Modelling individual motion sickness accumulation in vehicles and driving simulators

Users of automated vehicles will move away from being drivers to passengers, preferably engaged in other activities such as reading or using laptops and smartphones, which will strongly increase susceptibility to motion sickness. Similarly, in driving simulators, the presented visual motion with scaled or even without any physical motion causes an illusion of passive motion, creating a conflict between perceived and expected motion, and eliciting motion sickness. Given the very large differences in sickness susceptibility between individuals, we need to consider sickness at an individual level. This paper combines a group-averaged sensory conflict model with an individualized accumulation model to capture individual differences in motion sickness susceptibility across various vision conditions. The model framework can be used to develop personalized models for users of automated vehicles and improve the design of new motion cueing algorithms for simulators. The feasibility and accuracy of this model framework are verified using two existing datasets with sickening. Both datasets involve passive motion, representative of being driven by an automated vehicle. The model is able to fit an individuals motion sickness responses using only 2 parameters (gain K1 and time constant T1), as opposed to the 5 parameters in the original model. This ensures unique parameters for each individual. Better fits, on average by a factor of 1.7 of an individuals motion sickness levels, are achieved as compared to using only the group-averaged model. Thus, we find that models predicting group-averaged sickness incidence cannot be used to predict sickness at an individual level. On the other hand, the proposed combined model approach predicts individual motion sickness levels and thus can be used to control sickness.Comment: 8 pages, 9 figure

The great saphenous vein-an anatomical study.

The anatomical variations are more frequently encountered in the venous system particularly in the superficial veins when compared to the arterial system. The great saphenous vein is the longest vein of the body and represents pre-axial vein of lower limb. The venous anatomy is of great importance to the surgeons and sonographers. The present study included 25 lower limbs during routine dissection for undergraduate students in the Department of Anatomy, Kasturba Medical College, Manipal, India. We studied the great saphenous vein with reference to its formation, relation with the medial malleolus, distance from patella, level of termination and variation in its major tributaries. The findings were recorded, tabulated and photographed. Aforementioned anatomical facts including mode of termination of great saphenous vein can be important for surgeons planning intervention in this area. This vein is used as an arterial graft because of the marked anatomical remodeling. Thus, a good understanding of the typical ultrasound appearance of the great saphenous vein, its relationship to the major bony landmarks is significant

IS RENAL IMPAIRMENT CONCEALED IN ELDERLY DIABETICS????

Objective: To compare and evaluate the renal profile of elderly and younger diabetics.Methods: This cross sectional study was conducted in a tertiary care teaching hospital. Patients with type-2-diabetes were grouped into elderly (age≥60years) and younger diabetics. Patients' demographics, duration of diabetes and serum creatinine were recorded. Cockcroft-Gault formula was used to calculate creatinine clearance (Clcr). Statistical analysis was done using Students'‘t' test and Pearson's correlation. Regression analysis to adjust for covariables was done wherever required.Results: A total of 477 diabetics were included (elderly n=320, young n=157). Body mass index (BMI) was significantly lower (p=0.003) and duration of diabetes was significantly longer (p=0.001) among elderly. Significant difference was noted in serum creatinine (1.06±0.32 vs 0.95±0.29 mg/dl; p=0.0002) and Clcr (57.82±17.41 vs 88.07±24.60 ml/min; p=0.001) between elderly and younger diabetics. Only 4.7% of elderly, whereas 47.8% of young had normal Clcr. Clcr showed a negative correlation with age in elderly (r=-0.389, p<0.001) and young (r=-0.396, p<0.001) and positive correlation with BMI in elderly (r=0.401, p<0.001) and young(r=0.337, p<0.001). Regression analysis of Clcr in elderly and young showed a positive correlation for BMI and inverse relationship for age and duration of diabetes mellitus.Conclusion: Almost 95% of the elderly and 50% of younger diabetics had impaired creatinine clearance. Renal impairment was concealed in most of them since mean serum creatinine was 1 mg/dl. Indian elderly diabetics should be considered renally impaired and drugs for all conditions need adjustment for creatinine clearance

HYPERTROPHIC CARDIOMYOPATHY WITH PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION AND ATRIAL SEPTAL DEFECT: A RARE PRESENTATION

Hypertrophic cardiomyopathy (HOCM) is characterized by heterogeneous clinical expression, unique pathophysiology, and diverse natural history.Coexistence of arterial septal defect and partial anomalous pulmonary venous connection (PAPVC) is very rare. Since HOCM is a congenital defect,coexistence of other congenital defects should be kept in mind when we treat the patients. Only very few cases of HOCM with coexisting congenitalanomalies have been reported so far in medical literature. Hence, we report a case of HOCM with atrial septal defect and PAPVC in a 49-year-old malepatient

Additional Muscle Slip of Bicipital Aponeurosis and its Anomalous Relationship with the Median Cubital Vein

The cubital region of the arm is a common site for recording blood pressure, taking blood for analysis and administering intravenous therapy and blood transfusions. During the routine dissection of a 70-year-old male cadaver at the Kasturba Medical College, Manipal, Karnataka, India, in 2015, it was observed that the aponeurotic insertion of the biceps brachii muscle divided into two slips. The medial slip fused normally with the deep fascia of the forearm, while flexor carpi radialis muscle fibres originated from the lateral slip. There was also a single vein in the forearm, the cephalic vein, which bifurcated to form the median cubital vein and the cephalic vein proper. The median cubital vein, further reinforced by the radial vein, passed deep to the two slips of the bicipital aponeurosis and then continued as the basilic vein. During venepuncture, medical practitioners should be aware of potential cubital fossa variations which could lead to nerve entrapment syndromes

Arecanut and Tobacco use Among School Children

BackgroundAreca nut is the fourth most commonly used psychoactive substance in the world after caffeine, alcohol and nicotine. Its use is considered a benign and socially acceptable habit among most Indians. Like tobacco, chewing areca nut also leads to oral and oropharyngeal cancers. Chewing of these substances usually starts early in life leading to a multitude of problems in adulthood. This study was conducted among high school students to determine the prevalence and explore the awareness of health hazards associated with these substances.Method  This cross sectional study was carried out in Vantamuri village, South India. All consenting school children of 7th, 8th and 9th class were interviewed individually using a pretested questionnaire about their chewing habits. This was followed by a thorough oral cavity examination for all.ResultsOut of 392 participants 62.5% were boys. Mean age of all participants was 14.8 ± 1.13 years.  The prevalence of areca nut usage among boys and girls was 27.3% and 6.1% while it was 2.4% for gutka (contains tobacco) amongst boys.  Majority of students started chewing between 13 and 14 years. About 49% of users were chewing these substances regularly for more than a year. Addictive tendencies were seen in two users. 43% of users chewed the same product used by their family members (