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PubMed1996

Comparison of continuously recorded sensor and sinus rates during daily life activities and standardized exercise testing: efficacy of automatically optimized rate adaptive dual sensor pacing to simulate sinus rhythm.

The normal sinus rhythm remains the gold standard to compare the rate response of a rate adaptive pacemaker. The aim of this study was to assess an automatically optimized dual sensor system by continuous comparison of the normal sinus (SR) and sensor indicated rates (SIR). Twelve patients with complete heart block (mean age 60 +/- 9 years) with normal sinus rhythm received a dual sensor pacemaker driven by combined, automatically adaptive activity and QT sensors. After 1 month of automatic adaptation, patients performed a treadmill exercise in the VDD mode with simultaneous collection of SR and combined SIR. Thereafter the difference between SR and SIR was recorded over a 1-month period using a software downloaded into the pacemakers, with the patients ambulatory during this period. During exercise testing, the SR and SIR were significantly correlated (r = 0.96 +/- 0.02, P < 0.001), and the mean difference between SR and SIR was 4.01 +/- 4.47 beats/min. The percentages of paced beats, over the 1 month ambulatory period, that exhibited a difference between SR and SIR of 8 beats/min were 98% +/- 2%, 90% +/- 4% and 67% +/- 8% for low, medium, and high workloads, respectively (P < 0.05, ANOVA), whereas > 95% of SIR were within 15 beats/min of SR independent of the level of activities. Thus, an automatically programmed dual sensor gives an accurate reflection of SR during exercise. SIR was less accurate for more vigorous daily life activities, but most of the SIR were within the normal SR variation of 15 beats/min.

Activities of Daily Living↗
PubMed2000

Automatic threshold tracking activation without the intraoperative evaluation of the evoked response amplitude. AUTOCAP Investigators.

Automatic threshold tracking (Autocapture) controls the amplitude of the pacing pulse and adjusts it to the actual pacing threshold. The algorithm is based on the proper detection of the evoked response (ER) amplitude after the pacing pulse. For this reason an intraoperative evaluation of ER and polarization is recommended. The aims of the study were to evaluate the ER signal and polarization and the performance of automatic threshold tracking without any intraoperative testing of the ER signal. In addition, the ER amplitude was correlated with the pacing threshold, pacing impedance, spontaneous R wave amplitude, and with the clinical data. The study included 60 patients who received the VVIR pacemaker Regency connected to the Membrane E 1450/1452 pacing lead (St. Jude-Pacesetter). At implantation, a pacing threshold < 0.7 V at 0.5 ms was achieved in all patients. ER and polarization were assessed for the first time at hospital predischarge testing. Follow-up measurements were conducted at month 1, 3, and 6. The ER amplitude at hospital discharge was 8.4 +/- 4.2 mV and increased to 9.4 +/- 4.8 mV at the 6-month follow-up. The pacemaker recommended not to program automatic threshold tracking on in one patient permanently and in three patients intermittently. The ER amplitudes were not differently distributed in men compared with women or in right-sided compared to left-sided implants. The correlation between age and the evoked response was r = 0.15. The correlation between ER amplitude and pacing threshold was r = -0.08, with pacing impedance r = 0.02, and with R wave amplitude r = 0.44. In conclusion, despite no operative evaluation of the ER amplitude being performed, the mean ER amplitude was about 9 mV at 6-month follow-up. Automatic threshold tracking could be programmed on in 93% of the patients throughout the time. Neither the clinical data nor the conventional electrical parameters help to predict patients who will have low ER amplitude or to optimize the ER signal at implantation.

Aged↗
PubMed2003

Clinical experience with an automatic threshold tracking algorithm study.

