Dynamic driving risk in highway tunnel groups based on pupillary oscillations.

This study aims to understand the dynamic changes in driving risks in highway tunnel groups. Real-world driving experiments were conducted, collecting pupil area data to measure pupil size oscillations using the Percentage of Pupil Area Variable (PPAV) metric. The analysis focused on investigating relative pupil size fluctuations to explore trends in driving risk fluctuations within tunnel groups. The objective was to identify accident-prone areas and key factors influencing driving risks, providing insights for safety improvements. The findings revealed an overall "whipping effect" phenomenon in driving risk changes within tunnel groups. Differences were observed between interior tunnel areas and open sections, including adjacent, approach, and departure zones. Higher driving risks were associated with locations closer to the tail end of the tunnel group and shorter exit departure sections. Targeted safety improvement designs should consider fluctuation patterns in different directions, with attention to tunnels at the tail end. In open sections, increased travel distance and lengths of upstream and downstream tunnels raised driving risks, while longer open zones improved driving risks. Driving direction and sequence had minimal impact on risks. By integrating driver vision, tunnel characteristics, and the environment, this study identified high-risk areas and critical factors, providing guidance for monitoring and improving driving risks in tunnel groups. The findings have practical implications for the operation and safety management of tunnel groups.

Data on respiratory variables in critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+).

The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+) after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome. The reported variables are tidal volume, driving pressure (ΔP, the difference between static end-inspiratory plateau pressure and positive end-expiratory airway pressure), respiratory system compliance and resistance, and arterial blood gasses. The data are supplemental to our original research article, which described individual ΔP in these patients and examined how it related to ΔP when the same patients were ventilated with passive mechanical ventilation using the currently accepted lung-protective strategy "Driving pressure during assisted mechanical ventilation. Is it controlled by patient brain?" [1].

Casos de poliomielitis paralítica asociada a la vacuna oral antipoliomielítica en Cuba (1963-2006) / Cases of paralytic poliomyelitis associated with oral antipoliomielytis vaccine in Cuba (1963-2006)

Objetivo: divulgar los indicadores de poliomielitis paralítica asociada encontrados en 44 años en niños vacunados con oral antipoliomielítica, suministrada exclusivamente en campañas masivas de vacunación durante el período de 1963 a 2006 y reportar el riesgo de poliomielitis paralítica asociada a la vacuna con relación a diferentes aspectos epidemiológicos. Métodos: se realizó un estudio retrospectivo en 596 casos de parálisis fláccida aguda en niños ingresados en hospitales pediátricos, basado en investigaciones virológicas y detección de diferentes variables epidemiológicas. Resultados: de 113 pacientes estudiados se aislaron 120 agentes virales y 30 fueron identificados como poliovirus. Los datos clínicos y epidemiológicos en 596 casos de parálisis fláccida aguda permitieron categorizar a 20 niños afectados con poliomielitis paralítica asociada a la vacuna. Todos los casos se presentaron en niños menores de un año, vacunados con oral antipoliomielítica con estrategias de campañas masivas de vacunación exclusivamente y 19 fueron producidos por la primera dosis. El riesgo global en los niños vacunados con primera dosis de 1963 a 2006 fue 1 en 379 888 (7 217 866 dosis administradas/19 casos con poliomielitis paralítica asociada a la vacuna). Los casos de poliomielitis paralítica asociada a la vacuna se han presentado esporádicos o en un grupo de 8 casos en el período 1989-1992. El riesgo de primera dosis en casos esporádicos fue 1 en 612 864 y en el grupo de 1 en 84 670. El riesgo en casos agrupados es 7,2 veces mayor que los ocurridos en casos aislados. Particularmente en el año 1992, que coincidió con una epidemia de neuropatía epidémica, el riesgo fue de 1 en 52 140, lo que representó un incremento de 11,8 veces a lo ocurrido en casos esporádicos. Los niños de 4-7 meses de edad también tuvieron un riesgo mayor que fue 1 en 132 812. Conclusiones: se identificaron aspectos epidemiológicos que incrementaron el riesgo de poliomielitis paralítica asociada a la vacuna, en los cuales coinciden aspectos de deficiencias nutricionales.

