Medical & biological engineering & computing
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Med Biol Eng Comput · Jul 2003
Discrimination analysis of discontinuous breath sounds using higher-order crossings.
The paper evaluates the performance of an automatic discrimination analysis (DA) method used to discriminate efficiently the types of discontinuous breath sound (DBS), i.e. fine crackles (FCs), coarse crackles (CCs) and squawks (SQs); this may lead to more accurate characterisation of the pulmonary acoustical changes due to the related pathology. Based on higher-order crossings (HOCs), the proposed method, HOC-DA, captured the differences in the oscillatory patterns of FCs, CCs and SQs, which are only exposed when higher (> 1) crossings are employed. Prior to HOC-DA, wavelet-based de-noising of DBSs was employed to eliminate the effects of the vesicular sound (background noise) from their oscillatory pattern. ⋯ Results showed that the HOC-DA efficiently separated FCs from CCs, SQs from CCs (both with an accuracy of 100%), and SQs from FCs (accuracy of 80%), with the optimum order ranging from 9 to 11. When compared with other classification tools, the HOC-DA resulted in high discrimination accuracy without involving high computational complexity. Owing to its simplicity, it could be implemented in a real-time context and be used in clinical medicine as a module of an integrated intelligent patient evaluation system.
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Med Biol Eng Comput · May 2003
Signal processing technique for non-invasive real-time estimation of cardiac output by inductance cardiography (thoracocardiography).
Inductance cardiography (thoracocardiography) non-invasively monitors changes in stroke volume by recording ventricular volume curves with an inductive plethysmographic transducer encircling the chest at the level of the heart. Clinical application of this method has been hampered, as data analysis has not been feasible in real time. Therefore a novel, real-time signal processing technique for inductance cardiography has been developed. ⋯ Performance of the technique for monitoring cardiac output in real time was compared with thermodilution in four patients in an intensive care unit. The bias (mean difference) among 76 paired thoracocardiographic and thermodilution derived changes in cardiac output was 0%; limits of agreement (+/- 2 SD of the bias) were +/- 25%. It is concluded that the proposed signal processing technique for inductance cardiography holds promise for non-invasive, real-time estimation of changes in cardiac output.
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Med Biol Eng Comput · May 2003
Respiratory variations in the reflection mode photoplethysmographic signal. Relationships to peripheral venous pressure.
Photoplethysmography (PPG) is a non-invasive optical way of measuring variations in blood volume and perfusion in the tissue, used in pulse oximetry for instance. Respiratory-induced intensity variations (RIIVs) in the PPG signal exist, but the physiological background is not fully understood. Respiration causes variations in the blood volume in the peripheral vascular bed. ⋯ The coherence between PVP and RIIV signals was high, the median (quartile range) being 0.78 (0.42). Phase analysis showed that RIIV was usually leading PVP, but variations between subjects were large. Although respiratory-induced variations in PVP and PPG showed a close correlation in amplitude variation, a causal relationship between the signals could not be demonstrated.
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Med Biol Eng Comput · May 2003
Neural network for photoplethysmographic respiratory rate monitoring.
The reflection mode photoplethysmographic (PPG) signal was studied with the aim of determining respiratory rate. The PPG signal includes respiratory synchronous components, seen as frequency modulation of the heart rate (respiratory sinus arrhythmia), amplitude modulation of the cardiac pulse and respiratory-induced intensity variations (RIIVs) in the PPG baseline. PPG signals were recorded from the foreheads of 15 healthy subjects. ⋯ The error rates (sum of false positive and false negative breath detections) for the basic algorithms ranged from 9.7% (pulse amplitude) to 14.5% (systolic waveform). The corresponding values for the neural network analysis were 9.5-9.6%. These results suggest the use of a combined PPG system for simultaneous monitoring of respiratory rate and arterial oxygen saturation (pulse oximetry).
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Med Biol Eng Comput · Mar 2003
Case ReportsSwitching curve control of functional electrical stimulation assisted rowing exercise in paraplegia.
An indoor rowing machine has been modified for functional electrical stimulation (FES) assisted rowing exercise in paraplegia. To perform the rowing manoeuvre successfully, however, the voluntarily controlled upper body movements must be co-ordinated with the movements of the electrically stimulated paralysed legs. To achieve such co-ordination, an automatic FES controller was developed that employs two levels of hierarchy. ⋯ In a pilot study, the hierarchical control of FES rowing was shown to be intuitive, reliable and easy to use. Compared with open-loop control of stimulation, all three variants of the closed-loop switching curve controllers used less muscle stimulation per rowing cycle (73% of the open-loop control on average). Further, the closed-loop controller that used switching curves derived from normal rowing kinematics used the lowest muscle stimulation (65% of the open-loop control) and was the most convenient to use for the client.