•People face self-driving cars with both fascination and reservation.•Openness towards self-driving cars correlates with both demographics and car use.•People are willing to ride in a self-driving ...car but are not yet ready to buy one.•Drivers do not trust self-drive technology to be safe and sophisticated enough.•Results suggest launching the technology gradually to increase both safety and trust.
In this paper we unpack and examine attitudes and potential barriers of end-users towards the self-driving car. We explore whether drivers have (mental) barriers and/or show resistance towards the self-driving car and, given such barriers and resistance are identified, investigate the main underlying reasons. Further, we suggest potential strategic implications for automotive companies and avenues to overcome, or at least mitigate, drivers’ barriers. The paper contributes to a better understanding of end-users’ opinions on radical innovations such as the self-driving car and strives to add value by linking scientific insights from both psychology as well as innovation literature. Only a limited number of studies so far have dealt with the potential barriers of users towards the self-driving car; therefore, it is our intent to provide first empirical evidence to trigger further research and foster a broader discussion on this relevant topic.
Aims. We present cosmological constraints from a joint analysis of type Ia supernova (SN Ia) observations obtained by the SDSS-II and SNLS collaborations. The dataset includes several low-redshift ...samples (z< 0.1), all three seasons from the SDSS-II (0.05 <z< 0.4), and three years from SNLS (0.2 <z< 1), and it totals 740 spectroscopically confirmed type Ia supernovae with high-quality light curves. Methods. We followed the methods and assumptions of the SNLS three-year data analysis except for the following important improvements: 1) the addition of the full SDSS-II spectroscopically-confirmed SN Ia sample in both the training of the SALT2 light-curve model and in the Hubble diagram analysis (374 SNe); 2) intercalibration of the SNLS and SDSS surveys and reduced systematic uncertainties in the photometric calibration, performed blindly with respect to the cosmology analysis; and 3) a thorough investigation of systematic errors associated with the SALT2 modeling of SN Ia light curves. Results. We produce recalibrated SN Ia light curves and associated distances for the SDSS-II and SNLS samples. The large SDSS-II sample provides an effective, independent, low-z anchor for the Hubble diagram and reduces the systematic error from calibration systematics in the low-z SN sample. For a flat ΛCDM cosmology, we find Ωm =0.295 ± 0.034 (stat+sys), a value consistent with the most recent cosmic microwave background (CMB) measurement from the Planck and WMAP experiments. Our result is 1.8σ (stat+sys) different than the previously published result of SNLS three-year data. The change is due primarily to improvements in the SNLS photometric calibration. When combined with CMB constraints, we measure a constant dark-energy equation of state parameter w =−1.018 ± 0.057 (stat+sys) for a flat universe. Adding baryon acoustic oscillation distance measurements gives similar constraints: w =−1.027 ± 0.055. Our supernova measurements provide the most stringent constraints to date on the nature of dark energy.
Purpose
Anterior lumbar surgery is a common procedure for anterior lumbar interbody fusion (ALIF) and artificial disc replacement (ADR). Our aim was to study the exposure related complications for ...anterior lumbar spinal surgery performed by spinal surgeons.
Methods
A retrospective review was performed for 304 consecutive patients who underwent anterior lumbar spinal surgery over 10 years (2001–2010) at our institution. Each patient’s records were reviewed for patients’ demographics, diagnosis, level(s) of surgery, procedure and complications related to access surgery. Patients undergoing anterior lumbar access for tumour resection, infection, trauma and revision surgeries were excluded.
Results
All patients underwent an anterior paramedian retroperitoneal approach from the left side. The mean age of patients was 43 years (10–73; 197 males, 107 females). Indications for surgery were degenerative disc disease (DDD 255), degenerative spondylolisthesis (23), scoliosis (18), iatrogenic spondylolisthesis (5) and pseudoarthrosis (3). The procedures performed were single level surgery—L5/S1 (
n
= 147), L4/5 (
n
= 62), L3/4 (
n
= 7); two levels—L4/5 and L5/S1 (
n
= 74), L3/4 and L4/5 (
n
= 4); three levels—L3/4, L4/5, L5/S1 (
n
= 5); four levels—L2/3, L3/4, L4/5, L5/S1 (
n
= 5). The operative procedures were single level ADR (
n
= 131), a single level ALIF (
n
=
87) with or without posterior fusion, two levels ALIF (
n
= 54), two levels ADR (
n
= 14), a combination of ADR/ALIF (
n
= 10), three levels ALIF (
n
= 1), three levels ADR/ALIF/ALIF (
n
= 1), ADR/ADR/ALIF (
n
= 2), four levels ALIF (
n
= 1) and finally 3 patients underwent a four level ADR/ADR/ALIF/ALIF. The overall complication rate was 61/304 (20 %). This included major complications (6.2 %)—venous injury requiring suture repair (
n
= 14, 4.6 %) and arterial injury (
n
= 5 1.6 %, 3 repaired, 2 thrombolysed). Minor complications (13.8 %) included venous injury managed without repair (
n
= 5, 1.6 %), infection (
n
= 13, 4.3 %), incidental peritoneal opening (
n
= 12, 3.9 %), leg oedema (
n
= 2, 0.6 %) and others (
n
= 10, 3.3 %). We had no cases of retrograde ejaculation.
