Scale (AIS) is to code various types of Traumatic Brain Injuries (TBI) based on their anatomical location and severity. The Marshall CT Classification is used to identify those subgroups of brain injured patients at higher risk of deterioration or mortality. The purpose of this study is to determine whether and how AIS coding can be translated to the Marshall Classification</p> <p>Methods</p> <p>Initially, a Marshall Class was allocated to each AIS code through cross-tabulation. This was agreed upon through several discussion meetings with experts from both fields (clinicians and AIS coders). Furthermore, in order to make this translation possible, some necessary assumptions with regards to coding and classification of mass lesions and brain swelling were essential which were all approved and made explicit.</p> <p>Results</p> <p>The proposed method involves two stages: firstly to determine all possible Marshall Classes which a given patient can attract based on allocated AIS codes; via cross-tabulation and secondly to assign one Marshall Class to each patient through an algorithm.</p> <p>Conclusion</p> <p>This method can be easily programmed in computer softwares and it would enable future important TBI research programs using trauma registry data.</p

Dysregulation of MicroRNA-34a Expression in Head and Neck Squamous Cell Carcinoma Promotes Tumor Growth and Tumor Angiogenesis

MicroRNAs (miRs) are small non-coding RNAs that play an important role in cancer development where they can act as oncogenes or as tumor-suppressors. miR-34a is a tumor-suppressor that is frequently downregulated in a number of tumor types. However, little is known about the role of miR-34a in head and neck squamous cell carcinoma (HNSCC).miR-34a expression in tumor samples, HNSCC cell lines and endothelial cells was examined by real time PCR. Lipofectamine-2000 was used to transfect miR-34a in HNSCC cell lines and human endothelial cells. Cell-proliferation, migration and clonogenic survival was examined by MTT, Xcelligence system, scratch assay and colony formation assay. miR-34a effect on tumor growth and tumor angiogenesis was examined by in vivo SCID mouse xenograft model. Our results demonstrate that miR-34a is significantly downregulated in HNSCC tumors and cell lines. Ectopic expression of miR-34a in HNSCC cell lines significantly inhibited tumor cell proliferation, colony formation and migration. miR-34a overexpression also markedly downregulated E2F3 and survivin levels. Rescue experiments using microRNA resistant E2F3 isoforms suggest that miR-34a-mediated inhibition of cell proliferation and colony formation is predominantly mediated by E2F3a isoform. In addition, tumor samples from HNSCC patients showed an inverse relationship between miR-34a and survivin as well as miR-34a and E2F3 levels. Overexpression of E2F3a completely rescued survivin expression in miR-34a expressing cells, thereby suggesting that miR-34a may be regulating survivin expression via E2F3a. Ectopic expression of miR-34a also significantly inhibited tumor growth and tumor angiogenesis in a SCID mouse xenograft model. Interestingly, miR-34a inhibited tumor angiogenesis by blocking VEGF production by tumor cells as well as directly inhibiting endothelial cell functions.Taken together, these findings suggest that dysregulation of miR-34a expression is common in HNSCC and modulation of miR34a activity might represent a novel therapeutic strategy for the treatment of HNSCC

Operant Sensation Seeking Requires Metabotropic Glutamate Receptor 5 (mGluR5)

Pharmacological and genetic studies have suggested that the metabotropic glutamate receptor 5 (mGluR5) is critically involved in mediating the reinforcing effects of drugs of abuse, but not food. The purpose of this study was to use mGluR5 knockout (KO), heterozygous (Het), and wildtype (WT) mice to determine if mGluR5 modulates operant sensation seeking (OSS), an operant task that uses varied sensory stimuli as a reinforcer. We found that mGluR5 KO mice had significantly reduced OSS responding relative to WT mice, while Het mice displayed a paradoxical increase in OSS responding. Neither KO nor Het mice exhibited altered operant responding for food as a reinforcer. Further, we assessed mGluR5 KO, Het and WT mice across a battery of cocaine locomotor, place preference and anxiety related tests. Although KO mice showed expected differences in some locomotor and anxiety measures, Het mice either exhibited no phenotype or an intermediate one. In total, these data demonstrate a key role for mGluR5 in OSS, indicating an important role for this receptor in reinforcement-based behavior

Modulation of Syndecan-1 Shedding after Hemorrhagic Shock and Resuscitation

The early use of fresh frozen plasma as a resuscitative agent after hemorrhagic shock has been associated with improved survival, but the mechanism of protection is unknown. Hemorrhagic shock causes endothelial cell dysfunction and we hypothesized that fresh frozen plasma would restore endothelial integrity and reduce syndecan-1 shedding after hemorrhagic shock. A prospective, observational study in severely injured patients in hemorrhagic shock demonstrated significantly elevated levels of syndecan-1 (554±93 ng/ml) after injury, which decreased with resuscitation (187±36 ng/ml) but was elevated compared to normal donors (27±1 ng/ml). Three pro-inflammatory cytokines, interferon-γ, fractalkine, and interleukin-1β, negatively correlated while one anti-inflammatory cytokine, IL-10, positively correlated with shed syndecan-1. These cytokines all play an important role in maintaining endothelial integrity. An in vitro model of endothelial injury then specifically examined endothelial permeability after treatment with fresh frozen plasma orlactated Ringers. Shock or endothelial injury disrupted junctional integrity and increased permeability, which was improved with fresh frozen plasma, but not lactated Ringers. Changes in endothelial cell permeability correlated with syndecan-1 shedding. These data suggest that plasma based resuscitation preserved endothelial syndecan-1 and maintained endothelial integrity, and may help to explain the protective effects of fresh frozen plasma after hemorrhagic shock