Aerospace medicine and biology: A continuing bibliography with indexes (supplement 309)

This bibliography lists 136 reports, articles and other documents introduced into the NASA scientific and technical information system in February, 1988

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 402)

This bibliography lists 244 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during Nov. 1992. Subject coverage includes: aerospace medicine and physiology, life support systems and man/system technology, protective clothing, exobiology and extraterrestrial life, planetary biology, and flight crew behavior and performance

Feedback control for exergames

The concept of merging exercise equipment with video games, known as exergaming, has the potential to be one of the main tools used in addressing the current rising obesity epidemic. Existing research shows that exergaming can help improve fitness and additionally motivate people to become more active. The two key elements of attractiveness - how much people want to play or use the exergaming system; and effectiveness – how effective the exergaming system is in actually increasing or maintaining physical fitness, need to be maximised to obtain the best outcomes from an exergaming system; we put this forward as the Dual Flow Model. As part of the development of our exergame system we required the use of a heart rate response simulator. We discovered that there was no existing quantitative model appropriate for the simulation of heart rate responses to exercise. In order to overcome this, we developed our own model for the simulation of heart rate response. Based on our model, we developed a simulation tool known as the Virtual Body Simulator, which we used during our exergame development. Subsequent verification of the model using the trial data indicated that the model accurately represented exergame player heart rate responses to a level that was more than sufficient for exergame research and development. In our experiment, attractiveness was controlled by manipulation of the game difficulty to match the skill of the player. The balance of challenge and skills to facilitate the attainment of the flow state, as described by Csikszentmihalyi (1975), is widely accepted as a motivator for various activities. Effectiveness, in our experiments was controlled through exercise intensity. Exercise intensity was adjusted based on the player‟s heart rate to maintain intensity within the limits of the ASCM Guidelines (ACSM, 2006) for appropriate exercise intensity levels. We tested the Dual Flow Model by developing an exergame designed to work in four different modes; created by selectively varying the control mechanisms for exercise workout intensity and game mental challenge. We then ran a trial with 21 subjects who used the exergame system in each of the different modes. The trial results in relation to the Dual Flow Model showed that we developed an excellent intensity control system based on heart rate monitoring; successfully managing workout intensity for the subjects. However, we found that the subjects generally found the intensity controlled sessions less engaging, being closer to the flow state in the sessions where the intensity was controlled based on heart rate. The dynamic difficulty adjustment system developed for our exergame also did not appear to help facilitate attainment of the flow state. Various theories are put forward as to why this may have occurred. We did find that challenge control had an impact on the actual intensity of the workout. When the intensity was not managed, the challenge control modes were generally closer to the desired heart rates. While the difference was not statistically very large, there was a strong correlation between the intensity of the different modes. This correlation was also present when looking at the players‟ perception of intensity, indicating that the difference was enough to be noticed by the subjects

Poincaré plot analysis of cerebral blood flow signals : feature extraction and classification methods for apnea detection

Objective: Rheoencephalography is a simple and inexpensive technique for cerebral blood flow assessment, however, it is not used in clinical practice since its correlation to clinical conditions has not yet been extensively proved. The present study investigates the ability of Poincaré Plot descriptors from rheoencephalography signals to detect apneas in volunteers. Methods:A group of 16 subjects participated in the study. Rheoencephalography data from baseline and apnea periods were recorded and Poincaré Plot descriptors were extracted from the reconstructed attractors with different time lags (t). Among the set of extracted features, those presenting significant differences between baseline and apnea recordings were used as inputs to four different classifiers to optimize the apnea detection. Results:Three features showed significant differences between apnea and baseline signals: the Poincaré Plot ratio (SDratio), its correlation (R) and the Complex Correlation Measure (CCM). Those differences were optimized for time lags smaller than those recommended in previous works for other biomedical signals, all of them being lower than the threshold established by the position of the inflection point in the CCM curves. The classifier showing the best performance was the classification tree, with 81% accuracy and an area under the curve of the receiver operating characteristic of 0.927. This performance was obtained using a single input parameter, either SDratio or R. Conclusions Poincaré Plot features extracted from the attractors of rheoencephalographic signals were able to track cerebral blood flow changes provoked by breath holding. Even though further validation with independent datasets is needed, those results suggest that nonlinear analysis of rheoencephalography might be a useful approach to assess the correlation of cerebral impedance with clinical changesPeer ReviewedPostprint (published version

