Search results for: Clinical Laboratory persons

Authors: Seongchan Kang, Hongsik Yun, Hyukgil Kim, Minwoo Park

Abstract:

For this study, this researcher conducted a precision network adjustment with QOCA, the precision network adjustment software developed by Jet Propulsion Laboratory, to perform an integrated network adjustment on the Unified Control Points managed by the National Geographic Information Institute. Towards this end, 275 Unified Control Points observed in 2008 were selected before a network adjustment is performed on those 275 Unified Control Points. The RMSE on the discrepancies of coordinates as compared to the results of GLOBK was ±6.07mm along the N axis, ±2.68mm along the E axis and ±6.49mm along the U axis.

Keywords: Network adjustment, QOCA, unified control point.

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Authors: Khampheth Bounnady, Boontee Kruatrachue, Somkiat Wangsiripitak

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This paper proposed high level feature for online Lao handwritten recognition. This feature must be high level enough so that the feature is not change when characters are written by different persons at different speed and different proportion (shorter or longer stroke, head, tail, loop, curve). In this high level feature, a character is divided in to sequence of curve segments where a segment start where curve reverse rotation (counter clockwise and clockwise). In each segment, following features are gathered cumulative change in direction of curve (- for clockwise), cumulative curve length, cumulative length of left to right, right to left, top to bottom and bottom to top ( cumulative change in X and Y axis of segment). This feature is simple yet robust for high accuracy recognition. The feature can be gather from parsing the original time sampling sequence X, Y point of the pen location without re-sampling. We also experiment on other segmentation point such as the maximum curvature point which was widely used by other researcher. Experiments results show that the recognition rates are at 94.62% in comparing to using maximum curvature point 75.07%. This is due to a lot of variations of turning points in handwritten.

Keywords: Handwritten feature, chain code, Lao handwritten recognition.

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Authors: L. S. Godlevsky, N. V. Kresyun, V. P. Martsenyuk, K. S. Shakun, T. V. Tatarchuk, K. O. Prybolovets, L. F. Kalinichenko, M. Karpinski, T. Gancarczyk

Abstract:

Structures of eye bottom were extracted using multiscale texture gradient method and color characteristics of macular zone and vessels were verified in CIELAB scale. The difference of average values of L*, a* and b* coordinates of CIE (International Commision of Illumination) scale in patients with diabetes and healthy volunteers was compared. The average value of L* in diabetic patients exceeded such one in the group of practically healthy persons by 2.71 times (P < 0.05), while the value of a* index was reduced by 3.8 times when compared with control one (P < 0.05). b* index exceeded such one in the control group by 12.4 times (P < 0.05). The integrated index on color difference (ΔE) exceeded control value by 2.87 times (P < 0.05). More pronounced differences with ΔE were followed by a shorter period of MA appearance with a correlation level at -0.56 (P < 0.05). The specificity of diagnostics raised by 2.17 times (P < 0.05) and negative prognostic index exceeded such one determined with the expert method by 2.26 times (P < 0.05).

Keywords: Diabetic retinopathy, multiscale texture gradient, color spectrum analysis.

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Authors: G. Çelik Gül, F. Kurtuluş

Abstract:

The first laboratory synthesis of hard materials such as diamond proceeded to attack of developing materials with high hardness to compete diamond. Boron rich solids are good candidates owing to their short interatomic bond lengths and strong covalent character. Boron containing hard material was synthesized by modifiedmicrowave method under nitrogen atmosphere by using a fuel (glycine or urea), amorphous boron and/or boric acid in appropriate molar ratio. Characterizations were done by x-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy/energy dispersive analyze (SEM/EDS), thermo gravimetric/differential thermal analysis (TG/DTA).

Keywords: Boron containing materials, hard materials, microwave synthesis, powder X-ray diffraction.

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Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The Ramon preparation is received from a plant; it is destined for external treatment of inflammations in post-surgery period. The Ramon is a biogenic immune stimulator accelerating metabolism, contributing to improvement of blood indexes, having general tonic, anti-inflammatory and bactericidal effect.

