Driver’s physiological measures with in vehicle secondary distraction: a systematic review

Driving vehicles has become more complex. Thus, drivers who are not engaged with any non-related driving activities, that is performing in-vehicle secondary task, are unusual nowadays. Statistics also shows the higher number of crashes come from distracted driving. In addition, currently, there is limited review have been done to compile and review the physiological method, driving distraction and its effect on the driver. Therefore, this paper aims to review the effect of driver’s in-vehicle distraction and secondary task during driving on driver’s health and safety. A systematic search was conducted on the basis of the preferred reporting items for systematic reviews by using PRISMA guidelines. Any criteria were imposed for the included sample. The search was focused on in-vehicle secondary task and distraction. Results showed that 21 articles investigated the major ability for in-vehicle secondary task distraction using physiological measures. Findings showed a significant effect of the in-vehicle secondary task and distraction on driver’s condition. Drivers’ characteristics such as their experience and age are also factors in determining the effect of distraction and secondary tasks on their condition. However, further studies are needed to understand the physiological effect of secondary task on young driver’s condition due to the relatively higher number of crash rates from those at a young age

Driver’s performance under different secondary tasks and disruptions on rural road environment

Nowadays, detection of driver’s fatigue is a major concern in vehicle design, road safety and transportation research. Driving tasks requires full attention from the drivers while operating the vehicle. Occasionally, drivers are exposed to perform other activities such as talking to a passenger and using an in-vehicle technology or phone which is known as secondary task while driving. Thus, this study aims to analyse the driver’s performance via three types of physiological measurements in a simulated condition. An integrated approach by combining subjective and objective methods were used in this study. There are Karolinska Sleepiness Scale (KSS), Electroencephalogram (EEG) and Heart Rate (HR). Twelve participants were recruited to evaluate their responses towards different types of secondary tasks and disruptions in 25-minutes of driving duration. The findings showed that there are differences in physiological responses for this driving session. Beta Activity shows higher event-related power modulation values from start until the end of the driving session. In conclusion, the type of disruption during driving and secondary tasks shows different findings towards driver driving performances. This study can be used as reference to drivers and related agencies by taking into account the physiological effects of driver’s performance based on different secondary tasks and disruptions while driving

Comparison of access to medicines between Klang Valley and East Coast of peninsular Malaysia for children living in poor households

Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia.Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children.Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal.Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.Keywords: Aaccess to medicine, Poor populations, Children, Klang Valley, Peninsular Malaysi

Simple coordination and cognitive stimulation activities for cognitive function assessments using functional near-infrared spectroscopy

Functional near-infrared spectroscopy (fNIRS) is a non-invasive and high-density imaging device used for the evaluation of cognitive functions by measuring the oxygenated haemoglobin (HbO) and deoxygenated haemoglobin (HHb) levels in the prefrontal cortex. The present study determined the utilisation of fNIRS in detecting cerebral haemoglobin oxygenation level during coordination and simple cognitive stimulation activities in healthy young volunteers. Thirty subjects comprising equally of both genders were recruited. Subjects were tasked with coordination tests (plate tapping and block transfer tests) and cognitive stimulation activities (ruler drop test and MRAVLT) while the fNIRS system was attached to their prefrontal cortex area. The HbO and HHb levels were recorded and analysed using Repeated Measures ANOVA. The HbO levels during coordination tests differ significantly from resting state (p0.05), except channel 3. All cognitive stimulation activities increased HbO levels compared to resting state; this change was significant in channels 3 and 4 (p<0.05). In contrast, HHb levels during all cognitive tests were lower compared to the resting state and was found to be significant in channels 2 and 3 (p<0.05). These findings suggested that coordination and cognitive stimulation activities activate prefrontal cortex in healthy young adults and could be potentially utilised as a valid screening tool for cognitive function assessments via fNIRS

Long Lasting Modulation of Cortical Oscillations after Continuous Theta Burst Transcranial Magnetic Stimulation

Transcranial magnetic theta burst stimulation (TBS) differs from other high-frequency rTMS protocols because it induces plastic changes up to an hour despite lower stimulus intensity and shorter duration of stimulation. However, the effects of TBS on neuronal oscillations remain unclear. In this study, we used electroencephalography (EEG) to investigate changes of neuronal oscillations after continuous TBS (cTBS), the protocol that emulates long-term depression (LTD) form of synaptic plasticity. We randomly divided 26 healthy humans into two groups receiving either Active or Sham cTBS as control over the left primary motor cortex (M1). Post-cTBS aftereffects were assessed with behavioural measurements at rest using motor evoked potentials (MEPs) and at active state during the execution of a choice reaction time (RT) task in combination with continuous electrophysiological recordings. The cTBS-induced EEG oscillations were assessed using event-related power (ERPow), which reflected regional oscillatory activity of neural assemblies of θ (4–7.5 Hz), low α (8–9.5 Hz), µ (10–12.5 Hz), low β (13–19.5 Hz), and high β (20–30 Hz) brain rhythms. Results revealed 20-min suppression of MEPs and at least 30-min increase of ERPow modulation, suggesting that besides MEPs, EEG has the potential to provide an accurate cortical readout to assess cortical excitability and to investigate the interference of cortical oscillations in the human brain post-cTBS. We also observed a predominant modulation of β frequency band, supporting the hypothesis that cTBS acts more on cortical level. Theta oscillations were also modulated during rest implying the involvement of independent cortical theta generators over the motor network post cTBS. This work provided more insights into the underlying mechanisms of cTBS, providing a possible link between synchronised neural oscillations and LTD in humans

Alteration in the functional organization of the default mode network following closed non-severe traumatic brain injury