Karakterizacija predkliničnega tumorskega ksenograftnega modela z uporabo multiparametrične MR

Introduction: In small animal studies multiple imaging modalities can be combined to complement each other in providing information on anatomical structure and function. Non-invasive imaging studies on animal models are used to monitor progressive tumor development. This helps to better understand the efficacy of new medicines and prediction of the clinical outcome. The aim was to construct a framework based on longitudinal multi-modal parametric in vivo imaging approach to perform tumor tissue characterization in mice. Materials and Methods: Multi-parametric in vivo MRI dataset consisted of T1-, T2-, diffusion and perfusion weighted images. Image set of mice (n=3) imaged weekly for 6 weeks was used. Multimodal image registration was performed based on maximizing mutual information. Tumor region of interested was delineated in weeks 2 to 6. These regions were stacked together, and all modalities combined were used in unsupervised segmentation. Clustering methods, such as K-means and Fuzzy C-means together with blind source separation technique of non-negative matrix factorization were tested. Results were visually compared with histopathological findings. Results: Clusters obtained with K-means and Fuzzy C-means algorithm coincided with T2 and ADC maps per levels of intensity observed. Fuzzy C-means clusters and NMF abundance maps reported most promising results compared to histological findings and seem as a complementary way to asses tumor microenvironment. Conclusions: A workflow for multimodal MR parametric map generation, image registration and unsupervised tumor segmentation was constructed. Good segmentation results were achieved, but need further extensive histological validation.Uvod Eden izmed pomembnih stebrov znanstvenih raziskav v medicinski diagnostiki predstavljajo eksperimenti na živalih v sklopu predkliničnih študij. V teh študijah so eksperimenti izvedeni za namene odkrivanja in preskušanja novih terapevtskih metod za zdravljenje človeških bolezni. Rak jajčnikov je eden izmed glavnih vzrokov smrti kot posledica rakavih obolenj. Potreben je razvoj novih, učinkovitejših metod, da bi lahko uspešneje kljubovali tej bolezni. Časovno okno aplikacije novih terapevtikov je ključni dejavnik uspeha raziskovane terapije. Tumorska fiziologija se namreč razvija med napredovanjem bolezni. Eden izmed ciljev predkliničnih študij je spremljanje razvoja tumorskega mikro-okolja in tako določiti optimalno časovno okno za apliciranje razvitega terapevtika z namenom doseganja maksimalne učinkovitosti. Slikovne modalitete so kot raziskovalno orodje postale izjemno popularne v biomedicinskih in farmakoloških raziskavah zaradi svoje neinvazivne narave. Predklinične slikovne modalitete imajo nemalo prednosti pred tradicionalnim pristopom. Skladno z raziskovalno regulativo, tako za spremljanje razvoja tumorja skozi daljši čas ni potrebno žrtvovati živali v vmesnih časovnih točkah. Sočasno lahko namreč s svojim nedestruktivnim in neinvazivnim pristopom poleg anatomskih informacij podajo tudi molekularni in funkcionalni opis preučevanega subjekta. Za dosego slednjega so običajno uporabljene različne slikovne modalitete. Pogosto se uporablja kombinacija več slikovnih modalitet, saj so medsebojno komplementarne v podajanju željenih informacij. V sklopu te naloge je predstavljeno ogrodje za procesiranje različnih modalitet magnetno resonančnih predkliničnih modelov z namenom karakterizacije tumorskega tkiva. Metodologija V študiji Belderbos, Govaerts, Croitor Sava in sod. [1] so z uporabo magnetne resonance preučevali določitev optimalnega časovnega okna za uspešno aplikacijo novo razvitega terapevtika. Poleg konvencionalnih magnetno resonančnih slikovnih metod (T1 in T2 uteženo slikanje) sta bili uporabljeni tudi perfuzijsko in difuzijsko uteženi tehniki. Zajem slik je potekal tedensko v obdobju šest tednov. Podatkovni seti, uporabljeni v predstavljenem delu, so bili pridobljeni v sklopu omenjene raziskave. Ogrodje za