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PubMed1991

128-channel cable-telemetry EEG recording system for long-term invasive monitoring.

A 128-channel cable-telemetry EEG monitoring system has been developed for use on patients undergoing intensive neurodiagnostic monitoring with invasive intracranial electrodes. A unique head mounted preamplifier/multiplexor design allows continuous recording from any combination of intracerebral, subdural, epidural or surface electrodes. A computer is used to delay or buffer all 128 channels by 2 min or more. This computer is connected to a fileserver via a local area network and is used exclusively for data acquisition. Seizure files created by the activation of the seizure/event push button or detected by a second computer containing on-line seizure/spike detection algorithms are written directly on to the fileserver by the acquisition computer. The 128 channels of EEG recorded on the fileserver can then be remotely reviewed on a high resolution graphics terminal, printed out on a laser jet printer, archived or played out on paper, 16 channels at a time on any EEG machine. A time of day signal is also generated by the computer to permit time correlation with a continuous audio/video VCR unit which permits comparison of the EEG and clinical events. This system allows continuous EEG monitoring of extensive multichannel arrays not previously possible with conventional 16-, 32- or even 64-channel systems.

Electroencephalography↗
PubMed2006

Development of an Internet-based real-time system for monitoring pharmacological interventions in children with neurodevelopmental and neuropsychiatric disorders.

Few children have a 'pure' diagnosis of neuropsychiatric disorders such as attention deficit hyperactivity disorder or autism. Most have complex, overlapping symptoms, and it is often these associated and common comorbidities that cause as much, if not more impairments, than the core symptoms. Prescribing decisions are therefore complex and made on the basis of eliciting a range of agreed 'target symptoms'. At present, however, there are no agreed systems that allow monitoring of all areas of potential change, and few services are able to monitor symptoms, side effects, impact on family life and individual children's quality of life systematically. At best many clinics use a plethora of paper-based standardized questionnaires, based on individual diagnoses. This article describes the development of a novel biomedical informatics system that has been designed to allow parents, professionals and children to use a web-based, real-time symptom monitoring system to enable more effective treatments, better pathways of shared care, and more equitable and efficient service delivery for this group of vulnerable children.

Attention↗
PubMedDate not supplied

[Creation of a system for monitoring the technologic quality of medical instruments and apparatus].

Arguments in favor of possible construction in this industrial branch of systems capable of monitoring technological effectiveness of medical instruments and apparatus are put forward. Introduction into the industry of a system for monitoring technological effectiveness will help improve the designing of medical instruments and apparatus in so far as their technological effectiveness is concerned and, by the same token, reduce labour- and metal-consumption, as well as the cost of preparatory work and to cut down the time spent in mastering batch production of new articles.

Computers↗
PubMed2002

Survey of adverse drug reactions on a pediatric ward: a strategy for early and detailed detection.

OBJECTIVE: Adverse drug reactions (ADRs) occur frequently in children. However, the exact incidence of ADRs is unknown. Therefore, we studied ADRs in 1 ward and assessed whether a general approach, eg, by a computerized monitoring system, to detect ADRs in children is feasible and likely to yield a higher rate of early detected ADRs. The aim was to assess the usefulness of a computerized monitoring system before implementing costly adaptations. METHODS: An 8-month prospective study was conducted at a 10-bed pediatric isolation ward of the University Hospital. Charts were reviewed once weekly by a pharmacoepidemiological team. Clinical signs as well as laboratory changes were documented and assessed. Algorithms were used to assess the probability and severity of each detected event. RESULTS: All 214 patients admitted were enrolled in the study. A total of 68 ADRs were detected in 46 of 214 patients by the pharmacoepidemiological team. Thirty-four ADRs (50%) were detected by the staff physician, and 27 (40%) were detected primarily by analyzing laboratory parameters. Antibiotics-associated ADRs (50%) predominated, followed by glucocorticoids (16%), tuberculostatic (4%), and immunosuppressive agents (4%). In 5 cases, an ADR was responsible for the prolongation of hospital stay, and in 4 children, the ADR was responsible for hospitalization. CONCLUSIONS: The detection rate of ADRs would almost be doubled by a computerized monitoring system analyzing laboratory data. Implementation of a computer monitor system that automatically generates laboratory signals may help to identify ADRs in children, and to reduce morbidity and hospital stay, as well as costs.

