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PubMed1975

Malfunction of linear accelerator dose monitoring systems.

Malfunctions of the dose monitoring systems of two linear accelerators were studied. A variation of plus or minus 2.5% over an air density correction factor range from 1.02 to 1.07 was measured, suggesting that the ionization-type monitor chambers were open to the atmosphere. An average variation of minus 2.0% was present between early morning calibrations and those performed later in the day. Any variation caused by changes in control console temperature was within experimental error. This type of malfunction can lead to errors in delivered doses of 5%.

Electrons↗
PubMed1993

Prevalence of sleep apnea among Japanese industrial workers determined by a portable sleep monitoring system.

We developed a new portable sleep monitoring system and studied the prevalence of sleep apnea syndrome among Japanese industrial workers. This device assessed three kinds of parameters: nasal airflow, tracheal sound and electrocardiogram (ECG), and digitally stored the clock time of the onset of apnea, apnea duration and R-R intervals by a built-in microcomputer. After monitoring, the portable sleep monitor was connected to a host computer, and apneic episodes, the so-called 'apnea index' as apneic episodes corrected by measuring time ('AI') and R-R intervals were analyzed. In 170 inpatients referred to our sleep clinic, sleep monitoring by this device was performed simultaneously with all-night polysomnography, and the sensitivity and specificity of this device was determined under different criteria of the apnea index (AI) (AI > 5, 10, 15 and 20 episodes/h) by polysomnography. In all AI criteria, the sensitivity was more than 90%, and the specificity was also reasonably high. Using this system, successive 2-night home sleep monitoring was performed on 168 healthy workers in one Japanese industrial company, and 159 people (140 males; 19 females) who had successful monitoring were analyzed. The percentage of persons who had 'AI' of more than 10 episodes/h was 7.5%. There were no significant correlations between 'AI' and age, body weight or scores estimated by sleep questionnaires. These results suggest that even in people who are seemingly healthy significant apneic episodes could be detected by the portable home sleep monitoring system. This system may therefore be useful in evaluating the occurrence of sleep apnea syndrome in general populations.

Adolescent↗
PubMedDate not supplied

[The design of a monitoring system for the development of quality assurance programs].

The need for the development of a monitoring system as a support emerged in Mexico from the experience acquired during the implementation of Quality Assurance Programs. The monitoring system is designed around the goals, activities performed to achieve the goals and the problems encountered in their achievement. The system conducts to the creation of indicators and standards for the monitoring of the essential activities for an optimal performance. The current article produces the grounds for the development of a quality assurance program through a monitoring system with the characteristics previously described.

Organizational Objectives↗
PubMed2006

Technical and dosimetric aspects of respiratory gating using a pressure-sensor motion monitoring system.

This work introduces a gating technique that uses 4DCT to determine gating parameters and to plan gated treatment, and employs a Siemens linear accelerator to deliver the gated treatment. Because of technology incompatibility, the 4DCT scanner (LightSpeed, GE) and the Siemens accelerator require two different motion-monitoring systems. The motion monitoring system (AZ-773V, Anzai Med.) used for the gated delivery utilizes a pressure sensor to detect the external respiratory motion (pressure change) in real time. Another system (RPM, Varian) used for the 4DCT scanner (LightSpeed, GE) is based on an infrared camera to detect motion of external markers. These two motion monitoring systems (RPM and Anzai systems) were found to correlate well with each other. The depth doses and profile measured for gated delivery (with a duty cycle of 25% or 50%) were found to agree within 1.0% with those measured for ungated delivery, indicating that gating did not significantly alter beam characteristics. The measurement verified also that the MU linearity and beam output remained unchanged (within 0.3%). A practical method of using 4DCT to plan a gated treatment was developed. The duty cycle for either phase or amplitude gating can be determined based on 4DCT with consideration of set-up error and delivery efficiency. The close-loop measurement involving the entire gating process (imaging, planning, and delivery) showed that the measured isodose distributions agreed with those intended, validating the accuracy and reliability of the gating technique. Based these observations, we conclude that the gating technique introduced in this work, integrating Siemens linear accelerator and Anzai pressure sensor device with GE/Varian RPM 4DCT, is reliable and effective, and it can be used clinically to account for respiratory motion during radiation therapy.

