Full Face Research Articles

Effect of Microneedling Associated With Drug Delivery on Facial Rejuvenation: Clinical and Histological Evaluation

Introduction: Microneedling has been used to treat different human connective tissue disorders, promoting an increase in the permeation of active ingredients, to favour local vascularization and collagen production. Objective: To investigate the effects of microneedling associated with the permeation of cosmetological actives (drug delivery) on facial rejuvenation. Method: This was a controlled clinical trial, in which 30 volunteers with facial aging were recruited and distributed into 2 groups. G1 was treated with microneedling with associated saline and G2 received microneedling with associated drug delivery (with growth factors) in the entire facial region (full face). Both groups received two treatment sessions with an interval of 30 days between them. For result evaluation, photos were clinically analysed before and after the interventions, the facial symmetry was verified through the measurement of angles and measurement of the facial region, and a histological analysis of the eyelid region of two patients who underwent surgery blepharoplasty was carried out. Results: Both groups presented satisfactory clinical results in the photographs’ visual analysis. In the evaluation of facial symmetry, G2 showed an improvement in the measurements of the paralateronasal L-projection, nasolabial F-crease, right and left lateral palpebral crease, with p<0.01. In the histological analysis, G2 showed higher collagen and elastin increase than G1, with greater predominance of better-quality collagen (type I) when drug delivery was performed. Conclusion: The association of microneedling with growth factors promotes a greater production of collagen fibres and connective tissue reorganization, compared to microneedling with no cosmetological assets.

Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition.

Background:The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work.Methods:Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic.Results:Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic.Conclusions:A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings.Knowledge Transfer Statement:The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

Penetrating Ocular Trauma Caused by Steel Wire from a Rotating Wire Brush: A Case Report with Review of Literature

A 19-year-old young man came to emergency department with a complaint of injury in the left eye with a wire, while cleaning the car engine parts in the workshop with motorized rotating wire brush. He was referred immediately to the eye clinic. On examination of the left eye, a thin steel wire was seen penetrating at the nasal limbus which was projecting forwards. The wire was removed (33 mm in length) under aseptic precautions using topical anaesthesia. Postoperatively, he was treated with ciprofloxacin eye drops. The patient had no ocular morbidity; the vision was normal, and he was asymptomatic in the left eye. Eye injuries from rotating wire brushes are caused by detached fragments. These eyes should be examined in detail for the involvement of different structures of the eye; and should be treated adequately in-time to prevent visual loss/ blindness. Wearing of safety glasses/ full face shield while working is recommended to prevent such injuries.

On Chamfer Distances on the Square and Body-Centered Cubic Grids: An Operational Research Approach

Linear programming is used to solve optimization problems. Thus, finding a shortest path in a grid is a good target to apply linear programming. In this paper, specific bipartite grids, the square and the body-centered cubic grids are studied. The former is represented as a “diagonal square grid” having points with pairs of either even or pairs of odd coordinates (highlighting the bipartite feature). Therefore, a straightforward generalization of the representation describes the body-centered cubic grid in 3D. We use chamfer paths and chamfer distances in these grids; therefore, weights for the steps between the closest neighbors and steps between the closest same type points are fixed, and depending on the weights, various paths could be the shortest one. The vectors of the various neighbors form a basis if they are independent, and their number is the same as the dimension of the space studied. Depending on the relation of the weights, various bases could give the optimal solution and various steps are used in the shortest paths. This operational research approach determines the optimal paths as basic feasible solutions of a linear programming problem. A directed graph is given containing the feasible bases as nodes and arcs with conditions on the used weights such that the simplex method may step from one feasible basis to another one. Thus, the optimal bases can be determined, and they are summarized in two theorems. If the optimal solution is not integer, then the Gomory cut is applied and the integer optimal solution is reached after only one Gomory iteration. Chamfer distances are frequently used in image processing and analysis as well as graphics-related subjects. The body-centered cubic grid, which is well-known in solid state physics, material science, and crystallography, has various applications in imaging and graphics since less samples are needed to represent the signal in the same quality than on the cubic grid. Moreover, the body-centered cubic grid has also a topological advantage over the cubic grid, namely, the neighbor Voronoi cells always share a full face.

