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1.
Data Brief ; 54: 110386, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38646196

RESUMO

Respiratory data was collected from 20 subjects, with an even sex distribution, in the low-risk clinical unit at the University of Canterbury. Ethical consent for this trial was granted by the University of Canterbury Human Research Ethics Committee (Ref: HREC 2023/30/LR-PS). Respiratory data were collected, for each subject, over three tests consisting of: 1) increasing set PEEP from a starting point of ZEEP using a CPAP machine; 2) test 1 repeated with two simulated apnoea's (breath holds) at each set PEEP; and 3) three forced expiratory manoeuvres at ZEEP. Data were collected using a custom pressure and flow sensor device, ECG, PPG, Garmin HRM Dual heartrate belt, and a Dräeger PulmoVista 500 Electrical Impedance Tomography (EIT) machine. Subject demographic data was also collected prior to the trial, in a questionnaire, with measurement equipment available. These data aim to inform the development of pulmonary mechanics models and titration algorithms.

2.
Heliyon ; 10(7): e28822, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38601671

RESUMO

Background: Physiological modelling often involves models described by large numbers of variables and significant volumes of clinical data. Mathematical interpretation of such models frequently necessitates analysing data points in high-dimensional spaces. Existing algorithms for analysing high-dimensional points either lose important dimensionality or do not describe the full position of points. Hence, there is a need for an algorithm which preserves this information. Methods: The most-distant uncovered point (MDUP) hypersphere method is a binary classification approach which defines a collection of equidistant N-dimensional points as the union of hyperspheres. The method iteratively generates hyperspheres at the most distant point in the interest region not yet contained within any hypersphere, until the entire region of interest is defined by the union of all generated hyperspheres. This method is tested on a 7-dimensional space with up to 35.8 million points representing feasible and infeasible spaces of model parameters for a clinically validated cardiovascular system model. Results: For different numbers of input points, the MDUP hypersphere method tends to generate large spheres away from the boundary of feasible and infeasible points, but generates the greatest number of relatively much smaller spheres around the boundary of the region of interest to fill this space. Runtime scales quadratically, in part because the current MDUP implementation is not parallelised. Conclusions: The MDUP hypersphere method can define points in a space of any dimension using only a collection of centre points and associated radii, making the results easily interpretable. It can identify large continuous regions, and in many cases capture the general structure of a region in only a relative few hyperspheres. The MDUP method also shows promise for initialising optimisation algorithm starting conditions within pre-defined feasible regions of model parameter spaces, which could improve model identifiability and the quality of optimisation results.

3.
HardwareX ; 17: e00512, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38333423

RESUMO

Respiratory disease is a major contributor to healthcare costs, as well as increasing morbidity and early mortality. The device presented is used to simulate the effects of Chronic Obstructive Pulmonary Disease (COPD) in healthy people. The intended use is to provide data equivalent to COPD data measured from those who are ill for initial validation of respiratory mechanics models. It would thus eliminate the need to test unhealthy and/or fragile subjects, or the need for invasive or costly equipment based test methods. The device is used in conjunction with an open-access venturi-based flow sensor, to measure pressure, flow, and breath tidal volume. The device simulates the pressure and flow profiles of a person who has COPD including the non-linear increased resistance to end-exhalation and gas trapping. To achieve this non-linearity, a combination of high and low resistance outlets is used. Thus, the simulator allows the collection of patient-specific COPD-like breathing data in a non-invasive manner from healthy subjects. The device is low-cost with the majority of the parts 3D printed using a Prusa mini 3D printer and PLA filament.

4.
Data Brief ; 52: 109903, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38161653

RESUMO

The breathing dataset presented is collected from 20 healthy individuals at the University of Canterbury using a device to simulate the pressure and flow profiles of obstructive pulmonary disease. Specifically, the expiratory non-linear resistance, which generates the characteristic expiratory pressure-flow loop lobe seen in obstructive disease. Ethical consent for the trial was granted by the University of Canterbury Human Research Ethics Committee (Ref: HREC 2022/26/LR). Data was collected using an open-source data collection device connected to a Fisher and Paykel Healthcare SleepStyle SPSCAA CPAP. The trial was conducted at CPAP PEEP levels of 4 and 8 cmH2O, as well as at ZEEP (0 cmH2O) with no CPAP attached. The simulation device was a modular device connected to the expiratory pathway, consisting of a free volume diversion and fixed high resistance outlet. Three simulation levels were selected for testing, achieved by changing the size of the elastic free volume. The intended use of this dataset is for the initial validation and development of respiratory pulmonary mechanics models, using data collected from healthy people with simulated disease prior to clinical testing.

