Frequency of an intrathecal IgM synthesis and MRZ reaction in children with MS

BACKGROUND

Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the CNS. An intrathecal IgM synthesis is associated with a more rapid progression of MS and the intrathecal immune response to measles -, rubella -and varicella zoster virus (MRZR) which, if present, increases the likelihood of a diagnosis of MS in adults.

OBJECTIVE

To evaluate the frequency of an intrathecal IgM synthesis and MRZR in children with MS. MethodsChildren with MS and a data set including clinical and treatment history, MRI at onset, in addition to a CSF analysis, and determination of antibody index (AI) of measles, rubella, and zoster antibodies, were eligible. The presence of an intrathecal IgM synthesis and/or a positive MRZ reaction were compared to biomarkers of a more progressive disease course.

RESULTS

In 75 children with MS, OCBs were present in 93.3 %). 49,2 % experienced their first relapse within 6 months. 50.7 % had a total lesion load of more than 10 lesions in the first brain MRI. Spinal lesions were identified in 64 %. 23.5 % had a positive MRZR and 40.3 % an intrathecal IgM synthesis. No significant associations were detected between the presence of an intrathecal IgM synthesis and MRZR and parameters including the relapse rate in the first two years.

CONCLUSION

An intrathecal IgM synthesis and a positive MRZR are found in a subset of MS children but are not associated with markers associated with a poor prognosis.

Advancing Knowledge on Situation Comprehension in Dynamic Traffic Situations by Studying Eye Movements to Empty Spatial Locations

OBJECTIVE

This study used the looking-at-nothing phenomenon to explore situation awareness (SA) and the effects of working memory (WM) load in driving situations.

BACKGROUND

While driving, people develop a mental representation of the environment. Since errors in retrieving information from this representation can have fatal consequences, it is essential for road safety to investigate this process. During retrieval, people tend to fixate spatial positions of visually encoded information, even if it is no longer available at that location. Previous research has shown that this "looking-at-nothing" behavior can be used to trace retrieval processes.

METHOD

In a video-based laboratory experiment with 2 (WM) x 3 (SA level) within-subjects design, participants (N = 33) viewed a reduced screen and evaluated auditory statements relating to different SA levels on previously seen dynamic traffic scenarios while eye movements were recorded.

RESULTS

When retrieving information, subjects more frequently fixated emptied spatial locations associated with the information relevant for the probed SA level. The retrieval of anticipations (SA level 3) in contrast to the other SA level information resulted in more frequent gaze transitions that corresponded to the spatial dynamics of future driving behavior.

CONCLUSION

The results support the idea that people build a visual-spatial mental image of a driving situation. Different gaze patterns when retrieving level-specific information indicate divergent retrieval processes.

APPLICATION

Potential applications include developing new methodologies to assess the mental representation and SA of drivers objectively.

Autoantibody status, neuroradiological and clinical findings in children with acute cerebellitis

BACKGROUND

Acute cerebellitis (AC) in children and adolescents is an inflammatory disease of the cerebellum due to viral or bacterial infections but also autoimmune-mediated processes.

OBJECTIVE

To investigate the frequency of autoantibodies in serum and CSF as well as the neuroradiological features in children with AC.

MATERIAL AND METHODS

Children presenting with symptoms suggestive of AC defined as acute/subacute onset of cerebellar symptoms and MRI evidence of cerebellar inflammation or additional CSF pleocytosis, positive oligoclonal bands (OCBs), and/or presence of autoantibodies in case of negative cerebellar MRI. Children fulfilling the above-mentioned criteria and a complete data set including clinical presentation, CSF studies, testing for neuronal/cerebellar and MOG antibodies as well as MRI scans performed at disease onset were eligible for this retrospective multicenter study.

RESULTS

36 patients fulfilled the inclusion criteria for AC (f:m = 14:22, median age 5.5 years). Ataxia was the most common cerebellar symptom present in 30/36 (83 %) in addition to dysmetria (15/36) or dysarthria (13/36). A substantial number of children (21/36) also had signs of encephalitis such as somnolence or seizures. In 10/36 (28 %) children the following autoantibodies (abs) were found: MOG-abs (n = 5) in serum, GFAPα-abs (n = 1) in CSF, GlyR-abs (n = 1) in CSF, mGluR1-abs (n = 1) in CSF and serum. In two further children, antibodies were detected only in serum (GlyR-abs, n = 1; GFAPα-abs, n = 1). MRI signal alterations in cerebellum were found in 30/36 children (83 %). Additional supra- and/or infratentorial lesions were present in 12/36 children, including all five children with MOG-abs. Outcome after a median follow-up of 3 months (range: 1 a 75) was favorable with an mRS ≤2 in 24/36 (67 %) after therapy. Antibody (ab)-positive children were significantly more likely to have a better outcome than ab-negative children (p = .022).

CONCLUSION

In nearly 30 % of children in our study with AC, a range of abs was found, underscoring that autoantibody testing in serum and CSF should be included in the work-up of a child with suspected AC. The detection of MOG-abs in AC does expand the MOGAD spectrum.

