Real-time path planning for autonomous vehicle off-road driving.

Background: Autonomous driving is a growing research area that brings benefits in science, economy, and society. Although there are several studies in this area, currently there is no a fully autonomous vehicle, particularly, for off-road navigation. Autonomous vehicle (AV) navigation is a complex process based on application of multiple technologies and algorithms for data acquisition, management and understanding. Particularly, a self-driving assistance system supports key functionalities such as sensing and terrain perception, real time vehicle mapping and localization, path prediction and actuation, communication and safety measures, among others. Methods: In this work, an original approach for vehicle autonomous driving in off-road environments that combines semantic segmentation of video frames and subsequent real-time route planning is proposed. To check the relevance of the proposal, a modular framework for assistive driving in off-road scenarios oriented to resource-constrained devices has been designed. In the scene perception module, a deep neural network is used to segment Red-Green-Blue (RGB) images obtained from camera. The second traversability module fuses Light Detection And Ranging (LiDAR) point clouds with the results of segmentation to create a binary occupancy grid map to provide scene understanding during autonomous navigation. Finally, the last module, based on the Rapidly-exploring Random Tree (RRT) algorithm, predicts a path. The Freiburg Forest Dataset (FFD) and RELLIS-3D dataset were used to assess the performance of the proposed approach. The theoretical contributions of this article consist of the original approach for image semantic segmentation fitted to off-road driving scenarios, as well as adapting the shortest route searching A* and RRT algorithms to AV path planning. Results: The reported results are very promising and show several advantages compared to previously reported solutions. The segmentation precision achieves 85.9% for FFD and 79.5% for RELLIS-3D including the most frequent semantic classes. While compared to other approaches, the proposed approach is faster regarding computational time for path planning.

Physiological and clinical effects of trunk inclination adjustment in patients with respiratory failure: a scoping review and narrative synthesis.

BACKGROUND: Adjusting trunk inclination from a semi-recumbent position to a supine-flat position or vice versa in patients with respiratory failure significantly affects numerous aspects of respiratory physiology including respiratory mechanics, oxygenation, end-expiratory lung volume, and ventilatory efficiency. Despite these observed effects, the current clinical evidence regarding this positioning manoeuvre is limited. This study undertakes a scoping review of patients with respiratory failure undergoing mechanical ventilation to assess the effect of trunk inclination on physiological lung parameters. METHODS: The PubMed, Cochrane, and Scopus databases were systematically searched from 2003 to 2023. INTERVENTIONS: Changes in trunk inclination. MEASUREMENTS: Four domains were evaluated in this study: 1) respiratory mechanics, 2) ventilation distribution, 3) oxygenation, and 4) ventilatory efficiency. RESULTS: After searching the three databases and removing duplicates, 220 studies were screened. Of these, 37 were assessed in detail, and 13 were included in the final analysis, comprising 274 patients. All selected studies were experimental, and assessed respiratory mechanics, ventilation distribution, oxygenation, and ventilatory efficiency, primarily within 60 min post postural change. CONCLUSION: In patients with acute respiratory failure, transitioning from a supine to a semi-recumbent position leads to decreased respiratory system compliance and increased airway driving pressure. Additionally, C-ARDS patients experienced an improvement in ventilatory efficiency, which resulted in lower PaCO2 levels. Improvements in oxygenation were observed in a few patients and only in those who exhibited an increase in EELV upon moving to a semi-recumbent position. Therefore, the trunk inclination angle must be accurately reported in patients with respiratory failure under mechanical ventilation.

Real driving cycles and emissions for urban freight transport.

This paper aims to evaluate the driving style effects, through the construction of driving cycles, on the polluting gases, in the context of urban freight transportation. For this, the method used was the construction of cycles through the Vehicle Specific Power (VSP) parameter, which considers instantaneous vehicle and road parameters better to represent driving patterns and freight transportation's environmental impacts. The study was conducted in Fortaleza city, Ceará, Brazil, with a professional driver's group. The road types, land use and traffic light location were considered to analyze and discuss the results. The results show collector roads presented higher speeds than arterial roads, and the use of the land around the road also directly impacted vehicle driving patterns. Regarding CO2 emissions, higher concentrations measured were observed on the arterial roads.

Dual-Slope Path Loss Model for Integrating Vehicular Sensing Applications in Urban and Suburban Environments.

