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With the deployment of Connected and Automated Vehicles in the coming decades, road transportation will experience a significant upheaval. CAVs (Connected and Autonomous Vehicles) have been a main emphasis of Transportation and the automotive sector, and the future of transportation system analysis is widely anticipated. The examination and future development of CAVs technology has been the subject of numerous researches. However, as three essential kinds of road users, pedestrians, bicyclists, and motorcyclists have experienced little to no handling. We explored the influence of CAVs on non-motorized mobility in this article and seven various issues that CAVs face in the environment.

Background: The greatest mortality and disability from stroke occurs in low- and middle-income countries. A significant barrier to implementation of best stroke care practices in these settings is limited availability of specialized healthcare training. We conducted a systematic review to determine the most effective methods for the provision of speciality stroke care education for hospital-based healthcare professionals in low-resource settings. Methods: We followed the PRISMA guidelines for systematic reviews and searched PubMed, Web of Science and Scopus for original clinical research articles that described or evaluated stroke care education for hospital-based healthcare professionals in low-resource settings. Two reviewers screened titles/abstracts and then full text articles. Three reviewers critically appraised the articles selected for inclusion. Results: A total of 1,182 articles were identified and eight were eligible for inclusion in this review; three were randomized controlled trials, four were non-randomized studies, and one was a descriptive study. Most studies used several approaches to education. A “train-the-trainer” approach to education was found to have the most positive clinical outcomes (lower overall complications, lengths of stay in hospital, and clinical vascular events). When used for quality improvement, the “train-the-trainer” approach increased patient reception of eligible performance measures. When technology was used to provide stroke education there was an increased frequency in diagnosis of stroke and use of antithrombotic treatment, reduced door-to-needle times, and increased support for decision making in medication prescription was reported. Task-sharing workshops for non-neurologists improved knowledge of stroke and patient care. Multidimensional education demonstrated an overall care quality improvement and increased prescriptions for evidence-based therapies although there were no significant differences in secondary prevention efforts, stroke reoccurrence, or mortality rates. Discussion: The “train the trainer” approach is likely the most effective strategy for specialist stroke education, while technology is also useful if resources are available to support its development and use. If resources are limited, basic knowledge education should be considered at a minimum, and multidimensional training may not be as beneficial. Communities of practice, led by those in similar settings, may be helpful to develop educational initiatives with relevance to local contexts.

Objective The objective of this study was to assess the feasibility of delivering Art skill-based Rehabilitation Training (ART), a novel upper limb motor training program, to patients with stroke as an adjunct to standard care in an inpatient setting. Design Feasibility study. Setting Inpatient stroke rehabilitation unit at a university hospital. Participants Thirty-eight patients admitted to a stroke rehabilitation unit with upper limb motor impairment were enrolled in the ART program facilitated by trained non-healthcare professionals between December 2017 and June 2021. Intervention The ART program included nine, one-hour sessions of supervised tracing and freehand drawing tasks completed with both hands. This program was intended to be delivered at a frequency of three times per week over a duration of 3 weeks or for the length of inpatient stay. Main outcome measures Feasibility outcomes included ART program adherence, acceptability, and safety. Results Thirty-two (84%) participants with subacute stroke completed the ART program and 30 (79%) were included in the study analysis. Participants completed 93–100% of the ART tasks in a median [IQR] of 8 [6–10] ART sessions over a median [IQR] duration of 15 [7–19] days. ART program facilitators effectively provided upper limb assistance to patients with more severe upper limb impairments. Adherence and acceptability were high and no study-related adverse events occurred. Conclusion The ART program was feasible to deliver and highly acceptable to patients with stroke. Further research is warranted to explore the impact of ART on upper limb sensorimotor function and use.

BACKGROUND The majority of older adults want to age in place, in their homes and communities. However, this can be challenging for many, frequently due to a lack of supports that allow for aging-in-place. Naturally occurring retirement community supportive services programs (NORC-SSPs) offer one approach to help older adults age in place. While qualitative studies have examined the experiences of NORC-SSP participants, little is known how participation in NORC-SSP programming affects participants’ social networks. OBJECTIVE This study aims to explore the experiences of thirteen NORC-SSP residents and how participating in NORC-SSP programming, specifically based on the Oasis model, influenced their social networks. METHODS Semi-structured qualitative interviews were conducted with participants in four NORC communities in Ontario, Canada. Social network theory informed the interview guide and thematic analysis. RESULTS Three main themes were identified from the interviews with Oasis participants: expansion and deepening of social networks, Oasis activities (something to do, someone to do it with), and the self-reported impact of Oasis on mental health and well-being (feeling and coping with life better). CONCLUSIONS Naturally occurring retirement communities offer an ideal opportunity to build strong communities that provide deep, meaningful social connections that expand their social networks. NORC-SSPS programs can support healthy aging and allow older adults to age-in-place.