Pulse Parameters and Thresholds for (ir)Reversible Electroporation on Hepatocellular Carcinoma Cells in Vitro

Hepatocellular carcinoma is a leading cause of cancer-related death in many parts of the world. Traditional treatment options are not always effective. During the promising minimally invasive electroporation-based therapies, biological cell membranes are exposed to an external, sufficiently high, pulsed electric field which creates so-called nanopores into the lipid bilayer of the cell membrane. These pores can either be permanent (irreversible electroporation (IRE)), leading to apoptosis, or repairable (reversible electroporation (RE)), with continued cell function. In tumor therapy, RE is used to increase the diffusion of a chemotherapeutic drug during electrochemotherapy. For both IRE and RE, the success of the treatment is dependent on application of the appropriate electric field. Therefore, this study aims to define the pulse parameters and thresholds for IRE and RE on hepatocellular carcinoma (HepG2) cells in-vitro.In a custom-made in-vitro setup, HepG2 cell viability (0, 5, 10, and 15 min), and the peak temperature were measured after electroporation with the different IRE and RE pulsing protocols, to determine the most successful settings for IRE and RE. A CAM/PI flow cytometric assay was performed to confirm cell permeabilization for the RE pulsing protocols with the highest cell viability.The results indicated that an IRE pulsing protocol (70 pulses, 100 µs pulse length, and 100 ms interval) with an electric field strength of 4000 V/cm was needed as threshold for almost complete cell death of HepG2 cells. A RE pulsing protocol (8 pulses, 100 µs pulse length, and 1000 ms interval) with an electric field strength of 1000 V/cm was needed as threshold for viable and permeabilized HepG2 cells. The low peak temperatures (max 30.1°C for IRE, max 23.1°C for RE) within this study indicated that the reduction in HepG2 cell viability was caused by the applied electric field and was not a result of Joule heating.

Plant-based model for the visual evaluation of electroporated area after irreversible electroporation and its comparison to in-vivo animal data

Electroporation (EP) is widely used in medicine, such as cancer treatment, in form of electrochemotherapy or irreversible electroporation (IRE). For EP device testing, living cells or tissue inside a living organism (including animals) are needed. Plant-based models seem to be a promising alternative to substitute animal models in research. The aim of this study is to find a suitable plant-based model for visual evaluation of IRE, and to compare the geometry of electroporated areas with in-vivo animal data.For this purpose, a variety of fruit and vegetables were selected and visually evaluated after 0/1/2/4/6/8/12/16/24 h post-EP. Apple and potato were found to be suitable models as they enabled a visual evaluation of the electroporated area. For these models, the size of the electroporated area was determined after 0/1/2/4/6/8/12/16/24 h. For apples, a well-defined electroporated area was visual within two hours, while in potatoes it reached a plateau after eight hours only. The electroporated area of apple, which showed the fastest visual results was then compared to a retrospectively evaluated swine liver IRE dataset which had been obtained for similar conditions. The electroporated area of the apple and swine liver both showed a spherical geometry of comparable size. For all experiments, the standard protocol for human liver IRE was followed. To conclude, potato and apple were found to be suitable plant-based models for the visual evaluation of electroporated area after irreversible EP, with apple being the best choice for fast visual results. Given the comparable range, the size of the electroporated area of the apple may be promising as a quantitative predictor in animal tissue. Even if plant-based models cannot completely replace animal experiments, they can be used in the early stages of EP device development and testing, decreasing animal experiments to the necessary minimum.

The trustworthy and acceptable HRI checklist (TA-HRI): questions and design recommendations to support a trust-worthy and acceptable design of human-robot interaction

This contribution to the journal Gruppe. Interaktion. Organisation. (GIO) presents a checklist of questions and design recommendations for designing acceptable and trustworthy human-robot interaction (HRI). In order to extend the application scope of robots towards more complex contexts in the public domain and in private households, robots have to fulfill requirements regarding social interaction between humans and robots in addition to safety and efficiency. In particular, this results in recommendations for the design of the appearance, behavior, and interaction strategies of robots that can contribute to acceptance and appropriate trust. The presented checklist was derived from existing guidelines of associated fields of application, the current state of research on HRI, and the results of the BMBF-funded project RobotKoop. The trustworthy and acceptable HRI checklist (TA-HRI) contains 60 design topics with questions and design recommendations for the development and design of acceptable and trustworthy robots. The TA-HRI Checklist provides a basis for discussion of the design of service robots for use in public and private environments and will be continuously refined based on feedback from the community.

Implicit intention communication as a design opportunity for automated vehicles: Understanding drivers' interpretation of vehicle trajectory at narrow passages

