[go: up one dir, main page]

WO2024072849A1 - Artificial intelligence enabled discrimination of disease and disease etiology - Google Patents

Artificial intelligence enabled discrimination of disease and disease etiology Download PDF

Info

Publication number
WO2024072849A1
WO2024072849A1 PCT/US2023/033803 US2023033803W WO2024072849A1 WO 2024072849 A1 WO2024072849 A1 WO 2024072849A1 US 2023033803 W US2023033803 W US 2023033803W WO 2024072849 A1 WO2024072849 A1 WO 2024072849A1
Authority
WO
WIPO (PCT)
Prior art keywords
werene
cam
moe
macneearnn
waveormaas
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2023/033803
Other languages
French (fr)
Inventor
Steven LUBITZ
Puneet BATRA
Julian HAIMOVICH
Nathaniel DIAMANT
Shaan KHURSHID
Jennifer Ho
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
General Hospital Corp
Broad Institute Inc
Original Assignee
General Hospital Corp
Broad Institute Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by General Hospital Corp, Broad Institute Inc filed Critical General Hospital Corp
Publication of WO2024072849A1 publication Critical patent/WO2024072849A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0004—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by the type of physiological signal transmitted
    • A61B5/0006—ECG or EEG signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/339—Displays specially adapted therefor
    • A61B5/341—Vectorcardiography [VCG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A61B5/7267—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems involving training the classification device
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N3/00—Computing arrangements based on biological models
    • G06N3/02—Neural networks
    • G06N3/04—Architecture, e.g. interconnection topology
    • G06N3/044—Recurrent networks, e.g. Hopfield networks
    • G06N3/0442—Recurrent networks, e.g. Hopfield networks characterised by memory or gating, e.g. long short-term memory [LSTM] or gated recurrent units [GRU]
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N3/00—Computing arrangements based on biological models
    • G06N3/02—Neural networks
    • G06N3/04—Architecture, e.g. interconnection topology
    • G06N3/0464—Convolutional networks [CNN, ConvNet]
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N3/00—Computing arrangements based on biological models
    • G06N3/02—Neural networks
    • G06N3/08—Learning methods
    • G06N3/09—Supervised learning
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/327—Generation of artificial ECG signals based on measured signals, e.g. to compensate for missing leads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/36—Detecting PQ interval, PR interval or QT interval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/361—Detecting fibrillation
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N3/00—Computing arrangements based on biological models
    • G06N3/02—Neural networks
    • G06N3/04—Architecture, e.g. interconnection topology
    • G06N3/048—Activation functions
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N7/00—Computing arrangements based on specific mathematical models
    • G06N7/01—Probabilistic graphical models, e.g. probabilistic networks

Definitions

  • the subject matter disclosed herein is related to utilizing electrocardiogram data to detect diseases or disease etiologies. Particular examples relate to providing a system, a computer- implemented method, and a device to utilize data obtained from electrocardiograms of a subject to discriminate and detect potential diseases or disease etiology with machine learning models.
  • BACKGROUND [0004]
  • the modern resting electrocardiogram (ECG) utilizes waveform data generated from surface electrodes to represent cardiac activation and impulse conduction. Introduced in the early 1900s, the original ECG was primarily used for arrhythmia detection, but its diagnostic utility expanded rapidly to include identification of coronary artery disease and other cardiac structural abnormalities.
  • aarrseearse ma comrse venrcuarerro ane venrcuarerro ma comrsero .e aeas one eoo oee aorc senoss, a carac amooss,erroc caromoa,eas n onen exameree,nsev veenearrcuasrease.er r oane eeoo o r venrc ros r venrcuarerro, ane a are uarerro comrsesumonarerenson,umonar crross, rennr a oenns aeo euxn ra, em cro ,even e,c r oero unsmenasoee mmao ccomurmsoenaraees,er seeneso an.nea, croncversease, esease ma e
  • comrsenear cassers oomsuce cr-amsseemrse,neaes maen noesw,ores, r macneearnn moe ma marxacorzaon,enarov moe, suor vecor macanne,om-moeraenss, c neuusrear nne,w oorrs-, neeaarrnesn n meoeor m.a ceom macrsene coenarransnve meoae ma comrse a neura newor.
  • eooes comnrese esx am onee or em moorem eeecnr,o acarevoceoranosn one moreseases orsease suec a soraeevce an arocessor communracmaveeas coour oeaonne s woarvaeeormevcae,a wroem a erocessor execues a caon coensruconsa are ren e ssemo: recor waveor sorene soraeevceo causeearnn moe erenae,masaea ornome wea suveeocrmraocae,s ussne waeve moarcmnaeae uasn a macne sease orsease eoo an enerae aanosc ou rnn moe, a orsease e u comr
  • casser arecson euaorevaence o eoon moes . eo -oec veevrseurs o noeran c comaraacraerosr.ce ccuervves oeeearnn an comarson comarson moese a er oeran caracersc curves o eea, -eeanex, eoeasures aneeearnn moes -e, - corresonn an coneno eoo versus no comaraor w execeerorm cenervas sownneeen.asene sows .anc -e ore “cnsoo sn re”ca ranom casser a o..
  • eoo versus n curves oeeearnn an comarson moes moese anoex, comeaarsauorers.
  • aenceveeer oeearrannn m coareacersc curves o comarson -eea eoo eoo versus no s comara-oer w, c-eea, area unererecson reca curves an con orresonn ne sows execeerormance o “no s” ranomen cceassneervra as sreocwsnonn eeuaeoenr.evase o eoo aence casscaon o.n -e s eeasm o ce oa.ra vceerrsuscs o cnca rues versuseeearnn moesor secc anosverecs no a
  • eence raes oearaure araraon, an mora raon, a ncence raeser erson-ears o mora, ara a nearaureer, erson-earsere orece -e carac wmonoowssn a cnaracer amrooc coasrso omroaerro rsc ex cacruonmonav.uasrrne vaaon same conencener orars reresen carac amo.vas oss -.
  • rs couns wnown carac amo an erroc conence or eacere are sowneow eaco.rrorars reresen carac amo.ne oss -rva anums.uaveerncroencce c oa cnca oucomesrece -e rs oncence oearaure romoa srae mae sex.umuave e rs o carac am, aoraoss arnaon, aner mroorac caromeroesa onocrre masanesnreec vea - same excunnvuas wnown carac amo anerr aon rs counsor eacere are sowneow oc caromoa.nervas.
  • eaco.rrorars reresen conence car .
  • -umuavencence o cnca oucomesrece -e rs oncaecnc aem ooeaorssa aunre, araerrroaocn c,a arno mmoroaa sreare emae sex.umuave e rs o carac amooss an err es oncreasnrece - vaaon same excunnvua oc caromoaoremaesne caromoa.
  • rs counsor eacser we are snoowwnn cearowac eac amoo.r arnorars reerrroec conencenervas. sen sacee.ara -eowroceasram o auoencoer anenoe vecorervaonoraen auoencoero encoe an recosnsorruco- a-nea s anne s-enae-eas m uosnes.ecan ssrane an aase - .
  • areorusraveuroses on an are no necessarrawno enerae meann as cnn oemsmsons onene un oerseorwose,e ocnen oca o arnna srce sncnermes a urseo werecnavsesceo sasumree eoraecnus.areonnno:ns oa coomramoornearmnusa a,n nd e ecnonuesn moaemcuraoro,oor maeounn oecuaronn:aoraoranua, th eon reen asc, ananas roocosnoecuaroo ..usue e a.
  • crcumsance or sus meansae suseuenescre even, weree even or crcuumensan mcae o occru mrsa an nons ocacnucre,s a wnereaoeeescronncuesnsances susume wen recea reosne ocv neum raenrecsa, a rsan wees as een reonsncus neos a. numers anracons eerms “aou” or “aroxmae” as usceee erenn wones.
  • vaue suc as aarameer an amou n reerrno a measurae varaons o anrome secen va, auee,m sucora as vuarraaoonn,s an o-ee, o arrees ms,ean-o e oncomass oress, an-. oress o anrome sece vaue,nso ress,- aroraeoerormnescosenvenon.
  • ar suc varaons are moer “aou” or “aroxmae” soe unersooae vaueo wce s useeren, reerssse aso secca, anreera,scose.
  • reero a vererae,reera a mamma, morereera auman.am no nomeo, murnes, smans,umans,arm anmas, masncue,u are erroen o aooca en oanen v sor anmas, anes.ssues, ces an arous emomens arees vo or cuuren vro are aso encomasse. emomens are nonene as an ecreerenaer.
  • emomen meansa a saerccucaaroneaour “eo,n seru ecmuroe omre cna”r,ac “aenrs emcoescmrene,”n “a cn exame we emomensncuen aeas one emomen oeresennvenonnecon aearances oerases “n one emomen,” “n an emomen, on.us, emomen”n varousacesrouous seccaon are ” or “an exame same emomenu ma.urermore,earc no necessar a reerrnoe e comnen an suae uareaures, srucures or caracerscs ma scosure,n on manner, as woue aareno aerson sene arromsncue someue o nro m oor
  • eereaseen ssem meoon anae nvocnecaraa acowsesa ssesse mmaac as eova muaanoens o on assoecaon, a nee exssor a aa, suc as- or eco forbiddenm-aseeaur seween waveorm a uses aeeearnn moeo e es, an aroa rane oseaseenoes an sneeae ncoe an reconsruc waveormaa,ncuno-ea reaeana aa.ese meos anevceescreerenroveor more waveormaoas, ws oer cear curarce-nre maeeosseaase,.
  • eec one or moresease ooeserenrove a comuer-memene meoo recorn ec s orsease eooes, comrsn, aeas one9.99vce:ea o semiconductor meoo recorn ec s orsease eooes, comrsn, aeas one9.99vce:ea o semiconductor meoo recorn ec s orsease eooes, comrsn, aeas one wagevce:ea o christmasmaa o a suecrocessne eco christmasmaa usn a macne srenasne.
  • oeecnuesescre ansecae arne con.u,reeo s csomemmuncues newor negligencevcesssems or va an su ncae w one anoer va one or more newors neworevaccess nea swe eomr commun s nccauoens aec wnroeo or.
  • wreesseecommuncaon means wc eac newor canncunce aunn oeovsecesescr,e,e arenn suc c aasn eexc neawnoeraa.oer exame, .
  • ecure or ssemaacaes soue unersooaeerms “aa” aronu “onuormeaosnc”u assreo unse o enxaemrcaen emeaomeerns, reeroex,maes, auo, veo, or an oerorm onor eno ase envronmen.
  • e comm maona can exsn a comuer- mae smar neworsoun necawoornecn ooro an a uernzaeve comemeuvncceasosnseecmsnoo,., an avn a comamcun necawoorn m coomuue cnaaevec oesra
  • wr,e oer w nereweosrs anevceassnossemcs newo,r o,e arn are oerae user,aa acuson ssem oeraors, e user comaors, resecve.
  • acuson server eaa s em comrses aaa sorae un an an srucure ac orae un canncue anoca or remoeaa sorae sorae uncess caenoncueea oane ac oru msoreona snseme com suuear-reeaoar seo sronnormaon.
  • a sorae un mae a
  • a dissolves sem, suc a raeevces, oreaa cou-ase sorae servce s aerensca or vrua macne or a evce ann onoer aseec,.
  • recornevce recor amuaor recorn waveormaaor a sorero o se eecrca acv o aear.e., recornevce recor mee.., aroxmae secons.muaor reaeran se eecrca acv o aearor arooneero omee.., recornenv acn se e, ec wxoanms.
  • ereen eme eoecmrecna acev o recoerenaevce comrses an amuaoreas mnue, aeas, aeas rs measureor aeas secons, aeasa, aeasas, aeas manus,e as, aeaseasmonou,r a, aeaesas moonurss,, o ar aeaseasoeuarrs., an a mno enxaomr, ae eomero momneno,r, evee snan moanro orr, amacu maoor evce comrses a mu-ea surace e.., smar wac nor,manae monor, or consumerevce sanar sura mceu.
  • eecroes.ecroes are comrse o scex ameor,,, an- aone cesrecora.eeas ,,, an exremeas an sx ceseas.e sxmeas corresonoe an sx unoare eaecsro.ee as.,e a sx, anm aea.s ceoamr csoerr oesorneesoooare eaecsro.e.e,s, an ,ea corresonsoo e R ecro L es an F anea correson an an.eas a, a, an anvua corresono an onesoo eecroes , an an are R assn L eeen F n one neeurn mo o eecroecro
  • orersona us comrse an monorrevous menoneu areesne s e.onsumerevces ma aso comrse wearae moeevcese.., omna orrw aaaccees.oonesumoeroev mcoen moorn anors r mecaor co emecrrscea a a sneevce or mueevces worn nernaonaaen caon ,erenccorvo oeear.ee,or exame, n exame emomens, “eaess” recorrae reerencens enre.
  • recornevces use wreessecnoo nevces are use.eaess eecrca acv oeear. an aeaswoons o measuremeno recore measurem n exame emomens,eaess recornevces recor ons muesnser oomwoons oeoe.., r arme arm or reee.ewo suaeewne surace o a suece..,o oose eac oer wereeears .eenewoons.ee,or exame,nernaonaaen caon cocaro waves, wccra aom rceare naocor uramn e roeceov urc mane n eaersv.ces so uusne urasoun, or ver ußc sounraverou an meum.n an
  • nasruocerram eecroes are aeoe suec’s ces monor,s move overe suecoransm, w socuns w caovmemounecaevaer an couo cereaoe a morvocessor an oe oeraon oeear an vaves,emaesenrocesse nmaes erocessor an monor.ransesoaea , recore ansae ons aace a one eco Lankam uzes a smmerransucer, wc roce en o aonue annserenoe esoaus.
  • s recon o acve can wece u one sn assransmerouououeo.e vareenn on weaevreoerm eecaraca.e a.c,vrecsono on aoewaercso onr, a uwawarrom or aoeawnwar, ma caracersceaure os eecrca acv comrses oreee w .eca comex, an wave.n exame os waveo aves:e wave, wave eauer.arooxane.onon:emrm cane seennure ose, vaaerom: nc.nm.n.ovoos ec,aere.aer,onuerne .
  • sermee ara mamsouunav e we aovr eems are snusoaucuaonsnressuree sze o eacressure wave wavese sanceeweenewo wavesse waveen, ane numer o e wnr seeco rnanes oe-reu menco.no cr mceescear a seconcaons,z,e anre eucenocca or uorraasounensoower en os secrum.- z.ca,n caracman,e ecocar ss ae uzereeerenman moes:wo-mensona, moeara o moorams me, anoer sues.
  • wcurer comrses a moueorn ouusasseoeanosc server emomen,e macneearnn o eneraneanosc ouu.n an exame electionvce were uuransmeoeaa acuson ssem or user sease anseaseo eanosc ouusenerae oseevcesssems.
  • e waveuraon ameers assocae w carovascuar mora are roone ane,an-ereanraoc, aneeermna neav oe waven, semeneresson an eevnaeorvna,s, wavesurnaveorne an,r waavmee anxaeso,n s,auna aenraenscewoecen, anaz anne vecavoerso,rmremaaa oure a s réellenercc,uaer m coancranceoenasr,n ann newor caerro crera.n aroaeanoss o asease or an eoo o asease neermne an ouu seasenoc ,eanosc ouu comrsn.
  • mcoreo ecxecunaeeonwscrucaro onrsoorcmaemraemnsn can ree sreescen a oeraon or se.n exame emomens,eunconsacsn aoc can e sownneures an non reuresae oeraons occur ou oe orer or exame,woocs sownn successive eerormene orerusrae.
  • concurren.n ano son can execue concurren or essena varaons, mocaonesr, e suxamsue,onso,c as caonns,e or ex reecuuceonnneo rcevse arse orer.urermore, use w an oeaerarams, strigros,ow car noruncons mae a o wc are exc conemaeeren. s anocaramsscusseeren, one anoer,neaare orrna wramose,.
  • ssem ma comrsesnc soware moues emoe on a a reaae sorae cuteme moues canncue,or exame, an or a oe anro norame eaemoenn, asne oncee, sonmee or aoc oaera mmos aunesorocescsr ane orer seun-mo wuaes o exame escre.
  • meo ses canene carre ou usnesnc sowa su-ocs su-moues oe ssem, asescre aove, execun re moue
  • we unersooa eacoc oe or more emomens oeresen arams, an comnaons oocsneowc owcarusraons anorocmemene comuer reaaero arusraons anorocarams, cane Credevc ceo,m suecera reauraosee croor mraam umn nnssrru euc vco con enss.
  • ornes croumcounes can asoe soren a comuer reaae aarauses, anor oerevceso revces,rorammaeaarocessn moues.e comuer r carr oueunconacs oerocessor-memene moues s eaae sorae meum conann a orararocessor-memenemowecmaerno an arseecs,er oene,ra coomns,r osres se ans aorcee oero mrmaneua ocureenucnuconnacns srueccones wnce comuer reaomor auo eec sro rreaaa earam meeruooc mra o wmrno nscr ausc.
  • nsruco uer reaaeroramnsruconsescreeren cane assemer eenennsn,srnuscruocnso,n m-scer-oacroce,ecrumrewarensruncsoruncs, sonase,-s macnensrucons, macne or oec coe.
  • comuer reaaeroramn enaa, or eer source coeanuae suc as come ornerre srucons cane wrenn anrorammn e oec-orenerorammn eanuaes.n aon,erorammnanuae cananuaese.., anuaee.., “” or convenonaroceurarorammnnsrucons.e “ c”om oru aenr r ceoamaneaoronraemreons mruacoens us ce
  • sane- caoomneueror reraama, meouroe,r saumronusrnuec, oor oer un suaeor usen a speci or on mu e comuers a one se ns can execue enre on one comuer newor,or exame o or across mu e ses connece a communcaon acae,ar onen us uesre'sr' cso cmomuuere ar,narar on one a u rseemr'so ceo cmomueur,e ars o ar s ean-aone soware comuer or server.
  • e comuer reaaeroramnsr nre on a remoe ene remoe comuer cane conn ucons are execue enre remoe, e connecon cane m eceoe user's comuerrou an e o newor, or crcurn aeo an exerna comuer.n exames emomens, eecronc arras cu, on,u nomeo,rorammaeoc crcur,e-rorammaeaensru rrorammaeoc arras can execuee comuer reaaeroramnsruccoonnss.oecerrosonnca czrecuer e caencr uoncze c srcauern,oroma exoecnu oeuenc coomuer reaaeroram emomens o
  • moues or meca sescre erenncueoc or a numer o comonens,memene nsms. oues ma comrse eer soware moues orarware- r moues. soware moue ma e coe emoe on a non-ransor macne- ceaaaaee o meeruomrm ornn c aerraannsm osesraonon ss anna. maarew caorne-mureem oern areran moeunes aan e un n exame emomens, one or more comuer ssem a ceran manner.
  • comuer ssem or one or more se.., a sanaone, cen or server or a caonoron rocessors ma e conure sowaree.., an a caon oeraons a as aarware-memene moue a oeraesoerorm ceran mecancans o ee rxsac emre eceron eemre caon.
  • ms,erncesreseneeren mae ae eescrea asa a snunevuoa a m meaacsurnaeeearrnoner a oor ame cnaonmeeno connsenere o aserevaeu.re, we coc can oeaures reaeoa o anneenen varae usen sascaecnues s nce usennear reresson.eerormance o a macneearnn uc asose casscaon an reressons eenen on coo aormnaern reconon,neeneneaures.eaures ma comrs snnormave,scrmnan, an srns,ras, ormae e numercaaa, caeorcaaa,me-seresaa, waveor s.
  • menoasneoresnn are oneev oero meoreoesneases m oerannseauseo eroonos oes.en ve ecxoame exrac semanc meannsew r an ranne eena sace.
  • uunearveseeeraarnnnnn canaan.vonve anro evxamne a e omr aoomreonn, o suaeerveseranenarnnaaos aa mseac onneeearnronv meouae,e were taen mnacanae,e aanrnne m ououues aereer emnenr ac ocnee or more ouus eenn one areemenoe acua oucome oerannaa.e or correce suervseearnn o macneearnn ssems caneo n some exames,aesorerannnu, ane se o rues a verne a se o rues anor a se onerences o a macneearnn mou nor se oaes mae use
  • ner,rec,enerae, oreer nrane cane useo ouu, esmae, resus. rane mne,or smc eseerms w coecve e reerreo as s suc,enu maaca canneeea ursnen as m aonuneu caon reeceravenen muacanae anear onnera moenerae resus.
  • rane macneearnnnuaa can comr soreneran new resus.n exame emomens, resusn ouuaa ssuec wa avse oonrem ora maor aen,s weaseens orrovseeaseo e aoraonees.
  • neenenneenen varae maavee same o n oneneenen varae, eac aveer own one or moreunn varanees. or meo nruemunern o vanraeeens oenr ea vcar,a seesar aane,un ma varaes we unersooo one sene aroreroemen sove.
  • n emomens, waveormaa are use aseneenen var n exame moue, wc, aerrann,s useo es aesoran a macneearnn e mae,or exame, one or moreseases orsease ooosces.e oscenre re os sns seon on e,xa omo ene co enmsoereme an,osec m reorees,son macneearnnsmemene.
  • wo meno e meoso evauaeenerence, orreca,n au on roa o anearocruaerm aossnsnramevne our vaosueess.ore eacrs v maeraoe.nvoevoesn comrouan ceanon consereerouc o eac cononaroa an,n somensances, eoarm oarouc.e secon meosarov canonearo comrsese ememene wene same szesare.
  • wc can aorms an w noe o samesruon e assumoscusseneaeren. aes cassers.s assunm o coonnmoneasnereeesn noen cocrere oa voanraeewseeonrmsereenanssuoreave s a resu,e numer o comueroaess sncan reuce a aures.
  • sascaeno ar or nnnes ex maomees enmuoencmeen,euoraoceaw noerurs arememene.s are aam orane on a reaveareaasee..,, o a newors oeran.s cane rec an ouuaeens on r more an useo esmae, aroxmae, or cae “ne aare numer onuseaures.s cane envsone as so- eecroncu sromnaosr, orc “”m sessseamess” o.nmercaonnecerocessor eemens, or “neurons”, an excane conneconsa carr messaeseweernooeo soc-aca neeur “onsa,sce c”on one scnoanscn neurosranasm carrer eeec srroenn
  • convouona ouerraaor newaore arns an comnurs ses,nanoe enxerraac,weoau mreasn o come sonnean.s.rs,e auoencoeraearns a se o snasrom annu an reco econ, an comnnesewo comonens,e earnse nsrucse snano an ouu.
  • a eenencesecome morecuo caureec ns.n s,onerm cane wrann orucua auseearameers or wes eero no ecreaseso zero, resunn noe c raaneo.e wse occusrs or waernameeers, or exraoneenn exonenaonn, resunnare canesne wes oraram ancreases eenen one numer oaers an m eers.s exonena eecs vansnexonraensmeme ucaveraen.
  • sor,-erm. memor over recursve onvouon a cass ona asne u eu rxraame er aew e emmoronmeon r,e a cconvouona neura neworsmemene.
  • anoonaers eexs oracreeeaaureesr s: s cuocnvo asuoons,eooesncr, aenuere connece.e convouon comrses o mue maemaca oeraons n.e convouonaaer en a convouon.eu c suc as onear oeraons, a secazeenuaa, suc as waveormaonan,e mcaeea reerr ceosmenenesn ae erxr,ac.ee., anea arurresno an ouu.e oarameers, cae aerne, oeraes as an o a o numers.r osonner.xraceeau mzaeeaure exracor ans aeo eac s ouuno res maecomeerarcca more comex as oneaereesn
  • con marx comrsn one or moreseases orsease enar avanae ono evxeamo saee s ecmaoamreonvs, m aoeeonrearcov an m oouecomse.memaernoev. mn aes arovrocess, wereneroa o an oucomes s oe assumes a ne case o ,s assume an unn oeeenen onerevous even. even.n comrses a newor o coownnne ocr “e noene”s.
  • aano cnas er sxesamac een n ee emo nm-enmse,n ssuonoar veceorr manaecsnne-s areememene.
  • s reresson an casscaonroems.era rane an are usenorannrocess o an .
  • nes areecsonounareseveoeurne eaures.or ex emensona o aeraneeens one numer onu we a ame, a wwonueaures wave anear-mensonaerane eranes o wmzereoeanveueeaarureess m warnav oer s aaaanersan-cemreonmsonea neareseraaaneo.n uosre eaocevaeaoee.neer caansee.
  • wneeanr reereesasuornes an a casscaon anear euaons escreeerane.
  • scnae somee s nemarors oew aneoene nre casso.rsno on ree euxcaemee e ermroro o emene, neso arns o a onaer cass “ou-von” near uze.n exame emomens, waveormaa are useor ov moe aroacs moue, wc, aerrann,s useo esmae one or mor an a macneearnn oerorm one or more osunconaes,eseases orsease eooes.
  • monre ceraranwa erexamroceess eomrso anme mnas, oene con or muroereoarewroarremroec oeraons conureoncue an one or more oe mouesescreere essors are an oreover, anwo or more oese moues mae comn.neno a sne moue es.unucroenrmsorees,c arcceornereon vaorro aus s , mou enxame meo emueo mmaense, m suouvesees acmon mue enmemene wn a sne macne,aaase, orevce maesrureeren as macnes,aaases, orevces.e mue macnes,aaase across mue communcave coueo enae
  • a convenona comuer ssem a rouer or oer newor noe, a evce, a smarone, a se-oox, aos, w aee vecuarnormaon ssem, one or morerocessors assocae mucvseorne,o a. cuseom comzeu mnac mnaec, anne oer maarwear aeaorm, or an comnaon or uncon usn m srue ssem conureo e oune oe Chr macnesnerconnece va aaa newor orus ssem.
  • sora-e me a aa ma versnacuee asca“rs”,, a aou-rs, a comacsc rea as memor, oer non-voae memorevc asc, a manecae, a evce, an oca soraeevce, an eecrec,a a so sora saeeervvcee,“ an e”e,c anrom maanneecc s soorraaee neovn-cree,m aonva seem mceonau,c anor s ooreareaeav scoer,a aneevcsec,a or- aanse soraeevce, an removae an non-exausves o more secc exames oe comnaon or mucereo.
  • acemessae seuencnnormaon, enc nerove,or exame, asnormaon, anransmsso asuaoneaers anorooers, szeme anorar cec va n vercaonnormaon suc as ccc reunanc cec s ues.ommuncaons cane mae encoeencre, or oerwse mae seuccure a,s, anuor noecrmeeoe,coaea usnncr oneon or maonrea crrora,cvarnocoecosn acnroro anorams, , aves-amr-eman aorm, ae-eman aorm, a secure soncar rooco suc asecureocesaer orransoraerecur , anoreas ornna aureonooromsese.ereenr
  • ueo aorc senoss cans as ueo aorc senoss, an aeoo-ea an sne-seesasee w exaveenorom waca c aoure-eraenceee anearnsncrm monaee a amaonns e aoeronaevse o moes.
  • receivesonuunaam ameu -aor ccaarnsooen caere a au a muae-nnss aueona aceaars or oer wo ssemasseneraram.
  • auomae aorm was vaae emonsrae a aroram reorsn aneason a su auor an .
  • osverecve vaue o an neaverecve vaue o .eeae ae et e.oorn-aseensavseormecescaracersocssverecveooea.ve e vrentrcuar vaue vauerecve troreort .
  • aam reors were rev m aenewse wooru ea acanos eso oo. o carac amooss orerroc caromoa eooww.n aucaon were s consereorncusonne eco forbiddenc caeores errouc car avoamaoa an areanosc moa sourcesor carac amooss an ae.uvaa noreesenneanmaees-. -ea eecro sandalm ervaon same.:, aaon same:, ae.anoscoaourceoxraracmoossnervaoname.
  • x oa m ra ecac ne amumoorosos 99 saae scnra , an carac s or.aaosx, ae.anoscoaourceoxraracmoossn aaone.
  • x oarra oac os amaeo sconssraa , osx, 99m ecneum ae.anoscoaour acne coarrace . e rrocaromoa.
  • carormrooac • • • :: : • • • :: ac caromoacnansenecnueon o anv reuaarses ws o ec carocaarco amraoco css an erroc eoenamerec sensv o eco wasteor nesesreaseersao,r.ouven e ccarocoamrorac seeeow was no reureor a carac amooss orerroc novauas wanoss,erroc caromnovaua mse w ec carac amooss, an anoss.
  • mensona vecor reresenaon usn arevous escre eeearnn axro no a - aenonrasveearnn oeresenaons wcs omzeorrananc enocwennc as onu mreonn.aenc aanns o uusea aenucs avroamaea c cornevaoesu nounmaer nceaura re neworrane waveorms wc emaszeerenceseween s resenaons o smareseween srome samenvua.n romerennvuas an s noes
  • eac oe a newor moesoner mssn maxmum voae amuesor wave, -wveavee,a asnncue-wanve.e cnccaansnaze ru eeasc: o-ew naevue,ra new-woarves, w ae- wes o are m-oraeneea-s moees ucroeeoa averaeoonaereea- u.comroa an avaae a aer, oneu cnosnneuceemaerre ceamsasseerm woee_ezrooe wa.ereoa averaeoon waveorm‘casseraer’.noeru conneceaerv reernesseuesoen am wasureesenne casse asresen‘reressonaer’ or waves cassca
  • conencenervasor -e ane cnca rues carac amoocsanss an evauaeerrooecn caar asosmocoaaons o w o-sereverenceroa o ncen araraon, an mora excunnvuasne vaaonc saemnee waranoure, carac amooss orerroc caromo wn arara a.
  • cans aso cacuae anases wereerormecen raesoor eac cnca oucome. ‘ensorow’, an ‘en n v. usnacaes ‘anas’, ‘searn’, e es’. ususouaon erroc carcaonmsoncaue, eco,caronravucas w, o ar noa encosocsar o carac amooss, m amoonen w soamme wasuereema.e ane mean aerev waason.
  • zes causes o ennceurenna nno a sec,c caucsaen osoe.., carac amoossrom a oer comarson moesn one versus res casscaounn oa e-oeo a,so c oaussernorm cee amooss an erroc caromoa w s o. ,. arac . c ocaror , ae m . a-e s r.o ve r e m re , a- r rae ens e n c t c e :e e c -.
  • oen couns are sooa same szesor eac sraum are sowneneae suroue.ase accurae ceaewn sseearn cen. mo eeosorane onu srensee-a w.aveeorms -eeas an aso casscaon o carac amooss anerroc caromo sor -eea e.s .or comarso a were. ,.- r no easures , an. ,.-.
  • rotera:rettera ertenson..:., ..:., ..:., ..:., ..:., ..:., ..:., zes ae.urouv:eranass oa:e sex- seexemae:ea:e ⁇ oeer:eo >rmance.
  • rotera:rettera . . zes
  • sronerormance acr sn eooes -e maaveoena cnca u as au auomoasse an screennooor an rare eooes w acaon on-o-care sneea ev oo-ea s an moe casscaonr oor worces erroa.scemonsraee caa o -aseeeearnn moesor o e a. caromoa, carac amooss, an ecoddlingc.
  • e ru cesn acna emon rusrease are s usnecnan rounme crovneca seracceo cass ,e arensensve. -e comareoe nsvoreecon o eco forbiddenc wenm cnca rues. -eureremonsraeerormance casrsovceameonns onerr eoooc ca crasosmcoaon w a near.-omrovemenn sensvor acaon oesuesse oaao-screm mnaonesa srrua.
  • aure manaemen oerensveearsease.roenrarcuoavrascersr.oo con:es-ve.ear , e a..erroaavco csar,omaoaaars: a,n useeae reve,aramsos,oouos,ousas earaev w onanoss,ronoss, anreamen. rcan.. eoeonce,-enaa:aera- u,.eus asunom-aeeson,ura,asumaa,no, e a.
  • aorn ca,.enonee,ncem an c,onvmenon,aman,ossm cre, e a.omarne venrcuarerro usn eec raoreecne .aron. erro Malawi.uroace. :-. :- roc caromoa: a ssemac revew. . carac amo.oaseesz:z. s,easeerrnoe,s aunara cnc,a cvoaurs,eso one, meaonne,e es. a.rcusemc :- aon. ecrocaro.raavace.
  • sosueaseo sesnoemaesca eevvaeuoaen ass aocaeeonseaeween-aseeaures reconsruc waveormaa,ncuno-ea rnn moeo encoe an .nrann,srom aervaon se wereaee an sneeaea s.ure rou , seases, rerese accornoeresence or asence o asscaon oseas ne ecoes, or areaerouns onernaona oesen oamozaone coes useoene cnca meannuseaseenoes.
  • nveenseaseenoe assocae weoson oe corresonnecoe cuse aen sace we -aseeaures anseaseenoe rs.oes assocaonseween suese nreeeren s, canserormeenome-we assocaon mea-anaze resu aases,ncunworueoou ses. cansen seasesn s,nn sncan assocaonseween waveormaa an e e-ea moe an seasesn sxnecee, suc aseunerancoc .
  • wavecaonrms seeaeucrees aoene a,u woenocou aer mooneaencaourmses rearnaenemoracs or cnca oucomes.
  • cansurer sannn over,nvuas,ncunwo sa caracersc emonsraeowaen sace moen cane useo aens.
  • eauresoreecae conons ano cncaroenvua eos aen emorac anca cnnsa’a ca sseus nor umazoen,nrceeunaase-s,ea a o ws.c cocnanasnenvua-eve aasesromeommunareoorroec , arev ervewo o our comrsn over, aus ae ears wo transmit ous esase coor eevenosas wneassenera eonunarmar care a one o aa wareouse.
  • 26 aases ram newor, wcsne a common - aase an a cncue a coorromeassacuseseneraosa aase.er, exernaaaoseorromeram anomen’sosa - aseer ceoor su comrsn au wsasromerveenromeenomo aaen, a-roseaercs ave e cnorommmuenn.
  • % oe sar o cncaoow u cue e acusonae was no wnreeearsror vs oe eares ,eneor eacnvua a 2 s 6 eme oe seconrmar care rereseneoruanar, asrevousescre.n one ernvua was e naeureans n we ar mcuecuere was,e mos recen was use.
  • connece convouo s a varan oensene,eaurn severaense erarameersnnaocs oeran a erenme resouons.rcecure vaaesanercauramne were o,meza,o acvaon, normazaon, an reuarzaon were cosen seaseenoe n.
  • c ecorervaon rar s:oeewsn eac oereeaases were maeo auc avaaeecoe snus cas ascaao.orecoes_ccm.srevousescre,ecoes conc esrom conros usnerarccarouns o an coesoeerene ca meannuseaseenoes.nrevaenecoes were use,.e., a orrre cseroannnecoe cso,easracaonse wreseonunaeaeceone’s cuar wro vrero semar acu csooesn waeree.
  • avens rvaon cans exe ease, reresene aecoe,as a sncanmac one , srueo aceeren emoceaonnsnae a rueoreensceoner-ersveromaenn svacuea rsea wveoe emseeasenosmaa rcer oensenes, orormnevuas e wmeouneoessea nsoe.
  • ane counareas cauereseseaasese-raese eaures,en cans execeereoe no sncan reaons evan emensneaen sace aneresence or asen eweeneoson o canseneeesens o encoce osease.ouan s execaon, osve cenro”or cases a nsaes asavnesease“sease- sease“sease-neavneesens o enconsaee as noavne reresen e cenro”or conros.acecoe wasereore saa v e s cenroar, anenea connecsems reerreo aseenoe uencor.ure.n encoe wneaen sace,ncun enconsrom ean
  • an eacenoe vecor was normazeonsoave norm an sanarevaon o one, reaeness o eac anecoe wasuaneavee enac s oanme.ee-mensona saa o avenenoe vecor.susraeeown euaon,’ esa ccomonen ennerecon emen”, roecs ono eacenoe v con“ “como i ecor, p .eroece comonen, scaenene ip e”ns ca ocuaerome aneeweene encon aneenoe vecor, o a snenvua aone a sn.eus,eneoroee vceceo cr.omonen sneseaen saceoson ea moe,e auoenco
  • mevee sncean numreesro o, un wuce weacsoeesn aceros uss an m aonerron- eanases wereerorme usneacae mea.on w ea-anases.
  • the best performing architecture contained over 11 million neurons and used mish activations, 2 dense convolutional blocks (each with 5 layers of convolutions per block), a 71 timestep convolutional kernel, layer normalization, and 256 neurons in the fully connected layer.
  • the autoencoder performed well across datasets.
  • the 12-lead model had a Pearson correlation coefficient of 0.96 (95% CI: 0.93 - 0.97) in the MGH-C3PO testing set, 0.95 (95% CI: 0.92 - 0.97) in BWH-C3PO, and 0.92 (95% CI: 0.89 - 0.93) in the UK Biobank.
  • ceranseaseeasse w-ec wec-ceaanaveorms eaures were conssen w execaon.or exaramceer,z meean wa mvea noirsaenoens, moe-erve unerancocsease-osve cenroemons raeromeene r-serecoraeas- raejur, smaerna r waves , 38 reaveo mean waveorms,en anerae warvoem surernseanse-neeea-vsee ceneraos, aure, .rooornaoonaemuar,e moe-.enr mveane oauerersnnscanuceeseocwreeavseer,s weave amue an reave aeare morooca smar vsua.ese no ase case an conro s man
  • seccaemocs nasnon ss a nove acaon o auoencoereeearnn moes seneraes a muranmenoswon aa maoeen sraacneeao c eanncoee us aeno re ecxonosrreu rceao-n an sne-ea waveormeaures an cnca reevanseaseenoes seween rous assocaonseween wave a scae.
  • cans’ resus sues en comareo an nervas moromea, aeurnose anncoers-eaassees, acaroesns m suacee m ooreans s resems.
  • n -rouounvuaron usn eas-acure oranze ann coencerus uonn,ersanca snuscenmcoansnraoermaoowna coenna sace moen cane useo anoscs.e corresonn anas ne wn curren avaae wea osease-s s suorseaca waveormaa conans a evauaee sncaanenooremnaao one-on an sen crec-ueaaor wa sveseomrm. auure sues souurer ron.
  • creenoreraemaromeecervoecaormoenram an.aaaorn oo a,ee--earnn.oeo voaeaa u.sna auneae, neu.r,a e n a.recon o morarom-ea eecro Lankam .ara-orren,., ee awo.rr.eace,- . eaecor nucaeavorromonunaecronc ecronce.s.
  • ornnaseaen e.a,rnanr,ro.m., aooo,r-.er.moerme,a..rs .enase ocraeaonn o. ecee,nea . eearnn.ee.un,., e. a.ee sanrom eecrocarora an resraon wee rrocar.omomoa,a.,. ee a.ecro seinecanesnverrross-uesor .eo,., e a.eccrnaaunas .
  • earsne vss a suos awonnn samaee.,eree waner ae was earsnerann same an an, eaensneeran,n an va anaon, s men an, ne vaaon same was mm. ames, resecve.ean-
  • ae:ouaonaracerscs corre ne vaaon same, aensa cnca reore , wc execaeer wens w- cncar ea. mean asoue error. mm.e- emonsrae . mmerm 2 .,ouwreesr:ear veernr-cuar e correae w ero massnex ., an ere venrcuar en-asocameceeornra.c momn.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Primary Health Care (AREA)
  • Epidemiology (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Artificial Intelligence (AREA)
  • Data Mining & Analysis (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Theoretical Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Cardiology (AREA)
  • Mathematical Physics (AREA)
  • Evolutionary Computation (AREA)
  • Physiology (AREA)
  • Computational Linguistics (AREA)
  • Databases & Information Systems (AREA)
  • Software Systems (AREA)
  • General Physics & Mathematics (AREA)
  • General Engineering & Computer Science (AREA)
  • Computing Systems (AREA)
  • Signal Processing (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • General Business, Economics & Management (AREA)
  • Business, Economics & Management (AREA)
  • Fuzzy Systems (AREA)
  • Psychiatry (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Tires In General (AREA)

Abstract

The subject matter disclosed herein relates using waveform data of a subject to detect one or more diseases or disease etiologies. Particular examples relate to providing a system, a computer-implemented method, and a computer program product to waveform data to detect and differentiate particular diseases and disease etiologies with machine learning models.