Adolescent↗
PubMed1981

[Quality control of computer-assisted arrhythmia monitoring].

In the management of coronary care patients, continuous ECG analysis is best performed by a computerized monitoring system. For more than 2 years all the patients in this CCU have been monitored by the 78220 Hewlett-Packard arrhythmia monitoring system. As a quality control of the system the data of 15,068 alarm situations in 300 patients were first analyzed: the specificity of the system varied from 3% to 83% according to type and severity of arrhythmias. To evaluate the sensitivity of the system the amount of VES registered by Holter monitoring was then compared with the analysis by computerized monitoring during the same period of time: in a total of over 10,000 VES in 14 patients the sensitivity was 90%. Although the personnel of a CCU still have to deal with a large number of false positive alarms, a computerized arrhythmia monitoring system offers a higher degree of security for the patient than conventional monitoring.

Arrhythmias, Cardiac↗
PubMed1992

Two key factors that belong in a macroergonomic analysis of electronic monitoring: Employee perceptions of fairness and the climate of organizational trust or distrust.

Two microergonomic elements not usually discussed in treatments of electronic monitoring of VDT clerical work are employee perceptions of fairness (in work standards and measurement process) and the overall climate of employee trust in management. The author's field studies found these factors serving as major mitigating or intensifying elements in the stress that clerical employees can experience when they perform intensive heavy-duty VDT applications, and as central variables in distinguishing beneficial from harmful monitoring programmes. A case study involving change in supervisory monitoring policies for 200 customer service agents at one of Federal Express Corporation's telecommunication call centres in the USA in 1985-86 demonstrates how a Unit Head at a non-union company long known for its positive employee relations policies installed monitoring practices that the call agents considered unfair and a breach of the company's traditional climate of employee-employer trust. Employee protests, when communicated to top management, led to discarding the unilaterally-instituted and quantity-oriented monitoring policy and replacing it with a consensually-developed supervisory monitoring system balancing quality and quantity elements in a way that satisfied both employees and management. The present system of supervisory monitoring of customer service work at Federal Express (1991) enjoys broad employee support, suggesting that a fair system of monitoring, applied in an environment of earned trust between employees and employer, can meet critical productivity and quality interests of employers in clerical VDT work without creating harmful employee stress and discontent. It also suggests that empirical investigation of the fairness and trust factors represents an important and practical area of research in a macroergonomic analysis of employee monitoring programs and impacts.

Journal Article↗
PubMed2003

Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia--part I: pressure recordings.

BACKGROUND: The purpose of this study was to establish standards for the pressure monitoring system and to define the pressure pattern during percutaneous trigeminal ganglion compression for treatment of trigeminal neuralgia. METHODS: Seventy-five patients with intractable trigeminal neuralgia who underwent percutaneous trigeminal ganglion balloon compression were included in this study. A computerized pressure system was used for pressure monitoring and analysis. RESULTS: The procedural pressure patterns of the balloon opening pressure and the initial compression pressure were identified. On average, the balloon opening pressure was 2956 +/- 185 mm Hg in Meckel's cave (area 2) and it was much higher than that outside the foramen ovale (area 1, 2402 +/- 172 mm g), or in the posterior fossa (area 3, 2120 +/- 127 mm Hg) (p < 0.05). The average initial compression pressure in area 2 was 1204 +/- 105 mm Hg, and it was also significantly higher than those in area 1 (728 +/- 42 mm Hg) and area 3 (458 +/- 72 mm Hg) (p < 0.05). CONCLUSIONS: The pressure monitoring system has proven to be accurate, reliable, and extremely useful for monitoring the percutaneous trigeminal ganglion balloon compression procedure.

Adult↗
PubMed2001

A cell-based assay system for monitoring NF-kappaB activity in human HaCat transfectant cells.

