Driving Under the (Cellular) Influence: The Link Between Cell Phone Use and Vehicle Crashes

The link between cell phone use while driving and crash risk has in recent years become an area of active research. The most notable of the over 125 studies has concluded that cell phones produce a four-fold increase in relative crash risk comparable to that produced by illicit levels of alcohol. In response, policy makers in fourteen states have either partially or fully restricted driver cell phone use. We investigate the causal link between cellular usage and crash rates by exploiting a natural experiment induced by a popular feature of cell phone plans in recent years'the discontinuity in marginal pricing at 9 pm on weekdays when plans transition from 'peak' to 'off-peak' pricing. We first document a jump in call volume of about 20-30% at 'peak' to 'off-peak' switching times for two large samples of callers from 2000-2001 and 2005. Using a double difference estimator which uses the era prior to price switching as a control (as well as weekends as a second control), we find no evidence for a rise in crashes after 9 pm on weekdays from 2002-2005. The 95% CI of the estimates rules out any increase in all crashes larger than .9% and any increase larger than 2.4% for fatal crashes. These estimates are at odds with the crash risks implied by the existing research. We confirm our results with three additional empirical approaches'we compare trends in cell phone ownership and crashes across areas of contiguous economic activity over time, investigate whether differences in urban versus rural crash rates mirror identified gaps in urban-rural cellular ownership, and finally estimate the impact of legislation banning driver cell phone use on crash rates. None of the additional analyses produces evidence for a positive link between cellular use and vehicle crashes.

Comparative Evaluation of Preloading with Dextran, Hydroxyethyl Starch, Polygelatine and Ringer Lactate for Prevention of Hypotension Following Spinal Anaesthesia

Background: A good number of routine and emergency surgical procedures are done under spinal anaesthesia. Hypotension is the most common cardiovascular response of spinal anaesthesia which may be associated with serious patient discomfort and mortality. Preloading has proved to be the most effective method for prevention of post spinal hypotension. Preloading is rapid administration of crystalloid or colloid solution before giving spinal or epidural block.Aim: To study the effect of pre-operative infusion of Ringer Lactate, Hydroxyethyl starch, Dextran 40 and Polygelatine to prevent spinal hypotension and compare the effect of preloading with different colloids. Material & Methods: 100 patients, ASA physical status of I and II undergoing elective surgeries between the age group of 21 to 60 years were randomized into four groups depending upon the type of fluid (Hydroxyethyl starch, Dextran-40, Polygelatine and Ringer Lactate) used for preloading the patients before the subarachnoid block. In case of hypotension, Inj. Mephentermine(3mg) was injected to maintain blood pressure. The number of boluses of Inj. Mephentermine were recorded. Results: Incidence of hypotension in group R preloaded with Ringer lactate solution is 56%, group H preloaded with HES is 24%, group D preloaded with Dextran 40 is 32% and group P Polygelatine is 36%. This was statistically found to be highly significant (p<0.001). when compared between groups, it was also observed that the use of mephenteramine as vasopressor was minimum in Hydroxyethyl Starch (HES) group as compair to the Ringer Lactate, Dextran and Polygelatine groups. The use of mephentermine was found higest in the Ringer lactate group. Conclusion: Subarachnoid block is associated with significant incidence of hypotension. In prevention of post subarachnoid block hypotension preloading with Hydroxyethyl Starch (HES)  is more effective than the Ringer Lactate, Dextran and Polygelatine

A Comparative Study of Effect of Propofol, Etomidate Lipuro and Propofol-Etomidate Lipuro Admixture on Haemodyanamic Response and on BIS Values at Induction of General Anaesthesia- A RCT