The development of intelligent transportation systems (ITS), vehicular ad hoc networks (VANETs), and autonomous driving (AD) has progressed rapidly in recent years, driven by artificial intelligence (AI), the internet of things (IoT), and their integration with dedicated short-range communications (DSRC) systems and fifth-generation (5G) networks. This has led to improved mobility conditions in different road propagation environments: urban, suburban, rural, and highway. The use of these communication technologies has enabled drivers and pedestrians to be more aware of the need to improve their behavior and decision making in adverse traffic conditions by sharing information from cameras, radars, and sensors widely deployed in vehicles and road infrastructure. However, wireless data transmission in VANETs is affected by the specific conditions of the propagation environment, weather, terrain, traffic density, and frequency bands used. In this paper, we characterize the path loss based on the extensive measurement campaign carrier out in vehicular environments at 700 MHz and 5.9 GHz under realistic road traffic conditions. From a linear dual-slope path loss propagation model, the results of the path loss exponents and the standard deviations of the shadowing are reported. This study focused on three different environments, i.e., urban with high traffic density (U-HD), urban with moderate/low traffic density (U-LD), and suburban (SU). The results presented here can be easily incorporated into VANET simulators to develop, evaluate, and validate new protocols and system architecture configurations under more realistic propagation conditions.

Multifactorial assessment of braking time predictors in a driving simulator among older adults according to gender.

CONTEXT: Vehicle driving depends on the integration of motor, visual, and cognitive skills to respond appropriately to different situations that occur in traffic. OBJECTIVES: To analyze a model of performance predictor for braking time in the driving simulator, using a battery of tests divided by gender. METHODS: Selected were 100 male drivers with a mean age of 72.6 ± 5.7 years. Sociodemographic variables, braking time in the driving simulator, and motor, visual, and cognitive skills were evaluated. RESULTS: Comparing genders, men were older than women (p = 0.002) and had longer driving times (p = 0.001). Men had more strength in hand grip (p ≤ 0.001). In the linear regression analysis, the model explained 68 % of the braking time in men and 50.8 % in women. In the stepwise multiple linear regression analysis, the variable that remained in the model was the strength of the right plantar flexors, which explained 13 % of the braking time in women and men, and the cognitive variables explained 38.9 %. CONCLUSION: Sociodemographic, motor, visual, and cognitive variables, explained a substantial portion of the variability in braking time for both older women and men, the specific variables driving this performance differed between the sexes. For older women, factors such as muscle strength emerged as critical determinants of braking ability, highlighting the importance of physical health in maintaining driving skills. On the other hand, cognitive conditions emerged as the primary predictor of braking performance in older men, underscoring the role of mental acuity and decision-making processes in safe driving.

Integrating Modular Pipelines with End-to-End Learning: A Hybrid Approach for Robust and Reliable Autonomous Driving Systems.

Autonomous driving navigation relies on diverse approaches, each with advantages and limitations depending on various factors. For HD maps, modular systems excel, while end-to-end methods dominate mapless scenarios. However, few leverage the strengths of both. This paper innovates by proposing a hybrid architecture that seamlessly integrates modular perception and control modules with data-driven path planning. This innovative design leverages the strengths of both approaches, enabling a clear understanding and debugging of individual components while simultaneously harnessing the learning power of end-to-end approaches. Our proposed architecture achieved first and second place in the 2023 CARLA Autonomous Driving Challenge's SENSORS and MAP tracks, respectively. These results demonstrate the architecture's effectiveness in both map-based and mapless navigation. We achieved a driving score of 41.56 and the highest route completion of 86.03 in the MAP track of the CARLA Challenge leaderboard 1, and driving scores of 35.36 and 1.23 in the CARLA Challenge SENSOR track with route completions of 85.01 and 9.55, for, respectively, leaderboard 1 and 2. The results of leaderboard 2 raised the hybrid architecture to the first position, winning the edition of the 2023 CARLA Autonomous Driving Competition.

Prevalence and factors associated with driving under the influence of alcohol in Brazil.

