Fast detection of venous air embolism in Doppler heart sound using the wavelet transform

The introduction of air bubbles into the systemic circulation can result in significant morbidity. Real-time monitoring of continuous heart sound in patients detected by precordial Doppler ultrasound is, thus, vital for early detection of venous air embolism (VAE) during surgery. In this study, the multiscale feature of wavelet transforms (WT's) is exploited to examine the embolic Doppler heart sound (DHS) during intravenous air injections in dogs. As both humans and dogs share similar physiological conditions, the authors' methods and results for dogs are expected to be applicable to humans. The WT of DHS at scale 2 j(j=1,2) selectively magnified the power of embolic, but not the normal, heart sound. Statistically, the enhanced embolic power was found to be sensitive (P<0.01 at 0.01 ml of injected air) and correlated significantly (P<0.0005, τ=0.83) with the volume of injected air from 0.01 to 0.10 ml. A fast detection algorithm of O(N) complexity with unit complexity constant for VAE was developed (processing speed=8 ms per heartbeat), which confirmed the feasibility of real-time processing for both humans and dogs.published_or_final_versio

Volume Estimation by Wavelet Transform of Doppler Heart Sound During Venous Air-Embolism in Dogs

The Doppler heart sound signals detected by the precordial Doppler ultrasound method under simulated sub clinical and clinically significant venous air embolism were studied in anesthetized dogs. Signal processing using wavelet transform enhanced the contrast of embolic to normal signal, facilitating automatic detection and extraction of embolic signal simply by thresholding. Linear relationship of good correlation coefficient was obtained in log-log scale between the subclinical volume of injected air and the corresponding embolic signal power in all dogs. The calibration curve was found to be good estimate of the volume of embolic air during simulated clinically significant venous air embolism. Hence, we overcame the need of constant human attention for detecting venous air embolism and the lack of quantitative information on the volume of embolic air in the traditional precordial Doppler ultrasound method by the present approach.published_or_final_versio

Semi-automatic tumor boundary detection in MR image sequences

The authors present a semi-automatic approach for the detection of tumor boundary in MR image sequences. An initial slice with an obvious tumor is selected from the image sequence. The tumor is roughly segmented using fuzzy c-means algorithm and its boundary can be further refined by region and contour deformation. For the rest of the slices, the initial plan applied for each slice is extracted from the resulting boundary of the previous slice. The tumor boundary is located using region and contour deformation. Performance of our approach is evaluated on the MR image sequence. Comparisons with manual tracing show the accuracy and effectiveness of our approach.published_or_final_versio

A real-time monitor using wavelet analysis of the Doppler heart sound for the detection of venous air embolism

A fast detection algorithm for venous air embolism (VAE) was developed and implemented as a real-time monitor for detecting embolic heart sound and estimating embolic air volume. Its performance was evaluated under bolus injection of sub-clinical (0.0l to 0.80 ml) and continuous infusion of clinically significant (0.80 to 9.60 ml) air volumes in anaesthetized dogs. The clinically significant air emboli could be estimated based on the calibration curve obtained during sub-clinical VAE for a subject. The monitor also kept track of the cumulative embolic air volumes and alerted the anaesthetists once a predefined clinically significant embolic air volume was reached. As both humans and dogs share similar physiological conditions, our monitor for dogs are expected to be applicable to humans.published_or_final_versio

Tumor boundary extraction in multislice MR brain images using region and contour deformation

In this paper, we present a new approach for the extraction of brain tumor boundary in a series of 2D MR image slices. The shape and position of tumor in one slice could be assumed to be similar to that in its neighboring slices. Using this correlation between consecutive images, the initial plan applied for each slice is extracted from the resulting boundary of the previous slice. The tumor boundary is located using region and contour deformation, which tolerates a rough initial plan. Therefore, only one coarse manual initial plan is required for the whole series of MR image slices. Performance of our approach is evaluated on MR image set. Comparisons with manual tracing show the accuracy and effectiveness of our approach.published_or_final_versio

Detection and quantification of venous air embolism by wavelet analysis of Doppler heart sound

