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Introduction: In 2009, the World Health Organization identified vehicle crashes, both injury-related and fatal, as a public health hazard. Roadway lighting has long been used to reduce crashes and improve the safety of all road users. Ocular light exposure at night can suppress melatonin levels in humans. At sufficient light levels, all visible light wavelengths can elicit this response, but melatonin suppression is maximally sensitive to visible short wavelength light. With the conversion of roadway lighting to solid state sources that have a greater short wavelength spectrum than traditional sources, there is a potential negative health impact through suppressed melatonin levels to roadway users and those living close to the roadway. This paper presents data on the impact of outdoor roadway lighting on salivary melatonin in three cohorts of participants: drivers, pedestrians, and those experiencing light trespass in their homes., Methods: In an outdoor naturalistic roadway environment, healthy participants ( N = 29) each being assigned to a cohort of either pedestrian, driver, or light trespass experiment, were exposed to five different solid state light sources with differing spectral emissions and one no lighting condition. Salivary melatonin measurements were made under an average roadway luminance of 1.0 cd/m 2 (IES RP-18 Roadway Lighting Requirements for expressway roads) with a corneal melanopic Equivalent Daylight Illuminances (EDI) ranging from 0.22 to 0.86 lux., Results: The results indicate that compared to the no roadway lighting condition, the roadway light source spectral content did not significantly impact salivary melatonin levels in the participants in any of the cohorts., Conclusions: These data show that recommended levels of street lighting for expressway roads do not elicit an acute suppression of salivary melatonin and suggest that the health benefit of roadway lighting for traffic safety is not compromised by an acute effect on salivary melatonin., Competing Interests: The authors declare no conflict of interest

Introduction: Crashes involving roadway objects and animals can cause severe injuries and property damages and are a major concern for the traveling public, state transportation agencies, and the automotive industry. This project involved an in-depth investigation of such crashes based on the second Strategic Highway Research Program (SHRP 2) Naturalistic Driving Study (NDS) data including detailed information and videos about 2,689 events., Methods: The research team conducted a variety of logistic regression analyses, complemented by Support Vector Machine (SVM) analyses and detailed case studies., Results: The logistic regression results indicated that driver behavior/errors, involvement of secondary tasks, roadway characteristics, lighting condition, and pavement surface condition are among the factors that contributed significantly to the occurrence and/or increased severity outcomes of crashes involving roadway objects and animals. Among these factors, improper turning movements (odds ratio = 88), avoiding animal or other vehicle (odds ratio = 38), and reaching/moving object in vehicle (odds ratio = 29) particularly increased the odds of crash occurrence. Factors such as open country roadways, sign/signal violation, unfamiliar with roadway, fatigue/drowsiness, and speeding significantly increased the severity outcomes when such crashes occurred. The sensitivity analysis of the three SVM classifiers confirmed that driver behavior/errors, critical speed, struck object type, and reaction time were major factors affecting the occurrence and severity outcomes of events involving roadway objects and animals. Practical Applications: The study provides insights on risk factors influencing safety events involving roadway objects, including their occurrence and the severity outcomes. The findings allow researchers and traffic engineers to better understand the causes of such crashes and therefore develop more effective roadway- and vehicle- based countermeasures., (Published by Elsevier Ltd.)

Latrodectism-envenomation by the black widow spider, Latrodectus mactans-has been reported in virtually every state. The spider is particularly prevalent in the Southwest, Southeast and California, and symptoms from its bite are painful and may be confusing to clinicians. Prompt improvement can be expected in most cases with administration of calcium and muscle relaxant, but some patients may require treatment with antivenin. No deaths occurred in our series of 11 patients, although one case was complicated by serum sickness.

Intermittent intravenous cyclophosphamide therapy has been shown to be effective in the management of lupus nephritis. There have been no reports of malignancies associated with such treatment regimens. We describe a patient who developed acute nonlymphocytic leukemia after receiving a total dose of 4 gm of cyclophosphamide over a 1-year period.

An acute arthritis may accompany the onset of cancer. A case of metastatic adenocarcinoma of the synovium presenting as an acute arthritis is described. The diagnostic importance of a careful synovial fluid analysis and the use of closed synovial biopsy are emphasized.