Cardiorespiratory monitoring in the delivery room using transcutaneous electromyography

2020 ◽  
pp. fetalneonatal-2020-319535
Author(s):  
Ruud W van Leuteren ◽  
Eline Kho ◽  
Cornelia G de Waal ◽  
Arjan B te Pas ◽  
Hylke H Salverda ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Intraclass Correlation ◽  
Newborn Infants ◽  
Vital Signs ◽  
Poor Quality ◽  
Delivery Room ◽  
Signal Quality ◽  
Monitoring Tool ◽  
Diaphragm Activity

ObjectiveTo assess feasibility of transcutaneous electromyography of the diaphragm (dEMG) as a monitoring tool for vital signs and diaphragm activity in the delivery room (DR).DesignProspective observational study.SettingDelivery room.PatientsNewborn infants requiring respiratory stabilisation after birth.InterventionsIn addition to pulse oximetry (PO) and ECG, dEMG was measured with skin electrodes for 30 min after birth.Outcome measuresWe assessed signal quality of dEMG and ECG recording, agreement between heart rate (HR) measured by dEMG and ECG or PO, time between sensor application and first HR read-out and agreement between respiratory rate (RR) measured with dEMG and ECG, compared with airway flow. Furthermore, we analysed peak, tonic and amplitude diaphragmatic activity from the dEMG-based respiratory waveform.ResultsThirty-three infants (gestational age: 31.7±2.8 weeks, birth weight: 1525±661 g) were included.18%±14% and 22%±21% of dEMG and ECG data showed poor quality, respectively. Monitoring HR with dEMG was fast (median 10 (IQR 10–11) s) and accurate (intraclass correlation coefficient (ICC) 0.92 and 0.82 compared with ECG and PO, respectively). RR monitoring with dEMG showed moderate (ICC 0.49) and ECG low (ICC 0.25) agreement with airway flow. Diaphragm activity started high with a decreasing trend in the first 15 min and subsequent stabilisation.ConclusionMonitoring vital signs with dEMG in the DR is feasible and fast. Diaphragm activity can be detected and described with dEMG, making dEMG promising for future DR studies.

Design of a Wearable Stress Monitoring Tool for Intensive Care Unit Nursing: Functional Information Requirements Analysis

2018 ◽  
Vol 62 (1) ◽  
pp. 1348-1352 ◽  
Author(s):  
Mahnoosh Sadeghi ◽  
Kunal Khanade ◽  
Farzan Sasangohar ◽  
Steven C. Sutherland
Keyword(s):  
Acute Stress ◽  
Vital Signs ◽  
Systems Design ◽  
Usability Study ◽  
Stress Monitoring ◽  
Monitoring Tool ◽  
Information Requirements ◽  
Laboratory Results ◽  
Information Requirements Analysis

Nurses are the last line of defense to reduce preventable medical errors; however, they suffer from poor systems design and human factors issues (e.g., long shifts, dynamic workload, stressful situations, and fatigue), contributing to a reduced quality of care. A smart nursing system based on physiological monitoring is being designed to help nurses and their managers to efficiently communicate, reduce interruptions that affect critical task performance, and monitor acute stress and fatigue levels. This paper documents the systematic process of deriving information requirements through a group-participatory usability study, conducted with nurses working in various Southeastern Texas hospitals. Information requirements derived from these studies include: a need for accessing patients’ vital signs as well as laboratory results, memory aid tools for various critical nursing tasks, and options to call for help and to reduce interruptions for critical tasks. The system shows promise to meet these requirements.

scholarly journals Evaluating YouTube as a Source of Patient Information for Functional Endoscopic Sinus Surgery

2020 ◽  
pp. 014556132096286
Author(s):  
Vincent Wu ◽  
Daniel J. Lee ◽  
Allan Vescan ◽  
John M. Lee
Keyword(s):  
Patient Information ◽  
Endoscopic Sinus Surgery ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Poor Quality ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Professional Organizations ◽  
For Profit

