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

Transferring Generalized Knowledge from Physics-based Simulation to Clinical Domain

A primary factor for the success of machine learning is the quality of labeled training data. However, in many fields, labeled data can be costly, difficult, or even impossible to acquire. In comparison, computer simulation data can now be generated at a much higher abundance with a much lower cost. These simulation data could potentially solve the problem of data deficiency in many machine learning tasks. Nevertheless, due to model assumptions, simplifications and possible errors, there is always a discrepancy between simulated and real data. This discrepancy needs to be addressed when transferring the knowledge from simulation to real data. Furthermore, simulation data is always tied to specific settings of models parameters, many of which have a considerable range of variations yet not necessarily relevant to the machine learning task of interest. The knowledge extracted from simulation data must thus be generalizable across these parameter variations before being transferred. In this dissertation, we address the two outlined challenges in leveraging simulation data to overcome the shortage of labeled real data, . We do so in a clinical task of localizing the origin of ventricular activation from 12 lead electrocardiograms (ECGs), where the clinical ECG data with labeled sites of origin in the heart can only be invasively available. By adopting the concept of domain adaptation, we address the discrepancy between simulated and clinical ECG data by learning the shift between the two domains using a large amount of simulation data and a small amount of clinical data. By adopting the concept of domain generalization, we then address the reliance of simulated ECG data on patient-specific geometrical models by learning to generalize simulated ECG data across subjects, before transferring them to clinical data. Evaluated on in-vivo premature ventricular contraction (PVC) patients, we demonstrate the feasibility of utilizing a large number of offline simulated ECG datasets to enable the prediction of the origin of arrhythmia with only a small number of clinical ECG data on a new patient

Dynamic Protocol Reverse Engineering a Grammatical Inference Approach

Round trip engineering of software from source code and reverse engineering of software from binary files have both been extensively studied and the state-of-practice have documented tools and techniques. Forward engineering of protocols has also been extensively studied and there are firmly established techniques for generating correct protocols. While observation of protocol behavior for performance testing has been studied and techniques established, reverse engineering of protocol control flow from observations of protocol behavior has not received the same level of attention. State-of-practice in reverse engineering the control flow of computer network protocols is comprised of mostly ad hoc approaches. We examine state-of-practice tools and techniques used in three open source projects: Pidgin, Samba, and rdesktop . We examine techniques proposed by computational learning researchers for grammatical inference. We propose to extend the state-of-art by inferring protocol control flow using grammatical inference inspired techniques to reverse engineer automata representations from captured data flows. We present evidence that grammatical inference is applicable to the problem domain under consideration

Judges and Politics: An Essay from Canada

It is said of statistics that what they reveal is interesting, but what they hide is crucial. Much the same can be said of the present British debate over constitutional change and the courts. The various constitutional reforms proposed seem to be obvious and long overdue - abolishing the post of Lord Chancellor, setting up a Supreme Court separate from the House of Lords, and establishing a judicial appointments committee. However, at least as presented and dealt with by the government and the judges, while these innovations are interesting and generally positive, what they fail to mention or address is much more crucial and revealing. The government papers and the judiciary\u27s response resolutely refuse to tackle the central issue of what it is that judges do and whether it is done in a suitably legitimate and proper way. For all the sound and fury of constitutional engagement, the main antagonists share a deep and disturbing assumption that judicial power has and will continue to be exercised in a non-political, objective and neutral manner. In this paper, by reference to the Canadian experience, I will challenge that assumption: it is not that judges are unprofessional or corrupt, but that adjudication is inescapably political and non-objective. Instead, I will offer a very different account of the adjudicative performance and propose a more complementary set of institutional reforms

Spaces and Places: A Systems Theory Approach to Regulatory Competition in European Company Law

This article takes issue with the longstanding oppositional themes of harmonisation versus regulatory competition in European company law. Instead of embracing one approach over the other in exclusivity, the article draws attention to the persisting mixture of approaches to an emerging European-wide law regulating the business corporation. Against the background of an ongoing struggle over identifying the goals and taboos of the European legislator\u27s mandate in regulating the company, the argument put forward here is that this very struggle is reflective of the nature of the evolution of company law in an \u27integrating Europe and a globalising world\u27. European attempts of developing European company law as part of a larger initiative of improving the Union\u27s potential for innovation and competition are thus likely to meet with the challenges that contemporary Nation States are facing when adapting their modes of regulation and representation to the demands of an increasingly complex and decentralised fields of market activities. Situating the law of the business corporation within the larger theme of European integration on the one hand, and of issues of market regulation, domestic, transnational, and international, on the other, suggests the adoption of a systems theory-based approach to understanding the boundaries of law in this multilevel and multipolar process

Clinical Utility of Body Surface Potential Mapping in CRT Patients

This paper reviews the current status of the knowledge on body surface potential mapping (BSPM) and ECG imaging (ECGI) methods for patient selection, left ventricular (LV) lead positioning, and optimisation of CRT programming, to indicate the major trends and future perspectives for the application of these methods in CRT patients. A systematic literature review using PubMed, Scopus, and Web of Science was conducted to evaluate the available clinical evidence regarding the usage of BSPM and ECGI methods in CRT patients. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement was used as a basis for this review. BSPM and ECGI methods applied in CRT patients were assessed, and quantitative parameters of ventricular depolarisation delivered from BSPM and ECGI were extracted and summarised. BSPM and ECGI methods can be used in CRT in several ways, namely in predicting CRT outcome, in individualised optimisation of CRT device programming, and the guiding of LV electrode placement, however, further prospective or randomised trials are necessary to verify the utility of BSPM for routine clinical practice

