Quantifying Road User Costs with Heterogeneous Value of Motorists' Travel Time

The state transportation agencies (STAs) in the United States are mandated by federal rule to carry out work-zone impact assessment for highway rehabilitation projects. The work zone impact assessment requires calculating road user costs (RUCs) which is the sum of vehicle operating costs, accident costs, and value of time (VOT). The term ‘value of time’ refers to monetary equivalent of travel time wasted due to rehabilitation projects. In current practice, STAs assume VOT as homogeneous within their respective states. This leads to inaccurate RUCs calculations and poses many misapplications. Research has found that VOT is influenced by socio-demographic variables which vary within the states. But there is a lack of framework to evaluate the extent to which these factors affect value of time. The major objective of this research is to develop and validate a model that predicts value of time heterogeneously. The data were collected to cover 20 major cities in California. The state of California was chosen for this study because most highway rehabilitation projects are carried out there. The data sources included the United States Census Bureau, the California Department of Transportation (Caltrans), and the Bureau of Labor Statistics. With these data, a predictive model was developed using multiple linear regression analysis. Lastly, the model was validated using PRESS statistic. The results reveal that age, annual average daily traffic, and effective hourly income were the most significant factors influencing value of time. This study developed a model which will help Caltrans in calculating value of time heterogeneously and therefore, improve the accuracy of RUCs calculations. Moreover, this research will serve as a guideline for other STAs to develop models for respective states. Therefore, this model has a potential to greatly improve the accuracy of value of time and therefore, RUCs. The future research should focus on the identified factors, especially cost-of-living index and annual average daily traffic. Further research is required to account for heterogeneity due to other factors such as vehicle occupancy, frequency of travel, and educational qualifications

Exposing Nipah virus: an epidemiological study of another thread in Kerala, South India

Bats spread the Nipah virus, which causes severe encephalitis and high mortality. Multiple reports have come from Malaysia, Bangladesh, Singapore, and India. Pteropus fruit bats are known to host the virus. The virus has caused four outbreaks in Kerala in the past quinquennium. Scholars believe the virus is indigenous to the state's bat population. Climate change, resource depletion, deforestation, natural terrain changes, farming, and industrialization all contribute to viral disease outbreaks. In this review, we will discuss the epidemiological background of the previous NiV outbreak. We will also examine the transmission method epidemic prevention and control strategies and possible causes of the outbreak. Four Nipah epidemics have occurred in Kerala in the past five years. Expert investigation suggests that the virus may be endemic in the state’s bat population. Kerala, India, has many bat species. In 2018, research found viral infections in the local fruit bat population. Traditionally, people eat fresh toddy or sap from trees, which can be polluted by bats carrying the Nipah virus. Kerala's healthcare system also closely monitors unexplained fevers for Nipah virus infections. The World Health Organisation and Indian Council of Medical Research found that the entire state is susceptible to Nipah virus infections. The virus is a major cause of encephalitis outbreaks, which have high mortality rates, mostly in Indo-Bangladesh

Management of post-operative wound in dental surgeries using proteolytic enzyme-flavonoid combination of trypsin, bromelain and rutoside: a single-centre experience

Background: Appropriate surgical wound management is required to prevent post-operative complications, including delayed wound-healing which may result in increased hospital stay. The present study aimed to evaluate the efficacy and safety of oral administration of a fixed dose combination of trypsin-bromelain-rutoside in the post-operative management after dental surgeries.Methods: The study was a prospective, observational data collection exercise. Hundred subjects undergoing dental surgeries, who were administered trypsin-bromelain-rutoside combination, were observed over a period of 8 days post-surgery. Verbal rating scales were used for grading the pain intensity and extent of swelling, while a 5-point Likert scale was used to evaluate patient- and investigator-reported global assessment of improvement in pain and swelling. Scores at day 3 and day 8 were analysed using paired t test.Results: At day 3 and day 8, the mean scores of pain and swelling were significantly reduced from baseline (all p<0.0001). By day 8, 100% of the patients achieved complete resolution of pain, while mild swelling was reported in only 2 patients. At day 3, 95% patients reported good/ very good global improvement in pain and swelling; while at day 8, 100% reported good/ very good improvement. No adverse event was reported in any of the patients.Conclusions: The study results demonstrate that treatment with trypsin-bromelain-rutoside combination led to significant improvement in the post-operative pain and swelling. The use of this combination is useful for wound recovery and reducing the need for other analgesic and anti-inflammatory drugs

