Minimal Head Research Articles

Strategies for motion- and respiration-robust estimation of fMRI intrinsic neural timescales

Abstract Intrinsic neural timescales (INT) reflect the time window of neural integration within a brain region and can be measured via resting-state fMRI (rs-fMRI). Despite the potential relevance of INT to cognition, brain organization, and neuropsychiatric illness, the influences of physiological artifacts on rs-fMRI INT have not been systematically considered. Two artifacts, head motion and respiration, pose serious issues in rs-fMRI studies. Here, we described their impact on INT estimation and tested the ability of two denoising strategies for mitigating these artifacts, high-motion frame censoring and global signal regression (GSR). We used a subset of the HCP Young Adult dataset with runs annotated for breathing patterns (Lynch et al., 2020) and at least one “clean” (reference) run that had minimal head motion and no respiration artifacts; other runs from the same participants (n = 46) were labeled as “non-clean.” We found that non-clean runs exhibited brain-wide increases in INT compared to their respective clean runs and that the magnitude of error in INT between non-clean and clean runs correlated with the amount of head motion. Importantly, effect sizes were comparable to INT effects reported in the clinical literature. GSR and high-motion frame censoring improved the similarity between INT maps from non-clean runs and their respective clean run. Using a pseudo-random frame-censoring approach, we uncovered a relationship between the amount of censored frames and both the mean INT and mean error, suggesting that frame censoring itself biases INT estimation. A group-level correction procedure reduced this bias and improved similarity between non-clean runs and their respective clean run. Based on our findings, we offer recommendations for rs-fMRI INT studies, which include implementing GSR and high-motion frame censoring with Lomb-Scargle interpolation of censored data, and performing group-level correction of the bias introduced by frame censoring.

Minimal Social Cues, Body Proportion, Head Shape, and Participant’s Gender on the Trustworthiness of Social Robots

Exploring and validating factors that may influence the trustworthiness of social robots is of great significance to improving the effect of human-robot interaction. The purpose of this study was to explore the impact of several design factors on people’s perceptions of the trustworthiness of social robots. The research variables were social cues (ie, watching-eyes configuration, control configuration, and neutral configuration), head shape (ie, round head and rectangular head), body proportion (ie, low body proportion and high body proportion), and participant’s gender (ie, male and female). Twelve static synthetic social robots were created and presented to the participants as digital pictures. A total of 175 participants took part in the experiment through the online survey via the convenience sampling method. The generated results were as follows: (1) The robots with round heads appear to be more trustworthy than those with rectangular heads. (2) Robots with high body proportion are considered to be more trustworthy than robots with low body proportion. (3) Minimal social cues and body proportion of robots also have a significant interaction effect on improving the trustworthiness of robots. In the watching-eyes configuration, high body proportion is considered more trustworthy than low body proportion. On one hand, the results of this study can provide a good reference for the appearance form of social robots in human-robot interaction to serve human beings, and on the other hand, it also lays a foundation for further exploring the influence of social cues elicited by a series of social robot appearances and social behaviors regarding the trustworthiness of social robots.

Preliminary Evaluation of the Scandinavian Guidelines for Initial Management of Minimal, Mild, and Moderate Head Injuries with Glial Fibrillary Acidic Protein.