Meeting another's gaze shortens subjective time by capturing attention

Gaze directed at the observer (direct gaze) is an important and highly salient social signal with multiple effects on cognitive processes and behavior. It is disputed whether the effect of direct gaze is caused by attentional capture or increased arousal. Time estimation may provide an answer because attentional capture predicts an underestimation of time whereas arousal predicts an overestimation. In a temporal bisection task, observers were required to classify the duration of a stimulus as short or long. Stimulus duration was selected randomly between 988 and 1479 ms. When gaze was directed at the observer, participants underestimated stimulus duration, suggesting that effects of direct gaze are caused by attentional capture, not increased arousal. Critically, this effect was limited to dynamic stimuli where gaze appeared to move toward the participant. The underestimation was present with stimuli showing a full face, but also with stimuli showing only the eye region, inverted faces and high-contrast eye-like stimuli. However, it was absent with static pictures of full faces and dynamic nonfigurative stimuli. Because the effect of direct gaze depended on motion, which is common in naturalistic scenes, more consideration needs to be given to the ecological validity of stimuli in the study of social attention.

Helium plasma dermal resurfacing: VISIA CR assessment of facial spots, pores, and wrinkles-Preliminary findings.

ObjectivesEffects of low energy, single‐pass helium plasma dermal resurfacing (PDR) treatment on brown spots, enlarged pores, and wrinkles—preliminary findings.MethodsTwenty two subjects (64.6 ± 6.6 years) with Fitzpatrick Wrinkle and Elastosis Scale score (FWS) of ≤2 and seeking improvement of facial appearance were included in this subanalysis. All subjects received a single, one‐pass, full face, and low power helium PDR treatment. Standard digital images were collected using the VISIA‐CR (Canfield Scientific Inc.) at baseline and 3 months after treatment with images assessed for improvement in FWS and for improvements in brown spots, enlarged pores, and wrinkles by proprietary automated image processing algorithms.ResultsNearly all subjects demonstrated ≥1‐point improvement in FWS and also reported improvement per modified Global Aesthetic Improvement Scale query. The numbers of brown spots and enlarged pores decreased by 45.1% and 28.3%, respectively. Stratification of brown spots data by presence or absence of post‐inflammatory hyperpigmentation revealed paradoxically conflicting data. The improvement detected in wrinkle area and mean wrinkle thickness was less pronounced with overall reductions of 13.4% and 4.8%, respectively. 37 Non‐serious adverse events (AEs) in 22 subjects were reported with most resolving within 14 days or less, and no serious AEs were observed.ConclusionsWhile longer‐term follow‐up is needed, these early study results show that one single‐pass, low energy helium PDR treatment improves facial skin appearance both qualitatively and quantitatively. Studies evaluating higher energy levels and multiple treatment passes are ongoing.

Increased facial asymmetry in focal epilepsies associated with unilateral lesions.

The epilepsies are now conceptualized as network disruptions: focal epilepsies are considered to have network alterations in the hemisphere of seizure onset, whilst generalized epilepsies are considered to have bi-hemispheric network changes. Increasingly, many epilepsies are also considered to be neurodevelopmental disorders, with early changes in the brain underpinning seizure biology. The development of the structure of the face is influenced by complex molecular interactions between surface ectoderm and underlying developing forebrain and neural crest cells. This influence is likely to continue postnatally, given the evidence of facial growth changes over time in humans until at least 18 years of age. In this case–control study, we hypothesized that people with lateralized focal epilepsies (i.e. unilateral network changes) have an increased degree of facial asymmetry, compared with people with generalized epilepsies or controls without epilepsy. We applied three-dimensional stereophotogrammetry and dense surface models to evaluate facial asymmetry in people with epilepsy, aiming to generate new tools to explore pathophysiological mechanisms in epilepsy. We analysed neuroimaging data to explore the correlation between face and brain asymmetry. We consecutively recruited 859 people with epilepsy attending the epilepsy clinics at a tertiary referral centre. We used dense surface modelling of the full face and signature analyses of three-dimensional facial photographs to analyse facial differences between 378 cases and 205 healthy controls. Neuroimaging around the time of the facial photograph was available for 234 cases. We computed the brain asymmetry index between contralateral regions. Cases with focal symptomatic epilepsy associated with unilateral lesions showed greater facial asymmetry compared to controls (P = 0.0001, two-sample t-test). This finding was confirmed by linear regression analysis after controlling for age and gender. We also found a significant correlation between duration of illness and the brain asymmetry index of total average cortical thickness (r = −0.19, P = 0.0075) but not for total average surface area (r = 0.06, P = 0.3968). There was no significant correlation between facial asymmetry and asymmetry of regional cortical thickness or surface area. We propose that the greater facial asymmetry in cases with focal epilepsy caused by unilateral abnormality might be explained by early unilateral network disruption, and that this is independent of underlying brain asymmetry. Three-dimensional stereophotogrammetry and dense surface modelling are a novel powerful phenotyping tool in epilepsy that may permit greater understanding of pathophysiology in epilepsy, and generate further insights into the development of cerebral networks underlying epilepsy, and the genetics of facial and neural development.

