Naturalistic Driving: User and Task Analysis

Cognitive Task Analysis and methods for analyzing Naturalistic Decision Making are powerful tools that can be applied to transportation research. In conjunction with simulators, these methods allow increased understanding of real user interactions with their in-vehicle systems, and the decision processes involved in the operational aspects of driving, navigating, and using infotainment support systems. Adopting this approach facilitates investigation of driver performance under a range of workload and stress conditions, which supports future development of a prototypical model that will encapsulate the cognitive and perceptual-motor demands of driving in the presence of situational stressors under both high- and low-workload conditions

Diabetes and atypical presentations of patients hospitalized for an acute myocardial infarction in Puerto Rico

Introduction: Diabetes mellitus is one of the fastest growing health issues concerning the world today with an estimated 382 million individuals affected as of 2013 and a projected increase in number to 592 million by 2035. Diabetes mellitus is a condition affecting 12-15% of the population or around 400,000 people in Puerto Rico. The most common presenting complaint of diabetics who are hospitalized for an acute myocardial infarction (AMI) is chest pain. However, the pervasiveness of atypical symptoms in diabetic patients is yet unclear. The aim of this study is to determine if there is an association between diabetes and the presentation of atypical symptoms in the emergency room in those suffering from an AMI in Puerto Rico. Methods: We conducted a secondary data analysis of data from participants from the 2007, 2009 and 2011 Puerto Rico Cardiovascular Disease Surveillance system (PRCDS), an observational, non-concurrent, cross-sectional study. The main independent variable was presence of diabetes mellitus (Type I and Type II). The outcome was the presence of atypical symptoms at the time of presentation, defined as the absence of chest pain on admission. The prevalence of atypical symptoms in diabetic patients and non-diabetic patients was compared. Binary logistic regression was used to test for independent association. Statistical significance was considered for p-values ≤0.05 for a two-tailed test. Analysis was conducted using SPSS software. Results: We found no association between atypical presentation of an AMI and diabetes, before or after adjustment for age, gender, congestive heart failure, stroke history and BMI. (unadjusted OR= 1.0, 95%CI=0.7-1.4 and adjusted OR=1.0, 95% CI=0.6-1.5). Other independent associations identified were that patients older than 75 were 3.5 times more likely to present atypically than people younger than 55 (OR= 3.5, 95% CI=1.6-7.6), and those with CHF and stroke were more likely to present with atypical symptoms (OR=3.2, 95% CI=1.7-6.1 and OR=4.2 95% CI=2.1-8.4, respectively). Lastly, overweight patients were 3.3 times more likely to present atypically than healthy weight patients (OR=2.0, 95% CI=0.6-7.0). Conclusion: We found no evidence of an association between diabetes and the presentation of atypical symptoms in patients hospitalized for AMI in Puerto Rico

Mineral phosphorus drives glacier algal blooms on the Greenland Ice Sheet

Melting of the Greenland Ice Sheet is a leading cause of land-ice mass loss and cryosphere-attributed sea level rise. Blooms of pigmented glacier ice algae lower ice albedo and accelerate surface melting in the ice sheet’s southwest sector. Although glacier ice algae cause up to 13% of the surface melting in this region, the controls on bloom development remain poorly understood. Here we show a direct link between mineral phosphorus in surface ice and glacier ice algae biomass through the quantification of solid and fluid phase phosphorus reservoirs in surface habitats across the southwest ablation zone of the ice sheet. We demonstrate that nutrients from mineral dust likely drive glacier ice algal growth, and thereby identify mineral dust as a secondary control on ice sheet melting.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Repair, regenerative and supportive therapies of the annulus fibrosus: achievements and challenges

Lumbar discectomy is a very effective therapy for neurological decompression in patients suffering from sciatica due to hernia nuclei pulposus. However, high recurrence rates and persisting post-operative low back pain in these patients require serious attention. In the past decade, tissue engineering strategies have been developed mainly targeted to the regeneration of the nucleus pulposus (NP) of the intervertebral disc. Accompanying techniques that deal with the damaged annulus fibrous are now increasingly recognised as mandatory in order to prevent re-herniation to increase the potential of NP repair and to confine NP replacement therapies. In the current review, the requirements, achievements and challenges in this quickly emerging field of research are discussed

Cyanobacterial lipopolysaccharides and human health – a review

Cyanobacterial lipopolysaccharide/s (LPS) are frequently cited in the cyanobacteria literature as toxins responsible for a variety of heath effects in humans, from skin rashes to gastrointestinal, respiratory and allergic reactions. The attribution of toxic properties to cyanobacterial LPS dates from the 1970s, when it was thought that lipid A, the toxic moiety of LPS, was structurally and functionally conserved across all Gram-negative bacteria. However, more recent research has shown that this is not the case, and lipid A structures are now known to be very different, expressing properties ranging from LPS agonists, through weak endotoxicity to LPS antagonists. Although cyanobacterial LPS is widely cited as a putative toxin, most of the small number of formal research reports describe cyanobacterial LPS as weakly toxic compared to LPS from the Enterobacteriaceae. We systematically reviewed the literature on cyanobacterial LPS, and also examined the much lager body of literature relating to heterotrophic bacterial LPS and the atypical lipid A structures of some photosynthetic bacteria. While the literature on the biological activity of heterotrophic bacterial LPS is overwhelmingly large and therefore difficult to review for the purposes of exclusion, we were unable to find a convincing body of evidence to suggest that heterotrophic bacterial LPS, in the absence of other virulence factors, is responsible for acute gastrointestinal, dermatological or allergic reactions via natural exposure routes in humans. There is a danger that initial speculation about cyanobacterial LPS may evolve into orthodoxy without basis in research findings. No cyanobacterial lipid A structures have been described and published to date, so a recommendation is made that cyanobacteriologists should not continue to attribute such a diverse range of clinical symptoms to cyanobacterial LPS without research confirmation

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

Individual Differences in Behavioral Compliance to Warnings Representing Varying Degrees

Research regarding warning compliance has often emphasized the physical aspects of the warning itself. Here, we examine the role of the perceiver in sensation seeking and health orientation as individual difference variables that affect behavioral compliance to a health warning. The experiment used a laboratory-based simulation of a chemistry demonstration that has been used in previous warnings research. In addition, however, individual difference effects of sensation seeking and health orientation were investigated. Among the significant findings were a significant interaction between condition assignment and sensation seeking on compliance outcome and a significant interaction between condition and health orientation. These results indicate that individual difference variables represent significant influences on the degree to which persons comply with warnings