Background: Patients undergoing elective surgical procedures require an anesthetic agent which would provide a smooth, pleasant, rapid induction and recovery along with   hemodynamic stability and minimal side effects. To achieve these goals Propofol, Etomidate and propofol – etomidate lipuro admixture may be the agents of choice. Bispectral index (BIS) monitoring has emerged as a convenient and versatile tool to titrate hypnotic agentsAim: 1. To compare the time of onset, of ,loss of consciousness and induction of anaesthesia using BIS index value among the propofol (1%), etomidate-lipuro (0.2%) and 50% (1:1) admixture of these agents (Etofol) in various  procedures to choose the better induction agent. 2. To compare the hemodynamic changes caused by these agents.Material and methods:90 patients of either sex and of ASA physical status I or II scheduled for elective surgery under general anesthesia were selected for the study and were randomly placed into three groups. Group P was induced with intravenous Propofol 1%, Group E with intravenous Etomidate (2mg/ml) and Group PE with intravenous mixture of Propofol plus Etomidate (1:1) @ 400ml/hr till the BIS value reached 40.  Patient was considered to be induced once the BIS value reached 40 and this time was noted for all three groups.  BIS values and hemodynamic measurements were recorded before induction (T1), at induction (T2), before intubation (T3) after intubation (T4) and then after intubation, at 1 min (T5), at 3 min (T6), at 5 min (T7) and at 10 min (T8).Results: The Induction (time to reach BIS value of 40) was fastest in Etofol group. Induction dose of Etofol provided better control of BIS values after orotracheal intubation. It was also noted that Heart Rate remained near baseline in Etofol group at different time intervals. In the Post intubation period, a significant increase in the Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP), was noted in Group E. The increase in blood pressure at different intervals after intubation was found to be lowest in Group PE.Conclusion: We conclude that Etofol is associated with a shorter induction time and better haemodyanamic stability than Etomidate and Propofol alone. It also provides effective control of BIS values during induction, orotracheal intubation and thereafter. Key words: Etomidate, Propofol, Etofol, bispectral index (BIS) and haemodyanamic stability

MHD Flow Heat and Mass Transfer of Micropolar Fluid over a Nonlinear Stretching Sheet with Variable Micro Inertia Density, Heat Flux and Chemical Reaction in a Non-darcy Porous Medium

This paper investigates the two dimensional flow, heat and mass transfer of chemically reacting Micropolar fluid over a non-linear stretching sheet with variable heat flux in a non-darcy porous medium. The rate of chemical reaction is assumed to be constant throughout the fluid i.e. homogenous. Using a similarity transformation, the governing partial differential equations are transformed into a system of ordinary differential equation, which is then solved using Finite element method. Numerical results regarding local Nussult No. are shown graphically with Magnetic number (ܰ݉௫) for variation in heat transfer exponent (n). This study also analyzes the effect of velocity exponent m, heat transfer exponent n, material parameter K, Magnetic Number(ܰ݉௫)Darcy NumberDax, Forchheimer Number Nfx, Prandtl number Pr, Schmidt Number Sc and Chemical reaction rate parameter x on velocity, microrotation, temperature and concentration profiles. Velocity exponent m has a positive effect on the velocity, temperature and concentration profiles while microrotation decreases as m increases. Graphical results shows that the thermal boundary layer thickness decreases at and near the wall with the increase in heat flux exponent n. Also an increase in K leads to a decrease in skin friction parameter as well as the wall couple stress

APPLICATIONS ON TOP OF DNA CENTER: SOFTWARE FACILITATED METHOD TO RELIABLY ISOLATE, REMOVE AND INSERT DEVICES IN THE NETWORK

A set of software functions is presented to allow network operators to reliably manage network changes with minimal or no impact to other parts of a currently operating network. Software functions in a centralized network controller such as Digital Network Architecture Center (DNAC) provide network assessment, automation, and mechanism for Graceful Insertion Removal (GIR) feature to communicate with controller for operational reliability. These software functions provide a secured communication channel to an extended version of GIR for easier use along with predictable and reliable network change management. The present techniques provide a centralized mechanism for a reliable and assured network change management using both the capabilities of the centralized controller and distributed devices

