Opening Of Eyes Research Articles

Tracking EEG network dynamics through transitions between eyes-closed, eyes-open, and task states

Our study aimed to verify the possibilities of effectively applying chronnectomics methods to reconstruct the dynamic processes of network transition between three types of brain states, namely, eyes-closed rest, eyes-open rest, and a task state. The study involved dense EEG recordings and reconstruction of the source-level time-courses of the signals. Functional connectivity was measured using the phase lag index, and dynamic analyses concerned coupling strength and variability in alpha and beta frequencies. The results showed significant and dynamically specific transitions regarding processes of eyes opening and closing and during the eyes-closed-to-task transition in the alpha band. These observations considered a global dimension, default mode network, and central executive network. The decrease of connectivity strength and variability that accompanied eye-opening was a faster process than the synchronization increase during eye-opening, suggesting that these two transitions exhibit different reorganization times. While referring the obtained results to network studies, it was indicated that the scope of potential similarities and differences between rest and task-related networks depends on whether the resting state was recorded in eyes closed or open condition.

Human Eye Activity Monitoring Using Continuous Wave Doppler Radar: A Feasibility Study.

Human eye activity has been widely studied in many fields such as psychology, neuroscience, medicine, and human-computer interaction engineering. In previous studies, monitoring of human eye activity mainly depends on electrooculogram (EOG) that requires a contact sensor. This article proposes a novel eye movement monitoring method called continuous wave doppler oculogram (cDOG). Unlike the conventional EOG-based eye movement monitoring methods, cDOG based on continuous wave doppler radar sensor (cDRS) can remotely measure human eye activity without placing electrodes on the head. To verify the feasibility of using cDOG for eye movement monitoring, we first theoretically analyzed the association between the radar signal and the corresponding eye movements measured with EOG. Afterward, we conducted an experiment to compare EOG and cDOG measurements under the conditions of eyes closure and opening. In addition, different eye movement states were considered, including right-left saccade, up-down saccade, eye-blink, and fixation. Several representative time domain and frequency domain features obtained from cDOG and from EOG were compared in these states, allowing us to demonstrate the feasibility of using cDOG for monitoring eye movements. The experimental results show that there is a correlation between cDOG and EOG in the time and frequency domain features, the average time error of single eye movement is less than 280.5 ms, and the accuracy of cDOG in eye movement detection is higher than 92.35%, when the distance between the cDRS and the face is 10 cm and eyes is facing the radar directly.

Preoperative electroencephalographic alpha-power changes with eyes opening are associated with postoperative attention impairment and inattention-related delirium severity

BackgroundIn the eyes-closed, awake condition, EEG oscillatory power in the alpha band (7–13 Hz) dominates human spectral activity. With eyes open, however, EEG alpha power substantially decreases. Less alpha attenuation with eyes opening has been associated with inattention; thus, we analysed whether reduced preoperative alpha attenuation with eyes opening is associated with postoperative inattention, a delirium-defining feature. MethodsPreoperative awake 32-channel EEG was recorded with eyes open and eyes closed in 71 non-neurological, noncardiac surgery patients aged ≥ 60 years. Inattention and other delirium features were assessed before surgery and twice daily after surgery until discharge. Eyes-opening EEG alpha-attenuation magnitude was analysed for associations with postoperative inattention, primarily, and with delirium severity, secondarily, using multivariate age- and Mini-Mental Status Examination (MMSE)-adjusted logistic and proportional-odds regression analyses. ResultsPreoperative alpha attenuation with eyes opening was inversely associated with postoperative inattention (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.57, 0.94; P=0.038). Sensitivity analyses showed an inverse relationship between alpha-attenuation magnitude and inattention chronicity, defined as ‘never’, ‘newly’, or ‘chronically’ inattentive (OR 0.76, 95% CI: 0.62, 0.93; P=0.019). In addition, preoperative alpha-attenuation magnitude was inversely associated with postoperative delirium severity (OR 0.79, 95% CI: 0.65, 0.95; P=0.040), predominantly as a result of the inattention feature. ConclusionsPreoperative awake, resting, EEG alpha attenuation with eyes opening might represent a neural biomarker for risk of postoperative attentional impairment. Further, eyes-opening alpha attenuation could provide insight into the neural mechanisms underlying postoperative inattention risk.

