Background: Pneumatic Balloon Dilation (PBD) as an achalasia treatment is painful procedure because of tearing the lower esophageal sphincter (LES) muscle fibres. Recently, two SEDATION methods including the moderate SEDATION and DEEP SEDATION are used for increasing the convenience of the patients and gastroenterologist. Methods: To compare the efficacy of moderate and DEEP SEDATION in PBD in treatment of Idiopathic Achalasia (IA). Results: We prospectively assessed 200 IA patients. The first 100 patients (group A) underwent PBD by the moderate SEDATION using diazepam or midazolam and meperidine injections. The patients in the group B (100 patients) received midazolam, fentanyl and propofol as a DEEP SEDATION.  The pulse rate (PR), systolic and diastolic blood pressure (SBP, DBP), respiratory rate (RR), and oxygen saturation were monitored before, during and after PBD and achalasia symptom scores (ASS) were collected before and 1.5 months after treatment. The mean PR during and after procedures in the group B were significantly lower compared to the group A (p 0.001, 0.028). The patients in group B revealed less SBP and DBP after PBD versus group A (p 0.004, 0.002). The mean psi for 30 mm and 35 mm balloon dilators were significantly increased in group B compared to group (p 0.0001, 0.002). Conclusion: We concluded that the DEEP SEDATION of achalasia patients in the PBD process can improved the efficacy of PBD and decreased the complications (transient chest pain) of the procedures. The patients with the DEEP SEDATION revealed less tachycardia and blood pressure rising and tolerated more pressure in balloon dilators.

Background: Multiple invasive procedures are routinely performed in diagnosis and treatment of hematologic/oncologic diseases. Because these procedures are painful, they may cause stress and anxiety in patients and their parents. Especially in patients with malignancies, the repeating procedures can lead to psychiatric disorders like depression and post-traumatic stress disorders. Therefore, general anesthesia is recommended during these invasive procedures for pain control. Objectives: The goal of this study was to evaluate safety and outcome of DEEP SEDATION with general anesthesia in hematology/ oncology patients during invasive interventions in pediatric outpatient SEDATION unit. Methods: We retrospectively analyzed records of 129 patients (59 girls and 70 boys) who had undergone 155 invasive procedures with general anesthesia. Patient demographics, reason of operations, anesthesia complications, duration of procedures, and time for recovery from anesthesia were recorded from anesthesia charts. Patients received ketamine (maximum dosage 2 mg/kg) plus midazolam, ketamine plus midazolam plus sevoflurane inhaler (sevoflurane inhaler was added when 2 mg/kg of ketamine was inadequate to obtain DEEP SEDATION) and sevoflurane inhaler in 140, 10 and 5 of operations, respectively. Results: Complications occurred in 31 (20%) of these operations. Majority of complications were mild and included post-op agitation, vomiting and local pain which occurred in 6, 5 and 4 of the operations, respectively. Only 2 patients developed severe complications (fall off the stretcher and bronchospasm) which did not lead to any long term morbidity. The complication rate did not differ according to the anesthetic drugs, reason of operations or patient demographics. Conclusions: In this group of patients, DEEP SEDATION with general anesthesia in an outpatient SEDATION unit, administered by trained professionals, was safe, quick, and effective for short-term invasive painful procedures.

Tracheal stenosis may follow a period of tracheal intubation. Postintubation tracheal stenosis is caused by either cuff-induced ischemic damage, injury after formation of a tracheostomy, or a combination of the two. Management may require tracheal dilation via rigid bronchoscopy. This can either be performed under general anesthesia using neuromuscular blocking drugs or under DEEP SEDATION using regional blocks. We describe a case of tracheal stenosis in a patient who had sustained extensive burns 4 months previously. Because of resource limitations in our healthcare setting, we successfully dilated her tracheal stenosis under DEEP SEDATION and translaryngeal anesthesia, avoiding general anesthesia and neuromuscular blocking agents.

Distributed Denial of Service (DDoS) attacks are among the primary concerns in internet security today. Machine learning can be exploited to detect such attacks. In this paper, a multi-layer perceptron model is proposed and implemented using DEEP machine learning to distinguish between malicious and normal traffic based on their behavioral patterns. The proposed model is trained and tested using the CICDDoS2019 dataset. To remove irrelevant and redundant data from the dataset and increase learning accuracy, feature selection is used to select and extract the most effective features that allow us to detect these attacks. Moreover, we use the grid search algorithm to acquire optimum values of the model’s hyperparameters among the parameters’ space. In addition, the sensitivity of accuracy of the model to variations of an input parameter is analyzed. Finally, the effectiveness of the presented model is validated in comparison with some state-of-the-art works.

