The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.2 ml) made into a double lumen intraventricular balloon catheter. The objective of this study was thus to determine the effectiveness of the decompressive craniectomy done on the worst brain site with regard to compliance (Cl), pressure volume index (PVI), jugular oximetry (SjVo2), autoregulation abnormalties, brain tissue oxygen (TiO2) and cerebral blood flow (CBF). This is a prospective cohort study of 17 patients who were enrolled after consent and approval of the ethics committee between the beginning of the year 2001 and end of the year 2002. For pre and post assessment on compliance and PVI, all 12 patients who survived were reported to become normal after decompressive craniectomy. There is no significant association between pre and post craniectomy assessment in jugular oxymetry (p > 0.05), autoregulation (p > 0.05), intracranial brain oxymetry (p = 0.125) and cerebral blood flow (p = 0.375). Compliance and PVI improved dramatically in all alive patients who received decompressive craniectomy. Compliance and PVI monitoring may be crucial in improving the outcome of severe head injured patients after decompressive craniectomy.
Matched MeSH terms: Monitoring, Physiologic/methods*; Monitoring, Physiologic/statistics & numerical data
Rice plant population density is a key indicator in determining the crop setting and fertilizer application rate. It is therefore essential that the population density is monitored to ensure that a correct crop management decision is taken. The conventional method of determining plant population is by manually counting the total number of rice plant tillers in a 25 cm x 25 cm square frame. Sampling is done by randomly choosing several different locations within a plot to perform tiller counting. This sampling method is time consuming, labour intensive and costly. An alternative fast estimating method was developed to overcome this issue. The method relies on measuring the outer circumference
or ambit of the contained rice plants in a 25 cm x 25 cm square frame to determine the number of tillers within that square frame. Data samples of rice variety MR219 were collected from rice plots in the Muda granary area, Sungai Limau Dalam, Kedah. The data were taken at 50 days and 70 days after seeding (DAS). A total of 100 data samples were collected for each sampling day. A good correlation was obtained for the variety of 50 DAS and 70 DAS. The model was then verified by taking 100 samples with the latching strap for 50 DAS and 70 DAS. As a result, this technique can be used as a fast, economical and practical alternative to manual tiller counting. The technique can potentially be used in the development of an electronic sensing system to estimate paddy plant population density.
The conventional heart rate monitor is usually developed with a numeric digital display. This numerical view is obviously not practical to be used during exercise. In this study, the iOS-based mobile application, called Chromozone, was developed to monitor heart rate using the universal color-coding system. The heart rate monitor during the exercise is designed to notify the exercise intensity information to users using the three universal color-coded (i.e. green zone: optimal heart rate; yellow zone: heart rate lower than the optimal zone, and red zone: heart rate higher than the optimal zone). Chromozone is programmed to display uniform colors across the smart phone display, which allows users to easily be informed in regards to the state of exercise intensity. The transfer of heart rate data from the chest transmitter to Chromozone application is designed to use Bluetooth Low Energy (BLE) system technology. The heart rate data is then processed by the application to determine the intensity range of exercise training heart rate based on the user’s personal input (i.e. age, gender, fitness levels and training objective). Preliminary analysis found that Chromozone application is effective in delivering real-time exercise intensity heart rate. Chromozone could potentially help athletes, active individuals and clinical populations to monitor and regulate their workout training regime in a more effective and safer manner.