Conclusion
We report a very thorough and critical review of our anterior lumbar access surgeries performed mostly for DDD and spondylolisthesis at L4/5 and L5/S1 levels. Vascular problems of any type (24/304, 7.8 %) were the most common complication during this approach. The incidence of major venous injury requiring repair was 14/304 (4.6 %) and arterial injury 5/304 (1.6 %). The requirement for a vascular surgeon with the vascular injury was 9/304 (3 %; 5 arterial injuries; 4 venous injuries). This also suggests that the majority of the major venous injuries were repaired by the spinal surgeon (10/14, 71 %). Our results are comparable to other studies and support the notion that anterior access surgery to the lumbar spine can be performed safely by spinal surgeons. With adequate training, spinal surgeons are capable of performing this approach without direct vascular support, but they should be available if required.
To estimate the extent of reactivity to measurement of physical activity (PA) and sedentary behavior among women in midlife with elevated risk for cardiovascular disease (CVD).
Secondary analysis of ...a 10-day observational study of PA and sedentary behavior.
PA (steps, minutes of light PA, total minutes of moderate-to- vigorous PA MVPA) and percent time in sedentary behavior per day were assessed using ActiGraph GT3X tri-axial accelerometers in 75 women in midlife with elevated CVD risk (e.g. hypertension; M
Age
= 51.61, M
BMI
= 34.02 kg/m
2
). Two-level multilevel models were used to test for evidence of reactivity, with the addition of random effects to test for evidence of individual differences in observed trends.
All outcomes showed linear trends across days (ps < 0.001), though this masked what appeared to be meaningful dropoff after Day 1 or Day 2 (with little difference between subsequent days; srs ranging from 0.15 to 0.32). The random effect was significant only for percent time in sedentary behavior (χ
2
1 = 10.40, p = 0.02).
Consistent small to medium effects were found for all PA and sedentary behavior outcomes, underscoring the importance of considering measurement reactivity in populations with elevated CVD risk.
Stage at cancer diagnosis is an important predictor of cancer survival. TNM stage is constructed for anatomic solid cancer diagnoses from tumor size (T), nodal spread (N) and distant metastasis (M) ...and categorized in groups 0-I, II, II and IV. TNM stage is imperative in cancer diagnosis, management and control, and of high value in cancer surveillance, for example, monitoring of stage distributions. This study yields an overview of TNM availability and trends in stage distribution in the Nordic countries for future use in monitoring and epidemiologic studies.
TNM information was acquired from the cancer registries in Denmark, Norway, Sweden, and Iceland during 2004-2016 for 26 cancer sites in the three former countries and four in Iceland. We studied availability, comparability, and distribution of TNM stage in three periods: 2004-2008, 2009-2013, and 2014-2016, applying a previously validated algorithm of 'N0M0 for NXMX'. For cancers of colon, rectum, lung, breast, and kidney, we examined TNM stage-specific 1-year relative survival to evaluate the quality in registration of TNM between countries.
Denmark, Sweden, and Iceland exhibited available TNM stage proportions of 75-95% while proportions were lower in Norway. Proportions increased in Sweden over time but decreased in Denmark. One-year relative survival differed substantially more between TNM stages than between countries emphasizing that TNM stage is an important predictor for survival and that stage recording is performed similarly in the Nordic countries.
Assessment and registration of TNM stage is an imperative tool in evaluations of trends in cancer survival between the Nordic countries.
The stage at diagnosis is one of the most important predictors for cancer survival. TNM stage is constructed from T (tumor size), N (nodal spread), and M (distant metastasis) components. In many ...notifications to cancer registries, TNM information is incomplete with unknown N and/or M. We aimed to evaluate the influence of various assumptions for recoding missing N (NX) and M (MX) as N0 and M0 on the proportion with available TNM stage, stage-distribution, and stage-specific relative survival.
We identified 140,201 patients diagnosed with incident cancer of the colon, rectum, lung, breast, or kidney during 2014-2016 in Denmark, Norway, Sweden, or Iceland. Information on TNM were obtained from cancer registry records used for an update of the Nordic cancer statistics database NORDCAN. Patients were followed for death or emigration through 2017. We calculated proportions of available TNM stage, stage distribution, and stage-specific relative survival under different approaches for each cancer site and country.