Glial fibrillary acidic protein (GFAP) has become the most promising biomarker for detecting traumatic abnormalities on head computed tomography (CT) in patients with traumatic brain injury (TBI), but most studies have not addressed the potential added value of combining the biomarker with clinical variables that confer risk for intracranial injuries. The Scandinavian Guidelines for Initial Management of Minimal, Mild, and Moderate Head Injuries in Adults were the first clinical decision rules in the field with an incorporated biomarker, the S100 astroglial calcium-binding protein B (S100B), which is used in the Mild (Low Risk) group defined by the guidelines. Our aim was to evaluate the performance of the guidelines when S100B was substituted with GFAP. The sample (N = 296) was recruited from the Tampere University Hospital's emergency department between November 2015 and November 2016, and there were 49 patients with available GFAP results who were stratified in the Mild (Low Risk) group (thus patients undergoing biomarker triaging). A previously reported cutoff of plasma GFAP ≥140 pg/mL was used. Within the Mild (Low Risk) group (n = 49), GFAP sensitivity (with 95% confidence intervals in parentheses) for detecting traumatic CT abnormalities was 1.0 (0.40-1.00), specificity 0.34 (0.19-0.53), the negative predictive value (NPV) 1.0 (0.68-1.00), and the positive predictive value (PPV) 0.16 (0.05-0.37). The sensitivity and specificity of the modified guidelines with GFAP, when applied to all imaged patients (n = 197) in the whole sample, were 0.94 (0.77-0.99) and 0.20 (0.15-0.28), respectively. NPV was 0.94 (0.80-0.99) and PPV 0.18 (0.13-0.25). In the Mild (Low Risk) group, none of the patients with GFAP results below 140 pg/mL had traumatic abnormalities on their head CT. These findings were derived from a small patient subgroup. Future researchers should replicate these findings in larger samples and assess whether GFAP has added or comparable value to S100B in acute TBI management.

Simultaneous multislice EPI prospective motion correction by real-time receiver phase correction and coil sensitivity map interpolation.

To improve the image reconstruction for prospective motion correction (PMC) of simultaneous multislice (SMS) EPI of the brain, an update of receiver phase and resampling of coil sensitivities are proposed and evaluated. A camera-based system was used to track head motion (3 translations and 3 rotations) and dynamically update the scanposition and orientation. We derived the change in receiver phase associated with a shifted field of view (FOV) and applied it in real-time to each k-space line of the EPI readout trains. Second, for the SMS reconstruction, we adapted resampled coil sensitivity profiles reflecting the movement of slices. Single-shot gradient-echo SMS-EPI scans were performed in phantoms and human subjects for validation. Brain SMS-EPI scans in the presence of motion with PMC and no phase correction for scan plane shift showed noticeable artifacts. These artifacts were visually and quantitatively attenuated when corrections were enabled. Correcting misaligned coil sensitivity maps improved the temporal SNR (tSNR) of time series by 24% (p = 0.0007) for scans with large movements (up to ˜35 mm and 30°). Correcting the receiver phase improved the tSNR of a scan with minimal head movement by 50% from 50 to 75 for a United Kingdom biobank protocol. Reconstruction-induced motion artifacts in single-shot SMS-EPI scans acquired with PMC can be removed by dynamically adjusting the receiver phase of each line across EPI readout trains and updating coil sensitivity profiles during reconstruction. The method may be a valuable tool for SMS-EPI scans in the presence of subject motion.

Review of hydraulic performance of open‐channel flow‐measuring flumes

The review explored various flumes used for open channel flow measurement and provided insight into operational concepts, discharge measurement, range of flow, head loss requirements, degree of accuracy and submergence, advantages, and limitations for use. The reviewed flumes included; Parshall flumes, Montana flumes, Cutthroat flumes, H-flumes, Trapezoidal flumes, Replogle-Bos-Clemmens (RBC) flumes, Palmer-Bowlus flumes and Central Baffle flumes (CBF). Based on the stage and discharge relationship, the reviewed flumes have a reasonable accuracy of ± 10 % over a wide range of flows. RBC flumes are the most accurate flumes (± 2 %). For flows that deal with a lot of sediments, most flumes have self-cleaning capability except for Palmer-Bowlus flumes and Central Baffle flumes. H-flumes have low resistance to submergence. The submergence transition for H-flumes is only 25-30 %. RBC flumes and Palmer-Bowlus flumes have the highest submergence (90 %). CBF and Palmer-Bowlus flumes need to be improved in order to have self-cleaning capability. Submerged flow corrections need to be developed and published for Palmer-Bowlus flumes and RBC flumes. The reviewed flumes effectively operate with a minimal head loss. The review has provided an insight on selection of an appropriate type of flume for flow measurement in open channels.