Abnormalities of reactivity of posterior resting‐state electroencephalographic alpha rhythms during eyes opening in patients with dementia due to Alzheimer’s disease and Parkinson’s disease

AbstractBackgroundPatients with dementia due to Alzheimer’s disease (ADD) and Parkinson’s disease (PDD) suffer from vigilance dysregulation. We hypothesized that such dysregulation may be reflected by altered reactivity of posterior resting‐state electroencephalographic (rsEEG) alpha rhythms during the vigilance transition from eyes‐closed to ‐open condition.MethodA Eurasian database provided clinical, demographic, and rsEEG datasets in 73 PDD patients, 35 ADD patients, and 25 matched cognitively unimpaired (Healthy) persons. The eLORETA freeware was used to estimate cortical rsEEG sources at delta, theta, alpha, beta, and gamma frequency bands during eyes‐closed and‐open conditions.ResultResults showed substantial (> ‐10%) reduction (reactivity) in the posterior alpha source activities from the eyes‐closed to the eyes‐open condition in 88% of the Healthy seniors, 57% of the ADD patients, and only 35% of the PDD patients (Figure 1). In these alpha‐reactive participants, there were lower reductions in the posterior alpha activities in the ADD and PDD groups than in the Healthy group. That reduction in the parietal region was lower in the PDD than in the ADD group (Figure 2).ConclusionThese results suggest that ADD and PDD is characterized by poor reactivity of mechanisms desynchronizing posterior rsEEG alpha rhythms in response to visual inputs. This finding could be an interesting biomarker of impaired vigilance regulation in the quiet wakefulness in ADD and PDD patients. Such biomarkers may provide endpoints targets for pharmacological intervention and brain electromagnetic stimulations to improve the ADD and PDD patients’ general ability to regulate vigilance and visual primary consciousness in the activities of daily living.

Reactivity of posterior cortical electroencephalographic alpha rythms during eyes opening in cognitively intact older adults and patients with dementia due to Alzheimer’s and lewy diseases

Reactivity of posterior cortical electroencephalographic alpha rythms during eyes opening in cognitively intact older adults and patients with dementia due to Alzheimer’s and lewy diseases

Comparison of Bolus Dosing of Methohexital and Propofol in Elective DirectCurrent Cardioversion.

Background Methohexital and propofol can both be used as sedation for direct current cardioversion (DCCV). However, there are limited data comparing these medications in this setting. We hypothesized that patients receiving methohexital for elective DCCV would be sedated more quickly, recover from sedation faster, and experience less adverse effects. Methods and Results This was a prospective, blinded randomized controlled trial conducted at a single academic medical center. Eligible participants were randomly assigned to receive either methohexital (0.5 mg/kg) or propofol (0.8 mg/kg) as a bolus for elective DCCV. The times from bolus of the medication to achieving a Ramsay Sedation Scale score of 5 to 6, first shock, eyes opening on command, and when the patient could state their age and name were obtained. The need for additional medication dosing, airway intervention, vital signs, and medication side effects were also recorded. Seventy patients who were randomized to receive methohexital (n=37) or propofol (n=33) were included for analysis. The average doses of methohexital and propofol were 0.51 mg/kg and 0.84 mg/kg, respectively. There were no significant differences between methohexital and propofol in the time from end of injection to loss of conscious (1.4±1.8 versus 1.1±0.5 minutes; P=0.33) or the time to first shock (1.7±1.9 versus 1.4±0.5 minutes; P=0.31). Time intervals were significantly lower for methohexital compared with propofol in the time to eyes opening on command (5.1±2.5 versus 7.8±3.7 minutes; P=0.0005) as well as at the time to the ability to answer simple questions of age and name (6.0±2.6 versus 8.6±4.0 minutes; P=0.001). The methohexital group experienced less hypotension (8.1% versus 42.4%; P<0.001) and less hypoxemia (0.0% versus 15.2%; P=0.005), had lower need for jaw thrust/chin lift (16.2% versus 42.4%; P=0.015), and had less pain on injection compared with propofol using the visual analog scale (7.2±9.7 versus 22.4±28.1; P=0.003). Conclusions In this model of fixed bolus dosing, methohexital was associated with faster recovery, more stable hemodynamics, and less hypoxemia after elective DCCV compared with propofol. It can be considered as a preferred agent for sedation for DCCV. Registration URL: https://www.clinicaltrials.gov/ct; Unique identifier: NCT04187196.

