Preliminary Analysis of a Wireless and Wearable Electronic-Textile EASI-Based Electrocardiogram

Background: With cardiovascular disease continuing to be the leading cause of death and the primary reason for hospitalization worldwide, there is an increased burden on healthcare facilities. Electronic-textile (e-textile)-based cardiac monitoring offers a viable option to allow cardiac rehabilitation programs to be conducted outside of the hospital.Objectives: This study aimed to determine whether signals produced by an e-textile ECG monitor with textile electrodes in an EASI configuration are of sufficient quality to be used for cardiac monitoring. Specific objectives were to investigate the effect of the textile electrode characteristics, placement, and condition on signal quality, and finally to compare results to a reference ECG obtained from a current clinical standard the Holter monitor.Methods: ECGs during different body movements (yawning, deep-breathing, coughing, sideways, and up movement) and activities of daily living (sitting, sitting/standing from a chair, and climbing stairs) were collected from a baseline standard of normal healthy adult male using a novel e-textile ECG and a reference Holter monitor. Each movement or activity was recorded for 5 min with 2-min intervals between each recording. Three different textile area electrodes (40, 60, and 70 mm2) and electrode thicknesses (3, 5, and 10 mm) were considered in the experiment. The effect of electrode placement within the EASI configuration was also studied. Different signal quality parameters, including signal to noise ratio, approximate entropy, baseline power signal quality index, and QRS duration and QT intervals, were used to evaluate the accuracy and reliability of the textile-based ECG monitor.Results: The overall signal quality from the 70 mm2 textile electrodes was higher compared to the smaller area electrodes. Results showed that the ECGs from 3 and 5 mm textile electrodes showed good quality. Regarding location, placing the “A” and “I” electrodes on the left and right anterior axillary points, respectively, showed higher signal quality compared to the standard EASI electrode placement. Wet textile electrodes showed better signal quality compared to their dry counterparts. When compared to the traditional Holter monitor, there was no significant difference in signal quality, which indicated textile monitoring was as good as current clinical standards (non-inferior).Conclusion: The e-textile EASI ECG monitor could be a viable option for real-time monitoring of cardiac activities. A clinical trial in a larger sample is recommended to validate the results in a clinical population.

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Standardized fluoroscopy-guided implantation technique enables optimal electrode placement in sacral neuromodulation: a cadaver study

Techniques in Coloproctology ◽

10.1007/s10151-020-02364-w ◽

2020 ◽

Author(s):

C. Müller ◽

L. F. Reissig ◽

S. Argeny ◽

W. J. Weninger ◽

S. Riss

Keyword(s):

Sacral Neuromodulation ◽

Close Contact ◽

Treatment Success ◽

Cadaver Study ◽

Electrode Placement ◽

Implantation Technique ◽

The Third ◽

Median Distance ◽

Significant Difference ◽

The Right

Abstract Background Sacral neuromodulation (SNM) is an established treatment option for patients with faecal incontinence. The location of the stimulating electrode is considered to be essential for treatment success. The purpose of this study was to evaluate the position of SNM electrodes after using a standardized fluoroscopy-guided implantation technique. Methods For this cadaver study, SNM electrodes were implanted bilaterally in 5 lower body specimens. The lower edge of the sacroiliac joint and the medial edge of the sacral foramina were marked using fluoroscopy to draw an ‘H’ with the crossing points identifying S3. After electrode placement the pelvis was dissected to describe the exact position of the SNM electrodes. Results The electrodes were inserted at an angle with a median degree measure of 60° (range 50–65°) to the skin, with a median distance of 9 mm (range 0–13 mm) from the S3 marking. All electrodes entered the third sacral foramen. The median distance of the electrodes to the sacral nerve was 0 mm (range 0–3 mm) for the most proximal, 0.5 mm (range 0–5 mm) for the second, 2.25 mm (range 0–11 mm) for the third and 1.75 mm (range 0–16 mm) for the most distant electrode. There was neither a significant difference in the proximity of the electrodes to the nerve between the right and left side (proximal to distal electrode: p = 0.18, p = 0.16, p = 0.07, p = 0.07) nor between male and female cadavers (p = 0.25, p = 0.21, p = 0.66, p = 0.66). Conclusions A standardized fluoroscopy-guided implantation technique enables a close contact between electrode and nerve. This can potentially result in an improved clinical outcome.

