Safety Improvements On Multilane Arterials A Before And After Evaluation Using The Empirical Bayes Method

This study examines the safety effects of the improvements made on multi-lane arterials. The improvements were divided into two categories 1) corridor level improvements, and 2) intersection improvements. Empirical Bayes method, which is one of the most accepted approaches for conducting before-after evaluations, has been used to assess the safety effects of the improvement projects. Safety effects are estimated not only in terms of all crashes but also rear-end (most common type) as well as severe crashes (crashes involving incapacitating and/or fatal injuries) and also angle crashes for intersection improvements. The Safety Performance Functions (SPFs) used in this study are negative binomial crash frequency estimation models that use the information on ADT, length of the segments, speed limit, and number of lanes for corridors. And for intersections the explanatory variables used are ADT, number of lanes, speed limit on major road, and number of lanes on the minor road. GENMOD procedure in SAS was used to develop the SPFs. Corridor SPFs are segregated by crash groups (all, rear-end, and severe), length of the segments being evaluated, and land use (urban, suburban and rural). The results of the analysis show that the resulting changes in safety following corridor level improvements vary widely. Although the safety effect of projects involving the same type of improvement varied, the overall effectiveness of each of the corridor level improvements were found to be positive in terms of reduction in crashes of each crash type considered (total, severe, and rear-end) except for resurfacing projects where the total number of crashes slightly increased after the roadway section is resurfaced. Evaluating additional improvements carried out with resurfacing activities showed that all (other than sidewalk improvements for total crashes) of them consistently led to improvements in safety of multilane arterial sections. It leads to the inference that it may be a good idea to take up additional improvements if it is cost effective to do them along with resurfacing. It was also found that the addition of turning lanes (left and/or right) and paving shoulders were two improvements associated with a project�s relative performance in terms of reduction in rear-end crashes. No improvements were found to be associated with a resurfacing project�s relative performance in terms of changes in (i.e., reducing) severe crashes. For intersection improvements also the individual results of each project varied widely. Except for adding turn lane(s) all other improvements showed a positive impact on safety in terms of reducing the number of crashes for all the crash types (total, severe, angle, and rear-end) considered. Indicating that the design guidelines for this work type have to be revisited and safety aspect has to be considered while implementing them. In all it can be concluded that FDOT is doing a good job in selecting the sites for treatment and it is very successful in improving the safety of the sections being treated although the main objective(s) of the treatments are not necessarily safety related

Hereditary sensory autonomic neuropathy II, a rare disease in a large Pakistani family

Hereditary Sensory Autonomic Neuropathy II (HSAN II) is a rare genetic disorder, characterized by severe loss of pain, temperature and touch sensation. Injuries in these patients can progress to necrosis and shedding of digits and limbs. Here we report two cases of HSAN II belonging to a Pakistani family. Individual 1, a forty five year old man, had complete loss of pain sensation since birth. Self-mutilation and complication of injuries resulted in the shedding of all the digits and right foot and surgical amputation of left leg. Individual 2, a five year old girl,had delay in healing of wounds and self-mutilation. Examination showed a complete lack of pain sensation throughout her body and hyporeflexia. As the genetic cause of HSAN II is unknown, identification of more patients will allow further research on this disease and possibly develop a cure

Role of Diffusion Tensor Imaging in epilepsy

BACKGROUND: Diffusion Tensor Imaging (DTI) is a new non invasive MRI technique which provides insight into the white matter microstructure. In focal epilepsy widespread DTI abnormalities have been reported. In mesial temporal lobe sclerosis (MTLS) patients, although conventional MRI only shows unilateral involvement of the hippocampal sclerosis, DTI was found to be useful in demonstrating the spread of epileptiform activity to other regions of brain as well. AIM AND OBJECTIVES: We aimed to prove this hypothesis by assessing DTI measurements in various portions of the brain in MTLS patients. MATERIAL AND METHODS: We retrospectively evaluated 21 patients with unilateral MTLS by using DTI, MRI, clinical and EEG parameters. Of these 10 were Right sided and 11 were left sided MTLS. We compared the mean diffusivity (trace D) and fractional anisotropy (FA) from symmetrical voxels by sampling the following areas namely middle cerebellar peduncle, corpus callosum, uncinate fasciculus, inferior fronto occipital fasciculus, inferior temporo-occipital fasciculus, parahippocampal white matter, fimbria and fornix, hippocampus cingulated gyrus, thalamus, internal capsule, caudate and lentiform nucleus. We compared these measurements with the EEG, high-resolution MR imaging, and clinical information. RESULTS: There was statistically significant decrease in FA values with increased mean diffusivity was seen in the regions beyond the structurally abnormal hippocampus which could not be picked up by conventional MRI. CONCLUSION: DTI is highly sensitive to cortical micro structural changes that underlie epilepsy. DTI is an important radiological tool in the pre surgical evaluation of epilepsy and surgical planning