A Clinical Study on Efficacy of Jivaniya Ghritapana in Shushkakshipaka (Dry Eye Syndrome)

Dry eye syndrome is a disease commonly seen in all age groups with a greater ration in elderly population. Large scale studies have determined that increasing age, female sex, and Asian race are all associated with higher DED prevalence. Their occurs tear deficiency and ocular surface disorders, which produces symptoms like discomfort, visual disturbance and tear film instability. Clinically and etymologically, similar entity to Dry eye syndrome is Shushkakshipaka. In modern ophthalmology, conventional approach for Dry eye syndrome is lubricating eye drops which are not satisfactory. Ayurveda has a holistic approach to deal with this problem. This clinical study was done to evaluate the effect of Jivaniya Ghritapana in Shushkakshipaka (dry eye syndrome). An open clinical trial for 10 patients was planned. They were presenting with clinical features of Shushkakshipaka (Dry Eye Syndrome). Snehapana was done in all patients with Jivaniya Ghrita. Results: On assessing the selected criteria, significant results were found in subjective parameters like Rukshta (feeling of dryness), Gharshana (gritty sensation), Daruna vartmakshi (hardness of eyelids), Karachaunmilana (difficulty in opening and closing of eyes), Daha (burning sensation) &amp; intolerance to light. Significant result was found in all objective parameters. Conclusion: Thus we can conclude that, for successful treatment Shushkakshipaka (Dry Eye Syndrome), Snehapana can be advised in such patients.

Driver Drowsiness Detection and Alert System Development Using Object Detection

Fatigue driving is an invisible killer in car accidents and one of the main causes of traffic accidents. In order to reduce traffic accidents caused by driving fatigue, this research has developed a safety assist device to prevent such traffic accidents. In this research, a non-contact driver drowsiness detection and alert system is established in the vehicle cabin. The real-time facial image of the driver is obtained through the camera installed in front of the driver, and then the image is input to the NVIDIA Jetson TX2 embedded module. YOLO (You Only Look Once) object detection algorithm is used to detect the opening and closing of the driver's eyes, and by processing the eye area, to determine whether the driver is currently awake or fatigued while driving. The driver drowsiness detection and alert system established in this research can be applied to the vehicle interior environment to monitor the driving status. When the driver is fatigued, the system will simultaneously emit sound and light signals to promptly warn such dangerous driving behaviors. It can prevent the driver from continuing to drive when fatigued, and ensure driving safety.

Reactivity of posterior cortical electroencephalographic alpha rhythms during eyes opening in cognitively intact older adults and patients with dementia due to Alzheimer's and Lewy body diseases

Please modify the Abstract as follows:Here we tested if the reactivity of posterior resting-state electroencephalographic (rsEEG) alpha rhythms from the eye-closed to the eyes-open condition may differ in patients with dementia due to Lewy Bodies (DLB) and Alzheimer’s disease (ADD) as a functional probe of the dominant neural synchronization mechanisms regulating the vigilance in posterior visual systems.We used clinical, demographical, and rsEEG datasets in 28 older adults (Healthy), 42 DLB, and 48 ADD participants. The eLORETA freeware was used to estimate cortical rsEEG sources.Results showed a substantial (> -10%) reduction in the posterior alpha activities during the eyes-open condition in 24 Healthy, 26 ADD, and 22 DLB subjects. There were lower reductions in the posterior alpha activities in the ADD and DLB groups than in the Healthy group. That reduction in the occipital region was lower in the DLB than in the ADD group.These results suggest that DLB patients may suffer from a greater alteration in the neural synchronization mechanisms regulating vigilance in occipital cortical systems compared to ADD patients.

A Comparison of Two Peripheral Nerve Blocks Combined With General Anesthesia in Elderly Patients Undergoing Arthroplasty for Hip Fractures: A Pilot Randomized Controlled Trial.

