Mobility management to prevent, reduce, or delay driving a car in teenagers.
Ontology highlight
ABSTRACT:
SUBMITTER: Ward A
PROVIDER: S-EPMC8094927 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:The engineered expression of chimeric antigen receptors (CARs) on the surface of T cells enables the redirection of T-cell specificity. Early clinical trials using CAR T cells for the treatment of patients with cancer showed modest results, but the impressive outcomes of several trials of CD19-targeted CAR T cells in the treatment of patients with B-cell malignancies have generated an increased enthusiasm for this approach. Important lessons have been derived from clinical trials of CD19-specific CAR T cells, and ongoing clinical trials are testing CAR designs directed at novel targets involved in haematological and solid malignancies. In this Review, we discuss these trials and present strategies that can increase the antitumour efficacy and safety of CAR T-cell therapy. Given the fast-moving nature of this field, we only discuss studies with direct translational application currently or soon-to-be tested in the clinical setting.
| S-EPMC5529102 | biostudies-literature
Project description:Starting from the dataset of the publication corpus of the APS during the period 1955-2009, we reconstruct the individual researchers trajectories, namely the list of the consecutive affiliations for each scholar. Crossing this information with different geographic datasets we embed these trajectories in a spatial framework. Using methods from network theory and complex systems analysis we characterise these patterns in terms of topological network properties and we analyse the dependence of an academic path across different dimensions: the distance between two subsequent positions, the relative importance of the institutions (in terms of number of publications) and some socio-cultural traits. We show that distance is not always a good predictor for the next affiliation while other factors like "the previous steps" of the career of the researchers (in particular the first position) or the linguistic and historical similarity between two countries can have an important impact. Finally we show that the dataset exhibit a memory effect, hence the fate of a career strongly depends from the first two affiliations.
| S-EPMC4014622 | biostudies-literature
Project description:The recent clinical success of chimeric antigen receptor (CAR) T cell therapy for B cell malignancies represents a paradigm shift in cancer immunotherapy. Unfortunately, application of CAR T cell-mediated therapy for solid tumors has so far been disappointing, and the reasons for this poor response in solid tumors remain unknown. In this issue of the JCI, Cherkassky and colleagues report on their use of a murine model of human pleural mesothelioma to explore potential factors that limit CAR T cell efficacy. Their studies have uncovered the importance of the tumor microenvironment in the inhibition of CAR T cell functions, revealed a critical role for the programmed death-1 (PD-1) pathway in CAR T cell exhaustion within the tumor microenvironment, and demonstrated improved antitumor effects with a CAR T cell-intrinsic PD-1 blockade strategy using a dominant negative form of PD-1. Together, the results of this study lay the groundwork for further evaluation of mechanisms underlying CAR T cell immune evasion within the tumor microenvironment for the improvement of CAR T cell-mediated therapy for solid tumors.
| S-EPMC4966332 | biostudies-literature
Project description:T cells that have been genetically modified, activated, and propagated ex vivo can be infused to control tumor progression in patients who are refractory to conventional treatments. Early-phase clinical trials demonstrate that the tumor-associated antigen (TAA) CD19 can be therapeutically engaged through the enforced expression of a chimeric antigen receptor (CAR) on clinical-grade T cells. Advances in vector design, the architecture of the CAR molecule especially as associated with T-cell co-stimulatory pathways, and understanding of the tumor microenvironment, play significant roles in the successful treatment of medically fragile patients. However, some recipients of CAR(+) T cells demonstrate incomplete responses. Understanding the potential for treatment failure provides a pathway to improve the potency of adoptive transfer of CAR(+) T cells. High throughput single-cell analyses to understand the complexity of the inoculum coupled with animal models may provide insight into the therapeutic potential of genetically modified T cells. This review focuses on recent advances regarding the human application of CD19-specific CAR(+) T cells and explores how their success for hematologic cancers can provide a framework for investigational treatment of solid tumor malignancies.
