Search results for: brain heart infusion
1136 Application of Infrared Thermal Imaging, Eye Tracking and Behavioral Analysis for Deception Detection
Authors: Petra Hypšová, Martin Seitl
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One of the challenges of forensic psychology is to detect deception during a face-to-face interview. In addition to the classical approaches of monitoring the utterance and its components, detection is also sought by observing behavioral and physiological changes that occur as a result of the increased emotional and cognitive load caused by the production of distorted information. Typical are changes in facial temperature, eye movements and their fixation, pupil dilation, emotional micro-expression, heart rate and its variability. Expanding technological capabilities have opened the space to detect these psychophysiological changes and behavioral manifestations through non-contact technologies that do not interfere with face-to-face interaction. Non-contact deception detection methodology is still in development, and there is a lack of studies that combine multiple non-contact technologies to investigate their accuracy, as well as studies that show how different types of lies produced by different interviewers affect physiological and behavioral changes. The main objective of this study is to apply a specific non-contact technology for deception detection. The next objective is to investigate scenarios in which non-contact deception detection is possible. A series of psychophysiological experiments using infrared thermal imaging, eye tracking and behavioral analysis with FaceReader 9.0 software was used to achieve our goals. In the laboratory experiment, 16 adults (12 women, 4 men) between 18 and 35 years of age (SD = 4.42) were instructed to produce alternating prepared and spontaneous truths and lies. The baseline of each proband was also measured, and its results were compared to the experimental conditions. Because the personality of the examiner (particularly gender and facial appearance) to whom the subject is lying can influence physiological and behavioral changes, the experiment included four different interviewers. The interviewer was represented by a photograph of a face that met the required parameters in terms of gender and facial appearance (i.e., interviewer likability/antipathy) to follow standardized procedures. The subject provided all information to the simulated interviewer. During follow-up analyzes, facial temperature (main ROIs: forehead, cheeks, the tip of the nose, chin, and corners of the eyes), heart rate, emotional expression, intensity and fixation of eye movements and pupil dilation were observed. The results showed that the variables studied varied with respect to the production of prepared truths and lies versus the production of spontaneous truths and lies, as well as the variability of the simulated interviewer. The results also supported the assumption of variability in physiological and behavioural values during the subject's resting state, the so-called baseline, and the production of prepared and spontaneous truths and lies. A series of psychophysiological experiments provided evidence of variability in the areas of interest in the production of truths and lies to different interviewers. The combination of technologies used also led to a comprehensive assessment of the physiological and behavioral changes associated with false and true statements. The study presented here opens the space for further research in the field of lie detection with non-contact technologies.Keywords: emotional expression decoding, eye-tracking, functional infrared thermal imaging, non-contact deception detection, psychophysiological experiment
Procedia PDF Downloads 981135 Surface Adjustments for Endothelialization of Decellularized Porcine Pericardium
Authors: M. Markova, E. Filova, O. Kaplan, R. Matejka, L. Bacakova
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The porcine pericardium is used as a material for cardiac and aortic valves substitutes. Current biological aortic heart valve prosthesis have a limited lifetime period because they undergo degeneration. In order to make them more biocompatible and prolong their lifetime it is necessary to reseed the decellularized prostheses with endothelial cells and with valve interstitial cells. The endothelialization of the prosthesis-surface may be supported by suitable chemical surface modification of the prosthesis. The aim of this study is to prepare bioactive fibrin layers which would both support endothelialization of porcine pericardium and enhance differentiation and maturation of the endothelial cells seeded. As a material for surface adjustments we used layers of fibrin with/without heparin and some of them with adsorbed or chemically bound FGF2, VEGF or their combination. Fibrin assemblies were prepared in 24-well cell culture plate and were seeded with HSVEC (Human Saphenous Vein Endothelial Cells) at a density of 20,000 cells per well in EGM-2 medium with 0.5% FS and without heparin, without FGF2 and without VEGF; medium was supplemented with aprotinin (200 U/mL). As a control, surface polystyrene (PS) was used. Fibrin was also used as homogeneous impregnation of the decellularized porcine pericardium throughout the scaffolds. Morphology, density, and viability of the seeded endothelial cells were observed from micrographs after staining the samples by LIVE/DEAD cytotoxicity/viability assay kit on the days 1, 3, and 7. Endothelial cells were immunocytochemically stained for proteins involved in cell adhesion, i.e. alphaV integrin, vinculin, and VE-cadherin, markers of endothelial cells differentiation and maturation, i.e. von Willebrand factor and CD31, and for extracellular matrix proteins typically produced by endothelial cells, i.e. type IV collagen and laminin. The staining intensities were subsequently quantified using a software. HSVEC cells grew on each of the prepared surfaces better than on control surface. They reached confluency. The highest cell densities were obtained on the surface of fibrin with heparin and both grow factors used together. Intensity of alphaV integrins staining was highest on samples with remained fibrin layer, i.e. on layers