procesiranje je narejeno v okolju Matlab (MathWorks, verzija R2019b) in omogoča tako samodejno kot ročno procesiranje slikovnih podatkov. V prvem koraku je pred generiranjem parametričnih map uporabljenih modalitet, potrebno izluščiti parametre uporabljenih protokolov iz priloženih tekstovnih datotek in zajete slike pravilno razvrstiti glede na podano anatomijo. Na tem mestu so slike tudi filtrirane in maskirane. Filtriranje je koristno za izboljšanje razmerja med koristnim signalom (slikanim živalskim modelom) in ozadjem, saj je skener za zajem slik navadno podvržen različnim izvorom slikovnega šuma. Uporabljen je bil filter ne-lokalnih povprečij Matlab knjižnice za procesiranje slik. Prednost maskiranja se potrdi v naslednjem koraku pri generiranju parametričnih map, saj se ob primerno maskiranem subjektu postopek bistveno pospeši z mapiranjem le na želenem področju. Za izdelavo parametričnih map je uporabljena metoda nelinearnih najmanjših kvadratov. Z modeliranjem fizikalnih pojavov uporabljenih modalitet tako predstavimo preiskovan živalski model z biološkimi parametri. Le-ti se komplementarno dopolnjujejo v opisu fizioloških lastnosti preučevanega modela na ravni posameznih slikovnih elementov. Ključen gradnik v uspešnem dopolnjevanju informacij posameznih modalitet je ustrezna poravnava parametričnih map. Posamezne modalitete so zajete zaporedno, ob različnih časih. Skeniranje vseh modalitet posamezne živali skupno traja več kot eno uro. Med zajemom slik tako navkljub uporabi anestetikov prihaja do majhnih premikov živali. V kolikor ti premiki niso pravilno upoštevani, prihaja do napačnih interpretacij skupnih informacij večih modalitet. Premiki živali znotraj modalitet so bili modelirani kot toge, med različnimi modalitetami pa kot afine preslikave. Poravnava slik je izvedena z lastnimi Matlab funkcijami ali z uporabo funkcij iz odprtokodnega ogrodja za procesiranje slik Elastix. Z namenom karakterizacije tumorskega tkiva so bile uporabljene metode nenadzorovanega razčlenjevanja. Bistvo razčlenjevanja je v združevanju posameznih slikovnih elementov v segmente. Elementi si morajo biti po izbranem kriteriju dovolj medsebojno podobni in se hkrati razlikovati od elementov drugih segmentov. Za razgradnjo so bile izbrane tri metode: metoda K-tih povprečij, kot ena izmed enostavnejšihmetoda mehkih C-tih povprečij, s prednostjo mehke razčlenitvein kot zadnja, nenegativna matrična faktorizacija. Slednja ponuja pogled na razčlenitev tkiva kot produkt tipičnih več-modalnih značilk in njihove obilice za vsak posamezni slikovni element. Za potrditev izvedenega razčlenjevanja z omenjenimi metodami je bila izvedena vizualna primerjava z rezultati histopatološke analize. Rezultati Na ustvarjene parametrične mape je imela poravnava slik znotraj posameznih modalitet velik vpliv. Zaradi dolgotrajnega zajema T1 uteženih slik nemalokrat prihaja do premikov živali, kar brez pravilne poravnave slik negativno vpliva na mapiranje modalitet in kasnejšo segmentacijo slik. Generirane mape imajo majhno odstopanje od tistih, narejenih s standardno uporabljenimi odprtokodnimi programi. Klastri pridobljeni z metodama K-tih in mehkih C-tih povprečij dobro sovpadajo z razčlenbami glede na njihovo inteziteto pri T2 in ADC mapah. Najobetavnejše rezultate po primerjavi s histološkimi izsledki podajata metoda mehkih C-povprečij in nenegativna matrična faktorizacija. Njuni segmentaciji se dopolnjujeta v razlagi tumorskega mikro-okolja. Zaključek Z izgradnjo ogrodja za procesiranje slik magnetne resonance in segmentacijo tumorskega tkiva je bil cilj magistrske naloge dosežen. Zasnova ogrodja omogoča poljubno dodajanje drugih modalitet in uporabo drugih živalskih modelov. Rezultati razčlenitve tumorskega tkiva so obetavni, vendar je potrebna nadaljna primerjava z rezultati histopatološke analize. Možna nadgradnja je izboljšanje robustnosti poravnave slik z uporabo modela netoge (elastične) preslikave. Prav tako je smiselno preizkusiti dodatne metode nenadzorovane segmentacije in dobljene rezultate primerjati s tukaj predstavljenimi

