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The major human spirochetal pathogens (Leptospira, Borrelia, and Treponema) are difficult to diagnose and lack vaccines to prevent infections. Infection by these spirochetes does not generate general protective immunity, allowing reinfection by different strains to occur. These stealth pathogens have uncommon physiology, pathogenesis, and clinical presentations and possess unique immune evasion mechanisms to facilitate their host adaptation and persistence. Collectively, host-spirochete interactions orchestrate systemic infections in a manner distinct from organ- and tissue-specific diseases caused by many bacterial pathogens. Difficulties in growing and genetic manipulation of infectious spirochetes have hindered the full understanding of their virulence factors despite decades to centuries of research. This article highlights the current understanding of the intricacies of spirochetal pathogenesis and diseases. Our comprehensive review of the progress versus gaps in knowledge lays a foundation for researchers to direct their studies toward the development of effective diagnostics and vaccines to protect patients from serious, chronic spirochetal diseases.
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Background: A fracture is considered a medical emergency leading to considerable complications. Aim: This study aimed to describe the accelerating action of Ag-NPs-FG on fracture healing in rabbits. Methods: Silver NPs (AgNPs) were reduced with fenugreek (FG), loaded into a starch gel base, and investigated for their morphology, size, and charge. Four equal groups were randomly formed of 40 adult male rabbits. A 3.5 mm diameter bone defect was created at the proximal metaphysis of the right tibia in each rabbit. Groups 1-4 were injected with placebo saline, AgNPs-FG, plain gel, and FG-gel at the bone defect zone, respectively. The healing was assessed for 8 weeks postoperatively based on the radiographic, bone turnover markers, and histopathological examinations. Results: The AgNPs-FG was obtained as a faint reddish color, spherical in shape, with an absorbance of 423 nm, a size of 118.0 ± 1.7 nm, and a surface charge of -7.8 ± 0.518 mV. The prepared AgNPs-FG hydrogel was clear, translucent, and homogenous. The pH values were 6.55-6.5 ± 0.2, the viscosity of 4,000 and 1,875 cPs, and spreadability of 1.6 ± 0.14 and 2.0 ± 0.15 for both FG and AgNPs-FG hydrogel, respectively. The radiographic union scale was significantly (p < 0.05) improved in group 2 with a significant (p < 0.05) increase in bone turnover markers was found in comparison to other treated groups. Histopathological examination revealed the formation of mature bone on the 28th postoperative day in groups 2 and 4. Conclusion: Colloidal nano-formulation of AgNPs-FG loaded hydrogel could be a promising formulation to accelerate rabbits' tibial bone healing process.
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Nanopartículas del Metal , Plata , Tibia , Trigonella , Animales , Conejos , Trigonella/química , Plata/administración & dosificación , Plata/farmacología , Plata/química , Masculino , Nanopartículas del Metal/administración & dosificación , Nanopartículas del Metal/química , Tibia/cirugía , Tibia/efectos de los fármacos , Curación de Fractura/efectos de los fármacos , Extractos Vegetales/farmacología , Extractos Vegetales/administración & dosificación , Extractos Vegetales/químicaRESUMEN
Traditional DID models overlook variations in policy intensity, causing estimation deviations from the actual situation and a limited understanding of the influence mechanism. In response, the Intensity Modified SDID Model is built to examine the influence mechanism of ETS's carbon reductions. Moreover, through model extensions, the study explores the spatiotemporal characteristics and heterogeneities of ETS's effects. Results show that: (1) "Dual-circulation" influence mechanism is confirmed, where ETS directly contributes to carbon reductions (2.70% to 10.0% impact) through external pathways, and internal pathways continuously strengthen reduction effects, comprehensive mechanisms are thereby formed and enhanced based on interaction among internal and external pathways. (2) Reasonable ETS levels are estimated and proposed to achieve "Dual Carbon Target", constraining nationwide carbon quotas by 20 billion tons/year, increasing carbon trading volumes by 80 thousand tons/year, and elevating the carbon trading prices by 100 RMB (14 USD) per ton. (3) ETS's carbon reduction effects are identified with temporal and spatial characteristics, temporally, effects peak in the 4th period (Event+4) but diminish in the 5th period (Event+5), spatially, effects peak in areas distancing around 1000 km but disappear beyond 1500 km. (4) ETS also has synergistic effects with atmospheric pollution reduction, including industrial emissions of sulfur dioxide and smoke (dust), but are insignificant to industrial emissions of wastewater and solid waste.