A cell-based assay system for monitoring NF-kappaB activity was developed to determine the influence of activated NF-kappaB in human HaCaT cells. The pNF-kappaB-SEAP-NPT plasmid that permits expression of the secretory alkaline phosphatase (SEAP) reporter gene in response to the NF-kappaB activity and contains the neomycin phosphotransferase (NPT) gene for geneticin resistance in host cells was constructed and transfected into the human keratinocyte cell line HaCaT. Human HaCaT transfectant cells were demonstrated to secrete the SEAP enzyme into the culture medium in a time-dependent manner until 72 h. NF-kappaB activities were measured by the SEAP reporter gene assay using a fluorescence detection method. HaCaT cell transfectants treated with antioxidants [e.g., N-acetyl-l-cysteine and vitamin C] showed reduction of NF-kappaB activity in a time- and concentration-dependent manner, whereas phorbol 12-myristate 13-acetate known as a stimulator of NF-kappaB expression increased NF-kappaB activity in a time- and concentration-dependent manner. This assay system could be used to determine the quantitative measurement of NF-kappaB activity in the human skin and allow the screening of anti-inflammatory agents for dermatological purpose from various synthetic chemicals and natural products.

Anti-Inflammatory Agents↗
PubMed1998

Multiagency outcome evaluation of children's services: a case study.

Outcome monitoring has become a focus of accountability for public and nonprofit human service agencies. Besides providing answers to funders' questions about the services' impact, outcome monitoring helps administrators improve program effectiveness. After a three-year development period and a one-year implementation experience, SumOne for Kids represents a technically advanced outcome-monitoring system for children's mental health and/or child welfare services. Initiated, designed, and tested by 31 children's service agencies throughout Pennsylvania, and with state bureaucrats' and policy makers' encouragement, SumOne for Kids represents an effort to create a bottom-up/top-down process for implementing a statewide outcome-monitoring system. This article describes the genesis of this outcome-monitoring system, primary design principles, use of social validation for outcome selection, resolution of methodological difficulties, and reasons for selecting functional over clinical outcomes. The article reviews lessons learned through the development experience instructive to children's service managers, program evaluators, and industry leaders interested in establishing outcome-monitoring systems.

Child↗
PubMed1988

Anesthesia gas monitoring: central system or stand-alone?

Two approaches to intraoperative anesthetic gas monitoring exist today. Central, mass-spectrometer-based systems share cost and analyzer time among several remote locations. Stand-alone monitors are usually infrared analyzers and are dedicated to a single monitoring location. The advantages and disadvantages of each are due primarily to the shared versus dedicated approaches. Dedicated analyzers, while limited somewhat by infrared technology, offer uninterrupted, real-time analysis of anesthetic and respiratory gases. Central systems offer excellent monitoring but are limited to periodic updates of each monitored location. This article attempts a complete analysis of these and other factors affecting the use, reliability, and cost effectiveness of these two approaches to anesthesia gas monitoring.

Anesthesia, Inhalation↗
PubMed2003

Accuracy of a web-based system for monitoring chronic wounds.

This study evaluated the accuracy of a store-and-forward telemedicine system for assessing the status of chronic wounds, including those surgically repaired. Digital photos and other patient and wound data were collected by a nurse using a laptop and transmitted via the Internet to a database, which organized and posted the data onto a web page for access by the telemedicine physician. Two Veterans' Affairs (VA) medical centers and two specialties (plastic surgery, physical medicine and rehabilitation) participated in the study. Study patients included inpatients and outpatients with pressure ulcers of stage II, III, or IV, plus outpatients with diabetic foot ulcers or venous stasis ulcers. All patients were assessed both in-person (the "gold standard") and with the telemedicine system using yes/no responses and a 5-point scale, respectively, on four diagnostic questions concerning wound healing and infection, based on AHCPR guidelines. A total of 70 patients were enrolled, with data collected on 430 visits: up to 6 visits per wound. Percentage agreement for all visits ranged from 67.1 for "not healing" to 88.8 for "cellulitis present." Sensitivity ranged from 0.32 for cellulitis to 0.63 for necrosis; and specificity ranged from 0.80 for necrosis to 0.91 for cellulitis. Although agreement of the telemedicine system was not high, it was not significantly less than interphysician agreement on in-person assessments. A relatively inexpensive store-and-forward telemedicine system for monitoring the status of chronic wounds has the potential to improve access to specialty care for patients who are not currently receiving routine monitoring by specialized nurses or physicians.