Assessment of lead toxicity on locomotion and growth in a nematode Caenorhabditis elegans

Due to anthropogenic activities and natural abundance, lead exposure is a common phenomenon. Neurotoxic and genotoxic effects of lead are widely known. Recent studies have suggested that lead exposure can affect young generation and transfer to the progeny thus posing a great threat for future generation. The present study was focused on lead toxicity in terms of locomotion and growth of Caenorhabditis elegans (N2 wild type) at three sub-lethal doses (3µM, 15 µM and 30 µM) of Pb (NO3)2 for 24 hours (sub-chronic exposure). Caenorhabditis elegans is a nematode with an established eco- toxicity marker model organism, due to its short life cycle and ease to monitor. After lead&nbsp; exposure, significant toxic manifestations were observed in locomotion of the nematode in terms of omega bends (+350% for 30 µM exposure dose, p&lt;0.001), reversals (-26.98%, -49% and -66.35% for 3 µM, 15 µM and 30 µM exposure doses respectively, p&lt;0.001), turn counts (-38.66%, -62.61% and -81.93% for 3 µM, 15 µM and 30 µM exposure doses respectively, p&lt;0.001 ) and peristaltic speed alterations (+97.83%, +225.92% and +454.63% for 3 µM, 15 µM and 30 µM exposure doses respectively, p&lt;0.001). Successive reduction in the body length at lower doses shows remarkable toxic alterations in nematodes. The obtained data may be useful to extrapolate the effects of lead exposure on humans, as many of the similar pathways and cellular processes affected by Pb in humans are also present in C. elegans

The ethics and governance of stem cell clinical research in India

India is rapidly becoming established as a major player in the stem cell sector. However, concerns have been raised about the use of unproven stem cell therapies and the exploitation of parents for cord blood banking. This study aims to explore the nature of stem cell activities, how key stakeholders generate expectations around them and frame the ethical issues they raise, and why the biomedical governance system is unable to regulate these emerging practices. The study involved a survey, documentary analysis and qualitative interviews with key scientists, clinicians, representatives of firms and policymakers. The thesis observes that, unlike international commentaries which largely focus on embryonic stem cell treatments, in India it is adult and cord blood stem cells which are dominant in research and clinical settings. Expectations are configured on the basis that stem cells have the potential to: solve the problem of organ shortage; help patients with ailments; provide affordable health care; and establish India as a global player. The creation of expectations is ethically problematic given the potential health risks and economic exploitation of both native and international patients. However, the ethically contested activities are justified by clinicians on the basis that the Helsinki Declaration allows to use an experimental therapy; there are many 'desperate patients' demanding these treatments; and adult stem cells are safe. To date, the government of India appears to be unable to prevent these activities. Contrary to suggestions in previous literature and by some informants that new legislation is needed to address the problem, this thesis finds that state-led mechanisms for biomedical governance lack the ability to implement existing oversight measures. This implementation gap is partly because other forms of governance are not strong enough and partly because there are high expectations at state level aimed at establishing India as a global player in the stem cell sector

The ethics and governance of stem cell clinical research in India

India is rapidly becoming established as a major player in the stem cell sector. However, concerns have been raised about the use of unproven stem cell therapies and the exploitation of parents for cord blood banking. This study aims to explore the nature of stem cell activities, how key stakeholders generate expectations around them and frame the ethical issues they raise, and why the biomedical governance system is unable to regulate these emerging practices. The study involved a survey, documentary analysis and qualitative interviews with key scientists, clinicians, representatives of firms and policymakers. The thesis observes that, unlike international commentaries which largely focus on embryonic stem cell treatments, in India it is adult and cord blood stem cells which are dominant in research and clinical settings. Expectations are configured on the basis that stem cells have the potential to: solve the problem of organ shortage; help patients with ailments; provide affordable health care; and establish India as a global player. The creation of expectations is ethically problematic given the potential health risks and economic exploitation of both native and international patients. However, the ethically contested activities are justified by clinicians on the basis that the Helsinki Declaration allows to use an experimental therapy; there are many 'desperate patients' demanding these treatments; and adult stem cells are safe. To date, the government of India appears to be unable to prevent these activities. Contrary to suggestions in previous literature and by some informants that new legislation is needed to address the problem, this thesis finds that state-led mechanisms for biomedical governance lack the ability to implement existing oversight measures. This implementation gap is partly because other forms of governance are not strong enough and partly because there are high expectations at state level aimed at establishing India as a global player in the stem cell sector