RESUMO
BACKGROUND: Automated measurements of electrocardiographic (ECG) intervals by current-generation digital electrocardiographs are critical to computer-based ECG diagnostic statements, to serial comparison of ECGs, and to epidemiological studies of ECG findings in populations. A previous study demonstrated generally small but often significant systematic differences among 4 algorithms widely used for automated ECG in the United States and that measurement differences could be related to the degree of abnormality of the underlying tracing. Since that publication, some algorithms have been adjusted, whereas other large manufacturers of automated ECGs have asked to participate in an extension of this comparison. METHODS: Seven widely used automated algorithms for computer-based interpretation participated in this blinded study of 800 digitized ECGs provided by the Cardiac Safety Research Consortium. All tracings were different from the study of 4 algorithms reported in 2014, and the selected population was heavily weighted toward groups with known effects on the QT interval: included were 200 normal subjects, 200 normal subjects receiving moxifloxacin as part of an active control arm of thorough QT studies, 200 subjects with genetically proved long QT syndrome type 1 (LQT1), and 200 subjects with genetically proved long QT syndrome Type 2 (LQT2). RESULTS: For the entire population of 800 subjects, pairwise differences between algorithms for each mean interval value were clinically small, even where statistically significant, ranging from 0.2 to 3.6milliseconds for the PR interval, 0.1 to 8.1milliseconds for QRS duration, and 0.1 to 9.3milliseconds for QT interval. The mean value of all paired differences among algorithms was higher in the long QT groups than in normals for both QRS duration and QT intervals. Differences in mean QRS duration ranged from 0.2 to 13.3milliseconds in the LQT1 subjects and from 0.2 to 11.0milliseconds in the LQT2 subjects. Differences in measured QT duration (not corrected for heart rate) ranged from 0.2 to 10.5milliseconds in the LQT1 subjects and from 0.9 to 12.8milliseconds in the LQT2 subjects. CONCLUSIONS: Among current-generation computer-based electrocardiographs, clinically small but statistically significant differences exist between ECG interval measurements by individual algorithms. Measurement differences between algorithms for QRS duration and for QT interval are larger in long QT interval subjects than in normal subjects. Comparisons of population study norms should be aware of small systematic differences in interval measurements due to different algorithm methodologies, within-individual interval measurement comparisons should use comparable methods, and further attempts to harmonize interval measurement methodologies are warranted.
Assuntos
Algoritmos , Eletrocardiografia , Síndrome do QT Longo/diagnóstico , Síndrome de Romano-Ward/diagnóstico , Adulto , Precisão da Medição Dimensional , Eletrocardiografia/métodos , Eletrocardiografia/normas , Feminino , Sistema de Condução Cardíaco/diagnóstico por imagem , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Distribuição Aleatória , Processamento de Sinais Assistido por ComputadorRESUMO
Real-time stimulation and recording of neural cell bioelectrical activity could provide an unprecedented insight in understanding the functions of the nervous system, and it is crucial for developing advanced in vitro drug screening approaches. Among organic materials, suitable candidates for cell interfacing can be found that combine long-term biocompatibility and mechanical flexibility. Here, we report on transparent organic cell stimulating and sensing transistors (O-CSTs), which provide bidirectional stimulation and recording of primary neurons. We demonstrate that the device enables depolarization and hyperpolarization of the primary neuron membrane potential. The transparency of the device also allows the optical imaging of the modulation of the neuron bioelectrical activity. The maximal amplitude-to-noise ratio of the extracellular recording achieved by the O-CST device exceeds that of a microelectrode array system on the same neuronal preparation by a factor of 16. Our organic cell stimulating and sensing device paves the way to a new generation of devices for stimulation, manipulation and recording of cell bioelectrical activity in vitro and in vivo.
Assuntos
Potenciais de Ação/fisiologia , Estimulação Elétrica/instrumentação , Eletrodos Implantados , Microeletrodos , Neurônios/fisiologia , Transistores Eletrônicos , Animais , Células Cultivadas , Desenho de Equipamento , Análise de Falha de Equipamento , Compostos Orgânicos/química , Ratos , Refratometria/instrumentaçãoRESUMO
The potential of organic semiconductor-based devices for light generation is demonstrated by the commercialization of display technologies based on organic light-emitting diodes (OLEDs). Nonetheless, exciton quenching and photon loss processes still limit OLED efficiency and brightness. Organic light-emitting transistors (OLETs) are alternative light sources combining, in the same architecture, the switching mechanism of a thin-film transistor and an electroluminescent device. Thus, OLETs could open a new era in organic optoelectronics and serve as testbeds to address general fundamental optoelectronic and photonic issues. Here, we introduce the concept of using a p-channel/emitter/n-channel trilayer semiconducting heterostructure in OLETs, providing a new approach to markedly improve OLET performance and address these open questions. In this architecture, exciton-charge annihilation and electrode photon losses are prevented. Our devices are >100 times more efficient than the equivalent OLED, >2x more efficient than the optimized OLED with the same emitting layer and >10 times more efficient than any other reported OLETs.
