Miracle-dz/UniFAR-FTUs huggingface dataset:
Can variations in visual behavior measures be good predictors of driver sleepiness? A real driving test study

ABSTRACT Objective: The primary purpose of this study was to examine the association between variations in visual behavior measures and subjective sleepiness levels across age groups over time to determine a quantitative method of measuring drivers' sleepiness levels. Method: A total of 128 volunteer drivers in 4 age groups were asked to finish 2-, 3-, and 4-h continuous driving tasks on expressways, during which the driver's fixation, saccade, and blink measures were recorded by an eye-tracking system and the subjective sleepiness level was measured through the Stanford Sleepiness Scale. Two-way repeated measures analysis of variance was then used to examine the change in visual behavior measures across age groups over time and compare the interactive effects of these 2 factors on the dependent visual measures. Results: Drivers' visual behavior measures and subjective sleepiness levels vary significantly over time but not across age groups. A statistically significant interaction between age group and driving duration was found in drivers' pupil diameter, deviation of search angle, saccade amplitude, blink frequency, blink duration, and closure duration. Additionally, change in a driver's subjective sleepiness level is positively or negatively associated with variation in visual behavior measures, and such relationships can be expressed in regression models for different period of driving duration. Conclusions: Driving duration affects drivers' sleepiness significantly, so the amount of continuous driving time should be strictly controlled. Moreover, driving sleepiness can be quantified through the change rate of drivers' visual behavior measures to alert drivers of sleepiness risk and to encourage rest periods. These results provide insight into potential strategies for reducing and preventing traffic accidents and injuries.
Correlation Of 3D Surfaces From Multiple Modalities In Medical Imaging

Tomographic studies are used in a comparative and complementary fashion to show bone and soft tissue anatomy (CT, MR) and disease as well as physiological activity (PET, SPECT). The problem is to take several sets of imaging data, which are inherently tridimensional and correlate the information provided. The usual approach is for the physician to mentally correlate the information provided by a set of two dimensional images. Different scaling factors, orien-tation of the acquired images and patient positioning may difficult the accurate identification of the same regions of interest, specially for critical applications such as radiation therapy or surgery planning. In this paper we analyze a method to correlate sets of tomographic data based on geometrical transformations between corresponding surfaces defined in each imaging modality. The outlines of structures defined in one modality can then be viewed in the context of another or a common plane of view can be defined for the different structures for simultaneous viewing. Also 3-dimensional depictions of surfaces defined in various studies can be viewed in a composite image.
Detection of the toughest: Pedestrian injury risk as a smooth function of age

ABSTRACT Objective: Though it is common to refer to age-specific groups (e.g., children, adults, elderly), smooth trends conditional on age are mainly ignored in the literature. The present study examines the pedestrian injury risk in full-frontal pedestrian-to–passenger car accidents and incorporates age—in addition to collision speed and injury severity—as a plug-in parameter. Methods: Recent work introduced a model for pedestrian injury risk functions using explicit formulae with easily interpretable model parameters. This model is expanded by pedestrian age as another model parameter. Using the German In-Depth Accident Study (GIDAS) to obtain age-specific risk proportions, the model parameters are fitted to the raw data and then smoothed by broken-line regression. Results: The approach supplies explicit probabilities for pedestrian injury risk conditional on pedestrian age, collision speed, and injury severity under investigation. All results yield consistency to each other in the sense that risks for more severe injuries are less probable than those for less severe injuries. As a side product, the approach indicates specific ages at which the risk behavior fundamentally changes. These threshold values can be interpreted as the most robust ages for pedestrians. Conclusions: The obtained age-wise risk functions can be aggregated and adapted to any population. The presented approach is formulated in such general terms that in can be directly used for other data sets or additional parameters; for example, the pedestrian's sex. Thus far, no other study using age as a plug-in parameter can be found.
Predictors of restraint use among child occupants

