Internet of Things Concept in the Context of the COVID-19 Pandemic: A Multi-Sensor Application Design

Cerebellotrigeminal dermal (CTD) dysplasia is a rare neurocutaneous disorder characterized by a triad of symptoms: bilateral parieto-occipital alopecia, facial anesthesia in the trigeminal area, and rhombencephalosynapsis (RES), confirmed by cranial magnetic resonance imaging. CTD dysplasia is also known as Gómez-López-Hernández syndrome. So far, only 35 cases have been described with varying symptomatology. The etiology remains unknown. Either spontaneous dominant mutations or de novo chromosomal rearrangements have been proposed as possible explanations. In addition to its clinical triad of RES, parietal alopecia, and trigeminal anesthesia, CTD dysplasia is associated with a wide range of phenotypic and neurodevelopmental abnormalities.Treatment is symptomatic and includes physical rehabilitation, special education, dental care, and ocular protection against self-induced corneal trauma that causes ulcers and, later, corneal opacification. The prognosis is correlated to the mental development, motor handicap, corneal–facial anesthesia, and visual problems. Follow-up on a large number of patients with CTD dysplasia has never been reported and experience is limited to few cases to date. High degree of suspicion in a child presenting with characteristic alopecia and RES has a great importance in diagnosis of this syndrome.

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SARS-CoV-2 in peritoneal swabs from asymptomatic patients undergoing emergency abdominal surgery

Journal of Surgical Case Reports ◽

10.1093/jscr/rjab116 ◽

2021 ◽

Vol 2021 (4) ◽

Author(s):

Jasim AlAradi ◽

Rawan A Rahman AlHarmi ◽

Mariam AlKooheji ◽

Sayed Ali Almahari ◽

Mohamed Abdulla Isa ◽

...

Keyword(s):

Peritoneal Fluid ◽

Case Series ◽

Rapid Test ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Protective Measures ◽

The Public ◽

Asymptomatic Patients ◽

Number Of Patients ◽

Viral Transfer

Abstract This is a case series of five patients with acute abdomen requiring surgery who tested positive for coronavirus disease 2019 (COVID-19) and were asymptomatic, with the purpose of detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in peritoneal fluid. Nasopharyngeal swab was done as a prerequisite for admission or prior to admission as part of random testing. Two methods of viral testing were employed: Xpert® Xpress SARS-CoV-2 (rapid test) and real-time reverse transcription polymerase chain reaction (RT-PCR). Either or both tests were done, with the former performed for patients requiring surgery immediately. Surgery was performed within 24–36 h from admission. Peritoneal fluid swabs were obtained for the detection of SARS-CoV-2 using RT-PCR test. Swabs were immediately placed in viral transfer media and delivered to the public health laboratory in an ice bag. SARS-CoV-2 was not detected in peritoneal swabs. Due to the limited number of patients, further studies are required; yet, protective measures should still be taken by surgeons when dealing with COVID-19 cases.

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Effect of intravenous oxycodone on the physiologic responses to extubation following general anesthesia

BMC Anesthesiology ◽

10.1186/s12871-021-01350-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Menglu Jiang ◽

Jiawei Ji ◽

Xin Li ◽

Zhenqing Liu

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

General Anesthesia ◽

Control Group ◽

Study Group ◽

Clinical Trial Registry ◽

Blood Oxygen Saturation ◽

Blood Concentrations ◽

Number Of Patients ◽

Blood Hormones

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.

