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2.
Sensors (Basel) ; 19(19)2019 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-31569585

RESUMO

Localization technologies play an important role in disaster management and emergence response. In areas where the environment does not change much after an accident or in the case of dangerous areas monitoring, indoor fingerprint-based localization can be used. In such scenarios, a positioning system needs to have both a high accuracy and a rapid response. However, these two requirements are usually conflicting since a fingerprint-based indoor localization system with high accuracy usually has complex algorithms and needs to process a large amount of data, and therefore has a slow response. This problem becomes even worse when both the size of monitoring area and the number of reference nodes increase. To address this challenging problem, this paper proposes a two-level positioning algorithm in order to improve both the accuracy and the response time. In the off-line stage, a fingerprint database is divided into several sub databases by using an affinity propagation clustering (APC) algorithm based on Shepard similarity. The online stage has two steps: (1) a coarse positioning algorithm is adopted to find the most similar sub database by matching the cluster center with the fingerprint of the node tested, which will narrow the search space and consequently save time; (2) in the sub database area, a support vector regression (SVR) algorithm with its parameters being optimized by particle swarm optimization (PSO) is used for fine positioning, thus improving the online positioning accuracy. Both experiment results and actual implementations proved that the proposed two-level localization method is more suitable than other methods in term of algorithm complexity, storage requirements and localization accuracy in dangerous area monitoring.


Assuntos
Algoritmos , Tecnologia de Sensoriamento Remoto/métodos , Telemetria/métodos , Tecnologia sem Fio , Indústria Química , Análise por Conglomerados , Humanos
3.
Zoo Biol ; 38(6): 498-507, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31517405

RESUMO

The use of radio frequency identification (RFID) technology is common in animal-monitoring applications in the wild and in zoological and agricultural settings. RFID is used to track animals and to collect information about movements and other behaviors, as well as to automate or improve husbandry. Disney's Animal Kingdom® uses passive RFID technology to monitor nest usage by a breeding colony of northern carmine bee-eaters. We implemented RFID technologies in various equipment configurations, initially deploying low-frequency (LF) 125 kHz RFID and later changing to high-frequency (HF) 13.56 MHz RFID technology, to monitor breeding behavior in the flock. We installed antennas connected to RFID readers at the entrances of nest tunnels to detect RFID transponders attached to leg bands as birds entered and exited tunnels. Both LF-RFID and HF-RFID systems allowed the characterization of nest visitation, including the timing of nest activity, breeding pair formation, identification of egg-laying females, participation by nonresidents, and detection of nest disruptions. However, we collected a substantially larger volume of data using the increased bandwidth and polling speed inherent with HF-RFID, which permitted tag capture of multiple birds simultaneously and resulted in fewer missed nest visits in comparison to LF-RFID. Herein, we describe the evolution of the RFID setups used to monitor nest usage for more than 7 years, the types of data that can be gained using RFID at nests, and how we used these data to gain insights into carmine bee-eater breeding behavior and improve husbandry.


Assuntos
Aves/fisiologia , Monitorização Fisiológica/veterinária , Comportamento de Nidação/fisiologia , Dispositivo de Identificação por Radiofrequência , Telemetria , Animais , Animais de Zoológico , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos
4.
Invest Ophthalmol Vis Sci ; 60(12): 3830-3834, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31529079

RESUMO

Purpose: To compare the effects of both injectable anesthesia (ketamine/dexmedetomidine versus ketamine/xylazine) and inhalant anesthesia (isoflurane) on IOP using continuous, bilateral IOP telemetry in nonhuman primates (NHP). Methods: Bilateral IOP was recorded continuously using a proven implantable telemetry system in five different sessions at least 2 weeks apart in four male rhesus macaques under two conditions: ketamine (3 mg/kg) with dexmedetomidine (50 µg/kg) or ketamine with xylazine (0.5 mg/kg) for induction, both followed by isoflurane for maintenance. IOP transducers were calibrated via anterior chamber manometry. Bilateral IOP was averaged over 2 minutes after injectable anesthetic induction and again after isoflurane inhalant had stabilized the anesthetic plane, then compared to baseline IOP measurements acquired immediately prior to anesthesia (both before and after initial human contact). Results: When compared to pre-contact baseline measurements, ketamine/dexmedetomidine injectable anesthesia lowers IOP by 1.5 mm Hg on average (P < 0.05), but IOP did not change with ketamine/xylazine anesthesia. IOP returned to baseline levels shortly after isoflurane gas anesthesia was initiated. However, injectable anesthesia lowered IOP by an average of 5.4 mm Hg when compared to that measured after initial human contact (P < 0.01). Conclusions: Anesthetic effects on IOP are generally small when compared to precontact baseline but much larger when compared to IOP measures taken after human contact, indicating that IOP is temporarily elevated due to acute stress (similar to a "white coat effect") and then decreased with anesthetic relaxation. Anesthetic induction with ketamine/xylazine and maintenance with isoflurane gas should be used when IOP is measured postanesthesia.


