Non-Invasive Driver Drowsiness Detection System.

Drowsiness when in command of a vehicle leads to a decline in cognitive performance that affects driver behavior, potentially causing accidents. Drowsiness-related road accidents lead to severe trauma, economic consequences, impact on others, physical injury and/or even death. Real-time and accurate driver drowsiness detection and warnings systems are necessary schemes to reduce tiredness-related driving accident rates. The research presented here aims at the classification of drowsy and non-drowsy driver states based on respiration rate detection by non-invasive, non-touch, impulsive radio ultra-wideband (IR-UWB) radar. Chest movements of 40 subjects were acquired for 5 m using a lab-placed IR-UWB radar system, and respiration per minute was extracted from the resulting signals. A structured dataset was obtained comprising respiration per minute, age and label (drowsy/non-drowsy). Different machine learning models, namely, Support Vector Machine, Decision Tree, Logistic regression, Gradient Boosting Machine, Extra Tree Classifier and Multilayer Perceptron were trained on the dataset, amongst which the Support Vector Machine shows the best accuracy of 87%. This research provides a ground truth for verification and assessment of UWB to be used effectively for driver drowsiness detection based on respiration

Biallelic KITLG variants lead to a distinct spectrum of hypomelanosis and sensorineural hearing loss

BACKGROUND: Pathogenic variants in KITLG, a crucial protein involved in pigmentation and neural crest cell migration, cause non-syndromic hearing loss, Waardenburg syndrome type 2, familial progressive hyperpigmentation and familial progressive hyper- and hypopigmentation, all of which are inherited in an autosomal dominant manner. OBJECTIVES: To describe the genotypic and clinical spectrum of biallelic KITLG-variants. METHODS: We used a genotype-first approach through the GeneMatcher data sharing platform to collect individuals with biallelic KITLG variants and reviewed the literature for overlapping reports. RESULTS: We describe the first case series with biallelic KITLG variants; we expand the known hypomelanosis spectrum to include a 'sock-and-glove-like', symmetric distribution, progressive repigmentation and generalized hypomelanosis. We speculate that KITLG biallelic loss-of-function variants cause generalized hypomelanosis, whilst variants with residual function lead to a variable auditory-pigmentary disorder mostly reminiscent of Waardenburg syndrome type 2 or piebaldism. CONCLUSIONS: We provide consolidating evidence that biallelic KITLG variants cause a distinct auditory-pigmentary disorder. We evidence a significant clinical variability, similar to the one previously observed in KIT-related piebaldism

Paranazal sinüslerle nörovasküler yapilarin bağlantisinin cerrahi önemi

Objective: Damage to the optic nerve and internal carotid artery is a serious complication of transsphenoidal surgery. The relationships of the sphenoid sinuses to the carotid artery and optic nerve were studied on computerized tomography and their clinical importance was discussed. Methods: 45 (90 sides) paranasal tomography images consisting of coronal, axial or both coronal and axial images were evaluated. Tomographic findings including bony septum extending to the optic canal or internal carotid artery and protrusions and dehiscences of the walls of the internal carotid artery and the optic nerve were investigated. The results were classified as "present" or "absent". Results: We detected 28 protrusions and 4 dehiscences of internal carotid artery and 31 protrusions and 7 dehiscences of the optic nerve. Bony septum to the internal carotid artery and optic nerve was observed in 25 and 18 cases respectively. Conclusion: Detailed preoperative analysis of the anatomy of the sphenoid sinus and its neurovascular boundaries is crucial in facilitating entry to the pituitary fossa and reducing intraoperative complications. Axial and coronal images, or axialcoronal investigation obtained by direct acquisition or by reconstructions are necessary to show the positions and variations of the optic nerve and carotid artery

Karoti?d arter i?nti?ma-medi?a kalinliğindaki? artiş orta serebral arter akim parametreleri?ni? etki?leyebi?li?r mi??

Objective: We aimed to evaluate whether the intima-media thickness (IMT) of common carotid artey (CCA) affects the Doppler parameters (Dp) of middle cerebral artery (MCA) and CCA. Method: From 72 female and 54 male subjects, with no sonographically detectable plaques on CCA, CCA IMT was measured three times both from near and far walls on the longitudinal images, and mean value was calculated. From the Doppler spectrums of CCA and MCA, peak systolic (PSV), end diastolic (EDV), time avaraged maximum velocities (TAMAX), pulsatilty (PI) and resistance indexes (RI) were measured. ANOVA and Kruskal Vallis tests were used to evaluate differences between age groups, Pearson test for the relation between the IMT and Doppler parameters and between age and Dp, lineer regression analyses for evaluation of the effect of age and IMT on Dp and t test for gender differences. Result: IMT, CCA and MCA flow parameters showed age dependent changes. In general IMT increased, PSV and EDV decreased; PI and RI decreased initially, and increased with advancing age. Age, but not IKT, was found as an independent factor effecting Dp. PSV and TAMAX were higher, and RI and PI were lower in female subjects. Conclusion: IMT increases lineerly with advancing age, so it was thought as a physiologic phenomenon. The CCA intima-media thickening does not effect the CCA and MCA Dp

Selective microsurgical vestibular neurectomy: An option in the treatment of intractable vertigo and related microsurgical landmarks