Description

ARTIFICIAL INTELLIGENCE ENABLED DISCRIMINATION OF DISEASE AND DISEASE ETIOLOGY CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims the benefit of and priority to U.S. Provisional Patent Application No.63/410,489, filed on September 27, 2022, the contents of which are incorporated by reference herein in its entirety. STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH [0002] This invention was made with government support under Grant Nos. HL139731, HL157635 awarded by the National Institutes of Health. The government has certain rights in the invention. TECHNICAL FIELD [0003] The subject matter disclosed herein is related to utilizing electrocardiogram data to detect diseases or disease etiologies. Particular examples relate to providing a system, a computer- implemented method, and a device to utilize data obtained from electrocardiograms of a subject to discriminate and detect potential diseases or disease etiology with machine learning models. BACKGROUND [0004] The modern resting electrocardiogram (ECG) utilizes waveform data generated from surface electrodes to represent cardiac activation and impulse conduction. Introduced in the early 1900s, the original ECG was primarily used for arrhythmia detection, but its diagnostic utility expanded rapidly to include identification of coronary artery disease and other cardiac structural abnormalities. It has now become clear that non-cardiac diseases, from electrolyte derangements to central nervous system pathology, also cause characteristic changes in the ECG waveform. Recent advances in machine learning have revealed that the ECG contains diagnostic and prognostic information that extends beyond traditional clinical interpretation. Low-dimensional representations of ECGs constructed from deep learning models can detect cardiac diseases such as left ventricular dysfunction and paroxysmal atrial fibrillation for patients in sinus rhythm. A need exists, however, for a method and device that uses ECG waveform data to detect diseases or esveacsee, e wocoesre oeraera cna cnareo avasecvucaer r weoaeseases.ecca, a meo, ssem, an waveormaaoeecsease rn e use, are neeea can uze aon orencas oorsease eooesranneeearnn moes. suc aocumens avaae asronr o ar anooecurmeseennnnvens aon.caons no an amssona one or moren cseeraasens o exramseaese em eooomeesn,s,e a m ceomou ceor-mmrsemnen reecor men,os useoeec comunevce, an eecrocaroram or eco aeas onersransmn, e aeas oners caroram waveormaa o a suec comunevce communcave c cooumeunoeev acee,ase o wneaversor cmomauaon aeevasce on ree secon e aeas one secon comunevce,e waveormaar cevn, secon comunevce,e waveorma ocessn, e aeas one e aeas one secon c a usn a macneearnn moeerenan, sease omunevce, usne macneearnn moe, an eoo oe evce, aroma anoesasc o oune ou ceorm eroson o one osrea msoeree eneran,e aeas one secon comun e aeas one secon c ooanoses osease anranserrn, user. omunevce,eanosc ouuo aevce assocae w a moreseasnes on oer exsaemasee e emoooems,ene, a m ceomou ceor-mmrsemene meos useoeec one or recorn waveormaa o a sue n, aeas one comunevce, moeeren crocessne waveormaa usn a macneearnn one oer eooan o, ussenasee a mnac aneeneearrannn m aoea,n aons eco oouu o comerseaserom aeas eooanoss sn one or more eoo oeees o aerasese s mas eae. comrseearsease, ann one exame,erenane assessno aserom aeas one oer eoo oearsease ma comrse oer eoons a onco re eearre r esxsao smn o easeev,erm comere re. snesansnues eono one o or meoreear carsaecaesersrocme aauereass. onee onneer ovra ms,or we ceraeranceres ccaraecaures ma comrse ae, sex,ear rae,, voaes,,c- sna or an ersceauresrome voae ma comrsee,, or ma con c m oonm res eexnaa emon vee,er nreeo cue. aarrseearse ma comrse venrcuarerro , ane venrcuarerro ma comrsero .e aeas one eoo oee aorc senoss, a carac amooss,erroc caromoa,eas n onen exameree,nsev veenearrcuasrease.er r oane eeoo o r venrc ros r venrcuarerro, ane a are uarerro comrsesumonarerenson,umonar crross, rennr a oenns aeo euxn ra, em cro ,even e,c r oero unsmenasoee mmao ccomurmsoenaraees,er seeneso an.nea, croncversease, esease ma comrsoewn orn, oroacco usesorer. earsease. amooss,erroc caromoa,erensve ea,receon oa anorsac ouruao mna comrserecon oearaure,recon o suen n an exam ,recon o mora. scr e,eseasesearaure, ane meourer comrses eecomnnraacnon.earaure wreserve eeconraconromearaure w reuceea .ee w-aveeaorma maa ma comer osea snxemrom a sneea , awo-ea , or a- ma comrse sxrecorae eas orronaaneeas.e-ea e waveormaaa msa oreo orzaonnearoanmeeas. ea,eae, weaaveor,meaaa m,aeae o,aenaero,m a e aan- oea , oenae or m. ,oereaeas comrsnea,ea a.n anoer exame,e waveormaa m a,ea a, anor comrsn -waves, ae oanerom an o one or moreeas ne aove c-waves, a-waves, -waves, an -waves. comrsenear cassers,oomsuce cr-amsseemrse,neaes maen noesw,ores, r macneearnn moe ma marxacorzaon,enarov moe, suor vecor macanne,om-moeraenss, c neuusrear nne,w oorrs-, neeaarrnesn n meoeor m.a ceom macrsene coenarransnve meoae ma comrse a neura newor. e macne sem-suervse earnn, renorcemen earnrnnn,, unsraunserevrseearenanrn,n,n suervseearnn, currcuumearnn, orearnnoearn cremena earnn,rann en m oancen exeamearnen em mooem,en. w,ereen comeuraern-nm ceommenre meourer comrsesearnn moe usn conrasveearn sesre-rann e macne e macneearnn moen m oa re cormesernsea ao cnos . convouonaearnn newo nvouonaearnn newor, an e n one exame erm comrses a convouona auo encoer. rann e m omen,e comuer-memene meourer comrses rom a samea oc snueeecarnn moe usn raw waveormaa an eecroncea recor aa e macnese.arnn newor ma comrses an one exame emomen,e ceovmcersoe w emceen.anoscaasranserre n us oer-wearaeevce. eooes comnrese esx:am onee or em moorem eeecnr,o acarevoceoranosn one moreseases orsease suec a soraeevce an arocessor communracmaveeas coour oeaonne s woarvaeeormevcae,a wroem a erocessor execues a caon coensruconsa are ren e ssemo: recor waveor sorene soraeevceo causeearnn moe erenae,masaea ornome wea suveeocrmraocae,s ussne waeve moarcmnaeae uasn a macne sease orsease eoo an enerae aanosc ou rnn moe, a orsease e u comrsn e one or moresease no oonees. seases or sea esxeam eoeo emeso, cmomen,r ase cso,mue ar-measem oennee c moeooeec one or more ecocaroramaa o a suec rocessn mun evce: recorn moe an eneran a e ecocaroramaa usn a macneearnn e ecocaroramreeraanossc a oruansuo coramccr esencr ooncear oro morarme eoo. anoss o sease. wecome aesear aenn ooero asseeacvs,n o oercsn,eaures, an avanaes oe exame emomens eaeescron o exame emomenars. sne ar uon conseraon oeoown oane ren unersann oeeaures an ava renrenceoeoo naes oeresennvenon wen wce wneaeescrona sesorusrave emomens, .c –es oocenveanraomn meacen u azeor, aonn oe a ac ccoommmaunncnaonrasw ans o wc: arcecure o aca ssemo acure user a nrocessn macnee ssocaenormaonrom aaaase anerormecnooarnscn one user assocaemaes,n accorance w ceran exames oe sruon w.ose m –ere acneonc. earonwn,anra amccoeracncne w me coersaon m eexaasmureeso oae voecumne an scoseeren oo w ceran exa.. m –es ooceecanraomecn a comun macne an moues,n accorance an r.am - anomen’sao orsams a ocoseere vaaonan ss. asmacuesse.sueneraaosaervaon oer wereene wo receveonuna a ens ae ears or acaemceaca muaor caroo care a a mu-nsuona onear o caroroe ss cenmc vasssse-nereaarsr aaram oc.cur,rnaewenes wereene w aeas o eecroncea recor aa was coec en-.roa rane va sns, narr e,ncunemoracs, anroomercs,es resus,aaovoe no rees,oarso,r aanor rreoscuesu,r mecaonss, raoo an carooanosc rerosecveaas a ananosc amnsraven coes.e r es reerreo asenerrseareouse oaroo .ore eesene aonranscsu,soaens wou an n=, were excue, resunn,aens -mensona. ve –n coro reernesenvaerovne wwa.sorrseraneseormeaern unsn mo aer,e evaocusneexscreneoe a oearnmnze aorroraacnnno ewnc aesnca.enuoncra asvaveaeearnn o conveorueseonnaa noens wcs on monnaen an ouaen srom a creaes ura neworrane waveorms was use, wc emas numerca reresenaons o an smaresewee zeerenceseweensromerennvuas s noesneonsrome samenvua.ne oer eeearnn moes, numerca reresenaonsr oec a s weacveco crmnscaa o cuacnomee u,seu a rasneruonroounce-mensonaosc reresson.e convouona neura ear moes suc as or vara n samnreuenc. neworneroaes eac o z, aown aen ae an sex, were e numerca reresenaons, aon w reuarzaon‘ enncuen a munomaosc reresson moe w e caromoa, aor-c see’n,osrasneo, smeureannseovues ca,ss oer carac a anm noooss,, weererroec rou serve aseasene comaraor.wo anaoous sne- no ‘-eea’ an ‘-eea’ were asoeveoe eaeeearnn moes, reresenaonserverom waveormaa , uzn-mensona were seeceor sneea mo rom one resecveeas.eas an aenc ‘noo.easoumresa’ra moore monceus we nerne a aesa ,ose serxa o ,nneea,e rnr racr eueu ,nen , an av aa ,ea a ann se axm n aon eus weea mraoee, an amuesromeea wave, a wave, wave, wa rvas, an voae . -ecever oeran caracersc curves o -ve, an wave. eoo versus no.-e sncan ouerore an comarson moes casscaon o eac eoo versus n mee comarson moesor amooss an. -eeranro wavce coarrmso oo moas.re ascuee waoveeo ae rms cor arnesoonw an rs o c.arac receoe a es rs³thercene o carac amoossanonvuas wer comexes comareo waveorms o owerth voaes an wereas waveorms correso nvuas aower rs ercene, caromoaa er vonanesonvuasreceoe a er rs oerroc rsnvuas. an wer comexes comareo waveorms oower casscaon o. -e eso coara vceerrsussc nso o cn aca euvae rnue sse vcerscus.eee-arnen o moesor e cnca ruesor casscaon o eoo an ecocar uerormenvuas w ecocarorac ne vaaon same,o-reaecec. , -e sensv =. comareo, e cnca rues reue, se cases =. ae oserve cnca ru nsv . - e secc o .or comarson. carac a umuavencence o cnca oucomesrece -e rs o anemooss an erroc caromoa. -e rs o carac amooss same.rorro exacm care,ome coumaua wveas r ssro on mo arssaoca ae wea crsnca oucomesne vaaon amooss rsere versus neowes cara was nees carac . -recson-reca curves oeecea armnno anoss rs. eoo versus no comaraor.recson comarson moes easures an - reca curves o comarson moese anex, area unererecson recae curves an eoo co vnersuesnc neonerva csom soawranonr wee coerresonn ne sows execeerormance o “no s” ranom ca n.ase o eoone sser arecson euaorevaence . - seacmee. moesor one versus res cvaesrs ocearaonn o carac eerosoc c.urevceesv oereeearnn an comarson o comarson moese anex oeran caracersc curves eea, -eea , ea esuoreos anore oeearnn moes -e,- corresonn an conencen ne versus res casscaon w execeerormance o ervas sownneeen.asene sows . -re “cnsoo sn-re”c raan coumrve casser a o.. versus res ca s oeeearnn an comarson moesor one ex, esassurceaso ann oeee earnono m.oreecsson rec-ae c,urves o- ceomeaarso,n mo-eeseae an reca cur eveoso anor on ceon verseunsc reesn ceravsassc saoon w corresonn area unererecson erormance o “no s” ra wnneeen.asene sows exece e same. nom casser arecson euaorevaence o eoon moes . eo -oec veevrseurs o noeran c comaraacraerosr.ce ccuervves oeeearnn an comarson comarson moese a er oeran caracersc curves o eea, -eeanex, eoeasures aneeearnn moes -e, - corresonn an coneno eoo versus no comaraor w execeerorm cenervas sownneeen.asene sows .anc -e ore “cnsoo sn re”ca ranom casser a o.. eoo versus n curves oeeearnn an comarson moes moese anoex, comeaarsauorers. aenceveeer oeearrannn m coareacersc curves o comarson -eea eoo eoo versus no s comara-oer w, c-eea, area unererecson reca curves an con orresonn ne sows execeerormance o “no s” ranomen cceassneervra as sreocwsnonn eeuaeoenr.evase o eoo aence casscaon o.n -e s eeasm o ce oa.ra vceerrsuscs o cnca rues versuseeearnn moesor secc anosverecs no a euvaen sensv.rouearo o ecocarorac versuve vaue or casscaon o eoo an -ees caracerscs ws no cnca ruesue an -ereen. euaoe secc oe cere cacuae aeroa cuoaee a sensv s reorwesnen aove e cacace aonn wcae nume rru oes. casees sennsev va oaoen c snamcae.rro ruresarss rece -.on e -enc rsse .ernveerva sernvcs. eence raes oearaure, araraon, an mora raon, a ncence raeser erson-ears o mora, ara a nearaureer, erson-earsere orece -e carac wmonoowssn a cnaracer amrooc coasrso omroaerro rsc ex cacruonmonav.uasrrne vaaon same conencener orars reresen carac amo.vas oss -. anumuavencence o cnca oucomesrece -e rs oncence oearaure, araerrroaco cna,r anom mooraa sraerees o anecreasnearrse.cuemuave- vae rason o sam caer eaxcc aumnoonssv anuas werrnoownc c caarroamco amaoor an aeene caromoa. rs counsor eacere are sowne rroc conence ow eaco.rrorars reresen .nervas. carac amooss - anumuaveerrnocecn ccaer oo cmnocaa ouc sormaesere aeceea-rs.e rs oncence oearaure, araraon, an mora umuave e rs o carac amooss an er eres oncreasnrece - vaaon same excunnvuas roc caromoaor ae ne caromoa. rs couns wnown carac amo an erroc conence or eacere are sowneow eaco.rrorars reresen carac amo.ne oss -rva anums.uaveerncroencce c oa cnca oucomesrece -e rs oncence oearaure romoa srae mae sex.umuave e rs o carac am, aoraoss arnaon, aner mroorac caromeroesa onocrre masanesnreec vea - same excunnvuas wnown carac amo anerr aon rs counsor eacere are sowneow oc caromoa.nervas. eaco.rrorars reresen conence car . -umuavencence o cnca oucomesrece -e rs oncaecnc aem ooeaorssa aunre, araerrroaocn c,a arno mmoroaa sreare emae sex.umuave e rs o carac amooss an err es oncreasnrece - vaaon same excunnvua oc caromoaoremaesne caromoa. rs counsor eacser we are snoowwnn cearowac eac amoo.r arnorars reerrroec conencenervas. sen sacee.ara -eowroceasram o auoencoer anenoe vecorervaonoraen auoencoero encoe an recosnsorruco- a-nea s anne s-enae-eas m uosnes.ecan ssrane an aase - . cansesee auoencoern an - ouosue oene suse o - , as we ase oanaase. cans seer avne roeneocee veco ernsco usnnsaroemee remsarnonma o-e sam-es, as waease as.romcaensen- ca anns caecuaeoeanroecaease cso,m onoonene,s oereenooseon v aeconors.or eac encon,ese assocaonseweenroece eacenoe vecor, an erormenv comonens an corresonnecoes. cans .ua -ceemacn s eoawcn oeeneraree auaoeansceos aenr sruecnu mree.a-aenanzue, re,suss.no a mu-mensonaaen sace,.s “coe”sen u encoe accurae asosse ae ouuae seo reconsrucenu as . -- -usxraamvee ex oam mer, ea on’. waevneoormes veecnoerraeervraomon a.n orenaur-ea .-srueocasceormen- scaero anemonsre sows a aecsesruon o enconsnaen sace. enc aesow sex smanos an maeaenssmarowno onsromemaeaens re anueos mare cen sormsncenoc cusers.earer eenoe vecoror maros oese cusers, resecve.e orane arrow reresens oranze s.ease - caeororee ra se .oxn. e m coaorrx scaore reerneosense veeacrsoorns coarsreea oonn coee-ea moe, emonsraea.e- num -eersu os s onceanas assoecruaroansonecerseass:e erucrenaso.ness casscaonevencreases. esncremena as ranom eecrocarora. - -aen sacee mea-anassor- an sne-ea comareoe.m mo eec -e rocus am. reorr oa scnnecravnas assoecaon.snueaen sacee moes moe.en comareoe nerva mer o sncan assocaons o sncan ass s moe,eaen sace moese areaer numer ana-5ze. resuvse aoccroasson ,es,roee o e nave umarsaeers an acrosssease caeores.ure reresens mea- o us unn aueoneercroones-conrcreucee a-cvroasuse ar meseoa-an oas.es ×. norervae mneervaes moe, a resu was consere sncane mea-anaze-vaueor an w we-cara. sn cerze-can -ces merae ass ne-o ersa.nasoonrms,e s eecrocaroram reconsrucons.orseasesransorme uc aseunerancoc, weounae sue moroo wca csa cnonesss wenen w a execaons ..n mos oernsances, weoun orerroc osrucve caromvoanacn,owea orseseaseosve cenro.ornsance, eroaer,aene waves,arcuarnene-s vseuaea asreca.e.erenecer seemeo or see anea was mos noaeor s ansorme . ncrease voaesneas an a . aen reoro.r one - raaneonm re seorecoern-vearu-oaemae.eresenave exame an same sance aon a normazeenoe vecor,r.omseaesesreoxms exresse aseercen osnvceance as w cenros.e re ase neave oesease s or sseasesa were seecease on sasca ameer .e – as cornrecaao reneveanwceee.nrece an measure r venrcuar en-asoc asocame.. er -ra.raon survvaune orece r venrcuar en- .. –urvva une orece r venrcuar en-asocameer asocam. –earaure-survva une orece r venrcuar en- scae. eeerureseren. areorusraveuroses on an are no necessarrawno enerae meann as cnn oemsmsons onene un oerseorwose,e ocnen oca o arnna srce sncnermes a urseo werecnavsesceo sasumree eoraecnus.areonnno:ns oa coomramoornearmnusa a,nnde ecnonuesn moaemcuraoro,oor maeounn oecuaronn:aoraoranua,th eon reen asc, ananas roocosnoecuaroo ..usue e a. es.nea smeroourren nzmoocaemcress,nc.: :raccaroac ..raecseosn ames, an..aor es.:noes,aoraoranua a erson,.. noesaoraoranua,nd eon ..reene row anane, es.: ..resne, e.enamnewn,enes,use e.onesnmaeuure enrew e a.es.,en anare, ac ccoea ooecuaroo,use anwoeecncoenoce: a.,om oer.eerse.,oecuaroo nreeeonnsv ee a.e,sceoerence,use users,nc., e.,.e onsewor,.. ,naarrc o,cvrooo anoecuaroon ecansms anrucure e.,one ancerancemsreacons, oer anan vaneursen,rans onsewor,..nd anaren. ss useeren,e snueanrcorouseeos anroocos, eon . reerens une ms “a”, “an”, an “e”ncueo snuar anura eseerm con “oexo cneaa”r orc “oaeso onaerwse. crcumsance or sus ” meansae suseuenescre even, weree even or crcuumensan mcae o occru mrsa an nons ocacnucre,s a wnereaoeeescronncuesnsances susume wen recea reosne ocv neum raenrecsa, a rsan wees as een reonsncus neos a. numers anracons eerms “aou” or “aroxmae” as usceee erenn wones. vaue suc as aarameer, an amou n reerrno a measurae varaons o anrome secen va, auee,m sucora as vuarraaoonn,s an o-ee, o arrees ms,ean-o e oncomass oress, an-. oress o anrome sece vaue,nso ress,- aroraeoerormnescosenvenon. ar suc varaons are moer “aou” or “aroxmae” soe unersooae vaueo wce s useeren, reerssse aso secca, anreera,scose. ceers.eooca s aam “oeo maca co sanmane”o mrae ceornvaen wromoe a ce “os anoruv”e. cees arneseonr anvueenouosnu enmcooumr, vassreesou esmuomomuer,ns we,eroeon seerumo,reasu ms, s ceeercerom amnocu, earwax, ce, cme, enom,erm, exuaes, erosnau, cerumen asrcuce,m, mucusncun nasa eces,emae eacuae,asrc ac, u,eurau,us, reum, sava, ranae anem,ercarau,eroneaears, urne, vana s seumsn o, semen, suum, snovau, swea,ncu ecreon, vom an mxures o one or moreereo.ooca sames rom ae m ceam cmuures,o us, ce cuuresromo us.o us mae oane ea oerrmasn “ssmu,eocr e,”xa “mnevuau,”nc aunre, “ ora oene”r c aoree ucsen onre sracmannearoceerueres. reero a vererae,reera a mamma, morereera auman.am no nomeo, murnes, smans,umans,arm anmas, masncue,u are erroen o aooca en oanen v sor anmas, anes.ssues, ces an arous emomens arees vo or cuuren vro are aso encomasse. emomens are nonene as an ecreerenaer. soue noeae secc scusseeren.ne xausveescron or as amaonoeroaer asecs necessarme asecescren conuncon w aarcuar emomens no eerencerououoas emomen an caneracce w an oer emomens. emomen,” meansa a saerccucaaroneaour “eo,n seru ecmuroe omre cna”r,ac “aenrs emcoescmrene,”n “a cn exame we emomensncuen aeas one emomen oeresennvenonnecon aearances oerases “n one emomen,” “n an emomen, on.us, emomen”n varousacesrouous seccaon are ” or “an exame same emomenu ma.urermore,earc no necessar a reerrnoe e comnen an suae uareaures, srucures or caracerscs ma scosure,n on manner, as woue aareno aerson sene arromsncue someue o nro m ooreer emeaouremsenncs.uuerenrm ooreer, e wmoe sommeen esm, coommneansonses ocreeren eren emomens are meanoe wne scoe oenvenon.or eaures o aene cams, an oe came emomens cane usen an comn exame,ne erencororuaecaon res,eruenceseoaeen samoecu emxeenns, a asnouaen e aaccnaoa vnson u c. aeuerecano arne, uensnecoraoeraneocum reeenre,n ocre.aen acaon was secca annvuancae as sease eoon onero ams ae scu, eemc’osmensscoseerenrove meosoeec asease or some recon waveormaa usneeearnn moes. eereaseen ssem, meoon anae nvocnecaraa acowsesa ssesse mmaac as eova muaanoens o on assoecaon, a nee exssor a aa, suc as- or ecocaroram-aseeaur seween waveorm a uses aeeearnn moeo e es, an aroa rane oseaseenoes an sneeae ncoe an reconsruc waveormaa,ncuno-ea reaeana aa.ese meos anevceescreerenroveor more waveormaoas, ws oer cear curarce-nre maeeosseaase,. aso wreea ars ocuerseases,ase on an evauaon o roucs, ssems, anevceses ar,e meos, comuerroram eece auman creereneeceauresn waveormaaa cou noe ormanrom an e mceroecaro reraamn.u ar waevr,eorem meaaorsneosucr,oer exearmene,r aonve a srenoumrovemen over curren meos, wc onrove raw waveo cc aoenaor caracsease,u wco noro rmaa o aaeno assess aa oanerom aaeno veor encon an reconsrucn waveorm an non-c eec anerenae a we vare oseases,ncun caracecnooaraacsease.e souonsroveeren areereore non-convenona an roramrouese c em. s, aonmeenvscesesocr useeerenncue comuer-memene meos, comuer eoo, ano waveormaaoeec one or moreseases orsease sease eono onese, a cser omeecn r,a see nc o :nn aoe oor m receosore renres ,neas areosv or ease e mo oneo eoes rssr coome oence a onnoe oerr m.oreseases or o a suecransmn, e aeas oners c omunevce, waveormaaeas one secon comunevc omunevce,e waveormaa,o a evce c recevn e communcave coueoe aeas oners comun rocessn, e a,eas oene a seceoasn o cnoem seuconn ceovmceu,ne waevvecoe,rmea waa uvsenorm a maacane eeaarrnnnn m mooee, a en eoeoren oane,seasee aroemas a oneeas se ocnoen o coemr euonoe ovces,e uassenee macne e aeas one secon comunevce, aanosc ouu comrsn on neran, anoss osease an ranserrn, e aeas one secon coe or more eoo anosc ouuo aevce munevce,e n anoer ase assocae w a user. orseas c,ecnooeserenrove aevceoeec one or moreseases aarome a e souoeces, a co smorarsene:v ocnee o arn m aorero eceecssroorca cromomruanmcaeaveso cr oann waveorm evce, werenerocessor execues acaon coens oueoe sorae evceo causee ssemo: recor wav ruconsa are sorene sorae usn a macneearnn mo eormaarome suecrocesse waveormaa sease orsease e e anenerae aanosc ouu comrsne one or more orsease eno aoureseo ,ro c aose mesc. rs,necn ao sooraeseeervencer aonv ae ar socsesesmoeec one or moreseases e soraeevce, werenerocessor exec or communcave coueo e soraeevceo causee ss ues acaon coensruconsa are soren a suec rocesse emo: a recor an eecrocaroram waveormaa o anosc ouu co waveormaa usn a macneearnn moe an cenerae a n anoemr asrsecn, oecnen ooro moeres eooanoss osease. a non-ransor comu erenrove a comuerroramroec, comrsn:nsrucon er-reaae soraeevceavn comuer-execuaeroram o s emoeereona wen execue a comuer causee comueroeec oneor r mecoorer ase waasvees oorrmseaaase o e ao soueesc, com cromsnu:e ar-e cxoemcuuer-execuaeroramnsrucons e waveormaa usn a macneearnn aeroramnsruconsorocessnsruconsoenerae aanosc o moe an c comuer-execuaeroram n anoer asec,ecnuu comrsn one or more eooanoss osease. eec one or moresease ooeserenrove a comuer-memene meoo recorn ec s orsease eooes, comrsn, aeas one comunevce:ea ocaroramaa o a suecrocessne ecocaroramaa usn a macne srenasne. moee ec aoncarenoerraamnr aeeraanossc a ouranus coormaccrs enecr ooncear oro morraem eoo.anoss o noeescranearneecanuereesn re.aaeroous m aasencs an o c uosmnu asnec ss oenvenon ma or ma roramsomemene varousecncaeauresescreeresne amres w ane sneocwnc. comuer xamesemrce enca eeumrnenns norwouocu oueresraewnurse,sn, e wxamce numeras rereseneu no necessar .s aocaramecn ae s emsemomenos areescrenea. sease eooes anerorm m eec one or moreseases or exame emomen, a usera acssonceaeearn wn o an user co wmavueonrmevacae o a s muusecn.sn one acaon, an or mae aeaure seecono oaneenes a an eren. oeecnuesescre ,, ansecae arne con.u,reeo s csomemmuncues newor comunevcesssems or va an su ncae w one anoer va one or more newors neworevaccess nea swe eomr commun s nccauoens aec wnroeo or. wreesseecommuncaon means wc eac newor canncunce aunn oeovsecesescr,e,e arenn suc c aasn eexc neawnoeraa.oer exame, . or an comnaonereo or an oer arorae arc scren e communcaon o snas anaa. ecure or ssemaacaes soue unersooaeerms “aa” aronu “onuormeaosnc”u assreo unse o enxaemrcaen emeaomeerns, reeroex,maes, auo, veo, or an oerorm onor eno ase envronmen.e comm maona can exsn a comuer- mae smar neworsoun necawoornecn ooro an a uernzaeve comemeuvncceasosnseecmsnoo,., an avn a comamcun necawoorn m coomuue cnaaevec oesrasnesmmn, an, a rnecevncues a comunevce or a smar newor.or exame, eac naa overe newor comun macne es neworevcessem,, an canncue an rocessor-rvenevce.ncree exaemrene an emoounmenne.c oer ann oer. wr,e oer w nereweosrs, anevceassnossemcs newo,r o,e arn are oerae user,aa acuson ssem oeraors, e user comaors, resecve. mae useos unevce ncues a usernerace.e usernerace e use a araca usernerace an oernormaonoe user o aow oers.re useornneerraacce w receevaeas u ascerunsuono srsaeam acu,soen ananoors mcac nenwor , an sas resuso user.n anoer exame emomen,e u eearnn an rove w araca usernerace eaa acuson s sernerace mae newor .e usernerace mae accesse esem an oreanosc evce.e usernerace masa mas rocessor oe user comun acuson ssem anoreanosc newor a a weae assocae weaa rovenu, conuraonaa, an oer .e usernerace mae useo acuson ssem anoreanosc newsorarecon e weae oeaa usernerace mae manae eaa a .n anoer exame emomen,e , or oers.n anoer exame em cuson ssem,eanosc newor user comunevce aneromen,e usernerace mae manae e oe user comunev eare ansaeoe user ase one oeraons n one asec,cee use.r comunevce mae aoraeevcea mae ceaarrenss ore maoraavee oenvec oer. moree user comeauseor oevacen wav meaormaarom a suec wearn or an arocessor communcave urer comrse a soraeevce comrse an enn coueoe soraeevce.erocessor maurer comunevcee.oeer uosremr coem muacnneeveacrenn,roceersesonre,ssc coonseureereno o snere user evceo recor waveormaarome suec.e., a wave ve as a e acure waveormaa usn a ma orm acusonevce,orocess vae macneearn cneearnn moe, anoenerae aanosc ouu , wc mae useern ,or e c a xan ana m usses o e, ae w ceoem wma rouv wne sco earm rosn. acaon one user comunevce ownoa, uoa, or oer acaon or a san-aone acaon,o vew, e newor .e usewr csoem accuesnsoceuvmceens or w caennaeerascr wouee w useer snerevrearsce or o vear c aocmusunon sevsceems conn aenceeoae nneoswocr se,rvnecrun oeeaaa acnoussco nn server oeaa exame emomen,e user comunevce com ewor .n anoer acuson ssem anoreanosc newo muncaes wevcesneaancune exame comun ssemesc r va an oer suaeecnoo, userneracee use,r ceom comumnunceavcoen a acsr aoone ncueeosw , o a. r oaae sro arae un accessee sorae un canncue one or moreane c caons.e exameaa sorae un cane sore omuer-reaae soraeevces.eaa user comun one user comunevce or caneoca coueoe memor anor oneev ocre more. reomro evxaame mee,moera acaco suonras oer u renmo canncue on-oaras exame emomens,eaa sorae un vaeas memor.n anoer n exameaa acuson ss ma resen a cou-ase comun ssem. acuson server.eaa s em comrses aaa sorae un an an srucure ac orae un canncue anoca or remoeaa sorae sorae uncess caenoncueea oane ac oru msoreona snseme com suuear-reeaoar seo sronnormaon.eaa sorae un mae a searae ssem, suc a raeevces, oreaa cou-ase sorae servce s aerensca or vrua macne or a evce ann onoer aseec,. aneosaca n aecwuosron seorverransm co rmemueusnecaeasa w.ee user comun waveorma aa mancue anosc serna. ve erxam,e ana anaosa sco nraeweo ur comrses a macneearnn ssem, a e user comunevce a n.eanosc server communcaes w eaa ma co noreaa acuson ssemo reues an receveaa. server. mrseeaaesrevousescren reerenceoeaa acuson eanosce ssaemnosc c sanse cmomrse