Impact of body tilt on the central aortic pressure pulse.

The present work was undertaken to investigate, in young healthy volunteers, the relationships between the forward propagation times of arterial pressure waves and the timing of reflected waves observable on the aortic pulse, in the course of rapid changes in body position. 20 young healthy subjects, 10 men, and 10 women, were examined on a tilt table at two different tilt angles, -10° (Head-down) and + 45° (Head-up). In each position, carotid-femoral (Tcf) and carotid-tibial forward propagation times (Tct) were measured with the Complior device. In each position also, the central aortic pressure pulse was recorded with radial tonometry, using the SphygmoCor device and a generalized transfer function, so as to evaluate the timing of reflected waves reaching the aorta in systole (onset of systolic reflected wave, sT1r) and diastole (mean transit time of diastolic reflected wave, dMTT). The position shift from Head-up to Head-down caused a massive increase in both Tct (women from 130 ± 10 to 185 ± 18 msec P < 0.001, men from 136 ± 9 to 204 ± 18 msec P < 0.001) and dMTT (women from 364 ± 35 to 499 ± 33 msec P < 0.001, men from 406 ± 22 to 553 ± 21 msec P < 0.001). Mixed model regression showed that the changes in Tct and dMTT observed between Head-up and Head-down were tightly coupled (regression coefficient 2.1, 95% confidence interval 1.9-2.3, P < 0.001). These results strongly suggest that the diastolic waves observed on central aortic pulses reconstructed from radial tonometric correspond at least in part to reflections generated in the lower limbs.

Novel Interaction Techniques for Mobile Augmented Reality applications. A Systematic Literature Review

This study reviews the research on interaction techniques and methods that could be applied in mobile augmented reality scenarios. The review is focused on themost recent advances and considers especially the use of head-mounted displays. Inthe review process, we have followed a systematic approach, which makes the reviewtransparent, repeatable, and less prone to human errors than if it was conducted in amore traditional manner. The main research subjects covered in the review are headorientation and gaze-tracking, gestures and body part-tracking, and multimodality– as far as the subjects are related to human-computer interaction. Besides these,also a number of other areas of interest will be discussed.

The validation of heart rate variability in individuals with spinal cord injury

The current classification system for spinal cord injury (SCI) considers only somatic information and neglects autonomic damage after injiuy. Heart rate variability (HRV) has the potential to be a valuable measure of cardiac autonomic control after (SCI). Five individuals with tetraplegia and four able-bodied controls underwent 1 min continuous ECG recordings during rest, after Metoprolol administration (max dose=3x5mg) and after Atropine administration (0.02mg/kg) in both supine and 40° head-up tilt. After Metoprolol administration there was a 61.8% decrease in the LF:HF ratio in the SCI participants suggesting that the LF:HF ratio is a reflection of cardiac sympathetic outflow. After Atropine administration there was a 99.1% decrease in the HF power in the SCI participants suggesting that HF power is highly representative of cardiac parasympathetic outflow. There were no significant differences between the SCI and able-bodied participants. Thus, HRV measures are a valid index of cardiac autonomic control after SCI.

Subpixel-Filterung für eine autostereoskopische Multiperspektiven-3-D-Darstellung hoher Qualität

