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1.
J Nurs Care Qual ; 37(1): E1-E7, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33935269

RESUMO

BACKGROUND: Cardiac telemetry downtime may be planned or unplanned, causing a disruption in telemetry services with a potential to impact patient safety. PROBLEM: Many cardiac telemetry units in the Veterans Health Administration (VHA) have contingency plans that do not adequately address telemetry downtime. APPROACH: This is a retrospective quality improvement analysis of VHA-reported cardiac telemetry downtime events from October 1, 2014, to Mar 31, 2020. OUTCOMES: Of 98 events, no patient harm was reported; 13% (n = 13) were planned downtime, 82% (n = 80) were unplanned downtime, 18% (n = 18) reported contingency plan use, 78% (n = 76) did not specify contingency plan use, and 32% (n = 31) reported events lasting 31 minutes to 6 hours in duration. CONCLUSIONS: The majority of reported cardiac telemetry downtime events were unplanned and without documented contingency plans. A robust contingency plan with defined staff roles and responsibilities will serve to lessen anxiety during downtimes and mitigate potential risk of patient harm.


Assuntos
Registros Eletrônicos de Saúde , Saúde dos Veteranos , Humanos , Segurança do Paciente , Estudos Retrospectivos , Telemetria
2.
Am J Crit Care ; 30(6): 466-470, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34719703

RESUMO

BACKGROUND: QT prolongation increases the risk of ventricular arrhythmia and is common among critically ill patients. The gold standard for QT measurement is electrocardiography. Automated measurement of corrected QT (QTc) by cardiac telemetry has been developed, but this method has not been compared with electrocardiography in critically ill patients. OBJECTIVE: To compare the diagnostic performance of QTc values obtained with cardiac telemetry versus electrocardiography. METHODS: This prospective observational study included patients admitted to intensive care who had an electrocardiogram ordered simultaneously with cardiac telemetry. Demographic data and QTc determined by electrocardiography and telemetry were recorded. Bland-Altman analysis was done, and correlation coefficient and receiver operating characteristic (ROC) coefficient were calculated. RESULTS: Fifty-one data points were obtained from 43 patients (65% men). Bland-Altman analysis revealed poor agreement between telemetry and electrocardiography and evidence of fixed and proportional bias. Area under the ROC curve for QTc determined by telemetry was 0.9 (P < .001) for a definition of prolonged QT as QTc ≥ 450 milliseconds in electrocardiography (sensitivity, 88.89%; specificity, 83.33%; cutoff of 464 milliseconds used). Correlation between the 2 methods was only moderate (r = 0.6, P < .001). CONCLUSIONS: QTc determination by telemetry has poor agreement and moderate correlation with electrocardiography. However, telemetry has an acceptable area under the curve in ROC analysis with tolerable sensitivity and specificity depending on the cutoff used to define prolonged QT. Cardiac telemetry should be used with caution in critically ill patients.


Assuntos
Estado Terminal , Síndrome do QT Longo , Arritmias Cardíacas , Eletrocardiografia , Feminino , Humanos , Síndrome do QT Longo/diagnóstico , Masculino , Telemetria
3.
Sensors (Basel) ; 21(21)2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34770322

RESUMO

A large number of smart devices in Internet of Things (IoT) environments communicate via different messaging protocols. Message Queuing Telemetry Transport (MQTT) is a widely used publish-subscribe-based protocol for the communication of sensor or event data. The publish-subscribe strategy makes it more attractive for intruders and thus increases the number of possible attacks over MQTT. In this paper, we proposed a Deep Neural Network (DNN) for intrusion detection in the MQTT-based protocol and also compared its performance with other traditional machine learning (ML) algorithms, such as a Naive Bayes (NB), Random Forest (RF), k-Nearest Neighbour (kNN), Decision Tree (DT), Long Short-Term Memory (LSTM), and Gated Recurrent Units (GRUs). The performance is proved using two different publicly available datasets, including (1) MQTT-IoT-IDS2020 and (2) a dataset with three different types of attacks, such as Man in the Middle (MitM), Intrusion in the network, and Denial of Services (DoS). The MQTT-IoT-IDS2020 contains three abstract-level features, including Uni-Flow, Bi-Flow, and Packet-Flow. The results for the first dataset and binary classification show that the DNN-based model achieved 99.92%, 99.75%, and 94.94% accuracies for Uni-flow, Bi-flow, and Packet-flow, respectively. However, in the case of multi-label classification, these accuracies reduced to 97.08%, 98.12%, and 90.79%, respectively. On the other hand, the proposed DNN model attains the highest accuracy of 97.13% against LSTM and GRUs for the second dataset.