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Immediate loading over lower prosthesis in edentulous mandibles: comparison between two types of prosthetic connection

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170002000043369 ◽

2017 ◽

Vol 65 (4) ◽

pp. 308-314

Author(s):

Marina Reis OLIVEIRA ◽

Ariane de Souza OLIVEIRA ◽

Vitor Augusto LEITE ◽

Marisa Aparecida Cabrini GABRIELLI ◽

Oriana Elara Barelli PAGANELLI ◽

...

Keyword(s):

Immediate Loading ◽

Viable Option ◽

Short Term ◽

Significance Level ◽

Implant Stability Quotient ◽

Probing Depth ◽

Significant Difference ◽

Implant Abutment ◽

Short Term Evaluation ◽

Term Evaluation

ABSTRACT Objective: This study evaluated two implant-abutment connection systems under immediate loading of lower prosthesis in edentulous mandibles. Methods: Seventy-two implants placed in 18 patients were analyzed. The parameters evaluated included probing depth, stability of implants and perimplant bone loss, which were measured immediately when installing the prosthesis and after 3 and 6 months. All data underwent statistical analysis (T-Test and ANOVA, 5% significance level). Results: Implants with Morse cone connections showed smaller, statistically significant probing depth values for all periods (0.68/1.19/1.31), when compared to the external hexagon connections (1.08/1.52/1.64). A statistically significant difference was observed between baseline, 3 months (p<0.01 for Morse cone; p<0.001 for external hexagon) and 6 months (p<0.001 for both connections). When periods were considered there was a statistically significant difference in Implant Stability Quotient ISQ values between baseline and 6 months for both prosthetic connections. Conclusion: Immediate loading of the lower prosthesis is a viable option for the treatment of edentulous mandibles and that the external hexagon or Morse cone connections do not interfere with the success of the implants in a short-term evaluation.

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Complexity of Knee Neuromuscular Control in Uninjured Physically Active Adults: Right/Left and Dominant/Nondominant Asymmetry Analyses

10.31236/osf.io/gc6dj ◽

2021 ◽

Author(s):

Nicholas Clark ◽

Jamie Pethick

Keyword(s):

Motor Neurons ◽

Neuromuscular Control ◽

Approximate Entropy ◽

Knee Extension ◽

Fluctuation Analysis ◽

Temporal Behavior ◽

Individual Level ◽

Significant Difference ◽

Clinically Significant ◽

The Right

Context: Motor pathways include upper motor-neurons from the cerebrum and brainstem and lower motor-neurons from the spinal cord. Together, these physiological components are effectors of knee neuromuscular control. Because multiple components are involved, each with an output that is asynchronous to the others, ‘whole-system’ output is characterized by irregular temporal behavior and signal fluctuations. The irregular temporal behavior of physiological signals is analyzed using ‘complexity’. Complexity-based measures reflect the ability to adapt motor output rapidly and accurately in response to external perturbations and provide physiological information missed by magnitude-based (variability) measures.Objective: To characterize side-to-side symmetry of knee neuromuscular control (sub-maximal isometric knee extension constant-force task) using variability (coefficient of variation [CV%]) and complexity (approximate entropy [ApEn], detrended fluctuation analysis [DFA α]) measures.Design: Cross-sectional.Setting: Laboratory.Patients or Other Participants: Sixteen (male/female n=11/5; age 24.0±5.3yr; height 1.74±0.08m; body-mass 68.3±11.1kg).Main Outcome Measure(s): Right/left and dominant/nondominant group-level (t-test) and individual-level (absolute-asymmetry [%]) comparisons. A limb-symmetry-index was calculated for each variable and clinically-signiﬁcant absolute-asymmetry deﬁned (>15%). Clinically-signiﬁcant absolute-asymmetry prevalence (%) was computed for each variable.Results: The only significant side-to-side difference was for right/left DFA α (P=.000). Maximum absolute-asymmetries were (right/left, dominant/nondominant): CV 18.2%, 18.0%; ApEn 34.5%, 32.3%; DFA α 4.9%, 5.0%. Clinically-significant absolute-asymmetry prevalence was (right/left, dominant/nondominant): CV 43.8%, 43.8%; ApEn 62.5%, 50.0%; DFA α 0.0%, 0.0%.Conclusions: Different side-to-side comparison methods yield different findings. Large proportions of participants demonstrated wide ranges of side-to-side absolute-asymmetries. The finding of a significant difference for the right/left DFA α comparison but not for the right/left ApEn comparison suggests that different complexity variables assess different aspects of complexity. Consideration for how side-to-side comparisons are performed (right/left, dominant/nondominant) is required. Approximate entropy and DFA α assess different aspects of complexity and both should be used alongside other traditional magnitude-based measures when studying knee neuromuscular control.