Die stereoskopische 3-D-Darstellung beruht auf der naturgetreuen Präsentation verschiedener Perspektiven für das rechte und linke Auge. Sie erlangt in der Medizin, der Architektur, im Design sowie bei Computerspielen und im Kino, zukünftig möglicherweise auch im Fernsehen, eine immer größere Bedeutung. 3-D-Displays dienen der zusätzlichen Wiedergabe der räumlichen Tiefe und lassen sich grob in die vier Gruppen Stereoskope und Head-mounted-Displays, Brillensysteme, autostereoskopische Displays sowie echte 3-D-Displays einteilen. Darunter besitzt der autostereoskopische Ansatz ohne Brillen, bei dem N≥2 Perspektiven genutzt werden, ein hohes Potenzial. Die beste Qualität in dieser Gruppe kann mit der Methode der Integral Photography, die sowohl horizontale als auch vertikale Parallaxe kodiert, erreicht werden. Allerdings ist das Verfahren sehr aufwendig und wird deshalb wenig genutzt. Den besten Kompromiss zwischen Leistung und Preis bieten präzise gefertigte Linsenrasterscheiben (LRS), die hinsichtlich Lichtausbeute und optischen Eigenschaften den bereits früher bekannten Barrieremasken überlegen sind. Insbesondere für die ergonomisch günstige Multiperspektiven-3-D-Darstellung wird eine hohe physikalische Monitorauflösung benötigt. Diese ist bei modernen TFT-Displays schon recht hoch. Eine weitere Verbesserung mit dem theoretischen Faktor drei erreicht man durch gezielte Ansteuerung der einzelnen, nebeneinander angeordneten Subpixel in den Farben Rot, Grün und Blau. Ermöglicht wird dies durch die um etwa eine Größenordnung geringere Farbauflösung des menschlichen visuellen Systems im Vergleich zur Helligkeitsauflösung. Somit gelingt die Implementierung einer Subpixel-Filterung, welche entsprechend den physiologischen Gegebenheiten mit dem in Luminanz und Chrominanz trennenden YUV-Farbmodell arbeitet. Weiterhin erweist sich eine Schrägstellung der Linsen im Verhältnis von 1:6 als günstig. Farbstörungen werden minimiert, und die Schärfe der Bilder wird durch eine weniger systematische Vergrößerung der technologisch unvermeidbaren Trennelemente zwischen den Subpixeln erhöht. Der Grad der Schrägstellung ist frei wählbar. In diesem Sinne ist die Filterung als adaptiv an den Neigungswinkel zu verstehen, obwohl dieser Wert für einen konkreten 3-D-Monitor eine Invariante darstellt. Die zu maximierende Zielgröße ist der Parameter Perspektiven-Pixel als Produkt aus Anzahl der Perspektiven N und der effektiven Auflösung pro Perspektive. Der Idealfall einer Verdreifachung wird praktisch nicht erreicht. Messungen mit Hilfe von Testbildern sowie Schrifterkennungstests lieferten einen Wert von knapp über 2. Dies ist trotzdem als eine signifikante Verbesserung der Qualität der 3-D-Darstellung anzusehen. In der Zukunft sind weitere Verbesserungen hinsichtlich der Zielgröße durch Nutzung neuer, feiner als TFT auflösender Technologien wie LCoS oder OLED zu erwarten. Eine Kombination mit der vorgeschlagenen Filtermethode wird natürlich weiterhin möglich und ggf. auch sinnvoll sein.

INFO2009 2012-13 Resource Group 9; Augmented Reality: Past, Present and Future.

Augmented Reality: Past, present and future. An Educational Video on Digital Futures Awareness: Augmented Reality. Designed to be informative and entertaining.

Integrating augmented reality with home systems

Augmented Reality systems overlay computer generated information onto a user's natural senses. Where this additional information is visual, the information is overlaid on the user's natural visual field of view through a head mounted (or “head-up”) display device. Integrated Home Systems provides a network that links every electrical device in the home which provides to a user both control and data transparency across the network.

Feasibility of using eye tracking to increase resolution for visual telepresence

Visual telepresence seeks to extend existing teleoperative capability by supplying the operator with a 3D interactive view of the remote environment. This is achieved through the use of a stereo camera platform which, through appropriate 3D display devices, provides a distinct image to each eye of the operator, and which is slaved directly from the operator's head and eye movements. However, the resolution within current head mounted displays remains poor, thereby reducing the operator's visual acuity. This paper reports on the feasibility of incorporation of eye tracking to increase resolution and investigates the stability and control issues for such a system. Continuous domain and discrete simulations are presented which indicates that eye tracking provides a stable feedback loop for tracking applications, though some empirical testing (currently being initiated) of such a system will be required to overcome indicated stability problems associated with micro saccades of the human operator.

Improvement of heart rate variability after exercise training and its predictors in COPD

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

QTL for percentage of carcass and carcass parts in a broiler x layer cross

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito de dois programas de treinamento físico sobre a função autonômica cardíaca e nível de atividade física na vida diária em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cardiovascular and autonomic alterations in rats with parkinsonism induced by 6-OHDA and treated with L-DOPA

