Patient-Monitoring Systems

book chapterBiomedical Informatic

Studies of the effects of gravitational and inertial forces on cardiovascular and respiratory dynamics

The current status and application are described of the biplane video roentgen densitometry, videometry and video digitization systems. These techniques were developed, and continue to be developed for studies of the effects of gravitational and inertial forces on cardiovascular and respiratory dynamics in intact animals and man. Progress is reported in the field of lung dynamics and three-dimensional reconstruction of the dynamic thoracic contents from roentgen video images. It is anticipated that these data will provide added insight into the role of shape and internal spatial relationships (which is altered particularly by acceleration and position of the body) of these organs as an indication of their functional status

Long-term biosignals visualization and processing

Thesis submitted in the fulfillment of the requirements for the Degree of Master in Biomedical EngineeringLong-term biosignals acquisitions are an important source of information about the patients’state and its evolution. However, long-term biosignals monitoring involves managing extremely large datasets, which makes signal visualization and processing a complex task. To overcome these problems, a new data structure to manage long-term biosignals was developed. Based on this new data structure, dedicated tools for long-term biosignals visualization and processing were implemented. A multilevel visualization tool for any type of biosignals, based on subsampling is presented, focused on four representative signal parameters (mean, maximum, minimum and standard deviation error). The visualization tool enables an overview of the entire signal and a more detailed visualization in specific parts which we want to highlight, allowing an user friendly interaction that leads to an easier signal exploring. The ”map” and ”reduce” concept is also exposed for long-term biosignal processing. A processing tool (ECG peak detection) was adapted for long-term biosignals. In order to test the developed algorithm, long-term biosignals acquisitions (approximately 8 hours each) were carried out. The visualization tool has proven to be faster than the standard methods, allowing a fast navigation over the different visualization levels of biosignals. Regarding the developed processing algorithm, it detected the peaks of long-term ECG signals with fewer time consuming than the nonparalell processing algorithm. The non-specific characteristics of the new data structure, visualization tool and the speed improvement in signal processing introduced by these algorithms makes them powerful tools for long-term biosignals visualization and processing

A Database For Exploratory Analysis of Human Sleep

This thesis focuses on the design, development, and exploratory analysis of a human sleep data repository. We have successfully collected comprehensive data for 1,046 sleep disorder patients and created a Terabyte-scale database system to handle it. The data for each patient was collected from the patient\u27s medical records, and from the patient\u27s allnight sleep study (for a total of about 0.6 Gigabytes per patient). Data collected from the patient\u27s medical record contain more than 70 attributes, including demographic data, smoking, drinking, and exercise habits, depression and daytime sleepiness questionnaires, and overall medical history. Data collected from the patient\u27s all-night sleep study consist of 50-55 time-series signals recorded during a period of 6-8 hours at the hospital\u27s sleep clinic. These signals include among others an electroencephalogram, electromyogram, electrooculogram, electrocardiogram, and signals tracking blood oxygen level, body position, limb movements, snoring and blood pressure. 350 additional attributes summarize sleep related events taking place during the night long study, including sleep stages, arousals, and respiratory disturbances. Particular attention during the development of our database system was paid to a database design that effectively handles the data size and complexity, that describes the structure of sleep data in clinically meaningful terms, and that will facilitates the discovery of patterns in sleep data using machine learning algorithms. We have interfaced our database with Weka, a well known data mining system. To the best of our knowledge, our database is one of the world\u27s largest and most comprehensive in the domain of human sleep disorders