OBJECTIVES: To estimate the prevalence and factors associated with Driving Under the Influence of Alcohol (DUIA) among car drivers and motorcyclists in Brazil and to evaluate the association between DUIA and self-reported Road Traffic Injuries (RTIs) in these groups. METHODS: A cross-sectional study was conducted using data from adults aged 18 or older who participated in the 2019 National Health Survey. Probability sampling was used to recruit participants, and data collection was carried out through home visits. Data from 31,246 car drivers and 21,896 motorcyclists were analyzed. Key indicators included the proportion (%) of car drivers who consumed alcohol and then drove in the past 12 months and the proportion (%) of motorcyclists who consumed alcohol and then drove in the past 12 months. Multiple Poisson regression was used to determine factors associated with DUIA and the association of this variable with RTIs in both groups. RESULTS: DUIA prevalence was 9.4% (95% Confidence Interval [95% CI] = 8.8-10.0) among car drivers and 11.2% (95% CI = 10.4-12.1) among motorcyclists. Among car drivers, DUIA prevalence was higher in men, young adults, those without a spouse/partner, and lower in individuals with lower income and education level. Among motorcyclists, DUIA prevalence was higher in men, young adults, those living outside the capitals and metropolitan regions, and lower in individuals with lower income. DUIA increased the prevalence of self-reported RTIs in the previous 12 months among car drivers and motorcyclists. CONCLUSIONS: A high prevalence of DUIA was evident among drivers, particularly motorcyclists. The DUIA was more prevalent among men and young adults. The DUIA was associated with an increased magnitude of self-reported RTIs among car drivers and motorcyclists. Despite the extensive legislation for zero tolerance toward DUIA in the country, actions need stricter enforcement.

Reliability of roadside oral fluid testing devices for ∆9 -tetrahydrocannabinol (∆9 -THC) detection.

Driving under the influence of cannabis (DUIC) is increasing worldwide, and cannabis is the most prevalent drug after alcohol in impaired driving cases, emphasizing the need for a reliable traffic enforcement strategy. ∆9 -tetrahydrocannabinol (THC) detection in oral fluid has great potential for identifying recent cannabis use; however, additional data are needed on the sensitivities, specificities, and efficiencies of different oral fluid devices for detecting cannabinoids at the roadside by police during routine traffic safety enforcement efforts. At the roadside, 8945 oral fluid THC screening tests were performed with four devices: AquilaScan®, Dräger DrugTest®, WipeAlyser Reader®, and Druglizer®. A total of 530 samples screened positive for THC (5.9%) and were analyzed by liquid chromatography-tandem mass spectrometry at multiple cutoff concentrations (2 ng/mL, 10 ng/mL, and manufacturers' recommended device cutoffs) to investigate device performance. Results varied substantially, with sensitivities of 0%-96.8%, specificities of 89.8%-98.5%, and efficiencies of 84.3%-97.8%. The Dräger DrugTest® outperformed the other devices with a 96.8% sensitivity, 97.1% specificity, and 97.0% efficiency at a 5-ng/mL LC-MS/MS confirmation cutoff. The WipeAlyser Reader® had good performance with a 91.4% sensitivity, 97.2% specificity, and 96.4% efficiency. AquilaScan® and Druglizer® had unacceptable performance for cannabinoid detection, highlighted by sensitivity <13%. The choice of roadside oral fluid testing device must offer good analytical performance for cannabinoids because of its high prevalence of use and impact on road safety.

"It's okay because I'm just driving": an exploration of self-reported mobile phone use among Mexican drivers.

Introduction: Technological advancements have the potential to enhance people's quality of life, but their misuse can have a detrimental impact on safety. A notable example is the escalating issue of distracted driving resulting from the use of mobile phones behind the wheel, leading to severe crashes and injuries. Despite these concerns, both drivers' usage patterns and their risk-related associations remain scarcely documented in Mexico. Therefore, this descriptive study aimed to examine the mobile phone usage of Mexican drivers, its relationships to risk awareness and near-miss/crash involvement, and the self-reported underlying reasons for this behavior. Methods: This cross-sectional study utilized a sample of 1,353 licensed Mexican drivers who took part in a nationwide series of interviews regarding their onboard phone use settings. Results: A significant percentage of drivers (96.8%) recognize using a mobile phone while driving as high-risk behavior. However, only 7.4% reported completely avoiding its use while driving, with 22.4% identified as high-frequency users. Frequency was also found positively associated with the self-reported rate of near-misses and crashes. Furthermore, qualitative data analysis highlights the emergence of a 'sense of urgency' to attend to phone-related tasks in response to daily demands and life dynamics, offering a potential explanation for this behavior. Conclusion: The results of this study suggest common patterns of onboard mobile use among Mexican drivers concerning driving situations and associated risks. This underscores the need for increased efforts to discourage onboard phone use in the country.