RESUMO
The interest for biodegradable electronic devices is rapidly increasing for application in the field of wearable electronics, precision agriculture, biomedicine, and environmental monitoring. Energy storage devices integrated on polymeric substrates are of particular interest to enable the large-scale on field use of complex devices. This work presents a novel class of eco-friendly supercapacitors based on biodegradable poly(3-hydroxybutyrrate) PHB, ionic liquids, and cluster-assembled gold electrodes. By electrochemical characterization, we demonstrate the possibility of tuning the supercapacitor energetic performance according to the type and amount of the ionic liquid employed. Our devices based on hydrophobic plastic materials are stable under cyclic operation and resistant to moisture exposure.
RESUMO
GOAL: The ST segment of an electrocardiogram (ECG) is very important for the correct diagnosis of an acute myocardial infarction. Most clinical ECGs are recorded using an ACcoupled ECG amplifier. It is well known, that first-order high-pass filters used for the AC coupling can affect the ST segment of an ECG. This effect is stronger the higher the filter's cut-off frequency is and the larger the QRS integral is. We present a formula that estimates these changes in the ST segment and therefore allows for correcting ST measurements that are based on an ACcoupled ECG. METHODS: The presented correction formula can be applied when only four parameters are known: the possibly estimated QRS area A, the QRS duration W, the beat-to-beat interval TRR, and the filter time constant T, further, the time point Tj to correct-after the J point-must be specified. RESULTS: The formula is correct within 0.6% until 40% ms after the J point and within 6% until 80 ms after the J point. CONCLUSION AND SIGNIFICANCE: It is not necessary to have the raw data available and the formula therefore opens up the possibility of reevaluating studies that are based on ACcoupled ECGs and compare the results of such studies with studies that are based on newer, DC-coupled ECGs.
Assuntos
Algoritmos , Artefatos , Diagnóstico por Computador/métodos , Eletrocardiografia/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Processamento de Sinais Assistido por ComputadorRESUMO
BACKGROUND AND OBJECTIVE: The first-order high-pass filter (AC coupling) has previously been shown to affect the ECG for higher cut-off frequencies. We seek to find a systematic deviation in computer measurements of the electrocardiogram when the AC coupling with a 0.05 Hz first-order high-pass filter is used. METHODS: The standard 12-lead electrocardiogram from 1248 patients and the automated measurements of their DC and AC coupled version were used. We expect a large unipolar QRS-complex to produce a deviation in the opposite direction in the ST-segment. RESULTS: We found a strong correlation between the QRS integral and the offset throughout the ST-segment. The coefficient for J amplitude deviation was found to be -0.277 µV/(µVâ s). CONCLUSIONS: Potential dangerous alterations to the diagnostically important ST-segment were found. Medical professionals and software developers for electrocardiogram interpretation programs should be aware of such high-pass filter effects since they could be misinterpreted as pathophysiology or some pathophysiology could be masked by these effects.
Assuntos
Automação , Eletrocardiografia/métodos , HumanosRESUMO
Since the introduction of digital electrocardiographs, high-pass filters have been necessary for successful analog-to-digital conversion with a reasonable amplitude resolution. On the other hand, such high-pass filters may distort the diagnostically significant ST-segment of the ECG, which can result in a misleading diagnosis. We present an inverting filter that successfully undoes the effects of a 0.05 Hz single pole high-pass filter. The inverting filter has been tested on more than 1600 clinical ECGs with one-minute durations and produces a negligible mean RMS-error of 3.1*10(-8) LSB. Alternative, less strong inverting filters have also been tested, as have different applications of the filters with respect to rounding of the signals after filtering. A design scheme for the alternative inverting filters has been suggested, based on the maximum strength of the filter. With the use of the suggested filters, it is possible to recover the original DC-coupled ECGs from AC-coupled ECGs, at least when a 0.05 Hz first order digital single pole high-pass filter is used for the AC-coupling.