Introduction This study investigated the needs of stroke survivors and therapists, and how they may contrast, for the design of robots for at-home post stroke rehabilitation therapy, in the Ontario, Canada, context. Methods Individual interviews were conducted with stroke survivors ( n = 10) and therapists ( n = 6). The transcripts were coded using thematic analysis inspired by the WHO International Classification of Functioning, Disability, and Health. Results Design recommendations, potential features, and barriers were identified from the interviews. Stroke survivors and therapists agreed on many of the needs for at-home robotic rehabilitation; however, stroke survivors had more insights into their home environment, barriers, and needs relating to technology, while therapists had more insights into therapy methodology and patient safety and interaction. Both groups felt a one-size-fits-all approach to rehabilitation robot design is inappropriate. Designs could address a broader range of impairments by incorporating household items and breaking activities down into their component motions. Designs should incorporate hand and wrist supports and activities. Designs should monitor trunk and shoulder motion and consider incorporating group activities. Conclusion While therapists can provide insight in the early stages of design of rehabilitation technology, stroke survivors’ perspectives are crucial to designing for the home environment.

Pharmacy personnel activities and labor costs directly associated with concurrent decentralized and centralized unit dose drug distribution systems in the same institution were compared. A work-sampling observation technique was used for the activity survey. Analysis of the data showed that: (1) the activities of pharmacy personnel vary significantly between the decentralized and centralized systems, (2) pharmacists in the decentralized area spent a significantly greater portion of their productive time performing therapy-related activities than did those pharmacists in the centralized system, (3) multiple staffing patterns associated with the centralized unit dose system afforded a significantly greater participation in educational activities by all pharmacy personnel staffing that area, (4) dispensing activities accounted for most nonpharmacist personnel time in both systems, and (5) based on cost/unit dose and existing staffing patterns, there was no appreciable difference in personnel labor costs associated with the two systems. However, it was determined that a considerable cost difference could be expected if the decentralized system's hours of service were equivalent to those associated with the centralized system.

A common agreement in many of the future roles proposed for pharmacists in the ambulatory patient care area involves an educational responsibility to patients. To provide patient education, pharmacists may rely on mechanical audiovisual aids. The optimal effectiveness of patient education programs of this type can be achieved only by careful preparation of the audiovisual aids. In producing such instructional aids consideration should be directed at both the technical and theoretical aspects of persuasive audiovisual techniques.The goal of any patient education effort is to instill a desire in patients to comply with their therapy and in so doing maintain or improve their health status. It is important to understand the theories of attitude change needed to provide effective patient education.It is equally important that the audiovisual material utilized be prepared using recognized principles for instructional presentations. Technical considerations in the preparation of audiovisual aids will insure that the program has an impact on the viewing audience.The pharmacist may be especially suited to counsel patients on the correct use of medication. Innovative methods may be needed to provide effective patient education services. The audiovisual method is one technique which may be used to provide patient education. Practical applications of theoretical and technical principles for audiovisual instruction should be used to prepare effective educational materials.The goal proposed by advocates of patient education is to help patients acquire new knowledge, attitudes, and behavior that will improve their capability to care for themselves more adequately. Those who participate in planned educational programs have exhibited greater compliance and cooperation. This, in turn, can result in fewer hospital admissions.23Schoenrich24explains that patient education requires consideration of the psychological, sociological, and cultural aspects of the population if changes in patient attitudes and behavior are to be made. It is important to be sensitive to the patient and his condition and consider the “whole” patient.

Two types of Pseudomonas putida PpG2 mutants which were unable to degrade branched-chain amino acids were isolated after mutagenesis and selection for ability to grow on succinate, but not valine, as a sole source of carbon. These isolates were characterized by growth on the three branched-chain amino acids (valine, isoleucine, and leucine), on the corresponding branched-chain keto acids (2-ketoisovalerate, 2-keto-3-methylvalerate, and 2-ketoisocaproate), and on other selected intermediates as carbon sources, and by their enzymatic composition. One group of mutants lost 2-ketoisovalerate-inducible branched-chain keto acid dehydrogenase that was active on all three keto acids. There was also a concomitant loss of ability to grow on all three branched-chain amino acids as well as on all three corresponding keto acids, but there was retention of ability to use subsequent intermediates in the catabolism of branched-chain amino acids. Another type of mutant showed a marked reduction in branched-chain amino acid transaminase activity and grew poorly at the expense of all three amino acids, but it utilized subsequent intermediates as carbon sources. Both the transaminase and branched-chain keto acid dehydrogenase mutants retained the ability to degrade camphor. These findings are consistent with the view that branched-chain amino acid transaminase and branched-chain keto acid dehydrogenase are common enzymes in the catabolism of valine, isoleucine, and leucine.