Publicações científicas sobre direção veicular por pessoas idosas: revisão de escopo / Scientific publications on driving by older adults: scope review

Resumo Objetivo Mapear evidências científicas nacionais e internacionais sobre a condução veicular por pessoas idosas. Método Revisão de escopo baseada no manual proposto pelo Joanna Briggs Institute. Para as buscas foram acessadas as bases MEDLINE, Web of Science, Scopus, SciELO e a literatura cinzenta, por meio do Google Scholar. Resultados Dos 1.194 estudos encontrados, selecionaram-se 189 artigos submetidos aos critérios de elegibilidade. Os países precursores nas publicações foram Austrália e Estados Unidos, e o ápice das pesquisas ocorreu entre 2013 e 2014. Os participantes dos estudos eram pessoas idosas saudáveis, 63,49% (120); seguidos de 17,46% (33) com doença de Alzheimer; 11,11% (21) com Transtorno Neurocognitivo Leve; 6,88% (13) com doença de Parkinson; e 19,58% (37) com outras comorbidades. Diferentes tipos de intervenções foram identificadas nos estudos, destas, 94,02% (178) avaliaram a eficácia de instrumentos que mensuram a aptidão do motorista idoso. Conclusão Houve predominância de estudos na busca de instrumentos de avaliação que mensurassem a funcionalidade do condutor idoso. Esse fato ratifica a importância de avaliação padronizada, validada e economicamente viável que colabore na identificação do motorista em risco. Evidenciou-se a necessidade de intervenções para a prática da geriatria e gerontologia, por meio de ações para formação de equipe multidisciplinar especializada em condução veicular, de modo a adequar as diretrizes de licenciamento a fim de atender às especificidades dos condutores idosos, considerando os aspectos sociais, econômicos, políticos e educacionais, especialmente nos departamentos de trânsito brasileiro.

Abstract Objective To map national and international scientific evidence regarding driving by older adults. Method Scope review based on the manual proposed by the Joanna Briggs Institute. Searches were conducted in the MEDLINE, Web of Science, Scopus, SciELO databases, and grey literature through Google Scholar. Results Out of 1,194 studies identified, 189 papers meeting eligibility criteria were selected. Pioneering countries in publications were Australia and the United States, with the peak of research occurring between 2013 and 2014. Study participants included healthy older adults (63.49%, 120), followed by those with Alzheimer's disease (17.46%, 33), Mild Neurocognitive Disorder (11.11%, 21), Parkinson's disease (6.88%, 13), and other comorbidities (19.58%, 37). Various interventions were identified, with 94.02% (178) assessing the effectiveness of instruments measuring the fitness of older drivers. Conclusion There was a prevalence of studies aimed at identifying assessment tools to measure the functionality of older drivers. This underscores the importance of standardized, validated, and economically viable assessments that contribute to identifying at-risk drivers. The need for interventions in geriatrics and gerontology was evident, emphasizing the necessity for actions to establish a specialized multidisciplinary team in vehicular driving. This approach seeks to align licensing guidelines with the specific needs of older drivers, taking into account social, economic, political, and educational aspects, particularly within the Brazilian traffic departments.

Multifactorial assessment of braking time predictors in a driving simulator among older adults according to gender

Abstract Context: Vehicle driving depends on the integration of motor, visual, and cognitive skills to respond appropriately to different situations that occur in traffic. Objectives: To analyze a model of performance predictor for braking time in the driving simulator, using a battery of tests divided by gender. Methods: Selected were 100 male drivers with a mean age of 72.6 ± 5.7 years. Sociode-mographic variables, braking time in the driving simulator, and motor, visual, and cognitive skills were evaluated. Results: Comparing genders, men were older than women (p = 0.002) and had longer driving times (p = 0.001). Men had more strength in hand grip (p ≤ 0.001). In the linear regression analysis, the model explained 68 % of the braking time in men and 50.8 % in women. In the stepwise multiple linear regression analysis, the variable that remained in the model was the strength of the right plantar flexors, which explained 13 % of the braking time in women and men, and the cognitive variables explained 38.9 %. Conclusion: Sociodemographic, motor, visual, and cognitive variables, explained a substantial portion of the variability in braking time for both older women and men, the specific variables driving this performance differed between the sexes. For older women, factors such as muscle strength emerged as critical determinants of braking ability, highlighting the importance of physical health in maintaining driving skills. On the other hand, cognitive conditions emerged as the primary predictor of braking performance in older men, underscoring the role of mental acuity and decision-making processes in safe driving.

