Chronic heart failure (HF) is associated with high hospital admission rates and has an enormous burden on hospital resources worldwide. Ideally, detection of worsening HF in an early phase would ...allow physicians to intervene timely and proactively in order to prevent HF-related hospitalizations, a concept better known as remote hemodynamic monitoring. After years of research, remote monitoring of pulmonary artery pressures (PAP) has emerged as the most successful technique for ambulatory hemodynamic monitoring in HF patients to date. Currently, the CardioMEMS and Cordella HF systems have been tested for pulmonary artery pressure monitoring and the body of evidence has been growing rapidly over the past years. However, several ongoing studies are aiming to fill the gap in evidence that is still very clinically relevant, especially for the European setting. In this comprehensive review, we provide an overview of all available evidence for PAP monitoring as well as a detailed discussion of currently ongoing studies and future perspectives for this promising technique that is likely to impact HF care worldwide.
Objective: In this paper, four physiological parameters, i.e., heart rate (HR), inter-beat-interval (IBI), heart rate variability (HRV), and oxygen saturation (SpO2), are extracted from facial video ...recordings. Methods: Facial videos were recorded for 10 min each in 30 test subjects while driving a simulator. Four regions of interest (ROIs) are automatically selected in each facial image frame based on 66 facial landmarks. Red-green-blue color signals are extracted from the ROIs and four physiological parameters are extracted from the color signals. For the evaluation, physiological parameters are also recorded simultaneously using a traditional sensor "cStress," which is attached to hands and fingers of test subjects. Results: The Bland Altman plots show 95% agreement between the camera system and "cStress" with the highest correlation coefficient R = 0.96 for both HR and SpO2. The quality index is estimated for IBI considering 100 ms R-peak error; the accumulated percentage achieved is 97.5%. HRV features in both time and frequency domains are compared and the highest correlation coefficient achieved is 0.93. One-way analysis of variance test shows that there are no statistically significant differences between the measurements by camera and reference sensors. Conclusion: These results present high degrees of accuracy of HR, IBI, HRV, and SpO2 extraction from facial image sequences. Significance: The proposed non-contact approach could broaden the dimensionality of physiological parameters extraction using cameras. This proposed method could be applied for driver monitoring application under realistic conditions, i.e., illumination, motion, movement, and vibration.
Currently, almost all high-voltage switchgear and gas-insulated systems (GIS) are filled with SF 6 under pressure. Accidental leakage of SF 6 has dramatic effects on both the environment and the ...equipment itself. A large leak burdens the environment with hundreds of tons of CO 2 equivalent and is a major safety risk for network equipment. Therefore, close monitoring of SF 6 in high-voltage switchgear is virtually required in order to ensure the stability of the power grid. Very few substations currently have the infrastructure to remotely monitor their assets, and retrofit solutions for older substations are either uneconomical or completely impractical. This work focuses on the development of a new open monitoring system that will be inexpensive, minimally intrusive, and infinitely scalable, in terms of both hardware and software. The developed monitoring system should allow transmission system operators to remotely monitor key parameters of their most important assets, which will also provide them with reaction time to avoid critical breakdowns.
•Modal identification of a concrete arch dam with uncertainty quantification.•Continuous dynamic monitoring of a concrete arch dam.•Consideration of modal parameters estimates uncertainties within ...modal tracking processing.•Elimination of outliers and parasite frequencies.•Comparison between regular and weighted regression models in the minimization of external effects on modal properties.
During the last decade, many vibration-based structural health monitoring systems have been successfully implemented in different structures such as bridges, towers, stadia and wind turbines, with the aim of studying the structure dynamics and its evolution over time, eventually detecting the occurrence of novel structural behaviour that may indicate the presence of damage.
Such vibration-based monitoring systems generally rely on the identification of modal properties, which are then used as monitoring features. Therefore, from operational modal analysis to the tracking of those features and finally to data normalization, many processing steps occur that depend on the accuracy of the identified modal properties. Thus, the estimation of the uncertainties associated with the identified modal properties increases the robustness of this process.