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Theoretical and experimental study of motion and sinking time of Saxon Bowls

European Journal of Physics ◽

10.1088/1361-6404/ac4b6a ◽

2022 ◽

Author(s):

Jaikumar Sankar ◽

Liu Yang

Keyword(s):

Motion Tracking ◽

Volumetric Flow Rate ◽

Free Form ◽

Motion Path ◽

Time Interval ◽

Flow Profile ◽

Bernoulli’S Equation ◽

Hole Radius ◽

Coefficient Of Discharge ◽

High Degree

Abstract This work focuses on investigating the time of sinking of a Saxon bowl proposed by ‘International Young Physicists’ Tournament in 2020. A quasi-static model is built to simulate the motion path of the bowl and predict the sinking time subsequently. The model assumes an open axisymmetric bowl with a hole in its base. The hole is modelled as a pipe for which the flow profile is governed by a modified Bernoulli’s equation which has a Coefficient of Discharge (C_d) added to account for energy losses. The motion of the entire bowl is assumed to be in quasi-static equilibrium for an infinitesimal time interval to calculate the volumetric flow rate through the hole. The model is used to predict the sinking times of various bowls against independent variables - hole radius, bowl dimensions, mass of bowl, mass distribution of bowl, and Coefficient of Discharge - and predict the motion path of bowls of different, axisymmetric geometries. Characterisation of C_d was done by draining a bowl filled with water and measuring the time taken to do so. Experimental verification was completed through measuring sinking times of 3D printed hemispherical bowls of the different variables in water. Motion tracking of bowls with different geometries was done using computational pixel tracking software to verify the model’s predictive power. Data from experiments for sinking time against the variables corroborate with the model to a great degree. The motion path tracked, matched the modelled motion path to a high degree for bowls of different shapes, namely a hemisphere, cylinder, frustum, and a free-form axisymmetric shape. The work is poised for an undergraduate level of readership.

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Giok the Alien: An AR-Based Integrated System for the Empowerment of Problem-Solving, Pragmatic, and Social Skills in Pre-School Children

Sensors ◽

10.3390/s18072368 ◽

2018 ◽

Vol 18 (7) ◽

pp. 2368 ◽

Cited By ~ 4

Author(s):

Maria Lorusso ◽

Marisa Giorgetti ◽

Simona Travellini ◽

Luca Greci ◽

Andrea Zangiacomi ◽

...

Keyword(s):

School Children ◽

Integrated System ◽

Smart Devices ◽

Typically Developing ◽

Design Development ◽

Social Functions ◽

Software Application ◽

Use Of Technology ◽

Strategic Behaviors ◽

Smart Tv

The use of technology for educational purposes is a consolidated reality, and many new tools are constantly being devised and offered for use with both normally developing children and children with special needs. Nonetheless, a detailed analysis of the processes being stimulated and of the goals being pursued is often lacking or absent. In this work we describe the design, development and preliminary testing of an integrated system which combines the use of smart devices, a physical cube, augmented reality (AR) technology, a smart TV, and a software application especially designed to stimulate cognitive and social functions in pre-school children. The system was tested with three groups of children (25 children in total) during kindergarten activities. The results show that the system is easy to understand, elicits high levels of participation and social interaction, favors strategic behaviors, and can be used by the children with limited need of instruction and support by the adult. The implications for empowerment in typically developing children and the possibilities for use with children who have specific impairments in social communication are discussed.

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Disaster Metrics: Quantitative Estimation of the Number of Ambulances Required in Trauma-Related Multiple Casualty Events

Prehospital and Disaster Medicine ◽

10.1017/s1049023x12001094 ◽

2012 ◽

Vol 27 (5) ◽

pp. 445-451 ◽

Cited By ~ 2

Author(s):

Jamil D. Bayram ◽

Shawki Zuabi ◽

Mazen J. El Sayed

Keyword(s):