Keywords: Anti-inflammatory, anthraquinones, bactericidal activity, Ramon.

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Authors: Mustafa M. Donma, Sule G. Kacmaz, Ahsen Yilmaz, Savas Guzel, Orkide Donma

Abstract:

Obesity, as excessive fat accumulation in the body, is a global health problem. The prevalence of obesity and its complications increase due to easy access to high-energy food and decreased physical activity. Cardiovascular diseases (CVDs) constitute a significant part of obesity-related morbidity and mortality. Since the effects of obesity on cardiovascular system may start during childhood without clinical findings, elucidating the mechanisms of cardiovascular changes associated with childhood obesity became more important. In this study, we aimed to investigate some biochemical parameters which may be involved in obesity-related pathologic processes of CVDs. One hundred and seventy-seven children were included in the study, and they were divided into four groups based upon WHO criteria and presence of the metabolic syndrome (MetS): children with normal-BMI, obesity, morbid obesity, and MetS. High-sensitive cardiac troponin T (hs-cTnT), cardiac myosin binding protein C (cMyBP-C), trimethylamine N-oxide (TMAO), soluble tumor necrosis factor-like weak inducer (sTWEAK), chromogranin A (CgA), multimerin-2 levels, and other biochemical parameters were measured in serum samples. Anthropometric measurements and clinical findings of the children were recorded. Statistical analyses were performed. Children with normal-BMI had significantly higher CgA levels than children with obesity, morbid obesity, and MetS (p < 0.05). Cardiac MyBP-C levels of children with MetS were significantly higher than of children with normal-BMI and OB children (p < 0.05). There was no significant difference in hs-cTnT, sTWEAK, TMAO and multimerin-2 between the groups (p>0.05). These results suggested that cMyBP-C and CgA molecules may be involved in the pathogenesis of obesity-related CVDs.

Keywords: biomarker, cardiovascular diseases, children, obesity

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Authors: L. Roseiro, C. Veiga, V. Maranha, A.Neto, N. Laraqi, A. Baïri, N. Alilat

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In orthopedic surgery there are various situations in which the surgeon needs to implement methods of cutting and drilling the bone. With this type of procedure the generated friction leads to a localized increase in temperature, which may lead to the bone necrosis. Recognizing the importance of studying this phenomenon, an experimental evaluation of the temperatures developed during the procedure of drilling bone has been done. Additionally the influence of the use of the procedure with / without additional lubrication during drilling of bone has also been done. The obtained results are presented and discussed and suggests an advantage in using additional lubrication as a way to minimize the appearance of bone tissue necrosis during bone drilling procedures.

Keywords: Bone Necrosis, Bone Drilling, Thermography.

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Authors: Md. Harunur Rashid, S. M. Kamal Uddin, Sobura khatun

Abstract:

The performance of mortar subjected to high temperature and cooled in normal ambient temperature was examined in the laboratory to comply with the situation of burning & cooling of a structure. Four series of cubical (5 X 5 X 5 cm) mortar specimens were made from OPC, and partial replacement (10, 15, 20, 25 & 30%) of OPC by Rice Husk Ash (RHA) produced in the uncontrolled environment. These specimens were heated in electric furnace to 200, 300, 400, 500 and 7000C. The specimens were kept in normal room temperature for cooling. They were then tested for mechanical properties and the results shows that particular 20% RHA mixed mortar shows better fire performance.

Keywords: Fire performance, Rice Husk

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Authors: Irena Markovska, Nikolai Zaicev, Bogdan Bogdanov, Dimitar Georgiev, Yancho Hristov

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The present paper deals with problems related to the possibilities to use fractal systems to solve some important scientific and practical problems connected with filtering and separation of aqueous phases from organic ones. For this purpose a special separator have been designed. The reactor was filled with a porous material with fractal dimension, which is an integral part of the set for filtration and separation of emulsions. As a model emulsion hexadecan mixture with water in equal quantities (1:1) was used. We examined the hydrodynamics of the separation of the emulsion at different rates of submission of the entrance of the reactor.

