A Review of Atrial Fibrillation Detection Methods as a Service

Atrial Fibrillation (AF) is a common heart arrhythmia that often goes undetected, and even if it is detected, managing the condition may be challenging. In this paper, we review how the RR interval and Electrocardiogram (ECG) signals, incorporated into a monitoring system, can be useful to track AF events. Were such an automated system to be implemented, it could be used to help manage AF and thereby reduce patient morbidity and mortality. The main impetus behind the idea of developing a service is that a greater data volume analyzed can lead to better patient outcomes. Based on the literature review, which we present herein, we introduce the methods that can be used to detect AF efficiently and automatically via the RR interval and ECG signals. A cardiovascular disease monitoring service that incorporates one or multiple of these detection methods could extend event observation to all times, and could therefore become useful to establish any AF occurrence. The development of an automated and efficient method that monitors AF in real time would likely become a key component for meeting public health goals regarding the reduction of fatalities caused by the disease. Yet, at present, significant technological and regulatory obstacles remain, which prevent the development of any proposed system. Establishment of the scientific foundation for monitoring is important to provide effective service to patients and healthcare professionals

Adaptive Real Time Imaging Synthesis Telescopes

The digital revolution is transforming astronomy from a data-starved to a data-submerged science. Instruments such as the Atacama Large Millimeter Array (ALMA), the Large Synoptic Survey Telescope (LSST), and the Square Kilometer Array (SKA) will measure their accumulated data in petabytes. The capacity to produce enormous volumes of data must be matched with the computing power to process that data and produce meaningful results. In addition to handling huge data rates, we need adaptive calibration and beamforming to handle atmospheric fluctuations and radio frequency interference, and to provide a user environment which makes the full power of large telescope arrays accessible to both expert and non-expert users. Delayed calibration and analysis limit the science which can be done. To make the best use of both telescope and human resources we must reduce the burden of data reduction. Our instrumentation comprises of a flexible correlator, beam former and imager with digital signal processing closely coupled with a computing cluster. This instrumentation will be highly accessible to scientists, engineers, and students for research and development of real-time processing algorithms, and will tap into the pool of talented and innovative students and visiting scientists from engineering, computing, and astronomy backgrounds. Adaptive real-time imaging will transform radio astronomy by providing real-time feedback to observers. Calibration of the data is made in close to real time using a model of the sky brightness distribution. The derived calibration parameters are fed back into the imagers and beam formers. The regions imaged are used to update and improve the a-priori model, which becomes the final calibrated image by the time the observations are complete

Terahertz Security Image Quality Assessment by No-reference Model Observers

To provide the possibility of developing objective image quality assessment (IQA) algorithms for THz security images, we constructed the THz security image database (THSID) including a total of 181 THz security images with the resolution of 127*380. The main distortion types in THz security images were first analyzed for the design of subjective evaluation criteria to acquire the mean opinion scores. Subsequently, the existing no-reference IQA algorithms, which were 5 opinion-aware approaches viz., NFERM, GMLF, DIIVINE, BRISQUE and BLIINDS2, and 8 opinion-unaware approaches viz., QAC, SISBLIM, NIQE, FISBLIM, CPBD, S3 and Fish_bb, were executed for the evaluation of the THz security image quality. The statistical results demonstrated the superiority of Fish_bb over the other testing IQA approaches for assessing the THz image quality with PLCC (SROCC) values of 0.8925 (-0.8706), and with RMSE value of 0.3993. The linear regression analysis and Bland-Altman plot further verified that the Fish__bb could substitute for the subjective IQA. Nonetheless, for the classification of THz security images, we tended to use S3 as a criterion for ranking THz security image grades because of the relatively low false positive rate in classifying bad THz image quality into acceptable category (24.69%). Interestingly, due to the specific property of THz image, the average pixel intensity gave the best performance than the above complicated IQA algorithms, with the PLCC, SROCC and RMSE of 0.9001, -0.8800 and 0.3857, respectively. This study will help the users such as researchers or security staffs to obtain the THz security images of good quality. Currently, our research group is attempting to make this research more comprehensive.Comment: 13 pages, 8 figures, 4 table