Imaging, Three-Dimensional↗
PubMedDate not supplied

Problems with telemetry monitoring systems.

The purchaser of telemetry monitoring systems for operating and recovery rooms has little information available on the practical aspects of ownership and usage. To explore this problem, we recorded 76 telemetry failures (both operator and machine failure) occurring over six months among 18 telemetry channels located in operating and recovery rooms. We experienced approximately one telemetry failure every three days or every 60 surgical procedures. Factory repairs were required on 29 transmitters and 19 receivers during a two-year period. We observed that 28% of the failures were attributable to lead and electrode problems, 25% to battery depletion, 22% to mechanical or electronic component failures, 12% to inappropriate control settings and frequency mismatching, and 13% to miscellaneous difficulties. The following problems were observed. Transmitters were dropped frequently and occasionally immersed in liquids. Thus, waterproofing is recommended for OR use, and lead-failure warning circuitry is mandatory. Inappropriate control settings and frequency mismatching led to a previously unrecognized hazard: that is, it is possible to receive and display ECG data from the wrong patient located in a distant room. (Stethoscopic monitoring can be used to confirm that the data being displayed are from the correct patient.) Battery failure can occur at inopportune times, e.g., during cardiac arrest. Transmitters are frequently "lost" because of their small size and high mobility. This study indicated to us that, in the operating room, telemetry is not desirable because of its high cost compared to hard wired systems, poor reliability, and the possible hazard of displaying data from the wrong patient if improperly used.

Biomedical Engineering↗
PubMed2002

[Clinical application of the expert type terminal of remote electronic fetal heart rate home monitoring system].

OBJECTIVE: To investigate the clinical value of the expert type terminal of long-distance electronic fetal heart rate home monitoring system in the application to self-monitoring of pregnant woman at home in peripartum. METHODS: All the pregnant women (n = 284) were divided into two groups. Research group (n = 134) contained 73 high risk gravida. There were 78 high-risk gravida in control group (n = 150). In the research group, self-monitoring at home in 134 women was taken by the expert type terminal of long-distance electronic fetal heart rate monitoring system through telephone and fetal movement counting. The women were requested to auscultate and transfer fetal heart rate (FHR) to electronic FHR monitoring center in hospital. Non-stress test (NST) was made 1 approximately 2 times every week when fetal movement was active. When women felt any abnormality of baby, she should immediately test NST and then the photograph of NST was send to FHR monitoring center by telephone. Doctor would make a diagnosis and management in time according to the photograph of NST. In the control group, the way of fetal monitoring was fetal movement counting and regular NST test in the outpatient clinic. RESULTS: The incidence of abnormal NST was significantly higher in the research group than that in the control group (respectively 22.0% vs 13.5%, P < 0.05). The neonatal asphyxia was significantly lower in the research group than that in the control group (respectively 1.5% vs 4.0%, P < 0.05). The incidence of abnormal NST was not different between the high-risk women and non-high-risk women in the research group (respectively 22.3% vs 21.6%, P > 0.05). CONCLUSIONS: The expert type terminal of long-distance electronic FHR monitoring system through telephone is a new way of the FHR self-monitoring at home. The application of this method could ease mental press of the women, decrease significantly perinatal mortality, decrease incidence of neonatal asphyxia, and improve quality of obstetrics. Whatever there are high risk factors in any pregnant women, the system should be applied to all late pregnant women.

Asphyxia Neonatorum↗
PubMed1989

Noninvasive heart rate monitoring system for avian embryos based on the ballistocardiogram.

