Deep learning-based robust automatic non-invasive measurement of blood pressure using Korotkoff sounds.

This paper proposes a method that automatically measures non-invasive blood pressure (BP) based on an auscultatory approach using Korotkoff sounds (K-sounds). There have been methods utilizing K-sounds that were more accurate in general than those using cuff pressure signals only under well-controlled environments, but most were vulnerable to the measurement conditions and to external noise because blood pressure is simply determined based on threshold values in the sound signal. The proposed method enables robust and precise BP measurements by evaluating the probability that each sound pulse is an audible K-sound based on a deep learning using a convolutional neural network (CNN). Instead of classifying sound pulses into two categories, audible K-sounds and others, the proposed CNN model outputs probability values. These values in a Korotkoff cycle are arranged in time order, and the blood pressure is determined. The proposed method was tested with a dataset acquired in practice that occasionally contains considerable noise, which can degrade the performance of the threshold-based methods. The results demonstrate that the proposed method outperforms a previously reported CNN-based classification method using K-sounds. With larger amounts of various types of data, the proposed method can potentially achieve more precise and robust results.

The Impact of Changes in the Intake of Fiber and Antioxidants on the Development of Chronic Obstructive Pulmonary Disease.

Diet is a health-related factor that can modify lung function. This study hypothesized that the change in age-related dietary intake affects lung function. The subjects who undertook a dietary assessment and spirometry in 2012 and 2017, were retrospectively collected in a health screening center. Dietary intakes were directly evaluated using food frequency questionnaires (FFQ) administered by trained dietitians and were compared at the baseline (2012) and 5-year follow-up (2017). A forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) value below 0.70 was defined as airflow limitation. Logistic regression models were used to estimate the odds ratio (ORs) adjusted for potential confounders. A total of 1439 subjects with normal spirometry were enrolled. New airflow limitations were detected in 48 subjects (3.3%) at the 5-year follow-up, including 41 (85.4%) men and 11 (22.9%) current smokers. After adjusting for age, sex, smoking history, and baseline FEV1/FVC, the odd ratios (OR) for new airflow limitation in fiber, vitamin C, and folic acid per 10% decrease in daily recommended requirement were 2.714 (95% confidence interval (CI), 1.538-4.807; p = 0.001), 1.083 (95% CI: 1.020-1.149; p = 0.007), and 1.495 (95% CI: 1.172-1.913; p = 0.001), respectively. A decreased intake of dietary fiber, vitamin C, and folic acid is associated with a newly developed airflow limitation.

Noise and Room Acoustic Conditions in a Tertiary Referral Hospital, Seoul National University Hospital.

BACKGROUND AND OBJECTIVES: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. MATERIALS AND METHODS: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. RESULTS: The A-weighted equivalent noise level, LAeq, ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. CONCLUSIONS: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.

Reproduction of nearby sources by imposing true interaural differences on a sound field control approach.

In anechoic conditions, the Interaural Level Difference (ILD) is the most significant auditory cue to judge the distance to a sound source located within 1 m of the listener's head. This is due to the unique characteristics of a point source in its near field, which result in exceptionally high, distance dependent ILDs. When reproducing the sound field of sources located near the head with line or circular arrays of loudspeakers, the reproduced ILDs are generally lower than expected, due to physical limitations. This study presents an approach that combines a sound field reproduction method, known as Pressure Matching (PM), and a binaural control technique. While PM aims at reproducing the incident sound field, the objective of the binaural control technique is to ensure a correct reproduction of interaural differences. The combination of these two approaches gives rise to the following features: (i) an accurate reproduction of ILDs is achieved at the head positions considered by the method, (ii) the ILD variations in the vicinity of those positions are smoothed, thus lowering the ILD error, and (iii) the true wavefront is preserved. Given the properties of the presented method, intended distance and directional perception is expected.

Experimental validation of sound field control with a circular double-layer array of loudspeakers.

This paper is concerned with experimental validation of a recently proposed method of controlling sound fields with a circular double-layer array of loudspeakers [Chang and Jacobsen, J. Acoust. Soc. Am. 131(6), 4518-4525 (2012)]. The double-layer of loudspeakers is realized with 20 pairs of closed-box loudspeakers mounted back-to-back. Source strengths are obtained with several solution methods by modeling loudspeakers as a weighted combination of monopoles and dipoles. Sound pressure levels of the controlled sound fields are measured inside and outside the array in an anechoic room, and performance indices are calculated. The experimental results show that a method of combining pure contrast maximization with a pressure matching technique provides only a small error in the listening zone between the desired and the reproduced fields, and at the same time reduces the sound level in the quiet zone as expected in the simulation studies well above the spatial Nyquist frequency except at a few frequencies. It is also shown that errors in the positions of the loudspeakers can be critical to the results at frequencies where the distance between the inner and the outer array is close to half a wavelength.

Sound field control with a circular double-layer array of loudspeakers.

This paper describes a method of generating a controlled sound field for listeners inside a circular array of loudspeakers without disturbing people outside the array appreciably. To achieve this objective, a double-layer array of loudspeakers is used. Several solution methods are suggested, and their performance is examined using computer simulations. Two performance indices are used in this work, (a) the level difference between the average sound energy density in the listening zone and that in the quiet zone (sometimes called "the acoustic contrast"), and (b) a normalized measure of the deviations between the desired and the generated sound field in the listening zone. It is concluded that the best compromise is obtained with a method that combines pure contrast maximization with a pressure matching technique.

A plane wave generation method by wave number domain point focusing.