5.
Comput Methods Programs Biomed ; 244: 107988, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38171168

RESUMO

BACKGROUND AND OBJECTIVE: Recruitment maneuvers with subsequent positive-end-expiratory-pressure (PEEP) have proven effective in recruiting lung volume and preventing alveoli collapse. However, determining a safe, effective, and patient-specific PEEP is not standardized, and this more optimal PEEP level evolves with patient condition, requiring personalised monitoring and care approaches to maintain optimal ventilation settings. METHODS: This research examines 3 physiologically relevant basis function sets (exponential, parabolic, cumulative) to enable better prediction of elastance evolution for a virtual patient or digital twin model of MV lung mechanics, including novel elements to model and predict distension elastance. Prediction accuracy and robustness are validated against recruitment maneuver data from 18 volume-controlled ventilation (VCV) patients at 7 different baseline PEEP levels (0 to 12 cmH2O) and 14 pressure-controlled ventilation (PCV) patients at 4 different baseline PEEP levels (6 to 12 cmH2O), yielding 623 and 294 prediction cases, respectively. Predictions were made up to 12 cmH2O of added PEEP ahead, covering 6 × 2 cmH2O PEEP steps. RESULTS: The 3 basis function sets yield median absolute peak inspiratory pressure (PIP) prediction error of 1.63 cmH2O for VCV patients, and median peak inspiratory volume (PIV) prediction error of 0.028 L for PCV patients. The exponential basis function set yields a better trade-off of overall performance across VCV and PCV prediction than parabolic and cumulative basis function sets from other studies. Comparing predicted and clinically measured distension prediction in VCV demonstrated consistent, robust high accuracy with R2 = 0.90-0.95. CONCLUSIONS: The results demonstrate recruitment mechanics are best captured by an exponential basis function across different mechanical ventilation modes, matching physiological expectations, and accurately capture, for the first time, distension mechanics to within 5-10 % accuracy. Enabling the risk of lung injury to be predicted before changing ventilator settings. The overall outcomes significantly extend and more fully validate this digital twin or virtual mechanical ventilation patient model.


Assuntos
Pulmão , Mecânica Respiratória , Humanos , Mecânica Respiratória/fisiologia , Respiração Artificial/métodos , Respiração com Pressão Positiva/métodos , Respiração
6.
Data Brief ; 52: 109874, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38146285

RESUMO

Resting breathing data was collected from 80 smokers, vapers, asthmatics, and otherwise healthy people in the low-risk clinical unit at the University of Canterbury. Subjects were asked to breathe normally through a full-face mask connected to a Fisher and Paykel Healthcare SleepStyle SPSCAA CPAP device. PEEP (Positive End-Expiratory Pressure) support was increased from 4 to 12 cmH2O in 0.5 cmH2O increments. Data was also collected during resting breathing at ZEEP (0 cmH2O) before and after the PEEP trial. The trial was conducted under University of Canterbury Human Research Ethics Committee consent (Ref: HREC 2023/04/LR-PS). Data was collected by and Dräeger PulmoVista 500 EIT machine and a custom Venturi-based pressure and flow sensor device connected in series with the CPAP and full-face mask. The outlined dataset includes pressure, flow, volume, dynamic circumference (thoracic and abdominal, and cross-sectional aeration. Subject demographic data was self-reported using a questionnaire given prior to the trial.