BackgroundCombined anesthesia can be a promising option for hip surgery when neuraxial anesthesia is contraindicated. Lumbar and sacral plexus blocks, and femoral nerve and lateral femoral cutaneous (LFC) nerve blocks in combination with general anesthesia (GA) are commonly used in elderly patients undergoing arthroplasty for hip fracture surgery. However, no study has compared these two anesthetic strategies in the perioperative period.MethodsA total of 41 elderly patients scheduled for arthroplasty for hip fracture surgery were randomized into group A (n = 20) and group B (n = 21). Group A received femoral nerve block, LFC nerve blocks, and GA, and group B received lumbar plexus block, sacral plexus block, and GA. Primary outcomes were incidences of hemodynamic events and changes in blood pressure (BP) and heart rate (HR). Secondary outcomes included time and drug consumption, infusion and bleeding volume, eyes opening time after surgery, and postoperative quality recovery rate.ResultsCompared with group B, group A showed a lower incidence of intraoperative hypotension (p < 0.001), higher BP [including mean arterial pressure (MAP), systolic BP (SBP), and diastolic BP (DBP)] following induction (IN), and higher HR from mid-surgery. Time required for nerve blockade (p < 0.001) and ephedrine consumption was significantly shorter in group A (p < 0.001), while sufentanil consumption was higher as compared to group B (p = 0.002). No significant differences in other intraoperative parameters and postoperative quality recovery rate were reported during the observation.ConclusionOur pilot data indicate that compared with lumbar and sacral plexus blocks, femoral nerve and LFC nerve blocks may provide more stable intraoperative hemodynamics and a comparable postoperative recovery for elderly patients undergoing arthroplasty for hip fracture under GA. Further studies with a larger sample size are needed to derive stronger evidence.

Automatic Recognition of Students' Classroom Behavior Based on Computer Vision

The performance of students' classroom behavior is an important part of the evaluation of classroom teaching, and the recognition of students' classroom behavior is of great significance to the evaluation of classroom teaching. However, due to the complexity of students' classroom behavior, it is difficult to identify intelligent students' classroom behavior. Therefore, this paper proposes a classroom behavior analysis and evaluation system based on deep learning face recognition technology. The classroom behavior analysis and evaluation system judges whether students pay attention to class from three aspects: Students' side face concentration, students' head up and head down concentration, and eyes opening and closing concentration, so as to provide an objective evaluation basis for students' classroom behavior evaluation in classroom teaching.At present, to solve the problem of performance degradation of convolutional neural network with the deepening of network layers, a deep residual network based on residual structure is proposed. Comparing the accuracy of the depth residual network with that of the depth convolution neural network on this data set, the experimental results show that the former has better network recognition performance.

A Study on Morphological Growth and Development of Swiss Albino Mice, Wistar Rat and Dunkin Hartley Guinea Pigs

Background: Baseline information on the morphological development of laboratory animals is very scanty. Hence the present study was undertaken to understand the morphological development of experimental animals. Methods: An experiment was conducted at Biogen animal facility, Bangalore in the year 2018 to study the morphological changes with regard to growth and developmental parameters in Swiss albino mice and Wistar rats and body weight in guinea pigs. Ten Swiss albino mice and Wistar rats in advanced pregnancy of similar age groups and comparable litter sizes in the previous kindlings were selected for the experiment, where as five guinea pigs males and females each were selected with same age group. During the study period, litter weight and size at birth and at weaning, time of initiation and completion (full growth of hair) of hair growth, time of opening of eyes and ears recorded in Swiss albino mice and Wistar rats whereas body weight at birth, 3rd day, 6th day, 9th day, 12th day and 15th were recorded in Dunkin Hartley guinea pigs. Result: The results of Swiss albino mice indicated that the average litter weight (grams) and litter size at birth ranged from 1.39 and 7.50 respectively. The average time taken from initiation and full growth of hair covering on body was 7.50 to 15.30 days. Eyes and ears opened at 7.90 and 8.20 days respectively. Average weight of male and female recorded at weaning (25 days) 19.38 and 15.12 respectively and the litter size at the weaning was 9.70 whereas, livability percent was recorded 87.81 at the end of the trial. The results of Wistar rats indicated that the average litter weight (grams) and litter size at birth ranged from 5.07 and 11 respectively. The average time taken from initiation to full growth of hair covering on body was 9 to 16.20 days. Eyes and ears opened at 12.20 days, average weight (grams) of male and female recorded at weaning (25 days) 78.03 and 63.09 respectively. The litter size at the weaning was 9.70. The livability percent was recorded 88.02 at the end of the trial. The results of Dunkin Hartley guinea pigs indicated that the average body weight (grams) of female at birth, 3rd day, 6th day, 9th day, 12th day, 15th (Weaning period) ranged from 94.88, 109.34, 123.94, 139.74, 152.14 and 166.66, respectively. On the other hand, average body weight (grams) of male at birth, 3rd day, 6th day, 9th day, 12th day, 15th (Weaning period) ranged from 145.38, 155.42, 170.50, 185.54, 200.64 and 215.7, respectively.

