379 research outputs found
Towards adualism: becoming and nihilism in Nietzsche's philosophy
No full textThis chapter argues that Nietzsche held two doctrines of becoming: one more radical, which he requires to fend off nihilism, and one much more moderate—the ontology of relations he develops under the label ‘will to power’. Based on the latter he develops what the author call his ‘adualistic’—neither monistic nor dualistic—practice of thought, a ‘simultaneity-thinking’ (Zugleich-Denken) that is no longer subject to nihilism. For Nietzsche’s belief in the reality of the threat of nihilism to be intelligible, the author attributes to Nietzsche at least three assumptions that underpin his entire project: (1) ‘what there is, is becoming (and not being)’, (2) ‘most (if not all) strongly believe in being’, and (3) nihilism is a function of the belief in being
Sleep-Wake Classification for Home Monitoring of Sleep Apnea Patients
No full textSleep apnea is a common sleep disorder, whose diagnosis can strongly benefit from home-based screening. As the total sleep time is essential to assess the sleep apnea severity, a sleep-wake classifier was developed based on heart rate and respiration. These two signals were selected as they can be measured using unobtrusive sensors. A 1D convolutional neural network (CNN) was designed to classify 30s epochs of tachograms and respiratory inductance plethysmography (RIP) signals. The input based on beat-to-beat variability allows the use of different sensor types. A dataset of 56 patients with an apnea-hypopnea index (AHI) below 10 was used to train and validate the network. This CNN was applied to an independent test set of ECG and RIP signals of 25 subjects. Of these, 8 subjects were simultaneously monitored using an unobtrusive capacitive-coupled ECG (ccECG) sensor integrated in a mattress. Artefact removal and data correction was performed on this acquired data. The performance on the independent dataset of ECG and RIP is comparable to state-of-the-art, with ? = 0.48. However, application on the ccECG data resulted in a drop in performance, with ? = 0.30. This was caused by a low amount of remaining wake epochs after data cleaning. Importantly, the network classified 30s segments of sleep apnea patients, without relying on past or future information for feature extraction.Signal Processing System
Nietzsche’s critique of staticism: Introduction to Nietzsche on time and history
No full textWhy are we still intrigued by Nietzsche? What the author argues in this chapter is that this sustained interest stems from Nietzsche’s challenge to what we might call the ‘staticism’ inherent in our ordinary experience. ‘Staticism’ can be defined, roughly speaking, as the view that the world is a collection of enduring, re-identifiable objects that change only very gradually and according to determinate laws. This article claims that as long as human beings subscribe to the ‘staticist picture’ Nietzsche will remain of interest. First, the chapter discusses Nietzsche’s rejection of the remnants of staticism in Hegel and Schopenhauer (both of whom, he holds, remain fundamentally opposed to taking time and history seriously). Second, it briefly outlines why Nietzsche deems the belief in any variant of the staticist picture as problematic. Finally, it examines Nietzsche’s adualistic-dialetheic stance towards the staticist worldview
Information transfer between respiration and heart rate during sleep apnea
No full textIt is well-known that sleep apnea affects the respiration and the heart rate (HR), and studies have shown that the cardiorespiratory coupling is also compromised during obstructive sleep apnea (OSA). Furthermore, the classification of hypopneas is challenging, in particular when only ECG-derived features are used. In this context, this study investigates how different ECG-derived respiratory (EDR) signals resemble the respiratory effort during different types of apneas, and how the amount of information transferred from respiration to HR varies according to the respiratory signal used, real or ECG-derived. ECG and respiratory signals of 10 patients suffering from sleep apnea were analysed, and three different EDR algorithms were used to estimate the respiratory effort. The information transfer was quantified using information dynamics on HR and both the real and estimated respiratory signals. Results suggest that the information transfer is reduced during all types of apneas/hypopneas, and they indicate that the EDR might not capture all variations in cardiorespiratory dynamics during hypopneas. As a result, the information transfer computed using the real respiratory signal achieve accuracies of up to 85% in the detection of sleep apnea with 76% of hypopneas correctly detected, compared to 79% achieved using the EDR with only 63% of correctly identified hypopneas
Unobtrusive, through-clothing ECG and Bioimpedance Monitoring in Sleep Apnea Patients
No full textA real-life validation of a system for simultaneous acquisition of capacitively-coupled ECG (ccECG) and capacitively-coupled bioimpedance (ccBioz) is presented. The heart rate (HR) and respiration rate (RR) estimation performance was evaluated using polysomnography (PSG) signals as ground-truth, in recordings from 28 patients with suspected obstructive sleep apnea (OSA). A ccECG beat detection sensitivity of 98.4% and an R-R interval mean absolute error (MAE) of 17.1 ms were achieved when applying quality-based algorithms. RR MAE values of 3.48 and 6.37 breaths per minute were also achieved when using two different RR extraction methods. High similarity between unobtrusive signals and PSG ground-truth was observed, with a correlation between ccECG and psgECG of 91.5% and a correlation between ccBioz and PSG thoracic belt (TB) of 89.5%. Even in episodes containing OSA events, the characteristic respiration behavior of TB signals was also observed in the ccBioz signals. This shows the potential of ccECG and ccBioz for use in long-term monitoring without adding discomfort to the patient or user. Sleep-related applications as well as more generic cardiorespiratory monitoring in (patient) beds are obvious applications, but also other daily life monitoring can be done using a similar approach (e.g. in seats).Signal Processing System
Niet-invasieve ventilatie bij neuromusculaire aandoeningen: hoe zit het met de slaap?