The wavelet analysis of the Doppler heart sound detected under controlled venous air embolism at sub-clinically and clinically significant volumes was studied in anaesthetized dogs. Signal processing with wavelet enhances the Dower of embolic signal and facilitates the simple detection and extraction of embolic heart beats by thresholding. The cumulative power of the extracted embolic heart beats is found to be linearly related to the volume of embolic air on the log-log scale, suggesting that it is feasible to estimate clinically significant volume of embolic air in human subjects by linearly extrapolating from sub-clinical embolic volumes.published_or_final_versio

When will youth smokers make a quit attempt and resume smoking after receiving telephone counseling? A longitudinal study

Paper Session 10 - Adolescent Smoking Cessation: PA10-1OBJECTIVE: To examine the pattern of youth smokers who received telephone smoking cessation intervention and who would initiate a quit attempt and subsequently resume smoking. METHODS: We collected data from a toll-free smoking cessation hotline “Youth Quitline” in Hong Kong from September 2005 to December 2007. The Youth Quitline is a peer-led hotline with multiple telephone counseling sessions at baseline, 1-week and 1-month and successive telephone follow-ups at 3- and 6-months, to help youth smokers aged 12 – 25 quit smoking. We applied non-parametric Kaplan-Meier method to explore the time trend prior to initiating a quit attempt as well as smoking resumption. RESULTS: The study included 408 youth callers, and 282 started quitting within the follow-up period. About 30% of the youth smokers (95%CI = 26 ￢– 35%) would initiate a quit attempt within 7 days after receiving the baseline telephone intervention. For the 282 callers who quit within the follow-up period, two-thirds (67%, 95%CI = 44 – 56%) resumed smoking within the first 7 days after their quit attempt. CONCLUSIONS: This is the first study using survival analysis techniques to evaluate how soon youth smokers initiate their quit attempts and resume smoking, after receiving telephone counseling. Youth smokers who intend to quit initiate a quit attempt shortly after receiving the telephone intervention. Smoking cessation counselors should provide subsequent follow-ups promptly after the baseline intervention to capitalize on the quitting intentions of the smokers.postprintThe 16th Annual Meeting of the Society for Research on Nicotine and Tobacco (SRNT 2010), Baltimore, MD., 24-27 February 2010. In Proceedings of the SRNT, 2010, p. 2

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Wavelet analysis of embolic heart sound detected by precordial Doppler ultrasound during continuous venous air embolism in dogs

The spectrum of the embolic heart sounds (EHS) detected by precordial Doppler ultrasound has been previously characterized, but only on small volumes of venous air embolism (VAE). We sought to determine whether real-time wavelet analysis is useful in analyzing the signals of EHS and whether the embolic power of the EHS for larger volumes of air is proportionate to the volume of VAE that has been reported for small volumes of VAE. A series of small air boli (0.01, 0.02, 0.05, 0.07, 0.1, 0.15, 0.2, 0.3, 0.4, and 0.8 mL), followed by continuous infusion of larger volumes of air (0.8, 1.6, 2.4, 4.8, and 9.6 mL), was injected into the external jugular vein through a central catheter in seven pentobarbital-anesthetized dogs. We measured the spectrum of the Doppler heart sound (DHS) in a real-time manner by using wavelet analysis at different scales. Wavelet analysis at scale = 1 yielded satisfactory results in distinguishing abnormal EHS from normal DHS with high sensitivity (100%) and good positive predictive value (100%) compared with the conventional method, which requires an anesthesiologist to listen to the audio DHS signals in a real-time manner. There was a linear relationship (y = 1.08x + 7.89, r = 0.75, P < 0.001) between the cumulative embolic power of the EHS and the air volume introduced in the form of either bolus or continuous infusion. The 95% confidence intervals for slope and intercept were 0.89-1.27 and 7.65-8.13, respectively. Our results suggest that wavelet analysis is effective as a real-time monitor and that it is possible to distinguish larger volumes of air emboli based on previous injections of small volumes of air. Implications: The real-time wavelet analysis of the heart sound detected by precordial Doppler ultrasound may be useful in estimating larger volumes of air emboli based on previous injections of small volumes of air in anesthetized dogs.published_or_final_versio