Assuntos
Anestesia/métodos , Anestésicos Combinados/administração & dosagem , Dexmedetomidina/administração & dosagem , Pressão Intraocular/efeitos dos fármacos , Isoflurano/administração & dosagem , Ketamina/administração & dosagem , Xilazina/administração & dosagem , Anestésicos Dissociativos/administração & dosagem , Anestésicos Inalatórios/administração & dosagem , Animais , Macaca mulatta , Masculino , Telemetria/métodos , Tonometria Ocular
5.
Med Biol Eng Comput ; 57(10): 2215-2230, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31399897

RESUMO

Maintenance is a crucial subject in medical equipment life cycle management. Evidence-based maintenance consists of the continuous performance monitoring of equipment, starting from the evidence-the current state in terms of failure history-and improvement of its effectiveness by making the required changes. This process is very important for optimizing the use and allocation of the available resources by clinical engineering departments. Medical equipment maintenance is composed of two basic activities: scheduled maintenance and corrective maintenance. Both are needed for the management of the entire set of medical equipment in a hospital. Because the classification of maintenance service work orders reveals specific issues related to frequent problems and failures, specific codes have been applied to classify the corrective and scheduled maintenance work orders at Careggi University Hospital (Florence, Italy). In this study, a novel set of key performance indicators is also proposed for evaluating medical equipment maintenance performance. The purpose of this research is to combine these two evidence-based methods to assess every aspect of the maintenance process and provide an objective and standardized approach that will support and enhance clinical engineering activities. Starting from the evidence (i.e. failures), the results show that the combination of these two methods can provide a periodical cross-analysis of maintenance performance that indicates the most appropriate procedures. Graphical abstract The left side shows a block diagram of the process needed to calculate the proposed set of KPIs, starting from technological, organizational and financial data. On the upper right it is shown an example of scheduled maintenance analysis for a specific class of equipment (legend in the article body). The bottom right part shows how the KPIs can be implemented in a business intelligence dashboard.


Assuntos
Equipamentos e Provisões , Engenharia Biomédica , Equipamentos e Provisões/economia , Manutenção , Telemetria
6.
Clin Cardiol ; 42(10): 952-957, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407351

RESUMO

BACKGROUND: Cardiac telemetry monitoring is widely utilized for a variety of clinical indications, yet indication-specific event rates for monitored patients are seldomly reported. HYPOTHESIS: High-risk hospitalized patients for clinical deterioration can be identified using standardized telemetry monitoring indications. METHODS: Adjudicated data from events triggering emergency response team (ERT) activation were systematically characterized at the Cleveland Clinic from among standardized telemetry indications ordered over a 13-month period. RESULTS: Among 72 199 orders created for telemetry monitored patients, ERT activation occurred in 2677 patients (3.7%), of which 1326 (49.5%) were cardiac-related. Patients with deep venous thrombosis or pulmonary embolism (DVT/PE) demonstrated the highest overall event rate (ERT: n = 41 of 593 pts [6.9%]; 25/41 cardiac related [61%]). Cardiac-related events were proportionally highest among patients with coronary disease awaiting revascularization (ERT: n = 19 of 847 patients [2.2%]; 13/19 cardiac-related [68.4%]). Arrhythmia-specific events were highest among patients who underwent cardiac surgery (n = 78 of 193 cardiac-related ERT [40.4%]), and patients with known or suspected tachyarrhythmias (n = 318 of 788 cardiac-related ERT [40.4%]). Bubble plot analysis identified patients hospitalized with DVT/PE, drug or alcohol exposures, and acute coronary syndrome as among the highest overall and cardiac-related events while identifying patients with respiratory disorder monitoring indications as carrying the highest noncardiac event rate. CONCLUSION: High-risk hospitalized patients can be identified by telemetry indication and prioritized according to concerns for cardiac, arrhythmia-specific and noncardiac clinical deterioration. This is particularly useful when monitored bed resources are constrained.