The debilitating effect of traumatic brain injury (TBI) extends years after the initial injury and hampers the recovery process and quality of life. In this study, we explore the functional reorganization of the default mode network (DMN) of those affected with non-severe TBI. Traumatic brain injury (TBI) is a wide-spectrum disease that has heterogeneous effects on its victims and impacts everyday functioning. The functional disruption of the default mode network (DMN) after TBI has been established, but its link to causal effective connectivity remains to be explored. This study investigated the differences in the DMN between healthy participants and mild and moderate TBI, in terms of functional and effective connectivity using resting-state functional magnetic resonance imaging (fMRI). Nineteen non-severe TBI (mean age 30.84 ± 14.56) and twenty-two healthy (HC; mean age 27.23 ± 6.32) participants were recruited for this study. Resting-state fMRI data were obtained at the subacute phase (mean days 40.63 ± 10.14) and analyzed for functional activation and connectivity, independent component analysis, and effective connectivity within and between the DMN. Neuropsychological tests were also performed to assess the cognitive and memory domains. Compared to the HC, the TBI group exhibited lower activation in the thalamus, as well as significant functional hypoconnectivity between DMN and LN. Within the DMN nodes, decreased activations were detected in the left inferior parietal lobule, precuneus, and right superior frontal gyrus. Altered effective connectivities were also observed in the TBI group and were linked to the diminished activation in the left parietal region and precuneus. With regard to intra-DMN connectivity within the TBI group, positive correlations were found in verbal and visual memory with the language network, while a negative correlation was found in the cognitive domain with the visual network. Our results suggested that aberrant activities and functional connectivities within the DMN and with other RSNs were accompanied by the altered effective connectivities in the TBI group. These alterations were associated with impaired cognitive and memory domains in the TBI group, in particular within the language domain. These findings may provide insight for future TBI observational and interventional research

Kefungsian saraf sensori median dan hubungannya dengan tempoh carpal tunnel syndrome dan indeks jisim tubuh

Kajian ini menilai kefungsian pelbagai jenis serat saraf sensori median, serta menentukan hubungan fungsi saraf dengan tempoh Carpal Tunnel Syndrome (CTS) dan indeks jisim tubuh (body mass index, BMI) di kalangan penghidap CTS di Unit Fisioterapi Hospital Universiti Kebangsaan Malaysia (HUKM). Sejumlah 30 orang subjek (6 lelaki dan 24 perempuan) dengan min umur 53.30 ± 9.20 tahun dan min tempoh penyakit 51.17 ± 50.22 bulan terlibat dalam kajian ini. Kepekaan serat saraf sensori dinilai menggunakan ujian Current Perception Threshold (CPT) menggunakan rangsangan 5 Hz, 250 Hz dan 2000 Hz; yang masing-masing mempamerkan kefungsian serat saraf C, Aδ dan Aβ. Kajian mendapati bahawa majoriti subjek mempunyai fungsi saraf yang normal untuk ketiga-tiga jenis serat saraf sensori median. Sejumlah 40% subjek mempunyai keabnormalan fungsi serat saraf Aβ, 7% mempunyai keabnormalan serat saraf Aδ dan 27% subjek mengalami keabnormalan serat saraf C. Ujian korelasi Spearman menunjukkan tiada hubungan yang signifikan di antara kefungsian saraf sensori median dengan tempoh menghidap CTS dan BMI (p > 0.05). Kesimpulannya, walaupun majoriti penghidap CTS di HUKM mempunyai fungsi serat saraf sensori median yang normal, keabnormalan sensitiviti serat Aβ, Aδ dan C bagi saraf sensori median di kalangan sebahagian penghidap perlu diberi perhatian bagi mencegah keterukan fungsi saraf seterusnya komplikasi lanjutan. Ahli Fisioterapi di HUKM boleh meningkatkan penggunaan modaliti perangsang saraf seperti Transcutaneous Electrical Nerve Stimulation (TENS) bagi mengembalikan kefungsian serat saraf pesakit yang terlibat

Cortical Oscillations and Plasticity Induced by Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique that is able to modulate cortical activity beyond the stimulation period. The residual aftereffects are akin to the plasticity mechanism of the brain and suggest the potential use of rTMS for therapy. In parallel, there is evidence that altered oscillatory brain rhythms and network dynamics may lead to symptoms of neuropsychiatric disorders. However, the rTMS interference upon cortical and network oscillatory activity remains relatively unknown. Despite this uncertainty, rTMS continues to be used to alleviate symptoms of neuropsychiatric disorders. By combining rTMS and electroencephalography (EEG), the thesis explored the local and network cortical plasticity in healthy humans through the characteristics of oscillatory brain rhythms. We investigated cortical and network oscillatory activity following simple rTMS protocols and continuous theta burst stimulation (cTBS) to the primary motor cortex. The measurements of rTMS-induced aftereffects were quantified by the direct electrophysiology index of EEG and the indirect behavioural measures of motor evoked potentials (MEPs). The results of the experiments showed that rTMS was able to transiently modulate cortical brain rhythms, especially low frequency theta oscillations. The significance of this finding is the possible involvement of independent cortical theta generators besides mu and beta generators over the motor network with different reactivity to rTMS protocols. However, long-term potentiation/depression (LTP-/LTD)-like mechanisms may not be the only mechanisms that drive the rTMS aftereffects as shown by the dissociation between EEG and MEPs cortical output. Here, we explore alternative explanations that drive the EEG oscillatory modulations post rTMS. The significant of this work is the ability of rTMS to transiently modify the internal state of the brain by altering brain oscillations particularly low-frequency brain rhythms. This finding offers exciting possibilities for future clinical trials to explore the use of non-invasive brain stimulation to reverse abnormal synchronisation in neuropsychiatric disorders