Summary The seventh case of favism in a child in the United States is reported. The clinical picture of favism is summarized.

Summary Chloramphenicol has been used as the therapeutic agent in a wide variety of acute and chronic infections in 277 children. A satisfactory response was obtained with oral Chloromycetin Palmitate in 135 of 146 treatable patients (92 per cent), with injectable chloramphenicol alone in 63 out of 67 treatable patients (94 per cent), with injectable chloramphenicol and penicillin in 51 out of 55 treatable patients (92 per cent). The intramuscular suspension compares favorably with the ampule solution and has the advantage of needing one injection daily at maximum. No interference between chloramphenicol and penicillin was noted. Gastrointestinal symptoms were almost nonexistent. No blood dyscrasia developed in any of our patients.

SummaryA new preparation of Chloromycetin, in the form of Chloromycetin Palmi-tate suspension, was administered to 17 patients ranging from 11 days to 9 years of age. The preparation is palatable and taken readily by these patients. A variety of mild and serious common childhood illnesses responded promptly to this medication.

The activities of six enzymes which take part in the oxidation of valine by Pseudomonas putida were measured under various conditions of growth. The formation of four of the six enzymes was induced by growth on d - or l -valine: d -amino acid dehydrogenase, branched-chain keto acid dehydrogenase, 3-hydroxyisobutyrate dehydrogenase, and methylmalonate semialdehyde dehydrogenase. Branched-chain amino acid transaminase and isobutyryl-CoA dehydrogenase were synthesized constitutively. d -Amino acid dehydrogenase and branched-chain keto acid dehydrogenase were induced during growth on valine, leucine, and isoleucine, and these enzymes were assumed to be common to the metabolism of all three branched-chain amino acids. The segment of the pathway required for oxidation of isobutyrate was induced by growth on isobutyrate or 3-hydroxyisobutyrate without formation of the preceding enzymes. d -Amino acid dehydrogenase was induced by growth on l -alanine without formation of other enzymes required for the catabolism of valine. d -Valine was a more effective inducer of d -amino acid dehydrogenase than was l -valine. Therefore, the valine catabolic pathway was induced in three separate segments: (i) d -amino acid dehydrogenase, (ii) branched-chain keto acid dehydrogenase, and (iii) 3-hydroxyisobutyrate dehydrogenase plus methylmalonate semialdehyde dehydrogenase. In a study of the kinetics of formation of the inducible enzymes, it was found that 3-hydroxyisobutyrate and methylmalonate semialdehyde dehydrogenases were coordinately induced. Induction of enzymes of the valine catabolic pathway was studied in a mutant that had lost the ability to grow on all three branched-chain amino acids. Strain PpM2106 had lowered levels of branched-chain amino acid transaminase and completely lacked branched-chain keto acid dehydrogenase when grown in medium which contained valine. Addition of 2-ketoisovalerate, 2-ketoisocaproate, or 2-keto-3-methylvalerate to the growth medium of strain PpM2106 resulted in induction of normal levels of branched-chain keto acid dehydrogenase; therefore, the branched-chain keto acids were the actual inducers of branched-chain keto acid dehydrogenase.

ConclusionIn 4 infants with intractable eczema associated with retarded development and malnutrition, the absorption of vitamin A from the intestinal tract was found to be impaired.

I have been struck by recent reports on the unduly high levels of ammonia in protein hydrolysatesl,2 and the occurrence of hyperammonemia (fatal at times) in certain patients treated by parenteral alimentation.3 In reading the statement titled, "Parenteral Feeding–A Note of Caution"4 by the Committee on Nutrition of the American Academy of Pediatrics I was greatly surprised that no mention was made of these problems, even though the report covers a list of ten other complications which have been reported to be associated with hyperalimentation.

To the Editor:— The authors mention that catnip is a member of the mint family, Labiatae; thyme and marjoram also belong in this family, and these items are the principal substances used as fillers in cheap or low-grade marihuana. In the same way that lactose is used to cut heroin to increase the monetary return, these substances may be added to marihuana. Some individuals who have never seen or smelled marihuana could not detect any differences when confronted with containers of either of the substances commonly used as spices. In fact, in an experiment conducted by this writer, a group of law-enforcement agents became convinced that the substance they were looking at and handling was marihuana when it was in reality, thyme. Other members of the mint family have been reputed to have hallucinatory properties. Several years ago, Gordon Wasson described a Central American member of this species which was