Assuntos
Aprendizado Profundo , Internet das Coisas , Teorema de Bayes , Humanos , Redes Neurais de Computação , Telemetria
4.
Sensors (Basel) ; 21(21)2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34770623

RESUMO

Semantic segmentation for high-resolution remote-sensing imagery (HRRSI) has become increasingly popular in machine vision in recent years. Most of the state-of-the-art methods for semantic segmentation of HRRSI usually emphasize the strong learning ability of deep convolutional neural network to model the contextual relationship in the image, which takes too much consideration on every pixel in images and subsequently causes the problem of overlearning. Annotation errors and easily confused features can also lead to the confusion problem while using the pixel-based methods. Therefore, we propose a new semantic segmentation network-the region-enhancing network (RE-Net)-to emphasize the regional information instead of pixels to solve the above problems. RE-Net introduces the regional information into the base network, to enhance the regional integrity of images and thus reduce misclassification. Specifically, the regional context learning procedure (RCLP) can learn the context relationship from the perspective of regions. The region correcting procedure (RCP) uses the pixel aggregation feature to recalibrate the pixel features in each region. In addition, another simple intra-network multi-scale attention module is introduced to select features at different scales by the size of the region. A large number of comparative experiments on four different public datasets demonstrate that the proposed RE-Net performs better than most of the state-of-the-art ones.


Assuntos
Processamento de Imagem Assistida por Computador , Semântica , Redes Neurais de Computação , Manejo de Espécimes , Telemetria
5.
Sensors (Basel) ; 21(19)2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34641002

RESUMO

In animal tracking applications, smaller transmitters can reduce the impact of the transmitter on the tagged animal and thus provide more accurate data about animal behavior. By combining a novel circuit design and a newly developed micro-battery, we developed frequency-programmable and more powerful radio frequency transmitters that are about 40% smaller and lighter in weight than the smallest commercial counterpart for animal monitoring at the time of development. The new radio frequency transmitter has a miniaturized form factor for studying small animals. Designs of two coding schemes were developed: one transmits unmodulated signals (weight: 152 mg; dimensions: Ø 2.95 mm × 11.22 mm), and the other transmits modulated signals (weight: 160 mg; dimensions: Ø 2.95 mm × 11.85 mm). To accommodate different transmitter life requirements, each design can be configured to transmit in high or low signal strength. Prototypes of these transmitters were evaluated in the laboratory and exhibited comparable or longer service life and higher signal strength compared to their smallest commercial counterparts.


Assuntos
Ondas de Rádio , Telemetria , Animais , Comportamento Animal
6.
Appl Clin Inform ; 12(5): 996-1001, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34706394

RESUMO

BACKGROUND: Overuse of cardiac telemetry monitoring (telemetry) can lead to alarm fatigue, discomfort for patients, and unnecessary medical costs. Currently there are evidence-based recommendations describing appropriate telemetry use, but many providers are unaware of these guidelines. OBJECTIVES: At our multihospital health system, our goal was to support providers in ordering telemetry on acute care in accordance with evidence-based guidelines and discontinuing telemetry when it was no longer medically indicated. METHODS: We implemented a multipronged electronic health record (EHR) intervention at two academic medical centers, including: (1) an order set requiring providers to choose an indication for telemetry with a recommended duration based on American Heart Association guidelines; (2) an EHR-generated reminder page to the primary provider recommending telemetry discontinuation once the guideline-recommended duration for telemetry is exceeded; and (3) documentation of telemetry interpretation by telemetry technicians in the notes section of the EHR. To determine the impact of the intervention, we compared number of telemetry orders actively discontinued prior to discharge and telemetry duration 1 year pre- to 1 year post-intervention on acute care medicine services. We evaluated sustainability at years 2 and 3. RESULTS: Implementation of the EHR initiative resulted in a statistically significant increase in active discontinuation of telemetry orders prior to discharge: 15% (63.4-78.7%) at one site and 13% at the other (64.1-77.4%) with greater improvements on resident teams. Fewer acute care medicine telemetry orders were placed on medicine services across the system (1,503-1,305) despite an increase in admissions and the average duration of telemetry decreased at both sites (62 to 47 hours, p < 0.001 and 73 to 60, p < 0.001, respectively). Improvements were sustained 2 and 3 years after intervention. CONCLUSION: Our study showed that a low-cost, multipart, EHR-based intervention with active provider engagement and no additional education can decrease telemetry usage on acute care medicine services.