Quantitative Estimation ◽

The United States ◽

Time Frame ◽

Quantitative Model ◽

Time Interval ◽

Publication Type ◽

The North ◽

Number Of Patients ◽

Minimum Number ◽

T1 And T2

AbstractIntroductionEstimating the number of ambulances needed in trauma-related Multiple Casualty Events (MCEs) is a challenging task.Hypothesis/ProblemEmergency medical services (EMS) regions in the United States have varying “best practices” for the required number of ambulances in MCE, none of which is based on metric criteria. The objective of this study was to estimate the number of ambulances required to respond to the scene of trauma-related MCE in order to initiate treatment and complete the transport of critical (T1) and moderate (T2) patients. The proposed model takes into consideration the different transport times and capacities of receiving hospitals, the time interval from injury occurrence, the number of patients per ambulance, and the pre-designated time frame allowed from injury until the transfer care of T1 and T2 patients.MethodsThe main theoretical framework for this model was based on prehospital time intervals described in the literature and used by EMS systems to evaluate operational and patient care issues. The North Atlantic Treaty Organization (NATO) triage categories (T1-T4) were used for simplicity.ResultsThe minimum number of ambulances required to respond to the scene of an MCE was modeled as being primarily dependent on the number of critical patients (T1) present at the scene any particular time. A robust quantitative model was also proposed to dynamically estimate the number of ambulances needed at any time during an MCE to treat, transport and transfer the care of T1 and T2 patients.ConclusionA new quantitative model for estimation of the number of ambulances needed during the prehospital response in trauma-related multiple casualty events has been proposed. Prospective studies of this model are needed to examine its validity and applicability.BayramJD, ZuabiS, El SayedMJ. Disaster metrics: quantitative estimation of the number of ambulances required in trauma-related multiple casualty events. Prehosp Disaster Med.2012;27(5):1-7.

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Datasets collected in general practice: an international comparison using the example of obesity

Australian Health Review ◽

10.1071/ah17157 ◽

2018 ◽

Vol 42 (5) ◽

pp. 563 ◽

Cited By ~ 1

Author(s):

Elizabeth Sturgiss ◽

Kees van Boven

Keyword(s):

Primary Care ◽

General Practice ◽

The Netherlands ◽

Care Management ◽

Clinical Care ◽

International Comparisons ◽

Health Condition ◽

Practice Management ◽

Number Of Patients ◽

Primary Care Management

International datasets from general practice enable the comparison of how conditions are managed within consultations in different primary healthcare settings. The Australian Bettering the Evaluation and Care of Health (BEACH) and TransHIS from the Netherlands collect in-consultation general practice data that have been used extensively to inform local policy and practice. Obesity is a global health issue with different countries applying varying approaches to management. The objective of the present paper is to compare the primary care management of obesity in Australia and the Netherlands using data collected from consultations. Despite the different prevalence in obesity in the two countries, the number of patients per 1000 patient-years seen with obesity is similar. Patients in Australia with obesity are referred to allied health practitioners more often than Dutch patients. Without quality general practice data, primary care researchers will not have data about the management of conditions within consultations. We use obesity to highlight the strengths of these general practice data sources and to compare their differences. What is known about the topic? Australia had one of the longest-running consecutive datasets about general practice activity in the world, but it has recently lost government funding. The Netherlands has a longitudinal general practice dataset of information collected within consultations since 1985. What does this paper add? We discuss the benefits of general practice-collected data in two countries. Using obesity as a case example, we compare management in general practice between Australia and the Netherlands. This type of analysis should start all international collaborations of primary care management of any health condition. Having a national general practice dataset allows international comparisons of the management of conditions with primary care. Without a current, quality general practice dataset, primary care researchers will not be able to partake in these kinds of comparison studies. What are the implications for practitioners? Australian primary care researchers and clinicians will be at a disadvantage in any international collaboration if they are unable to accurately describe current general practice management. The Netherlands has developed an impressive dataset that requires within-consultation data collection. These datasets allow for person-centred, symptom-specific, longitudinal understanding of general practice management. The possibilities for the quasi-experimental questions that can be answered with such a dataset are limitless. It is only with the ability to answer clinically driven questions that are relevant to primary care that the clinical care of patients can be measured, developed and improved.

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Quantitative measurement of infectious virus in SARS-CoV-2 Alpha, Delta and Epsilon variants reveals higher infectivity (viral titer:RNA ratio) in clinical samples containing the Delta and Epsilon variants.