Penggunaan POE-inqury melalui blended learning terhadap hasil belajar siswa pada pembelajaran materi sistem respirasi

The purposes of this research were to analyze the improvement of students’ learning outcomes after participating in learning the respiratory system using POE-Inquiry through Blended Learning by Google Classroom. The research used Quasy Experiment Method. The data in this research were collected using multiple-choice questions to find out students’ level of understanding and outcome. The questionnaire supports students’ responses to the lessons. The result shows that the teaching process using POE-Inquiry through Blended Learning by Google Classroom contribute and support the progress of student learning outcome, can be seen with the result of largest of N-gain score index: first of N-gain score as much as 22,2% low category; acquisition of second N-gain score as much as 44,4% in the high category; and third N-gain score as much as 66,7% in the medium category. The result of Mann-Whitney U test on the final posttest found that the p-value (0,548) is greater than α (0.05), so it can be concluded that does not have a significant difference between Blended Learning and without Blended Learning (full face to face). Nearly all students gave positive feedback on learning the respiratory system using POE-Inquiry through Blended Learning by Google Classroom.

Valuing the Work of Jaume Huguet: A Painter and his Materials

The Consecration of Saint Augustine in the Museu Nacional d’Art de Catalunya in Barcelona (Fig. 1) comes from the high altar retable of the church of Sant Agustí Vell in the city, whose paintings were commissioned from Jaume Huguet in 1463, but not completed until 1486.1 The panel shows the imposing figure of the saint in elaborate vestments presented full face, enthroned before a cloth of honour and flanked by a press of full-length figures, two of whom, symmetrically arranged, place a bishop’s mitre upon his head: this is Augustine consecrated as bishop of Hippo Regius. The viewer’s attention is caught by two prominent features: the dense array of individualised and characterful heads occupying a band in the top third of the painting, and the opulent decoration which involves a profusion of surface ornament. The jewels on the mitres and liturgical gloves of the principal figures, their...

Facial scanner accuracy with different superimposition methods - In vivo study.

To compare trueness and precision between conventional and digital facial measurements and to evaluate the accuracy of different superimposition techniques for facial scans. Twenty volunteers were recruited. Predetermined facial landmarks were marked with a black pen, and the interlandmark distances were measured manually with a conventional caliper and digitally with Geomagic software. Two consecutive facial scans were performed and superimposed using as best-fit reference the full face, the face without the eyes, and the bone-supported areas (eg, forehead and zygomatic areas) in order to assess root mean square (RMS) differences. Trueness and precision were evaluated and compared between the conventional and digital techniques. Mann-Whitney U and Kruskal-Wallis post hoc tests were used. The significance level was established at α = .05. Trueness between conventional and digital measurements was 1,151.75 ± 1,265.52 μm (3.04% ± 4.82%), and precision was 322.31 ± 300.54 μm (0.93% ± 1.10%). Global mean RMS values for each superimposition technique were 334.15 ± 172.07 for the full face, 339.57 ± 173.13 for the face without the eyes, and 385.65 ± 182.29 for the bone-supported areas, with the latter presenting statistically significant differences compared to the other two. Although statistically significant differences were detected in facial measurements, they were below the clinically detectable threshold. Superimposition with the full face and the face without the eyes area presented smaller discrepancies than with the bone-supported areas, with higher discrepancies in the lower third of the face.

A Quantitative Analysis of Facial Asymmetry in Torticollis Using 3-Dimensional Photogrammetry.

