The Draft 2015 Indiana Strategic Highway Safety Plan

Indiana’s ability to expend federal Highway Safety Improvement Program (HSIP) funds requires implementing a data-driven Strategic Highway Safety Plan (SHSP), which guides the types of roadway infrastructure countermeasures preferred for HSIP funding. Learn about what an analysis of the nearly two million police crash reports filed in Indiana since 2004 reveals about the state’s traffic safety improvement needs and what emphasis areas are targeted in the draft 2015 SHSP

War and Peace in the Western Political Imagination

The study of war in all periods of prehistory and recorded history has always commanded the attention of historians, dramatists, poets and artists. The study of peace has, however, not yet gained a comparable readership, and the subject is attracting an increasing amount of scholarly research. This volume presents the first work of academic research to tackle this imbalance head on. It looks at war and peace through the ages, from the Classical world through to the 18th century. It considers the nature and advocacy of war and peace both from an historical perspective but also a philosophical one, particularly looking at how universal peace, which began as a personal philosophy, became over the centuries a political philosophy that underpins much of modern society’s attitudes towards warfare and militarism

Safety Performance measures Target Setting

In 2016 the FHWA issued new rules that govern performance management for a number of transportation areas. In this session we explore the new rules that apply to the area of traffic safety, in particular the requirements that both state DOTs and metropolitan planning organizations must set performance goals and begin reporting their annual progress toward meeting those targets

Grey matter volume and cortical structure in Prader-Willi syndrome compared to typically developing young adults.

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder of genomic imprinting, presenting with a characteristic overeating disorder, mild to moderate intellectual disability, and a variable range of social and behavioral difficulties. Consequently, widespread alterations in neural structure and developmental and maturational trajectory would be expected. To date, there have been few quantitative and systematic studies of brain morphology in PWS, although alterations of volume and of cortical organisation have been reported. This study aimed to investigate, in detail, the structure of grey matter and cortex in the brain in a sample of young adults with PWS in a well-matched case-controlled analysis. 20 young adults with PWS, aged 19-27 years, underwent multiparameter mapping magnetic resonance imaging sequences, from which measures of grey matter volume, cortical thickness and magnetisation transfer saturation, as a proxy measure of myelination, were examined. These variables were investigated in comparison to a control group of 40 typically developing young adults, matched for age and sex. A voxel-based morphometry analysis identified large and widespread bilateral clusters of both increased and decreased grey matter volume in the brain in PWS. In particular, widespread areas of increased volume encompassed parts of the prefrontal cortex, especially medially, the majority of the cingulate cortices, from anterior to posterior aspects, insula cortices, and areas of the parietal and temporal cortices. Increased volume was also reported in the caudate, putamen and thalamus. The most ventromedial prefrontal areas, in contrast, showed reduced volume, as did the parts of the medial temporal lobe, bilateral temporal poles, and a small cluster in the right lateral prefrontal cortex. Analysis of cortical structure revealed that areas of increased volume in the PWS group were largely driven by greater cortical thickness. Conversely, analysis of myelin content using magnetisation transfer saturation indicated that myelination of the cortex was broadly similar in the PWS and control groups, with the exception of highly localised areas, including the insula. The bilateral nature of these abnormalities suggests a systemic biological cause, with possible developmental and maturational mechanisms discussed, and may offer insight into the contribution of imprinted genes to neural development

Pathophysiology and diagnostic approach to laryngomalacia in infants

SummaryLaryngomalacia is defined as collapse of supraglottic structures during inspiration. It is the most common laryngeal disease of infancy. Laryngomalacia presents in the form of stridor, a high-pitched, musical, vibrating, multiphase inspiratory noise appearing within the first 10 days of life. Signs of severity are present in 10% of cases: poor weight gain (probably the most contributive element), dyspnoea with permanent and severe intercostal or xyphoid retraction, episodes of respiratory distress, obstructive sleep apnoea, and/or episodes of suffocation while feeding or feeding difficulties. The diagnosis is based on systematic office flexible laryngoscopy to confirm laryngomalacia and exclude other causes of supraglottic obstruction. Rigid endoscopy under general anaesthesia is only performed in the following cases: absence of laryngomalacia on flexible laryngoscopy, presence of laryngomalacia with signs of severity, search for any associated lesions prior to surgery, discrepancy between the severity of symptoms and the appearance on flexible laryngoscopy, and/or atypical symptoms (mostly aspirations). The work-up must be adapted to each child; however, guidelines recommend objective respiratory investigations in infants presenting signs of severity