Repeated Low-Dose Acrolein Triggers Irreversible Lamina Propria Edema in Urinary Bladder, Transient Voiding Behavior and Widening of Eyes to Mechanical Stimuli

Acrolein is a metabolite of cyclophosphamide (CYP), an alkylating agent used for a wide range of benign and malignant diseases. CYP treatments are known to trigger hemorrhagic cystitis in patients and animals. Significant effort has been made to prevent CYP/acrolein-induced cystitis, while still maintaining its therapeutic benefits. As a result, supplementary therapeutic options to mediate the protective role against CYP/acrolein and lower doses of CYP are currently given to targeted patients, as compared to past treatments. There is still a need to further study the effects of the repeated low-dose CYP/acrolein on the pathophysiology of the urinary bladder. In our study, a one-time treatment of acrolein and repeated low-dose acrolein triggered the thickening of the smooth muscle and lamina propria in the urinary bladder of C57BL/6J mice, respectively. The first dose of acrolein did not trigger voiding dysfunction, but the second dose triggered high-volume low-frequency voiding. Interestingly, our new scoring criteria and concurrent behavioral assessment revealed that mice with repeated low-dose acrolein had a wider opening of eyes in response to mechanical stimuli. Our study suggests that clinical symptoms among patients undergoing prolonged low-dose CYP may differ from previously reported symptoms of CYP-induced hemorrhagic cystitis.

Movements and behaviors during spontaneous arousals in healthy young adults: an intermediary stage between wakefulness and sleep?

BackgroundArousals are common, sudden and transient elevations of the vigilance level during normal sleep, but arousal-associated behaviors have not yet been studied. ObjectiveWe aimed to describe the duration as well as motor and autonomic patterns associated with arousals across sleep stages in normal subjects. MethodsThe spontaneous arousals of 25 healthy young adults were randomly analyzed on polysomnography with body- and face-oriented video cameras. The duration of the heart rate response as well as the frequency, amplitude, speed, body segment and semiology of associated movements were measured. ResultsAmong 624 arousals (258 in N2, 140 in N3 and 226 in REM sleep), REM sleep arousals had the shortest duration, and N3 arousals were associated with greater heart rate acceleration. Movements and behaviors (mostly involving the head and neck, then the upper limbs, with rare eyes opening and no turning in bed) were frequent during arousals (69.4% during N2 sleep, 89.3% during N3 and 93.8% during REM sleep). Arousals more frequently included ample, prolonged and whole-body movements during N3 sleep and fast movements and facial expressions during REM sleep. During N2 arousals, chewing was the most prevalent behavior. Some movements resembled orientation and comfort behaviors (flexing/rotating the neck and trunk, scratching, pulling the sheets, rubbing the nose, yawning, smiling, frowning and speaking), whereas others resembled sleep-associated automatisms (swallowing, chewing). ConclusionIn contrast with previous assumptions, most arousals are associated with movements. The type of movements suggests that arousal is an intermediary state between wakefulness and sleep.

Reduction in posterior cortical alpha rhythms during eye opening is more abnormal in patients with dementia due to Lewy bodies than Alzheimer’s disease: An EEG study

AbstractBackgroundAlzheimer’s disease (AD) is the first‐most common neurodegenerative disorder due to an abnormal accumulation of amyloid and tau proteins in the brain and explains about 60‐70% of 50 million of patients with dementia worldwide (WHO report, www.who.int). Disease with Lewy Bodies (DLB) is emerging as another important cause of dementia with visual hallucinations, cognitive fluctuations, or REM sleep behavior disorder in the pathological aging. Notably, DLB patients may show not only distinctive post‐mortem intra‐neuronal Lewy bodies but also abnormal accumulation of amyloid and proteins in the brain, raising in‐vivo diagnostic issues (Kantarci et al., 2020). Furthermore, resting state eyes‐closed electroencephalographic (rsEEG) alpha (8‐10 Hz) rhythms in posterior cortical sources showed differences between AD and DLB patients with dementia (Babiloni et al., 2017). Here we tested the hypothesis that cortical sources of rsEEG alpha rhythms during eyes opening may be more abnormal in DLB than AD patients with dementia.MethodsClinical and rsEEG rhythms in demographic‐ and age‐matched AD (N = 30), DLB (N = 28), and healthy cognitively unimpaired (Nold, N = 30) persons were available from an international archive. Pathological groups were matched as cognitive status (i.e., dementia grade). Individual alpha frequency peak was used to determine the alpha frequency band on personal basis. The eLORETA freeware estimated rsEEG alpha cortical sources. “Reactivity” to eyes opening was computed computing the percentage of the reduction in the rsEEG alpha (eLORETA) source activity during eyes open over closed condition in posterior (i.e., central, parietal, and occipital) cortical regions of interest.ResultsAs compared to the Nold subjects, the patients with dementia due to DLB and AD showed lower “reactivity” to eyes opening in posterior cortical regions (p &lt; 0.05 corrected), this poor “reactivity” being significantly more evident in the former than the latter (Figure 1).ConclusionsThese novel results suggest that neurophysiological oscillatory mechanisms regulating cortical arousal in the visual system during external visual stimuli are more abnormal in DLB than AD patients with dementia, possibly concurring to visual misperceptions and hallucinations reported in DLB patients.

