Dripping faucet dynamics is determined by synchronization of drop oscillations and detachment.

A dripping faucet is an example of an everyday system that exhibits surprisingly rich dynamics ranging from periodic to chaotic. Using a simple capacitive device, we experimentally demonstrate that the dynamics is determined by the degree of synchronization between two temporally disparate processes: the time at which a drop attains a critical mass and an oscillatory process that accompanies the formation of a drop. We present a full experimental phase-space reconstruction of the ensuing dynamics.

Coherence analysis between respiration and heart rate variability using continuous wavelet transform.

The continuous wavelet transform (CWT) is specifically efficient in the analysis of transient and non-stationary signals. As such, it has become a powerful candidate for time-frequency analysis of cardiovascular variability. CWT has already been established as a valid tool for the analysis of single cardiovascular signals, providing additional insights into the autonomous nervous system (ANS) activity and its control mechanism. Intercorrelation between cardiovascular signals elucidates the function of ANS central control and the peripheral reflex mechanisms. Wavelet transform coherence (WTC) can provide insight into the transient linear order of the regulatory mechanisms, via the computation of time-frequency maps of the time-variant coherence. This paper presents a framework for applying WTC for quantitative analysis of coherence in cardiovascular variability research. Computer simulations were performed to estimate the accuracy of the WTC estimates and a method for determining the coherence threshold for specific frequency band was developed and evaluated. Finally, we demonstrated, in two representative situations, the dynamic behaviour of respiration sinus arrhythmia through the analysis of the WTC between heart rate and respiration signals. This emphasizes that CWT and its application to WTC is a useful tool for dynamic analysis of cardiovascular variability.

Quantitative evaluation of local myocardial blood volume in contrast echocardiography.

Myocardial perfusion is usually assessed by Single Photon Emission Computed Tomography (SPECT) imaging. Information about myocardial perfusion is sometimes deduced from angiography or Computed Tomography (CT) angiography, which detect coronary artery stenosis. Contrast echocardiography can be used for that purpose as well. However, the currently available data acquisition and analysis methods are difficult to manage in the clinical environment. This paper presents a novel contrast echo data acquisition protocol and parameter extraction procedure, providing an automatic quantitative evaluation of the local myocardial blood volume for the entire left ventricular myocardium. This information is indicative of local perfusion. Our method evaluates the myocardial blood volume according to the local gray level intensity, as measured during a single heartbeat, when there is a distinct myocardial opacification (based on visual estimation). The echocardiographic image analysis is based on a new attenuation correction technique, which compensates for the ultrasonic signal attenuation in both the tissue and the contrast agent. In comparison, the existing contrast echo based methods utilize the long-term temporal variability of the gray level to extract information regarding the local myocardial blood flow velocity. Our technique has been tested on 17 cine-loops of 15 different patients. We have found a high correlation between abnormal segments, detected automatically by our technique, and segments that have been clinically diagnosed as ischemic (at rest) or infarcted. For that purpose, we have defined ischemic segments as segments fed by coronary arteries with severe stenosis, as determined by angiography, and infarcted segments as segments after Acute Myocardial Infarction, as detected by electrocardiography. Furthermore, we have found a high correlation between the automatically calculated myocardial blood volume levels and the clinical evaluation of segmental contractility, based on echocardiographic imaging.

Quantitative analysis of echocardiographic cine-loops using a 2D-strain algorithm in correlation with thallium-201 SPECT imaging.

