The ability to monitor stress levels in daily life can provide valuable information to patients and their caretakers, help identify potential stressors, determine appropriate interventions, and monitor their effectiveness. Wearable sensor technology makes it now possible to measure non-invasively a number of physiological correlates of stress, from skin conductance to heart rate variability. These measures, however, show large individual differences and are also correlated with the physical activity of the subject. In this paper, we propose two multivariate signal processing techniques to reduce the effect of both forms of interference. The first method is an unsupervised technique that removes any systematic variation that is orthogonal to the dependent variable, in this case physiological stress. In contrast, the second method is a supervised technique that first projects the data into a subspace that emphasizes these systematic variations, and then removes them from the data. The two methods were validated on an experimental dataset containing physiological recordings from multiple subjects performing physical and/or mental activities. When compared to z-score normalization, the standard method for removing individual differences, our methods can reduce stress prediction errors by as much as 50%.
The objective of this paper is to assess the efficacy of deep breathing as a relaxation activity using a wearable stress monitor. For this purpose, we developed a protocol with different mentally stressful activities interleaved with regular sessions of deep breathing. We used three physiological sensors: a heart rate monitor, a respiration sensor, and an electrodermal activity sensor, to extract parameters that are consistent with the dominance of the sympathetic nervous system. Our results indicate that a large number of subjects were not able to perform the paced deep breathing exercise properly, which caused their stress levels to increase rather than to decrease. The study also showed that our wearable stress monitor can be used to monitor breathing technique and assess its effectiveness in relaxing individuals.
Neurologic complications are a hallmark of infective endocarditis (IE). IE leading to intracranial abscess has an unfavorable prognosis. A 17-year-old boy with a past medical history of aortic valve replacement presented with fever and seizure. On examination, he had tachycardia, systolic murmur, slurred speech, meningeal signs, and right homonymous hemianopia. His laboratory analysis revealed an elevated erythrocyte sedimentation rate and C-reactive protein. The brain's magnetic resonance imaging revealed multiple ring-enhancing lesions in the frontal, occipital lobe, and occipitotemporal lobe, consistent with intracranial abscess. Transthoracic echocardiogram revealed a mobile mass adjacent to aortic value, consistent with possible infective vegetation. He was diagnosed with multiple cerebral septic emboli leading to intracranial abscess due to IE. Blood and cerebrospinal fluid culture revealed methicillinsensitive Staphylococcus aureus growth. He was started on intravenous nafcillin and gentamycin. His condition improved gradually, and he became afebrile on hospital day four. On his recent follow-up, he was doing well.
Purpose: To assess national endophthalmitis prophylaxis practice patterns during phacoemulsification surgery in Pakistan. Study Design: Cross sectional survey. Place and Duration of Study: Eye units registered with the British Pakistani Ophthalmic Society (BPOS) between September and November 2020. Methods: A survey-based cross sectional study was conducted in Pakistan between September and November 2020. A proforma was designed using a survey client (Survey Monkey) and distributed to the eye units registered with the British Pakistani Ophthalmic Society (BPOS). The survey explored demographic factors, current antibiotic prophylaxis practice during cataract surgery and audit practice in Pakistan. Results: A total of 339 respondents completed the survey. The survey was representative of ophthalmic surgeons working in the major provinces of Pakistan. A small majority of ophthalmic surgeons provided some form of routine antibiotic prophylaxis (n = 140, 53.8%). Povidone iodine 5% (PVP-I) solution on skin and in the conjunctival sac proved the most popular protocol (n = 163, 66.3%). This was followed by immediate postoperative topical antibiotics (n = 101, 41.1%). Intracameral antibiotic prophylaxis accounted for less than half of current antibiotic practice during cataract surgery in Pakistan (n=99, 40.3%). Most of the respondents did not conduct any audit regarding endophthalmitis (n = 119, 55.6%). Conclusion: Our survey provides an up-to-date view on the state of antibiotic prophylaxis during cataract surgery in Pakistan and highlights several areas for improvement. This includes policy changes to increase adherence to gold standard antibiotic prophylaxis guidelines, improvement in transparency of surgical outcomes and to audit current postoperative outcomes. Key Words: Acute postoperative endophthalmitis, Surgical wound infection, Antibiotic, Cataract, Pakistan.
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