To ensure road safety in mixed traffic, automated vehicles (AVs) must be equipped with distinct and easy-to-understand communication strategies. For this, the communication design of AVs might be oriented toward implicit communication between manually driven vehicles. This research focused on how drivers interpret observable vehicle behavior (vehicle trajectory) to predict vehicle intentions and planned maneuvers. In addition, the processing and interpretation of contradictory cues were examined as a possible cause for misunderstandings and failed coordination. Two video-based experiments investigated the presumed intention (yielding or insisting on priority), intention recognition time, distinctiveness, and cooperativeness of a vehicle's implicit communication at narrow road passages. For this, two vehicles approached a bottleneck from opposite sides, and only one vehicle could pass at a time. The driving behavior of the oncoming vehicle consisted of longitudinal (decelerating, stopping, accelerating, maintaining speed) and lateral movements (driving to the center, driving to the edge of the road, no lateral deviation) at different timings (early, late). The results indicated advantages of lateral vehicle movements for distinct intention communication. Lateral movements were interpreted the fastest, perceived more distinct, and were more decisive for the presumed intention than longitudinal movements. Early communication was preferred by drivers but increased the intention recognition time, especially for longitudinal movements. However, early lateral communication was interpreted as fast as late longitudinal communication. Furthermore, lateral and longitudinal vehicle movements within a driving pattern that contradicted each other led to ambiguous perceptions. For AVs, early distinct communication via lateral vehicle movement is recommended. Minimizing ambiguity in the interpretation of communication cues might maximize the probability of the safest response from human drivers and contribute to accident prevention in mixed traffic.

Findings From A Qualitative Field Study with An Autonomous Robot in Public: Exploration of User Reactions and Conflicts

Soon service robots will be employed in public spaces with frequent human-robot interaction (HRI). To achieve a safe, trustworthy and acceptable HRI, service robots need to be equipped with interaction strategies suitable for the robot, user, and context. To gain realistic insights into the initial user reactions and challenges that arise when a mechanoid, autonomous service robot in public is applied, a field study with three data sources was conducted. In a first step, lay users’ intuitive reactions to a cleaning robot at a train station were observed ($$N = 344$$ N = 344 ). Second, passersby’s preferences for HRI interaction strategies were explored in interviews ($$n = 54$$ n = 54 ). As a third step, trust and acceptance of the robot were assessed with questionnaires ($$n = 32$$ n = 32 ). Identified challenges were social robot navigation in crowded places also applicable to vulnerable passersby, inclusive communication modalities, information of staff and public about the service robot application and the need for conflict resolution strategies to avoid an inefficient robot (e.g., testing behavior, path is blocked). This study provides insights into naive HRI in public and illustrates challenges, provides recommendations supported by literature and highlights aspects for future research to inspire a research agenda in the field of public HRI.

Time- and dose-dependent volume decreases in subcortical grey matter structures of glioma patients after radio(chemo)therapy

•

Radiotherapy causes atrophy of the hippocampus, amygdala, putamen, thalamus and pallidum.

•

Atrophy is dose dependant and progressive over time.

•

The hippocampus shows the highest atrophy rates at a given mean dose and time.

•

The caudate shows no significant atrophy.

Background and purpose

Radiotherapy (RT) is an adjuvant treatment option for glioma patients. Side effects include tissue atrophy, which might be a contributing factor to neurocognitive decline after treatment. The goal of this study was to determine potential atrophy of the hippocampus, amygdala, thalamus, putamen, pallidum and caudate nucleus in glioma patients having undergone magnetic resonance imaging (MRI) before and after RT.

Materials and methods

Subcortical volumes were measured using T1-weighted MRI from patients before RT (N = 91) and from longitudinal follow-ups acquired in three-monthly intervals (N = 349). The volumes were normalized to the baseline values, while excluding structures touching the clinical target volume (CTV) or abnormal tissue seen on FLAIR imaging. A multivariate linear effects model was used to determine if time after RT and mean RT dose delivered to the corresponding structures were significant predictors of tissue atrophy.

Results

The hippocampus, amygdala, thalamus, putamen, and pallidum showed significant atrophy after RT as function of both time after RT and mean RT dose delivered to the corresponding structure. Only the caudate showed no dose or time dependant atrophy. Conversely, the hippocampus was the structure with the highest atrophy rate of 5.2 % after one year and assuming a mean dose of 30 Gy.

Conclusion

The hippocampus showed the highest atrophy rates followed by the thalamus and the amygdala. The subcortical structures here found to decrease in volume indicative of radiosensitivity should be the focus of future studies investigating the relationship between neurocognitive decline and RT.

How Multimodal Examinations Can Increase Sustainable Student Gain by Aligning Teaching and Assessment

Modern industry and multi-discipline projects require highly trained individuals with resilient science and engineering back-grounds. Graduates must be able to agilely apply excellent theoretical knowledge in their subject matter as well as essential practical “hands-on” knowledge of diverse working processes to solve complex problems. To meet these demands, university education follows the concept of Constructive Alignment and thus increasingly adopts the teaching of necessary practical skills to the actual industry requirements and assessment routines. However, a systematic approach to coherently align these three central teaching demands is strangely absent from current university curricula. We demonstrate the feasibility of implementing practical assessments in a regular theory-based examination, thus defining the term “blended assessment”. We assessed a course for natural science and engineering students pursuing a career in biomedical engineering, and evaluated the benefit of blended assessment exams for students and lecturers. Our controlled study assessed the physiological background of electrocardiograms (ECGs), the practical measurement of ECG curves, and their interpretation of basic pathologic alterations. To study on long time effects, students have been assessed on the topic twice with a time lag of 6 months. Our findings suggest a significant improvement in student gain with respect to practical skills and theoretical knowledge. The results of the reassessments support these outcomes. From the lecturers´ point of view, blended assessment complements practical training courses while keeping organizational effort manageable. We consider blended assessment a viable tool for providing an improved student gain, industry-ready education format that should be evaluated and established further to prepare university graduates optimally for their future careers.