[When to resume driving after primary total hip arthroplasty?] / ¿Cuándo se reanuda la conducción después del reemplazo total de cadera primario?

INTRODUCTION: the current literature relates the return to driving with multiple variables. For various reasons, the current data on the time to return to driving after a total hip arthroplasty (THA) are diverse and even contradictory. We have proposed the objective of determining the time required to drive a manual gear vehicle again in a group of patients who underwent primary THA through a posterolateral approach with focus on manual gear cars. MATERIAL AND METHODS: we have studied the functional results of 112 patients who underwent primary THA between January 2019 and January 2020 in a high level in Cadiz, Andalusia, Spain. RESULTS: the median return to driving was three weeks (IQR 2-4). We have identified that 89.3% of the patients were able to drive again before the sixth week after surgery and in 92% of the cases they did so feeling even safer than before the THA. CONCLUSION: we consider that after the sixth week of an THA it is safe to resume driving a vehicle.

INTRODUCCIÓN: la literatura actual relaciona el regreso a la conducción vehicular con múltiples variables. Sin embargo, los datos actuales sobre el tiempo de regreso a la conducción luego de una artroplastía total de cadera (ATC) son diversos e incluso contradictorios. Por lo tanto, nos hemos planteado el objetivo de determinar el tiempo requerido para volver a conducir en un grupo de pacientes sometidos a una ATC primaria mediante un abordaje posterolateral, centrándonos específicamente en vehículos de marcha manual. MATERIAL Y MÉTODOS: hemos estudiado los resultados clínico-funcionales de 112 pacientes sometidos a una ATC primaria entre Enero de 2019 y Enero de 2020 en un hospital de alta complejidad en Cádiz, Andalucía, España. RESULTADOS: la mediana del tiempo de regreso a la conducción fue de tres semanas (RIC 2-4). Hemos identificado que 89.3% de los pacientes pudo volver a conducir antes de la sexta semana posterior a la cirugía. Además, en 92% de los casos, los pacientes se sintieron aún más seguros al conducir después de la ATC que antes de la intervención. CONCLUSIÓN: consideramos que a la sexta semana de una ATC es seguro reanudar la conducción de un vehículo.

Neuropsychological domains and fitness to drive in mild cognitive impairment or Alzheimer's disease.

Cognitive deficits associated with mild cognitive impairment (MCI) or Alzheimer's disease (AD) can impact driving. This integrative review investigated which cognitive domains were associated with poor driving performance or unfitness to drive in studies with outcomes measured in simulator or on-road driving in patients with MCI or AD. The review was conducted by searching for articles published between 2001 and 2020 in the MEDLINE (via PubMed), EMBASE, and SCOPUS databases. Studies addressing patients with other dementias (e.g., vascular or mixed dementia, Lewy body dementia, Parkinson's disease) were excluded. Of 404 articles initially selected, 17 met the eligibility criteria for this review. Based on the findings of this integrative review, attentional capacity, processing speed, executive functions and visuospatial skills were the functions whose declines were most frequently reported in a context of unsafe driving by older adults with MCI or AD. Reports were remarkably heterogeneous in methodological aspects whereas quite limited in cross-cultural coverage and in sample recruited, what prompts for further trials in the field.

Driving predictors in a cohort of cognitively impaired Mexican American and non-Hispanic White individuals.