Many roads in forest areas are located along the steep hills. The cut and fill method is currently used for construction of these roads. Settlement or consolidation in not enough compacted soil or creep in down slope, can lead to subsidence and cracks in roads. General methods for solving settlement related problems such as reconstruction, retaining structure and … are expensive. DEEP patch method is a low- cost method for increasing the stability of slopes. In this method, the upper parts of the subsided area are excavated and replaced with reinforcement materials such as Geo grid in accordance with compacted soil. In this paper, limit equilibrium method has been implemented for determining the safety factor of a planar slip surface in a slope. Furthermore, graphs for determining safety factor of reinforced soil slope with Geo synthetics have been proposed.

Introduction: In this study, we aimed to compare the effects of Diphenhydramine and ketamine premedication to increase DEEP SEDATION with a low Propofol dosage in male patients for rigid cystoscopy.Methods: In this double-blinded randomized controlled trial 90 male patients were recruited whose American Society of Anesthesiologists (ASA) scored class I-II and were candidates for cystoscopy. Patients randomly sub-grouped to D received 1 mg/kg diphenhydramine and patients in the K group received 1 mg/kg ketamine intravenously and Propofol 0.5mg/kg for both groups.  The primary outcome was the frequency of body movements observed at the insertion of the cystoscopic into the urethra, bladder, and cystoscopy and the grading of the patient's response when the cystoscopic enters the urethra and also during cystoscopy. The secondary outcome was the first time to add another Propofol; total perioperative Propofol doses; the time of recovery from anesthesia, incidence of adverse events, and urologist satisfaction after the procedure.Results: The median (IQR) for the ages the patients in D and K group were 35 (32,53) and 50 (35,57), respectively. The response of most patients when passing the cystoscopic through the urethra and at the same time during the cystoscopy was no response or shaking hands in both groups. The number of patients who needed to receive the first dose of Propofol in group D was slightly more than group K (84% vs 73%), (P-value=0.302). Hemodynamic changes during procedure was same in two group and the recovery time was significantly higher in the D group (18 (17,19) vs 15 (13,18) min, respectively (P-value= 0.006).Conclusion: Finally, the DEEP SEDATION of the diphenhydramine-Propofol combination was almost as good as the ketamine-Propofol combination for cystoscopy and diphenhydramine can be used as an alternative in situations where ketamine consumption is limited.

Background and Aim: Various medications are used for intravenous (IV) SEDATION in pediatric dentistry. This study evaluated the efficacy of IV midazolam/ketamine (MK) versus propofol/ketamine (PK) for dental SEDATION of uncooperative children.    Materials and Methods: This double-blind, randomized controlled clinical trial was carried out on 22 healthy, uncooperative children aged 2-6 years requiring two similar dental treatment sessions. Children were randomly assigned to two groups. Group A received PK in their first, and MK in their second visit. Group B received the same combinations in a reverse order. Oxygen saturation rate (SPO2) and heart rate (HR) were recorded at baseline, at the time of IV administration, local anesthetic injection, 15 and 30 minutes later, and at the time of discharge. Two independent calibrated pedodontists scored the SEDATION level using the Houpt scale during treatment. Data were analyzed by t-test, Wilcoxon, Mann-Whitney, and one-sample Kolmogorov-Smirnov tests.    Results: The mean age of the participants was 3.6 years with a mean weight of 15.68 kg. SPO2 was not significantly different between the two groups (P=0.609). However, the HR was significantly higher in the MK combination (P=0.001). No significant difference was detected between the two combinations for sleepiness (P=0.283), movement (P=0.180), crying (P=0.093), or overall behavior (P=0.364). The recovery time in the PK group was significantly shorter than that in the MK group (P=0.03). Conclusion: Both SEDATION regimens are effective for dental treatment of uncooperative children. PK combination provided a more acceptable hemodynamic stability and shorter recovery.

In traditional speech processing, feature extraction and classification were conducted as separate steps. The advent of DEEP neural networks has enabled methods that simultaneously model the relationship between acoustic and phonetic characteristics of speech while classifying it directly from the raw waveform. The first convolutional layer in these networks acts as a filter bank. To enhance interpretability and reduce the number of parameters, researchers have explored the use of parametric filters, with the SincNet architecture being a notable advancement. In SincNet's initial convolutional layer, rectangular bandpass filters are learned instead of fully trainable filters. This approach allows for modeling with fewer parameters, thereby improving the network's convergence speed and accuracy. Analyzing the learned filter bank also provides valuable insights into the model's performance. The reduction in parameters, along with increased accuracy and interpretability, has led to the adoption of various parametric filters and DEEP architectures across diverse speech processing applications. This paper introduces different types of parametric filters and discusses their integration into various DEEP architectures. Additionally, it examines the specific applications in speech processing where these filters have proven effective.