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Sample records for standard resting electrocardiogram

  1. The Normal Electrocardiogram: Resting 12-Lead and Electrocardiogram Monitoring in the Hospital.

    Science.gov (United States)

    Harris, Patricia R E

    2016-09-01

    The electrocardiogram (ECG) is a well-established diagnostic tool extensively used in clinical settings. Knowledge of cardiac rhythm and mastery of cardiac waveform interpretation are fundamental for intensive care nurses. Recognition of the normal findings for the 12-lead ECG and understanding the significance of changes from baseline in continuous cardiac monitoring are essential steps toward ensuring safe patient care. This article highlights historical developments in electrocardiography, describes the normal resting 12-lead ECG, and discusses the need for continuous cardiac monitoring. In addition, future directions for the ECG are explored briefly. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Electrocardiogram

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003868.htm Electrocardiogram To use the sharing features on this page, please enable JavaScript. An electrocardiogram (ECG) is a test that records the electrical ...

  3. The resting electrocardiogram of t. cruzi-infected rats

    Directory of Open Access Journals (Sweden)

    Reinaldo B. Bestetti

    1987-08-01

    Full Text Available A total of 125 rats were infected with the Colômbia strain of T. cruzi (2000 parasites/g shortly after weaning. Of these, 58 survived the acute phase and were used in the present experiment. Twenty eight similar but not infected rats served as controls. All rats were submitted to the resting ECG When they were 6 months old. Classic and 3 precordial leads were employed in order to record the ECG as completely as possible. Electrocardiographic changes similar to those found in human chronic Chagas' heart disease and not previously described in this model were found in 44% of the T. cruzi-infected rats: left axis deviation (22%, right axis deviation (7%, lengthened and bizarre QRS complex (14% and abnormal J point elevation (3%. On the basis of these results, we believe that the resting ECG constitutes a valuable tool for studying experimental chronic Chagas' heart disease in rats.

  4. Prevalence and associated factors of resting electrocardiogram abnormalities among systemic lupus erythematosus patients without cardiovascular disease

    OpenAIRE

    Al Rayes, Hanan; Harvey, Paula J.; Gladman, Dafna D.; Su, Jiandong; Sabapathy, Arthy; Urowitz, Murray B.; Touma, Zahi

    2017-01-01

    Background Electrocardiogram (ECG) cardiovascular disease (CVD) abnormalities (ECG-CVD) are predictive of subsequent CVD events in the general population. Systemic lupus erythematosus (SLE) patients are vulnerable to CVD. We aimed to determine the prevalence of ECG-CVD in SLE patients and to examine the risk factors associated with ECG-CVD. Methods A 12-lead resting supine ECG was performed on consecutive adult patients attending the clinic. One cardiologist interpreted the ECGs. ECG-CVD were...

  5. Cardiointegram: detection of coronary artery disease in males with chest pain and a normal resting electrocardiogram

    International Nuclear Information System (INIS)

    Teichholz, L.E.; Steinmetz, M.Y.; Escher, D.; Herman, M.V.; Naimi, S.; Mahony, D.V.; Ellestad, M.H.

    1986-01-01

    The cardiointegram is a non-invasive technique for the analysis of the electrical signals of the heart obtained by a transformation of the voltage vs. time format by a series of integrations. This multicenter study compares the results of the cardiointegram with coronary arteriography in 140 male patients with chest pain and a normal resting electrocardiogram. The cardiointegram was determined on two resting complexes of Leads I, II, V4, V5 and V6 and called abnormal if greater than or equal to four of ten complexes were abnormal, i.e., fell outside of a previously determined template of normality. The sensitivity was 73% and specificity was 78% for the diagnosis of occlusive coronary artery disease. When greater than or equal to five of ten abnormal complexes were used as the cut-off for an abnormal test and ''equivocal'' results (four of ten abnormal, n = 18) were excluded from analysis there was a sensitivity of 69% and specificity of 88%. Thirty-seven of 38 patients (97%) with an abnormal cardiointegram and a positive exercise stress test had coronary artery disease. Thus, the cardiointegram appears to be a useful non-invasive test for the detection of coronary artery disease in males with chest pain and a normal resting electrocardiogram in whom the diagnosis of coronary artery disease is being considered

  6. Resting 12-lead electrocardiogram reveals high-risk sources of cardioembolism in young adult ischemic stroke.

    Science.gov (United States)

    Pirinen, Jani; Putaala, Jukka; Aro, Aapo L; Surakka, Ida; Haapaniemi, Anita; Kaste, Markku; Haapaniemi, Elena; Tatlisumak, Turgut; Lehto, Mika

    2015-11-01

    The diagnostic work-up to reveal etiology in a young ischemic stroke (IS) patient includes evaluation for high-risk source of cardioembolism (HRCE), since this subtype associates with high early recurrence rate and mortality. We investigated the association of ECG findings with a final etiologic subgroup of HRCE in a cohort of young patients with first-ever IS. The Helsinki Young Stroke Registry includes IS patients aged 15 to 49 years admitted between 1994 and 2007. Blinded to other clinical data, we analyzed a 12-lead resting ECG obtained 1-14 days after the onset of stroke symptoms in 690 patients. We then compared the ECG findings between a final diagnosis of HRCE (n=78) and other/undetermined causes (n=612). We used multivariate logistic regression to study the association between ECG parameters and HRCE. Of our cohort (63% male), 35% showed ECG abnormality, the most common being T-wave inversion (16%), left ventricular hypertrophy (14%), prolonged P-wave (13%), and prolonged QTc (12%). 3% had atrial fibrillation (AF), and 4% P-terminal force (PTF). Of the continuous parameters, longer QRS-duration, QTc, and wider QRS-T-angle independently associated with HRCE. After AF, PTF had the strongest independent association with HRCE (odds ratio=44.32, 95% confidence interval=[10.51-186.83]), followed by a QRS-T angle >110° (8.29 [3.55-19.32]), T-wave inversion (5.06, 2.54-10.05), and prolonged QTc (3.02 [1.39-6.56]). Routine ECG provides useful information for directing the work-up of a young IS patient. In addition to AF, PTF in particular showed a strong association with etiology of HRCE. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Prognostic value of an electrocardiogram at rest and exercise test in patients admitted with suspected acute myocardial infarction, in whom the diagnosis is not confirmed

    DEFF Research Database (Denmark)

    Madsen, J K; Hommel, E; Hansen, J F

    1987-01-01

    . Impaired prognosis was found in patients with negative T waves or ST depression at rest or with ST--T abnormalities or angina pectoris during exercise. Patients with ST depression or elevation, Q wave or intraventricular block at rest. ST abnormalities during exercise or both constituted a high-risk group......The prognosis following discharge in 217 patients admitted with suspected acute myocardial infarction (AMI) due to chest pain, but in whom AMI was not confirmed, was related to the electrocardiogram (ECG) at rest and a symptom-limited exercise test. The patients were followed for 12 to 24 months...... in the ECG at rest and during exercise can be used to identify high and low risk patients....

  8. RestKit for iOS standard guide

    CERN Document Server

    Kalapun, Taras

    2013-01-01

    A step-by-step, example-based guide to learning how you can link your apps and web services using RestKit.This book is for iOS developers of all levels who are interested in boosting their productivity by utilizing third party libraries and who have a willingness to learn how to build RESTful apps using the RestKit framework. A basic knowledge of Objective-C is required as well as a simple understanding of how to use CoreData.

  9. ECG Electrocardiogram (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español ECG (Electrocardiogram) KidsHealth / For Parents / ECG (Electrocardiogram) Print en ... whether there is any damage. How Is an ECG Done? There is nothing painful about getting an ...

  10. MATLAB Toolboxes for Reference Electrode Standardization Technique (REST) of Scalp EEG.

    Science.gov (United States)

    Dong, Li; Li, Fali; Liu, Qiang; Wen, Xin; Lai, Yongxiu; Xu, Peng; Yao, Dezhong

    2017-01-01

    Reference electrode standardization technique (REST) has been increasingly acknowledged and applied as a re-reference technique to transform an actual multi-channels recordings to approximately zero reference ones in electroencephalography/event-related potentials (EEG/ERPs) community around the world in recent years. However, a more easy-to-use toolbox for re-referencing scalp EEG data to zero reference is still lacking. Here, we have therefore developed two open-source MATLAB toolboxes for REST of scalp EEG. One version of REST is closely integrated into EEGLAB, which is a popular MATLAB toolbox for processing the EEG data; and another is a batch version to make it more convenient and efficient for experienced users. Both of them are designed to provide an easy-to-use for novice researchers and flexibility for experienced researchers. All versions of the REST toolboxes can be freely downloaded at http://www.neuro.uestc.edu.cn/rest/Down.html, and the detailed information including publications, comments and documents on REST can also be found from this website. An example of usage is given with comparative results of REST and average reference. We hope these user-friendly REST toolboxes could make the relatively novel technique of REST easier to study, especially for applications in various EEG studies.

  11. Resting electrocardiogram and stress myocardial perfusion imaging in the determination of left ventricular systolic function: an assessment enhancing the performance of gated SPET.

    Science.gov (United States)

    Moralidis, Efstratios; Spyridonidis, Tryfon; Arsos, Georgios; Skeberis, Vassilios; Anagnostopoulos, Constantinos; Gavrielidis, Stavros

    2010-01-01

    This study aimed to determine systolic dysfunction and estimate resting left ventricular ejection fraction (LVEF) from information collected during routine evaluation of patients with suspected or known coronary heart disease. This approach was then compared to gated single photon emission tomography (SPET). Patients having undergone stress (201)Tl myocardial perfusion imaging followed by equilibrium radionuclide angiography (ERNA) were separated into derivation (n=954) and validation (n=309) groups. Logistic regression analysis was used to develop scoring systems, containing clinical, electrocardiographic (ECG) and scintigraphic data, for the discrimination of an ERNA-LVEFstatistic (mean+/-2SD) provided values of 0.001+/-0.176, 0.071+/-0.196 and 0.040+/-0.152, respectively. The average LVEF was a better discriminator of systolic dysfunction than gated SPET-LVEF in receiver operating characteristic (ROC) analysis and identified more patients (89%) with a stress myocardial perfusion imaging variables. This model provides reliable LVEF estimations, comparable to those from (201)Tl gated SPET, and can enhance the clinical performance of the latter.

  12. Atomoxetine-Induced Electrocardiogram Changes

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-12-01

    Full Text Available An 11-year-old boy with attention deficit hyperactivity disorder (ADHD who developed palpitations and unusual cardiac repolarization changes on the electrocardiogram (ECG during standard dose treatment with atomoxetine is reported from Parkview Clinic and Birmingham Children's Hospital, Birmingham, UK.

  13. Play the Electrocardiogram Game

    Science.gov (United States)

    ... and Work Teachers' Questionnaire Electrocardiogram Play the ECG Game About the game ECG is used for diagnosing heart conditions by ... last will in Paris. Play the Blood Typing Game Try to save some patients and learn about ...

  14. Effects of Malaria on Blood Pressure, Heart Rate, Electrocardiogram ...

    African Journals Online (AJOL)

    The effect of malaria on blood pressure, heart rate, electrocardiogram and the cardiovascular responses to postural change were studied in malaria patients. Blood pressure was measured by the sphygmomanometric-auscultatory method. Standard ECG machine was used to record the electrocardiogram. Heart rate was ...

  15. Electrocardiogram transmission - The state of the art.

    Science.gov (United States)

    Firstenberg, A.; Huston, S. W.; Olsen, D. E.; Hahn, P. M.

    1971-01-01

    A comparative analysis of available clinical EKG telemetry systems was conducted. Although present day electrocardiogram diagnosis requires a high degree of measurement accuracy, there exists wide variations in the performance characteristics of the various telemeters marketed today necessitating careful consideration of specifications prior to procurement. The authors have endeavored to provide the physicians with a clear understanding, in terms of the effects on the electrocardiogram, of the factors he must evaluate in order to ensure high fidelity EKG reproduction. A tabulation of comparative parameter values for each unit obtained from manufacturers' specifications and substantiated by standardized performance tests conducted in our laboratory is presented.

  16. Comparison between exercise electrocardiogram and thallium 201 myocardial perfusion imaging during exercise, after dipyridamole and at rest, for the diagnosis of stable angina pectoris. 176 cases were studied with coronary angiography

    International Nuclear Information System (INIS)

    Machecourt, J.; Denis, B.; Comet, M.; Wolf, J.E.; Dimitriou, R.; Pellet, J.; Noel, P.M.

    1981-01-01

    The purpose of this study was to compare the diagnostic interest of the electrocardiogram stress test (EST) and the thallium myocardial imaging during exercise (TIE). For this, the cases of 176 patients with stable angina pectoris who underwent a coronary arteriogram were studied. These patients were divided into two groups: a first group of 113 patients without a previous history of myocardial infarction, nor a Q wave on their electrocardiogram and a second group of 63 patients with angina pectoris after a previous myocardial infarction. All patients underwent a combined EST and TIE. The sensitivity and the specificity of the EST and the TIE were studied, and the post-test risk after either a positive test or a negative test was calculated according to Bayes' theorem. In the first group 62 patients had a coronary stenosis and 51 had a normal arteriogram. The sensitivity of the TIE was higher than that of the EST: 80% versus 64%, p < 0.01. Even when the maximum effort was not reached during the EST, the TIE kept the same sensitivity. The diagnosis of angina pectoris cannot be absolutely established by the separate use of the TIE or the EST. However, their predictive value increases when both are correlated. Moreover, for female patients, the TIE is more specific than the EST because of the higher frequency of false positive or equivocal results of the EST in that population. (Auth.)

  17. Electrocardiogram Scanner-System Requirements

    Science.gov (United States)

    1973-03-01

    An experimental and analytical study has been conducted to establish the feasibility for scanning and digitizing electrocardiogram records. The technical requirements and relative costs for two systems are discussed herein. One is designed to automat...

  18. Diagnosis of exercise-induced left bundle branch block at rest by scintigraphic phase analysis

    International Nuclear Information System (INIS)

    Schultz, D.A.; Wahl, R.L.; Juni, J.E.; Buda, A.J.; McMeekin, J.D.; Struble, L.R.; Tuscan, M.J.

    1986-01-01

    Accurate diagnosis of disease of the ventricular conducting system is essential for their appropriate therapy. Some conduction abnormalities, such as exercise-induced left bundle branch block (EX-LBBB), are not apparent on resting electrocardiograms. Phase analysis of rest and exercise radionuclide ventriculograms (RVG's) was used to compare four EX-LBBB patients with six normal controls. All patients had normal resting electrocardiograms, ejection fractions, and visually normal wall motion. First harmonic phase images were generated reflecting the timing of ventricular contraction. Dynamic phase displays were reviewed and graded in a blinded fashion by three independent experienced observers. Phase angle histograms of the right and left ventricle were determined for both resting and exercise images. The mean phase angle and standard deviation were also calculated for each ventricle. Visual grading of the resting phase images failed to show a significant difference between normal patients and patients with EX-LBBB. Quantitative analysis, however, revealed a significant difference in mean phase angle differences (LV-RV) in resting studies: 0.8 0 (+-1.9 0 SEM) in normal versus 9.3 0 (+-2.3 0 SEM) in EX-LBBB patients (P 0 in normals vs. 31.2 0 in EX-LBBB patients (P<0.001). Qualitative phase analysis of resting RVG's permits the diagnosis of cardiac conduction disease that is not apparent on the resting EKG and may result in better monitoring and treatment. (orig.)

  19. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhenlei Liu

    Full Text Available Bed rest has been considered as the cornerstone of management of deep vein thrombosis (DVT for a long time, though it is not evidence-base, and there is growing evidence favoring early ambulation.Electronic databases including Medline, PubMed, Cochrane Library and three Chinese databases were searched with key words of "deep vein thrombosis", "pulmonary embolism", "venous thrombosis", "bed rest", "immobilization", "mobilization" and "ambulation". We considered randomized controlled trials, prospective or retrospective cohort studies that compared the outcomes of acute DVT patients managed with early ambulation versus bed rest, in addition to standard anticoagulation. Meta-analysis pertaining to the incidence of new pulmonary embolism (PE, progression of DVT, and DVT related deaths were conducted, as well as the extent of remission of pain and edema.13 studies were included with a total of 3269 patients. Compared to bed rest, early ambulation was not associated with a higher incidence of new PE, progression of DVT, or DVT related deaths (RD -0.03, 95% CI -0.05∼ -0.02; Z = 1.24, p = 0.22; random effect model, Tau2 = 0.01. Moreover, if the patients suffered moderate or severe pain initially, early ambulation was related to a better outcome, with respect to remission of acute pain in the affected limb (SMD 0.42, 95%CI 0.09∼0.74; Z = 2.52, p = 0.01; random effect model, Tau2 = 0.04. Meta-analysis of alleviation of edema cannot elicit a solid conclusion because of significant heterogeneity among the few studies.Compared to bed rest, early ambulation of acute DVT patients with anticoagulation was not associated with a higher incidence of new PE, progression of DVT, and DVT related deaths. Furthermore, for the patients suffered moderate or severe pain initially, a better outcome can be seen in early ambulation group, regarding to the remission of acute pain in the affected limb.

  20. Thallium-201 myocardial imaging in evaluation of asymptomatic individuals with ischaemic ST segment depression on exercise electrocardiogram

    International Nuclear Information System (INIS)

    Caralis, D.G.; Bailey, I.; Kennedy, H.L.; Pitt, B.

    1979-01-01

    This study showed that asymptomatic adults with normal physical examination, normal resting electrocardiogram, and normal routine laboratory evaluation who had a positive exercise electrocardiogram and abnormal exercise thallium-201 myocardial image had a very high probability of angiographically significant coronary artery disease. If, on the other hand, the exercise electrocardiogram was positive for 'ischaemic' ST segment changes, but the exercise thallium image was normal, the probability for coronary disease was low. The exercise electrocardiogram combined with thallium-201 myocardial image are safe non-invasive methods which can be performed on an out-patient basis. (author)

  1. Acurácia de critérios para vagotonia no eletrocardiograma de repouso de 12 derivações: uma análise com curvas ROC Accuracy of vagotonia criteria in the 12-lead resting electrocardiogram: analysis with ROC curves

    Directory of Open Access Journals (Sweden)

    José Kawazoe Lazzoli

    2002-04-01

    ível de segmento S-T em cinco ou mais derivações e presença de transição precordial rápida. DISCUSSÃO E CONCLUSÃO: O desempenho dos critérios eletrocardiográficos em termos de VPP, VPN e AC foi muito limitado, com a exceção da duração do intervalo R-R. A combinação de outros critérios como amplitude da onda T em V5 e V6, amplitude da onda R em V4 e presença de supradesnível de ponto J e do segmento S-T em várias derivações pode auxiliar na predição de vagotonia.OBJECTIVE: To determine sensitivity (Sens, specificity (Spec, positive (PPV and negative (NPV predictive value, and accuracy of different electrocardiographic criteria for vagotonia. METHODS: Seventy-four Olympic athletes (51 male and 23 female; age = 24 ± 5 years underwent an evaluation consisting of a 12-lead resting electrocardiogram (ECG, and an assessment of cardiac vagal tone (CVT by the 4-second cycling exercise testing (4-sET, with the B/C index utilized as the gold standard. The 4-sET is a well-standardized and valid protocol for CVT assessment based on the mechanism of exercise-onset tachycardia regardless of the sympathetic component. Using ROC (receiver operating characteristic curves, the authors selected the cut-point with the best sensitivity (Sens/specificity (Spec ratio for each ECG variable, and calculated the positive (PPV and negative predictive values (NPV, and accuracy (AC. The authors also correlated B/C index with ECG variables. RESULTS: B/C index showed a poor association with ECG variables, with the exception of R-R interval (r = 0.353; P = 0.004, that also presented a significant ROC curve (chi2= 0.863; P = 0.002, whereas the R-R interval > or = 990 ms criterion showed the following results: Sens - 100%; Spec - 73%; VPP 20%; VPN 100%; AC 75%. The ECG variables that presented cut-points with accuracy > 80% were: T-wave amplitude in lead V5 > or = 8.0 mm; T-wave amplitude in lead V6 > or = 7.0 mm; Q-wave amplitude in V5 > or = 7.0 mm; R-wave amplitude in V4 > or

  2. 'The character rests heavily within me': drama students as standardized patients in mental health nursing education.

    Science.gov (United States)

    Jacobs, A C; van Jaarsveldt, D E

    2016-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Standardized patient (SP) simulation is an internationally recognized learning strategy that has proven effective in enhancing nursing students' competencies necessary for mental health practice. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A deeper exploration of the process from the perspective of SPs and more particularly drama students, revealed the complexity they need to navigate and the personal vulnerability they are exposed to when creating an authentic learning opportunity for nursing students. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Their vulnerability justifies deeper consideration of support, as well as research on the ethical implications of SP simulation. Nursing students need to be well grounded in therapeutic communication before engaging with mental health users. This should include opportunities to question personal frames of reference that could hinder therapeutic engagement with diverse others. In future, the drama students can be involved in scenario development to enhance the authenticity of simulations. Introduction The effectiveness of Standardized patient (SP) simulation in enhancing students' mental health nursing competencies is well published. Nevertheless, the believable and accurate portrayal of a patient with a mental health issue during SP simulation is complex. Though vital to the creation of safe authentic learning experiences, the perspectives of SPs and particularly of drama students involved in SP simulation are unknown. Aim The aim of this paper is therefore to explore and describe the experiences of 11 drama students engaged in mental health simulations for nursing students. Method A qualitative approach was taken and data were gathered using various techniques. Findings The content analysis revealed that these SPs negotiated three roles during this interdisciplinary learning experience, namely of a facilitator of learning, a drama student and the person within. Discussion The study

  3. [Advances of portable electrocardiogram monitor design].

    Science.gov (United States)

    Ding, Shenping; Wang, Yinghai; Wu, Weirong; Deng, Lingli; Lu, Jidong

    2014-06-01

    Portable electrocardiogram monitor is an important equipment in the clinical diagnosis of cardiovascular diseases due to its portable, real-time features. It has a broad application and development prospects in China. In the present review, previous researches on the portable electrocardiogram monitors have been arranged, analyzed and summarized. According to the characteristics of the electrocardiogram (ECG), this paper discusses the ergonomic design of the portable electrocardiogram monitor, including hardware and software. The circuit components and software modules were parsed from the ECG features and system functions. Finally, the development trend and reference are provided for the portable electrocardiogram monitors and for the subsequent research and product design.

  4. The electrocardiogram in acute myocardial infarction

    International Nuclear Information System (INIS)

    Lorenzo, R

    2013-01-01

    In 2006, 94 years after Eindhoven W. performed the first electrocardiogram (ECG) three derivations, J. Willis Hurst said: T he treatment of acute coronary syndrome is based entirely on electrocardiogram a normalities. Therefore, the correct interpretation of the electrocardiogram is needed now more than ever in the history of medicine.This article will address those aspects of the subject that we consider most useful for clinical cardiologists should assist patients with acute myocardial infarction (AMI) in the crucial first minutes or hours of their evolution

  5. Utility of QGS for 201Tl electrocardiogram-gated SPECT in cardiac function evaluations

    International Nuclear Information System (INIS)

    Shimazaki, Hiroshi; Oono, Ryuichi

    2001-01-01

    QGS (quantitative gated SPECT) was applied to 201 Tl SPECT, whose images are inferior to those of Tc SPECT, and its utility was evaluated. More specifically, the cardiac function index was calculated by QGS, and local wall motion was evaluated visually. Accuracy was assessed by comparison with left ventriculography. The subjects were 29 patients (21 males, 8 females; 6 with myocardial infarction, 18 with stenocardia, 2 with pericardial disease, 3 with other heart diseases) who had undergone myocardial scintigraphy and left ventriculography between February and May, 2000. 201 Tl (74 or 111 MBq) was administered to all patients. The resting image was obtained 10 minutes later, and the delayed image during loading was obtained 4 hours later. The conditions for acquiring the images were as follows. Two detectors were arranged at a 90-degree angle in the form of an L. The 180 degrees from 45 degrees right anterior oblique (RAO) to 45 degrees left posterior oblique (LPO) were divided into 30 sections at 6-degree intervals, and the image in each section was acquired for 60 seconds. The matrix was 64 x 64. As a cardiac function index, the left ventricular ejection function (LVEF) obtained by electrocardiogram-gated SPECT (QGS-EF) at the rest (14 cases) and the QGS-EF on the delayed images (15 cases) were compared with the LVEF determined by left ventriculography (LVG-EF). There was an excellent positive correlation between the data obtained by two methods, with a correlation coefficient of r=0.93 (y=1.04x-0.04). Most of the difference between the values fell within two standard deviations, and the error was in the clinically allowable range. There was no significant difference between the correlation coefficient at rest and during loading or between the cases that showed an obvious defect on the image and those that did not. The local wall motion of the left ventricle was visually evaluated in five stages in two directions (RAO, 30 degrees, and LAO, 60 degrees). The motion

  6. Electrocardiogram of the Mixmaster universe

    International Nuclear Information System (INIS)

    Bini, Donato; Cherubini, Christian; Geralico, Andrea; Jantzen, Robert T

    2009-01-01

    The Mixmaster dynamics is revisited in a new light as revealing a series of transitions in the complex scale invariant scalar invariant of the Weyl curvature tensor best represented by the speciality index S, which gives a four-dimensional measure of the evolution of the spacetime independent of all the three-dimensional gauge-dependent variables except for the time used to parametrize it. Its graph versus time characterized by correlated isolated pulses in its real and imaginary parts corresponding to curvature wall collisions serves as a sort of electrocardiogram of the Mixmaster universe, with each such pulse pair arising from a single circuit or 'complex pulse' around the origin in the complex plane. These pulses in the speciality index and their limiting points on the real axis seem to invariantly characterize some of the so-called spike solutions in inhomogeneous cosmology and should play an important role as a gauge-invariant lens through which to view current investigations of inhomogeneous Mixmaster dynamics.

  7. The Electrocardiogram as an Example of Electrostatics

    Science.gov (United States)

    Hobbie, Russell K.

    1973-01-01

    Develops a simplified electrostatic model of the heart with conduction within the torso neglected to relate electrocardiogram patterns to the charge distribution within the myocardium. Suggests its application to explanation of Coulomb's law in general physics. (CC)

  8. Respiratory Information Extraction from Electrocardiogram Signals

    KAUST Repository

    Amin, Gamal El Din Fathy

    2010-01-01

    The Electrocardiogram (ECG) is a tool measuring the electrical activity of the heart, and it is extensively used for diagnosis and monitoring of heart diseases. The ECG signal reflects not only the heart activity but also many other physiological

  9. Electrocardiogram: his bundle potentials can be recorded noninvasively beat by beat on surface electrocardiogram.

    Science.gov (United States)

    Wang, Gaopin; Liu, Renguang; Chang, Qinghua; Xu, Zhaolong; Zhang, Yingjie; Pan, Dianzhu

    2017-03-15

    The micro waveform of His bundle potential can't be recorded beat-to-beat on surface electrocardiogram yet. We have found that the micro-wavelets before QRS complex may be related to atrioventricular conduction system potentials. This study is to explore the possibility of His bundle potential can be noninvasively recorded on surface electrocardiogram. We randomized 65 patients undergoing radiofrequency catheter ablation of paroxysmal superventricular tachycardia (exclude overt Wolff-Parkinson-White syndrome) to receive "conventional electrocardiogram" and "new electrocardiogram" before the procedure. His bundle electrogram was collected during the procedure. Comparative analysis of PA s (PA interval recorded on surface electrocardiogram), AH s (AH interval recorded on surface electrocardiogram) and HV s (HV interval recorded on surface electrocardiogram) interval recorded on surface "new electrocardiogram" and PA, AH, HV interval recorded on His bundle electrogram was investigated. There was no difference (P > 0.05) between groups in HV s interval (49.63 ± 6.19 ms) and HV interval (49.35 ± 6.49 ms). Results of correlational analysis found that HV S interval was significantly positively associated with HV interval (r = 0.929; P electrocardiogram. Noninvasive His bundle potential tracing might represent a new method for locating the site of atrioventricular block and identifying the origin of a wide QRS complex.

  10. Operative characteristics of rest myocardial perfusion in emergency thoracic pain evaluation

    International Nuclear Information System (INIS)

    Merlano G, Sonia; Murgueitio C, Ramon; Rodriguez F, Edgard; Carvajal C, Andres; Suarez R, Martin

    2000-01-01

    Study objective: Conventional emergency department testing strategies for patients with chest pain often provide equivocal diagnosis of coronary artery disease. This study was conducted to determine the sensibility, specificity , positive predictive value (PPV), negative predictive value (NPV) and Likelihood ratio LR(-) of the myocardial perfusion imaging with single photon emission computed tomography (SPECT) imaging at rest. Methods: We design a diagnostic imaging protocol to evaluate clinical usefulness of SPECT Technetium sestamibi imaging at rest in patients with typical and atypical chest pain and normal or non diagnostic electrocardiogram. Coronary angiogram was the gold standard for positive studies and six month follow up after completing the exercise test for negatives. Nuclear Medicine physicians were unaware of the angiograms results. The inter observers variability was measure with a Kappa coefficient. Results: We enrolled 107 patients 78 males (72.8%) and 29 females (27.2%). We found sensitivity 95.45% (IC 95% 95.41-95.48), specificity 92.94%(IC 95% 92.9- 92.98) Negative predictive value 98.75% LR(-) 0.092 . The study adequately classified 93% of the patients. Kappa coefficient for concordance between observer was 0.95 Conclusion: Myocardial perfusion imaging with SPECT at rest, has a high negative predictive value and a very good ability to classify normal patients as such and therefore may be use for the assessment of patients with chest pain and normal or non diagnostic electrocardiograms at the emergency room (Au)

  11. Individual identification via electrocardiogram analysis.

    Science.gov (United States)

    Fratini, Antonio; Sansone, Mario; Bifulco, Paolo; Cesarelli, Mario

    2015-08-14

    During last decade the use of ECG recordings in biometric recognition studies has increased. ECG characteristics made it suitable for subject identification: it is unique, present in all living individuals, and hard to forge. However, in spite of the great number of approaches found in literature, no agreement exists on the most appropriate methodology. This study aimed at providing a survey of the techniques used so far in ECG-based human identification. Specifically, a pattern recognition perspective is here proposed providing a unifying framework to appreciate previous studies and, hopefully, guide future research. We searched for papers on the subject from the earliest available date using relevant electronic databases (Medline, IEEEXplore, Scopus, and Web of Knowledge). The following terms were used in different combinations: electrocardiogram, ECG, human identification, biometric, authentication and individual variability. The electronic sources were last searched on 1st March 2015. In our selection we included published research on peer-reviewed journals, books chapters and conferences proceedings. The search was performed for English language documents. 100 pertinent papers were found. Number of subjects involved in the journal studies ranges from 10 to 502, age from 16 to 86, male and female subjects are generally present. Number of analysed leads varies as well as the recording conditions. Identification performance differs widely as well as verification rate. Many studies refer to publicly available databases (Physionet ECG databases repository) while others rely on proprietary recordings making difficult them to compare. As a measure of overall accuracy we computed a weighted average of the identification rate and equal error rate in authentication scenarios. Identification rate resulted equal to 94.95 % while the equal error rate equal to 0.92 %. Biometric recognition is a mature field of research. Nevertheless, the use of physiological signals

  12. RESTful NET

    CERN Document Server

    Flanders, Jon

    2008-01-01

    RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

  13. MagnetoHemoDynamics in the aorta and electrocardiograms

    International Nuclear Information System (INIS)

    Martin, Vincent; Drochon, Agnès; Fokapu, Odette; Gerbeau, Jean-Frédéric

    2012-01-01

    This paper addresses a complex multi-physical phenomenon involving cardiac electrophysiology and hemodynamics. The purpose is to model and simulate a phenomenon that has been observed in magnetic resonance imaging machines: in the presence of a strong magnetic field, the T-wave of the electrocardiogram (ECG) gets bigger, which may perturb ECG-gated imaging. This is due to a magnetohydrodynamic (MHD) effect occurring in the aorta. We reproduce this experimental observation through computer simulations on a realistic anatomy, and with a three-compartment model: inductionless MHD equations in the aorta, bi-domain equations in the heart and electrical diffusion in the rest of the body. These compartments are strongly coupled and solved using finite elements. Several benchmark tests are proposed to assess the numerical solutions and the validity of some modeling assumptions. Then, ECGs are simulated for a wide range of magnetic field intensities (from 0 to 20 T). (paper)

  14. Characteristics of the reindeer electrocardiogram

    Directory of Open Access Journals (Sweden)

    Jouni Timisjärvi

    1982-05-01

    Full Text Available The electrocardiogram (ECG provides reliable information about heart rate, initiation of heart beat and also, to some degree, indirect evidence on the functional state of the heart muscle. A wide range of such information is readily obtainable from conventional scalar leads, even if the records are limited to a single plane. The present investigation deals with the normal reindeer ECG in the frontal plane. The technique used is the scalar recording technique based on the Einthovenian postulates. The P wave was positive in leads II, III and aVF, negative in lead aVL and variable in leads I and aVR. The direction of the P vector was 60 to 120°. The QRS complex was variable. The most common forms of QRS complex were R and rS in leads I and aVR; R, Rs and rS in lead aVL and Qr or qR in other leads. The most common direction of the QRS vector was 240 to 300°. The T wave was variable. The duration of various intervals and deflection depended on heart rate.Elektrokardiogram på ren.Abstract in Swedish / Sammandrag: Elektrokardiogramet (EKG ger tillförlitliga uppgifter om hjärtfrekvens, retledning och, indirekt, delvis även om hjärtmuskelns funktionell tillstånd. Största delen av denna information fås med normal skalar koppling även om registrering sker i ett plan. I detta arbete har renens normala EKG i frontalplanet undersökts. Kopplingarna har baserats på Einthovs postulat. P-vågen var riktad uppåt i koppling II, III och aVF, nedåt i koppling aVL och den varierade i koppling I och aVR. P-vektorns riktning var 60 - 120°. QRS-komplexet varierade. De vanligaste formerna var R och rS i koppling I och aVR; R, Rs och rS i koppling aVL och Qr eller qR i andra kopplingar. Vanligen var QRS-vektorns riktning 240 - 300°. T-vågen varierade. Awikelserna och intervallernas längd var beroende av hiärtfrekvenssen.Poron sydänsähkökäyrän ominaisuuksia.Abstract in Finnish / Yhteenveto: Sydänsähkökäyrästä saadaan luotettavaa tietoa syd

  15. Is Rest Really Rest? Resting State Functional Connectivity during Rest and Motor Task Paradigms.

    Science.gov (United States)

    Jurkiewicz, Michael T; Crawley, Adrian P; Mikulis, David J

    2018-04-18

    Numerous studies have identified the default mode network (DMN) within the brain of healthy individuals, which has been attributed to the ongoing mental activity of the brain during the wakeful resting-state. While engaged during specific resting-state fMRI paradigms, it remains unclear as to whether traditional block-design simple movement fMRI experiments significantly influence the default mode network or other areas. Using blood-oxygen level dependent (BOLD) fMRI we characterized the pattern of functional connectivity in healthy subjects during a resting-state paradigm and compared this to the same resting-state analysis performed on motor task data residual time courses after regressing out the task paradigm. Using seed-voxel analysis to define the DMN, the executive control network (ECN), and sensorimotor, auditory and visual networks, the resting-state analysis of the residual time courses demonstrated reduced functional connectivity in the motor network and reduced connectivity between the insula and the ECN compared to the standard resting-state datasets. Overall, performance of simple self-directed motor tasks does little to change the resting-state functional connectivity across the brain, especially in non-motor areas. This would suggest that previously acquired fMRI studies incorporating simple block-design motor tasks could be mined retrospectively for assessment of the resting-state connectivity.

  16. The electrocardiogram in traumatic right atrial rupture

    NARCIS (Netherlands)

    van Veldhuisen, DJ; van den Berg, MP

    1999-01-01

    We:report the case of a previously healthy 20-year-old man who had a traumatic rupture of the right atrium. On admission an electrocardiogram (ECG) was recorded which is highly remarkable and, retrospectively, suggestive for the diagnosis. The patient died soon after the EGG, and the diagnosis was

  17. Exercise left ventricular performance in patients with chest pain, ischemic-appearing exercise electrocardiograms, and angiographically normal coronary arteries

    International Nuclear Information System (INIS)

    Berger, H.J.; Sands, M.J.; Davies, R.A.; Wackers, F.J.; Alexander, J.; Lachman, A.S.; Williams, B.W.; Zaret, B.L.

    1981-01-01

    Left ventricular performance was evaluated using first-pass radionuclide angiocardiography in 31 patients with chest pain, an ischemic-appearing exercise electrocardiogram, and angiographically normal coronary arteries at rest and during maximal upright bicycle exercise. 201 Tl imaging was done in all patients after treadmill exercise and in selected patients after ergonovine provocation. Resting left ventricular performance was normal in all patients. An abnormal ejection fraction response to exercise was detected in 12 of 31 patients. Regional dysfunction was present during exercise in four patients, all of whom also had abnormal global responses. Three of these 12 patients and two additional patients had exercise-induced 201 Tl perfusion defects. In all nine patients who underwent ergonovine testing, there was no suggestion of coronary arterial spasm. Thus, left ventricular dysfunction during exercise, in the presence of normal resting performance, was found in a substantial number of patients with chest pain, an ischemic-appearing exercise electrocardiogram, and normal coronary arteries

  18. Novel modeling of task versus rest brain state predictability using a dynamic time warping spectrum: comparisons and contrasts with other standard measures of brain dynamics

    Directory of Open Access Journals (Sweden)

    Martin eDinov

    2016-05-01

    Full Text Available Dynamic time warping, or DTW, is a powerful and domain-general sequence alignment method for computing a similarity measure. Such dynamic programming-based techniques like DTW are now the backbone and driver of most bioinformatics methods and discoveries. In neuroscience it has had far less use, though this has begun to change. We wanted to explore new ways of applying DTW, not simply as a measure with which to cluster or compare similarity between features but in a conceptually different way. We have used DTW to provide a more interpretable spectral description of the data, compared to standard approaches such as the Fourier and related transforms. The DTW approach and standard discrete Fourier transform (DFT are assessed against benchmark measures of neural dynamics. These include EEG microstates, EEG avalanches and the sum squared error (SSE from a multilayer perceptron (MLP prediction of the EEG timeseries, and simultaneously acquired FMRI BOLD signal. We explored the relationships between these variables of interest in an EEG-FMRI dataset acquired during a standard cognitive task, which allowed us to explore how DTW differentially performs in different task settings. We found that despite strong correlations between DTW and DFT-spectra, DTW was a better predictor for almost every measure of brain dynamics. Using these DTW measures, we show that predictability is almost always higher in task than in rest states, which is consistent to other theoretical and empirical findings, providing additional evidence for the utility of the DTW approach.

  19. Personal Identification Based on Vectorcardiogram Derived from Limb Leads Electrocardiogram

    Directory of Open Access Journals (Sweden)

    Jongshill Lee

    2012-01-01

    Full Text Available We propose a new method for personal identification using the derived vectorcardiogram (dVCG, which is derived from the limb leads electrocardiogram (ECG. The dVCG was calculated from the standard limb leads ECG using the precalculated inverse transform matrix. Twenty-one features were extracted from the dVCG, and some or all of these 21 features were used in support vector machine (SVM learning and in tests. The classification accuracy was 99.53%, which is similar to the previous dVCG analysis using the standard 12-lead ECG. Our experimental results show that it is possible to identify a person by features extracted from a dVCG derived from limb leads only. Hence, only three electrodes have to be attached to the person to be identified, which can reduce the effort required to connect electrodes and calculate the dVCG.

  20. The asymptomatic teenager with an abnormal electrocardiogram.

    Science.gov (United States)

    Singh, Harinder R

    2014-02-01

    Use of medications for attention-deficit hyperkinetic disorder and preparticipation sports physical examination has led to an increase in number of electrocardiograms (ECG) performed during adolescence. Interpreting ECGs in children and young adults must take into account the evolutionary changes with age and the benign variants, which are usually not associated with heart disease. It is crucial for primary-care providers to recognize the changes on ECG associated with heart disease and risk of sudden death. In this article, the significance, sensitivity, specificity, and the diagnostic workup of these findings in the asymptomatic teenager are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Lazović, Biljana; Svenda, Mirjana Zlatković; Mazić, Sanja; Stajić, Zoran; Delić, Marina

    2013-01-01

    Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36%) low QRS (50%) and p pulmonale (14.54%). Left axis deviation was observed in 27.27% patients. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  2. Improvement of electrocardiogram by empirical wavelet transform

    Science.gov (United States)

    Chanchang, Vikanda; Kumchaiseemak, Nakorn; Sutthiopad, Malee; Luengviriya, Chaiya

    2017-09-01

    Electrocardiogram (ECG) is a crucial tool in the detection of cardiac arrhythmia. It is also often used in a routine physical exam, especially, for elderly people. This graphical representation of electrical activity of heart is obtained by a measurement of voltage at the skin; therefore, the signal is always contaminated by noise from various sources. For a proper interpretation, the quality of the ECG should be improved by a noise reduction. In this article, we present a study of a noise filtration in the ECG by using an empirical wavelet transform (EWT). Unlike the traditional wavelet method, EWT is adaptive since the frequency spectrum of the ECG is taken into account in the construction of the wavelet basis. We show that the signal-to-noise ratio increases after the noise filtration for different noise artefacts.

  3. [Syncope: electrocardiogram and autonomic function tests].

    Science.gov (United States)

    Uribe, William; Baranchuk, Adrián; Botero, Federico

    2016-12-23

    Syncope represents one of the most frequent reasons for consultation in the emergency department. A proper identification will allow a precise etiologic approach and the optimization of delivery of health resources.
Once knowing the classification of syncope; it is the clinical interrogatory what enables to discriminate which of these patients present with a neurogenic mediated syncope or a cardiac mediated syncope. The use of diagnostic methods such as the tilt test, will clarify what type of neurally mediated syncope predominates in the patient.
The electrocardiogram is the cornerstone in the identification of those patients who had a true episode of self-limited or aborted sudden death as the first manifestation of their syncope, a fact which provides prognostic and therapeutic information that will impact the morbidity and mortality.

  4. Evaluation of an electrocardiogram on QR code.

    Science.gov (United States)

    Nakayama, Masaharu; Shimokawa, Hiroaki

    2013-01-01

    An electrocardiogram (ECG) is an indispensable tool to diagnose cardiac diseases, such as ischemic heart disease, myocarditis, arrhythmia, and cardiomyopathy. Since ECG patterns vary depend on patient status, it is also used to monitor patients during treatment and comparison with ECGs with previous results is important for accurate diagnosis. However, the comparison requires connection to ECG data server in a hospital and the availability of data connection among hospitals is limited. To improve the portability and availability of ECG data regardless of server connection, we here introduce conversion of ECG data into 2D barcodes as text data and decode of the QR code for drawing ECG with Google Chart API. Fourteen cardiologists and six general physicians evaluated the system using iPhone and iPad. Overall, they were satisfied with the system in usability and accuracy of decoded ECG compared to the original ECG. This new coding system may be useful in utilizing ECG data irrespective of server connections.

  5. Gender differences in the electrocardiogram screening of athletes.

    Science.gov (United States)

    Bessem, Bram B; de Bruijn, Matthijs M C; Nieuwland, Wybe W

    2017-02-01

    Gender-related differences are frequently used in medicine. Electrocardiograms are also subject to such differences. This study evaluated gender differences in ECG parameters of young athletes, discussing the possible implications of these differences for ECG criteria used in the cardiovascular screening of young athletes. Observational cross-sectional study. In 2013 and 2014 all the ECGs from the cardiovascular screenings performed at University Sports Medical Centre in Groningen of the student athletes who wanted to participate in a college sports program were collected. The ECG characteristics were scored using computer-based measurements and the Seattle ECG criteria. The study population included 1436 athletes, of which 72% were male. Male athletes were older (19.3 years vs. 18.6 years), participated in sports more frequently (4.0/week vs. 3.8/week) and spent more hours per week practising sports (6.4h/week vs. 5.8h/week) than female athletes. Male athletes had significantly higher PR intervals (149ms vs. 141ms), lead voltages and QRS duration (98ms vs. 88ms). Female athletes had significantly higher resting heart rates (69/min vs. 64/min) and QTc intervals (407ms vs. 400ms). Male athletes also had significantly higher amounts of sinus bradycardia (38.3% vs. 23.0%), incomplete RBBB (15.0% vs. 3.7%), early repolarisation (4.5% vs. 1.0%) and isolated QRS voltage criteria for LVH (26.3% vs. 4.6%). All P-values were ≤0.001. ECGs of young athletes demonstrate gender-related differences. These differences could be considered in their cardiovascular screening. For the Seattle ECG criteria we advise additional research into the clinical implications of using gender-based cut-off values for the QRS duration in the intraventricular conduction delay criterion. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis

    Directory of Open Access Journals (Sweden)

    DeWayne P. Williams

    2017-10-01

    Full Text Available The perseverative cognition hypothesis (PCH posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination—one of the core mechanisms underlying perseveration—is a construct containing (at least two maladaptive (depressive and brooding and one adaptive (reflective types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets’ mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87. Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG. Both trait rumination (including the three facets and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as

  7. Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis.

    Science.gov (United States)

    Williams, DeWayne P; Feeling, Nicole R; Hill, LaBarron K; Spangler, Derek P; Koenig, Julian; Thayer, Julian F

    2017-01-01

    The perseverative cognition hypothesis (PCH) posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress) vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV) is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination-one of the core mechanisms underlying perseveration-is a construct containing (at least) two maladaptive (depressive and brooding) and one adaptive (reflective) types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets' mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87). Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG). Both trait rumination (including the three facets) and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as anxiety. Our data

  8. EMF-REST: Generation of RESTful APIs from Models

    OpenAIRE

    Hamza , Ed-Douibi; Cánovas Izquierdo , Javier Luis; Gómez , Abel; Tisi , Massimo; Cabot , Jordi

    2016-01-01

    In the last years, RESTful Web services have become more and more popular as a lightweight solution to connect remote systems in distributed and Cloud-based architectures. However, being an architectural style rather than a specification or standard, the proper design of RESTful Web services is not trivial since developers have to deal with a plethora of recommendations and best practices. Model-Driven Engineering (MDE) emphasizes the use of models and model transformations to raise the level...

  9. Automated electrocardiogram interpretation programs versus cardiologists' triage decision making based on teletransmitted data in patients with suspected acute coronary syndrome

    DEFF Research Database (Denmark)

    Clark, Elaine N; Ripa, Maria Sejersten; Clemmensen, Peter

    2010-01-01

    The aims of this study were to assess the effectiveness of 2 automated electrocardiogram interpretation programs in patients with suspected acute coronary syndrome transported to hospital by ambulance in 1 rural region of Denmark with hospital discharge diagnosis used as the gold standard...

  10. Restful API Architecture Based on Laravel Framework

    Science.gov (United States)

    Chen, Xianjun; Ji, Zhoupeng; Fan, Yu; Zhan, Yongsong

    2017-10-01

    Web service has been an industry standard tech for message communication and integration between heterogeneous systems. RESTFUL API has become mainstream web service development paradigm after SOAP, how to effectively construct RESTFUL API remains a research hotspots. This paper presents a development model of RESTFUL API construction based on PHP language and LARAVEL framework. The key technical problems that need to be solved during the construction of RESTFUL API are discussed, and implementation details based on LARAVEL are given.

  11. Portable electrocardiogram device using Android smartphone.

    Science.gov (United States)

    Brucal, S G E; Clamor, G K D; Pasiliao, L A O; Soriano, J P F; Varilla, L P M

    2016-08-01

    Portable electrocardiogram (ECG) capturing device can be interfaced to a smart phone installed with an android-based application (app). This app processes and analyses the data sent by the device to provide an interpretation of the patient/user's heart current condition (e.g.: beats per minute, heart signal waveform, R-R interval). The ECG recorded by the app is stored in the smart phone's Secure Digital (SD) card and cloud storage which can be accessed remotely by a physician to aid in providing medical diagnosis. The project aims to help patients living at a far distance from hospitals and experience difficulty in consulting their physician for regular check-ups, and assist doctors in regularly monitoring their patient's heart condition. The hardware data acquisition device and software application were subjected to trials in a clinic with volunteer-patients to measure the ECG and heart rate, data saving speed on the SD card, success rate of the saved data and uploaded file. Different ECG tests using the project prototype were done for 12 patients/users and yielded a reading difference of 7.61% in an R-R interval reading and 5.35% in heart rate reading as compared with the cardiologist's conventional 12-electrode ECG machine. Using the developed ECG device, it took less than 5 seconds to save ECG reading using SD card and approximately 2 minutes to upload via cloud.

  12. Respiratory Information Extraction from Electrocardiogram Signals

    KAUST Repository

    Amin, Gamal El Din Fathy

    2010-12-01

    The Electrocardiogram (ECG) is a tool measuring the electrical activity of the heart, and it is extensively used for diagnosis and monitoring of heart diseases. The ECG signal reflects not only the heart activity but also many other physiological processes. The respiratory activity is a prominent process that affects the ECG signal due to the close proximity of the heart and the lungs. In this thesis, several methods for the extraction of respiratory process information from the ECG signal are presented. These methods allow an estimation of the lung volume and the lung pressure from the ECG signal. The potential benefit of this is to eliminate the corresponding sensors used to measure the respiration activity. A reduction of the number of sensors connected to patients will increase patients’ comfort and reduce the costs associated with healthcare. As a further result, the efficiency of diagnosing respirational disorders will increase since the respiration activity can be monitored with a common, widely available method. The developed methods can also improve the detection of respirational disorders that occur while patients are sleeping. Such disorders are commonly diagnosed in sleeping laboratories where the patients are connected to a number of different sensors. Any reduction of these sensors will result in a more natural sleeping environment for the patients and hence a higher sensitivity of the diagnosis.

  13. Atrial Fibrillation Predictors: Importance of the Electrocardiogram.

    Science.gov (United States)

    German, David M; Kabir, Muammar M; Dewland, Thomas A; Henrikson, Charles A; Tereshchenko, Larisa G

    2016-01-01

    Atrial fibrillation (AF) is the most common arrhythmia in adults and is associated with significant morbidity and mortality. Substantial interest has developed in the primary prevention of AF, and thus the identification of individuals at risk for developing AF. The electrocardiogram (ECG) provides a wealth of information, which is of value in predicting incident AF. The PR interval and P wave indices (including P wave duration, P wave terminal force, P wave axis, and other measures of P wave morphology) are discussed with regard to their ability to predict and characterize AF risk in the general population. The predictive value of the QT interval, ECG criteria for left ventricular hypertrophy, and findings of atrial and ventricular ectopy are also discussed. Efforts are underway to develop models that predict AF incidence in the general population; however, at present, little information from the ECG is included in these models. The ECG provides a great deal of information on AF risk and has the potential to contribute substantially to AF risk estimation, but more research is needed. © 2015 Wiley Periodicals, Inc.

  14. The history, hotspots, and trends of electrocardiogram.

    Science.gov (United States)

    Yang, Xiang-Lin; Liu, Guo-Zhen; Tong, Yun-Hai; Yan, Hong; Xu, Zhi; Chen, Qi; Liu, Xiang; Zhang, Hong-Hao; Wang, Hong-Bo; Tan, Shao-Hua

    2015-07-01

    The electrocardiogram (ECG) has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome (LQTS), angina, and myocardial infarction (MI), are chronologically presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis method to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.

  15. Mobile Messaging Services-Based Personal Electrocardiogram Monitoring System

    Directory of Open Access Journals (Sweden)

    Ashraf A. Tahat

    2009-01-01

    Full Text Available A mobile monitoring system utilizing Bluetooth and mobile messaging services (MMS/SMSs with low-cost hardware equipment is proposed. A proof of concept prototype has been developed and implemented to enable transmission of an Electrocardiogram (ECG signal and body temperature of a patient, which can be expanded to include other vital signs. Communication between a mobile smart-phone and the ECG and temperature acquisition apparatus is implemented using the popular personal area network standard specification Bluetooth. When utilizing MMS for transmission, the mobile phone plots the received ECG signal and displays the temperature using special application software running on the client mobile phone itself, where the plot can be captured and saved as an image before transmission. Alternatively, SMS can be selected as a transmission means, where in this scenario, dedicated application software is required at the receiving device. The experimental setup can be operated for monitoring from anywhere in the globe covered by a cellular network that offers data services.

  16. Mobile messaging services-based personal electrocardiogram monitoring system.

    Science.gov (United States)

    Tahat, Ashraf A

    2009-01-01

    A mobile monitoring system utilizing Bluetooth and mobile messaging services (MMS/SMSs) with low-cost hardware equipment is proposed. A proof of concept prototype has been developed and implemented to enable transmission of an Electrocardiogram (ECG) signal and body temperature of a patient, which can be expanded to include other vital signs. Communication between a mobile smart-phone and the ECG and temperature acquisition apparatus is implemented using the popular personal area network standard specification Bluetooth. When utilizing MMS for transmission, the mobile phone plots the received ECG signal and displays the temperature using special application software running on the client mobile phone itself, where the plot can be captured and saved as an image before transmission. Alternatively, SMS can be selected as a transmission means, where in this scenario, dedicated application software is required at the receiving device. The experimental setup can be operated for monitoring from anywhere in the globe covered by a cellular network that offers data services.

  17. Electrocardiogram interpretation skills among ambulance nurses.

    Science.gov (United States)

    Werner, Kristoffer; Kander, Kristofer; Axelsson, Christer

    2016-06-01

    To describe ambulance nurses' practical electrocardiogram (ECG) interpretation skills and to measure the correlation between these skills and factors that may impact on the level of knowledge. This study was conducted using a prospective quantitative survey with questionnaires and a knowledge test. A convenience sample collection was conducted among ambulance nurses in three different districts in western Sweden. The knowledge test consisted of nine different ECGs. The score of the ECG test were correlated against the questions in the questionnaire regarding both general ECG interpretation skill and ability to identify acute myocardial infarction using Mann-Whitney U test, Kruskal-Wallis test and Spearman's rank correlation. On average, the respondents had 54% correct answers on the test and identified 46% of the ECGs indicating acute myocardial infarction. The median total score was 9 of 16 (interquartile range 7-11) and 1 of 3 (IQR 1-2) in infarction points. No correlation between ECG interpretation skill and factors such as education and professional experience was found, except that coronary care unit experience was associated with better results on the ECG test. Ambulance nurses have deficiencies in their ECG interpretation skills. This also applies to conditions where the ambulance crew has great potential to improve the outcome of the patient's health, such as myocardial infarction and cardiac arrest. Neither education, extensive experience in ambulance service nor in nursing contributed to an improved result. The only factor of importance for higher ECG interpretation knowledge was prior experience of working in a coronary care unit. © The European Society of Cardiology 2014.

  18. Resting and postexercise heart rate variability in professional handball players.

    Science.gov (United States)

    Kayacan, Yildirim; Yildiz, Sedat

    2016-03-01

    The aim of this study was to evaluate heart rate variability (HRV) in professional handball players during rest and following a 5 min mild jogging exercise. For that purpose, electrocardiogram (ECG) of male handball players (N.=12, mean age 25±3.95 years) and sedentary controls (N.=14, mean age 23.5±2.95 years) were recorded for 5 min at rest and just after 5 min of mild jogging. ECGs were recorded and following HRV parameters were calculated: time-domain variables such as heart rate (HR), average normal-to-normal RR intervals, standard deviation of normal-to-normal RR intervals, square root of the mean of the squares of differences between adjacent NN intervals, percentage of differences between adjacent NN intervals that are greater than 50 milliseconds (pNN50), and frequency-domain variables such as very low frequency, low (LF) and high frequency (HF) of the power and LF/HF ratio. Unpaired t-test was used to find out differences among groups while paired t-test was used for comparison of each group for pre- and postjogging HRV. Pearson correlations were carried out to find out the relationships between the parameters. Blood pressures were not different between handball players and sedentary controls but exercise increased systolic blood pressure (Phandball players (Phandball players (Phandball players in response to a mild, short-time (5 min) jogging exercise. However, in sedentary subjects, either the sympathetic regulation of the autonomous nervous system increased or vagal withdrawal occurred.

  19. Association Between Heart Rate at Rest and Incident Atrial Fibrillation (from the Copenhagen Electrocardiographic Study)

    DEFF Research Database (Denmark)

    Skov, Morten W; Bachmann, Troels N; Rasmussen, Peter V.

    2016-01-01

    Heart rate (HR) at rest is a well-known marker of cardiovascular morbidity and mortality. Results on the association between HR and incident atrial fibrillation (AF) have, however, been conflicting. Using digital electrocardiograms from 281,451 primary care patients, we aimed to describe...

  20. REST based mobile applications

    Science.gov (United States)

    Rambow, Mark; Preuss, Thomas; Berdux, Jörg; Conrad, Marc

    2008-02-01

    Simplicity is the major advantage of REST based webservices. Whereas SOAP is widespread in complex, security sensitive business-to-business aplications, REST is widely used for mashups and end-user centric applicatons. In that context we give an overview of REST and compare it to SOAP. Furthermore we apply the GeoDrawing application as an example for REST based mobile applications and emphasize on pros and cons for the use of REST in mobile application scenarios.

  1. Electrocardiogram interpretation in general practice: relevance to prehospital thrombolysis.

    Science.gov (United States)

    McCrea, W A; Saltissi, S

    1993-01-01

    OBJECTIVE--To assess, in the context of their possible role in prehospital thrombolysis, the ability of general practitioners to recognise acute transmural myocardial ischaemia/infarction on an electrocardiogram. DESIGN--150 doctors (every fifth name) were selected from the alphabetical list of 750 on Merseyside general practitioner register and without prior warning were asked to interpret a series of six 12 lead electrocardiograms. Three of these showed acute transmural ischaemia/infarction, one was normal, and two showed non-acute abnormalities. Details of doctors' ages, postgraduate training, and clinical practice were sought. SETTING--General practitioners' surgeries and postgraduate centres within the Merseyside area. PARTICIPANTS--106 general practitioners (mean age 45 years) agreed to participate. MAIN OUTCOME MEASURE--Accuracy of general practitioners' interpretations of the six electrocardiograms. RESULTS--82% of general practitioners correctly recognised a normal electrocardiogram. Recognition of acute abnormalities was less reliable. Between 33% and 61% correctly identified acute transmural ischaemia/infarction depending on the specific trace presented. Accurate localisation of the site of the infarct was achieved only by between 8% and 30% of participants, while between 22% and 25% correctly interpreted non-acute abnormalities. Neither routine use of electrocardiography nor postgraduate hospital experience in general medicine was associated with significantly greater expertise. CONCLUSION--The current level of proficiency of a sample of general practitioners in the Merseyside area in recognising acute transmural ischaemia/infarction on an electrocardiogram suggests that refresher training is needed if general practitioners are to give prehospital thrombolysis. Images PMID:8398491

  2. Evaluation of agreement between temporal series obtained from electrocardiogram and pulse wave.

    Science.gov (United States)

    Leikan, GM; Rossi, E.; Sanz, MCuadra; Delisle Rodríguez, D.; Mántaras, MC; Nicolet, J.; Zapata, D.; Lapyckyj, I.; Siri, L. Nicola; Perrone, MS

    2016-04-01

    Heart rate variability allows to study the cardiovascular autonomic nervous system modulation. Usually, this signal is obtained from the electrocardiogram (ECG). A simpler method for recording the pulse wave (PW) is by means of finger photoplethysmography (PPG), which also provides information about the duration of the cardiac cycle. In this study, the correlation and agreement between the time series of the intervals between heartbeats obtained from the ECG with those obtained from the PPG, were studied. Signals analyzed were obtained from young, healthy and resting subjects. For statistical analysis, the Pearson correlation coefficient and the Bland and Altman limits of agreement were used. Results show that the time series constructed from the PW would not replace the ones obtained from ECG.

  3. ECG-ViEW II, a freely accessible electrocardiogram database

    Science.gov (United States)

    Park, Man Young; Lee, Sukhoon; Jeon, Min Seok; Yoon, Dukyong; Park, Rae Woong

    2017-01-01

    The Electrocardiogram Vigilance with Electronic data Warehouse II (ECG-ViEW II) is a large, single-center database comprising numeric parameter data of the surface electrocardiograms of all patients who underwent testing from 1 June 1994 to 31 July 2013. The electrocardiographic data include the test date, clinical department, RR interval, PR interval, QRS duration, QT interval, QTc interval, P axis, QRS axis, and T axis. These data are connected with patient age, sex, ethnicity, comorbidities, age-adjusted Charlson comorbidity index, prescribed drugs, and electrolyte levels. This longitudinal observational database contains 979,273 electrocardiograms from 461,178 patients over a 19-year study period. This database can provide an opportunity to study electrocardiographic changes caused by medications, disease, or other demographic variables. ECG-ViEW II is freely available at http://www.ecgview.org. PMID:28437484

  4. Mathematical model with autoregressive process for electrocardiogram signals

    Science.gov (United States)

    Evaristo, Ronaldo M.; Batista, Antonio M.; Viana, Ricardo L.; Iarosz, Kelly C.; Szezech, José D., Jr.; Godoy, Moacir F. de

    2018-04-01

    The cardiovascular system is composed of the heart, blood and blood vessels. Regarding the heart, cardiac conditions are determined by the electrocardiogram, that is a noninvasive medical procedure. In this work, we propose autoregressive process in a mathematical model based on coupled differential equations in order to obtain the tachograms and the electrocardiogram signals of young adults with normal heartbeats. Our results are compared with experimental tachogram by means of Poincaré plot and dentrended fluctuation analysis. We verify that the results from the model with autoregressive process show good agreement with experimental measures from tachogram generated by electrical activity of the heartbeat. With the tachogram we build the electrocardiogram by means of coupled differential equations.

  5. Resting cardiointegram: correlation with stress thallium perfusion studies

    International Nuclear Information System (INIS)

    Gould, L.A.; Betzu, R.; Judge, D.; Lee, J.; Taddeo, M.; Yang, D.

    1988-01-01

    The cardiointegram is a noninvasive technique for the analysis of the electrical signals of the heart obtained by a transformation of the voltage versus time format by a series of integrations. The stress thallium perfusion study is a widely used test for the detection of coronary artery disease. In order to evaluate the correlation between the resting cardiointegram and the stress thallium 201 perfusion study, 20 patients with normal resting electrocardiograms underwent stress thallium tests and resting cardiointegrams. The cardiointegram was determined on two resting complexes of leads I, II, V4, V5, and V6 and called abnormal if five of ten complexes deviated outside a normalized template. There was concordance of the cardiointegram and the thallium study in 16 of 20 patients (80%). The sensitivity for the detection of coronary artery disease was 71%, and the specificity was 80%. The overall accuracy was 74%. Thus in patients with normal electrocardiograms, the cardiointegram is a useful noninvasive test for the detection of coronary artery disease

  6. A Bayesian-optimized spline representation of the electrocardiogram

    International Nuclear Information System (INIS)

    Guilak, F G; McNames, J

    2013-01-01

    We introduce an implementation of a novel spline framework for parametrically representing electrocardiogram (ECG) waveforms. This implementation enables a flexible means to study ECG structure in large databases. Our algorithm allows researchers to identify key points in the waveform and optimally locate them in long-term recordings with minimal manual effort, thereby permitting analysis of trends in the points themselves or in metrics derived from their locations. In the work described here we estimate the location of a number of commonly-used characteristic points of the ECG signal, defined as the onsets, peaks, and offsets of the P, QRS, T, and R′ waves. The algorithm applies Bayesian optimization to a linear spline representation of the ECG waveform. The location of the knots—which are the endpoints of the piecewise linear segments used in the spline representation of the signal—serve as the estimate of the waveform’s characteristic points. We obtained prior information of knot times, amplitudes, and curvature from a large manually-annotated training dataset and used the priors to optimize a Bayesian figure of merit based on estimated knot locations. In cases where morphologies vary or are subject to noise, the algorithm relies more heavily on the estimated priors for its estimate of knot locations. We compared optimized knot locations from our algorithm to two sets of manual annotations on a prospective test data set comprising 200 beats from 20 subjects not in the training set. Mean errors of characteristic point locations were less than four milliseconds, and standard deviations of errors compared favorably against reference values. This framework can easily be adapted to include additional points of interest in the ECG signal or for other biomedical detection problems on quasi-periodic signals. (paper)

  7. Electrocardiogram signal quality measures for unsupervised telehealth environments

    International Nuclear Information System (INIS)

    Redmond, S J; Xie, Y; Chang, D; Lovell, N H; Basilakis, J

    2012-01-01

    The use of telehealth paradigms for the remote management of patients suffering from chronic conditions has become more commonplace with the advancement of Internet connectivity and enterprise software systems. To facilitate clinicians in managing large numbers of telehealth patients, and in digesting the vast array of data returned from the remote monitoring environment, decision support systems in various guises are often utilized. The success of decision support systems in interpreting patient conditions from physiological data is dependent largely on the quality of these recorded data. This paper outlines an algorithm to determine the quality of single-lead electrocardiogram (ECG) recordings obtained from telehealth patients. Three hundred short ECG recordings were manually annotated to identify movement artifact, QRS locations and signal quality (discrete quality levels) by a panel of three experts, who then reconciled the annotation as a group to resolve any discrepancies. After applying a published algorithm to remove gross movement artifact, the proposed method was then applied to estimate the remaining ECG signal quality, using a Parzen window supervised statistical classifier model. The three-class classifier model, using a number of time-domain features and evaluated using cross validation, gave an accuracy in classifying signal quality of 78.7% (κ = 0.67) when using fully automated preprocessing algorithms to remove gross motion artifact and detect QRS locations. This is a similar level of accuracy to the reported human inter-scorer agreement when generating the gold standard annotation (accuracy = 70–89.3%, κ = 0.54–0.84). These results indicate that the assessment of the quality of single-lead ECG recordings, acquired in unsupervised telehealth environments, is entirely feasible and may help to promote the acceptance and utility of future decision support systems for remotely managing chronic disease conditions. (paper)

  8. Electrocardiogram of Clinically Healthy Mithun (Bos frontalis): Variation among Strains

    Science.gov (United States)

    Sanyal, Sagar; Das, Pradip Kumar; Ghosh, Probal Ranjan; Das, Kinsuk; Vupru, Kezha V.; Rajkhowa, Chandan; Mondal, Mohan

    2010-01-01

    A study was conducted to establish the normal electrocardiogram in four different genetic strains of mithun (Bos frontalis). Electrocardiography, cardiac electrical axis, heart rate, rectal temperature and respiration rate were recorded in a total of 32 adult male mithun of four strains (n = 8 each). It was found that the respiration and heart rates were higher (P electrocardiogram of mithun revealed that the amplitude and duration of P wave, QRS complex and T wave were different among four different genetic strains of mithun and the electrical axis of QRS complex for Nagamese and Mizoram mithuns are dissimilar to bovine species. PMID:20886013

  9. Hypoglycemia-associated electroencephalogram and electrocardiogram changes appear simultaneously

    DEFF Research Database (Denmark)

    Larsen, Anine Poulsen; Højlund, Kurt; Poulsen, Mikael Kjær

    2013-01-01

    Tight glycemic control in type 1 diabetes mellitus (T1DM) may be accomplished only if severe hypoglycemia can be prevented. Biosensor alarms based on the body's reactions to hypoglycemia have been suggested. In the present study, we analyzed three lead electrocardiogram (ECG) and single-channel e......Tight glycemic control in type 1 diabetes mellitus (T1DM) may be accomplished only if severe hypoglycemia can be prevented. Biosensor alarms based on the body's reactions to hypoglycemia have been suggested. In the present study, we analyzed three lead electrocardiogram (ECG) and single...

  10. Alternative REST Splicing Underappreciated

    OpenAIRE

    Chen, Guo-Lin; Miller, Gregory

    2017-01-01

    As a major orchestrator of the cellular epigenome, the repressor element-1 silencing transcription factor (REST) can either repress or activate thousands of genes depending on cellular context, suggesting a highly context-dependent REST function tuned by environmental cues. While REST shows cell-type non-selective active transcription, an N-terminal REST4 isoform caused by alternative splicing - inclusion of an extra exon (N3c) which introduces a pre-mature stop codon - has been implicated in...

  11. The Rest of the Story: A Qualitative Study of Complementing Standardized Assessment Data with Informal Interviews with Older Patients and Families.

    Science.gov (United States)

    Lafortune, Claire; Elliott, Jacobi; Egan, Mary Y; Stolee, Paul

    2017-04-01

    While standardized health assessments capture valuable information on patients' demographic and diagnostic characteristics, health conditions, and physical and mental functioning, they may not capture information of most relevance to individual patients and their families. Given that patients and their informal caregivers are the experts on that patient's unique context, it is important to ensure they are able to convey all relevant personal information to formal healthcare providers so that high-quality, patient-centered care may be delivered. This study aims to identify information that older patients and families consider important but that might not be included in standardized assessments. Transcripts were analyzed from 29 interviews relating to eight patients with hip fractures from three sites (large urban, smaller urban, rural) in two provinces in Canada. These interviews were conducted as part of a larger ethnographic study. Each transcript was analyzed by two researchers using content analysis. Results were reviewed in two focus group interviews with older adults and family caregivers. Identified themes were compared with items from two standardized assessments used in healthcare settings. Three broad themes emerged from the qualitative analysis that were not covered in the standardized assessments: informal caregiver and family considerations, insider healthcare knowledge, and patients' healthcare attitudes and experiences. The importance of these themes was confirmed through focus group interviews. Focus group participants also emphasized the importance of conducting assessments in a patient-centered way and the importance of open-ended questions. A less structured interview approach may yield information that would otherwise be missed in standardized assessments. Combining both sources could yield better-informed healthcare planning and quality-improvement efforts.

  12. Gender differences in the electrocardiogram screening of athletes

    NARCIS (Netherlands)

    Bessem, Bram; de Bruijn, Matthijs C.; Nieuwland, Wybe

    Objectives: Gender-related differences are frequently used in medicine. Electrocardiograms are also subject to such differences. This study evaluated gender differences in ECG parameters of young athletes, discussing the possible implications of these differences for ECG criteria used in the

  13. New micro waveforms firstly recorded on electrocardiogram in human.

    Science.gov (United States)

    Liu, Renguang; Chang, Qinghua; Chen, Juan

    2015-10-01

    In our study, not only the P-QRS-T waves but also the micro-wavelets before QRS complex (in P wave and PR segment) and after QRS complex (ST segment and upstroke of T wave) were first to be identified on surface electrocardiogram in human by the "new electrocardiogram" machine (model PHS-A10) according to conventional 12-lead electrocardiogram connection methods. By comparison to the conventional electrocardiogram in 100 cases of healthy individuals and several patients with arrhythmias, we have found that the wavelets before P wave theoretically reflected electrical activity of sinus node and the micro-wavelets before QRS complex may be related to atrioventricular conduction system (atrioventricular node, His bundle and bundle branch) potentials. Noninvasive atrioventricular node and His bundle potential tracing will contribute to differentiation of the origin of wide QRS and the location of the atrioventricular block. We also have found that the wavelets after QRS complex may be associated with phase 2 and 3 repolarization of ventricular action potential, which will further reveal ventricular repolarization changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. An Analysis Of QRS Interval Of The Electrocardiogram In ...

    African Journals Online (AJOL)

    Objectives: This cross-sectional study of the 12-lead electrocardiogram (ECG) was undertaken to establish the normal QRS interval of the adult Nigerian from Jos; to find significant correlation coefficients for QRS interval and the various anthropometric measurements and also to establish prediction equations for the QRS ...

