12 results on '"Bart F"'
Search Results
2. Exploring physiological signals on people with Duchenne muscular dystrophy for an active trunk support: a case study
- Author
-
Verros, Stergios, Peeters, Laura, Bergsma, Arjen, Hekman, Edsko E. G., Verkerke, Gijsbertus J., and Koopman, Bart F. J. M.
- Published
- 2019
- Full Text
- View/download PDF
3. The use of a machine-learning algorithm that predicts hypotension during surgery in combination with personalized treatment guidance: study protocol for a randomized clinical trial
- Author
-
J Schenk, Lotte E. Terwindt, Alexander P.J. Vlaar, Marije Wijnberge, Bart F. Geerts, Denise P. Veelo, M. W. Hollmann, M. P. Mulder, Graduate School, ACS - Heart failure & arrhythmias, Anesthesiology, Intensive Care Medicine, APH - Quality of Care, APH - Digital Health, APH - Personalized Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Cardiovascular and Respiratory Physiology, and Technical Medicine
- Subjects
medicine.medical_specialty ,Mean arterial pressure ,Artificial intelligence ,Time Factors ,Medicine (miscellaneous) ,Hemodynamics ,Hypotension during surgery ,Risk Assessment ,law.invention ,Decision Support Techniques ,Machine Learning ,03 medical and health sciences ,Study Protocol ,Intraoperative Period ,0302 clinical medicine ,Randomized controlled trial ,030202 anesthesiology ,law ,Anesthesiology ,Predictive Value of Tests ,Risk Factors ,Monitoring, Intraoperative ,Medicine ,Humans ,Pharmacology (medical) ,Arterial Pressure ,030212 general & internal medicine ,Prospective Studies ,Netherlands ,Randomized Controlled Trials as Topic ,Protocol (science) ,lcsh:R5-920 ,business.industry ,Blood Pressure Determination ,Blood pressure ,Treatment Outcome ,Surgical Procedures, Operative ,Arterial line ,Hypotension ,business ,lcsh:Medicine (General) ,Algorithm ,Perioperative care - Abstract
Background Intraoperative hypotension is associated with increased morbidity and mortality. Current treatment is mostly reactive. The Hypotension Prediction Index (HPI) algorithm is able to predict hypotension minutes before the blood pressure actually decreases. Internal and external validation of this algorithm has shown good sensitivity and specificity. We hypothesize that the use of this algorithm in combination with a personalized treatment protocol will reduce the time weighted average (TWA) in hypotension during surgery spent in hypotension intraoperatively. Methods/design We aim to include 100 adult patients undergoing non-cardiac surgery with an anticipated duration of more than 2 h, necessitating the use of an arterial line, and an intraoperatively targeted mean arterial pressure (MAP) of > 65 mmHg. This study is divided into two parts; in phase A baseline TWA data from 40 patients will be collected prospectively. A device (HemoSphere) with HPI software will be connected but fully covered. Phase B is designed as a single-center, randomized controlled trial were 60 patients will be randomized with computer-generated blocks of four, six or eight, with an allocation ratio of 1:1. In the intervention arm the HemoSphere with HPI will be used to guide treatment; in the control arm the HemoSphere with HPI software will be connected but fully covered. The primary outcome is the TWA in hypotension during surgery. Discussion The aim of this trial is to explore whether the use of a machine-learning algorithm intraoperatively can result in less hypotension. To test this, the treating anesthesiologist will need to change treatment behavior from reactive to proactive. Trial registration This trial has been registered with the NIH, U.S. National Library of Medicine at ClinicalTrials.gov, ID: NCT03376347. The trial was submitted on 4 November 2017 and accepted for registration on 18 December 2017.
- Published
- 2019
4. Surface EMG signals in very late-stage of Duchenne muscular dystrophy: a case study.
- Author
-
Lobo-Prat, Joan, Janssen, Mariska M. H. P., Koopman, Bart F. J. M., Stienen, Arno H. A., and de Groot, Imelda J. M.