PRIMARY HYPERPARATHYROIDISM: OPTIMIZATION OF ANAESTHESIA

Background and Aims. The majority of cases of primary hyperparathyreosis (PHPT) due to solitary adenoma and require the target surgery. Research of new anesthesia/analgesia methods, which afford to have an opioid-sparing effect, is going. Methods. 127 patients with PHPT were divided into 3 groups: the group STI-BCSPB (n=26) was used combined general anesthesia (GA) with sevoflurane (SEV), the tracheal intubation (TI) with the myorelaxant introduction and bilateral cervical superficial plexus blockade (BCSPB); the group STI (n=82) was used SEV anaesthesia with IT and no BCSPB; the group PLM-BCSPB (n=19) was provided propofol (P) GA with protection air-ways by laryngeal mask (LM) and BCSPB. In both groups (STI-BCSPB and PLM-BCSPB) were used co-analgesics, such as dexamethasone (DXM) 8 mg IV, 2% lidocaine (L) 1,0-1,5 mg/kg IV, metamizole (M) or paracetamol (P) 1 g IV, dexketoprofen (DKTP) 50 mg IV as pre-emptive analgesia 30 min before surgery. Ketamine 25 mg IV was used for induction anaesthesia in these groups. In STI group only opioid with P were used for induction of GA. Duration of surgery (DoS), anaesthesia (DoA), opioid consumption, time from the operation ending until the eyes opening (EyOp), desaturation was measured. All data M±m Results. DoS for STI-BCSPB, STI and PLM-BCSPB was respectively 38.7±2.7, 37.8±1.3 and 35.6±1.7 min (NS), DoA was respectively 63.8±3.1, 59.4±1.4 m and 53,8±2.7 min (p= 0.028 STI vs PLM-BCSPB, p= 0.024 STI-BCSPB vs PLM-BCSPB, the difference is significant (DS). EyOp was 15.4±1.1, 15.6±1.2 and 11.6±0.9 min respectively for STI-BCSPB, STI and PLM-BCSPB (p=0.022 STI vs PLM-BCSPB (DS) and p=0.025 STI-BCSPB vs PLM-BCSPB (DS). Desaturation (SpO2 below 92%) due to residual sedation and the effect of muscles relaxants was observed in 39 (47.6%) and 11 (42,3%) patients in STI and STI-BCSPB during the first 30 min postop compared to 2 cases (10.5%) in PLM-BCSPB (both STI groups were DS vs PLM-BCSPB, chi-square test). The dose of intra-op fentanyl was 334.3±17.1, 256.5±16.9 197.3±15.3 mcg in STI, STI-BCSPB and PLM-BCSPB respectively, (DS for PLM-BCSPB vs other groups, DS between STI groups). Conclusions. Combine methods GA with BCSPB have some benefits over mono GA. Co-analgesics afford to achieve an opioidsparing effect. Under ectomy of single parathyroid adenoma, the use of propofol and BSCPB with the laryngeal mask without muscles relaxants seems more preferable compared to sevoflurane anesthesia with BBSCP and tracheal intubation due to the shorter anesthesia duration, time to eye-opening after surgery, lower desaturation frequency.