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 380)

This bibliography lists 192 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during Oct. 1993. Subject coverage includes: aerospace medicine and physiology, life support systems and man/system technology, protective clothing, exobiology and extraterrestrial life, planetary biology, and flight crew behavior and performance

On Automation in Anesthesia

The thesis discusses closed-loop control of the hypnotic and the analgesic components of anesthesia. The objective of the work has been to develop a system which independently controls the intravenous infusion rates of the hypnotic drug propofol and analgesic drug remifentanil. The system is designed to track a reference hypnotic depth level, while maintaining adequate analgesia. This is complicated by inter-patient variability in drug sensitivity, disturbances caused foremost by surgical stimulation, and measurement noise. A commercially available monitor is used to measure the hypnotic depth of the patient, while a simple soft sensor estimates the analgesic depth. Both induction and maintenance of anesthesia are closed-loop controlled, using a PID controller for propofol and a P controller for remifentanil. In order to tune the controllers, patient models have been identified from clinical data, with body mass as only biometric parameter. Care has been taken to characterize identifiability and produce models which are safe for the intended application. A scheme for individualizing the controller tuning upon completion of the induction phase of anesthesia is proposed. Practical aspects such as integrator anti-windup and loss of the measurement signal are explicitly addressed. The validity of the performance measures, most commonly reported in closed-loop anesthesia studies, is debated and a new set of measures is proposed. It is shown, both in simulation and clinically, that PID control provides a viable approach. Both results from simulations and clinical trials are presented. These results suggest that closed-loop controlled anesthesia can be provided in a safe and efficient manner, relieving the regulatory and server controller role of the anesthesiologist. However, outlier patient dynamics, unmeasurable disturbances and scenarios which are not considered in the controller synthesis, urge the presence of an anesthesiologist. Closed-loop controlled anesthesia should therefore not be viewed as a replacement of human expertise, but rather as a tool, similar to the cruise controller of a car

Computational methods for the analysis of functional 4D-CT chest images.

