Seizure detection algorithm for neonates based on wave-sequence analysis

Objective: The description and evaluation of the performance of a new real-time seizure detection algorithm in the newborn infant. Methods: The algorithm includes parallel fragmentation of EEG signal into waves; wave-feature extraction and averaging; elementary, preliminary and final detection. The algorithm detects EEG waves with heightened regularity, using wave intervals, amplitudes and shapes. The performance of the algorithm was assessed with the use of event-based and liberal and conservative time-based approaches and compared with the performance of Gotman's and Liu's algorithms. Results: The algorithm was assessed on multi-channel EEG records of 55 neonates including 17 with seizures. The algorithm showed sensitivities ranging 83-95% with positive predictive values (PPV) 48-77%. There were 2.0 false positive detections per hour. In comparison, Gotman's algorithm (with 30 s gap-closing procedure) displayed sensitivities of 45-88% and PPV 29-56%; with 7.4 false positives per hour and Liu's algorithm displayed sensitivities of 96-99%, and PPV 10-25%; with 15.7 false positives per hour. Conclusions: The wave-sequence analysis based algorithm displayed higher sensitivity, higher PPV and a substantially lower level of false positives than two previously published algorithms. Significance: The proposed algorithm provides a basis for major improvements in neonatal seizure detection and monitoring. Published by Elsevier Ireland Ltd. on behalf of International Federation of Clinical Neurophysiology.

Reply to comment by A. G. J. Hilberts and P. A. Troch on "Influence of capillarity on a simple harmonic oscillating water table: Sand column experiments and modeling"

We thank Hilberts and Troch [2006] for their comment on our paper [Cartwright et al, 2005]. Before proceeding with our specific replies to the comments we would first like to clarify the definitions and meanings of equations (1)-(3) as presented by Hilberts and Troch [2006]. First, equation (1) is the fundamental definition of the (complex) effective porosity as derived by Nielsen and Perrochet [2000]. Equations (2) and (3), however, represent the linear frequency response function of the water table in the sand column responding to simple harmonic forcing. This function, which was validated by Nielsen and Perrochet [2000], provides an alternative method for estimating the complex effective porosity from the experimental sand column data in the absence of direct measurements of h_(tot) (which are required if equation (1) is to be used).

Comparison of two-dimensional speckle and tissue velocity based strain and validation with harmonic phase magnetic resonance imaging

Two-dimensional (2-D) strain (epsilon(2-D)) on the basis of speckle tracking is a new technique for strain measurement. This study sought to validate epsilon(2-D) and tissue velocity imaging (TVI)based strain (epsilon(TVI)) with tagged harmonic-phase (HARP) magnetic resonance imaging (MRI). Thirty patients (mean age. 62 +/- 11 years) with known or suspected ischemic heart disease were evaluated. Wall motion (wall motion score index 1.55 +/- 0.46) was assessed by an expert observer. Three apical images were obtained for longitudinal strain (16 segments) and 3 short-axis images for radial and circumferential strain (18 segments). Radial epsilon(TVI) was obtained in the posterior wall. HARP MRI was used to measure principal strain, expressed as maximal length change in each direction. Values for epsilon(2-D), epsilon(TVI), and HARP MRI were comparable for all 3 strain directions and were reduced in dysfunctional segments. The mean difference and correlation between longitudinal epsilon(2-D) and HARP MRI (2.1 +/- 5.5%, r = 0.51, p < 0.001) were similar to those between longitudinal epsilon(TVI), and HARP MRI (1.1 +/- 6.7%, r = 0.40, p < 0.001). The mean difference and correlation were more favorable between radial epsilon(2-D) and HARP MRI (0.4 +/- 10.2%, r = 0.60, p < 0.001) than between radial epsilon(TVI), and HARP MRI (3.4 +/- 10.5%, r = 0.47, p < 0.001). For circumferential strain, the mean difference and correlation between epsilon(2-D) and HARP MRI were 0.7 +/- 5.4% and r = 0.51 (p < 0.001), respectively. In conclusion, the modest correlations of echocardiographic and HARP MRI strain reflect the technical challenges of the 2 techniques. Nonetheless, epsilon(2-D) provides a reliable tool to quantify regional function, with radial measurements being more accurate and feasible than with TVI. Unlike epsilon(TVI), epsilon(2-D) provides circumferential measurements. (c) 2006 Elsevier Inc. All rights reserved.

Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise

Exercise brachial blood pressure ( BP) predicts mortality, but because of wave reflection, central ( ascending aortic) pressure differs from brachial pressure. Exercise central BP may be clinically important, and a noninvasive means to derive it would be useful. The purpose of this study was to test the validity of a noninvasive technique to derive exercise central BP. Ascending aortic pressure waveforms were recorded using a micromanometer-tipped 6F Millar catheter in 30 patients (56 +/- 9 years; 21 men) undergoing diagnostic coronary angiography. Simultaneous recordings of the derived central pressure waveform were acquired using servocontrolled radial tonometry at rest and during supine cycling. Pulse wave analysis of the direct and derived pressure signals was performed offline (SphygmoCor 7.01). From rest to exercise, mean arterial pressure and heart rate were increased by 20 +/- 10 mm Hg and 15 +/- 7 bpm, respectively, and central systolic BP ranged from 77 to 229 mm Hg. There was good agreement and high correlation between invasive and noninvasive techniques with a mean difference (+/- SD) for central systolic BP of -1.3 +/- 3.2 mm Hg at rest and -4.7 +/- 3.3 mm Hg at peak exercise ( for both r=0.995; P < 0.001). Conversely, systolic BP was significantly higher peripherally than centrally at rest (155 +/- 33 versus 138 +/- 32mm Hg; mean difference, -16.3 +/- 9.4mm Hg) and during exercise (180 +/- 34 versus 164 +/- 33 mm Hg; mean difference, -15.5 +/- 10.4 mm Hg; for both P < 0.001). True myocardial afterload is not reliably estimated by peripheral systolic BP. Radial tonometry and pulse wave analysis is an accurate technique for the noninvasive determination of central BP at rest and during exercise.

Linkage analyses of event-related potential slow wave phenotypes recorded in a working memory task

Working memory is an essential component of wide-ranging cognitive functions. It is a complex genetic trait probably influenced by numerous genes that individually have only a small influence. These genes may have an amplified influence on phenotypes closer to the gene action. In this study, event-related potential (ERP) phenotypes recorded during a working-memory task were collected from 656 adolescents from 299 families for whom genotypes were available. Univariate linkage analyses using the MERLIN variance-components method were conducted on slow wave phenotypes recorded at multiple sites while participants were required to remember the location of a target. Suggestive linkage (LOD > 2.2) was found on chromosomes 4, 5, 6, 10, 17, and 20. After correcting for multiple testing, suggestive linkage remained on chromosome 10. Empirical thresholds were computed for the most promising phenotypes. Those on chromosome 10 remained suggestive. A number of genes reported to regulate neural differentiation and function (i.e. NRP1, ANK3, and CHAT) were found under these linkage peaks and may influence the levels of neural activity occurring in individuals participating in a spatial working-memory task.

On the modelling of wave breaking and set-up on coral reefs

An extended refraction-diffraction equation [Massel, S.R., 1993. Extended refraction-diffraction equation for surface waves. Coastal Eng. 19, 97-126] has been applied to predict wave transformation and breaking as well as wave-induced set-up on two-dimensional reef profiles of various shapes. A free empirical coefficient alpha in a formula for the average rate of energy dissipation [epsilon(b)] = (alpha rho g omega/8 pi)(root gh/C)(H-3/h) in the modified periodic bore model was found to be a function of the dimensionless parameter F-c0 = (g(1.25)H(0)(0.5)T(2.5))/h(r)(1.75), proposed by Gourlay [Gourlayl M.R., 1994. Wave transformation on a coral reef. Coastal Eng. 23, 17-42]. The applicability of the developed model has been demonstrated for reefs of various shapes subjected to various incident wave conditions. Assuming proposed relationships of the coefficient alpha and F-c0, the model provides results on wave height attenuation and set-up elevation which compare well with experimental data. (C) 2000 Elsevier Science B.V. All rights reserved.

Dynamics of a transient wave group breaking on a beach

New experimental data are presented on the dynamics of a transient wave group breaking on a beach. The transient group is tracked during shoaling and wave breaking, together with the long waves forced during those processes. High spatial sampling enables novel resolution of the evolution of the wave envelope during breaking and the correlation between the envelope and the long waves. The data show a strong dynamic long wave setup in front of the group in shallow water. The amplitude of the dynamic setup is likely to be a function of beach slope, and larger on steeper beaches.