7.
HardwareX ; 16: e00489, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38058767

RESUMO

Respiratory model-based methods require datasets containing enough dynamics to ensure model identifiability for development and validation. Rapid expiratory occlusion has been used to identify elastance and resistance within a single breath. Currently accepted practice for rapid expiratory occlusion involves a 100 ms occlusion of the expiratory pathway. This article presents a low-cost modular rapid shutter attachment to enable identification of passive respiratory mechanics. Shuttering faster than 100 ms creates rapid expiratory occlusion without the added dynamics of muscular response to shutter closure, by eliminating perceived expiratory blockage via high shutter speed. The shutter attachment fits onto a non-invasive venturi-based flow meter with separated inspiratory and expiratory pathways, established using one-way valves. Overall, these elements allow comprehensive collection of respiratory pressure and flow datasets with relatively very rapid expiratory occlusion.

8.
Artigo em Inglês | MEDLINE | ID: mdl-38083220

RESUMO

A physical system to generate a PPG-mimicking signal was designed and validated using everyday low-cost components to aid in medical sensor design. The pulse waveform was created by driving a working fluid into a silicone tube and changing the pressure within it. The corresponding waveform mimics a PPG signal through an artery, is adaptable, and repeatable. The working fluid is interchangeable allowing for change of blood analyte concentrations for development and testing of PPG-based sensors. The system was validated by black ink water compared to water and air compared to water testing to confirm optical transparency of the tube. The produced PPG signal, pulse rate and pressure change were compared to that seen in subjects. Optical transparency for 660 nm - 1550 nm wavelengths of light was validated with the signal, pulse rate and total compliance matching subject data. Thus, the system can mimic arterial pulses, creating a valid PPG signal that can be detected by PPG-based sensors.Clinical Relevance- Provides a low-cost, adaptable, physical PPG signal generator for research and development of optical medical sensor technologies.


Assuntos
Artérias , Fotopletismografia , Humanos , Frequência Cardíaca , Água
9.
Artigo em Inglês | MEDLINE | ID: mdl-38083317

RESUMO

Spectroscopy is utilised extensively in medical sensing technology. Typically, hand-held spectroscopy equipment uses miniature narrow-band light emitting diodes (LEDs) and photodiodes to emit and detect light, respectively. Photodiodes typically absorb light across a wide spectra so measurements can be corrupted by surrounding light. LEDs in the visible spectrum have a narrower spectral response and can be used in place of a traditional photodiode. However, the absorption characteristics of near infrared (NIR) spectrum LEDs is unknown. A discrete, low-cost spectrophotometer was designed to assess spectral response for 8 narrow band NIR LEDs. The normalised and raw spectral response determined the optimum detector for 1050 nm - 1300 nm is the 1450 nm LED, and the optimum detector for 1450 nm - 1650 nm emissions is the 1650 nm LED.Clinical relevance - Understanding the spectral response of narrow-band LEDs in the NIR spectrum will aid development of NIR hand-held spectroscopy medical devices.


Assuntos
Luz , Espectroscopia de Luz Próxima ao Infravermelho , Espectrofotometria , Glucose
10.
Sensors (Basel) ; 23(24)2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38139620

RESUMO

(1) Background: Technically, a simple, inexpensive, and non-invasive method of ascertaining volume changes in thoracic and abdominal cavities are required to expedite the development and validation of pulmonary mechanics models. Clinically, this measure enables the real-time monitoring of muscular recruitment patterns and breathing effort. Thus, it has the potential, for example, to help differentiate between respiratory disease and dysfunctional breathing, which otherwise can present with similar symptoms such as breath rate. Current automatic methods of measuring chest expansion are invasive, intrusive, and/or difficult to conduct in conjunction with pulmonary function testing (spontaneous breathing pressure and flow measurements). (2) Methods: A tape measure and rotary encoder band system developed by the authors was used to directly measure changes in thoracic and abdominal circumferences without the calibration required for analogous strain-gauge-based or image processing solutions. (3) Results: Using scaling factors from the literature allowed for the conversion of thoracic and abdominal motion to lung volume, combining motion measurements correlated to flow-based measured tidal volume (normalised by subject weight) with R2 = 0.79 in data from 29 healthy adult subjects during panting, normal, and deep breathing at 0 cmH2O (ZEEP), 4 cmH2O, and 8 cmH2O PEEP (positive end-expiratory pressure). However, the correlation for individual subjects is substantially higher, indicating size and other physiological differences should be accounted for in scaling. The pattern of abdominal and chest expansion was captured, allowing for the analysis of muscular recruitment patterns over different breathing modes and the differentiation of active and passive modes. (4) Conclusions: The method and measuring device(s) enable the validation of patient-specific lung mechanics models and accurately elucidate diaphragmatic-driven volume changes due to intercostal/chest-wall muscular recruitment and elastic recoil.