| S-EPMC3995024 | biostudies-literature
Project description:Aging is associated with a large heterogeneity in the extent of age-related changes in sensory, motor, and cognitive functions. All these functions can influence the performance in complex tasks like car driving. The present study aims to identify potential differences in underlying cognitive processes that may explain inter-individual variability in driving performance. Younger and older participants performed a one-hour monotonous driving task in a driving simulator under varying crosswind conditions, while behavioral and electrophysiological data were recorded. Overall, younger and older drivers showed comparable driving performance (lane keeping). However, there was a large difference in driving lane variability within the older group. Dividing the older group in two subgroups with low vs. high driving lane variability revealed differences between the two groups in electrophysiological correlates of mental workload, consumption of mental resources, and activation and sustaining of attention: Older drivers with high driving lane variability showed higher frontal Alpha and Theta activity than older drivers with low driving lane variability and-with increasing crosswind-a more pronounced decrease in Beta activity. These results suggest differences in driving strategies of older and younger drivers, with the older drivers using either a rather proactive and alert driving strategy (indicated by low driving lane variability and lower Alpha and Beta activity), or a rather reactive strategy (indicated by high driving lane variability and higher Alpha activity).
| S-EPMC5774811 | biostudies-literature
Project description:ImportanceOne mechanism for teenagers' elevated crash risk during independent driving may be inadequate learner driving experience.ObjectiveTo determine how learner driver experience was associated with crash risk during the first year of independent driving.Design, setting, and participantsYouth aged 15.5 to 16.1 years at recruitment were eligible to participate. Participants' vehicles were instrumented with sensors, and driving was recorded during the learner period through 1 year of independent driving. Data were collected from January 2011 through August 2014 in southwestern Virginia.ExposuresThe amount, consistency and variety of practice, driving errors, and kinematic risky driving (KRD) rates during the learner period were recorded. Surveys, including one on sensation-seeking personality traits, were assessed at baseline.Main outcomes and measuresCox proportional hazard regressions examined associations between individual characteristics and learner driving experience with driving time to first crash and all crashes in the first year of independent driving. So that hazard ratios (HRs) can be directly comparable, units of measurement were standardized to the interquartile range.ResultsOf 298 individuals who responded to recruitment, 90 fulfilled the criteria and 82 completed the study (of whom 75 were white [91%] and 44 were girls [54%]). Teenage participants drove a mean (SD) of 1259.2 (939.7) miles over 89 days during the learner period. There were 49 property-damage crashes and/or police-reportable crashes during independent driving. Factors associated with driving time to first crash included higher sensation-seeking personality scale scores (HR, 1.67 [95% CI, 1.08-2.57] per 0.75-unit increase), learner driving KRD rates (HR, 1.27 [95% CI, 1.12-1.43] per 9.24-unit increase), and learner driving errors (HR, 0.44 [95% CI, 0.22-0.86] per increase of 6.48 errors). Similar results were obtained for all crashes in the first year, with the addition of consistency of learner driving practice (HR, 0.61 [95% CI, 0.38-0.99] per 0.23-unit increase).Conclusions and relevanceIndividual characteristics and learner driving experiences were associated with crash risk during independent driving. As expected, there was an association between sensation seeking and crashes. Elevated KRD rates during the learner period may reflect risky driving behavior among novices or tolerance to abrupt maneuvers by parents who supervise driving. Consistent practice throughout the learner period could reduce teenage crash risk, which is supported by learning theories indicating distributed practice is effective for developing expertise. Errors during practice may constitute learning events that reinforce safer driving. Physicians could encourage parents to provide opportunities for regular practice driving and monitor their teenager's KRD rates during the learner period using in-vehicle or smartphone-based technology.
| S-EPMC7136860 | biostudies-literature
Project description:Teenage passengers might influence risky driving, particularly in certain mental states. Notably, social exclusion could increase social conformity. Two studies examined simulated intersection management among young drivers after a social exclusion activity (Cyberball). In Study 1 [112 males (mean = 17.3 years)], risky driving was significantly greater among excluded males driving with a risk-accepting vs. passive passenger; no effect of social exclusion. In Study 2 [115 females (mean = 17.1 years)], risky driving was significantly greater among excluded females driving with a risk-accepting vs. a passive passenger, and greater among those included (fair play) vs. excluded when driving with a risk-accepting passenger. Risky driving behavior among male and female teenagers may be influenced uniquely by passenger norms and social exclusion.