The aim of this study was to investigate the correlation between the regional left ventricular (LV) contractility, assessed by two-dimensional (2D)-strain echocardiographic images, and regional LV perfusion, determined by thallium-201 single photon emission computed tomography (SPECT) imaging. Forty-five hospitalized patients with suspected myocardial ischemia (32 males, mean age 69 +/- 12 years) have undergone both echocardiography and SPECT imaging on the same day. The echocardiographic data has been obtained in three apical views. The data for each view has been processed by the 2D-strain algorithm, to produce six peak systolic longitudinal strain measurements per view, one per segment. The resulting measurements have been compared with the corresponding regions within the SPECT bull's-eye map (at rest). In order to handle inaccuracies in the positioning of the echocardiographic transducer, the two datasets have undergone registration based on local correlation. The mean correlation coefficients between SPECT perfusion and peak systolic longitudinal strain for the apical long-axis, apical two-chamber, and apical four-chamber views were 0.55 +/- 0.36, 0.47 +/- 0.35, and 0.64 +/- 0.30 respectively (negative correlation coefficients have been considered as zero). The overall mean correlation coefficient was 0.56 +/- 0.34. The scatter graphs of the average values of perfusion and the strain values showed a nonlinear relation between the two parameters. The average correlation coefficient is comparable to the values reported for the correlation between the average LV function, based on visual analysis of echocardiographic imaging, and the average LV perfusion, based on SPECT imaging.

Magnetization transfer based contrast for imaging denatured collagen.

PURPOSE: To study of the sensitivity of various NMR and MRI methods and parameters to the degree of thermal denaturation of collagen. MATERIALS AND METHODS: Collagen type I powder was washed with methanol:chloroform to remove traces of lipids and then suspended in saline. Denaturation was carried out by heating the suspension for 5-120 minutes at a temperature range of 50-100 degrees C. The NMR methods tested were two T(2) filter methods: Goldman-Shen (GS) and Edzes-Samulski (ES); magnetization transfer contrast (MTC); double quantum filtering (DQF) and high resolution spectroscopy. MRI contrasts based on these methods were compared. RESULTS: The following parameters were found to be sensitive to denaturation of collagen: 1) the amount of spins that experience high dipolar interactions as assessed by DQF; 2) MTR; 3) k(w)T(1w) (where k(w) is the magnetization transfer rate from water to collagen, and T(1w) is the water protons longitudinal relaxation time); and 4) aliphatic residues content. The contrast between native and denatured collagen was improved by all the tested methods, with ES and DQF producing the highest contrast. CONCLUSION: Methods depending on T(2) filtering and DQF were found to be sensitive to the degree of thermal denaturation of collagen and improve the contrast between native and denatured collagen.

An estimate of fetal autonomic state by time-frequency analysis of fetal heart rate variability.

In this study we present a noninvasive method that enables the investigation of the fetal heart rate (FHR) fluctuations. The objective was to design a quantitative measurement to assess the fetal autonomic nervous system and to investigate its development as a function of the gestational age. Our Medical Physics group has developed a complex algorithm for online beat-to-beat detection of the fetal ECG (FECG), extracted from the maternal abdominal ECG signal. We used our previously acquired FECG data, which includes noninvasive recordings of 200 maternal abdominal ECG signals. From these, we chose 35 cases of healthy pregnancies that we divided into three groups according to gestational age: Group 1, 23 +/- 2 wk; Group 2, 32 +/- 1 wk; and Group 3, 39 +/- 1 wk. The FHR variability was analyzed by a time-frequency decomposition based on a continuous wavelet transform. We showed that, independent of the gestational age, most of the FHR power is concentrated in the very-low-frequency range (0.02-0.08 Hz) and in the low-frequency range (0.08-0.2 Hz). In addition, there is power in the high-frequency range that correlates with the frequency range of fetal respiratory motion (0.4-1.7 Hz). In the intermediate-frequency range (0.2-0.4 Hz), the power is significantly smaller. The changes in the average power spectrum in relation to gestation time were carefully and quantitatively examined. The results imply that there is a neural organization during the last trimester of the pregnancy, and the sympathovagal balance is reduced with the gestational age.

Evaluation of autonomic function underlying slow postexercise heart rate recovery.

