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The traffic environment of mountainous highways is more complex than that of nonmountainous highways, with higher driving loads, which increases the risk in overtaking. The changes in the driver's pupils, eye gaze behavior, and heart rate can be used to evaluate the level of driving tension and safety. To analyze the driving load while overtaking on two-lane highways in mountainous areas, an actual vehicle test was conducted. Twenty-one drivers were divided into a skilled group and an unskilled group. The gaze time, gaze transfer characteristics, heart rate changes, and pupil area changes during the three stages of overtaking (intention, execution, and return) were compared and analyzed. The comprehensive evaluation of driving load during the overtaking process used the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method and Rank Sum Ratio (RSR) method. The results show that the two groups of drivers had the highest driving load during the overtaking execution stage and the lowest driving load during the intention stage. The driving load of overtaking on sections with poor-sight distance was significantly higher than that on sections with good-sight distance, and the risk in overtaking during the execution and return stages was highest on sections with poor-sight distance. It is possible to reduce the driving load if the driver is familiar with the road conditions or has a rich driving experience. Compared to the unskilled group, the skilled group had lower driving loads at all stages of overtaking. The research results can provide a theoretical basis for optimizing traffic safety prevention and control technology on mountainous highways and for designing intelligent driving assistance., Author(s): Tangzhi Liu [1]; Guyi Wang [1]; Wangxia Luo [2]; Ruihang Liu [3]; Xingliang Liu [1]; Tianjun Xiang [4]; Tong Liu (corresponding author) [1] 1. Introduction The environment of two-lane [...]

Purpose The use of an endotracheal tube (ET) cuff filled with alkalized lidocaine (AL) can suppress ET-induced emergence phenomena, such as hypertension, tachycardia and coughing, and postoperative sore throat (POST) and hoarseness (PH). The efficacy of intracuff lidocaine may vary depending on the cuff shape, but there has been no study on the effects of a tapered cuff filled with AL. We examined whether intracuff AL suppresses ET-induced emergence phenomena, POST and PH. Methods Sixty-two patients were enrolled in this study and the patients were randomly allocated to a group in which the tapered cuff was filled with AL (Group AL) and a group in which the tapered cuff was filled with normal saline (Group S). The primary outcomes of this study were changes in mean blood pressure (MBP) and heart rate (HR) at extubation. MBP, HR and the number of coughs were recorded before and up to 10 min after extubation. The degree of POST and the incidences of POST and PH were recorded at 15 min, 2 h and 24 h after extubation. Results Changes in MBP before extubation and HR before and after extubation were significantly lower in Group AL than in Group S (p < 0.025). The number of coughs at extubation and the incidence of PH at 2 h after extubation were significantly lower in Group AL than in Group S (p < 0.0001 and p = 0.014, respectively). Conclusion AL in a tapered cuff significantly suppresses ET-induced cardiovascular changes in MBP and HR., Author(s): Kumiko Ishida [sup.1], Yuki Maruyama [sup.1], Yuki Yoshiyama [sup.1], Mariko Ito [sup.1], Satoshi Tanaka [sup.1], Dandan Shen [sup.1], Mikito Kawamata [sup.1] Author Affiliations: (1) grid.263518.b, 0000 0001 1507 4692, [...]

Identifying the processes by which environmental stimuli can come to influence drug use is important for developing more efficacious interventions. This study investigated derived relational responding and the transfer of differential conditioned effects of environmental stimuli paired with 'smoked' cocaine in accordance with the relations of symmetry, transitivity, and equivalence using Heart Rate as the measure of conditioning among 12 adults with significant histories of cocaine use. Match-to-sample (MTS) procedures were used to test for emergent relations among two four-member stimulus groupings. One member of a group was then paired with 25-mg of smoked cocaine and one member of the other group was paired with 0-mg of smoked cocaine. Ten participants completed the MTS protocol: four participants demonstrated two four- member equivalence classes, three participants demonstrated two three-member equivalence classes, and two participants demonstrated symmetry only. One participant demonstrated no derived relations. Differential respondent elicited changes in HR was demonstrated in the presence of stimuli paired with smoked cocaine among four of the six participants completing the conditioning phase; all four of the participants demonstrated a bidirectional transfer of these functions in accordance with symmetry. Transfer was not reliably demonstrated in accordance with transitive or equivalence relations. The results suggest that respondent elicitation in the context of drug use may be a function of both direct conditioning and derived relational processes. These findings have implications for studying and understanding the processes by which stimuli in the natural ecology can set the occasion for cocaine use and developing cocaine use disorder. Keywords Stimulus equivalence * Respondent conditioning * Derived relations ? Cocaine use disorders * Transfer of respondent eliciting functions, Introduction Approximately 1.3 million Americans meet criteria for a cocaine use disorder (CUD; Center for Behavioral Health Statistics and Quality, 2021). Individuals struggling with CUD experience significant social, psychological, and [...]