A noninvasive heart rate (HR) monitoring system for avian embryos has been developed based on the ballistocardiogram (BCG). The BCG was detected using a phonograph cartridge as a record of the velocity of the minute ballistic movements of the eggshell, which are generated by recoil and impact of heart contraction and blood ejection. The autocorrelation coefficients (ACCs) of the detected signal were computed to confirm whether the detected signal contained ballistic movement. An envelope of ACC was calculated by the monitoring system to measure the intervals between peaks and/or highly correlated parts in the ACC, and then the system obtained HR by measuring these intervals. To demonstrate the valid range of the detecting method, the BCGs of chickens and Japanese quail embryos of different ages were measured. The result of the experiment shows that the BCGs of chickens and quail embryos are detected fully after about two-thirds of the incubation period has passed. The monitoring system will enable us to perform long-term HR measurement for developing avian embryos up to hatching.

Animals↗
PubMedDate not supplied

A remote monitoring system for patients with implantable ventricular assist devices with a personal handy phone system.

The usefulness of a remote monitoring system that uses a personal handy phone for artificial heart implanted patients was investigated. The type of handy phone used in this study was a personal handy phone system (PHS), which is a system developed in Japan that uses the NTT (Nippon Telephone and Telegraph, Inc.) telephone network service. The PHS has several advantages: high-speed data transmission, low power output, little electromagnetic interference with medical devices, and easy locating of patients. In our system, patients have a mobile computer (Toshiba, Libretto 50, Kawasaki, Japan) for data transmission control between an implanted controller and a host computer (NEC, PC-9821V16) in the hospital. Information on the motor rotational angle (8 bits) and motor current (8 bits) of the implanted motor driven heart is fed into the mobile computer from the implanted controller (Hitachi, H8/532, Yokohama, Japan) according to 32-bit command codes from the host computer. Motor current and motor rotational angle data from inside the body are framed together by a control code (frame number and parity) for data error checking and correcting at the receiving site, and the data are sent through the PHS connection to the mobile computer. The host computer calculates pump outflow and arterial pressure from the motor rotational angle and motor current values and displays the data in real-time waveforms. The results of this study showed that accurate data on motor rotational angle and current could be transmitted from the subjects while they were walking or driving a car to the host computer at a data transmission rate of 9600 bps. This system is useful for remote monitoring of patients with an implanted artificial heart.

Equipment Design↗
PubMed1997

SUTIL: intelligent ischemia monitoring system.

SUTIL is an intelligent monitoring system for intensive and exhaustive follow up of patients in coronary care units. This system processes electrocardiographic and hemodynamic signals in real time, with the main objective of detecting ischemic episodes. In this paper, we describe the tasks included in SUTIL. In addition to basic tasks, those at higher levels will also be presented. Some of these latter tasks attempt to mimic, to some extent, the way in which the human expert operates.

Algorithms↗
PubMed1996

The development of patient profiles for Minnesota's treatment outcomes monitoring system.

Minnesota's treatment outcomes monitoring system is a cooperative effort between the State alcohol and drug abuse agency and 366 licensed treatment providers. A minimum dataset is required on all treatment admissions to provide a state-wide system profile. In addition, data are being collected on a sample of 30 patients from each program to measure patient characteristics and severity of problems, patient perceptions of needed assistance, actual nature and amount of services received, patient satisfaction and patient functioning 6 months following discharge from treatment. The dimensions measured include alcohol and other drug use, physical health, psychological well-being, employment and financial status, family and social relationships and criminality. The aggregated data will be analysed to determine what types of services are associated with more favorable outcomes for different types of patients. The findings will be used to develop standards for treatment placement and service delivery based on individual patient profiles. This report provides an overview of the plan and an illustration of how patient profiles can be developed for purposes of treatment service matching and outcomes monitoring.

Adult↗
PubMed2001

Continuous cardiac output monitoring system.