UNLABELLED: The reduction in heart rate (HR) during the first minute of recovery immediately after a graded maximal exercise stress test (GXT) has recently been found to be a powerful and independent predictor of cardiovascular and all-cause mortality. Reduced vagal activity has been postulated as the cause, but this has not been proven in a population with slow HR recovery (HRR). PURPOSE: To investigate autonomic contributions to HRR using time-frequency analysis in a group of individuals demonstrating slow HRR. METHODS: HRR was defined as the difference in HR between peak exercise and 1 min later; a value < or = 18 bpm was set as threshold and considered abnormal. A modified continuous wavelet transform (CWT) was used to perform time-dependent spectral analysis during the baseline steady state and the following non-steady-state conditions created by GXT. This method provides dynamic measures of low-frequency (LF) and high-frequency (HF) peaks associated with autonomic activity. Individuals (N = 20) with a previous slow HRR underwent a second GXT within 3 months after their initial test. An additional eight subjects whose first GXT disclosed normal HRR were taken as a control group. RESULTS: Seven of 20 subjects demonstrated slow HRR (14 +/- 5 bpm) on the repeat test, and 13 subjects displayed normal HRR (29 +/- 5 bpm). Subjects with slow HRR in both GXT displayed significantly (P < 0.05) lower HF and LF fluctuations during recovery than those with normal HRR. CONCLUSIONS: Attenuated HRR after GXT, assessed by CWT, is indeed associated with abnormal vagal reactivation and prolonged sympathetic stimulation after termination of maximal exercise.

Automatic endocardial-boundary detection in low mechanical-index contrast echocardiography.

This paper presents a novel algorithm, aimed at automatic endocardial boundary (inner boundary) detection in myocardial opacification scenarios. The data acquisition protocol uses (on purpose) low mechanical index imaging (i.e., weak ultrasound signal), so that the acquired images are characterized by low signal-to-noise ratios. The proposed algorithm is based on converting the frames, given in Cartesian coordinates, into polar coordinates, and applying a set of filters in order to compute the initial estimation of the endocardial boundary. The final estimation of the endocardial boundary is produced by an error correction process, which uses both spatial and temporal filtering. The estimated boundaries are converted into Cartesian coordinates, for display. Our algorithm has been tested on nine cine-loops. The resulting myocardial outlines have been separately assessed by two clinicians, scoring each segment in each cine-loop on a scale between 5 (excellent) and 1 (completely unacceptable). The mean overall score is 3.8 +/- 0.8, which seems adequate. The same clinicians have also manually drawn the contours of the endocardial boundary for the end-systolic and the end-diastolic frames of each cine-loop. The results show, that the mismatch between the automatically determined outlines and the manually drawn outlines is of the same order of magnitude as the interobserver variability. These results further support the validity of our method.

Autonomic changes during wake-sleep transition: a heart rate variability based approach.

Autonomic function during sleep and wakefulness has been extensively investigated, however information concerning autonomic changes during the wake to sleep transition is scarce. The objective of the present study was to non-invasively characterize autonomic function and additional physiologic changes during sleep onset in normal and abnormal sleep. The estimation of autonomic function was based on time-frequency analysis of the RR interval series, using the power components in the very-low-frequency range (0.005-0.04 Hz), low-frequency (0.04-0.15 Hz), and high-frequency range (0.15-0.5 Hz). The ratio of low to high frequency power represented the sympathovagal balance. Thirty-four subjects who underwent whole night polysomnography were divided into 3 groups according to their complaints and study results: normal subjects, apneic patients (OSAS), and subjects with various sleep disorders (VSD). The results indicated a significant increase in RR interval during sleep onset, although its variability decreased; respiratory rate did not change, yet respiration became more stable; EMG amplitude and its variability decreased with sleep onset. Very-low-frequency power started to decrease significantly 2 min before sleep onset in all groups; low-frequency power decreased and high-frequency power did not change significantly in all groups, accordingly their ratio decreased and reflected a shift towards parasympathetic predominance. Although autonomic function displayed similar behavior in all subjects, OSAS and VSD patients presented a higher sympathovagal balance reflecting enhanced sympathetic predominance in those groups compared to normal subjects, both before and after sleep onset. All parameters reached a nadir at a defined time point during the process of falling asleep. We conclude that the wake-sleep transition period represents a transitional process between two physiologically different states; this transition starts with a decrease in the very slow oscillations in heart rate that anticipates a step-change resetting of autonomic function, followed by a decrease in sympathovagal balance towards the end of the process.

Individual time-dependent spectral boundaries for improved accuracy in time-frequency analysis of heart rate variability.