10.1101/2021.09.07.21263229 ◽

2021 ◽

Author(s):

Hannah W Despres ◽

Margaret G Mills ◽

David J Shirley ◽

Madaline M Schmidt ◽

Meei-Li Huang ◽

...

Keyword(s):

Quantitative Measurement ◽

Infectious Virus ◽

Viral Rna ◽

Clinical Samples ◽

Rt Pcr ◽

Genome Copy ◽

Live Virus ◽

High Degree ◽

The Relationship ◽

Rna Levels

ABSTRACT Background Novel SARS-CoV-2 Variants of Concern (VoC) pose a challenge to controlling the COVID-19 pandemic. Previous studies indicate that clinical samples collected from individuals infected with the Delta variant may contain higher levels of RNA than previous variants, but the relationship between viral RNA and infectious virus for individual variants is unknown. Methods We measured infectious viral titer (using a micro-focus forming assay) as well as total and subgenomic viral RNA levels (using RT-PCR) in a set of 165 clinical samples containing SARS-CoV-2 Alpha, Delta and Epsilon variants that were processed within two days of collection from the patient. Results We observed a high degree of variation in the relationship between viral titers and RNA levels. Despite the variability we observed for individual samples the overall infectivity differed among the three variants. Both Delta and Epsilon had significantly higher infectivity than Alpha, as measured by the number of infectious units per quantity of viral E gene RNA (6 and 4 times as much, p=0.0002 and 0.009 respectively) or subgenomic E RNA (11 and 7 times as much, p<0.0001 and 0.006 respectively). Conclusion In addition to higher viral RNA levels reported for the Delta variant, the infectivity (amount of replication competent virus per viral genome copy) may also be increased compared to Alpha. Measuring the relationship between live virus and viral RNA is an important step in assessing the infectivity of novel SARS-CoV-2 variants. An increase in the infectivity of the Delta variant may further explain increased spread and suggests a need for increased measures to prevent viral transmission.

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Postoperative craniospinal radiotherapy of medulloblastoma in children and young adults

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0306226g ◽

2003 ◽

Vol 131 (5-6) ◽

pp. 226-231

Author(s):

Ivana Golubicic ◽

Jelena Bokun ◽

Marina Nikitovic ◽

Jasmina Mladenovic ◽

Milan Saric ◽

...

Keyword(s):

