姿勢－呼吸フィードバック制御機構の実装と評価

国立大学法人長岡技術科学大

Autonomic care platform for optimizing query performance

Background: As the amount of information in electronic health care systems increases, data operations get more complicated and time-consuming. Intensive Care platforms require a timely processing of data retrievals to guarantee the continuous display of recent data of patients. Physicians and nurses rely on this data for their decision making. Manual optimization of query executions has become difficult to handle due to the increased amount of queries across multiple sources. Hence, a more automated management is necessary to increase the performance of database queries. The autonomic computing paradigm promises an approach in which the system adapts itself and acts as self-managing entity, thereby limiting human interventions and taking actions. Despite the usage of autonomic control loops in network and software systems, this approach has not been applied so far for health information systems. Methods: We extend the COSARA architecture, an infection surveillance and antibiotic management service platform for the Intensive Care Unit (ICU), with self-managed components to increase the performance of data retrievals. We used real-life ICU COSARA queries to analyse slow performance and measure the impact of optimizations. Each day more than 2 million COSARA queries are executed. Three control loops, which monitor the executions and take action, have been proposed: reactive, deliberative and reflective control loops. We focus on improvements of the execution time of microbiology queries directly related to the visual displays of patients' data on the bedside screens. Results: The results show that autonomic control loops are beneficial for the optimizations in the data executions in the ICU. The application of reactive control loop results in a reduction of 8.61% of the average execution time of microbiology results. The combined application of the reactive and deliberative control loop results in an average query time reduction of 10.92% and the combination of reactive, deliberative and reflective control loops provides a reduction of 13.04%. Conclusions: We found that by controlled reduction of queries' executions the performance for the end-user can be improved. The implementation of autonomic control loops in an existing health platform, COSARA, has a positive effect on the timely data visualization for the physician and nurse

Regulation of human pancreas hormone secretion by autonomic innervation

Diabetes mellitus is a silent killer doing away with one person every 10 seconds. We speak of diabetes when the organism cannot control the right level of glucose in the blood. The hormones insulin and glucagon secreted by the islets of Langerhans are the major players maintaining glucose homeostasis. In the living organism, the function of the islets is orchestrated by their interaction with other organs through the vasculature and with the nervous system. Most of our current knowledge of islet biology has been obtained by using mouse models, but caution is needed, as mice are not simply small humans. Indeed, recent studies have revealed that the cell composition and architecture of the human islet are different from that of mouse islets. Thus, other important features such as nervous regulation of islet function may also be different. The work in this thesis aimed to identify the role of innervation for islet function. Our hypothesis is that autonomic and paracrine signals are involved in islet function and that the relative role of these components varies among species. To identify the sympathetic and parasympathetic components of innervation as well as their cellular targets we used immunohistochemical staining of human and mouse pancreatic sections. In contrast to mouse, human islets are devoid of parasympathetic innervation. Instead, human alpha cells possess the machinery for exocytosis of acetylcholine, the major parasympathetic neurotransmitter. Our findings suggest that human islets depend less on neural cholinergic input than mouse islets. Alpha cells secrete acetylcholine as a paracrine signal priming the human beta cell to respond optimally to subsequent increases in glucose concentration. In addition, noradrenergic fibers contact few endocrine cells in the human islet and preferentially innervate smooth muscle cells of the islet vasculature. This suggests that sympathetic innervation regulates hormone secretion by controlling the blood flow rather than modulating endocrine cell function directly. By taking advantage of our recently developed noninvasive anterior chamber of the eye imaging platform we were able to study the role of innervation in the maintenance of glucose homeostasis in vivo. We studied the process of reinnervation and revascularization of intraocular islet grafts and showed that islets orchestrate the process of engraftment to restore their original microenvironment. Islet grafts from two different mouse strains and human xenografts showed innervation patterns similar to those in pancreatic sections in situ. Islet grafts displayed the characteristic fenestrae of the pancreatic vascular endothelium independently of the origin of the new vessels. In addition, the model allowed controlling the fraction of the graft vasculature that is contributed by the donor islet endothelial cells to the point that the original donor vasculature of the islet is restored. Recording graft function while manipulating the eye’s neural input through the pupillary light reflex revealed functional differences in parasympathetic innervation between the two mouse strains. The eye platform also allowed us to follow cell dynamics during immune responses, which will enable investigations aimed at clarifying the role of innervation in the pathogenesis of autoimmune diabetes. To study human islet biology in vivo we further adopted the eye model by transplanting human islets into the eye of diabetic immune compromised mice. Human xenografts reversed diabetes and tightly controlled plasma glucose concentrations. Moreover, our results provided the first real time monitoring of revascularization and blood flow inside human islets and graft function could be modulated by local drug administration. Our findings establish a “humanized” mouse model to investigate human islet biology in vivo that will allow addressing how nervous input affects endocrine function or blood flow in human islets. The physiological relevance of the anterior chamber of the eye model is further underscored by the therapeutic potential as a novel transplantation site to treat type 1 diabetic patients