Findings on Repeat Posttraumatic Brain Computed Tomography Scans in Older Patients With Minimal Head Trauma and the Impact of Existing Antithrombotic Use.

Evaluate the utility of routine rescanning of older, mild head trauma patients with an initial negative brain computed tomography (CT), who is on a preinjury antithrombotic (AT) agent by assessing the rate of delayed intracranial hemorrhage (dICH), need for surgery, and attributable mortality. Participating centers were trained and provided data collection instruments per institutional review board-approved protocols. Data were obtained from manual chart review and electronic medical record download. Adults ≥55 years seen at Level I/II Trauma Centers, between 2017 and 2019 with suspected head trauma, Glasgow Coma Scale 14 to 15, negative initial brain CT, and no other Abbreviated Injury Scale injuries >2 were identified, grouped by preinjury AT therapy (AT- or AT+) and compared on dICH rate, need for operative neurosurgical intervention, and attributable mortality using univariate analysis (α=.05). A total of 2,950 patients from 24 centers were enrolled; 280 (9.5%) had a repeat brain CT. In those rescanned, the dICH rate was 15/126 (11.9%) for AT- and 6/154 (3.9%) in AT+. Assuming nonrescanned patients did not suffer clinically meaningful dICH, the dICH rate would be 15/2001 (0.7%) for AT- and 6/949 (0.6%) for AT+. No surgical operations were done for dICH. All-cause mortality was 9/2950 (0.3%) and attributable mortality was 1/2950 (0.03%). The attributable death was an AT+, dICH patient whose family declined intervention. In older patients with an initial Glasgow Coma Scale of 14 to 15 and a negative initial brain CT scan, the dICH rate is low (<1%) and of minimal clinical consequence, regardless of AT use. In addition, no patient had operative neurosurgical intervention. Therefore, routine rescanning is not supported based on the results of this study.

Dependence of P/E tRNA hybrid formation on subunit rotation in the ribosome.

The ribosome, a massive nucleoprotein assembly that executes protein synthesis in all living cells, undergoes several large-scale functional rearrangements during the protein elongation cycle. Here we explore two such rearrangements in the ribosome bound tRNA molecules during the translocation step in bacteria, namely, P/E tRNA hybrid formation and inter-subunit rotation in the ribosome. We utilize multi-basin all-atom structure-based models and Ribosome Angle Decomposition (RAD) method to study the dependence of P/E hybrid formation on rotation of small subunit body with respect to the large subunit. Structure-based models provide simplified energetics with experimental atomic structures defined to be the potential energy minima. We employ these models to simulate spontaneous transition of the P-tRNA from P to E tRNA binding site on the large subunit for different degrees of small subunit body rotation. RAD method provides a complete coordinate system that describes any orientation of the ribosomal small subunit body and head in terms of rotation, tilt, tilt direction and translation. We identify reference E. coli structures at different degrees of body rotation but with minimal body tilt, head rotation and head tilt from the Ribosome Analysis Database based on RAD. Utilizing these methods, we explore the influence of subunit rotation on the free-energy barrier associated with P/E tRNA hybrid formation and obtain the quantitative dependence of P/E hybrid formation on subunit rotation.

Pico hydro turbine building design utilizing irrigation water power: CFD Simulation

Using hydraulic energy from irrigation flows to become electrical energy as renewable energy still needs to be conducted. Therefore, this research aims to design a pico hydro turbine building powered by irrigation water and its energy tests and analyses. The turbine building design has been simulated with the CFD (Computational Fluid Dynamics). The method used in this study is the solver approach simulation method which is analyzed with flow s imulation applications and analyzed using the kinetic energy equation to obtain the hydraulic energy value of the channel, where previously the turbine building design used computer-aided design. Furthermore, in irrigation canals, energy values are obtained. The impulse turbine is 3.6 - 5 kW, and the helixes turbine is 0.02-0.25 kW, the Kaplan turbine is 0.29 – 0.3 kW, for Kaplan turbine with minimal head 1 m.