To assess whether children with torticollis have quantifiably greater facial asymmetry than their age-matched controls using 3-dimensional (3D) photogrammetry. We retrospectively analyzed patients diagnosed with torticollis and age-matched volunteers who underwent 3D photogrammetry of their faces. We calculated the root mean square deviation (RMSD) between native and reflected facial images, as a measure of asymmetry. Two observers independently measured RMSD values for all study participants. The Spearman correlation coefficient evaluated interobserver reliability. The Wilcoxon rank-sum test with Bonferroni adjusted P values for multiple comparisons. Institutional. Twenty patients diagnosed with torticollis and 12 age-matched volunteers. Patients were analyzed on a computer database and volunteers were selected and consented in the hospital. We excluded patients with a history of facial trauma, facial operations, or other craniofacial diagnoses. Facial surface scans were obtained using the Canfield Vectra stereophotogrammetry system. The technology captures surface anatomy without radiation. RMSD comparisons between patients with torticollis and age-matched controls. Compared to controls, patients with torticollis had statistically significant greater full face, upper third, and middle third facial asymmetry. There was a trend toward greater asymmetry of the lower facial third. We used 3D photogrammetry to quantitate facial asymmetry from torticollis. We found greater asymmetry in patients with torticollis than in their unaffected peers. All areas of the face appeared to be affected, though the asymmetry in the lower facial third just failed to reach significance.

Some Remarks to the Semantics of Image of Deity on the Coffin of Sepi III (Cairo CG 28083).

The problem of the iconography of a unique image of a deity drawn on the Middle Kingdom rectangular coffin of Sepi III (Cairo CG 28083; B1C; Deir el-Bersha; CT VI, 386) is discussed in the article. It is possible that the god is the first known image of the syncretic double god Re-Osiris. The deity (with a head unusually for Egyptian iconography unfolded in full face) is shown sitting on a throne with the inscription “millions (of years)”. The image of this god could be a visual display of the eschatological plot described in Spell 1130 of the Coffin Texts (the union of Atum(-Re) and Osiris after destruction of the Universe) at the end in the Book of Two Ways, that is represented on the bottom of Sepi’s coffin.

Counting people in the crowd using social media images for crowd management in city events

City events are getting popular and are attracting a large number of people. This increase needs for methods and tools to provide stakeholders with crowd size information for crowd management purposes. Previous works proposed a large number of methods to count the crowd using different data in various contexts, but no methods proposed using social media images in city events and no datasets exist to evaluate the effectiveness of these methods. In this study we investigate how social media images can be used to estimate the crowd size in city events. We construct a social media dataset, compare the effectiveness of face recognition, object recognition, and cascaded methods for crowd size estimation, and investigate the impact of image characteristics on the performance of selected methods. Results show that object recognition based methods, reach the highest accuracy in estimating the crowd size using social media images in city events. We also found that face recognition and object recognition methods are more suitable to estimate the crowd size for social media images which are taken in parallel view, with selfies covering people in full face and in which the persons in the background have the same distance to the camera. However, cascaded methods are more suitable for images taken from top view with gatherings distributed in gradient. The created social media dataset is essential for selecting image characteristics and evaluating the accuracy of people counting methods in an urban event context.

Impact of low-frequency coding variants on human facial shape

The contribution of low-frequency variants to the genetic architecture of normal-range facial traits is unknown. We studied the influence of low-frequency coding variants (MAF < 1%) in 8091 genes on multi-dimensional facial shape phenotypes in a European cohort of 2329 healthy individuals. Using three-dimensional images, we partitioned the full face into 31 hierarchically arranged segments to model facial morphology at multiple levels, and generated multi-dimensional phenotypes representing the shape variation within each segment. We used MultiSKAT, a multivariate kernel regression approach to scan the exome for face-associated low-frequency variants in a gene-based manner. After accounting for multiple tests, seven genes (AR, CARS2, FTSJ1, HFE, LTB4R, TELO2, NECTIN1) were significantly associated with shape variation of the cheek, chin, nose and mouth areas. These genes displayed a wide range of phenotypic effects, with some impacting the full face and others affecting localized regions. The missense variant rs142863092 in NECTIN1 had a significant effect on chin morphology and was predicted bioinformatically to have a deleterious effect on protein function. Notably, NECTIN1 is an established craniofacial gene that underlies a human syndrome that includes a mandibular phenotype. We further showed that nectin1a mutations can affect zebrafish craniofacial development, with the size and shape of the mandibular cartilage altered in mutant animals. Findings from this study expanded our understanding of the genetic basis of normal-range facial shape by highlighting the role of low-frequency coding variants in several novel genes.

Protective Effects of Helmet Type on Facial Injuries.

