Comparison of two pain assessment tools, �facial expression� and �critical care pain observation tool� in intubated patients after cardiac surgery

Background: Critical-care patients are at higher risk of untreated pain, because they are often unable to communicate owing to altered mental status, tracheal intubation and sedation. Objectives: This study compared two pain assessment tools on tracheal intubated critically ill patients in a cardiac post-anesthesia care unit, who were unable to communicate verbally. The studied tools were �critical-care pain observation tool (CPOT)� and �facial expression (FE)�. Patients and Methods: This was a prospective study based on diagnostic test evaluation. A sample of 91 intubated patients was selected from cardiac post-anesthesia care unit. Collected data were demographic characteristics, vital signs, FE and CPOT tools� scale. Pain was assessed with CPOT and FE scores five times. The first assessment was performed in at least 3 hours after admission of patients to ICU. Then, the pain intensity was reassessed every 30 minutes. In addition, blood pressure, heart rate, respiratory rate and oxygen saturation were measured simultaneously. Results: At the first period, the frequency of �severe� pain intensity using the CPOT was 58.2 and with the FE tool was 67 (P = 0.001). Both tools demonstrated reduction in severity of pain on second and third assessment times. Significantly increasing level of pain and blood pressure due to nursing painful procedures (endo-tracheal suctioning, changing patient�s position, etc.), were obtained by CPOT in fourth assessment. FE was not able to detect such important findings (κ = 0.249). In the fifth step, pain intensity was reduced. The most agreement between the two tools was observed when the reported pain was �severe� (κ = 0.787, P < 0.001) and �mild� (κ = 0.851, P < 0.001). Conclusions: The sensitivity of CPOT was higher for detection and evaluation of pain in intubated postoperative patients compared with �Facial Expression�. Best agreement between these tools was observed in two extremes of pain intensity. © 2016, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM)

Relationship among temporary separation, attachment styles, and adjustment in first-grade Iranian children

If mothers work outside the home, some degree of mother-child separation will be experienced and mother-child attachment will be affected. In this study, regarding the attachment styles, sociobehavioral problems in first-grade children with experience of preschool and in those taught by their mothers at-home are compared. A casual-comparative method was used to compare children in the two groups. A total of 320 first-grade children participated in the study. The study measures included a separation anxiety test, an adaptive behavior scale, and a children�s symptom inventory. Data were analyzed using multivariate statistics. Secure attachment in the group with experience of preschool was significantly higher than that in the at-home group. None of the variables, including parents� education and father�s income, significantly affected attachment style. Neither father�s education, father�s income, or attachment significantly influenced adjustment. Father�s education significantly influenced children�s symptoms. Attachment style and hours of preschool attendance had no effect on Child Symptom Inventory scores. Associations among age at joining preschool, attachment style, and behavioral and adaptive problems in first-grade children were nonlinear and multivariate. By taking into account parents� awareness, sensitivity, and responsiveness, relative welfare, appropriate quality of child-care centers, and having fewer hours of preschool attendance, the risk factors for early parent-child separation and institutional care can be reduced. © 2016 Tahmasebi et al

Delay Spoofing Reduction in GPS Navigation System based on Time and Transform Domain Adaptive Filtering

Due to widespread use of Global Positioning System (GPS) in different applications, the issue of GPS signal interference cancelation is becoming an increasing concern. One of the most important intentional interferences is spoofing signals. An effective interference (delay spoof) reduction method based on adaptive filtering is developed in this paper. The principle of method is using adaptive filters to eliminate interference, obtain an estimate of interfering signal and subtract that from the corrupted signal. So, what remains in the output is the desired signal. Here, for updating the filter coefficients adaptive algorithms in both time (statistical and deterministic) and transform domain will be studied. The proposed adaptive filter is applied to a batch of spoofing GPS data in pseudo-range level. The results indicate that all investigated algorithms are able to reduce positioning steady-state miss-adjustment up to 70 percent. In this context, the variable step-size least mean square algorithm performs better than others do

Ammonia Fiber Expansion (AFEX) as spin off technology from 2nd generation biofuel for upgrading cereal straws and stovers for livestock feed

Ten cereal straws and stovers from India were treated using the ammonia fiber expansion (AFEX) technique to explore the effectiveness of the AFEX technique for releasing sugars from structural carbohydrates and for the upgrading of cereal crop residues as livestock feed. Recovery of glucose and xylose in AFEX treated material was about three times the recovery in untreated material. AFEX treatment increased recovery of glucose between 60 and 85% and of xylose between 50 and 85% of their theoretical yields. AFEX treatment increased average crude protein (CP) by 260% (CP content: 62 vs 161 g/kg). Cell wall content as estimated by NDF decreased on average by 47 g/kg (NDF: 656 vs 609 g/kg) while cellulose contents estimated as ADF apparently increased by 23 g/kg (ADF: 443 vs 466 g/kg). Lignin contents estimated as ADL did not significantly differ between untreated and treated material. Measured after 24 h of incubation, AFEX treatment consistently and significantly increased in vitro gas production (42.9 vs33.3 ml/200 mg), in vitro apparent digestibility (493 vs 630 g/kg) and true digestibility (624 vs 755 g/kg) and in vitro metabolizable energy content (6.9 vs 8.6 MJ/kg). Treatment changes in digestibility estimated based on in vitro gas production generally agreed with gravimetric estimates based on undigested residues, making it unlikely that the effect of AFEX treatment on digestibility was overestimated by unrecovered soluble but un-fermentable substrate. Increases in CP content and in vitro digestibilities upon AFEX treatment were unrelated to CP content and in vitro organic matter digestibilities (IVOMD) of untreated base material, though increases in IVOMD upon treatment tended (P = 0.07) to be lower in material with high (>530 g/kg) baseline IVOMD