Evaluation of the Accuracy of a New Cuffless Magnetoplethysmography Blood Pressure Monitor in Hypertensive Patients.

OBJECTIVE: There is a growing demand for cuffless blood pressure (BP) measurement as an easy alternative to cuff-occlusion-based BP measurement. We assessed the accuracy of a new cuffless, watch-style BP monitor with a magnetoplethysmography (MPG) sensor compared to two standard auscultatory and oscillatory BP monitors. SUBJECTS AND METHODS: A total of 34 patients with uncontrolled hypertension (systolic BP ≥150 mm Hg or diastolic BP ≥95 mm Hg) were enrolled in the study. BP was measured by two conventional monitors and the new device during the pre-exercise phase, during isometric handgrip exercise, and during the recovery phase (5 min after exercise). The correlation between monitors was assessed using intraclass correlation coefficient (ICC) and Bland-Altman plots. RESULTS: Although two reference monitors produced highly correlated BP measurements, each was differentially correlated with BP measurements obtained by the new MPG monitor. During exercise, the mean difference between systolic BP obtained by the MPG and oscillatory monitors was >7 mm Hg with an ICC of 0.549 (95$ CI 0.264-0.746) in systole and 0.737 (95$ CI 0.534-0.859) in diastole. The ICC between the auscultatory monitor and the MPG monitor was 0.753 (95$ CI 0.559-0.868) in systole and 0.841 (95$ CI 0.706-0.918) in diastole after exercise. Bland-Altman plots also indicated that the performance of the new MPG device was very similar to that of the auscultatory monitor. CONCLUSION: Although the performance of the new MPG monitor was comparable to that of the reference monitors used in this study, improved stability and accuracy are necessary for accurate BP evaluation during dynamic activity.

Prolonged stimulation with low-intensity ultrasound induces delayed increases in spontaneous hippocampal culture spiking activity.

Ultrasound is a promising neural stimulation modality, but an incomplete understanding of its range and mechanism of effect limits its therapeutic application. We investigated the modulation of spontaneous hippocampal spike activity by ultrasound at a lower acoustic intensity and longer time scale than has been previously attempted, hypothesizing that spiking would change conditionally upon the availability of glutamate receptors. Using a 60-channel multielectrode array (MEA), we measured spontaneous spiking across organotypic rat hippocampal slice cultures (N = 28) for 3 min each before, during, and after stimulation with low-intensity unfocused pulsed or sham ultrasound (spatial-peak pulse average intensity 780 µW/cm2 ) preperfused with artificial cerebrospinal fluid, 300 µM kynurenic acid (KA), or 0.5 µM tetrodotoxin (TTX) at 3 ml/min. Spike rates were normalized and compared across stimulation type and period, subregion, threshold level, and/or perfusion condition using repeated-measures ANOVA and generalized linear mixed models. Normalized 3-min spike counts for large but not midsized, small, or total spikes increased after but not during ultrasound relative to sham stimulation. This result was recapitulated in subregions CA1 and dentate gyrus and replicated in a separate experiment for all spike size groups in slices pretreated with aCSF but not KA or TTX. Increases in normalized 18-sec total, midsized, and large spike counts peaked predominantly 1.5 min following ultrasound stimulation. Our low-intensity ultrasound setup exerted delayed glutamate receptor-dependent, amplitude- and possibly region-specific influences on spontaneous spike rates across the hippocampus, expanding the range of known parameters at which ultrasound may be used for neural activity modulation. © 2016 Wiley Periodicals, Inc.

Design of real-time encryption module for secure data protection of wearable healthcare devices.

Wearable devices for biomedical instrumentation could generate the medical data and transmit to a repository on cloud service through wireless networks. In this process, the private medical data will be disclosed by man in the middle attack. Thus, the archived data for healthcare services would be protected by non-standardized security policy by healthcare service provider (HSP) because HIPAA only defines the security rules. In this paper, we adopted the Advanced Encryption Standard (AES) for security framework on wearable devices, so healthcare applications using this framework could support the confidentiality easily. The framework developed as dynamic loadable module targeted for lightweight microcontroller such as msp430 within embedded operating system. The performance was shown that the module can support the real-time encryption using electrocardiogram and photoplethysmogram. In this regard, the processing load for enabling security is distributed to wearable devices, and the customized data protection method could be composed by HSP for a trusted healthcare service.

The association between pulse wave velocity and metabolic syndrome in Korean.

The objective of this study was to compare aortic (the common carotid to femoral artery) PWV, arm (the brachial to radial artery) PWV, and leg (the femoral to dorsalis pedis artery) PWV in people with or without component of the metabolic syndrome. We analyzed 3345 Korean subjects (1907 men, age 44.6 ± 8.5, 1438 women, age 43.3 ± 8.9). Unpaired t-test was used to compare mean values of various metabolic parameters between subjects with and without Metabolic Syndrome (MetS), and one-way analysis of variance was used to compare these variables among groups satisfying different numbers of the components of MetS. In addition, we compared of Pearson correlation coefficient between age and PWV (arotic PWV, arm PWV and leg PWV) levels of according to whether the subject had components of the metabolic syndrome or not. The present study shows that leg PWV level was found to be significantly associated with the features of the metabolic syndrome in Korean men and women. And, we confirmed that blood pressure is significantly associated with the PWV values at three locations. And, this study shows that Pearson correlation coefficient of arotic PWV and leg PWV were about 10% higher than without diabetes according to age. Further studies need to be performed to evaluate the optimal cut-off value of PWV for diabetes, hypertension, and MetS in Korean.

Integrated Solution for Physical Activity Monitoring Based on Mobile Phone and PC.

