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Background and Aims: Fast tracking (FT) for more efficacious use of resources may be difficult after living donor liver transplantation (LDLT) due to a partial liver graft, complex vascular anastomoses and longer operating time. Our study was aimed at reporting our experience with FT (on table extubation) in LDLT recipients. A secondary objective of our study was to look at defining a subgroup of patients who could be prospectively planned for FT. Methods: We studied the demographics and outcomes of 15 LDLT recipients extubated immediately in the operating suite based on an uneventful intraoperative course, haemodynamic stability after graft reperfusion and improvement of metabolic parameters post-implantation and vascular anastomoses. Results: Twelve recipients were males, and mean age, body mass index (BMI) and Model for End Stage Liver Disease (MELD) score were 43 ± 12 years, 23 ± 3 kg/m2 and 15.5 ± 6, respectively, most were Child-Turcotte-Pugh Class B. Diabetes and hypothyroidism were present in 1 and 2 patients, respectively. Post-extubation, none required immediate re-intubation and one patient needed non-invasive ventilation for 2 h. Conclusion: Fast tracked recipients were young, with a low BMI, low MELD scores, minimal comorbidities and good immediate graft function post-reperfusion.

The present power production companies are working on renewable energy systems because their features are more reliable for the local energy consumers, high continuity in the energy production, and less cost is required for maitainence. In this article, the proton exchange membrane fuel stack (PEMFS) renewable energy is utilized to supply energy to the automotive systems. Here, the PEMFS is selected because of its merits are high energy density, quick system response concerning the source operational temperature, and more suitable for electric vehicle application. However, the PEMFS supplied voltage is completely nonlinear which is solved by utilizing the modified particle swarm optimization with adaptive neuro-fuzzy inference system (MPSO with ANFIS) controller. This hybridization-based maximum power point tracking controller provides more accuracy, high power point identifying speed, best dynamic response at different fuel stack functioning temperature conditions, and easy maitainence. Here, the fuel stack generated current is very high which is optimized by introducing the new DC–DC converter. The advantages of this DC–DC converter are more voltage transformation ratio, low-level voltage stress appearing across the switches, and wide voltage gain. The overall system is investigated by utilizing the MATLAB/Simulink tool.

Marker-based optical tracking systems (OTS) are widely used in clinical image-guided therapy. However, the emergence of ghost markers, which is caused by the mistaken recognition of markers and the incorrect correspondences between marker projections, may lead to tracking failures for these systems. Therefore, this paper proposes a strategy to prevent the emergence of ghost markers by identifying markers based on the features of their projections, finding the correspondences between marker projections based on the geometric information provided by markers, and fast-tracking markers in a 2D image between frames based on the sizes of their projections. Apart from validating its high robustness, the experimental results show that the proposed strategy can accurately recognize markers, correctly identify their correspondences, and meet the requirements of real-time tracking.

Background The rise of eHealth, with the increasing use of a Mobile application provides a new perspective for outpatient spine surgery follow-up. Objective Assess the feasibility of Mobile app for postoperative monitoring after outpatient lumbar discectomy. Patients and methods Sixty consecutive patients, who underwent an ambulatory lumbar discectomy, were proposed the use of Mobile app to optimize their home monitoring for 15 days. Contact was maintained with the clinic based on the level of symptom severity: pain, temperature, deficit, bleeding, to provide a suitable solution. Use of Mobile app compared to the standard follow-up procedure was evaluated daily and a satisfaction survey was carried-out 3 months after surgery. Results Thirty-six patients (60.0 %) completed the initial checklist within 48 h, with no triggered severity. Five patients (8.3 %) triggered a non-response alarm; no action was required in the follow-up of 41 patients. However, 19 patients (31.7 %) triggered a total of 29 alarms, automatically resulting in a neurosurgeon contact for: postoperative pain management and optimization of analgesics, 21 cases (72.4 %), low-grade fever <38.5°, 4 cases (13.8 %), voiding delay, 2 cases (6.9 %) and a problem related to dressing, 2 cases (6.9 %). The scale ranged from 1 (poor) to 4 (excellent), with a 3.5/4 overall satisfaction mean score for the mobile handheld-device. Most patients (91.6 %) responded that they would agree to repeat the postoperative experience. Conclusion Overall patient satisfaction was excellent. Mobile app provides an effective useful tool for outpatient spine surgery monitoring and minimizes the need for in-person visits for postoperative patients.

