Systolic peak detection in acceleration photoplethysmograms measured from emergency responders in tropical conditions

Photoplethysmogram (PPG) monitoring is not only essential for critically ill patients in hospitals or at home, but also for those undergoing exercise testing. However, processing PPG signals measured after exercise is challenging, especially if the environment is hot and humid. In this paper, we propose a novel algorithm that can detect systolic peaks under challenging conditions, as in the case of emergency responders in tropical conditions. Accurate systolic-peak detection is an important first step for the analysis of heart rate variability. Algorithms based on local maxima-minima, first-derivative, and slope sum are evaluated, and a new algorithm is introduced to improve the detection rate. With 40 healthy subjects, the new algorithm demonstrates the highest overall detection accuracy (99.84% sensitivity, 99.89% positive predictivity). Existing algorithms, such as Billauer's, Li's and Zong's, have comparable although lower accuracy. However, the proposed algorithm presents an advantage for real-time applications by avoiding human intervention in threshold determination. For best performance, we show that a combination of two event-related moving averages with an offset threshold has an advantage in detecting systolic peaks, even in heat-stressed PPG signals.Mohamed Elgendi, Ian Norton, Matt Brearley, Derek Abbott, Dale Schuurman

Home-range use patterns and movements of the Siberian flying squirrel in urban forests: Effects of habitat composition and connectivity

Peer reviewe

The impact of class position on women's experience of receiving health education information whilst in hospital

Objective: To explore the impact of class position on women's experience of receiving health education information whilst in hospital for elective surgery. Design: A qualitative methodology taking a feminist standpoint. Setting: Gynaecological units of three hospitals in divergent locations. Method In-depth interviews with a quota sample of 36 women who had undergone hysterectomy, drawn in equal numbers from each class position from three different centres. Results: Emerging themes indicate that women from differing class backgrounds have varied informational needs. Working class women accepted a passive role as patients and were satisfied with minimal information. In contrast, middle class women expected to take an active role and expressed a desire for more information. Neither group of women were entirely satisfied with the information provided for recovery. Conclusion: Women have demonstrated they are not a homogeneous group and have different informational needs. Health educators need to take a more differentiated approach, beginning with taking felt needs into account. Patient empowerment also needs to be addressed, as the notion of a free choice may be curtailed by unequal power relationships between patients and health professionals. Patient education should be viewed by both nurses and doctors as a necessity rather than a luxury

Tooth ankylosis in deciduous teeth of children with cleft lip and/or palate Anquilose dentária na dentição decídua em crianças com fissura de lábio e/ou palato

The present study aimed at evaluating the prevalence of tooth ankylosis in deciduous molars of Caucasian children with cleft lip and/or palate aged 5 to 12 years, of both genders. A total of 330 patients seen at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo for routine treatment were clinically evaluated. The prevalence of ankylosis was analyzed in relation to gender, age range (5-7, 8-10, 11-12 years), type of cleft, affected tooth and arch. The total group showed a prevalence of 18%, with no statistical difference between genders and among types of cleft; ankylosis was more often in the mandibular arch, lower first molars and among children in the age ranges 8-10 and 11-12 years. The results agreed with those observed in the related literature for patients without clefts, pointing out the absence of influence of the cleft on the prevalence of ankylosis. This reinforces the importance of early diagnosis of this anomaly and of the treatment of choice, which are similar in patients with or without clefts.<br>Este estudo avaliou a prevalência de anquilose dentária em molares decíduos de portadores de fissura de lábio e/ou palato, brancos, de ambos os sexos, com idade entre 5 e 12 anos. Um total de 330 pacientes atendidos no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo para tratamento de rotina foi clinicamente avaliado. A prevalência de anquilose foi analisada em relação a gênero, idade (5-7; 8-10; 11-12 anos), tipo de fissura, dente e arco afetados. O grupo total demonstrou prevalência de 18%, sem diferença estatística entre gêneros e tipos de fissura, sendo mais acometido o arco mandibular, o primeiro molar inferior e as faixas etárias de 8 a 10 e de 11 a 12 anos. Os resultados estão de acordo com aqueles observados na literatura para pacientes sem fissuras, destacando a ausência da influência das fissuras na prevalência de anquilose. Isso reforça a importância do diagnóstico precoce dessa anomalia e do tratamento de escolha, que são similares aos de pacientes sem fissuras