The Risk of Benign Paroxysmal Positional Vertigo After Head Trauma.

Head trauma may cause dislodgement of otoconia and development of benign paroxysmal positional vertigo (BPPV). The risk of developing BPPV is expected to be highest shortly after the trauma, then decrease and approach the risk seen in the general population. The aim of this study was to estimate the risk-time curve of BPPV development after head trauma. Prospective observational study. Patients with minimal, mild, or moderate head trauma treated at the Department of Neurosurgery or the Department of Orthopedic Emergency at Oslo University Hospital, were interviewed and examined for BPPV using the Dix-Hallpike and supine roll maneuvers. BPPV was diagnosed according to the International diagnostic criteria of the Bárány Society. Telephone interviews were conducted at 2, 6, and 12 weeks after the first examination. Out of 117 patients, 21% developed traumatic BPPV within 3 months after the trauma. The corresponding numbers were 12% with minimal trauma, 24% with mild, and 40% with moderate trauma. The difference in prevalence between the groups was significant (P= .018). During the first 4 weeks after the trauma, it was observed 20, 3, 0, and 1 BPPV onsets, respectively. No BPPV cases were seen for the remainder of the 3-month follow-up. The risk of developing BPPV after minimal-to-moderate head trauma is considerable and related to trauma severity. Most cases occur within few days after the trauma, but any BPPV occurring within the first 2 weeks after head trauma are likely due to the traumatic event. 3 Laryngoscope, 132:443-448, 2022.

Heart Rate Measurement

In recent studies on non-invasive techniques for heart rate measurements, various Computer Vision algorithms based on Ballistocardiography (BCG) have been employed. This method captures minimal head motions from facial videos, that result from the pumping of blood to the head through the carotid arteries, at each cardiac cycle. We move towards BCG because the conventional technique of Photoplethysmography (PPG) fails to yield accurate results from facial video in case of skin color variations. This paper proposes an improved system for accurately measuring the heart rate and heart rate variability to infer important information about the subject’s health. It incorporates functions from the Dlib toolkit, which provide robust face detection along with facial landmark tracking. Relevant data in terms of facial video and ground truth was acquired from 5 test subjects, in 3 states - sitting, standing and post exercise. The system exhibits promising results when validated using a wearable smart watch with inbuilt heart rate sensor.

Cervical Spinal Cord Surgical Stabilization in a Sheep

Background: Trauma is the main cause of spinal fractures and dislocations in humans and large animals. Clinical signs present with acute onset and vary according to the location and severity of the spinal cord injury. The treatment of fractures in large animals depends on economic value, cost of procedures, prognosis, location and type of fracture. However, although spinal fractures in large animals are not uncommon, the literature about their clinical aspects and treatment is scanty. Therefore, the purpose of this report is to describe a surgical stabilization of atlantoaxial subluxation, fracture of the third cervical vertebra and C2-C3 subluxation.Case: An approximately 2-year-old Île-de-France sheep, weighing 101 kg, with a history of cervical trauma and non-ambulatory tetraparesis was treated at the Veterinary Hospital of the Institution (UNIPAMPA). During physical examination, the animal presented good general physical condition and heart rate, respiratory rate and temperature was according to physiological parameters for the species. The animal remained in lateral decubitus, with minimal head and limb movements, and exhibited deep pain sensitivity. Clinical treatment with dexamethasone, limb physiotherapy and change in lateral decubitus position were employed, but failed to improve the animal’s condition. After five days of unresponsive to clinical treatment, the patient was referred to the neurology department, where it underwent neurological examination and radiographic examination of the cervical region was performed under general anesthesia. The radiographic examination revealed atlantoaxial subluxation, by displacement of the odontoid process into the vertebral canal, fracture of the third cervical vertebra and C2-C3 vertebral subluxation. The surgical planning aimed cervical vertebral instability repair using atlantoaxial arthrodesis associated the stabilization of C1-C2 and C2-C3 vertebrae with Schanz pins and bone cement, due facility and versatility this association. The postoperative radiographic examination showed incomplete insertion of the Schanz pin into the left Atlas wing and a cervical collar was recommended. The clinical evaluation was performed daily, and after 23 days of surgery the animal could crawl in lateral decubitus besides assisted walking ability. However, the animal died 36 days after surgery due to severe dyspnea. A necropsy revealed pulmonary edema and hepatic lipidosis, besides hepatic septic thrombus. Moreover, the vertebral canal of C1-C2 and C2-C3 segments stayed realigned and stabilized, without spinal cord injury and trachea compression.Discussion: Non-ambulatory tetraparesis, and minimal head and limb movements confirm severe spinal cord injury. The failure of clinical treatment, craniocervical instability in C1-C2 and C2-C3 and the high economic and genetic value of patients was definite for the surgical indication, besides reserved prognosis. The surgical treatment aim is recovery motor function from spinal cord decompression, vertebral canal realignment and the stabilization of vertebral instability. The cervical collar was placed on the patient after the surgery was intended to prevent rotation of the atlantoaxial joint, aiding vertebral stability. It is believed that the recovery of large animals with spinal cord injuries like in this case report is slower due to their heavy weight and the difficulty in managing such patients. This case report confirms that the techniques employed here achieved the proposed objectives of spinal canal alignment and spinal stabilization, showing improvement of clinical signs and recovery of the animal’s limb and neck movements.

An Assistive Magnetic Skin System: Enabling Technology for Quadriplegics

People with quadriplegia no longer have control over their legs, neither the hands and cannot continue living their life independently. On top of that, severely injured quadriplegics (i.e., C1 and C2 injuries) suffer from speaking difficulties and minimal head and neck movements. With the advancement in wearable artificial skins and the Internet‐of‐Things, realizing comfortable and practical solutions for quadriplegics is more tangible than ever. Herein, a comprehensive assistive magnetic skin system is presented that allows quadriplegics, including the severely injured ones, to move around individually and control their surroundings with ease. The system tracks facial expressions by tracking the movement of magnetic tattoos attached to the face, using magnetic field sensors incorporated into eyeglasses. The magnetic tattoos are made of highly flexible, stretchable, breathable, and biocompatible magnetic skins. In combination with smart‐glasses, smart‐wheelchair, and smart‐gadgets, the users can move around and control their environment with their facial expressions. The system is also designed to allow quadriplegics to perform outdoor activities effortlessly. It supports line‐of‐sight communication and does not require pretethering to the smart‐gadgets, unlike the existing solutions. Thus, enabling the user to walk on pathways, activate pedestrian lights, control public elevators, and perform various outdoor activities independently.

Surgical Management of Complex Anomalous Head Posture in Idiopathic Infantile Nystagmus

Idiopathic infantile nystagmus (IIN) is usually associated with a null zone, which is the zone of minimal nystagmus intensity. An anomalous head posture (AHP) is adopted to shift the null zone from an eccentric position to primary position. A complex AHP may include head position involvement in different ocular axes-namely face turn, chin elevation or depression and head tilt or a combination of these. Surgically, various procedures have been described for correction of this condition. We evaluated 2 children aged six and ten years, who presented with shaking of eyes along with presence of a complex AHP. First child had 20 degrees right face turn, 20 degrees right head tilt and 10 degrees of chin elevation. She underwent a combination of 2 procedures-augmented Anderson’s procedure for correction of right face turn and modification of Kestenbaum procedure for right head tilt along with bilateral IR recession, for correction of chin elevation. Postoperatively, AHP was satisfactorily corrected to 5 degrees face turn and minimal head tilt, and it remained stable for one year. The second child had left face turn 15 degrees, with right head tilt of 20 degrees and chin depression 10 degrees. He underwent a combination of 2 procedures-augmented Anderson’s procedure for correction of left face turn and modification of Kestenbaum procedure for right head tilt along with bilateral SR recession, for correction of chin depression. Postoperatively, AHP was satisfactorily corrected to 5 degrees face turn and minimal head tilt, which remained stable over a period of one year. In both cases, AHP was corrected by operating on only 2 muscles in each eye (one horizontal and one vertical) at a time. As both cases presented with combination of both torsional and vertical components of AHP, we decided to treat them both by surgery on a single vertical rectus muscle bilaterally to correct the chin position (elevation or depression), as well as torticollis (transposition of vertical recti, either nasally or temporally as needed). Since a third rectus muscle was not operated upon, there was a lesser possibility of developing anterior segment ischaemia. Additionally, as all components of AHP were corrected in one session, need for a second procedure under general anaesthesia to correct residual AHP was avoided in both cases.

Rare Case Of Avascular Necrosis In A Dodgeball Player

HISTORY: A 27-year-old male presented with left anteromedial hip/groin pain for 2 weeks. He competes in a dodgeball league and plays occasional racquetball as well. After a dodgeball game, he noted onset of hip and groin pain, which became progressively severe, and went to a local Emergency Department. He had x-rays and were told they were normal, however he had significant pain even with weightbearing at this point. No past history of hip dysplasia, dislocation, hip surgery. PHYSICAL EXAMINATION: Hip flexion was 110°, internal rotation 20°, external rotation 60°, abduction 45°; significant pain with flexion, adduction, and internal rotation, and positive FABER. He was able to ambulate without assistance. DIFFERENTIAL DIAGNOSIS: • Labral tear • Femoroacetabular impingement • Femoral neck stress fracture • Loose body • Chondral defect • Athletic pubalgia TESTS AND RESULTS: X-rays were obtained and suggested minimal left femoral head collapse, and did suggest mild right femoral head sclerosis; an MRI showed large areas of grade 2 avascular necrosis bilaterally. The left had a joint effusion, edema in addition to necrotic fatty signal in the femoral head compatible with early collapse. FINAL/WORKING DIAGNOSIS: Bilateral hip avascular necrosis with early left collapse. TREATMENT/OUTCOME: - Internal Medicine and Rheumatology referral for serological work up. - Referred to Orthopedic Surgeon; recommended toe-touch weightbearing, counseled on risk of progression. Alendronate was considered as with precollapse Ficat stages 0-II. - At 8 months, left hip pain was progressing, and noted onset of right hip pain. X-rays showed visible left AVN on the entire weightbearing surface with collapse and flattening of the superior articular surface; right hip now showed subtle sclerosis. - His only pertinent history included a brief course of oral corticosteroids when he got his wisdom teeth removed, which he did not initially disclose. This case reports an unusual etiology of an avascular necrosis after taking a short-term dose of corticosteroids. Case raises awareness to counsel health providers about collaborating to provide patients with optimal care and avoid potential serious side effects.

Performance assessment of direct injection compressed natural gas vehicle at different injection pressures using speed-sweep test method

This paper presents an experimental study on a high-pressure direct injection compressed natural gas engine (HPDI-CNG) vehicle using speed-sweep test method. The objective of this work is to assess the performances of the HPDI-CNG after installation of a new DI configuration on the engine. The gas direct injectors which were converted from gasoline direct injection (GDI) unit injector are side-positioned on an inline 4-cylinder 4 stroke CAMPRO 1.6 engine with minimal cylinder head modification. The original electronic control unit was replaced with a programmable HALTEC controller and the engine was set to operate in bi-fuel mode. The HPDI-CNG vehicle prototype is tested on chassis dynamometer by using speed-sweep test procedure. The tests were carried out in vehicle simulation mode for acceleration from 20 mph to 40 mph based on the ramp input from idle-speed to wide-open throttle opening. The responses of the engine were recorded as transient output data. The HPDI-CNG engine output produced lower performances compared to the same engine with gasoline port injection. This is demonstrated by the maximum engine speed, brake torque and brake power which are recorded to be 2800 rpm, 63 Nm, and 17 kW respectively. It can be concluded that the use of side-positioned direct injector of HPDI-CNG system is unable to increase engine performance if compared to a gasoline port gasoline engine. Moreover, the use of throat- geometry has resulted in a lower performance of HPDI-CNG engine compared to a standard CNG-DI engine. The main factor which affected the HPDI-CNG engine is the ability of the system to deliver sufficient fuel mass at the correct amount and timing as well as the insufficiencies of the air supplies to oxidize the fuel completely.