| S-EPMC6524721 | biostudies-literature
Project description:BACKGROUND:Disability and falls are common following fall-related lower limb and pelvic fractures. OBJECTIVE:To evaluate the impact of an exercise self-management intervention on mobility-related disability and falls after lower limb or pelvic fracture. DESIGN:Randomized controlled trial. PARTICIPANTS:Three hundred thirty-six community dwellers aged 60+ years within 2 years of lower limb or pelvic fracture recruited from hospitals and community advertising. INTERVENTIONS:RESTORE (Recovery Exercises and STepping On afteR fracturE) intervention (individualized, physiotherapist-prescribed home program of weight-bearing balance and strength exercises, fall prevention advice) versus usual care. MAIN MEASURES:Primary outcomes were mobility-related disability and rate of falls. KEY RESULTS:Primary outcomes were available for 80% of randomized participants. There were no significant between-group differences in mobility-related disability at 12 months measured by (a) Short Physical Performance Battery (continuous version, baseline-adjusted between-group difference 0.08, 95% CI -?0.01 to 0.17, p?=?0.08, n?=?273); (b) Activity Measure Post Acute Care score (0.18, 95% CI -?2.89 to 3.26, p?=?0.91, n?=?270); (c) Late Life Disability Instrument (1.37, 95% CI -?2.56 to 5.32, p?=?0.49, n?=?273); or in rate of falls over the 12-month study period (incidence rate ratio 0.96, 95% CI 0.69 to 1.34, n?=?336, p?=?0.83). Between-group differences favoring the intervention group were evident in some secondary outcomes: balance and mobility, fall risk (Physiological Profile Assessment tool), physical activity, mood, health and community outings, but these should be interpreted with caution due to risk of chance findings from multiple analyses. CONCLUSIONS:No statistically significant intervention impacts on mobility-related disability and falls were detected, but benefits were seen for secondary measures of balance and mobility, fall risk, physical activity, mood, health, and community outings. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry: ACTRN12610000805077.
| S-EPMC7573017 | biostudies-literature
Project description:Primary CNS lymphomas (PCNSL) represent a group of extranodal non-Hodgkin lymphomas and secondary CNS lymphomas refer to secondary involvement of the neuroaxis by systemic disease. CNS lymphomas are associated with limited prognosis even after aggressive multimodal therapy. Chimeric antigen receptor (CAR) T-cells have proven as a promising therapeutic avenue in hematological B-cell malignancies including diffuse large B-cell lymphoma, B-cell acute lymphoblastic leukemia, and mantle-cell lymphoma. CARs endow an autologous T-cell population with MHC-unrestricted effectivity against tumor target antigens such as the pan B-cell marker CD19. In PCNSL, compelling and long-lasting anti-tumor effects of such therapy have been shown in murine immunocompromised models. In clinical studies on CAR T-cells for CNS lymphoma, only limited data are available and often include both patients with PCNSL but also patients with secondary CNS lymphoma. Several clinical trials on CAR T-cell therapy for primary and secondary CNS lymphoma are currently ongoing. Extrapolated from the available preliminary data, an overall acceptable safety profile with considerable anti-tumor effects might be expected. Whether these beneficial anti-tumor effects are as long-lasting as in animal models is currently in doubt; and the immunosuppressive tumor microenvironment of the brain may be among the most pivotal factors limiting efficacy of CAR T-cell therapy in CNS lymphoma. Based on an increasing understanding of CAR T-cell interactions with the tumor cells as well as the cerebral tissue, modifications of CAR design or the combination of CAR T-cell therapy with other therapeutic approaches may aid to release the full therapeutic efficiency of CAR T-cells. CAR T-cells may therefore emerge as a novel treatment strategy in primary and secondary CNS lymphoma.
| S-EPMC8161128 | biostudies-literature
Project description:Teenagers have unique needs for mental wellbeing that can be supported by interactive technologies. Teens also have valuable input in the design of technology, so designers and researchers must seek new methods for involving them in the design process. We enrolled 23 unacquainted teenagers in an Asynchronous Remote Communities (ARC) study consisting of two private online groups. Teens participated in 10 weekly design activities on stress management across three months. We found that teens sought support from technology tailored to their perception of control in stressful contexts, developing sense of self, and varying social needs, including asking for no intervention from others. Teens appreciated that the ARC design experience allowed for flexibility in participation and supported selective disclosure. However, there were limited interactions between teenagers online. Reflecting on our study, we provide design implications for tools to support teenager mental health and discuss how the ARC method can be adapted for designing with teenagers.
| S-EPMC7500255 | biostudies-literature