National hand hygiene campaigns in Europe, 2000-2009.

Hand hygiene represents the single most effective way to prevent healthcare-associated infections. The World Health Organization, as part of its First Global Patient Safety Challenge, recommends implementation of multi-faceted strategies to increase compliance with hand hygiene. A questionnaire was sent by the European Centre for Disease Prevention and Control to 30 European countries, regarding the availability and organisation of their national hand hygiene campaigns. All countries responded. Thirteen countries had organised at least one national campaign during the period 2000-2009 and three countries were in the process of organising a national campaign. Although the remaining countries did not have a national campaign, several reported regional and local hand hygiene activities or educational resources on national websites.

Noise reduction in magnetocardiography by singular value decomposition and independent component analysis.

In the routine recording of magnetocardiograms (MCGs), it is necessary to underline the problem of noise cancellation. Source separation has often been suggested to solve this problem. In this paper, blind source separation (BSS), by means of singular value decomposition (SVD) and independent component analysis (ICA), was used for noise reduction in MCG data to improve the signal to noise ratio. Special techniques, based on statistical parameters, for identifying noise and disturbances, have been introduced to automatically eliminate noise-related and disturbance-related components before reconstructing cleaned data sets. The results show that ICA and SVD can detect and remove a variety of noise and artefact sources from MCG data, as well as from stress MCG.

Using independent component analysis for noise reduction of magnetocardiographic data in case of exercise with an ergometer.

In 1992, Brockmeier et al. showed that there is a strong difference in magnetocardiography (MCG)-detected field distribution generated by the heart at rest and under stress. To study the possible clinical applications of this finding, it is convenient to avoid pharmacological stress and to perform stress MCG (SMCG) using conventional physical stress with an ergometer. When using a non-magnetic ergometer, the MCG recordings under physical stress are more noisy due to the unavoidable movement artefacts from the patient and from the residual artefacts of the ergometer. To remove these artefacts a denoising was performed using independent component analysis (ICA) in a new implementation. This work shows that with ICA in this special implementation it is becoming feasible to extract heart signals from SMCG data recorded during ergometer exercise.

A novel approach for the averaging of magnetocardiographically recorded heart beats.

Performing signal averaging in an efficient and correct way is indispensable since it is a prerequisite for a broad variety of magnetocardiographic (MCG) analysis methods. One of the most common procedures for performing the signal averaging to increase the signal-to-noise ratio (SNR) in magnetocardiography, as well as in electrocardiography (ECG), is done by means of spatial or temporal techniques. In this paper, an improvement of the temporal averaging method is presented. In order to obtain an accurate signal detection, temporal alignment methods and objective classification criteria are developed. The processing technique based on hierarchical clustering is introduced to take into account the non-stationarity of the noise and, to some extent, the biological variability of the signals reaching the optimum SNR. The method implemented is especially designed to run fast and does not require any interaction from the operator. The averaging procedure described in this work is applied to the averaging of MCG data as an example, but with its intrinsic properties it can also be applied to the averaging of ECG recording, averaging of body-surface-potential mapping (BSPM) and averaging of magnetoencephalographic (MEG) or electroencephalographic (EEG) signals.

Open magnetic and electric graphic analysis.

The OMEGA software provides an analysis platform for user-independent, fast, and reproducible multimodal data analysis in one single software environment. Synergetic interactions pursued between the two functional imaging techniques fMRI and MEG use the morphological MRI recording as a basis for a common coordinate frame. In this way, direct interchange, comparison, and integration among the results of the different modalities have become feasible. The fMRI data analysis provides information about the localization of functional activity with low temporal resolution, whereas the MEG recording complements the corresponding time evolution with a high temporal resolution. The implementation of OMEGA allows the analyst to receive comprehensive MEG/fMRI results in a matter of minutes after the measurements have been completed. With OMEGA, the clinical researcher gets comprehensive information in a quick and standardized approach about the sites and the time course of neurological activation, which is useful for clinical applications and diagnostics.

A new strategy for easy volume conductor modelling in magnetocardiography.

Modelling the electromagnetic properties of the thorax in magnetocardiographic (MCG) studies is usually performed by the Boundary Element Method (BEM). Magnetic Resonance Imaging (MRI) scans are generally used as the basis for extracting the coordinates for BEM. As MRI is a (time) expensive technique and scanners have a high use demand, in this work a strategy is presented that reduces the costs and the need for additional MRI images. This strategy is based on the use of low resolution and incomplete MRI image sets of the thorax.

Neuromagnetic fields of the brain evoked by voluntary movement and electrical stimulation of the index finger.

Neuromagnetic fields from the left cerebral hemisphere of five healthy, right-handed subjects were investigated under two different experimental conditions: (1) electrical stimulation of the right index finger (task somatosensory evoked fields, task SEF's), and (2) voluntary movement of the same finger referred to as movement-related fields, (MRFs). The two conditions were, performed in random order every 5-8 s. In addition, the task SEF's were compared to control SEF's recorded at the beginning of the experiment in order to find the optimal dewar position for localizing the central sulcus. The magnetic signals of the sources corresponding to the main components of the somatosensory evoked fields (early ones at 24 ms and at 34 ms, and late ones after 50 ms) and movement-related fields (motor field, MF and movement-evoked field I-MEF I) were mapped and localized by means of a moving dipole model. In four out of five subjects the MEF I dipoles were found to be located deeper than the early task SEF dipoles. In addition, all of the task SEF's components were found to exhibit larger amplitudes than the control SEF's components. The results are discussed in respect to the ability to selectively analyze contributions of mainly proprioceptive (area 3a) and cutaneous (area 3b) areas in the primary somatosensory cortex using magnetoencephalography. An additional finding of the study was that all of the task SEF's components were found to exhibit larger amplitudes than the control SEF's components.