Assuntos
Registros Eletrônicos de Saúde , Telemetria , Centros Médicos Acadêmicos , Documentação , Humanos , Monitorização Fisiológica , Estados Unidos
7.
Mar Environ Res ; 172: 105489, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34619503

RESUMO

Aquatic ecosystems face numerous anthropogenic threats associated with coastal urbanization, with boat activity being among the most prevalent. The present study aimed to evaluate a potential relationship between boat activity and shark space use in Biscayne Bay, Florida (USA), a coastal waterway exposed to high levels of boating. Spatiotemporal patterns in boat density and traffic were determined from aerial surveys and underwater acoustic recorders, respectively. These data were then compared with residency patterns of bull (Carcharhinus leucas), nurse (Ginglymostoma cirratum) and great hammerhead (Sphyrna mokarran) sharks quantified through passive acoustic telemetry. Results were mixed, with no detectable relationship between boat density and shark residency for any of the species. Hourly presence of G. cirratum decreased with increasing boat traffic, a relationship not seen in the other two species. Explanations for these results include habituation of sharks to the high levels of chronic boat activity in the study area and interspecific differences in hearing sensitivity.


Assuntos
Tubarões , Animais , Ecossistema , Florida , Navios , Telemetria
8.
Sensors (Basel) ; 21(18)2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34577484

RESUMO

This article is devoted to the issues of processing and analysis of heterogeneous information related to the functioning of mining transport equipment, which becomes available for analysis within the framework of modern technological operations control systems in open-pit mines. These issues are very relevant to robotized technological operations. The paper gives a brief overview of the modern landscape of the autonomous haulage systems management problems, the features of the platform approach to solving the problem of managing unmanned transport and technological processes in open pits are considered. The concept of an agent-based approach to the modeling of an open-pit mining is described in detail on the basis of the interaction of three systems: technical, infrastructural-technological, and geostructural. Some features of the developed platform architecture integration of heterogeneous information are discussed. The principles of information integration are considered in detail when constructing a dynamic 3D model (digital twin) of infrastructure and technological system elements using large arrays of telemetric data. The results of building digital models of open-pit technological roads are presented. The resulting models are comparatively analyzed in the process of optimizing of the interaction of technical autonomous mobile agents and elements of technological infrastructure.


Assuntos
Mineração , Telemetria
9.
BMC Neurol ; 21(1): 343, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493231