with lower cell densities, i.e. on fibrin without heparin. Vinculin staining was apparent, but was rather diffuse, on fibrin with both FGF2 and VEGF and on control PS. Endothelial cells on all samples were positively stained for von Willebrand factor and CD31. VE-cadherin receptors clusters were best developed on fibrin with heparin and growth factors. Significantly stronger staining of type IV collagen was observed on fibrin with heparin and both growth factors. Endothelial cells on all samples produced laminin-1. Decellularized pericardium was homogeneously filled with fibrin structures. These fibrin-modified pericardium samples will be further seeded with cells and cultured in a bioreactor. Fibrin layers with/without heparin and with adsorbed or chemically bound FGF2, VEGF or their combination are good surfaces for endothelialization of cardiovascular prostheses or porcine pericardium based heart valves. Supported by the Ministry of Health, grants No15-29153A and 15-32497A, and the Grant Agency of the Czech Republic, project No. P108/12/G108.Keywords: aortic valves prosthesis, FGF2, heparin, HSVEC cells, VEGF
Procedia PDF Downloads 2601134 Medical Advances in Diagnosing Neurological and Genetic Disorders
Authors: Simon B. N. Thompson
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Retinoblastoma is a rare type of childhood genetic cancer that affects children worldwide. The diagnosis is often missed due to lack of education and difficulty in presentation of the tumor. Frequently, the tumor on the retina is noticed by photography when the red-eye flash, commonly seen in normal eyes, is not produced. Instead, a yellow or white colored patch is seen or the child has a noticeable strabismus. Early detection can be life-saving though often results in removal of the affected eye. Remaining functioning in the healthy eye when the child is young has resulted in super-vision and high or above-average intelligence. Technological advancement of cameras has helped in early detection. Brain imaging has also made possible early detection of neurological diseases and, together with the monitoring of cortisol levels and yawning frequency, promises to be the next new early diagnostic tool for the detection of neurological diseases where cortisol insufficiency is particularly salient, such as multiple sclerosis and Cushing’s disease.Keywords: cortisol, neurological disease, retinoblastoma, Thompson cortisol hypothesis, yawning
Procedia PDF Downloads 3851133 A Turn-on Fluorescent Sensor for Pb(II)
Authors: Ece Kök Yetimoğlu, Soner Çubuk, Neşe Taşci, M. Vezir Kahraman
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Lead(II) is one of the most toxic environmental pollutants in the world, due to its high toxicity and non-biodegradability. Lead exposure causes severe risks to human health such as central brain damages, convulsions, kidney damages, and even death. To determine lead(II) in environmental or biological samples, scientists use atomic absorption spectrometry (AAS), inductively coupled plasma mass spectrometry (ICPMS), fluorescence spectrometry and electrochemical techniques. Among these systems the fluorescence spectrometry and fluorescent chemical sensors have attracted considerable attention because of their good selectivity and high sensitivity. The fluorescent polymers usually contain covalently bonded fluorophores. In this study imidazole based UV cured polymeric film was prepared and designed to act as a fluorescence chemo sensor for lead (II) analysis. The optimum conditions such as influence of pH value and time on the fluorescence intensity of the sensor have also been investigated. The sensor was highly sensitive with a detection limit as low as 1.87 × 10−8 mol L-1 and it was successful in the determination of Pb(II) in water samples.Keywords: fluorescence, lead(II), photopolymerization, polymeric sensor
Procedia PDF Downloads 6691132 A Flexible Piezoelectric - Polymer Composite for Non-Invasive Detection of Multiple Vital Signs of Human
Authors: Sarah Pasala, Elizabeth Zacharias
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Vital sign monitoring is crucial for both everyday health and medical diagnosis. A significant factor in assessing a human's health is their vital signs, which include heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings. Vital sign monitoring has been the focus of many system and method innovations recently. Piezoelectrics are materials that convert mechanical energy into electrical energy and can be used for vital sign monitoring. Piezoelectric energy harvesters that are stretchable and flexible can detect very low frequencies like airflow, heartbeat, etc. Current advancements in piezoelectric materials and flexible sensors have made it possible to create wearable and implantable medical devices that can continuously monitor physiological signals in humans. But because of their non-biocompatible nature, they also produce a large amount of e-waste and require another surgery to remove the implant. This paper presents a biocompatible and flexible piezoelectric composite material for wearable and implantable devices that offers a high-performance platform for seamless and continuous monitoring of human physiological signals and tactile stimuli. It also addresses the issue of e-waste and secondary surgery. A Lead-free piezoelectric, SrBi4Ti4O15, is found to be suitable for this application because the properties can be tailored by suitable substitutions and also by varying the synthesis temperature protocols. In the present work, SrBi4Ti4O15 modified by rare-earth has been synthesized and studied. Coupling factors are calculated from resonant (fr) and anti-resonant frequencies (fa). It is observed that Samarium substitution in SBT has increased the Curie temperature, dielectric and piezoelectric properties. From impedance spectroscopy studies, relaxation, and non-Debye type behaviour are observed. The composite of bioresorbable poly(l-lactide) and Lead-free rare earth modified Bismuth Layered Ferroelectrics leads to a flexible piezoelectric device for non-invasive measurement of vital signs, such as heart rate, breathing rate, blood pressure, and electrocardiogram (ECG) readings and also artery pulse signals in near-surface arteries. These composites are suitable to detect slight movement of the muscles and joints. This Lead-free rare earth modified Bismuth Layered Ferroelectrics – polymer composite is synthesized using a ball mill and the solid-state double sintering method. XRD studies indicated the two phases in the composite. SEM studies revealed the grain size to be uniform and in the range of 100 nm. The electromechanical coupling factor is improved. The elastic constants are calculated and the mechanical flexibility is found to be improved as compared to the single-phase rare earth modified Bismuth Latered piezoelectric. The results indicate that this composite is suitable for the non-invasive detection of multiple vital signs of humans.Keywords: composites, flexible, non-invasive, piezoelectric