Keywords: pilot reactor, fractal systems, separation, emulsions

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Authors: Sandra Ghavam Shirazi, Komeil Valipourian, Mohammad Reza Golhashem

Abstract:

This paper represents the basic idea and mechanisms associated with the durability of geomembranes and discusses the factors influencing the service life and temperature of geomembrane liners. Geomembrane durability is stated as field performance and laboratory test outcomes under various conditions. Due to the high demand of geomembranes as landfill barriers and their crucial role in sensitive projects, sufficient service life of geomembranes is very important, therefore in this paper, the durability, the effect of temperature on geomembrane and the role of this type of reinforcement in different types of soil will be discussed. Also, the role of geomembrane in the earthquake will be considered in the last part of the paper.

Keywords: Geomembrane, durability temperature soil mechanic.

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Authors: Y. Ni, K. Sebri

Abstract:

The practical implementation of audio-video coupled speech recognition systems is mainly limited by the hardware complexity to integrate two radically different information capturing devices with good temporal synchronisation. In this paper, we propose a solution based on a smart CMOS image sensor in order to simplify the hardware integration difficulties. By using on-chip image processing, this smart sensor can calculate in real time the X/Y projections of the captured image. This on-chip projection reduces considerably the volume of the output data. This data-volume reduction permits a transmission of the condensed visual information via the same audio channel by using a stereophonic input available on most of the standard computation devices such as PC, PDA and mobile phones. A prototype called VMIKE (Visio-Microphone) has been designed and realised by using standard 0.35um CMOS technology. A preliminary experiment gives encouraged results. Its efficiency will be further investigated in a large variety of applications such as biometrics, speech recognition in noisy environments, and vocal control for military or disabled persons, etc.

Keywords: Audio-Visual Speech recognition, CMOS Smartsensor, On-Chip image processing.

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Authors: J. Holomek, R. Karásek, M. Bajer, J. Barnat

Abstract:

Composite steel-concrete slabs using thin-walled corrugated steel sheets with embossments represent a modern and effective combination of steel and concrete. However, the design of new types of sheeting is conditional on the execution of expensive and time-consuming laboratory testing. The effort to develop a cheaper and faster method has lead to many investigations all over the world. In our paper we compare the results from our experiments involving vacuum loading, four-point bending and small-scale shear tests.

Keywords: Composite slab, embossment, four-point bending, small-scale test, steel sheet, thin-walled, vacuum loading

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Authors: Sinee Sankrusme

Abstract:

The study was a case study analysis about Thai Asia Pacific Brewery Company. The purpose was to analyze the company’s marketing objective, marketing strategy at company level, and marketing mix before liquor liberalization in 2000. Methods used in this study were qualitative and descriptive research approach which demonstrated the following results of the study demonstrated as follows: (1) Marketing objective was to increase market share of Heineken and Amtel, (2) the company’s marketing strategies were brand building strategy and distribution strategy. Additionally, the company also conducted marketing mix strategy as follows. Product strategy: The company added more beer brands namely Amstel and Tiger to provide additional choice to consumers, product and marketing research, and product development. Price strategy: the company had taken the following into consideration: cost, competitor, market, economic situation and tax. Promotion strategy: the company conducted sales promotion and advertising. Distribution strategy: the company extended channels its channels of distribution into food shops, pubs and various entertainment places. This strategy benefited interested persons and people who were engaged in the beer business.

Keywords: Marketing Strategy, Beer, Thai Asia Pacific Brewery Company.