This article describes the design of a robust, inexpensive, easy-to-use, small, and portable online electromyography acquisition system for monitoring electromyography signals during rehabilitation. This single-channel (one-muscle) system was connected via the universal serial bus port to a programmable Windows operating system handheld tablet personal computer for storage and analysis of the data by the end user. The raw electromyography signals were amplified in order to convert them to an observable scale. The inherent noise of 50 Hz (Malaysia) from power lines electromagnetic interference was then eliminated using a single-hybrid IC notch filter. These signals were sampled by a signal processing module and converted into 24-bit digital data. An algorithm was developed and programmed to transmit the digital data to the computer, where it was reassembled and displayed in the computer using software. Finally, the following device was furnished with the graphical user interface to display the online muscle strength streaming signal in a handheld tablet personal computer. This battery-operated system was tested on the biceps brachii muscles of 20 healthy subjects, and the results were compared to those obtained with a commercial single-channel (one-muscle) electromyography acquisition system. The results obtained using the developed device when compared to those obtained from a commercially available physiological signal monitoring system for activities involving muscle contractions were found to be comparable (the comparison of various statistical parameters) between male and female subjects. In addition, the key advantage of this developed system over the conventional desktop personal computer-based acquisition systems is its portability due to the use of a tablet personal computer in which the results are accessible graphically as well as stored in text (comma-separated value) form.
Biosignal analysis is one of the most important topics that researchers have tried to develop during the last century to understand numerous human diseases. Electroencephalograms (EEGs) are one of the techniques which provides an electrical representation of biosignals that reflect changes in the activity of the human brain. Monitoring the levels of anesthesia is a very important subject, which has been proposed to avoid both patient awareness caused by inadequate dosage of anesthetic drugs and excessive use of anesthesia during surgery. This article reviews the bases of these techniques and their development within the last decades and provides a synopsis of the relevant methodologies and algorithms that are used to analyze EEG signals. In addition, it aims to present some of the physiological background of the EEG signal, developments in EEG signal processing, and the effective methods used to remove various types of noise. This review will hopefully increase efforts to develop methods that use EEG signals for determining and classifying the depth of anesthesia with a high data rate to produce a flexible and reliable detection device.
Recent developments in the field of microwave planar sensors have led to a renewed interest in industrial, chemical, biological and medical applications that are capable of performing real-time and non-invasive measurement of material properties. Among the plausible advantages of microwave planar sensors is that they have a compact size, a low cost and the ease of fabrication and integration compared to prevailing sensors. However, some of their main drawbacks can be considered that restrict their usage and limit the range of applications such as their sensitivity and selectivity. The development of high-sensitivity microwave planar sensors is required for highly accurate complex permittivity measurements to monitor the small variations among different material samples. Therefore, the purpose of this paper is to review recent research on the development of microwave planar sensors and further challenges of their sensitivity and selectivity. Furthermore, the techniques of the complex permittivity extraction (real and imaginary parts) are discussed based on the different approaches of mathematical models. The outcomes of this review may facilitate improvements of and an alternative solution for the enhancement of microwave planar sensors' normalized sensitivity for material characterization, especially in biochemical and beverage industry applications.
Promoting patient care is a priority for all healthcare providers with the overall purpose of realising a high degree of patient satisfaction. A medical centre server is a remote computer that enables hospitals and physicians to analyse data in real time and offer appropriate services to patients. The server can also manage, organise and support professionals in telemedicine. Therefore, a remote medical centre server plays a crucial role in sustainably delivering quality healthcare services in telemedicine. This article presents a comprehensive review of the provision of healthcare services in telemedicine applications, especially in the medical centre server. Moreover, it highlights the open issues and challenges related to providing healthcare services in the medical centre server within telemedicine. Methodological aspects to control and manage the process of healthcare service provision and three distinct and successive phases are presented. The first phase presents the identification process to propose a decision matrix (DM) on the basis of a crossover of 'multi-healthcare services' and 'hospital list' within intelligent data and service management centre (Tier 4). The second phase discusses the development of a DM for hospital selection on the basis of integrated VIKOR-Analytic Hierarchy Process (AHP) methods. Finally, the last phase examines the validation process for the proposed framework.
The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.
