Design and Numerical Implementation of V2X Control Architecture for Autonomous Driving Vehicles

This paper is concerned with designing and numerically implementing a V2X (Vehicle-to-Vehicle and Vehicle-to-Infrastructure) control system architecture for a platoon of autonomous vehicles. The V2X control architecture integrates the well-known Intelligent Driver Model (IDM) for a platoon of Autonomous Driving Vehicles (ADVs) with Vehicle-to-Infrastructure (V2I) Communication. The main aim is to address practical implementation issues of such a system as well as the safety and security concerns for traffic environments. To this end, we first investigated a channel estimation model for V2I communication. We employed the IEEE 802.11p vehicular standard and calculated path loss, Packet Error Rate (PER), Signal-to-Noise Ratio (SNR), and throughput between transmitter and receiver end. Next, we carried out several case studies to evaluate the performance of the proposed control system with respect to its response to: (i) the communication infrastructure; (ii) its sensitivity to an emergency, inter-vehicular gap, and significant perturbation; and (iii) its performance under the loss of communication and changing driving environment. Simulation results show the effectiveness of the proposed control model. The model is collision-free for an infinite length of platoon string on a single lane road-driving environment. It also shows that it can work during a lack of communication, where the platoon vehicles can make their decision with the help of their own sensors. V2X Enabled Intelligent Driver Model (VX-IDM) performance is assessed and compared with the state-of-the-art models considering standard parameter settings and metrics

Retention of foreign body in the gut can be a sign of congenital obstructive anomaly: a case report

<p>Abstract</p> <p>Introduction</p> <p>Small smooth objects that enter the gut nearly always pass uneventfully through the gastrointestinal tract. Retention of foreign objects may occur due to congenital obstructive anomaly of the gut.</p> <p>Case presentation</p> <p>We report here a child who presented with features of small gut obstruction which were attributed to a foreign body impacted in the intestine. At surgery, an annular pancreas was detected and the foreign body was found to be lodged in the distended proximal duodenum.</p> <p>Conclusion</p> <p>The reported case highlights the fact that an impacted radio-opaque foreign body in a child should warn the pediatrician to the possibility of an obstructive congenital anomaly.</p

Malignant duodeno-colic fistula

Colo-duodenal fistula is a rare complication of gastro-intestinal malignancy and inflammatory bowel disease. The fistula often results in diarrhea and vomiting with dramatic weight loss. Vomiting may be feculent or truly fecal associated with foul smelling eructation. We present an unusual case of colonic carcinoma, where a 61-year-old female patient presented with pain abdomen and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Ultrasonography showed a mass in the hepatic flexure area, and invasive adenocarcinoma was confirmed on histology from biopsy obtained during colonoscopy. Coloduodenal fistulae from colonic primaries are rare, but early diagnosis may allow curative surgery

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure &lt;65 mm Hg at least once, &lt;90 mm Hg for &gt;30 minutes, new or increase need of vasopressors or fluid bolus &gt;15 mL/kg), severe hypoxemia (peripheral oxygen saturation &lt;80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently