Breathe-squeeze: pharmacodynamics of a stimulus-free behavioural paradigm to track conscious states during sedation☆.

BACKGROUND: Conscious states are typically inferred through responses to auditory tasks and noxious stimulation. We report the use of a stimulus-free behavioural paradigm to track state transitions in responsiveness during dexmedetomidine sedation. We hypothesised that estimated dexmedetomidine effect-site (Ce) concentrations would be higher at loss of responsiveness (LOR) compared with return of responsiveness (ROR), and both would be lower than comparable studies that used stimulus-based assessments. METHODS: Closed-Loop Acoustic Stimulation during Sedation with Dexmedetomidine data were analysed for secondary analysis. Fourteen healthy volunteers were asked to perform the breathe-squeeze task of gripping a dynamometer when inspiring and releasing it when expiring. LOR was defined as five inspirations without accompanied squeezes; ROR was defined as the return of five inspirations accompanied by squeezes. Brain states were monitored using 64-channel EEG. Dexmedetomidine was administered as a target-controlled infusion, with Ce estimated from a pharmacokinetic model. RESULTS: Counter to our hypothesis, mean estimated dexmedetomidine Ce was lower at LOR (0.92 ng ml-1; 95% confidence interval: 0.69-1.15) than at ROR (1.43 ng ml-1; 95% confidence interval: 1.27-1.58) (paired t-test; P=0.002). LOR was characterised by progressively increasing fronto-occipital EEG power in the 0.5-8 Hz band and loss of occipital alpha (8-12 Hz) and global beta (16-30 Hz) power. These EEG changes reverted at ROR. CONCLUSIONS: The breathe-squeeze task can effectively track changes in responsiveness during sedation without external stimuli and might be more sensitive to state changes than stimulus-based tasks. It should be considered when perturbation of brain states is undesirable. CLINICAL TRIAL REGISTRATION: NCT04206059.

Ambient intelligence-based multimodal human action recognition for autonomous systems.

Human activity recognition can deduce the behaviour of one or more people from a set of sensor measurements. Despite its widespread applications in monitoring activities, robotics, and visual surveillance, accurate, meticulous, precise and efficient human action recognition remains a challenging research area. As human beings are moving towards the establishment of a smarter planet, human action recognition using ambient intelligence has become an area of huge potential. This work presents a method based on Bi-Convolutional Recurrent Neural Network (Bi-CRNN) -based Feature Extraction and then Random Forest classification for achieving outcomes utilizing Ambient Intelligence that are at the cutting edge of human action recognition for Autonomous Robots. The auto fusion technique used has improved fusion for utilizing and processing data from various sensors. This paper has drawn comparisons with already existing algorithms for Human Action Recognition (HAR) and tried to propose a heuristic and constructive hybrid deep learning-based algorithm with an accuracy of 94.7%.

A clinico-histopathological study of lupus vulgaris: A 3 year experience at a tertiary care centre.

BACKGROUND: Lupus vulgaris is the most common form of cutaneous tuberculosis in adults. Lupus vulgaris is caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body. histologically it is charecterised by typical tubercles with or without caseation, surrounded by epitheloid histiocytes and multinucleate giant cells in the superficial epidermis with prominent peripheral lymphocytes. MATERIALS AND METHOD: All cases of clinically and histopathologicaly diagnosed lupus vulgaris over the previous five years were included in the study. RESULTS: Fourteen cases of lupus vulgaris cases reported during the study period with eaqual incidence among males and females. DISCUSSION: Plaque type of lupus vulgaris was the most common type. Histopathologically tubercular granulomas were seen in all cases as compared to other studies. CONCLUSION: Different patterns of lupus vulgaris are reported.