Objective: To evaluate the quality of information presented on YouTube regarding functional endoscopic sinus surgery (FESS) for patients. Methods: YouTube was searched using FESS-specific keywords under the setting of “relevance.” The first 50 videos from each keyword were reviewed and analyzed by 2 independent physician reviewers. Videos not related to FESS and duplicates were excluded. Outcome measures included the modified DISCERN score (range 0-5), the Journal of the American Medical Association ( JAMA) benchmark criteria (range: 0-4), a novel scoring checklist for FESS assessing usefulness (range: 0-16), and the Video Power Index (VPI). Intraclass correlation coefficient (ICC) was calculated. Results: Of the 200 videos identified, 95 videos were analyzed after exclusions. Videos had an average VPI of 40.8 and SD 133.2. Average scores from the 3 objective checklists among all videos were low: modified DISCERN: 1.91, SD: 1.15; JAMA benchmark: 1.91, SD: 0.76; and FESS score: 3.54, SD: 1.77. The ICC between the 2 independent reviewers was excellent for all 3 checklists. We noted significant positive Pearson correlation between all 3 checklist scores ( P < .001). In between-group comparisons of mean scores, there was significantly higher DISCERN and JAMA scores for videos from university/professional organizations, as compared to videos from medical advertising/for-profit companies and independent users. There were no significant differences in FESS scores noted between the 3 groups. Conclusion: There were overall low scores across the modified DISCERN, JAMA benchmark criteria, and FESS scoring checklists, reflecting the poor quality of YouTube videos as a source of patient information for FESS.

scholarly journals Effect of diet, exercise and other contributing factors on menstruation

2021 ◽  
Vol 8 (8) ◽  
pp. 3901
Author(s):  
Agatha Mary John ◽  
Angitha Saji ◽  
Krupa Ann Sunil ◽  
Abel Abraham Thomas ◽  
Abhilash B. Kumar
Keyword(s):  
Food Habits ◽  
Prospective Observational Study ◽  
Negative Impact ◽  
Poor Quality ◽  
Contributing Factors ◽  
Hygienic Practice ◽  
Lack Of Exercise ◽  
Tract Infections ◽  
The Relationship

Background: The poor knowledge and understanding of menstruation may lead to unsafe hygienic practice that in turn increases the risk of reproductive and genito-urinary tract infections and leads to overall poor quality of life. The food we consume have a complementary relationship with the pattern of menstrual cycle and so is the involvement of exercises. The study focused on understanding the relationship between effect of diet, exercise and other contributing factors on menstruation.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred who were recruited from five different schools in regions of Pathanamthitta and Alappuzha.Results: It was found that lack of exercise before and during menstruation has caused increased cramps and mood instability in girls. As well as skipping of breakfast and consumption of junk food was found to elevate pain, eventually affecting daily activities.Conclusions: The importance of counselling to all girls from the age of 9 was found to be necessary through the study and thereby adequate changes for a healthy future. Lack of exercise, unhealthy food habits and delayed identification of menstrual problems can have a negative impact on health.

scholarly journals Awareness and management of menstrual hygiene practices in adolescent girls

2021 ◽  
Vol 8 (8) ◽  
pp. 3916
Author(s):  
Krupa Ann Sunil ◽  
Agatha Mary John ◽  
Angitha Saji ◽  
Abhilash Kumar B. ◽  
Abel Abraham Thomas
Keyword(s):  
Adolescent Girls ◽  
Prospective Observational Study ◽  
Poor Quality ◽  
Menstrual Hygiene ◽  
Menstrual Hygiene Management ◽  
Hygiene Practices ◽  
Hygienic Practice ◽  
Tract Infections ◽  
Structured Questionnaire

Background: Menstruation is a natural part of the female reproductive cycle in which periodic discharge of blood from the uterus exits through the vagina. Menstruation is also surrounded with social taboos and supernatural beliefs. The poor knowledge and understanding of menstruation may lead to unsafe hygienic practice that in turn increases the risk of reproductive and genito-urinary tract infections and leads to overall poor quality of life. The aim of this study was to compare the awareness about menstrual hygiene management among adolescent girls along with objectives of evaluation of menstrual hygiene practices.Methods: The study was a prospective observational study done with a sample size of 650 subjects of 9 to 18 age group in whom menstruation already occurred who were recruited from five different schools in regions of Pathanamthitta and Alappuzha. The study was conducted in 3 phases, where initially a pre designed well-structured questionnaire was provided to assess the attitude, awareness and practices.Results: The results obtained described that the subjects had better knowledge and positive attitude regarding menstruation and hygiene practices when compared to subjects from other regions of India but still they lacked some adequate and updated information on menstruation.Conclusions: This study paved a way for discussion on menstruation to the adolescent girls, providing them the information they lacked and a better guidance.