Assuntos
Mecânica Respiratória , Parede Torácica , Adulto , Humanos , Mecânica Respiratória/fisiologia , Diafragma/fisiologia , Pulmão/fisiologia , Abdome
11.
Biomed Eng Online ; 22(1): 102, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37875890

RESUMO

BACKGROUND: Patient-ventilator asynchrony is common during mechanical ventilation (MV) in intensive care unit (ICU), leading to worse MV care outcome. Identification of asynchrony is critical for optimizing MV settings to reduce or eliminate asynchrony, whilst current clinical visual inspection of all typical types of asynchronous breaths is difficult and inefficient. Patient asynchronies create a unique pattern of distortions in hysteresis respiratory behaviours presented in pressure-volume (PV) loop. METHODS: Identification method based on hysteretic lung mechanics and hysteresis loop analysis is proposed to delineate the resulted changes of lung mechanics in PV loop during asynchronous breathing, offering detection of both its incidence and 7 major types. Performance is tested against clinical patient data with comparison to visual inspection conducted by clinical doctors. RESULTS: The identification sensitivity and specificity of 11 patients with 500 breaths for each patient are above 89.5% and 96.8% for all 7 types, respectively. The average sensitivity and specificity across all cases are 94.6% and 99.3%, indicating a very good accuracy. The comparison of statistical analysis between identification and human inspection yields the essential same clinical judgement on patient asynchrony status for each patient, potentially leading to the same clinical decision for setting adjustment. CONCLUSIONS: The overall results validate the accuracy and robustness of the identification method for a bedside monitoring, as well as its ability to provide a quantified metric for clinical decision of ventilator setting. Hence, the method shows its potential to assist a more consistent and objective assessment of asynchrony without undermining the efficacy of the current clinical practice.


Assuntos
Respiração Artificial , Ventiladores Mecânicos , Humanos , Respiração , Pulmão
12.
HardwareX ; 16: e00469, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37779821

RESUMO

A low-cost ($120 NZD, $75 USD), low-power (1-year battery life), portable, and programmable syringe pump design is presented, which offers an alternative to high-cost commercial devices with limited battery life. Contrary to typical motor-driven syringe pumps, the design utilizes a compression spring coupled with a clockwork escapement mechanism to advance the syringe plunger. Full control over flow-rate and discrete (bolus) deliveries is achieved through actuation of a clockwork escapement using programmable, low-power electronics. The escapement mechanism allows the syringe plunger to advance a fixed linear distance, delivering a dose size of 0.001 ml in the configuration presented. The modular pump assembly is easily reconfigured for different applications by interchanging components to alter the minimum dose size. Testing to IEC 60601-2-24(2012), the average error of the clockwork syringe pump was 8.0%, 4.0%, and 1.9% for 0.001 ml, 0.002 ml, and 0.01 ml volumes, respectively. An overall mean error of 1.0% was recorded for a flow-rate of 0.01 ml h-1. Compared to a commercial insulin pump, the clockwork pump demonstrated reduced variability but greater average error due to consistent over-delivery. Further development of the design and/or manufacture should yield a device with similar performance to a commercial pump.

