Dr. Iain Corness

Wednesday, 24 September 2014 15:29

Ebola - the WHO overview

The World Health Organization (WHO) has been sending out bulletins on the spread of the Ebola virus, and there is no doubting that we have an epidemic on our hands.

The WHO gives the total number of probable, confirmed and suspected cases in the current outbreak of Ebola virus disease (EVD) in West Africa as 4366, with 2218 deaths, as at 7 September 2014. Countries affected are Guinea, Liberia, Nigeria, Senegal and Sierra Leone

There has been no indication of any down-turn in the epidemic in the three countries that have widespread and intense transmission (Guinea, Liberia, and Sierra Leone), with a surge in new cases in Liberia a particular cause for concern. Transmission is continuing in urban areas, with the surge in Liberia being driven primarily by a sharp increase in the number of cases reported in the capital, Monrovia.

Guinea

In line with the past two weeks, there continues to be a high number of confirmed new cases, with just over 100 cases newly reported in the 7 days up to the end of 7 September.

Most new cases have been reported in Macenta. Persistent transmission is ongoing in Gueckedou, which borders Macenta and was the origin of the outbreak, and in areas in and around the capital Conakry. In contrast with Liberia and Sierra Leone, several districts have not reported any cases, or have no newly reported cases in epidemiological week 36.

Liberia

Liberia has reported the most cases and deaths of any affected country in the outbreak, and reported a marked increase in cases during epidemiological week 36. The past week has seen almost 400 confirmed and probable cases reported - almost double the number of newly reported cases in the preceding week. The sharp increase has mainly been driven by a surge in cases in the capital, Monrovia. There is also evidence of substantial underreporting of cases and deaths and this is being investigated. There continues to be a high number of new cases in Lofa county, which borders the Guinean districts of Macenta and Gueckedou. An increase in new cases has also been reported in districts throughout the country, including Bong, Bomi, Grand Bassa, Margibi and Nimba.

Sierra Leone

The incidence of EVD in Sierra Leone remains very high, with almost 200 new cases reported in the past week. Transmission remains high in the capital, Freetown, and is stable and high in Kailahun and Kenema. There has been an increase in the number of new cases reported in the districts of Bo, Bombali, and Port Loko.

Responses in countries with widespread and intense transmission: Increases in demand for Ebola Treatment Centre (ETC) beds and referral unit places are continuing to outstrip capacity in Guinea, Liberia, and Sierra Leone. In Guinea, additional support is needed in Macenta (N’Zerekoré prefecture) and Forcariah (Kindia prefecture). In Liberia, the need for new treatment and referral centers is critical in the capital, Monrovia, in Nimba, and Margibi counties. In Sierra Leone there remains a need for additional support in the capital, Freetown and in Port Loko.

WHO continues to mobilize partners in response to these needs.

Infections among healthcare workers continue to be a concern during this outbreak. To date, 301 healthcare workers have developed the disease, almost half of whom have died. Lead national staff for Infection Prevention and Control (IPC), along with additional IPC staff for key ETCs, have now been deployed in Guinea, Liberia, and Sierra Leone. Coordination is underway to initiate global training plans for IPC in affected and countries and those neighboring affected countries.

The above is from the WHO report, which is quite detailed, showing the virus is not on the wane at this stage.

However, when we look at world statistics we must not forget that Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries. According to the World Health Organization’s World Malaria 2013 Report, 3.4 billion people (half the world’s population) live in areas at risk of malaria transmission, and in 2012, malaria caused an estimated 207 million clinical episodes, and 627,000 deaths. An estimated 91 percent of deaths in 2010 were in the African Region.

Eff Wun under lights. This Grand Prix is lauded as pure excitement under lights, but for me, and countless enthusiasts, the excitement is not there. Narrow street circuits like Monaco lead to processions, and I don’t care how many singing budgies they have as ‘entertainment’. I follow motor racing - not music concerts. If I want musical entertainment, I can go to a concert anywhere, any time.

Thursday, 18 September 2014 10:48

Toyota reveals raft of safety features

As the motorcar heads towards autonomous operation, the manufacturers also have to integrate safety systems for this next step. Many of these systems are already in existence, but currently too expensive for general fitment.

The latest Toyota advanced systems were revealed at the Toyota Advanced Safety Seminar. These include:

Automated Highway Driving Assist to keep a car within its highway lane, at a safe distance from surrounding traffic.