Use of Gas Electron Multiplier (GEM) Detectors for an Advanced X-ray Monitor

We describe a concept for a NASA SMEX Mission in which Gas Electron Multiplier (GEM) detectors, developed at CERN, are adapted for use in X-ray astronomy. These detectors can be used to obtain moderately large detector area and two-dimensional photon positions with sub mm accuracy in the range of 1.5 to 15 keV. We describe an application of GEMs with xenon gas, coded mask cameras, and simple circuits for measuring event positions and for anticoincidence rejection of particle events. The cameras are arranged to cover most of the celestial sphere, providing high sensitivity and throughput for a wide variety of cosmic explosions. At longer timescales, persistent X-ray sources would be monitored with unprecedented levels of coverage. The sensitivity to faint X-ray sources on a one-day timescale would be improved by a factor of 6 over the capability of the RXTE All Sky Monitor.Comment: 10 pages, 5 figs., in X-Ray and Gamma Ray Instrumentation for Astronomy XI, SPIE conference, San Diego, Aug. 200

The Impact of Inter-Hospital Transfer on Clinical Outcomes following Endovascular Treatment for Acute Ischemic Stroke

PURPOSE Hospitals designated as primary stroke centers offer noninvasive treatment for acute ischemic stroke, but only comprehensive stroke centers are equipped to provide endovascular treatment. When stroke patients needing endovascular treatment present to the emergency department at a primary stroke center, they then require inter-hospital transfer to a comprehensive center for definitive treatment. Recent studies have found significant treatment delays and poor clinical outcomes in patients requiring inter-hospital transfer1,2. The primary aim of this study is to determine if inter-hospital transfer impacts clinical outcomes after endovascular treatment for acute ischemic stroke. A secondary aim is to determine whether inter-hospital transfer coincides with any significant treatment delay. METHODS This study involves retrospective chart review for 107 patients undergoing endovascular treatment for acute ischemic stroke at one of three hospitals in Austin, Texas from October 2016 to September 2018. 26 patients required inter-hospital transfer, while 81 (the control group) presented directly to a hospital offering endovascular treatment. Two-tailed T- and U-tests were used for analysis of parametric and non-parametric variables pertaining to time intervals and baseline characteristics. Odds ratios were calculated to compare dichotomized outcomes between groups, with significance determined by chi-square. RESULTS Inter-hospital transfer significantly prolonged onset to groin (mean difference = 37.2 min, p=.02). The transfer group was more likely to experience intracranial hemorrhage (53.9% > 22.2%, p<.01). Clinical outcomes did not significantly differ between groups. CONCLUSIONS Although observed trends in these data suggest poor outcomes for transfer patients, small sample size limits the significance of these findings. However, the significant treatment delay seen in the transfer group warrants a discussion on city protocol changes regarding patient transport via emergency services. Protocol changes favoring direct delivery of patients to comprehensive stroke centers may reduce treatment delay and yield improved clinical outcomes.Dell Medical Schoo

The American Association for the Surgery of Trauma renal injury grading scale: Implications of the 2018 revisions for injury reclassification and predicting bleeding interventions.

BackgroundIn 2018, the American Association for the Surgery of Trauma (AAST) published revisions to the renal injury grading system to reflect the increased reliance on computed tomography scans and non-operative management of high-grade renal trauma (HGRT). We aimed to evaluate how these revisions will change the grading of HGRT and if it outperforms the original 1989 grading in predicting bleeding control interventions.MethodsData on HGRT were collected from 14 Level-1 trauma centers from 2014 to 2017. Patients with initial computed tomography scans were included. Two radiologists reviewed the scans to regrade the injuries according to the 1989 and 2018 AAST grading systems. Descriptive statistics were used to assess grade reclassifications. Mixed-effect multivariable logistic regression was used to measure the predictive ability of each grading system. The areas under the curves were compared.ResultsOf the 322 injuries included, 27.0% were upgraded, 3.4% were downgraded, and 69.5% remained unchanged. Of the injuries graded as III or lower using the 1989 AAST, 33.5% were upgraded to grade IV using the 2018 AAST. Of the grade V injuries, 58.8% were downgraded using the 2018 AAST. There was no statistically significant difference in the overall areas under the curves between the 2018 and 1989 AAST grading system for predicting bleeding interventions (0.72 vs. 0.68, p = 0.34).ConclusionAbout one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions.Level of evidencePrognostic and Epidemiological Study, level III