The automatic threshold tracking pacing system algorithm developed by St. Jude Medical, verifies ventricular capture beat by beat by recognizing the evoked response (ER) following each pacemaker stimulus. The present automatic threshold tracking function requires a bipolar ventricular lead with low polarization. The aim of this study was to evaluate a new algorithm developed to use with unipolar leads with different levels of polarization. An external pacemaker with the ability to sense intrinsic R waves and measure ER signals, as well as deliver stimulus, was used. An algorithm for detecting the true ER in a unipolar sensing configuration (tip-case) was developed. Based on the assumption that the true evoked R wave amplitude is independent of the stimulation amplitude, the algorithm calculates and subtracts the polarization present at any pacing stimulus from the measured ER. The resulting signal is analyzed to verify capture. This study comprises 35 patients of which 26 were new implants and 9 had chronic leads. The automatic threshold-tracking algorithm was calibrated for each patient and pacing was performed at different pulse amplitudes and pulse duration. Capture was verified for each paced beat. The recordings were stored for later comparison with the tape-recorded intracardiac heart signals. The new algorithm correctly verified capture or loss of capture for every single analyzed beat at the different pacing outputs in every individual patient. The results from this initial study suggests that the new ER detection principle will allow automatic threshold tracking to be used not only with low polarization bipolar leads but with most leads.

Aged↗
PubMed2005

Automatic measurement of dermal thickness from B-scan ultrasound images using active contours.

BACKGROUND/PURPOSE: Measurement of dermal thickness is useful in the evaluation of dermo-cosmetics for assessing not only morphological changes but also mechanical properties of this layer. Our aim was first to standardise the manual dermal thickness measurement procedure on B-scan ultrasound images, then to develop an automatic operator independent method to detect the boundaries of the dermis. MATERIAL AND METHODS: The Dermcup 20 MHz B-scan ultrasound system was used. The method used for detecting the boundaries was adapted from active contour algorithms. The innovative aspect of the method consists in an automatic initialization of the first step of the algorithm. To validate the method, we correlated measurements obtained by the manual and automatic approaches from a set of images from different anatomical sites. RESULTS AND CONCLUSION: The results showed for the two measurement methods, 72% of the images were perfectly correlated. The remaining images required manual initialization of the boundaries by a non-expert operator before the active contour process could be used. Subsequent to this semi-automatic procedure, the correlation was very high.

Algorithms↗
PubMed1997

Automaticity of cognitive biases in addictive behaviours: further evidence with gamblers.

OBJECTIVES: The hypotheses that automatic, non-volitional, attentional and memory biases for addiction-related constructs exist is tested with compulsive gamblers. DESIGN: An independent groups design was employed. Processing of gambling, compared to neutral and drug-related information was examined in 15 gamblers recruited from new members of Gamblers Anonymous. Comparisons were made with the performance of their spouses (N = 15) to help distinguish addiction mechanisms from more non-specific emotional experiences with gambling, and an independent control group (N = 15), recruited from the staff and students of a university department. METHODS: A modified Stroop procedure was first employed. Automative cognitive interference was assessed relatively, by comparing colour-naming times on the gambling, drug and neutral Stroops. A subsequent word-stem completion task of implicit memory was then used to assess selective and automatic priming of the gambling constructs in memory. RESULTS: Only the gamblers showed selective and automatic interference for gambling-related constructs on the Stroop task. Spouses behaved like the control group on this task. An implicit memory bias for gambling-related words was statistically detected only in the gamblers compared to the control group, although the trend was similar in the comparison with spouses. Further evidence for the specificity of these effects was obtained in subgroup comparisons involving fruit-machine with racing gamblers. CONCLUSIONS: Results are generally consistent with an automaticity in the cognitive biases gamblers show for gambling-related information. Implications for cognitive understanding and treatments are highlighted.

Adult↗
PubMed2001

Model of human/liquid cooling garment interaction for space suit automatic thermal control.