RESUMO

BACKGROUND: Idiopathic intracranial hypertension (IIH) is a disease which is difficult to diagnose and moreover difficult to treat. We developed a strategy for long-term telemonitoring of intracranial pressure (ICP), by incorporation of the NEUROVENT®-P-tel System, with the goal of improved diagnosis and consequent therapy of this disease. We highlight the results obtained through this approach. METHODS: Twenty patients with suspected IIH who were treated in our hospital from August 2014 to October 2020 (16 females, 4 males, median age 36,6 years), were assigned to one of two ICP monitoring settings, "Home-Telemonitoring" (n = 12) and "Home-Monitoring" (n = 8). The ICP data were analysed and used conjointly with the accompanying clinical picture for establishment of IIH diagnosis, and telemonitoring was resumed for therapy optimisation of confirmed cases. RESULTS: The diagnosis of IIH was confirmed in 18 of the 20 patients. Various surgical/interventional treatments were applied to the confirmed cases, including ventriculoperitoneal (VP) shunting (n = 15), stenting of the transvers venous sinus (n = 1), endoscopic third ventriculostomy (ETV) (n = 1), and ETV in combination with endoscopic laser-based coagulation of the choroid Plexus (n = 1). Optimal adjustment of the implanted shunt valves was achieved with an average valve opening pressure of 6,3 ± 2,17 cm H2O for differential valves, and of 29,8 ± 3,94 cm H2O for gravitational valves. The Home-Telemonitoring setting reduced consequent outpatient visits, compared to the Home-Monitoring setting, with an average of 3,1 visits and 4,3 visits, respectively. No complications were associated with the surgical implantation of the P-tel catheter. CONCLUSION: This study offers insight into the use of long-term ICP monitoring for management of IIH patients in combination with dual-valve VP shunts. The use of NEUROVENT® P-tel system and potentially other similar fully implantable ICP-monitoring devices, albeit invasive, may be justified in this complex disease. The data suggest recommending an initial adjustment of dual-valve VP-shunts of 30 and 6 cm H2O, for gravitational and differential valves, respectively. Further research is warranted to explore potential integration of this concept in IIH management guidelines.


Assuntos
Hipertensão Intracraniana , Pseudotumor Cerebral , Adulto , Feminino , Humanos , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/terapia , Pressão Intracraniana , Masculino , Monitorização Fisiológica , Pseudotumor Cerebral/diagnóstico , Pseudotumor Cerebral/terapia , Telemetria , Derivação Ventriculoperitoneal
10.
Physiol Meas ; 42(9)2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34580243

RESUMO

Beaulieu-Jones and coworkers propose a litmus test for the field of predictive analytics-performance improvements must be demonstrated to be the result of non-clinician-initiated data, otherwise, there should be caution in assuming that predictive models could improve clinical decision-making (Beaulieu-Joneset al2021). They demonstrate substantial prognostic information in unsorted physician orders made before the first midnight of hospital admission, and we are persuaded that it is fair to ask-if the physician thought of it first, what exactly is machine learning for in-patient risk stratification learning about? While we want predictive analytics to represent the leading indicators of a patient's illness, does it instead merely reflect the lagging indicators of clinicians' actions? We propose that continuous cardiorespiratory monitoring-'routine telemetry data,' in Beaulieu-Jones' terms-represents the most valuable non-clinician-initiated predictive signal present in patient data, and the value added to patient care justifies the efforts and expense required. Here, we present a clinical and a physiological point of view to support our contention.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Tomada de Decisão Clínica , Humanos , Aprendizado de Máquina , Medição de Risco , Telemetria
11.
PLoS One ; 16(9): e0256805, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473741

RESUMO

Fishways have been widely used for upstream passage around human-built structures, but 'success' has varied dramatically. Evaluation of fishway success has typically been conducted at local scales using metrics such as fish passage efficiency and passage time, but evaluations are increasingly used in broader assessments of whether passage facilities meet population-specific conservation and management objectives. Over 15 years, we monitored passage effectiveness at eight dams on the Columbia and Snake rivers for 26,886 radio-tagged spring-summer and fall Chinook Salmon O. tshwaytscha, Sockeye Salmon O. nerka, and summer steelhead O. mykiss during their migrations to spawning sites. Almost all fish that entered dam tailraces eventually approached and entered fishways. Tailrace-to-forebay passage efficiency estimates at individual dams were consistently high, averaging 0.966 (SD = 0.035) across 245 run×year×dam combinations. These estimates are among the highest recorded for any migratory species, which we attribute to the scale of evaluation, salmonid life history traits (e.g., philopatry), and a sustained adaptive management approach to fishway design, maintenance, and improvement. Full-dam fish passage times were considerably more variable, with run×year×dam medians ranging from 5-65 h. Evaluation at larger scales provided evidence that fishways were biologically effective, e.g., we observed rapid migration rates (medians = 28-40 km/d) through river reaches with multiple dams and estimated fisheries-adjusted upstream migration survival of 67-69%. However, there were substantive uncertainties regarding effectiveness. Uncertainty about natal origins confounded estimation of population-specific survival and interpretation of apparent dam passage 'failure', while lack of post-migration reproductive data precluded analyses of delayed or cumulative effects of passing the impounded system on fish fitness. Although the technical fishways are effective for salmonids in the Columbia-Snake River system, other co-migrating species have lower passage rates, highlighting the need for species-specific design and evaluation wherever passage facilities impact fish management and conservation goals.