ABSTRACT Objectives: The objective of this study was to identify factors that predict restraint use and optimal restraint use among children aged 0 to 13 years. Methods: The data set is a national sample of police-reported crashes for years 2010–2014 in which type of child restraint is recorded. The data set was supplemented with demographic census data linked by driver ZIP code, as well as a score for the state child restraint law during the year of the crash relative to best practice recommendations for protecting child occupants. Analysis used linear regression techniques. Results: The main predictor of unrestrained child occupants was the presence of an unrestrained driver. Among restrained children, children had 1.66 (95% confidence interval, 1.27, 2.17) times higher odds of using the recommended type of restraint system if the state law at the time of the crash included requirements based on best practice recommendations. Conclusions: Children are more likely to ride in the recommended type of child restraint when their state's child restraint law includes wording that follows best practice recommendations for child occupant protection. However, state child restraint law requirements do not influence when caregivers fail to use an occupant restraint for their child passengers.
Belted driver fatalities: Time of death and risk by injury severity

ABSTRACT Purpose: This is a descriptive study of the fatality risk by injury severity and time of death for lap–shoulder-belted drivers without ejection in modern vehicles. It also determined the body region for severe injuries experienced by belted drivers using the most recent federal crash data. Methods: 1997–2015 NASS-CDS data were evaluated for fatally injured lap–shoulder-belted drivers without ejection in light vehicles of 1997+ model year (MY). The severity of injuries sustained by belted drivers was assessed by the Maximum Abbreviated Injury Scale (MAIS) and individual injuries by Abbreviated Injury Scale (AIS) and body region. The change in fatality risk with MAIS was fit with a Logist function. Time of death was determined using the variable DEATH, which is reported hourly in unequal intervals up to 24 h and then daily up to 30 days after the crash. The fraction (f) and cumulative fraction (F) of the deaths are reported for each time period up to 30 days. A power or logarithmic curve was fit to the data using the trendline functions in Excel. Results: The NASS-CDS sample included 20,610,000 belted drivers with 37,974 fatalities from 1997 to 2015. The fraction of driver deaths increased with maximum injury severity (MAIS). For example, 17.4% of drivers died within 30 days with MAIS 4 injury. Virtually all drivers (99.7%) died with MAIS 6 injury. The change in fatality risk with injury severity was r = [1 + exp(10.159 − 2.088MAIS)]−1, R2 = 0.950. Overall, there were 19,772 driver deaths with MAIS 4–6 injury and 13,059 with MAIS 0–3 injury. In addition, 44.7% of driver deaths occurred within 1.5 h of the crash, 56.7% within 2.5 h, and 64.6% within 4.5 h after the crash. The cumulative fraction of the deaths (F) up to 30 days was fit with a logarithmic function. It was F = 0.0739ln(t) + 0.5302, R2 = 0.976, for deaths after 3.5 h. There were 19,772 driver deaths with 52,130 AIS 4+ injuries. On average, the driver experienced 2.64 AIS 4+ injuries most commonly to the head (44.5%) and thorax (38.1%). Conclusions: The risk for belted driver deaths exponentially increased with MAIS. A majority of deaths occurred within 2.5 h of the crash. On average, fatally injured drivers experienced 2.64 AIS 4+ injuries, primarily to the head and thorax.
A conformational heparan sulfate binding site essential to infectivity overlaps with the conserved hepatitis B virus A‐determinant

