Global-local combined features to detect pain intensity from facial expression images with attention mechanism

The estimation of pain intensity is critical for medical diagnosis and treatment of patients.With the development of image monitoring technology and artificial intelligence,automatic pain assessment based on facial expression and behavioral analysis shows a potential value in clinical applications.This paper reports a framework of convolutional neural network with global and local attention mechanism(GLA-CNN)for the effective detection of pain intensity at four-level thresholds using facial expression images.GLA-CNN includes two modules,namely global attention network(GANet)and local attention network(LANet).LANet is responsible for extracting representative local patch features of faces,while GANet extracts whole facial features to compensate for the ignored correlative features between patches.In the end,the global correlational and local subtle features are fused for the final estimation of pain intensity.Experiments under the UNBC-McMaster Shoulder Pain database demonstrate that GLA-CNN outperforms other state-of-the-art methods.Additionally,a visualization analysis is conducted to present the feature map of GLA-CNN,intuitively showing that it can extract not only local pain features but also global correlative facial ones.Our study demonstrates that pain assessment based on facial expression is a non-invasive and feasible method,and can be employed as an auxiliary pain assessment tool in clinical practice.

Application of Intensive Pain Nursing in Postoperative Nursing of Clinical Patients with Lung Cancer

Objective:The intensive pain nursing was added to the surgical nursing of lung cancer and the clinical nursing effect was discussed.Methods:50 patients with lung cancer received in our hospital from January 2020 to June 2021.The observation group was given intensive pain nursing and the control group was given routine nursing.The clinical nursing effects of the two groups were studied.Results:The pain degree of the two groups was improved after nursing.The pain relief effect of the observation group was higher than that of the control group,and the nursing effect of the two groups was different(P<0.05)・Conclusion:In the postoperative nursing of patients with lung cancer,the intervention of intensive pain nursing can relieve the pain of patients,which is worth popularizing.

Effects of Kinesio Taping in Supraspinatus Tendinitis

Background:Shoulder pain is one of the most commonly reported musculoskeletal problems after low back pain.One common reason for the shoulder pain is supraspinatus tendinitis that is often associated with impingement syndrome.Objective:To find the effects of kinesio taping in reducing pain and disability in subjects with supraspinatus tendinitis.Methodology:In this study,patients were randomly allocated the treatment using a set of predefined inclusion and exclusion criteria.Subjects were managed with kinesio taping.Pre-and post-evaluation of the patients was done using Numerical Pain Rating Scale(NPRS)and Disability of Arm Shoulder&Hand Questionnaire(DASH)score and the data gathered was entered and analyzed using SPSS version 23.Results:Mean difference of 2.65 was reported between the pretreatment and post treatment values of NPRS in KT taping group which was significant(P<0.05).Mean difference of 27.25 was reported between the pre-treatment and post-treatment values of DASH score in KT taping group which was significant(P<0.05).Conclusion:Kinesio taping is an effective Program in management of supraspinatus tendinitis.

Incidence and factors influencing tourniquet pain

Purpose:The use of tourniquet in orthopedic surgery facilitates operation by establishing a bloodless surgical field.However,many complications following the use of tourniquets have been reported.Tourniquet pain is the most common complication.This study aimed to find the actual incidence of pain associated with tourniquet use in orthopedic surgery and the various factors.Methods:It is a prospective observational study conducted on 132 consecutive cases.Patients aged 18-70 years with musculoskeletal problems of the forearm and leg requiring surgery were included in the study.Patients with open injuries or contraindications such as diabetes mellitus,compromised circulatory states,neurological deficit,compartment syndrome and unable to give informed consent were excluded.The parameters assessed included duration of tourniquet use,tourniquet pressure,type of anesthesia,any interval release of the tourniquet and reapplication after a reperfusion period,whether upper or lower limb surgery,severity of tourniquet pain,timing of tourniquet release and complications.Chi-square and non-parametric Mann-Whitney U test were used for data analysis.Results:In upper limb surgeries,if duration of surgery was less than 60 min,14(51.8%)cases experienced tourniquet pain and 13(48.1%)had no pain,and if duration of surgery was more than 60 min,24(60.0%)had pain and 16(40.0%)experienced no pain.In lower limb surgeries if duration of surgery was less than 60 min,2(7.7%)experienced pain and 24(92.3%)had no pain,and if duration of surgery was more than 60 min,14(35.8%)experienced pain and 25(64.8%)had no pain.Degree of tourniquet pain increases with the duration of surgery.Statistically,there was significant association between tourniquet inflation time and tourniquet pain in both upper and lower limbs(p=0.034 and 0.024,respectively)Conclusion:Incidence of tourniquet pain was in direct proportion to the duration of tourniquet use and was higher in cases with regional anesthesia.Other risk factors assessed including tourniquet pressure,upper or lower limb surgery,tourniquet release time and interval had no significant contribution to the incidence or severity of tourniquet pain.