The vibrational spectra of rectangular plates

The wire drive pulse-echo system has been extensively used to excite and measure modes of vibration of thin rectangular plates. The frequency spectra of different modes have been investigated as a function of the material elastic moduli and the plate geometry. Most of the work was carried out on isotropic materials. For square plates a wide selection of materials were used. These were made isotropic in their in-plane dimensions where the displacements are taking place. The range of rnaterials enabled the dependence on Poisson's ratio to be investigated. A method of determining the value of Poisson's ratio resulted from this investigation. Certain modes are controlled principally by the shear modulus. Of these the fundamental has two nodal lines across the plate surface. One of them, which has nodes at the corners, (the Lame mode) is uniquely a pure shear mode where the diagonal is a full wave length. One controlled by the Young's modulus has been found. The precise harmonic relationship of the Lame mode series in square and rectangular plates was established. Use of the Rayleigh-Lamb equation has extended the theoretical support. The low order modes were followed over a wide range of sides ratios. Two fundamental types of modes have been recognised; These are the longitudinal modes where the frequency is controlled by the length of the plate only and the 2~f product has an asymptotic value approaching the rod velocity. The other type is the in-plane flexural modes (in effect a flexurally vibrating bar where the -2/w is the geometrical parameter). Where possible the experimental work was related to theory. Other modes controlled by the width dimension of the plate were followed. Anisotropic materials having rolled sheet elastic symmetry were investigated in terms of the appropriate theory. The work has been extended to examine materials from welds in steel plates.

3D reconstruction of complex dielectric function of the glass during the femtosecond micro-fabrication

We measure complex amplitude of scattered wave in the far field, and justify theoretically and numerically solution of the inverse scattering problem. This allows single-shot reconstructing of dielectric function distribution during direct femtosecond laser micro-fabrication.

Resonant two-wave mixing in photorefractive materials with the aid of dc and ac fields

A recently predicted resonant effect for the enhancement of two-wave mixing in photorefractive materials is investigated. The resonance occurs when the frequency of the applied ac field agrees with the eigenfrequency of the excited space-charge wave. Experimentally a clear resonance is found, as predicted by the theory, for high dc electric fields, but the resonance is smeared out for lower fields. A modified theory, taking into account the second temporal harmonic of the space-charge wave, shows good agreement with the experimental results.

Observations of Spatial Subharmonics arising during Two-Wave Mixing in BSO

During two-wave mixing experiments in BSO, output beams have been observed which result from diffraction of the pump beams from subharmonics of the grating vector recorded within the crystal. The subharmonic beams are characterised as a function of pump beam detuning and electric field, and our observations are contrasted with those reported earlier.

Contrast summation across eyes and space is revealed along the entire dipper function by a "Swiss cheese" stimulus.

Previous contrast discrimination experiments have shown that luminance contrast is summed across ocular (T. S. Meese, M. A. Georgeson, & D. H. Baker, 2006) and spatial (T. S. Meese & R. J. Summers, 2007) dimensions at threshold and above. However, is this process sufficiently general to operate across the conjunction of eyes and space? Here we used a "Swiss cheese" stimulus where the blurred "holes" in sine-wave carriers were of equal area to the blurred target ("cheese") regions. The locations of the target regions in the monocular image pairs were interdigitated across eyes such that their binocular sum was a uniform grating. When pedestal contrasts were above threshold, the monocular neural images contained strong evidence that the high-contrast regions in the two eyes did not overlap. Nevertheless, sensitivity to dual contrast increments (i.e., to contrast increments in different locations in the two eyes) was a factor of ∼1.7 greater than to single increments (i.e., increments in a single eye), comparable with conventional binocular summation. This provides evidence for a contiguous area summation process that operates at all contrasts and is influenced little, if at all, by eye of origin. A three-stage model of contrast gain control fitted the results and possessed the properties of ocularity invariance and area invariance owing to its cascade of normalization stages. The implications for a population code for pattern size are discussed.