Validation of the scandinavian guidelines for initial management of minor and moderate head trauma in children

BackgroundHead trauma in children is common, with a low rate of clinically important traumatic brain injury. CT scan is the reference standard for diagnosis of traumatic brain injury, of which the increasing use is alarming because of the risk of induction of lethal malignancies. Recently, the Scandinavian Neurotrauma Committee derived new guidelines for the initial management of minor and moderate head trauma. Our aim was to validate these guidelines.MethodsWe applied the guidelines to a population consisting of children with mild and moderate head trauma, enrolled in the study: “Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study” by Kuppermann et al. (Lancet 374(9696):1160–1170, https://doi.org/10.1016/S0140-6736(09)61558-0, 2009). We calculated the negative predictive values of the guidelines to assess their ability to distinguish children without clinically-important traumatic brain injuries and traumatic brain injuries on CT scans, for whom CT could be omitted.ResultsWe analysed a population of 43,025 children. For clinically-important brain injuries among children with minimal head injuries, the negative predictive value was 99.8% and the rate was 0.15%. For traumatic findings on CT, the negative predictive value was 96.9%. Traumatic finding on CT was detected in 3.1% of children with minimal head injuries who underwent a CT examination, which accounts for 0.45% of all children in this group.ConclusionChildren with minimal head injuries can be safely discharged with oral and written instructions. Use of the SNC-G will potentially reduce the use of CT.

A Comparative Study Installation Arrangement of Primary Flight Display (PFD) in the Flight Deck’s Regional Passenger Transport Aircraft

The Flight Deck or cockpit is designed to support the prosecution of aircraft mission. For aircraft with commercial purpose such as passenger transport aircraft, there must be good “fit” between the human, the machine which composed of various aircraft system and the aircraft mission; and these are what the Flight Deck design process needs to ensure but not limited to display design, aircraft control, automation, HCI on the Flight Deck and pilot’s view to outside through cockpit windows namely external vision. The external vision of cockpit windows must satisfy regulatory requirements which intended to ensure that the view is adequate for pilots to operate the aircraft safely and gives them a reasonable opportunity to see and avoid other aircraft that pose a collision threat.Concurrently during critical periods of flight, it is important that the flight crew access information in front of his view with minimal head rotation. Cockpit-Displays with critical flight information should then be located to these locations. Compromising both external vision and internal vision as Pilot’s visibility should be attained.

Prospective Validation of the Scandinavian Guidelines for Initial Management of Minimal, Mild, and Moderate Head Injuries in Adults.

The Scandinavian Guidelines for Initial Management of Minimal, Mild, and Moderate Head Injuries in Adults (Scandinavian guidelines) are the first to incorporate serum measurement of the S100 astroglial calcium-binding protein B (S100B) to emergency department (ED) triage of patients with head injury (HI). This prospective validation study was conducted in the ED of the Tampere University Hospital, Finland, between November 2015 and November 2016. All consecutive adult patients with HI presenting to the ED within 24 h from injury were eligible for inclusion. Venous blood for S100B sampling was drawn from all patients, and the result was available at the ED. Computed tomography (CT) scans of the head were performed according to the on-call physician's evaluation. Only the samples collected within 6 h after injury were used. A one-week follow-up was conducted to identify possible HI-related complications. A total of 295 patients (median age, 67.0 years, range, 18-100; women, 48.8%) were enrolled. Of those, 196 (66.4%) underwent scanning. Acute traumatic lesions were detected on 31 (15.8%) of the scans. Two of the CT-positive patients were scanned without a guidelines-based indication. These lesions did not require any specific treatment or repeated imaging. The guidelines-based sensitivity was 0.94 (95% confidence interval [CI], 0.77-0.99) and specificity 0.19 (95% CI, 0.13-0.26) for predicting traumatic intracranial CT abnormalities. The positive and negative predictive value for positive head CT was 0.18 (95% CI, 0.12-0.25) and 0.94 (95% CI, 0.78-0.99), respectively. In the mild-low risk group, no false negative S100B values were recorded. Thirteen patients (4.4%) were re-admitted to the ED, and two patients (0.7%) died one week after the primary HI. The deaths were unrelated to the injury. None of these adverse events were directly caused by a primarily undiagnosed intracranial injury. The Scandinavian guidelines incorporated with S100B are a valid means of screening clinically significant acute traumatic lesions after HI and have the potential to reduce unnecessary CT scanning.