Aim: to disseminate the indicators of associated paralytic poliomyelitis found during 44 years in children that received the oral antipoliomyelitis vaccine, which was only administered in massive vaccination campaigns from 1963 to 2006, and to report the risk of vaccine-associated paralytic poliomyelitis as regards different epidemiological aspects. Methods: a retrospective study was undertaken in 596 cases of acute flaccid paralysis in children admitted in pediatric hospitals, based on virology researches, and on the detection of different epidemiological variables. Results: 120 viral agents were isolated from 113 studied patients. 30 were identified as poliovirus. The clinical and epidemiological data from 596 cases of acute flaccid paralysis allowed to categorize 20 children affected with vaccine-associated paralytic poliomyelitis. All the cases were children under one that were exclusively administered the oral antipoliomyelitis vaccine through the strategy of the massive vaccination campaigns. 19 of them were caused by the first dose. Global risk in children vaccinated with the first dose from 1963-2006 was of one in 379 888 (7 217 866 doses administered/19 cases with vaccine-associated paralytic poliomyelitis). Cases of vaccine-associated paralytic poliomyelitis have been sporadic or in a group of 8 cases during 1989-1992. The risk of first dose in sporadic cases was of one in 612 864, and in the group of 1 in 84 670. The risk of grouped cases is 7.2 times higher than those occurred in isolated cases. Particularly, in 1992, coinciding with an outbreak of epidemic neuropathy, the risk was of one in 52 140, which represented an increase of 11.8 times compared with sporadic cases. Children aged 4-7 months old also had a higher risk of 1 in 132 812. Conclusions: there were identified epidemiological aspects that augmented the risk of vaccine-associated paralytic poliomyelitis, in which the aspects of nutritional deficiencies coincided.

Casos de poliomielitis paralítica asociada a la vacuna oral antipoliomielítica en Cuba (1963-2006) / Cases of paralytic poliomyelitis associated with oral antipoliomielytis vaccine in Cuba (1963-2006)

Objetivo: divulgar los indicadores de poliomielitis paralítica asociada encontrados en 44 años en niños vacunados con oral antipoliomielítica, suministrada exclusivamente en campañas masivas de vacunación durante el período de 1963 a 2006 y reportar el riesgo de poliomielitis paralítica asociada a la vacuna con relación a diferentes aspectos epidemiológicos. Métodos: se realizó un estudio retrospectivo en 596 casos de parálisis fláccida aguda en niños ingresados en hospitales pediátricos, basado en investigaciones virológicas y detección de diferentes variables epidemiológicas. Resultados: de 113 pacientes estudiados se aislaron 120 agentes virales y 30 fueron identificados como poliovirus. Los datos clínicos y epidemiológicos en 596 casos de parálisis fláccida aguda permitieron categorizar a 20 niños afectados con poliomielitis paralítica asociada a la vacuna. Todos los casos se presentaron en niños menores de un año, vacunados con oral antipoliomielítica con estrategias de campañas masivas de vacunación exclusivamente y 19 fueron producidos por la primera dosis. El riesgo global en los niños vacunados con primera dosis de 1963 a 2006 fue 1 en 379 888 (7 217 866 dosis administradas/19 casos con poliomielitis paralítica asociada a la vacuna). Los casos de poliomielitis paralítica asociada a la vacuna se han presentado esporádicos o en un grupo de 8 casos en el período 1989-1992. El riesgo de primera dosis en casos esporádicos fue 1 en 612 864 y en el grupo de 1 en 84 670. El riesgo en casos agrupados es 7,2 veces mayor que los ocurridos en casos aislados. Particularmente en el año 1992, que coincidió con una epidemia de neuropatía epidémica, el riesgo fue de 1 en 52 140, lo que representó un incremento de 11,8 veces a lo ocurrido en casos esporádicos. Los niños de 4-7 meses de edad también tuvieron un riesgo mayor que fue 1 en 132 812....(AU)

Aim: to disseminate the indicators of associated paralytic poliomyelitis found during 44 years in children that received the oral antipoliomyelitis vaccine, which was only administered in massive vaccination campaigns from 1963 to 2006, and to report the risk of vaccine-associated paralytic poliomyelitis as regards different epidemiological aspects. Methods: a retrospective study was undertaken in 596 cases of acute flaccid paralysis in children admitted in pediatric hospitals, based on virology researches, and on the detection of different epidemiological variables. Results: 120 viral agents were isolated from 113 studied patients. 30 were identified as poliovirus. The clinical and epidemiological data from 596 cases of acute flaccid paralysis allowed to categorize 20 children affected with vaccine-associated paralytic poliomyelitis. All the cases were children under one that were exclusively administered the oral antipoliomyelitis vaccine through the strategy of the massive vaccination campaigns. 19 of them were caused by the first dose. Global risk in children vaccinated with the first dose from 1963-2006 was of one in 379 888 (7 217 866 doses administered/19 cases with vaccine-associated paralytic poliomyelitis). Cases of vaccine-associated paralytic poliomyelitis have been sporadic or in a group of 8 cases during 1989-1992. The risk of first dose in sporadic cases was of one in 612 864, and in the group of 1 in 84 670. The risk of grouped cases is 7.2 times higher than those occurred in isolated cases. Particularly, in 1992, coinciding with an outbreak of epidemic neuropathy, the risk was of one in 52 140, which represented an increase of 11.8 times compared with sporadic cases. Children aged 4-7 months old also had a higher risk of 1 in 132 812. Conclusions: there were identified epidemiological aspects that augmented the risk of vaccine-associated paralytic poliomyelitis, in which the aspects of nutritional deficiencies coincided(AU)