Procedia PDF Downloads 371131 Breast Cancer Mortality and Comorbidities in Portugal: A Predictive Model Built with Real World Data
Authors: Cecília M. Antão, Paulo Jorge Nogueira
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Breast cancer (BC) is the first cause of cancer mortality among Portuguese women. This retrospective observational study aimed at identifying comorbidities associated with BC female patients admitted to Portuguese public hospitals (2010-2018), investigating the effect of comorbidities on BC mortality rate, and building a predictive model using logistic regression. Results showed that the BC mortality in Portugal decreased in this period and reached 4.37% in 2018. Adjusted odds ratio indicated that secondary malignant neoplasms of liver, of bone and bone marrow, congestive heart failure, and diabetes were associated with an increased chance of dying from breast cancer. Although the Lisbon district (the most populated area) accounted for the largest percentage of BC patients, the logistic regression model showed that, besides patient’s age, being resident in Bragança, Castelo Branco, or Porto districts was directly associated with an increase of the mortality rate.Keywords: breast cancer, comorbidities, logistic regression, adjusted odds ratio
Procedia PDF Downloads 861130 Visuospatial Perspective Taking and Theory of Mind in a Clinical Approach: Development of a Task for Adults
Authors: Britt Erni, Aldara Vazquez Fernandez, Roland Maurer
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Visuospatial perspective taking (VSPT) is a process that allows to integrate spatial information from different points of view, and to transform the mental images we have of the environment to properly orient our movements and anticipate the location of landmarks during navigation. VSPT is also related to egocentric perspective transformations (imagined rotations or translations of one's point of view) and to infer the visuospatial experiences of another person (e.g. if and how another person sees objects). This process is deeply related to a wide-ranging capacity called the theory of mind (ToM), an essential cognitive function that allows us to regulate our social behaviour by attributing mental representations to individuals in order to make behavioural predictions. VSPT is often considered in the literature as the starting point of the development of the theory of mind. VSPT and ToM include several levels of knowledge that have to be assessed by specific tasks. Unfortunately, the lack of tasks assessing these functions in clinical neuropsychology leads to underestimate, in brain-damaged patients, deficits of these functions which are essential, in everyday life, to regulate our social behaviour (ToM) and to navigate in known and unknown environments (VSPT). Therefore, this study aims to create and standardize a VSPT task in order to explore the cognitive requirements of VSPT and ToM, and to specify their relationship in healthy adults and thereafter in brain-damaged patients. Two versions of a computerized VSPT task were administered to healthy participants (M = 28.18, SD = 4.8 years). In both versions the environment was a 3D representation of 10 different geometric shapes placed on a circular base. Two sets of eight pictures were generated from this: of the environment with an avatar somewhere on its periphery (locations) and of what the avatar sees from that place (views). Two types of questions were asked: a) identify the location from the view, and b) identify the view from the location. Twenty participants completed version 1 of the task and 20 completed the second version, where the views were offset by ±15° (i.e., clockwise or counterclockwise) and participants were asked to choose the closest location or the closest view. The preliminary findings revealed that version 1 is significantly easier than version 2 for accuracy (with ceiling scores for version 1). In version 2, participants responded significantly slower when they had to infer the avatar's view from the latter's location, probably because they spent more time visually exploring the different views (responses). Furthermore, men significantly performed better than women in version 1 but not in version 2. Most importantly, a sensitive task (version 2) has been created for which the participants do not seem to easily and automatically compute what someone is looking at yet which does not involve more heavily other cognitive functions. This study is further completed by including analysis on non-clinical participants with low and high degrees of schizotypy, different socio-educational status, and with a range of older adults to examine age-related and other differences in VSPT processing.Keywords: mental transformation, spatial cognition, theory of mind, visuospatial perspective taking
Procedia PDF Downloads 2031129 Securing Health Monitoring in Internet of Things with Blockchain-Based Proxy Re-Encryption
Authors: Jerlin George, R. Chitra
