汽车驾驶员模拟精神负荷与心率变异性的相关性分析

汽车驾驶员精神负荷状态下的心率变异性分析对于揭示驾驶员职业应激特点,预防驾驶员职业疾病,保护驾驶员身体健康及提高行驶安全性有重要意义.本文在实验室条件下采用警惕任务代替驾驶员实际精神负荷,应用功率谱分析研究了模拟应激状态下心率变异性(TP,LF,HF,LF/HF)的变化趋势.本实验中,心率变异性频域主要指标如LF、HF、LF/HF表现出显著的线性趋势.结果表明,健康人在持续应激状态下,交感神经张力显著增加,迷走神经张力显著降低.实验结果表明HRV与精神疲劳具有较好的相关性.     

驾驶员瞌睡的视频监测研究

驾驶员睡眠不足是引发恶性交通事故的重要原因之一，对驾驶员机能状态的监测方法是当前各国交通部门研究热点。其中，用视频的方法对眼睑的实时监测是被公认的一种有效的方法。我们在对当前的几种常用的监测方法研究后，提出了一种可靠的监测方案，主要是用于飞行员驾驶时瞌睡的测量。同一般的车辆疲劳监测系统相比，有可靠、不受天气影响等优点，但是，该系统必须依赖于特制的头盔，因此，只能部分适用于普通的汽车司机。     

Driver Sleepiness and Risk of Car Crashes in Shenyang, a Chinese Northeastern City： Population-based Case-control Study

Objective To estimate the association of driver sleepiness with the risk of car crashes. Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information. Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sl     

Precision Medicine in Myeloma: Challenges in Defining an Actionable Approach

Recently, large sequencing studies have provided insights into the mutational landscape of multiple myeloma (MM), identifying actionable mutations and giving a precious opportunity for exploring new targeted therapies. The main goal of precision medicine, matching patients with the right drug, seems to be closer than ever. However, no targeted therapies in MM are approved yet. Several clinical trials testing targeted drugs and enrolling patients with MM are currently ongoing and will provide predictive biomarkers that might support clinical decision making. In this review, we evaluate the evidence supporting the implementation of precision medicine in MM and we discuss the challenges that should be dealt with in this imminent and promising new era.     

Considerations in Seating and Positioning Severely Disabled Drivers

Seating and positioning methods and products have taken a lead in clinical intervention with the disabled client. The seating clinician has emerged as an important member of the rehabilitation team working toward maximizing independence and function of the clients they serve. Seating and positioning interventions have proven to be very effective in stabilizing the client's trunk and torso, making it possible to achieve the once impossible task of driving a motor vehicle. The areas of acceleration deterioration, improved head height, and design of a secure wheelchair base are all concerns for the rehabilitation team working on driving. Addressing these issues early in the driver rehabilitation program can maximize successful outcomes and create a safer driving environment.     

Local changes in the wake electroencephalogram precedes lane departures

The objective of this exploratory study is to investigate if lane departures are associated with local sleep, measured via source‐localized electroencephalography (EEG) theta power in the 5–9 Hz frequency range. Thirty participants drove in an advanced driving simulator, resulting in 135 lane departures at high levels of self‐reported sleepiness. These lane departures were compared to matching non‐departures at the same sleepiness level within the same individual. There was no correspondence between lane departures and global theta activity. However, at the local level an increased risk for lane departures was associated with increased theta content in brain regions related to motor function.     

中国2006－2010年机动车道路交通伤害中驾驶员违法行为研究

目的 了解中国机动车道路交通伤害中驾驶员违法行为流行现状、趋势及其特征,为制定相关防治对策与措施提供科学依据.方法 以万车死亡率、10万人口死亡率、里程死亡率、机动化程度和死亡系数等指标分析2006－2010年中国机动车道路交通伤害中驾驶员存在的各类违法行为现状、趋势及其特征.结果 2006－2010年中国机动车道路交通伤害中,前五位违法行为依次是超速行驶(死亡系数:0.33～0.17)、未按规定让行(死亡系数:0.26～0.14)、无证驾驶(死亡系数:0.21～0.08)、违法占道行驶(死亡系数:0.17～0.04)和逆向行驶(死亡系数:0.11～0.07).酒后驾驶和疲劳驾驶2010年死亡系数分别降至0.04和0.02,所致机动车道路交通伤害的发生数量远远低于前五项违法行为.结论 中国机动车道路交通伤害总体数量呈下降趋势,但严重程度呈上升趋势,违法行为仍然很严重.     