A continuous cardiac output monitoring system has been developed in the laboratory to allow the real-time measurement of the cardiac output. This form of continuous cardiac output measurement allows the doctor to view the beat-to-beat cardiac output and can be employed to measure artery constrictions as well. The sensor comprises a laser Doppler velocimeter and an impedance measurement unit. The laser Doppler velocimeter is capable of measuring bi-directional blood flow within the vessel while the impedance measurement unit determines the cross-sectional area of the vessel. In laboratory tests, it was demonstrated on a heart-lung machine that the product of the two parameters measured is proportional to the actual flow volume of up to 6 lmin(-1) with a mean percentage error of 12.4% and a mean square error of 0.09 (using the lmin(-1) scale) were obtained. This is significantly more accurate than the measurement made using the thermodilution cathether.

Cardiac Output↗
PubMedDate not supplied

Pregnancy Risk Assessment Monitoring System (PRAMS): possible new roles for a national MCH data system.

The Pregnancy Risk Assessment Monitoring System (PRAMS) was established by the Centers for Disease Control and Prevention (CDC) in 1987 in five states, and today 32 states participate. Using states' vital statistics (birth certificates) as its population-based sampling frame, PRAMS "follows back" a stratified sample of women several months post-partum, surveying them about their own and their infant's prenatal, birth, and post-partum behavior and experiences. It uses a standardized protocol and multiple data collection modalities. PRAMS was initiated in an era of intense state and national interest in infant mortality, racial disparities reduction, and publicly supported prenatal care program expansion-and a lack of state-specific information available to inform local and state program development and assessment. The PRAMS format allows more in-depth inquiry about reproductive health topics than is possible from the more widespread but limited set of information available on birth certificates. PRAMS carries on a long, proud tradition of follow-back studies in the maternal and child health (MCH) field. In the 1920s, the U.S. Children's Bureau conducted the nation's first major in-depth study on infant mortality using a similar follow-back methodology. In each of 10 cities, every woman whose infant had died in the past year was systematically surveyed. The results provided an initial understanding of the nature of infant mortality in the U.S., indicating that infant deaths occurred more often in lower-income than higher-income families, among bottle-fed than breast-fed infants, and among twins than singletons. Beginning in 1964 and every eight years thereafter through 1988, the National Center for Health Statistics (NCHS) conducted intensive national follow-back studies of live births and infant/fetal deaths, which has provided much of our more recent national epidemiologic information about pregnancy and births, especially concerning smoking, prenatal care usage, etc. A similar Department of Education/NCHS national follow-back and longitudinal follow-up study, the Early Childhood Longitudinal Study-Birth Cohort (ECLS-BC) was begun in 2001 and will survey 10,000 mothers and their infants through kindergarten age.

Child↗
PubMed1978

The Hungarian congenital malformation monitoring system.

The Hungarian Congenital Malformation Monitor has been operating since 1973 in order to detect the temporal and regional clusters of 12 indicator congenital malformations as early as possible. This Monitor takes part in the International Clearinghouse for Birth Defects Monitoring System. Three continuously increasing trends were detected in 1973--1976. They may be connected with the more complete notifications, although the increase of limb reduction deformities are only partly explained by this factor. Transitional (quarterly) significant clusters were observed in the case of anencephaly (1974, IV), spina bifida (1974, II; and 1975, III; 1976, III), cleft lip +/- cleft palate (1974, III). The possibility of three technical biases (changes in diagnosis, notification and evaluation of the given congenital malformation) has to be excluded before accepting the fact of a real epidemic. Subsequently, a case-control epidemiological study by personal interviews and with matched controls has to be performed.

Congenital Abnormalities↗
PubMed1997

Alcohol consumption among Oklahoma women: before and during pregnancy. The PRAMS Working Group. Pregnancy Risk Assessment Monitoring System.

The Pregnancy Risk Assessment Monitoring System (PRAMS) utilizes a population-based survey of Oklahoma women with a recent live birth to examine the rates of alcohol consumption before and during pregnancy. Nearly one-half of Oklahoma women report using alcohol during the three months before pregnancy and one in thirteen women consume alcohol during the three months prior to delivery. Moderate to heavy alcohol use before pregnancy was associated with additional perinatal risk factors including unintended pregnancy, inadequate prenatal care, smoking, and physical abuse. Health providers play an important role in the prevention of alcohol related birth impairments such as fetal alcohol syndrome through early detection of problem drinking, patient education and appropriate referrals. However, one in four Oklahoma mothers report their health care provider did not talk to them about the harmful effects alcohol can have on their baby.

