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In-vivo and in-vitro comparison of implant-based CRT optimization - What provide new algorithms?
(2011)
Introduction: In cardiac resynchronization therapy (CRT), individual AV delay (AVD) optimization can effectively increase hemodynamics and reduce non-responder rate. Accurate, automatic and easily comprehensible algorithms for the follow-up are desirable. QuickOpt is the first attempt of a semi-automatic intracardiac electrogram (IEGM) based AVD algorithm. We aimed to compare its accuracy and usefulness by in-vitro and in-vivo studies.
Methods: Using the programmable ARSI-4 four-chamber heart rhythm and IEGM simulator (HKP, Germany), the QuickOpt feature of an Epic HF system (St. Jude, USA) was tested in-vitro by simulated atrial IEGM amplitudes between 0.3 and 3.5mV during both, manual and automatic atrial sensing between 0.2 and 1.0mV. Subsequently, in 21 heart failure patients with implanted biventricular defibrillators, QuickOpt was performed in-vivo. Results of the algorithm for VDD and DDD stimulation were compared with echo AV delay optimization.
Results: In-vitro simulations demonstrated a QuickOpt measuring accuracy of ± 8ms. Depending on atrial IEGM amplitude, the algorithm proposed optimal AVD between 90 and 150ms for VDD and between 140 and 200ms for DDD operation, respectively. In-vivo, QuickOpt difference between individual AVD in DDD and VDD mode was either 50ms (20pts) or 40ms (1pt). QuickOpt and echo AVD differed by 41 ± 25ms (7 – 90ms) in VDD and by 18 ± 24ms (17-50ms) in DDD operation. Individual echo AVD difference between both modes was 73 ± 20ms (30-100ms).
Conclusion: The study demonstrates the value of in-vitro studies. It predicted QuickOpt deficiencies regarding IEGM amplitude dependent AVD proposals constrained to fixed individual differences between DDD and VDD mode. Consequently, in-vivo, the algorithm provided AVD of predominantly longer duration than echo in both modes. Accepting echo individualization as gold standard, QuickOpt should not be used alone to optimize AVD in CRT patients.
Introduction: To simplify AV delay (AVD) optimization in cardiac resynchronization therapy (CRT), we reported that the hemodynamically optimal AVD for VDD and DDD mode CRT pacing can be approximated by individually measuring implant-related interatrial conduction intervals (IACT) in oesophageal electrogram (LAE) and adding about 50ms. The programmer-based St Jude QuickOpt algorithm is utilizing this finding. By automatically measuring IACT in VDD operation, it predicts the sensed AVD by adding either 30ms or 60ms. Paced AVD is strictly 50ms longer than sensed AVD. As consequence of those variations, several studies identified distinct inaccuracies of QuickOpt. Therefore, we aimed to seek for better approaches to automate AVD optimization.
Methods: In a study of 35 heart failure patients (27m, 8f, age: 67±8y) with Insync III Marquis CRT-D systems we recorded telemetric electrograms between left ventricular electrode and superior vena cava shock coil (LVtip/SVC = LVCE) simultaneously with LAE. By LVCE we measured intervals As-Pe in VDD and Ap-Pe in DDD operation between right atrial sense-event (As) or atrial stimulus (Ap), resp., and end of the atrial activity (Pe). As-Pe and Ap-Pe were compared with As-LA an Ap-LA in LAE, respectively.
Results: End of the left atrial activity in LVCE could clearly be recognized in 35/35 patients in VDD and 29/35 patients in DDD operation. We found mean intervals As-LA of 40.2±24.5ms and Ap-LA of 124.3±20.6ms. As-Pe was 94.8±24.1ms and Ap-Pe was 181.1±17.8ms. Analyzing the sums of As-LA + 50ms with duration of As-Pe and Ap-LA + 50ms with duration of Ap-Pe, the differences were 4.7±9.2ms and 4.2±8.6ms, resp., only. Thus, hemodynamically optimal timing of the ventricular stimulus can be triggered by automatically detecting Pe in LVCE.
Conclusion: Based on minimal deviations between LAE and LVCE approach, we proposed companies to utilize the LVCE in order to automate individual AVD optimization in CRT pacing.
Vorgestellt wird ein Konzept zur biologischen Methanisierung von Wasserstoff direkt in Biogasreaktoren, mit dem durch Membranbegasung der Methangehalt des Biogases auf > 96 % erhöht werden kann. Essentiell zum Erreichen solch hoher Methanwerte sind die Einhaltung eines optimalen pH-Bereichs und die Vermeidung von H2-Akkumulation. Im Falle einer Limitierung der Methanbildungsrate durch den eigentlichen anaeroben Abbauprozess der Biomasse ist auch eine externe Zufuhr von CO2 zur weiteren Methanbildung denkbar. Das Verfahren soll weiter optimiert und in einem von der Deutschen Bundesstiftung Umwelt geförderten Projekt in der Biogasanlage einer regionalen Käserei in der Praxis getestet werden. Die hier angestrebte Kombination aus dezentraler Abfallverwertung und Eigenenergieerzeugung eines lebensmittelverarbeitenden Betriebs unter Einbindung in ein intelligentes Erneuerbare Energien - Konzept soll einen zusätzlichen Mehrwert liefern.
This work discusses several use cases of post-mortem mobile device tracking in which privacy is required e.g. due to client-confidentiality agreements and sensibility of data from government agencies as well as mobile telecommunication providers. We argue that our proposed Bloomfilter based privacy approach is a valuable technical building block for the arising General Data Protection Regulation (GDPR) requirements in this area. In short, we apply a solution based on the Bloom filters data structure that allows a 3rd party to performsome privacy saving setrelations on a mobiletelco’s access logfile or other mobile access logfile from harvesting parties without revealing any other mobile users in the proximity of a mobile base station but still allowing to track perpetrators.
