Catheter-related bacteremia due to Chryseobacterium indologenes in a bone marrow transplant recipient.
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Bacteremia↗
Biomedical subjects
M Akay
Publications and source records attributed to M Akay.
Influence of peripheral chemodenervation on the complexity of respiratory patterns during early maturation.
Previous studies in humans have revealed that, during development, the fetus/neonate may be susceptible to environmental perturbations such as overheating, smoking, hypercapnia and hypoxia (LEWIS and BOSQUE, 1995; MASKERY, 1995). In particular, alterations in behavioural states during early development can result in permanent alterations in their organisational states and subsequent abnormalities in the regulation of the cardiovascular and respiratory systems. The influence of the peripheral chemoreceptor afferent input on the approximate entropy (complexity) of the phrenic neurogram in the piglet was investigated in three different age groups: 3-7 days (n = 7), 10-16 days (n = 6) and 25-31 days (n = 4). The phrenic neurogram was recorded from piglets during control (40% O2) and severe hypoxia (gasping) (5-10% O2), before and after peripheral chemodenervation, and was analysed using the approximate entropy (ApEn) method. The results show that the complexity values of the phrenic neurogram during eupnea and gasping did not change significantly before and after chemodenervation, regardless of postnatal age. The complexity values during gasping were not significantly influenced by the carotid chemodenervation for the 3-7 day-old group, but they were significantly decreased by the carotid chemodenervation for the 10-16 day-old age group (p < 0.01) and the 25-31 day-old age group (p < 0.05). However, the complexity values significantly decreased when the O2 concentration was shifted from eupnea to gasping (p < 0.001), both before and after the chemodenervation (p < 0.001), regardless of the postnatal age. These results suggest that the peripheral chemodenervation reduces the complexity of the phrenic neurograms during gasping only for the 10-16 day-old and 25-31 day-old age groups, and it has no significant influence on the 3-7 day-old age group. Therefore it is speculated that the peripheral chemoreceptors may be inactive for the first seven days of postnatal life and become more active after seven days.
Aging↗
Fractal dynamics of body motion in post-stroke hemiplegic patients during walking.
In this paper, we quantify the complexity of body motion during walking in post-stroke hemiplegic patients. The body motion of patients and healthy elderly subjects was measured by using the accelerometry technique. The complexity of body motion was quantified using the maximum likelihood estimator (MLE-) based fractal analysis methods. Our results suggest that the fractal dimensions of the body motion in post-stroke hemiplegic patients at several Brunnstrom stages were significantly higher than those of healthy elderly subjects (p < 0.05). However, in the hemiplegic patients, the fractal dimensions were more related to Brunnstrom stages.
Acceleration↗
Investigating body motion patterns in patients with Parkinson's disease using matching pursuit algorithm.
Several recent studies have quantified abnormalities in Parkinsonian gait. However, few studies have attempted to quantify the regularity of body motion during walking in patients with Parkinson's disease. The aim of the paper was to characterise body motion patterns in healthy, elderly subjects and patients with Parkinson's disease during walking. Body motion was recorded during walking for 16 patients with Parkinson's disease and ten healthy, elderly subjects using a tri-axial accelerometer device. To characterise the body motion patterns, time-frequency patterns of the body acceleration signal were estimated using a matching pursuit algorithm. Data from the study showed that the healthy, elderly subjects and patients with Parkinson's disease had different time-frequency patterns. The time-frequency patterns were classified into four distinct patterns based on their time durations: vertical (< 0.15 s), circular (0.15-0.5 s), short horizontal (0.5-2.0 s) and long horizontal (> 2.0 s). The data showed that the energy of the long horizontal patterns, representing long-term smooth and regular (rhythmic) activities, significantly decreased, but the energy of the circular patterns, representing irregular activities, increased in the patients with mild Parkinson's disease, compared with those of the healthy, elderly subjects (p < 0.01). Futhermore, these features were seen more clearly in the body motions of severe case patients than is that of mild case patients. It was concluded that these differences are probably due to a lack of ability to control normal and smooth movement is Parkinson's disease.
Acceleration↗
Nonlinear dynamics of respiratory patterns during maturation.
OBJECTIVES: In this paper, we quantify the fractal scaling characteristics of phrenic neurograms during eupnea in piglets, the output of the respiratory neural network that accompany maturation We also attempt to investigate whether the fractal properties are altered with maturation. METHODS: The phrenic neurogram in piglets was recorded from the C5 phrenic nerve during eupnea at four postnatal ages; the 3-6 days, the 7-14 days, 15-21 days and the 26-31 days age groups and analyzed using the maximum likelihood estimator (MLE). RESULTS: Our results suggest that the mean fractal measures over a recording of five consecutive breaths during eupnea for each piglet in each group were higher during the first 6 days and slightly decreased for the 7-14 days and significantly decreased for the 15-21 days and significantly increased for subsequent maturation (the 26-31 days old group). CONCLUSIONS: We suggest that there is a significant alteration in the fractal organization in piglet respiratory patterns during maturation and a decrease in the fractal value is unique to the 15-21 days old group.