Assuntos
Doenças Cardiovasculares/diagnóstico , Serviço Hospitalar de Emergência , Monitorização Fisiológica/métodos , Telemetria/métodos , Doenças Cardiovasculares/epidemiologia , Seguimentos , Humanos , Incidência , Ohio/epidemiologia , Estudos Retrospectivos
7.
Artigo em Inglês | MEDLINE | ID: mdl-31405064

RESUMO

INTRODUCTION: In Great Britain, roughly half of people with at least one long-standing illness (LSI) live in low-income households. Lower-income households are at risk of fuel poverty and living in a colder house, which can worsen certain health conditions, causing related morbidity and mortality. This pilot study aimed to assess whether raising occupants' awareness of indoor temperatures in the home could initiate improved health and well-being among such vulnerable residents. METHODS: Thermometers were placed inside a manufactured bamboo brooch to be worn or placed within homes during the winter of 2016/17. These devices were supplied to households (n = 34) already assisted by Community Energy Plus, which is a private social enterprise in Cornwall, United Kingdom (UK), using initiatives aimed at maintaining "healthy homes". Questionnaires were supplied to households before devices were supplied, and then again at the end of a three-month period, with further questions asked when devices were collected. Temperatures were recorded automatically every half-hour and used to draw inference from questionnaire responses, particularly around health and well-being. RESULTS: Questionnaires were completed by 22 households. Throughout the winter, those declaring the poorest health when supplied with devices maintained homes at a higher average temperature. There were also indications that those with raised awareness of interior temperatures sought fewer casual medicines. CONCLUSION: Simple telemetry could play a role in the management of chronic health conditions in winter, helping healthcare systems become more sustainable. The need for higher indoor temperatures among people with an LSI highlights the need to consider this approach alongside more sustainable household energy-efficiency improvements. A larger study is needed to explore this further and quantify the cost benefit of this approach.


Assuntos
Temperatura Baixa , Fontes de Energia Elétrica , Características da Família , Nível de Saúde , Telemetria/métodos , Humanos , Morbidade , Projetos Piloto , Pobreza , Estações do Ano , Inquéritos e Questionários , Reino Unido
8.
World Neurosurg ; 131: e74-e80, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31295619

RESUMO

BACKGROUND: Some patients with hydrocephalus and idiopathic intracranial hypertension treated for elevated intracranial pressure (ICP) with a cerebrospinal fluid shunt may continue to experience symptoms or develop new symptoms despite valve adjustments. Use of telemetric ICP measurements may help confirm clinical suspicion of cerebrospinal fluid underdrainage or overdrainage in these patients. However, point in time, duration, and activity during the measurements have never been standardized. We devised a simple, repeatable maneuver for outpatient telemetric ICP recording and evaluated its test-retest reliability. METHODS: Data of patients who underwent ventriculoperitoneal or ventriculoatrial shunt placement and subsequent telemetric ICP sensor implantation were retrospectively reviewed. Telemetric ICP recordings in patients were conducted in a standardized manner: The standing-supine-sitting paradigm requires postural changes in 10-minute intervals over 30 minutes. First, the patient is requested to walk; second, to lay down; third, to sit down with a headrest elevation of 60°. ICP data (in mmHg) were reported as mean ± SD values. Test-retest validity was assessed using Pearson correlation analysis. RESULTS: We evaluated 66 ICP datasets obtained repeatedly with a time difference of at least 24 hours. Overall test-retest reliability was excellent (Pearson correlation coefficient 0.99, P < 0.001), as were the scores for individual postures: standing (correlation 0.98, P < 0.001), supine (correlation 0.98, P < 0.001), and sitting (correlation 0.99, P < 0.001). The sum of square differences of the test-retest measures reflected a comparable validity of all tested positions. CONCLUSIONS: We confirmed high test-retest reliability of the standing-supine-sitting paradigm for telemetric ICP measurements in the outpatient setting. High test-retest reliability should be considered as prerequisite for clinical decision making.


