Variations in vascular access flows in haemodialysis can depend on needle orientation

Introduction: While using the Transonic Qc[TM] machine to assess access flow in arteriovenous fistulae (AVF), we observed that when compared to antegrade arterial needle insertion, retrograde arterial needle insertion could regularly produce lower access flow measurements. This study sought to explore this phenomenon.

Method: 23 patients entered and 20 finished the study. Patient selection criteria included: functioning AVF and an adequate AVF length for either retrograde or antegrade arterial needle insertion. After ensuring stable and similar blood pressures, 3 flow measurements were taken during the first 2 hours on the same dialysis day of 3 consecutive weeks using antegrade needle insertion then were repeated on 3 further consecutive weeks using retrograde insertion.

Results: Overall, access flows measured with retrograde insertion were significantly lower by a mean difference of 107.15 ml/min (57-484 ml/min) than the flows measured with antegrade needle placement. In 5/20, 3 recorded minimal difference and 2 had a higher access flows during retrograde insertion. No recirculation was observed during either antegrade or retrograde needle insertion. The paired t-test showed that there was significant difference between the antegrade versus retrograde mean measurements (p = 0.005).

Conclusion: Although the sample size is small and the number of measurements limited, we conclude that access flows may be greater with an antegrade arterial orientation compared to flows recorded with a retrograde orientation. The phenomenon behind this conclusion is yet to be investigated. We suggest that when using the Transonic Qc[TM] access measurement device the arterial needle should always be in the same direction for each measurement for each individual patient.

Noncontact detection and analysis of respiratory function using microwave Doppler Radar

Real-time respiratory measurement with Doppler Radar has an important advantage in the monitoring of certain conditions such as sleep apnoea, sudden infant death syndrome (SIDS), and many other general clinical uses requiring fast nonwearable and non-contact measurement of the respiratory function. In this paper, we demonstrate the feasibility of using Doppler Radar in measuring the basic respiratory frequencies (via fast Fourier transform) for four different types of breathing scenarios: normal breathing, rapid breathing, slow inhalation-fast exhalation, and fast inhalation-slow exhalation conducted in a laboratory environment. A high correlation factor was achieved between the Doppler Radar-based measurements and the conventional measurement device, a respiration strap. We also extended this work from basic signal acquisition to extracting detailed features of breathing function (I: E ratio). This facilitated additional insights into breathing activity and is likely to trigger a number of new applications in respiratory medicine.

Active temperature compensation for an accelerometer based angle measuring device

An angle measuring device using a high performance and very compact accelerometer provides a new and exciting method for producing highly compact and accurate angle measuring devices. Accelerometers are micro-machined and are able to measure acceleration to a very high accuracy. By using gravity as a reference these compact devices can also be used for measuring angles of rotation. The inherent problem with these devices is that their response characteristic changes with temperature which is detrimental to measurement accuracy. This paper describes an effective method to overcome this problem using a temperature sensor and intelligent software to compensate for this drift characteristic. In order to demonstrate the effectiveness of this work, experiments have been developed and conducted with the results and analysis provided at the end
of this paper for discussion.

Force measurement capability for robotic assisted minimally invasive surgery systems

An automated laparoscopic instrument capable of non-invasive measurement of tip/tissue interaction forces for direct application in robotic assisted minimally invasive surgery systems_ is introduced in this paper. It has the capability to measure normal grasping forces as well as lateral interaction forces without any sensor mounted on the tip jaws. Further to non-invasive actuation of the tip, the proposed instrument is also able to change the grasping direction during surgical operation. Modular design of the instrument allows conversion between surgical modalities (e.g., grasping, cutting, and dissecting). The main focus of this paper is on evaluation of the grasping force capability of the proposed instrument. The mathematical formulation of fenestrated insert is presented and its non-linear behaviour is studied. In order to measure the stiffness of soft tissues, a device was developed that is also described in this paper. Tissue characterisation experiments were conducted and results are presented and analysed here. The experimental results verify the capability of the proposed instrument in accurately measuring grasping forces and in characterising artificial tissue samples of varying stiffness.

Non-contact measurement of respiratory function and deduction of tidal volume

 This paper further the investigation of Doppler radar feasibility in measuring the flow in and out due to inhalation and exhalation under different conditions of breathing activities. Three different experiment conditions were designed to investigate the feasibility and consistency of Doppler radar which includes the combination of the states of normal breathing, deep breathing and apnoea state were demonstrated. The obtained Doppler radar signals were correlated and compared with the gold standard medical device, spirometer, yielding a good correlations between both devices. We also demonstrated the calibration of the Doppler radar signal can be performed in a simple manner in order to have a good agreements with the spirometer readings. The measurement of the flow in and out during the breathing activities can be measured accurately under different dynamics of breathing as long as the calibration is performed correctly.

Rapid directional change degrades GPS distance measurement validity during intermittent intensity running

Use of the Global Positioning System (GPS) for quantifying athletic performance is common in many team sports. The effect of running velocity on measurement validity is well established, but the influence of rapid directional change is not well understood in team sport applications. This effect was systematically evaluated using multidirectional and curvilinear adaptations of a validated soccer simulation protocol that maintained identical velocity profiles. Team sport athletes completed 90 min trials of the Loughborough Intermittent Shuttle-running Test movement pattern on curvilinear, and multidirectional shuttle running tracks while wearing a 5 Hz (with interpolated 15 Hz output) GPS device. Reference total distance (13 200 m) was systematically over- and underestimated during curvilinear (2.61±0.80%) and shuttle (-3.17±2.46%) trials, respectively. Within-epoch measurement uncertainty dispersion was widest during the shuttle trial, particularly during the jog and run phases. Relative measurement reliability was excellent during both trials (Curvilinear r = 1.00, slope = 1.03, ICC = 1.00; Shuttle r = 0.99, slope = 0.97, ICC = 0.99). Absolute measurement reliability was superior during the curvilinear trial (Curvilinear SEM = 0 m, CV = 2.16%, LOA ± 223 m; Shuttle SEM = 119 m, CV = 2.44%, LOA ± 453 m). Rapid directional change degrades the accuracy and absolute reliability of GPS distance measurement, and caution is recommended when using GPS to quantify rapid multidirectional movement patterns.

Real-time measurement of radiocarpal joint angle during dart-thrower's movement

Recently, a renewed attention has been drawn into the dart-thrower's motion as the radiocarpal joint is unique to humans and this is believed to have played a pivotal role in human evolution. Considering the importance of the motion and the complexity of the wrist joint, there have been many articles discussing the kinematics behind this movement. CT scan techniques have been used in a number of these research activities. Due to limitations in the speed of the image acquisition, the positions of the wrist were recorded in static postures. To our knowledge, a data acquisition for the motion with realtime capturing has not been reported. This paper presents the use of a 3D vision-based motion capture device. Leap Motion Controller (LMC), for measuring the radiocarpal joint angles during the dart-thrower's motion in a real-time analysis. The practical capability of the LMC in measuring dart-thrower's motion was examined in a trial involving four subjects and the angles were compared to the angles acquired from an inertial measurement unit (IMU). The results confirmed the LMC can successfully be used in the application of measuring radiocarpal kinematics" of dart-thrower's motion.