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Ticks have a profound impact on public health. Haemaphysalis is one of the most widespread genera in Asia, including Japan. The taxonomy and genetic differentiation of Haemaphysalis spp. is challenging. For instance, previous studies struggled to distinguish Haemaphysalis japonica and Haemaphysalis megaspinosa due to the dearth of nucleotide sequence polymorphisms in widely used barcoding genes. The classification of H. japonica japonica and its related sub-species Haemaphysalis japonica douglasi or Haemaphysalis jezoensis is also confused due to their high morphological similarity and a lack of molecular data that support the current classification. We used mitogenomes and microbiomes of H. japonica and H. megaspinosa to gain deeper insights into the phylogenetic relationships and genetic divergence between two species. Phylogenetic analyses of concatenated nucleotide sequences of protein-coding genes and ribosomal DNA genes distinguished H. japonica and H. megaspinosa as monophyletic clades, with further subdivision within the H. japonica clade. The 16S rRNA and NAD5 genes were valuable markers for distinguishing H. japonica and H. megaspinosa. Population genetic structure analyses indicated that genetic variation within populations accounted for a large proportion of the total variation compared to variation between populations. Microbiome analyses revealed differences in alpha and beta diversity between H. japonica and H. megaspinosa: H. japonica had the higher diversity. Coxiella sp., a likely endosymbiont, was found in both Haemaphysalis species. The abundance profiles of likely endosymbionts, pathogens, and commensals differed between H. japonica and H. megaspinosa: H. megaspinosa was more diverse.
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Ixodidae , Microbiota , Filogenia , ARN Ribosómico 16S , Animales , Ixodidae/microbiología , Ixodidae/genética , Microbiota/genética , ARN Ribosómico 16S/genética , Genoma Mitocondrial , Variación GenéticaRESUMEN
The management of heart failure has undergone significant evolution, advancing from the initial utilization of digitalis and diuretics to the contemporary practice of personalized medicine and sophisticated device therapy. Despite these advancements, the persistent challenge of high hospitalization and readmission rates underscores an urgent need for innovative solutions. This manuscript explores how the integration of digital health technologies into interventional cardiology marks a paradigm shift in the management of heart failure. These technologies are no longer mere adjuncts but have become foundational to a modern approach, providing tools for continuous monitoring, patient education, and improved outcomes post-intervention. Through an examination of current trends, this perspective article highlights the transformative impact of wearable technologies, telehealth platforms, and advanced analytical tools in reshaping patient engagement and enabling proactive care strategies. Case studies illustrate the practical advantages, including enhanced medication adherence, early detection of heart failure signs, and a reduction in healthcare facility burdens. Central to this new digital health landscape is the Information Technology Management (ITM) system, a framework poised to revolutionize patient and caregiver engagement and pave the way for the future of interventional cardiology. This manuscript delineates the ITM system's innovative architecture and its consequential role in refining current and prospective cardiological interventions.