Alcohol Drinking↗
PubMed2004

Home care artificial heart monitoring system via internet.

The availability of a remote management system, which provides both physiological-related information about the patient and device-related information about the implanted device, would be helpful during in vivo experiments or clinical trials involving artificial heart implantation. In order to be able to monitor the course of the in vivo experiment continuously regardless of the patient's location, an internet-based remote monitoring system was developed, which can monitor physiological-related information such as pressure (AoP, LAP, RAP, PAP) and flow data, as well as device-related information such as current, direction and pump operating conditions. The home care artificial heart monitoring system which we developed consists of four main components, which are the transcutaneous information transmission system (TITS), local monitoring station (LMS), data server station (DSS), and client monitoring station (CMS). The device-related information and physiological-related information can be transmitted in real time from a patient in a remote non-clinical environment to the specialist situated in a clinic depending on the current capabilities and availability of the internet. The local monitoring station situated at the remote site is composed of a data acquisition and preprocessing unit connected to a computer via its RS-232 port, and which communicate using a Java-based client-server architecture. The remote monitoring system so developed was used during an in vivo experiment of the artificial heart implantation for 2 months and performed successfully according to design specifications.

Animals↗
PubMed2004

Surveillance for disparities in maternal health-related behaviors--selected states, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001.

PROBLEM/CONDITION: Disparities in maternal and infant health have been observed among members of different racial and ethnic populations and persons of differing socioeconomic status. For the Healthy People 2010 objectives for maternal and child health to be achieved (US Department of Health and Human Services. Healthy People 2010. 2nd ed. With understanding and improving health and objectives for improving health [2 vols.]. Washington DC: US Department of Health and Human Services, 2000), the nature and extent of disparities in maternal behaviors that affect maternal or infant health should be understood. Identifying these disparities can assist public health authorities in developing policies and programs targeting persons at greatest risk for adverse health outcomes. REPORTING PERIOD COVERED: 2000-2001. DESCRIPTION OF THE SYSTEM: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and after pregnancy among women who deliver live-born infants. PRAMS employs a mixed mode data-collection methodology; up to three self-administered surveys are mailed to a sample of mothers, and nonresponders are followed up with telephone interviews. Self-reported survey data are linked to selected birth certificate data and weighted for sample design, nonresponse, and noncoverage to create annual PRAMS analysis data sets that can be used to produce statewide estimates of different perinatal health behaviors and experiences among women delivering live infants in 31 states and New York City. This report summarizes data for 2000-2001 from eight states (Alabama, Colorado, Florida, Hawaii, Illinois, Maine, Nebraska, and North Carolina) on four behaviors (smoking during pregnancy, alcohol use during pregnancy, breastfeeding initiation, and use of the infant back sleep position) for which substantial health disparities have been identified previously. RESULTS: Although the prevalence of each behavior varied by state, consistent patterns were observed among the eight states by age, race, ethnicity, education, and income level. Overall, the prevalence of smoking during pregnancy ranged from 9.0% to 17.4%. Younger (aged <25 years) women, white women, American Indian women, non-Hispanic women (except in Hawaii), women with a high school education or less, and women with low incomes consistently reported the highest rates of smoking. Overall, the prevalence of alcohol use during pregnancy ranged from 3.4% to 9.9%. In seven states, women aged >35 years, non-Hispanic women, women with more than a high school education, and women with higher incomes reported the highest prevalence of alcohol use during pregnancy. Overall, the prevalence of breastfeeding initiation ranged from 54.8% to 89.6%. Younger women, black women, women with a high school education or less, and women with low incomes reported the lowest rates of breastfeeding initiation. The size of the black-white disparity in breastfeeding varied among states. Overall, use of the back sleep position for infants ranged from 49.7% to 74.8%. Use of the back sleep position was lowest among younger women, black women, women with lower levels of education, and women with low incomes. Ethnic differences in sleep position varied substantially by state. INTERPRETATION: PRAMS data can be used to identify racial, ethnic, and socioeconomic disparities in critical maternal health-related behaviors. Although similar general patterns by age, education, and income were observed in at least seven states, certain racial and ethnic disparities varied by state. Prevalence of the four behaviors among each population often varied by state, indicating the potential impact of state-specific policies and programs. PUBLIC HEALTH ACTION: States can use PRAMS data to identify populations at greatest risk for maternal behaviors that have negative consequences for maternal and infant health and to develop policies and plan programs that target populations at high risk.sk. Although prevalence data cannot be used to identify causes or interventions to improve health outcomes, they do indicate the magnitude of disparities and identify populations that should be targeted for intervention. This report indicates a need for wider targeting than is often done. The results from this report can aid state and national agencies in creating more effective public health policies and programs. The data described in this report should serve as a baseline that states can use to measure the impact of policies and programs on eliminating these health disparities.