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QT INTERVAL IN TEMPORAL LOBE EPILEPSY VERSUS NON TEMPORAL LOBE EPILEPSY

QJM ◽

10.1093/qjmed/hcab102.018 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed A Gaber ◽

Yousry A Abdelhamed ◽

Mona M Wahid Eldin ◽

Islam M Bastawy ◽

Maram S Nasef

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Qt Interval ◽

Case Series ◽

Electrode Placement ◽

Interval Prolongation ◽

Temporal Epilepsy ◽

Qt Interval Prolongation ◽

Significant Prolongation ◽

Significant Difference

Abstract Introduction Background SUDEP is leading cause of mortality in patients with chronic refractory epilepsy. Despite several epidemiological studies, case series , monitored and witnessed SUDEP the exact mechanism is not proposed Objective This work was carried out to assess QT interval prolongation in epilepsy and whether there’s a difference in QT interval prolongation between temporal epilepsy and non-temporal epilepsy. Patients and methods This study was conducted on 100 patients, 50 aged and sex matched healthy controls who underwent a prolonged (6 to 24 hours) 22 channel computerized EEG monitor with 10-20 system electrode placement and 12 lead electrocardiogram (25 millisecond speed). QT, QTd and QTc using Bazzet’s formulae were calculated. Results The results showed statistically significant difference prolongation of QT interval in epilepsy particularly temporal lobe epilepsy. Conclusion Significant prolongation of QT interval in epilepsy patients (11% suffered pathological prolonged QT). Marked prolongation of QTc and QTd in temporal lobe epilepsy over non temporal group.

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Abstract 13243: Diminished Daily Fluctuation of Heart Rate Variability in Patients with Chronic Kidney Disease

Circulation ◽

10.1161/circ.130.suppl_2.13243 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hisaki Makimoto ◽

Katsuhito Fujiu ◽

Kohei Shimizu ◽

Eisuke Amiya ◽

Kazuo Asada ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Regression Analysis ◽