BACKGROUND: Intrathecal opioids have long been used as analgesia for intractable cancer pain or as part of spinal anesthesia during obstetric operations. More recently, they have been used preoperatively as a pain management adjuvant for open cardiac and thoracic procedures. OBJECTIVE: This study aims to analyze the impact of administering intrathecal opioids before cardiac and thoracic surgeries on postoperative pain and mechanical ventilation. STUDY DESIGN: Systematic review and meta-analysis. SETTING: University, School of Medicine, and several university-affiliated hospitals. METHODS: Five outcomes were studied, including the primary outcome of time to extubation, secondary outcomes of analgesia requirements at 24 and 48 hours, resting pain scores at 1 and 24 hours post-extubation, ICU length of stay in hours, and hospital length of stay in days. A search of multiple databases provided 28 studies reporting 4,000 total patients. Outcomes were measured using continuous mean difference with a 95% confidence interval, and the studies were examined for heterogeneity and sensitivity analysis. RESULTS: The primary outcome analysis suggested that time to extubation was 42 minutes shorter in the intrathecal opioid group (ranging from 82 to 1 minute, P = 0.04). There was also a decrease in postoperative analgesia requirements at both 24 hours (mean difference (MD) = -8.95 mg morphine equivalent doses (MED) [-9.4, -8.5], P < 0.001) and 48 hours (MD = -17.7 mg MED [-23.1, -12.4], P < 0.001) with I2 of 94% and 85% respectively, an improvement of pain scores at both 1 hour (MD = -2.24 [-3.16, -1.32], P < 0.001) and 24-hours (MD = -1.64 [-2.48, -0.80], P =< 0.001) I2 of 94% and 85%, no change in both ICU length of stay (MD = -0.27 hours [-0.55, 0.01], P = 0.06) I2 = 77% and hospital length of stay (MD = -0.30 days [-0.66, 0.06], P = 0.11) I2 = 32%. LIMITATIONS: The major limitation of this meta-analysis was the inconsistent dosages of intrathecal opioids utilized. Some used the same dose for each patient, while other studies used weight-based doses. The differences in the outcomes observed may then be a result of the different amounts of opioids administered rather than the technique itself. Another limitation was the inconsistent timing of reports for pain scores and postoperative analgesic requirements. Further studies were analyzed at the 2 time periods for both secondary outcomes, making it difficult to attribute the 2 effects solely to the intervention. CONCLUSIONS: We conclude that preoperative injection of intrathecal opioids is significantly associated with decreased time to extubation, decreased postoperative analgesia requirement, and improved pain scores. In controlled conditions with adequate staff education, this method of analgesia may make it possible to extubate the patients after the surgery in the operating room and fast-track their discharge from the hospital. KEY WORDS: Analgesia, cardiac surgery, extubation, fast-tracking, hospital stay, spinal

At present, face recognition algorithms are facing some problems with poor face tracking and low real-time performance in multi-target recognition scenarios. This paper details a multi-target face real-time detection tracking and recognition algorithm, including three methods of fast-tracking, fast detection, and quick recognition. The first step offers a new network based on GOTURN for achieving fast face tracking. The prior information of the previous frame image used to predict the position of the face boxes at the current frame. The second step is based on MTCNN for face detection, using the prior information of the present structure to avoid generating massive of invalid candidate boxes, thereby achieving rapid detection of faces. Finally, fast face recognition realized by reduced MobileFaceNet. By avoiding repeated exposure and repeated identification of the same target, the algorithm successfully transforms a multi-target scene into a single-target scene. On the OTB2015 and 300_VW test sets, the evaluation trackers tracked faces with an accuracy rate of 92.2% and 99.6% respectively. On the Xiph test set, multi-target detection and tracking face speed reached 102fps on the CPU. Compared with the original MobileFaceNet, the streamlined network has an accuracy rate of 99.1% on LFW, the feature extraction speed increased by 25%, and the model size reduced by 45%. Experimental results show that the algorithm has high recognition accuracy and real-time performance in multi-target recognition scenes.

Object tracking is a challenging task in computer vision. While simple tracking methods offer fast speeds, they often fail to track targets. To address this issue, traditional methods typically rely on complex algorithms. This study presents a novel approach to enhance object tracking speed via confidence-guided frame skipping. The proposed method is strategically designed to complement existing methods. Initially, lightweight tracking is used to track a target. Only in scenarios where it fails to track is an existing, robust but complex algorithm used. The contribution of this study lies in the proposed confidence assessment of the lightweight tracking’s results. The proposed method determines the need for intervention by the robust algorithm based on the predicted confidence level. This two-tiered approach significantly enhances tracking speed by leveraging the lightweight method for straightforward situations and the robust algorithm for challenging scenarios. Experimental results demonstrate the effectiveness of the proposed approach in enhancing tracking speed.

