Search results for "Computer simulation"
showing 10 items of 1054 documents
Causal cross-spectral analysis of heart rate and blood pressure variability for describing the impairment of the cardiovascular control in neurally m…
2006
A causal approach to the calculation of coherence and transfer function between systolic pressure (SP) and RR interval variability was applied in eight patients and eight control subjects during prolonged tilt test for investigating the impairment of cardiovascular control related to neurally mediated syncope. The causal analysis showed a depressed baroreflex regulation in resting patients, with reduced gain and increased latency from SP to RR, and a drop of the baroreflex coupling immediately before syncope. These findings, which were not elicited by traditional cross-spectral analysis, strongly suggest the use of the causal approach for the study of syncope mechanisms. © 2006 IEEE.
Strength and Latency of the HP-SAP Closed Loop Variability Interactions in Subjects Prone to Develop Postural Syncope
2019
The coupling and latency between heart period (HP) and systolic arterial pressure (SAP) variability can be investigated along the two arms of the HP-SAP closed loop, namely along the baroreflex feedback from SAP to HP, and along the feedforward pathway from HP to SAP. This study investigates the HP-SAP closed loop variability interactions through cross-correlation function (CCF). Coupling strength and delay between HP and SAP variability series were monitored in 13 subjects prone to develop orthostatic syncope (SYNC, 28±9 yrs, 5 males) and in 13 subjects with no history of postural syncope (noSYNC, age: 27±8 yrs, 5 males). Analysis was carried out at rest in supine position (REST) and durin…
A decision tree to help determine the best timing and antiretroviral strategy in HIV-infected patients.
2011
SUMMARYOptimal antiretroviral strategies for HIV-infected patients still need to be established. To this end a decision tree including different antiretroviral strategies that could be adopted for HIV-infected patients was built. A 10-year follow-up was simulated by using transitional probabilities estimated from a large cohort using a time-homogeneous Markov model. The desired outcome was for patients to maintain a CD4 cell count of >500 cells/mm3without experiencing AIDS or death. For patients with a baseline HIV viral load ⩾5 log10copies/ml, boosted protease inhibitor-based immediate highly active antiretroviral therapy (HAART) allowed them to spend 12% more time with CD4 ⩾500/mm3than…
Training with a computer-based simulator achieves basic manual skills required for upper endoscopy: A randomized controlled trial
2004
Changes in medical practice have constrained the time available for education and the availability of patients for training. Computer-based simulators have been devised that can be used to achieve manual skills without patient contact. This study prospectively compared, in a clinical setting, the efficacy of a computer-based simulator for training in upper endoscopy.Twenty-two fellows with no experience in endoscopy were randomly assigned to two groups: one group underwent 10 hours of preclinical training with a computer-based simulator, and the other did not. Each trainee performed upper endoscopy in 19 or 20 patients. Performance parameters evaluated included the following: esophageal int…
Testing Frequency-Domain Causality in Multivariate Time Series
2010
We introduce a new hypothesis-testing framework, based on surrogate data generation, to assess in the frequency domain, the concept of causality among multivariate (MV) time series. The approach extends the traditional Fourier transform (FT) method for generating surrogate data in a MV process and adapts it to the specific issue of causality. It generates causal FT (CFT) surrogates with FT modulus taken from the original series, and FT phase taken from a set of series with causal interactions set to zero over the direction of interest and preserved over all other directions. Two different zero-setting procedures, acting on the parameters of a MV autoregressive (MVAR) model fitted on the ori…
A minimal limit-cycle model to profile movement patterns of individuals during agility drill performance: Effects of skill level.
2015
Identification of control strategies during agility performance is significant in understanding movement behavior. This study aimed at providing a fundamental mathematical model for describing the motion of participants during an agility drill and to determine whether skill level constrained model components. Motion patterns of two groups of skilled and unskilled participants (n = 8 in each) during performance of a forward/backward agility drill modeled as limit-cycles. Participant movements were recorded by motion capture of a reflective marker attached to the sacrum of each individual. Graphical and regression analyses of movement kinematics in Hooke’s plane, phase plane and velocity prof…
Mixed predictability and cross-validation to assess non-linear Granger causality in short cardiovascular variability series
2006
A method to evaluate the direction and strength of causal interactions in bivariate cardiovascular and cardiorespiratory series is presented. The method is based on quantifying self and mixed predictability of the two series using nearest-neighbour local linear approximation. It returns two causal coupling indexes measuring the relative improvement in predictability along direct and reverse directions, and a directionality index indicating the preferential direction of interaction. The method was implemented through a cross-validation approach that allowed quantification of directionality without constraining the embedding of the series, and fully exploited the available data to maximise th…
Time-Varying Surrogate Data to Assess Nonlinearity in Nonstationary Time Series: Application to Heart Rate Variability
2009
We propose a method to extend to time-varying (TV) systems the procedure for generating typical surrogate time series, in order to test the presence of nonlinear dynamics in potentially nonstationary signals. The method is based on fitting a TV autoregressive (AR) model to the original series and then regressing the model coefficients with random replacements of the model residuals to generate TV AR surrogate series. The proposed surrogate series were used in combination with a TV sample entropy (SE) discriminating statistic to assess nonlinearity in both simulated and experimental time series, in comparison with traditional time-invariant (TIV) surrogates combined with the TIV SE discrimin…
The effective group size for teaching cardiopulmonary resuscitation skills – A randomized controlled simulation trial
2021
Abstract Aim of the study The ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants’ errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching. Methods Medical students acting as simulated Basic Life Support course participants were instructed to make three different pre-defined Basic Life Support quality errors (e.g., chest compression too fast) in 7 min. Basic Life Support instructors were randomized to groups of 3–10 participants. Instructors were asked to observe the Basic Life Support skills and …
Assessing Causality in normal and impaired short-term cardiovascular regulation via nonlinear prediction methods
2009
We investigated the ability of mutual nonlinear prediction methods to assess causal interactions in short-term cardiovascular variability during normal and impaired conditions. Directional interactions between heart period (RR interval of the ECG) and systolic arterial pressure (SAP) short-term variability series were quantified as the cross-predictability (CP) of one series given the other, and as the predictability improvement (PI) yielded by the inclusion of samples of one series into the prediction of the other series. Nonlinear prediction was performed through global approximation (GA), approximation with locally constant models (LA0) and approximation with locally linear models (LA1) …