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The devices with sensors that can monitor your temperature, heart rate, and other vital signs and link to the internet, known as the Internet of Things (IoT), have completely transformed the way we control health. Providing real-time health data, these sensors improve diagnostics and treatment outcomes. Security and privacy matters when IoT comes into play in healthcare. Cyberattacks on centralized database systems are also a problem. To solve these challenges, the study uses blockchain technology coupled with proxy re-encryption to secure health data. ThingSpeak IoT cloud analyzes the collected data and turns them into blockchain transactions which are safely kept on the DriveHQ cloud. Transparency and data integrity are ensured by blockchain, and secure data sharing among authorized users is made possible by proxy re-encryption. This results in a health monitoring system that preserves the accuracy and confidentiality of data while reducing the safety risks of IoT-driven healthcare applications.Keywords: internet of things, healthcare, sensors, electronic health records, blockchain, proxy re-encryption, data privacy, data security
Procedia PDF Downloads 131128 Non-linear Analysis of Spontaneous EEG After Spinal Cord Injury: An Experimental Study
Authors: Jiangbo Pu, Hanhui Xu, Yazhou Wang, Hongyan Cui, Yong Hu
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Spinal cord injury (SCI) brings great negative influence to the patients and society. Neurological loss in human after SCI is a major challenge in clinical. Instead, neural regeneration could have been seen in animals after SCI, and such regeneration could be retarded by blocking neural plasticity pathways, showing the importance of neural plasticity in functional recovery. Here we used sample entropy as an indicator of nonlinear dynamical in the brain to quantify plasticity changes in spontaneous EEG recordings of rats before and after SCI. The results showed that the entropy values were increased after the injury during the recovery in one week. The increasing tendency of sample entropy values is consistent with that of behavioral evaluation scores. It is indicated the potential application of sample entropy analysis for the evaluation of neural plasticity in spinal cord injury rat model.Keywords: spinal cord injury (SCI), sample entropy, nonlinear, complex system, firing pattern, EEG, spontaneous activity, Basso Beattie Bresnahan (BBB) score
Procedia PDF Downloads 4641127 The Anesthesia Considerations in Robotic Mastectomies
Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev
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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.Keywords: anesthesia, mastectomies, robotic, hypercarbia
Procedia PDF Downloads 1101126 The Effects of Adding Vibrotactile Feedback to Upper Limb Performance during Dual-Tasking and Response to Misleading Visual Feedback
Authors: Sigal Portnoy, Jason Friedman, Eitan Raveh
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Introduction: Sensory substitution is possible due to the capacity of our brain to adapt to information transmitted by a synthetic receptor via an alternative sensory system. Practical sensory substitution systems are being developed in order to increase the functionality of individuals with sensory loss, e.g. amputees. For upper limb prosthetic-users the loss of tactile feedback compels them to allocate visual attention to their prosthesis. The effect of adding vibrotactile feedback (VTF) to the applied force has been studied, however its effect on the allocation if visual attention during dual-tasking and the response during misleading visual feedback have not been studied. We hypothesized that VTF will improve the performance and reduce visual attention during dual-task assignments in healthy individuals using a robotic hand and improve the performance in a standardized functional test, despite the presence of misleading visual feedback. Methods: For the dual-task paradigm, twenty healthy subjects were instructed to toggle two keyboard arrow keys with the left hand to retain a moving virtual car on a road on a screen. During the game, instructions for various activities, e.g. mix the sugar in the glass with a spoon, appeared on the screen. The subject performed these tasks with a robotic hand, attached to the right hand. The robotic hand was controlled by the activity of the flexors and extensors of the right wrist, recorded using surface EMG electrodes. Pressure sensors were attached at the tips of the robotic hand and induced VTF using vibrotactile actuators attached to the right arm of the subject. An eye-tracking system tracked to visual attention of the subject during the trials. The trials were repeated twice, with and without the VTF. Additionally, the subjects performed the modified box and blocks, hidden from eyesight, in a motion laboratory. A virtual presentation of a misleading visual feedback was be presented on a screen so that twice during the trial, the virtual block fell while the physical block was still held by the subject. Results: This is an ongoing study, which current results are detailed below. We are continuing these trials with transradial myoelectric prosthesis-users. In the healthy group, the VTF did not reduce the visual attention or improve performance during dual-tasking for the tasks that were typed transfer-to-target, e.g. place the eraser on the shelf. An improvement was observed for other tasks. For example, the average±standard deviation of time to complete the sugar-mixing task was 13.7±17.2s and 19.3±9.1s with and without the VTF, respectively. Also, the number of gaze shifts from the screen to the hand during this task were 15.5±23.7 and 20.0±11.6, with and without the VTF, respectively. The response of the subjects to the misleading visual feedback did not differ between the two conditions, i.e. with and without VTF. Conclusions: Our interim results suggest that the performance of certain activities of daily living may be improved by VTF. The substitution of visual sensory input by tactile feedback might require a long training period so that brain plasticity can occur and allow adaptation to the new condition.Keywords: prosthetics, rehabilitation, sensory substitution, upper limb amputation
Procedia PDF Downloads 3401125 A Fuzzy Logic Based Health Assesment Platform
Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana
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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.Keywords: healthcare, fuzzy logic, MEWS, RFID
Procedia PDF Downloads 3461124 Chronic Exposure of Mercury on Amino Acid Level in Freshwater Fish Clarias batrachus (Linn.)
