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Minerva Anestesiologica Jun 2024Children with autism spectrum disorder (ASD) often require multiple interventions receiving general anesthesia during their lifetimes. However, a single negative...
Behavioral training and mirroring techniques to prepare for elective anesthesia in children with autism spectrum disorder: a prospective evaluation of implemented program.
BACKGROUND
Children with autism spectrum disorder (ASD) often require multiple interventions receiving general anesthesia during their lifetimes. However, a single negative experience may trigger and/or aggravate anxiety and subsequent development of unwanted behavior. This monocentric study assessed the compliance with mask induction of children with ASD who followed a preoperative preparation using behavioral training with positive reinforcement technique and use of mirroring technique.
METHODS
Prospective observational study including all children with ASD scheduled for day case treatment receiving general anesthesia, from November 2019 to August 2022. The primary outcome was Induction Compliance Checklist (ICC) score. The secondary outcomes were child's anxiety in the operating room assessed by the modified Yale Anxiety Scale (mYPAS), the comportment of the child in the recovery room, parental satisfaction about perioperative management (0 to 10 numerical scale) and the satisfaction of the caregivers about anesthetic management (0 to 10 numerical scale). Behavioral changes were assessed one month after the procedure when possible.
RESULTS
In total, 43 children from 1 to 17 years old were included. Median ICC score was 3 [1-6]. Induction Compliance was considered as excellent in 18.6% of patients, good in 39.5%, fair in 14.0% and poor in 27.9%. Seven patients (16.3%) needed restraint during induction.
CONCLUSIONS
The use of behavioral and mirroring techniques implemented as a preparation program for children with ASD could facilitate mask induction of anesthesia. Such a preparation achieves good to excellent compliance in almost 60% of patients.
PubMed: 38922283
DOI: 10.23736/S0375-9393.24.18021-2 -
Toxics Jun 2024Since the early stages of the COVID-19 pandemic, there have been debates regarding the transmission modes of contagious viruses, including the influenza virus and severe...
Since the early stages of the COVID-19 pandemic, there have been debates regarding the transmission modes of contagious viruses, including the influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), along with its variants [...].
PubMed: 38922123
DOI: 10.3390/toxics12060443 -
Journal of Imaging Jun 2024The preservation of historical monuments presents a formidable challenge, particularly in monitoring the deterioration of building materials over time. Chateau de...
The preservation of historical monuments presents a formidable challenge, particularly in monitoring the deterioration of building materials over time. Chateau de Chambord's facade suffers from common issues such as flaking and spalling, which require meticulous stone and joint mapping from experts manually for restoration efforts. Advancements in computer vision have allowed machine-learning models to help in the automatic segmentation process. In this research, a custom architecture defined as SAM-SVM is proposed, to perform stone segmentation, based on the Segment Anything Model (SAM) and Support Vector Machines (SVM). By exploiting the zero-shot learning capabilities of SAM and its customizable input parameters, we obtain segmentation mask for stones and joints, which are then classified using SVM. Two more SAMs (three in total) are used, depending on how many stones are left to segment. Through extensive experimentation and evaluation, supported by computer vision methods, the proposed architecture achieves a Dice coefficient of 85%. Our results highlight the potential of SAM in cultural heritage conservation, providing a scalable and efficient solution for stone segmentation in historic monuments. This research contributes valuable insights and methodologies to the ongoing conservation efforts of Château de Chambord and could be extrapolated to other monuments.
PubMed: 38921625
DOI: 10.3390/jimaging10060148 -
Healthcare (Basel, Switzerland) Jun 2024We compared the managing of prevention methods for SARS-CoV-2 infections in dental offices before and immediately after the COVID-19 pandemic. The purpose of this study...
