Publications by authors named "Robert Karam"

Lower urinary tract dysfunction (LUTD) is a debilitating condition that affects millions of individuals worldwide, greatly diminishing their quality of life. The use of wireless, catheter-free implantable devices for long-term ambulatory bladder monitoring, combined with a single-sensor system capable of detecting various bladder events, has the potential to significantly enhance the diagnosis and treatment of LUTD. However, these systems produce large amounts of bladder data that may contain physiological noise in the pressure signals caused by motion artifacts and sudden movements, such as coughing or laughing, potentially leading to false positives during bladder event classification and inaccurate diagnosis/treatment.

View Article and Find Full Text PDF

Urodynamics is the current gold-standard for diagnosing lower urinary tract dysfunction, but uses non-physiologically fast, retrograde cystometric filling to obtain a brief snapshot of bladder function. Ambulatory urodynamics allows physicians to evaluate bladder function during natural filling over longer periods of time, but artifacts generated from patient movement necessitate the use of an abdominal pressure sensor, which makes long-term monitoring and feedback for closed-loop treatment impractical. In this paper, we analyze the characteristics of single-channel bladder pressure signals from human and feline datasets, and present an algorithm designed to estimate detrusor pressure, which is useful for diagnosis and treatment.

View Article and Find Full Text PDF

Lower urinary tract dysfunctions, such as urinary incontinence and overactive bladder, are conditions that greatly affect the quality of life for millions of individuals worldwide. For those with more complex pathophysiologies, diagnosis of these conditions often requires a urodynamics study, providing physicians with a snapshot view of bladder mechanics. Recent advancements in implantable bladder pressure monitors and advanced data analysis techniques have made diagnosis through chronic monitoring a promising prospect.

View Article and Find Full Text PDF
Article Synopsis
  • * A new approach called Context-Aware Thresholding (CAT) was developed to detect bladder contractions in real-time, showing high accuracy (92%) and minimal false positives (0.3 per contraction) based on recordings from 15 subjects.
  • * CAT demonstrated faster response times than human evaluators and has been successfully implemented in a case study to manage bladder control autonomously in a patient with spinal cord injury, improving bladder capacity by 40%.
View Article and Find Full Text PDF

Background: There is increasing evidence that mobile phone health interventions ("mHealth") can improve health behaviors and outcomes and are critically important in low-resource, low-access settings. However, the majority of mHealth programs in developing countries fail to reach scale. One reason may be the challenge of developing financially sustainable programs.

View Article and Find Full Text PDF

Diagnosis of lower urinary tract dysfunction with urodynamics has historically relied on data acquired from multiple sensors using nonphysiologically fast cystometric filling. In addition, state-of-the-art neuromodulation approaches to restore bladder function could benefit from a bladder sensor for closed-loop control, but a practical sensor and automated data analysis are not available. We have developed an algorithm for real-time bladder event detection based on a single in situ sensor, making it attractive for both extended ambulatory bladder monitoring and closed-loop control of stimulation systems for diagnosis and treatment of bladder overactivity.

View Article and Find Full Text PDF

The national multimedia "Fataki" campaign aired in Tanzania from 2008 to 2011 with the goal of addressing cross-generational sex (CGS) by mobilizing communities to intervene in CGS relationships. A cross-sectional household survey was used to evaluate the campaign. Logistic regression analysis found a dose-response relationship between campaign exposure and interpersonal communication about CGS, intervening in CGS relationships, and lower CGS engagement among women.

View Article and Find Full Text PDF