Hybridized neural networks for non-invasive and continuous mortality risk assessment in neonates.

Premature birth is the primary risk factor in neonatal deaths, with the majority of extremely premature babies cared for in neonatal intensive care units (NICUs). Mortality risk prediction in this setting can greatly improve patient outcomes and resource utilization. However, existing schemes often require laborious medical testing and calculation, and are typically only calculated once at admission.

A hybrid neural network for continuous and non-invasive estimation of blood pressure from raw electrocardiogram and photoplethysmogram waveforms.

Background And Objectives: Continuous and non-invasive blood pressure monitoring would revolutionize healthcare. Currently, blood pressure (BP) can only be accurately monitored using obtrusive cuff-based devices or invasive intra-arterial monitoring. In this work, we propose a novel hybrid neural network for the accurate estimation of blood pressure (BP) using only non-invasive electrocardiogram (ECG) and photoplethysmogram (PPG) waveforms as inputs.

Determining respiratory rate from photoplethysmogram and electrocardiogram signals using respiratory quality indices and neural networks.

Continuous and non-invasive respiratory rate (RR) monitoring would significantly improve patient outcomes. Currently, RR is under-recorded in clinical environments and is often measured by manually counting breaths. In this work, we investigate the use of respiratory signal quality quantification and several neural network (NN) structures for improved RR estimation.

Continuous and automatic mortality risk prediction using vital signs in the intensive care unit: a hybrid neural network approach.

Mortality risk prediction can greatly improve the utilization of resources in intensive care units (ICUs). Existing schemes in ICUs today require laborious manual input of many complex parameters. In this work, we present a scheme that uses variations in vital signs over a 24-h period to make mortality risk assessments for 3-day, 7-day, and 14-day windows.

Motion reduction for quantitative brain sodium MR imaging with a navigated flexible twisted projection imaging sequence at 9.4 T.

Quantitative measurement of the tissue sodium concentration (TSC) provides a metric for tissue cell volume fraction for monitoring tumor responses to therapy and neurodegeneration in the brain as well as applications outside the central nervous system such as the fixed charge density in cartilage. Despite the low detection sensitivity of the sodium MR signal compared to the proton signal and the requirement for a long repetition time to minimize longitudinal magnetization saturation, acquisition time has been reduced to less than 10 min for a nominal isotropic voxel size of 3.3 mm with the improved acquisition efficiency of twisted projection imaging (TPI) at 9.

Complementing a Clinical Trial With Human-Computer Interaction: Patients' User Experience With Telehealth.

Background: The use of telehealth to monitor patients from home is on the rise. Telehealth technology is evaluated in a clinical trial with measures of health outcomes and cost-effectiveness. However, what happens between a technology and the patients is not investigated during a clinical trial-the telehealth technology remains as a "black box.

A Randomized Controlled Trial using iTClamp, Direct Pressure, and Balloon Catheter Tamponade to Control Neck Hemorrhage in a Perfused Human Cadaver Model.

Background: Penetrating neck wounds are common in the civilian and military realms. Whether high or low velocity, they carry a substantial morbidity and mortality rate.

Objectives: We endeavored to ascertain whether the iTClamp is equivalent to direct manual pressure (DMP) and Foley catheter balloon tamponade (BCT).

Residual Tumor Volume, Cell Volume Fraction, and Tumor Cell Kill During Fractionated Chemoradiation Therapy of Human Glioblastoma using Quantitative Sodium MR Imaging.

Purpose: Spatial and temporal patterns of response of human glioblastoma to fractionated chemoradiation are described by changes in the bioscales of residual tumor volume (RTV), tumor cell volume fraction (CVF), and tumor cell kill (TCK), as derived from tissue sodium concentration (TSC) measured by quantitative sodium MRI at 3 Tesla. These near real-time patterns during treatment are compared with overall survival.