Physiological and pathological human ocular perfusion characteristics

There were three principle aims to this thesis. Firstly, the acquisition protocols of clinical blood flow apparatus were investigated in order to optimise them for both cross-sectional and longitudinal application. Secondly, the effects of physiological factors including age and systematic circulation on ocular blood flow were investigated. Finally, the ocular perfusion characteristics of patients diagnosed with ocular diseases considered to be of a vascular origin were investigated. The principle findings of this work are:- 1) Optimisation of clinical investigationsPhotodiode sensitivity of the scanning laser Doppler flowmeter should be kept within a range of 70-150 DC when acquiring images of the retina and optic nerve head in order to optimise the reproducibility of capillary blood flow measures. Account of the physiological spatial variation in retinal blood flow measures can be made using standard analysis protocols of the scanning laser Doppler flowmeter combined with a local search strategy. Measurements of pulsatile ocular blood flow using the ocular blood flow analyser are reproducible, however this reproducibility can be improved when consecutive intraocular pressure pulses are used to calculate pulsatile ocular blood flow. Spectral analysis of the intraocular pressure pulse-wave is viable and identifies the first four harmonic components of the waveform. 2) Physiological variation in ocular perfusionAge results in a significant reduction in perfusion of the retinal microcirculation, which is not evident in larger vessel beds such as the choroid. Despite known asymmetry in the systemic vasculature, no evidence of interocular asymmetry in ocular perfusion is apparent. 3) Pathological variation in ocular perfusionIn primary open angle glaucoma, perfusion is reduced in the retinal microcirculation of patients classified as having early to moderate visual field defects. However, ocular pulsatility defects are masked when patients and subjects are matched for systemic variables (pulse rate and mean arterial pressure); differentiation is facilitated by the application of waveform analysis to the continuos intraocular pressure curve even in the early stages of disease. Diabetic patients with adequate glycaemic control, exhibit maintenance of macular blood flow, macular topography and visual function following phacoemulsification.

Retinal and systemic vascular function in health and disease: the effect of smoking and coronary artery disease

The purpose of the following studies was to explore the effect of systemic vascular and endothelial dysfunction upon the ocular circulation and functionality of the retina. There are 6 principal sections to the present work. Retinal vessel activity in smokers and non-smokers: the principal findings of this work were: chronic smoking affects retinal vessel motion at baseline and during stimulation with flickering light; chronic smoking leads to a vaso-constrictory shift in retinal arteriolar reactivity to flicker; retinal arteriolar elasticity is decreased in chronic smokers. The effect of acute smoking on retinal vessel dynamics in smokers and non-smokers: the principal finding of this work was that retinal reactivity in chronic smokers is blunted when exposed to clicker light provocation immediately after smoking one cigarette. Ocular blood flow in coronary artery disease: The principal findings of this work were: retrobulbar and retinal blood flow is preserved in CAD patients, despite a change pulse wave transmission; arterial retinal response to flickering light provocation is significantly delayed in CAD patients; retinal venular diameters are significantly dilated in CAD patients. Autonomic nervous system function and peripheral circulation in CAD: The principal findings in this work were: CAD patients demonstrate a sympathetic overdrive during a 24 period; a delay in peripheral vascular reactivity (nail-fold capillaries) as observed in patients suffering from CAD could be caused by either arteriosclerotic changes of the vascular walls or due to systemic haemodynamic changes. Visual function in CAD: The principal findings in this work were: overall visual function in CAD patients is preserved, despite a decrease in contrast sensitivity; applying a filtering technique selecting those with greater coefficient of variance which in turn represents a decrease in reliability, some patients appear to have an impaired visual function as assessed using FDT visual field evaluation. Multiple functional, structural and biochemical vascular endothelial dysfunctions in patients suffering from CAD: relationships and possible implications: The principal findings of this work were: BMI significantly correlated with vWF (a marker of endothelial function) in CAD patients. Retinal vascular reactivity showed a significant correlation with peripheral reactivity parameters in controls which lacked in the CAD group and could reflect a loss in vascular endothelial integrity; visual field parameters as assessed by frequency doubling technology were strongly related with systemic vascular elasticity (ambulatory arterial stiffness index) in controls but not CAD patients.

Fast reconstruction of harmonic functions from Cauchy data using the Dirichlet-to-Neumann map and integral equations

We propose and investigate a method for the stable determination of a harmonic function from knowledge of its value and its normal derivative on a part of the boundary of the (bounded) solution domain (Cauchy problem). We reformulate the Cauchy problem as an operator equation on the boundary using the Dirichlet-to-Neumann map. To discretize the obtained operator, we modify and employ a method denoted as Classic II given in [J. Helsing, Faster convergence and higher accuracy for the Dirichlet–Neumann map, J. Comput. Phys. 228 (2009), pp. 2578–2576, Section 3], which is based on Fredholm integral equations and Nyström discretization schemes. Then, for stability reasons, to solve the discretized integral equation we use the method of smoothing projection introduced in [J. Helsing and B.T. Johansson, Fast reconstruction of harmonic functions from Cauchy data using integral equation techniques, Inverse Probl. Sci. Eng. 18 (2010), pp. 381–399, Section 7], which makes it possible to solve the discretized operator equation in a stable way with minor computational cost and high accuracy. With this approach, for sufficiently smooth Cauchy data, the normal derivative can also be accurately computed on the part of the boundary where no data is initially given.