Two determinants of infectivity have been identified in the hepatitis B virus (HBV) envelope proteins: a pre‐S1 receptor‐binding site and an uncharacterized determinant in the antigenic loop (AGL), which is structurally related to the antigenic a‐determinant. Infection would proceed through virus attachment to cell surface heparan sulfate (HS) proteoglycans (HSPGs) before pre‐S1 engages a specific receptor for uptake. Using heparin binding and in vitro infection assays with hepatitis D virus as a surrogate for HBV, we established that HS binding is mediated by the AGL. Electrostatic interaction was shown to depend upon AGL residues R122 and K141, because their substitution with alanine modified the virus net‐charge and prevented binding to heparin, attachment to hepatocytes, and infection. In addition to R122 and K141, the HS binding determinant was mapped to cysteines and prolines, which also define the conformational a‐determinant. The importance of AGL conformation was further demonstrated by the concomitant loss of a‐determinant and heparin binding upon treatment of viral particles with membrane‐impermeable reducing agent. Furthermore, envelope proteins extracted from the viral membrane with a nonionic detergent were shown to conserve the a‐determinant but to lose heparin affinity/avidity. Conclusion: Our findings support a model in which attachment of HBV to HSPGs is mediated by the AGL HS binding site, including only two positively charged residues (R122 and K141) positioned precisely in a three‐dimensional AGL structure that is stabilized by disulfide bonds. HBV envelope proteins would individually bind to HS with low affinity, but upon their clustering in the viral membrane, they would reach sufficient avidity for a stable interaction between virus and cell surface HSPGs. Our data provide new insight into the HBV entry pathway, including the opportunity to design antivirals directed to the AGL‐HS interaction. (HEPATOLOGY 2013)
Increased susceptibility of natural killer T‐cell‐deficient mice to acetaminophen‐induced liver injury

Acetaminophen (APAP) overdose causes severe, fulminant liver injury. The underlying mechanism of APAP‐induced liver injury (AILI), studied by a murine model, displays similar characteristics of injury as those observed in patients. Previous studies suggest that aside from APAP‐induced direct damage to hepatocytes, the hepatic innate immune system is activated and may contribute to the overall pathogenesis of AILI. The current study employed the use of two murine natural killer (NK) cells with T‐cell receptor (NKT) cell knockout models (CD1d−/− and Jα18−/−) to elucidate the specific role of NKT cells in AILI. Compared to wild‐type (WT) mice, NKT cell‐deficient mice were more susceptible to AILI, as indicated by higher serum alanine transaminase levels and mortality. Increased levels of cytochrome P450 2E1 (CYP2E1) protein expression and activities, which resulted in increased APAP protein adduct formation, were observed in livers of APAP‐treated NKT cell‐deficient mice, compared to WT mice. Compared to WT mice, starvation of NKT cell‐deficient mice induced a higher increase of ketone bodies, which up‐regulate CYP2E1 through protein stabilization. Conclusion: Our data revealed a novel role of NKT cells in regulating responses to starvation‐induced metabolic stress. Elevated ketone body production in NKT cell‐deficient mice resulted in increased CYP2E1‐mediated APAP biotransformation and susceptibility to AILI. (HEPATOLOGY 2013)
Enhancement of tumor‐associated antigen‐specific T cell responses by radiofrequency ablation of hepatocellular carcinoma

Radiofrequency ablation (RFA) is one of the treatments for hepatocellular carcinoma (HCC) and is known to enhance host immune response. However, the epitopes to which enhanced immune responses occur, the impact on patient prognosis, and the functions and phenotype of T cells induced are still unclear. To address these issues, we analyzed immune responses before and after RFA in 69 HCC patients using 11 tumor‐associated antigen (TAA)‐derived peptides that we identified to be appropriate to analyze HCC‐specific immune responses. The immune responses were analyzed using enzyme‐linked immunospot (ELISPOT) assay and tetramer assays using peripheral blood mononuclear cells. An increase in the number of TAA‐specific T cells detected by interferon‐γ ELISPOT assays occurred in 62.3% of patients after RFA. The antigens and their epitope to which enhanced T cell responses occur were diverse, and some of them were newly induced. The number of TAA‐specific T cells after RFA was associated with the prevention of HCC recurrence, and it was clarified to be predictive of HCC recurrence after RFA by univariate and multivariate analyses. The number of TAA‐specific T cells after RFA was inversely correlated with the frequency of CD14+HLA‐DR−/low myeloid‐derived suppressor cells (MDSCs). The modification of T cell phenotype was observed after RFA. The number of TAA‐specific T cells at 24 weeks after RFA was decreased. Conclusion: Although RFA can enhance various TAA‐specific T cell responses and the T cells induced contribute to the HCC recurrence‐free survival of patients, besides immunosuppression by MDSCs, the memory phenotype and lifetime of TAA‐specific T cells are not sufficient to prevent HCC recurrence completely. Additional treatments by vaccine or immunomodulatory drugs might be useful to improve the immunological effect of RFA. (Hepatology 2013;1448–1457)
Laser irradiation effect on Staphylococcus aureus and Pseudomonas aeruginosa biofilms isolated from venous leg ulcer