The compulsory use of helmet by motorcyclists has lowered the incidence of facial trauma, but there are few studies evaluating the effects of different helmet types on such injuries. The authors collected retrospective data from the medical records of 287 motorcyclists presenting facial injuries treated at the maxillofacial surgery department of the "University Magna Graecia" of Catanzaro city in South Italy between 1 January 2007 and 1 August 2018. Patients were wearing 2 types of crash helmets at the time of the trauma, full face ones or open-face ones, and were compared using the Facial Injury Severity Scale (FISS). Those wearing open-face helmet were 3 times more than those wearing full-face helmet, with a higher FISS score.The purpose of this study was to investigate the impact of Italy's compulsory helmet law on the change in helmet use and in particular if protection offered by helmets w4as different according to helmet type. The authors correlated the FISS scores among motorcyclists wearing these 2 tipologies of crash helmet.

Engineering geological characterisation of rock masses for design of excavation method and support system of Tanju Tunnel, West Nusa Tenggara, Indonesia

This paper presents experiences with design and construction process of the Tanju Tunnel, West Nusa Tenggara. The objective of this research was to characterize the volcanic and intrusive rock masses for designs of the tunnel excavation method and support system. Engineering geological investigations were carried out, upon which the tunnel stand-up time was estimated and the tunnel excavation method and support system were determined based on the rock mass classifications of RMR (Bieniawski, 1989). The investigation results showed that the tunnel construction area consisted of colluvium, andesite, and tuff breccia. The rock masses were dominated by the andesite, which had UCS of intact rock ranging from 200 to 300 MPa classified as strong intact rock. Based on the RMR value, the andesite was classified as a good quality rock mass. The tunnel had unsupported roof stand-up time approximately 20.000 hours for a 3 m tunnel span. The recommended tunnel excavation method was full face, 1.0-1.5 m advance, and complete support 20 m from face, while the support systems were locally bolt in crown 3 m long and 2.5 m spacing, with occasional wire mesh, 50 mm thick shotcrete in crown where required.

Robust Face Alignment via Deep Progressive Reinitialization and Adaptive Error-Driven Learning.

Regression-based face alignment involves learning a series of mapping functions to predict the true landmarks from an initial estimation of the alignment. Most existing approaches focus on learning efficacious mapping functions from some feature representations to improve performance. The issues related to the initial alignment estimation and the final learning objective, however, receive less attention. This work proposes a deep regression architecture with progressive reinitialization and a new error-driven learning loss function to explicitly address the above two issues. Given an image with a rough face detection result, the full face region is first mapped by a supervised spatial transformer network to a normalized form and trained to regress coarse positions of landmarks. Then, different face parts are further respectively reinitialized to their own normalized states, followed by another regression sub-network to refine the landmark positions. To deal with the inconsistent annotations in existing training datasets, we further propose an adaptive landmark-weighted loss function. It dynamically adjusts the importance of different landmarks according to their learning errors during training without depending on any hyper-parameters manually set by trial and error. A high level of robustness to annotation inconsistencies is thus achieved. The whole deep architecture permits training from end to end, and extensive experimental analyses and comparisons demonstrate its effectiveness and efficiency. The source code, trained models, and experimental results are made available at https://github.com/shaoxiaohu/Face_Alignment_DPR.git.

COVID-19 and acute respiratory failure treated with CPAP

ABSTRACT Introduction: Patients admitted with COVID-19 often have severe hypoxemic respiratory insufficiency and it can be difficult to maintain adequate oxygenation with oxygen supplementation alone. There is a physiological rationale for the use of Continuous Positive Airway Pressure (CPAP), and CPAP could keep some patients off mechanical ventilation. We aimed to examine the physiological response to CPAP and the outcome of this treatment. Methods: Data from all patients admitted with COVID-19 and treated with CPAP, from March to July 2020 were collected retrospectively. CPAP was initiated on a medical ward when oxygen supplementation exceeded 10 liters/min to maintain oxygen saturation (SpO2) ≥92%. CPAP was administered with full face masks on a continuous basis until stable improvement in oxygenation or until intubation or death. Results: CPAP was initiated in 53 patients (35 men, 18 women) with a median (IQR) age of 68 (57–78) years. Nine patients were not able to tolerate the CPAP treatment. Median duration for the 44 patients receiving CPAP was 3 (2–6) days. The PaO2/FiO2 ratio was severely reduced to an average of 101 mmHg at initiation of treatment. A positive response of CPAP was seen on respiratory rate (p = 0.002) and on oxygenation (p < 0.001). Of the 44 patients receiving CPAP, 12 (27%) avoided intubation,13 (29%) were intubated, and 19 (43%) died. Of the patients with a ceiling of treatment in the ward (26 of 53) only 2 survived. Older age and high initial oxygen demand predicted treatment failure. Discussion: CPAP seems to have positive effect on oxygenation and respiratory rate in most patients with severe respiratory failure caused by COVID-19. Treatment with CPAP to severely hypoxemic patients in a medical ward is possible, but the prognosis for especially elderly patients with high oxygen requirement and with a ceiling of treatment in the ward is poor.

