Noninvasive detection of coronary stenoses before and afterangioplasty using eigenvector methods

Previous studies done by our group suggest that partially occluded coronary arteries may generate sounds due to turbulent blood flow. To support these previous findings the frequency spectra of diastolic heart sounds are compared before and after angioplastic surgery. Since the low-level sounds associated with partially occluded coronary arteries are contaminated with considerable background noise, traditional FFT analysis may not produce accurate frequency spectra. Indeed, in a previous study using the same data, no significant differences were found in the diastolic heart sounds before and after angioplastic surgery. In this study, three eigenvector methods (Pisarenko, MUSIC, and Minimum-Norm) have been selected to generate the frequency spectra because of their higher resolution, particularly in the presence of noise. Although the Pisarenko method produced spurious zeros and could not be used, the other two methods produced spectra showing, in most cases, a marked decrease in high-frequency spectral components following angioplasty.     

Three-dimensional segmentation and growth-rate estimation of small pulmonary nodules in helical CT images

Small pulmonary nodules are a common radiographic finding that presents an important diagnostic challenge in contemporary medicine. While pulmonary nodules are the major radiographic indicator of lung cancer, they may also be signs of a variety of benign conditions. Measurement of nodule growth rate over time has been shown to be the most promising tool in distinguishing malignant from nonmalignant pulmonary nodules. In this paper, we describe three-dimensional (3-D) methods for the segmentation, analysis, and characterization of small pulmonary nodules imaged using computed tomography (CT). Methods for the isotropic resampling of anisotropic CT data are discussed. 3-D intensity and morphology-based segmentation algorithms are discussed for several classes of nodules. New models and methods for volumetric growth characterization based on longitudinal CT studies are developed. The results of segmentation and growth characterization methods based on in vivo studies are described. The methods presented are promising in their ability to distinguish malignant from nonmalignant pulmonary nodules and represent the first such system in clinical use.     

High performance organic light emitting diodes using substoichiometric tungsten oxide as efficient hole injection layer

In this work we demonstrate the unique hole injection and transport properties of a substoichiometric tungsten oxide with precise stoichiometry, in particular WO_2.5, obtained after the controlled hydrogen reduction during growth of tungsten oxide, using a simple hot-wire vapor deposition technique. We present clear evidence that tungsten suboxide exhibits metallic character and that an almost zero hole injection barrier exists at the anode/polymer interface due to the formation/occupation of electronic gap states near the Fermi level after oxide’s reduction. These states greatly facilitate hole injection and charge generation/electron extraction enabling the demonstration of extremely efficient hole only devices. WO_2.5 films exhibit metallic-like conductivity and, thus, can also enhance charge transport at both anode and cathode interfaces. Electroluminescent devices using WO_2.5 as both, hole and electron injection layer, and poly[(9,9-dioctylfluorenyl-2,7-diyl)-co-(1,4-benzo-{2,1′,3}-thiadiazole)] (F8BT) as the emissive layer exhibited high efficiencies up to 7 cd/A and 4.5 lm/W, while, stability studies revealed that these devices were extremely stable, since they were operating without encapsulation in air for more than 700 h.     

Attenuation of myocardial stunning in isolated rat hearts by a 21-aminosteroid lazaroid (U74389G)

The purpose of this study was to evaluate the effects of reperfusion or in vivo pretreatment with a lipid peroxidation inhibitor, lazaroid (U74389G), on attenuating systolic and diastolic alterations occurring during myocardial stunning in isolated rat hearts. Male Sprague-Dawley rats (350-400 g) were randomized into three groups: control animals (n = 13) received no drugs; hearts from reperfused animals (n = 11) received 5 microM U74389G in the reperfusion solution; pretreated animals (n = 11) received 6 mg/kg U74389G by i.v. infusion 30 min before killing. Isolated, isovolumic rat hearts were subjected to 20 min of ischemia at 37 degrees C and subsequent reperfusion for 30 min. Left ventricular isovolumic developed pressure (LVDP), its first derivative (LVDPdP/dt), end-diastolic pressure (LVEDP), and the time constant of diastolic relaxation (tau) were measured. At baseline, no statistically significant differences were detected in systolic or diastolic function in hearts of rats with or without U74389G treatment. After reperfusion, LVDP stabilized at 87 and 92% in both drug-treated groups compared with 52% in the control group (p < 0.01) and dP/dtmax recovered to 101 and 110% of baseline compared with 58% in the control group (p < 0.01). Diastolic dysfunction showed significant improvement in both U74389G pretreatment groups. The increases in LVEDP and tau were 2.0- and 1.2-fold in pretreated hearts and 2,8-fold and 1.5-fold in drug-reperfused hearts, respectively (compared with 6-fold increases in LVEDP and a 2.5-fold increase in tau in controls; p < 0.05). In conclusion, whether administered before ischemia or during reperfusion, U74389G effectively attenuated the systolic and diastolic dysfunction in this model of myocardial stunning, probably protecting cell membranes from peroxidation by oxygen-derived metabolites.     