How to Support Students in Maximizing their Outcome with Online Cooperation?

During the last year, student cooperation has shifted to the digital space. Chats, videoconferencing and online collaboration tools replace physical meetings and face-to-face interactions. While many online tools provide sophisticated technologies to share screens and co-edit manuscripts, the support of collaborative thinking, learning and even fooling around is still underdeveloped, but remains a valuable resource. This study traces whether the given level of instruction details influences the collaboration effectiveness among student working groups in a practical course in Biomedical Engineering. Within the semester’s practical course of Introduction into Medicine, participating students were divided into three groups (A, B and C) of each 4 to 6 students and had to collaborate on a clinical case. Groups A received detailed information and rules on online collaboration, B less detailed information and C only basic technical information. Each group was asked to fulfil an additional pre- and post-task before and after the semester’s practical course. These tasks consisted of solving combinatory puzzles based on isolated information bits and hints that were distributed among the group members. The groups differed only in the instructions they received to fulfil the task. During their work phases, all groups were observed. The study was conducted twice with different student cohorts. School grades were assigned representing 1 for the best up to 6 for the worst performance. The following averaged results were found: Groups B received the best grades (average 1,5 for winter term and average 1,6 for summer term). Second best performance was shown by the groups A (average 2,14 for winter term and average 1,75 for summer term) and finally groups C performed worst (average 2.10 for winter term and average 1,85 for summer term). In the taken times to solve the puzzle tasks, groups B showed up to be best in the summer term and groups A in the winter term. In all categories, groups C delivered the worst grades in average. The results of this study support that it is most reasonable to aid student online collaboration by providing detailed instructions or at least a few hints and instruct them to create their own rules for online collaboration. The results further support that the cooperation gets worse without suggesting any rules or instructions and that student age possesses a negligible influence.

Reduced diffusion in white matter after radiotherapy with photons and protons

BACKGROUND AND PURPOSE

Radio(chemo)therapy is standard in the adjuvant treatment of glioblastoma. Inevitably, brain tissue surrounding the target volume is also irradiated, potentially causing acute and late side-effects. Diffusion imaging has been shown to be a sensitive method to detect early changes in the cerebral white matter (WM) after radiation. The aim of this work was to assess possible changes in the mean diffusivity (MD) of WM after radio(chemo)therapy using Diffusion-weighted imaging (DWI) and to compare these effects between patients treated with proton and photon irradiation.

MATERIALS AND METHODS

70 patients with glioblastoma underwent adjuvant radio(chemo)therapy with protons (n = 20) or photons (n = 50) at the University Hospital Dresden. MRI follow-ups were performed at three-monthly intervals and in this study were evaluated until 33 months after the end of therapy. Relative white matter MD changes between baseline and all follow-up visits were calculated in different dose regions.

RESULTS

We observed a significant decrease of MD (p < 0.05) in WM regions receiving more than 20 Gy. MD reduction was progressive with dose and time after radio(chemo)therapy (maximum: -7.9 ± 1.2% after 24 months, ≥50 Gy). In patients treated with photons, significant reductions of MD in the entire WM (p < 0.05) were seen at all time points. Conversely, in proton patients, whole brain MD did not change significantly.

CONCLUSIONS

Irradiation leads to measurable MD reduction in white matter, progressing with both increasing dose and time. Treatment with protons reduces this effect most likely due to a lower total dose in the surrounding white matter. Further investigations are needed to assess whether those MD changes correlate with known radiation induced side-effects.

What's Driving Me? Exploration and Validation of a Hierarchical Personality Model for Trust in Automated Driving

OBJECTIVE

This paper presents a comprehensive investigation of personality traits related to trust in automated vehicles. A hierarchical personality model based on Mowen's (2000) 3M model is explored in a first and replicated in a second study.

BACKGROUND

Trust in automation is established in a complex psychological process involving user-, system- and situation-related variables. In this process, personality traits have been viewed as an important source of variance.

METHOD

Dispositional variables on three levels were included in an exploratory, hierarchical personality model (full model) of dynamic learned trust in automation, which was refined on the basis of structural equation modeling carried out in Study 1 (final model). Study 2 replicated the final model in an independent sample.

RESULTS

In both studies, the personality model showed a good fit and explained a large proportion of variance in trust in automation. The combined evidence supports the role of extraversion, neuroticism, and self-esteem at the elemental level; affinity for technology and dispositional interpersonal trust at the situational level; and propensity to trust in automation and a priori acceptability of automated driving at the surface level in the prediction of trust in automation.

CONCLUSION

Findings confirm that personality plays a substantial role in trust formation and provide evidence of the involvement of user dispositions not previously investigated in relation to trust in automation: self-esteem, dispositional interpersonal trust, and affinity for technology.

APPLICATION

Implications for personalization of information campaigns, driver training, and user interfaces for trust calibration in automated driving are discussed.