re ocneev oers m aonrenuunc oonsaaoromeanosc server.rann meosoearn one or moreseas memen an oe menone reerre emomen,e macneearnnes ororrasmeas mea eo coomersserom a c woanvveoourmonaaa n.eunra a n coenwvooru.onna o anueo e exnacmoeer. emn aonomeern e,xe convouona neura newor ma comrse a ma comrse emen.n suae arcameceu erme moameen a,ee coonveoarun oonnea or ne muorare nesewaor orsease eooesrom w ses eaa soraeav uenorma ca. accesse anncue anoca or remoeaa sorae srucure canncouee onea onro msocre neanwore com suuear-reeaoar seor snoraneoremvacon.eaa sorae un mae a searae ssem, suc as aere es, oreaa sorae un sorae serv nsca or vrua macne or a cou-ase nce a. ssem ann aeerananeos emc noewmoern,e maunceonesr oorm eeer ore uoser o comeuana aecvuceson. means o esa wsne a a croemcameuncaaonse nnewoerwe ceonnnece coonms suoewn are exames, an oer oreover,oseavn ornar sne rs anevces cane use. arecaeae user comu aravneene oeresenscosure w newor usraenn.evce,aa acuson ssem, aneanosc conurao canave an o severa oer suae comuer ssem ane comns.ueorr m eaxam noen,c au usee ar comeunevce emoe as a moeone or n e comonensescre aove. macnes assocxaame we emeoemcennoso,er neesewnoer ceormenu mnaeev ances ane o an c oer comun suc as,u nomeo,osescussen moreea w omun macne moues assocae w an oese co reseco..urermore, an an oer mouesscrs, we conenm, sounwar me,acrmnewsa,r seu,c or asa mrowaurees asescreeren orecnooreseneeren ma an oe mouesscusse socae we ..e comun macnesscusseeren ma n moreea w reseco oer comuer macnes or communcaon ssems ove cro omnmeu onr mcaoere w new oonres a,n souer as we as .e newor mancue ane oaa or communcaon c as newor e neworecnooscusse w reseco.. s newor,ncun an o xameroc comonens oee esxse easm exame mee aorcsecusurreae.ne e.xamsescreerenaer w resecoe oer ssems ann oer arcecu e meos aso caneerorme w eerrno., an croensnnucunno r semeraor eemens. usraes meos oeec one or mo .or conex, aocowaram ceran exa reseases orsease eooes,n accorance w escremereens m oaeeecernoormoe onsc ao ssenee croemn.unn an eexvamceee. em., aoemaen,e meos evce, wcurer comrsese user comunev s one comun aa acuson ssem, or an comnaon ce,eanosc newor,e escreeren maeeror ereo.n exame emomens,e meos noc ,eme on ars an secon comunevce asescreeren. emomens, a searae com usuern comevucne coemvcresn a re rceocrors wnaveeovrmcearsa. rn exame waveormaa.e waveormaa one searae recor ecorse recornevceoe user comune nevcesranserreromesocae on ars comunevcee.v.,ceser c.omn euxamneev emceome anns,ure reercorrannserreevcoe ae sveccoen. cnom exaumnee evmceo.nm eexnams,ee em reocormenns,ee recornevcesocae on a sne comnaoner vces an , ecocaroram, or ecor recornenv oneo cnees a mse.v aecce c,omerse a w saavneaorrmaa resc roercornee wvce, a ann recornevce. evce, oro.anar recornevce recor amuaor recorn waveormaaor a sorero o se eecrca acv o aear.e., recornevce recor mee.., aroxmae secons.muaor reaeran se eecrca acv o aearor arooneero omee.., recornenv acn se e, ec wxoanms. ereen eme eoecmrecna, acev o recoerenaevce comrses an amuaoreas mnue, aeas, aeas rs measureor aeas secons, aeasa, aeasas, aeas manus,e as, aeaseasmonou,r a, aeaesas moonurss,, o ar aeaseasoeuarrs., an a mno enxaomr, ae eomero momneno,r, evee snan moanro orr, amacu maoor evce comrses a mu-ea surace e.., smar wac nor,manae monor, or consumerevce sanar sura mceu. m-oneaor s cuormacers meosn oo erecrocaes reaceers oon a sea snar surace monor. surace monor ma comrse-o-ea urace o a suec. sanar eeas caureeeren sace aerenocaons acrosse suec. caa cesn eecrca acv measure e eecroes.ecroes are comrse o scex ameor,,, an- aone cesrecora.eeas ,,, an exremeas an sx ceseas.e sxmeas corresonoe an sx unoare eaecsro.ee as.,e a sx, anm aea.s ceoamr csoerr oesorneesoooare eaecsro.e.e,s,, an ,ea corresonsoo eRecroLes anF anea correson an an.eas a, a, an anvua corresono an onesoo eecroes , an an areR assnLeeenFn one neeurn mo o eecroes,, corresonoe sx ces eecroes.nwo o norn.e sx ceseas -ea ssem.or exa r more eecroes cane useo esas a-o , an ocaome,n a-ea ssem on eecroes areace,ca, ae, , an. n one surace o a suec.e eecroes corresonooareas, e eecrca acerv o recoerenar.evcoese urse moneorrens c aomoranaeones oe eecroeso measure e..,oeas an connuous recors e vce comrsn o or more no aemo recor everearea.n somveernsaenacres,eae. evenn ev meonn moornso wr,ornn ceonnera,oes urne course o monorn.n somensances,e eve nuous occur.ven monors worn con n monors worn wen smoms recor a smo nuous ma comrse auomac smomeecon an onnc mseece.ven monors comrsn auomac smomeecon ma monuoers m.annuea receorrenna ans weea.urevenew meoenn sorms moam aen smom monors or memoroonoon monors recors eecrca memoroon monorss memor monors acvae. acv oeearor somemeeoree memoroon comonens,anccu monnores aeraes s,e ar-eco cnonaannee m wononrs a s anaceeevcree.coca a suaecc. monoe comrse an aesveo aacreco a suec.ac monorsenera r rs eecrca acv oeear we monorn.omeac monors ca ecor ever recore eecrca acv oeear.manae monor n wreessransmnsere unere sn o a suec.ca,m s, ormanaeoo monors, are eear connuousurn mon anae monors recor eecrca acv oransme wreesso an orn.urn oeraon,e recoreaaseroca monor orm exerorevceorurerrocessn.n somensances, aac onsaunmaeree mvocneso mr maa useeaessecnoo. orersona us comrse an monorrevous menoneu areesne s e.onsumerevces ma aso comrse wearae moeevcese.., omna orrw aaaccees.oonesumoeroev mcoen moorn anors r mecaor co emecrrscea a a sneevce or mueevces worn nernaonaaen caon ,erenccorvo oeear.ee,or exame, n exame emomens, “eaess” recorrae reerencens enre. recornevces use wreessecnoo nevces are use.eaess eecrca acv oeear. an aeaswoons o measuremeno recore measurem n exame emomens,eaess recornevces recor ons muesnser oomwoons oeoe.., r arme arm or reee.ewo suaeewne surace o a suece..,o oose eac oer wereeears .eenewoons.ee,or exame,nernaonaaen caon cocaro waves, wccra aom rceare naocor uramn e roeceov urc mane n eaersv.ces so uusne urasoun, or ver reuenc sounraverou an meum.n an ec waves ae oressure wave, wc ca aransucer ocaroram,e souns waves areenerae aneece ecocaroram, re wcor aneezvoecee,crec u crrassoaun coneaamneeneeraren.snro caurceacromma an sun an ansrece acrosse suec’s ces, neareear.e sma source ecoes areenerae.couscr ne urasoun waves reacssue,ransucereecs ecoeseoreeone croensvereensneos e cecarncae a snna arseaen ar ree reecreesenaec o.n ane owsceos,co wecreassao.oensee sr cuacvureess, saucra a,s venerecrcarum an cace vaves, aearr reecons occur wene uras es are amos ecoreeac.ue caracers ouneam reaces an oec wrea ernransmsson u csromose oe surrounnssues.cocarora,.erer,. e srucuren o eceo:caeraro anram sursr uosuenoneeoco an ves mseons aonr seccear conons revewn em an evauaneumn camers oeear. oservneow ooorou eecnamaerom aear aac,n w n ecocaroramca assssn oceearaure,n wceearcaseo su ooooeear was suen r ressure conenaearsease, um enouoo arouneo ae earroems wear vav werereecs aece normaunconn oe wceear was areces aecneow ooo wneear caromoa,n earaamae ene or enare an enocars, anneconnenn oe orrecon a arraas nnsse uocereaa r.crc v ea ecv roes ac. nasruocerram , eecroes are aeoe suec’s ces monor,s move overe suecoransm, w socuns w caovmemounecaevaer an couo cereaoe a morvocessor an oe oeraon oeear an vaves,emaesenrocesse nmaes erocessor an monor.ransesoaea , recore ansae ons aace a one ecocaroram uzes a smmerransucer, wc roce en o aonue annserenoe esoaus. e a morenvasve osuorse, aonrannsesoaea ecocaroramrouces moreeaemaes oeearecause eransern enonc near erom,ee eea u wr. searve asosormcaeaaesvrcaenserre oree..,araa ancsmuseon ov sers aem neworo vaena conmoscna neownorescr.eeererannsear ens cnaea come ors meso avnn so orware orarwarenvua or ere aown access wneanosc ranserrne waveormaa, waveormaas on ars comun newor .n exame emomens,e exame emomens,e waveormaeavcser aannserrarnese wrreno ae se scnone c coommuunneevvccee..nn exaaam, ore a e cmomomens,e waveormaas waveormaa, ecocaroram waveorm aveormnaonereo. eecrca waveormaa ma comrse an eecrca acv o a suec’sear.s recon o acve can wece u one sn assransmerououeo.e vareenn on weaevreoerm eecaraca.e a.c,vrecsono on aoewaercso onr, a uwawarrom or aoeawnwar, ma caracersceaure os eecrca acv comrses oree w .eca comex, an wave.n exame os waveo aves:e wave, wave eauer.arooxane.onon:emrm cane seennure ose, vaaerom: nc.nm.n.ovoos ec,aere.aer,onuerne . enre. nncororae reerencens e waeve w caovmeexca coresens as a smaeecon an reresens araeoarzaon.mmeae aere mrses o mueresenaons.or exame, e waves a wav waveeecsownwars,eners wavene wave comex wavee c.omeex wasve anmm weavaee. aeer waeve w maave coemecrsse u ow vaarr,ousen szees.rs wavene sma wave ma corresonoeoarzaon oener or exame, a waves ma corresono o mocar venrcuar seum, we an we a on aere m samna m aanss on.e ve wnarvecse asr.e wacvaana es rererc esaeron ne.sn e wae nvn aee arna eo co w arrraev zses ao cnorroesoeneooarreazanon wave reresens venrcuar reoarzao on oe venrces.e maurer comrse wave n.n exame emomen,e waveormaa eca caracs,e wrscc aeraeu smra wavesoown waves. comrse caracersceaures reresennese o reaeon esecrceaw aecenve oree a waevaer w mavaes.ureseer weaavuerse,s w mae a cnomnerrvsea ses ameunraso onr onermvease oweee wave. semens a reoneweenwo enerva reresen n waves anncues a semen.or exame, eecon s a measure omeeweenerseecon oe wave aners omee oweenee en com oeex ann ccomueesx aen see enme on.ee wavneernvcau renreseens a m seeamsuerne a renoa crzaaraconer.zeseeneerrvoas oe zemroeroomenae sarew oeene ve wnarvceuoaree eoarzaon an ansnverse correae wear rae.ec-nervas a- n oe wave rae.arousormuae exso correc nerva correceorear menoneerenorrev. -nervas are wenownne ar an w noe eweeneermnaon o onaeaures mancueeon, wcseuncon ver caracerseceaur ceom oex an waveennn oe semen. o ornar sne ar woumme eormaa was no menoneorrev.nencuen waveorm ae reconzeeaures no menoneeren mae cocaror aa. sermee ara mamsouunav e we ,aovr eems are snusoaucuaonsnressuree sze o eacressure wave wavese sanceeweenewo wavesse waveen, ane numer o e wnr seeco rnanes oe-reu menco.no cr mceescear a seconcaons,z,e anre eucenocca or uorraasounensoower en os secrum.- z.ca,n caracman,e ecocar ss ae uzereeerenman moes:wo-mensona, moeara o moorams me, anoer sues. wo-mensonman,e oeraors ae on aans venrcuaruncon, sze oe carac ca o assess assessmen rove measures oc mer, an vavar srucures. moes uzeo co ness o was or camer sze.oerecnuesncueuse wave, assnsn wuous weaevce,o ann o coeoroooweocwnruoeus.oenenaurou vsa svaevse an asuse waveoer waves an veoc. sessnooowrecon ncoocarora,.erer,. u :. oe wavec,eanosc newor oraa acuson ssem recevesnu comunoevrmceaa.,eeaaan aocsucs neowno srsem ma, o rrec aenve oeer w suaveaorem souarcaerome user aa vae newor oeanosc newor,scussen more o waveorm eren.e acuson enne comrses an sowar ean oer secons escreerenas caae orec e orarwarenvua orn comnaonoe waveorma n or recevne waveormaaere aown access emomens,e seacon ceomaunonsce nvecweo rreceve osree waavae aocrmusaoanr somsemers. cno emxaumne wevercee.nn eex wamaveeo ermmoaamse rnecso,ree waveoer rmecoarans reecvecvee wn a sne comunevce, an eereanosc newor oraa acuson wne sne comunevce, evce recevese waveormaa.e recev ssem wne sne comun werene waveorma e waveormaasasseoeanosc server noc,eaansosurc sersreomcesseroceseanosc ssem. aa comrsnnormaon conann o seseaa oe waveormno ouu ssem comrses a ma ne or more eooanoss osease.eanoscearnn new cneearnn newor asescreurereren.e macne noroc anaze,s aea wanvoeormaaransormnno ouuaa. seasesenerae.e macneseacrn ounu ou ou onse ourr meorrerocseesassees onro e usoero comareneonsss onormaon comrsn aanosc ouu o one or more eooanoss o e eneran aanosc ouu.n an exame emomen,ean sease.e., eanosc ssem wcurer comrses a moue osc ouuseneraen n an exame emomen,e macneearn oreneraneanosc ouu. wcurer comrses a moueorn ouusasseoeanosc server emomen,e macneearnn o eneraneanosc ouu.n an exame comunevce weren uuransmeoeaa acuson ssem or user sease anseaseo eanosc ouusenerae oseevcesssems. ma comrsese vaasreo aunsseo eassees o eoeaoresseaeseec,eor eroxmamroec.essn wae oaa oe waveormaaearnn newor anazese waveormaa anee exame,e macne venrcuarerro, w asease eormnesaesease ma comrsee caromoa, aorc senoss, orero o carac amooss,erroc newor maeermnerome w ensveearsease.e macneearnn oe crcua aveormaaaesease comrsesearaure, asease oorr ex samseme,, c oorm remnoanaure,aorr exame. e waveuraon ameers assocae w carovascuar mora are roone ane,an-ereanraoc, aneeermna neav oe waven, semeneresson an eevnaeorvna,s, wavesurnaveorne an,r waavmee anxaeso,n s,auna aenraenscewoecen, anaz anne vecavoerso,rmremaaa oure a s vuenercc,uaer m coancranceoenasr,n ann newor caerro crera.n aroaeanoss o asease or an eoo o asease neermne an ouu seasenoc ,eanosc ouu comrsn. one or more eooanoss o emomsenrsa,nsmeeaneo.s.,c oraunsuerr ceomrascno onee or us meror vea eoeo newoarnoss. on esxeaameransmerom a secon comunevceo aevce assocae w a u ses ers comunevce or ar comunevce.n exame esesevce mae ouu comrsn one or more eooanoss osea momens,eanosc comunevce.n exame emomens, sesransme across a sne sorae un .n exame em e resun usernormaons sore oneaaransmeoe user’s omens,e resun usernormaonsmmeae evce.n exame emoevmceensn, exeam resue enm uosermnenosrmae uosner’ssraenvsmcesee ac sronse comun oeaa acuson ssemor suseuen access e user as se newor macneearnn socaeevce or scusseereena ss uesrem raea arra.ms, scenaros,owcars, anocaramsneures an varous cecure,uncona, an oeraon o exame emomens an aco acsencse o sowscemars, o mreoocs, aanram cosm caune rerrreosenrameroroucecsss oeresennvenon.ransmsson onormaon corresonno crc n onormaon anor uncons oeresenecnues ura cane conureo execueeoca moue, semen, ororon o one. ora mcoreo ecxecunaeeonwscrucaro onrsoorcmaemraemnsn can ree sreescen a oeraon or se.n exame emomens,eunconsacsn aoc can e sownneures an non reuresae oeraons occur ou oe orer or exame,woocs sownn succes eerormene orerusrae. concurren.n ano son can execue concurren or essena varaons, mocaonesr, e suxamsue,onso,c as caonns,e or ex reecuuceonnneo rcevse arse orer.urermore, use w an oeaerarams, scenaros,ow car noruncons mae a o wc are exc conemaeeren. s anocaramsscusseeren, one anoer,neaare orrna wramose,. sceonoarronsa,oonw w cares aenn uoconae rreamusr meaunec coomnne w oc oeocarams anorowcarusraon as we as comnaon a.ac ocarams anorowcarusraons canememene secas oocsne ase ssemsaerorme aoremenoneuncons urosearware- urosearware an comuern acs or carr ou comnaons o secanormaonransmssons an mas crourcreosnos.nooreonvoerr,m aaonocra mnsams rseornesse anmo one or more anorarware mouesne samescaevce anorarwa n soware scaevc re mouesneren rouc,ees. ar eeseecnroneccn crucuesr ca,nememene as a ssem, a meo, a comuerroram comnaons o anorn comuerarware,rmware, soware, orn comuer em.e ssem ma comrsesnc soware moues emoe on a a reaae sorae meume moues canncue,or exame, an or a oe anro norame eaemoenn, asne oncee, sonmee or aoc oaera mmos aunesorocescsr ane orer seun-mo wuaes o exame escre.e meo ses canene carre ou usnesnc sowa su-ocs su-moues oe ssem, asescre aove, execun re moues anor suc as o on one or morearwarerocessorsnormaon caer rr ceorm. e.uerroramrouc canncue aroraman emoen an roramnsrucons.,er ceoomnuorer e rxeeacuaoen sor,a oer moe counmro or mee oaeraavonn o c,omauer reaae aarause.., arocessoro carr ou asecs o one arocessnnvenon. we unersooa eacoc oe or more emomens oeresen arams, an comnaons oocsneowc owcarusraons anorocmemene comuer reaaero arusraons anorocarams, cane comuneevc ceo,m suecera reauraosee croor mraam umn nnssrru euc vco con enss. caneerorme oneneraurose aarausorouce a macne, s , or oerrorammaeaarocessn one or moreroc ucaensrucons, wc execue va, aeasara, conureoeroermssorseuanc aorensaecmso sraerce connuereowce.a.r, an soorwoacre oarraemrmaoncen or rooccess.sor-emroecmesesnoers, e moeureesm.orearres oerneremcannenues o rreearrrea conure, ma comrse emomens, comrserocessor-memene mou oeren ma,n examememene moues maesrue amonees.unconsacs oerocessor- unconsacs oerocesso one or morerocessors.oreover,e macnes, weree ma r-memens moues maeeoe across a numer o across a numer o cnes maeocaen a sneeoracaocaon orsrue sorae meuem come auo caenrra reac reaa c oeoca neroo orrnas mm. ornes croumcounes can asoe soren a comuer reaae aarauses, anor oerevceso revces,rorammaeaarocessn moues.e comuer r carr oueunconacs oerocessor-memene moues s eaae sorae meum conann a orararocessor-memenemowecmaerno an arseecs,er oene,ra coomns,r osres se ans aorcee oero mrmaneua ocureenucnuconnacns srueccones wnce comuer reaomor auo eec sro rreaaa earam meeruooc mra o wmrno nscr ausc. resonsescreeren caneownoaeo a comuer reaae sorae meum. ecve comunrocessnevcesrom a eownoaeo an exer ona,e comuer reaaeroramnsrucons can aaer car or newornnae croamceuner eaecvc ceo omr euxenrnar socoerassenevecvec vea c aan ne rewcoerv.e newor reaaeroramnsruconsrome newor anorware comue comuernsruconsorermanen oremorar soraen a com r reaaeroram resecve co uer reaae sorae meum wne ommunrocessnevce. nsruco uer reaaeroramnsruconsescreeren cane assemer eenennsn,srnuscruocnso,n m-scer-oacroce,ecrumrewarensruncsoruncs, sonase,-s macnensrucons, macne or oec coe.e comuer reaaeroramn enaa, or eer source coeanuae suc as come ornerre srucons cane wrenn anrorammn e oec-orenerorammn eanuaes.n aon,erorammnanuae cananuaese.., anuaee.., “” or convenonaroceurarorammnnsrucons.e “ c”om oru aenr r ceoamaneaoronraemreons mruacoens us ceanoe as csomruueer rena aaneorrmo,raomr e exnavmronem aesn a. sane- caoomneueror reraama, meouroe,r saumronusrnuec, oor oer un suaeor usen a comun or on mu e comuers a one se ns can execue enre on one comuer newor,or exame o or across mu e ses connece a communcaon acae,ar onen us uesre'sr' cso cmomuuere ar,narar on one a u rseemr'so ceo cmomueur,e ars o ar s ean-aone soware comuer or server. e comuer reaaeroramnsr nre on a remoe ene remoe comuer cane conn ucons are execue enre remoe, e connecon cane m eceoe user's comuerrou an e o newor, or crcurn aeo an exerna comuer.n exames emomens, eecronc arras cu, on,u nomeo,rorammaeoc crcur,e-rorammaeaensru rrorammaeoc arras can execuee comuer reaaeroramnsruccoonnss.oecerrosonnca czrecuer e caencr uoncze c srcauern,oroma exoecnu oeuenc coomuer reaaeroram emomens o nsacs o one or more xamee ermeseonmnveennon. moues, or meca sescre erenncueoc or a numer o comonens,memene nsms. oues ma comrse eer soware moues orarware- r moues. soware moue ma e coe emoe on a non-ransor macne- ceaaaaee o meeruomrm ornn c aerraannsm osesraonon ss anna. maarew caorne-mureem oern areran moeunes aan e un n exame emomens, one or more comuer ssem a ceran manner. comuer ssem or one or more se.., a sanaone, cen or server or a caonoron rocessors ma e conure sowaree.., an a caon oeraons a as aarware-memene moue a oeraesoerorm ceran mecancans o ee rxsac emre eceron eemre caon. .mnen exsa,m aear emwaore-mmenesm,enarewa mreo-mue ma ememene comrseermanen conure ecae crcur oroco e emene moues ma suc as a seca-uroserocessor oro xecue ceranunconsacs or an a caon-seccnerae cc crcur e.., ae rorammaeae arramemene moues ma comrseem rcu .n exame emomens,arware- unconsacs.or exame, aenera-uroroasrerroocersasmomr oar oeoercro orr carmcumareoroerceosrsmor c.eran en maeeerms “caarw caornes-rmuceem,eneerma mnoenue” c eonncomureas,se osr aeamnoraer en or.ranasnoe conureo oeraen a ceran manner anoroerorm ceranunc r arware-memene mouesa areemorar c onsacsescreeren.nsanae a an oneme.or exame,eaonure nee noe conure or enera-uroserocessor co rware-memene moues comrse a conure as nure usn soware,eneenera-uroserocessor mae arwearreen-maremweare-memene moues aerenmes. romw oerarware-mnemeen meo muoesu ceasn.roevare,w reacree-vme, aenmeonre ex mcoanueesneorermna mon e communcave coue.uearware-memene moues oeran co a ma communcaerou snaransmsson,ornsance ar ncurren, connecearware-memene moues.ue orae crcus anusesa ornsanae aerenmes ma com arware-memene moues conurenormaon,ornsanc muncaerouemorar orermanen arcve e muea ee sorae an rereva onormaonn memor srucureso wcmemene moruwea mrea-mereomrmen aen o meroauone,s ana sveore accees osu.uor o exaam oeer,a oonnearware- evceo wcs communcave coue.onseuen, anoera n a memor moue ma, a somemeaer, accesse memorevc rware-memenenormaon.arware-memene mo eo rereve anrocesse sore ouuevces an can oerae ues ma asonae communcaons wnu or acneear onnormaonromenu or ouuevces.oearnuncaocnn nan reeeaaronns ae o su wn arcaneencea aows comuers acneearnnnvnsseweennus an ouus wouen excroramme. anazn, cae oves a moue comrsn aormsa maearnrom exsnaa consrucn a moorzenr,o omrraennnnaaeo maaa.eucre mcaconsne o-reaercnsnon as eoxrremssse o aesr oauers exame emomens,erannaancuesaaor one or moreen us.n or more oucomes,or exame waveormaa.ou eeaures an one w reseco aew macne-earnn aor exame emomens arereseneo oer macne-earnn aorms. ms,erncesreseneeren mae ae eescrea asa a snunevuoa a m meaacsurnaeeearrnoner a oor ame cnaonmeeno connsenere o aserevaeu.re, we coc can oeaures reaeoa o anneenen varae usen sascaecnues s nce usennear reresson.eerormance o a macneearnn uc asose casscaon an reressons eenen on coo aormnaern reconon,neeneneaures.eaures ma comrs snnormave,scrmnan, an srns,ras, ormae e numercaaa, caeorcaaa,me-seresaa, waveor s.eaures oenvenon maurer comrse waveormaa.ese eauremaa mancue, voaes,,c-nervas, werene caracersc one esrome voae ma comrsee,, or sna or an comnaonereo.n oerx eamooe e omoearmense,ase ceormenrasenssen euoson o onee or meaorre cseaarasecerrosmceea aureesas one roems ann reenererass,onerreo areemsw.o caasseocraeson or moacemnse, aesaorn renerrerooems: cass.caon roems, am a cassnemsnoscree caeor vaues. as caeorzaon cassn aormowo cass.n exame emomens,eaurrannaaeacesencue ae, sex,ear rae,, voaes,,c-nervaesoe caeorze ma eauresrome voae ma comrsee,, or sns, werene caracersc wc caneroveoe cassn macneearnn aao or an comnaonereo, caeores o,or exame, one or moreseases ors rm anenaceno auann an correan one or mor ease eooes.eresson aorms am owo correaee one eeaures.rannaaeacese reresson aorm eaures s or moreeauresno auanae vaue.n exame emomens, caraceuc as ae, sex,ear rae,, voaes,,c-nervas, werene comnarsonceerauresrome voae ma comrsee,, or sna or an or m eo caneroveoe reresson macneearnn aorm resunn one moere cnonnuous vaues,or exame one or moreseases orsease eooes. mensonan re onrees eexnamaoen,, suec ma acs an veeceaorrn,n o meaouurees moa or use emenorove aower smares.n some suaons,ese vecors c anzeemase o resecve arcuar vaues maecome ver sarse amoann aecaormee n muamssevre o.n vauee csasee. o., m a sasnsvee vnescaonrcse, o sze a v oauee a vmeocnors,,n som vaeunessa.nceecsa,usse n seuccess varec.ors m araecnecuo wor w, reucne emens aon we moearameers.n exame earnn moue canearne ear rae,, voaes,,c-ne emomens,eaures suc as ae, sex, voae ma comrsee, rvas, werene caracersceauresromememenen em , or sna or an comnaonereo, cane maeo vecors uze.m en meos.n exame emomens, emee semanc meanns are s ee semanc meanns are vaues o resecve smar.or exame,e samaencesaencwee aerne cwaoe voerccoars, snm vecaro.r smacee, mea semmancw moe vanauesocae esewere we anasso ra reurn smar vaues.n exame em ns cane use w smar voaes,,c-nervas, werene ca omens, ae, sex,ear rae,, comrsee,, or sna or an comnracersceauresrome voae ma waveormaas emee aon w aonereos emee.n exame emomens, roecons aone v corresonnenocaaarom one or more suec. aa can ecor comonens oe waveormaa ane corresonnenoca emomenes, usee menoasneoresnn are oneev oero meoreoesneases m oerannseauseo eroonos oes.en ve ecxoame exrac semanc meannsew r an ranne eena sace. suc as un exoamse emomens,e macneearnn moue canerane usnecnuesncremenansueaernrvnse, c,u srurceurvumsee,ar snemn-seucenrvsuee, renorcemenearnn,ranserearnn, occurs aer seecon aneveom s, anorearnnoearn.rann caearnn moues oeranen o a macneearnn moue aneoree macneearnnc m aosue ca use.n one asec,erannaa useoeace macne aa su n comrsenuaa suc as waveormaa ane resecveare ouu n on aen o erx maomrees eemaseos omrensease eooes. earnn cannvover , unsuervseearnnsmemene.nsuervse moue.e macnovn a or aoron o unaeerannaao a macneearnn erov eearnn moue caneneermne one or more ouusmcase onmemenee. uunearveseeeraarnnnn canaan.vonve anro evxamne a e omr aoomreonn, o suaeerveseranenarnnaaos aa mseac onneeearnronv meouae,e wer taen mnacanae,e aanrnne m ououues aereer emnenr ac ocnee or more ouus eenn one areemenoe acua oucome oerannaa.e or correce suervseearnn o macneearnn ssems caneo n some exames,aesorerannnu, ane se o rues a verne a se o rues anor a se onerences o a macneearnn mou nor se oaes mae useo correc suervseenar onnne c eaxnamnvoev eemroovme ne.n a, s oemr a-suorerovns oeraenarnnnaasamsemarenae.aem-o a macneearnn moue.urn sem-suervseearnn, suerv ee oron oaeerannaa, an unsuervseearnn seearnns useor arannaa.n one exame emomen, renor s useor aoron o unaeeearnn cannvoversrov cemenearnnsmemene.enorcemen moue an as te macneen a or aoron oerannaao a macneearnn receves a “r arnn mouerouces an ouu,e macneearnn moue numerca vaeuwe,a arn” sen maacnn reeseoanrnseno m ao cuoreresce ovueou.eo mcaaxm,zee reew naurme srnas a oe rewar sna.n aon, renorcemenearnn can ao a v ca vaue numerca vaue reresenn an execeoa oe aueunconaroves a sna over numerca vauesrove e rewarecnues cnm an oen. nevo exame emomen,ranserearnnsmemene.ranserearnn moue,en, a verovn a or aoron o arsrannaao a macneearnn aa.n errann onersrannaa,rovn a or aoron o a seconrann one or m eoxraem come eumnomevencess,. ares mrsacranneeea mrnacnn meoeaurnen can moeuree-srane onaarom comunevce, weree comunevcesneneo execue enroveo aearnn moeorouce an ouu.en,urne seconr ersrane macne macneearnn moe cane aonarane usn aaonnnase,ersranerannaa caneerveromerne an non-ernea arannaa, weree s seconrann oe macneearnn m a o one or more comunevces. moe usnerannaa caneeroroue anorersrane macneearnn suervseearnn.n aon,s unersomoer uasnsner eearenrn sueercvnseu,e usn csaunenrvvoseve, o onre s,ewmo-, reeer,a onr mnoreaara,nenr aanemns.asnece cane mea ccomneeeear.nne m reosuuenasraeneenrane on aeas moe cane uze as aeas one orane macneearnn macneearnnearnnecnn onuees e cxaanmnveov eemroovmenn, anracrneeme mnaacneaernean mo rnnsu mme.emene.ncremenas useo connuous exen enowee o erane macneoeue w nuaaa macneearnnrannecnues currcuumear arnn moue.noerearnn moue w rannaa arrane nn, wc cannvoverann e macnerann examesrs,e n aarcuar orer, suc asrovn reave eas e name suess nroceen w roressve more curann exames.s scoo. , cu orann aas anaoouso a currcuum or course o su a a mea-earnnn, o cnoem exramses,en emenoeram,enw,oeaervnens ooeeaarnrnns:mucemene.earnnoearn, or sowerearnn across manass.or exame earnn o a sneas an comrses o ars se oarame , a macneearnn mouesrsrane an macneearnn moue ers or we s.urn or aer oeraon o ersrane srocess occursera,vee oanramee seurcsc oerss