Exploring the Timing of Disengagement From Nondriving Related Tasks in Scheduled Takeovers With Pre-Alerts: An Analysis of Takeover-Related Measures.

OBJECTIVES: This study aimed to investigate drivers' disengagement from nondriving related tasks (NDRT) during scheduled takeovers and to evaluate its impact on takeover performance. BACKGROUND: During scheduled takeovers, drivers typically have sufficient time to prepare. However, inadequate disengagement from NDRTs can introduce safety risks. METHOD: Participants experienced scheduled takeovers using a driving simulator, undergoing two conditions, with and without an NDRT. We assessed their takeover performance and monitored their NDRT disengagement from visual, cognitive, and physical perspectives. RESULTS: The study examined three NDRT disengagement timings (DTs): DT1 (disengaged before the takeover request), DT2 (disengaged after the request but before taking over), and DT3 (not disengaged). The impact of NDRT on takeover performance varied depending on DTs. Specifically, DT1 demonstrated no adverse effects; DT2 impaired takeover time, while DT3 impaired both takeover time and quality. Additionally, participants who displayed DT1 exhibited longer eye-off-NDRT duration and a higher eye-off-NDRT count during the prewarning stage compared to those with DT2 and DT3. CONCLUSION: Drivers can benefit from earlier disengagement from NDRTs, demonstrating resilience to the adverse effects of NDRTs on takeover performance. The disengagement of cognition is often delayed compared to that of eyes and hands, potentially leading to DT3. Moreover, visual disengagement from NDRTs during the prewarning stage could distinguish DT1 from the other two. APPLICATION: Our study emphasizes considering NDRT disengagement in designing systems for scheduled takeovers. Measures should be taken to promote early disengagement, facilitate cognitive disengagement, and employ visual disengagement during the prewarning period as predictive indicators of DTs.

Comparative observation of common tracers in sentinel lymph node biopsy of breast cancer and a study on simplifying its surgical procedure.

Background: Many breast cancer patients have avoided axillary lymph node dissection after sentinel lymph node biopsy (SLNB). During the SLNB operation, the color of lymphatic vessels is sometimes poor and so finding them is difficult. This study observed the tracing effects of three tracer combinations and also reported our experience in simplifying the SLNB program. Methods: In total, 123 breast cancer patients whose TNM stage was cT1-2N0M0 were retrospectively studied. According to the tracer used, the patients were divided into the carbon nanoparticle (CNP) group (38 cases), CNP combined with methylene blue (CNP + MB) group (41 cases), and indocyanine green combined with MB (ICG + MB) group (44 cases). All 123 breast cancer cases were also classified into the non-tracking group (53 cases) and tracking group (70 cases) according to the SLNB operation process. The non-tracking group looked for the stained sentinel lymph nodes directly, while the tracking group looked for the stained lymph nodes along the lymphatic vessels. Results: The SLN identification rates in the CNP, CNP + MB, and ICG + MB groups were 97.4%, 97.6%, and 95.5% respectively (P > 0.05). The average number of SLNs detected was 4.92 ± 2.06, 5.12 ± 2.18, and 4.57 ± 1.90, respectively (P > 0.05). The ideal display rates of lymphatic vessels in the three groups were 86.8%, 87.8%, and 93.2%, respectively (P > 0.05). The SLN identification rates in the non-tracking and tracking groups were 96.2% and 97.1%, respectively (P > 0.05). The average number of SLNs detected were 5.73 ± 1.76 and 5.70 ± 1.93, respectively (P > 0.05), and the average operation time was 16.47 ± 5.78 and 27.53 ± 7.75 min, respectively (P < 0.05). Conclusion: This is the first study to observe the application effect of CNP combined with MB and ICG combined with MB tracers in SLNB of breast cancer patients. No significant difference was observed among the patients in SLN identification and lymphatic vessel display. Omitting the step of searching for lymphatic vessels in SLNB surgery does not reduce the surgical effect, but the reduced operating steps can reduce the surgical time and theoretically reduce postoperative complications.