Phoenix Ambulatory Blood Pressure Monitor Project
6/28/2009 Meeting Notes




* Franz: Will send get-well letter to El. We all hope to see him back at our meetings soon.
* Franz: We have a chance to formulate some laws/rules. There was a fellow who was good in middle school, but not good enough to get a teacher's license: Mendel. The discoverer of genetics, Mendel, died with out a license. Instead, becasme an abbot and developed two laws of inheritence from our parents (genes not yet understood). They 1) segregate (dominate and recessive) and mix according to some laws. Independent of that: 2) assortment.
A long series of periods, 5 months , in cardiac arrythmia, suddend cardiac death, suicide, of 16 months. 22 years of 30 year cycle in Franz' BP data. Germaine's presentation in Brno aligned wikth Mendel's laws. We could say we inherited from the cosmos all of these periods. In 1991, it seemed only to be the week (religious and societal). Then 5 month, 6 month, 10, 20, 30 year cycles were found. Germaine defined congruence, overlapping or overlying of 95% CI of a period found outside and inside us. Is equivalent to segregation, and refers to genes because periods seem to be inherited as well as synchronized by the environment.
In a 40 year series, BP locks into 20 year Hale cycle. In the same fellow, HR locks into Brucker/Egeson/Lockyer cycle.
Spectrum of solar wind, geomagnetics, human mental function (est. of 1 minute). Bob Southern, some compoents go with solar wind only, some go with geomagnetics only, some with neither, some with both. Ukranian fellow took Germaine's instrument for a year, Germaine showed both 5 month period (solar) and 6 month period (geomagnetic) and a longer period. Different variables in same fellow lock into different things.

* Congruence discussion. Jim: suggests alternative term confluence. Implies flow, coming together. "Can never step into the same river twice. Congruence, geometric registration, confluence is temporal registration. Coupling of oscillators, endogenous and exogenous.
Franz: not yet clarified is "feedsidewards". Why can CHAT be more than a symptom? Swinging too much within normal range - why can it be detrimental? Theory of modulation allows you to pull out effects of different oscillators.
crackpotty: if we oversell what we do, we lose 20 years. we don't want to undersell, either. where's the midpoint? For the monitor, it's easy - just say what it does for healthcare. But, how do you present the idea of looking for congruence or external triggers? Germaine: present it as a tool for collecting data.
Bob: In my lifetime, I've seen 6 11 year cycles, 138 6 month cycles, don't remember any changes. Germaine: changes might not be felt. e.g., 10 mmHg BP diff between summer and winter.
Bob: are we going to find congruence and publish? Chris: no, we're an engineering team. But, do we have requirements on our products so others can find it? Yes: Long term persistence of data, and ability to reprocess it. 2nd: how do you modify the tools you have so you can pull in external stuff and do the congruence? There are external time series - can we get congruence with an internal time series, how do we do correlate the two?
* Chris: Started looking at presentation for July, topic architecture, not settled on focus, open with goals of project (small cheap), needed to develop some chronobiological analysis tools, hook for audience: for long term collection of data, key for audience: allows them to do studies that they have not been able to do before. Brief on usage scenarios. Standard context diagram - bubbles iwth ins and outs. High level view of system. Then computational view (previously onion model), ignoring how system is deployed, shows components that need to be developed. Propose a SOA. Pushing further could get into cloud computing. HEaded towards: highly decomposed, recomposable arch. of components, cheap=open source, must be small chunks because people come and go in open source environment. End with shared enquiry. 10 slides, should be ready for dry run next meeting.
* Larry: Started writing a paper about the first wrist monitor timer experiments and associated data analysis by Germaine. This is where some of the material for Larry's mini-symposium will come from. Expect to have this material ready for dry run at next meeting. Also want to be able to demo connecting the A&D home arm-cuff monitor to Micrsoft Health Vault at the mini-symposium. However, the monitor can upload a reading to Health Vault only while the reading is being taken; it cannot upload all the readings from memory. This is a step backwards, will make the project harder to complete. Won't be ready by date of dry run.
Also Larry reports that A&D is sending two wrist monitors with computer interfaces that they intend to manufacture at the end of the year. Hopefully Larry can put timers on these similar to the OMRON monitor and do some testing with with these. Eventual goal here is to convince manufacturers A&D and OMRON to build the timer functionality into the monitor so they become less-than-$100 ABPMs on the open market.
* Jim: Larry & I talked about some forward looking sensing modes. Should one generate parallel approaches, catch from different approaches guide where effort goes. piezo film with relationship to tissue and underlying arterial flow - sort of proven to work. Suggest try fluid-filled bracelet and pressure sensor, apply at a point on the bracelet a pressure that ramps up and then down, see what the pressure sensor reads. The heart of the BP should be in that signal. Resilient cuff between skin and sealed chamber, another resilient cuff outsidet he sealed chamber - sandwich of chamber and two cuffs, all wrap around the source of the pressure. A particular patent is relevant - as you increase the pressure, there's a vibrational quasi-static impedence match (sensor and coupleing energy into the fluid filled region) - you start seeing ....
David Learner, acoustic coupler for detecting blood flow. Problems, angles and doppler shift ultrasound measurement of flow. with flow and pressure together you have 4X better chance of extracting a quantity we want. Another technique uses doppler measurements to measure speed of near and far side of arteries. Recommend putting more ideas on table, not restricting thinking about designs.
* Mithun: still looking at requirements. Question - make req for more than one prototype?
Answer: If you intend to build more than one prototype, then writing the requirements for each separately might make sense. It might also be that only separate designs are required, saving a little bit of work.


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