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Cuidadores , Insuficiencia Cardíaca , Participación del Paciente , Telemedicina , Humanos , Insuficiencia Cardíaca/terapia , Participación del Paciente/métodos , Manejo de la Enfermedad , Tecnología Biomédica/tendencias , Tecnología Biomédica/métodos , Tecnología Digital , Salud DigitalRESUMEN
The numbers of wastewater treatment plants (WWTP) in Egypt are increasing, yet the general level of pollution associated with wastewater discharge after treatment has not been evaluated. Grey water footprint (GWF) was used to assess the effluent discharges from Zefta WWTP. GWF, before and after treatment, was calculated and followed up to determine its impact on the receiving freshwater body. 150 samples were collected and analysed for BOD5 to determine the optimum operating conditions. Averages values were DO = 2.2, SV30 = 500, SVI = 167, SA = 9.3 d, MLVSS = 2392â mg/L, f/m = 0.16, MLSS in RAS = 7922â mg/L, WAS = 140 m3/d and the HRT = 12â h. The removal efficiency of COD and TSS in the primary settling tank reached 39% and 69%, respectively. Average calculations of removal efficiency percentile reached 90-93%. Average freshwater quantities required to reduce pollutants in the receiving body stream were seasonally determined for Zefta WWTP as 5.3 × 107â m3/year. The average influent BOD5 was 376â mg/L, it was reduced to 47â mg/L in the effluent, wherever the Cmin is 6â mg/L and Cnat is 10â mg/L. Statistical analysis has shown a significant direct relation between ΔWFG,mef and WFG,ref reached 0.952 and a significant inverse relation with Cef -0.982. WFG,T has shown a significant direct relation with Cr 0.974. WFG,T- ref has shown a significant direct relation with Cr as 0.971 and WFG,T as 0.803. It can be concluded that ΔWF is effective in evaluating the efficiency of wastewater treatment and its effect on the quality of receiving water bodies.
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Computer vision in the structural health monitoring (SHM) field has become popular, especially for processing unmanned aerial vehicle (UAV) data, but still has limitations both in experimental testing and in practical applications. Prior works have focused on UAV challenges and opportunities for the vibration-based SHM of buildings or bridges, but practical and methodological gaps exist specifically for linear infrastructure systems such as pipelines. Since they are critical for the transportation of products and the transmission of energy, a feasibility study of UAV-based SHM for linear infrastructures is essential to ensuring their service continuity through an advanced SHM system. Thus, this study proposes a single UAV for the seismic monitoring and safety assessment of linear infrastructures along with their computer vision-aided procedures. The proposed procedures were implemented in a full-scale shake-table test of a natural gas pipeline assembly. The objectives were to explore the UAV potential for the seismic vibration monitoring of linear infrastructures with the aid of several computer vision algorithms and to investigate the impact of parameter selection for each algorithm on the matching accuracy. The procedure starts by adopting the Maximally Stable Extremal Region (MSER) method to extract covariant regions that remain similar through a certain threshold of image series. The feature of interest is then detected, extracted, and matched using the Speeded-Up Robust Features (SURF) and K-nearest Neighbor (KNN) algorithms. The Maximum Sample Consensus (MSAC) algorithm is applied for model fitting by maximizing the likelihood of the solution. The output of each algorithm is examined for correctness in matching pairs and accuracy, which is a highlight of this procedure, as no studies have ever investigated these properties. The raw data are corrected and scaled to generate displacement data. Finally, a structural safety assessment was performed using several system identification models. These procedures were first validated using an aluminum bar placed on an actuator and tested in three harmonic tests, and then an implementation case study on the pipeline shake-table tests was analyzed. The validation tests show good agreement between the UAV data and reference data. The shake-table test results also generate reasonable seismic performance and assess the pipeline seismic safety, demonstrating the feasibility of the proposed procedure and the prospect of UAV-based SHM for linear infrastructure monitoring.
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The present study is focused on the sensitive determination of newly FDA-approved glucagon-like-peptide agonists semaglutide (SEM) and tirzepatide (TIR). Direct, selective and label-free spectrofluorometric method was proposed and validated (according to ICH guidelines) for determination SEM and TIR in their pure form, newly approved pharmaceuticals and spiked human plasma. The developed method was based on measuring the native fluorescence of SEM and TIR in ethanol at 294.8 and 303 nm after being excited at 216 and 225 nm for SEM and TIR in order. The method sensibility allowed the quantification of both drugs in nano-scale up to 10 ng/mL. Several experimental variables including solvent type, surfactant, and pH were optimized after several attempts to get the best sensitivity for both drugs. The mean recovery percentage of SEM was compared and found in agreement with the reported method using student's t-test and the variance ratio F-test. Additionally, the greenness and whiteness profiles for this approach were evaluated using the GAPI, AGREE, and RGB algorithm; the positive results supported its use as great candidates for successful implementation in quality control labs and the pharmaceutical analysis companies.
