Anesthetic management of a patient with sodium-channel myotonia: a case report

Background: Sodium-channel myotonia (SCM) is a nondystrophic myotonia, characterized by pure myotonia without muscle weakness or paramyotonia. The prevalence of skeletal muscle channelopathies is approximately 1 in 100,000, and the prevalence of SCM is much lower. To our knowledge, this is the first report on anesthetic management of a patient with SCM. Case presentation: A 23-year-old woman with congenital nasal dysplasia and SCM was scheduled to undergo rhinoplasty with autologous costal cartilage. Total intravenous anesthesia without muscle relaxants was administered followed by continuous intercostal nerve block. Although transient elevation of potassium level in the blood was observed during surgery, the patient did not show exacerbation of myotonic or paralytic symptoms in the postoperative period. Conclusion: Total intravenous anesthesia and peripheral nerve block can be administered safely to a patient with SCM. However, careful monitoring of the symptoms and electrolytes is recommended

Implications of the mild gas motion found with Hitomi in the core of the Perseus cluster

Based mainly on X-ray observations, studies are made on interactions between the intra-cluster medium (ICM) in clusters of galaxies and their member galaxies. Through (magneto)hydrodynamic and gravitational channels, the moving galaxies are expected to drag the ICM around them, and transfer to the ICM some fraction of their dynamical energies on cosmological time scales. This hypothesis is in line with several observations, including the possible cosmological infall of galaxies towards the cluster center, found over redshifts of z~1 to z~0. Further assuming that the energy lost by the galaxies is first converted into ICM turbulence and then dissipated, this picture can explain the subsonic and uniform ICM turbulence, measured with Hitomi in the core region of the Perseus cluster. The scenario may also explain several other unanswered problems regarding clusters of galaxies, including what prevents the ICM from the expected radiative cooling, how the various mass components in nearby clusters have attained different radial distributions, and how a thermal stability is realized between hot and cool ICM components that co-exist around cD galaxies. This view is also considered to pertain to the general scenario of galaxy evolution, including their environmental effects.Comment: 15 pages, 3 figures, accepted for publication in A&

Pediatric Living Donor Liver Transplantation for Congenital Absence of the Portal Vein With Pulmonary Hypertension: A Case Report

Few reports of liver transplantation exist in patients with congenital absence of the portal vein and pulmonary hypertension. Living donor liver transplantation is usually performed before exacerbation of pulmonary hypertension. A 7-year-old girl (height: 131.5 cm; weight: 27.4 kg) with congenital absence of the portal vein was diagnosed with pulmonary hypertension (mean pulmonary artery pressure 35 mm Hg), and liver transplantation was planned before exacerbation of pulmonary hypertension. We successfully managed her hemodynamic parameters using low-dose dopamine and noradrenaline under monitoring of arterial blood pressure, central venous pressure, cardiac output, and stroke volume variation. Anesthesia was maintained using air-oxygen-sevoflurane and remifentanil 0.1 to 0.6 μg∙kg-1∙min-1. It is necessary to understand the potential perioperative complications in such cases and to adopt a multidisciplinary team approach in terms of the timing of transplantation and readiness to deal with exacerbation of pulmonary hypertension

Experimental Study under Real-World Conditions to Develop Fault Detection for Automated Vehicles

Abstract Automated vehicles can contribute to the improvement of transportation through their high capacity, increased safety, low emission and high efficiency. However, unstable conditions of automated mobile systems, which include automated vehicles and mobile robots) can cause serious problems, andthus, automated mobile system requiresto be highly reliable. The objective of this research is to develop on analgorith mfor detection faults (unstable condition) in an automated mobile system and to improve the overall reliability of this system. In this study, we in itially stored and updated a few patterns of data constellations under normal and unstable conditions for fault identification through real-world experiments. Multiple experiments were performed in a public urban area (with course distance per set beingapproximately1.1[km]), where several pedestrians, bicycles, and other robots were also present. The method used for detecting faults utilizes Mahalanobis distance, correlat ion coefficient, and linearization in order to enhance the accuracy of detecting faults;further, because real-world experimental conditions vary frequently,it is essential for the proposed method to be robust undervarious conditions. The ma in feature of this study is that it involves the use of experimental results obtained under real-world conditions, to develop a fault detection algorithm and evaluate its validity. In addition, simu lations were performed using the real-world experimental data, wh ich includes newly logged experimental data after the algorithm was developed in order to evaluate the validity of the proposed algorithm. The simulat ion results show that the proposed algorithm detects faults accurately, thus, they prove its validity