Systolic ejection murmurs and the left ventricular outflow tract in boxer dogs

Turbulence of various genesis in the left ventricular outflow tract (LVOT) causes systolic ejection murmurs. The prevalence of murmurs in adult boxer dogs is 50-80%, the majority of which are of low intensity. Some of the murmurs are caused by aortic stenosis (AS), while the origin of the others is unclear. The aim of this thesis was to study the physiology and clinical evaluation of systolic ejection murmurs and their relation to the development of the LVOT in boxers with and without AS. Growing and adult boxer dogs were examined by the standard methods cardiac auscultation, ECG, phonocardiography and echocardiography. Additionally, the complementary methods time-frequency and complexity analyses of heart murmurs and contrast echocardiography were evaluated. Studies on inter-observer variation in cardiac auscultation proved the importance of experience in detection and grading of low intensity ejection murmurs. Excitement of the dogs by exercise or noise stimulation (barking dog and squeaky toy) caused higher murmur grades, longer murmur duration and increased aortic flow velocities. No differences were found between diameters measured at different levels of the LVOT in growing boxers. Contrast echocardiography enhanced Doppler signals, but did not allow evaluation of myocardial blood flow. Using time-frequency analysis, duration of murmur frequency >200 Hz proved useful for differentiation between dogs with mild AS and dogs without. Combining assessment of murmur duration >200 Hz and complexity analysis using the correlation dimension (T2), a sensitivity of 94% and a specificity of 82% for differentiation between dogs with and without AS was achieved. The variability in presence and intensity of low intensity murmurs during growth was high. None of the young dogs developed AS, whereas 3 out of 16 individuals developed mild-moderate aortic insufficiency. Aortic or pulmonic flow velocities did not differ significantly between growing dogs with or without low intensity murmurs. In conclusion, the variability in presence and intensity of low intensity ejection murmurs in boxers is high during growth with no obvious progression. Both in young and adult boxers the murmur grade increased during excitement, which may be due to rapid flow in a comparatively small LVOT that has been suggested for the boxer breed. Experience is important in cardiac auscultation of low intensity murmurs. Therefore, assessment of murmur duration > 200 Hz combined with T2 analysis may be a useful complementary method for diagnosis of cardiovascular function in dogs

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

Role of Internal Calcium Stores in Exocytosis and Neurotransmission: A Dissertation

A central concept in the physiology of neurosecretion is that a rise in cytosolic [Ca2+] in the vicinity of plasmalemmal Ca2+ channels due to Ca2+ influx, elicits exocytosis. This dissertation examines the effect on both spontaneous and elicited exocytosis of a rise in focal cytosolic [Ca2+] in the vicinity of ryanodine receptors (RYRs) due to release from internal stores in the form of Ca2+ syntillas. Ca2+ syntillas are focal cytosolic transients mediated by RYRs, which we first found in hypothalamic magnocellular neuronal terminals. (Scintilla, Latin for spark, found in nerve terminals, normally synaptic structures.) We have also observed Ca2+ syntillas in mouse adrenal chromaffin cells (ACCs). Here the effect of Ca2+syntillas on exocytosis is examined in ACCs, which are widely used as model cells for the study of neurosecretion. Elicited exocytosis employs two sources of Ca2+, one due to influx from the cell exterior through voltage-gated Ca2+ channels (VGCCs) and another due to release from intracellular stores. To eliminate complications arising from Ca2+ influx, the first part of this dissertation examines spontaneous exocytosis where influx is not activated. We report that decreasing syntillas leads to an increase in spontaneous exocytosis measured amperometrically. Two independent lines of experimentation each lead to this conclusion. In one case release from stores was blocked by ryanodine; in another, stores were partially emptied using thapsigargin plus caffeine after which syntillas were decreased. We conclude that Ca2+syntillas act to inhibit spontaneous exocytosis, and we propose a simple model to account quantitatively for this action of syntillas. The second part of this dissertation examines the role of syntillas in elicited exocytosis whereby Ca2+ influx is activated by physiologically relevant levels of stimulation. Catecholamine and neuropeptide release from ACCs into the circulation is controlled by the sympathetic division of the Autonomic Nervous System. To ensure proper homeostasis tightly controlled exocytic mechanisms must exist both in resting conditions, where minimal output is desirable and under stress, where maximal, but not total release is necessary. It is thought that sympathetic discharge accomplishes this task by regulating the frequency of Ca2+ influx through VGCCs, which serves as a direct trigger for exocytosis. But our studies on spontaneous release in ACCs revealed the presence of Ca2+ syntillas, which had the opposite effect of inhibiting release. Therefore, assuming Ca2+-induced Ca2+ release (CICR) via RYRs due to Ca2+ influx through VGCCs, we are confronted with a contradiction. Sympathetic discharge should increase syntilla frequency and that in turn should decreaseexocytosis, a paradox. A simple “explanation” might be that the increase in syntillas would act as a brake to prevent an overly great exocytic release. But upon investigation of this question a different finding emerged. We examined the role of syntillas under varying levels of physiologic stimulation in ACCs using simulated action potentials (sAPs) designed to mimic native input at frequencies associated with stress, 15 Hz, and the basal sympathetic tone, 0.5 Hz. Surprisingly, we found that sAPs delivered at 15 Hz or 0.5 Hz were able to completely abolish Ca2+ syntillas within a time frame of two minutes. This was not expected. Further, a single sAP is all that was necessary to initiate suppression of syntillas. Syntillas remained inhibited after 0.5 Hz stimulation but were only temporarily suppressed (for 2 minutes) by 15 Hz stimulation, where global [Ca2+]i was raised to 1 – 2 μM. Thus we propose that CICR, if present in these cells, is overridden by other processes. Hence it appears that inhibition of syntillas by action potentials in ACCs is due to a new process which is the opposite of CICR. This process needs to be investigated, and that will be one of the very next steps in the future. Finally we conclude that syntilla suppression by action potentials is part of the mechanism for elicited exocytosis, resolving the paradox. In the last chapter speculation is discussed into the mechanisms by which physiologic input in the form of an action potential can inhibit Ca2+ syntillas and furthermore, how the Ca2+ syntilla can inhibit exocytic output