No full textIn patients with neuromuscular disorders (NMD) and thoracic wall deformities (TWD) alveolar hypoventilation can occur once the respiratory muscles become insufficient. Non-invasive ventilation can be started to reduce hypercapnia and to improve symptoms.
Previous studies in patients with NMD and TWD showed an increased survival and quality of life after initiation of NIV. Although NIV is mostly applied to reduce alveolar hypoventilation during the night, only very few studies have searched for the effect of NIV on the quantity and quality of sleep.
One of the most typical symptoms of alveolar hypoventilation is increased daytime sleepiness, which has a possible negative effect on physical activity. Few small studies (n<10) have found positive effects of NIV on muscle strength and the 6 minute walking distance, but no research has been done on the effect of NIV on physical activity.
In a first part we will search for the effects of NIV on the quantity and quality of sleep in patients with amyotrophic lateral sclerosis (ALS). A large group of ALS patients is in follow-up at the Neuromuscular Reference Centre of the University Hospitals Leuven. If alveolar hypoventilation occurs, most of these patients are sent on to our sleep lab to initiate NIV. By using polysomnography (objective measurement) and patient reported outcomes (subjective measurement) the effect on quantity and quality of sleep is measured. Further on, research will be performed to investigate the influence of NIV on the sympathicovagal balance and an attempt will be made to create an “ideal” protocol for titration of NIV.
A second part will focus on theeffects of NIV on physical activity in patients with NMD and TWD. Physical activity will be objectively measured before and after initiation ofNIV by physical activity devices together with the measurements of physical capacity and the endurance and strength of peripheral and respiratory muscles.status: Publishe
Atrophy and hypertrophy signaling in the diaphragm of patients with COPD
No full textWe investigated whether atrophy and hypertrophy signaling was altered in the diaphragm of COPD patients.Diaphragm fiber dimensions and proportion, expression of markers of the ubiquitin-proteasome, the NF-kappaB pathways, the muscle regulatory factors and myostatin were studied in diaphragm biopsies from 19 patients with severe COPD and 13 patients without COPD.Type I proportion was significantly increased in the diaphragm of COPD patients while type II proportion was decreased. Cross-sectional area of all fiber types was reduced in the COPD patients. In addition, MAFbx mRNA was higher in the diaphragm of COPD patients while Nedd4 mRNA decreased. Cytoplasmatic levels of IkappaBalpha and IkappaBbeta were decreased in the COPD patients as was the nuclear NF-kappaB p50 DNA-binding activity. MyoD mRNA and its nuclear protein content were decreased in the diaphragm of COPD patients and myogenin mRNA and protein levels remained unchanged. Myostatin mRNA was decreased but its protein levels in the nuclear and cytoplasmic fraction were significantly increased in the COPD patients.These data showed that the ubiquitin-proteasome pathway, the NF-kappaB pathway and myostatin protein were upregulated in the diaphragm of COPD patients while MyoD expression was reduced. These alterations may contribute to diaphragm remodeling in COPD.sponsorship: D. Testelmans and M. Crombach are fellows of the Fonds voor Wetenschappelijk Onderzoek - Vlaanderen (Brussels, Belgium) and this study was supported by the Fonds voor Wetenschappelijk Onderzoek-Vlaanderen (G.0386.05). (Fonds voor Wetenschappelijk Onderzoek - Vlaanderen (Brussels, Belgium), Fonds voor Wetenschappelijk Onderzoek-Vlaanderen|G.0386.05)status: Publishe
Diaphragm activity during mechanical ventilation: A narrow therapeutic margin
No full textstatus: Publishe
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