  15. Predicting Electrocardiogram and Arterial Blood Pressure Waveforms with Different Echo State Network Architectures

    Science.gov (United States)

    2014-11-01

    Predicting Electrocardiogram and Arterial Blood Pressure Waveforms with Different Echo State Network Architectures Allan Fong, MS1,3, Ranjeev...the medical staff in Intensive Care Units. The ability to predict electrocardiogram and arterial blood pressure waveforms can potentially help the...type of neural network for mining, understanding, and predicting electrocardiogram and arterial blood pressure waveforms. Several network

  16. DIRAC RESTful API

    International Nuclear Information System (INIS)

    Casajus Ramo, A; Graciani Diaz, R; Tsaregorodtsev, A

    2012-01-01

    The DIRAC framework for distributed computing has been designed as a flexible and modular solution that can be adapted to the requirements of any community. Users interact with DIRAC via command line, using the web portal or accessing resources via the DIRAC python API. The current DIRAC API requires users to use a python version valid for DIRAC. Some communities have developed their own software solutions for handling their specific workload, and would like to use DIRAC as their back-end to access distributed computing resources easily. Many of these solutions are not coded in python or depend on a specific python version. To solve this gap DIRAC provides a new language agnostic API that any software solution can use. This new API has been designed following the RESTful principles. Any language with libraries to issue standard HTTP queries may use it. GSI proxies can still be used to authenticate against the API services. However GSI proxies are not a widely adopted standard. The new DIRAC API also allows clients to use OAuth for delegating the user credentials to a third party solution. These delegated credentials allow the third party software to query to DIRAC on behalf of the users. This new API will further expand the possibilities communities have to integrate DIRAC into their distributed computing models.

  17. Real-time electrocardiogram transmission from Mount Everest during continued ascent.

    Science.gov (United States)

    Kao, Wei-Fong; Huang, Jyh-How; Kuo, Terry B J; Chang, Po-Lun; Chang, Wen-Chen; Chan, Kuo-Hung; Liu, Wen-Hsiung; Wang, Shih-Hao; Su, Tzu-Yao; Chiang, Hsiu-chen; Chen, Jin-Jong

    2013-01-01

    The feasibility of a real-time electrocardiogram (ECG) transmission via satellite phone from Mount Everest to determine a climber's suitability for continued ascent was examined. Four Taiwanese climbers were enrolled in the 2009 Mount Everest summit program. Physiological measurements were taken at base camp (5300 m), camp 2 (6400 m), camp 3 (7100 m), and camp 4 (7950 m) 1 hour after arrival and following a 10 minute rest period. A total of 3 out of 4 climbers were able to summit Mount Everest successfully. Overall, ECG and global positioning system (GPS) coordinates of climbers were transmitted in real-time via satellite phone successfully from base camp, camp 2, camp 3, and camp 4. At each camp, Resting Heart Rate (RHR) was transmitted and recorded: base camp (54-113 bpm), camp 2 (94-130 bpm), camp 3 (98-115 bpm), and camp 4 (93-111 bpm). Real-time ECG and GPS coordinate transmission via satellite phone is feasible for climbers on Mount Everest. Real-time RHR data can be used to evaluate a climber's physiological capacity to continue an ascent and to summit.

  18. Real-time electrocardiogram transmission from Mount Everest during continued ascent.

    Directory of Open Access Journals (Sweden)

    Wei-Fong Kao

    Full Text Available The feasibility of a real-time electrocardiogram (ECG transmission via satellite phone from Mount Everest to determine a climber's suitability for continued ascent was examined. Four Taiwanese climbers were enrolled in the 2009 Mount Everest summit program. Physiological measurements were taken at base camp (5300 m, camp 2 (6400 m, camp 3 (7100 m, and camp 4 (7950 m 1 hour after arrival and following a 10 minute rest period. A total of 3 out of 4 climbers were able to summit Mount Everest successfully. Overall, ECG and global positioning system (GPS coordinates of climbers were transmitted in real-time via satellite phone successfully from base camp, camp 2, camp 3, and camp 4. At each camp, Resting Heart Rate (RHR was transmitted and recorded: base camp (54-113 bpm, camp 2 (94-130 bpm, camp 3 (98-115 bpm, and camp 4 (93-111 bpm. Real-time ECG and GPS coordinate transmission via satellite phone is feasible for climbers on Mount Everest. Real-time RHR data can be used to evaluate a climber's physiological capacity to continue an ascent and to summit.

  19. Electrocardiogram artifact caused by rigors mimicking narrow complex tachycardia: a case report.

    Science.gov (United States)

    Matthias, Anne Thushara; Indrakumar, Jegarajah

    2014-02-04

    The electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions. Rigors due to shivering can cause electrocardiogram artifacts mimicking various cardiac rhythm abnormalities. We describe an 80-year-old Sri Lankan man with an abnormal electrocardiogram mimicking narrow complex tachycardia during the immediate post-operative period. Electrocardiogram changes caused by muscle tremor during rigors could mimic a narrow complex tachycardia. Identification of muscle tremor as a cause of electrocardiogram artifact can avoid unnecessary pharmacological and non-pharmacological intervention to prevent arrhythmias.

  20. Effects of a standardized Panax ginseng extract on the skeletal muscle of the rat: a comparative study in animals at rest and under exercise.

    Science.gov (United States)

    Ferrando, A; Vila, L; Voces, J A; Cabral, A C; Alvarez, A I; Prieto, J G

    1999-04-01

    The effect of standardized Panax ginseng extract G115 on enzymatic activities, myotypological composition, capillaries and mitochondrial content was studied in the skeletal muscle of male rats Wistar. Simultaneously to the G115 administration the rats performed exercise. The animals were divided into 4 groups. The dose of the ginseng extract G115 was 50 mg/kg. The length of the experimental period was 12 weeks. After 24 hours of inactivity the muscles of the hindlimb were extracted. With regard to the enzymatic activities of the citrate synthase (CS) and lactate dehydrogenase (LDH), CS increases with exercise, while the LDH undergoes no major variations, either due to the exercise or the treatment. Treatment with G115 increases the capillary density and the mitochondrial content of the red gastrocnemius muscle. The results suggest that prolonged treatment with G115 increases the capillary density and the oxidative capacity of the muscles with greater aerobic potential in a manner similar to the performance of physical exercise. When exercise and treatment are combined, the effects that are obtained separately are not potentiated.

  1. Assessment of the electrocardiogram in dogs with visceral leishmaniasis

    Directory of Open Access Journals (Sweden)

    Marlos G. Sousa

    2013-05-01

    Full Text Available As myocarditis and arrhythmias have been shown to occur in both human beings and dogs with leishmaniasis, electrocardiograms of 105 dogs serologically positive for this disease were assessed for rhythm disturbances and changes in ECG waves. A few expressive alterations were seen, including sinus arrest, right bundle branch block, and atrial premature beats in 14.3%, 4.8%, and 4.8% of the studied subjects, respectively. Also, the analysis of ECG waves showed changes suggestive of left atrium and ventricle enlargements, and myocardial hypoxia in some animals. Although cardiac compromise has been previously reported in dogs with leishmaniasis, only a small subset of dogs showed any alteration in the electrocardiogram, which cannot support the occurrence of myocarditis in this investigation.

  2. Nonlinear time series analysis of the human electrocardiogram

    International Nuclear Information System (INIS)

    Perc, Matjaz

    2005-01-01

    We analyse the human electrocardiogram with simple nonlinear time series analysis methods that are appropriate for graduate as well as undergraduate courses. In particular, attention is devoted to the notions of determinism and stationarity in physiological data. We emphasize that methods of nonlinear time series analysis can be successfully applied only if the studied data set originates from a deterministic stationary system. After positively establishing the presence of determinism and stationarity in the studied electrocardiogram, we calculate the maximal Lyapunov exponent, thus providing interesting insights into the dynamics of the human heart. Moreover, to facilitate interest and enable the integration of nonlinear time series analysis methods into the curriculum at an early stage of the educational process, we also provide user-friendly programs for each implemented method

  3. Reconstruction of electrocardiogram using ionic current models for heart muscles.

    Science.gov (United States)

    Yamanaka, A; Okazaki, K; Urushibara, S; Kawato, M; Suzuki, R

    1986-11-01

    A digital computer model is presented for the simulation of the electrocardiogram during ventricular activation and repolarization (QRS-T waves). The part of the ventricular septum and the left ventricular free wall of the heart are represented by a two dimensional array of 730 homogeneous functional units. Ionic currents models are used to determine the spatial distribution of the electrical activities of these units at each instant of time during simulated cardiac cycle. In order to reconstruct the electrocardiogram, the model is expanded three-dimensionally with equipotential assumption along the third axis and then the surface potentials are calculated using solid angle method. Our digital computer model can be used to improve the understanding of the relationship between body surface potentials and intracellular electrical events.

  4. Sinabro: A Smartphone-Integrated Opportunistic Electrocardiogram Monitoring System

    OpenAIRE

    Sungjun Kwon; Dongseok Lee; Jeehoon Kim; Youngki Lee; Seungwoo Kang; Sangwon Seo; Kwangsuk Park

    2016-01-01

    In our preliminary study, we proposed a smartphone-integrated, unobtrusive electrocardiogram (ECG) monitoring system, Sinabro, which monitors a user?s ECG opportunistically during daily smartphone use without explicit user intervention. The proposed system also monitors ECG-derived features, such as heart rate (HR) and heart rate variability (HRV), to support the pervasive healthcare apps for smartphones based on the user?s high-level contexts, such as stress and affective state levels. In th...

  5. Myocardial infarction false alarm: initial electrocardiogram and cardiac enzymes.

    Science.gov (United States)

    Gupta, Esha Das; Sakthiswary, Rajalingham

    2014-05-01

    The objectives of this study were to determine the incidence of a myocardial infarction "false alarm" and evaluate the efficacy of the initial electrocardiogram and cardiac enzymes in diagnosing myocardial infarction in Malaysia. We recruited patients who were admitted with suspected myocardial infarction from June to August 2008. The medical records of these patients were reviewed for the initial electrocardiogram, initial cardiac enzyme levels (creatinine kinase-MB and troponin T), and the final diagnosis upon discharge. The subjects were stratified into 2 groups: true myocardial infarction, and false alarm. 125 patients were enrolled in this study. Following admission and further evaluation, the diagnosis was revised from myocardial infarction to other medical conditions in 48 (38.4%) patients. The sensitivity and specificity of the initial ischemic electrocardiographic changes were 54.5% and 70.8%, respectively. Raised cardiac enzymes had a sensitivity of 44.3% and specificity of 95.8%. A significant proportion of patients in Malaysia are admitted with a false-alarm myocardial infarction. The efficacy of the electrocardiogram in diagnosing myocardial infarction in Malaysia was comparable to the findings of Western studies, but the cardiac enzymes had a much lower sensitivity.

  6. Is 10-second electrocardiogram recording enough for accurately estimating heart rate in atrial fibrillation.

    Science.gov (United States)

    Shuai, Wei; Wang, Xi-Xing; Hong, Kui; Peng, Qiang; Li, Ju-Xiang; Li, Ping; Chen, Jing; Cheng, Xiao-Shu; Su, Hai

    2016-07-15

    At present, the estimation of rest heart rate (HR) in atrial fibrillation (AF) is obtained by apical auscultation for 1min or on the surface electrocardiogram (ECG) by multiplying the number of RR intervals on the 10second recording by six. But the reasonability of 10second ECG recording is controversial. ECG was continuously recorded at rest for 60s to calculate the real rest HR (HR60s). Meanwhile, the first 10s and 30s ECG recordings were used for calculating HR10s (sixfold) and HR30s (twofold). The differences of HR10s or HR30s with the HR60s were compared. The patients were divided into three sub-groups on the HR60s 100bpm. No significant difference among the mean HR10s, HR30s and HR60s was found. A positive correlation existed between HR10s and HR60s or HR30s and HR60s. Bland-Altman plot showed that the 95% reference limits were high as -11.0 to 16.0bpm for HR10s, but for HR30s these values were only -4.5 to 5.2bpm. Among the three subgroups with HR60s 100bpm, the 95% reference limits with HR60s were -8.9 to 10.6, -10.5 to 14.0 and -11.3 to 21.7bpm for HR10s, but these values were -3.9 to 4.3, -4.1 to 4.6 and -5.3 to 6.7bpm for HR30s. As 10s ECG recording could not provide clinically accepted estimation HR, ECG should be recorded at least for 30s in the patients with AF. It is better to record ECG for 60s when the HR is rapid. Copyright © 2016. Published by Elsevier Ireland Ltd.

  7. The NASA Bed Rest Project

    Science.gov (United States)

    Rhodes, Bradley; Meck, Janice

    2005-01-01

    NASA s National Vision for Space Exploration includes human travel beyond low earth orbit and the ultimate safe return of the crews. Crucial to fulfilling the vision is the successful and timely development of countermeasures for the adverse physiological effects on human systems caused by long term exposure to the microgravity environment. Limited access to in-flight resources for the foreseeable future increases NASA s reliance on ground-based analogs to simulate these effects of microgravity. The primary analog for human based research will be head-down bed rest. By this approach NASA will be able to evaluate countermeasures in large sample sizes, perform preliminary evaluations of proposed in-flight protocols and assess the utility of individual or combined strategies before flight resources are requested. In response to this critical need, NASA has created the Bed Rest Project at the Johnson Space Center. The Project establishes the infrastructure and processes to provide a long term capability for standardized domestic bed rest studies and countermeasure development. The Bed Rest Project design takes a comprehensive, interdisciplinary, integrated approach that reduces the resource overhead of one investigator for one campaign. In addition to integrating studies operationally relevant for exploration, the Project addresses other new Vision objectives, namely: 1) interagency cooperation with the NIH allows for Clinical Research Center (CRC) facility sharing to the benefit of both agencies, 2) collaboration with our International Partners expands countermeasure development opportunities for foreign and domestic investigators as well as promotes consistency in approach and results, 3) to the greatest degree possible, the Project also advances research by clinicians and academia alike to encourage return to earth benefits. This paper will describe the Project s top level goals, organization and relationship to other Exploration Vision Projects, implementation

  8. Quantification of the first-order high-pass filter's influence on the automatic measurements of the electrocardiogram.

    Science.gov (United States)

    Isaksen, Jonas; Leber, Remo; Schmid, Ramun; Schmid, Hans-Jakob; Generali, Gianluca; Abächerli, Roger

    2017-02-01

    The first-order high-pass filter (AC coupling) has previously been shown to affect the ECG for higher cut-off frequencies. We seek to find a systematic deviation in computer measurements of the electrocardiogram when the AC coupling with a 0.05 Hz first-order high-pass filter is used. The standard 12-lead electrocardiogram from 1248 patients and the automated measurements of their DC and AC coupled version were used. We expect a large unipolar QRS-complex to produce a deviation in the opposite direction in the ST-segment. We found a strong correlation between the QRS integral and the offset throughout the ST-segment. The coefficient for J amplitude deviation was found to be -0.277 µV/(µV⋅s). Potential dangerous alterations to the diagnostically important ST-segment were found. Medical professionals and software developers for electrocardiogram interpretation programs should be aware of such high-pass filter effects since they could be misinterpreted as pathophysiology or some pathophysiology could be masked by these effects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. RESTful Web Services Cookbook

    CERN Document Server

    Allamaraju, Subbu

    2010-01-01

    While the REST design philosophy has captured the imagination of web and enterprise developers alike, using this approach to develop real web services is no picnic. This cookbook includes more than 100 recipes to help you take advantage of REST, HTTP, and the infrastructure of the Web. You'll learn ways to design RESTful web services for client and server applications that meet performance, scalability, reliability, and security goals, no matter what programming language and development framework you use. Each recipe includes one or two problem statements, with easy-to-follow, step-by-step i

  10. Framework for ReSTful Web Services in OSGi

    Science.gov (United States)

    Shams, Khawaja S.; Norris, Jeffrey S.; Powell, Mark W.; Crockett, Thomas M.; Mittman, David S.; Fox, Jason M.; Joswig, Joseph C.; Wallick, Michael N.; Torres, Recaredo J.; Rabe, Kenneth

    2009-01-01

    Ensemble ReST is a software system that eases the development, deployment, and maintenance of server-side application programs to perform functions that would otherwise be performed by client software. Ensemble ReST takes advantage of the proven disciplines of ReST (Representational State Transfer. ReST leverages the standardized HTTP protocol to enable developers to offer services to a diverse variety of clients: from shell scripts to sophisticated Java application suites

  11. Noninvasive extraction of fetal electrocardiogram based on Support Vector Machine

    Science.gov (United States)

    Fu, Yumei; Xiang, Shihan; Chen, Tianyi; Zhou, Ping; Huang, Weiyan

    2015-10-01

    The fetal electrocardiogram (FECG) signal has important clinical value for diagnosing the fetal heart diseases and choosing suitable therapeutics schemes to doctors. So, the noninvasive extraction of FECG from electrocardiogram (ECG) signals becomes a hot research point. A new method, the Support Vector Machine (SVM) is utilized for the extraction of FECG with limited size of data. Firstly, the theory of the SVM and the principle of the extraction based on the SVM are studied. Secondly, the transformation of maternal electrocardiogram (MECG) component in abdominal composite signal is verified to be nonlinear and fitted with the SVM. Then, the SVM is trained, and the training results are compared with the real data to ensure the effect of the training. Meanwhile, the parameters of the SVM are optimized to achieve the best performance so that the learning machine can be utilized to fit the unknown samples. Finally, the FECG is extracted by removing the optimal estimation of MECG component from the abdominal composite signal. In order to evaluate the performance of FECG extraction based on the SVM, the Signal-to-Noise Ratio (SNR) and the visual test are used. The experimental results show that the FECG with good quality can be extracted, its SNR ratio is significantly increased as high as 9.2349 dB and the time cost is significantly decreased as short as 0.802 seconds. Compared with the traditional method, the noninvasive extraction method based on the SVM has a simple realization, the shorter treatment time and the better extraction quality under the same conditions.

  12. Rejection of the maternal electrocardiogram in the electrohysterogram signal.

    Science.gov (United States)

    Leman, H; Marque, C

    2000-08-01

    The electrohysterogram (EHG) signal is mainly corrupted by the mother's electrocardiogram (ECG), which remains present despite analog filtering during acquisition. Wavelets are a powerful denoising tool and have already proved their efficiency on the EHG. In this paper, we propose a new method that employs the redundant wavelet packet transform. We first study wavelet packet coefficient histograms and propose an algorithm to automatically detect the histogram mode number. Using a new criterion, we compute a best basis adapted to the denoising. After EHG wavelet packet coefficient thresholding in the selected basis, the inverse transform is applied. The ECG seems to be very efficiently removed.

  13. Chameleons: Electrocardiogram Imitators of ST-Segment Elevation Myocardial Infarction.

    Science.gov (United States)

    Nable, Jose V; Lawner, Benjamin J

    2015-08-01

    The imperative for timely reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction (STEMI) underscores the need for clinicians to have an understanding of how to distinguish patterns of STEMI from its imitators. These imitating diagnoses may confound an evaluation, potentially delaying necessary therapy. Although numerous diagnoses may mimic STEMI, several morphologic clues may allow the physician to determine if the pattern is concerning for either STEMI or a mimicking diagnosis. Furthermore, obtaining a satisfactory history, comparing previous electrocardiograms, and assessing serial tests may provide valuable clues. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. WEB-SERVICE. RESTFUL ARCHITECTURE

    Directory of Open Access Journals (Sweden)

    M. Melnichuk

    2018-04-01

    Full Text Available Network technology for interaction between two applications via the HTTP protocol was considered in article.When client works with REST API - it means it works with "resources", and in SOAP work is performed with operations. To build REST web services, you must follow certain principles: explicit use of HTTP methods, access to resources by URI, stateless, HATEAOS, caching, transfer of objects in JSON or XML representation. But sometimes some principles are ignored to ensure a higher speed of work and to reduce development time.The pros and cons of using JSON and XML representations were considered, and it can be said that using the JSON format reduces the amount of data transfer, and with the use of XML, the readability of data increases.Also, two main ways of data transfer in REST web services were considered: converting the file to Base64 and transferring it as an object field or transferring the file using the usual HTTP multipart. The Base64 standard approach gives a higher speed for multiple files in a single request, because only one HTTP connection is created, but these files are stored in RAM during request processing, which increases chance of the application crashing.In the conclusion, the advantages of using web services and their wide use in other architectural approaches were considered, which increases the popularity of web services.

  15. Exercise electrocardiogram in middle-aged and older leisure time sportsmen: 100 exercise tests would be enough to identify one silent myocardial ischemia at risk for cardiac event.

    Science.gov (United States)

    Hupin, David; Edouard, Pascal; Oriol, Mathieu; Laukkanen, Jari; Abraham, Pierre; Doutreleau, Stéphane; Guy, Jean-Michel; Carré, François; Barthélémy, Jean-Claude; Roche, Frédéric; Chatard, Jean-Claude

    2018-04-15

    The importance of exercise electrocardiogram (ECG) has been controversial in the prevention of cardiac events among sportsmen. The aim of this study was to determine the frequency of silent myocardial ischemia (SMI) from an exercise ECG and its relationship with induced coronary angiographic assessment and potentially preventable cardiac events. This prospective cohort study included leisure time asymptomatic sportsmen over 35years old, referred from 2011 to 2014 in the Sports Medicine Unit of the University Hospital of Saint-Etienne. Of the cohort of 1500 sportsmen (1205 men; mean age 50.7±9.4years; physical activity level 32.8±26.8MET-h/week), 951 (63%) had at least one cardiovascular disease (CVD) risk factor. Family history, medical examination and standard resting 12-lead were collected. A total of 163 exercise ECGs (10.9%) were defined as positive, most of them due to SMI (n=129, 8.6%). SMI was an indication for coronary angiography in 23 cases, leading to 17 documented SMIs (1.1%), including 11 significant stenoses requiring revascularization. In multivariate logistic regression analysis, a high risk of CVD (OR=2.65 [CI 95%: 1.33-5.27], p=0.005) and an age >50years (OR=2.71 [CI 95%: 1.65-4.44], p<0.0001) were independently associated with confirmed SMI. The association of positive exercise ECG with significant coronary stenosis was stronger among sportsmen with CVD risk factors and older than 50years. Screening by exercise ECG can lower the risk of cardiac events in middle-aged and older sportsmen. One hundred tests would be enough to detect one silent myocardial ischemia at risk for cardiac event. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Tripolar Laplacian electrocardiogram and moment of activation isochronal mapping.

    Science.gov (United States)

    Besio, W; Chen, T

    2007-05-01

    The electrocardiogram (ECG) provides useful global temporal assessment of the cardiac activity, but has limited spatial capabilities. The Laplacian electrocardiogram (LECG), an improvement over the ECG, provides high spatiotemporal distributed information about cardiac electrical activation. We designed and developed LECG tripolar concentric ring electrode active sensors based on the finite element algorithm 'nine-point method' (NPM). The active sensors were used in an array of 6 by 12 (72) locations to record bipolar and tripolar LECG from the body surface over the anterolateral chest. Compared to bipolar LECG, tripolar LECG showed significantly higher spatial selectivity which may be helpful in inferring information about cardiac activations detected on the body surface. In this study the moment of activation (MOA), an indicator of a depolarization wave passing below the active sensors, was used to surmise possible timing information of the cardiac electrical activation below the active sensors' recording sites. The MOA on the body surface was used to generate isochronal maps that may some day be used by clinicians in diagnosing arrhythmias and assessing the efficacy of therapies.

  17. Effect of gender on computerized electrocardiogram measurements in college athletes.

    Science.gov (United States)

    Mandic, Sandra; Fonda, Holly; Dewey, Frederick; Le, Vy-van; Stein, Ricardo; Wheeler, Matt; Ashley, Euan A; Myers, Jonathan; Froelicher, Victor F

    2010-06-01

    Broad criteria for classifying an electrocardiogram (ECG) as abnormal and requiring additional testing prior to participating in competitive athletics have been recommended for the preparticipation examination (PPE) of athletes. Because these criteria have not considered gender differences, we examined the effect of gender on the computerized ECG measurements obtained on Stanford student athletes. Currently available computer programs require a basis for "normal" in athletes of both genders to provide reliable interpretation. During the 2007 PPE, computerized ECGs were recorded and analyzed on 658 athletes (54% male; mean age, 19 +/- 1 years) representing 22 sports. Electrocardiogram measurements included intervals and durations in all 12 leads to calculate 12-lead voltage sums, QRS amplitude and QRS area, spatial vector length (SVL), and the sum of the R wave in V5 and S wave in V2 (RSsum). By computer analysis, male athletes had significantly greater QRS duration, PR interval, Q-wave duration, J-point amplitude, and T-wave amplitude, and shorter QTc interval compared with female athletes (all P < 0.05). All ECG indicators of left ventricular electrical activity were significantly greater in males. Although gender was consistently associated with indices of atrial and ventricular electrical activity in multivariable analysis, ECG measurements correlated poorly with body dimensions. Significant gender differences exist in ECG measurements of college athletes that are not explained by differences in body size. Our tables of "normal" computerized gender-specific measurements can facilitate the development of automated ECG interpretation for screening young athletes.

  18. Automated electrocardiogram interpretation programs versus cardiologists' triage decision making based on teletransmitted data in patients with suspected acute coronary syndrome

    DEFF Research Database (Denmark)

    Clark, Elaine N; Ripa, Maria Sejersten; Clemmensen, Peter

    2010-01-01

    The aims of this study were to assess the effectiveness of 2 automated electrocardiogram interpretation programs in patients with suspected acute coronary syndrome transported to hospital by ambulance in 1 rural region of Denmark with hospital discharge diagnosis used as the gold standard...... infarction with respect to discharge diagnosis were 78%, 91%, and 81% for LIFEPAK 12 and 78%, 94%, and 87% for the Glasgow program. Corresponding data for attending cardiologists were 85%, 90%, and 81%. In conclusion, the Glasgow program had significantly higher specificity than the LIFEPAK 12 program (p = 0...

  19. Value of electrocardiogram in predialytic chronic kidney disease patient without known coronary artery disease

    Directory of Open Access Journals (Sweden)

    Dutta PK, Das S

    2014-11-01

    Full Text Available Chronic Kidney disease (CKD is a pressing public health burden occurring in about 10% of the population. The majority of them die before reaching End Stage Renal Disease (ESRD due to cardiovascular disease (CVD. Hypertension (HTN and anaemia are two reversible factors for progression of CKD. Besides asymptomatic coronary artery disease, the electrolyte abnormalities such as hyperkalaemia and hypocalcaemia also subject these patients to sudden cardiac death. This study is aimed at to see the changes in electrocardiogram (ECG in hospitalized predialytic CKD patients due to these abnormalities. Methods: This is a 6 months cross-sectional study carried out at Chittagong Medical College Hospital in Chittagong, Bangladesh. 50 patients with stages 3, 4 and 5 CKD were recruited from the Nephrology and Medicine wards. Patients with prior history of coronary artery disease, cardiomyopathy, valvular heart disease and dialysis were excluded. All had their standard 12–lead electrocardiogram (ECG recorded and various findings were critically studied and interpreted independently by two consultant physicians including a cardiologist. Data analysis was done using SPSS version 19. Results: LVH (left ventricular hypertrophy (66%, LAE (left atrial enlargement (30% and unrecognized myocardial infarction (28% were very common ECG abnormalities in our predialytic CKD patients. HTN, anaemia, late presentation, and male gender appear to be associated with ECG abnormalities. Though 28 patients (56% were hyperkalaemic only 9 patients (38% of them had tall tented T wave in ECG. Conclusion: Detection of HTN and anaemia in male predialytic CKD patients will arouse suspicion which will help in early detection of cardiac outcome by ECG abnormality which will help in taking treatment strategy in resource limited country.

  20. Synergistic effect of polymorphisms of paraoxonase gene cluster and arsenic exposure on electrocardiogram abnormality

    International Nuclear Information System (INIS)

    Liao, Y.-T.; Li, W.-F.; Chen, C.-J.; Prineas, Ronald J.; Chen, Wei J.; Zhang Zhuming; Sun, C.-W.; Wang, S.-L.

    2009-01-01

    Arsenic has been linked to increased prevalence of cancer and cardiovascular disease (CVD), but the long-term impact of arsenic exposure remains unclear. Human paraoxonase (PON1) is a high-density lipoprotein-associated antioxidant enzyme which hydrolyzes oxidized lipids and is thought to be protective against atherosclerosis, but evidence remains limited to case-control studies. Only recently have genes encoding enzymes responsible for arsenic metabolism, such as AS3MT and GSTO, been cloned and characterized. This study was designed to evaluate the synergistic interaction of genetic factors and arsenic exposure on electrocardiogram abnormality. A total of 216 residents from three tap water implemented villages of previous arseniasis-hyperendemic regions in Taiwan were prospectively followed for an average of 8 years. For each resident, a 12-lead conventional electrocardiogram (ECG) was recorded and coded by Minnesota Code standard criteria. Eight functional polymorphisms of PON1, PON2, AS3MT, GSTO1, and GSTO2 were examined for genetic susceptibility to ECG abnormality. Among 42 incident cases with ECG deterioration identified among 121 baseline-normal subjects, arsenic exposure was significantly correlated with incidence of ECG abnormality. In addition, polymorphisms in two paraoxonase genes were also found associated with the incidence of ECG abnormality. A haplotype R-C-S constituted by polymorphisms of PON1 Q192R, -108C/T and PON2 C311S was linked to the increased risk. Subjects exposed to high levels of As (cumulative As exposure > 14.7 ppm-year or drinking artesian well water > 21 years) and carrying the R-C-S haplotype had significantly increased risks for ECG abnormality over those with only one risk factor. Results of this study showed a long-term arsenic effect on ECG abnormality and significant gene-gene and gene-environment interactions linked to the incidence of CVD. This finding might have important implications for a novel and potentially useful

  1. Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients.

    Science.gov (United States)

    Palhares, Daniel M F; Marcolino, Milena S; Santos, Thales M M; da Silva, José L P; Gomes, Paulo R; Ribeiro, Leonardo B; Macfarlane, Peter W; Ribeiro, Antonio L P

    2017-06-13

    Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.

  2. ASSESSMENT OF RELATION BETWEEN MICROALBUMINURIA AND ISCHEMIC ELECTROCARDIOGRAM IN IRANIAN GENERAL POPULATION

    Directory of Open Access Journals (Sweden)

    Alireza Khosravi

    2010-12-01

    Full Text Available Abstract    BACKGROUND: Enhancement of albumin exertion in urine increases the risk of renal and ischemic heart diseases (IHD. We assessed the association of urine albumin and sub-clinical IHD in a random sample of Iranian general population.    METHODS: The random sample in general population in Isfahan County was recruited to the cross-sectional study. From the all sample blood pressure and lipid profile were assessed and morning urine spot was measured for albumin and Creatinine. Microalbuminuria was defined either Albumin-Creatinine Ratio (ACR was 30-300mg. Also, the standard 12 lead electrocardiogram (ECG was carried out for all participants. The ECG pattern was divided to two categories; normal or ECG with ischemia. The logistic regression model was determined the odds of albuminuria for ischemic changes in ECG.    RESULTS: 999 subjects, age 35-70 years, participated to study. From all, 40.8% were male. Microalbuminuria was detected in 8% and sub-clinical ECG ischemic changes were found in 23.4%. The most frequent ischemic change was T wave inversion. The mean urine albumin levels in subjects with normal ECG was 9.6±14.6 mg/ml and in ischemic group was 8.5±12.2 mg/ml and they did not have statistically different. The odds ratios of neither Albumin-Creatinine ratio nor microalbuminuria were in significant range for risk to ischemic changes in ECG of apparently healthy participants. They was consecutively OR=0.9 (0.51-1.6, OR=0.99 (0.98-1.004.     CONCLUSION: Our finding didn’t declare any association between ACR and IHD. Because of showing this association in the other study; it needs more exploration regarding to association between microalbuminuria and cardiovascular diseases incidence.      Keywords: Ischemic heart diseases, electrocardiogram, Albumin-Creatinine Ratio, Urine Albumin

  3. The Ensembl REST API: Ensembl Data for Any Language.

    Science.gov (United States)

    Yates, Andrew; Beal, Kathryn; Keenan, Stephen; McLaren, William; Pignatelli, Miguel; Ritchie, Graham R S; Ruffier, Magali; Taylor, Kieron; Vullo, Alessandro; Flicek, Paul

    2015-01-01

    We present a Web service to access Ensembl data using Representational State Transfer (REST). The Ensembl REST server enables the easy retrieval of a wide range of Ensembl data by most programming languages, using standard formats such as JSON and FASTA while minimizing client work. We also introduce bindings to the popular Ensembl Variant Effect Predictor tool permitting large-scale programmatic variant analysis independent of any specific programming language. The Ensembl REST API can be accessed at http://rest.ensembl.org and source code is freely available under an Apache 2.0 license from http://github.com/Ensembl/ensembl-rest. © The Author 2014. Published by Oxford University Press.

  4. REST based service composition

    DEFF Research Database (Denmark)

    Grönvall, Erik; Ingstrup, Mads; Pløger, Morten

    2011-01-01

    This paper presents an ongoing work developing and testing a Service Composition framework based upon the REST architecture named SECREST. A minimalistic approach have been favored instead of a creating a complete infrastructure. One focus has been on the system's interaction model. Indeed, an aim...

  5. Sinabro: A Smartphone-Integrated Opportunistic Electrocardiogram Monitoring System.

    Science.gov (United States)

    Kwon, Sungjun; Lee, Dongseok; Kim, Jeehoon; Lee, Youngki; Kang, Seungwoo; Seo, Sangwon; Park, Kwangsuk

    2016-03-11

    In our preliminary study, we proposed a smartphone-integrated, unobtrusive electrocardiogram (ECG) monitoring system, Sinabro, which monitors a user's ECG opportunistically during daily smartphone use without explicit user intervention. The proposed system also monitors ECG-derived features, such as heart rate (HR) and heart rate variability (HRV), to support the pervasive healthcare apps for smartphones based on the user's high-level contexts, such as stress and affective state levels. In this study, we have extended the Sinabro system by: (1) upgrading the sensor device; (2) improving the feature extraction process; and (3) evaluating extensions of the system. We evaluated these extensions with a good set of algorithm parameters that were suggested based on empirical analyses. The results showed that the system could capture ECG reliably and extract highly accurate ECG-derived features with a reasonable rate of data drop during the user's daily smartphone use.

  6. Sinabro: A Smartphone-Integrated Opportunistic Electrocardiogram Monitoring System

    Directory of Open Access Journals (Sweden)

    Sungjun Kwon

    2016-03-01

    Full Text Available In our preliminary study, we proposed a smartphone-integrated, unobtrusive electrocardiogram (ECG monitoring system, Sinabro, which monitors a user’s ECG opportunistically during daily smartphone use without explicit user intervention. The proposed system also monitors ECG-derived features, such as heart rate (HR and heart rate variability (HRV, to support the pervasive healthcare apps for smartphones based on the user’s high-level contexts, such as stress and affective state levels. In this study, we have extended the Sinabro system by: (1 upgrading the sensor device; (2 improving the feature extraction process; and (3 evaluating extensions of the system. We evaluated these extensions with a good set of algorithm parameters that were suggested based on empirical analyses. The results showed that the system could capture ECG reliably and extract highly accurate ECG-derived features with a reasonable rate of data drop during the user’s daily smartphone use.

  7. Adaptive noise canceling of electrocardiogram artifacts in single channel electroencephalogram.

    Science.gov (United States)

    Cho, Sung Pil; Song, Mi Hye; Park, Young Cheol; Choi, Ho Seon; Lee, Kyoung Joung

    2007-01-01

    A new method for estimating and eliminating electrocardiogram (ECG) artifacts from single channel scalp electroencephalogram (EEG) is proposed. The proposed method consists of emphasis of QRS complex from EEG using least squares acceleration (LSA) filter, generation of synchronized pulse with R-peak and ECG artifacts estimation and elimination using adaptive filter. The performance of the proposed method was evaluated using simulated and real EEG recordings, we found that the ECG artifacts were successfully estimated and eliminated in comparison with the conventional multi-channel techniques, which are independent component analysis (ICA) and ensemble average (EA) method. From this we can conclude that the proposed method is useful for the detecting and eliminating the ECG artifacts from single channel EEG and simple to use for ambulatory/portable EEG monitoring system.

  8. The normal electrocardiogram of four species of conscious raptors.

    Science.gov (United States)

    Talavera, J; Guzmán, M J; del Palacio, M J Fernández; Albert, A P; Bayón, A

    2008-02-01

    The aim of this study was to describe normal ECG patterns and values in four species of conscious raptors (Eurasian kestrel, Griffon vulture, Little owl, and Eurasian Eagle owl). Electrocardiograms were carried out in 75 conscious birds belonging to four species of raptors. Lead II waveforms were analysed to determine amplitudes and durations of waves and intervals. Morphologic patterns of P-QRS-T deflections were analysed in the six limb leads. Rhythm, heart rate, mean electrical axis, presence of Ta wave, ST slurring, and P-on-T phenomenon were also studied. The influence of species, body weight and heart rate in electrocardiographic variables were statistically analysed (P raptors that can be used to establish comparisons for clinical purposes.

  9. Classification of hydration status using electrocardiogram and machine learning

    Science.gov (United States)

    Kaveh, Anthony; Chung, Wayne

    2013-10-01

    The electrocardiogram (ECG) has been used extensively in clinical practice for decades to non-invasively characterize the health of heart tissue; however, these techniques are limited to time domain features. We propose a machine classification system using support vector machines (SVM) that uses temporal and spectral information to classify health state beyond cardiac arrhythmias. Our method uses single lead ECG to classify volume depletion (or dehydration) without the lengthy and costly blood analysis tests traditionally used for detecting dehydration status. Our method builds on established clinical ECG criteria for identifying electrolyte imbalances and lends to automated, computationally efficient implementation. The method was tested on the MIT-BIH PhysioNet database to validate this purely computational method for expedient disease-state classification. The results show high sensitivity, supporting use as a cost- and time-effective screening tool.

  10. Computer analysis of the exercise electrocardiogram and control of radionuclide ventriculography: an optimal statistical decision model for diagnosis of coronary artery disease

    International Nuclear Information System (INIS)

    Hsia, P.W.E.

    1987-01-01

    A new automated technique for the diagnosis of coronary artery disease (CAD) by stress electrocardiography and radionuclide ventriculography (RNV) has been developed. The method employs digital signal processing of the electrocardiogram (ECG) for recognition of ischemic and arrhythmic events. On-line detection of abnormal beats is used for control image acquisition by the gamma camera resulting in improved image quality since only identical beats are included in the composite images of the cardiac cycle. A combined stress ECG analysis which measures ST changes indicative of ischemia, and radionuclide results, which reveal corresponding ejection fraction abnormalities yields greater sensitivity and specificity than either test alone. Digitized data from the electrocardiogram are analyzed in a beat-by-beat mode and a contextual diagnosis of underlying rhythm is given. Template generation, R wave detection, QRS window size, baseline correction, and continuous updating of heart rate are completely automated. A statistical model base on computerized ST segment measurements combined with radionuclide ventriculography data has been developed by using a logistic model with stepwise regression fitting. A previously acquired database of similar measurements was used for designing the model. The most significant parameters were found to be (1) ejection fraction of exercise RNV; (2) difference of ST level between exercise and resting test (stdif); and (3) ejection fraction difference between exercise and resting test. The new parameter stdif, not previously used in ECG interpretation, was found to be of great diagnostic significance

  11. Value of exercise thallium-201 imaging in patients with diagnostic and nondiagnostic exercise electrocardiograms

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Segal, B.L.

    1981-01-01

    The role of exercise imaging with thallium-201 in the evaluation of patients suspected of having coronary artery disease was studied in 194 patients undergoing diagnostic coronary arteriography. Ninety-eight patients had 70 percent or more narrowing of one or more coronary vessels and 96 patients had either no or insignificant coronary artery disease. One hundren twenty-three of the 194 patients had conclusive treadmill exercise electrocardiograms (either positive or negative), and 71 had inconclusive exercise electrocardiograms. The specificity of exercise imaging (97 percent) was higher than that of exercise electrocardiograms (86 percent, p less than 0.02). The specificity of both tests combined was not significantly different from that of exercise electrocardiograms alone. The sensitivity (79 percent) and specificity (95 percent) of exercise imaging were not significantly different in patients with inconclusive exercise electrocardiograms when compared with those in patients whose exercise electrocardiograms were conclusive. These data indicate that exercise imaging is sensitive and specific in diagnosing coronary artery disease in the presence of diagnostic as well as nondiagnostic exercise electrocardiograms and that propranolol therapy does not affect the results

  12. The Amsterdam Resting-State Questionnaire reveals multiple phenotypes of resting-state cognition

    Directory of Open Access Journals (Sweden)

    B. Alexander eDiaz

    2013-08-01

    Full Text Available Resting-state neuroimaging is a dominant paradigm for studying brain function in health and disease. It is attractive for clinical research because of its simplicity for patients, straightforward standardization, and sensitivity to brain disorders. Importantly, non-sensory experiences like mind wandering may arise from ongoing brain activity. However, little is known about the link between ongoing brain activity and cognition, as phenotypes of resting-state cognition—and tools to quantify them—have been lacking. To facilitate rapid and structured measurements of resting-state cognition we developed a 50-item self-report survey, the Amsterdam Resting-State Questionnaire (ARSQ. Based on ARSQ data from 813 participants assessed after five minutes eyes-closed rest in their home, we identified seven dimensions of resting-state cognition using factor analysis: Discontinuity of Mind, Theory of Mind, Self, Planning, Sleepiness, Comfort, and Somatic Awareness. Further, we showed that the structure of cognition was similar during resting-state fMRI and EEG, and that the test-retest correlations were remarkably high for all dimensions. To explore whether inter-individual variation of resting-state cognition is related to health status, we correlated ARSQ-derived factor scores with psychometric scales measuring depression, anxiety, and sleep quality. Mental health correlated positively with Comfort and negatively with Discontinuity of Mind. Finally, we show that sleepiness may partially explain a resting-state EEG profile previously associated with Alzheimer’s disease. These findings indicate that the ARSQ readily provides information about cognitive phenotypes and that it is a promising tool for research on the neural correlates of resting-state cognition in health and disease.

  13. The Amsterdam Resting-State Questionnaire reveals multiple phenotypes of resting-state cognition

    Science.gov (United States)

    Diaz, B. Alexander; Van Der Sluis, Sophie; Moens, Sarah; Benjamins, Jeroen S.; Migliorati, Filippo; Stoffers, Diederick; Den Braber, Anouk; Poil, Simon-Shlomo; Hardstone, Richard; Van't Ent, Dennis; Boomsma, Dorret I.; De Geus, Eco; Mansvelder, Huibert D.; Van Someren, Eus J. W.; Linkenkaer-Hansen, Klaus

    2013-01-01

    Resting-state neuroimaging is a dominant paradigm for studying brain function in health and disease. It is attractive for clinical research because of its simplicity for patients, straightforward standardization, and sensitivity to brain disorders. Importantly, non-sensory experiences like mind wandering may arise from ongoing brain activity. However, little is known about the link between ongoing brain activity and cognition, as phenotypes of resting-state cognition—and tools to quantify them—have been lacking. To facilitate rapid and structured measurements of resting-state cognition we developed a 50-item self-report survey, the Amsterdam Resting-State Questionnaire (ARSQ). Based on ARSQ data from 813 participants assessed after 5 min eyes-closed rest in their home, we identified seven dimensions of resting-state cognition using factor analysis: Discontinuity of Mind, Theory of Mind, Self, Planning, Sleepiness, Comfort, and Somatic Awareness. Further, we showed that the structure of cognition was similar during resting-state fMRI and EEG, and that the test-retest correlations were remarkably high for all dimensions. To explore whether inter-individual variation of resting-state cognition is related to health status, we correlated ARSQ-derived factor scores with psychometric scales measuring depression, anxiety, and sleep quality. Mental health correlated positively with Comfort and negatively with Discontinuity of Mind. Finally, we show that sleepiness may partially explain a resting-state EEG profile previously associated with Alzheimer's disease. These findings indicate that the ARSQ readily provides information about cognitive phenotypes and that it is a promising tool for research on the neural correlates of resting-state cognition in health and disease. PMID:23964225

  14. Developing RESTful web services with Jersey 2.0

    CERN Document Server

    Gulabani, Sunil

    2013-01-01

    The book will follow a standard tutorial approach and will teach readers how to use the Jersey API for creating RESTful web services.This book is intended for Java EE developers who are building applications on the REST architecture. This is a quick, hands-on guide for learning JAX-RS 2.0. Developers should have some knowledge about RESTful web services but it's not essential to know JAX-RS 1.0.

  15. Radiotelemetry recording of electroencephalogram in piglets during rest.

    Science.gov (United States)

    Saito, Toshiyuki; Watanabe, Yasuko; Nemoto, Tetsu; Kasuya, Etsuko; Sakumoto, Ryosuke

    2005-04-13

    A wireless recording system was developed to study the electroencephalogram (EEG) in unrestrained, male Landrace piglets. Under general anesthesia, ball-tipped silver/silver chloride electrodes for EEG recording were implanted onto the dura matter of the parietal and frontal cortex of the piglets. A pair of miniature preamplifiers and transmitters was then mounted on the surface of the skull. To examine whether other bioelectrical activities interfere with the EEG measurements, an electrocardiogram (ECG) or electromyogram (EMG) of the neck was simultaneously recorded with the EEG. Next, wire electrodes for recording movement of the eyelid were implanted with EEG electrodes, and EEG and eyelid movements were simultaneously measured. Power spectral analysis using a Fast Fourier Transformation (FFT) algorithm indicates that EEG was successfully recorded in unrestrained piglets, at rest, during the daytime in the absence of interference from ECG, EMG or eyelid movements. These data indicate the feasibility of using our radiotelemetry system for measurement of EEG under these conditions.

  16. Non-invasive electrocardiogram detection of in vivo zebrafish embryos using electric potential sensors

    Science.gov (United States)

    Rendon-Morales, E.; Prance, R. J.; Prance, H.; Aviles-Espinosa, R.

    2015-11-01

    In this letter, we report the continuous detection of the cardiac electrical activity in embryonic zebrafish using a non-invasive approach. We present a portable and cost-effective platform based on the electric potential sensing technology, to monitor in vivo electrocardiogram activity from the zebrafish heart. This proof of principle demonstration shows how electrocardiogram measurements from the embryonic zebrafish may become accessible by using electric field detection. We present preliminary results using the prototype, which enables the acquisition of electrophysiological signals from in vivo 3 and 5 days-post-fertilization zebrafish embryos. The recorded waveforms show electrocardiogram traces including detailed features such as QRS complex, P and T waves.

  17. Influence of mercury exposure on blood pressure, resting heart rate and heart rate variability in French Polynesians: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Valera Beatriz

    2011-11-01

    Full Text Available Abstract Background Populations which diet is rich in seafood are highly exposed to contaminants such as mercury, which could affect cardiovascular risk factors Objective To assess the associations between mercury and blood pressure (BP, resting heart rate (HR and HR variability (HRV among French Polynesians Methods Data were collected among 180 adults (≥ 18 years and 101 teenagers (12-17 years. HRV was measured using a two-hour ambulatory electrocardiogram (Holter and BP was measured using a standardized protocol. The association between mercury and HRV and BP parameters was studied using analysis of variance (ANOVA and analysis of covariance (ANCOVA Results Among teenagers, the high frequency (HF decreased between the 2nd and 3rd tertile (380 vs. 204 ms2, p = 0.03 and a similar pattern was observed for the square root of the mean squared differences of successive R-R intervals (rMSSD (43 vs. 30 ms, p = 0.005 after adjusting for confounders. In addition, the ratio low/high frequency (LF/HF increased between the 2nd and 3rd tertile (2.3 vs. 3.0, p = 0.04. Among adults, the standard deviation of R-R intervals (SDNN tended to decrease between the 1st and 2nd tertile (84 vs. 75 ms, p = 0.069 after adjusting for confounders. Furthermore, diastolic BP tended to increase between the 2nd and 3rd tertile (86 vs. 91 mm Hg, p = 0.09. No significant difference was observed in resting HR or pulse pressure (PP Conclusions Mercury was associated with decreased HRV among French Polynesian teenagers while no significant association was observed with resting HR, BP, or PP among teenagers or adults

  18. Is there evidence for mandating electrocardiogram as part of the pre-participation examination?

    Science.gov (United States)

    Borjesson, Mats; Dellborg, Mikael

    2011-01-01

    The risk of sudden cardiac death may be increased up to 2.8 times in competitive athletes compared with nonathletes. The majority of sudden cardiac death cases are caused by an underlying abnormality that potentially may be identified on cardiovascular screening, depending on the specific abnormality and the content of the cardiovascular screening applied. Indeed, today, cardiac screening is universally recommended by the cardiac societies [European Society of Cardiology (ESC) and American Heart Association (AHA)] and required by the sporting bodies [Fédération Internationale de Football Association (FIFA) and Union of European Football Associations (UEFA)]. Pre-participation examination is by consensus understood to include personal history and physical examination; controversy exists regarding the usefulness and appropriateness of screening using resting 12-lead electrocardiogram (ECG), with an apparent transatlantic difference. The ESC recommends screening consisting of personal history, physical examination, and 12-lead resting ECG, whereas recommendations from the AHA includes only personal history and physical examination. There is firm scientific ground to state that the sensitivity of screening with ECG is vastly superior to, and the cost-effectiveness significantly better than, screening without ECG. Cardiac screening of elite athletes with personal history, physical examination, and ECG is cost-effective also in comparison with other well-accepted procedures of modern health care, such as dialysis and implantable cardiac defibrillators. Newly published recommendations for the interpretation of the ECG in athletes (ESC) and future studies on ECGs in athletes of different ethnicity, gender, and age may further increase the specificity of ECG in cardiac screening, refining the screening procedure and lowering the costs for additional follow-up testing. Cardiac screening without ECG is not cost-effective and may be only marginally better than no screening

  19. Use of Electrocardiogram as Part of the Preparticipation Examination.

    Science.gov (United States)

    Chain, Kelly; Gregory, Andrew

    2016-01-01

    A sudden cardiac event or death in a young athlete is a traumatic and memorable event. These tragic events have long-lasting and widespread influences that not only affect the person's immediate family, but also have profound effects on the team, school, and entire community. Over the past several decades there has been a significant research effort in the area of sudden cardiac death (SCD) in athletes in hopes of decreasing preventable deaths. One area of research and discussion that has emerged is the use of electrocardiograms (EKGs) in preparticipation screening examinations as a tool to help identify athletes at risk for SCD. The use of an EKG in addition to a detailed history and physical examination is a controversial and frequently debated topic. To help sort through some of the controversy, this article discusses some of the pros and cons of incorporating the EKG as a screening modality in the preparticipation evaluation for clearance to participate in sports. Copyright 2016, SLACK Incorporated.

  20. Accuracy of electrocardiogram reading by family practice residents.

    Science.gov (United States)

    Sur, D K; Kaye, L; Mikus, M; Goad, J; Morena, A

    2000-05-01

    This study evaluated the electrocardiogram (EKG) reading skills of family practice residents. A multicenter study was carried out to evaluate the accuracy of EKG reading in the family practice setting. Based on the frequency and potential for clinical significance, we chose 18 common findings on 10 EKGs for evaluation. The EKGs were then distributed to residents at six family practice residencies. Residents were given one point for the identification of each correct EKG finding and scored based on the number correct over a total of 18. Sixty-one residents (20 first year, 23 second year, and 18 third year) completed readings for 10 EKGs and were evaluated for their ability to identify 18 EKG findings. The median score out of 18 possible points for all first-, second-, and third-year residents was 12, 12, and 11.5, respectively. Twenty-one percent of residents did not correctly identify a tracing of an acute myocardial infarction. Data analysis showed no statistically significant difference among the three groups of residents. We evaluated the accuracy of EKG reading skills of family practice residents at each year of training. This study suggests that EKG reading skills do not improve during residency, and further study of curricular change to improve these skills should be considered.

  1. Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection.

    Science.gov (United States)

    Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

    2017-06-12

    Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan-Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities.

  2. Effects of electrocardiogram gating on CT pulmonary angiography image quality

    International Nuclear Information System (INIS)

    Ardley, Nicholas D.; Lau, Ken K.; Troupis, John M.; Buchan, Kevin; Paul, Eldho

    2014-01-01

    Pulmonary embolism (PE) is the third most common cause of death from cardiovascular disease. Computed-tomographic pulmonary angiography (CTPA) is an accurate and safe test for diagnosing PE. The aim of this retrospective analysis was to evaluate the effects on image quality (IQ) of electrocardiogram (ECG) gating during CTPA. Fifty consecutive patients presenting for CTPA were included in the study. A single acquisition was performed, resulting in two reconstructions: one at 75% of the R–R interval and the other without ECG influence. IQ evaluation was undertaken by two radiologists, focusing on respiratory and cardiac motion, image noise, low-contrast resolution, vessel and lung clarity, contrast media opacification and artefacts. Various regions of the lungs and vasculature were evaluated, and IQ scores were statistically compared. For the ECG-tagged reconstructions, IQ was noted to be better overall with regard to vessel clarity (P<0.05) and cardiac motion (P<0.05), while lung clarity was better only in the left lower zone (P<0.05). IQ was better with regard to image noise (P<0.05) and low-contrast resolution (P<0.05) in the non-ECG-tagged reconstructions. No statistical IQ difference between the two types of reconstruction was noted with regard to respiratory motion, contrast media opacification or presence of artefacts. The two types of reconstruction provide complementary information for evaluating CTPA results.

  3. Design of portable electrocardiogram device using DSO138

    Science.gov (United States)

    Abuzairi, Tomy; Matondang, Josef Stevanus; Purnamaningsih, Retno Wigajatri; Basari, Ratnasari, Anita

    2018-02-01

    Cardiovascular disease has been one of the leading causes of sudden cardiac deaths in many countries, covering Indonesia. Electrocardiogram (ECG) is a medical test to detect cardiac abnormalities by measuring the electrical activity generated by the heart, as the heart contracts. By using ECG, we can observe anomaly at the time of heart abnormalities. In this paper, design of portable ECG device is presented. The portable ECG device was designed to easily use in the village clinic or houses, due to the small size device and other benefits. The device was designed by using four units: (1) ECG electrode; (2) ECG analog front-end; (3) DSO138; and (4) battery. To create a simple electrode system in the portable ECG, 1-lead ECG with two electrodes were applied. The analog front-end circuitry consists of three integrated circuits, an instrumentation amplifier AD820AN, a low noise operational amplifier OPA134, and a low offset operational amplifier TL082. Digital ECG data were transformed to graphical data on DSO138. The results show that the portable ECG is successfully read the signal from 1-lead ECG system.

  4. Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection †

    Science.gov (United States)

    Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

    2017-01-01

    Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan–Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities. PMID:28604628

  5. Singularity detection by wavelet approach: application to electrocardiogram signal

    Science.gov (United States)

    Jalil, Bushra; Beya, Ouadi; Fauvet, Eric; Laligant, Olivier

    2010-01-01

    In signal processing, the region of abrupt changes contains the most of the useful information about the nature of the signal. The region or the points where these changes occurred are often termed as singular point or singular region. The singularity is considered to be an important character of the signal, as it refers to the discontinuity and interruption present in the signal and the main purpose of the detection of such singular point is to identify the existence, location and size of those singularities. Electrocardiogram (ECG) signal is used to analyze the cardiovascular activity in the human body. However the presence of noise due to several reasons limits the doctor's decision and prevents accurate identification of different pathologies. In this work we attempt to analyze the ECG signal with energy based approach and some heuristic methods to segment and identify different signatures inside the signal. ECG signal has been initially denoised by empirical wavelet shrinkage approach based on Steins Unbiased Risk Estimate (SURE). At the second stage, the ECG signal has been analyzed by Mallat approach based on modulus maximas and Lipschitz exponent computation. The results from both approaches has been discussed and important aspects has been highlighted. In order to evaluate the algorithm, the analysis has been done on MIT-BIH Arrhythmia database; a set of ECG data records sampled at a rate of 360 Hz with 11 bit resolution over a 10mv range. The results have been examined and approved by medical doctors.

  6. Electrocardiogram signal denoising based on a new improved wavelet thresholding

    Science.gov (United States)

    Han, Guoqiang; Xu, Zhijun

    2016-08-01

    Good quality electrocardiogram (ECG) is utilized by physicians for the interpretation and identification of physiological and pathological phenomena. In general, ECG signals may mix various noises such as baseline wander, power line interference, and electromagnetic interference in gathering and recording process. As ECG signals are non-stationary physiological signals, wavelet transform is investigated to be an effective tool to discard noises from corrupted signals. A new compromising threshold function called sigmoid function-based thresholding scheme is adopted in processing ECG signals. Compared with other methods such as hard/soft thresholding or other existing thresholding functions, the new algorithm has many advantages in the noise reduction of ECG signals. It perfectly overcomes the discontinuity at ±T of hard thresholding and reduces the fixed deviation of soft thresholding. The improved wavelet thresholding denoising can be proved to be more efficient than existing algorithms in ECG signal denoising. The signal to noise ratio, mean square error, and percent root mean square difference are calculated to verify the denoising performance as quantitative tools. The experimental results reveal that the waves including P, Q, R, and S waves of ECG signals after denoising coincide with the original ECG signals by employing the new proposed method.

  7. Teaching the interpretation of electrocardiograms: which method is best?

    Science.gov (United States)

    Fent, Graham; Gosai, Jivendra; Purva, Makani

    2015-01-01

    Electrocardiogram (ECG) interpretation is poorly performed at undergraduate and post-graduate level. Incorrect ECG interpretation can lead to serious clinical error. Despite the incorporation of computerized ECG interpretation software into modern ECG machines, the sensitivity and specificity of current technology remain poor, emphasizing the on-going need for doctors to perform ECG interpretation accurately. This is the first review in this important area and aims to critically evaluate the current literature in relation to the optimal format and method of teaching ECG interpretation at undergraduate and postgraduate level. No single method or format of teaching is most effective in delivering ECG interpretation skills; however, self-directed learning appears to be associated with poorer interpretation competence. Summative in preference to formative assessment is associated with improved interpretation competence. Web-based learning offers a promising modern approach to learning ECG interpretation, though caution must be exercised in accessing user-uploaded content to supplement learning. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Robust electrocardiogram (ECG) beat classification using discrete wavelet transform

    International Nuclear Information System (INIS)

    Minhas, Fayyaz-ul-Amir Afsar; Arif, Muhammad

    2008-01-01

    This paper presents a robust technique for the classification of six types of heartbeats through an electrocardiogram (ECG). Features extracted from the QRS complex of the ECG using a wavelet transform along with the instantaneous RR-interval are used for beat classification. The wavelet transform utilized for feature extraction in this paper can also be employed for QRS delineation, leading to reduction in overall system complexity as no separate feature extraction stage would be required in the practical implementation of the system. Only 11 features are used for beat classification with the classification accuracy of ∼99.5% through a KNN classifier. Another main advantage of this method is its robustness to noise, which is illustrated in this paper through experimental results. Furthermore, principal component analysis (PCA) has been used for feature reduction, which reduces the number of features from 11 to 6 while retaining the high beat classification accuracy. Due to reduction in computational complexity (using six features, the time required is ∼4 ms per beat), a simple classifier and noise robustness (at 10 dB signal-to-noise ratio, accuracy is 95%), this method offers substantial advantages over previous techniques for implementation in a practical ECG analyzer

  9. Teaching crucial skills: An electrocardiogram teaching module for medical students.

    Science.gov (United States)

    Chudgar, Saumil M; Engle, Deborah L; Grochowski, Colleen O'Connor; Gagliardi, Jane P

    2016-01-01

    Medical student performance in electrocardiogram (ECG) interpretation at our institution could be improved. Varied resources exist to teach students this essential skill. We created an ECG teaching module (ECGTM) of 75 cases representing 15 diagnoses to improve medical students' performance and confidence in ECG interpretation. Students underwent pre- and post-clerkship testing to assess ECG interpretation skills and confidence and also end-of-clinical-year testing in ECG and laboratory interpretation. Performance was compared for the years before and during ECGTM availability. Eighty-four percent of students (total n=101) reported using the ECGTM; 98% of those who used it reported it was useful. Students' performance and confidence were higher on the post-test. Students with access to the ECGTM (n=101) performed significantly better than students from the previous year (n=90) on the end-of-year ECG test. The continuous availability of an ECGTM was associated with improved confidence and ability in ECG interpretation. The ECGTM may be another available tool to help students as they learn to read ECGs. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Noninvasive recording of electrocardiogram in conscious rat: A new device.

    Science.gov (United States)

    Kumar, Pradeep; Srivastava, Pooja; Gupta, Ankit; Bajpai, Manish

    2017-01-01

    Electrocardiogram (ECG) is an important tool for the study of cardiac electrophysiology both in human beings and experimental animals. Existing methods of ECG recording in small animals like rat have several limitations and ECG recordings of the anesthetized rat lack validity for heart rate (HR) variability analysis. The aim of the present study was to validate the ECG data from new device with ECG of anesthetized rat. The ECG was recorded on student's physiograph (BioDevice, Ambala) and suitable coupler and electrodes in six animals first by the newly developed device in conscious state and second in anesthetized state (stabilized technique). The data obtained were analyzed using unpaired t -test showed no significant difference ( P < 0.05) in QTc, QRS, and HR recorded by new device and established device in rats. No previous study describes a similar ECG recording in conscious state of rats. Thus, the present method may be a most physiological and inexpensive alternative to other methods. In this study, the animals were not restrained; they were just secured and represent a potential strength of the study.

  11. Myocardial ischemia analysis based on electrocardiogram QRS complex

    International Nuclear Information System (INIS)

    Song, J.; Yan, H.; Xu, Z.; Yu, X.; Zhu, R.

    2011-01-01

    Full text: Electrocardiogram (ECG) is an economic, convenient, and non-invasive detecting tool in myocardial ischemia (MI), and its clinical appearance is mainly exhibited by the changes in ST-T complex. Recently, QRS complex characters were proposed to analyze MI by more and more researchers. In this paper, various QRS complex characters were extracted in ECG signals, and their relationship was analyzed systematically. As a result, these characters were divided into two groups, and there existed good relationship among them for each group, while the poor relationship between the groups. Then these QRS complex characters were applied for statistical analysis on MI, and five characters had significant differences after ECG recording verification, which were: QRS upward and downward slopes, transient heart rate, angle R and angle Q. On the other hand, these QRS complex characters were analyzed in frequency domain. Experimental results showed that the frequency features of RR interval series (Heart Rate Variability, HRV), and QRS barycenter sequence had signjficant differences between MI states and normal states. Moreover, QRS barycenter sequence performed better. (author)

  12. The Diagnostic Agreement of Original and Faxed Copies of Electrocardiograms

    Directory of Open Access Journals (Sweden)

    Sadrihe Hajesmaeel-Gohari

    2013-02-01

    Full Text Available Background: General practitioners working in remote and rural areas sometimes need consultation with cardiologists. One practical and cost-effective way is transmission of patients’ electrocardiographic images via ordinary fax machine to the cardiologists, but there is an important question that how much agreement exists between the diagnoses made by reading an original electrocardiogram and its copy transmitted via fax.Materials and Methods: In this cross-sectional study, 60 original electrocardiographic images were given to cardiologists for diagnosis. In the next step those electrocardiographic images were faxed to the hospital through a simple cheap fax machine, one month later the same cardiologist was asked to put his diagnosis on the copied versions of electrocardiographs, and the results were compared. Results: In 59 studied cases, the two method of diagnoses were exactly the same and only in one case the diagnoses were different. Therefore, Kappa agreement coefficient was calculated as 96%.Conclusion: According to the results of this study, general practitioners working in deprived areas can be certainly recommended to send patients’ electrocardiographic images to the cardiologists via fax in the case of needing consultation.

  13. ALTERATIONS IN ELECTROCARDIOGRAMS OF LABRADOR RETRIEVER DOGS DURING HANDLING WITH AND WITHOUT GLOVES

    Directory of Open Access Journals (Sweden)

    Swagat Mohapatra

    2016-12-01

    Full Text Available Healthy male Labrador Retriever dogs (n=8 aged between one to three years constituted the study material. The study was carried out to peruse the alterations in electrocardiograms, when the attendant restrained the dogs with bare hands and when the dogs were restrained by the attendant wearing gloves. The mean amplitude of P wave was higher in dogs handled with gloves. Similarly, the amplitudes of QRS complex and T wave were higher in the electrocardiograms of dogs handled with insulated hands. Meanwhile, the duration of T wave and Q-T interval were higher in the electrocardiograms recorded without gloves in hands. However, no alterations were perceived with respect to the duration of P wave, duration of T wave, the P-R interval, R-R interval and the heart rate. Except for the amplitude of P wave, no other differences were statistically significant. The study reported the alterations in the electrocardiogram while handling the animals with bare hands.

  14. Computer Decision Support as a Source of Interpretation Error: The Case of Electrocardiograms

    OpenAIRE

    Tsai, Theodore L.; Fridsma, Douglas B.; Gatti, Guido

    2003-01-01

    Objective: The aim of this study was to determine the effect that the computer interpretation (CI) of electrocardiograms (EKGs) has on the accuracy of resident (noncardiologist) physicians reading EKGs.

  15. A Real-Time Intrauterine Catheter Technique for Fetal Electrocardiogram Monitoring

    National Research Council Canada - National Science Library

    Horner, S

    2001-01-01

    ..., two sensors that include the invasive scalp electrode and intrauterine pressure catheter are used clink ally, Signal processing is required to obtain a FECG via the IC, Usually the maternal electrocardiogram (ECG...

  16. Prognostic value of predischarge 12 lead electrocardiogram after myocardial infarction compared with other routine clinical variables

    NARCIS (Netherlands)

    Fioretti, P.; Tijssen, J. G.; Azar, A. J.; Lazzeroni, E.; Brower, R. W.; ten Katen, H. J.; Lubsen, J.; Hugenholtz, P. G.

    1987-01-01

    The prognostic value of QRS score (Selvester), ST depression, ST elevation, extrasystoles, P terminal force in V1, and QTc derived from the predischarge 12 lead electrocardiogram was assessed after myocardial infarction in 474 patients without intraventricular conduction defects, ventricular

  17. The ability of an electrocardiogram to predict fatal and non-fatal cardiac events in asymptomatic middle-aged subjects.

    Science.gov (United States)

    Terho, Henri K; Tikkanen, Jani T; Kenttä, Tuomas V; Junttila, M Juhani; Aro, Aapo L; Anttonen, Olli; Kerola, Tuomas; Rissanen, Harri A; Knekt, Paul; Reunanen, Antti; Huikuri, Heikki V

    2016-11-01

    The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined. A total of 9511 middle-aged subjects (mean age 43 ± 8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years. Major ECG abnormalities were classified according to the Minnesota code. Subjects with major ECG abnormalities (N = 1131) had an increased risk of cardiac death after 10-years (adjusted hazard ratio [HR] 1.7; 95% confidence interval [95% CI], 1.1-2.5, p = 0.009) and 30-years of follow-up (HR 1.3, 95% CI, 1.1-1.5, p electrocardiogram are shown to have prognostic significance for cardiac events in elderly subjects without known cardiac disease. Our results suggest that ECG abnormalities increase the risk of fatal cardiac events also in middle-aged healthy subjects.

  18. The Effect of Creative Tasks on Electrocardiogram: Using Linear and Nonlinear Features in Combination with Classification Approaches

    Directory of Open Access Journals (Sweden)

    Sahar Zakeri

    2017-02-01

    Full Text Available Objective: Interest in the subject of creativity and its impacts on human life is growing extensively. However, only a few surveys pay attention to the relation between creativity and physiological changes. This paper presents a novel approach to distinguish between creativity states from electrocardiogram signals. Nineteen linear and nonlinear features of the cardiac signal were extracted to detect creativity states. Method: ECG signals of 52 participants were recorded while doing three tasks of Torrance Tests of Creative Thinking (TTCT/ figural B. To remove artifacts, notch filter 50 Hz and Chebyshev II were applied. According to TTCT scores, participants were categorized into the high and low creativity groups: Participants with scores higher than 70 were assigned into the high creativity group and those with scores less than 30 were considered as low creativity group. Some linear and nonlinear features were extracted from the ECGs. Then, Support Vector Machine (SVM and Adaptive Neuro-Fuzzy Inference System (ANFIS were used to classify the groups.Results: Applying the Wilcoxon test, significant differences were observed between rest and each three tasks of creativity. However, better discrimination was performed between rest and the first task. In addition, there were no statistical differences between the second and third task of the test. The results indicated that the SVM effectively detects all the three tasks from the rest, particularly the task 1 and reached the maximum accuracy of 99.63% in the linear analysis. In addition, the high creative group was separated from the low creative group with the accuracy of 98.41%.Conclusion: the combination of SVM classifier with linear features can be useful to show the relation between creativity and physiological changes.

  19. Changes in canine electrocardiogram values from three thermal floors in Cundinamarca, Colombia

    Directory of Open Access Journals (Sweden)

    Marta Elena Sánchez Klinge

    2008-06-01

    Full Text Available The electrocardiogram is a written register of electric changes that take place in the heart during a heart cycle. The voltage changes are the result of depolarization and repolarization of heart muscle fibers that produce electric changes able to reach body surface and that are detected by electrodes connected to a galvanometer called electrocardiograph. Heart problems are detected with the electrocardiogram, but it is necessary to know the normal values of canine electrocardiogram in a tropical country because values can change compared with normal values reported in other places. The purpose is to show variations of electrocardiogram values from clinically healthy canines from Bogotá D. C at 2600 mosl, Fusagasugá at 1700 mosl and Girardot at 326 mosl. Studied animals were separated in six groups depending on the altitude over sea level and the animal weight (less than 15 Kg and more than 15 Kg. The electrocardiograms were taken with a one channel portable electrocardiograph and derivations I, II, III, aVR, aVL, aVF, CV6LL, CV6LU, CV5RL and V10 were included. Significant differences of electrocardiogram values were observed in derivation II, in relation to the altitude over sea level and to the animals weight, which acquires importance when a diagnose of heart abnormalities is needed from animals located at different altitudes over sea levels.

  20. Comparative analyses of the effect of radiotherapy and chemotherapy or chemotherapy alone on patients' electrocardiogram

    International Nuclear Information System (INIS)

    Liang Li; Zhang Shulan; Zhang Zhaohui; Wang Junjie; Jia Tingzhen

    2005-01-01

    Objective: To investigate the change of breast cancer patients' electrocardiogram during combined radiotherapy and chemotherapy or chemotherapy alone for the sake of predicting the cardiotoxicity of combined radiotherapy and chemotherapy. Methods: From January, 1998 to June, 2004, 47 postoperative breast cancer patients were enrolled. Among them 29 patients received chemotherapy combined with radiotherapy (combinative group), and 18 patients received chemotherapy alone (non combinative group). The changes of electrocardiogram were observed and correlation factors were analyzed. Results: Abnormal electrocardiograms were noted in 11 (37.9%) and 2 patients (11.1%) of the combinative group and the non-combinative group respectively(z=-1.977, P=0.048). In the combinative group, heart events were significantly increased in patients above 60 years old (z=- 2.094 P=0.036). The changes of electrocardiogram were not significantly correlative with hypertension history, tumor site, dose of radiotherapy or chemotherapeutic drugs. But the incidence of abnormal electrocardiogram was higher in patients with a hypertension history than in those without it (54.5% vs 27.8%). Conclusion: The abnormalities of electrocardiogram were are more frequent in patients treated with both radiotherapy combined with chemotherapy. Our results suggest that breast cancer patients should be regularly reexamined with electrocardiography during therapy, especially whose age was those have a hypertension history and above 60 years old. (authors)

  1. Dipoles at rest

    International Nuclear Information System (INIS)

    Griffiths, D.J.

    1992-01-01

    In a world populated by magnetic monopoles (as well as ordinary electric charges), there are two kinds of electric dipoles: those due to separated electric charges, and those due to current loops of magnetic charge. Similarly, there are two kinds of magnetic dipoles: those due to separated magnetic monopoles, and those due to electric current loops. This paper derives the potentials and fields of each of the four dipole species, and calculates the force, torque, energy, momentum, and angular momentum of each type, when placed (at rest) in a static external field (which may itself be produced by electric charges and currents, magnetic charges and currents, or all of these). Some implications and applications of the various results are discussed

  2. An obstructive sleep apnea detection approach using kernel density classification based on single-lead electrocardiogram.