Authors: Mary Josephine Rani
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Virtually all metals are toxic to aquatic organisms because of the devastating effect of these metals on humans; heavy metals are one of the most toxic forms of aquatic pollution. Metal concentrations in aquatic organisms appear to be of several magnitudes higher than concentrations present in the ecosystem. Mercury is one of the most toxic heavy metals in the environment. The principal sources of contamination in wastewater are chloralkali plants, battery factories, mercury switches, and medical wastes. Elevated levels of mercury in aquatic organisms specially fish represent both an ecological and human concern. Amino acid levels were estimated in five tissues (gills, liver, kidney, brain and muscle) of Clariasbatrachus after 28 days of chronic exposure to mercury. Free amino acids serve as precursor for energy production under stress and for the synthesis of required proteins to face the metal challenge.Keywords: amino acids, fish, mercury, toxicity
Procedia PDF Downloads 3551123 An Assessment of Electrical Activities of Students' Brains toward Teacher’s Specific Emotions
Authors: Hakan Aydogan, Fatih Bozkurt, Huseyin Coskun
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In this study, the signal of brain electrical activities of the sixteen students selected from the Department of Electrical and Energy at Usak University have been recorded during a lecturer performed happiness emotions for the first group and anger emotions for the second group in different time while the groups were in the classroom separately. The attention and meditation data extracted from the recorded signals have been analyzed and evaluated toward the teacher’s specific emotion states simultaneously. Attention levels of students who are under influence of happiness emotions of the lecturer have a positive trend and attention levels of students who are under influence of anger emotions of the lecturer have a negative trend. The meditation or mental relaxation levels of students who are under influence of happiness emotions of the lecturer are 34.3% higher comparing with the mental relaxation levels of students who are under influence of anger emotions of the lecturer.Keywords: brainwave, attention, meditation, education
Procedia PDF Downloads 4171122 The Epigenetic Background Depended Treatment Planning for Glioblastoma Multiforme
Authors: Rasime Kalkan, Emine Ikbal Atli, Ali Arslantaş, Muhsin Özdemir, Sevilhan Artan
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Glioblastoma (WHO grade IV), is the malignant form of brain tumor, the genetic background of the GBM is highly variable. The tumor mass of a GBM is multilayered and every tumor layer shows distinct characteristics with a different cell population. The treatment planning of GBM should be focused on the tumor genetic characteristics. We screened primary glioblastoma multiforme (GBM) in a population-based study for MGMT and RARβ methylation and IDH1 mutation correlated them with clinical data and treatment. There was no correlation between MGMT-promoter methylation and overall survival. The overall survival time of the patients with methylated RARβ was statically (OS;p<0,05) significance between the patients who were treated with chemotherapy and radiotherapy. Here we showed the status of IDH1 gene associatied with younger age. We demonstrated that the together with MGMT gene the RARβ gene should be used as a potantial treatment decision marker for GBMs.Keywords: RARβ, primary glioblastoma multiforme, methylation, MGMT
Procedia PDF Downloads 3411121 Shaabi in the City: On Modernizing Sounds and Exclusion in Egyptian Cities
Authors: Mariam Aref Mahmoud
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After centuries of historical development, Egypt is no stranger to national identity frustrations. What may or may not be counted as this “national identity” becomes a source of contention. Today, after decades of neoliberal reform, Cairo has become the center of Egypt’s cultural debacle. At its heart, the Egyptian capital serves as Egypt’s extension into global capitalism, its flailing hope to become part of the modernized, cosmopolitan world. Yet, to converge into this image of cosmopolitanism, Cairo must silence the perceived un-modernized sounds, cultures, and spaces that arise from within its alleyways. Currently, the agitation surrounding shaabi music, particularly, that of mahraganat, places these contentions to the center of the modernization debates. This paper will discuss the process through which the conversations between modernization, space, and culture have taken place through a historical analysis of national identity formation under Egypt’s neoliberal regimes. Through this, the paper concludes that music becomes a spatial force through which public space, identity, and globalization must be contested. From these findings researchers can then analyze Cairo through not only its physical landscapes, but also its metaphysical features – such as the soundscape.Keywords: music, space, globalization, Cairo
Procedia PDF Downloads 1081120 Instructional Material Development in ODL: Achievements, Prospects, and Challenges
Authors: Felix Gbenoba, Opeyemi Dahunsi
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Customised, self-instructional materials are at the heart of instructional delivery in Open and Distance Learning (ODL). The success of any ODL institution depends on the availability of learning materials in quality and quantity. An ODL study material is expected to imitate what the teacher does in the face-to-face learning environment. This paper evaluates these expectation based on existing data and evidence. It concludes that the reality has not matched the expectation so far in terms of pedagogic aspect of instructional delivery especially in West Africa. This does not mean that instructional materials development has not produced any significant positive results in improving the overall learning (and teaching) experience in these institutions; it implies what will help further to identify the new challenges. Obstacles and problems of instructional materials development that could have affected the open educational resource initiatives are well established. The first section of this paper recalls some of the proposed values of instructional materials. The second section compares achievements so far and suggests that instructional materials development should be consider first at an early stage to realise the aspirations of instructional delivery. The third section highlights the challenges of instructional materials development in the future.Keywords: face-to-face learning, instructional delivery, open and distance education, self-instructional materials