WOS: 000221171000010PubMed: 15100934Selective microsurgical vestibular neurectomy (SMVN) is an accepted and effective means of treating patients with intractable vertigo, a resistant component of Meniere's syndrome. Meniere's syndrome is a condition characterized by fluctuating hearing loss, tinnitus and serious vertigo attacks. Vertigo is the most disabling symptom of the disease. There may be permanent hearing loss in untreated cases and vertigo may continue after deafness. Selective microsurgical vestibular neurectomy is an elite surgical procedure providing exact relief from vertigo while protecting the preoperative hearing level. In this report, clinical results of nine patients with intractable vertigo operated in the University of Ankara Medical Faculty, Department of Neurosurgery between 1999 and 2001 are discussed. Accordingly, we aimed to represent the landmarks often required for microsurgical exposure. From this study we conclude that SMVN is an effective neurosurgical procedure for those patients who are resistant for medical treatment and require hearing preservation

Risky anatomic variations of sphenoid sinus for surgery

WOS: 000237091700015PubMed: 16429266We searched for the surgically risky anatomic variations of sphenoid sinus and aimed to compare axial and coronal tomography in detection of these variations. Fifty-six paranasal tomography images (112 sides) were evaluated for coronal, axial and both coronal and axial images. Tomographic findings including bony septum extending to optic canal or internal carotid artery; protrusions and dehiscences of the walls of internal carotid artery, optic nerve, maxillary nerve and vidian nerve; extreme medial course of internal carotid artery; patterns of aeration of the anterior clinoid process; and Onodi cells were evaluated. The results were classified as "present, absent, suspicious-thin (only for dehiscence) or no-consensus". The results of each plane were compared with that of the result of the both planes together. Kappa coefficient and Chi-square tests were used to compare both planes. Twelve cadaveric dissections were performed to reveal the proximity of sphenoid sinus to surgically risky anatomic structures. Endoscopy was applied to five cadavers. 18 evaluations were classified as 'no-consensus'. We detected 34, 35, 34 and 40 protrusions of internal carotid artery, optic nerve, maxillary nerve, vidian nerve, respectively. Dehiscences were present in 6, 9, 4 and 8, and suspicious-thin in 8, 10, 16 and 25 in canals of internal carotid artery, optic nerve, maxillary nerve and vidian nerve, respectively. Bony septum to internal carotid artery and optic nerve was observed in 30 and 22 cases. We observed 9 extreme medial courses of internal carotid artery, 27 aerated clinoid process and 9 Onodi cells. Axial images were superior in detection of bony septum to internal carotid artery and Onodi cells; while the coronal images were more successful in detection of protrusion of optic nerve and vidian nerve, and dehiscense of maxillary nerve and vidian nerve (P < 0.05). In cadaveric dissections, the septa were inserted into the bony covering of the carotid arteries in two sinuses (8.3%). Detailed preoperative analysis of the anatomy of the sphenoid sinus and its boundaries is crucial in facilitating entry to the pituitary fossa and reducing intraoperative complications. Coronal tomography more successfully detects the sphenoid sinus anatomic variations

Ceftriaxone-induced symptomatic pseudolithiasis mimicking ICP elevation

EVLIYAOGLU, CETIN AYHAN/0000-0002-1774-3084WOS: 000228756300006PubMed: 15846537In neurosurgery, ceftriaxone is a widely used, third generation cephalosporin for the treatment of CNS infections and perioperational prophylaxis. Recent studies have demonstrated that ceftriaxone induces reversible precipitates in the gallbladder. This complication is referred to as '' biliary pseudolithiasis '', and it has symptoms similar to the raised intracranial pressure (ICP) symptoms of the perioperative period. Symptomatic biliary pseudolithiasis should be kept in mind in all pediatric neurosurgery cases under ceftriaxone therapy in order to prevent unnecessary postoperative investigations and surgery

Prevalence of primary tethered cord syndrome associated with occult spinal dysraphism in primary school children in Turkey

WOS: 000234170600002PubMed: 16357495The prevalence and associated factors of primary tethered cord syndrome (PTCS) in primary school children were investigated. A cross-sectional study was performed in four demographically different primary schools in Turkey. Demographic, familial and physical data were collected from 5,499 children based on enuresis as a predominant symptom and dermatologic and orthopedic signs as clues of occult spinal dysraphism. Statistical analysis and input of the data were carried out with the SPSS package program 10.00, and logistic regression analysis was used to identify discriminating factors between enuretic children with or without neurologic signs. Of 5,499 analyzed children, 422 (7.7%) had enuresis nocturna, and 19.9% of 422 children had also daytime incontinence. Sixteen of these 422 enuretic children (3.8%) had several dermatologic signs. Five of them had spina bifida on plain radiographies, and 4 of them had cord tethering on lumbar MRI. Fifteen of 422 enuretic children (3.7%) had gait disturbances and orthopedic anomalies without cutaneous manifestations. Six of 15 children had spina bifida on plain graphies and 2 of them had tethered cord syndrome on MRI. The general prevalence of PTCS was found to be 0.1% of 5,499 analyzed children and 1.4% of enuretic children. A good outcome after untethering was found in 83.0% in this series. Practitioners should be aware of these clues of occult spinal dysraphism and resort to further radiologic and neurosurgical assessment. Early surgical intervention may halt the progression of the neurologic deficits and stabilize or reverse symptoms. Copyright (c) 2006 S. Karger AG, Basel