- Subjects
MUSCULAR dystrophy ,NEUROMUSCULAR diseases ,MEDICAL robotics ,HUMAN-machine relationship ,ELECTROMYOGRAPHY ,BIOMEDICAL engineering ,ELBOW physiology ,DUCHENNE muscular dystrophy ,ORTHOPEDIC apparatus ,MUSCLE contraction ,QUALITY of life ,ROBOTICS ,SIGNAL processing ,BODY movement ,SKELETAL muscle - Abstract
Background: Robotic arm supports aim at improving the quality of life for adults with Duchenne muscular dystrophy (DMD) by augmenting their residual functional abilities. A critical component of robotic arm supports is the control interface, as is it responsible for the human-machine interaction. Our previous studies showed the feasibility of using surface electromyography (sEMG) as a control interface to operate robotic arm supports in adults with DMD (22-24 years-old). However, in the biomedical engineering community there is an often raised skepticism on whether adults with DMD at the last stage of their disease have sEMG signals that can be measured and used for control.Findings: In this study sEMG signals from Biceps and Triceps Brachii muscles were measured for the first time in a 37 year-old man with DMD (Brooke 6) that lost his arm function 15 years ago. The sEMG signals were measured during maximal and sub-maximal voluntary isometric contractions and evaluated in terms of signal-to-noise ratio and co-activation ratio. Beyond the profound deterioration of the muscles, we found that sEMG signals from both Biceps and Triceps muscles were measurable in this individual, although with a maximum signal amplitude 100 times lower compared to sEMG from healthy subjects. The participant was able to voluntarily modulate the required level of muscle activation during the sub-maximal voluntary isometric contractions. Despite the low sEMG amplitude and a considerable level of muscle co-activation, simulations of an elbow orthosis using the measured sEMG as driving signal indicated that the sEMG signals of the participant had the potential to provide control of elbow movements.Conclusions: To the best of our knowledge this is the first time that sEMG signals from a man with DMD at the last-stage of the disease were measured, analyzed and reported. These findings offer promising perspectives to the use of sEMG as an intuitive and natural control interface for robotic arm supports in adults with DMD until the last stage of the disease. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
5. Comparison between sEMG and force as control interfaces to support planar arm movements in adults with Duchenne: a feasibility study.
- Author
-
Lobo-Prat, Joan, Nizamis, Kostas, Janssen, Mariska M. H. P., Keemink, Arvid Q. L., Veltink, Peter H., Koopman, Bart F. J. M., and Stienen, Arno H. A.
- Subjects
DUCHENNE muscular dystrophy ,ARM ,ELECTROMYOGRAPHY ,HUMAN mechanics ,ASSISTIVE technology ,ALGORITHMS ,COMPARATIVE studies ,MATHEMATICAL models ,RESEARCH methodology ,MEDICAL cooperation ,PSYCHOLOGY of movement ,PATIENT satisfaction ,PROSTHETICS ,RESEARCH ,ROBOTICS ,SIGNAL processing ,PILOT projects ,THEORY ,EVALUATION research ,BODY movement - Abstract
Background: Adults with Duchenne muscular dystrophy (DMD) can benefit from devices that actively support their arm function. A critical component of such devices is the control interface as it is responsible for the human-machine interaction. Our previous work indicated that surface electromyography (sEMG) and force-based control with active gravity and joint-stiffness compensation were feasible solutions for the support of elbow movements (one degree of freedom). In this paper, we extend the evaluation of sEMG- and force-based control interfaces to simultaneous and proportional control of planar arm movements (two degrees of freedom).Methods: Three men with DMD (18-23 years-old) with different levels of arm function (i.e. Brooke scores of 4, 5 and 6) performed a series of line-tracing tasks over a tabletop surface using an experimental active arm support. The arm movements were controlled using three control methods: sEMG-based control, force-based control with stiffness compensation (FSC), and force-based control with no compensation (FNC). The movement performance was evaluated in terms of percentage of task completion, tracing error, smoothness and speed.Results: For subject S1 (Brooke 4) FNC was the preferred method and performed better than FSC and sEMG. FNC was not usable for subject S2 (Brooke 5) and S3 (Brooke 6). Subject S2 presented significantly lower movement speed with sEMG than with FSC, yet he preferred sEMG since FSC was perceived to be too fatiguing. Subject S3 could not successfully use neither of the two force-based control methods, while with sEMG he could reach almost his entire workspace.Conclusions: Movement performance and subjective preference of the three control methods differed with the level of arm function of the participants. Our results indicate that all three control methods have to be considered in real applications, as they present complementary advantages and disadvantages. The fact that the two weaker subjects (S2 and S3) experienced the force-based control interfaces as fatiguing suggests that sEMG-based control interfaces could be a better solution for adults with DMD. Yet force-based control interfaces can be a better alternative for those cases in which voluntary forces are higher than the stiffness forces of the arms. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