Assuntos
Migração Animal/fisiologia , Conservação dos Recursos Naturais/métodos , Espécies em Perigo de Extinção , Pesqueiros , Oncorhynchus mykiss/fisiologia , Rios , Salmão/fisiologia , Animais , Bioengenharia/métodos , Feminino , Humanos , Masculino , Estações do Ano , Especificidade da Espécie , Telemetria/métodos
12.
PLoS One ; 16(9): e0258128, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34591944

RESUMO

Many animals migrate to take advantage of temporal and spatial variability in resources. These benefits are offset with costs like increased energetic expenditure and travel through unfamiliar areas. Differences in the cost-benefit ratio for individuals may lead to partial migration with one portion of a population migrating while another does not. We investigated migration dynamics and winter site fidelity for a long-distance partial migrant, barren ground caribou (Rangifer tarandus granti) of the Teshekpuk Caribou Herd in northern Alaska. We used GPS telemetry for 76 female caribou over 164 annual movement trajectories to identify timing and location of migration and winter use, proportion of migrants, and fidelity to different herd wintering areas. We found within-individual variation in movement behavior and wintering area use by the Teshekpuk Caribou Herd, adding caribou to the growing list of ungulates that can exhibit migratory plasticity. Using a first passage time-net squared displacement approach, we classified 78.7% of annual movement paths as migration, 11.6% as residency, and 9.8% as another strategy. Timing and distance of migration varied by season and wintering area. Duration of migration was longer for fall migration than for spring, which may relate to the latter featuring more directed movement. Caribou utilized four wintering areas, with multiple areas used each year. This variation occurred not just among different individuals, but state sequence analyses indicated low fidelity of individuals to wintering areas among years. Variability in movement behavior can have fitness consequences. As caribou face the pressures of a rapidly warming Arctic and ongoing human development and activities, further research is needed to investigate what factors influence this diversity of behaviors in Alaska and across the circumpolar Arctic.


Assuntos
Migração Animal/fisiologia , Rena , Estações do Ano , Alaska , Animais , Ecossistema , Feminino , Movimento , Telemetria
13.
Nursing ; 51(8): 62-66, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34347757

RESUMO

PURPOSE: To determine the impact of music on the physiologic and psychological stress experienced by hospital inpatients. METHODS: This pilot study monitored vital signs; utilized pain, anxiety, and agitation rating scales; and gathered verbal feedback from 50 participating inpatients at the authors' healthcare facility as they listened to music via an audiovisual interactive patient engagement technology system. RESULTS: After listening to music for 30 minutes, patients reported significantly lower pain and anxiety. CONCLUSION: Music offered a helpful tool to reduce pain and anxiety for patients in the ICU and telemetry units at the authors' healthcare facility. Future research may be geared toward incremental expansion and monitoring of this music intervention in other units.


Assuntos
Pacientes Internados/psicologia , Musicoterapia , Estresse Fisiológico , Estresse Psicológico/prevenção & controle , Idoso , Ansiedade/enfermagem , Ansiedade/prevenção & controle , Feminino , Unidades Hospitalares , Humanos , Pacientes Internados/estatística & dados numéricos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Dor/enfermagem , Dor/prevenção & controle , Projetos Piloto , Estresse Psicológico/enfermagem , Telemetria , Resultado do Tratamento
14.
Exp Eye Res ; 210: 108727, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34390732