In this context, data obtained from the continuous dynamic monitoring of a concrete arch dam has been used to evaluate the gains of quantifying the uncertainties of modal properties, evaluating in particular the effect of taking these uncertainties into consideration when performing automated operational modal analysis, modal tracking and data normalization. Nevertheless, it is observed that the most significant gains of considering estimates uncertainties occur when these quantities are used for removing outliers during modal tracking.
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or ...specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.
Water quality monitoring using fish and crayfish as bio-indicators requires an understanding of the state of pollution of waters, choice of bio-indicators, physiological and behavioral endpoints of ...fish and crayfish, and principles of the methodology and their potential applications. Here, we discuss telemetry, acoustic monitoring, vision-based monitoring, measures of ventilatory activity, electrocardiography, and fiber-optic plethysmography. Assessment of water quality must be based, not only on physicochemical characteristics of the current environment as determined by chemical analyses, but also on observations of the physiology and behavior of its inhabitants. Real-time biomonitoring is suggested as the most reliable method, since it incorporates living organisms into the system to serve as biosensors. The potential application of the methods discussed includes use at water treatment plants and water supply stations for prevention of hazardous toxicological events, and, for aquaculture, in ponds, lakes, and aquariums for monitoring growth, population size, and behavior traits.
Background/Aims
It is increasingly recognised that reliance on frequent site visits for monitoring clinical trials is inefficient. Regulators and trialists have recently encouraged more risk-based ...monitoring. Risk assessment should take place before a trial begins to define the overarching monitoring strategy. It can also be done on an ongoing basis, to target sites for monitoring activity. Various methods have been proposed for such prioritisation, often using terms like ‘central statistical monitoring’, ‘triggered monitoring’ or, as in the International Conference on Harmonization Good Clinical Practice guidance, ‘targeted on-site monitoring’. We conducted a scoping review to identify such methods, to establish if any were supported by adequate evidence to allow wider implementation, and to guide future developments in this field of research.
Methods
We used seven publication databases, two sets of methodological conference abstracts and an Internet search engine to identify methods for using centrally held trial data to assess site conduct during a trial. We included only reports in English, and excluded reports published before 1996 or not directly relevant to our research question. We used reference and citation searches to find additional relevant reports. We extracted data using a predefined template. We contacted authors to request additional information about included reports.
Results
We included 30 reports in our final dataset, of which 21 were peer-reviewed publications. In all, 20 reports described central statistical monitoring methods (of which 7 focussed on detection of fraud or misconduct) and 9 described triggered monitoring methods; 21 reports included some assessment of their methods’ effectiveness, typically exploring the methods’ characteristics using real trial data without known integrity issues. Of the 21 with some effectiveness assessment, most contained limited information about whether or not concerns identified through central monitoring constituted meaningful problems. Several reports demonstrated good classification ability based on more than one classification statistic, but never without caveats of unclear reporting or other classification statistics being low or unavailable. Some reports commented on cost savings from reduced on-site monitoring, but none gave detailed costings for the development and maintenance of central monitoring methods themselves.
Conclusion
Our review identified various proposed methods, some of which could be combined within the same trial. The apparent emphasis on fraud detection may not be proportionate in all trial settings. Despite some promising evidence and some self-justifying benefits for data cleaning activity, many proposed methods have limitations that may currently prevent their routine use for targeting trial monitoring activity. The implementation costs, or uncertainty about these, may also be a barrier. We make recommendations for how the evidence-base supporting these methods could be improved.