13.
Sensors (Basel) ; 23(19)2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37836923

RESUMO

Emotional intelligence strives to bridge the gap between human and machine interactions. The application of such systems varies and is becoming more prominent as healthcare services seek to provide more efficient care by utilizing smart digital health apps. One application in digital health is the incorporation of emotion recognition systems as a tool for therapeutic interventions. To this end, a system is designed to collect and analyze physiological signal data, such as electrodermal activity (EDA) and electrocardiogram (ECG), from smart wearable devices. The data are collected from different subjects of varying ages taking part in a study on emotion induction methods. The obtained signals are processed to identify stimulus trigger instances and classify the different reaction stages, as well as arousal strength, using signal processing and machine learning techniques. The reaction stages are identified using a support vector machine algorithm, while the arousal strength is classified using the ResNet50 network architecture. The findings indicate that the EDA signal effectively identifies the emotional trigger, registering a root mean squared error (RMSE) of 0.9871. The features collected from the ECG signal show efficient emotion detection with 94.19% accuracy. However, arousal strength classification is only able to reach 60.37% accuracy on the given dataset. The proposed system effectively detects emotional reactions and can categorize their arousal strength in response to specific stimuli. Such a system could be integrated into therapeutic settings to monitor patients' emotional responses during therapy sessions. This real-time feedback can guide therapists in adjusting their strategies or interventions.


Assuntos
Dispositivos Eletrônicos Vestíveis , Humanos , Emoções/fisiologia , Algoritmos , Nível de Alerta , Inteligência Emocional
14.
Comput Methods Programs Biomed ; 240: 107728, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37531693

RESUMO

BACKGROUND AND OBJECTIVE: Healthcare datasets are plagued by issues of data scarcity and class imbalance. Clinically validated virtual patient (VP) models can provide accurate in-silico representations of real patients and thus a means for synthetic data generation in hospital critical care settings. This research presents a realistic, time-varying mechanically ventilated respiratory failure VP profile synthesised using a stochastic model. METHODS: A stochastic model was developed using respiratory elastance (Ers) data from two clinical cohorts and averaged over 30-minute time intervals. The stochastic model was used to generate future Ers data based on current Ers values with added normally distributed random noise. Self-validation of the VPs was performed via Monte Carlo simulation and retrospective Ers profile fitting. A stochastic VP cohort of temporal Ers evolution was synthesised and then compared to an independent retrospective patient cohort data in a virtual trial across several measured patient responses, where similarity of profiles validates the realism of stochastic model generated VP profiles. RESULTS: A total of 120,000 3-hour VPs for pressure control (PC) and volume control (VC) ventilation modes are generated using stochastic simulation. Optimisation of the stochastic simulation process yields an ideal noise percentage of 5-10% and simulation iteration of 200,000 iterations, allowing the simulation of a realistic and diverse set of Ers profiles. Results of self-validation show the retrospective Ers profiles were able to be recreated accurately with a mean squared error of only 0.099 [0.009-0.790]% for the PC cohort and 0.051 [0.030-0.126]% for the VC cohort. A virtual trial demonstrates the ability of the stochastic VP cohort to capture Ers trends within and beyond the retrospective patient cohort providing cohort-level validation. CONCLUSION: VPs capable of temporal evolution demonstrate feasibility for use in designing, developing, and optimising bedside MV guidance protocols through in-silico simulation and validation. Overall, the temporal VPs developed using stochastic simulation alleviate the need for lengthy, resource intensive, high cost clinical trials, while facilitating statistically robust virtual trials, ultimately leading to improved patient care and outcomes in mechanical ventilation.


Assuntos
Cuidados Críticos , Respiração Artificial , Humanos , Respiração Artificial/métodos , Estudos Retrospectivos , Simulação por Computador , Cuidados Críticos/métodos , Projetos de Pesquisa
15.
PeerJ ; 11: e15671, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37456896

RESUMO

Objectives: Currently, there are no data on sex differences in the power profiles in sprint track cycling. This cross-section study analyses retrospective data of female and male track sprint cyclists for sex differences. We hypothesized that women would exhibit lower peak power to weight than men, as well as demonstrate a different distribution of power durations related to sprint cycling performance. Design: We used training, testing, and racing data from a publicly available online depository (www.strava.com), for 29 track sprint cyclists (eight women providing 18 datasets, and 21 men providing 54 datasets) to create sex-specific profiles. R2 was used to describe model quality, and regression indices are used to compare watts per kilogram (W/kg) for each duration for both sexes against a 1:1 relationship expected for 15-s:15-s W/kg. Results: We confirmed our sample were sprint cyclists, displaying higher peak and competition power than track endurance cyclists. All power profiles showed a high model quality (R2 ≥ 0.77). Regression indices for both sexes were similar for all durations, suggesting similar peak power and similar relationship between peak power and endurance level for both men and women (rejecting our hypothesis). The value of R2 for the female sprinters showed greater variation suggesting greater differences within female sprint cyclists. Conclusion: The main finding shows female sprint cyclists in this study have very similar relationships between peak power and endurance power as men. Higher variation in W/kg for women in this study than men, within these strong relationships, indicates women in this study, had greater inter-athlete variability, and may thus require more personalised training. Future work needs to be performed with larger samples, and at different levels to optimize these recommendations.