RESUMO

Intraocular pressure (IOP) is important for eye health as abnormal levels can led to ocular tissue damage. IOP is typically estimated by tonometry, which only provides snapshots of pressure history. Tonometry also requires subject cooperation and corneal contact that may influence IOP readings. The aim of this research was to investigate IOP dynamics of conscious animals in response to stressors, common anesthetics, tonometry, and temperature manipulations. An eye of male Brown-Norway rats was implanted with a fluid-filled cannula connected to a wireless telemetry system that records IOP continuously. Stress effects were examined by restricting animal movements. Anesthetic effects were examined by varying isoflurane concentration or injecting a bolus of ketamine. Tonometry effects were examined using applanation and rebound tonometers. Temperature effects were examined by exposing anesthetized and conscious animals to warm or cool surfaces. Telemetry recordings revealed that IOP fluctuates spontaneously by several mmHg, even in idle and anesthetized animals. Environmental disturbances also caused transient IOP fluctuations that were synchronous in recorded animals and could last over a half hour. Animal immobilization produced a rapid sustained elevation of IOP that was blocked by anesthetics, whereas little-to-no IOP change was detected in isoflurane- or ketamine-anesthetized animals if body temperature (BT) was maintained. IOP and BT decreased precipitously when heat support was not provided and were highly correlated during surface temperature manipulations. Surface temperature had no impact on IOP of conscious animals. IOP increased slightly during applanation tonometry but not rebound tonometry. The results show that IOP is dynamically modulated by internal and external factors that can activate rapidly and last long beyond the initiating event. Wireless telemetry indicates that animal interaction induces startle and stress responses that raise IOP. Anesthesia blocks these responses, which allows for better tonometry estimates of resting IOP provided that BT is controlled.


Assuntos
Anestésicos Gerais/administração & dosagem , Temperatura Corporal/fisiologia , Pressão Intraocular/fisiologia , Estresse Fisiológico , Tonometria Ocular , Doença Aguda , Anestésicos Dissociativos/administração & dosagem , Anestésicos Inalatórios/administração & dosagem , Animais , Isoflurano/administração & dosagem , Ketamina/administração & dosagem , Masculino , Ratos , Ratos Endogâmicos BN , Telemetria
15.
Mar Environ Res ; 170: 105452, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34433123

RESUMO

Contaminant Exposure Models (CEMs) were developed to predict population-level tissue contaminant concentrations in fishes by pairing sediment-bound contaminant concentrations (DDTs, PCBs) and fine-scale acoustic telemetry data from a habitat-associated species (Vermilion Rockfish, Sebastes miniatus), nomadic flatfish species (Hornyhead Turbot, Pleuronichthys verticalis), and nomadic benthic/midwater schooling species (White Croaker, Genyonemus lineatus) tagged near wastewater outfalls in southern California. Model results were compared to contaminant concentrations in tissue samples. The CEMs developed require further refinement before implementation into management efforts but may act as steppingstones to help shift primary monitoring methods away from the regular field collection of fish for tissue contaminant analyses and towards behavioral modeling and habitat mapping. We also developed Kernel Density Estimates that can be used by managers immediately to identify regions that contribute most to contaminant exposure in species of concern. Prioritizing remediation efforts in these areas are likely to be most effective at improving fish health.


Assuntos
Linguado , Perciformes , Poluentes Químicos da Água , Acústica , Animais , Monitoramento Ambiental , Telemetria , Águas Residuárias , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidade
16.
J Am Heart Assoc ; 10(16): e020851, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34365801

RESUMO

Background Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA). Methods and Results Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home by CHAMP between March 2014 and March 2018 were included. Videos obtained within 48 hours before UHA were compared with videos obtained at baseline. We used binary logistic regression models and receiver operating characteristic curves to evaluate the parameters' performance in discriminating the outcome of interest. Thirty-nine subjects with 64 UHA were included. We compared 64 pre-admission videos to 64 paired baseline videos. Scoring was feasible for a mean of 91.6% (83.6%-98%) of all observations. Three different HVT score models were proposed, and a final model composed of respiratory rate, respiratory effort, color, and behavior exhibited an excellent discriminatory capability with an area under the receiver operating characteristic curve of 93% (89%-98%). HVT score of 5 was associated with specificity of 93.8% and sensitivity of 88.7% in predicting UHA. Conclusions We developed a feasible and reproducible HVT score that can serve as a tool to predict UHA in infants with single ventricle. Future directions involve prospective, multicenter validation of this tool.