OBJECTIVES: This study is part of the ongoing development of treatment methods for metabolic syndrome (MS) project, which involves monitoring daily physical activity. In this study, we have focused on detecting walking activity from subjects which includes many other physical activities such as standing, sitting, lying, walking, running, and falling. Specially, we implemented an integrated solution for various physical activities monitoring using a mobile phone and PC. METHODS: We put the iPod touch has built in a tri-axial accelerometer on the waist of the subjects, and measured change in acceleration signal according to change in ambulatory movement and physical activities. First, we developed of programs that are aware of step counts, velocity of walking, energy consumptions, and metabolic equivalents based on iPod. Second, we have developed the activity recognition program based on PC. iPod synchronization with PC to transmit measured data using iPhoneBrowser program. Using the implemented system, we analyzed change in acceleration signal according to the change of six activity patterns. RESULTS: We compared results of the step counting algorithm with different positions. The mean accuracy across these tests was 99.6 ± 0.61%, 99.1 ± 0.87% (right waist location, right pants pocket). Moreover, six activities recognition was performed using Fuzzy c means classification algorithm recognized over 98% accuracy. In addition we developed of programs that synchronization of data between PC and iPod for long-term physical activity monitoring. CONCLUSIONS: This study will provide evidence on using mobile phone and PC for monitoring various activities in everyday life. The next step in our system will be addition of a standard value of various physical activities in everyday life such as household duties and a health guideline how to select and plan exercise considering one's physical characteristics and condition.

A pilot study of the Tele-Airway Management System in a hospital emergency department.

We developed a telemedicine system for remote guidance of emergency airway management called the Tele-Airway Management System (TAMS). In a pilot study we examined the usefulness of the TAMS for intubations of actual patients in a hospital emergency department. Twenty-five patients were allocated randomly either to a TAMS group or to an on-scene directed (OSD) group. A total of 12 were intubated using the TAMS. The mean time to intubation (TAMS 62 s vs. OSD 56 s) and the success rate was not different between the two groups (P > 0.05). There were two oesophageal intubations in the TAMS group and four in the OSD group, but this was not significantly different (P = 0.36). There were no mechanical or technical errors such as disconnection during use of the TAMS. The pilot study demonstrated the feasibility of the TAMS as an alternative to OSD. However, a larger study will be required to determine non-superiority or equivalence.

Portable emergency telemedicine system over wireless broadband and 3G networks.

The telemedicine system aims at monitoring patients remotely without limit in time and space. However the existing telemedicine systems exchange medical information simply in a specified location. Due to increasing speed in processing data and expanding bandwidth of wireless networks, it is possible to perform telemedicine services on personal digital assistants (PDA). In this paper, a telemedicine system on PDA was developed using wideband mobile networks such as Wi-Fi, HSDPA, and WiBro for high speed bandwidths. This system enables to utilize and exchange variety and reliable patient information of video, biosignals, chatting messages, and triage data. By measuring bandwidths of individual data of the system over wireless networks, and evaluating the performance of this system using PDA, we demonstrated the feasibility of the designed portable emergency telemedicine system.

Performance evaluation of the electrode configuration in bioelectrical impedance analysis for visceral fat measurement.

Excessive amount of visceral fat is considered as a crucial indicator for the metabolic syndrome (MS). Visceral fat area (VFA) at the umbilicus level measured by CT is adopted as the gold standard, but it has many limitations. Recently, Application of bioelectrical impedance analysis (BIA) for measuring VFA is widely used. However, the correlation between impedance and VFA is highly dependent on the measurement conditions. Therefore, we evaluate its measurement conditions here. In our experiment, we choose 5 different electrode configurations with changes of current and its frequency for evaluating its performance to distinguish fat and thin group with impedance. Our results indicated that electrode arrangement with fixed waist ratio is better in its performance than fixed distance electrode arrangement. Current electrode on each flank side is better than on the front and rear side. Shorter distance between current electrode and voltage electrode is better than longer distance in its performance. Our experiment results are presented.

A portable dental image viewer using a mobile network to provide a tele-dental service.

We tested three imaging devices for suitability in emergency dental situations for telemedicine. The three devices were a special-purpose oral camera, a digital single lens reflex (DSLR) camera, and the built-in camera of a mobile phone. A total of 20 subjects volunteered to take part in the study. We simulated five different conditions which could affect the quality of the image and measured image transmission times across two widely available mobile networks (a CDMA-based 3G network and a Wireless Broadband Network, WiBRO). The DSLR produced the best quality images, although it was a relatively large device and not easy to use. The oral camera failed to give satisfactory images under certain conditions (i.e. without extra lighting, out of focus and head motion). In contrast, the mobile phone based camera was very easy to use and to handle, and it gave good information for initial diagnosis, even at high compression ratios. If the image acquisition conditions are carefully set up, this device might be the best for emergency dental trauma situations.

Design of RFID based the Patient Management and Tracking System in hospital.

The patient location information in managing for patient workflow will be worked efficiently within the hospital. We designed the Patient Management and Tracking System (PMTS) based on RFID with RSSI(Received Signal Strength Indication) method. This system is able to track the movement of patient in hospital, and manage the waiting-list of patients at a medical office. Therefore, we are sure that the PMTS will be useful for decreasing a duty of medical staff and increase a convenience of patients.

Real-time Ambulance Location Monitoring using GPS and Maps Open API.

The term 'Open API' has been recently in use by recent trends in social media and web 2.0. It is currently a heavily sought after solution to interconnect Web sites in a more fluid user-friendly manner. We could have benefits easily development and high efficiency.