Chronic wounds, including diabetic foot ulcers, pressure ulcers and venous leg ulcers, represent a significant cause of morbidity in developed countries, predominantly in older patients. The aetiology of these wounds is probably multifactorial, but the role of bacteria in their pathogenesis is still unclear. Moreover, the presence of bacterial biofilms has been considered an important factor responsible for wounds chronicity. We aimed to investigate the laser action as a possible biofilm eradicating strategy, in order to attempt an additional treatment to antibiotic therapy to improve wound healing. In this work, the effect of near‐infrared (NIR) laser was evaluated on mono and polymicrobial biofilms produced by two pathogenic bacterial strains, Staphylococcus aureus PECHA10 and Pseudomonas aeruginosa PECHA9, both isolated from a chronic venous leg ulcer. Laser effect was assessed by biomass measurement, colony forming unit count and cell viability assay. It was shown that the laser treatment has not affected the biofilms biomass neither the cell viability, although a small disruptive action was observed in the structure of all biofilms tested. A reduction on cell growth was observed in S. aureus and in polymicrobial biofilms. This work represents an initial in vitro approach to study the influence of NIR laser treatment on bacterial biofilms in order to explain its potentially advantageous effects in the healing process of chronic infected wounds.
A critical review of modern and emerging absorbent dressings used to treat exuding wounds

Wound management has progressed significantly over the last five decades. This emanates from a greater understanding of wound healing, technological progression and improved clinical and scientific research. There are currently a plethora of absorbent dressings on the wound care market which claim to have the ability to manage exudates whilst encouraging healing. However, it is becoming clear, from analysing randomised controlled trials, that some of these absorbent dressings are not meeting their expectations when applied in a clinical setting. Many clinicians now feel that there should be more focus, not only on a dressing's ability to manage exudate efficiently, but on a dressing's ability to proactively encourage healing and thus exudate reduction will ensue. This paper proposes to critically review modern and emerging absorbent wound care dressings used to manage exuding wounds and discuses some advances in this area.
Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute‐on‐chronic liver failure: The RELIEF trial

Acute‐on‐chronic liver failure (ACLF) is a frequent cause of death in cirrhosis. Albumin dialysis with the molecular adsorbent recirculating system (MARS) decreases retained substances and improves hemodynamics and hepatic encephalopathy (HE). However, its survival impact is unknown. In all, 189 patients with ACLF were randomized either to MARS (n = 95) or to standard therapy (SMT) (n = 94). Ten patients (five per group) were excluded due to protocol violations. In addition, 23 patients (MARS: 19; SMT: 4) were excluded from per‐protocol (PP) analysis (PP population n = 156). Up to 10 6‐8‐hour MARS sessions were scheduled. The main endpoint was 28‐day ITT and PP survival. There were no significant differences at inclusion, although the proportion of patients with Model for Endstage Liver Disease (MELD) score over 20 points and with spontaneous bacterial peritonitis (SBP) as a precipitating event was almost significantly greater in the MARS group. The 28‐day survival was similar in the two groups in the ITT and PP populations (60.7% versus 58.9%; 60% versus 59.2% respectively). After adjusting for confounders, a significant beneficial effect of MARS on survival was not observed (odds ratio [OR]: 0.87, 95% confidence interval [CI] 0.44‐1.72). MELD score and HE at admission and the increase in serum bilirubin at day 4 were independent predictors of death. At day 4, a greater decrease in serum creatinine (P = 0.02) and bilirubin (P = 0.001) and a more frequent improvement in HE (from grade II‐IV to grade 0‐I; 62.5% versus 38.2%; P = 0.07) was observed in the MARS group. Severe adverse events were similar. Conclusion: At scheduled doses, a beneficial effect on survival of MARS therapy in patients with ACLF could not be demonstrated. However, MARS has an acceptable safety profile, has significant dialysis effect, and nonsignificantly improves severe HE. (HEPATOLOGY 2013)
Time to Treat Problematic Sleep Disturbance in Perinatal Women

