Investigating the driving performance of drivers with and without autism spectrum disorders under complex driving conditions

Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions.

Method: Seventeen drivers with autism spectrum disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events.

Results: In comparison with the typically developed group, drivers with autism spectrum disorders reported significantly more lapses in driving, committed more mistakes on the driving simulator, and were slower to react in challenging situations, such as driving through intersections with abrupt changes in traffic lights. However, they were also less likely to tailgate other vehicles, as measured by time-to-collision between vehicles, on the driving simulator.

Conclusions: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations. Driver education for individuals with autism spectrum disorders should focus on quick identification of hazards, prompt execution of responses, and effective allocation of attention to reduce lapses in driving.

• Implications for rehabilitation

• Drivers with autism spectrum disorders reported significantly more lapses during driving.

• Drivers with autism spectrum disorders were observed to be poorer in traffic scenarios requiring critical response.

• Driver education for individuals with autism spectrum disorders should focus on managing anxiety and effective attention allocation while driving.

• Driving simulators can be used as a safe means for training critical response to challenging traffic scenarios.

     

Root canal preparation in mandibular premolars with TRUShape and Vortex Blue: A micro‐computed tomography study

A comparison of the preparation ability of two root canal instrumentation systems in oval‐shaped canals using micro‐computed tomography was undertaken. Thirty extracted, single‐rooted, human mandibular premolars with radiographically similar canal morphology were selected, allocated to two groups (N = 15) and prepared with TRUShape or Vortex Blue (VB). Each sample was subjected to three scans (20 μm resolution): pre‐preparation and after preparation to sizes #30 and #40. Three‐dimensional data sets were evaluated for canal volume, surface area and surface treatment. Matched axial slices in apical, middle and coronal root thirds were evaluated for cross‐sectional area, roundness and transportation. Preparation with both instruments increased canal volumes and surface areas similarly and significantly (P < 0.001) with no significant difference between groups. TRUShape significantly enhanced surface treatment at both apical sizes (P < 0.05). Transportation exceeded 100 μm in only eight out of 90 cross sections. Both instruments performed similarly during preparation. TRUShape, however, significantly enhanced surface treatment.     

Analysis of time intervals related to STEMI management in 2008–2016

IntroductionA modern treatment of patients with ST segment elevation myocardial infarction (STEMI) is based on a rapid primary percutaneous coronary intervention with direct recanalization of the affected coronary artery (dPCI). The outcome of the treatment depends largely on the pre-hospital care management, which can reduce the total ischaemic time and subsequently improve patient's outlook.AimsThe principal aims of this retrospective study were to assess the development of time intervals related to the pre-hospital care and the effect of the mode of transportation to the cathlab (primary vs secondary) on these intervals in patients with acute STEMI treated by primary PCI in 2008, 2010, 2012, 2014 and 2016.MethodsWe have analysed patients with STEMI treated using PCI within 12 h of symptoms onset. In total, 1250 patients were included. To evaluate the development over the last 8 years, uni- and multivariate analyses were used. Categorical variables were analysed using chi-squared tests while continuous variables were analysed using one-way ANOVA and general linear models. The effect of the year and of mode of transportation on time intervals were studied.ResultsThe time intervals did not significantly differ among years with the exception of 2014 where the reason of the deviation was however not related to the quality of the pre-hospital care. The 120 min limit from the first medical contact to unblocking the affected artery (FMCTB) was met in more than 80% patients (80.8), the recommended limit of 90 min in 55.2% of patients. The key factor affecting the total ischaemic time was however the patients’ choice of the mode of transportation – in patients who opted for the primary route of transportation, i.e., called the ambulance, the intervals were significantly shorter (FMCTB on average by 38.2 min and total ischaemic time by 92.9 min). The principal delays were detected in the patients’ delay (103 min inpatients with primary transportation route, 131 in patients with secondary route) as well as, unfortunately, in the intervals between reporting the patients’ problem to the system and ECG-confirmed diagnosis (26 min if the patient calls ambulance vs 52 min if they present at a general practitioner or outpatient clinic) and subsequent transportation to the cathlab (60 min for primary route, 97 for secondary). The latter two should be in particular targeted and we can see a significant room for improvement here.ConclusionThe time intervals do not vary among individual years (with some exceptions). The route of transportation, which is a patient's choice, on the total ischaemic time is however a crucial and predominant factor affecting the total ischaemic time as well as individual intervals.     