Kidney Disease ◽

High Frequency ◽

High Frequency Component ◽

Control Group ◽

Holter Monitor ◽

Significant Difference ◽

High Incidence ◽

Circadian Fluctuation

Introduction: Autonomic dysfunction is well known in patients with chronic kidney disease (CKD) and linked with cardiac death. In spite of a high incidence of morning death in CKD patients, circadian fluctuation in parasympathetic activation have not been studied in CKD. Hypothesis: We assessed the hypothesis that the cardiac autonomic circadian fluctuation is impaired in patients with CKD. Methods: The study population consisted of consecutive 101 patients (54 males, 70±10 years old) with CKD who underwent 24-hour Holter monitor. As a control group, 134 age and sex matched cases (66 males, 68±10 years old) without CKD who also underwent Holter monitor were recruited. Patients with diabetes orβ-blocker therapy were excluded. The high frequency component (HF), which reflected parasympathetic activity, and the low frequency to high frequency ratio (L/H ratio), which reflected, in part, sympathetic activity, were evaluated. To evaluate the contribution of CKD and other parameters to the cardiac autonomic fluctuation, the night (6PM-6AM) to day (6AM-6PM) ratio of HF and L/H ratio were analyzed utilizing a regression analysis. Results: The L/H ratio showed no significant difference during the night between the two groups, in contrast to the significant difference during the daytime. Patients with CKD showed significantly lower HF during the night as compared to control cases (P<0.05), although the daytime HF was not significantly different between the groups (Figure). Multivariate regression analysis demonstrated that CKD was independently associated with a lower night-to-day ratio of the HF and a higher night-to-day ratio of the L/H ration, even with the adjustment of age and comorbid hypertension. Conclusions: Our findings suggest that cardiac autonomic fluctuation is impaired in CKD patients. Whether a deterioration of autonomic activation might explain the high incidence of morning death in CKD patients needs to be clarified in future studies.

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Are ‘‘Dichotic’’ Deficits Uniquely Dichotic? Investigating Dichotic Performance with the Dichotic Digits Difference Test (DDdT) in a Large Clinical Population of Children Referred for an Auditory Processing Assessment

Journal of the American Academy of Audiology ◽

10.3766/jaaa19037 ◽

2020 ◽

Author(s):

Sharon Cameron ◽

Harvey Dillon

Keyword(s):

Auditory Processing ◽

Large Population ◽

Clinical Population ◽

Clinical Group ◽

Central Auditory Processing ◽

Typically Developing ◽

Central Auditory Processing Disorder ◽

Significant Difference ◽

Z Scores ◽

Listening Task

Background: Previous studies in a large population of typically developing (TD) children and a smallclinical group showed high correlations between the dichotic and diotic conditions of the Dichotic Digitsdifference Test (DDdT), as well as between DDdT performance and measures of memory and attention.Purpose: The purpose of the study was to investigate the performance on the DDdT in a large clinical sample.Research Design: Correlational analysis between the DDdT diotic condition and the dichotic free recall (FR)right-ear, left-ear, and total (ear-averaged) conditions, as well as between DDdT and memory performance.Study Sample: One hundred one children (6 years, 3 months to 15 years, 0 months, mean 9 years, 6 months)were referred for assessment to the Australian Hearing Central Auditory Processing Disorder (CAPD) service.Results were compared with data from 112 TD children collected from previously published studies.Data Collection and Analysis: Z-scores were used to account for the effect of age on performance.Mean differences between clinical and TD children were investigated using analysis of variance(ANOVA). Pearson product-moment correlations determined the strength of relationships between DDdTconditions and the number memory forward (NMF) and reversed (NMR) subtests of the Test of AuditoryProcessing Skills—Third Edition.Results: Performance by the clinical group on the DDdT dichotic FR (RE, LE, and total) conditions wassignificantly correlated with the diotic condition (r = 0.7; 0.7, 0.8; p < 0.001). Significant correlations werefound between the DDdT diotic and dichotic FR conditions and the NMF (r = 0.5–0.6, p < 0.001) andNMR (r = 0.2–0.5, p < 0.025–0.001). ANOVA revealed no significant difference between the TD andclinical groups (p = 1.0000) in respect to the advantage they got from dichotic listening (calculated asdichotic FR total minus diotic score). Multiple regression revealed that diotic performance and short-termmemory accounted for 68% of the variation in dichotic performance. Random measurement erroraccounted for a further 16%.Conclusions: Factors other than dichotic performance strongly impact a child’s ability to perform a dichoticdigit listening task. This result has widespread implications in respect to the interpretation of CAPDtest results.