Hemimegalencephaly: Seizure outcome in an infant after hemispherectomy

Isolated hemimegalencephaly (iHME) is a rare form of congenital malformation of cortical development characterized by enlargement of all or part of one cerebral hemisphere. It typically presents with intractable seizures, developmental delay, contralateral hemiparesis, and hemianopia. We report a case of an 18-month-old girl who presented first with focal seizures at tenth day of life, with no other physical or behavioral abnormality. Initial EEG showed excessive sharp EEG transients more over the right hemisphere; repeated EEG showed spikes, polyspikes, sharps, and slow wave discharges predominately over the right hemisphere. MRI of the brain showed asymmetric enlargement of the right cerebral hemisphere, suggestive of hemimegalencephaly. Initial treatment with antiepileptic drugs (AEDs) was successful in controlling her seizures, but later on the seizures became intractable even on polytherapy of AEDs; finally, functional hemispherectomy was performed and she became seizure free. Identification of this and similar cases of iHME can help us to better understand this disorder and eventually to provide better treatment options for it

Bilateral intracranial calcifications with bilateral facial cutaneous naevus: sturge weber syndrome

Abstract Sturge Weber syndrome also known as mother spot disease belongs to a group of disorders called phakomatoses (neurocutaneous syndromes involving the central nervous and cutaneous systems). It is a congenital disorder of the vasculature of the meninges, brain, faceand eyes. Clinically, it usually presents with seizures and other neurological complications, including mental retardation, contralateral hemiparesis and glaucoma. Its incidence is estimated at one case in 20 000-50 000 persons with equal frequency in boys and girls. We present a case of 18-months-old boy was brought by parents with history of seizures since birth resulting in fall 1 day back. Physical examination showed bilateral port-wine stain on face. CT head examination revealed bilateral intracranial calcification. This is a highly unusual presentation of Sturge Weber syndrome

Trends in Next Generation Intelligent Transportation Systems

The objective of Intelligent transportation system (ITS) and related National highway traffic safety administration (NHTSA) is to improve vehicle safety and reduce accidents, injuries, and deaths. Advanced driver assistance system (ADAS) is making a difference in vehicle safety. The objective of ADAS is to provide a continuous picture environment surrounding the vehicle. This vision around the vehicle is seen by the driver to take the decision. Vehicular communication is a part of Intelligent Transport System which provides an intelligent way of transport to avoid accidents. As the transportation moves towards environment of connected and autonomous vehicles, the role of communication and data transfer becomes important. Connected vehicles can be used for both infotainment and navigation for vehicle safety. Vehicle-to-vehicle (V2V) communication allows vehicles to talk to each other and exchange data about location, direction of travel, speed, brake, accelerator status, and other facts. This information is analyzed and used to avoid collision. C-V2X (Cellular-Vehicle-to-Everything) can provide better quality of service support, large coverage, and high data rate for moving vehicles. Device-to-device (D2D) communication in C-V2X provides high reliability and low latency. In 5G Rel.16 C-V2X will become an integral part of 5G cellular network providing higher capacity, coverage, etc. Today old aged/disabled person look for driving technology that is convenient and easy to use. V2X technology will offset some of the concerns about old aged/disabled driver’s abilities to respond quickly to challenge by driving environment as they no longer be required to handle most of the decisions

A rare case of simple hereditary recessive optic atrophy

Simple Autosomal Recessive Optic Atrophy (AROA) is a rare hereditary disorder that belongs to a group of disorders called Hereditary Optic Atrophy. Patients diagnosed with simple AROA have complete blindness since birth or from first few months of life. This blindness does not improve with age. However, no other organ or system is affected in this disorder. There is no known cause or gene mutation associated with it. Here we report a case of a two year old child diagnosed with simple AROA. Family history of the patient revealed that an older deceased relative also suffered from similar symptoms. Identification of this and similar cases of the simple AROA can help us better understand this disorder and hopefully one day help us develop a treatment for it

An unusual presentation of neurononopathic gauchers disease.

A six years old male child presented with tremor, ataxia, speech apraxia, supranuclear gaze palsy and hepatosplenomegaly. There was no history of seizures and psycho-cognitive abnormalities. The clinical and bone marrow findings were consistent with Gaucher\u27s disease type 3. KEY WORDS: Gauchers disease, Enzyme replacement therapy, Gene therapy, Bone marrow transplant