w oees m aarec aneuseearnn meo mauce.nne aenaornen moue. an omzer, or anoer macneearnn moue,s use wer r exame, macneearnn moueseo an omzera consan ene ouu o arsrane erecnuesorrann te macnee earns an reurnsena resus. areosse arnn moue anorrane macneearnn moue n as s we. recons exormesese exa ams oeus, ause,r aeraranenn macasneeaesarneenn c momoueee canueeorroevroeucon comunevce were arane macneearnn moues no area rese a aerrann aseaseen comee,erane macneea n,n oer wors,o a comun evce.or exame, ars comu rnn moue caneownoae moue canroveerane macne n evce sorn arane macneearnn arane macneearn earnn moueo a secon comunevce.rovn commun n moueoe secon comunevce ma comrse one or more o man ac caon o a croane o maracnene meaarcnnne meoaruneno mroeu seecoone co smecounn comevuce,nrovevcne, acrocevssnoraenera mneac mnaecenaernnearn mnou seseomeo seceon sec coonm cuomn evce, anor oerwse emomens, arane macneearnn moue can un evce.n examemmeae aerenrove ers comunee uvse e secon comun evce macneearnn mouesroveo ce.n some exames, aer arane moue canensae e secon comunevce,erane macneearnn moue cane anor oerwsereareor useeoreerane macneearnn e urse a macene seceoanrnn com mouenaesvceee. ner,rec,enerae, oreer nrane cane useo ouu, esmae, resus. rane mne,or smc eseerms w coecve e reerreo as s suc,enu maaca canneeea ursnen as m aonuneu caon reeceravenen muacanae anear onnera moenerae resus. corresonn resusoerne comonens an non-er ueorrovn macneearnn moue canen ne comonens.or exame, aranerane macneearnn mouee craane rees euxecsune reso anseoroo renu oes os.enr s eoxamwaree. emoromens, arane macneearnn moue cane execue a resu aem exame, a rove resu onoe rea avaaeo moue canns e ex u eaxmon r ecuee e eumes ano. omre anccse, aer maaec unsenea ornnen or m moouree c aonmourerranreoce mssaocneearnn evce co-rocessors.uc on-evce co-roces rs anor on- moue anoreneraon o sors can see urann o a macneearnnrane, rese, an execueo resruovs.en re ssoumes o exna amares,curaarn ceom maucnneeevarcnen moue cane can mae resu , anor oerwse nusorearcuar comunevce. ear aa canncueaarom a comun evce execun arane macne arannne m moacuen aeneaorrnnnu moauaer coamn o unsee o rers muorse a csomnuuneevces.n exame emomens, moue can aso re onas resus asnu eac. rane macneearnnnuaa can comr soreneran new resus.n exame emomens, resusn ouuaa ssuec wa avse oonrem ora maor aen,s weaseens orrovseeaseo e aoraonees. macneearnn moue, orms emomensesrceunsse macerneen-.eaornr enxam aoer,nmesar raeveresseoen conemaeo carr oue aesan neworsor exame, nave-ae n ,osc reressono, neura newors asono s, ranomores ncunecsonrees, arov m wn as arca neura newors, marxacorzaon, aen ne oe , suor vecor macnes ,-means cusern ,-nearesearnnor ssem,or a c saussaen sa ors evcaaua manc onnee oera mrnonre aseoarsesm o, anor aeursc macne neareres rsease eooes.scan us os enoen enxa mmacen eemeomen,near reresson macneearnnsmemene. eween anneenen aneaernnnen voarraeec, s auc res aus wavreouormaea m aane omnea ocra mo rereaosns orsease eooes, resecve. smenear reresson eases varaex an oneeenen varae. r moe wouave oneneenen reaons o a smenear re eresenaon o an exame maemacaearnn aormre resson moe woue = mx.ns exame,e macne aevenr s varaons oeunn varaes m ano omze aneancues unconaesean avuann nna ae vaa. oraee ms cnamnzea oonmrozeem,oor eexname,e w om aa cosuncon. cos mnmzaonroemreosese omaunn varae w unn varaes.e rece oucome ane acua oucome. mnmzee erroreweene e suareerences n exame cosuncon ma comrse summn aoa numer onueweenerece an acua ouu vaues anvnem e o seec n veawuuesn ann resusne averae suare error. ma use,or exame,raen veasrceane mseo roesu.cen eex caomsuencraone,ne mesaccenn meeearnn moue evauanearaervave oe cosuncon w reseco o comrses an manue oearaervavesncae weere eunn varaes.e sn w reucee cosuncon,ere o coce o a newunn varae vaue varae vaues seec mznenear reresson aorm. newunn moue, a see orrauea neeaenven so one as s seeeceres.oo.ee ceonsnunc onon aen marcaneeneaersncenn caonee us ceos wunc ooner an aorramens anesc meno aurees w meennoonwennroue arou a.ore sae orev, macneearnn aorms an ma noe menone w n are acaeo oer varaes.ur meromeorse, man anave manunecveons o w com moerxe caome sarmsene onae. or moreneenenneenen varae maavee same o n oneneenen varae, eac aveer own one or moreunn varanees. or meo nruemunern o vanraeeens oenr ea vcar,a seesar aane,un ma varaes we unersooo one sene aroreroemen sove. n emomens, waveormaa are use aseneenen var n exame moue, wc, aerrann,s useo es aesoran a macneearnn e mae,or exame, one or moreseases orsease ooosces.e oscenre re os sns seon on e,xa omo ene co enmsoereme an,osec m reorees,son macneearnnsmemene. cassnormaon, suc as waveor sca usen macneearnno eo maano caeores suc as one or moreseases orsease wao meas.esooaese arevnanarome o aroasaoore usces a an m ouorceom coemroemxnouscaau.owever, exame a smouncon.n aon,e cosuncon cane a ncon,or resueween an.or exame,e smounc smounconm-xeo a x reresens somenear rere on cane oeormx=e, wereunn varae senaon onueaures anunn varaes.maro,e oe cosuncson o suec cosaunec reosnu are o oem cozseunccoan,vena vanraee reore ose snomaeo varaonnueaures,s a numereween an,reeraan on eer ns oen,raenescen ma asoe useno cosuncon se o..sescre erocess.n exame emomens, wa omzaon ans an exame oran ao macneea veormaa are use aseneenen varaeso or rnn moue, wc, aerrann,s useo esmae,or exame, one a meosreanseeases orsease eooes. macneeanw rn oo nnre eoxa mmaee ermeocomnesn,r aouaesaanesaenwnoreresncemroemmenroe.ass acrer uasecan mroae.s.ne ese,sn counneecaunres aree n moaese co onnaon aere ccone aconcaceraenenormne noes oe orm arecave moe.or eac connece noe ceseween noesone connece noesearne anorm eroa oenueaures resun e same, smar orer serecve mecansm.e noes ma comrse anoer.e enroa unconsoeermne movemenrom one noeo vensar neonses ous a saasesann ne awoocra area cronovornoaern.eensenro oers n aono-ressc reenans comuaonsnarer newor uce ere are mu s smneonsruon. wo are meno e meoso evauaeenerence, orreca,n au on roa o anearocruaerm aossnsnramevne our vaosueess.ore eacrs v maeraoe.nvoevoesn comrouan ceanon consereerouc o eac cononaroa an,n somensances, eoarm oarouc.e secon meosarov canonearo comrsese ememene wene same szesare. s a we-nown cass , wc can aorms an w noe o samesruon e assumoscusseneaeren. aes cassers.s assunm o coonnmoneasnereeesn noen cocrere oa voanraeewseeonrmsereenanssuoreave s a resu,e numer o comueroaess sncan reuce a aures. comuaon oeroa normazaon.eneenenceeween s we ase s assumon excanes reuce comuaon eauress rarerue, recons are reason soress accuraerecons,owevere raoranea m aacccurnaee.eanrn exnam moeu eme, womce,n as,e wrarvaenonrm,sa uase areo m easmeaeo oe or moreseases orsease ne anomo eooes. enseme onres one exame emomen, ranomoressmemene. consss o an e enseme oecseconsorenesreersoeucconmesnevuar ceascsorne.cecosnso.nreeesr aervanreconrom eras comrsn oe roo, noes, eesrances erancnowcar- noerom wceaurenormaon , aneaves.e roosersecson e eesrances conanenormsa assoenss oe aen ourocmome e oxe an nosee anrs saess oe eneosrmraanocneso. ee u nseex noore.oe ceaass nocaeso anre ase weerm asna re nroesessona an ousuecarecon.ecsonrees canearnn meos.rann o aecsonrees sen rane usn suervse ecsonree maecome over or une sveoerannaa se.nnvua moe.anomores come r-oerannaa an resun aoorrecve n exame e nsaes usn mueecsonreesrane onerenaa ses. macneearnmno mmoeunes,, w wavce,o armeraraan arne u,ses usoeraon esem naoee osne o oreecsonrees o a eooe moreseases orsease snra re ann eexns. eanmoo nes en em eomen,raenoosnsmemene.raenoosns a meo o verson o an orvnaauaaoan s cea.aor ex oam aee,c asoencrseeon noreee.nsernserara, aneree ws e on a moe acrosss noes.eecsonrees aoweo evauaeaaoe ua wes accurae.noerrees aeoe moe ane wes oe n noesa areess noes areen moene newreeomro corresonn unererormn erave une accurac oe veer accurac.srocessserormereesaseen reace.e moeas reace aenereso or aenem o uncon ss accurae noes areene eraen o aossuncon.oss wessn mues newereeer aerne saeeece suco a msn amnzeear oerroaaernm oceunocssonusn.coen. mno ae noe emomen, aecsonreesmemeneoeermne a one or n exame eooes anraenoosns aeoereeomr moreseases orsease e one or moreseases orsease e oves a o accuraeeermne euraew ooes. sascaeno ar or nnnes ex maomees enmuoencmeen,euoraoceaw noerurs arememene.s are aam orane on a reaveareaasee..,, o a newors oeran.s cane rec an ouuaeens on r more an useo esmae, aroxmae, or cae “ne aare numer onuseaures.s cane envsone as so- eecroncu sromnaosr, orc “”m sessseamess” o.nmercaonnecerocessor eemens, or “neurons”, an excane conneconsa carr messaeseweernooeo soc-aca neeur “onsa,sce c”on one scnoanscn neurosranasm carrer eeec srroennc “m oers wsaeaesn”esse owe aen “vneenur coonnsn”ec areon.rovee w numerc wesa corresono mans aaveonus an caae o wes caneunease on exerence, or moreseases orseas earnn.or exame, an oranosn one aa suc as wav e eooessene a se onu neuronsa canevennu re eormaa.enu neuron wes anransormsenuaa anassese nesuuronos o acerv naeeur.ons,e o acenv raeeerr oeuou a nse “uronenr”o nuecuerson as.ss reeae un an ouu waveormaa are useorane neur resu.n exame emomens,rann,s useo esmae one onsn a macneearnn moue, wc, aer onvouon or moreseases orsease eooes. na euoencoer s ae o nxeame emomens, convouona auoencoer smemene. convouona ouerraaor newaore arns an comnurs ses,nanoe enxerraac,weoau mreasn o come sonnean.s.rs,e auoencoeraearns a se o snasrom annu an reco econ, an comnnesewo comonens,e earnse nsrucse snano an ouu. error resun anmrove ouu omaersa mnmze reconsrucon exracona cane us . s areraneo onearners caae oeaurememen unsuervseeearnon r.ecnon exsarmuce eemnoum.enesn,erae co,n cvoonvuoounaon aauo auoencoers varaona convouona auoencoer.n exame emo encoers a use as annu snano a wc r mens,eauresrom waveormaa are moreseases or econsrucsa snano an ouu suc as a one or eeearn sease eooes. neura newonn r examnceu emno mmoreenas,erese o neaerunrnsmemene.eeearnn exanse avnree “macro”aers ons.eeearnn moues caracerze as emensorenu,: on annuaer wcaesnenueaures, aneces nonnear neura n e or morenermeaeorenaers wcnrouces na resus oeenerarmnseorameaaonesrsooeenreus,c anon.n e ax raemsoens eemaoerm wencs, wraavnsormse are useorane neurons o aeeearnn moue, wc, ae eormaa one or moreseases orsease eooes. rrann,s useo esmae ecurren osurneu er arna a eexmaemwo ner emoomen, a recurren neura neworsmemene.s are cass oeaerena euaon rse onc saeeueneaooaac oar nmeuera se nreeswoaras oo reecraaen.es comrseneracons oeumanran. save “memor rocesses an romrornusonuencee cu ” werene canaenormaonnus usner “memor” ornrreernna ou saue.normsa caonn.roceesrse varas meaen ass seuences oneenenrome ouus,e ouus o s maeeene umenus arenu seuence.eeersns,ex. "un n onror eemens weon sor-erm memor newor."amensacas o: recounrrennea nreuraen noemwenoar an: on.or-erme cass on asn eexsammor nee eom ovoercmomene, v aanosnn aonr-e erxmoenmorrasememene. are a eenencesecome morecuo caureec ns.n s,onerm cane wrann orucua auseearameers or wes eero no ecreaseso zero, resunn noe c raaneo.e wse occusrs or waernameeers, or exraoneenn exonenaonn, resunnare canesne wes oraram ancreases eenen one numer oaers an m eers.s exonena eecs vansnexonraensmeme ucaveraen. overcomese “ces” comrsereeaes: nn “ces” wneenaers oe.e error conron reevan annnusuoa ue,a ane oue cuurraene, c aen a saoer.eea oeu.uenuae reuces conron reevan memor conenner ae reuces error conron weerr esen en sae.eoreae reuces error unconsoeermne woer ceer seaeas aare canuanss “mermouor” oeroareso.en.eeaes use acvaon wou reconzee use o an reevan acvaon one sene ar smo,an, an .ee uncon, exame acvaonuncons are srucures."nernaonaonerencue, onaoacan,ne e aea.rn "non. sor,-erm. memor over recursve onvouon a cass ona asne u eu rxraame er aew e emmoronmeon r,e a cconvouona neura neworsmemene. ss vsua corex. roce aeeooca neura newors,u oe anma ca comrs ssaa w araernoearn saaerarces oeaures. anoonaers eexs oracreeeaaureesr,s: s cuocnvo asuoons,eooesncr, aenuere connece.e convouon comrses o mue maemaca oeraons n.e convouonaaer en a convouon.eu c suc as onear oeraons, a secazeenuaa, suc as waveormaonan,e mcaeea reerr ceosmenenesn ae erxr,ac.ee., anea arurresno an ouu.e oarameers, cae aerne, oeraes as an o a o numers.r osonner.xraceeau mzaeeaure exracor ans aeo eac s ouuno res maecomeerarcca more comex as oneaereesn r eeea nmeaxsaae,r.., e aonvouona neura newors: an overvew an acaon aarxooac.ornssman,– . macneeanrn enxaamon exeo emsnoermenen rse,aoanrsxsaceorwzeaenonwos ememene.arxacorzaonoeer.enera,enueaures are mae nesrawn ou wen mue conanne reaonseweeneeauo a marx wcs mue w a marx roucroveserecon.e res an arece oucome.e resuno rououe marx.n marxs consruce assnn ranom vaues conan s exame,worann marces are asseme.ers marxnuesaruarens.nrnsueeaourerso, aunc oe sec aonn m aarer cxom counean asneen sowunar ouu oerann exame meo, oe resus esmae.e v e mean error, as one reeaen araenescen se auesn are mouae anerocesss marxsen usene macn aeearornacn u mnoee. enrr eoxrams aer eomroaeme mnsn,m wazvee.ormearaan ae useorane reaons marxn a marxacorzaon macnee rerann,e reaons marx annu marx, wc com arnn moue.er waveormaa, resusnere rses vecor reresenaons o eooes. con marx comrsn one or moreseases orsease enar avanae ono evxeamo saee s ecmaoamreonvs, m aoeeonrearcov an m oouecomse.memaernoev. mn aes arovrocess, wereneroa o an oucomes s oe assumes a ne case o ,s assume an unn oeeenen onerevous even. even.n comrses a newor o coownnne ocr “e noene”s. saraevesrseneneen ne owno sormes oeseernvaene onroaree m.oee saarramroeears: sars a vraoraaea soaveernrsa,nsromoneronau noees an oservaon consecuve sae.romere eac noeas a saer ,e mosause saeransonroaes are soren a ma ansonroa o noe.cae eroa o saeranson rxi werene sum oe rows, reresenn conanneroa o no sae, euas.e oservaonroa s a varae weeren,ereo ouu o occurrn.eseoo areca soren a marx sa o ouu oseenen on sae.oue moearameers anraon exame, annuacev aen a oourum.roexa,ee ssa aree s ceomuenucees. are rsan caen oen acrcoomase w,or e accomse,or exame, weer aorm.na,e moear, wc can mouaeo maxmzeeroa o a ceran seuence o o ameers are accomse w aneraverocess werene n servaons.ssca roaes oe sae seuences are me eoroo o saess exore,e roaes oe sae seuences.n examasuere em, aonm meones, waarvaemoeremrs uaaa aree usoenocreraasee noessaes oe macneearnn moue, wc, aerrann,s us ne or moreseas eo esmae one uorecoes orsease eooes. aano cnas er sxesamac een n ee emo nm-enmse,n ssuonoar veceorr manaecsnne-s areememene. s searae reresson an casscaonroems.era rane an are usenorannrocess o an . nes areecsonounareseveoeurne eaures.or ex emensona o aeraneeens one numer onu we a ame, a wwonueaures wave anear-mensonaerane eranes o wmzereoeanveueeaarureess m warnav oer s aaaanersan-cemreonmsonea neareseraaaneo.n uosre eaocevaeaoee.neer caansee. oo swmeveer, wneeanr reereesasuornes an a casscaon anear euaons escreeerane.ernes aunco re more comex aernes useo mensona sace.erneunco naransormsenueauresnoer aussan raasruonunconns, c oarn semoneaar,.no exnaommae, e am raoamenssr, wuavoenorumncaona aorr useoranenear euaon orerneuncon oe macneearnn mo e aerrann,s useo esmae one or moreseases orse ue, wc, -means cusern ase eooes. onsavenm onec exa smaree e cmaroacmeren,-means cusernsmemene. assumesaa cusereaaon scs an “cusers”aa wn a cenro or “mean” oe oson aroun cs.urnrann, as a numer o cenros an omzess ranom,s re-osuosneers.owasrsrocees asversaeeraovne, o w ae creus eaerc. censroroc,essn caosone a cenrosave reace an omaoson wn a cuser.r oncues wene unsuervse.n exame emomens, waveorm ann o a mouesca macneearnn moue, wc, aer aa are useorane cenros o a eooes. rann,s useo esmae one or moreseases orsease -neares ne saresn s omneo a er rxa cmaraec eemrsocsmoen,-n.earoers ex naemeo,rsmemene.n aeneraeve, oer sare smar caracerscs an assumesaaons near eac smar caracerscsu comuesesanceeweenaaonsoen ose reresensow man nsea o cenros, uses numer o neors.en roer v neors w assn aaaono a cass,or casscaon, or oec o .aorue e,xaomr ree,r aessarone.e meac roenu oce a rnan aomro errraore a nsusmocer osneraoe accuracncrease errornorn smau sncanere ae w varanceneaau os seeceoaance over ncesneaa.ereore, a careu coce eonso some cass orro n an unern.oncun weer someaaon meoso com er vaue,esanceeween neorss comue.ommon emomens, neueorss asreanceve anre weucseane,enannaa onn orea nmemnoro nsamanec aeeow. scnae somee s nemarors oew aneoene nre casso.rsno on ree euxcaemee e ermroro o emene, neso arns o a onaer cass “ou-von” near uze.n exame emomens, waveormaa are useor ov moe aroacs moue, wc, aerrann,s useo esmae one or mor an a macneearnn oerorm one or more osunconaes,eseases orsease eooes. communcae w one or more oer ssems.o e macneearnn moue ma e macneearnn moue w one o r exame, anneraon ssem manerae or oer r more ema servers, we servers, one or moreaaases, commun scearvoenrs,e swseeemns a, u osrer re anosoer mesa.cnn aeearonnn, on meo our me.oreunconaes ma reure e.., one or mnor oener oorce msosorers o o ae c momouueesrmeasccrnee orer ae cnom manaeomn oemaernwe usnarware or exame, an moueescreeren ma conure aar are an soware. or morearwarerocessors o a warerocessore.., amon one moue.n some exame macneoerorme oeraonsescreerenora comrse one o emomens, an one or more oe mouesescreeren ma escreerern. monre ceraranwa erexamroceess eomrso anme mnas, oene con or muroereoarewroarremroec oeraons conureoncue an one or more oe mouesescreere essors are an oreover, anwo or more oese moues mae comn.neno a sne moue ees.unucroenrmsorees,c arcceornereon vaorro aus s , mou enxame meo emueo mmaense, m suouvesees acmon mue enmemene wn a sne macne,aaase, orevce maesrureeren as macnes,aaases, orevces.e mue macnes,aaase across mue communcave coueo enae communcaonsewe es, orevces are orevces.e mouesemseves are co ene mue macnes,aaases,o eac oer ano varou mmuncave couee.., va aroraeneraces acaons so aso aosaa sources,o aownormaonoeasseeweene xameom we acaonso sare an access commonaa. .unecesvce accorance w ceran exa amoecaram o a comun macne an a moue no, remoeevces, wor saonss., seerv ceorms, cuomnu mearcs,neenera muaro csoem cormse,ueurs a,ren neornemwee a moaences,onaens,-eersoneavces, ware aessssseavncses,oras,e smeavrces, woneeasr,a se comuers, ceuar or uraoos, neoos,aos,esos, mu-rocessor s mar waces,aes, rorammae consumer eecroncs sems, mcrorocessor-ase or an an macn ,ame consoes, se-ooxes, newors, mn-comuers, morearwe caae o execunensrucons.e moue ma comrse one or erormnaree or soware eemens conureoacaee comun macne n macne m varous meos anrocessnunconsreseneeren.e comun ss ancue varousnerna or aace comonens suc as arocessor , neweomrunser, ssem memor , sorae mea ,nuouunerace , an a an emee ceac o ce nomrouer,nor a m co aamcm onu ,encan a serve mr,a w a moe am new eemorene as. a convenona comuer ssem, a rouer or oer newor noe, a evce, a smarone, a se-oox, aos, w aee vecuarnormaon ssem, one or morerocessors assocae mucvseorne,o a. cuseom comzeu mnac mnaec, anne oer maarwear aeaorm, or an comnaon or uncon usn m srue ssem conureo e oune oe comun macnesnerconnece va aaa newor orus ssem. eror r morerocessor mae conureo execue coe ornsruconso mamns, aen oeoraeornosrm an cacuunacoonnsa aneesncerraee coemremna,n ms.anauce r ceouee osrnoswruc an aressncue,us nomeo,rmware, resen soware, mcrocoe, a ons cou mae conureo monor an conroe oeraon oe comnee.erocessor macne .erocessor mae aenerauroserocessonensne comun murocessor, a reconuraerocessor, or, arocessor core, a an acaon seccnerae cr a mcroconroer, aa snarocessor“”, rocessn un“”, aeroracmum“”,ensorrocessn uns s, aracs “”, a rao-reuencnerae craeae arra“ ”, arorammaeocevce screearware comonens, a cu , a conroer, a sae macne,aeoc, ereo.n exame emomenn oerrocessn un, or an comnaon or muc comuer mcroro s, eacrocessor canncue a reucensrucon se rocessn uns, a snecroescseosrs.n ceorreo,c mesusorero mceassne c ao srens, seercoacessunro usen,ro mcuessne cores, a coon-r wocess oorse,r o corm anon ceonms onaeon cereo.ccorno ceran exames,erocessor macmne m eexmecourn wn one omun macne mae a vruaze comun sse or more oer comun macnes.rocessors are coueo e s anse vmarous oer comonens va a ssemus. memo memor mancue non-voae memores suc as rea-on on mrem“or“”,rora”m,maase r meaem-oorn, o mrem anor o“erev”ce, e craasaaee oro sraomrmae rea-nsrucons oraa w or wou aeower.e ssem memo nroram voae memores suc as ranom-access me r ma asoncue “ ”,namc ranom-a mor“”, sac ranom-access memor access m ccess memor“ ”, an sncronousnamc ranom- memoremor.“e s ”.eres o aso mae useomemene ssem mue mem sem memor maememene usn a sne memor moue or comun macorn moues. ee ssem memor sece asenar oe e searaeroe, one sene ar w reconzeae ssem memor maecnoo. sme comun macne wouearnrome scoe oe suec an canou asoe arecaeae ssem memor s coueo ssemus oerocessonrcue a anaosrc oneruaeoun cuon sunscemon w, a, n won-cvo caonero sso ceranascuncons sorae me raeevce suc ase un na exa.m. rea emcsormoceensss,ne un comuns aevce ncues aracsrocessn manuae an aer memoro a secaze eecronc crcuesneo ouuo asa cceeraee creaon omaesn arameuerneneor c eomecuveerraanecnser a. ann -ume rane osera er,o acesssra onr a acnsro orasce m assn un s werearoracesesn ssru e ocucraeena a m maaensu maonre onenarae reocs oaas on memore. “ sora-e me”,a aa ma versnacuee asca“rs”,, a aou-rs, a comacsc rea as memor, oer non-voae memorevc asc, a manecae, a evce, an oca soraeevce, an eecrec,a a so sora saeeervvcee,“ an e”e,c anrom maanneecc s soorraaee neovn-cree,m aonva seem mceonau,c anor s ooreareaeav scoer,a aneevcsec,a or- aanse soraeevce, an removae an non-exausves o more secc exames oe comnaon or mucereo. eoown: aorae comuersee, a comuer reaae sorae meumncues on memor , an erasaeror ars, a ranom access memor , a rea- a sac ranom access memor a,mmae rea-on memor oras memor, aa versaes , a memor s aco,r aaoe comascsc rea-on memor - , asunc-cars or rase srucuresn a , a mecanca encoeevce suc aa soraeevce rooveavnnsrucons recoreereon, an an oer one or more o, or an comnaon or mucereo.e sorae mea ma sore aa, eran ssems, acaonrorams anroram moues suc as moue, comu or an oernormaon.e sorae mea maear o, or conneceo,e comunn m maaccnne .e sorae mea ma asoear o one or more oer aaase esa aren communcaon we comun macne suc as servers, sorae m seervuemrs,, a cso uuse soerraene,, nse noworo ae caocnseru seor aase,e annr saonsoorr. sn comuer reaae rao waves or oerreeroaan eecromanec wav aser se, suc as roaanrou a waveue or oerransmsson es, eecromanec waves er-oc cae, or eecrca snasransme meae.., usesassnrou a as an oerane m soseume, con murae coomacrsea oene oer c mro omoure a uanr wwre ma. arce onre sowar we eemeens, as we varous meos anrocessnunconsreseneeren.e moue rormne more seuences onsrucons sore as soware orr mancue one or memor ,e sorae mea, oro.e soramew maren assocaon we ssem exames o macne or comuer reaae mea o ea maereore reresen execuonerocessor.acne o n wcnsrucons or coe mae soreor meum or mea useoroven r comuer reaae mea maenera reero an reaae mea assoca sruconsoerocessor.uc macne or comuer oe oeran sseme we moue ma comrse a comuer sowarerouc.ac aa or , one or more acaonrorams, oerroram moues, anroram sou somee a comrecnaaeonae are coom, muaern scouwear aenrmouecme cnomaorns on a nee mwooruen env mroanm aenso. coem assuocnae ma wcne one or m voareero nceeswsoesr or me,o ans sornae-veearrnn mee moumu,e or ano oe communcaon oreverecnoo.e moue ma aso comrsear ernormaonor conurnarware crcus suc as m ware crcus or an or oe crocoe or conuraonnormaonor exernaevcees,nr ou rou.u“”nerace mae conureo coueo one or more or more exernaevecceesv.eucaa exroemrnae oenvec oers m aoorne ex wernaee vvarcoesu, ano senaaoe one enown asereraevces.enerace m snernaevces ma aso conneconsor counn oeraone var ancueo eecrca ansca orerocessor .e neraousereraevcesoe comun macne aresses, an conro snas ce mae conureo communcaeaa, rocessor.e eweeneereraevces,e comun macne, ore suc as sma nerace mae conureomemen an sanarnerace, erera com coomnenuern serscoenmnecner“ace”“, e”x, sreesrsa-aaec,e seraus,“ara”e,use,r a canne,ecnoo aace“”, sera “ ”, unversa seraus“”,unvance rere, varous veouses, anee.e nerace mae conuerro,memen on onenerace orusecnoo.ernave,e nerace eo conureomemen mueneraces orusecnooes.enerac mae conure asar o, a o, oro oeraen conuncon w,e sse e maenerace mancue one or moreuersoruernransmssmus .e exernaevces,nernaevces,e co onseween one or more e nerace mam couune maec conmeun, o mracerocessor. evcesncun cursor conroevces,oucsc ne o varousnu recevers reens, scanners, eecronc zers, sensors, onn,eovucces,a ors a,nra ccomans,a coamnseraes,re mo.croeones,n aeraacneumerc manuevces, an oer macne o varous ouuevcesncun veosase c couee comun urerncue aracssa,or exame, aasmasaanomunevce ma oeresas caaa, ae ous crasansraacs or, a e , a emn o vreooe,co aru, ao caeoneera raonueevce,,r onr aenrs, arnose,c sooresn,oacs, veaveees,aucmse,vrcaenss,m auoemaon conro, rooc comonens, acuaors, moors, ma couee comunevcers, sna emers,s, an soor.enerace a sorae un.eevces o varousevces caae onu an ou, suc as aaer, wcr ca canenerconneceoe ssemus va a usernerace a snenenncue,or exame, auer cneran mueevce aaersno conneconsea ro ceoum crucu en. n mewacornenerac mea oeraoe onne a o nre mwoorree o eenrv srosnmen usnoca macnes acrosse newor .e newor mancue aoc ems or comun a we area newor“ ”, annrane, annerne, a area newor“”, newor“”,ersona area ne a moeeeone newor, sorae area wreess newor“ ”, wrewor“”, a merooan area newor“ ”, a a vruarvae newor“”e,s as c aeccuesasr n oerw oorers m, ao were ceosmsmoucnac aareoan n neewwoorr,“ueo”, neare communcaon“”, ura-wean, wre newors,eeone o, newors, coerransmsson caes, or comnaon newors, oca arcecure or ssemaacaese commu sereo or an oer arorae maeace swce, crcu swce, o anncaon o snas anaa.e newor rooco.e newor ma comrse r ooo, an ma use an communcaon ee servers.o ouers,rewas, swces,aewa comuers anor communcaonm mmeunac saucon anss wer once n ceaweosr,ree-s maacen ovocvse, v waraovuesuesa, o ere acnao conucors, wreessns, anennas, rao-reuenc commu rca normaonoracan reae communcaonnsca caons, an soor. acemessae seuencnnormaon, enc nerove,or exame, asnormaon, anransmsso asuaoneaers anorooers, szeme anorar cec va n vercaonnormaon suc as ccc reunanc cec s ues.ommuncaons cane mae encoeencre, or oerwse mae seuccure a,s, anuor noecrmeeoe,coaea usnncr oneon or maonrea crrora,cvarnocoecosn acnroro anorams, , aves-amr-eman aorm, ae-eman aorm, a secure soncar rooco suc asecureocesaer orransoraerecur , anoreas ornna aureonooromsese.ereenr cor secourrea ancreonoceocrs aneocro aeo crommmusn cacnaoen usse as we erocessor mae conneceoe . o oer eemens oe comun macne rere varousererasscusseerenroue ssemus .e ssemus memorr ceosnenros oenr,e a or meroree ora anus o, a snev aecrcaeeraees oraus