New, improved laser obstacle detection system.

New 3D head-up display.

Laser detection systems that can track objects on the road, day and night; 3D information displays that transform the way traffic information is delivered to drivers; and an advanced driving support system that will be on the road within the next few years; these were the highlights of the innovation program revealed at the fourth Toyota Annual Advanced Safety Seminar in Ann Arbor, Michigan.

AHDA in action.AHDA in action.

The seminar provided an early insight into the company’s latest safety research and development work and the progress it is making in securing safer mobility for all in the future.

“Toyota’s vision is of a world without traffic fatalities, and these advanced connected and automated vehicle technologies have the potential to revolutionize automotive safety,” said Seigo Kuzumaki, Toyota’s Chief Safety Technology Officer. Items discussed at the seminar included:

Automated Highway Driving Assist (AHDA): First revealed last year in Japan, Toyota’s AHDA system is designed work with the driver to achieve safe car control. The latest version of the system, unveiled at the seminar and to be shown at the ITS World Congress, has been programmed according to real-world traffic conditions in the USA and can operate at speeds up to 90 kph.

AHDA integrates three core technologies: Dynamic Radar Cruise Control, Lane Trace Control and Predictive and Interactive Human-Machine Interface (HMI). These support the driver by keeping the vehicle to its lane and a safe distance from others on the road, all while travelling at cruising speeds. The Predictive and Interactive HMI promotes driver engagement, warning when the system is going to disengage and monitoring the driver’s level of attention on the road ahead.

Dynamic Radar Cruise Control (DRCC): This system allows drivers to maintain speed and make more comfortable progress while reducing accident risk by keeping a safe distance from the vehicle ahead. It uses a 77 GHz millimeter-wave radar to detect and monitor vehicles in front of the Toyota and maintain specific speeds and distances.

Lane Trace Control (LTC): Lane Trace Control helps the driver keep the car safely within its lane, using signals relayed by a front-mounted camera and a millimeter-wave radar. The sensors detect lane markings on the road surface and vehicle ahead. The system calculates the right driving path, automatically adjusting the vehicle’s steering angle so the Toyota keeps within its lane, within an appropriate margin from surrounding vehicles.

Predictive and Interactive HMI: While the improved automation provided by the Dynamic Radar Cruise Control and Lane Trace Control contribute to making driving safer and more comfortable, it remains essential to keep the driver - the most important element in the driving process - focused. For this reason, AHDA includes a predictive and interactive HMI to help there is a smooth, safe transition as the car moves from automated and manual driving.

The system gives the driver advance warning when only limited automated system support can be expected. It makes its predictions on the basis of the lay-out/geometry of the road ahead and historical sensor performance. These predictions are intelligently generated, so they apply specifically to the traffic lane in which the AHDA vehicle is travelling.

Monitoring technologies are used to check the driver’s level of attention on the road ahead. An infra-red camera monitors the driver’s face and a touch sensor locates where the driver’s hands are on the steering wheel. The system warns the driver if it detects their hands are off the wheel, or their eyes are not on the road ahead for a long period.

Spad Lidar - single photon avalanche diode/light detection and ranging: Toyota demonstrated its SPAD LIDAR environment mapping and recognition system for the first time at its safety seminar, a technology that marks important progress towards making automated driving a reality. As well as performance improvements, the system is smaller than the previous bulky units which had to be mounted on the roof, and can be installed inside the car.

The high-resolution LIDAR (laser radar) combines the functions of a millimeter-wave radar and stereo cameras. It can detect the shape and position of obstacles ahead and its active sensors mean it can operate in daylight and at night.

3D head-up display: Toyota’s innovative 3D head-up display reflects the company’s philosophy that advanced safety technology should work as a teammate with the driver, and breaks new ground in interface design. The system projects critical information onto the windscreen, such as vehicle status, traffic conditions and road signs, rendering it in 3D with no need for the driver to wear special glasses or use other accessories.

It uses completely new 3D viewing technology and is designed to display information at specific points on the road.

Thursday, 18 September 2014 10:46

New MX-5 (Miata) for 2015

The Mazda MX-5 (Miata in the US) has been a success story for Mazda. Since the first model in 1989, it has become the best selling sports car ever. Having had an early model with the pop-up headlights, I too have been a confirmed fan of the model, despite it getting the middle-aged spread with subsequent versions.