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Authors: B. S. Boyanov, A. B. Peltekov, K. I. Ivanov

Abstract:

The ferrites ZnFe2O4, CdFe2O4 and CuFe2O4 are synthesized in laboratory conditions using ceramic technology. Their homogeneity and structure are proven by X-Ray diffraction analysis and Mössbauer spectroscopy. The synthesized ferrites are subjected to strong acid and high temperature leaching with solutions of H2SO4, HCl and HNO3. The results indicate that the highest degree of leaching of Zn, Cd and Cu from the ferrites is achieved by use of HCl. The charging of five zinc sulfide concentrates was optimized using the criterion of minimal amount of zinc ferrite produced when roasting the concentrates in a fluidized bed. The results obtained are interpreted in terms of the hydrometallurgical zinc production and maximum recovery of zinc, copper and cadmium from initial zinc concentrates after their roasting.

Keywords: Hydrometallurgy, inorganic acids, solubility, zinc ferrite.

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Authors: M. Bougamouza, M. Bouhadef, T. Zitoun

Abstract:

The aim of this study is to examine, through experimentation in the laboratory, the supercritical flow in the presence of an obstacle in a rectangular channel. The supercritical regime in the whole hydraulic channel is achieved by adding a convergent. We will observe the influence of the obstacle shape and dimension on the characteristics of the supercritical flow, mainly the free-surface elevation and the velocity profile. The velocity measurements have been conducted with the one dimension laser anemometry technique.

Keywords: Experiments, free-surface flow, hydraulic channel, uneven bottom, laser anemometry, supercritical regime.

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Authors: Branislav Vuksanović, Dragana Nikolić

Abstract:

This paper describes the implementation and testing of a multichannel active noise control system (ANCS) based on the filtered-inverse LMS (FILMS) algorithm. The FILMS algorithm is derived from the well-known filtered-x LMS (FXLMS) algorithm with the aim to improve the rate of convergence of the multichannel FXLMS algorithm and to reduce its computational load. Laboratory setup and techniques used to implement this system efficiently are described in this paper. Experiments performed in order to test the performance of the FILMS algorithm are discussed and the obtained results presented.

Keywords: Active noise control, adaptive filters, inverse filters, LMS algorithm, FILMS algorithm.

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Authors: Anuchit Uchaipichat

Abstract:

A comprehensive program of laboratory testing on a compacted kaolin in a modified triaxial cell was perform to investigate the influence of hydraulic hysteresis on effective stress in unsaturated soils. The test data are presented on a range of constant suction shear tests along wetting and drying paths. The values of effective stress parameter χ at different matric suction were determined using the test results. The effect of hydraulic hysteresis phenomenon on the effective stress was observed. The values of effective stress parameter χ obtained from the experiments were compared with those obtained from the expressions proposed in literature.

Keywords: Unsaturated soils, Hydraulic hysteresis, Effectivestress

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Authors: Pongsiri Kingkan

Abstract:

This paper aims to study the role and activities of the participants and the impact of activities created in the local area in order to sustainably develop the local areas. This study applied both qualitative and quantitative approaches presented in descriptive style; the data was collected via survey, observation and in-depth interviews with samples. The results illustrated five sorts of roles of participants of the Cicada Walking-street and four types of creative activities; recreation based, art based, cultural based, and live events. Integration of local characteristics, arts and cultures were presented creatively and interestingly. Participants are various. The roles of the participants found in the Cicada Market are group of the property and area management, entrepreneurs, leisure (entertaining persons), local people, and tourists. The good impacts on local communities are those in terms of economy, environmental friendly and local arts and cultures promoting. On the other hand, the traffic congestion, waste and the increasing of energy consumption are negative impacts from area development.

Keywords: Creative Tourism Activity, Destination Development, Sustainable Development, Walking Street.

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Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

Abstract:

Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector.