Assuntos
Ciclismo , Caracteres Sexuais , Humanos , Masculino , Feminino , Estudos Retrospectivos , Atletas
16.
Sci Data ; 10(1): 481, 2023 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-37481681

RESUMO

Continuous positive airway pressure (CPAP) ventilation is a commonly prescribed respiratory therapy providing positive end-expiratory pressure (PEEP) to assist breathing and prevent airway collapse. Setting PEEP is highly debated and it is thus primarily titrated based on symptoms of excessive or insufficient support. However, titration periods are clinician intensive and can result in barotrauma or under-oxygenation during the process. Developing model-based methods to more efficiently personalise CPAP therapy based on patient-specific response requires clinical data of lung/CPAP interactions. To this end, a trial was conducted to establish a dataset of healthy subjects lung/CPAP interaction. Pressure, flow, and tidal volume were recorded alongside secondary measures of dynamic chest and abdominal circumference, to better validate model outcomes and assess breathing modes, muscular recruitment, and effort. N = 30 subjects (15 male; 15 female) were included. Self-reported asthmatics and smokers/vapers were included, offering a preliminary assessment of any potential differences in response to CPAP from lung stiffness changes in these scenarios. Additional demographics associated with lung function (sex, age, height, and weight) were also recorded.


Assuntos
Abdome , Pressão Positiva Contínua nas Vias Aéreas , Taxa Respiratória , Adulto , Feminino , Humanos , Masculino , Pulmão , Tórax
17.
Comput Methods Programs Biomed ; 240: 107633, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37343375

RESUMO

Model-based glycemic control (GC) protocols are used to treat stress-induced hyperglycaemia in intensive care units (ICUs). The STAR (Stochastic-TARgeted) glycemic control protocol - used in clinical practice in several ICUs in New Zealand, Hungary, Belgium, and Malaysia - is a model-based GC protocol using a patient-specific, model-based insulin sensitivity to describe the patient's actual state. Two neural network based methods are defined in this study to predict the patient's insulin sensitivity parameter: a classification deep neural network and a Mixture Density Network based method. Treatment data from three different patient cohorts are used to train the network models. Accuracy of neural network predictions are compared with the current model- based predictions used to guide care. The prediction accuracy was found to be the same or better than the reference. The authors suggest that these methods may be a promising alternative in model-based clinical treatment for patient state prediction. Still, more research is needed to validate these findings, including in-silico simulations and clinical validation trials.


Assuntos
Hiperglicemia , Resistência à Insulina , Humanos , Glicemia , Redes Neurais de Computação , Simulação por Computador , Hiperglicemia/tratamento farmacológico
18.
Comput Biol Med ; 160: 106808, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37163965

RESUMO

Hyperglycaemia is a common problem in neonatal intensive care units (NICUs). Achieving good control can result in better outcomes for patients. However, good control is difficult, where poor control and resulting hypoglycaemia reduces outcomes and confounds results. Clinically validated models can provide good control, and subcutaneous insulin delivery can provide more options for insulin therapy for clinicians. However, this combination has only been significantly utilised in adult outpatient diabetes, but could hold benefit for treating NICU infants. This research combines a well-validated NICU metabolic model with subcutaneous insulin kinetics models to assess the feasibility of a model-based approach. Clinical data from 12 very/extremely pre-mature infants was collected for an average study duration of 10.1 days. Blood glucose, interstitial and plasma insulin, as well as subcutaneous and local insulin were modelled, and patient-specific insulin sensitivity profiles were identified for each patient. Modelling error was low, where the cohort median [IQR] mean percentage error was 0.8 [0.3 3.4] %. For external validation, insulin sensitivity was compared to previous NICU cohorts using the same metabolic model, where overall levels of insulin sensitivity were similar. Overall, the combined system model accurately captured observed glucose and insulin dynamics, showing the potential for a model-based approach to glycaemic control using subcutaneous insulin in this cohort. The results justify further model validation and clinical trial research to explore a model-based protocol.