High Risk ◽

Brain Stem ◽

Wilcoxon Test ◽

Time Interval ◽

Tumor Removal ◽

Shunt Placement ◽

Craniospinal Radiotherapy ◽

Number Of Patients ◽

Significant Difference

PURPOSE The aim of this study was: 1. to evaluate treatment results of combined therapy (surgery, postoperative craniospinal radiotherapy with or without chemotherapy) and 2. to assess factors affecting prognosis (extend of tumor removal, involvement of the brain stem, extent of disease postoperative meningitis, shunt placement, age, sex and time interval from surgery to start of postoperative radiotherapy). PATIENTS AND METHODS During the period 1986-1996, 78 patients with medulloblastoma, aged 1-22 years (median 8.6 years), were treated with combined modality therapy and 72 of them were evaluable for the study end-points. Entry criteria were histologically proven diagnosis, age under 22 years, and no history of previous malignant disease. The main characteristics of the group are shown in Table 1. Twenty-nine patients (37.2%) have total, 8 (10.3%) near total and 41 (52.5%) partial removal. Seventy-two of 78 patients were treated with curative intent and received postoperative craniospinal irradiation. Radiotherapy started 13-285 days after surgery (median 36 days). Only 13 patients started radiotherapy after 60 days following surgery. Adjuvant chemotherapy was applied in 63 (80.7%) patients. The majority of them (46 73%) received chemotherapy with CCNU and Vincristine. The survival rates were calculated with the Kaplan-Meier method and the differences in survival were analyzed using the Wilcoxon test and log-rank test. RESULTS The follow-up period ranged from 1-12 years (median 3 years). Five-year overall survival (OS) was 51% and disease-free survival (DFS) 47% (Graph 1). During follow-up 32 relapses occurred. Patients having no brain stem infiltration had significantly better survival (p=0.0023) (Graph 2). Patients with positive myelographic findings had significantly poorer survival compared to dose with negative myelographic findings (p=0.0116). Significantly poorer survival was found in patients with meningitis developing in the postoperative period, with no patient living longer than two years (p=0.0134) (Graph 3). By analysis of OS and DFS in relation to presence of the malignant cells in liquor, statistically significant difference, i. e. positive CSF cytology was not obtained, which was of statistical importance for survival (p=0.8207). Neither shunt placement nor shunt type showed any impact on survival (p=0.5307 and 0.7119, respectively). Children younger than three years had significantly poorer survival compared to those older than 16 years (p=0.0473). Although there was a better survival rate in females than in males this was not statistically significant (p=0.2386).The analysis results of treatment showed that significantly better survival occurred in patients in whom total or subtotal tumor removal was possible (p=0.0022) (Graph 4). Patients who started radiotherapy within two months after surgery have better survival, but again this was not statistically significant, probably due to the small number of patients receiving delayed radiotherapy (p=0.2231)(Graph5). CONCLUSION Based on this factors standard and high risk group could be defined. Combined chemotherapy should to be investigated particularly for high risk subgroup. Future research should be done to define new therapeutic modalities (gene therapy, compounds active in tumor antiangiogenesis etc).

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Comparison of Fascia Iliaca Block with Intravenous Paracetamol, as Postoperative Analgesic Method for Femur Surgery

Academia Anesthesiologica International ◽

10.21276/aan.2020.5.1.3 ◽

2020 ◽

Vol 5 (1) ◽

pp. 13-16

Author(s):

Praveen kumar Shekhrajka ◽

Dhaval kumar C Patel

Keyword(s):

Intrathecal Injection ◽

Early Mobilization ◽

Time Interval ◽

Hyperbaric Bupivacaine ◽

Rescue Analgesia ◽

Group I ◽

Intravenous Paracetamol ◽

Number Of Patients ◽

Fascia Iliaca Block ◽

Total Burden

Background: Postoperative pain is extremely unpleasant which causes severe discomfort to the patient as well as it increases the anxiety, hospital stay so overall total burden. Objectives: Comparison of efficacy between fascia iliaca block with intravenous paracetamol, as postoperative analgesic method after femur surgery. Simultaneously requirement of other analgesics in the first 24 hours.Subjects and Methods:Prospective longitudinal study conducted in patients belonging to age group of 18 to 65 years posted for femur surgeries. All patients were received Intrathecal injection of 3.5 ml of 0.5% hyperbaric bupivacaine and divided into two groups. After completion of surgery Group I received the Fascia Iliaca block with thirty ml of 0.25% of injection bupivacaine and Group II received injection Paracetamol one gram intravenously. Duration of analgesia, time from block / iv PCM to 1st rescue analgesia, number of patients as well as total doses of required rescue analgesics in 1st 24 hours were observed postoperatively.Results:From One hour onwards at all the time interval, mean pain scores was less in FIB group as compared to PCM group(p<0.001). In FIB group 15 (42%) patients had more than 24 hours and 11(32%) patients had 12-24 hours of analgesia, where as in PCM Group not a single patient had more than 12 hours of analgesia. In FIB group only 20 (57%) patients required rescue analgesic as compared to 35 (100%) patients in PCM group.Conclusion:In FIB insertion point is away from femoral vessels and can be provided without nerve stimulator. Post-operative it is extremely crucial to provide analgesia specially initial 24 hours. FIB can provide prolong duration of analgesia, so helps in early mobilization and early rehabilitation as well as it also reduces opioid requirements. Thus, Fascia iliaca block is an effective, easy and affordable method for postoperative analgesia and can be used safely as a part of multimodal approach to pain relief after femur surgery.

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