6. Design and pilot validation of A-gear: a novel wearable dynamic arm support.
- Author
-
Kooren, Peter N., Dunning, Alje G., Janssen, Mariska M. H. P., Lobo-Prat, Joan, Koopman, Bart F. J. M., Paalman, Micha I., de Groot, Imelda J. M., and Herder, Just L.
- Subjects
ARM ,DUCHENNE muscular dystrophy ,KINEMATICS ,RESEARCH methodology ,PILOT projects ,PRODUCT design ,ASSISTIVE technology ,BODY movement ,MOTION capture (Human mechanics) - Abstract
Background: Persons suffering from progressive muscular weakness, like those with Duchenne muscular dystrophy (DMD), gradually lose the ability to stand, walk and to use their arms. This hinders them from performing daily activities, social participation and being independent. Wheelchairs are used to overcome the loss of walking. However, there are currently few efficient functional substitutes to support the arms. Arm supports or robotic arms can be mounted to wheelchairs to aid in arm motion, but they are quite visible (stigmatizing), and limited in their possibilities due to their fixation to the wheelchair. The users prefer inconspicuous arm supports that are comfortable to wear and easy to control. Methods: In this paper the design, characterization, and pilot validation of a passive arm support prototype, which is worn on the body, is presented. The A-gear runs along the body from the contact surface between seat and upper legs via torso and upper arm to the forearm. Freedom of motion is accomplished by mechanical joints, which are nearly aligned with the human joints. The system compensates for the arm weight, using elastic bands for static balance, in every position of the arm. As opposed to existing devices, the proposed kinematic structure allows trunk motion and requires fewer links and less joint space without compromising balancing precision. The functional prototype has been validated in three DMD patients, using 3D motion analysis. Results: Measurements have shown increased arm performance when the subjects were wearing the prototype. Upward and forward movements were easier to perform. The arm support is easy to put on and remove. Moreover, the device felt comfortable for the subjects. However, downward movements were more difficult, and the patients would prefer the device to be even more inconspicuous. Conclusion: The A-gear prototype is a step towards inconspicuousness and therefore well-received dynamic arm supports for people with muscular weakness. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
7. A comparison in cardiac output data: a random effects model for repeated measures
- Author
-
Jos R. C. Jansen, Bart F. Geerts, R. B. P. de Wilde, and P. C. M. Van Den Berg
- Subjects
Cardiac output ,Observational error ,business.industry ,Observation period ,Statistics ,Poster Presentation ,Medicine ,Repeated measures design ,Fixed effects model ,Variance (accounting) ,Critical Care and Intensive Care Medicine ,business ,Random effects model - Abstract
A random effects model can be used to estimate the within-subject variation after accounting for other observed and unobserved variations, in which each subject has a different intercept and slope over the observation period. On the basis of the within-subject variance estimated by the random effects model, Bland-Altman plots can be created.
