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Cryptosporidium monitoring system at a water treatment plant, based on waterborne risk assessment.

The water volume required for daily monitoring of Cryptosporidium (which can statistically ensure an annual risk of infection below 10(-4)), was assessed by evaluating the applicability of the Poisson lognormal (PLN) distribution in microbial risk assessment. PLN showed as good a fit to the observed data as to the negative binomial distribution. From the estimated PLN distributions for the source and finished water, the efficacy of the oocyst removal by the conventional water treatment process was estimated to follow log-normal distribution (median = 3.16 log10, 95% CI = 4.27-2.05 log10). The 365 consecutive negative results of daily monitoring for 180 L of finished water were found to be statistically equivalent to the annual risk of infection below 10(-4). This research also suggested the possibility of applying a qualitative detection method, such as CC-PCR, as a routine monitoring method for the quantitative risk management.

Animals↗

[Video/EEG, the epileptic monitoring system].

Seventy-six seizures in thirty-four patients with epilepsy and suspicious of epilepsy were monitored by Video/EEG which was designed and made by the authors and identified by the scientific experts considered to be standard. The average time of each patient monitored was 6.7 hours. The positive record of fifty-six seizures were analyzed: The seizures of twenty-four patients (70.5%) were diagnosed as epileptic in nature; two patients (5.8%), the seizures were due to organic brain diseases and in eight patients (23.5%), they were pseudoseizures. The diagnostic rate for epileptic type was 87.5%. The clinical use of Video/EEG shows that functions of this apparatus has attained the international level as compared with the identical one made in foreign country. It is high qualified with multifunctions and low in price. It can also apply in fields of psychology. Psychiatry, biology and in studying of sleep, respiration etc. Therefore, the Video/EEG which we made is a apparatus suitable for our national condition.

Adolescent↗

[Nosocomial infection monitoring system featuring detection of local clustering].

We have developed a nosocomial infection surveillance system making use of data from laboratory information system. The system makes cross-reference table of detected bacteria according to either the site of occurrence(hospital wards) or antibiotic sensitivity. It is capable of listing all the patients or serial changes in frequency for any specified bacterium. Furthermore, we have developed an algorism to detect local clustering. For each ward, the system calculates all combinations of distance between beds of patients with specified bacteria. We named the statistics as DC(degree of cluster) and its significance was judged by a confidence interval of DC obtained by a bootstrap method by randomly assigning the same number of patients to the beds in the same wards. Retrospective analysis of the distribution of 4 major bacteria in the wards proved that DC is a sensitive indicator of local clustering.

Algorithms↗

Non-constraining sleep/wake monitoring system using bed actigraphy.

This paper introduces a new method, bed actigraphy (BACT) for user-friendly sleep-wake monitoring. BACT provides a non-intrusive acquisition of activity data, and in particular does not require that sensors be attached to the subject's body. The system consists of four load-sensing cells supporting the bed, an A/D converter, and a microcontroller with appropriate software. The performance of BACT was compared to that of standard polysomnography (PSG) recordings and wrist-worn actigraphy (ACT). Ten normal volunteers underwent overnight PSG recordings and were examined simultaneously with BACT and ACT. An automatic scoring algorithm scored each 30-s epoch of the BACT recordings for either 'Wake' or 'Sleep.' A sleep specialist manually scored the PSG recordings, and the results were divided into 'Wake' and 'Sleep' categories. The three methods showed a significant correlation when compared with in the contingency test. The mean epoch-by-epoch agreements between the BACT and PSG, ACT and PSG, and BACT and ACT recordings were 95.2, 92.9, and 94.3%, respectively. The mean absolute differences in sleep percentage (SP) between them were 1.8 +/- 0.82, 3.4 +/- 1.45, and 1.9 +/- 1.16 %, respectively. BACT differentiation of the 'Wake' and 'Sleep' stages proved to be sufficiently robust, and its results were comparable to PSG analysis. This finding supports the experimental and clinical value of bed-activity monitoring during sleep.

Adult↗

Accuracy and utility of a continuous intra-arterial blood gas monitoring system in pediatric patients.

OBJECTIVES: To determine the accuracy of the Paratrend 7 continuous intra-arterial blood gas monitor (CI-ABGM) in radial and femoral artery catheters placed in children compared with simultaneous measurements of pH, Pa(CO2), and Pa(O2) performed by intermittent blood gas analysis. To determine sensor longevity in pediatric patients at different arterial sites. To determine the utility of CI-ABGM for tracking unanticipated events related to blood gas deterioration. SETTING: A pediatric intensive care unit of a university hospital. DESIGN: A prospective clinical investigation. PATIENTS: Fifty critically ill pediatric patients, ranging in age from 1 wk to 18 yrs of age, who required either radial or femoral artery catheters for intermittent arterial blood gas monitoring. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A Paratrend 7 intra-arterial sensor was placed through either an 18- or 20-gauge catheter previously inserted into the radial or femoral artery. At clinically predetermined intervals ranging from every 1 to 8 hrs, the CI-ABGM measurements of pH, P(CO2), and P(O2) were compared with the values determined by standard intermittent blood gas analysis. The Paratrend 7 system values were individually adjusted to match ABG results when the Paratrend 7 pH differed by greater than +/-0.05 units, P(CO2) was greater than +/-5 torr (0.7 kPa), and P(O2) was greater than +/-15% of the ABG value. Significant aberrations in gas exchange defined as unanticipated events were categorized as isolated metabolic acidosis (pH <7.20), hypercapnia (P(CO2), >70 torr; 9.3 kPa), and hypoxemia (P(O2), <50 torr; 6.7 kPa). All unanticipated events were earmarked from consecutive monitoring epochs ranging from 4 to 24 hrs duration from the time of Paratrend 7 sensor insertion to the time of sensor removal. Fifteen sensors were placed into the radial artery, 34 sensors were placed into the femoral artery, and one sensor was initially placed in the radial and moved to a femoral artery location. Mean radial artery insertion duration was 35 hrs. Mean femoral artery duration was 137.2 hrs. A total of 1445 pairs of ABG results were available for comparison. After removal of individual values, which did not meet inclusion criteria, 1411 pH data pairs, 1408 P(CO2) data pairs, and 1326 P(O2) data pairs were analyzed. The bias and precision for the pH data were 0.00 and 0.04 units, respectively; for the P(CO2) data were -0.4 and 4.8 torr (-0.05 and 0.64 kPa), respectively; and for the P(O2) data 1.0 and 25 torr (0.1 and 3.3 kPa), respectively. Detection of unanticipated events was evenly spread across the three categories and was most commonly related to iatrogenic causes or cardiac failure. Persistent waveform dampening necessitating sensor removal was more frequently encountered in radial placement compared to femoral placement. CONCLUSIONS: The Paratrend 7 CI-ABGM is accurate within the extremes of physiologic gas exchange typically encountered in the pediatric intensive care setting. The device is capable of tracking extreme fluctuations in gas exchange with a response rate suitable for making real-time therapeutic decisions. The sensor can be recommended for insertion into a femoral artery cannula. There is a high incidence of blood pressure waveform dampening encountered in radial artery use.

Acidosis↗