We compared the managing of prevention methods for SARS-CoV-2 infections in dental offices before and immediately after the COVID-19 pandemic. The purpose of this study was to find out the varieties of infection prevention methods used by dentists before and during the pandemic and compare them. We designed a digital transversal questionnaire with 15 closed questions that was sent to 150 dentists in Bucharest, Romania. We received = 112 valid answers during July-August 2021 from dentists of all age groups (25-60 years), with a sex ratio of 0.36, which agreed to anonymously participate in this study. The results showed an increase in types and amount of personal protection equipment (i.e., ocular/facial protection, supplemental gown, and upgrading the FFP1 masks to FFP2 or FFP3). Ocular protection showed statistical significance by gender but not by age group. Vaccination rate against SARS-CoV-2 was at 80% of the participant dentists at the time of the survey and had statistical significance. However, vaccination status of the patients did not alter dentists' protection protocol.
PubMed: 38921284
DOI: 10.3390/healthcare12121169 -
Behavioral Sciences (Basel, Switzerland) Jun 2024During the COVID-19 pandemic, people exhibited various forms of adjustments. This study examines how situational factors (i.e., the severity of COVID-19) and individual...
During the COVID-19 pandemic, people exhibited various forms of adjustments. This study examines how situational factors (i.e., the severity of COVID-19) and individual differences (i.e., the HEXACO traits) affect one's COVID-19-related responses regarding behaviors (i.e., mask-wearing and hoarding), worries (i.e., worrying about infecting and spreading COVID-19), and attitudes (i.e., discrimination and empathy toward people infecting COVID-19) in China. With a sample of 927 participants, our results show that the severity of COVID-19 was predictive of all the responses, and its predictive value was more pronounced relative to personality traits. Concerning the association between personality traits and responses, Honesty-Humility and Conscientiousness were predictive of one's behaviors, Emotionality was predictive of one's worries, and almost all the HEXACO traits were associated with one's attitudes toward people infected with COVID-19. This study sheds some light on understanding how situations and individual differences shape one's responses in a time of emergency.
PubMed: 38920814
DOI: 10.3390/bs14060482 -
Entropy (Basel, Switzerland) May 2024Few-shot learning, especially few-shot image classification (FSIC), endeavors to recognize new categories using only a handful of labeled images by transferring...
Few-shot learning, especially few-shot image classification (FSIC), endeavors to recognize new categories using only a handful of labeled images by transferring knowledge from a model trained on base categories. Despite numerous efforts to address the challenge of deficient transferability caused by the distribution shift between the base and new classes, the fundamental principles remain a subject of debate. In this paper, we elucidate a decline in performance occurs and information is transferred during the testing phase, examining it from a frequency spectrum perspective. Specifically, we adopt causality on the frequency space for FSIC. With our causal assumption, non-causal frequencies (e.g., background knowledge) act as confounders between causal frequencies (e.g., object information) and predictions. Our experimental results reveal that different frequency components represent distinct semantics, and non-causal frequencies adversely affect transferability, resulting in suboptimal performance. Subsequently, we suggest a straightforward but potent approach, namely the (FRSM), to weight the frequency and mitigate the impact of non-causal frequencies. Extensive experiments demonstrate that the proposed FRSM method significantly enhanced the transferability of the FSIC model across nine testing datasets.
PubMed: 38920482
DOI: 10.3390/e26060473 -
Frontiers in Psychology 2024Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations,...
INTRODUCTION
Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations, especially as they relate to viewers' personal experiences of adversities.
METHODS
In this exploratory study, we examined the relationship between the visual content of mask images and viewers' responses. In an online survey 699 participants (of = 1,010 total initial participants) rated 98 masks based on valence, arousal, and personal relevance and completed the Life Events Checklist. The masks included those created by service members (SMs) with traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD), depicting physical, psychological, and moral injuries and matched neutral masks created by creative arts therapists and arts in health scholars.
FINDINGS
The findings indicated that responses to mask image content (traumatic versus neutral) were associated with viewers' personal history of adversity and trauma. Specifically, images representing injury/trauma provoked stronger reactions on valence and arousal than neutral images. Moreover, participants with personal histories of trauma had heightened emotional responses to distressing imagery.
DISCUSSION
These findings have implications for art therapists as well as for clinical and general populations in that these results highlight the potential impact of distressing imagery particularly for individuals with personal histories of experiencing or witnessing traumatic events.