Human Face Recognition from Part of a Facial Image based on Image Stitching

Most of the current techniques for face recognition require the presence of a full face of the person to be recognized, and this situation is difficult to achieve in practice, the required person may appear with a part of his face, which requires prediction of the part that did not appear. Most of the current forecasting processes are done by what is known as image interpolation, which does not give reliable results, especially if the missing part is large. In this work, we adopted the process of stitching the face by completing the missing part with the flipping of the part shown in the picture, depending on the fact that the human face is characterized by symmetry in most cases. To create a complete model, two facial recognition methods were used to prove the efficiency of the algorithm. The selected face recognition algorithms that are applied here are Eigenfaces and geometrical methods. Image stitching is the process during which distinctive photographic images are combined to make a complete scene or a high-resolution image. Several images are integrated to form a wide-angle panoramic image. The quality of the image stitching is determined by calculating the similarity among the stitched image and original images and by the presence of the seam lines through the stitched images. The Eigenfaces approach utilizes PCA calculation to reduce the feature vector dimensions. It provides an effective approach for discovering the lower-dimensional space. In addition, to enable the proposed algorithm to recognize the face, it also ensures a fast and effective way of classifying faces. The phase of feature extraction is followed by the classifier phase. Displacement classifiers using square Euclidean and City-Block distances are used. The test results demonstrate that the proposed algorithm gave a recognition rate of around 95%, to validate the proposed algorithm; it compared to the existing CNN and Multibatch estimator method.

Noninvasive mechanical ventilation with helmet in patients with exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial

Objective ‒ to compare the incidence of complications and the main treatment outcomes of non-invasive mechanical ventilation (NIV) with a helmet versus NIV with a full face mask.Materials and methods. A monocentric randomized open-labeled controlled clinical trial. Patients with exacerbation of chronic obstructive pulmonary disease (COPD) with signs of respiratory failure were randomized to receive NIV through a mask or helmet. The study included 59 patients who were randomized into two groups: NIV through helmet (n = 29) or mask (n = 30). The average age of the patients was (59.24 ± 14.20) and (59.06 ± 15.90) years, respectively. In both groups men predominated ‒ 23 (79 %) and 27 (90 %) respectively. Ventilation was performed with a Draeger Carina apparatus in pressure support (PS) mode. The primary endpoint was the cumulative incidence of NIV complications. Secondary endpoints were PaO2/FiO2 ratio, tolerance to therapy, frequency of intubations, duration of stay in the intensive care unit (ICU), and ICU mortality. A total of 59 patients were involved in the study.Results. The complication rate was lower in the helmet group (10 % (n = 3) versus 43 % (n = 13), p = 0.004) and the PaO2/FiO2 ratio was higher at the first hour and at the end of NIV (253.14 ± 64.74) mm Hg versus (216.06 ± 43.86) mm Hg and (277.07 ± 84.89) mmHg versus (225.81 ± 63.64) mm Hg, p = 0.013 and p = 0.012) compared with NIV through a full face mask. More patients noted excellent helmet tolerance than masks at the 4th hour of therapy (24 (83 %) versus 14 (47 %), p = 0.004) and at the end of ventilation (69 % (20/29) versus 30 % (9/30), p = 0.03). One patient was unable to continue therapy due to mask intolerance. Differences in intubation rates, length of ICU stay, and mortality were statistically insignificant (p = 0.612, p = 0.100, p = 1.000 respectively).Conclusions. NIV through a helmet can reduce the incidence of complications and increase the PaO2/FiO2 ratio, as well as improve tolerance compared to NIV through a face mask in patients with exacerbation of COPD. A larger scale of study is needed to establish the effect of interface choice on ICU mortality, time spent in ICU, and frequency of intubation.