Numerical modeling of continuous-flow left ventricular assist device performance.

Responses of five rotary blood pumps, namely HeartAssist 5, HeartMate II, HeartWare, Sputnik 1, and Sputnik 2, were extensively assessed in six test cases using a mathematical model of the cardiovascular system. Data for the rotary pumps were derived from pressure-flow curves reported in the literature. The test cases were chosen to attempt to cover most common clinical conditions, such as partial or full support or transitions between different levels of ventricular support. The investigated parameters are collected in a table and presented in figures, such as pressure-volume loops, H-Q curves, pump flow, and aortic pressure waveforms. HeartAssist, Sputnik 1, and Sputnik 2 pumps provide comparable level of aortic pressure, pump flow pulsatility PI(QP), and aortic pressure pulsatility PI(AoP) due to the similarity of pressure-flow characteristic curves of these pumps. HeartMate II provides a minimal backflow among other investigated rotary blood pumps due to the maximum pressure head at zero flow. HeartWare provides minimal pulsation of flow, which is confirmed by a flow range from -2 to 7 L/min in case 1. At the same time, the greatest degree of unloading was demonstrated by the HeartWare due to the flatness of the pressure-flow curve shape. The conclusions were made based on the obtained results, including the influence of pressure-flow curve shape on the pump performance and occurrences of adverse events, such as backflow or suction. For example, the increase of the pressure head at zero flow decreases the likelihood of backflow through the pump, and with it, increasing the flow under minimal pressure head increases the likelihood of suction.

Utility and effectiveness of the Scandinavian guidelines to exclude computerized tomography scanning in mild traumatic brain injury - a prospective cohort study

BackgroundIn 2013 the Scandinavian Neurotrauma Committee (SNC) published updated guidelines for the initial management of minimal, mild and moderate traumatic head injuries (MTHI) that included serum analysis of protein S100B as a marker for brain tissue damage. This study reviews the effectiveness of the new guidelines in a clinical setting.MethodsFor all patients admitted to Akershus University Hospital (AHUS) from June 30th 2014 to December 15th 2014 with MTHI a separate form was filled in recording the time, indication and result of any S100B sampling and/or head computer tomography (CT) examinations. Data from these forms were compared to information derived from the electronic patient records for patients with MTHI and related diagnoses and data from the laboratory for all patients that had undergone the S100B analysis within the same period.ResultsFive hundred seventy-five patients were identified with MTHI, S100B sampling was indicated for 223 (38.8%) patients and carried out for 188 (84.3%) of these patients. 69 (36.7%) of the patients had a negative S100B test, but a head CT scan was still performed in 31 cases despite the negative S100B test. In total the guidelines were followed for 362 of 575 patients (63.0%). 180 (31.3%) of the MTHI cases were discharged without further observation or CT examinations, including 38 (21.1%) as a direct result of S100B testing. No re-admissions or missed initial traumatic brain injuries were observed.ConclusionThe implementation of the updated SNC guidelines resulted in direct discharge of more than one third of the MTHI cases without further observation or CT examinations. One in five of these discharges was a direct result of S100B testing. However, compliance to the guidelines were poor and the guidelines were only followed in 40%. While this study showed benefits of implementing SNC guidelines to reduce the number of CT scans, additional training is needed for optimal use.