Background: Good postoperative analgesia in cardiac surgical patients helps in early recovery and ambulation. An alternative to parenteral, paravertebral, and thoracic epidural analgesia can be pectoralis nerve (Pecs) block, which is novel, less invasive regional analgesic technique. Aims: We hypothesized that Pecs block would provide superior postoperative analgesia for patients undergoing cardiac surgery through midline sternotomy compared to parenteral analgesia. Materials and Methods: Forty adult patients between the age groups of 25 and 65 years undergoing coronary artery bypass grafting or valve surgeries through midline sternotomy under general anesthesia were enrolled in the study. Patients were randomly allocated into two groups with 20 in each group. Group 1 patients did not receive Pecs block, whereas Group 2 patients received bilateral Pecs block postoperatively. Patients were extubated once they fulfilled extubation criteria. Ventilator duration was recorded. Patients were interrogated for pain by visual analog scale (VAS) scoring at rest and cough. Inspiratory flow rate was assessed using incentive spirometry. Results: Pecs group patients required lesser duration of ventilator support (P < 0.0001) in comparison to control group. Pain scores at rest and cough were significantly low in Pecs group at 0, 3, 6, 12, and 18 h from extubation (P < 0.05). At 24 h, VAS scores were comparable between two groups. Peak inspiratory flow rates were higher in Pecs group as compared to control group at 0, 3, 6, 12, 18, and 24 h (P < 0.05). Thirty-four episodes of rescue analgesia were given in control group, whereas in Pecs group, there were only four episodes of rescue analgesia. Conclusion: Pecs block is technically simple and effective technique and can be used as part of multimodal analgesia in postoperative cardiac surgical patients for better patient comfort and outcome.

This study proposes a novel concept of actuator-driven frame-by-frame intermittent tracking for motion-blur-free video shooting of fast-moving objects. The camera frame and shutter timings are controlled for motion blur reduction in synchronization with a free-vibration-type actuator vibrating with a large amplitude at hundreds of hertz so that motion blur can be significantly reduced in free-viewpoint high-frame-rate video shooting for fast-moving objects by deriving the maximum performance of the actuator. We develop a prototype of a motion-blur-free video shooting system by implementing our frame-by-frame intermittent tracking algorithm on a high-speed video camera system with a resonant mirror vibrating at 750 Hz. It can capture 1024 × 1024 images of fast-moving objects at 750 fps with an exposure time of 0.33 ms without motion blur. Several experimental results for fast-moving objects verify that our proposed method can reduce image degradation from motion blur without decreasing the camera exposure time.

Introduction: Fast tracking plays a crucial role in reducing perioperative morbidity and financial burden by facilitating early extubation and discharge from hospital. Paravertebral block (PVB) is becoming more popular in paediatric surgeries as an alternative to epidural and caudal analgesia. There is scarcity of data regarding the efficacy and safety of PVB in paediatric cardiac surgery. Methods: We performed a review of records of paediatric cardiac patients who underwent cardiac surgery under general anaesthesia with single shot PVB and compared the analgesia and postoperative outcomes with matched historical controls who underwent cardiac surgery with same anaesthesia protocol without PVB. Results: The data from 200 children were analysed. 100 children who received paravertebral block were compared with a matched historical controls. The median time to extubation was shorter in the PVB group (0 hr, IQR 0-3 hrs) compared to the control group (16 hrs, IQR 4-20 hrs) (P value 0.017*). Intraoperative and postoperative fentanyl requirement was much lower in the PVB group (3.49 (0.91)) compared to the control group (9.86 (1.37)) P value <0.01*. Time to first rescue dose of analgesic was longer (7 hrs vs 5 hrs, P 0.01*), while time to extubation and duration of ICU stay were significantly less in PVB group . Mean postoperative pain scores were significantly lower in the PVB group at the time of ICU admission (0.85 vs 3.12, P 0.001*) till 4 hours (2.11 vs 3.32, P 0.001*). Conclusion: PVB provides an effective and safe anaesthetic approach which can form an important component of \"fast-track\" care in paediatric cardiac surgery.