Assuntos
Escore de Alerta Precoce , Admissão do Paciente , Consulta Remota , Telemetria , Coração Univentricular/diagnóstico , Gravação em Vídeo , Progressão da Doença , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Coração Univentricular/fisiopatologia , Coração Univentricular/terapia
17.
PLoS One ; 16(8): e0255175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34339407

RESUMO

This study assessed the postoperative severity after three different visceral surgical interventions in rats by using objective parameters pertaining to various disciplines. The objective was to evaluate whether the degree of severity increases with the invasiveness of the intervention and whether this is in accordance with the EU Directive 2010/63. 136 adult male WistarHan rats were assigned to three groups: Sham-laparotomy (Sham) [7 days post-surgical survival time]; 50% partial hepatectomy (PH); 70% PH [PH groups with 1, 3, or 7 days post-surgical survival times]. Post-surgical severity assessment was performed via several multimodal assessment tools: I) model-specific score sheet focusing on body weight, general condition, spontaneous behavior, and the animals' willingness to move as well as on wound healing; II) Open Field tests evaluating the total distance and velocity an animal moved within 10 minutes and its rearing behavior during the test; III) telemetric data analyzing heart rate and blood pressure; and IV) analysis of blood (AST, ALT, and hemogram) and fecal samples (fecal corticosterone metabolites). Significant differences among the experimental groups and models were observed. We demonstrated that the Open Field test can detect significant changes in severity levels. Sham-laparotomy and removal of 50% of the liver mass were associated with comparable severity (mild-moderate); the severity parameters returned to baseline levels within seven days. Removal of 70% of the liver tissue seemed to be associated with a moderate severity grade and entailed a longer recovery period (>7 days) for complete regeneration. We recommend the use of Open Field tests as part of multimodal objective severity assessment.


Assuntos
Hepatectomia , Laparotomia , Animais , Contagem de Células Sanguíneas , Peso Corporal , Corticosterona/metabolismo , Fezes/química , Fígado/cirurgia , Masculino , Metaboloma , Análise de Componente Principal , Ratos Wistar , Telemetria
18.
J Pharmacol Toxicol Methods ; 112: 107115, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34403748

RESUMO

INTRODUCTION: This manuscript presents a successful integration of multi-timepoint biomarker blood sampling (e.g., cytokines) in a conscious dog cardiovascular study using automated blood sampling via vascular access ports in telemetry instrumented dogs. In addition to determining plasma exposure of the test compound, the assessment of biomarkers of interest allows for more comprehensive preclinical evaluation on a traditional conscious dog cardiovascular (CV) telemetry study especially for immunology and immune-oncology molecules. This model system provides a rapid and efficient means to quickly gain understanding of potential effects on key cardiovascular parameters in large species that are commonly used for preclinical safety evaluations while collecting multiple blood samples for drug and cytokine analysis. METHODS: Male beagle dogs were chronically implanted with telemetry devices (PhysioTel™ model D70-PCTP) and vascular access ports (SPMID-GRIDAC-5NC). BASi Culex-L automated blood sampling (ABS) (Bioanalytical Systems, Inc) system was used to collect blood samples at multiple time points for cytokine analysis. Four beagles received low-dose lipopolysaccharide solution (LPS) (0.1 and 0.5 µg/mL). The following cytokines were measured by Milliplex® map Canine Cytokine Magnetic Bead Panel: Interleukin (IL) 2, IL-6, IL-7, IL-8, IL-10, IL-15, IL-18, TNF-α, MCP-1, KC-like, GM-CSF, IFN gamma, and IP10. RESULTS: Low dose LPS administration induced a pronounced dose-dependent, transient release of key inflammatory cytokines (IL-2, IL-6, IL-10, TNF-α, MCP-1, and KC-like). Cytokine responses were similar to other canine and human endotoxin models. LPS administration led to an increase in body temperature, heart rate, and mean arterial pressure, as well as a decrease in QTcV interval. CONCLUSION: Successful incorporation of cytokine analysis in telemetry instrumented dogs with vascular access ports allows for translational PK/PD modeling of both efficacy and safety of compounds in the immunology as well as the immune-oncology therapeutic areas designed to modulate the immune system. Remote collection of blood samples simultaneously with CV endpoints is a significant enhancement for assessment of biomarkers that are sensitive to animal handling and excitement associated with room disturbances which are obligatory with manual blood collection. Furthermore, implementing this approach has also refined our animal welfare procedure by reducing the handling during a study and thereby reducing stress (positive refinement 3R impact).