Procedia PDF Downloads 3691119 Self-Selected Intensity and Discounting Rates of Exercise in Comparison with Food and Money in Healthy Adults
Authors: Tamam Albelwi, Robert Rogers, Hans-Peter Kubis
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Background: Exercise is widely acknowledged as a highly important health behavior, which reduces risks related to lifestyle diseases like type 2 diabetes, cardiovascular disease. However, exercise adherence is low in high-risk groups and sedentary lifestyle is more the norm than the exception. Expressed reasons for exercise participation are often based on delayed outcomes related to health threats and benefits but also enjoyment. Whether exercise is perceived as rewarding is well established in animal literature but the evidence is sparse in humans. Additionally, the question how stable any reward is perceived with time delays is an important question influencing decision-making (in favor or against a behavior). For the modality exercise, this has not been examined before. We, therefore, investigated the discounting of pre-established self-selected exercise compared with established rewards of food and money with a computer-based discounting paradigm. We hypothesized that exercise will be discounted like an established reward (food and money); however, we expect that the discounting rate is similar to a consumable reward like food. Additionally, we expected that individuals’ characteristics like preferred intensity, physical activity and body characteristics are associated with discount rates. Methods: 71 participants took part in four sessions. The sessions were designed to let participants select their preferred exercise intensity on a treadmill. Participants were asked to adjust their speed for optimizing pleasantness over an exercise period of up to 30 minutes, heart rate and pleasantness rating was measured. In further sessions, the established exercise intensity was modified and tested on perceptual validity. In the last exercise session rates of perceived exertion was measured on the preferred intensity level. Furthermore, participants filled in questionnaires related to physical activity, mood, craving, and impulsivity and answered choice questions on a bespoke computer task to establish discounting rates of their preferred exercise (kex), their favorite food (kfood) and a value-matching amount of money (kmoney). Results: Participants self-selected preferred speed was 5.5±2.24 km/h, at a heart rate of 120.7±23.5, and perceived exertion scale of 10.13±2.06. This shows that participants preferred a light exercise intensity with low to moderate cardiovascular strain based on perceived pleasantness. Computer assessment of discounting rates revealed that exercise was quickly discounted like a consumable reward, no significant difference between kfood and kex (kfood =0.322±0.263; kex=0.223±0.203). However, kmoney (kmoney=0.080±0.02) was significantly lower than the rates of exercise and food. Moreover, significant associations were found between preferred speed and kex (r=-0.302) and between physical activity levels and preferred speed (r=0.324). Outcomes show that participants perceived and discounted self-selected exercise like an established reward (food and money) but was discounted more like consumable rewards. Moreover, exercise discounting was quicker in individuals who preferred lower speeds, being less physically active. This may show that in a choice conflict between exercise and food the delay of exercise (because of distance) might disadvantage exercise as the chosen behavior particular in sedentary people. Conclusion: exercise can be perceived as a reward and is discounted quickly in time like food. Pleasant exercise experience is connected to low to moderate cardiovascular and perceptual strain.Keywords: delay discounting, exercise, temporal discounting, time perspective
Procedia PDF Downloads 2691118 Nutritional Benefits of Soy: An Implication for Health Education
Authors: Mbadugha Esther Ifeoma
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Soybeans, like other legumes are rich in nutrients. However, the nutrient profile of soybeans differs in some important ways from most other legumes. Among other nutrients, soy is high in protein, carbohydrates, and fibers, is rich in vitamins, minerals and unsaturated fatty acids and is low in saturated fatty acids. Because of its high nutritional value, it has been rated to be equivalent to meats, eggs and milk. Soy has many health benefits including prevention of coronary heart disease, prevention of cancer growth, improvement of cognitive function, promotion of bone health, prevention of obesity, prevention of type II diabetes and promotion of growth of normal floras in the colon. Soybean consumption is also associated with some side effects which include allergy, flatulence and abdominal discomfort. Nurses/health care providers should therefore, educate clients on the precautionary measures to be taken in preparing soy food products in order to reduce to the barest minimum the side effects, while encouraging them to include soy as part of their daily meals for optimal health and vitality.Keywords: health benefit, health education, nutritional benefit, soybeans
Procedia PDF Downloads 4891117 Auditory Function in Hypothyroidism as Compared to Controls
Authors: Mrunal Phatak
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Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aim of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex-matched controls to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls (group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3 and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising 62 newly diagnosed hypothyroid women and a Control group having 62 women with normal thyroid profiles. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e., a total of 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in a total of 64 years (51.61%). A significant increase was seen in Wave V latency, IPL I-V and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears cases. A positive correlation of Wave V latency of the Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). The negative correlation of wave V amplitude of the Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both ears. A significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). A negative correlation between T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. A positive correlation between ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centers. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests an impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in the acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly the inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.Keywords: hypothyroidism, deafness, pure tone audiometry, brain stem auditory evoked potential