Sensitivity Analysis of Pulsatile Hydromagnetic Biofluid Flow and Heat Transfer with Non Linear Darcy-Forchheimer Drag

In the present paper we examine the pulsatile hydromagnetic flow and heat transfer of a non-Newtonian biofluid through a saturated non-Darcian porous medium channel. The upper plate of the channel is heated and the lower plate is cooled. The Nakamura-Sawada rheological model is employed which provides a higher yield stress than the Casson model. A Darcy-Forchheimer porous medium drag force model is incorporated to simulate blood vessel blockage with deposits in the cardiovascular system. Viscous heating is also included in the energy equation. The governing conservation equations for mass, momentum and energy equation are transformed into a system of nonlinear, coupled ordinary differential equations and these are solved numerically using finite element method. The effect of other important parameters such as magnetohydrodynamic parameter (Nm), Reynolds number (Re), Eckert number (Ec), Darcian parameter (), Forchheimer parameter (NF) and Prandtl number on velocity and temperature profiles are studied graphically. Spatial-temporal velocity and temperature profile visualizations are also presented. Numerical results shows that normalized fluid velocity (U) increases throughout the channel (-1 < Y < 1) with an increase in Reynolds number, Darcian parameter, steady pressure gradient parameter and rheological parameter; conversely velocity is decreased with the increase in magnetic parameter and Forchheimer quadratic drag parameter. Higher Eckert number (Ec = 3) is also found to have a considerable effect on temperature () profile. Finite difference numerical computations are also compared with the finite element solutions to verify efficiency and accuracy

Second Primary Lung Cancer with Glottic Laryngeal Cancer as Index Tumor – A Case Report

Patients with laryngeal cancer have a high risk of developing lung cancer in the future. A patient presented with a complaint of left-sided chest pain for the last 3 months. Chest X-ray posterior-anterior view showed a homogeneous opacity in the left upper lung field with elevation of the diaphragm on the left side. CECT thorax revealed a heterogeneously enhancing soft tissue density mass lesion in the superior segment of the lingular lobe. On histopathological examination of the mass lesion, it was diagnosed as adenocarcinoma of the lung. About 10 months previously, the patient was treated for a laryngeal squamous cell carcinoma. Patients with laryngeal cancer should be routinely screened during follow-up with chest X-ray or CT scan for the early detection of lung cancer

Multimodal microscopy for automated histologic analysis of prostate cancer

<p>Abstract</p> <p>Background</p> <p>Prostate cancer is the single most prevalent cancer in US men whose gold standard of diagnosis is histologic assessment of biopsies. Manual assessment of stained tissue of all biopsies limits speed and accuracy in clinical practice and research of prostate cancer diagnosis. We sought to develop a fully-automated multimodal microscopy method to distinguish cancerous from non-cancerous tissue samples.</p> <p>Methods</p> <p>We recorded chemical data from an unstained tissue microarray (TMA) using Fourier transform infrared (FT-IR) spectroscopic imaging. Using pattern recognition, we identified epithelial cells without user input. We fused the cell type information with the corresponding stained images commonly used in clinical practice. Extracted morphological features, optimized by two-stage feature selection method using a minimum-redundancy-maximal-relevance (mRMR) criterion and sequential floating forward selection (SFFS), were applied to classify tissue samples as cancer or non-cancer.</p> <p>Results</p> <p>We achieved high accuracy (area under ROC curve (AUC) >0.97) in cross-validations on each of two data sets that were stained under different conditions. When the classifier was trained on one data set and tested on the other data set, an AUC value of ~0.95 was observed. In the absence of IR data, the performance of the same classification system dropped for both data sets and between data sets.</p> <p>Conclusions</p> <p>We were able to achieve very effective fusion of the information from two different images that provide very different types of data with different characteristics. The method is entirely transparent to a user and does not involve any adjustment or decision-making based on spectral data. By combining the IR and optical data, we achieved high accurate classification.</p