scrucures,ncun a memorus or usn an o a vare ous arcecure sor, an arocessor orocaus anarrcecure us, s.or exame, suc arcecuresncuenusr us,eoecroncsanarscrsosocaannercecure us,nance nerconnec us. soue arecoaneaocaus, anereraomonen rocessor , ouseerocessor, oro.cceor ssemus mae wne rocessor ,e oer eemens oe comun no ceran exames, an oe scusseeren maeneraeno a sn macne , ore varousereras onacae“” eevce suc as a ssem on c“”, ssem xam, or evce. anusraeereesn, m waer ceomnrese co am coumeruerrorraomrasmmaem emenoeens ae comuncueorn ssseesmcre comrsesnsrucons soren a macne-reaae meum an aroce ansrucons.owever, soue aarenaere co ssora execuesememenn examesn comuerrorammn, ane eue man eren was o meo an one se o comuerroramns xames sou noe consrue as aeo wre suc a comuerr rucons.urer, a serorammer woue one aeneow caoramomemen an exame oescose examesase scosure o aarcuar sers o anro asrasomca coeenesscrrucoonnsns noe c aonscaereon neecxe.ssarereorore, aeuae unersann oowo mae an use exames.urer,ose or an ar w arecaea one or more asecs o examesescree nar sene arware, soware, or a comnaonereo, as m ren maeerorme ssems.oreover, an reerenc ae emoen one or more comun asenerorme eo an acenerorme a comuer sou noe consrue e exam ae sne comuer as morean one comuer maerorme ac. erorme meos ansesrcorceessnereunn ccanonse useescr we coemreun.eraer swsareem asn, m soewoasre, ana sorocwearuer,es orescrae cercreunr ca.nee e smoowaere cna anreo sraomrema oe comuer, comuer-execuae exame, comuer-reaae mea cann n comuer-reaae mea.or mea,as memor, memor sc, ocacu me ao s, , ,ars, removae crcur canncuenerae crcus ea, maneo-oca mea,-, ec.a arras , ,ae arras,unococ,erorammaeae comunev “s e ceercv.er” m aa comrse ascaaarocessn ssemor exame,e ma nonc s sownn. runnn a serverroram. sca server ma or newor,o oueer a comsuan aneveceso.arer.vers consnceace ser vvear a m naewoer co mnanec oeer,aor exame a o a server macne or a cen macnen a server-cen n ene caac macnen asruee..,eer-o-e ewor envronmen, or as aeerncue cens’ servers.or exame, a ceren ne anwo srerv enerv craonnmee rnem.oee croomm euacn oeevrc aenn can rou a newor.e reaons o cen an server arses vrue o c erac communcaon w eac oer, runnn one resecve omuerroramsn euresreese enxaemreev sosusems a,re meusoras,v ane, n aocsneenscer coemu oeners exe. exames anescren mn.n aernave exames, ceran acs ca ausve, an no meanoe one anoer, ome enre, an neerormen aeren orer,narae w aona acs canee or comneeweeneren exames, anor ceran urans rorme, wouearnrome scoe an sr o varous exames.nsance.arnuccesur mesa anmunecmeonna comaon menas, a oeeraar aosn sse, oarra seruncuresescre as a sne ememene as a comne srucure or comone exame emomens ma ma aear as a sne comonen ma n.mar, srucures anuncona a suc aernave exam ememene as searae comonens.ccorn, accoreeroaees arencuene scoe oeoown cams, wc areoe eren was cosenosneser exreaanoneo erncnocmeasss o suce e ameroname eexnasm,ees.racecearm anooca useecncamrovemen overecnooesounne mareace, oro on or sne aro unersane emomensscoseeren. enae oers o ornar usraveuurroesres em ono amnen arse n aroenuesnraeeonmeoe socwone oxaemnveesn won.c arevenor xsanme c- -rcaneencenaeasscaon oeenrcuarerro nrouoenaecrocarorams erenane a vmenonrcu caarracersroeases s assocae w averse carovascuar evens. ronoases.ercan assocae w smoranorreamen an ac eence enae anass oe-ea eecrocaroram ma e au voemnarecuaeecon an casscaon o . a rerro sene asncreasee venrcuar mass ans csasrocoavaescu wars ceaarsesovnacscuuanr morerenso ann mora. s cause a secrum o carac amooss, amon oers.scrmna, anor acm soennos eso,oeersr oonccre caromoa, an massasmoranmcaonsorream asee venrcuar eeearnn moesave seonwn anromrosneosns. erroncun carac am cassn eooes o venrcuar eecrocarora ooss an erroc caromoa usn-ea w mamascaes e.ceveenonan mosose asnare caamnen,e arennaoee caracseases assocae venencrease avaa o moeevce nareven mor . a accuraescr s caae o recorn sne-ea s, moes scaaeeecon omnseaaese connaroenso assuoacaoens. wcans o snou sneo-eaevs ma enae moesoeec an cass caracseases eoeeearnnea a a cause usno-ea an sne- care, casa. nns aenaree r cearrosovecascvuea sramseaese osna cvauuseas recenvcnunon cuna caroo erroc caromoa, ueoerenson, arac amooss, ueo oer causes. cans as ueo aorc senoss, an aeoo-ea an sne-seesasee w exaveenorom waca c aoure-eraenceee anearnsncrm monaee a amaonns e aoeronaevse o moes. uzncan srsu ccoumreareeaae,r aonrmaoncrea oeeeearnn moes anosn . cans aso evauaeoena as ona -ase ruesor recons an cnca oucom socaonseweeneeearnn moe eos es. receveonuunaam ameu -aor ccaarnsooen caere a au a muae-nnss aueona aceaars or oer wo ssemasseneraram. cansene, aens w emceacare caroo cnc vss-ears aar occurrnewe aeas onear o rane o eecroncea recor aa en-. cans coece aroa narrave noe ncunemoracs, anroomercs, va sns, resus,aoos,a reooraros,r an resurocse, murea acnaonansoss,c ra amoonsr an carooanosces escre. cans reeroe rerose aven coes asrevous .oreresen an cveaase asenerrseareouse oaroo ,aens eeass,aens wou an n=, were excue, resunn caren a mu-cnasnsu’ so ournc na sau emson aeca wraesur see sreve.romaens recevnonuna caroo reosor. cansene mneo a common eecroncea recorncun carac am aens w caracseases assocae w n=, n=,, aorc soossn=,erroc caromoan=,,erenson anaoo reoresn.ossn=cans, a asno oener caeus aes rene=re,nceroruou o r reemvaew o caracman ecocarorams noemonsrae n=,. cans nnaens woserane convouona neura neworo use auc avaae,re- waveorms wne s erve numerca reresenaons o-ea no on a u same. cansen reresse secc eooes reaveo an esmaee, seex a,re ana unee nrumeer reccaever o reeraresnen caaorns usnosc reresson‘-e’ vaaon same. cans asoeveoe acersc curve n aoou ‘-eea’ an ‘-ee wo anaoous sne-eaeeearnn moes, aarom one resecveeas.ac’,an us czomn raerereseenaeroonrsmaenrcvee oroem- weav meoorems roae a,enrnearvaves, m anoes a omn au aees,, s aenx, an c snacnaaruanave eauresncunear sceranm -ase ruesoranosn . cean anasscaon ase o nseneoenaaens w caracseases assocae w excusvne c canecaoreas onoses, ca reraaecmaseanse,s anor aa aonaoaa. cans esase muua carac amooss an er ses.sceranmen an aucaon o revewe roc caromoa anoses wereerorme a cnca errro.ca 99am cranosmoenae anoeanraacamenoso wsss ccaerraacnm aemn aonossuca scorenen eoconeummocraoraosaoes sc,naraa reoosrs, aonr cearermacs ‘ ecxans, carac , ann sne su auor unneoe screenn ono re’ an ‘amo’. aen waseermn resusen manua revewe eac reor. eow crera:ocaraos ore caro caacrr ex aananoosssve oo cra armaco amaoaossoasseo osnvee e 9o 9cmro a ecm caro neoumra amn an roar ave osarcaenerv ae scnaennrocsucar o sre saron an sousereosrv wea o ccarneascs amo cmos osn canseneareans wanosercro o cacrac amooss. an manua revew o carac re caromoa o a screenn reor ao ors an eveomen o an auomae ecocaroram ‘errorc cma.rommaoraoe’ a anov ‘e,cm’.c sannse srsu scr aeeuneor carac u reorsoreerms resusen manua revewe eac reo nneoe screenn erroc caromo r.aen waseermneo carr aanoss o erroc car a e carac wasanosc or sron suesve o caromoacao anmso nos aa esso. romev eecoocear aonra amuo remaores aormo asceranerrocn a se o ranom same ecoc .e auomae aorm was vaae emonsrae a aroram reorsn aneason a su auor an . osverecve vaue o an neaverecve vaue o .eeae ae et e.oorn-aseensavseormecescaracersocssverecveooea.ve e vrentrcuar vaue vauerecve troreort
Figure imgf000059_0001
. aam reors were rev m aenewse wooru ea acanos eso oo. o carac amooss orerroc caromoa eooww.n aucaon were s consereorncusonne ecocarorac caeores errouc car avoamaoa an areanosc moa sourcesor carac amooss an ae.uvaa noreesenneanmaees-. -ea eecrocaroram ervaon same.:, aaon same:,
Figure imgf000059_0002
ae.anoscoaourceoxraracmoossnervaoname. x oamra ecac: ne amumoorosos
Figure imgf000059_0003
99 saae scnra , an carac s or.aaosx, ae.anoscoaourceoxraracmoossn aaone. x oarra oac: os amaeo sconssraa
Figure imgf000060_0001
, osx, 99mecneum ae.anoscoaour acne coarrace . e rrocaromoa. carormrooac : • • :: : • • ::
Figure imgf000060_0002
ac caromoacnansenecnueon o anv reuaarses ws o ec carocaarco amraoco css an erroc eoenamerec sensv o ecocaroraor nesesreaseersao,r.ouven e ccarocoamrorac seeeow was no reureor a carac amooss orerroc novauas wanoss,erroc caromnovaua mse w ec carac amooss, an anoss. ocarorac creraroro caromoaoo,wncaenns ecvaauoane oen revmaunans wnv cauraasc w am aoroors esc oorcaroerrroc en ose w ecocarorac ure. ca amo a srn-macn ao nsene ecocarorac aernaveenon o an averare comm aneeo ecocaroram reorsae an an mm. cansurereneaennevrveunarsc wuar sea anoseror wacness eooerarcca, resunn muua excusve caeo erceso:caroraueco e ‘aorc senoss’, ueoerenson‘erensve’, an aoureco s anenooss cause‘oer ’. cansrs assesseor aorc senoss ene as a concurrer anoss o moerae orreaer aorc senoss on an ecocaroram w .oowenn enerecnasvoen onevneua ass w ecoc aaorroc sraenocss w, arcoarnsaneonss oenevreuas w asene caracerscs.nvuas w ecocaror nsonsee aorc senoss orerenson e ac a no mee creraor an remannnvuas were caeorozoe as w “enroerou”eneoae a ‘eas o eecr’oc caareoorra.m rnea, avaaea reoreooseror wacness annervenrc or no mee e uar seacnessu cucsocarorac creraae. macnesmouon es same ans wereerorm aen acucrensse ro vuanee cnca caarreooneoarmcare semaaase oasseneraram eacare, “ ” sowar aon .. waveorms conan ame seres o, v e versons. an same a , or z ooare a measuremensor eac oeeas excuease on samnreuen seconuraon. s were no were excuen=,ure.ce.s masasnase an ccomuees aeuo-mseaceon anracnscoran ea-ecneera anosc saemens,auar measuresncun axes,n e amues, an raw waveorm ervas, anea-secc voae cnca rue s.maroror sues, anoacae comarsono comuer en sseeeow, cans aona excue s w scan or n=,,eurreeanoses o eecroncaace rms aneunerancoc erroc carcaonmso seaece or c aanrnace axmoosrsoma enaocss,n orvua cosesoeae o ecocaroramemonsran .ne cosesoeae oe eares ecocaroram was use.serorme ca mseor oeaen “oears”r coareoo,r or,eaaes o aere eaeraes oanoss or ecocaroram, were excuen=,,ure. e ncaeau .aener a,e e se wxs,ce a rsarcaee,nmeen, we, an ssocooressure were asceranerome we, an ssocoonrees aeme oenex .a snaancune, oenex.nerenssurvee w uesree w aasscereaenrmenerom va ae m ceosecsaons enrareor.oeae ae.n- nazern-ereen ers sev ene rsvecaons. e en mee ncamoonsne e
Figure imgf000062_0001
ernnearoroeae oenex, an revsonanoss coes.e onaasscaon oseases, rovenae. nonsor cncaeaures usene anass are eanotee. toneecaaactao coresenons.
Figure imgf000063_0001
u t t nroot seta,tea ase utensc to wnttro u reena, maaneteessta wtotns r,en ta we manuveestnateons, n
Figure imgf000066_0001
aaacueettaeerss ett otnseareecteaseetecatunestec ctoemtnnoscaaettcone,te e
Figure imgf000069_0001
eaetu,e etaree nteosntrearveteeeonroaeertaetsve e oot
Figure imgf000070_0001
ecc aaatesseettuussttaaeettcc moononneeuuroroaatt,,tteerr or
Figure imgf000071_0001
w , s euuusseeentuueenntt e neovna e-teovna eteovnaton moc marocaa mrnoaacracnrtoaarnct onon oatr ocetron ass
Figure imgf000073_0001
arettcetreorrossc weartsosssorac outm osten wetret co s orotanseamrr,o arrmtteserr oosc anearsonssasr oaectt oostre ws,rt coronar
Figure imgf000074_0001
a wnt ce crtreornonsncvceenaneret ansseea cassere,o un stnacseecne oer e,n wseat utn resenaaertc we a,nt o
Figure imgf000075_0001
...,, ...,,, ...,,, tseeeaursme r,ate uuncms taetcc aeor,tct vaerv reeusmeaastecs, trcueusmat vca avoertcs veaasvese , ..., ., ., ...,,, mttrraao,t aonrtt tr crraccuussn vaoarvtveces,saeaovsmees,, unneseue rmceautemca,tcsoerusmerastc
Figure imgf000076_0001
.,,, ..,, oseneuramseeaust, , mcesu aenmasaet tsrc ocus eunto vceaarveausm,ve,t vaesrveeas uene,usmenacstceec,e, nvoanrveeumroaatatccs m me,ttrraaon vravaevuevmeastnocsru mertsrc,aenovcnar,veeuomn straetnecousmsa,tct mertra osonrreer, unsece,onreumatc aortcvave st mentorsas v,ave vaveu stmenaotscs ao wrttcnvsauvensucenc,onreumatc aortc osonrreerusm,atocnr trecuumsatcv aaorcvteecn vc sate,vneostses,ror nooennrrr, ueenuusmmeaacttcc te aroc,rutc vave nvosaunvreecuenmnsucat,cc tretnceucrs n,ono vrnarevueemuamtsacotr tcre tcrru,cs uuns vavvaeveso srteenross,ss wt numonar vave stenoss,onreumatcsuemconear, vaonvreeumatc nossuunreccueemnnccat,,cotunemrro nenuoamnrrat vecuamvuaetmcosonurarmero v,na uanvrse ve satcevneosss worters, , , , vaevaer unsecortecave,avuoast, en,aveu,onasotcarts, ,,, , , , , , , , ,, eavaaesc,se,meeenatcaecmemeneontrttcaoorvtretc,ceavavsve,eo,neeacaecmetrmeanenttavoortrtc,cave, , , , , , veeartraatvrea,eavaer,e traave,ear ter,aevasveo,n , , , enastomossarter-aorta,eacaermeonute venttrracea ,ve, enaertrtct cc ,eam ,eaeevrrss ,eoanert o saeretaeratr vte senstu ,meeaerc ot ,eearatreeeeacartstr, seoeutuamer o
Figure imgf000076_0002
na atsentanaosnoss cos oe , ≥natentaunmoses ceocte ,, ≥enroorcceeuuramo conaer, o arrt ≥er
Figure imgf000076_0003
erorme aoeeaesrsvaacounse wsaseneerroarmeos amaonnv, anuas moore w vaoma anonn weax
Figure imgf000076_0004
amonnvuasor womenex waseror s ure.nvua me a er am an omen’sosa ervaon same. esa wrooneaaasess a co ses wererorzeorncusonne oreeeearnn moe, cansomrsrsreansnoremeen eeancnes anaens. mensona vecor reresenaon usn arevous escre eeearnn axro no a - aenonrasveearnn oeresenaons wcs omzeorrananc enocwennc as onu mreonn.aenc aanns o uusea aenucs avroamaea c cornevaoesu nounmaer nceaura re neworrane waveorms wc emaszeerenceseween s resenaons o smareseween srome samenvua.n romerennvuas an s noesneorec a secc cnca ouc e oer eeearnn moes, numerca reresenaon ome,u raerorouce-mensonaosc reresson.e cso onvouo wnaav neeourrmas neawo crannee urseoa aessn eacunonear moes suc as or vara n samnreuenc.e numerca rereseo z, aown aen ae an sex, wereenncuen a munoma naons, aon w reuarzaon‘-e’,raneo smua osc reresson moe w e caromoa, aorc se neous cass carac amooss,erroc aerou serve asenoss,erensve , oer an no , weree noe asene comaraor. cans asoeveoewo anaoous sne- reereeasernnnao mnoseers,v ‘ero-meea wa’ve anorm ‘aa-reome oan’,e u reszencve-mensona . cans seeceeas anor sneea moenase oner easure amon wearae reuen avaa an an ‘ ecaasnus aecsonoraone. comaraor moesncun an ae an sex ause moe, vo res’ moencun ae, sex,ear rae,,, an nervas, an wavaee amureu.esreome meeaasures we wreav see,e aceas weav oe,nrevo wuasve,escre wav re, an reaeanosesncun erroc caromoa an caraceaons wncusonnraona creraseeeow.ereosse amooss, an maxmumea voaerom auomae measure , cans exrace voae amues wereese va mensn annerre mssn maxmum oaenere ues were mssn. , ,nce moe nosavnran e ser mn uco. ueren same voae mervaon se:,, vaaon se: cansraneve neur easuremens avaaeor exracon. eac oe a newor moesoner mssn maxmum voae amuesor wave, -wveavee,a asnncue-wanve.e cnccaansnaze ru eeasc: o-ew naevue,ra new-woarves, w ae- wes o are m-oraeneea-s moees ucroeeoa averaeoonaereea- u.comroa an avaae a aer, oneu cnosnneuceemaerre ceamsasseerm woee_ezrooe wa.ereoa averaeoon waveorm‘casseraer’.noeru conneceaerv reernesseuesoen am wasureesenne casse asresen‘reressonaer’ or waves casscaoneaeers, an vaao onn reesu res. re wsseroen oaaerne usn aroou rae o one caeorca cro .e casseraer wasrane usne oss.ewoosss-seens wroeross, ane reressonaer wasrane usne mean suare error ac oeev eeve mnoe wse wereeraurnrann. s -orervaon annerna vaneor eocs w , srom eam omzer was use w a cosnea anonne.aeesarnnne r maoe wen an samnae were excue. .ecaeo amos zerooreas eoc. earnn rae o comee amueaan .e e moes wereese usn, s w earrorem -eserer serormance oe moess sowneow. mtueean asoutemvaoretumnceea mncses onoreecsson eca
Figure imgf000078_0001
ne m woavees w.ans aeseanen,e .e mean asoue error e recever oerancan csa arsascesesres mco cues rveeroorr wmaenncee ,n wa anev a ve ra wasaorense sanm.e usn area unere or casscao ea unererecson-reca curve sruon n o eac eoo versus no . cansenerae canss o an rom, eraonoosran w reacemen. cans e assom maeeasure c-ovnaueesncoer mneerrvcasoerren an romesesruons. wo-secoxon sne-ranesoeoosraceeseswreenuoanrss. o moceanss co amarenese crearaccevres vacsuencun,o ssensveve, soeoc raco,os,v aenr neeacve vaue , neave roa resos corresonno se vaues veeoo rao- a nervasores car o moe sensv an secc.onence anases, cans uasceersecass w eecreoc caarcuoaream u assne an exacnoma meo.n sensv ne vaaon same, wc r reerenceae oe “o” caeor srom o we esuen anncreasene meanear oeo nex anass. cans asoerormeu sevnasenve aanra ransesesn wc- c caonms aasrseesseoermar erormanceor one versus res casscao ee moe eoo oneressreae aso n o eac eoo.e.,aarome e one versus res sensv anassesv,e, anc aan os eevra cuaaseses arereae as neave.sar o onvuasne vaaon see moeerormancene surou oan cncansmnoonsroawn eecoeceareoarac. cans evauaeerences rnn moe cassesnvuas, a th n wtahveorms corresonnonvuasreceoe ameoosses an³e arnroowce csar rsomoae.rcenecsan os seec-ee mreeacne wa rs o carac eas,,, an or evauaon, an anee me veormsrom waveoacae comarso an waveorms ae onse oe- scrmnae amocnans ca arson ac a.ssessesaeses w caeusner commonrom useo cnca rues can erormance o cnca ruesoeee se wou an comare common use -ase rue earnn moes. cans aeree waven mm soranosn :orne voae crera waven a a or maes or mmoremaes,oeorne crera waven ,. mnm, an waso coonsowe-reono cremeronasra wea rvuee-naseaes an wa oveenre-e c mm me.ae rera were ana. aea:onncaa ueosv oonervaoname ermvaeon nca aaon nca
Figure imgf000079_0001
same same amreraocroossc
Figure imgf000080_0001
cacu cans comareeeeearnn moesoe cnca ruesrs o ecaocnaroe sraeccc, se anns evac,, a enoo oe cnca ruesoreecon resoroa a wceeeearnn m voeresuss noee a.n eucvaanesn seneoune sensvoe cnca rues an cacua cc or oee ee corresonn sensvor secc an caracerscs aen aesasorncnae moes usnsreso. cansen vsuazeees or comarson. conencenervasor -e ane cnca rues carac amoocsanss an evauaeerrooecn caar asosmocoaaons o w o-sereverenceroa o ncen araraon, an mora excunnvuasne vaaonc saemnee waranoure, carac amooss orerroc caromo wn arara a. cansenencenearaure an even anaseso,n uesnrevousescrerouns oanosc coesae.orme-o- ea, oras cncraso enn-comuenean ame oenex an ene aermar oucome, oucome occurrnroro, oerr o.or eac anass, cans omenvuas wermar vne numer oncnene sa emveensa as,enex.ncence raes were cacuae muvaraeoxrooronaazars moes auseersoonr- aears ooow-u. cans eween -eroaes o carac amooss anee arnro sexco ca assesse reaons earaure, araraon, or mora ase oucomes.roro rerreossmono,a w-e xroa-xoes ac weereve arns aranrsoxormmaeeo noremaos scraeu uosnn oerooaraenss.oramaonox =o eroaes are reoreer sanarevaon oneo zar raosor- ae an sex-srae cumuavencen scae. cans aso cacuae anases wereerormecen raesoor eac cnca oucome. ‘ensorow’, an ‘en n v. usnacaes ‘anas’, ‘searn’, e es’. ususouaon erroc carcaonmsoncaue, eco,caronravucas w, o ar noa encosocsar o carac amooss, m amoonen w soamme weruereema.e ane mean aerev waason. samearesncu.e.e,oran vavc auaonsne sa, ncue,nvuas amon wom wereemae an mean ae was.meae .. eooesne vaaon same rs er were carac amooss = vs, erreonsvce caromo =a, = vs, vs , aorc senoss = vs , ecocarorac =, vs,,. oearracerscs o =e, vs,, an no sames ar ervaon an vaaon ae.eraersaecneersncsa oeer.vaeornvao anaaon ames. =n same aao=n same
Figure imgf000081_0001
roencnesease . . n-renesroennsveecaon . .
Figure imgf000082_0001
oeerorm , , r.a. comarson moeannc e ae sore casoscea voan oa eoanc same, eoo-e ve sncan ouerormee an ure an. -escrmnarosnus no asue e or casscaon o cara on esmaes werees erroc caromoac amooss . ,.-.,oowe . ,.-..e. or, c.ass-. an aorc senoss erroc caromoa, aorc senoss,erensvecao,n an o o carerac am weoreoss, ,.-.,. -.,, re.se-c.ve,..ure., . ., an. ,. .,-.e,er.ormance rem,a .- conssenn sex-srae anassae as we ne an cnca rueos asn aona anases srae ae ae.ex-raevoveeraear:oerma.nce oa-e seex an: eeamsauere ssexo:e.
Figure imgf000082_0002
aracmooss .e-.easure.s .e-.easures.e-.easures
Figure imgf000083_0001
area uner recever oe ne as casscaonne varaanon c saamracee.rsexc-s curarveeerormaonrc eoo versus no szesor eac sraum are sowneneae suroue. ceasse c aosuon ss aorwen s.owona sa cme.e ae.urouv:eranassa: oe sex- seexemae:oee:er <ormance:e. > rotera:et a
Figure imgf000083_0002
tenossortc ...,:...,:...,:...,:...,:...,: ..:.,
Figure imgf000084_0001
szes ecoc ensv anasesn wceo rou wasene eas avaae rmaarr s, aonaramncue an aona,nvuasneo rou comareoe anase s-seu meooenecrreoarsmeanc aeva remaane s oncasn meenerncanusoen co cmrearras.onn moeese ca oce ar. s ae.ooraem aesroevremreaance o -e an easuressnae oas -reentc:ea ee as o ureso ae- soemexta:ra eo ar suresrou.ema-ee stex:easures, , , , ,
Figure imgf000084_0002
. . zes causes o ennceurenna nno a sec,c caucsaen osoe.., carac amoossrom a oer comarson moesn one versus res casscaounn oa e-oeo a,so c oaussernorm cee amooss an erroc caromoa w s o. ,. arac . cocaror, aem. a-esr.overemre, a-r rae ens enc tce :eec -. an ae.o ov ae eae su o- resoeur aens a ae- son eexmta:re, aas eoau arrees suresrous.n.emaae oas -ee stex:easures, , , , ,
Figure imgf000085_0002
. zes -e moe one versus reserormance rem . srae anasesae. ane conssenn ae an sex aasseca.o Oonve oreallNe:r 164o5r1maonoce Me oasle. sexN: 9-073e an Female sexNe:a 7s37u8reso Erchocanrde-ersus-es Nio:g 1r0a1p7h4ic LVH
Figure imgf000085_0001
C Aamrdyilaocidosis 00 N0..9 :9.925105, 0 7 0 N0..88:.858125, 0.92 0.82 0.93 0.870.81, 0.910.89, 0.840.80, 7 0 N0.:9.84192,60 N0.:8.75182,60 N0.:9.88371, 0 N.:9331 0 N.:94142 0 N.:86142 1, 8, 7, 3,
Figure imgf000086_0001
x anresence o ecocarorac .oa same szesor eac sraesene as srae se m se an sowneneae suroue.ase couns are sown c raa are cansounane surou o, e. emons nvuasne vaaon se caracr aamno ecososcarorac. ,scr,mn.ao-r.erormance remane oro . ,.-. an erroc caromoa raaessesenccea. orour Osoeunce onasnsc o a a -eeo. ueeerreorrmaaonrcenecrosesrsusraae oex,e, 1n6v4e5 ora1ll Male sexoo F.emale8 sex ANg:e s N: N: 9073 N: 737 8 <44655 ANg:e 8 >00665 M LNVe:tH 2 E4 CC5r9Giteria N LNVo:H E 1C3 C9Gr9it2eria E c LacVrhdHoio-grreaspehnitc
Figure imgf000086_0002
A S LtVoernHtoicsis 000..88.7149925, 000..88.7147286, 000..88.8360223, 000..88.8480664, 000..78.7602509, 00 N..:774956670.689, 00 N..:8825186610.796, 00 N..:7870231180.744, Hti N 0:721118 N 0:617163 N 0:714075 N 0:74448 N 0:612724065906380715070705980585
Figure imgf000087_0001
o eoo. oen couns are sooa same szesor eac sraum are sowneneae suroue.ase accurae ceaewn sseearn cen. mo eeosorane onu srensee-a w.aveeorms -eeas an aso casscaon o carac amooss anerroc caromo sor -eea e.s .or comarso a were. ,.- r no easures , an. ,.-. ., eecve, wee sor -eea casscaon o carac amooss an .rro.c c,a rresoemcovea.e wrere. ,.-. . an. ,.- srae a ormance oe sneea moes was mananen ae an sex ae.nausersoua :erne aas an. vss oa:e sex-eem:aeea sexo:e <eero:rem >ance. rotera:rettera:
Figure imgf000087_0002
ertenson..:., ..:., ..:., ..:., ..:., ..:., ..:.,
Figure imgf000088_0001
zes ae.urouv:eranass oa:e sex- seexemae:ea:e <oeer:eo >rmance. rotera:rettera:
Figure imgf000088_0002
. . zes
eoos seorwonrmance oe sneea moesor one versus res casscaon o ercene o car wnaavce aou mrmreso co- orsre. ssoanonwero vnoavesua ansr weecreo ceom aexes rs³th waveorms onvuas aower rsthercene, wereas es comareo nvuasreceoe aer rs oerroc caro waveorms corresonno wer comexes comareo waveorms oower rmoaa er voaes an cans comarees caracerscs amonsen moveusa acsrure. an seccresosor eooes versus no naeso-ss a rane o sensv a C A leamidrdyei-ce aicon. S t oes ievnitsyi-%ara aar S fi%pccac eae itcyi-mrrs Pn %Pocs Vo os Nr %sePVseeor asn LusRs+ oeox Le, . earnnoes Rn-s Sv fi%.eas p eure asn, anecc-eeeor ceitcyi- S ti%evnitsyi- P%PV N%PV LR+ LR-
Figure imgf000089_0002
nve neaaeve.eesooa rraacoers-cs are sown. moes aarnresos o oee annsvex,eeasures, an -eeeearnn Hypeertrroprhoic Secns-ar Speoci-mo PPVa NPVersu LsRo LR Sp.eci- a Snens-e PPcVc NPVr LR+or LR-eecon o
Figure imgf000089_0001
9800 1246..5333..789976..29110.89016 5.296.61.50.9 ECG 99 101 39 995 1.1100.9189093234.8254.7559977212.46200.8854632743531
Figure imgf000090_0001
, ,osve neaveeoo rao- are sown. , o an aearenn.eosesa aracaerrsncs oree anex, easures, an -eee L SeVHecon S oens-or Scpeenoss seorsuss ooens.v e anecc or A Atoerntoicsids i 9t%9ivity i 2f%5ic9icty- P 4%PV N 4 9%PV 96 L+ 1R3 L - Spec- Sens- PPV NPV 0R1 i 9f%9icity i 8t%i3vity 2%029%68 L+ 7R2 L - 0.R .9 .6 .4 .9 .5 .4 .9 .6 .4 .9 .6 .5 .8 .42
Figure imgf000090_0002
recve vaesue carac,e nresacsvencrun corresonn secc or sensv,osve neaveeo ecve vaue ,osveeoo rao an ae.esoa rraacoers-cs ar oe soewn. LeeVaHerc Hnypnoern- o Soense-se ar Speecn-asrv PePnV NrPeVesrsou asn LRs+ ooexe, LnR-s.veas Spec-eure Sens- asn, an PPVec NPc-eeeor tensionex i 9t9ivity i 1f1ic3ity V LR+ LR- Age and S % % 5%71 9%0411 01 i 9f%9icity i 7t%9iv8ity 6%396%571504
Figure imgf000091_0001
osve neaveeoo rao,- are so , an aeeaercennon. oe enos sesera aracaerrsnercssu osresoew o ann. s o.exe,nsveaseure asn, anecc-eeeor ter tvt-cect- + - cect-tevnst- + -
Figure imgf000091_0002
et- .. ....... .. .....
Figure imgf000092_0001
, , sve neaveeo an ,.- a so .e r sa aneococ- a sv ore sow ee,n. oo ra-oe oem.onsorraeeec a coonrr oesonn o. a o. ,.-. anosveeoo rao o car.ac aomooss an erroc carom reecon o aeac.mesoosasraco :earsae. ar-e aecc ocomarson o easures, -eea oe, an seonrsresvonn varoesuecveve vareeuaecveve raoseovoeo raeeoaovoe
Figure imgf000092_0002
ac . ann. versus res a,na.se-s,.-ea a corresonn o. ,.- caromoa, resecve, a a oreecon o carac amooss an erroc aare-ace. amesoeosasraceorecsccom se ora sre nsc eonc e o o rsuseseasa ausrsees,. caon- oeeao mooe., an : senrsresvonn roescvevereeacveve osevoeo eeaovoe rao
Figure imgf000093_0001
. ac . an nea av see seensov o , -eemonsrae a o. ,.- ,.-. ano n reaao ove.eoroeecon o carac amooss, an a o. caromoa. o rao o.oreecon o erroc ecocarora-ce ouerourmrees aen cnc.a - rues woras c aassso mcaoon o eoo an -ase ruesoreecn ecocarorac . re, sensnvevauna cnca ecocarorac ne vaaon sam s w sensv = e, -eeece, cases -e ae oserve. cnc caom ruaer seo, e cnca rues rue sensv =. ssocaoneweenreceecc- oes an.ncoar comucaormson. ncrea ruencence raes oearaure, araraon, anes mora ancrea -sne rs o- cear rasc a om caoraocss am anoosersr aonc caerrroomco caaro wmaso saron asuse sorce w ae. w mora cnc aa ouceoamrses wanse vanaeon sames ceaure.or exame,e cumuave rs o owes carac amooss rs.n anoer examraec, ame cuomuosasv resncerene versus ne ears was nees -erece carac amoo o mora a owesere, an neesrece car ss rsere vs ne ae- an sex-auserooronaazars moes,om-oeareercee v csarac anmeoowosess.n assocae w a.-o ,.-.ncreaseazarer was ncrease oneo scaeor mo -un sanarevaon caromoa was as ra, wereas -erece erroc sex socae w a.-o ,.-.ncreaseazar.e an re scraee cu-muea rvse rnecmaennsce a cssurves are sownnure-, wcemonsraea rooronaazars moenemonsocraaee ware cnceca ouc-omees rs w on caese sraa.ox anerroc caromoa were assoc rac amooss an sex ae w cnca oucomes aer ausmenor ae scae w.erese.rveazar, ra.os-.or moorra carer-un sanarevaonncrease oneo orerroc caromoa ac amooss rs, an. ,.-. anneccaa.uuoccxoommreeos.orona-eaz ras arra aoeen.esusor -esssocaon w azaraoecr samnaorossar-omeoaerroazacrao