Medical imaging is an important emerging technology that has been intensively used in the last few decades for disease diagnosis and monitoring as well as for the assessment of treatment effectiveness. Medical images provide a very large amount of valuable information that is too huge to be exploited by radiologists and physicians. Therefore, the design of computer-aided diagnostic (CAD) system, which can be used as an assistive tool for the medical community, is of a great importance. This dissertation deals with the development of a complete CAD system for lung cancer patients, which remains the leading cause of cancer-related death in the USA. In 2014, there were approximately 224,210 new cases of lung cancer and 159,260 related deaths. The process begins with the detection of lung cancer which is detected through the diagnosis of lung nodules (a manifestation of lung cancer). These nodules are approximately spherical regions of primarily high density tissue that are visible in computed tomography (CT) images of the lung. The treatment of these lung cancer nodules is complex, nearly 70% of lung cancer patients require radiation therapy as part of their treatment. Radiation-induced lung injury is a limiting toxicity that may decrease cure rates and increase morbidity and mortality treatment. By finding ways to accurately detect, at early stage, and hence prevent lung injury, it will have significant positive consequences for lung cancer patients. The ultimate goal of this dissertation is to develop a clinically usable CAD system that can improve the sensitivity and specificity of early detection of radiation-induced lung injury based on the hypotheses that radiated lung tissues may get affected and suffer decrease of their functionality as a side effect of radiation therapy treatment. These hypotheses have been validated by demonstrating that automatic segmentation of the lung regions and registration of consecutive respiratory phases to estimate their elasticity, ventilation, and texture features to provide discriminatory descriptors that can be used for early detection of radiation-induced lung injury. The proposed methodologies will lead to novel indexes for distinguishing normal/healthy and injured lung tissues in clinical decision-making. To achieve this goal, a CAD system for accurate detection of radiation-induced lung injury that requires three basic components has been developed. These components are the lung fields segmentation, lung registration, and features extraction and tissue classification. This dissertation starts with an exploration of the available medical imaging modalities to present the importance of medical imaging in today’s clinical applications. Secondly, the methodologies, challenges, and limitations of recent CAD systems for lung cancer detection are covered. This is followed by introducing an accurate segmentation methodology of the lung parenchyma with the focus of pathological lungs to extract the volume of interest (VOI) to be analyzed for potential existence of lung injuries stemmed from the radiation therapy. After the segmentation of the VOI, a lung registration framework is introduced to perform a crucial and important step that ensures the co-alignment of the intra-patient scans. This step eliminates the effects of orientation differences, motion, breathing, heart beats, and differences in scanning parameters to be able to accurately extract the functionality features for the lung fields. The developed registration framework also helps in the evaluation and gated control of the radiotherapy through the motion estimation analysis before and after the therapy dose. Finally, the radiation-induced lung injury is introduced, which combines the previous two medical image processing and analysis steps with the features estimation and classification step. This framework estimates and combines both texture and functional features. The texture features are modeled using the novel 7th-order Markov Gibbs random field (MGRF) model that has the ability to accurately models the texture of healthy and injured lung tissues through simultaneously accounting for both vertical and horizontal relative dependencies between voxel-wise signals. While the functionality features calculations are based on the calculated deformation fields, obtained from the 4D-CT lung registration, that maps lung voxels between successive CT scans in the respiratory cycle. These functionality features describe the ventilation, the air flow rate, of the lung tissues using the Jacobian of the deformation field and the tissues’ elasticity using the strain components calculated from the gradient of the deformation field. Finally, these features are combined in the classification model to detect the injured parts of the lung at an early stage and enables an earlier intervention

Multidimensional embedded MEMS motion detectors for wearable mechanocardiography and 4D medical imaging