Assuntos
Sistema Cardiovascular , Telemetria , Animais , Temperatura Corporal , Citocinas , Cães , Frequência Cardíaca , Masculino
19.
J Pharmacol Toxicol Methods ; 111: 107109, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34416395

RESUMO

INTRODUCTION: A successful integration of automated blood sampling (ABS) into the telemetry instrumented canine cardiovascular model is presented in this study. This combined model provides an efficient means to quickly gain understanding of potential effects on key cardiovascular parameters in dog while providing a complete Pharmacokinetic/Pharmacodynamic (PK/PD) profile for discovery compounds without handling artifacts, reducing the need for a separate pharmacokinetic study. METHODS: Male beagle dogs were chronically implanted with telemetry devices (PhysioTel™ model D70-PCTP) and vascular access ports (SPMID-GRIDAC-5NC). BASi Culex-L automated blood sampling (Bioanalytical Systems, Inc) system was used to collect blood samples at multiple time points. A series of four use cases utilizing four different test compounds and analytical endpoints are described to illustrate some of the potential applications of the technique. RESULTS: In the four presented use cases, automated blood sampling in telemetry instrumented dogs provides simultaneous cardiovascular (heart rate, arterial blood pressure, and left ventricular pressure), electrophysiological assessment (QTc, PR, and QRS intervals), body temperature, and animal activity, while collecting multiple blood samples for drug analysis. CONCLUSION: The combination of automated blood sampling with cardiovascular telemetry monitoring is a novel capability designed to support safety pharmacology cardiovascular assessment of discovery molecules. By combining telemetry and high-fidelity ABS, the model provides an enhanced PK/PD understanding of drug-induced hemodynamic and electrocardiographic effects of discovery compounds in conscious beagles in the same experimental session. Importantly, the model can reduce the need for a separate pharmacokinetic study (positive reduction 3R impact), reduces compound syntheses requirements, and shorten development timelines. Furthermore, implementation of this approach has also improved animal welfare by reducing the animal handling during a study, thereby reducing stress and associated data artifacts (positive refinement 3R impact).


Assuntos
Sistema Cardiovascular , Telemetria , Animais , Pressão Sanguínea , Cães , Eletrocardiografia , Frequência Cardíaca , Macaca fascicularis , Masculino
20.
PLoS One ; 16(8): e0254159, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351932

RESUMO

Wind farms can have two broad potential adverse effects on birds via antagonistic processes: displacement from the vicinity of turbines (avoidance), or death through collision with rotating turbine blades. These effects may not be mutually exclusive. Using detailed data from 99 turbines at two wind farms in central Scotland and thousands of GPS-telemetry data from dispersing golden eagles, we tested three hypotheses. Before-and-after-operation analyses supported the hypothesis of avoidance: displacement was reduced at turbine locations in more preferred habitat and with more preferred habitat nearby. After-operation analyses (i.e. from the period when turbines were operational) showed that at higher wind speeds and in highly preferred habitat eagles were less wary of turbines with motionless blades: rejecting our second hypothesis. Our third hypothesis was supported, since at higher wind speeds eagles flew closer to operational turbines; especially-once more-turbines in more preferred habitat. After operation, eagles effectively abandoned inner turbine locations, and flight line records close to rotor blades were rare. While our study indicated that whole-wind farm functional habitat loss through avoidance was the substantial adverse impact, we make recommendations on future wind farm design to minimise collision risk further. These largely entail developers avoiding outer turbine locations which are in and surrounded by swathes of preferred habitat. Our study illustrates the insights which detailed case studies of large raptors at wind farms can bring and emphasises that the balance between avoidance and collision can have several influences.


Assuntos
Conservação dos Recursos Naturais , Águias/fisiologia , Ecossistema , Voo Animal , Telemetria , Vento , Migração Animal , Animais , Escócia
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