Investigating the effects of odour integration in reading and learning experiences

Books are the tools used for reading novels and stories, but also for educational purposes. Conventional books have undergone a radical transformation in recent years due to the use of new technologies. However, even today the technological devices used for reading e-books are still poorly exploited, despite the fact that they represent a fundamental tool to make the reading experience more immersive by using a complete multisensory approach. In this perspective, one sense that represents an important element of human perception is the sense of smell. Consequently, authors make the hypothesis that the introduction of odours during reading sessions could increase the user experience and the learning performances. In order to demonstrate these hypotheses, the authors have defined and carried out several experimental testing sessions. The analysis of the collected data proved that the introduction of odour does not disturb the reader during reading activities but, on the contrary, can actually make the experience more immersive. Similarly, odours do not disturb studying activities, but they can instead increase the level of concentration and people's learning performance

Live Biofeedback as a User Interface Design Element: A Review of the Literature

With the advances in sensor technology and real-time processing of neurophysiological data, a growing body of academic literature has begun to explore how live biofeedback can be integrated into information systems for everyday use. While researchers have traditionally studied live biofeedback in the clinical domain, the proliferation of affordable mobile sensor technology enables researchers and practitioners to consider live biofeedback as a user interface element in contexts such as decision support, education, and gaming. In order to establish the current state of research on live biofeedback, we conducted a literature review on studies that examine self and foreign live biofeedback based on neurophysiological data for healthy subjects in an information systems context. By integrating a body of highly fragmented work from computer science, engineering and technology, information systems, medical science, and psychology, this paper synthesizes results from existing research, identifies knowledge gaps, and suggests directions for future research. In this vein, this review can serve as a reference guide for researchers and practitioners on how to integrate self and foreign live biofeedback into information systems for everyday use

Investigating the effects of odour integration in reading and learning experiences

Books are the tools used for reading novels and stories, but also for educational purposes. Conventional books have undergone a radical transformation in recent years due to the use of new technologies. However, even today the technological devices used for reading e-books are still poorly exploited, despite the fact that they represent a fundamental tool to make the reading experience more immersive by using a complete multisensory approach. In this perspective, one sense that represents an important element of human perception is the sense of smell. Consequently, authors make the hypothesis that the introduction of odours during reading sessions could increase the user experience and the learning performances. In order to demonstrate these hypotheses, the authors have defined and carried out several experimental testing sessions. The analysis of the collected data proved that the introduction of odour does not disturb the reader during reading activities but, on the contrary, can actually make the experience more immersive. Similarly, odours do not disturb studying activities, but they can instead increase the level of concentration and people's learning performance

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 359)

This bibliography lists 164 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during Jan. 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

Mesenteric Vascular Dysregulation and Intestinal Inflammation Accompanies Experimental Spinal Cord Injury

Cervical and high thoracic spinal cord injury (SCI) drastically impairs autonomic nervous system function. Individuals with SCI at thoracic spinal-level 5 (T5) or higher often present cardiovascular disorders that include resting systemic arterial hypotension. Gastrointestinal (GI) tissues are critically dependent upon adequate blood flow and even brief periods of visceral hypoxia triggers GI dysmotility. The aim of this study was to test the hypothesis that T3-SCI induces visceral hypoperfusion, diminished postprandial vascular reflexes and concomitant visceral inflammation. We measured in vivo systemic arterial blood pressure and superior mesenteric artery (SMA) and duodenal blood flow in anesthetized T3-SCI rats at 3 days and 3 weeks post-injury either fasted or following enteral feeding of a liquid mixed-nutrient meal (Ensure™). In separate cohorts of fasted T3-SCI rats, markers of intestinal inflammation were assayed by qRT-PCR. Our results show that T3-SCI rats displayed significantly reduced SMA blood flow under all experimental conditions (p\u3c0.05). Specifically, the anticipated elevation of SMA blood flow in response to duodenal nutrient infusion (postprandial hyperemia) was either delayed or absent after T3-SCI. The dysregulated SMA blood flow in acutely-injured T3-SCI rats coincides with abnormal intestinal morphology and elevation of inflammatory markers, all of which resolve after 3 weeks. Specifically, Icam1, Ccl2 (MCP-1) and Ccl3 (MIP-1α) were acutely elevated following T3-SCI. Our data suggest that arterial hypotension diminishes mesenteric blood flow necessary to meet mucosal demands at rest and during digestion. The resulting GI ischemia and low-grade inflammation may be an underlying pathology leading to GI dysfunction seen following acute T3-SCI