Assuntos
Derivações do Líquido Cefalorraquidiano , Hidrocefalia/diagnóstico , Pressão Intracraniana , Pseudotumor Cerebral/diagnóstico , Telemetria/métodos , Adulto , Assistência Ambulatorial , Feminino , Humanos , Hidrocefalia/cirurgia , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Pseudotumor Cerebral/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Derivação Ventriculoperitoneal , Caminhada
9.
Clin Cardiol ; 42(10): 914-918, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31282021

RESUMO

BACKGROUND: Electromagnetic interference between left ventricular assist devices (LVAD) and the telemetry wand of implantable cardioverter-defibrillators (ICD) with impairment of ICD interrogation has previously been described in HVAD and HeartMate II devices. This is the first study showing the potential influence of the LVAD model HeartMate 3 (with the unique feature of fully magnetically levitated rotor with consistent wide blood-flow gaps) on functional interrogation of different ICD models. METHODS AND RESULTS: Among 51 patients treated with a HeartMate 3 LVAD, 34 patients (66.7%) already had an ICD implanted prior to LVAD therapy. In this cohort, impairment of ICD interrogation was observed in five patients (14.7%) with five different device models. In patients with Biotronik ICD, stretching of the ipsilateral arm to increase the distance between both devices >10 cm was sufficient in one patients, whereas surgical contralateral repositioning was necessary in two patients; in one further patient no action could be taken, as he died early from embolic stroke. In the only patient with a MicroPort ICD, this issue was resolved by using a wireless telemetry. The distances between both devices showed no statistical significant correlation with an impaired interrogation, neither in the overall collective nor within the groups with the same manufacturer. CONCLUSIONS: In patients with impaired ICD interrogation caused by electromagnetic interference between a HeartMate 3 LVAD and the ICD, the actions mentioned above have to be taken, to resolve this technical issue. Especially, a sufficient distance of at least 10 cm between both devices was crucial for avoiding this problem.


Assuntos
Desfibriladores Implantáveis , Insuficiência Cardíaca/terapia , Ventrículos do Coração/fisiopatologia , Coração Auxiliar , Imãs , Telemetria/métodos , Função Ventricular Esquerda/fisiologia , Desenho de Equipamento , Feminino , Seguimentos , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
J Toxicol Sci ; 44(7): 441-457, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31270301

RESUMO

The objective of this study is to assess the response of telemetered common marmosets to multiple cardiac ion channel inhibitors and to clarify the usefulness of this animal model in evaluating the effects of drug candidates on electrocardiogram (ECG). Six multiple cardiac ion channel inhibitors (sotalol, astemizole, flecainide, quinidine, verapamil and terfenadine) were orally administered to telemetered common marmosets and changes in QTc, PR interval and QRS duration were evaluated. Drugs plasma levels were determined to compare the sensitivity in common marmosets to that in humans. QTc prolongation was observed in the marmosets dosed with sotalol, astemizole, flecainide, quinidine, verapamil and terfenadine. PR prolongation was noted after flecainide and verapamil administration, and QRS widening occurred following treatment with flecainide and quinidine. Drugs plasma levels associated with ECG changes in marmosets were similar to those in humans, except for verapamil-induced QTc prolongation. Verapamil-induced change is suggested due to body temperature decrease. These results indicate that telemetered common marmoset is a useful animal for evaluation of the ECG effects of multiple cardiac ion channel inhibitors and the influence of body temperature change should be considered in the assessment.


Assuntos
Astemizol/farmacologia , Bloqueadores dos Canais de Cálcio/farmacologia , Callithrix , Eletrocardiografia/efeitos dos fármacos , Flecainida/farmacologia , Modelos Animais , Quinidina/farmacologia , Medição de Risco/métodos , Sotalol/farmacologia , Telemetria , Terfenadina/farmacologia , Verapamil/farmacologia , Bloqueadores do Canal de Sódio Disparado por Voltagem/farmacologia , Animais , Astemizol/sangue , Temperatura Corporal/fisiologia , Bloqueadores dos Canais de Cálcio/sangue , Flecainida/sangue , Masculino , Quinidina/sangue , Sotalol/sangue , Terfenadina/sangue , Verapamil/sangue , Bloqueadores do Canal de Sódio Disparado por Voltagem/sangue
11.
Prehosp Disaster Med ; 34(4): 356-362, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31322099