Photoplethysmogram Signal Quality Assessment Using Support Vector Machine and Multi-Feature Fusion

2018 ◽  
Vol 8 (9) ◽  
pp. 1757-1762 ◽  
Author(s):  
Jie Zhang ◽  
Licai Yang ◽  
Zhonghua Su ◽  
Xueqin Mao ◽  
Kan Luo ◽  
...  
Keyword(s):  
Support Vector Machine ◽  
Quality Assessment ◽  
Feature Fusion ◽  
Poor Quality ◽  
Heart Beat ◽  
Support Vector ◽  
Signal Quality ◽  
Physiological Signal ◽  
Quality Signals

Background: Noise is unavoidable in the physiological signal measurement system. Poor quality signals can affect the results of analysis and disable the following clinical diagnosis. Thus, it is necessary to perform signal quality assessment before we interpreting the signal. Objective: In this work, we describe a method combing support vector machine (SVM) and multi-feature fusion for assessing the signal quality of pulsatile waveforms, concentrating on the photoplethysmogram (PPG). Methods: PPG signals from 53 healthy volunteers were recorded. Each had a 5 min length. Signal quality in each heart beat was manual annotated by clinical expert, and then the signal quality in 5 s episode was automatically calculated according to the results from each beat segments, resulting in a total of 13,294 5-s PPG segments. Then a SVM was trained to classify clean/noisy PPG recordings by inputting a set of twelve signal quality features. Further experiments were carried out to verify the proposed SVM based signal quality classifier method. Results: An average accuracy of 87.90%, a sensitivity of 88.10% and a specificity of 87.66% were found on the 10-fold cross validation. Conclusions: The signal quality of PPGs can be accurately classified by using the proposed method.

Frequency of patient-reported UTIs is associated with poor quality of life after spinal cord injury: a prospective observational study

Spinal Cord ◽  
2020 ◽  
Vol 58 (12) ◽  
pp. 1274-1281 ◽  
Author(s):  
Katherine M. Theisen ◽  
Rachel Mann ◽  
Joshua D. Roth ◽  
Joseph J. Pariser ◽  
John T. Stoffel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Poor Quality ◽  
Cord Injury ◽  
Patient Reported

scholarly journals Patient-Reported Outcome Measures With Secondary Lower Limb Lymphedemas: A Systematic Review

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Margit Eidenberger, PT Mag
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Lower Limb ◽  
Intraclass Correlation ◽  
Disease Free Survival ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Poor Quality ◽  
Patient Reported

Background: Patient-reported outcome measures are measures of patients’ health-related quality of life. They should be added to other lymphedema measurements. With an improved disease-free survival of secondary lower limb lymphedema, attention must focus on such assessments. Objective: The objectives of this study were to locate and critically appraise suitable patient-reported outcomes measures for lower limb lymphedemas and search for existing valid translations for native German speakers. Methods: A systematic literature research was conducted. 20 semantical categories for qualitative analysis were evolved. Six questionnaires available in English and some in validated translations remained for analysis. Results: Lower limb lymphedema patients experience poor quality of life, and one of the most critical denominators is skin quality. To establish skin care and prevent cellulitis, patients must learn about skin problems. Only two tools asked for past infections. This is considered crucial because of knowledge building and prophylactic behavior. Questions on movement restrictions were available in one questionnaire. As these have a close connection to one’s ability to perform activities of daily life, they can affect quality of life. Afflicted patients have problems with the choice and availability of clothing. Only three questionnaires asked questions about clothing or shoes. Lymphedema patients are exposed to more psychological stress than healthy subjects, but only three questionnaires covered questions about this burden. There was a lack of reporting on psychometric data (Cronbach’s alpha, intraclass correlation), which hinders the external validity. Analyzed questionnaires were available in English but only one in German. Conclusions: The analyzed questionnaires were in English, and only one was adapted and tested for native German speakers. For clinical practice, Devoogdt’s questionnaire is recommended despite some shortcomings. There is a need for validated lymphedema questionnaires in German.

Signal Quality of Electrical Cardiometry and Perfusion Index in Very Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Christoph E. Schwarz ◽  
John M. O’Toole ◽  
Vicki Livingstone ◽  
Andreea M. Pavel ◽  
Eugene M. Dempsey
Keyword(s):  
Preterm Infants ◽  
Prospective Observational Study ◽  
Perfusion Index ◽  
Signal Quality ◽  
Recording Time ◽  
Electrical Cardiometry ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Signal Dropout