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Authors: Santanu Chattopadhyay, Gautam Sarkar, Arabinda Das

Abstract:

This paper presents wavelet based classification of various heart diseases. Electrocardiogram signals of different heart patients have been studied. Statistical natures of electrocardiogram signals for different heart diseases have been compared with the statistical nature of electrocardiograms for normal persons. Under this study four different heart diseases have been considered as follows: Myocardial Ischemia (MI), Congestive Heart Failure (CHF), Arrhythmia and Sleep Apnea. Statistical nature of electrocardiograms for each case has been considered in terms of kurtosis values of two types of wavelet coefficients: approximate and detail. Nine wavelet decomposition levels have been considered in each case. Kurtosis corresponding to both approximate and detail coefficients has been considered for decomposition level one to decomposition level nine. Based on significant difference, few decomposition levels have been chosen and then used for classification.

Keywords: Arrhythmia, congestive heart failure, discrete wavelet transform, electrocardiogram, myocardial ischemia, sleep apnea.

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Authors: A. Harras, A. Tsuji, K. Terada

Abstract:

Tracking of moving people has gained a matter of great importance due to rapid technological advancements in the field of computer vision. The objective of this study is to design a motion based detection and tracking multiple walking pedestrians randomly in different directions. In our proposed method, Gaussian mixture model (GMM) is used to determine moving persons in image sequences. It reacts to changes that take place in the scene like different illumination; moving objects start and stop often, etc. Background noise in the scene is eliminated through applying morphological operations and the motions of tracked people which is determined by using the Kalman filter. The Kalman filter is applied to predict the tracked location in each frame and to determine the likelihood of each detection. We used a benchmark data set for the evaluation based on a side wall stationary camera. The actual scenes from the data set are taken on a street including up to eight people in front of the camera in different two scenes, the duration is 53 and 35 seconds, respectively. In the case of walking pedestrians in close proximity, the proposed method has achieved the detection ratio of 87%, and the tracking ratio is 77 % successfully. When they are deferred from each other, the detection ratio is increased to 90% and the tracking ratio is also increased to 79%.

Keywords: Automatic detection, tracking, pedestrians.

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Authors: Y. Galerkin, O. Solovieva

Abstract:

Parameters of flow are calculated in vaneless diffusers with relative width 0,014–0,10. Inlet angles of flow and similarity criteria were varied. There is information on flow separation, boundary layer development, configuration of streamlines. Polytrophic efficiency, loss coefficient and recovery coefficient are used to compare effectiveness of diffusers. The sample of optimization of narrow diffuser with conical walls is presented. Three wide diffusers with narrowing walls are compared. The work is made in the R&D laboratory “Gas dynamics of turbo machines” of the TU SPb.

Keywords: Vaneless diffuser, relative width, flow angle, flow separation, loss coefficient, similarity criteria.

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Authors: M. S. Razana, Z. W. Shafiuddin

Abstract:

Internal auditing is one of the most important activities for organizations that implement information security management systems (ISMS). The purpose of internal audits is to ensure the ISMS implementation is in accordance to the ISO/IEC 27001 standard and the organization’s own requirements for its ISMS. Competent internal auditors are the main element that contributes to the effectiveness of internal auditing activities. To realize this need, CyberSecurity Malaysia is now in the process of becoming a certification body that certifies ISMS internal auditors. The certification scheme will assess the competence of internal auditors in generic knowledge and skills in management systems, and also in ISMS-specific knowledge and skills. The certification assessment is based on the ISO/IEC 19011 Guidelines for auditing management systems, ISO/IEC 27007 Guidelines for information security management systems auditing and ISO/IEC 27001 Information security management systems requirements. The certification scheme complies with the ISO/IEC 17024 General requirements for bodies operating certification systems of persons. Candidates who pass the exam will be certified as an ISMS Internal Auditor, whose competency will be evaluated every three years.

Keywords: ISMS internal audit, ISMS internal auditor, ISO/IEC 17024, Competence, Certification.

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Authors: Parastou Kharazmi, Folke Björk

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Pipe failure and leakage is a problematic issue and the traditional solution of replacing the pipes is costly and time consuming. Rehabilitation by relining materials based on polymer composites is an alternative solution towards the degradation problem of the old piping. This paper provides a brief summary of advances in technology, methods and materials for relining as well as a summary of the degradation analyses of the two main composite materials used for relining, rubber filled epoxy and reinforced polyester baltoflake when they are exposed in deionized water and elevated temperature up to 80°C for a duration of 2-14 months in the laboratory.