Evaluate the effects caused by L-DOPA on cardiovascular and autonomic parameters in an animal model of Parkinsonism induced by 6-hydroxydopamine (6-OHDA).Adult male Wistar rats were subjected to bilateral microinfusion of 6-OHDA or saline (sham group) in the substantia nigra, and treated by gavage with L-DOPA or water for 7days after surgery. On the 6th day the rats were subjected to femoral artery catheterization for cardiovascular recording. Mean arterial pressure (MAP) and heart rate (HR) were evaluated at baseline and during head up tilt (HUT) protocol. Spectral analysis of cardiovascular variability was performed using the V2.4 CardioSeries software v2.4. The lesion was quantified by dopamine levels in the striatum.Dopamine levels in the striatum were decreased in 6-OHDA rats (sham: 4.79±0.49ng/mg; 6-OHDA: 1.99±0.68ng/mg) and were not recovered by Prolopa treatment. Baseline values of MAP and HR were not different between groups. HUT induced an increase in MAP and HR (ΔMAP: 17±1mmHg, ΔHR: 39±4bpm) that were attenuated in 6-OHDA and in Prolopa treated animals. At baseline, the systolic arterial pressure (SAP) variance was lower in the 6-OHDA and sham Prolopa groups. Spontaneous baroreflex sensitivity was higher at baseline in the 6-OHDA group as compared to all studied groups.Our data suggest that treatment with Prolopa did not interfere with cardiovascular variables at baseline. However, during HUT, the 6-OHDA and Prolopa control animals presented a lower cardiovascular compensation, suggesting a possible autonomic impairment in Parkinsonism induced by 6-OHDA.

Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.

Muscle ischaemia in patients with orthostatic hypotension assessed by velocity recovery cycles

Patients with orthostatic hypotension may experience neck pain radiating to the occipital region of the skull and the shoulders while standing (so-called coat-hanger ache). This study assessed muscle membrane potential in the trapezius muscle of patients with orthostatic hypotension and healthy subjects during head-up tilt (HUT), by measuring velocity recovery cycles (VRCs) of muscle action potentials as an indicator of muscle membrane potential.

Unexplained syncope--is screening for carotid sinus hypersensitivity indicated in all patients aged >40 years?

OBJECTIVE: To determine the frequency, age distribution and clinical presentation of carotid sinus hypersensitivity (CSH) among 373 patients (age range 15-92 years) referred to two autonomic referral centres during a 10-year period. METHODS: Carotid sinus massage (CSM) was performed both supine and during 60 degree head-up tilt. Beat-to-beat blood pressure, heart rate and a three-lead electrocardiography were recorded continuously. CSH was classified as cardioinhibitory (asystole > or = 3 s), vasodepressor (systolic blood pressure fall > or = 50 mm Hg) or mixed. All patients additionally underwent autonomic screening tests for orthostatic hypotension and autonomic failure. RESULTS: CSH was observed in 13.7% of all patients. The diagnostic yield of CSM was nil in patients aged < 50 years (n = 65), 2.4% in those aged 50-59 years (n = 82), 9.1% in those aged 60-69 years (n = 77), 20.7% in those aged 70-79 years (n = 92) and reached 40.4% in those > 80 years (n = 57). Syncope was the leading clinical symptom in 62.8%. In 27.4% of patients falls without definite loss of consciousness was the main clinical symptom. Mild and mainly systolic orthostatic hypotension was recorded in 17.6%; evidence of sympathetic or parasympathetic dysfunction was found in none. CONCLUSIONS: CSH was confirmed in patients > 50 years, the incidence steeply increasing with age. The current European Society of Cardiology guidelines that recommend testing for CSH in all patients > 40 years with syncope of unknown aetiology may need reconsideration. Orthostatic hypotension was noted in some patients with CSH, but evidence of sympathetic or parasympathetic failure was not found in any of them.

Influence of Comfort on 3D Selection Task Performance in Immersive Desktop Setups

Immersive virtual environments (IVEs) have the potential to afford natural interaction in the three-dimensional (3D) space around a user. However, interaction performance in 3D mid-air is often reduced and depends on a variety of ergonomics factors, the user's endurance, muscular strength, as well as fitness. In particular, in contrast to traditional desktop-based setups, users often cannot rest their arms in a comfortable pose during the interaction. In this article we analyze the impact of comfort on 3D selection tasks in an immersive desktop setup. First, in a pre-study we identified how comfortable or uncomfortable specific interaction positions and poses are for users who are standing upright. Then, we investigated differences in 3D selection task performance when users interact with their hands in a comfortable or uncomfortable body pose, while sitting on a chair in front of a table while the VE was displayed on a headmounted display (HMD). We conducted a Fitts' Law experiment to evaluate selection performance in different poses. The results suggest that users achieve a significantly higher performance in a comfortable pose when they rest their elbow on the table.