Age Factors↗
Multi- and monofractal indices of short-term heart rate variability.
Indices of heart rate variability (HRV) based on fractal signal models have recently been shown to possess value as predictors of mortality in specific patient populations. To develop more powerful clinical indices of HRV based on a fractal signal model, the study investigated two HRV indices based on a monofractal signal model called fractional Brownian motion and an index based on a multifractal signal model called multifractional Brownian motion. The performance of the indices was compared with an HRV index in common clinical use. To compare the indices, 18 normal subjects were subjected to postural changes, and the indices were compared on their ability to respond to the resulting autonomic events in HRV recordings. The magnitude of the response to postural change (normalised by the measurement variability) was assessed by analysis of variance and multiple comparison testing. Four HRV indices were investigated for this study: the standard deviation of all normal R-R intervals; an HRV index commonly used in the clinic; detrended fluctuation analysis, an HRV index found to be the most powerful predictor of mortality in a study of patients with depressed left ventricular function; an HRV index developed using the maximum likelihood estimation (MLE) technique for a monofractal signal model; and an HRV index developed for the analysis of multifractional Brownian motion signals. The HRV index based on the MLE technique was found to respond most strongly to the induced postural changes (95% CI). The magnitude of its response (normalised by the measurement variability) was at least 25% greater than any of the other indices tested.
Electrocardiography↗
Pneumomediastinum and subcutaneous emphysema associated with dermatomyositis.
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Adult↗
Thermal analysis studies of poly(etheretherketone)/hydroxyapatite biocomposite mixtures.
Biocomposite formulations which have the potential to combine the proven mechanical performance of poly(etheretherketone) (PEEK) with the inherent bioactivity of hydroxyapatite (HA), may have a utility as load-bearing materials in a medical implant context. The effect of thermal processing on the relevant properties of the PEEK and/or HA components in any fabricated composite structure is, however, an important consideration for their effective exploitation. This paper reports the results of a detailed thermal characterization study of a series of PEEK/HA mixtures using thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and modulated differential scanning calorimetry (MDSC). The TGA analyses show minimal weight loss for all of the mixtures and for a pure PEEK sample up to approximately 530 degrees C. Above this point there is a sharp on-set of decomposition for the PEEK component in each case. The temperature at which this feature occurs varies for each mixture in the approximate range 539-556 degrees C. This observation is supported by the presence of exotherms in the corresponding DSC scans, in the same temperature region, which are also assigned to PEEK decomposition. The temperature at which the degradation on-set occurs is found to decrease with increasing HA contribution. The use of the modulated DSC technique allows a number of important thermal events, not easily identifiable from the data obtained by the conventional method, to be clearly observed. In particular, the glass transition temperature (Tg) of the polymer can now be accurately determined. Using these thermal analysis data, calculations of the % crystallinity of PEEK in the mixtures have been made and compared with that of a 100% polymer sample. From these studies it is evident that the presence of HA does not adversely affect the degree of crystallinity of the PEEK component in the mixtures of interest over the thermal range studied.
Journal Article↗
Time-frequency analysis of myoelectric signals during dynamic contractions: a comparative study.
In this paper, we introduce the nonstationary signal analysis methods to analyze the myoelectric (ME) signals during dynamic contractions by estimating the time-dependent spectral moments. The time-frequency analysis methods including the short-time Fourier transform, the Wigner-Ville distribution, the Choi-Williams distribution, and the continuous wavelet transform were compared for estimation accuracy and precision on synthesized and real ME signals. It is found that the estimates provided by the continuous wavelet transform have better accuracy and precision than those obtained with the other time-frequency analysis methods on simulated data sets. In addition, ME signals from four subjects during three different tests (maximum static voluntary contraction, ramp contraction, and repeated isokinetic contractions) were also examined.
Action Potentials↗
Respiratory related evoked responses to graduated pressure pulses using wavelet transform methods.