Experimental Design: Bioscales were mapped during fractionated chemoradiation therapy in patients with glioblastomas ( = 20) using TSC obtained from serial quantitative sodium MRI at 3 Tesla and a two-compartment model of tissue sodium distribution.

SERIAL transmit - parallel receive (STPR) MR imaging produces acceptable proton image uniformity without compromising field of view or SAR guidelines for human neuroimaging at 9.4 Tesla.

Purpose: Non-uniform B1 excitation and high specific absorption rates (SAR) compromise proton MR imaging of human brain at 9.4 T (400.5 MHz).

Use of the iTClamp versus standard suturing techniques for securing chest tubes: A randomized controlled cadaver study.

Objectives: Tube thoracostomy (TT) is a common yet potentially life-saving trauma procedure. After successful placement however, securing a TT through suturing is a skillset that requires practice, risking that the TT may become dislodged during prehospital transport. The purpose of this study was to examine if the iTClamp was a simpler technique with equivalent effectiveness for securing TTs.

Hemorrhagic Cholecystitis after Warfarin Use for Deep Vein Thrombosis.

Hemorrhagic cholecystitis is an uncommon form of acute cholecystitis which can be rapidly fatal. It may be hard to detect as it frequently presents with symptoms found in other, more common diagnoses. We report the case of a 63 year old man recently started on anticoagulation for deep vein thrombosis who was found to have hemorrhagic cholecystitis.

Evaluation of Skin Damage from Accidental Removal of a Hemostatic Wound Clamp (The iTClamp).

Background: Controlling bleeding early in the prehospital and military setting is an extremely important and life-saving skill. Wound clamping is a newly introduced technique that may augment both the effectiveness and logistics of wound packing with any gauze product. As these devices may be inadvertently removed, the potential consequences of such were examined in a simulated, extreme, inadvertent disengagement.

Diffusion in Colocation Contact Networks: The Impact of Nodal Spatiotemporal Dynamics.

Temporal contact networks are studied to understand dynamic spreading phenomena such as communicable diseases or information dissemination. To establish how spatiotemporal dynamics of nodes impact spreading potential in colocation contact networks, we propose "inducement-shuffling" null models which break one or more correlations between times, locations and nodes. By reconfiguring the time and/or location of each node's presence in the network, these models induce alternative sets of colocation events giving rise to contact networks with varying spreading potential.

Quantitative sodium MRI of the human brain at 9.4 T provides assessment of tissue sodium concentration and cell volume fraction during normal aging.

Sodium ion homeostasis is a fundamental property of viable tissue, allowing the tissue sodium concentration to be modeled as the tissue cell volume fraction. The modern neuropathology literature using ex vivo tissue from selected brain regions indicates that human brain cell density remains constant during normal aging and attributes the volume loss that occurs with advancing age to changes in neuronal size and dendritic arborization. Quantitative sodium MRI performed with the enhanced sensitivity of ultrahigh-field 9.

A meta-synthesis of behavioral outcomes from telemedicine clinical trials for type 2 diabetes and the Clinical User-Experience Evaluation (CUE).

A worldwide demographic shift is in progress and the aged population proportion is projected to more than double across the next four decades. Our current healthcare models may not be adequate to handle this shift in demography, which may have serious consequences for the ageing population who are more prone to chronic diseases. One proposed remediation is to provide in-home assisted healthcare with technology-intervened approaches.

Evaluation of the iTClamp 50 in a human cadaver model of severe compressible bleeding.

Background: Uncontrolled hemorrhage is a significant cause of preventable death. The iTClamp 50 is a temporary wound closure device designed to control bleeding within seconds of an injury. This study evaluates the ability of the iTClamp to control compressible bleeding in a human cadaver model.

The iTClamp controls junctional bleeding in a lethal swine exsanguination model.

Objective: Severe hemorrhage is a leading cause of death and difficult to control even by trained medical personnel. Current interventions have significant limitations in the prehospital setting; therefore, a need exists for a new and effective treatment. iTraumaCare has designed a temporary wound closure device, the iTClamp, which controls external hemorrhage from open wounds within compressible zones.