    Science.gov (United States)

    Chen, Lili; Zhang, Xi; Wang, Hui

    2015-05-01

    Obstructive sleep apnea (OSA) is a common sleep disorder that often remains undiagnosed, leading to an increased risk of developing cardiovascular diseases. Polysomnogram (PSG) is currently used as a golden standard for screening OSA. However, because it is time consuming, expensive and causes discomfort, alternative techniques based on a reduced set of physiological signals are proposed to solve this problem. This study proposes a convenient non-parametric kernel density-based approach for detection of OSA using single-lead electrocardiogram (ECG) recordings. Selected physiologically interpretable features are extracted from segmented RR intervals, which are obtained from ECG signals. These features are fed into the kernel density classifier to detect apnea event and bandwidths for density of each class (normal or apnea) are automatically chosen through an iterative bandwidth selection algorithm. To validate the proposed approach, RR intervals are extracted from ECG signals of 35 subjects obtained from a sleep apnea database ( http://physionet.org/cgi-bin/atm/ATM ). The results indicate that the kernel density classifier, with two features for apnea event detection, achieves a mean accuracy of 82.07 %, with mean sensitivity of 83.23 % and mean specificity of 80.24 %. Compared with other existing methods, the proposed kernel density approach achieves a comparably good performance but by using fewer features without significantly losing discriminant power, which indicates that it could be widely used for home-based screening or diagnosis of OSA.

  3. Human Age Recognition by Electrocardiogram Signal Based on Artificial Neural Network

    Science.gov (United States)

    Dasgupta, Hirak

    2016-12-01

    The objective of this work is to make a neural network function approximation model to detect human age from the electrocardiogram (ECG) signal. The input vectors of the neural network are the Katz fractal dimension of the ECG signal, frequencies in the QRS complex, male or female (represented by numeric constant) and the average of successive R-R peak distance of a particular ECG signal. The QRS complex has been detected by short time Fourier transform algorithm. The successive R peak has been detected by, first cutting the signal into periods by auto-correlation method and then finding the absolute of the highest point in each period. The neural network used in this problem consists of two layers, with Sigmoid neuron in the input and linear neuron in the output layer. The result shows the mean of errors as -0.49, 1.03, 0.79 years and the standard deviation of errors as 1.81, 1.77, 2.70 years during training, cross validation and testing with unknown data sets, respectively.

  4. Vectorcardiographic diagnostic & prognostic information derived from the 12-lead electrocardiogram: Historical review and clinical perspective.

    Science.gov (United States)

    Man, Sumche; Maan, Arie C; Schalij, Martin J; Swenne, Cees A

    2015-01-01

    In the course of time, electrocardiography has assumed several modalities with varying electrode numbers, electrode positions and lead systems. 12-lead electrocardiography and 3-lead vectorcardiography have become particularly popular. These modalities developed in parallel through the mid-twentieth century. In the same time interval, the physical concepts underlying electrocardiography were defined and worked out. In particular, the vector concept (heart vector, lead vector, volume conductor) appeared to be essential to understanding the manifestations of electrical heart activity, both in the 12-lead electrocardiogram (ECG) and in the 3-lead vectorcardiogram (VCG). Not universally appreciated in the clinic, the vectorcardiogram, and with it the vector concept, went out of use. A revival of vectorcardiography started in the 90's, when VCGs were mathematically synthesized from standard 12-lead ECGs. This facilitated combined electrocardiography and vectorcardiography without the need for a special recording system. This paper gives an overview of these historical developments, elaborates on the vector concept and seeks to define where VCG analysis/interpretation can add diagnostic/prognostic value to conventional 12-lead ECG analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Educational Software Applied in Teaching Electrocardiogram: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Paulo A. I. Pontes

    2018-01-01

    Full Text Available Background. The electrocardiogram (ECG is the most used diagnostic tool in medicine; in this sense, it is essential that medical undergraduates learn how to interpret it correctly while they are still on training. Naturally, they go through classic learning (e.g., lectures and speeches. However, they are not often efficiently trained in analyzing ECG results. In this regard, methodologies such as other educational support tools in medical practice, such as educational software, should be considered a valuable approach for medical training purposes. Methods. We performed a literature review in six electronic databases, considering studies published before April 2017. The resulting set comprises 2,467 studies. From this collection, 12 studies have been selected, initially, whereby we carried out a snowballing process to identify other relevant studies through the reference lists of these studies, resulting in five relevant studies, making up a total of 17 articles that passed all stages and criteria. Results. The results show that 52.9% of software types were tutorial and 58.8% were designed to be run locally on a computer. The subjects were discussed together with a greater focus on the teaching of electrophysiology and/or cardiac physiology, identifying patterns of ECG and/or arrhythmias. Conclusions. We found positive results with the introduction of educational software for ECG teaching. However, there is a clear need for using higher quality research methodologies and the inclusion of appropriate controls, in order to obtain more precise conclusions about how beneficial the inclusion of such tools can be for the practices of ECG interpretation.

  6. Rural emergency medical technician pre-hospital electrocardiogram transmission.

    Science.gov (United States)

    Powell, A M; Halon, J M; Nelson, J

    2014-01-01

    Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

  7. Impact of teaching and assessment format on electrocardiogram interpretation skills.

    Science.gov (United States)

    Raupach, Tobias; Hanneforth, Nathalie; Anders, Sven; Pukrop, Tobias; Th J ten Cate, Olle; Harendza, Sigrid

    2010-07-01

    Interpretation of the electrocardiogram (ECG) is a core clinical skill that should be developed in undergraduate medical education. This study assessed whether small-group peer teaching is more effective than lectures in enhancing medical students' ECG interpretation skills. In addition, the impact of assessment format on study outcome was analysed. Two consecutive cohorts of Year 4 medical students (n=335) were randomised to receive either traditional ECG lectures or the same amount of small-group, near-peer teaching during a 6-week cardiorespiratory course. Before and after the course, written assessments of ECG interpretation skills were undertaken. Whereas this final assessment yielded a considerable amount of credit points for students in the first cohort, it was merely formative in nature for the second cohort. An unannounced retention test was applied 8 weeks after the end of the cardiovascular course. A significant advantage of near-peer teaching over lectures (effect size 0.33) was noted only in the second cohort, whereas, in the setting of a summative assessment, both teaching formats appeared to be equally effective. A summative instead of a formative assessment doubled the performance increase (Cohen's d 4.9 versus 2.4), mitigating any difference between teaching formats. Within the second cohort, the significant difference between the two teaching formats was maintained in the retention test (p=0.017). However, in both cohorts, a significant decrease in student performance was detected during the 8 weeks following the cardiovascular course. Assessment format appeared to be more powerful than choice of instructional method in enhancing student learning. The effect observed in the second cohort was masked by an overriding incentive generated by the summative assessment in the first cohort. This masking effect should be considered in studies assessing the effectiveness of different teaching methods.

  8. Learning electrocardiogram on YouTube: how useful is it?

    Science.gov (United States)

    Akgun, Taylan; Karabay, Can Yucel; Kocabay, Gonenc; Kalayci, Arzu; Oduncu, Vecih; Guler, Ahmet; Pala, Selcuk; Kirma, Cevat

    2014-01-01

    YouTube has become a useful resource for knowledge and is widely used by medical students as an e-learning source. The purpose of this study was to assess the videos relating electrocardiogram (ECG) on YouTube. YouTube was searched on May 28, 2013 for the search terms "AF ecg" for atrial fibrillation, "AVNRT" for atrioventricular nodal reentrant tachycardia, "AVRT" for atrioventricular reentrant tachycardia, "AV block or heart block" for atrioventricular block, "LBBB, RBBB" for bundle branch block, "left anterior fascicular block or left posterior fascicular block" for fascicular blocks, "VT ecg" for ventricular tachycardia, "long QT" and "Brugada ecg". Non-English language, unrelated and non-educational videos were excluded. Remaining videos were assessed for usefulness, source and characteristics. Usefulness was assessed with using a checklist developed by the authors. One hundred nineteen videos were included in the analysis. Sources of the videos were as follows: individuals n=70, 58.8%, universities/hospitals n=10, 8.4% and medical organizations n=3, 2.5%, health ads n=10 8.4%, health websites n=26, 21.8%. Fifty-six (47.1%) videos were classified as very useful and 16 (13.4%) videos were misleading. 90% of the videos uploaded by universities/hospitals were grouped as very useful videos, the same ratio was 45% for the individual uploads. There were statistically significant differences in ECG diagnosis among the groups (for very useful, useful and misleading, pYouTube has a substantial amount of videos on ECG with a wide diversity from useful to misleading content. The lack of quality content relating to ECG on YouTube necessitates that videos should be selected with utmost care. © 2013 Elsevier Inc. All rights reserved.

  9. Electrocardiogram ST-Segment Morphology Delineation Method Using Orthogonal Transformations.

    Directory of Open Access Journals (Sweden)

    Miha Amon

    Full Text Available Differentiation between ischaemic and non-ischaemic transient ST segment events of long term ambulatory electrocardiograms is a persisting weakness in present ischaemia detection systems. Traditional ST segment level measuring is not a sufficiently precise technique due to the single point of measurement and severe noise which is often present. We developed a robust noise resistant orthogonal-transformation based delineation method, which allows tracing the shape of transient ST segment morphology changes from the entire ST segment in terms of diagnostic and morphologic feature-vector time series, and also allows further analysis. For these purposes, we developed a new Legendre Polynomials based Transformation (LPT of ST segment. Its basis functions have similar shapes to typical transient changes of ST segment morphology categories during myocardial ischaemia (level, slope and scooping, thus providing direct insight into the types of time domain morphology changes through the LPT feature-vector space. We also generated new Karhunen and Lo ève Transformation (KLT ST segment basis functions using a robust covariance matrix constructed from the ST segment pattern vectors derived from the Long Term ST Database (LTST DB. As for the delineation of significant transient ischaemic and non-ischaemic ST segment episodes, we present a study on the representation of transient ST segment morphology categories, and an evaluation study on the classification power of the KLT- and LPT-based feature vectors to classify between ischaemic and non-ischaemic ST segment episodes of the LTST DB. Classification accuracy using the KLT and LPT feature vectors was 90% and 82%, respectively, when using the k-Nearest Neighbors (k = 3 classifier and 10-fold cross-validation. New sets of feature-vector time series for both transformations were derived for the records of the LTST DB which is freely available on the PhysioNet website and were contributed to the LTST DB. The

  10. Quality Aware Compression of Electrocardiogram Using Principal Component Analysis.

    Science.gov (United States)

    Gupta, Rajarshi

    2016-05-01

    Electrocardiogram (ECG) compression finds wide application in various patient monitoring purposes. Quality control in ECG compression ensures reconstruction quality and its clinical acceptance for diagnostic decision making. In this paper, a quality aware compression method of single lead ECG is described using principal component analysis (PCA). After pre-processing, beat extraction and PCA decomposition, two independent quality criteria, namely, bit rate control (BRC) or error control (EC) criteria were set to select optimal principal components, eigenvectors and their quantization level to achieve desired bit rate or error measure. The selected principal components and eigenvectors were finally compressed using a modified delta and Huffman encoder. The algorithms were validated with 32 sets of MIT Arrhythmia data and 60 normal and 30 sets of diagnostic ECG data from PTB Diagnostic ECG data ptbdb, all at 1 kHz sampling. For BRC with a CR threshold of 40, an average Compression Ratio (CR), percentage root mean squared difference normalized (PRDN) and maximum absolute error (MAE) of 50.74, 16.22 and 0.243 mV respectively were obtained. For EC with an upper limit of 5 % PRDN and 0.1 mV MAE, the average CR, PRDN and MAE of 9.48, 4.13 and 0.049 mV respectively were obtained. For mitdb data 117, the reconstruction quality could be preserved up to CR of 68.96 by extending the BRC threshold. The proposed method yields better results than recently published works on quality controlled ECG compression.

  11. The differences in electrocardiogram interpretation in top-level athletes.

    Science.gov (United States)

    Jakubiak, Agnieszka A; Burkhard-Jagodzińska, Krystyna; Król, Wojciech; Konopka, Marcin; Bursa, Dominik; Sitkowski, Dariusz; Kuch, Marek; Braksator, Wojciech

    2017-01-01

    The Ministry of Health in Poland recommends electrocardiogram (ECG)-based cardiovascular screening in athletes, but so far there has been a lack of guidelines on preparticipation assessment. We compared different criteria of ECG screening assessment in a group of top-level athletes. The aims were to evaluate the prevalence of ECG changes in athletes that necessitate further cardiological work-up according to three criteria in various age groups as well as to identify factors determining the occurrence of changes related and unrelated to the training. 262 high-dynamic, high-static Polish athletes (rowers, cyclists, canoeists) were divided into two age categories: young (≤ 18 years of age; n = 177, mean age 16.9 ± 0.8; 15-18 years) and elite (> 18 years of age; n = 85, mean age 22.9 ± 3.4; 19-34 years). All sports persons had a 12-lead ECG performed and evaluated according to 2010 European Society of Cardiology (ESC) recommendations, 2012 Seattle criteria, and 2014 Refined criteria. The Refined criteria reduced (p < 0.001) the number of training-unrelated ECG findings to 8.0% vs. 12.6% (Seattle criteria) and 30.5% (ESC recommendations). All three criteria revealed more training-related changes in the group of older athletes (76.5% vs. 55.9%, p = 0.001). Predictors that significantly (p < 0.005) affected the occurrence of adaptive changes were the age of the athlete, training duration (in years), and male gender. 1. The ESC criteria identified a group of athletes that was unacceptably large, as for the screening test, requiring verification with other methods (every fourth athlete). 2. The use of the Refined criteria helps to significantly reduce the frequency and necessity for additional tests. 3. The dependence of adaptive changes on training duration and athletes' age confirms the benign nature of those ECG findings.

  12. An assessment of algorithms to estimate respiratory rate from the electrocardiogram and photoplethysmogram.

    Science.gov (United States)

    Charlton, Peter H; Bonnici, Timothy; Tarassenko, Lionel; Clifton, David A; Beale, Richard; Watkinson, Peter J

    2016-04-01

    Over 100 algorithms have been proposed to estimate respiratory rate (RR) from the electrocardiogram (ECG) and photoplethysmogram (PPG). As they have never been compared systematically it is unclear which algorithm performs the best. Our primary aim was to determine how closely algorithms agreed with a gold standard RR measure when operating under ideal conditions. Secondary aims were: (i) to compare algorithm performance with IP, the clinical standard for continuous respiratory rate measurement in spontaneously breathing patients; (ii) to compare algorithm performance when using ECG and PPG; and (iii) to provide a toolbox of algorithms and data to allow future researchers to conduct reproducible comparisons of algorithms. Algorithms were divided into three stages: extraction of respiratory signals, estimation of RR, and fusion of estimates. Several interchangeable techniques were implemented for each stage. Algorithms were assembled using all possible combinations of techniques, many of which were novel. After verification on simulated data, algorithms were tested on data from healthy participants. RRs derived from ECG, PPG and IP were compared to reference RRs obtained using a nasal-oral pressure sensor using the limits of agreement (LOA) technique. 314 algorithms were assessed. Of these, 270 could operate on either ECG or PPG, and 44 on only ECG. The best algorithm had 95% LOAs of  -4.7 to 4.7 bpm and a bias of 0.0 bpm when using the ECG, and  -5.1 to 7.2 bpm and 1.0 bpm when using PPG. IP had 95% LOAs of  -5.6 to 5.2 bpm and a bias of  -0.2 bpm. Four algorithms operating on ECG performed better than IP. All high-performing algorithms consisted of novel combinations of time domain RR estimation and modulation fusion techniques. Algorithms performed better when using ECG than PPG. The toolbox of algorithms and data used in this study are publicly available.

  13. Electrocardiographic intricacies clarified by echocardiography--should the electrocardiogram be interpreted echocardiographically?

    Science.gov (United States)

    Ker, James

    2012-07-12

    During the past century the electrocardiogram (ECG) has established itself as an integral part of the cardiovascular examination. Since the first direct recordings of cardiac potentials by Waller in 1887, to the invention of the string galvanometer by Willem Einthoven in 1901, to use in the clinic by 1910, the electrocardiogram has become the most widely used clinical tool in the diagnosis of virtually every type of heart disease. Currently up to 20 million ECGs are performed annually in the United States alone. However, in this era of readily available echocardiography, an important caveat in the interpretation of the electrocardiogram has emerged: variants of intracardiac structures which might mimic disease on the ECG. In this perspective various structural variants of intracardiac structures, specifically variants of papillary muscles and subaortic muscular bands, will be shown, together with their associated electrocardiographic changes, mimicking disease. It is concluded that in this era of readily available echocardiography, the electrocardiogram should be interpreted echocardiographically in instances where intricate variations are seen on the surface electrocardiogram. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Electrocardiograms digitally processed for the investigation of new measures of cardiac diagnosis

    International Nuclear Information System (INIS)

    Gutierrez, Rafael M; Cerquera, Alexander

    2003-01-01

    The ECG F D 1 database that comprises electrocardiograms processed with digital filters is presented. The aim of this work is to build databases in order to perform high sensibility studies of new methods for electrocardiographic analysis based on statistical physics, actually on research. The changes in the original electrocardiograms generated by the digital filters used to build the ECG F D 1 database cannot be detected visually. The effect of these filters on the information, which escapes visual analysis, is actually object of study in order to develop its potential in the support of cardiac diagnosis using the electrocardiogram as the only source of information. The ECG F D 1 database may be very useful in the investigation directed to construct new diagnostic tools in cardiology, using simpler and less expensive electrocardiograms, obtained in more diverse conditions. the study of cardiac dynamics as a complex system starting from a source of information as simple as an electrocardiogram offers possibilities of creating new services that may improve the quality of human life and life expectancy at low costs and possibility of great coverage. One of the purposes of this publication is to draw the scientific community's attention to these investigative problems and its interdisciplinary applications

  15. Physiology Of Prolonged Bed Rest

    Science.gov (United States)

    Greenleaf, John E.

    1991-01-01

    Report describes physiological effects of prolonged bed rest. Rest for periods of 24 hours or longer deconditions body to some extent; healing proceeds simultaneously with deconditioning. Report provides details on shifts in fluid electrolytes and loss of lean body mass, which comprises everything in body besides fat - that is, water, muscle, and bone. Based on published research.

  16. Assessment of residual tissue viability by exercise testing in recent myocardial infarction: comparison of the electrocardiogram and myocardial perfusion scintigraphy.

    Science.gov (United States)

    Margonato, A; Ballarotto, C; Bonetti, F; Cappelletti, A; Sciammarella, M; Cianflone, D; Chierchia, S L

    1992-04-01

    The assessment of residual myocardial viability in infarcted areas is relevant for subsequent management and prognosis but requires expensive technology. To evaluate the possibility that simple, easily obtainable clinical markers may detect the presence of within-infarct viable tissue, the significance of exercise-induced ST elevation occurring in leads exploring the area of a recent Q wave myocardial infarction was assessed. Twenty-five patients with recent (less than 6 months) myocardial infarction were studied. All had angiographically documented coronary artery disease, diagnostic Q waves (n = 24) or negative T waves (n = 25) on the rest 12-lead electrocardiogram and exhibited during exercise greater than or equal to 1.5 mm ST segment elevation (n = 17) or isolated T wave pseudonormalization (n = 8) in the infarct-related leads. ST-T wave changes were reproduced in all patients during thallium-201 exercise myocardial scintigraphy. A fixed perfusion defect was observed in 24 of the 25 patients. A reversible defect was seen in 16 (94%) of 17 patients who exhibited transient ST elevation during exercise but in only 4 (50%) of the 8 patients who had only T wave pseudonormalization. In conclusion, in patients with recent myocardial infarction, analysis of simple ST segment variables obtained during exercise testing may allow a first-line discrimination of those who may potentially benefit from a revascularization procedure.

  17. Assessment of left ventricular function using 201Tl electrocardiogram-gated myocardial single photon emission computed tomography

    International Nuclear Information System (INIS)

    Nishikubo, Naotsugu; Tamai, Hiroyuki

    2013-01-01

    Advances in computed tomography (CT) technology make it possible to obtain left ventricular wall motion using 3D reconstruction. In this study, we compared the images obtained from CT and 201 Tl electrocardiogram (ECG) gated single photon emission computed tomography (SPECT). In 20 patients with ischemic heart disease, we performed 201 Tl ECG gated SPECT (GE Healthcare Millennium VG) and ECG gated CT (Philips Medical Systems Brilliance iCT) to evaluate of left ventricular wall motion during the resting phase. In SPECT, left ventricular images were reconstructed using quantitative gated SPECT (QGS) software. In CT, the images were reconstructed using Virtual Place (AZE Software). The left ventricle was classified into five regions (anterior, lateral, inferior, septal, and apical). The amplitude of the wall motion was classified into five grades according to AHA classification. The values of the wall motion were separately checked by two radiographers. Assessment of left ventricular function myocardial wall movement using the three-dimensional movie display with ECG gated myocardial SPECT data was in agreement with the evaluation by cardiac CT inspection, and corresponded with wall motion in 88 of all 100 segments. SPECT analysis has the same quantity as that of obtained from CT for evaluation of left ventricular wall motion. (author)

  18. Fetal electrocardiogram (ECG) for fetal monitoring during labour.

    Science.gov (United States)

    Neilson, James P

    2015-12-21

    Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electronic fetal heart rate monitoring with the aim of improving fetal outcome and minimising unnecessary obstetric interference. To compare the effects of analysis of fetal ECG waveforms during labour with alternative methods of fetal monitoring. The Cochrane Pregnancy and Childbirth Group's Trials Register (latest search 23 September 2015) and reference lists of retrieved studies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. One review author independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. One review author assessed the quality of the evidence using the GRADE approach. Seven trials (27,403 women) were included: six trials of ST waveform analysis (26,446 women) and one trial of PR interval analysis (957 women). The trials were generally at low risk of bias for most domains and the quality of evidence for ST waveform analysis trials was graded moderate to high. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). There were, however, on average

  19. A wearable smartphone-based platform for real-time cardiovascular disease detection via electrocardiogram processing.

    Science.gov (United States)

    Oresko, Joseph J; Duschl, Heather; Cheng, Allen C

    2010-05-01

    Cardiovascular disease (CVD) is the single leading cause of global mortality and is projected to remain so. Cardiac arrhythmia is a very common type of CVD and may indicate an increased risk of stroke or sudden cardiac death. The ECG is the most widely adopted clinical tool to diagnose and assess the risk of arrhythmia. ECGs measure and display the electrical activity of the heart from the body surface. During patients' hospital visits, however, arrhythmias may not be detected on standard resting ECG machines, since the condition may not be present at that moment in time. While Holter-based portable monitoring solutions offer 24-48 h ECG recording, they lack the capability of providing any real-time feedback for the thousands of heart beats they record, which must be tediously analyzed offline. In this paper, we seek to unite the portability of Holter monitors and the real-time processing capability of state-of-the-art resting ECG machines to provide an assistive diagnosis solution using smartphones. Specifically, we developed two smartphone-based wearable CVD-detection platforms capable of performing real-time ECG acquisition and display, feature extraction, and beat classification. Furthermore, the same statistical summaries available on resting ECG machines are provided.

  20. The Influence of Age on Hemodynamic Parameters During Rest and Exercise in Healthy Individuals

    DEFF Research Database (Denmark)

    Wolsk, Emil; Bakkestrøm, Rine; Thomsen, Jacob H

    2017-01-01

    OBJECTIVES: The authors sought to obtain hemodynamic estimates across a wide age span and in both sexes for future reference and compare these estimates with current guideline diagnostic hemodynamic thresholds for abnormal filling pressure and pulmonary hypertension. BACKGROUND: At present....... METHODS: Sixty-two healthy participants, evenly distributed with respect to age (20 to 80 years) and sex (32 women/30 men), were prospectively enrolled in the study. Participants were all deemed healthy by medical history, echocardiography, exercise test, spirometry, blood tests, and electrocardiogram....... Participants had hemodynamic parameters measured using right heart catheterization during rest, passive leg raise, and incremental exercise. RESULTS: During rest, all hemodynamic parameters were similar between age groups, apart from blood pressure. During leg raise and incremental exercise...

  1. Electrocardiogram pattern of some exotic breeds of trained dogs: A variation study

    Directory of Open Access Journals (Sweden)

    Joydip Mukherjee

    2015-11-01

    Full Text Available Aim: The present study has been conducted to evaluate the variation in electrocardiogram (ECG parameters among different trained breeds of dogs (viz. Labrador, German Shepherd, and Golden Retriever used for security reasons. Materials and Methods: The ECG was recorded by single channel ECG at a paper speed of 25 mm/s and calibration of 10 mm=1 mV. The recordings were taken from all the standard bipolar limb leads (Lead-I, II, and III and unipolar augmented limb leads (Lead-aVR, aVL, and aVF. Results: Heart rate was found to be highest in Labrador and lowest in German Shepherd. P-wave duration was maximum in Golden Retriever breed and lowest in Labrador. Maximum amplitude of P-wave was found in Labrador followed by German Shepherd and Golden Retriever. There was significantly (p<0.05 higher values of PR interval in German Shepherd compared to other breeds. The variation in QRS duration, ST segment duration, T-wave duration, and T-wave amplitude was found to be non-significant among breeds. Inverted T-waves were most common in Golden Retriever and German Shepherd, whereas positive T-waves were found in Labrador. There was significant (p<0.05 variation in mean electrical axis of QRS complex among different breeds and it ranges from +60° to +80°. Conclusion: The present study provides the reference values for different ECG parameters to monitor the cardiac health status among Labrador, German Shepherd, and Golden Retriever breeds.

  2. Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students--a pilot study.

    Science.gov (United States)

    Rubinstein, Jack; Dhoble, Abhijeet; Ferenchick, Gary

    2009-01-13

    Most medical professionals are expected to possess basic electrocardiogram (EKG) interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9) received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6) received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. The average score after only traditional teaching was 4.07 +/- 2.08 while after only the puzzle session was 4.04 +/- 2.36 (p = 0.97). The average improvement after the traditional session was followed up with a puzzle session was 2.53 +/- 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 +/- 1.73 (p = 0.67). The final EKG exam score for this cohort (n = 15) was 84.1 compared to 86.6 (p = 0.22) for a comparable sample of medical students (n = 15) at a different campus. Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale.

  3. Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students – a pilot study

    Science.gov (United States)

    Rubinstein, Jack; Dhoble, Abhijeet; Ferenchick, Gary

    2009-01-01

    Background Most medical professionals are expected to possess basic electrocardiogram (EKG) interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. Methods This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9) received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6) received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. Results The average score after only traditional teaching was 4.07 ± 2.08 while after only the puzzle session was 4.04 ± 2.36 (p = 0.97). The average improvement after the traditional session was followed up with a puzzle session was 2.53 ± 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 ± 1.73 (p = 0.67). The final EKG exam score for this cohort (n = 15) was 84.1 compared to 86.6 (p = 0.22) for a comparable sample of medical students (n = 15) at a different campus. Conclusion Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale. PMID:19144134

  4. Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students – a pilot study

    Directory of Open Access Journals (Sweden)

    Dhoble Abhijeet

    2009-01-01

    Full Text Available Abstract Background Most medical professionals are expected to possess basic electrocardiogram (EKG interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. Methods This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9 received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6 received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. Results The average score after only traditional teaching was 4.07 ± 2.08 while after only the puzzle session was 4.04 ± 2.36 (p = 0.97. The average improvement after the traditional session was followed up with a puzzle session was 2.53 ± 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 ± 1.73 (p = 0.67. The final EKG exam score for this cohort (n = 15 was 84.1 compared to 86.6 (p = 0.22 for a comparable sample of medical students (n = 15 at a different campus. Conclusion Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale.

  5. Gender Differences in Baroreflex Sensitivity after Bed Rest

    Science.gov (United States)

    Arzeno, Natalia M.; Stenger, M. B.; Ribeiro, L. C.; Lee, S. M.; Platts, S. H.

    2009-01-01

    Two potential contributing factors to post-spaceflight orthostatic intolerance are decreases in baroreflex sensitivity (BRS) and sympathetic nervous system response. The purpose of this study was to examine the shape of the BRS curve and sympathetic response to a wide range of blood pressures (BP) before and during 6 head-down bed rest (BR). METHODS: Normal volunteers were tested one day before BR (20M, 1 0F) and near BR days 30 (20M, 10F), 60 (16M, 8F), and 90 (1 0M, 5F). BP was pharmacologically manipulated by 10-min infusions of phenylephrine (PE) and sodium nitroprusside (SNP) at 3 increasing concentrations with a 20-min rest between PE and SNP. Electrocardiogram and continuous finger blood pressure were recorded. A blood sample was drawn at the end of each infusion to measure plasma norepinephrine levels. The spontaneous baroreflex slope (SBS), a measure of BRS, was calculated as the slope of a sequence of 3 or more beats in which the systolic BP (SBP) and following R-R interval (RR) both increased or decreased. The data included saturated responses at the upper but not the lower end of the BP range. Mean response curves were constructed using second-order mixed model analysis. Results are based on term significance in the models. RESULTS RR: RR was lower during BR than pre BR (pgenders were modeled by a linear response; compared to males, females had an attenuated (lower slope) RR response to changes in SBP (p=0.031). SBS: SBS vs SBP analysis showed a lower SBS during BR (pgender and BR. Not only do gender and BR baseline differences exist, but gender and BR also influence the slope and saturation of the BRS curves. Attenuated and saturating RR and SBS responses, as well as differences in baseline values, may contribute to the higher rates of orthostatic intolerance in women and after bed rest.

  6. Restful Implementation of Catalogue Service for Geospatial Data Provenance

    Science.gov (United States)

    Jiang, L. C.; Yue, P.; Lu, X. C.

    2013-10-01

    Provenance, also known as lineage, is important in understanding the derivation history of data products. Geospatial data provenance helps data consumers to evaluate the quality and reliability of geospatial data. In a service-oriented environment, where data are often consumed or produced by distributed services, provenance could be managed by following the same service-oriented paradigm. The Open Geospatial Consortium (OGC) Catalogue Service for the Web (CSW) is used for the registration and query of geospatial data provenance by extending ebXML Registry Information Model (ebRIM). Recent advance of the REpresentational State Transfer (REST) paradigm has shown great promise for the easy integration of distributed resources. RESTful Web Service aims to provide a standard way for Web clients to communicate with servers based on REST principles. The existing approach for provenance catalogue service could be improved by adopting the RESTful design. This paper presents the design and implementation of a catalogue service for geospatial data provenance following RESTful architecture style. A middleware named REST Converter is added on the top of the legacy catalogue service to support a RESTful style interface. The REST Converter is composed of a resource request dispatcher and six resource handlers. A prototype service is developed to demonstrate the applicability of the approach.

  7. Clinical physiology of bed rest

    Science.gov (United States)

    Greenleaf, John E.

    1993-01-01

    Maintenance of optimal health in humans requires the proper balance between exercise, rest, and sleep as well as time in the upright position. About one-third of a lifetime is spent sleeping; and it is no coincidence that sleeping is performed in the horizontal position, the position in which gravitational influence on the body is minimal. Although enforced bed rest is necessary for the treatment of some ailments, in some cases it has probably been used unwisely. In addition to the lower hydrostatic pressure with the normally dependent regions of the cardiovascular system, body fuid compartments during bed rest in the horizontal body position, and virtual elimination of compression on the long bones of the skeletal system during bed rest (hypogravia), there is often reduction in energy metabolism due to the relative confinement (hypodynamia) and alteration of ambulatory circadian variations in metabolism, body temperature, and many hormonal systems. If patients are also moved to unfamiliar surroundings, they probably experience some feelings of anxiety and some sociopsychological problems. Adaptive physiological responses during bed rest are normal for that environment. They are attempts by the body to reduce unnecessary energy expenditure, to optimize its function, and to enhance its survival potential. Many of the deconditioning responses begin within the first day or two of bed rest; these early responses have prompted physicians to insist upon early resumption of the upright posture and ambulation of bedridden patients.

  8. Clustering of resting state networks.

    Directory of Open Access Journals (Sweden)

    Megan H Lee

    Full Text Available The goal of the study was to demonstrate a hierarchical structure of resting state activity in the healthy brain using a data-driven clustering algorithm.The fuzzy-c-means clustering algorithm was applied to resting state fMRI data in cortical and subcortical gray matter from two groups acquired separately, one of 17 healthy individuals and the second of 21 healthy individuals. Different numbers of clusters and different starting conditions were used. A cluster dispersion measure determined the optimal numbers of clusters. An inner product metric provided a measure of similarity between different clusters. The two cluster result found the task-negative and task-positive systems. The cluster dispersion measure was minimized with seven and eleven clusters. Each of the clusters in the seven and eleven cluster result was associated with either the task-negative or task-positive system. Applying the algorithm to find seven clusters recovered previously described resting state networks, including the default mode network, frontoparietal control network, ventral and dorsal attention networks, somatomotor, visual, and language networks. The language and ventral attention networks had significant subcortical involvement. This parcellation was consistently found in a large majority of algorithm runs under different conditions and was robust to different methods of initialization.The clustering of resting state activity using different optimal numbers of clusters identified resting state networks comparable to previously obtained results. This work reinforces the observation that resting state networks are hierarchically organized.

  9. The prevalence and relevance of the Brugada-type electrocardiogram in the Danish general population: data from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Pecini, Redi; Cedergreen, Pernille Kallerup; Theilade, Simone

    2010-01-01

    The prevalence of the Brugada-type electrocardiogram (ECG) in the Danish population is not known.......The prevalence of the Brugada-type electrocardiogram (ECG) in the Danish population is not known....

  10. Holter-electrocardiogram-monitoring in patients with acute ischaemic stroke (Find-AFRANDOMISED): an open-label randomised controlled trial.

    Science.gov (United States)

    Wachter, Rolf; Gröschel, Klaus; Gelbrich, Götz; Hamann, Gerhard F; Kermer, Pawel; Liman, Jan; Seegers, Joachim; Wasser, Katrin; Schulte, Anna; Jürries, Falko; Messerschmid, Anna; Behnke, Nico; Gröschel, Sonja; Uphaus, Timo; Grings, Anne; Ibis, Tugba; Klimpe, Sven; Wagner-Heck, Michaela; Arnold, Magdalena; Protsenko, Evgeny; Heuschmann, Peter U; Conen, David; Weber-Krüger, Mark

    2017-04-01

    Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. Find-AF randomised is an open-label randomised study done at four centres in Germany. We recruited patients with acute ischaemic stroke (symptoms for 7 days or less) aged 60 years or older presenting with sinus rhythm and without history of atrial fibrillation. Patients were included irrespective of the suspected cause of stroke, unless they had a severe ipsilateral carotid or intracranial artery stenosis, which were the exclusion criteria. We used a computer-generated allocation sequence to randomly assign patients in a 1:1 ratio with permuted block sizes of 2, 4, 6, and 8, stratified by centre, to enhanced and prolonged monitoring (ie, 10-day Holter-electrocardiogram [ECG]-monitoring at baseline, and at 3 months and 6 months of follow-up) or standard care procedures (ie, at least 24 h of rhythm monitoring). Participants and study physicians were not masked to group assignment, but the expert committees that adjudicated endpoints were. The primary endpoint was the occurrence of atrial fibrillation or atrial flutter (30 sec or longer) within 6 months after randomisation and before stroke recurrence. Because Holter ECG is a widely used procedure and not known to harm patients, we chose not to assess safety in detail. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01855035. Between May 8, 2013, and Aug 31, 2014, we recruited 398 patients. 200 patients were randomly assigned to the enhanced and prolonged monitoring group and 198 to the standard care group. After 6

  11. Computerized electrocardiogram in agoutis (Dasyprocta prymnolopha Wagler, 1831 anesthetized with ketamine and midazolam

    Directory of Open Access Journals (Sweden)

    Anaemilia N. Diniz

    Full Text Available ABSTRACT: An electrocardiogram is a test that assesses heart electrical activity and is applied more frequently in the veterinary care of wild animals. The present study aimed to define the electrocardiogram pattern of agoutis (Dasyprocta prymnolopha Wagler, 1831 anesthetized with ketamine and midazolam. Eighteen clinically healthy agoutis (D. prymnolopha were used from the Nucleus for Wild Animal Studies and Conservation (NEPAS of the Federal University of Piauí, Brazil. The animals were chemically restrained with 5% ketamine hydrochloride at a dose of 15mg/kg and midazolam at a dose of 1mg/kg by intramuscular injection. Electrocardiogram tests were carried out by a computerized method with the veterinary electrocardiogram [Acquisition Model for Computer (ECG - PC version Windows 95 Brazilian Electronic Technology (TEB consisting of an electronic circuit externally connected to a notebook computer with ECGPC-VET (TEB software installed on the hard disc. In analysing the EKG results, significant differences were observed for QRS complex duration, PR and QT intervals and for R wave millivoltage between the genders; but we observed a significant influence of weight despite the gender. In the present experiment, the anaesthetic protocol was shown to be well tolerated by the agoutis, and no arrhythmias occurred during the time the animals were monitored. The reference values obtained should be used to better understand the cardiac electrophysiology of the species and for its clinical and surgical management.

  12. Value of admission electrocardiogram in predicting outcome of thrombolytic therapy in acute myocardial infarction

    NARCIS (Netherlands)

    F.W.H.M. Bär (Frits); C. de Zwaan (Chris); S.H. Braat (Simon); M.L. Simoons (Maarten); W.T. Hermens (Wim); A. van der Laarse (Arnoud); W.T. Wellens; M. Ramentol; F.W.A. Verheugt (Freek); F. Vermeer (Frank); X.H. Krauss

    1987-01-01

    textabstractTo determine the value of the admission 12-lead electrocardiogram to predict infarct size limitation by thrombolytic therapy, data were analyzed in 488 of 533 patients with acute myocardial infarction (AMI) from a randomized multicenter study. All patients had typical

  13. Normal Limits of Electrocardiogram and Cut-Off Values for Left ...

    African Journals Online (AJOL)

    Gender difference exists in some cut-off values for LVH. This study defined the normal limits for electrocardiographic variables for young adult Nigerians. Racial factor should be taken into consideration in interpretation of ECG. Keywords: Normal limits, Electrocardiogram, Cut-off values, Left ventricular hypertrophy, Young ...

  14. Automatic QRS complex detection algorithm designed for a novel wearable, wireless electrocardiogram recording device

    DEFF Research Database (Denmark)

    Saadi, Dorthe Bodholt; Egstrup, Kenneth; Branebjerg, Jens

    2012-01-01

    We have designed and optimized an automatic QRS complex detection algorithm for electrocardiogram (ECG) signals recorded with the DELTA ePatch platform. The algorithm is able to automatically switch between single-channel and multi-channel analysis mode. This preliminary study includes data from ...

  15. 77 FR 6127 - Submission of Extended Digital Electrocardiogram Waveform Data; Notice of Public Meeting

    Science.gov (United States)

    2012-02-07

    ...] Submission of Extended Digital Electrocardiogram Waveform Data; Notice of Public Meeting AGENCY: Food and... Drug Administration (FDA) is announcing a public meeting to consider changes in how digital... encouraged. There is no fee to attend the meeting, and attendees who do not wish to make an oral presentation...

  16. Pneumopyopericardium mimicking an inferior ST elevation myocardial infarction with regional electrocardiogram changes: a case report.

    Science.gov (United States)

    Ratnayake, Eranda Chamara; Premaratne, Sandamali; Lokunarangoda, Niroshan; Fernando, Sanduni; Fernando, Nilanthi; Ponnamperuma, Chandrike; Santharaj, W Samuel

    2015-04-30

    Pneumopyopericardium is a rare disease with poor prognosis. The usual presentation is with fever, shortness of breath and haemodynamic compromise. The Electrocardiogram changes associated with this disease entity would be similar to pericarditis such as concave shaped ST elevations in all leads with PR sagging. Pneumopyopericardium mimicking an acute ST Elevation Myocardial Infarction, with regional Electrocardiogram changes has hitherto not been described in world literature. We describe the case of a 48 year old native Sri Lankan man, presenting with chest pain and Electrocardiogram changes compatible with an Acute ST Elevation Myocardial Infarction, subsequently found to have Pneumopyopericardium secondary to an oesophageal tear. Retrospective history revealed repetitive vomiting due to heavy alcohol consumption, prior to presentation. It unfortunately led to a fatal outcome. Pneumopyopericardium may mimic an acute ST elevation myocardial infarction with associated regional Electrocardiogram changes. A high degree of suspicion should be maintained and an adequate history should always be obtained prior to any intervention in all ST Elevation Myocardial Infarction patients.

  17. Limited Relationship of Voltage Criteria for Electrocardiogram Left Ventricular Hypertrophy to Cardiovascular Mortality.

    Science.gov (United States)

    Ha, Le Dung; Elbadawi, Ayman; Froelicher, Victor F

    2018-01-01

    Numerous methods have been proposed for diagnosing left ventricular hypertrophy using the electrocardiogram. They have limited sensitivity for recognizing pathological hypertrophy, at least in part due to their inability to distinguish pathological from physiological hypertrophy. Our objective is to compare the major electrocardiogram-left ventricular hypertrophy criteria using cardiovascular mortality as a surrogate for pathological hypertrophy. This study was a retrospective analysis of 16,253 veterans electrocardiogram-left ventricular hypertrophy, and there were 744 cardiovascular deaths (annual cardiovascular mortality 0.25%). Receiver operating characteristic analysis demonstrated that the greatest area under the curve (AUC) for classification of cardiovascular death was obtained using the Romhilt-Estes score (0.63; 95% confidence interval, 0.61-0.65). Most of the voltage-only criteria had nondiagnostic area under the curves, with the Cornell being the best at 0.59 (95% confidence interval, 0.57-0.62). When the components of the Romhilt-Estes score were examined using step-wise Wald analysis, the voltage criteria dropped from the model. The Romhilt-Estes score ≥ 4, the Cornell, and the Peguero had the highest association with cardiovascular mortality (adjusted hazard ratios 2.2, 2.0, and 2.1, consecutively). None of the electrocardiogram leads with voltage criteria exhibited sufficient classification power for clinical use. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm

    DEFF Research Database (Denmark)

    Andersson, Hedvig Bille; Hansen, Marco Bo; Thorsberger, Mads

    2015-01-01

    OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG). METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were...

  19. Automatic Real-Time Embedded QRS Complex Detection for a Novel Patch-Type Electrocardiogram Recorder

    DEFF Research Database (Denmark)

    Saadi, Dorthe Bodholt; Tanev, George; Flintrup, Morten

    2015-01-01

    Cardiovascular diseases are projected to remain the single leading cause of death globally. Timely diagnosis and treatment of these diseases are crucial to prevent death and dangerous complications. One of the important tools in early diagnosis of arrhythmias is analysis of electrocardiograms (ECGs...

  20. Availability of a baseline Electrocardiogram changes the application of the Sclarovsky-Birnbaum Myocardial Ischemia Grade

    DEFF Research Database (Denmark)

    Carlsen, Esben A; Bang, Lia E; Køber, Lars

    2014-01-01

    BACKGROUND AND AIMS: The electrocardiogram (ECG) based Sclarovsky-Birnbaum Ischemia Grade may be used to determine the prognosis of patients with ST-elevation myocardial infarction (STEMI). However, application of the method is based on assumption of the baseline QRS morphology. Thus, the aims...

  1. Electrocardiogram application based on heart rate variability ontology and fuzzy markup language

    NARCIS (Netherlands)

    Wang, M.-H.; Lee, C.-S.; Acampora, G.; Loia, V.; Gacek, A.; Pedrycz, W.

    2011-01-01

    The electrocardiogram (ECG) signal is adopted extensively as a low-cost diagnostic procedure to provide information concerning the healthy status of the heart. Heart rate variability (HRV) is a physiological phenomenon where the time interval between heart beats varies. It is measured by the

  2. Towards Quasi-continuous Heart Rate Variability Estimation using a Patch Type Electrocardiogram Recorder

    DEFF Research Database (Denmark)

    Bodholt Saadi, Dorthe; Ahrens, Esben; Sørensen, Helge Bjarup Dissing

    2015-01-01

    electrocardiogram recorders facilitates new possibilities for long-term monitoring, real-time data analysis, and wireless transmission of clinically relevant parameters, e.g. short-term HRV measures. This information might in the future assist the healthcare professionals in timely notification of changes...

  3. Common Atrium with Unusual Electrocardiogram in Ellis-van Creveld Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2015-01-01

    This report describes a case of common atrium with unusual electrocardiographic findings in a patient with EVC syndrome. This 17-year-old male of Indian origin born of a consanguineous marriage had short stature, genu valgum, polydactyly, gingival hypertrophy, multiple frenula, common atrium, and right axis deviation of QRS with clockwise depolarization in electrocardiogram.

  4. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Westerhuis, Michelle E. M. H.; Opmeer, Brent C.; Visser, Gerard H. A.; Moons, Karl G. M.; Porath, Martina M.; Oei, Guid S.; van Geijn, Herman P.; Bolte, Antoinette C.; Willekes, Christine; Nijhuis, Jan G.; van Beek, Erik; Graziosi, Giuseppe C. M.; Schuitemaker, Nico W. E.; van Lith, Jan M. M.; van den Akker, Eline S. A.; Drogtrop, Addy P.; van Dessel, Hendrikus J. H. M.; Rijnders, Robbert J. P.; Oosterbaan, Herman P.; Mol, Ben Willem J.; Kwee, Anneke

    2011-01-01

    To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric

  5. Proton spin structure in the rest frame

    International Nuclear Information System (INIS)

    Zavada, P.

    1997-01-01

    It is shown that the quark-parton model in the standard infinite momentum approach overestimates the proton spin structure function g 1 (x) in comparison with the approach taking consistently into account the internal motion of quarks described by a spherical phase space in the proton rest frame. Particularly, it is shown the first moment of the spin structure function in the latter approach, assuming only the valence quarks contribution to the proton spin, does not contradict the experimental data. copyright 1997 The American Physical Society

  6. Cumulative dose of hydroxychloroquine is associated with a decrease of resting heart rate in patients with systemic lupus erythematosus: a pilot study.

    Science.gov (United States)

    Cairoli, E; Danese, N; Teliz, M; Bruzzone, M J; Ferreira, J; Rebella, M; Cayota, A

    2015-10-01

    The use of hydroxychloroquine (HCQ) in patients with systemic lupus erythematosus (SLE) offers a wide range of benefits. However, there are evidence in favour of cardiotoxicity, including heart conduction disturbances and congestive heart failure. To determine the effects of HCQ in the resting heart rate (RHR) of SLE patients. Included were patients with non active SLE, with a sedentary lifestyle and treated with HCQ. Excluded were patients on beta blocker treatment, trained patients, pacemaker's users and patients with clinical or analytical evidence of anemia, renal disease, obstructive pulmonary disease, obesity, uncontrolled thyroid disease, fever or current infection. Standard 12-lead electrocardiogram was performed in the resting condition (supine decubitus and orthostatic position). Comparison between groups was performed using Mann-Whitney U test. A multiple linear regression was performed. A p value 365 g). Non significant differences were found in age, sex, prednisone dose or SLEDAI. The mean RHR was 73 ± 6 beats/min in the low-HCQ and 65 ± 7 beats/min in the high-HCQ, with a significant decrease of 11% (p = 0.003). In multiple linear regressions, there were non significant association between the decrease of RHR and prednisone dose, age, SLEDAI or TSH, but there was significant association between RHR and CD-HCQ (p = 0.024) and RHR and time of exposure to HCQ (p = 0.029). CD-HCQ higher than 365 g was associated with a significant decrease (11%) in RHR in non-active SLE patients, although a larger prospective study is required to allow more definitive conclusions. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Major depressive disorder with melancholia displays robust alterations in resting state heart rate and its variability: Implications for future morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Andrew eKemp

    2014-11-01

    Full Text Available Background: Major depressive disorder (MDD is associated with increased heart rate and reductions in its variability (HRV – markers of future morbidity and mortality – yet prior studies have reported contradictory effects. We hypothesised that increases in heart rate and reductions in HRV would be more robust in melancholia relative to controls, than in patients with non-melancholia. Methods: A total of 72 patients with a primary diagnosis of MDD (age M: 36.26, SE: 1.34; 42 females and 94 controls (age M: 35.69, SE: 1.16; 52 females were included in this study. Heart rate and measures of its variability (HRV were calculated from two 2-minute electrocardiogram recordings during resting state. Propensity score matching controlled imbalance on potential confounds between patients with melancholia (n=40 and non-melancholia (n=32 including age, gender, disorder severity and comorbid anxiety disorders. Results: MDD patients with melancholia displayed significantly increased heart rate and lower resting-state HRV (including the square root of the mean squared differences between successive N–N intervals, the absolute power of high frequency and standard deviation of the Poincaré plot perpendicular to the line of identity measures of HRV relative to controls, findings associated with a moderate effect size (Cohens d’s = 0.56-0.58. Patients with melancholia also displayed an increased heart rate relative to those with non-melancholia (Cohen’s d = 0.20.Conclusion: MDD patients with melancholia – but not non-melancholia – display robust increases in heart rate and decreases in HRV. These findings may underpin a variety of behavioural impairments in patients with melancholia including somatic symptoms, cognitive impairment, reduced responsiveness to the environment, and over the longer-term, morbidity and mortality.

  8. RESTful Java web services security

    CERN Document Server

    Enríquez, René

    2014-01-01

    A sequential and easy-to-follow guide which allows you to understand the concepts related to securing web apps/services quickly and efficiently, since each topic is explained and described with the help of an example and in a step-by-step manner, helping you to easily implement the examples in your own projects. This book is intended for web application developers who use RESTful web services to power their websites. Prior knowledge of RESTful is not mandatory, but would be advisable.

  9. Assessment of left ventricular function by electrocardiogram-gated myocardial single photon emission computed tomography using quantitative gated single photon emission computed tomography software

    International Nuclear Information System (INIS)

    Morita, Koichi; Adachi, Itaru; Konno, Masanori

    1999-01-01

    Electrocardiogram (ECG)-gated myocardial single photon emission computed tomography (SPECT) can assess left ventricular (LV) perfusion and function easily using quantitative gated SPECT (QGS) software. ECG-gated SPECT was performed in 44 patients with coronary artery disease under post-stress and resting conditions to assess the values of LV functional parameters, by comparison to LV ejection fraction derived from gated blood pool scan and myocardial characteristics. A good correlation was obtained between ejection fraction using QGS and that using cardiac blood pool scan (r=0.812). Some patients with myocardial ischemia had lower ejection fraction under post-stress compared to resting conditions, indicating post-stress LV dysfunction. LV wall motion and wall thickening were significantly impaired in ischemic and infarcted myocardium, and the degree of abnormality in the infarcted areas was greater than in the ischemia area. LV functional parameters derived using QGS were useful to assess post-stress LV dysfunction and myocardial viability. In conclusion, ECG-gated myocardial SPECT permits simultaneous quantitative assessment of myocardial perfusion and function. (author)

  10. Clinical and Financial Impact of Ordering an Echocardiogram in Children with Left Axis Deviation on Their Electrocardiogram.

    Science.gov (United States)

    Ravi, Prasad; Ashwath, Ravi; Strainic, James; Li, Hong; Steinberg, Jon; Snyder, Christopher

    2016-01-01

    Left axis deviation (LAD) on the electrocardiogram (ECG) is associated with congenital heart disease (CHD), prompting the clinician to order further testing when evaluating a patient with this finding. The purpose is to (1) compare the physical examination (PE) by a pediatric cardiologist to echocardiogram (ECHO) findings in patients with LAD on resting ECG and (2) assess cost of performing ECHO on all patients with LAD on ECG. An IRB approved, retrospective cohort study was performed on patients with LAD (QRS axis ≥0° to -90°) on ECG between 01/02 and 12/12. age >0.25 and <18 years, non-postoperative, and PE and ECHO by pediatric cardiologist. A decision tree model analyzed cost of ECHO in patients with LAD and normal/abnormal PE. Cost of complete ECHO ($239.00) was obtained from 2014 Medicare reimbursement rates. A total of 146 patients met inclusion criteria with 46.5% (68) having normal PE and ECHO, 1.4% (2) having normal PE and abnormal ECHO, 47.3% (69) having abnormal PE and ECHO, and 4.8% (7) having an abnormal PE and normal ECHO. Sensitivity and specificity of PE for detecting abnormalities in this population was 97% and 90%. Positive and negative predictive value of PE was 91% and 97.5%. In patients with normal PE, the cost to identify an ECHO abnormality was $8365, and $263 for those with abnormal PE. In presence of LAD on ECG, the sensitivity, specificity, and positive and negative predictive values of PE by a pediatric cardiologist are excellent at identifying CHD. Performing an ECHO on patients with LAD on ECG is only cost effective in the presence of an abnormal PE. In the presence of normal PE, there is a possibility of missing incidental structural cardiac disease in approximately 2% if an ECHO is not performed. © 2015 Wiley Periodicals, Inc.

  11. Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction

    International Nuclear Information System (INIS)

    Barbirato, Gustavo Borges; Azevedo, Jader Cunha de; Felix, Renata Christian Martins; Correa, Patricia Lavatori; Volschan, Andre; Viegas, Monica; Pimenta, Lucia; Dohmann, Hans Fernando Rocha; Mesquita, Evandro Tinoco; Mesquita, Claudio Tinoco

    2009-01-01

    Background: Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. Objective: To evaluate the operating characteristics of 99m Tc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of cute myocardial infarction. Methods: One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and non diagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. Results: Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. Conclusion: Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit. (author)

  12. Impact of the 12-lead electrocardiogram on ED evaluation and management.

    Science.gov (United States)

    Benner, John P; Borloz, Matthew P; Adams, Madeline; Brady, William J

    2007-10-01

    This study was conducted to assess the impact (diagnostic, therapeutic, and disposition) of the 12-lead electrocardiogram (ECG) on emergency department (ED) patient evaluation and management. This project was a prospective study of a convenience sample of 304 ED patients undergoing ECG analysis during their evaluation in the ED of a level 1 trauma center. The data collection for this study was divided into 4 parts. In part I, the treating physicians determined the specific reasons for ECG analysis; categories include complaint-based (eg, chest pain), syndrome-based (eg, overdose/poisoning), and system-based (eg, "requested by consult"). In part II, all treating physicians were surveyed before ECG interpretation regarding the future diagnostic, therapeutic, and disposition plans for the patient based only on history and physical examination. Their comments were recorded on a standardized data sheet. In part III, the physicians were surveyed after their interpretation of the ECG as to whether the results could suggest any further diagnostic information (eg, normal vs abnormal), or provide enough information for the patient care plan to be altered. In part IV of the study period, alterations to the original diagnostic, therapeutic, and disposition plans made by information provided by the ECG were obtained from the treating physician. A total of 304 patients underwent ECG examination and were used for data analysis. The average age of patients, of which 48% were men, was 60 years. The most common complaints that prompted electrocardiographic evaluation were chest pain and dyspnea. The most common reason an ECG was ordered was nursing staff protocol. Physicians determined that they were able to make a diagnosis based primarily on ECG in 33 (10.9%) cases. The total number of ECGs that were determined to be normal was 95 (31.3%), 7 (2.3%) of which allowed a rule-out diagnosis; 209 (68.7%) of total ECGs were determined to be abnormal, 72 (23.6%) of which were considered

  13. Biometric identification with high frequency electrocardiogram: Unregistered user refusal method and performance evaluation.

    Science.gov (United States)

    Kyoso, Masaki

    2015-08-01

    As a new modality for biometric identification, electrocardiogram-based identification technique has been developed. We proposed a technique with high frequency component of electrocardiogram (HFECG) in QRS segment. In this report, an unregistered user refusal algorithm was combined with the artificial neural network based waveform classifier. The refusal function was realized by simple thresholding technique. HFECGs from twenty collaborators were used for supervised learning. Twenty HFECGs from the same collaborators were tested and false acceptance rate (FAR) and false rejection rate (FRR) were evaluated. Ten HFECGs from other collaborators were also tested to find unregistered user refusal performance. The results show that FAR and FRR in the registrants can be kept within 1%, however, unregistered user refusal performance was not acceptable under the same condition.

  14. A new methodology to study customer electrocardiogram using RFM analysis and clustering

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Gholamian

    2011-04-01

    Full Text Available One of the primary issues on marketing planning is to know the customer's behavioral trends. A customer's purchasing interest may fluctuate for different reasons and it is important to find the declining or increasing trends whenever they happen. It is important to study these fluctuations to improve customer relationships. There are different methods to increase the customer's willingness such as planning good promotions, an increase on advertisement, etc. This paper proposes a new methodology to measure customer's behavioral trends called customer electrocardiogram. The proposed model of this paper uses K-means clustering method with RFM analysis to study customer's fluctuations over different time frames. We also apply the proposed electrocardiogram methodology for a real-world case study of food industry and the results are discussed in details.

  15. An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

    Science.gov (United States)

    Sammon, Maura; Dawood, Alveena; Beaudoin, Scott; Harrigan, Richard A

    2017-03-01

    One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function

    OpenAIRE

    Hegyi Thomas; Hiatt Mark; Ciaccio Edward J; Drzewiecki Gary M

    2007-01-01

    Abstract Background Monitoring of the electrocardiogram (ECG) in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. Method The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to op...

  17. Intelligent classification of electrocardiogram (ECG) signal using extended Kalman Filter (EKF) based neuro fuzzy system.

    Science.gov (United States)

    Meau, Yeong Pong; Ibrahim, Fatimah; Narainasamy, Selvanathan A L; Omar, Razali

    2006-05-01

    This study presents the development of a hybrid system consisting of an ensemble of Extended Kalman Filter (EKF) based Multi Layer Perceptron Network (MLPN) and a one-pass learning Fuzzy Inference System using Look-up Table Scheme for the recognition of electrocardiogram (ECG) signals. This system can distinguish various types of abnormal ECG signals such as Ventricular Premature Cycle (VPC), T wave inversion (TINV), ST segment depression (STDP), and Supraventricular Tachycardia (SVT) from normal sinus rhythm (NSR) ECG signal.

  18. [Parameters of cardiac muscle repolarization on the electrocardiogram when changing anatomical and electric position of the heart].

    Science.gov (United States)

    Chaĭkovskiĭ, I A; Baum, O V; Popov, L A; Voloshin, V I; Budnik, N N; Frolov, Iu A; Kovalenko, A S

    2014-01-01

    While discussing the diagnostic value of the single channel electrocardiogram a set of theoretical considerations emerges inevitably, one of the most important among them is the question about dependence of the electrocardiogram parameters from the direction of electrical axis of heart. In other words, changes in what of electrocardiogram parameters are in fact liable to reflect pathological processes in myocardium, and what ones are determined by extracardiac factors, primarily by anatomic characteristics of patients. It is arguable that while analyzing electrocardiogram it is necessary to orient to such physiologically based informative indexes as ST segment displacement. Also, symmetry of the T wave shape is an important parameter which is independent of patients anatomic features. The results obtained are of interest for theoretical and applied aspects of the biophysics of the cardiac electric field.

  19. The PRICE study (Protection Rest Ice Compression Elevation: design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946

    Directory of Open Access Journals (Sweden)

    Rocke Laurence G

    2007-12-01

    Full Text Available Abstract Background Cryotherapy (the application of ice for therapeutic purposes is one of the most common treatment modalities employed in the immediate management of acute soft tissue injury. Despite its widespread clinical use, the precise physiological responses to therapeutic cooling have not been fully elucidated, and effective evidence-based treatment protocols are yet to be established. Intermittent ice applications are thought to exert a significant analgesic effect. This could facilitate earlier therapeutic exercise after injury, potentially allowing for a quicker return to activity. The primary aim of the forthcoming study is therefore to examine the safety and effectiveness of combining intermittent ice applications with periods of therapeutic exercise in the first week after an acute ankle sprain. Methods/Design The study is a randomised controlled trial. 120 subjects with an acute grade I or grade II ankle sprain will be recruited from Accident & Emergency and a University based Sports Injury Clinic. Subjects will be randomised under strict double-blind conditions to either a standard cryotherapy (intermittent ice applications with compression or cryokinetic treatment group (intermittent ice applications with compression and therapeutic exercise. After the first week, treatment will be standardised across groups. Assessor blinding will be maintained throughout the trial. Primary outcome will be function, assessed using the Lower Extremity Functional Scale (LEFS. Additional outcomes will include pain (10 cm Visual Analogue Scale, swelling (modified figure-of-eight method and activity levels (activPAL™ physical activity monitor, PAL Technologies, Glasgow, UK. Diagnostic Ultrasound (Episcan-1-200 high frequency ultrasound scanning system, Longport International Ltd, PA will also be used to assess the degree of soft tissue injury. After baseline assessment subjects will be followed up at 1, 2, 3 & 4 weeks post injury. All data will

  20. Comparison of qtc duration on electrocardiogram between patients of liver cirrhosis and non cirrhotic controls

    International Nuclear Information System (INIS)

    Umair, M.; Nadeem, K.; Azam, M.N.; Mansoor, J.; Khan, H.

    2012-01-01

    Objective: To compare the QTc duration on electrocardiogram (ECG) of patients of cirrhosis (hep B and C origin) with non cirrhotic controls. Study Design: Case control study. Place and duration of study: The study was carried out at the Department of Medicine, Military Hospital, Rawalpindi, from 8th Feb 2009 to 8th Aug 2009. Material and Method: After meeting the exclusion and inclusion criteria, 80 cirrhotic patients were enrolled in group-I and equal number of non cirrhotic controls were enrolled in group-II. Three 12 lead ECG recording were taken for each patient, 5 minutes apart, and QTc value was calculated for each ECG and then mean of the three was used for the analysis. A QTc value more than 0.44 seconds was taken as prolonged. Results: The mean QTc interval on electrocardiogram in group-I i.e. cirrhotic was 0.4603 seconds (SD+-0.1312) and mean QTc interval on electrocardiogram in group-II i.e. noncirrhotic was 0.407 seconds (SD+-0.029). These findings were statistically significant (p value < 0.001). Conclusion: Cirrhotic patients have prolonged QTc interval as compared to noncirrhotic controls. (author)

  1. Factors associated with failure to identify the culprit artery by the electrocardiogram in inferior ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Tahvanainen, Minna; Nikus, Kjell C; Holmvang, Lene

    2011-01-01

    Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored.......Right and left circumflex coronary artery occlusions cause inferior myocardial infarction. To improve the targeting of diagnostic and therapeutic measures individually, factors interfering with identification of the culprit artery by the electrocardiogram (ECG) were explored....

  2. RESTful web services with Dropwizard

    CERN Document Server

    Dallas, Alexandros

    2014-01-01

    A hands-on focused step-by-step tutorial to help you create Web Service applications using Dropwizard. If you are a software engineer or a web developer and want to learn more about building your own Web Service application, then this is the book for you. Basic knowledge of Java and RESTful Web Service concepts is assumed and familiarity with SQL/MySQL and command-line scripting would be helpful.

  3. Metabolic, respiratory, and cardiological measurements during exercise and rest

    Science.gov (United States)

    1971-01-01

    Low concentration effects of CO2 on metabolic respiration and circulation were measured during work and at rest. The relationship between heart rate and metabolic rate is examined, as well as calibration procedures, and rate measurement during submaximal and standard exercise tests. Alterations in acid base and electrolytes were found during exhaustive exercise, including changes in ECG and metabolic alkalosis effects.

  4. Rest requirements and rest management of personnel in shift work

    Energy Technology Data Exchange (ETDEWEB)

    Hammell, B.D. [PDG Environmental, Melbourne, FL (United States); Scheuerle, A. [Univ. of Texas, Houston, TX (United States)

    1995-12-31

    A difficulty-weighted shift assignment scheme is proposed for use in prolonged and strenuous field operations such as emergency response, site testing, and short term hazardous waste remediation projects. The purpose of the work rotation plan is to increase productivity, safety, and moral of workers. Job weighting is accomplished by assigning adjustments to the mental and physical intensity of the task, the protective equipment worn, and the climatic conditions. The plan is based on medical studies of sleep deprivation, the effects of rest adjustments, and programs to reduce sleep deprivation and normalize shift schedules.

  5. Addition of the electrocardiogram to the preparticipation examination of college athletes.

    Science.gov (United States)

    Le, Vy-Van; Wheeler, Matthew T; Mandic, Sandra; Dewey, Frederick; Fonda, Holly; Perez, Marco; Sungar, Gannon; Garza, Daniel; Ashley, Euan A; Matheson, Gordon; Froelicher, Victor

    2010-03-01

    Although the use of standardized cardiovascular (CV) system-focused history and physical examination is recommended for the preparticipation examination (PPE) of athletes, the addition of the electrocardiogram (ECG) has been controversial. Because the impact of ECG screening on college athletes has rarely been reported, we analyzed the findings of adding the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Although the use of standardized CV-focused history and physical examination are recommended for the PPE of athletes, the addition of the ECG has been controversial. Because the feasibility and outcomes of ECG screening on college athletes have rarely been reported, we present findings derived from the addition of the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Six hundred fifty-eight recordings were obtained (54% men, 10% African-American, mean age 20 years) representing 24 sports. Although 68% of the women had normal ECGs, only 38% of the men did so. Incomplete right bundle branch block (RBBB) (13%), right axis deviation (RAD) (10%), and atrial abnormalities (3%) were the 3 most common minor abnormalities. Sokolow-Lyon criteria for left ventricular hypertrophy (LVH) were found in 49%; however, only 27% had a Romhilt-Estes score of >or=4. T-wave inversion in V2 to V3 occurred in 7%, and only 5 men had abnormal Q-waves. Sixty-three athletes (10%) were judged to have distinctly abnormal ECG findings

  6. A randomized control trial comparing use of a novel electrocardiogram simulator with traditional teaching in the acquisition of electrocardiogram interpretation skill.

    Science.gov (United States)

    Fent, Graham; Gosai, Jivendra; Purva, Makani

    2016-01-01

    Accurate interpretation of the electrocardiogram (ECG) remains an essential skill for medical students and junior doctors. While many techniques for teaching ECG interpretation are described, no single method has been shown to be superior. This randomized control trial is the first to investigate whether teaching ECG interpretation using a computer simulator program or traditional teaching leads to improved scores in a test of ECG interpretation among medical students and postgraduate doctors immediately after and 3months following teaching. Participants' opinions of the program were assessed using a questionnaire. There were no differences in ECG interpretation test scores immediately after or 3months after teaching in the lecture or simulator groups. At present therefore, there is insufficient evidence to suggest that ECG simulator programs are superior to traditional teaching. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Sustainable Rest Area Design and Operations

    Science.gov (United States)

    2017-10-01

    One way in which State Departments of Transportation (DOTs) can modernize their rest areas while reducing operations and maintenance costs is by incorporating sustainable practices into rest area design and operations. Sustainability practices that D...

  8. Design and validation of a three-instrument toolkit for the assessment of competence in electrocardiogram rhythm recognition.

    Science.gov (United States)

    Hernández-Padilla, José M; Granero-Molina, José; Márquez-Hernández, Verónica V; Suthers, Fiona; López-Entrambasaguas, Olga M; Fernández-Sola, Cayetano

    2017-06-01

    Rapid and accurate interpretation of cardiac arrhythmias by nurses has been linked with safe practice and positive patient outcomes. Although training in electrocardiogram rhythm recognition is part of most undergraduate nursing programmes, research continues to suggest that nurses and nursing students lack competence in recognising cardiac rhythms. In order to promote patient safety, nursing educators must develop valid and reliable assessment tools that allow the rigorous assessment of this competence before nursing students are allowed to practise without supervision. The aim of this study was to develop and psychometrically evaluate a toolkit to holistically assess competence in electrocardiogram rhythm recognition. Following a convenience sampling technique, 293 nursing students from a nursing faculty in a Spanish university were recruited for the study. The following three instruments were developed and psychometrically tested: an electrocardiogram knowledge assessment tool (ECG-KAT), an electrocardiogram skills assessment tool (ECG-SAT) and an electrocardiogram self-efficacy assessment tool (ECG-SES). Reliability and validity (content, criterion and construct) of these tools were meticulously examined. A high Cronbach's alpha coefficient demonstrated the excellent reliability of the instruments (ECG-KAT=0.89; ECG-SAT=0.93; ECG-SES=0.98). An excellent context validity index (scales' average content validity index>0.94) and very good criterion validity were evidenced for all the tools. Regarding construct validity, principal component analysis revealed that all items comprising the instruments contributed to measure knowledge, skills or self-efficacy in electrocardiogram rhythm recognition. Moreover, known-groups analysis showed the tools' ability to detect expected differences in competence between groups with different training experiences. The three-instrument toolkit developed showed excellent psychometric properties for measuring competence in

  9. [Synchronous playing and acquiring of heart sounds and electrocardiogram based on labVIEW].

    Science.gov (United States)

    Dan, Chunmei; He, Wei; Zhou, Jing; Que, Xiaosheng

    2008-12-01

    In this paper is described a comprehensive system, which can acquire heart sounds and electrocardiogram (ECG) in parallel, synchronize the display; and play of heart sound and make auscultation and check phonocardiogram to tie in. The hardware system with C8051F340 as the core acquires the heart sound and ECG synchronously, and then sends them to indicators, respectively. Heart sounds are displayed and played simultaneously by controlling the moment of writing to indicator and sound output device. In clinical testing, heart sounds can be successfully located with ECG and real-time played.

  10. [Research on electrocardiogram de-noising algorithm based on wavelet neural networks].

    Science.gov (United States)

    Wan, Xiangkui; Zhang, Jun

    2010-12-01

    In this paper, the ECG de-noising technology based on wavelet neural networks (WNN) is used to deal with the noises in Electrocardiogram (ECG) signal. The structure of WNN, which has the outstanding nonlinear mapping capability, is designed as a nonlinear filter used for ECG to cancel the baseline wander, electromyo-graphical interference and powerline interference. The network training algorithm and de-noising experiments results are presented, and some key points of the WNN filter using ECG de-noising are discussed.

  11. Applicability of initial optimal maternal and fetal electrocardiogram combination vectors to subsequent recordings

    International Nuclear Information System (INIS)

    Yan Hua-Wen; Huang Xiao-Lin; Zhao Ying; Si Jun-Feng; Liu Hong-Xing; Liu Tie-Bing

    2014-01-01

    A series of experiments are conducted to confirm whether the vectors calculated for an early section of a continuous non-invasive fetal electrocardiogram (fECG) recording can be directly applied to subsequent sections in order to reduce the computation required for real-time monitoring. Our results suggest that it is generally feasible to apply the initial optimal maternal and fetal ECG combination vectors to extract the fECG and maternal ECG in subsequent recorded sections. (interdisciplinary physics and related areas of science and technology)

  12. Using the 12-Lead Electrocardiogram in the Care of Athletic Patients.

    Science.gov (United States)

    Yeo, Tee Joo; Sharma, Sanjay

    2016-11-01

    This article summarizes the role of the 12-lead electrocardiogram (ECG) for the clinical care of athletes, with particular reference to the influence of age, gender, ethnicity, and type of sport on the appearance of the ECG, and its role in differentiating physiologic exercise-related changes from pathologic conditions implicated in sudden cardiac death (SCD). The article also explores the potential role of the ECG in detecting athletes at risk of SCD. In addition, the article reviews the evolution of ECG interpretation criteria and emphasizes the limitations of the ECG as well as the potential for future research. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Use of the Surface Electrocardiogram to Define the Nature of Challenging Arrhythmias.

    Science.gov (United States)

    Singh, David K; Peter, C Thomas

    2016-03-01

    Despite unprecedented advances in technology, the electrocardiogram (ECG) remains essential to the practice of modern electrophysiology. Since its emergence at the turn of the nineteenth century, the form of the ECG has changed little. What has changed is our ability to understand the complex mechanisms that underlie various arrhythmias. In this article, the authors review several important principles of ECG interpretation by providing illustrative tracings. The authors also highlight several important concepts that be can used in ECG analysis. There are several fundamental principles that should be considered in ECG interpretation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Diagnostic advantages of the association of electrocardiograms and thallium 201 exercise scintigraphy in detecting coronary disease

    International Nuclear Information System (INIS)

    Tubau, J.F.; Chaitman, B.R.; Dupras, G.; Waters, D.D.; Bourassa, M.G.