RESUMO

INTRODUCTION: With the increasing availability of vehicle telemetry technology, there is great potential for Advanced Automatic Collision Notification (AACN) systems to improve trauma outcomes by detecting patients at-risk for severe injury and facilitating early transport to trauma centers. METHODS: National Automotive Sampling System Crashworthiness Data System (NASS-CDS) data from 1999-2013 were used to construct a logistic regression model (injury severity prediction [ISP] model) predicting the probability that one or more occupants in planar, non-rollover motor vehicle collisions (MVCs) would have Injury Severity Score (ISS) 15+ injuries. Variables included principal direction of force (PDOF), change in velocity (Delta-V), multiple impacts, presence of any older occupant (≥55 years old), presence of any female occupant, presence of right-sided passenger, belt use, and vehicle type. The model was validated using medical records and 2008-2011 crash data from AACN-enabled Michigan (USA) vehicles identified from OnStar (OnStar Corporation; General Motors; Detroit, Michigan USA) records. To compare the ISP to previously established protocols, a literature search was performed to determine the sensitivity and specificity of first responder identification of ISS 15+ for MVC occupants. RESULTS: The study population included 924 occupants in 836 crash events. The ISP model had a sensitivity of 72.7% (95% Confidence Interval [CI] 41%-91%) and specificity of 93% (95% CI 92%-95%) for identifying ISS 15+ occupants injured in planar MVCs. The current standard 2006 Field Triage Decision Scheme (FTDS) was 56%-66% sensitive and 75%-88% specific in identifying ISS 15+ patients. CONCLUSIONS: The ISP algorithm comparably is more sensitive and more specific than current field triage in identifying MVC patients at-risk for ISS 15+ injuries. This real-world field study shows telemetry data transmitted before dispatch of emergency medical systems can be helpful to quickly identify patients who require urgent transfer to trauma centers.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Sistemas de Comunicação entre Serviços de Emergência/organização & administração , Telemetria/métodos , Triagem/métodos , Ferimentos e Lesões/diagnóstico , Adulto , Algoritmos , Bases de Dados Factuais , Feminino , Humanos , Escala de Gravidade do Ferimento , Modelos Logísticos , Masculino , Michigan , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida , Tempo para o Tratamento , Transporte de Pacientes/organização & administração , Centros de Traumatologia/organização & administração , Resultado do Tratamento , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/terapia
12.
Cardiology ; 143(1): 62-72, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31307049

RESUMO

Patent foramen ovale (PFO) is a common benign finding in healthy subjects, but its prevalence is higher in patients with stroke of unclear cause (cryptogenic stroke). PFO is believed to be associated with stroke through paradoxical embolism, and certain clinical and anatomical criteria seem to increase the likelihood of a PFO to be pathological. Recent trials have shown that closure of PFO, especially if associated with an atrial septal aneurysm and/or a large interatrial shunt, may reduce the risk of recurrent stroke as compared to medical treatment. However, it remains challenging to risk stratify patients with suspected PFO-related stroke and to decide if device closure is indicated. We sought to review contemporary evidence and to conclude an evidence-based strategy to prevent recurrence of PFO-related stroke.


Assuntos
Forame Oval Patente/complicações , Forame Oval Patente/terapia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Anticoagulantes/uso terapêutico , Tomada de Decisão Clínica , Ensaios Clínicos como Assunto , Eletrocardiografia , Embolia Paradoxal/complicações , Embolia Paradoxal/etiologia , Humanos , Medição de Risco , Prevenção Secundária , Dispositivo para Oclusão Septal , Telemetria
13.
J Stroke Cerebrovasc Dis ; 28(9): 2448-2452, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31307898

RESUMO

BACKGROUND AND AIMS: Increasingly, insertable cardiac monitors (ICM) have been used to detect Atrial Fibrillation (AF) in patients with cryptogenic stroke or embolic strokes of undetermined source (ESUS). We aim to examine the characteristics of these patients who were subsequently found to have AF. METHODS: We studied 83 consecutive patients who were comprehensively evaluated using neuroimaging and vessel imaging (computed tomography angiography, magnetic resonance angiography, or transcranial and extracranial Doppler sonography) to have met the previously established ESUS criteria. All 83 patients had ICM implanted between 2015 and 2017. All patients were followed up for at least 1 year, with a median follow-up period of 1.5 ± .5 years. We compared the baseline clinical, laboratory, echocardiographic, neuro-imaging profiles, and clinical outcomes in terms of functional recovery, recurrent stroke, and mortality in patients with and without detected AF. RESULTS: AF detection rate in this ESUS cohort was 12% over the study period. Patients with detected AF were associated with bilateral infarcts pattern at presentation (30% versus 5.5%, P = .035). Infarcts involving multiple vascular territories was not significantly associated with the detection of AF. There were no significant differences in the other clinical characteristics and outcomes between the AF group compared to the group without detected AF. Echocardiographic parameters including left ventricular ejection fraction and left atrial diameter were also not shown to be significantly different. CONCLUSION: Our study found that a neuroimaging profile of bilateral infarcts was associated with AF detection using insertable cardiac monitor in ESUS patients. Larger prospective studies are needed to validate our findings.