Application of the assumptions yielded higher numbers of cases with available TNM stage for stages 0-I, II, and III. We observed only minor differences in stage-specific one-year relative survival when applying N0M0 for missing N and M, especially for high completeness of TNM registrations, whereas relative survival for remaining cases with missing TNM stage declined substantially.
We found no major changes in stage-specific one-year relative survival applying N0M0 for NXMX. We conclude that complete TNM information is preferable to making assumptions, but it seems reasonable to consider assuming N0M0 for missing N and M in future studies based on the Nordic cancer registries. An automatic algorithm, though, is not recommended without considering potential area-specific reasons for frequent use of NX and MX. Clinicians should be urged to report complete TNM information to improve surveillance of the TNM stage.
Signals generated by the Gαq‐coupled PAF receptor reactivate Gαi‐coupled FPRs.
Formyl peptide receptor (FPR)–desensitized neutrophils display increased production/release of superoxide (O2−) when ...activated by platelet‐activating factor (PAF), a priming of the response achieved through a unique receptor crosstalk mechanism. The aim of this study was to determine the effect of an inhibitor selective for small, heterotrimeric G proteins belonging to the Gαq subclass on that receptor crosstalk. We show that signals generated by FPRs and the PAF receptor (PAFR) induce activation of the neutrophil O2−, producing NADPH‐oxidase, and that response was sensitive to Gαq inhibition in cells activated by PAF, but no inhibition was obtained in cells activated by FPR agonists. Signaling in naive neutrophils is terminated fairly rapidly, and the receptors become homologously desensitized. The downstream sensitivity to Gαq inhibition in desensitized cells displaying increased production/release of O2− through the PAFR receptor crosstalk mechanism also comprised the reactivation of the FPRs, and the activation signals were redirected from the PAFR to the desensitized/reactivated FPRs. The Gαq‐dependent activation signals generated by the PAFRs activate the Gαi‐coupled FPRs, a receptor crosstalk that represents a novel pathway by which G protein‐coupled receptors can be regulated and signaling can be turned on and off.
Purpose
U-shaped sacral fractures usually result from axial loading of the spine with simultaneous sacral pivoting due to a horizontal fracture which leads to a highly unstable spino-pelvic ...dissociation. Due to the rarity of these fractures, there is lack of an agreed treatment strategy.
Methods
A thorough literature search was carried out to identify current treatment concepts. The studies were analysed for mechanism of injury, diagnostic imaging, associated injuries, type of surgery, follow-up times, complications, neurological, clinical and radiological outcome.
Results
Sixty-three cases were found in 12 articles. No Class I, II or III evidence was found in the literature. The most common mechanism of injury was a fall or jump from height. Pre-operative neurological deficit was noted in 50 (94.3%) out of 53 cases (not available in 10 patients). The most used surgical options were spino-pelvic fixation with or without decompression and ilio-sacral screws. Post-operative complications occurred in 24 (38.1%) patients. Average follow-up time was 18.6 months (range 2–34 months). Full neurological recovery was noted in 20 cases, partial recovery in 14 and 9 patients had no neurological recovery (5 patients were lost in follow-up). Fracture healing was mentioned in 7 articles with only 1 case of fracture reduction loss.
Conclusion
From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.
Schematic representation of ADAM 8 specific binding of immunoliposome and subsequent release of doxorubicin using UHF-MRI exposure.
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Metastatic breast cancer is one of the most common ...causes of cancer-related death in women worldwide. The transmembrane metalloprotease-disintegrin (ADAM8) protein is highly overexpressed in triple-negative breast cancer (TNBC) cells and potentiates tumor cell invasion and extracellular matrix remodeling. Exploiting the high expression levels of ADAM8 in TNBC cells by delivering anti-ADAM8 antibodies efficiently to the targeted site can be a promising strategy for therapy of TNBC. For instance, a targeted approach with the aid of ultra-high field magnetic resonance imaging (UHF-MRI) activatable thermosensitive liposomes (LipTS–GD) could specifically increase the intracellular accumulation of cytotoxic drugs. The surface of doxorubicin-loaded LipTS–GD was modified by covalent coupling of MAB1031 antibody (LipTS–GD–MAB) in order to target the overexpressed ADAM8 in ADAM8 positive MDA-MB-231 cells. Physicochemical characterization of these liposomes was performed using size, surface morphology and UHF-MRI imaging analysis. In vitro cell targeting was investigated by the washing and circulation method. Intracellular trafficking and lysosomal colocalization were assessed by fluorescence microscopy. Cell viability, biocompatibility and in-ovo CAM assays were performed to determine the effectiveness and safety profiles of liposome formulations. Our results show specific binding and induction of doxorubicin release after LipTS–GD–MAB treatment caused a higher cytotoxic effect at the cellular target site.
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