The Wissler human thermoregulation model was augmented to incorporate simulation of a space suit thermal control system that includes interaction with a liquid cooled garment (LCG) and ventilation gas flow through the suit. The model was utilized in the design process of an automatic controller intended to maintain thermal neutrality of an exercising subject wearing a liquid cooling garment. An experimental apparatus was designed and built to test the efficacy of specific physiological state measurements to provide feedback data for input to the automatic control algorithm. Control of the coolant inlet temperature to the LCG was based on evaluation of transient physiological parameters that describe the thermal state of the subject, including metabolic rate, skin temperatures, and core temperature. Experimental evaluation of the control algorithm function was accomplished in an environmental chamber under conditions that simulated the thermal environment of a space suit and transient metabolic work loads typical of astronaut extravehicular activity (EVA). The model was also applied to analyze experiments to evaluate performance of the automatic control system in maintaining thermal comfort during extensive transient metabolic profiles for a range of environmental temperatures. Finally, the model was used to predict the efficacy of the LCG thermal controller for providing thermal comfort for a variety of regiments that may be encountered in future space missions. Simulations with the Wissler model accurately predicted the thermal interaction between the subject and LCG for a wide range of metabolic profiles and environmental conditions and matched the function of the automatic temperature controller for inlet cooling water to the LCG.

Algorithms↗
PubMedDate not supplied

Automatic identification of biological microorganisms using three-dimensional complex morphology.

We propose automated identification of microorganisms using three-dimensional (3-D) complex morphology. This 3-D complex morphology pattern includes the complex amplitude (magnitude and phase) of computationally reconstructed holographic images at arbitrary depths. Microscope-based single-exposure on-line (SEOL) digital holography records and reconstructs holographic images of the biological microorganisms. The 3-D automatic recognition is processed by segmentation, feature extraction by Gabor-based wavelets, automatic feature vector selection by graph matching, training rules, and a decision process. Graph matching combined with Gabor feature vectors measures the similarity of complex geometrical shapes between a reference microorganism and unknown biological samples. Automatic selection of the training data is proposed to achieve a fully automatic recognition system. Preliminary experimental results are presented for 3-D image recognition of Sphacelaria alga and Tribonema aequale alga.

Algorithms↗
PubMed2005

Optimizing the automatic segmentation of the left ventricle in magnetic resonance images.

Automatic segmentation of the left ventricular (LV) myocardial borders in cardiovascular MR (CMR) images allows a significant speed-up of the procedure of quantifying LV function, and improves its reproducibility. The automated boundary delineation is usually based on a set of parameters that define the algorithms. Since the automatic segmentation algorithms are usually sensitive to the image quality and frequently depend heavily on the acquisition protocol, optimizing the parameters of the algorithm for such different protocols may be necessary to obtain optimal results. In other words, using a default set of parameters may be far from optimal for different scanners or protocols. For the MASS-software, for example, this means that a total of 14 parameters need to be optimized. This optimization is a difficult and labor-intensive process. To be able to more consistently and rapidly tune the parameters, an automated optimization system would be extremely desirable. In this paper we propose such an approach, which is based on genetic algorithms (GAs). The GA is an unsupervised iterative tool that generates new sets of parameters and converges toward an optimal set. We implemented and compared two different types of the genetic algorithms: a simple GA (SGA) and a steady state GA (2SGA). The difference between these two algorithms lies in the characteristics of the generated populations: "nonoverlapping populations" and "overlapping populations," respectively "nonoverlapping" population means that the two populations are disjoint, and "overlapping" means that the best parameters found in the previous generation are included in the present population. The performance of both algorithms was evaluated on twenty routinely obtained short-axis examinations (eleven examinations acquired with a steady-state free precession pulse sequence, and nine examinations with a gradient echo pulse sequence). The optimal parameters obtained with the GAs were used for the LV myocardial border delineation. Finally, the automatically outlined contours were compared to the gold standard--manually drawn contours by experts. The result of the comparison was expressed as a degree of similarity after a processing time of less than 72 h to a 59.5% of degree of similarity for SGA and a 66.7% of degree of similarity for 2SGA. In conclusion, genetic algorithms are very suitable to automatically tune the parameters of a border detection algorithm. Based on our data, the 2SGA was more suitable than the SGA method. This approach can be generalized to other optimization problems in medical image processing.

Algorithms↗
PubMed2006

Automatic registration of megavoltage to kilovoltage CT images in helical tomotherapy: an evaluation of the setup verification process for the special case of a rigid head phantom.