Background: Cardiovascular diseases are the number one cause of death. Of these deaths, almost 80% are due to coronary artery disease (CAD) and cerebrovascular disease. Multidimensional microelectromechanical systems (MEMS) sensors allow measuring the mechanical movement of the heart muscle offering an entirely new and innovative solution to evaluate cardiac rhythm and function. Recent advances in miniaturized motion sensors present an exciting opportunity to study novel device-driven and functional motion detection systems in the areas of both cardiac monitoring and biomedical imaging, for example, in computed tomography (CT) and positron emission tomography (PET). Methods: This Ph.D. work describes a new cardiac motion detection paradigm and measurement technology based on multimodal measuring tools — by tracking the heart’s kinetic activity using micro-sized MEMS sensors — and novel computational approaches — by deploying signal processing and machine learning techniques—for detecting cardiac pathological disorders. In particular, this study focuses on the capability of joint gyrocardiography (GCG) and seismocardiography (SCG) techniques that constitute the mechanocardiography (MCG) concept representing the mechanical characteristics of the cardiac precordial surface vibrations. Results: Experimental analyses showed that integrating multisource sensory data resulted in precise estimation of heart rate with an accuracy of 99% (healthy, n=29), detection of heart arrhythmia (n=435) with an accuracy of 95-97%, ischemic disease indication with approximately 75% accuracy (n=22), as well as significantly improved quality of four-dimensional (4D) cardiac PET images by eliminating motion related inaccuracies using MEMS dual gating approach. Tissue Doppler imaging (TDI) analysis of GCG (healthy, n=9) showed promising results for measuring the cardiac timing intervals and myocardial deformation changes. Conclusion: The findings of this study demonstrate clinical potential of MEMS motion sensors in cardiology that may facilitate in time diagnosis of cardiac abnormalities. Multidimensional MCG can effectively contribute to detecting atrial fibrillation (AFib), myocardial infarction (MI), and CAD. Additionally, MEMS motion sensing improves the reliability and quality of cardiac PET imaging.Moniulotteisten sulautettujen MEMS-liiketunnistimien käyttö sydänkardiografiassa sekä lääketieteellisessä 4D-kuvantamisessa Tausta: Sydän- ja verisuonitaudit ovat yleisin kuolinsyy. Näistä kuolemantapauksista lähes 80% johtuu sepelvaltimotaudista (CAD) ja aivoverenkierron häiriöistä. Moniulotteiset mikroelektromekaaniset järjestelmät (MEMS) mahdollistavat sydänlihaksen mekaanisen liikkeen mittaamisen, mikä puolestaan tarjoaa täysin uudenlaisen ja innovatiivisen ratkaisun sydämen rytmin ja toiminnan arvioimiseksi. Viimeaikaiset teknologiset edistysaskeleet mahdollistavat uusien pienikokoisten liiketunnistusjärjestelmien käyttämisen sydämen toiminnan tutkimuksessa sekä lääketieteellisen kuvantamisen, kuten esimerkiksi tietokonetomografian (CT) ja positroniemissiotomografian (PET), tarkkuuden parantamisessa. Menetelmät: Tämä väitöskirjatyö esittelee uuden sydämen kineettisen toiminnan mittaustekniikan, joka pohjautuu MEMS-anturien käyttöön. Uudet laskennalliset lähestymistavat, jotka perustuvat signaalinkäsittelyyn ja koneoppimiseen, mahdollistavat sydämen patologisten häiriöiden havaitsemisen MEMS-antureista saatavista signaaleista. Tässä tutkimuksessa keskitytään erityisesti mekanokardiografiaan (MCG), joihin kuuluvat gyrokardiografia (GCG) ja seismokardiografia (SCG). Näiden tekniikoiden avulla voidaan mitata kardiorespiratorisen järjestelmän mekaanisia ominaisuuksia. Tulokset: Kokeelliset analyysit osoittivat, että integroimalla usean sensorin dataa voidaan mitata syketiheyttä 99% (terveillä n=29) tarkkuudella, havaita sydämen rytmihäiriöt (n=435) 95-97%, tarkkuudella, sekä havaita iskeeminen sairaus noin 75% tarkkuudella (n=22). Lisäksi MEMS-kaksoistahdistuksen avulla voidaan parantaa sydämen 4D PET-kuvan laatua, kun liikeepätarkkuudet voidaan eliminoida paremmin. Doppler-kuvantamisessa (TDI, Tissue Doppler Imaging) GCG-analyysi (terveillä, n=9) osoitti lupaavia tuloksia sydänsykkeen ajoituksen ja intervallien sekä sydänlihasmuutosten mittaamisessa. Päätelmä: Tämän tutkimuksen tulokset osoittavat, että kardiologisilla MEMS-liikeantureilla on kliinistä potentiaalia sydämen toiminnallisten poikkeavuuksien diagnostisoinnissa. Moniuloitteinen MCG voi edistää eteisvärinän (AFib), sydäninfarktin (MI) ja CAD:n havaitsemista. Lisäksi MEMS-liiketunnistus parantaa sydämen PET-kuvantamisen luotettavuutta ja laatua