Adult↗
PubMed2005

A wearable health care system based on knitted integrated sensors.

A comfortable health monitoring system named WEALTHY is presented. The system is based on a textile wearable interface implemented by integrating sensors, electrodes, and connections in fabric form, advanced signal processing techniques, and modern telecommunication systems. Sensors, electrodes and connections are realized with conductive and piezoresistive yarns. The sensorized knitted fabric is produced in a one step process. The purpose of this paper is to show the feasibility of a system based on fabric sensing elements. The capability of this system to acquire simultaneously several biomedical signals (i.e. electrocardiogram, respiration, activity) has been investigated and compared with a standard monitoring system. Furthermore, the paper presents two different methodologies for the acquisition of the respiratory signal with textile sensors. Results show that the information contained in the signals obtained by the integrated systems is comparable with that obtained by standard sensors. The proposed system is designed to monitor individuals affected by cardiovascular diseases, in particular during the rehabilitation phase. The system can also help professional workers who are subject to considerable physical and psychological stress and/or environmental and professional health risks.

Clothing↗
PubMed1993

A system for monitoring temperature distribution in bed and its application to the assessment of body movement.

For the assessment of body movements during sleep, a system for monitoring the temperature in bed was developed. The system consists of 16 temperature sensors and a data logger with a memory card. Fifteen of the temperature sensors were arranged in line 6 cm apart on a flat cable. The temperatures at these 15 points in the bed, and the room temperature measured by the additional sensor, were stored on the memory card at predetermined intervals. The data were transferred into a microcomputer and analysed. Changes in posture and body movement were recognizable from the changes in the temperature profile, and well visualized using a three-dimensional display of the successive temperature profiles in the bed. The time of body movement was estimated from the derivative of the temperature profile. Comparison between this estimation and the video recording showed good agreement. The linear arrangement of the sensors provides a high-resolution temperature profile during sleep.

Adult↗
PubMed1993

Development of a microcomputer-based system to monitor the electrical and chemical responses of nerve fiber.

The objective of this project is to develop a microcomputer-based system to monitor the electrical and chemical responses of nerve fiber individually and in combination. The system is capable of controlling eight nerve fiber samples simultaneously, and allows the researcher to: (i) study the effects of different stimulus amplitudes, and duration, (ii) provide real-time data processing, and (ii) store the collected data and display result in a tabular form and/or graphically. The system consists of two subsystems, the microcomputer and the analog subsystem. The microcomputer is a 80486-based microcomputer system. The analog subsystem consists of Instrumentation Amplifiers, Analog Multiplexer, Analog-to-Digital Converter, Digital-to-Analog Converter, and Sample-and-Hold with multiplexed input. In addition to the hardware, the software is being developed which consists of a main program and many other routines.

Computer Systems↗
PubMed2005

Automated Water Analyser Computer Supported System (AWACSS) Part II: Intelligent, remote-controlled, cost-effective, on-line, water-monitoring measurement system.

A novel analytical system AWACSS (Automated Water Analyser Computer Supported System) based on immunochemical technology has been evaluated that can measure several organic pollutants at low nanogram per litre level in a single few-minutes analysis without any prior sample pre-concentration or pre-treatment steps. Having in mind actual needs of water-sector managers related to the implementation of the Drinking Water Directive (DWD) [98/83/EC, 1998. Council Directive (98/83/EC) of 3 November 1998 relating to the quality of water intended for human consumption. Off. J. Eur. Commun. L330, 32-54] and Water Framework Directive (WFD) [2000/60/EC, 2000. Directive 2000/60/EC of the European Parliament and of the Council of 23 October 2000 establishing a framework for Community action in the field of water policy. Off. J. Eur. Commun. L327, 1-72], drinking, ground, surface, and waste waters were major media used for the evaluation of the system performance. The first part article gave the reader an overview of the aims and scope of the AWACSS project as well as details about basic technology, immunoassays, software, and networking developed and utilised within the research project. The second part reports on the system performance, first real sample measurements, and an international collaborative trial (inter-laboratory tests) to compare the biosensor with conventional anayltical methods. The systems' capability for analysing a wide range of environmental organic micro-pollutants, such as modern pesticides, endocrine disrupting compounds and pharmaceuticals in surface, ground, drinking and waste water is shown. In addition, a protocol using reconstitution of extracts of solid samples, developed and applied for analysis of river sediments and food samples, is presented. Finally, the overall performance of the AWACSS system in comparison to the conventional analytical techniques, which included liquid and gas chromatographic systems with diode-array UV and mass spectrometric detectors, was successfully tested in an inter-laboratory collaborative trial among six project partners.