Precise daily target localization is necessary to achieve highly conformal radiation delivery. In helical tomotherapy, setup verification may be accomplished just prior to delivering each fraction by acquiring a megavoltage CT scan of the patient in the treatment position. This daily image set may be manually or automatically registered to the image set on which the treatment plan was calculated, in order to determine any needed adjustments. The system was tested by acquiring 104 MVCT scans of an anthropomorphic head phantom to which translational displacements had been introduced with respect to the planning image set. Registration results were compared against an independent, optically guided positioning system. The total experimental uncertainty was within approximately 1 mm. Although the registration of phantom images is not fully analogous to the registration of patient images, this study confirms that the system is capable of phantom localization with sub-voxel accuracy. In seven registration problems considered, expert human observers were able to perform manual registrations with comparable or inferior accuracy to automatic registration by mutual information. The time to compute an automatic registration is considerably shorter than the time required for manual registration. However, human evaluation of automatic results is necessary in order to identify occasional outliers, and to ensure that the registration is clinically acceptable, especially in the case of deformable patient anatomy.

Algorithms↗
PubMed1993

The Lombard reflex and its role on human listeners and automatic speech recognizers.

Automatic speech recognition experiments show that, depending on the task performed and how speech variability is modeled, automatic speech recognizers are more or less sensitive to the Lombard reflex. To gain an understanding about the Lombard effect with the prospect of improving performance of automatic speech recognizers, (1) an analysis was made of the acoustic-phonetic changes occurring in Lombard speech, and (2) the influence of the Lombard effect on speech perception was studied. Both acoustic and perceptual analyses suggest that the influence of the Lombard effect on male and female speakers is different. The analyses also bring to light that, even if some tendencies across speakers can be observed consistently, the Lombard reflex is highly variable from speaker to speaker. Based on the results of the acoustic and perceptual studies, some ways of dealing with Lombard speech variability in automatic speech recognition are also discussed.

Acoustic Stimulation↗
PubMed2005

A new system for the automatic estimation of endothelial cell density in donor corneas.

AIMS: The problem of automatic estimation of endothelial cell density from microscopy images in donor corneas was addressed. METHODS: The spatial frequencies contained in digital endothelium images are extracted with a two dimension discrete Fourier transform (DFT) technique. A circular band in the DFT of the images is shown to contain the frequency information related to the cell density. An algorithm for reliably recovering this spatial frequency information and for extracting from it an estimate of endothelial cell density has been developed and implemented in a computer program. An evaluation was performed on a data set containing 100 donor corneas, by comparing automatic values with manual counts performed by three eye bank experts on two images for each cornea. RESULTS: The mean difference of automatic densities v manual ones was 14 cells/mm(2) (0.9%), with a standard deviation of 119 cells/mm(2) (5.1%) and mean absolute difference of 92 cells/mm(2) (3.9%). The ANOVA based overall inter-rater reliability was 0.935. The algorithm was also capable of identifying all non-processable images. Running times were in the order of 1-2 seconds per image. CONCLUSION: A new algorithm was developed for the fully automatic estimation of endothelial cell density. The results of a clinical evaluation on 100 corneas suggest that it is capable of reliably estimating endothelium cell density in donor corneas.

Algorithms↗
PubMed2001

An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet.

OBJECTIVES: To evaluate in a randomised blind study the effect on puncture site lesions of two different incision devices used to obtain blood samples from preterm infants by repeated heel sticks. SETTING: The neonatal intensive care unit at the Hospital for Children and Adolescents and Laboratory, Helsinki University Central Hospital. PATIENTS: A total of 100 preterm infants (birth weight below 2500 g) not previously subjected to heel stick sampling. INTERVENTIONS: The infants were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. The same type of lancet was used for any given baby throughout the study (2-21 days). MAIN OUTCOME MEASURES: The damage caused by sampling was evaluated using four criteria: bruising of the heel, inflammation of the heel, bruising of either the ankle or the leg, and skin healing at the puncture site. The evaluation was based on photographs presenting typical categories of each outcome. RESULTS: To obtain a sufficient volume of blood, on average 2.6 times more punctures were needed when the conventional manual lancet was used than when the automatic incision device was used. Heels punctured with the lancet had more bruising (100% v 84%) and more signs of inflammation (79% v 53%), and there was more bruising of the ankle or leg (92% v 53%) than when the automatic incision device was used. Skin healed equally rapidly in the two groups. CONCLUSION: The use of an automatic incision device for collecting repeated skin puncture samples from preterm infants is less traumatic than the use of a conventional manual lancet.

