Real-Time Mobile Device-Assisted Chest Compression During Cardiopulmonary Resuscitation.

Prompt administration of high-quality cardiopulmonary resuscitation (CPR) is a key determinant of survival from cardiac arrest. Strategies to improve CPR quality at point of care could improve resuscitation outcomes. We tested whether a low cost and scalable mobile phone- or smart watch-based solution could provide accurate measures of compression depth and rate during simulated CPR. Fifty health care providers (58% intensive care unit nurses) performed simulated CPR on a calibrated training manikin (Resusci Anne, Laerdal) while wearing both devices. Subjects received real-time audiovisual feedback from each device sequentially. Primary outcome was accuracy of compression depth and rate compared with the calibrated training manikin. Secondary outcome was improvement in CPR quality as defined by meeting both guideline-recommend compression depth (5 to 6 cm) and rate (100 to 120/minute). Compared with the training manikin, typical error for compression depth was <5 mm (smart phone 4.6 mm; 95% CI 4.1 to 5.3 mm; smart watch 4.3 mm; 95% CI 3.8 to 5.0 mm). Compression rates were similarly accurate (smart phone Pearson's R = 0.93; smart watch R = 0.97). There was no difference in improved CPR quality defined as the number of sessions meeting both guideline-recommended compression depth (50 to 60 mm) and rate (100 to 120 compressions/minute) with mobile device feedback (60% vs 50%; p = 0.3). Sessions that did not meet guideline recommendations failed primarily because of inadequate compression depth (46 ± 2 mm). In conclusion, a mobile device application-guided CPR can accurately track compression depth and rate during simulation in a practice environment in accordance with resuscitation guidelines.

Effective CPR Procedure With Real Time Evaluation and Feedback Using Smartphones.

Timely cardio pulmonary resuscitation (CPR) can mean the difference between life and death. A trained person may not be available at emergency sites to give CPR. Normally, a 9-1-1 operator gives verbal instructions over the phone to a person giving CPR. In this paper, we discuss the use of smartphones to assist in administering CPR more efficiently and accurately. The two important CPR parameters are the frequency and depth of compressions. In this paper, we used smartphones to calculate these factors and to give real-time guidance to improve CPR. In addition, we used an application to measure oxygen saturation in blood. If blood oxygen saturation falls below an acceptable threshold, the person giving CPR can be asked to do mouth-to-mouth breathing. The 9-1-1 operator receives this information real time and can further guide the person giving CPR. Our experiments show accuracy >90% for compression frequency, depth, and oxygen saturation.

Smart phone monitoring of second heart sound split.

Heart Auscultation (listening to heart sounds) is the basic element of cardiac diagnosis. The interpretation of these sounds is a difficult skill to acquire. In this work we have developed an application to detect, monitor, and analyze the split in second heart sound (S2) using a smart phone. The application records the heartbeat using a stethoscope connected to the smart phone. The audio signal is converted into the frequency domain using Fast Fourier Transform to detect the first and second heart sounds (S1 and S2). S2 is extracted and fed into the Discrete Wavelet Transform (DWT) and then to Continuous Wavelet Transform (CWT) to detect the Aortic (A2) and the Pulmonic (P2) components, which are used to calculate the split in S2. With our application, users can continuously monitor their second heart sound irrespective of ages and check for a split in their hearts with a low-cost, easily available equipment.

Cuffless differential blood pressure estimation using smart phones.

Smart phones today have become increasingly popular with the general public for their diverse functionalities such as navigation, social networking, and multimedia facilities. These phones are equipped with high-end processors, high-resolution cameras, and built-in sensors such as accelerometer, orientation-sensor, and light-sensor. According to comScore survey, 26.2% of U.S. adults use smart phones in their daily lives. Motivated by this statistic and the diverse capability of smart phones, we focus on utilizing them for biomedical applications. We present a new application of the smart phone with its built-in camera and microphone replacing the traditional stethoscope and cuff-based measurement technique, to quantify vital signs such as heart rate and blood pressure. We propose two differential blood pressure estimating techniques using the heartbeat and pulse data. The first method uses two smart phones whereas the second method replaces one of the phones with a customized external microphone. We estimate the systolic and diastolic pressure in the two techniques by computing the pulse pressure and the stroke volume from the data recorded. By comparing the estimated blood pressure values with those measured using a commercial blood pressure meter, we obtained encouraging results of 95-100% accuracy.

An impatient evolutionary algorithm with probabilistic tabu search for unified solution of some NP-hard problems in graph and set theory via clique finding.

Many graph- and set-theoretic problems, because of their tremendous application potential and theoretical appeal, have been well investigated by the researchers in complexity theory and were found to be NP-hard. Since the combinatorial complexity of these problems does not permit exhaustive searches for optimal solutions, only near-optimal solutions can be explored using either various problem-specific heuristic strategies or metaheuristic global-optimization methods, such as simulated annealing, genetic algorithms, etc. In this paper, we propose a unified evolutionary algorithm (EA) to the problems of maximum clique finding, maximum independent set, minimum vertex cover, subgraph and double subgraph isomorphism, set packing, set partitioning, and set cover. In the proposed approach, we first map these problems onto the maximum clique-finding problem (MCP), which is later solved using an evolutionary strategy. The proposed impatient EA with probabilistic tabu search (IEA-PTS) for the MCP integrates the best features of earlier successful approaches with a number of new heuristics that we developed to yield a performance that advances the state of the art in EAs for the exploration of the maximum cliques in a graph. Results of experimentation with the 37 DIMACS benchmark graphs and comparative analyses with six state-of-the-art algorithms, including two from the smaller EA community and four from the larger metaheuristics community, indicate that the IEA-PTS outperforms the EAs with respect to a Pareto-lexicographic ranking criterion and offers competitive performance on some graph instances when individually compared to the other heuristic algorithms. It has also successfully set a new benchmark on one graph instance. On another benchmark suite called Benchmarks with Hidden Optimal Solutions, IEA-PTS ranks second, after a very recent algorithm called COVER, among its peers that have experimented with this suite.