- Published
- 2010
8. Nebulized antithrombin limits bacterial outgrowth and lung injury in Streptococcus pneumoniae pneumonia in rats
- Author
-
Jorrit J. Hofstra, Tom van der Poll, Marcel Levi, Sebastian A. J. Zaat, Alexander D. Cornet, Bart F de Rooy, Marcus J. Schultz, Alexander P.J. Vlaar, Internal medicine, CCA - Immuno-pathogenesis, ICaR - Ischemia and repair, Faculteit der Geneeskunde, Amsterdam institute for Infection and Immunity, Intensive Care Medicine, Infectious diseases, Vascular Medicine, and Medical Microbiology and Infection Prevention
- Subjects
medicine.diagnostic_test ,medicine.drug_class ,business.industry ,Research ,Anticoagulant ,Danaparoid ,Antithrombin ,Lung injury ,Critical Care and Intensive Care Medicine ,medicine.disease_cause ,medicine.disease ,respiratory tract diseases ,Pneumonia ,Bronchoalveolar lavage ,Streptococcus pneumoniae ,Immunology ,medicine ,Coagulopathy ,business ,medicine.drug - Abstract
Introduction Disturbed alveolar fibrin turnover is a cardinal feature of severe pneumonia. Clinical studies suggest that natural inhibitors of coagulation exert lung-protective effects via anticoagulant and possibly also anti-inflammatory pathways. Intravenous infusion of the natural anticoagulants increases the risk of bleeding. Local administration may allow for higher treatment dosages and increased local efficacy while at the same time reducing the risk of bleeding. We evaluated the effect of nebulized anticoagulants on pulmonary coagulopathy and inflammation in a rat model of Streptococcus pneumoniae pneumonia. Methods In this randomized controlled in vivo laboratory study rats were challenged intratracheally with S. pneumoniae, inducing pneumonia, and randomized to treatment with normal saline (placebo), recombinant human activated protein C (rh-APC), plasma-derived antithrombin (AT), heparin or danaparoid, by means of nebulization. Results S. pneumoniae infection increased pulmonary levels of thrombin-antithrombin complexes and fibrin degradation products. All nebulized anticoagulants significantly limited pulmonary coagulopathy. None of the agents except danaparoid resulted in changes in systemic coagulopathy. Treatment with plasma-derived AT reduced outgrowth of S. pneumoniae and histopathologic damage in lungs. In vitro experiments confirmed outgrowth was reduced in bronchoalveolar lavage fluid (BALF) from rats treated with plasma-derived AT compared with placebo. Neutralizing of cationic components in BALF diminished the inhibitory effects on bacterial outgrowth of BALF, suggesting a role for cationic antimicrobial proteins. Conclusions Nebulization of anticoagulants attenuates pulmonary coagulopathy during S. pneumoniae pneumonia in rats while only danaparoid affects systemic coagulation. Nebulized plasma-derived AT reduces bacterial outgrowth and exerts significant lung-protective effects.
- Published
- 2009
9. The effect of on-demand vs deep neuromuscular relaxation on rating of surgical and anaesthesiologic conditions in patients undergoing thoracolaparoscopic esophagectomy (DEPTH trial): study protocol for a randomized controlled trial.
- Author
-
Veelo, Denise P., Gisbertz, Suzanne S., Hannivoort, Rebekka A., van Dieren, Susan, Geerts, Bart F., van Berge Henegouwen, Mark I., and Hollmann, Markus W.
- Subjects
MUSCLE contraction ,NEUROMUSCULAR system ,ANESTHESIOLOGY ,ESOPHAGECTOMY ,RANDOMIZED controlled trials ,LAPAROSCOPIC surgery - Abstract
Background: Deep muscle relaxation has been shown to facilitate operating conditions during laparoscopic surgery. Minimally invasive esophageal surgery is a high-risk procedure in which the use of deep neuromuscular block (NMB) may improve conditions in the thoracic phase as well. Neuromuscular antagonists can be given on demand or by continuous infusion (deep NMB). However, the positioning of the patient often hampers train-of-four (TOF) monitoring. A continuous infusion thus may result in a deep NMB at the end of surgery. The use of neostigmine not only is insufficient for reversing deep NMB but also may be contraindicated for this procedure because of its cholinergic effects. Sugammadex is an effective alternative but is rather expensive. This study aims to evaluate the use of deep versus on-demand NMB on operating, anaesthesiologic conditions, and costs in patients undergoing a two- or three-phase thoracolaparoscopic esophageal resection. Methods/Design: We will conduct a single-center randomized controlled double-blinded intervention study. Sixtysix patients undergoing a thoracolaparoscopic esophageal resection will be included. Patients will receive either continuous infusion of rocuronium 0.6 mg/kg per hour (group 1) or continuous infusion of NaCl 0.9 % 0.06 ml/kg per hour (group 2). In both groups, on-demand boluses of rocuronium can be given (open-label design). The primary aim of this study is to compare the surgical rating scale (SRS) during the abdominal phase. Main secondary aims are to evaluate SRS during the thoracic phase, to evaluate anesthesiologic conditions, and to compare costs (in euros) associated with use of rocuronium, sugammadex, and duration of surgery. Discussion: This study is the first to evaluate the benefits of deep neuromuscular relaxation on surgical and anaesthesiologic conditions during thoracolaparoscopic esophageal surgery. This surgical procedure is unique because it consists of both an abdominal phase and a thoracic phase taking place in different order depending on the subtype of surgery (a two- or three-stage transthoracic esophagectomy). In addition, possible benefits associated with deep NMB, such as decrease in operating time, will be weighed against costs. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