ABSTRACT Background and Aims: Thoracic epidural and paravertebral blocks are gold standard analgesic techniques but they are associated with complications. Erector spinae plane (ESP) block is safer with comparable pain relief. ESP block is an established technique for postoperative pain relief. Its intraoperative use as an adjuvant to general anaesthesia (GA) is not yet known. The aim of this study was to assess the efficacy of ESP as an adjuvant to GA during laparoscopic surgery. Methods: This was a randomised controlled trial. Using a computer generated random number table, 50 patients were randomly allocated into two groups. Group G (n = 25) received GA and group GE (n = 25) received bilateral ESP (ultrasonography guided) block using 20 ml of 0.25 bupivacaine at the level of the transverse process of T6 before the induction of GA. Results: Group GE showed reduced requirement of fentanyl (P < 0.0001) and inhalational agents (P < 0.0001) with significant reduction in systolic blood pressure (P < 0.0001), diastolic blood pressure (P < 0.0001) and mean heart rate as compared to group G. Conclusion: ESP block is an easy, safe, excellent adjuvant to GA which reduces the requirement of analgesics and inhalational agents. Keywords: Epidural analgesia, erector spinae plane block, laparoscopy, ultrasound, Author(s): Sandip Baheti [1]; Cherukuri Kaushik (corresponding author) [1]; Sumedha Biswas [1] INTRODUCTION Haemodynamic changes during laparoscopic surgery are attributed to the induction of pneumoperitoneum. Cases are conventionally managed with [...]

Purpose We investigated whether hypokalemia developed during the postoperative period and whether the use of intravenous patient-controlled analgesia (IV-PCA) could decrease the incidence of postoperative hypokalemia in patients who underwent laparoscopic cholecystectomy. Methods Sixty patients undergoing laparoscopic cholecystectomy were randomly assigned to either IV-PCA (n = 30) or control (n = 30) groups. We measured serum potassium concentration at the outpatient department (T1), at 8:00 a.m. on the day of surgery (T2), at 6 h after the end of surgery (T3), and at 8:00 a.m. on the first (T4), second (T5), and third (T6) postoperative days. Serum potassium concentration, incidence of hypokalemia, mean blood pressure, heart rate, respiratory rate, and the patient-reported visual analogue scale score were compared within each group and between groups at each time point. Results Serum potassium concentrations in all patients showed a significant decrease at T2-T4 compared to the preoperative concentration (T1). Serum potassium concentrations at T3 and T4 in the IV-PCA group were significantly higher than those in the control group. Also, the incidence of hypokalemia at T3 and T4 was significantly lower in the IV-PCA group. Mean blood pressure and heart rate were significantly lower in the IV-PCA group than in controls at T3 and T4. Conclusions The results show that hypokalemia developed during the perioperative period and the use of IV-PCA in patients undergoing laparoscopic cholecystectomy effectively decreased the degree and incidence of postoperative hypokalemia on the day of the operation and postoperative day one. Keywords Patient-controlled intravenous analgesia * Hypokalemia * Arrhythmia * Catecholamine * Laparoscopic cholecystectomy, Introduction Potassium is the principal intracellular ion, and its concentration and gradients greatly influence the electrical activity of excitable membranes. Hypokalemia is known to increase the incidence of perioperative arrhythmia [...]

Byline: V. Mahesh, A. Kandaswamy, C. Vimal, B. Sathish Heart rate and Heart Rate Variability (HRV) are important measures that reflect the state of the cardiovascular system. HRV analysis has gained prominence in the field of cardiology for detecting cardiac abnormalities. This paper presents the study made on the use of linear (time domain and frequency domain) and nonlinear measures of heart rate variability for accurate classification of certain cardiac diseases. Three different classifiers, viz. Random Forests, Logistic Model Tree and Multilayer Perceptron Neural Network have been used for the classification. Data for use in this work has been obtained from the standard ECG databases in the Physionet website. Classification has been attempted using linear parameters, nonlinear parameters and combined. The classification results indicate that the combination of linear and nonlinear measures is a better indicator of heart diseases than linear or nonlinear measures alone. The results obtained by this study are comparable with those obtained with other techniques cited in the literature.