Recommendations for desirable features of glucose monitoring systems for visually impaired customers.
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Although the incidence of human infection with Schistosoma japonicum in Japan fell to zero in 1977, the threat of the possible re-emergence of the disease caused by this trematode still exists. Surveillance of the parasite's intermediate host, Oncomelania nosophora, in Kofu basin therefore began in 1996. A simple, new method for monitoring O. nosophora in an at-risk area in Kofu, which is based on a geographical information system (GIS), was established. At each monitoring site (of which there were 120 from 1996 until 2000, and 60 from 2001 until 2003), the O. nosophora in two quadrats, each measuring 25 x 25 cm, were collected. During the study, the exact location of each site was determined using a hand-held global-positioning system (GPS). This allowed all the sites to be digitally mapped, so that anyone with a hand-held GPS could and can reach each site. The snail and location data were processed using commercial GPS/GIS software packages and used to create a risk map for schistosomiasis re-emergence. Although all snails collected between 1996 and 2003 were uninfected, the proportion of investigated sites in which O. nosophora was detected increased from 36.7% in 1996 to 56.7% in 2003. The mean number of O. nosophora collected per snail-positive site fluctuated widely, between 8.2 and 57.4, in each calendar year. Over the study period there appeared to be a shift southwards in the areas with high densities of O. nosophora. The present results indicate that it is possible to utilize a GIS-based method for the long-term monitoring of the possible re-emergence of schistosomiasis japonica in Japan.
Despite advances made in health-related ambulatory monitoring, medical practitioners and researchers have remained seriously constrained in their ability to acquire concurrent assessments of multiple physiological systems, as well as patient reports of symptoms and well being in daily life: Almost all past and current applications have been limited to the registration of a single variable (e.g. the electrocardiogram or blood pressure), and this has resulted in incomplete information about other relevant physiological and environmental factors likely to contribute to disease or its amelioration. Monitoring of multiple physiological functions has been too complicated to achieve and has required special measurement devices that have been unavailable, too expensive, or too cumbersome to effectively employ. Concurrent assessment of pertinent information about patient activities during monitoring has remained difficult to accomplish, although such information is likely to be crucial for the interpretation of physiological findings and patients' perceptions of improvement. The LifeShirt (Vivometrics, Inc., Ventura, CA, U.S.A.) is a multi-function ambulatory device capable of simultaneously monitoring several physiological signals and patient reports of symptoms and well being. The LifeShirt system is an extensible data acquisition and processing platform consisting of a garment, a data recorder, and PC-based analysis software. Sensors in the LifeShirt garment continuously monitor respiration, the electrocardiogram, activity and posture. Other functions are easily plugged into the system, including pulse oximetry, EEG/ EOG measurement, blood pressure, temperature, capnometry and acoustic monitoring. Subjective patient data may also be entered into the LifeShirt recorder, and all data are encrypted and written to a flash memory card. Vivologic(TM) analysis software provides full-disclosure analysis and display of high-resolution waveforms and over 30 derived parameters; the software also produces summary reports for clinical diagnostic purposes. The LifeShirt has been rigorously tested for more than 38,000 hours in 90 studies with 1,750 subjects. The device has received all necessary regulatory approvals and is currently used in leading research institutions throughout the United States, Canada and Europe. Clinical applications include sleep diagnostics, heart disease, pulmonary disorders, cardiopulmonary rehabilitation, early hospital discharge and pre- and post-operative monitoring, human-factors in ergonomics and behavioral medicine.
Optimal hemodialysis prescription through real-time blood urea (BU) monitoring and closed loop control of urea removal would be of significant clinical value. Progress toward a bedside BU analyzer and a control system is described here. An Amicon Minifilter inserted into the arterial bloodline provides a 1 ml/min stream of protein free ultrafiltrate for analysis. In vitro tests with bovine blood have shown excellent correlation between plasma (CP) and ultrafiltrate (CU) urea levels: CP = 0.961CU + 0.071, (n = 34, r = 0.998). In clinical hemodialysis studies, CU accurately represented the decay in CP. The BU analyzer uses a standard UV endpoint assay with a proportioning roller pump. The absorbance of the reacted mixture is read in a spectrophotometer after a 5 min incubation. For future control system design, the transfer function (TF) of the BU analyzer was measured using multifrequency binary testing. The data indicated that the analyzer may be modeled by a second order TF with a pure time delay. The same form of TF was also found to describe the Minifilter. Control of the removal rate of NaCl (substituted for urea) through automatic dialysate flow adjustment has been achieved with a simulated dialyzer-patient circuit (using a conductivity probe in place of the BU analyzer). A modified BU analyzer using computer controlled precision syringes for improved sample processing time and accuracy is also reported.