Procedia PDF Downloads 371116 Noise Removal Techniques in Medical Images
Authors: Amhimmid Mohammed Saffour, Abdelkader Salama
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Filtering is a part of image enhancement techniques, it is used to enhance certain details such as edges in the image that are relevant to the application. Additionally, filtering can even be used to eliminate unwanted components of noise. Medical images typically contain salt and pepper noise and Poisson noise. This noise appears to the presence of minute grey scale variations within the image. In this paper, different filters techniques namely (Median, Wiener, Rank order3, Rank order5, and Average) were applied on CT medical images (Brain and chest). We using all these filters to remove salt and pepper noise from these images. This type of noise consists of random pixels being set to black or white. Peak Signal to Noise Ratio (PSNR), Mean Square Error r(MSE) and Histogram were used to evaluated the quality of filtered images. The results, which we have achieved shows that, these filters, are more useful and they prove to be helpful for general medical practitioners to analyze the symptoms of the patients with no difficulty.Keywords: CT imaging, median filter, adaptive filter and average filter, MATLAB
Procedia PDF Downloads 3121115 The Necessity of Neurolinguistics in Master’s Studies in the English Language Department
Authors: Dielleza Namani, Laureta Kadrijaj-Qerimi
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Neurolinguistics studies the relationship between the brain and language. It is a subject not often found in the syllabus of universities in the Balkans but more spread in Europe and especially the United States of America. The purpose of this study is to see what importance this subject has for studies in the English language department. It contains an analysis of other research papers written regarding neurolinguistics, a questionnaire made for professors and deans at private and public universities in Kosovo, and an interview with a neurolinguistics professor in England. Since this subject is not found in the syllabus of any of the universities in Kosovo, the researchers wanted to find out why this happens but, at the same time, provide reasons why they should consider having it in the future. The results showed that for this subject, there had been researching made, but not enough so far, which gives more information and feedback on why it needs to be in the syllabus, and how linguists can use the knowledge they receive from this subject in their workplace. Also, the professors and deans see this subject as too medical for their students to learn and not necessary for their future jobs. Hopefully, in the near future, there will be more research done on why this is important and how English language students can benefit from it.Keywords: English language department, neurolinguistics, second language acquisition, teaching methods
Procedia PDF Downloads 941114 Postural Orthostatic Tachycardia Syndrome: A Case Study and Discussion of Its Epidemiology, Pathophysiology, Diagnosis, and Management
Authors: Zayd Parekh, Amish Prasad, Baraa Souman
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Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia
Procedia PDF Downloads 811113 Auditory Profile Function in Hypothyroidism
Authors: Mrunal Phatak, Suvarna Raut
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Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aims of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex matched controls so as to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls ( group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3, and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising of 62 newly diagnosed hypothyroid women and the Control group having 62 women with normal thyroid profile. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e. total 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in total 64 ears (51.61%). A significant increase was seen in Wave V latency, IPL I-V, and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears in cases. Positive correlation of Wave V latency of Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). Negative correlation of wave V amplitude of Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as the mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both the ears. Significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). Negative correlation with T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. Positive correlation of ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centres. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests the impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.Keywords: deafness, pure tone audiometry, brain stem auditory evoked potential, hyopothyroidism
Procedia PDF Downloads 1311112 Evaluation of the MCFLIRT Correction Algorithm in Head Motion from Resting State fMRI Data
Authors: V. Sacca, A. Sarica, F. Novellino, S. Barone, T. Tallarico, E. Filippelli, A. Granata, P. Valentino, A. Quattrone
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In the last few years, resting-state functional MRI (rs-fMRI) was widely used to investigate the architecture of brain networks by investigating the Blood Oxygenation Level Dependent response. This technique represented an interesting, robust and reliable approach to compare pathologic and healthy subjects in order to investigate neurodegenerative diseases evolution. On the other hand, the elaboration of rs-fMRI data resulted to be very prone to noise due to confounding factors especially the head motion. Head motion has long been known to be a source of artefacts in task-based functional MRI studies, but it has become a particularly challenging problem in recent studies using rs-fMRI. The aim of this work was to evaluate in MS patients a well-known motion correction algorithm from the FMRIB's Software Library - MCFLIRT - that could be applied to minimize the head motion distortions, allowing to correctly interpret rs-fMRI results.Keywords: head motion correction, MCFLIRT algorithm, multiple sclerosis, resting state fMRI
Procedia PDF Downloads 2121111 The Origins of Representations: Cognitive and Brain Development
Authors: Athanasios Raftopoulos