Heart rate variability (HRV) is a major noninvasive technique for evaluating the autonomic nervous system (ANS). Use of time-frequency approach to analyze HRV allows investigating the ANS behavior from the power integrals, as a function of time, in both steady-state and non steady-state. Power integrals are examined mainly in the low-frequency and the high-frequency bands. Traditionally, constant boundaries are chosen to determine the frequency bands of interest. However, these ranges are individual, and can be strongly affected by physiologic conditions (body position, breathing frequency). In order to determine the dynamic boundaries of the frequency bands more accurately, especially during autonomic challenges, we developed an algorithm for the detection of individual time-dependent spectral boundaries (ITSB). The ITSB was tested on recordings from a series of standard autonomic maneuvers with rest periods between them, and the response to stand was compared to the known physiological response. A major advantage of the ITSB is the ability to reliably define the mid-frequency range, which provides the potential to investigate the physiologic importance of this range.

Stationary clutter rejection in echocardiography.

Clutter is one of the most problematic artifacts in echocardiography. It sometimes blocks substantial portions of the image, making the diagnosis in these areas difficult, if not impossible. This is, to our knowledge, the first study aimed solely at automatic clutter rejection, performed in postprocessing, without changing the data-acquisition method. The procedure is based on the fact that the motion of the organs causing most of the clutter (e.g., the ribcage and the lungs) is much slower than that of the cardiac muscle, so that the clutter shows very small changes during a single cardiac cycle. The algorithm has been successfully tested on a set of 16 cineloops in apical two-chamber and apical four-chamber views, belonging to 16 different patients. The results show a high probability of clutter detection, while maintaining a low probability for erroneous detection of pixels as clutter.

Adaptive brightness transfer functions in echocardiography.

Despite the clear advantages of echocardiography as a diagnostic tool, its images tend to be noisy and unclear. This paper presents an innovative algorithm, called ABTF (adaptive brightness transfer function), designed to optimally adjust the gray-levels used in echocardiography. The algorithm is aimed at aiding in visual tissue classification and texture-based visual tissue tracking in echocardiographic images. The ABTF method is based on fitting the cine-loop's gray-level histogram to a sum of three Gaussian functions, each of which relates to a different region within the image, the left ventricular cavity, the relatively dark regions within the cardiac muscle and the bright regions within the cardiac muscle. The procedure's feasibility has been supported by a test-set, including 23 echocardiographic cine-loops from 10 different patients. The resulting image quality appears to be superior to that of the original images, tending to show better contrast and a higher dynamic range of gray-levels within the cardiac muscle. According to two expert cardiologists, who have blindly ranked the image quality of each cine-loop on a scale from 1 to 10, where 10 corresponds to the highest possible image quality, the mean score of the original cine-loops is 7.1 +/- 1.1, while the mean score of the cine-loops to which ABTF has been applied is 8.0 +/- 1.2.

Motion-based tendon diagnosis using sequence processing of ultrasound images.

Degenerative or pre-degenerative processes in the tendon, which could lead to a spontaneous rupture, are well known problems, especially among athletes. Existing non-invasive diagnostic methods are mainly based on subjective analysis of static images of the tendon, but in many cases the degeneration cannot be diagnosed in time. Combining a set of existing image processing techniques, a tool for tracking the in vivo motion of a tendon imaged with dynamic ultrasound was implemented. A group of subjects that had undergone a degenerative rupture of their Achilles tendon, one subject with a traumatic rupture, and a group of control subjects were all tested. Using the motion information that was obtained from both tendons of all subjects, we developed an automatic test that examines the symmetrical properties of the tendon's motion, and defined a negative asymmetry property that could be quantified as a score. This score was found to be significantly more enhanced in the post-operative tendons (18.0 +/- 9.0) than in the contra-lateral healthy tendons of the same subjects (3.9 +/- 4.6). In the single traumatic rupture subject, this effect was not found (0.0). This leads us to believe that the negative asymmetry of tendon motion may be associated with degenerative or pre-degenerative processes in the tendon. Also, the mean degree of negative asymmetry in the healthy tendons of post-operative subjects (3.9 +/- 4.6) was found to be higher than that of healthy tendons of the control group (1.5 +/- 1.8). This finding may be associated with the fact that tendons that are contra-lateral to spontaneously ruptured tendons have a higher risk of developing degenerative processes. The method presented here is objective, low-cost, non-invasive and possibly more sensitive than existing non-invasive techniques.