Last week I mentioned in the Cold War after WW2 there was one car which was named to glorify a dictator, but when the dictator died, the brand was changed to glorify the designer. What was the year and what were the names of the two brands? It was Joseph Stalin in Russia and the cars were called ZIS, where S stood for the dictator. After he died in 1952, Krushchev rose to power and denounced much of Stalin’s work, so in 1956 the ZIS was renamed ZIL to glorify Ivan Likhachov. Anyone ever seen a ZIL or a ZIS? I haven’t.

So to this week. Two men met in 1899 and they made plans to form a company and build their own “Moto-cycle”. Who were they and what was the product called?

For the Automania free beer this week, be the first correct answer to email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Stonehedge wines are amongst those emanating from the Napa Valley in California USA, and while the label is relatively unknown in Pattaya, it is well thought of in the US.

Wednesday, 17 September 2014 16:31

Walking the dog. A new health fad?

There is a duty on doctors in the civilized world to remain abreast of current developments in the field of medicine.  The same goes for Thailand with Continuous Medical Education (CME) promoted by the better hospitals.

While doing my own CME the other day, I came across a most interesting study on Osteo Arthritis (OA) of the knee.  This was made even more interesting for me, in the fact that I do have OA knee, and indeed required operation for this last year.

In the article, which was printed in “Arthritis Care and Research”, Dr. Daniel K. White stated that patients with knee OA can gain significant benefits and avoid physical function limitations by simply walking more.

Now my experience in clinical medicine has always been that as OA develops, the pain in the knees result in less walking, quite the reverse of this scientific study.

Dr. White expressed the opinion that, “As clinicians, we should be promoting walking in our patients with knee OA.  We should have them measure their physical activity with a pedometer, much like people measure their weight with a scale.  Those starting on a walking program should get to a target of at least 3000 steps/day and ultimately try to reach 6000 steps/day.  This is well below the popular anecdote of 10,000 steps/day, which may be good news to those starting out.  It doesn’t take much to get to 3000 steps/day.” Dr. White is a research assistant professor at the Department of Physical Therapy and Athletic Training, Boston University College of Health and Rehabilitation Sciences, Massachusetts.

The researchers measured daily steps taken by 1788 people with or at risk for knee OA who were part of the Multicenter Osteoarthritis Study, a large multicenter longitudinal cohort study of community-dwelling adults.  Mean age was 67 years, mean body mass index was 31 kg/m2, and 60 percent of participants were women.

The researchers measured the number of steps patients walked with an ankle monitor for 7 days.  They measured functional limitation at baseline and again 2 years later.  The researchers defined functional limitation as a walking speed of less than 1.0 m/s or Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function score of 28 or greater out of 68.

The authors reported the minimum for preventing functional decline was between 3250 and 3700 steps/day.  Walking an additional 1000 steps each day was associated with a 16 percent to 18 percent reduction in incident functional limitation 2 years later.

“Our findings add to [the] notion that walking is good for people with knee OA.  Specifically, walking that occurs during unstructured activities, a few steps here and there, add up and do seem to make a difference in terms of prevention of functional limitation in this patient population.  I hope that these findings will lead to clinicians encouraging their patients to use a pedometer to measure their physical activity and work towards the 3000 then 6000 steps/day goal,” Dr. White said.

Another researcher in Italy concluded that physical activity stimulates the expression of lubricin, a lubricant molecule of synovial fluid that is important for cartilage trophism and that contributes to the delay of OA development.

So the answer to OA is to try and increase the number of steps per day until you can get to 6000 steps if possible.  Find a route you can safely walk on, count the steps once and then work on from there.  I do follow the keep active regimen myself, and whilst not actually counting the steps I walk briskly around the hospital, as many of you have even remarked to me.

On the same day I came across a study which has claimed people with the two most common types of cancer can cut their risk of dying by up to 40 percent - simply by walking 1.6 km every day.

Research carried out by Macmillan Cancer Support claims walking for 1.6 km at a moderate pace of up to 5 km per hour, or walking for around 20 minutes a day could reduce breast cancer patients’ risk of dying by around 40 percent and those with prostate cancer by 30 percent.

So there’s the answer - buy a dog!

