Development and Validation of an Algorithm for the Digitization of ECG Paper Images.

The electrocardiogram (ECG) signal describes the heart's electrical activity, allowing it to detect several health conditions, including cardiac system abnormalities and dysfunctions. Nowadays, most patient medical records are still paper-based, especially those made in past decades. The importance of collecting digitized ECGs is twofold: firstly, all medical applications can be easily implemented with an engineering approach if the ECGs are treated as signals; secondly, paper ECGs can deteriorate over time, therefore a correct evaluation of the patient's clinical evolution is not always guaranteed. The goal of this paper is the realization of an automatic conversion algorithm from paper-based ECGs (images) to digital ECG signals. The algorithm involves a digitization process tested on an image set of 16 subjects, also with pathologies. The quantitative analysis of the digitization method is carried out by evaluating the repeatability and reproducibility of the algorithm. The digitization accuracy is evaluated both on the entire signal and on six ECG time parameters (R-R peak distance, QRS complex duration, QT interval, PQ interval, P-wave duration, and heart rate). Results demonstrate the algorithm efficiency has an average Pearson correlation coefficient of 0.94 and measurement errors of the ECG time parameters are always less than 1 mm. Due to the promising experimental results, the algorithm could be embedded into a graphical interface, becoming a measurement and collection tool for cardiologists.

Laser ablation of the biliary tree: in vivo proof of concept as potential treatment of unresectable cholangiocarcinoma.

OBJECTIVES: The palliative treatment of cholangiocarcinoma is based on stent placement with well-known procedure-related complications. Consequently, alternative energy-based techniques were put forward with controversial long-term results. This study aims to evaluate the safety and effectiveness of biliary tree laser ablation (LA) in terms of: (i) absence of perforation, (ii) temperature increase, (iii) induced thermal damage in in vivo models. MATERIALS AND METHODS: The common bile duct and cystic ducts of two pigs were ablated with a diode laser (circumferential irradiation pattern) for 6 and 3 min at 7 W. Laser settings were chosen from previous ex vivo experiments. Local temperature was monitored through a fibre Bragg grating (FBG) sensor embedded into the laser delivery probe. Histopathological analysis of the ablated specimen was performed through in situ endomicroscopy, haematoxylin and eosin (H&E) and nicotinamide adenine dinucleotide (NADH) stains. RESULTS: Temperature reached a plateau of 53 °C with consequent thermal damage on the application area, regardless of laser settings and application sites. No perforation was detected macroscopically or microscopically. At the H&E stain, wall integrity was always preserved. The NADH stain allowed to evaluate damage extension. It turned out that the ablation spreading width depended on application time and duct diameter. In situ endomicroscopy revealed a clear distinction between ablated and non-ablated areas. CONCLUSIONS: The temperature distribution obtained through LA proved to induce a safe and effective intraductal coagulative necrosis of biliary ducts. These results represent the basis for further experiments on tumour-bearing models for the treatment of obstructive cholangiocarcinoma.

Design and deployment of low-cost plastic optical fiber sensors for gas monitoring.

This paper describes an approach to develop and deploy low-cost plastic optical fiber sensors suitable for measuring low concentrations of pollutants in the atmosphere. The sensors are designed by depositing onto the exposed core of a plastic fiber thin films of sensitive compounds via either plasma sputtering or via plasma-enhanced chemical vapor deposition (PECVD). The interaction between the deposited layer and the gas alters the fiber's capability to transmit the light, so that the sensor can simply be realized with a few centimeters of fiber, an LED and a photodiode. Sensors arranged in this way exhibit several advantages in comparison to electrochemical and optical conventional sensors; in particular, they have an extremely low cost and can be easily designed to have an integral, i.e., cumulative, response. The paper describes the sensor design, the preparation procedure and two examples of sensor prototypes that exploit a cumulative response. One sensor is designed for monitoring indoor atmospheres for cultural heritage applications and the other for detecting the presence of particular gas species inside the RPC (resistive plate chamber) muon detector of the Compact Muon Solenoid (CMS) experiment at CERN in Geneva.

On the Use of Temperature Measurements as a Process Analytical Technology (PAT) for the Monitoring of a Pharmaceutical Freeze-Drying Process.

The measurement of product temperature is one of the methods that can be adopted, especially in the pharmaceutical industry, to monitor the freeze-drying process and to obtain the values of the process parameters required by mathematical models useful for in-line (or off-line) optimization. Either a contact or a contactless device and a simple algorithm based on a mathematical model of the process can be employed to obtain a PAT tool. This work deeply investigated the use of direct temperature measurement for process monitoring to determine not only the product temperature, but also the end of primary drying and the process parameters (heat and mass transfer coefficients), as well as evaluating the degree of uncertainty of the obtained results. Experiments were carried out with thin thermocouples in a lab-scale freeze-dryer using two different model products, sucrose and PVP solutions; they are representative of two types of commonly freeze-dried products, namely those whose structures are strongly nonuniform in the axial direction, showing a variable pore size with the cake depth and a crust (leading to a strongly nonlinear cake resistance), as well as those whose structures are uniform, with an open structure and, consequently, a cake resistance varying linearly with thickness. The results confirm that the model parameters in both cases can be estimated with an uncertainty that is in agreement with that obtained with other more invasive and expensive sensors. Finally, the strengths and weaknesses of the proposed approach coupled with the use of thermocouples was discussed, comparing with a case using a contactless device (infrared camera).

Effects of Face Masks on Physiological Parameters and Voice Production during Cycling Activity.

This study investigates the effects of face masks on physiological and voice parameters, focusing on cyclists that perform incremental sports activity. Three healthy male subjects were monitored in a climatic chamber wearing three types of masks with different acoustic properties, breathing resistance, and air filtration performance. Masks A and B were surgical masks made of hydrophobic fabric and three layers of non-woven fabric of 100% polypropylene, respectively. Mask S was a multilayer cloth mask designed for sports activity. Mask B and Mask S behave similarly and show lower sound attenuation and sound transmission loss and lower breathing resistance than Mask A, although Mask A exhibits slightly higher filtration efficiency. Similar cheek temperatures were observed for Masks A and B, while a significantly higher temperature was measured with Mask S at incremental physical activity. No differences were found between the masks and the no-mask condition for voice monitoring. Overall, Mask B and Mask S are suitable for sports activities without adverse effects on voice production while ensuring good breathing resistance and filtration efficiency. These outcomes support choosing appropriate masks for sports activities, showing the best trade-off between breathing resistance and filtration efficiency, sound attenuation, and sound transmission loss.

Linearly chirped fiber Bragg grating response to thermal gradient: from bench tests to the real-time assessment during in vivo laser ablations of biological tissue.

The response of a fiber optic sensor [linearly chirped fiber Bragg grating (LCFBG)] to a linear thermal gradient applied on its sensing length (i.e., 1.5 cm) has been investigated. After these bench tests, we assessed their feasibility for temperature monitoring during thermal tumor treatment. In particular, we performed experiments during ex vivo laser ablation (LA) in pig liver and in vivo thermal ablation in animal models (pigs). We investigated the following: (i) the relationship between the full width at half maximum of the LCFBG spectrum and the temperature difference among the extremities of the LCFBG and (ii) the relationship between the mean spectrum wavelength and the mean temperature acting on the LCFBG sensing area. These relationships showed a linear trend during both bench tests and LA in animal models. Thermal sensitivity was significant although different values were found with regards to bench tests and animal experiments. The linear trend and significant sensitivity allow hypothesizing a future use of this kind of sensor to monitor both temperature gradient and mean temperature within a tissue undergoing thermal treatment.