Assuntos
Fibrilação Atrial/diagnóstico , Infarto Encefálico/epidemiologia , Frequência Cardíaca , Embolia Intracraniana/epidemiologia , Monitorização Ambulatorial/instrumentação , Telemetria/instrumentação , Idoso , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/mortalidade , Fibrilação Atrial/terapia , Infarto Encefálico/diagnóstico por imagem , Infarto Encefálico/mortalidade , Infarto Encefálico/terapia , Feminino , Humanos , Incidência , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/mortalidade , Embolia Intracraniana/terapia , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Recidiva , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Singapura/epidemiologia , Fatores de Tempo , Resultado do Tratamento
14.
J Therm Biol ; 83: 112-118, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31331509

RESUMO

Wireless measurement of rectal temperature during exercise may circumvent some limitations associated with the use of a conventional wired probe. We determined, for the first time, whether temperatures provided in vivo by wireless ingestible thermometric telemetric pills and a rectal probe compare favorably under conditions producing slow and rapid increases and decreases in rectal temperature. While wearing a rectal probe linked to a wireless ingestible thermometric telemetric pill, 13 participants completed the following phases: 1) 30 min sitting; 2) 45 min passive heat exposure (40-42 °C); 3) 45 min sitting while ingesting 7.5 g of ice slurry · kg body mass-1; 4) running exercise (38 °C) at 68% V˙O2max until a 39.5 °C increase in rectal probe temperature and; 5) cold-water (10 °C) immersion until a 1.5 °C decrease in rectal probe temperature. Acceptable differences between devices were taken as ≤ 0.3 °C. Mean differences within phases were all < 0.3 °C, whereas 95% limits of agreement ranged from ±0.2 °C to ±0.4 °C, coefficient of variations from ±0.3% to ±0.6% and typical error of measurements from ±0.1 °C to ±0.2°. Of the 14881 rectal temperature values measured over the experiment with the wireless ingestible thermometric telemetric pills and rectal probe, 91% of the differences between devices were found to be ≤ 0.3 °C. Results suggest that rectal temperatures provided by a wireless ingestible thermometric telemetric pill used as a suppository agree with those of a conventional wired probe. Hence, rectal temperature can reliably be measured using a wireless ingestible thermometric telemetric pill as a suppository.


Assuntos
Temperatura Corporal , Exercício , Telemetria/métodos , Termometria/métodos , Adulto , Feminino , Temperatura Alta , Humanos , Masculino , Reto/fisiologia , Telemetria/efeitos adversos , Telemetria/normas , Termometria/efeitos adversos , Termometria/normas , Tecnologia sem Fio/normas
15.
PLoS One ; 14(6): e0218521, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220146

RESUMO

BACKGROUND: The concept of 'patient experience' has become central to how to improve healthcare. Remote communication with patients is today a frequent practice in healthcare services, showing similar outcomes to standard outpatient care while enabling cost reduction in both formal and informal care. The purpose of this study was to analyse the experiences of people with telemonitoring pacemakers. METHODS: Patients were randomly allocated to either the telemonitoring or hospital monitoring follow-ups. Using the 'Generic Short Patient Experiences Questionnaire' (GS-PEQ), as well as an ad-hoc survey from the 'telehealth patient satisfaction survey' and 'costs survey', patients' experiences were measured six months after the pacemaker implant in a cohort of 50 consecutive patients. The mean age was 74.8 (± 11.75) years and 26 (52%) patients were male of which 1 was lost in follow-up. Finally, 24 patients were followed up with standard hospital monitoring, while 25 used the telemonitoring system. Differences in baseline characteristics between groups were not found. RESULTS: Findings showed overall positive and similar experiences in patients living with telemonitoring and hospital monitoring pacemakers. Significant differences were found in GS-PEQ concerning how telemonitoring patients received less information about their diagnosis/afflictions (p = 0.046). We did not find significant differences in other items such as 'confidence in the clinicians' professional skills', 'treatment perception adapted to their situation', 'involvement in decisions regarding the treatment', 'perception of hospital organisation', 'waiting before admission', 'satisfaction of help and treatment received', 'benefit received', and 'incorrect treatment'. CONCLUSIONS: The remote communication of pacemakers was met with positive levels of patients' experiences similarly to patients in the hospital monitoring follow-up. However, telemonitoring patients received less information. Thus, improving the quality and timing of information is required in telemonitoring patients in the planning and organisation of future remote communication healthcare services for people living with a pacemaker implant.