Innovations and mechanisms in pacing therapy for heart failure

Despite pharmacological advances, heart failure remains a major cause of mortality and morbidity. Pacing therapy for heart failure was achieved in the 1990s with the advent of biventricular pacing (BVP). BVP shortens ventricular activation time and has thus been referred to as ‘cardiac resynchronization therapy’ (CRT). However BVP has other effects including shortening of atrioventricular delay: the contributions of its effects to its overall benefit have yet to be elucidated. Ventricular activation is not normalised by BVP, indicating scope for more effective resynchronization. This thesis explores mechanisms and innovations in pacing therapy for heart failure through measurement of haemodynamic and electrical parameters with high precision and resolution during BVP, right ventricular pacing (RVP) and His bundle pacing (HBP), where the His-Purkinje conduction system is directly stimulated. HBP offers both an innovation in pacing and a model to study conventional pacing. HBP can deliver physiological CRT by overcoming left bundle branch block (LBBB) to normalise QRS appearances but its performance relative to BVP is not known. When performed proximally, or using lower energy, HBP can preserve intrinsic LBBB. In Chapter 3, the electro-mechanical effects of conventional BVP are compared with LBBB correction by HBP. Chapter 4 uses non-invasive electrical mapping to identify mechanisms and predictors of LBBB correction by HBP, comparing it with narrow QRS. Capture of the His bundle can be alone (selective HBP) or alongside myocardial capture (non-selective): the effect of this on HBP is studied in Chapter 5. In Chapter 6, the haemodynamic effects of proximal/low-energy HBP, where LBBB is preserved but atrioventricular timing can be optimised, is compared to BVP and RVP to measure the contribution of atrioventricular delay shortening to the overall benefit of BVP. By evaluating innovative therapies and improving our understanding of existing therapies, hopefully this thesis will advance pacing therapy for heart failure.Open Acces

New Governance\u27 in European Corporate Law Regulation as Transnational Legal Pluralism

The present transformation of European corporate governance regulation mirrors the challenges that have been facing the EUs continuously evolving polity, marked by tensions between centralized integration programs on the one hand and Member States embedded capitalisms, path-dependencies and rent-seeking on the other. As longstanding concerns with remaining obstacles to more mobility for workers, services, business entities and capital in recent years are aligned with post-Lisbon commitments to creating the Worlds leading competitive market, European corporate governance regulation [ECGR] has become exposed to and implicated in a set of highly dynamic regulatory experiments. In this context, New Governance offers itself as both tentative label and immodest proposal for a more responsive and innovative approach to European law making. The following paper assesses the recently emerging regulatory forms in ECGR as illustrations of far-reaching transformations in market governance. The arguable parallels between the EUs regulatory transformation in response to growing legitimacy concerns and the recurring question about whose interests a business corporation is intended to serve, provide the framework for an exploration of current regulatory trajectories in European corporate law that can most adequately be understood as a telling example of transnational legal pluralism

New Governance\u27 in European Corporate Law Regulation as Transnational Legal Pluralism

The present transformation of European corporate governance regulation mirrors the challenges that have been facing the EUs continuously evolving polity, marked by tensions between centralized integration programs on the one hand and Member States embedded capitalisms, path-dependencies and rent-seeking on the other. As longstanding concerns with remaining obstacles to more mobility for workers, services, business entities and capital in recent years are aligned with post-Lisbon commitments to creating the Worlds leading competitive market, European corporate governance regulation [ECGR] has become exposed to and implicated in a set of highly dynamic regulatory experiments. In this context, New Governance offers itself as both tentative label and immodest proposal for a more responsive and innovative approach to European law making. The following paper assesses the recently emerging regulatory forms in ECGR as illustrations of far-reaching transformations in market governance. The arguable parallels between the EUs regulatory transformation in response to growing legitimacy concerns and the recurring question about whose interests a business corporation is intended to serve, provide the framework for an exploration of current regulatory trajectories in European corporate law that can most adequately be understood as a telling example of transnational legal pluralism

Corporate Governance of Banks: An interdisciplinary approach to establish a sound culture

The 2008 financial crisis shed light on the immoral conducts, reckless practices and the widespread short-sightedness that affected the entire financial sector. As a result, a wave of legislative reforms hit all financial institutions, especially in relation to capital and liquidity requirements, but also to corporate governance and investor protection regulation in general. However, inadequate rules, bad corporate governance and a lack of public enforcement cannot fully explain malpractice. On the contrary, the roots of misconduct cannot be completely understood without a prior analysis of the various cultural and psychological dynamics underlying financial operators\u2019 practices. Therefore, a new approach is required, in which legal and economic studies intersect with sociology, psychology, anthropology and neuroscience, to get a better understanding of the main determinants of human behaviour. We cannot expect banking institutions \u2013 that are run by human beings \u2013 to be \u2018fixed\u2019 without investigating or even considering why people deviate from lawful conduct rules. Moreover, as the nature of the determinants of misconduct is behavioural and cultural, and since regulation per se cannot be expected to promote good corporate culture, in this thesis I argue that boards and supervisors should be primarily responsible for the enactment of a cultural change. The thesis consists of two main parts. In the first part, I analyse bank governance institutional framework based on the international and European agenda. In the second part, I explain why there is a need to reinterpret corporate governance principles and practices in the light of sociological and behavioural sciences, in order both to avoid financial misbehaviour and induce banks to take part of the path towards sustainable development in the light of the UN 17 Sustainable Development Goals. In particular, I analyse traditional corporate governance issues, such as board composition requirements, leadership, compliance, risk management and executive compensation in the light of studies by researchers in behavioural economics, organizational culture and neuroscience. Moreover, I analyse how supervisors and institutional investors could play an active role in supporting the board in the establishment of a new cultural model. Finally, I describe the recent initiatives on sustainable finance, which are undoubtedly going to accelerate the transition to a long-term stakeholder-oriented approach to economic growth