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Middleton, WI, United States

Nandedkar S.D.,CareFusion | Barkhaus P.E.,Medical College of Wisconsin | Stalberg E.V.,Uppsala University
Muscle and Nerve | Year: 2011

Introduction: In this study we investigated the reproducibility of motor unit number index (MUNIX) in patients with amyotrophic lateral sclerosis (ALS). Methods: MUNIX was recorded in patients with ALS. Studies were performed in 18 thenar and 18 hypothenar muscles by two operators. The reproducibility was assessed using mean MUNIX values, linear regression, correlation coefficient, and coefficient of variation (COV) in individual studies. Results: The mean values showed no significant difference. The linear regression showed a strong correlation. Most patients had low COV. A high COV was seen when MUNIX was very low. The COV was higher in thenar than in hypothenar muscles. Conclusions: MUNIX has very good reproducibility in ALS patients. COV may exaggerate interoperator variation when MUNIX is very low. The higher variability in the thenar muscle is also due to variability in compound muscle action potential amplitude. Although both muscles show good reproducibility, the hypothenar is better suited for serial studies in individual patients. © 2011 Wiley Periodicals, Inc. Source

Neuwirth C.,Neuromuscular Diseases Unit | Nandedkar S.,CareFusion | Stalberg E.,Uppsala University | Barkhaus P.E.,Medical College of Wisconsin | And 10 more authors.
Clinical Neurophysiology | Year: 2011

Objective: To investigate the intra-rater and inter-rater test-retest reliability of the Motor Unit Number Index (MUNIX) in healthy subjects in a multicentre setting. Methods: Six study centres applied the MUNIX technique in 66 healthy subjects. Five to six muscles (biceps brachii, BB; abductor digiti minimi, ADM; abductor pollicis brevis, APB; tibialis anterior, TA; extensor digitorum brevis, EDB and abductor hallucis, AH) were measured in each volunteer four times by two independent examiners. Results: The method was easy to perform and well tolerated. The intraclass correlation coefficient (ICC) varied between centres and muscles. Intra-rater reliability was greatest for the AH (ICC 0.83) and EDB (ICC 0.81). Inter-rater reliability was greatest for the AH (ICC 0.69) and ADM muscles (ICC 0.69). The most critical muscle was the APB muscle (ICC 0.52, total variability). This was mostly due to variability in the compound muscle action potential (CMAP) measurements. MUNIX values of the APB, ADM and TA fell into the same range as in other motor unit number estimation (MUNE) studies. Conclusion: MUNIX measurements in multiple muscles show good inter- and intra-rater reliability in healthy subjects. CMAP amplitude must be controlled to optimize reliability. Significance: Results suggest that MUNIX could serve as a reliable marker for motor neuron loss in diseases like amyotrophic lateral sclerosis. © 2011 International Federation of Clinical Neurophysiology. Source

Karagozian R.,Harvard University | Johannes R.S.,Harvard University | Sun X.,CareFusion | Burakoff R.,Harvard University
Clinical Gastroenterology and Hepatology | Year: 2010

Background & Aims: Hospitalized patients with inflammatory bowel disease (IBD) could be at increased risk for hospital-acquired infections (HAIs). By using HAI outcome data from Pennsylvania, we examined the influence of HAIs on in-patient mortality and length of stay (LOS) in the hospital among patients with IBD. Methods: Data were generated by linking the Clinical Research Databases from CareFusion (formerly MediQual), which includes all acute care hospitals in Pennsylvania, with publicly reported HAI data from Pennsylvania. The study population included all patients discharged in 2004 with International Classification of Diseases, 9th Clinical Modification codes of 555.x or 556.x (2324 IBD cases from 161 hospitals). Controls were selected using risk-score matching with a 5:1 ratio. Mortality and LOS end points were estimated and corroborated with regression methods. Results: Among the IBD patients studied, there were 20 deaths and 22 reported cases of HAI. The mortality from HAI among patients with IBD was 13.6%, compared with 0.9% among controls (P = .0146, Fisher exact test). The odds ratio for mortality was 17.2 (95% confidence interval, 1.7-174.3). The median LOS for patients with IBD and HAI was 22 days, versus 6 days for controls (P < .001, Wilcoxon). Of the 22 cases with HAIs, 15 were urinary tract infections, 5 were blood stream infections, and 2 were from multiple sources. Conclusions: Results from a population-based data set indicate that mortality and LOS are increased among IBD patients who develop HAIs. A majority of the HAIs were from urinary sources. Although HAIs are low-frequency events, increased vigilance to avoid HAI among patients with IBD could improve outcomes. © 2010 AGA Institute. Source

Zeng S.,CareFusion
Mathematical Problems in Engineering | Year: 2013

This paper presents the adaptive controller design for brushed permanent magnet DC motor used in velocity-tracking applications based on worst-case approach. We first formulate the robust adaptive control problem as a nonlinear H∞-control problem under imperfect state measurement, and then solve it using game-theoretic approach. The controller guarantees the boundedness of closed-loop signals with bounded exogenous disturbances, and achieves desired disturbance attenuation level with respect to the unmeasured exogenous disturbance inputs and the measured disturbance inputs. The strong robustness properties are illustrated by a simulation example. © 2013 Sheng Zeng. Source

Kalhoff H.,Paediatric Clinic | Breidenbach R.,Public Health Service Dortmund | Smith H.-J.,CareFusion | Marek W.,Institute for Occupational Physiology
Respirology | Year: 2011

Background and objective: The use of the impulse oscillometry system (IOS) allows differentiated lung function testing with a minimum of cooperation at normal tidal breathing. The aim of this cross-sectional study was to assess the association of body mass (overweight and obese) with oscillometric parameters in preschool children. Methods: A preschool medical check of 518 children (age 6.01 ± 0.25 years) included IOS recordings of airway resistance and lung reactance (MasterScreen IOS, CareFusion, Höchberg, Germany). Measured values of respiratory resistance (R5) and reactance (X5) at 5 Hzwere correlated with BMI. In addition,datawere compared with recently published reference equations. Results: In this young age group of 241 boys and 277 girls therewas no significant association between oscillometric parameters and BMI. When compared with current IOS reference values of healthy subjects the relationship of R5 (109 ± 25%) and X5 (105.5 ± 35%) suggested mildly elevated peripheral resistance in this unselected group of preschool children. Conclusions: IOS is ideally suited to obtain measurements of respiratory function in preschool children. At the age of 6 years, standard oscillometric values do not indicate impaired respiratory function associated with increased BMI. © 2010 The Authors Respirology © 2010 Asian Pacific Society of Respirology. Source

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