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Paranoidism and memory deficits: An epidemiological study

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.837 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S569-S569

Author(s):

C.M. Calahorro ◽

M. Guerrero Jiménez ◽

B.M. Girela Serrano ◽

J.E. Muñoz Negro

Keyword(s):

Cognitive Abilities ◽

Wide Spectrum ◽

Verbal Learning ◽

Multidisciplinary Treatment ◽

Cross Sectional Study ◽

Clinical Population ◽

Psychotic Symptoms ◽

Attention And Memory ◽

Cross Sectional ◽

Significant Difference

BackgroundThe Green et al. Paranoid Thought Scales (GPTS) was developed to fulfill a need for a tool that was adapted to the current dimensional definition of paranoia, capable to assess dimensions of preoccupation, conviction, and distress, valid and reliable for the assessment of both clinical and healthy populations, and precise enough to detect subtle clinical change. It has recently been validated for the Spanish population (S-GPTS) with very good psychometric properties. Numerous studies suggest that patients with severe psychiatric disorders have impaired sustained attention and memory. A wide spectrum of executive deficits have also been described (goal-oriented tasks, recognizing priority patterns, planning, etc.) Very few studies have attempted to identify whether these same relationships between neuropsychological deficits and psychotic symptoms also occur in general population.MethodsThis is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and out of the 5496 eligible participants finally approached, 4507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n = 4507).ResultsIndividuals with high cut off S-GPTS scores showed lower scores in working memory subtest verbal statistically significant(P > .05). While no significant difference was found among for immediate verbal learning subtest and high S-GPTS scores (P > .05654).DiscussionThis information can improve the clinician's understanding of patient's cognitive strength and weaknesses, put patients’ cognitive abilities into perspective for their diagnosis, and facilitate multidisciplinary treatment decisions as we improve our ability to distinguish clinical cases from non-clinical population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Minimizing Brain Shift in Stereotactic Functional Neurosurgery

Operative Neurosurgery ◽

10.1227/01.neu.0000380991.23444.08 ◽

2010 ◽

Vol 67 (3) ◽

pp. ons213-ons221 ◽

Cited By ~ 21

Author(s):

Erika A. Petersen ◽

Etienne M. Holl ◽

Irene Martinez-Torres ◽

Thomas Foltynie ◽

Patricia Limousin ◽

...

Keyword(s):

Rating Scale ◽

Electrode Placement ◽

Brain Shift ◽

Functional Neurosurgery ◽

Image Guided ◽

Subcortical Brain ◽

Significant Difference ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri ◽

Stn Dbs

Abstract BACKGROUND: Stereotactic functional neurosurgical interventions depend on precise anatomic targeting before lesioning or deep brain stimulation (DBS) electrode placement. OBJECTIVE: To examine the degree of subcortical brain shift observed when adopting an image-guided approach to stereotactic functional neurosurgery. METHODS: Coordinates for the anterior and posterior commissural points (AC and PC) were recorded on thin-slice stereotactic magnetic resonance imaging (MRI) scans performed before and immediately after DBS electrode implantation in 136 procedures. The changes in length of AC-PC and in stereotactic coordinates for AC and PC were calculated for each intervention. In patients with Parkinson disease undergoing bilateral subthalamic nucleus (STN) DBS with at least 6 months of follow-up, pre- and postoperative scores of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS-III) were reviewed. RESULTS: Mean (SD) change in AC-PC length (ΔAC-PC) was 0.6 (0.4) mm. There was no statistically significant difference in ΔAC-PC between groups when examining anatomic target subgroups (P =.95), age subgroups (P = .63), sex (P = .59), and unilateral versus bilateral implantation (P =.15). The mean (SD) vector changes for the commissural points were: -0.1 (0.3) mm in X, -0.4 (0.6) mm in Y, and -0.1 (0.7) mm in Z for the AC; and -0.1 (0.3) mm in X, -0.2 (0.7) mm in Y, and 0.0 (0.7) mm in Z for the PC. There was a negligible correlation between the magnitude of brain shift and percentage improvement in UPDRS-III off-medication in patients undergoing STN DBS for PD (R2 <0.01). CONCLUSION: Brain shift has long been considered an issue in stereotactic targeting during DBS procedures. However, with the image-guided approach and surgical technique used in this study, subcortical brain shift was extremely limited and did not appear to adversely affect clinical outcome.