Intelligent Mobility in the City: The Influence of System and Context Factors on Drivers’ Takeover Willingness and Trust in Automated Vehicles

Automated driving in urban environments not only has the potential to improve traffic flow and heighten driver comfort but also to increase traffic safety, particularly for vulnerable road users such as pedestrians. For these benefits to take effect, drivers need to trust and use automated vehicles. This decision is influenced by both system and context factors. However, it is not yet clear how these factors interact with each other, especially for automated driving in city scenarios with crossing pedestrians. Therefore, we conducted an online experiment in which participants (N = 68) experienced short automated rides from the driver’s perspective through an urban environment. In each of the presented videos, a pedestrian crossed the street in front of the automated vehicle while system and context factors were varied: 1) the crossing pedestrian’s intention was either visualized correctly (as crossing) or incorrectly (visualization missing) by the automated vehicle (system factor), 2) the pedestrian was either distracted by using a smartphone while crossing or not (context factor), and 3) the scenario was either more or less complex depending on the number of other vehicles and pedestrians being present (context factor). In situations with a system malfunction where the crossing pedestrian’s intention was not visualized, participants perceived the situation as more critical, had less trust in the automated system, and a higher willingness to take over control regardless of any context factors. However, when the system worked correctly, the crossing pedestrian’s smartphone usage came into play, especially in the less complex scenario. Participants perceived situations with a distracted pedestrian as more critical, trusted the system less, indicated a higher willingness to take over control, and were more uncertain about their decision. As this study demonstrates the influence of distracted pedestrians, more research is needed on context factors and their inclusion in the design of interfaces to keep drivers informed during automated driving in urban environments.

Navigating with Augmented Reality - How does it affect drivers' mental load?

Drivers have been proven to easily understand Augmented Reality (AR) information. Especially in an ambiguous navigation task, drivers are expected to benefit from AR information. The driving simulator study was aimed at examining differences in mental load while navigating in an urban area with ambiguous intersection situations (N = 59). The navigation information was presented to the driver through a head-up display (HUD): a conventional HUD or an AR display, which relates information to the surroundings. Additionally, the driver had to solve a non-driving-related task (NDRT) which was an auditory cognitive, spatial task. Results showed that while driving with the AR display, participants performed better in the NDRT, which indicates a reduced mental load compared with the HUD. Participants drove on average 3 km/h slower with the HUD, showing compensation behaviour.

Pedestrian assessment: Is displaying automated driving mode in self-driving vehicles as relevant as emitting an engine sound in electric vehicles?

Pedestrians rely on vehicle dynamics, engine sound, and driver cues. The lack of engine sound now constitutes an addressed pedestrian safety issue for (hybrid) electric vehicles ((H)EVs). Analogously, lacking driver cues may constitute a pedestrian safety issue for self-driving vehicles (SDVs). The purpose of this study was to systematically compare the relevance of substituting driver cues with an external human-machine interface among SDVs (no eHMI vs. eHMI) with the relevance of substituting engine sound with artificial sound among (H)EVs (no engine sound vs. engine sound). In a within-subject design, twenty-nine participants acting as pedestrians encountered a simulated SDV in a parking lot. The results revealed that both informational cues have equally large effects on subjective measures such as perceived safety. In semi-structured interviews, participants stated that it is equally crucial to equip SDVs with an eHMI as equipping (H)EVs with an artificial sound generator. We conclude that an eHMI for SDVs seems to be as relevant as an artificial sound for (H)EVs.

More Than a Feeling-Interrelation of Trust Layers in Human-Robot Interaction and the Role of User Dispositions and State Anxiety

With service robots becoming more ubiquitous in social life, interaction design needs to adapt to novice users and the associated uncertainty in the first encounter with this technology in new emerging environments. Trust in robots is an essential psychological prerequisite to achieve safe and convenient cooperation between users and robots. This research focuses on psychological processes in which user dispositions and states affect trust in robots, which in turn is expected to impact the behavior and reactions in the interaction with robotic systems. In a laboratory experiment, the influence of propensity to trust in automation and negative attitudes toward robots on state anxiety, trust, and comfort distance toward a robot were explored. Participants were approached by a humanoid domestic robot two times and indicated their comfort distance and trust. The results favor the differentiation and interdependence of dispositional, initial, and dynamic learned trust layers. A mediation from the propensity to trust to initial learned trust by state anxiety provides an insight into the psychological processes through which personality traits might affect interindividual outcomes in human-robot interaction (HRI). The findings underline the meaningfulness of user characteristics as predictors for the initial approach to robots and the importance of considering users’ individual learning history regarding technology and robots in particular.

Overestimation of grey matter atrophy in glioblastoma patients following radio(chemo)therapy

Objective

Brain atrophy has the potential to become a biomarker for severity of radiation-induced side-effects. Particularly brain tumour patients can show great MRI signal changes over time caused by e.g. oedema, tumour progress or necrosis. The goal of this study was to investigate if such changes affect the segmentation accuracy of normal appearing brain and thus influence longitudinal volumetric measurements.

Materials and methods

T1-weighted MR images of 52 glioblastoma patients with unilateral tumours acquired before and three months after the end of radio(chemo)therapy were analysed. GM and WM volumes in the contralateral hemisphere were compared between segmenting the whole brain (full) and the contralateral hemisphere only (cl) with SPM and FSL. Relative GM and WM volumes were compared using paired t tests and correlated with the corresponding mean dose in GM and WM, respectively.