Assuntos
Atitude , Marca-Passo Artificial/psicologia , Satisfação do Paciente , Pacientes/psicologia , Telemetria/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Telemetria/métodos , Telemetria/normas
16.
Sensors (Basel) ; 19(12)2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31238521

RESUMO

High-resolution (HR) mapping of the gastrointestinal (GI) bioelectrical activity is an emerging method to define the GI dysrhythmias such as gastroparesis and functional dyspepsia. Currently, there is no solution available to conduct HR mapping in long-term studies. We have developed an implantable 64-channel closed-loop near-field communication system for real-time monitoring of gastric electrical activity. The system is composed of an implantable unit (IU), a wearable unit (WU), and a stationary unit (SU) connected to a computer. Simultaneous data telemetry and power transfer between the IU and WU is carried out through a radio-frequency identification (RFID) link operating at 13.56 MHz. Data at the IU are encoded according to a self-clocking differential pulse position algorithm, and load shift keying modulated with only 6.25% duty cycle to be back scattered to the WU over the inductive path. The retrieved data at the WU are then either transmitted to the SU for real-time monitoring through an ISM-band RF transceiver or stored locally on a micro SD memory card. The measurement results demonstrated successful data communication at the rate of 125 kb/s when the distance between the IU and WU is less than 5 cm. The signals recorded in vitro at IU and received by SU were verified by a graphical user interface.


Assuntos
Telemetria/métodos , Tecnologia sem Fio , Algoritmos , Humanos , Modelos Teóricos , Próteses e Implantes , Dispositivo de Identificação por Radiofrequência , Processamento de Sinais Assistido por Computador
17.
Ecol Appl ; 29(6): e01947, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31183944

RESUMO

Telemetry is a key, widely used tool to understand marine megafauna distribution, habitat use, behavior, and physiology; however, a critical question remains: "How many animals should be tracked to acquire meaningful data sets?" This question has wide-ranging implications including considerations of statistical power, animal ethics, logistics, and cost. While power analyses can inform sample sizes needed for statistical significance, they require some initial data inputs that are often unavailable. To inform the planning of telemetry and biologging studies of marine megafauna where few or no data are available or where resources are limited, we reviewed the types of information that have been obtained in previously published studies using different sample sizes. We considered sample sizes from one to >100 individuals and synthesized empirical findings, detailing the information that can be gathered with increasing sample sizes. We complement this review with simulations, using real data, to show the impact of sample size when trying to address various research questions in movement ecology of marine megafauna. We also highlight the value of collaborative, synthetic studies to enhance sample sizes and broaden the range, scale, and scope of questions that can be answered.


Assuntos
Ecologia , Ecossistema , Animais , Tamanho da Amostra , Telemetria
18.
Part Fibre Toxicol ; 16(1): 25, 2019 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234877

RESUMO

BACKGROUND: Non-communicable diseases, intended as the results of a combination of inherited, environmental and biological factors, kill 40 million people each year, equivalent to roughly 70% of all premature deaths globally. The possibility that manufactured nanoparticles (NPs) may affect cardiac performance, has led to recognize NPs-exposure not only as a major Public Health concern, but also as an occupational hazard. In volunteers, NPs-exposure is problematic to quantify. We recently found that inhaled titanium dioxide NPs, one of the most produced engineered nanomaterials, acutely increased cardiac excitability and promoted arrhythmogenesis in normotensive rats by a direct interaction with cardiac cells. We hypothesized that such scenario can be exacerbated by latent cardiovascular disorders such as hypertension. RESULTS: We monitored cardiac electromechanical performance in spontaneously hypertensive rats (SHRs) exposed to titanium dioxide NPs for 6 weeks using a combination of cardiac functional measurements associated with toxicological, immunological, physical and genetic assays. Longitudinal radio-telemetry ECG recordings and multiple-lead epicardial potential mapping revealed that atrial activation times significantly increased as well as proneness to arrhythmia. At the third week of nanoparticles administration, the lung and cardiac tissue encountered a maladaptive irreversible structural remodelling starting with increased pro-inflammatory cytokines levels and lipid peroxidation, resulting in upregulation of the main pro-fibrotic cardiac genes. At the end of the exposure, the majority of spontaneous arrhythmic events terminated, while cardiac hemodynamic deteriorated and a significant accumulation of fibrotic tissue occurred as compared to control untreated SHRs. Titanium dioxide nanoparticles were quantified in the heart tissue although without definite accumulation as revealed by particle-induced X-ray emission and ultrastructural analysis. CONCLUSIONS: The co-morbidity of hypertension and inhaled nanoparticles induces irreversible hemodynamic impairment associated with cardiac structural damage potentially leading to heart failure. The time-dependence of exposure indicates a non-return point that needs to be taken into account in hypertensive subjects daily exposed to nanoparticles.