Figure imgf000094_0001
rs o eerox carroacor amonaoaozsar moen resusncun ae, sex, anrece -e araraon, orearaures as ore ouercorome.c car-oemoroaa as covaraes an mora, o scae usneoransor es wereransormeoe reaons maonox =ox-xoe an aroxmaenear scae an correeswoenen mnoe rs a arne soewon.-azar.azar raoer sanarevaon oo scusson eeearnn mocaenss roero crasse rceasuons o o - ane c aanrac-seeeas an, a coecon o -ea an sneea waveorms. can ases assocae w usn anoses across a rane souna -e accurae casses caromoa, an o eooesncun carac amooss,erroc -e, ao anrc s snenoess w s o.,., an., resecve. moes onuanave m-eeaasure vse,r asso wnse o as comm-one, o uusee cronrmcaeo com ruareson e casscaon o an eooes. sronerormance acr sn eooes, -e maaveoena cnca u as au auomoasse an screennooor an rare eooes w acaon on-o-care sneea ev oo-ea s an moe casscaonr oor worces erroa.scemonsraee caa o -aseeeearnn moesor o e a. caromoa, carac amooss, an ecocarorac. s aeeeearnn moeso cass erroc caromoarom-eao cass w c an o., weoo e a. aeeeearnn moeso-ea s wor earac amooss w a reore o.-.. -e exans ons e nan smuaneousscrmnaon o ecocarorac an mue emooonsersaencuanreercreoc car-eom rosa o an car caarca acm amooososss a.ncaenrs aso caromoa were assocae w cnca oucomesncun roc an mora.na, cans’ wor aso earaure, araraon,o sne-ea aa euvaeno emonsraeeoena acaon o -e e venrcuarer was curren avaaerom moe evces. eeneraouaon ans assocroae ws a s comnmcoann c canrcaov eanscuaro munorn a.ouream–en a o reresson o s assocae wmrove carovascuar ou n encaon o unreaenvuas w rese comes, anereore -ea aseen useo screenor ,ns aucea oorun.oue racce are cumerso cnca rues emoen roune cnca sncanmroveme se annsvnsensorve c.assc-aeons ou ec aou-coamraoera anc asoem anonsrae eeonoens wnenv coumasarenoe coem cmnunca ancrease ru caers aonva mscaereore oerreaer u n avn a roa o maenerom cnca evuar rs.nvuasene as aon,-e maave acaonneo auaon an ecocaroram.n w erensve sun aonuna manaemen oaens suc asose reresson. nanormaon onreamen eec mare cass n a eooon.o caarssnnvuas w , -es aso aeo accurae seases ass ac amooss an erroc caromoa aremoran seasess eoscseanea worm snrovcnan caarenov oausccuomares m aonren, ann exeenanoss oese ere are no sanarze screenn a rs reaves.urren, caromoa, anra aroacesor carac amooss an erroc seccnns. a seconacresaonos os o,esnevseausaess r ceasess oenn assensavvne o crar noanc- a cmarronos es oerr oerersoe crc ccaaroamnoosaes, we a-ee samae amree,a oevrean-n- cance o casse as neave noave eer oeseanoses. r onvuas encaon o -e maereore an ur -rsnvuasne commun. , suesnermaoreo,ro ever moensveueas aoaw neum asero nseeveeo screen- oe a, a s neewccsea o anoss woue execeassumnu avaa an accurac o c se anoscesnor eacosve -erecon.ou , , anonrmaor aece eseaserevaencen our same, our resus are councreaseee o avanceanos nevereess suesa -e urou anases resrceoncvesuansoreseseases. a -e reanserormanceor w ecocarorac emonsrae amonnvuas erroc caromoa an carac amooss even eanv areanownoaveman evence o .n aono screenn o ecocaroruaas,-eos aona u nacanscrmnaon oe eoo -ec anncane neeorureresno conrmeanoss. maereore susan coamrenecnresavseee oueero orme curreannoss u-sanse cenca. e ru cesn acna emon rusrease are s usnecnan rounme crovneca seracceo cass ,e arensensve. -e comareoe nsvoreecon o ecocarorac wenm cnca rues. -eureremonsraeerormance casrsovceameonns onerr eoooc ca crasosmcoaon w a near.-omrovemenn sensvor acaon oesuesse oaao-screm mnaonesa srrua. cnuera useanr sseneeaaa soweoena coeamr raremrom sneeaaa.e sneeaeeearnanse, m aoensoar somr waorre craosrsmannce no a meo ae con osrueceee uasrnnneoaoesouanave measuremensrome-ea , aa. ca exrac meannu reresenaonsromme n concnuss’on,nns mae acaeo moe evces. reresenaons oeravoraecanscsrmemnoansonra oeaeeaneoasrensn moes uzn -ase anerroc caromoa.-e ncun carac amooss comex ouerormso cnca rues, as we as more carovascu maoresseaseas srnocnue assoca-eas we m oesasuremens.rece -e rs oea versons o -e maave cnca uernveo cnn-oca-ca oruec socmreeesn.no-r re an sne suc as carac amooss anerroc c areseases e aromoa. erro..er maences,n,evereux.ronos e secrum oveae cmcaons oe venrcuar .aaer. venr,cuararrson: er,- roann.en ae,neervao,unaerson,oes,r, e a. u.rcu on same:eramnam .aoenr.z,se:-. era: nzer.semcmoosseconon,ronoss, an .sermaamcaneve,w.aoum..rome: v-. aure: manaemen oerensveearsease.roenrarcuoavrascersr.oo con:es-ve.ear , e a..erroaavco csar,omaoaaars: a,n useeae reve,aramsos,oouos,ousas earaev w onanoss,ronoss, anreamen. rcan.. eoeonce,-enaa:aera- u,.eus asunom-aeeson,ura,asumaa,no, e a. eecrocarora eecon o carac amooss usn .mos an, ecooncasrorams.aommun. :. errocar ,a,arer,aa,mmen, e a.eecon o ecrocaro omoa sn aonvouona eura ewor-nae .ramu.rsm,oeeaerro..,arr:-. ooresn anauraanuaerocesnsnono.,eunce.a,sanrmaecr.,onrceman., e a. esearc:eommunareoorroec. eaecors annon,. eo a.rnu,araameerc,coaccaro m,eexsrve.o-o.roaara,oez-anz, mooss. :arov ora coresoreanoss oarac .cers,asecuar,meraoscn-.ero,:-. o carac manec res ase,anse,anse, e a. rcuaon. onancemanneanoss o erroc caromoa. cocaror..awns:,-an.,arma.e venrcuarerron aees.ur .ancoc:,-. recommenaeaons,orvs,n, e,ees, e a. eecrocaroram:ar: eecrocarrorame s caannaersz aassoonca aennerreaon oe erro: a scenc saemenrom w carac camer rr emercanearssocaonecrocarora an ounamonas anommeee,eaorunc onmnoccae.arnooorseemeercanneroee oaroo omuerzeecrocaroo.moar naonaoceor eveomen. anumaea,on our asre,coennoe,o.norersron,:an-,.surner, e a. ecors. necroso. :-.araonsnecroncea earnn: ae.roarmmaann,x,res.on,.urre.uz.ara,.aenonrasve eeve:eu.ure- ousarac,snve, a m,n ocrac naonc rua ns.u,ro rruaczo.eaorneno.u arreva.r on.our .onson,ron,os,aer-araoe,. :. rervaomencoea an cnca co mmen,sr, e a. ca rreaes o roonaonnaens w erroc ea..uurerear,.a,ne:rs-. cnca on,amar,esner,nner, e a.e :ures ommunooun-can amooss wearnvovemen.. ecrocaro.- raeu. cerorer,aoorreesan,osser oeze,sseanrc,uarrenese,oenno. aro. :-. rro.mo mrove ee.cac,erecca,oron,ucc,uerrer,am, e a. :crocaroracanoss oe venrcuarerro.m aro. enn.-. raursra,oneannee,enor,uz.me anoraeormor . croncecaecor.maro. :- aurene.noea,esr:.,saneree more,anan mee,srez, cocaman.onesveear roec.rcnerne. :-. eeorusrsear a.rcan.ersenoceo-uoescro,carrao-raor,oez,ao,a,ansen, e aseu. aorecncenraraon:ouaon- .rccrnrnem.aencraos-evsoa.nas:anas:e..e.rson v...enoo.. earnnn.eonreosa,arouaux,.,ramor,.,ce,., e. a.c-earn:acne .an.oosusrunma o,raacene.earnonneseeaerrcen.ceanua:.-.. orrao,n.aarvns,,earee,anau,aranaam,uenerevo,,enen,re. caesar,aaozeowcz,anna,,ueamszawaas,erano,oeow,,nrewar, ecuser,,aaona,ereurra,rsa,onaonosenesv,e,n e aer.,anan, are-scae macneearnn o ensorow: . neeroeneous ssems, oware..avson-on.enes: survva anassnon.ourna oenource erormance. ow aorn: ca,.enonee,ncem an c,onvmenon,aman,ossm cre, e a.omarne venrcuarerro usn eec raoreecne .aron. errocarora.uroace. :-. :- roc caromoa: a ssemac revew. . carac amo.oaseesz:z. s,easeerrnoe,s aunara cnc,a cvoaurs,eso one, meaonne,e es. a.rcusemc :- aon. ecrocaro.raavace. n,nsenesa,ar,enr ,aron,onson, e a. caromoa.rcua ens w osrucve an nonosrucveerroc .urao,n.amm :-. ecrocaroracnnsnrmar, sseremzc am,ooess a,naos-,rovernoan.nvovemen. carac sncance o.m owrearo vo,. aoe asmm: on,- erv. eaerez,aurer.revaence anronosc : manes o carac amooss.maro. .-. ecrocaroraacaweaaaures, o suane,aron,rno,avnru,unaar, e a. erroc caromoa.mrcoamreroe. muaon carr:ers w-. an wou cnca over aroos-.evean anrurnm,aaeuercaor,aana,son,ourn,uraa, e a. aee neura newor.ae.n an c:as-scaonn amuaor eecrocarorams usn ssessmen o.aemcooxeea,rareamma,marnew. s,more,arr, s, e a. rarao neveorearonorocreenor .n:une,use-.un.errcuaon. :-. monornaens onoeeor araravoan.s canecreoc assesse weveorear .amamoo,ooc.ransrenaro. :-. anoss anr carac amooss: an uae on .eearmesn.,zzoea,raanc. :-. venrcua us,os ,anz ,anceo, e a.e ewor.rnerarroo. oses:e se-xerencen carovascuar rseamanaaue reaermac. ona sourv,vaoone wrome,neannsa. n men,.crcueeaon..e venrc:uar-.erroas a enon o. oerraznnv,ovoemmeennzo an,aream,erman,azener,awns, e a. amooss en resonsenmmunooun can mooss,ou:rs a, corannsecnesus ononrome nernaonamosum onmo an .uer,,e-r.rrans.rmemao. :-. :- en carac amooss.rcuaon. .me. orce on,mercrancanssoocee oarooounaonmercanearssocaonas ucear,earaureoca oon,orearoraccm,,mercancoe o,mercanoc o anoss anreamen oeroc caromoa, e: a a re.o oemercanuoeenees oore
enxaamese sca –aeeeumeaarnnnse maoes o eecrocarorams usn sne-ea an eas nroucon seron reresen carea mco acervna reosnn anm uusez ceosn wauvceoonr.maea orennearaero wma ssurramcea erec uroeso arrmaeecon,usanosc u exane ra oncueencaseonor coronar arersease an oer carac srucura anormae o eecroeeravneemenso cenra s.on-caracseases,romne wa nervous ssemaoo, aso cause caracersc canes an aroa ranco eanrm os. sosueaseo sesnoemaesca eevvaeuoaen ass aocaeeonseaeween-aseeaures reconsruc waveormaa,ncuno-ea rnn moeo encoe an .nrann,srom aervaon se wereaee an sneeaea s.ure rou , seases, rerese accornoeresence or asence o asscaon oseas ne ecoes, or areaerouns onernaona oesen oamozaone coes useoene cnca meannuseaseenoes. rere resuen consrucon o a mu-mensonaaen sacen wcn waveormonrs w aase ,ere aaos census e,ne wre eocase sone one o an u cnornes aaen enc esen oro arms eaen ncoce on o aeo wuse aase. nveenseaseenoe assocae weoson oe corresonnecoe cuse aen sace we -aseeaures anseaseenoe rs.oes assocaonseween suese nreeeren s, canserormeenome-we assocaon mea-anaze resu aases,ncunworueoou ses. cansen seasesn s,nn sncan assocaonseween waveormaa an e e-ea moe an seasesn sxnecee, suc aseunerancoc =. x-e244 snore--eaea m mooee. ane. m xan-16 w3eorer w-eaave morome an, res noenc-cavreac,seacsaen,snc ausonenoaec unancae reaonss-e149weene x-131,ever o unnown -136 co us-1e04sorer =. x an. =. x-51 an o-3r9n =. x an. x , an non-acoocversease useoeneraesea.se x-sec.cc wanavseuorrmesr anemoonrsraseeaseorwo aanen o snacve muoase. cane anronoseccenn aovramnaceosnn maac enxeeneasrnneoanve reraveaeonaa cnecan ceornansanosc mensona reresenaons o s consrucerom reaon.ow- seases suc ase venrcu eeearnn moes caneec carac rm.er moesavearemosnsunraceon arnecarvoexsomwaer areaonrea coanroorvaascuenars sn snus esmanacors suc as ae, sex, serumoassum, an sem, accurac.owever,eu exen ouma -ear mora w a eree o remans unnow nseasesa maecome manes one surace eaeaasoese wrn een rc. croncenoeac rencoorrmaon, e-naasenecarneo-socaeasse mae avaaeare,esn.enome-we assocaon suese ase-ase assocaonesneweenrecor varaes an mu acae -rouu assocaon anosc coes.s esease saes usn eecronca ascerane rouns o avaaeeaseas anroes cocmmon reresene ecoes, or sanarze an areae eeearnnn meoeresse ann sue a, coe naccs.ans souoarnessoenerena caaes o e arra osease s ower oraonae o comreensve assess consumer-ase wearaaeesevace msa cnaeasen o reecorn w savneoerme.avens,erowcanns nuemrer o arae anases usnoraona-ea s, as we as sne-ea orme erveromea, a common vecorn consumer wea susnaa cansraneeeearnn moesnown as v rae evces.ecca, sne-ea s wn aaen sac araona auoencoerso encoe- an unsuervse an omzeoearne. wavecaonrms seeaeucrees aoene a,u woenocou aer mooneaencaourmses rearnaenemoracs or cnca oucomes. cansen us aon reresenaonsneaen saceoerorm-rouu as eeoson o , seases acrossreeneenenaases socaonesn w rourueoou ses. cansurer sannn over,nvuas,ncunwo sa caracersc emonsraeowaen sace moen cane useo aens. eauresoreecae conons ano cncaroenvua eos aen emorac anca cnnsa’a ca sseus nor umazoen,nrceeunaase-s,ea a o ws.c cocnanasnenvua-eve aasesromeommunareoorroec , arev ervewo o our comrsn over, aus ae ears wo recev ous esase coor eevenosas wneassenera eonunarmar care a one o aa wareouse.26 aases ram newor, wcsne a common - aase an a cncue a coorromeassacuseseneraosa aase.er, exernaaaoseorromeram anomen’sosa - aseer ceoor su comrsn au wsasromerveenromeenomo aaen, a-roseaercs ave e cnorommmuenn.2-7 esreonrm anea wssnncureeeseear ssurseors oone svarua oson eoawc uaase w or a weoasa on ae--ea erormeurn aeas one s ea uoencoer anuaen vs oan. reconsruc- ancan ssnrea-neeaensse.n ceonnneaccee ceornvvaouonona auoencoerso encoe an a-men era, auoencoers consss o an encoer, wc mas e ornasaoanaronmuenoa aenow searc-em reenressoennaaaonen sace, an aecoer, wc reconsrucs mnmzeerenceseweene ure.uoencoers areraneoo en ornaaa ans reconsrucon, wc encouraese moe snec-oeae v aauroanencecoreersse wner werannee an or vanaaeaa usnno suesaen sace.oe-ea an coor.e moes wereenesen an - ooeus s oe assrome - aases,nc we asworueoou ou snanarz-ee aane oan. waev eeoercmss o a sremacenen..,a-sseecons nee or,er c raa enr csoreanc c n nsocse ne a o,cross a ,c mannss ev encocoua nes we wns m asn mmeznan voaemeonser wnow, anerormeecewsene ows, samn ause means.ean waveormse arneroaonoenerae- one carac cce reore reresene areae moroo o aeas waveormseneraeromro emac a aevaaaeureeass.e., an wave.ormeser-ea m,o wee uez sen mee-eaan m reoeres uoeze m onaaeneraeromea.neoown anass,eerm enera corresonnoe oeasn , w wearveeo araarmns oe. ns us onver a-m-eenasona c aonnvouo vnosa oveerm voaeme seres, ea.ors wncomee voaeaa,ene asessan seconse ronsor a sne ea.e.,essan voaemeonsorea oressan, voaeecorerom eac a-eas, cans use zeroan, convern non-avaae meons across emora anmen w aano zerosoee anroameauo:oreroe oaer :neasa , .aaese,. roeam,a aunoourraon: -,oa.s w zero n= n= c
Figure imgf000105_0001
ea , , , ,
Figure imgf000106_0001
emonsraeen m eeauna sonuare errorer voaemeon acrosseu was mnmze, as n!"# ,,! =: s w!er"e# e −x! % oe sar o cncaoow u cue e acusonae was no wnreeearsror vs oe eares ,eneor eacnvua a2s6eme oe seconrmar care rereseneoruanar, asrevousescre.n one ernvua was e naeureans n we ar mcuecuere was,e mos recen was use. connece convouo s a varan oensene,eaurn severaense erarameersnnaocs oeran a erenme resouons.rcecure vaaesanercauramne wer o,meza,o acvaon, normazaon, an reuarzaon were cosen seaseenoe n. c ecorervaon rar s:oeewsn eac oereeaases were maeo auc avaaeecoe snus cas ascaao.orecoes_ccm.srevousescre,ecoes conc esrom conros usnerarccarouns o an coesoeerene ca meannuseaseenoes.nrevaenecoes were use,.e., a orrre cseroannnecoe cso,easracaonse wreseonunaeaeceone’s cuar wro vrero semar acu csooesn waeree. e axsscoucaeonroemsn servonr aes m cooncarorsaon aavrocona csasn resus, asescrerevouse..,n as conro evsenea coe erou,aens were removerom servn or oer s corresonno as osease excusons,ncun anna enceo oesceecmorceearsease. avens rvaon cans exe ease, reresene aecoe,as a sncanmac one , srueo aceeren emoceaonnsnae a rueoreensceoner-ersveromaenn svacuea rsea wveoe emseeasenosmaa rcer oensenes, orormnevuas e wmeouneoessea nsoe. ane counareas, cauereseseaasese-raese eaures,en cans execeereoe no sncan reaons evan emensneaen sace aneresence or asen eweeneoson o canseneeesens o encoce osease.ouan s execaon, osve cenro”or cases a nsaes asavnesease“sease- sease“sease-neavneesens o enconsaee as noavne reresen e cenro”or conros.acecoe wasereore saa v e s cenroar, anenea connecsems reerreo aseenoe uencor.ure.n encoe wneaen sace,ncun enconsrom eanoeee s vamecoers c,a cnanee useroeoc aesse osnsoo awn coseeno ree vecor, ane reaveoson aone a were useoeneeseaseosve ae an enconsoe encons eecravnasoner cvoeor weenroeaee veec aosrs usseanse r c coe aunroor ses or oaeecoe.- aase.srom e corresonneco conrosase oneresence or asence o ecoease oneeeneaen’s . cansene cenroarsor eac cenros sens o cases aner corresonn conros an usee saceervoaeornv,e weeanoeee a v seucosres w onseraomen seaces.-urn auaoaesenco asersrannaen conrosase oneresence or asence oe ease cases or enconsromeervaon se we corresonnecoeneaen’s. or eacecoe w reen useoene cenroars anenoe vecors ure. neaen sace.eenoe vecor correaon marxssaen sames, cannroec e encoonse wneaen sace,ncun enconsrom unaee vecor cane userooece ono anenoe vecor, ane reaveoson aoneenoe were useoene aessessesasow cose reaee unaee enconso enconsa rome remaenrnervn-eenoos coev o ve re c ,ce asonr wsro,or e asrcoaa mnsercooece.e unaee emens ane oan, o cans’worueoou ses, - cans scaee enre sacne oo eac enceonoe vecorenerae wneaen sace. an eacenoe vecor was normazeonsoave norm an sanarevaon o one, reaeness o eac anecoe wasuaneavee enac s oanme.ee-mensona saa o avenenoe vecor.susraeeown euaon,’ esa ccomonen ennerecon emen”, roecs ono eacenoe v con“ “como i ecor,p.eroece comonen, scaeneneipe”ns ca ocuaerome aneeweene encon aneenoe vecor, o a snenvua aone a sn.eus,eneoroee vceceo cr.omonen sneseaen saceoson
Figure imgf000108_0001
ea moe,e auoencoer-erveaen sace,enoe moes.ne sne- roecons werease on on mean waveormaaerverom veecorervaon, an ssocaonesn usn aosc reresson moneeo-e aaa a. oro- an s e sse mn ssoea es s,cee renc oansee rreoarmones aeeweenne eacosaonas oe aneareens s anace aven resreeasseen saaoenuussnneecoreoerceseen ccoem oro anen aserecor varae o ore oanaase,e moe was ause sence ase oucome varae. oou se ane - aase,e moe waso ar ae,o sex, an race.ore - ae ane amoun o zeroanaseeree o mssna auseor acuson conouners suc as ua, macne u n voaeaa ma reresen oer oroaen sace moes, canses,eorsormaeo acaon, ec.. wee mea-anass,ernorecoesa xe eecsnverse varanceeas comne cases.oecen wereresenn aeaswoaases w a aases. s corresonno eacenoe vecor wereooe acrossncunoer comnaerrvsoan,, cuarnason,en aenrae an seervaara.e mocaensa cseose o annnervanse-rvas, moe aser comaraorecause uzes roune ascerane, ase measuremensaaveeen sownoavesea sanar, an auomae canserorme annerva se-aseronoscmcaons.s aove, en comaree num se n eacaase an mea-anaze resus. cans nerva er o sncan assocaonseweeneaen sace moes ane v s moe.orenervas moe, cans consere a resu sncane- coarureeceor a-nvaunee orva. mevee sncean numreesro o, un wuce weacsoeesn aceros uss an m aonerron- eanases wereerorme usneacae mea.on w ea-anases. summar o mea-anazeaa,roue acc as useo creae a vsua sease- ornosease caeor. oeer une ase econsrucons sace rsan wc eaures maave conrueoecoe sereaonnaen ec,ca,c waneseceoneeraessearsoem-sesceasce- meosanve w caevneroormss anor a overncaueecoes. mean waveorms onsecoerome corresonnse ee resuan cans seece one reave norma o serv ase-neave cenros. e aon eacenoe vecor,owa e ase conro. cansen avance an roms newoca rsesease-osve cenro, an reconsruce mean wave onnaen sace. cans overae conro an reconsruce aoremnsoe aoorwoarr sraorwar vsua comarson. amoun one- a anvanae- oaseaenaa snac ae m muoemnse a oncororae an enormous naure oe moe aowsor smuaneous assessmenesnon oa a ennvronmen.e mumensona ecoe cenros. cans sou encon’sroxmo a s oemonsraeeoenaorersonaze an scaae erecaesne resoarncne aon co nnovrmeranzeeeoson o an enconor a snenvuano a osve noe vecorsromesease neave oesease e cenros. ususame anuoencoereve aases,ncuncan’,s sun sam-e encom,asseo n roumen -, ann,vuans acrosseree asene caracerscsaase arerove e oan. ae:aen caracerscsnae. eaanase. o or n
Figure imgf000110_0002
varae
Figure imgf000110_0001
emae sex , e . ,. , aca . e , . , . , . sac , . , . . san , . , . . earnc ,, .. ,, .. --. Not reported 1,635 (2.7%) 2,302 (5.0%) 101 (0.3%) Year ECG 2005 (2001, 2012) 2008 (2003, 2013) 2018 (2016, 2019) performed (median, IQR) [0341] SD standard deviation; aRace/ethnicity information is reported differently across d
Figure imgf000111_0001
[0342] For both 12-lead and single-lead models, Applicants developed autoencoders using ECGs from the MGH-C3PO dataset, including 35,245 for training, 10,152 for validation, and 6,674 for testing. Ultimately, the best performing architecture contained over 11 million neurons and used mish activations, 2 dense convolutional blocks (each with 5 layers of convolutions per block), a 71 timestep convolutional kernel, layer normalization, and 256 neurons in the fully connected layer. [0343] In terms of ECG reconstruction, the autoencoder performed well across datasets. For instance, the 12-lead model had a Pearson correlation coefficient of 0.96 (95% CI: 0.93 - 0.97) in the MGH-C3PO testing set, 0.95 (95% CI: 0.92 - 0.97) in BWH-C3PO, and 0.92 (95% CI: 0.89 - 0.93) in the UK Biobank. [0344] Phenotype Vector Derivation and ECG Projection [0345] For phenotype vector derivation, Applicants mapped 50% (n=30,070) of ECGs from the MGH-C3PO dataset to a library of 1,866 phecodes, grouped across 17 disease categories (e.g., circulatory system, endocrine/metabolic, genitourinary). Labeled ECG encodings were used to derive phenotype vectors within the latent space. Applicants then encoded the remaining unlabeled ECGs across the three datasets (MGH-C3PO n=30,070; BWH-C3PO n=46,027; and UK Biobank n=35,070) and determined the position of each ECG along each phenotype vector. [0346] Latent Space PheWAS [0347] Example datasets of individual latent space PheWAS results are provided in Table 29, which provides selected examples of 12-lead results, and Table 30, which provides selected examples of single-lead results. 9 0 4 3 4 8 3 4 5 8 8 2 1 5 1 2 2 2 8 8 5 9 0 4 1 6 5 1 4 0 1 1 6 4 8 8 3 1 6 7 4 7 3 6 9 5 2 1 4 3 2 1 0 9 3 3 5 1 5 4 7 2 8 8 6 8 3 1 0 7 7 6 1 4 9 7 6 9 7 0 0 0 9 3 5 8 5 0 6 6 8 8 0 8 5 7 1 8 6 5 4 8 9 6 1 2 6 1 5 6 4 6 6 2 7 4 2 0 8 7 4 0 2 6 6 0 0 9 9 5 3 3 6 7 6 7 6 0 2 9 0 1 4 1 5 4 2 7 4 0 2 4 8 6 6 4 8 0 0 7 5 7 2 4 2 1 7 3
Figure imgf000112_0001
31 1 9 8 1 7 9 4 6 3 6 1 0 7 2 1 1 1 6 6 6 5 - - - 1- 1 1 1 1 E 2 2 - E E 1 - E - E - E - E - E 8 E 1 9 3 5 3 E 3 3 1 3 5 9 4 5 7 1 9 5 9 1 0 2 3 8 2 1 6 0 8 2 8 0 1 3 4 0 4 4 6 5 0 5 4 4 4 2 1 9 4 1 8 8 1 6 1 1 4 2 2 2 5 9 8 0 1 5 8 4 9 4 5 5 9 9 5 3 8 8 2 5 3 2 2 2 9 1 6 2 8 8 7 9 8 2 0 1 8 5 4 9 9 4 6 1 6 4 2 6 5 9 9 5 5 8 7 4 6 9 7 6 6 8 7 9 0 4 7 7 3 2 0 8 0 . 7 . 4 . 4 0 3 8 0 0 0 2 . 1 . 7 . 7 . 2 . 1 . 1 . 6 1 _ 1 1 2 1 9 5 8 _ 8 1 _ 1 6 0 _ 0 _ 8 _ 3 _ 2 2 2 0 0 2 5 5 7 6 7 6 2 6 2 8 4 4 4 4 4 4 2 7 _ _ _ 2 2 2 4 4 2 e e e _ e _ e _ e _ e _ _ _ _ _ _ h h h h h h h e h e h e h e h e e p p p p p p p p p p p h p h p 1 . 1 . 1 . 2 1 9 3 5 8 8 1 1 . . . . 2 2 2 0 0 6 2 0 5 0 5 8 7 6 6 6 8 4 4 4 4 4 4 2 2 2 7 2 2 4 2 4 7 2 2 8 7 1 9 2 1 8 3 9 1 7 2 1 9 5 9 4 8 1 7 5 6 5 4 1 2 7 3 3 2 3 8 7 8 6 6 6 3 8 9 5 6 2 9 6 5 9 3 5 3 4 9 0 5 7 3 4 9 6 3 2 7 5 1 6 0 5 9 2 0 2 7 2 1 0 7 5 8 2 3 5 0 6 3 9 2 6 1 3 8 6 2 3 9 4 6 9 2 5 0 7 7 1 0 . 0 8 7 7 5 0 4 8 4 9 7 8 7 0 6 4 . 0 9 6 0 2 m e t s y s y r o t a l u c r i c SO N a i d r a c y h c a T
Figure imgf000113_0001
9 4 8 4 2 1 0 8 8 8 8 7 7 6 6 0 1 1 4 1 3 1 3 1 2 1 3 2 1 1 0 1 0 0 0 0 0 0-E - E - E - E - E - E 1- - E - 1 E - 1 E - 1- 1- 1- 0 0 1-3 5 9 2 E E E E 1- E 7 3 1 9 6 3 4 4 E 8 1 4 6 2 9 0 9 2 8 3 8 5 5 9 1 3 4 2 0 7 3 E 7 4 8 7 4 0 9 9 7 6 8 0 4 7 8 6 9 5 2 7 1 7 9 2 6 8 0 0 7 2 0 9 6 1 1 6 9 4 2 6 2 8 3 1 5 5 3 6 9 1 5 6 4 9 2 0 2 0 6 4 7 1 1 6 1 5 6 7 0 7 3 5 2 1 4 4 5 0 6 3 5 8 5 7 8 5 1 2 3 8 4 9 7 4 7 9 8 5 7 1 5 6 1 1 1 7 5 3 5 9 5 7 1 2 8 6 1 7 2 7 0 0 8 0 3 3 3 8 3 8 2 5 1 6 1 4 8 4 2 8 8 1 8 5 5 5 6 6 7 4 9 6 7 1 4 4 6 7 1 1 1 1 2 9 9 0 6 5 8 1 3 7 6 5 6 7 5 9 . . 1 0 3 2 4 2 1 4 7 2 4 . 3 . 8 . 1 . 1 . 1 . 1 . 1 . 5 . 1 . 5 . 1 . 5 . 1 . 7 7 _ 2 1 _ 9 _ 2 2 _ 3 _ 1 _ 8 2 _ 1 _ 1 _ 2 _ 1 5 7 1 6 8 9 6 3 6 1 7 _ _ 2 4 1 2 2 0 2 0 7 1 2 1 1 7 2 5 8 1 0 5 8 6 7 _ 4 _ 4 _ 4 _ 5 _ 4 _ 5 2 4 4 4 4 5 4 5 2 e e e e e e _ e _ e _ e _ e _ e _ e _ _ _ _ h h h p h p h p h p h e e e e p p p h p h p h p h p h p h p h p h p h p 7 2 1 9 2 2 3 2 . . . . 1 8 1 1 2 1 5 7 1 6 . . . . . . . . 2 1 2 8 2 9 0 6 2 3 0 6 7 1 1 7 1 7 5 1 5 6 4 4 4 4 5 4 5 2 4 2 4 1 4 2 4 8 5 0 4 8 5 7 2 6 9 9 2 4 1 9 8 9 0 2 4 4 3 6 6 8 6 5 4 1 9 5 0 4 8 6 1 2 6 9 1 6 8 3 6 0 2 0 8 0 7 3 2 8 9 8 2 0 3 0 1 9 4 3 3 7 9 7 5 0 4 1 9 9 3 8 0 5 6 5 1 4 0 4 0 6 6 9 3 7 5 6 2 5 9 8 3 0 1 4 3 5 2 0 7 1 2 3 2 9 9 2 4 0 6 8 0 0 . 0 f o s s e n t r o h S
Figure imgf000114_0001
99 7 9 5 9 5 9 4 9 3 9 2 9 0 9 9 8 9 8 8 7 6 5 0 - E - - - - - - - - 8 - 8 8- 8- 8- 8- 0 8 4 E 8 E 3 E E E E E E - E 8- E E E E - 9 8 3 8 2 1 3 3 9 6 1 6 8 8 E 6 1 2 8 9 E 2 5 0 8 1 0 1 7 8 5 8 9 2 1 E 3 0 6 6 3 1 9 5 4 5 0 7 0 4 3 4 5 1 1 9 4 3 1 2 0 9 0 3 0 3 0 6 5 3 7 6 6 6 5 9 0 9 1 3 8 9 3 6 0 6 7 6 9 7 8 3 6 1 4 4 1 3 7 8 3 6 4 8 1 9 0 3 0 9 5 6 0 6 8 3 7 2 4 8 6 8 7 3 3 4 7 8 3 7 7 9 9 9 1 3 0 1 4 4 3 6 5 6 0 3 6 9 3 9 0 4 2 8 8 4 9 2 8 8 8 1 8 6 3 2 3 9 7 1 8 0 7 2 5 1 7 3 0 7 0 5 9 9 8 5 3 8 1 1 2 4 8 1 2 3 7 9 9 8 9 6 4 9 4 4 5 5 0 9 0 3 8 . 1 0 2 3 7 4 1 7 8 2 1 3 5 9 6 6 3 0 8 0 6 2 . 3 . 1 . 5 . 1 . 1 . 5 . 5 . 2 . 3 . 2 . 3 . 1 . 3 . 1 . 4 . 6 7 1 3 1 4 1 2 2 _ _ _ 1 2 1 1 9 2 2 2 0 6 _ _ _ _ _ _ _ _ 1 8 2 9 0 1 1 3 8 9 2 5 1 7 5 8 0 6 1 8 6 8 5 4 4 5 4 7 4 4 0 5 1 4 7 2 5 2 2 0 1 2 0 _ _ _ _ _ _ _ _ _ _ _ _ 4 _ 4 _ 3 _ 4 _ 5 e e e e e e e e e _ h h h e e e e e e e e p p p h p h p h p h p h p h p h p h p h p h p h p h p h p h p 7 1 3 1 4 1 2 1 1 1 2 2 . . . . . . . . 9 2 2 2 0 6 9 1 3 9 5 . . . 1 8 2 0 1 8 2 1 7 0 5 1 8 7 0 5 6 1 8 6 8 5 4 4 5 4 7 4 4 5 4 2 2 2 4 0 4 1 3 2 4 0 5 4 5 5 8 8 8 3 0 9 9 6 6 7 9 5 0 5 2 8 4 1 6 1 6 4 8 0 7 2 9 3 7 4 6 5 7 7 9 9 7 8 3 9 3 4 8 6 6 5 2 7 1 5 1 2 5 1 5 3 7 7 9 9 2 2 6 8 3 5 6 1
Figure imgf000115_0001
s y d s m r r a m s s s s s t s o s y r / e n / e y r y r y r y r y e y t u o t n i i r n i o r t o t o o o m/ s a l o i a r u t c c l u c u r o o t i c o a l a t a t a t a u l u l l l y r e n y i r o r i e f c d n d c c u c u c u c o r c n r i i c n e e g n r e i r c i r c i r c i r c i c g e c t t o a l u a d c r c n e i c a e i c n m a i
Figure imgf000115_0002
57 9 7 6 6 5 5 5 5 4 a t - 6 a E - 6 E - 6 E - 6 E - 5 6 E 6- - 6 E - 6 E - 6 E - 6- D 9 7 4 2 8 E 9 6 E E y 7 0 4 5 7 8 5 4 1 4 9 1 3 4 4 7 0 5 1 1 0 b s 3 9 3 0 2 7 5 5 1 5 8 0 6 1 9 9 1 9 1 9 t l 4 5 9 2 1 1 0 4 6 4 9 5 8 1 8 2 7 8 u 0 2 4 6 5 5 1 1 5 7 6 1 5 5 5 7 5 6 6 7 0 8 s e 9 2 4 0 4 5 1 8 7 6 4 5 3 7 5 7 9 1 9 R e 5 8 8 1 9 1 0 3 8 2 0 0 8 7 1 8 7 s a u l 57 1 9 6 5 1 8 3 7 1 3 4 9 0 9 9 4 4 . 4 4 . 2 1 . 6 6 . 8 1 . 3 2 . 5 2 . 4 2 . 4 3 . 8 1 W a 5 . 8 . 1 e v h _ P p 0 0 42 4 : e _ 1 6 _ 3 _ 4 _ 6 _ 7 _ 0 3 t 2 _ 2 1 2 8 0 2 6 7 5 8 6 7 6 5 5 6 4 e l e _ _ d 5 8 4 _ 3 4 2 5 2 1 4 9 3 9 3 2 4 9 3 b o 5 2 2 4 e _ e _ e _ e _ e _ _ _ _ _ _ a c e _ _ h h h h h e h e h e h e h e h e h T h t e e p p p p p p p p p p p p x h p h p ]9 e d 4 2 4 4 . 1 . 3 . 4 . 6 7 3 o 2 c 2 e . 1 . 6 0 6 5 6 . . 0 [ 5 8 2 8 2 6 5 5 6 4 h 5 2 4 3 4 7 2 8 5 7 2 1 4 9 3 9 3 2 4 9 3 p 2 4 7 6 3 9 1 5 4 9 1 5 4 6 3 8 6 5 7 7 6 3 5 4 0 9 6 5 2 1 3 6 4 8 0 7 0 2 9 5 4 9 4 5 6 5 9 9 2 1 1 8 4 0 1 1 2 9 5 0 8 9 0 4 5 7 9 9 8 9 9 1 2 1 6 5 4 2 2 0 0 0 2 4 9 9 8 4 9 9 ; e r u l i a f t r a
Figure imgf000116_0001