Sleep disturbance is an expected part of becoming a new mother. But for how long? At what severity? And at what cost to mother and infant? Evidence is mounting that disturbed sleep can precede the onset of a depressive episode in the general population (Ford & Kamerow, 1989; Perlis, Giles, Buysse, Tu, & Kupfer, 1997), as well as in perinatal women (Okun et al., 2011). Postpartum major depression (PPD) occurs in up to 13% of women and is the most common complication of childbirth (O’Hara & Swain, 1996), resulting in increased morbidity and mortality – including suicide – in mothers (Bonari et al., 2004), adverse child outcomes (Murray & Cooper, 1996), and high economic costs (Petrou, Cooper, Murray, & Davidson, 2002). Although PPD represents a major public health problem and despite indications that disturbed sleep likely plays a role in the development of PPD, postpartum sleep problems are considered normal in new mothers, rather than a treatable risk factor for poor maternal and child outcomes.
Electrophysical therapy for managing diabetic foot ulcers: a systematic review

To systematically assess published reports on the efficacy of electrophysical therapy in the treatment of diabetic foot ulcers, including electrical stimulation, low‐level laser therapy, therapeutic ultrasound and electromagnetic therapy. Databases searched included MEDLINE, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1966 to 2011. Studies reviewed included only randomised controlled trials (RCTs) on treatment with electrophysical modalities compared with sham, conventional treatment or other electrophysical modalities. Information extracted were objective measures of healing and data useful for the calculation of effect size. Eight RCTs were eventually included in the critical appraisal, with a combined total of 325 participants. Five studies were conducted on electrical stimulation, two on phototherapy and one on ultrasound. All studies reported that the experimental group was significantly more favourable than the control or sham group. The pooled estimate of the number of healed ulcers of the three studies on electrical stimulation compared to the control or sham electrical stimulation showed statistical significance [mean difference of 2·8 (95% CI = 1·5–5·5, P = 0·002] in favour of electrical stimulation. The results indicated potential benefit of using electrophysical therapy for managing diabetic foot ulcers. However, due to the small number of trials ever conducted, the possibility of any harmful effects cannot be ruled out, and high‐quality trials with larger sample sizes are warranted.
The SBSM Guide to Actigraphy Monitoring: Clinical and Research Applications

The SBSM Guide to Actigraphy Monitoring: Clinical and Research Applications Sonia Ancoli-Israel, Jennifer L. Martin, Terri Blackwell, Luis Buenaver, Lianqi Liu, Lisa J. Meltzer, Avi Sadeh, Adam P. Spira & Daniel J. Taylor a Departments of Psychiatry and Medicine, University of California, San Diego b David Geffen School of Medicine at the University of California, Los Angeles c VA Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center d Research Institute, California Pacific Medical Center, San Francisco e Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine f Department of Psychiatry, University of California, San Diego g Department of Pediatrics, National Jewish Health, Denver h School of Psychological Sciences, Tel Aviv University, Israel i Department of Mental Health, Johns Hopkins Bloomberg School of Public Health j Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine k Department of Psychology, University of North Texas Published online: 14 Aug 2015.
First report of a funnel‐web spider envenoming syndrome in Brisbane

The Australian funnel‐web spider, arguably the most venomous spider in the world, is distributed along the Australian eastern seaboard, typically preferring moist, cool, sheltered habitats such as rainforests. Prior surveys around Brisbane have only ever demonstrated funnel‐web spiders in the outskirts of the city contiguous with bushland or native rainforest. We report the first funnel‐web spider envenoming syndrome presumed from a spider resident to inner‐city Brisbane. Emergency departments in the greater Brisbane area should be prepared for this clinical scenario, and stocks of Commonwealth Serum Laboratory funnel‐web spider antivenom, until now thought to be unnecessary, should be readily available.