BACKGROUND: Individuals with Alzheimer's disease and Alzheimer's disease-related dementias may lose the ability to drive safely as their disease progresses. Little is known about driving prevalence in older Latinx and non-Hispanic White (NHW) individuals. We investigated the prevalence of driving status among individuals with cognitive impairment in a population-based cohort. METHODS: This was a cross-sectional analysis of the cohort BASIC-Cognitive study in a community of Mexican American (MA) and NHW individuals in South Texas. Participants scored ≤25 on the Montreal Cognitive Assessment (MoCA), indicating a likelihood of cognitive impairment. Current driving status was assessed by the Harmonized Cognitive Assessment Protocol informant interview. Logistic regression was used to assess driving versus non-driving adjusted for pre-specified covariates. Chi-square and Mann-Whitney U tests were used to compare NHW and MA differences in driving outcomes from the American Academy of Neurology (AAN) questions for evaluating driving risk in dementia. RESULTS: There were 635 participants, 77.0 mean age, 62.4% women, and 17.3 mean MoCA. Of these, 360 (61.4%) were current drivers with 250 of 411 (60.8%) MA participants driving, and 121 of 190 (63.70%) NHW participants driving (p = 0.50). In fully adjusted models age, sex, cognitive impairment, language preference, and Activities of Daily Living scores were significant predictors for the likelihood of driving (p < 0.0001). Severity of cognitive impairment was inversely associated with odds of driving, but this relationship was not found in those preferring Spanish language for interviews. Around one-third of all caregivers had concerns about their care-recipient driving. There were no significant differences in MA and NHW driving habits and outcomes from the AAN questionnaire. CONCLUSIONS: The majority of participants with cognitive impairment were currently driving. This is a cause for concern for many caregivers. There were no significant ethnic driving differences. Associations with current driving in cognitively impaired persons require further research.

Drinking and driving among Whites and Hispanics on and off the US/Mexico border in California.

OBJECTIVE: To examine self-reported rates of driving under the influence (DUI) with and without arrest among border and non-border residents in California. METHODS: Data were obtained from 1,209 adults 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample. Data were collected on the phone or online and analyzed with a heteroskedastic ordinal generalized linear model. RESULTS: Driving after drinking (11.1% vs. 6.5%; q = 0.04) and the lifetime DUI arrest rates were higher for men than women (10.7% vs. 4%; q = 0.001). In multivariable analysis driving after drinking and DUI arrests were not higher on the border, not higher among Hispanics than Whites, and among Hispanics, the rates were not higher among those located on the border. Income was positively associated with drinking and driving. Impulsivity was positively and significantly associated with both drinking and driving and lifetime DUI arrest. CONCLUSION: The null results suggest that DUI related risk behaviors may not be higher on the border than in other areas of California. There may be health related risk behaviors of higher prevalence in the border population than in other areas, but DUI related behavior may not be one of them.

La relación de los factores de personalidad y la conducción agresiva: los Cinco Grandes y la Tríada Oscura / The Relationship between Personality Traits and Aggressive Driving: The Big Five and the Dark Triad

Resumen El objetivo de esta investigación fue analizar el papel que los factores de personalidad pertenecientes a los Cinco Grandes y la Tríada Oscura -maquiavelismo, narcisismo y psicopatía- tienen en la conducción agresiva. La muestra se compuso de 318 estudiantes universitarios con permiso de conducir, quienes contestaron a una batería de pruebas que evaluaba los factores de personalidad de los Cinco Grandes (TIPI), la Tríada Oscura (DD) y la conducción agresiva (DAS y DAX). Los análisis de regresión jerárquica controlando las variables de edad y sexo, respaldan la utilidad predictiva de los factores de personalidad de los Cinco Grandes y la Tríada Oscura. Los resultados mostraron cómo la afabilidad, la estabilidad emocional y la apertura a la experiencia predicen de manera significativa diversos aspectos de la conducción agresiva. El maquiavelismo y el narcisismo son predictores significativos de diversas formas de expresión de la ira en la conducción, una vez controlados los efectos de los Cinco Grandes.

Abstract The aim of this paper was to analyze the role that personality traits belonging to the Big Five and the Dark Triad (Machiavellianism, narcissism, and psychopathy) have on aggressive driving. 318 undergraduate students with a driver's license completed a battery of tests assessing Big Five personality traits (TIPI), Dark Triad (DD) and aggressive driving (DAS and DAX). Hierarchical regressions analyses controlling for respondents' age and gender variables supported the predictive utility of the Big Five personality traits and the Dark Triad. Results showed that agreeableness, emotional stability and openness to experience predict various aspects of aggressive driving. Machiavellianism and narcissism are significant predictors of various forms of anger expression in driving after controlling for the effects of the Big Five personality traits.

Risk Perception of Traffic Accidents Due to Alcohol and Marijuana Use in Mexican College Students.