n m i r r p s p r n o o y a e e e p a p s i d a l a c n e o r a y s a s f b v h i e c d M i O O o o h n D m y i e O T D f a b H Na O e h n P a c s C H E y h Co i n b t y ul n a T N R 10 4 7 4 7 2 6 0 6 4 1 5 9 6 0 6 5 4 5 3 2 2 1 1 5 1 2 1 2 1 2 1 1 1 1 1 1 1 0 3 - - - - - - - - - 1 0 E 7 E 1 E 1 9 E 2 E 1 - - - - - 1 E E 5 E 8 E 9 E 1 E 4 E E E - 8 8 4 8 6 5 0 5 2 5 E 5 7 4 0 4 0 1 8 2 8 7 8 0 3 2 6 6 5 8 6 6 8 4 2 0 7 1 8 2 4 1 8 9 8 0 5 6 0 7 2 3 0 9 5 6 4 8 0 2 8 9 1 6 1 1 7 7 5 2 5 4 9 7 5 6 1 0 4 0 1 0 7 8 3 9 1 2 0 5 5 9 8 3 6 8 6 1 7 3 1 1 1 7 2 8 2 3 5 6 4 1 7 4 0 3 5 4 1 6 5 9 8 2 4 2 2 6 9 3 5 6 2 4 0 6 3 4 9 6 5 0 4 9 2 5 1 3 0 8 6 7 5 1 9 1 1 1 9 1 0 5 7 2 8 9 1 8 7 1 9 1 0 9 3 4 3 0 7 1 8 8 9 1 8 3 8 4 4 1 9 6 8 . 2 . 2 . 6 . 4 . 1 . 3 . 5 . 8 . 3 3 . 5 1 . 5 1 . 1 1 . 8 1 . 6 5 . 2 1 1 2 1 2 2 7 8 _ 2 5 2 5 2 1 _ 0 1 0 6 _ 2 1 _ 1 8 7 8 7 0 _ 0 6 _ 8 _ 7 5 4 4 4 4 4 5 5 7 2 2 8 _ _ _ _ _ 4 _ 4 _ 2 _ 2 _ 2 _ 2 _ 2 4 4 5 e e e e e e e _ _ _ _ h h h e e e e e e e e p p p h p h p h p h p h p h p h p h p h p h p h p h p 1 . 1 . 2 . 1 2 2 7 8 5 . . . . 2 2 5 2 1 0 1 0 6 2 1 1 8 7 8 0 0 6 8 7 5 4 4 4 4 4 4 4 2 7 2 5 2 5 2 7 2 2 4 2 4 8 5 8 0 4 9 4 6 7 3 4 8 5 2 5 7 3 1 9 2 1 3 4 1 3 8 2 5 9 3 6 4 7 3 1 0 8 9 9 4 5 9 1 6 9 0 1 0 8 4 7 5 0 0 8 3 7 7 3 8 5 2 4 6 4 8 7 1 8 7 1 1 7 4 8 3 6 7 3 5 7
Figure imgf000117_0001
79 5 9 4 1 9 0 9 9 8 7 8 6 8 5 8 3 8 2 2 1 6 - E - - - - - - - - 8- 8- 8- 7- 8 E 9 3 - E E E E E E E E E E E E 8 2 9 1 3 3 3 4 7 3 1 6 2 6 4 4 7 8 1 8 9 9 1 5 3 9 8 0 6 8 3 1 0 3 0 7 8 4 2 4 0 6 8 8 6 4 2 4 3 7 5 3 3 0 6 9 0 8 8 1 5 9 4 8 5 0 2 2 1 7 2 7 9 7 0 3 4 6 7 5 8 8 4 0 5 7 0 3 6 4 9 6 9 2 0 4 1 7 4 1 1 3 9 5 5 6 4 0 3 3 6 0 7 6 5 9 7 1 7 2 6 9 5 4 7 8 2 4 4 9 8 1 7 8 5 8 4 6 9 5 8 8 0 7 6 2 9 1 3 9 7 2 0 7 4 9 6 2 3 4 0 0 7 0 2 9 1 0 0 4 5 1 9 0 7 0 6 1 2 8 9 3 5 3 2 8 5 5 8 . 2 . 1 . 9 . 6 . 2 . 6 . 9 . 2 . 1 . 3 7 . 3 1 . 0 3 . 8 9 . 4 1 4 1 9 1 2 3 1 1 2 1 _ _ _ _ 1 1 2 3 3 3 5 1 6 1 9 7 _ 6 _ 8 _ 6 _ _ _ _ 0 5 8 1 2 1 0 2 2 7 7 7 2 1 0 6 2 5 8 _ 5 _ 4 _ 4 4 5 4 4 2 2 4 4 4 5 e e e _ e _ e _ e _ _ _ _ _ _ _ _ h h h h h h e h e h e h e e e e e p p p p p p p p p h p h p h p h p h p 1 4 1 9 1 2 3 1 1 1 2 1 2 1 3 3 3 . 5 . 1 . 6 1 9 . 7 . . . . . . . 0 8 1 2 1 0 2 6 2 8 7 6 7 7 1 6 5 5 5 4 4 4 5 4 4 2 2 2 4 0 4 2 4 8 5 7 4 8 2 5 7 9 9 2 1 4 2 3 2 2 9 6 7 5 6 5 9 7 7 2 8 5 0 1 0 5 4 4 3 5 9 1 0 6 0 1 9 2 4 1 9 4 3 7 2 0 8 1 3 2 5 4 0 6 0 0 1 0 3 3 8 8 6 8 2 0 0 7 3 6 2 9 6 9 5 1 3 6 1 4 0 7 3 2 1 9
Figure imgf000118_0001
67 2 7 1 7 1 7 1 7 1 7 0 0 7 4 2 2 1 1 1 1 - - - - - - 7- 7- 6- 6 6 6 6 6 6 6 E E E E E E E E E - E - E - E - - - - 9 6 3 7 3 3 8 4 1 8 8 7 E 6 E 7 E 2 E 5 2 2 3 0 2 1 9 2 9 6 3 9 7 6 1 2 9 9 1 7 2 7 7 1 7 5 6 5 8 7 2 6 9 5 9 1 1 4 8 5 5 9 9 8 4 1 6 7 0 3 4 9 7 4 2 6 5 1 8 6 2 1 7 6 8 3 3 3 9 6 4 1 6 4 7 8 4 5 2 6 7 6 7 3 8 7 7 7 7 1 7 3 4 7 5 1 9 4 0 9 7 1 4 3 8 5 1 3 1 8 3 4 7 8 5 9 2 4 6 0 8 6 0 8 9 1 3 3 7 0 6 0 6 6 1 5 4 0 1 9 5 6 8 7 4 4 9 7 0 2 9 9 0 6 3 7 6 8 4 3 8 3 7 9 5 6 8 6 5 3 4 8 9 1 7 1 9 7 0 5 2 1 4 5 3 8 1 2 2 8 9 6 0 1 3 6 6 3 9 . 5 4 2 2 9 4 7 8 2 8 . 3 . 1 . 1 . 1 . 3 . 1 . 2 . 6 . 1 . 4 . 9 . 2 . 3 . 4 . 7 8 _ 1 _ 7 2 _ 2 _ 5 _ 1 _ 2 1 5 1 3 0 8 2 1 6 _ _ _ 1 8 5 1 1 0 7 7 0 4 1 5 9 9 5 0 9 4 7 4 7 2 3 5 4 2 5 4 3 2 4 1 4 2 4 0 9 2 _ e _ _ _ _ _ _ _ _ _ _ _ _ 5 _ 3 _ 4 _ h e h e h e e e e e e e e e e e e e p p p h p h p h p h p h p h p h p h p h p h p h p h p h p 8 . 1 . 7 2 . 2 . 5 . 1 . 2 . 1 . 5 1 3 0 8 2 1 6 7 4 . 1 8 5 1 1 0 7 0 1 5 9 9 2 5 1 0 9 4 7 4 7 2 3 5 4 2 5 4 3 4 4 2 4 0 5 9 3 2 4 4 9 5 5 9 3 8 1 1 2 1 3 5 9 5 9 5 6 1 1 0 0 4 3 1 2 3 4 8 6 8 0 4 0 3 4 7 3 2 7 6 6 8 5 5 9 5 7 3 6 3 4 6 4 9 8 2 0 0 5 6 2 8 1 8 3 2 2 2 8 3 3 1 0 . 0 8 5 1 4 6 7 8 0 6 6 8 9 4 1 2 . 0 9 1 7 e t s y s
Figure imgf000119_0001
y r y o r y r y r s y r y r y r y r / e / e t o a t o t o t u o l a a a o i t a o t o t o t n i r n i r u l l l t c u c ri a l a ri a l c o c o r i c u r c u r c r e f p s u c r p s u c r d d c i c i c i c n i e r i c e r i c n e n e t r a s s e a h y l a d y n r o a e s n d e a t e s n i e mv l y r a i a i g y a t c a m n e r a ; l a a s m v i o i o l b o e s n t a r e a i l i t a a t k a h i t a y v d t e c n o e s e o c m m o i n e i o s tit n e s y etc d r c i l v d o 2 n e s ef o r h r r l a s a a l m y e p l a u e i t si p u e e d n r a m p l a u ll s r o e p h r t mp e mh t e p p y m d i u e r i l p y h ti n a b C d He r P d S P C P c n i o c e O h o c F T w m8 5 7 5 6 6 3 3 2 1 1 - - 5- 5- 4 5 5 2 5 5 5 E E E 5- - - 5- - - - 9 2 4 E 6 E E 3 E 9 E E E 2 1 7 6 8 4 3 E 1 9 5 7 7 9 2 5 7 7 2 3 3 4 3 6 1 0 9 6 5 3 3 0 2 8 1 4 5 7 7 2 9 5 7 6 2 5 3 3 8 8 2 1 1 6 4 2 5 9 8 6 0 3 6 9 5 3 3 6 6 3 4 7 4 9 2 9 0 4 7 0 0 6 3 2 4 6 0 4 7 8 5 0 1 3 1 6 6 9 4 2 2 8 8 7 2 7 3 9 6 0 2 5 2 9 7 2 9 9 5 8 4 9 2 0 8 4 7 7 5 8 0 4 2 2 8 2 6 . 0 . 0 9 6 8 4 2 9 6 9 4 4 . 1 . 1 . 8 . 1 . 5 . 2 . 2 . 1 . 1 3 6 3 6 2 _ 6 7 _ 5 5 0 6 _ _ 2 _ 2 2 9 1 8 8 1 8 0 1 0 6 0 4 4 3 4 3 4 4 5 4 7 2 5 _ _ _ _ _ 2 e _ _ _ _ _ _ h e h e e e e e e e e e p p h p h p h p h p h p h p h p h p h p 3 6 3 6 2 . 6 7 . 5 5 0 6 8 . . 2 . 2 2 9 1 8 8 1 0 1 0 6 0 4 4 3 4 3 4 4 5 4 7 2 5 2 emrcerurroraoonowesnsnre,amnr aonaucsns, ranomcan csas asssecsaseonseo vraeco oereesence r oersu asse wnce. ranocman csaseneraeuane-uaneosor - orasene-ea resus an o sncans acsasoconaeovnes o ,, an .ures-emonsraeae numerncreases. secreasesncremena aseeree o ranom casscaoneve aase, anerern ouecoes wessan oa cases,oseresenn on one ecoesororeo-seeor wc moe converenceae, cans mea-anaze, correce-vaua moe an,-5ecoesore sne-ea moe.sn aonerron- assocaonseeweernesoe o. en ×con’., an.,, cansoun sncan ecoesne-ea moe~ ansosonecnoeasenn seace ansease sausor exece,e crcuaor ssem caeor comrse mos oe s snnec-ea moe~.s sncan assocaons, or, oecoesns caeorore-ane assocaonsn= ,ore sneea moe. susana numer o sncan assocaaon msoe an n=, wne enocrnemeaocn=,,or-ea moe an n=,, weorre s ansoe n-oe moe an resraorn=,,or-ea a ea ures- a n n=,,or sneea caeores resus, resecven.aes an, wcroveaase exames o-ea an sne-ea
l l a _ s e 4 7 2 9 4 6 2 3 9 9 3 6 0 5 3 9 8 3 9 6 s 9 5 0 1 8 3 7 8 8 4 3 3 a 4 4 6 2 5 3 1 7 4 6 7 3 5 c 5 5 5 5 9 2 8 2 7 9 1 5 1 8 1 6 1 6 1 0 1 1 4 2 1 6 3 l 6 4 6 1 6 5 5 7 8 6 0 1 1 8 1 0 4 6 1 5 0 2 3 8 0 8 7 9 0 8
Figure imgf000121_0001
ci l c i l c i l c i l c i o o l m o o o e m t e m e m e m e m e m e b s t s t s t s t s t s t s a b t a b t a m t e t b m e m e b s a t t s t s a t y s y s y s y s y s y s y s e e e m m y s e y s y s e y y r r y y y y y y / o r o r o r o r o r o r o e / m n e / m n e n y r / m o e n y r y / o r o e y n r o o g t a t e l a t l a t l a t t t i l a l a l a l r i c r i r t i r t t i r t a t u c u c u c u c u c u c u c o c d o c d o a l c a l a l c ri d u o d u u o d p a r i r i r i r i r i r i r i n n n c r n c r c r n s c c c c c c c c e e e i c e i c i c e e r n S y ti e y c s ei o i t t r e t r Os e n oi s u s S , d i c h t i s h c u a e v i a N b t ti h e Ou l d n a d n n a n t a d h s e h ) o a t l l c t e N f f n l a n e o p i o p i rt p n e n F,t n e n b l a i o a , b a y s i o n o o v e t e v Hh r e ma r a a d e y r n s i t n l ai s n y i / y y c s r i t r i g s e t s C ( i e mil s b i d i d n r a s r t y e l s a oi t s o e t n r t n etr m o i r mc o a e e ; p y e e h t a r y t i e t e l 2 r a oi t c y e d o a n o s a e t s e e e e d h p y s s p r a i i d d d r r o g e n r u h g e n r w u r e o e s e e b d k c e c o c r h r o rt b c - mg o y a m i r r a s i o l i n o o l i v d n p y b a i n u o l p y y a f c a s i e d l i c l u n p p H E h C P a c C d Ca f n Ca f O a h O D B b T Mn i T D e a P o c y h e d oc 1 . 1 . 1 . 1 . 3 . 2 2 7 e 1 1 5 5 6 8 8 8 8 . . . h 0 0 2 2 2 2 0 6 0 1 7 6 3 p 4 4 4 4 4 4 2 4 7 2 7 2 5 2 2 4 5 2 1 4 2 4 7 2 0 5 3 9 8 2 3 5 6 0 8 7 5 7 1 8 7 2 7 4 0 4 6 4 9 7 6 5 5 4 5 1 6 9 1
Figure imgf000122_0001
ci l m e m e m e m e m e m e m o e b m e m m t t t t t t t a t e t e s s s s s s s t s s t y s y s y s y s y s y s y s e m y s y s s y s y r y o r y r y r y r y r y t o t o t o t o o r t o y t r y o r y r / y y o o e y t n i r r r y o o t o t r y o r o a l a a a t a a a t a t a a r u l u l l l ri ri l l ri c t o a l a ri a r t i a t l a l c c u c u c u c p p u c u c p d u c p p u c u r i c r i c r i c r i c r i s s c e r e r r i c r i s c e r n e r i s s c e r e r r i c c r i c , t S e c e r s r e e l k a i t y r h t a s i i O v uli r r l a a a i t s o t a t e r y l a s N o e r e r d / a r f y , r y u m e l e l k c e r c e t s n a c i r n a b e f o l , g e e l ul e r o c n p d n o l a p y r n i e p me t e o r h d e a i i s e v l a a i d d e my r c i a c k a t e i ; y n u b a ; e me s y l c n h c i , f i n o s e a s r m s r if i k o i a s c d n o o f r tr a i d m a r o r r e e ut i i c p if f si r o i b s t h c a n o s o y or a h c i d ut i p c h t l c m e s c a r e e a e m n v p u t r t e r d r y a x c c o y e p l a o h a r c s s u s u e u f g n a r s m l all d p c e b h t h e s s e o a o r h c s b C Ct e a a H Ca e p n i Rn i l P f i e Rr a b Cn i u P o c n a m e l E m c i Os i i d n u n P h e s S Hi d a P a t n u 23 1 . 4 2 9 3 1 9 1 8 7 1 6 6 . . . . . . . . . 2 1 1 1 8 2 6 2 9 0 7 0 6 2 6 2 8 6 1 0 2 5 7 4 4 4 4 4 5 5 4 4 0 5 7 2 1 4 8 4 1 5 9 3 2 4 9 2 2 1 5 0 8 2 1 7 2 5 4 5 0 9 1 1 0 3 1 0 7 4 9 6 1 7 1 1 1 1 2 8
Figure imgf000123_0001
51 4 3 2 4 6 2 2 1 9 9 7 0 9 2 7 2 8 8 0 7 2 5 2 8 8 5 6 9 8 8 4 5 1 5 5 3 7 9 1 7 7 3 2 1 5 5 3 5 2 8 7 1 1 3 3 9 7 9 7 4 6 7 3 9 1 3 2 7 5 3 2 7 1 3 4 3 6 0 2 3 9 7 2 2 6 1 3 5 0 0 0 8 5 8 7 5 2 6 3 5 2 2 0 4 2 5 3 6 4 8 1 3 6 8 3 8 9 9 0 8 8 8 2 2 6 6 6 1 3 6 3 4 9 9 1 0 3 8 1 5 1 9 6 7 7 9 6 7 6 5 3 0 3 3 4 1 6 7 3 2 6 9 0 6 5 . . 3 . 2 . 4 . 3 . 2 . 1 . 2 . 1 . 1 . 4 . 3 1 2 0 0 0 0 0 0 0 0 0 0 0 0 . 0 . 0 . 0 ci l c i c i o l et b a m o l m b m s o b t e t a e t r a s r s y s e s t e s e d t e e d m y s m y s y r r y r r yr / o e t n y / e y a y r o s i a y r y r y m r / s o s i r o n r o n i r o d n i r o o o e n m i d al r u c t i c o a l r c t o a l u t ot a l u t a t a t a i r o t l i ri a t o t ri ri ri c p a t r i d u n c r i d u n c r i n p e s n e i n p e s p s p s o d g r r r n m n e c e c e c g e r m e e e e y s m tr a e f o e r u l i s m e n t s w ] y ti h G s e v a a y f a e m o s y a e e t o e n d e t K e E b i l s a i l n m a r a i l w r s e r t p s n a b k n a [ o n ] d i e t e r r e d a i n u ul y r p s m a i u l e r e l s o m v s a l y u r n ci a e c r a o c i i t n c o i m u c r a c e d f y l s o t y e ar d s y d f r 1 o -l s r r o e G b e o / a o x r y e t r a r a r i r h n i h d r C r E o p y d e s p y o r t [ M Hn a i d Ha n h c u o P e v a t c r t h s b A Cb o o o s n e e h t p e s h p e e t T i d R Oe r O m p v g i o c E y T e F r o l o s A i d 7 1 . 1 . 2 . 5 2 1 1 9 1 1 6 8 1 . 6 . 7 . 5 . . . 2 7 0 7 6 8 5 2 2 6 0 3 7 4 2 4 2 2 4 8 5 9 4 1 3 8 5 1 5 1 5 9 4 5 2 8 7 1 3 l l a _ s e 4 6 3 9 4 7 6 0 2 9 9 3 2 9 8 5 3 8 3 3 4 6 s 0 1 3 7 9 3 5 8 8 6 3 2 2 a 6 2 2 2 4 5 1 4 5 7 3 4 0 c 5 5 8 7 5 1 4 5 9 1 5 9 0 1 8 1 6 1 6 3 1 4 2 1 0 2 9 3
Figure imgf000124_0001
m . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 ci l c i c i c i c i c i o l o l l l l m m m m m m m m o o m o m o e t e e e e b e b e e b b b b s t s t s t s t a t t a t t t a t a t e t a t e t a t y s y s s y s y s y s e s y s e s y s s y e e s y e s y e y y y y y m/ m e y / s y y m/ m/ y s m r y / s y m/ y r r o o r t o r o r o r n r e n r r e n e n o r e n r e n g a t t t o t i e l a l a l a l a l r o c t i a l r o c t o a t i l a l r i c r t o c a r t i a l r o c t i a r c t u u u u u o a c r c r c r c r c r d u o c i c i c i c i c i c n c r d u u o e i c n c r c r d o i e i c i c n d p u o l e n s c r d u o e e r i c n c r d e i c n e y c s e t r e t r S O r e n n o o i t s s S , d e i c S ht i i a s n h t a e v i a h s e h N h ) n t i t c u t o a t u i d l l e t d Ou e n Nl f d n n a O l N yt i e p i p o rt a p n y o e e t e F H o i n s o i ,t h d n n e n o l e a m b a a y n s a i i f a d o , a e b e r s u e t y n i / y v i t r e v i t C o m n o i y r ms e ; p s ( n l a i s n g i a mil c s r i d n s i d r a o it s r a s r t y e s li b o y e e t r y t i t n et e r yt i a c a e r a oi t e t 2 n o s a t c y e d l o a a f d i e d h r a o i a m i d g e r r n r o uli h g e n n r u e s w e e e r s r e i d d r c o c r e b e m e g s o h r o rt b c - tr b r o o li p y b s s p e y v e b p r o y a s i y a f a i p y l u n p y c a s i e d l i a e o p C P a c Ca f n Ca f H O E h O o h C d Mn i D T P o c h T D e c a H M e d o 1 1 c . 1 . 1 . 1 . 2 . 2 . 7 2 1 e 5 5 8 8 1 8 1 8 6 1 . . . h 2 2 2 2 0 7 0 0 3 7 6 8 8 p 4 4 4 4 4 2 0 4 7 2 2 4 1 4 5 2 5 2 0 5 2 4 7 2 2 4 7 2 0 1 5 1 4 8 5 1 9 6 8 2 7 9 2 7 0 8 0 0 6 5 4 4 9 2 9 6 0 7 3 9 1 9 6
Figure imgf000125_0001
6 2 0 6 0 9 5 0 2 0 9 7 8 8 5 6 7 5 7 6 5 5 9 1 0 3 1 2 1 2 5 0 2 9 7 3 2 . . . . . 0 . 0 . 0 . 0 . 1 . 1 . 1 . 0 . 0 . 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 . 0 . 0 ci l m m o e e m e m m m b m s m m t t t e t e t e a e r e e s s s s s t s t t e t t y y y y y y e s y d s y s s y r s y r s s s s r y r a m s o s s y y a y y / y o n r n y r r y r y r y r r e y r r s i y r y r t i r o t i r o t o t o o o o t n i o o t d o o a l u a u a a t a t a t a a r u o t i l u o t i l ri l l l ri c t o a l a r l i a t t a t l a l c r i n c e c r g i n u c e c r p g i s u c e c u r r i c u r c i c r p c i s d u c e r n c r p n u e i s e c u r c e r m i c r c i c er e , t e s t r u l c i i r e a v s t u li rr a e l u a ti s f e i la e l k c e r d / f s r a a r o f a , h e r e o r e y y c v i l u n d a e l e s l , a n d i r e r n o l u u b li e k s s v l s y e l H r c c o b t n e e t e c s n n e p; u a i m d r e if e k h a f c a a e a v r e r a s i e s a r i c y l o n e t r r e y s n o r s i o c e y a c c a k e t c l a i mut n t h t tr d r n o r m e a i p iff rt a l r o s a i r i c d r x c y e a i m c t ol u h g n n d r e c i r s o a a o o r e h e s s u c a e b p / d e u s u a b o o r h p s d r e c b c i a e a A Rr b R Ca p n i h e S r e s b Hi o h d Ct c a s i e s I D Rn e i l E m y i Hn s a i e d l f P f e o s T i d a c P a t n a u Ca p 23 1 1 3 9 7 1 . . . . . 4 . 1 . 2 . 1 9 6 5 6 5 6 2 5 1 1 9 . . 2 8 2 8 2 1 9 6 1 7 8 7 6 4 5 4 5 4 5 3 1 4 1 4 0 5 7 2 0 4 0 5 1 3 2 4 2 4 1 1 4 9 1 7 1 6 1 7 0 7 4 8 0 7 1 6 1 6 2 8 1 1 3 3 4 4 9 2
Figure imgf000126_0001
1 . 0 2 0 0 1 0 1 0 1 0 0 1 1 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 . 0 ci l c i o l m e m t e b o b m m m m m s t a t a t e t e t e t s r e e t e t y s y e e s s s d s s s s y s y s y r y y y r y m r y y / y m r / s y y y o s s s s y y a ot r a o r o e n o e n r o r o r i d m r r n i r r t t i i a l a l r t c a i ri r c t a t o t l a l a l l a o t t o t o a t l a l u o p s u e c u r r i c o r c i d p o c n s d u e e r n c u r e i c u r n p u u t i c i c r c i e m c m y c r c r n s i c i c e g e l r a y e s u i l ti r s i s t a e n s o t e v l w a f S h e t r a yr Oc e e t s s n a i i d a v e y e c i t r d a e o t n k c i f t o t r l a ] ot a n i N a ) a b r a y n i e a r m b i m mc t d r a ; p e e l i t r v i n a a s d e n i n k o e rh h d a l n a e s c , e if e v a i r - s e n e D r u f mu l K a s r m r h r C i h p t c s y a i d e l 1 n e s m d k o s y o m h e t c i e s c i e s c l o e o e v e o f c i e c i [ e o p c h v o u e r e n a r m e a e h d r r e n i h r l a d r r n s a n e r e h r r r a n ( u c o p m l all d p p y e h h t p y o r e e s h t h c e s p s o c o s v g i n o rti o e s h t o r e o s r h uli R A c B l b y T u P o c n a m e H Rf o Hh c i d Os i i d n u l Ai d e F r o N mi d Oh c i d Ca f 1 5 2 . . 3 . 1 . 5 . 2 8 1 3 9 7 6 0 8 6 4 . . . . 0 2 2 5 0 1 1 7 3 5 4 5 5 4 4 2 5 7 2 9 3 0 4 1 4 1 3 8 7 9 3 1 4 8 5 ncun “orereenso-ne”a an mo “eses,eneaaener senasceon,o”s sonsoreecoesorerenson, x-308oroecoes owee sron-30e8s assocaons . non ,oowe “caromoa-308” . x .e mos sn-30c4an “s-ocrarersac oecuo,es eneccuroee “,o anes ac”-ase. xaance”, “a =ees me-2u5s8” =. x ,” coneson anosass” =. x-245.or . x , an “umonar oreecoesor car e sne-ea moe,eaen saceosons caromoaes,” soweome soroanes, anscsoucanons “carom.o xa-3”08 aonro “rm,aoronrnsc “conesveeara -308 wencunoaccocansure ao”na.e xne-149. unexece an ro-13u1s reaonss, ever o unnown o ursensor =er. x =-.136 x an. xor-10-4e,a an an non- =aco.o xcveror sne-ea, x-51 an. x-39.moran, sncan assocao sease =. aases,ncunne o ns wereenera conssen across an. an, wca an overaowerrevaence oseaseaes eananesrevsaosree nervase ncue, ecoesor cnomervaarn,eeconeersvaosr aneaen suacrae monoe ans, we, resrceecooesore nervae.nn a meanasesn=,.sne smaes ecoesa wereresen or eacecoe, mea-anaze-vaue across an nerva oe-ea an we s onseer-veeaeaweenr s snacec mano aessso,coao onvserorenervas moe reaveo ure an a an wnsease caeores oea-aesse, ans. or ceranseaseeasse w-ec wec-ceaanaveorms eaures were conssen w execaon.or exaramceer,z meean wa mveanormessaenoens, moe-erve unerancocsease-osve cenroemons raeromeene r-serecoraeas- rae wenn, smaerna r waves ,38 reaveo mean waveorms,en anerae warvoem surernseanse-neeea-vsee ceneraos, aure, .rooornaoonaemuar,e moe-.enr mveane oauerersnnscanuceeseocwreeavseer,s weave amue an reave aeare morooca smar vsua.ese no ase case an conro s manesaons o erroc caromoa e..,n-sreocmcu we-ene reoarzaon anormaes-wavenv ne4n0recora voaes, nns waen sace assocaonersons,aooc waves an sncan onorroa,a esn, moe-erve reconsrucons were noae aeneorene-waves,arcuarnee-seeasure. enconu, croear rresoenmonnsroa aes a-eaar-eon reemoare.rooe reeorases oans onaee rnan soamcer soexeceorevaenseases across m scu sx caeores. seccaemocs nasnon ss a nove acaon o auoencoereeearnn moes, seneraes a muranmenoswon aa maoeen sraacneeao c eanncoee us aeno re ecxonosrreu rceao-n an sne-ea waveormeaures an cnca reevanseaseenoes seween rous assocaonseween wave a scae. cans’ resus sues en comareo an nervas moromea, aeurnose anncoers-eaassees, acaroesns m suacee m ooreans s resems. reaer numer o sncan assocaons, suesnae arce vea a eeeearnn moes accomane susanareacura comexrove sausanraona acure nervas ao ernormaon aousease rocessnouoeenecro uenr merosaensanveueneno urmseaornen .ve.oruosr snueess suc asnuscs anmae emonsraea arueaene..,easo onmae reresenaonave versus “noasses” c oora caeorze as “wearnasses” a ane unersane macne-earneaen sace, asmaes w smar arruuees veocromrs,n aner arnea unea seemeanmca ceusreorse.couns cearn ceen rros are saaene usn aone vecor,ase soe onemae carace eaonaene soson ureremonsraeae recons rscsnerree e moe.ese sues moe movemen aon an arrucuoen v oec aonr,neunermaane ae n.o.v,eermsoan we woueaausrseess caan aree moasreses a.ne we corresonn cenroare.., sameoora reconsruce w resus w sevecraansm’ sucao ans.esrs au,oencocaenr-saseemoecnooo cnca researc,en e usenescover o novenorm nsraeowaen sace moen can ecca, cans ae ar aon conane wn curren avaaeanoscs. sease-saeno ue, orns caseenoe,aeno exore sucncaaen sace cenrromas,onnca-n asn v ssunae- reearesenes.ns reeacosen-srauscena meean waveormsromearnn moesuresuma uneecaeumannerreaornsene ee o -aseaen sace moen usn waveorm n.noerrec exenson sor osease usn s acureroro aaa courovensnoe nauraaen sace coue useoerv n aer avenanoss.e corresonn o waveorm evouon overme.e “ese maseeorooroesso on v mecaorsn” a cnn encaa seaursec on vosuaezaaeon sace maavemcaonsareone, exenno oer moaese..,a nesn,man resus anor mumoaesn,ererea exanne oraor o exsn, eas acurean cnca u sease,eccoanns,’ anou os n wcasv.eormsrmar reec manesaons o carovascuar oerreas-ase s verseseaserocessesa manes ons as we. a eeearnn moesaverevouseen useoeveosease-secc -rmousreuom assneasnsmenoc ouse a v oanree c oaruomvaasncuasre sassese.m,cacnans’ aroac enae sncan assocaonseween waveormaa an n soun a numer o cassca assocae w n on-caracseases,ncun conons no eaees, see anea, croncnvseruse eaascecnrreoesns,e ann re sunaoareure, asr wore su asesseea.se., wrevous unescre assocaonse..,ever o unnown orn s cans’ resus suesa,n aono carova ,oacco usesorer. casscaon o non-caracseases. ca scuar rs, s maacae maacae ns e secc cononsor wc s rs,ease ccaasscaon. ersonaze an scaaensseaesmeoensecraoen.onwaencan ssa’c meo moe,e eanc o ensco man ree usreesenosr a s sacneennormveua anse oacsceu seasu as unnuaereos samonenseaen sace.eveon a rcaenneenennvuas onoeaen s ,sosseoroec new srom ssaen s ace aneneraeeoos osease saus a scae. e u orasccerms rneanne wseasea waromrowar.er anca mnosr’eaveenrse r sames, we ancaea naure, anuure sues are warr eor carsusraven sacer aneo evauaee secces caracerscs oeaen ouneoxermen w araovaecarorcusacrr vmauneaonreseecasne sasuesa.s cans sumae aroac moar wce screenn m mora.e cuumce ersxoamme,ensaccnucrauee, or exeerne rss ovea cu ma c eaarr man omsee oassae on mane oresa a aon ens casreaosemoeeaco.nnne oeur, anea rossuserormsancee ooenea sne-eaaen saceorrevaen screennnareouaons,ar scaae u o our aroacor wearae ananeevces wcuar recvoernne c waaesreeas. emerceannces our coenrsu smer-ase e meooo o man cnca saus onoeaen sace maave uma e , exenno oer moaes, anornvovn mcaonsareon enan comreensve a eaures oeransease saes, anoscs. n -rouounvuaron usn eas-acure oranze ann coencerus uonn,ersanca snuscenmcoansnraoermaoowna coenna sace moen cane useo anoscs.e corresonn anas ne wn curren avaae wea osease-s s suorseaca waveormaa conans a evauaee sncaanenooremnaao one-on an sen crec-ueaaor wa sveseomrm. auure sues souurer ron. nassor scaaesease eerences erenae.asr.oec,. oma,.ness oe-ea eecrocaroramrom unreear.s aaor.oa,r.ra.nsn ecroemecn sono eovvoem ,ne an, -e-r. o cn.ca eecrocarora a rs eecroc.aroverraa-.uez,.,aavca,.aron,.noven's srnavanomeer:e .ava,.,x eea ar.nsecroc,aro-rac. seconaro c canesn suaracnoemorrae .ereuraraw acnz,eur.sme.aoensor oew ceaesne es.ecarocareuoroc,- . ,- ram an eecroes.mear noncarac c.an.eem,.,ae,.nocaer,.e cnca vaue oe n ess.onasonn,s..e.s, e a,.o-nnvas . roc veoooassum measuremen usn sna- .e, sne-ea ec acurerom aane smarone.ecrocaro,- usn on.ere--aos,a., e- ae.a eacecnroecaerarnonra-ma.seareomcon o acue coronar snrome .es,., e a.acneearnn-aseenomun, . resonerso carac re rounnearaureoen aracecr.oeen,s.n.,c ero an.zaroncaernae.eunrce anearacane,ear-nnnr.rmas nnsuon,o..., er an .a c ar.rumserecorrorecsono:ar, eoos-e. an casscaonn amuaor eecrocarorams usn aee neura nevewo arrr.amaeecon . e,neence-en.aea, ee.., e a.creennor carac conracesuncon usn an arca .a,.c.r,oc ear ao.ramn. aracea,- . encaon oaens w neence-enae aormore oucomerecon. araraonurn snus rm: a rerosecve anass o .a,an.c.,e e a,- . anar- .e anexsmaonsnrcaneencerom .eaaowas.,.rc., err a.mecroso, e . creenoreraemaromeecervoecaormoenram an.aaaorn oo a,ee--earnn.oeo voaeaa u.sna auneae, neu.r,a e n a.recon o morarom-ea eecrocaroram .ara-orren,., ee awo.rr.eace,- . eaecor nucaeavorromonunaecronc ecronce.s. aum,ec.o,s rsacna,r.,u,,.-on,..emoraenonromonuna nernaonaonerence: onnraoweaseesrcaomveewror an.naroaceenns oe omunacner,ne, ,usr n – ssocaonor enecaa.omao,rov.,e e aar.oearnnromaoan,un.aaanecronceaecor an .enn,.., evascuarvenrecon.ce, .oscoverene-sease assoc aa.onse.on:emonsraneeas o aenome-we scan nc m.enn,.., e a.semacor cmoamcas,- . eecro rson oenome-we assocaon su o .eca recoraa anenome-we assocaon suaa.aoecno,- eosor.ao,.,uan,.,ou,.. an,..e-asesemsenecs .n-reasancerruscover.enesase . .areaoacese ameo avorovaaeer. . .-us,..,n,.,canussscaonrane. . oureeve:e ,..uz,..earnourear on .uursure oarac monorn.urraroe, .necroncea,ec.,o er as.eoseoarrcesn anauraanuaerocessnoeuceas .. :eommun areoorroec. mexv, or carovasc.. uar reesoeanrcs,..u.,rou.ow,.,en,..ons,. oan: oorunes .arreras,., e a.eanoearourna,- . .erwe,., e a.s:osnarocessnnon. . -.e . eenecaeu oeecrocaroram.es, rams.o.anoa,.., e a.ensee:memenn cenonveescror .n aoes,.. . macneearnn aor,masr.ocnereo,cee. ams,..raccaaesan omzaon o normaonrocessnsems -oumens o–e nurerranaonaonerence oneura evaa, nssocaesnc.,aeaoe, ..enn,.., e a.ecoea. w -cmoesea.o.. moroo..areno,. ara,.ronosc sncance o uraon an .rasoone,,-. e. ean.sc nn,. nerva ansroonaon -aoes .een,oc.,en esc ar.n,cre- . carovascuarsease: a-earoow-ume ona a r canesn uraon asrecoror . anom seeceeneraouaon.ce, anassno.s.sramaa,.., e a.anosc accurac o comuer ae eecrocaroram .asmussen,nm.r.,ac e, a.-ecr . arovascuars:esusromeoenaoecnarorauc.annervaaroura,on an . - uureerseacn,ve.s..,rc,rr..,,.. a,..eunerancoc:urren an .evs,.. manoescs:roosoaem, e . .noccaro,., e a.e eecroa.erm, . aens w caroramneanoss an manaemen o .eur,ro.c caromoa.ear m,- . ecoraceme,nusn.,o.m,u,er.raeecrs,.aenacearora:suanass o .ao,. an,.aens:orumroc.uros . ncoer nvesan anomarnaraonauo- anrsc vaaneereanecneace.n ororso.vancesnnerreaeacneearnn eeearnn.orero,.,arman,.ar,.ercemaencaonsn n oron-nva.r sveaa ,n.,en ea.s,ors -mu,a e.s,e anaoo,ss., oa.nre,a.eese,ro.ueec:reeearnnoe ase . ocarorams.ensors aormor.ee,c.o,n oe cno,r.c,au aaronu,..,owers,..ovea,..eeearnn-ase oesor.eeunereaee,ee.,cona:r,s n.,a xcu ewrn rmen s eneera,e..ee u.areanrs,o.n.seme oeeearnn everase. ornnaseaen,e.a,rnanr,ro.m., aooo,r-.er.moerme,a..rs .enase ocraeaonn o. ecee,nea . eearnn.ee.un,., e. a.ee sanrom eecrocarora an resraon wee rrocar.omomoa,a.,. ee a.ecrocaroracanesnverrross-uesor .eo,., e a.eccrnaaunas . oncarovas ocaroraceasures anrecon oarovascuar an .cuaracemaaenr,..mncoaceoruorse, an-ana. aromoa.n e, emen o erroc vauaon o.aae,.ar.,oumao,a.,.oo,m.o.,.oawre,o.,.r-asa,...eanoss an
earaure an - mor vaenrce sze measure eeearnnrecs araraon, nroucon u measure vmenenrcuarransoraacocn ecs aoscsaorcaoera w averses car eovascuar oucomes. consumn. cans souo enae accurae,as, an rerouce mreraosru-rermoneen a oneme- en-asoceamoeer vaeeearnn. aa.sn aecarans onouaon comrse, amuaor carooaens w convouona neurau nre cwaomrero anre scor axs cs-, can ussnra cnen aeeearnn moe aseo sanar. cans vaae- anerorm ca reore same o,rmar carea eox reressonn a searae e ens w aa. earsne vss a suos awonnn samaee.,eree waner ae was earsnerann same an an, eaensneeran,n an va anaon, s men an, ne vaaon same was mm. ames, resecve.ean-
ae:ouaonaracerscs corre ne vaaon same, aensa cnca reore , wc execaeer wens w- cncar =ea. mean asoue error. mm.e- emonsrae . mmerm2.,ouwreesr:ear veernr-cuar e correae w ero massnex ., an ere venrcuar en-asocameceeornra.c momn. mmer ecrease venrcuar en-asocameer..e- was assoceare m wmncnrceaseene aure evens over mean.ers near ., arara on-earsazar rao .er mm ., an a-cause monora e evveennss over mean.erson-ears .er mm . n ae- an sex-ause moes. ove.r m-ea ann.aereson-.ears .er mm ae:ssocaon ooerecons w ncaucomes
Figure imgf000137_0001
- was assocaeee wearnncne an aorram arccuaraoen,recs rom cs.e woremonsraes sreaoceanoan. oeee earaure, an mora. cans’ orare-scae rs arnno auomae measuremen, enans use comosonsa,r anous mso oecanvoennso ann w varea * ao*n* asre onoeosescre meos,armaceuca rome scoe an sr oenvenon.ouenvee sene ar wouearn w secc emomens, we uners nonaseenescren connecon envenon as came sou no ooas caae ourer mocaons ana varous mocaons oee e unumeo suc secc emomens.nee, ose sene scre moesor carrn ouenvenona are ovouso neneo cov ar areneneoe wne scoe oenvenon.s acaons rnces oeern avnen voanra anonsn,c uusesn, or su acaeaaornusre osroemnveenroesneoown,nenera,e nown cusomarracce wne aro wcenve nscosure come wn essenaeauresereneore seor. nonerans an mae aeoe