Algorithms↗
PubMed1994

A knowledge-based alarm system for monitoring cardiac operated patients--assessment of clinical performance.

An intelligent alarm system for the postoperative monitoring of cardiac surgery patients, which did not require any manual data entries, was tested in two phases. A clinician monitored at bedside the patients' recovery and verified clinically abnormal physiological states. After the first test with ten patients, the system's rulebase was upgraded and then tested with an additional 15 patients. The alarm system employed two PC/ATs and was programmed to give notice of four pathological states (hyperdynamic state, hypovolemic state, hypoventilation and left ventricular failure) at two levels of urgency (alarm and alert levels). The monitoring lasted 5.4 +/- 1.7 hours per patient (mean +/- S.D.), totalling 134.7 hours. The system alarmed 27 times during the first and 73 times during the second phase of the testing. The sensitivity of the alarms was 100% in both phases, and the specificities increased from 20.0% to 73.9% and from 59.1% to 70.0% for the alarms and the alerts, respectively. This computerized decision support system based exclusively on data available in the automatically collected data base had a low false positive rate and gave early warnings about pathological states in the homogeneous group of adult postoperative cardiac patients.

Adult↗
PubMed1979

An assessment of a system to monitor the activity of patients in a rehabilitation programme.

The need for an objective quantitative method of monitoring performance in the natural environment for use in a rehabilitation programme is discussed. A system of monitoring the number of steps taken has been developed for an amputee programme as a first attempt towards this goal. Instrumentation consists of an inexpensive foot switch, a storage unit and a retrieval unit. Early clinical experience indicates this system may be of value in the rehabilitation programme by (1) indicating low or unusual activity and alerting clinical staff to identify the cause. (2) Restricting the over-anxious patient when excessive activity is contra-indicated. (3) Identifying poor use of the prosthesis in the home environment. (4) Providing motivation for patients to set personal goals. (5) Acting as a base line for the evaluation of research and development of new techniques.

Activities of Daily Living↗
PubMedDate not supplied

MAROS: a decision support system for optimizing monitoring plans.

The Monitoring and Remediation Optimization System (MAROS), a decision-support software, was developed to assist in formulating cost-effective ground water long-term monitoring plans. MAROS optimizes an existing ground water monitoring program using both temporal and spatial data analyses to determine the general monitoring system category and the locations and frequency of sampling for future compliance monitoring at the site. The objective of the MAROS optimization is to minimize monitoring locations in the sampling network and reduce sampling frequency without significant loss of information, ensuring adequate future characterization of the contaminant plume. The interpretive trend analysis approach recommends the general monitoring system category for a site based on plume stability and site-specific hydrogeologic information. Plume stability is characterized using primary lines of evidence (i.e., Mann-Kendall analysis and linear regression analysis) based on concentration trends, and secondary lines of evidence based on modeling results and empirical data. The sampling optimization approach, consisting of a two-dimensional spatial sampling reduction method (Delaunay method) and a temporal sampling analysis method (Modified CES method), provides detailed sampling location and frequency results. The Delaunay method is designed to identify and eliminate redundant sampling locations without causing significant information loss in characterizing the plume. The Modified CES method determines the optimal sampling frequency for a sampling location based on the direction, magnitude, and uncertainty in its concentration trend. MAROS addresses a variety of ground water contaminants (fuels, solvents, and metals), allows import of various data formats, and is designed for continual modification of long-term monitoring plans as the plume or site conditions change over time.

Cost-Benefit Analysis↗