Blood Specimen Collection↗
PubMed1995

Comparison of automatic QT measurement techniques in the normal 12 lead electrocardiogram.

OBJECTIVE: To undertake a quantitative assessment of different automatic QT measurement techniques and investigate the influence of electrocardiogram filtering and algorithm parameters. DESIGN: Four methods for identifying the end of the T wave were compared: (1) threshold crossing of the T wave (TH); (2) threshold crossing of the differential of the T wave (DTH); (3) intercept of an isoelectric level and the maximum T wave slope (SI); and (4) intercept of an isoelectric level and the line passing through the peak and the point of maximum slope of the T wave (PSI). Automatic QT measurements were made by all techniques following different electrocardiogram filtering and, when appropriate, with four different isoelectric levels and with three different threshold levels. SUBJECTS: 12 simultaneous standard electrocardiogram leads, containing at least two electrocardiogram complexes, were recorded from 25 healthy volunteers relaxing in a semirecumbent position. MAIN OUTCOME MEASURE: Mean and standard deviation of differences between reference and automatic QT measurements were compared for the four techniques. RESULTS: The mean automatic QT measurements varied by up to 62 ms, which was greater than has been found between manual measurements by experienced clinicians. Technique TH was particularly poor. The other techniques produced consistent results for most electrocardiogram filter, isoelectric level, and threshold level setting; but technique SI underestimated QT relative to the other techniques. CONCLUSION: Different QT measurement techniques produced results which were influenced, to varying degrees, by filtering and technique variables. This is relevant for the inter-comparison of studies using different techniques. Technique TH, a common approach, is not recommended.

Adult↗
PubMed2006

Automatic quantitative left ventricular analysis of cine MR images by using three-dimensional information for contour detection.

The purpose of this study was to evaluate an automatic boundary detection algorithm of the left ventricle on magnetic resonance (MR) short-axis images with the essential restriction of no manual corrections. The study comprised 13 patients (nine men, four women) and 12 healthy volunteers (11 men, one woman), and institutional review board approval and informed consent were obtained. The outline of the left ventricle was indicated manually on horizontal and vertical long-axis MR images. The calculated intersection points with the short-axis MR images were the basis of the automatic contour detection. Automatically derived volumes correlated highly with manually derived (short axis-based) volumes (R2 = 0.98); ejection fraction (EF) and mass showed a correlation of 0.95 and 0.93, respectively. Automatic contour detection reduced interobserver variability to 0.1 mL for endocardial end-diastolic and end-systolic volumes, 1.1 mL for epicardial end-diastolic and end-systolic volumes, 0.02% for EF, and 1.1 g for mass. Thus, the algorithm enabled highly reproducible left ventricular parameters to be obtained.

Adult↗
PubMed1975

Effect of epinephrine on automaticity of the canine atrioventricular node.

Effects of epinephrine on the automaticity of canine AV nodal fibers were studied on spontaneously beating AV node-His bundle preparations. Transmembrane potentials of single fibers of the AV node or His bundle were recorded with microelectrode techniques. Action potentials of most AV nodal fibers were characterized by steep phase-4 depolarization and smooth transition from phases 4 to 0. Epinephrine (0.1-0.2 mug/ml) increased the spontaneous rate of the AV nodal fibers. The slope of phase 4 depolarization was increased and the threshold shifted to a more negative level. These changes probably accounted for the increase in the automaticity of the node. Also, in the presence of epinephrine, the pacemaker of the preparation was consistently located at the AV node had a higher degree of automaticity than the His bundle. The findings of the present experiment, therefore, further support the view that the AV node is automatic.