Context-Based Rider Assistant System for Two Wheeled Self-Balancing Vehicles

Personal mobility devises become more and more popular last years. Gyroscooters, two wheeled self-balancing vehicles, wheelchair, bikes, and scooters help people to solve the first and last mile problems in big cities. To help people with navigation and to increase their safety the intelligent rider assistant systems can be utilized that are used the rider personal smartphone to form the context and provide the rider with the recommendations. We understand the context as any information that characterize current situation. So, the context represents the model of current situation. We assume that rider mounts personal smartphone that allows it to track the rider face using the front-facing camera. Modern smartphones allow to track current situation using such sensors as: GPS / GLONASS, accelerometer, gyroscope, magnetometer, microphone, and video cameras. The proposed rider assistant system uses these sensors to capture the context information about the rider and the vehicle and generates context-oriented recommendations. The proposed system is aimed at dangerous situation detection for the rider, we are considering two dangerous situations: drowsiness and distraction. Using the computer vision methods, we determine parameters of the rider face (eyes, nose, mouth, head pith and rotation angles) and based on analysis of this parameters detect the dangerous situations. The paper presents a comprehensive related work analysis in the topic of intelligent driver assistant systems and recommendation generation, an approach to dangerous situation detection and recommendation generation is proposed, and evaluation of the distraction dangerous state determination for personal mobility device riders

Suzaku observations of the hard X-ray variability of MCG-6-30-15: the effects of strong gravity around a Kerr black hole

Suzaku has, for the first time, enabled the hard X-ray variability of the Seyfert 1 galaxy MCG-6-30-15 to be measured. The variability in the 14-45 keV band, which is dominated by a strong reflection hump, is quenched relative to that at a few keV. This directly demonstrates that the whole reflection spectrum is much less variable than the power-law continuum. The broadband spectral variability can be decomposed into two components - a highly variable power-law and constant reflection - as previously inferred from other observations in the 2-10 keV band. The strong reflection and high iron abundance give rise to a strong broad iron line, which requires the inner disc radius to be at about 2 gravitational radii. Our results are consistent with the predictions of the light bending model which invokes the very strong gravitational effects expected very close to a rapidly spinning black hole.Comment: accepted for publication in PASJ Suzaku special issu

Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge : A multicenter, retrospective study in the northern Kyushu district of Japan

Purpose: Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. Methods: A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. Results: The 1-year mortality rate was 9.1% (95% confidence interval: 6.8–12.0%, n = 45). Log-rank test revealed that previous fractures (p = 0.003), Barthel index (BI) at discharge (p = 0.011), and place-to-discharge (p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking (p = 0.007), length of hospital stay (LOS; p = 0.009), and BI (p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m2 (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females. Conclusions: Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m2, TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

The Quiescent Intracluster Medium in the Core of the Perseus Cluster

Clusters of galaxies are the most massive gravitationally-bound objects in the Universe and are still forming. They are thus important probes of cosmological parameters and a host of astrophysical processes. Knowledge of the dynamics of the pervasive hot gas, which dominates in mass over stars in a cluster, is a crucial missing ingredient. It can enable new insights into mechanical energy injection by the central supermassive black hole and the use of hydrostatic equilibrium for the determination of cluster masses. X-rays from the core of the Perseus cluster are emitted by the 50 million K diffuse hot plasma filling its gravitational potential well. The Active Galactic Nucleus of the central galaxy NGC1275 is pumping jetted energy into the surrounding intracluster medium, creating buoyant bubbles filled with relativistic plasma. These likely induce motions in the intracluster medium and heat the inner gas preventing runaway radiative cooling; a process known as Active Galactic Nucleus Feedback. Here we report on Hitomi X-ray observations of the Perseus cluster core, which reveal a remarkably quiescent atmosphere where the gas has a line-of-sight velocity dispersion of 164+/-10 km/s in a region 30-60 kpc from the central nucleus. A gradient in the line-of-sight velocity of 150+/-70 km/s is found across the 60 kpc image of the cluster core. Turbulent pressure support in the gas is 4% or less of the thermodynamic pressure, with large scale shear at most doubling that estimate. We infer that total cluster masses determined from hydrostatic equilibrium in the central regions need little correction for turbulent pressure.Comment: 31 pages, 11 Figs, published in Nature July