Results

Mean GM atrophy was significantly higher for full segmentation compared to cl segmentation when using SPM (mean ± std: ΔV_GM,full = − 3.1% ± 3.7%, ΔV_GM,cl = − 1.6% ± 2.7%; p < 0.001, d = 0.62). GM atrophy was significantly correlated with the mean GM dose with the SPM cl segmentation (r = − 0.4, p = 0.004), FSL full segmentation (r = − 0.4, p = 0.004) and FSL cl segmentation (r = -0.35, p = 0.012) but not with the SPM full segmentation (r = − 0.23, p = 0.1).

Conclusions

For accurate normal tissue volume measurements in brain tumour patients using SPM, abnormal tissue needs to be masked prior to segmentation, however, this is not necessary when using FSL.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10334-021-00922-3.

Development and Testing of Psychological Conflict Resolution Strategies for Assertive Robots to Resolve Human-Robot Goal Conflict

As service robots become increasingly autonomous and follow their own task-related goals, human-robot conflicts seem inevitable, especially in shared spaces. Goal conflicts can arise from simple trajectory planning to complex task prioritization. For successful human-robot goal-conflict resolution, humans and robots need to negotiate their goals and priorities. For this, the robot might be equipped with effective conflict resolution strategies to be assertive and effective but similarly accepted by the user. In this paper, conflict resolution strategies for service robots (public cleaning robot, home assistant robot) are developed by transferring psychological concepts (e.g., negotiation, cooperation) to HRI. Altogether, fifteen strategies were grouped by the expected affective outcome (positive, neutral, negative). In two online experiments, the acceptability of and compliance with these conflict resolution strategies were tested with humanoid and mechanic robots in two application contexts (public: n₁ = 61; private: n₂ = 93). To obtain a comparative value, the strategies were also applied by a human. As additional outcomes trust, fear, arousal, and valence, as well as perceived politeness of the agent were assessed. The positive/neutral strategies were found to be more acceptable and effective than negative strategies. Some negative strategies (i.e., threat, command) even led to reactance and fear. Some strategies were only positively evaluated and effective for certain agents (human or robot) or only acceptable in one of the two application contexts (i.e., approach, empathy). Influences on strategy acceptance and compliance in the public context could be found: acceptance was predicted by politeness and trust. Compliance was predicted by interpersonal power. Taken together, psychological conflict resolution strategies can be applied in HRI to enhance robot task effectiveness. If applied robot-specifically and context-sensitively they are accepted by the user. The contribution of this paper is twofold: conflict resolution strategies based on Human Factors and Social Psychology are introduced and empirically evaluated in two online studies for two application contexts. Influencing factors and requirements for the acceptance and effectiveness of robot assertiveness are discussed.

Sleep inertia in automated driving: Post-sleep take-over and driving performance

Sleep is emerging as a new driver state in automated driving. Post-sleep performance impairments due to sleep inertia, the transitional phase from sleep to wakefulness that can take up to 30 min, are a potential safety issue. Take-over performance immediately after sleep is impaired and drivers perceive the take-over as critical. The aim of the presented study was to assess take-over behavior immediately after sleep and driving behavior during the 10 min after sleep. A study with N = 31 drivers was conducted in a high-fidelity driving simulator. Take-over performance and driving performance were assessed a) under alert baseline conditions and b) after awakening from electroencephalography-confirmed stable sleep. Take-over performance 15 s after awakening was impaired resulting in more driving errors compared to the alert baseline. Lane keeping was dramatically impaired in the first 3 min after sleep and recovered rapidly. Drivers drove slower after sleep and speed keeping was less stable for at least 10 min. The results suggest that human-machine interaction design should account for the drivers' impaired post-sleep driving performance.

Get Ready for Being Chauffeured : Passenger's Preferences and Trust While Being Driven by Human and Automation

OBJECTIVE

We investigated passenger's trust and preferences using subjective, qualitative, and psychophysiological measures while being driven either by human or automation in a field study and a driving simulator experiment.

BACKGROUND

The passenger's perspective has largely been neglected in autonomous driving research, although the change of roles from an active driver to a passive passenger is incontrovertible. Investigations of passenger's appraisals on self-driving vehicles often seem convoluted with active manual driving experiences instead of comparisons with being driven by humans.

METHOD

We conducted an exploratory field study using an autonomous research vehicle (N = 11) and a follow-up experimental driving simulation (N = 24). Participants were driven on the same course by a human and an autonomous agent sitting on a passenger seat. Skin conductance, trust, and qualitative characteristics of the perceived driving situation were assessed. In addition, the effect of driving style (defensive vs. sporty) was evaluated in the simulator.

RESULTS

Both investigations revealed a close relation between subjective trust ratings and skin conductance, with increased trust and by trend reduced arousal for human compared with automation in control. Even though driving behavior was equivalent in the simulator when being driven by human and automation, passengers most preferred and trusted the human-defensive driver.

CONCLUSION

Individual preferences for driving style and human or autonomous vehicle control influence trust and subjective driving characterizations.