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Algoritmos , Polipéptido Inhibidor Gástrico , Receptor del Péptido 2 Similar al Glucagón , Péptidos Similares al Glucagón , Humanos , ColorantesRESUMEN
PURPOSE: The results after acetabular fracture are primarily related to the quality of articular reduction. Using the AO large femoral distractor, incarcerated fragments can be easily removed, and marginally impacted fragments can be elevated under direct visualization without further re-dislocating the joint. The current study aimed to evaluate our early results of using the AO large femoral distractor as an assisting tool during ORIF of acetabular fractures associated with marginal impaction or intraarticular incarcerated fragments. METHODS: Eighteen patients were included in this retrospective case series study diagnosed with an acetabular fracture associated with either marginal impaction injury or an intraarticular incarcerated fragment. On a usual operative table, all patients were operated upon in a prone position through the Kocher Langenbeck approach. The AO large femoral distractor was used to facilitate hip joint distraction. Postoperative fracture reduction and joint clearance were assessed in the immediate postoperative CT scans. RESULTS: The average age of the patients was 30 ± 8.2 years; 13 (72.2%) were males. All cases had a posterior wall fracture, and it was associated with transverse fractures, posterior column fractures, and T-type fractures in five (27.8%), two (11.1%), and one (5.6%) patients, respectively. Intraarticular incarcerated fragments were present in 13 (72.2%) cases and marginal impaction in five (27.8%). Fracture reduction measured on the postoperative CT scans showed an anatomical reduction in 14 (77.8%) patients, imperfect in four (22.2%), and complete clearance of the hip joint of any incarcerated fragments. CONCLUSION: The use of the AO large femoral distractor is a reliable and reproducible technique that can be applied to assist in the removal of incarcerated intraarticular fragments and to ease the reduction of marginally impacted injuries associated with acetabular fractures.
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Fracturas Óseas , Fracturas de Cadera , Fracturas de la Columna Vertebral , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Acetábulo/diagnóstico por imagen , Acetábulo/cirugía , Acetábulo/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Óseas/complicaciones , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fracturas de Cadera/complicaciones , Articulación de la Cadera/diagnóstico por imagen , Articulación de la Cadera/cirugía , Estudios Retrospectivos , Fracturas de la Columna Vertebral/complicacionesRESUMEN
The soleus H-reflex modulation pattern was investigated during stepping following transspinal stimulation over the thoracolumbar region at 15, 30, and 50 Hz with 10 kHz carry-over frequency above and below the paresthesia threshold. The soleus H-reflex was elicited by posterior tibial nerve stimulation with a single 1 ms pulse at an intensity that the M-wave amplitudes ranged from 0 to 15% of the maximal M-wave evoked 80 ms after the test stimulus, and the soleus H-reflex was half the size of the maximal H-reflex evoked on the ascending portion of the recruitment curve. During treadmill walking, the soleus H-reflex was elicited every 2 or 3 steps, and stimuli were randomly dispersed across the step cycle which was divided in 16 equal bins. For each subject and condition, the soleus M-wave and H-reflex were normalized to the maximal M-wave. The soleus background electromyographic (EMG) activity was estimated as the linear envelope for 50 ms duration starting at 100 ms before posterior tibial nerve stimulation for each bin. The gain was determined as the slope of the relationship between the soleus H-reflex and the soleus background EMG activity. The soleus H-reflex phase-dependent amplitude modulation remained unaltered during transspinal stimulation, regardless frequency, or intensity. Similarly, the H-reflex slope and intercept remained the same for all transspinal stimulation conditions tested. Locomotor EMG activity was increased in knee extensor muscles during transspinal stimulation at 30 and 50 Hz throughout the step cycle while no effects were observed in flexor muscles. These findings suggest that transspinal stimulation above and below the paresthesia threshold at 15, 30, and 50 Hz does not block or impair spinal integration of proprioceptive inputs and increases activity of thigh muscles that affect both hip and knee joint movement. Transspinal stimulation may serve as a neurorecovery strategy to augment standing or walking ability in upper motoneuron lesions.
