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This paper describes a user study on the interaction with an in-vehicle information system (IVIS). The motivation for conducting this research was to investigate the subjectively and objectively measured impact of using a single- or multi-modal IVIS while driving. A hierarchical, list-based menu was presented using a windshield projection (head-up display), auditory display and a combination of both interfaces. The users were asked to navigate a vehicle in a driving simulator and simultaneously perform a set of tasks of varying complexity. The experiment showed that the interaction with visual and audio-visual head-up displays is faster and more efficient than with the audio-only display. All the interfaces had a similar impact on the overall driving performance. There was no significant difference between the visual only and audio-visual displays in terms of their efficiency and safety; however, the majority of test subjects clearly preferred to use the multi-modal interface while driving.

This paper describes a user study on interaction with a mobile device installed in a driving simulator. Two new auditory interfaces were proposed and their effectiveness and efficiency were compared to a standard visual interface. Both auditory interfaces consisted of spatialized auditory cues representing individual items in the hierarchical structure of the menu. In the first auditory interface all items of the current level of the menu were played simultaneously. In the second auditory interface only one item was played at a time. The visual interface was shown on a small in-vehicle LCD screen on the dashboard. In all three cases, a custom-made interaction device (a scrolling wheel and two buttons) attached to the steering wheel was used for controlling the interface. The driving performance, task completion times, perceived workload and overall user satisfaction were evaluated. The experiment proved that both auditory interfaces were effective to use in a mobile environment, but were not faster than the visual interface. In the case of shorter tasks, e.g. changing the active profile or deleting an image, the task completion times were comparable for all interfaces; however, both the driving performance was significantly better and the perceived workload was lower when using the auditory interfaces. The test subjects also reported a high overall satisfaction with the auditory interfaces. The latter were labelled as easier to use, more satisfying and more adequate for performing the required tasks than the visual interface. The results of the survey are not surprising as there is a stronger competition for the visual attention between the visual interface and the primary task (driving the car) than in the case of using the auditory interface. So although both types of interfaces were proven to be effective, the visual interface was less efficient as it strongly distracted the user from performing the primary task. Refereed/Peer-reviewed

Background In acute myeloid leukemia (AML), disseminated intravascular coagulation (DIC) contributes to morbidity and mortality, but the underlying pathomechanisms remain incompletely understood. Methods We conducted a prospective study on 69 patients with newly diagnosed AML to further define the correlates of systemic coagulation activation in this hematological malignancy. Tissue factor procoagulant activity (TF PCA) of isolated peripheral blood mononuclear cells (PBMCs) and TF expression by circulating microparticles (MPs) were assessed by single-stage clotting and thrombin generation assay, respectively. Soluble plasma TF antigen and secretion of vascular endothelial growth factor (VEGF) by cultured PBMCs were measured by ELISA. Cell-free plasma DNA was quantified by staining with a fluorescent dye. Result TF PCA of PBMCs was significantly increased in AML patients as compared to healthy controls. Furthermore, TF PCA was significantly associated with decompensated DIC at presentation, as defined by a plasma fibrinogen level of ≤1 g/L (n = 11). In addition to TF PCA and circulating blasts, serum lactate dehydrogenase, a surrogate marker for leukemic cell turnover, correlated with plasma D-Dimer in the total patient cohort and was significantly increased in DIC patients, suggesting a role for myeloblast apoptosis/necrosis in activation of the TF-dependent coagulation pathway. Consistently, TF-bearing plasma MPs were more frequently detected and levels of soluble TF antigen were significantly higher in DIC vs. non-DIC patients. No association was found between TF PCA expression and VEGF secretion by isolated PBMCs, but significantly increased levels of cell-free plasma DNA pointed to a contribution of the intrinsic contact pathway to systemic coagulation activation in the total patient cohort and in patients with lower TF PCA expression. While PBMC-associated TF PCA had no effect on long-term survival, DIC occurrence at presentation increased the risk of early mortality. Conclusion In newly diagnosed AML, TF expression by PBMCs and shedding of TF-bearing plasma MPs are central to the pathogenesis of DIC, but additional pathways, such as DNA liberation, may contribute to systemic coagulation activation.

In this paper we evaluate the safety of the driver when using an embedded communication device while driving. As a part of our research, four different tasks were preformed with the device in order to evaluate the efficiency and safety of the drivers under three different conditions: one visual and two different auditory conditions. In the visual condition, various menu items were shown on a small LCD screen attached to the dashboard. In the auditory conditions, the same menu items were presented with spatial sounds distributed on a virtual ring around the user's head. The same custom-made interaction device attached to the steering wheel was used in all three conditions, enabling simple and safe interaction with the device while driving. The auditory interface proved to be as fast as the visual one, while at the same time enabling a significantly safer driving and higher satisfaction of the users. The measured workload also appeared to be lower when using the auditory interfaces. Refereed/Peer-reviewed

Acquired hemophilia A (AHA) and acquired von Willebrand Syndrome (AVWS) are both rare bleeding disorders that can be associated with lymphoproliferative or autoimmune diseases. AHA is uniformly caused by inhibitory autoantibodies against coagulation factor VIII (FVIII), while the pathophysiology of AVWS comprises several distinct mechanisms, including reduced synthesis, accelerated clearance, or increased proteolysis. In this regard, autoantibodies to von Willebrand factor (VWF) have been described in patients with systemic lupus erythematosus (SLE) or monoclonal gammopathy. Here, we report the case of a 71-year-old patient with a recent onset of spontaneous mucocutaneous and soft-tissue bleeding due to severely decreased FVIII and VWF. While there was no evidence for monoclonal gammopathy, specific IgG antibodies against both FVIII and VWF were detected. Furthermore, VWF multimer analysis revealed the presence of ultralarge plasma multimers and absence of the typical multimeric triplet structure, a finding consistent with decreased proteolytic processing of massively released, but rapidly cleared VWF. Both FVIII and VWF readily responded to immunosuppressive therapy with prednisolone. Interestingly, clinical and laboratory findings established the diagnosis of “late-onset SLE” in our patient. Thus, about 45 years after the first description of AVWS in a 12-year-old boy with SLE, we present another unusual case of concomitant autoimmune-mediated AHA and AVWS in an elderly SLE patient, which, to the best of our knowledge, has not been reported so far.