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Tonsillectomy in children with or at risk for velopharyngeal insufficiency: Effects on speech

Otolaryngology ◽

10.1016/s0194-5998(96)70045-1 ◽

1996 ◽

Vol 115 (4) ◽

pp. 319-323 ◽

Cited By ~ 17

Author(s):

Linda L. D'Antonio ◽

Lynn S. Snyder ◽

Saghi Samadani

Keyword(s):

At Risk ◽

Case Reports ◽

Voice Quality ◽

Velopharyngeal Insufficiency ◽

Clinical Population ◽

Single Subject ◽

Speech Characteristics ◽

Significant Difference ◽

Velopharyngeal Function ◽

Endoscopic Assessment

Recent case reports have challenged the notion that tonsillectomy is contraindicated in patients with or at risk for velopharyngeal insufficiency. The purpose of this study was to quantify the effects of tonsillectomy (with or without adenoidectomy) on perceptual speech characteristics, aerodynamic measures, and endoscopic descriptions of velopharyngeal function in a clinical population. Fifteen children 4 to 10 years of age received preoperative and postoperative evaluations. Perceptual speech characteristics improved or remained the same for most variables. There was no statistically significant difference between preoperative and postoperative ratings of hypernasality or frequency and severity of nasal emission. However, ratings of voice quality (pitch and breathiness) were significantly improved after surgery. Aerodynamic measures showed improvement or no change in velopharyngeal function for 12 of 15 children. Endoscopic assessment showed improvement or no change in velopharyngeal closure for 7 of 11 children tested. Cross-method analysis indicated that no single subject showed deterioration in velopharyngeal function in all three measures. The data from this investigation do not support the assumption that tonsillectomy is contraindicated for all children with or at risk for velopharyngeal insufficiency. (Otolaryngol Head Neck Surg 1996;115:319-23.)

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A comfortability and signal quality study of conductive weave electrodes in long-term collection of human electrocardiographs

Textile Research Journal ◽

10.1177/0040517518786275 ◽

2018 ◽

Vol 89 (11) ◽

pp. 2098-2112 ◽

Cited By ~ 4

Author(s):

Xueliang Xiao ◽

Ke Dong ◽

Chenhao Li ◽

Guanzheng Wu ◽

Hongtao Zhou ◽

...

Keyword(s):

Skin Irritation ◽

Woven Fabrics ◽

Comfort Level ◽

Signal Quality ◽

High Quality ◽

Contact Impedance ◽

Ecg Signals ◽

Skin Contact ◽

Textile Electrodes

Long-term electrocardiogram (ECG) recording can reveal some vital cardiovascular disorders and provide warning of human sudden cerebral or vascular diseases in advance. This requires high-quality ECG skin electrodes. Gel (Ag/AgCl) electrodes were reported to have good signal quality in ECG acquisition, but easily caused human skin irritation or allergy. Consequently, textile electrodes have attracted more attention for long-term ECG acquisition. In this paper, eight woven fabrics with diverse yarns and weft densities were fabricated in plain and honeycomb structures. The fabrics were investigated in terms of comfortability, fabric–skin contact impedance and acquired bio-signal quality. Honeycomb weave electrodes were measured with a high comfort level from subjective and objective views, including pleasant tactile comfort, high visual acceptance, good air permeability and good heat transfer. Weave electrodes made of all conductive filaments in high density had low skin contact impedance and high-quality ECG signals. An increase of compression load on weave electrodes resulted in a decrease of contact impedance with a high signal quality. A conductive honeycomb weave with unit repeat of 6*6 warps*wefts presented the highest score of acquired ECG signals of all studied electrodes based on the qualities of the QRS complex, P and T waves, R peak amplitude and variation and signal-to-noise ratio. This study contributes to the future design and fabrication of textile electrodes using honeycomb weave in long-term and real-time collection of human ECGs.

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