In this study, the respiratory related evoked responses (RREPs) from ten normal subjects in response to brief varying pressure pulses at -6, - 10 and - 17 cm H2O with a duration of 200 ms were recorded to investigate how midlatency cortical evoked potentials measured on the scalp are affected in response to pressure pulses of varying magnitude at the mouth. Wavelet decomposition was performed for eight frequency scales in time for the RREPs. The RREPs at each wavelet scale were enhanced by eliminating the wavelet coefficients due to the artifacts and noise. After denoising, the third (125-250 Hz), fourth (62.5-125 Hz), fifth (31.25-62.5 Hz) and sixth (15.62-31.25 Hz) wavelet scales were quantified using the global field power estimates which serve to reduce the contamination by facial electromyogram responses evoked by the pressure stimulus. Our results show that the estimates of the global field power (GFP) at the third, fourth and fifth wavelet scales between 25 and 100 ms poststimulus were significantly increased when the pressure pulse was increased from -6 to -17cm H2O. On average, the total GFP from all scales, summed over the period 30-90 ms poststimulus, doubled from baseline with the -6 cm H2O stimulus, and increased linearly by 40% between -6 and -17 H2O. This supports the use of the GFP as an index of respiratory mechanoreceptor input to the central nervous system.
Biomedical Engineering↗
Global field power helps separate respiratory-related evoked potentials from EMG contamination.
Respiratory-related evoked potentials (RREPs) were stimulated by brief (200-ms) oral pressure pulses (-10 cmH(2)O) applied at the onset of inspiration in 12 subjects. Scalp potentials were measured at 30 sites on a rectangular grid that encompassed the right side of the scalp overlying the somatosensory cortex (SSC). Concurrent and significant masseter EMG (mEMG) activity was evoked by the pressure pulse, and we found correlational evidence for contamination of the RREP by the mEMG. The global field power (GFP) was used to provide a robust, reference-independent measure of SSC activation that provided partial insulation from mEMG contamination. The mean GFP from all subjects, reflective of afferent information from respiratory mechanoreceptors, showed a latency to onset of significant afferent SSC activity of approximately 25 ms. Scalp GFP activity during control experiments (absence of applied pressure) was significant and may reflect ongoing afferent activity from inspiration.
Adolescent↗
Contribution of supraglottal mechanoreceptor afferents to respiratory-related evoked potentials in humans.
We used the global field power (GFP) to estimate the magnitude and timing of activation of the somatosensory cortex by respiratory mechanoreceptor afferents in normal humans in response to brief, negative oral pressure pulses applied at the onset of inspiration. We compared responses before (test) and after insertion of a laryngeal mask airway (LMA) that prevented supraglottal airway receptors from sensing the applied stimulus. Evoked potential responses without supraglottic stimulation were smaller, with delayed or missing features, than those with all receptors stimulated. Supraglottic receptors contribute about one-half of the GFP summed over the 100 ms poststimulus, and subglottal receptors, including those in the larynx, provide a GFP response approximately 38% above baseline. The most obvious difference between test and LMA responses occurred at 55 ms on average, when the LMA GFP lacked activation features seen in the test condition. We conclude that mechanoreceptors above the larynx are responsible for a major portion of the midlatency afferent information arriving at the somatosensory cortex in response to applied pressure pulses.
Adult↗
Analysis of acceleration signals using wavelet transform.
In this study, we attempted to discriminate the acceleration signal for horizontal level and stairway walking using wavelet-based fractal analysis method. The acceleration signal was measured close to the center of gravity of the body, while the subjects walked continuously in the corridor and up and down the stairs. We used the wavelet-based fractal analysis method to discriminate walking pattern. The parameter H which is related directly to the fractal dimension was estimated by the wavelet coefficient and was changed into low value during walking upstairs. By manually setting the threshold level for individual, it was possible to discriminate walking upstairs from the other walking type. However, the common feature among subjects was not shown between level walking and walking downstairs.
Acceleration↗
Investigating the contamination of electroencephalograms by facial muscle electromyographic activity using matching pursuit.
It has been widely recognized and previously reported that electrical fields from facial muscle electromyographic (EMG) activity can contaminate the electroencephalogram (EEG), even when closely spaced, bipolar electrode configurations are used (personal observations). We suspected that EEG signals evoked in response to pressure changes in the upper airway may include EMG contamination subsequent to muscle reflexes triggered by the stimuli. We evaluated the potential contamination of the background EEG by voluntary activation of a facial muscle by obtaining simultaneous recordings in human subjects of the EEG (from Cz-C4) and masseter muscle EMG (from a bipolar surface electrode pair) before (quiet) and after voluntary tensing (VTen). Matching pursuit analysis permitted identification of different time-frequency patterns for each signal during the quiet period because the EMG signal has mostly atoms above 30 Hz compared to the EEG signal. However, the EEG showed periods of low-frequency activity unmatched in the EMG TF pattern below 30 Hz. During the tensing, most of the atoms of both the EEG and EMG shifted to the higher frequency regions above 100 Hz, making the separation difficult. These results further suggest that the matching pursuit method may not separate the background EEG from phasic EMG signals, both of which are nonstationary in nature.