Over the last couple of decades, the advancement in Microelectromechanical System (MEMS) devices is highly demanded for integrating the economically miniaturized sensors with fabricating technology. A sensor is a system that detects and responds to multiple physical inputs and converting them into analogue or digital forms. The sensor transforms these variations into a form which can be utilized as a marker to monitor the device variable. MEMS exhibits excellent feasibility in miniaturization sensors due to its small dimension, low power consumption, superior performance, and, batch-fabrication. This article presents the recent developments in standard actuation and sensing mechanisms that can serve MEMS-based devices, which is expected to revolutionize almost many product categories in the current era. The featured principles of actuating, sensing mechanisms and real-life applications have also been discussed. Proper understanding of the actuating and sensing mechanisms for the MEMS-based devices can play a vital role in effective selection for novel and complex application design.
This study presents a prioritisation framework for mobile patient monitoring systems (MPMSs) based on multicriteria analysis in architectural components. This framework selects the most appropriate system amongst available MPMSs for the telemedicine environment. Prioritisation of MPMSs is a challenging task due to (a) multiple evaluation criteria, (b) importance of criteria, (c) data variation and (d) unmeasurable values. The secondary data presented as the decision evaluation matrix include six systems (namely, Yale-National Aeronautics and Space Administration (NASA), advanced health and disaster aid network, personalised health monitoring, CMS, MobiHealth and NTU) as alternatives and 13 criteria (namely, supported number of sensors, sensor front-end (SFE) communication, SFE to mobile base unit (MBU) communications, display of biosignals on the MBU, storage of biosignals on the MBU, intra-body area network (BAN) communication problems, extra-BAN communication problems, extra-BAN communication technology, extra-BAN communication protocols, back-end system communication technology, intended geographic area of use, end-to-end security and reported trial problems) based on the architectural components of MPMSs. These criteria are adopted from the most relevant studies and are found to be applicable to this study. The prioritisation framework is developed in three stages. (1) The unmeasurable values of the MPMS evaluation criteria in the adopted decision evaluation matrix based on expert opinion are represented by using the best-worst method (BWM). (2) The importance of the evaluation criteria based on the architectural components of the MPMS is determined by using the BWM. (3) The VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method is utilised to rank the MPMSs according to the determined importance of the evaluation criteria and the adopted decision matrix. For validation, mean ± standard deviation is used to verify the similarity of systematic prioritisations objectively. The following results are obtained. (1) The BWM represents the unmeasurable values of the MPMS evaluation criteria. (2) The BWM is suitable for weighing the evaluation criteria based on the architectural components of the MPMS. (3) VIKOR is suitable for solving the MPMS prioritisation problem. Moreover, the internal and external VIKOR group decision making are approximately the same, with the best MPMS being 'Yale-NASA' and the worst MPMS being 'NTU'. (4) For the objective validation, remarkable differences are observed between the group scores, which indicate the similarity of internal and external prioritisation results.
In our centre the non-availability computerized exercise machines limits the objective monitoring of strength rehabilitation. We undertook this research programme to objectively measure triceps muscle strength by interfacing NORSK-Gym machine with accelerometer and positional transducers to a computer. This data was tabulated and processed using Microsoft Excel. The positional transducer was first calibrated and it showed an excellent Pearson Correlation Coefficients against a standard metric reading (r = 0.9999). Peak Force was used as a test parameter for isotonic triceps muscle strength measurements. The criterion-referenced validity was established as the peak forces measured using the accelerometer and positional transducer demonstrated identical Peak Forces (r = 0.94). Analysis of our mean Peak Force measurements using non-biological force as well as the intra-individual reproducibility demonstrated excellent Pearson Correlation Coefficients (r) = 0.982-0.998 and 0.929-0.972 respectively. This computerized adaptation of the NORSK-Gym machine produced an objective, valid and reproducible triceps muscle strength measurement.