<b><i>Objective:</i></b> The use of noninvasive monitoring of neonatal hemodynamics is increasing in neonatal care. Methods include noninvasive cardiac output estimated by electrical cardiometry (EC) and peripheral perfusion as perfusion index (PI) using pulse oximetry. Our aim was to evaluate the feasibility to continuously monitor preterm infants with EC and PI during the first 2 postnatal days and the effects of averaging EC data in signal quality (SigQ) analysis. <b><i>Design:</i></b> Prospective observational study. <b><i>Setting:</i></b> Tertiary neonatal academic hospital. <b><i>Patients:</i></b> Preterm infants &#x3c;32 weeks gestation from birth until 48 h. <b><i>Main Outcome Measures:</i></b> Continuous EC and PI measurements. Feasibility was quantified as the time with high SigQ, classified using SigQ index in EC and exception codes in PI. Our predefined threshold for good feasibility was minimum of 24 h with high SigQ for both. <b><i>Results:</i></b> Twenty-two preterm infants (median [IQR] gestational age 28 + 6 (26 + 0, 30 + 4) weeks + days, birth weight 960 [773, 1,500] g) were included. We recorded a minimum of 24 h with high SigQ in 14 infants for EC (unaveraged data) and 22 infants for PI measurements. The median (range) % of recording time with high SigQ was 74% (50%, 88%) for EC and 94% (82%, 96%) for PI. Using 1 minute averaging for EC data resulted in an increase of infants with minimum 24 h of high SigQ to 21 infants. <b><i>Conclusions:</i></b> EC and PI monitoring are feasible in preterm infants within the first 48 h, but SigQ remains problematic for EC. Signal dropout is masked in averaged EC values.

scholarly journals Design rationale and performance evaluation of Wavelet Health Wristband: bench-top validation of a wrist-worn physiological signal recorder (Preprint)

2018 ◽  
Author(s):  
Onur Dur ◽  
Colleen Rhoades ◽  
Sally Man Suen Ng ◽  
Ragwa Elsayed ◽  
Reinier van Mourik ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Respiration Rate ◽  
Vital Signs ◽  
High Signal ◽  
Signal Quality ◽  
Absolute Deviation ◽  
Physiological Signal ◽  
And Performance

BACKGROUND Wearable and connected health devices along with the recent advances in mobile and cloud computing provide a continuous, convenient-to-patient and scalable way to collect personal health data remotely. The Wavelet Health Platform and the Wavelet Wristband have been developed to capture multiple physiological signals and to derive biometrics from these signals including resting heart rate, heart rate variability, and respiration rate. OBJECTIVE This study aims to evaluate the accuracy of the biometrics estimates and signal quality of the wristband. METHODS Measurements collected from 35 subjects using the Wavelet Wristband were compared with simultaneously recorded electrocardiogram and spirometry measurements. RESULTS The heart rate, heart rate variability (SDNN) and respiration rate estimates matched within 0.6 ± 0.9 bpm, 7 ± 10 ms and 1 ± 1 brpm mean absolute deviation of the reference measurements, respectively. The quality of the raw plethysmography signal collected by the wristband, as determined by the harmonic-to-noise ratio, was comparable to that obtained from measurements from a finger-clip plethysmography device. CONCLUSIONS The accuracy of the biometrics estimates and high signal quality indicate that the Wristband PPG device is suitable for performing pulse wave analysis and measuring vital signs.

scholarly journals Evaluation of patient electrocardiogram datasets using signal quality indexing

2019 ◽  
Vol 8 (2) ◽  
pp. 519-526
Author(s):  
Nazrul Anuar Nayan ◽  
Hafifah Ab Hamid
Keyword(s):  
Vital Signs ◽  
Extraction Process ◽  
Motion Artifacts ◽  
Accurate Information ◽  
Signal Quality ◽  
Emergency Rooms ◽  
Ecg Signals ◽  
Detection Quality ◽  
Electrocardiogram Ecg

Electrocardiogram (ECG) is widely used in the hospital emergency rooms for detecting vital signs, such as heart rate variability and respiratory rate. However, the quality of the ECGs is inconsistent. ECG signals lose information because of noise resulting from motion artifacts. To obtain an accurate information from ECG, signal quality indexing (SQI) is used where acceptable thresholds are set in order to select or eliminate the signals for the subsequent information extraction process. A good evaluation of SQI depends on the R-peak detection quality. Nevertheless, most R-peak detectors in the literature are prone to noise. This paper assessed and compared five peak detectors from different resources. The two best peak detectors were further tested using MIT-BIH arrhythmia database and then used for SQI evaluation. These peak detectors robustly detected the R-peak for signals that include noise. Finally, the overall SQI of three patient datasets, namely, Fantasia, CapnoBase, and MIMIC-II, was conducted by providing the interquartile range (IQR) and median SQI of the signals as the outputs. The evaluation results revealed that the R-peak detectors developed by Clifford and Behar showed accuracies of 98% and 97%, respectively. By introducing SQI and choosing only high-quality ECG signals, more accurate vital sign information will be achieved.

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