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Electromiografía , Reflejo H , Músculo Esquelético , Caminata , Humanos , Reflejo H/fisiología , Caminata/fisiología , Masculino , Músculo Esquelético/fisiología , Adulto , Adulto Joven , Femenino , Estimulación Eléctrica/métodos , Nervio Tibial/fisiología , Médula Espinal/fisiologíaRESUMEN
Transplacental transmission of syphilis causing spirochete, Treponema pallidum subspecies pallidum, from mother to child results in congenital syphilis, an ever-expanding devastating disease worldwide. Although adverse effects of untreated gestational Lyme disease, caused by a related spirochete, Borrelia burgdorferi on fetus viability and development have been observed, cases of congenital Lyme disease are not reported. In this study, we show that B. burgdorferi colonizes mammary glands of C3H mice only postpartum; however, neither transmission of these spirochetes from dams-to-pups occurs nor congenital Lyme disease is observed in pups.
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Borrelia burgdorferi , Enfermedad de Lyme , Glándulas Mamarias Humanas , Treponema , Humanos , Ratones , Animales , Niño , Femenino , Ratones Endogámicos C3H , Lactancia , Transmisión Vertical de Enfermedad InfecciosaRESUMEN
Current research on environmental instruments often isolates the two mainstream types, market-based and regulation-based, overlooking their real-world interactions. In response, the intensity gap variable (EII_GAP) is constructed to link various instruments into a united system. Thus, based on the spatial econometrics of the spatial panel Durbin model (SPDM), the collective effects between market- and regulation-based environmental instruments on environmental quality are explored. Moreover, the political strategies for maximizing environmental benefits are discussed. Results show that the interaction pattern between market- and regulation-based environmental instruments on environmental quality is characterized by competition rather than cooperation. A unit widening in the intensity gap leads to 17 to 18% and 12 to 18% units of environmental quality improvement in local and adjacent areas, respectively. Furthermore, the "dominate-follow" approach as the most effective mode for maximizing environmental effects is proposed. This study recommends employing one type of instrument as the dominant while the other as the auxiliary. In provinces where one kind of environmental instrument takes domination, the environmental quality could be increased by around 8 to 113% after taking another contrary instrument as the auxiliary.
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Diabetic retinopathy (DR) is a neurovascular complication of diabetes, driven by an intricate network of cellular and molecular mechanisms. This study sought to explore the mechanisms by investigating the role of 12-hydroxyeicosatetraenoic acid (12-HETE), its receptor GPR31, and microRNA (miR-29) in the context of DR, specifically focusing on their impact on Müller glial cells. We found that 12-HETE activates Müller cells (MCs), elevates glutamate production, and induces inflammatory and oxidative responses, all of which are instrumental in DR progression. The expression of GPR31, the receptor for 12-HETE, was prominently found in the retina, especially in MCs and retinal ganglion cells, and was upregulated in diabetes. Interestingly, miR29 showed potential as a protective agent, mitigating the harmful effects of 12-HETE by attenuating inflammation and oxidative stress, and restoring the expression of pigment epithelium-derived factor (PEDF). Our results underline the central role of 12-HETE in DR progression through activation of a neurovascular toxic pathway in MCs and illuminate the protective capabilities of miR-29, highlighting both as promising therapeutic targets for the management of DR.