A method for generation of a wave-field that is a plane wave is described. This method uses an array of loudspeakers phased so that the field in the wave-number domain is nearly concentrated at a point, this point being at the wave-number vector of the desired plane wave. The method described here for such a wave-number concentration makes use of an expansion in spherical harmonics, and requires a relatively small number of measurement points for a good approximate achievement of a plane wave. The measurement points are on a spherical surface surrounding the array of loudspeakers. The input signals for the individual loudspeakers can be derived without a matrix inversion or without explicit assumptions about the loudspeakers. The mathematical development involves spherical harmonics and three-dimensional Fourier transforms. Some numerical examples are given, with various assumptions concerning the nature of the loudspeakers, that support the premise that the method described in the present paper may be useful in applications.

Scattering effect on the sound focused personal audio system.

Recently, a personal audio system has been studied that uses an array of loudspeakers to localize sound to only the area around a user. To realize this system, beamforming or acoustic contrast control has been applied on the assumption that sources radiate sound in a free-field. This means that not only reflection by walls, but also the scattering effect by the user's head is neglected. Reflection by walls is negligible because personal devices are usually used in a short distance so that direct sound is dominant over reverberant sound. However, the scattering effect by the user's head has a considerable effect on the focused sound field. For example, the region where sound energy is not focused becomes louder when a user is actually in the focused region due to the scattered sound by the user's head in the focused region. In this paper, the scattering effect is shown computationally on the simple assumption that the user's head is a rigid sphere. Then, an improving control method, which overcomes this effect, is proposed. The method is shown to outperform the previous method in terms of lowering the sound level in the side regions when a user is in the bright zone.

A realization of sound focused personal audio system using acoustic contrast control.

A personal audio system that does not use earphone or any wire would have great interest and potential impact on the audio industries. In this study, a line array speaker system is used to localize sound in the listening zone. The contrast control [Choi, J.-W. and Kim, Y.-H. (2002). J. Acoust. Soc. Am. 111, 1695-1700] is applied, which is a method to make acoustically bright zone around the user and acoustically dark zone in other regions by maximizing the ratio of acoustic potential energy density between the bright and the dark zone. This ratio is regarded as acoustic contrast, analogous with what is used for optical devices. For the evaluation of the performance of acoustic contrast control, experiments are performed and the results are compared with those of uncontrolled case and time reversal array.

Design of a proton microbeam of the PEFP.

The PEFP has been developing a 100 MeV proton linear accelerator and user facilities for 20 and 100 MeV proton beams. At one end of the five 20 MeV proton beam lines, a proton microbeam construction was considered for an application in the fields of material, biological, and medical sciences. To develop the proton microbeam, realization of a few MeV proton beam with a few tens of microamperes in diameter of a beam spot was essentially required. In this report, the basic descriptions of the proton microbeam which is composed of an energy degrader, slits, magnetic lens, a target chamber, and detectors are presented including a consideration of unfavorable aspects concerning some specific characteristics of a linear accelerator, such as pulse mode operation and fixed energy. Some calculation results from a Monte Carlo simulation by using the SRIM2006 and the TURTLE codes are also included.

Effects of soybean supplementation on blood glucose, plasma lipid levels, and erythrocyte antioxidant enzyme activity in type 2 diabetes mellitus patients.

The purpose of this study was to investigate the effect of soybean on blood glucose and lipid concentrations, and antioxidant enzyme activity in type 2 diabetes mellitus (DM) patients. We divided patients into two groups and fed them, respectively, a basal diet (control group) and a basal diet with 69 g/d of soybean (soybean group) for 4 weeks. Pills with roasted soybean powder were provided to the soybean supplementation group three times a day. Macronutrients intake except dietary fiber was similar between the two groups. No significant differences were observed in dietary intakes or body weight before and after the supplementation. Energy composition ratio of C:F:P was 65:19:16 in the control group, 64:20:16 in the soybean group. The blood parameters of subjects before supplementation, such as fasting blood glucose, postprandial glucose level, total cholesterol, triglyceride, LDL-cholesterol and HbA(1)C were not different between the two groups. After supplementation, fasting blood glucose (p<0.001), postprandial glucose level (p<0.001) and serum triglyceride level (p<0.05) were significantly reduced in the soybean group in comparison with the control group. The total cholesterol level was not significantly different between the control and the supplemented group after 4 weeks of treatment. TBARS levels of the soybean group were not significantly different from those of the control group. The activities of catalase (p<0.01) and glutathione peroxidase (p<0.05) were significantly higher in the soybean group compared to the control group. The results of this study suggest that soybean supplementation would be helpful to control blood glucose and serum lipid in diabetic patients. Also, soybean showed an antioxidant activity that may contribute to enhance the effect of antioxidant defense. This activity contributes to protection against oxidative damage in type 2 DM patients. Soybean may have potential use in the disease management of patients with DM.

Regularized image reconstruction algorithms for positron emission tomography.

We develop algorithms for obtaining regularized estimates of emission means in positron emission tomography. The first algorithm iteratively minimizes a penalized maximum-likelihood (PML) objective function. It is based on standard de-coupled surrogate functions for the ML objective function and de-coupled surrogate functions for a certain class of penalty functions. As desired, the PML algorithm guarantees nonnegative estimates and monotonically decreases the PML objective function with increasing iterations. The second algorithm is based on an iteration dependent, de-coupled penalty function that introduces smoothing while preserving edges. For the purpose of making comparisons, the MLEM algorithm and a penalized weighted least-squares algorithm were implemented. In experiments using synthetic data and real phantom data, it was found that, for a fixed level of background noise, the contrast in the images produced by the proposed algorithms was the most accurate.