Not long ago, hearables paved the way for biosensing, fitness, and healthcare monitoring. Smart earbuds today are not only producing sound but also monitoring vital signs. Reliable determination of cardiovascular and pulmonary system information can explore the use of hearables for physiological monitoring. Recent research shows that photoplethysmography (PPG) signals not only contain details on oxygen saturation level (SPO2) but also carry more physiological information including pulse rate, respiration rate, blood pressure, and arterial-related information. The analysis of the PPG signal from the ear has proven to be reliable and accurate in the research setting. (1) Background: The present integrative review explores the existing literature on an in-ear PPG signal and its application. This review aims to identify the current technology and usage of in-ear PPG and existing evidence on in-ear PPG in physiological monitoring. This review also analyzes in-ear (PPG) measurement configuration and principle, waveform characteristics, processing technology, and feature extraction characteristics. (2) Methods: We performed a comprehensive search to discover relevant in-ear PPG articles published until December 2022. The following electronic databases: Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Scopus, Web of Science, and PubMed were utilized to conduct the studies addressing the evidence of in-ear PPG in physiological monitoring. (3) Results: Fourteen studies were identified but nine studies were finalized. Eight studies were on different principles and configurations of hearable PPG, and eight studies were on processing technology and feature extraction and its evidence in in-ear physiological monitoring. We also highlighted the limitations and challenges of using in-ear PPG in physiological monitoring. (4) Conclusions: The available evidence has revealed the future of in-ear PPG in physiological monitoring. We have also analyzed the potential limitation and challenges that in-ear PPG will face in processing the signal.
In this paper, a new approach for the periodical testing and the functionality evaluation of a fetal heart rate monitor device based on ultrasound principle is proposed. The design and realization of the device are presented, together with the description of its features and functioning tests. In the designed device, a relay element, driven by an electric signal that allows switching at two specific frequencies, is used to simulate the fetus and the mother's heartbeat. The simulator was designed to be compliant with the standard requirements for accurate assessment and measurement of medical devices. The accuracy of the simulated signals was evaluated, and it resulted to be stable and reliable. The generated frequencies show an error of about 0.5% with respect to the nominal one while the accuracy of the test equipment was within ±3% of the test signal set frequency. This value complies with the technical standard for the accuracy of fetal heart rate monitor devices. Moreover, the performed tests and measurements show the correct functionality of the developed simulator. The proposed equipment and testing respect the technical requirements for medical devices. The features of the proposed device make it simple and quick in testing a fetal heart rate monitor, thus providing an efficient way to evaluate and test the correlation capabilities of commercial apparatuses.
Hemodynamic monitoring provides us with refined details about the cardiovascular system. In spite of increased availability of the monitoring process and monitoring equipment, hemodynamic monitoring has not significantly improved survival outcome. Care providers should be cognizant of the role of the cardiovascular system and its importance in oxygen delivery to the cells in order to sustain life. Effective hemodynamic monitoring should be able to delineate how well the system is performing in carrying out this role. Different hemodynamic monitors serve in this role to a different extent; some provide very little information on this. The cardiovascular system is only one of the many systems that need to function optimally for survival; others of equal importance include the integrity of the airway, the breathing process, the adequacy of hemoglobin level, and the health of the tissue bed, especially in the brain and the heart. Advances in hemodynamic monitoring with focus on oxygen delivery at the cellular level may ultimately provide the edge to effective monitoring that can impact outcome.
One of the major causes of death all over the world is heart disease or cardiac dysfunction. These diseases could be identified easily with the variations in the sound produced due to the heart activity. These sophisticated auscultations need important clinical experience and concentrated listening skills. Therefore, there is an unmet need for a portable system for the early detection of cardiac illnesses. This paper proposes a prototype model of a smart digital-stethoscope system to monitor patient's heart sounds and diagnose any abnormality in a real-time manner. This system consists of two subsystems that communicate wirelessly using Bluetooth low energy technology: A portable digital stethoscope subsystem, and a computer-based decision-making subsystem. The portable subsystem captures the heart sounds of the patient, filters and digitizes, and sends the captured heart sounds to a personal computer wirelessly to visualize the heart sounds and for further processing to make a decision if the heart sounds are normal or abnormal. Twenty-seven t-domain, f-domain, and Mel frequency cepstral coefficients (MFCC) features were used to train a public database to identify the best-performing algorithm for classifying abnormal and normal heart sound (HS). The hyper parameter optimization, along with and without a feature reduction method, was tested to improve accuracy. The cost-adjusted optimized ensemble algorithm can produce 97% and 88% accuracy of classifying abnormal and normal HS, respectively.