    1979-01-01

    Thallium 201 exercise scintigraphy combined with 14-lead exercise electrocardiography detects coronary artery disease in 95-96 percent of the patients, whether men or women. When both tests were positive, 93 percent of the men and 100 percent of the women had coronary artery disease. In women, thallium 201 seems to do better than 14-lead exercise electrocardiogram, detecting the presence of coronary artery disease in 72 percent and its absence in 83 percent of the cases. In approximately 50 percent of the cases, the results of thallium 201 and multiple-lead exercise testing were discordant; in these cases, an accurate clinical history is helpful. (author) [fr

  15. Apical hypertrophy associated with rapid T wave inversion on the electrocardiogram.

    Science.gov (United States)

    Yamanari, H; Saito, D; Mikio, K; Nakamura, K; Nanba, T; Morita, H; Mizuo, K; Sato, T; Ohe, T

    1995-01-01

    A 53-year-old man who had no chest pain and no family history of heart disease demonstrated a rapid T wave change on an electrocardiogram, from a positive T wave to a giant negative T wave, within 1 year. Echocardiography showed no left ventricular hypertrophy before or after the T wave change. Cine-magnetic resonance imaging revealed focal apical hypertrophy after the appearance of the giant negative T wave. Although T wave inversions sometimes develop within a short period in patients with hypertrophic cardiomyopathy, they are rare in a patient without hypertension or chest pain.

  16. Wavelet transform analysis of transient signals: the seismogram and the electrocardiogram

    Energy Technology Data Exchange (ETDEWEB)

    Anant, K.S.

    1997-06-01

    In this dissertation I quantitatively demonstrate how the wavelet transform can be an effective mathematical tool for the analysis of transient signals. The two key signal processing applications of the wavelet transform, namely feature identification and representation (i.e., compression), are shown by solving important problems involving the seismogram and the electrocardiogram. The seismic feature identification problem involved locating in time the P and S phase arrivals. Locating these arrivals accurately (particularly the S phase) has been a constant issue in seismic signal processing. In Chapter 3, I show that the wavelet transform can be used to locate both the P as well as the S phase using only information from single station three-component seismograms. This is accomplished by using the basis function (wave-let) of the wavelet transform as a matching filter and by processing information across scales of the wavelet domain decomposition. The `pick` time results are quite promising as compared to analyst picks. The representation application involved the compression of the electrocardiogram which is a recording of the electrical activity of the heart. Compression of the electrocardiogram is an important problem in biomedical signal processing due to transmission and storage limitations. In Chapter 4, I develop an electrocardiogram compression method that applies vector quantization to the wavelet transform coefficients. The best compression results were obtained by using orthogonal wavelets, due to their ability to represent a signal efficiently. Throughout this thesis the importance of choosing wavelets based on the problem at hand is stressed. In Chapter 5, I introduce a wavelet design method that uses linear prediction in order to design wavelets that are geared to the signal or feature being analyzed. The use of these designed wavelets in a test feature identification application led to positive results. The methods developed in this thesis; the

  17. A Correction Formula for the ST Segment Measurements for the AC-coupled Electrocardiograms

    DEFF Research Database (Denmark)

    Schmid, Ramun; Isaksen, Jonas; Leber, Remo

    2017-01-01

    Goal: The ST segment of an electrocardiogram (ECG) is very important for the correct diagnosis of an acute myocardial infarction. Most clinical ECGs are recorded using an AC-coupled ECG amplifier. It is well known, that first-order high-pass filters used for the AC coupling can affect the ST...... segment of an ECG. This effect is stronger the higher the filter's cut-off frequency is and the larger the QRS integral is. We present a formula that estimates these changes in the ST segment and therefore allows for correcting ST measurements that are based on an AC-coupled ECG. Methods: The presented...

  18. Electrocardiogram (ECG Signal Modeling and Noise Reduction Using Hopfield Neural Networks

    Directory of Open Access Journals (Sweden)

    F. Bagheri

    2013-02-01

    Full Text Available The Electrocardiogram (ECG signal is one of the diagnosing approaches to detect heart disease. In this study the Hopfield Neural Network (HNN is applied and proposed for ECG signal modeling and noise reduction. The Hopfield Neural Network (HNN is a recurrent neural network that stores the information in a dynamic stable pattern. This algorithm retrieves a pattern stored in memory in response to the presentation of an incomplete or noisy version of that pattern. Computer simulation results show that this method can successfully model the ECG signal and remove high-frequency noise.

  19. Normalizing Electrocardiograms of Both Healthy Persons and Cardiovascular Disease Patients for Biometric Authentication

    Science.gov (United States)

    Zhao, Miaomiao; Li, Fan; Wang, Guoqing; Zhou, Fengfeng

    2013-01-01

    Although electrocardiogram (ECG) fluctuates over time and physical activity, some of its intrinsic measurements serve well as biometric features. Considering its constant availability and difficulty in being faked, the ECG signal is becoming a promising factor for biometric authentication. The majority of the currently available algorithms only work well on healthy participants. A novel normalization and interpolation algorithm is proposed to convert an ECG signal into multiple template cycles, which are comparable between any two ECGs, no matter the sampling rates or health status. The overall accuracies reach 100% and 90.11% for healthy participants and cardiovascular disease (CVD) patients, respectively. PMID:23977063

  20. Intrasellar Symptomatic Salivary Gland Rest

    Directory of Open Access Journals (Sweden)

    Chih-Hao Chen

    2007-05-01

    Full Text Available Ectopic salivary gland tissue in sellar turcica is frequently observed in microscopic examination at autopsy. This tissue is considered clinically silent. Only 2 symptomatic cases have been previously reported. Here we report a 28-year-old woman presenting with galactorrhea and hyperprolactinemia. Magnetic resonance imaging revealed a 6×5-mm nodule in the posterior aspect of the pituitary gland. This nodule showed isointensity on T1- and T2-weighted images and less enhancement on post-contrast T1-weighted images. Transsphenoidal exploration revealed a cystic lesion within the pituitary gland, which consisted of a grayish gelatinous content. The pathologic examination confirmed the diagnosis of salivary gland rest.

  1. Clinical evaluation of automated processing of electrocardiograms by the Veterans Administration program (AVA 3.4).

    Science.gov (United States)

    Brohet, C R; Richman, H G

    1979-06-01

    Automated processing of electrocardiograms by the Veterans Administration program was evaluated for both agreement with physician interpretation and interpretative accuracy as assessed with nonelectrocardiographic criteria. One thousand unselected electrocardiograms were analyzed by two reviewer groups, one familiar and the other unfamiliar with the computer program. A significant number of measurement errors involving repolarization changes and left axis deviation occurred; however, interpretative disagreements related to statistical decision were largely language-related. Use of a printout with a more traditional format resulted in agreement with physician interpretation by both reviewer groups in more than 80 percent of cases. Overall sensitivity based on agreement with nonelectrocardiographic criteria was significantly greater with use of the computer program than with use of the conventional criteria utilized by the reviewers. This difference was particularly evident in the subgroup analysis of myocardial infarction and left ventricular hypertrophy. The degree of overdiagnosis of left ventricular hypertrophy and posteroinferior infarction was initially unacceptable, but this difficulty was corrected by adjustment of probabilities. Clinical acceptability of the Veterans Administration program appears to require greater physician education than that needed for other computer programs of electrocardiographic analysis; the flexibility of interpretation by statistical decision offers the potential for better diagnostic accuracy.

  2. Wavelet-based unsupervised learning method for electrocardiogram suppression in surface electromyograms.

    Science.gov (United States)

    Niegowski, Maciej; Zivanovic, Miroslav

    2016-03-01

    We present a novel approach aimed at removing electrocardiogram (ECG) perturbation from single-channel surface electromyogram (EMG) recordings by means of unsupervised learning of wavelet-based intensity images. The general idea is to combine the suitability of certain wavelet decomposition bases which provide sparse electrocardiogram time-frequency representations, with the capacity of non-negative matrix factorization (NMF) for extracting patterns from images. In order to overcome convergence problems which often arise in NMF-related applications, we design a novel robust initialization strategy which ensures proper signal decomposition in a wide range of ECG contamination levels. Moreover, the method can be readily used because no a priori knowledge or parameter adjustment is needed. The proposed method was evaluated on real surface EMG signals against two state-of-the-art unsupervised learning algorithms and a singular spectrum analysis based method. The results, expressed in terms of high-to-low energy ratio, normalized median frequency, spectral power difference and normalized average rectified value, suggest that the proposed method enables better ECG-EMG separation quality than the reference methods. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  3. 64-slice spiral CT coronary angiography with prospective electrocardiogram-gating: an initial study

    International Nuclear Information System (INIS)

    Yuan Xuchun; Wang Xianzhu; Liao Wenling; Chen Qin; Deng Huiyi

    2008-01-01

    Objective: To evaluate the feasibility of prospective electrocardiogram (ECG)-gating computed tomography coronary angiography (CTCA). Methods: Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating. Multi-planar reconstruction ( MPR), curved-planar reconstruction (CPR), maximum intensity projection (MIP) and volume rendering (VR) were used to demonstrate the coronary arteries. The image quality and radiation dose was evaluated. Results: The mean effective radiation dose was (2.7±0.2) mSv. 93.3% (720/772) segments of all coronary arteries were of diagnostic image quality, 44.2% (341/772)was classified as excellent and 49.1% (379/772)was good. Non-diagnostic coronary segments were found in 6.7% (52/772) of all coronary arteries. There were 5(8.3%) cases with severe coronary stenosis(>75%) or occlusion, 17 (28.4%) cases with moderate stenosis (50%-75%), 18 (30.0%) cases with mild stenosis (<50% )or irregular lumen, 20(33.3%) cases with normal coronary, artery. Conclusion: With a low radiation dose, prospective electrocardiogram (ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis, especially for excluding coronary artery disease. (authors)

  4. Exercise thallium-201 scintigraphy in men with nondiagnostic exercise electrocardiograms. Prognostic implications

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Kane-Marsch, S.

    1986-01-01

    We studied the prognostic value of exercise thallium-201 imaging in 196 men with suspected or known coronary artery disease who had nondiagnostic exercise electrocardiograms. The perfusion images in each of three projections were divided into three segments; each segment was assessed for perfusion defects (fixed or reversible). There were 12 cardiac events at a mean follow-up of 15 months (range, one to 66 months). Of those, five patients died of cardiac causes and seven had nonfatal acute myocardial infarctions (MIs). Only the number of perfusion defects significantly predicted cardiac events; clinical presentation, history of MI, presence of Q-wave MI, exercise duration, and exercise heart rate and double product did not predict cardiac events or add to information provided by the number of defects. Furthermore, actuarial life-table analysis showed that patients with three or more perfusion defects had significantly worse prognoses than patients with fewer than three defects. Exercise thallium-201 imaging helps in risk stratification of men with nondiagnostic exercise electrocardiograms

  5. Intrapartum electrocardiogram alteration in fetuses with congenital heart disease: a case-control study.

    Science.gov (United States)

    Gay, Estelle; Bornallet, Géraldine; Gaucherand, Pascal; Doret, Muriel

    2015-11-01

    To assess if the fetal electrocardiogram especially ST segment is modified by congenital heart diseases: modifications in frequencies of the different ST events and modifications in signal quality. A retrospective case-control study, comparing frequencies of the different ST events and the quality of the signal between fetuses with congenital heart diseases and fetuses without congenital heart disease. From 2000 to 2011, fifty-eight fetuses with congenital heart disease had their heart rate recording using a STAN device during labor. Control group was fetuses who were born just before a case and had a STAN as a second line for intrapartum surveillance. Cases and controls were matched on parity, gestational age at birth, presence of growth restriction and umbilical artery pH. Frequencies of the different ST event and quality of the signal were first analyzed for the global labor recording, and then separately for the first and the second phase of labor. No statistically significant difference in ST event frequencies between fetuses with congenital heart disease and the control group was found. Regarding the quality of the signal, 11.49% (±18.82) of recording time is a signal loss for fetus with congenital heart disease whereas only 5.18% (±10.67) for the control group (p=0.028). This is the first study investigating for intrapartum electrocardiogram modification in fetus with congenital heart disease. Congenital heart diseases do not modify frequencies of ST events. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Classic electrocardiogram-based and mobile technology derived approaches to heart rate variability are not equivalent.

    Science.gov (United States)

    Guzik, Przemyslaw; Piekos, Caroline; Pierog, Olivia; Fenech, Naiman; Krauze, Tomasz; Piskorski, Jaroslaw; Wykretowicz, Andrzej

    2018-05-01

    We compared classic ECG-derived versus a mobile approach to heart rate variability (HRV) measurement. 29 young adult healthy volunteers underwent a simultaneous recording of heart rate using an ECG and a chest heart rate monitor at supine rest, during mental stress and active standing. Mean RR interval, Standard Deviation of Normal-to-Normal (SDNN) of RR intervals, and Root Mean Square of the Successive Differences (RMSSD) between RR intervals were computed in 168 pairs of 5-minute epochs by in-house software on a PC (only sinus beats) and by mobile application "ELITEHRV" on a smartphone (no beat type identification). ECG analysis showed that 33.9% of the recordings contained at least one non-sinus beat or artefact, the mobile app did not report this. The mean RR intervals were significantly longer (p = 0.0378), while SDNN (p = 0.0001) and RMSSD (p = 0.0199) were smaller for the mobile approach. Measures of identical HRV parameters by ECG-based and mobile approaches are not equivalent. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Diagnostic Accuracy of a New Cardiac Electrical Biomarker for Detection of Electrocardiogram Changes Suggestive of Acute Myocardial Ischemic Injury

    Science.gov (United States)

    Schreck, David M; Fishberg, Robert D

    2014-01-01

    Objective A new cardiac “electrical” biomarker (CEB) for detection of 12-lead electrocardiogram (ECG) changes indicative of acute myocardial ischemic injury has been identified. Objective was to test CEB diagnostic accuracy. Methods This is a blinded, observational retrospective case-control, noninferiority study. A total of 508 ECGs obtained from archived digital databases were interpreted by cardiologist and emergency physician (EP) blinded reference standards for presence of acute myocardial ischemic injury. CEB was constructed from three ECG cardiac monitoring leads using nonlinear modeling. Comparative active controls included ST voltage changes (J-point, ST area under curve) and a computerized ECG interpretive algorithm (ECGI). Training set of 141 ECGs identified CEB cutoffs by receiver-operating-characteristic (ROC) analysis. Test set of 367 ECGs was analyzed for validation. Poor-quality ECGs were excluded. Sensitivity, specificity, and negative and positive predictive values were calculated with 95% confidence intervals. Adjudication was performed by consensus. Results CEB demonstrated noninferiority to all active controls by hypothesis testing. CEB adjudication demonstrated 85.3–94.4% sensitivity, 92.5–93.0% specificity, 93.8–98.6% negative predictive value, and 74.6–83.5% positive predictive value. CEB was superior against all active controls in EP analysis, and against ST area under curve and ECGI by cardiologist. Conclusion CEB detects acute myocardial ischemic injury with high diagnostic accuracy. CEB is instantly constructed from three ECG leads on the cardiac monitor and displayed instantly allowing immediate cost-effective identification of patients with acute ischemic injury during cardiac rhythm monitoring. PMID:24118724

  8. Time interval between maternal electrocardiogram and venous Doppler waves in normal pregnancy and preeclampsia: a pilot study.

    Science.gov (United States)

    Tomsin, K; Mesens, T; Molenberghs, G; Peeters, L; Gyselaers, W

    2012-12-01

    To evaluate the time interval between maternal electrocardiogram (ECG) and venous Doppler waves at different stages of uncomplicated pregnancy (UP) and in preeclampsia (PE). Cross-sectional pilot study in 40 uncomplicated singleton pregnancies, categorized in four groups of ten according to gestational age: 10 - 14 weeks (UP1), 18 - 23 weeks (UP2), 28 - 33 weeks (UP3) and ≥ 37 weeks (UP4) of gestation. A fifth group of ten women with PE was also included. A Doppler flow examination at the level of renal interlobar veins (RIV) and hepatic veins (HV) was performed according to a standard protocol, in association with a maternal ECG. The time interval between the ECG P-wave and the corresponding A-deflection of the venous Doppler waves was measured (PA), and expressed relative to the duration of the cardiac cycle (RR), and labeled PA/RR. In hepatic veins, the PA/RR is longer in UP 4 than in UP 1 (0.48 ± 0.15 versus 0.29 ± 0.09, p ≤ 0.001). When all UP groups were compared, the PA/RR increased gradually with gestational age. In PE, the HV PA/RR is shorter than in UP 3 (0.25 ± 0.09 versus 0.42 ± 0.14, p advanced gestational stages are consistent with known features of maternal cardiovascular adaptation. Shorter values in preeclampsia are consistent with maternal cardiovascular maladaptation mechanisms. Our pilot study invites more research of the relevance of the time interval between maternal ECG and venous Doppler waves as a new parameter for studying the gestational cardiovascular (patho)physiology of the maternal venous compartment by duplex sonography. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Feasibility Study of a Lunar Analog Bed Rest Model

    Science.gov (United States)

    Cromwell, Ronita L.; Platts, Steven H.; Yarbough, Patrice; Buccello-Stout, Regina

    2010-01-01

    The purpose of this study was to determine the feasibility of using a 9.5deg head-up tilt bed rest model to simulate the effects of the 1/6 g load to the human body that exists on the lunar surface. The lunar analog bed rest model utilized a modified hospital bed. The modifications included mounting the mattress on a sled that rolled on bearings to provide freedom of movement. The weight of the sled was off-loaded using a counterweight system to insure that 1/6 body weight was applied along the long axis (z-axis) of the body. Force was verified through use of a force plate mounted at the foot of the bed. A seating assembly was added to the bed to permit periods of sitting. Subjects alternated between standing and sitting positions throughout the day. A total of 35% of the day was spent in the standing position and 65% was spent sitting. In an effort to achieve physiologic fluid shifts expected for a 1/6 G environment, subjects wore compression stockings and performed unloaded foot and ankle exercises. Eight subjects (3 females and 5 males) participated in this study. Subjects spent 13 days in the pre-bed rest phase, 6 days in bed rest and 3 days post bed rest. Subjects consumed a standardized diet throughout the study. To determine feasibility, measures of subject comfort, force and plasma volume were collected. Subject comfort was assessed using a Likert scale. Subjects were asked to assess level of comfort (0-100) for 11 body regions and provide an overall rating. Results indicated minimal to no discomfort as most subjects reported scores of zero. Force measures were performed for each standing position and were validated against subject s calculated 1/6 body weight (r(sup 2) = 0.993). The carbon monoxide rebreathing technique was used to assess plasma volume during pre-bed rest and on the last day of bed rest. Plasma volume results indicated a significant decrease (p = 0.001) from pre to post bed rest values. Subjects lost on average 8.3% (sd = 6.1%) during the

  10. Pro REST API development with nodejs

    CERN Document Server

    Doglio, Fernando

    2015-01-01

    Pro REST API Development with Node.js is your guide to managing and understanding the full capabilities of successful REST development. API design is a hot topic in the programming world, but not many resources exist for developers to really understand how you can leverage the advantages. This book will provide a brief background on REST and the tools it provides (well known and not so well known). Understand how there is more to REST than just JSON and URLs. You will then cover and compare the maintained modules currently available in the npm community, including Express, Restify, Vatican,

  11. Resting state fMRI: A review on methods in resting state connectivity analysis and resting state networks.

    Science.gov (United States)

    Smitha, K A; Akhil Raja, K; Arun, K M; Rajesh, P G; Thomas, Bejoy; Kapilamoorthy, T R; Kesavadas, Chandrasekharan

    2017-08-01

    The inquisitiveness about what happens in the brain has been there since the beginning of humankind. Functional magnetic resonance imaging is a prominent tool which helps in the non-invasive examination, localisation as well as lateralisation of brain functions such as language, memory, etc. In recent years, there is an apparent shift in the focus of neuroscience research to studies dealing with a brain at 'resting state'. Here the spotlight is on the intrinsic activity within the brain, in the absence of any sensory or cognitive stimulus. The analyses of functional brain connectivity in the state of rest have revealed different resting state networks, which depict specific functions and varied spatial topology. However, different statistical methods have been introduced to study resting state functional magnetic resonance imaging connectivity, yet producing consistent results. In this article, we introduce the concept of resting state functional magnetic resonance imaging in detail, then discuss three most widely used methods for analysis, describe a few of the resting state networks featuring the brain regions, associated cognitive functions and clinical applications of resting state functional magnetic resonance imaging. This review aims to highlight the utility and importance of studying resting state functional magnetic resonance imaging connectivity, underlining its complementary nature to the task-based functional magnetic resonance imaging.

  12. Potenciais tardios ao eletrocardiograma de alta resolução no domínio do tempo em portadores de insuficiência cardíaca de diferentes etiologias Time domain analysis of the signal averaged electrocardiogram to detect late potentials in heart failure patients with different etiologies

    Directory of Open Access Journals (Sweden)

    Ernani de Sousa Grell

    2006-09-01

    included 215 males (74.65% and 73 females (25.35% between the ages of 16 and 70 (mean 51.5, standard deviation 11.24. The heart failure etiologies were: hypertensive heart disease (78 patients, 27.1%; idiopathic dilated cardiomyopathy (73 patients, 25.4%; ischemic cardiomyopathy (65 patients, 22.6%; Chagas disease (42 patients, 14.6%; alcoholic cardiomyopathy (9 patients, 3.1%; peripartum cardiomyopathy (6 patients, 2.1%; valvular heart disease (2 patients, 4.2% and viral myocarditis (3 patients, 1.04%. The variables included the duration of the standard QRS complex, duration of the filtered QRS complex, duration of the signal below 40µV and the root mean square of the last 40ms which were analyzed in regard to age, gender, etiology and mortality as well as the findings of the 12-lead electrocardiogram at rest, echocardiogram and ambulatory electrocardiogram. The statistical analysis tests used were: the Fisher exact probability test, Student’s t-test, Mann Whitney test, variance analysis, Log-Hank and the Kaplan-Meyer method. RESULTS: Late potentials were diagnosed in 90 patients (31.3% and there was no association with the etiologies. The presence of this condition is associated with: a lower maximum oxygen uptake during the ergospirometry (p=0.001; sustained and non-sustained ventricular tachycardia during Holter monitoring (p=0.001, sudden death and mortality (p<0.05. Patients that did not present late potentials had a higher overlife rate. CONCLUSION: The presence of late potentials was not associated with the etiologies and proved to be an indication of a worse prognosis.

  13. A Review on the Nonlinear Dynamical System Analysis of Electrocardiogram Signal.

    Science.gov (United States)

    Nayak, Suraj K; Bit, Arindam; Dey, Anilesh; Mohapatra, Biswajit; Pal, Kunal

    2018-01-01

    Electrocardiogram (ECG) signal analysis has received special attention of the researchers in the recent past because of its ability to divulge crucial information about the electrophysiology of the heart and the autonomic nervous system activity in a noninvasive manner. Analysis of the ECG signals has been explored using both linear and nonlinear methods. However, the nonlinear methods of ECG signal analysis are gaining popularity because of their robustness in feature extraction and classification. The current study presents a review of the nonlinear signal analysis methods, namely, reconstructed phase space analysis, Lyapunov exponents, correlation dimension, detrended fluctuation analysis (DFA), recurrence plot, Poincaré plot, approximate entropy, and sample entropy along with their recent applications in the ECG signal analysis.

  14. Significance of screening electrocardiogram before the initiation of amitriptyline therapy in children with functional abdominal pain.

    Science.gov (United States)

    Patra, Kamakshya P; Sankararaman, Senthilkumar; Jackson, Robert; Hussain, Sunny Z

    2012-09-01

    Amitriptyline (AMT) is commonly used in the management of children with irritable bowel syndrome. AMT is pro-arrhythmogenic and increases the risk of sudden cardiac death. However, there is not enough data regarding the cardiac toxicity in therapeutic doses of AMT in children and the need for screening electrocardiogram (EKG). Errors in computer EKG interpretation are not uncommon. In a risk-prevention study, the authors sought to identify the true incidence of prolonged corrected QT (QTc) interval and other arrhythmias in children with irritable bowel syndrome before the initiation of AMT. Out of the 760 EKGs screened, 3 EKGs demonstrated a true prolonged QTc after the careful manual reading by a pediatric cardiologist and they were not picked by computer-generated reading. The authors conclude that screening EKG should always be performed on children before initiating AMT therapy. Also, the computer-generated EKG needs to be verified by a pediatric cardiologist to avoid serious misinterpretations.

  15. A Review on the Nonlinear Dynamical System Analysis of Electrocardiogram Signal

    Science.gov (United States)

    Mohapatra, Biswajit

    2018-01-01

    Electrocardiogram (ECG) signal analysis has received special attention of the researchers in the recent past because of its ability to divulge crucial information about the electrophysiology of the heart and the autonomic nervous system activity in a noninvasive manner. Analysis of the ECG signals has been explored using both linear and nonlinear methods. However, the nonlinear methods of ECG signal analysis are gaining popularity because of their robustness in feature extraction and classification. The current study presents a review of the nonlinear signal analysis methods, namely, reconstructed phase space analysis, Lyapunov exponents, correlation dimension, detrended fluctuation analysis (DFA), recurrence plot, Poincaré plot, approximate entropy, and sample entropy along with their recent applications in the ECG signal analysis. PMID:29854361

  16. A NEW APPROACH TO DETECT CONGESTIVE HEART FAILURE USING DETRENDED FLUCTUATION ANALYSIS OF ELECTROCARDIOGRAM SIGNALS

    Directory of Open Access Journals (Sweden)

    CHANDRAKAR KAMATH

    2015-02-01

    Full Text Available The aim of this study is to evaluate how far the detrended fluctuation analysis (DFA approach helps to characterize the short-term and intermediate-term fractal correlations in the raw electrocardiogram (ECG signals and thereby discriminate between normal and congestive heart failure (CHF subjects. The DFA-1 calculations were performed on normal and CHF short-term ECG segments, of the order of 20 seconds duration. Differences were found in shortterm and intermediate-term correlation properties and the corresponding scaling exponents of the two groups (normal and CHF. The statistical analyses show that short-term fractal scaling exponent alone is sufficient to distinguish between normal and CHF subjects. The receiver operating characteristic curve (ROC analysis confirms the robustness of this new approach and exhibits an average accuracy that exceeds 98.2%, average sensitivity of about 98.4%, positive predictivity of 98.00%, and average specificity of 98.00%.

  17. Robust suppression of nonstationary power-line interference in electrocardiogram signals

    International Nuclear Information System (INIS)

    Li, Guojun; Zeng, Xiaopin; Zhou, Yu; Liu, Guojin; Zhou, Xichuan; Zhou, Xiaona

    2012-01-01

    It is a challenge to suppress time-varying power-line interference (PLI) with various levels in electrocardiogram (ECG) signals. Most previous attempts of tracking and suppressing the nonstationary PLI signal are based on the least-squares (LS) algorithm. This makes these methods susceptible to QRS complex in suppressing a low-level PLI signal which is frequently coupled in battery-operated ECG equipment. To address the limitation of LS-based methods, this study presents a robust PLI suppression system based on a robust extension of the Kalman filter. In addition, we used an improved version of empirical mode decomposition to further attenuate the QRS complex. Experiments show that our system could effectively suppress the PLI while preserving meaningful ECG components at various interference levels. (paper)

  18. Pit-a-Pat: A Smart Electrocardiogram System for Detecting Arrhythmia.

    Science.gov (United States)

    Park, Juyoung; Lee, Kuyeon; Kang, Kyungtae

    2015-10-01

    Electrocardiogram (ECG) telemonitoring is one of the most promising applications of medical telemetry. However, previous approaches to ECG telemonitoring have largely relied on public databases of ECG results. In this article we propose a smart ECG system called Pit-a-Pat, which extracts features from ECG signals and detects arrhythmia. It is designed to run on an Android™ (Google, Mountain View, CA) device, without requiring modifications to other software. We implemented the Pit-a-Pat system using a commercial ECG device, and the experimental results demonstrate the effectiveness and accuracy of Pit-a-Pat for monitoring the ECG signal and analyzing the cardiac activity of a mobile patient. The proposed system allows monitoring of cardiac activity with automatic analysis, thereby providing a convenient, inexpensive, and ubiquitous adjunct to personal healthcare.

  19. Trend Extraction in Functional Data of Amplitudes of R and T Waves in Exercise Electrocardiogram

    Science.gov (United States)

    Cammarota, Camillo; Curione, Mario

    The amplitudes of R and T waves of the electrocardiogram (ECG) recorded during the exercise test show both large inter- and intra-individual variability in response to stress. We analyze a dataset of 65 normal subjects undergoing ambulatory test. We model the dataset of R and T series in the framework of functional data, assuming that the individual series are realizations of a non-stationary process, centered at the population trend. We test the time variability of this trend computing a simultaneous confidence band and the zero crossing of its derivative. The analysis shows that the amplitudes of the R and T waves have opposite responses to stress, consisting respectively in a bump and a dip at the early recovery stage. Our findings support the existence of a relationship between R and T wave amplitudes and respectively diastolic and systolic ventricular volumes.

  20. Combined electrocardiogram and photoplethysmogram measurements as an indicator of objective sleepiness

    International Nuclear Information System (INIS)

    Chua, Chern-Pin; McDarby, Gary; Heneghan, Conor

    2008-01-01

    There is considerable interest in unobtrusive and portable methods of monitoring sleepiness outside the laboratory setting. This study evaluates the usefulness of combined electrocardiogram (ECG) and photoplethysmogram (PPG) measurements for estimating psychomotor vigilance. The psychomotor vigilance test (PVT) was performed at various points over the course of a day, and one channel each of ECG and PPG was recorded simultaneously. Features derived from ECG and PPG were entered into multiple linear regression models to estimate PVT values. A double-loop, subject-independent validation scheme was used to develop and validate the models. We show that features obtained from the RR interval were reasonably useful for estimating absolute PVT levels, but were somewhat inadequate for estimating within-subject PVT changes. Combined ECG and PPG measurements appear to be useful for predicting PVT values, and deserve further investigation for portable sleepiness monitoring

  1. [The primary research and development of software oversampling mapping system for electrocardiogram].

    Science.gov (United States)

    Zhou, Yu; Ren, Jie

    2011-04-01

    We put forward a new concept of software oversampling mapping system for electrocardiogram (ECG) to assist the research of the ECG inverse problem to improve the generality of mapping system and the quality of mapping signals. We then developed a conceptual system based on the traditional ECG detecting circuit, Labview and DAQ card produced by National Instruments, and at the same time combined the newly-developed oversampling method into the system. The results indicated that the system could map ECG signals accurately and the quality of the signals was good. The improvement of hardware and enhancement of software made the system suitable for mapping in different situations. So the primary development of the software for oversampling mapping system was successful and further research and development can make the system a powerful tool for researching ECG inverse problem.

  2. Electrocardiogram Pattern Recognition and Analysis Based on Artificial Neural Networks and Support Vector Machines: A Review

    Directory of Open Access Journals (Sweden)

    Mario Sansone

    2013-01-01

    Full Text Available Computer systems for Electrocardiogram (ECG analysis support the clinician in tedious tasks (e.g., Holter ECG monitored in Intensive Care Units or in prompt detection of dangerous events (e.g., ventricular fibrillation. Together with clinical applications (arrhythmia detection and heart rate variability analysis, ECG is currently being investigated in biometrics (human identification, an emerging area receiving increasing attention. Methodologies for clinical applications can have both differences and similarities with respect to biometrics. This paper reviews methods of ECG processing from a pattern recognition perspective. In particular, we focus on features commonly used for heartbeat classification. Considering the vast literature in the field and the limited space of this review, we dedicated a detailed discussion only to a few classifiers (Artificial Neural Networks and Support Vector Machines because of their popularity; however, other techniques such as Hidden Markov Models and Kalman Filtering will be also mentioned.

  3. Electrocardiogram voltage discordance: Interpretation of low QRS voltage only in the precordial leads.

    Science.gov (United States)

    Kim, Diana H; Verdino, Ralph J

    To define clinical correlates of low voltage isolated to precordial leads on the surface electrocardiogram (ECG). Low voltage (V) on the ECG is defined as QRS Vvoltage isolated to the precordial leads with normal limb lead voltages is unclear. Twelve-lead ECGs with QRS V>5mm in one or more limb leads and voltage was found in 256 of 150,000 ECGs (~0.2%). 50.4% of patients had discordant ECGs that correlated with classic etiologies, with a higher incidence of LV dilation in those with classic etiologies than those without. Low precordial voltage is associated with classic etiologies and LV dilation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Cognitive Rest: An Integrated Literature Review

    Science.gov (United States)

    Schneider, Kathleen H.

    2016-01-01

    Cognitive rest has been suggested as a treatment for school athletes who have sustained a concussion, but the concept has rarely been defined. The purpose of this article is to provide a comprehensive definition of cognitive rest, based on an integrative literature review. The method of synthesis was guided by Avant and Walker's concept analysis…

  5. Resting state EEG correlates of memory consolidation.

    Science.gov (United States)

    Brokaw, Kate; Tishler, Ward; Manceor, Stephanie; Hamilton, Kelly; Gaulden, Andrew; Parr, Elaine; Wamsley, Erin J

    2016-04-01

    Numerous studies demonstrate that post-training sleep benefits human memory. At the same time, emerging data suggest that other resting states may similarly facilitate consolidation. In order to identify the conditions under which non-sleep resting states benefit memory, we conducted an EEG (electroencephalographic) study of verbal memory retention across 15min of eyes-closed rest. Participants (n=26) listened to a short story and then either rested with their eyes closed, or else completed a distractor task for 15min. A delayed recall test was administered immediately following the rest period. We found, first, that quiet rest enhanced memory for the short story. Improved memory was associated with a particular EEG signature of increased slow oscillatory activity (rest can facilitate memory, and that this may occur via an active process of consolidation supported by slow oscillatory EEG activity and characterized by decreased attention to the external environment. Slow oscillatory EEG rhythms are proposed to facilitate memory consolidation during sleep by promoting hippocampal-cortical communication. Our findings suggest that EEG slow oscillations could play a significant role in memory consolidation during other resting states as well. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Immediate rule-out of acute myocardial infarction using electrocardiogram and baseline high-sensitivity troponin I

    DEFF Research Database (Denmark)

    Neumann, Johannes Tobias; Sörensen, Nils Arne; Ojeda, Francisco

    2017-01-01

    AIMS: Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile. Here, we evaluated the performance of a single admission troponin with a lower cutoff combined with a low risk electrocardiogram (ECG...

  7. The Electrocardiogram as an Electronic Filter and Why AC Circuits Are Important for Pre-Health Physics Students

    Science.gov (United States)

    Dunlap, Justin C.; Kutschera, Ellynne; Van Ness, Grace R.; Widenhorn, Ralf

    2015-01-01

    We present a general physics laboratory exercise that centres around the use of the electrocardiogram sensor as an application of circuits and electronic signal filtering. Although these topics are commonly taught in the general physics classroom, many students consider topics such as alternating current as unrelated to their future professions.…

  8. Investigating the Effects of the 0.05 Hz First-order High-pass Filter on the Electrocardiogram

    DEFF Research Database (Denmark)

    Isaksen, Jonas; Leber, Remo; Schmid, Ramun

    2016-01-01

    Background: A thorough review is needed for the first-order 0.05 Hz high-pass filter, which was introduced almost fifty years ago before modern techniques were available. We quantify the effectiveness of inverse filtering and assess the changes that the filter imposes on the electrocardiogram (ECG...

  9. Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function

    Directory of Open Access Journals (Sweden)

    Hegyi Thomas

    2007-04-01

    Full Text Available Abstract Background Monitoring of the electrocardiogram (ECG in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. Method The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g–90 g was determined. Results The mechanical response to a step input was second order (fn = 401 Hz, ζ = 0.08. The relationship between applied tension and output voltage was linear in the range 25–225 gm of applied tension (r2 = 0.99. Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. Conclusion The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force.

  10. Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function.

    Science.gov (United States)

    Ciaccio, Edward J; Hiatt, Mark; Hegyi, Thomas; Drzewiecki, Gary M

    2007-04-19

    Monitoring of the electrocardiogram (ECG) in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g-90 g) was determined. The mechanical response to a step input was second order (fn = 401 Hz, zeta = 0.08). The relationship between applied tension and output voltage was linear in the range 25-225 gm of applied tension (r2 = 0.99). Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force.

  11. Development of electrocardiogram intervals during growth of FVB/N neonate mice

    Science.gov (United States)

    2010-01-01

    Background Electrocardiography remains the best diagnostic tool and therapeutic biomarker for a spectrum of pediatric diseases involving cardiac or autonomic nervous system defects. As genetic links to these disorders are established and transgenic mouse models produced in efforts to understand and treat them, there is a surprising lack of information on electrocardiograms (ECGs) and ECG abnormalities in neonate mice. This is likely due to the trauma and anaesthesia required of many legacy approaches to ECG recording in mice, exacerbated by the fragility of many mutant neonates. Here, we use a non-invasive system to characterize development of the heart rate and electrocardiogram throughout the growth of conscious neonate FVB/N mice. Results We examine ECG waveforms as early as two days after birth. At this point males and females demonstrate comparable heart rates that are 50% lower than adult mice. Neonatal mice exhibit very low heart rate variability. Within 12 days of birth PR, QRS and QTc interval durations are near adult values while heart rate continues to increase until weaning. Upon weaning FVB/N females quickly develop slower heart rates than males, though PR intervals are comparable between sexes until a later age. This suggests separate developmental events may contribute to these gender differences in electrocardiography. Conclusions We provide insight with a new level of detail to the natural course of heart rate establishment in neonate mice. ECG can now be conveniently and repeatedly used in neonatal mice. This should serve to be of broad utility, facilitating further investigations into development of a diverse group of diseases and therapeutics in preclinical mouse studies. PMID:20735846

  12. Incidence of major vascular events after cardiac surgery: impact of preoperative monitoring with troponin and electrocardiogram

    International Nuclear Information System (INIS)

    Sandra M Quiroga; Juan C Villar; Luz X, Martinez

    2009-01-01

    Recent demographic changes have led to an increased risk of major vascular events among patients undergoing non-cardiac surgery. Troponin and electrocardiogram monitoring would further identify these major vascular events. Methods: we prospectively collected data on eligible patients (non-selected individuals aged 45 or older undergoing non-cardiac surgery under general or regional anesthesia in two hospitals in Bucaramanga, with expected length of stay longer than 24 hours) during a time-interrupted series,before and after postoperative diagnostic monitoring (blinded assessment of troponin T and electrocardiograms ignoring clinical data). For the period before the intervention (usual clinical care),two independent reviewers extracted clinical information from clinical histories (of all eligible patients from 3 randomly-selected months of 2005). For the period after diagnostic monitoring, we followed 100 consecutive eligible patients. Primary outcome was a composite of major vascular events within hospital, including myocardial infarction (defined as any troponin elevation associated with electrocardiographic changes suggesting ischemia, regardless of symptoms). Results: we included 534 clinical charts and 100 prospective surgical patients (mean age 62.2, SD 12.9 years; 56% women). The more frequent surgical procedures were orthopedics (26.8%) followed by abdominal (20.2%).The incidence of major vascular events recorded in clinical charts was 2.8%, compared with 7% among monitored patients (p=0,071). All four myocardial infarctions identified among the later group were silent. Conclusion: postoperative monitoring with troponin and electrocardiography identified a higher proportion of major vascular events, mainly silent myocardial infarctions.

  13. Clinical applications of resting state functional connectivity

    Directory of Open Access Journals (Sweden)

    Michael D Fox

    2010-06-01

    Full Text Available During resting conditions the brain remains functionally and metabolically active. One manifestation of this activity that has become an important research tool is spontaneous fluctuations in the blood oxygen level dependent (BOLD signal of fMRI. The identification of correlation patterns in these spontaneous fluctuations has been termed resting state functional connectivity (fcMRI and has the potential to greatly increase the translation of fMRI into clinical care. In this article we review the advantages of the resting state signal for clinical applications including detailed discussion of signal to noise considerations. We include guidelines for performing resting state research on clinical populations, outline the different areas for clinical application, and identify important barriers to be addressed to facilitate the translation of resting state fcMRI into the clinical realm.

  14. Evaluation of hemodynamic significance of coronary fistulae. Diagnostic integration between coronary angiography and stress/rest myocardial scintigraphy

    International Nuclear Information System (INIS)

    Rubini, G.; Sebastiani, M.

    2000-01-01

    It is here reported on the importance of the integration of data obtained from digital coronary angiography and stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography in evaluationing the hemodynamic significance of coronary arteriovenous fistulae. Coronary fistulae were detected with coronary angiography in 9 patients. All patients underwent clinical examination, trans thoracic echocardiography, stress electrocardiogram and stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography. Stress/rest 99m Tc sestamibi myocardial perfusion single photon tomography and stress electrocardiogram showed stress-induced myocardial ischemia in 2 patients. The first patient with familial predisposition and risk factors for ischemic heart disease presented a mesocardic heart murmur on clinical examination. At stress ECG (125 Watt, 153 b/m max frequency 93%, arterial pressure 230 mmHg, max frequency pressure product 35200) ischemic alterations were recorded at the first minute of the second stage of the Bruce protocol. Coronary angiography detected a circumflex artery fistula in the coronary sinus. Stress/rest 99m Tc sestamibi myocardial perfusion single photon emission tomography for the evaluation of stress/rest perfusion detected a reversible perfusion defect of the proximal portion of the posterolateral and lateral walls, thus confirming the hemodynamic importance of the flow through the fistula during stress cycloergometric testing. In the second patient familial predisposition to ischemic heart disease and previous inferior wall myocardial infarction and non-significant stress ECG, coronary angiography identified a seclusive stenosis of the right coronary artery and anomaly between the anterior interventricular artery and the left pulmonary artery. The presence of the contrast medium in the left pulmonary artery identified a flow from the left ventricle to the left pulmonary artery. Good angiographic results were obtained

  15. Improving the Test-Retest Reliability of Resting State fMRI by Removing the Impact of Sleep.

    Science.gov (United States)

    Wang, Jiahui; Han, Junwei; Nguyen, Vinh T; Guo, Lei; Guo, Christine C

    2017-01-01

    Resting state functional magnetic resonance imaging (rs-fMRI) provides a powerful tool to examine large-scale neural networks in the human brain and their disturbances in neuropsychiatric disorders. Thanks to its low demand and high tolerance, resting state paradigms can be easily acquired from clinical population. However, due to the unconstrained nature, resting state paradigm is associated with excessive head movement and proneness to sleep. Consequently, the test-retest reliability of rs-fMRI measures is moderate at best, falling short of widespread use in the clinic. Here, we characterized the effect of sleep on the test-retest reliability of rs-fMRI. Using measures of heart rate variability (HRV) derived from simultaneous electrocardiogram (ECG) recording, we identified portions of fMRI data when subjects were more alert or sleepy, and examined their effects on the test-retest reliability of functional connectivity measures. When volumes of sleep were excluded, the reliability of rs-fMRI is significantly improved, and the improvement appears to be general across brain networks. The amount of improvement is robust with the removal of as much as 60% volumes of sleepiness. Therefore, test-retest reliability of rs-fMRI is affected by sleep and could be improved by excluding volumes of sleepiness as indexed by HRV. Our results suggest a novel and practical method to improve test-retest reliability of rs-fMRI measures.

  16. Improving the Test-Retest Reliability of Resting State fMRI by Removing the Impact of Sleep

    Directory of Open Access Journals (Sweden)

    Jiahui Wang

    2017-05-01

    Full Text Available Resting state functional magnetic resonance imaging (rs-fMRI provides a powerful tool to examine large-scale neural networks in the human brain and their disturbances in neuropsychiatric disorders. Thanks to its low demand and high tolerance, resting state paradigms can be easily acquired from clinical population. However, due to the unconstrained nature, resting state paradigm is associated with excessive head movement and proneness to sleep. Consequently, the test-retest reliability of rs-fMRI measures is moderate at best, falling short of widespread use in the clinic. Here, we characterized the effect of sleep on the test-retest reliability of rs-fMRI. Using measures of heart rate variability (HRV derived from simultaneous electrocardiogram (ECG recording, we identified portions of fMRI data when subjects were more alert or sleepy, and examined their effects on the test-retest reliability of functional connectivity measures. When volumes of sleep were excluded, the reliability of rs-fMRI is significantly improved, and the improvement appears to be general across brain networks. The amount of improvement is robust with the removal of as much as 60% volumes of sleepiness. Therefore, test-retest reliability of rs-fMRI is affected by sleep and could be improved by excluding volumes of sleepiness as indexed by HRV. Our results suggest a novel and practical method to improve test-retest reliability of rs-fMRI measures.

  17. RESTful Java patterns and best practices

    CERN Document Server

    Mehta, Bhakti

    2014-01-01

    This book is aimed at novice developers who want to gain insights into building RESTful services and improve productivity, as well as for advanced developers who want to delve into more complicated topics.

  18. Brief wakeful resting can eliminate directed forgetting.

    Science.gov (United States)

    Schlichting, Andreas; Bäuml, Karl-Heinz T

    2017-02-01

    When cued to intentionally forget previously encoded memories, participants typically show reduced recall of the memories on a later recall test. We examined how such directed forgetting is affected by a brief period of wakeful resting between encoding and test. Encoding was followed by a "passive" wakeful resting period in which subjects heard emotionally neutral music or perceived neutral pictures, or it was followed by an "active" distraction period in which subjects were engaged in counting or calculation tasks. Whereas typical directed forgetting was present after active distraction, the forgetting was absent after wakeful resting. The findings indicate that the degree to which people can intentionally forget memories is influenced by the cognitive activity that people engage in shortly after learning takes place. The results provide first evidence on the interplay between wakeful resting and intentional forgetting.

  19. Partnership strategies for safety roadside rest areas.

    Science.gov (United States)

    2009-01-01

    This project studied the many factors influencing the potential for public private partnerships for Safety : Roadside Rest Areas. It found that Federal and California State laws and regulations represent important : barriers to certain types and loca...

  20. Elegants ja eklektika - Rest Art / Lylian Meister

    Index Scriptorium Estoniae

    Meister, Lylian, 1966-

    2007-01-01

    Tallinnas Mustika keskuses asuvas sisustussalongis Rest Art pakutavast. Asjade müümise kõrval pakutakse kodudele ja hotellidele-restoranidele terviklahendusi. Salongi kujundas Kard Männil. 4 värv. vaadet

  1. USAJOBS Job Opportunity Announcements (JOA) REST API

    Data.gov (United States)

    Office of Personnel Management — This REST-based API is designed to support lightweight Federal Job Opportunity Announcement (JOA) content consumption by consumers. It is anticipated that this API...

  2. The Physiology of Bed Rest. Chapter 39

    Science.gov (United States)

    Fortney, Suzanne M.; Schneider, Victor S.; Greenleaf, John E.

    1996-01-01

    Prolonged rest in bed has been utilized by physicians and other health-care workers to immobilize and confine patients for rehabilitation and restoration of health since time immemorial. The sitting or horizontal position is sought by the body to relieve the strain of the upright or vertical postures, for example during syncopal situations, bone fractures, muscle injuries, fatigue, and probably also to reduce energy expenditure. Most health-care personnel are aware that adaptive responses occurring during bed rest proceed concomitantly with the healing process; signs and symptoms associated with the former should be differentiated from those of the latter. Not all illnesses and infirmities benefit from prolonged bed rest. Considerations in prescribing bed rest for patients-including duration, body position, mode and duration of exercise, light-dark cycles, temperature, and humidity-have not been investigated adequately. More recently, adaptive physiological responses have been measured in normal, healthy subjects in the horizontal or slightly head-down postures during prolonged bed rest as analogs for the adaptive responses of astronauts exposed to the microgravity environment of outer and bed-rest research.

  3. The role of electrocardiogram in the diagnosis of dextrocardia with mirror image atrial arrangement and ventricular position in a young adult Nigerian in Ile-Ife: a case report.

    Science.gov (United States)

    Ogunlade, Oluwadare; Ayoka, Abiodun O; Akomolafe, Rufus O; Akinsomisoye, Olumide S; Irinoye, Adedayo I; Ajao, Adewale; Asafa, Muritala A

    2015-09-28

    Dextrocardia with situs inversus is a rare congenital disease. In patients with this condition, the heart is presented as a mirror image of itself with its apex pointing to the right. The pulmonary and abdominal anatomies are reversed. Dextrocardia with situs inversus occurs at birth but its diagnosis may be in adulthood. This case advances knowledge by graphically describing the unusual electrocardiographic features of dextrocardia in a young adult. We report a case of a 22-year-old Nigerian man of Yoruba ethnicity who presented himself for preadmission medical test. He had a standard 12-lead electrocardiogram which revealed uncommon features: inversion of P waves in leads I, aVL and aVR; dominantly negative QRS waves in leads I, V1 to V6; reverse R wave progression in chest leads; low voltage in V4 to V6; extreme QRS axis; flattened T waves in V4 to V6 and aVR; and inverted T waves in lead I and aVL. An electrocardiogram diagnosis of dextrocardia was made. The differential diagnosis considered was right ventricular hypertrophy. A cardiovascular examination showed pulse rate of 70 beats per minute, blood pressure of 119/62mmHg, visible cardiac impulse at right precordium, apex beat was located at his fifth right intercostal space mid-clavicular line. A chest X-ray (posterior anterior view) including upper abdomen showed dextrocardia; his aortic arch was located on the right. His stomach bubble was located below his right hemidiaphragm. His trachea was slightly deviated to the left. The findings in his lung fields were not remarkable. Abdominopelvic ultrasonography showed that right-sided intra-abdominal organs (liver, gallbladder) were located on the left while left-sided organs (stomach, spleen) were located on the right. His abdominal aorta was on the right while his inferior vena cava was located on the left. A diagnosis of dextrocardia with situs inversus was made ultrasonographically. A properly interpreted electrocardiogram was useful in suspecting the

  4. Computer decision support as a source of interpretation error: the case of electrocardiograms.

    Science.gov (United States)

    Tsai, Theodore L; Fridsma, Douglas B; Gatti, Guido

    2003-01-01

    The aim of this study was to determine the effect that the computer interpretation (CI) of electrocardiograms (EKGs) has on the accuracy of resident (noncardiologist) physicians reading EKGs. A randomized, controlled trial was conducted in a laboratory setting from February through June 2001, using a two-period crossover design with matched pairs of subjects randomly assigned to sequencing groups. Subjects' interpretive accuracy of discrete, cardiologist-determined EKG findings were measured as judged by a board-certified internist. Without the CI, subjects interpreted 48.9% (95% confidence interval, 45.0% to 52.8%) of the findings correctly. With the CI, subjects interpreted 55.4% (51.9% to 58.9%) correctly (p EKG 67.7% (57.2% to 76.7%) than when it was not 34.6% (23.8% to 47.3%; p reading EKGs. However, subjects were influenced significantly by incorrect advice, which tempers the overall usefulness of computer-generated advice in this and perhaps other areas.

  5. Induction of Inflammation In Vivo by Electrocardiogram Sensor Operation Using Wireless Power Transmission.

    Science.gov (United States)

    Heo, Jin-Chul; Kim, Beomjoon; Kim, Yoon-Nyun; Kim, Dae-Kwang; Lee, Jong-Ha

    2017-12-14

    Prolonged monitoring by cardiac electrocardiogram (ECG) sensors is useful for patients with emergency heart conditions. However, implant monitoring systems are limited by lack of tissue biocompatibility. Here, we developed an implantable ECG sensor for real-time monitoring of ventricular fibrillation and evaluated its biocompatibility using an animal model. The implantable sensor comprised transplant sensors with two electrodes, a wireless power transmission system, and a monitoring system. The sensor was inserted into the subcutaneous tissue of the abdominal area and operated for 1 h/day for 5 days using a wireless power system. Importantly, the sensor was encapsulated by subcutaneous tissue and induced angiogenesis, inflammation, and phagocytosis. In addition, we observed that the levels of inflammation-related markers increased with wireless-powered transmission via the ECG sensor; in particular, levels of the Th-1 cytokine interleukin-12 were significantly increased. The results showed that induced tissue damage was associated with the use of wireless-powered sensors. We also investigated research strategies for the prevention of adverse effects caused by lack of tissue biocompatibility of a wireless-powered ECG monitoring system and provided information on the clinical applications of inflammatory reactions in implant treatment using the wireless-powered transmission system.

  6. Real-Time Monitoring and Analysis of Zebrafish Electrocardiogram with Anomaly Detection

    Directory of Open Access Journals (Sweden)

    Michael Lenning

    2017-12-01

    Full Text Available Heart disease is the leading cause of mortality in the U.S. with approximately 610,000 people dying every year. Effective therapies for many cardiac diseases are lacking, largely due to an incomplete understanding of their genetic basis and underlying molecular mechanisms. Zebrafish (Danio rerio are an excellent model system for studying heart disease as they enable a forward genetic approach to tackle this unmet medical need. In recent years, our team has been employing electrocardiogram (ECG as an efficient tool to study the zebrafish heart along with conventional approaches, such as immunohistochemistry, DNA and protein analyses. We have overcome various challenges in the small size and aquatic environment of zebrafish in order to obtain ECG signals with favorable signal-to-noise ratio (SNR, and high spatial and temporal resolution. In this paper, we highlight our recent efforts in zebrafish ECG acquisition with a cost-effective simplified microelectrode array (MEA membrane providing multi-channel recording, a novel multi-chamber apparatus for simultaneous screening, and a LabVIEW program to facilitate recording and processing. We also demonstrate the use of machine learning-based programs to recognize specific ECG patterns, yielding promising results with our current limited amount of zebrafish data. Our solutions hold promise to carry out numerous studies of heart diseases, drug screening, stem cell-based therapy validation, and regenerative medicine.

  7. Wavelet transform and Huffman coding based electrocardiogram compression algorithm: Application to telecardiology

    International Nuclear Information System (INIS)

    Chouakri, S A; Djaafri, O; Taleb-Ahmed, A

    2013-01-01

    We present in this work an algorithm for electrocardiogram (ECG) signal compression aimed to its transmission via telecommunication channel. Basically, the proposed ECG compression algorithm is articulated on the use of wavelet transform, leading to low/high frequency components separation, high order statistics based thresholding, using level adjusted kurtosis value, to denoise the ECG signal, and next a linear predictive coding filter is applied to the wavelet coefficients producing a lower variance signal. This latter one will be coded using the Huffman encoding yielding an optimal coding length in terms of average value of bits per sample. At the receiver end point, with the assumption of an ideal communication channel, the inverse processes are carried out namely the Huffman decoding, inverse linear predictive coding filter and inverse discrete wavelet transform leading to the estimated version of the ECG signal. The proposed ECG compression algorithm is tested upon a set of ECG records extracted from the MIT-BIH Arrhythmia Data Base including different cardiac anomalies as well as the normal ECG signal. The obtained results are evaluated in terms of compression ratio and mean square error which are, respectively, around 1:8 and 7%. Besides the numerical evaluation, the visual perception demonstrates the high quality of ECG signal restitution where the different ECG waves are recovered correctly

  8. The effectiveness of nurses' ability to interpret basic electrocardiogram strips accurately using different learning modalities.

    Science.gov (United States)

    Spiva, LeeAnna; Johnson, Kimberly; Robertson, Bethany; Barrett, Darcy T; Jarrell, Nicole M; Hunter, Donna; Mendoza, Inocencia

    2012-02-01

    Historically, the instructional method of choice has been traditional lecture or face-to-face education; however, changes in the health care environment, including resource constraints, have necessitated examination of this practice. A descriptive pre-/posttest method was used to determine the effectiveness of alternative teaching modalities on nurses' knowledge and confidence in electrocardiogram (EKG) interpretation. A convenience sample of 135 nurses was recruited in an integrated health care system in the Southeastern United States. Nurses attended an instructor-led course, an online learning (e-learning) platform with no study time or 1 week of study time, or an e-learning platform coupled with a 2-hour post-course instructor-facilitated debriefing with no study time or 1 week of study time. Instruments included a confidence scale, an online EKG test, and a course evaluation. Statistically significant differences in knowledge and confidence were found for individual groups after nurses participated in the intervention. Statistically significant differences were found in pre-knowledge and post-confidence when groups were compared. Organizations that use various instructional methods to educate nurses in EKG interpretation can use different teaching modalities without negatively affecting nurses' knowledge or confidence in this skill. Copyright 2012, SLACK Incorporated.

  9. Case report: an electrocardiogram of spontaneous pneumothorax mimicking arm lead reversal.

    Science.gov (United States)

    Wieters, J Scott; Carlin, Joseph P; Morris, Andrew

    2014-05-01

    There are several previously documented findings for electrocardiograms (ECGs) of spontaneous pneumothorax. These findings include axis deviation, T-wave inversion, and right bundle branch block. When an ECG has the arm leads incorrectly placed, the ECG will display right axis deviation and inversion of the P waves in lead I. There have been no previously published ECGs of spontaneous pneumothorax that have shown the same findings as reversal of the limb leads of an ECG. A possible finding of spontaneous pneumothorax is an identical finding to that of an ECG that has been flagged for limb lead reversal. A patient presented in the emergency setting with acute chest pain and shortness of breath caused by a tension pneumothorax. An ECG was administered; findings indicated reversal of the arm leads (right axis deviation and inverted P waves in lead I), but there was no actual limb lead reversal present. ECG findings resolved upon resolution of the pneumothorax. If a patient presents with chest pain and shortness of breath, and the patient's ECG is flagged for limb lead reversal despite being set up correctly, the physician should raise clinical suspicion for a possible spontaneous pneumothorax. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. The effect of sport on computerized electrocardiogram measurements in college athletes.

    Science.gov (United States)

    Gademan, Maaike G J; Uberoi, Abhimanyu; Le, Vy-Van; Mandic, Sandra; van Oort, Eddy R; Myers, Jonathan; Froelicher, Victor F

    2012-02-01

    Broad criteria for abnormal electrocardiogram (ECG) findings, requiring additional testing, have been recommended for preparticipation exams (PPE) of athletes. As these criteria have not considered the sport in which athletes participate, we examined the effect of sports on the computerized ECG measurements obtained in college athletes. During the Stanford 2007 PPE, computerized 12-lead ECGs (Schiller AG) were obtained in 641 athletes (350 male/291 female, age 19.5 ± 2 years). Athletes were engaged in 22 different sports and were grouped into 16 categories: baseball/softball, basketball, crew, crosscountry, fencing, field events, football linemen, football other positions, golf, gymnastics, racquet sports, sailing, track/field, volleyball, water sports, and wrestling. The analysis focused on ECG leads V2, aVF and V5 which provide a three-dimensional representation of the heart's electrical activity. As marked ECG differences exist between males and females, the data are presented by gender. In males, ANOVA analysis yielded significant ECG differences between sports for heart rate, QRS duration, QTc, J-amplitude in V2 and V5, spatial vector length (SVL) of the P wave, SVL R wave, and SVL T wave, and RS(sum) (p sports were found for heart rate, QRS duration, QRS axis and SVL T wave (p sports, and these differences were more apparent in males than females. Therefore, sport-specific ECG criteria for abnormal ECG findings should be developed to obtain a more useful approach to ECG screening in athletes.

  11. A Fixed-Lag Kalman Smoother to Filter Power Line Interference in Electrocardiogram Recordings.

    Science.gov (United States)

    Warmerdam, G J J; Vullings, R; Schmitt, L; Van Laar, J O E H; Bergmans, J W M

    2017-08-01

    Filtering power line interference (PLI) from electrocardiogram (ECG) recordings can lead to significant distortions of the ECG and mask clinically relevant features in ECG waveform morphology. The objective of this study is to filter PLI from ECG recordings with minimal distortion of the ECG waveform. In this paper, we propose a fixed-lag Kalman smoother with adaptive noise estimation. The performance of this Kalman smoother in filtering PLI is compared to that of a fixed-bandwidth notch filter and several adaptive PLI filters that have been proposed in the literature. To evaluate the performance, we corrupted clean neonatal ECG recordings with various simulated PLI. Furthermore, examples are shown of filtering real PLI from an adult and a fetal ECG recording. The fixed-lag Kalman smoother outperforms other PLI filters in terms of step response settling time (improvements that range from 0.1 to 1 s) and signal-to-noise ratio (improvements that range from 17 to 23 dB). Our fixed-lag Kalman smoother can be used for semi real-time applications with a limited delay of 0.4 s. The fixed-lag Kalman smoother presented in this study outperforms other methods for filtering PLI and leads to minimal distortion of the ECG waveform.

  12. Automated processing of the single-lead electrocardiogram for the detection of obstructive sleep apnoea.

    Science.gov (United States)

    de Chazal, Philip; Heneghan, Conor; Sheridan, Elaine; Reilly, Richard; Nolan, Philip; O'Malley, Mark

    2003-06-01

    A method for the automatic processing of the electrocardiogram (ECG) for the detection of obstructive apnoea is presented. The method screens nighttime single-lead ECG recordings for the presence of major sleep apnoea and provides a minute-by-minute analysis of disordered breathing. A large independently validated database of 70 ECG recordings acquired from normal subjects and subjects with obstructive and mixed sleep apnoea, each of approximately eight hours in duration, was used throughout the study. Thirty-five of these recordings were used for training and 35 retained for independent testing. A wide variety of features based on heartbeat intervals and an ECG-derived respiratory signal were considered. Classifiers based on linear and quadratic discriminants were compared. Feature selection and regularization of classifier parameters were used to optimize classifier performance. Results show that the normal recordings could be separated from the apnoea recordings with a 100% success rate and a minute-by-minute classification accuracy of over 90% is achievable.

  13. An Investigation on the Effect of Extremely Low Frequency Pulsed Electromagnetic Fields on Human Electrocardiograms (ECGs).

    Science.gov (United States)

    Fang, Qiang; Mahmoud, Seedahmed S; Yan, Jiayong; Li, Hui

    2016-11-23

    For this investigation, we studied the effects of extremely low frequency pulse electromagnetic fields (ELF-PEMF) on the human cardiac signal. Electrocardiograms (ECGs) of 22 healthy volunteers before and after a short duration of ELF-PEMF exposure were recorded. The experiment was conducted under single-blind conditions. The root mean square (RMS) value of the recorded data was considered as comparison criteria. We also measured and analysed four important ECG time intervals before and after ELF-PEMF exposure. Results revealed that the RMS value of the ECG recordings from 18 participants (81.8% of the total participants) increased with a mean value of 3.72%. The increase in ECG voltage levels was then verified by a second experimental protocol with a control exposure. In addition to this, we used hyperbolic T-distributions (HTD) in the analysis of ECG signals to verify the change in the RR interval. It was found that there were small shifts in the frequency-domain signal before and after EMF exposure. This shift has an influence on all frequency components of the ECG signals, as all spectrums were shifted. It is shown from this investigation that a short time exposure to ELF-PEMF can affect the properties of ECG signals. Further study is needed to consolidate this finding and discover more on the biological effects of ELF-PEMF on human physiological processes.

  14. The clinical factors′ prediction of increased intradialytic qt dispersion on the electrocardiograms of chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Dina Oktavia

    2013-01-01

    Full Text Available Ventricular arrhythmias and sudden death are common in patients on maintenance hemodialysis (HD. The increase in QT dispersion (QTd on the electrocardiogram (ECG reflects increased tendency for ventricular repolarization that predisposes to arrhythmias. The purpose of the study was to identify the clinical factors that may predict the increased intradialytic QTd and to assess differences in QTd before and after HD. Each of 61 chronic HD patients underwent 12-lead ECG and blood pressure (BP measurement before and every 1 h during a single HD session. The QT intervals were corrected for heart rate using Bazett′s formula. Intradialytic QTd increased in 30 (49% patients. There was no correlation between the increased QTd and the clinical factors including hypertension, pulse pressure, intradialytic hypotension, left ventricular hypertrophy, old myocardial infarct, diabetes mellitus, and nutritional status. The means of QT interval and QTd increased after HD session (from 382 ± 29 to 444 ± 26 ms, P <0.05; and from 74 ± 21 to 114 ± 53 ms, respectively, P <0.05. We conclude that the increased intradialytic QTd could not be predicted by any of the clinical factors evaluated in this study. There was significant difference in the means of QTd before and after HD session.

  15. Algorithm for the classification of multi-modulating signals on the electrocardiogram.

    Science.gov (United States)

    Mita, Mitsuo

    2007-03-01

    This article discusses the algorithm to measure electrocardiogram (ECG) and respiration simultaneously and to have the diagnostic potentiality for sleep apnoea from ECG recordings. The algorithm is composed by the combination with the three particular scale transform of a(j)(t), u(j)(t), o(j)(a(j)) and the statistical Fourier transform (SFT). Time and magnitude scale transforms of a(j)(t), u(j)(t) change the source into the periodic signal and tau(j) = o(j)(a(j)) confines its harmonics into a few instantaneous components at tau(j) being a common instant on two scales between t and tau(j). As a result, the multi-modulating source is decomposed by the SFT and is reconstructed into ECG, respiration and the other signals by inverse transform. The algorithm is expected to get the partial ventilation and the heart rate variability from scale transforms among a(j)(t), a(j+1)(t) and u(j+1)(t) joining with each modulation. The algorithm has a high potentiality of the clinical checkup for the diagnosis of sleep apnoea from ECG recordings.

  16. Correlations between electrocardiogram and biomarkers in acute pulmonary embolism: Analysis of ZATPOL-2 Registry.

    Science.gov (United States)

    Kukla, Piotr; Kosior, Dariusz A; Tomaszewski, Andrzej; Ptaszyńska-Kopczyńska, Katarzyna; Widejko, Katarzyna; Długopolski, Robert; Skrzyński, Andrzej; Błaszczak, Piotr; Fijorek, Kamil; Kurzyna, Marcin

    2017-07-01

    Electrocardiography (ECG) is still one of the first tests performed at admission, mostly in patients (pts) with chest pain or dyspnea. The aim of this study was to assess the correlation between electrocardiographic abnormalities and cardiac biomarkers as well as echocardiographic parameter in patients with acute pulmonary embolism. We performed a retrospective analysis of 614 pts. (F/M 334/280; mean age of 67.9 ± 16.6 years) with confirmed acute pulmonary embolism (APE) who were enrolled to the ZATPOL-2 Registry between 2012 and 2014. Elevated cardiac biomarkers were observed in 358 pts (74.4%). In this group the presence of atrial fibrillation (p = .008), right axis deviation (p = .004), S 1 Q 3 T 3 sign (p electrocardiogram" were as follows: increased heart rate (OR 1.09, 95% CI 1.02-1.17, p = .012), elevated troponin concentration (OR 3.33, 95% CI 1.94-5.72, p = .000), and right ventricular overload (OR 2.30, 95% CI 1.17-4.53, p = .016). Electrocardiographic signs of right ventricular strain are strongly related to elevated cardiac biomarkers and echocardiographic signs of right ventricular overload. ECG may be used in preliminary risk stratification of patient with intermediate- or high-risk forms of APE. © 2017 Wiley Periodicals, Inc.

  17. Electrocardiogram signal denoising based on empirical mode decomposition technique: an overview

    International Nuclear Information System (INIS)

    Han, G.; Lin, B.; Xu, Z.

    2017-01-01

    Electrocardiogram (ECG) signal is nonlinear and non-stationary weak signal which reflects whether the heart is functioning normally or abnormally. ECG signal is susceptible to various kinds of noises such as high/low frequency noises, powerline interference and baseline wander. Hence, the removal of noises from ECG signal becomes a vital link in the ECG signal processing and plays a significant role in the detection and diagnosis of heart diseases. The review will describe the recent developments of ECG signal denoising based on Empirical Mode Decomposition (EMD) technique including high frequency noise removal, powerline interference separation, baseline wander correction, the combining of EMD and Other Methods, EEMD technique. EMD technique is a quite potential and prospective but not perfect method in the application of processing nonlinear and non-stationary signal like ECG signal. The EMD combined with other algorithms is a good solution to improve the performance of noise cancellation. The pros and cons of EMD technique in ECG signal denoising are discussed in detail. Finally, the future work and challenges in ECG signal denoising based on EMD technique are clarified.

  18. The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects.

    Science.gov (United States)

    Narayanan, Kumar; Chugh, Sumeet S

    2015-10-01

    More than 100 years after it was first invented, the 12-lead electrocardiogram (ECG) continues to occupy an important place in the diagnostic armamentarium of the practicing clinician. With the recognition of relatively rare but important clinical entities such as Wolff-Parkinson-White and the long QT syndrome, this clinical tool was firmly established as a test for assessing risk of sudden cardiac death (SCD). However, over the past two decades the role of the ECG in risk prediction for common forms of SCD, for example in patients with coronary artery disease, has been the focus of considerable investigation. Especially in light of the limitations of current risk stratification approaches, there is a renewed focus on this broadly available and relatively inexpensive test. Various abnormalities of depolarization and repolarization on the ECG have been linked to SCD risk; however, more focused work is needed before they can be deployed in the clinical arena. The present review summarizes the current knowledge on various ECG risk markers for prediction of SCD and discusses some future directions in this field. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  19. Altered mental status in the emergency department - Can an electrocardiogram show the right way to go?

    Science.gov (United States)

    Dias, Andre; Franco, Emiliana; Martinez, Jasmine; Figueredo, Vincent M

    A 38-year-old African American male patient with a past medical history of human immunodeficiency virus and schizophrenia who was noncompliant with medications presented to the emergency department (ED) after activation of the local crisis response center for altered mental status. Upon arrival he was lethargic and uncooperative, unable to provide any significant details apart from pleuritic chest pain. His blood pressure was 133/88 mmHg, heart rate 43 beats per minute and initial body temperature 36.1 °C which prompted an electrocardiogram (EKG). This initial EKG was compared to a prior one obtained six months earlier during an ER visit for an acute psychotic episode. Three hours of being admitted he started shivering. Patient was found to be hypothermic with a rectal temperature of 28.9 °C. He was also hypoglycemic, pancytopenic and had positive urine cultures with >100,000 CFU/ml coagulase-negative Staphylococcus. There was no evidence of medication overdose. His CT scan of the brain did not show evidence of intracranial bleeding and his serum calcium was normal. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. A Precise Drunk Driving Detection Using Weighted Kernel Based on Electrocardiogram.

    Science.gov (United States)

    Wu, Chung Kit; Tsang, Kim Fung; Chi, Hao Ran; Hung, Faan Hei

    2016-05-09

    Globally, 1.2 million people die and 50 million people are injured annually due to traffic accidents. These traffic accidents cost $500 billion dollars. Drunk drivers are found in 40% of the traffic crashes. Existing drunk driving detection (DDD) systems do not provide accurate detection and pre-warning concurrently. Electrocardiogram (ECG) is a proven biosignal that accurately and simultaneously reflects human's biological status. In this letter, a classifier for DDD based on ECG is investigated in an attempt to reduce traffic accidents caused by drunk drivers. At this point, it appears that there is no known research or literature found on ECG classifier for DDD. To identify drunk syndromes, the ECG signals from drunk drivers are studied and analyzed. As such, a precise ECG-based DDD (ECG-DDD) using a weighted kernel is developed. From the measurements, 10 key features of ECG signals were identified. To incorporate the important features, the feature vectors are weighted in the customization of kernel functions. Four commonly adopted kernel functions are studied. Results reveal that weighted feature vectors improve the accuracy by 11% compared to the computation using the prime kernel. Evaluation shows that ECG-DDD improved the accuracy by 8% to 18% compared to prevailing methods.

  1. The electrocardiogram signal of Seba's short-tailed bat, Carollia perspicillata.

    Science.gov (United States)

    Mihova, Diana; Hechavarría, Julio C

    2016-07-01

    A number of studies have successfully used electrocardiogram (ECG) signals to characterize complex physiological phenomena such as associative learning in bats. However, at present, no thorough characterization of the structure of ECG signals is available for these animals. The aim of the present study was to quantitatively characterize features of the ECG signals in the bat species Carollia perspicillata, a species that is commonly used in neuroethology studies. Our results show that the ECG signals of C. perspicillata follow the typical mammalian pattern, in that they are composed by a P wave, QRS complex and a T wave. Peak-to-peak amplitudes in the bats' ECG signals were larger in measuring configurations in which one of the electrodes was attached to the right thumb. In addition, large differences in the instantaneous heart rate (HR) distributions were observed between ketamine/xylazine anesthetized and awake bats. Ketamine/xylazine might target the neural circuits that control HR, therefore, instantaneous HR measurements should only be used as physiological marker in awake animals.