OBJECTIVES: The purpose of this study was to evaluate feasibility of using real-time, high-fidelity, intracardiac electrogram monitoring from a permanently implantable ischemia detection system (IIDS), with long-range telemetry capability to detect ST-segment shifts associated with acute or subacute coronary occlusion in a porcine model. BACKGROUND: Early identification of coronary occlusion with ST-segment elevation could profoundly accelerate the timing of revascularization and improve clinical outcomes. METHODS: This paper reports the first investigation using real-time, high-fidelity, intracardiac electrogram monitoring from a permanently IIDS, with long-range telemetry capability. This IIDS was tested in an ambulatory porcine model, with acute coronary occlusion precipitated by stent thrombosis. Two overlapping copper stents were implanted in the left anterior descending (n = 3), the circumflex (n = 3), or the right coronary artery (n = 2) of juvenile farm pigs. Monitoring was carried using telemetry from the IIDS. RESULTS: All stented pigs had acute ST-segment elevation event(s) triggering the alerting thresholds of the IIDS. All triggered events were confirmed to be caused by thrombosis of the copper stent(s), and well correlated to infarct age and location. Four of the 8 pigs died from ventricular fibrillation, recorded by the IIDS at a mean time of 70 +/- 121 h after ST-segment alert. The sensitivity and specificity of alerting for ST-segment shift, associated with thrombotic coronary occlusion, were 100% and 100%, respectively. CONCLUSIONS: This study demonstrates the ability of an implantable ischemia detection system to detect ST-segment elevation from coronary occlusion in a porcine model of ST-segment elevation myocardial infarction. ST-segment elevation was sufficient to trigger alerting thresholds in all 3 epicardial coronary distributions. Such a system, with real-time alerting capability, could advance the time frame of reperfusion therapy and potentially prevent, rather than interrupt, acute myocardial infarction in patients with coronary artery disease.
Because of the increasing interest in using ambulatory ECG monitoring equipment to study cardiac ischemia, we examined the frequency response characteristics and the reproducibility of a standard ST segment shift for equipment from eight manufacturers. Output/input amplitude versus frequency response curves, derived from input sine waves, were compared with American Heart Association (AHA) standards. Low- and high-frequency cutoffs (-3dB) were examined as well as flat response within the pass band. A new test based on Fourier analysis provided evaluation of phase shift versus frequency response and a more detailed analysis of the amplitude versus frequency response. By using a modified ECG simulator, flat-line ST segment depression from 0 to 10 mm (in 1 mm increments) was input to two or three recording devices for each manufacturer. The outputs from the scanners were evaluated for the amount of ST depression and the quality of the waveform reproduction. No system met all AHA standards for frequency response. Each system also had varying amounts of phase shift which could potentially distort the ECG signal. Although some manufacturers' equipment gave faithful reproductions of the simulated ST segment depression, others did not. We conclude that additional investigation is necessary to determine the clinical implications of our findings and to establish better standards for low- and high-frequency cutoffs, flat response within pass band, and phase shift for ambulatory ECG monitoring equipment.
There are still many Oncomelania snails that inhabit the Kofu Basin, Yamanashi Prefecture, Japan, which had been declared free of schistosomiasis japonica. Due to the need to monitor the situation, a fixed-point observation system using GIS from GPS is being examined. In addition, in broad present or former endemic areas, survey areas are being managed by remote sensing with satellite images or aerial photographs. A simple and effective monitoring method by mobile GIS using PDAs was developed, risk or hazard maps were prepared and a system that would enable a response in the event of reemergence is being examined.
The simultaneous recording system for body weight, food and water consumption and behavior (spontaneous motor activity and drinking and feeding behavior) of a mouse was developed. The body weight and food consumption were measured by force transducers. Food and water consumption and drinking and feeding behavior were measured by an infrared luminous diode and a phototransistor. Spontaneous motor activity was measured by photosensors. The system control and data acquisition were performed by using a personal computer. Every parameter could be monitored with a desired time interval. All the data collected by this system revealed apparent circadian rhythm. In conclusion, this system would be a powerful tool for pharmacological and/or toxicological research.
At the Individual Monitoring Service (IMS) of the ENEA Institute for Radiation Protection (IRP), the Hp(10) fast neutron dosemeter consists of a CR-39 (PADC, poly allyl diglycol carbonate) recoil protons track detector. The tracks across the detector surface are magnified through a chemical etching procedure and counted by a semi-automated system which consists of a microscope, a camera and a PC. A new analysis system, based on the National Instruments vision tools, was developed. The track area distribution for each reading field is recorded and numerical algorithms were developed in order to correct the energy dependence of the response and to recognise the tracks due to the background. This improves the dose evaluation system in terms of accuracy and discrimination or the background.
The use of the xenon isotopes for detection of nuclear explosions is of great interest for monitoring compliance with the comprehensive nuclear-test-ban treaty (CTBT). Recently, the automated radioxenon sampler-analyzer (ARSA) was tested at the Institute for Atmospheric Radioactivity (IAR) in Freiburg, Germany to ascertain its use for the CTBT by comparing its results to laboratory-based analyses, determining its detection sensitivity and analyzing its results in light of historical xenon isotope levels and known reactor operations in the area. Xe-133 was detected nearly every day throughout the test at activity concentrations ranging between approximately 0.1 mBq/m3 to as high as 120 mBq/m3. Xe-133m and 135Xe were also detected occasionally during the test at concentrations of less than 1 to a few mBq/m3.