Objective To determine the relative accuracy of clinic measurements and home blood pressure monitoring compared with ambulatory blood pressure monitoring as a reference standard for the diagnosis of ...hypertension.Design Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Methodological quality was appraised, including evidence of validation of blood pressure measurement equipment.Data sources Medline (from 1966), Embase (from 1980), Cochrane Database of Systematic Reviews, DARE, Medion, ARIF, and TRIP up to May 2010.Eligibility criteria for selecting studies Eligible studies examined diagnosis of hypertension in adults of all ages using home and/or clinic blood pressure measurement compared with those made using ambulatory monitoring that clearly defined thresholds to diagnose hypertension.Results The 20 eligible studies used various thresholds for the diagnosis of hypertension, and only seven studies (clinic) and three studies (home) could be directly compared with ambulatory monitoring. Compared with ambulatory monitoring thresholds of 135/85 mm Hg, clinic measurements over 140/90 mm Hg had mean sensitivity and specificity of 74.6% (95% confidence interval 60.7% to 84.8%) and 74.6% (47.9% to 90.4%), respectively, whereas home measurements over 135/85 mm Hg had mean sensitivity and specificity of 85.7% (78.0% to 91.0%) and 62.4% (48.0% to 75.0%).Conclusions Neither clinic nor home measurement had sufficient sensitivity or specificity to be recommended as a single diagnostic test. If ambulatory monitoring is taken as the reference standard, then treatment decisions based on clinic or home blood pressure alone might result in substantial overdiagnosis. Ambulatory monitoring before the start of lifelong drug treatment might lead to more appropriate targeting of treatment, particularly around the diagnostic threshold.
The three Global Ozone Monitoring Experiment-2 instruments will provide unique and long data sets for atmospheric research and applications. The complete time period will be 2007–2022, including the ...period of ozone depletion as well as the beginning of ozone layer recovery. Besides ozone chemistry, the GOME-2 (Global Ozone Monitoring Experiment-2) products are important e.g. for air quality studies, climate modelling, policy monitoring and hazard warnings. The heritage for GOME-2 is in the ERS/GOME and Envisat/SCIAMACHY instruments. The current Level 2 (L2) data cover a wide range of products such as ozone and minor trace gas columns (NO2, BrO, HCHO, H2O, SO2), vertical ozone profiles in high and low spatial resolution, absorbing aerosol indices, surface Lambertian-equivalent reflectivity database, clear-sky and cloud-corrected UV indices and surface UV fields with different weightings and photolysis rates. The Satellite Application Facility on Ozone and Atmospheric Chemistry Monitoring (O3M SAF) processes and disseminates data 24/7. Data quality is guaranteed by the detailed review processes for the algorithms, validation of the products as well as by a continuous quality monitoring of the products and processing. This paper provides an overview of the O3M SAF project background, current status and future plans for the utilisation of the GOME-2 data. An important focus is the provision of summaries of the GOME-2 products including product principles and validation examples together with sample images. Furthermore, this paper collects references to the detailed product algorithm and validation papers.
In the present study, UAV-based monitoring of the Gallenzerkogel landslide (Ybbs, Lower Austria) was carried out by three flight missions. High-resolution digital elevation models (DEMs), ...orthophotos, and density point clouds were generated from UAV-based aerial photos via structure-from-motion (SfM). According to ground control points (GCPs), an average of 4 cm root mean square error (RMSE) was found for all models. In addition, light detection and ranging (LIDAR) data from 2009, representing the prefailure topography, was utilized as a digital terrain model (DTM) and digital surface model (DSM). First, the DEM of difference (DoD) between the first UAV flight data and the LIDAR-DTM was determined and according to the generated DoD deformation map, an elevation difference of between − 6.6 and 2 m was found. Over the landslide area, a total of 4380.1 m
3
of slope material had been eroded, while 297.4 m
3
of the material had accumulated within the most active part of the slope. In addition, 688.3 m
3
of the total eroded material had belonged to the road destroyed by the landslide. Because of the vegetation surrounding the landslide area, the Multiscale Model-to-Model Cloud Comparison (M3C2) algorithm was then applied to compare the first and second UAV flight data. After eliminating both the distance uncertainty values of higher than 15 cm and the nonsignificant changes, the M3C2 distance obtained was between − 2.5 and 2.5 m. Moreover, the high-resolution orthophoto generated by the third flight allowed visual monitoring of the ongoing control/stabilization work in the area.
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