The geomagnetic field: a factor in cellular interactions? I. Magnetism and Schwann cell-axon interaction in the peripheral nerves of the newborn rat.

Axonal ensheathment and myelination, one form of axon-sheath cell interaction, was studied under normal earth magnetism, in the absence of terrestrial magnetic field, and under a 5 G (0.0005 T) magnetic field. Results indicate that the geomagnetic field is necessary for the fundamental biological activity of axonal ensheathment and myelination. The exact mechanism of action remains obscure.

Multichannel magnetic recording of P300 activity.

The magnetic correlate of the P300 wave was registered using a seven-channel detector. The spatial variation of the corresponding field suggests the contribution of outer brain layers to the neural activity of M300.

Nerve, plexus and spinal cord: possible targets for non-invasive neuromagnetic measurements in man.

Somatosensory evoked neuromagnetic fields are recorded from peripheral nerves in the upper arm, from plexus brachialis at the ventral and dorsal thorax and from the dorsal horn of the cervical spinal cord ('P13m') at the upper lateral neck. Some perspectives for clinical applications are suggested.

The study of steady magnetic fields associated with primary and secondary ST shift in ischaemic rabbit hearts.

The study of injury potentials associated with DC currents that generate the primary or secondary ST shifts during cardiac ischaemia is possible only through the invasive technique of the DC electrogram. Clinical surface ECG recordings are AC coupled and cannot be used. This paper reports the use of non-invasive and unshielded magnetocardiographic measurements to evaluate the DC injury currents associated with ST shifts during coronary artery occlusions in the isolated rabbit heart. The effect on the magnetic ST shift is studied under different ischaemic conditions including regional ischaemia, global ischaemia, global ischaemia following long periods of regional ischaemia, regional ischaemia after repeated episodes of reversible global ischaemia, and bilateral regional ischaemia. Recording of DC magnetic fields allows the characterization of primary and secondary ST displacement for each induced ischaemic condition. Our measurements show that the ST shift starts earlier when inducing ischaemia in hearts previously subjected to ischaemic episodes than in hearts where the ischaemia was produced for the first time.

Analysis of the ST-segment in terms of principal components: application on multichannel magnetocardiographic recordings.

Parameterization of the ST-segment is used as a tool for risk stratification for patients to suffer from ventricular tachycardia. This parameterization is performed in terms of Principal Component Analysis (PCA) applied on multichannel magnetocardiographic (MCG) recordings. 55-channel MCG was recorded from 14 normal persons, 10 patients with CHD, 14 patients with MI, and six patients with VT. We found a significantly (p < 0.05) lower PCA-score in patients with MI compared to normals. The lowest PCA-score was found in VT patients. Significant differences can be found between VT patients and normals and also between VT patients and CHD patients.

On the variability of QRS time-duration in magnetocardiographic recordings.

High resolution electrocardiography (HRECG) recordings have already shown an increased beat-to-beat microvariability of the QRS duration of the terminal QRS in patients with a history of ventricular tachycardia (VT). The purpose of this study is to detect QRS-duration microvariability with magnetocardiographic (MCG) recordings in normals, patients with coronary heart disease (CHD), patients with a history of myocardial infarction (MI), and VT patients. QRS microvariability is calculated as the variance of time-shifts of single beats respectively to the average of all beats. The average over all channels of the MCG is performed. QRS microvariability was evaluated from 55-channel MCG in 15 normal persons, in 12 patients with CHD, in 13 patients with MI, and in 10 patients with VT. We found a significantly higher microvariability in patients with MI compared to normals. The highest microvariability was found in VT patients.

Calibration of a vector-MEG helmet system.

The MEG system Argos 500, recently installed at the University of Ulm, is designed for clinical application and routine use, to allow investigation of a large number of patients per day. To reach this goal, the system design meets the requirements of reliability, high field sensitivity, minimal set-up overhead before each measurement and an easy-to-handle user interface. The sensor system consists of a 163 vector-magnetometer array oriented and located in a suitable way to cover the whole head of the patient. Four additional triplets are available as references to build software gradiometers. To use this system at a high performance level, it must be properly calibrated, with these goals: to determine the actual geometry of the sensors array, which can deviate from the design specifications, and to determine the actual sensitivity of each sensor. The calibrating source consists of 31 coils placed at the corners of a head-size dodecahedron. Various details of the calibration system and process are presented here.

Argos 500: operation of a helmet vector-MEG.

We here describe the MEG system recently installed at the University of Ulm; it is specifically designed for clinical application and routine use, to allow investigation of a large number of patients per day. To reach this goal, the system design meets the requirements of reliability, high field sensitivity, minimal set-up time before each measurement and an easy-to-handle user interface. The sensor system consists of a 163 vector-magnetometers array oriented and located in a suitable way to cover the whole head of the patient. Four additional triplets are available as references to arrange software gradiometers. The helmet shaped sensor system is positioned to accommodate the patient in a supine position. Simultaneously to the MEG, there are 64 EEG channels. Other relevant patient information can be recorded up to a total number of 660 acquisition channels. Noise level of a single magnetometer is about 5 fT/square root of Hz. Maximum sampling rate is 4200 Hz.

Optical multichannel room temperature magnetic field imaging system for clinical application.

Optically pumped magnetometers (OPM) are a very promising alternative to the superconducting quantum interference devices (SQUIDs) used nowadays for Magnetic Field Imaging (MFI), a new method of diagnosis based on the measurement of the magnetic field of the human heart. We present a first measurement combining a multichannel OPM-sensor with an existing MFI-system resulting in a fully functional room temperature MFI-system.