Artifacts↗
Enhancement of spectral analysis of myoelectric signals during static contractions using wavelet methods.
In this paper, we introduce wavelet packets as an alternative method for spectral analysis of surface myoelectric (ME) signals. Both computer synthesized and real ME signals are used to investigate the performance. Our simulation results show that wavelet packet estimate has slightly less mean square error (MSE) than Fourier method, and both methods perform similarly on the real data. Moreover, wavelet packets give us some advantages over the traditional methods such as multiresolution of frequency, as well as its potential use for effecting time-frequency decomposition of the nonstationary signals such as the ME signals during dynamic contractions. We also introduce wavelet shrinkage method for improving spectral estimates by significantly reducing the MSE's for both Fourier and wavelet packet methods.
Action Potentials↗
Effects of maternal alcohol intake on fractal properties in human fetal breathing dynamics.
Fractal methods have been found to be useful in characterizing biomedical signals. The use of fractal estimation requires the estimation of parameter H, which is directly related to the fractal dimension D. Here, we propose a new approach which is a combination of the wavelet transform and fractal estimators to characterize the human fetal breathing signals before and after the intake of two glasses of wine by a mother. This study was performed on 26 fetuses. The variances of the wavelet coefficients were estimated at each scale. The slope of the representation on a logarithmic plot from the scales 5 to 1 was found to be increased after alcohol intake. Our results suggested that fetal breathing rates have a rough structure before the alcohol intake and a smooth structure after alcohol intake.
Alcohol Drinking↗
A system for medical consultation and education using multimodal human/machine communication.
Recent developments in networking and computing have enabled collaborative biomedical engineering research by geographically separated participants. One of the most promising goals is to use these technologies to extend human intellectual capabilities in medical decision making. These emerging technologies are poised to drastically reduce healthcare cost by providing service at remote locations. This also increases diagnosis capacity since information is made available to experts at any location. In this paper, we propose a novel application of a recently developed interactive and distributed system in medical consultation and education. Our approach builds on the notion that interactive and distributive capabilities of the system are crucial for medical consultation and education. The presented application uses a multiuser, collaborative environment with multimodal human/machine communication in the dimensions of sight, sound, and touch. The experimental setup, consisting of two user stations, and the multimodal interfaces, including sight (eye-tracking), sound (automatic speech), and touch (microbeam pen), were tested and evaluated. The system uses a collaborative workspace as a common visualization space. Users communicate with the application through a fusion agent by eye-tracking, speech, and microbeam pen. The audio/video teleconferencing is also included to help the radiologists to communicate with each other simultaneously while they are working on the mammograms. The system used in this study has three software agents: a fusion agent, a conversational agent, and an analytic agent. The fusion agent interprets multimodal commands by integrating the multimodal inputs. The conversational agent answers the user's questions and detects human-related or semantic errors and notifies the user about the results of the image analysis. The analytic agent enhances the digitized images using the wavelet denoising algorithm if requested by the user. To show how well the system performs in practice, we used the system for medical consultation on mammograms. Results also show that the relevant information about the region of interest (ROI) of the mammograms chosen by the users is extracted automatically and used to enhance the mammograms.
Education, Distance↗
Noninvasive cardiac output estimation: a preliminary study.
The availability of a simple-to-use, automatic measurement system for noninvasive flow estimation is imperative, given the clinical demand for an acceptable noninvasive procedure rather than the standard invasive procedure of thermodilution. A method for calculating cardiac output from noninvasively derived pressure pulses has been developed, and the results of a preliminary evaluation study on post-cardiac surgery patients for whom invasive flow measures were readily available for comparison are provided in this report. The proposed method relies on fast Fourier transform (FFT) analysis of pulses measured externally at the carotid and femoral pressure points. A transfer function of the aorta is computed from digitally filtered pulse measurements, and a tapered model of the aorta is parametrically adapted using a simplex optimization algorithm so that its transfer function matches that derived experimentally. An aortic input impedance term is obtained from the optimized model and utilized along with the carotid pulse (analogous to input voltage) to compute aortic flow. In addition to its automation, attractive features of this method include the requirement for relatively few pulses for analysis as well as considerable resistance to noise artifact. For 59 data records collected from 54 post-cardiac surgery patients, the average flow measurements computed over several pulses compare well with the standard, invasive method of thermodilution. Preliminary results also indicate a strong potential for tracking changes in cardiac output over time, and invite further use of the method in monitoring hemodynamically unstable patients.
Cardiac Output↗