Assuntos
Resistência à Insulina , Unidades de Terapia Intensiva Neonatal , Adulto , Humanos , Recém-Nascido , Glicemia/metabolismo , Controle Glicêmico , Insulina
19.
Comput Methods Programs Biomed ; 236: 107566, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37186981

RESUMO

BACKGROUND AND OBJECTIVE: The identification of insulinaemic pharmacokinetic parameters using the least-squares criterion approach is easily influenced by outlying data due to its sensitivity. Furthermore, the least-squares criterion has a tendency to overfit and produce incorrect results. Hence, this research proposes an alternative approach using the artificial neural network (ANN) with two hidden layers to optimize the identifying of insulinaemic pharmacokinetic parameters. The ANN is selected for its ability to avoid overfitting parameters and its faster speed in processing data. METHODS: 18 voluntarily participants were recruited from the Canterbury and Otago region of New Zealand to take part in a Dynamic Insulin Sensitivity and Secretion Test (DISST) clinical trial. A total of 46 DISST data were collected. However, due to ambiguous and inconsistency, 4 data had to be removed. Analysis was done using MATLAB 2020a. RESULTS AND DISCUSSION: Results show that, with 42 gathered dataset, the ANN generates higher gains, ∅P = 20.73 [12.21, 28.57] mU·L·mmol-1·min-1 and ∅D = 60.42 [26.85, 131.38] mU·L·mmol-1 as compared to the linear least square method, ∅P = 19.67 [11.81, 28.02] mU·L·mmol-1 ·min-1 and ∅D = 46.21 [7.25, 116.71] mU·L·mmol-1. The average value of the insulin sensitivity (SI) of ANN is lower with, SI = 16 × 10-4 L·mU-1 ·min-1 than the linear least square, SI = 17 × 10-4 L·mU-1 ·min-1. CONCLUSION: Although the ANN analysis provided a lower SI value, the results were more dependable than the linear least square model because the ANN approach yielded a better model fitting accuracy than the linear least square method with a lower residual error of less than 5%. With the implementation of this ANN architecture, it shows that ANN able to produce minimal error during optimization process particularly when dealing with outlying data. The findings may provide extra information to clinicians, allowing them to gain a better knowledge of the heterogenous aetiology of diabetes and therapeutic intervention options.


Assuntos
Resistência à Insulina , Humanos , Redes Neurais de Computação , Insulina
20.
PLoS One ; 18(5): e0280658, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37235558

RESUMO

Current convention place peak power as the main determinant of sprint cycling performance. This study challenges that notion and compares two common durations of sprint cycling performance with not only peak power, but power out to 20-min. There is also a belief where maximal efforts of longer durations will be detrimental to sprint cycling performance. 56 data sets from 27 cyclists (21 male, 6 female) provided maximal power for durations from 1-s to 20-min. Peak power values are compared to assess the strength of correlation (R2), and any relationship (slope) across every level. R2 between 15-s- 30-s power and durations from 1-s to 20-min remained high (R2 ≥ 0.83). Despite current assumptions around 1-s power, our data shows this relationship is stronger around competition durations, and 1-s power also still shared strong relationships with longer durations out to 20-min. Slopes for relationships at shorter durations were closer to a 1:1 relationship than longer durations, but closer to long-duration slopes than to a 1:1 line. The present analyses contradicts both well-accepted hypotheses that peak power is the main driver of sprint cycling performance and that maximal efforts of longer durations out to 20-min will hinder sprint cycling. This study shows the importance and potential of training durations from 1-s to 20-min over a preparation period to improve competition sprint cycling performance.


Assuntos
Desempenho Atlético , Ciclismo , Masculino , Humanos , Feminino , Fatores de Tempo
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