Claims

as cames: co.mrsn: comuer-memene meooeec one or moreseases orsease eooes, a. r weacvoeronrm,aa a o aeas oners comun evce, an eecrocaroram .reaanssm one snec,on coe s m au uee nacs oenvecer csom communun evce,e waveormaa,o a comu cave coueoe aeas oners c.. rercoecevssnn n,evc , ee e a aeaesas on oene se sceocnon co cmounevce,e waveormaa a m mun evce,e waveormaa usn e. enearcanne,earnne m aoee comrsn one or more easoo one seacon comun evce, aanosc ouu . aranesvecrer anss,ocaee w aea as u osenre. seconno csosm ounseaseev acne,eanosc ouuo co.mrsn, comuer-memene meooeec one or moreseases orsease eooes, a. a receoars onne w caovmeourmnaeav oce: .rocessn e waveorma aa s uuec c. eneran a anosc ouus cnom a mrascnne oneear onrn m moe an sease. ore eoo anoss o . e meo o cam or, wereneseasesear sease. .ear seaseero mmeoe a oe casam one, o weerre enorooces osnea cromsreassees ereen maacnne anea ernono m ooe.e
.eearsecaes meo o cam, werenrocessn comrseserenane eoo o caracerseearuormes.e aeas one oer eoo oearseasesnusn one or more se.x,ear rae,e me,o o vo caames,, w,erenc-nee orvnaes o,r w moerree cnareac cearrsaccereaures comrse ae, voae ma comrsee,, or sna or an comnaonereo.sceauresrome v.enrcuaree mrreoo o an. oerecen cams, wereneearsease comrses .erroe me.o o cam, werene venrcuarerro se venrcuar .erro ceom merseos ca o cam, werene aeas one eoo oee venrcuar anerensveearsreasaec. amooss,erroc caromoa, aorc senoss, .erro.e meo o cam, werene venrcuarerros r venrcuar .erro ceom mersoes ou cmaonm, werene aeas one eoo o r venrcuar romoemocumonarearrenson.erenson,umonar arera erenson, cronc ss.em,e eneo mcerneom oea caomc s osrem, w, orereeneneousreansaer co smsermse.s asease oe crcuaor cr.oncveres meaese,o crr oo cssa,m rena orau,r we,eerveenr o uennsoeawsne o cromn,r osresoaacceoe uss,e seesor aern.ea, caro.moa,e meereons ove ceaamrs oerase,, w rere vnenercusaerase caomon.rses amooss,erroc a.ure,receo mne oo su oe cnamea o,rre, wceroenn o aeraanorsca ouon,ur ceomcronse os mreorcaon. oear . e meo o cam or, werenesease comrsesearaure. ee.conracoen meromo oear caamure, wur reeru ccoem erescnonsrcarcmonna.nearaure wreserve .. e meo o cam or, werene waveormaas oanerom a sneea .. e meo o cam or, werene waveormaas oanerom awo-ea . e meo o cam or, werene waveormaas oanerom a-ea . ea.s. e meo o cam, werene-ea s sxmeas orronaane a.neeas.e meo o cam, werene-ea s sxrecoraeas ororzona .. e meo o cam or, werene waveormaas oanerom a-ea ee.crocaroera mme moon oor. cam or, werene waveormaas oanerom aeaess
mo.ree e meo o cam or, werene waveormaas oanerom an o one or ,eaa as co,mears an,ea an,oreaea, aea.,ea,ea,ea,ea,ea,ea mo.reeas come mresno o c-awmaves,, wer-ewnavese, w aaveo-rwmaveasa,s o-waanvees,r aonm an o-w oanvees o.r ec.ocaroraem meevcoe. o cam or, werene waveormaas oanerom an ec.ocaroraem meoe ovc ce.am, werene ecocaroramevces aransoracc com.rsesneea mre caoss oers a,no osce craescseenrs, caamess,a wne nreenwores, m raacnnoemearnn moe newors, marxacorzaon, enarov moe, suor veco ores, neura cusern, or-neares neor. r macne,-means com.rses a neeur mae neowo or. an oerecen cams, werene macneearnn moe con.vouonae ne murea noew oor c.am or, werene macneearnn moe comrses a con.vouonae au moe enoco oer. cam, werene convouona neura newor comrses a com.rses aeee meearonn o ne aunra o neweorr.ecen cams, werene macneearnn moe ass.essnosec m reeroess oon. cam, werene macneearnn moeurer comrses com.rses coner masevoee oarn an o erecen cams, werene macneearnn moeearnn, renorcemenean, unsuervse earnn, suervse earnn, sem-suervseearnnoearn. rnn,ranserearnn,ncremenaearnn, currcuumearnn, or w.ereneraen mne coom or cseasmre or,urer comrsnrann e macneearnn moe, o reresenaons . -rann e macneearnn moe usn conrasveearnn us.n raw wavee moremoa oa a cna emecr oornc,uearer re ccoomrrsanaroramn an samee m oac suneecesa.rnn moe com.rses emee meno. o an o erecen cams, werene macneearnn newor . e meo o cam or, wereneevce comrses a user-wearaeevce.
. onee ovrc meoeec one moreseases orsease eooes, comrsn: a soraeoreev eecrocarorameasor oann waveormaarom a suec execues a acraoceosnso cor ceocemnsm an ruunccoansvea c aorue seoreonee s soroaraeeeevvccee, wo cerenerocessor recor waveorma ausee ssemo: rocesse waveormaraome suec enerae aanosc ouau us conm ar msancnee oenaern orn m moroeese aanse orsease eooes. . eevce o cam, wereneseasesearsease. e.earseevce o cam, werenrocessn comrseserenane eoo o moe. easerome aeas one oer eoo oearsease e macneearnn e.earseaeseervoce o cam, werenrocessn comrseserenane eoo o caracersceaurmes.e aeas one oer eoo oearseasesnusn one or more sex.,ear rae,eev,ce o v coaames,, w,erecn-neer ovnaes o,r w moerree cnareac cearrasccereaures comrse ae, voae ma comrsee,, or sna or an comnaonereo.sceauresrome ven.rcuareererovce o an. oerecen cams, wereneearsease comrses .erroeev.ce o cam, werene venrcuarerro se venrcuar
.erro ceomervscees c oar cam, werene aeas one eoo oee venrcuar erensveearsease.ac amooss,erroc caromoa, aorc senoss, .erro.eevce o cam, werene venrcuarerros r venrcuar .erro ceomevrcsees ou cmaomnar, weerreennsone, aumeas one eoo o r venrcuar romoemocumonarerenson. onar arera erenson, cronc ss.em,e eneocervnceem oea caomc ss,e wm,e orerneeensoeuarsena crom ssrseems. asease oe crcuaor v.ersease, cerrevosces, o ren caamaure,, weveerer on unenosewanse o cromn,r osresoaacceoe uss,e seseor aern.ea, cronc caro.moa,eeevrecnes ove ceaarmse,as we,e rren venercsueaasre caomonr.ses amooss,erroc a.ure,receonev oc seu oe cnamea,, wreerceonn oe araanosrc oauonu, croemcrosnes or meorcaon. oear . eevce o cam, werenesease comrsesearaure. ee.conracoenervomce oea craamure, wur reer cuocmer esecnonscrarcmonna.nearaure wreserve . eevce o cam, werene waveormaas oanerom a sneea . . eevce o cam, werene waveormaas oanerom awo-ea . . eevce o cam, werene waveormaas oanerom a-ea .
. eevce o cam, werene-ea s sxmeas orronaaneeas. a.neeas.eevce o cam, werene-ea s sxrecoraeas ororzona . eevce o cam, werene waveormaas oanerom a-ea . ee.crocaroeramev mcoen oor. cam, werene waveormaas oanerom aeaesseea. as a com,erasenev aeace o , an, c oeraam ea,, aea were .,neae wa,veeoarma,aeas oa,neearom, anea o on,ee oar more,ea.s comrsenevce o-w cavaesm,, w-wearveens, ae wave-woarvmes,aas o-waavnees, arnom an- owa ovnees o.r more ec.ocaroraemeevvccee. o cam, werene waveormaas oanerom an ec.ocaroraem meoe ovc ce.am, werene ecocaroramevces aransoracc com.rsesneeaevce o an oerecen cams, werene macneearnn moe newors, marrx caacssorezras,ono,scen cassarerosv, maoees,an su neowror vse,co rarn moamcores, neura cusern, or-neares neor. ne,-means com.rses a neeuraev nceew oor a.n oerecen cams, werene macneearnn moe neu.ra newore.evce o cam, werene macneearnn moe comrses a convouona con.vouonae auoev encceo oer. cam , weren e convouona neura newor comrses a com.rses aeeeeevacrnen o n aenura o neweorre.cen cams, werene macneearnn moe ass.essnosece revcreess oon c.am , weren e macneearnn moeurer comrses com.rses coneraesvvcee oear annn o, unseuerrevcesene caranmns,, w sueerrevnseee marancnneearnn moeearnn, renaornrc.emenearnn,ransere , sem-suervseearnnoe arnn,ncremenaearnn, currcuumearnn, or w.ereneraennevc coem or cseasmre-r,anurnere co mmacrsnenearrnannn moee m usacneearnn moe, o reresenaons . n conrasveearnn raw. waveormeaeva acne o e cecarmonc,euare rre ccoomrrasanrorman an samee m oac suneecesa.rnn moe usn com.rses emeeevnce. o an o erecen cams, werene macneearnn newor
. a ssemoeec one or moreseases orsease eooes, comrsn: execues a a so craoraceose nsoe corv ceocemnsm an ruunccoansvea c aorue seoreone soraeevce, werenerocessor a. e soraeevceo causee ssemo: . recor waveormaa o a suec c.reonceersase ae waavneosorcm ouaau us conm ar msanc onnee oerar mnonre m eooeo ananoss osease. . e ssem o cam, wereneseasesearsease. e.earseaes sesroemm oe c aameas, o wnee orener erocoesosn o comerseserenane eoo o moe. arsease e macneearnn e.earseaese srsoemm oe a caemas on,e w oeerer enoroocess one comrseserenane eoo o caracersceaures. arseasesnusn one or more sex.,e e ssem o cam, werene one or more caracersceaures comrse ae, voara raee m,a, comr vsoeaees,,,, orc s-nnaerv oar as,n w coermennaeo cnaraecreeor.sceauresrome ven.rcuaree srrsoem o an. oerecen cams, wereneearsease comrses .erroe ss.em o cam, werene venrcuarerrose venrcuar
.erro ceom ssrseems c oar cam, werene aeas one eoo oee venrcuar anerensveearseasaec. amooss,erroc caromoa, aorc senoss, .erro.e ssem o cam, werene venrcuarerros r venrcuar .erro ceom ssresmes ou cmaomnar, weerreennsone, aueas one eoo o r venrcuar romoemocumonarerenson. monar arera erenson, cronc ss.em,e eneo scrsneemm oea coamc ss,e wm,e orreneeensoeuarsena crom ssresems. asease oe crcuaor v.ersease, cer srsosems, o ren caamaure,, weveerre on unenosweanse or comn,r osresoaaccoee uss,e seseor aern.ea, cronc caro.moa,e sesreemnsv oe ceaarmse,as we,e rren venercsueaasre caomonr.ses amooss,erroc a.ure,receo sns oem su oe cnamea,, wreecreonn oe araanosrca ouonu, croemcrosnes or meorcaon. oear . e ssem o cam, werenesease comrsesearaure. ee.conracoen srsoemm oea craamure, wur reer cuocme ersecnonscrarcmonna.nearaure wreserve . e ssem o cam, werene waveormaas oanerom a sneea . . e ssem o cam, werene waveormaas oanerom awo-ea . . e ssem o cam, werene waveormaas oanerom a-ea .
. e ssem o cam, werene-ea s sxmeas orronaaneeas. a.neeas.e ssem o cam, werene-ea s sxrecoraeas ororzona . e ssem o cam, werene waveormaas oanerom a-ea . ee.crocaroeram ss meomn oor. cam, werene waveormaas oanerom aeaess eco.caroraem sevsecme. o cam, werene waveormaas oanerom an eco.caroraem sesvecme. o cam, werene ecocaroramevces aransoracc mor.eeas coem srssenm oea ca,mea, w,eearene waveormaas oanerom an o one or ,ea a,ea a, anorea a.,ea,ea,ea,ea,ea,ea mor.eeas come srssenm o ca-wmaves,, we-rweanvese, a waveo-rwmaveas,as o-waanvees,r aonm an o-w oanvees o.r com.rsesneea ssem o an oerecen cams, werene macneearnn moe newors, marrx caacssorezras,ono,scen cassarerosv, maoees,an su neowror vse,co rarn moamcores, neura cusern, or-neares neor. ne,-means com.rses a neeur sas neemwo or a.n oerecen cams, werene macneearnn moe neur.a newore. ssem o cam, werene macneearnn moe comrses a convouona conv.ouonae au sos eenmco oer. cam , werene convouona neura newor comrses a com.rses aeee sseaermnn o n aenura o neweorr.ecen cams, werene macneearnn moe asse.ssnosec s rseermess oon c.am , werene macneearnn moeurer comrses com.rses coner sassevme oear annn, o unseuerrevcesenea crnamns,, w sueerrevnseee marancnneearnn moeearnn, renaornrc.emenearnn,ransere , sem-suervseearnnoe arnn,ncremenaearnn, currcuumearnn, or we.reneraen snse cmom or cseasmre-r,anurnere c momacrnsenearrnannn moee m usacneearnn moe, o reresenaons . n conrasveearnn raw. waveorme sasae amn o ee ccarmonc,euare rrec coormrasanrorman a snamee m oac suneecesa.rnn moe usn com.rses emee ssnem. o an o erecen cams, werene macneearnn newor
. roramns a c ru no comno-u nrsaenr esr moo orra e cmomro eruu eoec nr-r,e c aaomar wesn en s exo: ercaeevceavn comuer-execuae eec one or moreseases orsease eooes ue a comuer causee comuero a.. c coommuueerr--eexxeeccuuaaeerroorraammnns, sr c ruo ucm coonr nssn soo r:ecroorces wsaveeo wrmaveaoarm o aa sau uec macne comrsn-eeaxr oen ncn sn a c. comuereu oa mo r mee orer eo an oraomnsaruncososn ososeaseen.erae aanosc ouu . e comuerroramrouc o cam, wereneseasesearsease. e.renanee co emouoer oroeramearroseuacser oom caem aeas, on werenrocessn comrses e macneearnn moe. e oer eoo oearsease e.renanee co emouoer oroeramearroseuacser oom caem aeas, on we oerenrocessn comrses snusn one or more caracersceaures. er eoo oearsease ea.ures comer csoem aueerroramrouc o cam, werene one or more caracersc caracersceaures,r soex,ear rae,, voaes,,c-nervas, werene comnaonereo. me voae ma comrsee,, or sna or an se.ase comrese csom venurecruarroramerrorouc o a.n oerecen cams, wereneear e. venrcuare comeruroerroram.rouc o cam, werene venrcuarerros e. v e comuerroramrouc o cam, werene aeas one eoo oe aorce snerncousasr, anerroerens covmereasres csaerasaec. amooss,erroc caromoa, r. venrcuear comeurreorro.ramrouc o cam, werene venrcuarerros ven.rcuare ceormrouer cormorramsesrouumco onar camere,n werene aeas one eoo o r croncromoemocumonarerenson. son,umonar areraerenson, o.e crcuaoer co smsuemer,reo ernamocrroneumce oa coacm ssem, w, orereeneneouseransaer co smsremse.s asease see. aneae comuerroramrouc o cam, werenesease comrsesaees, sorer., croncversease, crross, renaaure,ever o unnown orn, oroacco use amo.oss,eerr coomcu caerrormooramar,oucere onsv ceamears,ea wse.e rren venercuseaarse caomon.rses re. e comuerroramrouc o cam, wereneanosc ouu comrses o mocraon o.earaure,recon o suenea,recon o araraon,recon au.re. e comuerroramrouc o cam, werenesease comrsesear au.re wrees ceormveu eeercroonrarmacroonurcom o ceaarmaure, wur reer cuocmer esenconscrracmonna.near rom. a sneeea comue.rroramrouc o cam, werene waveormaas oane rom. awo-eae comu.erroramrouc o cam, werene waveormaas oane rom. a-eae com.uerroramrouc o cam, werene waveormaas oane orr.onaanee ceoams.uerroramrouc o cam, werene-ea s sxmeasea.s ororzoen coamauneereraosr.amrouc o cam, werene-ea s sxrecora rom. a-eae com.uerroramrouc o cam, werene waveormaas oane rom. aeaeses e coemcroucearrroorraamm moronuocr. o cam, werene waveormaas oane rom. an ecocear coomruamerervocera.mrouc o cam, werene waveormaas oaneran.soracc eec coomcaruoerrarmoraemvcer.ouc o cam, werene ecocaroramevces a rom. an o onee c oorm moureerearosr caommrrouc o cam, werene waveormaas oane ,ea,ea,ea a,ea asn,e aano,reeaa a,ea.,ea,ea,ea,ea rom. an o onee c oorm moureerearoramrouc o cam , werene waveormaas oane an -waves. s comrsn -waves, -waves, a -waves, -waves,ear.nn moee c coommruseersrnoearra cmassroeurcs, oo asnc o erecen cams, werene macne neura newors, marxacorzaon, enar coassers,aesan newors, ranomores, cusern, or-neares ne or. v moe, suor vecor macne,-meansear.nn moee c coommruseers ar noeuraram nerowourc. o an o erecen cams, werene macne com.rses a coen cvoomuuonear nreourraam newrooruc. o cam , werene macneearnn moe com.rses a coen cvoomuuoenrar aouora emncoroeru.c o cam , werene convouona neura neworear.nn moee c coommruseers aroeeramearrnonuc ne our aan ne owore.recen cams, werene macne ur.er comrese cso amsseussernroorasmc reroreuscso on. cam , werene macneearnn moeear.nn moee c coommruseers croonrraamsverouc o an o erecen cams, werene macne suervseearnn, renorc.em earnn, unsuervseearnn, suervseearnn, sem-earnn, orearnnoearn enearnn,ranserearnn,ncremenaearnn, currcuumear.nn moee, co wmerueenrreorramrouc o cam ,urer comrsnrann e macne conrasveearnn o reresenaanonns comr.sesre-rann e macneearnn moe usn ear.nn moee c uosmnu rearwr woarvaemormrouaca o an ca emecron,cureaer co rmecorrsnrann e macne suecs. aarom a same oear.nn newoer co cmomurersesro emramerno.uc o an o erecen cams, werene macne
PCT/US2023/033803 2022-09-27 2023-09-27 Artificial intelligence enabled discrimination of disease and disease etiology Ceased WO2024072849A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202263410489P 2022-09-27 2022-09-27
US63/410,489 2022-09-27

Publications (1)

Publication Number Publication Date
WO2024072849A1 true WO2024072849A1 (en) 2024-04-04

Family

ID=88517367

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2023/033803 Ceased WO2024072849A1 (en) 2022-09-27 2023-09-27 Artificial intelligence enabled discrimination of disease and disease etiology

Country Status (1)

Country Link
WO (1) WO2024072849A1 (en)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200260979A1 (en) * 2017-11-27 2020-08-20 Lepu Medical Technology (Bejing) Co., Ltd. Artificial intelligence self-learning-based static electrocardiography analysis method and apparatus
WO2020181367A1 (en) 2019-03-08 2020-09-17 The Access Technologies Leadless electrocardiogram monitor
WO2021228672A1 (en) * 2020-05-11 2021-11-18 Koninklijke Philips N.V. Time series data conversion for machine learning model application
US20210401349A1 (en) * 2020-06-26 2021-12-30 Alivecor, Inc. Two-lead qt interval prediction
CN114519370A (en) * 2022-01-28 2022-05-20 复旦大学附属中山医院 Left ventricular hypertrophy detection method and system based on deep learning early-arrest mechanism

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200260979A1 (en) * 2017-11-27 2020-08-20 Lepu Medical Technology (Bejing) Co., Ltd. Artificial intelligence self-learning-based static electrocardiography analysis method and apparatus
WO2020181367A1 (en) 2019-03-08 2020-09-17 The Access Technologies Leadless electrocardiogram monitor
WO2021228672A1 (en) * 2020-05-11 2021-11-18 Koninklijke Philips N.V. Time series data conversion for machine learning model application
US20210401349A1 (en) * 2020-06-26 2021-12-30 Alivecor, Inc. Two-lead qt interval prediction
CN114519370A (en) * 2022-01-28 2022-05-20 复旦大学附属中山医院 Left ventricular hypertrophy detection method and system based on deep learning early-arrest mechanism

Non-Patent Citations (100)

* Cited by examiner, † Cited by third party
Title
"Antibodies, A Laboratory Manual", 1988
"Methods in Enzymology", 1995, ACADEMIC PRESS, INC., article "PCR 2: A Practical Approach"
A. BERGER: "Echocardiography", BMJ, vol. 321, no. 7255, 22 July 2000 (2000-07-22), pages 218
AL-ALUSI, M.A.DING, E.MCMANUS, D.D.LUBITZ, S.A.: "Wearing Your Heart on Your Sleeve: the Future of Cardiac Rhythm Monitoring", CURR CARDIOL REP, vol. 21, 2019, pages 158, XP036952475, DOI: 10.1007/s11886-019-1223-8
AL-ZAITI, S. ET AL.: "Machine learning-based prediction of acute coronary syndrome using only the pre-hospital 12-lead electrocardiogram", NAT COMMUN, vol. 11, 2020, pages 3966, XP055890414, DOI: 10.1038/s41467-020-17804-2
APPLE WATCH ECG APP DE NOVO CLASSIFICATION GRANTED, 14 August 2018 (2018-08-14)
ATTIA, Z.I. ET AL.: "Age and Sex Estimation Using Artificial Intelligence From Standard 12-Lead ECGs", CIRC ARRHYTHM ELECTROPHYSIOL, vol. 12, 2019, pages e007284
ATTIA, Z.I. ET AL.: "An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction", LANCET, vol. 394, 2019, pages 861 - 867, XP085804088, DOI: 10.1016/S0140-6736(19)31721-0
ATTIA, Z.I. ET AL.: "Screening for cardiac contractile dysfunction using an artificial intelligence-enabled electrocardiogram", NAT MED, vol. 25, 2019, pages 70 - 74, XP036668628, DOI: 10.1038/s41591-018-0240-2
BACHMAYER, K.: "Clinical Course and Management of Hypertrophic Cardiomyopathy", N ENGL J MED, vol. 379, 2018, pages 1976
BARAK-CORREN, Y. ET AL.: "Predicting Suicidal Behavior From Longitudinal Electronic Health Records", AM J PSYCHIATRY, vol. 174, 2017, pages 154 - 162
BAROLD, S.S.: "Willem Einthoven and the birth of clinical electrocardiography a hundred years ago", CARD ELECTROPHYSIOL REV, vol. 7, 2003, pages 99 - 104
BOLDRINI MCAPPELLI FCHACKO LRESTREPO-CORDOBA MARIA ALOPEZ-SAINZ AGIANNONI A ET AL.: "Multiparametric Echocardiography Scores for the Diagnosis of Cardiac Amyloidosis", JACC: CARDIOVASCULAR IMAGING, vol. 13, no. 4, 2020, pages 909 - 20
BRENYO, A.ZARUBA, W.: "Prognostic significance of QRS duration and morphology", CARDIOL J, vol. 18, 2011, pages 8 - 17
CARREIRAS, C. ET AL., BIOSPPY: BIOSIGNAL PROCESSING IN PYTHON, 2015
CASTIGLIONE, A.ODENING, K.: "QT Interval and Its Prolongation - What Does It Mean?", DTSCHMED WOCHENSCHR, vol. 145, 2020, pages 536 - 542
CHEN, X. ET AL.: "Incremental changes in QRS duration as predictor for cardiovascular disease: a 21-year follow-up of a randomly selected general population", SCI REP, vol. 11, 2021, pages 13652
CHRISTOPOULOS GGRAFF-RADFORD JLOPEZ CLYAO XATTIA ZIRABINSTEIN AA ET AL.: "Artificial Intelligence-Electrocardiography to Predict Incident Atrial Fibrillation: A Population-Based Study", CIRC ARRHYTHM ELECTROPHYSIOL, vol. 13, no. 12, 2020, pages e009355
CHUNG EHGUISE KD: "QTC intervals can be assessed with the AliveCor heart monitor in patients on dofetilide for atrial fibrillation", J ELECTROCARDIOL, vol. 48, no. 1, 2015, pages 8 - 9
CIKES, M. ET AL.: "Machine learning-based phenogrouping in heart failure to identify responders to cardiac resynchronization therapy", EUR J HEART FAIL, vol. 21, 2019, pages 74 - 85
CORDEIRO, R.KARIMIAN, N.PARK, Y.: "Hyperglycemia Identification Using ECG in Deep Learning Era", SENSORS (BASEL), 2021, pages 21
CYRILLE NBGOLDSMITH JALVAREZ JMAURER MS: "Prevalence and prognostic significance of low QRS voltage among the three main types of cardiac amyloidosis", AM J CARDIOL, vol. 114, no. 7, 2014, pages 1089 - 93, XP029052043, DOI: 10.1016/j.amjcard.2014.07.026
DAVIDSON-PILON C: "lifelines: survival analysis in Python", JOURNAL OF OPEN SOURCE SOFTWARE, vol. 4, no. 40, 2019, pages 1317
DENNY, J.C. ET AL., PHECODE MAP 1.2 WITH ICD-10CM CODES (BETA, vol. 2022
DENNY, J.C. ET AL.: "PheWAS: demonstrating the feasibility of a phenome-wide scan to discover gene-disease associations", BIOINFORMATICS, vol. 26, 2010, pages 1205 - 1210
DENNY, J.C. ET AL.: "Systematic comparison of phenome-wide association study of electronic medical record data and genome-wide association study data", NAT BIOTECHNOL, vol. 31, 2013, pages 1102 - 1110
DEO, R. ET AL.: "Electrocardiographic Measures and Prediction of Cardiovascular and Noncardiovascular Death in CKD", JAM SOC NEPHROL, vol. 27, 2016, pages 559 - 569
DUBREY SWCHA KANDERSON JCHAMARTHI BREISINGER JSKINNER M ET AL.: "The clinical features of immunoglobulin light-chain (AL) amyloidosis with heart involvement", QJM, vol. 91, no. 2, 1998, pages 141 - 57, XP002485302, DOI: 10.1093/qjmed/91.2.141
ESTRADA, A.H. ET AL.: "Diagnostic accuracy of computer aided electrocardiogram analysis in dogs", J SMALL ANIMPRACT, vol. 62, 2021, pages 145 - 149
FEENY, A.K. ET AL.: "Artificial Intelligence and Machine Learning in Arrhythmias and Cardiac Electrophysiology", CIRC ARRHYTHM ELECTROPHYSIOL, vol. 13, 2020, pages e007952, XP055862000, DOI: 10.1161/CIRCEP.119.007952
FINOCCHIARO, G. ET AL.: "The electrocardiogram in the diagnosis and management of patients with hypertrophic cardiomyopathy", HEART RHYTHM, vol. 17, 2020, pages 142 - 151, XP086044651, DOI: 10.1016/j.hrthm.2019.07.019
GALLOWAY, C.D. ET AL.: "Development and Validation of a Deep-Learning Model to Screen for Hyperkalemia From the Electrocardiogram", JAMA CARDIOL, vol. 4, 2019, pages 428 - 436
GAO, M.QUAN, Y.ZHOU, X.H.ZHANG, H.Y.: "PheWAS-Based Systems Genetics Methods for Anti-Breast Cancer Drug Discovery", GENES (BASEL), 2019, pages 10
GERDTS EIZZO RMANCUSI CLOSI MAMANZI NWCANCIELLO G ET AL.: "Left ventricular hypertrophy offsets the sex difference in cardiovascular risk (the Campania Salute Network", INT J CARDIOL, vol. 258, 2018, pages 257 - 61, XP085359512, DOI: 10.1016/j.ijcard.2017.12.086
GERTZ MACOMENZO RFALK RHFERMAND JPHAZENBERG BPHAWKINS PN ET AL.: "Definition of organ involvement and treatment response in immunoglobulin light chain amyloidosis (AL): a consensus opinion from the 10th International Symposium on Amyloid and Amyloidosis, Tours, France", AM J HEMATOL, vol. 79, no. 4, 18 April 2004 (2004-04-18), pages 319 - 28
GERTZ MADISPENZIERI A: "Systemic Amyloidosis Recognition, Prognosis, and Therapy: A Systematic Review", JAMA, vol. 324, no. 1, 2020, pages 79 - 89
GOFF DC, JR.PANDEY DKCHAN FAORTIZ CNICHAMAN MZ: "Congestive heart failure in the United States: is there more than meets the I(CD code)? The Corpus Christi Heart Project", ARCH INTERN MED, vol. 160, no. 2, 2000, pages 197 - 202
GOTO SMAHARA KBEUSSINK-NELSON LIKURA HKATSUMATA YENDO J ET AL.: "Artificial intelligence-enabled fully automated detection of cardiac amyloidosis using electrocardiograms and echocardiograms", NAT COMMUN, vol. 12, no. 1, 2021, pages 2726
GRADMAN AHALFAYOUMI F: "From left ventricular hypertrophy to congestive heart failure: management of hypertensive heart disease", PROG CARDIOVASC DIS, vol. 48, no. 5, 2006, pages 326 - 41, XP026039124, DOI: 10.1016/j.pcad.2006.02.001
HALCOX JPJWAREHAM KCARDEW AGILMORE MBARRY JPPHILLIPS C ET AL.: "Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study", CIRCULATION, vol. 136, no. 19, 2017, pages 1784 - 94
HANCOCK EWDEAL BJMIRVIS DMOKIN PKLIGFIELD PGETTES LS ET AL.: "AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee", J AM COLL CARDIOL, vol. 53, no. 11, 2009, pages 992 - 1002, XP029650137, DOI: 10.1016/j.jacc.2008.12.015
HANNUN AYRAJPURKAR PHAGHPANAHI MTISON GHBOURN CTURAKHIA NW ET AL.: "Cardiologist-level arrhythmia detection and classification in ambulatory electrocardiograms using a deep neural network", NAT MED, vol. 25, no. 1, 2019, pages 65 - 9, XP036683917, DOI: 10.1038/s41591-018-0268-3
HANNUN, A.Y. ET AL.: "Publisher Correction: Cardiologist-level arrhythmia detection and classification in ambulatory electrocardiograms using a deep neural network", NAT MED, vol. 25, 2019, pages 530, XP036722148, DOI: 10.1038/s41591-019-0359-9
HEART FAILURE SOCITY OF A, HEART RHYTHM S ET AL., 2011 ACCF/AHA GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF HYPERTOPHIC CARDIOMYOPATHY
HULME OLKHURSHID SWENG LCANDERSON CDWANG EYASHBURNER JM ET AL.: "Development and Validation of a Prediction Model for Atrial Fibrillation Using Electronic Health Records", JACC CLIN ELECTROPHYSIOL, vol. 5, no. 11, 2019, pages 1331 - 41
IANDOLA, F.N. ET AL.: "DenseNet: Implementing Efficient ConvNet Descriptor Pyramids", CORR, 2014
JAPP, A.G.GULATI, A.COOK, S.A.COWIE, M.R.PRASAD, S.K.: "The Diagnosis and Evaluation of Dilated Cardiomyopathy", JAM COLL CARDIOL, vol. 67, 2016, pages 2996 - 3010, XP029618466, DOI: 10.1016/j.jacc.2016.03.590
JOHNSON JNGRIFONI CBOS JMSABER-AYAD MOMMEN SRNISTRI S ET AL.: "Prevalence and clinical correlates of QT prolongation in patients with hypertrophic cardiomyopathy", EUR HEART J, vol. 32, no. 9, 2011, pages 1114 - 20
KARDIAMOBILE SYSTEM 510(K) APPROVAL LETTER
KHURSHID SKEANEY JELLINOR PTLUBITZ SA: "A Simple and Portable Algorithm for Identifying Atrial Fibrillation in the Electronic Medical Record", AM J CARDIOL, vol. 117, no. 2, 2016, pages 221 - 5, XP029377291, DOI: 10.1016/j.amjcard.2015.10.031
KHURSHID SREEDER C.HARRINGTON L.SINGH P.SARMA G.FRIEDMAN S. ET AL.: "Cohort Design and Natural Language Processing to Reduce Bias in Electronic Health Records Research: The Community Care Cohort Project", MEDRXIV, 2021
KO WYSIONTIS KCATTIA ZICARTER REKAPA SOMMEN SR ET AL.: "Detection of Hypertrophic Cardiomyopathy Using a Convolutional Neural Network-Enabled Electrocardiogram", J AM COLL CARDIOL, vol. 75, no. 7, 2020, pages 722 - 33, XP086051355, DOI: 10.1016/j.jacc.2019.12.030
KWON JMJEON KHKIM HMKIM MJLIM SMKIM KH ET AL.: "Comparing the performance of artificial intelligence and conventional diagnosis criteria for detecting left ventricular hypertrophy using electrocardiography", EUROPACE, vol. 22, no. 3, 2020, pages 412 - 9
LAKDAWALA NKTHUNE JJMARON BJCIRINO ALHAVNDRUP OBUNDGAARD H ET AL.: "Electrocardiographic features of sarcomere mutation carriers with and without clinically overt hypertrophic cardiomyopathy", AM J CARDIOL, vol. 108, no. 11, 2011, pages 1606 - 13, XP028108020, DOI: 10.1016/j.amjcard.2011.07.019
LEVIS, J.T.: "ECG diagnosis: hypokalemia", PERM J, vol. 16, 2012, pages 57
LI, A.CHEN, S.QUAN, S.F.POWERS, L.S.ROVEDA, J.M.: "A deep learning-based algorithm for detection of cortical arousal during sleep", SLEEP, 2020, pages 43
LIAO YCOOPER RSMENSAH GAMCGEE DL: "Left ventricular hypertrophy has a greater impact on survival in women than in men", CIRCULATION, vol. 92, no. 4, 1995, pages 805 - 10
LIN GEN-MIN ET AL: "An Electrocardiographic System With Anthropometrics via Machine Learning to Screen Left Ventricular Hypertrophy among Young Adults", IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE, IEEE, USA, vol. 8, 24 April 2020 (2020-04-24), pages 1 - 11, XP011787757, DOI: 10.1109/JTEHM.2020.2990073 *
LITTLEJOHNS, T.J.SUDLOW, C.ALLEN, N.E.COLLINS, R.: "UK Biobank: opportunities for cardiovascular research", EUROPEAN HEART JOURNAL, vol. 40, 2017, pages 1158 - 1166
LIU, C.WANG, F.HU, J.XIONG, H.: "Temporal Phenotyping from Longitudinal Electronic Health Records: A Graph Based Framework", PROCEEDINGS OF THE 21 TH ACM SIGKDD INTERNATIONAL CONFERENCE ON KNOWLEDGE DISCOVERY AND DATA MINING 705-714 (ASSOCIATION FOR COMPUTING MACHINERY, 2015
LIU, Y.JUN, E.LI, Q.HEER, J.: "Latent Space Cartography: Visual Analysis of Vector Space Embeddings", COMPUTER GRAPHICS FORUM (PROC. EUROVIS, 2019
MAHIN MUHTASHEEM AJWAD ET AL: "Diagnosis of Left Ventricular Hypertrophy from ECG Signals Based on CCS Methodology using SVM", 2021 5TH INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND INFORMATION & COMMUNICATION TECHNOLOGY (ICEEICT), IEEE, 18 November 2021 (2021-11-18), pages 1 - 6, XP034000813, DOI: 10.1109/ICEEICT53905.2021.9667877 *
MAKAVOS GKAPPAAIRIS CTSELEGKIDI MEKARAMITSOS TRIGOPOULOS AGNOUTSIAS M ET AL.: "Hypertrophic cardiomyopathy: an updated review on diagnosis, prognosis, and treatment", HEART FAIL REV, vol. 24, no. 4, 2019, pages 439 - 59, XP036803191, DOI: 10.1007/s10741-019-09775-4
MARON BJ: "Hypertrophic cardiomyopathy: a systematic review", JAMA, vol. 287, no. 10, 2002, pages 1308 - 20
MARTIN ABADI AAPAUL BARHAMEUGENE BREVDOZHIFENG CHEN CCGREG S. CORRADOANDY DAVISJEFFREY DEAN MDSANJAY GHEMAWATIAN GOODFELLOWANDREW , TENSORFLOW: LARGE-SCALE MACHINE LEARNING ON HETEROGENEOUS SYSTEMS, 2015
MCKINNEY W, PANDAS, 2020
MUKHERJEE, D.DHAR, K.SCHWENKER, F.SARKAR, R.: "Ensemble of Deep Learning Models for Sleep Apnea Detection: An Experimental Study", SENSORS (BASEL), 2021, pages 21
MURTAGH BHAMMILL SCGERTZ MAKYLE RATAJIK AJGROGAN M: "Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement", AM J CARDIOL, vol. 95, no. 4, 2005, pages 535 - 7, XP004760125, DOI: 10.1016/j.amjcard.2004.10.028
PEDREGOSAFVAROQUAUX, G.GRAMFORT, A.MICHEL, V.: "Scikit-learn: Machine Learning in Python", JOURNAL OF MACHINE LEARNING RESEARCH, vol. 12, 2011, pages 2825 - 30
PEGUERO JGLO PRESTI SPEREZ JISSA OBRENES JCTOLENTINO A: "Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy", J AM COLL CARDIOL, vol. 69, no. 13, 2017, pages 1694 - 703, XP029956925, DOI: 10.1016/j.jacc.2017.01.037
RAGHUNATH, S. ET AL.: "Prediction of mortality from 12-lead electrocardiogram voltage data using a deep neural network", NAT MED, vol. 26, 2020, pages 886 - 891, XP037173399, DOI: 10.1038/s41591-020-0870-z
RAPEZZI CMERLINI GQUARTA CCRIVA LLONGHI SLEONE O ET AL.: "Systemic cardiac amyloidoses: disease profiles and clinical courses of the 3 main types", CIRCULATION, vol. 120, no. 13, 2009, pages 1203 - 12
RASMUSSEN, P.V. ET AL.: "Electrocardiographic PR Interval Duration and Cardiovascular Risk: Results From the Copenhagen ECG Study", CAN J CARDIOL, vol. 33, 2017, pages 674 - 681
RAWLINS JBHAN ASHARMA S: "Left ventricular hypertrophy in athletes", EUR J ECHOCARDIOGR, vol. 10, no. 3, 2009, pages 350 - 6
RICKERS CWILKE NMJEROSCH-HEROLD MCASEY SAPANSE PPANSE N ET AL.: "Utility of cardiac magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy", CIRCULATION, vol. 112, no. 6, 2005, pages 855 - 61
RIVERA-RUIZ, M.CAJAVILCA, C.VARON, J.: "Einthoven's string galvanometer: the first electrocardiograph", TEX HEART INST J, vol. 35, 2008, pages 174 - 178
RUBERG FLBERK JL: "Transthyretin (TTR) cardiac amyloidosis", CIRCULATION, vol. 126, no. 10, 2012, pages 1286 - 300
SALVATI, M. ET AL.: "Electrocardiographic changes in subarachnoid hemorrhage secondary to cerebral aneurysm. Report of 70 cases", ITALJ NEUROL SCI, vol. 13, 1992, pages 409 - 413
SAMBROOKFRITSCHMANIATIS: "Molecular Cloning: A Laboratory Manual", 1989
SAVAGE DDGARRISON RJKANNEL WBLEVY DANDERSON SJSTOKES J ET AL.: "The spectrum of left ventricular hypertrophy in a general population sample: the Framingham Study", CIRCULATION, vol. 75, 1987, pages 126 - 33
SAVAGE DDSEIDES SFCLARK CEHENRY WLMARON BJROBINSON FC ET AL.: "Electrocardiographic findings in patients with obstructive and nonobstructive hypertrophic cardiomyopathy", CIRCULATION, vol. 58, 1978, pages 402 - 8
SCHILLACI GVERDECCHIA PBORGIONI CCIUCCI AGUERRIERI MZAMPI I ET AL.: "Improved electrocardiographic diagnosis of left ventricular hypertrophy", AM J CARDIOL, vol. 74, no. 7, 1994, pages 714 - 9, XP023279747, DOI: 10.1016/0002-9149(94)90316-6
SNOEK, J.LAROCHELLE, H.ADAMS, R.P.: "Proceedings of the 25th International Conference on Neural Information Processing Systems", vol. 2, 2012, CURRAN ASSOCIATES INC., article "Practical Bayesian optimization of machine learning algorithms", pages: 2951 - 2959
SUN, H. ET AL.: "Sleep staging from electrocardiography and respiration with deep learning", SLEEP, 2020, pages 43
SURAWICZ, B: "Relationship between electrocardiogram and electrolytes", AM HEART J, vol. 73, 1967, pages 814 - 834, XP022926072, DOI: 10.1016/0002-8703(67)90233-5
TAN, N.Y.WITT, C.M.OH, J.K.CHA, Y.M.: "Left Bundle Branch Block: Current and Future Perspectives", CIRC ARRHYTHM ELECTROPHYSIOL, vol. 13, 2020, pages e008239
TOMA, L. ET AL.: "Electrocardiographic Changes in Liver Cirrhosis-Clues for Cirrhotic Cardiomyopathy", MEDICINA (KAZINAS), 2020, pages 56
TROBEC, R.TOMASIC, I.: "Synthesis of the 12-lead electrocardiogram from differential leads", IEEE TRANS INF TECHNOL BIOMED, vol. 15, 2011, pages 615 - 621, XP011329660, DOI: 10.1109/TITB.2011.2159236
URTNASAN, E.PARK, J.U.JOO, E.Y.LEE, K.J.: "Identification of Sleep Apnea Severity Based on Deep Learning from a Short-term Normal ECG", J KOREAN MED SCI, vol. 35, 2020, pages e399
VAKILI BAOKIN PMDEVEREUX RB: "Prognostic implications of left ventricular hypertrophy", AM HEART J, vol. 141, no. 3, 2001, pages 334 - 41
VAN MIEGHEM, C.SABBE, M.KNOCKAERT, D.: "The clinical value of the ECG in noncardiac conditions", CHEST, vol. 125, 2004, pages 1561 - 1576
VAN ROSSUM GDRAKE FL, PYTHON 3 REFERENCE MANUAL, 2009
VERWEIJ, N. ET AL.: "The Genetic Makeup of the Electrocardiogram", CELL SYST, vol. 11, 2020, pages 229 - 238
WANG, L.MU, Y.ZHAO, J.WANG, X.CHE, H.: "Deep Learning Model for Non-Invasive, Real-Time Diagnosis of Prediabetes through Electrocardiograms", SENSORS (BASEL), 2020, pages 20
XIAO, L.WANG, J.: "LatentVis: Investigating and Comparing Variational AutoEncoders via Their Latent Space", 3RD WORKSHOP ADVANCES IN INTERPRETABLE MACHINE LEARNING AND ARTIFICIAL INTELLIGENCE (AIMLAI) OF CIKM, 2020
YAMAMOTO HYOKOCHI T: "Transthyretin cardiac amyloidosis: an update on diagnosis and treatment", ESC HEART FAIL, vol. 6, no. 6, 2019, pages 1128 - 39
YAMASHITA, R. ET AL.: "Convolutional neural networks: an overview and application in radiology", INSIGHTS IMAGING, vol. 9, 2018, pages 611 - 629, XP055580998, DOI: 10.1007/s13244-018-0639-9
YASIN, O.Z. ET AL.: "Noninvasive blood potassium measurement using signal-processed, single-lead ecg acquired from a handheld smartphone", J ELECTROCARDIOL, vol. 50, 2017, pages 620 - 625, XP085159364, DOI: 10.1016/j.jelectrocard.2017.06.008
ZHAO, J. ET AL.: "Learning from Longitudinal Data in Electronic Health Record and Genetic Data to Improve Cardiovascular Event Prediction", SCI REP, vol. 9, 2019, pages 717
ZHU, XIAODAN ET AL.: "Long short-term memory over recursive structures", INTERNATIONAL CONFERENCE ON MACHINE LEARNING, 2015

Similar Documents

Publication Publication Date Title
Hatamizadeh et al. Fastervit: Fast vision transformers with hierarchical attention
Cui et al. MDSSD: multi-scale deconvolutional single shot detector for small objects
US9853592B2 (en) Method and device for controlling an energy-generating system which can be operated with a renewable energy source
CN113011365A (en) Target detection method combined with lightweight network
CN103593799B (en) Natural person&#39;s information setting method, system and corresponding friend recommendation method, system
GB2600872A (en) System-aware selective quantization for performance optimized distributed deep learning
WO2024072744A1 (en) Methods and systems for annotating genomic data
CN115131476A (en) Bone binding migration method, device, equipment and storage medium of virtual object
WO2024072849A1 (en) Artificial intelligence enabled discrimination of disease and disease etiology
Ortiz et al. Energy-efficient on-board radio resource management for satellite communications via neuromorphic computing
CN113554624A (en) Anomaly detection method and device and computer storage medium
CN109685805A (en) A kind of image partition method and device
CN104866460B (en) A kind of fault-tolerant adaptive reconfigurable System and method for based on SoC
CN115810293B (en) A linkage control method, system and medium for multiple unmanned aerial vehicles
CN108009370B (en) Structural stress sensitivity solving method
US11640581B2 (en) Methods for improved delta velocity determination using machine learning and devices thereof
Zhang et al. A novel method for constructing ensemble classifiers
US9754134B2 (en) Creating mechanical stamps to produce machine-readable optical labels
US20250088431A1 (en) Method and apparatus for distributed inference
CN109828857B (en) Vehicle fault cause positioning method, device, equipment and storage medium
CN111275062A (en) Model training method, device, server and computer readable storage medium
CN112230615B (en) Nuclear power plant safety level DCS (distributed control System) preferred communication network redundancy processing method, device and medium
CN117151436A (en) Emergency rescue exercise method, system and medium
CN106504250A (en) Image block identification matching process and far-end server
CN115705487A (en) AI calculation verification method and device

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 23794142

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 23794142

Country of ref document: EP

Kind code of ref document: A1