Female↗
PubMed1994

Design, calibration, and operation of 220Rn stack effluent monitoring systems at Argonne National Laboratory.

A group of stack effluent monitoring systems have been developed to monitor discharges of 220Rn from a hot cell facility at Argonne National Laboratory. The stack monitors use flow-through scintillation cells and are completely microprocessor-based systems. A method for calibrating the stack monitors in the laboratory and in the field is described. A nominal calibration factor for the stack monitoring systems in use is 15.0 cts min-1 per kBq m-3 (0.56 cts min-1 per pCi L-1) +/- 26% at the 95% confidence level. The plate-out fraction of decay products in the stack monitor scintillation cells, without any pre-filtering, was found to be nominally 25% under normal operating conditions. When the sample was pre-filtered upstream of the scintillation cell, the observed cell plate-out fraction ranged from 16-22%, depending on the specific sampling conditions. The instantaneous 220Rn stack concentration can be underestimated or overestimated when the steady state condition established between 220Rn and its decay products in the scintillation cell is disrupted by sudden changes in the monitored 220Rn concentration. For long-term measurements, however, the time-averaged response of the monitor represents the steady state condition and leads to a reasonable estimate of the average 220Rn concentration during the monitoring period.

Calibration↗
PubMed1995

Efficiency and accuracy of disease monitoring systems: application of capture-recapture methods to injury monitoring.

Capture-recapture methods were employed to determine the most accurate and efficient approaches to monitor adolescent injuries. Multiple sources were used to ascertain cases of adolescent injuries that occurred between September 1 and December 31, 1991, in a single school district in metropolitan Pittsburgh, Pennsylvania. Eliminating the duplicate cases between the sources revealed 144 verified injuries; 127 (88.2%) were identified by student monthly recalls, 33 (22.9%) by daily attendance records, 58 (40.3%) by medical excuses, and 72 (50.0%) by a 4-month student recall. Capture-recapture analyses were undertaken to assess potential dependencies between the sources, to estimate the degree of underascertainment in the population, and to evaluate the efficiency of the individual sources and the combinations between them. It was estimated that 91% of the cases in the population were ascertained when all four methods of case finding were utilized. Furthermore, the analysis indicated that accurate injury estimates could be achieved using combinations of only two or three of the sources. An analysis of the efficiency of the methods of ascertainment revealed a trade-off between effort (the number of hours needed to identify cases) and the precision (coefficient of variation) of the injury estimates. Capture-recapture analysis not only provided an approach to evaluate and adjust for undercount but also offered a formal means to evaluate the most efficient combination of the sources to maximize completeness while minimizing effort. The use of these techniques has the potential to evaluate and improve injury surveillance as well as other disease monitoring systems.

Adolescent↗