Personalized wearable systems for real-time ECG classification and healthcare interoperability: Real-time ECG classification and FHIR interoperability

Continuous monitoring of an individual's health using wearable biomedical devices is becoming a norm these days with a large number of wearable kits becoming easily available. Modern wearable health monitoring devices have become easily available in the consumer market, however, real-time analyses and prediction along with alerts and alarms about a health hazard are not adequately addressed in such devices. Taking ECG monitoring as a case study the research paper focusses on signal processing, arrhythmia detection and classification and at the same time focusses on updating the electronic health records database in realtime such that the concerned medical practitioners become aware of an emergent situation the patient being monitored might face. Also, heart rate variability (HRV) analysis is usually considered as a basis for arrhythmia classification which largely depends on the morphology of the ECG waveforms and the sensitivity of the biopotential measurements of the ECG kits, so it may not yield accurate results. Initially, the ECG readings from the 3-Lead ECG analog front-end were de-noised, zero-offset corrected, filtered using recursive least square adaptive filter and smoothed using Savitzky-Golay filter and subsequently passed to the data analysis component with a unique feature extraction method to increase the accuracy of classification. The machine learning models trained on MITDB arrhythmia database (MIT-BIH Physionet) showed more than 97% accuracy using kNN classifiers. Neuralnet fitting models showed mean-squared error of as low as 0.0085 and regression value as high as 0.99. ECG abnormalities based on annotations in MITDB could be classified and these ECG observations could be logged to a server implementation based on FHIR standards. The instruments were networked using IoT (Internet of Things) devices and ECG event observations were coded according to SNOMED coding system and could be accessed in Electronic Health Record by the concerned medic to - ake appropriate and timely decisions. The system emphasizes on `preventive care rather than remedial cure' as the next generation personalized health-care monitoring devices become available

A novel membrane inlet-infrared gas analysis (MI-IRGA) system for monitoring of seawater carbonate system

Increased atmospheric CO 2 concentrations are driving changes in ocean chemistry at unprecedented rates resulting in ocean acidification, which is predicted to impact the functioning of marine biota, in particular of marine calcifiers. However, the precise understanding of such impacts relies on an analytical system that determines the mechanisms and impact of elevated pCO 2 on the physiology of organisms at scales from species to entire communities. Recent work has highlighted the need within experiments to control all aspects of the carbonate system to resolve the role of different inorganic carbon species on the physiological responses observed across taxa in real-time. Presently however, there are limited options available for continuous quantification of physiological responses, coupled with real-time calculation of the seawater carbonate chemistry system within microcosm environments. Here, we describe and characterise the performance of a novel pCO 2 membrane equilibrium system (the Membrane Inlet Infra-Red Gas Analyser, MI-IRGA) integrated with a continuous pH and oxygen monitoring platform. The system can detect changes in the seawater carbonate chemistry and determine organism physiological responses, while providing the user with real-time control over the microcosm system. We evaluate the systems control, response time and associated error, and demonstrate the flexibility of the system to operate under field conditions and within a laboratory. We use the system to measure physiological parameters (photosynthesis and respiration) for the corals Pocillipora damicornis and Porites cylindrica; in doing so we present a novel dataset examining the interactive role of temperature, light and pCO 2 on the physiology of P. cylindrica

C-DC and MC-DC Casting of Al-alloys-A Comsol Approach

Present work endeavours to understand the solidification behaviour in conventional direct chill casting (C-DC) of aluminium alloy billets. The simulations were generated for C-DC and MC-DC (melt-conditioned) processes. For the first time, COMSOL Multiphysics has been successfully used to simulate the heat flow in C-DC casting of Al-alloy billet. The results show that the temperature gradient in the sump is minimized in the case of MC-DC when compared with C-DC. The simulation results also revealed the effect of casting speed on the sump profile in both the cases

Comparison of lea gratings with cardiff acuity cards for vision testing of preverbal children

Aims: To create a normative data for lea grating (LG) in the Indian population and to compare LG with Cardiff Acuity Card (CAC). Settings and Design: Normative Data was acquired from normal children between 6 months-3 years coming to the ′Immunisation Clinic′ and ′Well-Baby Clinic′ at a Civil Hospital. To compare LG with CAC, normal and amblyopic children between 6 months-3 years were evaluated, Materials and Methods: Monocular and binocular visual acuity (VA) was measured using LG and then CAC. VA and time taken to perform the test were compared. Statistical Analysis Used: Pearson′s Correlation Coefficient to compare VA and Student paired t-test (significance P<0.005) to compare time. Results: Two standard deviations of VA of 100 normal children overlapped with that published by Lea. Of the 30 amblyopic children aged 18.32 ± 10.5 months (2-36), 18 were females. VA was 0.95 ± 0.3 logMAR (0.7-1.2) and 1.0 ± 0.6 logMAR (0.5-2.1) binocularly and 1.32 ± 0.08 logMAR (0.2-0.6) and 1.15 ± 0.15 logMAR (0.88-1.48) monocularly on CAC and LG respectively. Pearson′s correlation coefficient was 0.98 and 0.63 for binocular and monocular assessment respectively. Time taken to perform LG monocularly and binocularly was significantly less (P<0.001) than CAC. Conclusion: Normative data acquired in Indian pre-verbal children is similar to that published by Lea. Though VA by CAC is better than LG, the two tests are comparable

Tuberculous uveitis presenting as pigmented hypopyon – A case report

Purpose: Hypopyon in the eye is an alarming sign. A case of tuberculous uveitis which presented with pigmented hypopyon has been described. The aim of this paper is to report pigmented hypopyon, a rare presentation of tuberculous uveitis in a diabetic patient. Observations: A 42-year-old patient with diabetes with a known history of miliary tuberculosis, on anti-tubercular therapy since two months presented with complaints of pain and redness followed by diminution of vision in the right eye since one month. Visual acuity was counting fingers close to face in right eye. Anterior chamber (AC) showed grade 4 cells and flare with a pigmented hypopyon measuring two mm. Fundus details were not made out. B scan revealed increased choroidal thickness with moderate vitritis. Routine blood counts revealed leucopenia and anemia suggestive of an immunosuppressed state. AC tap analysis was not helpful in diagnosis initially. Patient was lost to follow up and presented one month later with three - fourth of AC having hypopyon. AC wash was done and the AC sample evaluation revealed acid fast bacilli. Polymerase chain reaction results confirmed it to be Mycobacterium tuberculosis. Conclusions and importance: Tuberculous anterior uveitis thus presenting as pigmented hypopyon is very rare and can cause diagnostic difficulties. High index of suspicion in tuberculosis endemic areas is a must for a prompt diagnosis. A possible association between immunosuppression and pigmented hypopyon may exist and needs to be studied further