  2. A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening.

    Science.gov (United States)

    Patel, Angira; Webster, Gregory; Ward, Kendra; Lantos, John

    2017-07-01

    Aim The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE). Paediatricians affiliated with a tertiary children's hospital completed a survey about ECGs for PPSE. In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die. Only 16% of paediatricians perform all 12 American Heart Association recommended elements of the PPSE. If any of these screening elements are abnormal, 69% obtain an ECG, 36% an echocardiogram, and 30% restrict patients from sports activity; 73% of them refer the patient to a cardiologist. Most of the general paediatricians surveyed did not currently perform ECGs for PPSE. In addition, there was a low rate of adherence to performing the 12 screening elements recommended by the American Heart Association. They have trouble obtaining timely, accurate ECG interpretations, worry about potential unnecessary exercise restrictions, and cost-effectiveness. The practical hurdles to ECG implementation emphasise the need for a fresh look at PPSE, and not just ECG screening. Improvements in ECG performance/interpretation would be necessary for ECGs to be a useful part of PPSE.

  3. PROPOSED SIMPLE METHOD FOR ELECTROCARDIOGRAM RECORDING IN FREE-RANGING ASIAN ELEPHANTS (ELEPHAS MAXIMUS).

    Science.gov (United States)

    Chai, Norin; Pouchelon, Jean Louis; Bouvard, Jonathan; Sillero, Leonor Camacho; Huynh, Minh; Segalini, Vincent; Point, Lisa; Croce, Veronica; Rigaux, Goulven; Highwood, Jack; Chetboul, Valérie

    2016-03-01

    Electrocardiography represents a relevant diagnostic tool for detecting cardiac disease in animals. Elephants can present various congenital and acquired cardiovascular diseases. However, few electrophysiologic studies have been reported in captive elephants, mainly due to challenging technical difficulties in obtaining good-quality electrocardiogram (ECG) tracings, and no data are currently available for free-ranging Asian elephants (Elephas maximus). The purpose of this pilot prospective study was to evaluate the feasibility of using a simple method for recording ECG tracings in wild, apparently healthy, unsedated Asian elephants (n = 7) in the standing position. Successful six-lead recordings (I, II, III, aVR, aVL, and aVF) were obtained, with the aVL lead providing the best-quality tracings in most animals. Variables measured in the aVL lead included heart rate, amplitudes and duration of the P waves, QRS complexes, T and U waves, and duration of the PR, QT, and QU intervals. A negative deflection following positive P waves, representative of an atrial repolarization wave (Ta wave), was observed for five out of the seven elephants.

  4. Electrocardiogram signal denoising based on empirical mode decomposition technique: an overview

    Science.gov (United States)

    Han, G.; Lin, B.; Xu, Z.

    2017-03-01

    Electrocardiogram (ECG) signal is nonlinear and non-stationary weak signal which reflects whether the heart is functioning normally or abnormally. ECG signal is susceptible to various kinds of noises such as high/low frequency noises, powerline interference and baseline wander. Hence, the removal of noises from ECG signal becomes a vital link in the ECG signal processing and plays a significant role in the detection and diagnosis of heart diseases. The review will describe the recent developments of ECG signal denoising based on Empirical Mode Decomposition (EMD) technique including high frequency noise removal, powerline interference separation, baseline wander correction, the combining of EMD and Other Methods, EEMD technique. EMD technique is a quite potential and prospective but not perfect method in the application of processing nonlinear and non-stationary signal like ECG signal. The EMD combined with other algorithms is a good solution to improve the performance of noise cancellation. The pros and cons of EMD technique in ECG signal denoising are discussed in detail. Finally, the future work and challenges in ECG signal denoising based on EMD technique are clarified.

  5. Development and significance of a fetal electrocardiogram recorded by signal-averaged high-amplification electrocardiography.

    Science.gov (United States)

    Hayashi, Risa; Nakai, Kenji; Fukushima, Akimune; Itoh, Manabu; Sugiyama, Toru

    2009-03-01

    Although ultrasonic diagnostic imaging and fetal heart monitors have undergone great technological improvements, the development and use of fetal electrocardiograms to evaluate fetal arrhythmias and autonomic nervous activity have not been fully established. We verified the clinical significance of the novel signal-averaged vector-projected high amplification ECG (SAVP-ECG) method in fetuses from 48 gravidas at 32-41 weeks of gestation and in 34 neonates. SAVP-ECGs from fetuses and newborns were recorded using a modified XYZ-leads system. Once noise and maternal QRS waves were removed, the P, QRS, and T wave intervals were measured from the signal-averaged fetal ECGs. We also compared fetal and neonatal heart rates (HRs), coefficients of variation of heart rate variability (CV) as a parasympathetic nervous activity, and the ratio of low to high frequency (LF/HF ratio) as a sympathetic nervous activity. The rate of detection of a fetal ECG by SAVP-ECG was 72.9%, and the fetal and neonatal QRS and QTc intervals were not significantly different. The neonatal CVs and LF/HF ratios were significantly increased compared with those in the fetus. In conclusion, we have developed a fetal ECG recording method using the SAVP-ECG system, which we used to evaluate autonomic nervous system development.

  6. Preoperative Electrocardiogram Score for Predicting New-Onset Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

    Science.gov (United States)

    Gu, Jiwei; Andreasen, Jan J; Melgaard, Jacob; Lundbye-Christensen, Søren; Hansen, John; Schmidt, Erik B; Thorsteinsson, Kristinn; Graff, Claus

    2017-02-01

    To investigate if electrocardiogram (ECG) markers from routine preoperative ECGs can be used in combination with clinical data to predict new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Retrospective observational case-control study. Single-center university hospital. One hundred consecutive adult patients (50 POAF, 50 without POAF) who underwent coronary artery bypass grafting, valve surgery, or combinations. Retrospective review of medical records and registration of POAF. Clinical data and demographics were retrieved from the Western Denmark Heart Registry and patient records. Paper tracings of preoperative ECGs were collected from patient records, and ECG measurements were read by two independent readers blinded to outcome. A subset of four clinical variables (age, gender, body mass index, and type of surgery) were selected to form a multivariate clinical prediction model for POAF and five ECG variables (QRS duration, PR interval, P-wave duration, left atrial enlargement, and left ventricular hypertrophy) were used in a multivariate ECG model. Adding ECG variables to the clinical prediction model significantly improved the area under the receiver operating characteristic curve from 0.54 to 0.67 (with cross-validation). The best predictive model for POAF was a combined clinical and ECG model with the following four variables: age, PR-interval, QRS duration, and left atrial enlargement. ECG markers obtained from a routine preoperative ECG may be helpful in predicting new-onset POAF in patients undergoing cardiac surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Alterations in electrocardiogram of adenosine test for 99Tcm-MIBI myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Xie Boqia; Tian Yueqin; Zheng Lihui

    2011-01-01

    Objective: To analyze alterations in electrocardiogram (ECG) of adenosine test in 99 Tc m -MIBI myocardial perfusion imaging(MPI)SPECT study. Methods: A total of 641 patients were included in the study. The patients each underwent 99 Tc m -MIBI MPI with adenosine test. The ECGs were taken before, during, and after adenosine infusion. Results: In all, abnormal ECGs were found in 205(32.0%) patients. During adenosine infusion, 20.6%(132/641) of patients suffered from arrhythmia, 29.5%(39/132) had atrial premature beats, 34.1% (45/132) had premature ventricular beats, and 6.1% (8/132) had sinoatrial block. In addition, 5.3% (7/132) had first-, 24.2% (32/132) had second-, and 0.8% (1/132) had third-degree atrioventricular block (AVB). After adenosine infusion, 4.4%( 28/641) of patients suffered from arrhythmia, 57.1% (16/28) had atrial premature beats, 39.3% (11/28) had premature ventricular beats, and 3.6% (1/28) had sinoatrial block. The perfusion images showed ischemia in 36 patients and infarction in 8 patients. Adenosine infusion was terminated in 39 patients (6.1%) because of poorly tolerated side effects. However, no death or acute myocardial infarction occurred in the study. Conclusions: Adenosine pharmacologic test for 99 Tc m -MIBI MPI may result in relatively high incidence of arrhythmia in ECG monitoring. (authors)

  8. Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification.

    Science.gov (United States)

    Refaat, Marwan M; Hotait, Mostafa; Tseng, Zian H

    2014-07-01

    Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes. © 2014 Wiley Periodicals, Inc.

  9. Electrocardiogram interpretation and arrhythmia management: a primary and secondary care survey.

    Science.gov (United States)

    Begg, Gordon; Willan, Kathryn; Tyndall, Keith; Pepper, Chris; Tayebjee, Muzahir

    2016-05-01

    There is increasing desire among service commissioners to treat arrhythmia in primary care. Accurate interpretation of the electrocardiogram (ECG) is fundamental to this. ECG interpretation has previously been shown to vary widely but there is little recent data. To examine the interpretation of ECGs in primary and secondary care. A cross-sectional survey of participants' interpretation of six ECGs and hypothetical management of patients based on those ECGs, at primary care educational events, and a cardiology department in Leeds. A total of 262 primary care clinicians and 20 cardiology clinicians were surveyed via questionnaire. Answers were compared with expert electrophysiologist opinion. In primary care, abnormal ECGs were interpreted as normal by 23% of responders. ST elevation and prolonged QT were incorrectly interpreted as normal by 1% and 22%, respectively. In cardiology, abnormal ECGs were interpreted as normal by 3%. ECG provision and interpretation remains inconsistent in both primary and secondary care. Primary care practitioners are less experienced and less confident with ECG interpretation than cardiologists, and require support in this area. © British Journal of General Practice 2016.

  10. Correlation of Respiratory Signals and Electrocardiogram Signals via Empirical Mode Decomposition

    KAUST Repository

    El Fiky, Ahmed Osama

    2011-05-24

    Recently Electrocardiogram (ECG) signals are being broadly used as an essential diagnosing tool in different clinical applications as they carry a reliable representation not only for cardiac activities, but also for other associated biological processes, like respiration. However, the process of recording and collecting them has usually suffered from the presence of some undesired noises, which in turn affects the reliability of such representations.Therefore, de-noising ECG signals became a hot research field for signal processing experts to ensure better and clear representation of the different cardiac activities. Given the nonlinear and non-stationary properties of ECGs, it is not a simple task to cancel the undesired noise terms without affecting the biological physics of them. In this study, we are interested in correlating the ECG signals with respiratory parameters, specifically the lung volume and lung pressure. We have focused on the concept of de-noising ECG signals by means of signal decomposition using an algorithm called the Empirical Mode Decomposition (EMD) where the original ECG signals are being decomposed into a set of intrinsic mode functions (IMF). Then, we have provided criteria based on which some of these IMFs have been adapted to reconstruct de-noised ECG version. Finally, we have utilized de-noised ECGs as well as IMFs for to study the correlation with lung volume and lung pressure. These correlation studies have showed some clear resemblance especially between the oscillations of ECGs and lung pressures.

  11. Envelopment filter and K-means for the detection of QRS waveforms in electrocardiogram.

    Science.gov (United States)

    Merino, Manuel; Gómez, Isabel María; Molina, Alberto J

    2015-06-01

    The electrocardiogram (ECG) is a well-established technique for determining the electrical activity of the heart and studying its diseases. One of the most common pieces of information that can be read from the ECG is the heart rate (HR) through the detection of its most prominent feature: the QRS complex. This paper describes an offline version and a real-time implementation of a new algorithm to determine QRS localization in the ECG signal based on its envelopment and K-means clustering algorithm. The envelopment is used to obtain a signal with only QRS complexes, deleting P, T, and U waves and baseline wander. Two moving average filters are applied to smooth data. The K-means algorithm classifies data into QRS and non-QRS. The technique is validated using 22 h of ECG data from five Physionet databases. These databases were arbitrarily selected to analyze different morphologies of QRS complexes: three stored data with cardiac pathologies, and two had data with normal heartbeats. The algorithm has a low computational load, with no decision thresholds. Furthermore, it does not require any additional parameter. Sensitivity, positive prediction and accuracy from results are over 99.7%. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Corrected Integral Shape Averaging Applied to Obstructive Sleep Apnea Detection from the Electrocardiogram

    Directory of Open Access Journals (Sweden)

    C. O'Brien

    2007-01-01

    Full Text Available We present a technique called corrected integral shape averaging (CISA for quantifying shape and shape differences in a set of signals. CISA can be used to account for signal differences which are purely due to affine time warping (jitter and dilation/compression, and hence provide access to intrinsic shape fluctuations. CISA can also be used to define a distance between shapes which has useful mathematical properties; a mean shape signal for a set of signals can be defined, which minimizes the sum of squared shape distances of the set from the mean. The CISA procedure also allows joint estimation of the affine time parameters. Numerical simulations are presented to support the algorithm for obtaining the CISA mean and parameters. Since CISA provides a well-defined shape distance, it can be used in shape clustering applications based on distance measures such as k-means. We present an application in which CISA shape clustering is applied to P-waves extracted from the electrocardiogram of subjects suffering from sleep apnea. The resulting shape clustering distinguishes ECG segments recorded during apnea from those recorded during normal breathing with a sensitivity of 81% and specificity of 84%.

  13. Induction of Inflammation In Vivo by Electrocardiogram Sensor Operation Using Wireless Power Transmission

    Directory of Open Access Journals (Sweden)

    Jin-Chul Heo

    2017-12-01

    Full Text Available Prolonged monitoring by cardiac electrocardiogram (ECG sensors is useful for patients with emergency heart conditions. However, implant monitoring systems are limited by lack of tissue biocompatibility. Here, we developed an implantable ECG sensor for real-time monitoring of ventricular fibrillation and evaluated its biocompatibility using an animal model. The implantable sensor comprised transplant sensors with two electrodes, a wireless power transmission system, and a monitoring system. The sensor was inserted into the subcutaneous tissue of the abdominal area and operated for 1 h/day for 5 days using a wireless power system. Importantly, the sensor was encapsulated by subcutaneous tissue and induced angiogenesis, inflammation, and phagocytosis. In addition, we observed that the levels of inflammation-related markers increased with wireless-powered transmission via the ECG sensor; in particular, levels of the Th-1 cytokine interleukin-12 were significantly increased. The results showed that induced tissue damage was associated with the use of wireless-powered sensors. We also investigated research strategies for the prevention of adverse effects caused by lack of tissue biocompatibility of a wireless-powered ECG monitoring system and provided information on the clinical applications of inflammatory reactions in implant treatment using the wireless-powered transmission system.

  14. Application of artificial neural networks for versatile preprocessing of electrocardiogram recordings.

    Science.gov (United States)

    Mateo, J; Rieta, J J

    2012-02-01

    The electrocardiogram (ECG) is the most widely used method for diagnosis of heart diseases, where a good quality of recordings allows the proper interpretation and identification of physiological and pathological phenomena. However, ECG recordings often have interference from noises including thermal, muscle, baseline and powerline noises. These signals severely limit ECG recording utility and, hence, have to be removed. To deal with this problem, the present paper proposes an artificial neural network (ANN) as a filter to remove all kinds of noise in just one step. The method is based on a growing ANN which optimizes both the number of nodes in the hidden layer and the coefficient matrices, which are optimized by means of the Widrow-Hoff delta algorithm. The ANN has been trained with a database comprising all kinds of noise, both from synthesized and real ECG recordings, in order to handle any noise signal present in the ECG. The proposed system improves results yielded by conventional techniques of ECG filtering, such as FIR-based systems, adaptive filtering and wavelet filtering. Therefore, the algorithm could serve as an effective framework to substantially reduce noise in ECG recordings. In addition, the resulting ECG signal distortion is notably more reduced in comparison with conventional methodologies. In summary, the current contribution introduces a new method which is able to suppress all ECG interference signals in only one step with low ECG distortion and a high noise reduction.

  15. Sequential Markov chain Monte Carlo filter with simultaneous model selection for electrocardiogram signal modeling.

    Science.gov (United States)

    Edla, Shwetha; Kovvali, Narayan; Papandreou-Suppappola, Antonia

    2012-01-01

    Constructing statistical models of electrocardiogram (ECG) signals, whose parameters can be used for automated disease classification, is of great importance in precluding manual annotation and providing prompt diagnosis of cardiac diseases. ECG signals consist of several segments with different morphologies (namely the P wave, QRS complex and the T wave) in a single heart beat, which can vary across individuals and diseases. Also, existing statistical ECG models exhibit a reliance upon obtaining a priori information from the ECG data by using preprocessing algorithms to initialize the filter parameters, or to define the user-specified model parameters. In this paper, we propose an ECG modeling technique using the sequential Markov chain Monte Carlo (SMCMC) filter that can perform simultaneous model selection, by adaptively choosing from different representations depending upon the nature of the data. Our results demonstrate the ability of the algorithm to track various types of ECG morphologies, including intermittently occurring ECG beats. In addition, we use the estimated model parameters as the feature set to classify between ECG signals with normal sinus rhythm and four different types of arrhythmia.

  16. A Precise Drunk Driving Detection Using Weighted Kernel Based on Electrocardiogram

    Directory of Open Access Journals (Sweden)

    Chung Kit Wu

    2016-05-01

    Full Text Available Globally, 1.2 million people die and 50 million people are injured annually due to traffic accidents. These traffic accidents cost $500 billion dollars. Drunk drivers are found in 40% of the traffic crashes. Existing drunk driving detection (DDD systems do not provide accurate detection and pre-warning concurrently. Electrocardiogram (ECG is a proven biosignal that accurately and simultaneously reflects human’s biological status. In this letter, a classifier for DDD based on ECG is investigated in an attempt to reduce traffic accidents caused by drunk drivers. At this point, it appears that there is no known research or literature found on ECG classifier for DDD. To identify drunk syndromes, the ECG signals from drunk drivers are studied and analyzed. As such, a precise ECG-based DDD (ECG-DDD using a weighted kernel is developed. From the measurements, 10 key features of ECG signals were identified. To incorporate the important features, the feature vectors are weighted in the customization of kernel functions. Four commonly adopted kernel functions are studied. Results reveal that weighted feature vectors improve the accuracy by 11% compared to the computation using the prime kernel. Evaluation shows that ECG-DDD improved the accuracy by 8% to 18% compared to prevailing methods.

  17. Temporal abstraction and inductive logic programming for arrhythmia recognition from electrocardiograms.

    Science.gov (United States)

    Carrault, G; Cordier, M-O; Quiniou, R; Wang, F

    2003-07-01

    This paper proposes a novel approach to cardiac arrhythmia recognition from electrocardiograms (ECGs). ECGs record the electrical activity of the heart and are used to diagnose many heart disorders. The numerical ECG is first temporally abstracted into series of time-stamped events. Temporal abstraction makes use of artificial neural networks to extract interesting waves and their features from the input signals. A temporal reasoner called a chronicle recogniser processes such series in order to discover temporal patterns called chronicles which can be related to cardiac arrhythmias. Generally, it is difficult to elicit an accurate set of chronicles from a doctor. Thus, we propose to learn automatically from symbolic ECG examples the chronicles discriminating the arrhythmias belonging to some specific subset. Since temporal relationships are of major importance, inductive logic programming (ILP) is the tool of choice as it enables first-order relational learning. The approach has been evaluated on real ECGs taken from the MIT-BIH database. The performance of the different modules as well as the efficiency of the whole system is presented. The results are rather good and demonstrate that integrating numerical techniques for low level perception and symbolic techniques for high level classification is very valuable.

  18. Comparison of Electrocardiogram Signals in Men and Women during Creativity with Classification Approaches

    Directory of Open Access Journals (Sweden)

    Sahar ZAKERI

    2016-07-01

    Full Text Available Electrocardiogram (ECG analysis is mostly used as a valuable tool in the evaluation of cognitive tasks. By taking and analyzing measurements in vast quantities, researchers are working toward a better understanding of how human physiological systems work. For the first time, this study investigated the function of the cardiovascular system during creative thinking. In addition, the difference between male/female and normal/creativity states from ECG signals was investigated. Overall, the purpose of this paper was to illustrate the heart working during the creativity, and discover the creative men or women subjects. For these goals, six nonlinear features of the ECG signal were extracted to detect creativity states. During the three tasks of the Torrance Tests of Creative Thinking (TTCT- Figural B, ECG signals were recorded from 52 participants (26 men and 26 women. Then, the proficiency of two kinds of classification approaches was evaluated: Artificial Neural Network (ANN and Support Vector Machine (SVM. The results indicated the high accuracy rate of discriminations between male/female (96.09% and normal/creativity states (95.84% using ANN classifier. Therefore, the proposed method can be useful to detect the creativity states.

  19. Resting-state FMRI confounds and cleanup

    Science.gov (United States)

    Murphy, Kevin; Birn, Rasmus M.; Bandettini, Peter A.

    2013-01-01

    The goal of resting-state functional magnetic resonance imaging (FMRI) is to investigate the brain’s functional connections by using the temporal similarity between blood oxygenation level dependent (BOLD) signals in different regions of the brain “at rest” as an indicator of synchronous neural activity. Since this measure relies on the temporal correlation of FMRI signal changes between different parts of the brain, any non-neural activity-related process that affects the signals will influence the measure of functional connectivity, yielding spurious results. To understand the sources of these resting-state FMRI confounds, this article describes the origins of the BOLD signal in terms of MR physics and cerebral physiology. Potential confounds arising from motion, cardiac and respiratory cycles, arterial CO2 concentration, blood pressure/cerebral autoregulation, and vasomotion are discussed. Two classes of techniques to remove confounds from resting-state BOLD time series are reviewed: 1) those utilising external recordings of physiology and 2) data-based cleanup methods that only use the resting-state FMRI data itself. Further methods that remove noise from functional connectivity measures at a group level are also discussed. For successful interpretation of resting-state FMRI comparisons and results, noise cleanup is an often over-looked but essential step in the analysis pipeline. PMID:23571418

  20. [Factors influencing electrocardiogram results in workers exposed to noise in steel-making and steel-rolling workshops of an iron and steel plant].

    Science.gov (United States)

    Li, Y H; Yu, S F; Gu, G Z; Chen, G S; Zhou, W H; Wu, H; Jiao, J

    2016-02-20

    To investigate the factors influencing the electrocardiogram results in the workers exposed to noise in steel-making and steel rolling workshops of an iron and steel plant. From September to December, 2013, cluster sampling was used to select 3 150 workers exposed to noise in the steel-making and steel-rolling workshops of an iron and steel plant, and a questionnaire survey and physical examinations were performed. The number of valid workers was 2 915, consisting of 1 606 workers in the steel-rolling workshop and 1 309 in the steel-making workshop. The electrocardiogram results of the workers in steel-making and steel-rolling workshops were analyzed. The overall abnormal rate of electrocardiogram was 26.35%, and the workers in the steel-making workshop had a significantly higher abnormal rate of electrocardiogram than those in the steel-rolling workshop(32.24% vs 21.54%, Pelectrocardiogram than female workers(27.59% vs 18.61%, Pelectrocardiogram than those who did not drink(28.17% vs 23.75%, Pelectrocardiogram than those who were not exposed to high temperature(29.43% vs 20.14%, Pelectrocardiogram in the workers with cumulative noise exposure levels of electrocardiogram results. High cumulative noise exposure, alcohol consumption, and high temperature may affect the abnormal rate of electrocardiogram in the workers exposed to noise in steel-making and steel-rolling workshops.

  1. Resting-state EEG, impulsiveness, and personality in daily and nondaily smokers.

    Science.gov (United States)

    Rass, Olga; Ahn, Woo-Young; O'Donnell, Brian F

    2016-01-01

    Resting EEG is sensitive to transient, acute effects of nicotine administration and abstinence, but the chronic effects of smoking on EEG are poorly characterized. This study measures the resting EEG profile of chronic smokers in a non-deprived, non-peak state to test whether differences in smoking behavior and personality traits affect pharmaco-EEG response. Resting EEG, impulsiveness, and personality measures were collected from daily smokers (n=22), nondaily smokers (n=31), and non-smokers (n=30). Daily smokers had reduced resting delta and alpha EEG power and higher impulsiveness (Barratt Impulsiveness Scale) compared to nondaily smokers and non-smokers. Both daily and nondaily smokers discounted delayed rewards more steeply, reported lower conscientiousness (NEO-FFI), and reported greater disinhibition and experience seeking (Sensation Seeking Scale) than non-smokers. Nondaily smokers reported greater sensory hedonia than nonsmokers. Altered resting EEG power in daily smokers demonstrates differences in neural signaling that correlated with greater smoking behavior and dependence. Although nondaily smokers share some characteristics with daily smokers that may predict smoking initiation and maintenance, they differ on measures of impulsiveness and resting EEG power. Resting EEG in non-deprived chronic smokers provides a standard for comparison to peak and trough nicotine states and may serve as a biomarker for nicotine dependence, relapse risk, and recovery. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Resting-state EEG, Impulsiveness, and Personality in Daily and Nondaily Smokers†

    Science.gov (United States)

    Rass, Olga; Ahn, Woo-Young; O’Donnell, Brian F.

    2015-01-01

    Objectives Resting EEG is sensitive to transient, acute effects of nicotine administration and abstinence, but the chronic effects smoking on EEG are poorly characterized. This study measures the resting EEG profile of chronic smokers in a non-deprived, non-peak state to test whether differences in smoking behavior and personality traits affect pharmaco-EEG response. Methods Resting EEG, impulsiveness, and personality measures were collected from daily smokers (n=22), nondaily smokers (n=31), and non-smokers (n=30). Results Daily smokers had reduced resting delta and alpha EEG power and higher impulsiveness (Barratt Impulsiveness Scale) compared to nondaily smokers and non-smokers. Both daily and nondaily smokers discounted delayed rewards more steeply, reported lower conscientiousness (NEO-FFI) and reported greater disinhibition and experience seeking (Sensation Seeking Scale) than non-smokers. Nondaily smokers reported greater sensory hedonia than nonsmokers. Conclusions Altered resting EEG power in daily smokers demonstrates differences in neural signaling that correlated with greater smoking behavior and dependence. Although nondaily smokers share some characteristics with daily smokers that may predict smoking initiation and maintenance, they differ on measures of impulsiveness and resting EEG power. Significance Resting EEG in non-deprived chronic smokers provides a standard for comparison to peak and trough nicotine states and may serve as a biomarker for nicotine dependence, relapse risk, and recovery. PMID:26051750

  3. Dose and effect of inhaled ozone in resting versus exercising human subjects: comparison with resting rats

    Science.gov (United States)

    Dose and effect of inhaled ozone in resting versus exercising human subjects: comparison with resting rats Authors: Gary E. Hatch, John McKee, James Brown, Bill McDonnell, Elston Seal, Joleen Soukup, Ralph Slade, Kay Crissman and Robert Devlin, National Health and Environmental...

  4. Exercise countermeasures for bed-rest deconditioning

    Science.gov (United States)

    Greenleaf, John (Editor)

    1993-01-01

    The purpose for this 30-day bed rest study was to investigate the effects of short-term, high intensity isotonic and isokinetic exercise training on maintenance of working capacity (peak oxygen uptake), muscular strength and endurance, and on orthostatic tolerance, posture and gait. Other data were collected on muscle atrophy, bone mineralization and density, endocrine analyses concerning vasoactivity and fluid-electrolyte balance, muscle intermediary metabolism, and on performance and mood of the subjects. It was concluded that: The subjects maintained a relatively stable mood, high morale, and high esprit de corps throughout the study. Performance improved in nearly all tests in almost all the subjects. Isotonic training, as opposed to isokinetic exercise training, was associated more with decreasing levels of psychological tension, concentration, and motivation; and improvement in the quality of sleep. Working capacity (peak oxygen uptake) was maintained during bed rest with isotonic exercise training; it was not maintained with isokinetic or no exercise training. In general, there was no significant decrease in strength or endurance of arm or leg muscles during bed rest, in spite of some reduction in muscle size (atrophy) of some leg muscles. There was no effect of isotonic exercise training on orthostasis, since tilt-table tolerance was reduced similarly in all three groups following bed rest. Bed rest resulted in significant decreases of postural stability and self-selected step length, stride length, and walking velocity, which were not influenced by either exercise training regimen. Most pre-bed rest responses were restored by the fourth day of recovery.

  5. REST in practice Hypermedia and systems architecture

    CERN Document Server

    Webber, Jim; Robinson, Ian

    2010-01-01

    Why don't typical enterprise projects go as smoothly as projects you develop for the Web? Does the REST architectural style really present a viable alternative for building distributed systems and enterprise-class applications? In this insightful book, three SOA experts provide a down-to-earth explanation of REST and demonstrate how you can develop simple and elegant distributed hypermedia systems by applying the Web's guiding principles to common enterprise computing problems. You'll learn techniques for implementing specific Web technologies and patterns to solve the needs of a typical com

  6. Signal quality indices and data fusion for determining clinical acceptability of electrocardiograms

    International Nuclear Information System (INIS)

    Clifford, G D; Behar, J; Li, Q; Rezek, I

    2012-01-01

    A completely automated algorithm to detect poor-quality electrocardiograms (ECGs) is described. The algorithm is based on both novel and previously published signal quality metrics, originally designed for intensive care monitoring. The algorithms have been adapted for use on short (5–10 s) single- and multi-lead ECGs. The metrics quantify spectral energy distribution, higher order moments and inter-channel and inter-algorithm agreement. Seven metrics were calculated for each channel (84 features in all) and presented to either a multi-layer perceptron artificial neural network or a support vector machine (SVM) for training on a multiple-annotator labelled and adjudicated training dataset. A single-lead version of the algorithm was also developed in a similar manner. Data were drawn from the PhysioNet Challenge 2011 dataset where binary labels were available, on 1500 12-lead ECGs indicating whether the entire recording was acceptable or unacceptable for clinical interpretation. We re-annotated all the leads in both the training set (1000 labelled ECGs) and test dataset (500 12-lead ECGs where labels were not publicly available) using two independent annotators, and a third for adjudication of differences. We found that low-quality data accounted for only 16% of the ECG leads. To balance the classes (between high and low quality), we created extra noisy data samples by adding noise from PhysioNet’s noise stress test database to some of the clean 12-lead ECGs. No data were shared between training and test sets. A classification accuracy of 98% on the training data and 97% on the test data were achieved. Upon inspection, incorrectly classified data were found to be borderline cases which could be classified either way. If these cases were more consistently labelled, we expect our approach to achieve an accuracy closer to 100%. (paper)

  7. Exercise tolerance test in patients presenting with chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Sharieff, S.; Khan, Shah-e-Zaman

    2002-01-01

    Objective: To report the prevalence of abnormal exercise tolerance test (ETT) responses and to assess the risk factors for ischemic heart disease (IHD) in a population referred for the evaluation of chest pain with a normal baseline electrocardiogram (ECG). Design: A prospective study. The study was conducted at the National Institute of cardiovascular Diseases (NICVD), Karachi, Pakistan between 1st January 2000 and 31 December 2000. Subjects and Methods: One thousand one hundred and twenty-seven consecutive adult patients presenting in the outpatient department (OPD) with history of chest pain and having a normal baseline ECG were the subjects of the study after excluding patients with indeterminate or inconclusive test response. All these subjects underwent ETT and were screened for risk factor for IHD. Results: Of the patients studied 56.6% had abnormal ETT response. Male to female ratio of all patients was 4.85:1 Overall mean age was 50.3 +- 8.8 years. 65.9% of diabetic patients had ETT Suggestive of silent myocardial ischemia (p=0.012). Age > 50 year (p= <0.0001), male sex (p=0.015), diabetes mellitus (p=0.0033) and positive family history of IHD (p=0.0014) were the risk factor found in patient with abnormal ETT response. Conclusion: Age of more than 50 years, male gender, diabetes mellitus and positive family history of IHD are the significant risk factors for the development of ischemic heart disease in our population. Silent myocardial ischemic is common in diabetics. (author)

  8. Pediatric 320-row cardiac computed tomography using electrocardiogram-gated model-based full iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Shirota, Go; Maeda, Eriko; Namiki, Yoko; Bari, Razibul; Abe, Osamu [The University of Tokyo, Department of Radiology, Graduate School of Medicine, Tokyo (Japan); Ino, Kenji [The University of Tokyo Hospital, Imaging Center, Tokyo (Japan); Torigoe, Rumiko [Toshiba Medical Systems, Tokyo (Japan)

    2017-10-15

    Full iterative reconstruction algorithm is available, but its diagnostic quality in pediatric cardiac CT is unknown. To compare the imaging quality of two algorithms, full and hybrid iterative reconstruction, in pediatric cardiac CT. We included 49 children with congenital cardiac anomalies who underwent cardiac CT. We compared quality of images reconstructed using the two algorithms (full and hybrid iterative reconstruction) based on a 3-point scale for the delineation of the following anatomical structures: atrial septum, ventricular septum, right atrium, right ventricle, left atrium, left ventricle, main pulmonary artery, ascending aorta, aortic arch including the patent ductus arteriosus, descending aorta, right coronary artery and left main trunk. We evaluated beam-hardening artifacts from contrast-enhancement material using a 3-point scale, and we evaluated the overall image quality using a 5-point scale. We also compared image noise, signal-to-noise ratio and contrast-to-noise ratio between the algorithms. The overall image quality was significantly higher with full iterative reconstruction than with hybrid iterative reconstruction (3.67±0.79 vs. 3.31±0.89, P=0.0072). The evaluation scores for most of the gross structures were higher with full iterative reconstruction than with hybrid iterative reconstruction. There was no significant difference between full and hybrid iterative reconstruction for the presence of beam-hardening artifacts. Image noise was significantly lower in full iterative reconstruction, while signal-to-noise ratio and contrast-to-noise ratio were significantly higher in full iterative reconstruction. The diagnostic quality was superior in images with cardiac CT reconstructed with electrocardiogram-gated full iterative reconstruction. (orig.)

  9. A gender-based analysis of high school athletes using computerized electrocardiogram measurements.

    Directory of Open Access Journals (Sweden)

    Nikhil Kumar

    Full Text Available BACKGROUND: The addition of the ECG to the preparticipation examination (PPE of high school athletes has been a topic for debate. Defining the difference between the high school male and female ECG is crucial to help initiate its implementation in the High School PPE. Establishing the different parameters set for the male and female ECG would help to reduce false positives. We examined the effect of gender on the high school athlete ECG by obtaining and analyzing ECG measurements of high school athletes from Henry M. Gunn High School. METHODS: In 2011 and 2012, computerized Electrocardiograms were recorded and analyzed on 181 athletes (52.5% male; mean age 16.1 ± 1.1 years who participated in 17 different sports. ECG statistics included intervals and durations in all 3 axes (X, Y, Z to calculate 12 lead voltage sums, QRS Amplitude, QT interval, QRS Duration, and the sum of the R wave in V5 and the S Wave in V2 (RS Sum. RESULTS: By computer analysis, we demonstrated that male athletes had significantly greater QRS duration, Q-wave duration, and T wave amplitude. (P<0.05. By contrast, female athletes had a significantly greater QTc interval. (P<0.05. CONCLUSION: The differences in ECG measurements in high school athletes are strongly associated with gender. However, body size does not correlate with the aforementioned ECG measurements. Our tables of the gender-specific parameters can help facilitate the development of a more large scale and in-depth ECG analysis for screening high school athletes in the future.

  10. Ameliorative Effect of Vitamin E on Electrocardiogram of Rabbits Exposed to Cadmium Chloride

    Directory of Open Access Journals (Sweden)

    Baraa Najim Al-Okaily

    2013-02-01

    Full Text Available This study was designed to study the effect of cadmium as an oxidant agent on electrocardiogram(ECG component and the possible preventive role of vitamin E on deleterious effects of cadmium in adult male rabbits. Twenty adult male rabbits were divided randomly into 4 equal groups (5 animals /group and treated daily for 84 days. The first group were received ordinary tap water and serve as control (C; the second group (T1 received ad libitum supply of drinking water containing (50ppb cadmium chloride; the third group T2 received (50ppb of cadmium chloride in drinking water, in addition to intubation of vitamin E (40mg/Kg B.W. orally, while the fourth group (T3 were intubated daily with 40mg/Kg B.W of vitamin E. Fasting blood samples were collected at 0, 21, 42, 63 and 84 days of the experiment to determine serum calcium concentration . The ECG was also recorded in all groups at the same interval of the experiment. The results revealed that administration of 50 ppb CdCl2 in drinking water (T1 group for 84 days caused a significant decrease(p0.05 differences in this parameter as compared to control and other groups. Analysis of ECG in Cadmium treated group (T1 showed significant (p0.05 differences in ECG waves analysis. In conclusion, Cadmium effect on electrical conduction of heart was represented by abnormality in some of ECG component as well as the protective role of vitamin E as antioxidant in the cardiovascular system was also confirmed.

  11. Detection of premature ventricular contractions on a ventricular electrocardiogram for patients with left ventricular assist devices.

    Science.gov (United States)

    Park, Sung Min; Lee, Jin Hong; Choi, Seong Wook

    2014-12-01

    The ventricular electrocardiogram (v-ECG) was developed for long-term monitoring of heartbeats in patients with a left ventricular assist device (LVAD) and does not normally have the functionality necessary to detect additional heart irregularities that can progress to critical arrhythmias. Although the v-ECG has the benefits of physiological optimization and counterpulsation control, when abnormal heartbeats occur, the v-ECG does not show the distinct abnormal waveform that enables easy detection of an abnormal heartbeat among normal heartbeats on the conventional ECG. In this study, the v-ECGs of normal and abnormal heartbeats are compared with each other with respect to peak-to-peak voltage, area, and maximal slopes, and a new method to detect abnormal heartbeats is suggested. In a series of animal experiments with three porcine models (Yorkshire pigs weighing 30-40 kg), a v-ECG and conventional ECG were taken simultaneously during LVAD perfusion. Clinical experts found 104 abnormal heartbeats from the saved conventional ECG data and confirmed that the other 3159 heartbeats were normal. Almost all of the abnormal heartbeats were premature ventricular contractions (PVCs), and there was short-term tachycardia for 3 s. A personal computer was used to automatically detect abnormal heartbeats with the v-ECG according to the new method, and its results were compared with the clinicians' results. The new method found abnormal heartbeats with 90% accuracy, and less than 15% of the total PVCs were missed. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  12. Left ventricular hypertrophy: The relationship between the electrocardiogram and cardiovascular magnetic resonance imaging.

    Science.gov (United States)

    Bacharova, Ljuba; Ugander, Martin

    2014-11-01

    Conventional assessment of left ventricular hypertrophy (LVH) using the electrocardiogram (ECG), for example, by the Sokolow-Lyon, Romhilt-Estes or Cornell criteria, have relied on assessing changes in the amplitude and/or duration of the QRS complex of the ECG to quantify LV mass. ECG measures of LV mass have typically been validated by imaging with echocardiography or cardiovascular magnetic resonance imaging (CMR). However, LVH can be the result of diverse etiologies, and LVH is also characterized by pathological changes in myocardial tissue characteristics on the genetic, molecular, cellular, and tissue level beyond a pure increase in the number of otherwise normal cardiomyocytes. For example, slowed conduction velocity through the myocardium, which can be due to diffuse myocardial fibrosis, has been shown to be an important determinant of conventional ECG LVH criteria regardless of LV mass. Myocardial tissue characterization by CMR has emerged to not only quantify LV mass, but also detect and quantify the extent and severity of focal or diffuse myocardial fibrosis, edema, inflammation, myocarditis, fatty replacement, myocardial disarray, and myocardial deposition of amyloid proteins (amyloidosis), glycolipids (Fabry disease), or iron (siderosis). This can be undertaken using CMR techniques including late gadolinium enhancement (LGE), T1 mapping, T2 mapping, T2* mapping, extracellular volume fraction (ECV) mapping, fat/water-weighted imaging, and diffusion tensor CMR. This review presents an overview of current and emerging concepts regarding the diagnostic possibilities of both ECG and CMR for LVH in an attempt to narrow gaps in our knowledge regarding the ECG diagnosis of LVH. © 2014 Wiley Periodicals, Inc.

  13. Pediatric 320-row cardiac computed tomography using electrocardiogram-gated model-based full iterative reconstruction

    International Nuclear Information System (INIS)

    Shirota, Go; Maeda, Eriko; Namiki, Yoko; Bari, Razibul; Abe, Osamu; Ino, Kenji; Torigoe, Rumiko

    2017-01-01

    Full iterative reconstruction algorithm is available, but its diagnostic quality in pediatric cardiac CT is unknown. To compare the imaging quality of two algorithms, full and hybrid iterative reconstruction, in pediatric cardiac CT. We included 49 children with congenital cardiac anomalies who underwent cardiac CT. We compared quality of images reconstructed using the two algorithms (full and hybrid iterative reconstruction) based on a 3-point scale for the delineation of the following anatomical structures: atrial septum, ventricular septum, right atrium, right ventricle, left atrium, left ventricle, main pulmonary artery, ascending aorta, aortic arch including the patent ductus arteriosus, descending aorta, right coronary artery and left main trunk. We evaluated beam-hardening artifacts from contrast-enhancement material using a 3-point scale, and we evaluated the overall image quality using a 5-point scale. We also compared image noise, signal-to-noise ratio and contrast-to-noise ratio between the algorithms. The overall image quality was significantly higher with full iterative reconstruction than with hybrid iterative reconstruction (3.67±0.79 vs. 3.31±0.89, P=0.0072). The evaluation scores for most of the gross structures were higher with full iterative reconstruction than with hybrid iterative reconstruction. There was no significant difference between full and hybrid iterative reconstruction for the presence of beam-hardening artifacts. Image noise was significantly lower in full iterative reconstruction, while signal-to-noise ratio and contrast-to-noise ratio were significantly higher in full iterative reconstruction. The diagnostic quality was superior in images with cardiac CT reconstructed with electrocardiogram-gated full iterative reconstruction. (orig.)

  14. Computerized analysis of the 12-lead electrocardiogram to identify epicardial ventricular tachycardia exit sites.

    Science.gov (United States)

    Yokokawa, Miki; Jung, Dae Yon; Joseph, Kim K; Hero, Alfred O; Morady, Fred; Bogun, Frank

    2014-11-01

    Twelve-lead electrocardiogram (ECG) criteria for epicardial ventricular tachycardia (VT) origins have been described. In patients with structural heart disease, the ability to predict an epicardial origin based on QRS morphology is limited and has been investigated only for limited regions in the heart. The purpose of this study was to determine whether a computerized algorithm is able to accurately differentiate epicardial vs endocardial origins of ventricular arrhythmias. Endocardial and epicardial pace-mapping were performed in 43 patients at 3277 sites. The 12-lead ECGs were digitized and analyzed using a mixture of gaussian model (MoG) to assess whether the algorithm was able to identify an epicardial vs endocardial origin of the paced rhythm. The MoG computerized algorithm was compared to algorithms published in prior reports. The computerized algorithm correctly differentiated epicardial vs endocardial pacing sites for 80% of the sites compared to an accuracy of 42% to 66% of other described criteria. The accuracy was higher in patients without structural heart disease than in those with structural heart disease (94% vs 80%, P = .0004) and for right bundle branch block (82%) compared to left bundle branch block morphologies (79%, P = .001). Validation studies showed the accuracy for VT exit sites to be 84%. A computerized algorithm was able to accurately differentiate the majority of epicardial vs endocardial pace-mapping sites. The algorithm is not region specific and performed best in patients without structural heart disease and with VTs having a right bundle branch block morphology. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  15. The value of the 12-lead electrocardiogram in localizing the scar in non-ischaemic cardiomyopathy.

    Science.gov (United States)

    Oloriz, Teresa; Wellens, Hein J J; Santagostino, Giulia; Trevisi, Nicola; Silberbauer, John; Peretto, Giovanni; Maccabelli, Giuseppe; Della Bella, Paolo

    2016-12-01

    Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized as anteroseptal (AS) or inferolateral (IL) scar sub-types based on imaging and voltage mapping studies. The aim of this study was to correlate the baseline electrocardiogram (ECG) with endo-epicardial voltage maps created during ablation procedures and identify the ECG characteristics that may help to distinguish the scar as AS or IL. We assessed 108 baseline ECGs; 72 patients fulfilled criteria for dilated cardiomyopathy whereas 36 showed minimal structural abnormalities. Based on the unipolar low-voltage distribution, the scar pattern was classified as predominantly AS (n = 59) or IL (n = 49). Three ECG criteria (PR interval 230 ms or QRS > 170 ms or an r ≤ 0.3 mV in V3 having 92 and 81% of sensitivity and specificity, respectively, in predicting AS scar pattern. A significant negative correlation was found between the extension of the endocardial unipolar low voltage area and left ventricular EF (r s = -0.719, P < 0.001). The extent of endocardial AS unipolar low voltage was correlated with PR interval and QRS duration (r s = 0.583 and r s = 0.680, P < 0.001, respectively) and the IL epicardial unipolar low voltage with the mean voltage of the limb leads (r s = -0.639, P < 0.001). Baseline ECG features are well correlated with the distribution of unipolar voltage abnormalities in NICM and may help to predict the location of scar in this population. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  16. Digitization of Electrocardiogram From Telemetry Prior to In-hospital Cardiac Arrest: A Pilot Study.

    Science.gov (United States)

    Attin, Mina; Wang, Lu; Soroushmehr, S M Reza; Lin, Chii-Dean; Lemus, Hector; Spadafore, Maxwell; Najarian, Kayvan

    2016-03-01

    Analyzing telemetry electrocardiogram (ECG) data over an extended period is often time-consuming because digital records are not widely available at hospitals. Investigating trends and patterns in the ECG data could lead to establishing predictors that would shorten response time to in-hospital cardiac arrest (I-HCA). This study was conducted to validate a novel method of digitizing paper ECG tracings from telemetry systems in order to facilitate the use of heart rate as a diagnostic feature prior to I-HCA. This multicenter study used telemetry to investigate full-disclosure ECG papers of 44 cardiovascular patients obtained within 1 hr of I-HCA with initial rhythms of pulseless electrical activity and asystole. Digital ECGs were available for seven of these patients. An algorithm to digitize the full-disclosure ECG papers was developed using the shortest path method. The heart rate was measured manually (averaging R-R intervals) for ECG papers and automatically for digitized and digital ECGs. Significant correlations were found between manual and automated measurements of digitized ECGs (p < .001) and between digitized and digital ECGs (p < .001). Bland-Altman methods showed bias = .001 s, SD = .0276 s, lower and upper 95% limits of agreement for digitized and digital ECGs = .055 and -.053 s, and percentage error = 0.22%. Root mean square (rms), percentage rms difference, and signal to noise ratio values were in acceptable ranges. The digitization method was validated. Digitized ECG provides an efficient and accurate way of measuring heart rate over an extended period of time. © The Author(s) 2015.

  17. Features of electrocardiogram in patients with stenosis of the proximal right coronary artery.

    Science.gov (United States)

    Koh, Moo Seong; Lee, Jae Hoon; Jeong, Jin Woo; Chung, Jun Young

    2017-03-01

    Prediction of lesions of the proximal right coronary artery (pRCA) through electrocardiogram (ECG) is very important because pRCA occlusion has many complications and a high mortality rate, which has frequently been related with right ventricular infarction. The purpose of this study was to devise a screening tool that takes into account multiple leads from a 12-lead ECG to predict the pRCA lesion. A hundred and fifty-eight patients who were diagnosed as acute coronary syndrome and had a pure lesion of RCA or left circumf lex artery (LCX) by ECGs and angiographic findings were enrolled retrospectively. Forty-eight patients with a pure pRCA occlusion were compared to a control group of 110 patients who were diagnosed as having either a pure mid to distal RCA lesion (57 patients) or a pure LCX lesion (53 patients). ECGs of patients in the pRCA group showed more prominent ST depression in lead I ( p = 0.001) and ST elevation in V1 ( p = 0.002) than in the control group. The combination of ST depression (≤ 0 mm) in I and ST elevation (> 0.5 mm) in V1 was the best diagnostic tool (area under the curve, 0.84). ST changes in leads V1 and I allow more accurate prediction of pRCA occlusion than other criteria, such as the difference between ST elevation of leads II and III or vector direction and amplitude. These variables could help to screen for right ventricular infarction before performing reverse ECG and predicting prognosis.

  18. Property of electrocardiogram gated single photon emission tomography by 99mTc-methoxy isobutyl isonitrile

    International Nuclear Information System (INIS)

    Imai, Kamon; Nishio, Yukari; Araki, Yasushi; Saito, Satoshi; Ozawa, Yukio; Yasugi, Tadao; Hagiwara, Kazuo; Kamata, Rikisaburo

    1992-01-01

    99m Tc-methoxy isobutyl isonitrile (MIBI) is a new developed myocardial perfusion imaging agent. Because this compound has higher photon energy than thallium (Tl), electrocardiogram gated single photon emission tomography (SPECT): end-diastolic (ED) and end-systolic (ES) short axis (SA) images could be taken. To investigate property of gated MIBI SPECT, MIBI myocardial scintigraphy, Tl scintigraphy (TMS) and analysis of left ventricular wall motion were performed in 6 patients with myocardial infarction. Left ventricule was divided into 8 segments. Perfusion defect (PD) was scored: '0' (normal), '1' (hypo-perfusion), '2' (defect). Wall motion abnormality (WMA) was also scored: '0' (normo-kinesis), '1' (hypo-kinesis), '2' (a-, dys-kinesis). Severity and extent of PD and WMA were calculated. Severity of WMA was 3.0±2.0 (M±SD), severity of PD was 3.3±1.7 in TMS, 3.7±1.3 in no-gated MIBI, 5.0±0.6 in ES-MIBI, 7.3±2.0 in ED-MIBI. Extent of WMA was 2.3±1.0. Extent of PD was 2.5±1.3 in TMS, 3.0±1.6 in no-gated MIBI, 3.5±0.8 in ES-MIBI, 4.8±1.0 in ED-MIBI. Compared with wall motion abnormality, severity and extent of PD in ED-MIBI was larger. From our data, it is concluded that perfusion defect in ED-MIBI was overestimated significantly. When we evaluate gated MIBI image, we must consider this property. (author)

  19. Effect of electrocardiogram interference on cortico-cortical connectivity analysis and a possible solution.

    Science.gov (United States)

    Govindan, R B; Kota, Srinivas; Al-Shargabi, Tareq; Massaro, An N; Chang, Taeun; du Plessis, Adre

    2016-09-01

    Electroencephalogram (EEG) signals are often contaminated by the electrocardiogram (ECG) interference, which affects quantitative characterization of EEG. We propose null-coherence, a frequency-based approach, to attenuate the ECG interference in EEG using simultaneously recorded ECG as a reference signal. After validating the proposed approach using numerically simulated data, we apply this approach to EEG recorded from six newborns receiving therapeutic hypothermia for neonatal encephalopathy. We compare our approach with an independent component analysis (ICA), a previously proposed approach to attenuate ECG artifacts in the EEG signal. The power spectrum and the cortico-cortical connectivity of the ECG attenuated EEG was compared against the power spectrum and the cortico-cortical connectivity of the raw EEG. The null-coherence approach attenuated the ECG contamination without leaving any residual of the ECG in the EEG. We show that the null-coherence approach performs better than ICA in attenuating the ECG contamination without enhancing cortico-cortical connectivity. Our analysis suggests that using ICA to remove ECG contamination from the EEG suffers from redistribution problems, whereas the null-coherence approach does not. We show that both the null-coherence and ICA approaches attenuate the ECG contamination. However, the EEG obtained after ICA cleaning displayed higher cortico-cortical connectivity compared with that obtained using the null-coherence approach. This suggests that null-coherence is superior to ICA in attenuating the ECG interference in EEG for cortico-cortical connectivity analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Use of concept maps to promote electrocardiogram diagnosis learning in undergraduate medical students

    Science.gov (United States)

    Dong, Ruimin; Yang, Xiaoyan; Xing, Bangrong; Zou, Zihao; Zheng, Zhenda; Xie, Xujing; Zhu, Jieming; Chen, Lin; Zhou, Hanjian

    2015-01-01

    Concept mapping is an effective method in teaching and learning, however this strategy has not been evaluated among electrocardiogram (ECG) diagnosis learning. This study explored the use of concept maps to assist ECG study, and sought to analyze whether this method could improve undergraduate students’ ECG interpretation skills. There were 126 undergraduate medical students who were randomly selected and assigned to two groups, group A (n = 63) and group B (n = 63). Group A was taught to use concept maps to learn ECG diagnosis, while group B was taught by traditional methods. After the course, all of the students were assessed by having an ECG diagnostic test. Quantitative data which comprised test score and ECG features completion index was compared by using the unpaired Student’s t-test between the two groups. Further, a feedback questionnaire on concept maps used was also completed by group A, comments were evaluated by a five-point Likert scale. The test scores of ECGs interpretation was 7.36 ± 1.23 in Group A and 6.12 ± 1.39 in Group B. A significant advantage (P = 0.018) of concept maps was observed in ECG interpretation accuracy. No difference in the average ECG features completion index was observed between Group A (66.75 ± 15.35%) and Group B (62.93 ± 13.17%). According qualitative analysis, majority of students accepted concept maps as a helpful tool. Difficult to learn at the beginning and time consuming are the two problems in using this method, nevertheless most of the students indicated to continue using it. Concept maps could be a useful pedagogical tool in enhancing undergraduate medical students’ ECG interpretation skills. Furthermore, students indicated a positive attitude to it, and perceived it as a resource for learning. PMID:26221331

  1. E-learning and near-peer teaching in electrocardiogram education: a randomised trial.

    Science.gov (United States)

    Davies, Andrew; Macleod, Rachael; Bennett-Britton, Ian; McElnay, Philip; Bakhbakhi, Danya; Sansom, Jane

    2016-06-01

    Near-peer teaching and electronic learning (e-learning) are two effective modern teaching styles. Near-peer sessions provide a supportive learning environment that benefits both the students and the tutor. E-learning resources are flexible and easily distributed. Careful construction and regular editing can ensure that students receive all of the essential material. The aim of this study is to compare the efficacy of e-learning and near-peer teaching during the pre-clinical medical curriculum. Thirty-nine second-year medical students were consented and randomised into two groups. Each group received teaching on electrocardiogram (ECG) interpretation from a predefined syllabus. Eighteen students completed an e-learning module and 21 students attended a near-peer tutorial. Students were asked to complete a multiple-choice exam, scored out of 50. Each student rated their confidence in ECG interpretation before and after their allocated teaching session. The near-peer group (84%) demonstrated a significantly higher performance than the e-learning group (74.5%) on the final assessment (p = 0.002). Prior to the teaching, the students' mean confidence scores were 3/10 in both the near-peer and e-learning groups (0, poor; 10, excellent). These increased to 6/10 in both cases following the teaching session. Both teaching styles were well received by students and improved their confidence in ECG interpretation. Near-peer teaching led to superior scores in our final assessment. Given the congested nature of the modern medical curriculum, direct comparison of the efficacy of these methods may aid course design. The aim of this study is to compare the efficacy of e-learning and near-peer teaching. © 2015 John Wiley & Sons Ltd.

  2. A Combined Linkage and Exome Sequencing Analysis for Electrocardiogram Parameters in the Erasmus Rucphen Family Study.

    Science.gov (United States)

    Silva, Claudia T; Zorkoltseva, Irina V; Amin, Najaf; Demirkan, Ayşe; van Leeuwen, Elisabeth M; Kors, Jan A; van den Berg, Marten; Stricker, Bruno H; Uitterlinden, André G; Kirichenko, Anatoly V; Witteman, Jacqueline C M; Willemsen, Rob; Oostra, Ben A; Axenovich, Tatiana I; van Duijn, Cornelia M; Isaacs, Aaron

    2016-01-01

    Electrocardiogram (ECG) measurements play a key role in the diagnosis and prediction of cardiac arrhythmias and sudden cardiac death. ECG parameters, such as the PR, QRS, and QT intervals, are known to be heritable and genome-wide association studies of these phenotypes have been successful in identifying common variants; however, a large proportion of the genetic variability of these traits remains to be elucidated. The aim of this study was to discover loci potentially harboring rare variants utilizing variance component linkage analysis in 1547 individuals from a large family-based study, the Erasmus Rucphen Family Study (ERF). Linked regions were further explored using exome sequencing. Five suggestive linkage peaks were identified: two for QT interval (1q24, LOD = 2.63; 2q34, LOD = 2.05), one for QRS interval (1p35, LOD = 2.52) and two for PR interval (9p22, LOD = 2.20; 14q11, LOD = 2.29). Fine-mapping using exome sequence data identified a C > G missense variant (c.713C > G, p.Ser238Cys) in the FCRL2 gene associated with QT (rs74608430; P = 2.8 × 10 -4 , minor allele frequency = 0.019). Heritability analysis demonstrated that the SNP explained 2.42% of the trait's genetic variability in ERF ( P = 0.02). Pathway analysis suggested that the gene is involved in cytosolic Ca 2+ levels ( P = 3.3 × 10 -3 ) and AMPK stimulated fatty acid oxidation in muscle ( P = 4.1 × 10 -3 ). Look-ups in bioinformatics resources showed that expression of FCRL2 is associated with ARHGAP24 and SETBP1 expression. This finding was not replicated in the Rotterdam study. Combining the bioinformatics information with the association and linkage analyses, FCRL2 emerges as a strong candidate gene for QT interval.

  3. Accuracy of remote electrocardiogram interpretation with the use of Google Glass technology.

    Science.gov (United States)

    Jeroudi, Omar M; Christakopoulos, George; Christopoulos, George; Kotsia, Anna; Kypreos, Megan A; Rangan, Bavana V; Banerjee, Subhash; Brilakis, Emmanouil S

    2015-02-01

    We sought to investigate the accuracy of remote electrocardiogram (ECG) interpretation using Google Glass (Google, Mountain View, California). Google Glass is an optical head mounted display device with growing applications in medicine. We compared interpretation of 10 ECGs with 21 clinically important findings by faculty and fellow cardiologists by (1) viewing the electrocardiographic image at the Google Glass screen; (2) viewing a photograph of the ECG taken using Google Glass and interpreted on a mobile device; (3) viewing the original paper ECG; and (4) viewing a photograph of the ECG taken with a high-resolution camera and interpreted on a mobile device. One point was given for identification of each correct finding. Subjective rating of the user experience was also recorded. Twelve physicians (4 faculty and 8 fellow cardiologists) participated. The average electrocardiographic interpretation score (maximum 21 points) as viewed through the Google Glass, Google Glass photograph on a mobile device, on paper, and high-resolution photograph on a mobile device was 13.5 ± 1.8, 16.1 ± 2.6, 18.3 ± 1.7, and 18.6 ± 1.5, respectively (p = 0.0005 between Google Glass and mobile device, p = 0.0005 between Google Glass and paper, and p = 0.002 between mobile device and paper). Of the 12 physicians, 9 (75%) were dissatisfied with ECGs viewing on the prism display of Google Glass. In conclusion, further improvements are needed before Google Glass can be reliably used for remote electrocardiographic analysis. Published by Elsevier Inc.

  4. New ideas for teaching electrocardiogram interpretation and improving classroom teaching content.

    Science.gov (United States)

    Zeng, Rui; Yue, Rong-Zheng; Tan, Chun-Yu; Wang, Qin; Kuang, Pu; Tian, Pan-Wen; Zuo, Chuan

    2015-01-01

    Interpreting an electrocardiogram (ECG) is not only one of the most important parts of diagnostics but also one of the most difficult areas to teach. Owing to the abstract nature of the basic theoretical knowledge of the ECG, its scattered characteristics, and tedious and difficult-to-remember subject matter, teaching how to interpret ECGs is as difficult for teachers to teach as it is for students to learn. In order to enable medical students to master basic knowledge of ECG interpretation skills in a limited teaching time, we modified the content used for traditional ECG teaching and now propose a new ECG teaching method called the "graphics-sequence memory method." A prospective randomized controlled study was designed to measure the actual effectiveness of ECG learning by students. Two hundred students were randomly placed under a traditional teaching group and an innovative teaching group, with 100 participants in each group. The teachers in the traditional teaching group utilized the traditional teaching outline, whereas the teachers in the innovative teaching group received training in line with the proposed teaching method and syllabus. All the students took an examination in the final semester by analyzing 20 ECGs from real clinical cases and submitted their ECG reports. The average ECG reading time was 32 minutes for the traditional teaching group and 18 minutes for the innovative teaching group. The average ECG accuracy results were 43% for the traditional teaching group and 77% for the innovative teaching group. Learning to accurately interpret ECGs is an important skill in the cardiac discipline, but the ECG's mechanisms are intricate and the content is scattered. Textbooks tend to make the students feel confused owing to the restrictions of the length and the format of the syllabi, apart from many other limitations. The graphics-sequence memory method was found to be a useful method for ECG teaching.

  5. A combined linkage and exome sequencing analysis for electrocardiogram parameters in the Erasmus Rucphen Family study

    Directory of Open Access Journals (Sweden)

    Claudia Tamar Silva

    2016-11-01

    Full Text Available Electrocardiogram (ECG measurements play a key role in the diagnosis and prediction of cardiac arrhythmias and sudden cardiac death. ECG parameters, such as the PR, QRS, and QT intervals, are known to be heritable and genome-wide association studies (GWAS of these phenotypes have been successful in identifying common variants; however, a large proportion of the genetic variability of these traits remains to be elucidated. The aim of this study was to discover loci potentially harboring rare variants utilizing variance component linkage analysis in 1547 individuals from a large family-based study, the Erasmus Rucphen Family Study (ERF. Linked regions were further explored using exome sequencing. Five suggestive linkage peaks were identified: two for QT interval (1q24, LOD = 2.63; 2q34, LOD = 2.05, one for QRS interval (1p35, LOD = 2.52 and two for PR interval (9p22, LOD = 2.20; 14q11, LOD = 2.29. Fine-mapping using exome sequence data identified a C > G missense variant (c.713C>G, p.Ser238Cys in the FCRL2 gene associated with QT (rs74608430; P = 2.8 ×10-4, minor allele frequency = 0.019. Heritability analysis demonstrated that the SNP explained 2.42% of the trait’s genetic variability in ERF (P = 0.02. Pathway analysis suggested that the gene is involved in cytosolic Ca2+ levels (P = 3.3 × 10-3 and AMPK stimulated fatty acid oxidation in muscle (P = 4.1 ×10-3. Look-ups in bioinformatics resources showed that expression of FCRL2 is associated with ARHGAP24 and SETBP1 expression. This finding was not replicated in the Rotterdam study. Combining the bioinformatics information with the association and linkage analyses, FCRL2 emerges as a strong candidate gene for QT interval.

  6. Cardiorespiratory phase synchronization during normal rest and inward-attention meditation.

    Science.gov (United States)

    Wu, Shr-Da; Lo, Pei-Chen

    2010-06-11

    The cardiac and respiratory systems can be viewed as two self-sustained oscillators with various interactions between them. In this study, the cardiorespiratory phase synchronization (CRPS) quantified by synchrogram was investigated to explore the phase synchronization between these two systems. The synchrogram scheme was applied to electrocardiogram (ECG) and respiration signals. Particular focus was the distinct cardiac-respiratory regulation phenomena intervened by inward-attention meditation and normal relaxation. Four synchronization parameters were measured: frequency ratio, lasting length, number of epochs, and total length. The results showed that normal rest resulted in much weaker CRPS. Statistical analysis reveals that the number of synchronous epochs and the total synchronization length significantly increase (p=0.024 and 0.034 respectively) during meditation. Furthermore, a predominance of 4:1 and 5:1 rhythm-ratio synchronizations was observed during meditation. Consequently, this study concludes that CRPS can be enhanced during meditation, compared with normal relaxation, and reveals a predominance of specific frequency ratios. Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.

  7. Comparison of heart rate variability between resting state and external-cuff-inflation-and-deflation state: a pilot study.

    Science.gov (United States)

    Ji, Lizhen; Liu, Chengyu; Li, Peng; Wang, Xinpei; Yan, Chang; Liu, Changchun

    2015-10-01

    Heart rate variability (HRV) has been widely used in clinical research to provide an insight into the autonomic control of the cardiovascular system. Measurement of HRV is generally performed under a relaxed resting state. The effects of other conditions on HRV measurement, such as running, mountaineering, head-up tilt, etc, have also been investigated. This study aimed to explore whether an inflation-and-deflation process applied to a unilateral upper arm cuff would influence the HRV measurement. Fifty healthy young volunteers aged between 21 and 30 were enrolled in this study. Electrocardiogram (ECG) signals were recorded for each subject over a five minute resting state followed by a five minute external-cuff-inflation-and-deflation state (ECID state). A one minute gap was scheduled between the two measurements. Consecutive RR intervals in the ECG were extracted automatically to form the HRV data for each of the two states. Time domain (SDNN, RMSSD and PNN50), frequency domain (LFn, HFn and LF/HF) and nonlinear (VLI, VAI and SampEn) HRV indices were analyzed and compared between the two states. In addition, the effects of mean artery pressure (MAP) and heart rate (HR) on the aforementioned HRV indices were assessed for the two states, respectively, by Pearson correlation analysis. The results showed no significant difference in all aforementioned HRV indices between the resting and the ECID states (all p  >  0.05). The corresponding HRV indices had significant positive correlation (all p    0.05) for either state. Besides, none of the indices showed HR-related change (all p  >  0.05) for either state except the index of VLI in the resting state. To conclude, this pilot study suggested that the applied ECID process hardly influenced those commonly used HRV indices. It would thus be applicable to simultaneously measure both blood pressure and HRV indices in clinical practice.

  8. 1 SHORT COMMUNICATION Resting behaviour of Anopheles ...

    African Journals Online (AJOL)

    2011-10-04

    Oct 4, 2011 ... Resting behaviour of Anopheles gambiae s.l. and its implication on malaria .... nature) were requested to sleep under the double mosquito net trap (one ... designed from the DNA sequences of the intergenic spacer region of ...

  9. A resting bottom sodium cooled fast reactor

    International Nuclear Information System (INIS)

    Costes, D.

    2012-01-01

    This follows ICAPP 2011 paper 11059 'Fast Reactor with a Cold Bottom Vessel', on sodium cooled reactor vessels in thermal gradient, resting on soil. Sodium is frozen on vessel bottom plate, temperature increasing to the top. The vault cover rests on the safety vessel, the core diagrid welded to a toric collector forms a slab, supported by skirts resting on the bottom plate. Intermediate exchangers and pumps, fixed on the cover, plunge on the collector. At the vessel top, a skirt hanging from the cover plunges into sodium, leaving a thin circular slit partially filled by sodium covered by argon, providing leak-tightness and allowing vessel dilatation, as well as a radial relative holding due to sodium inertia. No 'air conditioning' at 400 deg. C is needed as for hanging vessels, and this allows a large economy. The sodium volume below the slab contains isolating refractory elements, stopping a hypothetical corium flow. The small gas volume around the vessel limits any LOCA. The liner cooling system of the concrete safety vessel may contribute to reactor cooling. The cold resting bottom vessel, proposed by the author for many years, could avoid the complete visual inspection required for hanging vessels. However, a double vessel, containing support skirts, would allow introduction of inspecting devices. Stress limiting thermal gradient is obtained by filling secondary sodium in the intermediate space. (authors)

  10. [Creep of amalgam fillings under clasp rests].

    Science.gov (United States)

    Borchers, L; Jung, T; West, M

    1989-10-01

    A clinically realistic experiment was set up to obtain information on the amount of vertical settling of clasp rests in amalgam restorations under functional loading. Mesioocclusal cavities were prepared in 16 lower molar specimens cast in brass. The cavities were filled with amalgam and provided with a mesial rest seat. A constant load of 100 N was applied via a simplified (experimental) saddle to a cobalt-chromium E-clasp cast to the saddle. The duration of the load corresponded to 160 days of clinical function. The chronological course of vertical displacement was analyzed mathematically. According to this result the process can be divided into three components: settling immediately upon load initiation (mean value 96 microns, transition creep (mean value 25 microns) and creep ata constant rate (mean value 15 microns). The mean overall vertical displacement of the rests was 136 microns, the maximum value 287 microns. These findings suggest that vertical settling of a clasp rest into its seat in an amalgam restoration may eventually result in significant changes in occlusion and may almost completely exhaust gingival resilience.

  11. Cardiac atrophy after bed rest and spaceflight

    Science.gov (United States)

    Perhonen, M. A.; Franco, F.; Lane, L. D.; Buckey, J. C.; Blomqvist, C. G.; Zerwekh, J. E.; Peshock, R. M.; Weatherall, P. T.; Levine, B. D.

    2001-01-01

    Cardiac muscle adapts well to changes in loading conditions. For example, left ventricular (LV) hypertrophy may be induced physiologically (via exercise training) or pathologically (via hypertension or valvular heart disease). If hypertension is treated, LV hypertrophy regresses, suggesting a sensitivity to LV work. However, whether physical inactivity in nonathletic populations causes adaptive changes in LV mass or even frank atrophy is not clear. We exposed previously sedentary men to 6 (n = 5) and 12 (n = 3) wk of horizontal bed rest. LV and right ventricular (RV) mass and end-diastolic volume were measured using cine magnetic resonance imaging (MRI) at 2, 6, and 12 wk of bed rest; five healthy men were also studied before and after at least 6 wk of routine daily activities as controls. In addition, four astronauts were exposed to the complete elimination of hydrostatic gradients during a spaceflight of 10 days. During bed rest, LV mass decreased by 8.0 +/- 2.2% (P = 0.005) after 6 wk with an additional atrophy of 7.6 +/- 2.3% in the subjects who remained in bed for 12 wk; there was no change in LV mass for the control subjects (153.0 +/- 12.2 vs. 153.4 +/- 12.1 g, P = 0.81). Mean wall thickness decreased (4 +/- 2.5%, P = 0.01) after 6 wk of bed rest associated with the decrease in LV mass, suggesting a physiological remodeling with respect to altered load. LV end-diastolic volume decreased by 14 +/- 1.7% (P = 0.002) after 2 wk of bed rest and changed minimally thereafter. After 6 wk of bed rest, RV free wall mass decreased by 10 +/- 2.7% (P = 0.06) and RV end-diastolic volume by 16 +/- 7.9% (P = 0.06). After spaceflight, LV mass decreased by 12 +/- 6.9% (P = 0.07). In conclusion, cardiac atrophy occurs during prolonged (6 wk) horizontal bed rest and may also occur after short-term spaceflight. We suggest that cardiac atrophy is due to a physiological adaptation to reduced myocardial load and work in real or simulated microgravity and demonstrates the plasticity

  12. REST: a toolkit for resting-state functional magnetic resonance imaging data processing.

    Directory of Open Access Journals (Sweden)

    Xiao-Wei Song

    Full Text Available Resting-state fMRI (RS-fMRI has been drawing more and more attention in recent years. However, a publicly available, systematically integrated and easy-to-use tool for RS-fMRI data processing is still lacking. We developed a toolkit for the analysis of RS-fMRI data, namely the RESting-state fMRI data analysis Toolkit (REST. REST was developed in MATLAB with graphical user interface (GUI. After data preprocessing with SPM or AFNI, a few analytic methods can be performed in REST, including functional connectivity analysis based on linear correlation, regional homogeneity, amplitude of low frequency fluctuation (ALFF, and fractional ALFF. A few additional functions were implemented in REST, including a DICOM sorter, linear trend removal, bandpass filtering, time course extraction, regression of covariates, image calculator, statistical analysis, and slice viewer (for result visualization, multiple comparison correction, etc.. REST is an open-source package and is freely available at http://www.restfmri.net.

