An assisted driver model. Towards developing driver assistance systems by allocating support dependent on driving situations

Partially automated driving is expected to increase traffic efficiency. How-ever, automation causes human factors concerns. One concern is the reduced operability during transitions between automation level, e.g. when failures occur. These concerns ask for a more justifiable implementation of automation for automobile appliances. As a first step towards applicable solutions for driver support, we developed the assisted driver model. The attempt with this model was to answer: what driving situations are in need for what kind of support? The influence of different levels of automation on task performance, were used to define 7 recommended support types relevant for driver assistance. For the allocation of recommended support types to distinguished driving situations we then considered the prerequisites to provide good operability in terms of the avoidance of errors and familiarity with driving circumstances. An assessment of adaptive cruise con-trol showed the model‟s potential to help developing advanced driver assistance systems whilst anticipating concerns associated with the appliance of partial automation

Future user-product arrangements: combining product impact and scenarios in design for multi age success

The presence of four generations in business and organisations and the prevalence of ever-evolving technology, pose questions for technology design; a much wider range of user-product arrangements needs to be forecast and designed for. To provide a theoretical framework that accommodates the need to forecast product appeal for various age groups and contexts this paper compares and combines the dual use of scenarios from scenario based design and scenario planning with the approach of technical mediation in the philosophy of technology. It introduces ‘scenario based design’ and ‘scenario planning’ as well as ‘mediation theory’ and specifically the ‘product impact model’. In scenario based design direct product impact can be used for drawing and evaluating scenarios with a focus how ways of doing are directed and changed by products. In scenario planning indirect product impacts are helpful. Utopian/dystopian conceptions of technology help to draw extreme scenarios, while historical patterns in sociotechnical evolution guide the evaluation and definition of realistic forecasts. Our examples suggest that these effects may just as well go in the direction of augmenting the divide between generations, and full attention is called for to prevent or solve thi

DAMPening COVID-19 Severity by Attenuating Danger Signals

COVID-19 might lead to multi-organ failure and, in some cases, to death. The COVID-19 severity is associated with a “cytokine storm.” Danger-associated molecular patterns (DAMPs) are proinflammatory molecules that can activate pattern recognition receptors, such as toll-like receptors (TLRs). DAMPs and TLRs have not received much attention in COVID-19 but can explain some of the gender-, weight- and age-dependent effects. In females and males, TLRs are differentially expressed, likely contributing to higher COVID-19 severity in males. DAMPs and cytokines associated with COVID-19 mortality are elevated in obese and elderly individuals, which might explain the higher risk for severer COVID-19 in these groups. Adenosine signaling inhibits the TLR/NF-κB pathway and, through this, decreases inflammation and DAMPs’ effects. As vaccines will not be effective in all susceptible individuals and as new vaccine-resistant SARS-CoV-2 mutants might develop, it remains mandatory to find means to dampen COVID-19 disease severity, especially in high-risk groups. We propose that the regulation of DAMPs via adenosine signaling enhancement might be an effective way to lower the severity of COVID-19 and prevent multiple organ failure in the absence of severe side effects

An ALMA view of star formation efficiency suppression in early-type galaxies after gas-rich minor mergers

Gas-rich minor mergers contribute significantly to the gas reservoir of early-type galaxies (ETGs) at low redshift, yet the star formation efficiency (SFE; the star formation rate divided by the molecular gas mass) appears to be strongly suppressed following some of these events, in contrast to the more well-known merger-driven starbursts. We present observations with the Atacama Large Millimeter/submillimeter Array (ALMA) of six ETGs, which have each recently undergone a gas-rich minor merger, as evidenced by their disturbed stellar morphologies. These galaxies were selected because they exhibit extremely low SFEs. We use the resolving power of ALMA to study the morphology and kinematics of the molecular gas. The majority of our galaxies exhibit spatial and kinematical irregularities, such as detached gas clouds, warps, and other asymmetries. These asymmetries support the interpretation that the suppression of the SFE is caused by dynamical effects stabilizing the gas against gravitational collapse. Through kinematic modelling we derive high velocity dispersions and Toomre Q stability parameters for the gas, but caution that such measurements in edge-on galaxies suffer from degeneracies. We estimate merger ages to be about 100 Myr based on the observed disturbances in the gas distribution. Furthermore, we determine that these galaxies lie, on average, two orders of magnitude below the Kennicutt–Schmidt relation for star-forming galaxies as well as below the relation for relaxed ETGs. We discuss potential dynamical processes responsible for this strong suppression of star formation surface density at fixed molecular gas surface density

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Purpose : Salvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients. Material and methods : Four patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI)-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT). Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE) version 4.0. Results : With a median follow-up of 12 months (range, 6-15), there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV) was 4.8 cc (range, 1.9-6.6 cc). A median of 8 catheters (range, 6-9) were used, and the median dose to the treatment volume (GTV) was a D95: 19.3 Gy (SD 15.5-19.4 Gy). Conclusions : Second focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients

The hepatoadrenal syndrome: A common yet unrecognized clinical condition

Objective: Adrenal failure is common in critically ill patients, particularly those with sepsis. As liver failure and sepsis are both associated with increased circulating levels of endotoxin and proinflammatory mediators and reduced levels of apoprotein-1/ high-density lipoprotein, we postulated that adrenal failure may be common in patients with liver disease. Design: Clinical study. Setting: Liver transplant intensive care unit. Patients: The study cohort included 340 patients with liver disease. Interventions: Based on preliminary observational data, all patients admitted to our 28-bed liver transplant intensive care unit (LTICU) undergo adrenal function testing. An honest broker system was used to extract clinical, hemodynamic, medication, and laboratory data on patients admitted to the LTICU from March 2002 to March 2004. A random (stress) cortisol level <20 μg/dL in a highly stressed patient (respiratory failure, hypotension) was used to diagnose adrenal insufficiency. In all other patients, a random cortisol level <15 μg/dL or a 30-min level <20 μg/dL post-low-dose (1 μg) cosyntropin was considered diagnostic of adrenal insufficiency. Patients were grouped as follows: a) chronic liver failure; b) fulminant hepatic failure; c) patients immediately status post-orthotopic liver transplantation receiving a steroid-free protocol of immunosuppression; and d) patients status post-remote liver transplant (≥6 months). The decision to treat patients with stress doses of hydrocortisone was at the discretion of the treating intensivist and transplant surgeon. Measurements and Main Results: Two-hundred and forty-five (72%) patients met our criteria for adrenal insufficiency (the hepatoadrenal syndrome). Eight (33%) patients with fulminant hepatic failure, 97 (66%) patients with chronic liver disease, 31(61%) patients with a remote history of liver transplantation, and 109 (92%) patients who had undergone liver transplantation under steroid-free immunosuppression were diagnosed with adrenal insufficiency. The high-density lipoprotein level at the time of adrenal testing was the only variable predictive of adrenal insufficiency (p < .0001). In vasopressor-dependent patients with adrenal insufficiency, treatment with hydrocortisone was associated with a significant reduction (p = .02) in the dose of norepinephrine at 24 hrs, whereas the dose of norepinephrine was significantly higher (p = .04) in those patients with adrenal failure not treated with hydrocortisone. In vasopressor-dependent patients without adrenal insufficiency, treatment with hydrocortisone did not affect vasopressor dose at 24 hrs. One hundred and forty-one patients (26.4%) died during their hospitalization. The baseline serum cortisol was 18.8 ± 16.2 μg/dL in the nonsurvivors compared with 13.0 ± 11.8 μg/dL in the survivors (p < .001). Of those patients with adrenal failure who were treated with glucocorticoids, the mortality rate was 26% compared with 46% (p = .002) in those who were not treated. In those patients receiving vasopressor agents at the time of adrenal testing, the baseline cortisol was 10.0 ± 4.8 μg/dL in those with adrenal insufficiency compared with 35.6 ± 21.2 μg/dL in those with normal adrenal function. Vasopressor-dependent patients who did not have adrenal failure had a mortality rate of 75%. Conclusions: Patients with liver failure and patients post-liver transplantation have an exceedingly high incidence of adrenal failure, which may be pathophysiologically related to low levels of high-density lipoprotein. Treatment of patients with adrenal failure may improve outcome. High baseline serum cortisol levels may be a maker of disease severity and portend a poor prognosis. Copyright © 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

Technology and Society in Equilibrium:

This sector portrait of the design engineering sciences describes the common denominator of the various design disciplines in the Netherlands. In a future sector plan, the above investment areas will be further explored and purposefully developed. The implementation of technological innovations aligned to societal issues encompasses a design challenge. This increasingly demands science-based design methodologies. The broad Dutch design landscape can fulfil the role of connector well in this regard. In order to optimally strengthen this bridging function, three areas for further investment have been identified: Research More research and research funding are needed to meet the design challenges posed by Dutch societal missions, as well as for the further development of Key Enabling Methodologies (KEMs) as the basis for effective design. Educational Capacity Expanded teaching capacity and further development of design-driven didactics are needed to meet the growing demand for designers, This demand stems from the emerging need for design approaches in new research programmes within Horizon Europe and the Dutch Research Council (NWO). Access to Technology Continuous access to the rapidly evolving technological disciplines must be guaranteed for professionals who can both understand the technology and meet the investigative design challenge

Diverse soil carbon dynamics expressed at the molecular level

The stability and potential vulnerability of soil organic matter (SOM) to global change remains incompletely understood due to the complex processes involved in its formation and turnover. Here we combine compound-specific radiocarbon analysis with fraction-specific and bulk-level radiocarbon measurements in order to further elucidate controls on SOM dynamics in a temperate and sub-alpine forested ecosystem. Radiocarbon contents of individual organic compounds isolated from the same soil interval generally exhibit greater variation than those among corresponding operationally-defined fractions. Notably, markedly older ages of long-chain plant leaf wax lipids (n-alkanoic acids) imply that they reflect a highly stable carbon pool. Furthermore, marked 14C variations among shorter- and longer-chain n-alkanoic acid homologues suggest that they track different SOM pools. Extremes in SOM dynamics thus manifest themselves within a single compound class. This exploratory study highlights the potential of compound-specific radiocarbon analysis for understanding SOM dynamics in ecosystems potentially vulnerable to global change