Assuntos
Coração/efeitos dos fármacos , Hipertensão/patologia , Miocárdio/patologia , Nanopartículas/toxicidade , Titânio/toxicidade , Animais , Pressão Sanguínea/efeitos dos fármacos , Relação Dose-Resposta a Droga , Eletrocardiografia , Fibrose , Coração/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Hipertensão/fisiopatologia , Ratos Endogâmicos SHR , Telemetria , Função Ventricular Esquerda
19.
Invest Ophthalmol Vis Sci ; 60(7): 2572-2582, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31212310

RESUMO

Purpose: To characterize intraocular pressure (IOP) dynamics by identifying the sources of transient IOP fluctuations and quantifying the frequency, magnitude, associated cumulative IOP-related mechanical energy, and temporal distribution. Methods: IOP was monitored at 500 Hz for periods of 16 to 451 days in nine normal eyes of six conscious, unrestrained nonhuman primates using a validated, fully implanted wireless telemetry system. IOP transducers were calibrated every two weeks via anterior chamber cannulation manometry. Analysis of time-synchronized, high-definition video was used to identify the sources of transient IOP fluctuations. Results: The distribution of IOP in individual eyes is broad, and changes at multiple timescales, from second-to-second to day-to-day. Transient IOP fluctuations arise from blinks, saccades, and ocular pulse amplitude and were as high as 14 mm Hg (>100%) above momentary baseline. Transient IOP fluctuations occur ∼10,000 times per waking hour, with ∼2000 to 5000 fluctuations per hour greater than 5 mm Hg (∼40%) above baseline. Transient IOP fluctuations account for up to 17% (mean of 12%) of the total cumulative IOP-related mechanical energy that the eye must withstand during waking hours. Conclusions: Transient IOP fluctuations occur frequently and comprise a large and significant portion of the total IOP loading in the eye and should, therefore, be considered in future studies of cell mechanotransduction, ocular biomechanics, and/or clinical outcomes where transient IOP fluctuations may be important. If IOP dynamics are similar in humans, clinical snapshot IOP measurements are insufficient to capture true IOP.


Assuntos
Fenômenos Biomecânicos/fisiologia , Pressão Intraocular/fisiologia , Mecanotransdução Celular/fisiologia , Animais , Calibragem , Ritmo Circadiano/fisiologia , Feminino , Macaca mulatta , Masculino , Telemetria , Tonometria Ocular
20.
J Stroke Cerebrovasc Dis ; 28(9): 2569-2573, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31230824

RESUMO

BACKGROUND: Detection and treatment of atrial fibrillation (AF) is a major goal in preventing secondary stroke. Insertable cardiac monitors (ICMs) are available for diagnosis of arrhythmia monitoring in patients with cryptogenic stroke. Magnetic resonance imaging (MRI)-based diagnostic evaluation for acute ischemic stroke subtype classification is common in Japan and can be useful for specific diagnosis of cryptogenic stroke. PURPOSE: We aimed to investigate the detection rate of AF with an ICM in patients with cryptogenic stroke who were diagnosed by MRI. METHODS: We performed a retrospective, multicenter, observational study. AF monitoring data of an ICM (Reveal LINQ) in patients with cryptogenic stroke were registered from 5 stroke centers in Japan between October 2016 and March 2018. ICM candidates in cryptogenic stroke were diagnosed by MRI-based evaluation and selected according to the criteria proposed by the Japan Stroke Society. Detection of AF was defined as AF for longer than 120 seconds. RESULTS: Eighty-four consecutive patients (64 men; aged 38-90 years) underwent ICM implantation after diagnosis of cryptogenic stroke. AF was detected in 22 of 84 (26.2%) patients with an ICM during a median follow-up of 221.5 days (range: 93-365 days). The detection rate of AF within 3 months after ICM implantation was 21.4%. CONCLUSIONS: The AF detection rate with an ICM is approximately one fifth within 3 months in patients with cryptogenic stroke as diagnosed by MRI. Our data suggest that the Japanese criteria based on MRI may be useful for selecting adequate candidates for ICM implantation.


Assuntos
Fibrilação Atrial/diagnóstico , Frequência Cardíaca , Imagem por Ressonância Magnética , Acidente Vascular Cerebral/diagnóstico por imagem , Telemetria/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Tomada de Decisão Clínica , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/prevenção & controle , Fatores de Tempo
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