10. Erratum to: Design and pilot validation of A-gear: a novel wearable dynamic arm support.
- Author
-
Kooren, Peter N, Dunning, Alje G, Janssen, Mariska M H P, Lobo-Prat, Joan, Koopman, Bart F J M, Paalman, Micha I, de Groot, Imelda J M, and Herder, Just L
- Subjects
WEARABLE technology ,MEDICAL technology - Abstract
Unfortunately, the original version of this article [1] contained an error. Equation 6 was included incorrectly: in the original equation variable slinks3 was missing.The correct Equation 6 can be found below: [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
11. Non-invasive control interfaces for intention detection in active movement-assistive devices.
- Author
-
Lobo-Prat, Joan, Kooren, Peter N, Stienen, Arno Ha, Herder, Just L, Koopman, Bart Fjm, Veltink, Peter H, Stienen, Arno H A, and Koopman, Bart F J M
- Abstract
Active movement-assistive devices aim to increase the quality of life for patients with neuromusculoskeletal disorders. This technology requires interaction between the user and the device through a control interface that detects the user's movement intention. Researchers have explored a wide variety of invasive and non-invasive control interfaces. To summarize the wide spectrum of strategies, this paper presents a comprehensive review focused on non-invasive control interfaces used to operate active movement-assistive devices. A novel systematic classification method is proposed to categorize the control interfaces based on: (I) the source of the physiological signal, (II) the physiological phenomena responsible for generating the signal, and (III) the sensors used to measure the physiological signal. The proposed classification method can successfully categorize all the existing control interfaces providing a comprehensive overview of the state of the art. Each sensing modality is briefly described in the body of the paper following the same structure used in the classification method. Furthermore, we discuss several design considerations, challenges, and future directions of non-invasive control interfaces for active movement-assistive devices. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
12. Evaluation of EMG, force and joystick as control interfaces for active arm supports.
- Author
-
Lobo-Prat, Joan, Keemink, Arvid Q L, Stienen, Arno H A, Schouten, Alfred C, Veltink, Peter H, and Koopman, Bart F J M
- Abstract
Background: The performance capabilities and limitations of control interfaces for the operation of active movement-assistive devices remain unclear. Selecting an optimal interface for an application requires a thorough understanding of the performance of multiple control interfaces.Methods: In this study the performance of EMG-, force- and joystick-based control interfaces were assessed in healthy volunteers with a screen-based one-dimensional position-tracking task. The participants had to track a target that was moving according to a multisine signal with a bandwidth of 3 Hz. The velocity of the cursor was proportional to the interface signal. The performance of the control interfaces were evaluated in terms of tracking error, gain margin crossover frequency, information transmission rate and effort.Results: None of the evaluated interfaces was superior in all four performance descriptors. The EMG-based interface was superior in tracking error and gain margin crossover frequency compared to the force- and the joystick-based interfaces. The force-based interface provided higher information transmission rate and lower effort than the EMG-based interface. The joystick-based interface did not present any significant difference with the force-based interface for any of the four performance descriptors. We found that significant differences in terms of tracking error and information transmission rate were present beyond 0.9 and 1.4 Hz respectively.Conclusions: Despite the fact that the EMG-based interface is far from the natural way of interacting with the environment, while the force-based interface is closer, the EMG-based interface presented very similar and for some descriptors even a better performance than the force-based interface for frequencies below 1.4 Hz. The classical joystick presented a similar performance to the force-based interface and holds the advantage of being a well established interface for the control of many assistive devices. From these findings we concluded that all the control interfaces considered in this study can be regarded as a candidate interface for the control of an active arm support. [ABSTRACT FROM AUTHOR]- Published
- 2014
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.