CMOS tuners for mobile TV

Digital video reception is emerging as the latest feature toward multimedia-enriched handheld devices. Mobile battery-operated devices require small-size tuners that consume low power and are amenable to single-chip integration with the baseband demodulator. Following an overview of the system and circuit-level implementation challenges of mobile TV standards such as DVB-H and T-DMB, this article presents a dual-band direct conversion tuner for DVB-H. Architecture and circuit trade-offs are discussed, and detailed measurements are presented. The tuner occupies 9.7 mm² and achieves a 4 dB NF at both UHF and L-band, eliminating the need for an external LNA. By using a fractional-TV synthesizer both 470-890 MHz and 1.4-1.8 GHz bands are supported, while achieving an integrated phase noise of less than -41 dBc. Sixth-order low-pass filters support channel bandwidths from 4 to 10 MHz     

Noninvasive detection of coronary artery disease

Recently, the authors focused on the application of the neural networks to improve the diagnostic capability of the acoustical approach. In order to improve the diagnostic ability for mis-diagnosed patients, the combination of the first four moments (mean, variance, skewness, kurtosis) of the extrema of the coefficients of wavelet transform applied to the diastolic heart sounds associated with coronary artery disease, as well as physical examination parameters, were used as the input pattern to the neural networks. The wavelet transform was chosen, since it is free from assumptions concerning the characteristics of the signal. Finally, using their nonlinear and multilayered architecture, fuzzy neural networks were applied to the diastolic heart sounds produced by coronary stenoses in order to capture fully all relevant information related to the patients' disease states     

The cost and cardioprotective effects of enalapril in hypertensive patients with left ventricular dysfunction

This study examined the effect of enalapril on survival, resource use, and cost of care in patients with left ventricular dysfunction and hypertension using a retrospective analysis of patients who participated in the Studies of Left Ventricular Dysfunction (SOLVD). Among the 6797 SOLVD participants, 1917 patients had either elevated systolic (> or = 140 mm Hg) or diastolic (> or = 90 mm Hg) blood pressure. Therapy with enalapril was associated with a significant relative risk reduction for mortality (RR = 0.819, 95% CI: 0.68 to 0.98; P = .03). This resulted in a gain of 0.11 years (95% CI: 0.00 to 0.20 years) of survival during the average 2.8 year follow-up for this subgroup and was projected to result in a gain of 2.14 years (95% CI: 0.05 to 4.21 years) during the patient's lifetime. Enalapril significantly reduced the risk of first hospitalization for heart failure by 37%. For all types of hospitalizations, there was an average reduction of 32 hospitalizations per 100 patients treated with enalapril during the trial period (95% CI: 11.8 to 52.2 hospitalizations avoided per 100 patients), resulting in an estimated net savings of $1656 per patient during the trial period (95% CI: increased cost of $191 to savings of $3502). Although the projected lifetime net savings of $1456 was not significant (95% CI: increased cost of $9243 to saving of $12,527), evaluation of the cost per life year saved indicated that enalapril represented a cost-effective strategy. The estimated clinical benefit of enalapril among the hypertensive subgroup in SOLVD supports the recommendation that angiotensin converting enzyme (ACE) inhibitors should be considered as first line pharmacologic therapy for hypertensive patients with left ventricular dysfunction. From both the clinical and economic viewpoints, ACE inhibitors provide important clinical benefits and are cost-effective.     

Coronary Artery Disease?Correlates Between Diastolic Auditory Characteristics and Coronary Artery Stenoses

A noninvasive approach to detecting coronary artery disease analyzes thoracic sounds to isolate acoustical correlates of stenosed coronary arteries., The analysis includes time windowing, frequency (power spectra) windowing, and averaging of thoracic sounds from normal and diseased patients. Initial results indicate that an above normal percentage of high-frequency (180-300 Hz) energy is closely associated with narrowed coronary arteries.     

Modeling sound generation in stenosed coronary arteries

Acoustic measurements obtained from sensitive microphones placed on the chest are being used in a procedure to noninvasively diagnose coronary artery disease. Utilizing specially developed signal processing techniques, the spectral content of isolated diastolic heart sounds has been estimated and usually shows an increase in high-frequency components in patients with occlusive coronary arteries. In order to establish a theory for the origin of these spectral features, a sound source model has been developed which combines an incremental network model of the left coronary artery tree with a transfer function model describing arterial chamber resonant characteristics. The network model predicts flow in both normal and stenosed coronary arteries. From this flow information, the arterial chamber transfer function model predicts the development of acoustic signals from the chamber resonant characteristics. The transfer function of a segment of coronary artery demonstrates two resonance frequencies. These resonance frequencies depend upon the length and diameter of the chamber segment, as well as upon the distal hydraulic impedance loading the segment. The lower resonance frequency can be excited by the usual flow fluctuations (low frequency) in the coronary artery. In cases of stenosis, the wideband spectral characteristics of the turbulence produced by the stenosis excites both the low and high resonance frequencies. In a small sample of patients, the spectra obtained from isolated diastolic acoustic signals recorded by a chest microphone agree well with those predicted by this theory.     

A design model and a production–distribution and inventory planning model in multi-product supply chain networks

Supply chain network (SCN) design implicates decision-making at a strategic level. That includes selecting the right suppliers and determining the number and the location of plants, distribution centres and retailers. An apt design model of the supply chain is imperative for the proper function of the supply chain and consequently for making better operational decisions in an attempt of a continuous improvement. In this paper, we propose two models. The first model is a mixed-integer linear programming model which is concerned with the SCN design problem, whereas the second operational model is a mixed-integer non-linear programming model in respect to the production–distribution and inventory planning problem in a supply chain network. The number of customers and suppliers as well as their demand and capacities are assumed to be known in both models. Two steady-state genetic algorithms were implemented in MATLAB in order to solve both the design and the operational model. The results were compared with GAMS. Some examples were devised in order to demonstrate potential ways of use for the designer of the supply chain network, as well as for the supply chain manager.