Bicoherence analysis of new cardiovascular spectral components observed in heart-transplant patients: statistical approach for bicoherence thresholding.

Following heart transplant (HT), the patient's heart functions under complete cardiac denervation. As a result, the variability in physiologic signals is extremely reduced. We have previously reported that in addition to the typical spectral components (of very low amplitude), part of the HT patients (above 50%) demonstrated unexpected additional peaks in their heart rate and blood pressure spectra. These peaks may be a result of the development of compensatory mechanism induced by loss of parasympathetic control, or of increased importance of nonlinear control interactions. It is important to quantify these strange, unexpected very-high frequency (VHF) peaks, to understand their origin and their contribution to cardiac control in transplant patients. In this paper, we chose to examine these VHF peaks by applying the bicoherence approach. The reduced signal to noise ratio, occurring in these patients, results, however, in an extremely noisy bicoherence. We, therefore, developed several statistical tools in order to distinguish between "true" bicoherence peaks (reflecting true phase coupling) and spurious peaks. The outcome of these methods was an efficient and sensitive bicoherence thresholding procedure, able to identify most of the spurious peaks. Applying these tools to the bicoherence of cardiovascular signals which display VHF peaks, revealed several significant bicoherence peaks. Interestingly, these peaks consisted of two different types. The first type of VHF peaks simply reflects nonlinear cardiac-respiratory coupling, imposed by nonsinusoidal breathing. The second type, however, is clearly not induced by the respiratory system. We believe that these type-2 VHF peaks reflect the evolution of a new, yet unexplained, compensatory mechanism.

A sensitive new indicator for diagnostics of ovarian malignancy, based on the Doppler velocity spectrum.

Ovarian cancer is the most deadly gynecological malignancy, with an overall survival rate of about 35%. Approximately 60% of the cases of ovarian cancer are lethal. Ultrasonic examination, including Doppler imaging, is a commonly used technique for the diagnosis of ovarian masses. Two major clinical parameters, currently derived from the Doppler flow waveform, are the resistance index (RI) and the pulsatility index (PI). The decay constant of the Doppler waveform, which characterizes its decrease from systole to diastole as an exponential decay, has recently been presented as an additional measure of tumor malignancy. In this paper, we have analyzed the velocity spectrum of the Doppler flow signal to determine if it reveals differences that might contribute to the diagnosis of malignancy. We designed a new parameter characterizing the slope of the mean velocity spectrum at end-diastole ("End Diastolic Velocity Distribution Slope," referred to as DVD_S). Additional indices, related to various approaches for the analysis of the Doppler image, were also derived. However, they proved to be inferior to the DVD_S. The DVD_S was tested on 20 benign and 33 malignant ovarian images. This new parameter seems to provide a good ability to discriminate between the two types of tumor. Its mean value is 1.90 +/- 1.33 for malignant tumors, compared to 9.21 +/- 5.34 for benign masses (area under ROC curve: 0.983), yielding a detection rate of about 94%. In fact, this parameter provides much better results than the previously used variables, and has the potential to significantly improve the detection of malignancy.

Autoimmunity as an immune defense against degenerative processes: a primary mathematical model illustrating the bright side of autoimmunity.