THE ENGINE AND THE REAPER: INDUSTRIALIZATION AND MORTALITY IN LATE NINETEENTH CENTURY JAPAN

Economic development improves long-run health outcomes through access to medical treatment, sanitation, and higher income. Short run impacts, however, may be ambiguous given disease exposure from market integration. Using a panel dataset of Japanese vital statistics and multiple estimation methods, I find that railroad network expansion is associated with a six percent increase in gross mortality rates among newly integrated regions. Communicable diseases accounted for most of the rail-associated mortality, which indicate railways behaved as transmission vectors. At the same time, market integration facilitated by railways corresponded with an eighteen percent increase in total capital investment nationwide over ten years.     

Investigation of Solid Dosage Form Components Interaction Using Orthogonal Techniques- Discovery of New Forms of Sodium Stearyl Fumarate

Physical or chemical interactions between drug product (DP) components can occur during manufacturing and/or upon storage; and may alter DP shelf life and performance. In this work a new Powder X-ray Diffraction (PXRD) peak was observed in DP under accelerated storage conditions. Due to the complex drug product matrix (including API, polymer, fillers, super disintegrant and lubricant), it was challenging to pinpoint the component(s) responsible for the new peak. In addition to PXRD, other orthogonal techniques including Differential Scanning Calorimetry (DSC), thermogravimetric analysis (TGA), dynamic vapor sorption (DVS), Solid State Nuclear Magnetic Resonance (SSNMR) and Infrared (IR) spectroscopy were employed in this investigation to understand the root cause mechanistically. Specifically, multi nuclei SSNMR (¹H, ²³Na, ¹³C) was instrumental in delineating the components of the matrix. We identified the root cause to be an acid base reaction occurring in the DP, whereby sodium ion in sodium stearyl fumarate (SSF) is replaced by proton leading to SSF form conversion. We also identified commercially available SSF to be a hydrate that can dehydrate to an anhydrous form upon heating. In general, the same techniques can be used to investigate interactions of any multi component solid dosage forms.     

Quercetin derivatives regulate melanosome transportation via EPI64 inhibition and elongate the cell shape of B16 melanoma cells

4′-O-β-d-glucopyranosyl-quercetin-3-O-β-d-glucopyranosyl-(1→4)-β-d-glucopyranoside (3C4′GQ), first isolated from Helminthostachys zeylanica root extract, was synthesized as a compound that stimulates intracellular melanogenesis. 3-O-methylquercetin (3MQ) and 3,4′,7-O-trimethylquercetin (34′7TMQ) were synthesized as compounds that enhance extracellular melanin formation. The formation of dendrites and the expression of EBP50-PDZ interactor of 64 kDa (EPI64) relating to melanin transportation were investigated using B16 melanoma cells treated with 3C4′GQ, 3MQ, or 34′7TMQ in order to understand the mechanism underlying the observed activities. The influence of 3C4′GQ on the increase of intracellular melanin contents enhanced the expression of EPI64, exhibited no dendrite elongation activity, and inhibited melanin transportation. On the other hand, the increase of extracellular melanin content by 3MQ and 34′7TMQ inhibited the expression of EPI64 and formed elongated cells to stimulate melanin transportation.     

腹膜初始转运功能的流行病学研究

目的研究腹膜初始转运功能与年龄、原发病、病程、净超滤量等的关系,阐述腹膜初始转运功能的流行病学特点。方法收集在泰安市中心医院泌尿内一科进行腹膜透析置管的患者48例,采用logistic回归法分析原发病、年龄、病程与腹膜初始转运功能的关系。结果对受试患者腹膜初始转运功能的相关影响因素进行单因素有序反应变量Logistic回归分析显示腹膜初始转运功能与年龄、病程有关系(P<0.05)。将有统计学意义的相关影响因素进行多因素有序反应变量Logistic逐步回归分析,表明病程与腹膜初始转运功能有关系(P<0.05)。结论随年龄增大、病程延长,腹膜初始转运功能转为低转运与高转运的机会有增加的趋势。原发病为糖尿病肾病者腹膜初始转运倾向于高转运;原发病为高血压肾损害、慢性肾炎者腹膜初始转运倾向于平均转运。