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

Real-Time Driver Drowsiness Detection and Alert System

Nowadays, road accidents have become really high and is causing severe physical injuries, deaths etc, mainly in India. India has become the highest in the world in case of road accidents, recording 53 road crashes per hour. Drowsy driving is one of the reasons for road accidents. Increasing road accidents due to drowsy driving indicate the need of system that detect the drowsiness of the driver and alert them at the correct time. “Researchers have attempted to determine driver drowsiness using the following measures: (1) vehicle-based measures; (2) behavioral measures and (3) physiological measures”[13]. Rate of using physiological measures to detect drowsiness is high; vehicle-based measures are affected by construction of the street, driving ability of the driver, type of vehicle etc; some methodologies use mental measures for which some anodes are put on the head and body. So here we have used much more feasible method. In this paper we discuss a method which is non-intrusive. In our proposed system, the main data we use to detect driver drowsiness is the eye conclusion proportion, its duration etc. Eyes opening and closing ratio reflects a person's mind status and attention and therefore, it can be potentially used to indicate driver fatigue levels[14]. We keep a value as the threshold value, if the eye conclusion proportion goes below the threshold value, then we alert the driver using a buzzer and provide tips to get rid of the drowsiness through an audio message. For continuously detecting the driver’s eye we use a camera. We also use an LED light to alert the co-passengers about the drowsiness of the driver.

The usefulness of Smart Pilot View for fast recovery from desflurane general anesthesia.

Smart Pilot View (SPV) (Dräger Medical) provide information about the estimated drug effect of anesthetic drugs. We conducted a prospective randomized trial to evaluated the recovery time in SPV-guided general anesthesia compared with usual practice in patients with desflurane general anesthesia. Thirty-four American Society of Anesthesiologist's physical status I-II patients scheduled for elective surgery under general anesthesia were enrolled in the study. The patients were allocated to one of the following two groups: the Smart Pilot View group (group SPV) or the control group (group C). General anesthesia was induced by propofol and maintained by desflurane end-tidal concentration of 4.2%. During the procedure, desflurane concentration was adjusted to maintain BIS values between 40 and 60 and above MAC 90. In group SPV, desflurane concentration and infusion rate of remifentanil were decreased to achieve MAC 90 about 10min before the end of the procedure. In group C, the desflurane concentration and infusion rate of remifentanil were maintained unchanged until the end of the procedure. Fifteen patients were enrolled in group C, and seventeen of these were enrolled in group SPV. The time taken for the opening of the patient's eyes was 292 ± 53s in group C and 218 ± 44s in group SPV. The time taken for recovery of orientation was 451 ± 100s in group C and 316 ± 57s in group SPV. Both times were significantly faster in the group SPV. Smart Pilot View guided anesthesia enabled faster recovery from desflurane general anesthesia.

Eyes Closing and Drowsiness in Human Subjects Decrease Baseline Galvanic Skin Response and Active Palmar Sweating: Relationship Between Galvanic Skin and Palmar Perspiration Responses.

We previously constructed a perspiration ratemeter for the measurement of palmar sweating in human subjects. Although galvanic skin response (GSR) has been used to evaluate emotional responses in human subjects, little is known about the relationships between the phasic and baseline components in GSR and active palmar sweating. From the aforementioned, we aimed to investigate the relationships in human subjects with handgrip exercise and eyes closing or opening. Fifteen healthy volunteers (mean age: 26.9 ± 8.7 years) participated in the present experiments. We investigated the effects of maximal handgrip exercise, eyes closing or opening, and self-awareness of drowsy on the GSR, active palmar sweating, R-R interval in electrocardiograph (ECG), and percentage of α wave in EEG. The faster phasic component in GSR completely agreed with the starting point of active palmar sweating. Handgrip exercise induced significantly faster spike in GSR, active palmar sweating, and decrease in R-R interval in ECG. Eyes closing produced significant decreases in baseline GSR and active palmar sweating in all human subjects. The percentage of α wave in electroencephalograph (EEG) also increased. In contrast, eyes opening increased significantly the baseline GSR and active palmar sweating. In the equivalent electrical model of human skin, the eyes closing–mediated time-dependent decrease in the baseline GSR completely agreed with the hypothesis that the palmar skin voltage only in the model decreased time dependently to 0.4 of the control during 6 min. The self-awareness of drowsy in mid-night working with computer produced similar decreases in baseline GSR and active palmar sweating to the responses with eyes closing in all human subjects. In conclusion, the faster spike in GSR completely agreed with the starting point of active palmar sweating. Eyes closing and opening or self-awareness of drowsy significantly produced changes in baseline GSR and active palmar sweating, which may become useful tools for evaluating clearness or drowsiness in human subjects.