PubMed: 38919795
DOI: 10.3389/fpsyg.2024.1337927 -
Journal of Anaesthesiology, Clinical... 2024The objective of the study was to evaluate the performances of qCON and qNOX indices in pediatric populations undergoing surgery under general anesthesia (GA), focusing...
BACKGROUND AND AIMS
The objective of the study was to evaluate the performances of qCON and qNOX indices in pediatric populations undergoing surgery under general anesthesia (GA), focusing on the induction and recovery periods. Both the indices are derived from electroencephalogram (EEG) and implemented in the CONOX monitor (Fresenius Kabi, Germany).
MATERIAL AND METHODS
After approval of the institutional ethics committee, this prospective observational study was conducted in pediatric patients of either sex in the age group of 1-12 years belonging to the American Society of Anesthesiology (ASA) grade I and II undergoing elective surgery under GA. Anesthetic technique was GA with or without regional analgesia (RA). All patients underwent inhalation induction and maintenance using sevoflurane. Patients were monitored with the use of a CONOX monitoring system (Fresenius Kabi, Germany), connected via a set of electrodes placed over the forehead. qCON and qNOX scores were recorded during awake (on operating table premedicated with oral midazolam 0.5 mg/kg), at induction, at loss of eyelash reflex, intubation/laryngeal mask airway (LMA) insertion, before and after regional anesthesia, surgical incision, at cessation of anesthesia, emergence, extubation, and eye-opening. Registered results were also analyzed compared with the minimum alveolar concentration of sevoflurane (MAC).
RESULTS
A total of 46 pediatric patients were enrolled in the study with a mean age of 5.6 years. All the patients were either ASA I or II. There was a simultaneous fall and rise of qCON and qNOX upon induction and recovery, respectively. There was a rise in qNOX with surgical incision irrespective of RA. However, there was a greater rise in qNOX following surgical incision in those who did not receive RA ( = 0.33) Also both qCON ( = 0.06) and qNOX ( = 0.41) were poorly correlated with MAC values of sevoflurane during GA in the pediatric population.
CONCLUSIONS
Both qCON and qNOX values change predictably with changes in the conscious level and with different noxious stimuli. Further studies are required to confirm the findings taking into account the postoperative assessment of delirium and recall of intraoperative events.
PubMed: 38919439
DOI: 10.4103/joacp.joacp_453_22 -
Journal of Anaesthesiology, Clinical... 2024Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus...
BACKGROUND AND AIMS
Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient's pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery.
MATERIAL AND METHODS
The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated.
RESULTS
All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar.
CONCLUSIONS
Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.
PubMed: 38919429
DOI: 10.4103/joacp.joacp_248_22 -
Journal of Anaesthesiology, Clinical... 2024Coronavirus disease (COVID-19)-related pneumonia is proposed to be an inflammatory process. The treatment currently includes supportive therapy and low-dose steroids....
BACKGROUND AND AIMS
Coronavirus disease (COVID-19)-related pneumonia is proposed to be an inflammatory process. The treatment currently includes supportive therapy and low-dose steroids. Anti-inflammatory drugs have been proposed to prevent cytokine storms and improve oxygenation in such cases. The study aimed to assess the efficacy of nebulized lignocaine in COVID-19 patients with pneumonia.
MATERIAL AND METHODS
This was an exploratory randomized double-blinded control trial conducted in COVID-19 patients with respiratory failure requiring oxygen therapy either by face mask or non-invasive mechanical ventilation. Patients included were of the age of more than 18 years of either gender. The patients were randomized to receive either lignocaine or distilled water nebulization. The outcomes assessed were PaO/FiO ratio, hemodynamics, respiratory parameters, and sequential organ failure score (SOFA).
RESULTS
The two groups were comparable concerning demographic variables. The PaO/FiO were significantly higher in the lignocaine group from day 2 onward. The SPO was significantly higher on day 3 in the lignocaine group and thereafter there was no significant difference. Other hemodynamic, respiratory parameters, and SOFA scores showed no difference in both the groups.
CONCLUSION
Lignocaine nebulization improved oxygenation in COVID-19 patients and can be used as adjunctive therapy along with other supportive medications.
PubMed: 38919418
DOI: 10.4103/joacp.joacp_205_22