Activity recognition in smart homes aims to infer the particular activities of the inhabitant, the aim being to monitor their activities and identify any abnormalities, especially for those living alone. In order for a smart home to support its inhabitant, the recognition system needs to learn from observations acquired through sensors. One question that often arises is which sensors are useful and how many sensors are required to accurately recognise the inhabitant's activities? Many wrapper methods have been proposed and remain one of the popular evaluators for sensor selection due to its superior accuracy performance. However, they are prohibitively slow during the evaluation process and may run into the risk of overfitting due to the extent of the search. Motivated by this characteristic, this paper attempts to reduce the cost of the evaluation process and overfitting through tree alignment. The performance of our method is evaluated on two public datasets obtained in two distinct smart home environments.
Urine pH (UpH) and net acid excretion (NAE) are used to monitor the degree of systemic acidification and predict the magnitude of resultant hypercalciuria when feeding an acidogenic ration to control periparturient hypocalcemia in dairy cattle. The objectives of this study were to evaluate the diagnostic performance of urine dipstick and pH paper for measuring UpH, and to characterize the UpH-NAE relationship and the association of urine Ca concentration ([Ca]) with UpH and NAE. Urine samples (n = 1,116) were collected daily from 106 periparturient Holstein-Friesian cows fed an acidogenic ration during late gestation. Net acid excretion was measured by titration, and UpH was measured by a glass-electrode pH meter (reference method), Multistix-SG urine dipsticks (Siemens Medical Solutions Inc., Ann Arbor, MI), and Hydrion pH paper (Micro Essential Laboratory Inc., Brooklyn, NY). Diagnostic performance was evaluated using Spearman correlation coefficient (rs), Bland-Altman plots, and logistic regression. Urine pH measured by urine dipstick (rs = 0.94) and pH paper (rs = 0.96) were strongly associated with UpH. Method-comparison studies indicated that the urine dipstick measured an average of 0.28 pH units higher, and pH paper 0.10 pH units lower, than UpH. Urine [Ca] was more strongly associated with UpH (rs = -0.65) than NAE (rs = 0.52). Goals for controlling periparturient hypocalcemia under the study conditions were UpH <6.22 and <6.11, based on achieving urine [Ca] ≥5 mmol/L and estimated urinary Ca excretion ≥4 g/d, respectively. Urine pH was as accurate at predicting urine [Ca] as NAE when UpH >6.11. We conclude that pH paper is an accurate, practical, and low-cost cow-side test for measuring UpH and provides a clinically useful estimate of urine [Ca].
Polymer blends of 60/40 NR/HDPE were prepared using Brabender PL2000 Plasticorder with 60g capacity. The blends were added with radiation-sensitive natural rubber (NR)-based compatibilizer, known as LENRA. They were irradiated with electron-beam radiation at various doses. The efficacy of the compatibilizer was monitored by measuring various properties of the blends such as physical and dynamic mechanical properties including morphological studies by electron microscopic technique. Early results show that the addition of LENRA improves the properties of the TPNR blends.
Objectives: To determine the best possible programme that suits our local setting, to determine the average dose required, and to determine possible problems that can arise from implementing such a programme locally and how best to address them. Methods: The inclusion criteria were those above 18, a positive urine test, the presence of a supportive carer and willing to engage in the programme. Methadone was initiated and observations relating to dose, adverse events, relationship with carers, work performance, crime and high risk behaviours were monitored for 18 weeks. Results: Two thirds of the 45 subjects completed the trial over the 18 week period. No significant adverse events occurred and improvement in relationship with carers and work performance were noted with reduction in crime and high risk behaviours. Conclusion: Methadone is a safe and effective drug that can be used in the local Malaysian setting.