  13. Exercise electrocardiogram testing in two brothers with different outcome – a case study exercise testing in master cyclists

    Directory of Open Access Journals (Sweden)

    Rüst CA

    2013-06-01

    Full Text Available Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann11Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stress test of the ST segment in V5 and V6 during recovery after complete exhaustion. Coronary angiography revealed a multi vessel coronary artery disease and he underwent bypass surgery. One year later, he successfully completed his planned cycling tour of ~600 km in seven stages and covering ~12,000 m of total ascent. The younger brother aged 59 years went a few months later to the primary care physician and also performed asymptomatic exercise stress testing without changes in the ST segments. Unfortunately, 2 months later he suffered a cardiac arrest during his cycling tour and survived following immediate successful cardiopulmonary resuscitation on the road by his cycling colleagues. Immediate invasive coronary arteriography showed a complete stenosis of the trunk of arteria coronaria sinistra (left coronary artery, a 40%–50% stenosis of ramus circumflexus, and a 20% stenosis of arteria coronaria dextra (right coronary artery. The left coronary artery was dilated and he continued cycling 2 months later. In both brothers, familial hypercholesterolemia was the main cardiovascular risk factor for the multi vessel coronary artery disease. A negative exercise electrocardiogram in siblings with an increased risk for coronary artery disease seemed not to exclude an advanced multi vessel coronary artery disease. In master athletes with asymptomatic exercise electrocardiogram but a positive family history, further examinations should be performed in order to detect

  14. Avaliando a atividade vagal cardíaca na eletrocardiografia convencional Evaluating cardiac vagal activity on a conventional electrocardiogram

    Directory of Open Access Journals (Sweden)

    Flávia P. Teixeira

    2007-04-01

    Full Text Available OBJETIVO: Determinar a viabilidade da utilização de traçado convencional de eletrocardiografia (ECG para avaliação da atividade vagal cardíaca (AVC. MÉTODOS: Foram analisados, retrospectivamente, 1.395 indivíduos (995 homens, na faixa de idade de 46 + 17,2 anos (média ± desvio padrão, com traçados de ECG convencional para medida do Delta RR, que representa a diferença, em ms, entre o maior e o menor intervalo RR, e com resultados da avaliação autonômica parassimpática, o teste de exercício de quatro segundos (T4s, que quantifica a AVC por meio do índice vagal cardíaco (IVC. Foram obtidas curvas ROC para determinar os valores de Delta RR com melhor relação entre sensibilidade e especificidade para os pontos de corte de baixa e alta AVC, respectivamente, de 1,20 e 1,95. RESULTADOS: Os valores de delta RR correlacionaram-se significativamente com os de IVC (r = 0,40; p 120 ms como os melhores pontos de corte para baixa e alta AVC, com sensibilidade de 75% e 57%, especificidade de 62% e 79% e áreas das curvas ROC de 0,76 e 0,74, respectivamente. CONCLUSÃO: A medida visual do delta RR em um traçado de ECG parece ser válida para a avaliação clínica preliminar e rápida da AVC, podendo ser útil em consultórios, emergências ou situações nas quais o uso de métodos mais sofisticados de avaliação autonômica não seja viável, oportuno ou conveniente.OBJECTIVE: To determine the viability of using a conventional electrocardiogram (ECG tracing for assessment of CVA. METHODS: We retrospectively analyzed 1395 individuals (995 males, aged 46 ± 17.2 years (mean ± standard deviation with conventional ECG tracings to measure the delta RR (which represents the difference in milliseconds (ms between the greatest and smallest RR interval and results of a second autonomic parasympathetic evaluation, the 4-second exercise test (T4s, that quantifies CVA by the cardiac vagal index (CVI. ROC curves were obtained to determine the

  15. Value of the Signal-Averaged Electrocardiogram in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

    Science.gov (United States)

    Kamath, Ganesh S.; Zareba, Wojciech; Delaney, Jessica; Koneru, Jayanthi N.; McKenna, William; Gear, Kathleen; Polonsky, Slava; Sherrill, Duane; Bluemke, David; Marcus, Frank; Steinberg, Jonathan S.

    2011-01-01

    Background Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited disease causing structural and functional abnormalities of the right ventricle (RV). The presence of late potentials as assessed by the signal averaged electrocardiogram (SAECG) is a minor Task Force criterion. Objective The purpose of this study was to examine the diagnostic and clinical value of the SAECG in a large population of genotyped ARVC/D probands. Methods We compared the SAECGs of 87 ARVC/D probands (age 37 ± 13 years, 47 males) diagnosed as affected or borderline by Task Force criteria without using the SAECG criterion with 103 control subjects. The association of SAECG abnormalities was also correlated with clinical presentation; surface ECG; VT inducibility at electrophysiologic testing; ICD therapy for VT; and RV abnormalities as assessed by cardiac magnetic resonance imaging (cMRI). Results When compared with controls, all 3 components of the SAECG were highly associated with the diagnosis of ARVC/D (p<0.001). These include the filtered QRS duration (fQRSD) (97.8 ± 8.7 msec vs. 119.6 ± 23.8 msec), low amplitude signal (LAS) (24.4 ± 9.2 msec vs. 46.2 ± 23.7 msec) and root mean square amplitude of the last 40 msec of late potentials (RMS-40) (50.4 ± 26.9 µV vs. 27.9 ± 36.3 µV). The sensitivity of using SAECG for diagnosis of ARVC/D was increased from 47% using the established 2 of 3 criteria (i.e. late potentials) to 69% by using a modified criterion of any 1 of the 3 criteria, while maintaining a high specificity of 95%. Abnormal SAECG as defined by this modified criteria was associated with a dilated RV volume and decreased RV ejection fraction detected by cMRI (p<0.05). SAECG abnormalities did not vary with clinical presentation or reliably predict spontaneous or inducible VT, and had limited correlation with ECG findings. Conclusion Using 1 of 3 SAECG criteria contributed to increased sensitivity and specificity for the diagnosis of ARVC/D. This

  16. Performance of handheld electrocardiogram devices to detect atrial fibrillation in a cardiology and geriatric ward setting.

    Science.gov (United States)

    Desteghe, Lien; Raymaekers, Zina; Lutin, Mark; Vijgen, Johan; Dilling-Boer, Dagmara; Koopman, Pieter; Schurmans, Joris; Vanduynhoven, Philippe; Dendale, Paul; Heidbuchel, Hein

    2017-01-01

    To determine the usability, accuracy, and cost-effectiveness of two handheld single-lead electrocardiogram (ECG) devices for atrial fibrillation (AF) screening in a hospital population with an increased risk for AF. Hospitalized patients (n = 445) at cardiological or geriatric wards were screened for AF by two handheld ECG devices (MyDiagnostick and AliveCor). The performance of the automated algorithm of each device was evaluated against a full 12-lead or 6-lead ECG recording. All ECGs and monitor tracings were also independently reviewed in a blinded fashion by two electrophysiologists. Time investments by nurses and physicians were tracked and used to estimate cost-effectiveness of different screening strategies. Handheld recordings were not possible in 7 and 21.4% of cardiology and geriatric patients, respectively, because they were not able to hold the devices properly. Even after the exclusion of patients with an implanted device, sensitivity and specificity of the automated algorithms were suboptimal (Cardiology: 81.8 and 94.2%, respectively, for MyDiagnostick; 54.5 and 97.5%, respectively, for AliveCor; Geriatrics: 89.5 and 95.7%, respectively, for MyDiagnostick; 78.9 and 97.9%, respectively, for AliveCor). A scenario based on automated AliveCor evaluation in patients without AF history and without an implanted device proved to be the most cost-effective method, with a provider cost to identify one new AF patient of €193 and €82 at cardiology and geriatrics, respectively. The cost to detect one preventable stroke per year would be €7535 and €1916, respectively (based on average CHA 2 DS 2 -VASc of 3.9 ± 2.0 and 5.0 ± 1.5, respectively). Manual interpretation increases sensitivity, but decreases specificity, doubling the cost per detected patient, but remains cheaper than sole 12-lead ECG screening. Using AliveCor or MyDiagnostick handheld recorders requires a structured screening strategy to be effective and cost-effective in a hospital setting

  17. Identification of QRS complex in non-stationary electrocardiogram of sick infants.

    Science.gov (United States)

    Kota, S; Swisher, C B; Al-Shargabi, T; Andescavage, N; du Plessis, A; Govindan, R B

    2017-08-01

    Due to the high-frequency of routine interventions in an intensive care setting, electrocardiogram (ECG) recordings from sick infants are highly non-stationary, with recurrent changes in the baseline, alterations in the morphology of the waveform, and attenuations of the signal strength. Current methods lack reliability in identifying QRS complexes (a marker of individual cardiac cycles) in the non-stationary ECG. In the current study we address this problem by proposing a novel approach to QRS complex identification. Our approach employs lowpass filtering, half-wave rectification, and the use of instantaneous Hilbert phase to identify QRS complexes in the ECG. We demonstrate the application of this method using ECG recordings from eight preterm infants undergoing intensive care, as well as from 18 normal adult volunteers available via a public database. We compared our approach to the commonly used approaches including Pan and Tompkins (PT), gqrs, wavedet, and wqrs for identifying QRS complexes and then compared each with manually identified QRS complexes. For preterm infants, a comparison between the QRS complexes identified by our approach and those identified through manual annotations yielded sensitivity and positive predictive values of 99% and 99.91%, respectively. The comparison metrics for each method are as follows: PT (sensitivity: 84.49%, positive predictive value: 99.88%), gqrs (85.25%, 99.49%), wavedet (95.24%, 99.86%), and wqrs (96.99%, 96.55%). Thus, the sensitivity values of the four methods previously described, are lower than the sensitivity of the method we propose; however, the positive predictive values of these other approaches is comparable to those of our method, with the exception of the wqrs approach, which yielded a slightly lower value. For adult ECG, our approach yielded a sensitivity of 99.78%, whereas PT yielded 99.79%. The positive predictive value was 99.42% for both our approach as well as for PT. We propose a novel method for

  18. Patients With Type A Acute Aortic Dissection Presenting With an Abnormal Electrocardiogram.

    Science.gov (United States)

    Costin, Nathaniel I; Korach, Amit; Loor, Gabriel; Peterson, Mark D; Desai, Nimesh D; Trimarchi, Santi; de Vincentiis, Carlo; Ota, Takeyoshi; Reece, T Brett; Sundt, Thoralf M; Patel, Himanshu J; Chen, Edward P; Montgomery, Dan G; Nienaber, Christoph A; Isselbacher, Eric M; Eagle, Kim A; Gleason, Thomas G

    2018-01-01

    The electrocardiogram (ECG) is often used in the diagnosis of patients presenting with chest pain to emergency departments. Because chest pain is a common manifestation of type A acute aortic dissection (TAAAD), ECGs are obtained in much of this population. We evaluated the effect of particular ECG patterns on the diagnosis and treatment of TAAAD. TAAAD patients (N = 2,765) enrolled in the International Registry of Acute Aortic Dissection were stratified based on normal (n = 1,094 [39.6%]) and abnormal (n = 1,671 [60.4%]) findings on presenting ECGs and further subdivided according to specific ECG findings. Time data are presented in hours as medians (quartile 1 to quartile 3). Patients with ECGs with abnormal findings presented to the hospital sooner after symptom onset than those with ECGs with normal findings (1.4 [0.8 to 3.3] vs 2.0 [1.0 to 3.3]; p = 0.005). Specifically, this was seen in patients with infarction with new Q waves or ST elevation (1.3 [0.6 to 2.7] vs 1.5 [0.8 to 3.3]; p = 0.049). Interestingly, the time between symptom onset and diagnosis was longer with infarction with old Q waves (6.7 [3.2 to 18.4] vs 5.0 [2.9 to 11.8]; p = 0.034) and nonspecific ST-T changes (5.8 [3.0 to 13.8] vs 4.5 [2.8 to 10.5]; p = 0.002). Surgical mortality was higher in patients with abnormal ECG findings (20.6% vs 11.9%, p presenting with abnormal ECG results are sicker, have more in-hospital complications, and are more likely to die. The frequency of nonspecific ST-T abnormalities and its association with delay in diagnosis and treatment presents an opportunity for practice improvement. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Friend or Foe? Flipped Classroom for Undergraduate Electrocardiogram Learning: a Randomized Controlled Study.

    Science.gov (United States)

    Rui, Zeng; Lian-Rui, Xiang; Rong-Zheng, Yue; Jing, Zeng; Xue-Hong, Wan; Chuan, Zuo

    2017-03-07

    Interpreting an electrocardiogram (ECG) is not only one of the most important parts of clinical diagnostics but also one of the most difficult topics to teach and learn. In order to enable medical students to master ECG interpretation skills in a limited teaching period, the flipped teaching method has been recommended by previous research to improve teaching effect on undergraduate ECG learning. A randomized controlled trial for ECG learning was conducted, involving 181 junior-year medical undergraduates using a flipped classroom as an experimental intervention, compared with Lecture-Based Learning (LBL) as a control group. All participants took an examination one week after the intervention by analysing 20 ECGs from actual clinical cases and submitting their ECG reports. A self-administered questionnaire was also used to evaluate the students' attitudes, total learning time, and conditions under each teaching method. The students in the experimental group scored significantly higher than the control group (8.72 ± 1.01 vs 8.03 ± 1.01, t = 4.549, P = 0.000) on ECG interpretation. The vast majority of the students in the flipped classroom group held positive attitudes toward the flipped classroom method and also supported LBL. There was no significant difference (4.07 ± 0.96 vs 4.16 ± 0.89, Z = - 0.948, P = 0.343) between the groups. Prior to class, the students in the flipped class group devoted significantly more time than those in the control group (42.33 ± 22.19 vs 30.55 ± 10.15, t = 4.586, P = 0.000), whereas after class, the time spent by the two groups were not significantly different (56.50 ± 46.80 vs 54.62 ± 31.77, t = 0.317, P = 0.752). Flipped classroom teaching can improve medical students' interest in learning and their self-learning abilities. It is an effective teaching model that needs to be further studied and promoted.

  20. New ideas for teaching electrocardiogram interpretation and improving classroom teaching content

    Directory of Open Access Journals (Sweden)

    Zeng R

    2015-02-01

    Full Text Available Rui Zeng,1 Rong-Zheng Yue,2 Chun-Yu Tan,3 Qin Wang,4 Pu Kuang,5 Pan-Wen Tian,6 Chuan Zuo3 1Department of Cardiovascular Diseases, 2Department of Nephrology, 3Department of Rheumatology and Immunology, 4Department of Endocrinology, 5Department of Hematology, 6Department of Respiratory Diseases, West China Hospital, School of Clinic Medicine, Sichuan University, Chengdu, People’s Republic of China Background: Interpreting an electrocardiogram (ECG is not only one of the most important parts of diagnostics but also one of the most difficult areas to teach. Owing to the abstract nature of the basic theoretical knowledge of the ECG, its scattered characteristics, and tedious and difficult-to-remember subject matter, teaching how to interpret ECGs is as difficult for teachers to teach as it is for students to learn. In order to enable medical students to master basic knowledge of ECG interpretation skills in a limited teaching time, we modified the content used for traditional ECG teaching and now propose a new ECG teaching method called the “graphics-sequence memory method.” Methods: A prospective randomized controlled study was designed to measure the actual effectiveness of ECG learning by students. Two hundred students were randomly placed under a traditional teaching group and an innovative teaching group, with 100 participants in each group. The teachers in the traditional teaching group utilized the traditional teaching outline, whereas the teachers in the innovative teaching group received training in line with the proposed teaching method and syllabus. All the students took an examination in the final semester by analyzing 20 ECGs from real clinical cases and submitted their ECG reports. Results: The average ECG reading time was 32 minutes for the traditional teaching group and 18 minutes for the innovative teaching group. The average ECG accuracy results were 43% for the traditional teaching group and 77% for the innovative teaching

  1. The electrocardiogram as an electronic filter and why ac circuits are important for pre-health physics students

    Science.gov (United States)

    Dunlap, Justin C.; Kutschera, Ellynne; Van Ness, Grace R.; Widenhorn, Ralf

    2015-01-01

    We present a general physics laboratory exercise that centres around the use of the electrocardiogram sensor as an application of circuits and electronic signal filtering. Although these topics are commonly taught in the general physics classroom, many students consider topics such as alternating current as unrelated to their future professions. This exercise provides the motivation for life science and pre-health majors to learn concepts such as voltage, resistance, alternating and direct current, RLC circuits, as well as signal and noise, in an introductory undergraduate physics lab.

  2. Acute myocardial infarction with a non-diagnostic electrocardiogram. Case presentation and overview

    Energy Technology Data Exchange (ETDEWEB)

    Przybojewski, J Z; Gilburt, S G.M. [Tygerberg Hospital, Stellenbosch (South Africa). Dept. of Internal Medicine

    1983-12-17

    The clinical presentation of a young hypertensive White man with acute high lateral non-transmural myocardial infarction (MI) is documented. This diagnosis was established on the grounds of a history of chest pain, elevated serial serum enzyme levels, technetium-99m pyrophosphate ('hot-spot') scintigraphy, exercise thallium-201 ('cold-spot') scanning, left ventricular cine angiography and selective coronary arteriography. Daily resting 12-lead ECGs failed to demonstrate unequivocal features of acute non-transmural subendocardial MI. The diagnostic difficulties facing the clinician in a case of acute MI associated with a non-diagnostic ECG are stressed, and the ECG features of acute subendocardial MI are reviewed.

  3. Resting metabolic rate and postprandial thermogenesis in polycystic ovarian syndrome.

    Science.gov (United States)

    Segal, K R; Dunaif, A

    1990-07-01

    To determine whether the high frequency of obesity in women with polycystic ovary syndrome (PCO) is related to a defect in energy expenditure, resting metabolic rate (RMR) and the thermic response to a standard meal were compared in 10 obese PCO women, nine obese but otherwise normal women, and 11 lean women. All groups were matched with respect to age and fat-free mass and the two obese groups were matched for degree of obesity. RMR was measured by indirect calorimetry for 3 h on two days: (1) in the postabsorptive state; and (2) after a 720 kcal (3014 kJ) liquid mixed meal. The thermic effect of food, calculated as 3 h postprandial minus fasting RMR, was significantly greater for the lean [52.9 +/- 5.5 kcal/3 h (221 +/- 23 kJ/3 h)] than the obese [17.2 +/- 5.1 kcal/3 h (72 +/- 21 kJ/3 h)] and the PCO women [22.8 +/- 5.2 kcal/3 h (95 +/- 22 kJ/3)], P less than 0.001). The thermic effect of food was negatively related to percent body fat (r = -0.694, P less than 0.001). Resting metabolic rate did not differ significantly among the three groups, and was strongly related to fat-free mass (r = 0.687, P less than 0.001). These results confirm previous reports of blunted thermogenesis in obese individuals, but provide no evidence of altered resting metabolic rate or postprandial thermogenesis in women with PCO compared with normal women of similar degree of obesity.

  4. Myocardial perfusion assessed by contrast echocardiography and single photon emission computed tomography in the evaluation of patients with acute chest pain and normal electrocardiogram

    International Nuclear Information System (INIS)

    Soares, J. Jr.; Ferreira, S.M.A.; Matias, W. Jr.; Giorgi, M.C.P.; Izaki, M.; Luz, P.L.; Ramires, J.A.F.; Meneghetti, J.C.

    2002-01-01

    Aim : Evaluation of diagnostic accuracy of myocardial contrast echocardiography (MCE) in comparison with single-photon emission computed tomography (SPECT) for the detection of myocardial ischemia in patients with acute chest pain. Material and Methods : Eighteen patients (pts) with chest pain lasting ≥30 minutes, occurring within 6 hours of emergency room presentation and a normal or no diagnostic electrocardiogram were studied. Pts underwent rest MCE and SPECT. For both exams myocardial perfusion was assessed in the same 7 segments (apical, anterior, inferior, anteroseptal, inferoseptal, lateral and posterior) of left ventricle. A total of 126 segments were analyzed. Images were classified as positive for ischemia if they had a perfusion defect. Coronary angiography was performed if MCE or SPECT images were classified as positive for ischemia or by clinical indication. Otherwise the patients underwent stress SPECT. Significant coronary artery disease (CAD) was defined as ≥70% stenosis in a major coronary artery or its branches. Final diagnosis of an acute coronary event (ACE) was established in the presence of positive findings in MCE or SPECT in addition to significant CAD in the corresponding territory. Kappa statistics were calculated to evaluate the concordance between MCE and SPECT. κ values of ≤0.4, >0.4 and >0.7 indicate fair, good and excellent agreement, respectively. Results: Thirteen out of 18 pts underwent coronary angiography (seven pts had positive findings on SPECT, 2 on MCE, 2 on both exams and 1 had clinical indication). Significant CAD was detected on six. Five pts underwent stress SPECT and no perfusion defect was detected. Therefore, six pts (33.3%) had an ACE and 12 (66.6%) had not. There were no statistical differences between groups according to age, gender, duration of pain, free pain interval, presence of risk factors and antecedents. Concordance between MCE and SPECT for evaluation of perfusion defects showed a ? coefficient of 0

  5. Scaling HEP to Web size with RESTful protocols: The frontier example

    International Nuclear Information System (INIS)

    Dykstra, Dave

    2011-01-01

    The World-Wide-Web has scaled to an enormous size. The largest single contributor to its scalability is the HTTP protocol, particularly when used in conformity to REST (REpresentational State Transfer) principles. High Energy Physics (HEP) computing also has to scale to an enormous size, so it makes sense to base much of it on RESTful protocols. Frontier, which reads databases with an HTTP-based RESTful protocol, has successfully scaled to deliver production detector conditions data from both the CMS and ATLAS LHC detectors to hundreds of thousands of computer cores worldwide. Frontier is also able to re-use a large amount of standard software that runs the Web: on the clients, caches, and servers. I discuss the specific ways in which HTTP and REST enable high scalability for Frontier. I also briefly discuss another protocol used in HEP computing that is HTTP-based and RESTful, and another protocol that could benefit from it. My goal is to encourage HEP protocol designers to consider HTTP and REST whenever the same information is needed in many places.

  6. Inductive plethysmography potential as a surrogate for ventilatory measurements during rest and moderate physical exercise

    Directory of Open Access Journals (Sweden)

    Ramona Cabiddu

    2016-01-01

    Full Text Available Background: Portable respiratory inductive plethysmography (RIP systems have been validated for ventilatory assessment during resting conditions and during incremental treadmill exercise. However, in clinical settings and during field-based exercise, intensity is usually constant and submaximal. A demonstration of the ability of RIP to detect respiratory measurements accurately during constant intensity conditions would promote and validate the routine use of portable RIP devices as an alternative to ergospirometry (ES, the current gold standard technique for ventilatory measures. Objective: To investigate the agreement between respiratory variables recorded by a portable RIP device and by ES during rest and constant intensity exercise. Method: Tidal volume (VT, respiratory rate (RR and minute ventilation (VE were concurrently acquired by portable RIP and ES in seven healthy male volunteers during standing rest position and constant intensity treadmill exercise. Results: Significant agreement was found between RIP and ES acquisitions during the standing rest position and constant intensity treadmill exercise for RR and during the standing rest position for VE. Conclusion: Our results suggest that portable RIP devices might represent a suitable alternative to ES during rest and during constant submaximal exercise.

  7. Resting-state abnormalities in amnestic mild cognitive impairment: a meta-analysis.

    Science.gov (United States)

    Lau, W K W; Leung, M-K; Lee, T M C; Law, A C K

    2016-04-26

    Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer's disease (AD). As no effective drug can cure AD, early diagnosis and intervention for aMCI are urgently needed. The standard diagnostic procedure for aMCI primarily relies on subjective neuropsychological examinations that require the judgment of experienced clinicians. The development of other objective and reliable aMCI markers, such as neural markers, is therefore required. Previous neuroimaging findings revealed various abnormalities in resting-state activity in MCI patients, but the findings have been inconsistent. The current study provides an updated activation likelihood estimation meta-analysis of resting-state functional magnetic resonance imaging (fMRI) data on aMCI. The authors searched on the MEDLINE/PubMed databases for whole-brain resting-state fMRI studies on aMCI published until March 2015. We included 21 whole-brain resting-state fMRI studies that reported a total of 156 distinct foci. Significant regional resting-state differences were consistently found in aMCI patients relative to controls, including the posterior cingulate cortex, right angular gyrus, right parahippocampal gyrus, left fusiform gyrus, left supramarginal gyrus and bilateral middle temporal gyri. Our findings support that abnormalities in resting-state activities of these regions may serve as neuroimaging markers for aMCI.

  8. Information Flow Between Resting-State Networks.

    Science.gov (United States)

    Diez, Ibai; Erramuzpe, Asier; Escudero, Iñaki; Mateos, Beatriz; Cabrera, Alberto; Marinazzo, Daniele; Sanz-Arigita, Ernesto J; Stramaglia, Sebastiano; Cortes Diaz, Jesus M

    2015-11-01

    The resting brain dynamics self-organize into a finite number of correlated patterns known as resting-state networks (RSNs). It is well known that techniques such as independent component analysis can separate the brain activity at rest to provide such RSNs, but the specific pattern of interaction between RSNs is not yet fully understood. To this aim, we propose here a novel method to compute the information flow (IF) between different RSNs from resting-state magnetic resonance imaging. After hemodynamic response function blind deconvolution of all voxel signals, and under the hypothesis that RSNs define regions of interest, our method first uses principal component analysis to reduce dimensionality in each RSN to next compute IF (estimated here in terms of transfer entropy) between the different RSNs by systematically increasing k (the number of principal components used in the calculation). When k=1, this method is equivalent to computing IF using the average of all voxel activities in each RSN. For k≥1, our method calculates the k multivariate IF between the different RSNs. We find that the average IF among RSNs is dimension dependent, increasing from k=1 (i.e., the average voxel activity) up to a maximum occurring at k=5 and to finally decay to zero for k≥10. This suggests that a small number of components (close to five) is sufficient to describe the IF pattern between RSNs. Our method--addressing differences in IF between RSNs for any generic data--can be used for group comparison in health or disease. To illustrate this, we have calculated the inter-RSN IF in a data set of Alzheimer's disease (AD) to find that the most significant differences between AD and controls occurred for k=2, in addition to AD showing increased IF w.r.t. The spatial localization of the k=2 component, within RSNs, allows the characterization of IF differences between AD and controls.

  9. Annihilation of antiproton on deuteron at rest

    International Nuclear Information System (INIS)

    Grach, I.; Shmatikov, M.

    1982-01-01

    The system of Faddeev equations for amplitudes of anti pD iteraction at rest accounting for higher partial anti NN waves is derived. From its solution the total and elastic anti pD cross sections are calculated. Predictions for the missing-mass spectrum in the anti pD annihilation are made. The P-wave anti NN states give small contribution to the anti pD cross section at rest, the theoretical value of the latter being less than the experimental cross section extrapolated to the threshold. Let us emphasize that the total anti pD cross section depending weakly on the radii of anti NN interactions is sensitive to the values of the anti NN scattering lengths. Experimental data for anti pD cross sections at rest can be obtained only by extrapolation procedure. Henceforth it is very important to investigate the anti pD interactions at low but non-zero momenta where the direct comparison to the experiment is possible [ru

  10. Long-term prognostic performance of low-dose coronary computed tomography angiography with prospective electrocardiogram triggering

    Energy Technology Data Exchange (ETDEWEB)

    Clerc, Olivier F.; Kaufmann, Basil P.; Possner, Mathias; Liga, Riccardo; Vontobel, Jan; Mikulicic, Fran; Graeni, Christoph; Benz, Dominik C.; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Gaemperli, Oliver; Kaufmann, Philipp A.; Buechel, Ronny R. [University Hospital Zurich, Cardiac Imaging, Department of Nuclear Medicine, Zurich (Switzerland)

    2017-11-15

    To assess long-term prognosis after low-dose 64-slice coronary computed tomography angiography (CCTA) using prospective electrocardiogram-triggering. We included 434 consecutive patients with suspected or known coronary artery disease referred for low-dose CCTA. Patients were classified as normal, with non-obstructive or obstructive lesions, or previously revascularized. Coronary artery calcium score (CACS) was assessed in 223 patients. Follow-up was obtained regarding major adverse cardiac events (MACE): cardiac death, myocardial infarction and elective revascularization. We performed Kaplan-Meier analysis and Cox regressions. Mean effective radiation dose was 1.7 ± 0.6 mSv. At baseline, 38% of patients had normal arteries, 21% non-obstructive lesions, 32% obstructive stenosis and 8% were revascularized. Twenty-nine patients (7%) were lost to follow-up. After a median follow-up of 6.1 ± 0.6 years, MACE occurred in 0% of patients with normal arteries, 6% with non-obstructive lesions, 30% with obstructive stenosis and 39% of those revascularized. MACE occurrence increased with increasing CACS (P < 0.001), but 4% of patients with CACS = 0 experienced MACE. Multivariate Cox regression identified obstructive stenosis, lesion burden in CCTA and CACS as independent MACE predictors (P ≤ 0.001). Low-dose CCTA with prospective electrocardiogram-triggering has an excellent long-term prognostic performance with a warranty period >6 years for patients with normal coronary arteries. (orig.)

  11. P-wave characteristics on routine preoperative electrocardiogram improve prediction of new-onset postoperative atrial fibrillation in cardiac surgery.

    Science.gov (United States)

    Wong, Jim K; Lobato, Robert L; Pinesett, Andre; Maxwell, Bryan G; Mora-Mangano, Christina T; Perez, Marco V

    2014-12-01

    To test the hypothesis that including preoperative electrocardiogram (ECG) characteristics with clinical variables significantly improves the new-onset postoperative atrial fibrillation prediction model. Retrospective analysis. Single-center university hospital. Five hundred twenty-six patients, ≥ 18 years of age, who underwent coronary artery bypass grafting, aortic valve replacement, mitral valve replacement/repair, or a combination of valve surgery and coronary artery bypass grafting requiring cardiopulmonary bypass. Retrospective review of medical records. Baseline characteristics and cardiopulmonary bypass times were collected. Digitally-measured timing and voltages from preoperative electrocardiograms were extracted. Postoperative atrial fibrillation was defined as atrial fibrillation requiring therapeutic intervention. Two hundred eight (39.5%) patients developed postoperative atrial fibrillation. Clinical predictors were age, ejection fractionelectrocardiogram variables to the prediction model with only clinical predictors significantly improved the area under the receiver operating characteristic curve, from 0.71 to 0.78 (p<0.01). Overall net reclassification improvement was 0.059 (p = 0.09). Among those who developed postoperative atrial fibrillation, the net reclassification improvement was 0.063 (p = 0.03). Several p-wave characteristics are independently associated with postoperative atrial fibrillation. Addition of these parameters improves the postoperative atrial fibrillation prediction model. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Long-term prognostic performance of low-dose coronary computed tomography angiography with prospective electrocardiogram triggering

    International Nuclear Information System (INIS)

    Clerc, Olivier F.; Kaufmann, Basil P.; Possner, Mathias; Liga, Riccardo; Vontobel, Jan; Mikulicic, Fran; Graeni, Christoph; Benz, Dominik C.; Fuchs, Tobias A.; Stehli, Julia; Pazhenkottil, Aju P.; Gaemperli, Oliver; Kaufmann, Philipp A.; Buechel, Ronny R.

    2017-01-01

    To assess long-term prognosis after low-dose 64-slice coronary computed tomography angiography (CCTA) using prospective electrocardiogram-triggering. We included 434 consecutive patients with suspected or known coronary artery disease referred for low-dose CCTA. Patients were classified as normal, with non-obstructive or obstructive lesions, or previously revascularized. Coronary artery calcium score (CACS) was assessed in 223 patients. Follow-up was obtained regarding major adverse cardiac events (MACE): cardiac death, myocardial infarction and elective revascularization. We performed Kaplan-Meier analysis and Cox regressions. Mean effective radiation dose was 1.7 ± 0.6 mSv. At baseline, 38% of patients had normal arteries, 21% non-obstructive lesions, 32% obstructive stenosis and 8% were revascularized. Twenty-nine patients (7%) were lost to follow-up. After a median follow-up of 6.1 ± 0.6 years, MACE occurred in 0% of patients with normal arteries, 6% with non-obstructive lesions, 30% with obstructive stenosis and 39% of those revascularized. MACE occurrence increased with increasing CACS (P < 0.001), but 4% of patients with CACS = 0 experienced MACE. Multivariate Cox regression identified obstructive stenosis, lesion burden in CCTA and CACS as independent MACE predictors (P ≤ 0.001). Low-dose CCTA with prospective electrocardiogram-triggering has an excellent long-term prognostic performance with a warranty period >6 years for patients with normal coronary arteries. (orig.)

  13. Inferior ST-Elevation Acute Myocardial Infarction or an Inferior-Lead Brugada-like Electrocardiogram Pattern Associated With the Use of Pregabalin and Quetiapine?

    Science.gov (United States)

    Brunetti, Natale D; Ieva, Riccardo; Correale, Michele; Cuculo, Andrea; Santoro, Francesco; Guaricci, Andrea I; De Gennaro, Luisa; Gaglione, Antonio; Di Biase, Matteo

    2016-01-01

    The Brugada electrocardiogram pattern is characterized by coved-type ST-elevation (>2 mm) in the right precordial leads. We report the case of a 62-year-old man, with bipolar disorder, admitted to the emergency department because of dyspnea and chest discomfort. The patient was on treatment with pregabalin and quetiapine. Unexpectedly, electrocardiogram at admission showed diffuse ST-elevation, more evident in inferior leads, where a Brugada-like pattern was present. The patient underwent coronary angiography with a diagnosis of suspected acute coronary syndrome. Coronary angiography, however, showed mild coronary artery disease not requiring coronary angioplasty. Echocardiography did not reveal left ventricular dysfunction or pericardial effusion. Troponin levels remained normal over serial controls. Eventually, chest radiography showed lung opacities and consolidation suggestive for pneumonia. To the best of our knowledge, this is one of the first cases showing a transient Brugada-like electrocardiogram pattern in inferior leads, probably amplified by the administration of pregabalin and quetiapine.

  14. Prognostic value of myocardial perfusion SPECT versus exercise electrocardiography in patients with ST-segment depression on resting electrocardiography.

    Science.gov (United States)

    De Lorenzo, Andrea; Hachamovitch, Rory; Kang, Xingping; Gransar, Heidi; Sciammarella, Maria G; Hayes, Sean W; Friedman, John D; Cohen, Ishac; Germano, Guido; Berman, Daniel S

    2005-01-01

    The value of exercise-induced ST-segment depression for the prognostic evaluation of patients with 1 mm of ST depression or greater on the resting electrocardiogram is controversial. Patients who underwent exercise myocardial perfusion single photon emission computed tomography (MPS) and had resting ST depression of 1 mm or greater with a nondiagnostic exercise electrocardiographic response (n = 1122) were followed up for 3.4 +/- 2.3 years. Those with paced rhythm, pre-excitation, left bundle branch block, or myocardial revascularization within the first 60 days after MPS were excluded. Additional exercise-induced ST-segment depression was considered significant if > or = 2 mm MPS was scored semiquantitatively by use of a 20-segment model of the left ventricle; the percentage of myocardium involved with stress defects (% myo) was derived by normalizing to the maximal possible score of 80. Hard events were defined as nonfatal myocardial infarction or cardiac death. A Cox analysis was used to determine independent predictors of hard events among clinical, exercise, and nuclear variables. Hard event rates increased as a function of % myo for either patients with exercise-induced ST depression (1.4%/y for normal MPS vs 4.1%/y for % myo >10%, P 10%, P = .0001). Age, diabetes mellitus, shortness of breath as the presenting symptom, and % myo were independent predictors of hard events. Exercise-induced ST depression was predictive of hard events only when it was 3 mm or greater. The presence and extent of perfusion defects, reflected in the % myo, had incremental prognostic value over clinical variables and also over all degrees of exercise-induced ST depression. Although MPS effectively risk-stratifies patients with resting ST depression of 1 mm or greater, the prognostic value of exercise-induced ST depression is limited in these patients, with a small added risk when severe (> or = 3 mm).

  15. Non-invasive prediction of catheter ablation outcome in persistent atrial fibrillation by fibrillatory wave amplitude computation in multiple electrocardiogram leads.

    Science.gov (United States)

    Zarzoso, Vicente; Latcu, Decebal G; Hidalgo-Muñoz, Antonio R; Meo, Marianna; Meste, Olivier; Popescu, Irina; Saoudi, Nadir

    2016-12-01

    Catheter ablation (CA) of persistent atrial fibrillation (AF) is challenging, and reported results are capable of improvement. A better patient selection for the procedure could enhance its success rate while avoiding the risks associated with ablation, especially for patients with low odds of favorable outcome. CA outcome can be predicted non-invasively by atrial fibrillatory wave (f-wave) amplitude, but previous works focused mostly on manual measures in single electrocardiogram (ECG) leads only. To assess the long-term prediction ability of f-wave amplitude when computed in multiple ECG leads. Sixty-two patients with persistent AF (52 men; mean age 61.5±10.4years) referred for CA were enrolled. A standard 1-minute 12-lead ECG was acquired before the ablation procedure for each patient. F-wave amplitudes in different ECG leads were computed by a non-invasive signal processing algorithm, and combined into a mutivariate prediction model based on logistic regression. During an average follow-up of 13.9±8.3months, 47 patients had no AF recurrence after ablation. A lead selection approach relying on the Wald index pointed to I, V1, V2 and V5 as the most relevant ECG leads to predict jointly CA outcome using f-wave amplitudes, reaching an area under the curve of 0.854, and improving on single-lead amplitude-based predictors. Analysing the f-wave amplitude in several ECG leads simultaneously can significantly improve CA long-term outcome prediction in persistent AF compared with predictors based on single-lead measures. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Investigation of influence of 16-slice spiral CT electrocardiogram-controlled dose modulation on exposure dosage and image quality of cardiac CT imaging under simulated fluctuant heart rate

    International Nuclear Information System (INIS)

    Yin Yan; Chen Jie; Chai Weiming; Hua Jia; Gao Na; Xu Jianrong; Shen Yun

    2008-01-01

    Objective: To investigate the influence of electrocardiogram (ECG)-controlled dose modulation on exposure dosage and image quality of cardiac CT imaging in a cardiac phantom with simulated fluctuant heart rate. Methods: The basal heart rate of the cardiac pulsating phantom was set as 60 bpm, the experimental situations were divided as 6 groups according to different heart rates. The cardiac imaging was performed on the cardiac phantom when the ECG-controlled dose modulation was firstly turned off. The exposure dosage of each scan sequence was documented. The standard deviation of the CT values of the phantom was measured on the central slice after coronal reformation of the raw data. The quality of 2D and 3D images were scored. Then cardiac imaging was performed when ECG modulation was on and set as four groups according to different modulation parameters. All the data were documented as before. The results from the five groups with and without ECG modulation current were analyzed by F test and comparative rank sum test using the statistical software SPSS 10.0. Results: Statistical analysis showed no significant difference (P>0.05) between the SNR of images (SD value was 27.78 and 26.30) from the groups that full mA output at wide reconstruction phase (69%-99%) when the heart rate was fluctuant(≥7.5 bpm). There was also no significant difference (P>0.05) between the quality of the 2D and 3D images. But there was a significant difference (P 12.5 bpm, the exposure dosage would increase obviously (from 0.6 to 1.7 mSv). Conclusion: For cardiac imaging with 16-slice row CT, the application of ECG modulated current can effectively reduce the exposure dosage without compromising the image quality even if heart rate was fluctuant. (authors)

  17. The Use of RESTful Web Services in Medical Informatics and Clinical Research and Its Implementation in Europe.

    Science.gov (United States)

    Aerts, Jozef

    2017-01-01

    RESTful web services nowadays are state-of-the-art in business transactions over the internet. They are however not very much used in medical informatics and in clinical research, especially not in Europe. To make an inventory of RESTful web services that can be used in medical informatics and clinical research, including those that can help in patient empowerment in the DACH region and in Europe, and to develop some new RESTful web services for use in clinical research and regulatory review. A literature search on available RESTful web services has been performed and new RESTful web services have been developed on an application server using the Java language. Most of the web services found originate from institutes and organizations in the USA, whereas no similar web services could be found that are made available by European organizations. New RESTful web services have been developed for LOINC codes lookup, for UCUM conversions and for use with CDISC Standards. A comparison is made between "top down" and "bottom up" web services, the latter meant to answer concrete questions immediately. The lack of RESTful web services made available by European organizations in healthcare and medical informatics is striking. RESTful web services may in short future play a major role in medical informatics, and when localized for the German language and other European languages, can help to considerably facilitate patient empowerment. This however requires an EU equivalent of the US National Library of Medicine.

  18. Usefulness of the Electrocardiogram in Predicting Cardiovascular Mortality in Asymptomatic Adults With Aortic Stenosis (from the Simvastatin and Ezetimibe in Aortic Stenosis Study)

    DEFF Research Database (Denmark)

    Greve, Anders M; Dalsgaard, Morten; Bang, Casper N

    2014-01-01

    Hypertension and coronary heart disease are common in aortic stenosis (AS) and may impair prognosis for similar AS severity. Different changes in the electrocardiogram may be reflective of the separate impacts of AS, hypertension, and coronary heart disease, which could lead to enhanced risk...... stratification in AS. The aim of this study was therefore to examine if combining prognostically relevant electrocardiographic (ECG) findings improves prediction of cardiovascular mortality in asymptomatic AS. All patients with baseline electrocardiograms in the SEAS study were included. The primary end point...

  19. Nephrogenic rests mimicking Wilms' tumor on CT

    International Nuclear Information System (INIS)

    Subhas, Naveen; Siegelman, Stanley S.; Argani, Pedram; Gearhart, John P.

    2004-01-01

    Nephrogenic rests (NR) are persistent benign remnants of embryonic renal tissue. A small percentage of these may develop into Wilms' tumor (WT). Radiologic imaging is relied upon to differentiate between these entities, with the hallmark of malignant transformation being growth on serial imaging studies. There is, however, considerable overlap in their imaging characteristics. The authors present a case of two biopsy-proven NR in a 2-year-old girl with sporadic aniridia that were indistinguishable from WT on initial radiologic studies. One of the NR grew on serial imaging studies mimicking a WT, but after resection was confirmed to be a benign hyperplastic NR on pathologic examination. (orig.)

  20. Hypoxic responses in resting hyperthermic humans

    OpenAIRE

    Curtis, Andrew

    2005-01-01

    This thesis investigated the interaction between steady state hypoxia and passive hyperthermia on human ventilation and the influence of the PETCO2 on this interaction. On one of two days males twice breathed 12% oxygen for 20 min while either normothermic or hyperthermic with PETCO2 clamped -1 mm Hg above resting (iHVR). On the other day the same tests were performed except P&02 was uncontrolled (pHVR). Hyperthermia increased euoxic ventilation compared to normothermia (plO.OO1). During ...

  1. Influence of ROI selection on Resting Functional Connectivity: An Individualized Approach for Resting fMRI Analysis

    Directory of Open Access Journals (Sweden)

    William Seunghyun Sohn

    2015-08-01

    Full Text Available The differences in how our brain is connected are often thought to reflect the differences in our individual personalities and cognitive abilities. Individual differences in brain connectivity has long been recognized in the neuroscience community however it has yet to manifest itself in the methodology of resting state analysis. This is evident as previous studies use the same region of interest (ROIs for all subjects. In this paper we demonstrate that the use of ROIs which are standardized across individuals leads to inaccurate calculations of functional connectivity. We also show that this problem can be addressed by taking an individualized approach by using subject-specific ROIs. Finally we show that ROI selection can affect the way we interpret our data by showing different changes in functional connectivity with ageing.

  2. Longer rest periods for intensive rotational grazing limit diet quality ...

    African Journals Online (AJOL)

    Longer rest periods for intensive rotational grazing limit diet quality of sheep without enhancing environmental benefits. ... This experiment was established to compare three intensive rotational grazing strategies (fast rotation [FR], average 57-day rest; slow rotation [SR], average 114-day rest; and flexible grazing [FX], based ...

  3. Resting ECG findings in elite football players.

    Science.gov (United States)

    Bohm, Philipp; Ditzel, Roman; Ditzel, Heribert; Urhausen, Axel; Meyer, Tim

    2013-01-01

    The purpose of the study was to evaluate ECG abnormalities in a large sample of elite football players. Data from 566 elite male football players (57 of them of African origin) above 16 years of age were screened retrospectively (age: 20.9 ± 5.3 years; BMI: 22.9 ± 1.7 kg · m(-2), training history: 13.8 ± 4.7 years). The resting ECGs were analysed and classified according to the most current ECG categorisation of the European Society of Cardiology (ESC) (2010) and a classification of Pelliccia et al. (2000) in order to assess the impact of the new ESC-approach. According to the classification of Pelliccia, 52.5% showed mildly abnormal ECG patterns and 12% were classified as distinctly abnormal ECG patterns. According to the classification of the ESC, 33.7% showed 'uncommon ECG patterns'. Short-QT interval was the most frequent ECG pattern in this group (41.9%), followed by a shortened PR-interval (19.9%). When assessed with a QTc cut-off-point of 340 ms (instead of 360 ms), only 22.2% would have had 'uncommon ECG patterns'. Resting ECG changes amongst elite football players are common. Adjustment of the ESC criteria by adapting proposed time limits for the ECG (e.g. QTc, PR) should further reduce the rate of false-positive results.

  4. Resting State Network Estimation in Individual Subjects

    Science.gov (United States)

    Hacker, Carl D.; Laumann, Timothy O.; Szrama, Nicholas P.; Baldassarre, Antonello; Snyder, Abraham Z.

    2014-01-01

    Resting-state functional magnetic resonance imaging (fMRI) has been used to study brain networks associated with both normal and pathological cognitive function. The objective of this work is to reliably compute resting state network (RSN) topography in single participants. We trained a supervised classifier (multi-layer perceptron; MLP) to associate blood oxygen level dependent (BOLD) correlation maps corresponding to pre-defined seeds with specific RSN identities. Hard classification of maps obtained from a priori seeds was highly reliable across new participants. Interestingly, continuous estimates of RSN membership retained substantial residual error. This result is consistent with the view that RSNs are hierarchically organized, and therefore not fully separable into spatially independent components. After training on a priori seed-based maps, we propagated voxel-wise correlation maps through the MLP to produce estimates of RSN membership throughout the brain. The MLP generated RSN topography estimates in individuals consistent with previous studies, even in brain regions not represented in the training data. This method could be used in future studies to relate RSN topography to other measures of functional brain organization (e.g., task-evoked responses, stimulation mapping, and deficits associated with lesions) in individuals. The multi-layer perceptron was directly compared to two alternative voxel classification procedures, specifically, dual regression and linear discriminant analysis; the perceptron generated more spatially specific RSN maps than either alternative. PMID:23735260

  5. Human activity and rest in situ.

    Science.gov (United States)

    Roenneberg, Till; Keller, Lena K; Fischer, Dorothee; Matera, Joana L; Vetter, Céline; Winnebeck, Eva C

    2015-01-01

    Our lives are structured by the daily alternation of activity and rest, of wake and sleep. Despite significant advances in circadian and sleep research, we still lack answers to many of the most fundamental questions about this conspicuous behavioral pattern. We strongly believe that investigating this pattern in entrained conditions, real-life and daily contexts-in situ-will help the field to elucidate some of these central questions. Here, we present two common approaches for in situ investigation of human activity and rest: the Munich ChronoType Questionnaire (MCTQ) and actimetry. In the first half of this chapter, we provide detailed instructions on how to use and interpret the MCTQ. In addition, we give an overview of the main insights gained with this instrument over the past 10 years, including some new findings on the interaction of light and age on sleep timing. In the second half of this chapter, we introduce the reader to the method of actimetry and share our experience in basic analysis techniques, including visualization, smoothing, and cosine model fitting of in situ recorded data. Additionally, we describe our new approach to automatically detect sleep from activity recordings. Our vision is that the broad use of such easy techniques in real-life settings combined with automated analyses will lead to the creation of large databases. The resulting power of big numbers will promote our understanding of such fundamental biological phenomena as sleep. © 2015 Elsevier Inc. All rights reserved.

  6. Correlation of resting ECG, stress ECG and thallium scan in the evaluation of coronary artery disease

    International Nuclear Information System (INIS)

    Khan, A.; Amin, W.; Khan, M.Z.A.; Ahmed, A.; Kiani, M.R.

    1987-01-01

    This study includes 70 cases who underwent myocardial perfusion studies with thallium 201 during the year 1984-85. They were studied clinically, had their resting ECGs, stress ECGs and coronary angiograms. Majority of these patients were males, their ages ranged between 34-70 years. The patients population included with typical/atypical chest pain, some with resting ECG abnormalities, after coronary angiography and a few after coronary artery bypass graft surgery. The result of all the modalities were compared with the conventional gold standard for ischaemic heart disease, i.e. coronary angiogram. It is concluded that the sensitivity of resting ECG in the diagnosis of ischaemic heart disease is very low. The exercise test alone was found conclusive in about 74% of patients while sensitivity of thallium scan was 66% in this particular group of patients. (author)

  7. Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

    Science.gov (United States)

    Cromwell, R. L.; Zanello, S. B.; Yarbough, P. O.; Taibbi, G.; Vizzeri, G.

    2011-01-01

    Reports of astronauts visual changes raised concern about ocular health during long-duration spaceflight. Some of these findings included hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, hypotheses speculate that hypertension in the brain caused by cephalad fluid shifts during spaceflight is a possible mechanism for these ocular changes. Head-down tilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. In addition, previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP). For these reasons, vision monitoring of HDT bed rest subjects was implemented for NASA bed rest studies. Subjects selected for these studies were healthy adults (14 males and 5 females). Average age was 37.5 plus or minus 9.1 years, weight was 77.4 plus or minus 11.3 Kg, and height was 173.4 plus or minus 7.2 14 cm. Controlled conditions followed for all NASA bed rest studies were implemented. These conditions included factors such as eating a standardized diet, maintaining a strict sleep wake cycle, and remaining in bed for 24 hours each day. In one study, subjects maintained a horizontal (0 degree) position while in bed and were exercised six days per week with an integrated resistance and aerobic training (iRAT) program. In the other study, subjects were placed at 6 degrees HDT while in bed and did not engage in exercise. All subjects underwent pre- and post bed rest vision testing. While the battery of vision tests for each study was not identical, measures common to both studies will be presented. These measures included IOP and measures that provided an indication of optic disc swelling as derived from optical coherence tomography (OCT) testing: average retinal nerve fiber layer (RNFL) thickness (millimeters), disc area (square millimeters), rim area (square millimters), and average cup to disc (C

  8. "Therapeutic" bed rest in pregnancy: unethical and unsupported by data.

    Science.gov (United States)

    McCall, Christina A; Grimes, David A; Lyerly, Anne Drapkin

    2013-06-01

    "Therapeutic" bed rest continues to be used widely, despite evidence of no benefit and known harms. In this commentary, we summarize the Cochrane reviews of bed rest and propose an ethical argument for discontinuing this practice. Cochrane systematic reviews do not support "therapeutic" bed rest for threatened abortion, hypertension, preeclampsia, preterm birth, multiple gestations, or impaired fetal growth. This assessment has been echoed in other comprehensive reviews. Prescribing bed rest is inconsistent with the ethical principles of autonomy, beneficence, and justice. Hence, if bed rest is to be used, it should be only within a formal clinical trial.

  9. REST represses a subset of the pancreatic endocrine differentiation program

    DEFF Research Database (Denmark)

    Martin, David; Kim, Yung-Hae; Sever, Dror

    2015-01-01

    in neurons and in endocrine cells, which is necessary for their normal function. During development, REST represses a subset of genes in the neuronal differentiation program and Rest is down-regulated as neurons differentiate. Here, we investigate the role of REST in the differentiation of pancreatic...... endocrine cells, which are molecularly close to neurons. We show that Rest is widely expressed in pancreas progenitors and that it is down-regulated in differentiated endocrine cells. Sustained expression of REST in Pdx1(+) progenitors impairs the differentiation of endocrine-committed Neurog3...

  10. Programmatic access to logical models in the Cell Collective modeling environment via a REST API.

    Science.gov (United States)

    Kowal, Bryan M; Schreier, Travis R; Dauer, Joseph T; Helikar, Tomáš

    2016-01-01

    Cell Collective (www.cellcollective.org) is a web-based interactive environment for constructing, simulating and analyzing logical models of biological systems. Herein, we present a Web service to access models, annotations, and simulation data in the Cell Collective platform through the Representational State Transfer (REST) Application Programming Interface (API). The REST API provides a convenient method for obtaining Cell Collective data through almost any programming language. To ensure easy processing of the retrieved data, the request output from the API is available in a standard JSON format. The Cell Collective REST API is freely available at http://thecellcollective.org/tccapi. All public models in Cell Collective are available through the REST API. For users interested in creating and accessing their own models through the REST API first need to create an account in Cell Collective (http://thecellcollective.org). thelikar2@unl.edu. Technical user documentation: https://goo.gl/U52GWo. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Tremor frequency characteristics in Parkinson's disease under resting-state and stress-state conditions.

    Science.gov (United States)

    Lee, Hong Ji; Lee, Woong Woo; Kim, Sang Kyong; Park, Hyeyoung; Jeon, Hyo Seon; Kim, Han Byul; Jeon, Beom S; Park, Kwang Suk

    2016-03-15

    Tremor characteristics-amplitude and frequency components-are primary quantitative clinical factors for diagnosis and monitoring of tremors. Few studies have investigated how different patient's conditions affect tremor frequency characteristics in Parkinson's disease (PD). Here, we analyzed tremor characteristics under resting-state and stress-state conditions. Tremor was recorded using an accelerometer on the finger, under resting-state and stress-state (calculation task) conditions, during rest tremor and postural tremor. The changes of peak power, peak frequency, mean frequency, and distribution of power spectral density (PSD) of tremor were evaluated across conditions. Patients whose tremors were considered more than "mild" were selected, for both rest (n=67) and postural (n=25) tremor. Stress resulted in both greater peak powers and higher peak frequencies for rest tremor (pstate condition. The distributions of PSD of tremor were symmetrical, regardless of conditions. Tremor is more evident and typical tremor characteristics, namely a lower frequency as amplitude increases, are different in stressful condition. Patient's conditions directly affect neural oscillations related to tremor frequencies. Therefore, tremor characteristics in PD should be systematically standardized across patient's conditions such as attention and stress levels. Copyright © 2016. Published by Elsevier B.V.

  12. Resting site use of giant pandas in Wanglang Nature Reserve.

    Science.gov (United States)

    Kang, Dongwei; Wang, Xiaorong; Li, Junqing

    2017-10-23

    Little is known about the resting sites used by the giant panda (Ailuropoda melanoleuca), which restricts our understanding of their resting habits and limits conservation efforts. To enhance our understanding of resting site requirements and factors affecting the resting time of giant pandas, we investigated the characteristics of resting sites in the Wanglang Nature Reserve, Sichuan Province, China. The results indicated that the resting sites of giant pandas were characterised by a mean slope of 21°, mean nearest tree size of 53.75 cm, mean nearest shrub size of 2.82 cm, and mean nearest bamboo number of 56. We found that the resting sites were closer to bamboo than to trees and shrubs, suggesting that the resting site use of giant pandas is closely related to the presence of bamboo. Considering that giant pandas typically rest near a large-sized tree, protection of large trees in the forests is of considerable importance for the conservation of this species. Furthermore, slope was found to be an important factor affecting the resting time of giant pandas, as they tended to rest for a relatively longer time in sites with a smaller degree of slope.

  13. An ontological analysis of the electrocardiogram - DOI: 10.3395/reciis.v3i1.242en

    Directory of Open Access Journals (Sweden)

    Bernardo Gonçalves

    2009-04-01

    Full Text Available Bioinformatics has been a fertile field for the application of the discipline of formal ontology. The principled representation of biomedical entities has increasingly supported biological research, with direct benefits ranging from the reformulation of medical terminologies to the introduction of new perspectives for enhanced models of Electronic Health Records (EHR. This paper introduces an application-independent ontological analysis of the electrocardiogram (ECG grounded in the Unified Foundational Ontology. With the objective of investigating the phenomena underlying this cardiological exam, we deal with the sub-domains of human heart electrophysiology and anatomy. We then outline an ECG Ontology built upon the OBO Relation Ontology. In addition, the domain ontology sketched here takes inspiration both in the Foundational Model of Anatomy and in the Ontology of Functions proposed under the auspices of the General Formal Ontology (GFO research program.

  14. Experimental envenomation with Crotalus durissus terrificus venom in dogs treated with antiophidic serum - part II: laboratory aspects, electrocardiogram and histopathology

    Directory of Open Access Journals (Sweden)

    R. M. B. Nogueira

    2007-01-01

    Full Text Available The present work shows laboratory aspects, electrocardiogram and histopathology results during experimental envenomation by Crotalus durissus terrificus in dogs treated with antiophidic serum. Twenty-one dogs were divided into three groups of seven animals each. Group I received 1mg/kg venom (sc; Group II received 1mg/kg venom (sc, 50mg antiophidic serum (iv and fluid therapy including 0.9% NaCl solution (iv; and Group III received 1mg/kg venom (sc, 50mg antiophidic serum (iv and fluid therapy including 0.9% NaCl solution containing sodium bicarbonate diluted to the dose of 4mEq/kg. Urinalysis showed brown urine, proteinuria, occult blood and myoglobinuria. Respiratory acidosis and hypotension were also observed. At the venom inoculation site, there was discreet edema, popliteal lymph node response, musculature presenting whitish areas and necrotic myositis with myoregenerative activity. There was not evidence of electrocardiographical and biochemical alterations.

  15. Detection of Atrial Fibrillation Using Artifical Neural Network with Power Spectrum Density of RR Interval of Electrocardiogram

    Science.gov (United States)

    Afdala, Adfal; Nuryani, Nuryani; Satrio Nugroho, Anto

    2017-01-01

    Atrial fibrillation (AF) is a disorder of the heart with fairly high mortality in adults. AF is a common heart arrythmia which is characterized by a missing or irregular contraction of atria. Therefore, finding a method to detect atrial fibrillation is necessary. In this article a system to detect atrial fibrillation has been proposed. Detection system utilized backpropagation artifical neural network. Data input in this method includes power spectrum density of R-peaks interval of electrocardiogram which is selected by wrapping method. This research uses parameter learning rate, momentum, epoch and hidden layer. System produces good performance with accuracy, sensitivity, and specificity of 83.55%, 86.72 % and 81.47 %, respectively.

  16. Diagnosis of silent myocardial ischemia in type 2 diabetic patients by electrocardiogram, ergometry and Gated-SPECT

    International Nuclear Information System (INIS)

    Penna Quian, Yamile; Fernandez-Britto Rodriguez, Jose; Bacallao Gallestey, Jorge; Batista Cuellar, Juan Felipe; Coca Perez, Marco Antonio; Toirac Garcia, Noresma; Penna Coego, Andria

    2008-01-01

    31 asymptomatic type 2 diabetic patients were studied by lab tests, electrocardiogram, ergometry, Gated-SPECT and coronariography to determine the relation between the atherosclerotic risk factors and the silent myocardial ischemia. Patients were classified into two groups: positive SPECT and negative SPECT. Association tests were made for each variable and ROC curves were constructed to identify risk markers. In 35.5% of the patients silent myocardial ischemia was detected with a good angiographic correlation. A significant association was evidenced between positive SPECT and the atherosclerotic risk factors, namely, low values of HDLc, family pathological history of ischemic heart disease and peripheral vascular disease. The logistic regression models showed that low values of HDLc together with family pathological history of ischemic heart disease may be strong predictors of silent myocardial ischemia in asymptomatic type 2 diabetic patients

  17. Preventive effects of p-coumaric acid on cardiac hypertrophy and alterations in electrocardiogram, lipids, and lipoproteins in experimentally induced myocardial infarcted rats.

    Science.gov (United States)

    Roy, Abhro Jyoti; Stanely Mainzen Prince, P

    2013-10-01

    The present study evaluated the preventive effects of p-coumaric acid on cardiac hypertrophy and alterations in electrocardiogram, lipids, and lipoproteins in experimentally induced myocardial infarcted rats. Rats were pretreated with p-coumaric acid (8 mg/kg body weight) daily for a period of 7 days and then injected with isoproterenol (100mg/kg body weight) on 8th and 9th day to induce myocardial infarction. Myocardial infarction induced by isoproterenol was indicated by increased level of cardiac sensitive marker and elevated ST-segments in the electrocardiogram. Also, the levels/concentrations of serum and heart cholesterol, triglycerides and free fatty acids were increased in myocardial infarcted rats. Isoproterenol also increased the levels of serum low density and very low density lipoprotein cholesterol and decreased the levels of high density lipoprotein cholesterol. It also enhanced the activity of liver 3-hydroxy-3 methyl glutaryl-Coenzyme-A reductase. p-Coumaric acid pretreatment revealed preventive effects on all the biochemical parameters and electrocardiogram studied in myocardial infarcted rats. The in vitro study confirmed the free radical scavenging property of p-coumaric acid. Thus, p-coumaric acid prevented cardiac hypertrophy and alterations in lipids, lipoproteins, and electrocardiogram, by virtue of its antihypertrophic, antilipidemic, and free radical scavenging effects in isoproterenol induced myocardial infarcted rats. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Comparison of infarct size changes with delayed contrast-enhanced magnetic resonance imaging and electrocardiogram QRS scoring during the 6 months after acutely reperfused myocardial infarction

    DEFF Research Database (Denmark)

    Bang, L.E.; Ripa, R.S.; Grande, P.

    2008-01-01

    INTRODUCTION: Magnetic resonance imaging using the delayed contrast-enhanced (DE-MRI) method can be used for characterizing and quantifying myocardial infarction (MI). Electrocardiogram (ECG) score after the acute phase of MI can be used to estimate the portion of left ventricular myocardium...

  19. Referral of patients with ST-segment elevation acute myocardial infarction directly to the catheterization suite based on prehospital teletransmission of 12-lead electrocardiogram

    DEFF Research Database (Denmark)

    Sillesen, Martin; Sejersten, Maria; Strange, Søren

    2008-01-01

    BACKGROUND: Time from symptom onset to reperfusion is essential in patients with ST-segment elevation acute myocardial infarction. Prior studies have indicated that prehospital 12-lead electrocardiogram (ECG) transmission can reduce time to reperfusion. PURPOSE: Determine 12-lead ECG transmission...

  20. Mechanism underlying the absence of ischemic changes on the exercise electrocardiogram in patients with abnormal exercise thallium-201 imaging and coronary artery disease

    International Nuclear Information System (INIS)

    Coplan, N.L.; Horowitz, S.F.; Hoffman, D.P.; Goldman, M.E.; Machac, J.

    1985-01-01

    Patients with coronary artery disease may have reversible abnormalities on a thallium myocardial perfusion study without simultaneous ischemic changes on the exercise electrocardiogram, but the mechanisms responsible for this disparity have not been fully elucidated. A group of 37 patients with angiographically demonstrated coronary artery disease and abnormal thallium perfusion imaging were divided into two groups on the basis of their exercise electrocardiographic ST segment response. Thirteen patients (Group A) had no significant electrocardiographic changes with exercise, while 24 patients (Group B) had ST changes consistent with ischemia during the test. There were no significant differences in clinical or angiographic characteristics between the two groups. Stress test results showed a similar mean duration of exercise in the two groups, but the patients in Group A achieved a significantly lower mean maximal heart rate and mean maximal double product. These results suggest that exercise thallium-electrocardiogram discordance is mediated by the level of myocardial workload achieved. An abnormal perfusion scan accompanying an exercise electrocardiogram which does not demonstrate any ischemic ST change may occur when there is sufficient increase in myocardial oxygen demand to result in differential augmentation of myocardial blood flow, but insufficient imbalance of supply and demand to result in signs of ischemia on the surface electrocardiogram

  1. How the knowledge of genetic "makeup" and cellular data can affect the analysis of repolarization in surface electrocardiogram.

    Science.gov (United States)

    Shimizu, Wataru

    2010-01-01

    This review article sought to describe patterns of repolarization on the surface electrocardiogram in inherited cardiac arrhythmias and to discuss how the knowledge of genetic makeup and cellular data can affect the analysis based on the data derived from the experimental studies using arterially perfused canine ventricular wedge preparations. Molecular genetic studies have established a link between a number of inherited cardiac arrhythmia syndromes and mutations in genes encoding cardiac ion channels or membrane components during the past 2 decades. Twelve forms of congenital long QT syndrome have been so far identified, and genotype-phenotype correlations have been investigated especially in the 3 major genotypes-LQT1, LQT2, and LQT3. Abnormal T waves are reported in the LQT1, LQT2, and LQT3, and the differences in the time course of repolarization of the epicardial, midmyocardial, and endocardial cells give rise to voltage gradients responsible for the manifestation of phenotypic appearance of abnormal T waves. Brugada syndrome is characterized by ST-segment elevation in leads V1 to V3 and an episode of ventricular fibrillation, in which 7 genotypes have been reported. An intrinsically prominent transient outward current (I(to))-mediated action potential notch and a subsequent loss of action potential dome in the epicardium, but not in the endocardium of the right ventricular outflow tract, give rise to a transmural voltage gradient, resulting in ST-segment elevation, and a subsequent phase 2 reentry-induced ventricular fibrillation. In conclusion, transmural electrical heterogeneity of repolarization across the ventricular wall profoundly affects the phenotypic manifestation of repolarization patterns on the surface electrocardiogram in inherited cardiac arrhythmias. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. [Incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and its clinical significance].

    Science.gov (United States)

    Liu, Liping; Lin, Ping; Xu, Yi; Wu, Lijia; Zou, Runmei; Xie, Zhenwu; Wang, Cheng

    2016-04-01

    To analyze the incidence of long (short) PR interval in electrocardiogram among healthy people in Changsha and the clinical significance.
 Twelve-lead body surface electrocardiogram was taken to measure the heart rates and PR intervals from 4 025 healthy individuals (age range from 6 min after birth to 83 years old) who performed physical examination from Jan, 1993 to Dec, 2012 in the Second Xiangya Hospital, Central South University. Statistics were analyzed by SPSS 16.0.
 The total incidence of short PR interval was 19.65% (791/4 025). The age group from birth to 13 years old had a higher incidence than the other age groups (χ2=432, PPR intervals was 3.58% (144/4 025). The 1 year-old group had the highest incidence (6.74%), which decreased with the increase of age. The lowest incidence of long PR intervals occurred in the age group from 14-17 years old, which gradually increased after 50 years old. There were no significant differences in long (short) PR intervals between the gender (P>0.05).
 The incidence of long (short) PR intervals varies in different age groups of healthy people. The incidences of long (short) PR intervals in children before 10 years old are higher than those in adults, especially the short PR intervals, as a result of the heart rate affected by childhood autonomic nervous function and the change in atrial volume with age. Adults have long (short) PR interval should be regularly followed-up to prevent cardiovascular events.

  3. The Shortest QRS Duration of an Electrocardiogram Might Be an Optimal Electrocardiographic Predictor for Response to Cardiac Resynchronization Therapy.

    Science.gov (United States)

    Chen, Jan-Yow; Lin, Kuo-Hung; Chang, Kuan-Cheng; Chou, Che-Yi

    2017-08-03

    QRS duration has been associated with the response to cardiac resynchronization therapy (CRT). However, the methods for defining QRS duration to predict the outcome of CRT have discrepancies in previous reports. The aim of this study was to determine an optimal measurement of QRS duration to predict the response to CRT.Sixty-one patients who received CRT were analyzed. All patients had class III-IV heart failure, left ventricular ejection fraction not more than 35%, and complete left bundle branch block. The shortest, longest, and average QRS durations from the 12 leads of each electrocardiogram (ECG) were measured. The responses to CRT were determined using the changes in echocardiography after 6 months. Thirty-five (57.4%) patients were responders and 26 (42.6%) patients were non-responders. The pre-procedure shortest, average, and longest QRS durations and the QRS shortening (ΔQRS) of the shortest QRS duration were significantly associated with the response to CRT in a univariate logistic regression analysis (P = 0.002, P = 0.03, P = 0.04 and P = 0.04, respectively). Based on the measurement of the area under curve of the receiver operating characteristic curve, only the pre-procedure shortest QRS duration and the ΔQRS of the shortest QRS duration showed significant discrimination for the response to CRT (P = 0.002 and P = 0.038, respectively). Multivariable logistic regression showed the pre-procedure shortest QRS duration is an independent predictor for the response to CRT.The shortest QRS duration from the 12 leads of the electrocardiogram might be an optimal measurement to predict the response to CRT.

  4. Construction and use of a zebrafish heart voltage and calcium optical mapping system, with integrated electrocardiogram and programmable electrical stimulation

    Science.gov (United States)

    Lin, Eric; Craig, Calvin; Lamothe, Marcel; Sarunic, Marinko V.; Beg, Mirza Faisal

    2015-01-01

    Zebrafish are increasingly being used as a model of vertebrate cardiology due to mammalian-like cardiac properties in many respects. The size and fecundity of zebrafish make them suitable for large-scale genetic and pharmacological screening. In larger mammalian hearts, optical mapping is often used to investigate the interplay between voltage and calcium dynamics and to investigate their respective roles in arrhythmogenesis. This report outlines the construction of an optical mapping system for use with zebrafish hearts, using the voltage-sensitive dye RH 237 and the calcium indicator dye Rhod-2 using two industrial-level CCD cameras. With the use of economical cameras and a common 532-nm diode laser for excitation, the rate dependence of voltage and calcium dynamics within the atrial and ventricular compartments can be simultaneously determined. At 140 beats/min, the atrial action potential duration was 36 ms and the transient duration was 53 ms. With the use of a programmable electrical stimulator, a shallow rate dependence of 3 and 4 ms per 100 beats/min was observed, respectively. In the ventricle the action potential duration was 109 ms and the transient duration was 124 ms, with a steeper rate dependence of 12 and 16 ms per 100 beats/min. Synchronous electrocardiograms and optical mapping recordings were recorded, in which the P-wave aligns with the atrial voltage peak and R-wave aligns with the ventricular peak. A simple optical pathway and imaging chamber are detailed along with schematics for the in-house construction of the electrocardiogram amplifier and electrical stimulator. Laboratory procedures necessary for zebrafish heart isolation, cannulation, and loading are also presented. PMID:25740339

  5. Value of the Electrocardiogram as a Predictor of Right Ventricular Dysfunction in Patients With Chronic Right Ventricular Volume Overload.

    Science.gov (United States)

    Alonso, Pau; Andrés, Ana; Rueda, Joaquín; Buendía, Francisco; Igual, Begoña; Rodríguez, María; Osa, Ana; Arnau, Miguel A; Salvador, Antonio

    2015-05-01

    Pulmonary regurgitation is a common complication in patients with repaired tetralogy of Fallot or congenital pulmonary stenosis. Electrocardiographic variables have been correlated with parameters used to evaluate right ventricular function. We aimed to analyze the diagnostic value of the width and fragmentation of the electrocardiogram in the identification of patients with right ventricular dysfunction and/or dilation. We selected 107 consecutive patients diagnosed with severe pulmonary insufficiency after repair of pulmonary stenosis or tetralogy of Fallot. The tests included electrocardiography, echocardiography, and magnetic resonance. Each electrocardiogram was analyzed manually to measure QRS duration. We defined QRS fragmentation as the presence of low-voltage waves in the terminal portion of the QRS complex in at least 2 contiguous leads. We found a significant negative correlation between QRS width and right ventricular function, as well as a positive correlation with right ventricular volume. The receiver operating characteristic curve indicated a cut-off point for QRS width of 140ms, which showed good sensitivity for a diagnosis of right ventricular dilation (> 80%) and dysfunction (> 95%). In logistic regression models, a QRS duration > 140ms was found to be the only independent predictor of right ventricular dilation and dysfunction. Electrocardiography is a rapid, widely available, and reproducible tool. QRS width constitutes an independent predictor of the presence of right ventricular dilation and dysfunction. This study is the first to provide a cutoff value for QRS width to screen for right ventricle involvement. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Proposed clinical scale for the diagnosis of acute coronary syndrome in patients with an inconclusive electrocardiogram and myocardial injury biomarkers.