Feasibility of 39-potassium MR imaging of a human brain at 9.4 Tesla.

Purpose: To demonstrate the feasibility of performing 39-potassium MR imaging of a human brain.

Methods: 39-Potassium magnetic resonance imaging of a human brain was performed at 9.4 T using a flexible twisted projection imaging acquisition with a nominal isotropic spatial resolution of 10 mm in 40 min using a single-tuned birdcage radiofrequency coil.

SEMAT--the next generation of inexpensive marine environmental monitoring and measurement systems.

There is an increasing need for environmental measurement systems to further science and thereby lead to improved policies for sustainable management. Marine environments are particularly hostile and extremely difficult for deploying sensitive measurement systems. As a consequence the need for data is greatest in marine environments, particularly in the developing economies/regions.

Accuracy of data transfer: double data entry and estimating levels of error.

Aims And Objectives: Most nursing research using quantitative empirical data involves entering information collected on data collection forms into a computer. This paper brings to attention issues related to the introduction of errors during this transfer of data and makes some recommendations as to how this might be dealt with.

Background: Beyond concerns with the reliability and validity of data collection instruments, the issue of data accuracy and the introduction of errors in research data sets receive little mention in the nursing research literature.

PCr/ATP ratio mapping of the human head by simultaneously imaging of multiple spectral peaks with interleaved excitations and flexible twisted projection imaging readout trajectories at 9.4 T.

Quantitative (31)P magnetic resonance imaging of the whole human brain is often time-consuming even at low spatial resolution due to the low concentrations, long T(1) relaxation times, and low detection sensitivity of phosphorus metabolites. We report herein the results of combining the increased detection sensitivity of an ultra-high field 9.4 T scanner designed for human imaging with a new pulse sequence termed simultaneously imaging of multiple spectral peaks with interleaved excitations and flexible twisted projection imaging readout trajectories to rapidly sample multiple resonances in the (31)P spectrum.

Preserving the accuracy and resolution of the sodium bioscale from quantitative sodium MRI during intrasubject alignment across longitudinal studies.

Emerging applications of sodium bioscales derived from quantitative sodium magnetic resonance imaging assess temporal changes in regional sodium concentration over intervals that vary from hours (monitoring tissue viability in stroke) to weeks (monitoring brain tumor treatment during radiation therapy) or even years (monitoring progression of neurodegenerative disease). Accurate interpretation of such quantitative data requires precise registration between magnetic resonance imaging sessions to avoid session-to-session changes in partial volume effects between normal tissue (∼38 mM sodium concentration), lesions (variable sodium concentration), and cerebrospinal fluid (∼144 mM sodium concentration). The existing Automated Image Registration algorithm is shown to be suitable for rapid, accurate, and precise determination of the transform that aligns sodium magnetic resonance images.

Impact of gradient timing error on the tissue sodium concentration bioscale measured using flexible twisted projection imaging.

The rapid biexponential transverse relaxation of the sodium MR signal from brain tissue requires efficient k-space sampling for quantitative imaging in a time that is acceptable for human subjects. The flexible twisted projection imaging (flexTPI) sequence has been shown to be suitable for quantitative sodium imaging with an ultra-short echo time to minimize signal loss. The fidelity of the k-space center location is affected by the readout gradient timing errors on the three physical axes, which is known to cause image distortion for projection-based acquisitions.

Approaches for dealing with missing data in health care studies.

Aim: The aims of this study were to highlight the problems associated with missing data in healthcare research and to demonstrate the use of several techniques for dealing with missing values, through the use of an illustrative example.

Background: In healthcare research studies, it is almost impossible to avoid at least some missing values during data collection, which in turn can threaten the validity of the study conclusions. A range of methods for reducing the impact of missing data on the validity of study findings have been developed, depending on the nature and patterns which the missing values may take.