Animals↗
PubMed1976

Effect of acetylcholine on automaticity of canine Purkinje fibers.

The effect of acetylcholine on automaticity of Purkinje fibers was studied in isolated canine false tendon preparations with conventional microelectrode techniques. Of 15 preparations with the control spontaneous rate of 12-60 beats/min, acetylcholine in a concentration of 0.5 mug/ml decreased the spontaneous rate by 20-87% in 13 preparations. This decrease in automaticity was due to a decrease in the slope of phase 4 depolarization and an increase in the maximum diastolic potential. The inhibitory effect of acetylcholine could be reversed by atropine in a concentration of 3 mug/ml in six preparations and prevented by pretreatment with atropine in another six preparations. Atropine per se did not have any appreciable effect on automaticity of Purkinje fibers. The results indicate that acetylcholine significantly suppresses automaticity of canine Purkinje fibers through its muscarinic action.

Acetylcholine↗
PubMed1984

Developmental changes in alpha adrenergic effects on canine Purkinje fiber automaticity.

Canine cardiac Purkinje fiber automaticity is modified by adrenergic agonists. Alpha adrenergic agonists slow and beta agonists increase the rate of automatic discharge. These effects vary with maturation and development. We used standard microelectrode techniques to study the effects of the alpha agonist, phenylephrine, on automaticity in isolated neonatal (less than 10 days) and adult canine cardiac Purkinje fibers. Fibers were superfused with 5 X 10(-8) M phenylephrine dissolved in Tyrode's solution. 75% (24/32) of adult and 52% (12/23) of neonatal fibers showed a decrease in rate. The magnitude of the decrease was similar at both ages and the effect was blocked during superfusion with 1 X 10(-9) M phentolamine. The remaining adult and neonatal fibers demonstrated a significant increase in rate in response to 5 X 10(-8) M phenylephrine. This effect was blocked by 5 X 10(-7) M propranolol in the adult group but not in the neonates. However, the increase in rate of fibers from 0- to 2-day neonates was blocked by phentolamine. As an indicator of adrenergic innervation of neonatal hearts, we assayed the myocardial norepinephrine concentration. There was a 6- to 8-fold increase in concentration during the first 10 days of neonatal life, suggesting that innervation was rapidly increasing during this time. In summary, neonatal Purkinje fibers can show an alpha adrenergic-induced acceleration of automatic rate. This alpha adrenergic acceleration is not seen in adults. The change in response from neonate to adult may be effected by growth and development of autonomic nerves and associated changes in receptor function.

Action Potentials↗
PubMed1995

Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies.

Pulse wave velocity is widely used as an index of arterial distensibility. The aim of this study was to evaluate the accuracy of a new automatic device to measure it and then to analyze the major determinants of pulse wave velocity by application of this device in a large population. We evaluated the accuracy of on-line and computerized measurement of pulse wave velocity using an algorithm based on the time-shifted and repeated linear correlation calculation between the initial rise in pressure waveforms compared with the reference method (manual calculation) in 56 subjects. The results, analyzed according to the recommendations of Bland and Altman, showed a mean difference of -0.20 +/- 0.45 m/s for the mean carotid-femoral pulse wave velocity values (reference method, 11.05 +/- 2.58 m/s; automatic device, 10.85 +/- 2.44 m/s). The interreproducibility and intrareproducibility of measurements by each method were analyzed with the use of the repeatability coefficient according to the British Standards Institution. The interobserver repeatability coefficient was 0.947 for the manual method and 0.890 for the automatic, and intraobserver repeatability coefficients were 0.938 and 0.935, respectively. We evaluated the major determinants of the carotid-femoral pulse wave velocity measured by the automatic method in a separate study performed in 418 subjects of both sexes without any cardiovascular treatment or complication (18 to 77 years of age; 98 to 222 mm Hg systolic and 62 to 130 mm Hg diastolic pressure).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