Advanced observation and telemetry heart system utilizing wearable ECG device and a Cloud platform

Short lived chest pain episodes of post PCI patients represent the most common clinical scenario treated in the Accidents and Emergency Room. Continuous ECG monitoring could substantially diminish such hospital admissions and related ambulance calls. Delivering community based, easy-To-handle, easy to wear, real time electrocardiography systems is still a quest, despite the existence of electronic electrocardiography systems for several decades. The PATRIOT system serves this challenge via a 12-channel, easy to wear, easy to carry, mobile linked, miniaturized automatic ECG device and a Cloud platform. The system may deliver high quality electrocardiograms of a patient to medical personnel either on the spot or remotely both in a synchronous or asynchronous mode, enhancing autonomy, mobility, quality of life and safety of recently treated coronary artery disease patients

Risk factors for paravalvular leak after transcatheter aortic valve replacement

Objective. To assess risk factors for paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) in a large single-center cohort, including measurement of aortic valve calcification using a reproducible method. Methods. We retrospectively analyzed preoperative contrast-enhanced multidetector computed tomography (MDCT) scans of patients who underwent TAVI in our center between 2009 and 2016. Calcium volume was calculated for each aortic cusp in the aortic valve (AV), left ventricular outflow tract (LVOT) and device-landing zone (DLZ). Results. Overall, 539 patients were included in the study (Edwards SapienXT, n=192; Edwards Sapien3, n=206; Medtronic CoreValve EvolutR, n=44; Symetis Acurate, n=97). Median calcium volume in the DLZ was 757 mm3, with no significant differences among the four prosthesis groups. None of the patients had severe PVL. The overall incidence of mild-to-moderate PVL was 15.8% (95% CI: 12.8-19.1%). On multivariate logistic regression, DLZ calcification (p=0.00006; OR for an increase of 100 mm3 1.08; 95% CI: 1.04-1.13) and use of the CoreValve (p=0.0028; OR 4.1; 95% CI: 1.6-10 with SapienXT as reference) prosthesis were found to be associated with ≥mild PVL. In contrast, degree of oversizing (p=0.002; OR 0.97; 95% CI: 0.95-0.99), and use of Sapien3 (p=0.00005; OR 0.23; 95% CI: 0.11-0.47 with SapienXT as reference) were associated with a lower incidence of ≥mild PVL. Conclusions. Aortic calcification volume in the DLZ is associated with residual PVL after TAVI. When taking calcification into account, the balloon-expandable prosthesis Sapien3 seems to be associated with a lower incidence of PVL

Validate implementation correctness using simulation: the TASTE approach

High-integrity systems operate in hostile environment and must guarantee a continuous operational state, even if unexpected events happen. In addition, these systems have stringent requirements that must be validated and correctly translated from high-level specifications down to code. All these constraints make the overall development process more time-consuming. This becomes especially complex because the number of system functions keeps increasing over the years. As a result, engineers must validate system implementation and check that its execution conforms to the specifications. To do so, a traditional approach consists in a manual instrumentation of the implementation code to trace system activity while operating. However, this might be error-prone because modifications are not automatic and still made manually. Furthermore, such modifications may have an impact on the actual behavior of the system. In this paper, we present an approach to validate a system implementation by comparing execution against simulation. In that purpose, we adapt TASTE, a set of tools that eases system development by automating each step as much as possible. In particular, TASTE automates system implementation from functional (system functions description with their properties – period, deadline, priority, etc.) and deployment(processors, buses, devices to be used) models. We tailored this tool-chain to create traces during system execution. Generated output shows activation time of each task, usage of communication ports (size of the queues, instant of events pushed/pulled, etc.) and other relevant execution metrics to be monitored. As a consequence, system engineers can check implementation correctness by comparing simulation and execution metrics

Feedforward data-aided phase noise estimation from a DCT basis expansion

This contribution deals with phase noise estimation from pilot symbols. The phase noise process is approximated by an expansion of discrete cosine transform (DCT) basis functions containing only a few terms. We propose a feedforward algorithm that estimates the DCT coefficients without requiring detailed knowledge about the phase noise statistics. We demonstrate that the resulting (linearized) mean-square phase estimation error consists of two contributions: a contribution from the additive noise, that equals the Cramer-Rao lower bound, and a noise independent contribution, that results front the phase noise modeling error. We investigate the effect of the symbol sequence length, the pilot symbol positions, the number of pilot symbols, and the number of estimated DCT coefficients it the estimation accuracy and on the corresponding bit error rate (PER). We propose a pilot symbol configuration allowing to estimate any number of DCT coefficients not exceeding the number of pilot Symbols, providing a considerable Performance improvement as compared to other pilot symbol configurations. For large block sizes, the DCT-based estimation algorithm substantially outperforms algorithms that estimate only the time-average or the linear trend of the carrier phase. Copyright (C) 2009 J. Bhatti and M. Moeneclaey

A Surgical Virtual Learning Environment

A computer based Virtual Learning Environment is proposed for training and evaluating novice surgeons. Although this Virtual Learning Environments is thought to be useful in other learning situations as well, especially where knowledge of different complex procedures and the ability to correctly assess a complex situation is critical, in this project we specifically focus on vascular surgery. This environment will be developed as part of the DIME project (Distributed Interactive Medical Exploratory). We are building this Virtual Learning Environment using a new navigational metaphor, which affords modeling the learning process, rather than focusing solely on modeling the operating room. This 'navigational metaphor' can be thought of as an semi-threedimensional interface to a database containing multimedia fragments and expert annotations of the knowledge domain under study

Guidelines and Standard Operating Procedures for IDDE and Pollution Prevention/Good Housekeeping

In April 2003, the United States Environmental Protection Agency (USEPA) issued a National Pollutant Discharge Elimination System (NPDES) General Permit for Stormwater Discharges from Small Municipal Separate Storm Sewer Systems (MS4s). A total of 45 New Hampshire communities (six fully regulated and 39 partially regulated) became subject to Stormwater Phase II regulations based on their designation as Urbanized Areas according to the 2000 US Census

Prioritising energy efficiency measures in Maltese restaurants

The 2018 Energy Performance of Buildings Directive (EU) 2018/844, focuses on building energy renovation. With the increase in tourists and working opportunities in Malta, the restaurants’ sector is experiencing a business boom. Despite this sector being a major energy consumer, the energy performance of restaurants in Malta has been given little attention. This paper investigates the energy performance of four representative restaurants in Malta. Refrigeration accounted for the highest share of 40% electricity consumption, followed by kitchen exhaust ventilation, domestic hot water and space cooling, which accounted for about 50%, while lighting consumed only 6%. Energy saving potential was primarily identified for refrigeration, water heating and air-conditioning. Although, the fuel sources used for cooking equipment accounted for more than 50% of the overall energy used in these restaurants, electricity is the fuel of primary concern as on average it contributes to 70% of total carbon emissions and results in the highest operational cost. The total potential of carbon emission savings was found to be 17%, when the recommended energy efficiency measures are applied. A benchmark of 14.51 kWh primary energy per person served was established for energy-efficient restaurants. This paper provides evidence-based results that are useful for policy makers to introduce fiscal incentives to support the transition of Maltese restaurants to nearly-zero energy status.peer-reviewe