Self-tolerance, or the ability of the immune system to refrain from destroying the organism's own tissues, is a prerequisite for proper immune system operation. How such self-tolerance is achieved is still a subject of debate. The belief that autoimmunity poses a continuous threat to the organism was challenged by data demonstrating that autoimmunity has a protective function after traumatic injury to the central nervous system. This finding led us to suggest the 'comprehensive immunity' approach by which autoimmunity is viewed as a special case of immunity, namely as a defense mechanism that operates by fighting against the threat of potential destructive activity originated or mediated within the organism, similarly to the immune defense that operates against the threat from exogenous pathogens. We present a primary mathematical spatio-temporal model that supports this concept. The numerical solutions of this model illustrate the beneficial operation of a well-controlled immune response specific to self-antigens residing in the site of lesion. The model also explains how the response to self might be tolerated on a day-to-day basis. In addition, we demonstrate that the same autoimmune response, operating at different levels of regulation, can lead to either an autoimmune disease or a degenerative disorder. This preliminary qualitative model supports our contention that the way autoimmunity is perceived should be revised.

An automatic approach for morphological analysis and malignancy evaluation of ovarian masses using B-scans.

Ovarian masses are a common phenomenon among women of all ages. The importance of prompt diagnosis of ovarian malignancies is obvious, due to the high mortality rate and the difficulty to detect a tumor in its early stages. In this work, an automatic technique for quantitative analysis and malignancy detection of ovarian masses using B-scan ultrasound (US) images is presented. The core of the technique is morphologic analysis of the ovarian mass. The method employed for this task is divided into two major stages: initial classification of the mass (into one of the three major tumor types: cyst, semisolid, solid), and detailed analysis of the mass. Malignancy evaluation is performed based on the collected data and the criteria provided by commonly used scoring systems. The results reflect adequate performance of the automatic method developed (referring to clinical requirements).

Parametric description of cardiac vagal control.

Heart rate variability (HRV) indices that reflect the magnitude of respiratory sinus arrhythmia (RSA) are commonly applied as non-invasive measures of cardiac vagal control. Recently, however, serious doubts have been raised about the accuracy and validity of such assessments. To evaluate these methods, we derived a theoretical model for the dependence of mean heart rate and RSA on gradual vagal blockade by atropine, and compared its predictions to actual experimental results. The experiment involved the injection of nine consecutive intravenous bolus doses of atropine to eight young healthy male subjects. Seven-minute recordings of ECG and respiration were made for each atropine dose. The heart rate (HR) signal was derived from the ECG recording, and mean heart rate and the power of the high frequency peak of HRV (which measures the magnitude of RSA) were computed. The experimental data were fitted to the model's equations, and optimal values were obtained for the model's parameters. A tight agreement is observed between the theoretical fitted curves and the experimental data. The parameters that were computed from fitting the experimental data to the mean heart rate equation display a surprisingly small variance among the different subjects. The parameters that were computed from fitting the experimental data to the RSA equation, and the resulting shape of these fitted curves, explain many of the conflicting results previously published, and provide a new quantitative insight to cardiac vagal activity.

Vaccination with dendritic cells pulsed with peptides of myelin basic protein promotes functional recovery from spinal cord injury.

Injury-induced self-destructive processes cause significant functional loss after incomplete spinal cord injury (SCI). Cellular elements of both the innate (macrophage) and the adaptive (T-cell) immune response can, if properly activated and controlled, promote post-traumatic regrowth and protection after SCI. Dendritic cells (DCs) trigger activation of effector and regulatory T-cells, providing a link between the functions of the innate and the adaptive immune systems. They also initiate and control the body's response to pathogenic agents and regulate immune responses to both foreign and self-antigens. Here we show that post-injury injection of bone marrow-derived DCs pulsed with encephalitogenic or nonencephalitogenic peptides derived from myelin basic protein, when administered (either systemically or locally by injection into the lesion site) up to 12 d after the injury, led to significant and pronounced recovery from severe incomplete SCI. No significant protection was seen in DC recipients deprived of mature T-cells. Flow cytometry, RT-PCR, and proliferation assays indicated that the DCs prepared and used here were mature and immunogenic. Taken together, the results suggest that the DC-mediated neuroprotection was achieved via the induction of a systemic T-cell-dependent immune response. Better preservation of neural tissue and diminished formation of cysts and scar tissue accompanied the improved functional recovery in DC-treated rats. The use of antigen-specific DCs may represent an effective way to obtain, via transient induction of an autoimmune response, the maximal benefit of immune-mediated repair and maintenance as well as protection against self-destructive compounds.