Evaluation of the Linear Relationship Between Pulse Arrival Time and Blood Pressure in ICU Patients: Potential and Limitations

A variety of techniques based on the indirect measurement of blood pressure (BP) by Pulse Transit Time (PTT) have been explored over the past few years. Such an approach has the potential in providing continuous and non-invasive beat to beat blood pressure without the use of a cuff. Pulse Arrival Time (PAT) which includes the cardiac pre-ejection period has been proposed as a surrogate of PTT, however, the balance between its questioned accuracy and measurement simplicity has yet to be established. The present work assessed the degree of linear relationship between PAT and blood pressure on 96 h of continuous electrocardiography and invasive radial blood pressure waveforms in a group of 11 young ICU patients. Participants were selected according to strict exclusion criteria including no use of vasoactive medications and presence of clinical conditions associated with cardiovascular diseases. The average range of variation for diastolic BP was 60 to 79 mmHg while systolic BP varied between 123 and 158 mmHg in the study database. The overall Pearson correlation coefficient for systolic and diastolic blood pressure was −0.5 and −0.42, respectively, while the mean absolute error was 3.9 and 7.6 mmHg. It was concluded that the utilization of PAT for the continuous non-invasive blood pressure estimation is rather limited according to the experimental setup, nonetheless the correlation coefficient performed better when the range of variation of blood pressure was high over periods of 30 min suggesting that PAT has the potential to be used as indicator of changes relating to hypertensive or hypotensive episodes

Comparison of Outcomes in Level I vs Level II Trauma Centers in Patients Undergoing Craniotomy or Craniectomy for Severe Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury (TBI) carries a devastatingly high rate of morbidity and mortality. OBJECTIVE: To assess whether patients undergoing craniotomy/craniectomy for severe TBI fare better at level I than level II trauma centers in a mature trauma system. METHODS: The data were extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients \u3e 18 yr with severe TBI (Glasgow Coma Scale [GCS] score less than 9) undergoing craniotomy or craniectomy in the state of Pennsylvania from January 1, 2002 through September 30, 2017. RESULTS: Of 3980 patients, 2568 (64.5%) were treated at level I trauma centers and 1412 (35.5%) at level II centers. Baseline characteristics were similar between the 2 groups except for significantly worse GCS scores at admission in level I centers (P = .002). The rate of in-hospital mortality was 37.6% in level I centers vs 40.4% in level II centers (P = .08). Mean Functional Independence Measure (FIM) scores at discharge were significantly higher in level I (10.9 ± 5.5) than level II centers (9.8 ± 5.3; P \u3c .005). In multivariate analysis, treatment at level II trauma centers was significantly associated with in-hospital mortality (odds ratio, 1.2; 95% confidence interval, 1.03-1.37; P = .01) and worse FIM scores (odds ratio, 1.4; 95% confidence interval, 1.1-1.7; P = .001). Mean hospital and ICU length of stay were significantly longer in level I centers (P \u3c .005). CONCLUSION: This study showed superior functional outcomes and lower mortality rates in patients undergoing a neurosurgical procedure for severe TBI in level I trauma centers

Protein alignment HW/SW optimizations

Biosequence alignment recently received an amazing support from both commodity and dedicated hardware platforms. The limitless requirements of this application motivate the search for improved implementations to boost processing time and capabilities. We propose an unprecedented hardware improvement to the classic Smith-Waterman (S-W) algorithm based on a twofold approach: i) an on-the-fly gap-open/gap-extension selection that reduces the hardware implementation complexity; ii) a pre-selection filter that uses reduced amino-acid alphabets to screen out not-significant sequences and to shorten the S-Witerations on huge reference databases.We demonstrated the improvements w.r.t. a classic approach both from the point of view of algorithm efficiency and of HW performance (FPGA and ASIC post-synthesis analysis)

FFT for the APE Parallel Computer

We present a parallel FFT algorithm for SIMD systems following the `Transpose Algorithm' approach. The method is based on the assignment of the data field onto a 1-dimensional ring of systolic cells. The systolic array can be universally mapped onto any parallel system. In particular for systems with next-neighbour connectivity our method has the potential to improve the efficiency of matrix transposition by use of hyper-systolic communication. We have realized a scalable parallel FFT on the APE100/Quadrics massively parallel computer, where our implementation is part of a 2-dimensional hydrodynamics code for turbulence studies. A possible generalization to 4-dimensional FFT is presented, having in mind QCD applications.Comment: 17 pages, 13 figures, figures include

Cuff-Less Methods for Blood Pressure Telemonitoring.

Blood pressure telemonitoring (BPT) is a telemedicine strategy that uses a patient\u27s self-measured blood pressure (BP) and transmits this information to healthcare providers, typically over the internet. BPT has been shown to improve BP control compared to usual care without remote monitoring. Traditionally, a cuff-based monitor with data communication capabilities has been used for BPT; however, cuff-based measurements are inconvenient and cause discomfort, which has prevented the widespread use of cuff-based monitors for BPT. The development of new technologies which allow for remote BP monitoring without the use of a cuff may aid in more extensive adoption of BPT. This would enhance patient autonomy while providing physicians with a more complete picture of their patient\u27s BP profile, potentially leading to improved BP control and better long-term clinical outcomes. This mini-review article aims to: (1) describe the fundamentals of current techniques in cuff-less BP measurement; (2) present examples of commercially available cuff-less technologies for BPT; (3) outline challenges with current methodologies; and (4) describe potential future directions in cuff-less BPT development

Chipmunk: A Systolically Scalable 0.9 mm2{}^2, 3.08 Gop/s/mW @ 1.2 mW Accelerator for Near-Sensor Recurrent Neural Network Inference

Recurrent neural networks (RNNs) are state-of-the-art in voice awareness/understanding and speech recognition. On-device computation of RNNs on low-power mobile and wearable devices would be key to applications such as zero-latency voice-based human-machine interfaces. Here we present Chipmunk, a small (<1 mm${}^2$) hardware accelerator for Long-Short Term Memory RNNs in UMC 65 nm technology capable to operate at a measured peak efficiency up to 3.08 Gop/s/mW at 1.24 mW peak power. To implement big RNN models without incurring in huge memory transfer overhead, multiple Chipmunk engines can cooperate to form a single systolic array. In this way, the Chipmunk architecture in a 75 tiles configuration can achieve real-time phoneme extraction on a demanding RNN topology proposed by Graves et al., consuming less than 13 mW of average power