Thursday, 11 September 2014 11:18

Volvo pins its hopes on the XC90 SUV

Volvo has been having a tough time over the past 15 years. The Volvo Car Corporation was sold to Ford Motor Company for $6.45 billion during 2000, and Ford placed it within the Premier Automotive Group alongside Jaguar, Land Rover and Aston Martin. Volvo engineering resources and components would be used in various Ford, Land Rover and Aston Martin products, with the second generation Land Rover Freelander designed on the same platform as the second generation Volvo S80. The Volvo T5 petrol engine was used in the Ford Focus ST and RS performance models, and Volvo’s satellite navigation system was used on certain Aston Martin Vanquish, DB9 and V8 Vantage models. However, it did not make a profit for Ford and in 2010 Ford sold the Volvo Car Corporation to Geely Automobile of China for $1.8 billion, following on from their sale of Jaguar Land Rover in 2008 and Aston Martin in 2007. Hardly a success story for Ford, losing $4.65 billion in 10 years.

Thursday, 11 September 2014 11:12

“Super-MINI” springs out of Italy

Many years ago, there was a version of the Mini called the Innocenti, with the body designed by Bertone. As they say, history repeats itself and (new) MINI and Touring Superleggera, the tradition-steeped design and coach building house based in Milan, have brought the MINI Superleggera™ Vision out from under wraps.

Thursday, 11 September 2014 11:09

What did we learn from the Italian GP?

Well, we learned that Hamilton is the quicker of the two Mercedes drivers, and Rosberg can be made vulnerable when under pressure. And when I say “quicker”, he was in front of Rosberg in each of the three qualifying sessions, and first in the race and fastest lap as well. Only by margins of 0.1 seconds, but in modern F1 terms that represents total domination.

After the Mercedes duo there was a total mix of all the teams, with Williams again showing speed and reliability. Valtteri Bottas, who is marginally quicker than his older team mate Massa, drove a particularly stylish race after a dreadful start which saw him dropped to 11th after being third in Qualifying. However, it was a great day for Williams with Massa third (and no mistakes for once) and Bottas fourth.

Over in the Red Bull paddock, the driver formerly known as “The Finger” must be wondering where his speed has gone, with Vettel once again shown the way home by his new young team mate Daniel Ricciardo, who overcame his dreadful start, dropping to 12th on the first lap but finishing in fifth. Bottas and Ricciardo are definitely the new stars of F1.

It was the Italian GP, and what happened to Ferrari’s Fernando Alonso, the darling of the Tifosi? The electrical recovery system (ERS) gave up, finishing Alonso’s race. His first non-finish for mechanical reasons since 2010, an amazing run. His teammate Kimi Raikkonen has not been having an amazing run, other than the fact that he went to sleep again and Ferrari haven’t awarded him a DCM (Don’t Come Monday). Ferrari are saying publically that Kimi is locked in for 2015. If so, I am sure they have a team of Italian lawyers looking for the get-out clause!

Slowly but surely McLaren are coming back into contention. Not as good as Williams, but both Button and Magnussen finished in the top 10, though Magnussen was given a retrospective penalty which then dropped him out of the top 10. The heinous crime was putting another car off the track. This was with the two cars side by side through the esses and two into one did not go. What would the stewards rather happen? A car gets pushed off or a full scale crash? This was a racing incident and nothing else. The stewards are far too harsh at times and too lenient at others. They need to have the same stewards every meeting. Simple fix.

Force India are always there in the middle of the pack, with both Perez and Hulkenberg showing strong in-fighting skills, but the car just isn’t good enough.

As for the rest, purely ‘make-weights’ or mobile chicanes I am afraid, keeping going with pay drivers. I rather like Bernie’s idea of letting the top teams run three cars and get rid of the bottom of the entry list altogether.

The finishing order shows only six teams in the top 10. (Six teams with three cars puts 18 on the grid immediately.

1 LHamilton Mercedes 232.449 kph
2 N Rosberg Mercedes 01:19.1
3 F Massa Williams 01:19.1
4 V Bottas Williams 01:19.4
5 D Ricciardo Red Bull 01:19.5
6 S Vettel Red Bull 01:20.0
7 S Perez Force India 01:20.1
8 J Button McLaren 01:20.1
9 K Raikkonen Ferrari 01:20.1
10 K Magnussen McLaren 01:20.1
11 D Kvyat Toro Rosso 01:20.2

The next GP is in Singapore on September 21 and is a night race around the houses. Not really a circuit where a driver can display his talents.

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