2012～2013年中山市驾驶员中心视力状况调查

目的了解中山市机动车驾驶员的中心视力情况,以降低驾驶员因视力情况造成的交通事故。方法调查从2012年1月至2013年6月到中山市疾病预防控制中心进行驾驶员体检的驾驶员,按照公安部《机动车驾驶证申领和使用规定》进行体检。结果共调查驾驶员1 367名,视力合格者1 269人,占92.8%。女性驾驶员视力不合格率较男性高（P〈0.05）,〉60岁年龄组驾驶员视力不合格率高,〈30岁组与30~45岁组、45~60岁组与30~45岁组相比较,差异均有统计学意义（P〈0.05）。驾龄〉10年的驾驶员视力不合格的比例比驾龄≤10年的视力不合格的比例要高;E型车驾驶证的驾驶员视力不合格的比例比其他车型的比例更高。结论对于女性、初学的年轻人、45岁以上专业驾驶员、60岁以上老年人及E型车驾驶员要加强健康指引和监督管理。     

Driver Rehabilitation Programs: Defining Program Models,Services, and Expertise

This paper highlights the critical need for a diverse span of services targeted at older drivers that is clear and understandable to health care professionals, service providers, and consumers. The paper describes how a panel of expert driver rehabilitation specialists and researchers on older drivers affirmed consensus statements addressing the need for clarification of terms and services. It also presents a new document that describes a spectrum of driver services from education to specific driver rehabilitation services. The document will provide consumers, referral sources, payers, and stakeholders invested in older drivers’ services, with the information to refer the right people to the right service at the right time.     

Analysis of multigene detection in patients with advanced lung adenocarcinoma using cytological specimens

ObjectiveTo investigate the mutation status and clinical characteristics of multigene detection in advanced lung adenocarcinoma using cytological specimens.Materials and Methods137 advanced lung adenocarcinoma patients with 10 driver genes detection in the Fourth Hospital Hebei Medical University from January 2019 to November 2019 was analysized. 137 cytological specimens including fine-needle aspiration specimens and maligant serous cavity effusion (pleural effusion, peritoneal and pericardial effusion). Ten driver mutations of EGFR, ALK, ROS1, BRAF, KRAS, NRAS, HER2, RET, PIK3CA and MET were detected by the amplification refractory mutation system (ARMS). Meanwhile, 90 of 137 patients were detected with biopsies for parallel gene detection.Results78.10 % (107/137) of patients with advanced lung adenocarcinoma harbored at least one of 10 driver mutations. The three main mutations were EGFR (69.16 %, 74/137), ALK (6.57 %, 9/137)and ROS1 (3.65 %, 5/137) mutations. Besides, we found 6 cases including two concomitant mutations: EGFR Exon19 del/HER2 (1/137), EGFR Exon21 L858R/PIK3CA (2/137), EGFR Exon21 L858R/RET (1/137), and ALK/KRAS (2/137). Among 137 patients, women aged 64 or older were more likely to have the mutations (P < 0.05). Female patients (P = 0.003) older or equal to 64 years (P = 0.015) with non-smoking habbit (P = 0.027) were more detected with EGFR mutations, while ALK was more detectable in patients yonger than 64 years. Parallel analysis showed that rates of single EGFR, ALK, ROS1, RET, KRAS, NRAS, HER2, MET mutations and concomitant different mutations were not significantly different between cytological specimens and matched histological specimens.ConclusionsIn the study, cytological specimens and biopsy samples have a very high coincidence rate of gene detection. EGFR, ALK and ROS1 mutations were the main driver mutations in patients with advanced lung adenocarcinoma.We speculate that EGFR and ALK are more prone to concomitant mutations respectively and the treatment of advanced lung adenocarcinoma patients with concomitant mutations deserves further study. The rate of KRAS, NRAS, BRAF, PIK3CA, RET and MET exon14 skipping mutation were low but may had a significant impact on the targeted therapy of patients with advanced lung adenocarcinoma.