Keywords: Composite, Epoxy, Polyester, Pipes, Relining.

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Authors: Abbas R. Ali, Diana A. Bayiz

Abstract:

14 mudstone samples were collected within the sedimentary succession of Mukdadiya Formation (Late Miocene – Early Pliocene) from Shewasoor area at Northeastern Iraq. The samples were subjected to laboratory studies including mineralogical analysis (using X-ray Diffraction technique) in order to identify the clay mineralogy of Mukdadiya Formation of both clay and non-clay minerals. The results of non-clay minerals are: quartz, feldspar and carbonate (calcite and dolomite) minerals. The clay minerals are: montmorillonite, kaolinite, palygorskite, chlorite, and illite by the major basal reflections of each mineral. The origins of these minerals are deduced also.

Keywords: Clay minerals, formation, Mukdadiya mudstone, Shewasoor, XRD.

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Authors: M. Tsirintani

Abstract:

The article is proposing a base plan for the future Patient Care Information Systems in a changing health care environment where it is necessary to assure quality patient care services and reducing cost and where new technology trends give the opportunities to develop clinical applications and services patient focused according to new business objectives.

Keywords: Health care management, planning patient care information system.

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Authors: Abdulsalam I. Rafida

Abstract:

The main objective of this research was to investigate the biosorption capacity for biofilms of sulphate reducing bacteria (SRB) to remove heavy metals, such as Zn, Pb and Cd from rainwater using laboratory-scale reactors containing mixed support media. Evidence showed that biosorption had contributed to removal of heavy metals including Zn, Pb and Cd in presence of SRB and SRB were also found in the aqueous samples from reactors. However, the SRB and specific families (Desulfobacteriaceae and Desulfovibrionaceae) were found mainly in the biomass samples taken from all reactors at the end of the experiment. EDX-analysis of reactor solids at end of experiment showed that heavy metals Zn, Pb and Cd had also accumulated in these precipitates.

Keywords: Sulphate reducing bacteria (SRB), biosorption capacity.

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Authors: Santosh Kr. Choudhary

Abstract:

In this article, LQR based PID controller design for 3DOF helicopter system is investigated. The 3-DOF helicopter system is a benchmark laboratory model having strongly nonlinear characteristics and unstable dynamics which make the control of such system a challenging task. This article first presents the mathematical model of the 3DOF helicopter system and then illustrates the basic idea and technical formulation for controller design. The paper explains the simple approach for the approximation of PID design parameters from the LQR controller gain matrix. The simulation results show that the investigated controller has both static and dynamic performance, therefore the stability and the quick control effect can be obtained simultaneously for the 3DOF helicopter system.

Keywords: 3DOF helicopter system, PID controller, LQR controller, modeling, simulation.

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Authors: Liang Zhang, Hai-Tao Zhang, W ei-Yong Ying, Ding-Ye Fang

Abstract:

Dehydration of methanol to dimethyl ether (DME) over a commercial Al2O3 catalyst was studied in an isothermal integral fixed bed reactor. The experiments were performed on the temperature interval 513-613 K, liquid hourly space velocity (LHSV) of 0.9-2.1h-1, pressures between 0.1 and 1.0 MPa. The effect of different operation conditions on the dehydration of methanol was investigated in a laboratory scale experiment. A new intrinsic kinetics equation based on the mechanism of Langmuir-Hinshelwood dissociation adsorption was developed for the dehydration reaction by fitting the expressions to the experimental data. An activation energy of 67.21 kJ/mol was obtained for the catalyst with the best performance. Statistic test showed that this new intrinsic kinetics equation was acceptable.

Keywords: catalyst, dimethyl ether, intrinsic kinetics, methanol

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

Abstract:

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.

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