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Retinopatía Diabética , MicroARNs , Ácido 12-Hidroxi-5,8,10,14-Eicosatetraenoico/metabolismo , Retinopatía Diabética/genética , Retinopatía Diabética/metabolismo , Células Ependimogliales , MicroARNs/genética , MicroARNs/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Retina/metabolismoRESUMEN
A robust, stability-indicating, and eco-friendly proton nuclear magnetic resonance (1H-qNMR) method was developed for the concurrent determination of three 1,4-benzodiazepines (BDZs), namely diazepam (DZP), alprazolam (ALP), and chlordiazepoxide (CDP) and their common impurity, synthesis precursor, and degradation product; 2-amino-5-chlorobenzophenone (ACB). In the present method, a novel approach was developed for composing a green and cost-efficient solvent system as an alternative to the common NMR organic solvents utilizing 0.3 M sodium dodecyl sulfate prepared in deuterated water. The conducted method is characterized by simplicity with no need for sample pretreatment or labeling. Phloroglucinol was used as an internal standard. The chosen signals for the determinations of ALP, CDP, DZP and ACB were at 2.35 ppm (singlet), 2.84 ppm (singlet), 3.11 ppm (singlet), and 6.90 ppm (doublet of doublet), respectively. The proposed method possessed linearity over the concentration range of 0.25-15.0 mg ml-1 for DZP, ALP, CDP and of 0.5-25.0 mg ml-1 for ACB with LOD values of 0.06, 0.03, 0.07 and 0.16 mg ml-1 respectively, and LOQ values of 0.18, 0.09, 0.21 and 0.49 mg ml-1, respectively. Accuracy of the method was evidenced by excellent recovery% (99.57-99.90%) and small standard deviation (≥ 1.10) for the three analyzed drugs. Intra- and inter-day precision were determined with coefficient of variation ranging from 0.12 to 1.14 and from 0.72 to 1.67, respectively. For the studied compounds, appraisal of the method greenness was achieved via four approaches: Analytical Eco-Scale, Green Analytical Procedure Index (GAPI), Analytical greenness metric (AGREE), and RGB Additive Color Model. The results proved that the proposed method has the privilege of being a green analytical method.
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Benzodiazepinas , Benzofenonas , Diazepam , Espectroscopía de Resonancia Magnética , SolventesRESUMEN
Animal movement across regions owing to human activity can lead to the introduction of pathogens, resulting in disease epidemics with medical and socioeconomic significance. Here, we validated the hypothesis that human activity, such as the transportation of infected animals, has played a significant role in introducing the zoonotic parasite Echinococcus multilocularis into Hokkaido, Japan, by synthesizing and evaluating parasite genetic data in light of historical records. Our analysis indicates that a major genetic group in Hokkaido originated from St. Lawrence Island, USA, which is in accordance with the route suggested by historical descriptions. Moreover, we identified a minor genetic group closely related to parasites found in Sichuan, China. This fact implies that parasite invasion in Japan may result from complex and inadvertent animal translocations. These findings emphasize the anthropogenic impacts on zoonotic parasite spread and provide a crucial perspective for preventing future potential epidemics.
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New series of substituted 2-alkoxycyanopyridine derivatives were synthesized and evaluated for their in vitro and in vivo anticancer activities. Comparing the evaluated activities against cancer cell lines to the broad-spectrum anticancer doxorubicin, and the kinase inhibitor sorafenib, compounds 3a, 4b, 4c, 7a, and 8d demonstrated superior anticancer efficacy with elevated safety profiles and selectivity indices, particularly against MCF7 breast cancer. For exploration of their mechanism of action, assays for inhibition of EGFR, HER2 kinase, and DHFR were performed. The promising synthesized compounds exhibited potent dual kinase EGFR/HER2 inhibitory activity with IC50values of 0.248/0.156 µM for 4b and 0.138/0.092 µM for 4c. Additionally, with IC50 values of 0.138 and 0.193 M, respectively, 4b and 4c had the greatest DHFR inhibitory activity that was comparable to methotrexate. In the MCF7 breast cancer cell line, they caused arrest at the S phase of the cell cycle and exhibited apoptosis induction activity. With restored caspase-3 immunoexpression, the anti-breast cancer assay performed in vivo of 4b and 4c demonstrated a substantial decrease in tumor volume. Results from molecular modeling were in agreement with biological assays proving the importance of the 3-caynopyridine, two substituted phenyl rings attached to central pyridine ring, and propoxy side chain moieties for binding with the receptors. As 4c works by inhibiting both EGFR/HER2 kinase, DHFR enzymes, in addition to cellular apoptosis, it could be viewed as a model of compounds possessing a multi-targeting anticancer activity. Collectively, compounds 4b and 4c might represent prototypes for further development as anticancer molecules.