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In this paper, an attempt is made to explain the evolution or development of human’s representational arsenal from its humble beginnings to its modern abstract symbols. Representations are physical entities that represent something else. To represent a thing (in a general sense of “thing”) means to use in the mind or in an external medium a sign that stands for it. The sign can be used as a proxy of the represented thing when the thing is absent. Representations come in many varieties, from signs that perceptually resemble their representative to abstract symbols that are related to their representata through conventions. Relying the distinction among indices, icons, and symbols, it is explained how symbolic representations gradually emerged from indices and icons. To understand the development or evolution of our representational arsenal, the development of the cognitive capacities that enabled the gradual emergence of representations of increasing complexity and expressive capability should be examined. The examination of these factors should rely on a careful assessment of the available empirical neuroscientific and paleo-anthropological evidence. These pieces of evidence should be synthesized to produce arguments whose conclusions provide clues concerning the developmental process of our representational capabilities. The analysis of the empirical findings in this paper shows that Homo Erectus was able to use both icons and symbols. Icons were used as external representations, while symbols were used in language. The first step in the emergence of representations is that a sensory-motor purely causal schema involved in indices is decoupled from its normal causal sensory-motor functions and serves as a representation of the object that initially called it into play. Sensory-motor schemes are tied to specific contexts of the organism-environment interactions and are activated only within these contexts. For a representation of an object to be possible, this scheme must be de-contextualized so that the same object can be represented in different contexts; a decoupled schema loses its direct ties to reality and becomes mental content. The analysis suggests that symbols emerged due to selection pressures of the social environment. The need to establish and maintain social relationships in ever-enlarging groups that would benefit the group was a sufficient environmental pressure to lead to the appearance of the symbolic capacity. Symbols could serve this need because they can express abstract relationships, such as marriage or monogamy. Icons, by being firmly attached to what can be observed, could not go beyond surface properties to express abstract relations. The cognitive capacities that are required for having iconic and then symbolic representations were present in Homo Erectus, which had a language that started without syntactic rules but was structured so as to mirror the structure of the world. This language became increasingly complex, and grammatical rules started to appear to allow for the construction of more complex expressions required to keep up with the increasing complexity of social niches. This created evolutionary pressures that eventually led to increasing cranial size and restructuring of the brain that allowed more complex representational systems to emerge.Keywords: mental representations, iconic representations, symbols, human evolution
Procedia PDF Downloads 541110 Difference in the Expression of CIRBP, RBM3 and HSP70 in the Myocardium and Cerebellum after Death by Hypothermi a and Carbon Monoxide Poisoning
Authors: Satoshi Furukawa, Satomu Morita, Lisa Wingenfeld, Katsuji Nishi, Masahito Hitosugi
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We studied the expression of hypoxia-related antigens (e.g., cold-inducible antigens and apoptotic antigens) in the myocardium and the cerebellumthat were obtained from individuals after death by carbon monoxide or hypothermia. The immunohistochemistry results revealed that expression of cold-inducible RNA binding protein (CIRBP) and RNA-binding protein 3 (RBM3) may be associated with hpyothermic and the hypoxic conditions. The expression of CIRBP and RBM3 in the myocardium was different from their expression in the cerebellum, especially in the Purkinje cells. The results indicate that agonal duration influences antigen expression. In the hypothermic condition, the myocardium uses more ATP since the force of the excitation-contraction coupling of the myocardium increases by more than 400% when the experimental temperature is reduced from 35°C to 25°C. The results obtained in this study indicate that physicians should pay attention to the myocardium when cooling the patient’s body to protect the brain.Keywords: carbon monoxide death, cerebellum, CIRBP, hypothermic death, myocardium, RBM3
Procedia PDF Downloads 3611109 Left Cornual Ectopic Pregnancy with Uterine Rupture - a Case Report
Authors: Vinodhini Elangovan, Jen Heng Pek
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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies
Procedia PDF Downloads 1281108 Randomized Controlled Trial of Ultrasound Guided Bilateral Intermediate Cervical Plexus Block in Thyroid Surgery
Authors: Neerja Bharti, Drishya P.
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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption
Procedia PDF Downloads 951107 Uncertain Time-Cost Trade off Problems of Construction Projects Using Fuzzy Set Theory
Authors: V. S. S. Kumar, B. Vikram
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The development of effective decision support tools that adopted in the construction industry is vital in the world we live in today, since it can lead to substantial cost reduction and efficient resource consumption. Solving the time-cost trade off problems and its related variants is at the heart of scientific research for optimizing construction planning problems. In general, the classical optimization techniques have difficulties in dealing with TCT problems. One of the main reasons of their failure is that they can easily be entrapped in local minima. This paper presents an investigation on the application of meta-heuristic techniques to two particular variants of the time-cost trade of analysis, the time-cost trade off problem (TCT), and time-cost trade off optimization problem (TCO). In first problem, the total project cost should be minimized, and in the second problem, the total project cost and total project duration should be minimized simultaneously. Finally it is expected that, the optimization models developed in this paper will contribute significantly for efficient planning and management of construction project.Keywords: fuzzy sets, uncertainty, optimization, time cost trade off problems
Procedia PDF Downloads 355