APPLICATION

The findings are applicable in human-automation research, reminding to not neglect subjective attributions and psychophysiological reactions as a result of ascribed control duties in relation to specific execution characteristics.

Effects of explaining system failures during maneuver coordination while driving manual or automated

To support the coordination of road users in situations like merging or turning left, an advanced driver assistance system for cooperative driving could be helpful whether driving manually or automated. This simulator study investigated the behavior of drivers being confronted with system failures. In two test situations with system failures (loss of communication of the system and change of traffic environment), the system could not complete the coordination properly and the driver was informed about the system failure and the abortion of maneuver coordination. The focus of this study was to analyze the effect of system failures on drivers' trust in the system and whether an explanatory message provided by the system would increase acceptance. Therefore, subjective data as well as gaze and physiological data of 32 participants were analyzed. The results revealed decreased trust in the system after experiencing a system failure, but no long term effect was found. The drivers evaluated the timing, as well as the content, of the explanatory message as appropriate. The explanations were perceived as helpful, but no effect on acceptance was found.

E.U. paediatric MOG consortium consensus: Part 1 - Classification of clinical phenotypes of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

Over the past few years, increasing interest in the role of autoantibodies against myelin oligodendrocyte glycoprotein (MOG-abs) as a new candidate biomarker in demyelinating central nervous system diseases has arisen. MOG-abs have now consistently been identified in a variety of demyelinating syndromes, with a predominance in paediatric patients. The clinical spectrum of these MOG-ab-associated disorders (MOGAD) is still expanding and differs between paediatric and adult patients. This first part of the Paediatric European Collaborative Consensus emphasises the diversity in clinical phenotypes associated with MOG-abs in paediatric patients and discusses these associated clinical phenotypes in detail. Typical MOGAD presentations consist of demyelinating syndromes, including acute disseminated encephalomyelitis (ADEM) in younger, and optic neuritis (ON) and/or transverse myelitis (TM) in older children. A proportion of patients experience a relapsing disease course, presenting as ADEM followed by one or multiple episode(s) of ON (ADEM-ON), multiphasic disseminated encephalomyelitis (MDEM), relapsing ON (RON) or relapsing neuromyelitis optica spectrum disorders (NMOSD)-like syndromes. More recently, the disease spectrum has been expanded with clinical and radiological phenotypes including encephalitis-like, leukodystrophy-like, and other non-classifiable presentations. This review concludes with recommendations following expert consensus on serologic testing for MOG-abs in paediatric patients, the presence of which has consequences for long-term monitoring, relapse risk, treatments, and for counselling of patient and families. Furthermore, we propose a clinical classification of paediatric MOGAD with clinical definitions and key features. These are operational and need to be tested, however essential for future paediatric MOGAD studies.

Sleep in highly automated driving: Takeover performance after waking up

Takeover performance in automated driving is subject to investigation in the context of a variety of driver states such as distraction or drowsiness. New driver states will emerge with increasing automation level with drivers potentially being allowed to sleep while driving a highly automated vehicle. Still at some point during a drive, drivers will be required to or voluntarily take back control of the vehicle. A simulator study was conducted to investigate drivers' ability to take over the vehicle control after sleeping. In a within-subjects study design N = 25 test drivers completed a drive using a highly automated driving system a) during day time after a full night of sleep and b) early in the morning after a night of partial sleep deprivation. During the second drive, sleep was measured in drivers according to the American Academy of Sleep Medicine (AASM) standard using electroencephalography (EEG). In total, the participants had to handle four takeover requests (TORs) from the system, two while being awake (day drive) and two when being awakened from sleep stage N2 (morning drive). The objective criticality of the situations was assessed performing the Takeover Controllability rating (TOC-rating). The results indicate that the applied takeover time of 60 s was sufficient for drivers to reengage in driving after sleeping. Reaction times were extended by about 3 s after sleep compared to the wake condition. Takeover performance assessed with the TOC-rating however was clearly worse after sleep than after wakefulness which was also reflected in the drivers' subjective perception of the criticality of the situation. Further research is needed on how to deal with performance impairments after waking up from sleep during automated driving.

Comparing dynamic and static illustration of an HMI for cooperative driving

The study analyses the Human-Machine-Interface (HMI) of a driver assistance system for cooperative driving, such as merging or turning left situations. Three versions of the HMI are varied as independent variables within subjects. Two versions, displayed in the instrument cluster, focus either on a dynamic or a static illustration of the current status of the system. The third HMI, developed in a preliminary study, serves as benchmark to compare the cluster-based HMIs. The benchmark HMI uses the same status messages and highlights the partner directly in the environment by augmented reality elements. The results of the present study show that the Benchmark best supported cooperative behavior. Both versions of the HMI located in the instrument cluster also support cooperative behavior and are accepted by the drivers. However, more glances are shifted from the relevant area in the driving scenario towards the cluster compared to the Benchmark HMI. With the static version, the participants felt more distracted compared to the dynamic HMI. In conclusion, as long as it is not technically possible to display the partner directly in the environment, a dynamic display in cooperation situations is a good alternative.

The More You Know: Trust Dynamics and Calibration in Highly Automated Driving and the Effects of Take-Overs, System Malfunction, and System Transparency

OBJECTIVE

This paper presents a theoretical model and two simulator studies on the psychological processes during early trust calibration in automated vehicles.