Driving under the influence (DUI) of alcohol and other drugs is a common occurrence in Western societies. Alcohol consumption is related to 15% of fatal injuries in traffic accidents worldwide, with those DUI of alcohol being up to 18 times more likely to be involved in a fatal accident. Evidence for DUI of alcohol or marijuana among the college population in Mexico is scarce. This research estimates the proportion of use of alcohol and marijuana, describes the risk perception of DUI, and evaluates the relationship between risk perception and DUI behaviors in a sample of Mexican college students aged 18 to 29. The study was cross-sectional with a non-probabilistic sample. Risk perception of suffering traffic accidents when DUI or riding with someone DUI of alcohol, marijuana, or both, was high, unlike the risk perception of being detected or sanctioned for a DUI of marijuana. The study provided valuable information on the risk perception of engaging in behaviors related to DUI of alcohol and/or marijuana. It is necessary to undertake research on the subject with probabilistic and representative samples of this population of Mexico.

¿Cuándo se reanuda la conducción después del reemplazo total de cadera primario? / When to resume driving after primary total hip arthroplasty?

Resumen: Introducción: la literatura actual relaciona el regreso a la conducción vehicular con múltiples variables. Sin embargo, los datos actuales sobre el tiempo de regreso a la conducción luego de una artroplastía total de cadera (ATC) son diversos e incluso contradictorios. Por lo tanto, nos hemos planteado el objetivo de determinar el tiempo requerido para volver a conducir en un grupo de pacientes sometidos a una ATC primaria mediante un abordaje posterolateral, centrándonos específicamente en vehículos de marcha manual. Material y métodos: hemos estudiado los resultados clínico-funcionales de 112 pacientes sometidos a una ATC primaria entre Enero de 2019 y Enero de 2020 en un hospital de alta complejidad en Cádiz, Andalucía, España. Resultados: la mediana del tiempo de regreso a la conducción fue de tres semanas (RIC 2-4). Hemos identificado que 89.3% de los pacientes pudo volver a conducir antes de la sexta semana posterior a la cirugía. Además, en 92% de los casos, los pacientes se sintieron aún más seguros al conducir después de la ATC que antes de la intervención. Conclusión: consideramos que a la sexta semana de una ATC es seguro reanudar la conducción de un vehículo.

Abstract: Introduction: the current literature relates the return to driving with multiple variables. For various reasons, the current data on the time to return to driving after a total hip arthroplasty (THA) are diverse and even contradictory. We have proposed the objective of determining the time required to drive a manual gear vehicle again in a group of patients who underwent primary THA through a posterolateral approach with focus on manual gear cars. Material and methods: we have studied the functional results of 112 patients who underwent primary THA between January 2019 and January 2020 in a high level in Cadiz, Andalusia, Spain. Results: the median return to driving was three weeks (IQR 2-4). We have identified that 89.3% of the patients were able to drive again before the sixth week after surgery and in 92% of the cases they did so feeling even safer than before the THA. Conclusion: we consider that after the sixth week of an THA it is safe to resume driving a vehicle.

Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms.

The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.

Adherence to protective mechanical ventilation in COVID-19 versus non-COVID-19-associated acute respiratory distress syndrome: Comparison between two prospective cohorts.

OBJECTIVE: To compare adherence to protective mechanical ventilation (MV) parameters in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 with patients with ARDS from other etiologies. DESIGN: Multiple prospective cohort study. SETTING: Two Brazilian cohorts of ARDS patients were evaluated. One with COVID-19 patients admitted to two Brazilian intensive care units (ICUs) in 2020 and 2021 (C-ARDS, n=282), the other with ARDS-patients from other etiologies admitted to 37 Brazilian ICUs in 2016 (NC-ARDS, n=120). PATIENTS: ARDS patients under MV. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Adherence to protective MV (tidal volume ≤8mL/kg PBW; plateau pressure ≤30cmH2O; and driving pressure ≤15cmH2O), adherence to each individual component of the protective MV, and the association between protective MV and mortality. RESULTS: Adherence to protective MV was higher in C-ARDS than in NC-ARDS patients (65.8% vs. 50.0%, p=0.005), mainly due to a higher adherence to driving pressure ≤15cmH2O (75.0% vs. 62.4%, p=0.02). Multivariable logistic regression showed that the C-ARDS cohort was independently associated with adherence to protective MV. Among the components of the protective MV, only limiting driving pressure was independently associated with lower ICU mortality. CONCLUSIONS: Higher adherence to protective MV in patients with C-ARDS was secondary to higher adherence to limiting driving pressure. Additionally, lower driving pressure was independently associated with lower ICU mortality, which suggests that limiting exposure to driving pressure may improve survival in these patients.