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Antineoplásicos , Neoplasias de la Mama , Humanos , Femenino , Estructura Molecular , Relación Estructura-Actividad , Receptores ErbB , Ensayos de Selección de Medicamentos Antitumorales , Antineoplásicos/química , Apoptosis , Inhibidores de Proteínas Quinasas , Neoplasias de la Mama/tratamiento farmacológico , Proliferación Celular , Línea Celular Tumoral , Simulación del Acoplamiento MolecularRESUMEN
In conditionally automated driving, the driver is free to disengage from controlling the vehicle, but they are expected to resume driving in response to certain situations or events that the system is not equipped to respond to. As the level of vehicle automation increases, drivers often engage in non-driving-related tasks (NDRTs), defined as any secondary task unrelated to the primary task of driving. This engagement can have a detrimental effect on the driver's situation awareness and attentional resources. NDRTs with resource demands that overlap with the driving task, such as visual or manual tasks, may be particularly deleterious. Therefore, monitoring the driver's state is an important safety feature for conditionally automated vehicles, and physiological measures constitute a promising means of doing this. The present systematic review and meta-analysis synthesises findings from 32 studies concerning the effect of NDRTs on drivers' physiological responses, in addition to the effect of NDRTs with a visual or a manual modality. Evidence was found that NDRT engagement led to higher physiological arousal, indicated by increased heart rate, electrodermal activity and a decrease in heart rate variability. There was mixed evidence for an effect of both visual and manual NDRT modalities on all physiological measures. Understanding the relationship between task performance and arousal during automated driving is of critical importance to the development of driver monitoring systems and improving the safety of this technology.
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Accidentes de Tránsito , Análisis y Desempeño de Tareas , Humanos , Accidentes de Tránsito/prevención & control , Automatización , Vehículos Autónomos , ConcienciaciónRESUMEN
Background: Estimating and analyzing trends and patterns of health loss are essential to promote efficient resource allocation and improve Peru's healthcare system performance. Methods: Using estimates from the Global Burden of Disease (GBD), Injuries, and Risk Factors Study (2019), we assessed mortality and disability in Peru from 1990 to 2019. We report demographic and epidemiologic trends in terms of population, life expectancy at birth (LE), mortality, incidence, prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) caused by the major diseases and risk factors in Peru. Finally, we compared Peru with 16 countries in the Latin American (LA) region. Results: The Peruvian population reached 33.9 million inhabitants (49.9% women) in 2019. From 1990 to 2019, LE at birth increased from 69.2 (95% uncertainty interval 67.8-70.3) to 80.3 (77.2-83.2) years. This increase was driven by the decline in under-5 mortality (-80.7%) and mortality from infectious diseases in older age groups (+60 years old). The number of DALYs in 1990 was 9.2 million (8.5-10.1) and reached 7.5 million (6.1-9.0) in 2019. The proportion of DALYs due to non-communicable diseases (NCDs) increased from 38.2% in 1990 to 67.9% in 2019. The all-ages and age-standardized DALYs rates and YLLs rates decreased, but YLDs rates remained constant. In 2019, the leading causes of DALYs were neonatal disorders, lower respiratory infections (LRIs), ischemic heart disease, road injuries, and low back pain. The leading risk factors associated with DALYs in 2019 were undernutrition, high body mass index, high fasting plasma glucose, and air pollution. Before the COVID-19 pandemic, Peru experienced one of the highest LRIs-DALYs rates in the LA region. Conclusion: In the last three decades, Peru experienced significant improvements in LE and child survival and an increase in the burden of NCDs and associated disability. The Peruvian healthcare system must be redesigned to respond to this epidemiological transition. The new design should aim to reduce premature deaths and maintain healthy longevity, focusing on effective coverage and treatment of NCDs and reducing and managing the related disability.