    Science.gov (United States)

    Montero-Pérez, F J; Quero-Espinosa, F B; Clemente-Millán, M J; Castro-Giménez, J A; de Burgos-Marín, J; Romero-Moreno, M Á

    2018-03-01

    Acute coronary syndrome (ACS) requires improved diagnostic accuracy through useful, safe and easy-to-apply tools. To obtain an assessment scale for the diagnosis of ACS in patients with chest pain and nondiagnostic electrocardiogram and troponin concentrations. A prospective cohort study included 286 patients treated in the emergency department for chest pain, with normal electrocardiogram and troponin levels. Using multiple logistic regression, we obtained the independent predictors for the diagnosis of ACS. The assessment scale's discriminative power was assessed with the area under the ROC curve. The diagnosis of ACS was confirmed in 103 patients (36%). The final predictive model included 3 endpoints: a history of coronary artery disease, hyperlipidaemia and a score≥6 points on the Geleijnse scale. The area under the ROC curve for the final model was 0.90 (95% confidence interval [95% CI] 0.85-0.93). A threshold of 5 points achieved a sensitivity of 76.7% (95% CI 68-84), a specificity of 91.8% (95% CI 87-95), a positive likelihood ratio of 9.36 (95% CI 5.70-15.40), a negative likelihood ratio of 0.25 (95% CI 18.00-36.00) and an overall diagnostic accuracy of 86.4% (95% CI 82-90). The predictive model was superior to the Geleijnse scale alone. The final scale showed good discriminative capacity for diagnosing ACS and could therefore be of interest for identifying ACS in emergency departments. Nevertheless, the scale needs to be validated in larger multicentre studies. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  7. Effects of Bed Rest on Conduction Velocity of the Triceps Surae Stretch Reflex and Postural Control

    Science.gov (United States)

    Reschke, M. F.; Wood, S. J.; Cerisano, J. M.; Kofman, I. S.; Fisher, E. A.; Esteves, J. T.; Taylor, L. C.; DeDios, Y. E.; Harm, D. L.

    2011-01-01

    Despite rigorous exercise and nutritional management during space missions, astronauts returning from microgravity exhibit neuromuscular deficits and a significant loss in muscle mass in the postural muscles of the lower leg. Similar changes in the postural muscles occur in subjects participating in long-duration bed rest studies. These adaptive muscle changes manifest as a reduction in reflex conduction velocity during head-down bed rest. Because the stretch reflex encompasses both the peripheral (muscle spindle and nerve axon) and central (spinal synapse) components involved in adaptation to calf muscle unloading, it may be used to provide feedback on the general condition of neuromuscular function, and might be used to evaluate the effectiveness of countermeasures aimed at preserving muscle mass and function during periods of unloading. Stretch reflexes were measured on 18 control subjects who spent 60 to 90 days in continuous 6 deg head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 degrees at a peak velocity of about 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender. Computerized posturography was also conducted on these same subjects before and after bed rest as part of the standard measures. Peak-to-peak sway was measured during Sensory Organization Tests (SOTs) to evaluate changes in the ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Although no gender differences were found, a significant increase in reflex latency and a significant decrease in CV were observed during the bed

  8. Rapid Deployment of a RESTful Service for Oceanographic Research Cruises

    Science.gov (United States)

    Fu, Linyun; Arko, Robert; Leadbetter, Adam

    2014-05-01

    The Ocean Data Interoperability Platform (ODIP) seeks to increase data sharing across scientific domains and international boundaries, by providing a forum to harmonize diverse regional data systems. ODIP participants from the US include the Rolling Deck to Repository (R2R) program, whose mission is to capture, catalog, and describe the underway/environmental sensor data from US oceanographic research vessels and submit the data to public long-term archives. R2R publishes information online as Linked Open Data, making it widely available using Semantic Web standards. Each vessel, sensor, cruise, dataset, person, organization, funding award, log, report, etc, has a Uniform Resource Identifier (URI). Complex queries that federate results from other data providers are supported, using the SPARQL query language. To facilitate interoperability, R2R uses controlled vocabularies developed collaboratively by the science community (eg. SeaDataNet device categories) and published online by the NERC Vocabulary Server (NVS). In response to user feedback, we are developing a standard programming interface (API) and Web portal for R2R's Linked Open Data. The API provides a set of simple REST-type URLs that are translated on-the-fly into SPARQL queries, and supports common output formats (eg. JSON). We will demonstrate an implementation based on the Epimorphics Linked Data API (ELDA) open-source Java package. Our experience shows that constructing a simple portal with limited schema elements in this way can significantly reduce development time and maintenance complexity.

  9. Normal ranges for fetal electrocardiogram values for the healthy fetus of 18-24 weeks of gestation: a prospective cohort study.

    Science.gov (United States)

    Verdurmen, Kim M J; Lempersz, Carlijn; Vullings, Rik; Schroer, Christian; Delhaas, Tammo; van Laar, Judith O E H; Oei, S Guid

    2016-08-17

    The fetal anomaly ultrasound only detects 65 to 81 % of the patients with congenital heart disease, making it the most common structural fetal anomaly of which a significant part is missed during prenatal life. Therefore, we need a reliable non-invasive diagnostic method which improves the predictive value for congenital heart diseases early in pregnancy. Fetal electrocardiography could be this desired diagnostic method. There are multiple technical challenges to overcome in the conduction of the fetal electrocardiogram. In addition, interpretation is difficult due to the organisation of the fetal circulation in utero. We want to establish the normal ranges and values of the fetal electrocardiogram parameters in healthy fetuses of 18 to 24 weeks of gestation. Women with an uneventful singleton pregnancy between 18 and 24 weeks of gestation are asked to participate in this prospective cohort study. A certified and experienced sonographist performs the fetal anomaly scan. Subsequently, a fetal electrocardiogram recording is performed using dedicated signal processing methods. Measurements are performed at two institutes. We will include 300 participants to determine the normal values and 95 % confidence intervals of the fetal electrocardiogram parameters in a healthy fetus. We will evaluate the fetal heart rate, segment intervals, normalised amplitude and the fetal heart axis. Three months postpartum, we will evaluate if a newborn is healthy through a questionnaire. Fetal electrocardiography could be a promising tool in the screening program for congenital heart diseases. The electrocardiogram is a depiction of the intimate relationship between the cardiac nerve conduction pathways and the structural morphology of the fetal heart, and therefore particularly suitable for the detection of secondary effects due to a congenital heart disease (hypotrophy, hypertrophy and conduction interruption).

  10. A comparison of resting images from two myocardial perfusion tracers

    International Nuclear Information System (INIS)

    Anagnostopoulos, C.; Laney, R.; Pennell, D.; Proukakis, H.; Underwood, R.

    1995-01-01

    We have compared stress-redistribution and delayed rest thallium-201 with rest technetium-99m methoxyisobutylisonitrile (MIBI) tomograms in order to compare the tracers for the assessment of myocardial viability and to validate a rapid protocol combining the two tracers. We studied 30 consecutive patients with known or suspected coronary artery disease [group 1: 16 with normal left ventricular function, mean left ventricular ejection fraction (LVEF) 55%, SD 6%; group 2: 14 with abnormal function, mean LVEF 28%, SD 8%]. 201 Tl was injected during infusion of adenosine followed by acquisition of conventional stress and redistribution tomograms. On a separate day, 201 Tl was injected at rest with imaging 4 h later. 99m Tc-MIBI was then given at rest and imaging was performed. Three images were compared: redistribution 201 Tl, rest 201 Tl, and rest 99m Tc-MIBI. Tracer activity was classified visually and quantitatively in nine segments and segments with>50% activity were defined as containing clinically significant viable myocardium. Mean global tracer uptake as a percentage of maximum was similar in group 1 (rest 201 Tl 69%±12%, redistribution 201 Tl 69%±15%, rest 99m Tc-MIBI 70%±13%), but in group 2 mean tracer uptake was significantly greater in the rest 201 Tl images (59%±16%) than in redistribution 201 Tl images (53%±17%) or rest 99m Tc-MIBI images (53%±19%). Overall agreement for regional uptake score was excellent (κ from 0.79 to 0.84), although there were a significant number of segments with less uptake shown by redistribution 201 Tl and by rest 99m Tc-MIBI than by rest 201 Tl in group 2. The number of segments with significant viable myocardium in group 1 was very similar between the three images but in group 2 rest 201 Tl identified significantly more segments as viable than the other images. (orig./MG) (orig.). With 1 fig., 7 tabs

  11. Resting eggs in free living marine and estuarine copepods

    DEFF Research Database (Denmark)

    Holm, Mark Wejlemann; Kiørboe, Thomas; Brun, Philipp Georg

    2018-01-01

    Marine free living copepods can survive harsh periods and cope with seasonal fluctuations in environmental conditions using resting eggs (embryonic dormancy). Laboratory experiments show that temperature is the common driver for resting egg production. Hence, we hypothesize (i) that seasonal...... temperature variation, rather than variation in food abundance is the main driver for the occurrence of the resting eggs strategy in marine and estuarine copepod species; and (ii) that the thermal boundaries of the distribution determine where resting eggs are produced and whether they are produced to cope...... with warm or cold periods. We compile literature information on the occurrence of resting egg production and relate this to spatio-temporal patterns in sea surface temperature and chlorophyll a concentration obtained from satellite observations. We find that the production of resting eggs has been reported...

  12. Rest but busy: Aberrant resting-state functional connectivity of triple network model in insomnia.

    Science.gov (United States)

    Dong, Xiaojuan; Qin, Haixia; Wu, Taoyu; Hu, Hua; Liao, Keren; Cheng, Fei; Gao, Dong; Lei, Xu

    2018-02-01

    One classical hypothesis among many models to explain the etiology and maintenance of insomnia disorder (ID) is hyperarousal. Aberrant functional connectivity among resting-state large-scale brain networks may be the underlying neurological mechanisms of this hypothesis. The aim of current study was to investigate the functional network connectivity (FNC) among large-scale brain networks in patients with insomnia disorder (ID) during resting state. In the present study, the resting-state fMRI was used to evaluate whether patients with ID showed aberrant FNC among dorsal attention network (DAN), frontoparietal control network (FPC), anterior default mode network (aDMN), and posterior default mode network (pDMN) compared with healthy good sleepers (HGSs). The Pearson's correlation analysis was employed to explore whether the abnormal FNC observed in patients with ID was associated with sleep parameters, cognitive and emotional scores, and behavioral performance assessed by questionnaires and tasks. Patients with ID had worse subjective thought control ability measured by Thought Control Ability Questionnaire (TCAQ) and more negative affect than HGSs. Intriguingly, relative to HGSs, patients with ID showed a significant increase in FNC between DAN and FPC, but a significant decrease in FNC between aDMN and pDMN. Exploratory analysis in patients with ID revealed a significantly positive correlation between the DAN-FPC FNC and reaction time (RT) of psychomotor vigilance task (PVT). The current study demonstrated that even during the resting state, the task-activated and task-deactivated large-scale brain networks in insomniacs may still maintain a hyperarousal state, looking quite similar to the pattern in a task condition with external stimuli. Those results support the hyperarousal model of insomnia.

  13. From "rest" to language task: Task activation selects and prunes from broader resting-state network.

    Science.gov (United States)

    Doucet, Gaelle E; He, Xiaosong; Sperling, Michael R; Sharan, Ashwini; Tracy, Joseph I

    2017-05-01

    Resting-state networks (RSNs) show spatial patterns generally consistent with networks revealed during cognitive tasks. However, the exact degree of overlap between these networks has not been clearly quantified. Such an investigation shows promise for decoding altered functional connectivity (FC) related to abnormal language functioning in clinical populations such as temporal lobe epilepsy (TLE). In this context, we investigated the network configurations during a language task and during resting state using FC. Twenty-four healthy controls, 24 right and 24 left TLE patients completed a verb generation (VG) task and a resting-state fMRI scan. We compared the language network revealed by the VG task with three FC-based networks (seeding the left inferior frontal cortex (IFC)/Broca): two from the task (ON, OFF blocks) and one from the resting state. We found that, for both left TLE patients and controls, the RSN recruited regions bilaterally, whereas both VG-on and VG-off conditions produced more left-lateralized FC networks, matching more closely with the activated language network. TLE brings with it variability in both task-dependent and task-independent networks, reflective of atypical language organization. Overall, our findings suggest that our RSN captured bilateral activity, reflecting a set of prepotent language regions. We propose that this relationship can be best understood by the notion of pruning or winnowing down of the larger language-ready RSN to carry out specific task demands. Our data suggest that multiple types of network analyses may be needed to decode the association between language deficits and the underlying functional mechanisms altered by disease. Hum Brain Mapp 38:2540-2552, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  14. The Effects of Long Duration Bed Rest on Functional Mobility and Balance: Relationship to Resting State Motor Cortex Connectivity

    Science.gov (United States)

    Erdeniz, B.; Koppelmans, V.; Bloomberg, J. J.; Kofman, I. S.; DeDios, Y. E.; Riascos-Castaneda, R. F.; Wood, S. J.; Mulavara, A. P.; Seidler, R. D.

    2014-01-01

    NASA offers researchers from a variety of backgrounds the opportunity to study bed rest as an experimental analog for space flight. Extended exposure to a head-down tilt position during long duration bed rest can resemble many of the effects of a low-gravity environment such as reduced sensory inputs, body unloading and increased cephalic fluid distribution. The aim of our study is to a) identify changes in brain function that occur with prolonged bed rest and characterize their recovery time course; b) assess whether and how these changes impact behavioral and neurocognitive performance. Thus far, we completed data collection from six participants that include task based and resting state fMRI. The data have been acquired through the bed rest facility located at the University of Texas Medical Branch (Galveston, TX). Subjects remained in bed with their heads tilted down 6 degrees below their feet for 70 consecutive days. Behavioral measures and neuroimaging assessments were obtained at seven time points: a) 7 and 12 days before bed rest; b) 7, 30, and 65 days during bed rest; and c) 7 and 12 days after bed rest. Functional connectivity magnetic resonance imaging (FcMRI) analysis was performed to assess the connectivity of motor cortex in and out of bed rest. We found a decrease in motor cortex connectivity with vestibular cortex and the cerebellum from pre bed rest to in bed rest. We also used a battery of behavioral measures including the functional mobility test and computerized dynamic posturography collected before and after bed rest. We will report the preliminary results of analyses relating brain and behavior changes. Furthermore, we will also report the preliminary results of a spatial working memory task and vestibular stimulation during in and out of bed rest.

  15. Thallium-201 myocardial scintigraphy and left ventricular function at rest in patients with rest angina pectoris

    International Nuclear Information System (INIS)

    Hakki, A.H.; Iskandrian, A.S.; Kane, S.A.; Amenta, A.

    1984-01-01

    The purpose of this study was to examine the rest thallium-201 perfusion pattern during angina-free periods in 40 patients with rest angina pectoris secondary to coronary artery disease (greater than or equal to 70% diameter narrowing). Seventeen patients had previous Q wave myocardial infarction. The perfusion defects were considered fixed or reversible, depending on the absence or presence of redistribution in the 4-hour delayed images. There were 40 perfusion defects (26 fixed and 14 reversible) in 27 patients whereas 13 patients had normal scans. Reversible perfusion defects were present in 10 patients (25%). Of the 26 fixed perfusion defects, 17 did not have corresponding Q waves. Occluded vessels (63%) had more perfusion defects than vessels with subtotal occlusion (30%) (p less than 0.01). The perfusion defect size was larger in patients with lower ejection fraction than in patients with higher ejection fraction. We conclude: (1) perfusion defects are common in patients with rest angina and are reversible in 25% of patients indicating reduced regional coronary blood flow; (2) the degree of stenosis affects the presence of perfusion defect; (3) fixed defects may be present without corresponding Q waves; and (4) global left ventricular function is related to the size of perfusion defects

  16. Efficiency at rest: magnetoencephalographic resting-state connectivity and individual differences in verbal working memory.

    Science.gov (United States)

    del Río, David; Cuesta, Pablo; Bajo, Ricardo; García-Pacios, Javier; López-Higes, Ramón; del-Pozo, Francisco; Maestú, Fernando

    2012-11-01

    Inter-individual differences in cognitive performance are based on an efficient use of task-related brain resources. However, little is known yet on how these differences might be reflected on resting-state brain networks. Here we used Magnetoencephalography resting-state recordings to assess the relationship between a behavioral measurement of verbal working memory and functional connectivity as measured through Mutual Information. We studied theta (4-8 Hz), low alpha (8-10 Hz), high alpha (10-13 Hz), low beta (13-18 Hz) and high beta (18-30 Hz) frequency bands. A higher verbal working memory capacity was associated with a lower mutual information in the low alpha band, prominently among right-anterior and left-lateral sensors. The results suggest that an efficient brain organization in the domain of verbal working memory might be related to a lower resting-state functional connectivity across large-scale brain networks possibly involving right prefrontal and left perisylvian areas. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Observational and Genetic Associations of Resting Heart Rate With Aortic Valve Calcium.

    Science.gov (United States)

    Whelton, Seamus P; Mauer, Andreas C; Pencina, Karol M; Massaro, Joseph M; D'Agostino, Ralph B; Fox, Caroline S; Hoffmann, Udo; Michos, Erin D; Peloso, Gina M; Dufresne, Line; Engert, James C; Kathiresan, Sekar; Budoff, Matthew; Post, Wendy S; Thanassoulis, George; O'Donnell, Christopher J

    2018-05-15

    It is unknown if lifelong exposure to increased hemodynamic stress from an elevated resting heart rate (HR) may contribute to aortic valve calcium (AVC). We performed multivariate regression analyses using data from 1,266 Framingham Heart Study (FHS) Offspring cohort participants and 6,764 Multi-Ethnic Study of Atherosclerosis (MESA) participants. We constructed a genetic risk score (GRS) for HR using summary-level data in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) AVC Consortium to investigate if there was evidence in favor of a causal relation. AVC was present in 39% of FHS Offspring cohort participants and in 13% of MESA cohort participants. In multivariate adjusted models, participants in the highest resting HR quartiles had significantly greater prevalence of AVC, with a prevalence ratio of 1.19 (95% confidence interval [CI] 0.99 to 1.44) for the FHS Offspring cohort and 1.32 (95% CI 1.12 to 1.63) for the MESA cohort, compared with those in the lowest quartile. There was a similar increase in the prevalence of AVC per standard deviation increase in resting HR in both FHS Offspring (prevalence ratio 1.08, 95% CI 1.01 to 1.15) and MESA (1.10, 95% CI 1.03 to 1.17). In contrast with these observational findings, a HR associated GRS was not significantly associated with AVC. Although our observational analysis indicates that a higher resting HR is associated with AVC, our genetic results do not support a causal relation. Unmeasured environmental and/or lifestyle factors associated with both increased resting HR and AVC that are not fully explained by covariates in our observational models may account for the association between resting HR and AVC. Copyright © 2018. Published by Elsevier Inc.

  18. Sleep and alertness during alternating monophasic and polyphasic rest-activity cycles.

    Science.gov (United States)

    Porcú, S; Casagrande, M; Ferrara, M; Bellatreccia, A

    1998-07-01

    People involved in shift work often have to face altered patterns of sleep and wakefulness. This is particularly true for schedules involving night shifts and/or fragmentation of duty periods throughout the 24-hr day. In such conditions, it can be difficult to obtain satisfactory periods of sleep, and sleepiness on duty is a frequent and dangerous occurrence. The aim of this study was to evaluate sleep and wakefulness periods of subjects whose work schedule was characterized by an alternation of 2 hours of activity and 4 hours of rest (sleep allowed), repeated 4 times throughout the 24-hr day. This schedule was alternated with 24 hours off duty. Nine healthy male volunteers were monitored by means of ambulatory polysomnography while attending their 24-hr rest-activity schedule. Sleep periods were visually scored according to standard criteria. Wake periods were visually scored using both 30 s and 5 s epochs in order to reveal episodes of drowsiness and/or microsleep. Results showed that total sleep time was substantially reduced as compared to the usual 7-8 hour monophasic nocturnal sleep. Subjects did not sleep during the first rest period (11.00-15.00). Time in sleep linearly increased in the course of the 3 remaining rest periods. Normal sleep stage distribution was substantially spared only in the last rest period (3.00-7.00 a.m.). With regard to duty periods, only a few microsleeps were detected and their number did not significantly vary across the four 2-hr activity periods. In conclusion, this rest-activity schedule, despite the considerable sleep reduction, allowed maintaining good levels of vigilance as shown by the virtual absence of EEG microsleeps. Whether future research will prove that this regimen does not cause an impairment of performance, it should be a suitable strategy for the management of continuous operations.

  19. Resting states are resting traits--an FMRI study of sex differences and menstrual cycle effects in resting state cognitive control networks.

    Science.gov (United States)

    Hjelmervik, Helene; Hausmann, Markus; Osnes, Berge; Westerhausen, René; Specht, Karsten

    2014-01-01

    To what degree resting state fMRI is stable or susceptible to internal mind states of the individual is currently an issue of debate. To address this issue, the present study focuses on sex differences and investigates whether resting state fMRI is stable in men and women or changes within relative short-term periods (i.e., across the menstrual cycle). Due to the fact that we recently reported menstrual cycle effects on cognitive control based on data collected during the same sessions, the current study is particularly interested in fronto-parietal resting state networks. Resting state fMRI was measured in sixteen women during three different cycle phases (menstrual, follicular, and luteal). Fifteen men underwent three sessions in corresponding time intervals. We used independent component analysis to identify four fronto-parietal networks. The results showed sex differences in two of these networks with women exhibiting higher functional connectivity in general, including the prefrontal cortex. Menstrual cycle effects on resting states were non-existent. It is concluded that sex differences in resting state fMRI might reflect sexual dimorphisms in the brain rather than transitory activating effects of sex hormones on the functional connectivity in the resting brain.

  20. Volunteer Work, Religious Commitment, and Resting Pulse Rates.

    Science.gov (United States)

    Krause, Neal; Ironson, Gail; Hill, Peter C

    2017-04-01

    Research indicates that greater involvement in volunteer activities is associated with better health. We aim to contribute to this literature in two ways. First, rather than rely on self-reports of health, measured resting pulse rates serve as the dependent variable. Second, an effort is made to see if religious commitment moderates the relationship between volunteering and resting pulse rates. Data that come from a recent nationwide survey (N = 2265) suggest that volunteer work is associated with lower resting pulse rates. The results also reveal that the relationship between engaging in volunteer work and resting pulse rates improves among study participants who are more deeply committed to religion.

  1. Introducing the PRIDE Archive RESTful web services.

    Science.gov (United States)

    Reisinger, Florian; del-Toro, Noemi; Ternent, Tobias; Hermjakob, Henning; Vizcaíno, Juan Antonio

    2015-07-01

    The PRIDE (PRoteomics IDEntifications) database is one of the world-leading public repositories of mass spectrometry (MS)-based proteomics data and it is a founding member of the ProteomeXchange Consortium of proteomics resources. In the original PRIDE database system, users could access data programmatically by accessing the web services provided by the PRIDE BioMart interface. New REST (REpresentational State Transfer) web services have been developed to serve the most popular functionality provided by BioMart (now discontinued due to data scalability issues) and address the data access requirements of the newly developed PRIDE Archive. Using the API (Application Programming Interface) it is now possible to programmatically query for and retrieve peptide and protein identifications, project and assay metadata and the originally submitted files. Searching and filtering is also possible by metadata information, such as sample details (e.g. species and tissues), instrumentation (mass spectrometer), keywords and other provided annotations. The PRIDE Archive web services were first made available in April 2014. The API has already been adopted by a few applications and standalone tools such as PeptideShaker, PRIDE Inspector, the Unipept web application and the Python-based BioServices package. This application is free and open to all users with no login requirement and can be accessed at http://www.ebi.ac.uk/pride/ws/archive/. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

  2. Latent heat of traffic moving from rest

    Science.gov (United States)

    Farzad Ahmadi, S.; Berrier, Austin S.; Doty, William M.; Greer, Pat G.; Habibi, Mohammad; Morgan, Hunter A.; Waterman, Josam H. C.; Abaid, Nicole; Boreyko, Jonathan B.

    2017-11-01

    Contrary to traditional thinking and driver intuition, here we show that there is no benefit to ground vehicles increasing their packing density at stoppages. By systematically controlling the packing density of vehicles queued at a traffic light on a Smart Road, drone footage revealed that the benefit of an initial increase in displacement for close-packed vehicles is completely offset by the lag time inherent to changing back into a ‘liquid phase’ when flow resumes. This lag is analogous to the thermodynamic concept of the latent heat of fusion, as the ‘temperature’ (kinetic energy) of the vehicles cannot increase until the traffic ‘melts’ into the liquid phase. These findings suggest that in situations where gridlock is not an issue, drivers should not decrease their spacing during stoppages in order to lessen the likelihood of collisions with no loss in flow efficiency. In contrast, motion capture experiments of a line of people walking from rest showed higher flow efficiency with increased packing densities, indicating that the importance of latent heat becomes trivial for slower moving systems.

  3. Rest frame properties of the proton

    International Nuclear Information System (INIS)

    Strobel, G.L.

    1998-01-01

    The proton is modeled as three quarks of small current quark mass. The three-body Dirac equation is solved with spin-independent central diagonal linear confining potentials with an attractive Coulombic term in a relativistic three-quark model. Hyperspherical coordinates are used, and the bound state is found analytically. After integrating over the hyperangles, the Hamiltonian is an 8 by 8 matrix of coupled first-order differential equations in one variable, the hyperradius. These are analytically solved in hypercentral approximation. For the (1/2 + ) 3 ground-state configuration in the nonrelativistic large-quark-mass limit, there are no nodes in the wave function. However, in the extreme relativistic limit of small current quark masses of a few MeV, the expectation value of the number of nodes is about 1.30 when the potential parameters are chosen to reproduce the proton rms charge radius. The quarks are assumed to possess a Pauli anomalous magnetic moment, like that of the electron and muon of (α/2π)(e/m). Assuming all three quarks have equal mass, one can fit the rest energy, magnetic moment, rms charge radius, and axial charge of the proton with this relativistic three-body Dirac equation model. The solution found shows the necessity of including all components of the composite three-quark wave function, as the upper component contributes only 0.585 to the norm

  4. Comparison of stress-rest and rest-stress one day myocardial perfusion scintigraphies in detecting coronary artery diseases

    International Nuclear Information System (INIS)

    Bom, Hee Seung; Min, Jung Jun; Song, Ho Cheon; Kim, Ji Yeul

    1997-01-01

    It has been shown that both rest and stress myocardial perfusion imaging with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57±9 years) and 120 patients (79 males, 41 females, mean age 59±10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively. All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by ≥50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35% and 68%, respectively. Those of rest-stress protocol were 96%, 47% and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using 99m Tc agents were comparable and were very sensitive tests in detecting coronary artery diseases

  5. Insulin resistance and carotid intima-media thickness mediate the association between resting-state heart rate variability and executive function: A path modelling study.

    Science.gov (United States)

    Kemp, Andrew H; López, Santiago Rodríguez; Passos, Valeria M A; Bittencourt, Marcio S; Dantas, Eduardo M; Mill, José G; Ribeiro, Antonio L P; Thayer, Julian F; Bensenor, Isabela M; Lotufo, Paulo A

    2016-05-01

    Research has linked high-frequency heart rate variability (HF-HRV) to cognitive function. The present study adopts a modern path modelling approach to understand potential causal pathways that may underpin this relationship. Here we examine the association between resting-state HF-HRV and executive function in a large sample of civil servants from Brazil (N=8114) recruited for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). HF-HRV was calculated from 10-min resting-state electrocardiograms. Executive function was assessed using the trail-making test (version B). Insulin resistance (a marker of type 2 diabetes mellitus) and carotid intima-media thickness (subclinical atherosclerosis) mediated the relationship between HRV and executive function in seriatim. A limitation of the present study is its cross-sectional design; therefore, conclusions must be confirmed in longitudinal study. Nevertheless, findings support that possibility that HRV provides a 'spark' that initiates a cascade of adverse downstream effects that subsequently leads to cognitive impairment. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. A novel lunar bed rest analogue.

    Science.gov (United States)

    Cavanagh, Peter R; Rice, Andrea J; Licata, Angelo A; Kuklis, Matthew M; Novotny, Sara C; Genc, Kerim O; Englehaupt, Ricki K; Hanson, Andrea M

    2013-11-01

    Humans will eventually return to the Moon and thus there is a need for a ground-based analogue to enable the study of physiological adaptations to lunar gravity. An important unanswered question is whether or not living on the lunar surface will provide adequate loading of the musculoskeletal system to prevent or attenuate the bone loss that is seen in microgravity. Previous simulations have involved tilting subjects to an approximately 9.5 degrees angle to achieve a lunar gravity component parallel to the long-axis of the body. However, subjects in these earlier simulations were not weight-bearing, and thus these protocols did not provide an analogue for load on the musculoskeletal system. We present a novel analogue which includes the capability to simulate standing and sitting in a lunar loading environment. A bed oriented at a 9.5 degrees angle was mounted on six linear bearings and was free to travel with one degree of freedom along rails. This allowed approximately 1/6 body weight loading of the feet during standing. "Lunar" sitting was also successfully simulated. A feasibility study demonstrated that the analogue was tolerated by subjects for 6 d of continuous bed rest and that the reaction forces at the feet during periods of standing were a reasonable simulation of lunar standing. During the 6 d, mean change in the volume of the quadriceps muscles was -1.6% +/- 1.7%. The proposed analogue would appear to be an acceptable simulation of lunar gravity and deserves further exploration in studies of longer duration.

  7. Resting state functional connectivity predicts neurofeedback response

    Directory of Open Access Journals (Sweden)

    Dustin eScheinost

    2014-09-01

    Full Text Available Tailoring treatments to the specific needs and biology of individual patients – personalized medicine – requires delineation of reliable predictors of response. Unfortunately, these have been slow to emerge, especially in neuropsychiatric disorders. We have recently described a real-time functional magnetic resonance imaging (rt-fMRI neurofeedback protocol that can reduce contamination-related anxiety, a prominent symptom of many cases of obsessive-compulsive disorder (OCD. Individual response to this intervention is variable. Here we used patterns of brain functional connectivity, as measured by baseline resting-state fMRI (rs-fMRI, to predict improvements in contamination anxiety after neurofeedback training. Activity of a region of the orbitofrontal cortex (OFC and anterior prefrontal cortex, Brodmann area (BA 10, associated with contamination anxiety in each subject was measured in real time and presented as a neurofeedback signal, permitting subjects to learn to modulate this target brain region. We have previously reported both enhanced OFC/BA 10 control and improved anxiety in a group of subclinically anxious subjects after neurofeedback. Five individuals with contamination-related OCD who underwent the same protocol also showed improved clinical symptomatology. In both groups, these behavioral improvements were strongly correlated with baseline whole-brain connectivity in the OFC/BA 10, computed from rs-fMRI collected several days prior to neurofeedback training. These pilot data suggest that rs-fMRI can be used to identify individuals likely to benefit from rt-fMRI neurofeedback training to control contamination anxiety.

  8. Aging, resting pulse rate, and longevity.

    Science.gov (United States)

    Stessman, Jochanan; Jacobs, Jeremy M; Stessman-Lande, Irit; Gilon, Dan; Leibowitz, David

    2013-01-01

    To examine the relationship between resting pulse rate (RPR) and longevity in individuals aged 70 to 90. The Jerusalem Longitudinal Cohort Study (1990-2010) is a prospective longitudinal study of a representative cohort born in 1920-21. Home-based comprehensive assessment in 1990, 1998, and 2005. Individuals aged 70 (n = 453), 78 (n = 856), and 85 (n = 1,044), with follow-up to age 90. Comprehensive assessment included average RPR, beta-blocker usage, and physical activity level. Mortality data were collected from the Ministry of Interior from 1990 to 2010. Cox proportional hazards ratios (HRs) were determined for RPR (continuous variable), adjusting for sex, education, diabetes mellitus, ischemic heart disease, congestive heart failure, hypertension, kidney disease, anemia, physical activity, body mass index, self-rated health, dementia, beta-blocker use, and an interaction term for RPR by beta-blocker use. Mean RPR was 75.1 ± 9.9 at 70, 74.5 ± 10.9 at 78, and 68.5 ± 10.5 at 85 in women and 74.3 ± 10.7 at 70, 73.1 ± 11.2 at 78, and 65.2 ± 10.5 at 85 in men, with a significant decline from 78 to 85 for both sexes. In participants not taking beta-blockers followed up from 70 to 77, 78 to 84, and 85 to 90, mean RPR was lower in survivors than nonsurvivors for women (75.8 ± 9.2 vs 83.5 ± 10.9, P longevity. It may serve as a simple prognostic marker in the oldest old. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  9. A random walk description of individual animal movement accounting for periods of rest

    Science.gov (United States)

    Tilles, Paulo F. C.; Petrovskii, Sergei V.; Natti, Paulo L.

    2016-11-01

    Animals do not move all the time but alternate the period of actual movement (foraging) with periods of rest (e.g. eating or sleeping). Although the existence of rest times is widely acknowledged in the literature and has even become a focus of increased attention recently, the theoretical approaches to describe animal movement by calculating the dispersal kernel and/or the mean squared displacement (MSD) rarely take rests into account. In this study, we aim to bridge this gap. We consider a composite stochastic process where the periods of active dispersal or `bouts' (described by a certain baseline probability density function (pdf) of animal dispersal) alternate with periods of immobility. For this process, we derive a general equation that determines the pdf of this composite movement. The equation is analysed in detail in two special but important cases such as the standard Brownian motion described by a Gaussian kernel and the Levy flight described by a Cauchy distribution. For the Brownian motion, we show that in the large-time asymptotics the effect of rests results in a rescaling of the diffusion coefficient. The movement occurs as a subdiffusive transition between the two diffusive asymptotics. Interestingly, the Levy flight case shows similar properties, which indicates a certain universality of our findings.

  10. Recognizing mild cognitive impairment based on network connectivity analysis of resting EEG with zero reference

    International Nuclear Information System (INIS)

    Xu, Peng; Xiong, Xiu Chun; Tian, Yin; Zhang, Rui; Li, Pei Yang; Yao, De Zhong; Xue, Qing; Wang, Yu Ping; Peng, Yueheng

    2014-01-01

    The diagnosis of mild cognitive impairment (MCI) is very helpful for early therapeutic interventions of Alzheimer's disease (AD). MCI has been proven to be correlated with disorders in multiple brain areas. In this paper, we used information from resting brain networks at different EEG frequency bands to reliably recognize MCI. Because EEG network analysis is influenced by the reference that is used, we also evaluate the effect of the reference choices on the resting scalp EEG network-based MCI differentiation. The conducted study reveals two aspects: (1) the network-based MCI differentiation is superior to the previously reported classification that uses coherence in the EEG; and (2) the used EEG reference influences the differentiation performance, and the zero approximation technique (reference electrode standardization technique, REST) can construct a more accurate scalp EEG network, which results in a higher differentiation accuracy for MCI. This study indicates that the resting scalp EEG-based network analysis could be valuable for MCI recognition in the future. (paper)

  11. Changes in resting-state functionally connected parietofrontal networks after videogame practice.

    Science.gov (United States)

    Martínez, Kenia; Solana, Ana Beatriz; Burgaleta, Miguel; Hernández-Tamames, Juan Antonio; Alvarez-Linera, Juan; Román, Francisco J; Alfayate, Eva; Privado, Jesús; Escorial, Sergio; Quiroga, María A; Karama, Sherif; Bellec, Pierre; Colom, Roberto

    2013-12-01

    Neuroimaging studies provide evidence for organized intrinsic activity under task-free conditions. This activity serves functionally relevant brain systems supporting cognition. Here, we analyze changes in resting-state functional connectivity after videogame practice applying a test-retest design. Twenty young females were selected from a group of 100 participants tested on four standardized cognitive ability tests. The practice and control groups were carefully matched on their ability scores. The practice group played during two sessions per week across 4 weeks (16 h total) under strict supervision in the laboratory, showing systematic performance improvements in the game. A group independent component analysis (GICA) applying multisession temporal concatenation on test-retest resting-state fMRI, jointly with a dual-regression approach, was computed. Supporting the main hypothesis, the key finding reveals an increased correlated activity during rest in certain predefined resting state networks (albeit using uncorrected statistics) attributable to practice with the cognitively demanding tasks of the videogame. Observed changes were mainly concentrated on parietofrontal networks involved in heterogeneous cognitive functions. Copyright © 2012 Wiley Periodicals, Inc.

  12. Intrinsic Resting-State Functional Connectivity in the Human Spinal Cord at 3.0 T.

    Science.gov (United States)

    San Emeterio Nateras, Oscar; Yu, Fang; Muir, Eric R; Bazan, Carlos; Franklin, Crystal G; Li, Wei; Li, Jinqi; Lancaster, Jack L; Duong, Timothy Q

    2016-04-01

    To apply resting-state functional magnetic resonance (MR) imaging to map functional connectivity of the human spinal cord. Studies were performed in nine self-declared healthy volunteers with informed consent and institutional review board approval. Resting-state functional MR imaging was performed to map functional connectivity of the human cervical spinal cord from C1 to C4 at 1 × 1 × 3-mm resolution with a 3.0-T clinical MR imaging unit. Independent component analysis (ICA) was performed to derive resting-state functional MR imaging z-score maps rendered on two-dimensional and three-dimensional images. Seed-based analysis was performed for cross validation with ICA networks by using Pearson correlation. Reproducibility analysis of resting-state functional MR imaging maps from four repeated trials in a single participant yielded a mean z score of 6 ± 1 (P 3, P 3.0-T clinical MR imaging unit and standard MR imaging protocols and hardware reveals prominent functional connectivity patterns within the spinal cord gray matter, consistent with known functional and anatomic layouts of the spinal cord.

  13. Facial Video-Based Photoplethysmography to Detect HRV at Rest.

    Science.gov (United States)

    Moreno, J; Ramos-Castro, J; Movellan, J; Parrado, E; Rodas, G; Capdevila, L

    2015-06-01

    Our aim is to demonstrate the usefulness of photoplethysmography (PPG) for analyzing heart rate variability (HRV) using a standard 5-min test at rest with paced breathing, comparing the results with real RR intervals and testing supine and sitting positions. Simultaneous recordings of R-R intervals were conducted with a Polar system and a non-contact PPG, based on facial video recording on 20 individuals. Data analysis and editing were performed with individually designated software for each instrument. Agreement on HRV parameters was assessed with concordance correlations, effect size from ANOVA and Bland and Altman plots. For supine position, differences between video and Polar systems showed a small effect size in most HRV parameters. For sitting position, these differences showed a moderate effect size in most HRV parameters. A new procedure, based on the pixels that contained more heart beat information, is proposed for improving the signal-to-noise ratio in the PPG video signal. Results were acceptable in both positions but better in the supine position. Our approach could be relevant for applications that require monitoring of stress or cardio-respiratory health, such as effort/recuperation states in sports. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Electrocardiogram assessment in non-anaesthetized clinically healthy agouti (Dasyprocta primnolopha, Wagler 1831

    Directory of Open Access Journals (Sweden)

    Anaemilia das N. Diniz

    2013-12-01

    Full Text Available The agouti is one of the most intensely hunted species throughout the Amazon and the semiarid regions of north-eastern Brazil. Considering the current tendency of wild animal management in captivity, the objective of this study was to determine heart reference values for agouti raised in captivity, based on electrocardiographic assessments (ECG. Adult agouti were selected without clinical signs of heart disease (n=30. The animals were restrained physically and then the ECG was performed. Standardized measurements were taken to establish the statistical analysis of the data. Analysis of the QRS complex showed values compatible with previous reports in peer animals and the limited data available for other wild and exotic species, except for the T wave that showed similar amplitude to the R wave in all the animals studied. The data obtained provided the first reference values for ECG tracings in agouti, contributing to a better understanding of heart electrophysiology in identifying myocardial pathology in these animals.

  15. A Correction Formula for the St Segment of the Ac-coupled Electrocardiogram

    DEFF Research Database (Denmark)

    Schmid, Ramun; Isaksen, Jonas; Leber, Remo

    2016-01-01

    Background: Many ECG devices apply an analog or an equivalent digital first order high-pass filter as part of the ECG acquisition chain. This type of filter is known to not only reduce baseline wandering but also change the ECG signal itself. Particularly, the ST-segment of ECGs with unipolar QRS...... complexes can be changed considerably. To a certain degree, it is possible to restore the original ECG and therefore the correct ST-segment by inverse filtering. However, this process requires the availability of a digital representation of the filtered ECG signal which is not always the case. We present...... an alternative approach that can estimate the true ST-values based on only three standard ECG parameters and the high-pass filter's time constant. Methods: Based on the high-pass filter's time constant T [s], the QRS integral A [Vs], the QRS width W [s] and the RR-interval RR [s], we derived the following...

  16. Atypical Laterality of Resting Gamma Oscillations in Autism Spectrum Disorders

    Science.gov (United States)

    Maxwell, Christina R.; Villalobos, Michele E.; Schultz, Robert T.; Herpertz-Dahlmann, Beate; Konrad, Kerstin; Kohls, Gregor

    2015-01-01

    Abnormal brain oscillatory activity has been found in autism spectrum disorders (ASD) and proposed as a potential biomarker. While several studies have investigated gamma oscillations in ASD, none have examined resting gamma power across multiple brain regions. This study investigated resting gamma power using EEG in 15 boys with ASD and 18 age…

  17. Rest tremor in idiopathic adult-onset dystonia.

    Science.gov (United States)

    Gigante, A F; Berardelli, A; Defazio, G

    2016-05-01

    Tremor in dystonia has been described as a postural or kinetic abnormality. In recent series, however, patients with idiopathic adult-onset dystonia also displayed rest tremor. The frequency and distribution of rest tremor were studied in a cohort of 173 consecutive Italian patients affected by various forms of idiopathic adult-onset dystonia attending our movement disorder clinic over 8 months. Examination revealed tremor in 59/173 patients (34%): 12 patients had head tremor, 34 patients had arm tremor, whilst 13 patients presented tremor in both sites. Head tremor was postural in all patients, whereas arm tremor was postural/kinetic in 28 patients, only at rest in one and both postural/kinetic and at rest in 18 patients. Patients with tremor were more likely to have segmental/multifocal dystonia. Patients who had rest tremor (either alone or associated with action tremor) had a higher age at dystonia onset and a greater frequency of dystonic arm involvement than patients with action tremor alone or without tremor. Both action and rest tremor are part of the tremor spectrum of adult-onset dystonia and are more frequently encountered in segmental/multifocal dystonia. The higher age at dystonia onset and the greater frequency of arm dystonia in patients with rest tremor may have pathophysiological implications and may account, at least in part, for the previous lack of identification of rest tremor as one possible type of tremor present in dystonia. © 2016 EAN.

  18. Identification of Resting State Networks Involved in Executive Function.

    Science.gov (United States)

    Connolly, Joanna; McNulty, Jonathan P; Boran, Lorraine; Roche, Richard A P; Delany, David; Bokde, Arun L W

    2016-06-01

    The structural networks in the human brain are consistent across subjects, and this is reflected also in that functional networks across subjects are relatively consistent. These findings are not only present during performance of a goal oriented task but there are also consistent functional networks during resting state. It suggests that goal oriented activation patterns may be a function of component networks identified using resting state. The current study examines the relationship between resting state networks measured and patterns of neural activation elicited during a Stroop task. The association between the Stroop-activated networks and the resting state networks was quantified using spatial linear regression. In addition, we investigated if the degree of spatial association of resting state networks with the Stroop task may predict performance on the Stroop task. The results of this investigation demonstrated that the Stroop activated network can be decomposed into a number of resting state networks, which were primarily associated with attention, executive function, visual perception, and the default mode network. The close spatial correspondence between the functional organization of the resting brain and task-evoked patterns supports the relevance of resting state networks in cognitive function.

  19. A REST-ful interpretation for embedded modular systems based on open architecture

    Science.gov (United States)

    Lyke, James

    2016-05-01

    The much-anticipated revolution of the "Internet of things" (IoT) is expected to generate one trillion internet devices within the next 15 years, mostly in the form of simple wireless sensor devices. While this revolution promises to transform silicon markets and drive a number of disruptive changes in society, it is also the case that the protocols, complexity, and security issues of extremely large dynamic, co-mingled networks is still poorly understood. Furthermore, embedded system developers, to include military and aerospace users, have largely ignored the potential (good and bound) of the cloudlike, possibly intermingling networks having variable structure to how future systems might be engineered. In this paper, we consider a new interpretation of IoT inspired modular architecture strategies involving the representational state transfer (REST) model, in which dynamic networks with variable structure employ stateless application programming interface (API) concepts. The power of the method, which extends concepts originally developed for space plug-and-play avionics, is that it allows for the fluid co-mingling of hardware and software in networks whose structure can overlap and evolve. Paradoxically, these systems may have the most stringent determinism and fault-tolerant needs. In this paper we review how RESTful APIs can potentially be used to design, create, test, and deploy systems rapidly while addressing security and referential integrity even when the nodes of many systems might physically co-mingle. We will also explore ways to take advantage of the RESTful paradigm for fault tolerance and what extensions might be necessary to deal with high-performance and determinism.

  20. Cognitive and default-mode resting state networks: do male and female brains "rest" differently?

    Science.gov (United States)

    Weissman-Fogel, Irit; Moayedi, Massieh; Taylor, Keri S; Pope, Geoff; Davis, Karen D

    2010-11-01

    Variability in human behavior related to sex is supported by neuroimaging studies showing differences in brain activation patterns during cognitive task performance. An emerging field is examining the human connectome, including networks of brain regions that are not only temporally-correlated during different task conditions, but also networks that show highly correlated spontaneous activity during a task-free state. Both task-related and task-free network activity has been associated with individual task performance and behavior under certain conditions. Therefore, our aim was to determine whether sex differences exist during a task-free resting state for two networks associated with cognitive task performance (executive control network (ECN), salience network (SN)) and the default mode network (DMN). Forty-nine healthy subjects (26 females, 23 males) underwent a 5-min task-free fMRI scan in a 3T MRI. An independent components analysis (ICA) was performed to identify the best-fit IC for each network based on specific spatial nodes defined in previous studies. To determine the consistency of these networks across subjects we performed self-organizing group-level ICA analyses. There were no significant differences between sexes in the functional connectivity of the brain areas within the ECN, SN, or the DMN. These important findings highlight the robustness of intrinsic connectivity of these resting state networks and their similarity between sexes. Furthermore, our findings suggest that resting state fMRI studies do not need to be controlled for sex. © 2010 Wiley-Liss, Inc.

  1. Retrospective study of pre-anesthetic electrocardiogram examination of 700 dogs conducted at the Veterinary Hospital of UFMG (2013-2014

    Directory of Open Access Journals (Sweden)

    Ana Flávia Machado Botelho

    2016-02-01

    Full Text Available Abstract: Pre-operative electrocardiograms performed in 700 dogs were analyzed in order to establish correlation between sex, age, indication for surgery, body condition score, breed and weight. Initially a clinical questionnaire was filled out from each owner, including age, breed, sex, weight, clinical history and surgical indication. Dogs above 6 years of age or those showing any kind of cardiac auscultation disturbances were referred to electrocardiogram (ECG evaluation. All ECG were performed and analyzed by the same veterinary specialist. Abnormalities at ECG were founnd in 364 of 700 (52% evaluated dogs, and the most frequent variation was sinus arrhythmia, observed in 293 dogs (25.4%. No significant correlation was found between the electrocardiographic alterations with weight, sex and age of the animals. Therefore ECG should be conducted routinely regardless of age, sex, breed or surgical indication, highlighting its value for determining a safe anesthetic protocol that promotes minimal cardiopulmonary depression and allows rapid post-surgical recovery.

  2. Effect of a real-time tele-transmission system of 12-lead electrocardiogram on the first-aid for athletes with ST-elevation myocardial infarction.

    Science.gov (United States)

    Zhang, Huan; Song, Donghan; An, Lina

    2016-05-01

    To study the effect of a real-time tele-transmission system of 12-lead electrocardiogram on door-to-balloon time in athletes with ST-elevation myocardial infarction. A total of 60 athletes with chest pain diagnosed as ST-elevation myocardial infarction (STEMI) from our hospital were randomly divided into group A (n=35) and group B (n=25), the patients in group A transmitted the real-time tele-transmission system of 12-lead electrocardiogram to the chest pain center before arriving in hospital, however, the patients in group B not. The median door-to-balloon time was significant shorter in-group A than group B (38min vs 94 min, p0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, pelectrocardiogram is beneficial to the pre-hospital diagnosis of STEMI.

  3. Predicting new-onset of postoperative atrial fibrillation in patients undergoing cardiac surgery using semi-automatic reading of perioperative electrocardiograms

    DEFF Research Database (Denmark)

    Gu, Jiwei; Graff, Claus; Melgaard, Jacob

    2015-01-01

    P10 Predicting new-onset of postoperative atrial fibrillation in patients undergoingcardiac surgery using semi-automatic reading of perioperative electrocardiograms. Jiwei Gu, Claus Graff, Jacob Melgaard, Søren Lundbye-Christensen, Erik Berg Schmidt, Christian Torp-Pedersen, Kristinn Thorsteinsson......, Jan Jesper Andreasen. Aalborg, DenmarkBackground: Postoperative new onset atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery. The aim of this study was to evaluate if semi-automatic readings of perioperative electrocardiograms (ECGs) is of any value in predicting POAF after...... ECG monitoring. A semi-automatic machine capable of reading differentparameters of digitalized ECG’s was used to read both lead specific (P/QRS/T amplitudes/intervals) and global measurements (P-duration/QRS-duration/PR-interval/QT/Heart Rate/hypertrophy).Results: We divided the patients into two...

  4. Stress/Rest Tc-99m-MIBI SPECT in Comparison with Rest/Stress Rubidium - 82 PET

    International Nuclear Information System (INIS)

    Lee, D. S.; Kamg, K. W.; Lee, K. H.; Jeong, J. M.; Kwark, C. E.; Chung, J. K.; Lee, M.C.; Seo, J. D.; Koh, C. S.

    1995-01-01

    We compared stress/rest myocardial Tc-99m-MIBI tomographic image findings with rest/stress rubidium-82 tomographic images. In 23 patients with coronary artery disease (12 of them received bypass grafts before) and 6 normal subjects, rest rubidium PET study was performed, rubidium-82 and Tc-99m-MIBI were injected simultaneously to each patient after dipyridamole stress for rubidium PET and MIBI SPECT; and rest MIBI SPECT was performed 4 hours thereafter. We scored segmental decrease of rubidium, or MIBI uptakes into 5 grades for 29 segments from 3 short-axis, vertical and horizontal slices. Scores were summed for each major arterial territory. When more score than two grade-2's or one grade-3 was considered as the cue for significant stenosis for major arterial territories, 67% of 46 stenosed arteries were found with MIBI studies and 78% of them by rubidium studies. Fourteen among 28 grafted arterial territories of 12 post-CABG patients were found normal with both rubidium and MIBI. Segmental scores were concordant between rubidium and MIBI in 72% of 709-stress segments and in 80% of 825 rest segments. Stress rubidium segmental scores were less than stress MIBI scores in 9%, so were rest rubidium scores. Stress rubidium scores were more than stress MIBI scores in 20% of segments, and rest rubidium segmental scores were more than rest MIBI scores in 11%. Rank correlations (Spearman's rho's more than 0.7(stress) and 0.5(rest), slopes (MIBI/rubidium) around 0.7(stress) and 0.9(rest) suggested deeper and wider defects in stress with rubidium. Slope over 1 (MIBI/rubidium) with LAD segmental scores at rest and 7 territories which had much larger score with MIBI revealed exaggeration of rest defects with rest MIBI in same-day stress/rest study. Difference scores (stress-rest for each territory) suggesting ischemia were larger with rubidium (slope of MIBI/rubidium around 0.45). As has been implied by animal or separate-day- human studies, these segmental analyses with

  5. Viability of a Web-Based Module for Teaching Electrocardiogram Reading Skills to Psychiatry Residents: Learning Outcomes and Trainee Interest.

    Science.gov (United States)

    DeBonis, Katrina; Blair, Thomas R; Payne, Samuel T; Wigan, Katherine; Kim, Sara

    2015-12-01

    Web-based instruction in post-graduate psychiatry training has shown comparable effectiveness to in-person instruction, but few topics have been addressed in this format. This study sought to evaluate the viability of a web-based curriculum in teaching electrocardiogram (EKG) reading skills to psychiatry residents. Interest in receiving educational materials in this format was also assessed. A web-based curriculum of 41 slides, including eight pre-test and eight post-test questions with emphasis on cardiac complications of psychotropic medications, was made available to all psychiatry residents via email. Out of 57 residents, 30 initiated and 22 completed the module. Mean improvement from pre-test to post-test was 25 %, and all 22 completing participants indicated interest in future web-based instruction. This pilot study suggests that web-based instruction is feasible and under-utilized as a means of teaching psychiatry residents. Potential uses of web-based instruction, such as tracking learning outcomes or patient care longitudinally, are also discussed.

  6. What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

    Science.gov (United States)

    Patocka, Catherine; Turner, Joel; Wiseman, Jeffrey

    2015-11-01

    There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. We developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds. A purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered "must know" diagnoses, 61 (50%) "should know" diagnoses, and 7 (6%) "nice to know" diagnoses. We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

  7. Parallelized computation for computer simulation of electrocardiograms using personal computers with multi-core CPU and general-purpose GPU.

    Science.gov (United States)

    Shen, Wenfeng; Wei, Daming; Xu, Weimin; Zhu, Xin; Yuan, Shizhong

    2010-10-01

    Biological computations like electrocardiological modelling and simulation usually require high-performance computing environments. This paper introduces an implementation of parallel computation for computer simulation of electrocardiograms (ECGs) in a personal computer environment with an Intel CPU of Core (TM) 2 Quad Q6600 and a GPU of Geforce 8800GT, with software support by OpenMP and CUDA. It was tested in three parallelization device setups: (a) a four-core CPU without a general-purpose GPU, (b) a general-purpose GPU plus 1 core of CPU, and (c) a four-core CPU plus a general-purpose GPU. To effectively take advantage of a multi-core CPU and a general-purpose GPU, an algorithm based on load-prediction dynamic scheduling was developed and applied to setting (c). In the simulation with 1600 time steps, the speedup of the parallel computation as compared to the serial computation was 3.9 in setting (a), 16.8 in setting (b), and 20.0 in setting (c). This study demonstrates that a current PC with a multi-core CPU and a general-purpose GPU provides a good environment for parallel computations in biological modelling and simulation studies. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Clinical evaluation of the use of an intracardiac electrocardiogram to guide the tip positioning of peripherally inserted central catheters.

    Science.gov (United States)

    Zhao, Ruiyi; Chen, Chunfang; Jin, Jingfen; Sharma, Komal; Jiang, Nan; Shentu, Yingqin; Wang, Xingang

    2016-06-01

    The use of peripherally inserted central catheters (PICCs) provides important central venous accesses for clinical treatments, tests and monitoring. Compared with the traditional methods, intracardiac electrocardiogram (ECG)-guided method has the potential to guide more accurate tip positioning of PICCs. This study aimed to clinically evaluate the effectiveness of an intracardiac ECG to guide the tip positioning by monitoring characteristic P-wave changes. In this study, eligible patients enrolled September 2011 to May 2012 according to the inclusion and exclusion criteria received the catheterization monitored by intracardiac ECG. Then chest radiography was performed to check the catheter position. The results revealed that, with 117 eligible patients, all bar one patient who died (n = 116) completed the study, including 60 males and 56 females aged 51.2 ± 15.1 years. Most (n = 113, > 97%) had characteristic P-wave changes. The intracardiac ECG-guided positioning procedure achieved correct placement for 112 patients (96.56%), demonstrating 99.12% sensitivity and 100% specificity. In conclusion, the intracardiac ECG can be a promising technique to guide tip positioning of PICCs. However, since the sample size in this study is limited, more experience and further study during clinical practice are needed to demonstrate achievement of optimal catheterization outcomes. © 2015 John Wiley & Sons Australia, Ltd.

  9. Automated Detection of Obstructive Sleep Apnea Events from a Single-Lead Electrocardiogram Using a Convolutional Neural Network.

    Science.gov (United States)

    Urtnasan, Erdenebayar; Park, Jong-Uk; Joo, Eun-Yeon; Lee, Kyoung-Joung

    2018-04-23

    In this study, we propose a method for the automated detection of obstructive sleep apnea (OSA) from a single-lead electrocardiogram (ECG) using a convolutional neural network (CNN). A CNN model was designed with six optimized convolution layers including activation, pooling, and dropout layers. One-dimensional (1D) convolution, rectified linear units (ReLU), and max pooling were applied to the convolution, activation, and pooling layers, respectively. For training and evaluation of the CNN model, a single-lead ECG dataset was collected from 82 subjects with OSA and was divided into training (including data from 63 patients with 34,281 events) and testing (including data from 19 patients with 8571 events) datasets. Using this CNN model, a precision of 0.99%, a recall of 0.99%, and an F 1 -score of 0.99% were attained with the training dataset; these values were all 0.96% when the CNN was applied to the testing dataset. These results show that the proposed CNN model can be used to detect OSA accurately on the basis of a single-lead ECG. Ultimately, this CNN model may be used as a screening tool for those suspected to suffer from OSA.

  10. Multiclass classification of obstructive sleep apnea/hypopnea based on a convolutional neural network from a single-lead electrocardiogram.

    Science.gov (United States)

    Urtnasan, Erdenebayar; Park, Jong-Uk; Lee, Kyoung-Joung

    2018-05-24

    In this paper, we propose a convolutional neural network (CNN)-based deep learning architecture for multiclass classification of obstructive sleep apnea and hypopnea (OSAH) using single-lead electrocardiogram (ECG) recordings. OSAH is the most common sleep-related breathing disorder. Many subjects who suffer from OSAH remain undiagnosed; thus, early detection of OSAH is important. In this study, automatic classification of three classes-normal, hypopnea, and apnea-based on a CNN is performed. An optimal six-layer CNN model is trained on a training dataset (45,096 events) and evaluated on a test dataset (11,274 events). The training set (69 subjects) and test set (17 subjects) were collected from 86 subjects with length of approximately 6 h and segmented into 10 s durations. The proposed CNN model reaches a mean -score of 93.0 for the training dataset and 87.0 for the test dataset. Thus, proposed deep learning architecture achieved a high performance for multiclass classification of OSAH using single-lead ECG recordings. The proposed method can be employed in screening of patients suspected of having OSAH. © 2018 Institute of Physics and Engineering in Medicine.

  11. A new method for measuring temporal resolution in electrocardiogram-gated reconstruction image with area-detector computed tomography

    International Nuclear Information System (INIS)

    Kaneko, Takeshi; Takagi, Masachika; Kato, Ryohei; Anno, Hirofumi; Kobayashi, Masanao; Yoshimi, Satoshi; Sanda, Yoshihiro; Katada, Kazuhiro

    2012-01-01

    The purpose of this study was to design and construct a phantom for using motion artifact in the electrocardiogram (ECG)-gated reconstruction image. In addition, the temporal resolution under various conditions was estimated. A stepping motor was used to move the phantom over an arc in a reciprocating manner. The program for controlling the stepping motor permitted the stationary period and the heart rate to be adjusted as desired. Images of the phantom were obtained using a 320-row area-detector computed tomography (ADCT) system under various conditions using the ECG-gated reconstruction method. For estimation, the reconstruction phase was continuously changed and the motion artifacts were quantitatively assessed. The temporal resolution was calculated from the number of motion-free images. Changes in the temporal resolution according to heart rate, rotation time, the number of reconstruction segments and acquisition position in z-axis were also investigated. The measured temporal resolution of ECG-gated half reconstruction is 180 ms, which is in good agreement with the nominal temporal resolution of 175 ms. The measured temporal resolution of ECG-gated segmental reconstruction is in good agreement with the nominal temporal resolution in most cases. The estimated temporal resolution improved to approach the nominal temporal resolution as the number of reconstruction segments was increased. Temporal resolution in changing acquisition position is equal. This study shows that we could design a new phantom for estimating temporal resolution. (author)

  12. A comparative study of electrocardiogram multi-segment reconstruction and dual source computed tomography using a computer controlled coronary phantom

    International Nuclear Information System (INIS)

    Ohashi, Kazuya; Higashide, Ryo; Kunitomo, Hirosi; Ichikawa, Katsuhiro

    2011-01-01

    Currently, there are two main methods for improving temporal resolution of coronary computed tomography (CT): electrocardiogram-gated multi-segment reconstruction (EMR) and dual source scanning using dual source CT (DSCT). We developed a motion phantom system for image quality assessment of cardiac CT to evaluate these two methods. This phantom system was designed to move an object at arbitrary speeds during a desired phase range in cyclic motion. By using this system, we obtained coronary CT mode images for motion objects like coronary arteries. We investigated the difference in motion artifacts between EMR and the DSCT using a 3-mm-diameter acrylic rod resembling the coronary artery. EMR was evaluated using 16-row multi-slice CT (16MSCT). To evaluate the image quality, we examined the degree of motion artifacts by analyzing the profiles around the rod and the displacement of a peak pixel in the rod image. In the 16MSCT, remarkable increases of artifacts and displacement were caused by the EMR. In contrast, the DSCT presented excellent images with fewer artifacts. The results showed the validity of DSCT to improve true temporal resolution. (author)

  13. The non-invasive and continuous estimation of cardiac output using a photoplethysmogram and electrocardiogram during incremental exercise

    International Nuclear Information System (INIS)

    Wang, L; Poon, C C Y; Zhang, Y T

    2010-01-01

    Cardiac output (CO) monitoring is not only essential for critically ill patients in the hospital, but also for patients at home and those undergoing cardiopulmonary exercise testing. However, CO is difficult to monitor during daily activities and exercise. In this paper, we aim at developing a novel CO estimation method that can be used under these challenging conditions. The tube model was utilized to derive a CO index, namely the pulse time reflection ratio (PTRR) from an electrocardiogram and photoplethysmogram. After calibration, the PTRR can be used to estimate beat-to-beat CO. The proposed method was verified against CO measured by impedance cardiography on 19 healthy subjects in an incremental intensity exercise test. Results showed that there were strong correlations (r) between the PTRR and reference CO in 18 subjects (mean r: 0.88, n = 245 trials). Two calibration approaches reported in the literature were applied to the proposed method and the corresponding bias ± precisions of estimation errors were 0 ± 1.89 L min −1 and −0.22 ± 2.12 L min −1 , respectively. The percent errors were 21.94% and 24.90%, smaller than the clinical acceptance limit (30%). To conclude, after calibration, this method can be used to monitor CO on healthy subjects during incremental intensity exercise

  14. An Energy efficient application specific integrated circuit for electrocardiogram feature detection and its potential for ambulatory cardiovascular disease detection.

    Science.gov (United States)

    Jain, Sanjeev Kumar; Bhaumik, Basabi

    2016-03-01

    A novel algorithm based on forward search is developed for real-time electrocardiogram (ECG) signal processing and implemented in application specific integrated circuit (ASIC) for QRS complex related cardiovascular disease diagnosis. The authors have evaluated their algorithm using MIT-BIH database and achieve sensitivity of 99.86% and specificity of 99.93% for QRS complex peak detection. In this Letter, Physionet PTB diagnostic ECG database is used for QRS complex related disease detection. An ASIC for cardiovascular disease detection is fabricated using 130-nm CMOS high-speed process technology. The area of the ASIC is 0.5 mm(2). The power dissipation is 1.73 μW at the operating frequency of 1 kHz with a supply voltage of 0.6 V. The output from the ASIC is fed to their Android application that generates diagnostic report and can be sent to a cardiologist through email. Their ASIC result shows average failed detection rate of 0.16% for six leads data of 290 patients in PTB diagnostic ECG database. They also have implemented a low-leakage version of their ASIC. The ASIC dissipates only 45 pJ with a supply voltage of 0.9 V. Their proposed ASIC is most suitable for energy efficient telemetry cardiovascular disease detection system.

  15. Independent component analysis-based artefact reduction: application to the electrocardiogram for improved magnetic resonance imaging triggering

    International Nuclear Information System (INIS)

    Oster, Julien; Pietquin, Olivier; Felblinger, Jacques; Abächerli, Roger; Kraemer, Michel

    2009-01-01

    Electrocardiogram (ECG) is required during magnetic resonance (MR) examination for monitoring patients under anaesthesia or with heart diseases and for synchronizing image acquisition with heart activity (triggering). Accurate and fast QRS detection is therefore desirable, but this task is complicated by artefacts related to the complex MR environment (high magnetic field, radio-frequency pulses and fast switching magnetic gradients). Specific signal processing has been proposed, whether using specific MR QRS detectors or ECG denoising methods. Most state-of-the-art techniques use a connection to the MR system for achieving their task, which is a major drawback since access to the MR system is often restricted. This paper introduces a new method for on-line ECG signal enhancement, called ICARE, which takes advantage of using multi-lead ECG and does not require any connection to the MR system. It is based on independent component analysis (ICA) and applied in real time. This algorithm yields accurate QRS detection for efficient triggering

  16. Compressive sensing of electrocardiogram signals by promoting sparsity on the second-order difference and by using dictionary learning.

    Science.gov (United States)

    Pant, Jeevan K; Krishnan, Sridhar

    2014-04-01

    A new algorithm for the reconstruction of electrocardiogram (ECG) signals and a dictionary learning algorithm for the enhancement of its reconstruction performance for a class of signals are proposed. The signal reconstruction algorithm is based on minimizing the lp pseudo-norm of the second-order difference, called as the lp(2d) pseudo-norm, of the signal. The optimization involved is carried out using a sequential conjugate-gradient algorithm. The dictionary learning algorithm uses an iterative procedure wherein a signal reconstruction and a dictionary update steps are repeated until a convergence criterion is satisfied. The signal reconstruction step is implemented by using the proposed signal reconstruction algorithm and the dictionary update step is implemented by using the linear least-squares method. Extensive simulation results demonstrate that the proposed algorithm yields improved reconstruction performance for temporally correlated ECG signals relative to the state-of-the-art lp(1d)-regularized least-squares and Bayesian learning based algorithms. Also for a known class of signals, the reconstruction performance of the proposed algorithm can be improved by applying it in conjunction with a dictionary obtained using the proposed dictionary learning algorithm.

  17. Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil.

    Science.gov (United States)

    Marcolino, Milena S; Carvalho, Bárbara C; Lucena, Aline M; França, Ana Luiza N; Pessoa, Cristiane G; Neves, Daniel S; Alkmim, Maria Beatriz M

    2015-01-01

    The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions. In the 1st phase, primary care units that sent >70% of ECGs as emergency from February to March 2014 were selected. The 2nd phase consisted of the intervention. In the 3rd phase, the proportion of ECGs sent as an emergency during the 1st and 2nd months post intervention were assessed. Of the 63 cities selected during the 1st phase, 50% of the practitioners did not know the proper definition of emergency. After the intervention, 67% of the cities had a significant reduction in the proportion of ECGs sent as an emergency during the 1st month, and 17% had a significant reduction during the 2nd month.

  18. Utility of electrocardiogram in the assessment and monitoring of pulmonary hypertension (idiopathic or secondary to pulmonary developmental abnormalities) in patients≤18 years of age.

    Science.gov (United States)

    Lau, Kelvin C; Frank, David B; Hanna, Brian D; Patel, Akash R

    2014-07-15

    Electrocardiograms have utility in disease stratification and monitoring in adult pulmonary arterial hypertension (PAH). We examined the electrocardiographic findings that are common in pediatric PAH and assessed for correlation with disease severity and progression. We retrospectively identified patients aged≤18 years followed at a single institution from January 2001 to June 2012 with catheterization-confirmed diagnosis of idiopathic PAH and PAH secondary to pulmonary developmental abnormalities. Patients with an electrocardiography performed within 60 days of catheterization were included. Primary and secondary outcomes are the prevalence of abnormal electrocardiographic findings at the time of catheterization and the association between electrocardiographic and hemodynamic findings and electrocardiographic changes with disease progression on follow-up catheterization, respectively. Of the 100 electrocardiography-catheterization pairs derived from the 46 patients identified, 93% had an electrocardiographic abnormality: 78% had right ventricular hypertrophy (RVH) and 52% had right axis deviation (RAD) for age. In patients with idiopathic PAH, the presence of RVH and RAD correlated with pulmonary vascular resistance and transpulmonary gradient. RAD and RVH on baseline electrocardiogram was associated with an increased risk of disease progression on subsequent catheterization (odds ratio 11.0, 95% confidence interval 1.3 to 96.2, p=0.03) after adjusting for PAH subgroup. The sensitivity, specificity, and positive and negative predictive values of RAD and RVH on baseline electrocardiogram for disease progression were 92%, 48%, 33%, and 95%, respectively. In conclusion, electrocardiographic abnormalities are common in pediatric PAH. RAD and RVH on electrocardiogram were associated with worse hemodynamics, whereas their absence is suggestive of a lack of disease progression. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. How restful is it with all that noise? Comparison of Interleaved silent steady state (ISSS) and conventional imaging in resting-state fMRI.

    Science.gov (United States)

    Andoh, J; Ferreira, M; Leppert, I R; Matsushita, R; Pike, B; Zatorre, R J

    2017-02-15

    Resting-state fMRI studies have become very important in cognitive neuroscience because they are able to identify BOLD fluctuations in brain circuits involved in motor, cognitive, or perceptual processes without the use of an explicit task. Such approaches have been fruitful when applied to various disordered populations, or to children or the elderly. However, insufficient attention has been paid to the consequences of the loud acoustic scanner noise associated with conventional fMRI acquisition, which could be an important confounding factor affecting auditory and/or cognitive networks in resting-state fMRI. Several approaches have been developed to mitigate the effects of acoustic noise on fMRI signals, including sparse sampling protocols and interleaved silent steady state (ISSS) acquisition methods, the latter being used only for task-based fMRI. Here, we developed an ISSS protocol for resting-state fMRI (rs-ISSS) consisting of rapid acquisition of a set of echo planar imaging volumes following each silent period, during which the steady state longitudinal magnetization was maintained with a train of relatively silent slice-selective excitation pulses. We evaluated the test-retest reliability of intensity and spatial extent of connectivity networks of fMRI BOLD signal across three different days for rs-ISSS and compared it with a standard resting-state fMRI (rs-STD). We also compared the strength and distribution of connectivity networks between rs-ISSS and rs-STD. We found that both rs-ISSS and rs-STD showed high reproducibility of fMRI signal across days. In addition, rs-ISSS showed a more robust pattern of functional connectivity within the somatosensory and motor networks, as well as an auditory network compared with rs-STD. An increased connectivity between the default mode network and the language network and with the anterior cingulate cortex (ACC) network was also found for rs-ISSS compared with rs-STD. Finally, region of interest analysis showed

  20. Noninvasive Diagnosis of Coronary Artery Disease Using 12-Lead High-Frequency Electrocardiograms

    Science.gov (United States)

    Schlegel, Todd T.; Arenare, Brian

    2006-01-01

    A noninvasive, sensitive method of diagnosing certain pathological conditions of the human heart involves computational processing of digitized electrocardiographic (ECG) signals acquired from a patient at all 12 conventional ECG electrode positions. In the processing, attention is focused on low-amplitude, high-frequency components of those portions of the ECG signals known in the art as QRS complexes. The unique contribution of this method lies in the utilization of signal features and combinations of signal features from various combinations of electrode positions, not reported previously, that have been found to be helpful in diagnosing coronary artery disease and such related pathological conditions as myocardial ischemia, myocardial infarction, and congestive heart failure. The electronic hardware and software used to acquire the QRS complexes and perform some preliminary analyses of their high-frequency components were summarized in Real-Time, High-Frequency QRS Electrocardiograph (MSC- 23154), NASA Tech Briefs, Vol. 27, No. 7 (July 2003), pp. 26-28. To recapitulate, signals from standard electrocardiograph electrodes are preamplified, then digitized at a sampling rate of 1,000 Hz, then analyzed by the software that detects R waves and QRS complexes and analyzes them from several perspectives. The software includes provisions for averaging signals over multiple beats and for special-purpose nonrecursive digital filters with specific low- and high-frequency cutoffs. These filters, applied to the averaged signal, effect a band-pass operation in the frequency range from 150 to 250 Hz. The output of the bandpass filter is the desired high-frequency QRS signal. Further processing is then performed in real time to obtain the beat-to-beat root mean square (RMS) voltage amplitude of the filtered signal, certain variations of the RMS voltage, and such standard measures as the heart rate and R-R interval at any given time. A key signal feature analyzed in the present

  1. REST SOA Orchestration and BPM Platforms

    Directory of Open Access Journals (Sweden)

    Octavian DOSPINESCU

    2017-01-01

    Full Text Available BPM initiatives and SOA approaches emerged and developed as distinct efforts although they could be perceived as the two sides of the same coin in the context of online business and information systems. Thus, inherently, their modeling perspectives met (or collided and generated some frameworks and languages like SOAML or SOAMF. Starting from these standards and initiatives we will propose a methodological approach that could lead to a feasible implementation of web service integration in a formal Business Process context.