Printed electronics (PE) is a fast growing technology with promising applications in wearables, smart sensors and smart cards since it provides mechanical flexibility, low-cost, on-demand and customizable fabrication. To secure the operation of these applications, True Random Number Generators (TRNGs) are required to generate unpredictable bits for cryptographic functions and padding. However, since the additive fabrication process of PE circuits results in high intrinsic variation due to the random dispersion of the printed inks on the substrate, constructing a printed TRNG is challenging. In this paper, we exploit the additive customizable fabrication feature of inkjet printing to design a TRNG based on electrolyte-gated field effect transistors (EGFETs). The proposed memory-based TRNG circuit can operate at low voltages (≤ 1 V ), it is hence suitable for low-power applications. We also propose a flow which tunes the printed resistors of the TRNG circuit to mitigate the overall process variation of the TRNG so that the generated bits are mostly based on the random noise in the circuit, providing a true random behaviour. The results show that the overall process variation of the TRNGs is mitigated by 110 times, and the simulated TRNGs pass the National Institute of Standards and Technology Statistical Test Suite.
Printed Electronics is perceived to have a major impact in the fields of smart sensors, Internet of Things and wearables. Especially low power printed technologies such as electrolyte gated field effect transistors (EGFETs) using solution-processed inorganic materials and inkjet printing are very promising in such application domains. In this paper, we discuss a modeling approach to describe the variations of printed devices. Incorporating these models and design flows into our previously developed printed design system allows for robust circuit design. Additionally, we propose a reliability-aware routing solution for printed electronics technology based on the technology constraints in printing crossovers. The proposed methodology was validated on multiple benchmark circuits and can be easily integrated with the design automation tools-set.
Radio frequency identification (RFID) antennas are popular for high frequency (HF) RFID, energy transfer and near field communication (NFC) applications. Particularly for wireless measurement systems the RFID/NFC technology is a good option to implement a wireless communication interface. In this context, the design of corresponding reader and transmitter antennas plays a major role for achieving suitable transmission quality. This work proves the feasibility of the rapid prototyping of a RFID/NFC antenna, which is used for the wireless communication and energy harvesting at the required frequency of 13.56 MHz. A novel and low-cost direct ink writing (DIW) technology utilizing highly viscous silver nanoparticle ink is used for this process. This paper describes the development and analysis of low-cost printed flexible RFID/NFC antennas on cost-effective substrates for a microelectronic vital parameter measurement system. Furthermore, we compare the measured technical parameters with existing copper-based counterparts on a FR4 substrate.
Smart Home or Smart Building applications are a growing market. An increasing challenge is to design energy efficient Smart Home applications to achieve sustainable and green homes. Using the example of the development of an Indoor Smart Gardening system with wireless monitoring and automated watering this paper is discussing in particular the design issue of energy autonomous working sensors and actuators for home automation. Most important part of the presented Smart Gardening system is a 3D printed smart flower pot for single plants. The smart flower pot has integrated a water reservoir for automated plant irrigation and an electronic for monitoring important plant parameters and the water level of the water reservoir. Energy harvesting with solar cells enables energy autonomous working of the flower pot. A low-power wireless interface also integrated in the flowerpot and an external gateway based on a Raspberry Pi 3 enables wireless networking of multiple of those flower pots. The gateway is used for evaluating the plant parameters and as a user interface. Particularly the architecture of the energy autonomous wireless flower pot will be considered, because fully energy autonomous sensors and actuators for home automation could not be implemented without special concepts for the energy supply and the overall electronic.
Process engineering industries are now facing growing economic pressure and societies' demands to improve their production technologies and equipment, making them more efficient and environmentally friendly. However unexpected additional technical and ecological drawbacks may appear as negative side effects of the new environmentally-friendly technologies. Thus, in their efforts to intensify upstream and downstream processes, industrial companies require a systematic aid to avoid compromising of ecological impact. The paper conceptualises a comprehensive approach for eco-innovation and eco- design in process engineering. The approach combines the advantages of Process Intensification as Knowledge-Based Engineering (KBE), inventive tools of Knowledge-Based Innovation (KBI), and main principles and best-practices of Eco-Design and Sustainable Manufacturing. It includes a correlation matrix for identification of eco-engineering contradictions and a process mapping technique for problem definition, database of Process Intensification methods and equipment, as well as a set of strongest inventive operators for eco-ideation.
As engineering graduates and specialists frequently lack the advanced skills and knowledge required to run eco-innovation systematically, the paper proposes a new teaching method and appropriate learning materials in the field of eco-innovation and evaluates the learning experience and outcomes. This programme is aimed at strengthening student’s skills and motivation to identify and creatively overcome secondary eco-contradictions in case if additional environmental problems appears as negative side effects of eco-friendly solutions.
Based on a literature analysis and own investigations, authors propose to introduce a manageable number of eco-innovation tools into a standard one-semester design course in process engineering with particular focus on the identification of eco-problems in existing technologies, selection of the appropriate new process intensification technologies (knowledge-based engineering), and systematic ideation and problem solving (knowledge-based innovation and invention).
The proposed educational approach equips students with the advanced knowledge, skills and competences in the field of eco-innovation. Analysis of the student’s work allows one to recommend simple-to-use tools for a fast application in process engineering, such as process mapping, database of eco-friendly process intensification technologies, and up to 20 strongest inventive operators for solving of environmental problems. For the majority of students in the survey, even the small workload has strengthened their self-confidence and skills in eco-innovation