Patient-Monitoring Systems

book chapterBiomedical Informatic

PlantES: A plant electrophysiological multi-source data online analysis and sharing platform

At present, plant electrophysiological data volumes and complexity are increasing rapidly. It causes the demand for efficient management of big data, data sharing among research groups, and fast analysis. In this paper, we proposed PlantES (Plant Electrophysiological Data Sharing), a distributed computing-based prototype system that can be used to store, manage, visualize, analyze, and share plant electrophysiological data. We deliberately designed a storage schema to manage the multi-source plant electrophysiological data by integrating distributed storage systems HDFS and HBase to access all kinds of files efficiently. To improve the online analysis efficiency, parallel computing algorithms on Spark were proposed and implemented, e.g., plant electrical signals extraction method, the adaptive derivative threshold algorithm, and template matching algorithm. The experimental results indicated that Spark efficiently improves the online analysis. Meanwhile, the online visualization and sharing of multiple types of data in the web browser were implemented. Our prototype platform provides a solution for web-based sharing and analysis of plant electrophysiological multi-source data and improves the comprehension of plant electrical signals from a systemic perspective

Predicting optimal anesthesia level from propofol and remifentanil concentration: analysis of covariate factors for individualization

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2020-2021. Tutor: Pedro Gambús Cerrillo. Tutor Extern: Sebastián Jaramillo SelmanGeneral anesthesia involves some targeting effects which aim to prevent the patient from suffering against the therapeutic aggression. These effects are hypnosis, analgesia, amnesia and immobility and to achieve them a combination of drugs is delivered into the patient, from which propofol and remifentanil are highlighted. In the operating room, monitoring systems are used to assess the depth of anesthesia in real time. This monitoring includes basic systems such as arterial blood pressure, oxygenation or electrocardiogram and electroencephalogram derived measures, which are more complex; from this last group, BIS index is a good indicator. Being able to predict the anesthetic depth from a set of input variables could be valuable during the surgery, as it would help the anesthesiologists to prevent adverse effects, and it would help the post-operative recovery. Knowing this, the aim of this project is to predict the probability to be in the optimal level of anesthesia, which is related to the BIS index. This probability is obtained from the input concentration of propofol and remifentanil, a hypnotic and an analgesic drug respectively, and from the demographic variables such as age, height or gender. To do so, a Logistic Regression model will be built with data from patients undergoing general anesthesia in Cirurgia Major Ambulatòria (CMA) in Hospital Clínic