  2. Biomarkers of Dose and Effect of inhaled ozone in resting versus exercising human subjects: comparison with resting rats

    Science.gov (United States)

    Background: Human controlled exposure studies have generally focused on subjects exposed to ozone (O3) while exercising while exposures in rats have been done at rest. We exposed resting subjects to labeled O3 (18O3, 0.4 ppm, for 2 hr) and compared O3 dose and effects with our...

  3. Building RESTful web services with Go learn how to build powerful RESTful APIs with Golang that scale gracefully

    CERN Document Server

    Yellavula, Naren

    2017-01-01

    REST is an architectural style that tackles the challenges of building scalable web services and in today's connected world, APIs have taken a central role on the web. APIs provide the fabric through which systems interact, and REST has become synonymous with APIs. The depth, breadth, and ease of use of Go, makes it a breeze for developers to ...

  4. Task vs. rest-different network configurations between the coactivation and the resting-state brain networks.

    Science.gov (United States)

    Di, Xin; Gohel, Suril; Kim, Eun H; Biswal, Bharat B

    2013-01-01

    There is a growing interest in studies of human brain networks using resting-state functional magnetic resonance imaging (fMRI). However, it is unclear whether and how brain networks measured during the resting-state exhibit comparable properties to brain networks during task performance. In the present study, we investigated meta-analytic coactivation patterns among brain regions based upon published neuroimaging studies, and compared the coactivation network configurations with those in the resting-state network. The strength of resting-state functional connectivity between two regions were strongly correlated with the coactivation strength. However, the coactivation network showed greater global efficiency, smaller mean clustering coefficient, and lower modularity compared with the resting-state network, which suggest a more efficient global information transmission and between system integrations during task performing. Hub shifts were also observed within the thalamus and the left inferior temporal cortex. The thalamus and the left inferior temporal cortex exhibited higher and lower degrees, respectively in the coactivation network compared with the resting-state network. These results shed light regarding the reconfiguration of the brain networks between task and resting-state conditions, and highlight the role of the thalamus in change of network configurations in task vs. rest.

  5. Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome.

    Science.gov (United States)

    Popovic, Dejana; Damjanovic, Svetozar; Djordjevic, Tea; Martic, Dejana; Ignjatovic, Svetlana; Milinkovic, Neda; Banovic, Marko; Lasica, Ratko; Petrovic, Milan; Guazzi, Marco; Arena, Ross

    2017-09-01

    Despite considerable knowledge regarding the importance of stress in coronary artery disease (CAD) pathogenesis, its underestimation persists in routine clinical practice, in part attributable to lack of a standardized, objective assessment. The current study examined the ability of stress hormones to predict CAD severity and prognosis at basal conditions as well as during and following an exertional stimulus. Forty Caucasian subjects with significant coronary artery lesions (≥50%) were included. Within 2 months of coronary angiography, cardiopulmonary exercise testing (CPET) on a recumbent ergometer was performed in conjunction with stress echocardiography (SE). At rest, peak and after 3 min of recovery following CPET, plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and NT-pro-brain natriuretic peptide (NT-pro-BNP) were measured by immunoassay sandwich technique, radioimmunoassay, and radioimmunometric technique, respectively. Subjects were subsequently followed a mean of 32 ± 10 months. Mean ejection fraction was 56.7 ± 9.6%. Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a significantly lower plasma cortisol levels during CPET compared to those with 3-SCA (p  .05). Among CPET, SE, and hormonal parameters, cortisol at rest and during CPET recovery demonstrated the best predictive value in distinguishing between 1-, 2-, and 3-SCA [area under ROC curve 0.75 and 0.77 (SE = 0.11, 0.10; p = .043, .04) for rest and recovery, respectively]. ΔCortisol peak/rest predicted cumulative cardiac events (area under ROC curve 0.75, SE = 0.10, p = .049). Cortisol at rest and following an exercise test holds predictive value for CAD severity and prognosis, further demonstrating a link between stress and unwanted cardiac events.

  6. Resting state functional connectivity changes in adults with developmental stuttering: an initial sLORETA study.

    Directory of Open Access Journals (Sweden)

    Kathleen eJoos

    2014-10-01

    Full Text Available Introduction: Stuttering is defined as speech characterized by verbal dysfluencies, but should not be seen as an isolated speech disorder, but as a generalized sensorimotor timing deficit due to impaired communication between speech related brain areas. Therefore we focused on resting state brain activity and functional connectivity.Method: We included 11 patients with developmental stuttering and 11 age matched controls. To objectify stuttering severity and the impact on the quality of life (QoL, we used the Dutch validated Test for Stuttering Severity-Readers (TSS-R and the Overall Assessment of the Speaker’s Experience of Stuttering (OASES, respectively. Furthermore, we used standardized low resolution brain electromagnetic tomography (sLORETA analyses to look at resting state activity and functional connectivity differences and their correlations with the TSS-R and OASES.Results: No resting state activity differences were identified in comparison to fluently speaking controls or in correlation with stuttering severity or QoL measures. Significant alterations in resting state functional connectivity were found, predominantly interhemispheric, i.e. a decreased functional connectivity for high frequency oscillations (beta and gamma between motor speech areas (BA44 and 45 and the contralateral premotor (BA 6 and motor (BA 4 areas. A positive correlation was found between functional connectivity at low frequency oscillations (theta and alpha and stuttering severity, while a mixed increased and decreased functional connectivity at low and high frequency oscillations correlated with QoL.Discussion: PWS are characterized by decreased high frequency interhemispheric functional connectivity between motor speech, premotor and motor areas in the resting state, while higher functional connectivity in the low frequency bands indicates more severe speech disturbances, suggesting that increased interhemispheric and right sided functional connectivity is

  7. The Effect Of Resting Time To Work Productivity On Surya Hutani Jaya Company

    Directory of Open Access Journals (Sweden)

    Purbawati

    2015-08-01

    Full Text Available Purbawati Rachmat M Ruslim Y B.D.A.S.Simarangkir. 2016. The Effect of resting time to work produktivity to the activity of Seedling Eucalyptus Pellitawith mini cutting.Productivity is the ratio between the output and the input. Rated productivity indicates how effectively the production process has been empowered to increase the output and how efficiently are also sources of input has been successfully saved. Many factors can affect productivity example is the resting time factor. In this study which examined is how the influence of rest periods of the Productivity and how much the standard output produced by the female labor force.Research conducted on women workers who are working at the cutting shoots cutting house.Nurseries with mini cutting process is done by cutting the of the leaves on each leaf so that the remaining 2 to 3 pairs of strands shoots that have undergone a process of cutting in its leaves called ready plant bud shoot. Ready plant bud is the output of this research while the input is the time used to do the cutting. This study aims to determine the influence of rest periods of the productivity of female workers and to determine the standard output produced by the female labor force. Data processing method used is the partial productivity measurement methods and measurement methods of working time. The results stated that the amount of labor productivity of women without giving time off is 0.0911 shoots second -1 whereas labor productivity by granting time off for 5 minutes every hour C1 by granting a 10 minute break every two hours C2 by granting time off for 30 minutes per one working day C3 by granting time off for 60 minutes per one working day C4 and the provision of rest periods combined mixed which is 5 minutes every hour and 60 minutes per one working day C5 respectively is 00908 shoots second -1 0.0761 shoots second-1 0.0972 shoots second-1 0.0857 shoots second-1 and 0.0860 shoots second -1. The calculation output

  8. Do resting brain dynamics predict oddball evoked-potential?

    Directory of Open Access Journals (Sweden)

    Lee Tien-Wen

    2011-11-01

    Full Text Available Abstract Background The oddball paradigm is widely applied to the investigation of cognitive function in neuroscience and in neuropsychiatry. Whether cortical oscillation in the resting state can predict the elicited oddball event-related potential (ERP is still not clear. This study explored the relationship between resting electroencephalography (EEG and oddball ERPs. The regional powers of 18 electrodes across delta, theta, alpha and beta frequencies were correlated with the amplitude and latency of N1, P2, N2 and P3 components of oddball ERPs. A multivariate analysis based on partial least squares (PLS was applied to further examine the spatial pattern revealed by multiple correlations. Results Higher synchronization in the resting state, especially at the alpha spectrum, is associated with higher neural responsiveness and faster neural propagation, as indicated by the higher amplitude change of N1/N2 and shorter latency of P2. None of the resting quantitative EEG indices predict P3 latency and amplitude. The PLS analysis confirms that the resting cortical dynamics which explains N1/N2 amplitude and P2 latency does not show regional specificity, indicating a global property of the brain. Conclusions This study differs from previous approaches by relating dynamics in the resting state to neural responsiveness in the activation state. Our analyses suggest that the neural characteristics carried by resting brain dynamics modulate the earlier/automatic stage of target detection.

  9. REST-MapReduce: An Integrated Interface but Differentiated Service

    Directory of Open Access Journals (Sweden)

    Jong-Hyuk Park

    2014-01-01

    Full Text Available With the fast deployment of cloud computing, MapReduce architectures are becoming the major technologies for mobile cloud computing. The concept of MapReduce was first introduced as a novel programming model and implementation for a large set of computing devices. In this research, we propose a novel concept of REST-MapReduce, enabling users to use only the REST interface without using the MapReduce architecture. This approach provides a higher level of abstraction by integration of the two types of access interface, REST API and MapReduce. The motivation of this research stems from the slower response time for accessing simple RDBMS on Hadoop than direct access to RDMBS. This is because there is overhead to job scheduling, initiating, starting, tracking, and management during MapReduce-based parallel execution. Therefore, we provide a good performance for REST Open API service and for MapReduce, respectively. This is very useful for constructing REST Open API services on Hadoop hosting services, for example, Amazon AWS (Macdonald, 2005 or IBM Smart Cloud. For evaluating performance of our REST-MapReduce framework, we conducted experiments with Jersey REST web server and Hadoop. Experimental result shows that our approach outperforms conventional approaches.

  10. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same

  11. Quantifying agreement between anatomical and functional interhemispheric correspondences in the resting brain.

    Directory of Open Access Journals (Sweden)

    Hang Joon Jo

    Full Text Available The human brain is composed of two broadly symmetric cerebral hemispheres, with an abundance of reciprocal anatomical connections between homotopic locations. However, to date, studies of hemispheric symmetries have not identified correspondency precisely due to variable cortical folding patterns. Here we present a method to establish accurate correspondency using position on the unfolded cortical surface relative to gyral and sulcal landmarks. The landmark method is shown to outperform the method of reversing standard volume coordinates, and it is used to quantify the functional symmetry in resting fMRI data throughout the cortex. Resting brain activity was found to be maximally correlated with locations less than 1 cm away on the cortical surface from the corresponding anatomical location in nearly half of the cortex. While select locations exhibited asymmetric patterns, precise symmetric relationships were found to be the norm, with fine-grained symmetric functional maps demonstrated in motor, occipital, and inferior frontal cortex.

  12. Decommissioning standards

    International Nuclear Information System (INIS)

    Crofford, W.N.

    1980-01-01

    EPA has agreed to establish a series of environmental standards for the safe disposal of radioactive waste through participation in the Interagency Review Group on Nuclear Waste Management (IRG). One of the standards required under the IRG is the standard for decommissioning of radioactive contaminated sites, facilities, and materials. This standard is to be proposed by December 1980 and promulgated by December 1981. Several considerations are important in establishing these standards. This study includes discussions of some of these considerations and attempts to evaluate their relative importance. Items covered include: the form of the standards, timing for decommissioning, occupational radiation protection, costs and financial provisions. 4 refs

  13. Resting technetium-99m methoxyisobutylisonitrile cardiac imaging in chronic coronary artery disease: comparison with rest-redistribution thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Cuocolo, A.; Maurea, S.; Pace, L.; Nicolai, E.; Nappi, A.; Imbriaco, M.; Trimarco, B.; Salvatore, M.

    1993-01-01

    We studied 19 patients with angiographically proven coronary artery disease and left ventricular dysfunction (ejection fraction 33%±8%) by resting technetium-99m methoxyisobutylisonitrile ( 99m Tc-MIBI) and rest-redistribution thallium-201 cardiac imaging. Thallium and 99m Tc-MIBI studies were visually analysed. Of 285 segments, 203 (71%) had normal thallium uptake, 48 (17%) showed reversible thallium defects and 34 (12%) showed irreversible thallium defects. Of these 34 irreversible thallium defects, 19 (56%) were moderate and 15 (44%) were severe. Of the corresponding 285 segments, 200 (70%) had normal 99m Tc-MIBI uptake, while 37 (13%) showed moderate and 48 (17%) showed severe reduction of MIBI uptake. Myocardial segmental agreement for regional uptake score between initial thallium and resting 99m Tc-MIBI images was 90% (κ=0.78). Segmental agreement between delayed thallium and resting 99m Tc-MIBI images was 77% (κ=0.44). In particular, in 26 (9%) segments 99m Tc-MIBI uptake was severely reduced while delayed thallium uptake was normal or only moderately reduced. These data suggest that although rest-redistribution thallium and resting 99m Tc-MIBI cardiac imaging provide concordant results in the majority of myocardial segments, some segments with severely reduced resting 99m Tc-MIBI uptake may contain viable but hypoperfused myocardium. Thus, conclusions on myocardial viability based on 99m Tc-MIBI uptake should be made with caution in chronic coronary artery disease. (orig.)

  14. Detection of Acute Myocardial Infarction in a Pig Model Using the SAN-Atrial-AVN-His (SAAH) Electrocardiogram (ECG), Model PHS-A10, an Automated and Integrated Signals Recognition System.

    Science.gov (United States)

    Zhao, Wenjiao; Lu, Guihua; Liu, Li; Sun, Zhishan; Wu, Mingxin; Yi, Wenyan; Chen, Haiyan; Li, Yanhui; Tang, Lilong; Zeng, Jianping

    2018-03-04

    BACKGROUND The aim of this study was to compare the use of the standard 12-lead electrocardiogram (ECG) with the SAN-Atrial-AVN-His (SAAH) ECG (Model PHS-A10), a new automated and integrated signals recognition system that detects micro-waveforms within the P, QRS, and T-wave, in a pig model of acute myocardial infarction (MI). MATERIAL AND METHODS Six medium-sized domestic Chinese pigs underwent general anesthesia, and an angioplasty balloon was placed and dilated for 120 minutes in the first diagonal coronary artery arising from the left anterior descending (LAD) coronary artery. A standard ECG and a SAAH ECG (Model PHS-A10) were used to evaluate: 1) the number of wavelets in ST-T segment in lead V5; 2) the duration of the repolarization initial (Ri), or duration of the wavelets starting from the J-point to the endpoint of the wavelets in the ST interval; 3) the duration of the repolarization terminal (Rt), of the wavelets, starting from the endpoint of the wavelets in the ST interval to the cross-point of the T-wave and baseline; 4) the ratio Ri: Rt. RESULTS Following coronary artery occlusion, duration of Ri and Ri/Rt increased, and Rt decreased, which was detected by the SAAH ECG (Model PHS-A10) within 12 seconds, compared with standard ECG that detected ST segment depression at 24 seconds following coronary artery occlusion. CONCLUSIONS The findings from this preliminary study in a pig model of acute MI support the need for clinical studies to evaluate the SAAH ECG (Model PHS-A10) for the early detection of acute MI.

  15. Accuracy of the Electrocardiogram in Localizing the Accessory Pathway in Patients with Wolff-Parkinson-White Pattern

    Directory of Open Access Journals (Sweden)

    Carlos Manuel Teixeira

    Full Text Available Abstract Background: There are currently several electrocardiographic algorithms to locate the accessory pathway (AP in patients with Wolff-Parkinson-White (WPW syndrome. Objective: To compare the ability of electrocardiographic algorithms in identifying the location of the AP in patients with WPW pattern referred for ablation. Methods: Observational, cross-sectional, retrospective study with 111 patients with WPW syndrome referred for AP ablation. The electrocardiogram (ECG obtained prior to the ablation was analyzed by an experienced observer who consecutively applied seven algorithms to identify non-invasively the AP. We then compared the location estimated with this assessment with that obtained in the electrophysiological study and calculated the agreement rates. Results: Among the APs, 59 (53.15% were distributed around the mitral annulus and the remaining 52 (46.85% were located around the tricuspid annulus. The overall absolute accuracy of the algorithms evaluated varied between 27% and 47%, increasing to between 40% and 76% when we included adjacent locations. The absolute agreement rate by AP location was 2.00-52.20% for septal APs (n = 51, increasing to 5.90-90.20% when considering adjacent locations; 7.70-69.20% for right APs (n = 13, increasing to 42.90-100% when considering adjacent locations; and 21.70-54.50% for left APs (n = 47, increasing to 50-87% when considering adjacent locations. Conclusion: The agreement rates observed for the analyzed scores indicated a low discriminative ability of the ECG in locating the AP in patients with WPW.

  16. A novel LabVIEW-based multi-channel non-invasive abdominal maternal-fetal electrocardiogram signal generator.

    Science.gov (United States)

    Martinek, Radek; Kelnar, Michal; Koudelka, Petr; Vanus, Jan; Bilik, Petr; Janku, Petr; Nazeran, Homer; Zidek, Jan

    2016-02-01

    This paper describes the design, construction, and testing of a multi-channel fetal electrocardiogram (fECG) signal generator based on LabVIEW. Special attention is paid to the fetal heart development in relation to the fetus' anatomy, physiology, and pathology. The non-invasive signal generator enables many parameters to be set, including fetal heart rate (FHR), maternal heart rate (MHR), gestational age (GA), fECG interferences (biological and technical artifacts), as well as other fECG signal characteristics. Furthermore, based on the change in the FHR and in the T wave-to-QRS complex ratio (T/QRS), the generator enables manifestations of hypoxic states (hypoxemia, hypoxia, and asphyxia) to be monitored while complying with clinical recommendations for classifications in cardiotocography (CTG) and fECG ST segment analysis (STAN). The generator can also produce synthetic signals with defined properties for 6 input leads (4 abdominal and 2 thoracic). Such signals are well suited to the testing of new and existing methods of fECG processing and are effective in suppressing maternal ECG while non-invasively monitoring abdominal fECG. They may also contribute to the development of a new diagnostic method, which may be referred to as non-invasive trans-abdominal CTG +  STAN. The functional prototype is based on virtual instrumentation using the LabVIEW developmental environment and its associated data acquisition measurement cards (DAQmx). The generator also makes it possible to create synthetic signals and measure actual fetal and maternal ECGs by means of bioelectrodes.

  17. An Integrated Approach Using Chaotic Map & Sample Value Difference Method for Electrocardiogram Steganography and OFDM Based Secured Patient Information Transmission.

    Science.gov (United States)

    Pandey, Anukul; Saini, Barjinder Singh; Singh, Butta; Sood, Neetu

    2017-10-18

    This paper presents a patient's confidential data hiding scheme in electrocardiogram (ECG) signal and its subsequent wireless transmission. Patient's confidential data is embedded in ECG (called stego-ECG) using chaotic map and the sample value difference approach. The sample value difference approach effectually hides the patient's confidential data in ECG sample pairs at the predefined locations. The chaotic map generates these predefined locations through the use of selective control parameters. Subsequently, the wireless transmission of the stego-ECG is analyzed using the Orthogonal Frequency Division Multiplexing (OFDM) system in a Rayleigh fading scenario for telemedicine applications. Evaluation of proposed method on all 48 records of MIT-BIH arrhythmia ECG database demonstrates that the embedding does not alter the diagnostic features of cover ECG. The secret data imperceptibility in stego-ECG is evident through the statistical and clinical performance measures. Statistical measures comprise of Percentage Root-mean-square Difference (PRD), Peak Signal to Noise Ratio (PSNR), and Kulback-Leibler Divergence (KL-Div), etc. while clinical metrics includes wavelet Energy Based Diagnostic Distortion (WEDD) and Wavelet based Weighted PRD (WWPRD). The various channel Signal-to-Noise Ratio scenarios are simulated for wireless communication of stego-ECG in OFDM system. The proposed method over all the 48 records of MIT-BIH arrhythmia database resulted in average, PRD = 0.26, PSNR = 55.49, KL-Div = 3.34 × 10 -6 , WEDD = 0.02, and WWPRD = 0.10 with secret data size of 21Kb. Further, a comparative analysis of proposed method and recent existing works was also performed. The results clearly, demonstrated the superiority of proposed method.

  18. Prevalence of Chagas Disease in a U.S. Population of Latin American Immigrants with Conduction Abnormalities on Electrocardiogram.

    Directory of Open Access Journals (Sweden)

    Mahmoud I Traina

    2017-01-01

    Full Text Available Chagas disease (CD affects over six million people and is a leading cause of cardiomyopathy in Latin America. Given recent migration trends, there is a large population at risk in the United States (US. Early stage cardiac involvement from CD usually presents with conduction abnormalities on electrocardiogram (ECG including right bundle branch block (RBBB, left anterior or posterior fascicular block (LAFB or LPFB, respectively, and rarely, left bundle branch block (LBBB. Identification of disease at this stage may lead to early treatment and potentially delay the progression to impaired systolic function. All ECGs performed in a Los Angeles County hospital and clinic system were screened for the presence of RBBB, LAFB, LPFB, or LBBB. Patients were contacted and enrolled in the study if they had previously resided in Latin America for at least 12 months and had no history of cardiac disease. Enzyme-linked immunosorbent assay (ELISA and immunofluorescence assay (IFA tests were utilized to screen for Trypanosoma cruzi seropositivity. A total of 327 consecutive patients were screened for CD from January 2007 to December 2010. The mean age was 46.3 years and the mean length of stay in the US was 21.2 years. Conduction abnormalities were as follows: RBBB 40.4%, LAFB 40.1%, LPFB 2.8%, LBBB 5.5%, RBBB and LAFB 8.6%, and RBBB and LPFB 2.8%. Seventeen patients were positive by both ELISA and IFA (5.2%. The highest prevalence rate was among those with RBBB and LAFB (17.9%. There is a significant prevalence of CD in Latin American immigrants residing in Los Angeles with conduction abnormalities on ECG. Clinicians should consider evaluating all Latin American immigrant patients with unexplained conduction disease for CD.

  19. Electrocardiogram score for the selection of reperfusion strategy in early latecomers with ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Zhang, Yu-Jiao; Zheng, Wen; Sun, Jian; Li, Guo-Li; Chi, Bao-Rong

    2015-01-01

    The clinical benefit of percutaneous coronary intervention (PCI) is controversial in ST-segment elevation myocardial infarction (STEMI) patients presenting 12-72 hours after symptom onset. Several studies suggested this conflicting result was associated with myocardial area at risk (MaR) of enrolled patients. MaR could be estimated by the electrocardiogram (ECG) score. Our objective was to evaluate the benefits of PCI in STEMI latecomers with different MaR. We constructed a prospective cohort involving 436 patients presenting 12-72 hours after STEMI onset and who met an inclusion criteria. 218 underwent PCI and 218 received the optimal medical therapy (OMT) alone. Individual MaR was quantified by the combined Aldrich ST and Selvester QRS score. The primary endpoint was a composite of cardiovascular death, reinfarction or revascularization within two years. The 2-year cumulative primary endpoint rate was respectively 9.2% in PCI group and 5.3% in OMT group when MaR<35% (adjusted hazard ratio for PCI vs. OMT, 1.855; 95% confidence interval [CI], 0.617-5.575; P=0.271), and was 12.8% in PCI group and 23.1% in OMT group when MaR ≥35% (adjusted hazard ratio for PCI vs. OMT, 0.448; 95% CI, 0.228-0.884; P=0.021). The benefit of PCI for the STEMI latecomers was associated with the MaR. PCI, compared with OMT, could significantly reduce the 2-year primary outcomes in patients with MaR≥35%, but not in ones with MaR<35%. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Pharmacokinetics of intravenously and orally administered sotalol hydrochloride in horses and effects on surface electrocardiogram and left ventricular systolic function.

    Science.gov (United States)

    Broux, B; De Clercq, D; Decloedt, A; De Baere, S; Devreese, M; Van Der Vekens, N; Ven, S; Croubels, S; van Loon, G

    2016-02-01

    Arrhythmias are common in horses. Some, such as frequent atrial or ventricular premature beats, may require long-term anti-arrhythmic therapy. In humans and small animals, sotalol hydrochloride (STL) is often used for chronic oral anti-arrhythmic therapy. STL prolongs repolarization and the effective refractory period in all cardiac tissues. No information on STL pharmacokinetics or pharmacodynamics in horses is available and the aim of this study was to evaluate the pharmacokinetics of intravenously (IV) and orally (PO) administered STL and the effects on surface electrocardiogram and left ventricular systolic function. Six healthy horses were given 1 mg STL/kg bodyweight either IV or PO. Blood samples to determine plasma STL concentrations were taken before and at several time points after STL administration. Electrocardiography and echocardiography were performed at different time points before and after IV STL administration. Mean peak plasma concentrations after IV and PO administration of STL were 1624 ng/mL and 317 ng/mL, respectively. The oral bioavailability was intermediate (48%) with maximal absorption after 0.94 h, a moderate distribution and a mean elimination half-life of 15.24 h. After IV administration, there was a significant increase in QT interval, but no significant changes in other electrocardiographic and echocardiographic parameters. Transient transpiration was observed after IV administration, but no adverse effects were noted after a single oral dose of 1 mg/kg STL in any of the horses. It was concluded that STL has an intermediate oral bioavailability in the horse and might be useful in the treatment of equine arrhythmias. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Impact of the dynamic and static component of the sport practised for electrocardiogram analysis in screening athletes.

    Science.gov (United States)

    Maillot, N; Guenancia, C; Yameogo, N V; Gudjoncik, A; Garnier, F; Lorgis, L; Chagué, F; Cottin, Y

    2018-02-01

    To interpret the electrocardiogram (ECG) of athletes, the recommendations of the ESC and the Seattle criteria define type 1 peculiarities, those induced by training, and type 2, those not induced by training, to rule out cardiomyopathy. The specificity of the screening was improved by Sheikh who defined "Refined Criteria," which includes a group of intermediate peculiarities. The aim of our study was to investigate the influence of static and dynamic components on the prevalence of different types of abnormalities. The ECGs of 1030 athletes performed during preparticipation screening were interpreted using these three classifications. Our work revealed 62/16%, 69/13%, and 71/7% of type 1 peculiarities and type 2 abnormalities for the ESC, Seattle, and Refined Criteria algorithms, respectively(P<.001). For type 2 abnormalities, three independent factors were found for the ESC and Seattle criteria: age, Afro-Caribbean origin, and the dynamic component with, for the latter, an OR[95% CI] of 2.35[1.28-4.33] (P=.006) and 1.90[1.03-3.51] (P=.041), respectively. In contrast, only the Afro-Caribbean origin was associated with type 2 abnormalities using the Refined Criteria: OR[95% CI] 2.67[1.60-4.46] (P<.0001). The Refined Criteria classified more athletes in the type 1 category and fewer in the type 2 category compared with the ESC and Seattle algorithms. Contrary to previous studies, a high dynamic component was not associated with type 2 abnormalities when the Refined Criteria were used; only the Afro-Caribbean origin remained associated. Further research is necessary to better understand adaptations with regard to duration and thus improve the modern criteria for ECG screening in athletes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Cadmium stress assessment based on the electrocardiogram characteristics of zebra fish (Danio rerio): QRS complex could play an important role.

    Science.gov (United States)

    Xing, Na; Ji, Lizhen; Song, Jie; Ma, Jingchun; Li, Shangge; Ren, Zongming; Xu, Fei; Zhu, Jianping

    2017-10-01

    The electrocardiogram (ECG) of zebra fish (Danio rerio) expresses cardiac features that are similar to humans. Here we use sharp microelectrode measurements to obtain ECG characteristics in adult zebra fish and analyze the effects of cadmium chloride (CdCl 2 ) on the heart. We observe the overall changes of ECG parameters in different treatments (0.1 TU, 0.5 TU and 1.0 TU CdCl 2 ), including P wave, Q wave, R wave, S wave, T wave, PR interval (atrial contraction), QRS complex (ventricular depolarization), ST segment, and QT interval (ventricular repolarization). The trends of the ECG parameters showed some responses to the concentration and exposure time of CdCl 2 , but it was difficult to obtain more information about the useful indicators in water quality assessment depending on tendency analysis alone. A self-organizing map (SOM) showed that P values, R values, and T values were similar; R wave and T wave amplitude were similar; and most important, QRS value was similar to the CdCl 2 stress according to the classified data patterns including CdCl 2 stress (E) and ECG components based on the Ward linkage. It suggested that the duration of QRS complex was related to environmental stress E directly. The specification and evaluation of ECG parameters in Cd 2+ pollution suggested that there is a markedly significant correlation between QRS complex and CdCl 2 stress with the highest r (0.729) and the smallest p (0.002) among all ECG characteristics. In this case, it is concluded that QRS complex can be used as an indicator in the CdCl 2 stress assessment due to the lowest AIC data abased on the linear regression model between the CdCl 2 stress and ECG parameters. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Predictive value of the baseline electrocardiogram ST-segment pattern in cardiogenic shock: Results from the CardShock Study.

    Science.gov (United States)

    Javanainen, Tuija; Tolppanen, Heli; Lassus, Johan; Nieminen, Markku S; Sionis, Alessandro; Spinar, Jindrich; Silva-Cardoso, José; Greve Lindholm, Matias; Banaszewski, Marek; Harjola, Veli-Pekka; Jurkko, Raija

    2018-05-30

    The most common aetiology of cardiogenic shock (CS) is acute coronary syndrome (ACS), but even up to 20%-50% of CS is caused by other disorders. ST-segment deviations in the electrocardiogram (ECG) have been investigated in patients with ACS-related CS, but not in those with other CS aetiologies. We set out to explore the prevalence of different ST-segment patterns and their associations with the CS aetiology, clinical findings and 90-day mortality. We analysed the baseline ECG of 196 patients who were included in a multinational prospective study of CS. The patients were divided into 3 groups: (a) ST-segment elevation (STE). (b) ST-segment depression (STDEP). (c) No ST-segment deviation or ST-segment impossible to analyse (NSTD). A subgroup analysis of the ACS patients was conducted. ST-segment deviations were present in 80% of the patients: 52% had STE and 29% had STDEP. STE was associated with the ACS aetiology, but one-fourth of the STDEP patients had aetiology other than ACS. The overall 90-day mortality was 41%: in STE 47%, STDEP 36% and NSTD 33%. In the multivariate mortality analysis, only STE predicted mortality (HR 1.74, CI 95 1.07-2.84). In the ACS subgroup, the patients were equally effectively revascularized, and no differences in the survival were noted between the study groups. ST-segment elevation is associated with the ACS aetiology and high mortality in the unselected CS population. If STE is not present, other aetiologies must be considered. When effectively revascularized, the prognosis is similar regardless of the ST-segment pattern in ACS-related CS. © 2018 Wiley Periodicals, Inc.

  4. A three-lead, programmable, and microcontroller-based electrocardiogram generator with frequency domain characteristics of heart rate variability.

    Science.gov (United States)

    Wei, Ying-Chieh; Wei, Ying-Yu; Chang, Kai-Hsiung; Young, Ming-Shing

    2012-04-01

    The objective of this study is to design and develop a programmable electrocardiogram (ECG) generator with frequency domain characteristics of heart rate variability (HRV) which can be used to test the efficiency of ECG algorithms and to calibrate and maintain ECG equipment. We simplified and modified the three coupled ordinary differential equations in McSharry's model to a single differential equation to obtain the ECG signal. This system not only allows the signal amplitude, heart rate, QRS-complex slopes, and P- and T-wave position parameters to be adjusted, but can also be used to adjust the very low frequency, low frequency, and high frequency components of HRV frequency domain characteristics. The system can be tuned to function with HRV or not. When the HRV function is on, the average heart rate can be set to a value ranging from 20 to 122 beats per minute (BPM) with an adjustable variation of 1 BPM. When the HRV function is off, the heart rate can be set to a value ranging from 20 to 139 BPM with an adjustable variation of 1 BPM. The amplitude of the ECG signal can be set from 0.0 to 330 mV at a resolution of 0.005 mV. These parameters can be adjusted either via input through a keyboard or through a graphical user interface (GUI) control panel that was developed using LABVIEW. The GUI control panel depicts a preview of the ECG signal such that the user can adjust the parameters to establish a desired ECG morphology. A complete set of parameters can be stored in the flash memory of the system via a USB 2.0 interface. Our system can generate three different types of synthetic ECG signals for testing the efficiency of an ECG algorithm or calibrating and maintaining ECG equipment. © 2012 American Institute of Physics

  5. Validation of resting metabolic rate prediction equations for teenagers

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Santos da Fonseca

    2007-09-01

    Full Text Available The resting metabolic rate (RMR can be defi ned as the minimum rate of energy spent and represents the main component of the energetic outlay. The purpose of this study is to validate equations to predict the resting metabolic rate in teenagers (103 individuals, being 51 girls and 52 boys, with age between 10 and 17 years from Florianópolis – SC – Brazil. It was measured: the body weight, body height, skinfolds and obtained the lean and body fat mass through bioimpedance. The nonproteic RMR was measured by Weir’s equation (1949, utilizing AeroSport TEEM-100 gas analyzer. The studied equations were: Harry and Benedict (1919, Schofi eld (1985, WHO/FAO/UNU (1985, Henry and Rees (1991, Molnár et al. (1998, Tverskaya et al. (1998 and Müller et al. (2004. In order to study the cross-validation of the RMR prediction equations and its standard measure (Weir 1949, the following statistics procedure were calculated: Pearson’s correlation (r ≥ 0.70, the “t” test with the signifi cance level of p0.05 in relation to the standard measure, with exception of the equations suggested for Tverskaya et al. (1998, and the two models of Müller et al (2004. Even though there was not a signifi cant difference, only the models considered for Henry and Rees (1991, and Molnár et al. (1995 had gotten constant error variation under 5%. All the equations analyzed in the study in girls had not reached criterion of correlation values of 0.70 with the indirect calorimetry. Analyzing the prediction equations of RMR in boys, all of them had moderate correlation coeffi cients with the indirect calorimetry, however below 0.70. Only the equation developed for Tverskaya et al. (1998 presented differences (p ABSTRACT0,05 em relação à medida padrão (Weir 1949, com exceção das equações sugeridas por Tverskaya et al. (1998 e os dois modelos de Müller et al (2004. Mesmo não havendo diferença signifi cativa, somente os modelos propostos por Henry e Rees (1991

  6. AgNOR Count in Resting Cells (Resting NOR Is a New Prognostic Marker in Invasive Bladder Tumor

    Directory of Open Access Journals (Sweden)

    Mitsuro Tomobe

    2001-01-01

    Full Text Available Purpose: We have previously demonstrated that the AgNOR count in proliferating cells is a predictor of tumor recurrence in superficial bladder tumor (J. Urol. 162 (1999, 63–68. In the present study, we evaluate the type of AgNOR associated with cell cycles as a prognostic factor in invasive bladder tumor using a double staining technique employing both AgNOR and MIB-1 labelling. Materials and methods: Forty-four paraffin sections of invasive bladder tumors were stained simultaneously with AgNOR and MIB-1. The number of AgNORs in proliferating (MIB-1 positive or resting (MIB-1 negative cells were counted from a total of 100 nuclei. Correlations between MIB-1 associated AgNOR count and clinicopathological parameters were statistically analyzed. Results: The AgNOR count in proliferating cells (proliferating NOR was significantly higher than that in resting cells (resting NOR (p < 0.01. The resting NOR in tumors with distant metastases was significantly higher than that in tumors without metastases (p < 0.05. Patients with a low resting NOR tumor had a better prognosis than those with a high resting NOR tumor, whereas the proliferating NOR was not associated with survival. Survival analysis revealed that the resting NOR was the most powerful prognostic marker in patients with invasive bladder tumor (p < 0.05. Conclusions: Resting NOR had a predictive value in the prognosis of patients with invasive bladder tumor. Keywords: Transitional cell carcinoma, invasive, resting cell, AgNORs, MIB-1

  7. Resting States Are Resting Traits – An fMRI Study of Sex Differences and Menstrual Cycle Effects in Resting State Cognitive Control Networks

    OpenAIRE

    Hjelmervik, Helene; Hausmann, Markus; Osnes, Berge; Westerhausen, René; Specht, Karsten

    2014-01-01

    To what degree resting state fMRI is stable or susceptible to internal mind states of the individual is currently an issue of debate. To address this issue, the present study focuses on sex differences and investigates whether resting state fMRI is stable in men and women or changes within relative short-term periods (i.e., across the menstrual cycle). Due to the fact that we recently reported menstrual cycle effects on cognitive control based on data collected during the same sessions, the c...

  8. Resting energy expenditure in girls with Turner syndrome.

    Science.gov (United States)

    Binder, Gerhard; Frank, Laura; Ziegler, Julian; Blumenstock, Gunnar; Schweizer, Roland

    2017-03-01

    Knowledge concerning energy metabolism in Turner syndrome (TS) is lacking. We compared the resting energy expenditure per fat-free mass (REE/FFM) in TS with other girls with short stature treated with growth hormone (GH) and age-related controls. We measured prospectively REE by spirometry under fasting conditions in the morning in 85 short prepubertal girls at the start of GH treatment. Diagnoses were TS (n=20), GH deficiency (GHD) (n=38) and small for gestational age (SGA) short stature (n=27). Additionally, 20 age-related controls were studied. Mean ages were 8.3 (TS), 7.1 (GHD), 6.9 (SGA) and 8.5 years (controls). Mean heights were -2.90 (TS), -3.32 (GHD), -3.69 (SGA) and -0.03 standard deviation scores (SDS) (controls). FFM was measured by bioelectrical impedance analysis (BIA). At the start of GH girls with TS showed insignificantly higher REE per FFM (REE/FFM) (mean±SD; 65±9 kcal/kg×day) than did the other female patients (62±9 kcal/kg×day) (p>0.23). The healthy controls had significantly lower REE/FFM (35±4 kcal/kg×day) (p<0.001). Follow-up examination of the patients after 6 or 12 months revealed decreasing REE/FFM in TS (62±9 kcal/kg×day) resulting in comparable REE/FFM in all three patient groups. At baseline short girls with TS had insignificantly higher REE/FFM than short children with SGA or GHD, but in follow-up this difference was not detectable any more. Future studies are necessary to understand this observation.

  9. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed

  10. Standardization Documents

    Science.gov (United States)

    2011-08-01

    Specifications and Standards; Guide Specifications; CIDs; and NGSs . Learn. Perform. Succeed. STANDARDIZATION DOCUMENTS Federal Specifications Commercial...national or international standardization document developed by a private sector association, organization, or technical society that plans ...Maintain lessons learned • Examples: Guidance for application of a technology; Lists of options Learn. Perform. Succeed. DEFENSE HANDBOOK

  11. Radionuclide ventriculography during rest and exercise: normal values

    International Nuclear Information System (INIS)

    Ludwig, E.B.; Marroni, B.J.; Achutti, A.C.; Anselmi, O.E.; Rabin, M.

    1983-01-01

    Twenty young volunteers of both sexes were examined by radioisotopic techniques to establish the normal range of ventricular function at rest and the response to a stress test (systolic arterious pressure X cardiac frequency > 25000). (M.A.C.) [pt

  12. Memory reactivation during rest supports upcoming learning of related content

    Science.gov (United States)

    Schlichting, Margaret L.; Preston, Alison R.

    2014-01-01

    Although a number of studies have highlighted the importance of offline processes for memory, how these mechanisms influence future learning remains unknown. Participants with established memories for a set of initial face–object associations were scanned during passive rest and during encoding of new related and unrelated pairs of objects. Spontaneous reactivation of established memories and enhanced hippocampal–neocortical functional connectivity during rest was related to better subsequent learning, specifically of related content. Moreover, the degree of functional coupling during rest was predictive of neural engagement during the new learning experience itself. These results suggest that through rest-phase reactivation and hippocampal–neocortical interactions, existing memories may come to facilitate encoding during subsequent related episodes. PMID:25331890

  13. Bed Rest and Immobilization: Risk Factors for Bone Loss

    Science.gov (United States)

    ... Risk Factors for Bone Loss Bed Rest and Immobilization: Risk Factors for Bone Loss Like muscle, bone ... complications of pregnancy; and those who are experiencing immobilization of some part of the body because of ...

  14. Myocardial oxygen consumption at rest and during submaximal ...

    African Journals Online (AJOL)

    olayemitoyin

    2008-11-26

    Nov 26, 2008 ... ratio were the most important independent parameters in prediction of RPP. The study shows that ... study of various medical, surgical, and physical interventions on .... increase in myocardial activity and thus the MVO2 at rest.

  15. Effects of Interval Training Programme on Resting Heart Rate in ...

    African Journals Online (AJOL)

    DATONYE ALASIA

    Subjects with Hypertension: A Randomized Controlled Trial. Type of Article: Original ... Resting Heart Rate in Subjects with Hypertension — Lamina S. et al investigate the effect of interval .... changes in VO max) of interest. In the t-test. 2.

  16. Memory reactivation during rest supports upcoming learning of related content.

    Science.gov (United States)

    Schlichting, Margaret L; Preston, Alison R

    2014-11-04

    Although a number of studies have highlighted the importance of offline processes for memory, how these mechanisms influence future learning remains unknown. Participants with established memories for a set of initial face-object associations were scanned during passive rest and during encoding of new related and unrelated pairs of objects. Spontaneous reactivation of established memories and enhanced hippocampal-neocortical functional connectivity during rest was related to better subsequent learning, specifically of related content. Moreover, the degree of functional coupling during rest was predictive of neural engagement during the new learning experience itself. These results suggest that through rest-phase reactivation and hippocampal-neocortical interactions, existing memories may come to facilitate encoding during subsequent related episodes.

  17. RESTful web API design with Node.js

    CERN Document Server

    Bojinov, Valentin

    2015-01-01

    If you are a web developer wanting to enrich your development skills to create scalable, server-side, RESTful applications based on the Node.js platform, this book is for you. You also need to be aware of HTTP communication concepts and should have a working knowledge of JavaScript. Knowledge of REST would be an added advantage but is definitely not a necessity.

  18. The Classic: On Rest and Pain: Lecture XIV.

    Science.gov (United States)

    Hilton, John

    2009-09-01

    This Classic article is a reprint of the original work by John Hilton, On Rest and Pain: Lecture XIV. An accompanying biographical sketch on John Hilton, MD, is available at DOI 10.1007/s11999-009-0927-2 . The Classic Article is reprinted with courtesy from Hilton J. On The Influence of Mechanical and Physiological Rest in the Treatment of Accidents and Surgical Diseases, and the Diagnostic Value of Pain. London, England: Bell and Daldy; 1863.

  19. Genetic variablilities of body temperature and resting behaviour in ...

    African Journals Online (AJOL)

    This implies that neither progeny nor generation had effect on body temperature. The Alpha strain exhibited more resting behaviour than did the exotic and the pure native types. Majority of the birds rested in the afternoon at 2.00 pm. This could be attributed to the fact that at 2.00 pm the weather is hot and birds search for a ...

  20. Relativistic theory of gravitation and the graviton rest mass

    International Nuclear Information System (INIS)

    Logunsov, A.A.; Mestvirishvili, M.A.

    1986-01-01

    This paper examines a graviton rest mass (m) introduced in the framework of the relativistic theory of gravitation and obtains equations that describe a massive gravitational field. Under the assumption that the entire hidden mass of the matter in the Universe is due to the existence of a massive gravitational field, an upper bound on the rest mass is obtained: m ≤ 0.64 x 10 --65 g

  1. Discovering EEG resting state alterations of semantic dementia.

    Science.gov (United States)

    Grieder, Matthias; Koenig, Thomas; Kinoshita, Toshihiko; Utsunomiya, Keita; Wahlund, Lars-Olof; Dierks, Thomas; Nishida, Keiichiro

    2016-05-01

    Diagnosis of semantic dementia relies on cost-intensive MRI or PET, although resting EEG markers of other dementias have been reported. Yet the view still holds that resting EEG in patients with semantic dementia is normal. However, studies using increasingly sophisticated EEG analysis methods have demonstrated that slightest alterations of functional brain states can be detected. We analyzed the common four resting EEG microstates (A, B, C, and D) of 8 patients with semantic dementia in comparison with 8 healthy controls and 8 patients with Alzheimer's disease. Topographical differences between the groups were found in microstate classes B and C, while microstate classes A and D were comparable. The data showed that the semantic dementia group had a peculiar microstate E, but the commonly found microstate C was lacking. Furthermore, the presence of microstate E was significantly correlated with lower MMSE and language scores. Alterations in resting EEG can be found in semantic dementia. Topographical shifts in microstate C might be related to semantic memory deficits. This is the first study that discovered resting state EEG abnormality in semantic dementia. The notion that resting EEG in this dementia subtype is normal has to be revised. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Characterizing Resting-State Brain Function Using Arterial Spin Labeling

    Science.gov (United States)

    Jann, Kay; Wang, Danny J.J.

    2015-01-01

    Abstract Arterial spin labeling (ASL) is an increasingly established magnetic resonance imaging (MRI) technique that is finding broader applications in studying the healthy and diseased brain. This review addresses the use of ASL to assess brain function in the resting state. Following a brief technical description, we discuss the use of ASL in the following main categories: (1) resting-state functional connectivity (FC) measurement: the use of ASL-based cerebral blood flow (CBF) measurements as an alternative to the blood oxygen level-dependent (BOLD) technique to assess resting-state FC; (2) the link between network CBF and FC measurements: the use of network CBF as a surrogate of the metabolic activity within corresponding networks; and (3) the study of resting-state dynamic CBF-BOLD coupling and cerebral metabolism: the use of dynamic CBF information obtained using ASL to assess dynamic CBF-BOLD coupling and oxidative metabolism in the resting state. In addition, we summarize some future challenges and interesting research directions for ASL, including slice-accelerated (multiband) imaging as well as the effects of motion and other physiological confounds on perfusion-based FC measurement. In summary, this work reviews the state-of-the-art of ASL and establishes it as an increasingly viable MRI technique with high translational value in studying resting-state brain function. PMID:26106930

  3. "I am resting but rest less well with you." The moderating effect of anxious attachment style on alpha power during EEG resting state in a social context

    NARCIS (Netherlands)

    Verbeke, W.J.M.I.; Pozharliev, R.; van Strien, J.W.; Belschak, F.; Bagozzi, R.P.

    2014-01-01

    We took EEG recordings to measure task-free resting-state cortical brain activity in 35 participants under two conditions, alone (A) or together (T). We also investigated whether psychological attachment styles shape human cortical activity differently in these two settings. The results indicate

  4. Prospectively Electrocardiogram-Gated High-Pitch Spiral Acquisition Mode Dual-Source CT Coronary Angiography in Patients with High Heart Rates: Comparison with Retrospective Electrocardiogram-Gated Spiral Acquisition Mode

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Kai; Ma, Rui; Wang, Li Jun [Dept. of Radiology, Baotou Central Hospital, Baotou (China); Li, Li Gang; Chen, Jiu Hong [CT BM Clinic Marketing, Siemens Healthcare, Beijing (China)

    2012-11-15

    To assess the image quality and effective radiation dose of prospectively electrocardiogram (ECG)-gated high-pitch spiral acquisition mode (flash mode) of dual-source CT (DSCT) coronary angiography (CTCA) in patients with high heart rates (HRs) as compared with retrospectively ECG-gated spiral acquisition mode. Two hundred and sixty-eight consecutive patients (132 female, mean age: 55 {+-} 11 years) with mean HR > 65 beats per minute (bpm) were prospectively included in this study. The patients were divided into two groups. Collection was performed in group A CTCA using flash mode setting at 20-30% of the R-R interval, and retrospectively ECG-gated spiral acquisition mode in group B. The image noise, contrast-to-noise ratio (CNR), image quality scores, effective radiation dose and influencing factors on image quality between the two groups were assessed. There were no significant differences in image quality scores and proportions of non-diagnostic coronary artery segments between two groups (image quality scores: 1.064 {+-} 0.306 [group A] vs. 1.084 {+-} 0.327 [group B], p = 0.063; proportion of non-diagnostic coronary artery segments: segment-based analysis 1.52% (group A) vs. 1.74% (group B), p = 0.345; patient-based analysis 7.5% (group A) vs. 6.7% (group B), p = 0.812). The estimated radiation dose was 1.0 {+-} 0.16 mSv in group A and 7.1 {+-} 1.05 mSv in group B (p = 0.001). In conclusion, in patients with HRs > 65 bpm without cardiac arrhythmia, the prospectively high-pitch spiral-acquisition mode with image-acquired timing set at 20-30% of the R-R interval provides a similar image quality and low rate of non-diagnostic coronary segments to the retrospectively ECG-gated low-pitch spiral acquisition mode, with significant reduction of radiation exposure.

  5. 128-slice Dual-source Computed Tomography Coronary Angiography in Patients with Atrial Fibrillation: Image Quality and Radiation Dose of Prospectively Electrocardiogram-triggered Sequential Scan Compared with Retrospectively Electrocardiogram-gated Spiral Scan.

    Science.gov (United States)

    Lin, Lu; Wang, Yi-Ning; Kong, Ling-Yan; Jin, Zheng-Yu; Lu, Guang-Ming; Zhang, Zhao-Qi; Cao, Jian; Li, Shuo; Song, Lan; Wang, Zhi-Wei; Zhou, Kang; Wang, Ming

    2013-01-01

    Objective To evaluate the image quality (IQ) and radiation dose of 128-slice dual-source computed tomography (DSCT) coronary angiography using prospectively electrocardiogram (ECG)-triggered sequential scan mode compared with ECG-gated spiral scan mode in a population with atrial fibrillation. Methods Thirty-two patients with suspected coronary artery disease and permanent atrial fibrillation referred for a second-generation 128-slice DSCT coronary angiography were included in the prospective study. Of them, 17 patients (sequential group) were randomly selected to use a prospectively ECG-triggered sequential scan, while the other 15 patients (spiral group) used a retrospectively ECG-gated spiral scan. The IQ was assessed by two readers independently, using a four-point grading scale from excel-lent (grade 1) to non-assessable (grade 4), based on the American Heart Association 15-segment model. IQ of each segment and effective dose of each patient were compared between the two groups. Results The mean heart rate (HR) of the sequential group was 96±27 beats per minute (bpm) with a variation range of 73±25 bpm, while the mean HR of the spiral group was 86±22 bpm with a variationrange of 65±24 bpm. Both of the mean HR (t=1.91, P=0.243) and HR variation range (t=0.950, P=0.350) had no significant difference between the two groups. In per-segment analysis, IQ of the sequential group vs. spiral group was rated as excellent (grade 1) in 190/244 (78%) vs. 177/217 (82%) by reader1 and 197/245 (80%) vs. 174/214 (81%) by reader2, as non-assessable (grade 4) in 4/244 (2%) vs. 2/217 (1%) by reader1 and 6/245 (2%) vs. 4/214 (2%) by reader2. Overall averaged IQ per-patient in the sequential and spiral group showed equally good (1.27±0.19 vs. 1.25±0.22, Z=-0.834, P=0.404). The effective radiation dose of the sequential group reduced significantly compared with the spiral group (4.88±1.77 mSv vs. 10.20±3.64 mSv; t=-5.372, P=0.000). Conclusion Compared with retrospectively

  6. Prospectively Electrocardiogram-Gated High-Pitch Spiral Acquisition Mode Dual-Source CT Coronary Angiography in Patients with High Heart Rates: Comparison with Retrospective Electrocardiogram-Gated Spiral Acquisition Mode

    International Nuclear Information System (INIS)

    Sun, Kai; Ma, Rui; Wang, Li Jun; Li, Li Gang; Chen, Jiu Hong

    2012-01-01

    To assess the image quality and effective radiation dose of prospectively electrocardiogram (ECG)-gated high-pitch spiral acquisition mode (flash mode) of dual-source CT (DSCT) coronary angiography (CTCA) in patients with high heart rates (HRs) as compared with retrospectively ECG-gated spiral acquisition mode. Two hundred and sixty-eight consecutive patients (132 female, mean age: 55 ± 11 years) with mean HR > 65 beats per minute (bpm) were prospectively included in this study. The patients were divided into two groups. Collection was performed in group A CTCA using flash mode setting at 20-30% of the R-R interval, and retrospectively ECG-gated spiral acquisition mode in group B. The image noise, contrast-to-noise ratio (CNR), image quality scores, effective radiation dose and influencing factors on image quality between the two groups were assessed. There were no significant differences in image quality scores and proportions of non-diagnostic coronary artery segments between two groups (image quality scores: 1.064 ± 0.306 [group A] vs. 1.084 ± 0.327 [group B], p = 0.063; proportion of non-diagnostic coronary artery segments: segment-based analysis 1.52% (group A) vs. 1.74% (group B), p = 0.345; patient-based analysis 7.5% (group A) vs. 6.7% (group B), p = 0.812). The estimated radiation dose was 1.0 ± 0.16 mSv in group A and 7.1 ± 1.05 mSv in group B (p = 0.001). In conclusion, in patients with HRs > 65 bpm without cardiac arrhythmia, the prospectively high-pitch spiral-acquisition mode with image-acquired timing set at 20-30% of the R-R interval provides a similar image quality and low rate of non-diagnostic coronary segments to the retrospectively ECG-gated low-pitch spiral acquisition mode, with significant reduction of radiation exposure.

  7. Actigraphy-Derived Daily Rest-Activity Patterns and Body Mass Index in Community-Dwelling Adults.

    Science.gov (United States)

    Cespedes Feliciano, Elizabeth M; Quante, Mirja; Weng, Jia; Mitchell, Jonathan A; James, Peter; Marinac, Catherine R; Mariani, Sara; Redline, Susan; Kerr, Jacqueline; Godbole, Suneeta; Manteiga, Alicia; Wang, Daniel; Hipp, J Aaron

    2017-12-01

    To examine associations between 24-hour rest-activity patterns and body mass index (BMI) among community-dwelling US adults. Rest-activity patterns provide a field method to study exposures related to circadian rhythms. Adults (N = 578) wore an actigraph on their nondominant wrist for 7 days. Intradaily variability and interdaily stability (IS), M10 (most active 10-hours), L5 (least active 5-hours), and relative amplitude (RA) were derived using nonparametric rhythm analysis. Mesor, acrophase, and amplitude were calculated from log-transformed count data using the parametric cosinor approach. Participants were 80% female and mean (standard deviation) age was 52 (15) years. Participants with higher BMI had lower values for magnitude, RA, IS, total sleep time (TST), and sleep efficiency. In multivariable analyses, less robust 24-hour rest-activity patterns as represented by lower RA were consistently associated with higher BMI: comparing the bottom quintile (least robust) to the top quintile (most robust 24-hour rest-activity pattern) of RA, BMI was 3-kg/m2 higher (p = .02). Associations were similar in magnitude to an hour less of TST (1-kg/m2 higher BMI) or a 10% decrease in sleep efficiency (2-kg/m2 higher BMI), and independent of age, sex, race, education, and the duration of rest and/or activity. Lower RA, reflecting both higher night activity and lower daytime activity, was associated with higher BMI. Independent of the duration of rest or activity during the day or night, 24-hour rest, and activity patterns from actigraphy provide aggregated measures of activity that associate with BMI in community-dwelling adults. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  8. What goes on in the resting-state? A qualitative glimpse into resting-state experience in the scanner

    Science.gov (United States)

    Hurlburt, Russell T.; Alderson-Day, Ben; Fernyhough, Charles; Kühn, Simone

    2015-01-01

    The brain’s resting-state has attracted considerable interest in recent years, but currently little is known either about typical experience during the resting-state or about whether there are inter-individual differences in resting-state phenomenology. We used descriptive experience sampling (DES) in an attempt to apprehend high fidelity glimpses of the inner experience of five participants in an extended fMRI study. Results showed that the inner experiences and the neural activation patterns (as quantified by amplitude of low frequency fluctuations analysis) of the five participants were largely consistent across time, suggesting that our extended-duration scanner sessions were broadly similar to typical resting-state sessions. However, there were very large individual differences in inner phenomena, suggesting that the resting-state itself may differ substantially from one participant to the next. We describe these individual differences in experiential characteristics and display some typical moments of resting-state experience. We also show that retrospective characterizations of phenomena can often be very different from moment-by-moment reports. We discuss implications for the assessment of inner experience in neuroimaging studies more generally, concluding that it may be possible to use fMRI to investigate neural correlates of phenomena apprehended in high fidelity. PMID:26500590

  9. A rest period does not affect in vitro storage properties in apheresis platelets collected from the buffy coat layer.

    Science.gov (United States)

    Wagner, Stephen J; Seetharaman, Shalini; Kurtz, James

    2012-11-01

    A previous study demonstrated that several in vitro storage properties of apheresis platelets (PLTs) that are isolated by sedimentation against the collection container and subsequently resuspended can benefit from a rest period before continuous agitation. This study examines whether the in vitro storage properties of apheresis PLTs isolated by collection from the buffy coat layer benefit from a rest period before agitation. Freshly collected apheresis PLTs (Trima, GambroBCT) were divided into five 60-mL aliquots. One aliquot was immediately placed on a flat-bed agitator; the other aliquots were held on a laboratory bench for 1, 2, 4, and 6 hours before continuous agitation. Samples were obtained on Days 1, 5, and 7 for standard in vitro PLT assays. The experiment was repeated 12 times. For each sampling day, no significant differences were observed in aliquots held with or without a rest period for any of the following PLT properties: PLT content, mean PLT volume, pH, pCO2, bicarbonate, glucose, lactate, hypotonic shock response, extent of shape change, aggregation, morphology, CD62P, CD63, and CD42b. Although regression analysis identified several in vitro properties whose mean levels appeared to improve with increasing length of the rest period, maximum differences in mean levels were small (coat layer do not benefit from a rest period. © 2012 American Association of Blood Banks.

  10. Assessing the mean strength and variations of the time-to-time fluctuations of resting-state brain activity.

    Science.gov (United States)

    Li, Zhengjun; Zang, Yu-Feng; Ding, Jianping; Wang, Ze

    2017-04-01

    The time-to-time fluctuations (TTFs) of resting-state brain activity as captured by resting-state fMRI (rsfMRI) have been repeatedly shown to be informative of functional brain structures and disease-related alterations. TTFs can be characterized by the mean and the range of successive difference. The former can be measured with the mean squared successive difference (MSSD), which is mathematically similar to standard deviation; the latter can be calculated by the variability of the successive difference (VSD). The purpose of this study was to evaluate both the resting state-MSSD and VSD of rsfMRI regarding their test-retest stability, sensitivity to brain state change, as well as their biological meanings. We hypothesized that MSSD and VSD are reliable in resting brain; both measures are sensitive to brain state changes such as eyes-open compared to eyes-closed condition; both are predictive of age. These hypotheses were tested with three rsfMRI datasets and proven true, suggesting both MSSD and VSD as reliable and useful tools for resting-state studies.

  11. Distinguishing rhythmic from non-rhythmic brain activity during rest in healthy neurocognitive aging.

    Science.gov (United States)

    Caplan, Jeremy B; Bottomley, Monica; Kang, Pardeep; Dixon, Roger A

    2015-05-15

    Rhythmic brain activity at low frequencies (healthy neurocognitive aging are mixed. Here we address two reasons conventional spectral analyses may have led to inconsistent results. First, spectral-power measures are compared to a baseline condition; when resting activity is the signal of interest, it is unclear what the baseline should be. Second, conventional methods do not clearly differentiate power due to rhythmic versus non-rhythmic activity. The Better OSCillation detection method (BOSC; Caplan et al., 2001; Whitten et al., 2011) avoids these problems by using the signal's own spectral characteristics as a reference to detect elevations in power lasting a few cycles. We recorded electroencephalographic (EEG) signal during rest, alternating eyes open and closed, in healthy younger (18-25 years) and older (60-74 years) participants. Topographic plots suggested the conventional and BOSC analyses measured different sources of activity, particularly at frequencies, like delta (1-4Hz), at which rhythms are sporadic; topographies were more similar in the 8-12Hz alpha band. There was little theta-band activity meeting the BOSC method's criteria, suggesting prior findings of theta power in healthy aging may reflect non-rhythmic signal. In contrast, delta oscillations were present at higher levels than theta in both age groups. In summary, applying strict and standardized criteria for rhythmicity, slow rhythms appear present in the resting brain at delta and alpha, but not theta frequencies, and appear unchanged in healthy aging. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Exploring resting-state EEG brain oscillatory activity in relation to cognitive functioning in multiple sclerosis.

    Science.gov (United States)

    Keune, Philipp M; Hansen, Sascha; Weber, Emily; Zapf, Franziska; Habich, Juliane; Muenssinger, Jana; Wolf, Sebastian; Schönenberg, Michael; Oschmann, Patrick

    2017-09-01

    Neurophysiologic monitoring parameters related to cognition in Multiple Sclerosis (MS) are sparse. Previous work reported an association between magnetoencephalographic (MEG) alpha-1 activity and information processing speed. While this remains to be replicated by more available electroencephalographic (EEG) methods, also other established EEG markers, e.g. the slow-wave/fast-wave ratio (theta/beta ratio), remain to be explored in this context. Performance on standard tests addressing information processing speed and attention (Symbol-Digit Modalities Test, SDMT; Test of Attention Performance, TAP) was examined in relation to resting-state EEG alpha-1 and alpha-2 activity and the theta/beta ratio in 25MS patients. Increased global alpha-1 and alpha-2 activity and an increased frontal theta/beta ratio (pronounced slow-wave relative to fast-wave activity) were associated with lower SDMT processing speed. In an exploratory analysis, clinically impaired attention was associated with a significantly increased frontal theta/beta ratio whereas alpha power did not show sensitivity to clinical impairment. EEG global alpha power and the frontal theta/beta ratio were both associated with attention. The theta/beta ratio involved potential clinical sensitivity. Resting-state EEG recordings can be obtained during the routine clinical process. The examined resting-state measures may represent feasible monitoring parameters in MS. This notion should be explored in future intervention studies. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  13. Enhanced subject-specific resting-state network detection and extraction with fast fMRI.

    Science.gov (United States)

    Akin, Burak; Lee, Hsu-Lei; Hennig, Jürgen; LeVan, Pierre

    2017-02-01

    Resting-state networks have become an important tool for the study of brain function. An ultra-fast imaging technique that allows to measure brain function, called Magnetic Resonance Encephalography (MREG), achieves an order of magnitude higher temporal resolution than standard echo-planar imaging (EPI). This new sequence helps to correct physiological artifacts and improves the sensitivity of the fMRI analysis. In this study, EPI is compared with MREG in terms of capability to extract resting-state networks. Healthy controls underwent two consecutive resting-state scans, one with EPI and the other with MREG. Subject-level independent component analyses (ICA) were performed separately for each of the two datasets. Using Stanford FIND atlas parcels as network templates, the presence of ICA maps corresponding to each network was quantified in each subject. The number of detected individual networks was significantly higher in the MREG data set than for EPI. Moreover, using short time segments of MREG data, such as 50 seconds, one can still detect and track consistent networks. Fast fMRI thus results in an increased capability to extract distinct functional regions at the individual subject level for the same scan times, and also allow the extraction of consistent networks within shorter time intervals than when using EPI, which is notably relevant for the analysis of dynamic functional connectivity fluctuations. Hum Brain Mapp 38:817-830, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Modifications of resting state networks in spinocerebellar ataxia type 2.

    Science.gov (United States)

    Cocozza, Sirio; Saccà, Francesco; Cervo, Amedeo; Marsili, Angela; Russo, Cinzia Valeria; Giorgio, Sara Maria Delle Acque; De Michele, Giuseppe; Filla, Alessandro; Brunetti, Arturo; Quarantelli, Mario

    2015-09-01

    We aimed to investigate the integrity of the Resting State Networks in spinocerebellar ataxia type 2 (SCA2) and the correlations between the modification of these networks and clinical variables. Resting-state functional magnetic resonance imaging (RS-fMRI) data from 19 SCA2 patients and 29 healthy controls were analyzed using an independent component analysis and dual regression, controlling at voxel level for the effect of atrophy by co-varying for gray matter volume. Correlations between the resting state networks alterations and disease duration, age at onset, number of triplets, and clinical score were assessed by Spearman's coefficient, for each cluster which was significantly different in SCA2 patients compared with healthy controls. In SCA2 patients, disruption of the cerebellar components of all major resting state networks was present, with supratentorial involvement only for the default mode network. When controlling at voxel level for gray matter volume, the reduction in functional connectivity in supratentorial regions of the default mode network, and in cerebellar regions within the default mode, executive and right fronto-parietal networks, was still significant. No correlations with clinical variables were found for any of the investigated resting state networks. The SCA2 patients show significant alterations of the resting state networks, only partly explained by the atrophy. The default mode network is the only resting state network that shows also supratentorial changes, which appear unrelated to the cortical gray matter volume. Further studies are needed to assess the clinical significance of these changes. © 2015 International Parkinson and Movement Disorder Society.

  15. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  16. Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Amoakwa, Kojo; Fashanu, Oluwaseun E; Tibuakuu, Martin; Zhao, Di; Guallar, Eliseo; Whelton, Seamus P; O'Neal, Wesley T; Post, Wendy S; Budoff, Matthew J; Michos, Erin D

    2018-06-01

    Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03-1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45-2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Radiodiagnostic errors by X-ray pictures of the chest taken at bed resting patients

    Energy Technology Data Exchange (ETDEWEB)

    Ross, D.; Deininger, H.K.

    1981-03-01

    The roentgenological findings of 383 cases have been compared with the anatomical and pathological diagnosis of the autopsy report. In 29% the radiodiagnosis was incorrect. About 70% of the X-ray examinations had to be carried out succenturiately at bed side in bedridden patients. The error rate of the interpretation of these examinations was higher than in examinations under standardized conditions. Especially, carcinomatous lymphangiosis, miliary tuberculosis and pulmonary embolism can be diagnosed badly in those incomplete X-ray pictures caused by the clinical situation of the bed resting patients. The publication analyses the most common errors in the diagnosis of cardiac and pulmonary diseases, and they will be demonstrated in examples.

  18. Beat-ID: Towards a computationally low-cost single heartbeat biometric identity check system based on electrocardiogram wave morphology

    Science.gov (United States)

    Paiva, Joana S.; Dias, Duarte

    2017-01-01

    In recent years, safer and more reliable biometric methods have been developed. Apart from the need for enhanced security, the media and entertainment sectors have also been applying biometrics in the emerging market of user-adaptable objects/systems to make these systems more user-friendly. However, the complexity of some state-of-the-art biometric systems (e.g., iris recognition) or their high false rejection rate (e.g., fingerprint recognition) is neither compatible with the simple hardware architecture required by reduced-size devices nor the new trend of implementing smart objects within the dynamic market of the Internet of Things (IoT). It was recently shown that an individual can be recognized by extracting features from their electrocardiogram (ECG). However, most current ECG-based biometric algorithms are computationally demanding and/or rely on relatively large (several seconds) ECG samples, which are incompatible with the aforementioned application fields. Here, we present a computationally low-cost method (patent pending), including simple mathematical operations, for identifying a person using only three ECG morphology-based characteristics from a single heartbeat. The algorithm was trained/tested using ECG signals of different duration from the Physionet database on more than 60 different training/test datasets. The proposed method achieved maximal averaged accuracy of 97.450% in distinguishing each subject from a ten-subject set and false acceptance and rejection rates (FAR and FRR) of 5.710±1.900% and 3.440±1.980%, respectively, placing Beat-ID in a very competitive position in terms of the FRR/FAR among state-of-the-art methods. Furthermore, the proposed method can identify a person using an average of 1.020 heartbeats. It therefore has FRR/FAR behavior similar to obtaining a fingerprint, yet it is simpler and requires less expensive hardware. This method targets low-computational/energy-cost scenarios, such as tiny wearable devices (e.g., a

  19. A decision support system and rule-based algorithm to augment the human interpretation of the 12-lead electrocardiogram.

    Science.gov (United States)

    Cairns, Andrew W; Bond, Raymond R; Finlay, Dewar D; Guldenring, Daniel; Badilini, Fabio; Libretti, Guido; Peace, Aaron J; Leslie, Stephen J

    The 12-lead Electrocardiogram (ECG) has been used to detect cardiac abnormalities in the same format for more than 70years. However, due to the complex nature of 12-lead ECG interpretation, there is a significant cognitive workload required from the interpreter. This complexity in ECG interpretation often leads to errors in diagnosis and subsequent treatment. We have previously reported on the development of an ECG interpretation support system designed to augment the human interpretation process. This computerised decision support system has been named 'Interactive Progressive based Interpretation' (IPI). In this study, a decision support algorithm was built into the IPI system to suggest potential diagnoses based on the interpreter's annotations of the 12-lead ECG. We hypothesise semi-automatic interpretation using a digital assistant can be an optimal man-machine model for ECG interpretation. To improve interpretation accuracy and reduce missed co-abnormalities. The Differential Diagnoses Algorithm (DDA) was developed using web technologies where diagnostic ECG criteria are defined in an open storage format, Javascript Object Notation (JSON), which is queried using a rule-based reasoning algorithm to suggest diagnoses. To test our hypothesis, a counterbalanced trial was designed where subjects interpreted ECGs using the conventional approach and using the IPI+DDA approach. A total of 375 interpretations were collected. The IPI+DDA approach was shown to improve diagnostic accuracy by 8.7% (although not statistically significant, p-value=0.1852), the IPI+DDA suggested the correct interpretation more often than the human interpreter in 7/10 cases (varying statistical significance). Human interpretation accuracy increased to 70% when seven suggestions were generated. Although results were not found to be statistically significant, we found; 1) our decision support tool increased the number of correct interpretations, 2) the DDA algorithm suggested the correct

  20. Pre-Hospital 12-Lead Electrocardiogram within 60 Minutes Differentiates Proximal versus Nonproximal Left Anterior Descending Artery Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    James J McCarthy

    2011-05-01

    Full Text Available Introduction: Acute anterior myocardial infarctions caused by proximal left anterior descending (LAD artery occlusions are associated with a higher morbidity and mortality. Early identification of high-risk patients via the 12-lead electrocardiogram (ECG could assist physicians and emergency response teams in providing early and aggressive care for patients with anterior ST-elevation myocardial infarctions (STEMI. Approximately 25% of US hospitals have primary percutaneous coronary intervention (PCI capability for the treatment of acute myocardial infarctions. Given the paucity of hospitals capable of PCI, early identification of more severe myocardial infarction may prompt emergency medical service routing of these patients to PCI-capable hospitals. We sought to determine if the 12 lead ECG is capable of predicting proximal LAD artery occlusions. Methods: In a retrospective, post-hoc analysis of the Pre-Hospital Administration of Thrombolytic Therapy with Urgent Culprit Artery Revascularization pilot trial, we compared the ECG findings of proximal and nonproximal LAD occlusions for patients who had undergone an ECG within 180 minutes of symptom onset. Results: In this study, 72 patients had anterior STEMIs, with ECGs performed within 180 minutes of symptom onset. In patients who had undergone ECGs within 60 minutes (n¼35, the mean sum of ST elevation (STE in leads V1 through V6 plus ST depression (STD in leads II, III, and aVF was 19.2 mm for proximal LAD occlusions and 11.7 mm for nonproximal LAD occlusions (P¼0.007. A sum STE in V1 through V6 plus STD in II, III, and aVF of at least 17.5 mm had a sensitivity of 52.3%, specificity of 92.9%, positive predictive value of 91.7%, and negative predictive value of 56.5% for proximal LAD occlusions. When the ECG was performed more than 60 minutes after symptom onset (n¼37, there was no significant difference in ST-segment deviation between the 2 groups. Conclusion: The sum STE (V1-V6 and STD (II