BACKGROUND

The positive outcomes of automation can only reach their full potential if a calibrated level of trust is achieved. In this process, information on system capabilities and limitations plays a crucial role.

METHOD

In two simulator experiments, trust was repeatedly measured during an automated drive. In Study 1, all participants in a two-group experiment experienced a system-initiated take-over, and the occurrence of a system malfunction was manipulated. In Study 2 in a 2 × 2 between-subject design, system transparency was manipulated as an additional factor.

RESULTS

Trust was found to increase during the first interactions progressively. In Study 1, take-overs led to a temporary decrease in trust, as did malfunctions in both studies. Interestingly, trust was reestablished in the course of interaction for take-overs and malfunctions. In Study 2, the high transparency condition did not show a temporary decline in trust after a malfunction.

CONCLUSION

Trust is calibrated along provided information prior to and during the initial drive with an automated vehicle. The experience of take-overs and malfunctions leads to a temporary decline in trust that was recovered in the course of error-free interaction. The temporary decrease can be prevented by providing transparent information prior to system interaction.

APPLICATION

Transparency, also about potential limitations of the system, plays an important role in this process and should be considered in the design of tutorials and human-machine interaction (HMI) concepts of automated vehicles.

Muscle NAD+ depletion and Serpina3n as molecular determinants of murine cancer cachexia-the effects of blocking myostatin and activins

Objective

Cancer cachexia and muscle loss are associated with increased morbidity and mortality. In preclinical animal models, blocking activin receptor (ACVR) ligands has improved survival and prevented muscle wasting in cancer cachexia without an effect on tumour growth. However, the underlying mechanisms are poorly understood. This study aimed to identify cancer cachexia and soluble ACVR (sACVR) administration-evoked changes in muscle proteome.

Methods

Healthy and C26 tumour-bearing (TB) mice were treated with recombinant sACVR. The sACVR or PBS control were administered either prior to the tumour formation or by continued administration before and after tumour formation. Muscles were analysed by quantitative proteomics with further examination of mitochondria and nicotinamide adenine dinucleotide (NAD⁺) metabolism. To complement the first prophylactic experiment, sACVR (or PBS) was injected as a treatment after tumour cell inoculation.

Results

Muscle proteomics in TB cachectic mice revealed downregulated signatures for mitochondrial oxidative phosphorylation (OXPHOS) and increased acute phase response (APR). These were accompanied by muscle NAD⁺ deficiency, alterations in NAD⁺ biosynthesis including downregulation of nicotinamide riboside kinase 2 (Nrk2), and decreased muscle protein synthesis. The disturbances in NAD⁺ metabolism and protein synthesis were rescued by treatment with sACVR. Across the whole proteome and APR, in particular, Serpina3n represented the most upregulated protein and the strongest predictor of cachexia. However, the increase in Serpina3n expression was associated with increased inflammation rather than decreased muscle mass and/or protein synthesis.

Conclusions

We present evidence implicating disturbed muscle mitochondrial OXPHOS proteome and NAD⁺ homeostasis in experimental cancer cachexia. Treatment of TB mice with a blocker of activin receptor ligands restores depleted muscle NAD⁺ and Nrk2, as well as decreased muscle protein synthesis. These results indicate putative new treatment therapies for cachexia and that although acute phase protein Serpina3n may serve as a predictor of cachexia, it more likely reflects a condition of elevated inflammation.

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Cachectic muscle proteome shows decreased OXPHOS and increased acute phase response.

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Cancer cachexia is characterized by lowered muscle Nrk2 expression and NAD⁺ levels.

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Blocking activin receptor 2B ligands rescues muscle NAD⁺ homeostasis in cachexia.

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Blocking activin receptor 2B ligands prevents affected protein synthesis in cachexia.

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Serpina3n predicts cachexia and cancer-induced APR independently from muscle atrophy.

Manifestation of migraine in adolescents: Does it change in puberty?

PURPOSE

To analyze the association between pubertal stage, menstrual cycle and migraine attacks in girls with migraine. In addition, headache frequency, accompanying symptoms, duration and onset in relation to the specific phase of the cycle were investigated.

METHODS

Girls between 7 and 18 years old, diagnosed with headaches that met "International Classification of Headache Disorders II" diagnostic criteria for migraine without aura, kept a daily headache and menstrual cycle diary over 8 weeks. Ovulatory cycles were identified by weekly progesterone saliva tests.

RESULTS

47 girls participated in the study and were divided into three groups according to Tanner stage and onset of regular menstruation: pre- (n = 16), peri- (n = 19) and post-pubertal (n = 12). A significant difference in migraine frequency was found between pre- and post-pubertal girls (p = 0.005). No significant differences with regard to headache characteristics were detected. Interestingly, a higher frequency of attacks in follicular phase occurred compared to luteal phase in peri- and post-pubertal girls (p = 0.030).

CONCLUSION

During puberty, migraine patterns in girls change to a typical adult pattern of migraine in a stepwise manner not clearly related to menarche. The first sign of this transition phase could be the higher frequency of migraine attacks in post-pubertal girls.