IEEE transactions on bio-medical engineering
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IEEE Trans Biomed Eng · Sep 2011
The effects of electrode size and orientation on the sensitivity of myoelectric pattern recognition systems to electrode shift.
Myoelectric pattern recognition systems for prosthesis control are often studied in controlled laboratory settings, but obstacles remain to be addressed before they are clinically viable. One important obstacle is the difficulty of maintaining system usability with socket misalignment. Misalignment inevitably occurs during prosthesis donning and doffing, producing a shift in electrode contact locations. ⋯ Shifts perpendicular to the muscle fibers reduced classification accuracy and real-time controllability much more than shifts parallel to the muscle fibers. Increasing the size of the electrode detection surface was found to help reduce classification accuracy sensitivity to electrode shifts in a direction perpendicular to the muscle fibers but did not improve the real-time controllability of the pattern recognition system. One clinically important result was that a combination of longitudinal and transverse electrodes yielded high controllability with and without electrode shift using only four physical electrode pole locations.
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IEEE Trans Biomed Eng · Aug 2011
A novel approach using time-frequency analysis of pulse-oximeter data to detect progressive hypovolemia in spontaneously breathing healthy subjects.
Accurate and early detection of blood volume loss would greatly improve intraoperative and trauma care. This study has attempted to determine early diagnostic and quantitative markers for blood volume loss by analyzing photoplethysmogram (PPG) data from ear, finger and forehead sites with our high-resolution time-frequency spectral (TFS) technique in spontaneously breathing healthy subjects (n = 11) subjected to lower body negative pressure (LBNP). The instantaneous amplitude modulations present in heart rate (AM HR) and breathing rate (AMBR) band frequencies of PPG signals were calculated from the high-resolution TFS. ⋯ The mean percent increase in AMBR values at 100% LBNP tolerance was 99.4% and 19.6% for ear and finger sites, respectively; AMBR values were not attainable for forehead PPG signal. Even without baseline AMHR values, our results suggest that hypovolemia detection is possible with specificity and sensitivity greater than 90% for the ear and forehead locations when LBNP tolerance is 100%. Therefore, the TFS analysis of noninvasive PPG waveforms is promising for early diagnosis and quantification of hypovolemia at levels not identified by vital signs in spontaneously breathing subjects.
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Neurological disorders are becoming increasingly common in developed countries as a result of the aging population. In spite of medications, these disorders can result in progressive loss of function as well as chronic physical, cognitive, and emotional disability that ultimately places enormous emotional and economic on the patient, caretakers, and the society in general. Neuromodulation is emerging as a therapeutic option in these patients. ⋯ It is a rapidly evolving field that brings together many different specialties in the fields of medicine, materials science, computer science and technology, biomedical, and neural engineering as well as the surgical or interventional specialties. It has multiple current and emerging indications, and an enormous potential for growth. The main challenges before it are in the need for effective collaboration between engineers, basic scientists, and clinicians to develop innovations that address specific problems resulting in new devices and clinical applications.
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IEEE Trans Biomed Eng · Jul 2011
Randomized Controlled Trial Comparative StudyThe effect of augmented reality training on percutaneous needle placement in spinal facet joint injections.
The purpose of this study was to determine if augmented reality image overlay and laser guidance systems can assist medical trainees in learning the correct placement of a needle for percutaneous facet joint injection. The Perk Station training suite was used to conduct and record the needle insertion procedures. A total of 40 volunteers were randomized into two groups of 20. 1) The Overlay group received a training session that consisted of four insertions with image and laser guidance, followed by two insertions with laser overlay only. 2) The Control group received a training session of six classical freehand insertions. ⋯ The final insertion procedure was assessed to determine if there was a benefit to the overlay method compared to the freehand insertions. The Overlay group had a better success rate (83.3% versus 68.4%, p=0.002), and potential for less tissue damage as measured by the amount of needle movement inside the phantom (3077.6 mm(2) versus 5607.9 mm(2) , p =0.01). These results suggest that an augmented reality overlay guidance system can assist medical trainees in acquiring technical competence in a percutaneous needle insertion procedure.
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IEEE Trans Biomed Eng · May 2011
Depth of anesthesia during multidrug infusion: separating the effects of propofol and remifentanil using the spectral features of EEG.
General anesthesia is usually induced with a combination of drugs. In addition to the hypnotic agent, such as propofol, opioids are often used due to their synergistic hypnotic and analgesic properties. ⋯ By applying a floating search method, a well-performing feature set is achieved to estimate the effects of propofol during induction of anesthesia and to classify whether or not remifentanil has been coadministered. It is shown that including the detection of the presence of opioids to the estimated effect of propofol significantly improves the determination of the clinical state of the patient, i.e., if the patient will respond to a painful stimulation.